Journal of medicine最新文献

{"title":"Clinical Characteristics of Deceased with COVID-19 Infection: Data from the Largest COVID-19 Dedicated Hospital in Bangladesh","authors":"M. Hoque, Reaz Mahmud, P. K. Datta, E. Khan, S. Biswas, Kamolesh Chandra Basu, M. M. Khan, Muhammad Faizur Rahman, Md. Uzzwal Mallik, M. Adnan, Imran Mahmud, Md. Arman Hossain, Nazia Binte Ali, Md Khairul Islam, Md. Titu Miah, Md. Mujibur Rahman","doi":"10.3329/jom.v24i1.64901","DOIUrl":"https://doi.org/10.3329/jom.v24i1.64901","url":null,"abstract":"The death toll of the coronavirus disease 2019 (COVID-19) has been considerable. Several risk factors have been linked to mortality due to COVID-19 in hospitals. This study aimed to describe the clinical characteristics of patients who either died from COVID-19 at Dhaka Medical College Hospital in Bangladesh. In this retrospective study, we reviewed the hospital records of patients who died or recovered and tested positive for COVID-19 from May 3 to August 31, 2020. All patients who died during the study period were included in the analysis. A comparison group of patients who survived COVID-19 at the same hospital during the same period was systematically sampled. All available information was retrieved from the records, including demographic, clinical, and laboratory variables. Of the 3115 patients with confirmed COVID-19 during the study period, 282 died. The mean age of patients who died was higher than that of those who survived (56.7 vs 52.6 years). Approximately three-fourths of deceased patients were male. History of smoking (risk ratio 2.3; 95% confidence interval: 1.6–3.4), comorbidities (risk ratio: 1.5; 95% confidence interal:1.1–2.1), chronic kidney disease (risk ratio: 3.2; 95% confidence interval: 1.7–6.25), and ischemic heart disease (risk ratio:1.8; 95% confidence interval: 1.1–2.9) were higher among the deceased than among those who survived. Mean C-reactive protein and D-dimer levels [mean (interquartile range), 34 (21–56) vs. 24 (12–48); and D-dimer [1.43 (1–2.4) vs. 0.8 (0.44–1.55)] were higher among those who died than among those who recovered. Older age, male sex, rural residence, history of smoking, and chronic kidney disease were found to be important predictors of mortality. Early hospitalization should be considered for patients with COVID-19 who are older, male, and have chronic kidney disease. Rapid referral to tertiary care facilities is necessary for high-risk patients in rural settings\u0000J MEDICINE 2023; 24: 28-36","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45263568","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":"Impact of Low-Level Knowledge on Breast Cancer in Bangladeshi Patients during Medical Help Seeking","authors":"K. Akhtar, S. Nahar, K. Akhtar","doi":"10.3329/jom.v24i1.64900","DOIUrl":"https://doi.org/10.3329/jom.v24i1.64900","url":null,"abstract":"Overall, knowledge on breast cancer acts as a decision maker for medical help seeking during disease diagnosis and treatment. With this study we determined the impact of knowledge on breast cancer and related causes. A cross sectional study was conducted among newly diagnosed breast cancer patients National Institute of Cancer Research and Hospital, Dhaka from July 2017-June 2018. Face to face interview was taken by pretested semi structured questionnaire asking every breast cancer woman regarding knowledge and practice on sign-symptom, Breast-Self-Examination and mammography. After symptom identification first consultation to health care provider was a critical point and homeopathy was the major mean of first consultation. Breast cancer patients did not know the symptoms might cause cancer and as well negligence also play a role in help seeking. Improved knowledge can increase awareness as well influence practice on Breast-Self-Examination. To overcome this problem massive program is needed for early diagnosis and treatment.\u0000J MEDICINE 2023; 24: 23-27","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47567689","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":"First Dominant Circulation of Influenza A/H3 among Patients with Acute Respiratory Tract Infections in a Tertiary Care Hospital in Dhaka 2022","authors":"Mizanur Rahman, K. Ayaz, S. Islam, Nazmul Hasan, R. Rahim, A. Hasan","doi":"10.3329/jom.v24i1.64902","DOIUrl":"https://doi.org/10.3329/jom.v24i1.64902","url":null,"abstract":"The seasonal circulation of influenza viruses varies from year to year. We have retrospectively analyzed our hospital data of respiratory pathogens among patients of respiratory tract infections and extracted circulation of influenza viruses and characterized patients with influenza attended to a tertiary care hospital in Dhaka from July 2021 to September 2022. We have analyzed data of real-time reverse transcription polymerase chain reaction testing of respiratory panel done in QIAstatDx (Qiagen, Germany) using nasopharyngeal samples to identify the presence of influenza viruses and to determine the subtypes. A total of 547 patient’s data were analyzed in this study, with an influenza positivity rate of 15.62% in 2021 and 23.63% in 2022. We identified an exclusive circulation of influenza A/H3 viruses in 2022 while cocirculation of Influenza A (H1N1 pdm 09 – 10.15%, H3– 2.34%, A not subtyped – 2.34%) and influenza B (0.78%) was observed in 2021 in our cohort. Further, subtyping data showed that both Influenza A/H1N1 pdm09 and Influenza A/H3 was equally observed in influenza like illness (ILI) and severe acute respiratory infection (SARI) patients. This small study in our cohort warrants further elaborate investigation to know circulating influenza A subtyping in the country which may assist health care providers in making treatment decisions and hence, appropriate patient management.\u0000J MEDICINE 2023; 24: 37-42","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47055760","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":"Role of Initial and Follow-up LDH Titer in COVID-19 Pneumonia: A Single Center Experience of 2000 Cases in Tertiary Care Setting in India","authors":"S. Patil, Shubhangi Khule, Deepak Patil","doi":"10.3329/jom.v24i1.64898","DOIUrl":"https://doi.org/10.3329/jom.v24i1.64898","url":null,"abstract":"Introduction: Robust data of LDH (Lactate dehydrogenase) is available in bacterial infection, and it can be utilized in this COVID-19 Pneumonia pandemic for initial assessment, planning of treatment in indoor setting in association with HRCT severity.\u0000Methods: Prospective, observational, 12 weeks follow up study, included 2000 COVID-19cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, LDH at entry point and follow up. Age, gender, comorbidity and BIPAP/NIV use and outcome as with or without lung fibrosis as per CT severity. Statistical analysis is done by Chi square test.\u0000Results: HRCT severity score at entry point has significant correlation with LDH titer [p<0.00001] LDH titer has significant association with duration of illness (Doi) [p<0.00001] Comorbidities has significant association with LDH titer. [p<0.00001] LDH titer has significant association with oxygen saturation [p<0.00001] BIPAP/NIV requirement during hospitalization has significant association with LDH titer. [p<0.00001] Timing of BIPAP/NIV requirement has significant association with LDH titer. [p<0.00001] Follow-up LDH titer during hospitalization as compared to entry point (initial) normal and abnormal LDH has significant association in post-covid lung fibrosis [p<0.00001]\u0000Conclusion: LDH is easily available, and universally acceptable inflammatory marker in COVID-19 pandemic and documented very crucial role in covid-19 pneumonia in predicting severity of illness, assessing response to treatment and analyzing outcome during hospitalization.\u0000J MEDICINE 2023; 24: 10-17","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46056530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Suspicious Skin Lesion: Sufferings of A Remittance Warrior","authors":"Ishrat Binte Reza, H. Ahasan, S. K. Prince","doi":"10.3329/jom.v24i1.64908","DOIUrl":"https://doi.org/10.3329/jom.v24i1.64908","url":null,"abstract":"Tuberculosis verrucosa cutis (TVC) is a rare form of cutaneous tuberculosis. it is usually found as a solitary lesion but Extensive multifocal presentation is very rare. Here, we report this case of extensive, multifocal tuberculosis verrucosa cutis in a 36-year-old immunocompetent male patient in the absence of any primary tubercular focus.\u0000J MEDICINE 2023; 24: 67-68","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45285719","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":"Behçet’s Disease - A Rare Form of Small Vessel Vasculitis","authors":"Miah Mr, Afsana L, Akter S, B. S, Kabir Ma, Chowdhury Mfi, A. M, Y. M, Babu Nh","doi":"10.3329/jom.v24i1.64905","DOIUrl":"https://doi.org/10.3329/jom.v24i1.64905","url":null,"abstract":"Behçet’s disease is a rare vasculitis of unknown aetiology though there is a strong genetic association with HLA-B51 characteristically targets small arteries and venules. Multiple deep oral ulcer and genital ulcer is a common presentation. Ocular involvement is also commonly occurs in the form of anterior or posterior uveitis or retinal vasculitis. Neurological manifestation occurs in the form of brainstem or pyramidal tract symptom. Thrombosis can occur but renal involvement is unlikely. Our patient Mrs X, 47 year old has been suffering from recurrent episode of oral ulcer, genital ulcer, redness of eye and dysphagia for the last 12 years. T here was relapse and remission of the symptoms. Her Ophthalmoscopic examination was normal. Upper GI endoscopy revealed multiple esophageal ulcers. ANA, Anti CCP, cANCA, pANCA, HSV 1&2- IgM, CMV- IgM, TPHA, Anti -HIV 1&2 were negative. She was treated with oral steroid and azathioprine and all the lesions resolved completely.\u0000J MEDICINE 2023; 24: 56-58","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45628119","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":"Frequency of Osteoporosis in Post-Menopausal Diabetic Women attending Physical Medicine and Rehabilitation Department of a Tertiary Care Hospital","authors":"L. C. Gomes, Md Khairul Islam, M. M. Hossain, A. Salek","doi":"10.3329/jom.v23i2.60630","DOIUrl":"https://doi.org/10.3329/jom.v23i2.60630","url":null,"abstract":"Introduction: Osteoporosis is a silent disaster among postmenopausal women worldwide and carries the highest contribution to morbidity and mortality, especially with concomitant Diabetes Mellitus.\u0000Materials and Methods: This was a cross-sectional observational study conducted to evaluate Osteoporosis in postmenopausal women having diabetes mellitus attending outdoor in the department of Physical Medicine & Rehabilitation, BSMMU. The study was conducted from July 2020 to June 2021. A total of 54 patients were included in the study.\u0000Results: Osteoporosis of the lumbar spine and femoral neck were present among 72.2% and 55.6% of respondents. Osteoporosis of at least one site was present among 83.3% of respondents. Statistically, a significant relationship was found between osteoporosis and co morbidity, BMI, age of onset of menstruation, age of onset of menopause, and duration of menopause (p=0.025, 0.01, 0.049, 0.043, and 0.032 respectively).\u0000Conclusion: This study showed postmenopausal women are susceptible to Osteoporosis.\u0000J MEDICINE 2022; 23: 132-138","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47937701","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":"Serial CRP (C-reactive protein) Monitoring in COVID-19 Pneumonia for the Assessment of Severity, Ventilatory Support Requirement and Predicting Early Lung Fibrosis","authors":"S. Patil, G. Gondhali, Abhijit Acharya","doi":"10.3329/jom.v23i2.60627","DOIUrl":"https://doi.org/10.3329/jom.v23i2.60627","url":null,"abstract":"Introduction: Robust data of CRP is available in bacterial infection, and now it can be utilized in Covid- 19 pneumonia pandemic initial assessment of severity and planning of treatment.\u0000Materials and Methods: Multicentric, prospective, observational and interventional study conducted during July 2020 to May 2021 included 1000 Covid-19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker as CRP at entry point and follow up. Age, gender, Comorbidity and use BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis is done by using Chi square test.\u0000Observations and analysis: Age (<50 and >50 years) and gender (male versus female) has significant association with CRP in predicting severity [p<0.00001] & [p<0.010] respectively. CT severity score at entry point with CRP level has significant correlation [p<0.00001] CRP level has significant association with duration of illness (Doi) [p<0.00001] Comorbidities has significant association with CRP level. [p<0.00001] CRP level has significant association with oxygen saturation [p<0.00001] BIPAP/NIV requirement during hospitalization has significant association with CRP level. [p<0.00001] Timing of BIPAP/NIV requirement has significant association with CRP level. [p<0.00001] Follow-up CRP titer during hospitalization as compared to entry point normal and abnormal CRP has significant association in post-covid lung fibrosis [p<0.00001]\u0000Conclusion: CRP is easily available and universally acceptable inflammatory marker in Covid-19 pandemic and ‘serial titer’ documented very crucial role in predicting severity of illness, need of ventilatory support and help in predicting post-covid lung fibrosis.\u0000J MEDICINE 2022; 23: 112-120","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46796220","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":"Histopathological Patterns of Lung Cancer along with Clinico-Radiological Correlation in a Tertiary Care Hospital in Bangladesh","authors":"R. Chakrabortty, Dibanur Rashid Siddiqua, S. Paul, S. Rahman, S. Biswas","doi":"10.3329/jom.v23i2.60629","DOIUrl":"https://doi.org/10.3329/jom.v23i2.60629","url":null,"abstract":"Background: Lung cancer is the most common fatal neoplastic disease and the leading cause of cancerrelated deaths worldwide. In Bangladesh, lung cancer has been on the rise, possibly due to an increase in smoking and air pollution. So, it is essential to understand the natural history of this disease. Aim: This study aimed to find out the correlation between Clinico-radiological profiles with histopathological patterns of lung cancer in Bangladesh.\u0000Material and Methods: A total of 100 confirmed cases of lung cancer were included in this crosssectional observational study between January 1, 2021, to December 31, 2021. The complete sociodemographic characteristics, smoking status, previous history of COPD, details of radiological imaging findings, pathological characteristics of the tumor, and the performance status of patients were recorded in this study. Data were entered and analyzed using SPSS software.\u0000Results: A total of 100 (86 male, and 14 female) confirmed lung cancer patients were included in our study with a mean ± SD age of 59.57±10.41 years. Cough (87%), breathlessness (61%), and chest pain (58%) were the most common symptom and mass lesions (83%) followed by collapse (8%) was the most common radiological presentation. Among the histopathological types adenocarcinoma (48%) was the most common type followed by squamous cell carcinoma (35%). Correlation showed that mass lesion was the most common radiological finding in both adenocarcinoma and squamous cell carcinoma. ECOG performance status 2, and status 3 were about 36% and 35% respectively. Multivariate logistic regression analysis shows male gender with COPD independently had a 1.681-fold risk of developing lung cancer.\u0000Conclusion: The Clinico-histopathological pattern of lung cancer has changed recently. The incidence of adenocarcinoma is increasing, and becoming the most common cause in both smokers and non-smokers.\u0000J MEDICINE 2022; 23: 126-131","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46714794","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":"Status of Vitamin D among Patients Admitted with Acute Exacerbation of COPD in Cox’s Bazar Medical College Hospital","authors":"Ummay Fatema Khatun, Ayesha Zerin, U. K. Barua","doi":"10.3329/jom.v23i2.60628","DOIUrl":"https://doi.org/10.3329/jom.v23i2.60628","url":null,"abstract":"Background: Acute exacerbations of COPD (AECOPD) are common and strongly affect disease severity and relative healthcare costs. Vitamin D deficiency is frequent among COPD patients and its role in disease exacerbations is widely debated.\u0000Method: This study was carried out in the medicine department of Cox’s Bazar medical college. A total of 50 patients admitted with AECOPD were selected consecutively who had given consent and agreed to carry out 25 (OH) D level assays during the period from January 2021 to December 2021. Inclusion criteria were patients with confirmed cases of COPD. At the enrolment visit, patients were subjected to full clinical history and examination, and pulmonary function testing. Vitamin D [25 hydroxyvitamin D, 25(OH) D] assay was done by Automated Immunoassay Analyzer Model “MINI-VIDAS” using Biomerieux reagent in ELFA (Enzyme linked fluorescence assay) Technology. Vitamin D deficiency was defined as 25(OH) D <=20ng/ml, Vitamin D insufficiency was recognized as 21-29 ng/ml and Vitamin D level >30 ng/ ml was recognized as sufficient.\u0000Results: Among 50 patients 38 were males and 12 were females. The mean age of patients in this study was 72.2±13.8 years. The mean 25(OH) D level was 22.026±6.0519 ng/ml (95%CI 8.1-40.2). The mean level of vitamin D in males was (22.06±6.08 ng/ml) and in females (21.93±6.24ng/ml) (P= 0.948). Associated comorbidities are present in 54% of patients, among which Hypertension (HTN) contributes in 26%, Diabetes Mellitus (DM) in 18%, coronary artery disease (CAD) in 8%, and cerebrovascular disease (CVD) in 2%. The majority of the participants were former smokers (60%), and the mean pack-year of smoking was 22.09±6.14. In this study, vitamin D levels did not differ among various smoking groups. It was 21.9±8.1 ng/ml in non-smokers, 21.4±5.1 ng/ml in current smokers, and 22.3±6.1 ng/ml in ex-smokers groups (P= 0.904). 56% of the patients belong to low socioeconomic conditions in this study, and 42% were from lower-middle-class families. Most of the patients (86%) were from rural areas, followed by 10% from urban areas and 2% from slum areas. Regarding vocational status, 70% were retired, 10% were housemakers, farmers 6%, and the rest were service holders or business people with mean vitamin D levels of 22.2±5.9 ng/ml, 20.1±8.6 ng/ml, 24.3±2.8 ng/ml and 21.4±6.5 ng/ml respectively. The majority (44%) of patients had mMRC Grade -2 dyspnea, followed by 40% in Grade- 1, 10% in Grade-3, and only 6% of patients had Grade- 4 dyspnea. In the study, only 12% of the patients had sufficient levels of serum vitamin D. The majority had an insufficient level of serum vitamin D (52%) and 36% had a deficient level of serum vitamin D.\u0000Conclusion: This study finds a high prevalence of hypovitaminosis D (88%) in AECOPD patients. Vitamin D deficiency and insufficiency are more prevalent in females. In this study, vitamin D levels did not differ between smoking groups.\u0000J MEDICINE 2022; 23: 121-125","PeriodicalId":76013,"journal":{"name":"Journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42084318","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}