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

{"title":"Gastric outlet obstruction by a polypoid tumor: Author's reply.","authors":"Nurettin Suna,&nbsp;Serkan Öcal,&nbsp;Diğdem Özer Etik,&nbsp;Seda Boyacıoğlu","doi":"10.5152/tjg.2018.18118","DOIUrl":"https://doi.org/10.5152/tjg.2018.18118","url":null,"abstract":"<p><p></p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"243-244"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284709/pdf/tjg-29-2-243b.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36592352","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":"Effects of Delta-tocotrienol Supplementation on Liver Enzymes, Inflammation, Oxidative stress and Hepatic Steatosis in Patients with Nonalcoholic Fatty Liver Disease.","authors":"Muhammad Amjad Pervez,&nbsp;Dishad Ahmet Khan,&nbsp;Aamir Ijaz,&nbsp;Shamrez Khan","doi":"10.5152/tjg.2018.17297","DOIUrl":"https://doi.org/10.5152/tjg.2018.17297","url":null,"abstract":"<p><strong>Background/aims: </strong>Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and is associated with increased morbidity and mortality. Currently, there is no definitive treatment for this disease. δ-Tocotrienol has potent anti-inflammatory and antioxidant properties and may reduce liver injury in NAFLD. The present study aims to evaluate the efficacy and safety of δ-tocotrienol in the treatment of NAFLD.</p><p><strong>Materials and methods: </strong>The present study was a randomized, double-blind, placebo-controlled pilot study conducted in patients aged > 20 years, belonging to both sexes, having ultrasound-proven fatty liver disease, having a fatty liver index (FLI) of ≥ 60, and persistent elevation of alanine transaminase. A total of 71 patients were assigned to receive either oral δ-tocotrienol (n=35, 300 mg twice daily) or placebo (n=36) for 12 weeks. At the baseline and at the end of the study, clinical and biochemical parameters, including lipid profile, liver function tests, high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were measured. Body mass index and FLI were calculated, and ultrasound grading of hepatic steatosis was performed.</p><p><strong>Results: </strong>Out of 71 enrolled patients, 64 patients, 31 in the δ-tocotrienol group and 33 in the placebo group, completed the study. After 12 weeks of supplementation, δ-tocotrienol showed greater efficacy than placebo by decreasing serum aminotransferases, hs-CRP, MDA, and FLI score (p<0.001). However, it did not improve hepatic steatosis on ultrasound examination. No adverse effects were reported.</p><p><strong>Conclusion: </strong>δ-Tocotrienol was safe, and it effectively improved aminotransferase levels and inflammatory and oxidative stress markers in patients with NAFLD. Large-scale randomized clinical trials are warranted to further support these findings.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"170-176"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284694/pdf/tjg-29-2-170.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36087907","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":"Safety of simultaneous endoscopic submucosal dissection for two large colorectal neoplasias in the same patient.","authors":"Min Seob Kwak,&nbsp;Dong-Hoon Yang,&nbsp;Sung Wook Hwang,&nbsp;Jung Ho Bae,&nbsp;Jae Seung Soh,&nbsp;Seohyun Lee,&nbsp;Ho-Su Lee,&nbsp;Hyo Jeong Lee,&nbsp;Sang Hyoung Park,&nbsp;Byong Duk Ye,&nbsp;Jeong-Sik Byeon,&nbsp;Seung-Jae Myung,&nbsp;Suk-Kyun Yang","doi":"10.5152/tjg.2018.17409","DOIUrl":"https://doi.org/10.5152/tjg.2018.17409","url":null,"abstract":"<p><strong>Background/aims: </strong>Multiple large colorectal lesions requiring endoscopic submucosal dissection (ESD) are sometimes diagnosed during colonoscopy. We evaluated the feasibility and safety of ESD of two colorectal lesions in one session.</p><p><strong>Materials and methods: </strong>The lesions of 16 patients who underwent two ESD procedures in a single session (double ESD group) from November 2009 to July 2014 were matched with those of 64 patients who underwent a single ESD procedure (single ESD group) based on the size and location of the lesion and presence of submucosal fibrosis.</p><p><strong>Results: </strong>The net ESD time per patient was longer in double ESD group than in single ESD group (104.0±36.2 vs. 59.1±39.2 min, p<0.001). The net ESD time per lesion tended to be shorter in double ESD group than in single ESD group (49.6±30.0 vs. 59.1±39.2 min, p=0.077). The en bloc resection and curative resection rates did not differ between double ESD and single ESD groups (93.8 % vs. 98.4%, p=0.262; 90.6 % vs. 84.4 %, p=0.534, respectively). The intra- and postprocedural bleeding rates were 12.5% and 0% in double ESD group and 15.6% and 3.1% in single ESD group, respectively. Perforation occurred in two (6.3%) in double ESD group and in six (9.4%) in single ESD group (p=0.715).</p><p><strong>Conclusion: </strong>Compared with the single ESD, two simultaneous colorectal ESD procedures in a patient did not increase complications; the en bloc and curative resection rates were similar when performed a single ESD procedure and two simultaneous ESD procedures.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"183-190"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284699/pdf/tjg-29-2-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36087909","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":"Effects of hemodialysis combined with hemoperfusion on severe acute pancreatitis.","authors":"Zhenhe Li,&nbsp;Guixia Wang,&nbsp;Guodong Zhen,&nbsp;Yuliang Zhang,&nbsp;Jiaqiang Liu,&nbsp;Shanmei Liu","doi":"10.5152/tjg.2018.17415","DOIUrl":"https://doi.org/10.5152/tjg.2018.17415","url":null,"abstract":"<p><strong>Background/aims: </strong>Severe acute pancreatitis (SAP) is characterized by persistent organ failure. This research aimed to evaluate the effect of hemodialysis combined with hemoperfusion on SAP.</p><p><strong>Materials and methods: </strong>Thirty-seven patients who were treated with hemoperfusion combined with hemodialysis were included in group O, and 31 patients treated with conventional therapy and hemoperfusion were included as control (group C). Leukocyte count, neutrophil percentage, amylase (AMY), blood urine nitrogen (BUN), creatinine (Cr), and total bilirubin (TBIL) were noted. The time when symptoms disappeared as well as complications after treatment was recorded.</p><p><strong>Results: </strong>Leukocyte count, neutrophil percentage, AMY, BUN, Cr, and TBIL in two groups were remarkably decreased after treatment. However, these indexes were significantly lower in group O than those in group C after treatment, especially the neutrophil percentage, AMY, BUN, Cr, and TBIL. The time when the symptoms disappeared was 3.01±1.02 days in group O, which was shorter than 5.56±1.88 days in group C. There were 4 patients with acute renal failure and 2 patients had multiple organ failure in group C after treatment. But only 1 patient developed acute renal failure in group O. The difference in complications between two groups was significant (p<0.024).</p><p><strong>Conclusion: </strong>The combination of hemodialysis and hemoperfusion could have a better effect on SAP in removing toxic metabolites and inflammation mediators. It not only shortens the time of symptoms disappearing but also decreases the incidence of complications and the mortality.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"198-202"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284718/pdf/tjg-29-2-198.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36087911","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":"Gastric outlet obstruction by polypoid tumors.","authors":"Herwig Cerwenka","doi":"10.5152/tjg.2018.17727","DOIUrl":"https://doi.org/10.5152/tjg.2018.17727","url":null,"abstract":"In the aforementioned article, we presented the case of a patient with gastric outlet obstruction, which was an extraordinary clinical representation for gastric gastrointestinal stromal tumors (1). In this case, on performing esophagogastroduodenoscopy (EGD), a polypoid lesion with a thick and long stalk (originating from the fundus and prolapsing to the duodenum via the pylorus) causing gastric outlet obstruction was observed. In Figure 2, the thick stalk of the polypoid lesion (originating from the fundus and extending to the pylorus) was shown in the retroflexion position of EGD. As the head of the polypoid lesion could not be removed from the duodenum by endoscopic methods, this section could not be monitored endoscopically. The complete image of the polypoid lesion was obtained after its surgical resection (Figure 3). In light of the authors’ criticism, we presented an EGD view of this case in Figure 1 for better understanding. The thick stalk (belonging to the polypoid) in the pylorus shown the flat position of the EGD.","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"243-244"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284704/pdf/tjg-29-2-243a.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36088384","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":"Combined treatment for gastric cancer: Immunological approach.","authors":"Olzhas Zhandossov,&nbsp;Galina Kaussova,&nbsp;Avraam Koten","doi":"10.5152/tjg.2018.17398","DOIUrl":"https://doi.org/10.5152/tjg.2018.17398","url":null,"abstract":"<p><strong>Background/aims: </strong>Gastric cancer is one of the most common oncological diseases. It can develop in any part of the stomach and spread to other organs, especially the esophagus, lungs, and liver. The aim of our study was to investigate the effectiveness of our proposed therapy.</p><p><strong>Materials and methods: </strong>Our research promises more effective neoadjuvant therapy, including immunotherapy and multi-agent chemotherapy. Of the 62 patients involved in our study, 32 underwent neoadjuvant chemotherapy in combination with surgery, whereas the rest underwent neoadjuvant chemoimmunotherapy with surgery.</p><p><strong>Results: </strong>Investigation of T-cell-mediated and humoral immunity in patients with gastric cancer over the course of treatment found a reduction of the main indices of cell-mediated and humoral immunity in the patients who underwent standard therapy, which greatly caused a decline of antitumor, anti-infective, and antitoxic protection of the patients' organisms.</p><p><strong>Conclusion: </strong>This study can contribute to the development of new therapies for gastric cancer as well as other types of cancer.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"151-156"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284695/pdf/tjg-29-2-151.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36089479","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":"Effect of ursodeoxycholic acid and vitamin E in the prevention of liver injury from methotrexate in pediatric leukemia.","authors":"Mohammadreza Bordbar,&nbsp;Nader Shakibazad,&nbsp;Mohammadreza Fattahi,&nbsp;Sezaneh Haghpanah,&nbsp;Naser Honar","doi":"10.5152/tjg.2018.17521","DOIUrl":"https://doi.org/10.5152/tjg.2018.17521","url":null,"abstract":"<p><strong>Background/aims: </strong>Ursodeoxycholic acid (UDCA) and antioxidants such as vitamin E are considered to have a protective role in preventing chemotherapy-induced liver damage. The aim of this study was to assess the efficacy of these agents for hepatoprotection in pediatric patients with B-cell acute lymphoblastic leukemia (ALL), who were treated with methotrexate in their maintenance phase of treatment.</p><p><strong>Materials and methods: </strong>Eighty children with B-cell ALL were randomly divided into four groups. Group 1 was administered oral vitamin E (400 mg/day); group 2 was administered oral UDCA (15 mg/kg/day); group 3 was administered a combination of the two drugs; and group 4 served as a control group and was administered no drug except their chemotherapy drugs. Complete blood count, liver function test, liver ultrasonography, and liver fibroscan were requested, and the results were compared.</p><p><strong>Results: </strong>Group 1 showed a slight increase in total bilirubin levels compared to baseline levels during the study (P=0.036). Group 2 showed a decline in aspartate aminotransferase and alanine aminotransferase levels during the study and at 6 months after discontinuing the drug; however, these differences were not statistically significant (P=0.051 and 0.083, respectively). None of the patients showed the evidence of significant fibrosis on liver fibroscan. Eight patients showed some evidence of mild-to-moderate fibrosis (F1, F2), but the results were not different between the groups as well as between pre- and post-study periods in each group.</p><p><strong>Conclusion: </strong>Low-dose methotrexate does not cause significant liver fibrosis in pediatric leukemia. UDCA and vitamin E have minimal roles in hepatoprotection among pediatric patients with ALL.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"203-209"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284693/pdf/tjg-29-2-203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36087912","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":"Colonoscopic decompression of childhood sigmoid and cecal volvulus.","authors":"Iraj Shahramian,&nbsp;Ali Bazil,&nbsp;Danial Ebadati,&nbsp;Karim Rostami,&nbsp;Mojtaba Delaramnasab","doi":"10.5152/tjg.2018.17507","DOIUrl":"https://doi.org/10.5152/tjg.2018.17507","url":null,"abstract":"<p><p>Cases of colonic volvulus in children are infrequently described in the literature. Here we describe the case of three patients with colonic volvulus. The first patient was a 10-year-old girl with abdominal dilation and pain and no bowel movement for 48 h. Her abdominal X-ray showed the coffee bean sign adjacent to the diaphragm, which was compatible with a diagnosis of cecal volvulus. The second patient was a 4-year-old boy with a history of chronic constipation during the past year and with no bowel movement for 24 h. Clinical manifestations included severe nausea, vomiting, and abdominal distension. His abdominal X-ray demonstrated the coffee bean sign in the right upper quadrant with upward convexity corresponding to a diagnosis of sigmoid volvulus. The third patient was a 10-month-old male who presented with excessive crying, malnutrition, and no bowel movement for 36 h. His abdominal X-ray demonstrated the coffee bean sign in the left upper quadrant with upward convexity. The presence of gas was not observed in the distal obstructed region, corresponding to a diagnosis of sigmoid volvulus. All three patients successfully underwent colonoscopy for volvulus reduction. Volvulus did not reoccur in any of the patients within 6 months of follow-up. It is recommended to perform abdominal X-ray imaging in patients who present with abdominal pain and distension, diarrhea, or constipation for possibly diagnosing volvulus.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"221-225"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284711/pdf/tjg-29-2-221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36088377","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":"Unexpected outcome following radiofrequency ablation of a malignant biliary stricture.","authors":"Andrew J Kruger,&nbsp;Somashekar G Krishna","doi":"10.5152/tjg.2018.17653","DOIUrl":"https://doi.org/10.5152/tjg.2018.17653","url":null,"abstract":"<p><p>We present a case of a 60-year-old woman with extrahepatic cholangiocarcinoma and recurrent malignant biliary strictures status post placement of two overlapping distal bile duct uncovered self-expandable metal stents (SEMSs) who presented with biliary obstruction due to tumor/tissue ingrowth. She subsequently underwent radiofrequency ablation (RFA) through SEMS to improve biliary stent patency. Post-RFA, thermal injury was observed in the periampullary mucosa. She later developed acute pancreatitis. This is the first case of RFA-induced acute pancreatitis with endoscopic evidence of thermal injury. It should be noted that RFA-induced acute pancreatitis is a potential adverse effect as RFA through SEMS is being used more widely.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"230-232"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284715/pdf/tjg-29-2-230.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36088379","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":"Bacteremia in cirrhotic patients with upper gastrointestinal bleeding.","authors":"Hsin-An Shih,&nbsp;Pei-Chuan Tsai,&nbsp;Kai-Hsiang Wu,&nbsp;Yi-Ting Chen,&nbsp;Yi-Chuan Chen","doi":"10.5152/tjg.2018.17309","DOIUrl":"https://doi.org/10.5152/tjg.2018.17309","url":null,"abstract":"<p><strong>Background/aims: </strong>Increased risk of bacterial infection is common in cirrhotic patients with upper gastrointestinal bleeding (UGIB). Our study aimed to explore the association of the bacteremia with in-hospital mortality and risk factors of bacteremia in these patients.</p><p><strong>Materials and methods: </strong>In our retrospective cohort study, we collected data for cirrhotic patients with UGIB admitted to our hospital between August 2010 and December 2010. The primary outcome was in-hospital mortality. The secondary outcome was bacteremia. A multivariate logistic regression analysis was performed to determine risk factors for mortality and bacteremia.</p><p><strong>Results: </strong>A total of 202 patients with cirrhosis presenting with UGIB at the emergency department (ED) were enrolled. Bacteremia was associated with a higher mortality rate (adjusted odds ratio [OR]: 9.7; 95% confidence interval [CI]: 1.9-50.6, p=0.007), whereas shock (systolic blood pressure <90 mmHg at ED triage) and bandemia (>0% immature neutrophils of band form) were associated with bacteremia in cirrhotic patients with UGIB (adjusted OR: 5.3; 95% CI: 2.3-12.7, p<0.0001 and adjusted OR: 4.0; 95% CI: 1.6-9.9, p=0.0003, respectively).</p><p><strong>Conclusion: </strong>Bacteremia in cirrhotic patients with UGIB is one of the major risk factors leading to in-hospital mortality. On the basis of our findings, prevention of bacteremia in cirrhotic patients with UGIB, especially in those with shock and bandemia, is important; thus, adequate antibiotic treatment is suggested.</p>","PeriodicalId":518528,"journal":{"name":"The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology","volume":" ","pages":"164-169"},"PeriodicalIF":1.2,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284712/pdf/tjg-29-2-164.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36087906","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}