Pub Date : 2023-01-02DOI: 10.18502/crcp.v7i4.11601
R. Taslimi, Taha Bayat, Behshad Pazook, Seyed Ali Nabipoorashrafi
Salmonella typhi is the cause of an acute febrile illness with high morbidity and mortality, especially in countries with poor sanitation. Neurological complications of salmonella are severe and usually under-diagnosed. This article reports an extremely rare case of a woman with typhoid fever with a history of travel and consumption of raw fish. She had no sign of meningitis but developed diplopia and sixth nerve palsy, which was ultimately resolved by antibiotic therapy.
{"title":"Cranial Nerve Palsy and Diplopia in Typhoid Fever: Case Report","authors":"R. Taslimi, Taha Bayat, Behshad Pazook, Seyed Ali Nabipoorashrafi","doi":"10.18502/crcp.v7i4.11601","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11601","url":null,"abstract":"Salmonella typhi is the cause of an acute febrile illness with high morbidity and mortality, especially in countries with poor sanitation. Neurological complications of salmonella are severe and usually under-diagnosed. This article reports an extremely rare case of a woman with typhoid fever with a history of travel and consumption of raw fish. She had no sign of meningitis but developed diplopia and sixth nerve palsy, which was ultimately resolved by antibiotic therapy.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45415615","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 : 2023-01-02DOI: 10.18502/crcp.v7i4.11591
Tahereh Davarpasand, A. Hosseinsabet, K. Abbasi, S. Shirani
Herein, we present a case with clinical and laboratory manifestations of infectious endocarditis but in echocardiography, the ventricular septal defect and bicuspid aortic valve were detected without any vegetation. However, an aortic root pseudoaneurysm was first suspected in transesophageal echocardiography and then confirmed in computed tomography angiography of the aorta that points to importance of searching infectious endocarditis complications even in absence of vegetation.
{"title":"Pseudoaneurysm of the Aortic Root in the Presence of Aortic Valve Infective Endocarditis","authors":"Tahereh Davarpasand, A. Hosseinsabet, K. Abbasi, S. Shirani","doi":"10.18502/crcp.v7i4.11591","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11591","url":null,"abstract":"Herein, we present a case with clinical and laboratory manifestations of infectious endocarditis but in echocardiography, the ventricular septal defect and bicuspid aortic valve were detected without any vegetation. However, an aortic root pseudoaneurysm was first suspected in transesophageal echocardiography and then confirmed in computed tomography angiography of the aorta that points to importance of searching infectious endocarditis complications even in absence of vegetation.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42286953","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 : 2023-01-02DOI: 10.18502/crcp.v7i4.11594
M. Khalili, M. Hoseini, F. Bayat, Mehrdad Jahani
The use of dipyridamole for thallium imaging has proved very successful in demonstrating coronary arterial disease [1]. Dipyridamole causes coronary arteriolar vasodilation by increasing interstitial adenosine levels by inhibition of both adenosine deaminase and facilitated cellular adenosine uptake. Differential flow changes occur in coronary arteries if a significant luminal stenosis exists [2]. Intravenous infusion of dipyridamole is safe although transient noncardiac side effects are common. These side effects are mostly mild and not need to treat although can be treated with aminophylline [5]. High-grade AV block after dipyridamole has been described in few case reports and mostly was associated with transient myocardial ischemia [2-4]. We describe a case of long-lasting high grade AV block following dipyridamole infusion. In context of near normal baseline ECG. In our case the AV block occurred without evidence of ischemia in myocardial perfusion imaging and we think it can be an unexpected adverse effect of dipyridamole and clinicians should be aware of AV block as a possible adverse effect of dipyridamole.
{"title":"High Grade AV Block Associated with Dipyridamole Infusion","authors":"M. Khalili, M. Hoseini, F. Bayat, Mehrdad Jahani","doi":"10.18502/crcp.v7i4.11594","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11594","url":null,"abstract":"The use of dipyridamole for thallium imaging has proved very successful in demonstrating coronary arterial disease [1]. Dipyridamole causes coronary arteriolar vasodilation by increasing interstitial adenosine levels by inhibition of both adenosine deaminase and facilitated cellular adenosine uptake. Differential flow changes occur in coronary arteries if a significant luminal stenosis exists [2]. Intravenous infusion of dipyridamole is safe although transient noncardiac side effects are common. These side effects are mostly mild and not need to treat although can be treated with aminophylline [5]. High-grade AV block after dipyridamole has been described in few case reports and mostly was associated with transient myocardial ischemia [2-4]. We describe a case of long-lasting high grade AV block following dipyridamole infusion. In context of near normal baseline ECG. In our case the AV block occurred without evidence of ischemia in myocardial perfusion imaging and we think it can be an unexpected adverse effect of dipyridamole and clinicians should be aware of AV block as a possible adverse effect of dipyridamole.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46664129","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 : 2023-01-02DOI: 10.18502/crcp.v7i4.11600
Alireza Rashidinejad, M. Khalili, Shirin Habibi khorasani, Z. Shahidzadeh
Interventricular septal dissection is a rare Complication of the interventricular septum. It may result from an aneurysm of the sinuses of Valsalva, bacterial endocarditis, trauma, cardiac surgery, Myocardial infarction, endomyocardial biopsy, or a congenital myocardial developmental anomaly. Postmyocardial infarction ventricular septal rupture (VSR) is a rare complication (1/1000), and ventricular septal dissection is an even less common complication with only five case reports previously described, But unruptured post Myocardial Infarction (MI) dissection is even rarer with only one reported study before. In this case report we describe an unruptured post-MI Interventricular septal dissection following anterior wall MI.
{"title":"Unruptured Ventricular Septal Dissection Complicating Anterior Wall Myocardial Infarction","authors":"Alireza Rashidinejad, M. Khalili, Shirin Habibi khorasani, Z. Shahidzadeh","doi":"10.18502/crcp.v7i4.11600","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11600","url":null,"abstract":"Interventricular septal dissection is a rare Complication of the interventricular septum. It may result from an aneurysm of the sinuses of Valsalva, bacterial endocarditis, trauma, cardiac surgery, Myocardial infarction, endomyocardial biopsy, or a congenital myocardial developmental anomaly. Postmyocardial infarction ventricular septal rupture (VSR) is a rare complication (1/1000), and ventricular septal dissection is an even less common complication with only five case reports previously described, But unruptured post Myocardial Infarction (MI) dissection is even rarer with only one reported study before. In this case report we describe an unruptured post-MI Interventricular septal dissection following anterior wall MI.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42985524","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 : 2023-01-02DOI: 10.18502/crcp.v7i4.11595
Sahar Delavari, Sogol Olamazadeh, Nima Ameli, B. Pourghaz, A. Tafakhori
Lafora disease is a rare genetic disease caused by the accumulation of malformed glycogen products in the tissues. The disease usually manifests with idiopathic generalized tonic colonic seizures with poor response to antiepileptic drugs (AEDs). We report the case of a 19-year-old girl with the chief complaint of generalized refractory seizures, jerky movement, and cognitive deterioration with a positive history of epilepsy in her younger brother. The disease onset was at the age of 16 with jerky movement and blurred vision. She was admitted to our ward to have a long-term video EEG monitoring for further evaluation. Clinical presentation accompanied with abnormal EEG characteristics for Lafora disease, and the positive familial history were highly suggestive of Lafora disease. The disease was confirmed with genetic testing by which the mutation of EPM2A was detected.
{"title":"Lafora Disease: A Case Report of Progressive Myoclonic Epilepsy","authors":"Sahar Delavari, Sogol Olamazadeh, Nima Ameli, B. Pourghaz, A. Tafakhori","doi":"10.18502/crcp.v7i4.11595","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11595","url":null,"abstract":"Lafora disease is a rare genetic disease caused by the accumulation of malformed glycogen products in the tissues. The disease usually manifests with idiopathic generalized tonic colonic seizures with poor response to antiepileptic drugs (AEDs). We report the case of a 19-year-old girl with the chief complaint of generalized refractory seizures, jerky movement, and cognitive deterioration with a positive history of epilepsy in her younger brother. The disease onset was at the age of 16 with jerky movement and blurred vision. She was admitted to our ward to have a long-term video EEG monitoring for further evaluation. Clinical presentation accompanied with abnormal EEG characteristics for Lafora disease, and the positive familial history were highly suggestive of Lafora disease. The disease was confirmed with genetic testing by which the mutation of EPM2A was detected.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48122835","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 : 2023-01-02DOI: 10.18502/crcp.v7i4.11590
Ebrahim Farashi, S. Rasihashemi, M. Halimi
Adrenal ganglioneuromas are rare benign and non-secretory neoplasms that, in the majority of cases, are unexpectedly discovered during imaging studies. In this study, we reported a large adrenal ganglioneuromas in a young patient, clinically presented as a pheochromocytoma. Laboratory evaluation and tumor markers were also reported in the normal range. The mass was then resected through laparoscopy. Ultimately, histopathology revealed the diagnosis of Ganglioneuroma. Large adrenal ganglioneuromas can be resected laparoscopically without any complications. An accurate pathological examination is usually essential for definitive diagnosis. Prognosis of mature adrenal ganglioneuromas is excellent.
{"title":"Large Adrenal Ganglioneuroma Presenting with Clinical Pheochromocytoma: A Rare Case Report","authors":"Ebrahim Farashi, S. Rasihashemi, M. Halimi","doi":"10.18502/crcp.v7i4.11590","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11590","url":null,"abstract":"Adrenal ganglioneuromas are rare benign and non-secretory neoplasms that, in the majority of cases, are unexpectedly discovered during imaging studies. In this study, we reported a large adrenal ganglioneuromas in a young patient, clinically presented as a pheochromocytoma. Laboratory evaluation and tumor markers were also reported in the normal range. The mass was then resected through laparoscopy. Ultimately, histopathology revealed the diagnosis of Ganglioneuroma. Large adrenal ganglioneuromas can be resected laparoscopically without any complications. An accurate pathological examination is usually essential for definitive diagnosis. Prognosis of mature adrenal ganglioneuromas is excellent.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43900752","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 : 2023-01-02DOI: 10.18502/crcp.v7i4.11593
N. Radman, V. Aghamollaii, Zahra Mirsepassi
Myotonic Dystrophy type 1 (DM1) is a progressive life-threatening disorder that affects several systems in the human body. Besides physical involvements, previous studies reported various psychiatric and cognitive presentations in these patients. We presented a 65-year-old patient with adult-onset DM who suffered from multisystem involvement. She has also experienced a series of psychiatric symptoms including depressed mood, insomnia, fatigue, reference delusion, visual and auditory hallucinations besides impaired cognitive functions. With the diagnosis of major depressive disorder with psychotic features, she was treated with Sertraline and Haloperidol. The cognitive impairment was continued after improvement in mood, and donepezil 5 mg was prescribed. Whereas patients with DM1 and with psychiatric manifestations have significantly lower function than those without psychiatric symptoms, clinicians should be aware of the mental status examination and eventual psychiatric disorders in these patients. Our case presentation suggests a multidisciplinary approach to these patients to provide comprehensive health care.
{"title":"Psychiatric Presentation in a Patient with Myotonic Dystrophy: A Case Report","authors":"N. Radman, V. Aghamollaii, Zahra Mirsepassi","doi":"10.18502/crcp.v7i4.11593","DOIUrl":"https://doi.org/10.18502/crcp.v7i4.11593","url":null,"abstract":"Myotonic Dystrophy type 1 (DM1) is a progressive life-threatening disorder that affects several systems in the human body. Besides physical involvements, previous studies reported various psychiatric and cognitive presentations in these patients. We presented a 65-year-old patient with adult-onset DM who suffered from multisystem involvement. She has also experienced a series of psychiatric symptoms including depressed mood, insomnia, fatigue, reference delusion, visual and auditory hallucinations besides impaired cognitive functions. With the diagnosis of major depressive disorder with psychotic features, she was treated with Sertraline and Haloperidol. The cognitive impairment was continued after improvement in mood, and donepezil 5 mg was prescribed. Whereas patients with DM1 and with psychiatric manifestations have significantly lower function than those without psychiatric symptoms, clinicians should be aware of the mental status examination and eventual psychiatric disorders in these patients. Our case presentation suggests a multidisciplinary approach to these patients to provide comprehensive health care.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47137750","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 : 2022-11-13DOI: 10.18502/crcp.v7i3.11123
S. Pothiawala
Accessory navicular bone occurs due to failure of fusion of a secondary ossification center with the navicular. It is the second most common ossicle of the foot, with majority of them being identified incidentally on imaging studies. We report a case of 45-year-old female who presented with complaints of pain and localized redness over the medial aspect of the right foot which was aggravated on walking. This brief review aims to describe the pathophysiology, radiographic findings and management of Os naviculare syndrome. We also wish to highlight to the physicians that it must be suspected in patients with localized painover the medial aspect of the midfoot without obvious trauma. The presence of accessory navicular should not be disregarded as an incidental radiological variant in a symptomatic patient.
{"title":"Os Navicular Syndrome: A Symptomatic Accessory Ossicle of the Foot","authors":"S. Pothiawala","doi":"10.18502/crcp.v7i3.11123","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11123","url":null,"abstract":"Accessory navicular bone occurs due to failure of fusion of a secondary ossification center with the navicular. It is the second most common ossicle of the foot, with majority of them being identified incidentally on imaging studies. We report a case of 45-year-old female who presented with complaints of pain and localized redness over the medial aspect of the right foot which was aggravated on walking. This brief review aims to describe the pathophysiology, radiographic findings and management of Os naviculare syndrome. We also wish to highlight to the physicians that it must be suspected in patients with localized painover the medial aspect of the midfoot without obvious trauma. The presence of accessory navicular should not be disregarded as an incidental radiological variant in a symptomatic patient.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47965436","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 : 2022-11-13DOI: 10.18502/crcp.v7i3.11122
Aamir Bashir Raina, Mohammad Abrar Khan, Aamir Majeed Shahr
Double J stent or DJ stent, is a self-retaining ureteral stent mainly used to provide effective drainage of kidney into urinary baldder. However, because of widespread use, lack of patient education or due to lack of adherence to regular follow up,patients may end up with a forgotten DJ stent which can stay undiagnosed in the pelvi-ureteral system for years and cause a lot of complications before coming to attention. We present a unique case of repetitively neglected (forgotten) DJ stent in a 28-year-old male, who had the stent placed 11 years back as a part of Percutaneous Nephrolithotomy (PCNL) and now presentedwith encrusted DJ stent with large bladder calculus and calculus deposits along entire length of the stent. To our knowledge, this study reports the forgotten stent with the maximum stone burden available in literature.
{"title":"Forgotten Double J Stent with Maximum Stone Burden","authors":"Aamir Bashir Raina, Mohammad Abrar Khan, Aamir Majeed Shahr","doi":"10.18502/crcp.v7i3.11122","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11122","url":null,"abstract":"Double J stent or DJ stent, is a self-retaining ureteral stent mainly used to provide effective drainage of kidney into urinary baldder. However, because of widespread use, lack of patient education or due to lack of adherence to regular follow up,patients may end up with a forgotten DJ stent which can stay undiagnosed in the pelvi-ureteral system for years and cause a lot of complications before coming to attention. We present a unique case of repetitively neglected (forgotten) DJ stent in a 28-year-old male, who had the stent placed 11 years back as a part of Percutaneous Nephrolithotomy (PCNL) and now presentedwith encrusted DJ stent with large bladder calculus and calculus deposits along entire length of the stent. To our knowledge, this study reports the forgotten stent with the maximum stone burden available in literature.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47139437","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 : 2022-11-13DOI: 10.18502/crcp.v7i3.11124
A. Tafakhori, A. S. Khaboushan, Aydin Taghilou, S. Shafiee
A 20-year-old woman presented with left eye ptosis without any headache and pupillary dysfunctions. After the radiological examination, the oculomotor nerve compression was detected in the interpeduncular space by the posterior communicating artery (PCoA) with normal size and shape. The patient underwent frontotemporal craniotomy, and during the surgery, the nerve was detached from the PCoA. Immediately after surgery, all symptoms disappeared. Although oculomotor nerve palsy (ONP)owing to internal carotid-PCoA aneurysm is common, vascular compression due to a non- aneurysmal PCoA is very rare. To the extent of our knowledge, this is the first case in which a slightly displaced, otherwise normal, PCoA causes ONP without any pupillary involvement. After ruling out an aneurysmal artery, this should be considered as one of the possible causes of the ONP.
{"title":"Oculomotor Nerve Palsy Due to a Slightly Displaced Posterior Communicating Artery, Manifested by Twitching Ptosis: A Case Report and Review of Literature","authors":"A. Tafakhori, A. S. Khaboushan, Aydin Taghilou, S. Shafiee","doi":"10.18502/crcp.v7i3.11124","DOIUrl":"https://doi.org/10.18502/crcp.v7i3.11124","url":null,"abstract":"A 20-year-old woman presented with left eye ptosis without any headache and pupillary dysfunctions. After the radiological examination, the oculomotor nerve compression was detected in the interpeduncular space by the posterior communicating artery (PCoA) with normal size and shape. The patient underwent frontotemporal craniotomy, and during the surgery, the nerve was detached from the PCoA. Immediately after surgery, all symptoms disappeared. Although oculomotor nerve palsy (ONP)owing to internal carotid-PCoA aneurysm is common, vascular compression due to a non- aneurysmal PCoA is very rare. To the extent of our knowledge, this is the first case in which a slightly displaced, otherwise normal, PCoA causes ONP without any pupillary involvement. After ruling out an aneurysmal artery, this should be considered as one of the possible causes of the ONP.","PeriodicalId":34254,"journal":{"name":"Case Reports in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42713167","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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