OTA international : the open access journal of orthopaedic trauma最新文献

{"title":"A retrospective review of the rate of septic knee arthritis after retrograde femoral nailing for traumatic femoral fractures at a single academic institution.","authors":"Ryan S Bailey,&nbsp;Benjamin A Nwadike,&nbsp;Thomas Revak","doi":"10.1097/OI9.0000000000000264","DOIUrl":"10.1097/OI9.0000000000000264","url":null,"abstract":"<p><strong>Background: </strong>Retrograde intramedullary nailing of the femur is a popular treatment option for femoral shaft fractures. However, this requires accessing the intramedullary canal through the knee, posing a risk of intra-articular infection. The purpose of this study was to examine the rate of intra-articular infection of the knee after retrograde nailing of femoral shaft fractures.</p><p><strong>Methods: </strong>All patients who underwent retrograde intramedullary nailing for femoral shaft fractures between June 2004 and December 2017 at a level 1 trauma center were reviewed. Six months of follow-up or documented fracture union was required. Records were reviewed for documentation of septic arthritis of the ipsilateral knee during the follow-up period.</p><p><strong>Results: </strong>A total of 294 fractures, including 217 closed and 77 open injuries, were included. Eighteen had an associated ipsilateral traumatic arthrotomy; 188 cases had an associated ipsilateral lower extremity fracture. No cases of septic arthritis were identified.</p><p><strong>Conclusion: </strong>There were no cases of septic arthritis in 294 fractures treated with retrograde intramedullary nailing. Retrograde nailing appears safe for risk of postoperative septic arthritis of the knee even in the face of open fractures and traumatic wounds.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e264"},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/d9/oi9-6-e264.PMC10538562.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174284","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":"Is human immunodeficiency virus a risk factor for the development of nonunion?-a case-control study.","authors":"Simon Matthew Graham, Sithombo Maqungo, Maritz Laubscher, Nando Ferreira, Michael Held, William James Harrison, A Hamish Simpson, Peter MacPherson, David G Lalloo","doi":"10.1097/OI9.0000000000000251","DOIUrl":"10.1097/OI9.0000000000000251","url":null,"abstract":"<p><strong>Objective: </strong>Human immunodeficiency virus (HIV) infection has been suggested to be associated with an increased risk of the development of nonunion after a fracture. This prospective matched case-control study in South Africa investigated common risk factors, including HIV status, that influence the development of a nonunion after a femur or tibia fracture.</p><p><strong>Methods: </strong>Adult participants (cases) with established nonunions of the femur or tibia shaft were recruited over a 16-month period, between December 2017 and April 2019. They were matched for (1) age; (2) sex; (3) fracture site; and (4) fracture management type, with \"control\" participants who progressed to fracture union within 6 months of injury. All participants were tested for HIV. Multivariable logistic regression models were constructed to investigate associations between known risk factors for the development of nonunion and impaired fracture healing.</p><p><strong>Results: </strong>A total of 57 cases were matched with 57 \"control\" participants (44/57 male, 77.2% vs. 13/57 female, 22.8%, median age 36 years). HIV status was not associated with the development of nonunion after the management of tibia and femur fractures, on both univariate (odds ratio, 0.40; confidence interval, 0.10-1.32; <i>P</i> = 0.151) or multivariable (odds ratio, 0.86; confidence interval, 0.18-3.73; <i>P</i> = 0.831) analysis. No other confounding factors were shown to have any statistically significant impact on the odds of developing nonunion in this study cohort.</p><p><strong>Conclusion: </strong>This study demonstrates that HIV does not seem to increase the risk of the development of nonunion and HIV-positive individuals who sustain a fracture can be managed in the same manner as those who are HIV negative.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e251"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/3f/oi9-6-e251.PMC10538559.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41124866","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":"Intramedullary brachytherapy for the treatment of long bone metastatic disease: A case report.","authors":"David Eric O'Neill,&nbsp;Bhavani Gannavarapu,&nbsp;Brian Hrycushko,&nbsp;Michael Folkert,&nbsp;Robert Timmerman,&nbsp;Alexandra Callan","doi":"10.1097/OI9.0000000000000267","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000267","url":null,"abstract":"<p><strong>Case: </strong>A 56-year-old woman with metastatic melanoma and femoral lesions with impending pathologic fracture was indicated for intramedullary brachytherapy (IMBT) and intramedullary nail.</p><p><strong>Conclusions: </strong>IMBT + intramedullary nail is a new technique for the treatment of long bone metastases. IMBT maximizes radiation to the tumor and minimizes radiation to surrounding tissues. It allows the patient to resume systemic treatment expediently. Our cadaver model and patient were both treated for femoral metastases; however, this technique allows for the treatment of any long bone. This is a safe technique that minimizes treatment time compared with other standard radiation regimens.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e267"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/74/oi9-6-e267.PMC10538573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159914","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":"Open tibial shaft fractures: treatment patterns in sub-Saharan Africa.","authors":"","doi":"10.1097/OI9.0000000000000228","DOIUrl":"10.1097/OI9.0000000000000228","url":null,"abstract":"<p><strong>Objective: </strong>Open tibial shaft fractures are a leading cause of disability worldwide, particularly in low and middle-income countries (LMICs). Guidelines for these injuries have been developed in many high-income countries, but treatment patterns across Africa are less well-documented.</p><p><strong>Methods: </strong>A survey was distributed to orthopaedic service providers across sub-Saharan Africa. Information gathered included surgeon and practice setting demographics and treatment preferences for open tibial shaft fractures across 3 domains: initial debridement, antibiotic administration, and fracture stabilization. Responses were grouped according to country income level and were compared between LMICs and upper middle-income countries (UMICs).</p><p><strong>Results: </strong>Responses from 261 survey participants from 31 countries were analyzed, with 80% of respondents practicing in LMICs. Most respondents were male practicing orthopaedic surgeons at a tertiary referral hospital. For all respondents, initial debridement occurred most frequently in the operating room (OR) within the first 24 hours, but LMIC surgeons more frequently reported delays due to equipment availability, treatment cost, and OR availability. Compared with their UMIC counterparts, LMIC surgeons less frequently confirmed tetanus vaccination status and more frequently used extended courses of postoperative antibiotics. LMIC surgeons reported lower rates of using internal fixation, particularly for high-grade and late-presenting fractures.</p><p><strong>Conclusions: </strong>This study describes management characteristics of open tibial shaft fractures in sub-Saharan Africa. Notably, there were reported differences in wound management, antibiotic administration, and fracture stabilization between LMICs and UMICs. These findings suggest opportunities for standardization where evidence is available and further research where it is lacking.</p><p><strong>Level of evidence: </strong>VI-Cross-Sectional Study.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e228"},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/5b/otai-6-e228.PMC10005832.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9179485","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":"Anteroinferior plating is an independent factor for decreasing symptomatic implant removal rates after plate fixation for midshaft clavicle fractures.","authors":"Akane Ariga,&nbsp;Haruhiko Shimura,&nbsp;Koji Fujita,&nbsp;Akimoto Nimura","doi":"10.1097/OI9.0000000000000253","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000253","url":null,"abstract":"<p><strong>Objectives: </strong>The factors that significantly influence the symptomatic implant removal rates after plate fixation for midshaft clavicle fractures remain controversial. The purpose of this study was to compare the symptomatic implant removal rates between 2 different types of plating technique and to evaluate independently associated factors.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Acute care center.</p><p><strong>Patients/participants: </strong>A total of 71 patients 16 years or older who were diagnosed with displaced midshaft clavicle fractures from April 2016 to March 2020.</p><p><strong>Intervention: </strong>Thirty-nine patients were treated with superior plating (Group SP), and the remaining 32 patients were treated with anteroinferior plating (Group AIP).</p><p><strong>Main outcome measurements: </strong>Symptomatic implant removal rates after plate fixation for midshaft clavicle fractures.</p><p><strong>Results: </strong>Symptomatic implant removal rates were significantly lower in Group AIP (28.1%) than in Group SP (53.8%) (<i>P</i> = 0.033). Multivariate analyses showed that symptomatic implant removal rates were significantly decreased by three independent factors, namely AIP (odds ratio [OR] = 0.323) (<i>P</i> = 0.037), greater age (45 years or older) (OR = 0.312) (<i>P</i> = 0.029), and high body mass index (≥25 kg/m²) (OR = 0.117) (<i>P</i> = 0.034).</p><p><strong>Conclusions: </strong>AIP significantly and independently decreased the symptomatic implant removal rate. Among the three explanatory factors showing significant difference, plating technique is the only factor that can be altered by medical institutions. Therefore, we recommend this technique for displaced midshaft clavicle fractures to reduce a second surgery such as symptomatic implant removal.</p><p><strong>Level of evidence: </strong>Level 3, retrospective cohort study.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 1","pages":"e253"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/13/oi9-6-e253.PMC9953037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10783337","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":"Medial and lateral dual plating of native distal femur fractures: a systematic literature review.","authors":"Dillon C O'Neill,&nbsp;Anne J Hakim,&nbsp;Graham J DeKeyser,&nbsp;Lillia N Steffenson,&nbsp;Carsten W Schlickewei,&nbsp;Lucas S Marchand,&nbsp;Alexej Barg,&nbsp;Justin M Haller","doi":"10.1097/OI9.0000000000000227","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000227","url":null,"abstract":"<p><strong>Introduction: </strong>Lateral locked plating (LLP) development has improved outcomes for distal femur fractures. However, there is still a modest rate of nonunion in fractures treated with LLP alone, with higher nonunion risk in high-energy fractures, intra-articular involvement, poor bone quality, severe comminution, or bone loss. Several recent studies have demonstrated both the safety and the biomechanical advantage of dual medial and lateral plating (DP). The purpose of this study was to evaluate the clinical outcomes of DP for native distal femoral fractures by performing a systematic review of the literature.</p><p><strong>Methods: </strong>Studies reporting clinical outcomes for DP of native distal femur fractures were identified and systematically reviewed. Publications without full-text manuscripts, those solely involving periprosthetic fractures, or fractures other than distal femur fractures were excluded. Fracture type, mean follow-up, open versus closed fracture, number of bone grafting procedures, nonunion, reoperation rates, and complication data were collected. Methodologic study quality was assessed using the Coleman methodology score.</p><p><strong>Results: </strong>The initial electronic review and reverse inclusion protocol identified 1484 publications. After removal of duplicates and abstract review to exclude studies that did not discuss clinical treatment of femur fractures with dual plating, 101 potential manuscripts were identified and manually reviewed. After final review, 12 studies were included in this study. There were 199 fractures with average follow-up time of 13.72 months. Unplanned reoperations and nonunion occurred in 19 (8.5%) and 9 (4.5%) cases, respectively. The most frequently reported complications were superficial infection (n = 6, 3%) and deep infection (n = 5, 2.5%) postoperatively. Other complications included delayed union (n = 6, 3%) not requiring additional surgical treatment and knee stiffness in four patients (2%) necessitating manipulation under anesthesia or lysis of adhesions. The average Coleman score was 50.5 (range 13.5-72), suggesting that included studies were of moderate-to-poor quality.</p><p><strong>Conclusions: </strong>Clinical research interest in DP of distal femoral fractures has markedly increased in the past few decades. The current data suggest that DP of native distal femoral fractures is associated with favorable nonunion and reoperation rates compared with previously published rates associated with LLP alone. In the current review, DP of distal femoral fractures was associated with acceptable rates of complications and generally good functional outcomes. More high-quality, directly comparable research is necessary to validate the conclusions of this review.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 1","pages":"e227"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/7d/otai-6-e227.PMC9904193.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10684894","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":"Periprosthetic fracture management of the proximal femur.","authors":"Luis G Padilla-Rojas,&nbsp;Dario E Garín-Zertuche,&nbsp;Leonardo López-Almejo,&nbsp;Germán Garabano,&nbsp;César Ángel Pesciallo,&nbsp;Jaime A Leal,&nbsp;Andrés Pinzón,&nbsp;Vincenzo Giordano,&nbsp;Robinson Esteves-Pires","doi":"10.1097/OI9.0000000000000246","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000246","url":null,"abstract":"<p><p>The most common periprosthetic fractures occur around the hip. The most widely used classification is the Vancouver classification, and management requires careful planning and skill in both arthroplasty and fracture surgery. This article presents an overview of the diagnosis, classification, and management of periprosthetic fractures of the proximal femur. This work represents a summary review from Latin American Society Members of the International Orthopaedic Trauma Association.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 1 Suppl","pages":"e246"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/54/oi9-6-e246.PMC10064640.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9233848","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":"How resources affect management of periprosthetic fractures of the distal femur: perspectives from Israel, South Sudan, and South Africa.","authors":"Brian P Bernstein,&nbsp;Gurion Rivkin,&nbsp;Yoram A Weil,&nbsp;Alexander Greenberg,&nbsp;Brian B Madison,&nbsp;Mapour M Areu,&nbsp;Omojowk B Joda,&nbsp;Kirsty Leigh Berry,&nbsp;Marc Nortje","doi":"10.1097/OI9.0000000000000238","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000238","url":null,"abstract":"<p><p>Periprosthetic fractures of the distal femur have significant morbidity in both total hip and total knee arthroplasty (THA and TKA, respectively). The incidence of these fractures is growing, with the predominant mechanism of injury being a fall from a standing height and therefore considered fragility fractures. In many countries, improved public funding and a flourishing private health care sector, when coupled with increased life expectancy, translates to more older patients receiving both TKA and THA and therefore an increased prevalence of periprosthetic fractures and their associated complications. These fractures may occur below a long stem THA, above a TKA, or between the two (so-called \"interprosthetic fracture\"). We will outline fracture classification, risk factors, diagnosis, and treatment options, highlighting perspectives on treating these fractures in Israel, South Africa, and South Sudan. These countries represent differing access to resources, varied comorbidity factors, and differing health care systems. The points of difference and the points of similarity will be considered.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 1 Suppl","pages":"e238"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/30/oi9-6-e238.PMC10064638.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9240359","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":"Managing periprosthetic tibia fractures: International perspectives.","authors":"Daniel P Lewis,&nbsp;Seth M Tarrant,&nbsp;Stuart MacKenzie,&nbsp;Lachlan Cornford,&nbsp;Toru Sato,&nbsp;Naofumi Shiota,&nbsp;Zsolt J Balogh","doi":"10.1097/OI9.0000000000000241","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000241","url":null,"abstract":"<p><p>Knee arthroplasty, both total knee and unicompartmental, has had a significant impact on millions of patients globally. Although satisfaction is usually high, complications such as periprosthetic fracture are increasingly common. Distal femur periprosthetic fractures are relatively well researched and understood in comparison with periprosthetic proximal tibia fractures (PTFs). The management of PTFs is essentially an evidence-free area. This review explores the literature (or lack thereof) and integrates cases from Australia and Japan. As it stands, there is scant literature relating to all facets of PTFs, including, most concerningly, the management of them. Larger studies are required to help further investigate this important interface between arthroplasty and orthopaedic trauma. As a guide, those with loose prostheses will likely benefit most from revision total knee arthroplasty, while those with well-fixed prostheses can be managad according to the fracture with homage paid to the presence of the prosthesis. The use of periarticular locked plates is likely a better option over conventional large or small fragment plates. Nonoperative management is a viable option for selected individuals and can be associated with favorable outcomes.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 1 Suppl","pages":"e241"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/2f/oi9-6-e241.PMC10064641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9240360","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":"Periprosthetic fracture management: global approaches","authors":"T. Miclau","doi":"10.1097/oi9.0000000000000260","DOIUrl":"https://doi.org/10.1097/oi9.0000000000000260","url":null,"abstract":"Abstract The incidence of periprosthetic fractures (PPFs) continues to increase worldwide. The goal of management is to restore mobility early while minimizing potential treatment complications. The general medical frailty of patients sustaining PPFs complicates the management of these conditions, with many of those affected being highly susceptible to the consequences of impaired mobilization. Outcomes depend on patient-related (eg, age, physiological condition, medical comorbidities, quality of bone, presence of osteolysis, previous procedures, sex) and surgeon-related (eg, diagnosis, choice of procedure, selected implant, and surgical technique) factors, and preventative measures to decrease the risk of PPFs should be pursued whenever possible. The articles in this supplement address the treatment of the most commonly encountered PPFs, specifically those in the proximal humerus, acetabulum, proximal femur, distal femur, and proximal tibia. This work represents a collaborative effort of the member societies of the International Orthopaedic Trauma Association, an international association of orthopaedic organizations dedicated to the promotion of musculoskeletal trauma care through advancements in patient care, research, and education. The expectation is that the information provided in this supplement will improve the care of patients with PPFs.","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48892237","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}