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Correlation of Increased Total Serum Immunoglobulin E Levels and Hidradenitis Suppurativa 血清总免疫球蛋白E水平升高与化脓性汗腺炎的相关性
Pub Date : 2021-03-01 DOI: 10.2478/acm-2021-0002
A. Ballová, K. Vorčáková, J. Péč
Abstract Introduction: Hidradenitis suppurativa is a chronic inflammatory skin disease with a typical formation of inflamed nodules, abscesses, and sinus tracts usually in the axillary, inguinal, and anogenital region. We decided to investigate the possible association of hidradenitis suppurativa and total IgE elevation and to explore the patients’ characteristics which can be related to high IgE levels. Methods: We performed a retrospective observational study which included 67 patients with moderate-to-severe stage of hidradenitis suppurativa followed up in our outpatient dermatology department. Total IgE, IgA, IgG, IgM, and CRP serum levels were measured. A personal and family history was taken. We asked them about allergic diseases and cigarette smoking and determined the basic parameters such as the weight and height of the patients. Results: Elevated total IgE levels were noticed in 21 patients (31.3%), of which 6 had a history of allergic disorder. Three of them had allergic rhinoconjunctivitis and the other three were suffering from atopic dermatitis. The mean total IgE level was 203.0 IU/ml with a maximum value of 1,954 IU/ml. Analysis of the factors, such as cigarette smoking, sex, elevated CRP, body mass index, and the number of affected areas, did not show an association with increased IgE levels. Conclusion: Our study showed a higher mean value of total IgE in patients with moderate to severe hidradenitis suppurativa than in the general population. However, we did not confirm an association with any characteristics of the patients. Limitations of this work include a small number of patients and a lack of the control group, therefore further and more extensive studies are needed to support these results.
摘要简介:化脓性汗腺炎是一种慢性炎症性皮肤病,通常在腋窝、腹股沟和肛门生殖区形成典型的炎症结节、脓肿和窦道。我们决定调查化脓性汗腺炎与总IgE升高的可能关联,并探讨与高IgE水平相关的患者特征。方法:对我院皮肤科门诊就诊的67例中重度化脓性汗腺炎患者进行回顾性观察性研究。测定血清总IgE、IgA、IgG、IgM和CRP水平。记录了个人和家族病史。我们询问他们过敏性疾病和吸烟情况,并确定患者的体重和身高等基本参数。结果:总IgE升高21例(31.3%),其中6例有过敏史。其中3人患有过敏性鼻结膜炎,另外3人患有特应性皮炎。平均总IgE水平为203.0 IU/ml,最高值为1954 IU/ml。对吸烟、性别、CRP升高、身体质量指数和受影响区域数量等因素的分析没有显示出与IgE水平升高有关。结论:我们的研究显示,中重度化脓性汗腺炎患者的总IgE平均值高于一般人群。然而,我们没有证实与患者的任何特征有关。这项工作的局限性包括患者数量少,缺乏对照组,因此需要进一步和更广泛的研究来支持这些结果。
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引用次数: 1
Spindle Cell Melanoma Harboring a Nodule of Epitheloid Cell Melanoma Component: A Study of a Diagnostically Challenging Case 梭形细胞黑色素瘤含有上皮样细胞黑色素瘤成分的结节:一个诊断上具有挑战性的病例的研究
Pub Date : 2021-03-01 DOI: 10.2478/acm-2021-0005
V. Bartoš, A. Farkašová
Abstract Background: Melanoma is a very heterogeneous human neoplasm. In addition to four major (conventional) histologic subtypes a number of uncommon variants do exist. Objective: An unusual case of a spindle cell melanoma (SCM) containing a demarcated nodule of conventional epitheliod cell melanoma component is described. Material and Methods: A 71-year-old man manifested with a protuberated ulcerated skin tumor arising on the right forearm. The resected biopsy was analyzed immunohistochemically with a variety of anti-human antibodies. Results: The tumor consisted of a highly cellular mass of spindle-shaped cells without any significant intratu-moral fibrosis. In addition, a nodule of epithelioid cell tumor component was present within the lesion. The spindle cell component showed a disperse reactivity for S100 protein and was negative for other melanocytic markers. It exhibited a very high mitotic activity and proliferation Ki-67 index. No melanin pigment was detected. In contrast, the epithelioid cell component was strongly positive for S100 protein, Melan-A/MART-1, HMB-45, and PNL-2. The mitotic and proliferation indices were much less pronounced and melanin deposits were visible. A diagnosis of a non-desmoplastic SCM harboring a nodule of epithelioid cell melanoma component was established. Conclusion: SCM often posses a diagnostic dilemma because its histomorphology is atypical and its immunohistochemical profile may differ from other subtypes of melanomas. The present paper points out this uncommon histopathological entity that may sometimes be encountered in dermatopathological practice and that requires more complex diagnostic approach.
摘要背景:黑色素瘤是一种非常异质的人类肿瘤。除了四种主要的(传统的)组织学亚型外,还存在许多不常见的变异。目的:描述一例不寻常的梭形细胞黑色素瘤(SCM),其包含常规上皮样细胞黑色素癌成分的界定结节。材料和方法:一位71岁的男性,表现为右前臂出现隆起的溃疡性皮肤肿瘤。用多种抗人抗体对切除的活检进行免疫组织化学分析。结果:肿瘤由高细胞质量的梭形细胞组成,没有任何明显的肝内纤维化。此外,病变内存在上皮样细胞肿瘤成分结节。梭形细胞组分对S100蛋白表现出分散反应性,对其他黑素细胞标志物呈阴性。它表现出非常高的有丝分裂活性和增殖Ki-67指数。未检测到黑色素。相反,上皮样细胞成分对S100蛋白、黑色素-A/MART-1、HMB-45和PNL-2呈强阳性。有丝分裂和增殖指数不那么明显,可见黑色素沉积。诊断为非促结缔组织增生性SCM携带上皮样细胞黑色素瘤成分结节。结论:SCM的组织形态不典型,且其免疫组织化学图谱可能与其他亚型的黑色素瘤不同,因此其诊断往往存在困境。本文指出了这种罕见的组织病理学实体,有时可能在皮肤病理学实践中遇到,需要更复杂的诊断方法。
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引用次数: 0
A Retrospective Analysis of the Palliative Surgical Treatment in Patients with Malignant Pleural Effusion 恶性胸腔积液姑息性手术治疗的回顾性分析
Pub Date : 2021-03-01 DOI: 10.2478/acm-2021-0003
G. Krajnakova, A. Dzian, M. Skaličanová, Ľ. Hamada, M. Malík, M. Grendár
Abstract Introduction: The formation of malignant pleural effusion (MPE) is a clinical manifestation of an advanced malignancy or its dissemination. The focus of treatment is primarily palliative and aimed at relieving symptoms, especially dyspnoea. Material and Methods: Clinical data from patients who were hospitalized at the Clinic of Thoracic Surgery, JFMED CU and Martin University Hospital, in the years 2015–2019 were retrospectively explored and statistically analyzed based on their medical records. Results: From the group of patients with proven MPE (n=67), 32 patients were male (48%) and 35 were female (52%). The mean age was 62.3 years (65.4 for males and 59.4 for females). The three most common primary malignancies were lung cancer (n=24), breast cancer (n=14), and kidney cancer (n=6). In 38 patients with MPE a talc pleurodesis via VATS was performed, with a median survival of 341 days (95% CI 256–859). Drainage following the talc slurry pleurodesis was performed in 10 patients with a median survival of 91.5 days (95% CI 64-NA). Ten patients with MPE underwent drainage only. The overall median survival time after all types of surgical interventions was 301 days (95% CI 207-389 days). Conclusion: Management of MPE depends on the patient´s prognosis. A definitive intervention is required in patients with a long-term survival, while in patients with a short life expectancy procedures leading to the shortest hospital stay are preferred. Videothoracoscopic procedures with pleurodesis represent an effective treatment for patients with symptomatic MPE with a good performance status, presence of lung re-expansion following pleural drainage or expected survival.
摘要简介:恶性胸腔积液(MPE)的形成是晚期恶性肿瘤或其扩散的临床表现。治疗的重点主要是缓解症状,尤其是呼吸困难。材料和方法:回顾性分析2015-2019年在JFMED CU和马丁大学医院胸外科诊所住院的患者的临床数据,并根据他们的医疗记录进行统计分析。结果:证实MPE的患者组(n=67)中,32例为男性(48%),35例为女性(52%)。平均年龄62.3岁(男性65.4岁,女性59.4岁)。三种最常见的原发性恶性肿瘤是肺癌癌症(n=24)、癌症(n=14)和肾脏癌症(n=6)。在38名MPE患者中,通过VATS进行了滑石胸膜固定术,中位生存期为341天(95%CI 256–859)。10名患者在滑石浆胸膜固定术后进行引流,中位生存期为91.5天(95%CI 64-NA)。仅对10例MPE患者进行了引流。所有类型的手术干预后的总中位生存时间为301天(95%CI 207-389天)。结论:MPE的处理取决于患者的预后。对于长期存活的患者,需要进行明确的干预,而对于预期寿命较短的患者,则首选能缩短住院时间的手术。胸腔镜胸膜固定术是一种有效的治疗有症状的MPE患者的方法,具有良好的表现状态、胸膜引流后肺部再次扩张或预期生存率。
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引用次数: 0
Serum Inflammation Markers in Tuberculosis 肺结核的血清炎症标志物
Pub Date : 2020-12-01 DOI: 10.2478/acm-2020-0012
P. Kusnir, M. Dohál, I. Porvazník, J. Mokrý
Tuberculosis remains one of the leading infectious cause of death in the world. The goals of screening are to detect active tuberculosis early enough and to identify individuals eligible for preventive therapy to reduce a po tential co-infection by tuberculosis. Plasma/serum screening for selected potential biomarkers could represent a suitable method of tuberculosis diagnosis and treatment outcome. Furthermore, monitoring of tuberculosis treatment is crucial to clinical decision-making and besides the plasmatic concentration of administered antituberculosis drugs, the biomarkers appear to play a significant role in the estimation of the real therapeutical impact. The current standard remains focused on culture conversion, especially two-month culture status, which has a relatively low sensitivity. Identification of non-sputum-based biomarkers of the treatment respond would be beneficial for individual monitoring of tuberculosis patients. This mini-review describes several serological/plasmatic markers that can be analyzed by simple immunoassays as ELISA method, e.g. C-reactive protein, soluble intercellular adhesion molecule-1, soluble urokinase plasminogen activator receptor, soluble lymphocyte activation gene-3, granzyme B and soluble tumor necrosis factor receptor one and two as reliable enough as an indicator of successful treatment of tuberculosis.
结核病仍然是世界上导致死亡的主要传染病之一。筛查的目的是尽早发现活动性结核病,并确定有资格接受预防性治疗的个体,以减少结核病的潜在合并感染。血浆/血清筛选选定的潜在生物标志物可能代表一种合适的结核病诊断和治疗结果的方法。此外,监测结核病治疗对临床决策至关重要,除了抗结核药物的血浆浓度外,生物标志物似乎在评估实际治疗效果方面发挥着重要作用。目前的标准仍然关注文化转换,特别是两个月文化状态,敏感性相对较低。鉴定治疗反应的非痰基生物标志物将有利于结核病患者的个体监测。这篇综述介绍了几种血清学/血浆标记物,这些标记物可以用ELISA方法进行简单的免疫分析,如c反应蛋白、可溶性细胞间粘附分子-1、可溶性尿激酶纤溶酶原激活物受体、可溶性淋巴细胞激活基因-3、颗粒酶B和可溶性肿瘤坏死因子受体1和2,它们足够可靠,可以作为结核病成功治疗的指标。
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引用次数: 0
Case Report of a Term Newborn with Prenatally Diagnosed Alobar Holoprosencephaly 一例足月新生儿产前诊断为Alobar无脑畸形的病例报告
Pub Date : 2020-12-01 DOI: 10.2478/acm-2020-0016
E. Malchova, K. Demova
Holoprosencephaly is a congenital structural abnormality of brain resulting from incomplete cleavage of prosencephalon into two cerebral hemispheres. It is classified as a disorder of organogenesis and brain histogenesis and is typically associated with facial anomalies. Holoprosencephaly is relatively rare – the incidence in live births varies between 1:10,000 – 1:15,000 but is described in 1 out of 250 spontaneously aborted embryos. There are four major varieties of holoprosencephaly according to the degree of separation of the brain hemispheres; this division is crucial for the patient’s prognosis. Three classic subtypes are alobar, semilobar, and lobar holoprosencephaly and there is also a fourth subtype called middle interhemispheric variant. We present a case study of a term newborn with prenatally diagnosed holoprosencephaly with severe facial dys-morphism and associated health complications.
全前脑畸形是一种先天性大脑结构异常,由前脑不完全分裂为两个大脑半球引起。它被归类为器官发生和脑组织发生障碍,通常与面部异常有关。全无脑畸形相对罕见——活产的发生率在1:10000至1:15000之间,但在250个自然流产胚胎中有1个发生。根据大脑半球的分离程度,前脑无裂有四种主要类型;这种划分对患者的预后至关重要。三种典型的亚型是脑叶、半脑叶和脑叶无裂,还有第四种亚型称为中半球间变体。我们对一例足月新生儿进行了个案研究,该新生儿产前诊断为无前脑畸形,伴有严重的面部畸形和相关的健康并发症。
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引用次数: 0
Development Strategies in the Field of Lifelong Learning of Older Adults 老年人终身学习领域的发展策略
Pub Date : 2020-12-01 DOI: 10.2478/acm-2020-0014
AM Hosnjak, B. Ilić, B. Kurtovic, Ficko S Ledinski, M. Smrekar
Introduction: European gerontological research confirms that accelerated aging of the population will lead to a pronounced occurrence of target groups of functionally capable older people. Lifelong learning is a tool that enables an active post-retirement period in order to enhance cognitive mental capacities, prevent dementia, and overcome the intergenerational gap. The aim of this paper is to develop strategies in the field of lifelong learning for older adults through SWOT analysis. Methods: A qualitative study on lifelong learning for older adults was conducted during the month of November 2019 using 4 SWOT matrices which were subsequently analyzed and integrated into one common matrix. Four strategies were developed based on this template. Results: The analysis of the SWOT matrix showed that lifelong learning contributes most to a sense of belonging, prevention of social isolation, prevention of dementia, and better personal satisfaction. The biggest obstacles for older people when it comes to participating in lifelong learning programs are finances, physical illness, and a lack of understanding from their family members and the wider society for this kind of activity. Discussion: Lifelong learning contributes to a long-term maintenance of cognitive processes of participants involved in education processes. Lifelong learning provides the opportunity to promote older people’s health regardless of the formal education they received in early adulthood. Conclusion: Learning and further education are not only the indicators of active aging, but also a need for older people to master new tools so that they can actively participate and contribute to the society.
引言:欧洲老年病学研究证实,人口老龄化的加速将导致功能性老年人目标群体的明显出现。终身学习是一种工具,可以使退休后的生活更加活跃,以增强认知心理能力,预防痴呆症,并克服代际差距。本文的目的是通过SWOT分析,制定老年人终身学习领域的战略。方法:在2019年11月,使用4个SWOT矩阵对老年人的终身学习进行了定性研究,随后对这些矩阵进行了分析并整合为一个通用矩阵。根据这一模板制定了四项战略。结果:SWOT矩阵分析表明,终身学习对归属感、预防社会孤立、预防痴呆和更好的个人满意度贡献最大。老年人在参与终身学习计划时面临的最大障碍是经济、身体疾病,以及家庭成员和更广泛的社会对这类活动缺乏理解。讨论:终身学习有助于长期维持参与教育过程的参与者的认知过程。终身学习为促进老年人的健康提供了机会,无论他们在成年早期接受过什么正规教育。结论:学习和继续教育不仅是积极老龄化的指标,也是老年人掌握新工具的需要,使他们能够积极参与社会并为社会做出贡献。
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引用次数: 1
Congenital Abdominal Wall Defects: A Topic Review and a Case Report of a Lethal Polymalformation Syndrome with a Giant Abdominoschisis 先天性腹壁缺陷:一例致命的多发畸形综合征合并巨大腹部畸形的专题回顾和病例报告
Pub Date : 2020-12-01 DOI: 10.2478/acm-2020-0015
V. Bartoš
Abdominal wall defects (AWDs) represent a wide spectrum of congenital anomalies which are characterized by a herniation of abdominal organs through a pathologic opening in the abdominal region. The author describes a 29-year-old pregnant woman who was prenatally found to have a living female fetus with a giant omphalocele and a spinal deformation in the lumbosacral region. An evisceration of the abdominal contents into the amnionic cavity was visible. Based on USG findings the limb-body wall complex was suggested. An amniocentesis was performed and a genetic testing identified a chromosome 17q23.1–q23.2 duplication. As the fetal anomaly was considered incompatible with life, a medical termination of the pregnancy was carried out. Postmortem examination of the fetus revealed a huge abdominoschisis with a complete evisceration of the liver, stomach, small and large intestines, spleen, and the right kidney. A severe left-sided scoliosis deformity of the spine with crooked trunk was evident. The gross findings shared the features of omphalocele and limb-body wall complex with no postnatal life expectancy. Most fetal AWDs have poor prognosis. The pathology of these conditions differ greatly and require specific prenatal evaluation and pregnancy management for each entity. Accurate assessment of AWDs will allow the identification of isolated forms with better clinical outcomes compared to associated multiple malformations with chromosomal anomalies or genetic syndromes.
腹壁缺损(AWD)是一种广泛的先天性畸形,其特征是腹部器官通过腹部病理开口突出。作者描述了一名29岁的孕妇,她在产前被发现有一个活的女性胎儿,患有巨大的脐膨出和腰骶部脊柱变形。可见腹腔内容物进入羊膜腔。根据美国地质调查局的调查结果,提出了肢体-体壁复合体。进行羊水穿刺,基因检测发现染色体17q23.1-q23.2重复。由于胎儿畸形被认为与生命不相容,因此进行了医学终止妊娠。胎儿尸检显示巨大的腹裂,肝、胃、小肠和大肠、脾脏和右肾全部切除。严重的左侧脊柱侧弯畸形伴躯干弯曲。大体发现具有脐膨出和四肢体壁复合体的特征,没有产后预期寿命。大多数胎儿AWD预后不良。这些疾病的病理学差异很大,需要对每个实体进行具体的产前评估和妊娠管理。与染色体异常或遗传综合征相关的多发畸形相比,AWD的准确评估将有助于识别具有更好临床结果的孤立形式。
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引用次数: 0
Experimental Models of Acute Lung Injury: their Advantages and Limitations 急性肺损伤实验模型的优点和局限性
Pub Date : 2020-12-01 DOI: 10.2478/acm-2020-0011
D. Mokra, P. Mikolka, P. Kosutova, A. Calkovska
Acute damage to the lung may originate from various direct and indirect reasons. Direct lung injury may be caused by pneumonia, near-drowning, aspiration, inhalation of toxic gases etc., while indirect lung injury is secondary, following any severe extra-pulmonary disease, e.g. sepsis, acute pancreatitis, or severe trauma. Due to a complex pathophysiology of the acute lung injury, the treatment is also extremely complicated and except for lung-protective ventilation there have been no specific treatment approaches recommended. An urgent need for a reliable and sufficiently effective treatment forces the researchers into testing novel therapeutic strategies. However, most of these determinations should be done in the laboratory conditions using animals. Complex methods of preparation of various experimental models of the acute lung injury has gradually developed within decades. Nowadays, there have been the models of direct, indirect, or mixed lung injury well established, as well as the models evoked by a combination of two triggering factors. Although the applicability of the results from animal experiments to patients might be limited by many factors, animal models are essential for understanding the patho-physiology of acute lung injury and provide an exceptional opportunity to search for novel therapeutical strategies.
肺部的急性损伤可能源于各种直接和间接的原因。直接肺损伤可能由肺炎、溺水、误吸、吸入有毒气体等引起,而间接肺损伤是继发性的,发生在任何严重的肺外疾病之后,如败血症、急性胰腺炎或严重创伤。由于急性肺损伤的病理生理学复杂,治疗也极其复杂,除了肺保护性通气外,还没有推荐具体的治疗方法。迫切需要一种可靠且足够有效的治疗方法,迫使研究人员测试新的治疗策略。然而,这些测定大多应在实验室条件下使用动物进行。几十年来,各种急性肺损伤实验模型的复杂制备方法逐渐发展起来。目前,已经建立了直接、间接或混合肺损伤的模型,以及由两种触发因素组合引起的模型。尽管动物实验结果对患者的适用性可能受到许多因素的限制,但动物模型对于理解急性肺损伤的病理生理学至关重要,并为寻找新的治疗策略提供了难得的机会。
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引用次数: 0
Oral Microbiome of Permanently Mentally Disabled and Healthy Children 永久性精神残疾和健康儿童口腔微生物组
Pub Date : 2020-12-01 DOI: 10.2478/acm-2020-0013
M. Smatanová, E. Nováková, M. Bacinský, D. Hvizdos, D. Statelová, J. Kompaníková, M. Novák, K. Mikušková
The oral cavity is a biologically significant and complex site of the human body. It is a gateway into the internal environment of the organism. There are many processes, such as the beginning of digestion, speech creation, and sensory perception of taste. Oral health is closely related to the general health of a person. The oral cavity contains an enormous number of microorganisms that can cause various diseases. Oral bacteria are responsible for diseases in the mouth, but can also seriously harm human health. The oral microbiome also serves as an indicator of health, respectively morbidity of the human organism. Compared to healthy children, mentally disabled children suffer from many congenital and acquired diseases and disorders that affect their overall and oral health. These children require a specific approach to the examination, but also to the therapy. Therefore, it is necessary to pay attention to the prevention of oral diseases in children, whether healthy or mentally disabled.
口腔是人体的一个具有生物学意义的复杂部位。它是进入生物体内部环境的门户。有许多过程,如消化的开始、言语的创造和味觉的感官感知。口腔健康与一个人的整体健康密切相关。口腔中含有大量的微生物,这些微生物会导致各种疾病。口腔细菌是口腔疾病的罪魁祸首,但也会严重危害人类健康。口腔微生物组也可以分别作为人体健康和发病率的指标。与健康儿童相比,精神残疾儿童患有许多先天性和后天性疾病和障碍,影响他们的整体和口腔健康。这些孩子需要一种特殊的检查方法,也需要治疗方法。因此,有必要注意预防儿童口腔疾病,无论是健康儿童还是精神残疾儿童。
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引用次数: 0
Benefits of Therapeutic Drug Monitoring of First Line Antituberculosis Drugs 一线抗结核药物治疗药物监测的益处
Pub Date : 2020-08-01 DOI: 10.2478/acm-2020-0006
K. Pršo, N. Žideková, M. Dohál, I. Porvazník, M. Pršo, M. Kertys, J. Mokrý
Abstract Tuberculosis is an airborne infectious disease that remains a huge global health-related issue nowadays. Despite constant approvals of newly developed drugs, the use of first-line antituberculosis medicines seems reasonable in drug-susceptible Mycobacterium tuberculosis strains. Therapeutic drug monitoring presents a useful technique for the determination of plasma drug concentration to adjust appropriate dose regimes. In tuberculosis treatment, therapeutic drug monitoring is aiding clinicians in selecting an optimal therapeutic level, which is essential for the personalisation of therapy. This review is aimed at clarifying the use of therapeutic drug monitoring of the first-line antituberculosis drugs in routine clinical practice.
摘要结核病是一种空气传播的传染病,目前仍是一个巨大的全球健康问题。尽管新开发的药物不断获得批准,但在药物敏感的结核分枝杆菌菌株中使用一线抗结核药物似乎是合理的。治疗药物监测为测定血浆药物浓度以调整适当的剂量方案提供了一种有用的技术。在结核病治疗中,治疗药物监测有助于临床医生选择最佳治疗水平,这对个性化治疗至关重要。本综述旨在阐明一线抗结核药物治疗药物监测在常规临床实践中的应用。
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引用次数: 0
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Acta Medica Martiniana
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