Middle East Journal of Digestive Diseases最新文献

{"title":"Outcomes of Draining Seton Insertion Followed by Ligation of the Intersphincteric Fistula Tract Versus Cutting Seton Insertion for Anal Fistula: A 5-Year Retrospective Cohort Study.","authors":"Siavash Masoumi, Ahmed Mohammed Ali Hussein Alhurry, Seyed Vahid Hosseini, Sara Shojaei-Zarghani, Mohammad Mostafa Safarpour, Zahra Ghanbarzadegan, Alimohammad Bananzadeh","doi":"10.34172/mejdd.2025.442","DOIUrl":"10.34172/mejdd.2025.442","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare healing time, recurrence rates, incidence of incontinence, and quality of life between the ligation of the intersphincteric fistula tract (LIFT) procedure (preceded by draining seton insertion) and cutting seton insertion for anal fistula over a 5-year period.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients with high-type perianal fistulas who underwent either LIFT (preceded by draining seton insertion) or cutting seton insertion between May 16, 2018, and April 17, 2024, at Shahid Faghihi and Ghadir mother and child hospitals. A comparative analysis was performed to evaluate healing time, recurrence rates, incidence of incontinence, and quality of life between the two surgical approaches.</p><p><strong>Results: </strong>The study included 51 patients who underwent LIFT surgery and 48 who received cutting seton insertion. There were no significant differences between the two groups in terms of demographic characteristics or behavioral factors. Additionally, no statistically significant differences were observed between the two groups regarding fecal incontinence, healing rates, recurrence, healing time, and quality of life (<i>P</i>>0.05). However, patients who underwent cutting seton insertion exhibited a non-significant lower recurrence rate compared with those who received the LIFT procedure (8.3% vs. 17.6%).</p><p><strong>Conclusion: </strong>This study provides valuable insights into the comparison of the efficacy of cutting seton insertion versus the LIFT procedure for managing anal fistulas. By evaluating key postoperative outcomes, the findings may help in clinical decision-making and enhance patient care strategies in colorectal surgery.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"269-274"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868991","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":"Insights into Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis: The Role of Fibrinogen and Pepsinogen.","authors":"Zahra Eslami, Alireza Norouzi","doi":"10.34172/mejdd.2025.438","DOIUrl":"10.34172/mejdd.2025.438","url":null,"abstract":"<p><strong>Background: </strong>Fibrinogen is a multifunctional protein that contributes to inflammatory processes. Elevated levels of fibrinogen have been associated with increased liver fibrosis and disease severity of non-alcoholic steatohepatitis (NASH). Fibrinogen appears to interact with other factors implicated in NASH pathophysiology, such as activation of immune cells to induce pro-inflammatory cytokines and cellular signaling pathways. Additionally, fibrinogen-mediated pathways may disrupt normal tissue repair processes. Pepsinogen, the inactive precursor of pepsin and a specific functional enzyme in the gastric mucosa, is a serological marker with subtypes closely related to different gastrointestinal diseases. Changes in pepsinogen levels in liver disease are not entirely understood and likely relate to many factors, including inflammation, altered gastrin levels, and <i>Helicobacter pylori</i> infection. The clinical implications of altered pepsinogen levels in liver disease are still under investigation, but they may have relevance in the diagnosis and monitoring of liver disease.</p><p><strong>Methods: </strong>Databases searched included PubMed, Google Scholar, and Scopus from 2005 to 2024, and the following keywords were used: fibrinogen, pepsinogen, non-alcoholic steatohepatitis, NASH, non-alcoholic fatty liver disease, NAFLD, and fibrosis.</p><p><strong>Results: </strong>As a potential biomarker for NASH, measuring fibrinogen levels could offer valuable insights into disease diagnosis and progression monitoring. On the other hand, pepsinogen is involved in gut health and liver function, contributing to liver inflammation and fibrosis through mechanisms like the gut-liver axis and signaling pathways.</p><p><strong>Conclusion: </strong>Overall, both fibrinogen and pepsinogen appear to have a more significant negative impact on liver health and the progression of NAFLD than beneficial effects. Integrating assessments of fibrinogen and pepsinogen into clinical practice could facilitate earlier intervention strategies aimed at slowing disease progression.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"240-246"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869021","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":"Survival Rate in Hepatocellular Carcinoma after Surgery and Its Association with Clinicopathological Factors: A Single-Center Report.","authors":"Masoomeh Safaei, Farid Azmoudeh-Ardalan, Ali Jafarian, Maede Hoseini, Amir Mohammad Azizpour","doi":"10.34172/mejdd.2025.441","DOIUrl":"10.34172/mejdd.2025.441","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and the third leading cause of cancer-related deaths. Survival rate is a key health indicator that aids in assessing diagnostic and therapeutic approaches. This study aimed to evaluate the survival rate of patients with HCC and identify clinicopathological factors influencing survival in Iran, where data are limited.</p><p><strong>Methods: </strong>This cross-sectional retrospective study examined the medical records of 45 patients with HCC who underwent surgery at Imam Khomeini hospital, Tehran, from 2013 to 2019. Demographic, clinical, and histopathological data were collected, and survival rates were analyzed using the Kaplan-Meier method. Multivariate analysis was performed using Cox regression to identify independent prognostic factors.</p><p><strong>Results: </strong>The mean age of patients was 48.6±18.56 years, with 62.2% being male. The average follow-up period was 34.28 months, with a maximum of 102 months. The median overall survival was 26 months, with 1-year and 3-year survival rates of 66.7% and 46.7%, respectively. Multivariate analysis identified older age, tumor size>5 cm, presence of steatosis, history of recurrence, and non-transplantation treatment as independent risk factors for mortality. Other factors, such as tumor stage, histological subtype, and serum alpha-fetoprotein levels, were not significantly related to survival.</p><p><strong>Conclusion: </strong>Based on the results, mortality in patients with HCC is significantly influenced by factors such as advanced age, larger tumor size (>5 cm), presence of steatosis, prior recurrence, and absence of liver transplantation as a treatment. These findings underscore the limited prognostic value of variables such as tumor stage, histological subtype, and serum AFP levels. Emphasizing the importance of proactive management, regular follow-up of high-risk individuals, and timely detection to facilitate curative interventions appears to be an essential strategy for enhancing survival outcomes in patients with HCC.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"261-268"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868963","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":"Esophagus Impaction and Perforation by Jujube: A Tale of Double Trouble.","authors":"Ahmad Shukri Mohamad, Ikhwan Sani Mohamad, Michael Wong Pak Kai, Wan Mokhzani Wan Mokhter, Maya Mazuwin Yahya, Siti Rahmah Hashim Isa Merican","doi":"10.34172/mejdd.2025.446","DOIUrl":"10.34172/mejdd.2025.446","url":null,"abstract":"<p><p>Sharp foreign body ingestion may result in simple impaction to mucosal perforation along the gastrointestinal tract. We report a rare case of a 62-year-old woman with jujube ingestion, a fruit that contains sharp-edged seeds causing impaction in the esophagus. Contrast computed tomography (CT) confirmed the transverse lie of the seed at the esophageal wall with features of through-and-through perforation. Flexible endoscopy under local anaesthesia successfully retrieved the jujube seed, followed by application of endoscopic hemoclips for the esophageal perforation. The patient was discharged well within a few days with no fatal outcomes.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"290-292"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868956","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-Diarrheal Celiac Disease in Iraq: A Multicenter study.","authors":"Abdullah Zuhair Alyouzbaki, Ahmed Abdul Hussein Alhilly, Samar Saad Abdulhussein, Azhar Khalaf Alazawi, Kamal Breesam Lafta, Khalid N M Alkheroo","doi":"10.34172/mejdd.2025.443","DOIUrl":"10.34172/mejdd.2025.443","url":null,"abstract":"<p><strong>Background: </strong>Non-diarrheal celiac disease (NDCD) is increasingly recognized in Iraq, but many cases are often missed or underdiagnosed because of its non-classical presentation. This study aimed to determine the clinical features and relevant investigations for patients with NDCD in Iraq.</p><p><strong>Methods: </strong>This is a prospective study that includes 117 cases of NDCD collected from different centers across Iraq. The study evaluated presenting symptoms, associated features, serological markers, endoscopic findings, and histopathological features. Patients with classical diarrhea were excluded from the study.</p><p><strong>Results: </strong>90 patients (77%) were women, and 94 patients (80%) were younger than 40 years. More than half had a normal body mass index, while a quarter of patients were classified as overweight and obese. Only 22% of patients with NDCD received a diagnosis within one year of the onset of symptoms, and 99 patients (84.6%) were suspected of having celiac disease during gastroscopy. Common symptoms among patients with NDCD included epigastric pain and anemia reported by 78.6% and 86.3% of patients, respectively. Endoscopic features suggestive of celiac disease were present in 94% of cases, and Marsh grade 3 histopathological features were observed in 75% of patients.</p><p><strong>Conclusion: </strong>NDCD is more prevalent in young, normal-weight, and obese female patients. Due to non-classical presentations such as epigastric pain or anemia, there is often a delay of more than one year in receiving a diagnosis. A gastroscopy performed by an experienced doctor yields a high diagnostic success rate in identifying NDCD. Furthermore, most patients with NDCD exhibit advanced histopathological features of celiac disease in their duodenal biopsies.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"275-281"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868967","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":"Primary Gastric Hodgkin Lymphoma: A Case Report.","authors":"Hana Ben Hammamia, Dorra Jabr, Raoudha Mansouri, Malek Sayadi, Karima Kacem, Raihane Ben Lakhal, Ghada Sahraoui, Karima Mrad","doi":"10.34172/mejdd.2025.448","DOIUrl":"10.34172/mejdd.2025.448","url":null,"abstract":"<p><p>Hodgkin lymphoma is among the most frequent hematologic malignancies that affects the lymphatic system. Primary extranodal involvement in Hodgkin disease is unusual. We report the case of primary gastric Hodgkin lymphoma in a 50-year-old man, who complained about epigastralgia and poor appetite. An upper gastrointestinal endoscopy, biopsy, and immunohistochemical exam confirmed the diagnosis of Hodgkin lymphoma. Primary gastric Hodgkin lymphoma is a very rare entity; clinicians and anatomopathologists should be sensitized to its uncommon extranodal localization.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"298-300"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869010","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":"An Unusual Cause of Dysphagia in a 16-Year-Old Girl.","authors":"Samira Saeian, Saeedeh Esmaeili, Mohammad Hossein Anbardar, Alireza Dehghan, Kamran B Lankarani","doi":"10.34172/mejdd.2025.445","DOIUrl":"10.34172/mejdd.2025.445","url":null,"abstract":"<p><p>This report presents the case of a 16-year-old girl with progressive dysphagia and weight loss over 6 months. Initial examinations, laboratory findings, and upper endoscopy were unremarkable. High-resolution esophageal manometry was suspicious of achalasia, but subsequent imaging revealed the presence of a non-homogeneous mass in the esophageal wall, identified as esophageal leiomyoma through histopathological and immunohistochemical analyses. Despite the rarity of this tumor in adolescents, our findings emphasize the importance of considering esophageal leiomyoma in the differential diagnoses of intramural esophageal lesions. The patient was advised of surgical treatment, which she and her family refused. This case underscores the need for accurate tissue diagnosis via endoscopic ultrasonography (EUS)-guided biopsies to guide treatment decisions, especially in young patients presenting with significant esophageal symptoms.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"287-289"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869019","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":"Change of Expression of Ki 67, P53, and Cyclin D1 Immunoreactivity after <i>Helicobacter pylori</i> Eradication in Patients with Chronic Gastritis and Intestinal Metaplasia.","authors":"Seyed Mohammad Valizadeh Toosi, Somayeh Sheidaei","doi":"10.34172/mejdd.2025.444","DOIUrl":"10.34172/mejdd.2025.444","url":null,"abstract":"<p><strong>Background: </strong>We investigated the impact of <i>Helicobacter pylori</i> eradication on the expression of Ki67, p53, and cyclin D1 in patients diagnosed with chronic gastritis and intestinal metaplasia, utilizing the immunohistochemistry (IHC) method.</p><p><strong>Methods: </strong>The immunoexpression of Ki67, p53, and cyclin D1 in the gastric mucosa was analyzed in 26 patients with chronic gastritis, intestinal metaplasia, and confirmed <i>H. pylori</i> infection, as well as 10 patients with normal gastric histology and no <i>H. pylori</i> infection. The assessments were performed both before and after <i>H. pylori</i> eradication.</p><p><strong>Results: </strong>Successful eradication of <i>H. pylori</i> resulted in a significant reduction in the immunoexpression of Ki67, p53, and cyclin D1 in the majority of patients compared to pre-treatment. High immunoreactivity for Ki67, p53, and cyclin D1 was observed before eradication in 13 (50%), 4 (15.4%), and 9 (34.6%) patients, respectively. Following <i>H. pylori</i> eradication, none of the patients exhibited high immunoreactivity for these markers. Additionally, negative immunoreactivity for Ki67, p53, and cyclin D1 was noted in 21 (80.7%), 21 (80.7%), and 12 (46.1%) patients, respectively, with statistically significant P values of 0.005, 0.02, and 0.004.</p><p><strong>Conclusion: </strong>The eradication of <i>H. pylori</i> in patients with chronic gastritis and intestinal metaplasia leads to a significant regression in the immunoreactivity of Ki67, p53, and cyclin D1. This suggests the potential for reversing precancerous changes in the gastric mucosa through timely treatment.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 4","pages":"282-286"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868958","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":"Pancreatitis Manifestation and Mimicking Gallstone Symptoms Caused by Fasciola Hepatica: A Case Report.","authors":"Zahra Bigdeli Shamloo, Ahmad Hormati, Amir Anushiravani","doi":"10.34172/mejdd.2025.435","DOIUrl":"10.34172/mejdd.2025.435","url":null,"abstract":"<p><p>Fasciola hepatica is a parasitic trematode that infects humans, typically through the consumption of contaminated water or raw vegetables. The infection progresses through acute and chronic phases, with the latter often presenting as jaundice, cholangitis, pancreatitis, and cholecystitis due to bile duct obstruction. We report the case of a 53-year-old Iranian woman who experienced persistent eosinophilia, nausea, right upper quadrant and epigastric pain, and occasional chills for one year. Imaging revealed a dilated common bile duct (CBD) with sludge, and endoscopic retrograde cholangiopancreatography (ERCP) successfully identified and extracted five live Fasciola hepatica parasites. This case illustrates the vital role of early recognition and intervention in fascioliasis, as timely endoscopic management can prevent severe complications. Increased awareness among clinicians, especially in regions where the disease is uncommon, is essential to ensure prompt diagnosis and effective treatment of this often-overlooked infection.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 3","pages":"226-229"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365927","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":"Does Serum Anti-tissue Transglutaminase Level Predict Duodenal Histopathology and Clinical Manifestations of Celiac Disease in Adults?","authors":"Reza Gholamrezaei, Atefeh Vaezi, Fatemeh Maghool, Nahid Jamali, Mohammad Hassan Emami","doi":"10.34172/mejdd.2025.429","DOIUrl":"10.34172/mejdd.2025.429","url":null,"abstract":"<p><strong>Background: </strong>Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion. This study aimed to evaluate the correlation between anti-tTG antibodies and histopathology, as classified by the Marsh system, and clinical manifestations.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analyzed the records of 346 patients with confirmed CD from 2010 to 2021. Anti-tTG levels, clinical manifestations, body mass index (BMI), and pathological results were reviewed.</p><p><strong>Results: </strong>This study included 346 patients (mean age 26.5±16.6 years; 56.4% female). Most patients (53.2%) had atypical CD, and normal BMI was prevalent (57.1%). Common symptoms included anxiety (70.2%), fatigue/weakness (64.2%), borborygmi (53.2%), abdominal pain (51.2%), and bloating (46.8%). Disease severity analysis revealed 75.1% had Marsh III, while 15.9% had normal/Marsh I and 9.0% had Marsh II. Anti-tTG levels were significantly higher in advanced Marsh classes (Marsh III: 169.27±180.17 vs. normal/Marsh I: 70.94±116.45, <i>P</i><0.001) and in typical CD (180.44±216.22) compared to atypical CD (126.20±121.72, <i>P</i>=0.005). Diarrhea, arthralgia, and osteoporosis/osteomalacia showed significant correlations with anti-tTG levels (<i>P</i><0.05). ROC analysis for anti-tTG in diagnosing Marsh II or higher yielded an AUC of 0.733.</p><p><strong>Conclusion: </strong>Anti-tTG demonstrated moderate diagnostic accuracy for advanced duodenal damage, highlighting its utility as a biomarker in CD. Larger studies are needed to validate these findings further.</p>","PeriodicalId":18517,"journal":{"name":"Middle East Journal of Digestive Diseases","volume":"17 3","pages":"183-189"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365936","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}