Indian Journal of Medical and Paediatric Oncology最新文献

{"title":"Double-Expressor Lymphoma in a Young Child—A Case Report and Review of Literature","authors":"Anjali Shaju, Latha M. Sneha, Nidarshana Pandian, Suresh Chandra, Sonam Poonam Nisar, Krishnakumar Subramanian, Priyathersini Nagarajan","doi":"10.1055/s-0043-1772233","DOIUrl":"https://doi.org/10.1055/s-0043-1772233","url":null,"abstract":"Abstract Double hit lymphoma (DHL) and double-expressor lymphoma (DEL) are now considered as aggressive types of diffuse large B cell lymphoma. DHL is characterized by a dual rearrangement of MYC and B cell lymphoma 2 (BCL-2) and/or B cell lymphoma 6 (BCL-6) and DEL by overexpression of MYC and BCL-2. Both DHL and DEL have aggressive presentation and are more common in elderly population. We present a case of 1 ½ years old boy who presented with bilateral proptosis, and diagnosed as non-Hodgkin lymphoma with central nervous system involvement. Immunohistochemistry revealed high expression of MYC and BCL-2. Fluorescence in situ hybridization studies done to rule out DHL showed no translocation of C-MYC, Bcl-2, and Bcl-6 and hence were confirmed as double-expressor high-grade B cell lymphoma. Dual expression of C- MYC, Bcl-2, or Bcl-6 always needs further evaluation to rule out the more aggressive DHL subtypes.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136015172","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":"Clinical Syndrome of Seizures, Headache, and Visual Blurring in Metastatic Carcinoma Colon","authors":"Lakshmi Raj, T.M. Anoop, Rakesh CA","doi":"10.1055/s-0043-1772710","DOIUrl":"https://doi.org/10.1055/s-0043-1772710","url":null,"abstract":"Abstract A 51-year-old lady diagnosed as a case of metastatic carcinoma colon stage IV involving lung and left adrenal metastasis was initiated with palliative chemotherapy with FOLFOX-6 chemotherapy infusion regimen that consisted of 5-flurouracil, calcium leucovorin, and oxaliplatin and injection bevacizumab was added to cycle seven of FOLFOX-6 chemotherapy. After 2 months of initiating bevacizumab, she was presented with one episode of generalized tonic clonic seizure, headache, and visual blurring of 2 days duration and magnetic resonance imaging brain T2 fluid-attenuated inversion recovery image revealed subcortical white matter edema in bilateral frontoparietal, occipital, left temporal lobes (Fig. 1A and B), and hyperintense edema with effacement of folia in both cerebellum with nodular areas of contrast enhancement suggestive of posterior reversible encephalopathy syndrome.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136015467","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":"Complete Remission of Cutaneous Metastasis from Invasive Breast Cancer with Abemaciclib plus Letrozole","authors":"Shaunak N. Valame, Dhruti D. Manek","doi":"10.1055/s-0043-1771046","DOIUrl":"https://doi.org/10.1055/s-0043-1771046","url":null,"abstract":"Abstract Skin metastases from internal malignancies can be the first clinical finding of cancer recurrence. If presentation is delayed, they may ulcerate and develop secondary infection. Through this case, we will highlight a case of breast cancer recurrence with extensive cutaneous metastases that clinically completely responded to oral systemic therapy, thereby obviating the need for chemotherapy and leading to stark improvement in performance status and quality of life.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135149174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study Conducted at a Tertiary Cancer Care Center, Evaluating the Serum Asparaginase Activity in Children Suffering from Acute Lymphoblastic Leukemia after the Administration of Biosimilar Pegaspargase","authors":"Archana Melavarige Venkatagiri, Vasudeva K Bhat, Arjun Asok, Krishnananda Prabhu","doi":"10.1055/s-0043-1774806","DOIUrl":"https://doi.org/10.1055/s-0043-1774806","url":null,"abstract":"Abstract Introduction L-asparaginase is considered to be the most important component in the treatment of acute lymphoblastic leukemia (ALL). Intensifying the use of L-asparaginase during treatment for ALL has resulted in a significant rise in the percentage of children and adolescents who are cured of the disease. Asparaginase trough activity more than or equal to 100 IU/L on day 7 has been found to be the desired activity level in all childhood leukemia patients. Objectives Due to the paucity of data on biosimilar pegaspargase in the upfront setting, we planned this prospective pilot study to evaluate the levels of serum asparaginase activity (SAA) after biosimilar pegaspargase infusion. Materials and Methods It is a prospective, single-center, pilot study of 10 pediatric ALL patients for the duration of 6 months. All children less than 18 years with ALL on treatment with curative intent and receiving pegaspargase and who provided informed consent were included in this study. The enzymatic spectrophotometric method was used to determine SAA, and it was measured on the 7th and 14th days after the first dosage of pegaspargase-asparaginase, as well as on the 14th day after the second dose of pegaspargase-asparaginase, while toxicity was charted according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Results From 10 patients with a median age of 5.5 years, a grand total of 29 samples were taken for analysis. Children who received pegaspargase had either B-ALL or T-ALL. After the first dose, mean ± SD (standard deviation), SAA levels at day 7 was 131.3 ± 38 IU/L and at Day 14 was 94.8 ± 8 IU/L. After the second dose, mean ± SD SAA level at day 14 was 86.1 ± 15 IU/L. No patient had clinical hypersensitivity reaction and no patient reported any asparaginase-related toxicity. One patient died due to sepsis, infection with multidrug-resistant gram-negative bacteria. Conclusions Biosimilar pegaspargase maintained good SAA levels 7 and 14 days after infusion. Drug Trial Registration: Clinical Trial Registry of India vide reference CTRI/2021/08/036033 and available at https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=59285&EncHid=&userName=","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135150383","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":"Bleeding Diathesis Secondary to a Heparin-Like Anticoagulant in a Patient with Multiple Myeloma—A Case Report and Review of Literature","authors":"Nihar Desai, Seema Biswas, Dinesh Chandra, Ruchi Gupta, Anshul Gupta, Rajesh Kashyap","doi":"10.1055/s-0043-1769789","DOIUrl":"https://doi.org/10.1055/s-0043-1769789","url":null,"abstract":"Abstract Multiple myeloma (MM) is a clonal plasma cell disorder that commonly presents with anemia, renal failure, hypercalcemia, and lytic bone lesions. MM is also frequently associated with thrombotic complications; however, it may rarely present with bleeding diathesis. We report a case of a 42-year-old gentleman with relapsed immunoglobulin G lambda MM who presented with epistaxis, gingival bleeding, and oozing at the venepuncture site. Routine tests of coagulation revealed a prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin time. The PT and aPTT failed to correct with pooled normal plasma and the patient was thus diagnosed to have an acquired heparin-like anticoagulant (HLAC). The source of this HLAC has long been debated, but recent data have demonstrated that this HLAC may be the paraproteins produced by the malignant plasma cells. The patient was treated with intravenous protamine sulfate, repeated cycles of plasma exchange, and a daratumumab-based quadruplet regimen but eventually succumbed to an intracranial hemorrhage. HLAC is a rare but potentially fatal complication of MM that must be considered when patients with MM present with bleeding diathesis.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135149171","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":"To Augment or Not to Augment Consolidation Therapy for High-Risk Childhood Acute Lymphoblastic Leukemia","authors":"Shyam Srinivasan","doi":"10.1055/s-0043-1774778","DOIUrl":"https://doi.org/10.1055/s-0043-1774778","url":null,"abstract":"Nachman et al in the year 1998 published the results of the Children's Cancer Group (CCG)-1882 study in which they explored the role of augmented intensive postinduction therapy among children with high-risk acute lymphoblastic leukemia (ALL).[1] Following this study, the augmented Berlin-Frankfurt-Munster (BFM) consolidation which consists of additional vincristine and asparaginase during periods of myelosuppression of the standard IB phase became the preferred postinduction therapy for high-risk ALL across several cooperative groups. Nearly 25 years later, the intercontinental BFM group have published results of the BFM-2009 study, which aimed to address a similar question.[2] In the BFM-2009 study, patients belonging to the intermediate-/high-risk group were randomized following induction therapy to either the standard IB phase or the augmented IB phase. The results of this study showed no difference in relapse incidence (19.1% vs. 20.5%; p = 0.55) or overall survival (OS) (81.9% vs. 80.3%; p = 0.46) between the standard IB and augmented IB phases, respectively. Further, a subgroup analysis failed to demonstrate an impact of the augmented regimen on either risk group (intermediate-risk or high-risk) or immunophenotype (B-ALL or T-ALL). In addition, the incidence of allergic reactions to asparaginase, infections, and pancreatitis were higher in the augmented IB arm. In contrast to the results of the BFM-2009 study, the CCG-1882 randomized study showed a significant improvement in survival following postinduction augmentation of therapy.[1] So, what accounted for the disparity between the two studies? First, the CCG-1882 study included National Cancer Institute (NCI) high-risk (age ≥ 10 years or total leukocyte count [TLC] ≥ 50 × 109 /L) patients with poor early response defined as > 25% marrow blasts on day 7, whereas the BFM-2009 study employed a different age (6 years) and TLC cutoff (≥ 20 × 109/L) in addition to day 15 measurable residual disease (MRD) and adverse cytogenetics to define risk groups eligible for randomization. Moreover, the CCG-1882 study extended intensification not only to the IB phase but also to the interim maintenance and delayed intensification phases, while the BFM-2009 study limited augmentation to the IB phase. A significant difference was also observed in the central nervous system (CNS) prophylaxis between the two studies. The BFM-2009 study restricted cranial radiotherapy (CRT) exclusively for CNS-3 disease and offered high-dose methotrexate (HDMTX) to all patients, whereas the CCG-1882 offered Capizzi I escalating intravenous MTX without leucovorin rescue plus asparaginase and prophylactic CRT for all patients. The promising results of the CCG-1882 study led to a similar randomized study (CCG-1961) but among NCI high-risk patients with rapid early response (< 25% marrow blasts on day 7), which again concluded in favor of the augmented regimen.[3] More recently, the Medical Research Council group in their UKALL-20","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135150386","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":"Primary Intracranial Extraskeletal Mesenchymal Chondrosarcoma of the Brain in a Pediatric Patient: A Case Report and Review of Literature","authors":"Debanjan Sikdar, Sweety Gupta, Ravi Roshan, Shruti Agarwal, Deepa M. Joseph, Manoj Gupta","doi":"10.1055/s-0043-1770925","DOIUrl":"https://doi.org/10.1055/s-0043-1770925","url":null,"abstract":"Abstract Intracranial extraskeletal mesenchymal chondrosarcoma, which is characterized by undifferentiated mesenchymal cells in the presence of occasional pockets of mature hyaline cartilage, is rare in our clinical practice and commonly seen in young adults. In the pediatric population, only a few cases have been reported. In this article, we describe a case of primary recurrent intracranial mesenchymal chondrosarcoma in an 11-year-old boy well treated by surgery, radiation, and chemotherapy. We also reviewed all previously published reports on pediatric patients on the basis of their manifestations and management.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135553041","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":"An Approach to Nodal T- and NK-Cell Lymphomas—A Systemic Review","authors":"Mayur Parkhi, A. Bal","doi":"10.1055/s-0043-1772192","DOIUrl":"https://doi.org/10.1055/s-0043-1772192","url":null,"abstract":"Abstract T-cell lymphomas are rare neoplasms that have complex pathology. The multiparameter approach has been recommended by World Health Organization (WHO) for the classification of T-cell lymphomas taking into account morphology, immunophenotype, genetics, and clinical features. This also includes division established on the possible cell-of-origin (COO) from T regulatory or T-follicular helper (TFH) cells. The recent WHO-HAEM5 has classified entities as precursor T-lymphoblastic neoplasms, mature T-cell neoplasms, Epstein-Barr virus (EBV)-related T- and NK/T-cell lymphomas, and tumor-like lesions with T-cells predominance. Distinct entities have been recognized within the anaplastic large cell lymphoma (ALCL) family founded on the status of anaplastic lymphoma kinase (ALK) gene rearrangement: ALK-positive and molecularly heterogeneous ALK-negative. The family of lymphomas arising from TFH cells consists of three distinct nodal TFH cell lymphoma entities: angioimmunoblastic-type, follicular-type, and not otherwise specified. These three entities show significant clinical and immunophenotypic overlap. The cases that do not qualify for ALCL or nodal TFH cell lymphomas are labelled as peripheral T-cell lymphomas-not otherwise specified after ruling out nodal EBV-positive T- and NK- cell lymphoma. The new category termed tumor-like lesions with T cell predominance has a high chance to be misdiagnosed as lymphoma. This category includes entities such as Kikuchi-Fujimoto disease, indolent T-lymphoblastic proliferation, and autoimmune lymphoproliferative syndrome. For pathologists, diagnosing nodal T-cell lymphomas may be thought-provoking due to their broad histopathologic spectrum that mimics reactive as well as other neoplastic processes. This review provides a comprehensive diagnostic criterion of the most commonly encountered nodal T-cell and NK cell lymphomas in day-to-day training and an algorithmic approach.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42126965","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":"Risk Stratification of Early Breast Cancer (HR +/HER 2–) by CanAssist Breast and Its Corelation with Other Online Prognostic Tools: Experience from a Single Center","authors":"A. Bapna, S. Patni, N. Patni, A. Gupta, A. Samar, Naresh Ledwani, T. Gupta, P. Agarwal","doi":"10.1055/s-0043-1771404","DOIUrl":"https://doi.org/10.1055/s-0043-1771404","url":null,"abstract":"Abstract Introduction  Risk assessment by various methods for HR +/HER2– early-stage breast cancer (EBC) patients help clinicians stratify risk and tailor individual treatment. Multiple prognostic tests are available, both free and expensive. Free prognostic tools, the Nottingham Prognostic Index (NPI), and modified Adjuvant Online (mAOL) rely on clinical parameters. CanAssist Breast (CAB) considers both clinical parameters and tumor biology for assessing the risk of recurrence. Objectives  The objective is to assess risk by CAB, NPI, and mAOL and discern the differences in the risk stratification in the EBC cohort of Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India. Methods  Study cohort comprises 100 patients. Risk concordance was assessed by the kappa correlation coefficient and restratification analysis between risk groups of CAB, NPI, and mAOL was assessed using a two-sided p -value. Results  Cohort was predominated by patients aged above 50, with T2/N0/G2 tumors. Low-risk (LR) and high-risk (HR) proportions by CAB, NPI, and mAOL were 67:33, 19:81, and 14:86, respectively. Across both age groups, CAB stratified more patients as LR compared with NPI and mAOL. In subgroups of patients with N0, G2, and T2 tumors, CAB identified significantly ( p  < 0.0001) higher (3–8 times) patients as LR than NPI and mAOL. In patients with T1/G1 tumors, risk proportions were similar by all three tools. Interestingly, CAB LR (57%) was four times that of NPI (14%) in the N1 subgroup. In G3 tumors CAB LR was 13%. mAOL failed to identify LR in the N1 and G3 subgroups and NPI in the G3 subgroup. There was poor agreement between CAB and NPI/mAOL (k 0.14 [95% confidence interval: 0.03–0.24]/0.11 [0.02–0.20]). Up to 11% of mAOL/NPI LR were detected as HR by CAB and up to 63% of mAOL and NPI HR as LR by CAB. Conclusion  Prognostication by tools that use clinical parameters alone might be inadequate. Prognostication using CAB that integrates critical biomarkers indicative of tumor biology along with clinical parameters could be significant. The earlier published data on CAB across various ethnic cohorts and its comparable performance with Oncotype DX makes CAB a relevant prognostic test in HR +/HER2– EBC to make decisions on chemotherapy use.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42652290","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":"Deceptive Presentation of Low-Grade Lymphoma with Grade 3 Marrow Fibrosis and Aplasia: Diagnostic and Clinical Considerations","authors":"Suvir Singh, Rintu Sharma, Jagdeep K. Singh, P. Paul","doi":"10.1055/s-0043-1771264","DOIUrl":"https://doi.org/10.1055/s-0043-1771264","url":null,"abstract":"Abstract Bone marrow fibrosis with lymphoproliferative disorders is rare with the exception of hairy cell leukemia and nodular sclerosis Hodgkin's lymphoma. We report the case of a 63-year-old gentleman with indolent B-cell lymphoma presenting with myelofibrosis and aplasia. He was evaluated for pancytopenia with no organomegaly or lymphadenopathy. Bone marrow aspiration was a dry tap and biopsy revealed a hypocellular marrow with a cellularity of 10 to 20% with absent megakaryocytes and grade 2 to 3 reticulin fibrosis. Myeloproliferative neoplasms were ruled out based on morphology and absence of myeloid mutations on next-generation sequencing. Further sections revealed interstitial infiltrates of lymphoid cells with round, clumped chromatin and inconspicuous nucleoli, which on immunohistochemistry (IHC) were positive for CD20 and BCL2, and negative for CD5, CD10, BCL6, annexin A1, cyclin D1, and TdT. The final diagnosis was thus confirmed as CD5-negative low-grade B-cell lymphoma and he was initiated on therapy with a combination of Bendamustine and Rituximab. He had resolution of symptoms and cytopenia after six cycles of the same. Presence of significant myelofibrosis on the background of a hypocellular marrow can mimic several subtypes of myeloproliferative neoplasms or myelodysplastic syndromes, providing a diagnostic challenge. IHC is essential in determining the exact subtype to decide further therapy. Based on literature search, only a handful of patients with this presentation have been described and this case will be a valuable addition to the same.","PeriodicalId":13513,"journal":{"name":"Indian Journal of Medical and Paediatric Oncology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48941060","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}