ASAIO Journal最新文献_第9页

Extracorporeal Membranous Oxygenation Associated With Tracheal Procedures: An Extracorporeal Life Support Organization (ELSO) Registry Analysis.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-07 DOI: 10.1097/MAT.0000000000002389

Yota Suzuki, Ian G Christie, Ernest G Chan, John Ryan, Matthew J Schuchert, Holt N Murray, Masashi Furukawa, Pablo G Sanchez

{"title":"Extracorporeal Membranous Oxygenation Associated With Tracheal Procedures: An Extracorporeal Life Support Organization (ELSO) Registry Analysis.","authors":"Yota Suzuki, Ian G Christie, Ernest G Chan, John Ryan, Matthew J Schuchert, Holt N Murray, Masashi Furukawa, Pablo G Sanchez","doi":"10.1097/MAT.0000000000002389","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002389","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) has been primarily used for respiratory and circulatory failure, but its airway-related use has not been investigated well. Tracheal procedures are a situation when ECMO could be used to support patients during anticipated difficult airway management. The Extracorporeal Life Support Organization registry was queried for adult patients treated with ECMO in 2010-2022 during the same admission with types of tracheal procedures. Tracheal procedures were divided into surgical procedure and bronchoscopic procedure groups, and the survival rate was analyzed for each procedural type. Two-hundred sixty-nine patients met the inclusion criteria (64 surgical procedures and 205 bronchoscopic procedures), and 173 (64.3%) patients survived to discharge. Among the surgical procedures, tracheal resection was most performed (30 patients; 46.9%) and was associated with a high survival rate to discharge (86.7%; p = 0.003) compared with airway reconstruction (57.1%) and airway injury repair (46.2%). In bronchoscopic procedure, tracheal stent had favorable survival (76.1%; p = 0.004), whereas tumor debulking was associated with poor prognosis (48.3%; p = 0.006). Hemorrhagic complications were seen in 70 (26.0%) patients and were associated with a worse survival rate (58.6%; p < 0.001). Among them, surgical site bleeding was seen in 35 (13.0%) patients and was also associated with worse survival (42.9%; p = 0.007).","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of Different Membranes for Continuous Renal Replacement Therapies: An In Vitro Study.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-05 DOI: 10.1097/MAT.0000000000002387

Benjamin Malard, Michael Hulko, Julia Koch, Rose Speidel, Dominique Pouchoulin, Jorge Echeverri, Lenar Yessayan

{"title":"Comparison of Different Membranes for Continuous Renal Replacement Therapies: An In Vitro Study.","authors":"Benjamin Malard, Michael Hulko, Julia Koch, Rose Speidel, Dominique Pouchoulin, Jorge Echeverri, Lenar Yessayan","doi":"10.1097/MAT.0000000000002387","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002387","url":null,"abstract":"Inflammatory mediators play a major role in the development and progression of acute kidney injury (AKI). Continuous renal replacement therapy (CRRT) removes these mediators from the blood using AN69-M, AN69-ST, and HF1400 filters to target low and middle-molecular weight molecules. We characterized the in vitro removal performance of each filter in a 72 hour simulated CRRT procedure. Urea clearance with AN69-M and AN69-ST remained stable (52.4 and 51.2 ml/minute, respectively) but decreased with HF1400 (47.0 ml/minute; p < 0.001). Vancomycin clearance remained stable for AN69 filters but decreased for HF1400. Interleukin (IL)-8 was removed primarily via adsorption with the AN69 filters (92.2 and 91.2 ml/minute for AN69-M and AN69-ST, respectively), but clearance was significantly lower with HF1400 (8.4 ml/minute). Tumor necrosis factor (TNF)-α clearance was higher with AN69-ST compared with AN69-M or HF1400 (10.3, 1.8, and 2.3 ml/minute, respectively). β2-microglobulin clearance was higher with both AN69-based filters. The hydrogel water repartition of AN69 filters was different, with a higher percentage of bound water in AN69-ST versus AN69-M (30.5% ± 0.2% and 19.3% ± 1.5%, respectively; p < 0.05). These results suggest that clearance profiles of CRRT filters differ according to their properties; further investigation is needed to translate this into clinical improvements.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immediate Clinical Complications Occurring During Membrane Change in Patients on Veno-Venous Extracorporeal Membrane Oxygenation. 静脉体外膜氧合患者换膜期间出现的即刻临床并发症。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2024-07-25 DOI: 10.1097/MAT.0000000000002270

Paul Masi, Loic Gouriet, Costin Radu, Thierry Folliguet, Antonio Fiore, Romain Gallet, François Bagate, Armand Mekontso Dessap, Nicolas De Prost

{"title":"Immediate Clinical Complications Occurring During Membrane Change in Patients on Veno-Venous Extracorporeal Membrane Oxygenation.","authors":"Paul Masi, Loic Gouriet, Costin Radu, Thierry Folliguet, Antonio Fiore, Romain Gallet, François Bagate, Armand Mekontso Dessap, Nicolas De Prost","doi":"10.1097/MAT.0000000000002270","DOIUrl":"10.1097/MAT.0000000000002270","url":null,"abstract":"The clinical tolerance of extracorporeal membrane oxygenation (ECMO) membrane changes in acute respiratory distress syndrome (ARDS) patients under veno-venous ECMO (VV-ECMO) has not been reported. The aim of this study was to describe the tolerance of membrane change. Patients requiring VV-ECMO were retrospectively included between March 2020 and May 2022. In case of membrane dysfunction or an increase in hemolysis markers or an alteration in gas exchange, a membrane change was performed. The primary outcome was a composite measure defined as the occurrence of at least one of the following events within 1 hour of membrane change: severe hypoxemia, hemodynamic collapse, bradycardia, arrhythmia, cardiac arrest, and death. During the study period, 70 patients required a VV-ECMO, 29 (41%) of whom died. Thirty-two patients required a membrane change for a total of 56 changes. The primary outcome occurred for 33 (59%) changes. Arterial desaturation <80% occurred for all complicated membrane changes and cardiac arrest concerned nine changes (16%). Low tidal volume (V T ), respiratory system compliance (Crs), PaO 2 , and high ECMO blood flow (Q ECMO ) were associated with poor tolerance of membrane change. Threshold values of 130 ml for V T , 9.3 cm H 2 O for Crs, 72 mm Hg for PaO 2 , and 3.65 L/minute for Q ECMO best determined the risk of poor tolerance of membrane change.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"120-127"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Galectin-3 as a Prognostic Biomarker of Left Ventricular Assist Device Implantation Outcomes. 作为左心室辅助装置植入术预后生物标志物的Galectin-3

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2024-08-01 DOI: 10.1097/MAT.0000000000002292

Ryan Hoang, Mary E Acosta, Mark N Belkin, Nabeel F Rasheed, Umar Siddiqi, Jennifer M Cruz, Sydney E Lupo, Corinne R Stonebraker, Sara Kalantari, Jonathan Grinstein

{"title":"Galectin-3 as a Prognostic Biomarker of Left Ventricular Assist Device Implantation Outcomes.","authors":"Ryan Hoang, Mary E Acosta, Mark N Belkin, Nabeel F Rasheed, Umar Siddiqi, Jennifer M Cruz, Sydney E Lupo, Corinne R Stonebraker, Sara Kalantari, Jonathan Grinstein","doi":"10.1097/MAT.0000000000002292","DOIUrl":"10.1097/MAT.0000000000002292","url":null,"abstract":"We assessed the prognostic potential of Galectin-3 in a sample of 159 heart failure patients who received a left ventricular assist device (LVAD) implant from 2012 to 2020. Clinical outcomes included hemodynamic data, right heart failure (RHF), hemocompatibility-related adverse events (HRAEs), and mortality. Galectin-3 was compounded into Michigan-RVF and EUROMACS-RHF risk scores and compared to the noncompounded risk scores. Right heart failure was significantly correlated with Galectin ( p = 0.004) on a continuous spectrum. Inotrope duration was significantly correlated to Galectin-3 (interquartile range [IQR]: 7.58-8.65, p < 0.001) along with INTERMACS score (IQR: 2.14-1.90, p < 0.001). Intensive care unit length of stay (median 8 days, p = 0.02), blood urea nitrogen ( p < 0.001), creatinine ( p < 0.001), and pulmonary artery pulsatility index ( p = 0.05) were also significantly correlated with Galectin-3. In our c-statistic analysis, the predictive value for RHF improved when Galectin-3 was included for both the Michigan-RVF (0.80-0.86) and EUROMACS-RHF (0.77-0.82) risk scores. When elevated over a binary cutoff of 18.2 ng/ml, Galectin-3 significantly correlated with HRAEs ( p = 0.014) and mortality ( p = 0.031). Galectin-3 shows great promise as a predictive biomarker in patients implanted with durable LVADs. In addition to significant correlation with key clinical outcomes, Galectin-3 enhanced the Michigan-RVF and EUROMACS-RHF risk scores in predicting progression to RHF.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"136-142"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Right Ventricular-Arterial Compliance Index: A Novel Hemodynamic Marker to Predict Right Heart Failure Following Left Ventricular Assist Device. 右心室-动脉顺应性指数：预测左心室辅助装置术后右心衰竭的新型血液动力学标志物

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2024-10-03 DOI: 10.1097/MAT.0000000000002280

Ning Song, Sara L Hungerford, Sumita Barua, Katherine L Kearney, Kavitha Muthiah, Christopher S Hayward, David W M Muller, Audrey I Adji

{"title":"The Right Ventricular-Arterial Compliance Index: A Novel Hemodynamic Marker to Predict Right Heart Failure Following Left Ventricular Assist Device.","authors":"Ning Song, Sara L Hungerford, Sumita Barua, Katherine L Kearney, Kavitha Muthiah, Christopher S Hayward, David W M Muller, Audrey I Adji","doi":"10.1097/MAT.0000000000002280","DOIUrl":"10.1097/MAT.0000000000002280","url":null,"abstract":"The development of right heart failure (RHF) in patients with advanced heart failure following left ventricular assist device (LVAD) implantation remains difficult to predict. We proposed a novel composite hemodynamic index-the right ventricular-arterial compliance index (RVACi), derived from pulmonary artery pulse pressure (PAPP), ejection time (ET), heart rate (HR), and cardiac output (CO), with and expressed as mm Hg·s/L. We then conducted a retrospective, single-center analysis comparing the predictive value of RVACi for the development of RHF or unplanned right ventricular (RV) mechanical circulatory support following LVAD implantation against existing hemodynamic indices. One hundred patients were enrolled after screening 232 patients over a 10 year period, with 74 patients having complete hemodynamic data for RVACi calculation. There was good correlation between pulmonary arterial capacitance ( R ² = 0.48) and pulmonary vascular resistance ( R ² = 0.63) with RVACi, but not RV stroke work index or pulmonary artery pulsatility index. Reduced baseline RVACi (52 ± 23 vs . 92 ± 55 mm Hg·s/L; p = 0.02) was the strongest hemodynamic predictor of unplanned RV mechanical circulatory support requirement in patients following LVAD insertion. Composite pulsatile hemodynamic indices including RVACi may provide additional insight over existing hemodynamic indices for the prediction of RHF and need for RV mechanical circulatory support.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"111-119"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Meet the Authors.

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2025-01-24 DOI: 10.1097/01.mat.0001098200.33120.12

引用次数: 0

A Mock Circulatory Loop Analysis of Cardiorenal Hemodynamics With Intra-Aortic Mechanical Circulatory Support. 主动脉内机械循环支持下的心肾血流动力学模拟循环分析

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2024-07-25 DOI: 10.1097/MAT.0000000000002277

Sumita Barua, Michael Stevens, Pankaj Jain, Gabriel Matus Vazquez, Laurence Boss, Kavitha Muthiah, Christopher Hayward

{"title":"A Mock Circulatory Loop Analysis of Cardiorenal Hemodynamics With Intra-Aortic Mechanical Circulatory Support.","authors":"Sumita Barua, Michael Stevens, Pankaj Jain, Gabriel Matus Vazquez, Laurence Boss, Kavitha Muthiah, Christopher Hayward","doi":"10.1097/MAT.0000000000002277","DOIUrl":"10.1097/MAT.0000000000002277","url":null,"abstract":"Type 1 cardiorenal syndrome is associated with significant excess morbidity and mortality in patients with severe acute decompensated heart failure. Previous trials of vasoactive drugs and ultrafiltration have not shown superiority over placebo or intravenous diuretics. Pilot data suggest short-term mechanical support devices may support diuresis in the cardiorenal syndrome. We evaluated the intra-aortic balloon pump (IABP) and a novel intra-aortic entrainment pump (IAEP) in a mock circulation loop (MCL) biventricular systolic heart failure model, to assess impact on renal flow and cardiac hemodynamics. Both devices produced similar and only modest increase in renal flow (IABP 3.3% vs. IAEP 4.3%) and cardiac output, with associated reduction in afterload elastance in the MCL. There were minor changes in coronary flow, increase with IABP and minor decrease with IAEP. Differences in device preload and afterload did not impact percentage change in renal flow with IABP therapy, however, there was a trend toward higher percentage flow change with IAEP in response to high baseline renal flow. The IAEP performed best in a smaller aorta and with more superior positioning within the descending aorta. Demonstrated changes in MCL flow during IAEP were of lower magnitude than previous animal studies, possibly due to lack of autoregulation and hormonal responses.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"128-135"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technique for Weaning From Peripheral Venopulmonary Extracorporeal Membrane Oxygenation in Combined Cardiopulmonary Failure. 合并心肺功能衰竭患者的外周静脉体外膜氧合断流技术。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2024-06-24 DOI: 10.1097/MAT.0000000000002251

J Michael Brewer, Marc O Maybauer

引用次数: 0

Pressure Support Ventilation During Extracorporeal Membrane Oxygenation Support in Patients With Acute Respiratory Distress Syndrome. 急性呼吸窘迫综合征患者体外膜氧合支持期间的压力支持通气。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2024-08-08 DOI: 10.1097/MAT.0000000000002285

Benedetta Fumagalli, Marco Giani, Michela Bombino, Denise Fumagalli, Milena Merelli, Gaia Chiesa, Roberto Rona, Giacomo Bellani, Emanuele Rezoagli, Giuseppe Foti

{"title":"Pressure Support Ventilation During Extracorporeal Membrane Oxygenation Support in Patients With Acute Respiratory Distress Syndrome.","authors":"Benedetta Fumagalli, Marco Giani, Michela Bombino, Denise Fumagalli, Milena Merelli, Gaia Chiesa, Roberto Rona, Giacomo Bellani, Emanuele Rezoagli, Giuseppe Foti","doi":"10.1097/MAT.0000000000002285","DOIUrl":"10.1097/MAT.0000000000002285","url":null,"abstract":"In the initial phases of veno-venous extracorporeal membrane oxygenation (VV ECMO) support for severe acute respiratory distress syndrome (ARDS), ultraprotective controlled mechanical ventilation (CMV) is typically employed to limit the progression of lung injury. As patients recover, transitioning to assisted mechanical ventilation can be considered to reduce the need for prolonged sedation and paralysis. This study aimed to evaluate the feasibility of transitioning to pressure support ventilation (PSV) during VV ECMO and to explore variations in respiratory mechanics and oxygenation parameters following the transition to PSV. This retrospective monocentric study included 191 adult ARDS patients treated with VV ECMO between 2009 and 2022. Within this population, 131 (69%) patients were successfully switched to PSV during ECMO. Pressure support ventilation was associated with an increase in respiratory system compliance ( p = 0.02) and a reduction in pulmonary shunt fraction ( p < 0.001). Additionally, improvements in the cardiovascular Sequential Organ Failure Assessment score and a reduction in pulmonary arterial pressures ( p < 0.05) were recorded. Ninety-four percent of patients who successfully transitioned to PSV were weaned from ECMO, and 118 (90%) were discharged alive from the intensive care unit (ICU). Of those who did not reach PSV, 74% died on ECMO, whereas the remaining patients were successfully weaned from extracorporeal support. In conclusion, PSV is feasible during VV ECMO and potentially correlates with improvements in respiratory function and hemodynamics.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"171-176"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal Membrane Oxygenation in Amniotic Fluid Embolism: A Systematic Review of Case Reports. 体外膜氧合治疗羊水栓塞：病例报告的系统回顾。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-02-01 Epub Date: 2025-01-24 DOI: 10.1097/MAT.0000000000002269

Ngan Hoang Kim Trieu, Nam Nhat Nguyen, Huy Minh Pham, Dai Quang Huynh, Anh Tuan Mai

{"title":"Extracorporeal Membrane Oxygenation in Amniotic Fluid Embolism: A Systematic Review of Case Reports.","authors":"Ngan Hoang Kim Trieu, Nam Nhat Nguyen, Huy Minh Pham, Dai Quang Huynh, Anh Tuan Mai","doi":"10.1097/MAT.0000000000002269","DOIUrl":"10.1097/MAT.0000000000002269","url":null,"abstract":"Amniotic fluid embolism (AFE) is an obstetric complication that can result in acute circulatory failure during and after labor. The effectiveness of extracorporeal membrane oxygenation (ECMO) in AFE patients has not been established, especially in the context of coagulopathy. This review aims to evaluate the efficacy of ECMO support in AFE patients. We conducted a systematic review of case reports following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality assessment was performed using a standardized tool. Out of 141 studies screened, 33 studies included 79 AFE patients. The median age was 34 years, and the median gestational age was 37.5 weeks. The majority of AFE cases occurred during cesarean section delivery (55.2%), followed by labor before fetal delivery (26.7%). Extracorporeal membrane oxygenation configurations included venoarterial ECMO (81.3%) and extracorporeal cardiopulmonary resuscitation (CPR, 10.7%). The maternal survival rate was 72%, with 21.2% experiencing minor neurological sequelae and 5.8% having major neurological sequelae. Rescue ECMO to support circulation has demonstrated both safety and efficacy in managing AFE. We suggest early activation of local or mobile ECMO as soon as an AFE diagnosis is established. Further studies are needed to assess the benefits and implications of early ECMO support in AFE patients.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"143-148"},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0