Pulmonologiya最新文献

{"title":"Contribution of the intestinal current measurement method to assessment of the efficacy of CFTR modulators in cystic fibrosis","authors":"Y. Melyanovskaya","doi":"10.18093/0869-0189-2024-34-2-283-288","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-34-2-283-288","url":null,"abstract":"Cystic fibrosis (CF) is a disease caused by pathogenic variants of the CFTR gene. In the last decade, the treatment algorithm has entered a new era as several drugs have become available that restore the function of the CFTR chloride channel and are called CFTR modulators. The efficacy and safety of targeted drugs in cystic fibrosis needs to be further investigated using additional assessment methods.The aim of this study was to investigate the role of intestinal current measurement (ICM) in assessing the efficacy of targeted therapy for cystic fibrosis.Methods. The efficacy of CFTR modulator therapy was evaluated in 15 patients, of which 10 were children and 5 were adults. In addition to the ICM method, patients’ clinical parameters, sweat test, and pulmonary function were also evaluated according to clinical guidelines.Results. Patients with genotypes 2143delT/7121G>T and G542X/R785X had no restoration of chloride channel function with elexacaftor + tezacaftor + ivacaftor therapy, and patients with the L467F;F508del genotype with lumacaftor + ivacaftor therapy. In patients with the F508del/F508del, N1303K/G461E, N1303K/3321delG genotype, improvements were noted in terms of the restoration of CFTR channel function during therapy with elexacaftor + tezacaftor + ivacaftor therapy, and in patients with the F508del/F508del genotype during therapy with tezacaftor + ivacaftor therapy and lumacaftor + ivacaftor.Conclusion. Restoring the function of the epithelial chloride channel (CFTR) is the basis for increasing life expectancy in CF. The crucial role of the ICM method in determining the efficacy of CFTR modulators is shown.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"825 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776925","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":"Swyer – James – McLeod syndrome in an adult male","authors":"A. М. Makarevich, A. Zaytsev, E. М. Makarevich","doi":"10.18093/0869-0189-2024-4363","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-4363","url":null,"abstract":"Swyer – James syndrome, also called Swyer – James – MacLeod syndrome (SJMS), is a rare acquired disorder characterized by pulmonary artery hypoplasia, unilateral hyperlucent lungs, and usually also bronchiectasis. Adults with SJMS are often diagnosed with and treated for chronic obstructive pulmonary disease (COPD), bronchial asthma, pneumothorax, or pulmonary embolism due to the similar clinical manifestations. Underestimation of an important radiological sign – unilateral “impoverishment” of the pulmonary pattern and hyperlucent lung – leads to erroneous diagnosis and inadequate treatment. Diagnosis of SJMS involves a computed tomography scan of the chest. The aim of this work was to familiarize readers with aspects of diagnosis and detail the clinical, radiological, and other characteristics of a patient with McLeod syndrome. The described adult man was diagnosed with SJMS at the age of 32. Some typical mistakes in examinations of such patients and the lack of vigilance of radiologists in case of unilateral hyperlucent lung are presented. Conclusion. Using the example of a rare clinical case of SJMS, we demonstrated the need to consider this syndrome when diagnosing adults with unjustified shortness of breath and a history of frequently recurrent pulmonary infections, with radiological signs of unilateral pulmonary emphysema and hyperlucent lung. According to the literature and our observations, computed tomography of the chest organs is a fast and reliable method for establishing the diagnosis of SJMS.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"42 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140431522","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":"Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia in adults","authors":"G. E. Baimakanova, N. D. Kirichenko, N. Karnaukhov, E. M. Kolyago, O. Brodskaya, I. N. Butyugina, D. Gripas, S. K. Ukolova","doi":"10.18093/0869-0189-2024-4313","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-4313","url":null,"abstract":"Diffuse Idiopathic Pulmonary NeuroEndocrine Cell Hyperplasia (DIPNECH) is an understudied rare disease that should be taken into account in the differential diagnosis of therapy-resistant bronchial obstruction combined with focal pulmonary lesions and mosaic attenuation on chest CT. The aim of this article is to discuss the aspects of clinical and morphological diagnosis, therapeutic options, prognosis assessment, and the need for follow-up using a clinical case as an example. The article describes a clinical case of DIPNECH in a 55-year-old woman, and also provides a brief review of the scientific literature on DIPNECH. DIPNECH is a rare disease that most often affects non-smoking women aged around 60 years. The most frequent clinical manifestations are cough, dyspnea, stridor, and broncho-obstructive syndrome. Only histological and immunohistochemical assays can confirm the diagnosis. DIPNECH should be considered as part of the differential diagnosis in patients with prolonged cough, dyspnea of unclear genesis and changes on chest CT in the form of pulmonary focal lesions and mosaic attenuation. Conclusion. The presented clinical case shows the challenges and importance of timely diagnosis.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"43 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140431286","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":"Current views on the functional role of hydrogen and its kinetics in the human body","authors":"О. S. Medvedev","doi":"10.18093/0869-0189-2024-34-1-7-18","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-34-1-7-18","url":null,"abstract":"The purpose of this overview was to present historical data on the discovery of hydrogen and a brief summary of its physical properties that form the basis for its use in aeronautics. Information is provided on the use of hydrogen, a biologically neutral molecule, in medicine as a diagnostic indicator for penetrating wounds of the gastrointestinal tract, the determination of local blood flow using the hydrogen clearance method, the use of the hydrogen breath test for the diagnosis of malabsorption and carbohydrate intolerance, achlorhydria, the diagnosis of bacterial overgrowth syndrome, the assessment of biodegradation of magnesium-containing implants, the orocecal transit time, and during deep-sea diving. The reasons for the sharp increase in the doctors’ interest in studying the biological role of hydrogen after the discovery of its antioxidant properties by a group of Japanese scientists (2007) are analyzed. In order to increase antioxidant protection of the body, data from recent research on ways to increase its concentration in the body through the supply of exogenous gas by inhalation or by administering hydrogen-rich water or saline solution is presented. Particular attention is paid to a critical analysis of studies on the kinetics of hydrogen by different routes, its concentration in blood and tissues, inhalation, and the use of hydrogen-rich water. Based on an analysis of publications, that the use of molecular hydrogen to relieve oxidative stress in the tissues of the intestines, liver and lungs is most promising, since its highest concentration is found in these tissues. Fermentation of carbohydrates has also been shown to increase the production of hydrogen by the intestinal  microbiota. Considering that a large number of molecular hydrogen generators appeared on the market, the data on the requirements for their safety are summarized. Considerations on the use of molecular hydrogen for the purpose of antioxidant protection of the body in cardiology, gastroenterology, pulmonology, and other areas of medicine are based on modern views on the mechanisms of antioxidant, anti-apoptotic, cytoprotective, and anti-inflammatory effects of hydrogen. Particular attention is paid to the analysis of experimental and clinical research on the use of hydrogen in acute and chronic lung lesions, therapy of acute and chronic COVID-19 infection.Conclusion. Based on an analysis of the literature and our own data, a conclusion was drawn on the safety and prospects of the clinical use of molecular hydrogen in a wide range of concentrations in many diseases with the pathogenesis based on oxidative stress. In particular, the need for additional research was highlighted to clarify the regimen, frequency, duration and concentrations of hydrogen used, and a personalized approach to the combination of endogenous (from the intestinal microbiota) and exogenous hydrogen in various diseases.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"29 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140445162","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 first experience of the combined use of nitric oxide and molecular hydrogen for cardiac surgery in high-risk patients","authors":"V. Pichugin, A. V. Deryugina, S. Domnin, A. S. Shirshin, S. A. Fedorov, S. N. Buranov, S. A. Jourko, M. Ryazanov, Yu.D. Brichkin, D. A. Danilova","doi":"10.18093/0869-0189-2024-34-1-32-41","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-34-1-32-41","url":null,"abstract":"The purpose of the study was to evaluate the effectiveness of myocardial protection with a combined supply of nitric oxide (NO) (40 ppm) and hydrogen (1.2 ppm) into the gas-air mixture delivery line of the cardiopulmonary bypass (CPB) machine during the entire period of CPB.Methods. The study included patients (n = 91) who had cardiac surgery under cardiopulmonary bypass and pharmacological cold cardioplegia. Patients were randomized into 3 groups. The Group 1 (n = 30) was control. Groups 2 (n = 28) and 3 (n = 33) received an isolated supply of NO (40 ppm) and a combined supply of NO (40 ppm) and hydrogen (1.2 ppm) into the extracorporeal IR circuit, respectively. During the postoperative period, clinical and functional indicators were studied (dynamics of myocardial contractile function according to ultrasound data); duration of artificial pulmonary ventilation (ALV); stay in the intensive care unit; hospital stay; mortality; level of marker of myocardial injury – troponin I (cTnI). Myocardial injury index (MII) was calculated to assess the degree of injury.Results. It was found that the level of cTnI in the postoperative period increased statistically significantly in all groups but was statistically significantly lower in Groups 2 and 3 compared to Group 1 at the end of the surgery and 12 and 24 hours after the surgery. Also, level of cTnI was statistically significantly lower in Group 3 at all stages of the study compared to Group 1 and after 12, 24 and 48 hours compared to Group 2. Statistically significantly lower MII values were revealed at all stages of the postoperative period in Group 3 compared with Groups 1 and 2. Changes in indicators of myocardial contractile function suggest an earlier and more complete recovery in Groups 2 and 3 (the changes were statistically significantly higher than that in Group 1). In Groups 2 and 3, the incidence of acute heart failure was statistically significantly lower (p = 0.046) compared to Group 1, according to Fisher’s exact test. There were no statistically significant differences in the incidence of acute respiratory and multiple organ failure in Groups 2 and 3 compared to Group 1. Also, patients of Groups 2 and 3 did not experience any complications in the early postoperative period. In Group 3, there was a statistically significant decrease in the duration of mechanical ventilation and stay in the intensive care unit after surgery compared to Group 2.Conclusion. Isolated supply of NO into the IR circuit has an additional cardioprotective effect, which is confirmed by statistically lower levels of troponin I and smaller changes in the indicators of myocardial contractile function during the postoperative period compared to standard technology. A more pronounced protective effect on the myocardium was shown with the combined supply of NO and molecular hydrogen to the IR circuit as seen by statistically lower levels of troponin I and MII in the postoperative period compared with the isolated supply ","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140444679","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":"Effect of hydrogen inhalation on cardiovascular and interstitial components of pulmonary hypertension in rats","authors":"T. Kuropatkina, K. Gufranov, F. Sychev, M. Artemieva, G. N. Bondarenko, D. I. Esaulenko, T. V. Samoylenko, V. V. Shyshkina, N. Medvedeva, O. Medvedev","doi":"10.18093/0869-0189-2024-34-1-19-30","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-34-1-19-30","url":null,"abstract":"Hydrogen is known to have selective antioxidant properties. It binds highly reactive hydroxyl radicals. The pathogenesis of the monocrotaline animal model of pulmonary hypertension is associated with oxidative stress and leads to all the symptoms of pulmonary hypertension (PH) and interstitial lung disease (ILD) associated with hypertension.The aim of this work was to study the effect of 4% hydrogen inhalations on the symptoms of PH and ILD in rats.Methods. To model monocrotaline-induced pulmonary hypertension (MCT-PH), two groups of animals received a single subcutaneous injection of monocrotaline (MCT) on day 1. The control group was injected subcutaneously with MCT solvent only. The animals receiving MCT were further divided into 2 subgroups. Subgroup 1 rats breathed room air and subgroup 2 rats breathed a mixture of room air and 4% hydrogen. The regular inhalations continued until day 21. On day 21, hemodynamic parameters were measured under urethane anesthesia, the heart and its components and the lungs were weighed, and lung tissue was preserved for morphological study.Results. The inhalation had no effect on the main cardiovascular symptoms of PH, but a positive effect on the state of the connective tissue of the lungs affected by PH was shown. The mast cell response was reduced both quantitatively and functionally. There was a decrease in tryptase expression by mast cells, with predominance of the forms without signs of degranulation. TGF-β secretion was also significantly reduced and visualized by immunopositive cells in alveolar cellular structures and vessel walls.Conclusion. Inhalation of 4% hydrogen reduces inflammation and fibrosis of lung tissue during the development of MCT-PH. ","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"15 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442749","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 case of severe pneumonia complicated by sepsis, endocarditis, and prolonged comatose state, with successful rehabilitation","authors":"N. N. Pribylova, E. A. Shabanov, S. A. Pribylov, K. O. Leonidova, V. S. Pribylov","doi":"10.18093/0869-0189-2024-34-1-122-128","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-34-1-122-128","url":null,"abstract":"Sepsis with acute organ dysfunction is an urgent problem of modern healthcare. A clinical case of a 38-year-old young woman with communityacquired severe viral-bacterial pneumonia complicated by sepsis, endocarditis, and multiple organ failure is presented. On the 68th day of her stay in the intensive care unit (ICU), the patient was brought out of comatose state and transferred to the pulmonology department for rehabilitation.The purpose of the work was to demonstrate the significance of this clinical case because of the urgent need to increase the effectiveness of treatment and long-term rehabilitation of patients with this severe comorbid pathology.Conclusion. Early diagnosis is extremely important to select effective treatment. The Quick SOFA (Sepsis-related sequential Organ Failure Assessment) score should be used to identify patients with suspected sepsis outside the ICU. This score is based on simple and accessible clinical characteristics that do not require laboratory analysis of homeostatic parameters. The patient was discharged in satisfactory condition to continue rehabilitation in outpatient settings.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"128 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140451804","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":"Use of inhaled nitric oxide in COVID-19","authors":"H. C. Nguyen, D. D. Pozdnyakova, I. A. Baranova, A. G. Chuchalin","doi":"10.18093/0869-0189-2024-4305","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-4305","url":null,"abstract":"Inhaled nitric oxide (iNO) is being considered as a potential therapeutic intervention for COVID-19 and post-COVID syndrome due to its various mechanisms such as vasodilation, antiviral activity, antithrombotic and anti-inflammatory effects. There is currently a lack of information on patient selection criteria, optimal dosing, duration and timing of administration, and methods of administration. These factors are of substantial importance for the efficacy of iNO therapy.Aim. To discuss the physiological basis of using inhaled nitric oxide for treating patients with COVID-19 and post-COVID syndrome, analyze the research findings, and present the achievements in nitric oxide synthesis technology in medicine.Conclusion. The early initiation and use of high-dose iNO appears to be an effective and safe treatment strategy for patients with COVID-19, as it targets the basic pathological mechanisms of the disease. iNO may also be a promising therapeutic option for patients with post-COVID syndrome. However, the optimal dosing regimen, continuous or intermittent, warrants further investigation. Recent advances in nitric oxide synthesis technology are of great significance for the broad practical application of iNO therapy.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":" 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139790734","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":"Use of inhaled nitric oxide in COVID-19","authors":"H. C. Nguyen, D. D. Pozdnyakova, I. A. Baranova, A. G. Chuchalin","doi":"10.18093/0869-0189-2024-4305","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-4305","url":null,"abstract":"Inhaled nitric oxide (iNO) is being considered as a potential therapeutic intervention for COVID-19 and post-COVID syndrome due to its various mechanisms such as vasodilation, antiviral activity, antithrombotic and anti-inflammatory effects. There is currently a lack of information on patient selection criteria, optimal dosing, duration and timing of administration, and methods of administration. These factors are of substantial importance for the efficacy of iNO therapy.Aim. To discuss the physiological basis of using inhaled nitric oxide for treating patients with COVID-19 and post-COVID syndrome, analyze the research findings, and present the achievements in nitric oxide synthesis technology in medicine.Conclusion. The early initiation and use of high-dose iNO appears to be an effective and safe treatment strategy for patients with COVID-19, as it targets the basic pathological mechanisms of the disease. iNO may also be a promising therapeutic option for patients with post-COVID syndrome. However, the optimal dosing regimen, continuous or intermittent, warrants further investigation. Recent advances in nitric oxide synthesis technology are of great significance for the broad practical application of iNO therapy.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"121 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139850502","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 potential use of N-acetylcysteine in respiratory conditions","authors":"V. Antonov, G. Ignatova, M. Belsner","doi":"10.18093/0869-0189-2024-34-1-105-113","DOIUrl":"https://doi.org/10.18093/0869-0189-2024-34-1-105-113","url":null,"abstract":"Currently, despite the accumulated experience with the use of N-acetylcysteine (NAC) in scientific and real clinical practice, there are a number of questions about its potential and the future prospects for its use.The aim of this work was to summarize new data on the use of NAC in patients with various conditions, based on publications in domestic and foreign medical journals.Results. The article presents an overview of publications in domestic and foreign medical journals devoted to the use of N-acetylcysteine (NAC) in pulmonology practice. The experience with the use of NAC in chronic bronchitis (CB), chronic obstructive pulmonary disease (COPD), bronchial asthma, community-acquired pneumonia, idiopathic pulmonary fibrosis, postinfectious bronchiectasis, and acute respiratory distress syndrome associated with COVID-19 (COronaVIrus Disease 2019) is summarized. The aspects of dose-dependent clinical effects and long-term administration of NAC in CB and COPD are analyzed. In addition, there are controversial and contradictory data on the possibility of prescribing NAC for idiopathic pulmonary fibrosis.Conclusion. NAC is a drug with a broad spectrum of action. Due to its antioxidant and anti-inflammatory properties, minor side effects compared to other anti-inflammatory drugs even at high doses, and low price, NAC can be prescribed for many respiratory diseases. Although it has been used for more than half a century, interest in both its practical application and clinical research has not waned to this day.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"465 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140471505","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}