Multiple sclerosis and related disorders最新文献

{"title":"A multicenter, retrospective study in patients with multiple sclerosis treated with natalizumab in a real-world setting in Japan: The REFIND study","authors":"Ichiro Nakashima , Takashi Ohashi , Kazumasa Yokoyama , Kenichi Kaida , Jin Nakahara , Takayuki Kondo , Nobuaki Yoshikura , Yuko Shimizu , Chiyoko Nohara , Kenzo Sakurai , Hiroaki Yokote , Masaaki Niino , Takashi Yamamura , Kazuo Fujihara , Noriko Isobe , Hirofumi Ochi , Masahiro Mori , Izumi Kawachi , Fumitaka Shimizu , Michihiro Kanda , Toshiyuki Fukazawa","doi":"10.1016/j.msard.2026.107007","DOIUrl":"10.1016/j.msard.2026.107007","url":null,"abstract":"<div><h3>Background</h3><div>Natalizumab (TYSABRI<sup>Ⓡ</sup>) is known to be an efficacious treatment at a standard-interval dosing (SID; 300 mg administered intravenously every 4 weeks) for patients with relapsing-remitting sclerosis (RRMS). However, the SID of natalizumab is associated with increased risk of progressive multifocal leukoencephalopathy (PML). Lengthening the time between doses of natalizumab beyond 4 weeks, also known as extended-interval dosing (EID), is associated with lower risk of PML in patients with RRMS, and patients have been switched from SID to EID without meaningful loss of efficacy. In this multicenter, retrospective, observational study, REFIND, we examined real-world natalizumab dosing patterns and MS disease activity in patients with RRMS in Japan.</div></div><div><h3>Methods</h3><div>REFIND retrospectively collected data from medical records of patients at 20 study centers in Japan. Patients with MS aged 20 years and older who received at least one dose of natalizumab after January 1, 2018, and had at least one clinical assessment were included. The primary endpoints were dosing patterns used in clinical practice and MS disease activity by dosing patterns. SID was defined as a mean natalizumab dosing interval ≤35 days, and EID was defined as a mean natalizumab dosing interval ≥36 to ≤84 days. Dosing pattern groups included SID-only, EID-only, or SID followed by EID (SID/EID). For each dosing pattern group, the annualized relapse rate (ARR) before and after administration of natalizumab was compared using a negative binomial regression model.</div></div><div><h3>Results</h3><div>Of the 203 patients with MS eligible for inclusion in the REFIND study, 120 patients with RRMS were treated with natalizumab for ≥1 year, with a mean ± standard deviation (SD) age of 36.0 ± 9.4 years and a mean ± SD administration period of 32.8 ± 18.8 months. Among these patients, 13 had an SID-only natalizumab dosing pattern, 49 had EID-only, and 58 had SID/EID, with mean ± SD dosing intervals of 30.8 ± 1.6 days, 45.9 ± 3.4 days, and 38.7 ± 3.4 days, respectively. Overall ARR 1 year before vs 1 year after initiation of natalizumab was 1.03 vs 0.12 (<em>P</em> < 0.0001). ARR before vs after natalizumab in the SID-only group was 1.08 vs 0.62 (<em>P</em> = 0.378), in the EID-only group was 0.95 vs 0.02 (97.9% reduction, <em>P</em> = 0.0005), and in the SID/EID group was 1.08 vs 0.09 (91.7% reduction, <em>P</em> < 0.0001). Proportions of patients with new or enlarging T2 lesions in the SID-only, and the EID-only, and SID/EID groups were reduced by 89.1%, 83.5%, and 95.7%, respectively, after natalizumab initiation compared with the year before natalizumab.</div></div><div><h3>Conclusions</h3><div>The significant reduction in ARR observed with EID or SID/EID suggests that there is little difference between these dosing regimens in this retrospective dataset in Japan. The effectiveness of natalizumab in reducing the number of new or enla","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107007"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078598","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}

{"title":"Letter to the editor on “efficacy of caffeine supplementation on fatigue in patients with multiple sclerosis: A randomized double-blind placebo-controlled trial”","authors":"Sina Pakkhesal , Sarvin Sanaie , Amirreza Naseri","doi":"10.1016/j.msard.2026.106969","DOIUrl":"10.1016/j.msard.2026.106969","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106969"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939984","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}

{"title":"Comment on “Relapse activity during pregnancy and the postpartum year is associated with accelerated disability progression in multiple sclerosis”","authors":"Bhumesh Tyagi , Leelabati Toppo , Aishwarya Biradar","doi":"10.1016/j.msard.2025.106938","DOIUrl":"10.1016/j.msard.2025.106938","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106938"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842629","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}

{"title":"Real-world effectiveness and safety of ofatumumab in relapsing multiple sclerosis: A multicenter cohort study","authors":"Katarina Tešija ,&nbsp;Magdalena Krbot Skorić ,&nbsp;Vanja Bašić Kes ,&nbsp;Lucija Zadro Matovina ,&nbsp;Josip Sremec ,&nbsp;Dora Vogrinc ,&nbsp;Vladimira Vuletić ,&nbsp;David Bonifačić ,&nbsp;Sanda Pavelin ,&nbsp;Ines Lazibat ,&nbsp;Spomenka Kiđemet Piskač ,&nbsp;Dominik Piskač ,&nbsp;Andrijana Bogoje Raspopović ,&nbsp;Lidija Dežmalj Grbelja ,&nbsp;Mašan Sredanović ,&nbsp;Tereza Gabelić ,&nbsp;Barbara Barun ,&nbsp;Ivan Adamec ,&nbsp;Ivan Martinez ,&nbsp;Mario Habek","doi":"10.1016/j.msard.2026.106994","DOIUrl":"10.1016/j.msard.2026.106994","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the real-world effectiveness, safety, and tolerability of ofatumumab in people with relapsing multiple sclerosis (pwMS) in Croatia.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study in eight Croatian hospitals (March 2022–March 2025). Clinical, MRI, and laboratory data were collected before treatment initiation and every six months. Effectiveness measures included annualized relapse rate (ARR), MRI activity, and sustained accumulation of disability (SAD), and the proportion achieving no evidence of disease activity (NEDA-3). Safety assessments included adverse events (AEs), immunoglobulin levels, infections, and pregnancy outcomes.</div></div><div><h3>Results</h3><div>The study included 665 pwMS (65.6 % female; mean age 40.2 ± 10.7 years; 59.7 % treatment-naïve). Median follow-up was 1.55 years. ARR decreased from 0.70 ± 0.67 pre-treatment to 0.03 ± 0.18 post-treatment (<em>p</em> &lt; 0.001). MRI activity occurred in 17.1 % of patients; 76.7 % achieved NEDA-3. SAD was observed in 6.3 % of pwMS, with male sex as the only independent predictor. Ofatumumab discontinuation occurred in 4.2 % of patients, mainly due to pregnancy. Injection reactions occurred in 15.8 % and infections in 7.4 % (3 hospitalizations). IgG and IgM declined slightly over time, with low IgM (&lt;0.4 g/L) persisting in &gt;10 % after two years, but without correlation to infection rates. Two malignancies were observed. Pregnancy outcomes were favorable in most cases.</div></div><div><h3>Conclusion</h3><div>In a real-world Croatian cohort, ofatumumab demonstrated high effectiveness in reducing relapses and MRI activity, with a favorable safety profile over three years. These findings align with pivotal trial results, supporting ofatumumab as an effective and well-tolerated therapy for active relapsing MS in clinical practice.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106994"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034512","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}

{"title":"Association between chronological age and vascular function in adults with and without multiple sclerosis","authors":"Noah G. DuBose ,&nbsp;Sydney R. DeJonge ,&nbsp;Trevor B. Martin ,&nbsp;Petra Šilić ,&nbsp;Ariel Kidwell-Chandler ,&nbsp;Bo Fernhall ,&nbsp;Lara A. Pilutti ,&nbsp;Robert W. Motl","doi":"10.1016/j.msard.2026.106997","DOIUrl":"10.1016/j.msard.2026.106997","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is associated with vascular comorbidity that increases with age. Vascular function (VF) is associated with vascular comorbidity and outcomes such as cognition, fatigue, and disability in MS. Age predicts VF in the general population, yet this relationship is unknown in MS.</div></div><div><h3>Objectives/Methods</h3><div>This study compared MS (n=129) and controls (n=51) based on carotid-femoral pulse wave velocity (PWV) and heart rate-corrected augmentation index (AIx75) and examined age as a predictor of PWV and AIx75.</div></div><div><h3>Results</h3><div>The samples did not differ based on age, sex or body mass index (BMI). PWV was higher in MS than controls (7.2 m/s vs. 6.6 m/s), whereas AIx75 was not different (21.3 % vs. 18.7 %). Regression analysis indicated that after controlling for BMI and mean arterial pressure (MAP), age remained a significant predictor of PWV only in MS (β = 0.256, p&lt;0.01). After controlling for sex, expanded disability status scale (EDSS) scores, disease duration, and MAP, age remained a significant predictor of AIx75 in MS (β = 0.371, p&lt;0.01), as well as in controls after controlling for sex, BMI, and MAP (β = 0.347, p&lt;0.01).</div></div><div><h3>Conclusions</h3><div>These results suggest that age predicts VF in MS and establish the need for future research that examines VF across the lifespan in MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106997"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978566","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}

{"title":"Defining highly active multiple sclerosis: Survey bias and the interpretation of clinical definitions","authors":"Vihaan Sahu","doi":"10.1016/j.msard.2026.106993","DOIUrl":"10.1016/j.msard.2026.106993","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106993"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978567","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}

{"title":"Safe to stay: A longitudinal evaluation of the sequential relationship between psychological safety, work self-efficacy, fatigue, and employment exit intentions of employees with multiple sclerosis","authors":"Andrea Kirk-Brown ,&nbsp;Pieter Van Dijk ,&nbsp;Brian Cooper ,&nbsp;Ross Donohue ,&nbsp;Ingrid van der Mei","doi":"10.1016/j.msard.2026.107015","DOIUrl":"10.1016/j.msard.2026.107015","url":null,"abstract":"<div><h3>Background</h3><div>Psychosocial factors are implicated in the decision to prematurely leave employment for people with multiple sclerosis (PwMS), beyond the impact of symptoms. We longitudinally tested the sequential relationship between psychological safety (PS), work self-efficacy (WSE), and the perceived impact of fatigue on work performance predicting employment exit intentions (EI).</div></div><div><h3>Methods</h3><div>Participants (<em>n</em> = 372) were surveyed at three time points over a four-year period (86% female; mean age 46 at T1) using latent variable structural equation modelling.</div></div><div><h3>Results</h3><div>PS at T1 was positively related to WSE at T2 (β = 0.17, 95% CI: 0.05 to 0.29). WSE mediated the relationship between PS and EI (Indirect Effect (IE) = -0.03, 95% CI = -0.07 to -0.01). WSE and fatigue sequentially mediated the relationship between PS and EI (IE, -0.02, 95% CI = -0.05 to -0.01). Unexpectedly, PS directly reduced perceptions of fatigue decreasing EI. PS was directly related to EI at T3 independently of WSE and fatigue (β = -0.24, SE = 0.07, <em>p</em> &lt; .01, 95% CI: -0.10 to -0.38).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that PS represents a supportive job resource that is critical in dealing with work-related demands, which helps explain why employees leave before medically assessed disability would indicate the need to. Over time, employees who experience a work environment characterised by PS also experience higher levels of WSE and reduced perceptions of work-related fatigue, which in turn reduces the risk of prematurely leaving employment. Interventions targeting these modifiable aspects of the workplace psychosocial climate are required.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107015"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034584","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}

{"title":"A scoping review of diet-focused resources to improve depression and anxiety among people with multiple sclerosis","authors":"Georgia Brice ,&nbsp;Anthony P. James ,&nbsp;Daniel Rudaizky ,&nbsp;Lucinda J. Black ,&nbsp;Eleanor Dunlop ,&nbsp;Rebecca D. Russell","doi":"10.1016/j.msard.2026.107017","DOIUrl":"10.1016/j.msard.2026.107017","url":null,"abstract":"<div><div>Depression and anxiety are more prevalent in people with multiple sclerosis (MS) than in the general population. A high-quality diet has been shown to have beneficial effects on MS symptoms, including mental health outcomes. Adults with MS gather information from a range of resources with the aim of improving their diet and mental health. However, the development and nature of diet-focused resources aimed at improving mental health in adults with MS remain unclear. We conducted a scoping review to identify and map diet-focused resources aimed at improving depression and anxiety in adults with MS. From 956 resources screened (<em>n</em> = 834 articles and other resources retrieved from databases; <em>n</em> = 98 resources retrieved from websites; <em>n</em> = 17 resources retrieved from organisations; <em>n</em> = 7 retrieved from citation searching), 64 were included (<em>n</em> = 42 resources from organisations or web searches, e.g., podcast episodes, blog posts, web articles; <em>n</em> = 20 peer-reviewed articles; <em>n</em> = 1 mobile application in development; <em>n</em> = 1 book). Resources mentioned an extensive range of dietary information linked to depression and anxiety for people with MS. These resources involved a combination of input from experts (<em>n</em> = 54), organisations (<em>n</em> = 23), lived experience (<em>n</em> = 22), authors/journalists (<em>n</em> = 5), or co-design (<em>n</em> = 1); however, six resources were based solely on lived experience. Twenty resources were not directly accessible to people with MS. There is a need to develop co-designed and accessible diet-focused resources to improve mental health in people with MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107017"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034630","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}

{"title":"Clinical and diagnostic characteristics of autoimmune, infectious, and cryptogenic central nervous system vasculitis at a tertiary care center","authors":"Gerome B. Vallejos ,&nbsp;Jackson A. Roberts ,&nbsp;Carla Y. Kim ,&nbsp;Kiran T. Thakur ,&nbsp;Kathryn B. Holroyd","doi":"10.1016/j.msard.2026.106970","DOIUrl":"10.1016/j.msard.2026.106970","url":null,"abstract":"<div><h3>Background</h3><div>Central nervous system (CNS) vasculitis is a rare, diagnostically challenging disorder involving inflammation of cerebral arteries. Differentiating infectious from autoimmune etiologies is difficult due to nonspecific presentations and limited tools. We characterized CNS vasculitis cases at a tertiary care center to identify distinguishing features by etiology.</div></div><div><h3>Methods</h3><div>Patients admitted to Columbia University Irving Medical Center between 2020–2024 with an ICD diagnosis of CNS vasculitis were reviewed. Cases were classified as infectious, autoimmune, or cryptogenic based on clinical, laboratory, radiographic, and pathologic data. Demographics, symptoms, cerebrospinal fluid (CSF) findings, neuroimaging, treatments, and outcomes were analyzed with nonparametric testing.</div></div><div><h3>Results</h3><div>Of 43 included cases, the mean age was 45.7 years; 51.2 % male; 44.2 % immunocompromised; median symptom duration 7 days. Etiologies were infectious (14 %), autoimmune (30 %), and cryptogenic (56 %), with definitive diagnosis in 23.3 %. Headache, cognitive dysfunction, and motor symptoms were common. CSF parameters did not significantly differ across groups (median protein 53 mg/dL; glucose 79 mg/dL; RBC 60/µL; WBC 3/µL). Vessel narrowing occurred in 81.4 %; involvement of &gt;2 vessels was more frequent in infectious (50 %) and cryptogenic (41.7 %) vs autoimmune (0 %) cases (<em>p</em> = 0.016). Cryptogenic cases more often showed ischemia (75 %), hemorrhage (25 %), and FLAIR hyperintensities (75 %) (<em>p</em> &lt; 0.010). Biopsy was performed in 27.9 %. Steroids were given in 97.4 % and disease-modifying therapies in 25.6 %.</div></div><div><h3>Conclusions</h3><div>Despite extensive testing, definitive diagnosis of CNS vasculitis remains difficult. While clinical and CSF features lacked discriminatory value, vascular and imaging patterns differed by etiology, highlighting the need for improved biomarkers and imaging strategies.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106970"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934402","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}

{"title":"A comparative study of gait pattern characteristics between individuals with multiple sclerosis and healthy individuals during anticipatory postural adjustment and gait initiation: A scoping review","authors":"Narges Jahantigh Akbari ,&nbsp;Fatemeh Ehsani ,&nbsp;Marzieh Mortezaejad ,&nbsp;Mohammad Yousefi ,&nbsp;Khorshid Bijari","doi":"10.1016/j.msard.2025.106949","DOIUrl":"10.1016/j.msard.2025.106949","url":null,"abstract":"<div><div>Individuals diagnosed with multiple sclerosis (MS) are known to face more challenging situations, such as gait initiation (GI), compared to healthy individuals. This provides a deeper insight into the mechanisms that govern dynamic postural control. A search was conducted across several databases, including PubMed, Cochrane, ScienceDirect, Web of Science, Scopus, ProQuest, and Google Scholar. Studies of any design were included if they satisfied the following criteria: the experimental group consisted of individuals with MS or clinically isolated syndrome, the control group included healthy individuals or MS patients, and the studies examined gait patterns across various parameters, such as the center of pressure (COP), center of mass, and anticipatory postural adjustments, while also assessing the gait initiation phase. Utilizing the modified Downs and Black checklist, nine articles were selected for the final analysis. The results indicated deceleration, a reduction in posterior COP displacement, and an increase in COP during anterior GI. Compared with healthy controls, individuals with MS exhibited greater instability during balance recovery and in kinetic parameters of the stance limb. Furthermore, a delay and reduction in muscle activity were noted in individuals with MS who had a history of falls, in contrast to non-falling MS patients and healthy individuals.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106949"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940036","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}