Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia最新文献_第7页

Primary Extraskeletal Ewing Sarcoma of the Thoracolumbar Epidural Space: Rare Case Report in a Child 胸腰椎硬膜外间隙原发性骨外尤文氏肉瘤:罕见儿童病例报告

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-04-04 DOI: 10.1055/s-0042-1742710

A. F. D. Silva, Ana Carolina de Carvalho Ruela Pires, A. D. P. V. Costa, Fabiana Lopes Amaral, R. Bomfim, Ângelo M. S. Bomfim Filho, Alessandra Lamenha Feitosa, I. Buarque

{"title":"Primary Extraskeletal Ewing Sarcoma of the Thoracolumbar Epidural Space: Rare Case Report in a Child","authors":"A. F. D. Silva, Ana Carolina de Carvalho Ruela Pires, A. D. P. V. Costa, Fabiana Lopes Amaral, R. Bomfim, Ângelo M. S. Bomfim Filho, Alessandra Lamenha Feitosa, I. Buarque","doi":"10.1055/s-0042-1742710","DOIUrl":"https://doi.org/10.1055/s-0042-1742710","url":null,"abstract":"\u0000 Introduction Ewing sarcomas are a family of tumors that can be of skeletal or extraskeletal origin. We report a rare case of a child with extraskeletal Ewing sarcoma in the thoracolumbar epidural space.\u0000 Case Report The patient was a 1-year-old female child with sphincter alteration, flaccid paraplegia, and areflexia. A magnetic resonance imaging (MRI) scan showed a large extensive epidural lesion with compression of the dural sac in the D6–L2 segment, and a left paravertebral extension through the L1–L2 foramen. Laminotomy was performed, with subtotal resection of the lesion. The histopathological and immunohistochemical analyses indicated Ewing sarcoma. Due to the child's age, radiotherapy was not performed, only chemotherapy, due to the aggressiveness of the neoplasm. The patient showed rapid tumor recurrence and ended up dying.\u0000 Discussion Extraskeletal Ewing sarcoma can appear in different locations in the body. They are aggressive tumors with local recurrence and distant metastases. In our case, a combination of MRI and positron-emission tomography–computed tomography scan presented a clearer result, especially in the presence of metastasis. In the histopathological analysis, small blue cells with a clear cytoplasm and indistinct nucleoli were observed. In the immunohistochemical analysis, CD99 (MIC2) expression is highlighted. The best treatment outcome would have been surgical resection with chemotherapy and radiotherapy.\u0000 Conclusion We reported a rare case of thoracolumbar epidural Ewing sarcoma in which, despite surgery and chemotherapy, the tumor behaved very aggressively, leading to an unfavorable prognosis.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"3 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82159315","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}

引用次数: 0

Multi-Level Cervical Disc Degeneration and Vertigo 多层次颈椎间盘退变与眩晕

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-03-21 DOI: 10.1055/s-0042-1749369

S. Ercan, M. Baloglu

{"title":"Multi-Level Cervical Disc Degeneration and Vertigo","authors":"S. Ercan, M. Baloglu","doi":"10.1055/s-0042-1749369","DOIUrl":"https://doi.org/10.1055/s-0042-1749369","url":null,"abstract":"Abstract Objective While complaints of pain, loss of strength, and numbness radiating to the neck and arm are common in patients due to cervical disc degeneration, vertigo is a rare symptom. The articles previously published on the subject focus on single-level disk degeneration and its correlation with vertigo. However, in the case of multilevel cervical discopathy, its effect on the severity of vertigo and its response to surgical treatment has not been clarified. Therefore, the objective of the present study is to shed light on the topic. Methods Patients with vertigo complaints in whom all known etiological causes of vertigo had been excluded, but with cervical disc degeneration, were included in the study. The scores on the Visual Analog Scale (VAS) and Cervical Vertigo Evaluation Scale (CVES) were analyzed in terms of numbers of discopathy, spine levels, and differences regarding the preoperative and postoperative status. Results A total of 24 patients (14 with single-level and 10 with multi-level disc degeneration) underwent anterior cervical discectomy. The preoperative CVES score was significantly decreased after surgery. Multi-level disc degeneration causes fewer vertigo symptoms than the single-level kind. No significant correlation between the severity of pain and vertigo was observed. Conclusion Multi-level disc degeneration causes fewer vertigo symptoms. These symptoms decreased after anterior cervical discectomy in cases of single-level disk herniation at upper segments. The surgical intervention could be a favorable choice of treatment. However, the mechanism and treatment approach to cervical vertigo is still a controversial issue.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"1 1","pages":"e311 - e315"},"PeriodicalIF":0.1,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86524489","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}

引用次数: 0

Enterogenous Cyst and Glioblastoma: A Brief Histopathological Review of Two Uncommon Cystic Lesions of the Central Nervous System 肠源性囊肿和胶质母细胞瘤:两种罕见中枢神经系统囊性病变的组织病理学回顾

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-03-14 DOI: 10.1055/s-0042-1744112

E. Cambruzzi, N. Ferreira, M. Ferreira, Guilherme Gago, João Pedro Pattussi Bertinatti

引用次数: 0

Cervical Primitive Neuroectodermal Tumor in an Adult: Case Report and Literature Review 成人宫颈原始神经外胚层肿瘤一例报告及文献复习

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-03-08 DOI: 10.1055/s-0042-1742709

Guilherme dos Santos de Alencar, Maria Eduarda Turczyn de Lucca, Felipe Antonio Torres Mazzo, Milena Massumi Konozoe, Eduardo Talib Bacchi Jaouhari, R. Morais, Carlos Eliseu Barcelos, R. S. Torres

{"title":"Cervical Primitive Neuroectodermal Tumor in an Adult: Case Report and Literature Review","authors":"Guilherme dos Santos de Alencar, Maria Eduarda Turczyn de Lucca, Felipe Antonio Torres Mazzo, Milena Massumi Konozoe, Eduardo Talib Bacchi Jaouhari, R. Morais, Carlos Eliseu Barcelos, R. S. Torres","doi":"10.1055/s-0042-1742709","DOIUrl":"https://doi.org/10.1055/s-0042-1742709","url":null,"abstract":"\u0000 Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare.\u0000 Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV- on the left upper limb, and grade IV+ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 × 1.8 Gy in the skull and neuroaxis and 5 × 1.8 Gy in tumor boost), the patient progressed without recurrence.\u0000 Conclusion Since the characteristics of the tumor are similar to those of medulloblastoma, it is necessary to expand the studies on these lesions, to better understand their pathophysiology and list better diagnostic and therapeutic methods, in addition to those already available.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"77 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77524564","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}

引用次数: 0

Peculiarities of Atypical Meningiomas: Literature Review 非典型脑膜瘤的特点:文献综述

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-03-03 DOI: 10.1055/s-0042-1742427

R. Santos, Ana Carla Mondek Rampazzo, C. A. Zicarelli, L. V. D. Camargo

{"title":"Peculiarities of Atypical Meningiomas: Literature Review","authors":"R. Santos, Ana Carla Mondek Rampazzo, C. A. Zicarelli, L. V. D. Camargo","doi":"10.1055/s-0042-1742427","DOIUrl":"https://doi.org/10.1055/s-0042-1742427","url":null,"abstract":"\u0000 Introduction Meningiomas are common tumors of the central nervous system that represent around 30% of primary tumors. However, the incidence of atypical meningiomas (AMs) is lower, of approximately 15% of all meningiomas, and they present high rates of relapse and mortality.\u0000 Aim To review peculiarities of AMs.\u0000 Methodology A literature review of articles published in English between 2009 and 2020 on the PubMed and Biblioteca Virtual em Saúde (BVS) databases using the terms meningioma and atypical.\u0000 Results Atypical meningiomas are rare and more prevalent in older males. The clinical condition depends on the site of the tumor, and a definitive diagnosis of AM is only possible via anatomical pathology. Moreover, prominent studies have indicated a relationship between the presence of the anti-Ki67 antibody/mindbomb (Ki-67/MIB1) marker as an aid in the definition of AM and one of the determinants of tumor aggressiveness. Imaging studies have also advanced in terms of seeking criteria using magnetic resonance that may suggest the malignancy of a lesion. As far as treatment is concerned, total resection remains the main therapeutic option, and it has a direct relationship with survival and time until disease progression. Lastly, there are many factors involved in the prognosis of AM.\u0000 Conclusion Atypical meningiomas continue to be a challenge, requiring further and more specific studies to provide a better understanding of it.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"54 5 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83413566","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}

引用次数: 0

Um cirurgião sob o olhar de Deus 上帝眼中的外科医生

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-03-01 DOI: 10.1055/s-0042-1743468

E. Figueiredo, M. Teixeira

引用次数: 0

Predictive Mortality Factors after Decompressive Craniectomy in Ischemic Stroke 缺血性脑卒中开颅减压术后预测死亡率因素

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-02-25 DOI: 10.1055/s-0042-1743106

Maria Luísa Brito Almino Leite, Matheus Silva Leite, Fernando Diogo Barbosa, I. Kessler

{"title":"Predictive Mortality Factors after Decompressive Craniectomy in Ischemic Stroke","authors":"Maria Luísa Brito Almino Leite, Matheus Silva Leite, Fernando Diogo Barbosa, I. Kessler","doi":"10.1055/s-0042-1743106","DOIUrl":"https://doi.org/10.1055/s-0042-1743106","url":null,"abstract":"\u0000 Background Decompressive craniectomy is a consolidated method for the treatment of malignant ischemic stroke (iS) in the territory of the middle cerebral artery. Thus, factors contributing to mortality constitute an important area of investigation.\u0000 Objective To evaluate the epidemiological clinical profile and predictors of mortality in a single-center population of patients undergoing decompressive craniectomy for the treatment of malignant iS.\u0000 Methods A single-center retrospective study was performed in 87 patients with malignant iS subjected to emergency decompressive craniectomy from January 2014 to December 2017. Age, gender, laterality, aphasia, time interval between disease onset and treatment, and clinical and neurological outcomes using the Glasgow coma scale were assessed. The patients were stratified by age: a group of participants 60 years old or younger, and a group of participants older than 60 years old for assessment of survival and mortality by the Kaplan-Meier test and log-rank comparison. The intensity of the association between demographic and clinical variables was evaluated by multivariate Cox regression.\u0000 Results Ischemic stroke was prevalent in patients with hypertension (63.29%). Seventy-seven (84%) patients had some type of postoperative complication, mostly pneumonia (42.8%). The risk of death was 2.71 (p = 0.0041) and 1.93 (p = 0.0411) times higher in patients older than 60 and with less than 8 points on the Glasgow coma scale, respectively.\u0000 Conclusion Malignant iS has a significant mortality rate. Age above 60 years and Glasgow coma scale values below 8 were statistically correlated with unfavorable prognosis.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"58 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76916472","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}

引用次数: 0

The Evolution of Neurosurgery Throughout the Ages: From Trepanations in Prehistory to The Robotic Era 神经外科的进化贯穿各个时代:从史前的钻孔到机器人时代

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-02-25 DOI: 10.1055/s-0042-1742424

F. Souza, Rhuann Pontes dos Santos Silva, Luiz Severo Bem Junior, H. A. Azevedo Filho

{"title":"The Evolution of Neurosurgery Throughout the Ages: From Trepanations in Prehistory to The Robotic Era","authors":"F. Souza, Rhuann Pontes dos Santos Silva, Luiz Severo Bem Junior, H. A. Azevedo Filho","doi":"10.1055/s-0042-1742424","DOIUrl":"https://doi.org/10.1055/s-0042-1742424","url":null,"abstract":"\u0000 Introduction Throughout the historical course, the emergence of neurosurgery invariably involved the narrative about different eras, marked by relevant discoveries in the field of medical science. From prehistoric mystical and therapeutic reports to the Robotic Era in the 21st century, there were changes that contributed to current neurosurgery. Thus, this study will analyze articles and studies that describe the history of neurosurgery and demonstrate the main advances in the field of science.\u0000 Materials and methods This is a narrative review of scientific literature, carried out by searching the following databases: Scientific Electronic Library Online (SCIELO), Online System for Searching and Analyzing Medical Literature (MEDLINE), Latin American Literature and Caribbean in Health Sciences (LILACS), and Public Medical Literature Analysis and Retrieval System Online (PubMed).The following descriptors were used: History of neurosurgery and Neuroanatomy, together with the Boolean operator “AND”. In addition, the descriptors History of Neurosurgery and Robotics were used between the Boolean operator “AND”. In this sense, in order to establish a linearity of the narrative presented, the evolution of neurosurgery in five eras was didactically separated.\u0000 Conclusion Neurosurgery, throughout history, has undergone several transformations. There was a series of events that made neurosurgery one of the most evolutionary and progressive sciences. This is because technology combined with scientific knowledge was, in fact, what made it possible to get where we are. In this sense, the studied ages allow the comprehension of a history that needs to be understood and valued by all students of the neurological and neurosurgical sciences.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"100 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90743473","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}

引用次数: 1

Circumbilical Access for Ventriculoperitoneal Bypass Insertion in Adults 成人脑室-腹膜旁路置入的环周通路

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-02-19 DOI: 10.1055/s-0043-1769778

V. B. D. Silva, J. C. Rodrigues

{"title":"Circumbilical Access for Ventriculoperitoneal Bypass Insertion in Adults","authors":"V. B. D. Silva, J. C. Rodrigues","doi":"10.1055/s-0043-1769778","DOIUrl":"https://doi.org/10.1055/s-0043-1769778","url":null,"abstract":"Abstract Introduction The use of a minilaparotomy for catheter implantation can bring important complications such as adhesions, intestinal lesions, incisional hernias and postoperative pain. In neurosurgery, the umbilical access, currently widely used by surgeons of different specialties mainly for its aesthetic results, is still restricted by the unfamiliarity of the access. Material and Method During the period between 2019 and 2020, a total of 12 patients who required ventricular bypass were selected, using circumbilical access for insertion of the peritoneal catheter and followed up for 12 months to analyze possible complications. Description of the Technique The surgeon responsible for the abdomen performs an umbilical incision bordering the upper edge of the upper ring, avoiding the mamelon, quickly finding the linea alba under the umbilical plane, which after dissection allows reaching the peritoneum, without breaking the rectus muscles. The peritoneum can then be opened under visual control. Results All patients presented resolution of hydrocephalus with good aesthetic results and without complications. Discussion The aesthetic result of the transumbilical procedure was the stimulus for the development of the technique that proved to be easy, safe, cheap, and aesthetic. Initially, the ease of access to the peritoneal cavity is clear, in addition to avoiding manipulation of the rectus abdominis muscle, which improves postoperative pain. Conclusion The circumbilical access for the implantation of a ventriculoperitoneal shunt is safe, effective and has a better aesthetic result for adult patients and should be part of the operative arsenal of neurosurgeons.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"69 1","pages":"e101 - e104"},"PeriodicalIF":0.1,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73129831","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}

引用次数: 0

Neurosurgery in the Treatment of Alcohol Use Disorder: A Systematic Literature Review 神经外科治疗酒精使用障碍:系统文献综述

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-02-16 DOI: 10.1055/s-0041-1733866

B. Almeida, L. Silva

{"title":"Neurosurgery in the Treatment of Alcohol Use Disorder: A Systematic Literature Review","authors":"B. Almeida, L. Silva","doi":"10.1055/s-0041-1733866","DOIUrl":"https://doi.org/10.1055/s-0041-1733866","url":null,"abstract":"Alcohol abuse has impacts on public health worldwide. Conservative treatment to achieve abstinence consists of detoxification combined with psychotherapy and the use of drugs, but it is estimated that only half of the individuals achieve long-term abstinence with the available treatments. In this sense, neurosurgery appears as a therapeutic proposal. The present study aimed to gather information about the circuitry related to alcohol use disorder (AUD), to describe possible surgical targets, and to establish whether a surgical approach could be a safe and effective treatment option. A systematic review of the literature was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The 14 selected articles analyze ablative operations, deep brain stimulation (DBS), and a new procedure in which the patient is first submitted to repetitive transcranial magnetic stimulation to evaluate their response, and later an implant is surgically positioned on the evaluated target to obtain more lasting results. The most relevant outcomes were found when the anterior cingulate cortex (ACC) and the nucleus accumbens (NAcc) were used as targets, demonstrating a large reduction in alcohol intake and even its cessation. However, important side effects were observed, such as psychotic symptoms, right frontal venous infarction, seizures after implantation in the ACC and a hypomanic period after DBS in the NAcc, which could be reversed. Due to the lack of studies involving the surgical treatment of AUD, more clinical trials are needed to compare targets, to assess surgical techniques, and to estimate the safety of these techniques.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"134 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79459423","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}

引用次数: 0