Surgical neurology international最新文献

{"title":"The preclinical and clinical trials of mesenchymal stem cell's secretome in traumatic brain injury: Review of basic science.","authors":"I Gde Anom Ananta Yudha, Andi Asadul Islam, Mochammad Hatta, Firdaus Hamid","doi":"10.25259/SNI_1025_2024","DOIUrl":"10.25259/SNI_1025_2024","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) presents with associated neurologic and vascular damage triggers a chain of events that lead to a secondary brain injury. Proper prevention may limit undesirable outcomes. Mesenchymal stem cells (MSCs) and their secretome are promising therapeutic agents for a variety of neurological injuries, including TBI, due to their neuroprotective effects. This paper offers a concise overview of the use of MSCs and secretomes to prevent secondary brain injury and improve functional outcomes in TBI patients.</p><p><strong>Methods: </strong>An electronic database search on PubMed, Cochrane, Scopus, and clinicaltrials.gov was performed to include all relevant studies. Our framework incorporates an analysis of preclinical and clinical studies investigating the effects of MSCs and secretome on clinically relevant neurological and histopathological outcomes.</p><p><strong>Results: </strong>Immunomodulation by molecular factors secreted by MSCs is considered to be a key mechanism involved in their multi-potential therapeutic effects. Regulated neuroinflammation is required for healthy remodeling of the central nervous system during development and adulthood. Moreover, immune cells and their secreted factors can also contribute to tissue repair and neurological recovery following acute brain injury. The use of secretome has key advantages over cell-based therapies, such as lower immunogenicity and easy production, handling, and storage.</p><p><strong>Conclusion: </strong>Compared with traditional therapies, MSC and secretome treatment can directly improve TBI-induced pathological changes and promote recovery of neurological function. MSCs and their secretome hold great promise to bridge this gap in translation for TBI. Further clinical trials are needed to confirm its efficacy and safety.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"235"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628446","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":"Dexamethasone-associated regression of glioblastoma.","authors":"Maria Magdalena Segura Arderiu, Sheikh M B Momin, Ute Pohl, Huan Chan","doi":"10.25259/SNI_818_2024","DOIUrl":"10.25259/SNI_818_2024","url":null,"abstract":"<p><strong>Background: </strong>Dexamethasone-induced regression of an intracranial space-occupying lesion is commonly characteristic of primary central nervous system lymphoma (PCNSL). However, dexamethasone does not have an established chemotherapeutic role in glioblastoma multiforme (GBM). This is a report on dexamethasone-induced regression in GBM with the aim of exploring the mechanisms behind the phenomenon.</p><p><strong>Case description: </strong>We present the case of a 63-year-old male presenting with status epilepticus. Initial imaging showed a high-grade glioma with significant vasogenic edema. Following 23 days of dexamethasone therapy, magnetic resonance imaging demonstrated notable tumor regression, raising differential diagnoses, including lymphoma or a nonneoplastic inflammatory process. After discontinuation of dexamethasone, the tumor rapidly regrew. A biopsy confirmed the diagnosis of high-grade glioma. Immunohistochemistry revealed the following: glial fibrillary acidic protein positive, isocitrate dehydrogenase-1 (IDH-1) R132H negative, ATP-dependent helicase ATRX (ATRX) positive, p53 with 30% nuclear labeling index, and Ki-67 with maximal labeling index of 25%. The patient underwent an image-guided awake craniotomy for tumor resection.</p><p><strong>Conclusion: </strong>This case demonstrates substantial dexamethasone-induced GBM regression in our patient, serving as a diagnostic confounder with PCNSL. The decision to wean steroids with the aim of increasing diagnostic yield for PCNSL resulted in a missed opportunity for early surgery for GBM, with the development of neurological symptoms, higher surgical risk and possibly shorter survival. Healthcare professionals caring for patients with suspected GBM must be aware of this potential pitfall in rare cases, planning for timely surgical intervention to optimize the outcome for such patients. This case introduces the second case of a GBM behaving in such a manner, along with molecular characterization.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"245"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628322","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":"Mechanical thrombectomy for M2 occlusion sharply branching from M1 near an aneurysm.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Masanori Kinosada, Minami Uezato, Yoshitaka Kurosaki, Masaki Chin","doi":"10.25259/SNI_359_2025","DOIUrl":"10.25259/SNI_359_2025","url":null,"abstract":"<p><strong>Background: </strong>Mechanical thrombectomy (MT) for vessel occlusion near an aneurysm carries the risk of aneurysm rupture due to mechanical stress during the procedure. We report a case of MT performed for M2 occlusion that sharply branched from M1 near the aneurysm.</p><p><strong>Case description: </strong>A 73-year-old woman presented with a left middle cerebral artery (MCA) bifurcation aneurysm, exhibiting right-sided hemiparesis and aphasia. MT was performed for M2 occlusion, which sharply branched from M1 near the MCA bifurcation aneurysm. Lesion crossing was carefully performed, and a stent retriever was deployed at the occlusion site. Using a stent retriever as an anchor, a bent-tip aspiration catheter was guided past the aneurysm to the proximal end of the thrombus. A combined technique, during which the stent retriever was retracted into the aspiration catheter, was used. This approach minimized mechanical stress on the aneurysm and helped achieve effective recanalization.</p><p><strong>Conclusion: </strong>In cases of vessel occlusion with a proximal cerebral aneurysm, a combined technique of retracting a stent retriever into an aspiration catheter positioned distal to the aneurysm after stent retriever deployment may help reduce the mechanical stress on the aneurysm during MT and provide a safer approach.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"243"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628423","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":"Reconstruction of the orbital floor with a pericranial flap in a cocaine-addicted patient.","authors":"Carlo Mandelli, Cinzia Mura, Ervin Karaj, Andrea Bisoglio, Pietro Mortini","doi":"10.25259/SNI_436_2025","DOIUrl":"10.25259/SNI_436_2025","url":null,"abstract":"<p><strong>Background: </strong>The orbit is a complex anatomical region. Cocaine-induced midline destructive lesions (CIMDL) can severely damage the orbital walls. This study evaluates the effectiveness of the pericranial flap in reconstructing orbital defects in CIMDL patients, focusing on its proper positioning, stretching, and anchoring to the orbital bone.</p><p><strong>Case description: </strong>We present the case of a 57-year-old male with a history of chronic cocaine use, who presented with enophthalmos, diplopia, and reduced vision in the left eye. Imaging revealed extensive destruction of orbital walls. After a prolonged period of cocaine abstinence, the patient underwent reconstructive surgery using a pericranial flap to restore orbital integrity. Postoperative imaging confirmed correct placement of the pericranial flap, which successfully restored orbital integrity and sealed the sinus communication. Clinically, the patient showed significant improvement in enophthalmos, resolution of diplopia, and enhanced vision.</p><p><strong>Conclusion: </strong>Harvesting and positioning the pericranial flap under the eyeball, appropriately stretched and anchored to the orbital bone, are a feasible and effective technique for complex orbital reconstruction in CIMDL cases. This approach successfully restores anatomical structure, improves eye alignment, and resolves diplopia, supporting both anatomical restoration and functional recovery.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"239"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628440","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":"Viral immunological complications in neurological surgery: A comprehensive review of homeostatic disturbances and cognitive impairments.","authors":"Maral Moafi, Rasa Zafari, Kamyab Rabiee, Mohammad Javad Ebrahimi, Homa Seyedmirzaei, Alireza Soltani Khaboushan","doi":"10.25259/SNI_337_2025","DOIUrl":"10.25259/SNI_337_2025","url":null,"abstract":"<p><strong>Background: </strong>Neurosurgical procedures are essential for treating various brain and spinal conditions, but they also carry the risk of infections, including viral infections. These infections can disrupt brain homeostasis, leading to cognitive impairments. During surgery, protective barriers like the blood-brain barrier (BBB) can be compromised, and cerebrospinal fluid may be exposed to pathogens. This makes the brain more susceptible to viral infections, which can trigger inflammation. Over time, this inflammation can have lasting effects on cognitive function, impacting the brain's ability to maintain neural integrity.</p><p><strong>Methods: </strong>A review of the literature was performed using PubMed, Google Scholar, Scopus, and Web of Science from inception to January 2025. We focus on the impact of viral infections after neurosurgical procedures and how these infections lead to neuroinflammation.</p><p><strong>Results: </strong>Viral infections after neurosurgery activate neuroinflammatory responses, with microglia and astrocytes playing a key role. The release of cytokines such as tumor necrosis factor-alpha and interleukin-1 causes significant neuronal damage, impairing synaptic function and connectivity. This inflammatory process, combined with BBB disruption, leads to cognitive dysfunction both in the immediate postoperative period and in the long-term. Understanding these processes is essential for addressing cognitive decline in patients who have undergone neurosurgery.</p><p><strong>Conclusion: </strong>Viral infections following neurosurgery are a significant risk factor for cognitive decline. Neuroinflammation, especially when coupled with BBB disruption, contributes to both short-term and long-term cognitive impairments. This review highlights the need for targeted interventions to control inflammation and protect the BBB in the perioperative period. Future research focused on neuroprotective therapies, including anti-inflammatory agents and strategies to preserve BBB integrity, is critical for improving cognitive outcomes in neurosurgical patients.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"241"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628452","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":"Delayed epidural hematoma after spinal cord stimulator implantation in a patient with von Willebrand disease: Illustration.","authors":"Stephen Jaffee, Jyothika Mamadhi, Trent Kite, Dallas E Kramer, Nestor Tomycz","doi":"10.25259/SNI_311_2025","DOIUrl":"10.25259/SNI_311_2025","url":null,"abstract":"<p><strong>Background: </strong>A patient with von Willebrand disease developed a delayed epidural hematoma originating from the tunneling tract and gluteal generator pocket following the placement of a thoracic spinal cord stimulator (SCS).</p><p><strong>Case description: </strong>A 43-year-old male with von Willebrand disease underwent thoracic SCS placement to treat chronic bilateral lower extremity pain with paresthesias in 2024. The patient had previously experienced a postoperative hematoma in 2010. At the time of the thoracic SCS placement, he received 7 days of prophylactic antihemophilic factor/von Willebrand factor complex therapy. One month following placement of the thoracic SCS, the patient noted significant swelling localized to the thoracic and buttock incisions. Exploratory surgery documented an additional hematoma tracking from the tunneling tract and gluteal generator pocket all the way into the epidural space; it was promptly removed. At the 6-month follow-up, he exhibited no further wounds or neurological issues.</p><p><strong>Conclusion: </strong>Patients with coagulopathies, and critically, von Willebrand disease, undergoing SCS placement are at increased risk for postoperative hematomas.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"227"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628321","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":"Cervical laminectomy and fusion versus laminoplasty in degenerative cervical myelopathy: A propensity score matching analysis.","authors":"Hannon W Levy, Bennett R Levy, Mohamed A R Soliman, Esteban Quiceno, Jacob David Greisman, Asham Khan, Juan Bautista Amiotti, John Pollina, Jeffrey P Mullin","doi":"10.25259/SNI_299_2025","DOIUrl":"10.25259/SNI_299_2025","url":null,"abstract":"<p><strong>Background: </strong>Degenerative cervical myelopathy (DCM) is a common cause of spinal cord dysfunction. The effectiveness of laminoplasty (LP) versus laminectomy with fusion (LF) for treating DCM is still debated. Here, we compared LP versus LF for treating DCM using propensity score matching (PSM) to minimize selection bias.</p><p><strong>Methods: </strong>We identified DCM patients undergoing LP versus LF (2004-2022). Our analysis included demographics, preoperative/postoperative modified Japanese orthopedic association (mJOA) scoring, Visual Analog Scale (VAS) scores, assessment of postoperative cervical lordosis, operative time, blood loss, length of stay (LOS), and adverse events. PSM was performed to create balanced groups and minimize selection bias. Paired t-tests and Chi-square tests were used for statistical analysis.</p><p><strong>Results: </strong>After PSM, 55 patients in each group were analyzed. LP patients had significantly shorter operative times and LOS, but VAS scores were significantly better for the LF group. Notably, both groups showed similar improvements in mJOA scores, frequency of intraoperative/postoperative adverse events, and reoperation rates. Although changes in cervical lordosis were significantly different between the groups, both groups showed comparable final lordotic curvatures.</p><p><strong>Conclusion: </strong>LP procedures resulted in significantly shorter operative times and LOS, but VAS scores were correlated with significantly better outcomes in the LF group. Notably, both LP and LF patients demonstrated similar improvement in mJOA scores, frequencies of intraoperative/postoperative adverse events, and reoperation rates.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"220"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628316","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":"Classical type of superficial hemosiderosis presenting with temporal lobe epilepsy.","authors":"Kazunori Arita, Koshi Yokota, Yushi Nagano, Hitoshi Yamahata, Nayuta Higa, Masaaki Yamamoto, Junpei Kubo, Ryosuke Hanaya","doi":"10.25259/SNI_153_2025","DOIUrl":"10.25259/SNI_153_2025","url":null,"abstract":"<p><strong>Background: </strong>Classical type of superficial hemosiderosis (SH) is subpial hemosiderin deposition mainly affecting the cerebellum, brainstem, and spinal cord, which generally presents with cerebellar ataxia and sensorineural hearing disturbance. We here report a rare case of the classical type of SH presenting with temporal lobe epilepsy and perform a literature review on similar cases.</p><p><strong>Case description: </strong>A 63-year-old man with four episodes of impaired awareness and confusion lasting for around 5 minutes after feeling vague uneasiness, suggesting focal impaired awareness seizure, visited a neurosurgical clinic. T2*-weighted magnetic resonance imaging (MRI) showed hemosiderin deposition on the surface of the cerebellum, brainstem, upper spinal cord, and bases of bilateral frontal and temporal lobes. Neurological examination found mild gait ataxia and anosmia. Audiogram showed sensorineural high-frequency hearing loss. Electroencephalogram showed rhythmic theta activities accompanied by intermittent sharp waves over the right fronto-temporal region during a subclinical seizure episode, which led to the diagnosis of temporal lobe epilepsy. Up-dosing of levetiracetam to 1,500 mg/day brought about a seizure-free status. Gait disturbance, however, gradually deteriorated over the following 6 months. Spinal MRI and myelogram found a dural defect at the T3 level. The 4 mm long defect was surgically closed, which led to the gradual improvement of the gait ataxia.</p><p><strong>Conclusion: </strong>In this case of the classical type of SH due to a dural defect, temporal lobe epilepsy is presumably caused by the neurotoxicity of decomposed products of hemoglobin impregnated in the temporal lobes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"225"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628318","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":"Craniocervical intradural pseudotumor causing bulbomedullary compression.","authors":"Inês Almeida Lourenço, Diogo Roque, Nuno Cubas Farinha, Rafael Roque, Nuno Simas","doi":"10.25259/SNI_403_2025","DOIUrl":"10.25259/SNI_403_2025","url":null,"abstract":"<p><strong>Background: </strong>Pseudotumors are rare lesions that may cause compression of adjacent neural structures. Treatment options range from conservative management to surgical intervention.</p><p><strong>Case description: </strong>A 59-year-old female presented with a 3-month history of headaches, difficulty speaking, swallowing, gait disturbance, and progressive left-sided weakness. Her examination confirmed left-sided tetraparesis. The cervical magnetic resonance showed a right-sided mass compressing the bulbomedullary junction. Through a modified right-sided far lateral craniotomy, an intradural \"pseudotumor\" was removed. Postoperatively, the patient's symptoms gradually improved. Histopathological analysis revealed an acellular fibrocartilaginous mass consistent with the diagnosis of pseudotumor.</p><p><strong>Conclusion: </strong>Pseudotumors at the craniocervical junction may cause progressive tetraparesis readily resolved following gross total surgical excision.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"232"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628320","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":"BurstDR™ spinal cord stimulation for chemotherapy-induced peripheral neuropathy.","authors":"Stephen Jaffee, Jyothika Mamagdi, Miriam Vaezi, Trent Kite, Bhavika Gupta, Samuel Valleta, Feno Monaco, Nestor Tomycz","doi":"10.25259/SNI_284_2025","DOIUrl":"10.25259/SNI_284_2025","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common persistent adverse effects of chemotherapy affecting cancer survivors. Other than the use of duloxetine, no other intervention has a proven benefit for these patients. Here, a patient with multiple myeloma who developed CIPN experienced a significant reduction in their symptoms after the implantation of a spinal cord stimulator.</p><p><strong>Case description: </strong>A 64-year-old male with a history of multiple myeloma presented with chronic pain 4 years after chemotherapy, followed by an autologous stem cell transplant. As the patient's symptoms were refractory to medical management, he underwent placement of a permanent spinal cord stimulator, resulting in 80% relief of calf pain and a 60% improvement in foot paresthesias/pain.</p><p><strong>Conclusion: </strong>Spinal cord stimulation proved effective in treating CIPN (CIPN following autologous stem cell transplant) in a 64-year-old male treated 4 years ago for multiple myeloma.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"222"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628402","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}