African Journal of Paediatric Surgery最新文献

{"title":"Absorbable Mesh Splenorrhaphy in an Adolescent with Blunt Splenic Rupture: A Case Report and Narrative Review.","authors":"Christelle Sophie Destinval, Jean-Louis Lemelle","doi":"10.67481/ajps.v23i1.345","DOIUrl":"10.67481/ajps.v23i1.345","url":null,"abstract":"<p><p>Operative management of blunt splenic trauma is rare in the paediatric population. Splenorrhaphy, with or without absorbable mesh, is a surgical procedure rarely used, although it preserves splenic function and has good outcomes. A 12-year-old girl accidentally fell from a height onto an iron bar. She complained of abdominal pain and difficulty breathing. Physical examination showed abdominal guarding and tenderness. Abdominal ultrasound demonstrated haemoperitoneum and splenic lacerations, confirmed by a CT scan, which highlighted active splenic bleeding. As she became haemodynamically unstable despite saline administration, we performed an absorbable mesh splenorrhaphy. She also received a blood transfusion. Surgical outcomes were good. She was discharged home on postoperative day 12. At a two-year follow-up, she is doing well. Absorbable mesh splenorrhaphy is an effective surgical procedure in children with haemodynamically unstable splenic trauma. Few paediatric cases are reported in the literature despite its ease of performance, its advantage of preserving spleen function, and its good outcomes.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"23 1","pages":"64-67"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036072","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":"Rare Cause of Infantile Respiratory Distress: A Case Report of Lobar Hyperinflation in a Kenyan Neonate.","authors":"Anne Irungu, Mark Nelson Awori, Ismail Ahmed","doi":"10.67481/ajps.v22i3.1265","DOIUrl":"https://doi.org/10.67481/ajps.v22i3.1265","url":null,"abstract":"<p><p>Congenital lobar emphysema is a rare non‑vascular lung malformation with an incidence of 1:20,000-1:30,000 live births. It presents as respiratory distress in the neonatal period and associated imaging findings of lobar hyperinflation. We report on a case from our institution to enhance diagnosis of this rare disorder. A 3‑week‑old male with acute respiratory distress, hypoxia, reduced unilateral breath sounds and pneumonia whose diagnosis was missed on the initial chest radiograph. Current foetal ultrasonography should be able to detect these cases, but they are missed and present with respiratory distress which may be due to infection or the primary disorder. Delay in diagnosis and treatment is associated with mortality from infection and the effects of compression of mediastinal structures. Surgery for symptomatic cases is preferred with good outcomes. Conservative management has been reported in asymptomatic cases, but the risk of missing a malignancy and not confirming the diagnosis by histology, especially for post‑natal diagnosed lesions remains.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"161-163"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954837","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":"Comparison between Fixed Tourniquet Inflation Pressure and Limb Occlusion Pressure in Children Undergoing Corrective Osteotomy for Blount's Disease.","authors":"Obinna C Imo, Olatunji O Babalola, Emeka B Izuagba, Anthony Ifeanyi Ugezu, Chukwuemeka Chibuzom","doi":"10.67481/ajps.v22i3.1258","DOIUrl":"10.67481/ajps.v22i3.1258","url":null,"abstract":"<p><strong>Background: </strong>A tourniquet is commonly used to achieve a clear operative field during corrective osteotomies for Blount's disease in children. Excessive tourniquet pressures may, however, lead to complications that may threaten the child's limb, causing avoidable morbidity. Determining the minimum effective cuff pressure required to achieve a bloodless field without causing any harm to the child's limb becomes essential to good surgical practice.</p><p><strong>Objectives: </strong>To compare the effectiveness of and the complications arising from the tourniquet between fixed inflation pressure (FIP) and pressure determined by limb occlusion pressure (LOP) in children undergoing corrective osteotomy for Blount's disease.</p><p><strong>Materials and methods: </strong>Fifty lower limbs of 50 children aged 5-17 years who were undergoing corrective osteotomy for Blount's disease were randomised into two groups (A and B) of 25 each. Group A is the LOP, whereas Group B is the FIP group. The tourniquet pressure, quality of the clear operative field, local tourniquet complications of pain, skin damage and nerve palsy were compared between the groups. Tourniquet pressure, effectiveness, complications, corrective osteotomy and Blount's disease between the groups. Data were analysed using IBM SPSS statistic version 23.</p><p><strong>Results: </strong>The mean age of the population was 7.2 years. There was a significant mean decrease of pressure of 82 mmHg in Group A compared to Group B. Both groups had similar quality of the bloodless field; however, there were significantly less complications in Group A.</p><p><strong>Conclusions: </strong>LOP method performs better than the fixed pressure method. It achieves a comparable bloodless field while having a better safety profile.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"132-137"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954798","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":"Appendiceal Abnormalities Associated with Congenital Pouch Colon.","authors":"Amit Gupta, M Aditya, Sahaj Prajapati, Partap Singh Yadav, Subhasis Roy Choudhury, Rajiv Chadha","doi":"10.67481/ajps.v22i3.1261","DOIUrl":"https://doi.org/10.67481/ajps.v22i3.1261","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective cohort study aims to identify the incidence and type of appendiceal abnormalities in the various subtypes of congenital pouch colon (CPC) associated with anorectal malformation. The possible embryopathogenesis of appendiceal abnormalities in CPC is also discussed.</p><p><strong>Methods: </strong>The case records of 74 patients of CPC, managed from 1998 to 2022, were studied, and the subtype of CPC, details regarding the vermiform appendix (presence/absence, number, morphology and location) and other relevant findings were noted.</p><p><strong>Results: </strong>The CPC subtypes were Type I (n = 12), Type II (n = 41), Type III (n = 11) and Type IV (n = 10). Overall, 26 patients had a single, normal appendix, 12 patients a short, stubby appendix and 17 appendiceal duplication (Type A2 [n = 9], Type B1 [n = 3] and Type C [n = 5]). Type I CPC cases had appendicular agenesis. A short stubby appendix (26.8%) or Type A2/B1/C appendicular duplication (31.3%) was frequent in Type II CPC and Type C duplication in Type III CPC. Type IV CPC patients had a single, normal appendix. In 10 (24.4%) patients with Type II CPC, the caecum and normal proximal colon appeared dilated.</p><p><strong>Conclusions: </strong>Appendiceal abnormalities are frequent in Type I-III CPC and may result from the abnormal development and dilatation, along with shortening, of a varying length of colon. As in other reports of appendiceal duplication associated with major intestinal, genitourinary or vertebral malformations, appendiceal duplication in patients with CPC was of the Type A2/B1/C subtypes.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954764","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":"Constipation Faecolith as a Cause for Paediatric Appendicitis - A Retrospective Review from Rural Tertiary Care Centre.","authors":"Vipan Kumar, Pranesh R Madhan, Nidhi Kumari, Shashi Bhushan Pandey, Dhiraj Parihar, Sanjeev Sing","doi":"10.67481/ajps.v22i3.1256","DOIUrl":"https://doi.org/10.67481/ajps.v22i3.1256","url":null,"abstract":"<p><strong>Background: </strong>Occlusion of the appendiceal lumen by faecolith results in appendicitis and its sequelae, including perforation and gangrenous alterations. A faecolith is believed to be the outcome of constipation. This study assessed the association between constipation faecolith, the occurrence of acute appendicitis and its complications.</p><p><strong>Methodology: </strong>This study examined the patients in the paediatric surgery department between the ages of 2 and 14 years who were diagnosed with acute appendicitis between January 2022 and January 2024. The study included 79 patients in total. The collected data were analysed using the SPSS software (IBM SPSS 25.0, Chicago, IL, USA.). AChi‑square test was used to find the association between the categorical variables. P < 0.05 was considered statistically significant with a 95% of confidence interval.</p><p><strong>Results: </strong>A total of 79 patients were admitted during the study period. In that male‑to‑female ratio was 2.3/1. In the present study, 34% (27/79) of patients had a history of constipation, of which 22.8% (18/79) were found to have faecolith in the appendiceal lumen intraoperatively. There was a statistically significant (P < 0.001) association between the history of constipation among patients with appendicitis, appendicitis with faecolith and appendicitis with complications. Patients with a history of constipation had an operational finding of faecolith in the appendiceal lumen that was statistically significant (P < 0.001).</p><p><strong>Conclusion: </strong>This retrospective study showed that one of the new risk factors for the development of faecolith, which leads to acute appendicitis and its sequelae, is constipation, which may be due to poor diet habits among children. Therefore, when it comes to planning surgery and post‑operative management, the presence of constipation histories and faecolith findings should be taken into consideration.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"123-126"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954804","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":"Enemata: The Enigma of Rent Rectums in Children Presenting to the Korle-Bu Teaching Hospital, Ghana: A Case Series.","authors":"Jessica Dei-Asamoa, Antoinette Bediako-Bowan, Clement Agyekum Nyame, Samira Abdulai, Awo Smart-Yeboah, Wilfred Kojo Asman, Victor Etwire, Hope Glover-Addy, William Appeadu-Mensah, Afua A J Hesse","doi":"10.67481/ajps.v22i3.1263","DOIUrl":"10.67481/ajps.v22i3.1263","url":null,"abstract":"<p><p>Enemata are used in children in Ghana for various reasons, including for deworming, abdominal pain and constipation. A few isolated case reports have been on enema injuries in children worldwide. We report five cases of enema injuries in children aged 3-5 years, all presenting within 2023 at a tertiary institution in Accra, Ghana. The children presented late after their injuries and some of the guardians did not readily disclose the cause of the injury. The injuries were to the anus and rectum extraperitoneally, and in two cases, extended to the proximal rectum with intraperitoneal manifestations. Children who had anal injuries had their injuries located between the 6 o'clock and 7 o'clock positions. The injuries were managed with temporary colostomies and debridement, drainage of abscesses with or without primary repair, sitz baths and antibiotics. All five patients have had reversals of their colostomies with excellent outcomes.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"153-157"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954884","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":"Comparing Clinical Examination versus Ultrasound in Detecting the Presence of Contralateral Patent Processus Vaginalis in Patients with Inguinal Hernia/Hydrocele in a Developing Country.","authors":"Abdulazeez Mustapha, John Chinda, Philip Mshelbwala","doi":"10.67481/ajps.v22i3.1255","DOIUrl":"https://doi.org/10.67481/ajps.v22i3.1255","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernias are extremely common conditions in childhood and form a large part of the general paediatric surgical practice. While most hernias are unilateral, bilateral ones are usually recorded. In patients with bilateral hernias, the hernias on the contralateral side may not be clinically detectable at the time of the herniotomy. There has been the debate about the necessity and indications for exploring the apparently normal side during herniotomy. The aim of the study was to compare objectively the sensitivity of silk glove sign and ultrasound in detecting presence of a patent processus vaginalis (PPV).</p><p><strong>Materials and methods: </strong>This is a prospective comparative study. A total of 79 patients with confirmed unilateral inguinal hernias were examined for the presence of patent contra‑lateral by checking for a positive silk‑glove sign. These patients subsequently had an ultrasound scan done on the same contralateral side by a different senior paediatric surgery resident trained in taking such scans with the supervision of a consultant radiologist (all blinded to the clinical findings). Patients who exhibited both positive clinical and ultrasound findings underwent herniotomies on the symptomatic side accompanied by contralateral exploration. Collated data were entered and analysed using the SPSS software version 27.0. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The hernias occurred more on the right - 52 (65.8%) and 25 (34.2%) on the left. A total of 53 (67.1%) had hernias, while 26 (32.9%) had hydroceles. The sensitivity, specificity and diagnostic accuracy of the silk glove sign were 100.0% respectively, for all 4 patients that were positive, while the ultrasound scan had a sensitivity of 98.7%, specificity of 100% and diagnostic accuracy of 98.7%.</p><p><strong>Conclusion: </strong>This study demonstrates that both the silk glove sign and ultrasound are equally effective in detecting the PPV in the contralateral groin of patients with unilateral inguinal hernia and hydrocele. The comparable sensitivities, specificities and diagnostic accuracies between the two methods suggest that either can be reliably used in clinical practice, depending on the availability of resources and the clinician's expertise.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954791","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":"Firearm Injuries in Children: Four‑year Experience from a Rural Tertiary Care Centre of Northern India.","authors":"Chaudhary Amit, Abdul Rahman Rafey, Muniba Alim, Umesh Kumar Gupta, Survesh Kumar Gupta","doi":"10.67481/ajps.v22i3.1260","DOIUrl":"10.67481/ajps.v22i3.1260","url":null,"abstract":"<p><strong>Background: </strong>Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing.</p><p><strong>Aim: </strong>The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India.</p><p><strong>Materials and methods: </strong>This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre‑hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed.</p><p><strong>Results: </strong>Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%).</p><p><strong>Conclusion: </strong>The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country‑made gun was the most common firearm causing injury in children.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"142-146"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954863","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":"Serum Adiponectin and Fibroscan as Non‑invasive Post‑operative Prognostic Markers for Biliary Atresia.","authors":"Majhi Sukanti, Jena Pradeep Kumar, Tripathy Prasanta Kumar, Nayak Parsuram, Sushanta Kumar Jena","doi":"10.67481/ajps.v22i3.1257","DOIUrl":"https://doi.org/10.67481/ajps.v22i3.1257","url":null,"abstract":"<p><strong>Background: </strong>Majority of patients with biliary atresia (BA), including those who undergo Kasai hepatico‑portoenterostomy, develop cirrhosis, hepatic fibrosis and eventually progress to end‑stage liver disease. Therefore, early assessment of hepatic status and fibrosis is essential. The study objective was to estimate serum adiponectin, liver function tests and to associate them with liver stiffness scores in post‑operative BA patients.</p><p><strong>Materials and methods: </strong>A total of 30children (20 post‑Kasai BA cases and 10 healthy controls) were enrolled in this prospective case-control study. Serum adiponectin was measured by enzyme‑linked immunosorbent assay, and hepatic fibrosis by transient elastography (TE) (FibroScan). The BA patients were further divided into two groups: a jaundiced group (total bilirubin [TB] ≥2 mg/dl) and a non‑jaundiced group (TB <2 mg/dl). Comparison of biomarkers was also done in these subgroups and controls by Kruskal-Wallis test.</p><p><strong>Results: </strong>Adiponectin levels were significantly higher in BA cases than controls (median and interquartile range: 27.4 and 14.7 vs. 3.65 and 3.45 mg/ml, P = 0.001). Liver stiffness values in BA patients were also markedly more than controls (9.95 and 5.45 vs. 4.60 and 4.48 kPa, P = 0.002). Furthermore, serum adiponectin and liver stiffness scores were considerably higher in cases with jaundice in comparison to non‑jaundiced cases (P = 0.013 and 0.001, respectively). Serum adiponectin revealed a positive correlation with TB (r = 0.81, P < 0.00001) and FibroScan status (r = 0.96, P < 0.00001).</p><p><strong>Conclusion: </strong>The estimation of adiponectin levels and TE can be considered to be novel non‑invasive methods to monitor post‑Kasai hepatic status in BA patients.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"127-132"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954807","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":"Sensitivity of Flush Genitogram in the Diagnosis of Disorder of Sex Development (DSD).","authors":"Lawal Barau Abdullahi, Mohammad Aminu Mohammad, Lofty-John C Anyanwu","doi":"10.67481/ajps.v22i3.1259","DOIUrl":"https://doi.org/10.67481/ajps.v22i3.1259","url":null,"abstract":"<p><strong>Background: </strong>Disorder of sex development (DSD), previously known as ambiguous genitalia are group of Individuals who have a genital appearance that does not permit gender declaration at birth. Gender assignment in children with DSD must be done as early as possible and requires close correlation between the history and physical examination, appropriate genetic and laboratory studies and imaging studies.</p><p><strong>Objective: </strong>The objective of this study is to assess the sensitivity of the flush genitogram in the evaluation of children with DSD.</p><p><strong>Materials and methods: </strong>A prospective study was done over 5 years; the flush genitogram findings of the children were compared with the laparotomy findings at mini lap.</p><p><strong>Results: </strong>Over 5 years, 39 children were evaluated using both a flush genitogram and mini laparotomy. The correct sex was identified by a flush genitogram in 18 children, with a sensitivity of 56% and a false positive in 6 children.</p><p><strong>Conclusion: </strong>The sensitivity of the flush genitogram is found to be low, other methods of assessment are necessary before gender assignment in children with DSD.</p>","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"22 3","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954815","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}