African journal of paediatric surgery : AJPS最新文献

{"title":"Congenital Urethrocutaneous Fistula.","authors":"Bijay Kumar Suman, Ram Jeewan Singh, Amit Kumar Sinha, Bindey Kumar","doi":"10.4103/ajps.ajps_97_22","DOIUrl":"10.4103/ajps.ajps_97_22","url":null,"abstract":"<p><strong>Abstract: </strong>Male congenital urethrocutaneous fistula is an extremely rare anomaly that is commonly associated with chordee or anorectal malformations. It is characterised by an abnormal urethral opening on the ventral aspect of the penis with well-formed distal urethra and meatus at the tip of the glans. The treatment is individualised according to the site of the fistula, associated anomalies and condition of the distal urethra. The principles of hypospadias surgery should be strictly followed.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"73-74"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522273","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":"Health-related Quality of Life of Children with Gastro-oesophageal Reflux Disease after Nissen Fundoplication and Gastrostomy Tube Insertion - A Retrospective Observational Study.","authors":"Felix Musibi, Machoki Mugambi, Pauline Samia, Waceke Nganga","doi":"10.4103/ajps.ajps_50_22","DOIUrl":"10.4103/ajps.ajps_50_22","url":null,"abstract":"<p><strong>Background: </strong>Severe gastro-oesophageal reflux disease (GERD) is associated with a poor health-related quality of life (HRQoL). Nissen fundoplication is the most common surgical procedure for patients with GERD. A feeding gastrostomy tube may be inserted at the same time in selected patients where there are unsafe swallowing and/or feeding difficulties. The goals of surgery are to eliminate symptoms, prevent reflux complications and ultimately improve the quality of life. The main objective of this study was to assess the HRQoL of children with GERD after Nissen fundoplication and gastrostomy tube insertion.</p><p><strong>Materials and methods: </strong>This was an observational retrospective cohort study at two private, not-for-profit tertiary hospitals in Nairobi. The study population included children under 18 years of age with GERD who had Nissen fundoplication with or without gastrostomy tube insertion from January 2010 to December 2020. The quality of life was assessed from the caretakers using the Paediatric Quality of Life Inventory applied through a telephone call. Data analysis was done using SPSS version 26. The HRQoL was summarised using mean and standard deviation (SD) with a 95% confidence interval (CI) around the scores. Independent samples t -test was conducted to compare the means of HRQoL for gender, complications and comorbidities. Spearman's correlation was done for HRQoL and age.</p><p><strong>Results: </strong>Eighty-two children were included in the study. Eighty-four per cent had comorbidities, with almost three-quarters of them having neurological impairment. Majority (91%) had open Nissen fundoplication, while 9% had laparoscopic Nissen fundoplication. One-third of these children reported complications post-procedure. Nissen fundoplication failure rate was 10%. Two-thirds had a concurrent gastrostomy tube insertion. The global mean HRQoL score was 75.8 (SD: 23.5, 95% CI: 70.4-81.2). Gastrostomy tube insertion had no impact on the quality of life. Children with neurological impairment had significantly lower quality of life than those without neurological impairment.</p><p><strong>Conclusion: </strong>The global score of the HRQoL following Nissen fundoplication in this cohort of children was 75.8. Further studies to reduce the proportion of children who experience complications postoperatively in this setting are required.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"288-294"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661601","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":"Perianal Human Tail with Lower Imperforate Anus: A Case Report.","authors":"Satoshi Yokoyama, Akinori Sekioka, Hirofumi Utsunomiya","doi":"10.4103/ajps.ajps_11_22","DOIUrl":"10.4103/ajps.ajps_11_22","url":null,"abstract":"<p><strong>Abstract: </strong>The human tail is usually attached to the sacrococcygeal skin. However, few reports of the human tail at the perineal or perianal region have been described. Moreover, the tails are rarely accompanied with anorectal malformations (ARMs). Although the exact relationship between the human tail at the perineal or perianal region and ARM remains obscure, we consider that the human tail at the sacrococcygeal region and the perineal or perianal region may have a slightly different mechanism of development.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"321-322"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70660521","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":"A Prospective Comparative Study to Assess the Management Outcomes of Patients with Infantile Hypertrophic Pyloric Stenosis Using Ramstedt's Pyloromyotomy and Double 'Y' Pyloromyotomy.","authors":"Arun Kumar Dash, Rakesh Sahoo, P K Mohanty, P K Jena, A K Panda, P K Tripathy","doi":"10.4103/ajps.ajps_67_22","DOIUrl":"10.4103/ajps.ajps_67_22","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infancy in which the pyloric portion of the stomach becomes hypertrophied, leading to obstruction of gastric emptying. Various approaches have been tried for surgical management of IHPS. The first successful surgery was performed by Dufour and Fredet in which the hypertrophic pyloric muscle is longitudinally splitted and closed transversely. However, Ramstedt introduced extramucosal pyloromyotomy, introduced in 1912 which still remains the gold standard for surgical management of IHPS. Later on, in 2009, Alayet et al . introduced a new technique known as Alayet's double-Y (DY) pyloromyotomy which he claimed to have a better functional outcome compared to Ramstedt's pyloromyotomy (RP) while maintaining a safety profile similar. The objective of this study was to compare the outcome of surgical management of IHPS between DY pyloromyotomy and Ramstedt's pyloromyotomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;It was a prospective study conducted in the Paediatric Surgery Department of SVPPGIP, SCB Medical College, Cuttack, from January 2019 to April 2022. All the IHPS cases were admitted and optimised thoroughly with regard to hydration, acid-base status and electrolyte imbalance. We have included 60 patients and were divided into two groups; every alternate patient was pooled into one group. Detailed and informed consent was taken from parents regarding the surgical procedure of their baby. The patients were selected alternatively, i.e., if one patient underwent Ramstedt's pyloromyotomy then in the next patient Alayet's DY pyloromyotomy procedure was done. The demographic characteristics of all patients, operative procedure performed, duration of surgery, intraoperative anaesthesia or surgical complication, post-operative vomiting patterns and weight gain data were collected and analysed in Microsoft Excel sheet and SPSS software. The student's t -test was used to compare both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We found that both groups were similar while considering the demographic characteristics as there were no significant statistical differences noticed in the patient population with regard to age (DY Group 42.73 ± 9.01 days vs. RP Group 40.63 ± 7.6 days; P = 0.8209), sex (DY 4F/26M vs. RP 6F/24 M), weight at presentation (DY 3.3 ± 0.33 kg vs. RP 3.2 ± 0.21 kg; P = 0.33449), symptoms and clinical condition. All patients were optimally resuscitated before proceeding to surgery with regard to hydration, electrolyte imbalance and acid-base status. While considering anaesthesia, both groups were equal in terms of it and no anaesthesia-related complications were recorded in our study. However, during the first post-operative week, a significant difference was noted between DY versus RP groups with regard to vomiting (DY 1.33 ± 0.59 days vs. RP 2.8 ± 0.76 days; P = &lt; 0.0001) and weight gain (299.86 ± 41.90","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"264-268"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661571","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":"Caecal Volvulus: A Report of Three Paediatrics Cases.","authors":"Benmassaoud Zineb, Fatoumata Binta Baldé, Othmane Alaoui, Abdelhalim Mahmoudi, Khalid Khattala, Youssef Bouabdallah","doi":"10.4103/ajps.ajps_27_22","DOIUrl":"10.4103/ajps.ajps_27_22","url":null,"abstract":"<p><strong>Abstract: </strong>Caecal volvulus is favoured by the lack of caecal adhesion and intestinal malrotation. According to the per operation findings, the treatment consists of a de-rotation with or without cecopexy. We present the three cases of caecum volvulus in children and discuss our management. Case 1: 11-year-old girl admitted for caecal volvulus in an acute occlusive syndrome picture. There was caecal volvulus and atresia of the volvulated area. We performed resection and end-to-end anastomosis. Good evolution. Case 2: 6-year-old girl admitted for caecal volvulus in an acute occlusive syndrome picture. We performed caecopexy at the right parietal-colic gutter by three interrupted stitches. Good evolution. Case 3: 6-year-old girl admitted for caecal volvulus in an acute sub-occlusive syndrome picture with hypovolemic choc stage. There were suffering areas and necrosis of the caecum, a part of the ascending colon and iléal loops. We resected the gangrene part of the digest if tract and performed end-to-end ileocolic anastomosis. Good evolution. Caecal volvulus is rare. In our series, a patient had an ultrasound diagnosis. The diagnosis of caecum volvulus was made by computed tomography scan to the second one. The third patient had a perioperative diagnosis which is frequently reported in the literature. Management varies from the simple de-rotation with appendectomy to caecopexy. Caecal volvulus is a therapeutic emergency because the risk of necrosis and perforation is obvious. With proper support, the overall evolution is good.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"318-320"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661079","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":"Use of Propanolol versus Intralesional Bleomycin in the Management of Infantile Hemangioma: A Comparative Study.","authors":"Ali Raza Chaudhry, Mudassar Fiaz Gondal, Rashid Khan, Inayat Ur Rehman, Rumaisaa Saman, Khawar Abbas","doi":"10.4103/ajps.ajps_55_22","DOIUrl":"10.4103/ajps.ajps_55_22","url":null,"abstract":"<p><strong>Background: </strong>Infantile haemangiomas (IHs) are widespread vascular tumours having incidence of 10% and most of them involute spontaneously. However, they are known to be located in proximity of vital organs and can have poor cosmetic and functional sequel if left untreated. The aim of the study is to assess the efficacy of oral propranolol and intraleisonal bleomycin in the treatment of infantile cutaneous haemangioma in terms of size regression.</p><p><strong>Materials and methods: </strong>IH patients presenting in the outpatient department in PIMS were divided randomly by stratified random sampling in two groups. Out of 90 patients, 45 patients had treatment with oral propranolol and other 45 patients received intralesional bleomycin. Baseline size of haemangiomas was taken and regression in size was noted again at 3 and 6 months. Mean and standard deviation were calculated for the age and size of haemangioma in both groups. The mean size regression for both treatments was compared using independent t -test taking P < 0.05 as significant.</p><p><strong>Results: </strong>Out of 90 cases included in this study, the mean age of patients was 10.9 ± 6.1 months in Bleomycin group compared to 10.2 ± 6.9 months in propranolol group. The average size of haemangioma at baseline was 9.5 cm 2 in bleomycin group compared to 8.9 cm 2 in propranolol group. At 3 months after the intervention, the mean size regression was 3.5 cm 2 in bleomycin group compared to 5.3 cm 2 in propranolol group and after 6 months of treatment with bleomycin group the mean size of haemangioma was 0.45 cm 2 , whereas in the propranolol group, it was 2.8 cm 2 and difference in the two was found statistically highly significant ( P < 0.001).</p><p><strong>Conclusion: </strong>The present study concluded that treatment with intralesional injection Bleomycin for IHs helps in size reduction more efficiently with minimal side effects as compared to oral propranolol for comparable sized haemangiomas.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"269-273"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661707","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":"Lung Hydatid and Broncho-Cavitary Communications: Challenges in the Management and Outcome.","authors":"Nitin Sharma, Shipra Sharma, M Amin Memon, Mini Sharma","doi":"10.4103/ajps.ajps_63_22","DOIUrl":"10.4103/ajps.ajps_63_22","url":null,"abstract":"<p><strong>Background: </strong>The aim was to analyse the challenges and outcomes in operated patients of hydatid lung with broncho-cavitary communications.</p><p><strong>Materials and methods: </strong>The retrospective data between June 2017 and May 2022 were obtained. The number of broncho-cavitary communications was recorded and they were suture repaired using polypropylene. The duration required for repair and the average fall in the SpO 2 were recorded. Those with incomplete data or follow-up were excluded. The outcome parameters considered were number of broncho-cavitary communications, duration of stay, duration of intercostal tube, duration of air leak and requirement of ventilator support.</p><p><strong>Results: </strong>A total of 33 patients out of 36 formed the study group. The mean age was 6 years (range 2-18 years). There were 23 right-sided, eight left-sided and two bilateral cysts. Broncho-cavitary communications were seen in 33 patients. The average number of communications was 3 (range: 2-8). The average duration required to suture close the communications was 30 s (range 20-180 s). The average fall in the SpO 2 was 40% (range 20%-74%). The main challenge was rapid identification of communications and prompt repair. The mean duration of surgery was 2.15 h (range 1.45-3.15 h). Ventilator support in the post-operative period was required in four patients. The average duration of intercostal tube drainage required was 7 days (range: 6-14 days). The average duration of hospital stay was 14 days (range 12-34 days). All the communications were repaired using Prolene 3-0 sutures. None of the patients was operated with a double-lumen endobronchial tube.</p><p><strong>Conclusion: </strong>Broncho-cavitary communication in hydatid cyst is associated with an operative challenge due to sudden air leak. These patients require judicious management.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"306-309"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661361","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 Foetus-in-Fetu or Fetiform Teratoma - A Diagnostic Dilemma and Operative Challenge.","authors":"Pankaj Kumar, Tushar S Mishra, Mukund Namdev Sable, Sindhu Sankaran, Swagatika Samal","doi":"10.4103/ajps.ajps_26_22","DOIUrl":"10.4103/ajps.ajps_26_22","url":null,"abstract":"<p><strong>Abstract: </strong>Foetus-in-fetu (FIF) is a condition where one of the twin foetuses is found developing inside the other. Differentiating this condition from fetiform teratoma (FT), in which the teratoma becomes highly differentiated to take a foetus-like appearance, often becomes arduous. Unfamiliarity with the situation and the presence of bone and hair within such lesions can potentially mislead the surgeon to diagnose it as a dermoid cyst erroneously. Suboptimal surgery can complicate things further when it comes to redoing operations and the final histopathological reporting. We report this case of a partially removed cystic retroperitoneal mass in a 14-year-old male, posing a significant surgical challenge due to dense adhesions to the vital retroperitoneal structures, such as common iliac vessels and ureter. We also faced similar diagnostic dilemmas during histopathology due to the tissues removed during the previous surgery. Based on gross and microscopic features, the possibility of a FIF or FT was rendered.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"313-317"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70660953","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":"Acute Colonic Ischaemia due to Schistosomiasis: A Case Report.","authors":"Enas Ismail, Ibrahim Salih, Haitham Dagash","doi":"10.4103/ajps.ajps_12_22","DOIUrl":"10.4103/ajps.ajps_12_22","url":null,"abstract":"<p><strong>Abstract: </strong>Schistosomiasis or bilharziasis is a disease caused by parasitic worms, and is endemic in the tropics, with an estimated 250 million people affected worldwide. The main organs involved are the liver and urinary bladder. We present a rare case whereby the gastrointestinal system was involved in a child.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"310-312"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70660930","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":"Femoral Hernia in Children as a Rare Pathology: A Retrospective Case Series.","authors":"Emine Burcu Cigsar Kuzu, Mustafa Onur Oztan, Gokhan Koyluoglu","doi":"10.4103/ajps.ajps_38_22","DOIUrl":"10.4103/ajps.ajps_38_22","url":null,"abstract":"<p><strong>Background: </strong>Femoral hernias are uncommon groin pathology among children. The rarity of the pathology results in increased complications, delayed diagnosis and inappropriate inguinal exploration. In this study, we review our experience with this surgical entity over a 10-year period.</p><p><strong>Materials and methods: </strong>The medical records of seven children who underwent femoral hernia repair between January 2010 and January 2021 at a single tertiary centre were retrospectively analysed. Reviewed data included demographics, pre-operative diagnosis, operative technique, complications and follow-up.</p><p><strong>Results: </strong>Seven children (5 females [71%] and 2 males [29%]) were operated due to femoral hernia. Median age was 8 years (range: 3-16 years). Four (57%) patients had right-sided femoral hernia and three (43%) were on the left side. The correct pre-operative diagnosis was obtained in three (42%) cases. The remaining four misdiagnosed cases were diagnosed as femoral hernia at the surgery. In all cases, the initial presentation was swelling; two (28%) had inguinal pain and three patients (42%) required emergency inguinal exploration due to suspected incarceration. All patients had repair of their hernia by open technique; the femoral canal was closed by mesh plug or Vicryl sutures. All patients were discharged without complications. No recurrence was detected and the median post-operative follow-up period was 24 months (range: 8-48 months).</p><p><strong>Conclusion: </strong>Femoral hernia is a challenging pathology and correct diagnosis requires a high index of clinical suspicion. In equivocal cases, ultrasonography and laparoscopy may be useful. Appropriate pre-operative diagnosis evades complications and delays in treatment. Regardless of the surgical approach recurrences and complications are very rare in children.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"260-263"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661046","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}