World journal for pediatric & congenital heart surgery最新文献

{"title":"Complete Atrioventricular Septal Defect Repair in Patients With Down Syndrome Presenting Beyond Six Months- A Single Center Experience.","authors":"Kartik Patel, Chandrasekaran Ananthanarayanan, Trushar Gajjar, Amit Mishra, Bhavik Champaneri, Jigar Surti, Himani Pandya","doi":"10.1177/21501351251322162","DOIUrl":"https://doi.org/10.1177/21501351251322162","url":null,"abstract":"<p><p>BackgroundComplete atrioventricular septal defect (cAVSD) is the most common cardiac lesions associated with Down syndrome (DS). In DS, cAVSD repair is ideally performed before six months of age to prevent irreversible pulmonary artery hypertension (PAH). However, in developing countries, delayed repair is often unavoidable. We retrospectively analyzed the outcomes of cAVSD repair in DS patients presenting beyond six months of age.MethodBetween 2015 and 2019, 60 DS patients with cAVSD who underwent biventricular repair were reviewed. During the same time period 42 DS patients under 6 months of age underwent cAVSD repair. Their laboratory parameters and echocardiographic data were analyzed. Clinical findings as well as echocardiographic results at last follow-up were recorded.ResultMedian age of the cohort was eight months. There were 7/60 (11.7%) early mortalities due to right ventricular dysfunction secondary to persistent PAH (n = 4) and sepsis (n = 3). We found that right atrioventricular valve regurgitation (AVVR) grade (OR = 5.7, <i>P</i> = .017), postoperative serum bilirubin (OR = 4.03, <i>P</i> = .04), postoperative creatinine (OR = 7.06, <i>P</i> = .008), and right AVVR Gmax (OR = 6.08, <i>P</i> = .009) were independent risk factors for mortality. Mean follow-up was 1658 ± 771 days with a survival rate of 85% at 1, 5, and 10 years. Late reoperation (5.6% vs 3.7%) as well as prevalence of more than mild regurgitation was higher for the right AV valve as compared with the left AV valve (11.5% vs 1.9%). We did not find any factors associated with reoperation. All patients were clinically asymptomatic and did not have residual severe PAH.ConclusionComplete Atrioventricular septal defect repair in late-presenting patients with DS is feasible and yields good long-term outcomes. However, close follow-up is necessary to monitor for the late development of right AVVR.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251322162"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782322","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":"In Memoriam: Albert Starr (1926-2024).","authors":"Marshall L Jacobs, Carl L Backer","doi":"10.1177/21501351251322901","DOIUrl":"https://doi.org/10.1177/21501351251322901","url":null,"abstract":"","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251322901"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733848","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":"Fate of Residual Patch Leak After Surgical Closure of Congenital Perimembranous Ventricular Septal Defects.","authors":"Hani N Mufti, Ysmeen T Bucklain, Abdulaziz M Shaheen, Ahmed Qumsani, Arwa A Alrrzqi, Sereen M Kazim, Luis Acosta, Alfredo Gamboa","doi":"10.1177/21501351251314387","DOIUrl":"https://doi.org/10.1177/21501351251314387","url":null,"abstract":"<p><p>IntroductionVentricular septal defects (VSDs) account for 50% of congenital heart defects in children. Surgical closure of moderate to large VSDs using patch material is considered the standard treatment in children to prevent future complications.ObjectivesWe evaluated the fate of VSD patch leak and its impact on aortic and tricuspid valve regurgitation at one year after surgery.MethodsThis retrospective study consisted of patients with a perimembranous VSD who underwent surgery between January 2016 and July 2021. Demographic, echocardiographic, clinical, and operative data were retrospectively reviewed. All patients' echocardiographic images were analyzed at discharge, 6, and 12 months after surgery. Echocardiography assessment focused on the degree of residual VSD (rVSD) patch leak and aortic and tricuspid regurgitation grade compared with preoperative echocardiography.ResultsSeventy-one consecutive patients who underwent perimembranous VSD surgical closure were reviewed. No patient required reintervention. There was one early mortality during follow-up. Of the 70 patients with complete follow-up, 24 patients (34.33%) had a 1-2 mm rVSD patch leak and 4 patients (5.7%) had a 2-3 mm rVSD patch leak at the time of discharge. At 12-month follow-up echocardiography, 67 patients (95.7%) had no rVSD patch leak. Aortic and tricuspid valve regurgitation significantly improved from discharge to 12 months after surgery. The size of the patch leak did not affect patients' weight gain (<i>P</i> ≥ .05).ConclusionsWe demonstrated that a 2 mm or less rVSD patch leak is benign, has no impact on tricuspid or aortic valve function, no impact on weight gain, and almost always decreases in severity or disappears.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251314387"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702463","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":"Over 3,000 Minimally Invasive Thoracotomies From the European Congenital Heart Surgeons Association for Quality Repairs of the Most Common Congenital Heart Defects: Safe and Routine for Selected Repairs.","authors":"Ali Dodge-Khatami, Juan-Miguel Gil-Jaurena, Jürgen Hörer, Paul Philipp Heinisch, Julie Cleuziou, Sara C Arrigoni, Robert A Cesnjevar, Hitendu H Dave, Alessandro Giamberti, Mauro Lo Rito, Alexander Kadner, Matthias Siepe, Roman Sekelyk, Dmytro Kozhokar, Illya Yemets, Alain Poncelet, Geoffroy de Beco, Jean Rubay, Andre Rüffer, Vincent Kundt, Sameh M Said, Zdzislaw Tobota, Jeffrey P Jacobs, Massimo Padalino, Vladimiro Vida","doi":"10.1177/21501351251322155","DOIUrl":"https://doi.org/10.1177/21501351251322155","url":null,"abstract":"<p><p>BackgroundMinimally invasive thoracotomies to repair selected congenital heart defects are considered only a cosmetic alternative approach by many; however, they represent the routine alternative in centers of expertise.MethodsPooled institutional data from the European Congenital Heart Surgeons Association using mini-thoracotomy approaches were analyzed since the beginning of their respective experiences until an inclusion surgical date of January 31, 2024, allowing at least six months postoperative follow-up.ResultsFrom 1999 to 2024, 3,007 patients from 11 centers underwent surgery. Age and weight ranged from 4 days to 73 years and 3.1 to 106 kg, respectively. Repaired defects included atrial and ventricular septal defects, partial anomalous pulmonary venous return, partial and complete atrioventricular septal defects, double-chambered right ventricle, cor triatriatum, scimitar syndrome, subaortic stenosis, and total anomalous pulmonary venous return (TAPVR). There was no surgical mortality or intraoperative conversion to sternotomy. Complications included wound infections (0.59%), pacemaker requirement (0.23%), phrenic nerve injury (0.26%), bleeding requiring exploration (0.13%), and neurologic injury (0.29%). Early or late reoperations were needed in 0.73%.ConclusionMinimally invasive thoracotomies are the preferred approach for selected congenital heart defects in the participating pediatric heart centers. Mini-thoracotomy incisions allow safe access to an ever-expanding spectrum of quality repairs, low morbidity, superior cosmetics, and early return to functionality in infants, children, and adults.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251322155"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702468","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":"Long-Term Clinical and Echocardiographic Follow-Up After Aortic Valve Tricuspidization With Polytetrafluoroethylene in Children: 15-Year Experience at a Single Center.","authors":"Matej Nosáľ, Fadi Sabateen, Pavel Valentík, Michal Šagát, Aref Saif Nagi, Vladimír Soják","doi":"10.1177/21501351251322159","DOIUrl":"https://doi.org/10.1177/21501351251322159","url":null,"abstract":"<p><p>ObjectivesAortic valve repair by tricuspidization with leaflet extensions is utilized in the management of aortic valve disease in children and adolescents. The aim of this study is to evaluate the long-term outcomes following aortic valve tricuspidization using polytetrafluoroethylene (PTFE) leaflet extensions at a single center.MethodsWe conducted a retrospective single-center analysis of 50 patients who underwent aortic valvuloplasty by tricuspidization with PTFE leaflet extensions between 2008 and 2024.ResultsFifty patients (37/50, 74% female) underwent aortic valvuloplasty using PTFE. The median age was 13 (interquartile range [IQR]: 1.8-25) years. During the median follow-up duration of 8.5 years (IQR: 8 months-15.8 years), 18 patients required reoperation at a mean of 7.3 ± 4 years. The 15-year survival rate was 95.6% (95% confidence interval [CI], 88%-98.8%), and 2 late deaths occurred. The freedom from reoperation at 1, 5, and 12 years was 100% (95% CI, 100%-100%), 82.8% (95% CI, 66.6%-91.4%), and 44.2% (95% CI, 26.2%-61%), respectively. At discharge, the mean peak systolic aortic valve gradients (15 ± 10 mm Hg) were significantly lower than preoperative (72 ± 35 mm Hg) values (<i>P</i> < .001). Mean of left ventricular end-diastolic diameter/body surface area index decreased from 38 ± 13 mm preoperatively to 34.4 ± 10.5 mm postoperatively, then reduced to 32 ± 7 mm at the latest follow-up (<i>P</i> = .003). Aortic regurgitation improved in all patients, and none had more than mild aortic regurgitation at hospital discharge.ConclusionsAortic leaflet extension valvuloplasty using PTFE is effective, safe, with excellent survival and favorable long-term outcomes. It provides reliable palliation in patients with congenital aortic valve diseases until a more permanent replacement alternative is available.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251322159"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675138","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":"Remote Didactic Pediatric Cardiac Critical Care Education Addresses Theory-Practice Gap in Low-Resource Settings.","authors":"Samantha Druckman, Julianne P Moss, Alicia H Chaves, Peter Gaskin, Melanie L Scala, Deborah Linehan, Jamie Tumulty, Nicholas Pietris, Christian Nicolosi, Jessica R Eichner, Svetlana Streltsova-Verma, Vincent U Ohaju, Chimaobi Nwagboso, Ede Jude Ebere, Uzuoma Nwogu, Njoku Faustina Oluchi, Adrian Holloway","doi":"10.1177/21501351251322157","DOIUrl":"https://doi.org/10.1177/21501351251322157","url":null,"abstract":"<p><p>In order to bridge the theory-practice gap in pediatric cardiac critical care among clinicians in a low-resource setting, multidimensional training is crucial. In this study, we implemented a dual-methodology approach to cardiac critical care education in a low-resource setting, integrating both proactive didactic education and a subsequent peer mentor model into one comprehensive education curriculum ahead of a visiting team's mission. We theorized that this process would significantly increase both theoretical knowledge attainment and acquisition of real-world competency. Ultimately, we found that ensuring the acquisition of competence prior to working with a visiting team enhanced both theoretical and practical understanding, leading to well-rounded knowledge acquisition and increased professional comfort by members of the local team.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251322157"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675139","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":"Residual Pulmonary Valve Disease Following Repair of Tetralogy of Fallot-Is Stenosis Better Than Regurgitation?","authors":"Maria von Stumm, Gregory Heger, Julia Danner, Zahra Alalawi, Cordula Wolf, Katarzyna Gendera, Stanimir Georgiev, Peter Ewert, Jürgen Hörer, Julie Cleuziou","doi":"10.1177/21501351251321533","DOIUrl":"https://doi.org/10.1177/21501351251321533","url":null,"abstract":"<p><p>BackgroundResidual pulmonary valve disease (PVD) including pulmonary stenosis (PS), pulmonary regurgitation (PR), or both remains a known complication following repair of Tetralogy of Fallot (TOF). We sought to clarify prevalence, progression, and prognostic impact of residual PVD.MethodsWe identified consecutive patients who underwent repair of TOF at our institution between January 2004 and July 2023. Based on echocardiographic measurements following repair, residual PVD was defined: nonsevere PVD (PS < 25 mm Hg; PR<Grade3), isolated PS (PS ≥ 25 mm Hg; PR<Grade3), isolated PR (PS < 25 mm Hg; PR ≥ Grade3), and mixed PVD (PS ≥ 25 mm Hg; PR ≥ Grade3). Primary study endpoint was the composite of reoperation and catheter-based reintervention.ResultsA total of 244 patients (median age 6 months) were included. Mean follow-up time was 9 ± 5 years. At discharge, 54 patients (23%) showed nonsevere PVD, PS (n = 62, 26%), PR (n = 63, 26%), or mixed PVD (n = 61, 25%). Freedom from primary endpoint was 92 ± 2% and 88 ± 2% at 5 and 10 years, respectively for all patients with residual PVD. There was no significant difference between patients with PS and PR at 10 years (PS, 86 ± 5% vs PR, 93 ± 4%; log-rank test, <i>P</i> = .85). Multivariable analysis demonstrated a significant association between mixed PVD and the primary study endpoint.ConclusionAlthough residual PVD was frequent in patients following TOF repair, freedom from reintervention and reoperation was acceptable at midterm. Residual PS did not protect from reoperation or reintervention when compared with residual PR. The combination of PS and PR was identified as arisk factor for reoperation and reintervention<i>.</i></p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251321533"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675141","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":"Prevalence, Risk Factors, and Outcomes of Hospital-Acquired Infections in Children After Congenital Heart Surgery.","authors":"Saif Awlad Thani, Maroa Al Sawaaiya, Zakiya Al Sinani, Shadha Al Muzaini, Maha Al Aamri, Husam Al Balushi, Said Al Hanshi","doi":"10.1177/21501351251315147","DOIUrl":"https://doi.org/10.1177/21501351251315147","url":null,"abstract":"<p><p>BackgroundHospital-acquired infections (HAIs) are associated with morbidity and mortality in children following congenital cardiac surgery. Our center performs approximately 200 congenital surgeries a year, but infection rates and risk factors remain unknown. This study aims to identify HAI prevalence, risk factors, and outcomes.MethodsRetrospective cross-sectional study of children who underwent congenital cardiac surgery between 2018 and 2022. The infection risk factors were identified using univariate and multivariate analyses. Assessed outcomes are length of stay, duration of mechanical ventilation, and mortality.ResultsOut of 653 patients, 102 (15.6%) developed an infection. Independent risk factors for infection included preoperative critical care admission (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.01-7), delayed sternal closure (OR, 3.3; 95% CI, 1.37-8.0), peritoneal drain (OR, 12.7; 95% CI, 1.65-97), heterotaxy syndrome (OR, 5.6; 95% CI, 1-31), and extracorporeal membrane oxygenation (ECMO) placement in the critical care unit (OR, 10.6; 95% CI, 1.8-64.2). The pediatric critical care and hospital stays of patients with infections were significantly longer with 12.79 (12.15) days versus 4.07(5.47) days and 25.53 (16.86) days versus 10.21 (7.5) days, respectively. Infected patients had a longer mechanical ventilation duration, 169.5 (264.8) versus 28.16 (53.6) hours. Infections were associated with a higher mortality rate, with 7 (6.9%) versus 12 (2.2%).ConclusionsThe prevalence of HAIs following cardiac surgery was 15.6%. Preoperative critical care unit admission, delayed sternal closure, heterotaxy syndrome, peritoneal drain, and ECMO placement in the critical care unit were independent risk factors. Infected patients have worse outcomes. Preventive strategies are greatly needed.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251315147"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627305","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":"The Association Between Platelet Transfusion and Acute Kidney Injury Following Fontan Surgery.","authors":"Marianne E Nellis, Asaf Mandel, Yshia Langer, Salmas Watad, Hiba Abuelhija, Yshai Salem, David Mishaly, Alain E Serraf, Uri Pollak","doi":"10.1177/21501351241313318","DOIUrl":"https://doi.org/10.1177/21501351241313318","url":null,"abstract":"<p><p><b>Objectives:</b> Previous studies have demonstrated an association between transfusion and increased organ dysfunction. We sought to determine the association between transfusion of blood components (red blood cell [RBC], plasma, platelet, and cryoprecipitate transfusions) with development of acute kidney injury (AKI) in children following the Fontan procedure. <b>Methods:</b> This is a single center, retrospective cohort study from 2009 to 2016. All children who underwent the Fontan procedure during the prescribed period who had transfusion and laboratory data available were included. <b>Results:</b> Eighty-eight children were enrolled. The median (interquartile range [IQR]) age was 4.5 (3.3-6.0) years, and median (IQR) weight was 14.8 (13.0-18.8) kg. The median (IQR) cardiopulmonary bypass (CPB) time was 62 (47-89) minutes. Following surgery, according to Kidney Disease Improving Global Outcomes criteria, 41% (36/88) had stage 1 AKI, 23% (20/88) stage 2 AKI, and 15% (13/88) stage 3 AKI. Fifty-eight percent (51/88) of children received at least one RBC transfusion, 73% (64/88) received at least one plasma transfusion, 47% (41/88) received at least one platelet transfusion, and 28% (25/88) received at least one cryoprecipitate transfusion. Children with severe AKI received more of each blood component. After adjusting for age, weight, pre-Fontan pulmonary vascular resistance, pre-Fontan dominant ventricular end-diastolic pressure, CPB time, RBC dose, plasma dose, and cryoprecipitate dose, each 1 mL/kg of platelet transfusion was associated with an increased risk in development of severe AKI (odds ratio: 1.160, 95%CI 1.006-1.339, <i>P</i> = .041). <b>Conclusions:</b> In our cohort of children undergoing the Fontan procedure, platelet transfusion was independently associated with an increased risk of severe AKI postoperatively. The risks, benefits, and alternatives to transfusion should be carefully weighed in this patient population.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351241313318"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627307","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":"Peritoneal Dialysis Catheter Placement on the Right Side of the Falciform Ligament to Prevent Obstruction by the Omentum.","authors":"F Doig, H Kheslat, Y d'Udekem, S P Namachivayam, A J Iyengar","doi":"10.1177/21501351241299762","DOIUrl":"10.1177/21501351241299762","url":null,"abstract":"<p><p>We describe a simple and reproducible technique for neonatal peritoneal dialysis catheter insertion following cardiac surgery which prevents the catheter from becoming blocked by the omentum.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"273-275"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866957","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}