The Egyptian Journal of Internal Medicine最新文献

{"title":"Evaluation of the diagnostic performance of estimated fecal calprotectin and serum intelectin-1 and C-reactive protein solo or in combination for differentiation between patients with query ulcerative colitis and irritable bowel syndrome","authors":"Rizk Sayad R. Sarhan, Yasmin M. Marei, Yomna M. Marei","doi":"10.1186/s43162-023-00263-8","DOIUrl":"https://doi.org/10.1186/s43162-023-00263-8","url":null,"abstract":"Abstract Objectives Evaluation of the ability of estimated levels of fecal calprotectin (FCP), serum intelectin-1 (ITLN1), and C-reactive protein (CRP) to differentiate between patients with ulcerative colitis (UC) and irritable bowel syndrome (IBS). Patients Three-hundred forty-two patients were evaluated clinically for diagnostic criteria of UC and IBD and underwent colonoscopic examination and grading according to Mayo endoscopic scores (MES). Colorectal biopsies were taken for microscopic examination. Fecal and blood samples were obtained for ELISA estimation of levels of the studied variate. Patients were grouped according to microscopic examination of the obtained biopsies as UC and IBD groups. Study outcome is the ability of the laboratory variate for prediction of the microscopic diagnosis. Results In UC patients, FCP and serum CRP levels were notably elevated compared to controls and IBS patients. Conversely, UC patients exhibited significantly reduced serum ITLN1 levels in comparison to controls and IBS patients with insignificantly lower levels in samples of IBS patients. Statistical analyses defined high FCP and low serum ITLN1 as the significant predictors for UC diagnosis with high specificity for FCP level > 150 µg/ml and high sensitivity for serum ITLN1 ≤ 30 and ≤ 18 ng/ml to predict colonoscopic and microscopic UC diagnosis, respectively. Conclusion The combination of high FCP and low serum ITLN1 could accurately predict the colonoscopic and microscopic findings of UC and can differentiate UC from IBS and may spare the need for colonoscopy and biopsy especially for IBS patients.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137104","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":"Corticosteroid and antibiotic use in hospitalized patients in Lebanon with acute exacerbation of chronic obstructive pulmonary disease","authors":"S. Basma, A. Al-Hajje, P. Salameh, I. Nader, AM. Henaine","doi":"10.1186/s43162-023-00259-4","DOIUrl":"https://doi.org/10.1186/s43162-023-00259-4","url":null,"abstract":"Abstract Background Chronic obstructive pulmonary disease (COPD) is currently one of the leading causes of death worldwide, with 90% of these deaths reported in low- and middle-income countries. In Lebanon, the prevalence of COPD is 9.7%. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends the use of antibiotics and corticosteroids in inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The studies examining the level of conformity with the GOLD recommendations are rare, which increases the need for the current study. Methods A 3-month cross-sectional study was done. Patients included were those diagnosed with acute exacerbations of COPD and admitted to one of the selected hospitals in Beirut, of various nationalities and sexes, aged 18 to 89. Data were selected from patient files admitted between January 2020 and June 2022 using a data collection sheet. The SPSS version 24 statistics software was used to conduct statistical analysis. Results A total of 260 patients were recruited, with 86.7% receiving systemic corticosteroids, 24.3% respecting dose, and 81.8% respecting the appropriate duration of corticosteroid intake. 80% exhibited pulmonary indications for receiving antibiotics, and 56.53% had the necessary cardinal symptoms. Around 74.5% of patients use antibiotics for the recommended time of 5 to 7 days. Age ( p value = 0.006), gender ( p value = 0.049), alcohol consumption ( p value = 0.018), and use of psychiatric medications ( p value = 0.049) are correlated with the conformity index of corticosteroid administration. A correlation was observed between the duration of use of antibiotics with cardinal symptoms ( p value = 0.003), CRP-value ( p value = 0.007), and type of hospital ( p value = 0.00). Conclusion This investigation revealed a need for correction in a deviation from the guidelines, shed light on existing clinical procedures, and emphasized the growing concern about the uncontrollable rate of antibiotic use and inadequate corticosteroid dosing.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135342356","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":"Herpes zoster ophthalmicus and varicella zoster meningoencephalitis in a newly diagnosed case of retroviral disease: a case report","authors":"Aniruddha Jog, Vinayak M. Sawardekar, Arjun Agarwal","doi":"10.1186/s43162-023-00261-w","DOIUrl":"https://doi.org/10.1186/s43162-023-00261-w","url":null,"abstract":"Abstract Background Meningoencephalitis and herpes zoster ophthalmicus (HZO) are rare neurological and ocular complications of herpes zoster, respectively. Their co-occurrence is rarer, even in patients with retroviral disease (RVD), and may occur in the presence of normal CD4 count. Case presentation A 35-year-old woman presented with altered sensorium. Four days back, she developed left-sided severe, deep burning type headache, and on the next day, painful vesicles developed over the left side of the scalp which progressively involved the forehead, upper part of left cheek, and tip of the nose, with swelling around the eyes. Ophthalmic examination revealed conjunctivitis and keratitis suggesting acute HZO. Neck rigidity was present, and MRI brain was suggestive of acute meningoencephalitis. The DNA polymerase chain reaction of cerebrospinal fluid for varicella zoster virus (VZV) confirmed the diagnosis of acute meningoencephalitis. The search for cause of immunosuppression led to the diagnosis of RVD. Treatment with intravenous acyclovir and dexamethasone led to rapid recovery and clearing of lesions. Conclusion VZV infection should be included in the differential diagnosis among patients with newly diagnosed RVD presenting with meningoencephalitis and HZO.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135342399","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":"Diagnostic dilemma in disseminated TB could be fatal: lesson learned through a bitter encounter","authors":"Ahmed Suparno Bahar Moni, Tiffany Ann Johnson, Cade Ray McGarvey, Razia Sultana Ivy, Tasmia Jahan Yean, Muhamad Zabidi Ahmad","doi":"10.1186/s43162-023-00262-9","DOIUrl":"https://doi.org/10.1186/s43162-023-00262-9","url":null,"abstract":"Abstract A definitive diagnosis of soft tissue cystic swelling is challenging, as clinical and imaging findings might misguide the clinician and delay timely diagnosis and treatment as well as outcome. The radiological features of tubercular cysts often overlap with that of sarcoma or metastatic cancer. Involvement of a multidisciplinary team, tissue biopsy, and histopathology should supplement standard diagnostic testing and imaging to confirm the diagnosis and avoid delay in treatment. We report a case of multiple cystic swelling of the upper limb, ankle, and pelvis mimicking metastatic ovarian cancer which was later diagnosed as a case of disseminated tuberculosis.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634806","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":"Re-infections with SARS-CoV-2 require a clarification of favourable risk factors","authors":"Josef Finsterer","doi":"10.1186/s43162-023-00260-x","DOIUrl":"https://doi.org/10.1186/s43162-023-00260-x","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820380","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":"Brain-derived neurotrophic factor is associated with cardiometabolic risk factors in HIV patients on combination antiretroviral therapy in Ghana","authors":"Kwame Yeboah, Francys Frimpong Otu, Jennifer Adjepong Agyekum, Bartholomew Dzudzor","doi":"10.1186/s43162-023-00257-6","DOIUrl":"https://doi.org/10.1186/s43162-023-00257-6","url":null,"abstract":"Abstract Background Brain-derived neurotrophic factor (BDNF) has been implicated in the development of cardiometabolic risk factors in some populations. However, few studies have investigated the role of BDNF and cardiometabolic risk factors in HIV patients despite the plethora of evidence linking HIV infection with the dysregulation of circulating BDNF levels. We investigated the association between serum BDNF and cardiometabolic risk factors in HIV patients in a primary hospital in Ghana. We recruited 450 participants, comprising 150 combination antiretroviral (cART)-treated HIV patients, 150 cART-naïve HIV patients, and 150 non-HIV controls. Data on sociodemographic parameters and medical history were collected using a structured questionnaire. Fasting venous blood samples were collected to measure plasma glucose levels, lipid profiles, and BDNF. Metabolic syndrome (MetS) was defined using the joint interim statement criteria. Results Compared to untreated HIV patients and uninfected controls, the proportion of participants having MetS was high in cART-exposed HIV patients (26.8% vs 21.1% vs 52.1%, respectively, p < 0.001). Generally, BDNF levels were higher in uninfected controls compared with untreated and cART-exposed HIV patients [7.1 (3.4–13.3) vs 4.9 (2.7–9.6) vs 5.6 (2.9–8.9) ng/ml, p = 0.025]. In participants without MetS, square root-transformed serum BDNF was lowest in cART-exposed HIV patients, followed by untreated HIV patients, with uninfected controls having the highest (1.8 ± 0.8 vs 2.4 ± 1.2 vs 2.9 ± 1.2 ng/ml, p < 0.001). MetS was associated with serum BDNF levels in only the cART-exposed HIV patients [OR (95% CI) = 2.98 (1.64–5.41), p < 0.001]. In cART-exposed HIV patients, an increase in BDNF was associated with increased likelihood of having impaired fasting glucose [2.49 (1.51–4.11), p < 0.001], high systolic blood pressure [1.64 (1.1–2.46), p = 0.016], and hypertriglyceridemia [2.73 (1.65–4.52), p < 0.001], as well as decreased likelihood of having low HDL cholesterol levels [0.32 (0.19–0.56), p < 0.001]. Conclusion In our study population, MetS was higher in cART-exposed HIV patients. HIV patients have low levels of serum BDNF, especially those without MetS. BDNF was associated with MetS and its components in HIV patients on cART management.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135778672","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":"Peroral Endoscopic Myotomy (POEM) for the treatment of achalasia in an Egyptian cohort","authors":"Shaimaa Elkholy, Kareem Essam, Gina Gamal, Karim K. Maurice, Zeinab Abdellatif, Mohammed El-Sherbiny, Hany Haggag, Abeer Awad, Kerolis Yousef","doi":"10.1186/s43162-023-00226-z","DOIUrl":"https://doi.org/10.1186/s43162-023-00226-z","url":null,"abstract":"Abstract Background and study aims Peroral endoscopic myotomy (POEM) has been regarded as a novel and minimally invasive therapy for the treatment of achalasia. Data from the Middle East and North Africa (MENA) region and Arabic countries are scarce, and this study represents the first study from this area. The aim of this study was to assess the efficacy and safety of POEM in an Egyptian cohort. Patients and methods This is a prospective study that included 34 Egyptian patients who underwent POEM for achalasia. Results This study included 19 (55.9%) males with a median age of 33.5 years (range: 11–75 years). 16 (47.1%) patients had previous pneumatic balloon dilation, and 1 (2.9%) patient had previous surgical myotomy. The median Eckardt score pre-POEM was 9 (range: 4–12). The median integrated relaxation pressure for 4 s (IRP4s) was 25.6 mmHg (range: 11.5–49.4 mmHg). High-resolution manometry showed that 12 patients had type I achalasia (35.2%), 18 patients had type II achalasia (52.9%), and 4 patients had type III achalasia (11.7%). The median procedure time was 120 min (range: 75–260 min). Technical success was achieved in all patients (100%), and clinical success was achieved in 33/34 patients (97.1%). There was no significant difference in success rates among different types of achalasia (p 0.208). There was a significant reduction in the Eckardt score ( P < 0.0001) and IRP4s values pre- and post-POEM ( P < 0.0001). There was also a significant increase in the body mass index of the patients (P 0.006) during a median follow-up of 10 months (range: 6–24 months). Conclusions POEM is a safe, effective, and feasible treatment option for achalasia in an Egyptian cohort. POEM is becoming an attractive option and is gaining patient satisfaction.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136032626","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":"Effects of two different angiotensin receptor blockers on blood glucose level and HbA1c in type-2 diabetes mellitus patients with hypertension","authors":"Shafat Iqbal Bhati, S. F. Haque, S. S. Siddiqi, Rizwan Ahmad","doi":"10.1186/s43162-023-00256-7","DOIUrl":"https://doi.org/10.1186/s43162-023-00256-7","url":null,"abstract":"Abstract Diabetes mellitus is a common metabolic disorder characterized by chronic hyperglycemia and disturbance of carbohydrate, fats, and protein metabolism. Type 2 diabetes mellitus results from reduced insulin secretion, decreased glucose utilization, and increased glucose production, which results in hyperglycemia. Hypertension further increases the risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease (PAD). Angiotensin receptor blockers (ARBs) are very effective antihypertensive drugs. This study was done to find the effects of two different angiotensin receptor blockers on various biochemical markers in type-2 diabetes mellitus patients. Methods This was a prospective interventional study, comparing two ARBs Azilsartan and telmisartan, involving 76 patients with type 2 diabetes mellitus and hypertension. Results Both drugs controlled blood pressure equally. The study showed that improvement in fasting plasma glucose was more with Azilsartan as compared to Telmisartan but their mean difference is not statistically significant ( p > 0.05). The improvement in post-prandial plasma glucose and HbA1C was more with Telmisartan as compared to Azilsartan but only mean HbA1C was statistically significant ( p < 0.05). Conclusions Telmisartan has a better impact on HbA1c reduction than Azilsartan, as a part of the pleotropic effect of ARBs.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136032896","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":"Dehydroepiandrosterone sulfate to cortisol ratio as a prognostic factor in cirrhotic patients with spontaneous bacterial peritonitis","authors":"Mohamed Ramadan Asker, Loai Mohamed Elahwal, Sahar Mohy-Eldin Hazzaa, Shireen Ali Elhoseeny, Mohamed Elsayed Sarhan","doi":"10.1186/s43162-023-00258-5","DOIUrl":"https://doi.org/10.1186/s43162-023-00258-5","url":null,"abstract":"Abstract Background Chronic liver disease and decompensated cirrhosis are associated with serious complications; spontaneous bacterial peritonitis is considered one of them that may lead to sepsis and adrenal insufficiency. This trial aimed to study the role of dehydroepiandrosterone sulfate (DHEAS) and DHEAS/cortisol ratio for assessing cirrhotic patients’ adrenal function and as a possible prognostic factor in cirrhotic cases with spontaneous bacterial peritonitis (SBP). Patients and methods It was a prospective cohort trial carried out on 100 patients in the Internal Medicine Department, Tanta University Hospital, from June 2021 to July 2022 divided into 2 studied patient groups: group I, 50 cases with liver cirrhosis and sterile ascites; and group II, 50 cases with liver cirrhosis and SBP. Adrenal function was evaluated using serum cortisol levels (9 A.M, 9 P.M, and post synacthen stimulation test), DHEAS level, and DHEAS/cortisol ratio. Results The cirrhotic patients with SBP have significantly decreased DHEAS, decreased DHEAS/cortisol ratio, and high cortisol level post stimulation compared with patients with sterile ascites, cirrhotic cases with decreased DHEAS/cortisol ratio (< 0.65) had elevated C-reactive protein (CRP) levels, a higher model for end-stage liver disease (MELD) score and Child–Pugh score had higher hospital mortality. Both DHEAS and the DHEAS/cortisol ratio were significant predictors of hospital mortality (area under the receiver operating characteristic curve 0.267 and 0.298, respectively). The cirrhotic patients with SBP had decreased DHEAS and DHEAS/cortisol ratio but higher hospital mortality, compared to the cirrhotic patients with sterile ascites. Conclusions It was found that a significant increase in cortisol level was after synacthen stimulation, decreased DHEAS, and low DHEAS to cortisol ratio in the cirrhotic patients with spontaneous bacterial peritonitis and was associated with high mortality compared to cirrhotic patients without spontaneous bacterial peritonitis.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115555","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":"Spectrum and prevalence of renal dysfunction among heart failure patients attending tertiary care hospital: first report from Somalia","authors":"Mohamed Osman Omar Jeele, Ahmed Abdirahman Hussein, Mohamed Abdullahi Mohamud, Abdulkamil Abdullahi Adani, Mohamed Farah Yusuf Mohamud","doi":"10.1186/s43162-023-00253-w","DOIUrl":"https://doi.org/10.1186/s43162-023-00253-w","url":null,"abstract":"Abstract Introduction Heart failure is one of the major global health problems that we face today, worldwide. The main objective of our study is to evaluate the spectrum and prevalence of renal dysfunction among heart failure patients in Mogadishu, Somalia. The design of the study is a retrospective descriptive study aimed at heart failure patients who presented to the largest tertiary care center in southern somalia between January 2021 to september 2021. Demographic data, co-morbidities, types of heart failure, causes of heart failure and the presence or absence of renal dysfunction were analysed. Results Overall 180 heart failure patients were enrolled in the study. The mean age of the participants was 62.26 ± 14 years. Regarding the age group, patients aged between 61–80 years was the most abundant participants with ( n = 87, 48.3%). Regarding the type of heart failure in our study, HFpEF was the most common type in our respondents with frequency of ( n = 85, 47.2%). When analysed the cause of heart failure among patients; hypertension was the most common cause of heart failure ( n = 90, 50%). Also, hypertension was the most common co-morbidity among our patients ( n = 106, 59%), followed by coronary artery diseases ( n = 50, 28%). The prevalence of renal dysfunction in heart failure patients was ( n = 37, 20.6%). Our analysis showed that among the 37 renal dysfunction patients, 12.3% of them ( n = 22) were CKD (chronic kidney disease) while the remaining 8.3% ( n = 15) had AKI (acute kidney injury). We found a significant correlation between gender and renal dysfunction in heart failure patients with (95% CI: 0.098–0.574, OR: 0.237, p value: < 0.001). Males were 2 and half times more likely to develop renal failure than females. Conclusions we found that the prevalence of renal dysfunction in heart failure patients is 20.6%. It was more prevalent in males and elderly population.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134975993","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}