European journal of rheumatology最新文献

{"title":"A Diagnostic Conundrum: Unusual Presentation of Acute Cutaneous Lupus Erythematosus Mimicking Toxic Epidermal Necrolysis.","authors":"Nilesh Kamble, Rajashree Khot, Saransh Barai, Sachin Chaudhari, Bharatsing Rathod, Onkar Awadhiya","doi":"10.5152/eurjrheum.2025.24030","DOIUrl":"https://doi.org/10.5152/eurjrheum.2025.24030","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is an intricate autoimmune disorder with diverse clinical presentations, encompassing various cutaneous manifestations. This case report describes a diagnostically challenging occurrence of acute cutaneous lupus erythematosus (ACLE) exhibiting a toxic epidermal necrolysis (TEN)-like rash in a 28-year-old female already diagnosed with SLE. The patient's rapid progression from itching to maculopapular skin eruptions involving the face, extremities, and torso within days, coupled with facial puffiness and systemic symptoms, presented a clinical conundrum. Histopathological findings of epidermal hyperkeratosis, acanthosis, and a subcorneal neutrophilic abscess guided the exclusion of other conditions, emphasizing the distinctive features of TEN-like ACLE. The patient exhibited a favorable response to pulse methylprednisolone, mycophenolate mofetil, and hydroxychloroquine.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"12 1","pages":"1-4"},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771863","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":"Hearing Loss in Connective Tissue Diseases: A Systematic Review.","authors":"Thelma L Skare, Jozélio Freire de Carvalho","doi":"10.5152/eurjrheum.2025.23076","DOIUrl":"10.5152/eurjrheum.2025.23076","url":null,"abstract":"<p><p>Hearing loss may be found in patients with systemic autoimmune disorders such as connective tissue diseases (CTD). This work aimed to review the literature on ear involvement in CTD. A systematic search of articles published in PubMed/MEDLINE, EMBASE, and SCOPUS from 1966 to June 2023 following PRISM guidelines was done. Seventy-nine papers were selected: 39 on rheumatoid arthritis; 16 on systemic lupus erythematosus; 14 on scleroderma; 6 on Sjogren's syndrome; 1 on mixed connective tissue disease; and 3 that approached more than one CTD. Most of them showed that hearing loss (HL) in connective tissue disease patients was higher than in controls, mainly of the sensorineural type and at high frequencies. Associations with clinical features and autoantibodies profile of underlying conditions varied widely among the results. In conclusion, sensorineural hearing loss is common in individuals with CTD, and it is essential to be aware of this complication in order to establish an effective treatment.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"12 1","pages":"1-24"},"PeriodicalIF":1.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771866","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":"Decade-Long Study on Phenotype and Prognosis of Lupus Myelitis (LM) in Systemic Lupus Erythematosus (SLE): Insights from a Single-Centre in India.","authors":"Ritasman Baisya, Keerthi Vardhan Yerram, G S R Murthi, Sravan Kr Appani, Phani Kumar Devarasetti, Liza Rajasekhar","doi":"10.5152/eurjrheum.2025.24129","DOIUrl":"10.5152/eurjrheum.2025.24129","url":null,"abstract":"<p><p>Background: Systemic lupus erythematosus (SLE)-associated myelitis or lupus myelitis (LM), one of the twelve neuropsychiatric lupus (NPSLE) syndromes, is a rare but severe complication of lupus. In this study, we observed the clinical and imaging profiles of LM patients to assess long-term outcomes. Methods: This was a retrospective study; data of LM with follow-up were extracted from the lupus registry in the last 15 years (2007-2022). Clinically, they were divided as grey matter myelitis (GMM) versus white matter myelitis (WMM). Disease activity was assessed by the SLE Disease Activity Index (SLEDAI-2K) & outcome by death, recurrence, and modified Rankin Score (MRS). Survival analysis was performed using the Kaplan-Meier (KM) and Weibull survival probability tests. Results: 38 patients were included out of 1700 lupus patients over the last 15 years. Among them, 26 patients presented with GMM, and 12 presented with WMM. Patients with GMM had significantly higher SLEDAI and MRS at discharge compared to WMM patients. (P-value-.021 and .08, respec-tively). White matter myelitis patients had higher levels of anti-cardiolipin antibodies. (P-.005) MRI-positive myelitis was associated with higher dsDNA levels compared to MRI-negative myelitis (P-.03), but there was no significant difference in disease activity or outcome. The Weibull probability plot indicated poor survival status in GMM. Conclusion: The prevalence of LM in our cohort is around 2%. Grey matter myelitis is associated with more active disease and significant disability. Survival analysis revealed a poor outcome for GMM in this study.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"12 1","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771864","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":"Rare Presentations of Sarcoidosis: Cases of Non-Pulmonary Involvement.","authors":"Gokhan Koker, Lutfullah Zahit Koc, Sevgi Gulsen, Sibel Bakirci, Cengiz Aldemir","doi":"10.5152/eurjrheum.2025.23042","DOIUrl":"10.5152/eurjrheum.2025.23042","url":null,"abstract":"<p><p>Sarcoidosis, an inflammatory disease characterized by non-caseating granulomas of unknown etiology, typically manifests with pulmonary involvement. However, presentations without pulmonary manifestations are exceedingly rare. We present 2 cases illustrating unusual presentations of sarcoidosis without pulmonary involvement. A 60-year-old male presented with chronic joint pain and swelling in the left hand. Despite recurrent hospital visits and inconclusive evaluations, granulomatous tenosynovitis was confirmed through histopathological examination. Systemic involvement was ruled out, and the patient responded well to corticosteroid therapy. A 36-year-old female exhibited persistent subcutaneous nodules on the left hand for 6 years. A biopsy confirmed non-caseating granulomas consistent with sarcoidosis. Despite the absence of pulmonary findings, systemic screening revealed no further involvement. Intralesional corticosteroid therapy yielded significant improvement. Although sarcoidosis typically presents with pulmonary involvement, cases without pulmonary manifestations are rare. Our cases highlight the diagnostic challenges and delayed recognition of such presentations. Increased awareness of atypical presentations is crucial for timely diagnosis and management to prevent potential systemic complications.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"12 1","pages":"1-4"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771870","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":"Tuberculous Necrotizing Fasciitis in a Patient with Rheumatoid Arthritis on Anti-TNF Treatment: A Case Report.","authors":"Juan Carlos Cataño, Pablo Arango Guerra","doi":"10.5152/eurjrheum.2025.23035","DOIUrl":"10.5152/eurjrheum.2025.23035","url":null,"abstract":"<p><p>Tuberculous necrotizing fasciitis (NF) is an exceedingly rare condition, particularly in patients undergoing immunosuppressive therapy for autoimmune diseases such as rheumatoid arthritis. This case describes a 69-year-old male with a history of rheumatoid arthritis treated with adalimumab, who presented with severe pain, swelling, and redness in the right upper limb. Despite initial treatment for presumed bacterial NF, histological examination and tuberculosis (TB) polymerase chain reaction (PCR) confirmed tuberculous fasciitis. The patient exhibited respiratory symptoms, and imaging revealed a cavitary lesion suggestive of pulmonary tuberculosis, which was also confirmed by sputum PCR. Unfortunately, the patient succumbed to an acute myocardial infarction during treatment. This case highlights the importance of considering TB in the differential diagnosis of necrotizing fasciitis, particularly in immunocompromised individuals, to ensure timely and appropriate management.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"12 1","pages":"1-4"},"PeriodicalIF":1.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771871","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":"Multi-organ Involvement in Catastrophic Antiphospholipid Syndrome: A Challenging Case with a Fatal Outcome.","authors":"Selma Özlem Çelikdelen, Reyhan Bilici","doi":"10.5152/eurjrheum.2025.24025","DOIUrl":"10.5152/eurjrheum.2025.24025","url":null,"abstract":"<p><p>Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening variant of antiphospholipid syndrome (APS) characterized by extensive thrombosis, multi-organ involvement, and high mortality. Despite advances in the understanding and management of APS, CAPS remains a challenge because of its rapidly progressive and potentially lethal course. We report the case of a 33-year-old man with a history of chronic venous insufficiency and recent surgery for chronic thromboembolic pulmonary hypertension (CTEPH) who presented with abdominal pain, exertional dyspnoea, and rapidly worsening clinical status leading to multi-organ dysfunction. Despite aggressive treatment, including anticoagulation, corticosteroids, intravenous immunoglobulin, and immunosuppression, the patient succumbed, highlighting the aggressive nature of CAPS. Initial treatment consisted of anticoagulation with low-molecular-weight heparin and warfarin, supplemented by immunosuppressive therapy including hydroxychloroquine, corticosteroids, and cyclophosphamide. The complexity of management escalated with the development of diffuse alveolar hemorrhage, which required broadspectrum antibiotics and hemodiafiltration for acute renal failure. Despite multidisciplinary efforts and adherence to recommended CAPS protocols, the patient's condition progressively deteriorated, culminating in fatal multiorgan failure. The unpredictable and aggressive nature of CAPS and the limitations of current management strategies are highlighted in this case. This case highlights the need for increased awareness and early aggressive treatment of CAPS patients. It also highlights the importance of ongoing research into more effective treatment modalities and the potential benefits of a multidisciplinary approach in the management of such complex cases. Early recognition and intervention remain critical to the improvement of the prognosis and outcome of patients with CAPS.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"12 1","pages":"1-3"},"PeriodicalIF":1.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771868","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":"The Relationship Between Pain Acceptance and Acceptance of Illness in Individuals with Rheumatoid Arthritis.","authors":"Derya Akça Doğan, Seda Pehlivan, Yavuz Pehlivan","doi":"10.5152/eurjrheum.2024.23078","DOIUrl":"10.5152/eurjrheum.2024.23078","url":null,"abstract":"<p><strong>Objective: </strong>Managing treatment and symptoms of chronic diseases without accepting the illness is challenging. This study aimed to determine the relationship between pain acceptance and the acceptance of illness in individuals with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>In this descriptive study of 123 people diagnosed with rheumatoid arthritis (RA), data were collected through a questionnaire. The questionnaire included a Patient Information Form, Visual Analog Scale (VAS), Health Assessment Questionnaire (HAQ), Disease Activity Score 28 (DAS28), Chronic Pain Acceptance Questionnaire (CPAQ), and Acceptance of Illness Scale (AIS).</p><p><strong>Results: </strong>The mean chronic pain acceptance score of individuals with RA was 55.32 ± 12.96, and the mean acceptance of illness score was 25.00 ± 8.02. A statistically significant relationship existed between levels of pain measured by VAS and CPAQ (r=-0.184, P=.042). A statistically significant correlation existed between AIS and CPAQ total score (r=0.284, P=.001).</p><p><strong>Conclusion: </strong>As the levels of pain acceptance increased in RA patients, the levels of pain decreased, and the levels of acceptance of the illness increased. Patients must first acknowledge and accept their illness to follow their treatment plan effectively. Considering that the pain acceptance of individuals diagnosed with RA affects the level of acceptance of illness, it is essential to evaluate patients' pain and disease acceptance processes and support patients to increase treatment success.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"11 4","pages":"399-404"},"PeriodicalIF":1.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800046","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":"Diagnosis of Mental Disorders Complicated by Rheumatoid Arthritis: A Study of the Validity of a Questionnaire Method and Diagnosis by the Psychiatrist.","authors":"Miwa Yusuke, Tomioka Hiroi, Miwa-Mitamura Yuko","doi":"10.5152/eurjrheum.2024.24014","DOIUrl":"10.5152/eurjrheum.2024.24014","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is associated with depression in approximately 15% of patients, most of whom have been studied using questionnaires. As the depression questionnaire includes questions about physical symptoms, caution should be exercised when interpreting the results due to an underlying disease. In addition, few studies have been conducted on other psychiatric disorders. Here, we examined the validity of diagnosing rheumatoid arthritis complicated by psychiatric disorders using a questionnaire.</p><p><strong>Methods: </strong>Forty-nine outpatients with RA who consented to participate in this study were included. The patient background information included age, sex, type of anti-rheumatic drug, prednisolone use, presence of diabetes, hypertension, dyslipidemia, and C-reactive protein. The Patient Health Questionnaire-9 (PHQ-9) and Center for Epidemiologic Studies Depression Scale (CES-D) questionnaires were used; scores of ≥10 on the PHQ-9 and ≥16 on the CES-D were considered the cut-off. The psychiatrist was blinded to the questionnaire results and arrived at a diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM) in a separate room. Additionally, the specificity and sensitivity of the PHQ-9 and CES-D were examined.</p><p><strong>Results: </strong>Eleven patients had abnormal psychiatric diagnoses. The PHQ-9 had a specificity of 0.98, a sensitivity of 0.36, a positive predictive value of 0.80, and a negative predictive value of 0.89. The CES-D had a specificity of 0.87, a sensitivity of 0.91, a positive predictive value of 0.51, and a negative predictive value of 0.98.</p><p><strong>Conclusion: </strong>The PHQ-9 and CES-D may help screen for psychiatric disorders associated with RA.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"11 4","pages":"405-409"},"PeriodicalIF":1.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799915","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":"The COVID-19 Pandemic Heightens Interest in Cytokine Storm Disease and Advances in Machine Learning Diagnosis, Telemedicine, and Primordial Prevention of Rheumatic Diseases.","authors":"Tomohiro Koga, Shin-Ya Kawashiri, Fumiaki Nonaka, Yoshika Tsuji, Mami Tamai, Atsushi Kawakami","doi":"10.5152/eurjrheum.2024.23059","DOIUrl":"10.5152/eurjrheum.2024.23059","url":null,"abstract":"<p><p>Insights gained during the coronavirus disease 2019 pandemic has underscored the critical role played by both innate and adaptive immune responses in determining the severity of diseases. This newfound understanding holds significant potential to bring about a paradigm shift in the diagnosis, treatment, and management of autoimmune conditions. Advanced technologies that are emerging in the field are expected to play a pivotal role in this transformation. These include the utilization of multi-omics analysis to stratify disease states, the application of precision medicine through the integration of digital technologies, and the implementation of telemedicine to bridge existing regional disparities in healthcare provision. The objective of this descriptive review is to offer a detailed overview of reclassifying cytokine storm diseases, explore the use of machine learning methodologies in autoimmune diseases, and highlight the importance of incorporating telemedicine and innovative prevention strategies into the management of rheumatoid arthritis. Through this review, we aim to present the most recent research findings and expert insights, and discuss the future prospects and directions in these areas of research.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"11 4","pages":"410-417"},"PeriodicalIF":1.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799997","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":"Clinical and Serological Findings of Patients with Antiphospholipid Syndrome in Mashhad, Iran, from 2008 to 2018: A Retrospective, Descriptive, Cross-sectional Study.","authors":"Zahra Rezaieyazdi, Maryam Sahebari, Kianoosh Shahideh, Muhammed Joghatayi, Mandana Khodashahi","doi":"10.5152/eurjrheum.2024.23019","DOIUrl":"10.5152/eurjrheum.2024.23019","url":null,"abstract":"<p><strong>Objective: </strong>Antiphospholipid syndrome (APS) is among the autoimmune disorders caused by antiphospholipid antibodies, which provoke blood clots (thrombosis) in arteries and veins. It can also cause such complications as severe preeclampsia, miscarriage, premature birth, and stillbirth in pregnant women. We investigated the clinical and serological characteristics of antiphospholipid syndrome patients.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was performed on those with persistently positive antiphospholipid syndrome. Data were extracted from medical records from the hospital information system(HIS) of rheumatology, neurology, cardiology, gynecology, general, and hematology wards of Ghaem Hospital and private rheumatology clinics of Mashhad, which were surveyed for 10 years (2008-2018).</p><p><strong>Results: </strong>Of the 284 patients, 85.6% were female. The most common adverse outcome of pregnancy was miscarriage (68.1%). Non-criteria manifestations, including arthralgia and arthritis, were observed in 37.7% and 33.1% of the patients, respectively. Moreover, deep vein thrombosis (DVT) and cerebrovascular accident (CVA) (13%), organ gangrene (7.4%), and pulmonary thromboendarterectomy (PTE) and transient ischemic attack (TIA) (4.6%) were the most common thrombotic events in antiphospholipid syndrome patients. Deep vein thrombosis was seen in 70.3% of females (P=.005), and subclavian thrombosis was seen in 66.7% of males (P < .001). The risk of DVT in the presence of anti-cardiolipin Ab IgG positive was increased 2.7 times (CI: 95%, 1.2-5.7; P=.007), and it was increased 2.4 times in the presence of anti-β-2 glycoprotein 1 Ab IgG positive (CI: 95%, 1-5.8; P=.033) and 4.2 times in the presence of lupus anticoagulant Ab positive (CI: 95%, 1.9-9.1; P < .001). In patients with anti-β-2 glycoprotein 1 Ab IgG positive, the risk of placental dysfunction increased 4.3 times (CI: 95%, 0.9-20.3; P=.04).</p><p><strong>Conclusion: </strong>This study's results found that this APS syndrome is mainly seen in women with a mean age of 38, and the most common symptoms associated with it are DVT, CVA, and abortion. Anti-β-2 Glycoprotein 1 Ab IgM and Anti-Cardiolipin Ab IgM were the most common positive antibodies in the patients.</p>","PeriodicalId":12066,"journal":{"name":"European journal of rheumatology","volume":"11 4","pages":"390-398"},"PeriodicalIF":1.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799910","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}