Indian Journal of Surgical Oncology最新文献

{"title":"Assessment of Chemotherapy Knowledge and Practices Among Breast Surgeons in India: Identifying Gaps and Areas for Improvement.","authors":"Ashish Jakhetiya, Priyanka Kaul, Jitendra Kumar Meena, Ajay Kumar Yadav, Ajeet Ramamani Tiwari, Rahul Kumar, Pankaj Kumar Garg","doi":"10.1007/s13193-024-02040-7","DOIUrl":"10.1007/s13193-024-02040-7","url":null,"abstract":"<p><p>This cross-sectional survey aimed to assess the knowledge and current practice of chemotherapy among breast surgeons in India. The objective was to evaluate their familiarity with chemotherapy protocols, treatment preferences, and utilisation of emerging technologies to identify areas for improvement and potential gaps in the delivery of breast cancer care. The survey employed a questionnaire-based approach using the Google Forms platform. A total of 264 breast surgeons actively involved in the clinical management of breast cancer participated in the study. The questionnaire consisted of 19 closed-ended questions covering various aspects of breast cancer management. The survey was distributed to participants via WhatsApp or email. The survey involved 264 surgeons, 60.6% employed at a cancer centre and 27.2% at a teaching hospital. A total of 43.1% reported routinely administering chemotherapy to patients with breast cancer, 32.8% took a selective approach, and 24.1% had never administered chemotherapy to breast cancer patients. In addition, 39.7% consistently discussed cases in a multidisciplinary team (MDT) setting, 24.8% preferred MDT discussions but not on every occasion, and 35.5% did not have access to an MDT. Regarding central venous access device (CVAD) utilisation, 10.3% always used CVADs, 67.2% used them selectively, and 22.4% did not routinely employ CVADs. Furthermore, 96.6% of respondents consistently inquired about molecular subtypes, while 53.4% advised patients about genetic testing. For management strategies, 86.2% considered NACT for selected EBC patients. The sandwich protocol was used for large operable breast cancer by 53.4%, and 58.6% used it for LABC. Only 36.2% considered SLNB in post-NACT cases, while 11.7% performed SLNB in this setting. These findings highlight the need for continued research, professional development training, consensus-building, and adherence to evidence-based guidelines to ensure optimal and standardised care for breast cancer patients in India.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"103-108"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671605","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":"Does Contrast-Enhanced Mammography Outperform Digital Breast Tomosynthesis for Detection and Characterization of Breast Lesions or Vice Versa?","authors":"Veenu Singla, Pallavi T, Saumya Soni, Tulika Singh, Siddhant Khare, Amanjit Bal","doi":"10.1007/s13193-024-02090-x","DOIUrl":"10.1007/s13193-024-02090-x","url":null,"abstract":"<p><p>Mammograms are the mainstay of diagnostic breast imaging and cancer screening. Despite mammography advances like full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT), these imaging techniques provide purely structural information. Though the most sensitive modality for breast cancer detection is magnetic resonance imaging (MRI), its widespread use has been limited due to high cost, long scan times, and lack of availability. Contrast-enhanced mammography (CEM) is a novel technique which combines dual energy FFDM with injection of iodinated contrast. It provides structural and functional imaging similar to MRI. The objectives of this study were to assess and compare the diagnostic performance of CEM and DBT in characterizing breast lesions and to analyze additional findings revealed by CEM and examining their implications for patient management. This was a single center prospective observational study on 58 women with BI-RADS category of 3, 4, and 5 breast lesions who underwent CEM following DBT. CEM detected 62 lesions, out of which 46 were categorized as suspicious/malignant and 16 as benign. On histopathology, 44 turned out to be malignant and 18 benign. CEM achieved a sensitivity of 100% and specificity of 88%. In contrast, DBT identified 56 of these 62 lesions (42 were malignant and 14 were benign on histopathology), with sensitivity of 95% and specificity of 77.8%. Compared to DBT, CEM provided superior delineation of disease extent, depicting multifocal and multicentric lesions, as well as picking up lesions in contralateral breasts, thereby altering patient management.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"333-343"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671607","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":"Intraosseous Mucoepidermoid Carcinoma-Case Series of a Rare but Recurring Entity.","authors":"Rajat Choudhari, Pinakin Patel, Suresh Singh, Kamal Kishor Lakhera, Yashasvi Patel","doi":"10.1007/s13193-024-02092-9","DOIUrl":"10.1007/s13193-024-02092-9","url":null,"abstract":"<p><p>Salivary gland tumors constitute 3-6% of all head and neck neoplasms. Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm, and 2-4% of these tumors can occur in the mandible. This is the largest single report of five cases, all treated within a span of 1 year. After obtaining approval from the institutional ethics committee, a retrospective review was done of the cases where an intraosseous MEC was treated with surgical resection. Five patients were diagnosed as intraosseous MEC and treated within a span of 1 year. All patients underwent a wide local excision with hemimandibulectomy and modified radical neck dissection with a flap reconstruction. Four patients underwent a pectoralis major myocutaneous flap, of which 2 were bipaddle and 1 received a fibular free flap. Four patients received adjuvant radiotherapy and 1 was observed. All of them had good surgical outcome and 3 of them had a DFS of 12 months until follow-up whereas 1 developed a local recurrence. Intraosseous MEC presents with a painless growth in the jaw and may spread beyond the mandible to involve the oral cavity. Primary treatment consists of surgical resection with mandibulectomy and adjuvant radiotherapy for high-risk cases. They have an excellent prognosis with survival up to 98% for low-grade tumors.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"320-325"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670156","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":"Potentiality of Curcumin Against Radio-Chemotherapy Induced Oral Mucositis: A Review.","authors":"Manoj Kumar Sarangi","doi":"10.1007/s13193-024-02082-x","DOIUrl":"10.1007/s13193-024-02082-x","url":null,"abstract":"<p><p>In recent era, cancer is a major global health hazard and is mostly treated with either radio or chemotherapy. The above treatment procedure induces a secondary concern named as oral mucositis (OM). The disorder OM is specifically associated with oral mucosa and leads to bleeding, pain, difficulty in swallowing of solids, as well as fluids and speech difficulty. Curcumin is explored for prevention as well as treatment of OM. The article was organized via collection of enormous literatures by using the keywords like oral mucositis, chemotherapy, anti-inflammatory, curcumin, and clinical trials from search engines of different domains like Scopus, PubMed/MEDLINE, Science Direct, <i>and</i> Google Scholar with an increasing order of their year of publications. A numerous antineoplastic therapies resulted OM, as a devastating side effect. Moreover, the expanded pathogenesis of the disease permits a sound predictability over the patient's risk, thereby directing its adaptability and management protocols towards the achievement of novel therapeutics. An augmented interest towards curcumin as a potential therapeutic emerged because of its easy accessibility, antioxidant, anti-inflammatory, antiulcer, antimicrobial, and wound-healing abilities along with reduced side effects. Curcumin can potentially alter OM and OM-induced weight loss but showed a great heterogeneity.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"296-311"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671425","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":"Effective Treatment of Primary Orbital Squamous Cell Carcinoma with Radiotherapy: A Rare Case Report and Literature Review Update.","authors":"Jyotiman Nath, Abhinandan Das, Debasmita Saha, Shiraj Ahmed, Kaberi Kakati, Anamika Dutta","doi":"10.1007/s13193-024-02096-5","DOIUrl":"10.1007/s13193-024-02096-5","url":null,"abstract":"<p><p>Primary squamous cell carcinoma (SCC) of the orbit is exceptionally rare, comprising only a small fraction of ocular tumours, with most cases being secondary to tumours originating from nearby structures or due to distant metastasis. We present a case of primary orbital SCC in a 60-year-old male, discussing its diagnostic workup, imaging findings, and multidisciplinary management. The patient underwent definitive radiotherapy with concurrent chemotherapy after being deemed inoperable. Without any severe treatment-related adverse event, the patient achieved a complete metabolic response at 7 months post-treatment with maintained vision. As evident from a review of the literature, treatment approaches vary widely in this group of patients, with radiotherapy emerging as a successful modality in achieving disease control while preserving vision with acceptable toxicity. This case underscores the complexity of managing primary orbital SCCs and highlights the efficacy of radiotherapy in achieving favourable outcomes.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"349-355"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671611","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 Intraoperative Bone Dust Cytology for Assessing Bone Margins: A Novel Technique.","authors":"Lakshminarasimman Parasuraman, Nikhilesh Borkar, Neelam Prabhudesai, Kintan Sanghvi, Shubhada Kane, Dinesh Shah, Prathamesh Pai","doi":"10.1007/s13193-024-02069-8","DOIUrl":"10.1007/s13193-024-02069-8","url":null,"abstract":"<p><p>Surgical margin influences the outcome of oral squamous cell carcinoma (OSCC). There are few techniques described in the literature for assessing intraoperative bone margins which are cumbersome. We present a novel technique for rapid intraoperative analysis of cortical bone. Fifty untreated patients with OSCC had their margins analysed with bone dust cytology during surgery. This was compared with standard final histopathology in terms of sensitivity and specificity. A total of 227 sites were analysed. A total of 152 sites (66.9%) were true negative while 54 sites (23.8%) were true positive in comparison to final histology following bone decalcification. Overall, 15 sites (6.6%) were false negative while 6 sites (2.6%) were false positive giving a sensitivity of 78.26%, specificity of 96.20%, positive predictive value of 90%, and a negative predictive value of 91.02%. The overall accuracy rate for bone dust cytology was 90.75%. Bone dust cytology is a simple, feasible and less time-consuming with an accuracy rate of 90.75%.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"326-332"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671432","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 Laterality of Port Catheter Placement in Breast Cancer Patients: Investigating the Impact of Side Selection.","authors":"Fatemeh Farsiani, Pouya Tayebi, Maryam Parsa, Ali Bijani, Majid Nabipour, Dariush Moslemi","doi":"10.1007/s13193-024-02095-6","DOIUrl":"10.1007/s13193-024-02095-6","url":null,"abstract":"<p><p>Breast cancer, the most prevalent malignancy in women, has witnessed an increased incidence alongside the rising use of port catheters and chemotherapy. Despite the conventional practice of contralateral port placement, the impact of side selection on complications remains unclear, necessitating a nuanced investigation. This prospective cross-sectional study, conducted from 2021 to 2022, involved 100 females over 18 undergoing port catheter placements for breast cancer. Meticulous data collection included patient demographics, procedure details, and postoperative complications. Statistical analyses were employed to assess variables, and ethical principles were followed. Findings revealed no statistically significant differences in complication rates between ipsilateral and contralateral placements. The absence of infections, fractures, thrombosis, or catheter displacement underscored overall safety. Intriguingly, no discernible impact on breast cancer subtype distribution was observed, challenging conventional assumptions. This investigation into the laterality of port catheter placement in breast cancer patients yielded promising outcomes. The absence of significant complications and the negligible impact on cancer subtype distribution underscore the safety and efficacy of this intervention. However, individual patient characteristics and procedural nuances should guide decisions about port catheter placement, contributing valuable insights to optimize strategies for improved patient outcomes.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"344-348"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671447","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":"An Analysis of the Results of Breast Imaging Reporting and Data System 4 Lesions in Tertiary Care Center in South India.","authors":"Lakshmi Revi, Chitrathara Kesava Pillai, Anupama Sreedhar, Sanam Puzhakkal","doi":"10.1007/s13193-024-02089-4","DOIUrl":"10.1007/s13193-024-02089-4","url":null,"abstract":"<p><p>The Breast Imaging Reporting and Data System (BIRADS) is a reporting system used to describe the results of mammogram, breast ultrasound, or breast MRI in a standard way. BIRADS ranks the test findings according to one of the seven categories, ranging from normal or benign to highly suspicious of cancer or malignant. This has specific accuracy for breast cancer. Out of the seven categories, BIRADS 4 is linked with a greater possibility for carcinoma breast. The research objective was to establish the rate of malignancy and clinical net result of BIRADS 4 lesions. The retrospective study, conducted in in Lakeshore Hospital and Research Centre (LHRC), Kochi, for a duration of 3 years, from December 2019 to December 2022, includes patients diagnosed as BIRADS 4 by mammographic or ultrasonographic or MRI findings. Previous medical records and electronic database were used to collect data. The study includes patients with BIRADS 4 lesions who went through surgery. Predictors such as patient demographics, comorbidities, and imaging features were considered. The rate of malignancy and positive predictive factor of BIRADS 4 lesions associated with carcinoma breast was calculated. A total of 394 lesions were classified as BIRADS 4 according to mammogram, ultrasound, or MRI for a time period of 3 years, from December 2019 to December 2022 at LHRC. Nevertheless, only 383 BIRADS 4 lesions for whom surgery was done were included in the survey. Out of the 383 lesions, the final histopathological report of the biopsied samples revealed 339 lesions to be malignant. Multivariate logistic regression analysis showed that menopausal status, mass lesions and spiculations in mammogram, and ductal abnormality in ultrasonography were greatly linked with carcinoma breast. Invasive breast carcinoma was the most common malignant lesion while fibro-cystic disease remained the predominant benign pathology. This study showed that majority of the BIRADS 4 lesions in LHRC were malignant. Both mammogram and ultrasonography were able to pick up early-stage breast cancer. Tissue diagnosis had higher sensitivity and is useful to avoid surgeries for non-significant lesions which can be followed up. Routine health check-up should be done according to the recent guidelines to detect early-stage breast cancer.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"312-319"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671590","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":"Internal Jugular Vein Reconstruction with Cephalic Vein Interposition Graft: A Case Report and Review of Literature.","authors":"Purushottam Chavan, Guru Keerthi B, Greeshma Upadhya, Jaykumar V Patel, Gaurang Singhal, Roopa Malali","doi":"10.1007/s13193-024-02063-0","DOIUrl":"10.1007/s13193-024-02063-0","url":null,"abstract":"<p><p>At times, radical neck dissection may necessitate the sacrifice of bilateral internal jugular veins due to extensive nodal disease. This can lead to serious consequences such as the risk of blindness, potentially catastrophic laryngeal edema, stroke, and even death if the internal jugular vein (IJV) is absent or occluded. The reconstruction of the IJV presents an opportunity to mitigate these risks and their subsequent effects, whether performed during or after the neck dissection. The external jugular vein is commonly utilized for anastomosis when reconstructing the IJV, but its availability may be limited at times, prompting the consideration of alternative options. We present the case of a 50-year-old male patient with supraglottic malignancy (cT2N1M0), who had previously undergone chemo-radiotherapy. After a disease-free interval of 9 months, the patient experienced a nodal recurrence at bilateral level III. Subsequently, he underwent bilateral lateral neck dissection, involving the sacrifice of bilateral internal jugular veins due to extensive extranodal spread. The left-sided internal jugular vein was re-anastomosed using a right cephalic vein interposition graft. During the last follow-up, the disease was locoregionally controlled, with no observed neck lymphedema, and the patient maintained a functional larynx with good speech and swallow. Internal jugular vein re-anastomosis with a cephalic vein interposition graft proves to be a viable alternative in cases involving bilateral IJV ligation.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"198-202"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671626","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":"Sentinel Lymph Node Biopsy Evaluation in Early Stage T1, T2, N0, Squamous Cell Carcinoma of the Oral Cavity with Methylene Blue Dye.","authors":"Amit Kumar, Mahendra Singh Hada, Anjali Gupta, Sunil Samdhani","doi":"10.1007/s13193-024-02078-7","DOIUrl":"10.1007/s13193-024-02078-7","url":null,"abstract":"<p><p>This study aims to evaluate the expediency of the sentinel lymph node biopsy (SLNB) for the presence of occult node metastasis in patients with squamous cell carcinoma (SCC) of the oral cavity presenting with early-stage node-negative disease. A hospital-based descriptive type of cross-sectional study was conducted over a period of 1 year at a tertiary care hospital and referral center after approval by the institute ethical committee. Forty patients underwent SLNB using a peri-tumoral methylene blue dye injection. A total of 59 blue-dyed nodes were dissected in 34 cases and sent for frozen section analyses and histopathological examination (HPE). Elective neck dissection (END) was done in all 40 patients. The SLNB results were correlated with subsequent histopathological grading. Level IIA had the highest proportion of blue-stained sentinel nodes in 15 (37.5%) cases. The frozen section analysis has 75% sensitivity, 100% specificity, 100% positive predictive value (PPV), and 92.86% negative predictive value (NPV). The frozen section analysis of blue-stained sentinel nodes detected occult metastasis in 17.6% of cases (6 out of 34 patients), while subsequent HPE of the dye-stained sentinel nodes revealed positive occult metastasis in 23.5% of cases (8 out of 34 patients). Once SLN is detected on methylene blue, a higher detection rate of occult metastasis is present in comparison to dye-negative nodes. The use of sentinel lymph node biopsy can be a valuable diagnostic technique, especially in regions with limited resources, such as many parts of the developing world.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 1","pages":"245-250"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671443","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}