Surgery Case Reports最新文献

{"title":"Liver transplantation for post-COVID-19 cholangiopathy: Report of 2 cases","authors":"Julio Cezar Uili Coelho ,&nbsp;Katia Cristina Kampa ,&nbsp;Marco Aurelio Raeder da Costa ,&nbsp;Daphane Benatti Gonçalves Morsoletto ,&nbsp;Diogo Pena dos Anjos","doi":"10.1016/j.sycrs.2024.100012","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100012","url":null,"abstract":"<div><p>Post-Covid-19 cholangiopathy is a rare disease characterized by chronic cholestasis, that typically appears after resolution of the covid-19 virus infection. The pathophysiology is not fully understood, and prognosis in severe cases remains poor with liver transplantation remaining the only curative treatment option. We present two patients who developed post-covid-19 cholangiopathy after prolonged intensive care unit stay due to severe COVID-19 pneumonia. Both patients required invasive ventilation for more than a month. After adequate recovery from respiratory failure, the patients developed severe cholestatic jaundice and liver failure. The patients had not history of previous liver disease. Both patients underwent deceased liver transplantation 15 and 29 months after the initial COVID-19 diagnosis. One patient had good recovery and good liver function two years after LT and the other died in the fourth month after LT of disseminated infection and diffuse bleeding.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"2 ","pages":"Article 100012"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000124/pdfft?md5=723fe7877536ec558a36e6939be07bca&pid=1-s2.0-S2950103224000124-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of peritoneal dialysis for ventilated COVID-19 patients with acute kidney injury","authors":"Erin M. Duggan ,&nbsp;Andrew J. Benintende ,&nbsp;Anna Koerner ,&nbsp;Dustin Carpenter ,&nbsp;Pedro Rodrigo Sandoval ,&nbsp;Kasi McCune ,&nbsp;Lloyd E. Ratner","doi":"10.1016/j.sycrs.2024.100011","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100011","url":null,"abstract":"<div><h3>Background</h3><p>Peritoneal dialysis for acute kidney injury is not typically a first-line option for mechanically ventilated patients in the intensive care unit. This series investigates the technical feasibility and clinical implications of bedside peritoneal dialysis catheter placement and utilization for mechanically ventilated COVID-19 patients.</p></div><div><h3>Methods</h3><p>Patient data was retrospectively collected on patient characteristics, hospital course, fluid balance, ventilatory mechanics and associated morbidity and mortality of qualifying patients at a single center from March to April of 2020. Peritoneal dialysis catheters were inserted at bedside in the ICU for use as the primary modality of renal replacement therapy. Ventilatory mechanics were obtained prior to catheter insertion and after the first dwell. Statistics were calculated using GraphPad Prism and Excel.</p></div><div><h3>Results</h3><p>Seven male ventilated patients ages 52–83 were included. They were primarily Hispanic (71.43%). Comorbidities included chronic kidney disease (14.29%), hypertension (57.14%), hyperlipidemia (42.86%), and diabetes (28.57%). There were no mortalities associated the procedure. All-cause mortality at the time of data collection was 42.8%. Two patients had delayed initiation of peritoneal dialysis due to bleeding. Ventilatory mechanics before and after the first dwell did not demonstrate a significant difference in required FiO₂, PEEP, tidal volumes or PaO₂ to FiO₂ ratios (p = 0.9172, p = 0.7398, p = 0.0924, p = 0.7227).</p></div><div><h3>Discussion</h3><p>Bedside placement of catheters was performed quickly and safely. Peritoneal dialysis was utilized for the treatment of acute kidney injury in mechanically ventilated patients with COVID-19 without significantly impacting respiratory mechanics. Peritoneal dialysis should be considered for similar ICU patients needing renal replacement therapy.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"2 ","pages":"Article 100011"},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000112/pdfft?md5=1da49850b9d4d59fcbc07a6b75ee1a3b&pid=1-s2.0-S2950103224000112-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic intussusception from pedunculated colonic lipoma at hepatic flexure: A case report and review of current literature","authors":"Richard Edmund Hogan ,&nbsp;Ben Michael Murray ,&nbsp;Michael Flanagan ,&nbsp;Shane Brennan ,&nbsp;Conor Shortt ,&nbsp;Dara Kavanagh","doi":"10.1016/j.sycrs.2024.100008","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100008","url":null,"abstract":"<div><p>Colonic lipomas are a benign tumor that can present in multiple ways, including; incidentally, abdominal pain, change in bowel habit, bleeding, intestinal obstruction and intussusception. We present the case of a 48-year-old gentlemen who presented to the emergency department with a 3 day history of abdominal pain and was found to have a 5 cm intramural ischemic pedunculated colonic lipoma causing intussusception and large bowel obstruction. He received initial management with emergency laparoscopic exploration, reduction of intussusception, colotomy and lipoma excision. He made a full recovery. The current approaches to management of colonic lipomas are conservative, endoscopic or surgical. This case highlights the potential consequences of untreated colonic lipomas. In our review of the literature, we highlight that there is a lack of clear consensus on appropriate management of these patients.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100008"},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000082/pdfft?md5=1ee583c40e44ea0b1784d0d5879619c3&pid=1-s2.0-S2950103224000082-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteosarcoma of the mandible and its management: A rare case report","authors":"S. Mohanavalli ,&nbsp;M.S. Viswanathan ,&nbsp;R. Karthikeyan ,&nbsp;Vijay Gnanaguru ,&nbsp;G. Sree Vijayabala ,&nbsp;Lotavath Jhansi Rani","doi":"10.1016/j.sycrs.2024.100009","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100009","url":null,"abstract":"<div><p>Osteosarcoma is a classical malignant bone-forming neoplasm, characterised by osteoid synthesis by malignant osteoblasts. Osteosarcomas have an aggressive clinical course with a high mortality rate, despite their relatively low risk of distant metastases. The jaw bone is the most common site of occurrence in the head and neck region. These neoplasms often show characteristic clinical behaviours, varied radiological appearances, and a wide-ranging histological growth pattern. Early diagnosis and radical surgery, followed by radiotherapy and chemotherapy if required, have been the treatment of choice. This case report emphasises the importance of early diagnosis of this tumour based on clinical features, radiographic examination, and confirmation by histopathology. Confirmation of the final diagnosis of osteosarcoma often requires a histopathological examination of the multiple biopsy specimens. Adjuvant chemotherapy followed by radical surgery resulted in an excellent prognosis in the present case. Considering the rarity of the neoplasm, its fast progression, and its aggressiveness, the present case report would contribute to a better understanding of osteosarcomas involving the jaw bone and the management of the tumour involving the central arch of the mandible with involvement of the adjacent soft tissue structures.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100009"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000094/pdfft?md5=a42fe092fb3cc65c58be1f6735acf833&pid=1-s2.0-S2950103224000094-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sino-nasal Mucormycosis in non-compliant insulin-dependent diabetic patient: A case report with an insight on underlying psychological factors","authors":"Mahmoud Anous ,&nbsp;Mai Alotaibi ,&nbsp;Razan Alqahtani ,&nbsp;Fatmah Alhendi","doi":"10.1016/j.sycrs.2024.100005","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100005","url":null,"abstract":"<div><h3>Background</h3><p>Mucormycosis is a severe fungal infection manifested mostly in immunocompromised hosts. Underlying causes for Mucormycosis include uncontrolled diabetes mellitus (DM), malignancies, chronic corticosteroid use, and organ transplant.</p></div><div><h3>Case report</h3><p>a 57-year-old Caucasian female, with insulin-dependent DM, presented to otolaryngology casualty complaining about a severe headache and nasal discharge. Clinical, laboratory, imaging, and histopathological investigations confirmed the diagnosis of Mucormycosis due to uncontrolled DM. Mucormycosis was managed pharmacologically, surgically, and by improving glycemic control. Psychological factors leading to non-adherence to insulin therapy were investigated and psychiatric evaluation and counseling were emphasized.</p></div><div><h3>Practical implications</h3><p>Healthcare providers should be aware of the signs, symptoms, and underlying causes of Mucormycosis and should manage it promptly. Mental health status should be part of the patient's evaluation and treatment plan.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100005"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000057/pdfft?md5=0e118a6e0285ab1386585fe8bb3f2578&pid=1-s2.0-S2950103224000057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intragastric pressure and peristalsis analysis of the sleeve gastric tube after laparoscopic sleeve gastrectomy","authors":"Mamiko Takii ,&nbsp;Masanori Yamada,&nbsp;Tsutomu Oshima,&nbsp;Yoshinori Tanaka,&nbsp;Masashi Takemura","doi":"10.1016/j.sycrs.2024.100003","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100003","url":null,"abstract":"<div><h3>Introduction</h3><p>Laparoscopic sleeve gastrectomy (LSG) is a procedure that is being increasingly recommended. However, LSG can worsen gastroesophageal reflux disease (GERD) and cause vomiting, and consequently impact the quality of life (QOL) of patients. Abnormal motility of the sleeve gastric tube has been linked to the onset of GERD and vomiting. Hence, this study investigated the peristalsis of the sleeve gastric tube after LSG and its relationship with gastroesophageal reflux. There are only a few reports on the peristalsis of the sleeve gastric tube after LSG.</p></div><div><h3>Methods</h3><p>We measured the motility function of the sleeve gastric tube using high-resolution manometry (HRM) within 2–4 weeks after LSG. The manometry catheter was positioned in the antrum using fluoroscopy.</p></div><div><h3>Results</h3><p>This analysis included 18 patients. Postoperative HRM measurement of the sleeve gastric tube was characterized by the absence of gastric body peristalsis in at least 90% of swallows and contractions of the antrum. Furthermore, reverse peristalsis was observed from the pyloric antrum toward the stomach body although the frequency was low.</p></div><div><h3>Conclusions</h3><p>LSG was associated with characteristic of pressure and peristalsis in sleeve gastric tube. HRM was able to detect and visualize intragastric pressure and peristalsis of the sleeve gastric tube.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100003"},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000033/pdfft?md5=3e9195d1002d8f5df111a9c5e7e55234&pid=1-s2.0-S2950103224000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of stapled closure of the aortic stump with axillo-bifemoral bypass grafting for abdominal aortic infection","authors":"Toshihiro Onohara ,&nbsp;Kentaro Inoue ,&nbsp;Shinichiro Yoshino ,&nbsp;Yutaka Matsubara ,&nbsp;Tadashi Furuyama","doi":"10.1016/j.sycrs.2024.100007","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100007","url":null,"abstract":"<div><h3>Objectives</h3><p>The stapled suture is used to close the aortic stump during surgery for abdominal aortic infection. The current study aimed to investigate the short- and long-term outcomes of stapled closure of the aortic stump with axillo-bifemoral (AxBF) bypass grafting.</p></div><div><h3>Methods</h3><p>The short- and long-term outcomes of 11 patients who underwent surgery for abdominal aortic infection were retrospectively analyzed.</p></div><div><h3>Results</h3><p>Of 11 patients, 7 underwent stapled closure of the aortic stump with AxBF bypass grafting, and four underwent other reconstructive procedures with no aortic stump. Four patients (three who underwent stapled closure of the aortic stump and one who underwent other reconstructive procedures without the aortic stump) had operative death. However, none of the patients had aortic stump blow-out during the same hospitalization for surgery. The 1- and 5-year survival rates of the patients who underwent stapled closure of the aortic stump with AxBF bypass grafting were 57% and 29%, respectively. One patient developed aorto-duodenal fistula at 32 months after surgery. The patient survived for 12 months until bleeding in the recurrent aorto-enteric fistula occurred.</p></div><div><h3>Conclusion</h3><p>Stapled closure of the aortic stump is durable. The use of a linear stapler is a useful technique for reinforcing the aortic stump in patients who underwent excision of an infected abdominal aortic aneurysm or an infected abdominal graft.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100007"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000070/pdfft?md5=f6c7a3b9e02d9d036086e4c178522866&pid=1-s2.0-S2950103224000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An uncommon encounter in an unusual location – A case report on acute emphysematous suppurative thyroid abscess","authors":"Sarrah Idrees ,&nbsp;Prathyusha Godi ,&nbsp;Rahul Kumar ,&nbsp;Gyan Chand ,&nbsp;Gaurav Agarwal ,&nbsp;Anil Kumar Singh ,&nbsp;Neha Yadav","doi":"10.1016/j.sycrs.2024.100010","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100010","url":null,"abstract":"<div><p>Acute emphysematous suppurative thyroid abscess is a potentially life threatening uncommon disease caused most commonly by gram positive organisms. It usually occurs in immunocompromised individuals with pre-existing multinodular goiter secondary to hematogenous spread of infection. The most characteristic feature of this disease is the presence of gas within the thyroid swelling seen on imaging, even though crepitus may be absent on examination. Surgical debridement and thyroidectomy are the procedure of choice in such cases and can lead to effective cure. We present an unusual and rare case of an acute emphysematous suppurative thyroid abscess caused by a gram negative (non-clostridial) organism in an immunocompromised patient after a fine needle aspiration cytology intervention.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100010"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000100/pdfft?md5=d62dd8597c767d671b0e6ca97d180d97&pid=1-s2.0-S2950103224000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraskeletal osteosarcoma misdiagnosed as metastatic breast cancer: A case report","authors":"Emmanuel T. Limpin ,&nbsp;Sonaira U. Maunting ,&nbsp;Karen B. Damian ,&nbsp;Abdel Hadi M. Mohammad Isa ,&nbsp;Eduardo C. Ayuste Jr. ,&nbsp;Siegfredo R. Paloyo","doi":"10.1016/j.sycrs.2024.100004","DOIUrl":"https://doi.org/10.1016/j.sycrs.2024.100004","url":null,"abstract":"<div><h3>Introduction</h3><p>Extraskeletal osteosarcomas are rare tumors with poor overall survival and a high propensity for recurrence. It frequently arises in the lower extremities and has been reported to metastasize commonly in the lungs. Controversy exists as to whether it should be treated as a soft tissue sarcoma or an osteosarcoma. Various adjuvant treatment approaches have also been studied with conflicting results.</p></div><div><h3>Case report</h3><p>We present a 73-year-old female with a painless, gradually enlarging right upper arm mass for 2 months. She previously underwent a left mastectomy 5 years ago for a stage II breast cancer. Preoperative imaging showed a resectable, heterogenous right upper arm mass. She subsequently underwent radical excision with frozen section revealing spindle cell neoplasm. Final histopathology was consistent with extraskeletal osteosarcoma. The patient remains disease-free as of most recent follow-up.</p></div><div><h3>Discussion</h3><p>There are several proposed mechanisms for extraskeletal osteosarcomas. Based on the history and location of the tumor, we initially thought that this was metastatic breast cancer. Preoperative imaging determines resectability and surgical approach. Radical surgery is frequently performed which largely depends on the site of the tumor. Complete primary resection with adequate margins remains to be the treatment of choice to prevent recurrence or metastasis. The role of adjuvant radiotherapy or chemotherapy is still to be established.</p></div><div><h3>Conclusion</h3><p>This case highlights the various treatment options and the need for further research on its clinical behavior and potential targeted therapies.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100004"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000045/pdfft?md5=0246e11fc1d1b9c63bdb6bb75dfb2f2d&pid=1-s2.0-S2950103224000045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of atraumatic CSF leak into brachial plexus elements","authors":"Raufay G. Abbasi ,&nbsp;Daniel Hsu ,&nbsp;Stephen Sozio ,&nbsp;Jonathan Ferro ,&nbsp;Sudipta Roychowdhury ,&nbsp;Gaurav Gupta ,&nbsp;Arevik Abramyan ,&nbsp;Srihari Sundararajan","doi":"10.1016/j.sycrs.2024.100002","DOIUrl":"10.1016/j.sycrs.2024.100002","url":null,"abstract":"<div><p>We present the case of a patient with unexplained postural headaches who was found to have an atraumatic Cerebrospinal Fluid (CSF) leak from the foraminal and extraforaminal epidural spaces at the levels of C5-C6, C6-C7, C7-T1, and T1-T2, with contrast tracking along the brachial plexus elements as well as the bilateral scalene and paraspinal musculature. This is a rare presentation as the etiology was not connected to brachial plexus injury or surgical trauma but rather was a spontaneous occurrence. The patient was successfully treated with a CT-guided epidural blood patch that conferred complete resolution of the symptoms. We hope this case study offers clinical utility with the diagnosis and management of patients with orthostatic headaches.</p></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"1 ","pages":"Article 100002"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950103224000021/pdfft?md5=2b8a9575a4e00fecfcd130d8d6bfd1cb&pid=1-s2.0-S2950103224000021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139686160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}