Gastroenterologie a Hepatologie最新文献

{"title":"Multimodal approach in the treatment of generalized malignancies of the gastrointestinal tract","authors":"Z. Bielcikova, J. Ulrych, V. Frýba, M. Zubal, Ľ. Křížová, L. Petruželka","doi":"10.48095/ccgh2022409","DOIUrl":"https://doi.org/10.48095/ccgh2022409","url":null,"abstract":"Summary: Background: More than 10,000 patients are diagnosed with malignant tumors of the intestine, pancreas, esophagus and stomach in the Czech Republic each year. A significant proportion of patients relapse or are primary diagnosed at a locally advanced inoperable or metastatic stage. The prognosis of these patients can be influenced by oncological treatment and in many cases also by surgical, endoscopic or radiological intervention. Methods: The article summarizes treatment options of patients with advanced or metastatic malignancies of the gastrointestinal tract from the perspective of oncologist and surgeon in order to present oncological data on prognosis of patients and surgical methods of treatment to other members of the multidisciplinary team. Endoscopic methods are consulted with gastroenterologist. Results: The importance of surgery is not the same for all mentioned cancer types and it is influenced by many variables. The highest benefit of the surgical treatment has resection of liver metastases of colorectal cancer, on the other hand, surgery has only limited palliative impact in pancreatic cancer patients. Conclusions: A multimodal approach to the treatment of tumors of the gastrointestinal tract offers the inclusion of surgical treatment at the present time even where it was not routinely recommended in the past. The condition for the correct indication of surgery is a multidisciplinary assessment of each individual patient. Key words: colorectal cancer – pancreatic cancer – esophageal cancer – stomach cancer – GIT malignancies – relapses – surgergical procedures","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73073735","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 rare cause of painless obstructive jaundice in the elderly – a case series","authors":"T. Koller, P. Vrbová, V. Gál, I. Mečiarová","doi":"10.48095/ccgh2022392","DOIUrl":"https://doi.org/10.48095/ccgh2022392","url":null,"abstract":"Summary: A series of two case reports discusses the differential diagnosis of painless jaundice in the elderly and points to autoimmune pancreatitis as one of its rarer causes. In search for the cause, the first step is to rule out the malignant origin of the obstruction using the clinical picture, imaging examinations, and EUS-guided biopsy. An imaging examination can initially point to the possibility of autoimmune pancreatitis, but in the case of focal pancreatic involvement the distinction from cancer is unreliable. Elevated concentration of IgG4 antibodies can further increase the probability of IgG4-associated pancreatitis. Histological examination of the pancreas will help reveal typical features of autoimmune pancreatitis such as lymphoplasmacytic infiltrate, storiform fibrosis, obliterating phlebitis and increased number of IgG4 positive plasma cells. Once the diagnosis is probable, it is advisable to start a treatment with steroids. A quick decrease in cholestatic markers and bilirubin is typical. Patients with autoimmune pancreatitis require long-term follow-up, to adjust the treatment in case of relapses, the risk of developing exocrine or endocrine insufficiency, and in case of IgG4 associated disease due to the risk of other organ systems involvement. The risk of pancreatic cancer is still a matter of discussion. Key words: autoimmune pancreatitis – IgG4 – obstructive jaundice – case report","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"120 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76291913","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":"Stent as a solution for perforation of the “black esophagus”","authors":"Miloš Rys, T. Fejfar, R. Repák, Š. Šembera, M. Kopacova, I. Tachecí","doi":"10.48095/ccgh2022442","DOIUrl":"https://doi.org/10.48095/ccgh2022442","url":null,"abstract":"Summary: “Black esophagus”, also known as acute esophageal necrosis (AEN), is a relatively rare disease characterized by black discoloration of the esophageal mucosa. The condition can be located only distally, but it can also affect the entire esophagus. Hematemesis is the most common clinical manifestation is; the condition is associated with increased lethality in high-risk groups of patients. Early diagnosis of AEN can be made by gastroscopy, the initiation of adequate treatment is crucial for a favorable patient prognosis. The most serious complications of AEN include esophageal perforation with the risk of other complications such as mediastinitis and sepsis. The nature of the disease and the affection of the esophagus and potentially the mediastinum require a multidisciplinary approach. Below we present a case report of a 68-year-old patient with a diagnosis of AEN complicated by perforation confirmed by CT and early endoscopy. An endoscopic approach with the introduction of a fully coated metal stent was chosen as the primary solution for the esophageal perforation. Nevertheless, the patient developed other complications of perforation: mediastinitis and empyema requiring chest drainage. In addition to interventional methods, the patient was treated with broad-spectrum antibiotics and a combination of parenteral and enteral nutrition. After 3 months of treatment and resolving the complications, the patient was released to outpatient care in a good clinical condition. Key words: acute esophageal necrosis – oesophageal perforation – mediastinitis – Danis stent – metallic stent","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80612514","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":"Association of non-alcoholic fatty liver disease with cardiac structural impairment","authors":"K. Demková, Tibor Varga, J. Tokarčík","doi":"10.48095/ccgh2022341","DOIUrl":"https://doi.org/10.48095/ccgh2022341","url":null,"abstract":"Summary: Non-alcoholic fatty liver disease encompasses a spectrum of pathologic entities ranging from liver steatosis through non-alcoholic steatohepatitis and fibrosis to cirrhosis of the liver. Patients with non-alcoholic fatty liver disease have a higher incidence of coronary artery disease, cardiovascular events due to atherosclerosis, both ischemic and haemorrhagic strokes, thromboembolic events, conduction system disorders, left ventricular dysfunction, and also cardiovascular mortality. Non-alcoholic fatty liver disease is also associated with structural abnormalities of the myocardium and valves. Non-alcoholic steatohepatitis develops in about 8–20% of obese patients with simple hepatic steatosis. The disease tends to progress and may be poorly controlled therapeutically. Non-alcoholic steatohepatitis increases the risk of mortality from cardiovascular disease by 2.1-fold and the risk of mortality from any cause by 2.3-fold. The inflammatory process in the liver may represent a major determinant of systemic complications in people with non-alcoholic fatty liver disease, so its assessment could be useful for cardiovascular risk assessment. Due to the documented association between the severity of hepatic steatosis assessed by ultrasonography and coronary or carotid atherosclerosis, ultrasonographic examination of the liver may be helpful in identifying people at high cardiovascular risk. The present case report confirms the importance of echocardiographic screening for structural and functional cardiac abnormalities in patients with chronic non-alcoholic steatohepatitis in order to initiate early treatment and improve their prognosis. Key words: non-alcoholic fatty liver disease – ultrasonography – echocardiography – screening","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85913451","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":"Lifestyle modification for improving anxiety and depression among patients with irritable bowel syndrome","authors":"S. Banihashem, Afrooz Ahmadi Ghadikolaee, A. Sadeghi, Reyhaneh Rastegar, Mona Mirzaei, Forough Yousefi Saber","doi":"10.48095/ccgh2022327","DOIUrl":"https://doi.org/10.48095/ccgh2022327","url":null,"abstract":"Summary: Objective: The aim of this study was to evaluate the beneficial effects of lifestyle modification and dietary intervention on the severity of symptoms, quality of life, anxiety and depression status in patients with irritable bowel syndrome. Methods: In this clinical interventional trial study, patients aged 15 to 65 years with IBS (based on the ROME IV criteria) who were referred to the gastrointestinal clinic of Taleghani hospital, Tehran, Iran between March 2020 and August 2020 were included. After initial evaluation, lifestyle modification intervention was performed. Statistical analysis was performed using SPSS software. Results: In the present study, 55 patients consisting in 27 men and 28 women with IBS were included. The patients‘ mean anxiety score (based on BAI) and mean depression score (based on BDI) were significantly reduced after lifestyle and diet modification intervention as compared to the baseline. The mean score of the patients‘ quality of life (based on IBS-QOL) was 68.36 ±24.90 before the intervention, which increased to 82.75 ±29.52 after the intervention, indicating a significant difference (P <0.001). Similarly, the mean score of severity of IBS symptoms (based on IBS-SSS) was 28.29 ±8.27 before the intervention, which was reduced to 20.87 ±8.47 after the intervention with a significant difference (P <0.001). Conclusion: Our findings suggest that lifestyle and dietary modification might be a feasible and effective treatment approach in patients with IBS, which has a positive and significant effect on amelioration of the severity of symptoms, improving the quality of life as well as alleviating symptoms of anxiety and depression. Key words: irritable bowel syndrome – anxiety – depression – quality of life – lifestyle modification","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"2006 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88203045","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":"Role of biological therapy in early Crohn’s disease: mini-review","authors":"L. Bajer","doi":"10.48095/ccgh2022296","DOIUrl":"https://doi.org/10.48095/ccgh2022296","url":null,"abstract":"disease (IBD). CD has progressive character and is associated with the development of various complications leading to potentially serious bowel damage (BD). Early stage of Crohn’s disease (eCD) is characterized by a specific immune response and represents an attractive target for specific agressive therapy. The use of bio­logics (BL) in eCD may help to prevent BD and allow early dose reduction or even discontinuation of BL. Wide scientific evidence supports the importance of BL in eCD based on studies with anti-TNF bio­logics (being part of clinical practice for relatively long time now). However, studies on novel bio­logics with low rate of the adverse events (vedolizumab, ustekinumab) also show promising results. Defining high-risk groups and suitable bio­markers would help to select those eCD patients who would benefit the most from early bio­logical therapy. Key words: inflammatory bowel disease – Crohn’s disease – bio­logical therapy","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78876604","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":"Liver cirrhosis in Roma patients from the perspective of the liver transplant centre","authors":"Ľ. Skladaný, Svetlana Adamcová Selčanová, Radovan Takáč, J. Vnencakova, Daniela Žilinčanová, Lukáš Lafférs","doi":"10.48095/ccgh2022334","DOIUrl":"https://doi.org/10.48095/ccgh2022334","url":null,"abstract":"Summary: Introduction: Slovakia is a country with the highest prevalence of liver cirrhosis in the world and a country with the highest proportion of Roma ethnicity at the same time. However, there is only little evidence of Roma representation in national cohorts with cirrhosis. Aims: 1. To determine the prevalence of Roma ethnicity in our cirrhosis and liver transplant registers; to compare their 2. fundamental characteristics and 3. final results with patients from the majority population. Patients and methods: A retrospective study; we acquired data from 1. Cirrhosis registry RH7; 2. Liver transplant registry: a) patients listed active on the liver-transplant waiting list; b) patients underwent first LT. The first source – the cirrhosis registry RH7 (NCT 04767945; since 2014, RH7 has been listing consecutive patients admitted to hospital with liver cirrhosis). Up to 2021, the mode of the ethnicity determination was so-called “ascribed ethnicity”. The second source – the Liver transplant registry (since 2008); the mode of ethnicity determination was identical to the one of RH7. Apart from the ethnicity, the following points were recorded and analyzed in all patients: demographics, elementary cirrhosis-relevant clinical variables such as etiology and MELD score, as well as an elementary LT-relevant variables, such as waiting time and mortality. Results: We present the results on Roma ethnic group in three cohorts from two datasets, i.e. on 1,515 patients from RH7, on 464 waitlisted patients from LT registry and on 302 transplanted patients from LT registry, respectively. The representation of Roma ethnicity in these cohorts were 2%, 4%, and 4%, respectively. Significant differences in age and gender were detected in Roma cirrhotic patients: 46 vs. 55 years (P = 0.001) and female gender 25% vs. 39% (P = 0.042). Of the first time waitlisted candidates for LT, Roma patients were also significantly younger – 42.6 vs. 51.5 years; in addition, Romas had a less prevalent alcohol-associated etiology (ALD) and a more prevalent autoimmune etiology. Finally, Roma patients after first LT were younger – 40.2 vs. 51.6 years, again with lower etiology of ALD – 15% vs. 47% and more autoimmune etiology – 39% vs. 23%. The results of Romas from all cohorts in tertiary care were comparable. Conclusion: 1. the admission of Romas to a tertiary liver care is lower than expected, for unknown reasons; 2. the age of Romas entering tertiary care is approximately ten years lower; 3. the results of Romas in tertiary care is comparable to the majority population. Key words: liver cirrhosis – Roma ethnicity – tertiary liver care – waiting list – liver transplantation","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87668752","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 ketamine, an NMDA-receptor antagonist, on gastric myoelectric activity in experimental pigs","authors":"J. Bureš, J. Kvetina, V. Radochova, M. Zavoral, S. Suchanek, S. Rejchrt, M. Valis, Veronika Knoblochová, J. Zdarova Karasova, O. Soukup, D. Kohoutová","doi":"10.48095/ccgh2022309","DOIUrl":"https://doi.org/10.48095/ccgh2022309","url":null,"abstract":"Summary: Introduction: Preclinical studies in experimental pigs are carried out mostly under general anaesthesia. Ketamine is commonly used for induction of anaesthesia. However, there are concerns that ketamine, an NMDA-receptor antagonist, may influence gastric motor function. The aim of this study was to investigate porcine gastric myoelectric activity by means of electrogastrography (EGG). Methods: Seventeen female animals (mean weight 36.2±3.8 kg) were enrolled. Drugs used for induction of anaesthesia were: Group A (n=5): medetomidine 0.1 mg/kg i. m.; butorphanol 0.3 mg/kg i. m.; midazolam 0.3 mg/kg i. m.; Group B (n=6): azaperon 2.2 mg/kg i. m.; Group C (n=6): ketamine 20 mg/kg i. m.; azaperon 2.2 mg/kg i. m., followed in all groups by i.v. 1% propofol (repeated one-mL boluses, 10–12 mL in total). EGG recording started 15 min. after the induction administration and lasted 30 min. Results were evaluated as the dominant frequency of gastric slow waves (DF) and EGG power (areas of amplitudes). Results: In total, 510 one-minute EGG intervals were assessed. DFs were (mean ± standard deviation): 1.4±0.4 (Group A), 1.3±0.3 (Group B) and 0.2±0.1 cycles per min. (Group C). The differences between group C and groups A and B were statistically significant (p<0.001). Median power (IQR) was 0.13 (0.02–0.44; Group A), 0.13 (0.03–0.54; Group B) and 0.30 V2 (0.07–1.44; Group C). The difference between groups A and C was of borderline significance (p=0.066; type 2 error beta 0.295). Conclusions: Ketamine, administered even in a single intramuscular dose, affected myoelectric function of the porcine stomach. Therefore, it should be avoided in gastrointestinal motility studies in experimental pigs. Key words: ketamine – NMDA (N-methyl-D-aspartate) -receptor antagonist – electrogastrography – myoelectrical activity – experimental pigs","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81251772","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":"Colorectal carcinoma after liver transplantation","authors":"J. Jungwirth, P. Mačinga, J. Kral, P. Taimr, J. Fronek, J. Spicak, T. Hucl","doi":"10.48095/ccgh2022302","DOIUrl":"https://doi.org/10.48095/ccgh2022302","url":null,"abstract":"Summary: Introduction: Patients after liver transplantation (LTx) have an increased risk of developing malignancies, especially skin malignancies and lymphomas. Colorectal cancer is one of the most common malignancies, its incidence may be higher after transplantation of certain organs. In liver transplant patients, the risk of developing CRC is not clearly known. Aim and methods: The aim of this work was to evaluate the incidence of CRC in patients after liver transplantation and to enrich these data with our own experience from our transplant center. Results: In the literature, the documented incidence of colorectal cancer ranges from comparable to twice as high, compared to the general population. Most studies evaluate incidence of different tumors after transplantatin of various organs irrespective of the indication for transplantation. An unequivocally proven risk factor is the presence of primary sclerosing cholangitis by ulcerative colitis, which is, however, a precancer in itself. Studies in which non-PSC and UC liver transplant recipients were evaluated separately mostly did not show an increased risk of CRC. Conclusion: According to most studies, the incidence of colorectal cancer in all liver transplant patients is slightly higher than in the general population. The risk of PSC/UC in liver transplant patients is significantly higher, which strongly supports the necessity of their regular endoscopic surveillance. In patients transplanted for other indications, the risk of developing CRC seems comparable with the general population. Posttransplant CRC is characterized by location in the right colon, diagnosis at a later stage and worse prognosis. Key words: transplantation – liver transplantion– colorectal carcinoma","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73305659","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":"Sarcopenia, myosteatosis and frailty in patients with liver cirrhosis","authors":"Denisa Kyselová, I. Mikova, P. Trunec̃ka","doi":"10.48095/ccgh2022288","DOIUrl":"https://doi.org/10.48095/ccgh2022288","url":null,"abstract":"Skeletal muscles are the biggest tissue in healthy people (30–40% of total body mass) and they comprise three quarters of total body proteins. Muscle alterations, especially muscle wasting and loss of muscle function, have an indisputable prognostic value in the outcome of chronic diseases, including chronic liver diseases. Muscle wasting is associated with higher morbidity, mortality and poor quality of life. The terms sarcopenia and myosteatosis are used to describe specific muscle alterations, both forming substantial components of multidimensional construct “frailty syndrome”. Sarcopenia is defined as loss of muscle mass and/or loss of muscle function. It is usually dia­gnosed using the skeletal muscle index from computed tomography (CT) image analysis at the L3 vertebra. Myosteatosis is defined as an excess intramyocelullar and intermyocellular fat deposition. Dia­gnosis of myosteatosis is based on a measurement of skeletal muscle density by CT imaging at the L3 vertebra (skeletal muscle radiation attenuation – SM-RA). Besides muscle alterations and decreased physical performance, frailty syndrome also comprises changes of other organ systems, leading to the loss of functional reserves and higher vulnerability. Different scoring systems, such as Fried Frailty Index (FFI) or modified Liver Frailty Index (LFI) for patients with liver cirrhosis, are used to dia­gnose patients with frail phenotype. The principle of the treatment of patients with muscle alterations is therapy of liver disease (including liver transplant in advanced cirrhosis), improvement of the nutritional status, adequate physical activity and supplementation of vitamin D deficiency, if necessary. In this review, we summarize up-to-date knowledge about pathophysiology, dia­gnostic tools and treatment options of sarcopenia, myosteatosis and frailty syndrome in patients with liver cirrhosis. Key words: sarcopenia – myosteatosis – frailty syndrome – liver cirrhosis","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74679707","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}