Case Reports in Gastrointestinal Medicine最新文献

{"title":"Foveolar-Type Gastric Adenoma With a Raspberry-Like Appearance That Underwent Dramatic Morphological Changes Within Eight Months.","authors":"Kohei Funasaka, Tadahiro Yokoyama, Noriyuki Horiguchi, Takahiro Marukawa, Hyuga Yamada, Ryoji Miyahara, Madoka Isomura, Takao Sakai, Sachiko Minamiguchi, Yoshiki Hirooka","doi":"10.1155/crgm/1594833","DOIUrl":"10.1155/crgm/1594833","url":null,"abstract":"<p><strong>Background: </strong>Foveolar-type gastric adenomas with a raspberry-like appearance in the stomach have recently been identified. However, their etiology and mechanisms of development and growth remain unknown.</p><p><strong>Case presentation: </strong>We observed a foveolar-type gastric adenoma with a raspberry-like appearance that underwent rapid morphological changes. The first esophagogastroduodenoscopy revealed multiple reddish polyps on the cardia and fundus of the stomach, without <i>Helicobacter pylori</i> infection. The second-largest polyp on the fundus had a red glove appearance and measured 5 mm in diameter. We diagnosed all of them as hyperplastic polyps on the basis of their shape. Given that the patient had received 10 mg of vonoprazan for a long time to treat reflux esophagitis, 20 mg of famotidine was prescribed instead. Eight months later, the largest polyp on the cardia had disappeared.However, a reddish raspberry-like lesion was observed at the site of a previously identified polyp on the fundus and was diagnosed as foveolar-type gastric adenoma by forceps biopsy. The pathological diagnosis was foveolar-type gastric adenoma with high-grade dysplasia as determined by tissue resection with endoscopic mucosal resection (EMR).</p><p><strong>Conclusion: </strong>This is a valuable case report of a lesion evolving from a hyperplastic-like polyp morphology to a raspberry-like lesion within eight months.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"1594833"},"PeriodicalIF":0.6,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036221","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":"Smoldering Amiodarone-Induced Decompensated Cirrhosis: Cumulative Dose-Related Toxicity.","authors":"Jason Ta, Ritesh Bhandari, Joseph Di Francesco, Austin Roberts, Eileen Long, Puneet Chhabra, Junaid Beig","doi":"10.1155/crgm/9933788","DOIUrl":"10.1155/crgm/9933788","url":null,"abstract":"<p><p>Amiodarone is a widely prescribed antiarrhythmic drug, but it can rarely cause severe progressive hepatotoxicity. This report presents a 74-year-old man on long-term amiodarone therapy who developed tense ascites and cholestatic liver dysfunction after 12 years of continuous treatment, corresponding to a cumulative dose of 876 g. Five months prior to presentation, routine liver tests showed subtle and nonspecific abnormalities in liver enzymes, and there were no clinical stigmata of chronic liver disease. Quad-phase CT imaging demonstrated features of chronic liver disease, with increased hepatic attenuation on the noncontrast phase, consistent with iodine deposition in the context of long-term amiodarone exposure. Liver biopsy confirmed cirrhosis with ballooning hepatocytes, Mallory-Denk bodies, and neutrophilic satellitosis in the absence of steatosis, histological features suggestive of amiodarone-induced liver injury. Secondary causes were excluded. Despite discontinuation of amiodarone and initiation of supportive therapy, the patient experienced recurrent decompensation. This case underscores the potential for subclinical progression of amiodarone-induced liver injury, even in the presence of subtle or nonspecific abnormalities in liver biochemistry without a clear pattern to predict advanced fibrosis or imminent decompensation. Increased hepatic density on noncontrast CT imaging may serve as a radiologic indicator of drug deposition. Long-term vigilance and monitoring of cumulative dose are essential for early detection and prevention of irreversible liver injury.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"9933788"},"PeriodicalIF":0.6,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036248","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":"Selective ARID1A Loss Restricted to the Undifferentiated Component of a Mismatch Repair-Deficient Gastric Carcinoma: A Case Report.","authors":"Rika Omote, Ryosuke Hamano, Shinya Otsuka, Takehiro Tanaka, Hiroyuki Yanai","doi":"10.1155/crgm/8863202","DOIUrl":"10.1155/crgm/8863202","url":null,"abstract":"<p><p>Mismatch repair-deficient (dMMR) gastric carcinomas often harbor ARID1A alteration, but a sharply demarcated undifferentiated/rhabdoid component with selective ARID1A loss is uncommon and may create a diagnostic dilemma. An 80-year-old man underwent esophagogastroduodenoscopy for anemia, which revealed a circumferential Borrmann Type 3 lesion in the gastric body, and distal gastrectomy was performed. Histologically, the tumor was composed predominantly of undifferentiated carcinoma with focal rhabdoid features and a minute well-differentiated adenocarcinoma component, with an abrupt transition between the two. Immunohistochemistry showed loss of nuclear MLH1 and PMS2 in both components, whereas loss of ARID1A expression was confined to the undifferentiated component; SMARCB1 (INI1), SMARCA2 (BRM), and SMARCA4 (BRG1) were retained. EBER in situ hybridization was negative. Because gene-level testing, MSI testing, and MLH1 promoter methylation analysis were not performed, the molecular basis of the dMMR phenotype and ARID1A loss could not be determined. The restricted scope of molecular testing limits the ability to draw broad or generalizable conclusions and to fully establish clinicopathological correlations. The value of this report is, therefore, not mechanistic proof but recognition of a practical morphologic-immunophenotypic observation: When a gastric carcinoma shows a sharply demarcated shift from differentiated to undifferentiated/rhabdoid morphology, dMMR should be considered, and selective ARID1A loss in the undifferentiated component may be associated with dedifferentiation. These findings should be interpreted with caution as preliminary, hypothesis-generating observations that require validation in larger studies with more extensive molecular profiling.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"8863202"},"PeriodicalIF":0.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844233","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":"Metastatic Squamous Cell Carcinoma of the Cervix Presenting With Haematemesis and Duodenal Obstruction: A Case Report and Literature Review.","authors":"D L Moodley, A C Van Wyk, M Y Sungay, A A Abdelsalem, M S Gabriel","doi":"10.1155/crgm/4772159","DOIUrl":"10.1155/crgm/4772159","url":null,"abstract":"<p><strong>Background: </strong>Metastatic spread of cervical squamous cell carcinoma (SCC) to the duodenum is exceedingly rare, with fewer than 25 cases reported in the literature. Such metastases can present with gastrointestinal symptoms, including upper gastrointestinal bleeding or gastric outlet obstruction (GOO).</p><p><strong>Case presentation: </strong>We report the case of a 58-year-old female with a history of Stage IIB cervical cancer in remission, who presented with haematemesis. Initially, this was ascribed to peptic ulcer disease but was later diagnosed as GOO due to a duodenal mass. Histology confirmed metastatic p16-positive SCC, in keeping with metastatic cervical cancer. The patient's malignant GOO was palliated successfully with the placement of a self-expanding metal stent (SEMS). She died 1 month after discharge.</p><p><strong>Conclusion: </strong>This case highlights an uncommon metastatic pattern of cervical cancer, as well as the diagnostic challenge it can represent. In patients with prior malignancy, a high index of suspicion should be maintained when they present with GOO, regardless of the time interval. It also demonstrates the role of enteral stenting as an effective palliative approach in malignant GOO.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"4772159"},"PeriodicalIF":0.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844171","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":"A Rare but Life-Threatening Complication of Direct Endoscopic Necrosectomy: Tension Pneumoperitoneum With Pneumothorax and Hypercapnia due to Walled-Off Necrosis Rupture.","authors":"Yasuo Otsuka, Kosuke Minaga, Akane Hara, Mamoru Takenaka, Chihoko Nobori, Takaaki Murase, Ippei Matsumoto, Masatoshi Kudo","doi":"10.1155/crgm/6599334","DOIUrl":"10.1155/crgm/6599334","url":null,"abstract":"<p><p>Endoscopic ultrasonography (EUS)-guided drainage followed by direct endoscopic necrosectomy (DEN) is widely used as a minimally invasive treatment for walled-off necrosis (WON). While this approach is considered effective and safe, serious complications may occur. We report a case of carbon dioxide (CO₂)-related tension pneumoperitoneum accompanied by severe hypercapnia during DEN. A 65-year-old man with gallstone pancreatitis developed a large WON causing gastric outlet obstruction. He underwent EUS-guided transgastric drainage with placement of a lumen-apposing metal stent (LAMS), followed by planned DEN sessions under CO₂ insufflation with propofol sedation. During the second DEN session, the LAMS became dislodged, and subsequent DEN was continued after balloon dilation of the endosonographically created route. During the fourth DEN session, the patient experienced sudden oxygen desaturation. Imaging revealed extensive free air in the abdominal and thoracic cavities, and arterial blood gas analysis showed severe hypercapnia. Emergency exploratory laparotomy revealed disruption of the WON wall with communication into the abdominal cavity. Surgical necrosectomy and abdominal irrigation were performed. The patient recovered uneventfully. This case highlights a rare but potentially serious CO₂-related complication of DEN and underscores the need for meticulous control of intracavitary pressure and close respiratory monitoring during the procedure.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"6599334"},"PeriodicalIF":0.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821930","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":"A Novel Approach to Recurrent Hepatic Hydatid Cyst Using EUS-Guided Aspiration and Ethanol Injection: A Case Report and Focused Literature Review.","authors":"Pouyan Ebrahimi, Amin Esmaeilnia Shirvani, Mohammad Golparvar Azizi, Hadie Razjouyan, Seyed Hassan Abedi","doi":"10.1155/crgm/5497218","DOIUrl":"10.1155/crgm/5497218","url":null,"abstract":"<p><strong>Background: </strong>Hepatic hydatid disease, a manifestation of cystic echinococcosis caused by <i>Echinococcus granulosus</i>, remains endemic in many regions and poses a persistent therapeutic challenge. Although surgery is often employed for definitive management, recurrence, procedural risks, and anatomical constraints have led to growing interest in minimally invasive alternatives such as percutaneous aspiration and endoscopic interventions.</p><p><strong>Case presentation: </strong>We report a 52-year-old male with an incidentally detected hepatic hydatid cyst who initially underwent surgical cystectomy and cholecystectomy. Twenty-five days postoperatively, the patient developed new abdominal fullness, and repeat imaging revealed a cystic lesion in the left hepatic lobe measuring 13.4 × 9.9 cm, reported radiologically as recurrence. The patient underwent endoscopic ultrasound (EUS)-guided fine-needle aspiration and lavage of the cyst cavity with 20 mL of 96% ethanol. The procedure was well tolerated with no adverse events, and follow-up imaging at 6 months confirmed complete cyst resolution.</p><p><strong>Conclusion: </strong>This case demonstrates the technical feasibility and clinical safety of EUS-guided ethanol ablation as a minimally invasive alternative for recurrent hepatic hydatid cysts. It highlights the expanding therapeutic potential of EUS beyond conventional indications and supports further exploration of this technique in selected cases.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"5497218"},"PeriodicalIF":0.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783638","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":"Staphylococcal Gangrenous Cholecystitis: A Case Report.","authors":"Anandu Mathews Anto, George Sarin Zacharia, Maria Jaquez Duran, Dmitry Lvovsky","doi":"10.1155/crgm/3341650","DOIUrl":"10.1155/crgm/3341650","url":null,"abstract":"<p><p>Gangrenous cholecystitis is a severe and potentially fatal complication of acute cholecystitis, typically resulting from ischemic necrosis of the gallbladder wall secondary to sustained obstruction and inflammation. We present a rare case of methicillin-sensitive <i>Staphylococcus aureus</i>-associated gangrenous cholecystitis with bacteremia in an elderly female without identifiable risk factors for staphylococcal infection. The patient was treated with antibiotics and emergent percutaneous cholecystostomy. This case highlights the need to consider infrequent pathogens, such as <i>S. aureus</i>, in patients with severe cholecystitis, particularly when clinical deterioration persists despite standard empirical therapy. Early diagnosis and prompt multidisciplinary management remain the key to a favorable outcome in this medically complex patient.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"3341650"},"PeriodicalIF":0.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783597","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":"Markedly Elevated CA 19-9 in ANA/ASMA-Negative IgG4-Related Autoimmune Hepatitis With Concomitant Pancreatitis: A Case Report.","authors":"Hunter Scott, Samuel Reiss","doi":"10.1155/crgm/3494971","DOIUrl":"10.1155/crgm/3494971","url":null,"abstract":"<p><strong>Background: </strong>IgG4-related disease (IgG4-RD) can involve the liver and pancreas and may present without conventional autoimmune hepatitis (AIH) autoantibodies, creating diagnostic delay unless IgG4 testing and tissue immunostaining are pursued. We describe an older man with acute hepatocellular injury and marked hyperbilirubinemia who was negative for antinuclear (ANA) and antismooth muscle (ASMA) antibodies but had markedly elevated serum IgG4 and IgG4-positive plasma cell infiltration on liver biopsy, consistent with IgG4-related autoimmune hepatitis (IgG4-AIH).</p><p><strong>Case presentation: </strong>A man in his 80s presented with abdominal pain followed by progressive jaundice and pruritus, with acute hepatocellular injury and hyperbilirubinemia. Evaluation showed negative ANA and ASMA, elevated total IgG (2166 mg/dL) and IgG4 (442.5 mg/dL), CA 19-9 1268 U/mL, and CT/MRCP findings consistent with pancreatitis without biliary obstruction or mass. HFE analysis showed compound heterozygosity. Liver biopsy demonstrated interface hepatitis with plasma cell-rich inflammation and increased IgG4-positive plasma cells (up to 58 per high-power field), supporting IgG4-AIH. Minimal iron deposition on biopsy favored inflammation-related iron study abnormalities rather than primary hemochromatosis. The pancreatic findings were most consistent with probable Type 1 autoimmune pancreatitis. Prednisone 40 mg daily led to improvement, with normalization of transaminases and total bilirubin by Day 57 (approximately 8 weeks) in available follow-up testing.</p><p><strong>Conclusion: </strong>IgG4-AIH is diagnostically challenging, particularly in seronegative presentations. Unexpectedly high CA 19-9 may be seen in IgG4-RD, which may mimic malignancy. In atypical presentations such as those occurring in older adults without conventional antibody positivity or with concurrent pancreatitis on imaging, clinicians should promptly consider early biopsy with immunostaining to avoid diagnostic delay and enable timely steroid treatment.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"3494971"},"PeriodicalIF":0.6,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783600","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":"Varicella-Zoster Virus-Associated Esophagogastritis.","authors":"Masaya Iwamuro, Takehiro Tanaka, Motoyuki Otsuka","doi":"10.1155/crgm/9319708","DOIUrl":"10.1155/crgm/9319708","url":null,"abstract":"<p><p>Varicella-zoster virus (VZV) typically manifests as varicella or herpes zoster; however, in immunocompromised patients, viral reactivation may result in disseminated infection with visceral organ involvement. Gastrointestinal involvement is particularly rare and often underrecognized. We report a case of biopsy-proven VZV-associated esophagogastritis in a patient with Richter syndrome undergoing chemotherapy. A 77-year-old man was admitted with abdominal pain, anorexia, and fatigue. On hospital Day 3, he developed disseminated papulovesicular skin lesions. Cytologic examination of vesicular fluid revealed multinucleated giant cells, and antigen testing confirmed VZV infection. Esophagogastroduodenoscopy demonstrated erosions with white exudates in the esophagus and multiple gastric ulcers. Biopsy specimens from both the esophagus and stomach showed positive immunohistochemical staining for VZV. In addition, esophageal specimens exhibited characteristic viral cytopathic changes, including intranuclear inclusion bodies and multinucleation, confirming the diagnosis of VZV-associated esophagogastritis. Intravenous acyclovir therapy resulted in marked improvement of both cutaneous and gastrointestinal lesions. VZV-associated esophagogastritis is a rare but clinically significant manifestation of disseminated VZV infection. This condition should be considered in immunocompromised patients presenting with unexplained gastrointestinal symptoms, even before the appearance of characteristic skin lesions. Early endoscopic evaluation with biopsy and appropriate virological testing is essential for timely diagnosis and effective antiviral treatment.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"9319708"},"PeriodicalIF":0.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724134","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":"Biliary Obstruction Secondary to Transjugular Intrahepatic Portosystemic Shunt Presenting as Alcohol-Associated Hepatitis.","authors":"Yash Hegde, Dana Ley, Adnan Said, Prasad Dalvie, Mark Benson, Deepak V Gopal","doi":"10.1155/crgm/6660623","DOIUrl":"10.1155/crgm/6660623","url":null,"abstract":"<p><p>Transjugular portosystemic intrahepatic shunt (TIPS) is a procedure used to alleviate portal hypertension. The two most common clinical indications for TIPS are secondary prevention of variceal hemorrhage and refractory ascites. Biliary complications, of which biliary-shunt fistulas are the most common, are very rare. There are very limited data on TIPS placement leading to biliary obstruction. We describe a patient who underwent TIPS placement leading to biliary obstruction, initially thought to have alcohol-associated hepatitis, who was successfully treated with interventional radiology-guided percutaneous biliary drain placement.</p>","PeriodicalId":45645,"journal":{"name":"Case Reports in Gastrointestinal Medicine","volume":"2026 ","pages":"6660623"},"PeriodicalIF":0.6,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279184","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}