Neurocirugia (English Edition)最新文献

{"title":"Relationship between optic nerve length and interoptic angle in the prediction of optic chiasm location.","authors":"Reyhan Kasab, Selcuk Yilmazlar, Oguz Altunyuva, Recep Fedakar","doi":"10.1016/j.neucie.2024.09.005","DOIUrl":"10.1016/j.neucie.2024.09.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The sellar region is an area in the base of the skull that is among the most common sites for tumors of the central nervous system. Surgical interventions are currently performed via different routes. While the optic chiasm occupies its expected position in 70% of the population, it can deviate from this position. In such cases, surgery involving this region becomes more difficult as the known surgical routes are narrowed. Advance awareness of these variations can help surgeons to identify the optimal route for safe surgical intervention in the sellar region. By performing simple measurements of both the lengths of the optic nerves and the angle between them, a surgeon can predict the location of the chiasm.</p><p><strong>Materials and methods: </strong>Twenty specimens collected from autopsies performed at Bursa Forensic Medicine İnstitute were examined to determine the optic chiasm types and the relationships between the surrounding subchiasmal structures.</p><p><strong>Results: </strong>Among the 20 specimens, we found two prefixed (10%), 10 normo-fixed (50%), and eight postfixed chiasms (40%). The mean interoptic angle was 81.03 (±17.41)⁰. Prefixed chiasms had angles in the range 115.36⁰-124.76 ⁰ (mean 120.06 [±6.65]⁰), normo-fixed chiasm angles were between 83.11⁰-97.53 ⁰ (mean 86.07 [±6.73]⁰), and postfixed chiasms ranged between 53.01⁰-78.71 ⁰ (mean 69.20 [±9.13]⁰). The length of the right optic nerve ranged between 6.95-13.83 mm (mean 10.25 [±1.81] mm), and the length of the left between 7.25-12.51 mm (mean 10.40 [±1.47] mm). Obtuse angles indicated that the chiasm was prefixed, and acute angles were indicative of a postfixed chiasm. There was a strong negative correlation between optic nerve lengths and the interoptic angle; thus, as the length of the nerves increases, the interoptic angle becomes more acute.</p><p><strong>Conclusions: </strong>We have proposed a simple measurement of the optic nerve lengths and the angle between them to predict the relative location of the OC, which can be done easily on MRI.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376395","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":"Mortality risk factors for adult trauma patients treated with halo brace for cervical spine fracture.","authors":"Kim Hoang, Jeffrey Santos, Areg Grigorian, Lourdes Swentek, Hansen Bow, Jeffry Nahmias","doi":"10.1016/j.neucie.2024.09.003","DOIUrl":"10.1016/j.neucie.2024.09.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Halo braces treat upper cervical spine fractures and serve as the most rigid form of external immobilization. Recently, halo braces have lost favor due to known complications and advances in surgical stabilization. This study aims to determine the contemporary incidence for use of halo braces and identify risk factors associated with mortality in trauma patients undergoing halo brace for cervical spine fractures.</p><p><strong>Materials and methods: </strong>The 2017-2019 Trauma Quality Improvement Program Database was queried for patients ≥18 years-old with a cervical spine fracture undergoing halo brace. Patients sustaining penetrating trauma and severe torso injuries (abbreviated injury scale >3 for the abdomen or thorax) were excluded. Bivariate and multivariable logistic regression analyses were performed.</p><p><strong>Results: </strong>From 144,434 patients with a cervical spine fracture, 272 (0.2%) underwent halo brace and 14 (5%) of these died. Those who died were older (73.5 vs. 53 years-old, p = 0.011) and had higher rates of hypertension (78.6% vs 33.1%, p < 0.001) and chronic kidney disease (14.3% vs. 1.2%, p < 0.001). Glasgow Coma Scale ≤8 (46.2% vs. 8.2%, p < 0.001) and cervical spinal cord injury (71.4% vs. 21.3%, p < 0.001) were more common in patients who died. In addition, those who died more often sustained respiratory complications (7.1% vs. 0.4%, p = 0.004) and sepsis (7.1% vs. 0.4%, p = 0.004). On multivariable logistic regression analysis, only Glasgow Coma Scale ≤8 (OR 19.77, 3.04-128.45, p = 0.002) was associated with increased mortality.</p><p><strong>Conclusions: </strong>Only 5% of cervical spine fracture patients undergoing halo brace died. Respiratory complications and sepsis were more common in those who died. On multivariable analysis only Glasgow Coma Scale ≤8 remained an independent associated risk factor for mortality.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367752","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":"Epidemiological aspects of syringomyelia in a 19-year old cohort of spinal cord injury patients.","authors":"Vitor Viana Bonan de Aguiar, Giovani Batista, Ricardo Gepp, Asdrubal Falavigna","doi":"10.1016/j.neucie.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.neucie.2024.09.004","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence, clinical and radiological risk factors, and surgical management of post-traumatic syringomyelia (PTS) in a 19-year cohort study of Spinal Cord Injury (SCI) patients treated at a SCI rehabilitation center.</p><p><strong>Methods: </strong>Retrospective study of SCI patients in whom PTS was radiologically confirmed between January 2000 and December 2018. Protocols for assessing signs and symptoms of PTS were applied prior to PTS diagnosis and treatment and later at neurosurgical and rehabilitation reviews. The variables analyzed were prevalence, demographic data, trauma event, clinical and radiological risk factors, location and size of the syrinx, and effectiveness of the surgical procedures.</p><p><strong>Results: </strong>Over the 19-year period, review of 920 SCI patients revealed 85 patients who met the clinical and neuroradiological criteria for the diagnosis of PTS and who were prospectively followed. Road traffic accidents were the leading cause of injury (n = 58; 68.2%), syringomyelia was most commonly observed in the thoracic spine (n = 56; 65.9%), and upper extremity paresis was the most common indication for surgical treatment (n = 27; 45%). Surgical treatment was indicated in 48 patients and the operative procedures included 29 syringopleural shunts (60.4%), 17 adhesiolysis (35.4%), and two syringosubarachnoid shunts (4.1%). The prevalence of PTS was 9% and was higher in patients with ASIA impairment scale grade A injuries. Most patients with PTS (63/85, 74.1%) were treated surgically at the time of injury. There was a significant reduction both in the extent (p = 0.05) and largest area (p = 0.001) of the syrinx after surgical treatment. Reoperation rates were 47% and 37.9% for adhesiolysis and syringopleural shunting, respectively.</p><p><strong>Conclusion: </strong>Follow-up and routine clinical examination of SCI patients is critical for the diagnosis of PTS in patients with late neurological deterioration. Surgical treatment has a positive impact in reducing the size of the syrinx as seen on postoperative MRI.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367751","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":"Endovascular treatment of chronic subdural hematoma in a dual-trained neurosurgical unit: Results and proposal of a randomized controlled trial protocol.","authors":"Sergio García García, Ignacio Arrese Regañón, Santiago Cepeda Chafla, Rosario Sarabia Herrero","doi":"10.1016/j.neucie.2024.09.002","DOIUrl":"10.1016/j.neucie.2024.09.002","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition with an increasing incidence due to the rising life expectancy and the widespread use of anticoagulant and antiplatelet therapies. Insights into the inflammatory origins of cSDH led to the exploration of Middle Meningeal Artery (MMA) embolization as a therapeutic strategy. In recent years the endovascular treatment of MMA has gained momentum. Herein we present the initial experience of a dual trained neurovascular unit implementing this therapeutic technique.</p><p><strong>Methods: </strong>This single-center, prospective pilot study aimed to evaluate the feasibility, safety, and efficacy of MMA embolization in the treatment of cSDH. Following ethical approval and informed consent, demographic, clinical, and radiological data were collected. Patients requiring emergent surgical treatment were excluded. The study focused on assessing clinical outcomes, including the Modified Rankin Score (mRS) and volumetric analysis of cSDH, before and after embolization.</p><p><strong>Results: </strong>Fifteen patients underwent MMA embolization, with a predominance of males (80%) and a mean age of 72.4 years. The most common presenting symptom was headache (53.3%). The average hospital stay was 3.9 days. Various embolization techniques were employed, with DMSO-EVOH being the most frequent. All procedures were successfully conducted without complications. Although not statistically significant, trends suggested better outcomes in patients with homogeneous cSDH on the CT scan, displaying the cotton wool sign on angiography and treated with EVOH-DMSO.</p><p><strong>Conclusion: </strong>MMA embolization for cSDH demonstrates promise as a safe and effective treatment, potentially reducing the need for surgical intervention and recurrence rates. This study lays the groundwork for a larger, randomized controlled trial which protocol is herein presented.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302802","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":"Cervical spine spondylodiscitis due to neglected esophageal perforation after a dilation procedure 30 years after a laringectomy and radiotherapy. Report of a case and review of literature.","authors":"Caribay Vargas-Reverón, Ernesto Muñoz-Mahamud, Alex Soriano, Andrés Combalia","doi":"10.1016/j.neucie.2024.09.001","DOIUrl":"10.1016/j.neucie.2024.09.001","url":null,"abstract":"<p><p>Current treatment of cervical spine spondylodiscitis generally involves a radical surgical debridement and stable reconstruction together with antibiotic therapy until complete healing. But this classical approach could be difficult for patients who have been treated previously for an esophageal carcinoma and received radiotherapy. We present a case of a 75-year-old male who underwent an esophageal dilation procedure and developed afterward a spondylodiscitis with epidural abscess due to a neglected esophageal perforation. Blood cultures were positive for Peptostreptococcus. Cervical spondylodiscitis and epidural abscess are extremely rare complications of esophageal dilations. Successful treatment without debridement was achieved by performing a posterior fixation without decompression associated with antibiotic therapy for 8 weeks. The present case highlights that spondylodiscitis and epidural abscess may be treated in selected cases where the anterior neck is unapproachable and with a recognized pathogen by a posterior approach fixation without debridement, in association to specific antibiotic therapy.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302801","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":"Partial sensory rhizotomy in recurrent trigeminal neuralgia. Our experience and literature review","authors":"","doi":"10.1016/j.neucie.2024.07.003","DOIUrl":"10.1016/j.neucie.2024.07.003","url":null,"abstract":"<div><h3>Background and objective</h3><p><span>Trigeminal Neuralgia (NT) is a common pathology in </span>Neurosurgery<span>. It can be classified as idiopathic or secondary to other pathologies, such as Multiple Sclerosis<span><span> (MS). Several surgical treatments have been described, some of them being replaced by more modern techniques. Partial sensory rhizotomy (PSR), described by Dandy is a technique replaced by other techniques due to its permanent side effects. We present our experience with this technique in patients with recurrent </span>NT.</span></span></p></div><div><h3>Methods and materials</h3><p>A retrospective review is carried out on five patients who underwent surgery at our center from 2018 to 2023 using the PSR technique.</p></div><div><h3>Results</h3><p>All the patients intervened showed significant clinical improvement, except one patient who required reintervention due to uncontrolled pain. According to the Barrow Neurological Institute (BNI) scale, 80% (4/5) of patients showed improvement from grade V to grades I/II except for one of them. This patient suffered from MS. Additionally, one patient presented a corneal ulcer<span> after surgery due to impairment of the corneal reflex.</span></p></div><div><h3>Conclusion</h3><p>In our experience, PSR is a valid treatment option in selected patients with recurrent TN. It has a low incidence of complications with an adequate surgical technique and anatomical knowledge of the region. To the best of our knowledge, we are one of the few centers in Spain to publish our results with PSR in the last ten years. We report good results in pain control withdrawing medication in 80% (4/5) of the operated patients.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556144","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":"Gamma Knife radiosurgery for the treatment of trigeminal neuralgia: A single center-experience","authors":"","doi":"10.1016/j.neucie.2024.04.001","DOIUrl":"10.1016/j.neucie.2024.04.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>We aimed to assess the outcomes of patients with trigeminal neuralgia<span> (TGN) who underwent Gamma Knife radiosurgery (GKRS).</span></p></div><div><h3>Materials and methods</h3><p>Fifty-three patients with typical TGN underwent GKRS from May 2012 until December 2022. Among these patients, 45 patients who were follow-up for at least 12 months were included in the study. A mean dose of 87.5 Gy (range, 80–90) was administered to the trigeminal nerve. Postoperatively, outcome was considered excellent if the patient was pain- and medication-free.</p></div><div><h3>Results</h3><p>The mean symtpom duration was 9.53 years, and the mean patient age was 59.8 years (range, 34–85). The mean follow-up period was 46.8 months (range, 12–127 months). 46.7% of patients had a history of previous surgical interventions. A single nerve division was affected in 14 patients (31.1%), and multiple divisions were affected in 31 patients (68.9%). The rate of initial pain relief was 80%. Hypoesthesia in the area of trigeminal nerve developed in 30 (66.7%). Twenty patients (44.4%) exhibited excellent results within 72.4 months. Recurrence occurred in 11 patients (24.4%) with 27.6 months.</p></div><div><h3>Conclusions</h3><p>Our results suggest that GKRS is a safe and effective procedure. Thus, it is an attractive first- and second-line treatment choice for TGN.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759575","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":"Intracranial hypertension secondary to unruptured pial arteriovenous malformation. Suitability of isolated endovascular treatment with ethylene vinyl alcohol/dimethyl sulfoxide (Onyx®). Case report and literature review","authors":"","doi":"10.1016/j.neucie.2024.07.001","DOIUrl":"10.1016/j.neucie.2024.07.001","url":null,"abstract":"<div><p><span>A 36-year-old male presented to the Emergency Department<span> with clinical symptoms of blurred vision of progressive onset of two years of evolution. The ophthalmological examination revealed the existence of bilateral papilledema<span>. Using cranial computed tomography<span><span> and magnetic resonance imaging, the presence of a right occipital pial arteriovenous malformation<span> was certified. Arteriographically, pial arterial contributions dependent on the right middle cerebral artery and the right </span></span>posterior cerebral artery<span><span> were identified. Venous drainage was located at the level of the superior sagittal sinus<span>. An associated right transverse sinus stenosis was also identified. The existence of secondary </span></span>intracranial hypertension was corroborated by monitoring with an </span></span></span></span></span>intracranial pressure<span><span> sensor. An interventional procedure was carried out consisting of embolization of the </span>arterial supplies<span> of the lesion using Onyx®. The clinical-radiological findings after the procedure were favorable: the papilledema disappeared and complete exclusion of the malformation was achieved. A new intracranial pressure measurement showed resolution of intracranial hypertension. Subsequent regulated radiological controls showed complete exclusion of the malformation up to 5 years later.</span></span></p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556143","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":"Short-term and long-term results of odontoid screw fixation in patients with Type II and rostral Type III dens fractures","authors":"","doi":"10.1016/j.neucie.2024.05.003","DOIUrl":"10.1016/j.neucie.2024.05.003","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate both the short-term and long-term outcomes of odontoid screw fixation (OSF), identifying potential risk factors<span> for implant-related complications in patients with odontoid fractures.</span></p></div><div><h3>Methods</h3><p>This is a retrospective observational cohort study<span><span>. Inclusion criteria were as follows: 1) Type II fractures and rostral Type III fractures, according to the Anderson and D’Alonzo classification; 2) patients older than 15 years. Exclusion criteria were: 1) other Type III injuries<span><span>; 2) osteoporosis confirmed by </span>densitometry<span> or a CT bone density score below 100 Hounsfield units; 3) odontoid fractures related to tumors or </span></span></span>aneurysmal bone cysts.</span></p></div><div><h3>Results</h3><p>In total, 56 patients were considered for the analysis of short-term results, and 26 patients were evaluated for long-term outcomes. No significant differences were observed in the preoperative imaging data and intraoperative features of OSF between patients with Type II and rostral Type III fractures. The mean operative duration was 63.9 ± 20.9 min, and the mean intraoperative blood loss was 22.1 ± 22.9 ml.</p><p>Screw cut-out was identified in four patients with rostral Type III fractures (p = 0.04). The rate of screw cut-out was found to correlate with the degree of dens fragment displacement. The bone fusion rate was 95.7%. CT scans identified stable pseudarthrosis<span> in two cases. We observed C2–C3 ankylosis<span> in all cases following partial disc resection. One third of patients with screws placed through the anterior lip of C2 showed no C2–C3 ankylosis. A strong trend towards lateral joint ankylosis formation in patients with a median lateral mass dislocation of 11.9 mm was observed. Most SF-36 scores either matched or exceeded the corresponding normal median values in the published reference database.</span></span></p></div><div><h3>Conclusions</h3><p>OSF is a reliable treatment method of Type II and rostral Type III odontoid fractures with fragment displacement of 4 mm or less. The minimally invasive OSF through the anterior-inferior lip of C2, using monocortical screw placement and cannulated instruments, without rigid intraoperative head immobilization, is sufficient to achieve favorable clinical and fusion results. This technique reduces the risk of ankylosis in the C2–C3 segment. OSF restore the quality of life for patients with odontoid fractures to levels comparable to those of the general population norm.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184648","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":"Terson’s syndrome after endoscopic removal of a colloid cyst","authors":"","doi":"10.1016/j.neucie.2024.03.004","DOIUrl":"10.1016/j.neucie.2024.03.004","url":null,"abstract":"<div><p><span>An extremely rare complication of endoscopic colloid cyst<span><span> removal is presented. Terson’s syndrome related to endoscopic resection of a </span>colloid cyst has been reported only twice before in the literature and it could be explained by </span></span>intracranial hypertension related to rinsing during the procedure. The case is described and the complications in the neuroendoscopic removal of colloid cyst are reviewed from the literature.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795788","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}