International Journal of Burns and Trauma最新文献

{"title":"Risk factors of surgical site infection in elective laparotomy in a tertiary care center: an observational study.","authors":"Farhanul Huda,&nbsp;Sruthi Shasheendran,&nbsp;Somprakas Basu,&nbsp;Navin Kumar,&nbsp;Deepak Rajput,&nbsp;Sudhir K Singh,&nbsp;Lena E David,&nbsp;Chezhian Subramanian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infections (SSI) encompass 20-25% of all hospital-acquired infections with their prevalence ranging from 2.5 to 41.9% across the world. Prevalence and risk factors of SSI vary greatly between countries and between healthcare institutions within a country. There is limited data on the pattern and risk factors of SSI in the Indian healthcare scenario. This study is an attempt to identify risk factors of SSI in patients who underwent elective laparotomy in the general surgery department of a tertiary care hospital in India.</p><p><strong>Methodology: </strong>This is an observational cross-sectional retrospective study, conducted over 5 years from January 1, 2015, to December 31, 2019. A total of 112 patients who underwent elective laparotomy in the department of general surgery, were enrolled in the study. Data collection was done from hospital case records and discharge summaries of patients.</p><p><strong>Results and discussion: </strong>Out of the 112 patients, a total of 16 patients (14.29%) developed surgical site infections. Preoperative serum total protein (W-465.500, P 0.012) and length of hospital stay (W=1235.000, P≤0.001) were found to have a significant association with surgical site infection. Age, gender, smoking, comorbidity, class of surgical wound and, preoperative albumin did not show any significant association with the development of SSI. Escherichia coli was the predominant organism isolated in culture.</p><p><strong>Conclusion: </strong>Measures to curtail SSI can only be adopted after a thorough understanding of its prevalence and predictors. The characteristics and pattern of SSI will help identify prevalent organisms, their resistance pattern and will aid in formulating antibiotic policy tailor-made for the healthcare institution.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301157/pdf/ijbt0012-0106.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of steal syndrome following arteriovenous fistula and arteriovenous graft.","authors":"Abbas Saroukhani,&nbsp;Aryan Rafiee Zadeh,&nbsp;Seyed-Masoud-Reza Ahmadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Renal failure is one of the dangerous chronic diseases that different solutions are used for dialysis in these patients. Arteriovenous graft (AVG) and arteriovenous fistula (AVF) are two communication methods for dialysis in these patients, associated with pain, sensory and Pulse disturbances, and even limb necrosis. Using cubital AVF and AVG for hemodialysis is a critical issue in vascular surgery. Arterial steal syndrome is an essential medical condition requiring surgical interventions. In this research project, we decided to measure the incidence of steal syndrome among AVF and AVG patients and compare them with each other.</p><p><strong>Methods: </strong>This cohort study was performed in Al-Zahra Hospital, Isfahan, Iran, from 2018 to 2020. Two hundred one patients undergoing AVF or AVG were included, and patients were followed for six months. The frequency of pain symptoms, anesthesia and pulse disorders, necrosis of the limbs, and the frequency of steal syndrome were assessed.</p><p><strong>Results: </strong>Among the studied patients, 2 cases in the AVF group and 10 cases in the AVG group had steal syndrome, and there was a significant difference between the two groups based on the frequency of steal syndrome (P=0.007). Also, there was a considerable difference between the two groups based on the pulse disorder (P<0.05), but there was no significant difference between the two groups in terms of symptoms of sensory impairment, pain, and evidence of necrosis (P>0.05).</p><p><strong>Conclusion: </strong>AVF technique is better than AVG in creating symptoms of steal syndrome, and also, the number of symptoms such as pulse disorder was relatively less seen in the AVF method.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301160/pdf/ijbt0012-0121.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of the outcome of McKay surgery with and without pin in clubfoot patients.","authors":"Amir Zarei,&nbsp;Morteza Saeb,&nbsp;Aryan Rafiee Zadeh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Clubfoot is one of the most common foot deformities in children. Surgical treatment is the only choice for patients who have failed conservative treatment. To the best of our knowledge, no studies have been done to compare the McKay surgery with a pin versus without a pin. Our study aimed to compare the outcomes of McKay surgery with and without pins in clubfoot patients.</p><p><strong>Method: </strong>This study is an analytical study. The sample size included patients referred to Imam Reza Hospital from 2016 to 2018. Children who did not respond to plaster therapy were under McKay surgery. In this study, patients were divided into two groups of 50 patients. In the first group, after ligament release and tendon extension, a pin was used to maintain the direction of the talonavicular joint. In the second group, no pin was used. Every six months, radiographs were taken of the patients to monitor their progress. After collecting the study data, they were entered into SPSS software (version 25, IBM Corporation, Armonk, NY) and analyzed.</p><p><strong>Result: </strong>The mean age of patients was 5.36±2.07 months. Of these, 79 were boys and 21 girls, most of the subjects were aged 4-6 months, and 24% had unilateral one-way clubs. The severity of the disease was 7 feet in grade 2 (moderate) and 93 feet in grade 3 (severe). There was a significant relationship between age, outcome and type of complications with surgical type.</p><p><strong>Conclusion: </strong>Finally, it can be concluded that McKay surgery (both with and without a pin) is exceptionally effective at treating clubfoot.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301156/pdf/ijbt0012-0114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plate osteosynthesis for atypical femoral fractures in patients with severely bowed femurs: comparing short versus long segment fixation - a case series.","authors":"Yiu Hin Kwan,&nbsp;Yao Jie Shuy,&nbsp;Claris Jy Shi,&nbsp;Allan Sh Ng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Intramedullary nail fixation is currently the modality of choice in surgical treatment for atypical femoral fractures (AFF). Its uses are limited, however, in severely bowed femurs, narrow medullary canals, or in the presence of thick endosteal callus at the apex of the femoral curve. In these cases, extramedullary plate osteosynthesis is preferred. The consideration when adopting plate osteosynthesis is whether a short or long segment fixation is superior. We hypothesize that a long segment fixation has the potential advantage of protecting the entire length of the femur from future fractures in the adynamic bone. In this series, we present two cases from our institution, with the aims of discussing the benefits and limitations of short versus long segment plate fixation in AFF.</p><p><strong>Case summary: </strong>We report two uncommon cases of bisphosphonate-related AFF in two Asian patients with severe femoral curvature, who were treated with extramedullary plate osteosynthesis at our institution. One patient underwent fixation with a short segment plate osteosynthesis, and the other received a long plate osteosynthesis spanning the proximal to distal femur in an attempt to protect the bone from future fractures. Both patients showed a favourable and uncomplicated course post-surgery, with early return to ambulation and radiographic bone union at follow up.</p><p><strong>Conclusion: </strong>We expect to see an increase in the number of patients with AFF and bowed femurs, especially with the increased usage of bisphosphonates given an ageing Asian population. Surgical treatment with short and long plate osteosynthesis are options with their own advantages and limitations. With the advent of new anatomical plate options, long segment fixation has become more accessible and may be considered in this patient group as it has the potential advantage of protecting the adynamic femur from future fractures. Further studies should be targeted to determine which method of treatment is superior in this particular group of patients.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301159/pdf/ijbt0012-0073.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frostbite in hot climates of Central Asia: retrospective analysis of the microflora of wound and antibiotic therapy.","authors":"Babur M Shakirov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The problem of deep frostbites belongs to one of the most complex in surgery. Treatment of such victims is very prolonged, expensive, requiring crippling operations resulting in disability. The purpose of this present study is of etiological structure of the wound microflora and its tolerance to antibacterial preparations in patients with cold injury in the regions with warm climate of severe degree. 57 microbiological investigations of wound secretions in 38 patients with severe cold injury treated in our Burn Department of RSCUMA, Samarkand, Uzbekistan had been carried out. Microflora of wounds in patients who suffered from cold injury is characterized by polyetiology and is presented by gramnegative (49.5%) and grampositive (50.5%) microorganisms. There are Pseudomonas aeruginosa (17.9%). Among gramnegative microorganisms. In this context sensitivity to preparations owing activity to Pseudomonas aeruginosa-Ceftazidim, Ceferin and Amycacin makes 48.8%, 54.5% and 81.3% accordingly. Prevailing flora of grampositive is Staphylococcus aureus (26.3% of agents), of which 60% makes MRSA. High resistance to Ciprofloxacin (66.6%), Erythromycin (52.5%) and Lincomycin (44.4%) is noted. The investigations give evidence that ABT in patient with severe frostbites is a serious problem and needs well-ground approach in prescribing antibacterial preparations.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301161/pdf/ijbt0012-0093.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyogenic granuloma after burns: a case report and review of the literature.","authors":"Ghita Belmaati Cherkaoui,&nbsp;Ayyoub Souarji,&nbsp;Ayat Allah Oufkir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pyogenic granuloma (PG) is a benign vascular proliferative tumor of the skin and mucous membranes, it can appear spontaneously or following triggering factors. Different clinical aspects are described, pyogenic granulomas following burns (GB) are rare. We report a case of post-burn pyogenic granuloma confirmed by histological study and treated surgically. This new observation will allow us to further clarify this condition.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301154/pdf/ijbt0012-0127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of acute kidney injury in severely burned patients in Mulago Hospital, Uganda - a prospective cohort.","authors":"Joel Wandabwa,&nbsp;Robert Kalyesubula,&nbsp;Irene Najjingo,&nbsp;Joanitah Nalunjogi,&nbsp;Badru Ssekitooleko,&nbsp;Ronald Mbiine,&nbsp;Rose Alenyo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Acute Kidney Injury (AKI) is associated with increased mortality among severely burned patients. According to World Health Organization (WHO) 11 million people suffer from burns worldwide and burns contribute to 180,000 deaths yearly. Majority of these burns occur in the Low and Middle-Income Countries. Currently there is no published data on the incidence, risk factors and outcomes of AKI among patients with severe burns in Uganda. Early screening and treatment of patients at risk of developing AKI has been shown to improve survival. We therefore carried out a study to determine the incidence and risk factors of AKI in Uganda.</p><p><strong>Methods: </strong>This was a prospective cohort study that consecutively included patients with severe burns admitted in Mulago National Referral Hospital burns unit between February and May 2018. Patients were followed up for 14 days and AKI was assessed according to the KIDGO criteria. The incidence of AKI was expressed as a proportion. Kaplan Meier graph was used to estimate the median survival of patients with or without AKI. The risk factors for AKI were assessed using cox proportion hazard regression analysis.</p><p><strong>Results: </strong>Of the 147 patients screened, 92 met the inclusion criteria but 2 declined to participate in the study. Of the study participants, 48 (53.3%) were male, 47 (52.2%) were aged 3 years and below, the median TBSA was 17 (IQR; 13-23), 58 (69.9%) had low albumin levels and 16 (18.6%) had inhalation burns. The incidence of AKI was found to be 34.4% (95% CI; 25.9-45.9) with a mortality of 11.76% (95% CI; 6.37-20.73). Total burn surface area HR=3.10 (95% CI; 1.39 to 6.94 P=0.003) was the only independent risk factor for AKI.</p><p><strong>Conclusion: </strong>The incidence and mortality rate of AKI in patients with severe burns was found to be high. Having burns greater than 18% TBSA was an independent risk factor for AKI. Therefore, patients with burns greater than 18% should be assessed regularly for AKI so that treatment is instituted early should it occur.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301158/pdf/ijbt0012-0131.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of macrophages in thermal injury.","authors":"Julia A Penatzer,&nbsp;Shruthi Srinivas,&nbsp;Rajan K Thakkar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Macrophages, first discovered for their phagocytic ability, are a complicated and heterogeneous cell type. The unique properties of macrophages allow them to perform a vast array of functions, including phagocytosis, cytokine production, antigen presentation, and wound healing. Some macrophage populations are derived from monocytes and are induced into specific phenotypes by the local tissue microenvironment, while other macrophages form during early embryonic development. The exposure of the host to local pathogens and/or traumatic injury alters the tissue microenvironment and, in turn, influences changes in macrophage phenotype and function. Perhaps the most significant change in the local tissue microenvironment and subsequent macrophage phenotype occurs after thermal injury, which causes localized tissue damage and a massive systemic inflammatory response. However, few studies have explored the influence of burn injury on the host macrophages and macrophage function in burn wounds. Furthermore, the literature is scant regarding the impact macrophage function has on outcomes in thermal injury. This review will focus on the current knowledge of macrophage function in burn wounds and the phenotypic changes in macrophages during thermal injury while identifying knowledge gaps.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40308316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of functional outcome and comparison of three different surgical modalities for management of intertrochanteric fractures in elderly population.","authors":"Abhishek Garg,&nbsp;Pradeep Kamboj,&nbsp;Pankaj Kumar Sharma,&nbsp;Umesh Yadav,&nbsp;Ram Chander Siwach,&nbsp;Virender Kadyan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to compare the role of the various surgical modalities ie, Hemiarthroplasty (HA), Dynamic Hip Screw (DHS), Cephalo-medullary nail (CMN) in the management of intertrochanteric fractures in elder patients with comparison of the results and assessment of the complications encountered with each method.</p><p><strong>Methods: </strong>Total 105 adult patients having intertrochanteric fractures managed during July 2013 to December 2018 at tertiary trauma care centre and followed for minimum 12 months were included in the study. Patients were divided into three groups. Primary hemiarthroplasty was done in 35 patients (group A) while DHS and PFN was done in 35 patients each in group B and group C respectively. Functional evaluation was done using Modified Harris Hip score (HHS) at different intervals while ambulatory function was measured using the Parker Mobility Score.</p><p><strong>Results: </strong>The mean age of patients was 72.14±2.9 years. Mean operative time and blood loss in group A was significantly higher than the other two groups. Hemiarthroplasty group could ambulate earlier than DHS/PFN group. Mean HHS at final follow up was 85.40±7 in group A while in group B and group C these values were 76.36±16.45 and 86.85±10.52 respectively. HHS was significantly higher (P, 0.01) in hemiarthroplasty group in comparison to DHS group. Post-operative complications were comparable in all the groups.</p><p><strong>Conclusion: </strong>We support the use of hemiarthroplasty for unstable intertrochanteric fracture in elderly patients with lesser failure rates, early mobilization and better functional outcomes. Early mobilization and less hospital stay should be the goal of every surgical procedure in the elder population.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40308318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of patterns, cause and risk factors of burns in patients with seizure.","authors":"Seyyed Mahdi Zia Ziabari,&nbsp;Mohammad Reza Mobayen,&nbsp;Sheyda Rimaz,&nbsp;Daniel Rahimi Nejat,&nbsp;Siamak Rimaz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Burns following convulsion could be an important problem for patients with epilepsy. In the present study we aimed to identify the pattern and the cause of burns in these patients.</p><p><strong>Methods: </strong>This is a cross-sectional study that was performed in 2017-2019 in Guilan on 40 patients with burns following seizure. The information in the records of patients were reviewed. We collected data including age, sex, marital status, occupation, place of residence, length of hospital stay, anatomy of the burn site, percentage of burn, degree of burns, cause of burns and disease outcome.</p><p><strong>Results: </strong>The mean age of the patients was 42.2±2.99 years. Seven cases (17.5%) had burns due to fire, 5 cases (12.5%) due to gas explosion, 3 cases (7.5%) due to electrocution, 15 cases (37.5%) with hot water, 1 case (2.5%) with hot liquids, 5 cases (12.5%) with hot surface, 1 case (2.5%) with hot bath, 2 cases (5%) with hot food and 1 case (2.5%) with hot glue. The mean burning percentage of patients was 19.3±3.18%. The most common patterns of burns were observed as 7 (17.5%) upper limbs and 7 (17.5%) lower limbs. The mean duration of hospitalization was 5.05±0.69 days ranging from 1 to 18 days. 37 patients (92.5%) recovered partially and 3 patients (7.5%) died.</p><p><strong>Conclusion: </strong>Hot water, fire and hot surface are most common causes of burns and there were significant direct correlations between age with percentage of burns and duration of hospitalization. We believe further studies should evaluate the preventive strategies in this regard.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40308315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}