{"title":"Enfortumab Vedotin-Induced Diabetic Ketoacidosis and Acute Tubulointerstitial Nephritis Requiring Intensive Care in the Treatment of Advanced Urothelial Carcinoma: A Case Report.","authors":"Ryo Matsui, Yoshihide Kawasaki, Yohei Satake, Kei Takahashi, Satoko Kurosawa, Tomonori Sato, Hiromichi Katayama, Takuma Sato, Naoki Kawamorita, Shinichi Yamashita, Hideki Katagiri, Akihiro Ito","doi":"10.1159/000545957","DOIUrl":"10.1159/000545957","url":null,"abstract":"<p><strong>Introduction: </strong>Enfortumab vedotin (EV) has been approved for the treatment of many types of cancer, and its use is still expanding. It is an essential drug used as a standard treatment for advanced and metastatic urothelial carcinoma but is known to cause various adverse events (AEs).</p><p><strong>Case presentation: </strong>We report a patient with metastatic urothelial carcinoma who experienced multiple AEs associated with diabetic ketoacidosis (DKA) during EV treatment. The onset of DKA during EV treatment has been reported to be associated with poor prognosis. Although strict management was required in the intensive care unit, we were able to save the patient's life.</p><p><strong>Conclusion: </strong>Although the detailed mechanism that induced insulin resistance remains unclear, the patient required high-dose insulin because of a marked increase in insulin resistance. If hyperglycemia is observed during EV therapy, DKA may lead to the occurrence of serious AEs. We report on the pathogenesis and management of drug-induced DKA caused by EV based on our case and a literature review.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"667-674"},"PeriodicalIF":0.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246585","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":"Unexpected Twin Pregnancy in a BRCA2-Positive Breast Cancer Patient with Post-Chemotherapy Amenorrhea: A Case Report and Call for Comprehensive Contraceptive Counseling.","authors":"Rui Omori, Kenji Gonda, Megumi Arai, Toyoaki Sawano, Tomohiro Kurokawa, Yutaka Tamada, Ayu Yasui, Mika Nashinoto, Masahiro Wada, Kazunoshin Tachibana, Tetsuya Tanimoto, Hiroaki Shimmura, Tohru Ohtake, Akihiko Ozaki","doi":"10.1159/000546095","DOIUrl":"10.1159/000546095","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive counseling for cancer patients, especially during periods of treatment-induced amenorrhea, is often overlooked. This can lead to unexpected pregnancies with significant implications for patient care and outcomes.</p><p><strong>Case presentation: </strong>We report a case of a 38-year-old BRCA2-positive breast cancer patient who experienced an unexpected twin pregnancy while undergoing treatment with tamoxifen and olaparib. The patient had been amenorrheic since initiating chemotherapy for more than 600 days and had not received contraceptive counseling. The pregnancy was discovered during routine follow-up imaging computed tomography. After thorough counseling regarding the teratogenic potential of her treatments and radiation exposure, and considering the patient's strong desire to prioritize her own treatment to safeguard her existing three children, the pregnancy was terminated.</p><p><strong>Conclusion: </strong>This case highlights the need for comprehensive contraceptive counseling throughout cancer treatment, regardless of apparent fertility status. It also emphasizes the importance of considering both teratogenicity of treatments and patients' personal circumstances in managing unexpected pregnancies in cancer patients.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"721-727"},"PeriodicalIF":0.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282457","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}
Guangxing Li, Chuanji Han, Jin Cao, Yongcun Zhu, Shengbo Sun
{"title":"A Case of Primary Squamous Cell Carcinoma of the Small Intestine: A Case Report.","authors":"Guangxing Li, Chuanji Han, Jin Cao, Yongcun Zhu, Shengbo Sun","doi":"10.1159/000545101","DOIUrl":"10.1159/000545101","url":null,"abstract":"<p><strong>Introduction: </strong>Primary squamous cell carcinoma (SCC) of the small intestine is an exceptionally rare malignancy, with limited cases reported in the literature. The rarity of this condition, combined with nonspecific clinical manifestations, poses significant diagnostic and therapeutic challenges.</p><p><strong>Case presentation: </strong>We report the case of a 47-year-old woman who presented with a 2-month history of left lower abdominal pain and discomfort. Imaging studies, including enhanced abdominal CT and PET-CT, revealed a suspicious mass in the jejunum. Comprehensive diagnostic evaluations excluded metastatic origins, and a diagnosis of primary small intestinal SCC was confirmed by histopathology and immunohistochemistry. The patient underwent radical surgical resection, which revealed a poorly differentiated SCC invading the serosa and regional lymph nodes. Postoperative management included infection prevention and fluid rehydration, with recommendations for adjuvant chemotherapy and immunotherapy based on multidisciplinary consultation. Despite the advanced disease stage, the patient recovered well post-surgery and is undergoing regular follow-up.</p><p><strong>Conclusion: </strong>This case underscores the importance of thorough diagnostic evaluation to distinguish primary SCC from metastatic lesions. Early surgical intervention is critical for improving prognosis of this rare malignancy. The findings contribute to the limited knowledge of the primary SCC of the small intestine and emphasize the need for further research to guide optimal management strategies.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"582-592"},"PeriodicalIF":0.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126863","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}
Fabian J Bolte, Christopher K Luminais, Matthew Mistro, Michael E Devitt
{"title":"MRI-Guided Adaptive Radiation Therapy for Oligometastatic Prostate Cancer Involving the Adrenal Gland: A Case Report and Literature Review.","authors":"Fabian J Bolte, Christopher K Luminais, Matthew Mistro, Michael E Devitt","doi":"10.1159/000545983","DOIUrl":"10.1159/000545983","url":null,"abstract":"<p><strong>Introduction: </strong>Metastasis-directed therapy is an evolving treatment modality for patients with oligometastatic prostate cancer. Although the microenvironment of the adrenal glands is enriched in androgen precursors, isolated adrenal metastases are rare. The application of stereotactic ablative radiotherapy (SBRT) to oligometastatic adrenal lesions has been limited due to toxicity concerns.</p><p><strong>Case presentation: </strong>We report a patient with castration resistant prostate cancer and oligometastatic disease recurrence to the adrenal gland who underwent MRI-guided adaptive radiotherapy, which allowed accurate delivery of SBRT while minimizing exposure to adjacent radiosensitive organs. This approach was safe and resulted in long-term local and systemic disease control.</p><p><strong>Conclusion: </strong>This case highlights the potential role for MRI-guided SBRT in selected patients with oligometastatic prostate cancer to the adrenal glands.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"638-645"},"PeriodicalIF":0.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172726","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":"38-Year Delayed Spinal Leptomeningeal Dissemination of a Paediatric Pilocytic Astrocytoma: A Case Report.","authors":"Alexander Irving, Simon Lammy, Likhith Alakandy","doi":"10.1159/000545935","DOIUrl":"10.1159/000545935","url":null,"abstract":"<p><strong>Introduction: </strong>Pilocytic astrocytoma (PA) is among the commonest primary intracranial tumours in children but has a low incidence among the adult population, and spinal occurrences are particularly infrequent. We report a spinal intradural extramedullary (IDEM) recurrence of this tumour a significant duration after initial treatment. Such a case is previously unreported in the literature.</p><p><strong>Case summary: </strong>A 46-year-old female presented with a 3-month history of worsening back pain. Reduced sensation on the right side in L1, L2, and per rectum was found on examination. MRI displayed a L3 IDEM mass. Background was significant for childhood PA, debulked at age 8 and 13. Right L3 hemilaminectomy and subtotal resection was performed. The mass was found to be composed of pleomorphic astroglial cells and was glial fibrillary acidic protein-positive with a fusion between exon 16 of KIAA1549 and exon 9 of BRAF. A recurrence of pilocytic astrocytoma in the lumbar spine was diagnosed, over 38 years after previous treatment.</p><p><strong>Conclusion: </strong>This novel case of long-term leptomeningeal dissemination of cerebellar PA to the lumbar spine is unprecedented. The delayed dissemination of this tumour may warrant further molecular investigation of pilocytic astrocytoma to assess underlying predispositions for such a presentation.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"702-710"},"PeriodicalIF":0.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246584","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}
Nadav Weijel, Safwat Odeh, Amjad Mousa, Nina Nazarov, Olga Zelman, Ilana Levy Yurkovski
{"title":"Obinutuzumab-Induced Inflammatory Bowel Disease-Like Colitis.","authors":"Nadav Weijel, Safwat Odeh, Amjad Mousa, Nina Nazarov, Olga Zelman, Ilana Levy Yurkovski","doi":"10.1159/000545677","DOIUrl":"10.1159/000545677","url":null,"abstract":"<p><strong>Introduction: </strong>Obinutuzumab, an anti-CD20 antibody, is widely used in the treatment of B-cell lymphomas. While diarrhea is a known side effect, obinutuzumab-induced inflammatory bowel disease (IBD)-like conditions are rarely reported. Here, we present a case of obinutuzumab-induced pancolitis.</p><p><strong>Case presentation: </strong>A 69-year-old male with stage IV follicular lymphoma, treated with obinutuzumab-CHOP and subsequent obinutuzumab maintenance therapy, developed non-bloody diarrhea after his third maintenance dose. Endoscopic and histological findings mimicked Crohn's disease, leading to a diagnosis of obinutuzumab-induced pancolitis. Obinutuzumab was discontinued, and the patient was transitioned to infliximab therapy, leading to partial improvement.</p><p><strong>Conclusion: </strong>This case demonstrates a severe instance of obinutuzumab-induced pancolitis with IBD-like features, emphasizing the need for clinicians to consider drug-induced etiologies in patients presenting with new gastrointestinal symptoms during obinutuzumab therapy. Timely diagnosis and a multidisciplinary approach are crucial for effective management. Further reports are needed to better understand the full spectrum of gastrointestinal toxicity associated with obinutuzumab and guide future treatment.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"613-619"},"PeriodicalIF":0.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149357","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":"Signet Ring Cell Carcinoma of the Stomach with Chylous Pleural Effusion: Laterality Shift and Fluid Composition Change.","authors":"Akina Nigi, Toshikazu Kumasa, Keisuke Iwamoto, Junichiro Nishiki, Haruka Nakamura, Hidetoshi Itani, Shigeto Kondou","doi":"10.1159/000545958","DOIUrl":"10.1159/000545958","url":null,"abstract":"<p><strong>Introduction: </strong>Chylothorax is a rare manifestation of malignant pleural effusion, with gastric cancer accounting for only a small percentage of cases. Signet ring cell carcinoma (SRCC) is an aggressive tumor subtype that frequently invades the lymphatic system, leading to early dissemination.</p><p><strong>Case presentation: </strong>A 66-year-old woman presented with bilateral chylothorax that was initially suspected to be a lymphoma. After a transient resolution, the pleural effusion returned on the left side, with a shift from chylous to non-chylous fluid and an increase in carcinoembryonic antigen levels. Despite endoscopic findings resembling early stage gastric cancer, cytology confirmed SRCC. Despite treatment with capecitabine plus oxaliplatin and nivolumab, the disease progressed, resulting in bilateral effusion recurrence and death within 4 months. Genetic analysis revealed CLDN18.2 positivity.</p><p><strong>Conclusion: </strong>This case is unique because it demonstrates a rare progression from bilateral to unilateral pleural effusion, accompanied by a transition in pleural fluid characteristics, which has not been previously reported. The observations suggest dynamic changes in lymphatic obstruction and tumor infiltration. Early molecular profiling, which includes CLDN18.2 testing, may provide new opportunities for targeted therapy in aggressive gastric cancer cases.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"694-701"},"PeriodicalIF":0.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246637","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}
Kacper Koczyk, Arkadiusz Nowak, Marcin M Machnicki, Łukasz Zdzisław Michałowski, Edyta Maj, Tomasz Stoklosa, Przemysław Kunert
{"title":"Intramedullary Glioblastoma as One of Multiple Radiation-Induced Neoplasms.","authors":"Kacper Koczyk, Arkadiusz Nowak, Marcin M Machnicki, Łukasz Zdzisław Michałowski, Edyta Maj, Tomasz Stoklosa, Przemysław Kunert","doi":"10.1159/000545250","DOIUrl":"10.1159/000545250","url":null,"abstract":"<p><strong>Introduction: </strong>Intramedullary glioblastoma is a rare entity comprising 1.4-9% of spinal gliomas. Spinal cord radiation-induced gliomas are unique, with only 13 cases reported to date.</p><p><strong>Case presentation: </strong>A 53-year-old female with a history of mediastinal Hodgkin lymphoma treated with chemotherapy and radiotherapy who subsequently developed thyroid cancer and breast cancer throughout her life was admitted due to slowly progressing spastic tetraparesis. Cervical MRI revealed an intramedullary lesion at the C4-T1 level, enlarging the spinal cord, with a heterogenous contrast enhancement and a lesion within T1 vertebral body showing contrast enhancement. Whole-body <sup>18</sup>F-FDG-PET/CT revealed increased radionuclide uptake within the cervical spinal cord at the C2-C7 level and a focus of increased metabolic activity within the T1 vertebral body. The patient underwent a C4-T2 laminectomy with tumor debulking, and a biopsy of the T1 vertebral body was taken. Closure was performed with thecal sac expansion using a fascia lata graft and open-door laminoplasty. The histomolecular results confirmed the diagnosis of glioblastoma, IDH-wildtype (CNS WHO G4), in the cervical spinal cord lesion and breast cancer metastasis in the T1 vertebral body. Postoperatively, the patient experienced progression of lower extremities and left arm paresis. No adjuvant therapy was administered due to neurological deficit progression. The patient died 6 months after surgery.</p><p><strong>Conclusion: </strong>We report a case of an intramedullary glioblastoma in a patient with a history of radiation and multiple neoplasms located at the irradiation field borders. The full molecular analysis allowed for classification of the tumor as glioblastoma, IDH-wildtype (CNS WHO G4), and screening for germinal mutations potentially predisposing to spontaneous neoplasm development.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"682-693"},"PeriodicalIF":0.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246586","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}
Vicka Poudyal, Marianne S Elston, Saleen Nottingham, Michael J Swarbrick, Adam Davies, Veronica Boyle
{"title":"Cushing's Syndrome due to a Renal Neuroendocrine Tumor: A Case Report.","authors":"Vicka Poudyal, Marianne S Elston, Saleen Nottingham, Michael J Swarbrick, Adam Davies, Veronica Boyle","doi":"10.1159/000545734","DOIUrl":"10.1159/000545734","url":null,"abstract":"<p><strong>Introduction: </strong>Cushing's syndrome (CS) due to ectopic adrenocorticotrophic hormone (ACTH) is rare and usually due to neuroendocrine neoplasia (NEN). Primary renal NEN is exceptionally rare but may be a cause of rapidly progressive CS.</p><p><strong>Case presentation: </strong>A 51-year-old man presented with profound hypokalemia, cellulitis, and new-onset type 2 diabetes and hypertension with 1 month of muscle weakness, labile mood, and insomnia. CS due to ectopic ACTH production was confirmed. Biochemical control was achieved using a \"block-and-replace\" regimen with dual blockade with ketoconazole and metyrapone and hydrocortisone replacement in addition to mineralocorticoid receptor blockade using spironolactone. CT and ultrasound demonstrated a 24 mm right renal lesion with features concerning for renal cell carcinoma. Right laparoscopic nephrectomy was performed. Histology demonstrated a WHO grade one NEN with ACTH staining.</p><p><strong>Conclusion: </strong>In CS, where the source of ectopic ACTH production is unable to be identified, a renal source should be considered. Diagnosis may be difficult as there are no reliable radiological characteristics to distinguish renal NENs from renal cell carcinomas, so a high degree of suspicion is required.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"593-601"},"PeriodicalIF":0.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141507","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":"A Case of Immune-Related Adverse Events, Including Myasthenia Gravis, Myositis, and Myocarditis, during Avelumab and Axitinib Combination Therapy.","authors":"Jurii Karibe, Ryohei Horiguchi, Yohei Hanajima, Akihito Hashizume, Daiji Takamoto, Takashi Kawahara, Kimito Osaka, Jun-Ichi Teranishi, Naohisa Ueda, Hiroji Uemura","doi":"10.1159/000545733","DOIUrl":"https://doi.org/10.1159/000545733","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors are the mainstay of treatment for unresectable or metastatic renal cell carcinoma (RCC). However, they can cause immune-related adverse events (irAEs), and the management of these irAEs is critical. The combination of myasthenia gravis, myositis, and myocarditis, which are irAEs, is rare, and it has not been reported to occur with avelumab. This report aimed to present a rare case of RCC metastasis that developed irAEs during avelumab and axitinib combination therapy.</p><p><strong>Case presentation: </strong>A 76-year-old woman who underwent radical nephrectomy for clear cell RCC (pT1bN0M0 Grade 3 INFb) at the age of 67 years presented to our hospital after her family doctor noted a pancreatic tumor. She was diagnosed with pancreatic metastasis of RCC based on histopathological examination, and avelumab and axitinib combination therapy was initiated. She developed irAEs, including myasthenia gravis, myositis, and myocarditis, which were treated with steroid pulse therapy. The patient recovered after treatment and was discharged without sequelae.</p><p><strong>Conclusion: </strong>Myasthenia gravis, myositis, and myocarditis can occur during avelumab and axitinib combination therapy for RCC. Prompt diagnosis, treatment, and collaboration with other departments are extremely important for managing irAEs.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"18 1","pages":"563-569"},"PeriodicalIF":0.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977579","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}