Pub Date : 2024-06-11DOI: 10.2340/actadv.v104.19663
Danielle Rogner, Laura Heimerl, Tilo Biedermann, Elke Sattler, Alexander Zink
The MDHHgermany registry was initiated to characterize the "real-life" situation of affected individuals with Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH), including their treatment and healthcare. To gain deeper insights into medical care of patients with DD, various aspects such as demographics, subjective symptoms, patient satisfaction with medical care, past and current therapies were explored. Patients with diagnosed DD were included. Subjective symptoms such as itch, pain and burning sensation were assessed. Individual therapy goals were recorded and patients assessed previous/current therapies along with satisfaction of medical care and treatment. A total of 55 patients were recruited; 47 patients were eligible for the analysis. Pruritus was rated the most bothersome symptom. Some 42.6% had not received systemic treatment so far or systemic therapies were rated ineffective (32.6%). Most commonly oral retinoids were prescribed, followed by corticosteroids. Patient satisfaction with medical care and treatment proved to be mediocre. This "real-life" data show an alarming unmet need regarding patients' satisfaction with medical care and treatment, evidenced by the reported lack of disease control. Further studies and interventions are needed to improve the spectrum of available therapies. MDHHgermany provides a foundational platform for future clinical trials, epidemiological studies, and pathophysiological analyses.
{"title":"Unmet Needs in Darier's Disease from a Patient's Perspective: Lessons Learnt from the German Registry.","authors":"Danielle Rogner, Laura Heimerl, Tilo Biedermann, Elke Sattler, Alexander Zink","doi":"10.2340/actadv.v104.19663","DOIUrl":"10.2340/actadv.v104.19663","url":null,"abstract":"<p><p>The MDHHgermany registry was initiated to characterize the \"real-life\" situation of affected individuals with Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH), including their treatment and healthcare. To gain deeper insights into medical care of patients with DD, various aspects such as demographics, subjective symptoms, patient satisfaction with medical care, past and current therapies were explored. Patients with diagnosed DD were included. Subjective symptoms such as itch, pain and burning sensation were assessed. Individual therapy goals were recorded and patients assessed previous/current therapies along with satisfaction of medical care and treatment. A total of 55 patients were recruited; 47 patients were eligible for the analysis. Pruritus was rated the most bothersome symptom. Some 42.6% had not received systemic treatment so far or systemic therapies were rated ineffective (32.6%). Most commonly oral retinoids were prescribed, followed by corticosteroids. Patient satisfaction with medical care and treatment proved to be mediocre. This \"real-life\" data show an alarming unmet need regarding patients' satisfaction with medical care and treatment, evidenced by the reported lack of disease control. Further studies and interventions are needed to improve the spectrum of available therapies. MDHHgermany provides a foundational platform for future clinical trials, epidemiological studies, and pathophysiological analyses.</p>","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.2340/actadv.v104.34882
Natalia Ratusznik, Sofie Marie Edslev, Marc Stegger, Bo Söderquist
Patients with atopic dermatitis (AD) are more likely than healthy individuals to harbour Staphylococcus aureus on their skin. Superantigens (SAgs) produced by specific S. aureus strains may contribute to AD-associated skin inflammation. The present study compared the prevalence and types of SAg-encoding genes between S. aureus isolated from patients with AD and from controls, and within the AD group between isolates from different sampling sites (lesional skin, non-lesional skin, and nares). This retrospective case-control study extracted data from 2 previous studies that examined S. aureus using whole-genome sequencing. The 138 S. aureus isolates obtained from 71 AD patients contained 349 SAg-encoding genes; 22 (6.3%) were found in isolates from nares (0.4 ± 0.6 genes per isolate), 99 (28.4%) in isolates from non-lesional skin (3.7 ± 3.9), and 228 (65.3%) in isolates from lesional skin (4.2 ± 4.5). S. aureus (n = 101) from the control group contained 594 SAg-encoding genes (5.9 ± 4.2). Of the S. aureus isolated from lesional AD skin, 69% carried at least 1 gene encoding SAg compared with 33% of AD nasal isolates. SAg could be a factor in the pathogenesis of a subset of AD patients.
与健康人相比,特应性皮炎(AD)患者的皮肤上更容易携带金黄色葡萄球菌。由特定金黄色葡萄球菌菌株产生的超级抗原(SAgs)可能会导致与特应性皮炎相关的皮肤炎症。本研究比较了从 AD 患者和对照组中分离出的金黄色葡萄球菌以及 AD 组中从不同取样部位(病变皮肤、非病变皮肤和鼻腔)分离出的金黄色葡萄球菌的 SAg 编码基因的流行率和类型。这项回顾性病例对照研究从之前两项使用全基因组测序法检测金黄色葡萄球菌的研究中提取了数据。从71名AD患者中分离出的138株金黄色葡萄球菌含有349个SAg编码基因;其中22株(6.3%)来自鼻腔(每株0.4±0.6个基因),99株(28.4%)来自非皮损皮肤(3.7±3.9个基因),228株(65.3%)来自皮损皮肤(4.2±4.5个基因)。对照组的金黄色葡萄球菌(n = 101)含有 594 个 SAg 编码基因(5.9 ± 4.2)。从AD病变皮肤分离出的金黄色葡萄球菌中,69%至少携带1个编码SAg的基因,而AD鼻腔分离物中这一比例为33%。SAg可能是导致部分AD患者发病的一个因素。
{"title":"Superantigen Encoding Genes in Staphylococcus aureus Isolated from Lesional Skin, Non-Lesional Skin, and Nares of Patients with Atopic Dermatitis.","authors":"Natalia Ratusznik, Sofie Marie Edslev, Marc Stegger, Bo Söderquist","doi":"10.2340/actadv.v104.34882","DOIUrl":"10.2340/actadv.v104.34882","url":null,"abstract":"<p><p>Patients with atopic dermatitis (AD) are more likely than healthy individuals to harbour Staphylococcus aureus on their skin. Superantigens (SAgs) produced by specific S. aureus strains may contribute to AD-associated skin inflammation. The present study compared the prevalence and types of SAg-encoding genes between S. aureus isolated from patients with AD and from controls, and within the AD group between isolates from different sampling sites (lesional skin, non-lesional skin, and nares). This retrospective case-control study extracted data from 2 previous studies that examined S. aureus using whole-genome sequencing. The 138 S. aureus isolates obtained from 71 AD patients contained 349 SAg-encoding genes; 22 (6.3%) were found in isolates from nares (0.4 ± 0.6 genes per isolate), 99 (28.4%) in isolates from non-lesional skin (3.7 ± 3.9), and 228 (65.3%) in isolates from lesional skin (4.2 ± 4.5). S. aureus (n = 101) from the control group contained 594 SAg-encoding genes (5.9 ± 4.2). Of the S. aureus isolated from lesional AD skin, 69% carried at least 1 gene encoding SAg compared with 33% of AD nasal isolates. SAg could be a factor in the pathogenesis of a subset of AD patients.</p>","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.2340/actadv.v104.24213
Assaf A Zeltzer, Aviad Keren, Ralf Paus, Amos Gilhar
{"title":"Topical Minoxidil Rejuvenates Hair Follicles from Men with Androgenetic Alopecia in Vivo.","authors":"Assaf A Zeltzer, Aviad Keren, Ralf Paus, Amos Gilhar","doi":"10.2340/actadv.v104.24213","DOIUrl":"10.2340/actadv.v104.24213","url":null,"abstract":"","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.2340/actadv.v104.39822
Yiting Li, Xi Tan, Shu Nie, Xin Tian, Zhouwei Wu
{"title":"Real-world Experience of Abrocitinib on Difficult-to-treat Hand Eczema in Chinese Patients.","authors":"Yiting Li, Xi Tan, Shu Nie, Xin Tian, Zhouwei Wu","doi":"10.2340/actadv.v104.39822","DOIUrl":"10.2340/actadv.v104.39822","url":null,"abstract":"","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.2340/actadv.v104.40419
Nidia Planella-Fontanillas, David Pesqué, Laura Parra-Navarro, Ramon M Pujol
{"title":"A 71-year-old Woman with CREST Syndrome and Multiple Waxy Facial Papules and Plaques: A Quiz.","authors":"Nidia Planella-Fontanillas, David Pesqué, Laura Parra-Navarro, Ramon M Pujol","doi":"10.2340/actadv.v104.40419","DOIUrl":"10.2340/actadv.v104.40419","url":null,"abstract":"","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.2340/actadv.v104.40377
Daoning Zhang, Pingping Lin, Hang Li
{"title":"An Asymptomatic Brown Plaque on the Face: A Quiz.","authors":"Daoning Zhang, Pingping Lin, Hang Li","doi":"10.2340/actadv.v104.40377","DOIUrl":"10.2340/actadv.v104.40377","url":null,"abstract":"","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.2340/actadv.v104.40665
Alexis B Lyons, Mardeen S Karim, Tasneem F Mohammad
{"title":"Fragmented Facial Flushing: A Quiz.","authors":"Alexis B Lyons, Mardeen S Karim, Tasneem F Mohammad","doi":"10.2340/actadv.v104.40665","DOIUrl":"10.2340/actadv.v104.40665","url":null,"abstract":"","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term Efficacy of Dupilumab in Papulo-erythroderma of Ofuji.","authors":"Clélia Vanhaecke, Laurence Gusdorf, Manuelle Viguier","doi":"10.2340/actadv.v104.40220","DOIUrl":"10.2340/actadv.v104.40220","url":null,"abstract":"","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atopic diseases such as atopic dermatitis, food allergy, allergic rhinoconjunctivitis, and/or asthma are common. In Denmark, however, there are multiple referral pathways for these diseases in the healthcare system and they are poorly understood. To describe how children with atopic diseases navigate their way through the Danish healthcare system, a questionnaire was distributed to children aged ≤ 17 years, who were being treated for atopic diseases between August 2020 and June 2021, either by a practising specialist or a hospital department, in the Capital Region of Denmark. A total of 279 children completed the questionnaire and most were referred to a specialist or to a hospital by their general practitioner. No "common track" to hospital existed for patients with ≥ 3 atopic diseases. These patients were more often referred to a hospital compared with children with 2 atopic diseases or fewer (odds ratio [OR] 3.79; 95% CI 2.07-7.24). The primary determinants for hospital treatment were food allergy (OR 4.69; 95% CI 2.07-10.61) and asthma (OR 2.58; 95% CI 1.18-5.63). In conclusion, children with multiple atopic diseases were more likely to be referred to hospital departments than to practising specialists, mainly due to food allergies.
特应性皮炎、食物过敏、过敏性鼻结膜炎和/或哮喘等特应性疾病很常见。然而,在丹麦,这些疾病在医疗系统中有多种转诊途径,而且人们对这些途径的了解甚少。为了描述特应性疾病患儿如何通过丹麦医疗系统进行治疗,我们向丹麦首都地区年龄小于17岁、在2020年8月至2021年6月期间接受特应性疾病治疗的儿童发放了一份调查问卷,这些儿童均由专科医生或医院科室负责治疗。共有 279 名儿童填写了调查问卷,其中大部分儿童是由全科医生转诊至专科医生或医院的。对于患有≥3种特应性疾病的患者来说,并不存在转院的 "共同途径"。与患有两种或两种以下特应性疾病的儿童相比,这些患者更常被转诊到医院(几率比 [OR] 3.79;95% CI 2.07-7.24)。医院治疗的主要决定因素是食物过敏(OR 4.69;95% CI 2.07-10.61)和哮喘(OR 2.58;95% CI 1.18-5.63)。总之,患有多种特应性疾病的儿童更有可能被转诊到医院科室,而不是执业专科医生,主要原因是食物过敏。
{"title":"Referral Pathways for Children with Atopic Diseases in Denmark.","authors":"Gitte Færk, Malin Glindvad Ahlström, Viktoria Helt-Eggers Lura, Susanne Reventlow, Jeanne Duus Johansen, Jacob P Thyssen, Kirsten Skamstrup Hansen, Lone Skov","doi":"10.2340/actadv.v104.34961","DOIUrl":"10.2340/actadv.v104.34961","url":null,"abstract":"<p><p>Atopic diseases such as atopic dermatitis, food allergy, allergic rhinoconjunctivitis, and/or asthma are common. In Denmark, however, there are multiple referral pathways for these diseases in the healthcare system and they are poorly understood. To describe how children with atopic diseases navigate their way through the Danish healthcare system, a questionnaire was distributed to children aged ≤ 17 years, who were being treated for atopic diseases between August 2020 and June 2021, either by a practising specialist or a hospital department, in the Capital Region of Denmark. A total of 279 children completed the questionnaire and most were referred to a specialist or to a hospital by their general practitioner. No \"common track\" to hospital existed for patients with ≥ 3 atopic diseases. These patients were more often referred to a hospital compared with children with 2 atopic diseases or fewer (odds ratio [OR] 3.79; 95% CI 2.07-7.24). The primary determinants for hospital treatment were food allergy (OR 4.69; 95% CI 2.07-10.61) and asthma (OR 2.58; 95% CI 1.18-5.63). In conclusion, children with multiple atopic diseases were more likely to be referred to hospital departments than to practising specialists, mainly due to food allergies.</p>","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-30DOI: 10.2340/actadv.v104.40090
Jamila Hess, Marjam-Jeanette Barysch-Bonderer, Corsin Seeli, Julia Laube, Adhideb Ghosh, Julia Deinsberger, Benedikt Weber, Jürg Hafner, Barbara Meier-Schiesser
Martorell hypertensive ischaemic leg ulcer (Martorell HYTILU) is a rare but significant cause of distal leg ulcers. Although hypertension and diabetes are known factors in its development, the precise pathogenesis of Martorell HYTILU remains elusive. To reach a better understanding of Martorell HYTILU, transcriptomic analysis was conducted through RNA sequencing and immunohistochemical comparison of Martorell HYTILU (n = 17) with chronic venous ulcers (n = 4) and healthy skin (n = 4). Gene expression analysis showed a marked activation of immune-related pathways in both Martorell HYTILU and chronic venous ulcers compared with healthy skin. Notably, neutrophil activity was substantially higher in Martorell HYTILU. While pathway analysis revealed a mild downregulation of several immune pathways in Martorell HYTILU compared with chronic venous ulcers, keratinization, cornification, and epidermis development were significantly upregulated in Martorell HYTILU. Additionally, STAC2, a gene encoding for a protein promoting the expression of the calcium channel Cav1.1, was significantly upregulated in Martorell HYTILU and was detected perivascularly in situ (Martorell HYTILU n = 24; chronic venous ulcers n = 9, healthy skin n = 11). The high expression of STAC2 in Martorell HYTILU suggests that increased calcium influx plays an important role in the pathogenesis of the disease. Consequently, calcium channel antagonists could be a promising treatment avenue for Martorell HYTILU.
{"title":"Identifying Key Drivers in the Pathogenesis of Martorell Hypertensive Ischaemic Leg Ulcer: A Comparative Analysis with Chronic Venous Leg Ulcer.","authors":"Jamila Hess, Marjam-Jeanette Barysch-Bonderer, Corsin Seeli, Julia Laube, Adhideb Ghosh, Julia Deinsberger, Benedikt Weber, Jürg Hafner, Barbara Meier-Schiesser","doi":"10.2340/actadv.v104.40090","DOIUrl":"10.2340/actadv.v104.40090","url":null,"abstract":"<p><p>Martorell hypertensive ischaemic leg ulcer (Martorell HYTILU) is a rare but significant cause of distal leg ulcers. Although hypertension and diabetes are known factors in its development, the precise pathogenesis of Martorell HYTILU remains elusive. To reach a better understanding of Martorell HYTILU, transcriptomic analysis was conducted through RNA sequencing and immunohistochemical comparison of Martorell HYTILU (n = 17) with chronic venous ulcers (n = 4) and healthy skin (n = 4). Gene expression analysis showed a marked activation of immune-related pathways in both Martorell HYTILU and chronic venous ulcers compared with healthy skin. Notably, neutrophil activity was substantially higher in Martorell HYTILU. While pathway analysis revealed a mild downregulation of several immune pathways in Martorell HYTILU compared with chronic venous ulcers, keratinization, cornification, and epidermis development were significantly upregulated in Martorell HYTILU. Additionally, STAC2, a gene encoding for a protein promoting the expression of the calcium channel Cav1.1, was significantly upregulated in Martorell HYTILU and was detected perivascularly in situ (Martorell HYTILU n = 24; chronic venous ulcers n = 9, healthy skin n = 11). The high expression of STAC2 in Martorell HYTILU suggests that increased calcium influx plays an important role in the pathogenesis of the disease. Consequently, calcium channel antagonists could be a promising treatment avenue for Martorell HYTILU.</p>","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}