Monaldi Archives for Chest Disease最新文献

{"title":"Diaphragmatic morphological <i>post-mortem</i> findings in critically ill COVID-19 patients: an observational study.","authors":"Luigi Vetrugno, Cristian Deana, Savino Spadaro, Gianmaria Cammarota, Domenico Luca Grieco, Annarita Tullio, Tiziana Bove, Carla Di Loreto, Salvatore Maurizio Maggiore, Maria Orsaria, Diasus Study Group","doi":"10.4081/monaldi.2024.2829","DOIUrl":"10.4081/monaldi.2024.2829","url":null,"abstract":"<p><p>Our study investigates the post-mortem findings of the diaphragm's muscular structural changes in mechanically ventilated COVID-19 patients. Diaphragm samples of the right side from 42 critically ill COVID-19 patients were analyzed and correlated with the type and length of mechanical ventilation (MV), ventilatory parameters, prone positioning, and use of sedative drugs. The mean number of fibers was 550±626. The cross-sectional area was 4120±3280 μm2, while the muscular fraction was 0.607±0.126. The overall population was clustered into two distinct populations (clusters 1 and 2). Cluster 1 showed a lower percentage of slow myosin fiber and higher fast fiber content than cluster 2 (68% vs. 82%, p<0.00001, and 29.8% vs. 18.8%, p=0.00045, respectively). The median duration of MV was 180 (41-346) hours. In cluster 1, a relationship between assisted ventilation and fast myosin fiber percentage (R2=-0.355, p=0.014) was found. In cluster 2, fast fiber content increased with increasing length of the controlled MV (R2=0.446, p=0.006). A high grade of fibrosis was reported. Cluster 1 was characterized by fibers' atrophy and cluster 2 by hypertrophy, supposing different effects of ventilation on the diaphragm but without excluding a possible direct viral effect on diaphragmatic fibers.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869526","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":"Active <i>versus</i> latent pulmonary tuberculosis: which one is the appropriate distinguishing biomarker?","authors":"Rizk Sayad R Sarhan, Omnia Y Habashy, Raafat R Mohammed, Yasmin M Marei","doi":"10.4081/monaldi.2024.2947","DOIUrl":"10.4081/monaldi.2024.2947","url":null,"abstract":"<p><p>This study tried to assess the possibility of using the estimated levels of plasma expression of microRNAs (miR) for distinguishing healthy subjects with latent pulmonary tuberculosis (LTB) from healthy controls (HC) and patients with active tuberculosis (ATB). Study participants included 30 newly diagnosed ATB patients, 30 of the households of ATB patients who were free of clinical manifestations, had normal chest radiography but had positive results on the whole-blood QuantiFERON tuberculosis (TB) Gold In-Tube (QFT-GIT) test (LTB patients), and 30 HC who were free of clinical symptoms and showed normal chest X-rays and negative QFT-GIT tests. All participants gave blood samples for quantitation of the plasma expression levels of miR using the reverse transcription-quantitative polymerase chain reaction. Plasma levels of miR-150-5p were significantly downregulated in ATB samples than in other samples. However, miR-155-5p and miR-378-5p were significantly overexpressed in patients' samples compared to HC's samples and in ATB samples compared to LTB samples. On the contrary, plasma miR-4523-5p showed significant upregulation in LTB samples compared to ATB and HC samples, indicating insignificant in-between differences. The receiver operating characteristic curve analysis showed the ability of the estimated levels of the four miR to differentiate TB patients from HC. Multivariate regression analysis defined expression levels of miR-155-5p and miR-378-5p as the significant biomarkers for distinguishing TB patients and levels of miR-378-5p and miR-4523-5p for the identification of LTB patients. Pulmonary TB induces deregulated expression of miR-, according to the infection severity. An estimation of the expression levels of miR-378-5p and miR-4523-5p might be a reliable combination for identifying LTB patients.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762527","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 diagnostics: current scenario and review.","authors":"Amitesh Gupta, Eshutosh Chandra, Shipra Anand, Naresh Kumar, Richa Arora, Divyanshi Rana, Parul Mrigpuri","doi":"10.4081/monaldi.2024.2984","DOIUrl":"10.4081/monaldi.2024.2984","url":null,"abstract":"<p><p>This review presents a comprehensive examination of the contemporary landscape pertaining to latent tuberculosis infection (LTBI) diagnostics, with a particular emphasis on the global ramifications and the intricacies surrounding LTBI diagnosis and treatment. It accentuates the imperative of bolstering diagnostic, preventive, and treatment modalities for tuberculosis (TB) to fulfill the ambitious targets set forth by the World Health Organization aimed at reducing TB-related mortalities and the incidence of new TB cases. The document underscores the significance of addressing LTBI as a means of averting the progression to active TB, particularly in regions burdened with high TB prevalence, such as India. An in-depth analysis of the spectrum delineating latent and active TB disease is provided, elucidating the risk factors predisposing individuals with LTBI to progress towards active TB, including compromised immune functionality, concurrent HIV infection, and other immunosuppressive states. Furthermore, the challenges associated with LTBI diagnosis are elucidated, encompassing the absence of a definitive diagnostic assay, and the merits and demerits of tuberculin skin testing (TST) and interferon-γ release assays (IGRAs) are expounded upon. The document underscores the necessity of confronting these challenges and furnishes a meticulous examination of the advantages and limitations of TST and IGRAs, along with the intricacies involved in interpreting their outcomes across diverse demographics and settings. Additionally, attention is drawn towards the heritability of the interferon-γ response to mycobacterial antigens and the potential utility of antibodies in LTBI diagnosis.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871236","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":"Hormonal harmony disrupted: hypothyroidism and diabetes mellitus in interstitial lung disease. An observational study.","authors":"Manju Bala, Akhlesh Rajpoot, Dinesh Chandra Punera, Suyash Singh Rathore","doi":"10.4081/monaldi.2024.2956","DOIUrl":"10.4081/monaldi.2024.2956","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that affect the lungs and airways. ILD encompasses approximately 200 different conditions with known and unknown causes. Various comorbidities, such as cardiovascular, psychological, obstructive sleep apnea, and gastrointestinal disorders, are often associated with them. However, little is known about the relationship and prevalence of hypothyroidism and diabetes mellitus (DM) in ILD and COPD. Therefore, understanding these connections is crucial for proper treatment. This cross-sectional, prospective observational study was conducted at a tertiary care hospital in North India. After obtaining informed consent, we consecutively enrolled 100 patients with ILD and 100 patients with COPD who reported to the Respiratory Medicine Outpatient Department. We collected demographic, clinical, and medical data from the patients and conducted appropriate statistical analysis to determine the prevalence of hypothyroidism and DM in patients with ILD. ILD patients exhibit a significantly higher prevalence of hypothyroidism (24% vs. 4%) and DM (24% vs. 4%) compared to those with COPD (p<0.05). Additionally, the study showed that ILD patients also had a significantly higher prevalence of self-reported gastroesophageal reflux disease (30%), had a higher body mass index, and consulted a pulmonologist earlier than COPD patients after the onset of symptoms (p<0.05). Therefore, it is important to screen for hypothyroidism and DM in ILD patients due to their high prevalence and potential impact on disease progression and management. Additionally, evidence suggests a bidirectional relationship between these conditions, making it essential to screen patients with hypothyroidism and DM for ILD if there is any suspicion. These screening measures could contribute to the early detection and management of these comorbidities, thereby improving the overall outcome for ILD patients.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762529","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":"Relationship between fractional exhaled nitric oxide, asthma control test, and spirometry measurement in individuals with asthma receiving treatment.","authors":"Arthana Kanagaraj, Santhiya Ramachandran, Pajanivel Ranganadin, Akila Mohan","doi":"10.4081/monaldi.2025.3300","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3300","url":null,"abstract":"<p><p>To evaluate the relationship between fractional exhaled nitric oxide (FeNO), asthma control test (ACT), and spirometry measurements in individuals with asthma receiving treatment, a cross-sectional study was conducted involving 47 diagnosed asthmatic patients. FeNO levels were measured using Eversens Evernoa FeNO, ACT scores were recorded, and spirometry (pre- and post-bronchodilator) was conducted. Correlations between these parameters were analyzed using Pearson's correlation and t-tests. The study found no statistically significant correlation between FeNO and spirometry parameters [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC] or ACT scores. While FeNO was higher in individuals without a family history of asthma and nonsmokers, these differences were not statistically significant. Additionally, spirometry parameters showed significant improvement after bronchodilator use, but FeNO did not strongly predict lung function improvement. The findings suggest that while FeNO is useful as an indicator of airway inflammation, it may not consistently correlate with functional lung measurements or asthma control as assessed by spirometry and ACT. This highlights the need for a multidimensional approach to asthma management that combines these tools for more comprehensive disease assessment.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676449","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":"Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population.","authors":"Ruchi Sharma, Bhushan Shah, Sumit Verma, Vijay Pathak, Sunil Sharma, Pradeep Meena, Shekhar Kunal","doi":"10.4081/monaldi.2025.3386","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3386","url":null,"abstract":"<p><p>Risk stratification is essential in managing patients with non-ST-elevation myocardial infarction (NSTEMI). While multiple risk scores exist, their validation in developing countries like India remains limited. This study compares the predictive accuracy of the PURSUIT, HEART, TIMI, GRACE 2.0, and CAMI-NSTEMI scores for major adverse cardiovascular events (MACE), including death, non-fatal myocardial infarction, emergency percutaneous coronary intervention, and coronary artery bypass grafting, in NSTEMI patients. This was a single-center prospective observational study wherein patients diagnosed with NSTEMI were enrolled. Detailed clinical histories, including symptomatology and risk factors, were recorded. Five risk scores (TIMI, GRACE 2.0, PURSUIT, HEART, and CAMI-NSTEMI scores) were computed. Outcomes were assessed for in-hospital, 14-day, six-month, and one-year MACE. A total of 1102 patients were enrolled, with a mean age of 59.6±11.2 years. MACE occurred in 140 patients (12.7%), with 89 deaths (8.1%). Patients with MACE were older and more likely to smoke or have hypertension, diabetes, or stroke. Multivariate logistic regression analysis identified angina in the last 48 hours, diabetes, smoking, cardiac arrest, and fragmented QRS on electrocardiogram as independent MACE predictors. TIMI showed the highest predictive ability for in-hospital MACE, while GRACE excelled for 14-day, 6-month, and 1-year outcomes. All risk scores effectively predicted short- and intermediate-term MACE, with GRACE performing best for longer-term predictions.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676450","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":"Interplay of psychological factors and bronchial asthma: a comprehensive review.","authors":"Ajay Kumar Verma, Shreya Tripathi, Adarsh Tripathi, Sarika Gupta, Arpita Singh, Pranjal Tripathi, Jyoti Bajpai, Surya Kant","doi":"10.4081/monaldi.2025.3208","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3208","url":null,"abstract":"<p><p>Bronchial asthma, a chronic condition marked by persistent inflammation and bronchial obstruction, affects over 334 million people globally. Although extensive research has been conducted on its biological and environmental causes, the impact of psychiatric disorders such as stress and anxiety on asthma is less understood, despite their significant association with the condition. Stress can exacerbate asthma by weakening the body's response to medications and is associated with a higher prevalence of anxiety and depressive disorders among asthmatics. A bidirectional relationship exists between asthma and psychiatric disorders, influenced by genetic and environmental factors. The interplay between asthma and psychological states involves psychophysiological mediation, medication noncompliance, exposure to triggers, and symptom misperception. Non-pharmacological interventions, including cognitive behavioral therapy, relaxation therapy, breathing exercises, and yoga, show promise in reducing the asthma burden. Combined efforts between mental health specialists and allergists can improve symptom control, quality of life, and overall functioning in asthma patients, thereby decreasing morbidity and mortality.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676448","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":"Hospital Anxiety and Depression Scale in patients undergoing extracorporeal circulation: an Italian cross-sectional study.","authors":"Gloria D'Angelo, Silvia Caucci, Alessandra Carminucci, Giuliana Ciapanna, Sara Sfredda, Elisa Baldoni, Alfredo Fioroni, Vito Maurizio Parato","doi":"10.4081/monaldi.2025.3425","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3425","url":null,"abstract":"<p><p>Globally, cardiovascular diseases (CVDs) are the major leading cause of death. Medical literature shows an association between CVDs and depressive symptoms, anxiety, low social support, and optimism. Also, cardiac surgery, even if the progress in extracorporeal circulation (ECC) ensures the patient's recovery \"ad integrum\", can provoke strong emotional processes, including states of anxiety and fear, leading to true depression disorders. The aim of this study is to identify the degree of anxiety and depression detected by means of the validated Hospital Anxiety and Depression Scale (HADS) following cardiac surgery with ECC. This is a single-center, cross-sectional, observational study that was conducted from 26/04/2023 to 23/10/2024. It involved patients who had undergone ECC for several reasons (coronary bypass, valve replacement, aortic root and arch replacement, trans-apical transcatheter aortic valve implantation) at Marche's Polytechnic University Hospital, who were subsequently admitted to the Rehabilitation Cardiology Unit of the \"Madonna del Soccorso\" Hospital in San Benedetto del Tronto. The study procedure involved the administration of the HADS questionnaire by a registered psychologist. We enrolled 100 patients with an average age of 71±4 years, predominantly male (64%) rather than female (35%). The results show that at the first administration of the HADS scale questionnaire (T0), the overall mean score is 14.54±5.86. In detail, the first subscale relating to anxiety reveals a mean value of 7.18±3.54, while the second subscale relating to depression shows a mean value of 7.36±3.09. At the second administration of the HADS scale questionnaire (T1), after a medium time interval of 22 days, the overall mean score is 4.09±4.11. In detail, the first subscale relating to anxiety reveals a mean value of 2.03±2.25, while the second subscale relating to depression shows a mean value of 2.87±2.39. A two-tailed test (t-test) was performed and showed a significant reduction of HADS values between the first (T0) and the second (T1) questionnaire administration [p<0.05 (df=99) (t-stat=25)]. The study shows a significant reduction of anxiety and depressive status in patients who underwent ECC and were subsequently admitted to a short-term psycho-educational intervention by a registered psychologist included in a multi-professional team of a Rehabilitation Cardiology Unit.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627693","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":"ST-elevation myocardial infarction late-presenting patients: time for a new paradigm?","authors":"Francesco Antonio Veneziano, Francesca Frecentese, Raffaella Mistrulli, Roberta Veneziano","doi":"10.4081/monaldi.2025.3372","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3372","url":null,"abstract":"<p><p>Timely performed percutaneous coronary angioplasty (PCI) remains the most critical factor predicting favorable outcomes in patients with ST-elevation myocardial infarction (STEMI). Guidelines have traditionally identified the first 12 hours from symptom onset as the \"golden window\" for PCI. However, recommendations for patients presenting beyond this timeframe remain inconsistent. Late presenters are associated with worse outcomes and significantly higher rates of in-hospital mortality. Notably, the recent COVID-19 pandemic has further increased the prevalence of late presentations. Emerging imaging techniques now offer new opportunities to better characterize both patients and the pathological consequences of late-presented STEMI. Despite this progress, evidence supporting the adoption of imaging-guided strategies remains mixed. These advancements hold the potential to pave the way for personalized management approaches for this heterogeneous patient population soon. In this review, we explore the current evidence regarding the treatment of late presenters and discuss how emerging imaging techniques may transform clinical strategies in this challenging subset of STEMI patients.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627694","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":"Anti-reflux therapy and mortality in patients with idiopathic pulmonary fibrosis and gastroesophageal reflux disease: a systematic review and meta-analysis.","authors":"Konstantinos Dodos, Tsampika-Vasileia Kalamara, Nikolaos Trakas, Alexandru Corlateanu, Vasiliki Epameinondas Georgakopoulou","doi":"10.4081/monaldi.2025.3349","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3349","url":null,"abstract":"<p><p>Gastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF) frequently coexist, with GERD potentially exacerbating IPF progression through microaspiration and pulmonary inflammation. This systematic review and meta-analysis assessed the impact of anti-reflux therapy, including proton pump inhibitors and H2-receptor antagonists, on mortality outcomes in IPF patients with concurrent GERD. A systematic search identified six eligible studies, including 2874 patients, for quantitative synthesis. Results indicate that anti-reflux therapy may reduce IPF-related mortality, with a pooled relative risk (RR) of 0.79 [95% confidence interval (CI): 0.55-1.33], although this finding was not statistically significant. However, no significant effect was observed on overall mortality (pooled RR: 0.97, 95% CI: 0.74-1.25). Study heterogeneity was moderate (I²=60%), reflecting variability in study designs, populations, and therapeutic regimens. The observational nature of most studies highlights the need for randomized controlled trials to better understand anti-reflux therapy's role in IPF management. While anti-reflux therapy was associated with a potential reduction in IPF-related mortality (RR: 0.79, 95% CI: 0.55-1.33), no significant effect on overall mortality was observed (RR: 0.97, 95% CI: 0.74-1.25). Future research should also evaluate the long-term safety of anti-reflux therapy, given concerns about complications such as infections and renal impairment. This analysis underscores the importance of tailored treatment approaches in IPF patients with GERD to optimize clinical outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592909","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}