Khirurgiya最新文献

{"title":"[Treatment of patients with obstructive jaundice in the flagship center].","authors":"S S Petrikov, E A Kiselev, P A Yartsev, S V Novikov, M L Rogal, A M Shadiev, Yu S Teterin","doi":"10.17116/hirurgia20250515","DOIUrl":"https://doi.org/10.17116/hirurgia20250515","url":null,"abstract":"<p><strong>Objective: </strong>To improve treatment outcomes in patients with obstructive jaundice at the flagship center through distributing patient flows and applying optimal tactics.</p><p><strong>Material and methods: </strong>A retrospective study included patients with obstructive jaundice between January 2022 and April 2024. Patients were divided into 2 groups: the main group - patients hospitalized between March 2023 and April 2024 (the first year of work of the flagship center); the control group - patients hospitalized between January 2022 and February 2023 (one year before the commissioning of the flagship center). In both groups, we analyzed gender- and age-adjusted distribution of patients, channels of hospitalization, severity of obstructive jaundice and its etiology, nature and number of surgical interventions, postoperative morbidity and mortality. Mean time to diagnosis, waiting time for surgery, postoperative and overall hospital-stay were compared.</p><p><strong>Results: </strong>There was significantly lower postoperative morbidity in the main group (<i>p</i><0.05). Moreover, the same group was characterized by significantly shorter time for diagnosis (3.4 versus 12.1 hours; <i>p</i><0.0001), earlier surgical treatment (6.8 versus 17.4 hours; <i>p</i><0.0001), postoperative (2.8 versus 5.7 days) and overall hospital-stay (3.6 versus 6.4 days).</p><p><strong>Conclusion: </strong>The capabilities of the flagship center make it possible to provide specialized high-tech medical care within the first hours after admission, significantly reduce the time for correct diagnosis and period until surgery. Original algorithm for patient distribution and optimal tactics based on minimally invasive technologies significantly improved treatment outcomes in patients with obstructive jaundice.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040118","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":"[Personalized prediction of acute pancreatitis after endoscopic transpapillary interventions].","authors":"Yu I Vedenin, M I Turovets, V V Mandrikov, G V Mikhailichenko","doi":"10.17116/hirurgia202501129","DOIUrl":"10.17116/hirurgia202501129","url":null,"abstract":"<p><strong>Objective: </strong>To develop the personalized model for predicting the risk of acute pancreatitis after endoscopic transpapillary interventions.</p><p><strong>Material and methods: </strong>A retrospective analysis of treatment outcomes included 366 patients with benign and malignant pancreaticobiliary diseases who underwent endoscopic transpapillary interventions. Risk factors associated with patients, underlying diseases and interventions were analyzed. Logistic regression analysis was used to present the personalized model for predicting the risk of acute pancreatitis.</p><p><strong>Results: </strong>Female gender (<i>p</i>=0.028), age <40 years (<i>p</i>=0.001-0.018), calculous cholecystitis (<i>p</i>=0.010) and stenosis of the major duodenal papilla (<i>p</i>=0.008) are patient-associated risk factors of acute postoperative pancreatitis. Stenting of the main pancreatic duct and thoracic epidural analgesia reduced this risk by 6.5 and 4.6 times, respectively. We developed significant (<i>p</i><0.001) regression model to determine the likelihood of acute post-manipulation pancreatitis.</p><p><strong>Conclusion: </strong>Original prediction model is valuable to determine the risk of acute pancreatitis after endoscopic transpapillary interventions. This model justifies various methods to prevent this complication.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123607","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":"[Pulmonary distress syndrome in urgent surgery: A concept, pathogenesis, and fundamentals of treatment].","authors":"A P Vlasov, V A Trofimov, T I Vlasova, N A Myshkina, T A Muratova, N Y Leshchankina, K M Dukhovnova","doi":"10.17116/hirurgia202502177","DOIUrl":"10.17116/hirurgia202502177","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To study several non-respiratory lung functions in conjunction with the respiratory component in acute abdominal diseases with different natures of the inflammatory process; to identify the key mechanisms of organ damage; and, based on the data, establish a new syndrome in urgent surgery-pulmonary distress syndrome-and evaluate the effectiveness of Remaxol in its treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Chronic experiments have been done on dogs. Under anesthesia, progressive acute peritonitis was simulated in the first group (24) (the first subgroup (12) received infusion therapy, the second subgroup (12) received Remaxol (20 mL/kg)), in the second group (8) acute destructive pancreatitis, in the third group (8) acute obstructive ileus. The treatment outcomes of 78 patients with acute surgical pathology of the abdomen were analyzed: 38 patients with acute peritonitis caused by destructive appendicitis, hollow viscus perforation (the first subgroup (16) received standard of care, in the second (22) Remaxol was added to the standard of care); 18 with acute severe pancreatitis complicated by enzymatic peritonitis, 22 with acute intestinal obstruction. Surgeries were performed on all the patients. The extension and type of the surgeries depended on the condition. In the early postoperative period (up to 5 days), several indicators of respiratory lung function were evaluated in the experiment and patients, and non-respiratory function was assessed using several indicators of arterial and venous blood. In the experiment, the state of lipid metabolism and the hemostasis system was assessed in lung tissues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;It was established that in acute abdominal diseases, lung damage occurs regardless of the nature of the inflammatory process. It manifested not only with changes in the homeostasis indicators due to modifications of the respiratory component but also non-respiratory functions of the organ. It was shown that the signs of the non-respiratory dysfunction of the lungs, as indicated by the parameters of blood inflowing to the lungs and outflowing from the lungs, included a deterioration in their detoxification and lipid-modifying ability and changes in the blood coagulation system. The key and unifying feature of respiratory and non-respiratory lung damage in various types of inflammatory processes are disorders of the lipid metabolism of lung cells. In the pathogenesis of membrane destabilization, the peroxidation of membrane lipids and the high activity of phospholipases play a decisive role. In the pathological process, a certain role is assigned to the tissue (pulmonary) coagulation-lytic system. The inclusion of Remaxol in the treatment of acute peritonitis increased lung tolerance to trigger pathogenetic agents, as indicated by improved laboratory and clinical parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Experimental and clinical evidence was obtained for establishing th","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366155","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":"[Improvement of surgical strategy for acute biliary pancreatitis].","authors":"B M Belik, Z A Abduragimov, R Sh Tenchurin, A V Rodakov, S Yu Efanov","doi":"10.17116/hirurgia202503140","DOIUrl":"10.17116/hirurgia202503140","url":null,"abstract":"<p><strong>Objective: </strong>To improve surgical tactics for acute biliary pancreatitis.</p><p><strong>Material and methods: </strong>Treatment outcomes were analyzed in 502 patients with acute biliary pancreatitis. Patients were divided into two groups depending on surgical tactics: control group (<i>n</i>=293) - standard diagnosis and treatment of biliary pancreatitis, main group (<i>n</i>=209) - treatment of biliary pancreatitis based on original algorithm. In these patients, therapeutic and diagnostic program included functional state of biliary tract and stratification of patients depending on severity of acute pancreatitis (APACHE II and Imrie/Glasgow scale) in addition to standard procedures.</p><p><strong>Results: </strong>There are 2 fundamentally different clinical variants of ductal hypertension and biliary pancreatitis: with acute blockade of pancreatobiliary tract (obstructive variant) and without this blockade (non-obstructive variant). Each variant included various clinical forms of acute biliary pancreatitis etiologically associated with specific biliary disease. In the 2^nd group, a differentiated surgical approach was applied taking into account clinical variant of biliary pancreatitis. The first stage implied correction of pancreatobiliary ductal hypertension through minimally invasive methods. At the second stage, radical surgical debridement of biliary tract was performed with elimination of etiological factor of biliary pancreatitis within the same hospitalization in patients with mild-to-moderate disease. In patients with severe biliary pancreatitis, the second stage of treatment was carried out 3 months after discharge. This treatment strategy reduced the number of infectious and inflammatory complications from 26.6% to 11.5%, mortality from 7.5% to 3.3% and avoid recurrent biliary pancreatitis.</p><p><strong>Conclusion: </strong>Original therapeutic and diagnostic algorithm optimizes surgical strategy and improves the effectiveness of treatment of acute biliary pancreatitis.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"40-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658835","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":"[Surgical access for thoracic and intrathoracic goiter].","authors":"L P Kotelnikova, S A Plaksin","doi":"10.17116/hirurgia202501154","DOIUrl":"10.17116/hirurgia202501154","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of surgical approach for resection of retrosternal and intrathoracic goiter.</p><p><strong>Material and methods: </strong>There were 33 patients who underwent surgery for retrosternal (31) and intrathoracic goiter (2) through various surgical approaches. For retrosternal goiter, a Farabeuf hook was used to remove a large retrosternal component of tumor.</p><p><strong>Results: </strong>In 28 cases (84.8%), substernal goiter was resected through cervical collar incision. In 4 cases, a Farabeuf hook was used to extract retrosternal part of the goiter to the neck and avoid sternotomy. In one case, a combined approach was used (thoracoscopy and cervical collar incision). Sternotomy was performed in only one patient for suspected thyroid malignancy. In two patients with tumors of posterior mediastinum, intrathoracic goiter was removed through thoracoscopic access.</p><p><strong>Conclusion: </strong>Cervical collar incision allows resection of retrosternal goiter in 84.4% of cases. Retrosternal part can be effectively displaced to the neck wound using a Farabeuf hook. Thoracoscopy is preferable for removal of intrathoracic goiter and can be used to mobilize a large node in mediastinum as an alternative to sternotomy.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123679","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 use of low-frequency ultrasound in the treatment of patients with infected pancreatic necrosis].","authors":"A M Zainutdinov, I S Malkov, A V Berdnikov","doi":"10.17116/hirurgia202502186","DOIUrl":"10.17116/hirurgia202502186","url":null,"abstract":"<p><strong>Objective: </strong>To improve the treatment of patients with infected pancreatic necrosis by using non-contact ultrasound treatment of purulent-necrotic foci (NUST).</p><p><strong>Material and methods: </strong>We analyzed the results of treatment of 39 patients with infected pancreatic necrosis, admitted to the surgical department No. 2 of the City Clinical Hospital No. 7 in Kazan from 2017 to 2021. The central method of their surgical treatment was open draining operations combined with sequestrectomy. The study group consisted of 20 patients (4 women, 16 men) aged from 39 to 60 years (mean age - 49±9.5 years). In this group, the effectiveness of non-contact ultrasound treatment of purulent-necrotic foci using the SONOCA-185 apparatus was studied.</p><p><strong>Results: </strong>The application of ultrasound treatment of purulent foci of infected pancreatic necrosis in the study group allowed to increase their drainage effectiveness, which was reflected in the dynamics of reparative-proliferative process and relief of systemic inflammatory reaction. Wound healing occurred on the 7-9 day (on average, on the 7.6±2^th day) without resuturing.</p><p><p>The pronounced bactericidal effect of low-frequency ultrasound and its phonophoretic effect are confirmed by the reduction of microbial content of wounds and cavities from 105 CFU and 104 CFU to 102 CFU after 3 sessions.</p><p><p>The sparing ultrasound sequestrectomy allows to remove only devitalized tissues, without causing destructions of the ductal system, vascular wall and hollow organs.</p><p><p>Ultrasound treatment of cavities in the study group resulted in a pronounced increase in transparency indicators and its approximation to reference solution, decreased peripheral blood leukocytosis, temperature reaction in patients on the 3^rd, 7^th, 12^th days compared to the control group, where the temperature response is maintained at this time, and reduction in hospitalization duration on the 2.6±1 day in the study group of patients.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"86-93"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366163","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":"[Amputation risk scale in patients with acute limb ischemia].","authors":"N G Khorev, A A Chichvarov, S V Sapelkin, A V Beller","doi":"10.17116/hirurgia202503169","DOIUrl":"10.17116/hirurgia202503169","url":null,"abstract":"<p><strong>Objective: </strong>To create a scale for predicting amputation in patients with acute limb ischemia.</p><p><strong>Material and methods: </strong>We retrospectively analyzed inpatient treatment data of 1.353 patients over a 22-year period. Patients were divided into two groups depending on limb salvage (<i>n</i>=1.212) and limb loss (<i>n</i>=141). Six factors influencing the risk of limb amputation were identified, and odds ratio for each factor was assessed.</p><p><strong>Results: </strong>A scoring scale including 15 clinical and laboratory parameters was created. Prognostic ability of the scale was assessed using ROC analysis. AUC was 0.794 with 95% CI 0.755-0.833. The median score for group 1 (limb salvage) was 17 [14; 21], for group 2 (amputation) - 23 [19; 26] (<i>p</i><0.0001). We stratified groups of low (up to 4.2%), medium (4.3-19.2%) and high (19.3-55.7%) risk of limb amputation in patients with acute limb ischemia.</p><p><strong>Conclusion: </strong>A simple scale for assessing the probability of limb amputation in patients with acute ischemia was developed. Practical application of this tool is possible in surgical and specialized departments.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658913","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":"[Hand burns in pediatrics].","authors":"L I Budkevich, V V Soshkina, V S Zhamnova","doi":"10.17116/hirurgia202503196","DOIUrl":"10.17116/hirurgia202503196","url":null,"abstract":"<p><p>Burns of the hands in pediatrics are an important topic in combustiology. The hand plays a huge role in the development of mental and physical skills in a child. A retrospective analysis of electronic medical records of 282 victims with hand burns who were treated in Moscow Pediatric Hospital No. 9 named by G.N. Speransky was carried out. The study showed that most often children receive burns of the hands in the first three years of life, the main thermal agent is hot liquid. 35 patients had different types of surgery: excision with one stage or delayed grafting, enzymatic debridement and mechanical debridement. Silver containing atraumatic hydrocolloid dressings were used on all stages of treatment. Clinical examples demonstrate different variants of surgical tactics used in children from 0 till 6 years. Surgery types depend of the depth of damage to the integumentary tissues and deep structures of the hand and fingers. The work highlights diagnostic and clinical approaches to the management of patients with this pathology. The algorithm of conservative and surgical treatment of patients with burns II-III and III degree in the area of the palmar and dorsal surfaces of the hand and fingers is presented. This algorithm also includes tactics at rehabilitation stages restoring functional and aesthetic disorders. Compliance all recommendations contributes to the speedy socialization of patients in this age group.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"96-106"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658923","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":"[Universal intestinal suture in rehabilitation of patients with single-layer anastomoses after elective upper gastrointestinal tract surgery].","authors":"S R Bashirov, S S Klokov, V A Korepanov, D V Krinitsky, N S Rudaya, M B Arzhanik","doi":"10.17116/hirurgia202501137","DOIUrl":"10.17116/hirurgia202501137","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate universal intestinal suture in rehabilitation of patients with single-row anastomoses after elective upper gastrointestinal tract surgery.</p><p><strong>Material and methods: </strong>A single-center study included 142 patients over 8-year period. There were 72 (50.7%) pancreaticoduodenectomies and 70 (49.3%) gastric resections and gastrectomies. The rehabilitation program included single-layer anastomoses using universal intestinal suture, intestinal drainage for decompression and enteral nutrition, therapeutic and diagnostic endoscopy to stimulate motor evacuation function, patency of anastomoses and assessment of anastomositis.</p><p><strong>Results: </strong>Intestinal drainage for decompression and enteral nutrition was used for 6 (4; 7) days after surgery. Intraluminal endoscopy was performed after 9 (7; 11) days. In patients with anastomositis grade 0 (26.5%) and 1 (62.4%), we observed minimal inflammation along intestinal suture line (mean hospital-stay 16 (13; 20) days). In patients with anastomositis grade 2 (8.5%) and 3 (2.6%), we observed surface erosions and ulcers in the anastomosis zone (mean postoperative hospital-stay 20 (16; 27) days). Postoperative complications unrelated to anastomoses were diagnosed in 17.6% of cases; 12% of patients underwent redo surgery. Mortality rate was 2.8%.</p><p><strong>Conclusion: </strong>Universal intestinal suture in rehabilitation of patients with single-layer anastomoses contributed to uncomplicated healing of anastomoses in 88.9% of patients with anastomositis grade 0-1 and reduced the incidence of anastomositis grade 2-3 to 11.1%, as well as hospital-stay after elective upper gastrointestinal tract surgery.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"37-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123684","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":"[Extracervical approach for retrosternal goiter].","authors":"A A Pechetov, N V Gulova, D A Volchansky, A N Lednev, A I Baeva, T N Khlan, I S Gruzdev","doi":"10.17116/hirurgia202505144","DOIUrl":"https://doi.org/10.17116/hirurgia202505144","url":null,"abstract":"<p><strong>Objective: </strong>To analyze treatment outcomes in patients with retrosternal goiter.</p><p><strong>Material and methods: </strong>There were 13 patients aged 32-77 years with retrosternal goiter between 2016 and 2024. The ratio of men and women was 2:11.</p><p><strong>Results: </strong>Twelve patients underwent thyroidectomy, one patient - video-assisted thoracoscopic thymectomy with resection of aberrant goiter. Among 12 patients, thyroidectomy through collotomy was performed in 6 patients, sternotomy was performed in 5 patients. Aberrant goiter was removed through thoracotomy in one patient with recurrent retrosternal goiter. Complicated postoperative period was observed in 4 patients. Two patients underwent postoperative tracheostomy (prevention of respiratory failure following high risk of bilateral paresis of recurrent laryngeal nerves in one case and laryngeal edema in the second case). There were no deaths in long-term period.</p><p><strong>Conclusion: </strong>Preoperative planning should include CT-based analysis of intrathoracic component of thyroid gland and volume of chest cavity. This is valuable to plan the optimal surgical approach and reduces the risk of intraoperative complications.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044172","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}