The Egyptian Journal of Surgery最新文献

{"title":"Assessment of rivaroxaban as venous thromboembolism prophylaxis after gastric bypass surgery","authors":"Mohamed H. Elemawy, M. Abo-Ryia, T. A. Ismail, Reda F. Ali","doi":"10.21608/ejsur.2024.275171.1016","DOIUrl":"https://doi.org/10.21608/ejsur.2024.275171.1016","url":null,"abstract":"Background: Bariatric surgery is increasingly utilized to manage and prevent health issues related to obesity and the associated high incidence of venous thromboembolism (VTE). This work aimed to evaluate the effectiveness of a prophylactic dose of rivaroxaban against the development of VTE after bariatric surgery. Patients and Methods: This prospective cohort study was carried out on 40 morbid obese patients aged 18–60 years old, both sexes, with BMI) greater than or equal to 40 or greater than 35 kg/m 2 with obesity-related co-morbidities who underwent gastric bypass surgery. Patients received rivaroxaban 10 mg once a day orally 24 h postoperation for 1 month. Results: After 30 days, thrombosis did not occur in any patient. Intra luminal bleeding occurred in 3(7.5%) of the patients who were presented with melena, tachycardia, and hypotension and readmitted and all managed conservatively. The mean red blood cells transfused was 2.7 units, plasma transfused was 3.3 units, and the mean hospital stay was 2.3 days. Conclusion: Prophylactic oral rivaroxaban 10 mg once daily 24 h after gastric bypass surgery for 1 month is effective against VTE development.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694451","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":"Laparoscopic transabdominal preperitoneal repair of bilateral inguinal hernia: Using single mesh versus one mesh for each defect","authors":"Mohamed F. Abdelhalim, Emad E. M. A. El-Hafez, Hussein G. El-Gohary, Mohamed S. S. Eldeeb, Mohamed I. Abuelnasr","doi":"10.21608/ejsur.2024.357104","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357104","url":null,"abstract":"Background: The use of laparoscopic transabdominal preperitoneal (TAPP) repair is increasingly becoming more common as a treatment approach for bilateral inguinal hernias. Aim: This study aimed to analyze the results of bilateral inguinal hernia laparoscopic TAPP repair utilizing a single mesh against a single mesh for each defect. Patients and Methods: Six months of follow-up were conducted on the 60 patients who underwent laparoscopic TAPP repair for bilateral inguinal hernias and were admitted to the general surgery outpatient clinic at Benha University Hospital. There were two equal groups of patients: Patients in group A had bilateral inguinal hernias repaired by laparoscopic TAPP utilizing a single mesh. Patients in group B had laparoscopic TAPP repair of bilateral inguinal hernias, with a single mesh used for each abnormality. Results: Group B’s mesh insertion time was much longer ( P=0.019 ). Tacking staples utilized for mesh fixing were significantly less in group A ( P<0.001 ). Group A exhibited consistently decreased postoperative pain levels on the 1 st , 2 nd , 3 rd , 4 th , and 5 th days ( P<0.05 ). Group A patients consumed much fewer analgesics ( P<0.001 ), and they recovered to normal activity more quickly ( P<0.001 ). In group A, seroma development was much less common ( P=0.026 ). Conclusion: For bilateral inguinal hernias, utilizing a single big mesh in TAPP will make fixation simpler, need fewer tacking stables, and lessen discomfort. For bilateral inguinal hernia, laparoscopic TAPP with a single big mesh is a secure, efficient, and economical method.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701200","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":"Flexible ureteroscopy for large renal stones: Are we pushing the limits: A multi-center retrospective analysis","authors":"Hani Nour, H. Elmansy, Ayman Ali, Younis Alshamsi, Amr Hodhod, Afaf Mogharbel, Amin Fraij, Mohamed Gadelmoula, Ahlam Busaber, Ahmad Ismaila","doi":"10.21608/ejsur.2024.357136","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357136","url":null,"abstract":",","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705856","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":"Carotid artery stenting in surgically unfit patients with symptomatic carotid artery stenosis: Does it worth?","authors":"Sayed Younis, Ahmed G. Karmota, Mahmoud M. Nasser","doi":"10.21608/ejsur.2024.357133","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357133","url":null,"abstract":"Background: Carotid endarterectomy (CEA) is the gold standard for the treatment of patients with severe carotid stenosis (CS). However, carotid artery stenting (CAS) has emerged as an alternative to CEA in surgically unfit patients. The present study aimed to assess the role of CAS with an embolic protection device (EPD) in the management of symptomatic CS in patients who were deemed unfit surgically for CEA. Patients and Methods: This is a retrospective study that encompassed the analysis of patients who presented with symptomatic CS and were treated with CAS using EPD. The patients’ clinical data, procedure details, and procedure outcomes were obtained from the medical files and analyzed. Results: This study included 40 patients. During the immediate postprocedural period, one case (2.5%) showed stroke due to early stent occlusion. The late adverse events were stent occlusion that occurred in 3 patients (7.5%), TIA (n=2; 5%), myocardial infarction (n=3; 7.5%), and stroke (n=2; 5%). The primary patency rate during the follow-up period was 89.5%, and the secondary patency rate was 94.8%. The presence of diabetes and the stenosis length were significant predictors of stent occlusion. The delayed mortality rate was 7.5%. The predictors of patients’ mortality were the presence of diabetes mellitus, stent occlusion, and the occurrence of myocardial infarction (MI). Conclusion: The one-year primary and secondary patency rates were encouraging at 89.5% and 97.4%. Diabetes and stenosis length were identified as significant predictors of stent occlusion. Mortality was predicted by diabetes, stent occlusion, and MI.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701271","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":"Vitamin D deficiency and insufficiency in Egyptian bariatric patients","authors":"Mohamed A.M. Amin El Masry, Ahmed Haitham","doi":"10.21608/ejsur.2024.357135","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357135","url":null,"abstract":". ABSTRACT Background: Obesity is currently a pandemic that continues to increase all over the world. Nutritional disorders are among the obesity-related adverse events, with vitamin D insufficiency or deficiency being the most frequently encountered one. The aim of the current study was to assess the prevalence of reduced vitamin D levels in Egyptian patients with obesity who were candidates for bariatric surgery and to assess the relation between these levels and the patients’ characteristics. Patients and Methods: This is a retrospective study that included patients with obesity who were recruited for bariatric surgery. The patient’s medical files were screened for demographic and clinical data, including data regarding vitamin D status. Results: This study included 426 patients who were eligible for the study. The patients’ vitamin D levels ranged from 4 to 50 ng/ml, with a mean of 30.2±13.7 ng/ml. A statistically significant lower mean vitamin D levels were shown in females ( P=0.006 ), patients with extreme obesity ( P=0.021 ), diabetes mellitus ( P=0.014 ), and polycystic ovary syndrome ( P=0.016 ). Patients with depression also showed lower mean levels of vitamin D, with marginal statistical significance ( P=0.056 ). Conclusion: This study confirms the high prevalence of abnormally low vitamin D levels in patients with obesity who were candidates for bariatric surgery. The study highlighted differences based on sex and revealed connections between low vitamin D levels and conditions like type 2 diabetes mellitus, polycystic ovary syndrome, depression, and eligibility for bypass surgeries.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703694","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":"Role of columellar strut in long-term maintenance of tip support in primary Rhinoplasty","authors":"Amr T. Ahmed, Ahmed Elbadawy, Hany S. Setta, Raghda E. Talal","doi":"10.21608/ejsur.2024.357145","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357145","url":null,"abstract":"Background: The nasal tip can be enhanced or improved using several different procedures. To get the intended outcome, these procedures frequently make use of undetectable grafts and stitching methods. The literature provides a thorough description of the earlier techniques. Among these later methods, the columellar strut continues to be a widely used and successful type of invisible graft in rhinoplasty. The goal of this research is to clarify whether or not the columellar strut graft is a necessary step in maintaining tip support during a primary rhinoplasty. Aim: Debatable has been the impact of a columellar strut graft on the ultimate location of the nasal tip. The objective of this research was to conduct a prospective analysis of thirty consecutive primary rhinoplasty instances, both with and without the use of columellar strut grafts. The study specifically aimed to compare the changes in nasal tip position that occurred before and after surgery. Patients and Methods: The Plastic, Burn, and Maxillofacial Surgery Department at Ain Shams University Hospital carried out this 2-year, two-arm, randomized control clinical study between 2020 and 2022. There were two groups: the first had a rhinoplasty with a columellar strut, while the second group had surgery without a strut graft. Results: The examination of the changes in nasal tip rotation and projection was the primary focus of postoperative assessment. This was achieved by measuring and comparing the nasolabial angle and Goode ratio (preoperative and 6 months postoperative). With the columellar strut group, we saw a considerable improvement in tip rotation and projection postoperatively, which was in line with the patient’s satisfaction with the ultimate cosmetic results. Conclusion: This study shows that, when compared with preoperative measurements, postoperative nasal projection and the nasolabial angle (NLA) are raised and stabilized. This implies that the columellar strut graft is a useful tool for supporting the nasal tip and improving the success of rhinoplasty.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709591","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":"Interrupted versus continuous sutures in the posterior wall of bilioenteric anastomosis: A retrospective study","authors":"Hamdy M.M. Ahmed, Amr A.R.A. Naser, Ahmed S. Mohamed, Hatem S. Saber","doi":"10.21608/ejsur.2024.357121","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357121","url":null,"abstract":"Background: Hepaticojejunostomy (HJ) anastomosis is a vital surgical procedure in gastrointestinal surgery that involves the creation of a connection between the bile duct and the jejunum. This study aimed to evaluate the effectiveness of interrupted suturing, compared with continuous suturing of the posterior wall of the anastomosis, regarding primary and secondary outcomes of HJ anastomosis. Patients and Methods: Sixty patients were allocated to two groups, each group comprising 30 patients where in group A (Interrupted Suture, n=30), 4/0 polydioxanone sutures were used. In group B (continuous Suture, n=30), 4/0 proline sutures were used. In addition, in all cases interrupted sutures 4/0 polydioxanone were used in the anterior wall of anastomosis to decrease postoperative stricture incidence, then all patients were followed up until the end of data analysis (6 months after HJ anastomosis) using a standardized data collection sheet. Results: The primary postoperative outcomes: Regarding the incidence of leakage, the continuous group (13.3%) had a lower rate of postoperative biliary leak than the interrupted group (16.7%). Regarding the incidence of stricture of anastomosis, two (6.7%) cases had strictures in the interrupted group, whereas there were four (13.8%) strictures in the continuous group. This suggests that the interrupted group had a lower risk of postoperative strictures than the continuous group. Regarding secondary outcomes, the mean number of sutures of the posterior wall was six in the interrupted group, while it was two in the continuous group which means the continuous group was better than the interrupted group as regards cost and time consumed during anastomosis. Conclusion: Postoperative outcomes in HJ vary with interrupted and continuous suture techniques. The continuous sutures revealed lower postoperative biliary leakage, and had better time and cost-effectiveness, while the interrupted sutures had lower incidence of stricture formation.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692642","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":"Comparative study between duct-to-duct anastomosis versus R-Y hepaticojejunostomy in pediatric living donor liver transplantation: A retrospective cohort study","authors":"Ahmed Khalil, Amr Abdel Aal, Mostafa Abdo, Mahmoud Talaat","doi":"10.21608/ejsur.2024.357140","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357140","url":null,"abstract":"Background: Biliary complications after pediatric living donor liver transplantation (LDLT) remain a significant cause of morbidity and graft loss. Because of the predominance of biliary atresia and the small size of donor ducts, Roux-en-Y hepaticojejunostomy has been the standard procedure for biliary reconstruction in pediatric LDLT. However, duct-to-duct (D2D) reconstruction is suggested to have less risk of biliary contamination and shorter operative time. In our study, we compare D2D and Roux-en-Y hepaticojejunostomy as regards biliary outcome. Patients and Methods: A retrospective cohort study was conducted on pediatric LDLTs between July 2015 and December 2022. In all, 107 cases were divided into two groups according to the type of biliary anastomosis: group A included 53 recipients who had stentless D2D biliary anastomosis compared with group B including 54 recipients, who underwent Roux-en-Y hepaticojejunostomy. Results: The incidence of biliary-related complications was higher in the D2D group reaching 44.4%, double that recorded in the H-J group (22.8%, P=0.011 ). The incidence of biliary leakage alone was significantly higher (61.5%, n=8/13) in the H-J group versus 8.7% (n=2/23) in the D2D group ( P=0.027 ). Biliary anastomotic stricture alone represented 39.1% (n=9/23) of the biliary complications in D2D groups and only 23.1% (n=3/13) in the H-J group ( P=0.014 ), and it was accompanied by leakage in 26.1% (n=6/23) in the D2D group and 7.7% (n=1/13) in H-J groups and had been proceeded by leakage in a similar number of cases ( P=0.093 ). Most of the biliary complications (84.6%, n=11) ( P=0.050 ) in the H-J group were diagnosed early (<3 months), while in the D2D group, the incidence was nearly equally distributed between early and late presentations (56.5 vs. 43.5%, respectively) ( P=0.030 ). Biliary-related mortality was nearly similar in both groups (8.7 vs. 7.7%) ( P=0.558 ). Conclusion: The D2D anastomosis seems to be a safe and feasible method of biliary reconstruction in pediatric LDLT and harbors multiple advantages over H-J, especially the ability to use Endoscopic retrograde cholangio pancreatography (ERCP) in the management of Biliary Complications (BCs). Our study showed a relatively high rate of postoperative BCs, which was the most among patients who had undergone D2D biliary reconstruction. As these complications can be managed safely and effectively, D2D biliary reconstruction can be the method of choice for pediatric patients with suitable bile ducts for reconstruction and surgeons should master both techniques.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693995","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":"Effect of the pandemic on the presentation and management of patients with acute appendicitis at King Abdulaziz University Hospital in Saudi Arabia","authors":"Moaz Abulfaraj, Jumana Akbar, Ashraf A Maghrabi, Sara Mozahim, Reema Alzahrani, Lamiaa Alqahtani, Shahad Alahmadi, Haneen Rahbini, Waad Alalwani, Wisam Jamal, Omar Iskanderani","doi":"10.21608/ejsur.2024.277284.1029","DOIUrl":"https://doi.org/10.21608/ejsur.2024.277284.1029","url":null,"abstract":"Background: The emergence of the coronavirus disease 2019 (COVID-19) pandemic led to significant changes in global healthcare systems, with a particular emphasis on prioritizing COVID-19 patients, even in emergency surgical scenarios. This study aimed to explore the impact of COVID-19 on the presentation and management of acute appendicitis cases in Saudi Arabia. Patients and Methods: This retrospective study was carried out at King Abdulaziz University Hospital (KAUH) from March 2019 to March 2021, encompassing all patients with appendicitis during this time frame. The data collected included demographic characteristics, clinical symptoms, laboratory findings, time taken before seeking medical help, diagnostic approaches, treatment strategies, postoperative complications, and hospital stay duration. Results: A total of 238 patients with acute appendicitis were hospitalized during the study, with a predominance of male patients (59.7%). Of these, 72.3% (174) were admitted during the pandemic period. Perforated appendicitis was diagnosed in 25 (10.5%) individuals. There were no significant differences observed between pre-and postpandemic periods concerning the time from presentation to surgery ( P=0.741 ), postoperative complications ( P=0.563 ), ICU admissions ( P=0.637 ), readmissions ( P=0.234 ), and overall length of hospital stay ( P=0.228 ). However, notable associations were noted in blood loss ( P<0.001 ) and postoperative length of stay ( P=0.021 ) between the two periods. Conclusion: Throughout the COVID-19 pandemic, there were no discernible differences in the duration from presentation to surgery, complications, ICU admissions, readmissions, and total length of hospital stay compared with the pre-pandemic period.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699019","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":"Comparative study between effect of topical sucralfate cream and glyceryl trinitrate cream on post haemorrhoidectomy pain and wound healing","authors":"Islam H. Elmetwally, Tito E.A. Elhamid, Mohamed H. Mohamed, H. M. Elgendy","doi":"10.21608/ejsur.2024.357118","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357118","url":null,"abstract":"Background: Haemorrhoidectomy is the treatment of choice for third-and fourth-degree haemorrhoids. Haemorrhoidectomy is avoided by many patients because it is linked to severe pain after surgery. Topical sucralfate cream hastens the healing of wounds and reduces discomfort following hemorrhoidal surgery. After a haemorrhoidectomy, topical use of glyceryl trinitrate (GTN) can reduce spasm and postoperative pain; also, increase Ano dermal blood flow, and accelerate the healing of the wound. Patients and Methods: This prospective randomized control single-blinded study was conducted over a one-year duration. In General Surgery Department, Mansoura Faculty of Medicine with the inclusion of 60 patients with third-and fourth-degree piles who underwent conventional Milligan–Morgan haemorridectomy. Three groups of 60 patients were randomly assigned to participate in the current study: group A (the control group): included 20 patients who received a placebo (petrolatum cream). group B (the sucralfate group), group C (GTN cream group). The visual analogue scale (VAS 0–10) was used to assess postoperative pain on days 1, 7, and 14 following surgery and wound healing was assessed after 28 days. Results: There was no significant difference between the three study groups as regards demographic data, symptoms, and the VAS score on the first postoperative day. On the seventh and 14 th day postoperative, respectively, the VAS score was statistically significantly lower in the GTN group followed by the Sucralfate group and finally the control group ( P<0.001 ). The duration for complete wound healing and the duration to return to daily activities were statistically significantly shorter in the sucralfate group followed by the GTN group.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709341","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}