Journal of clinical and experimental hematopathology : JCEH最新文献

{"title":"Hodgkinoid histiocytosis, a distinctive histiocytic/dendritic cell disorder clinically mimicking drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms.","authors":"Yuzo Oyama, Riko Kubota-Furukawa, Kanami Saito, Takumi Nishikawa, Kuniko Takano, Takanori Izumi, Katsuhiko Yoshimura, Seiji Shiota, Yutaka Hatano, Haruto Nishida, Morishige Takeshita, Tsutomu Daa","doi":"10.3960/jslrt.25085","DOIUrl":"10.3960/jslrt.25085","url":null,"abstract":"<p><p>We report a case of Hodgkinoid histiocytosis (HH) with protracted skin manifestations. A 72-year-old Japanese woman presented with fever of unknown origin, lymphadenopathy, eosinophilia, and a generalized pruritic and erythematous maculopapular rash. Biopsy of an inguinal lymph node indicated a proliferation of large cells with clear cytoplasm, mimicking Hodgkin lymphoma (HL). Immunohistochemical analysis showed that the Hodgkin-like cells were positive for S-100 protein and CD30 but negative for langerin, CD20, PAX5, and CD3. The cells were also positive for PD-L1. The histological findings were similar to those of HL; conversely, immunohistochemical results suggested a histiocytic/dendritic cell origin. Therefore, the patient was diagnosed with HH. Systemic corticosteroid therapy markedly improved her systemic manifestations; nonetheless, cutaneous symptoms persisted. Drug-induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) was suspected because of the prolonged cutaneous manifestations, and the diagnostic criteria for these conditions were fulfilled. Discontinuation of the culprit drug resulted in the remission of cutaneous symptoms. Because lymph node lesions in DIHS/DRESS also demonstrate HL-like histology, this case suggests that HH, while a novel and distinct histiocytic/dendritic cell disorder, may be associated with lymph nodal lesions occurring in the context of DIHS/DRESS.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 1","pages":"91-97"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596852","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":"Karyotype evolution of multiple myeloma.","authors":"Yosuke Matsumoto, Tsuyoshi Ichimura, Junichi Harukawa, Kozue Fujioka, Harunori Suzuki, Koichi Nonaka, Ayako Muramatsu, Mio Sugitani, Tsutomu Kobayashi, Toshiki Iwai, Hitoji Uchiyama","doi":"10.3960/jslrt.25086","DOIUrl":"10.3960/jslrt.25086","url":null,"abstract":"<p><p>To clarify the karyotype evolution of multiple myeloma (MM), multiple karyotypes of 22 patients with MM were analyzed using G-banding, and their karyotype evolutions were depicted as phylogenetic trees. Eleven patients exhibited highly complex karyotype evolutions, combining branched evolution, linear evolution, parallel evolution and macroevolution. While chromosomal structural abnormalities involving 14q32 were detected at the roots of the phylogenetic trees of karyotype evolution, aneuploidies and the other structural abnormalities were identified in both the initial clones and karyotypically evolved subclones. The findings indicated that aneuploidies might be caused by unequal chromosomal segregation, loss of the chromosome with unbalanced whole-arm translocation, and whole-chromosome doubling in patients with near-tetraploidy. Four patients had karyotype abnormalities (three del(20)(q) and one del(5)(q)) associated with myelodysplastic syndrome independent of the karyotype evolution of MM. In conclusion, the phylogenetic trees depicted by G-banding present the karyotype evolution of MM.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 1","pages":"19-26"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596804","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":"Histiocytic sarcoma with a common clonal origin emerged after 33 years from B-cell precursor acute lymphoblastic leukemia.","authors":"Misayo Miyake, Naoko Tsuyama, Yuki Togashi, Akito Dobashi, Yuri Okimoto, Hiroko Noguchi, Dai Maruyama, Kengo Takeuchi","doi":"10.3960/jslrt.26019","DOIUrl":"10.3960/jslrt.26019","url":null,"abstract":"<p><p>Histiocytic sarcoma (HS) is a rare, aggressive malignant neoplasm characterized by histiocytic features, frequently presenting in advanced clinical stages and associated with a poor prognosis. Although HS can occur sporadically or secondary to other hematological malignancies, cases with a long latency period have been rarely reported. This case report presents a unique case of secondary HS diagnosed 33 years and seven months after the initial diagnosis of B-cell precursor acute lymphoblastic leukemia. Both neoplasms shared identical immunoglobulin heavy chain and T-cell receptor gene rearrangements, confirming a clonal relationship. To the best of our knowledge, this case represents the longest reported interval between primary leukemia and secondary HS, highlighting the potential for lineage switching and transformation over extended periods. These findings underscore the need for ongoing research on the mechanisms underlying \"transdifferentiation\", including the roles of transcription factors, cytokine signaling, and epigenetic modifications.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 2","pages":"156-165"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348755","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":"Retained epcoritamab activity despite routine CD20 assay negativity approximately one terminal half-life after mosunetuzumab in B-cell lymphoma.","authors":"Seiji Kakiuchi, Hiroaki Akiyama, Naru Tomigaki, Akimasa Sakamoto, Shutaro Fujioka, Isamu Harima, Ryotaro Niwa, Ikumi Takagi, Yoko Kozuki, Yoshiharu Miyata, Nobuko Iwata, Kyoko Otani","doi":"10.3960/jslrt.26029","DOIUrl":"https://doi.org/10.3960/jslrt.26029","url":null,"abstract":"<p><p>CD20 testing shortly after CD20-directed therapy can be difficult to interpret. We report an 89-year-old woman with multiply relapsed B-cell lymphoma who underwent excisional biopsy of an enlarging right axillary lymph node 17 days after the last dose of mosunetuzumab. A prior lymph node biopsy showed follicular lymphoma grade 3A with preserved CD20 expression. The relapse specimen showed diffuse large B-cell lymphoma of the germinal center B-cell subtype. Immunohistochemistry using the CD20 clone L26 failed to detect CD20 expression, whereas PAX5 and CD79a remained positive. Flow cytometry showed undetectable CD20 with clone L27; the large-cell gate contained CD19-positive B cells and showed kappa light-chain restriction. No morphologic findings of a lineage switch were observed. IGH and IGK rearrangement analyses demonstrated identical monoclonal peaks in the specimens obtained at the follicular lymphoma stage and relapse, supporting clonal continuity. Positron emission tomography/computed tomography revealed a 40-mm right axillary lymph node with a maximum standardized uptake value of 26.7. Epcoritamab was started as the seventh-line treatment despite negativity on routine assays for CD20. During step-up dosing, grade 1 cytokine release syndrome resolved after one dose of tocilizumab. Computed tomography on day 22 revealed a reduction in the size of the right axillary lymph node from 40 to 20 mm. The lesion remained 20 mm on days 41 and 51, with decreases in lactate dehydrogenase and soluble interleukin-2 receptor. Disease progression was documented on day 83. These findings suggest that negative CD20 results by routine assays shortly after mosunetuzumab therapy do not necessarily reflect true target loss. Integrated interpretation of histopathology, flow cytometry, and clonality studies may help guide subsequent CD20-directed treatment decisions.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 3","pages":"248-253"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122413","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":"ER stress-associated apoptosis and pyroptosis-like changes in Kikuchi-Fujimoto disease.","authors":"Shigeyuki Asano, Koji Shikano, Kazuki Yamazaki, Yoichiro Sogame, Rin Yamada, Yuko Hashimoto, Yasuhiro Nakamura, Yoshihiro Komohara","doi":"10.3960/jslrt.26037","DOIUrl":"https://doi.org/10.3960/jslrt.26037","url":null,"abstract":"","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 3","pages":"272-275"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122491","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":"CD5-positive diffuse large B-Cell lymphoma presenting with protein-losing enteropathy.","authors":"Kenji Moriwaki, Hiro Tatetsu, Yusuke Higuchi, Takahisa Nakamura, Ayuko Naito, Asami Yamada, Takafumi Shichijo, Kenji Tokunaga, Ryosuke Gushima, Takuya Shiota, Yoshiki Mikami, Kisato Nosaka, Yasuhito Tanaka, Kennosuke Karube, Jun-Ichiro Yasunaga","doi":"10.3960/jslrt.25057","DOIUrl":"10.3960/jslrt.25057","url":null,"abstract":"<p><p>Primary gastrointestinal lymphoma accounts for only 1-4% of all gastrointestinal malignancies, yet the gastrointestinal tract is the most common extranodal site of non-Hodgkin lymphoma, comprising 10-15% of all non-Hodgkin lymphomas. Among these, diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue lymphoma frequently affect the stomach and small intestine. Protein-losing enteropathy associated with malignant lymphoma is exceedingly rare, particularly when caused by CD5-positive DLBCL. We report the case of a 60-year-old woman with a four-year history of refractory diarrhea and progressive lower extremity edema, ultimately diagnosed with CD5-positive DLBCL of the small intestine. Diagnostic workup revealed hypoproteinemia with significant protein leakage in the ascending colon and distal small intestine. Double-balloon endoscopy demonstrated shallow, wide ulcers with patchy whitish exudates, and histopathology confirmed a diagnosis of de novo CD5-positive DLBCL. Chemotherapy with rituximab, etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH-R) led to prompt improvement in serum albumin levels and resolution of the protein-losing enteropathy. Subsequent high-dose chemotherapy with autologous stem cell transplantation has maintained remission. Given the rarity of this presentation and its strong similarity to a previously reported case of CD5-positive DLBCL with protein-losing enteropathy, we propose that this might represent a distinct clinical entity.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 1","pages":"45-51"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597625","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":"Independent PML::RARA-positive acute promyelocytic leukemia arising during BCR::ABL1-positive chronic myeloid leukemia.","authors":"Takanori Yoshioka, Akira Kondo, Masayuki Matsuda, Yasuhisa Sando, Makoto Nakamura, Nobuharu Fujii, Kazutaka Sunami","doi":"10.3960/jslrt.26010","DOIUrl":"10.3960/jslrt.26010","url":null,"abstract":"<p><p>Acute promyelocytic leukemia (APL) arising during the clinical course of BCR::ABL1-positive chronic myeloid leukemia (CML) is rare and may represent either promyelocytic blast phase or the emergence of an independent Philadelphia chromosome-negative clone. We report an octogenarian man with chronic-phase CML who was intolerant to multiple tyrosine kinase inhibitors and underwent temporary discontinuation of asciminib. During molecular relapse, bone marrow examination revealed 88% abnormal promyelocytes with Auer rods and markedly elevated PML::RARA transcripts, whereas BCR::ABL1 transcript levels were more than 3 logs lower than at CML diagnosis. Conventional cytogenetics demonstrated t(15;17) without t(9;22) as the dominant clone, supporting de novo APL arising independently of the residual CML clone. All-trans retinoic acid plus arsenic trioxide achieved molecular remission of PML::RARA and was followed by an initial marked reduction in BCR::ABL1 transcript levels, which subsequently remained detectable at low levels during continued follow-up. This case highlights the importance of integrated cytogenetic and molecular evaluation to distinguish blast phase from independent leukemogenesis in patients with CML who develop cytopenias.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 2","pages":"142-147"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348722","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":"Clonality patterns of IGH and TCRB gene rearrangement across lymphoma and non-lymphoma: a pitfall in the interpretation of multiplex PCR.","authors":"Miwa Fujikawa, Tomoko Miyata-Takata, Akihiro Kitadate, Noriko Okuno, Tomomi Kunisawa, Seiji Yamamoto, Shohei Kikuchi, Tsutomu Sato, Naoto Takahashi, Katsuyoshi Takata","doi":"10.3960/jslrt.26027","DOIUrl":"https://doi.org/10.3960/jslrt.26027","url":null,"abstract":"<p><p>Clonality testing using BIOMED-2-based multiplex PCR is widely applied in routine diagnostics, but its interpretation can be complicated by clonal-like peaks arising from non-neoplastic immune responses. In this study, we retrospectively analyzed routine diagnostic cases examined by IGH and TCRB multiplex PCR and assessed both the number of rearranged regions and peak patterns in B-cell lymphoma (N = 291), T-cell lymphoma (N = 48), Classic Hodgkin lymphoma (N = 31), reactive lymphoid hyperplasia (N = 28), and carcinoma (N = 41). The most clinically relevant finding was the frequent detection of apparent IGH clonality in carcinoma, often accompanied by polyclonal background. Clonal IGH peaks were detected in 16 of 35 carcinoma cases (46%), including 7 of 35 cases (20%) with peaks in two or more regions. Among these 16 cases, 11 (69%) showed polyclonal background. In contrast, reactive lymphoid hyperplasia showed much lower IGH positivity, with clonal peaks in 3 of 25 cases (12%) and only 1 of 25 cases (4%) with peaks in two or more regions. More informative than lineage-associated positivity itself were the disease-specific peak patterns, especially the frequent appearance of clonal-like IGH peaks with polyclonal background in carcinoma and the background-rich patterns seen in T-follicular helper cell lymphoma, angioimmunoblastic type/angioimmunoblastic T-cell lymphoma (AITL). These findings indicate that BIOMED-2 clonality assays capture not only neoplastic clones but also disease-specific immune background. Frequent IGH peaks with polyclonal background in carcinoma represent an important diagnostic pitfall and should be interpreted carefully together with the pathological and immunohistochemical results.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 3","pages":"217-224"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122352","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":"Fatal TAFRO syndrome in which adrenal hemorrhage preceded thrombocytopenia.","authors":"Madoka Miyazaki, Hiroko Tsunemine, Chika Fujita, Chiho Ohbayashi, Shusaku Take, Yasuhiro Tanaka, Tomoo Itoh, Nobuyoshi Arima","doi":"10.3960/jslrt.26031","DOIUrl":"https://doi.org/10.3960/jslrt.26031","url":null,"abstract":"<p><p>TAFRO syndrome is a rare systemic inflammatory disease characterized by thrombocytopenia, anasarca, fever, renal dysfunction, and myelofibrosis, and its follows a rapidly fatal clinical course. A few cases of TAFRO syndrome complicated by adrenal hemorrhage were recently reported; however, its pathogenetic significance remains largely unclear.The present case was a 59-year-old man presenting with left lower back pain. Imaging studies revealed left adrenal hemorrhage. Although an elevated C-reactive protein level was observed in the initial visit, there were no obvious abnormalities in the platelet count, renal function, or coagulation profile. Subsequently, fluid retention and renal dysfunction progressed rapidly, and thrombocytopenia emerged, leading to a diagnosis of TAFRO syndrome. Treatment including glucocorticoid therapy was initiated, but was ineffective; the disease progressed rapidly, and the patient succumbed to multiple organ failure. Autopsy revealed findings consistent with TAFRO syndrome in small lymph nodes and those suggestive of thrombotic microangiopathy in renal glomeruli.Based on these findings, adrenal hemorrhage may occur as an initial presentation prior to the manifestation of the full systemic picture of TAFRO syndrome. Furthermore, the disease progressed rapidly to a severe state in a short period without initial thrombocytopenia-which complicated the diagnosis-and demonstrated resistance to conventional treatments including glucocorticoids, which underscores the importance of early recognition and therapeutic intervention.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 3","pages":"254-259"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122410","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":"Clinicopathological features of primary cold agglutinin disease in the Japanese population: Heterogeneous characteristics and diagnostic challenges.","authors":"Yoshinori Sato, Hideyuki Nakazawa, Takeshi Uehara, Mai Iwaya, Hiroko Kazumoto, Hikaru Kobayashi, Yoichi Kohara, Fumihiro Ishida, Hideki Makishima, Naoko Asano","doi":"10.3960/jslrt.25074","DOIUrl":"10.3960/jslrt.25074","url":null,"abstract":"<p><p>Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia triggered by exposure to cold. Primary CAD, defined as CAD not associated with malignant neoplasms or infections, has recently been recognized as a monoclonal B-cell lymphoproliferative disorder in the fifth edition of the World Health Organization Classification of Tumors: Hematolymphoid Tumors. This study aimed to clarify the clinicopathologic spectrum of primary CAD in a Japanese cohort through comprehensive clinicopathologic and molecular analyses. Twenty-one patients were clinically diagnosed with CAD, of whom eight were classified as having cold agglutinin syndrome (CAS) due to underlying conditions such as infections or neoplasms. The remaining 13 patients underwent detailed histologic and molecular evaluation and were stratified into three groups: Group 1, four patients with clinicopathologic features consistent with primary CAD; Group 2, six patients showing overlapping features with other indolent B-cell lymphomas; and Group 3, three patients in whom tumor cells were scarcely detectable histologically. Based on integrated clinicopathologic and molecular findings, nine patients (69%) were ultimately classified as having primary CAD, including all Group 1 patients, four from Group 2, and one from Group 3. These findings highlight the diagnostic challenges of primary CAD, even after exclusion of CAS-associated underlying conditions by standard clinical evaluation, and demonstrate that primary CAD encompasses a heterogeneous clinicopathologic spectrum. Our results suggest that further refinement of the current diagnostic criteria for primary CAD may be warranted.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":"66 1","pages":"1-10"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597631","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}