Plastic & Reconstructive Surgery最新文献

{"title":"Discussion: Neurotized Platysma Graft: A New Technique for Functional Reanimation of the Eye Sphincter in Longstanding Facial Paralysis.","authors":"S. Rozen","doi":"10.1097/PRS.0000000000006297","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006297","url":null,"abstract":"www.PRSJournal.com 1071e C protection is one of the highest priorities in longstanding flaccid facial paralysis patients. The inability to close the palpebral aperture secondary to a paralyzed orbicularis oculi muscle increases the risk of keratoconjunctivitis, ulcerations and, in severe cases, blindness. The orbicularis oculi muscle is a unique muscle. It is extremely thin, as it lies under the thinnest skin in the body—the upper and lower eyelids. Also, its circular shape combined with medial and lateral anchoring allows it a very distinctive sphincter action, enabling palpebral aperture closure in a cranial-to-caudal direction with minimal medialto-lateral vector. In addition, its proper tone and function are essential in periorbital aesthetics. Even when midface palsy reconstruction is optimal, patients with suboptimal aesthetic periorbital reconstruction will always carry the stigmata of facial paralysis. Static upper and lower eyelid procedures provide some corneal protection during sleeping hours but are limited during awake hours when normal blink reflex and voluntary palpebral closure are vital. Although orbicularis oculi muscle neurotization is feasible in the acute and subacute phase, longstanding palsy patients need a new neuromuscular unit. This has previously been attempted by either muscle transfers or functional muscle transplants.1 Both are imperfect. The former often suffer from lateral-to-medial action, sometimes providing closure but nearly always creating distortion. The latter demand very high technical proficiency2 and are frequently bulky. This is where the work by Drs. Nassif and Chia is unique.3 Although free muscle grafts were described as early as 1970 by Tamai et al.,4 they were inherently unreliable because of muscle ischemia, especially in thicker muscles. Nevertheless, the periorbital area needs an extremely thin muscle and, as demonstrated in regenerative peripheral nerve interface studies, small muscle grafts without axial blood supply may survive in wellvascularized wound beds and available early neurotization.5 Nassif and Chia took advantage of this approach and of the similar embryologic, histologic, architectural, and fine motor unit arrangement properties of the platysma and orbicularis oculi muscle. They transplanted two very thin platysma muscle grafts to the upper and lower eyelids after preparing the recipient bed with respective cross-facial nerve grafts. The premise is that these thin muscle grafts survive because of early vascularization and neurotization. By no means is this procedure portrayed as simple, but its beauty is its simplicity. It may seem that Nassif and Chia have provided the holy grail of periorbital reconstruction in longstanding paralyzed patients, addressing the most difficult challenges by providing a reproducible, functional, aesthetic and thin, sphincter-like reconstruction. Nevertheless, a discussion must point out limitations and encourage further development; thus, the followin","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87600133","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":"Infections following Immediate Implant-Based Breast Reconstruction: A Case-Control Study over 11 Years.","authors":"Joseph Banuelos, M. Sabbagh, Si-Gyun Roh, M. Nguyen, V. Lemaine, N. Tran, S. Jacobson, J. Boughey, J. Jakub, T. Hieken, A. Degnim, J. Mandrekar, E. Berbari, Basel Sharaf","doi":"10.1097/PRS.0000000000006202","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006202","url":null,"abstract":"BACKGROUND\u0000Surgical-site infection after implant-based breast reconstruction adversely affects surgical outcomes and increases health care costs. This 11-year case-control study examines risk factors specific for surgical-site infection after immediate tissue expander/implant-based breast reconstruction.\u0000\u0000\u0000METHODS\u0000The authors performed a retrospective review to identify all consecutive patients with breast implant infections between 2006 and 2016. Patients who developed surgical-site infection after immediate tissue expander/implant-based breast reconstruction were included. Surgical-site infection was defined using the Centers for Disease Control and Prevention criteria; specifically, infections requiring hospital admission, intravenous antibiotics, or surgical intervention were included. The authors matched a control patient to each infection case by patient age and date of surgery. Patient demographics, medical comorbidities, and perioperative surgical variables were examined. Univariate and multivariable conditional logistic regression models were constructed.\u0000\u0000\u0000RESULTS\u0000A total of 270 breasts in 252 patients were evaluated. On multivariate analysis, patients with a higher body mass index (OR, 1.1 per 1 body mass index point increase; 95 percent CI, 1.0 to 1.2; p = 0.02), hypertension (OR, 6.5; 95 percent CI, 1.9 to 22.3; p = 0.002), neoadjuvant chemotherapy (OR, 2.6; 95 percent CI, 1.0 to 6.3; p = 0.04), axillary lymph node dissection (OR, 7.1; 95 percent CI, 1.7 to 29.2; p = 0.006), seroma formation (OR, 15.34; 95 percent CI, 3.7 to 62.5; p = 0.0001), and wound healing complications (OR, 23.91; 95 percent CI, 6.1 to 93.4; p < 0.0001) were significantly associated with surgical-site infection.\u0000\u0000\u0000CONCLUSIONS\u0000Women with obesity, women with hypertension, and those treated with neoadjuvant chemotherapy are at increased risk of surgical-site infection. Further risks are also associated with postoperative seroma and wound complications. This may help patient selection and counseling, adjusted based on risk factors regarding complications of immediate implant-based breast reconstruction.\u0000\u0000\u0000CLINICAL QUESTION/LEVEL OF EVIDENCE\u0000Risk, III.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81988951","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":"Rasch Analysis of the Patient and Observer Scar Assessment Scale in Linear Scars: Suggestions for a Patient and Observer Scar Assessment Scale v2.1.","authors":"F. Franchignoni, A. Giordano, S. Vercelli, Elisabetta Bravini, Valeria Stissi, G. Ferriero","doi":"10.1097/PRS.0000000000006265","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006265","url":null,"abstract":"BACKGROUND\u0000The Patient and Observer Scar Assessment Scale (POSAS) v2.0 is a widely used instrument to evaluate postsurgical scars. Its two subscales respectively investigate the patient's and clinician's opinion on the scar quality. However, psychometric studies of the POSAS have indicated that its metric performance is suboptimal, and structural adjustments may be appropriate. The authors aimed to verify through Rasch analysis the measurement properties of the POSAS v2.0, and propose eventual structural refinements for an easier and more confident use of the scale in clinical practice and research.\u0000\u0000\u0000METHODS\u0000Consecutive patients admitted to two rehabilitation centers for postsurgery rehabilitation over a 2-year period underwent scar assessments with the POSAS v2.0. We performed Rasch analysis to examine the scale's dimensionality, rating categories, item fit, reliability indices, local item independence, and differential item functioning.\u0000\u0000\u0000RESULTS\u0000The study population consisted of 115 patients. The 10 response options of the POSAS showed malfunctioning, and thus were collapsed, forming a parsimonious five-level rating scale, which helped to improve the measurement accuracy. After that, unidimensionality of both subscales was confirmed. Then, internal construct validity of the POSAS v2.0 was demonstrated (through item fit to the Rasch model). Reliability indices were high (≥0.80). No significant differential item functioning was detected concerning age or sex.\u0000\u0000\u0000CONCLUSION\u0000This study demonstrates the good psychometric properties of a simplified Rasch-based version of the Patient and Observer Scar Assessment Scale with five response options (POSAS v2.1) in patients with postsurgical linear scars, and provides insights for future refinement of the tool.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87473488","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":"Preliminary Results Supporting the Bacterial Hypothesis in Red Breast Syndrome following Postmastectomy Acellular Dermal Matrix- and Implant-Based Reconstructions.","authors":"M. Danino, A. El Khatib, O. Doucet, Lan Dao, J. Efanov, J. Bou-Merhi, M. Iliescu-nelea","doi":"10.1097/PRS.0000000000006227","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006227","url":null,"abstract":"Acellular dermal matrices have become a mandatory tool in reconstructive breast surgery. Since their introduction, they have been considered to be nonreactive and nonimmunogenic scaffolds. However, some patients who undergo implant-based breast reconstruction with acellular dermal matrices develop postoperative cutaneous erythema overlying their matrices, a condition commonly referred to as red breast syndrome. The aim of this study was to gain a better understanding of this phenomenon. An analysis was conducted on consecutive patients who underwent acellular dermal matrix- and implant-based breast reconstructions and developed red breast syndrome that was treated surgically between April of 2017 and June of 2018 at the authors' institution. During surgery, 1-cm specimens of acellular dermal matrix were sampled and analyzed by scanning electron microscopy. Observations were charted to score and record the presence and thickness of biofilm, and for identification of bacteria. These measurements were performed using Adobe Photoshop CS6 Extended software. Six postmastectomy breast reconstruction patients were included, all with AlloDerm Ready-to-Use-based reconstructions. All specimens were colonized by various bacteria ranging from Gram-negative bacilli to Gram-positive microorganisms. Biofilm was present in all studied specimens. The cause of skin erythema overlying acellular dermal matrix grafts, and the so-called red breast syndrome, may be related to contamination with various bacteria. Although contamination was omnipresent in analyzed samples, its clinical significance is variable. Even if acellular dermal matrix-based reconstructions are salvaged, this could come at the price of chronic local inflammation.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"402 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76620154","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":"Visualizing the pharmacological preconditioning effect of botulinum toxin A by the infrared thermography in a rat pedicled perforator island flap model.","authors":"Miao Chen, Xiucun Li, Zhenmin Jiang, Xu Gong","doi":"10.1097/PRS.0000000000006251","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006251","url":null,"abstract":"BACKGROUND\u0000Surgical delay can improve flap viability, leading to vasodilation, neovascularization, and vessel reorganization. Experiments suggest similar positive effect of botulinum toxin A (BTX-A) on pedicled flaps' viability. However, whether it may convert the choke anastomoses into the true anastomoses and how to identify the optimal timing for flap transfer remains unclear.\u0000\u0000\u0000METHODS\u0000One hundred and fifty-four Sprague-Dawley rats were divided into a control group, three saline injection groups, and three BTX-A injection groups defined by time of injection (2, 3, 4 weeks before flap harvest). A pedicled flap of 11×3 cm was marked on the unilateral dorsum of rat. Before flap harvest, the flap donors were assessed by the infrared thermal imaging, postmortem arteriography, immunohistochemical staining of CD 31 and ELISA. Flap survival areas percentage was measured on postoperative day 7.\u0000\u0000\u0000RESULTS\u0000In the control group and saline groups, the infrared thermography showed three independent white hotspots interspaced by red zones over flaps, whereas it presented a continuous white band in the BTX-A groups. There was a significant increase in the flap survival area, flap surface temperatures, the numbers of identifiable vessels in the choke zones, microvascular density and vascular endothelial growth factor concentration in the BTX-A groups.\u0000\u0000\u0000CONCLUSIONS\u0000BTX-A can convert the choke anastomoses into the true anastomoses and its preconditioning effect cannot increase over time; it is appropriate to choose the timing point when the infrared thermal images show a continuous white band existing over flaps for flap transfer.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73504738","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":"Clockwise Rotation of the Occlusal Plane for Aesthetic Purposes by Double Jaw Surgery without Orthodontic Treatment.","authors":"T. Lee, Sanghoon Park","doi":"10.1097/PRS.0000000000006248","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006248","url":null,"abstract":"The occlusal plane angle is an important factor in lateral facial aesthetics. Low occlusal plane facial profiles appear planar and long-faced, whereas high occlusal plane facial profiles are considered more attractive, especially in Asian regions. Clockwise rotation of the occlusal plane for truly aesthetic purposes can be accomplished with double jaw surgery, without need for orthodontic treatments. Patients with normal occlusion who desired to improve their lateral facial aesthetics were included in this study. A conventional Le Fort I osteotomy was followed by a sagittal split ramus osteotomy under general anesthesia. The movement of the maxillomandibular complex was determined in accord with a preoperative analysis. From 2015 to 2017, 43 patients with normal occlusion underwent double jaw surgery without orthodontic treatment. Whereas all patients were subjectively satisfied with the surgery, two underwent orthodontic treatment to correct mild occlusal discrepancies noticed after surgery. There were no delayed occlusal problems or relapses reported during the study. For patients who desired to improve their lateral facial aesthetics but had normal occlusion, orthognathic surgery without orthodontic treatment can be effective. Clockwise rotation of the occlusal plane by double jaw surgery without orthodontic treatment resulted in satisfactory aesthetic outcomes with stable and reliable long-term results. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88217443","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":"Discussion: Analysis of the Visual Perception of Female Breast Aesthetics and Symmetry: An Eye-Tracking Study.","authors":"Maurice Y Nahabedian","doi":"10.1097/PRS.0000000000006293","DOIUrl":"10.1097/PRS.0000000000006293","url":null,"abstract":"","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"3 1","pages":"1267-1268"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91516671","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":"Contemporary Approaches to Postoperative Pain Management.","authors":"A. Murphy, S. Haykal, D. Lalonde, T. Zhong","doi":"10.1097/PRS.0000000000006268","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006268","url":null,"abstract":"LEARNING OBJECTIVES\u0000After reading this article, the participant should be able to: 1. Describe the fundamental concepts of multimodal analgesia techniques and how they target pain pathophysiology. 2. Effectively educate patients on postoperative pain and safe opioid use. 3. Develop and implement a multimodal postoperative analgesia regimen.\u0000\u0000\u0000SUMMARY\u0000For many years, opioids were the cornerstone of postoperative pain control, contributing to what has become a significant public health concern. This article discusses contemporary approaches to multimodal, opioid-sparing postoperative pain management in the plastic surgical patient.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90113806","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":"The Efficacy of Platelet-Rich Plasma Dressing for Chronic Nonhealing Ulcers: A Meta-Analysis of 15 Randomized Controlled Trials.","authors":"Yijun Xia, Jun Zhao, Juan Xie, Yang Lv, Dongsheng Cao","doi":"10.1097/PRS.0000000000006281","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006281","url":null,"abstract":"BACKGROUND\u0000Several randomized controlled trials comparing platelet-rich plasma to standard wound care for chronic wounds have been published. Previous articles have revealed that the role of platelet-rich plasma in promoting chronic wound healing is uncertain. This quantitative meta-analysis was conducted to evaluate whether superior outcomes can be obtained by using platelet-rich plasma in nonhealing ulcers compared with traditional wound care.\u0000\u0000\u0000METHODS\u0000The PubMed, EMBASE, EBSCO (Cumulative Index to Nursing and Allied Health Literature), and Cochrane databases were searched through November of 2018 for randomized controlled trials comparing platelet-rich plasma to standard wound care for chronic wounds. For binary outcome measures, we calculated the risk ratio. The continuous outcomes were expressed as the mean differences. Subgroup analyses were also performed according to the type of chronic ulcer.\u0000\u0000\u0000RESULTS\u0000Overall, 630 adult patients in 15 randomized controlled trials from 2000 to 2018 were included. The number of ulcers healed in the platelet-rich plasma group was higher than in the control group, and the difference was statistically significant (risk ratio, 1.26; 95 percent CI, 1.11 to 1.42; p = 0.0003). During the fourth week of follow-up, the number of ulcers healed in the platelet-rich plasma group was significantly greater than in the control group (risk ratio, 3.50; 95 percent CI, 1.80 to 6.81; p = 0.0002).\u0000\u0000\u0000CONCLUSIONS\u0000Platelet-rich plasma is a valuable and safe treatment dressing for chronic nonhealing ulcers; it is simple to prepare and has remarkable effects. Further high-quality prospective studies are necessary to validate these results.\u0000\u0000\u0000CLINICAL QUESTION/LEVEL OF EVIDENCE\u0000Therapeutic, II.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89569922","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":"The Cutting Edge of Headache Surgery: A Systematic Review on the Value of Extracranial Surgery in the Treatment of Chronic Headache.","authors":"Thijs Bink, L. Duraku, Ryan P. Ter Louw, J. Zuidam, I. Mathijssen, C. Driessen","doi":"10.1097/PRS.0000000000006270","DOIUrl":"https://doi.org/10.1097/PRS.0000000000006270","url":null,"abstract":"BACKGROUND\u0000Migraine is a debilitating neurologic condition, with a large socioeconomic impact. There is a subgroup of patients that does not adequately respond to pharmacologic management and may have underlying neuralgia. Surgical decompression of extracranial sensory nerves has been proposed as an alternative therapy. The aim of this article is to review the evidence for the surgical treatment of neuralgias.\u0000\u0000\u0000METHODS\u0000A systematic review was conducted to study the efficacy of decompression of extracranial sensory nerves as a treatment for neuralgia. Clinical studies were included that studied patients, aged 18 years or older, diagnosed with any definition of headache and were treated with extracranial nerve decompression surgery. Outcome parameters included intensity (on a 10-point scale), duration (in days), and frequency (of headaches per month).\u0000\u0000\u0000RESULTS\u0000Thirty-eight articles were found describing extracranial nerve decompression in patients with headaches. Postoperative decrease in headache intensity ranged from 2 to 8.2, reduction of duration ranged from 0.04 to 1.04 days, and reduction in frequency ranged between 4 and 14.8 headaches per month. Total elimination of symptoms was achieved in 8.3 to 83 percent of cases. A detailed summary of the outcome of single-site decompression is described. Statistical pooling and therefore meta-analysis was not possible, because of articles having the same surgeon and an overlapping patient database.\u0000\u0000\u0000CONCLUSIONS\u0000Nerve decompression surgery is an effective way of treating headaches in a specific population of patients with neuralgia. Although a meta-analysis of the current data was not possible, the extracranial decompression of peripheral head and neck sensory nerves has a high success rate.","PeriodicalId":20168,"journal":{"name":"Plastic & Reconstructive Surgery","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90767591","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}