M. Yilma, Karen Trang, M. Schwab, M. Bowman, M. Sugi, J. Courtier, L. Baskin, D. Ozgediz
Background: Prune belly syndrome (PBS) and congenital pouch colon (CPC) are rare congenital syndromes with a low incidence in the United States (U.S.) with most CPC cases being from India. In this case report, we describe, to the best of our knowledge, the first PBS variant and CPC patient in the U.S. Case Presentation: A 30-year-old G2P0010 woman was referred to a tertiary center after an 18-week ultrasound showed a fetal abdominal mass. A prenatal MRI showed a dilated loop of bowel containing a mixture of urine and meconium, oligohydramnios, and a protuberant abdominal wall. Born at 37 weeks, the child’s physical exam was notable for a distended abdomen with thin abdominal musculature, non-palpable bilateral testes, no anal opening, and flat buttocks. Intra-operatively, a dilated cecum/ascending colon was noted with an abrupt change in caliber at the transverse colon, bilateral enlarged ureters, a left testis at the internal ring and no visualized right testis. A colostomy and mucous fistula were created 5 cm from the sigmoid pouch. Conclusion: While most reported cases of CPC undergo single stage repair (one operation) at 1 day of life, our patient underwent the first procedure of a staged repair at 16 hours of life given his clinical instability at the time as well as his unknown urological anatomy in the setting of urinary obstruction. This case demonstrates the importance of fetal imaging, multidisciplinary approach at a tertiary care center, and reinforces a staged repair when necessary.
{"title":"A case of prenatally diagnosed prune belly syndrome variant and congenital pouch colon in the United States: A case report","authors":"M. Yilma, Karen Trang, M. Schwab, M. Bowman, M. Sugi, J. Courtier, L. Baskin, D. Ozgediz","doi":"10.47338/jns.v10.1012","DOIUrl":"https://doi.org/10.47338/jns.v10.1012","url":null,"abstract":"Background: Prune belly syndrome (PBS) and congenital pouch colon (CPC) are rare congenital syndromes with a low incidence in the United States (U.S.) with most CPC cases being from India. In this case report, we describe, to the best of our knowledge, the first PBS variant and CPC patient in the U.S.\u0000Case Presentation: A 30-year-old G2P0010 woman was referred to a tertiary center after an 18-week ultrasound showed a fetal abdominal mass. A prenatal MRI showed a dilated loop of bowel containing a mixture of urine and meconium, oligohydramnios, and a protuberant abdominal wall. Born at 37 weeks, the child’s physical exam was notable for a distended abdomen with thin abdominal musculature, non-palpable bilateral testes, no anal opening, and flat buttocks. Intra-operatively, a dilated cecum/ascending colon was noted with an abrupt change in caliber at the transverse colon, bilateral enlarged ureters, a left testis at the internal ring and no visualized right testis. A colostomy and mucous fistula were created 5 cm from the sigmoid pouch.\u0000Conclusion: While most reported cases of CPC undergo single stage repair (one operation) at 1 day of life, our patient underwent the first procedure of a staged repair at 16 hours of life given his clinical instability at the time as well as his unknown urological anatomy in the setting of urinary obstruction. This case demonstrates the importance of fetal imaging, multidisciplinary approach at a tertiary care center, and reinforces a staged repair when necessary.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45453697","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 surgeon expects either necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) in preemies with pneumoperitoneum. But there is another cause wherein the operative findings simulate meconium ileus [1]: The terminal ileum and colon are tiny and obstructed by inspissated meconium; The bowel proximal to the obstruction may be diffusely dilated, or there may be aneurysmal (segmental) dilatation, which may be single or multiple; Resection with ileostomy is all that is attempted in these tiny, fragile babies; Surprisingly, when the ileostomy is closed 4-6 weeks later, the bowel appears to be normal, the obstruction has cleared and the caliber disparity has disappeared, which suggests that immaturity was causative of the obstruction and the occasional aneurysmal dilatation.
{"title":"Meconium obstruction in a premature neonate: An etiology that may simulate spontaneous intestinal perforation","authors":"James G. Glasser","doi":"10.47338/jns.v10.1013","DOIUrl":"https://doi.org/10.47338/jns.v10.1013","url":null,"abstract":"A surgeon expects either necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) in preemies with pneumoperitoneum. But there is another cause wherein the operative findings simulate meconium ileus [1]: The terminal ileum and colon are tiny and obstructed by inspissated meconium; The bowel proximal to the obstruction may be diffusely dilated, or there may be aneurysmal (segmental) dilatation, which may be single or multiple; Resection with ileostomy is all that is attempted in these tiny, fragile babies; Surprisingly, when the ileostomy is closed 4-6 weeks later, the bowel appears to be normal, the obstruction has cleared and the caliber disparity has disappeared, which suggests that immaturity was causative of the obstruction and the occasional aneurysmal dilatation.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70820170","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}
Ravi Patcharu, Jaiprakash Yadav, K. Chand, Badal Parikh
Background: Duplications of the alimentary tract are rare congenital malformations, out of which, true pyloric duplications constitute only 2.2%. They present with non-bilious vomiting and mimic hypertrophic pyloric stenosis (HPS). Pyloric duplications that are intraluminal are not separately visible at laparotomy, making their diagnosis difficult. Case presentation: Our case is a neonate with an intraluminal pyloric duplication cyst who presented with recurrent vomiting. The radiological evaluation suggested a duplication cyst medial to the second part of the duodenum towards the stomach’s lesser curvature with features of gastric outlet obstruction. Intraoperatively, a cystic mass of 1 x 2 cm intraluminally was found on opening the pylorus which was excised and pyloroplasty was done. Postoperatively the baby was discharged in a stable condition. Conclusion: Intraluminal pyloric duplication cysts are rare and the clinical presentation mimics HPS. They should be considered as a differential diagnosis in a neonate presenting with features of gastric outlet obstruction.
背景：消化道重复是一种罕见的先天性畸形，其中真正的幽门重复仅占2.2%。它们表现为非胆汁性呕吐和类似肥厚性幽门狭窄（HPS）。腔内幽门重复在剖腹手术中不能单独看到，这使其诊断变得困难。病例介绍：我们的病例是一名新生儿，患有腔内幽门重复囊肿，并伴有反复呕吐。放射学评估显示，十二指肠第二部分内侧有一个朝向胃小曲的重复囊肿，具有胃出口梗阻的特征。术中，在打开幽门时发现管腔内1 x 2 cm的囊性肿块，将其切除并进行幽门成形术。术后婴儿出院，情况稳定。结论：腔内幽门重复囊肿是罕见的，临床表现类似HPS。对于以胃出口梗阻为特征的新生儿，应将其视为鉴别诊断。
{"title":"Intraluminal pyloric duplication cyst- a rare cause of non-bilious vomiting in a neonate: A case report","authors":"Ravi Patcharu, Jaiprakash Yadav, K. Chand, Badal Parikh","doi":"10.47338/jns.v10.1006","DOIUrl":"https://doi.org/10.47338/jns.v10.1006","url":null,"abstract":"Background: Duplications of the alimentary tract are rare congenital malformations, out of which, true pyloric duplications constitute only 2.2%. They present with non-bilious vomiting and mimic hypertrophic pyloric stenosis (HPS). Pyloric duplications that are intraluminal are not separately visible at laparotomy, making their diagnosis difficult. \u0000Case presentation: Our case is a neonate with an intraluminal pyloric duplication cyst who presented with recurrent vomiting. The radiological evaluation suggested a duplication cyst medial to the second part of the duodenum towards the stomach’s lesser curvature with features of gastric outlet obstruction. Intraoperatively, a cystic mass of 1 x 2 cm intraluminally was found on opening the pylorus which was excised and pyloroplasty was done. Postoperatively the baby was discharged in a stable condition.\u0000Conclusion: Intraluminal pyloric duplication cysts are rare and the clinical presentation mimics HPS. They should be considered as a differential diagnosis in a neonate presenting with features of gastric outlet obstruction.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45779660","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}
Sravanthi Vutukuru, N. Peters, S. Dogra, R. Samujh
Background: Tracheoesophageal fistula (TEF) is associated with many other congenital anomalies like cardiac, renal, and vertebral, but the association with cystic hygroma is very rare. Case Presentation: We report a neonate, antenatally diagnosed with cystic hygroma of the neck and incidentally diagnosed to have TEF. The baby was operated on after adequate stabilization and the cystic hygroma was managed with injection sclerotherapy. The genetic analysis for the FOX genes complex has been done in this case and the results showed no association between the two. Conclusion: There is a need for future studies to find out if the association between cystic hygroma and TEF is by chance or if any embryological or genetic cause can be attributed to it.
{"title":"Cystic hygroma and esophageal atresia with tracheoesophageal fistula: Is there a genetic association?","authors":"Sravanthi Vutukuru, N. Peters, S. Dogra, R. Samujh","doi":"10.47338/jns.v10.997","DOIUrl":"https://doi.org/10.47338/jns.v10.997","url":null,"abstract":"Background: Tracheoesophageal fistula (TEF) is associated with many other congenital anomalies like cardiac, renal, and vertebral, but the association with cystic hygroma is very rare.\u0000Case Presentation: We report a neonate, antenatally diagnosed with cystic hygroma of the neck and incidentally diagnosed to have TEF. The baby was operated on after adequate stabilization and the cystic hygroma was managed with injection sclerotherapy. The genetic analysis for the FOX genes complex has been done in this case and the results showed no association between the two.\u0000Conclusion: There is a need for future studies to find out if the association between cystic hygroma and TEF is by chance or if any embryological or genetic cause can be attributed to it.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48916396","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}
Background: Congenital segmental dilatation of intestine is a rare entity characterized by a localized dilated segment of the intestine. It manifests as neonatal intestinal obstruction. Occurrence with another surgical anomaly may masquerade it and complicate the treatment course. Case Presentation: A 1-day-old male neonate with anorectal malformation underwent colostomy as first stage of the treatment. The stoma did not function postoperatively. At repeat surgery, congenital segmental dilatation of the ileum, with slightly different morphology, was found. Resection of the lesion and ileostomy were formed. Postoperative course remained uneventful. Conclusion: Congenital segmental dilatation of intestine may be missed at initial surgery. Complete surgical resection is curative.
{"title":"Congenital segmental dilatation of intestine with different morphology: A case report","authors":"Bilal Mirza, Sumaira Noor Maham, N. Talat","doi":"10.47338/jns.v10.1021","DOIUrl":"https://doi.org/10.47338/jns.v10.1021","url":null,"abstract":"Background: Congenital segmental dilatation of intestine is a rare entity characterized by a localized dilated segment of the intestine. It manifests as neonatal intestinal obstruction. Occurrence with another surgical anomaly may masquerade it and complicate the treatment course.\u0000Case Presentation: A 1-day-old male neonate with anorectal malformation underwent colostomy as first stage of the treatment. The stoma did not function postoperatively. At repeat surgery, congenital segmental dilatation of the ileum, with slightly different morphology, was found. Resection of the lesion and ileostomy were formed. Postoperative course remained uneventful.\u0000Conclusion: Congenital segmental dilatation of intestine may be missed at initial surgery. Complete surgical resection is curative.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49575614","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}
I read, with great interest, the article by Sinacer et al. on the association of congenital Spigelian hernia with cryptorchidism, polydactyly, and anal stenosis.[1] Although this association is known since 1895, only in 2005 it was recognized as a new syndrome.[2,3] Since then there has been an increasing awareness about this clinical entity.[4] In 2015 Moles-Morenilla et al. named it ‘Raveenthiran syndrome’ and classified it into two types: type-1 is an exclusive association of Spigelian hernia and ectopic testis while type-2 is Spigelian hernia and ectopic testis associated with other anomalies.[5] Accordingly, the newborn reported by Sinacer et al. belongs to type-2 Raveenthiran syndrome.
{"title":"The Raveenthiran Syndrome—Ectopic testis within Spigelian hernia: Few additional remarks","authors":"Venkatachalam Raveenthiran","doi":"10.47338/jns.v10.1024","DOIUrl":"https://doi.org/10.47338/jns.v10.1024","url":null,"abstract":"I read, with great interest, the article by Sinacer et al. on the association of congenital Spigelian hernia with cryptorchidism, polydactyly, and anal stenosis.[1] Although this association is known since 1895, only in 2005 it was recognized as a new syndrome.[2,3] Since then there has been an increasing awareness about this clinical entity.[4] In 2015 Moles-Morenilla et al. named it ‘Raveenthiran syndrome’ and classified it into two types: type-1 is an exclusive association of Spigelian hernia and ectopic testis while type-2 is Spigelian hernia and ectopic testis associated with other anomalies.[5] Accordingly, the newborn reported by Sinacer et al. belongs to type-2 Raveenthiran syndrome.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41893546","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":"Type III wide colonic atresia: An etiological introspection","authors":"M. Hassan","doi":"10.47338/jns.v10.1020","DOIUrl":"https://doi.org/10.47338/jns.v10.1020","url":null,"abstract":"","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47475769","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}
Background: Spigelian hernia (SH) is a rare entity characterized by a defect of the anterior abdominal wall located along the Spigelian line, it may be congenital or acquired.Association with other anomalies is worth reporting. Case Presentation: A 22-day-old male newborn was admitted with strangulated right inguinal hernia and operated on emergently. Clinical examination also revealed a Spigelian hernia in the left lower abdominal quadrant with bilateral cryptorchidism, associated with polydactyly of the small right finger and anal stenosis. At surgery, the SH contained a part of the small intestine and the ipsilateral undescended testis. Conclusion: Pediatric SH is rare, but its association with undescended ipsilateral testis is frequent. Other abnormalities can be concomitant to this association.
{"title":"Congenital Spigelian hernia in a neonate associated with several anomalies: A case report","authors":"Samira Sinacer, Bilal Zakaria Semari, Soumia Khemari, Ahlem Kharchi, Assia Haif, Zineddine Soualili","doi":"10.47338/jns.v10.972","DOIUrl":"https://doi.org/10.47338/jns.v10.972","url":null,"abstract":"Background: Spigelian hernia (SH) is a rare entity characterized by a defect of the anterior abdominal wall located along the Spigelian line, it may be congenital or acquired.Association with other anomalies is worth reporting.\u0000Case Presentation: A 22-day-old male newborn was admitted with strangulated right inguinal hernia and operated on emergently. Clinical examination also revealed a Spigelian hernia in the left lower abdominal quadrant with bilateral cryptorchidism, associated with polydactyly of the small right finger and anal stenosis. At surgery, the SH contained a part of the small intestine and the ipsilateral undescended testis.\u0000Conclusion: Pediatric SH is rare, but its association with undescended ipsilateral testis is frequent. Other abnormalities can be concomitant to this association.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41315499","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}
B. Khalil, Abdalla E. Zarroug, Abubakr Elawad, S. Moussa, C. Donnelly, Saleem Mammoo, G. Brisseau, Alison R Bedford Russell, H. Hummler
Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, "greenfield" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region. Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 – 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded. Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully. Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %. Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations.
{"title":"Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development","authors":"B. Khalil, Abdalla E. Zarroug, Abubakr Elawad, S. Moussa, C. Donnelly, Saleem Mammoo, G. Brisseau, Alison R Bedford Russell, H. Hummler","doi":"10.47338/jns.v10.975","DOIUrl":"https://doi.org/10.47338/jns.v10.975","url":null,"abstract":"Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, \"greenfield\" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region.\u0000Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 – 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded.\u0000Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully. Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %.\u0000Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44079020","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}
N. Pawar, Pramila Sharma, P. Mittal, V. Chaturvedi
{"title":"Jejunal atresia with ileojejunal knotting: An unusual presentation","authors":"N. Pawar, Pramila Sharma, P. Mittal, V. Chaturvedi","doi":"10.47338/JNS.V10.951","DOIUrl":"https://doi.org/10.47338/JNS.V10.951","url":null,"abstract":" ","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45106041","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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