Ural Medical Journal最新文献

{"title":"Difficulties of Differential Diagnosis of Peptic Ulcer and Stomach Cancer","authors":"E. Stepina, N. V. Ovchinnikova, A. A. Chetina, О. V. Khlynova","doi":"10.52420/umj.23.3.79","DOIUrl":"https://doi.org/10.52420/umj.23.3.79","url":null,"abstract":"Introduction. Stomach cancer is a serious problem of modern medicine and is one of the most common malignant diseases in the world, being in fourth place among the causes of death from cancer. Most patients seek medical help in the late stages of the disease and, as a result, mortality during the first year after diagnosis is about 50 %.Description. A case of clinical observation of a patient with diagnosed ring-cell carcinoma of the stomach is presented. In the course of the description, key aspects that require attention in determining risk factors, examination tactics and management of a patient with suspected malignant gastric disease are highlighted.Conclusions. Detection of the disease in the early stages allows not only to significantly increase the patient’s chances of a complete cure, but also to carry out therapy using the most gentle methods. The differential diagnosis of peptic ulcer disease and infiltrative gastric cancer is particularly difficult. Comprehensive clinical, laboratory and instrumental examination of patients contributes to the early establishment of a correct diagnosis and, as a result, timely surgical treatment.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"87 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141652916","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":"Pro‑coagulant Considerations in Patients with Arterial Hypertension and Multifocal Atherosclerosis","authors":"S. S. Vedenskaya, O. Smolenskaya, V. G. Grachev, E. S. Klyachina, K. V. Shirobokova","doi":"10.52420/umj.23.3.36","DOIUrl":"https://doi.org/10.52420/umj.23.3.36","url":null,"abstract":"The aim of the work to determine the features of hemostasis and blood rheology in patients with arterial hypertension (HTN) and multifocal atherosclerosis (MFA).Materials and methods. The study enrolled male and female patients aged from 40 to 70 years, including 59 patients with controlled stage I–II hypertension and multifocal vascular lesions (Group 1) and 42 patients with controlled stage III hypertension, who have suffered an ischemic stroke and have multifocal vascular lesions (Group 2). A test using the Thrombodynamics analyser system T-2 (GemaKor, LLC, Moscow, Russia) was performed to detect the impairment of hemostasis.Results. Patients with HTN and MFA have an impaired coagulation hemostasis system (an increase in the initial and stationary clot growth rate and the size of the clot, as well as the presence of spontaneous clots), which leads to a high residual risk of cerebral complications, despite BP lowering to target figures and control of lipid profile.Discussion. Elevated blood pressure in patients with MFA leads to endothelial dysfunction, which is accompanied by activation of coagulation and fibrinolysis pathways. These changes lead to a violation of microcirculatory hemostasis in the brain, the development and progression of cerebral ischemia, and subsequently the occurrence of stroke, both the first and repeated.Conclusion. An important result of this study is the first registered change in the coagulation link of hemostasis in patients with HTN and MFA aged from 40 to 70 years, which can be considered an additional criterion for stroke prediction.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658055","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":"Mixed Saliva Chemical Parameters Changes in Age‑Related Oral Diseases","authors":"M. Kopenkin, L. Polushina, E. A. Sementsova, Y. Mandra, V. Bazarnyi","doi":"10.52420/umj.23.3.46","DOIUrl":"https://doi.org/10.52420/umj.23.3.46","url":null,"abstract":"Introduction. The prevalence of oral cavity age-related diseases, such as chronic periodontitis (CP) and oral lichen planus (OLP) increases in the elderly and senile age people. The aim of the study was to evaluate changes in the biochemical parameters of mixed saliva in age-related oral diseases and evaluate impact of correction by total protein concentration.Materials and methods. The study included 86 elderly people from 60 to 74 years. They were divided into following groups: excessive attrition of teeth patients (n = 16); moderate CP patients (n = 22); OLP patients (n = 28); healthy peoples (n = 20). Reagent strips Siemens Multistix 10 SG (USA), analyzer Siemens Clinitek Status+ (USA), chemistry analyzer Mindray BS-240Pro (China) were used. In total, 16 biochemical markers and 4 calculated indices were determined. Saliva results were expressed without any correction, and corrected by total protein concentration.Results. It was found that OLP patients differed by a higher specific gravity and an increased level of total protein and calcium from the control group. CP patients had a higher level of c-reactive protein in compared to the healthy peoples. There were no differences between groups after correction.Discussion. The data corresponded to literature sources describing mixed saliva changes in age-related oral diseases. However, correction methods practically were not used in the considered works.Conclusion. Mixed saliva chemical markers changed in age-related oral diseases. It is necessary to find the optimal correction method because dilution and viscosity can significantly affect mixed saliva research results.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"122 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657061","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":"Analysis of Comorbidity in HIV–Infected Patients with Immunological Inefficiency of Antiretroviral Therapy","authors":"T. V. Balykchinova, A. U. Sabitov, V. V. Zhukov","doi":"10.52420/umj.23.3.7","DOIUrl":"https://doi.org/10.52420/umj.23.3.7","url":null,"abstract":"Introduction. Studies indicate high risks of secondary diseases and adverse events not related to HIV in patients with immunological inefficiency of antiretroviral therapy (ART). The effect of comorbidity on the increase of CD4+ is detected.The aim of the study is assessing the effect of comorbidity on CD4+ growth and the probability of developing immunological inefficiency of ART.Materials and methods. A retrospective study was conducted that included HIV-infected patients with CD4+ at the beginning of treatment <200 cells/µl. Two groups were formed: the main group — patients with immunological inefficiency of ART (281 people); the control group — patients with sufficient immunological response on ART (188 people). Results. The probability of developing immunological inefficiency in patients with tuberculosis was 1.7 times higher (odds ratio (OR) — 1.7; 95 % confidence interval (CI) — 1.0–2.9); in patients with HCV-infection — 1.8 times higher (OR — 1.8; 95 % CI — 2.6–1.2). The probability of cardiovascular disease in the main group was 2 times higher (OR — 2.3; 95 % CI — 1.0–5.4).Discussion. Tuberculosis, HCV-infection and cardiovascular diseases frequently registered in the structure comorbidity in the main group of patients.Conclusion. According to the results of this study, HIV-infected patients with HCV and tuberculosis co-infection have a higher chance of developing immunological inefficiency of ART.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"130 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656589","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":"The Influence of the COVID‑19 Pandemic on the Detection, Diagnosis and Treatment in the Republic of North Ossetia — Alania","authors":"N. V. Kobesov, M. V. Sinitsin, Z. Zagdyn, M. K. Pagieva","doi":"10.52420/umj.23.3.16","DOIUrl":"https://doi.org/10.52420/umj.23.3.16","url":null,"abstract":"Introduction. Prioritization of measures to contain the COVID-19 pandemic has led to a decrease in the coverage and intensity of TB control activities.The aim of study to assess the indicators of detection, diagnosis and treatment of tuberculosis during the COVID-19 pandemic in the Republic of North Ossetia-Alania and compare them with those at the all-Russian level.Materials and methods. A preliminary collection of statistical information in Russian and several foreign sources closest to the topic was carried out on the PubMed, ResearchGate, ScienceDirect, CyberLeninka and eLibrary platforms. An analysis of the epidemiology of tuberculosis in North Ossetia for 2020–2021 was performed. according to annual reporting forms and reports from epidemiological monitoring systems for tuberculosis.Results. The detection rate of tuberculosis has decreased during the pandemic. The indicator in North Ossetia was higher than the national level. Clinical and diagnostic indicators for tuberculosis in the republic in 2020 were lower compared to those for 2021 for the study of sputum, decay phase, and bacterial excretion. The proportion of successful tuberculosis chemotherapy in the republic was higher than in a number of regions of the Russia.Discussion. There was a decrease in registered and, obviously, accumulation of latent cases of tuberculosis during the COVID 19 2020 pandemic due to a drop in preventive coverage of the population in the Russia. A worsening of the clinical structure of tuberculosis in 2021 in Republic of North Ossetia and an increase in the proportion of patients with destruction of lung tissue and the fibrous-cavernous type of disease in the Russia are revealed, possibly due to untimely detection of tuberculosis.Conclusion. Low activity of primary health care organizations regarding tuberculosis was revealed. Restrictions to prevent the spread of the SARS-CoV-2 pathogen contributed to a decrease in the coverage and intensity of anti-tuberculosis measures. The COVID-19 pandemic clearly affected the rates of primary diagnosis of tuberculosis in 2020, and in 2021 a significant increase was noted.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"119 52","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656756","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":"Nephrotransplantectomy Using Radiosurgical Techniques","authors":"R. R. Akhtyamov, V. P. Ionin","doi":"10.52420/umj.23.2.65","DOIUrl":"https://doi.org/10.52420/umj.23.2.65","url":null,"abstract":"Introduction. Aſter the loss of kidney transplant function, patient curation can be a difficult task. Nephrotransplantectomy (NTE) is the method of choice between reduction of immunosuppression with the abandonment of a non-functioning kidney transplant and embolization. This is an operation with potentially significant indicators of blood loss, complications and mortality. Along with traditional NTE, we began to use endovascular isolation of the allograſt as a method of preoperative preparation before its removal.The aim of the work is to investigate the effect of the use of radiosurgical minimally invasive techniques on the surgical tactics of nephrotransplantectomy, the degree of blood loss, the frequency of complications and blood transfusion.Materials and methods. A retrospective analysis of the data of 52 patients aſter NTE was performed. Depending on the method, patients are divided into two groups. In group 1 (main, n = 22), the operation was performed with pre-performed endovascular embolization of the graſt arteries (EEAT), in group 2 (control, n = 30) — without EEAT. The analysis of the results of the examination, intra- and postoperative indicators in patients by groups was carried out.Results. In group 1, intraoperative blood loss was 10–80 ml, on average (35.4±19.9) ml; in group 2 — from 100 to 600 ml, on average (289.7±138.4) ml (p < 0.001). In group 2, damage to the main vessels occurred more oſten (n = 4) (13.3 % vs. 0 %), hemotransfusion was performed in 53.3 % of cases (n = 16) to correct posthemorrhagic anemia. Postoperative complications in the control group were recorded in 8 patients (26.7 %).Discussion. Preventive endovascular embolization of the arteries of a kidney transplant significantly reduces the frequency ofintra- and postoperative complications, allows nephrectomy to be performed on a planned basis andin a delayed manner.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140992979","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":"Correction of Nitrosative Stress During Reparative Regeneration of the Nasal Cavity Mucosa in an Experimental","authors":"I. Y. Berest","doi":"10.52420/umj.23.2.98","DOIUrl":"https://doi.org/10.52420/umj.23.2.98","url":null,"abstract":"Introduction. Nitric oxide metabolites play an important role in prolongation of the inflammatory reaction, disorders of epithelial regeneration in diseases of the upper respiratory tract. One of the promising approaches to regulating the bioactivity of nitric oxide is the use of antioxidants.The objective of the study is to evaluate the effectiveness of antioxidant therapy for the correction of nitrosative stress during reparative regeneration of the nasal mucosa in an experiment.Methods. A preclinical randomized experimental study is conducted on 160 rats, divided into 4 groups. The control group (n = 40) consists of intact animals. Animals in experimental group 1 (n = 40) do not receive treatment aſter injury; in group 2 (n = 40) anti-inflammatory treatment is prescribed. The third group consists of laboratory rats (n = 40), which are additionally injected into the nasal cavity with an antioxidant — a 15 % solution of 1,1-dimethyl-3-oxobutylphosphonic acid dimethyl ester. On days 2, 5, 10, and 14 of observation, the concentration of nitrates and nitrites and C-reactive protein in the blood of animals are determined.Results. In group 3, aſter an increase in the level of nitric oxide metabolites on day 2 aſter injury on day 5, a significant (p < 0.05) decrease was noted in comparison with other groups, and by day 10— normalization of the indicator. An increase in the level of C-reactive protein in blood serum correlated with the concentration of nitric oxide metabolites.Discussion. The optimal therapeutic effect when taking antioxidants develops when administered in the first hours aſter injury to reduce the excessive formation of reactive nitrogen radicals. However, the duration of administration should not exceed 4–5 days to avoid a significant decrease in the level of nitric oxide metabolites and deterioration of mucosal regeneration.Conclusions. Assessment of nitric oxide metabolitesin the blood at different times aſter injury is an important marker of inflammatory activity. The use of antioxidants helps to reduce the concentration of active nitrogen radicals.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991947","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":"Variability of Knee Joint Anatomy and the Impact of Its Individual Parameters on the Topography of the Anterior Cruciate Ligament","authors":"I. V. Volodin, D. Malanin, K. Kalitin, O. Mukha, I. A. Suchilin, L. L. Cherezov","doi":"10.52420/umj.23.2.76","DOIUrl":"https://doi.org/10.52420/umj.23.2.76","url":null,"abstract":"Introduction. The anatomical features of the knee joint are significant as potential predictors of various diseases and injuries. However, the relationship between the anatomical position of the ACL and the structural parameters of the knee remains insufficiently studied. This work aims to identify statistically significant correlations between individual knee parameters and their association with the topography of the ACL within the joint.Purpose of the study. To determine statistically significant relationships between individual knee parameters and their potential impact on the positioning of the ACLin the joint based on MRI data.Materials and methods. The study involved the analysis of MRI images of 391 knee from patients of different sexes. Measurements were taken for 19 parameters using standard tools for linear and angular measurements. The data underwent statistical processing.Results and discussion. Six factors influencing the positioning of the ACL were identified. The study results challenge the validity of existing knee structure classifications, highlighting the need to explore the relationships between joint parameters. Factor analysis of the measured knee values allows for the identification of new systems of interrelated parameters, including those independent of patient sex. The study emphasizes the importance of developing new MRI analysis methods for the knee using multiparametric models.Conclusion. Our research highlights important correlations between knee parameters and the positioning of the ACL. Factors affecting this dynamic underscore the need for an individualized approach to planning ACL reconstruction. The results provide a basis for developing more accurate analysis methods and personalized treatment strategies for orthopedic diseases, enhancing the efficacy of clinical practice.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140992681","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":"Central Retinal Vein Occlusion as the Debut of a Chronic Myeloproliferative Neoplasm","authors":"L. Moshetova, L. Egoryan, O. Vinogradova, D. I. Shikhbabaeva, K. Turkina","doi":"10.52420/umj.23.2.123","DOIUrl":"https://doi.org/10.52420/umj.23.2.123","url":null,"abstract":"Introduction. Most retinal vascular diseases are associated with systemic risk factors such as hypertension, diabetes mellitus, age and smoking. However, in their absence, further examination is required to identify possible hematological disorders.Purpose. Improve the diagnostic and management scheme for patients with occlusion of the central retinal vein or its branches.Materials and methods. A clinical case of the onset of polycythemia vera with the central retinal vein occlusion is described. As part of the study, a molecular genetic analysis was carried out to identify the driver mutation JAK2V617F in peripheral blood as a screening diagnosis of Ph-negative chronic myeloproliferative neoplasms (CMN), a cytological, cytogenetic study of bone marrow aspirate and a morphological study of bone marrow trephine biopsy.Results. A mutant allele of the JAK2V617F gene with a diagnostically significant allele load of 14.61 % was determined in a patient hospitalized in the ophthalmology department with a diagnosis of central retinal vein occlusion (CRVO) of the right eye. The patient was referred for further examination to the Moscow City Hematology Center of Botkin City Clinical Hospital, where, aſter examination, the diagnosis was established: True polycythemia.Discussion. CMN are a group of tumor diseases of hematopoietic tissue characterized by malignant transformation of bone marrow stem cells with their subsequent clonal proliferation. Cytogenetic and molecular genetic disorders play a significant role in the pathogenesis of chronic CMN. True polycythemia, essential thrombocytemia, primary myelofibrosis belong to the group of classical Ph-negative CMP, Thrombotic, vascular and hemorrhagic complications are the most common causes of death in patients with this pathology.Conclusion. Previously, various ophthalmological manifestations and symptoms have been described in patients with CMN. The observed complications are diverse and oſten secondary to the pathognomonic hematological disorders for these diseases. It is worth considering the clinical value of molecular genetic analysis to detect the JAK2V617F mutation in patients with central retinal vein occlusion for early diagnosis of CMN and timely administration of appropriate therapy.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991390","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":"Hemocoagulation Disorders and Intoxication in Severe Acute Post-Manipulation Pancreatitis in the Experiment","authors":"M. I. Prudkov, M. Rantsev, P. Sarapultsev, O. Chupakhin","doi":"10.52420/umj.23.2.89","DOIUrl":"https://doi.org/10.52420/umj.23.2.89","url":null,"abstract":"Introduction. Acute post-manipulation pancreatitis (APMP) is a frequent complication aſter interventions on the major duodenal papilla. The APMP incidence reaches 15 %, of which 5–10 % are severe. The goal of the research is to determine the possibility of correcting hemocoagulation disorders and reducing endogenous toxemia syndrome severity in APMP.Materials and methods. A comparative study was performed in 40 animals (nonlinear albino rats) with severe acute pancreatitis on APMP experimental model. L-17 compound from a new group of organic compounds substituted thiadiazines at a daily dose of 40 mg/kg was used.Results. The development of hemocoagulation disorders and severe toxemia in animals with an experimental model of APMP has been shown. The indicators of the severity of hemocoagulation disorders and toxemia were studied in experimental APMP against the background of the introduction of the compound L-17 from the group of substituted thiadiazines.Discussion. The course of APMP in the experiment is accompanied by the development of severe hemocoagulation disorders and severe toxemia. Effective indicators reflecting the severity of APLP are D-dimers (hemocoagulation) and albumin binding capacity (toxemia).Conclusion. The course of experimental severe APMP is accompanied by pronounced hemocoagulation disorders development involved in the pathogenesis and progression of multiple organ dysfunction, that is characterized by a high level of endogenous toxemia. The course of experimental APMP against the background of the introduction of the compound L-17 is marked by a decrease in the severity of hemocoagulation disorders and the level of endogenous toxemia.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994188","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}