The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology最新文献

{"title":"An unusual gastric biopsy.","authors":"Dmitry Zinovkin, Mikhail Zhandarov, Elizaveta Bredyhina, Md Zahidul Islam Pranjol","doi":"10.5152/tjg.2020.18889","DOIUrl":"https://doi.org/10.5152/tjg.2020.18889","url":null,"abstract":"Dmitry Zinovkin1 , Mikhail Zhandarov2, Elizaveta Bredyhina3, Md Zahidul Islam Pranjol4 1Department of Pathology, Gomel State Medical University, Gomel, Belarus 2Department of Pathology of Cell Technologies Laboratory, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus 3Department of Endoscopy, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus 4William Harvey Research Institute, Barts & The London School of Medicine & Dentistry Queen Mary University of London, London, UK","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"76-77"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075685/pdf/tjg-31-1-76.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601191","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":"How the Internet influences the relationship between outpatients and gastroenterologists: A multicenter study.","authors":"Vasile Liviu Drug,&nbsp;Ioan Chirila,&nbsp;Ahmed Albusoda,&nbsp;Ion Bancila,&nbsp;Sevastita Iordache,&nbsp;Laurentiu Nedelcu,&nbsp;Ciortescu Irina,&nbsp;Oana Bogdana Barboi,&nbsp;Diana Drug,&nbsp;Dan L Dumitrascu","doi":"10.5152/tjg.2019.18353","DOIUrl":"https://doi.org/10.5152/tjg.2019.18353","url":null,"abstract":"<p><strong>Background/aims: </strong>The Internet offers a lot of non-filtered medical information which may interfere with the patient-doctor relationship. The aim of the present study was to assess the influence of the Internet on the classical doctor-patient relationship in gastroenterological outpatient settings.</p><p><strong>Materials and methods: </strong>A multicenter study was conducted, including a representative sample selected from five major regional medical centers throughout Romania. We designed a questionnaire which had two parts. One had to be filled out by adult patients on their first visit to a gastroenterology clinic and the other by physicians, stating the diagnosis and giving a doctor-patient collaboration score.</p><p><strong>Results: </strong>From a total of 485 patients (49.9% females, mean age 50.42 years), 64.9% had Internet access, 75% out of whom searched for their symptoms online. University graduates searched for their symptoms online more often than secondary school graduates (80% vs. 31.1%, p<0.05). Most patients stated that they used the Internet to identify the most appropriate medical specialist for their condition. Internet users were less likely to visit a general practitioner (GP) before coming to a specialist (85.3% vs. 92.2%, odds ratio (OR) 0.491, 95% confidence interval (CI) 0.24-0.98, p<0.05). Patients who had searched for their symptoms online were less likely to follow the treatment prescribed by the GP (53.6% vs. 67.5%, p=0.004), but they received a better collaboration score (OR 1.12, 95% CI 1.05-1.36, p<0.05).</p><p><strong>Conclusion: </strong>The Internet exerts a positive influence on specialist doctor-patient relationship, but it might burden the health system with the incorrect tendency to replace the role of the GP.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"17-22"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075688/pdf/tjg-31-1-17.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37505721","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":"Submucosal tunneling endoscopic resection for large symptomatic submucosal tumors of the esophagus: A clinical analysis of 24 cases.","authors":"Guo-Xiang Wang,&nbsp;Guang Yu,&nbsp;Yan-Li Xiang,&nbsp;Yang-De Miu,&nbsp;Hong-Gang Wang,&nbsp;Mei-Dong Xu","doi":"10.5152/tjg.2020.19062","DOIUrl":"https://doi.org/10.5152/tjg.2020.19062","url":null,"abstract":"<p><strong>Background/aims: </strong>Studies evaluating submucosal tunneling endoscopic resection (STER) for the treatment of upper gastrointestinal submucosal tumors (SMTs) have recently increased. However, the efficacy and safety of STER for the treatment of large symptomatic SMTs in the esophagus have not been well investigated. The aim of the present study was to evaluate the efficacy and safety of STER for the treatment of large symptomatic SMTs in the esophagus.</p><p><strong>Methods: </strong>A total of 24 patients with large symptomatic SMTs in the esophagus who underwent STER in our hospitals between January 2015 and May 2018 were included in the study. The tumors were confirmed to be of muscularis propria layer origin. Treatment outcomes, complications, and follow-up results were retrospectively analyzed.</p><p><strong>Results: </strong>All 24 lesions were resected en bloc with STER. The mean maximum transverse diameter of the lesions was 4.7 (3.5-6.5) cm. The mean maximum longitudinal diameter of the lesions was 2.1 (1.5-3.0) cm. The mean duration from mucosal incision to complete mucosal closure was 65 (50-115) min. Postoperative pathological diagnosis confirmed 18 cases with leiomyomas, 4 cases with stromal tumors, and 2 cases with schwannomas. There were no major complications. There were no residual lesions or disease recurrence during follow-up.</p><p><strong>Conclusion: </strong>STER is safe and effective for the treatment of large symptomatic SMTs of muscularis propria layer origin in the esophagus.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"42-48"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075684/pdf/tjg-31-1-42.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of abdominal pain with bloody stool.","authors":"Gin-Shen Su,&nbsp;Tsung-Wei Chen,&nbsp;Jen-Wei Chou","doi":"10.5152/tjg.2020.18821","DOIUrl":"https://doi.org/10.5152/tjg.2020.18821","url":null,"abstract":"Gin-Shen Su1 , Tsung-Wei Chen2 , Jen-Wei Chou1,3,4 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China 2Department of Pathology, China Medical University Hospital, Taichung, Taiwan, Republic of China 3School of Medicine, China Medical University, Taichung, Taiwan, Republic of China 4Taiwan Association for the Study of Small Intestinal Diseases, Taiwan, Republic of China","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"73-74"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075683/pdf/tjg-31-1-73.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601190","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":"ERCP for severe acute cholangitis: The earlier, the better.","authors":"Iyad Khamaysi,&nbsp;Rana Taha","doi":"10.5152/tjg.2020.19103","DOIUrl":"https://doi.org/10.5152/tjg.2020.19103","url":null,"abstract":"We conducted a retrospective study at Rambam University Hospital, Haifa, Israel. The study was conducted as a retrospective registry study at the Department of Gastroenterology, a 1100-bed tertiary referral center where 500-600 ERCP procedures were performed yearly. Data collection and storage were performed with the consent and approval of the local Institutional Review Board (Rambam Health Care Campus Helsinki Review, January 1, 2016).","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"78-79"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075686/pdf/tjg-31-1-78.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601192","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":"Inborn errors of metabolism in the differential diagnosis of fatty liver disease.","authors":"Yılmaz Yıldız,&nbsp;Hatice Serap Sivri","doi":"10.5152/tjg.2019.19367","DOIUrl":"https://doi.org/10.5152/tjg.2019.19367","url":null,"abstract":"<p><p>Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease across all age groups. Obesity, diabetes, and metabolic syndrome, are the primary causes that are closely linked with the development of NAFLD. However, in young children, rare inborn errors of metabolism are predominant secondary causes of NAFLD. Furthermore, inborn errors of metabolism causing hepatosteatosis are often misdiagnosed as NAFLD in adolescents and adults. Many inborn errors of metabolism are treatable disorders and therefore require special consideration. This review aims to summarize the basic characteristics and diagnostic clues of inborn errors of metabolism associated with fatty liver disease. A suggested clinical and laboratory diagnostic approach is also discussed.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"3-16"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075690/pdf/tjg-31-1-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37602748","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":"Central neuropeptide-S administration alleviates stress-induced impairment of gastric motor functions through orexin-A.","authors":"Mehmet Bülbül,&nbsp;Osman Sinen,&nbsp;Onur Bayramoğlu","doi":"10.5152/tjg.2020.18626","DOIUrl":"https://doi.org/10.5152/tjg.2020.18626","url":null,"abstract":"BACKGROUND/AIMS The novel brain peptide neuropeptide-S (NPS) is produced exclusively by a small group of cells adjacent to the noradrenergic locus coeruleus. The NPSR mRNA has been detected in several brain areas involved in stress response and autonomic outflow, such as amygdala and hypothalamus, suggesting that central NPS may play a regulatory role in stress-induced changes in gastrointestinal (GI) motor functions. In rodents, exogenous central NPS was shown to inhibit stress-stimulated fecal output. Moreover, exogenous NPS was demonstrated to activate hypothalamic neurons that produce orexin-A (OXA), which has been shown to stimulate postprandial gastric motor functions via central vagal pathways. Therefore, we tested whether OXA mediates the NPS-induced alterations in gastric motor functions under stressed conditions. MATERIALS AND METHODS We investigated the effect of central exogenous NPS on solid gastric emptying (GE) and gastric postprandial motility in acute restraint stress (ARS)-loaded conscious rats. The OXA receptor antagonist SB-334867 was administered centrally prior to the central NPS injection. The expression of NPSR in the hypothalamus and dorsal vagal complex was analyzed by immunofluorescence. RESULTS Central administration of NPS restored the ARS-induced delayed GE and uncoordinated postprandial antro-pyloric contractions. The alleviative effect of NPS on GE was abolished by pretreatment of the OX1R antagonist SB-334867. In addition to hypothalamus, NPSR was detected in the dorsal motor nucleus of vagus, which suggest a direct stimulatory action of exogenous NPS on gastric motility. CONCLUSION NPS may be a novel candidate for the treatment of stress-related gastric disorders.","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"65-72"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075687/pdf/tjg-31-1-65.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601189","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":"Efficacy of traction, using a clip-with-thread, for esophageal endoscopic submucosal dissection for esophageal lesions with fibrosis in an ex vivo pig training model.","authors":"Mitsuru Esaki,&nbsp;Yosuke Minoda,&nbsp;Eikichi Ihara,&nbsp;Seiichiro Sakisaka,&nbsp;Shinichi Tsuruta,&nbsp;Taizo Hosokawa,&nbsp;Masafumi Wada,&nbsp;Yoshitaka Hata,&nbsp;Sho Suzuki,&nbsp;Aya Iwao,&nbsp;Shun Yamakawa,&nbsp;Akira Irie,&nbsp;Hirotada Akiho,&nbsp;Yoshihiro Ogawa","doi":"10.5152/tjg.2020.19207","DOIUrl":"https://doi.org/10.5152/tjg.2020.19207","url":null,"abstract":"<p><strong>Background/aims: </strong>Endoscopic submucosal dissection (ESD) of recurrent esophageal carcinoma is technically difficult to perform due to submucosal fibrosis that develops after definitive chemoradiation therapy. Therefore, our aim was to evaluate the usefulness of clip-with-thread traction for ESD of esophageal lesions with submucosal fibrosis.</p><p><strong>Materials and methods: </strong>Four endoscopists excised 16 lesions by ESD in an ex vivo pig training model. Mock lesions (30 mm in diameter) were created, including a 10-mm area of submucosal fibrosis in the center of each lesion. Each endoscopist performed two ESDs with traction (ESD-T) and two without traction (ESD-N). The primary outcome was the time required for submucosal dissection. Secondary outcomes were the rate of en bloc (complete) resection and perforation during the procedure, and the total amount of solution injected.</p><p><strong>Results: </strong>All esophageal ESDs were completed. The median dissection time was significantly shorter for the ESD-T group (median 12.5 min, interquartile range 10.2-14.5) when comparing to the ESD-N group (median 18.0 min, interquartile range 14.6-19.2) (P=0.040). The en bloc resection rate was 100% in both groups, with a rate of complete resection of 87.5% and a rate of perforation of 37.5% for both groups. The median amount of solution injected was not significantly different between the ESD-T (18.0 ml) and ESD-N (20.5 ml) groups (P=0.526).</p><p><strong>Conclusion: </strong>Clip-with-thread traction improved the performance of ESD for lesions with submucosal fibrosis. However, the method might not reduce the risk of perforation, which remains an important clinical issue to resolve.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"58-64"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075676/pdf/tjg-31-1-58.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601188","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":"Long-term outcomes of endoscopic resection for non-ampullary duodenal epithelial tumors: A single-center experience.","authors":"Kyung Lim Hwang,&nbsp;Gwang Ha Kim,&nbsp;Bong Eun Lee,&nbsp;Moon Won Lee,&nbsp;Dong Hoon Baek,&nbsp;Geun Am Song","doi":"10.5152/tjg.2020.19156","DOIUrl":"https://doi.org/10.5152/tjg.2020.19156","url":null,"abstract":"<p><strong>Background/aims: </strong>The malignant potential of non-ampullary duodenal epithelial tumors (NADETs) is lower compared to that of other gastrointestinal epithelial tumors, but it should not be overlooked. Recently, endoscopic resection (ER) has been proposed as an alternative treatment option for NADETs. Therefore, we aimed to analyze the clinical outcomes of ER of NADETs and determine the factors associated with an incomplete resection.</p><p><strong>Materials and methods: </strong>We conducted a retrospective observational study of 54 patients (56 lesions) with NADETs, who underwent ER in the period between October 2006 and March 2016, and analyzed the therapeutic outcomes and procedure-related adverse events.</p><p><strong>Results: </strong>Endoscopic mucosal resection (EMR) was performed on 41 lesions, and endoscopic submucosal dissection (ESD) was performed on 15 lesions. The en bloc and complete resection rates were 82% (46/56) and 54% (30/56), respectively. Multivariate logistic regression analyses determined that the resection method (EMR: odds ratio 4.356, 95% confidence interval 1.021-18.585, p=0.047) was independently associated with incomplete resection. The procedure-related bleeding and perforation rates were 4% and 5%, respectively. Recurrence of tumor occurred in one of 44 patients during the median follow-up period of 25 months (range: 6-89 months).</p><p><strong>Conclusion: </strong>ER is an effective, safe, and feasible treatment option for NADETs. However, the incomplete resection rate increases when EMR is performed. Nevertheless, given the longer procedure time and the technical difficulty associated with ESD, and the excellent long-term outcomes associated with EMR, EMR of NADETs is appropriate, especially in patients with dysplastic lesions.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"49-57"},"PeriodicalIF":1.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075677/pdf/tjg-31-1-49.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601187","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":"Is celiac disease misdiagnosed in children with functional constipation?","authors":"Sezin Akman,&nbsp;Özlem Şahaloğlu,&nbsp;Ceyhun Dalkan,&nbsp;Nerin Nadir Bahçeciler,&nbsp;Çiğdem Arıkan","doi":"10.5152/tjg.2018.17369","DOIUrl":"https://doi.org/10.5152/tjg.2018.17369","url":null,"abstract":"<p><strong>Background/aims: </strong>Functional constipation is one of the common problems in childhood, and it comprises approximately 5% of the pediatric outpatient clinical applications. On the other hand, celiac disease (CD) is an immune enteropathy with the prevalence between 1/150 and 1/200. In addition to the classical symptoms of the disease such as diarrhea and weight loss, the incidence of atypical symptoms is increasing. This study aims to determine the prevalence of CD in patients with chronic constipation.</p><p><strong>Materials and methods: </strong>The study was conducted between 2010 and 2012 and included 1046 children (range, 2-18 y; median, 11.4 y) diagnosed with chronic constipation according to the Rome III criteria. Serum immunoglobulin A, tissue transglutaminase, and/or anti-endomysial antibodies were examined. The patients with serological positive results were subjected to upper gastrointestinal system endoscopy and duodenal biopsy to confirm the diagnosis of CD.</p><p><strong>Results: </strong>Blood tests were positive in 36 patients (3.25%). One of the patients had Hashimoto's thyroiditis, and 4 patients had short stature. Endoscopic findings included nodularity in bulbus and duodenal mucosa (n=16), scalloping fold (n=13), and normal mucosa (n=5). Histopathologic findings revealed that 10 patients had total villous atrophy, 24 patients had subtotal and partial villous atrophy, and 34 patients had intraepithelial lymphocyte infiltration. All patients followed a gluten-free diet, resulting in a resolution of symptoms.</p><p><strong>Conclusion: </strong>In the present study, a CD ratio of 1:28 was diagnosed in chronically constipated children. The use of screening tests for CD should be considered in children with conventional treatment-resistant constipation.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"210-214"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284708/pdf/tjg-29-2-210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36087913","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}