Langenbeck's Archives of Surgery最新文献

{"title":"Utility of intraoperative ultrasonography in laparoscopic nonanatomical liver resection - results from National Polish registry of minimally invasive liver surgery.","authors":"Wojciech A Serednicki, Wacław Hołówko, Aleksander Tarasik, Stanisław Pierściński, Piotr Hogendorf, Jerzy Mielko, Michał Wysocki, Anna Dąbrowska, Michał Pędziwiatr","doi":"10.1007/s00423-025-03790-w","DOIUrl":"10.1007/s00423-025-03790-w","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic liver resection (LLR), being an established method, strongly relies on preoperative and intraoperative imaging. The aim of this study is to assess the utility, with a primary focus on oncological radicality, of intraoperative laparoscopic ultrasonography (IOUS) in nonanatomical laparoscopic liver resections data based on National Polish Registry of Minimally Invasive Liver Surgery.</p><p><strong>Methods: </strong>An observational multicenter cohort study involving data from 8 Polish liver surgery departments was conducted. Patients who underwent minimally invasive nonanatomical liver resection in the years 2010-2024 in Poland were included in the research. Patients were divided into a control group without intraoperative ultrasonography and a study group with IOUS. Statistical analysis was performed to assess the perioperative results of IOUS usage in LLR.</p><p><strong>Results: </strong>Study results show that IOUS is associated with a considerably higher R0 resection margin (91,6% vs. 84,2%, p = 0,039) with, yet not statistically significant, but higher textbook outcome (82,8% vs. 78,2%, p = 0,258). Other results, such as intraoperative blood loss (median 200 ml vs. 150 ml, p = 0,62 and transfusion rate (9,3% vs. 9,7%, p = 0,896), as well as postoperative complications (11,2% vs. 11,6%, p = 0,175) were similar in both groups. IOUS is associated with longer operation time (median 200 min. vs. 140 min., p < 0,001), however, it is chosen by liver surgeons in more difficult cases (28,4% vs. 15,2% posterosuperior segments, p = 0,003).</p><p><strong>Conclusion: </strong>Laparoscopic intraoperative ultrasonography is a useful tool in non-anatomical liver surgery, that ensures oncologic radicality with similar other outcomes compared to no IOUS usage. Therefore, it should be considered as mandatory in LLR. Furthermore, IOUS training programmes should be weighed into being a part of LLR training programmes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"212"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between guidelines and reality; the complex decision-making of acute cholecystitis in pregnancy.","authors":"Maryam Hassanesfahani, Brithica Villavarajan, Ibironke Otusile, Benjamin Seth Williams, Jane Tian, Andrew Miele, Martine A Louis, Nageswara Mandava","doi":"10.1007/s00423-025-03768-8","DOIUrl":"10.1007/s00423-025-03768-8","url":null,"abstract":"<p><strong>Purpose: </strong>Gallbladder disease is the primary non-obstetrical cause of hospitalization during pregnancy. The hormonal milieu changes with elevated estrogen and progesterone, reducing gallbladder contraction, promoting biliary stasis, and increasing cholesterol stone formation. This eventually causes biliary colic and acute cholecystitis. Both SAGES and ACOG consider laparoscopic cholecystectomy safe in all trimesters. We present a case series of gallbladder disease presenting during pregnancy comparing outcomes of patients who underwent Non-Operative Management (NOM) and those who received surgery.</p><p><strong>Methods: </strong>A 10-year retrospective electronic medical records review of pregnant patients between October 2012- December 2022, with the diagnosis of gallbladder disease. Data collection included patient characteristics, clinical presentation, lab values, imaging, treatment modalities, and outcomes. Fischer's exact test was used to determine statistical significance.</p><p><strong>Results: </strong>A total of 228 pregnant patients presented with gallbladder disease; 8 underwent OM, with indications of failed NOM secondary to intractable pain, with no complications. Of 220 managed conservatively, 77% experienced recurrence, and most underwent elective surgery postpartum. No maternal-fetal complications occurred in either group, though NOM was associated with high recurrence and readmission rates.</p><p><strong>Conclusion: </strong>Despite current guidelines recommending surgical intervention, our study reveals that non-operative management remains the predominant approach in real-world practice. While it is associated with a high rate of symptom recurrence and postpartum readmissions, fetal outcomes remain favorable in patients managed conservatively. These findings underscore the need for updated guidelines that reflect evolving clinical trends and emphasize individualized patient care.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"211"},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' obesity is linked to prolonged thyroidectomy operative time.","authors":"Ben Eliachar, Ohad Ronen","doi":"10.1007/s00423-025-03789-3","DOIUrl":"10.1007/s00423-025-03789-3","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is a prevalent condition with potential implications for surgical outcomes, including thyroidectomy. This study investigated the relationship between body mass index (BMI) and the duration of thyroidectomy surgery and length of hospital stay.</p><p><strong>Method: </strong>A retrospective analysis of patient records. Data included patient age, sex, procedure type, surgery duration, length of hospital stay, histological results, and BMI. Statistical analysis methods (t-tests, ANOVA, Spearman/Pearson correlation, linear regression) were used. Patients were categorized into groups based on BMI. The primary outcome was the relationship between BMI and surgical outcomes. The research was conducted in a tertiary care academic medical center over 7 years (2016-2022). Included were patients who underwent a thyroidectomy performed by otolaryngology residents (N = 232).</p><p><strong>Results: </strong>Surgery duration was significantly prolonged in obese patients, with an average increase of 1.3 min per BMI category (p-value < 0.01), resulting in a mean difference of approximately 10 min between normal weight and obese patients. Length of hospital stay was significantly extended for overweight and obese patients compared to the non-obese group (p-value < 0.01), with an average extension of 0.9 days between normal weight and obese groups.</p><p><strong>Conclusions: </strong>Obesity is associated with prolonged thyroidectomy surgery duration and length of hospital stay. Our findings highlight the importance of considering BMI in surgical planning and resource allocation. These results can inform preoperative counseling and perioperative management of obese patients undergoing thyroidectomy. Further research is needed to investigate specific factors contributing to prolonged surgery in obese patients.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"209"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colostomy complications in patients with anorectal malformations.","authors":"Tobias Klein, Gloria Stephany Guarnizo-Diaz, Alexander Semaan, Thomas M Boemers, Reza M Vahdad","doi":"10.1007/s00423-025-03795-5","DOIUrl":"10.1007/s00423-025-03795-5","url":null,"abstract":"<p><strong>Purpose: </strong>Anorectal malformations (ARM) are a common reason for protective colostomy in children, but there is no consensus on the best type or location. The objective of this study is to assess the prevalence of colostomy malposition in clinical settings with limited expertise in the management of patients with anorectal malformations, as well as the associated complications of colostomy.</p><p><strong>Methods: </strong>Medical records of all children with ARM treated at our hospital between 2005 and 2019 were retrospectively reviewed. The incidence of stoma complications and the rates of colostomy revision during ARM repair were compared by colostomy type and location.</p><p><strong>Results: </strong>The study included 276 children. A proximal colostomy was performed in 205 cases (74.3%) and a distal colostomy in 71 cases (25.7%). Loop colostomies were done in 233 patients (84.4%), while split colostomies were done in 43 (15.6%). Stoma-related complications occurred in 65 patients (23.6%), with prolapse (8.3%) and maceration (4.0%) being the most common. Complications were significantly lower with proximal colostomies (20.2% vs. 32.9%, p = 0.036) and loop stomas (21.0% vs. 37.2%, p = 0.030). Stoma revision due to malposition was needed in 39.4% of patients with distal colostomies, but none with proximal colostomies (p < 0.0001).</p><p><strong>Conclusions: </strong>Colostomy in children with ARM is associated with a high overall complication rate. In particular, many distal colostomies are incorrectly placed too distally, which complicates subsequent corrective surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"210"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The thoracic surgery patient's journey through the hospital - a pilot project on resource consumption and potentials for sustainability.","authors":"Lena Katharina Knüvener, Sebastian Kalverkamp, Jan Spillner, Julia Wallqvist, Wiam Khader, Sebastian Ziemann, Julia Schuler, Rose Nangah Mankaa, Marzia Traverso, Linda Grüßer","doi":"10.1007/s00423-025-03782-w","DOIUrl":"10.1007/s00423-025-03782-w","url":null,"abstract":"<p><strong>Purpose: </strong>Medical societies around the globe are searching for ways to decrease the environmental impacts of patient care. This pilot project aims to identify potentials for more sustainability in clinical routine by investigating the resource consumption of thoracic surgery patients.</p><p><strong>Methods: </strong>This single-centre, observational, prospective pilot project was conducted at the RWTH Aachen University Hospital, Germany, from May 2023 to August 2023. Five patients with planned video-assisted-thoracoscopic surgery for removal of (suspected) lung cancer were included and followed throughout their treatment at the hospital. We recorded resource consumption for their direct care and investigated the share of disposable and reusable products and the packaging of disposable products. Additionally, we conducted a PubMed literature search on available life cycle assessments of the utilised products and investigated manufacturers' online information on sustainability aspects of their products.</p><p><strong>Results: </strong>An average of 1254 disposable (75%) and reusable (25%) products were used per patient throughout their hospital journey. Most disposable products' packaging contained plastic. We identified 30 publications that reported life cycle assessments. Manufacturers provided information on sustainability aspects for 10% of the products utilised.</p><p><strong>Conclusions: </strong>In-hospital patient care is resource intensive. Disposable products outnumbered reusable products at every stage of the patient's journey and were mostly packaged in materials containing plastic. For the majority of products, no information concerning their environmental impact was accessible hampering informed purchasing choices by clinicians. Further efforts are essential to make environmental data available, leverage circular-economy systems, and ultimately decrease the environmental impacts of the healthcare sector.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"200"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescence indocyanine green (ICG) for sentinel-lymph-node mapping in colorectal cancer: a systematic review.","authors":"Alexis Litchinko, Jeremy Meyer, Leo Buhler, Frederic Ris, Michel Adamina","doi":"10.1007/s00423-025-03786-6","DOIUrl":"10.1007/s00423-025-03786-6","url":null,"abstract":"<p><strong>Objective: </strong>Modern surgical guidance in laparoscopic colon cancer procedures could be enhanced by visualizing lymphatic flow during surgery, already helping surgeons in determining the precise extent of digestive resection and could be useful in lymphadenectomy. Related to oncological procedure, lymphadenectomy is mandatory to assess the extension of the disease. To explore this approach, the objective of this review is to examine the use of indocyanine green fluorescence imaging for real-time in vivo identification of lymphatic flow and especially sentinel nodes in patients undergoing elective surgery for colorectal cancer.</p><p><strong>Methods: </strong>A systematic review was conducted to identify relevant studies on sentinel node mapping using indocyanine green (ICG) in colorectal cancer surgery. A comprehensive search was performed in electronic databases including PubMed, Embase, and Cochrane Library from inception to December 2024. The search strategy incorporated relevant keywords and MeSH terms, combining variations of \"colorectal neoplasms,\" \"sentinel lymph node,\" \"indocyanine green,\" and related terms. The search was limited to articles published in English language.</p><p><strong>Results: </strong>A total of 405 studies were identified across all databases. After screening, 45 full-text articles were assessed for eligibility, and 12 studies were ultimately included in the systematic review. ICG-FI has not yet demonstrated superiority over the standard blue dye technique. Moreover, a notable heterogeneity exists among the reported studies concerning ICG dosage, injection methods and the definition of positive LN status for sensitivity calculations, making direct comparisons challenging.</p><p><strong>Conclusion: </strong>Despite the potential shown with other surgical oncological resections, ICG-FI requires further investigation and standardization in protocols and indications to fully harness its capabilities for SLN detection in CRC, especially metastatic nodes. Larger patient populations should be considered in future research to comprehensively assess its efficacy. This systematic review highlights the heterogeneity and limitations of current evidence regarding ICG-FI for SLN detection in colorectal cancer. While preliminary results are encouraging, further well-designed prospective trials are required before routine clinical implementation can be recommended.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"202"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative assessment of NIFTP clinicopathological characteristics and its impact on avoiding overtreatment.","authors":"M Andrade de Almeida, P Canão, J Capela, P Sá Couto, S Carneiro","doi":"10.1007/s00423-025-03788-4","DOIUrl":"10.1007/s00423-025-03788-4","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"204"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the surgical outcomes of endoscopic thyroidectomy via a contralateral-axillo-bilateral-breast approach and open thyroidectomy.","authors":"Huaiyu Weng, Wangwang Qiu, Ting Yan, Yufan Tang, Ziyi Chen, Bomin Guo, XinYu Huang, Youben Fan, Zhili Yang","doi":"10.1007/s00423-025-03784-8","DOIUrl":"10.1007/s00423-025-03784-8","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic thyroidectomy via extracervical approaches has been developed to avoid anterior neck surgical scars. However, each approach has its own limitations. We developed a novel endoscopic thyroidectomy via the contralateral-axillo-bilateral-breast approach (CABBA-ET) and compared the surgical outcomes with those of open thyroidectomy (OT).</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent thyroidectomy by the same surgeon between January 2021 and December 2023 at our institution. The surgical outcomes and postoperative complications of CABBA-ET and OT were compared after propensity score matching (PSM) of the clinicopathologic characteristics.</p><p><strong>Results: </strong>A total of 433 patients who underwent CABBA-ET or OT were enrolled in this study, of whom 83 underwent CABBA-ET, and the remaining 350 underwent OT. After PSM, 16 pairs of patients with benign thyroid nodules and 56 pairs of patients with differentiated thyroid carcinoma (DTC) were matched between the CABBA-ET and OT groups. Compared with the OT group, patients with benign nodules and DTC in the CABBA-ET group had a longer operation time (both P < 0.01) and a higher 24-h postoperative drainage volume (P = 0.03 and < 0.01). The length of hospitalization was comparable between the two groups, and there were no significant differences in postoperative complications.</p><p><strong>Conclusions: </strong>CABBA-ET is a viable cosmetic procedure and may represent an alternative for selective patients.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"201"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of domino transplantation with Two-Way Paired Exchange and normal transplantation: acute rejection, surgical complications, and 5-year survival outcomes.","authors":"Amil Huseynov, Sevim Nuran Kuslu Cicek","doi":"10.1007/s00423-025-03787-5","DOIUrl":"10.1007/s00423-025-03787-5","url":null,"abstract":"<p><strong>Background: </strong>Domino kidney paired donation and Two-Way Paired Exchange have emerged as vital strategies to expand the donor pool in renal transplantation, especially for patients facing ABO or HLA incompatibilities. Despite their potential benefits, concerns remain regarding immunological risks, infectious complications, and long-term graft survival.</p><p><strong>Methods: </strong>In this retrospective cohort study conducted at Medicana Transplant Center, 980 adult kidney transplant recipients were categorized into three groups: Domino (n = 144), Two-Way Paired Exchange (n = 350), and Normal Transplant (n = 486). Baseline characteristics, acute rejection rates, and surgical or infectious complications were collected, alongside data on 1-year and 5-year patient and graft survival. Statistical analysis included Kaplan-Meier survival curves and Cox proportional hazards modeling for independent predictors of graft outcomes.</p><p><strong>Results: </strong>The Domino group had the highest 1-year acute rejection rate (17.4%) compared to Two-Way Paired Exchange (4.3%) and Normal Transplant (3.7%), yet 1-year graft survival rates remained comparable (92%, 95%, and 96%, respectively; p = 0.271). Infectious complications were more frequent in the Domino group (25%) than in others (p < 0.01). Extended follow-up to 5 years indicated no statistically significant difference in overall graft or patient survival among the three groups (log-rank p = 0.197), despite a trend toward lower 5-year graft survival in the Domino group. Donor-specific antibodies and higher HLA mismatches independently predicted acute rejection.</p><p><strong>Conclusions: </strong>Domino transplantation, while associated with higher immunologic challenges, achieves acceptable short-term and 5-year outcomes akin to Two-Way Paired Exchange and Normal Transplant. Careful immunosuppressive strategies, vigilant monitoring, and collaborative protocols are integral for optimizing long-term success in high-risk transplant scenarios.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"203"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of endovascular treatment of splenic artery aneurysms: a single centre experience.","authors":"Laura Lech, Annette Thurner, Dominik Peter, Christoph-Thomas Germer, Sven Flemming, Ralph Kickuth","doi":"10.1007/s00423-025-03791-9","DOIUrl":"10.1007/s00423-025-03791-9","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"205"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}