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Assessment of the Measures Implemented in Bulgarian Legislation to Reduce the Content of Nitrates in Groundwater Used for Public Water Supply 评估保加利亚立法中为减少用于公共供水的地下水中硝酸盐含量而实施的措施
Pub Date : 2023-06-01 DOI: 10.2478/jbcr-2023-0006
Emilia K. Bankova
Summary The article analyzes the application of the current documents related to reducing nitrate pollution of groundwater bodies used for public water supply in the Pleven administrative region. The requirements of the European legislation are fully implemented in the Bulgarian legislation, but the legislative measures have not led to quick and permanent results, i.e., small drinking water sources contaminated with nitrates still exist. Special attention should be paid to the diffusive sources of pollution (mineral fertilization of soils) since they are of the most significant importance in groundwater contamination with nitrates. For settlements with permanently elevated nitrate content (over 50 mg/L), it is necessary to consider the application of an individual approach in dealing with this long-standing problem: changing the water source, mixing the water from two neighboring water sources or implementing specific purification methods (biological denitrification, ion exchange resins, etc.). We analyzed the data from the monitoring of drinking water carried out by the Regional Health Inspectorate – Pleven and found that in the Pleven region, there are 17 towns or villages (out of a total of 123) for which some of the listed measures should be foreseen. The district’s relative share of the exposed population is 3.2%, comparable to the country’s exposed population for 2004-2007.
本文分析了普列文行政区域公共供水用地下水水体硝酸盐污染降低相关文献的应用情况。欧洲立法的要求在保加利亚立法中得到充分执行,但是立法措施没有产生迅速和持久的结果,即仍然存在被硝酸盐污染的小型饮用水源。应特别注意扩散污染源(土壤的矿物施肥),因为它们在硝酸盐污染地下水中是最重要的。对于硝酸盐含量永久升高(超过50 mg/L)的定居点,有必要考虑采用单独的方法来处理这个长期存在的问题:改变水源,混合两个相邻水源的水或实施特定的净化方法(生物反硝化,离子交换树脂等)。我们分析了普列文地区卫生监察局开展的饮用水监测数据,发现在普列文地区,有17个城镇或村庄(总共123个)应该预见到某些列出的措施。该地区在暴露人口中所占的相对比例为3.2%,与2004-2007年全国暴露人口的比例相当。
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引用次数: 0
Characteristics of Adult Celiac Disease in Eastern Algeria 阿尔及利亚东部成人乳糜泻的特点
Pub Date : 2023-06-01 DOI: 10.2478/jbcr-2023-0003
Nousseiba Abed, Imen Bouzaroura, Amel Guergour
Summary The objective of this study was to determine the clinical picture of adult celiac disease in the population of eastern Algeria. We conducted a retrospective study on a sample of 156 patients in Internal Medicine service, Hepato-Gastroenterology Service, Endoscopy Service in the University Hospital BENBADIS - Constantine and the Military Regional University Hospital - Constantine. Our results have shown that, in this population, celiac disease can be manifested by a number of signs and related pathologies. A variety of digestive symptoms were reported, primarily chronic diarrhea (81.4%), abdominal pain (57.1%), anorexia (42.9%) and vomiting (48%). Extra-digestive symptoms manifested mainly as weight loss (90.4%), pallorous of skin and mucosa (84%), asthenia (60,3%), edema of the lower limbs (46.8%) and dehydration sings (37.8%). In addition, we noted biological disorders, the most common being hypocalcemia (77.4%) and hypoalbuminemia (57.7%), and a series associated pathologies namely: anemia (67.9%) and digestive diseases (38.46%). CD in adults in our population may express a variety of digestive and extra-digestive symptoms in addition to a number of associated pathologies.
本研究的目的是确定阿尔及利亚东部人群中成人乳糜泻的临床表现。我们对康斯坦丁本巴迪斯大学医院和康斯坦丁军区大学医院内科、肝消化科、内窥镜科的156例患者进行了回顾性研究。我们的研究结果表明,在这个人群中,乳糜泻可以表现为一些体征和相关病理。报告了多种消化系统症状,主要是慢性腹泻(81.4%)、腹痛(57.1%)、厌食(42.9%)和呕吐(48%)。消化系统外症状主要表现为体重减轻(90.4%)、皮肤黏膜苍白(84%)、虚弱(60.3%)、下肢水肿(46.8%)和脱水(37.8%)。此外,我们注意到生物性疾病,最常见的是低钙血症(77.4%)和低白蛋白血症(57.7%),以及一系列相关病理,即贫血(67.9%)和消化系统疾病(38.46%)。在我们的人群中,成人乳糜泻除了一些相关的病理外,还可能表现出各种消化和消化外症状。
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引用次数: 0
Diabetic Foot: Old Disease, New Challenges 糖尿病足:旧病,新挑战
Pub Date : 2023-06-01 DOI: 10.2478/jbcr-2023-0002
Dobromir D. Nguen, Vasil M. Dimitrov
Summary Diabetes is a socially significant disease that brings a significant burden to healthcare systems worldwide. The vicious nature of the disease affects almost all of the systems and organs of the body. The foot is one of the most important and clinically significant areas where these complications are manifested. Diabetic foot gangrene is a leading cause of non-traumatic foot loss worldwide. Although the disease has been known for over a decade, understanding it has gone through highs and lows, leading to suboptimal results in many cases. In this review article, we focused on diabetic foot and the methods for evaluation and assessment of the condition to properly initiate adequate treatment.
糖尿病是一种具有重大社会意义的疾病,给世界各地的卫生保健系统带来了重大负担。这种疾病的恶性性质影响到身体几乎所有的系统和器官。足部是这些并发症表现的最重要和临床意义的区域之一。糖尿病足坏疽是世界范围内非创伤性足部丧失的主要原因。尽管人们对这种疾病的认识已经有十多年了,但对它的理解经历了高潮和低谷,在许多情况下导致了不理想的结果。在这篇综述文章中,我们着重于糖尿病足和评估和评估的方法,以适当地开始适当的治疗。
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引用次数: 0
A Survey of Allergic Contact Dermatitis Among Hairdressers 理发师过敏性接触性皮炎调查
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0024
K. Gospodinova, Adriana D. Angelova
Summary The study aimed to investigate the relationship between the professional environment and hypersensitivity reactions to various contact allergens, the features of the clinical course, and the type of allergic contact dermatitis (ACD) in 35 hairdressers. The analysis was based on data on length of professional experience, localization of rashes, clinical diagnosis and allergens, and the cause of positive reactions in patch testing. Skin changes most often affect the hands, palms, face, and neck. The frequency of ACD diagnosed was 46%, followed by dyshidrotic eczema (DE) - 34%. The highest percentage of contact dermatitis (68%) was seen in the upper extremities, followed by dermatitis of the face and hands (26%). Of the patients investigated, 34% had a history of illness up to 3 years. A negative correlation was found between professional experience and “hand eczema” (p=0.005). Patch tests showed that the most frequent positive reactions were to Nickel (II) sulfate hexahydrate (Nickel, 15 times) and p-Phenylenediamine (PPD, 14 times). These contact allergens are directly correlated with hand eczema. We compared the results with those published in the literature.
摘要本研究旨在探讨35名美发师职业环境与各种接触性过敏原过敏反应的关系、临床病程特点及变应性接触性皮炎(ACD)的类型。该分析基于专业经验的长短、皮疹的定位、临床诊断和过敏原以及在斑贴试验中阳性反应的原因等数据。皮肤变化最常影响手、手掌、面部和颈部。ACD的诊断频率为46%,其次是湿性湿疹(DE) - 34%。接触性皮炎的比例最高(68%)见于上肢,其次是面部和手部皮炎(26%)。在接受调查的患者中,34%的患者有长达3年的病史。专业经验与“手湿疹”呈负相关(p=0.005)。斑贴试验显示,最常见的阳性反应是六水合硫酸镍(镍,15次)和对苯二胺(PPD, 14次)。这些接触性过敏原与手部湿疹直接相关。我们将结果与文献中发表的结果进行了比较。
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引用次数: 0
Anemia and Left Ventricular Hypertrophy in Chronic Renal Failure 慢性肾功能衰竭的贫血和左心室肥厚
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0021
Gergana V. Todorova, A. Akisheva, M. Stoimenova
Summary Chronic renal failure (CRF) syndrome significantly alters patients’ quality of life. Anaemia, hypertension, and cardiovascular diseases are common complications of CRF. The study aimed to determine the incidence of arterial hypertension (AH), anaemia, and left ventricular hypertrophy (LVH) in patients with CRF and to analyze the relationship between them. The study included 212 patients with CRF, treated at the Clinic of Nephrology and Dialysis at the University Hospital “Dr. G. Stranski,” Pleven, during 2008-2020. The AH accounted for 88.2% of the patients with CRF. The incidence of AH is comparable to that in patients in the predialysis period – 88.6% and among patients on dialysis – 87.9%. LVH was diagnosed in 94.3% of patients with CRF. The incidence of LVH in the predialysis period was 94.3%, and among dialysis patients -94.4%. The incidence of LVH among hypertensive and normotensive patients was comparable. The incidence of anaemia among patients with CRF was 86.3%. Anaemia was present in 94.4% of the patients on dialysis and in 78.1% of the patients in the predialysis period. The difference was significant (p <0.05). There was no correlation between anaemia and AH, nor between AH and LVH. A significant dependence of LVH on the duration of chronic renal failure and dialysis treatment was established.
慢性肾衰竭(CRF)综合征显著改变患者的生活质量。贫血、高血压和心血管疾病是CRF的常见并发症。本研究旨在确定CRF患者动脉高血压(AH)、贫血和左心室肥厚(LVH)的发生率,并分析三者之间的关系。该研究包括2008-2020年期间在普列文大学医院“Dr. G. Stranski”肾内科和透析诊所接受治疗的212例CRF患者。AH占CRF患者的88.2%。AH的发生率与透析前患者的发生率(88.6%)和透析患者的发生率(87.9%)相当。94.3%的CRF患者诊断为LVH。透析前LVH发生率为94.3%,透析患者LVH发生率为-94.4%。高血压患者和正常患者LVH的发生率是相似的。CRF患者中贫血发生率为86.3%。94.4%的透析患者和78.1%的透析前患者存在贫血。差异有统计学意义(p <0.05)。贫血和AH之间没有相关性,AH和LVH之间也没有相关性。LVH与慢性肾功能衰竭和透析治疗的持续时间有显著的相关性。
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引用次数: 0
Complications in Transanal Total Mesorectal Excision (TATME) – Early Experience 经肛门全肠系膜切除术(TATME)的并发症-早期经验
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0018
M. Karamanliev, T. Yotsov, D. Dimitrov
Summary Transanal total mesorectal excision (TaTME) is a trending and promising surgical procedure to treat rectal cancer with oncologically oriented precision. Complication rates are promising after the learning curve is passed. A prospective study on the first 12 consecutive TaTME patients was done. The primary aim was the intraoperative and the early and late postoperative complications rate. Оne persisting failure as an intraoperative complication was reported: two anastomotic leaks and a ventral hernia as postoperative complications. TaTME is safe in terms of intra- and postoperative complications.
经肛门直肠全肠系膜切除术(TaTME)是一种趋势和有前途的外科手术治疗直肠癌肿瘤定向精度。通过学习曲线后,并发症发生率是有希望的。对前12例连续的TaTME患者进行了前瞻性研究。主要目的是术中及术后早期和晚期并发症的发生率。Оne术中并发症持续失败:术后并发症2例吻合口漏和1例腹疝。就手术内和术后并发症而言,TaTME是安全的。
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引用次数: 0
Role of Diet and Supplementation with Omega-3 Polyunsaturated Fatty Acids for Managing Chronic Fatigue in Patients with Relapsing-Remitting Multiple Sclerosis 饮食和补充Omega-3多不饱和脂肪酸在缓解多发性硬化症患者慢性疲劳中的作用
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0013
Emiliya M. Ovcharova, M. Danovska, Diana L. Marinova, D. Pendicheva, P. Tonchev, Nicholas M. Shepherd
Summary Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) with unclear and multifactorial etiology, variable clinical symptoms with different severity, and treatment with limited efficacy. Authors conclude that the immune system has a role in pathogenesis, and many modern therapies target the immune system. Among clinicians, it is accepted that not every patient will progress in the same way, and there is high variability between clinical courses of MS in different patients. Modern therapies have shown to reduce new lesions and clinical relapses but lack effectiveness at halting underlying neurodegeneration at lesions, the localized inflammation on a small scale, chronic demyelination, and axonal and neuronal damage. Dietary metabolites have far-reaching and systemic effects. It has been suggested that diet can play an essential role in helping to modify immune system function to promote regulation as opposed to inflammation. Polyunsaturated fatty acids decrease inflammation through conversion into anti-inflammatory prostaglandins E1 and E2, which affect cytokine production, leukocyte migration, and other immune system components. The Mediterranean style diet is a diet low in saturated fats, high in polyunsaturated and monounsaturated fats, rich in fruits and vegetables, and low in processed foods (low salt content). Eating a Mediterranean-style diet can help reduce fatigue (as reported by patients) and change the clinical course favorably.
多发性硬化症(Multiple sclerosis, MS)是一种慢性中枢神经系统自身免疫性脱髓鞘疾病,病因不明,多因素,临床症状多变,严重程度不一,治疗效果有限。作者得出结论,免疫系统在发病机制中起作用,许多现代治疗以免疫系统为靶点。在临床医生中,并不是每个患者都会以相同的方式发展,并且不同患者的MS临床病程之间存在很大的可变性。现代治疗方法已显示可减少新发病变和临床复发,但在阻止病变处潜在的神经退行性变、小范围局部炎症、慢性脱髓鞘以及轴突和神经元损伤方面缺乏有效性。膳食代谢物具有深远的全身性影响。有研究表明,饮食在帮助改变免疫系统功能、促进调节而不是炎症方面发挥着重要作用。多不饱和脂肪酸通过转化为抗炎前列腺素E1和E2来减少炎症,而抗炎前列腺素E1和E2会影响细胞因子的产生、白细胞的迁移和其他免疫系统成分。地中海式饮食是一种低饱和脂肪,高多不饱和脂肪和单不饱和脂肪,富含水果和蔬菜,低加工食品(低盐含量)的饮食。吃地中海式饮食有助于减轻疲劳(据患者报告),并有利于改变临床病程。
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引用次数: 0
Probiotic Prophylaxis of Neonatal Jaundice 新生儿黄疸的益生菌预防
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0022
Tatyana D. Itova, V. Georgieva
Summary We investigated the effect of the administration of probiotics (PB) for the prevention of neonatal jaundice (NJ) in 315 full-term newborns (NBs). We grouped them according to the type and duration of PB intake: A – 5 days L. rhamnosus; B – 5 days L. reteri; C – 5 days B. animalis; D – 30 days L. rhamnosus; E – 30 days L. reuteri, F – 30 days B. animalis; G – without PB. Bilirubin (BR) was measured from 1st to 5th, on 14th, and on 28th day. The incidence of pathologic NJ in groups A&D, B&E, C&F, and G was 37, 36, 29, and 44%, respectively. During first five days, the lowest BR levels were found in Group C, the highest in Group G. BR levels on 14th and 28th days were not significantly different between groups A and D, B and E, C and F. The lowest levels of BR on the same days were found in group F and the highest in group E. The prophylactic use of L. rhamnosus, L. reuteri and B. animalis in full-term NBs significantly reduced the incidence and continuance of NJ. Duration of taking PB significantly affects the development of NJ. The most pronounced effect was when B. animalis was added.
我们对315例足月新生儿(NBs)给予益生菌(PB)预防新生儿黄疸(NJ)的效果进行了研究。根据PB摄取量的种类和持续时间进行分组:A ~ 5 d鼠李糖;B - 5天;C - 5天b动物;D - 30天鼠李糖;E - 30天罗伊氏乳杆菌,F - 30天动物乳杆菌;G -不含PB。第1 ~ 5天、第14天、第28天测定胆红素(BR)。病理性NJ在A&D组、B&E组、C&F组和G组的发生率分别为37%、36%、29%和44%。在前五天,BR最低水平被发现在C组,组g . BR水平最高的14日和28日天组A和D之间没有显著差异,B和E、C、F . BR的最低水平在同一日被发现在F组和最高的组E .喂食的预防性使用这种l和B . animalis足月国家统计局显著降低发病率和新泽西的延续。服用PB的持续时间对NJ的发展有显著影响。添加动物双歧杆菌效果最明显。
{"title":"Probiotic Prophylaxis of Neonatal Jaundice","authors":"Tatyana D. Itova, V. Georgieva","doi":"10.2478/jbcr-2022-0022","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0022","url":null,"abstract":"Summary We investigated the effect of the administration of probiotics (PB) for the prevention of neonatal jaundice (NJ) in 315 full-term newborns (NBs). We grouped them according to the type and duration of PB intake: A – 5 days L. rhamnosus; B – 5 days L. reteri; C – 5 days B. animalis; D – 30 days L. rhamnosus; E – 30 days L. reuteri, F – 30 days B. animalis; G – without PB. Bilirubin (BR) was measured from 1st to 5th, on 14th, and on 28th day. The incidence of pathologic NJ in groups A&D, B&E, C&F, and G was 37, 36, 29, and 44%, respectively. During first five days, the lowest BR levels were found in Group C, the highest in Group G. BR levels on 14th and 28th days were not significantly different between groups A and D, B and E, C and F. The lowest levels of BR on the same days were found in group F and the highest in group E. The prophylactic use of L. rhamnosus, L. reuteri and B. animalis in full-term NBs significantly reduced the incidence and continuance of NJ. Duration of taking PB significantly affects the development of NJ. The most pronounced effect was when B. animalis was added.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"186 1","pages":"158 - 164"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79389677","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}
引用次数: 1
Acquired Enterocutaneous Fistulas: Classification and Treatment 获得性肠皮瘘:分类与治疗
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0014
P. Vladova, S. Iliev
Summary Acquired enterocutaneous fistulas are a considerable problem of abdominal surgery. In most cases, they result from surgical intervention. There are different classifications based on different signs and factors. We aimed to summarize the management principles for patients with acquired enterocutaneous fistulas. Critical evaluation of the data available from existing studies. The therapeutic regimen includes nutritional support, sepsis control, skin care, and, possibly, surgical treatment. Surgical interventions are considered in high-output small bowel fistulas. The treatment is continuous and requires a multidisciplinary approach.
获得性肠皮瘘是腹部外科的一个重要问题。在大多数情况下,它们是由手术干预引起的。根据不同的标志和因素有不同的分类。我们旨在总结获得性肠皮瘘患者的处理原则。对现有研究数据的批判性评价。治疗方案包括营养支持、脓毒症控制、皮肤护理以及可能的手术治疗。高输出量小肠瘘考虑手术干预。治疗是连续的,需要多学科的方法。
{"title":"Acquired Enterocutaneous Fistulas: Classification and Treatment","authors":"P. Vladova, S. Iliev","doi":"10.2478/jbcr-2022-0014","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0014","url":null,"abstract":"Summary Acquired enterocutaneous fistulas are a considerable problem of abdominal surgery. In most cases, they result from surgical intervention. There are different classifications based on different signs and factors. We aimed to summarize the management principles for patients with acquired enterocutaneous fistulas. Critical evaluation of the data available from existing studies. The therapeutic regimen includes nutritional support, sepsis control, skin care, and, possibly, surgical treatment. Surgical interventions are considered in high-output small bowel fistulas. The treatment is continuous and requires a multidisciplinary approach.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"24 1","pages":"105 - 111"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82562593","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}
引用次数: 0
COVID-19: Some Pathophysiological and Endocrine Aspects COVID-19:一些病理生理和内分泌方面的问题
Pub Date : 2022-12-01 DOI: 10.2478/jbcr-2022-0015
K. Todorova
Summary The pandemic caused by COVID-19 infection almost two years ago is associated with many unknown multi-organ damages, including the endocrine system. Based on the fact that endocrine gland tissues express ACE-2 and TMPRSS2, it has been suggested that they may be directly attacked by the virus and cause toxic effects on them directly or indirectly by an autoimmune mechanism. Hypothalamic-pituitary-adrenal axis hormones are crucial for the course and progression of the disease and modulate the magnitude of the immune response and adaptation to stress. The aim of the present review is to summarize the state of the art in the COVID-19 and endocrine problems in its clinical and pathophysiological part and to answer the question of to what extent patients with COVID-19 have a higher risk of adverse outcomes.
近两年前由COVID-19感染引起的大流行与许多未知的多器官损伤有关,包括内分泌系统。基于内分泌腺组织表达ACE-2和TMPRSS2的事实,有人认为它们可能受到病毒的直接攻击,并通过自身免疫机制直接或间接地对其产生毒性作用。下丘脑-垂体-肾上腺轴激素对疾病的过程和进展至关重要,并调节免疫反应的大小和对应激的适应。本文旨在总结COVID-19及其临床和病理生理部分内分泌问题的研究现状,并回答COVID-19患者不良结局的风险在多大程度上更高的问题。
{"title":"COVID-19: Some Pathophysiological and Endocrine Aspects","authors":"K. Todorova","doi":"10.2478/jbcr-2022-0015","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0015","url":null,"abstract":"Summary The pandemic caused by COVID-19 infection almost two years ago is associated with many unknown multi-organ damages, including the endocrine system. Based on the fact that endocrine gland tissues express ACE-2 and TMPRSS2, it has been suggested that they may be directly attacked by the virus and cause toxic effects on them directly or indirectly by an autoimmune mechanism. Hypothalamic-pituitary-adrenal axis hormones are crucial for the course and progression of the disease and modulate the magnitude of the immune response and adaptation to stress. The aim of the present review is to summarize the state of the art in the COVID-19 and endocrine problems in its clinical and pathophysiological part and to answer the question of to what extent patients with COVID-19 have a higher risk of adverse outcomes.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"88 1","pages":"112 - 117"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90922301","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}
引用次数: 0
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Journal of Biomedical and Clinical Research
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