中华胃肠外科杂志最新文献

{"title":"[Probiotics empower postoperative intestinal function recovery after colorectal surgery: mechanisms and clinical progress].","authors":"P Lai, Z He","doi":"10.3760/cma.j.cn441530-20250310-00093","DOIUrl":"10.3760/cma.j.cn441530-20250310-00093","url":null,"abstract":"<p><p>Gastrointestinal dysfunction is a common and significant complication in colorectal surgical practice, which is associated with gut microbiota dysbiosis caused by various perioperative interventions. Currently, enhanced recovery after surgery (ERAS) protocols have been increasingly adopted in clinical practice, greatly accelerating the recovery of postoperative intestinal function. However, there are still no effective interventions in the ERAS protocols to target surgery-induced gut microbiota dysbiosis. Probiotics, as a key treatment method targeting the gut microbiota, can stimulate intestinal motility, inhibit the colonization of pathogenic bacteria, enhance intestinal barrier function, among other effects. Based on these effects of probiotics, they are expected to resolve the neglected gut microbiota dysbiosis, further accelerating the postoperative recovery of intestinal function after colorectal surgery. This article reviews the mechanisms and clinical progress in postoperative bowel functional recovery after colorectal surgery.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 6","pages":"619-626"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476979","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":"[Interpretation of the update points of colorectal and anal cancer in CACA guidelines (2025 edition)].","authors":"Z J Guan, W Y Zhang, G Y Wang","doi":"10.3760/cma.j.cn441530-20250306-00087","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250306-00087","url":null,"abstract":"<p><p>The key points of the update of the content related to colorectal cancer and anal cancer in the Chinese Anti-Cancer Association (CACA) Guidelines for Integrative Oncology 2025 Edition (hereinafter referred to as the CACA 2025 Guidelines) include 4 aspects. In terms of epidemiology, the latest data on the incidence and mortality of colorectal cancer in China have been updated, and the recommended screening age has been adjusted. In diagnosis, the application of enhanced MRI examination in diagnosis has been optimized, and the recommendation for peripheral blood microsatellite instability (MSI) detection has been added. In terms of treatment, in surgical treatment, the total mesorectal excision of the right colon, the safety of the Natural Orifice Specimen Extraction Surgery (NOSES) technique, the applicable range of robotic surgery, and the high-level evidence-based medical evidence of transanal total mesorectal excision (taTME) have been newly added, and the principles of surgical treatment have been added as well. In medical treatment, the role of circulating tumor DNA (ctDNA) in treatment decision-making has been supplemented. The application of dual immunotherapy in advanced patients has been recommended, and the application of third-line and subsequent-line treatments in advanced patients has been newly added. The guidelines improved the principle of preoperative neoadjuvant radiotherapy for rectal cancer, changed the indication of short-course radiotherapy, and added a variety of chemoradiotherapy combinations and recommendations for the timing of surgery. In addition, the follow-up programs for colorectal cancer and anal canal cancer are clarified, and nutritional therapy, traditional Chinese medicine rehabilitation therapy and nursing care for sequelae are emphasized, which provide more scientific and comprehensive guidance for the diagnosis and treatment of colorectal cancer and anal canal cancer.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 6","pages":"693-699"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476975","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":"[Expert consensus on permanent ostomy for colorectal cancer (version 2025)].","authors":"","doi":"10.3760/cma.j.cn441530-20250528-00206","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250528-00206","url":null,"abstract":"<p><p>Permanent stoma is an important method often selected in the surgical treatment of colorectal cancer, mainly including but not limited to the sigmoid colon single-lumen stoma after abdominoperineal resection. Since the stoma needs to be retained permanently, preoperative intervention for the stoma, the stoma surgical procedure, prevention and treatment of complications, and long-term postoperative follow-up are all closely related to the patient's quality of life. Under the guidance of the Colorectal Surgery Group of the Society of Surgery, Chinese Medical Association, the Colorectal Tumor Professional Committee of the Chinese Medical Doctor Association, and the Anorectal Physicians Branch of the Chinese Medical Doctor Association, led by the Stoma Study Group of the Anorectal Physicians Branch of the Chinese Medical Doctor Association and with the academic support of <i>Chinese Journal of Gastrointestinal Surgery</i>, experts in related fields were gathered. By drawing on the latest domestic and international guidelines and relevant literature, combining clinical practice and expert opinions, and through repeated discussions and revisions, 24 recommendations were put forward for preoperative evaluation and preparation, surgical technical operation specifications, postoperative management, complication prevention and treatment, and long-term follow-up. The aim is to provide guidance for the clinical practice of permanent stoma in colorectal cancer surgery in China.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 6","pages":"587-598"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477050","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":"[Intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: Experience from Singapore].","authors":"C H U A N Tan, K A I A N N Chia, B O K Y A N So","doi":"10.3760/cma.j.cn441530-20250410-00151","DOIUrl":"10.3760/cma.j.cn441530-20250410-00151","url":null,"abstract":"<p><p>Systemic chemotherapy currently remains the standard treatment for gastric cancer with peritoneal metastasis (GCPM). However, the plasma-peritoneum barrier significantly limits drug penetration into the peritoneal cavity, resulting in the poor prognosis for GCPM patients. In Singapore, intraperitoneal chemotherapy has been demonstrated as a safe and effective approach for GCPM treatment following the implementation of various modalities including pressurized intraperitoneal aerosol chemotherapy (PIPAC), catheter-based intraperitoneal (IP) chemotherapy and conventional hyperthermic intraperitoneal chemotherapy (HIPEC). This article reviews the evolution of intraperitoneal chemotherapy in Singapore and highlights several important clinical trials. Looking forward, the bidirectional approach combining intraperitoneal and systemic chemotherapy will be further refined through the integration of novel drug combinations, optimization of delivery techniques, and expansion of clinical research.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"493-496"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128731","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":"[Clinical value of medical imaging artificial intelligence in the diagnosis and treatment of peritoneal metastasis in gastrointestinal cancers].","authors":"M J Fang, D Dong, J Tian","doi":"10.3760/cma.j.cn441530-20250301-00075","DOIUrl":"10.3760/cma.j.cn441530-20250301-00075","url":null,"abstract":"<p><p>Peritoneal metastasis is a key factor in the poor prognosis of advanced gastrointestinal cancer patients. Traditional radiological diagnostic faces challenges such as insufficient sensitivity. Through technologies like radiomics and deep learning, artificial intelligence can deeply analyze the tumor heterogeneity and microenvironment features in medical images, revealing markers of peritoneal metastasis and constructing high-precision predictive models. These technologies have demonstrated advantages in tasks such as predicting peritoneal metastasis, assessing the risk of peritoneal recurrence, and identifying small metastatic foci during surgery. This paper summarizes the representative progress and application prospects of medical imaging artificial intelligence in the diagnosis and treatment of peritoneal metastasis, and discusses potential development directions such as multimodal data fusion and large model. The integration of medical imaging artificial intelligence with clinical practice is expected to advance personalized and precision medicine in the diagnosis and treatment of peritoneal metastasis in gastrointestinal cancers.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"473-480"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127686","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":"[Reflections on the current state of diagnosis and treatment for peritoneal metastasis in colorectal cancer].","authors":"J Wang, X G He, Y T Hu, L F Sun, K F Ding","doi":"10.3760/cma.j.cn441530-20250308-00090","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250308-00090","url":null,"abstract":"<p><p>Peritoneal metastasis of colorectal cancer is the second most common metastatic pattern after liver metastasis, clinically common and associated with a poor prognosis. Refractory subtypes such as mucinous adenocarcinoma, signet-ring cell carcinoma, and BRAF V600E-mutated colorectal cancers account for a relatively high proportion in peritoneal metastasis. While previous diagnosis and treatment faced significant challenges, recent advances in new technologies and evolving therapeutic concepts have achieved progress in management. Many patients with colorectal cancer peritoneal metastasis have obtained favorable treatment outcomes, though numerous challenges persist. This article provides an in-depth analysis of current status and advancements in the diagnosis and treatment of colorectal cancer peritoneal metastasis, examines existing clinical difficulties and unresolved issues, and explores the application of advanced technologies in clinical practice. Through promoting individualized, precise, and standardized treatment concepts, we aim to enhance survival benefits for more patients.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"465-472"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128841","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":"[Normothermic intraperitoneal and systemic treatment (NIPS) for gastric cancer with peritoneal metastasis: Japanese experience].","authors":"S Z E Joji, S H D Hironori, K B J Hironori","doi":"10.3760/cma.j.cn441530-20250319-00109","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250319-00109","url":null,"abstract":"<p><p>Despite advances in targeted therapies, the prognosis for patients with peritoneal metastases (PM) from gastric cancer remains poor, due to the \"blood-peritoneal barrier,\" which limits delivery of systemically administered drugs to peritoneal lesions. Intraperitoneal (IP) administration of paclitaxel (PTX) offers pharmacokinetic advantages by enhancing drug retention and infiltration in peritoneal lesions. Normothermic intraperitoneal and systemic chemotherapy (NIPS), developed in Japan two decades ago, combines repeated IP infusion of PTX via an intraperitoneal access port with systemic chemotherapy, and is currently regarded as one of the most effective treatment modalities for managing PM from gastric cancer. This review provides an overview of the theoretical rationale and clinical outcomes associated with this treatment strategy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"487-492"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128831","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":"[Integrated diagnosis and treatment of peritoneal metastasis in gastric cancer].","authors":"B W Li, P Gao, K Feng, G T Wu, T J Tongjia, Z N Wang","doi":"10.3760/cma.j.cn441530-20250301-00076","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250301-00076","url":null,"abstract":"<p><p>The high incidence and mortality rates of gastric cancer pose a significant burden on human health and public health systems. Peritoneal metastasis is one of the main routes of metastasis in gastric cancer, and patients with this condition have poor prognosis. With advancements in medicine and sociology, the concept of integrated medicine emerged in the late 1980s. It emphasizes treating patients as holistic entities, integrating various medical fields multidimensionally, and combining medicine with other fields. This article organizes the management of gastric cancer peritoneal metastasis around the core concept of \"Prevention, Screening, Diagnosis, Treatment, and Rehabilitation\": Prevention relies on standardized tumor-free surgical techniques and intraoperative interventions. Screening involves early detection of peritoneal metastasis through integrated technologies. Diagnosis combines multiple methods, including laparoscopic exploration with cytological and histopathological examination, imaging studies, peritoneal fluid cytology, and artificial intelligence. Treatment encompasses comprehensive strategies such as intraperitoneal and systemic chemotherapy, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy, pressurized intraperitoneal aerosolized chemotherapy, dendritic cell vaccines combined with nivolumab, and supportive care for managing ascites, malignant bowel obstruction, and nutritional support. This integrated medical perspective offers new insights into the management of gastric cancer peritoneal metastasis.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"455-464"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128483","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":"[Short-term effects and safety outcomes of the combination of tislelizumab and neoadjuvant chemotherapy in the perioperative treatment of locally advanced gastric cancer].","authors":"Y W Chen, Y H Gao, Y S Zhao, X D Zhao, L Li, H Cui, H Zhang, C X Long, Z Qiao","doi":"10.3760/cma.j.cn441530-20250304-00081","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250304-00081","url":null,"abstract":"<p><p><b>Objective:</b> In this study, we aimed to investigate the short-term efficacy and safety of perioperative administration of the PD-1 inhibitor tislelizumab combined with the SOX regimen (oxaliplatin plus S-1) in patients with locally advanced gastric cancer, and to identify factors influencing therapeutic outcomes. <b>Methods:</b> In this retrospective cohort study, we analyzed clinical data of 166 patients who had undergone perioperative therapy and D2 radical gastrectomy in the Department of General Surgery, First Medical Center of Chinese PLA General Hospital between September 2021 and September 2023. The cohort comprised 140 men and 26 women, of median age 62 years (range: 30-75). The patients were allocated to two groups: 62 receiving tislelizumab plus SOX (combination therapy group), and 104 SOX alone (chemotherapy-only group). Primary outcomes included pathological complete response rate, treatment-related adverse events, and complications of surgery. Secondary outcomes comprised major pathological response rate, tumor regression grade (Grades 1-2 denoting favorable response, Grade 3 moderate, and Grades 4-5 poor response), R0 resection rate, and short-term survival outcomes (1-year disease-free and overall survivals). Risk factors associated with pCR in the combination group were also analyzed. <b>Results:</b> The combination therapy group exhibited significantly higher rates of pCR (25.8% vs. 8.7%, χ²=8.93, <i>P</i>=0.003) and Grade 1 tumor regression (25.8% vs. 16.3%, χ²=15.32, <i>P</i>=0.001) than the chemotherapy-only group. There were no statistically significant differences in major pathological response rates (41.9% vs. 39.4%), R0 resection rates (96.8% vs. 97.1%,), treatment- related adverse events (48.4% vs. 42.3%,), surgical complications (9.7% vs. 12.5%), 1-year disease-free survival (82.3% vs. 78.8%), or 1-year overall survival (93.5% vs. 91.3%), There were no statistically significant differences (all <i>P</i>>0.05). Multivariate logistic analysis identified neural invasion as an independent risk factor for reduced pCR in the combination group (OR=0.10, 95%CI:0.01-0.85,<i>P</i>=0.035). <b>Conclusions:</b> Perioperative tislelizumab combined with SOX chemotherapy improves pathological response rates in patients with locally advanced gastric cancer and has favorable short-term efficacy and safety profiles. Neural invasion may diminish the therapeutic efficacy of immunotherapy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"536-543"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128796","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":"[Study on the impact of ultrasound-guided bedside hyperthermic intraperitoneal chemotherapy after laparoscopic gastric cancer surgery on the prognosis of patients with positive peritoneal lavage fluid cytology].","authors":"L Y Tong, J Lu, C B Lv, L S Cai, Y H Wu","doi":"10.3760/cma.j.cn441530-20240920-00324","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240920-00324","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the impact of bedside ultrasound-guided hyperthermic intraperitoneal chemotherapy (HIPEC) after laparoscopic gastric cancer surgery on the prognosis of patients with only positive peritoneal lavage cytology (CY+) and no other distant metastases. &lt;b&gt;Methods:&lt;/b&gt; The clinicopathological data of 49 patients with only positive peritoneal lavage cytology who underwent laparoscopic gastrectomy and D2 lymph node dissection from December 2017 to December 2022 were retrospectively analyzed. The patients were divided into the HIPEC group (27 cases) and the non-HIPEC group (22 cases) based on whether they received postoperative bedside ultrasound-guided HIPEC. The patterns of postoperative recurrence and metastasis and the 3-year survival rates were compared between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to determine the prognostic factors. &lt;b&gt;Results:&lt;/b&gt; There was no statistically significant difference in all baseline clinicopathological data between the two groups (&lt;i&gt;P&lt;/i&gt;&gt;0.05); the median follow-up time for all patients was 31 months (ranging from 13 to 73 months), and the overall recurrence rate for all patients was 55.1% (27/49). Among them, 12 cases (24.5%) had peritoneal metastasis, 7 cases (14.3%) had hematogenous recurrence, 5 cases (10.2%) had distant lymph node metastasis, and 3 cases (6.1%) had local recurrence. The overall recurrence rates of patients in the HIPEC group and the non-HIPEC group were 51.8% (14/27) and 59.1% (13/22), respectively. There was no statistically significant difference (χ&lt;sup&gt;2&lt;/sup&gt;=0.26, &lt;i&gt;P&lt;/i&gt;=0.612). The peritoneal metastasis rate of patients in the HIPEC group was 18.5% (5/27), which was lower than that of the non-HIPEC group at 31.8% (7/22). However, there was no statistically significant difference (χ&lt;sup&gt;2&lt;/sup&gt;=1.16, &lt;i&gt;P&lt;/i&gt;=0.282). The proportions of local recurrence, hematogenous metastasis, and distant lymph node metastasis were comparable between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The cumulative 3-year recurrence rates of the two groups were similar (70.7% vs. 71.3%, &lt;i&gt;P&lt;/i&gt;=0.266). In the HIPEC group, the 3-year overall survival rate was 61.1%, which was significantly higher than that of the non-HIPEC group (31.5%). The difference was statistically significant (&lt;i&gt;P&lt;/i&gt;=0.014). The disease-free progression survival rates of the two groups were 29.3% and 28.7% respectively, and there was no statistically significant difference between them (&lt;i&gt;P&lt;/i&gt;=0.266). Cox multivariate analysis showed that no postoperative HIPEC (HR=5.21, 95%CI:1.90-14.31, &lt;i&gt;P&lt;/i&gt;=0.001), poor tumor differentiation (HR=3.78, 95%CI:1.07-13.26, &lt;i&gt;P&lt;/i&gt;=0.038), and later N stage (HR=6.18, 95%CI:1.39-7.59, &lt;i&gt;P&lt;/i&gt;=0.017) were independent risk factors for the overall survival rate after surgery (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Later N stage (HR=3.67, 95%CI:1.07-12.55, &lt;i&gt;P&lt;/i&gt;=0.038) was an independent risk factor for the disease-free pr","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"528-535"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128803","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}