Journal of Orthopaedic Case Reports最新文献

{"title":"Is Native Joint Line More Accurately Restored with Robotic Assisted Total Knee Arthroplasty than with Conventional Instruments?","authors":"Pramod Bhor, Sawankumar Pawar, Dnyanada Kutumbe, Arvind Vatkar, Sachin Kale, Rahul Jagtap","doi":"10.13107/jocr.2025.v15.i02.5294","DOIUrl":"10.13107/jocr.2025.v15.i02.5294","url":null,"abstract":"<p><strong>Introduction: </strong>Changes in joint line (JL) position after total knee arthroplasty (TKA) have revealed implant failure, diminished knee function, and altered knee biomechanics. The purpose of this study was to compare the joint line restoration of robotic-assisted TKA (RA-TKA) and conventional TKA (c-TKA).</p><p><strong>Materials and methods: </strong>In a prospective cohort study trial, trained fellows performed radiographic analyses on patients receiving RA-TKA (group-1) and c-TKA (group-2) to quantify joint line using the adductor tubercle method. Statistical analysis was used using t-tests, with statistical significance defined as a P < 0.005.</p><p><strong>Results: </strong>The study contained 150 RA-TKAs and 150 total C-TKAs. Both groups were comparable in demographics such as age, gender, and body mass index. On average, RA-TKAs resulted in a 1.65 ± 0.46 mm shift in the JL position, while C-TKAs resulted in a 2.52 ± 0.52 mm change (P = 0.000). The interclass correlation coefficient between the robotic and conventional groups is around 0.992.</p><p><strong>Conclusion: </strong>RA-TKA restores the JL position better than C-TKA, which appears to depend on precise planning and ligament balancing, which is attainable with robotic-aided surgery. The clinical relevance of this statistically significant difference requires additional investigation.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"233-238"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433316","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":"Longitudinal Management of Progressive Femoral Deformities in a Pediatric Patient: A Case Study on Adaptative Surgical Interventions and Outcomes.","authors":"Asad Khan, Yasir Salam Siddiqui, Mohammad Baqar Abbas, Ahsan Firoz, Mohammad Arshad Rahman, Mamoon Rashid","doi":"10.13107/jocr.2025.v15.i02.5280","DOIUrl":"10.13107/jocr.2025.v15.i02.5280","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric femoral deformities present unique challenges in orthopedics, requiring careful management to accommodate ongoing growth and development in young patients. This case report illustrates the longitudinal treatment of a child who experienced multiple complications following an initial femoral neck fracture in a cystic lesion, highlighting the complexity of managing such conditions over time.</p><p><strong>Case report: </strong>A 4-year-old child presented in 2016 with a femoral neck fracture and a cystic lesion in the proximal femur, initially managed with valgus osteotomy and dynamic compression plate fixation. Two years later, the patient exhibited a malunited fracture leading to coxa vara, which was managed by implant removal. In 2021, the child developed a bowing deformity which was corrected operatively with another osteotomy and TENS wire insertion. The most recent intervention in 2022 involved a valgus osteotomy and fixation with a dynamic hip screw to address persistent coxa vara, resulting in a successful union.</p><p><strong>Conclusion: </strong>This case emphasizes the need for ongoing, adaptive management strategies in pediatric orthopedics, particularly for patients with complex femoral deformities. Each surgical intervention was tailored to the child's evolving anatomical needs, with close follow-up to ensure optimal outcomes as the patient grew. The multidisciplinary approach and continuous reassessment are critical in achieving favorable long-term results in similar pediatric cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"193-197"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433320","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":"Novel Case of Ipsilateral Supracondylar Fracture with Distal Radio-Ulna Fracture with Acute Compartment Syndrome: A Rare Case Report.","authors":"Sumedh D Chaudhary, Akshay Phupate, Nilesh S Sakharkar, Karan R Lakhani","doi":"10.13107/jocr.2025.v15.i02.5232","DOIUrl":"10.13107/jocr.2025.v15.i02.5232","url":null,"abstract":"<p><strong>Introduction: </strong>Fractures involving the supracondylar or distal end radius are the most common fracture in pediatric population. Although they have similar mechanisms of injury, i.e., hyperextension, they occur in isolation and combined supracondylar and distal end radius injuries in the same limb are extremely uncommon. We are reporting an extremely rare clinical presentation of a child with ipsilateral supracondylar fracture with fracture of distal end radius and ulna associated with acute compartment syndrome (ACS).</p><p><strong>Case report: </strong>A 13-year-old male had sustained trauma to left upper limb due to fall from tree. He was initially treated elsewhere with suturing of wound over his forearm and was brought to our emergency room after 12 h with complaints of swelling and severe pain in left arm, forearm, and hand. On clinical examination, there was tense swelling over the left arm, forearm, and hand. Passive stretch pain was present. Limb was warm, there were multiple blisters present over the flexor aspect over anti-cubital fossa of the left limb. On vascular and neurological evaluation, sensation was decreased compared to other limb over the volar aspect of the hand and forearm, also the pulses were feeble. The patient was immediately sent for Doppler of the left upper limb which showed biphasic flow. X-rays revealed ipsilateral left supracondylar humerus fracture (Type 4 according to Gartland Classification) with distal end radius and distal ulna fracture. As the patient had developed ACS which was evident from the tense swelling and passive stretch pain, we decided to urgently operate the patient with fasciotomy followed by fracture fixation. Wound was closed by shoelace suturing technique, and then, split-thickness skin grafting was done. K-wires were after a period of 6 weeks and gradual range of motion exercises was started.</p><p><strong>Conclusion: </strong>Ipsilateral supracondylar with distal end radius with ACS is a rare entity. ACS should be given priority and fasciotomy must be done properly so as to ensure adequate decompression of intercompartmental pressure. This should be followed by fixation of the fractures. If appropriate intervention is done urgently, good results can be achieved even in such challenging injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"70-75"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433399","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":"Outcomes of Combined Distal Femur Plating and Retrograde Femur Nailing in Comminuted Distal Femur Fractures: Case Series of Seven Cases with 6 Months Follow-up.","authors":"Sachin Kale, Shikhar Singh, Arvind Vatkar, Rohan Jayaram, Sonali Das, Ashmit Verma","doi":"10.13107/jocr.2025.v15.i02.5284","DOIUrl":"10.13107/jocr.2025.v15.i02.5284","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates the functional outcomes of combining distal femur plating with retrograde femur nailing in treating comminuted distal femur fractures.</p><p><strong>Case report: </strong>A retrospective analysis was conducted on patients treated at a tertiary health care center from January 1, 2023, to November 30, 2023. The cohort comprised patients with an average age of 54.57 years (standard deviation [SD] = 13.34) and a male-to-female ratio of 3:4. The primary outcome measure was knee range of motion (ROM). At the 1.5-month follow-up, the average knee flexion was 54° (SD = 13.46). This improved to 110° (SD = 8.7) at 3 months and to 138.6° (SD = 7.34) at the 6-month follow-up. These findings indicate significant improvement in knee function over the study period. All patients showed union at fracture sites at the end of 6 months.</p><p><strong>Conclusions: </strong>The combination of distal femur plating and retrograde femur nailing demonstrates promising functional recovery in knee ROM for patients with comminuted distal femur fractures. This surgical approach may offer an effective strategy for enhancing post-operative outcomes in this patient population.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433436","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":"Late Presentation of Cauda Equina Syndrome with Isolated Bladder Bowel Incontinence in Massive Lower Lumbar Disc Herniation: A Series of Three Cases.","authors":"Kiran Dhole, Kuber Sakhare, Nilesh Sakharkar, Pravin Agrawal, Sumedh Chaudhary, Vishal Giri","doi":"10.13107/jocr.2025.v15.i02.5242","DOIUrl":"10.13107/jocr.2025.v15.i02.5242","url":null,"abstract":"<p><strong>Introduction: </strong>Cauda equina syndrome (CES) is a constellation of symptoms that include lower limb paralysis, saddle anesthesia, bowel bladder incontinence, and sexual dysfunction. However, atypical cases of CES may present with isolated bladder-bowel involvement without motor weakness. This often leads to late patient presentation to an orthopedic surgeon and late surgical intervention. Surgical outcomes in such cases are unpredictable owing to chronic bladder incontinence. The purpose of this case series is to evaluate the effect of surgical decompression in delayed presentation of CES with isolated bladder bowel involvement.</p><p><strong>Case report: </strong>We attended three such patients at our institute with massive lumbar disc herniation. All of them had bladder and bowel dysfunction with the absence of lower limb weakness. Patients were operated with conventional laminectomy and discectomy. Bladder ultrasonography was done preoperatively and postoperatively. Bladder and bowel function improved in all three patients, but recovery duration was different in all three cases.</p><p><strong>Conclusion: </strong>Atypical presentation of CES presenting to other broad specialties, especially urology, may not detect massive lumbar disc herniation in the absence of lower limb deficit. Clinicians should be highly suspicious about the isolated presentation of CES and refer to spine surgeons. Thus, surgical decompression of massive lumbar disc prolapse can be done in the initial stages of bladder-bowel dysfunction. Surgical decompression is effective in delayed presentation of CES with good long-term prognosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433317","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":"Atlantoaxial Instability in Neurofibromatosis Type 1: A Case Report.","authors":"Sankalp Lal, Pankaj Kumar Damor, Mahendra Singh Tak, Mukesh Kumar Saini, Mahesh Bhati","doi":"10.13107/jocr.2025.v15.i02.5270","DOIUrl":"10.13107/jocr.2025.v15.i02.5270","url":null,"abstract":"<p><strong>Introduction: </strong>Neurofibromatosis (NF) is a cluster of conditions in which tumors grow in the nervous system. Even though the spine is the most common site of skeletal involvement in NF type 1 (NF-1), cervical spinal anomalies are infrequent.</p><p><strong>Case report: </strong>The atlantoaxial joint is a critical transitional zone in the cervical spine and is prone to instability. We report the case of a 49-year-old gentleman with atlantoaxial instability due to NF-1 who presented with quadriparesis and was managed by reduction with skull traction followed by C1-C2 Goel-Harms fixation.</p><p><strong>Conclusion: </strong>In the present case, there was substantial bleeding and significant vertebral dysplasia, which makes the case distinctly unique. Skull traction and C1-C2 Goel-Harms fixation with fusion should be considered for patients with NF-1 complicated by atlantoaxial instability.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433292","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":"Management of Kyphosis, Lumbar Spondylosis, and Mycobacterium avium Discitis in a 70-year Male with Chronic Lymphocytic Leukemia with Vascular Complication.","authors":"Vadim Dolgov, David Frolov, Ryan Tapio, Samantha Hill, Miguel Schmitz","doi":"10.13107/jocr.2025.v15.i02.5272","DOIUrl":"10.13107/jocr.2025.v15.i02.5272","url":null,"abstract":"<p><strong>Introduction: </strong>Kyphosis is characterized by excessive forward curvature of the spine often causing back pain and stiffness, and occasionally, neurological deficit. Surgical management of kyphosis can entail an anterior lumbar interbody fusion (ALIF) in addition to a posterior spinal fusion with or without a laminectomy. Chronic lymphocytic leukemia (CLL) is a slow-growing cancer that affects the bone marrow. If ALIF is considered as a treatment option for kyphosis in a patient with CLL, attention needs to be taken to minimize complications.</p><p><strong>Case report: </strong>A 70-year-old male with a history of kyphosis and CLL presented with refractory lower back pain attributed to his kyphosis. The patient required multiple procedures to correct his kyphosis including an ALIF between L3 and S1. During the ALIF, significant scar tissue and phlegmon were noted at the surgical site, and disc cultures revealed Mycobacterium avium. The accumulation of phlegmon and scar tissue required significant manipulation of the vessels to perform the procedure. Before closure of the anterior incision, the patient presented with absent pulses of the left leg. A thrombosis in the left iliac artery was noted and treated with stent placement during the surgery.</p><p><strong>Discussion: </strong>CLL leads to an immune compromised state which may lead to undiagnosed infections, specifically M. avium in our patient. Imaging showed the infection likely played a role in the disc degeneration of the lumbar spine, exacerbating the formation of the phlegmon and scar tissue. This required extensive manipulation of the vessels that resulted in the formation of thrombosis of the left iliac artery.</p><p><strong>Conclusion: </strong>Care must be taken during ALIF procedures on patients with CLL during manipulation of the vessels. If kyphosis is rapidly worsening in a patient with CLL, infection of the vertebra should be ruled out.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"172-176"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433322","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":"Delayed Mycotic Prosthetic Joint Infection: A Rare Case Report.","authors":"Nikhil Cs, Sharafuddeen Mammu, Vishnu Unnikrishnan, Saad Sulaiman","doi":"10.13107/jocr.2025.v15.i02.5266","DOIUrl":"10.13107/jocr.2025.v15.i02.5266","url":null,"abstract":"<p><strong>Introduction: </strong>Fungal infections following total knee replacement surgeries are rare but present significant challenges in management due to their delayed diagnosis and resistance to standard antimicrobial therapies.</p><p><strong>Case report: </strong>This case report describes the management of a delayed prosthetic joint infection in a 65-year-old female, diagnosed as a fungal infection 4 years after total knee replacement. Initially presented with persistent knee pain, swelling, and restricted range of motion despite standard antimicrobial therapy, further investigation revealed fungal elements in synovial fluid analysis, confirming the diagnosis. The patient underwent a staged procedure involving debridement, application of antifungal and antibiotic cement spacer, followed by delayed revision surgery. A 12-week course of antifungal fluconazole therapy was administered postoperatively. Subsequent 1-year follow-ups revealed symptomatic improvement and the absence of infection recurrence.</p><p><strong>Conclusion: </strong>This case highlights the efficacy of staged surgical interventions and targeted antifungal therapy in achieving favorable outcomes for fungal prosthetic joint infections. It underscores the importance of long-term follow-up for monitoring and surveillance in such cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"155-160"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433312","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":"Non-union of a Tibial Plafond Fracture in a COVID-Positive Patient: A Case Report.","authors":"Amy Singleton, Anthony J Mancuso Ii, Samuel G Eaddy, Seth Phillips","doi":"10.13107/jocr.2025.v15.i02.5210","DOIUrl":"10.13107/jocr.2025.v15.i02.5210","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have proposed a relationship between the coronavirus disease 2019 (COVID-19)-induced cytokine storm and prohibitive effects on the musculoskeletal system, including increased risk of fracture, osteoporosis, and impaired bone healing. To our knowledge, this is the first known case report involving a fracture non-union concomitant with COVID-19 infection and apparent cytokine storm.</p><p><strong>Case report: </strong>A 47-year-old male presented with an open pilon fracture of the left ankle after falling off a 6-foot ladder. At his 4-month post-operative follow-up, the patient attempted to ambulate without his cam boot for the 1st time, causing acute displacement of his poorly healed tibia fracture. A non-union laboratory workup demonstrated elevated inflammatory markers indicative of septic non-union; however, the patient also tested positive for severe acute respiratory syndrome coronavirus 2 at this time. Because of this, antibiotic treatment was not initiated due to suspicion of a cytokine storm. One month later, the patient's inflammatory markers had decreased and he underwent revision surgery.</p><p><strong>Conclusion: </strong>This case underscores the potential impact of COVID-19 on fracture healing and the importance of vigilant monitoring and differential diagnosis in managing non-union in COVID-19-positive patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433394","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":"Hip Fusion Takedown with Dislocation and Cup Dislodgement Requiring Revision Arthroplasty: A Case Report.","authors":"Justin T Butler, Samuel D Stegelmann, Amy Singleton, Chris J Leibold, Samuel G Eaddy, Richard M Miller","doi":"10.13107/jocr.2025.v15.i02.5268","DOIUrl":"10.13107/jocr.2025.v15.i02.5268","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous hip fusion is a multifactorial condition that can cause drastic functional limitations. Total hip arthroplasty (THA) can provide symptomatic improvement but leads to high rates of instability, dislocation, and revision.</p><p><strong>Case report: </strong>A 66-year-old woman with a long-standing history of dysplastic and spontaneously fused left hip received a fusion takedown to primary THA. She subsequently dislocated with catastrophic acetabular cup failure necessitating revision THA. She reports no pain or dislocations at 12 months post-revision.</p><p><strong>Conclusion: </strong>Deciding to perform THA for spontaneous hip fusion should consider clinical benefit alongside increased risks of dislocation and revision. Patients with acetabular dysplasia and longer durations of fusion are at an increased risk, due to skewed anatomic landmarks, weak abductors, and altered spinopelvic parameters. However, in the case of primary THA failure, revision surgery can provide satisfactory benefits.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"161-166"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433314","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}