Pub Date : 2021-09-23DOI: 10.17709/2410-1893-2021-8-3-3
К. С. Држевецкая, Г. П. Корженкова
Purpose of the study. To evaluate the results of breast cancer screening (BC) in the conditions of an unfavorable epidemiological situation COVID‑19 based on the analysis of the BC screening project in the Kaluga Region. Patients and methods. Screening system: creation and implementation in practice of mobile mammography complexes (MMC); training of medical personnel in the method of conducting a standardized mammographic examination (ME); quality control of ME; "Cloud" storage and software development for archiving patients; an independent review of mammograms by certified specialists; expert review of images in case of discrepancies in diagnoses; referral of patients diagnosed with BI-RADS IV and V to the regional oncological dispensary for further examination and treatment. From 04.2018 to 12.2020 patients were examined on MMC according to the BC screening protocol. We examined 47367 patients over the age of 40 years. SD 57.66 ± 8.17 years (38-93). During the COVID‑19 pandemic, imaging of breast diseases must be carried out in compliance with all safety regulations for both personnel and patients. Balancing the need to avoid delays in diagnosing BC while preventing infection requires careful attention to personal protective equipment, handling of diagnostic equipment, diagnostic facilities, and physical distancing and vigilance to maintain these measures. Results . From 07.2020 to 11.2020: a total of 10736 studies have been carried out. In the context of new coronavirus infection, we noted an increased demand among patients wishing to undergo BC screening. The flow of patients over the same period of previous years was less, which indicates the demand and justification for screening mammography and the use of MMC in an unfavorable epidemiological situation. 174 patients received category BI-RADS IV-V and were referred for a follow-up examination and required treatment at an oncological dispensary. In 39 patients (22.4 %), BC was verified, and appropriate treatment was carried out. In 135 cases, benign processes were verified. Conclusion. BC screening should not be stopped against the backdrop of the COVID‑19 epidemic since a delay in BC diagnosis later threatens to reveal more voluminous processes with a worse prognosis for treatment and rehabilitation than timely detected changes in the mammary glands in the early preclinical stages of the disease.
{"title":"ПРОВЕДЕНИЕ СКРИНИНГА РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ В УСЛОВИЯХ НЕБЛАГОПРИЯТНОЙ ЭПИДЕМИОЛОГИЧЕСКОЙ СИТУАЦИИ COVID-19","authors":"К. С. Држевецкая, Г. П. Корженкова","doi":"10.17709/2410-1893-2021-8-3-3","DOIUrl":"https://doi.org/10.17709/2410-1893-2021-8-3-3","url":null,"abstract":"Purpose of the study. To evaluate the results of breast cancer screening (BC) in the conditions of an unfavorable epidemiological situation COVID‑19 based on the analysis of the BC screening project in the Kaluga Region. Patients and methods. Screening system: creation and implementation in practice of mobile mammography complexes (MMC); training of medical personnel in the method of conducting a standardized mammographic examination (ME); quality control of ME; \"Cloud\" storage and software development for archiving patients; an independent review of mammograms by certified specialists; expert review of images in case of discrepancies in diagnoses; referral of patients diagnosed with BI-RADS IV and V to the regional oncological dispensary for further examination and treatment. From 04.2018 to 12.2020 patients were examined on MMC according to the BC screening protocol. We examined 47367 patients over the age of 40 years. SD 57.66 ± 8.17 years (38-93). During the COVID‑19 pandemic, imaging of breast diseases must be carried out in compliance with all safety regulations for both personnel and patients. Balancing the need to avoid delays in diagnosing BC while preventing infection requires careful attention to personal protective equipment, handling of diagnostic equipment, diagnostic facilities, and physical distancing and vigilance to maintain these measures. Results . From 07.2020 to 11.2020: a total of 10736 studies have been carried out. In the context of new coronavirus infection, we noted an increased demand among patients wishing to undergo BC screening. The flow of patients over the same period of previous years was less, which indicates the demand and justification for screening mammography and the use of MMC in an unfavorable epidemiological situation. 174 patients received category BI-RADS IV-V and were referred for a follow-up examination and required treatment at an oncological dispensary. In 39 patients (22.4 %), BC was verified, and appropriate treatment was carried out. In 135 cases, benign processes were verified. Conclusion. BC screening should not be stopped against the backdrop of the COVID‑19 epidemic since a delay in BC diagnosis later threatens to reveal more voluminous processes with a worse prognosis for treatment and rehabilitation than timely detected changes in the mammary glands in the early preclinical stages of the disease.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130184230","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}
Pub Date : 2021-09-23DOI: 10.17709/2410-1893-2021-8-3-1
Д. А. Розенко, А. И. Шихлярова, Лариса Ващенко, Наталья Николаевна Попова, Ю. Ю. Арапова, А. Ю. Арджа, А. А. Коробов
Purpose of the study . To study functional changes in the neuropsychological status of reproductive age patients with newly diagnosed breast cancer and to assess the possibility of using xenon-oxygen therapy to correct disorders. Patients and methods . This study included 60 reproductive age patients with newly diagnosed breast cancer who were undergoing surgical treatment at the Department of Bone, Skin, Soft Tissue and Breast Tumors of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2018 to 2020. The main group included 30 patients with breast cancer diagnosed at the surgical stage of combined treatment, who underwent a rehabilitation course of xenon-oxygen therapy in the early postoperative period. The control group was formed from patients with the same diagnosis, without the use of this therapy. The functional state of the central nervous system in all patients was assessed by the parameters of the electroencephalography (EEG) bioelectrical activity. For the final assessment of the physiological and psychological state of the patients, a standardized questionnaires of the quality of life – ESAS, MOS-SF‑36, were used. Statistical data processing was performed using the Statistica 10 software package. Results . During the study, statistically significant differences were found in the assessment of subjective indicators, so in the group of patients using xenon-oxygen therapy, there was an improvement in well-being by 2.6 times, a decrease in depression by 2.3 times, a decrease in symptoms of nausea by 3 times, anxiety 1.9 times (p < 0.05). Against the background of an improvement in the psychophysiological state, the EEG showed a significant increase in the power of slow delta and theta rhythms, an increase in the power of the alpha rhythm and a decrease in the power of the beta rhythm, while in the patients of the control group only a decrease in the power of the beta rhythm was noted. Conclusion . The early postoperative period in patients with newly diagnosed breast cancer is characterized by the formation of a depressive symptom complex. The use of a course of xenon-oxygen therapy contributes to the normalization of the subjective feeling of physical and psychological health, increasing vital and social activity. Changes in the indicators of brain bioelectric activity and an improvement in psychophysiological state occur against the background of changes in brain activity caused by the normalizing effect of xenon.
{"title":"Нейропсихологические особенности пациенток репродуктивного возраста с диагнозом рак молочной железы на этапе хирургического лечения с применением ксенон-кислородной терапии","authors":"Д. А. Розенко, А. И. Шихлярова, Лариса Ващенко, Наталья Николаевна Попова, Ю. Ю. Арапова, А. Ю. Арджа, А. А. Коробов","doi":"10.17709/2410-1893-2021-8-3-1","DOIUrl":"https://doi.org/10.17709/2410-1893-2021-8-3-1","url":null,"abstract":"Purpose of the study . To study functional changes in the neuropsychological status of reproductive age patients with newly diagnosed breast cancer and to assess the possibility of using xenon-oxygen therapy to correct disorders. Patients and methods . This study included 60 reproductive age patients with newly diagnosed breast cancer who were undergoing surgical treatment at the Department of Bone, Skin, Soft Tissue and Breast Tumors of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2018 to 2020. The main group included 30 patients with breast cancer diagnosed at the surgical stage of combined treatment, who underwent a rehabilitation course of xenon-oxygen therapy in the early postoperative period. The control group was formed from patients with the same diagnosis, without the use of this therapy. The functional state of the central nervous system in all patients was assessed by the parameters of the electroencephalography (EEG) bioelectrical activity. For the final assessment of the physiological and psychological state of the patients, a standardized questionnaires of the quality of life – ESAS, MOS-SF‑36, were used. Statistical data processing was performed using the Statistica 10 software package. Results . During the study, statistically significant differences were found in the assessment of subjective indicators, so in the group of patients using xenon-oxygen therapy, there was an improvement in well-being by 2.6 times, a decrease in depression by 2.3 times, a decrease in symptoms of nausea by 3 times, anxiety 1.9 times (p < 0.05). Against the background of an improvement in the psychophysiological state, the EEG showed a significant increase in the power of slow delta and theta rhythms, an increase in the power of the alpha rhythm and a decrease in the power of the beta rhythm, while in the patients of the control group only a decrease in the power of the beta rhythm was noted. Conclusion . The early postoperative period in patients with newly diagnosed breast cancer is characterized by the formation of a depressive symptom complex. The use of a course of xenon-oxygen therapy contributes to the normalization of the subjective feeling of physical and psychological health, increasing vital and social activity. Changes in the indicators of brain bioelectric activity and an improvement in psychophysiological state occur against the background of changes in brain activity caused by the normalizing effect of xenon.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130480532","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}
Pub Date : 2021-09-23DOI: 10.17709/2410-1893-2021-8-3-9
Илья Олегович Дементьев, К. М. Нюшко, Олег Борисович Карякин, В. С. Чайков, А. В. Троянов, И. Н. Заборский, Е. О. Щукина
Currently, due to the dynamic development of surgical technologies, indications for organ-sparing treatment of kidney cancer are expanding. Acute kidney injury is a serious complication that leads to chronic kidney disease, increased postoperative mortality, deterioration of long-term functional outcomes, and increased hospitalization. At present, it is known that even a slight damage to kidneys or their impairment, presented by a decreased urine output and change in blood biochemical parameters, entails serious clinical consequences and is associated with a poor prognosis. Damaging factors, when the kidney is exposed, initially induce molecular changes, which entail the production of certain biomarkers, and only after that clinical aspects of kidney damage develop. The causes of acute kidney injury can be different, from specific renal disorders (acute interstitial nephritis, vascular and glomerular lesions, prerenal azotemia, obstructive disorders) to toxic damages, direct trauma and surgical treatment. The development of acute renal injury in the postoperative period is a serious complication of the surgical treatment of kidney disease, and, according to various authors, the frequency of its occurrence varies from 5.5 % to 34 %. An active study of this problem made it possible to find specific biomarkers that give the possibility to predict and diagnose acute renal injury in the early stages, to optimize the treatment strategy, to reduce the incidence of postoperative complications, and to shorten the period of postoperative rehabilitation. Currently, the most studied of acute kidney injury (AKI) biomarkers are cystatin C, neutrophil gelatinase-associated lipocalin‑2 (NGAL), hepatic protein L-FABP, KIM‑1 (Kidney injury molecule‑1), Interleukin – 18. Further study of AKI biomarkers will make it possible to determine the most significant ones for subsequent use in everyday practice
{"title":"Роль биомаркеров острого повреждения почек в прогнозировании функциональных результатов хирургического лечения у больных локализованным раком почки","authors":"Илья Олегович Дементьев, К. М. Нюшко, Олег Борисович Карякин, В. С. Чайков, А. В. Троянов, И. Н. Заборский, Е. О. Щукина","doi":"10.17709/2410-1893-2021-8-3-9","DOIUrl":"https://doi.org/10.17709/2410-1893-2021-8-3-9","url":null,"abstract":"Currently, due to the dynamic development of surgical technologies, indications for organ-sparing treatment of kidney cancer are expanding. Acute kidney injury is a serious complication that leads to chronic kidney disease, increased postoperative mortality, deterioration of long-term functional outcomes, and increased hospitalization. At present, it is known that even a slight damage to kidneys or their impairment, presented by a decreased urine output and change in blood biochemical parameters, entails serious clinical consequences and is associated with a poor prognosis. Damaging factors, when the kidney is exposed, initially induce molecular changes, which entail the production of certain biomarkers, and only after that clinical aspects of kidney damage develop. The causes of acute kidney injury can be different, from specific renal disorders (acute interstitial nephritis, vascular and glomerular lesions, prerenal azotemia, obstructive disorders) to toxic damages, direct trauma and surgical treatment. The development of acute renal injury in the postoperative period is a serious complication of the surgical treatment of kidney disease, and, according to various authors, the frequency of its occurrence varies from 5.5 % to 34 %. An active study of this problem made it possible to find specific biomarkers that give the possibility to predict and diagnose acute renal injury in the early stages, to optimize the treatment strategy, to reduce the incidence of postoperative complications, and to shorten the period of postoperative rehabilitation. Currently, the most studied of acute kidney injury (AKI) biomarkers are cystatin C, neutrophil gelatinase-associated lipocalin‑2 (NGAL), hepatic protein L-FABP, KIM‑1 (Kidney injury molecule‑1), Interleukin – 18. Further study of AKI biomarkers will make it possible to determine the most significant ones for subsequent use in everyday practice","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114221830","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}
Pub Date : 2020-09-10DOI: 10.17709/2409-2231-2020-7-3-1
S. A. Ivanov, L. Petrov, D. Erygin, I. Gulidov, A. A. Karpov
Purpose of the study. Direct evaluation of the antitumor effectiveness of neoadjuvant chemoradiotherapy for rectal cancer using local electromagnetic hyperthermia. Materials and methods. The analysis of the direct results of treatment of patients with locally advanced rectal cancer in the clinic of the MRRC them. A.F.Tsyba is a branch of the Federal State Budgetary Institution Scientific Research Center for Radiology of the Ministry of Health of Russia from 2015 to 2018. The study included 2 groups of patients: the study group of 54 patients and the control group of 56 people. All patients underwent a comprehensive examination with the aim of staging and morphological verification of the tumor. Patients of the study group in the neoadjuvant mode received conventional radiation therapy with classical dose fractionation in ROD 2 Gy, up to SOD 50 Gy, for 5 weeks with CAPOX chemotherapy, and local electromagnetic hyperthermia on the Yacht 4 unit, in the amount of 6 sessions. Patients in the control group received neoadjuvant treatment in an absolutely identical manner, with the exception of local hyperthermia. After the end of neoadjuvant therapy after 8–10 weeks, a comprehensive examination was again performed to assess the response of the tumor and a decision was made to conduct surgical treatment. During the follow-up examination, the following parameters were evaluated: tumor regression according to clinical and radiological examination. After surgical treatment, a comprehensive evaluation of the removed drug was carried out, including an assessment of the degree of therapeutic tumor pathomorphism according to Lavnikova G. P. Results. When conducting a comparative analysis of the frequency of complete clinical regressions of the tumor in the thermo-chemoradiotherapy group, we more often recorded the full clinical response, 12 patients (22%), compared with the chemoradiotherapy group, 8 patients (14%). In terms of partial response and stabilization in the chemoradiotherapy group, partial regression was observed in 75% of patients, while in the thermochemioradiation group only in 52% of cases. Stabilization in the study and control groups was 14% and 6%, respectively. All patients of the study and control groups with partial tumor regression and stabilization underwent surgical treatment. As a result, the frequency of surgical operations in the control group was slightly higher than 48 (85.7%) versus 42 (77.7%) from the main group (p>0.05). When analyzing the frequency of a complete pathomorphological response, we noted that in the thermochemo-radiation therapy group it was 34% versus 4% in the chemo-radiation therapy group. On the contrary, pathomorphism of the 1st degree was much more common in patients of the control group — 21% versus 2% in the study group. The differences in both cases are statistically highly significant (p<0.001, χ 2 15, χ 2 7). Conclusion. The use of thermochemoradiotherapy with high statistical significance (p<0.001) incre
研究目的:局部电磁热疗对直肠癌新辅助放化疗抗肿瘤效果的直接评价。材料和方法。分析局部晚期直肠癌患者在MRRC临床治疗的直接效果。aftsyba是2015年至2018年俄罗斯卫生部联邦国家预算机构放射学科学研究中心的分支机构。本研究分为两组患者:研究组54例，对照组56例。所有患者都接受了全面的检查，目的是肿瘤的分期和形态学验证。新辅助模式下，研究组患者接受传统放射治疗，ROD 2 Gy, SOD 50 Gy，经典剂量分割，5周，CAPOX化疗，Yacht 4单元局部电磁热疗，共6个疗程。对照组患者除局部热疗外，以完全相同的方式接受新辅助治疗。新辅助治疗结束后8-10周，再次进行全面检查以评估肿瘤的反应，并决定进行手术治疗。在随访检查中，评估以下参数:根据临床和放射学检查肿瘤消退。手术治疗后，对移除的药物进行综合评价，包括根据Lavnikova G. P. Results评估治疗性肿瘤的病理程度。在对热放化疗组肿瘤临床完全消退的频率进行比较分析时，我们更多地记录了完全临床缓解，12例(22%)，而放化疗组为8例(14%)。在部分缓解和稳定方面，放化疗组75%的患者出现部分消退，而热化学放疗组只有52%的病例出现部分消退。研究组和对照组的稳定性分别为14%和6%。所有肿瘤部分消退稳定的实验组和对照组患者均行手术治疗。对照组手术次数48次(85.7%)略高于对照组42次(77.7%)(p>0.05)。当分析完全病理形态学反应的频率时，我们注意到，在热化疗-放疗组中，这一比例为34%，而在化疗-放疗组中为4%。相反，1级病理型在对照组患者中更为常见，为21%，而研究组为2%。两种病例的差异具有高度统计学意义(p<0.001， χ 2 15， χ 27)。使用具有高统计学意义(p<0.001)的热放化疗增加了完全病理形态学反应的频率:研究组为34%，而放化疗组为4%。
{"title":"Direct effectiveness of adding local hyperthermia to the scheme of neoadjuvant chemoradiotherapy for locally advanced rectal cancer","authors":"S. A. Ivanov, L. Petrov, D. Erygin, I. Gulidov, A. A. Karpov","doi":"10.17709/2409-2231-2020-7-3-1","DOIUrl":"https://doi.org/10.17709/2409-2231-2020-7-3-1","url":null,"abstract":"Purpose of the study. Direct evaluation of the antitumor effectiveness of neoadjuvant chemoradiotherapy for rectal cancer using local electromagnetic hyperthermia. Materials and methods. The analysis of the direct results of treatment of patients with locally advanced rectal cancer in the clinic of the MRRC them. A.F.Tsyba is a branch of the Federal State Budgetary Institution Scientific Research Center for Radiology of the Ministry of Health of Russia from 2015 to 2018. The study included 2 groups of patients: the study group of 54 patients and the control group of 56 people. All patients underwent a comprehensive examination with the aim of staging and morphological verification of the tumor. Patients of the study group in the neoadjuvant mode received conventional radiation therapy with classical dose fractionation in ROD 2 Gy, up to SOD 50 Gy, for 5 weeks with CAPOX chemotherapy, and local electromagnetic hyperthermia on the Yacht 4 unit, in the amount of 6 sessions. Patients in the control group received neoadjuvant treatment in an absolutely identical manner, with the exception of local hyperthermia. After the end of neoadjuvant therapy after 8–10 weeks, a comprehensive examination was again performed to assess the response of the tumor and a decision was made to conduct surgical treatment. During the follow-up examination, the following parameters were evaluated: tumor regression according to clinical and radiological examination. After surgical treatment, a comprehensive evaluation of the removed drug was carried out, including an assessment of the degree of therapeutic tumor pathomorphism according to Lavnikova G. P. Results. When conducting a comparative analysis of the frequency of complete clinical regressions of the tumor in the thermo-chemoradiotherapy group, we more often recorded the full clinical response, 12 patients (22%), compared with the chemoradiotherapy group, 8 patients (14%). In terms of partial response and stabilization in the chemoradiotherapy group, partial regression was observed in 75% of patients, while in the thermochemioradiation group only in 52% of cases. Stabilization in the study and control groups was 14% and 6%, respectively. All patients of the study and control groups with partial tumor regression and stabilization underwent surgical treatment. As a result, the frequency of surgical operations in the control group was slightly higher than 48 (85.7%) versus 42 (77.7%) from the main group (p>0.05). When analyzing the frequency of a complete pathomorphological response, we noted that in the thermochemo-radiation therapy group it was 34% versus 4% in the chemo-radiation therapy group. On the contrary, pathomorphism of the 1st degree was much more common in patients of the control group — 21% versus 2% in the study group. The differences in both cases are statistically highly significant (p<0.001, χ 2 15, χ 2 7). Conclusion. The use of thermochemoradiotherapy with high statistical significance (p<0.001) incre","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124443378","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}
Pub Date : 2020-06-23DOI: 10.17709/2409-2231-2020-7-2-1
A. Kaprin, E. Gameeva, D. O. Roshchin, A. Kostin, G. S. Alekseeva, V. Khoronenko, G. Abuzarova, A. Fedenko, L. V. Pashigorova, Y. Samsonov
The article is devoted to the most relevant topic at present - the possibilities of providing full medical care to cancer patients in the context of the spread of the COVID-19 coronavirus pandemic Cancer patients are the most vulnerable group, because they are at high risk from the position of immunosuppression, which is often combined with other risk factors for infection: old age, diabetes and cardiovascular diseases Procrastination and delaying the start of antitumor therapy is unacceptable, since it inevitably leads to a deterioration of treatment results, an increase in one-year mortality and worsens the overall survival rate for malignant neoplasms Thus, it is necessary to develop a set of measures that will allow all types of anti-cancer treatment to be carried out in parallel with anti-epidemic measures without losing the quality of treatment and preserving the safety of patients and medical personnel Статья посвящена наиболее актуальной в настоящее время теме - возможностям оказания полноценной медицинской помощи онкологическим пациентам в условиях распространения пандемии коронавируса COVID-19 Онкологические пациенты являются наиболее уязвимым контингентом, поскольку находятся в зоне повышенного риска с позиции иммуносупрессии, которая зачастую сочетается с остальными факторами риска развития инфекции: пожилой возраст, наличие диабета и сердечно-сосудистых заболеваний Промедление и затягивание сроков начала противоопухолевой терапии недопустимы, поскольку неизбежно ведут к ухудшению результатов лечения, повышению одногодичной летальности и ухудшают показатели общей выживаемости при злокачественных новообразованиях Таким образом, необходимо разработать комплекс мер, которые позволят проводить все виды противоопухолевого лечения параллельно с противоэпидемическими мероприятиями без потери качества лечения и сохраняя безопасность для пациентов и медицинского персонала
{"title":"Remodeling the cancer service in the context of the COVID-19 pandemic at the Federal research center of the 1st level","authors":"A. Kaprin, E. Gameeva, D. O. Roshchin, A. Kostin, G. S. Alekseeva, V. Khoronenko, G. Abuzarova, A. Fedenko, L. V. Pashigorova, Y. Samsonov","doi":"10.17709/2409-2231-2020-7-2-1","DOIUrl":"https://doi.org/10.17709/2409-2231-2020-7-2-1","url":null,"abstract":"The article is devoted to the most relevant topic at present - the possibilities of providing full medical care to cancer patients in the context of the spread of the COVID-19 coronavirus pandemic Cancer patients are the most vulnerable group, because they are at high risk from the position of immunosuppression, which is often combined with other risk factors for infection: old age, diabetes and cardiovascular diseases Procrastination and delaying the start of antitumor therapy is unacceptable, since it inevitably leads to a deterioration of treatment results, an increase in one-year mortality and worsens the overall survival rate for malignant neoplasms Thus, it is necessary to develop a set of measures that will allow all types of anti-cancer treatment to be carried out in parallel with anti-epidemic measures without losing the quality of treatment and preserving the safety of patients and medical personnel Статья посвящена наиболее актуальной в настоящее время теме - возможностям оказания полноценной медицинской помощи онкологическим пациентам в условиях распространения пандемии коронавируса COVID-19 Онкологические пациенты являются наиболее уязвимым контингентом, поскольку находятся в зоне повышенного риска с позиции иммуносупрессии, которая зачастую сочетается с остальными факторами риска развития инфекции: пожилой возраст, наличие диабета и сердечно-сосудистых заболеваний Промедление и затягивание сроков начала противоопухолевой терапии недопустимы, поскольку неизбежно ведут к ухудшению результатов лечения, повышению одногодичной летальности и ухудшают показатели общей выживаемости при злокачественных новообразованиях Таким образом, необходимо разработать комплекс мер, которые позволят проводить все виды противоопухолевого лечения параллельно с противоэпидемическими мероприятиями без потери качества лечения и сохраняя безопасность для пациентов и медицинского персонала","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122898452","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}
Pub Date : 2019-06-28DOI: 10.17709/2409-2231-2019-6-2-5
V. B. Filimonov, R. V. Vasin, I. S. Sobennikov
Purpose of the study. To improve the quality of prostate transurethral resection by means of intraoperative ultrasound monitoring of the removed tissue volume.Patients and methods. The study included 92 patients who, according to indications, underwent prostate transurethral resection. Patients were divided into 2 groups. The 1st group included patients (n = 50) operated on using the method of monitoring the removed tissue volume, proposed in the study. The average age of patients in this group was 67.4 ± 3.88 years, the average prostate volume before surgery was 59.5 ± 4.5 cm3 with a range of values from 42 cm3 to 94 cm3. The 2nd group (n = 42) included patients operated on according to the classical method of prostate transurethral resection. The average age of patients in this group was 68.1 ± 2.9 years, the average prostate volume before surgery was 53.5 ± 4.5 cm3. Results. The average prostate volume atier surgery in patients of the 1st group was 23.2 ± 1.8 cm3. Thus, the average volume of the removed tissue was 63.2% of the prostate gland initial volume. The average prostate volume atier surgery in patients of the 2nd group was 25.6 ± 1.9 cm3 (p < 0.05). The average volume of the removed tissue was 52.1% of the prostate gland initial volume. The number of complications is comparable in groups of patients. When using the removed tissue control during surgery, it was possible to increase the resection radicality, which is refl ected by a smaller average residual volume of the prostate gland (by 9.4%) atier surgery.Conclusion. The use of ultrasonic control of the prostate adenoma removed tissue volume during prostate transurethral resection does not increase the risks of possible postoperative complications, wherein increases radicality of the performed operation.
{"title":"IMPROVING THE QUALITY OF PROSTATE TRANSURETHRAL RESECTION IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA THROUGH INTRAOPERATIVE TRANSRECTAL ULTRASOUND MONITORING OF THE REMOVED TISSUE VOLUME","authors":"V. B. Filimonov, R. V. Vasin, I. S. Sobennikov","doi":"10.17709/2409-2231-2019-6-2-5","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-2-5","url":null,"abstract":"Purpose of the study. To improve the quality of prostate transurethral resection by means of intraoperative ultrasound monitoring of the removed tissue volume.Patients and methods. The study included 92 patients who, according to indications, underwent prostate transurethral resection. Patients were divided into 2 groups. The 1st group included patients (n = 50) operated on using the method of monitoring the removed tissue volume, proposed in the study. The average age of patients in this group was 67.4 ± 3.88 years, the average prostate volume before surgery was 59.5 ± 4.5 cm3 with a range of values from 42 cm3 to 94 cm3. The 2nd group (n = 42) included patients operated on according to the classical method of prostate transurethral resection. The average age of patients in this group was 68.1 ± 2.9 years, the average prostate volume before surgery was 53.5 ± 4.5 cm3. Results. The average prostate volume atier surgery in patients of the 1st group was 23.2 ± 1.8 cm3. Thus, the average volume of the removed tissue was 63.2% of the prostate gland initial volume. The average prostate volume atier surgery in patients of the 2nd group was 25.6 ± 1.9 cm3 (p < 0.05). The average volume of the removed tissue was 52.1% of the prostate gland initial volume. The number of complications is comparable in groups of patients. When using the removed tissue control during surgery, it was possible to increase the resection radicality, which is refl ected by a smaller average residual volume of the prostate gland (by 9.4%) atier surgery.Conclusion. The use of ultrasonic control of the prostate adenoma removed tissue volume during prostate transurethral resection does not increase the risks of possible postoperative complications, wherein increases radicality of the performed operation.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122168736","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}
Pub Date : 2019-06-28DOI: 10.17709/2409-2231-2019-6-2-9
E. Frantsiyants, E. Sheiko
The review examined and analyzed scientific publications on the effect of electromagnetic fields (EMF) on various systems of the human body and animals with tumors, as well as on pain in the experiment and the clinic. The theoretical foundations and practical results of the use of EMF in various modulations and modes in the goals and objectives of oncology, including how to optimize the process of anesthesia and correct the vital activity of the body's functional systems with a tumor, are consecrated. Information is given on possible physicochemical effects, features, and mechanisms of therapeutic influence at various levels of a living organism. The ability of electromagnetic waves to transfer information both within a single biosystem and at the level of a whole living organism with a tumor is shown. Studies of combined action of EMF and chemotherapy were analyzed. It has been established that there are experimental prerequisites for using this factor in order to induce changes in the permeability of the membranes of tumor cells by increasing the internalization of chemotherapeutic agents and, thus, enhance the antitumor effect. The role of EMF in the induction of apoptosis in tumor cells is shown. It has been shown that chemotherapy together with electromagnetic fields induces apoptosis and has an inhibitory effect on DNA synthesis in osteosarcoma cells, breast cancer, colon cancer, melanoma and other tumors. The role of magnetic fields in order to enhance the analgesic effect was investigated. The analgesic effect is due to the cessation or weakening of nerve impulses from the painful focus due to the elimination of hypoxia, the improvement of microcirculation, and the reduction of edema, it has been shown. Transcranial magnetic therapy is used as an analgesic tool in onconurology. The therapeutic anti-pain effect is associated with the stimulation of the antinociceptive system, an increase in the synthesis of natural analgesics — endorphins with their subsequent release into the cerebrospinal fluid and blood. As it has already been shown, with the increase in the intensity of pain and its duration, all indicators of the quality of life and the results of treatment of the patient deteriorate, so the search for ways to improve the antitumor effectiveness of specialized treatment and eliminate the causes that prevent their implementation continue to be relevant and in demand.
{"title":"ANTITUMOR EFFECT OF ELECTROMAGNETIC FIELDS AND THEIR EFFECT ON PAIN IN EXPERIMENTAL AND CLINICAL ONCOLOGY","authors":"E. Frantsiyants, E. Sheiko","doi":"10.17709/2409-2231-2019-6-2-9","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-2-9","url":null,"abstract":"The review examined and analyzed scientific publications on the effect of electromagnetic fields (EMF) on various systems of the human body and animals with tumors, as well as on pain in the experiment and the clinic. The theoretical foundations and practical results of the use of EMF in various modulations and modes in the goals and objectives of oncology, including how to optimize the process of anesthesia and correct the vital activity of the body's functional systems with a tumor, are consecrated. Information is given on possible physicochemical effects, features, and mechanisms of therapeutic influence at various levels of a living organism. The ability of electromagnetic waves to transfer information both within a single biosystem and at the level of a whole living organism with a tumor is shown. Studies of combined action of EMF and chemotherapy were analyzed. It has been established that there are experimental prerequisites for using this factor in order to induce changes in the permeability of the membranes of tumor cells by increasing the internalization of chemotherapeutic agents and, thus, enhance the antitumor effect. The role of EMF in the induction of apoptosis in tumor cells is shown. It has been shown that chemotherapy together with electromagnetic fields induces apoptosis and has an inhibitory effect on DNA synthesis in osteosarcoma cells, breast cancer, colon cancer, melanoma and other tumors. The role of magnetic fields in order to enhance the analgesic effect was investigated. The analgesic effect is due to the cessation or weakening of nerve impulses from the painful focus due to the elimination of hypoxia, the improvement of microcirculation, and the reduction of edema, it has been shown. Transcranial magnetic therapy is used as an analgesic tool in onconurology. The therapeutic anti-pain effect is associated with the stimulation of the antinociceptive system, an increase in the synthesis of natural analgesics — endorphins with their subsequent release into the cerebrospinal fluid and blood. As it has already been shown, with the increase in the intensity of pain and its duration, all indicators of the quality of life and the results of treatment of the patient deteriorate, so the search for ways to improve the antitumor effectiveness of specialized treatment and eliminate the causes that prevent their implementation continue to be relevant and in demand.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124771025","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}
Pub Date : 2019-06-28DOI: 10.17709/2409-2231-2019-6-2-4
T. P. Berezoskaya, S. A. Mozerov, Ya. A. Dayneko, A. Nevolskikh, Z. Shavladze, S. A. Ivanov, A. Kaprin
Purpose of the study. To study the patterns of forming an MRI picture of a complete pathological morphological response (pCR) of colorectal cancer a er neoadjuvant chemoradia on therapy (NHLT) based on comparisons with the pathomorphological picture. Patients and methods. Among 130 patients with locally advanced colorectal cancer who received a combined treatment with NHL at A. Tsyb MRRC clinic — a Branch of HMRRC of the Ministry of Health of the Russian Federation within the period 2012–2017 thirteen patients were selected for the study, in whom pCR was achieved, according to the pathological analysis of surgical specimen. MRI was performed on all patients before the NHLT and atier the end (atier 6–10 weeks) of treatment. We analyzed the MRI fi ndings from case histories (prospective assessment) on degree of tumor regression (mrTRG) using a fi ve-point grading scale. Ten of these patients had MRI examinations available for re-review (retrospective assessment), which allowed for a qualitate ve assessment of the signal intensity in T2 mode on a nominal scale, according to which low, medium, moderately elevated and high MR signals were discerned; signal localization was determined relative to the intestinal lumen with conditional selection of the inner and outer layer of the wall, and the outer contour was charactezied (smooth or uneven due to hypointense spicules). The obtained data on the localization of the MR signal of varying intensity were compared with the data of the pathological description of the operating drugs.Results. A prospective MRI assessment of pCR in 77% of cases corresponded to TRG2 and in 92% — y N0. Macroscopically, the pCR in all patients had an appearance of an ulcerative defect of the intestinal wall, to which on T2-WI in 80% of cases corresponded to a moderately elevated MR signal from the inside of the wall, due to necroti c changes and granulations, and in 100% of cases — a low MR signal from the outer layer of the intestinal wall, caused by a more mature connective tissue, the outer contour in 50% of cases was tight due to the desmoplastic reaction; hypo-intensive inclusions corresponded to lime deposits, and “mucous lakes” — inclusions with high signal intensity and clear contours.Conclusion The features of forming MRI picture of the pCR are due to a range of radiation pathomorphosis manifestations, including destructive, regenera ve and infl ammatory processes in the tumor stroma.
{"title":"MRI-PATHOLOGICAL PARALLELS WITH THE COMPLETE TUMOR RESPONSE TO NEOADJUVANT CHEMORADIATION TREATMENT OF RECTAL CANCER","authors":"T. P. Berezoskaya, S. A. Mozerov, Ya. A. Dayneko, A. Nevolskikh, Z. Shavladze, S. A. Ivanov, A. Kaprin","doi":"10.17709/2409-2231-2019-6-2-4","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-2-4","url":null,"abstract":"Purpose of the study. To study the patterns of forming an MRI picture of a complete pathological morphological response (pCR) of colorectal cancer a er neoadjuvant chemoradia\u0085 on therapy (NHLT) based on comparisons with the pathomorphological picture. Patients and methods. Among 130 patients with locally advanced colorectal cancer who received a combined treatment with NHL at A. Tsyb MRRC clinic — a Branch of HMRRC of the Ministry of Health of the Russian Federation within the period 2012–2017 thirteen patients were selected for the study, in whom pCR was achieved, according to the pathological analysis of surgical specimen. MRI was performed on all patients before the NHLT and atier the end (atier 6–10 weeks) of treatment. We analyzed the MRI fi ndings from case histories (prospective assessment) on degree of tumor regression (mrTRG) using a fi ve-point grading scale. Ten of these patients had MRI examinations available for re-review (retrospective assessment), which allowed for a qualitate ve assessment of the signal intensity in T2 mode on a nominal scale, according to which low, medium, moderately elevated and high MR signals were discerned; signal localization was determined relative to the intestinal lumen with conditional selection of the inner and outer layer of the wall, and the outer contour was charactezied (smooth or uneven due to hypointense spicules). The obtained data on the localization of the MR signal of varying intensity were compared with the data of the pathological description of the operating drugs.Results. A prospective MRI assessment of pCR in 77% of cases corresponded to TRG2 and in 92% — y N0. Macroscopically, the pCR in all patients had an appearance of an ulcerative defect of the intestinal wall, to which on T2-WI in 80% of cases corresponded to a moderately elevated MR signal from the inside of the wall, due to necroti c changes and granulations, and in 100% of cases — a low MR signal from the outer layer of the intestinal wall, caused by a more mature connective tissue, the outer contour in 50% of cases was tight due to the desmoplastic reaction; hypo-intensive inclusions corresponded to lime deposits, and “mucous lakes” — inclusions with high signal intensity and clear contours.Conclusion The features of forming MRI picture of the pCR are due to a range of radiation pathomorphosis manifestations, including destructive, regenera\u0085 ve and infl ammatory processes in the tumor stroma.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124919578","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}
Pub Date : 2019-06-28DOI: 10.17709/2409-2231-2019-6-2-7
A. Syskova, I. Stilidi, A. N. Polyakov
Common bile duct cancer is a rare malignant disease with a poor prognosis. Five-year overall survival is 18-48%, and more than half of the patients relapse within five years. Metastases in the regional lymph nodes and the presence of tumor cells in the margin of the resection are independent factors of a negative prognosis and are associated with a high risk of recurrence. The clinical significance of other prognostic factors, such as renal invasion, low degree of differentiation, tumor size, pancreatic invasion and the need for resection of adjacent organs, require further study.
{"title":"PROGNOSTIC FACTORS FOR RESECTABLE COMMON BILE DUCT CANCER","authors":"A. Syskova, I. Stilidi, A. N. Polyakov","doi":"10.17709/2409-2231-2019-6-2-7","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-2-7","url":null,"abstract":"Common bile duct cancer is a rare malignant disease with a poor prognosis. Five-year overall survival is 18-48%, and more than half of the patients relapse within five years. Metastases in the regional lymph nodes and the presence of tumor cells in the margin of the resection are independent factors of a negative prognosis and are associated with a high risk of recurrence. The clinical significance of other prognostic factors, such as renal invasion, low degree of differentiation, tumor size, pancreatic invasion and the need for resection of adjacent organs, require further study.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127078047","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}
Pub Date : 2019-06-28DOI: 10.17709/2409-2231-2019-6-2-2
G. D. Iluridze, V. Karpenko, V. Derzhavin, A. V. Bukharov
Surgical treatment of patients with tumoral defeat of pelvic bones, of preacetabular region, in particular, is one of the most challenging topics of modern oncorthopedics. Currently, one of the most modern methods of reconstruction of the pelvic bones is the use of modular endoprostheses based on the conical leg, the advantage of which is the ability to intraoperatively simulate an endoprosthesis that best meets the specific clinical situation. Purpose of research. To assess the benefits of modular endoprosthesis of the acetabulum in patients with tumoral defeat periacetabular region.Patients and methods. Within the period of 2011–2018 30 patients underwent surgical treatment in form of periacetabular resection with a modular endoprosthesis reconstruction in P.Hertsen Moscow Oncology Research Institute – Branch of National Medical Research Radiological Centre of Ministry of Health of Russian Federation. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary bone cancers were in 19 (63%) patients, giant cell tumors in 5 (17%), locally advanced soft tissue sarcoma in 1 (3%), solitary metastases of kidney cancer in 2 (7%), and recurrent sarcomas after previous surgical treatment in 3 (10%) patients.Results. The average duration of the operation was 310 min (145–520 min), the volume of intraoperative blood loss was 5520 ml (600–20 000 ml). The positive edge of resection according to the results of the planned morphological study was revealed in 3 (10%) patients. The average follow-up period was 36 months (4-73 months). Disease progression in terms of 6 to 40 months was revealed in 10 (33%) patients. 8 (27%) patients from disease progression. Complications of different types were diagnosed in 11 (37%) patients, among whom infectious complications prevailed 9 (30%). The average value of the functional results on a scale MSTS accounted for 59% (15 to 82%). Conclusion. The use of modular systems of endoprosthesis replacement of the acetabulum and hip joint in tumor lesions is a promising surgical technique that allows to achieve adequate functional results with a comparable number of postoperative complications.
{"title":"THE RESULTS OF MODULAR ENDOPROSTHESIS OF PERIACETABULAR REGION IN TUMOR LESIONS OF THE ACETABULUM AND HIP JOINT","authors":"G. D. Iluridze, V. Karpenko, V. Derzhavin, A. V. Bukharov","doi":"10.17709/2409-2231-2019-6-2-2","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-2-2","url":null,"abstract":"Surgical treatment of patients with tumoral defeat of pelvic bones, of preacetabular region, in particular, is one of the most challenging topics of modern oncorthopedics. Currently, one of the most modern methods of reconstruction of the pelvic bones is the use of modular endoprostheses based on the conical leg, the advantage of which is the ability to intraoperatively simulate an endoprosthesis that best meets the specific clinical situation. Purpose of research. To assess the benefits of modular endoprosthesis of the acetabulum in patients with tumoral defeat periacetabular region.Patients and methods. Within the period of 2011–2018 30 patients underwent surgical treatment in form of periacetabular resection with a modular endoprosthesis reconstruction in P.Hertsen Moscow Oncology Research Institute – Branch of National Medical Research Radiological Centre of Ministry of Health of Russian Federation. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary bone cancers were in 19 (63%) patients, giant cell tumors in 5 (17%), locally advanced soft tissue sarcoma in 1 (3%), solitary metastases of kidney cancer in 2 (7%), and recurrent sarcomas after previous surgical treatment in 3 (10%) patients.Results. The average duration of the operation was 310 min (145–520 min), the volume of intraoperative blood loss was 5520 ml (600–20 000 ml). The positive edge of resection according to the results of the planned morphological study was revealed in 3 (10%) patients. The average follow-up period was 36 months (4-73 months). Disease progression in terms of 6 to 40 months was revealed in 10 (33%) patients. 8 (27%) patients from disease progression. Complications of different types were diagnosed in 11 (37%) patients, among whom infectious complications prevailed 9 (30%). The average value of the functional results on a scale MSTS accounted for 59% (15 to 82%). Conclusion. The use of modular systems of endoprosthesis replacement of the acetabulum and hip joint in tumor lesions is a promising surgical technique that allows to achieve adequate functional results with a comparable number of postoperative complications.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123982371","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}
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