Antipsychotic-induced extrapyramidal symptoms should be recognised and adequately treated. We report an unusual complication of not doing so: a patient’s self-medicating to control these symptoms, which produced diphenhydramine-dependence.
{"title":"Diphenhydramine-dependence Resulting From Self-medication of Antipsychotic- induced Extrapyramidal Symptoms","authors":"Faisal S Shaikh M.B.B.S., A. Mortimer","doi":"10.29046/JJP.021.1.005","DOIUrl":"https://doi.org/10.29046/JJP.021.1.005","url":null,"abstract":"Antipsychotic-induced extrapyramidal symptoms should be recognised and adequately treated. We report an unusual complication of not doing so: a patient’s self-medicating to control these symptoms, which produced diphenhydramine-dependence.","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"4 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87245979","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}
Genital self-mutilation (GSM) is a rare event that is commonly associated with psychotic disorders; we report an occurrence in the context of psychosis and drug use. We also review the etiologies of this phenomenon and how these etiologies differ across gender.
{"title":"Autocastration and Autoamputation of the Penis in a Patient with Delusions of Sexual Guilt","authors":"C. Franke, J. Rush","doi":"10.29046/JJP.021.1.002","DOIUrl":"https://doi.org/10.29046/JJP.021.1.002","url":null,"abstract":"Genital self-mutilation (GSM) is a rare event that is commonly associated with psychotic disorders; we report an occurrence in the context of psychosis and drug use. We also review the etiologies of this phenomenon and how these etiologies differ across gender.","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"2 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90200530","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}
Introductory Remarks The Evidence-Based Medicine (EBM) movement crystallized in the early 1990’s at McMaster University in Canada (3). The movement originally challenged practitioners to validate their treatments based on reasoning and clinical studies rather than personal authority (9). In this essay, I will argue that, contrary to this wholesome intention, EBM is authoritarian in spirit and actually constricts discourse about how to make clinical decisions.
{"title":"Evidence-B(i)ased Medicine: Limitations and Non-Superstition-Based Alternatives","authors":"Green, S. Joshua","doi":"10.29046/JJP.021.1.006","DOIUrl":"https://doi.org/10.29046/JJP.021.1.006","url":null,"abstract":"Introductory Remarks The Evidence-Based Medicine (EBM) movement crystallized in the early 1990’s at McMaster University in Canada (3). The movement originally challenged practitioners to validate their treatments based on reasoning and clinical studies rather than personal authority (9). In this essay, I will argue that, contrary to this wholesome intention, EBM is authoritarian in spirit and actually constricts discourse about how to make clinical decisions.","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"51 6 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91123835","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}
Neurofibromatosis, type 1, (NF1) is a common neurocutaneous disorder of childhood. Little is known about the psychiatric aspects of the condition. We present the case of a 10-year-old male with NF1 and complex spells. For two years he had been experiencing self-limited paroxysms of auditory and visual hallucination, assaultiveness, excited undressing, and amnesia. The spells have been refractory to multiple treatments, including antipsychotic medication. The question remains whether this episodic amnestic disorder is comorbid with NF1 or is caused by it. Neurofibromatosis is a relatively common neurocutaneous disorder that consistently has its onset in childhood. Most common is type 1 (NF1), also known as von Recklinghausen’s neurofibromatosis, which accounts for 85 percent of cases and has an incidence of 1 in 3000 persons (1). Penetrance of NF1 is complete in those with the mutation, whether the mutation is sporadic or familial in origin. Phenotypic expression of the disorder varies greatly, even among family members (2). Clinical features of NF1 are decreased stature, scoliosis, hypertension, cognitive impairment, learning disability, and seizure disorders. Benign and malignant tumors of central nervous system (CNS) and non-CNS origin may occur (3-5). Little is known about the relationship between the disease and psychiatric disorders. Mouridsen and Sorensen (6), in a review of the literature, describe associations between NF1 and autism, learning disability, and attention deficit/hyperactivity disorder (ADHD). In one study, 23 (33%) of 69 adult patients with NF1 had comorbid psychiatric illness: depressive syndromes, anxiety with somatic complaints, and organic
{"title":"Dissociative-like Spells in a Child With Neurofibromatosis (type 1)","authors":"G. Singleton, Ann M. Lagges, Karen G. Meighen","doi":"10.29046/JJP.021.1.004","DOIUrl":"https://doi.org/10.29046/JJP.021.1.004","url":null,"abstract":"Neurofibromatosis, type 1, (NF1) is a common neurocutaneous disorder of childhood. Little is known about the psychiatric aspects of the condition. We present the case of a 10-year-old male with NF1 and complex spells. For two years he had been experiencing self-limited paroxysms of auditory and visual hallucination, assaultiveness, excited undressing, and amnesia. The spells have been refractory to multiple treatments, including antipsychotic medication. The question remains whether this episodic amnestic disorder is comorbid with NF1 or is caused by it. Neurofibromatosis is a relatively common neurocutaneous disorder that consistently has its onset in childhood. Most common is type 1 (NF1), also known as von Recklinghausen’s neurofibromatosis, which accounts for 85 percent of cases and has an incidence of 1 in 3000 persons (1). Penetrance of NF1 is complete in those with the mutation, whether the mutation is sporadic or familial in origin. Phenotypic expression of the disorder varies greatly, even among family members (2). Clinical features of NF1 are decreased stature, scoliosis, hypertension, cognitive impairment, learning disability, and seizure disorders. Benign and malignant tumors of central nervous system (CNS) and non-CNS origin may occur (3-5). Little is known about the relationship between the disease and psychiatric disorders. Mouridsen and Sorensen (6), in a review of the literature, describe associations between NF1 and autism, learning disability, and attention deficit/hyperactivity disorder (ADHD). In one study, 23 (33%) of 69 adult patients with NF1 had comorbid psychiatric illness: depressive syndromes, anxiety with somatic complaints, and organic","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"207 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77686768","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}
Gastrointestinal complications of anticholinergic medications are prevalent, potentially life-threatening, and could be more actively prevented. We present a case report of an ileus that required surgical intervention and developed in the context of clozapine, benztropine, and fluoxetine use. The case exemplifies the potential anticholinergic toxicities of clozapine and benztropine as well as possible pharmacokinetic interactions between fluoxetine, clozapine, and benztropine. We discuss ways to minimize the likelihood of anticholinergic complications with these medications.
{"title":"Clozapine, Fluoxetine, and Benztropine- associated Ileus: Case Report","authors":"Pegah Pajouhi, J. O.D.","doi":"10.29046/JJP.021.1.001","DOIUrl":"https://doi.org/10.29046/JJP.021.1.001","url":null,"abstract":"Gastrointestinal complications of anticholinergic medications are prevalent, potentially life-threatening, and could be more actively prevented. We present a case report of an ileus that required surgical intervention and developed in the context of clozapine, benztropine, and fluoxetine use. The case exemplifies the potential anticholinergic toxicities of clozapine and benztropine as well as possible pharmacokinetic interactions between fluoxetine, clozapine, and benztropine. We discuss ways to minimize the likelihood of anticholinergic complications with these medications.","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"78 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79748509","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}
A. Shefrin, D. Puddester, S. Greenham, L. Bisnaire, Hazen Gandy
Psychiatrists are often left with the dilemma of which investigations to order in adolescents presenting with a first episode of psychosis. Blood work, urine studies, and neuroimaging studies were tracked in 13 adolescents admitted with a diagnosis of first-episode psychosis over a 13-month period to the Children’s Hospital of Eastern Ontario. Variation was found in the amount of investigation ordered: 85% of patients received a drug screen; 54% a CT scan; 8% an MRI; 92% a CBC with differential; 92% electrolytes. Abnormalities of CT scans were detected in 2 patients (29%); in neither case did the result lead to a diagnosis of brain-lesion-related psychosis, nor did it affect the clinical care of the patient. This study highlights the need to develop clinical practice-guidelines for the workup of first-episode psychosis in adolescents. First-episode psychosis has received considerable attention in both the pediatric and adult literature. One area of ongoing research is the degree to which children and adolescents require investigations to rule in or rule out non-psychiatric disease. According to the Diagnostic and Statistical Manual of Mental Disorders 4 Edition Text Revision (DSM-IV-TR), the diagnosis of schizophrenia and other psychotic illnesses require that criteria be met: where “the disturbance is not due to the direct physiological effects of a substance (e.g., of abuse or a medication) or a general medical condition”(1). Yet, in spite of these essential criteria, a standardized workup for first episode psychosis in children and youth is difficult to find. Psychiatry associations and textbooks differ in their recommendations and often leave the decision to perform a test at the discretion of the attending physician. A summary of different guidelines can be found in Table 1.
{"title":"What Investigations Are Ordered in Patients with First-episode Psychosis?","authors":"A. Shefrin, D. Puddester, S. Greenham, L. Bisnaire, Hazen Gandy","doi":"10.29046/JJP.020.1.001","DOIUrl":"https://doi.org/10.29046/JJP.020.1.001","url":null,"abstract":"Psychiatrists are often left with the dilemma of which investigations to order in adolescents presenting with a first episode of psychosis. Blood work, urine studies, and neuroimaging studies were tracked in 13 adolescents admitted with a diagnosis of first-episode psychosis over a 13-month period to the Children’s Hospital of Eastern Ontario. Variation was found in the amount of investigation ordered: 85% of patients received a drug screen; 54% a CT scan; 8% an MRI; 92% a CBC with differential; 92% electrolytes. Abnormalities of CT scans were detected in 2 patients (29%); in neither case did the result lead to a diagnosis of brain-lesion-related psychosis, nor did it affect the clinical care of the patient. This study highlights the need to develop clinical practice-guidelines for the workup of first-episode psychosis in adolescents. First-episode psychosis has received considerable attention in both the pediatric and adult literature. One area of ongoing research is the degree to which children and adolescents require investigations to rule in or rule out non-psychiatric disease. According to the Diagnostic and Statistical Manual of Mental Disorders 4 Edition Text Revision (DSM-IV-TR), the diagnosis of schizophrenia and other psychotic illnesses require that criteria be met: where “the disturbance is not due to the direct physiological effects of a substance (e.g., of abuse or a medication) or a general medical condition”(1). Yet, in spite of these essential criteria, a standardized workup for first episode psychosis in children and youth is difficult to find. Psychiatry associations and textbooks differ in their recommendations and often leave the decision to perform a test at the discretion of the attending physician. A summary of different guidelines can be found in Table 1.","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"97 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86024921","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}
The neuroleptic malignant syndrome (NMS) is an idiopathic, life-threatening reaction to antipsychotic medication. NMS was traditionally attributed to potent dopamine antagonism of typical antipsychotics, but cases of NMS have now been reported for each of the newer antipsychotics. When NMS is caused by a newer, atypical antipsychotic the presentation differs somewhat; fever, rigidity, and, possibly, death may be less frequent. Diagnostic features, predisposing factors, and treatment are discussed, as is the important matter of reinstituting antipsychotic treatment. Neuroleptic malignant syndrome (NMS) is an idiosyncratic, life-threatening reaction to antipsychotic medication, characterized principally by delirium, fever, autonomic instability, and muscular rigidity (1). Most cases occur within a month of starting the medication, two-thirds within the first week. NMS develops in 0.022.44 percent of patients who are prescribed antipsychotics (2-4); NMS may occur even when doses are in the therapeutic range; the risk is somewhat greater with rapid dose escalation and with parenteral administration. Hyperthermia, delirium, autonomic instability, and extrapyramidal symptoms in a person treated with antipsychotic medications should prompt consideration of NMS. Classically, the extrapyramidal symptoms of NMS manifest as “lead pipe” rigidity of the limbs; other extrapyramidal signs, such as tremor, and cogwheeling, may be present. The muscular rigidity leads to rhabdomyolysis, which can in turn result in renal failure. A wide range of mental status presentations are possible, but patients are most often mute and stuporous. Laboratory findings include leukocytosis (most often 10-20,000, thought to be a stress response) elevated creatine kinase (can reach 100,000), hypocalcemia (from muscle sequestration of calcium), moderate elevations of LDH, AST and ALT, and elevated serum osmolarity from dehydration. An EEG may show generalized slowing, consistent with delirium (5). Symptoms generally develop over 24-72 hours and, in
{"title":"Neuroleptic Malignant Syndrome, with Attention to Its Occurrence with Atypical Antipsychotic Medication: A Review","authors":"Sarah Guzofski, R. Peralta","doi":"10.29046/JJP.020.1.009","DOIUrl":"https://doi.org/10.29046/JJP.020.1.009","url":null,"abstract":"The neuroleptic malignant syndrome (NMS) is an idiopathic, life-threatening reaction to antipsychotic medication. NMS was traditionally attributed to potent dopamine antagonism of typical antipsychotics, but cases of NMS have now been reported for each of the newer antipsychotics. When NMS is caused by a newer, atypical antipsychotic the presentation differs somewhat; fever, rigidity, and, possibly, death may be less frequent. Diagnostic features, predisposing factors, and treatment are discussed, as is the important matter of reinstituting antipsychotic treatment. Neuroleptic malignant syndrome (NMS) is an idiosyncratic, life-threatening reaction to antipsychotic medication, characterized principally by delirium, fever, autonomic instability, and muscular rigidity (1). Most cases occur within a month of starting the medication, two-thirds within the first week. NMS develops in 0.022.44 percent of patients who are prescribed antipsychotics (2-4); NMS may occur even when doses are in the therapeutic range; the risk is somewhat greater with rapid dose escalation and with parenteral administration. Hyperthermia, delirium, autonomic instability, and extrapyramidal symptoms in a person treated with antipsychotic medications should prompt consideration of NMS. Classically, the extrapyramidal symptoms of NMS manifest as “lead pipe” rigidity of the limbs; other extrapyramidal signs, such as tremor, and cogwheeling, may be present. The muscular rigidity leads to rhabdomyolysis, which can in turn result in renal failure. A wide range of mental status presentations are possible, but patients are most often mute and stuporous. Laboratory findings include leukocytosis (most often 10-20,000, thought to be a stress response) elevated creatine kinase (can reach 100,000), hypocalcemia (from muscle sequestration of calcium), moderate elevations of LDH, AST and ALT, and elevated serum osmolarity from dehydration. An EEG may show generalized slowing, consistent with delirium (5). Symptoms generally develop over 24-72 hours and, in","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"20 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89055196","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":"NMS, and Why We Should Call It (Malignant) Catatonia","authors":"Johnson, R. Arnold","doi":"10.29046/JJP.020.1.006","DOIUrl":"https://doi.org/10.29046/JJP.020.1.006","url":null,"abstract":"","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"46 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74330562","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":"A Kind of Poem for My Friend and Me","authors":"H. O'Neill","doi":"10.29046/JJP.020.1.007","DOIUrl":"https://doi.org/10.29046/JJP.020.1.007","url":null,"abstract":"","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"98 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82687317","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}
Williams Syndrome (WS) is a genetic disorder associated with mental retardation (MR) and a distinct behavioral phenotype including a friendly and outgoing personality. This population, like others with MR, has been reported to have an increased rate of symptoms of mental illness; however, few studies have used DSM-IV criteria to quantify specific psychiatric diagnoses in WS and the prevalence of psychiatric illness in relatives of individuals with WS and the possible relationship between family and patient diagnoses is currently unknown. Methods: Twenty-one families participated; the patients’ average age was 16 years. DSM-IV diagnoses were applied by using the Anxiety Disorders Interview Schedule (ADIS, Parent and Child Versions) and the Family History Screen. Results: A diagnosis from the ADIS was applicable to 13 patients (62%), and in 16 patients (76%) a diagnosis was applicable in their first-degree family members. Ten patients (48%) had some form of anxiety, specific phobia being the most common. Three patients (14%) had major depressive disorder and 9 patients (43%) had attention-deficit/hyperactivity disorder (ADHD). The presence of anxiety or mood disorders in patients with WS and the presence of these disorders in their family members were unrelated. Conclusions: Patients with WS have a high prevalence of anxiety disorders and of ADHD. The presence of psychiatric disorders in WS did not appear to have a significant relationship to family history of psychiatric disorders, consistent with the hypothesis that the specific genetic alteration in WS causes, or contributes to causing, the anxiety disorders and the ADHD that are so common in the disorder. Populations with mental retardation (MR), especially those with known genetic alterations, offer a window into the effects of genes on determining cognition and behavior. Populations with MR are known to have increased rates of emotional distress and mental illness (1, 2). While estimates vary, the prevalence of
{"title":"Psychiatric Diagnoses in Patients with Williams Syndrome and Their Families","authors":"J. Kennedy, D. Kaye, L. Sadler","doi":"10.29046/JJP.020.1.003","DOIUrl":"https://doi.org/10.29046/JJP.020.1.003","url":null,"abstract":"Williams Syndrome (WS) is a genetic disorder associated with mental retardation (MR) and a distinct behavioral phenotype including a friendly and outgoing personality. This population, like others with MR, has been reported to have an increased rate of symptoms of mental illness; however, few studies have used DSM-IV criteria to quantify specific psychiatric diagnoses in WS and the prevalence of psychiatric illness in relatives of individuals with WS and the possible relationship between family and patient diagnoses is currently unknown. Methods: Twenty-one families participated; the patients’ average age was 16 years. DSM-IV diagnoses were applied by using the Anxiety Disorders Interview Schedule (ADIS, Parent and Child Versions) and the Family History Screen. Results: A diagnosis from the ADIS was applicable to 13 patients (62%), and in 16 patients (76%) a diagnosis was applicable in their first-degree family members. Ten patients (48%) had some form of anxiety, specific phobia being the most common. Three patients (14%) had major depressive disorder and 9 patients (43%) had attention-deficit/hyperactivity disorder (ADHD). The presence of anxiety or mood disorders in patients with WS and the presence of these disorders in their family members were unrelated. Conclusions: Patients with WS have a high prevalence of anxiety disorders and of ADHD. The presence of psychiatric disorders in WS did not appear to have a significant relationship to family history of psychiatric disorders, consistent with the hypothesis that the specific genetic alteration in WS causes, or contributes to causing, the anxiety disorders and the ADHD that are so common in the disorder. Populations with mental retardation (MR), especially those with known genetic alterations, offer a window into the effects of genes on determining cognition and behavior. Populations with MR are known to have increased rates of emotional distress and mental illness (1, 2). While estimates vary, the prevalence of","PeriodicalId":14750,"journal":{"name":"Japanese journal of pharmacology","volume":"28 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72963973","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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