{"title":"Update in diagnosis and management of irritable bowel syndrome","authors":"Tsung-Hsing Hung, Chih-Ying Wang, Hsing-Feng Lee","doi":"10.4103/tcmj.tcmj_104_23","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_104_23","url":null,"abstract":"A BSTRACT Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by a lack of structural or biochemical abnormalities. The current diagnosis of IBS is based on the Rome IV criteria, and it is recommended to approach IBS patients using a multidimensional clinical profile (MDCP). The pathophysiology of IBS is multifactorial and involves motility disorders, genetic factors, immune responses, visceral hypersensitivity, brain–gut dysregulation, and altered intestinal microbiota. The management of IBS includes both nonpharmacologic and pharmacologic therapies. Nonpharmacologic therapy options include physical activity, low fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet, as well as cognitive behavioral therapy. Pharmacologic therapy options include probiotics, antidepressants, antispasmodics, and new agents. In clinical practice, a multidisciplinary strategy, including nonpharmacologic or/and pharmacologic treatment for IBS, is emphasized. Therefore, clinicians should carefully consider the underlying pathophysiology before selecting an appropriate therapeutic option for the treatment of IBS. In other words, individualized treatment plans are necessary for managing IBS.","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136005083","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":"Comparative study of different combinations of mirabegron and antimuscarinics in treatment for overactive bladder syndrome in elderly patients.","authors":"Yuh-Chen Kuo, Hann-Chorng Kuo","doi":"10.4103/tcmj.tcmj_209_21","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_209_21","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the therapeutic efficacy, adverse events (AEs), and patient preference in elderly patients with overactive bladder (OAB) receiving different combinations of mirabegron and solifenacin.</p><p><strong>Materials and methods: </strong>Elderly OAB patients received mirabegron 25 mg (M25) daily for 1 month (1M) followed by randomization to receive M25 (Group 1), mirabegron 50 mg (M50, Group 2), solifenacin 5 mg (S5, group 3); or M25 plus S5 (Group 4) for further 2 months. Efficacy and AEs were evaluated. At the end of 3M, patients' preferred option for future treatment was investigated.</p><p><strong>Results: </strong>A total of 168 patients were enrolled, and 100 completed 3-month treatment. At 1M, all parameters improved significantly except postvoid residual (PVR), 23 (13.7%) patients had no symptom, 16 (9.5%) had no improvement, and 10 (6.0%) withdrew from the trial. Compared parameters at 3M with 1M revealed that quality of life, Patient's Perception of Bladder Condition scores, and voided volume improved significantly in group 1; the OAB Symptom Score (OABSS) increased in group 2; mean PVR and Global Response Assessment (GRA) deteriorated in group 3; and the OABSS and GRA improved in group 4. At 3M, the AEs prevalence increased significantly in group 3. Only 38.1% in group 4 preferred long-term usage of combination therapy.</p><p><strong>Conclusion: </strong>M25 daily is effective and safe in treating elderly OAB patients. Dose escalation to 50 mg or shifting to S5 does not increase the therapeutic efficacy. Combining M25 with S5 provides better treatment efficacy but is associated with lower patient compliance than M25 alone.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"62-68"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/1d/TCMJ-35-62.PMC9972936.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827924","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}
Jamshid Ahmadi, Amir Bazrafshan, Ali Sahraian, Sara Jalali, Maedeh Fakhermanesh, Zahra Hooshyari
{"title":"Anxiety treatment of methamphetamine-dependent patients with buprenorphine: A randomized, double-blind, clinical trial.","authors":"Jamshid Ahmadi, Amir Bazrafshan, Ali Sahraian, Sara Jalali, Maedeh Fakhermanesh, Zahra Hooshyari","doi":"10.4103/tcmj.tcmj_297_21","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_297_21","url":null,"abstract":"<p><strong>Objectives: </strong>In this double-blind, randomized clinical trial, the effectiveness of buprenorphine (BUPRE) in the reduction of anxiety symptoms among the methamphetamine (MA) dependents was evaluated.</p><p><strong>Materials and methods: </strong>The 60 MA-dependent patients were randomly assigned to three groups (0.1 mg, 1 mg, and 8 mg of BUPRE), The Hamilton Anxiety Rating Scale was administrated to assess the anxiety symptoms daily at baseline and second to the 5<sup>th</sup> day after intervention. The inclusion criteria were the MA dependence, age of over 18 years, and absence of any chronic physical illnesses; exclusion criteria were the presence of other drug dependence in combination with MA. The mixed-design analysis of variance was performed for data analysis.</p><p><strong>Results: </strong>A significant main effect of time (<i>F</i> = 51.456, <i>P</i> < 0.001) and group (<i>F</i> = 4.572, <i>P</i> = 0.014) and group-by-time interaction (<i>F</i> = 8.475, <i>P</i> < 0.001) were detected.</p><p><strong>Conclusions: </strong>This finding supports the efficacy of BUPRE to decrease anxiety. High doses of the drug (1 and 8 mg) were more effective than 0.1 mg. Here was not a significant difference between anxiety score when patients received 1 mg of BUPRE instead of 8 mg.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"89-94"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/70/TCMJ-35-89.PMC9972937.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389129","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}
Fathur Nur Kholis, Kevin Gracia Pratama, Jessica Novia Hadiyanto
{"title":"Association between inhaled corticosteroid use and risk of hyperglycemia in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Fathur Nur Kholis, Kevin Gracia Pratama, Jessica Novia Hadiyanto","doi":"10.4103/tcmj.tcmj_131_23","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_131_23","url":null,"abstract":"A BSTRACT Objectives: Chronic obstructive pulmonary disease (COPD) patients have a higher risk of developing diabetes, and studies suggest that inhaled corticosteroids (ICSs) use may be associated with a higher risk of diabetes, particularly at higher doses. This study aims to investigate the effects of ICS use on the risk of diabetes and blood glucose levels in COPD patients. Materials and Methods: A systematic search was carried out on the PubMed, EBSCOhost, and ProQuest databases using the terms “Inhaled Corticosteroids,” “Diabetes,” and “Chronic Obstructive Pulmonary Disease” for the period between 2013 and 2023. The systematic review adhered to the PRISMA 2020 guideline. A meta-analysis was conducted using a random-effects model using the RevMan 5 software. Results: A total of 14 studies were included in the final analysis, with 10 randomized controlled trials (RCTs) and 4 observational studies. Two observational studies investigated the relationship between ICS dose and diabetes risk. A meta-analysis of the RCTs studies showed a nonstatistically significant tendency toward increased blood glucose (odds ratio [OR] 1.07 and 95% confidence interval [CI] 0.88–1.30) after a 52-week follow-up. Whereas the observational studies showed a tendency toward an increased risk of diabetes (OR 1.40 and 95% CI 0.96–2.03). Furthermore, a subgroup meta-analysis of high-dose ICS (>900 mg/day) showed a significant increase in the risk of diabetes (OR 1.20 and 95% CI 1.09–1.32). Conclusion: Short-term use of ICS does not have a significant effect on blood glucose. However, long-term use, especially at higher doses, can increase the risk of developing diabetes.","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136005095","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":"The relationship between child development and small for gestational age among preschool children.","authors":"Sheng-Hsun Chou, Shu-Hui Wen, Hsin-Chi Wu","doi":"10.4103/tcmj.tcmj_227_21","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_227_21","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the impact of small for gestational age (SGA) on the development of Taiwanese preschool children using the Chinese Child Developmental Inventory (CCDI).</p><p><strong>Materials and methods: </strong>A total of 982 children were enrolled in this study between June 2011 and December 2015. The samples were divided into two groups: SGA (<i>n</i> = 116, mean age = 2.98) and non-SGA (<i>n</i> = 866, mean age = 3.33) groups. The development scores were based on the CCDI, which consist of eight dimensions of development between the two groups. The linear regression analysis was adopted to examine the relationship of SGA with child development.</p><p><strong>Results: </strong>On average, the children in the SGA group scored less in all eight subitems of the CCDI than those in the non-SGA group. However, regression analysis revealed that there was no significant difference in both performance and delay frequency in the CCDI between the two groups.</p><p><strong>Conclusion: </strong>SGA children had similar developmental scores in CCDI as non-SGA children for preschool age in Taiwan.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"78-83"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/27/TCMJ-35-78.PMC9972930.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827920","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}
Ya-Ling Hong, Yu-Chih Shen, En-Ting Chang, Shu-Chin Kung
{"title":"Continuous positive airway pressure improved daytime sleepiness and memory function in patients with obstructive sleep apnea.","authors":"Ya-Ling Hong, Yu-Chih Shen, En-Ting Chang, Shu-Chin Kung","doi":"10.4103/tcmj.tcmj_4_22","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_4_22","url":null,"abstract":"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is a sleep disorder which results in daytime sleepiness and impaired memory function. The aim of this study was to investigate the effect of continuous positive airway pressure (CPAP) on daytime sleepiness and memory function in OSA patients. We also investigated whether CPAP compliance impacted the effect of this treatment.</p><p><strong>Materials and methods: </strong>The nonrandomized, nonblinded clinical trial enrolled 66 patients with moderate-to-severe OSA subjects. All subjects completed a polysomnographic study, daytime sleepiness questionnaires (the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index), and four memory function tests (working memory; processing speed [PS]; logical memory [LM]; face memory [FM]).</p><p><strong>Results: </strong>Before CPAP treatment, no significant differences (<i>P</i> < 0.05) were noted in the demographic data, daytime sleepiness, or memory function between two groups (with/without CPAP). However, OSA patients treated with CPAP for 2 months showed significant improvements in daytime sleepiness, PS, mostly of LM, and FM comparing to 2 months ago. As compared to those who did not receive CPAP treatment, CPAP can improve only parts of LM (delayed LM [DLM] and LM percentage [LMP]). In addition, compared to control group, a significant improvement of daytime sleepiness and LM (LM learning, DLM, and LMP) in good compliance with CPAP treatment group and of DLM and LMP in the low compliance with CPAP treatment group was found.</p><p><strong>Conclusion: </strong>CPAP treatment for 2 months could improve some of LM in OSA patients, especially in patients exhibiting good CPAP compliance.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"84-88"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/81/TCMJ-35-84.PMC9972931.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389134","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":"Experimental animal models and evaluation techniques in intracerebral hemorrhage.","authors":"Shaik Ismail Mohammed Thangameeran, Cheng-Yoong Pang, Chien-Hui Lee, Sheng-Tzung Tsai, Wei-Fen Hu, Hock-Kean Liew","doi":"10.4103/tcmj.tcmj_119_22","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_119_22","url":null,"abstract":"<p><p>Intracerebral hemorrhage (ICH) is the most lethal type of cerebral stroke without effective therapy. Although clinical trials with various surgeries have been conducted, none have improved clinical outcomes compared to the current medical management for ICH. Several ICH animal models, including autologous blood injection, collagenase injection, thrombin injection, and microballoon inflation methods, have been developed to elucidate the underlying mechanisms of ICH-induced brain injury. These models could also be used for discovering new therapy for ICH preclinically. We summarize the existing ICH animal models and the evaluation parameters used to measure the disease outcomes. We conclude that these models, resembling the different aspects of ICH pathogenesis, have their advantages and disadvantages. None of the current models closely represent the severity of ICH seen in clinical settings. More appropriate models are needed to streamline ICH's clinical outcomes and be used for validating newly developed treatment protocols.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/7f/TCMJ-35-1.PMC9972928.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389136","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":"Humoral immune response to an mRNA-1273 booster after chAdOx1-nCoV-19-priming among patients undergoing hemodialysis","authors":"Bo-Yu Cheng, Ting-Yun Lin, Szu-Chun Hung","doi":"10.4103/tcmj.tcmj_107_23","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_107_23","url":null,"abstract":"A BSTRACT Objectives: Patients who are undergoing dialysis due to end-stage kidney disease are susceptible to greater coronavirus disease 2019 (COVID-19) complications. While vaccination is seen as the most effective tactic against COVID-19, the dialysis population usually has impaired immune responses to vaccination. Owing to the global vaccine supply shortage in the early phase of the COVID-19 pandemic, hemodialysis patients in Taiwan were administered homologous ChAdOx1 nCoV-19/ChAdOx1 nCoV-19 at 12-week intervals, with a third booster shot of mRNA-1273 given 12 weeks after the second dose. We assessed the antibody responses of these patients to this extended-interval dosing protocol. Materials and Methods: A total of 168 hemodialysis patients (mean age: 67 ± 13 years) without prior COVID-19 infection were vaccinated between June 16, 2021, and January 5, 2022, and followed until February 10, 2022. The primary outcome was seroconversion with an antispike immunoglobulin G (IgG) antibody level ≥50 arbitrary units (AU)/mL at 4 weeks after the administration of an mRNA-1273 booster shot. The secondary outcome was the level of antispike IgG antibodies. Multivariable linear regression models were used to evaluate the associations between the baseline characteristics and the antispike IgG level. Results: A total of 163 (97.0%) patients reached the primary endpoint, with antibody levels after the third booster dose of mRNA-1273 being significantly higher than those after the second dose of ChAdOx1 nCoV-19 (median IgG titer 12,007 [4394–23,860] vs. 846 [interquartile range 295–2114] AU/mL; P < 0.001). Patients who were male, older, had a higher body mass index, had a lower total lymphocyte count, and used immunosuppressants had lower antibody levels. Conclusion: A third booster dose of mRNA-1273 after two consecutive priming doses of ChAdOx1 nCoV-19 with extended intervals resulted in adequate humoral immune responses among hemodialysis patients.","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136004615","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":"Rodent models of senile normal-pressure hydrocephalus.","authors":"Li-Jin Chen, Sheng-Tzung Tsai, Guo-Fang Tseng","doi":"10.4103/tcmj.tcmj_120_22","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_120_22","url":null,"abstract":"<p><p>Cerebrospinal fluid (CSF) and its drainage are crucial in clearing metabolic waste and maintaining the microenvironment of the central nervous system for proper functioning. Normal-pressure hydrocephalus (NPH) is a serious neurological disorder of the elderly with obstruction of CSF flow outside the cerebral ventricles, causing ventriculomegaly. The stasis of CSF in NPH compromises brain functioning. Although treatable, often with shunt implantation for drainage, the outcome depends highly on early diagnosis, which, however, is challenging. The initial symptoms of NPH are hard to be aware of and the complete symptoms overlap with those of other neurological diseases. Ventriculomegaly is not specific to NPH as well. The lack of knowledge on the initial stages in its development and throughout its progression further deters early diagnosis. Thus, we are in dire need for an appropriate animal model for researches into a more thorough understanding of its development and pathophysiology so that we can enhance the diagnosis and therapeutic strategies to improve the prognosis of NPH following treatment. With this, we review the few currently available experimental rodent NPH models for these animals are smaller in sizes, easier in maintenance, and having a rapid life cycle. Among these, a parietal convexity subarachnoid space kaolin injection adult rat model appears promising as it shows a slow onset of ventriculomegaly in association with cognitive and motor disabilities resembling the elderly NPH in humans.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"18-23"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/81/TCMJ-35-18.PMC9972929.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827923","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":"Role of cancer-associated mesenchymal stem cells in the tumor microenvironment: A review.","authors":"Kai-Hung Wang, Dah-Ching Ding","doi":"10.4103/tcmj.tcmj_138_22","DOIUrl":"https://doi.org/10.4103/tcmj.tcmj_138_22","url":null,"abstract":"<p><p>Mesenchymal stem cells (MSCs) were applied to the therapy for degenerative diseases, immune, and inflammation. In tumor microenvironments (TME), different sources of MSCs showed that tumor-promoting and -inhibiting effects were mediated by different signaling pathways. Cancer-associated MSCs (CaMSCs) could be recruited from bone marrow or local tissues and mainly showed tumor-promoting and immunosuppressive effects. The transformed CaMSCs preserve the characteristics of stem cells, but the properties of regulating TME are different. Hence, we specifically focus on CaMSCs and discuss the detailed mechanisms of regulating the development of cancer cells and immune cells. CaMSCs could be a potential therapeutic target in various types of cancer. However, the detailed mechanisms of CaMSCs in the TME are relatively less known and need further study.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 1","pages":"24-30"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/8f/TCMJ-35-24.PMC9972927.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389132","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}