{"title":"Lung transplantation in China: a new era in perspective","authors":"Jingyu Chen, Chun-xiao Hu, Xiao-shan Li","doi":"10.21037/ccts-21-10","DOIUrl":"https://doi.org/10.21037/ccts-21-10","url":null,"abstract":"","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49518967","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":"Overview summary of the Current Challenges in Thoracic Surgery lung transplant series","authors":"B. Yue, Michael K Y Hsin, Jingyu Chen","doi":"10.21037/ccts-21-41","DOIUrl":"https://doi.org/10.21037/ccts-21-41","url":null,"abstract":"","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48782691","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: 10.21037/CCTS-2020-LCS-04
Aaron R. Dezube, M. Jaklitsch
Lung cancer is the leading cause of cancer-death worldwide. The U.S. Preventative Services Task Force (USPTSF) approved screening for current or former smokers aged 55–80 based on the results of the National Lung Screening trial (NLST). Current guidelines use rigid inclusion criteria, therefore new attention has turned to use of risk-prediction models for lung cancer to reduce the number needed to screen as well as identify high-risk patients who don’t meet current screening guidelines. Our paper serves as an expert narrative review of new literature pertaining to lung cancer risk prediction models for screening based on review of articles from PubMed and Cochrane database from date of inception through June 11, 2020. We used the MeSH search terms: “lung cancer”; “screening”; “low dose CT”, and “risk prediction model” to identify any new relevant articles for inclusion in our review. We reviewed multiple risk-prediction models including recent updates and systematic reviews. Our results suggest risk projection models may reduce false positive rates and identify high risk patients not currently eligible for screening. However, most studies were heterogenous in both their variables and risk threshold cutoffs for screening. Furthermore, a lack of prospective validation continues to limit the generalizability. Therefore, we acknowledge the need for further prospective data collection regarding use of risk-prediction modeling to refine lung cancer screening.
{"title":"A narrative review of risk prediction models for lung cancer screening","authors":"Aaron R. Dezube, M. Jaklitsch","doi":"10.21037/CCTS-2020-LCS-04","DOIUrl":"https://doi.org/10.21037/CCTS-2020-LCS-04","url":null,"abstract":"Lung cancer is the leading cause of cancer-death worldwide. The U.S. Preventative Services Task Force (USPTSF) approved screening for current or former smokers aged 55–80 based on the results of the National Lung Screening trial (NLST). Current guidelines use rigid inclusion criteria, therefore new attention has turned to use of risk-prediction models for lung cancer to reduce the number needed to screen as well as identify high-risk patients who don’t meet current screening guidelines. Our paper serves as an expert narrative review of new literature pertaining to lung cancer risk prediction models for screening based on review of articles from PubMed and Cochrane database from date of inception through June 11, 2020. We used the MeSH search terms: “lung cancer”; “screening”; “low dose CT”, and “risk prediction model” to identify any new relevant articles for inclusion in our review. We reviewed multiple risk-prediction models including recent updates and systematic reviews. Our results suggest risk projection models may reduce false positive rates and identify high risk patients not currently eligible for screening. However, most studies were heterogenous in both their variables and risk threshold cutoffs for screening. Furthermore, a lack of prospective validation continues to limit the generalizability. Therefore, we acknowledge the need for further prospective data collection regarding use of risk-prediction modeling to refine lung cancer screening.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47458863","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}
Betül Bahar Kazak, G. Kocaman, Süleyman Gökalp Güneş, B. Yenigün, H. Kutlay
Catamenial pneumothorax (CP) is a special type of pneumothorax occurring in women of reproductive age related with the menstrual cycles. In most cases patients are misdiagnosed as primary spontaneous pneumothorax and are admitted to the hospital with recurrences. CP is mostly associated with thoracic endometriosis. Characteristic lesions of the disease include diaphragmatic perforations and also diaphragmatic or pleural spots or nodules in addition to bullae or blebs. There are a few cases in the literature with partial liver herniation from diaphragmatic defects in patients with catamenial pneumothorax. In this study, we present a 45-year-old female patient with the diagnosis of catamenial pneumothorax and herniation of liver from diaphragmatic defects.
{"title":"Catamenial pneumothorax with liver herniation","authors":"Betül Bahar Kazak, G. Kocaman, Süleyman Gökalp Güneş, B. Yenigün, H. Kutlay","doi":"10.26663/cts.2021.0024","DOIUrl":"https://doi.org/10.26663/cts.2021.0024","url":null,"abstract":"Catamenial pneumothorax (CP) is a special type of pneumothorax occurring in women of reproductive age related with the menstrual cycles. In most cases patients are misdiagnosed as primary spontaneous pneumothorax and are admitted to the hospital with recurrences. CP is mostly associated with thoracic endometriosis. Characteristic lesions of the disease include diaphragmatic perforations and also diaphragmatic or pleural spots or nodules in addition to bullae or blebs. There are a few cases in the literature with partial liver herniation from diaphragmatic defects in patients with catamenial pneumothorax. In this study, we present a 45-year-old female patient with the diagnosis of catamenial pneumothorax and herniation of liver from diaphragmatic defects.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80825305","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: Pulmonary contusion is a potentially life-threatening clinical manifestation frequently seen in acute thoracic trauma. It can be life-threatening if diffuse in nature. This study investigated the tissue damage-reducing effect of carvacrol, an antioxidant, in rats with induced lung damage. Materials and Methods: Twenty-one female Wistar Albino rats weighing 240-320 g were used in the study. Pulmonary contusion was induced with the application of 2.25 joules of energy with a modification of the isolated bilateral pulmonary contusion model. Lung tissues of rats administered two doses of oral 50 mg/kg carvacrol were then subjected to histopathologic examination. Results: Congestion, alveolar destruction, alveolar hemorrhage, and leukocyte infiltration were subjected to histopathologic examination in all lung sections. The amount of alveolar hemorrhage was significantly lower in the carvacrol group compared with the control and trauma groups (p = 0.033). Congestion, leukocyte infiltration, and destruction also decreased, albeit statistically insignificantly, in the carvacrol group. Conclusion: The antioxidant carvacrol significantly prevented alveolar hemorrhage in pulmonary contusion developing following trauma. Congestion decreased, and no leukocyte infiltration developed in the carvacrol group. However, it did not affect destruction.
{"title":"The parenchyma-protecting effect of carvacrol in pulmonary contusion induced in rats","authors":"O. Yakşi, Songül Peltek Özer","doi":"10.26663/cts.2021.0020","DOIUrl":"https://doi.org/10.26663/cts.2021.0020","url":null,"abstract":"Background: Pulmonary contusion is a potentially life-threatening clinical manifestation frequently seen in acute thoracic trauma. It can be life-threatening if diffuse in nature. This study investigated the tissue damage-reducing effect of carvacrol, an antioxidant, in rats with induced lung damage. Materials and Methods: Twenty-one female Wistar Albino rats weighing 240-320 g were used in the study. Pulmonary contusion was induced with the application of 2.25 joules of energy with a modification of the isolated bilateral pulmonary contusion model. Lung tissues of rats administered two doses of oral 50 mg/kg carvacrol were then subjected to histopathologic examination. Results: Congestion, alveolar destruction, alveolar hemorrhage, and leukocyte infiltration were subjected to histopathologic examination in all lung sections. The amount of alveolar hemorrhage was significantly lower in the carvacrol group compared with the control and trauma groups (p = 0.033). Congestion, leukocyte infiltration, and destruction also decreased, albeit statistically insignificantly, in the carvacrol group. Conclusion: The antioxidant carvacrol significantly prevented alveolar hemorrhage in pulmonary contusion developing following trauma. Congestion decreased, and no leukocyte infiltration developed in the carvacrol group. However, it did not affect destruction.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89807843","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}
Seray Hazer, G. Fındık, K. Aydoğdu, Y. Ağaçkıran, S. Gülhan, M. Demiröz, Pınar Bıçakçıoğlu, S. Kaya
Background: Ewing sarcoma (ES) is an uncommon aggressive malignant tumor of the bone and/or soft tissue and belongs to peripheral primitive neuroectodermal tumor (PNET) family of tumors. Bone PNETs primarily arise from the diaphysis of long bones, where as soft tissue PNETs are most commonly found in the chest wall. Multidisciplinary treatments, including chemotherapy, surgery, radiotherapy, or all three combined, improve the survival of patients with localized ES. However, the best approach to achieve local control remains controversial. Materials and Methods: We retrospectively analysed the medical records and pathology data of 14 patients (8 male, 6 female; mean age, 23.2 [range, 4-54] years) with primary thoracic ES who underwent surgery in our clinic between January 2002 and December 2019. In addition, the treatment modalities and tumor-related factors of chest wall ES and lung parenchyma were evaluated. Results: The most frequent complaint was chest pain (n = 7). In 10 patients, the tumor originated from the ribs, whereas the remaining 4 patients had lung parenchymal tumors. Ten patients underwent complete tumor excision with chest wall resection, one patient underwent lower lobectomy with chest wall resection, and three patients underwent complete tumor excision via wedge resection. All patients were treated with chemotherapy, except two who underwent bone marrow transplantation. The median follow-up was 31.6 (range, 2-84) months. Relapses were seen in 5 cases in the median 19.8th (range, 4-60) month. Conclusions: Complete tumor resection is the most effective treatment for thoracic ES and multimodal therapy (surgical resection, chemotherapy, and local radiation therapy), which is recommended when indicated, constitutes the optimal treatment for ES. Although relapses occur within the early postoperative period, late relapses are not uncommon. The follow-up periods must be short and should be maintained long term for late relapses.
{"title":"Is primary thoracic ewing sarcoma aggressive than others? seventeenyears' experience","authors":"Seray Hazer, G. Fındık, K. Aydoğdu, Y. Ağaçkıran, S. Gülhan, M. Demiröz, Pınar Bıçakçıoğlu, S. Kaya","doi":"10.26663/cts.2021.0009","DOIUrl":"https://doi.org/10.26663/cts.2021.0009","url":null,"abstract":"Background: Ewing sarcoma (ES) is an uncommon aggressive malignant tumor of the bone and/or soft tissue and belongs to peripheral primitive neuroectodermal tumor (PNET) family of tumors. Bone PNETs primarily arise from the diaphysis of long bones, where as soft tissue PNETs are most commonly found in the chest wall. Multidisciplinary treatments, including chemotherapy, surgery, radiotherapy, or all three combined, improve the survival of patients with localized ES. However, the best approach to achieve local control remains controversial. Materials and Methods: We retrospectively analysed the medical records and pathology data of 14 patients (8 male, 6 female; mean age, 23.2 [range, 4-54] years) with primary thoracic ES who underwent surgery in our clinic between January 2002 and December 2019. In addition, the treatment modalities and tumor-related factors of chest wall ES and lung parenchyma were evaluated. Results: The most frequent complaint was chest pain (n = 7). In 10 patients, the tumor originated from the ribs, whereas the remaining 4 patients had lung parenchymal tumors. Ten patients underwent complete tumor excision with chest wall resection, one patient underwent lower lobectomy with chest wall resection, and three patients underwent complete tumor excision via wedge resection. All patients were treated with chemotherapy, except two who underwent bone marrow transplantation. The median follow-up was 31.6 (range, 2-84) months. Relapses were seen in 5 cases in the median 19.8th (range, 4-60) month. Conclusions: Complete tumor resection is the most effective treatment for thoracic ES and multimodal therapy (surgical resection, chemotherapy, and local radiation therapy), which is recommended when indicated, constitutes the optimal treatment for ES. Although relapses occur within the early postoperative period, late relapses are not uncommon. The follow-up periods must be short and should be maintained long term for late relapses.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75326180","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}
: Over the past decade, chest computed tomography (CT) utilization has steadily increased in conjunction with lung cancer CT screening. As a result, small lung nodules have become an increasingly common finding. CT guided lung biopsy plays a pivotal role in the sampling of these small lung nodules and the subsequent diagnosis of lung cancer. The success of lung biopsies has a substantial downstream impact on diagnosis and treatment planning. It is well-recognized that the efficacy of lung biopsy is both operator-dependent and patient-dependent. Several considerations are necessary for the safe and successful performance of CT-guided lung biopsy. A familiarity with biopsy contraindications and their management can drastically reduce serious complications, such as intractable hemorrhage. Conscientious patient preparation and empathic communication are essential for reducing patient anxiety while increasing patient tolerance for the procedure and its common complications. Strategic and precise nodule-targeting techniques are crucial for obtaining adequate tissue and for improving diagnostic accuracy. On-site cytologic assessment is a powerful tool that can further boost diagnostic yield while also reducing complication rates by eliminating the need for additional biopsy attempts. Vigilant observation and careful assessment throughout the procedure are key factors in the effective mitigation of the most frequently encountered complications. As personalized medicine plays an increasingly integral part in the diagnosis and treatment of early-stage lung cancers, coordination between radiologists, clinicians, pathologists, and the patient becomes especially important.
{"title":"The radiologist’s role in pathologic diagnosis of small lung nodules: radiographic methods of tissue acquisition","authors":"M. Cham, C. Henschke, D. Yankelevitz","doi":"10.21037/ccts-21-36","DOIUrl":"https://doi.org/10.21037/ccts-21-36","url":null,"abstract":": Over the past decade, chest computed tomography (CT) utilization has steadily increased in conjunction with lung cancer CT screening. As a result, small lung nodules have become an increasingly common finding. CT guided lung biopsy plays a pivotal role in the sampling of these small lung nodules and the subsequent diagnosis of lung cancer. The success of lung biopsies has a substantial downstream impact on diagnosis and treatment planning. It is well-recognized that the efficacy of lung biopsy is both operator-dependent and patient-dependent. Several considerations are necessary for the safe and successful performance of CT-guided lung biopsy. A familiarity with biopsy contraindications and their management can drastically reduce serious complications, such as intractable hemorrhage. Conscientious patient preparation and empathic communication are essential for reducing patient anxiety while increasing patient tolerance for the procedure and its common complications. Strategic and precise nodule-targeting techniques are crucial for obtaining adequate tissue and for improving diagnostic accuracy. On-site cytologic assessment is a powerful tool that can further boost diagnostic yield while also reducing complication rates by eliminating the need for additional biopsy attempts. Vigilant observation and careful assessment throughout the procedure are key factors in the effective mitigation of the most frequently encountered complications. As personalized medicine plays an increasingly integral part in the diagnosis and treatment of early-stage lung cancers, coordination between radiologists, clinicians, pathologists, and the patient becomes especially important.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43781690","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}
Bronchial atresia is one of the rare congenital bronchopulmonary malformations. The affected bronchus is atresic and usually the upper lobe of the left lung is involved and is not connected to the central airways. In this case report, we present the treatment process of a patient with post-intubation tracheal stenosis, left main bronchial stenosis, and an agenesis of left upper lobe bronchus.
{"title":"A successfully treated patient with bronchial atresia and tracheal stenosis","authors":"Bayram Metin, M. Turan","doi":"10.26663/cts.2021.0026","DOIUrl":"https://doi.org/10.26663/cts.2021.0026","url":null,"abstract":"Bronchial atresia is one of the rare congenital bronchopulmonary malformations. The affected bronchus is atresic and usually the upper lobe of the left lung is involved and is not connected to the central airways. In this case report, we present the treatment process of a patient with post-intubation tracheal stenosis, left main bronchial stenosis, and an agenesis of left upper lobe bronchus.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86188196","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: 10.21037/CCTS-2019-FILSC-04-M04
Y. Matsuura, J. Ichinose, M. Nakao, S. Okumura, M. Mun
: Currently, lobectomy with systematic lymph node dissection (LND) is the standard surgical procedure for early stage, non-small cell lung cancer (NSCLC). Several issues may arise when performing a lobectomy such as a fused fissure, especially during thoracoscopic surgery. In this case, performing hilar LND in a conventional manner may be difficult. Since both hilar and mediastinal LND are essential procedures during surgery for NSCLC, it is crucial to achieve both safe lobectomy and precise systematic LND in fused fissure cases. To address this difficult situation, we have developed the following three novel thoracoscopic techniques that focus on LND: (I) the “anterior fissure first technique”, (II) the “#4L-posterior first technique”, and (III) the “anterior #7 dissection technique”. First, the anterior fissure first technique enables the operator to view the entire hilar lymph node, similar to a situation with a complete fissure, and allows the hilar LND to proceed in a conventional manner. Second, when using the #4L-posterior first technique, the left lower paratracheal (#4L) LND is straightforward since the left recurrent laryngeal nerve (RLN) has already been dissected, and only the anterior area of #4L remains to be dissected. Finally, during the anterior #7 dissection technique, when performing the subcarinal (#7) LND, we do not dissect between the dorsal side of the trachea and esophagus. Consequently, the bronchial artery (BA) is preserved and postoperative ischemic change in the bronchial stumps is prevented. We believe that our techniques are oncologically appropriate and enable the safe and straightforward execution of precise thoracoscopic lobectomy and systematic LND, even in cases of fused fissures.
{"title":"Novel thoracoscopic lymph node dissection techniques for left upper lobectomy with a fused fissure","authors":"Y. Matsuura, J. Ichinose, M. Nakao, S. Okumura, M. Mun","doi":"10.21037/CCTS-2019-FILSC-04-M04","DOIUrl":"https://doi.org/10.21037/CCTS-2019-FILSC-04-M04","url":null,"abstract":": Currently, lobectomy with systematic lymph node dissection (LND) is the standard surgical procedure for early stage, non-small cell lung cancer (NSCLC). Several issues may arise when performing a lobectomy such as a fused fissure, especially during thoracoscopic surgery. In this case, performing hilar LND in a conventional manner may be difficult. Since both hilar and mediastinal LND are essential procedures during surgery for NSCLC, it is crucial to achieve both safe lobectomy and precise systematic LND in fused fissure cases. To address this difficult situation, we have developed the following three novel thoracoscopic techniques that focus on LND: (I) the “anterior fissure first technique”, (II) the “#4L-posterior first technique”, and (III) the “anterior #7 dissection technique”. First, the anterior fissure first technique enables the operator to view the entire hilar lymph node, similar to a situation with a complete fissure, and allows the hilar LND to proceed in a conventional manner. Second, when using the #4L-posterior first technique, the left lower paratracheal (#4L) LND is straightforward since the left recurrent laryngeal nerve (RLN) has already been dissected, and only the anterior area of #4L remains to be dissected. Finally, during the anterior #7 dissection technique, when performing the subcarinal (#7) LND, we do not dissect between the dorsal side of the trachea and esophagus. Consequently, the bronchial artery (BA) is preserved and postoperative ischemic change in the bronchial stumps is prevented. We believe that our techniques are oncologically appropriate and enable the safe and straightforward execution of precise thoracoscopic lobectomy and systematic LND, even in cases of fused fissures.","PeriodicalId":72729,"journal":{"name":"Current challenges in thoracic surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68326214","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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