Genitourinary Medicine最新文献

{"title":"Characterisation of high level tetracycline resistant Neisseria gonorrhoeae isolates.","authors":"T Kuroki, T Murase, Y Watanabe, Y Asai, S Yamai, S Nakayama, A Wada, H Watanabe","doi":"10.1136/sti.73.5.421-b","DOIUrl":"https://doi.org/10.1136/sti.73.5.421-b","url":null,"abstract":"","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 5","pages":"421-2"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.5.421-b","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20457073","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 association between non-gonococcal urethritis and bacterial vaginosis and the implications for patients and their sexual partners.","authors":"F E Keane,&nbsp;B J Thomas,&nbsp;L Whitaker,&nbsp;A Renton,&nbsp;D Taylor-Robinson","doi":"10.1136/sti.73.5.373","DOIUrl":"https://doi.org/10.1136/sti.73.5.373","url":null,"abstract":"<p><strong>Objectives: </strong>The aetiology of non-gonococcal urethritis (NGU) in a considerable proportion of men remains unaccounted for. We wished to investigate the possible aetiological role of bacterial vaginosis (BV), the commonest cause of abnormal discharge in women, in this condition.</p><p><strong>Methods: </strong>We carried out two studies. In the first, case-control, study, we recruited men with and without NGU and examined their female partners for evidence of BV. The second, cohort design, study which ran concurrently with the first study involved recruiting women with and without BV and examining their male partners for evidence of NGU. The diagnoses of both NGU and BV were made microscopically to include symptomatic and asymptomatic individuals in both disease categories.</p><p><strong>Results: </strong>In the case-control study 51 couples were recruited. Of these 39 men had NGU and 12 (31%) of their female contacts had BV. In contrast, of 12 men without NGU, only one (8%) of the female partners had BV (odds ratio 4.89, 95% CI: 0.51-42.27). When only Chlamydia trachomatis negative patients were considered, the odds ratio for an association between BV and NGU was increased to 6.77, 95% CI: 0.73-62.68). Thirty eight couples were recruited to the cohort design study. Of 17 women with BV, 12 (71%) of their male partners had NGU. In contrast, of 21 women without BV, seven (33%) of their male partners had NGU (p = 0.049, odds ratio 4.8). When only C trachomatis negative patients were considered, the significance of the association was increased (p = 0.037; odds ratio 5.42).</p><p><strong>Conclusions: </strong>An association exists between NGU and BV, and vice versa. If BV arises de novo the findings could help to explain the development of urethritis in stable sexual relationships.</p>","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 5","pages":"373-7"},"PeriodicalIF":0.0,"publicationDate":"1997-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.5.373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20459761","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":"Patient attitudes to type specific serological tests in the diagnosis of genital herpes.","authors":"I Fairley,&nbsp;E F Monteiro","doi":"10.1136/sti.73.4.259","DOIUrl":"https://doi.org/10.1136/sti.73.4.259","url":null,"abstract":"<p><strong>Objective: </strong>To assess patient attitudes to HSV-2 serotesting and the effect of providing detailed information regarding genital herpes, the blood test, and its implications.</p><p><strong>Methods: </strong>Consecutive genitourinary medicine clinic attenders were asked to complete an anonymous self administered questionnaire. Half received minimal additional information while the other half received a detailed information sheet.</p><p><strong>Results: </strong>Overall, 200 clinic attenders with a median age of 27 years (range 15-57) completed the questionnaire, 92.4% wanted to know if they, and 90.8% if their partners, had been infected with genital herpes; 65% expected testing as part of screening without further discussion. Overall, on a scale of 1-10, 2% scored 1 (equivalent to definitely not wanting a test), while 45.5% scored 10 (equivalent to definitely wanting a test). The overall median score was 9 (95% confidence interval 8-10) suggesting a strong opinion in favour of testing. The desire to test in each of five described hypothetical situations increased significantly (p < 0.001) when compared with the general desire.</p><p><strong>Conclusions: </strong>Clinic attenders expressed a strong preference to be serotested for HSV-2 which was unaltered by the provision of information highlighting implications, although influenced significantly by the context in which they were asked. Should reliable tests become available the level of demand could have important implications on laboratory and counselling resources.</p>","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"259-62"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20318303","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":"Semen donors and STD screening.","authors":"J M Craig,&nbsp;C L Barratt,&nbsp;G R Kinghorn","doi":"10.1136/sti.73.4.280","DOIUrl":"https://doi.org/10.1136/sti.73.4.280","url":null,"abstract":"<p><strong>Aim: </strong>The British Andrology Society recommends screening semen donors for sexually transmitted infections to minimise the risk of pathogen transmission to the mother and fetus. The aim was to review recent findings of semen donor screening and, if appropriate, recommend changes to the screening protocol.</p><p><strong>Subjects: </strong>175 consecutive men attending for STD screening between January 1992 and December 1995 who had been preselected by the Department of Obstetrics and Gynaecology as suitable semen donors.</p><p><strong>Methods: </strong>Retrospective review of case notes and group comparison of demographic and sexual history data.</p><p><strong>Results: </strong>11 men (6%) had evidence of infection, excluding CMV seropositivity, at their first STD screen. After semen donation, 109 men (63%) were rescreened and, of these, 12% had positive findings. Positive findings at initial screening were predicted by a history of more than one partner in the preceding 6 months (OR 7.11, 95% CI 1.66-30.4) but it did not predict rescreening findings. Other factors such as age, marital status, employment status or past STDs were not predictive for either screen.</p><p><strong>Discussion: </strong>Less than 20% of initial volunteers meet the full criteria of high quality post-thaw semen, no transmissible genetic disorders, and no transmissible pathogens. Sexual history may predict but would not alone preclude all positive STD screening findings. It is essential that sequential STD screening of donors continues and that genitourinary physicians should be involved in this process. Validation of newer diagnostic techniques as screening tests in this setting is required.</p>","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"280-3"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20319524","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":"Should acyclovir prophylaxis be used in late pregnancy in women with recurrent genital herpes infection? How to use a clinical decision analysis.","authors":"P Brocklehurst,&nbsp;T Roberts","doi":"10.1136/sti.73.4.314","DOIUrl":"https://doi.org/10.1136/sti.73.4.314","url":null,"abstract":"","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"314-9"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20320101","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":"Syndromic management of sexually transmitted diseases.","authors":"Y Venkataram,&nbsp;R al-Suwaid","doi":"10.1136/sti.73.4.324","DOIUrl":"https://doi.org/10.1136/sti.73.4.324","url":null,"abstract":"urethral discharge was noted. Microscopy of a Gram stained urethral specimen revealed Gram negative, intracellular diplococci for which he was treated immediately with a dose of 400 mg of ofloxacin. A provisional diagnosis of first episode of herpes simplex virus infection of the oropharyngeal cavity was made, and he was advised to take aciclovir 200 mg x 5 for 5 days. The patient reported to have always practised homosexual orogenital sex and had never practised anal sex. The sexual history of the recent casual partner was not known. He admitted to having had a similar sexual contact with another male partner 10 weeks earlier. This was his previous regular partner for 5 years who had no known history of genital herpes. He retumed after 10 days when he was reported to be well and asymptomatic. On examination the oropharyngeal ulcers were noted to be almost healed. A test of cure for N gonorrhoeae from a urethral specimen was reported negative on microscopy. A blood sample was sent for a repeat estimation of HSV antibody. Herpes simplex virus type 1 (HSV-1) was isolated from the specimen from oropharyngeal ulcers in cell culture. The serum HSV-1 antibody level showed a significant rise from less than 1 in 10 during the first visit to more than 1 in 40 on the tenth day during the follow up visit. This rise in HSV-1 antibody level was consistent with seroconversion for HSV-1. Microscopy result of N gonorrhoeae from the urethra on his first visit was confirmed on culture. A pharyngeal specimen did not grow N gonorrhoeae. Isolation of a high proportion of HSV-1 among women with first episode of genital HSV infection was first reported from Sheffield.3 Since then an annually increasing prevalence of HSV-1 in female anogenital herpes has been reported by others.4 The practice of cunnilingus has been proposed as one of the possible causes of such a trend.5 It seems reasonable to assume that such sexual activity could similarly lead to a transmission ofHSV from the genital area to the oropharyngeal cavity. In the present case, the occurrence of herpetic lesions in the oropharyngeal cavity within 1 week of unprotected orogenital contact suggests possible transmission of HSV-1 from the genital area to the oropharynx. A first episode of genital HSV-1 infection almost always indicates a true primary infection with HSV.6 Thus, seroconversion for HSV-1 in the present case suggests primary infection with this virus and also substantiates the possibility of transmission of HSV from recent orogenital contact. The incidence of sexually acquired oropharyngeal herpes due to HSV may increase as a result of increased prevalence of orogenital sexual activity. Because of the risk of transmission of HSV from asymptomatic viral shedding, the prevalence of HSV carriage and shedding from the oropharynx of sexually active adults needs to be investigated. During counselling, the possibility of acquisition of HSV infection of the oropharyngeal cavity from the anogenital region,","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"324"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20320107","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":"High level ciprofloxacin resistant gonorrhoea imported from Russia.","authors":"D A Lewis,&nbsp;M G Brook,&nbsp;M S Shafi","doi":"10.1136/sti.73.4.325-a","DOIUrl":"https://doi.org/10.1136/sti.73.4.325-a","url":null,"abstract":"general population in this high risk area, HIV test requests in the general practice sentinel network in Amsterdam have been recorded from 1989 to 1992, and from September 1994 to September 1996. The coverage of the network was reduced from 10% (198992) to 7% (1994-5) and 2% (1995-6) of the Amsterdam population, but it remained representative in terms of distribution of practices over the city and sex-age distribution. Through the years, homosexual men accounted for 15-20% of the HIV test requests and drug users for 3-6%. The average yearly incidence of test requests between 1989 and 1992 was 5-3 (4.7-5.5) per 1000 patients, after which it decreased to 3.9 (1994-5) and 2-6 (1995-6). The average percentage of positive test results between 1989 and 1996 was 7.0 (5.9-9 0), with peaks in 1991 (8.6%) and 1994-5 (9.0%). In the nationwide general practice sentinel network, which covers about 1% of the Dutch population, the yearly incidence of HIV test requests per 1000 patients rose steadily from 0-8 (1988) to 1-8 (1993). Of the tests performed, an average of 1% were positive.2 The higher incidence of test requests and positive test results in general practices in Amsterdam confirm the status of Amsterdam as a high risk area for HIV. The marked decline since 1992, in the incidence of test requests in general practices in Amsterdam is interesting, as it contradicts the trend seen elsewhere in the Netherlands. This may well reflect a certain saturation towards HIV testing among the general population in a high risk area. Towards the end of 1996, the new effective combination treatment for HIV became available.3 This is expected to stimulate HIV test requests from individuals who have been at risk for HIV but have not tested before. Given the trend described here, it remains to be seen if a rise in HIV test requests will occur in Amsterdam. L WIGERSMA Department of General Practice, Academic Medical Centre, Meibergdreef 15, 1105 AZ Amsterdam, Netherlands","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"325-6"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.325-a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20320110","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":"HSV type specific antibody tests: patients are ready, are clinicians?","authors":"R L Ashley,&nbsp;L Corey","doi":"10.1136/sti.73.4.235","DOIUrl":"https://doi.org/10.1136/sti.73.4.235","url":null,"abstract":"Genital herpes infections continue to increase. In the United Kingdom, HSV-2 seroprevalence is 11%. In the United States, HSV-2 seroprevalence has risen from 16% in 1978 to 22% in 1990-a 31% increase. The greatest increase in incidence is in white people between 19 and 35 years of age. In Europe and the United States, 30% to 60% of clients attending STD clinics are HSV-2 seropositive In all populations studied, whether of high or low HSV-2 prevalence, the majority of genital HSV-2 infections are unrecognised by patients or clinicians.'-3 A number of studies also suggest that source partners in most transmission events (including mother to infant transmission) are unaware that they have genital herpes.4 Clearly, undiagnosed genital herpes infections are the major factor in fuelling the genital herpes epidemic. The most practical and common method for identifying silent virus carriers is testing for serum antibodies. Accurate, HSV type specific serology methods have been available in a number of research laboratories in Scandinavia,8 the United States,9 10 Australia,\" 12 and the United Kingdom'3 for a number of years and the technology for wide commercial distribution of these tests has existed for over a decade. Yet, in our opinion, companies have been reluctant to invest in type specific HSV test development because clinicians have shown little interest in diagnosing subclinical genital herpes. Why is this? Perhaps the medical and psychosocial consequences of genital herpes infections are not fully appreciated by most clinicians. Perhaps healthcare providers have been fearful of opening a \"Pandora's box\" of follow up concerns from patients who, in the absence of appropriate testing, would be otherwise unaware of their infections. The time involved in explaining to each of a potential 30-60% of STD clinic clients that he/she has a chronic, intermittently transmissible, infection is daunting. The personal aspects of answering questions such as \"How did I acquire this infection?\"; \"What are my responsibilities regarding my present and future partners?\"; or, even, \"What do you mean these symptoms are not due to a treatable yeast infection?\" are disconcerting. Unfortunately, medical and scientific information to easily answer such questions is not fully available. Thus, it is of interest that this issue of Genitourinary Medicine offers three articles related to the patient's viewpoint on genital herpes.'1'6 In particular, Drs Fairley and Monteiro have offered important insights on the opinions of patients regarding who should be tested and under what circumstances.'6 Their article, \"Patient attitudes to type specific serological tests in the diagnosis of genital herpes' reveals that the majority of genitourinary medicine clinic attendees want to know their HSV serostatus. Further, a scaled response measure revealed that this desire to know was extremely strong in the following, perceived, \"high risk\" circumstances; having had sex with a partner known ","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"235-6"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20318298","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":"Treatment of male partners and recurrence of bacterial vaginosis: a randomised trial.","authors":"E Colli,&nbsp;M Landoni,&nbsp;F Parazzini","doi":"10.1136/sti.73.4.267","DOIUrl":"https://doi.org/10.1136/sti.73.4.267","url":null,"abstract":"<p><strong>Objective: </strong>To test the efficacy of treatment with clindamycin of a partner on the recurrence rate of bacterial vaginosis in women within 3 months from diagnosis.</p><p><strong>Subjects: </strong>Eligible for the study were sexually active women with one current sexual partner, who were aged 18-45 years, with a clinical diagnosis of bacterial vaginosis and whose partner agreed to be treated.</p><p><strong>Methods: </strong>A double blind, randomised, controlled trial was conducted comparing the effect of treating the partner with either clindamycin capsules or placebo on the reduction of the recurrence rate of bacterial vaginosis. Women were treated with clindamycin 2% vaginal cream, administered intravaginally once daily at bedtime for 7 consecutive days. The partners were randomly allocated to clindamycin hydrochloride capsules, 150 g by mouth four times daily for 7 consecutive days, or a placebo. A total of 139 couples were randomised--69 were treated with clindamycin vaginal cream group and 70 with placebo. One, 4, and 12 weeks after the end of treatment the patients and their partners were examined; vaginal discharges were examined to check for clue cells, vaginal pH was determined, and a KOH test carried out.</p><p><strong>Results: </strong>Overall, 131 women out of the 139 who entered the study were cured (94.2%, lower 95% confidence interval 79.8, based on Poisson's approximation). There was no difference in the cure rate among women whose partner received clindamycin or placebo (chi(2) p = not significant). A total of 55 couples (26 in the clindamycin and 29 in the placebo group) withdrew from the study during the follow up period. Of the 69 women whose partner received clindamycin, 22 (31.9%) reported \"recurrence\" or persistence. The corresponding number was 21 (30%) of the 70 women whose partner received placebo (chi(2) p = not significant). Of the 84 couples in which the woman was cured by the first week's visit and who completed the study; there were five recurrences (11.6%) among the 43 women whose partner received clindamycin and nine (22.0%) of the 41 whose partner received placebo (chi(2) p = not significant).</p><p><strong>Conclusion: </strong>This study indicates that vaginal clindamycin is effective and safe in the treatment of bacterial vaginosis, but it does not support the suggestion that male treatment markedly reduces the short term recurrence rate.</p>","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"267-70"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20318305","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":"Markers of sexually transmitted diseases in seminal fluid of male clients of female sex workers.","authors":"A M Worm,&nbsp;E Lauritzen,&nbsp;I P Jensen,&nbsp;J S Jensen,&nbsp;C B Christiansen","doi":"10.1136/sti.73.4.284","DOIUrl":"https://doi.org/10.1136/sti.73.4.284","url":null,"abstract":"<p><strong>Objectives: </strong>To screen for certain STD markers in a group of male clients of female sex workers.</p><p><strong>Method: </strong>Condoms with seminal fluid were collected at 10 \"massage parlours\" in Copenhagen. The seminal fluid samples were examined for HIV antibodies, markers of hepatitis B virus (HBV), Chlamydia trachomatis, and Mycoplasma genitalium.</p><p><strong>Results: </strong>All samples (n = 332) were negative for HIV antibodies. Out of 327 samples examined for HBV markers 32 (9.8%) were positive for HBV core antibodies, one of which was also positive for HBV antigen. C trachomatis could be demonstrated in six out of 122 (4.9%) samples and M genitalium in one out of 122 samples.</p><p><strong>Conclusions: </strong>The finding of a C trachomatis prevalence of 4.9% is considerable higher than expected in men with a presumed age of 35-55 years. The demonstration of a prevalence of HBV markers of 9.8% indicates that these clients have an increased risk of HBV infection, a finding that further consolidates the recommendation of HBV vaccination of sex workers. As shown in this study, STD transmission in commercial sex may also have the client as the source.</p>","PeriodicalId":12621,"journal":{"name":"Genitourinary Medicine","volume":"73 4","pages":"284-7"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/sti.73.4.284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20319525","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}