Julián Castro Castro , Juan Manuel Villa Fernández , Jesús Patricio Agulleiro Díaz
{"title":"Craniofacial fibrous dysplasia and aneurismal bone cyst in a patient with McCune-Albright syndrome. A case report and review of the literature","authors":"Julián Castro Castro , Juan Manuel Villa Fernández , Jesús Patricio Agulleiro Díaz","doi":"10.1016/j.neucie.2022.09.002","DOIUrl":"10.1016/j.neucie.2022.09.002","url":null,"abstract":"<div><p><span>McCune-Albright syndrome (MAS) is a rare heterogeneous genetic disorder that is characterized by a triad of polyostotic fibrous dysplasia (FD), </span>café au lait spots<span> (CAL), and multiple hyperfunctional endocrinopathies. In general, it is diagnosed clinically. From the triads, 2 of the findings are enough to make the diagnosis.</span></p><p>Craniofacial fibrous dysplasia is a term that is used to describe the fibrous dysplasia, which was localized at the craniofacial skeleton and is common in MAS patients.</p><p><span>Aneurysmal bone cyst<span> (ABC) is a rare non-neoplastic bone lesion that involves mostly the long bones and </span></span>vertebrae and may occur very rarely in the craniofacial bones. ABCs may occur as secondary bony pathologies in association with various benign and malignant bone tumors and with fibrous dysplasia. Secondary ABC occurring in craniofacial FD is extremely rare. We present the case of a 21-year-old patient treated at our center for a right orbital aneurysmal bone cyst associated with MAS and provide a review of the relevant literature.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 268-272"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144070","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}
Mustafa Onur Ulu , Mehmet Yigit Akgun , Orkhan Alizada , Eren Fatma Akcil , Tufan Kartum , Murat Hanci
{"title":"Posterior-only approach in patients with poor general condition and spinal metastatic vertebral fracture","authors":"Mustafa Onur Ulu , Mehmet Yigit Akgun , Orkhan Alizada , Eren Fatma Akcil , Tufan Kartum , Murat Hanci","doi":"10.1016/j.neucie.2022.10.002","DOIUrl":"10.1016/j.neucie.2022.10.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The surgical treatment of spinal metastases is mostly palliative in nature and focuses on improving the quality of life of patients. The posterior transpedicular surgical approach provides circumferential 360° decompression, allows reconstruction and stabilisation to be achieved in a single session and can be performed using an open, mini-open or minimally invasive approach. We present and discuss the surgical techniques and outcomes for patients with single-level metastatic spinal disease and in poor general condition who underwent surgery via the posterior-only transpedicular corpectomy approach and reconstruction with expandable corpectomy cages.</p></div><div><h3>Methods</h3><p>Patients with a single level thoracolumbar metastatic disease (T3-L5) and a Karnofsky score of ≤70, who underwent a complete posterior transpedicular corpectomy with expandable cage reconstruction of the anterior spinal column were retrospectively reviewed. Patients’ demographics, SINS, modified Tokuhashi scores as well as preoperative and postoperative ASIA scale, Karnofsky scores, VAS scores and vertebral height/Cobb angle values were analysed.</p></div><div><h3>Results</h3><p>A total of 44 patients (24 M/20 F) (mean age 53.25<!--> <!-->±<!--> <!-->21.26 years) met the inclusion criteria. The modified Tokuhashi scores were as follows: score 0–8, 5 (11.4%) patients; score 9–11, 14 (31.8%) patients; and score 12–15, 25 (56.8%) patients. There were significant improvements in the postoperative VAS scores (mean 7.7–2.9), Karnofsky scores (mean 63.3–79.6) as well as the Cobb angles (18.6–12.8°) and vertebral height. Thirtyfive patients showed improved neurological function by at least one ASIA grade, whereas 9 showed no improvement during the postoperative period.</p></div><div><h3>Conclusions</h3><p>This technique, which has a low complication rate and a short recovery time, can help achieve satisfactory results even in patients with poor metabolic profiles and Karnofsky scores in the preoperative period. Further clinical studies with large patient groups are warranted to confirm the results of this study.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 247-255"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10197817","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}
Alejandra Arévalo-Sáenz , Fernando J. Rascón-Ramírez , Manuel Pedrosa Sánchez
{"title":"Cavernous hemangioma of the peripherical nerve: A case report","authors":"Alejandra Arévalo-Sáenz , Fernando J. Rascón-Ramírez , Manuel Pedrosa Sánchez","doi":"10.1016/j.neucie.2022.09.001","DOIUrl":"10.1016/j.neucie.2022.09.001","url":null,"abstract":"<div><p>Cavernous hemangiomas<span><span><span><span>, also known as deep hemangiomas are benign tumors of blood vessels, including normal and abnormal </span>vascular structures, that develop in skin tissue and sometimes even in deep tissues. Its intraneural development in the </span>peripheral nerve is very rare with less than 50 cases reported in the literature. We present a case of a cavernous hemangioma of the medial </span>sural nerve<span><span> in a patient with symptoms of severe pain and allodynia with complete resolution of symptoms with </span>microsurgery.</span></span></p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 213-216"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913789","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}
Alper Turkkan , Marzieh Karimi Khezri , Pinar Eser , Turgut Kuytu , Sahsine Tolunay , Ahmet Bekar
{"title":"Hemorrhagic presentation of previously silent brain tumors","authors":"Alper Turkkan , Marzieh Karimi Khezri , Pinar Eser , Turgut Kuytu , Sahsine Tolunay , Ahmet Bekar","doi":"10.1016/j.neucie.2022.11.023","DOIUrl":"10.1016/j.neucie.2022.11.023","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Acute presentation with intracranial hemorrhage owing to a previously silent brain tumor (BT) is rare. Although any BT can bleed, the frequency and type of bleeding varies across tumor types.</p></div><div><h3>Materials and methods</h3><p>We aimed to retrospectively review our experience with 55 patients with BTs presenting with ICH.</p></div><div><h3>Results</h3><p>Signs of increased intracranial pressure were the most common symptoms. The temporal lobe was the most common lesion site (<em>n</em> <!-->=<!--> <!-->22). Hemorrhages were mainly confined to the tumor margins (HCTs) (<em>n</em> <!-->=<!--> <!-->34). Extensive intraparenchymal hemorrhages (EIHs) were mainly associated with moderately/severely decreased levels of consciousness (LOCs) (<em>n</em> <!-->=<!--> <span>15/16). High-grade glioma (HGGT) (</span><em>n</em> <!-->=<!--> <!-->25) was the leading pathological diagnosis followed by metastasis (MBT) (<em>n</em> <!-->=<!--> <!-->16/55). The hemorrhage type was associated with the pathological diagnosis of the tumor. Patients with HGGT (<em>n</em> <!-->=<!--> <!-->19/25) and MBT (<em>n</em> <!-->=<!--> <!-->9/16) mainly presented with HCTs, whereas low-grade gliomas (LGGT) primarily caused EIHs (<em>n</em> <!-->=<!--> <!-->6/7).</p></div><div><h3>Conclusions</h3><p>Hemorrhagic presentation is a rare occurrence in BTs. Among all, MBT and HGGT are responsible for majority of the cases. Importantly, despite their relatively benign characteristics, LGGTs mainly result in extensive parenchymal destruction once they bleed. Maximum surgical resection of hemorrhagic BTs and decompression of the affected brain regions followed by histological confirmation of the diagnosis should be the main goals of treatment in cases with hemorrhagic BTs.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 177-185"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217908","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":"Craniocervical Rosai-Dorfman Disease presentation: Case report and review of literature","authors":"Mohamad Yazbeck , Youssef Comair , Christin Berjaoui , Baraa Dabboucy","doi":"10.1016/j.neucie.2022.11.018","DOIUrl":"10.1016/j.neucie.2022.11.018","url":null,"abstract":"<div><p>Rosai Dorfman Disease (RDD) is a benign histiocytic lymphoproliferative disease that has variable presentations. The concurrent presentation of RDD<span> in the spinal cord and brain parenchyma is an extremely rare entity. Here, we report another case of a 24-year-old gentleman who presented with a tuberculum sellae<span> and bilateral cavernous extra-axial tumors extending to the subtemporal lobe and was found to have craniocervical lesions. Axillary lymph node biopsy was done showing markedly dilated sinuses filled with large histiocytes and emperipolesis of numerous lymphocytes and plasma cells confirming the diagnosis of RDD. Because the definitive diagnosis of RDD is always pathological, the clinical presentation plays a major role in widening the margin of differential diagnosis. Finally, surgical intervention is the first option to treat RDD with relatively satisfactory follow-up outcomes, and other adjuvant therapies optimize the prognosis.</span></span></p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 203-207"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9859542","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}
Ilyas Dolas , Tugrul Cem Unal , Cafer Ikbal Gulsever , Duran Sahin , Heydar Huseynov , Mehmet Barburoglu , Onur Ozturk , Halil Can , Ali Ekrem Adiyaman , Huseyin Emre Dagdeviren , Pulat Akin Sabanci , Aydin Aydoseli , Yavuz Aras , Altay Sencer , Serra Sencer
{"title":"Endovascular treatment of posterior circulation aneurysms: Results from a single-team experience of 81 cases including 13 flow diversion treatment","authors":"Ilyas Dolas , Tugrul Cem Unal , Cafer Ikbal Gulsever , Duran Sahin , Heydar Huseynov , Mehmet Barburoglu , Onur Ozturk , Halil Can , Ali Ekrem Adiyaman , Huseyin Emre Dagdeviren , Pulat Akin Sabanci , Aydin Aydoseli , Yavuz Aras , Altay Sencer , Serra Sencer","doi":"10.1016/j.neucie.2022.11.022","DOIUrl":"10.1016/j.neucie.2022.11.022","url":null,"abstract":"<div><h3>Introduction</h3><p>Relatively constant surgical risks and rapid advances in endovascular treatment have caused a major shift toward endovascular management of posterior circulation aneurysms. This paper presents the results of a series of endovascularly treated posterior circulation aneurysms.</p></div><div><h3>Methods</h3><p>A total of 81 patients who underwent endovascular treatment of posterior circulation aneurysms performed by a single team between 2009 and 2019 were included. Demographic, clinical, radiologic, and management details were retrospectively obtained from hospital records.</p></div><div><h3>Results</h3><p><span><span>Among the included patients, 50 (61.7%) and 31 (38.3%) were female and male, respectively. Subarachnoid hemorrhage was observed in 30 patients (37%). Moreover, 40 (49.3%) aneurysms were treated with stent-assisted coiling, 1 (1.2%) aneurysm was treated with parent </span>artery occlusion, 2 (2.4%) aneurysms were coiled using balloon assistance, 24 (29.6%) aneurysms were coiled primarily, 1 (1.2%) patient had an unsuccessful treatment attempt, and 13 (16.0%) aneurysms were treated with flow-diverter stents or stent </span>monotherapy. During the last follow-up, 57 (83.8%) aneurysms were completely occluded, whereas 6 (8.8%) and 2 (2.9%) aneurysms did and did not have a residual neck, respectively. Flow diversion was used to treat 13 patients, among whom 8 had total occlusion or stable residue. A total of 7 deaths (8.6%) were encountered in this series.</p></div><div><h3>Conclusion</h3><p>Endovascular treatment should be considered as the primary treatment modality for posterior circulation aneurysms. Despite the high morbidity and mortality rates, promising results can be achieved with correct patient selection. Flow diversion can be a feasible alternative for complex aneurysms that are difficult to treat.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 168-176"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9859545","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}
Peiran Wei , Yan Xu , Huikang Zhang , Qingqiang Yao , Liming Wang
{"title":"Evaluation of outcomes of discectomy with a dynamic neutralization system in treatment of lumbar disk herniation","authors":"Peiran Wei , Yan Xu , Huikang Zhang , Qingqiang Yao , Liming Wang","doi":"10.1016/j.neucie.2022.11.020","DOIUrl":"10.1016/j.neucie.2022.11.020","url":null,"abstract":"<div><h3>Objective</h3><p>The study aimed to explore the clinical outcomes of discectomy with dynamic neutralization system (Dynesys) for single-segmental lumbar disk herniation (LDH) versus simple discectomy.</p></div><div><h3>Methods</h3><p>The eligible patients with single-segmental LDH were randomly divided into the discectomy with Dynesys group (group A) and the simple discectomy group (group B). The Oswestry disability index (ODI), visual analog score (VAS), radiological results of intervertebral height and range of motion (ROM) of the treated segment were evaluated pre- and post-operatively in both groups. Operation duration and blood loss were recorded. Complications, reoperation, and mortality were also assessed. All patients received a 2-year follow-up.</p></div><div><h3>Results</h3><p>123 (96.1%) participants completed the follow-up. The operation duration and blood loss of group B were significantly lower than those of group A (<em>p</em> <!--><<!--> <span>0.05). After operation, ODI and VAS were improved significantly in both groups, and there was no significant difference between the two groups immediately after surgery. But a rising trend was found in ODI and VAS of group B, especially after the 1-year follow-up (</span><em>p</em> <!--><<!--> <!-->0.05). X-rays showed a continuing loss of intervertebral height of the treated segment in group B, while it was preserved in group A (<em>p</em> <!--><<!--> <!-->0.05). ROM of the treated segment was also maintained stable in group A.</p></div><div><h3>Conclusion</h3><p>Discectomy with Dynesys is safe and effective for LDH treatment.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 161-167"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9859541","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}
Filipa de Oliveira , Rui Vaz , Clara Chamadoira , Maria José Rosas , Manuel J. Ferreira-Pinto
{"title":"Bilateral deep brain stimulation of the subthalamic nucleus: Targeting differences between the first and second side","authors":"Filipa de Oliveira , Rui Vaz , Clara Chamadoira , Maria José Rosas , Manuel J. Ferreira-Pinto","doi":"10.1016/j.neucie.2022.07.001","DOIUrl":"10.1016/j.neucie.2022.07.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a recognized treatment for drug-refractory Parkinson's disease (PD). However, the therapeutic success depends on the accuracy of targeting. This study aimed to evaluate potential accuracy differences in the placement of the first and second electrodes implanted, by comparing chosen electrode trajectories, STN activity detected during microelectrode recording (MER), and the mismatch between the initially planned and final electrode positions on each side.</p></div><div><h3>Materials and methods</h3><p>In this retrospective cohort study, we analyzed data from 30 patients who underwent one-stage bilateral DBS. For most patients, three arrays of microelectrodes were used to determine the physiological location of the STN. Final target location depended also on the results of intraoperative stimulation. The choice of central versus non-central channels was compared. The Euclidean vector deviation was calculated using the initially planned coordinates and the final position of the tip of the electrode according to a CT scan taken at least a month after the surgery.</p></div><div><h3>Results</h3><p>The central channel was chosen in 70% of cases on the first side and 40% of cases on the second side. The mean length of high-quality STN activity recorded in the central channel was longer on the first side than the second (3.07<!--> <!-->±<!--> <!-->1.85<!--> <!-->mm vs. 2.75<!--> <!-->±<!--> <!-->1.94<!--> <!-->mm), while in the anterior channel there were better MER recordings on the second side (1.59<!--> <!-->±<!--> <!-->2.07<!--> <!-->mm on the first side vs. 2.78<!--> <!-->±<!--> <!-->2.14<!--> <!-->mm on the second). Regarding the mismatch between planned versus final electrode position, electrodes on the first side were placed on average 0.178<!--> <!-->±<!--> <!-->0.917<!--> <!-->mm lateral, 0.126<!--> <!-->±<!--> <!-->1.10<!--> <!-->mm posterior and 1.48<!--> <!-->±<!--> <!-->1.64<!--> <!-->mm inferior to the planned target, while the electrodes placed on the second side were 0.251<!--> <!-->±<!--> <!-->1.08<!--> <!-->mm medial, 0.355<!--> <!-->±<!--> <!-->1.29<!--> <!-->mm anterior and 2.26<!--> <!-->±<!--> <!-->1.47<!--> <!-->mm inferior to the planned target.</p></div><div><h3>Conclusion</h3><p>There was a tendency for the anterior trajectory to be chosen more frequently than the central on the second side. There was also a statistically significant deviation of the second electrodes in the anterior and inferior directions, when compared to the electrodes on the first side, suggesting that another cause other than brain shift may be responsible. We should therefore factor this during planning for the second implanted side. It might be useful to plan the second side more anteriorly, possibly reducing the number of MER trajectories tested and the duration of surgery.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 186-193"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217905","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":"Scientific authorship in neurosurgery","authors":"Rubén Diana-Martín, Pedro David Delgado-López","doi":"10.1016/j.neucie.2022.11.007","DOIUrl":"10.1016/j.neucie.2022.11.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Assessment of scientific bibliographic production is a complex issue, mainly based on the impact factor (IF) of the journals and the h index, that quantifies the number of cites an author receives. In order to estimate the bibliographic production and the influence of co-authorship among Spanish neurosurgeons, we performed a PubMed search aimed to identify all papers published by a sample of neurosurgeons.</p></div><div><h3>Methods</h3><p>Cross-sectional observational and regional study. We identified a sample of 183 neurosurgeons from Madrid and Castilla y León Autonomous Communities. The bibliometric information was gathered in March 2022 via PubMed free access website. For each author we registered the type of journal, total number of articles, order of appearance in the authors’ list, total IF, the proportion of articles signed as first or second author (Personal Authorship Quotient [PAQ]) and the percentage of IF attributable to those articles (Personal Impact Quotient [PIQ]).</p></div><div><h3>Results</h3><p>A total of 3,592 articles from 183 authors were published in 412 different journals, of which only 9.9% were pure neurosurgical journals. Only 17 neurosurgeons (9,3%) had published at least one article as unique author. The average number of articles per neurosurgeon was 20 (median 9) of which 57.7% were published in neurosurgical journals, and 22,2% in <em>Neurocirugía</em> (official publication of the SENEC). The average PAQ was 0.367 (median 0.364) and the average PIQ was 0.317 (median 0.251). Both proportions tended to decrease as the number of publications increased.</p></div><div><h3>Conclusions</h3><p>On average, Spanish neurosurgeons publish half of their articles in neurosurgical journals, appear as first or second author in one third of the cases, and the IF attributable to these papers comprise 25% of the total IF. The PAQ and PIQ provide bibliometric information that minimizes the enlarging effect on curriculum of massive co-authorship and allow comparisons among authors and different scientific fields.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 194-202"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862581","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}