Pub Date : 2021-07-01DOI: 10.4103/TheIAForum.TheIAForum_45_21
M. Raghuraman, A. Murugesan, Vinod Krishnagopal
{"title":"Radiofrequency ablation of stellate ganglion for neuropathic pain due to brachial plexus neurofibroma in a patient with neurofibromatosis type 1","authors":"M. Raghuraman, A. Murugesan, Vinod Krishnagopal","doi":"10.4103/TheIAForum.TheIAForum_45_21","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_45_21","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"197 - 198"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48467536","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_168_20
S. Rajan, A. Subramanian, Pulak Tosh, Niranjan Kumar
{"title":"Airway management of a child with a large hemangio-lymphangioma of the face, neck, and upper airway in stridor","authors":"S. Rajan, A. Subramanian, Pulak Tosh, Niranjan Kumar","doi":"10.4103/TheIAForum.TheIAForum_168_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_168_20","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"109 - 110"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44434464","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_1_21
Rashmi Syal, S. Chander, P. Kala, K. Suresh, S. Chhabra
{"title":"Mending the after-effects of simulation-based cross-skill airway training during COVID-19 pandemic: The “real” plastic surgery","authors":"Rashmi Syal, S. Chander, P. Kala, K. Suresh, S. Chhabra","doi":"10.4103/TheIAForum.TheIAForum_1_21","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_1_21","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"113 - 114"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41407204","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_90_20
P. Tiwari, R. Bhatia, V. Asthana, R. Maheshwari
Background and Aims: Our aim was to assess the postoperative analgesia after ultrasound-guided transmuscular “Quadratus lumborum block” (QLB) and lumbar “Erector spinae plane block” (ESPB) in hip surgeries postoperatively. Design: Double-blinded, randomized prospective study. Materials and Methods: Sixty-three patients who underwent hip surgeries were divided into three groups, with 21 patients each. Each group was given spinal anesthesia using 30 ml of 0.5% hyperbaric bupivacaine. After the completion of the surgery, Group I patients were given ipsilateral transmuscular QLB and Group II patients were given ipsilateral lumbar ESPB. No block was given in Group III. In the postanesthesia care unit (PACU), pain was assessed using the Numeric Rating Scale (NRS) scoring. The time of first analgesic requirement and the total postoperatively tramadol consumption in first 24 h was recorded. Results: No significant difference was seen between the three groups pertaining to patient's demographic data, type, and duration of surgery. Statistically significant lower NRS scores were present in QLB group and ESPB group than the control group in the first 24 h (P < 0.001). The total tramadol consumption was significantly more in the control group (346.67 ± 71.37) mg than QLB group (159.05 ± 39.74) mg and ESPB group (190.48 ± 33.83) mg with P < 0.001. Time duration of first analgesic requirement in PACU was 344.05 min, 267.86 min, and 105.24 min for QLB, ESPB, and control group, respectively. Conclusion: In conclusion, both QLB and ESPB provide good postoperative pain control in hip surgeries with QLB providing a better analgesic profile when compared to ESPB.
{"title":"Role of ultrasound-guided lumbar “Erector spinae plane block” and ultrasound-guided transmuscular “Quadratus lumborum block” for postoperative analgesia after hip surgeries: A randomized, controlled study","authors":"P. Tiwari, R. Bhatia, V. Asthana, R. Maheshwari","doi":"10.4103/TheIAForum.TheIAForum_90_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_90_20","url":null,"abstract":"Background and Aims: Our aim was to assess the postoperative analgesia after ultrasound-guided transmuscular “Quadratus lumborum block” (QLB) and lumbar “Erector spinae plane block” (ESPB) in hip surgeries postoperatively. Design: Double-blinded, randomized prospective study. Materials and Methods: Sixty-three patients who underwent hip surgeries were divided into three groups, with 21 patients each. Each group was given spinal anesthesia using 30 ml of 0.5% hyperbaric bupivacaine. After the completion of the surgery, Group I patients were given ipsilateral transmuscular QLB and Group II patients were given ipsilateral lumbar ESPB. No block was given in Group III. In the postanesthesia care unit (PACU), pain was assessed using the Numeric Rating Scale (NRS) scoring. The time of first analgesic requirement and the total postoperatively tramadol consumption in first 24 h was recorded. Results: No significant difference was seen between the three groups pertaining to patient's demographic data, type, and duration of surgery. Statistically significant lower NRS scores were present in QLB group and ESPB group than the control group in the first 24 h (P < 0.001). The total tramadol consumption was significantly more in the control group (346.67 ± 71.37) mg than QLB group (159.05 ± 39.74) mg and ESPB group (190.48 ± 33.83) mg with P < 0.001. Time duration of first analgesic requirement in PACU was 344.05 min, 267.86 min, and 105.24 min for QLB, ESPB, and control group, respectively. Conclusion: In conclusion, both QLB and ESPB provide good postoperative pain control in hip surgeries with QLB providing a better analgesic profile when compared to ESPB.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"60 - 66"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45758651","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_70_20
Tushar D. Bhavar, A. Shetti, Priyanka B Gulve, P. Yenurkar
Objectives: Cardiac arrest is a substantial public health problem. The American Heart Association recommends that those whose daily work requires knowledge and skills in advanced cardiovascular life support (ACLS) should not only be trained in ACLS but also be given a refresher course at least every 2 years. We conducted a study to find out how much knowledge and skill was improved in the participants following the workshop and also how much of it they retain after 6 months. Materials and Methods: The study, a prospective repeated measures quasi-experimental design, was done to test the knowledge and skill about basic life support (BLS) and ACLS among MBBS Interns at the entry to internship before training, posttraining and 6 months after training. This was done using a structured questionnaire containing 25 knowledge and practice questions and a checklist containing 15 points was used to assess the skills was also assessed using the Laerdal CPRQ Manikin with skill guide using parameters compression score, ventilation score, and compression fraction. Results: Knowledge mean total score for pretest, immediate posttest, and 6 months posttest was 10.9, 23.54, and 15.77, respectively, and skill mean score for pretest, immediate posttest, and 6 months posttest was 3.55, 12.99, and 9.06, respectively. Knowledge and skill assessed for immediate posttest was significantly higher than the pretest score. Six months posttest total score was significantly higher than the pretest total score but was significantly lower than posttest score in regard to both knowledge and skills. Conclusion: We found that there is gross lack of knowledge and skills among interns, which needs to be looked at with proper BLS and ACLS training and periodic reinforcement of the same with trainings as there is a significant decrease in both knowledge and skills at 6 months. The skill guide can be considered for skill assessment.
{"title":"Evaluation of knowledge and skills of MBBS interns in basic life support/advanced cardiovascular life support and their ability to retain","authors":"Tushar D. Bhavar, A. Shetti, Priyanka B Gulve, P. Yenurkar","doi":"10.4103/TheIAForum.TheIAForum_70_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_70_20","url":null,"abstract":"Objectives: Cardiac arrest is a substantial public health problem. The American Heart Association recommends that those whose daily work requires knowledge and skills in advanced cardiovascular life support (ACLS) should not only be trained in ACLS but also be given a refresher course at least every 2 years. We conducted a study to find out how much knowledge and skill was improved in the participants following the workshop and also how much of it they retain after 6 months. Materials and Methods: The study, a prospective repeated measures quasi-experimental design, was done to test the knowledge and skill about basic life support (BLS) and ACLS among MBBS Interns at the entry to internship before training, posttraining and 6 months after training. This was done using a structured questionnaire containing 25 knowledge and practice questions and a checklist containing 15 points was used to assess the skills was also assessed using the Laerdal CPRQ Manikin with skill guide using parameters compression score, ventilation score, and compression fraction. Results: Knowledge mean total score for pretest, immediate posttest, and 6 months posttest was 10.9, 23.54, and 15.77, respectively, and skill mean score for pretest, immediate posttest, and 6 months posttest was 3.55, 12.99, and 9.06, respectively. Knowledge and skill assessed for immediate posttest was significantly higher than the pretest score. Six months posttest total score was significantly higher than the pretest total score but was significantly lower than posttest score in regard to both knowledge and skills. Conclusion: We found that there is gross lack of knowledge and skills among interns, which needs to be looked at with proper BLS and ACLS training and periodic reinforcement of the same with trainings as there is a significant decrease in both knowledge and skills at 6 months. The skill guide can be considered for skill assessment.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"86 - 90"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42637008","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_80_20
R. Mariappan, V. Cherian, M. Joy, KG Selvaraj
Background: Low-dose ketamine can provide effective perioperative analgesia while reducing its side effects. This study aims to estimate the effect of a low dose of ketamine administered preemptively and during the surgery on postoperative opioid requirement and the incidence of side effects of ketamine. Methods: This prospective, double-blind, randomized control trial enrolled 60 adult women (>18 years) scheduled for open abdominal hysterectomy. All patients received general anesthesia using a standard protocol. Patients were randomized to receive 0.2 mg/kg of ketamine as bolus before induction of anesthesia, followed by an infusion of 0.002 mg/kg/min for the duration of surgery (Group K) or an equivalent volume of 0.9% saline (Group C). The primary outcome was to compare the morphine requirement over the 24 h postoperatively between the two groups. The secondary outcomes were to compare the intraoperative morphine requirement, and the incidence of side effects of ketamine. Results: The intraoperative morphine requirement was significantly less (P = 0.006) in those who received ketamine (6.5 ± 1.5 mg) compared to the placebo (7.67 ± 1.7 mg). The 24-hour morphine requirement was less in the Group K (7.87 ± 4.7 mg) compared to Group C (9.2 ± 4.5 mg), but was not statistically significant. The incidence of hallucination and nystagmus was significantly higher in the ketamine group, but it lasted <2 h. Conclusion: The preemptive and the intraoperative infusion of low-dose ketamine decreases the morphine requirement intraoperatively but not during the postoperative period.
{"title":"Effect of low dose ketamine on perioperative analgesia in patients undergoing open abdominal hysterectomy - A double-blind, randomized, placebo-controlled trial","authors":"R. Mariappan, V. Cherian, M. Joy, KG Selvaraj","doi":"10.4103/TheIAForum.TheIAForum_80_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_80_20","url":null,"abstract":"Background: Low-dose ketamine can provide effective perioperative analgesia while reducing its side effects. This study aims to estimate the effect of a low dose of ketamine administered preemptively and during the surgery on postoperative opioid requirement and the incidence of side effects of ketamine. Methods: This prospective, double-blind, randomized control trial enrolled 60 adult women (>18 years) scheduled for open abdominal hysterectomy. All patients received general anesthesia using a standard protocol. Patients were randomized to receive 0.2 mg/kg of ketamine as bolus before induction of anesthesia, followed by an infusion of 0.002 mg/kg/min for the duration of surgery (Group K) or an equivalent volume of 0.9% saline (Group C). The primary outcome was to compare the morphine requirement over the 24 h postoperatively between the two groups. The secondary outcomes were to compare the intraoperative morphine requirement, and the incidence of side effects of ketamine. Results: The intraoperative morphine requirement was significantly less (P = 0.006) in those who received ketamine (6.5 ± 1.5 mg) compared to the placebo (7.67 ± 1.7 mg). The 24-hour morphine requirement was less in the Group K (7.87 ± 4.7 mg) compared to Group C (9.2 ± 4.5 mg), but was not statistically significant. The incidence of hallucination and nystagmus was significantly higher in the ketamine group, but it lasted <2 h. Conclusion: The preemptive and the intraoperative infusion of low-dose ketamine decreases the morphine requirement intraoperatively but not during the postoperative period.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"67 - 72"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44692090","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_159_20
S. Agarwal, N. Gupta, Vinod Kumar, S. Bharti
{"title":"Confirmation of double-lumen tube position with ultrasound during COVID-19: Need of the hour!","authors":"S. Agarwal, N. Gupta, Vinod Kumar, S. Bharti","doi":"10.4103/TheIAForum.TheIAForum_159_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_159_20","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"110 - 111"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45078812","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_61_20
Navneeta Bisht, T. Muniraju, A. Hasan, Vivek Kumar, D. Bhaumik
Background: Pain due to pneumoperitoneum after laparoscopic cholecystectomy (LC) may contribute to prolong hospital stay, patient discomfort, and failure of the surgery as an ambulatory procedure. A balanced multimodal analgesia regimen consisting of premedication with selective alpha-2 agonists is gaining popularity for postoperative pain relief for multiple surgeries. Although both clonidine (CLO) and dexmedetomidine (DEX) belong to this group, DEX is seen to have more selective α2 action and better sympatholytic properties. The present study aims to assess the coanalgesic effect of premedication with CLO and DEX for LC, done as an overnight stay procedure, and to compare their efficacy. Methodology: This was a prospective, randomized, single-blinded comparative study, conducted between July 2015 and July 2016. A total of 80 patients undergoing LC were randomly assigned to either CLO or DEX groups (n = 40). The patients were premedicated with low-dose (1 μg/kg) bolus intravenous drugs before induction according to the allotted group. Effect of individual drugs on the postoperative visual analog scale (VAS) score was noted, hemodynamic status was monitored, and analgesic-sparing effect to a multimodal analgesic regimen comprising intraoperative fentanyl and postoperative tramadol was noted. Results: VAS scores at 15 min postextubation, the number of patients required rescue analgesia, and the number of injections required were all found significantly low with DEX. Systolic as well as diastolic blood pressure was significantly lower in the DEX group. Conclusions: Although both the drugs were effective for short hospital stay LC, early pain relief and better hemodynamic stability were seen with DEX. Thus, routine premedication with DEX for ambulatory LC may be recommended.
{"title":"Premedication with clonidine and dexmedetomidine as multimodal analgesia for overnight stay laparoscopic cholecystectomy: A randomized comparative study","authors":"Navneeta Bisht, T. Muniraju, A. Hasan, Vivek Kumar, D. Bhaumik","doi":"10.4103/TheIAForum.TheIAForum_61_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_61_20","url":null,"abstract":"Background: Pain due to pneumoperitoneum after laparoscopic cholecystectomy (LC) may contribute to prolong hospital stay, patient discomfort, and failure of the surgery as an ambulatory procedure. A balanced multimodal analgesia regimen consisting of premedication with selective alpha-2 agonists is gaining popularity for postoperative pain relief for multiple surgeries. Although both clonidine (CLO) and dexmedetomidine (DEX) belong to this group, DEX is seen to have more selective α2 action and better sympatholytic properties. The present study aims to assess the coanalgesic effect of premedication with CLO and DEX for LC, done as an overnight stay procedure, and to compare their efficacy. Methodology: This was a prospective, randomized, single-blinded comparative study, conducted between July 2015 and July 2016. A total of 80 patients undergoing LC were randomly assigned to either CLO or DEX groups (n = 40). The patients were premedicated with low-dose (1 μg/kg) bolus intravenous drugs before induction according to the allotted group. Effect of individual drugs on the postoperative visual analog scale (VAS) score was noted, hemodynamic status was monitored, and analgesic-sparing effect to a multimodal analgesic regimen comprising intraoperative fentanyl and postoperative tramadol was noted. Results: VAS scores at 15 min postextubation, the number of patients required rescue analgesia, and the number of injections required were all found significantly low with DEX. Systolic as well as diastolic blood pressure was significantly lower in the DEX group. Conclusions: Although both the drugs were effective for short hospital stay LC, early pain relief and better hemodynamic stability were seen with DEX. Thus, routine premedication with DEX for ambulatory LC may be recommended.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"79 - 85"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49364535","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 : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_76_20
S. Choudhary, Sunanda Gupta
Postpartum hemorrhage (PPH) is the leading cause of preventable maternal mortality and morbidity. Women undergoing cesarean delivery are at increased risk of PPH as compared to vaginal delivery. Improvement in obstetric care and advances in diagnostic modalities have empowered obstetricians to detect, predict, and therefore prevent catastrophic uterine bleeding. Patients at increased risk for PPH should be referred to tertiary care centers equipped with interventional radiology suite, where multidisciplinary teams are available 24 h and are prepared to deal with potential complications. This review highlights the management of PPH with special emphasis on interventional radiology procedures for the prevention of PPH. Minimally invasive interventional radiological techniques such as selective arterial embolization and arterial balloon occlusion have been effectively used to avert hysterectomy and reduce the overall incidence of blood transfusion and its associated complications while preserving reproductive functions.
{"title":"Prophylactic interventional radiological procedures in postpartum hemorrhage: The present scenario","authors":"S. Choudhary, Sunanda Gupta","doi":"10.4103/TheIAForum.TheIAForum_76_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_76_20","url":null,"abstract":"Postpartum hemorrhage (PPH) is the leading cause of preventable maternal mortality and morbidity. Women undergoing cesarean delivery are at increased risk of PPH as compared to vaginal delivery. Improvement in obstetric care and advances in diagnostic modalities have empowered obstetricians to detect, predict, and therefore prevent catastrophic uterine bleeding. Patients at increased risk for PPH should be referred to tertiary care centers equipped with interventional radiology suite, where multidisciplinary teams are available 24 h and are prepared to deal with potential complications. This review highlights the management of PPH with special emphasis on interventional radiology procedures for the prevention of PPH. Minimally invasive interventional radiological techniques such as selective arterial embolization and arterial balloon occlusion have been effectively used to avert hysterectomy and reduce the overall incidence of blood transfusion and its associated complications while preserving reproductive functions.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"11 - 16"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48329856","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}