JTCVS open最新文献

{"title":"Transcatheter versus minimally invasive surgical aortic valve replacement: A propensity score-matched analysis in low-risk patients","authors":"Mark R. Lutz BA ,&nbsp;Shaelyn M. Cavanaugh MD, MPH ,&nbsp;Samuel J. Martin BS ,&nbsp;Anna Gleboff MPH ,&nbsp;Karikehalli Dilip MD ,&nbsp;Ahmad Nazem MD ,&nbsp;Anton Cherney MD ,&nbsp;Zhandong Zhou MD ,&nbsp;Charles Lutz MD","doi":"10.1016/j.xjon.2025.05.001","DOIUrl":"10.1016/j.xjon.2025.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>Minimally invasive aortic valve replacement (MIAVR) and transcatheter aortic valve replacement (TAVR) represent less-invasive alternatives to conventional surgical aortic valve replacement. In contrast to Society of Thoracic Surgeons (STS) Database data revealing &lt;10% of all surgical aortic valve replacement procedures are performed via a minimally invasive approach, our center performs a high volume of MIAVR procedures. This propensity-score matched study aims to compare the outcomes of MIAVR versus TAVR in low-risk patients (STS Predicted Risk of Mortality &lt;4%).</div></div><div><h3>Methods</h3><div>We identified 476 low-risk patients who underwent MIAVR via a right anterolateral minithoracotomy and 679 low-risk patients who underwent TAVR at our institution between 2017 and 2024. In a total of 1155 cases, propensity score analysis performed at a ratio of 1:1 yielded 295 matched pairs.</div></div><div><h3>Results</h3><div>The matched groups had similar baseline characteristics aside from a higher proportion of tricuspid valves in the TAVR group and greater rates of aortic regurgitation in the MIAVR group. The baseline STS scores were also higher in the TAVR group (1.84 vs 1.69; <em>P</em> = .030), although still below the low-risk threshold (STS-PROM &lt;4.0). Postoperatively, patients in the MIAVR group experienced lower rates of permanent pacemaker implantation (0.4% vs 7.8%; <em>P</em> &lt; .001), aortic regurgitation (0.3% vs 5.4%; <em>P</em> &lt; .001), and paravalvular leak (0.0% vs 5.8%; <em>P</em> &lt; .001). Patients undergoing MIAVR had longer hospital lengths of stay (6.23 vs 2.07; <em>P</em> &lt; .001) and higher aortic valve mean gradients (7.29 vs 6.04 mm Hg; <em>P</em> = .004). There was no significant difference in early mortality or stroke rates between the 2 groups.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first propensity-score matched comparison of clinical outcomes in low-risk patients undergoing MIAVR versus TAVR, revealing that MIAVR could provide lower rates of permanent pacemaker implantation, paravalvular leak, and aortic regurgitation, without any increase in short-term mortality or stroke. Future prospective or randomized controlled trials are needed to validate these results.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 75-84"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913232","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":"Imaging surveillance for thoracic aortic aneurysms in Medicare beneficiaries","authors":"Roxanne S. Steijn MD ,&nbsp;Hechuan Hou MS ,&nbsp;Nicholas S. Burris MD ,&nbsp;Joost van Herwaarden MD, PhD ,&nbsp;Himanshu J. Patel MD ,&nbsp;Michael P. Thompson PhD","doi":"10.1016/j.xjon.2025.05.004","DOIUrl":"10.1016/j.xjon.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Regular imaging surveillance is guideline-recommended for the management of thoracic aortic aneurysm (TAA) but has not been well described in clinical practice. Here we evaluated the frequency of imaging procedures and associated outcomes, procedures, and healthcare costs in patients with TAA.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of inpatient and professional claims for 28,459 Medicare beneficiaries age ≥65 years with a diagnosis of TAA between 2017 and 2019 was performed. Imaging types (computed tomography, magnetic resonance angiography, or transthoracic echocardiography) were identified from professional claims for beneficiaries with TAA during the 2 calendar years and categorized as any (yes vs no) and number of imaging procedures. Multivariable logistic regression was used to evaluate the association of patient and clinical factors with undergoing any imaging and to compare clinical outcomes (surgical intervention, all-cause mortality, and hospitalization) across imaging types.</div></div><div><h3>Results</h3><div>A total of 12,968 beneficiaries (45.6%) underwent imaging during the study period, including 24.9% with 1 image, 13.07% with 2 images, and 7.6% with ≥3 images. Younger age, female sex, white race/ethnicity, and lower comorbidity score were independently associated with undergoing any imaging. Compared to receiving no imaging and after risk adjustment, beneficiaries with ≥3 images had more frequent surgical interventions (0.4% vs 6.6%; <em>P</em> &lt; .001) and all-cause hospitalization (41.6% vs 75.9%; <em>P</em> &lt; .001) but lower mortality (16.4% vs 13.3%; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Imaging for TAA is underutilized among Medicare beneficiaries, and more frequent imaging is associated with more frequent surgical intervention, hospitalization, and lower mortality.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 44-51"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913235","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":"Commentator Discussion: Objective performance indicators provide a novel, quantitative method to evaluate surgeon proficiency in robotic lobectomy training","authors":"","doi":"10.1016/j.xjon.2025.03.003","DOIUrl":"10.1016/j.xjon.2025.03.003","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 337-338"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912818","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":"Cavernous hemangioma of the mediastinum originating from a left persistent superior vena cava","authors":"Mo'men Alashwas ,&nbsp;Wedad Alashwas ,&nbsp;Ahmad Dalal ,&nbsp;Natalie Khamashta ,&nbsp;Hamad Madi MD","doi":"10.1016/j.xjon.2025.05.007","DOIUrl":"10.1016/j.xjon.2025.05.007","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 288-291"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912927","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":"Outcomes of the Fontan operation in patients with Ebstein anomaly: An Australia and New Zealand Fontan registry study","authors":"Michael Daley MD, MSurg ,&nbsp;Igor E. Konstantinov MD, PhD, FRACS ,&nbsp;Julian Ayer MBBS, PhD, FRACP ,&nbsp;Ajay Iyengar MBBS, PhD, FRACS ,&nbsp;David Celermajer MBBS, PhD, FRACP ,&nbsp;Rachael Cordina MBBS, PhD, FRACP ,&nbsp;Terry Robertson MBBS, FRACP ,&nbsp;Aditya Patukale MCh ,&nbsp;Nelson Alphonso MBBS, FRACS ,&nbsp;Yves d’Udekem MD, PhD, FRACS","doi":"10.1016/j.xjon.2025.06.004","DOIUrl":"10.1016/j.xjon.2025.06.004","url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to review the outcomes of patients with Ebstein anomaly (EA) after the Fontan operation.</div></div><div><h3>Methods</h3><div>Patients with EA were identified from a large binational registry about the Fontan operation. Data were collected from hospital records, registry data, and clinical correspondence.</div></div><div><h3>Results</h3><div>Of the 1601 patients who underwent a contemporary Fontan operation from 1991 to 2023, 34 patients had EA. Seven patients (21%) had concomitant congenitally corrected transposition of great arteries. Prior Starnes procedure was performed in 18 (53%) patients. Survival after Fontan operation in patients with EA was 92% (95% CI, 70%-98%) and freedom from Fontan failure was 80% (95% CI, 53%-92%) at 10 years. Patients with EA had worse long-term survival (<em>P =</em> .01) after Fontan operation and lower freedom from Fontan failure (<em>P =</em> .004) compared with other patients with left-ventricle dominance. Patients with EA, who underwent prior Starnes procedure, had 100% survival and freedom from Fontan failure, albeit at a shorter follow-up (median, 4.2 years; range, 13 days-17.7 years), with no difference between patients with prior Starnes and patients with tricuspid atresia (<em>P</em> = .76 and <em>P</em> = .69, respectively), although comparison was hindered by low numbers. Of the 7 patients with congenitally corrected transposition of great arteries and EA, there were no mortalities; however, 2 patients had Fontan failure at 7.0 and 9.8 years post-Fontan.</div></div><div><h3>Conclusions</h3><div>Patients with EA have worse long-term outcomes after the Fontan operation compared with other patients with left ventricular dominance. Patients with a prior Starnes procedure appear to have good post-Fontan outcomes, although bias may occur due to small numbers.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 160-165"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913300","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":"A single-institution outcome of bronchial valve placement for persistent air leak","authors":"Kaity H. Tung MD ,&nbsp;Sujay Sreenivasan MD ,&nbsp;Rajesh Kunadharaju MD ,&nbsp;Soumya Gupta MD ,&nbsp;Nathaniel M. Ivanick MD, FCCP ,&nbsp;Elisabeth U. Dexter MD, FACS","doi":"10.1016/j.xjon.2025.05.006","DOIUrl":"10.1016/j.xjon.2025.05.006","url":null,"abstract":"<div><h3>Objective</h3><div>Persistent pulmonary air leak happens in a minority of patients with various thoracic pathologies. Spiration (Olympus America Inc.) bronchial valves (BVs) are approved by the Food and Drug Administration under Humanitarian Use Device status to treat persistent air leak after lung resection. We evaluate our experience with use of BVs for air leak resolution attributable to multiple etiologies.</div></div><div><h3>Methods</h3><div>A retrospective review of the use of BVs for persistent air leak at a single institution from 2013 to 2024 was performed. Patient demographics and outcomes were tabulated, and mean, median, and standard deviation were calculated.</div></div><div><h3>Results</h3><div>A total of 67 unique cases of BV placement for persistent air leak after lung resection (n = 49), iatrogenic or spontaneous pneumothorax, pleural malignancy, bronchopleural fistula or exploratory thoracotomy (n = 18) were analyzed. Air leak resolution was at least 95% across all categories, except for the spontaneous pneumothorax cohort (80%). Only 7% of all patients underwent post-BV pleurodesis. Rate of BV removal for lung resection patients was 86% and 72% for other etiologies. 61% of patients were discharged safely with a chest tube. Ninety-day all-cause mortality rate was 9%.</div></div><div><h3>Conclusions</h3><div>BV placement is an endoscopic and well-tolerated method that facilitates discharge with chest tube and resolution of air leak for multiple different etiologies, especially after lung resection to which we proposed an algorithm for persistent air leak management.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 266-278"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913583","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":"Early experience with a prefabricated bioprosthetic aortic valved conduit: The first 100","authors":"Rolando Calderon-Rojas MD ,&nbsp;Gabor Bagameri MD ,&nbsp;Hartzell V. Schaff MD ,&nbsp;Juan A. Crestanello MD ,&nbsp;Arman Arghami MD, MPH ,&nbsp;Phillip Rowse MD ,&nbsp;Claire Yee PhD ,&nbsp;Nishant Saran MBBS ,&nbsp;Philip J. Spencer MD ,&nbsp;Joseph A. Dearani MD ,&nbsp;Malakh Shrestha MBBS, PhD","doi":"10.1016/j.xjon.2025.04.024","DOIUrl":"10.1016/j.xjon.2025.04.024","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the early postoperative morbidity, mortality, and prosthetic conduit function of patients who underwent aortic root replacement using a prefabricated bioprosthetic aortic valved conduit.</div></div><div><h3>Methods</h3><div>Single-center retrospective review of 124 consecutive adult patients who underwent aortic root replacement with a certified prefabricated bioprosthetic aortic valved conduit from 2021 to December 2023.</div></div><div><h3>Results</h3><div>Indications for operation were aortic aneurysms (n = 92), endocarditis (n = 12), deterioration of prior valve prosthesis (n = 13), and aortic dissection (n = 6). Implanted valve sizes were 29 mm (n = 37), 27 mm (n = 41), 25 mm (n = 31), 23 mm (n = 14), and 21 mm (n = 1). Isolated aortic root repair was performed in 48 patients, concomitant hemiarch in 69 patients and total arch in 7 patients. Thirty-day mortality rate was 5% (n = 6), permanent pacemaker implantation was necessary in 14% (n = 17), reoperation for bleeding in 4% (n = 5), and only 1 patient developed postoperative stroke. Discharge echocardiogram was available in 118 patients, and follow-up assessment in 45 patients. Prosthetic aortic valve gradient, effective orifice area, and Doppler velocity index remained within normal limits.</div></div><div><h3>Conclusions</h3><div>The prefabricated bioprosthetic aortic valved conduit was used in all settings, including complex reoperations, acute dissection, and endocarditis with acceptable short-term morbidity and mortality. The hemodynamic performance of the valve within the studied period was normal, the long-term durability and hemodynamic performance are yet to be proven.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 34-43"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913236","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":"Trans-Atlantic analysis of gender representation in general thoracic surgery: Challenges permeate the academic community","authors":"Rajika Jindani MD, MPH, MS ,&nbsp;Debora Brascia MD ,&nbsp;Albert Dweck BA ,&nbsp;Javeria Tariq MD ,&nbsp;Justin Olivera BS ,&nbsp;Amanda Ghanie MD ,&nbsp;Jorge Humberto Rodriguez-Quintero MD, MPH ,&nbsp;Mara B. Antonoff MD ,&nbsp;Brendon M. Stiles MD ,&nbsp;Cecilia Pompili MD, PhD","doi":"10.1016/j.xjon.2025.06.006","DOIUrl":"10.1016/j.xjon.2025.06.006","url":null,"abstract":"<div><h3>Objective</h3><div>The underrepresentation of women in thoracic surgery has been well described worldwide. Women can serve as role models for trainees and advance their careers through academic appointments, leadership positions, and involvement in thoracic societies. We aimed to characterize differences between representation of women in thoracic surgery in the United States and Europe.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using publicly available data for hospitals with 30 general thoracic-track training programs in the United States and Europe from December 2023 to May 2024. Membership data for national/international societies were obtained directly from respective organizations.</div></div><div><h3>Results</h3><div>Among 30 US institutions with dedicated general thoracic surgery training tracks, women comprised 17.7% (102 out of 475) of faculty, compared with those of 30 general thoracic surgery centers in 8 European countries, where women comprised 29.5% (79 out of 268) of faculty. Of programs with available data, 26.7% (8 out of 30) had women as thoracic surgery program directors in the United States and 13% (4 out of 30) in Europe. Regarding societal membership in the General Thoracic Surgical Club (United States) and European Society of Thoracic Surgeons (Europe), women were well represented as trainee members (United States, 39.2% [20 out of 51] vs Europe, 46.1% [113 out of 245]; <em>P</em> = .367), but comprised a lower proportion of active/senior members (United States, 12.9% [45 out of 349] vs Europe, 19.2% [283 out of 1474]; <em>P</em> = .006).</div></div><div><h3>Conclusions</h3><div>We identified universal disparities in the representation of women in faculty appointments, leadership positions, and membership in professional societies. Efforts to address imbalances may benefit from shared experiences and initiatives, aiding resident recruitment and career advancement for women thoracic surgeons while fostering diversity, equity, and inclusion on a global scale.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 321-328"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912814","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":"Outcomes of surgical management of carcinoid heart disease in patients with primary gonadal neuroendocrine tumors","authors":"Tedy Sawma MD ,&nbsp;Hartzell V. Schaff MD ,&nbsp;Anita Zheng MD ,&nbsp;Gokce Belge Bilgin MD ,&nbsp;Thorvardur R. Halfdanarson MD ,&nbsp;S.Allen Luis MD, PhD ,&nbsp;Patricia A. Pellikka MD ,&nbsp;Heidi M. Connolly MD ,&nbsp;Juan A. Crestanello MD","doi":"10.1016/j.xjon.2025.05.010","DOIUrl":"10.1016/j.xjon.2025.05.010","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the clinical presentation of patients with gonadal neuroendocrine tumors and carcinoid heart disease (CaHD) and to evaluate long-term outcomes following valvular surgery.</div></div><div><h3>Methods</h3><div>Retrospective review of patients with primary gonadal neuroendocrine tumor who were surgically treated for CaHD at our institution between 1990 and 2021.</div></div><div><h3>Results</h3><div>Eight patients (median age, 70 years) were included in the study, 7 with ovarian tumors and 1 with testicular tumor. None of the patients had liver metastasis at the time of cardiac surgery. Three patients presented with both CaHD symptoms and carcinoid syndrome symptoms (diarrhea and flushing). Three others presented with symptoms of CaHD but without diarrhea or flushing. One patient with ovarian tumor presented with severe diarrhea and flushing without CaHD symptoms and had tumor resection but then developed severe CaHD symptoms few months later. The last patient presented initially with an asymptomatic testicular mass, which was resected, but then developed severe CaHD symptoms years later. All patients had severe tricuspid regurgitation at time of surgery, and 7 had severe pulmonary regurgitation. All were treated with replacement of affected valves. Both 5- and 10-year survival rates were 86% and were higher than a control group of patients with CaHD and nongonadal primary neuroendocrine tumor (35% and 23%, respectively).</div></div><div><h3>Conclusions</h3><div>Patients with primary gonadal neuroendocrine tumors can develop CaHD in the absence of liver metastasis. Some patients have delayed presentation of cardiac symptoms, emphasizing the importance of thorough assessment and regular echocardiographic follow-up. Cardiac intervention is safe and yields excellent long-term survival.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 115-121"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913307","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":"Who gets the last bed in the intensive care unit: Nonmedical factors in delaying an operation","authors":"Brandi B. Scully MD, MS ,&nbsp;Joshua B. Goldberg MD ,&nbsp;Robert M. Sade MD","doi":"10.1016/j.xjon.2025.06.008","DOIUrl":"10.1016/j.xjon.2025.06.008","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 329-333"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912815","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}