Medical Reports最新文献

{"title":"Distal limb ischemia from jellyfish envenomation: A case report","authors":"Eunizar Omar ,&nbsp;Vanitha Porhcisaliyan ,&nbsp;Sujata Sheth ,&nbsp;Kunzang Norbu","doi":"10.1016/j.hmedic.2025.100302","DOIUrl":"10.1016/j.hmedic.2025.100302","url":null,"abstract":"<div><h3>Introduction</h3><div>This case report presents a rare instance of acute limb ischemia following jellyfish envenomation. Only 16 other documented cases have been reported worldwide.</div></div><div><h3>Case report</h3><div>Our patient is a 15-year-old male who was stung by a jellyfish while swimming in the sea off Langkawi. Six days after the sting, the patient developed significant numbness and cyanosis in his left hand, with CT angiography confirming compromised blood flow. Initial treatments included analgesics and tetanus prophylaxis. The patient ultimately required intravenous heparin, nitroglycerin, and alprostadil, and he achieved full recovery after three days of treatment. This case, along with the other 16 reported cases, highlights vasospasm and thrombosis as possible key mechanisms for distal limb ischemia secondary to jellyfish envenomation.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Jellyfish stings are fairly common, and patients may present to the Emergency Department or even primary care facilities. Although uncommon, physicians should be aware of potential complications in order to deliver timely and effective treatment.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100302"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of high dose IVIG, convalescent plasma combination, and dexmedetomidine in severe COVID ARDS during pregnancy: A retrospective case series","authors":"Serdar Efe ,&nbsp;Hulya Poyraz Efe","doi":"10.1016/j.hmedic.2025.100301","DOIUrl":"10.1016/j.hmedic.2025.100301","url":null,"abstract":"<div><h3>Objective</h3><div>Physiological and immunological changes during pregnancy may cause COVID-19 infection to progress more severely. This study presents the potential protective effect of the combination of intravenous immunoglobulin (IVIG) and convalescent plasma (CP) in preventing intubation in three pregnant patients who developed severe COVID-19-associated acute respiratory distress syndrome (CARDS).</div></div><div><h3>Methods</h3><div>During the early phase of the pandemic (2020–2021), three pregnant patients at the threshold of intubation were treated with high-dose IVIG (0.4 g/kg/day) and two doses of CP administered 48 h apart. All patients also received nasal high-flow oxygen (HFNC), low-molecular-weight heparin, antibiotics, and dexamethasone. Patients with severe back and chest pain received a short-term (24-hour) dexmedetomidine infusion to control anxiety and improve positional oxygenation. Patients were monitored for fetal well-being using NST and Doppler ultrasound.</div></div><div><h3>Results</h3><div>None of the cases required intubation and all were discharged from the intensive care unit. No serious side effects were observed except for transient and isolated troponin elevation associated with IVIG treatment. All mothers delivered healthy babies, and the neurodevelopmental follow-up of the infants was uneventful for 36 months.</div></div><div><h3>Conclusion</h3><div>This case series demonstrates that the combination of IVIG and convalescent plasma in pregnant women with severe CARDS may reduce the need for intubation and improve maternal and fetal outcomes. Additionally, the role of dexmedetomidine infusion in reducing the risk of intubation by facilitating positional oxygenation is noteworthy. Our findings may serve as a guide in similar clinical scenarios during future pandemics.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100301"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From rib to groin: An unusual case report of chest wall leiomyosarcoma with distant lymphatic spread","authors":"Annmy Jose ,&nbsp;Upinderjeet Singh ,&nbsp;Priyadharshini Bargunam ,&nbsp;Alfa Shamim Saifi ,&nbsp;Prasath Rajendran","doi":"10.1016/j.hmedic.2025.100300","DOIUrl":"10.1016/j.hmedic.2025.100300","url":null,"abstract":"<div><div>Leiomyosarcoma is a malignant tumor originating from smooth muscle cells. While they may occur at any anatomical location, they are commonly seen in the uterus and retroperitoneum, followed by the trunk and extremities, with a subset originating from the blood vessel wall, particularly the inferior vena cava It is an aggressive neoplasm that grows rapidly and can potentially metastasize unlike its benign counterpart, leiomyomas. Here we present an unusual case of rapidly-growing posterior chest wall lesion in a 53-year-old male presenting as a rib mass, histologically diagnosed and molecularly confirmed as leiomyosarcoma with multiple metastatic deposits to the lung, liver, and inguinal lymph nodes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100300"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of STEC-negative hemolytic uremic syndrome with C2 gene mutation variant","authors":"Daria Hoang ,&nbsp;Farzana Hoque","doi":"10.1016/j.hmedic.2025.100299","DOIUrl":"10.1016/j.hmedic.2025.100299","url":null,"abstract":"<div><div>Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. While Shiga toxin-producing <em>E. coli</em> (STEC) remains the most common cause, atypical HUS (aHUS), driven by complement dysregulation, poses a significant diagnostic challenge, particularly in adults. We present the case of a 29-year-old female with no prior medical history who developed severe gastrointestinal symptoms, acute kidney injury, thrombocytopenia, and hemolytic anemia following suspected foodborne illness. Initial labs revealed schistocytosis, elevated LDH, low haptoglobin, and markedly impaired renal function. Given her high PLASMIC score (6), empiric plasmapheresis was initiated while awaiting ADAMTS13 results, which later returned normal. Despite negative testing for STEC, influenza, and other infectious etiologies, complement levels were borderline low, raising suspicion for aHUS. Although genetic testing revealed an equivocal C2 gene variant and common CFH polymorphisms statistically enriched in aHUS, the variant was classified as likely benign. The patient’s renal function improved significantly with supportive care and temporary hemodialysis, and ravulizumab was deferred. This case highlights the importance of early recognition and management of thrombotic microangiopathies, especially when infectious workup is negative and ADAMTS13 results are pending. Prompt initiation of plasmapheresis in cases with high PLASMIC scores remains critical, even in indeterminate presentations. Further investigation into the potential pathogenic role of rare complement gene variants such as C2 may refine our understanding of aHUS. This case underscores the need for rapid diagnostics and early resource mobilization in patients with suspected microangiopathic processes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100299"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Azithromycin-induced allergic reaction – A rare case report and review of literature","authors":"Abraham Sisay Abie ,&nbsp;Eden Belay Tilahun ,&nbsp;Nahom Desalegn Mekonen ,&nbsp;Tamrat Petros Elias ,&nbsp;Mikias Wondwesen Ayele","doi":"10.1016/j.hmedic.2025.100298","DOIUrl":"10.1016/j.hmedic.2025.100298","url":null,"abstract":"<div><h3>Introduction</h3><div>Macrolides are commonly prescribed antibiotics with rare adverse effects. We report the case of a 30-year-old female patient with bronchial asthma who developed azithromycin-induced allergic reaction.</div></div><div><h3>Case report</h3><div>A 30-year-old female patient with bronchial asthma presented to our hospital with a one week history of cough, low-grade fever with chills, myalgia, and fatigue. Vital signs showed a low grade fever; other parameters were normal. Chest auscultation revealed crackles over the left posterior chest with a few scattered wheezes. Her complete blood count was unremarkable. A clinical diagnosis of community-acquired pneumonia was made, and she was prescribed azithromycin 500 mg once daily for three days. Within an hour of taking the first dose, the patient had developed pruritus, swelling of the lips, and eyelid, but she did not experience any difficulty breathing or swallowing. Soon after the development of these symptoms, she had discontinued azithromycin on her own and visited our hospital the following day. On evaluation, she was clinically stable but had persistent pruritus and facial swelling. Pruritus was relieved with diphenhydramine, and the patient was monitored and subsequently discharged with instructions on danger signs. At her follow-up visit within a week, all symptoms had resolved.</div></div><div><h3>Discussion</h3><div>Azithromycin-induced allergic reactions can occur in rare circumstances. These reactions range from mild cutaneous reactions to life-threatening anaphylaxis, with immediate-type skin reactions and angioedema being the most commonly reported. To date, only a few successful cases of macrolide desensitization have been reported.</div></div><div><h3>Conclusion</h3><div>While azithromycin is one of the commonly prescribed antibiotics with rare adverse effects, clinicians should be vigilant, as serious reactions may still occur.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100298"},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Takotsubo Syndrome induced by sclerotherapy: A case report","authors":"Rui Carlos Detsch Junior ,&nbsp;Joel Avancini Rocha Filho ,&nbsp;Lucas Dionysio ,&nbsp;Walter Campos Junior ,&nbsp;Ana Beatriz Boffa ,&nbsp;Gabriela Araujo Attie ,&nbsp;Pedro Puech-Leão ,&nbsp;Nelson de Luccia ,&nbsp;Maria José Carvalho Carmona","doi":"10.1016/j.hmedic.2025.100297","DOIUrl":"10.1016/j.hmedic.2025.100297","url":null,"abstract":"<div><div>Takotsubo Syndrome (TS), also known as stress cardiomyopathy, is an acute, reversible left ventricular dysfunction often triggered by emotional or physical stressors. Although most cases are associated with emotional distress, TS has also been reported following medical procedures. We present the case of a 40-year-old female who developed TS immediately after undergoing sclerotherapy with Polidocanol for pelvic varices. Shortly after the injection, she experienced acute chest pain, dyspnea, tachycardia, and hypertension. Electrocardiography showed T-wave inversion, and echocardiography revealed a severely reduced left ventricular ejection fraction (23 %) with apical ballooning. Coronary angiography ruled out obstructive coronary disease, consistent with a diagnosis of Polidocanol-induced Takotsubo Syndrome. The patient required inotropic support in the Intensive Care Unit and an intra-aortic balloon pump, with cardiac recovery within seven days. Although rare, TS should be considered in patients experiencing acute cardiovascular symptoms after sclerotherapy. The pathophysiological mechanisms remain unclear but may involve endothelial irritation, systemic inflammation, and autonomic dysregulation. This specific case is unique due to the patient’s age, the severity of the cardiac dysfunction and the time of symptom onset. Awareness of this complication is crucial for early recognition and appropriate management, particularly in high-risk patients undergoing minimally invasive vascular procedures in an ambulatory care unit.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100297"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic lymphocytic leukemia and Priapism: An Unusual association","authors":"Jahnavi Ethakota,&nbsp;Sakshi Bai,&nbsp;Danesh Kumar,&nbsp;Bipneet Singh,&nbsp;Palak Grover,&nbsp;Devin Malik","doi":"10.1016/j.hmedic.2025.100295","DOIUrl":"10.1016/j.hmedic.2025.100295","url":null,"abstract":"<div><h3>Introduction</h3><div>Priapism is a prolonged penile erection, unrelated to sexual arousal. It can lead to permanent tissue damage if not promptly managed. While it is more commonly associated with hematologic disorders such as sickle cell disease and hypercoagulable states, priapism in chronic lymphocytic leukemia (CLL) is exceptionally rare. There are few published case reports regarding CLL presenting with priapism as initial manifestation of the disease.</div></div><div><h3>Case presentation</h3><div>This is a case of a 67-year-old male with CLL on monitoring, presented to the ED with priapism and further evaluation revealed a WBC count of 186.9 k correlating to his CLL diagnosis. The priapism was initially thought to be secondary to trazodone and was subsequently discontinued. The patient presented again in 2 weeks with priapism despite discontinuing trazodone with an elevated WBC count of 246.6 k, uptrending WBC count. The priapism was considered to be secondary to CLL, further imaging revealed extensive lymphadenopathy in the chest and upper abdomen (largest lymph node 2.7 cm).</div></div><div><h3>Treatment</h3><div>He was started on Obinutuzumab and responded well with a decrease in WBC count to 6.65 k after just one dose of Obinutuzumab. The priapism was resolved successfully without recurrence. The patient is currently being treated with Obinutuzumab and Venetoclax.</div></div><div><h3>Conclusion</h3><div>Priapism can be a sign of progression as seen in the above case or as an initial manifestation of CLL. It happens due to leukostasis, where high leukocyte counts cause blood stasis in the penile vasculature. Hyperviscosity and leukemic cell infiltration of penile tissue may further contribute to blood flow obstruction, leading to priapism. This case emphasizes the need to consider hematologic malignancies, such as CLL, as potential causes of priapism in patients with high WBC counts. Immediate intervention is essential to prevent permanent penile damage.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventriculoperitoneal shunt malfunction in a complex parturient: a case report","authors":"Nicole Y. Xu,&nbsp;Christine Y. Shen,&nbsp;Allen Wang,&nbsp;Michelle Yanik,&nbsp;Erin I. Martin,&nbsp;Lawrence Weinstein","doi":"10.1016/j.hmedic.2025.100296","DOIUrl":"10.1016/j.hmedic.2025.100296","url":null,"abstract":"<div><div>A ventriculoperitoneal (VP) shunt is an effective procedure used to treat congenital hydrocephalus and has significantly improved the survivability of these patients to reach a reproductive age. However, as people with VP shunts become pregnant, they face a substantial risk related to shunt failure. The literature reports that up to 50 % of parturients with a VP shunt will experience some form of shunt related complication during their pregnancy. However, there are few published case reports documenting the clinical sequelae of parturients who ultimately experience these complications. The added physiological changes associated with pregnancy can further challenge the management of these parturients. Parturients with a VP shunt require a multidisciplinary team and close monitoring to detect any potential neurological changes and shunt malfunction. The use of a multidisciplinary team is essential to ensure the safety of both the mother and the fetus. Here, we present a case of a complex parturient with a VP shunt complicated by shunt malfunction along with a literature review of the incidence of shunt malfunction, severity of symptoms, possible treatment options, and the importance of a collaborative, multidisciplinary approach to optimize maternal and fetal outcomes.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the heart: hidden lymphoma-induced HLH driving cardiogenic shock","authors":"Elizabeth R. Rimsky ,&nbsp;Kai Wang ,&nbsp;Agarwal Alaukika ,&nbsp;Mokhtar Asmaa ,&nbsp;Amor Martin ,&nbsp;Marcel Odaimi","doi":"10.1016/j.hmedic.2025.100294","DOIUrl":"10.1016/j.hmedic.2025.100294","url":null,"abstract":"<div><h3>Background</h3><div>Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory condition triggered by factors like genetic abnormalities, malignancies, and infections. It leads to uncontrolled macrophage activity and cytokine release, causing tissue damage and multi-organ failure. Prompt recognition and diagnosis are essential due to its nonspecific presentation and high mortality.</div></div><div><h3>Case</h3><div>A 76-year-old male with known atrial fibrillation, presented with progressive fatigue. The patient was being treated with steroids and methotrexate (MTX) for a recent episode of sudden onset blurry vision while further evaluation of suspected temporal arteritis was being pursued. Upon admission, the patient developed cardiogenic shock, respiratory failure, and mental status changes, requiring intensive care. Lab findings showed thrombocytopenia, elevated ferritin, high triglycerides, and pancytopenia, fulfilling 5 of the 8 HLH diagnostic criteria. A bone marrow biopsy confirmed B-cell non-Hodgkin’s lymphoma, leading to a diagnosis of lymphoma-induced HLH. The patient was treated with etoposide and later transitioned to R-CHOP chemotherapy, leading to significant clinical improvement and stabilization of HLH markers.</div></div><div><h3>Discussion:</h3><div>This case illustrates the diagnostic complexity of HLH. Early suspicion, diagnosis, and treatment are crucial to improving outcomes in patients with multi-organ dysfunction and nonspecific systemic symptoms.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100294"},"PeriodicalIF":0.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ménétrier's disease presenting with melena and severe anemia in the absence of hypoalbuminemia: A case report","authors":"Bipneet Singh ,&nbsp;Jahnavi Ethakota ,&nbsp;Palak Grover ,&nbsp;Gurleen Kaur ,&nbsp;Sruthi Ramanan","doi":"10.1016/j.hmedic.2025.100290","DOIUrl":"10.1016/j.hmedic.2025.100290","url":null,"abstract":"<div><h3>Introduction</h3><div>Ménétrier's disease (MD), an uncommon protein-losing gastropathy characterized by hypertrophic gastric folds, primarily affects individuals in their 30–60s.</div></div><div><h3>Case</h3><div>We present a case of MD in a 69-year-old female with atypical symptoms of melena, fatigue, and lightheadedness. Admission revealed severe anemia with a hemoglobin of 5.1 g/dL (Females: 12.0–15.5 g/dL). Esophagogastroduodenoscopy (EGD) demonstrated markedly hypertrophied gastric folds with mucoid secretions, elevated serum gastrin levels of 339 pg/mL (0–180 pg/mL). Pathology confirmed MD, revealing characteristic mucosal changes without significant inflammation or H. pylori.</div></div><div><h3>Discussion</h3><div>Menetrier's disease is a rare disorder with a low incidence, affecting less than 1 in 100,000 people. The disease is characterized by thickened gastric mucosa, with Middle-aged men having a higher prevalence. The disease is diagnosed with foveolar hyperplasia, and no antibiotic therapy is offered. The trigger for the disease is unclear, but studies have linked it to subclinical viral infections and genetic links. The disease is caused by an increase in the signaling of the epidermal growth factor receptor (EGFR), leading to increased mucus production and decreased acid production. The patient presents with melena, edema, vomiting, anorexia, diarrhea, and rarely gastric intussusception. The patient is initially treated conservatively with PPI and a high-protein diet, with plans to try Cetuximab if hypoalbuminemia and melena persist.</div></div><div><h3>Conclusion</h3><div>Diagnosing rare diseases like Menetrier's disease requires thorough examination and treatment. Treatment and surveillance guidelines are often influenced by gastroenterologists, and providers must stay updated on pathophysiology and current treatments. Complications, such as protein loss, should be managed with protein supplements, and patients should be monitored for potential malignancy.</div></div>","PeriodicalId":100908,"journal":{"name":"Medical Reports","volume":"13 ","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}