Journal of Clinical and Experimental Hepatology最新文献

{"title":"Acute Hepatitis C as an Acute Cause of Acute-on-chronic Liver Failure in Alcohol-associated Liver Disease","authors":"Narendra S. Choudhary, Kunwar A. Singh, Swapnil Dhampalwar, Neeraj Saraf, Virendra Singh","doi":"10.1016/j.jceh.2024.102423","DOIUrl":"10.1016/j.jceh.2024.102423","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102423"},"PeriodicalIF":3.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573048","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":"Comparison of NAFLD, MAFLD, and MASLD Prevalence and Clinical Characteristics in Asia Adults","authors":"Xinjuan Huang ,&nbsp;Ruoling Yu ,&nbsp;Xinyun Tan ,&nbsp;Manjie Guo ,&nbsp;Yuanqin Xia ,&nbsp;Huihui Zou ,&nbsp;Xuelian Liu ,&nbsp;Chunxiang Qin","doi":"10.1016/j.jceh.2024.102420","DOIUrl":"10.1016/j.jceh.2024.102420","url":null,"abstract":"<div><h3>Background/Aims</h3><div>The principal limitations of the term non-alcoholic fatty liver disease (NAFLD) are the reliance on exclusionary confounder terms and the use of potentially stigmatizing language. Within three years, NAFLD went through two name changes, from NAFLD to metabolic-dysfunction-associated fatty liver disease (MAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD). However, there is no Asian consensus statement on the renaming of MASLD, and evidence on the epidemiology and characteristics in the Asia population under different diagnostic criteria remain limited. This study aimed to fill these gaps by analyzing the prevalence and characteristics of MASLD, NAFLD, and MAFLD in an Asian population.</div></div><div><h3>Methods</h3><div>A retrospective, cross-sectional study was conducted in regional China with participants from the health management database in 2017–2022. Demographic and laboratory metabolic profile and body composition data were obtained. Hepatic steatosis were diagnosed by ultrasound. The likelihood of having fibrosis was assessed using the NAFLD fibrosis score (NFS). Recently proposed criteria for metabolic dysfunction-associated steatotic liver disease (MASLD) were applied.</div></div><div><h3>Results</h3><div>A total of 20,226 subjects were included for final analysis. 7465 (36.91%) participants were categorized as MASLD patients, 10,726 (53.03%) participants were MAFLD, and 7333 (36.26%) participants were NAFLD. Compared with MAFLD, body composition of MASLD and NAFLD patients were obviously different. MASLD patients were older, had a higher body mass index and percentage of male gender, and had a higher ALT, diastolic blood pressure, triglyceride, and waist circumference but lower High-Density Lipoprotein Cholesterol (HDL-C) than non-MASLD patients. Using binary regression analysis, we found for the first time that putative bone mass (OR = 4.62, 95CI% 3.12–6.83) is associated with the risk of developing MASLD. The area under the receiver operating curve (AUC) for predicting cardiovascular outcomes (CV) was 0.644 for MAFLD and 0.701 for MASLD.</div></div><div><h3>Conclusion</h3><div>MASLD (36.91%) prevalence was closed to NAFLD (36.26%) and lower than MAFLD (53.03%). Presumed bone mass might be the predictor of disease progression in MASLD patients. MASLD better identifies patients likely to have a higher risk of metabolic disorders or CV events.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102420"},"PeriodicalIF":3.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587174","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":"Branched-Chain Amino Acid Supplements for Sarcopenia in Liver Cirrhosis: A Systematic Review and Meta-analysis","authors":"Mohamed Abuelazm ,&nbsp;Ahmed Fares ,&nbsp;Mahmoud M. Elhady ,&nbsp;Ahmed Mazen Amin ,&nbsp;Ubaid Khan ,&nbsp;Ibrahim Gowaily ,&nbsp;Fouad Jaber","doi":"10.1016/j.jceh.2024.102417","DOIUrl":"10.1016/j.jceh.2024.102417","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia, a key aspect of malnutrition in liver cirrhosis (LC), affects 30–70% of LC patients. Given the inconsistent results from RCTs on branched-chain amino acids (BCAAs) for treating sarcopenia in LC, we conducted a systematic review and meta-analysis to assess the efficacy and safety of BCAAs for sarcopenia management in LC patients.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis synthesizing evidence from RCTs obtained from PubMed, Embase, Cochrane, Scopus, and Web of Science from inception to April 2024. We used the fixed-effects model to report dichotomous outcomes using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: <span><span>CRD42024542761</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>Five RCTs with 434 patients were included. BCAAs were significantly associated with decreased liver frailty index change (MD: −0.14 with 95% CI [-0.28, −0.01], <em>P</em> = 0.03). However, there was no significant difference between BCAAs and the control group regarding hand grip strength change (MD: 0.98 with 95% CI [-0.45, 2.41], <em>P</em> = 0.18). Also, BCAAs were associated with increased body mass index (BMI) change (MD: 0.99 with 95% CI [0.16, 1.82], <em>P</em> = 0.02) and increased QoL (standardized mean difference : 0.27 with 95% CI [0.03, 0.52], <em>P</em> = 0.03). However, there was no significant difference between BCAAs and the control group in model for end-stage liver disease (MELD) score change (MD: 0.65 with 95% CI [-1.20, 2.50], <em>P</em> = 0.49), skeletal muscle index change (MD: 0.21 with 95% CI [-0.23, 0.65], <em>P</em> = 0.35), and gait speed change (MD: 0.10 with 95% CI [-0.15, 0.34], <em>P</em> = 0.43).</div></div><div><h3>Conclusion</h3><div>BCAA supplementation in cirrhotic patients with sarcopenia reduced the liver frailty index, increased BMI and QoL, but did not affect handgrip strength, skeletal muscle index, gait speed, or MELD score. Outcome heterogeneity and study bias were noted, highlighting the need for further RCTs to confirm these results.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102417"},"PeriodicalIF":3.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698643","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":"An Innovative Approach to Assessing the Psychosocial Impacts on Liver Transplant Recipients: The Prediction-by-correspondence Analysis","authors":"Se-Kang Kim ,&nbsp;Rachel A. Annunziato","doi":"10.1016/j.jceh.2024.102418","DOIUrl":"10.1016/j.jceh.2024.102418","url":null,"abstract":"<div><h3>Background</h3><div>Innovative analytic techniques are applied to the psychological functioning of liver transplant (LT) recipients to comprehend its effect on post-transplant survival, hypothesizing that adherence will be predicted by psychosocial functioning.</div></div><div><h3>Methods</h3><div>The psychosocial functioning of 248 LT recipients (88 females) aged 19 to 74 is assessed using the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT). In addition, the Medication Level Variability Index (MLVI) and biopsy-proven rejection are utilized to evaluate successful adherence. The Z-scores of the SIPAT scores are used to transform them into an ordinal variable with excellent, good, minimally acceptable, and poor categories. We employ a modified version of correspondence analysis to predict the binary MLVI and rejection, which signify either success or failure in adherence, using ordinal MLVI categories as predictors.</div></div><div><h3>Results</h3><div>The excellent SIPAT category for LT beneficiaries was strongly related to adherence, whereas the minimally acceptable SIPAT was strongly related with failure in adherence. Females, ages 19–50, and ages 67–74 were associated with adherence (r = 0.49–1.00), whereas males and ages 56–60 were associated with failure in adherence (r = 0.43–0.91)</div></div><div><h3>Conclusion</h3><div>The clinical implications and utility of the novel analytic approaches introduced in the study are discussed.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102418"},"PeriodicalIF":3.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444588","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":"“Parvovirus B19–related Acute Hepatitis: Clinical Spectrum and Outcome in Children”","authors":"Arghya Samanta ,&nbsp;Anshu Srivastava ,&nbsp;Sangram S. Patel ,&nbsp;Moinak Sen Sarma ,&nbsp;Ujjal Poddar ,&nbsp;Prabhakar Mishra","doi":"10.1016/j.jceh.2024.102416","DOIUrl":"10.1016/j.jceh.2024.102416","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Acute liver injury is a common manifestation of parvovirus B19 (PVB19) infection in immunocompromised patients. However, literature in immunocompetent children is scarce. We aimed to study the clinicolaboratory features and outcome of hepatic involvement by PVB19 infection in hospitalized children.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed our prospectively kept database of all children (&lt;18 years old) admitted with acute viral hepatitis (AVH), acute liver failure (ALF) or acute-on-chronic liver failure (ACLF), and PVB19 infection between January 2010 and December 2023. Clinical features, laboratory parameters, and complications were evaluated. Poor outcome was defined as death or liver transplantation.</div></div><div><h3>Results</h3><div>A total of 35 children (19 boys [54%], median age: 7.25 [interquartile range: 4–10.8] years) with PVB19-related hepatitis were studied (28 [80%] isolated PVB19 infection and 7 [20%] coinfections [3 with Epstein–Barr virus, 2 with hepatitis A, and 1 each with hepatitis-E and cytomegalovirus]). AVH (17, 49%) was the most common presentation, followed by ALF (13, 37%) and acute insult in ACLF (5, 14%). Patients with coinfection had significantly higher bilirubin (14.6 [9.4–21.5] vs 6.8 [4.3–10.9] mg/dl; <em>P</em>=0.004) and transaminases (ALT: 697 [428–1296] vs. 277 [157–478] U/L; <em>P</em>=0.02) but similar mortality (1/7 vs 6/23; <em>P</em>=1.0) than PVB19 alone. Nine cases (25.7%) had extrahepatic complications (hemophagocytic lymphohistiocytosis [HLH]: 3, acute kidney injury: 3, aplastic anemia: 2, and myocarditis: 1). Poor outcome occurred in 38% (5/13) ALF, 11.7% (2/17) AVH (HLH: 1, myocarditis: 1), and none (0/5) of the ACLF cases.</div></div><div><h3>Conclusion</h3><div>PVB19 should be considered in children presenting with indeterminate acute liver injury, especially in younger children or those with complications such as aplastic anemia, HLH, or myocarditis.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102416"},"PeriodicalIF":3.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444587","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":"Hepatocellular Carcinoma: Molecular Diagnosis and Perspectives for Therapy","authors":"Madhumita Premkumar,&nbsp;Yogesh Chawla","doi":"10.1016/j.jceh.2024.102413","DOIUrl":"10.1016/j.jceh.2024.102413","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"14 6","pages":"Article 102413"},"PeriodicalIF":3.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433258","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":"Risk Stratification of Patients with Metabolic Dysfunction-associated Steatotic Liver Disease: Steatohepatitis, Fibrosis, and Hepatocellular Carcinoma","authors":"Mohamed El-Kassas ,&nbsp;Heba A. Othman ,&nbsp;Mohamed Elbadry ,&nbsp;Khalid Alswat ,&nbsp;Yusuf Yilmaz","doi":"10.1016/j.jceh.2024.102415","DOIUrl":"10.1016/j.jceh.2024.102415","url":null,"abstract":"<div><div>The metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is increasing globally, creating a growing public health concern. Metabolic disorders such as central obesity, dyslipidemia, hypertension, and hyperglycemia are intimately related to MASLD. Advanced hepatic fibrosis is the main predictor of morbidity, liver-related complications, and deaths. Various noninvasive scoring systems are used to practice acceptable general population screening and diagnose patients with MASLD. Unfortunately, as of right now, no single diagnostic test is thought to be reliable enough to diagnose and monitor MASLD patients. Liver biopsy remains the gold standard for diagnosing metabolic dysfunction-associated steatohepatitis (MASH) (with or without fibrosis), impacting the prognosis and survival of patients with MASLD.</div><div>Moreover, it is anticipated that MASLD is a risk factor for hepatocellular carcinoma (HCC) development, and several risk factors for MASLD occurrence are also linked to the development of HCC. Identifying patients with a risk of developing MASH, fibrosis, and HCC is more challenging; there is limited evidence on utilizing available noninvasive methods for these purposes. This review discusses the tools and steps of risk stratification in MASLD patients, providing data to guide the utilization of various diagnostic and scoring tools, focusing on the latest techniques to non-invasively detect patients at risk of developing MASH, fibrosis, and HCC.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102415"},"PeriodicalIF":3.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419488","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":"Comparison of Vascular Complications Between Living-donor and Deceased-donor Liver Transplantation – A Systematic Review and Meta-analysis","authors":"Suprabhat Giri ,&nbsp;Sarat Chandra Panigrahi ,&nbsp;Vedavyas Mohapatra ,&nbsp;Preetam Nath ,&nbsp;Saroj K. Sahu ,&nbsp;Bipadabhanjan Mallick ,&nbsp;Dibya L. Praharaj ,&nbsp;Anil C. Anand","doi":"10.1016/j.jceh.2024.102414","DOIUrl":"10.1016/j.jceh.2024.102414","url":null,"abstract":"<div><h3>Background</h3><div>Vascular complications commonly cause graft loss and morbidity after liver transplantation (LT). Comparative data on the risk of vascular complications are limited. Hence, the present meta-analysis was conducted to analyze the difference in vascular complications between living-donor LT (LDLT) and deceased-donor LT (DDLT).</div></div><div><h3>Methods</h3><div>A literature search of three databases was conducted for studies comparing the incidence of vascular complications with LDLT and DDLT. The event rates and odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>A total of 20 studies were included in the final analysis. There was no difference in the incidence of overall vascular complications (9.3%, 95% CI: 6.6–12.0 vs. 8.5%, 95% CI: 5.6–11.4) between LDLT and DDLT with OR 0.94 (95% CI: 0.73–1.21) (15 studies).There was a higher incidence of vascular complications with LDLT in older studies (published before 2013) but not in new studies. When comparing the individual complications, LDLT was associated with a higher incidence of hepatic artery thrombosis (HAT) (3.8%, 95% CI: 2.4–5.2 vs. 1.6%, 95% CI: 1.1–2.2)with OR 2.20 (95% CI: 1.53–3.17) (14 studies)and a significantly lower incidence of intra-abdominal bleeding(4.8%, 95% CI: 3.3–6.2 vs. 7.9%, 95% CI: 5.0–10.7) with OR 0.64 (95% CI: 0.47–0.87) (11 studies). However, there was no difference in the incidence (2.1%, 95% CI: 0.5–3.8 vs. 1.0%, 95% CI: 0.1–1.9) of portal vein thrombosis between LDLT and DDLT with OR 1.85 (95% CI: 0.82–4.18) (6 studies).</div></div><div><h3>Conclusion</h3><div>Despite a comparable risk of vascular complications between LDLT and DDLT, LDLT was associated with a higher risk of HAT and a lower risk of intraprocedural bleeding. Further studies are required to analyze the effect of donor-recipient characteristics and surgical techniques on the risk of vascular complications.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102414"},"PeriodicalIF":3.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432142","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":"Complex Reconstruction of Right-Lobe Grafts on the Bench: Portal Vein, Anterior Sector Hepatic Veins, Inferior Hepatic Veins and Multiple Bile Ducts","authors":"Ankur A. Gupta,&nbsp;Arvinder S. Soin","doi":"10.1016/j.jceh.2024.102411","DOIUrl":"10.1016/j.jceh.2024.102411","url":null,"abstract":"<div><div>Living donor liver transplantation (LDLT) employing right-lobe (RL) grafts has become indispensable amid limited deceased donor graft availability. RL grafts, while smaller, offer outcomes comparable with deceased donor grafts, prompting a surge in global RL LDLT. However, bench surgery in LDLT requires meticulous preparation to minimize warm ischaemia time and ensure optimal inflow and outflow reconstruction. This review combines an analysis of existing literature with a discussion of our technique, emphasizing the intricacies of RL graft bench reconstruction.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102411"},"PeriodicalIF":3.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444589","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":"Therapeutic Plasma Exchange in Hepatology: Indications, Techniques, and Practical Application","authors":"Dhiraj Agrawal ,&nbsp;Kishore K. Ariga ,&nbsp;Subhash Gupta ,&nbsp;Sanjiv Saigal","doi":"10.1016/j.jceh.2024.102410","DOIUrl":"10.1016/j.jceh.2024.102410","url":null,"abstract":"<div><div>It is sobering that many liver failure patients die in the absence of liver transplantation (LT), and reducing its morbidity and mortality urgently needs more non-transplant treatment options. Among the several artificial liver support devices available, therapeutic plasma exchange (TPE) is the only one that improves survival in acute liver failure (ALF) patients. In many other disorders, data on survival benefits and successful bridging to transplant is encouraging. TPE removes the entire plasma, including damage-associated-molecular patterns, and replaces it with healthy donor fresh frozen plasma. In contrast, other artificial liver support systems (ALSS) correct the blood composition through dialysis techniques. TPE has become increasingly popular due to advances in apheresis techniques and a better understanding of its applicability in treating liver failure's pathophysiology. It provides metabolicdetoxification, and synthetic functions and modulates early innate immunity, fulfilling the role of ALSS. TPE is readily available in intensive care units, dialysis units, or blood banks and has enormous potential to improve survival outcomes. Hepatologists must take advantage of this treatment option by thoroughly understanding its most frequent indications and its rationale and techniques. This primer on TPE for liver clinicians covers its current clinical, technical, and practical applications, addresses the knowledge gaps, and provides future directions.</div></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 1","pages":"Article 102410"},"PeriodicalIF":3.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419487","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}