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Highlights on Medicine and Medical Science Vol. 18最新文献

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An Exploratory Qualitative Study on Indonesian Mothers' Needs and Concerns about Having a Thalassemic Child and Its Treatment 印度尼西亚母亲对地中海贫血儿童的需求和关注及其治疗的探索性质的研究
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/10008d
Henny Suzana Mediani, Ikeu Nurhidayah, Ai Mardhiyah, R. Panigoro
Thalassemia is a major genetic blood disorder that considered as a public health problem in Indonesia. Yet, little is known about affected individuals thalassemic children and parents overall experiences with and perceptions of thalassemia mayor in Indonesia. This study aimed to explore the concerns, beliefs, feelings and needs of mothers' who have a thalassemic child. A total of (N=24) mothers' were chosen as participants. Focus Group Discussion (FGD) was carried out to better elucidate the mothers' perceptions of their needs and concerns. A semi-structure focus group moderator’s guide corresponding to the research questions was developed. To gain in-depth understanding, questions were divided in four major domains which were (i) Perceptions about child disease, (ii) Knowledge about thalassemia and its treatment, (iii) Thalassemia impact on child and family, and (iv) Needs and future concerns. Transcripts were thematically coded according to the research themes that emerged from the data, and the themes were further sorted into subthemes. The finding of this study indicates significant impact of thalassemic children on their families in terms of emotional well-being, financial burden and social impact. Mother’s education level was very low about Thalassemia. Mother also expressed their needs for more information about thalassemia and its treatment, social, professional support, and financial support. Results of this study provided a portrait of the reality that thalassemia has a significant impact on children and their families. A holistic approach should be carried out while caring with thalassemic children and their families. Nurses and health care professionals should explore the feelings, concerns and needs of mothers' who have thalassemic children and eventually provide appropriate care plans that alleviate their suffering.
地中海贫血是一种主要的遗传性血液疾病,在印度尼西亚被视为一个公共卫生问题。然而,在印度尼西亚,人们对地中海贫血患者、儿童和父母的总体经历和对地中海贫血的看法知之甚少。本研究旨在探讨有地中海贫血孩子的母亲的担忧、信念、感受和需求。共有(N=24)名母亲被选为参与者。焦点小组讨论(FGD)是为了更好地阐明母亲对她们的需要和关切的看法。针对研究问题制定了半结构式焦点小组主持人指南。为了深入了解,问题分为四个主要领域,即:(一)对儿童疾病的认识,(二)对地中海贫血及其治疗的认识,(三)地中海贫血对儿童和家庭的影响,以及(四)需求和未来关切。根据从数据中产生的研究主题对转录本进行主题编码,并进一步将主题分类为子主题。本研究结果表明,地中海贫血儿童对其家庭在情感幸福感、经济负担和社会影响方面有显著影响。母亲对地中海贫血的教育程度很低。母亲还表示,他们需要更多关于地中海贫血及其治疗、社会、专业支持和财政支持的信息。这项研究的结果为地中海贫血对儿童及其家庭产生重大影响的现实提供了一幅肖像。在照顾地中海贫血儿童及其家庭的同时,应采取整体办法。护士和卫生保健专业人员应探索有地中海贫血儿童的母亲的感受、关切和需求,并最终提供适当的护理计划,减轻她们的痛苦。
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引用次数: 0
Cholelithiasis and Its Management: A Clinical Study 胆石症及其治疗:一项临床研究
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/2278f
C. Mohan, J. Kabalimurthy, R. Jayavarmaa
Background: The study was carried out to investigate the clinical presentation, incidence, and variations in presentation among different age/sex groups, as well as the various modes of management of Cholelithiasis. Methods: From October 2016 to September 2018, this study was undertaken in our hospital's department of general surgery on 50 patients who arrived with symptoms and signs suggestive of gallstones and were confirmed as Cholelithiasis based on radiological and laboratory evidence.  The management of the disease, and postoperative complications and histopathological evaluation of the specimen were done and the results were correlated with various other studies. Results: Between the ages of 17 and 79, the most people are afflicted.Almost all of the patients had dyspepsia and right hypchondrial discomfort.The diagnosis of cholelithiasis was confirmed in 100% of the patients by USG abdomen.In our study, the average age of the patients was 48 years. Gallstones of various types were the most common.Cholesterol stones are next on the list, followed by pigment stones.52% of the patients were female. All the 50 patients were treated surgically, 39 open cholecystectomy and 11 laparoscopy cholecystectomy. All 50 gall bladders sent for HPE, out of which 49 reported as chronic cholecystitis and 1 reported as adenocarcinoma. Conclusion: Cholelithiasis is most usually found as incidental finding on ultrasonography, especially in the fourth or fifth decade of life.Surgery was planned for the symptomatic individuals after USG confirmation. The procedure of choice is laparoscopic cholecystectomy.
背景:本研究旨在探讨胆石症的临床表现、发病率、不同年龄/性别人群的表现差异,以及胆石症的不同治疗模式。方法:2016年10月至2018年9月,在我院普外科对50例出现胆结石症状体征,经影像学和实验室证实为胆石症的患者进行研究。完成了疾病的处理、术后并发症和标本的组织病理学评估,并将结果与其他各种研究相关联。结果:17岁至79岁是患此病最多的年龄段。几乎所有患者均有消化不良和右侧疑病症。超声心动图对胆石症的诊断率为100%。在我们的研究中,患者的平均年龄为48岁。各种类型的胆结石最为常见。胆固醇结石紧随其后,其次是色素结石。52%的患者为女性。50例均行手术治疗,其中开腹胆囊切除术39例,腹腔镜胆囊切除术11例。全部50例胆囊行HPE检查,其中49例报告为慢性胆囊炎,1例报告为腺癌。结论:胆石症通常是超声检查的偶然发现,尤其是在40岁或50岁时。在USG确认后,计划对有症状的个体进行手术。手术的选择是腹腔镜胆囊切除术。
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引用次数: 0
Study on Cutaneous Tuberculosis: Issues in the Diagnose 皮肤结核的研究:诊断问题
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/11038d
Y. C. Hechavarria, T. Maria, L. Varona, Esema Christopher, Ayesha Binte Ashfaq
Liquen scrofulosorum, also known as tuberculosis cutis lichenoides, is a rare tuberculid that presents as lichenoid eruptions of minute papule, is an uncommon disease and easily misdiagnosed. The lesions are usually asymptomatic, closely grouped, skin colored to reddish-brown papules, often perifollicular. The eruption usually is associated with a strongly positive tuberculin reaction. Diagnosis of the lesions can be difficult, as they resemble many other dermatological conditions that are often primarily considered. A report a case of lichen scrofulosorum in an adult male with a florid medical history is done with the objective of determinate the effectivity of the antitubercular therapy, was revealed the promptly responded to antitubercular therapy of the patient with a complete clearance of the lesions after one month. Background: This case highlights the uncommon easily misdiagnosed but readily treatable case of lichen scrofulosorum.
阴囊性结核菌(Liquen scrolosorum),又称类地衣结核,是一种罕见的结核,表现为微小丘疹的类地衣疹,是一种罕见的疾病,容易误诊。病变通常无症状,紧密聚集,皮肤颜色至红棕色丘疹,常为毛囊周围。出疹通常伴有强烈的结核菌素阳性反应。病变的诊断可能是困难的,因为它们类似于许多其他通常主要考虑的皮肤病。本文报告了一名有丰富病史的成年男性的阴囊性地衣病例,目的是确定抗结核治疗的有效性,结果显示该患者在一个月后病变完全清除,对抗结核治疗迅速有反应。背景:本病例为罕见的易误诊但易治疗的阴囊苔藓病。
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引用次数: 0
Diagnostic Diligence 诊断勤奋
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/2569f
Joseph L. Lewis III, MFS
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引用次数: 0
Role of Odontoblast TRPC5 in Dentin Hypersensitivity 成牙细胞TRPC5在牙本质过敏中的作用
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/10718d
T. Bhople, Priyanka Zille Bhople
Dentin hypersensitivity (DH) is a relatively common painful condition among dental problems for which several treatment options have been tested. Although many studies have been performed regarding the diagnosis and treatment of DH, dental professionals are still confused about the definite diagnosis and treatment. The neurosensory mechanisms for dentin hypersensitivity are still unclear. According to the hydrodynamic theory, DHS is related to fluid movements within exposed dentinal tubules. Although, this theory cannot explain for all pain associated with DHS. TRPC5 also known as transient receptor protein 5 (TRP-5) is a protein that in humans is encoded by the TRPC5 gene. In this chapter we will study the role of odontoblasts when equipped with the cold-sensor TRPC5 along with TRPA1, can lead to sensitivity.
牙本质过敏症(DH)是一种相对常见的疼痛状况的牙齿问题,几个治疗方案已经测试。虽然对DH的诊断和治疗进行了许多研究,但牙科专业人员仍然对明确的诊断和治疗感到困惑。牙本质过敏的神经感觉机制尚不清楚。根据流体力学理论,DHS与暴露在外的牙本质小管内的流体运动有关。然而,这一理论并不能解释所有与DHS相关的疼痛。TRPC5也被称为瞬时受体蛋白5 (TRP-5),是一种由人类TRPC5基因编码的蛋白质。在本章中,我们将研究当配备冷传感器TRPC5和TRPA1时,成牙细胞的作用,可以导致敏感性。
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引用次数: 0
Study on Five Cases of an Accessory Left Vertebral Artery on the Aortic Arch 主动脉弓上左椎副动脉5例分析
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/11507d
Guinevere Granite, K. Lashley, G. Wind
Vascular variations of the head and neck are common, but often go unnoticed because they generally do not present clear clinical symptoms. Lack of awareness of the presence and location of such variations may result in iatrogenic complications or even fatalities. Physicians and surgeons should be cognizant of such variations given their potential clinical significance. Vertebral artery variations are prevalent in both number and origin, but documented infrequently in the literature. Each of the five case studies described here: a White 65-year-old male (Case 1), a White 89-year-old female (Case 2), a White 80-year-old female (Case 3), a White 96-year-old female (Case 4), and a White 95-year-old female (Case 5), presented with an accessory left vertebral artery originating from the aortic arch, between the left common carotid artery and the left subclavian artery. This is the most common place for variations of this type in the literature. All five cases, however, also presented with a left vertebral artery branching from the left subclavian artery. For Cases 1 and 3, the accessory left vertebral artery coursed cranially and entered the foramen transversarium at the C5 level. For Case 2, it entered at the C3 level. For Cases 4 and 5, it entered at the C4 level. With a prevalence rate of 7.81%, among a population of 64 donors randomly selected and undergoing cadaveric review, this anatomical variant illustrates the potential frequency, and thus, the clinical importance of extensive anatomical understanding of head and neck vascular variations.
头部和颈部的血管变异是常见的,但往往被忽视,因为它们通常没有明确的临床症状。缺乏对这些变异的存在和位置的认识可能导致医源性并发症甚至死亡。鉴于其潜在的临床意义,内科医生和外科医生应该认识到这些变异。椎动脉变异在数量和起源上都很普遍,但文献记载很少。本文描述的五个病例研究:一名65岁的白人男性(病例1),一名89岁的白人女性(病例2),一名80岁的白人女性(病例3),一名96岁的白人女性(病例4)和一名95岁的白人女性(病例5),表现为左颈总动脉和左锁骨下动脉之间起源于主动脉弓的左侧辅助椎动脉。这是文学作品中这种类型的变体最常见的地方。然而,所有5例病例也表现为左椎动脉从左锁骨下动脉分支。在病例1和病例3中,左椎副动脉沿颅骨走行,并在C5水平进入横椎孔。对于案例2,它进入C3层。对于病例4和5,它进入C4级别。在随机选择的64名供者中,患病率为7.81%,并进行了尸体检查,这种解剖变异说明了潜在的频率,因此,广泛的解剖学理解头颈部血管变异的临床重要性。
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引用次数: 0
A Cross-sectional Study of Congenital Anomalies in a Tertiary Care Hospital in North East Region, India 印度东北地区一家三级医院先天性异常的横断面研究
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/3032f
Kangjam Radhesana Devi, R. Devi, J. Priya, Ahanthembi Sanaton, L. R. Singh, L. Murray
Background: Congenital anomalies are described as structural and functional abnormalities, including metabolic problems, apparent at birth, and are a significant source of morbidity and mortality in infants. These birth defects are caused by poor embryogenesis or intrinsic anomalies in the development process, and they are linked to a number of risk factors. Methods: Our research took place at the Regional Institute of Medical Sciences in Imphal over the course of a year and a half, from May 2016 to October 2017. The study's goal was to determine the prevalence of congenital malformations and the proportions of various types of congenital defects.Maternal age, religion, parity, gestational age, baby's sex, outcome, and birth weight were all investigated.           Results: There were 91 congenital anomalies in total, out of 13658 births.Congenital anomalies were found in 0.66 percent of the population.Cleft lip was the most prevalent congenital defect (17.6%), followed by CTEV (13.2%), and was more common in male term newborns. These were most common in the maternal age group of 18-24 years (34.1%), followed by 30-34 years (26.4%), and women of parity P0-P2. Conclusions: Stillbirths and infant mortality are frequently caused by congenital abnormalities. At 18-20 weeks, a level II targeted scan should be performed to detect anomalies and lower the prevalence. There should be comprehensive education in the community about common congenital abnormalities, their outcomes, and possible treatment options.
背景:先天性异常被描述为结构和功能异常,包括出生时明显的代谢问题,是婴儿发病率和死亡率的重要来源。这些出生缺陷是由胚胎发育不良或发育过程中的内在异常引起的,它们与许多风险因素有关。方法:我们的研究在2016年5月至2017年10月的一年半时间里在英帕尔地区医学科学研究所进行。该研究的目的是确定先天性畸形的患病率和各种类型的先天性缺陷的比例。调查了产妇年龄、宗教、胎次、胎龄、婴儿性别、结局和出生体重。结果:13658例新生儿中,先天性异常91例。先天性畸形占总人口的0.66%。唇裂是最常见的先天性缺陷(17.6%),其次是CTEV(13.2%),在男性足月新生儿中更为常见。这些在18-24岁的产妇年龄组中最常见(34.1%),其次是30-34岁(26.4%)和胎次p - p2的妇女。结论:死产和婴儿死亡通常是由先天性异常引起的。在18-20周时,应进行II级靶向扫描以发现异常并降低患病率。社区应该对常见的先天性畸形、其后果和可能的治疗方案进行全面的教育。
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引用次数: 0
Training and Evaluation of a Knowledge-Based Model for Automated Treatment Planning of Multiple Brain Metastases: An Advanced Study 基于知识的多发性脑转移自动治疗计划模型的训练和评估:一项先进的研究
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/10941d
V. Dumane, T. Tseng, R. Sheu, Y. Lo, Vishal Gupta, Audrey Saitta, K. Rosenzweig, S. Green
Aim: Volumetric modulated arc therapy (VMAT) has been utilized to plan and treat multiple cranial lesion metastases using a single isocenter due to its ability to provide steep dose gradients around targets as well as low doses to critical structures. VMAT treatment is delivered in a much shorter time compared to using a single isocenter for the treatment of each lesion. However, there is a need to develop methods to reduce the treatment planning time for these cases while also standardizing the plan quality. In this work we demonstrate the use of RapidPlan, which is a knowledge-based treatment (KBP) planning software to plan multiple cranial SRS cases. Methods: 66 patient plans with 125 lesions (range 1-4, median 1) were used to train a model. In addition, the model was validated using 10 cases that were previously treated and chosen randomly. The clinical plans were compared to plans generated by RapidPlan for target coverage and critical organ dose. Results: Coverage to the target volume, gradient index (GI), conformity index (CI) and minimum dose to the target showed no significant difference between the original clinical plan versus the plan generated by KBP. A comparison of doses to the critical organs namely the brainstem, brain, chiasm, eyes, optic nerves and lenses showed no significant difference. Target dose homogeneity was slightly better with the clinical plan, however this difference was also statistically insignificant. Conclusion: This work demonstrates that KBP can be trained and efficiently utilized to help decrease the treatment planning time while standardizing and optimizing treatment plan quality.
目的:体积调制弧线疗法(VMAT)由于能够在靶点周围提供陡峭的剂量梯度以及对关键结构的低剂量,已被用于计划和治疗多发性颅脑病变转移。与使用单个等中心治疗每个病变相比,VMAT治疗在更短的时间内完成。然而,有必要制定方法来减少这些病例的治疗计划时间,同时也规范计划质量。在这项工作中,我们展示了使用RapidPlan,这是一个基于知识的治疗(KBP)计划软件来计划多个颅SRS病例。方法:使用66例患者计划,125个病变(范围1-4,中位数1)来训练模型。此外,随机选择10例先前治疗过的病例对模型进行验证。将临床计划与RapidPlan生成的目标覆盖率和关键器官剂量计划进行比较。结果:原临床方案与KBP生成的方案在靶体积覆盖率、梯度指数(GI)、一致性指数(CI)、靶最小剂量等指标上均无显著差异。对脑干、脑、交叉、眼睛、视神经和晶状体等关键器官的剂量比较无显著差异。靶剂量均匀性略好于临床计划,但这种差异在统计学上也不显著。结论:KBP可以训练和有效利用,有助于缩短治疗计划时间,规范和优化治疗计划质量。
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引用次数: 0
Juvenile Nasopharyngeal Angiofibromas: Clinico-Radiological Evaluation 青少年鼻咽血管纤维瘤:临床放射学评价
Pub Date : 2021-08-14 DOI: 10.9734/bpi/hmms/v18/10032d
B. Sharma, Shweta Sharma, Shashi Sharma, Akriti Sharma, Mir Rizwan Aziz
Background: Juvenile nasopharyngeal angiofibroma (JNA) is also known as bleeding fibroma since it is highly vascular tumour.. This is a benign tumour that is locally aggressive and bleeds in prepubescent and young adults. The tumour expands due to the potential space available in the nasopharyngeal area without much of the resistance JNA requires early and accurate diagnosis by cross sectional modalities with the background setting of  clinical symptomatology. This will helpful in early management and can avoid various future complications. Case Presentation: We present two cases of JNAs where the role of contrast enhanced computed tomography (CECT) is highlighted. These  two examples of adolescent nasopharyngeal angiofibromas (JNAs) were diagnosed at at differing stages with the help of CECT reformatted reconstructed 3D images.. Conclusion: We lay a high value on the clinico-radiological evaluation in concluding the diagnosis. The adequate pre-operative radiological staging is required for the surgical management
背景:青少年鼻咽血管纤维瘤(JNA)是一种高度血管性肿瘤,也被称为出血性纤维瘤。这是一种良性肿瘤,局部侵袭性强,在青春期前和年轻人中出血。由于鼻咽区域的潜在可用空间而没有太多的耐药性,肿瘤扩大需要通过具有临床症状背景的横断面模式进行早期和准确的诊断。这将有助于早期治疗,并可避免未来的各种并发症。病例介绍:我们提出了两例JNAs,其中对比增强计算机断层扫描(CECT)的作用是突出的。这两个例子的青少年鼻咽血管纤维瘤(JNAs)在不同的阶段诊断的帮助下,CECT重组重建三维图像。结论:临床影像学评价对诊断具有重要意义。术前放射分期是手术治疗的必要条件
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引用次数: 0
FOETAL Organ Implantation into Adult Animals: A Model for In vivo Culture of Stem Cells? 胚胎器官植入成体动物:干细胞体内培养的模型?
Pub Date : 2021-06-29 DOI: 10.9734/bpi/hmms/v18/2425f
V. Coulic, V. N. Novikov, F. Mboti, P. Delrée
Background: Presently stem cell implantations are more and more developed and applied in clinics as alternative and complementary solutions to adult organ transplantation because of the growing demand and capacities to provide these interventions, while lack of donors is patent. But some limitations of stem cell use remain (for instance integration within the recipient organism of engineered tissues and organoids obtained in vitro from stem cells). The use of foetal organ implantation into adult animals may be an alternative for in vivo study of stem cell development and evaluation of the host participation to this process. The objectives of this work were to try different foetal organ implantations into adult animals (part I) and to evaluate their use for repairing experimental lesions of some adult organs (part II). Material and Methods: Part I: In > 650 experiments on rats and mice, different sites of foetal organ syngeneic implantation were proposed. Physiological (electric activity, motor and secretion activity) and morphological (per illumination, ultra sound and magnetic imaging, optic and electron microscopy) methods were used for implant development evaluation during up to 12 months. Part II: Foetal heart and foetal digestive organs were tested for both oesophagus circular defect and heart thermic lesion repair (38 and 29 rats).Trials with foetal pancreas implantation were provided in rats with diabetes induced by Streptozotocin and/or protein deficit and in a small pilot group of diabetic patients. Result: Part I: After a “dedifferentiation” phase, foetal organ implants could grow following ontogenetic pattern but – at least in our experimental conditions - some of them were not able to re-organize as a whole functional adult organ. The factors enhancing or limiting the organoid formation are considered. Part II: Foetal heart implants were proved to enhance heart lesion morphological and functional repair. Foetal oesophagus, stomach or intestine fragments combined with chitosan flaps ensured a complete restoration of the oesophagus wall after oval or segmental resection. Implantation of foetal pancreas was able to reverse Streptozotocin induced diabetes and to prevent chronic glucose disorders following protein deprivation in rats. In patients temporary positive influence was noted. Conclusion: Implantation of different foetal organs into syngeneic adults may constitute a valuable model for theoretical studies of in vivo stem cell differentiation and organoid growth. The ear implantation site deserves special attention. Some interesting applications are possible and worthwhile to be discussed and developed.
背景:目前干细胞移植越来越发达,作为成人器官移植的替代和补充解决方案应用于临床,因为提供这些干预措施的需求和能力不断增长,而缺乏供体是专利。但是,干细胞的使用仍然存在一些限制(例如,在体外从干细胞中获得的工程组织和类器官在受体体内的整合)。利用胚胎器官植入成年动物可能是干细胞发育的体内研究和评估宿主参与这一过程的另一种选择。本工作的目的是尝试不同的胚胎器官植入成年动物(第一部分),并评估它们在修复某些成年器官实验性病变中的应用(第二部分)。材料和方法:第一部分:在650多个大鼠和小鼠实验中,提出了不同的胚胎器官同基因植入部位。生理(电活动、运动和分泌活动)和形态学(照度、超声和磁成像、光学和电子显微镜)方法用于长达12个月的种植体发育评估。第二部分:对38只大鼠和29只大鼠进行了食道环形缺损和心脏热损伤修复的胎儿心脏和胎儿消化器官的检测。胎儿胰腺植入试验是在链脲佐菌素和/或蛋白质缺陷诱导的糖尿病大鼠和一小部分糖尿病患者中进行的。结果:第一部分:在“去分化”阶段之后,胎儿器官植入物可以按照个体发生模式生长,但至少在我们的实验条件下,其中一些器官不能重新组织成一个完整的功能成人器官。考虑了促进或限制类器官形成的因素。第二部分:胎儿心脏植入物增强心脏病变形态和功能修复。胎儿食管、胃或肠碎片联合壳聚糖瓣确保卵状或节段性切除后食管壁完全恢复。胚胎胰腺植入能够逆转链脲佐菌素诱导的糖尿病,并预防大鼠蛋白质剥夺后的慢性葡萄糖紊乱。在患者中发现了暂时的积极影响。结论:同种异体成体移植不同胎儿器官可能为体内干细胞分化和类器官生长的理论研究提供了一个有价值的模型。耳植入部位值得特别注意。一些有趣的应用是可能的,值得讨论和开发。
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引用次数: 0
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Highlights on Medicine and Medical Science Vol. 18
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