Hernia最新文献

{"title":"The impact of simultaneous panniculectomy in ventral hernia repair: a systematic review and meta-analysis.","authors":"Ana Caroline Dias Rasador, Patricia Marcolin, Carlos André Balthazar da Silveira, João Pedro Gonçalves Kasakewitch, Raquel Nogueira, Sergio Mazzola Poli de Figueiredo, Diego Laurentino Lima, Flavio Malcher","doi":"10.1007/s10029-024-03149-y","DOIUrl":"10.1007/s10029-024-03149-y","url":null,"abstract":"<p><strong>Background: </strong>Ventral hernia repair (VHR) is often performed in patients with obesity. While panniculectomy improves cosmetic outcomes, it may increase complications, particularly wound-related adverse events. Despite its widespread use, the impact of concurrent panniculectomy on postoperative complications in VHR remains unclear. This study aimed to assess whether concurrent panniculectomy increases postoperative complications in VHR.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Web of Science, and Cochrane databases for studies published up to April 2024 comparing surgical outcomes in patients undergoing VHR with and without concurrent panniculectomy. We assessed recurrence, seroma, hematoma, surgical site infections (SSI), wound dehiscence, skin necrosis, chronic wound, length of stay (LOS), readmissions, duration of surgery, and deep venous thromboembolism (DVT). Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled for dichotomous and continuous endpoints, respectively. We used RStudio for statistics and heterogeneity was assessed with I<sup>2</sup> statistics.</p><p><strong>Results: </strong>We screened 890 studies, fully reviewed 40, and included 11 observational studies and 2 randomized controlled trials, comprising 23,354 patients. Of these, 2,972 (13%) patients underwent VHR with concurrent panniculectomy (VHR-PAN). The mean age ranged from 37 to 59 years, and 73% of the sample were women. The mean BMI varied from 29 to 45 kg/m<sup>2</sup>, and 75% of the patients underwent mesh repair. The mean defect area ranged from 36 to 389 cm<sup>2</sup>. Most repairs were performed using mesh (75%) in an underlay position (68%) and 24% underwent component separation. VHR-PAN was associated with a decrease in recurrence rates (RR 0.74; 95% CI 0.62 to 0.89; p < 0.001; I2 = 1%) with a follow-up ranging from 1 to 36 months. Furthermore, subgroup analysis of recurrence in studies with a mean follow-up of at least one year also showed a reduction in recurrence (RR 0.72; 95% CI 0.60 to 0.88; p < 0.001; I2 = 12%), with a follow-up ranging from 12 to 36 months. Moreover, concurrent panniculectomy was associated with increased SSI (RR 1.31; 95% CI 1.13 to 1.51; p < 0.001; I2 = 0%), SSO (RR 1.49; 95% CI 1.26 to 1.77; p < 0.001; I2 = 11%), skin necrosis (RR 2.94; 95% CI 1.26 to 6.85; p = 0.012; I2 = 0%) and reoperation (RR 1.73; 95% CI 1.32 to 2.28; p < 0.001; I<sup>2</sup> = 0%), and longer LOS (MD 0.90 day; 95%CI 0.40 to 1.40; p < 0.001; I<sup>2</sup> = 56%). There was no significant difference in ocurrence of DVT, enterocutaneous fistula, hematoma, seroma, or wound dehiscence, neither on operative time or readmission rates.</p><p><strong>Conclusion: </strong>VHR-PAN is associated with lower recurrence rates. However, it increases the risk of wound morbidity and reoperation and prolongs hospital stay. Surgeons should carefully weigh the risks and benefits of performing VHR-PAN.</p><p><","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesh exposure after ventral hernia repair with onlay biosynthetic mesh: a retrospective review of associated risk factors and management strategies.","authors":"Chris Amro, Isabel Ryan, Mehdi S Lemdani, Corey M Bascone, Phoebe B McAuliffe, Abhishek A Desai, J Reed McGraw, Robyn B Broach, Stephen J Kovach, John P Fischer","doi":"10.1007/s10029-024-03108-7","DOIUrl":"10.1007/s10029-024-03108-7","url":null,"abstract":"<p><strong>Background: </strong>Although intraperitoneal and retromuscular mesh placement in ventral hernia repair (VHR) are associated with lower recurrence rates, the onlay plane remains a well-established option for certain clinical scenarios. A knowledge gap remains regarding resorbable biosynthetic onlay mesh and mesh exposure. We aim to determine exposure rate, risk factors, and treatment options.</p><p><strong>Study design: </strong>A single-center, two-surgeon retrospective review was performed examining patients who underwent VHR with onlay, Poly-4-hydroxybutyrate (P4HB) mesh from 2015 to 2021. Demographics, operative characteristics, outcomes, and mesh exposure management were analyzed.</p><p><strong>Results: </strong>Of 346 patients, 15 (4.3%) experienced mesh exposure. The mean age was 53 years and BMI of 33.6 kg/m². Patients were majority ASA class 3 (65%), female (64.2%), and averaged a defect size of 307.9 ± 235.2 cm². Independent risk factors included diabetes (AOR = 4.3,CI 1.5-12.5;p < 0.005) and COPD (AOR = 5.2,CI 1.3-21.8;p = 0.02). Mesh exposures were identified as outpatient (20%) or intraoperative (80%). All underwent operative debridement, in which nine were managed with skin reclosure, two with partial closure, and four healed by secondary intention. Five patients required excision of unincorporated mesh. Four patients required further debridement from chronic surgical site occurrences; however, all mesh exposure patents healed after a mean of 260.8 ± 313.2 days and retained original mesh. The recurrence rate was 6.7% for mesh exposure patients.</p><p><strong>Conclusion: </strong>When faced with mesh exposure, resorbable biosynthetic mesh placed in onlay fashion was retained in all patients. Patients with a history of diabetes or COPD have increased risk of mesh exposure and should be counseled.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective randomized study comparing mesh displacement in enhanced-view totally extraperitoneal versus totally extraperitoneal laparoscopic inguinal hernia repair without mesh fixation.","authors":"Abdullah Hilmi Yilmaz, Mehmet Esref Ulutas, Saim Turkoglu","doi":"10.1007/s10029-024-03181-y","DOIUrl":"10.1007/s10029-024-03181-y","url":null,"abstract":"<p><strong>Purpose: </strong>In laparoscopic inguinal hernia repair, it is thought that the mesh can be displaced more in the enhanced-view totally extraperitoneal (eTEP) technique. The aim of this study was to compare eTEP and totally extraperitoneal (TEP) techniques without mesh fixation in terms of mesh displacement and hernia recurrence.</p><p><strong>Methods: </strong>Between December 2022 and April 2023, 60 consecutive patients with unilateral inguinal hernia were randomized into two groups; eTEP group (n = 30) and TEP group (n = 30). There was without mesh fixation in both groups. Study was registered at http://Clinicaltrials.gov (NCT06070142). The mesh was marked with three radiopaque clips. Pelvic radiographs were performed to evaluate the displacement of the mesh. The primary outcome of this study was mesh displacement. In addition, this is the first study in the literature to compare eTEP and TEP techniques in terms of mesh displacement without fixation in laparoscopic inguinal hernia.</p><p><strong>Results: </strong>There was no significant difference between the groups in terms of mesh displacement, recurrence, postoperative VAS scores, length of hospital stay, hematoma, and seroma formation. The operation time was higher in the eTEP group and was statistically significant.</p><p><strong>Conclusion: </strong>Without mesh fixation, the eTEP technique does not increase the risk of mesh displacement and recurrence. The eTEP technique can be safely applied without mesh fixation in laparoscopic inguinal hernia repairs.</p><p><strong>Trial registration: </strong>ClinicalTrials number: NCT06070142.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoendoscopic extraperitoneal surgical techniques for ventral hernias and diastasis recti repair: a systematic review.","authors":"Francesco Ferrara, Federico Fiori","doi":"10.1007/s10029-024-03144-3","DOIUrl":"10.1007/s10029-024-03144-3","url":null,"abstract":"<p><strong>Purpose: </strong>this systematic review aims to classify and summarize the characteristics and outcomes of the different laparoendoscopic extraperitoneal approaches for the repair of ventral hernias and diastasis recti described in the last 10 years.</p><p><strong>Methods: </strong>a literature search was performed by two reviewers in December 2023 including articles from January 2013, 01 to December 2023, 15. The techniques were selected according to the surgical access site (anterior or posterior to the rectus sheath), the access type (laparoendoscopic, single incision laparoscopic, mini or less open), the main space used to repair the defect (subcutaneous or retromuscular) and the mesh place (onlay, sublay-retromuscular or sublay-preperitoneal) and classified as anterior or posterior approaches.</p><p><strong>Results: </strong>the literature search retrieved 1755 results and 27 articles were included in the study. The studies included 1874 patients, the mean age ranged from 37.8 to 60.2 years. The access site was anterior in 16 cases and posterior in 11 cases. The mesh was positioned onlay in 13 cases and sublay in 13 cases, with only one study using no mesh. Complications were: seroma, ranging from 0.8 to 81%, followed by skin complications (leak, ischemia, necrosis) from 0.8 to 6.4%, surgical site infections and bleeding. Recurrences ranged from 0% to 12,5%, with a mean follow-up from 1 to 24 months.</p><p><strong>Conclusion: </strong>this systematic review confirms the presence of several new minimally invasive extraperitoneal techniques for the repair of abdominal wall defects, with different advantages and disadvantages. Further studies, with more extensive follow-up data and wider patient groups, are necessary to define specific indications for each technique.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD.","authors":"Zhihao Zhu, Jinlei Mao, Menghui Zhou, Minjun Xia, Junjie Wu, Qi Chen, Fei Zhao, Hongxia Liang, Zhifei Wang","doi":"10.1007/s10029-024-03172-z","DOIUrl":"10.1007/s10029-024-03172-z","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic sphincter augmentation (MSA) is a novel surgical technique investigated at many clinical institutes worldwide. In 2012, it received approval for treating Gastroesophageal reflux disease (GERD) because of its superior benefits compared to drug therapies. This study aimed to explore the safety and efficacy of MSA compared with Laparoscopic Nissen fundoplication (LNF) for GERD treatment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 40 patients who received preoperative matching features of MSA and LNF. The surgical details and one-year postoperative outcomes were analyzed and reported.</p><p><strong>Results: </strong>Significant improvement in GERD symptoms was observed in both MSA and LNF patients over the one-year surgical follow-up. Dysphagia was a common postoperative complication observed in both procedures, but no cases required endoscopic dilation. MSA had a significantly shorter operative time compared to LNF (112 vs.175 min, P < 0.001), with faster postoperative dietary recovery [1(0.5,1.5) vs. 3(1.63,5.38) month(s), P < 0.001] and more preservation of hiccup ability (87.5% vs. 45.83%, P = 0.01). No significant disparities were observed between the two groups regarding hospital duration, recovery of physical strength, and upper gastrointestinal complaints.</p><p><strong>Conclusion: </strong>In conclusion, both LNF and MSA are safe and successful surgical therapies for GERD. The benefits of MSA include reduced surgical time, quicker nutritional recovery following surgery, and preservation of hiccup capacity. However, with both surgeries, postoperative dysphagia is a prevalent problem that emphasizes the significance of improving preoperative communication. When selecting between two surgical techniques, it is crucial to consider the postoperative symptoms associated with each procedure.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid intraperitoneal onlay mesh repair for incisional hernias: a systematic review and meta-analysis.","authors":"Patrícia Marcolin, Sarah Bueno Motter, Gabriela R Brandão, Diego L Lima, Bruna Oliveira Trindade, Sérgio Mazzola Poli de Figueiredo","doi":"10.1007/s10029-024-03105-w","DOIUrl":"10.1007/s10029-024-03105-w","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic IPOM is technically challenging, especially regarding fascial closure. Hybrid repair has been proposed as a simpler approach. We aimed to compare hybrid and laparoscopic intraperitoneal onlay mesh repair (IPOM) in patients undergoing ventral hernia repair (VHR).</p><p><strong>Methods: </strong>We performed a systematic review of Cochrane, Scopus, and MEDLINE databases to identify studies comparing hybrid versus laparoscopic IPOM VHR reporting the outcomes of recurrence, mortality, seroma, postoperative complications, reoperation, surgical site infection, and operative time. Statistical analysis was performed using RStudio 4.1.2 using a random-effects model.</p><p><strong>Results: </strong>We screened 2,896 articles and fully reviewed 22 of them. A total of five studies, encompassing 664 patients were included. Among them, 337 (50.8%) underwent laparoscopic IPOM. All patients had incisional hernias, with a mean diameter varying from 3 to 12.7 cm, 60% were women, with a mean BMI varying from 29.5 to 38. The hybrid approach had a lower rate of seroma when compared to the laparoscopic (OR 0.22; 95% CI 0.05 to 0.92; p = 0.038; I²=78%). We found no difference in recurrence, mortality, postoperative complications, reoperation, surgical site infection, and operative time between groups.</p><p><strong>Conclusion: </strong>Hybrid IPOM is a safe and effective method for incisional hernia repair. Moreover, it facilitates fascial defect closure and decreases postoperative seromas.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher rates of recurrence and worse quality of life in obese patients undergoing inguinal hernia repair.","authors":"Mikhail Attaar, Beau Forester, Kristine Kuchta, Michael B Ujiki, John Linn, Woody Denham, H Mason Hedberg, Stephen Haggerty","doi":"10.1007/s10029-024-03154-1","DOIUrl":"10.1007/s10029-024-03154-1","url":null,"abstract":"<p><strong>Purpose: </strong>Prior investigations regarding the effect of obesity on inguinal hernia repair have been mixed. The aim of our study was to retrospectively compare perioperative outcomes, recurrence rate, and quality of life between obese and non-obese patients undergoing inguinal hernia repair.</p><p><strong>Methods: </strong>Patients who underwent inguinal hernia repair by any approach at a single institution were identified from a prospectively maintained quality database. Patients with a body mass index (BMI) greater than or equal to 30 kg/m² were considered obese. Quality of life was measured with the Surgical Outcomes Measurement System (SOMS) and Carolinas Comfort Scale (CSS) surveys. Differences between obese and non-obese patients were assessed using independent samples t-tests, Wilcoxon rank-sum, and chi-square tests.</p><p><strong>Results: </strong>Between 2010 and 2021, a total of 5575 patients underwent inguinal hernia repair. Fifteen percent of patients were identified as obese (835 patients, mean BMI 33.2 ± 3.3 kg/m²). A significantly higher percentage of obese patients were diabetic, and operative time and estimated blood loss were higher in the obese group (all p < 0.001). Rates of hernia recurrence in obese patients was significantly more likely than in non-obese patients (4.2% vs 2.0%, p < 0.001). Up to 2 years postoperatively, a greater percentage of obese patients reported worse quality of life on the SOMS and more bothersome symptoms on the CCS.</p><p><strong>Conclusions: </strong>Inguinal hernia repair in obese patients is a more technically challenging operation. Long-term follow-up revealed a greater risk of hernia recurrence and worse quality of life up to 2 years postoperatively in this patient population.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Make a difference: become a volunteer.","authors":"A Kingsnorth","doi":"10.1007/s10029-024-03063-3","DOIUrl":"10.1007/s10029-024-03063-3","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to: Usefulness of laparoscopic inguinal hernia repair using the Endoscope Manipulator Robot (EMARO).","authors":"Xiaosong Li, Hao Zhang, Hang Li","doi":"10.1007/s10029-024-03141-6","DOIUrl":"10.1007/s10029-024-03141-6","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lap-re-Do Keyhole versus Lap-re-Do Sugarbaker techniques in large parastomal hernia repair: a retrospective cohort study.","authors":"Xiaojian Fu, Minglei Li, Rong Hua, Qiyuan Yao","doi":"10.1007/s10029-024-03130-9","DOIUrl":"10.1007/s10029-024-03130-9","url":null,"abstract":"<p><strong>Purpose: </strong>To review the safety and efficacy of Lap-re-Do technique in the treatment of large parastomal hernia.</p><p><strong>Methods: </strong>We retrospectively analyzed the recurrence and complications of 81 patients with large parastomal hernia who underwent Lap-re-Do technique in Huashan Hospital of Fudan University from May 2010 to December 2019. And the patients should be able to complete follow-up. With such criteria, we included 40 Lap-re-Do Keyhole patients and 41 Lap-re-Do Sugarbaker patients. Observation time was defined as time to recurrence, death, or last nonevent visit.</p><p><strong>Results: </strong>In large parastomal hernias, Lap-re-Do had a recurrence rate of 25.9% and complication rate of 16.0%, and reoperation rate of 9.9% during the average follow-up time of 41.1 ± 17.8 months. Recurrence rates were 40% (16/40) after Lap-re-Do Keyhole repair and 12.2% (5/41) after Lap-re-Do Sugarbaker repair. Complication rates were 12.5% after Lap-re-Do keyhole and 19.5% after Lap-re-Do Sugarbaker repair Re-operation rates referred to Lap-re-Do keyhole repair were 15% and Lap-re-Do Sugarbaker repair 4.9% during follow-up.The majority of reoperations were indicated by recurrence.</p><p><strong>Conclusions: </strong>Large parastomal hernias are still difficult to be treated. Lap-re-Do Sugarbaker is recommended as an appropriate procedure to close the hernia ring, removing the lengthy colostomy, and effectively reduce recurrence and complication rates.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}