International Medical Case Reports Journal最新文献

{"title":"Rupture of Left Ventricular Aneurysm in Infant: Case Report.","authors":"Andriy A Pereyaslov, Bohdan Malovanyy, Iryna I Hoshovska, Halyna P Zaremba, Olesya M Nykyforuk, Svitlana A Tomashova, Oleg Sodoma, Lilia Y Gyzha, Roman I Dats","doi":"10.2147/IMCRJ.S636019","DOIUrl":"https://doi.org/10.2147/IMCRJ.S636019","url":null,"abstract":"<p><p>Rupture of ventricular aneurysm is an unusual pathology in children. This case describes a preterm infant who had been in the hospital since birth due to necrotizing enterocolitis, which was complicated by narrowing of the ascending colon that required surgery. Throughout the entire period, the infant exhibited signs of infection, first caused by <i>Staphylococcus haemolyticus</i> and subsequently by <i>Staphylococcus epidermidis</i>. Several echocardiographic examinations did not reveal any significant changes; however, the final echocardiography revealed a structure connected to the left ventricular cavity. The infant experienced sudden cardiac arrest due to significant pericardial effusion. Despite continued resuscitation efforts, including emergency pericardiocentesis, the asystole recurred, further advanced life support measures were unsuccessful, and death was pronounced. Autopsy revealed a small outpouching on the anterior wall of the left ventricle, associated with thinning of the myocardium and a linear rupture with uneven edges. Histological examination showed that the aneurysm wall was composed of myocardium and connective tissue, exhibiting signs of inflammation, necrosis, and hemorrhage.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"636019"},"PeriodicalIF":0.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169442","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":"Adult-Onset Henoch-Schönlein Purpura Triggered by Isotretinoin with Persistent Polyarthritis and Isolated Cutaneous-Gastrointestinal Involvement: A Case Report.","authors":"Hussam Aldeen Mansour, Abdullah Alfandi, Aiman Abo Al Shamat, Abdalrhman Alras, Mohamad Nour Qanbar, Sameer Eshrifeh, Reham Almukbel, Hosin Alhaj Omar Khalil, Ali Jumaa, Mohammad Adi, Ahmad Anwar Alkheder","doi":"10.2147/IMCRJ.S650612","DOIUrl":"https://doi.org/10.2147/IMCRJ.S650612","url":null,"abstract":"<p><strong>Introduction: </strong>IgA vasculitis (Henoch-Schönlein purpura, HSP) is a small-vessel vasculitis predominantly affecting children, while adult-onset disease is less common and often more severe, particularly with renal involvement. Drug-induced cases are rare, with only isolated reports linking isotretinoin to IgAV.</p><p><strong>Case presentation: </strong>A 30-year-old woman developed palpable purpura, abdominal pain, and symmetric polyarthritis three weeks after starting isotretinoin. Laboratory evaluation showed mild inflammation with negative autoimmune workup and normal renal function; repeated urinalysis remained normal. Isotretinoin was discontinued, and corticosteroid therapy led to resolution of cutaneous and gastrointestinal symptoms. However, persistent inflammatory polyarthritis beyond six weeks required initiation of methotrexate, with subsequent improvement. No renal involvement developed during follow-up.</p><p><strong>Conclusion: </strong>This case highlights isotretinoin as a rare trigger of adult-onset IgAV and expands its clinical spectrum to include persistent, treatment-resistant arthritis without renal disease. Early recognition, drug withdrawal, and appropriate immunosuppression are key, with close renal monitoring recommended.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"650612"},"PeriodicalIF":0.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165428","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":"Anaphylaxis Following Intravenous Methylprednisolone Sodium Succinate: A Case Report.","authors":"Fatimah Alahmari, Yahya Shabi","doi":"10.2147/IMCRJ.S643043","DOIUrl":"https://doi.org/10.2147/IMCRJ.S643043","url":null,"abstract":"<p><strong>Background: </strong>Immediate hypersensitivity to systemic corticosteroids is rare but potentially life-threatening, and it may be overlooked when the cardiovascular presentation is atypical. Identifying the responsible determinant, whether the corticosteroid molecule, a solubilizing ester, or a formulation excipient, is often difficult.</p><p><strong>Case presentation: </strong>A 45-year-old woman with rheumatoid arthritis developed a generalized pruritic, erythematous, raised eruption, dyspnea, hypoxemia, bradycardia, and reduced consciousness within 5 minutes of starting intravenous methylprednisolone sodium succinate 250 mg. The infusion was stopped, and symptoms resolved after intramuscular epinephrine 0.4 mg. Approximately 7 hours later, because the reaction was considered unlikely to be allergic, the same formulation was re-administered in two graded steps (25%, then 75%) under continuous monitoring and direct physician supervision. This high-risk re-exposure after clinically convincing anaphylaxis reproduced the cutaneous and respiratory features, again with bradycardia (heart rate 51 beats/min) and hypoxemia (oxygen saturation 88%), and required intramuscular epinephrine 0.3 mg, an intravenous antihistamine, oxygen, and a bronchodilator. Serum tryptase and formal allergy testing were not obtained. She later reported tolerating oral prednisolone, with no recurrent symptoms during 3 months of follow-up.</p><p><strong>Conclusions: </strong>Recurrence on re-exposure supports anaphylaxis to the administered methylprednisolone formulation, but without confirmatory testing the reaction cannot be attributed to methylprednisolone itself, the succinate ester, or an excipient. This patient-safety case shows that bradycardia does not exclude anaphylaxis; that a graded challenge is a diagnostic test, not desensitization, and is not a recommended strategy after convincing anaphylaxis; and that the exact implicated formulation should be documented instead of a nonspecific steroid-allergy label.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"643043"},"PeriodicalIF":0.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165816","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":"Blackwater Fever Complicated by Severe Acute Kidney Injury and a Therapeutic Dilemma: A Case Report from Niger.","authors":"Abdoul-Aziz Adamou Bara, Ibrahim I Abdou Maman, Lamine Mahaman Moustapha, Fils Souleymane Adoum, Abdoulaye Alassane Mahamidou, Hamsatou Bagnou, Hassane Diongolé Moussa, Mahamadou Doutchi","doi":"10.2147/IMCRJ.S649196","DOIUrl":"10.2147/IMCRJ.S649196","url":null,"abstract":"<p><strong>Introduction: </strong>Blackwater fever (BWF) is a rare complication of antimalarial treatment characterized by acute intravascular hemolysis. Its diagnosis is mainly clinical, particularly based on the presence of dark-colored urine.</p><p><strong>Case presentation: </strong>We report the case of a 50-year-old woman admitted to the Infectious and Tropical Diseases Department of the National Hospital of Zinder for fever, jaundice, and acute kidney injury in the context of persistent <i>Plasmodium falciparum</i> infection and repeated antimalarial treatments, including artesunate. Clinical and laboratory findings were suggestive of severe intravascular hemolysis, with severe acute kidney injury (serum creatinine: 1104.1 µmol/L). After renal replacement therapy was initiated and urine output resumed, the patient developed dark 'Coca-Cola'-colored urine, suggestive of hemoglobinuria. Blackwater fever was strongly suspected based on the overall clinical context. The patient underwent eight sessions of hemodialysis and received alternative antimalarial therapy. The outcome was favorable, with progressive recovery of renal function.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic and therapeutic challenges of suspected blackwater fever in a patient with persistent <i>Plasmodium falciparum</i> infection and repeated antimalarial exposure. Although repeated artesunate exposure raises the possibility of a drug-related contribution, causality cannot be established. Early recognition of hemolysis and acute kidney injury, together with appropriate antimalarial and supportive treatment, is essential.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"649196"},"PeriodicalIF":0.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136376","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":"Complete Regression of 11 Hepatic Metastases in Metastatic Pancreatic Adenosquamous Carcinoma and the Role of GPT in Patient Navigation.","authors":"Suleyman T Khalil","doi":"10.2147/IMCRJ.S639766","DOIUrl":"10.2147/IMCRJ.S639766","url":null,"abstract":"<p><p>Complete responses in metastatic pancreatic adenosquamous carcinoma (ASCP) are extremely rare and carbohydrate antigen 19-9 (CA 19-9) interpretation is difficult during cholestasis. A 65-year-old man underwent Whipple procedure on 29 May 2025; pathology confirmed ASCP (pT3 pN2, R0). Contrast-enhanced magnetic resonance imaging (MRI) on 26 June 2025 showed 11 liver lesions interpreted as metastases. Treatment with folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) began on 7 July 2025. From cycle 2, high-dose intravenous vitamin C, doxycycline and later azithromycin were added by the patient and author as off-label home measures, without efficacy claims. After three cycles, follow-up MRI showed complete radiological regression of the hepatic lesions; MRI around the sixth cycle confirmed complete radiological response. Chemotherapy stopped after six cycles. In late September 2025, cholestasis and CA 19-9 rise were initially suspected as recurrence; after ursodeoxycholic acid, CA 19-9 decreased and normalized by 10 January 2026. Follow-up MRI on 20 February 2026 showed no visible hepatic lesions.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"639766"},"PeriodicalIF":0.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136441","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":"Many Factors Determine Phenotypic Heterogeneity in LHON [Letter].","authors":"Josef Finsterer","doi":"10.2147/IMCRJ.S650361","DOIUrl":"10.2147/IMCRJ.S650361","url":null,"abstract":"","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"650361"},"PeriodicalIF":0.7,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136531","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":"Isolated Prostatic Tuberculosis Coexisting with Benign Prostatic Hyperplasia: A Case Report.","authors":"Mohammad Hussain Modabber, Mohammad Ibrahim Kamal, Mohammad Fahim Sarwary, Amjadzia Bawarzai, Mahbobullah Sediqi, Maiwand Marofi, Latifa Sadeqy, Abdulghani Azizi","doi":"10.2147/IMCRJ.S640903","DOIUrl":"10.2147/IMCRJ.S640903","url":null,"abstract":"<p><strong>Background: </strong>Prostatic tuberculosis is a rare manifestation of genitourinary tuberculosis and an uncommon form of extrapulmonary tuberculosis. Because its clinical presentation is often nonspecific and closely resembles benign prostatic hyperplasia (BPH), chronic prostatitis, or prostate carcinoma, the diagnosis is frequently delayed and often established only after histopathological examination of prostatic tissue. Reporting such cases is important to increase clinical awareness and facilitate timely diagnosis, particularly in tuberculosis-endemic regions.</p><p><strong>Case presentation: </strong>A 70-year-old man presented with a one-month history of lower urinary tract symptoms complicated by recurrent urinary retention requiring repeated urethral catheterization. His prostate-specific antigen level was 5.5 ng/mL, and ultrasonography demonstrated a 59-gr enlarged prostate, consistent with benign prostatic hyperplasia. He subsequently underwent transurethral resection of the prostate. Histopathological evaluation revealed caseating granulomatous inflammation strongly suggestive of prostatic tuberculosis coexisting with benign prostatic hyperplasia, in the absence of primary microbiological or molecular confirmation, with no evidence of malignancy. Anti-tuberculosis treatment was commenced, and the patient showed significant clinical improvement during follow-up.</p><p><strong>Conclusion: </strong>Prostatic tuberculosis remains a diagnostic challenge, as it can silently coexist with benign prostatic hyperplasia in endemic regions; this case highlights the value of routine histopathological examination of resected tissue for uncovering unsuspected disease and ensuring prompt anti-tuberculous therapy.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"640903"},"PeriodicalIF":0.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109591","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":"Markedly Elevated CA 19-9 in Type I Mirizzi Syndrome in the Absence of Malignancy: A Case Report.","authors":"Abdullahi Khalif Ali, Abdikani Mohamednor Mohamed, Abdirahman Ahmed Mohamud, Abdinasir Mohamed Elmi, Nimo Mohamednor Mohamed, Abdirahman Abdullahi Hassan","doi":"10.2147/IMCRJ.S641943","DOIUrl":"10.2147/IMCRJ.S641943","url":null,"abstract":"<p><p>Mirizzi syndrome (MS) is a rare complication of long-standing cholelithiasis in which an impacted gallstone causes extrinsic compression of the common hepatic duct. Markedly elevated carbohydrate antigen 19-9 (CA 19-9) is strongly associated with pancreaticobiliary malignancies, but severe benign biliary obstruction can also cause substantial elevations, presenting a diagnostic challenge. We present a 50-year-old man with acute obstructive jaundice, fever, right upper quadrant pain, and a serum CA 19-9 level of 1000 U/mL. Triphasic contrast-enhanced computed tomography confirmed Type I Mirizzi syndrome caused by an 11.9-mm gallstone impacted in Hartmann's pouch, with no evidence of malignancy. Due to dense adhesions obliterating Calot's triangle, the patient underwent subtotal (fenestrating) cholecystectomy. Postoperatively, cholestatic liver tests markedly improved, and CA 19-9 decreased to 153 U/mL, supporting a benign obstructive and inflammatory etiology. This case highlights the importance of considering Mirizzi syndrome in patients with obstructive jaundice and markedly elevated CA 19-9 to avoid misdiagnosis and unnecessary aggressive surgical intervention.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"641943"},"PeriodicalIF":0.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109566","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":"Thalamic Tuberculoma Presenting as Isolated Gait Disturbance Without Systemic or Meningeal Symptoms in a 2-Year-Old Child: A Case Report.","authors":"Khadija Yasmin, Muhammad Abdullah, Sana Shaik, Minahil Zaheer, Aleena Ihtasham, Hamna Hassan Siddiqui, Saira Shamim, Hudaifa Hassan Salad","doi":"10.2147/IMCRJ.S628684","DOIUrl":"https://doi.org/10.2147/IMCRJ.S628684","url":null,"abstract":"<p><strong>Introduction: </strong>Intracranial tuberculoma is an important manifestation of pediatric central nervous system tuberculosis, especially in endemic regions. While seizures and signs of raised intracranial pressure are common presenting features, isolated focal neurological deficits without systemic or meningeal symptoms are rare, resulting in diagnostic delay. We report an unusual case of thalamic tuberculoma presenting primarily with gait disturbance in a young child.</p><p><strong>Case presentation: </strong>A 2-year-old boy from Karachi, Pakistan, presented with inability to walk independently at 20 months age. On neurological examination, he had decreased power involving left side of body. MRI of the brain showed a ring-enhancing lesion in the right thalamus extending into the midbrain with surrounding vasogenic edema. Magnetic resonance spectroscopy (MRS) showed a lipid/lactate peak, which supported an infectious granulomatous etiology; a presumptive diagnosis of tuberculoma was made based on imaging findings and household TB exposure.</p><p><strong>Discussion: </strong>Although intracranial tuberculoma does not always present with systemic manifestations of tuberculosis in children, as observed in the present study, it is also a challenging disease to diagnose in young children due to the atypical presentation. Neuroimaging: Early diagnosis is possible. For deep-seated lesions where operative therapy and surgical treatment are highly risky, conservative management is often effective with anti-tuberculous therapy and adjunctive corticosteroids. Early physiotherapy to achieve functional recovery is very important.</p><p><strong>Conclusion: </strong>The case illustrates the need for consideration of intracranial tuberculoma in an individual neurological impairment case, considering children with isolated neurological deficits, when systemic forms of tuberculosis do not develop, even in the absence of evidence of systemic tuberculosis symptoms and history of direct exposure. Prompt imaging, early diagnosis, and treatment with anti-tuberculous therapy may lead to good outcomes.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"628684"},"PeriodicalIF":0.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109535","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":"Pyogenic Granuloma in the Sinonasal Cavity: A Potential 38-Year Latency Following Foreign Body Entrapment.","authors":"Matin Ghazizadeh, Sina Hooshmandnia, Mohammadsoheil Hemmat Esfeh, Milad Elyasi","doi":"10.2147/IMCRJ.S643463","DOIUrl":"https://doi.org/10.2147/IMCRJ.S643463","url":null,"abstract":"<p><strong>Background: </strong>Lobular capillary hemangioma (LCH), also known as pyogenic granuloma (PG), is a benign vascular lesion typically associated with minor trauma or irritation, predominantly occurring in the oral cavity and in females. Its sinonasal occurrence, particularly in males, is rare, and an association with remote childhood trauma remains a speculative hypothesis. Clinically, it must be differentiated from other vascular sinonasal lesions such as angiofibroma, hemangioma variants, and malignant mimics.</p><p><strong>Case presentation: </strong>This rare case report descripts a highly unusual case of an inflammatory nasal mass in a 43-year-old male who presented with left-sided nasal obstruction, rhinorrhea, and hyposmia for two months. Endoscopic evaluation and CT/MRI revealed a highly vascular mass attached to the left middle turbinate. Notably, the patient had a history of foreign body entrapment in the left nasal cavity at the age of 5, which was removed without immediate complications. This suggests a potential association between the initial trauma and the subsequent manifestation of the lesion after a 38-year latency period. The mass was successfully excised en bloc through endoscopic surgery.</p><p><strong>Conclusion: </strong>This case highlights a potential, albeit rare, etiological association for sinonasal PG, raising the hypothesis that past mucosal trauma, such as a foreign body, may contribute to the delayed formation of vascular lesions decades later, particularly in a male patient at an unusual nasal site. A comprehensive diagnostic workup, including imaging and histopathology, is essential to confirm the diagnosis and ensure complete surgical management. The patient remained asymptomatic with no recurrence observed at one-year follow-up.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"643463"},"PeriodicalIF":0.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109612","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}