Simon P. Hurley, Chris Horwood, Jake Mallon, Arduino A. Mangoni, Joshua M. Inglis
The management of paracetamol poisoning in our local health network and consistency with national guidelines is unclear. We conducted a 4-month retrospective study of all paracetamol poisonings identified in two South Australian hospitals. Most presentations were deliberate self-poisoning (90.7%) with immediate-release formulations (88.0%). Although most were managed in accordance with national guidelines, there were deficiencies in documentation of the poisoning details and patient weight as well as cases of underdosing of the antidote. Quality improvement initiatives are needed.
{"title":"Characteristics of paracetamol poisoning in a local health network and consistency of hospital management with national guidelines","authors":"Simon P. Hurley, Chris Horwood, Jake Mallon, Arduino A. Mangoni, Joshua M. Inglis","doi":"10.1111/imj.16592","DOIUrl":"10.1111/imj.16592","url":null,"abstract":"<p>The management of paracetamol poisoning in our local health network and consistency with national guidelines is unclear. We conducted a 4-month retrospective study of all paracetamol poisonings identified in two South Australian hospitals. Most presentations were deliberate self-poisoning (90.7%) with immediate-release formulations (88.0%). Although most were managed in accordance with national guidelines, there were deficiencies in documentation of the poisoning details and patient weight as well as cases of underdosing of the antidote. Quality improvement initiatives are needed.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 1","pages":"139-142"},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.16592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlotte Chen, Rebecca Davies, Christopher Lewis, Jennifer Paynter, Timothy Christmas, Mitzi Nisbet
This review of non-tuberculous mycobacterial pulmonary disease over an 11-year period identified 87 patients (74% women, mean age 66 years). Mycobacterium avium complex was isolated in 86% of patients. Antibiotics were commenced in 52% of patients; however, treatment was poorly tolerated with 36% terminating prematurely. Mortality was significant; death occurred in 31% of patients, with no relationship between death and treatment.
{"title":"Clinical outcomes of patients with non-tuberculous mycobacterial pulmonary disease in Auckland, New Zealand","authors":"Charlotte Chen, Rebecca Davies, Christopher Lewis, Jennifer Paynter, Timothy Christmas, Mitzi Nisbet","doi":"10.1111/imj.16570","DOIUrl":"10.1111/imj.16570","url":null,"abstract":"<p>This review of non-tuberculous mycobacterial pulmonary disease over an 11-year period identified 87 patients (74% women, mean age 66 years). <i>Mycobacterium avium</i> complex was isolated in 86% of patients. Antibiotics were commenced in 52% of patients; however, treatment was poorly tolerated with 36% terminating prematurely. Mortality was significant; death occurred in 31% of patients, with no relationship between death and treatment.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"325-328"},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole Hersch, Samira Girgis, Guy Barrington Marks, Frances Smith, Peter R. Buchanan, Jonathan P. Williamson, Frances Garden, Hima Vedam
Background
Unrecognised obstructive sleep apnoea (OSA) has been associated with adverse cardiorespiratory perioperative outcomes. However, with changing anaesthetic and perioperative management, there is ongoing uncertainty about the importance of OSA as a risk factor for post-operative complications.
Methods
A cohort study involving subjects undergoing elective surgery was conducted. OSA was diagnosed with a limited channel sleep monitor. In subjects undergoing routine perioperative care, complications were identified based on the assessment of the attending clinical team. The primary outcome was a composite end-point of cardiorespiratory outcomes comprising myocardial infarction, atrial fibrillation, other arrhythmias, bradycardia, need for inotropic support, unplanned intensive care unit admission, pneumonia or respiratory failure.
Results
Four hundred seventy-two subjects were recruited, with 356 being included in the analyses; 281 (79%) had OSA and 66 (19%) had severe OSA. Subjects with OSA did not have a significantly higher incidence of complications (5.7%) compared to those without (2.7%, adjusted relative risk 1.89 (0.23–15.67)). Additionally, complications were not increased in those with severe OSA.
Conclusions
Unrecognised OSA was not associated with an increase in clinically evident cardiorespiratory complications in this cohort. The lower complication rates compared with earlier studies suggest that increased use of less invasive surgical techniques, improved pain management and increased awareness of OSA have had an impact in reducing postoperative complications in this group. Further research is needed to clarify the impact of severe OSA on post-operative outcomes in different surgical cohorts with varying risk profiles in order to develop optimal perioperative pathways.
{"title":"The impact of obstructive sleep apnoea on post-operative outcomes","authors":"Nicole Hersch, Samira Girgis, Guy Barrington Marks, Frances Smith, Peter R. Buchanan, Jonathan P. Williamson, Frances Garden, Hima Vedam","doi":"10.1111/imj.16595","DOIUrl":"10.1111/imj.16595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Unrecognised obstructive sleep apnoea (OSA) has been associated with adverse cardiorespiratory perioperative outcomes. However, with changing anaesthetic and perioperative management, there is ongoing uncertainty about the importance of OSA as a risk factor for post-operative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort study involving subjects undergoing elective surgery was conducted. OSA was diagnosed with a limited channel sleep monitor. In subjects undergoing routine perioperative care, complications were identified based on the assessment of the attending clinical team. The primary outcome was a composite end-point of cardiorespiratory outcomes comprising myocardial infarction, atrial fibrillation, other arrhythmias, bradycardia, need for inotropic support, unplanned intensive care unit admission, pneumonia or respiratory failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred seventy-two subjects were recruited, with 356 being included in the analyses; 281 (79%) had OSA and 66 (19%) had severe OSA. Subjects with OSA did not have a significantly higher incidence of complications (5.7%) compared to those without (2.7%, adjusted relative risk 1.89 (0.23–15.67)). Additionally, complications were not increased in those with severe OSA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unrecognised OSA was not associated with an increase in clinically evident cardiorespiratory complications in this cohort. The lower complication rates compared with earlier studies suggest that increased use of less invasive surgical techniques, improved pain management and increased awareness of OSA have had an impact in reducing postoperative complications in this group. Further research is needed to clarify the impact of severe OSA on post-operative outcomes in different surgical cohorts with varying risk profiles in order to develop optimal perioperative pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"241-248"},"PeriodicalIF":1.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bacteraemia is associated with significant morbidity and mortality. Understanding local patterns of bacteraemia including pathogen distribution, infection source, clinical speciality team burden, susceptibility data and mortality rates can inform empiric antibiotic choices, prevention approaches and education strategies.
Aims
To obtain descriptive data from positive blood cultures identified from Nepean Blue Mountains Local Health District in Greater Western Sydney.
Methods
A retrospective descriptive study was performed from August 2018 to March 2023 with data extracted from electronic medical records.
Results
A total of 6720 isolates were identified from positive blood cultures, of which 71.2% were clinically significant. The median age was 69 years. A total of 74.6% of clinically significant isolates were acquired in the community. The most commonly isolated pathogen was Escherichia coli (31.3%), followed by Staphylococcus aureus (14.3%), and 8.6% of patients with clinically significant positive blood cultures were neutropenic. Neutropenic patients were more likely to have Pseudomonas aeruginosa as the causative pathogen (11.4%) compared to the entire study population (3.9%). The most commonly identified source of infection was the urinary tract. The 30-day all-cause mortality rate for clinically significant positive blood cultures was 16.8%, with higher mortality rates seen with Candida species (and species previously known as Candida), P. aeruginosa and Enterococcus species. 94% of bacteraemia from Enterobacterales tested susceptible in vitro to ampicillin and/or gentamicin. The rate of methicillin resistance in S. aureus was 24%.
Conclusions
This study provides valuable insight into the local epidemiology of bacteraemia, which will allow for targeted prevention, management and educational strategies to improve outcomes.
{"title":"Bacteraemia over 4 years in a Greater Western Sydney Metropolitan Local Health District: a retrospective descriptive study","authors":"Vidthiya Menon","doi":"10.1111/imj.16596","DOIUrl":"10.1111/imj.16596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bacteraemia is associated with significant morbidity and mortality. Understanding local patterns of bacteraemia including pathogen distribution, infection source, clinical speciality team burden, susceptibility data and mortality rates can inform empiric antibiotic choices, prevention approaches and education strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To obtain descriptive data from positive blood cultures identified from Nepean Blue Mountains Local Health District in Greater Western Sydney.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective descriptive study was performed from August 2018 to March 2023 with data extracted from electronic medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 6720 isolates were identified from positive blood cultures, of which 71.2% were clinically significant. The median age was 69 years. A total of 74.6% of clinically significant isolates were acquired in the community. The most commonly isolated pathogen was <i>Escherichia coli</i> (31.3%), followed by <i>Staphylococcus aureus</i> (14.3%), and 8.6% of patients with clinically significant positive blood cultures were neutropenic. Neutropenic patients were more likely to have <i>Pseudomonas aeruginosa</i> as the causative pathogen (11.4%) compared to the entire study population (3.9%). The most commonly identified source of infection was the urinary tract. The 30-day all-cause mortality rate for clinically significant positive blood cultures was 16.8%, with higher mortality rates seen with <i>Candida</i> species (and species previously known as <i>Candida</i>), <i>P. aeruginosa</i> and <i>Enterococcus</i> species. 94% of bacteraemia from Enterobacterales tested susceptible <i>in vitro</i> to ampicillin and/or gentamicin. The rate of methicillin resistance in <i>S. aureus</i> was 24%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides valuable insight into the local epidemiology of bacteraemia, which will allow for targeted prevention, management and educational strategies to improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 1","pages":"66-76"},"PeriodicalIF":1.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There continues to be significant interest from both clinicians and patients in using faecal transplantation, as the integral role of the gut microbiome is increasingly recognised in various disease conditions, both within and beyond the gut. This Clinical Perspectives article provides an overview of existing literature, factors limiting the use of faecal microbial transplantation in clinical practice and exciting new advancements on the horizon.
{"title":"Faecal transplantation: the good, the bad and the ugly","authors":"Hiu C. L. Sin, Craig Haifer","doi":"10.1111/imj.16559","DOIUrl":"10.1111/imj.16559","url":null,"abstract":"<p>There continues to be significant interest from both clinicians and patients in using faecal transplantation, as the integral role of the gut microbiome is increasingly recognised in various disease conditions, both within and beyond the gut. This Clinical Perspectives article provides an overview of existing literature, factors limiting the use of faecal microbial transplantation in clinical practice and exciting new advancements on the horizon.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 1","pages":"35-40"},"PeriodicalIF":1.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/imj.16559","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan M. Mathias, Samantha L. Plush, Elka J. S. Fairhead, Benjamin Ngoi, Louisa Edwards, Alice S. Day, Robert V. Bryant
Background and Aims
Functional gastrointestinal disorders (FGIDs) impact quality of life and represent a significant burden on healthcare services. Guidelines recommend an early, positive diagnosis to reduce harmful over-investigation in FGID patients. The aim of this multicentre study was to evaluate FGID management against current guidelines.
Methods
A multicentre, retrospective evaluation of patients with a primary diagnosis of FGID across two tertiary gastroenterology services over a 12-month period was performed. Time to diagnosis of a FGID, number of outpatient encounters, number and type of investigations performed and time to discharge from the outpatient service were assessed. Whether care was delivered by single or multiple clinicians was recorded. Statistical analysis was performed using Student's t test, logistic regression analysis and Kaplan–Meir curves.
Results
Between June 2021 and June 2022, 275 individual patients were reviewed primarily for FGID. Median time to FGID diagnosis was 70 days (interquartile range (IQR): 0–175), over a median of four outpatient encounters (IQR: 3–6), with an overall time in service of 182 days (IQR: 105–344). When care was delivered by a single rather than multiple clinicians, patients were more likely to receive a FGID diagnosis early (hazard ratio (HR): 1.6, 95% confidence interval (CI): 1.25–2.04, P < 0.0001), be discharged sooner (HR: 1.83, 95% CI: 1.44–2.33, P < 0.0001), with a trend towards less harmful investigations (odds ratio: 1.79, 95% CI: 0.96–3.58, P = 0.08).
Conclusions
Consistent delivery of clinical care reduces healthcare utilisation in the management of FGIDs. Further studies are needed to identify optimal care models for managing outpatients with FGIDs.
{"title":"Patients with functional gastrointestinal disorders spend less time in tertiary care when managed by a single clinician: results of a multicentre audit in South Australia","authors":"Ryan M. Mathias, Samantha L. Plush, Elka J. S. Fairhead, Benjamin Ngoi, Louisa Edwards, Alice S. Day, Robert V. Bryant","doi":"10.1111/imj.16591","DOIUrl":"10.1111/imj.16591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Functional gastrointestinal disorders (FGIDs) impact quality of life and represent a significant burden on healthcare services. Guidelines recommend an early, positive diagnosis to reduce harmful over-investigation in FGID patients. The aim of this multicentre study was to evaluate FGID management against current guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentre, retrospective evaluation of patients with a primary diagnosis of FGID across two tertiary gastroenterology services over a 12-month period was performed. Time to diagnosis of a FGID, number of outpatient encounters, number and type of investigations performed and time to discharge from the outpatient service were assessed. Whether care was delivered by single or multiple clinicians was recorded. Statistical analysis was performed using Student's <i>t</i> test, logistic regression analysis and Kaplan–Meir curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between June 2021 and June 2022, 275 individual patients were reviewed primarily for FGID. Median time to FGID diagnosis was 70 days (interquartile range (IQR): 0–175), over a median of four outpatient encounters (IQR: 3–6), with an overall time in service of 182 days (IQR: 105–344). When care was delivered by a single rather than multiple clinicians, patients were more likely to receive a FGID diagnosis early (hazard ratio (HR): 1.6, 95% confidence interval (CI): 1.25–2.04, <i>P</i> < 0.0001), be discharged sooner (HR: 1.83, 95% CI: 1.44–2.33, <i>P</i> < 0.0001), with a trend towards less harmful investigations (odds ratio: 1.79, 95% CI: 0.96–3.58, <i>P</i> = 0.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Consistent delivery of clinical care reduces healthcare utilisation in the management of FGIDs. Further studies are needed to identify optimal care models for managing outpatients with FGIDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"55 2","pages":"260-269"},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher S. Nguyen, Dev Kevat, Rahul D. Barmanray
{"title":"Changes to diabetes therapy access on the Pharmaceutical Benefits Scheme: ensuring equitable access","authors":"Christopher S. Nguyen, Dev Kevat, Rahul D. Barmanray","doi":"10.1111/imj.16578","DOIUrl":"https://doi.org/10.1111/imj.16578","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"54 12","pages":"2093"},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fiona Runacres, Scott Reeves, Harshan S. Jeyakumar, Philip George, June Song
{"title":"Management of malignant pleural effusions and drainage care: a hospital in the home and palliative care service","authors":"Fiona Runacres, Scott Reeves, Harshan S. Jeyakumar, Philip George, June Song","doi":"10.1111/imj.16579","DOIUrl":"https://doi.org/10.1111/imj.16579","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"54 12","pages":"2094-2095"},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noor Lammoza, Nina Murphy, Nicole Evans, Harry Gibbs, Patrick Elliott
{"title":"Point-of-care ultrasound: prime time has arrived","authors":"Noor Lammoza, Nina Murphy, Nicole Evans, Harry Gibbs, Patrick Elliott","doi":"10.1111/imj.16581","DOIUrl":"https://doi.org/10.1111/imj.16581","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"54 12","pages":"2089-2090"},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Udaya Seneviratne, Lisa Gillinder, Thomas Kraemer, Andrew Lee, Simon Bower
{"title":"Home-based ambulatory video EEG monitoring: a cost-effective and underutilised diagnostic tool for people with seizure disorders in Australia","authors":"Udaya Seneviratne, Lisa Gillinder, Thomas Kraemer, Andrew Lee, Simon Bower","doi":"10.1111/imj.16582","DOIUrl":"https://doi.org/10.1111/imj.16582","url":null,"abstract":"","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":"54 12","pages":"2096-2097"},"PeriodicalIF":1.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号