Canadian journal of ophthalmology. Journal canadien d'ophtalmologie最新文献

{"title":"Five-year reoperation rates after Schlemm's canal-based glaucoma surgery versus trabeculectomy.","authors":"Keyu Hu, Jin Wang, Qing Sang, Dapeng Mou, Ye Zhang, Ningli Wang","doi":"10.1016/j.jcjo.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.02.016","url":null,"abstract":"<p><strong>Objective: </strong>To compare 5-year reoperation rates between Schlemm's canal (SC)-based glaucoma surgery and trabeculectomy (Trab), and to identify risk factors for reoperations.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent glaucoma surgery between January 2017 and December 2021. Propensity score matching was used to identify comparable participants among groups. SC-based glaucoma surgery included gonioscopy-assisted transluminal trabeculotomy, microcatheter-assisted trabeculotomy, ab-interno canaloplasty, canaloplasty, and trabectome. The primary outcome was unanticipated reoperations after the original procedure. Kaplan-Meier survival analysis compared reoperation rates between groups. Univariate and multivariate Cox regression analyses identified risk factors for reoperation.</p><p><strong>Results: </strong>The final analysis included 112 eyes (106 patients) in the SC-based glaucoma surgery group and 147 eyes (137 patients) in the Trab group. The 5-year cumulative reoperation rate was significantly higher in the Trab group compared to the SC-based glaucoma surgery group (15.4% [93/604] vs 11.9% [72/604], respectively, and p = 0.045). Uncontrolled intraocular pressure (IOP) was the primary indication for reoperations in both groups. Trab surgery, higher preoperative IOP, greater number of preoperative medications, and previous glaucoma surgery history were independent risk factors for reoperation.</p><p><strong>Conclusions: </strong>SC-based glaucoma surgery showed a significantly lower 5-year reoperation rate than Trab, indicating a more favourable long-term safety profile. Trab surgery, higher preoperative IOP, more preoperative medications, and previous glaucoma surgery history were identified as independent risk factors for reoperation, which may help identify patients at higher risk for reoperation and potentially improve postoperative management.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763161","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":"Accessibility of Canadian ophthalmology department webpages for the visually impaired.","authors":"Mostafa S Bondok, Mohamed S Bondok, Rishika Selvakumar, Nina Ahuja, Edsel Ing","doi":"10.1016/j.jcjo.2025.02.018","DOIUrl":"10.1016/j.jcjo.2025.02.018","url":null,"abstract":"<p><strong>Objective: </strong>We reviewed Canadian university ophthalmology department webpages to determine the extent of web content accessibility for users with visual impairment and color vision deficiency.</p><p><strong>Methods: </strong>The Web Content Accessibility Guidelines 2.0 (WCAG 2.0) were used to assess the accessibility of all 15 Canadian ophthalmology website homepages using automated assessment and manual assessment strategies.</p><p><strong>Results: </strong>All department webpages had accessibility errors. The mean number of errors identified by each tool were: AChecker (13.3, SD = 9.4), ARC ToolKit (16.5, SD = 35.1), and WAVE (4.9, SD = 14). Forty-seven percent (7/15) of the websites had contrast errors, with the mean number of errors being 2.2 (SD = 3.9). Accessibility errors relevant to users with visual impairment or those that utilize screen readers included the absence of alternative text, explaining the content of images, hyperlinks without information regarding where the link navigates to, improper declaration of website language causing screen readers to read French text as if it were in English, and the duplication of the same element ID resulting in screen reader processing errors.</p><p><strong>Conclusions: </strong>The ophthalmology webpages of Canadian universities should be revised to better comply with the WCAG guidelines and enhance digital accessibility for users with visual impairment.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691197","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":"Prevalence of systemic disease in patients undergoing cataract surgery at a hospital versus outpatient clinics.","authors":"Angel Gao, Davin Johnson","doi":"10.1016/j.jcjo.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.03.002","url":null,"abstract":"<p><strong>Objective: </strong>To compare demographic and clinical characteristics of patients undergoing cataract surgery at a hospital versus a private outpatient clinic (POC) within a shared funding model in Ontario, Canada. Our tertiary academic hospital operates a unique funding arrangement, in which some hospital funds support cataract surgeries at a POC, enabling oversight of provincially funded surgeries at both sites.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>All patients who underwent cataract surgery in 2023 at both the hospital (Kingston Health Sciences Centre) and the affiliated POC were included.</p><p><strong>Methods: </strong>We compared demographic and clinical data, including age, gender, blood pressure, comorbidities (e.g., diabetes, hypertension), American Society of Anesthesiologists scores, and medication usage.</p><p><strong>Results: </strong>Patients included in this study numbered 3441 (1982 hospital patients and 1459 POC patients). Mean age was similar, although significantly more females underwent surgery at the POC (p = 0.004). Hospital patients had higher systolic blood pressure (p < 0.0001), higher rates of diabetes (1.5 odds ratio, 95% confidence interval [CI] 1.3-1.8; p < 0.0001), higher American Society of Anesthesiologist scores (0.3 mean difference, 95% CI 0.27-0.35; p < 0.0001), and higher smoking rates (p < 0.0001). The use of anticoagulation, antidiabetes, and prostate medications were significantly higher among hospital patients (p < 0.001), with greater use of antihypertensive medications (p = 0.018).</p><p><strong>Conclusions: </strong>Our data support concerns that healthier patients are more likely to undergo surgery at outpatient clinics. Factors, such as mandated restrictions on patient selection at POCs, surgeon preference, and referral patterns may contribute. As outpatient surgical care grows, documenting these differences is essential to ensure fair distribution of resources and equitable access to care.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763163","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":"Analyzing clinical variables indicative of uveal melanoma to determine how they affect decisions made by an artificial intelligence classifier.","authors":"Emily Laycock, Ezekiel Weis, Antoine Sylvestre-Bouchard, Rachel Curtis, Esmaeil Shakeri, Emad Mohammed, Behrouz Far, Trafford Crump","doi":"10.1016/j.jcjo.2025.02.012","DOIUrl":"10.1016/j.jcjo.2025.02.012","url":null,"abstract":"<p><strong>Objective: </strong>The \"black box\" nature of many artificial intelligence (AI) models has limited their adoption in real-world ophthalmologic practices. Our lab developed an AI model for detecting the presence of a choroidal melanocytic lesion (CML) in colour fundus images. The purpose of this article is to investigate whether there are known clinical features of CMLs that are associated with false-negative (FN) classifications from the model to aid in validation and increase its interpretability.</p><p><strong>Methods: </strong>A retrospective cohort study of CML patients was performed. A total of 388 fundus images from 194 patients with (n = 194) and without (n = 194) CMLs collected through routine clinical assessment were used to train an AI model. The model's classification (lesion present/lesion absent) of the images with CMLs, as well as CML characteristics, demographics, and risk factors for uveal melanoma (UM) were extracted. Logistic regression models were used to test for associations between the FN classifications and these characteristics.</p><p><strong>Results: </strong>The AI model returned 150 true-positive classifications and 44 FN classifications (23%) for CML eyes. Thinner lesions were more likely to be missed by the model (p = 0.026), resulting in a FN classification. The presence of imaging risk factors for UM was not shown to have any statistically significant relationships with a FN classification.</p><p><strong>Conclusions: </strong>The results from this study demonstrate that the FN classifications for CML fundus image classifications from our AI model are not associated with the presence of imaging risk factors for UM but are influenced by thinness of the lesion.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669111","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":"Outer nuclear layer thickness as a biomarker for photoreceptor function in pachychoroid spectrum disorders.","authors":"Su Min Jo, Kyung Tae Kim, Eoi Jong Seo","doi":"10.1016/j.jcjo.2025.02.009","DOIUrl":"10.1016/j.jcjo.2025.02.009","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the outer nuclear layer (ONL) could serve as a quantitative biomarker for photoreceptor function in pachychoroid pigment epitheliopathy (PPE) and pachychoroid neovasculopathy (PNV). Additionally, to assess the impact of pachychoroid features, the presence of neovascularization, and a history of exudation on photoreceptor function.</p><p><strong>Methods: </strong>One hundred and one eyes with pachychoroid features and thirty-four normal control eyes were retrospectively analyzed. The study groups were categorized into PNV and PPE subgroups based on the presence of neovascularization detected on optical coherence tomography angiography. PNV eyes were further stratified based on a history of exudation. The average thicknesses of individual retinal layers and choroidal thickness were measured, along with best-corrected visual acuity (BCVA). The relationship between BCVA and each retinal/choroidal layer thickness was analyzed.</p><p><strong>Results: </strong>ONL thickness differed significantly among the 3 groups, with the thinnest in the PNV group and the thickest in the control group (p = 0.001), revealing a linear correlation to BCVA. The PPE group exhibited thicker ONL and better BCVA than the PNV group without a history of exudation (p < 0.001 and p = 0.015, respectively). In PNV eyes, those with a history of exudation had thinner ONL and worse BCVA compared to those without such a history (p = 0.003 and 0.008, respectively).</p><p><strong>Conclusions: </strong>ONL thickness serves as a quantitative biomarker of photoreceptor function in PNV and PPE. Photoreceptor function declines in eyes with pachychoroid features, the presence of neovascularization, and a history of exudation. The development of neovascularization or exudation in PNV or PPE should be treated promptly to salvage photoreceptors.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633623","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":"Disproportionality analysis of BRAF and MEK inhibitors demonstrate risk of retinal detachment: an analysis of the FDA Adverse Event Reporting System.","authors":"Connor Frey, Mahyar Etminan","doi":"10.1016/j.jcjo.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.03.003","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742547","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":"Vacuolated lymphocytes: a diagnostic biomarker for CLN3-related Batten disease.","authors":"Miguel Cruz-Pimentel, Deepika C Parameswarappa, Giwon Ryu, Regan Klatt, Ajoy Vincent","doi":"10.1016/j.jcjo.2025.02.021","DOIUrl":"10.1016/j.jcjo.2025.02.021","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691227","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":"Idiopathic granulomatous orbital inflammation: A case series and literature review.","authors":"Sonia Huang, Valerie Juniat, Jessica Y Tong, Craig James, Nigel Morlet, Saul Rajak, Roy Tan Da Duan, Peerooz Saeed, Ilse Mombaerts, Dinesh Selva","doi":"10.1016/j.jcjo.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.02.023","url":null,"abstract":"<p><strong>Purpose: </strong>Idiopathic granulomatous orbital inflammation is an uncommon histological finding that remains poorly defined due to its overlap with specific causes of granulomatous orbital inflammation, such as orbital sarcoidosis. We aim to identify clinico-radiological features that may differentiate it from other aetiologies of granulomatous inflammation.</p><p><strong>Methods: </strong>Retrospective case series involving 12 patients and review of the literature.</p><p><strong>Results: </strong>Eight patients (66.7%) were female. The mean age at presentation was 57.8 ± 9.1 years of age. Eleven cases were unilateral (91.7%). The most common presenting symptoms and signs were palpable mass (n = 10; 83.3%), lid swelling (n = 9; 75%) decreased extraocular movements (n = 4; 33.3%), and proptosis (n = 4; 33.3%). One patient (8.3%) had signs consistent with optic neuropathy on presentation. The lacrimal glands were involved in 6 (50%) cases. For initial management, 2 patients (16.7%) underwent observation only, 8 patients (66.7%) were managed with immunosuppressive drugs, and 2 patients (16.7%) were managed with surgical excision or debulking. Four patients (33.3%) required additional management with either methotrexate or intralesional triamcinolone. Patients were followed up for a mean of 68.4 months. At last follow-up, 7 patients (63.6%) had complete resolution, and 5 (41.7%) had stable disease without further progression.</p><p><strong>Conclusion: </strong>We present a case series of idiopathic granulomatous orbital inflammation. We found that those with idiopathic disease often had unilateral presentations and appeared to present at a later age than those with orbital sarcoidosis in the literature. Although the differentiation between orbital sarcoidosis and idiopathic disease remains difficult, the features described in this series contribute to a greater understanding of the latter condition.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742548","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":"Correlation of point-wise retinal sensitivity with localized features of diabetic macular edema using deep learning.","authors":"Heiko Stino, Klaudia Birner, Irene Steiner, Laetitia Hinterhuber, Markus Gumpinger, Simon Schürer-Waldheim, Hrvoje Bogunovic, Ursula Schmidt-Erfurth, Gregor S Reiter, Andreas Pollreisz","doi":"10.1016/j.jcjo.2025.02.013","DOIUrl":"10.1016/j.jcjo.2025.02.013","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between localized features of diabetic macular edema (DME) and point-wise retinal sensitivity (RS) assessed with microperimetry (MP) using deep learning (DL)-based automated quantification on optical coherence tomography (OCT) scans.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>Twenty eyes of 20 subjects with clinically significant DME were included in this study.</p><p><strong>Methods: </strong>Patients with DME visible on OCT scans (Spectralis Heidelberg Retina Angiograph [HRA]+OCT) completed 2 MP examinations using a custom 45 stimuli grid on MAIA (CenterVue). MP stimuli were coregistered with the corresponding OCT location using image registration algorithms. DL-based algorithms were used to quantify intraretinal fluid (IRF) and ellipsoid zone (EZ) thickness. Hard exudates (HEs) were quantified semiautomatically. Multivariable mixed-effect models were calculated to investigate the association between DME-specific OCT features and point-wise RS. As EZ thickness values below HEs were excluded, the models included either EZ thickness or HEs.</p><p><strong>Results: </strong>A total of 1800 MP stimuli from 20 eyes of 20 patients were analyzed. Stimuli with IRF (n = 568) showed significantly decreased RS compared to areas without (estimate [95% CI]: -1.11 dB [-1.69, -0.52]; p = 0.0002). IRF volume was significantly negatively (-0.45 dB/nL [-0.71; -0.18]; p = 0.001) and EZ thickness positively (0.14 dB/µm [0.1; 0.19]; p < 0.0001) associated with localized point-wise RS. In the multivariable mixed model, including HE volume instead of EZ thickness, a negative impact on RS was observed (-0.43/0.1 nL [-0.81; -0.05]; p = 0.027).</p><p><strong>Conclusions: </strong>DME-specific features, as analyzed on OCT, have a significant impact on point-wise RS. IRF and HE volume showed a negative and EZ thickness, a positive association with localized RS.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639558","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":"Analysis of diplopia referrals in a tertiary neuro-ophthalmology center.","authors":"Mariam Issa, Milena Cioana, Marko M Popovic, Laura Donaldson, Jonathan Micieli, Edward Margolin","doi":"10.1016/j.jcjo.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.03.001","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the potential for morbidity and mortality in patients referred to neuro-ophthalmology service for evaluation of diplopia.</p><p><strong>Methods: </strong>A retrospective chart review of all patients seen by two neuro-ophthalmologists in a tertiary neuro-ophthalmology practice between December 2, 2021, and May 21, 2022, was performed. All patients who were referred for diplopia were included. The primary outcome was to describe the potential for vision loss, progression of symptoms, or systemic morbidity or mortality without a neuro-ophthalmic consult.</p><p><strong>Results: </strong>One hundred ninety-six patients were referred for diplopia. The mean age at presentation was 61.3 ± 17.0 years, and 48.5% were women. The most common final diagnosis reached following neuro-ophthalmology consultation were cranial nerve palsies (38.3%, 75/196), convergence insufficiency and decompensated phoria (22.4%, 44/196), non-neuro-ophthalmic causes (19.9%, 39/196), thyroid eye disease (4.5%, 9/196), myasthenia gravis (3.5%, 7/196), and multiple sclerosis (6/196, 3.1%). On the basis of final diagnosis, 15.3% of patients referred to neuro-ophthalmology service for diplopia had the potential for morbidity or mortality. Specifically, 1% (2/196) were at risk for visual loss due severe papilledema in the context of untreated idiopathic intracranial hypertension, and 3.0% (6/196) had the potential for systemic morbidity or mortality due to their final diagnosis (brain aneurysms in 2/196, pituitary apoplexy in 1/196, anaplastic glioma in 1/196, and other malignancy in 2/196). In addition, 11.2% (22/196) had the potential for progression of symptoms and systemic morbidity due to thyroid eye disease (9/196), myasthenia gravis (7/196), and multiple sclerosis (6/196). Of the patients who had a prereferral neuroimaging study, 30.1% required additional neuroimaging after neuro-ophthalmic consultation.</p><p><strong>Conclusions: </strong>Overall, 15.3% (30/196) of patients with diplopia had potential for morbidity and mortality without neuro-ophthalmic consultation. This study emphasizes the importance of urgent neuro-ophthalmologic referral for patients with diplopia to allow for appropriate evaluation and investigations to reduce potential morbidity and mortality.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708654","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}