Medicinskij alʹâns最新文献

{"title":"Preclinical study of mutagenicity and safety of a vaccine against pneumococcal infection based on a recombinant hybrid protein","authors":"","doi":"10.36422/23076348-2023-11-3-78-86","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-78-86","url":null,"abstract":"Pneumococcal infection is the cause of pneumo-nia. Vaccination can prevent the severe course of this disease. The pneumococcal vaccine considered in the work was created by a genetically modified method based on a hybrid recombinant protein. The aim of the work was preclinical investigation of the mutagenic, genetic safety of the new pneumococcal vaccine, Irivax, against pneumococcal infection in rats. Materials and methods. Studies of the Irivax vaccine were carried out in male Wistar rats’ cell populations of the bone marrow and peripheral blood mononuclear cells. The karyoty-pic stability of cells and myelogram of the bone mar-row were studied. Results. After the introduction of the vaccine, the content of the lymphoid germ cells in the blood of rats was increased to 74.2% (p <0.05), which proves the body’s immune response. The frequency of cells with an unstable genome, as an indicator of the genetic safety of the AL-vaccine, was rare both in expe-rimental and control animals, and did not exceed 1.5%. Conclusion. Thus, the new pneumococcal vaccine Irivax and its components have mutagenic and toxic safety.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"21 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":"135010290","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":"Clinical example of effective treatment of a patient with a combination of fibrous-cavernous tuberculosis and chronic aspergillosis of the right lung","authors":"","doi":"10.36422/23076348-2023-11-3-35-44","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-35-44","url":null,"abstract":"ntroduction. The combination of destructive tuberculosis and chronic pulmonary aspergillosis remains a pressing and understudied problem. Respiratory tuberculosis is a significant risk factor for bronchopulmonary aspergillosis in 40–72% of cases. The current treatment strategy for pulmonary tuberculosis and bronchopulmonary aspergillosis is governed by clinical guidelines. However, the issues of surgical treatment tactics in complicated forms of the combination of active tuberculosis and pulmonary aspergillosis require discussion and remain relevant at present. Material and methods. A clinical case of complex treatment of a patient with a combination of fibrous-cavernous tuberculosis and chronic aspergillosis of the right lung is described. Patient S., 42 years old, became ill with infiltrative tuberculosis of the right lung in August 2008. On the background of a 9-month anti-tuberculosis chemotherapy according to the I regimen she was cured and in 2012 was removed from the dispensary registration. In February 2018, an episode of pulmonary hemorrhage (volume 200 ml) occurred, and was stopped by conservative methods. At the follow-up examination, tuberculosis recurrence was verified in the right lung with the formation of fibrous-cavernous lesion. On the background of the repeated 6-month course of treatment according to the I regimen no dynamics was obtained, pulmonary hemorrhage of the Ia stage recurred regularly. In September 2018, the patient was hospitalized to SPb NIIF. Pre-examination revealed chronic pulmonary aspergillosis. Voriconazole therapy was started, and correction of the ongoing antituberculosis therapy was carried out, taking into account drug interaction. Surgical treatment was indicated. Results. On 09.25.2018, an upper bilobectomy was performed on the right side. There were no intraoperative complications. The operation was completed by draining the pleural cavity with two drains and suturing the thoracotomy wound. Postoperative period without complications. In order to correct the volume of hemithorax, an artificial pneumoperitoneum of 1000 ml was applied. The drains were removed on the 4thand 5th days after surgery, the surgical wound healed by primary tension. At the follow-up examination after five years, there was no evidence of disease recurrence or late surgical complications. Conclusion. Providing medical care to patients with a combination of tuberculosis and pulmonary aspergillosis requires the organization of full-fledged primary diagnosis and routing of patients to a specialized hospital. A complex approach to treatment allows for successful treatment outcomes with minimal risks.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"22 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":"135010550","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":"Autofluorescent stomatoscopy and its possibilities to evaluate results of the oral mucosa leukoplakia surgical treatment","authors":"","doi":"10.36422/23076348-2023-11-3-109-117","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-109-117","url":null,"abstract":"Background: Leukoplakia belongs to facultative precancerous diseases. In this regard, the issues of timely diagnosis and treatment of leukoplakia will always be relevant. Autofluorescent stomatoscopy (AFS) is one of the promising methods that allows to detect early signs of malignancy of diseases of the oral mucosa and determine risk zones for pathological processes that are not accompanied by visual clinical manifestations. The aim of the study is to increase the effectiveness of treatment of patients with oral leukoplakia by optimizing the volume of surgical intervention and the timing of postoperative follow–up with the help of AFS. Materials and methods.A survey of 45 patients with oral leukoplakia, who under went conservative and surgical treatment, was conducted. During the clinical examination, the device for autofluorescent stomatoscopy — AFS-400 was used. Surgical treatment of patients was performed at the Department of maxillofacial surgery at St Petersburg State Medical Institution «City Multidisciplinary Hospital No.2». The results of the study. To clarify the area of the pathological process and determine the location for the collection of material for histological examination, it is advisable to use AFS. Histological examination is the main method for confirming the presumed diagnosis and determine the specific nosological form of the disease. After cryodestruction, 7% of patients retained minor foci of hyperkeratosis, however, they had a smaller area compared to the initial examination and during the AFS had a normal green glow of tissues, which made it possible to make a favorable prognosis of the course of the disease. Conclusion: patients who had hyperkeratosis focus smaller than the size of the tissue glow focus in AFS, as well as patients with uneven attenuation of tissue glow in AFS, need a longer period of follow-up and regular check-ups to exclude the processes of malignancy.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"3 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":"135008630","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":"Experimental evaluation of the bone fragments fixation rigidity using standard transosseous elements and extracortical clamp device in the model of femoral lengthening over the intramedullary nail","authors":"","doi":"10.36422/10.36422/23076348-2023-11-3-45-55","DOIUrl":"https://doi.org/10.36422/10.36422/23076348-2023-11-3-45-55","url":null,"abstract":"Introdu ction. Fe mur lengthening over nail is an ef-fective method to reduce the rate of typical complica-tions of external fixation. However, the technical feature of the method is the tangential insertion of half-pins and wires and problems of nail jamming related with this. Ex-tracortical clamp device is one of the solutions to these problems. External fixation device used in this technique requires additional studies of fixation rigidity, including in the presence of the internal fixator. Aim: Compare ex- ternal fixation rigidity during femur lengthening over the nail using traditional half-pins and wires and extracorti-cal clamp device. Materials and m ethods. The fixation rigidity of 8 variants of the complete arrangement of the external fixation device in combination with an intra-medullary nail inserted both antegrade and retrograde were studied: 4 modules using only half-pins and wires and 4 modules with combination of half-pins, wires and extracortical clamp device. The studies were carried out using a biomechanical testing bench with the definition of longitudinal rigidity, angular and rotational stability. Results. Antegr ade modules had lower fixati on rigidi-ty, except for the longitudinal ones, compared to retro-grade modules. It can be associated with a technically more complex tangential insertion of half-pins in the proximal femur due to the nail in the canal. The retro-grade modules using extracortical clamp device had the highest fixation rigidity compared to other models in all series of experiment. The use of the extracortical clamp device increased the fixation rigidity of external fixation 1.5–2 times. Conclusion. The use of extracortical clamp device increases the fixation rigidity of bone fragments in combined osteosynthesis (external fixation device with intramedullary nail) and can be recommended for femur lengthening over the nail.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"22 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":"135009525","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":"Latent tuberculosis infection in draft aged young men","authors":"","doi":"10.36422/23076348-2023-11-3-21-28","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-21-28","url":null,"abstract":"Evaluation of latent tuberculosis infection based on the results of skin test with a recombinant tuberculosis allergen (RTA) in men aged 15–17 linked to care at TB dispensary, and influence of epidemiological and clinical signs on immunological test intensity were studied. The results of RTA tests of 96 adolescents (main group — 57 (59.4%) young men, and comparison group — 39 (40.6%) girls) followed up at St Petersburg Tuberculosis Dispensary no. 5 from 2017 through 2019 were evaluated. In the main group the average size of RTA test was 9.25±6.5 mm. 15 young men (26.3%) had hyperergic tests — 17.4±2.3; 16 (28.1%) — pronounced positive (11.2±1.5); 11 (19.3%) — moderately positive (6.5±1.4); 4 (7.0%) — slightly positive (3.25±1.0); and 11 (19.3%) — negative. For girls the mean value of the RTA tests was 9.8±7.3 mm: hyperergic — 17.3±3.4 (12; 30.8%) pronounced positive — 12.2±1.5 (11; 28.2%), moderately positive — 8,2±1.4 (4; 10.3%); no slightly positive tests; negative tests — 12 (30.8%). 11 (19.3%) young men had chronic accompanying diseases and their tests were hyperergic (5) and pronounced positive (4). 19 (33.3%) young men and 17 (43.6%) girls had contact with TB patients: 12 (26.7%) young men grew up in single-parent families and these cases were with hyperergic and pronounced positive RTA tests. 9 girls had an incomplete family: 2 of them were with hyperergic, 5 — pronounced positive, 2 — moderately positive tests. Draft aged young men with latent tuberculosis infection should comprise a group of especially strict diagnostics and treatment in view of their further possible conscription into military service","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"24 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":"135008631","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":"Acidity and content of fluoride in canned children’s food as factors influencing caries-resistance of children’s teeth","authors":"","doi":"10.36422/23076348-2023-11-3-103-108","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-103-108","url":null,"abstract":"SummaryIntroduction. The alimentary factor is recognized as one of the leading factors in the etiopathogenesis of dental caries. The organization of nutrition in young children, including the introduction of complementary foods, its composition, the content of fluorides in it and acidity, can affect the formation of hard tissues of the child’s teeth, their mineralization, and, consequently, the susceptibility to caries and the maintenance of a cariogenic situation in the oral cavity. Purpose: develop general recommendations to reduce the possible cariogenic effects of canned foods for young children based on the determination of acidity and fluoride content. Materials and methods: through interviewing 398 parents of children between the ages of three and 10 years during a routine medical examination, the algorithm of use as well as the most popular brands and types of ready-made canned foods for infants as complementary foods in St. Petersburg were identified. A chemical analysis of samples of popular canned baby food products was carried out, their acidity (pH) and fluoride content were determined. Results. It was found that the acidity indicators of canned baby food samples are in the critical range for triggering the demineralization of temporary teeth enamel, which, combined with their low fluoride content, indicates the cariogenic potential of this type of food. In addition, parents do not always follow the recommended algorithm for the introduction and withdrawal of complementary foods. Conclusions. To reduce the possible cariogenic effect of canned baby food, further work is needed with parents on the prevention of caries in milk teeth, including recommendations regarding oral hygiene, monitoring of fluoride intake, and rational, balanced nutrition of children.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"27 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":"135010288","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":"A clinical case of pulmonary Hodgkin’s lymphoma","authors":"","doi":"10.36422/23076348-2023-11-3-29-34","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-29-34","url":null,"abstract":"A clinical case of Hodgkin’s disease with lung damage in patient I., 27 years old, the manifestations of which were regarded as a tuberculous process, is presented. The patient received chemotherapy according to regimen III, the negative dynamics was regarded as multidrug resistance of M. tuberculosis, followed by re-registration for chemotherapy regimen IV, negative radiological dynamics still persisting. For the period of patient’s follow up, Mycobacteria and its genetic markers were not isolated. The patient was presented to the medical commission, consulted by a phthisiosurgeon, and diagnostic surgery was recommended. Videothoracoscopy was performed: combined resection of S 2.6 of the right lung with histological examination: large cell anaplastic lymphoma could not be excluded. Immunohistochemical study revealed an immunohistotype characteristic of Hodg-kin’s lymphoma. Hodgkin’s disease was diagnosed. Positive dynamics was achieved against the background of chemotherapy","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"144 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":"135010553","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":"Similarities and special features of modern approaches to surgical treatment of intra-articular fractures of tibial proximal and distal metaepiphyses","authors":"","doi":"10.36422/23076348-2023-11-3-56-68","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-56-68","url":null,"abstract":"SummaryIntroduction. Analysis of special scientific literature concerning the modern principles of diagnostics, preop-erative planning and surgical treatment of intra- articular fractures of two localizations: proximal and distal me-taepiphyses of the tibia, was carried out. Aim of the review. To evaluate, through the analysis of specialized scientific publications, similarities and differences in classification approaches, diagnostic methods, princi-ples of planning and performing osteosynthesis in pa-tients with intra-articular fractures of the proximal and distal metaepiphyses of the tibia. It is noted that the modern classifications of both tibial plateau and pilon fractures are based on the column theory. A thorough analysis of computed tomography data is necessary to precisely determine the fracture pattern. On this ba-sis, osteosynthesis surgeries are planned as to provide fixation of all damaged columns. Authors discuss the combinations of surgical approaches necessary for this purpose. Variants of osteosynthesis are also considered, with special attention paid to fixation of the posterior aspects of the tibial plateau and pilon. The differences in approaches to surgical treatment of patients with frac-tures of the tibial plateau and pilon are primarily due to a significant difference in the overall size of the tibia in the area of the knee and ankle joints and, in particular, with a significantly smaller volume of soft tissues at the level of the distal metaepiphysis of the tibia. These dif-ferences in anatomy should be taken into account by surgeons when choosing surgical approaches for osteo-synthesis of the discussed fractures. Conclusion. Adher-ence to the classical principles of surgical treatment of intra-articular fractures with the use of modern surgical approaches and osteosynthesis techniques is a sure way to improve specialized trauma care for a complex category of patients with intra-articular fractures of the proximal and distal tibial metaepiphyses, which should help to reduce the incidence of postoperative complica-tions and improve treatment outcomes.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"79 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":"135010289","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":"Ways to improve the effectiveness of treatment of patients with destructive pulmonary tuberculosis with multiple and broad drug resistance of the pathogen","authors":"","doi":"10.36422/23076348-2023-11-3-69-77","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-69-77","url":null,"abstract":"SummaryTreatment of patients with destructive forms of drug-resistant pulmonary tuberculosis remains a difficult problem. The presence of a destruction cavity in the lung reduces the effectiveness of therapy and is a negative prognostic factor. The objective of the study: to search for the optimal tactics for the treatment of destructive drug-resistant pulmonary tuberculosis and to evaluate the impact of collapsing procedures and surgical interventions on the outcome of treatment according to immediate and long-term observations. Materials and methods. The study included 398 patients with destruc-tive pulmonary tuberculosis with registered multiple (MDR-TB) in 61.3% and extensively drug-resistant (XDR-TB) in 38.7% of patients. Depending on the treat-ment tactics chosen in the clinic, 2 groups of patients were formed who received individualized chemothera-py based on the results of drug susceptibility testing of the pathogen and were comparable in other significant evaluation criteria. The main group consisted of 269 pa-tients, whose management tactics included the staged use of invasive methods of treatment, the comparison group — 129 patients who received only adequately selected anti-tuberculosis chemotherapy due to the im-possibility of using invasive methods. Staged invasive treatment included collapsotherapeutic techniques used in the absence of regression of the tuberculosis process against the background of adequately selected chemo-therapy for 1.5–2 months, and, if the previous stage was ineffective, resection surgery 4–6 months after the start of treatment in the clinic. Results: In the main group, collapse therapy procedures were performed in 179/269 (66.5%) patients, and they were successful in 106/115 (92.2%) patients with MDR-TB and in 51/64 (79.7%) pa-tients with XDR TB (p=0.44). Surgical interventions were performed in 25/269 (9.3%) patients, which were effec-tive in 20/25 (80%). Postoperative complications were registered in 4/25 (16%) patients. In general, microbiolog-ical conversion of sputum and closure of decay cavities were registered in 245/269 (91.1%) patients of the main group and in 75 out of 129 (58.6%) of the comparison group. Conclusion. Timely correction of treatment tac-tics based on the staged application of collapse therapy and surgical methods made it possible to achieve a cure in 91.1% of previously ineffectively treated patients with destructive pulmonary MDR/XDR tuberculosis.","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"11 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":"135008629","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":"Features of respiratory impedance in patients with respiratory tuberculosis with bronchial patency disorders","authors":"","doi":"10.36422/23076348-2023-11-3-87-92","DOIUrl":"https://doi.org/10.36422/23076348-2023-11-3-87-92","url":null,"abstract":"SummaryAim. To establish the features of respiratory im-pedance deviations detected by the method of forced oscillations in patients with tuberculosis of the respiratory organs and bronchial patency disorders. Маterials and methods. The parameters of spirometry and the method of forced oscillations were studied in 310 patients and in healthy subjects (group 3, n=22). At 8, 12, 16 Hz (oscillation frequencies), the respiratory impedance (RI) was measured: RI with calm breathing at inspiration — Rin; RI with calm breathing at exhalation — Rex; RI with respiratory volume — Rfo. In group 1 (n=229), the following subgroups were identified: 1A subgroup — 62 patients with initial obstructive disorders, 1B — 108 people with moderate, and 1C — 59 patients with significant obstruction. Patients without obstructive disorders comprised group 2 (n=81). Results. In group 1: the parameters of RI were higher than in groups 2 and 3, the frequency dependence of the RI was established. In subgroup 3B values of the parameters of RI, index of the frequency dependence of the RI, the number of RI indicators with pathological changes were higher than in 3A subgroup. Conclusion. In patients with tuberculosis of the respiratory organs with obstructive disorders an increase in respiratory impedance and the frequency dependence of respiratory impedance were observed. With the aggravation of obstructive disorders, the respiratory impedance and frequency dependence increase, pathologically altered impedance parameters are more often recorded","PeriodicalId":489032,"journal":{"name":"Medicinskij alʹâns","volume":"91 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":"135008636","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}