Wounds : a compendium of clinical research and practice最新文献

{"title":"Is nanofat the long-awaited treatment for hypertensive ischemic leg ulcers?","authors":"Vivien Moris, Mélodie Terrasa, Eleonor Goubeau, Leslie Ann See, David Guillier, Narcisse Zwetyenga, Geraldine Jeudy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Martorell hypertensive ischemic leg ulcer (HYTILU) is a chronic, hard-to-heal wound linked to hypertension. This study explores nanofat grafting as a regenerative alternative to traditional skin grafting for improved healing and patient outcomes.</p><p><strong>Objective: </strong>To explore the efficacy of nanofat grafting in the management of HYTILU and compare it with skin grafting.</p><p><strong>Materials and methods: </strong>This was a retrospective single-center pilot study involving 23 patients with HYTILU treated with adipose-derived stromal cells (adipose-derived stromal cells/nanofat). The primary outcomes were ulcer healing rate, pain reduction, and improvements in quality of life, as measured by SCAR-Q (a scar quality of life questionnaire) and the Vancouver Scar Scale, over a period of 6 months posttreatment.</p><p><strong>Results: </strong>This study revealed a significant decrease in ulcer size from an initial mean of 39.69 cm² to complete healing, with an average healing time of 4.65 months. The mean visual analog scale pain scores significantly decreased from an initial score of 5.87 to 0.39 at 3 months postinjection (P < .0001). Quality of life was significantly improved after treatment, as underscored by higher SCAR-Q scores and lower Vancouver scale scores, indicating better scar quality and minimal adverse effects.</p><p><strong>Conclusion: </strong>These study results underscore nanofat grafting as a superior alternative to traditional skin grafting for HYTILU, offering advantages in terms of healing time, pain management, and patient quality of life. Further research is needed to confirm these findings and assess the use of nanofat in the management of other chronic wounds.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 2","pages":"95-101"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of the effect of vaporous hyperoxia therapy as an adjunct to standard wound care in chronic wounds.","authors":"David G Armstrong, Dustin Kruse, Marissa J Carter, Charles M Zelen, Adam L Isaac","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Considering the rising incidence and cost associated with chronic wounds, further investigation of safe and effective treatments is needed.</p><p><strong>Objective: </strong>To conduct a retrospective analysis of patients with chronic wounds in order to evaluate the healing effect of vaporous hyperoxia therapy (VHT) used adjunctively with standard wound care.</p><p><strong>Materials and methods: </strong>The data of patients with chronic wounds (≥4 weeks' duration) who received commercial treatment with VHT between February 28, 2020, and August 30, 2022, were reviewed. After debridement (as appropriate), the limb was placed in the treatment chamber, and a 56-minute treatment of alternating cycles of a low-frequency, noncontact, nonthermal ultrasonic mist and concentrated oxygen therapy was administered twice weekly. Wounds were offloaded and dressed appropriately. The number of wounds healed at 16 weeks, percentage area reduction (PAR), and percentage volume reduction (PVR) were analyzed, and Kaplan-Meier time to heal analysis was performed.</p><p><strong>Results: </strong>Forty patients with 53 wounds were evaluated. The mean (standard deviation [SD]) comorbidity count per patient was 4.6 (2.5). At 16 weeks, 33 wounds healed (62%), and 40 wounds healed at 1 year, including 35 of 47 diabetic foot ulcers (74%). Five patients treated with VHT and fewer than 5 cellular and/or tissue-based products (CTPs) achieved healing. The mean healing time was 14.5 weeks (95% confidence interval, 9.9-18.1). The mean (SD) PAR and PVR over 16 weeks were 69% (156.7%) and 82% (70.3%), respectively.</p><p><strong>Conclusion: </strong>This real-world analysis demonstrates that VHT healed most chronic wounds within 14 weeks. In addition, VHT appears to accelerate healing in wounds that are also treated with CTPs.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 2","pages":"56-62"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Wound Reporting in Animal and Human Preclinical Studies (WRAHPS) guidelines.","authors":"Nkemcho Ojeh, Nicole M Vecin, Irena Pastar, Susan W Volk, Traci Wilgus, Sarah Griffiths, Allison N Ramey-Ward, Vickie R Driver, Luisa A DiPietro, Lisa J Gould, Marjana Tomic-Canic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Preclinical studies for wound healing disorders are an essential step in translating discoveries into therapies. Also, they are an integral component of initial safety screening and gaining mechanistic insights using an in vivo approach. Given the complexity of the wound healing process, existing guidelines for animal testing do not capture key information due to the inevitable variability in experimental design. Variations in study interpretation are increased by complexities associated with wound aetiology, wounding procedure, multiple treatment conditions, wound assessment, and analysis, as well as lack of acknowledgement of limitation of the model used. Yet, no standards exist to guide reporting crucial experimental information required to interpret results in translational studies of wound healing. Consistency in reporting allows transparency, comparative, and meta-analysis studies and avoids repetition and redundancy. Therefore, there is a critical and unmet need to standardise reporting for preclinical wound studies. To aid in reporting experimental conditions, The Wound Reporting in Animal and Human Preclinical Studies (WRAHPS) Guidelines have now been created by the authors working with the Wound Care Collaborative Community (WCCC) GAPS group to provide a checklist and reporting template for the most frequently used pre-clinical models in support of development for human clinical trials for wound healing disorders. It is anticipated that the WRAHPS Guidelines will standardise comprehensive methods for reporting in scientific manuscripts and the wound healing field overall. This article is not intended to address regulatory requirements but is intended to provide general guidelines on important scientific considerations for such studies.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 1","pages":"13-45"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsurgical management of pressure injury with a new silicone rubber negative pressure wound therapy with instillation device: a case report.","authors":"Yaping Zhu, Xiuzhen Zhang, Yufan Zhang, Xiaojuan Zhong, Xiangyue Lu, Yanrong Zhai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Surgical debridement and flap-based reconstruction are essential procedures for managing stage 3 and 4 pressure injuries (PIs). However, the recurrence of PIs after flap reconstruction is high; moreover, many patients cannot tolerate surgical management.</p><p><strong>Case report: </strong>An 81-year-old male presented with 3 stage 4 PIs (1 each on the sacral region and heels) that were successfully treated without surgical management. The patient was bedridden with progressive dementia, pneumonia, and malnutrition. He could not tolerate thorough debridement. A new silicone rubber negative pressure drainage tube with instillation device was applied to the wounds on the right heel, left heel, and sacral region for 20, 25, and 80 days, respectively, until the wounds were filled with healthy granulation tissue. This device comprises a principal, a connector, an instillation, and a negative pressure drainage tube. The principal part of the device is made of medical-grade silicone rubber shaped into a columnar structure; there is also an instillation channel in the center of the principal tube, forming an instillation loop and ensuring the whole wound is thoroughly instilled. The wounds treated in this case healed without thorough debridement or flap-based reconstruction and had not recurred as of 1-year follow-up.</p><p><strong>Conclusion: </strong>Wound healing was achieved without thorough debridement or flap reconstruction, using a new silicone rubber anti-blocking negative pressure wound therapy with instillation device that was able to remove thick exudate and slough.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 1","pages":"8-12"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buttock necrosis following uterine artery embolization: a case report.","authors":"Cooper Wardell, Steven Whitworth, Jennifer Wolfe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Uterine artery embolization (UAE) is an increasingly common procedure for the management of uterine leiomyoma (fibroid). Up to 70% of White women and more than 80% of women of African ancestry will develop benign fibroid tumors of the uterus, many of whom will have symptoms including increased menstrual bleeding, urinary symptoms, pain, and infertility. When medical management does not adequately treat symptoms, UAE is a minimally invasive surgical treatment option. Nontarget embolization is a rare complication of this procedure and can result in soft tissue necrosis. Few case reports describe this phenomenon.</p><p><strong>Case report: </strong>A 46-year-old female presented to the wound clinic 5 months after UAE. Following this procedure, the patient developed burning pain in the thigh and buttock. After 5 weeks, a small eschar formed over the right buttock, which progressed to a large necrotic ulceration. The patient was treated successfully, with wound closure by secondary intention occurring 24 weeks after initial presentation. Treatment included sharp debridement, advanced dressings, oral antibiotics (for infection), and negative pressure wound therapy.</p><p><strong>Conclusion: </strong>This case adds to the body of literature describing a full-thickness wound forming due to nontarget embolization. The patient was treated successfully in clinic without the need for further surgery or inpatient treatment.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 1","pages":"1-4"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyoderma gangrenosum secondary to chimeric antigen receptor T-cell therapy for diffuse large B-cell lymphoma.","authors":"Layna Mager, Jacob McFeeters, Jose A Plaza, Brittany Dulmage, Benjamin H Kaffenberger","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressive ulcers. PG manifests clinically as painful ulcers with undetermined violaceous borders. A case of diffuse large B-cell lymphoma with cutaneous involvement treated with chimeric antigen receptor T-cell (CAR T-cell) therapy with subsequent development of PG is presented.</p><p><strong>Case report: </strong>Based on her clinical presentation, the patient was started on a prednisone taper with wound vacuum. Complete granulation and 90% reepithelialization were noted at 3-month follow-up. The wound was fully resolved within 4 months, without subsequent reactions.</p><p><strong>Conclusion: </strong>The relationship between CAR T-cell therapy and PG remains unknown. In this case, excellent response was achieved using standard treatment for PG wounds, which included prednisone taper and appropriate wound care. The discovery of novel cutaneous manifestations resulting from immunotherapy treatment remains essential for targeted therapy and further management of post-radiation site reactions. More research is needed to determine the significance of CAR T-cell therapy on post-treatment reactions, including PG.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 1","pages":"5-7"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of clinician support tools to improve wound healing outcomes and simplify treatment selection for effective exudate management.","authors":"Amanda Loney, Britney Butt, Sophie Berry","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Achievement of moisture balance can be a critical factor affecting time to closure of nonhealing wounds, and dry wounds can take much longer to heal than those with high exudate levels. Whether the goal of management is to donate moisture to the wound or control excessive fluid until the cause has been identified and addressed, choice of dressing and other wound management products can affect nursing resources, clinical outcomes, concordance, and quality of life for the patient.</p><p><strong>Case reports: </strong>The cases discussed illustrate differences in management approaches for dry and wet wounds and show how clinician support tools (eg, tissue type, infection/inflammation, moisture imbalance, epithelial edge advancement [TIME] clinical decision support tool) can facilitate treatment decisions. Dressing selection in particular can be challenging given the range of wound types, increasing demands on wound care practitioner time and the requirements necessitated by individualized patient treatment goals. Development of wound management decision tools can help to simplify product selection, and use of patient discussion guides can help to identify patients and caregivers who have the confidence to help implement their wound management plan.</p><p><strong>Conclusion: </strong>Adopting wound management decision tools has the potential to ease the increasing burden of wound care to health care systems, patients, and society.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 12","pages":"437-443"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bromelain-based enzymatic debridement: mechanism of action in the wound environment. A literature review.","authors":"Robert Snyder, Timothy Hoffmeister, Joey Karim Ead, Anwar Nass, Ety Klinger, Keren David-Zarbiv, Yael Kats-Levy, Aya Ben Yaakov","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic hard-to-heal wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, present significant safety concerns, patient burdens, and challenges to health care systems globally.</p><p><strong>Objective: </strong>To review the mechanism of action and clinical function of bromelain-based enzymatic debridement (BBD) in the context of wound care, focusing on the mechanism of action of BBD and its formulation for chronic wounds in particular.</p><p><strong>Methods: </strong>A literature review was conducted to assess both bromelain's mechanism of action as well as clinical and preclinical studies on the use of BBD, searching the PubMed and Google Scholar databases for articles published between November 1992 and July 2024.</p><p><strong>Results: </strong>The literature review shows that BBD, a mixture of proteolytic enzymes derived from the pineapple plant, demonstrates multifaceted actions beneficial to wound healing. It selectively targets devitalized tissue, inhibits bacterial biofilm formation, promotes granulation tissue formation, and maintains moisture balance, thus facilitating a conducive wound microenvironment. Clinical studies and in vivo experiments support the efficacy of BBD in expediting wound debridement, in the formation of granulation tissue, and in reducing bioburden.</p><p><strong>Conclusion: </strong>The mechanistic insights presented in this review underscore the potential of BBD as a novel standard in chronic wound care that warrants further exploration and clinical validation across diverse wound classifications.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 12","pages":"429-436"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of introduction of elastic compression bandages on quality of life in patients with lower extremity vascular skin ulcers: a prospective study correlating WOUND-Q patient-reported outcome measures and evidence-based medicine.","authors":"Marco Gratteri, Giovanni Francesco Marangi, Carlo Mirra, Annalisa Cogliandro, Barbara Cagli, Francesco Segreto, Pier Camillo Parodi, Anna Scarabosio, Luca Savani, Paolo Persichetti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based medicine and patient-reported outcome measures (PROMs) are helpful tools in the wound care field, but few studies correlating quality of life (QoL) changes with objective changes exist.</p><p><strong>Objective: </strong>To investigate the QoL changes following the shift from primary dressings alone to elastic compression bandages in patients with a new diagnosis of vascular skin ulcer, and to evaluate a possible correlation between objective and subjective changes.</p><p><strong>Materials and methods: </strong>This study included 122 patients with a new diagnosis of vascular skin ulcer, who had previously used only primary dressings alone. The WOUND-Q was administered at time 0, and after 1 month, 6 months, and 12 months of appropriate compression bandage use. Standardized photographs were taken at the first visit. Group 1 consisted of 51 patients (vascular ulcers of mixed origin), group 2 had 31 patients (arterial origin), and group 3 had 40 patients (venous origin). Software was used for statistical analysis.</p><p><strong>Results: </strong>The ulcer areas decreased by a mean (standard deviation [SD]) of 4.47 (1.76) cm2, 4.06 (0.73) cm2, and 5.04 (0.34) cm2 for groups 1, 2, and 3, respectively, to a mean (SD) area of 3.19 (2.94) cm2, 2.23 (1.78) cm2, and 4.79 (2.56) cm2, respectively, at 12 months. Almost all WOUND-Q values tended to improve over time for the drainage, smell, and life impact scales. The Spearman correlation coefficient r value was 0.3430 for group 1, 0.5893 for group 2, and 0.3959 for group 3 for correlation between the delta of areas and the delta of the life impact.</p><p><strong>Conclusion: </strong>Introducing compression bandages improved QoL of patients with vascular skin ulcers. Drainage and smell tended to improve over a 1-year period following the switch. A correlation was found between improvements in ulcer area reduction and improvement in life impact scale data.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 12","pages":"419-428"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaboration encourages innovation: setting new standards in wound care with the Wound Care Collaborative Community expert panel consensus Recommendations.","authors":"Vickie R Driver, Howard Walthall, Alisha Oropallo, Marissa J Carter, Marjana Tomic-Canic, Joseph Rolley, Maribel Henao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The Wound Care Collaborative Community (WCCC) assesses shortcomings and unmet needs in wound care by partnering with key stakeholders, such as the National Institutes of Health, the US Food and Drug Administration (FDA), industry leaders, and expert health care providers and researchers, to advance the study of wound healing. Through this work, the WCCC has identified a few key barriers to innovation in wound care. The WCCC aims to accelerate the development of science-based, patient-centered solutions and address public policy challenges related to ensuring patients receive early access to innovative treatment options.</p><p><strong>Objective: </strong>To develop consensus recommendations that would address current deficiencies in wound care and promote improved innovation and patient access with an expert panel discussion based on both the work conducted within the WCCC and the existing evidence. These recommendations include the voices of the at-large, US-based wound care community.</p><p><strong>Methods: </strong>In May 2024, a multi-panel summit with 65 leading voices in clinical practice, academia, industry, and the FDA convened in person in Orlando, Florida. Thirty-two participants with backgrounds in clinical practice, surgery, industry, academia, and research took part in panel discussions. Following the panel meeting, the group corresponded via email and a formal survey process to create consensus recommendations, with the ultimate goal of identifying and overcoming barriers to innovation in wound care.</p><p><strong>Results: </strong>A total of 32 experts convened during the 1-day summit, each representing key stakeholders. Five panel discussions took place to discuss the obstacles to innovation, including alternative primary and co-primary endpoints, generating and reporting evidence, real-world evidence in policy decision-making, and the appropriate standard of care in wound management. From these discussions, 12 consensus statements were generated. The statements, their proportion of agreement or disagreement, and summary comments are presented in the order they appeared at the presentation. Overall, greater than or equal to 85% agreement was received on all statements.</p><p><strong>Conclusion: </strong>The consensus recommendations promote and encourage a standardized path forward to established, consistent metrics that facilitate innovation and quality assessment, improving patient access to advancements in healing.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"36 12","pages":"410-418"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}