BMC Anesthesiology最新文献

{"title":"Effects of sedatives on diaphragm activity monitored by ultrasound: a systematic review and meta-analysis.","authors":"Jiaren Luo, Luhao Wang, Bilin Wei, Zhikun Huang, Huifang Zheng, Bin Gu, Fei Pei, Zenan Chang, Yang Liu, Xiangdong Guan, Xuyu Zhang, Zimeng Liu","doi":"10.1186/s12871-025-03187-8","DOIUrl":"10.1186/s12871-025-03187-8","url":null,"abstract":"<p><strong>Background: </strong>Current research lacks comprehensive evaluations on the inhibitory effects of sedatives on diaphragm activity under ultrasound monitoring. This meta-analysis aims to launch this problem by systematically analyzing the available evidence.</p><p><strong>Methods: </strong>The EMBASE, PubMed, and Web of Science databases were searched. Original studies that explored the effects of sedative agents on human diaphragm activity via ultrasound were eligible. The quality of the included studies was evaluated using the Revised Cochrane Risk-of-Bias tool for randomized trials (RoB 2) and the Newcastle-Ottawa Scale (NOS). The pooled assessment encompassed alterations in diaphragmatic motion (DM) and diaphragmatic thickening fraction (DTF). Mean difference (MD) with 95% confidence intervals (CI) were calculated. The trial sequential analysis (TSA) was performed to calculate the required information size (RIS). The strength of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Pro Guideline Development Tool (GDT). Subgroup analysis and meta-regression was conducted to explore heterogeneity. Sensitivity analysis was used to evaluate the robustness for the meta-analysis results.</p><p><strong>Results: </strong>Six randomized controlled trials and four prospective observational studies involving 727 patients were ultimately included. In the pooled analysis, DM and DTF were measured at three time points: during sedation (T1), upon awakening (T2), and at baseline (T0). Comparisons were conducted between the values at each time point, revealing mean differences (MDs) for DM of 2.54 mm (95% CI [2.01, 3.08], P < 0.00001, I<sup>2</sup> = 92%) (T0 vs. T1), - 1.14 mm (95% CI [-1.90, -0.93], P < 0.00001, I<sup>2</sup> = 95%) (T1 vs. T2), and 1.47 mm (95% CI [ 0.90, 2.05], P < 0.00001, I<sup>2</sup> = 92%) (T0 vs. T2). For DTF, the corresponding MDs were 0.11 (95% CI [0.09, 0.13], P < 0.00001, I<sup>2</sup> = 89%), - 0.06 (95% CI [- 0.08, - 0.04], P < 0.00001, I<sup>2</sup> = 88%), and 0.04 (95% CI [0.03, 0.05], P < 0.00001, I<sup>2</sup> = 71%). Subgroup analyses further demonstrated that the MDs at T0 vs. T1 for DM and DTF were 3.62 mm (95% CI [3.15, 4.10], P < 0.00001, I<sup>2</sup> = 76%) and 0.13 (95% CI [0.11, 0.14], P < 0.00001, I<sup>2</sup> = 75%), respectively, in the propofol group, compared to 1.65 mm (95% CI [1.21, 2.09], P < 0.00001, I<sup>2</sup> = 73%) (DM) and 0.09 (95% CI [0.08, 0.10], P < 0.00001, I<sup>2</sup> = 0%) (DTF) in the group receiving propofol in combination with other sedatives. Sensitivity analysis suggested high robustness of the analysis for DTF. The TSA indicated that the sample size was sufficient. And GDT showed a low but important strength of this review.</p><p><strong>Conclusion: </strong>This meta-analysis reveals that sedatives can inhibit diaphragm activity, with this negative impact persisting post-awakening. Propofol alone achieves a more pronou","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"325"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial\".","authors":"Weilong Diwu, Wenhao Tang, Ming Yan, Wenrui Ma, Huifa Xu, Qiang Sun, Yisheng Han, Yi Wang, Chen Wang, Dawei Zhang, Long Bi, Min Yang","doi":"10.1186/s12871-025-03182-z","DOIUrl":"10.1186/s12871-025-03182-z","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain is an important complication that impedes the functional recovery of the total knee arthroplasty (TKA). A variety of analgesic methods including the popliteal artery and capsule of the posterior knee block (IPACK), local infiltration analgesia (LIA) and peripheral cutaneous nerve (PCN) block have been applied via intraoperative or postoperative local injection for alleviating pain after TKA. The purpose of this study was to compare the analgesic effect and function outcome of two local anesthetic methods for reducing postoperative pain after TKA.</p><p><strong>Methods: </strong>We demonstrated the effect of these two methods on postoperative pain, need for additional analgesics, functional recovery, and pain-related secreted proteins.</p><p><strong>Results: </strong>One hundred twenty patients aged 50-75 years who underwent TKA for osteoarthritis between December 2021 to June 2024 were included in the study and divided into two groups as follows: Group A was given local anesthetic drug by IPACK combined with LIA; Group B was given the same local anesthetic drug formulation by IPACK combined with a novel PCN block. The visual analog scale (VAS) values, the need for additional analgesics and the expression of pain-related proteins in the Group B were lower than in the Group A on postoperative 6 h, 1, 2 and 3 days (P < 0.05). However, the joint ROM and early ambulation in the Group B were significantly higher than in the Group A on postoperative 1, 2 and 3 days (P < 0.05).</p><p><strong>Conclusions: </strong>Based on the present evidence, patients treated with IPACK combined with new PCN block method can effectively reduce pain after TKA compared to IPACK combined with LIA. Furthermore, this approach not only mitigates postoperative pain but also decreases the need for postoperative analgesics and enhances patient's functional recovery.</p><p><strong>Trial registration: </strong>NCT05202730, Date: 05/12/2021.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"322"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-assisted technique versus the conventional landmark location method in spinal anesthesia for cesarean delivery in parturients with class 3 obesity: a randomized controlled trial.","authors":"Ayşegül Bilge, Betül Başaran","doi":"10.1186/s12871-025-03176-x","DOIUrl":"10.1186/s12871-025-03176-x","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"305"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' anesthesia preferences for Cesarean delivery: exploring the role of personality beliefs in spinal vs. General anesthesia.","authors":"Esra Turunc, Sezgin Bilgin, Sevda Akdeniz, Ozgur Komurcu, Leman Tomak, Yasemin Burcu Ustun, Ersin Koksal, Burhan Dost","doi":"10.1186/s12871-025-03185-w","DOIUrl":"10.1186/s12871-025-03185-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the personality belief scores of patients who chose either general or spinal anesthesia during cesarean delivery (CD) and explore the relationship between personality beliefs, and anxiety levels.</p><p><strong>Methods: </strong>This prospective study included expecting mothers, aged 18-45 years, who were classified as ASA II-III, scheduled for elective CD. Anesthesia (general or spinal) was selected based on the patient's preference. Patients with emergency CD indications, contraindications to either anesthesia type, or inability to complete the evaluation scales were excluded. After collecting sociodemographic data and medical history, patients completed the Spielberger Trait Anxiety Inventory (STAI II) and Personality Belief Questionnaire Short Form (PBQ-SF). On the day of surgery, patients were asked to complete the Spielberger State Anxiety Inventory (STAI I) in the preoperative waiting room. After discharge, the collected results were analyzed and compared based on the women's anesthetic choices (general or spinal anesthesia).</p><p><strong>Results: </strong>The study included 150 patients, with 71 expressing a preference for spinal anesthesia and 79 indicating a preference for general anesthesia. The dependent, narcissistic, and borderline personality belief scores, as well as the state anxiety (STAI I) scores, were significantly higher in the spinal anesthesia group than in the general anesthesia group (dependent p = 0.003, narcissistic p = 0.013, borderline = 0.018, STAI I = 0.01). These differences had small to medium effect sizes (η² = 0.053, 0.040, 0.034, respectively). Spearman's correlation analysis revealed weak positive correlations between state anxiety (STAI I) scores and dependent (rho = 0.237, p = 0.004), narcissistic (rho = 0.287, p < 0.001), histrionic (rho = 0.300, p < 0.001), and borderline (rho = 0.231, p = 0.005) personality belief scores.A weak positive correlation was also observed between trait anxiety (STAI II) scores and dependent personality belief scores (rho = 0.193, p = 0.018).</p><p><strong>Conclusions: </strong>Women who preferred spinal anesthesia had higher scores in dependent, narcissistic, and borderline personality beliefs compared to those who preferred general anesthesia. Although weak, these personality beliefs were also associated with preoperative anxiety. Although these findings are inconclusive, they indicate that personality traits may influence anesthesia preference for CD.</p><p><strong>Trial registration: </strong>The study was registered on ClinicalTrials.gov (Identifier: NCT06795321).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"313"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of anaesthesia type with one-year mortality after surgery in elderly patients: a secondary retrospective cohort study.","authors":"Ping Jin, Fengjiao Lu, Rongzhi Zhang, Panpan Lü, Shixiong Gao","doi":"10.1186/s12871-025-03191-y","DOIUrl":"10.1186/s12871-025-03191-y","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether regional anaesthesia (RA) versus general anaesthesia (GA) is associated with the one-year postoperative mortality among the older surgical patients.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study from 2012 to 2016. Patients aged 70 years or older who underwent surgery were included, and those who underwent transplantation, burn surgery, or minor procedures were excluded. The primary exposure was anaesthesia type (RA vs. GA); the main outcome was one-year all-cause mortality, which was verified through hospital records and a national registry. Demographic, clinical, and laboratory variables were included as covariates. Multivariable-adjusted logistic regression models were used to evaluate the independent effect of anaesthesia methods on one-year mortality. Kaplan-Meier curves assessed survival rates by anaesthesia method, with log-rank tests comparing the curves.</p><p><strong>Main results: </strong>Among 16,599 older adults, 29.7% received RA. The one-year mortality rate was lower in the RA group (6.44%) than in the GA group (9.52%), yielding an adjusted odds ratio of 0.72 (95% CI, 0.63-0.82). K‒M analyses revealed improved survival in the RA group (log-rank P < 0.05). Propensity score matching and inverse probability weighting analyses corroborated these findings. The E-value of 2.12 demonstrates the robustness of the results against unmeasured confounding.</p><p><strong>Conclusions: </strong>Regional anaesthesia may be linked to better one-year survival in older patients. Although other confounding factors cannot be excluded, these findings underscore the need for multicenter, prospective investigations to inform perioperative decisions in geriatric populations.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"316"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dynamic lung compliance-guided positive end-expiratory pressure on postoperative pulmonary complications following thoracoscopic lobectomy: a randomized controlled trial.","authors":"Yihu Zhou, Zhenghuan Song, Jiaqin Cai, Shiyi Huang, Mengyue Zhu, Yueyi Jiang, Qinyu Bao, Lin Zhang, Ruyi Jin, Lianbing Gu, Jing Tan","doi":"10.1186/s12871-025-03183-y","DOIUrl":"10.1186/s12871-025-03183-y","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"306"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal outcomes among pregnant women with shunt-related congenital heart disease-associated pulmonary hypertension: a retrospective study.","authors":"Tiantian Sun, Hao Che, Jun Zhang, Yufang Lv, Yaguang Liu, Daqi Liu, Jinjing Wu, Sheng Wang, Liyun Zhao","doi":"10.1186/s12871-025-03082-2","DOIUrl":"10.1186/s12871-025-03082-2","url":null,"abstract":"<p><strong>Background: </strong>Studies on pregnant women with shunt-related congenital heart disease (CHD)-associated pulmonary hypertension (PH) are scarce and limited by small sample sizes. This study aimed to describe the outcomes of pregnant women.</p><p><strong>Methods: </strong>Outcomes of pregnant women with shunt-related CHD-associated PH were retrospectively evaluated from 2010 to 2020. PH was diagnosed based on echocardiography. The incidence of maternal death and postoperative vasoactive drug therapy were compared between women with mild-to-moderate and severe PH. The characteristics and factors influencing postoperative vasoactive drug therapy in women with severe PH were studied. Postoperative vasoactive drug therapy was defined as the use of vasoactive drugs for over 48 h after cesarean section or abortion to maintain circulatory stability.</p><p><strong>Results: </strong>A total of 255 pregnant patients with shunt-related CHD-associated PH were enrolled, including 147 with mild-to-moderate pulmonary artery systolic pressure (PASP) of 30-70 mmHg and 108 with severe PH (PASP > 70 mmHg). Overall, women with mild-to-moderate PH had better maternal outcomes than those with severe PH, including the incidence of maternal mortality (0.68% vs. 11.11%, P < 0.001) and postoperative vasoactive drug therapy (2.74% vs. 50.47%, P < 0.001). Gestational week at delivery (OR 0.9, 95% CI[0.82,0.98], P = 0.016), Eisenmenger syndrome (OR 2.64, 95% [1.08,6.64], P = 0.034), and New York Heart Association (NYHA) functional class III to IV (OR 5.22, 95% [1.90,14.35], P < 0.001) were independently associated with postoperative vasoactive drug therapy in pregnant women with severe PH.</p><p><strong>Conclusions: </strong>Women with shunt-related CHD-associated mild to moderate PH had better outcomes than those with severe PH in terms of the incidence of maternal mortality and postoperative vasoactive drug therapy. Multimodal risk assessment, including PH severity, gestational week, Eisenmenger syndrome, and NYHA functional class, may be useful for risk stratification in pregnant women with shunt-related CHD-associated PH.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"299"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The median effective dose of oxycodone for acute postoperative pain after thoracoscopic pulmonary surgery with intercostal nerve blockin in patients of different ages: a dose-finding study protocol.","authors":"Min Zhang, Yi Liu, Jing Cao, Mengjie Liu, Xiaojun Gao, Na Guo, Chuansong Wei, Ye Zhu, Yongtao Sun, Jianbo Wu","doi":"10.1186/s12871-025-03198-5","DOIUrl":"10.1186/s12871-025-03198-5","url":null,"abstract":"<p><strong>Background: </strong>Oxycodone is an effective drug for controlling acute postoperative pain (APP), especially visceral pain. However, the effective dose needed for controlling APP depends on the surgical method and the patient age. Therefore, through use of the Dixon up-and-down method, this study investigated the median effective dose (ED₅₀) of oxycodone that could be combined with intercostal nerve block (INB) to effectively control APP after thoracoscopic pulmonary surgery in patients of different ages.</p><p><strong>Methods: </strong>This is a prospective, interventional, dose-finding study. Patients undergoing thoracoscopic lobar and sublobar resections under general anaesthesia will be selected and divided into 4 groups according to age and surgical method: the elderly lobectomy group (aged ≥ 65 years), the nonelderly lobectomy group (aged < 65 years), the elderly sublobar resection group (aged ≥ 65 years), and the nonelderly sublobar resection group (aged < 65 years). The study will be performed simultaneously in four experimental groups via the Dixon up-and-down method. The initial dose for the first patient in each group will be set to 0.1 mg/kg; the dose for the next patient will be determined by the response of the previous patient. The primary outcome is the ED₅₀ of oxycodone.</p><p><strong>Discussion: </strong>The results of this study are expected to provide an effective strategy for the management of APP following thoracoscopic pulmonary surgery and specifically to offer more accurate dose guidance for the use of oxycodone in older patients. This will not only improve the development of individualized pain management plans but also optimize the patient's postoperative recovery, reduce unnecessary drug side effects, and increase the overall comfort and quality of life of patients.</p><p><strong>Trial registration: </strong>This study was registered on clinicaltrials.gov (NCT06534801) on August 1, 2024.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"323"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurally adjusted ventilatory assisted ventilation compared to pressure support during post-operative weaning of hepatic patients undergoing major abdominal surgeries: a randomized control trial.","authors":"Eman Sayed Ibrahim, Hatem A Attalah, Essam A Eid, Rasha F Elshoney, Amany A Sultan","doi":"10.1186/s12871-025-03159-y","DOIUrl":"10.1186/s12871-025-03159-y","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"297"},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of peri-operative mortality in care of preterm children in non-cardiac surgery.","authors":"Gerrit Jansen, Linda Irmscher, Sunil Jagoda, Jochen Hinkelbein, Theodor W May, Jakob Popp, Sebastian Rehberg","doi":"10.1186/s12871-025-03168-x","DOIUrl":"10.1186/s12871-025-03168-x","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"296"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}