Nigerian Journal of Medicine最新文献

{"title":"A community survey of the vaccination status of under-five children in a community in Southern Nigeria","authors":"O. Ochei, M. Ntaji, O. Adesoye, Nathaniel Oserada, Sandra Ordiah, Kojo Osaekete, Ololade Oshadiya","doi":"10.4103/njm.njm_109_22","DOIUrl":"https://doi.org/10.4103/njm.njm_109_22","url":null,"abstract":"Regarding vaccine coverage, Nigeria is currently making slow progress despite the previous achievements in immunisation coverage. This is contrary to the World Health Organisation's goal of achieving health equity for all people globally. Operational research to determine the immunisation status of children should be unrelenting. Thus, this study sought to assess the proportion of under-five children who had completed vaccination as well as parental variables associated with the vaccination in a South-southern community in Nigeria. Materials and Methods: A cross-sectional study and a multi-stage sampling technique were used to select respondents from the community. Respondents were interviewed using a pretested semi-structured questionnaire. Information related to parents' sociodemographic characteristics, mother's knowledge of immunisation, their children's vaccination status, and the reasons for vaccination were collected and entered into SPSS software. The percentage of children who had received all the required number of vaccines in the routine immunisation schedule was calculated. The proportion of children who had each of the vaccines was also calculated. Mother's knowledge of vaccination was scored based on some questions asked and was further graded into good and poor knowledge. Chi-square test was used to determine the association between parents' sociodemographic characteristics and children's vaccination status. Results: One hundred and seventy (68%) children completed their vaccination. There was a marked difference when the dropout rates from pentavalent 1/pentavalent 3 vaccine (2.7%) and Bacille Calmette–Guerin/measles vaccines (17.9%) were compared. Maternal knowledge (P = 0.00001), maternal parity (P = 0.006), mother's education (P < 0.00001), father's education (P < 0.00001), and father's age (P = 0.0002) were associated with vaccine uptake within the community. Conclusion: Mothers' knowledge and parity, parents' educational status, and the father's age significantly influenced vaccine uptake.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44081744","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":"Case Report of Ectopic Pregnancy Occurring in the Tubal Stump after a Previous Salpingectomy","authors":"Maradona E. Isikhuemen, Weyinmi E. Kubeyinje","doi":"10.4103/njm.njm_54_23","DOIUrl":"https://doi.org/10.4103/njm.njm_54_23","url":null,"abstract":"Abstract Tubal stump ectopic pregnancy is rare but a potentially life-threatening condition. A high index of suspicion is required for early diagnosis and effective treatment, thereby minimising morbidity associated with this type of abnormal pregnancy. The aim of this report was to document a rare case of repeat ectopic pregnancy in the tubal stump following previous salpingectomy. We report a 35-year-old para 1+ 1 with one living child who had one previous right salpingectomy for ruptured right ectopic pregnancy. She presented with complaint of abdominal pain of one-day duration following a five-week history of absent menstruation. On presentation, she was in shock and there were features of intra-abdominal fluid (blood) collection. Abdominopelvic ultrasound scan demonstrated intraperitoneal fluid collection with floating loops of bowel. She was resuscitated, had salpingectomy for ruptured tubal stump ectopic pregnancy, and remained stable on follow-up. In conclusion, tubal stump ectopic pregnancy is a rare but possible complication of a previous salpingectomy. A high index of suspicion is required for early diagnosis and effective management.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649106","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":"Sociodemographic Determinants of Overweight and Obesity in Adults Attending a Tertiary Hospital in Rivers State, Nigeria","authors":"Boma Oyan, Chinyere Ndu-Akinla","doi":"10.4103/njm.njm_44_23","DOIUrl":"https://doi.org/10.4103/njm.njm_44_23","url":null,"abstract":"Abstract Background: There has been an increase in the prevalence of obesity in developing countries with a concomitant rise in morbidity and mortality. The sociodemographic factors of an individual may play a role in his or her body weight. This study aims to determine the relationship between overweight/obesity and sociodemographic characteristics among adults attending the Family Medicine Clinic of a tertiary health centre in Nigeria. Materials and Methods: This was a descriptive, hospital-based study. Interviewer-administered questionnaires were used to obtain the sociodemographic variables (age, sex, social class, highest educational level attained, average monthly income, and marital status). A clinical examination was performed to assess the body mass index (BMI), waist circumference (WC), and waist/hip ratio (WHR). Fisher’s exact test was used to test for associations between overweight/obesity and the various sociodemographic determinants and the level of significance was set at P < 0.05. Results: With the BMI, overweight was present in 32.5% of the study population while 36.6% was obese. The WC was increased (>94 cm and >80 cm, respectively) in 43.5% of males and 92.8% of females. The WHR was increased (>0.90 and >0.85) in 52.2% of males and 80.8% of females. The only sociodemographic factor independently associated with being overweight or obese BMI in this study was the female gender ( P = 0.011). Conclusion: No region of the world has been successful at reversing the obesity epidemic once it has begun. This study highlights how sociodemographic factors may influence obesity and measures to modulate this disease can be targeted to certain groups.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650531","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":"Pregnancy-associated Plasma Protein-A, Progesterone, and Oestriol Levels and Some Birth Outcomes in HIV-seropositive Pregnant Women at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria","authors":"John Ekenedirichukwu Okwara, Joseph Eberendu Ahaneku, Charles Chinedum Onyenekwe, Gerald Okanandu Udigwe, Joseph Ifeanyichukwu Ikechebelu, Emmanuel Chidiebere Okwara, Nuratu Adejumoke Okwara, Jude Anaelechi Onuegbu, Japhet Madu Olisekodiaka","doi":"10.4103/njm.njm_37_23","DOIUrl":"https://doi.org/10.4103/njm.njm_37_23","url":null,"abstract":"Abstract Background: Pregnancy is associated with biochemical alterations and may be compounded by human immunodeficiency virus (HIV) infection potentially affecting pregnancy outcome such as birth weight, Apgar score, and foetal viability (stillbirth or intrauterine foetal death [IUFD]). Aims: This prospective case–control study evaluated some biochemical parameters and their possible effects on pregnancy outcome in HIV-seropositive subjects. Patients, Materials and Methods: The study involved 136 HIV seropositives on highly active antiretroviral therapy and 137 HIV-seronegative pregnant women, recruited from the Antenatal Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Pregnancy-associated plasma protein-A (PAPP-A), oestriol (E3), and progesterone were analysed using an enzyme-linked immunosorbent assay method, and the delivery outcomes were reported. Results: Progesterone was significantly higher ( P = 0.002) in HIV-seropositive individuals (59.3 ± 17.84 ng/mL) compared to controls (54.89 ± 8.24 ng/mL). There were no significant differences in the levels of E3 and PAPP-A between the two groups. In HIV seronegatives, there were no significant changes in measured biochemical parameters between trimesters ( P &gt; 0.05). There were no significant differences in measured biochemical parameters between subjects with IUFD and subjects with live births ( P &gt; 0.05) for both the test and control groups. Subjects with significantly lower PAPP-A in HIV seropositives had babies with higher Apgar score. The incidence of IUFD was 7.31% among HIV seropositives and 7.47% among HIV seronegatives. Conclusion: HIV infection affects some biochemical indices such as progesterone and PAPP-A but does not adversely affect pregnancy outcomes in HIV seropositives under antiretroviral therapy.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650894","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":"Prevalence and Spectrum of Albuminuria among Type 2 Diabetic Patients in a Tertiary Health-care Facility in Southern Nigeria","authors":"Beniboba J. Eleki, P. Emem-Chioma","doi":"10.4103/njm.njm_119_22","DOIUrl":"https://doi.org/10.4103/njm.njm_119_22","url":null,"abstract":"Background: Diabetic nephropathy (DN) is a life-threatening microvascular complication often leading to progressive renal failure and death. Microalbuminuria is an early marker of DN and a major risk factor for endothelial dysfunction. Routine screening for albuminuria will improve health outcomes in these patients. Materials and Methods: A cross-sectional study comprising 150 consecutive adults with type 2 diabetes mellitus (DM) (WHO criteria) attending the medical outpatient clinic of our hospital from December 2017 to December 2018. The study was done in accordance with the Declaration of Helsinki. Ethical approval was sought and obtained from the Ethical and Research Committee of the hospital before the commencement of the study. Written informed consent was obtained from individual participants after a careful explanation of the study. Samples for spot urine albumin-to-creatinine ratio were collected for analysis. Results were analysed with the Statistical Package for the Social Sciences (SPSS)-23 software. Results: The study involved 94 (62.7%) females and 56 (37.3%) males with a mean age of 55.87 ± 10.96 years. The mean duration of diabetes was 9.45 ± 6.94 years and 56 (37.3%) have had diabetes for 6–10 years. The mean urine albumin-to-creatinine ratio (uACR) was 153.54 ± 146.28 mg/g, with 66.7% having values between 30 and 299 mg/g while 15.3% had values ≥ 300 mg/g. The prevalence of albuminuria was 82% among participants. The relationship between the duration of Type 2 DM and UACR categories was not statistically significant, with P = 0.473. Conclusion: Routine screening for albuminuria in type 2 DM patients will improve health outcomes.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49057852","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":"Primary mesenteric angiosarcoma in an adult presenting with peritonitis: A case report and review of literature","authors":"Bello Bashir, S. Agbo, M. Umar, I. Abubakar, Hamza Sani, M. Abdullahi, Faruk Emetuma","doi":"10.4103/njm.njm_74_22","DOIUrl":"https://doi.org/10.4103/njm.njm_74_22","url":null,"abstract":"Primary mesenteric angiosarcoma is a rare soft tissue tumour accounting for 1%–2% of soft tissue tumours. Because of the ubiquity of blood vessels and lymphatics, it can occur anywhere with a poor prognosis. To the best extent of our literature search, this type of tumour is sparsely reported in our environment; we hereby report a case of primary mesenteric angiosarcoma in a 32-year-old man who presented with acute abdomen, intraperitoneal haemorrhage, and shock. Abdominal ultrasound revealed intraperitoneal collection, and intraoperative findings revealed haemoperitoneum 1.5l with vascular cystic tumour at the mesentery close to the duodenojejunal junction. Histopathological examination of the resected specimen revealed angiosarcoma. The patient was seen last at follow-up in early 2022.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44909844","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":"Histopathologic profile of bone and joint lesions in a tertiary health institution in Southeast Nigeria: A nine-year review","authors":"I. Ezejiofor, Olaniyi Olaofe, O. Ezejiofor, C. Ukah, N. Ozor, ChukwuemekaN Osonwa","doi":"10.4103/njm.njm_110_22","DOIUrl":"https://doi.org/10.4103/njm.njm_110_22","url":null,"abstract":"Background: The human skeletal system is composed of all the bones, joints, cartilage, ligaments, and tendons. The lesions of this system were thought to be uncommon in our environment and like lesions in any other part of the body are better managed when early presentations and correct diagnosis are made. The paucity of research on these lesions has prompted the need to study the topic. Aims: We aimed to study the bone and joint lesions, with a view to determining the most common types, the most involved sites of the body, the sex, and the age of presentations. Materials and Methods: This was a retrospective study carried out at the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from 2011 to 2019. Results: Eighty-four cases of bone and joint lesions were diagnosed in the study period, and they had a slight male preponderance with a M: F ratio of 1.4:1 and a mean age of 38.7 ± 22.0 years. Nonneoplastic lesions were more common 58.3% (49/84) than neoplastic tumours 41.7% (35/84). Benign tumours were however more common 27.4% (23/84) than malignant tumours 14.3% (12/84). Nonneoplastic lesions and benign tumours were seen in the first and second decades of life while malignant tumours occurred in the third and fourth decades. Of the 84 lesions, 47 cases were bone lesions while 37 were joint lesions. Osteomyelitis was the most common nonneoplastic bone lesion (7/47; 14.9%) while osteochondroma and giant cell tumours were the most common and only benign bone tumours seen and accounted for 14.9% (7/47) of cases each. Metastatic bone diseases (5/47; 10.6%) and osteosarcoma (4/47; 8.5%) were the most common malignant bone tumours, with osteosarcoma being the most common primary bone malignant tumours (4/7; 57.1%). Ganglion cysts were the most common lesions in all accounting for 23.8% (20/84) and the most common nonneoplastic (20/49; 40.8%) and joint lesions (20/37; 54.1%). Nodular tenosynovitis was the most common benign joint tumour and accounted for 10.8% (4/37) of cases; there is no malignant joint tumour. Skull was the most common anatomic site for bone lesions while the humerus was the most common anatomic site for bone tumours whereas wrist was the most common site for joint lesions. Conclusion: Nonneoplastic bone and joint lesions were more common than neoplastic lesions in our environment, with ganglion cysts being the most common joint lesions while osteomyelitis, osteochondroma, and giant cell tumours were the most common bone lesions. There is no malignant joint tumour observed in this study.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47654904","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":"Health-seeking Behavioural Practices of the Elderly in Rural Community of Ekiti State, Southwestern Nigeria","authors":"Kayode Rasaq Adewoye, Shuaib Kayode Aremu, David Sylvanus Ekpo, Taofeek Adedayo Sanni, Tope Michael Ipinnimo, Azeez Oyemomi Ibrahim","doi":"10.4103/njm.njm_13_23","DOIUrl":"https://doi.org/10.4103/njm.njm_13_23","url":null,"abstract":"Abstract Background: The aging process increases the risks of contracting a disease among elderly people. Health-seeking behaviour is poor among the aged in sub-Saharan countries like Nigeria, escalating the burden of noncommunicable diseases and the cost of health care which further impact the utilisation of orthodox medicine. Aim: This study aims to assess the health-care-seeking behavioural practices and associated factors among elderly people in Ido-Ekiti. Materials and Methods: A descriptive cross-sectional study was conducted among 420 elderly respondents in Ido-Ekiti. An interviewer-administered semi-structured questionnaire was used to collect information. The data collected were analyzed using SPSS version 25 and results were presented in the form of tables and bar charts. Chi-square tests were used to test for associations. All data analysis was done at a 5% level of significance. Results: The age range of respondents was between 65 and 95 years, with a mean age of 73.88 ± 6.84 years and 64.0% within the age range of 65–75 years. About 63.3% of the respondents have had an episode of illness in the last year preceding the study and only 35.3% consulted a doctor for treatment (good health-seeking behaviour); however, 57.9% of the respondents admitted utilising any of the following: self-medication, consult spiritualist, and use of herbal medicine (poor health-seeking behaviour). The factors statistically significantly associated with respondents’ health-seeking behavioural practices are employment status ( P < 0.001), educational level ( P < 0.002), cost of health care, access to the health facility, length of time before consultation, beliefs, and lack of support from relations ( P < 001). Conclusion: This study shows that the majority of the elderly had poor health-seeking behaviour due to educational and economic factors. Making the free or subsidized cost of health care for the elderly in rural communities and the provision of monthly financial support to the aged by the government will promote and encourage good health-seeking behaviour of old people.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650233","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":"Bilateral Giant Juvenile Fibroadenoma of the Breast Developing Metachronously in a 10-Year-Old Girl","authors":"Babatunde Moses Duduyemi, Emmanuel Sandy, Nnaemeka T. Onyishi, Alie Amin Sesay, Isaac Olufemi Smalle","doi":"10.4103/njm.njm_107_22","DOIUrl":"https://doi.org/10.4103/njm.njm_107_22","url":null,"abstract":"Abstract Giant juvenile fibroadenoma (GJF) is very rare and represents about 0.5% of all fibroadenomas. We describe a case of a 10-year-old premenarche girl that presented with huge bilateral GJFs. The right breast mass appeared first and was managed accordingly. The left mass developed rapidly within three months necessitating a second subtotal mastectomy.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135650653","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":"Poor acoustic window limits the diagnostic utility of transcranial colour doppler ultrasonography for acute stroke in an African population","authors":"O. Olowoyeye, O. Omidiji, Busola Joohnson-Aina, K. Soyebi","doi":"10.4103/njm.njm_4_23","DOIUrl":"https://doi.org/10.4103/njm.njm_4_23","url":null,"abstract":"Background: Stroke is a major cause of death and disability. Brain computed tomography (CT) scan is used for evaluating such patients with stroke followed by prompt interventions to reduce associated complications. Transcranial colour Doppler (TCCD) offers relatively affordable, nonionising, noninvasive analysis of cerebral hemodynamics. Aim: The aim of this study was to provide preliminary data on the utility of TCCD in adult acute stroke in sub-Saharan Africa, specifically to correlate Doppler assessed vascular flow dynamics with morphological CT variables observed in patients with stroke. Patients, Materials and Methods: A prospective study on fifty adult patients with acute stroke (25 ischemic and 25 hemorrhagic) who had computed tomography scans and duplex ultrasonography performed within 24 h of the onset of acute stroke. The Doppler variables from TCCD were correlated with the brain CT data. Results: For ischemic stroke, the middle cerebral artery (MCA) and anterior cerebral artery (ACA) were visualised bilaterally in 8 (32%) of patients, while the posterior cerebral artery (PCA) was seen bilaterally in only 1 (4%) case. For the hemorrhagic stroke category, the MCA and ACA were visualised bilaterally in 16 (64%) of patients, while the PCA was seen bilaterally in only 6 (24%) cases. The ACA asymmetry index showed a strong negative correlation (r = −0.938, P = 0.046) with the total stroke volume and a strong correlation with the amount of midline shift (r = 0.993, P = 0.0006). There was no correlation between the other indices of asymmetry and the CT scan quantitative data. Conclusion: This study shows that evaluating adult patients with acute stroke using TCCD with the currently available two-dimensional ultrasound transducers may be limited by poor acoustic window in a sub-Saharan African population. In future, the application of three-dimensional transducers with lower frequencies and the introduction contrast enhanced TCCD might bring about a positive outcome.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45891383","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}