{"title":"Prognostic Significance of Immunohistochemical Surrogate Molecular Sub-Typing of Small Cell Lung Carcinoma","authors":"Sananda Kumar, Navneet Singh, Parul Gupta, Rajender Kumar, Suvradeep Mitra, Amanjit Bal","doi":"10.1111/apm.70035","DOIUrl":"https://doi.org/10.1111/apm.70035","url":null,"abstract":"<div>\u0000 \u0000 <p>Small cell lung carcinoma (SCLC) was considered a homogenous tumor both morphologically and genetically. Gene expression profiling of SCLC has revealed existence of four distinct subtypes within the SCLC which may impact the prognosis and therapeutic outcome. In the present study, surrogate molecular subtyping of SCLC was done using immunohistochemistry. Histologically confirmed cases of SCLC were included in the study. For molecular sub-typing, primary antibodies specific for ASCL1, POU2F3, NEUROD1, and YAP1 were used. The results were also correlated with baseline demographic and clinical parameters as well as treatment outcome. ASCL1, NEUROD1, and POU2F3 were expressed in 68 (67.3%), 15 (14.9%) and 3 (3.0%) cases, respectively. YAP1 showed cytoplasmic expression in 3 cases (3.0%). ASCL1 and NEUROD1 were co-expressed in 6.9% of cases. The remaining 25.7% of cases were negative for or had low expression of all four transcription factors. SCLC cases were thus classified as ASCL1-dominant, NEUROD1-dominant, ASCL1/NEUROD1 co-expressing, POU2F3-dominant, and Quadruple-negative subtypes. We did not recognize the YAP1 subtype. The overall survival was significantly reduced in the ASCL1 subtype compared to other subtypes. Sub-classification of SCLC patients may help in predicting the prognosis in such patients and may also help in guiding the therapy in the future.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immunohistochemical Profiling of Interferon-Stimulated Genes in Histopathological Specimens: A Potential Screening Approach for Viral Infections","authors":"Christian Thomsen, Svend Birkelund, Rasmus Røge","doi":"10.1111/apm.70034","DOIUrl":"https://doi.org/10.1111/apm.70034","url":null,"abstract":"<p>Thomsen C, Birkelund S, Røge R. Immunohistochemical profiling of interferon-stimulated genes in histopathological specimens: A potential screening approach for viral infections. Identifying viral infections in histopathological specimens can pose a diagnostic challenge. Increased expression of interferon-stimulated genes (ISGs) may serve as a potential screening marker for such infections. This study undertakes a comparative analysis of ISG immunohistochemical expression in various tissue types, encompassing both normal and inflamed tissues, including both viral and nonviral etiologies. Archival formalin-fixed paraffin-embedded (FFPE) tissues with confirmed viral infection (<i>n</i> = 27) and nonviral inflammation (<i>n</i> = 15) were analyzed. Tissue microarrays (TMAs) were constructed and stained with antibodies against ISGs: Human myxovirus resistance protein 1 (MxA), RIG-I, MDA5, PKR, and PD-L1. Qualitative assessment compared their upregulation to five normal controls of each tissue type. MxA exhibited significantly increased upregulation in viral infections compared to nonviral inflammation (OR 6.53 [CI 1.59, 26.79]), with sensitivity and specificity of 0.70 (0.50, 0.86) and 0.73 (0.45, 0.92), respectively. The remaining ISGs showed no significant differences and had moderate sensitivity and low specificity. In conclusion, while MxA, PD-L1, PKR, MDA5, and RIG-I generally showed upregulation in most viral infections, variability was observed. MxA holds promise as a viral infection screening marker in FFPE samples, but its utility may be limited by an inadequate interferon response to certain viruses.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unraveling the Potential Role of SIGNR1(CD209b) in Shaping Gut Microbiota During the Early Postnatal Life","authors":"Nihal Hasan, Sizhe Zhu, Tie Chen","doi":"10.1111/apm.70033","DOIUrl":"https://doi.org/10.1111/apm.70033","url":null,"abstract":"<div>\u0000 \u0000 <p>Increasing evidence suggests a significant interconnection between developing several chronic diseases later in adult life and early-life gut microbiota composition. Postnatal is crucial in shaping gut microbiota, maintaining immune balance, and establishing microbe-host interactions. However, the molecular mechanisms that contribute to shaping gut microbiota in early life remain poorly understood. During this crucial phase, various innate immune receptors play an active role in influencing the gut microbiota. The DC-SIGN receptor and its mouse homolog, SIGNR1, act as a sensor, facilitating communication between microorganisms, particularly Gram-negative bacteria, and the host's immune system. This study aimed to investigate the role of the SIGNR1 receptor in shaping the gut microbiota composition during early life in a murine model. The results showed that Firmicutes was the most abundant phylum in SIGNR1 KO mice, while WT mice displayed a higher abundance of Proteobacteria. Functional composition analysis demonstrated that the proportion of Gram-negative bacteria was notably lower in KO mice compared to WT mice. In addition, the absence of SIGNR1 is associated with alterations in immune response and metabolic pathways, highlighting its potential indirect role in modulating the microbiota. Finally, these results suggest that SIGNR1 may influence early-life gut microbiota composition through direct and indirect mechanisms.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katrine Top Hartmann, Anton Alexander Nolte Peterlin, Marie Høy Hansen, Julie Knippel Melsted Birch, Anders Odgaard, Bent Aalbæk, Mads Holm Christensen, Ida Thaarup, Thomas Bjarnsholt, Karen L. de Mesy Bentley, Andreas Petersen, Henrik Elvang Jensen, Louise Kruse Jensen
{"title":"Delayed Bacterial Neutrophil Recruitment and Bacterial Bone Dispersion: New Identified Factors in Peri-Prosthetic Joint Infection Development. Insights From an Adult Minipig Model","authors":"Katrine Top Hartmann, Anton Alexander Nolte Peterlin, Marie Høy Hansen, Julie Knippel Melsted Birch, Anders Odgaard, Bent Aalbæk, Mads Holm Christensen, Ida Thaarup, Thomas Bjarnsholt, Karen L. de Mesy Bentley, Andreas Petersen, Henrik Elvang Jensen, Louise Kruse Jensen","doi":"10.1111/apm.70031","DOIUrl":"https://doi.org/10.1111/apm.70031","url":null,"abstract":"<p>Clinically relevant animal models of peri-prosthetic joint infection (PJI) are essential for studying infection initiation and progression. This study developed a PJI model in adult Göttingen minipigs, explicitly focusing on the early stages of infection to gain new perceptions of PJI initiation. The model was established by drilling a hole into the femoral head, followed by inoculation with either <i>Staphylococcus aureus</i> (<i>n</i> = 6) or saline (<i>n</i> = 4) and inserting a stainless-steel screw. The animals were euthanized within 2 or 3 days post-inoculation. Comprehensive bone and joint pathology analyses were performed. All <i>S. aureus</i> inoculated animals had bacteria reisolated from bone, screw, synovial fluid, and synovial membrane. Histology revealed numerous bacterial colonies in the peri-implant bone tissue, many of which were unaccompanied by neutrophils, indicating delayed neutrophil recruitment to bacteria. In contrast, all synovial membrane-located bacteria were recognized by the immune system. Digital pathology measures showed deep bacterial dispersion within the bone, at a far distance from the point of inoculation. This study presents a new PJI model, which facilitates the investigation of infection initiation and supports studies aimed at preventing PJI. The study uncovered two previously unknown insights into the development of PJI: delayed bacterial neutrophil recruitment and widespread osseous bacterial dissemination within 48 h.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martina Humez, Mustafa Citak, Stefan Luck, Philip Linke, Thorsten Gehrke, Christian Paul, Klaus-Dieter Kühn
{"title":"Enhancing PMMA Cements With Manually Added Antimicrobial Agents","authors":"Martina Humez, Mustafa Citak, Stefan Luck, Philip Linke, Thorsten Gehrke, Christian Paul, Klaus-Dieter Kühn","doi":"10.1111/apm.70029","DOIUrl":"https://doi.org/10.1111/apm.70029","url":null,"abstract":"<div>\u0000 \u0000 <p>Periprosthetic joint infection (PJI) is an infrequent yet severe complication. A fundamental aspect of PJI treatment involves the use of polymethylmethacrylate (PMMA) cement augmented with antibiotics. For therapeutic application, it is often necessary to manually mix antibiotics with commercially produced PMMA cements. However, the potential issues arising from this manual admixing have not been thoroughly documented. This study aims to elucidate the impact of additional homogenization through dry mixing of a polymer-active substance blend on the quality of manually mixed PMMA cement. In this laboratory-based investigation, four cement samples were prepared using various methods for the manual incorporation and homogenization of the antibiotic vancomycin. The reference controls were Copal G + V and Copal G + C pro (Heraeus Medical GmbH, Wehrheim, Germany), representing commercially available PMMA cements and a closed mixing system. The samples were analyzed for mechanical, microbiological, and microscopic properties. The mechanical and microbiological analyses revealed no statistically significant differences between the manually mixed samples and the references. However, microscopic examination of the mixing cartridges' inner surfaces indicated scratching and signs of abrasion during the mixing process. The manual incorporation of antibiotics into PMMA cement should be limited to specific indications, with a preference for using commercially available mixtures whenever possible.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 5","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Identification of Natural Killer Cell-Related Genes as Potential Diagnostic Biomarkers for Pediatric Sepsis","authors":"Zhihong Liu, Minghua Su, Peiqi Wan, Xiumei Zhen, Lixia He, Huan Liang","doi":"10.1111/apm.70030","DOIUrl":"https://doi.org/10.1111/apm.70030","url":null,"abstract":"<div>\u0000 \u0000 <p>Pediatric sepsis is a prevalent severe condition with a high disability rate and mortality. The purpose of this study was to investigate how NK cell-related genes (NKGs) function in the diagnosis of pediatric sepsis. Differential analysis and Venn analysis were utilized to screen differentially expressed NKGs (DE-NKGs) in pediatric sepsis. The PPI network of DE-NKGs was generated using STRING. Candidate drugs are predicted using the CMAP database. miRNA and transcription factor (TF) targeting hub genes were screened using the Networkanalyst website. A total of 22 DE-NKGs were identified, which were mainly enriched in immune-related biological processes. Ten hub genes that were filtered out from DE-NKGs exhibited good diagnostic performance. Immune infiltration analysis revealed that macrophages and neutrophils had higher infiltration abundance in the pediatric sepsis group, whereas NK cells had higher infiltration abundance in the normal group. NKGs (LCK, FCER1G, PRF1, CD247, GZMB, CD2, CCL4, KLRD1, CCL5, and ITGB2) with diagnostic performance were successfully predicted, and some potential miRNAs, TFs, and candidate drugs were also predicted. In conclusion, this study threw light on a comprehensive understanding of the role of NK cells in pediatric sepsis.</p>\u0000 </div>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 5","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Ellekvist, Hans Johan Niklas Lorentsson, Kåre Nielsen, Stine Ambeck Kaarsberg, Karen Brorup Heje Pedersen, Diana Chabané Schmidt, Jette Bangsborg, Frederik Boetius Hertz, Christian Søborg
{"title":"Microbiological Analysis of Lower Airway Samples: Does It Influence the Outcome in Patients With Community-Acquired Pneumonia?","authors":"Peter Ellekvist, Hans Johan Niklas Lorentsson, Kåre Nielsen, Stine Ambeck Kaarsberg, Karen Brorup Heje Pedersen, Diana Chabané Schmidt, Jette Bangsborg, Frederik Boetius Hertz, Christian Søborg","doi":"10.1111/apm.70027","DOIUrl":"https://doi.org/10.1111/apm.70027","url":null,"abstract":"<p>This prospective randomized trial examined the impact of extensive lower respiratory tract sampling and microbial analysis on treatment decisions and patient outcomes in community-acquired pneumonia (CAP). One hundred and eighteen patients were randomized to rigorous sampling (intervention group, <i>n</i> = 64) or standard care (control group, <i>n</i> = 54). The primary outcome was antibiotic therapy change based on microbiological results. Secondary outcomes included intravenous therapy duration, hospital stay length, 30-day mortality, and readmission rate. Unexpectedly, many control group patients underwent sampling at the physician's discretion, making the groups equivalent in sampling frequency. Microbiological analysis led to antibiotic therapy changes in 28% of intervention and 30% of control patients. Overall, 34% of sampled patients had treatment adjustments, generally leading to antibiotic broadening. No significant differences were observed between groups in secondary outcomes. While rigorous sampling did not significantly impact overall patient outcomes, microbiological analysis influenced treatment decisions in a substantial proportion of patients. Future studies should evaluate the effects of sampling for CAP diagnosis in settings where broader-spectrum antibiotics are the empirical treatment of choice to determine the impact on treatment decisions.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 5","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Borisz Rabán Petrik, Bálint Gergely Szabó, Boglárka Laky, Bence Marosi, Dorina Korózs, Csaba Lőrinczi, Katalin Fried, Botond Lakatos
{"title":"Clinical and Microbiological Characteristics of Hospitalized Adults Aged ≤ 45 Years With Clostridioides (Formerly Clostridium) difficile Infection: A Prospective Observational Cohort Study From Hungary","authors":"Borisz Rabán Petrik, Bálint Gergely Szabó, Boglárka Laky, Bence Marosi, Dorina Korózs, Csaba Lőrinczi, Katalin Fried, Botond Lakatos","doi":"10.1111/apm.70028","DOIUrl":"https://doi.org/10.1111/apm.70028","url":null,"abstract":"<p>Studies focusing on young adults with <i>Clostridiodes</i> (formerly <i>Clostridium</i>) <i>difficile</i> infection (CDI) are scarce. Our objective was to assess characteristics and outcomes of CDI among hospitalized young adults between the ages of 18–45 years at diagnosis, compared to a subcohort of randomly selected older patients aged > 45 years. We performed a prospective, observational cohort study by enrolling and stratifying 234 consecutive cases of first/recurrent CDI at our tertiary referral center between 2015 and 2019. At 30 days post-treatment initiation, young adults had a higher clinical cure (99.1% vs. 81.2%; <i>p</i> < 0.01) and lower all-cause mortality (0.9% vs. 16.4%; <i>p</i> < 0.01). Metronidazole was a common first-line choice (77.8% vs. 46.2%; <i>p</i> < 0.01) with similar relapse rates (6.0% vs. 5.1%, <i>p</i> = 0.56). We conclude that CDI in patients aged between 18 and 45 years was associated with fewer complications and higher clinical cure with metronidazole, compared to older patients.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 5","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jontana Allkja, Ahmed Bakri, Bryn Short, Andrew Gilmour, Jason L. Brown, Abhijit M. Bal, Kelly J. M. Newby, Toby Jenkins, Rob D. Short, Craig Williams, Gordon Ramage
{"title":"Investigating the Prevalence of Fungi in Diabetic Ulcers: An Under-Recognised Contributor to Polymicrobial Biofilms","authors":"Jontana Allkja, Ahmed Bakri, Bryn Short, Andrew Gilmour, Jason L. Brown, Abhijit M. Bal, Kelly J. M. Newby, Toby Jenkins, Rob D. Short, Craig Williams, Gordon Ramage","doi":"10.1111/apm.70025","DOIUrl":"https://doi.org/10.1111/apm.70025","url":null,"abstract":"<p>Diabetic foot ulcers (DFUs) are common complications for diabetic patients, often exacerbated by complex polymicrobial biofilm infections. While the majority of DFU studies are bacterial focused, fungi have also been identified. This study aims to investigate the prevalence of fungi in DFUs, as well as their potential role and influence on persistence and wound healing. Consecutive DFU swabs were collected from 128 patients (<i>n</i> = 349). Fungal positivity was assessed using enhanced culture and real-time qPCR. Routine microbiology cultures were carried out as part of standard care in the clinics, and their results were then compared to our laboratory investigation. Routine and enhanced culture resulted in similar rates of fungal detection (~9%), whereas qPCR resulted in a higher rate of detection (31%). Notably, the predominant yeast <i>Candida parapsilosis</i> was present in ischaemic and penetrating bone wounds. These findings support existing evidence of fungal presence in DFUs. We demonstrated that routine diagnostic methods are sufficient for fungal detection, but enhanced culture methods allow for more precise fungal identification. Finally, while fungal presence does not appear to impact patient outcomes in our study, their role within these infections remains poorly understood, and further studies are needed to fully understand their relationship to the microbiome.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RETRACTION: Molecular Diversity of the Planctomycetes in the Human Gut Microbiota in France and Senegal","authors":"","doi":"10.1111/apm.70026","DOIUrl":"https://doi.org/10.1111/apm.70026","url":null,"abstract":"<p><b>RETRACTION</b>: C. Cayrou, B. Sambe, F. Armougom, D. Raoult, and M. Drancourt, “Molecular Diversity of the Planctomycetes in the Human Gut Microbiota in France and Senegal,” <i>APMIS</i> 121, no. 11 (2013): 1082–1090, https://doi.org/10.1111/apm.12087.</p><p>The above article, published online on 18 April 2013 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editors-in-Chief, T. Bjarnsholt, P. Ø. Jensen, L. Kruse Jensen; the Scandinavian Societies for Pathology, Medical Microbiology and Immunology; and John Wiley & Sons Ltd. The retraction has been agreed due to concerns raised by third parties. It has come to the attention of the journal that the study did not receive adequate ethical approval for the research on human subjects conducted on the “Senegalese individual” group. Accordingly, the article is retracted. The authors have been informed of the decision of retraction but unavailable for a final confirmation.</p>","PeriodicalId":8167,"journal":{"name":"Apmis","volume":"133 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apm.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}