The Journal of the Association of Physicians of India最新文献

{"title":"Indian Expert Consensus on Allergic Rhinitis in Women: A Modified Delphi Survey.","authors":"Mohan Kameswaran, Madan Kapre, Nitika Gupta, Gayatri S Pandit, Subir Jain, Vikram Khanna, Manzoor Ahmad Latoo, Arunabha Sengupta, Voorakaranam Venkata Kasyapi, Anthony Irudhayarajan, Gauri Kapre, Rohan Gupta, Parmod Kalsotra, Lakshmanan Somu, Archana Karadkhele","doi":"10.59556/japi.74.1373","DOIUrl":"https://doi.org/10.59556/japi.74.1373","url":null,"abstract":"<p><strong>Introduction: </strong>At present, there are many significant gaps in understanding the clinical needs of Indian women with allergic rhinitis. To address a critical gap in clinical practice, the consensus group created an innovative questionnaire tailored to assist Indian clinicians in the diagnosis and management of allergic rhinitis among female patients.</p><p><strong>Methods: </strong>The modified Delphi survey utilized a systematic approach to group communication in addressing research questions and resolving conflicting viewpoints through detailed evaluation of various arguments. In total, 80 statements were developed focusing on disease burden, risk factors, clinical presentation, comorbidities, symptoms, and treatment of allergic rhinitis.</p><p><strong>Results: </strong>Out of 61 statements reviewed by the expert panel, around 38 statements received over 80% agreement, leading to a consensus.</p><p><strong>Conclusion: </strong>Allergic conditions are more common among Indian women, impacting them disproportionately. A high level of consensus indicates that many Indian women spend most of their time indoors, which can result in heightened exposure to indoor allergens and pollutants, consequently increasing their vulnerability to allergies. The experts also offered real-world clinical recommendations while assessing and managing modifiable and nonmodifiable allergens in Indian women with allergic rhinitis.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"e13-e20"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723718","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":"Thyroid Hormone Levels, even within the Euthyroid Range, are Associated with Lipid Levels.","authors":"R S Sudharshini, A Velayutharaj, Monisha Mohan, Praveen Kumar","doi":"10.59556/japi.74.1448","DOIUrl":"https://doi.org/10.59556/japi.74.1448","url":null,"abstract":"<p><strong>Background: </strong>Thyroid dysfunction of any magnitude is associated with dyslipidemia. But the relationship of thyroid hormones with lipid parameters among euthyroid population is still unclear.</p><p><strong>Materials and methods: </strong>This is a cross-sectional study to assess relationship between measured [free T3 (fT3), free T4 (fT4), and TSH] and derived (free T3/free T4 ratio, and TSH index) parameters of thyroid profile with different components of lipid profile among euthyroid population.</p><p><strong>Results: </strong>We included 100 patients (60 men and 40 women) in this study. The mean free T3, free T4, and TSH levels of our study population were 2.4 ± 0.5 pg/mL, 1.2 ± 0.2 ng/dL, and 3.0 ± 1.6 µIU/mL, respectively. Overall, fT3 had a significant positive correlation with HDL cholesterol (<i>r</i> = 0.4, <i>p</i> = 0.01) and a negative correlation with total cholesterol levels (<i>r</i> = -0.3, <i>p</i> = 0.04). While fT4 (<i>r</i> = 0.3, <i>p</i> = 0.04) and fT3/fT4 ratio (<i>r</i> = 0.5, <i>p</i> = 0.001) showed positive correlation only with HDL levels. In subgroup analysis, positive association of fT3 (<i>r</i> = 0.6, <i>p</i> = 0.008), fT4 (<i>r</i> = 0.4, <i>p</i> = 0.04), and fT3/fT4 ratio (<i>r</i> = 0.8, <i>p</i> = 0.001) with HDL cholesterol was significant only in men. And only in the subgroup with TSH ≥ 3 µIU/mL (<i>N</i> = 48), we found a significant negative correlation of fT3 with total cholesterol (<i>r</i> = -0.5, <i>p</i> = 0.01) and LDL levels (<i>r</i> = -0.7, <i>p</i> = 0.001) and a positive correlation with HDL levels (<i>r</i> = 0.5, <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>Among euthyroid subjects, fT3 seems to have a significant and consistent favorable association with lipid levels, especially with HDL cholesterol. This positive association of fT3 with HDL is more marked in men and in subjects with TSH ≥ 3 µIU/mL.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723750","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":"\"Dead\" Patients Coming Alive: A Case for a Foolproof Death Pronouncement in India.","authors":"Sadananda B Naik, Sangram Biradar","doi":"10.59556/japi.74.1447","DOIUrl":"https://doi.org/10.59556/japi.74.1447","url":null,"abstract":"<p><p>It is not a rare occurrence where a patient who has been declared dead in the hospital comes alive either during transport back home or while performing the last rites. But in recent times we are witnessing a steady rise in such incidences.^1-4 Though it is a global phenomenon, in our country it has brought a lot of negativity and adverse publicity against medical professionals and hospitals. These incidences are casting serious doubt in the minds of the public about the ability and knowledge of medical professionals in declaring someone dead and have eroded the public trust in doctors. On many occasions it is being perceived as serious negligence or total irresponsibility on the part of a medical professional. A patient who has been declared dead but comes alive could put medical professionals under serious mental stress with long-lasting emotional trauma as well. Beyond the medical realm, such cases raise legal and ethical dilemmas. Families go through unnecessary mental trauma, funeral services are disrupted, and, in some cases, patients wake up in morgues or coffins-an unimaginable horror. In India we have neither any data on such occurrences nor a well-accepted protocol or guidelines for the determination and declaration of death. While cases of the \"dead\" coming back to life remain rare, they highlight the gaps in medical practices that need urgent attention, and there is a pressing need for a foolproof protocol for pronouncement of death that is acceptable legally and medically and with a pan-India application.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"12-13"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724053","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":"Acute Pancreatitis beyond Gallstones and Alcohol.","authors":"Ravi Shankar Bagepally, Vijay Rampally, Gr Srinivas Rao, Viswanath R Donapati, Rakesh K Adi, Anil K Mannava, Vamshidhar Reddy","doi":"10.59556/japi.74.1460","DOIUrl":"https://doi.org/10.59556/japi.74.1460","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a potentially grave abdominal condition where the pancreas gets inflamed and is associated with variable regional and systemic involvement. The inflammatory state is usually characterized by acute abdominal pain with concomitant increase in serum pancreatic enzymes. Investigative workup includes serum amylase, lipase, liver function tests, triglycerides, serum calcium, and parathyroid hormone (PTH) assay; imaging includes ultrasonography, computed tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP), and/or endoscopic ultrasound in some patients.</p><p><strong>Aim: </strong>To identify the etiology and frequency of nonalcoholic and nonbiliary causes of AP in a hospital scenario, and analyze the severity and outcome of the disease.</p><p><strong>Materials and methods: </strong>A prospective, observational, hospital-based study was conducted on 150 consecutive AP patients in the Department of Gastroenterology at Yashoda Hospitals, Secunderabad, India. A total of 150 consenting patients who were hospitalized consecutively with AP were included, and subjects with chronic pancreatitis were excluded.</p><p><strong>Results: </strong>Overall, 150 patients were included; 117 (72.9%) were men, and 37 (27.1%) women. Alcohol was the most common etiological factor noted in 54 (36%), followed by biliary tract disease 45 (30%), idiopathic 21 (14%), hypertriglyceridemia 7 (4.67%), endoscopic retrograde cholangiopancreatography (ERCP)-related 3 (2%), infection-related 5 (3%), hyperparathyroidism 3 (2%), and drug-induced 8 (5.33%). The most common presentation was abdominal pain (98.6%). Organ failure and mortality were low in the nonalcoholic/nonbiliary cause of pancreatitis.</p><p><strong>Conclusion: </strong>AP in our study reports a significant number of nonalcoholic/nonbiliary causes. The current study showed that the mortality rate in nonalcoholic/nonbiliary cases was low. Despite low mortality in this group, there is a need to identify these causes and treat on an urgent basis for limiting the hospital stay.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"32-35"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724036","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":"Modern Device-based Renal Denervation Approach for the Management of Uncontrolled Hypertension.","authors":"Arun Gopi, Sarita Rao, Nakul Sinha, Nihar Mehta, Milind Nadkar, Mangesh Tiwaskar","doi":"10.59556/japi.74.1468","DOIUrl":"https://doi.org/10.59556/japi.74.1468","url":null,"abstract":"<p><p>Uncontrolled hypertension can result from untreated high blood pressure (BP) or the inefficacy of established antihypertensive therapeutic regimens. Renal denervation (RDN) is a nonpharmacologic catheter-based intervention that achieves targeted renal sympathetic nerve ablation to modulate sympathetic activation. RDN is suitable for those with uncontrolled primary hypertension, resistant to therapy or intolerant to drugs, and who have a favorable renal artery anatomy. Long-term data demonstrate RDN's efficacy in significantly reducing elevated BP. RDN procedures have shown a good safety profile, and no significant difference in adverse events has been reported between RDN-treated and control groups in most clinical trials. Thus, RDN offers an effective and safe approach for sustained BP control.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"96-102"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723710","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":"Sodium-Glucose Cotransporter 2 Inhibitors in Kidney Diseases Other Than That Due to Diabetes: Benefits in Composite Renal Outcomes Driven by Immunoglobulin A Nephropathy.","authors":"Subhankar Roy, Madhurima Basu, Pradip Mukhopadhyay, Sujoy Ghosh","doi":"10.59556/japi.74.1337","DOIUrl":"https://doi.org/10.59556/japi.74.1337","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a well-established treatment for managing diabetic kidney disease (DKD). Clinical trials, including DAPA-CKD and EMPA-KIDNEY, indicate that these drugs are probably protective for the kidneys even in cases of chronic kidney disease (CKD) without diabetes, and secondary analysis of trials suggests that the overall outcome may be driven by the benefits of IgA nephropathy (IgAN). We aimed to evaluate whether benefits in composite renal outcomes in CKD, other than those due to diabetes, are observed beyond those with IgA nephropathy.</p><p><strong>Methods: </strong>Data were extracted from the clinical trials DAPA-CKD and EMPA-KIDNEY, including patients with and without diabetes and CKD. Kidney diseases were classified as hypertensive/renovascular nephropathy or glomerular diseases, further subdivided into IgAN, focal segmental glomerulosclerosis (FSGS), and other glomerulonephritis. The heterogeneous group labeled as other/unknown was excluded from all analyses. The composite renal outcome was analyzed from pooled data using the Mantel-Haenszel risk ratio with a random-effects model and analyzed for all groups and then reanalyzed excluding the IgAN subgroup.</p><p><strong>Results: </strong>The first pooled analysis, including all groups, demonstrated a 22% reduction in composite renal outcomes (RR 0.78, 95% CI 0.63-0.96, <i>p</i> = 0.02). However, when the IgAN group was excluded, the analysis revealed that the renoprotective benefits were no longer significant (RR 0.84, 95% CI 0.67-1.04, <i>p</i> = 0.11).</p><p><strong>Conclusion: </strong>The overall benefit of SGLT2i in CKD due to causes other than diabetes, in patients with or without diabetes, may be predominantly driven by the benefits of IgAN.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"e1-e5"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723741","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":"A Study on Electrocardiography Echocardiography and Cardiac Biomarkers in Aluminium Phosphide Poisoning and Their Prognostic Correlation.","authors":"Harshvardhan Tiwari, Deepti Sharma, Meenaxi Sharda, Dinesh Bishnoi, Harshit Garg","doi":"10.59556/japi.74.1415","DOIUrl":"https://doi.org/10.59556/japi.74.1415","url":null,"abstract":"<p><strong>Background: </strong>Aluminum phosphide (AlP) poisoning is a medical emergency with an alarmingly high mortality rate, primarily due to its rapid cardiotoxic effects.</p><p><strong>Objective: </strong>To identify and evaluate key prognostic indicators-clinical, electrocardiographic, echocardiographic, and biochemical-in patients with AlP poisoning.</p><p><strong>Materials and methods: </strong>A cross-sectional observational study was conducted on 100 patients with confirmed AlP ingestion. ECG changes, cardiac biomarkers (troponin-I, CPK-MB, LDH, and CPK-NAC), 2D echocardiography findings, and acid-base disturbances were analyzed in relation to survival outcomes.</p><p><strong>Results: </strong>ECG abnormalities and decreased ejection fraction were significantly associated with mortality. Elevated cardiac biomarkers and profound acidosis were strong independent predictors of poor prognosis.</p><p><strong>Conclusion: </strong>AlP poisoning causes critical cardiovascular compromise. Early identification of high-risk patients may guide aggressive intervention and resource allocation in intensive care settings.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"50-53"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723992","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":"Perioperative FLOT Chemotherapy in Resectable Gastric Adenocarcinoma: A Single-center Retrospective Observational Study.","authors":"Hemasireesha Natti, Vishesh Gumdal, Deepak Koppaka, Sanjana Reddy Potu, Rajeena Moulasa Jaffer, Rudra Sanjeev Rapolu, Venu Bhargava Mulpuri","doi":"10.59556/japi.74.1456","DOIUrl":"https://doi.org/10.59556/japi.74.1456","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer (GC) is a leading cause of cancer-related mortality worldwide. Perioperative chemotherapy improves tumor downstaging and survival rates. The FLOT regimen was proven superior in the FLOT4-AIO trial, establishing it as the standard care for resectable gastric adenocarcinoma. Despite these encouraging results from randomized controlled trials, real-world data on the feasibility and outcomes of FLOT in diverse patient populations, particularly in low- and middle-income settings, remain limited. This study aimed to assess the feasibility, safety, and clinical outcomes of perioperative FLOT chemotherapy in patients with resectable gastric adenocarcinoma at a tertiary care center.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of the medical records of patients diagnosed with resectable gastric adenocarcinoma who received perioperative FLOT chemotherapy between April 2019 and April 2025. The primary outcomes were the feasibility of perioperative FLOT chemotherapy and pathological complete response (pCR). The secondary outcomes were surgical outcomes, treatment adherence, and adverse events (AEs).</p><p><strong>Results: </strong>The results showed that 64.4% of patients completed at least four cycles of neoadjuvant FLOT, while only 24.4% underwent surgical resection. No pathological complete responses were observed. Grade 3-4 AEs occurred in 18.1% of patients, primarily cytopenias. A high rate of loss to follow-up (45.4%) was noted in the preoperative phase.</p><p><strong>Conclusion: </strong>While FLOT demonstrated an acceptable safety profile, the lower-than-expected surgical resection rate and high attrition highlight the challenges in managing locally advanced gastric cancer in real-world settings. This study emphasizes the need for strategies to improve treatment adherence and optimize patient selection to maximize the benefits of perioperative chemotherapy for gastric cancer.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723736","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":"A Study Comparing Tuberculosis-related Stigma in Healthcare Providers and Receivers.","authors":"Mustansir Abbas Ali, Sahithi Bhavana, Vyshnavi Induri, Ifrah Khan, Pradeep Valluri","doi":"10.59556/japi.74.1466","DOIUrl":"https://doi.org/10.59556/japi.74.1466","url":null,"abstract":"<p><strong>Background: </strong>Global efforts to reduce tuberculosis (TB) are severely hampered by stigma. With a high number of TB infections, India struggles with the widespread stigma surrounding the illness, which makes it difficult to diagnose and treat patients promptly. To shed light on an important but often ignored component of TB management, we calculate the prevalence of TB-related stigma and variability in the manifestation in different groups.</p><p><strong>Methods: </strong>After calculating the sample size, we stratified them into different groups: patients with TB, healthcare workers providing TB services, and family members living with the patients. A validated, predesigned questionnaire was employed to assess stigma across various domains. MS Excel was used to compile the data, and Epi Info 7 to analyze it.</p><p><strong>Results: </strong>Health professionals made up the largest percentage of those who experienced stigma (11.78%), followed by family members (8.91%), and patients (6.05%). The association of stigma with different groups of study participants was statistically significant, implying that stigma exists variably in the other groups. The majority of the patients (3.50%) perceived stigma at their home, whereas the majority of the family members faced stigma in the community (5.41%). Healthcare workers face stigma majorly in the community (7.96%).</p><p><strong>Conclusion: </strong>Stigma related to TB lays its foundation in varied perceptions by society. Societal norms determine acceptable and undesirable behaviors. Our study reveals major roadblocks on the way to TB eradication in the country and reveals a picture that can be extrapolated to most communities throughout. Aiming to reduce stigma will, in turn, improve treatment-related outcomes in TB and pave the way for smoother management and eradication.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"88-91"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723989","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":"Respiratory Examination for Postgraduate Residents: Unrevealing Expert's Questions and Answers.","authors":"Deependra Kumar Rai, Agam Vora, Pranav Ish, Saurabh Mittal","doi":"10.59556/japi.74.1313","DOIUrl":"https://doi.org/10.59556/japi.74.1313","url":null,"abstract":"<p><p>Physical examination is pivotal for getting a clue about the disease and making a provisional diagnosis. The respiratory examination is considered to be one of the toughest systemic examinations by undergraduate and postgraduate residents. No well-defined literature is available regarding the ideal method and interpretation of respiratory examination findings. There are many questions asked by experts that are hardly found in the literature. This review included a total of 30 important questions and the best possible answers, including expert questions from top institutes that are important for respiratory examination and would help all students (MBBS/MD/DNB/DM) to excel in their practical examination.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"103-109"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723747","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}