Journal of Chest Surgery最新文献

{"title":"Robot-Assisted Transcervical Esophagectomy for Thoracic Esophageal Carcinoma.","authors":"Takeo Fujita","doi":"10.5090/jcs.25.031","DOIUrl":"10.5090/jcs.25.031","url":null,"abstract":"<p><p>Surgical approaches for thoracic esophageal cancer have evolved from invasive open procedures to minimally invasive techniques such as thoracoscopic and robot-assisted surgery. While robotic surgery offers improved precision and visualization, it still relies on single-lung ventilation and may not significantly reduce postoperative complications. Recently, transcervical esophagectomy (TCE) using a mediastinoscope has emerged as a promising alternative, enabling esophageal resection and lymphadenectomy via the neck without thoracic incisions. However, challenges such as recurrent laryngeal nerve palsy and limited reproducibility persist. Robot-assisted TCE addresses these issues by improving precision and reducing interference in the narrow mediastinum. Early studies, including the authors' pilot work, have shown encouraging results. Despite its potential, comprehensive data on the short-term outcomes and safety of this technique remain limited. This study aims to introduce robot-assisted TCE for patients with thoracic esophageal carcinoma and compare its clinical benefits with those of transthoracic robot-assisted esophagectomy, thereby clarifying its role in the evolving field of esophageal cancer surgery.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"209-213"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Mortality-Related Factors in Patients Aged >80 Years Treated for Abdominal Aortic Aneurysms.","authors":"Juan Kim, Sung Woon Chung, Jongwon Kim, Miju Bae, Chung Won Lee, Up Huh","doi":"10.5090/jcs.25.003","DOIUrl":"10.5090/jcs.25.003","url":null,"abstract":"<p><strong>Background: </strong>With an aging population, the number of patients over 80 undergoing abdominal aortic aneurysm (AAA) repair is increasing. This study examines factors associated with mortality in these patients.</p><p><strong>Methods: </strong>A retrospective cohort study involving 66 patients aged >80 who underwent AAA repair between January 2010 and December 2022 was conducted. Baseline characteristics, treatment methods (open surgical repair [OSR] or endovascular aneurysm repair [EVAR]), post-treatment mortality, complications, and reinterventions were analyzed.</p><p><strong>Results: </strong>The mean age of patients was 82.74±2.64 years, with men comprising 74.2%. The OSR group had significantly younger patients than the EVAR group (81.92 years vs. 83.28 years, p=0.04). Rupture prevalence was significantly higher in the OSR group (27% vs. 7.5%, p=0.03). No significant difference was found in 30-day mortality rates between the OSR and EVAR groups (11.5% vs. 10%, p=0.85). Univariate logistic regression identified emergency surgery (odds ratio [OR], 6.18; p=0.04), post-treatment pneumonia (OR, 7.47; 95% confidence interval [CI], 1.00-55.70; p=0.05), and vasopressor use (OR, 44.57; p<0.01) as significant factors associated with 30-day mortality. Cox proportional hazard regression revealed age (hazard ratio [HR], 1.19; p=0.02), preoperative bedridden state (HR, 22.24; p<0.01), sacrifice of both internal iliac arteries (HR, 5.26; p=0.04), and postoperative vasopressor use (HR, 30.04; p<0.01) as significant predictors of overall mortality.</p><p><strong>Conclusion: </strong>In patients aged >80 years, aneurysm rupture and emergency operation significantly increased 30-day mortality following AAA repair. Preoperative bedridden status, management of internal iliac arteries, and postoperative vasopressor use were significant predictors of overall mortality. When determining surgical indications and predicting outcomes, careful attention should be given to factors influencing mortality throughout the entire surgical process.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"196-204"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Open Surgical Repair Remains Essential: Insights into the Suitability of Endovascular Aneurysm Repair in Ruptured Abdominal Aortic Aneurysms from a Tertiary Referral Center in South Korea.","authors":"Sang Yoon Kim, Dong Kyu Yoon, Jae Hang Lee, Hyoung Woo Chang, Kay-Hyun Park","doi":"10.5090/jcs.24.116","DOIUrl":"10.5090/jcs.24.116","url":null,"abstract":"<p><strong>Background: </strong>Several studies have demonstrated that emergency endovascular aneurysm repair (eEVAR) has become the standard treatment for ruptured abdominal aortic aneurysm (rAAA) compared to open surgical repair (OSR). This study investigated the feasibility of eEVAR in rAAA patients and analyzed the outcomes of OSR.</p><p><strong>Methods: </strong>At our institution, all patients (n=58) presenting with rAAA underwent OSR. We conducted a retrospective review of surgically treated rAAA patients between February 2006 and March 2021. Patients with impending rupture or isolated iliac aneurysm rupture were excluded.</p><p><strong>Results: </strong>Anatomic measurements based on preoperative computed tomography indicated that 28 patients (48.3%) could have been candidates for eEVAR. Reasons for unsuitability included: (1) proximal neck length <10 mm (n=21, 51.7%); (2) proximal neck angulation >60° (n=11, 19.0%); (3) iliac artery diameter <5 mm (n=6, 10.3%); and (4) proximal neck diameter >32 mm (n=3, 5.2%). The 30-day mortality rate for OSR was 17.2% (n=10). The 1-year and 5-year survival rates were 53.4%±6.5% and 33.4%±6.3%, respectively. Multivariable logistic regression analysis revealed that a high preoperative serum lactate level (>5 mmol/L) and the presence of bowel ischemia were significant risk factors for 30-day mortality (odds ratio [OR], 11.95; 95% confidence interval [CI], 1.53-93.08; p<0.018; and OR, 15.28; 95% CI, 1.60-146.18; p<0.018, respectively).</p><p><strong>Conclusion: </strong>More than half of rAAA patients were not candidates for eEVAR due to various anatomical reasons. OSR demonstrated favorable short- and long-term outcomes and remains a viable standard treatment for rAAA.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":"185-192"},"PeriodicalIF":1.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidermal Growth Factor Receptor Exon 20 Insertion in Early Resected Non-Small Cell Lung Cancer: A Retrospective, Single-Center Study in Taiwan.","authors":"Ying Shian Chen, Hsu-Kai Huang, Ying-Yi Chen, Yen-Shou Kuo, Kuan Hsun Lin, Cheng-Jung Lin, Tsai-Wang Huang","doi":"10.5090/jcs.25.027","DOIUrl":"https://doi.org/10.5090/jcs.25.027","url":null,"abstract":"<p><strong>Background: </strong><i>EGFR</i> exon 20 insertions account for 1% to 10% of <i>EGFR</i> mutations in non-small-cell lung cancer (NSCLC) and are known to confer resistance to traditional tyrosine kinase inhibitors. However, the prognostic significance of these mutations in early-stage resected NSCLC remains unclear. This study assesses outcomes in patients with resected NSCLC harboring <i>EGFR</i> exon 20 insertions, comparing them to patients with common <i>EGFR</i> mutations and those with wild-type <i>EGFR</i>.</p><p><strong>Methods: </strong>We retrospectively reviewed 3,235 patients who underwent resection for NSCLC at Tri-Service Hospital between 2008 and 2021. After excluding cases lacking <i>EGFR</i> testing, incomplete data, or advanced-stage disease, 44 patients with exon 20 insertions were matched to 602 patients with common <i>EGFR</i> mutations and 729 with wild-type <i>EGFR</i>. Clinical characteristics, disease-free survival (DFS), and overall survival (OS) were analyzed using the Kaplan-Meier method, with statistical comparisons performed using the log-rank test. Cox proportional hazards models were used to identify independent prognostic factors.</p><p><strong>Results: </strong>Patients with exon 20 insertions were younger and more frequently presented with stage IA disease. The 5-year DFS was 79% in the exon 20 insertion group, compared to 81% in the common mutation group and 83.9% in the wild-type group. The 5-year OS was 78.5% for exon 20, 91.9% for common mutations, and 91% for wild-type. While no significant differences in DFS or OS were observed between groups, the exon 20 insertion group had a higher incidence of secondary cancers. Multivariable analysis indicated that exon 20 insertion was independently associated with worse OS, but not with DFS.</p><p><strong>Conclusion: </strong><i>EGFR</i> exon 20 insertions do not significantly shorten DFS, but are associated with inferior OS in early-stage resected NSCLC. Given the limited treatment options, the role of adjuvant therapy warrants further investigation.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972284","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 26-Year Secret: An Unusual Culprit Behind Massive Hemoptysis: A Case Report.","authors":"Robin Benzigar Poovattil, Roman Dutta, Haritha Therse Joseph, Abhishek Mohan, Shyam Rengan, Rohit Rathi, Sabyasachi Bal","doi":"10.5090/jcs.25.026","DOIUrl":"https://doi.org/10.5090/jcs.25.026","url":null,"abstract":"<p><p>Foreign body aspiration is frequently encountered in children but can also occur in adults, where it often remains undiagnosed for years. Forgotten foreign bodies within the bronchial tree may later manifest with either vague symptoms or life-threatening complications, such as massive hemoptysis. Contrast-enhanced computed tomography of the thorax is the preferred initial diagnostic modality and can suggest the presence of a foreign body. We present a case involving an adult who remained undiagnosed until adulthood, when he was ultimately found to have a foreign body embedded in the lung parenchyma.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972316","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 19F Blake Drain versus a 28F Conventional Drain Following Video-Assisted Thoracoscopic Esophagectomy for Esophageal Cancer: A Comparative Retrospective Study.","authors":"Hiep Van Pham, Tuan Anh Nguyen, Thang Manh Tran","doi":"10.5090/jcs.25.060","DOIUrl":"https://doi.org/10.5090/jcs.25.060","url":null,"abstract":"<p><strong>Background: </strong>Pleural drainage is essential for preventing and managing respiratory complications after video-assisted thoracoscopic esophagectomy (VATE). Conventional large-bore drains often cause significant pain. Small-bore drains (e.g., 19F Blake drains) may reduce discomfort; however, evidence regarding their use in VATE is limited. This study compared drainage effectiveness and pain between 19F Blake drains and conventional 28F drains after VATE for esophageal cancer.</p><p><strong>Methods: </strong>This retrospective study included 77 male patients with middle- or lower-third esophageal cancer who underwent VATE with laparoscopic retrosternal tunneling from November 2018 to November 2022. Fifty-five patients received a 28F conventional drain, and 22 received a 19F Blake drain. Outcomes included drainage duration and volume, pain levels (Visual Analog Scale [VAS]), postoperative pneumonia rates, and pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) on postoperative day 3.</p><p><strong>Results: </strong>The 19F group reported significantly lower pain scores on postoperative days 1-3 (VAS: 2.95-3.25 vs. 4.07-4.62, p<0.001). Drainage duration and pneumonia rates were similar between groups. The 19F group demonstrated a trend toward higher drainage volume and significantly better preservation of pulmonary function, with smaller declines in FVC (ΔFVC: 0.24±0.20 L vs. 0.63±0.17 L, p<0.001) and FEV1 (ΔFEV1: 0.38±0.25 L vs. 0.58±0.25 L, p=0.02).</p><p><strong>Conclusion: </strong>19F Blake drains provide similar drainage effectiveness to that of 28F drains, with reduced postoperative pain and better pulmonary function preservation. These findings support the use of 19F Blake drains to improve patient comfort and recovery following VATE.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972259","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":"Prothrombin Complex Concentrate versus Frozen Plasma in Adult Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.","authors":"Ahmed Nazmy, Mohamed Hesham Gamal, Hesham Elharti, Ahmed Sobhy, Ahmed Yasser Shaban","doi":"10.5090/jcs.25.056","DOIUrl":"https://doi.org/10.5090/jcs.25.056","url":null,"abstract":"","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971587","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 Impact of the Number of Ports on Perioperative Outcomes Following Video-Assisted Thoracoscopic Surgery for Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis.","authors":"Fegita Beatrix Pajala, Caroline Tanadi, Raden Haryo Aribowo","doi":"10.5090/jcs.25.037","DOIUrl":"https://doi.org/10.5090/jcs.25.037","url":null,"abstract":"<p><p>Video-assisted thoracoscopic surgery (VATS) has emerged as a less invasive technique for treating resected lung cancer compared with open surgery. In recent years, the uniportal VATS technique has gained popularity for lung resection in small nodules and ground glass lesions. However, it remains unclear whether single-port VATS offers more favorable perioperative outcomes than multi-port approaches. This study aims to evaluate the perioperative outcomes of single-port versus 2-port and 3-port VATS in patients with early-stage non-small cell lung cancer. A literature search was conducted across 5 online databases (PubMed, CENTRAL, ProQuest, SAGE, and ScienceDirect). Meta-analysis was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Study quality was assessed using the risk of bias tool in randomized trials (RoB 2) and the Newcastle-Ottawa Scale, while meta-analysis was conducted with Review Manager (RevMan) 5.4. This study was registered in PROSPERO under protocol number CRD42025634395. A comprehensive initial search identified 9,178 records, of which 22 studies were included in the systematic review and 19 were incorporated into the meta-analysis, with a total of 3,324 participants. Compared with 3-port VATS, single-port VATS was associated with significantly lower intra-operative blood loss (mean difference [MD], -10.52; 95% confidence interval [CI], -17.37 to -3.66; p=0.003), shorter chest tube duration (MD, -0.71; 95% CI, -1.07 to -0.35; p<0.001), lower postoperative drainage volume (MD, -68.25; 95% CI, -117.64 to -18.87; p=0.007), shorter postoperative hospital stay (MD, -1.00; 95% CI, -1.65 to -0.35; p=0.003), and lower pain scores on postoperative day 1 and day 3 (MD, -0.73; 95% CI, -1.19 to -0.28; p=0.002; MD, -0.59; 95% CI, -0.85 to -0.32; p<0.001), as well as a reduced rate of postoperative complications (MD, 0.83; 95% CI, 0.69 to 0.99; p=0.04). No significant differences were observed between single-port and 2-port or 3-port VATS regarding operation time and number of dissected lymph nodes. The risk of bias was low, and the overall certainty was moderate. Single-port VATS is safe and feasible, with short-term outcomes comparable to those of 2-port and 3-port approaches.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817698","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":"Left Ventricular Assist Device Use as a Bridge to Heart Transplantation in Restrictive Cardiomyopathy: A Series of 2 Cases.","authors":"Arif Okay Karslıoğlu, Endri Balla, Atilla Sezgin","doi":"10.5090/jcs.25.012","DOIUrl":"https://doi.org/10.5090/jcs.25.012","url":null,"abstract":"<p><p>Restrictive cardiomyopathy (RCM) is associated with a high mortality rate among patients awaiting heart transplantation, largely due to the challenges inherent in mechanical circulatory support device implantation and the limited effectiveness of pharmacologic therapies. The small size of the left ventricular cavity in RCM patients can cause significant complications, such as inflow cannula obstruction, impaired diastolic filling, and an increased risk of suction events. Here, we present 2 cases, each rare individually, both of which posed unique surgical challenges. Our aim was to evaluate the preoperative conditions, clinical characteristics, surgical approaches, and early outcomes in 2 RCM patients: one who received a left ventricular assist device (LVAD) as a bridge to heart transplantation, and the other as a bridge to candidacy. For the first patient, LVAD implantation with mitral valve resection was performed under emergency conditions due to the presence of a left atrial thrombus; subsequent heart transplantation was later achieved. For the second patient, LVAD implantation with mitral valve replacement was conducted as a bridge to candidacy in the setting of high pulmonary vascular resistance.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817728","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 Current Consensus on Salvage Surgery after Targeted Therapy for Advanced EGFR-Mutant Non-Small Cell Lung Cancer.","authors":"Yu-Wei Liu, Po-Chih Chang, Jadzia Tin-Tsen Chou, Shah-Hwa Chou","doi":"10.5090/jcs.25.047","DOIUrl":"https://doi.org/10.5090/jcs.25.047","url":null,"abstract":"<p><p>Salvage surgery is an emerging option for carefully selected patients with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) whose disease remains controlled on tyrosine kinase inhibitor (TKI) therapy. Fourteen retrospective series report median progression-free survival (PFS) of 14-52 months and overall survival (OS) often exceeding 3 years, suggesting better disease control than continued TKI therapy alone. Although PFS generally improves, some cohorts show no OS advantage, probably because effective post-progression treatments dilute survival differences. Non-surgical local consolidative therapies remain essential for oligometastatic disease; nevertheless, resection yields intact specimens for comprehensive pathologic and molecular analysis. Access to tissue permits earlier identification of resistance mechanisms-most commonly the T790M mutation-more accurate prognostication, and more precise systemic-therapy selection. Comprehensive sampling can also identify histologic transformation and compound mutations that precede radiologic progression. Adverse prognostic factors include older age, high preoperative carcinoembryonic antigen levels, advanced pathological T stage, programmed death-ligand 1 ≥1%, and spread through air spaces. Salvage surgery is feasible and effective in carefully selected patients, especially those with oligoresidual disease and favorable tumor biology. Patient selection should integrate performance status, anatomic extent, histopathology, and genomic profile through multidisciplinary discussions. Despite regional differences (e.g., higher EGFR-mutation prevalence and wider adoption of minimally invasive approaches in East Asia) oncologic outcomes are comparable when selection criteria are applied consistently. Prospective trials are warranted to validate these retrospective observations, refine selection algorithms, establish optimal timing, and clarify how surgery can best be integrated with next-generation targeted agents and immunotherapies.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795685","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}