Pub Date : 2025-11-29DOI: 10.1016/j.jclinane.2025.112081
Wenchao Chen MD , Guojun Yu MD , Hongmin Cai MD , Cuiying Du MD , Liang Feng MD , Jing Bian MD , Zhe Yuan MD , Ning Wang MD
Objective
The success rates of the intercostobrachial nerve (ICBN) blocks varied from 51 % to 100 % by different techniques, which required rich expertise from the operators and/or high-resolution ultrasound. We proposed a simplified ultrasound-guided plane block and explored the 50 % effective volume (EV50) and the 95 % effective volume (EV95) with corresponding 95 % confidence intervals.
Methods
We recruited patients undergoing surgery of the upper limb and performed the simplified block. The needle target was positioned at 3 cm caudal to the centre of the axillary artery on the anterior surface of the conjoint tendon. The EV of 0.5 % ropivacaine was determined by Dixon's up-and-down method with an initial volume of 5 mL, and a successful or failed block could produce a 0.5 mL decrement or increment. Probit regression was fitted to determine the EV. To enhance robustness, a bootstrap analysis with 1000 resamples was performed. We recorded the block performance and adverse events.
Results
A total of 28 patients were included. The EV50 calculated by the Dixon's up-and-down method was 3.29 ± 0.60 mL. Based on Probit regression analysis, the EV50 and EV95 were 3.31 (3.09–3.53) and 3.94 (3.46–4.42) mL. The bootstrap-derived EV50 and EV95 were 3.32 (3.05–3.52) and 3.90 (3.54–4.41) mL. No adverse events occurred.
Conclusions
This simplified standardized ultrasound-guided plane block can provide a reliable anesthesia of the intercostobrachial nerve, with an EV50 of 3.31 mL and an EV95 of 3.94 mL for 0.5 % ropivacaine. This approach may enhance teaching and clinical practice by improving ergonomics, procedural efficiency, and reproducibility, while minimizing local anesthetic dosage and enhancing safety.
{"title":"A simplified standardized ultrasound-guided plane block for the Intercostobrachial nerve: Effective volume of 0.5 % ropivacaine determined by Dixon's up-and-down method","authors":"Wenchao Chen MD , Guojun Yu MD , Hongmin Cai MD , Cuiying Du MD , Liang Feng MD , Jing Bian MD , Zhe Yuan MD , Ning Wang MD","doi":"10.1016/j.jclinane.2025.112081","DOIUrl":"10.1016/j.jclinane.2025.112081","url":null,"abstract":"<div><h3>Objective</h3><div>The success rates of the intercostobrachial nerve (ICBN) blocks varied from 51 % to 100 % by different techniques, which required rich expertise from the operators and/or high-resolution ultrasound. We proposed a simplified ultrasound-guided plane block and explored the 50 % effective volume (EV50) and the 95 % effective volume (EV95) with corresponding 95 % confidence intervals.</div></div><div><h3>Methods</h3><div>We recruited patients undergoing surgery of the upper limb and performed the simplified block. The needle target was positioned at 3 cm caudal to the centre of the axillary artery on the anterior surface of the conjoint tendon. The EV of 0.5 % ropivacaine was determined by Dixon's up-and-down method with an initial volume of 5 mL, and a successful or failed block could produce a 0.5 mL decrement or increment. Probit regression was fitted to determine the EV. To enhance robustness, a bootstrap analysis with 1000 resamples was performed. We recorded the block performance and adverse events.</div></div><div><h3>Results</h3><div>A total of 28 patients were included. The EV50 calculated by the Dixon's up-and-down method was 3.29 ± 0.60 mL. Based on Probit regression analysis, the EV50 and EV95 were 3.31 (3.09–3.53) and 3.94 (3.46–4.42) mL. The bootstrap-derived EV50 and EV95 were 3.32 (3.05–3.52) and 3.90 (3.54–4.41) mL. No adverse events occurred.</div></div><div><h3>Conclusions</h3><div>This simplified standardized ultrasound-guided plane block can provide a reliable anesthesia of the intercostobrachial nerve, with an EV50 of 3.31 mL and an EV95 of 3.94 mL for 0.5 % ropivacaine. This approach may enhance teaching and clinical practice by improving ergonomics, procedural efficiency, and reproducibility, while minimizing local anesthetic dosage and enhancing safety.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112081"},"PeriodicalIF":5.1,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1016/j.jclinane.2025.112078
Qian Xu, Jianmin Zhang, Fang Wang, Zhengzheng Gao, Lijing Li, Xiaolu Nie, Shanshan Li
Background
Emergence delirium (ED), a common postoperative neurological disorder in children, is characterized by disturbances in consciousness, attention, disorientation, and perceptual changes. Intraoperative burst suppression has been associated with postoperative delirium in adults, and its relationship with emergence delirium in children remains unclear and controversial.
Methods
This investigation was conducted at Beijing Children's Hospital, Capital Medical University, from January 2022 to January 2023. The study incorporated children aged 6 months to 9 years who were undergoing general anesthesia with electroencephalography (EEG) monitoring. Intraoperative processed EEG and the incidence of burst suppression were recorded. Postoperative delirium was evaluated using the Pediatric Anesthesia Emergence Delirium Scale. A score of 10 points or higher on this scale was used as an indicator of the presence of emergence delirium.
Results
Among the 207 children enrolled, the incidence of emergence delirium was 43 % in the set of children with burst suppression, whereas it was only 7 % in the non-burst suppression set. Binary logistic regression analysis pinpointed two distinct risk factors for the emergence of delirium. These were the agent used for maintenance of anesthesia and intraoperative burst suppression. Children maintained under intravenous propofol for maintenance of anesthesia experienced 57 % lower incidence of emergence delirium than those maintained under sevoflurance for anesthesia maintenance. Furthermore, children with burst suppression were eight times more likely to develop emergence delirium, according to intraoperative processed EEG monitoring.
Conclusions
This study demonstrated a notable association between intraoperative burst suppression and the incidence of postoperative emergence delirium. These findings suggest that processed EEG-based monitoring and tailored anesthesia strategies may help prevent emergence delirium and other unfavorable outcomes in pediatric surgical patients.
{"title":"Intraoperative burst suppression and emergence delirium in pediatric: A prospective observational study","authors":"Qian Xu, Jianmin Zhang, Fang Wang, Zhengzheng Gao, Lijing Li, Xiaolu Nie, Shanshan Li","doi":"10.1016/j.jclinane.2025.112078","DOIUrl":"10.1016/j.jclinane.2025.112078","url":null,"abstract":"<div><h3>Background</h3><div>Emergence delirium (ED), a common postoperative neurological disorder in children, is characterized by disturbances in consciousness, attention, disorientation, and perceptual changes. Intraoperative burst suppression has been associated with postoperative delirium in adults, and its relationship with emergence delirium in children remains unclear and controversial.</div></div><div><h3>Methods</h3><div>This investigation was conducted at Beijing Children's Hospital, Capital Medical University, from January 2022 to January 2023. The study incorporated children aged 6 months to 9 years who were undergoing general anesthesia with electroencephalography (EEG) monitoring. Intraoperative processed EEG and the incidence of burst suppression were recorded. Postoperative delirium was evaluated using the Pediatric Anesthesia Emergence Delirium Scale. A score of 10 points or higher on this scale was used as an indicator of the presence of emergence delirium.</div></div><div><h3>Results</h3><div>Among the 207 children enrolled, the incidence of emergence delirium was 43 % in the set of children with burst suppression, whereas it was only 7 % in the non-burst suppression set. Binary logistic regression analysis pinpointed two distinct risk factors for the emergence of delirium. These were the agent used for maintenance of anesthesia and intraoperative burst suppression. Children maintained under intravenous propofol for maintenance of anesthesia experienced 57 % lower incidence of emergence delirium than those maintained under sevoflurance for anesthesia maintenance. Furthermore, children with burst suppression were eight times more likely to develop emergence delirium, according to intraoperative processed EEG monitoring.</div></div><div><h3>Conclusions</h3><div>This study demonstrated a notable association between intraoperative burst suppression and the incidence of postoperative emergence delirium. These findings suggest that processed EEG-based monitoring and tailored anesthesia strategies may help prevent emergence delirium and other unfavorable outcomes in pediatric surgical patients.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112078"},"PeriodicalIF":5.1,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1016/j.jclinane.2025.112079
Terry J. Biel MD MBA , Cristina L. Wood MD MS , Rachel M. Kacmar MD
{"title":"Response to the Comment on “From ‘how busy we are’ to ‘how we are busy’: Pragmatic, minute-by-minute analysis of obstetric anesthesia activity, service capacity, and utilization”","authors":"Terry J. Biel MD MBA , Cristina L. Wood MD MS , Rachel M. Kacmar MD","doi":"10.1016/j.jclinane.2025.112079","DOIUrl":"10.1016/j.jclinane.2025.112079","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112079"},"PeriodicalIF":5.1,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-21DOI: 10.1016/j.jclinane.2025.112074
Amelie Delaporte MD , Ehab Bahrun MD , Kenneth Lin , Tristan Grogan MS , Alexandre Joosten MD PhD
{"title":"Hemodynamic data reporting and group separation: Key to interpreting individualized blood pressure trials","authors":"Amelie Delaporte MD , Ehab Bahrun MD , Kenneth Lin , Tristan Grogan MS , Alexandre Joosten MD PhD","doi":"10.1016/j.jclinane.2025.112074","DOIUrl":"10.1016/j.jclinane.2025.112074","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112074"},"PeriodicalIF":5.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-21DOI: 10.1016/j.jclinane.2025.112077
Gustavo R.M. Wegner , Bruno F.M. Wegner , Gabriel L. González , Juliano N. Quineper , Carlos H.O. Ferreira , Hudson M. de Brito , Alesson M. Miranda , André B. Donato , Tatiana S. do Nascimento
Study objective
To compare the acceptability and immediate behavioral response of different premedications, considering routes and formulations.
Design
Systematic review and Bayesian network meta-analysis of randomized controlled trials
Setting
Elective procedures involving pediatric patients undergoing general anesthesia or sedation
Patients
Children aged 1–12 years, classified as ASA physical status I–III, receiving premedication with midazolam, dexmedetomidine, clonidine, ketamine, or related agents.
Measurements
Two separate Bayesian network meta-analyses were performed. The first evaluated premedication acceptability (the child's willingness to take the drug), and the second assessed the immediate behavioral response after administration. Each intervention was classified by drug, formulation, and route of administration. Outcomes were ranked using SUCRA values. Risk of bias, node-splitting, and model diagnostics were assessed to evaluate robustness and consistency
Main results
Twenty-four trials comprising 1858 patients were included in the quantitative synthesis. Both oral midazolam in commercial syrup and oral midazolam using the intravenous formulation mixed with syrup showed the highest acceptability. Interventions with low acceptability included nebulized ketamine, midazolam, and dexmedetomidine. For immediate behavioral response, the most favorable responses were observed with oral or intranasal clonidine, followed by oral midazolam mixed with syrup. Intranasal midazolam consistently showed the poorest behavioral response among all interventions. Commercial midazolam syrup could not be analyzed.
Conclusions
Syrup-based oral midazolam offers a favorable balance between acceptability and behavioral response, making it a practical option for pediatric premedication. Intranasal clonidine and dexmedetomidine demonstrated moderate behavioral performance, with dexmedetomidine also showing moderate acceptability. In contrast, nebulized formulations were poorly accepted, and intranasal midazolam, despite good acceptability, was poorly tolerated. These findings provide comparative evidence on acceptability and tolerability, which should be integrated with existing evidence on efficacy and safety when selecting premedication strategies in pediatric anesthesia.
{"title":"Comparative acceptability and immediate behavioral response to different pediatric premedications: A systematic review and network meta-analysis","authors":"Gustavo R.M. Wegner , Bruno F.M. Wegner , Gabriel L. González , Juliano N. Quineper , Carlos H.O. Ferreira , Hudson M. de Brito , Alesson M. Miranda , André B. Donato , Tatiana S. do Nascimento","doi":"10.1016/j.jclinane.2025.112077","DOIUrl":"10.1016/j.jclinane.2025.112077","url":null,"abstract":"<div><h3>Study objective</h3><div>To compare the acceptability and immediate behavioral response of different premedications, considering routes and formulations.</div></div><div><h3>Design</h3><div>Systematic review and Bayesian network meta-analysis of randomized controlled trials</div></div><div><h3>Setting</h3><div>Elective procedures involving pediatric patients undergoing general anesthesia or sedation</div></div><div><h3>Patients</h3><div>Children aged 1–12 years, classified as ASA physical status I–III, receiving premedication with midazolam, dexmedetomidine, clonidine, ketamine, or related agents.</div></div><div><h3>Measurements</h3><div>Two separate Bayesian network meta-analyses were performed. The first evaluated premedication acceptability (the child's willingness to take the drug), and the second assessed the immediate behavioral response after administration. Each intervention was classified by drug, formulation, and route of administration. Outcomes were ranked using SUCRA values. Risk of bias, node-splitting, and model diagnostics were assessed to evaluate robustness and consistency</div></div><div><h3>Main results</h3><div>Twenty-four trials comprising 1858 patients were included in the quantitative synthesis. Both oral midazolam in commercial syrup and oral midazolam using the intravenous formulation mixed with syrup showed the highest acceptability. Interventions with low acceptability included nebulized ketamine, midazolam, and dexmedetomidine. For immediate behavioral response, the most favorable responses were observed with oral or intranasal clonidine, followed by oral midazolam mixed with syrup. Intranasal midazolam consistently showed the poorest behavioral response among all interventions. Commercial midazolam syrup could not be analyzed.</div></div><div><h3>Conclusions</h3><div>Syrup-based oral midazolam offers a favorable balance between acceptability and behavioral response, making it a practical option for pediatric premedication. Intranasal clonidine and dexmedetomidine demonstrated moderate behavioral performance, with dexmedetomidine also showing moderate acceptability. In contrast, nebulized formulations were poorly accepted, and intranasal midazolam, despite good acceptability, was poorly tolerated. These findings provide comparative evidence on acceptability and tolerability, which should be integrated with existing evidence on efficacy and safety when selecting premedication strategies in pediatric anesthesia.</div></div><div><h3>Registration</h3><div>PROSPERO ID: CRD420251048872.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112077"},"PeriodicalIF":5.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-20DOI: 10.1016/j.jclinane.2025.112076
Franklin Dexter MD, PhD, FASA , Richard H. Epstein MD, FASA
{"title":"Obstetric anesthesia workload modeling study results match earlier research findings","authors":"Franklin Dexter MD, PhD, FASA , Richard H. Epstein MD, FASA","doi":"10.1016/j.jclinane.2025.112076","DOIUrl":"10.1016/j.jclinane.2025.112076","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112076"},"PeriodicalIF":5.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: Preoperative sleep disturbances as a modifiable risk factor for postoperative cognitive dysfunction in older adults","authors":"Nina Butris MSc , Ellene Yan HBSc , Frances Chung MD","doi":"10.1016/j.jclinane.2025.112073","DOIUrl":"10.1016/j.jclinane.2025.112073","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112073"},"PeriodicalIF":5.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-18DOI: 10.1016/j.jclinane.2025.112071
N. Patel , R. Brull , E.M. Yung , N. Hussain , T. Got , T. Dwyer , R. Urman , F.W. Abdallah
Background
The subacromial-subdeltoid bursa block (SBB) has been reported to provide postoperative pain relief following arthroscopic shoulder surgery, although evidence of its efficacy remains unclear. This meta-analysis evaluates the analgesia efficacy of adding SBB to systemic analgesia compared to systemic analgesia alone.
Methods
Literature was searched for randomized controlled trials comparing SBB and systemic analgesia to systemic analgesia alone (Control). Post-operative analgesic consumption, measured in oral morphine equivalents over the first 24 h post-operatively, was the primary outcome. Secondary outcomes included pain scores up to 48 h post-operatively, patient satisfaction, functional outcomes, opioid-related side effects, and block-related complications.
Results
Fifteen trials (679 patients) were included. Compared to systemic analgesia alone, the addition of single injection SBB reduced 24-h post-operative morphine consumption by 58.98 mg [−100.14, −17.81] (p = 0.005) over the first 24 h. SBB also reduced pain scores up to 18 h post-operatively. In contrast, continuous SBB did not reduce opioid consumption, with a mean difference of −40.36 mg [−81.77, 1.06] (p = 0.06). Additionally, continuous SBB did not improve pain control at any time point. The addition of SBB did not yield any differences in patient satisfaction, functional scores, or adverse events compared to systemic analgesia alone.
Conclusions
Compared to systemic analgesia alone, this meta-analysis suggests that for arthroscopic shoulder surgery, the addition of single-injection SBB can reduce postoperative pain and opioid consumption for up to 18 and 24 h, respectively. In contrast, continuous SBB does not seem to improve any of the analgesic outcomes. Single-injection SBB may be considered an effective analgesic technique for arthroscopic shoulder surgery when proximal brachial plexus blockade is contraindicated or otherwise undesirable.
{"title":"The analgesic efficacy of subacromial bursa block for arthroscopic shoulder surgery: A systematic review and meta-analysis","authors":"N. Patel , R. Brull , E.M. Yung , N. Hussain , T. Got , T. Dwyer , R. Urman , F.W. Abdallah","doi":"10.1016/j.jclinane.2025.112071","DOIUrl":"10.1016/j.jclinane.2025.112071","url":null,"abstract":"<div><h3>Background</h3><div>The subacromial-subdeltoid bursa block (SBB) has been reported to provide postoperative pain relief following arthroscopic shoulder surgery, although evidence of its efficacy remains unclear. This meta-analysis evaluates the analgesia efficacy of adding SBB to systemic analgesia compared to systemic analgesia alone.</div></div><div><h3>Methods</h3><div>Literature was searched for randomized controlled trials comparing SBB and systemic analgesia to systemic analgesia alone (Control). Post-operative analgesic consumption, measured in oral morphine equivalents over the first 24 h post-operatively, was the primary outcome. Secondary outcomes included pain scores up to 48 h post-operatively, patient satisfaction, functional outcomes, opioid-related side effects, and block-related complications.</div></div><div><h3>Results</h3><div>Fifteen trials (679 patients) were included. Compared to systemic analgesia alone, the addition of single injection SBB reduced 24-h post-operative morphine consumption by 58.98 mg [−100.14, −17.81] (<em>p</em> = 0.005) over the first 24 h. SBB also reduced pain scores up to 18 h post-operatively. In contrast, continuous SBB did not reduce opioid consumption, with a mean difference of −40.36 mg [−81.77, 1.06] (<em>p</em> = 0.06). Additionally, continuous SBB did not improve pain control at any time point. The addition of SBB did not yield any differences in patient satisfaction, functional scores, or adverse events compared to systemic analgesia alone.</div></div><div><h3>Conclusions</h3><div>Compared to systemic analgesia alone, this meta-analysis suggests that for arthroscopic shoulder surgery, the addition of single-injection SBB can reduce postoperative pain and opioid consumption for up to 18 and 24 h, respectively. In contrast, continuous SBB does not seem to improve any of the analgesic outcomes. Single-injection SBB may be considered an effective analgesic technique for arthroscopic shoulder surgery when proximal brachial plexus blockade is contraindicated or otherwise undesirable.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"108 ","pages":"Article 112071"},"PeriodicalIF":5.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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