Actas urologicas espanolas最新文献

{"title":"Evaluación de los factores predictivos tras uretrotomía interna endoscópica para estenosis de uretra bulbar","authors":"A. García Fernández ,&nbsp;F. Campos-Juanatey ,&nbsp;P. Calleja Hermosa ,&nbsp;A. González Fernández ,&nbsp;R. Varea Malo ,&nbsp;J.L. Gutiérrez Baños","doi":"10.1016/j.acuro.2024.10.007","DOIUrl":"10.1016/j.acuro.2024.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Direct vision internal urethrotomy (DVIU) is usually the first treatment offered to patients with bulbar urethral strictures (US). Advances in devices and surgical techniques have contributed to reducing associated complications. Despite the favorable success rate of DVIU, various factors predicting better outcomes have been studied, including patient characteristics, stricture features, and procedural aspects. The main aim of our study is to assess predictive factors for success.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive study of patients who underwent endoscopic internal urethrotomy at our hospital over a 30 year period. Out of 788 DVIU performed, we selected 491 (62.3%) conducted for bulbar US with a minimum follow-up of 12 months. We examined clinical outcomes obtained, and assessed the relationship between different patient characteristics, stricture-related factors and procedural aspects related with clinical success -considered as the avoidance of further interventions for stricture recurrence-. Descriptive statistics were calculated and parametrical and non-parametrical comparative tests were applied. Kaplan-Meier survival analysis was used for evaluating time until recurrence.</div></div><div><h3>Results</h3><div>Mean stricture length was 1.2<!--> <!-->cm (SD 0.5), with only 12 patients presenting with more than 1 US in the bulbar area during DVIU<em>.</em> After a median follow-up of 170 months, 67.4% of patients did not experience clinical recurrence. Severe postoperative complications appear in 0.4% of cases, and need for overnight admission was 4.5%. A positive association was observed between clinical recurrence and a history of prior pelvic radiotherapy (OR 2.8, 95%IC 1.3-22.2), active smoking (OR 2.1, 95% IC 1.6-2.4), infectious etiology of stricture (OR 2.3, 95% IC 1.6-8), history of previous urethroplasty (OR 2.5, 95% IC 1.7-3.2), and higher postoperative urinary catheter sizes (OR 1.8 95% IC 1.1-2.9). Median time until recurrence after the first DVIU was 65 months, after the second was 60 months, after the third was 32 months, and after the fourth was 6 months.</div></div><div><h3>Conclusions</h3><div>Bulbar US could be safely managed with DVIU. The best clinical success is achieved in non-irradiated, non-smoker patients, without prior urethroplasties. The repetition of the procedure is significantly associated with a shorter time to clinical recurrence.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 94-101"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complicaciones estéticas de la cirugía de uretra anterior: revisión exploratoria y galería de imágenes","authors":"F. Chierigo ,&nbsp;G. Mantica ,&nbsp;G. Drocchi ,&nbsp;F.X. Madec ,&nbsp;W. Verla ,&nbsp;Ł. Białek ,&nbsp;J. Adamowicz ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;J. Klemm ,&nbsp;P. Neuville ,&nbsp;M. Oszczudłowski ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;M. Waterloos ,&nbsp;M.W. Vetterlein ,&nbsp;F. Campos-Juanatey ,&nbsp;en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos (YAU) - Asociación Europea de Urología (EAU)","doi":"10.1016/j.acuro.2024.11.002","DOIUrl":"10.1016/j.acuro.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Anterior urethroplasty is the gold standard for treating complex urethral strictures, primarily focusing on restoring urinary function. However, aesthetic complications, including penile curvature, scarring, and meatal deformities, can impact patient satisfaction, self-image, and quality of life. Despite their significance, cosmetic outcomes are underreported in the literature, affecting patient counseling and surgical planning.</div></div><div><h3>Objective</h3><div>This scoping review aims to assess the prevalence, types, and contributing factors of cosmetic complications after anterior urethroplasty. A photographic collection of these complications is also presented to aid in clinical education.</div></div><div><h3>Materials and methods</h3><div>A systematic search of PubMed, Scopus, and Web of Science databases was performed, including studies from 2000 onward that report cosmetic outcomes in male adult patients post-urethroplasty. Following PRISMA guidelines, studies focusing on pediatric cases, case reports with fewer than 10 patients, and those lacking specific cosmetic data were excluded.</div></div><div><h3>Results</h3><div>Of the 493 studies screened, 97 met the inclusion criteria, with only a minority (8 studies) explicitly discussing cosmetic complications. Reported issues varied widely, including penile curvature, skin tethering, hypertrophic scarring, meatal deformities, and penile shortening, underscoring the diversity of aesthetic challenges in urethral reconstruction.</div></div><div><h3>Conclusion</h3><div>This review highlights the need for incorporating aesthetic considerations into surgical planning and patient counseling for anterior urethroplasty. Standardized metrics for evaluating cosmetic outcomes could improve patient satisfaction and the quality of care in urethral reconstruction.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 42-62"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historia de la cirugía uretral: lecciones aprendidas del pasado","authors":"F.X. Madec ,&nbsp;P. Neuville ,&nbsp;F. Chierigo ,&nbsp;J. Adamowicz ,&nbsp;Ł. Białek ,&nbsp;A. Cocci ,&nbsp;M. Frankiewicz ,&nbsp;G. Mantica ,&nbsp;M. Oszczudłowski ,&nbsp;E.J. Redmond ,&nbsp;C.M. Rosenbaum ,&nbsp;W. Verla ,&nbsp;M. Waterloos ,&nbsp;F. Campos-Juanatey ,&nbsp;J. Klemm ,&nbsp;M. Vetterlein ,&nbsp;en representación del Grupo de Trabajo de Urología Reconstructiva y Trauma Urológico de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología","doi":"10.1016/j.acuro.2024.12.001","DOIUrl":"10.1016/j.acuro.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Although failures are undesirable, they offer valuable learning opportunities that drive progress through necessary changes. This concept holds particularly true in the history of urethral reconstruction.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted using PubMed, focusing on the history of the urethral stricture and current trends based on national and international guidelines for urethral stricture management.</div></div><div><h3>Results</h3><div>Urethral strictures are among the oldest known urological conditions, with initial treatments centred around dilatation. These palliative measures proved disappointing. The advent of reconstructive urology has transformed this pathology into a treatable condition, notably through Excision and Primary Anastomosis (EPA) and one-stage augmentation urethroplasty using buccal grafts.</div></div><div><h3>Conclusion</h3><div>Urethroplasty is the gold standard treatment for urethral strictures, and ongoing refinements aim to further reduce morbidity.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 63-71"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia y seguridad del balón de dilatación uretral Optilume® en la práctica clínica real: análisis multicéntrico en España","authors":"C. Ballesteros Ruiz ,&nbsp;F. Campos-Juanatey ,&nbsp;I. Povo Martín ,&nbsp;S. Mitjana Biosca ,&nbsp;Ó. Gorría Cardesa ,&nbsp;J.F. Aguilar Guevara ,&nbsp;N. García Formoso ,&nbsp;E. Fernández Pascual ,&nbsp;J.I. Martínez Salamanca ,&nbsp;S. Martínez Pérez ,&nbsp;J.M. Alonso Dorrego ,&nbsp;E. Ríos González ,&nbsp;S. San Cayetano Talegón ,&nbsp;A.M. Araujo Suarez ,&nbsp;E. Moran Pascual ,&nbsp;M.Á. Bonillo García ,&nbsp;J. Medina Polo ,&nbsp;L. Viver Clotet ,&nbsp;A.J. Vicens Morton ,&nbsp;J. Arce Gil ,&nbsp;L. Martínez-Piñeiro Lorenzo","doi":"10.1016/j.acuro.2024.07.002","DOIUrl":"10.1016/j.acuro.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The Optilume® paclitaxel-coated urethral dilatation balloon is an alternative to conventional endoscopic treatments that combines mechanical dilatation with local delivery of paclitaxel.</div></div><div><h3>Objective</h3><div>To describe the success rate and analyze the safety of the device in real clinical practice. To evaluate possible predictors of treatment failure.</div></div><div><h3>Material and methods</h3><div>Retrospective multicenter study in patients diagnosed with urethral stricture and treated with an Optilume® balloon in routine clinical practice. Data were collected from flowmetry, questionnaires (PROM and IPSS) and cystoscopy before surgery, and 3, 6 and 12 months after the procedure, according to standard practice. Surgical success was defined as the absence of subsequent urethral manipulation and a Qmax<!--> <!-->&gt;<!--> <!-->10<!--> <!-->ml/s.</div></div><div><h3>Results</h3><div>238 patients treated with Optilume® in 12 Spanish hospitals between May 2021 and April 2024 were included in the study. Of these, 156 who had a minimum follow-up of 3 months, were analyzed. Median stricture length: 1.5<!--> <!-->cm (0.5 - 5.3), mainly in bulbar urethra (87.7%). Of the total, 12.8% of patients had a history of pelvic radiotherapy, and 81.4% had undergone prior urethral manipulation. Postoperative complications were reported in 14.2% of the total. The treatment success rate was 73.8%, with a median follow-up of 8 months (5-12). No predictors of stricture recurrence were identified. Recurrence rates were higher in strictures located in the posterior versus anterior urethra (42.9% vs. 24.6%, p<!--> <!-->=<!--> <!-->0.126). No significant differences were observed between patients with and without prior urethral manipulation.</div></div><div><h3>Conclusion</h3><div>Treatment with Optilume® has been shown to be safe and effective in short-term routine clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 1","pages":"Pages 80-85"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversias en el abordaje del cáncer de próstata: consenso de recomendaciones de expertos del norte de España","authors":"D. Pérez Fentes ,&nbsp;P. Willisch ,&nbsp;S. Martínez Breijoo ,&nbsp;M. Domínguez ,&nbsp;U. Anido ,&nbsp;C. Álvarez ,&nbsp;A. Gómez Caamaño","doi":"10.1016/j.acuro.2024.06.001","DOIUrl":"10.1016/j.acuro.2024.06.001","url":null,"abstract":"<div><div>In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 739-750"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relación entre varicocele e hipogonadismo o disfunción eréctil: revisión sistemática y metaanálisis","authors":"S.J. Gonzalez-Daza ,&nbsp;A.M. Díaz-Hung ,&nbsp;H.A. García-Perdomo","doi":"10.1016/j.acuro.2024.05.002","DOIUrl":"10.1016/j.acuro.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between varicocele and hypogonadism, or erectile dysfunction.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager® 5.3 and reported information about the odds ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.</div></div><div><h3>Results</h3><div>We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR: 3.27; 95% CI: 1.23-8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.</div></div><div><h3>Conclusion</h3><div>There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 751-759"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimización de la triple terapia en el tratamiento del cáncer de próstata hormonosensible metastásico","authors":"A. Borque-Fernando ,&nbsp;D.A. Pérez-Fentes ,&nbsp;M. Rodrigo-Aliaga ,&nbsp;J. Puente-Vázquez ,&nbsp;A. Gómez-Iturriaga ,&nbsp;M. Unda ,&nbsp;M.A. Calleja-Hernández ,&nbsp;J.M. Cózar-Olmo ,&nbsp;J.L. Álvarez-Ossorio","doi":"10.1016/j.acuro.2024.07.003","DOIUrl":"10.1016/j.acuro.2024.07.003","url":null,"abstract":"<div><div>Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 703-717"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hacia un cambio de modelo en el manejo de la hiperplasia benigna de próstata: importancia de un enfoque individualizado","authors":"A. Alcántara Montero","doi":"10.1016/j.acuro.2024.09.001","DOIUrl":"10.1016/j.acuro.2024.09.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 761-762"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluación de los cambios en la función sexual en pacientes sometidos a cirugía endoscópica de la litiasis del tracto urinario superior","authors":"J. Tabares Jiménez,&nbsp;G. Bueno Serrano,&nbsp;M.P. Alcoba García,&nbsp;R. González López,&nbsp;B. Gómez Jordana,&nbsp;I. Mahillo Fernández,&nbsp;C. González Enguita","doi":"10.1016/j.acuro.2024.06.002","DOIUrl":"10.1016/j.acuro.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of endoscopic surgery on sexual function in patients with upper urinary tract (UUT) lithiasis.</div></div><div><h3>Material and methods</h3><div>We conducted an observational, prospective, longitudinal study with a single cohort of cases undergoing ureteroscopy (URS), retrograde intrarenal surgery (RIRS), or endoscopic combined intrarenal surgery (ECIRS). Patients’ sexual response was assessed with questionnaires in the 30 days prior to surgery, and at one and three months after surgery. The International Index of Erectile Function (IIEF-t) was used in male patients, and the Female Sexual Function Index (FSFI) was used in female patients.</div></div><div><h3>Results</h3><div>Seventy patients -34 men and 36 women- completed the study. Among men, the IIEF-t did not show significant difference between baseline scores (64.1<!--> <!-->±<!--> <!-->7.50) and those obtained at 3 months (63.8<!--> <!-->±<!--> <!-->9.51), with a non-significant decrease (p<!--> <!-->=<!--> <!-->0.054) at the first month (61.4<!--> <!-->±<!--> <!-->10.4). Subdomains did not worsen at 3 months, and desire (IIEF-SD) improved from 7.3<!--> <!-->±<!--> <!-->1.9 to 8.0<!--> <!-->±<!--> <!-->1.8. Among women, the FSFI-t did not change significantly after surgery: baseline score (27.3<!--> <!-->±<!--> <!-->4.1), 1-month score (26.8<!--> <!-->±<!--> <!-->3.7) and 3-month score (27.5<!--> <!-->±<!--> <!-->4.2). No subdomain worsened at the third month.</div></div><div><h3>Conclusion</h3><div>Endoscopic surgery for UUT is a safe technique in both sexes with no negative effect on sexual function. There are no differences between the baseline IIEF-t and FSFI-t scores and those obtained at 3 months.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Pages 688-694"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El leaking pipeline y las brechas de género en Urología","authors":"A. Medina Gamero","doi":"10.1016/j.acuro.2024.05.001","DOIUrl":"10.1016/j.acuro.2024.05.001","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"48 10","pages":"Page 760"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}