{"title":"Comminuted Transverse Femoral Shaft Fractures Are at Risk for Nonunion.","authors":"Toru Matsugaki, Hideki Mizu-Uchi, Yuji Aratake, Keitarou Yasumoto","doi":"10.2739/kurumemedj.MS7112005","DOIUrl":"10.2739/kurumemedj.MS7112005","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the effect of the main fragment fracture type (oblique or transverse) on the union rate of femoral shaft fractures.</p><p><strong>Methods: </strong>Patients who underwent surgical treatment with an antegrade intramedullary nail for femoral shaft fracture (Arbeitsgemeinschaft für Osteosynthesefragen / Orthopaedic Trauma Association; AO/OTA type 32 type B or C) between January 2009 and March 2021 were included in this study. Patients with oblique fractures of the two main fragments on radiographs immediately after surgery were classified into the oblique fracture group. Patients with at least one of the two main fractures being transverse fractures were classified into the transverse fracture group. We investigated age, sex, height, weight, body mass index (BMI), AO/OTA classification, time from fracture to surgery, intramedullary nail length and diameter, number of interlocking screws, and bone union rate.</p><p><strong>Results: </strong>A total of 55 fractures were included. The mean age was 34.4 ± 16.7 (range, 16-77) years. There were 41 fractures classified into the oblique fracture group and 14 fractures classified into the transverse fracture group. There was a significantly higher proportion of men in the transverse fracture group. Patients in the transverse fracture group were significantly younger and taller. Only 1 of 41 (2.4%) patients in the oblique group experienced nonunion, while 3 of 14 (21.4%) patients in the transverse group experienced nonunion (p = 0.030).</p><p><strong>Conclusion: </strong>Comminuted femoral shaft fractures with transverse fracture components are more prone to nonunion.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740774","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 Treatment of Simultaneous Common Femoral and Profunda Femoris Artery Aneurysms.","authors":"Yusuke Shintani, Satoru Tobinaga, Hiroyuki Saisho, Shigeaki Aoyagi, Eiki Tayama, Hiroshi Yasunaga","doi":"10.2739/kurumemedj.MS7112006","DOIUrl":"10.2739/kurumemedj.MS7112006","url":null,"abstract":"<p><p>Profunda femoris artery aneurysms (PFAAs) are rare because of the histo-anatomical characteristics of the profunda femoris arteries. We present a case of simultaneous PFAA and common femoral artery aneurysm (CFAA) incidentally detected on computed tomography in a 58-year-old man with diverticular bleeding. Images revealed a 37-mm right PFAA and a 24-mm right CFAA. According to the report, PFAAs >20 mm are a surgical indication, and surgery should be decided based on the patient's general condition. We resected the aneurysms and reconstructed the arteries using vascular prostheses. The postoperative course was uneventful, and the patient was discharged 8 days postoperatively.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"75-78"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740876","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":"Effects of Hyperbaric Oxygen Therapy for Malignant Bowel Obstruction Caused by Peritoneal Dissemination.","authors":"Daisuke Muroya, Shoichiro Arai, Takamichi Nishida, Takahide Ishimaru, Yuta Yamazaki, Youjirou Goto, Shinya Nadayoshi, Yutaro Kai, Tetsu Masuda, Hisaaki Shimokobe, Yuichi Goto, Yuichi Nagao, Yoshito Wada, Takayuki Torigoe, Yoshinori Tomoda, Yuji Maruyama, Hajime Imada, Hironobu Sou, Yoshito Akagi, Toru Hisaka","doi":"10.2739/kurumemedj.MS7112001","DOIUrl":"10.2739/kurumemedj.MS7112001","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the efficacy of hyperbaric oxygen therapy (HBOT) in patients presenting with malignant bowel obstruction (MBO) and peritoneal dissemination.</p><p><strong>Materials and methods: </strong>We retrospectively examined whether HBOT affects prognosis following MBO with peritoneal dissemination. This study included 44 patients diagnosed with MBO secondary to peritoneal dissemination at our hospital between January 2013 and December 2022. Among these patients, 30 underwent HBOT. The treatment protocol involved daily HBOT administration, comprising 100% oxygen at 2.5 atmospheres absolute for 60 min.</p><p><strong>Results: </strong>In a univariate analysis of HBOT and non-HBOT groups, the proportion of patients able to resume eating was significantly higher in the HBOT group. Therefore, the percentage of patients in the non-HBOT group whose MBO did not improve was significantly higher than that in the HBOT group. The percentage of patients undergoing surgery or receiving anticancer treatment did not differ significantly between the groups, whereas overall survival was significantly longer in the HBOT group. Furthermore, when examining inoperable patients, significantly more individuals in the HBOT group could resume eating, and their overall survival was significantly prolonged.</p><p><strong>Conclusions: </strong>HBOT may increase the spontaneous resolution rate and improve long-term prognoses of patients with MBO secondary to peritoneal dissemination.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"19-28"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356010","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":"High Expression of NDRG1 is a Poor Prognostic Factor in Patients with Endometrial Endometrioid Carcinoma with Long-Term Observation.","authors":"Morio Ijichi, Kimio Ushijima, Tomohiko Yamaguchi, Naoyo Nishida, Kazuto Tasaki, Jongmyung Park, Shin Nishio, Toshiharu Kamura, Jun Akiba, Tatsuyuki Kakuma, Michihiko Kuwano, Naotake Tsuda","doi":"10.2739/kurumemedj.MS7112004","DOIUrl":"10.2739/kurumemedj.MS7112004","url":null,"abstract":"<p><p>N-myc downstream regulated gene-1 (NDRG1) has attracted much attention as a protein associated with angiogenesis. This study investigated the associations of NDRG1 expression, determined by immunohistochemical analysis, with other clinicopathological factors and prognosis in patients with endometrial endometrioid carcinoma (EEC). Surgical specimens were obtained from 113 patients with EEC. High NDRG1 expression was correlated with advanced stage, poor differentiation, lymph node metastasis, and significantly poorer survival compared with patients with low expression. High expression of NDRG1 was also correlated with high levels of angiogenesis and low expression of the estrogen receptor. These results suggest that high expression of NDRG1 is associated with angiogenesis and is an indicator of a poor prognosis in women with EEC.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740831","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":"Validity of High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Mobile Tongue Cancer in Terms of the Acute Mucosal Reaction.","authors":"Hironori Akiyama, Ken Yoshida, Tadayuki Kotsuma, Koji Masui, Tadashi Takenaka, Manabu Kano, Fumiaki Isohashi, Yuji Seo, Taiju Shimbo, Naoya Murakami, Yui Mori, Shinya Kotaki, Hitoshi Yoshimoto, Eiichi Tanaka, Nikolaos Tselis, Zoltán Takácsi-Nagy, Hideya Yamazaki, Satoaki Nakamura, Noboru Tanigawa, Kimishige Shimizutani, Kazuhiko Ogawa, Yoshiko Ariji","doi":"10.2739/kurumemedj.MS7112003","DOIUrl":"10.2739/kurumemedj.MS7112003","url":null,"abstract":"<p><strong>Background: </strong>The present study investigated the acute mucosal reaction (AMR) after high-dose-rate interstitial brachytherapy at 54 Gy/9 fractions (HDR54) as monotherapy administered twice a day for tongue cancer in 13 patients, and attempted to validate HDR54 by comparing the AMR with that of our previously reported HDR at 60 Gy/10 fractions (HDR60), and low-dose-rate interstitial brachytherapy at approximately 70 Gy (LDR70).</p><p><strong>Methods: </strong>The European Organization for Research on Treatment of Cancer/ Radiation Therapy Oncology Group scoring system with modifications (score: 1-4.5) was used to evaluate AMR. The time courses of the AMR scores of HDR54 were recorded. The time courses of the AMR of HDR54, HDR 60, and LDR70 were each divided into 6 phases and compared.</p><p><strong>Results: </strong>The number of cases in the HDR54 group with a lower score (1-2) at the time of the initial response was significantly higher (12 cases) than those in the HDR60 group (1 case) (p=0.0077) and LDR70 group (1 case) (p=0.0077). In the HDR54 group, the time between the end of treatment and appearance of the first response was significantly longer (median: 3 days) than those in the HDR60 group (median: 1 day) (p<0.001) and LDR70 group (median: 1 day) (p<0.001). No significant differences were observed in the maximum score, its duration, or other parameters.</p><p><strong>Conclusions: </strong>The results indicated that the AMR of HDR54 started later and was gentler and more easily tolerated than the other two methods, suggesting the validity of HDR54 in terms of AMR.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740880","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}
Kurume Medical JournalPub Date : 2025-08-01Epub Date: 2025-03-07DOI: 10.2739/kurumemedj.MS7112011
Teruyuki Yoshimitsu, Shin Nishio, Jongmyung Park, Hiroki Nasu, Ken Matsukuma, Kazuto Tasaki, Takahiro Katsuda, Atsumu Terada, Kimio Ushijima, Naotake Tsuda, Akihiko Kawahara, Jun Akiba, Michihiko Kuwano
{"title":"Upregulated Nuclear Y-box Binding Protein-1 Expression is Closely Associated with Mammalian Target of Rapamycin Expression in Endometrial Cancer.","authors":"Teruyuki Yoshimitsu, Shin Nishio, Jongmyung Park, Hiroki Nasu, Ken Matsukuma, Kazuto Tasaki, Takahiro Katsuda, Atsumu Terada, Kimio Ushijima, Naotake Tsuda, Akihiko Kawahara, Jun Akiba, Michihiko Kuwano","doi":"10.2739/kurumemedj.MS7112011","DOIUrl":"10.2739/kurumemedj.MS7112011","url":null,"abstract":"<p><p>Enhanced oncogenic Y-box binding protein-1 (YB-1) expression, associated with the aberrant expression of genes involved in cell proliferation, survival, and drug resistance, can predict prognostic outcomes in patients with various malignancies. We examined whether YB-1 could predict prognostic outcomes in patients with endometrial cancer and whether enhanced YB-1 expression affects the expression of mammalian target of rapamycin (mTOR) in endometrial cancer. We examined the expression levels of YB-1 and mTOR in tumor samples of 166 patients with endometrial cancer, including those with endometrioid grade 1-3, serous carcinoma, and stage I-IV disease, who underwent surgery. The expression levels of both molecules were assessed using immunohistochemical analysis. The correlation between the expression levels of YB-1 or mTOR and prognosis was also confirmed.The positivity rate of nuclear YB-1 expression was 9.4%. YB-1 expression was associated with poor progression-free survival (P = 0.012) and overall survival (P = 0.003). Fifty-nine patients (35.5%) exhibited mTOR expression. Nuclear YB-1 expression was also correlated with mTOR expression (P = 0.006). We observed similar results when examining only patients who underwent adjuvant chemotherapy. Enhanced nuclear YB-1 expression could predict poor outcomes in endometrial cancer and was significantly associated with enhanced mTOR expression.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"51-60"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587560","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 Sarcoid Reaction in Subcarinal Lymph Node in A Postoperative Breast Cancer Diagnosed by Thoracoscopic Biopsy.","authors":"Kunihiro Ozaki, Shintaro Yokoyama, Toshihiro Hashiguchi, Kensuke Tajiri, Kou Shigemura, Daigo Murakami, Yutaka Nishimura, Maki Tanaka, Ryouzou Hayashida, Fumihiko Fujita","doi":"10.2739/kurumemedj.MS7112009","DOIUrl":"10.2739/kurumemedj.MS7112009","url":null,"abstract":"<p><p>Lymph node recurrence is common in patients with breast cancer, and breast surgeons often diagnose it based solely on computed tomography (CT) or fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT). In this case report, we present a patient with breast cancer having a false positive lymph node detected by FDG-PET/CT, which was later identified as a sarcoid reaction through thoracoscopic surgery. This pathological diagnosis allowed the patient to avoid unnecessary long-term cancer therapies, such as chemotherapy and hormone therapy. In conclusion, lymph nodes in patients with breast cancer should undergo pathological diagnosis, and thoracoscopic surgery is a valuable approach for accurate diagnosis, even when FDG-PET/CT shows positive results.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"85-88"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740771","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":"Situs Inversus Totalis in Conjunction with an Anomalous Artery Connecting the Common Hepatic Artery and a Jejunal Branch of the Superior Mesenteric Artery: A Cadaveric Case Report.","authors":"Azumi Yano, Aya Han, Yoko Tabira, Keishiro Kikuchi, Yuto Haikata, Tatsuya Harano, Keigo Shimizu, Eiko Inoue, Kunimitsu Nooma, Joe Iwanaga, Tsuyoshi Saga, Koichi Watanabe","doi":"10.2739/kurumemedj.MS7112010","DOIUrl":"10.2739/kurumemedj.MS7112010","url":null,"abstract":"<p><p>We encountered a case of situs inversus totalis in conjunction with an anomalous artery connecting the common hepatic artery and a jejunal branch of the superior mesenteric artery during anatomical dissection of a cadaver. The heart was located in the center of the thorax, with the apex located anterioinferiorly to the right of the midline and the base located posterosuperiorly to the left of the midline. The aortic arch coursed from right anterior to right posterior. The right lung was divided into two lobes, and the left lung was divided into three. The entire intraperitoneal gastrointestinal tract, from the stomach to the rectum, formed a mirror image with the expected normal anatomy. The liver was located on the left side of the upper abdominal cavity, and the spleen was located on the right. The cardia of the stomach was located on the right side, and the pylorus was on the left. The cecum and appendix were located on the left, and the sigmoid colon ran toward the pelvic cavity from the right. In addition to situs inversus totalis, an anomalous artery called the arc of Bühler that branched off the common hepatic artery and entered the mesenteric arcade between the first and second jejunal arteries was observed. These anomalies were not embryologically related and occurred separately from each other. However, their presence may cause confusion during abdominal surgery. Knowledge of this specific combination of anatomical variations may help surgeons who encounter it in clinical practice.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587559","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":"Survival and Endoscopic/Clinical Features of Patients with Colorectal Cancer Resected by Cold Snare Polypectomy: The Importance of Chronic Kidney Disease.","authors":"Tsutomu Nagata, Miwa Sakai, Michita Mukasa, Hiroshi Tanaka, Shinpei Minami, Tomonori Cho, Tomoyuki Nakane, Akihiro Ohuchi, Shuhei Fukunaga, Jun Akiba, Yoshinobu Okabe, Takumi Kawaguchi","doi":"10.2739/kurumemedj.MS7112002","DOIUrl":"10.2739/kurumemedj.MS7112002","url":null,"abstract":"<p><strong>Background and aims: </strong>Colorectal polyps resected by cold snare polypectomy (CSP) are rarely diagnosed as colorectal cancer (CRC). We aimed to investigate the prevalence, clinical features, and prognosis of patients with CRC resected by CSP.</p><p><strong>Subjects: </strong>Patients with colorectal polyps treated with CSP between 2018 and 2022 were enrolled and regularly followed up (median observation period: 30.6 months). Logistic regression analysis and decision tree analysis were employed to investigate the clinical features of the patients.</p><p><strong>Results: </strong>A total of 5,064 colorectal polyps from 2,530 patients were resected by CSP. Of these, 0.24% were diagnosed as CRC; however, no patients died due to CRC. eGFR was an independent risk factor for the presence of CRC (unit 10, OR 0.716, 95%CI 0.525-0.973, P=0.0323) and its optimal cut-off value was 59.9 mL/min/1.73 m<sup>2</sup>. The decision-tree analysis revealed that 2.03% of patients with creatinine ≥ 1.0 mg/dL had CRC.</p><p><strong>Conclusion: </strong>CRC was diagnosed in 0.24% of the polyps; however, no patients died due to CRC. eGFR <60 mL/min/1.73 m<sup>2</sup> and creatinine >1.0 mg/dL were associated with CRC. Thus, colorectal polyps should be carefully examined in patients with chronic kidney disease.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356011","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":"Clinical Profile of Cerebral Sinus Venous Thrombosis: A Prospective Observational Study in South India.","authors":"Gowthaman Kasiviswanathan, Sujatha Sivashanmugam, Ramya Bakthavatchalam, Archana Gaur, Kotha Sugunakar Reddy, Sakthivadivel Varatharajan","doi":"10.2739/kurumemedj.MS7112012","DOIUrl":"10.2739/kurumemedj.MS7112012","url":null,"abstract":"<p><strong>Background: </strong>Cerebral sinus venous thrombosis (CSVT) is a thrombosis of the cerebral veins and dural sinuses. It is a challenging condition for a physician due to varied symptoms. We aimed to study the clinical, radiological, etiology, and outcome of CSVT in a rural population.</p><p><strong>Methods: </strong>Patients with suspected symptoms of CSVT and positive neuroimaging by MRI with MRV were enrolled in the study. Patients with normal neuroimaging, arterial stroke, space-occupying lesions, and unwillingness to participate were excluded from the study. The patient's demographic data and clinical presentation were noted. Protein C and S, anti-thrombin III, ANA, anti-phospholipid antibodies (APLA), and homocysteine were analyzed.</p><p><strong>Results: </strong>The incidence of CSVT was most common in the age group of 21-40 years (44.3%) and in males. The presentation was mostly subacute (61.4%). Headache was the most common presentation (80%), followed by seizures. The most common site of the thrombus is the superior sagittal sinus (51.4%), the next being the transverse sinus (25.7%). CSVT was attributed to hyperhomocysteinemia in 40% of patients, and protein C and S deficiency was seen in 14.3%. Almost all of them recovered completely (93%).</p><p><strong>Conclusion: </strong>Cerebral sinus venous thrombosis primarily afflicts adults in their middle age, marked by notable manifestations such as headaches and seizures. The prognosis is good with early diagnosis and management.</p>","PeriodicalId":39559,"journal":{"name":"Kurume Medical Journal","volume":" ","pages":"61-67"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587542","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}