Surgery for Obesity and Related Diseases最新文献

{"title":"A prospective assessment of weight bias internalization in patients seeking body contouring after bariatric surgery","authors":"Ashley Dunford Ph.D ,&nbsp;Abigail Metzler B.A. ,&nbsp;Brian Pittman M.S. ,&nbsp;Michael Alperovich M.D. ,&nbsp;Gary Price M.D. ,&nbsp;Valentina Ivezaj Ph.D.","doi":"10.1016/j.soard.2025.06.020","DOIUrl":"10.1016/j.soard.2025.06.020","url":null,"abstract":"<div><h3>Background</h3><div>Weight bias internalization (WBI), or the internalization of “antifat” attitudes, is associated with greater eating-disorder psychopathology, body image, and mental health concerns in patients following bariatric surgery. Yet, WBI in patients seeking body contouring surgery (BCS) after bariatric surgery remains unstudied.</div></div><div><h3>Objectives</h3><div>This study prospectively examined the relationship between WBI, eating-disorder psychopathology, and depressive symptoms in patients seeking BCS after bariatric surgery.</div></div><div><h3>Setting</h3><div>Yale University School of Medicine, United States</div></div><div><h3>Methods</h3><div>Participants were 56 adults (93% female) seeking consultation for BCS after bariatric surgery; 42.9% (n = 24) went on to have BCS. Participants completed established measures assessing WBI, eating-disorder psychopathology, and depressive symptoms at baseline following the BCS consultation, then repeated at 1-month and 3-month follow-ups.</div></div><div><h3>Results</h3><div>WBI was positively associated with eating-disorder psychopathology and depression at all assessments (all <em>P</em> &lt; .01) including baseline (all <em>r</em> &gt; .40), 1-month (all <em>r</em> &gt; .33), and 3-month (all <em>r</em> &gt; .45) follow-ups. In a prospective analysis of WBI, a significant group by time interaction was observed (<em>P</em> = .03) owing to lower postbaseline levels among BCS at both 1-month (<em>P</em> = .03) and 3-months (<em>P</em> = .009) assessments. Groups with and without BCS did not differ significantly on body mass index (BMI), weight loss, or eating-disorder psychopathology.</div></div><div><h3>Conclusions</h3><div>WBI is associated significantly with greater eating-disorder psychopathology and depressive symptoms, but not BMI or weight loss, in patients seeking BCS after bariatric surgery. Group differences in WBI at 1-month and 3-month follow-ups suggest that BCS may help reduce WBI independent of BMI. Bariatric teams should be aware that higher WBI may persist for patients unable to obtain BCS.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages 1350-1356"},"PeriodicalIF":3.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056506","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":"Metabolic and bariatric surgery in adolescents compared to young adults: an MBSAQIP database analysis","authors":"Mark Shacker B.A. ,&nbsp;Stephanie D. Chao M.D. ,&nbsp;Justine O. Chinn M.D. ,&nbsp;Gillian L. Fell M.D., Ph.D. ,&nbsp;Claudia M. Mueller M.D., Ph.D. ,&nbsp;Janey S.A. Pratt M.D.","doi":"10.1016/j.soard.2025.08.010","DOIUrl":"10.1016/j.soard.2025.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic and bariatric surgery (MBS) is a highly durable, safe and effective treatment for severe obesity in adults. However, MBS remains underutilized in the pediatric and adolescent population, likely due to safety concerns of elective surgery in children.</div></div><div><h3>Objectives</h3><div>We aimed to analyze whether the benefits of MBS outweigh the risks in adolescents when compared to young adults.</div></div><div><h3>Setting</h3><div>Multicenter, national database study.</div></div><div><h3>Methods</h3><div>Patients aged 10-39 who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Patients with prior foregut surgery were excluded.</div></div><div><h3>Results</h3><div>556,628 patients were identified; 10,883 (2.0%) were aged 10-19 (adolescents), 161,938 (29.1%) were 20-29 (young adults), and 383,807 (69.0%) were 30-39 (adults). Preoperative body mass index (BMI) was clinically similar between groups, though statistically significant due to large sample size (10-19: 46, 20-29: 45, 30-39: 45 kg/m², <em>P</em> &lt; .001). SG was more common in younger cohorts (10-19: 86%, 20-29: 77%, 30-39: 75%, <em>P</em> &lt; .001). At 30 days postoperatively, adolescents demonstrated marginally greater BMI reduction (10-19: 2.91, 20-29: 2.69, 30-39: 2.53 kg/m², <em>P</em> &lt; .001). Adolescents had fewer postoperative complications, including surgical site infections, gastrointestinal bleeding, and blood transfusions (<em>P</em> &lt; .001). Among adolescents, SG (aOR: .39, CI: .31-.48, <em>P</em> &lt; .001) was associated with reduced postoperative complications.</div></div><div><h3>Conclusions</h3><div>Adolescents undergoing MBS have BMI reductions similar to those of young adults and have lower rates of complications and readmissions. MBS should be offered as a safe treatment for adolescents to treat morbid obesity with at least similar frequency as it is offered to adults.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages 1334-1341"},"PeriodicalIF":3.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058775","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":"Predictors of dehydration requiring outpatient intervention following bariatric surgery","authors":"Mélissa V. Wills M.D. ,&nbsp;Jack Loesch B.A. ,&nbsp;Juan S. Barajas-Gamboa M.D. ,&nbsp;Gabriela Restrepo-Rodas M.D. ,&nbsp;Pattharasai Kachornvitaya M.D. ,&nbsp;Andrew Strong M.D. ,&nbsp;Salvador Navarrete M.D. ,&nbsp;Jerry Dang M.D., Ph.D. ,&nbsp;Matthew Kroh M.D. ,&nbsp;Valentin Mocanu M.D., Ph.D.","doi":"10.1016/j.soard.2025.08.013","DOIUrl":"10.1016/j.soard.2025.08.013","url":null,"abstract":"<div><h3>Background</h3><div>Dehydration is a common cause of emergency department visits and readmissions following bariatric surgery. Despite the increasing use of outpatient rehydration therapy (ORT) to manage this complication, predictors of ORT utilization remain poorly understood.</div></div><div><h3>Objectives</h3><div>To identify independent predictors of ORT utilization following bariatric surgery and examine its relationship with same-day discharge (SDS) protocols.</div></div><div><h3>Setting</h3><div>Analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database across accredited bariatric surgical centers.</div></div><div><h3>Methods</h3><div>We analyzed Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data from 2020–2023 for adult patients who underwent primary laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB). Multivariable logistic regression identified independent predictors of ORT utilization.</div></div><div><h3>Results</h3><div>Of 692,525 patients, 26,215 (3.8%) required ORT. These patients were younger (41.5 ± 11.3 versus 43.2 ± 11.8 years, <em>P</em> &lt; .001), had higher body mass index (45.3 ± 7.4 versus 45.1 ± 7.7 kg/m², <em>P</em> &lt; .001), and were more likely to be female (90.0% versus 81.8%, <em>P</em> &lt; .001). ORT rates were higher among RYGB versus sleeve gastrectomy patients (4.3% versus 3.6%, <em>P</em> &lt; .001). SDS patients comprised 7.5% of the cohort but 12.6% of those requiring ORT. Independent predictors of ORT included younger age (odds ratio [OR]: .86 per 10 years), female sex (OR: 1.94), SDS (OR: 2.04), Black race (OR: 1.25), and RYGB (OR: 1.19) (all <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Identifying predictors of ORT use supports effective implementation of SDS protocols through strategic resource allocation. ORT represents a cost-effective approach that enables the benefits of accelerated discharge pathways while preventing costly readmissions. These findings can help bariatric programs optimize outpatient hydration services for high-risk patients, enhancing the overall efficiency and value of care delivery.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages 1308-1315"},"PeriodicalIF":3.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093142","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 technology-based intervention to reduce alcohol use after metabolic and bariatric surgery: feasibility, acceptability, and preliminary outcomes","authors":"Lisa R. Miller-Matero Ph.D. ,&nbsp;Celeste Pappas M.P.H. ,&nbsp;Brittany Christopher B.A. ,&nbsp;Roman Grossi B.A. ,&nbsp;Alyssa Vanderziel Ph.D. ,&nbsp;Nancy P. Barnett Ph.D. ,&nbsp;Roland S. Moore Ph.D. ,&nbsp;Aaron Hamann Psy.D. ,&nbsp;Arthur M. Carlin M.D. ,&nbsp;Oliver A. Varban M.D. ,&nbsp;Jordan M. Braciszewski Ph.D.","doi":"10.1016/j.soard.2025.08.014","DOIUrl":"10.1016/j.soard.2025.08.014","url":null,"abstract":"<div><h3>Background</h3><div>Patients who undergo metabolic and bariatric surgery (MBS) are at increased risk for an alcohol use disorder. A technology-based intervention, rooted in motivational interviewing, could broadly reach patients after MBS and has the potential to reduce alcohol use.</div></div><div><h3>Objective</h3><div>Examine the feasibility, acceptability, and preliminary outcomes of a technology-based intervention to reduce alcohol use delivered after MBS.</div></div><div><h3>Setting</h3><div>Health system.</div></div><div><h3>Methods</h3><div>Participants (N = 60) who were 3-18 months post-MBS were randomized to the intervention or treatment-as-usual control group. The tailored intervention consisted of 2 (15-minute) sessions of interactive web-based content followed by 3-months of daily text messaging. Participants completed baseline and a postintervention assessment (91.7% retention).</div></div><div><h3>Results</h3><div>Participants were primarily female (90%), White (55.0%) or Black (43.3%), with a mean age of 44.6 years (SD = 10.4). Of those randomized to the intervention (n = 24), 83.3% (n = 20) began the intervention and 95% (n = 19) completed it. The majority of participants rated all intervention components positively and 100% agreed that other patients would use the intervention. The intervention group reported a significant increase in level of motivation to avoid alcohol use from baseline to postintervention (<em>P</em> = .02), whereas the control group did not show a significant change (<em>P</em> = .73). At the postintervention, the intervention group had significantly fewer participants endorsing alcohol use than the control group (43.5% versus 75%; X² = 5.63, <em>P</em> = .02).</div></div><div><h3>Conclusion</h3><div>A technology-based intervention delivered after MBS was feasible, acceptable, and showed promising preliminary outcomes for increasing motivation to avoid alcohol use as well as reducing alcohol use.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages 1363-1369"},"PeriodicalIF":3.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984605","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":"Revising the sleeve: a clearer picture emerges in the sleeve gastrectomy-to-roux-en-Y gastric bypass landscape","authors":"Eric Velazquez M.D., M.B.A., F.A.C.S., F.A.S.M.B.S.","doi":"10.1016/j.soard.2025.08.002","DOIUrl":"10.1016/j.soard.2025.08.002","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages e27-e28"},"PeriodicalIF":3.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056492","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":"Diabetes status and not preoperative glycemic control is associated with postoperative outcomes in metabolic/bariatric surgery","authors":"Florina Corpodean M.D. ,&nbsp;Michael Kachmar D.O. ,&nbsp;Denise Danos Ph.D. ,&nbsp;Philip R. Schauer M.D. ,&nbsp;Vance L. Albaugh M.D., Ph.D.","doi":"10.1016/j.soard.2025.07.018","DOIUrl":"10.1016/j.soard.2025.07.018","url":null,"abstract":"<div><h3>Background</h3><div>Elevated hemoglobin A1C (HbA1C) is a surrogate for poor glycemic control, but its association with outcomes in metabolic surgery is not well established with respect to diabetes severity. This study aimed to extend prior evidence and evaluate the influence of preoperative HbA1C on postsurgical outcomes in patients undergoing primary laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB), hypothesizing that poor glycemic control and/or worse diabetes severity would lead to increased postoperative complications.</div></div><div><h3>Objectives</h3><div>Identify the association of HbA1C or diabetes status on postoperative complications.</div></div><div><h3>Setting</h3><div>Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) database (2017–2022).</div></div><div><h3>Methods</h3><div>Primary SG and RYGB cases were analyzed in patients with diabetes (n = 106,486), identified by a known diagnosis or preoperative HbA1C ≥ 6.5%. Multivariate logistic regression models with generalized estimating equations were used to assess the effects of preoperative HbA1C on clinical outcomes, controlling for demographics, procedure type, and co-morbidities.</div></div><div><h3>Results</h3><div>Similar to smaller studies, no significant association was found between preoperative HbA1C levels and clinical outcomes for SG or RYGB. In contrast, subset analysis revealed increased odds ratios (ORs) for serious complications in both noninsulin-using (OR: 1.04, 95% confidence interval [CI]: 1.00–1.09) and insulin-using (OR: 1.07, 95% CI: 1.03–1.12) patients with diabetes. Insulin-using diabetes was also associated with an increased risk of infectious complications (OR: 1.05, 95% CI: 1.01–1.10). Stratification by procedure type showed that the association was significant only for RYGB (OR: 1.08, 95% CI: 1.02–1.14).</div></div><div><h3>Conclusions</h3><div>Increased preoperative HbA1C levels are not associated with increased risk for complications overall; however, higher HbA1C in patients with insulin-using diabetes, which is suggestive of more advanced disease, is associated with an increased risk of serious and infectious complications following RYGB. While preoperative glycemic control does not lead to poor outcomes, this study demonstrates that patients with more severe diabetes do have slightly higher risk of complications but that risk is not modifiable and intrinsic to their chronic disease status.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 12","pages":"Pages 1342-1349"},"PeriodicalIF":3.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056520","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":"Paired editorial on sleeve to gastric bypass conversion: a multi-institutional study of 217 patients","authors":"Enrico Facchiano M.D., Ph.D.,&nbsp;Emanuele Soricelli M.D., Ph.D.","doi":"10.1016/j.soard.2025.08.003","DOIUrl":"10.1016/j.soard.2025.08.003","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1196-1197"},"PeriodicalIF":3.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984527","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":"Perioperative safety profile of single anastomosis duodeno-ileal bypass and Roux-en-Y gastric bypass after sleeve gastrectomy","authors":"Emiliano G. Manueli Laos M.D. ,&nbsp;Lily Zhang ,&nbsp;Reed Berger M.D. ,&nbsp;Francesco Bianco M.D. ,&nbsp;Khaled Abdelhady M.D. ,&nbsp;Francisco Schlottmann M.D., M.P.H. ,&nbsp;Mario A. Masrur M.D., F.A.C.S., F.A.S.M.B.S.","doi":"10.1016/j.soard.2025.07.019","DOIUrl":"10.1016/j.soard.2025.07.019","url":null,"abstract":"<div><h3>Background</h3><div>Although metabolic and bariatric surgery (MBS) is highly effective for weight management, revisional procedures are often needed after sleeve gastrectomy (SG). While Roux-en-Y gastric bypass (RYGB) has historically been the most commonly performed revisional procedure, single anastomosis duodeno-ileal bypass (SADI) is a more recently endorsed alternative.</div></div><div><h3>Objective</h3><div>To compare the safety profile of revisional RYGB and SADI after SG in the first postoperative 30 days.</div></div><div><h3>Setting</h3><div>United States of America.</div></div><div><h3>Methods</h3><div>Using the 2022-2023 MBSAQIP database, patients undergoing revisional RYGB or SADI after SG were identified and matched using propensity scores. Demographic, medical, and perioperative variables were analyzed, including length of stay, operative time, complications, and 30-day readmission, reoperation, and mortality rates.</div></div><div><h3>Results</h3><div>After propensity score matching, a total of 6108 patients were included; 4581 (75.0%) to RYGB group and 1527 (25.0%) to SADI group. Operative times were longer for RYGB (<em>P</em> = .03). Mean length of stay was 1.57 ± 1.84 days for RYGB and 1.44 ± 1.28 days for SADI (<em>P</em> &lt; .01) Postoperative bowel obstruction was more common after RYGB (.9% vs .3%, <em>P</em> = .01). RYGB 30-day readmission rate was 5.5% and reoperation rate was 1.8%. SADI 30-day readmission rate was 4.3% and reoperation rate was 2.2% (<em>P</em> = .06 for readmission rates; <em>P</em> = .3 for reoperation rates). Thirty-day mortality was similarly low in both groups (Group 1: .2%, Group 2: .1%, <em>P</em> &gt; .7).</div></div><div><h3>Conclusion</h3><div>Revisional RYGB and SADI after SG are both safe and associated with low morbidity in a short-term period. However, SADI may offer advantages over RYGB for its lower risk of postoperative bowel obstruction.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1256-1263"},"PeriodicalIF":3.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984530","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":"Response to the letter to the editor regarding “role of bariatric surgery in patients with advanced heart failure”","authors":"Darae Kim M.D., Ph.D.,&nbsp;In-Cheol Kim M.D., Ph.D.,&nbsp;Jong-Chan Youn M.D., Ph.D.,&nbsp;Jon A. Kobashigawa M.D.","doi":"10.1016/j.soard.2025.08.009","DOIUrl":"10.1016/j.soard.2025.08.009","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1287-1288"},"PeriodicalIF":3.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984581","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":"Comments on: prevalence of dysphagia after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a national propensity score study","authors":"Samuel D. Butensky M.D.,&nbsp;Saber Ghiassi M.D., M.P.H., F.A.C.S., F.A.S.M.B.S.","doi":"10.1016/j.soard.2025.08.006","DOIUrl":"10.1016/j.soard.2025.08.006","url":null,"abstract":"","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"21 11","pages":"Pages 1188-1189"},"PeriodicalIF":3.8,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984578","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}