Journal of the Turkish German Gynecological Association最新文献

{"title":"Postoperative care in the caesarean intensive care unit: experience from a tertiary maternity hospital","authors":"Seval Yılmaz Ergani, İskender Dicle, Alperen Aksan, Müjde Can İbanoğlu, Betül Tokgöz Çakır, Tugba Kinay, Salim Erkaya, Can Tekin İskender, Sevki Celen, Ali Turhan Cağlar, Yaprak Ustun","doi":"10.4274/jtgga.galenos.2022.2021-9-27","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2021-9-27","url":null,"abstract":"Objective: The aim was to determine whether follow-up in the intensive care unit (ICU) for the postoperative first eight hours was beneficial for early intervention in postpartum hemorrhage. Material and Methods: In our hospital, all patients are admitted to the ICU for the first eight hours after cesarean section. Patients with postpartum hemorrhage after cesarean delivery who received medical and/or surgical treatment between 2016 and 2020 were reviewed in the presented study retrospectively. Results: All cases (n=36,396) who underwent cesarean delivery were reviewed. Three hundred and fifty-nine patients with postpartum hemorrhage were identified and included. In the study group the time between cesarean section and diagnosis of postpartum hemorrhage was 10.1±19.1 hours, and the time between cesarean section and re-laparotomy was 9.26±23.1 hours. A total of three maternal deaths occurred after cesarean section in our hospital. In the last five years, the mortality rate in patients delivering by cesarean section was 3.9 per 100,000. The incidence of postpartum hemorrhage in cesarean deliveries at our hospital was calculated to be 1.0%, and the rate of obstetric near-miss events was calculated to be 0.6 per 1000 live births. Conclusion: Follow-up of patients in the ICU in the first eight postoperative hours after cesarean section may result in a lower number of relaparotomies due to postpartum hemorrhage, a shortened interval between cesarean section and re-laparotomy, and a lower maternal mortality rate.","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"42-47"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/dd/JTGGA-24-42.PMC10019003.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9482102","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":"Laparoscopic radical hysterectomy and total vaginectomy for vaginal malignant melanoma with cervical metastasis","authors":"Mehmet Ali Vardar,&nbsp;Ghanim Khatib,&nbsp;Ahmet Barış Güzel,&nbsp;Ümran Küçükgöz Güleç,&nbsp;Mesut Mısırlıoğlu","doi":"10.4274/jtgga.galenos.2022.2022-4-5","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-4-5","url":null,"abstract":"<p><p>The presented case is a 63-years-old multiparous woman admitted with the complaint of postmenopausal bleeding. On gynecologic examination multifocal lesions were detected, including 1 cm on lateral vaginal wall, 4 cm on posterior vaginal wall and 0.5 cm on the left lateral part of the cervix. Histopathology examination gave a diagnosis of epithelioid malignant melanoma. Consequently, laparoscopic radical hysterectomy and total vaginectomy with bilateral pelvic and inguinofemoral lymph node dissection were planned. On both sides, pararectal and paravesical spaces were created and the ureter was identified. Then, the vesicouterine and vesicovaginal spaces were developed. Uterine artery and superior vesical artery were coagulated, cut and the lateral parametrium was prepared. The left ureter was dissected and the ureteral tunnel was unroofed up to the bladder entrance. Subsequently, the anterolateral parametrium was transected. Then, the infundibulopelvic and sacrouterine ligaments were sealed and transected. At this time, the rectovaginal space was developed. Bilateral paracolpos were transected. The endopelvic fascia with the levator muscles were sealed and cut circumferentially. Anteriorly, the pubovesicocervical fascia was transected and the bladder was mobilized up to the uretrovesical junction. Thereafter, through a vaginal approach, the cervix and vagina were inverted by grasping the cervix with a tenaculum. An incision on the posterior vaginal wall at the introitus was made and the urogenital diaphragm was dissected to connect with the pelvic cavity. The vaginal entrance was cut circumferentially and the surgical specimen was extracted. In conclusion, laparoscopy can be considered as a feasible approach for radical hysterectomy and total vaginectomy in selected patients.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"84-85"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/00/JTGGA-24-84.PMC10019016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187579","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":"What is your diagnosis?","authors":"Kavita Khoiwal,&nbsp;Poonam Gill,&nbsp;Latika Chawla,&nbsp;Shruti Agrawal,&nbsp;Jaya Chaturvedi","doi":"10.4274/jtgga.galenos.2022.2022-2-3","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-2-3","url":null,"abstract":"A 39 year-old woman, P2L2, presented to the emergency department with vaginal bleeding. She was diagnosed as having a molar pregnancy one and half months previously, for which surgical evacuation was performed at a private clinic. Beta-human chorionic gonadotropin ( β -hCG) level before evacuation was 40,738 mIU/mL and follow-up values followed a declining trend from 3,820 mIU/mL 48 hours after evacuation, to 1,342 mIU/mL after one week. Histopathological examination (HPE) ruled out any possibility of malignancy. During follow-up, she had an episode of severe vaginal bleeding on the fifteenth day after evacuation. Magnetic resonance imaging of the pelvis suggested uterine arteriovenous (A-V) malformation with the possibility of residual gestational trophoblastic disease (GTD), in view of medical history and raised β -hCG (1,083 mIU/mL) (Figure1a-c). She received a blood transfusion and single-agent chemotherapy (methotrexate) at her primary centre, however, her β -hCG values continued to fall. After one month, she had another episode of severe vaginal bleeding and was referred to our centre. Here, her vitals were stable and systemic examination showed no abnormality. Gynecological examination revealed normal vulva, vagina, cervix, and soft and enlarged uterus of 14 weeks size. β -hCG was 23.55 mIU/mL. Transvaginal sonography showed thin endometrium and a cystic lesion in the uterine fundus invading the anterior myometrium, which was hyper-vascular on colour Doppler, suggestive of A-V malformation (Figure 2a,b). Therefore, bilateral uterine artery embolization (UAE) was performed. The patient was then discharged in a stable condition. After one week of UAE, she again presented with severe vaginal bleeding. She had pallor, pulse rate of 110/","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"76-78"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/dd/JTGGA-24-76.PMC10019005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9564146","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":"Long-term outcomes of fetal posterior fossa abnormalities diagnosed with fetal magnetic resonance imaging","authors":"Erdal Şeker,&nbsp;Batuhan Aslan,&nbsp;Ezgi Aydın,&nbsp;Acar Koç","doi":"10.4274/jtgga.galenos.2022.2022-7-13","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-7-13","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis of posterior fossa abnormalities (PFA) in the intrauterine period and association with pregnancy outcomes are still controversial. PFA is generally referred to maternal-fetal medicine specialists. The primary purpose of PFA diagnosis is to screen for other accompanying abnormalities, provide prognostic information to families, and discuss the termination option.</p><p><strong>Material and methods: </strong>This retrospective study was conducted in patients diagnosed with PFA between January 2013 and September 2020 in a tertiary perinatology clinic. All patients underwent routine second-trimester ultrasound screening and definitive diagnosis was made by fetal magnetic resonance imaging (MRI) in the presence of a suspected anomaly.</p><p><strong>Results: </strong>There were 164 fetal MRIs for fetal abnormalities during the study period and 22 (13.4%) were diagnosed with a PFA on fetal MRI. Indications for fetal MRI included four (18%) with Mega Cisterna Magna, two (9.1%) with rhomboencephalosynapsis, and thirteen (59.1%) with Vermian Hypoplasia-Dandy-Walker variant. Two patients, with neural tube defects and lumbosacral neural-tube defect are still alive. However, iniencephaly was detected in last patient who died in the postnatal period.</p><p><strong>Conclusion: </strong>Diagnosis of PFA abnormalities is complex, and the prognosis in PFA is often unclear. The prognosis is not affected by maternal and fetal factors and allows the recognition of additional accompanying abnormalities. Fetal MRI is an imaging method that can provide retrospective examination and research, especially in pregnancies with poor prognoses.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"28-32"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/e2/JTGGA-24-28.PMC10019011.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9123045","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":"video 1","authors":"","doi":"10.4274/jtgga.galenos.2022.2022-4-5.video1","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-4-5.video1","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135648432","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":"Does advanced paternal age affect global DNA methylation of human spermatozoa and intracytoplasmic sperm injection outcome?","authors":"Laqqan M. Mohammed,&nbsp;Yassin M. Maged","doi":"10.4274/jtgga.galenos.2022.2022-4-8","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-4-8","url":null,"abstract":"<p><strong>Objective: </strong>This study was performed to (I) evaluate the potential effect of advanced paternal age on global DNA methylation in spermatozoa, and (II) to investigate the association between the outcome of intracytoplasmic sperm injection (ICSI), semen parameters, and advanced paternal age.</p><p><strong>Material and methods: </strong>This study comprised 230 semen samples collected from males with a mean age of 38.2±8.5 years. Medical records were used to gather clinical information related to the female partner. The participants were divided into three groups depending on age: age <30 years; age 30-40 years; and age >40 years. The DNA was extracted from purified spermatozoa. Then the sperm global DNA methylation, sperm DNA fragmentation, and chromatin decondensation were evaluated by an ELISA, TUNEL, and Chromomycin A3 staining, respectively.</p><p><strong>Results: </strong>The sample counts were n=50 (21.8%), n=90 (39.1%) and n=90 (39.1%) for the <30, 30-40 and >40 year age-groups, respectively. A significant variation was found in the age of males included in this study (p<0.001). There was a significant reduction in sperm count, total motility, and non-progressive motility in the older group compared to the younger group (p<0.001). There was also a significant elevation in chromatin decondensation, DNA fragmentation, and global DNA methylation of spermatozoa in the older age group (p<0.001). Finally, there was a significant positive correlation between the percentage of non-motile sperm, sperm chromatin decondensation, DNA fragmentation, global DNA methylation status, and paternal age (p<0.001).</p><p><strong>Conclusion: </strong>These results suggest that advanced paternal age increased the DNA fragmentation, chromatin decondensation, and global DNA methylation level in human spermatozoa, which negatively affects the ICSI outcomes in couples undergoing ICSI cycles.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"18-27"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/91/JTGGA-24-18.PMC10019006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9130363","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":"Selection bias, a caveat in gestational weight gain research","authors":"Sumanta Saha","doi":"10.4274/jtgga.galenos.2022.2022-9-1","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-9-1","url":null,"abstract":"©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation Available online at www.jtgga.org Journal of the Turkish-German Gynecological Association published by Galenos Publishing House. To the Editor, In epidemiological studies on gestational weight gain (GWG), the selection bias burden due to a mismatch between the selected and eligible target population remains unclear and underexplored. It is, therefore, critical to explore the plausible sources of selection bias to ensure rigor in epidemiological estimates determining associations between GWG and other parameters of interest. GWG is the difference between predelivery weight and first trimester or pre-pregnancy weight, which has emerged as a burning research topic due to its independent association with adverse perinatal outcomes, such as large for gestational age and macrosomia (1). Selection bias can happen due to the pathophysiological and clinical complexities associated with GWG. This letter highlights some of these scenarios that require a calibrated study population selection approach to minimize the selection bias risk in future GWG studies. I begin with the Institute of Medicine 2009 guideline, (2) a popular prepregnancy body mass index-based recommendation of GWG ranges and patterns, widely used in population-based epidemiological studies. It’s critical to identify and exclude pregnant females with the following characteristics from the eligible study population, as this guideline may not apply to them due to inadequate evidence: Aborigines; preeclampsia; gestational diabetes mellitus; different obesity subclasses; and triplet and higher-order pregnancies (2-4). Besides, some physicians believe that the recommendations for overweight and obese women are too high (4). Then, what are the conditions or situations in which GWG measurements are at risk of reverse causation bias? for example in gestational diabetes mellitus (GDM), a late metabolic complication of pregnancy characterized by hyperglycemia, GDM treatment with a calorie-restricted diet, for instance, can alter the GWG course. Besides, variation in the treatment can cause differences in GWG patterns among patients suffering from the same ailment. For example, while weight loss may occur in GDM patients compliant with non-pharmacological interventions, the opposite can happen in insulin-treated GDM patients. Pre-existing health conditions can also determine the GWG pattern because of the disease course itself or its treatment, as may be seen in thyroid dysfunction and SteinLeventhal syndrome. Next, it’s essential to distinguish pregnancies prone to GWG fluctuations. For instance, women with preeclampsia, a pregnancy-induced hypertensive condition associated with proteinuria, may present with decreased weight gain in early pregnancy due to inadequate intravascular plasma volume expansion and increased weight gain in late pregnancy because of excessive vascular permeability and edema (due to oncotic pr","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"80-81"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/6e/JTGGA-24-80.PMC10019014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187575","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":"Obstetric and neonatal complications in large for gestational age pregnancy with late gestational diabetes","authors":"Shaymaa Kadhim Jasim,&nbsp;Hayder Al-Momen,&nbsp;Zina Ismaiel Mahdi,&nbsp;Rand Almomen","doi":"10.4274/jtgga.galenos.2022.2021-10-6","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2021-10-6","url":null,"abstract":"<p><strong>Objective: </strong>Gestational diabetes (GDM) is increasing in prevalence with effects starting in-utero, leading to excessive fetal growth. It is the leading cause of many perinatal complications. The aim was to determine the rate of obstetric and neonatal complications in pregnant women with high fetal weight and a recent diagnosis of GDM during the third trimester, despite normal earlier glycemic control.</p><p><strong>Material and methods: </strong>Prospective cohort study over four years involving pregnant women regularly visiting a single center who had normal glycemic index at 24-28 gestational weeks and ultrasonography (US) suggested high fetal weight during the third trimester. Oral glucose tolerance test was given, dividing the sample into the late GDM (LGDM) and the non-LGDM group.</p><p><strong>Results: </strong>Of 176 women, 24 (13.64%) had LGDM, and 152 (86.36%) had non-LGDM. After exclusions these groups' sizes were (n=21) in LGDM and (n=132) in non-LGDM. Hemoglobin A1c level was significantly higher in LGDM than non-LGDM (5.9% versus 5.1%). However, obstetric and neonatal complications were largely comparable (p≥0.05) but higher in LGDM than non-LGDM women. Exceptions to this were birth weight (3219 g versus 3326 g), large for gestational age at delivery (85.72% versus 88.64%), and gestational age at delivery (37.9 versus 38.2 weeks) in the LGDM vs. non-LGDM groups, respectively. There was a significantly higher cesarean section (CS) rate (76.19% versus 51.52%; p<0.05) in the LGDM group.</p><p><strong>Conclusion: </strong>The rate of newly diagnosed LGDM in pregnant women with high fetal weight during the third trimester by US was 13.64%. They had comparable obstetric and neonatal complications with non-GDM women, except for the rate of CS that was significantly higher in LGDM women.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"12-17"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/de/JTGGA-24-12.PMC10019017.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187571","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":"Regional differences in the sex ratio at birth in Mexico","authors":"Victor Grech","doi":"10.4274/jtgga.galenos.2022.2022-8-14","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022-8-14","url":null,"abstract":"<p><strong>Objective: </strong>The sex ratio at birth, defined as males/total (M/T) approximates 0.515 but is affected by many factors. Acute and chronic stress have been shown to lower M/T, and both regional and racial differences exist. This study analysed regional differences in M/T in Mexico.</p><p><strong>Material and methods: </strong>Live births by sex and year were available for 1994-2020. Regional births were available for 2010-2020 for five regions: North, Centre, West, East and South.</p><p><strong>Results: </strong>There were 68,423,415 births for 1994-2020 and 25,436,687 for 2010-2020 (M/T=0.5060, 95% confidence interval: 0.5058-0.5062). M/T was <0.515 (p<0.0001). Live births correlated negatively with year (p<0.0001). M/T fell for 1994-2003 then rose to 2020 (p<0.0001). M/T was highest in North followed by West, South, Centre and East (p<0.0001).</p><p><strong>Conclusion: </strong>Chronic stress with socioeconomic deprivation may reduce M/T and may explain the low M/T found in this study from Mexico.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"24 1","pages":"1-4"},"PeriodicalIF":1.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/91/JTGGA-24-1.PMC10019010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9483678","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":"Tips and tricks for adnexal lifting and mobilisation during laparoscopic cystectomy","authors":"Christos Iavazzo, Ioannis D Gkegkes","doi":"10.4274/jtgga.galenos.2022.2022.8-8","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2022.2022.8-8","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135598824","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}