Brain CirculationPub Date : 2024-03-21eCollection Date: 2024-01-01DOI: 10.4103/bc.bc_83_23
Liu Ran, Pingping Wang, Hongxiu Chen, Na Li, Fubo Zhou, Wenbo Zhao, Qingfeng Ma, Yingqi Xing
{"title":"Compromised dynamic cerebral autoregulation is a hemodynamic marker for predicting poor prognosis even with good recanalization after endovascular thrombectomy.","authors":"Liu Ran, Pingping Wang, Hongxiu Chen, Na Li, Fubo Zhou, Wenbo Zhao, Qingfeng Ma, Yingqi Xing","doi":"10.4103/bc.bc_83_23","DOIUrl":"10.4103/bc.bc_83_23","url":null,"abstract":"<p><strong>Purpose: </strong>In patients undergoing endovascular thrombectomy (EVT) with acute ischemic stroke (AIS), dynamic cerebral autoregulation (dCA) may minimize neurological injury from blood pressure fluctuations. This study set out to investigate the function of dCA in predicting clinical outcomes following EVT.</p><p><strong>Methods: </strong>43 AIS of the middle cerebral or internal carotid artery patients underwent with EVT, and 43 healthy individuals (controls) were enrolled in this case control research. The dCA was evaluated using transcranial Doppler 12 h and five days after EVT. The transfer function analysis was used to derive the dCA parameters, such as phase, gain, and coherence. The modified Rankin scale (mRS) at 3 months after EVT was used to assess the clinical outcomes. Thefavorable outcome group was defined with mRS ≤2 and the unfavorable outcome group was defined with mRS score of 3-6. Logistic regression analysis was performed to determine the risk factors of clinical outcomes.</p><p><strong>Results: </strong>A significant impairment in dCA was observed on the ipsilateral side after EVT, particularly in patients with unfavorable outcomes. After 5 days, the ipsilateral phase was associated with poor functional outcomes (adjusted odds ratio [OR] = 0.911, 95% confidence interval [CI]: 0.854-0.972; <i>P</i> = 0.005) and the area under the curve (AUC) (AUC, 0.878, [95% CI: 0.756-1.000] <i>P</i> < 0.001) (optimal cutoff, 35.0°). Phase change was an independent predictor of clinical outcomes from 12 h to 5 days after EVT (adjusted OR = 1.061, 95% CI: 1.016-1.109, <i>P</i> = 0.008).</p><p><strong>Conclusions: </strong>dCA is impaired in patients with AIS after EVT. Change in dCA could be an independent factor related to the clinical outcomes.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"77-84"},"PeriodicalIF":2.3,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847910","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}
Brain CirculationPub Date : 2024-03-21eCollection Date: 2024-01-01DOI: 10.4103/bc.bc_17_23
Adeel S Zubair, Lea Saab, Kirsten Scharer, Babar Khokhar
{"title":"Patients' experiences with methylcobalamin injections in amyotrophic lateral sclerosis.","authors":"Adeel S Zubair, Lea Saab, Kirsten Scharer, Babar Khokhar","doi":"10.4103/bc.bc_17_23","DOIUrl":"https://doi.org/10.4103/bc.bc_17_23","url":null,"abstract":"<p><strong>Background and objectives: </strong>Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease with no definitive treatment. Vitamin B12 is not a Food and Drug Administration-approved treatment in the United States, although it has been prescribed off-label as ultra-high-dose methylcobalamin, which has been shown to be safe and effective in slowing functional decline in patients with ALS. This study evaluates the impact of Vitamin B12 injections on the quality of life of five patients.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with the patients and caregivers. The data was carefully read, coded, and organized into themes and sub-themes by two independent researchers.</p><p><strong>Results: </strong>The study found four themes and 11 subthemes from the data, including initial circumstances, administration of the injection, subjective experience with Vitamin B12, and outcomes and expectations. All participants recognized some benefits from Vitamin B12 injections, specifically increased energy, reduced fatigue, and improved balance. However, some patients had difficulty monitoring its specific effect due to the progressive nature of the disease.</p><p><strong>Discussion: </strong>The flexibility offered by this intervention is beneficial for patients with declining mobility and strength who wish to adapt their treatment to their schedule. This work is a modest call to fill the existing gap in the literature and push for more randomized controlled trials investigating and clarifying the effects of Vitamin B12 injections on disease progression, muscle function, and quality of life in a small but diverse pool of patients with ALS.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"60-66"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847917","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}
Brain CirculationPub Date : 2024-03-21eCollection Date: 2024-01-01DOI: 10.4103/bc.bc_9_24
Ahmed Elmadhoun, Hongrui Wang, Yuchuan Ding
{"title":"Impacts of futile reperfusion and reperfusion injury in acute ischemic stroke.","authors":"Ahmed Elmadhoun, Hongrui Wang, Yuchuan Ding","doi":"10.4103/bc.bc_9_24","DOIUrl":"https://doi.org/10.4103/bc.bc_9_24","url":null,"abstract":"<p><p>Acute ischemic stroke (AIS) remains to be a challenging cerebrovascular disease. The mainstay of AIS management is endovascular reperfusion therapy, including thrombectomy and thrombolysis. However, ineffective (futile) reperfusion (FR) or reperfusion injury (RI) can be seen in a significant number of patients undergoing reperfusion strategy. In this article, we discuss two clinically relevant concepts known as \"time window\" and \"tissue window\" that can impact the clinical outcome of reperfusion therapy. We also explore patient risk factors, leading to FR and RI as well as an emerging concept of \"no-reflow phenomenon\" seen in ineffective reperfusion. These fundamental concepts provide insight into the clinical management of AIS patients and provide references for future research.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861902","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}
Linhui Qin, Peter Kamash, Yong Yang, Yuchuan Ding, Changhong Ren
{"title":"Potential neural repair poststroke: Decoction of Chinese angelica and peony in regulating microglia polarization through the neurosteroid pathway","authors":"Linhui Qin, Peter Kamash, Yong Yang, Yuchuan Ding, Changhong Ren","doi":"10.4103/bc.bc_45_23","DOIUrl":"https://doi.org/10.4103/bc.bc_45_23","url":null,"abstract":"\u0000 Ischemic stroke is a major global health crisis, characterized by high morbidity and mortality rates. Although there have been significant advancements in treating the acute phase of this condition, there remains a pressing need for effective treatments that can facilitate the recovery of neurological functions. Danggui-Shaoyao-San (DSS), also known as the Decoction of Chinese Angelica and Peony, is a traditional Chinese herbal formula. It has demonstrated promising results in the regulation of microglial polarization and modulation of neurosteroid receptor expression, which may make it a potent strategy for promoting the recovery of neurological functions. Microglia, which plays a crucial role in neuroplasticity and functional reconstruction poststroke, is regulated by neurosteroids. This review posits that DSS could facilitate the recovery of neuronal function poststroke by influencing microglial polarization through the neurosteroid receptor pathway. We will further discuss the potential mechanisms by which DSS could enhance neural function in stroke, including the regulation of microglial activation, neurosteroid regulation, and other potential mechanisms.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"32 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948543","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":"No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review.","authors":"Yuan Kan, Sijie Li, Bowei Zhang, Yuchuan Ding, Wenbo Zhao, Xunming Ji","doi":"10.4103/bc.bc_37_23","DOIUrl":"10.4103/bc.bc_37_23","url":null,"abstract":"<p><p>The no-reflow phenomenon (NRP) after successful vascular recanalization in acute ischemic stroke (AIS) has become a major cause of poor clinical prognosis and ineffective recanalization. However, there is currently no clear definition or unified clinical assessment method for the NRP. Therefore, it is urgent to clarify the clinical evaluation criteria for the NRP and develop new no-reflow evaluation techniques so that remedial treatment can be applied to AIS patients suffering from the NRP. In this brief review, a variety of NRP assessment methods and defining criteria for clinical practice are presented.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"9 4","pages":"214-221"},"PeriodicalIF":2.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569667","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}
Yi Yan, Zhaohui Wang, Xiao Liu, Song Han, Junfa Li, Ying Zhang, Li Zhao
{"title":"Identification of brain endothelial cell-specific genes and pathways in ischemic stroke by integrated bioinformatical analysis","authors":"Yi Yan, Zhaohui Wang, Xiao Liu, Song Han, Junfa Li, Ying Zhang, Li Zhao","doi":"10.4103/bc.bc_40_23","DOIUrl":"https://doi.org/10.4103/bc.bc_40_23","url":null,"abstract":"BACKGROUND: Ischemic stroke (IS) is a life-threatening condition with limited treatment options; thus, finding the potential key genes for novel therapeutic targets is urgently needed. This study aimed to explore novel candidate genes and pathways of brain microvessel endothelial cells (ECs) in IS by bioinformatics analysis. MATERIALS AND METHODS: The gene expression profiles of brain tissues or brain ECs in IS mice were downloaded from the online gene expression omnibus (GEO) to obtain the differentially expressed genes (DEGs) by R software. Functional enrichment analyses were used to cluster the functions and signaling pathways of the DEGs, while DEG-associated protein–protein interaction network was performed to identify hub genes. The target microRNAs and competitive endogenous RNA networks of key hub genes were constructed by Cytoscape. RESULTS: Totally 84 DEGs were obtained from 6 brain tissue samples and 4 brain vascular EC samples both from IS mice in the datasets GSE74052 and GSE137482, with significant enrichment in immune responses, such as immune system processes and T-cell activation. Eight hub genes filtered by Cytoscape were validated by two other GEO datasets, wherein key genes of interest were verified by reverse transcription-polymerase chain reaction using an in vitro ischemic model of EC cultures. Our data indicated that AURKA and CENPF might be potential therapeutic target genes for IS, and Malat1/Snhg12/Xist-miR-297b-3p-CENPF, as well as Mir17 hg-miR-34b-3p-CENPF, might be RNA regulatory pathways to control IS progression. CONCLUSIONS: Our work identified two brain EC-specific expressed genes in IS, namely, AURKA and CENPF, as potential gene targets for IS treatment. In addition, we presented miR-297b-3p/miR-34b-3p-CENPF as the potential RNA regulatory axes to prevent pathogenesis of IS.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"228 - 239"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139327382","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}
Ashitha Arumadi, A. Hrishi, Unnikrishnan Prathapadas, M. Sethuraman, Easwer Hari Venket
{"title":"Evaluation of markers of cerebral oxygenation and metabolism in patients undergoing clipping of cerebral aneurysm under total intravenous anesthesia versus inhalational anesthesia: A prospective randomized trial (COM-IVIN trial)","authors":"Ashitha Arumadi, A. Hrishi, Unnikrishnan Prathapadas, M. Sethuraman, Easwer Hari Venket","doi":"10.4103/bc.bc_66_23","DOIUrl":"https://doi.org/10.4103/bc.bc_66_23","url":null,"abstract":"INTRODUCTION: Anesthetic goals in patients undergoing clipping of cerebral aneurysm include maintenance of cerebral blood flow, oxygenation, and metabolism to avoid cerebral ischemia and maintenance of hemodynamic stability. We intend to study the influence of anesthetic agents on the outcome of aneurysmal subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This is a prospective, randomized, parallel, single-center pilot trial approved by the Institutional Ethics Committee and is prospectively registered with the Clinical Trial Registry of India. Patients with aneurysmal SAH (aSAH) admitted to our institution for surgical clipping, fulfilling the trial inclusion criteria, will be randomized in a 1:1 allocation ratio utilizing a computerized random allocation sequence to receive either total intravenous anesthesia (n = 25) or inhalational anesthesia (n = 25). Our primary objective is to study the effects of these anesthetic techniques on cerebral oxygenation and metabolism in patients with aSAH. Our secondary objective is to evaluate the impact of these anesthetic techniques on the incidence of delayed cerebral ischemia and long-term patient outcomes in patients with aSAH. The Modified Rankin Score and Glasgow Outcome Scale (GOS) at discharge and 3 months following hospital discharge will be evaluated. An observer blinded to the study intervention will assess the outcome measures. DISCUSSION: This study will provide more insight as to which is the ideal anesthetic agent that offers a better neurophysiological profile regarding intraoperative cerebral oxygenation and metabolism, thereby contributing to better postoperative outcomes in aSAH patients.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"252 1","pages":"251 - 257"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139326225","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":"Probucol will become a new model for treating cerebral infarction with a high risk of hemorrhage: A narrative review","authors":"Liguo Lang, Jianying Zhang, Dongju Zheng, Huanmin Gao","doi":"10.4103/bc.bc_44_23","DOIUrl":"https://doi.org/10.4103/bc.bc_44_23","url":null,"abstract":"Lipid-lowering agents are relevant in stroke prevention. Probucol (PU) is an antioxidative and lipid-lowering drug that has been used to treat atherosclerotic cardiovascular diseases and xanthomas. The drug penetrates the core of low-density lipoprotein cholesterol (LDL-C) particles, enhancing the activity of plasma cholesterol l ester transfer protein (CETP) and strengthening the liver scavenger receptor type I, resulting in reducing LDL-C; by increasing the activity of paraoxonase 1, upregulating the antioxidant function of high-density lipoprotein (HDL), and it decreases the serum HDL-cholesterol (HDL-C) level. This drug has been retired from the Western markets for lowering HDL-C levels and Q-interval prolongation. The latter side effect has been rarely reported and may be transient. Recent clinical evidence supports the effectiveness of PU in preventing cardiovascular events and in reducing mortality, irrespective of the reduction of HDL-C. Based on basic research and clinical studies, it appears that PU might be a valuable alternative when statins are ineffective or contraindicated, in patients at high risk of recurrence of cerebral ischemia and hemorrhage.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"59 1","pages":"222 - 227"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139327587","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}
Yilin Wang, Tao Wang, Z. Han, Rongliang Wang, Yue Hu, Zhenhong Yang, Tong Shen, Yangmin Zheng, Jichang Luo, Yan Ma, Yumin Luo, Liqun Jiao
{"title":"Explore the role of long noncoding RNAs and mRNAs in intracranial atherosclerotic stenosis: From the perspective of neutrophils","authors":"Yilin Wang, Tao Wang, Z. Han, Rongliang Wang, Yue Hu, Zhenhong Yang, Tong Shen, Yangmin Zheng, Jichang Luo, Yan Ma, Yumin Luo, Liqun Jiao","doi":"10.4103/bc.bc_63_23","DOIUrl":"https://doi.org/10.4103/bc.bc_63_23","url":null,"abstract":"CONTEXT: Circulating neutrophils and long noncoding RNAs (lncRNAs) play various roles in intracranial atherosclerotic stenosis (ICAS). OBJECTIVE: Our study aimed to detect differentially expressed (DE) lncRNAs and mRNAs in circulating neutrophils and explore the pathogenesis of atherosclerosis from the perspective of neutrophils. METHODS: Nineteen patients with ICAS and 15 healthy controls were enrolled. The peripheral blood of the participants was collected, and neutrophils were separated. The expression profiles of lncRNAs and mRNAs in neutrophils from five patients and five healthy controls were obtained, and DE lncRNAs and mRNAs were selected. Six lncRNAs were selected and validated using quantitative reverse transcription–polymerase chain reaction (qRT-PCR), and ceRNA and lncRNA-RNA binding protein (RBP)-mRNA networks were constructed. Correlation analysis between lncRNAs and mRNAs was performed. Functional enrichment annotations were also performed. RESULTS: Volcano plots and heat maps displayed the expression profiles and DE lncRNAs and mRNAs, respectively. The qRT-PCR results revealed that the four lncRNAs showed a tendency consistent with the expression profile, with statistical significance. The ceRNA network revealed three pairs of regulatory networks: lncRNA RP3-406A7.3-NAGLU, lncRNA HOTAIRM1-MVK/IL-25/GBF1/CNOT4/ANKK1/PLEKHG6, and lncRNA RP11-701H16.4-ZNF416. The lncRNA-RBP-mRNA network showed five pairs of regulatory networks: lncRNA RP11-701H16.4-TEK, lncRNA RP11-701H16.4-MED17, lncRNA SNHG19-NADH-ubiquinone oxidoreductase core subunit V1, lncRNA RP3-406A7.3-Angel1, and lncRNA HOTAIRM1-CARD16. CONCLUSIONS: Our study identified and verified four lncRNAs in neutrophils derived from peripheral blood, which may explain the transcriptional alteration of neutrophils during the pathophysiological process of ICAS. Our results provide insights for research related to the pathogenic mechanisms and drug design of ICAS.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"240 - 250"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139331487","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":"Localization of cerebral vasculopathy following bacterial meningitis: What can we learn about postinfective ischemic sequelae?","authors":"V. Kumar, V. Kumar","doi":"10.4103/bc.bc_97_22","DOIUrl":"https://doi.org/10.4103/bc.bc_97_22","url":null,"abstract":"Cerebrovascular complications of bacterial meningitis account for a high incidence of mortality and postinfective neurologic sequelae. Cerebrovascular complications occurring during acute bacterial meningitis are evident from angiographic evidence demonstrating arterial occlusion and vessel wall narrowing, histopathological studies demonstrating vessel wall changes, and radiographic studies demonstrating the presence of brain infarcts. Cerebrovascular disease during bacterial meningitis has been demonstrated in of Haemophilus influenzae, Streptococcus pneumonia, Group B Streptococcus, and Mycobacterium tuberculosis models of meningitis. Despite models of bacterial meningitis showing variable patterns of cerebral vasculopathy as a contributor to different aspects of postinfectious neurological decline, very few studies describe the predominant localization of cerebral vasculopathy with different meningitis causing pathogens. Thus, this review attempts to analyze the different locations of cerebral vasculopathic changes occuring in response to different microbial pathogens and provide a pathophysiologic basis for such an observation.","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"191 1","pages":"205 - 213"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139325800","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}