中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.009
Jie Lin, Q. Cao, Bi-ru Li, M. Tang, L. Luo
{"title":"Clinical characteristics and prevalence of adenovirus with respiratory tract infections in children","authors":"Jie Lin, Q. Cao, Bi-ru Li, M. Tang, L. Luo","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.009","url":null,"abstract":"Objective \u0000To explore the clinical characteristics prevalence of respiratory adenovirus infections in children, and to provide reference for diagnosis, monitoring and timely treatment. \u0000 \u0000 \u0000Methods \u0000A total of 775 clinical specimens were collected from Shanghai Children′s Medical Center during November 2016 to November 2017, and 84 cases of adenovirus infections were detected by FilmArray. \u0000 \u0000 \u0000Results \u0000Among 775 samples, 84 samples(10.8%) were adenovirus positive.The epidemic peak of adenovirus infection was winter, spring and summer, especially in winter(20.8%), and the highest detection rate was in January(32.2%). The age ranged from 6 months to 2 years(47.7%). The common clinical manifestations are fever(91.7%), cough(96.4%), wheezing(48.8%), and shortness of breath(14.2%). A total of 15 cases(17.9%) had underlying diseases, the most of them were congenital heart diseases(9 cases, 10.7%). A total of 53 cases(63.1%) were mixed infection, and 21 cases(25.0%) were complicated with human rhinovirus/enterovirus.There were 5 cases of upper respiratory tract infection, 3 cases of bronchitis and 76 cases of pneumonia, including 55 cases of mild pneumonia and 21 cases of severe pneumonia.The average length of hospital stay was 8.3 days.The length of hospital stay, cases of wheezing and severe cases in the mixed infection group were significantly higher than those in the single infection group(P<0.05). Hospitalization days, wheezing symptoms, extrapulmonary symptoms, basic diseases and mixed infections in severe group were significantly higher than those in mild group(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Adenovirus infection occurs in children aged 6 months to 2 years, with a high incidence in winter, spring and summer.The peak month is January.The main clinical manifestations are high fever, cough and wheezing.Children with underlying diseases, wheezing symptoms, extrapulmonary symptoms and mixed infections are more likely to develop severe diseases.FilmArray detection system can quickly and accurately detect pathogens, provide a good basis for early diagnosis, monitoring and treatment of clinicians. \u0000 \u0000 \u0000Key words: \u0000Adenovirus; Epidemiology; Clinical characteristics; Children; FilmArray detection","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"114-118"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48738012","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.010
Hui Li, Hua Wang
{"title":"Effect of methylprednisolone shock therapy on immune function of electrical status epilepticus during sleep in children","authors":"Hui Li, Hua Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.010","url":null,"abstract":"Objective \u0000To study the effect of methylprednisolone shock therapy on electrical status epilepticus during sleep (ESES) in children and the changes of immune function before and after methylprednisolone shock therapy. \u0000 \u0000 \u0000Methods \u0000Thirty-five children hospitalized in pediatric neurology ward of Shengjing Hospital of China Medical University from October 2017 to October 2018 were selected, including 19 children with newly diagnosed temporal lobe epilepsy (TLE group) and 16 children with initial diagnosis of TLE with ESES (ESES group), and 21 healthy children in the same period were selected as normal control group.A total of 32 cases with ESES who were taken oral administration of more than 2 anti-epileptic drugs(AEDs)ineffective were given methylprednisolone shock treatment for 3 days.Changes of lymphocyte subsets and cytokines among groups were compared. \u0000 \u0000 \u0000Results \u0000The longer the course of disease, the worse the prognosis of children with ESES.Compared with normal control group, the NK cell activity were significantly lower in children of ESES group(P<0.05). The levels of IL-6 were higher in children of ESES group compared with that in children of TLE group, and there was significant difference between two groups(P<0.05). In children with ESES who had poor therapeutic effect of oral AEDs, the proportion of peripheral blood B lymphocytes increased after methylprednisolone shock treatment, and the proportion of T lymphocyte subsets and NK cells decreased, and the differences were statistically significant(P<0.05). The levels of IL-2, IL-4 and IL-10 were higher than those before treatment, the levels of IL-6, IL-17, INF-γ and TNF were lower than those before treatment, and the difference between the level of IL-6 before and after treatment was statistically significant(P<0.05). EEG spike waves index decreased significantly after treatment, some children′s growth and development and cognitive function improved, all children had no serious infection, high blood pressure, electrolyte imbalance and other adverse reactions.The correlation between therapeutic effect and changes of immune indexes was statistically significant in levels of NK cells(r=0.50, P<0.01), B lymphocytes (r=0.35, P=0.04) and IL-6(r=0.46, P=0.01), and all of them were positively correlated(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Children with ESES have immune dysfunction and may have excessive inactivation of NK cells and elevated levels of IL-6.Congenital immunity and adaptive immunity may play a role in the pathogenesis and pathophysiology of ESES syndrome.Methylprednisolone shock therapy could significantly reduce the non-rapid eye movement discharge index in children with ESES.The mechanism may be related to the significant decrease of IL-6 level.It may also be related to redistribution of lymphocyte subsets, affecting cell differentiation and balancing various cytokines. \u0000 \u0000 \u0000Key words: \u0000Electrical status epilepticus during sleep; Lymphocyte; Cytokines; Methylprednisolone","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"119-124"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43531775","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":"Comparison of the effects of caffeine citrate administering at different time on outcome and neuro-development of premature infants","authors":"Xiaonan Li, Fa-lin Xu, Yaxuan Liu, Wenli Duan, Meng-Di Liu, Jia-xin Liu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.012","url":null,"abstract":"Objective \u0000To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants. \u0000 \u0000 \u0000Methods \u0000A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old. \u0000 \u0000 \u0000Results \u0000Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively). \u0000 \u0000 \u0000Conclusion \u0000Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system. \u0000 \u0000 \u0000Key words: \u0000Caffeine citrate; Premature infant; Very low birth weight infant; Neural development","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"129-133"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47386735","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.008
Sujuan Wang, Hao Zhou, Weiming Chen, G. Lu
{"title":"Early respiratory rehabilitation for critically ill children with mechanical ventilation","authors":"Sujuan Wang, Hao Zhou, Weiming Chen, G. Lu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.008","url":null,"abstract":"Objective \u0000To develop the early respiratory rehabilitation techniques in pediatric intensive care unit(PICU) for children with mechanical ventilation. \u0000 \u0000 \u0000Methods \u0000A respiratory rehabilitation team was established, and early respiratory rehabilitation intervention methods for critically ill children were also developed.Early bedside rehabilitation were implemented after the vital signs of mechanical ventilation children were stable for 24 hours, and the rehabilitation effect and adverse events were observed. \u0000 \u0000 \u0000Results \u0000According to the patient′s condition, 23 patients in PICU received early respiratory rehabilitation after incubations, including 10 males and 13 females, aged 57.0(17.5, 91.5) months.There was no adverse event in 729 rehabilitation practices.The average consulting time was 8.0(4.0, 18.0) days after incubations.The average incubation time was 693.5(345.2, 1 027.1)hours of all the patients.As to 16 patients who were weaned before charged out, the average incubation time was 566.2(243.4, 928.7)hours, and the average incubation time from respiratory rehabilitation performance to weaning was 168.0(6.0, 564.0) hours.In 19 patients who only received limbs massage and passive movements, the average incubation time was 381.7(309.6, 541.4) hours and the average incubation time from respiratory rehabilitation performance to weaning was 187.2(81.5, 382.9) hours.However the difference between these who received respiratory rehabilitation and only received limbs massage and passive movements was not statistically significant. \u0000 \u0000 \u0000Conclusion \u0000It′s safe and feasible to perform the early respiratory rehabilitation in PICU for critically ill children with mechanical ventilation. \u0000 \u0000 \u0000Key words: \u0000Respiratory rehabilitation; Critically ill; Mechanical ventilation; Pediatric intensive care unit","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"110-113"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49391069","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.004
Shan-lin Chen
{"title":"Clinical application of dexmedetomidine in pediatrics","authors":"Shan-lin Chen","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.004","url":null,"abstract":"Dexmedetomidine(DEX) is a new type of highly selective α2 adrenergic receptor agonist with multiple effects, such as sedation, analgesic, anti-anxiety and inhibition of sympathetic nervous system activity.DEX is usually used as an anesthetic adjuvant and as an sedative and analgesic in PICU, also possessing effects of preventing and treating emergence agitation, counteracting postoperative shivering and organ protection.This paper summarized the clinical application of DEX in pediatric field. \u0000 \u0000 \u0000Key words: \u0000Dexmedetomidine; Pediatrics; Clinical application","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"92-95"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44371023","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.015
T. Ma
{"title":"Advances in the study of antibodies associated with myasthenia gravis","authors":"T. Ma","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.015","url":null,"abstract":"As an autoimmune disease involving the neuromuscular junction, the pathogenesis of myasthenia gravis(MG) is closely related to autoimmune antibodies.Regarding related antibodies, acetylcholine receptor antibody(AChR-Ab) is the most studied and clear.In recent years, researchers have began to study antibodies other than AChR-Ab due to the presence of AChR-Ab-negative MG patients, such as muscle-specific tyrosine kinase antibodies, low-density lipoprotein 4 antibodies, and explore the corresponding treatment options.This article reviewed the research progress of MG related antibodies, and provided clinical evidence and reference for the future treatment of this disease. \u0000 \u0000 \u0000Key words: \u0000Antibody; Myasthenia gravis; Autoimmune disease; Thyroid","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"144-148"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43415522","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.007
Zhi-jia Wang
{"title":"Effect of neurokinin 1 receptor antagonist on airway inflammation and hyperresponsiveness in asthmatic mice","authors":"Zhi-jia Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.007","url":null,"abstract":"Objective \u0000To investigate the effects of neurokinin-1 receptor antagonist WIN 62, 577 on airway inflammation and airway hyperresponsiveness in asthmatic mice. \u0000 \u0000 \u0000Methods \u0000Thirty-two BALB/c mice(Specific-pathogen-free grade) were randomly divided into 4 groups: control group, asthmatic group, WIN 62, 577 intervention group and dexamethasone group.The asthmatic group, the WIN 62, 577 intervention group, and the dexamethasone group were given intraperitoneal injection of 0.2 ml of OVA sensitization solution at 0 d, 7 d, and 14 d, respectively.Then the asthmatic group, WIN 62, 577 group and dexamethasone group were given OVA challenge solution(4% OVA solution) by inhalation once a day for 30 min from 21 d to 28 d for 7 consecutive days.The WIN 62, 577 intervention group was given WIN 62, 577 300 μg intraperitoneal injection 1 h before each challenge; the dexamethasone group was given intraperitoneal injection of dexamethasone 2 mg/kg 1 h before each challenge.The airway responsiveness of each group of mice was detected by non-invasive pulmonary function test.The bronchoalveolar lavage fluid(BALF) was obtained for inflammatory count.The HE staining of lung tissue was used to observe airway inflammation in mice. \u0000 \u0000 \u0000Results \u0000Compared with the asthmatic group, the mice in the WIN 62, 577 intervention group showed less restlessness, standing upright, crouching back, scratching the ears and scratching the cheeks, shortness of breath and cyanosis of the lips.After inhaling different concentrations of acetylcholine, the Penh value of mice in the WIN 62, 577 intervention group and the dexamethasone group was significantly lower than that in the asthmatic group(P<0.05). Compared with the asthmatic group, the number of WBC and EOS in BALF decreased significantly in the WIN 62, 577 intervention group and the dexamethasone group(P<0.01). HE staining showed that the inflammatory changes in the lung tissue of mice in the WIN 62, 577 intervention group were significantly reduced, the bronchial epithelium did not fall off significantly, the mucosal edema was not obvious, the smooth muscle proliferation was reduced, and the inflammatory cell infiltration was reduced, similar to the airway changes in the dexamethasone group. \u0000 \u0000 \u0000Conclusion \u0000Neurokinin-1 receptor antagonist WIN 62, 577 can reduce airway inflammation and airway hyperresponsiveness in asthmatic mice. \u0000 \u0000 \u0000Key words: \u0000Asthma; Inflammation; Hyperresponsiveness; Substance P; Neurokinin-1 receptor","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43637733","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.011
Qiaolin Chen, Chen-mei Zhang
{"title":"Analysis of the effect of valproic acid with different loading doses in treatment of children with status epilepticus","authors":"Qiaolin Chen, Chen-mei Zhang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.011","url":null,"abstract":"Objective \u0000To explore the effect of valproic acid with different loading doses in treatment of children with status epilepticus. \u0000 \u0000 \u0000Methods \u0000The data of children who were hospitalized in the intensive care unit of the Children′s Hospital Affiliated to Zhejiang University because of status epilepticus from January 1, 2013 to December 31, 2017 were collected.All the patients were divided into different groups according to loading dose of valproic acid.The effect were analyzed in different groups. \u0000 \u0000 \u0000Results \u0000(1)There were 66 children with status epilepticus were admitted, including 35 males and 31 females.Among all children with status epilepticus, the etiology included epilepsy(n=36, 54.5%), intracranial infection(n=16, 24.2%), hypoxic asphyxia (n=3, 4.5%), intracranial tumor(n=2, 3.0%), abnormal brain development(n=2, 3.0%), intracranial hemorrhage(n=2, 3.0%), and etiology was not clear(n=5, 7.6%). (2)All children with status epilepticus were divided into four groups according to different valproic acid loading dose(0 mg/kg, 10-15 mg/kg, 16-39 mg/kg, 40 mg/kg). There are no significant differences in gender and age among groups.There were no significant differences in duration of status epilepticus and epileptic treatment efficiency(P=0.402, 0.034). (3)All children were monitored for liver function after the treatment of sodium valproate, and no patient had been found increased alanine aminotransferase. \u0000 \u0000 \u0000Conclusion \u0000There are no significant differences in the effect of different valproic acid loading doses in children with status epilepticus, and no adverse side effects are observed in children with status epilepticus who received a dose of 40 mg/kg. \u0000 \u0000 \u0000Key words: \u0000Status epilepticus; Valproic acid; Loading dose","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"125-128"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44219242","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}
中国小儿急救医学Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.02.005
Ying Hu, Bo Huang
{"title":"Clinical application of remifentanil in children with critical diseases","authors":"Ying Hu, Bo Huang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.02.005","url":null,"abstract":"Analgesia and sedation are important for children with acute critical diseases.With the new development of the concept of analgesia and sedation, new analgesics and sedatives are constantly introduced.Remifentanil has the characteristics of short half-life, no accumulation, less impact on important organs of patients, better controllability, better analgesic effect and quick onset, and has been widely used in children with critical diseases.This paper discussed the application advantages of remifentanil in children with critical diseases. \u0000 \u0000 \u0000Key words: \u0000Remifentanil; Analgesia and Sedation; Severe disease; Pediatrics","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45528122","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}