Pub Date : 2014-01-01DOI: 10.1097/ASA.0000000000000020
A. Hadžić, M. Latmore, M. Levine, C. Vandepitte, Caroline Vloka
Lower extremity nerve blocks are becoming more frequently used for anesthesia and postoperative analgesia in the setting of ambulatory surgery because of their favorable recovery and side-effect profiles. Perineural catheters can be placed in many situations to prolong duration of action, and patients are increasingly being sent home with catheters in situ and disposable infusion pumps. Ultrasound guidance is commonly used and may result in faster onset, increased success, and reduced performance time when compared with more traditional techniques. The purpose of this chapter is to discuss relevant details of these blocks, including theoretical and technical considerations, and to highlight developments from the recent literature that may influence your practice.
{"title":"Lower Extremity Nerve Blocks","authors":"A. Hadžić, M. Latmore, M. Levine, C. Vandepitte, Caroline Vloka","doi":"10.1097/ASA.0000000000000020","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000020","url":null,"abstract":"Lower extremity nerve blocks are becoming more frequently used for anesthesia and postoperative analgesia in the setting of ambulatory surgery because of their favorable recovery and side-effect profiles. Perineural catheters can be placed in many situations to prolong duration of action, and patients are increasingly being sent home with catheters in situ and disposable infusion pumps. Ultrasound guidance is commonly used and may result in faster onset, increased success, and reduced performance time when compared with more traditional techniques. The purpose of this chapter is to discuss relevant details of these blocks, including theoretical and technical considerations, and to highlight developments from the recent literature that may influence your practice.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"65-74"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62016447","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000016
M. O’Connor, G. Maccioli
Learning Objectives: As a result of completing this activity, the participant will be able to List the causes of perioperative cardiac arrest and contrast them with the causes envisioned in traditional Advanced Cardiac Life Support Describe the systematic assessment of the patient in crisis and discuss strategies for avoiding cardiac arrest Utilize annotated adaptations of the Advanced Cardiac Life Support algorithms for the perioperative setting
{"title":"Anesthesia-centric Advanced Cardiac Life Support","authors":"M. O’Connor, G. Maccioli","doi":"10.1097/ASA.0000000000000016","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000016","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to List the causes of perioperative cardiac arrest and contrast them with the causes envisioned in traditional Advanced Cardiac Life Support Describe the systematic assessment of the patient in crisis and discuss strategies for avoiding cardiac arrest Utilize annotated adaptations of the Advanced Cardiac Life Support algorithms for the perioperative setting","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"108–112"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62016807","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000001
D. Provenzano
Learning Objectives: As a result of completing this activity, the participant will be able to Explain the role of radiofrequency ablation for spine pain Define the electrophysiological principles of radiofrequency Discuss the evidence for the safety and efficacy of radiofrequency ablation for spine pain Describe the current limitations of radiofrequency ablation Describe methods to modulate lesion size
{"title":"Radiofrequency Ablation for the Treatment of Spine Pain: Understanding the Basic Principles and Clinical Application","authors":"D. Provenzano","doi":"10.1097/ASA.0000000000000001","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000001","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Explain the role of radiofrequency ablation for spine pain Define the electrophysiological principles of radiofrequency Discuss the evidence for the safety and efficacy of radiofrequency ablation for spine pain Describe the current limitations of radiofrequency ablation Describe methods to modulate lesion size","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"113–118"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015204","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000018
B. Fahy
The pertinent perioperative issue of glucose control in known diabetics and in patients who exhibit stressinduced hyperglycemia is the focus of this chapter. With 8.3% of the population of the United States (approximately 26 million individuals) suffering from diabetes mellitus, the issue of glycemic control in the perioperative period will be encountered by every US anesthesiologist. The vast majority (more than 90%) of these patients suffer from a type of diabetes that results from inadequate production of insulin, lack of responsiveness to the insulin produced, or excessive gluconeogenesis; a combination of these factors may also be present. Evidence-based medicine (EBM) can help guide management. The evidence currently available and limitations of its application during the perioperative period will be reviewed, including the basis for the evidence supporting clinical recommendations and areas where additional research and data may be needed. The risks imposed by inadvertent hypoglycemia will be discussed and will provide a framework to address current controversies that clinicians face when attempting to optimize the care of patients with perioperative hyperglycemia based on EBM (Supplemental Digital Content 1, http://links.lww.com/ ASA/A497).
{"title":"Controversies in Critical Care: Glycemic Control","authors":"B. Fahy","doi":"10.1097/ASA.0000000000000018","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000018","url":null,"abstract":"The pertinent perioperative issue of glucose control in known diabetics and in patients who exhibit stressinduced hyperglycemia is the focus of this chapter. With 8.3% of the population of the United States (approximately 26 million individuals) suffering from diabetes mellitus, the issue of glycemic control in the perioperative period will be encountered by every US anesthesiologist. The vast majority (more than 90%) of these patients suffer from a type of diabetes that results from inadequate production of insulin, lack of responsiveness to the insulin produced, or excessive gluconeogenesis; a combination of these factors may also be present. Evidence-based medicine (EBM) can help guide management. The evidence currently available and limitations of its application during the perioperative period will be reviewed, including the basis for the evidence supporting clinical recommendations and areas where additional research and data may be needed. The risks imposed by inadvertent hypoglycemia will be discussed and will provide a framework to address current controversies that clinicians face when attempting to optimize the care of patients with perioperative hyperglycemia based on EBM (Supplemental Digital Content 1, http://links.lww.com/ ASA/A497).","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"46-54"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62016740","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000019
M. Mccunn
Trauma is the third leading cause of death in the United States and the leading cause of death in patients under the age of 44 years. One person dies from injury every 3 minutes (Supplemental Digital Content 1, http://links.lww. com/ASA/A489). The Centers for Disease Control and Prevention reports that falls are now the leading cause of all traumatic injury, because of the aging population, followed by motor vehicle collisions and penetrating trauma. Violent trauma, including assaults firearm injuries, and suicides, are increasing. Deaths due to homicide from gun violence are rising, specifically in African American men and in metropolitan areas. The risk of death after injury is significantly lower when patients are treated at trauma centers compared with nontrauma hospitals. This is in part due to the 24/7 staffing of experts in the field of trauma care. Anesthesiologists are key partners in the resuscitation, operative management, and intensive care of the injured.
{"title":"Advanced Trauma Life Support® (ATLS®) Update: What Every Anesthesiologist Should Know","authors":"M. Mccunn","doi":"10.1097/ASA.0000000000000019","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000019","url":null,"abstract":"Trauma is the third leading cause of death in the United States and the leading cause of death in patients under the age of 44 years. One person dies from injury every 3 minutes (Supplemental Digital Content 1, http://links.lww. com/ASA/A489). The Centers for Disease Control and Prevention reports that falls are now the leading cause of all traumatic injury, because of the aging population, followed by motor vehicle collisions and penetrating trauma. Violent trauma, including assaults firearm injuries, and suicides, are increasing. Deaths due to homicide from gun violence are rising, specifically in African American men and in metropolitan areas. The risk of death after injury is significantly lower when patients are treated at trauma centers compared with nontrauma hospitals. This is in part due to the 24/7 staffing of experts in the field of trauma care. Anesthesiologists are key partners in the resuscitation, operative management, and intensive care of the injured.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"92-99"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62016782","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000002
Martin R. Smith
Several techniques are available for global and regional brain monitoring that provide an assessment of cerebral perfusion, oxygenation, and metabolic status, and early warning of impending brain hypoxia and ischemia (Supplemental Digital Content 1, http:// links.lww.com/ASA/A397). Some monitoring modalities are well established, whereas others are relatively new to the clinical arena and their indications are still being evaluated; all have advantages and disadvantages (Table 1). The general indications for intracranial monitoring are summarized in Table 2. Monitoring of several physiological variables simultaneously (multimodal monitoring) has enabled a move away from rigid physiological target setting to an individually tailored, patient-specific approach toward management after acute brain injury. The pathophysiology of acute brain injury is complex and involves the interrelation between changes in cerebral blood flow (CBF), cerebral oxygen and glucose delivery and utilization, and electrophysiological derangements, with substantial regional and temporal heterogeneity. Although intracranial pressure (ICP) and cerebral perfusion pressure (CPP) are crucially important and are routinely monitored, they do not provide an assessment of the adequacy of cerebral perfusion. Therapeutic targets and choice of therapy are therefore best determined by multimodal monitoring.
{"title":"Physiological Brain Monitoring","authors":"Martin R. Smith","doi":"10.1097/ASA.0000000000000002","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000002","url":null,"abstract":"Several techniques are available for global and regional brain monitoring that provide an assessment of cerebral perfusion, oxygenation, and metabolic status, and early warning of impending brain hypoxia and ischemia (Supplemental Digital Content 1, http:// links.lww.com/ASA/A397). Some monitoring modalities are well established, whereas others are relatively new to the clinical arena and their indications are still being evaluated; all have advantages and disadvantages (Table 1). The general indications for intracranial monitoring are summarized in Table 2. Monitoring of several physiological variables simultaneously (multimodal monitoring) has enabled a move away from rigid physiological target setting to an individually tailored, patient-specific approach toward management after acute brain injury. The pathophysiology of acute brain injury is complex and involves the interrelation between changes in cerebral blood flow (CBF), cerebral oxygen and glucose delivery and utilization, and electrophysiological derangements, with substantial regional and temporal heterogeneity. Although intracranial pressure (ICP) and cerebral perfusion pressure (CPP) are crucially important and are routinely monitored, they do not provide an assessment of the adequacy of cerebral perfusion. Therapeutic targets and choice of therapy are therefore best determined by multimodal monitoring.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"119-128"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015276","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000011
R. Dutton
The Anesthesia Quality Institute (AQI) is a related organization of the American Society of Anesthesiologists (ASA). The AQI was formed in 2009 to promote quality in anesthesia patient care through collection and dissemination of clinical practice data. The AQI created the National Anesthesia Clinical Outcomes Registry (NACOR) in 2010, and the Anesthesia Incident Reporting System (AIRS) in 2011, to accomplish this purpose. Data are collected from anesthesia practices and anesthesiologists across the United States and are aggregated to create benchmarks for clinical outcomes. Benchmarks encompass all aspects of anesthesia quality, including operational efficiency, safety, and patient experience. Practices contributing to the AQI receive continual online access to their own data, as well as comparators on the basis of practice size and type drawn from the whole of NACOR. Aggregated information describes the practice of anesthesiology in the United States, and is available to ASA and subspecialty society leaders. Selected cases from AIRS that illustrate emerging threats to patient safety are used to generate teaching articles in the ASA Newsletter, which is circulated to more than 50,000 anesthesiologists around the world. Contribution of case-specific data to NACOR and AIRS will be increasingly important to practices in the future, to meet multiple regulatory requirements. The purpose of this chapter is to provide a brief overview of the structure, mechanics, and current status of the AQI and its registries, and to present some of the aggregate data gathered to date.
{"title":"Fifty Facts in Fifty Minutes: An Update From the Anesthesia Quality Institute","authors":"R. Dutton","doi":"10.1097/ASA.0000000000000011","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000011","url":null,"abstract":"The Anesthesia Quality Institute (AQI) is a related organization of the American Society of Anesthesiologists (ASA). The AQI was formed in 2009 to promote quality in anesthesia patient care through collection and dissemination of clinical practice data. The AQI created the National Anesthesia Clinical Outcomes Registry (NACOR) in 2010, and the Anesthesia Incident Reporting System (AIRS) in 2011, to accomplish this purpose. Data are collected from anesthesia practices and anesthesiologists across the United States and are aggregated to create benchmarks for clinical outcomes. Benchmarks encompass all aspects of anesthesia quality, including operational efficiency, safety, and patient experience. Practices contributing to the AQI receive continual online access to their own data, as well as comparators on the basis of practice size and type drawn from the whole of NACOR. Aggregated information describes the practice of anesthesiology in the United States, and is available to ASA and subspecialty society leaders. Selected cases from AIRS that illustrate emerging threats to patient safety are used to generate teaching articles in the ASA Newsletter, which is circulated to more than 50,000 anesthesiologists around the world. Contribution of case-specific data to NACOR and AIRS will be increasingly important to practices in the future, to meet multiple regulatory requirements. The purpose of this chapter is to provide a brief overview of the structure, mechanics, and current status of the AQI and its registries, and to present some of the aggregate data gathered to date.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015780","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000007
R. Sniecinski
The early circuits for cardiopulmonary bypass (CPB) required fairy large priming volumes, typically around 2.5 L. Once the benefits of hemodilution were recognized in the 1960s, crystalloids replaced blood as the main component of priming solutions. With this advance, however, came the realization of myocardial edema and its associated sequelae. Edema formation was also a problem in trauma patients, and at about the same time there was interest in decreasing the amount of crystalloid administered during large-volume resuscitations. Colloids held the potential to restore plasma volume more rapidly and more efficiently with less fluid accumulation in the lungs and interstitial space. These observations have guided the ensuing search for the ideal fluid for CPB priming, as well as for volume resuscitation commonly required in cardiac surgical patients (Supplemental Digital Content 1, http:// links.lww.com/ASA/A431).
{"title":"Synthetic Colloids in Cardiac Surgery: What Are the Indications?","authors":"R. Sniecinski","doi":"10.1097/ASA.0000000000000007","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000007","url":null,"abstract":"The early circuits for cardiopulmonary bypass (CPB) required fairy large priming volumes, typically around 2.5 L. Once the benefits of hemodilution were recognized in the 1960s, crystalloids replaced blood as the main component of priming solutions. With this advance, however, came the realization of myocardial edema and its associated sequelae. Edema formation was also a problem in trauma patients, and at about the same time there was interest in decreasing the amount of crystalloid administered during large-volume resuscitations. Colloids held the potential to restore plasma volume more rapidly and more efficiently with less fluid accumulation in the lungs and interstitial space. These observations have guided the ensuing search for the ideal fluid for CPB priming, as well as for volume resuscitation commonly required in cardiac surgical patients (Supplemental Digital Content 1, http:// links.lww.com/ASA/A431).","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"129–135"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015772","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000008
B. Abdelmalak
Learning Objectives: As a result of completing this activity, the participant will be able to Describe the epidemiology of undiagnosed diabetes and hyperglycemia in the perioperative period Justify a management plan for preoperative and postoperative hyperglycemia Discuss hyperglycemic surgical stress response, its extent, pattern, and the impact of steroids Formulate a plan for intraoperative insulin dosing, route, and glucose monitoring List necessary steps in caring for patients using insulin pumps
{"title":"Anesthesiologist’s Guide to Perioperative Glycemic Management","authors":"B. Abdelmalak","doi":"10.1097/ASA.0000000000000008","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000008","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Describe the epidemiology of undiagnosed diabetes and hyperglycemia in the perioperative period Justify a management plan for preoperative and postoperative hyperglycemia Discuss hyperglycemic surgical stress response, its extent, pattern, and the impact of steroids Formulate a plan for intraoperative insulin dosing, route, and glucose monitoring List necessary steps in caring for patients using insulin pumps","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"1–11"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015417","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 : 2014-01-01DOI: 10.1097/ASA.0000000000000009
B. Carvalho
Learning Objectives: As a result of completing this activity, the participant will be able to Describe techniques that prolong the duration of neuraxial analgesia after cesarean delivery Discuss multimodal pain management strategies Identify wound infiltration and peripheral nerve blockade techniques that optimize cesarean analgesia Explain therapeutic principles to minimize analgesic drug exposure in breast-feeding infants
{"title":"Strategies to Optimize Pain Control Following Cesarean Delivery","authors":"B. Carvalho","doi":"10.1097/ASA.0000000000000009","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000009","url":null,"abstract":"Learning Objectives: As a result of completing this activity, the participant will be able to Describe techniques that prolong the duration of neuraxial analgesia after cesarean delivery Discuss multimodal pain management strategies Identify wound infiltration and peripheral nerve blockade techniques that optimize cesarean analgesia Explain therapeutic principles to minimize analgesic drug exposure in breast-feeding infants","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"42 1","pages":"23–30"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62015474","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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