Acta orthopaedica Belgica最新文献

{"title":"Hyaluronic acid as an alternative treatment option for degenerative rotator cuff tears.","authors":"Philip Tack,&nbsp;Sofie Vanhaverbeke,&nbsp;Lieven De Wilde,&nbsp;Alexander Van Tongel","doi":"10.52628/88.4.10794","DOIUrl":"https://doi.org/10.52628/88.4.10794","url":null,"abstract":"<p><p>Rotator cuff tears have a high prevalence in older people. This research examines the clinical outcome of the non-operative treatment of symptomatic degenerative rotator cuff tears with hyaluronic acid (HA) injections. 72 patients (43 females/29 males), with an average age of 66 years with symptomatic degenerative full- thickness rotator cuff tear, confirmed with arthro-CT, were treated with three intra-articular hyaluronic acid injections and followed on multiple observational moments during a 5-year follow-up using the SF- 36 (Short-Form Health Survey), DASH (Disabilities of the Arm, Shoulder, and Hand), CMS (Constant Murley Score), and OSS (Oxford Shoulder Scale. 54 patients completed the 5-year follow-up questionnaire. 77% of the patients did not require additional treatment for their shoulder pathology, and 89% were treated conservatively. Only 11% of the patients included in this study needed surgery. Between subjects, the analysis revealed a significant difference in response in the DASH (p=0.015) and CMS (p=0.033) when the subscapularis muscle was involved. Intra-articular infiltrations with hyaluronic acid improve pain and shoulder function, especially if the subscapularis muscle is not involved.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"691-698"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10740747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical spine injuries in spinal ankylosing disorders: results of single-stage posterior stabilization without posterolateral fusion.","authors":"Roslind Karolina Hackenberg,&nbsp;Kristian Welle,&nbsp;Martin Gathen,&nbsp;Adnan Kasapovic,&nbsp;Michael Kehrer,&nbsp;Koroush Kabir","doi":"10.52628/88.4.9801","DOIUrl":"https://doi.org/10.52628/88.4.9801","url":null,"abstract":"<p><p>Patients with long-segment cervical spinal fusion resulting from spinal ankylosing disorders (SADs) are at high risk for highly unstable cervical spine fractures necessitating surgery as the treatment of choice; however, without an existing gold standard. Specifically, patients without concomitant myelo- pathy, representing a rare entity, may benefit from a minimized surgical approach of a single-stage posterior stabilization without bone grafting for posterolateral fusion. This retrospective monocenter study in a Level I trauma center included all patients treated with navigated posterior stabilization without posterolateral bone grafting between January 2013 and January 2019 for cervical spine fractures in preexisting SADs without myelopathy. The outcomes were analyzed based on complication rates, revision frequency, neurologic deficits, and fusion times and rates. Fusion was evaluated by X-ray and computed tomography. 14 patients (11 male, 3 female) with a mean age of 72.7 ± 17.6 years were included. Five fractures were at the upper and nine at the subaxial cervical spine (predominantly C5-7). There was one surgery-specific complication of postoperative paresthesia. There was no infection, implant loosening, or dislocation, and no revision surgery necessary. All fractures healed after a median time of 4 months and 12 months being the latest time of fusion in one patient. Single-stage posterior stabilization without posterolateral fusion is an alternative for patients with SADs and cervical spine fractures without myelopathy. They can benefit from a minimization of surgical trauma while having equal times of fusion and no increased rate of complications.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"675-683"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey regarding prevention of surgical site infection after orthopaedic surgery in Belgium: are we on the right track?","authors":"Mathieu Raad,&nbsp;Maïte Van Cauter,&nbsp;Christine Detrembleur,&nbsp;Olivier Cornu,&nbsp;Guillaume Vandemeulebroecke","doi":"10.52628/88.4.9722","DOIUrl":"https://doi.org/10.52628/88.4.9722","url":null,"abstract":"<p><p>Prevention strategies are essential to reduce the rate of surgical site infection (SSI) in orthopaedic surgery. Members of the Royal Belgian Society for Orthopaedic Surgery and Traumatology (SORBCOT) and the Belgische Vereniging voor Orthopedie en Traumatologie (BVOT) were asked to answer a 28-question questionnaire on the internet about the application of surgical antimicrobial prophylaxis measures and to compare them with current inter- national recommendations. 228 practicing orthopedic surgeons responded to the survey from different regions (Flanders, Wallonia and Brussels), different hospitals (university, public and private), different levels of experience (< 5 years, 5 to 10 years and > 10 years) and different subspecialties (lower limb, upper limb and spine). Regarding the questionnaire: 7% systematically perform a dental check-up. 47.8% of the participants never carry out a urinalysis, 41.7% when the patient presents symptoms and 10.5% carry it out systematically. 2.6% systematically propose a pre-operative nutritional assessment. 5.3% of respondents suggest stopping biotherapies (Remicade®, Humira®, rituximab®, etc.) before an operation and 43.9% do not feel comfortable with this type of treatment. 47.1% suggest smoking cessation before the operation and 22% of them advise smoking cessation for a period of 4 weeks. 54.8% never carry out MRSA screening. 68.3% systematically per- formed hair removal, 18.5% when the patient had hirsutism. Among them, 17.7% use shaving with razors. Alcoholic Isobetadine is the most used product with 69.3% when disinfecting the surgical site. 42.1% of the surgeons chose a delay between the injection of antibiotic prophylaxis and the incision of less than 30 minutes, 55.7% between 30 and 60 minutes and 2.2% between 60 and 120 minutes. However, 44.7% did not wait for the injection time to be respected before incising. An incise drape is used in 79.8% of cases. The response rate was not influenced by the surgeon's experience. Most international recommendations in terms of prevention of surgical site infection are correctly applied. However, some bad habits are maintained. These include the use of shaving for depilation and the use of non-impregnated adhesive drapes. Practices that could be improved include management of treatment in patients with rheumatic diseases, a 4-week smoking cessation period, and treating positive urine tests only when symptomatic.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"645-654"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10757850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of physical activity as conservative treatment for massive rotator cuff tears in elderly patients: a systematic review.","authors":"Lorenzo Alirio Diaz Balzani,&nbsp;Rocco Papalia,&nbsp;Anna Maria Alifano,&nbsp;Erika Albo,&nbsp;Giuseppe Francesco Papalia,&nbsp;Mauro Ciuffreda,&nbsp;Chiara De Andreis,&nbsp;Chiara Fossati,&nbsp;Vincenzo Denaro","doi":"10.52628/88.4.9068","DOIUrl":"https://doi.org/10.52628/88.4.9068","url":null,"abstract":"<p><p>The aim of this systematic review is to determine the effectiveness on functional and pain outcomes of different exercise protocols as a conservative treatment for massive, irreparable rotator cuff tears in elderly patients. A literature search was carried out consulting Pubmed -Medline, Cochrane central and Scopus to select randomized clinical trials, prospective and retrospective cohort studies or case series, that evaluated functional and pain outcomes after physical therapy in patients aged 65 or over, affected by massive rotator cuff tears. The present systematic review followed the Cochrane methodology for systematic reviews and the reporting was implemented using through the PRISMA guidelines. The Cochrane risk of bias tool and MINOR score were used for methodologic assessment. Nine articles were included. Data concerning physical activity, functional outcomes and pain assessment were obtained from the included studies. The exercise protocols assessed within the included studies were extremely wide with equally different methods of evaluation of the outcomes. However, most of the studies demonstrated a trend of improvement after the treatment, in terms of functional scores, pain, ROM and quality of life. An intermediate methodological quality of the included papers was assessed through the risk of bias evaluation. Our results showed a positive trend in patients who underwent physical exercise therapy. Our conclusion is that further studies of a high level of evidence are needed to achieve consistent evidence to improve clinical practice in the future.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"699-711"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10757855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modular uncemented revision total hip arthroplasty in young versus elderly patients: a good alternative?","authors":"Henrik Constantin Bäcker,&nbsp;Chia H Wu,&nbsp;Hadis Darvishi Nakhl Ebrahimi,&nbsp;Daniel Karczewski,&nbsp;Carsten Perka,&nbsp;Moritz Caspar Deml,&nbsp;Dominik Adl-Amini","doi":"10.52628/88.4.9900","DOIUrl":"https://doi.org/10.52628/88.4.9900","url":null,"abstract":"<p><p>For revision hip arthroplasty, both cemented and cementless techniques have been described for implantation of modular and non-modular implants. Although many articles have been published on non-modular prosthesis, there is a dearth of data on cementless, modular revision arthroplasty in young patients. This study aims to analyze the complication rate of modular tapered stems in young patients below 65 years of age as compared to elderly patients older than 85 years old, in order to predict the complication rate. A retrospective study was performed using a major revision hip arthroplasty center database. Inclusion criteria consisted of patients undergoing modular, cementless revision total hip arthroplasties. Data on demographics, functional outcome, intraoperative, early and medium term complications were assessed. In total, 42 patients met inclusion criteria (<65 years old: 25 patients; >85 years old: 17 patients). For the <65 years old cohort, the mean age and follow-up time was 55.4 ± 9.3 years old and 13.3 ± 13.2 months, respectively. For the >85 years old cohort, the mean age and follow-up time was 87.6 ± 2.1 years old and 4.3±8.8 years, respectively. For intraoperative and short-term complications, no significant differences were observed. Medium term complication is noted in 23.8% (n=10/42) overall, preferentially affecting the elderly group at 41.2% (only 12.0% in the younger cohort; p=0.029). To our knowledge, this study is the first to investigate the complication rate and implant survival for modular revision hip arthroplasty based on age group. It shows that the complication rate is significantly lower in young patients and age should be a consideration in surgical decision making.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"773-780"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10740284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ulnar lateral digital flap for Dupuytren's disease of the fifth finger, a technique not be forgotten.","authors":"Canelle Bakota Morrison,&nbsp;Antonia Gkotsi,&nbsp;Jorg Bahm,&nbsp;Frédéric A Schuind,&nbsp;Wissam El Kazzi","doi":"10.52628/88.4.04","DOIUrl":"https://doi.org/10.52628/88.4.04","url":null,"abstract":"<p><p>Dupuytren's disease is a common condition in hand surgery. The fifth finger is frequently affected, pre- senting the highest recurrence rate after surgical treatment. The ulnar lateral-digital flap is used when a skin defect prevents direct closure after fasciectomy of the fifth finger at the level of the MP joint. Our case series comprises of 11 patients undergoing this procedure. Their mean preoperative extension deficit was 52° at the MP joint and 43° at the PIP joint. Full extension of the MP joint and a mean of 8° extension deficit at the PIP joint was achieved with surgery. All patients maintained full extension at the MP joint, with a follow-up of 1 to 3 years. Minor complications were reported. The ulnar lateral digital flap is a simple and reliable alternative when surgically treating Dupuytren's disease of the fifth finger.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"761-764"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined radial wedge and shortening osteotomy versus scaphocapitate arthrodesis in advanced Kienböck's disease.","authors":"Seong-Hwan Woo,&nbsp;Sung-Min Kim,&nbsp;Yeong-Seub Ahn,&nbsp;Jeong-Hun Hyun,&nbsp;Hee-Yeon Kim,&nbsp;Myung-Sun Kim","doi":"10.52628/88.4.10833","DOIUrl":"https://doi.org/10.52628/88.4.10833","url":null,"abstract":"<p><p>Although various surgical techniques have been reported for the treatment of advanced Kienböck's disease (Lichtman stage IIIB and above), the ap- propriate operative treatment is still being debated. This study compared the clinical and radiological outcomes of combined radial wedge and shortening osteotomy (CRWSO) and scaphocapitate arthrodesis (SCA) in the treatment of advanced Kienböck's disease (above type IIIB) with a minimum of 3 years of follow-up. We analyzed the data from 16 and 13 patients who underwent CRWSO and SCA, respectively. The average follow-up period was 48.6±12.8 months. Clinical outcomes were evaluated using the flexion-extension arc, grip strength, Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), and Visual Analogue Scale (VAS) for pain. The following radiological parameters were measured: ulnar variance (UV), carpal height ratio (CHR), radioscaphoid angle (RSA), and Stahl index (SI). Osteoarthritic changes in the radiocarpal and midcarpal joints were evaluated using computed tomography (CT). Clinically, both groups showed significant improvements in the grip strength, DASH, and VAS at final follow-up. However, regarding the flexion-extension arc, the CRWSO group showed a significant improvement, while the SCA group did not. Radiologically, compared to the preoperative values, the CHR results improved at final follow-up in the CRWSO and SCA groups. There was no statistically significant difference in the degree of CHR correction between the 2 groups. By the final follow-up visit, none of the patients in either group had progressed from Lichtman stage IIIB to stage IV. Considering restoration of wrist joint range of motion, CRWSO may be a good alternative for limited carpal arthrodesis for advanced Kienböck's disease.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"739-747"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study of 93 unicompartmental knee prosthesis emphasises the appearance of radiolucencies under the tibial component.","authors":"Peter Reynders-Frederix,&nbsp;Cristina Reynders-Frederix,&nbsp;Dragos Schiopu,&nbsp;Tamàs Illés","doi":"10.52628/88.4.9566","DOIUrl":"https://doi.org/10.52628/88.4.9566","url":null,"abstract":"<p><strong>Background and study aims: </strong>Here, we report the presence of radiolucent lines in a consecutive group of 93 partial knee replacements (UKA).</p><p><strong>Materials and methods: </strong>The prospective study was conducted from 2011 to 2019 with a minimum follow-up of two years. Clinical data and radiographs were recorded. Of the 93 UKA, 65 were cemented. The Oxford Knee Score was recorded before and two years after surgery. In 75 cases, the follow-up was conducted at > 2 years. A lateral knee replacement was performed in 12 cases. In one case, a medial UKA with patellofemoral prosthesis was performed.</p><p><strong>Results: </strong>In eight patients (8.6%), a radiolucent line (RLL) underneath the tibia component was observed. In four of these eight patients, RLLs were non-progressive, without clinical implications. In two cemented UKAs, RLLs were progressive and were revised with total knee arthroplasty. Early severe osteopenia of the tibia (zone 1 to 7) in the frontal view was observed in two cementless medial UKA cases. The demineralisation occurred spontaneously five months after surgery. We diagnosed two early deep infections, one of which was treated locally.</p><p><strong>Conclusions: </strong>RLLs were present in 8.6% of the patients. Even in severe cases of osteopenia, spontaneous recovery of RLLs is possible with cementless UKAs.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"781-787"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10757853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial implications of the renewed reimbursement system of total hip arthroplasty in Belgium.","authors":"Noëmi Rabbachin,&nbsp;Siddhartha Lieten,&nbsp;Vincent De Smet,&nbsp;Karen Pien,&nbsp;Thierry Scheerlinck","doi":"10.52628/88.4.10193","DOIUrl":"https://doi.org/10.52628/88.4.10193","url":null,"abstract":"<p><p>In Belgium, from June 1st 2018 on, a renewed reim- bursement for hip arthroplasty implants was launched and from January 1st 2019 on, a lump sum covering doctors' fees for \"low variable patients\", was introduced. We investigated the impact of both reimbursement systems on the funding of a University Hospital in Belgium. All patients from the UZ Brussel with a severity of illness score of one or two whom had an elective total hip replacement implanted between January 1st and May 31st 2018, were included retrospectively. We compared their invoicing data to those of patients operated in the same period but one year later. Moreover, we simulated the invoicing data of both groups as if they had been operated in the other period. Overall, we compared invoicing data of 41 patients before and 30 after the introduction of both renewed reimbursement systems. After the introduction of both new laws, we noted a loss of funding per patient and per intervention between 46.8€ and 753.5€ for a single room and, between 105.5€ and 1877.7€ for a double room. We noted the highest loss in the subcategory \"physicians' fees\". The renewed reimbursement system is not \"budget neutral\". In time, the new system can lead to an optimization of care, but it can also lead to a progressive decrease of funding if future fees and implant reimbursements would be aligned towards the national mean. More- over, we fear the new financing system could affect the quality of care and/or result in the selection of profitable patients.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"765-772"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10740746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis on the correlation between the occurrence of vertebral artery ostium stenosis and the severity of osteoporosis in elderly patients with atherosclerosis.","authors":"Zhongyong Peng,&nbsp;Songqiang Tao,&nbsp;Yuanliang Liu,&nbsp;Ping Sun,&nbsp;Ling Gong,&nbsp;Ying Bai,&nbsp;Taifeng Tang","doi":"10.52628/88.4.01","DOIUrl":"https://doi.org/10.52628/88.4.01","url":null,"abstract":"<p><p>To analyze the correlation between the occurrence of vertebral artery ostium stenosis (VAOS) and the severity of osteoporosis in elderly patients with atherosclerosis (AS), and disclose the physiopathologic mechanism of the correlation between VAOS and osteoporosis. 120 patients were divided into two groups. The baseline data of both groups were collected. The biochemical indicators of patients in both groups were collected. The EpiData database was established to enter all the data into the database for statistical analysis. There were significant differences in the incidence of dyslipidemia among risk factors of cardia-cerebrovascular disease (P<0.05). LDL-C, Apoa and Apob were significantly lower than the control group (P<0.05). BMD, T-value and Ca in the observation group were significantly lower than the control group, while BALP and serum phosphorus in the observation group were significantly higher than the control group (P<0.05). The more severe the VAOS stenosis, the higher the incidence of osteoporosis, and there was a statistical difference in the risk of osteoporosis among different VAOS stenosis degrees (P<0.05). Apolipoprotein A, B and LDL-C in blood lipids are important factors affecting the development of bone and artery diseases. There is a significant correlation between VAOS and the severity of osteoporosis. The pathological calcification process of VAOS has many similarities with the process of bone metabolism and osteogenesis, and shows preventable and reversible physiological characteristics.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":"88 4","pages":"685-690"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}