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The comparison of local tumor control after microwave ablation, surgical resection and combined treatment for colorectal liver metastases 结直肠癌肝转移灶微波消融、手术切除及联合治疗后局部肿瘤控制的比较
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p125132
F. Güngören, C. Erol, A. Bilici, M. Dayangaç, M. Şeker, Ö. Ölmez, O. Yaprak, Özcan Yıldız, Mustafa Öncel
Aim. We aimed to compare the local therapeutic efficiency of microwave ablation (MWA), surgical resection, and combined treatment, assess the outcomes, and identify predictive factors for local treatment response in colorectal liver metastases (CLMs). Methods. From March 2013 to September 2019, a total of 54 patients with 302 CLMs were enrolled in this retrospective study. Eleven patients (20.4%) were treated with MWA, 9 patients (16.7%) with surgery, and 34 patients (63%) with the combined method. Univariate and multivariate analyses were performed to investigate overall survival (OS) and hepatic progression-free survival (HPFS) using the Cox proportional hazard regression model. The logistic regression analysis was used to identify the predictive factors for the local treatment response. Results. Total treatment response was achieved in 46.3% (n=25) of the patients. Local tumor progression was seen in 7.4% (n=4) of the patients, and the rate of intrahepatic distal recurrence was 46.3% (n=25). There were no significant differences in HPFS and OS between the three groups (p=0.56 and 0.90, respectively). Younger age (<60), smaller (≤ 2 cm) or fewer (≤3) liver metastases, and wild-type RAS were predictive for higher rates of local treatment response (OR 0.22, 95% CI 0.15-0.93, p=0.04; OR 1.12, 95% CI 0.54-2.12, p=0.029; OR 1.37, 95% CI 0.97-2.37, p=0.035; OR 0.23, 95% CI 0.10-0.85, p=0.028, respectively). Conclusions. The results of this study reveal that the use of MWA, alone or combined with resection, may achieve high local treatment response and similar survival rates compared to patients undergoing resection, suggesting that MWA could potentially be preferred over surgical procedures.
的目标。我们的目的是比较微波消融(MWA)、手术切除和联合治疗的局部治疗效果,评估结果,并确定结肠直肠癌肝转移(CLMs)局部治疗反应的预测因素。方法。2013年3月至2019年9月,共纳入54例302例clm患者。MWA治疗11例(20.4%),手术治疗9例(16.7%),联合治疗34例(63%)。采用Cox比例风险回归模型对总生存期(OS)和肝脏无进展生存期(HPFS)进行单因素和多因素分析。采用logistic回归分析确定局部治疗反应的预测因素。结果。46.3% (n=25)的患者达到了总治疗反应。局部肿瘤进展率为7.4% (n=4),肝内远端复发率为46.3% (n=25)。三组患者HPFS和OS差异无统计学意义(p分别为0.56和0.90)。年龄较小(<60岁)、肝转移灶较小(≤2 cm)或较少(≤3个)以及野生型RAS可预测较高的局部治疗缓解率(or 0.22, 95% CI 0.15-0.93, p=0.04;OR 1.12, 95% CI 0.54 ~ 2.12, p=0.029;OR 1.37, 95% CI 0.97-2.37, p=0.035;OR 0.23, 95% CI 0.10-0.85, p=0.028)。结论。本研究结果显示,与切除患者相比,单独使用MWA或联合切除可获得较高的局部治疗反应和相似的生存率,这表明MWA可能比外科手术更可取。
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引用次数: 1
Laboratory findings in COVID-19 - alterations of hematological, immunological, biochemical, hormonal and other lab panels: a narrative review COVID-19的实验室结果-血液学、免疫学、生化、激素和其他实验室检测结果的改变:叙述性回顾
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p3855
Yousef Rasmi, L. Saavedra, M. Cozma, H. El-Nashar, S. Aly, Nouran M. Fahmy, O. Eldahshan, M. El-Shazly, E. Dobrica, H. Kord-Varkaneh, Camelia Diaconu, M. Gaman
Up to the present date, according to the official reports of the World Health Organization (WHO), 205,338,159 patients have been confirmed with the coronavirus disease (COVID-19) and 4,333,094 have died as a consequence of this infectious disorder. The majority of COVID-19 patients will develop hematological, biochemical, immunological, hormonal and other complex alterations of their laboratory data which may be diagnosed using different biomarkers. In this paper, we review the alterations of the hematology, immunology, biochemistry, hormonal and other laboratory panels discovered in the subjects diagnosed with SARS-CoV-2 infection, based on the available data in the literature.
截至目前,根据世界卫生组织(世界卫生组织)的官方报告,已有205338159名患者确诊感染了冠状病毒疾病(新冠肺炎),4333094人死于这种传染病。大多数新冠肺炎患者的实验室数据会发生血液学、生物化学、免疫学、激素和其他复杂变化,这些变化可以使用不同的生物标志物进行诊断。在这篇论文中,我们根据文献中的可用数据,回顾了在被诊断为严重急性呼吸系统综合征冠状病毒2型感染的受试者中发现的血液学、免疫学、生物化学、激素和其他实验室小组的改变。
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引用次数: 3
Modern interpretation of risk factors in breast cancer of women 女性乳腺癌危险因素的现代解释
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p8895
O. Bălălău, R. Scaunasu, O. Olaru, A. Dumitriu, S. Păunică, L. Andronache, A. Stănescu
Breast cancer is a major public health problem, being the most common cancer diagnosed in women and accounting for more than 1 in 10 new diagnoses of cancer each year. It is the most common neoplasm of women under the age of 40 and the second leading cause of cancer death in this age group, with more frequent detection of pathogenic mutations in breast cancer susceptibility genes. Women with BRCA1 and BRCA2 mutations are about 70% more likely to develop breast cancer. The incidence is rising in most countries and it is expected to have a growing trend in the next 20 years, despite the current efforts to prevent the disease. In order to improve the survival rate, it is necessary to make a diagnosis as early as possible and to initiate the appropriate therapeutic management as soon as possible. Therefore, in order to detect breast formations, mammography screening is very important, breast density being an important factor in predicting the risk of breast cancer. Thus, the presence of high breast density represents a 4-6 times higher risk of developing breast cancer compared to women with low breast density. Aging and menopause are also risk factors for breast cancer. Hormone replacement therapy for postmenopausal women has the benefit of relieving symptoms such as hot flashes, depression or sleep disturbances, but it increases the risk of developing breast cancer.
癌症是一个主要的公共卫生问题,是诊断出的女性最常见的癌症,每年约有十分之一以上的新诊断为癌症。它是40岁以下女性最常见的肿瘤,也是该年龄组癌症死亡的第二大原因,更频繁地检测到癌症易感性基因的致病突变。BRCA1和BRCA2突变的女性患癌症的可能性高出70%。尽管目前正在努力预防这种疾病,但大多数国家的发病率都在上升,预计在未来20年内还会有增长趋势。为了提高生存率,有必要尽早做出诊断,并尽快开始适当的治疗管理。因此,为了检测乳房的形成,乳房X光检查是非常重要的,乳房密度是预测癌症风险的重要因素。因此,与低乳腺密度女性相比,高乳腺密度女性患癌症的风险高4-6倍。衰老和更年期也是患癌症的危险因素。绝经后妇女的激素替代疗法有助于缓解潮热、抑郁或睡眠障碍等症状,但会增加患癌症的风险。
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引用次数: 1
Inflammatory bowel disease: pathogenesis, diagnosis and current therapeutic approach 炎症性肠病:发病机制、诊断和目前的治疗方法
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p5677
A. Silaghi, V. Constantin, B. Socea, P. Banu, Vladimir Sandu, L. Andronache, A. Dumitriu, S. Păunică
Inflammatory bowel disease is a group of conditions of unknown etiology, represented by Crohn’s disease and ulcerative colitis and characterized by the presence of intestinal wall inflammation. From the first cases described to date, several studies have been performed to elucidate the cause of inflammatory bowel disease. Generally, the genetic factors predispose to their occurrence while epigenetic and environmental factors trigger them. Genetic factors are mutations of the genes involved in the response and recognition of immune cells to different pathogens. The most studied epigenetic and environmental factors are smoking (which predisposes to Crohn’s disease and can be protective for ulcerative colitis), lack of vitamin D, a diet rich in sugars and low in flavonoids and fibers. The diagnosis is usually established by endoscopy and biopsy. Recent technologies can perform live biopsies such as endocytoscopy or confocal laser endomicroscopy, with an accuracy of 100% compared to classical methods. Therapy involves several classes of drugs, preferably in association with diet and lifestyle changes. In case of complications or in non-responsive diseases, surgery must be considered, as documented for ulcerative colitis that can be cured by removing the entire colon. The purpose of this review is to present recent findings on pathology, as well as modern diagnosis and treatment methods for IBD.
炎症性肠病是一组病因不明的疾病,以克罗恩病和溃疡性结肠炎为代表,以肠壁炎症为特征。从第一个病例描述到目前为止,已经进行了几项研究来阐明炎症性肠病的病因。一般来说,遗传因素易导致其发生,而表观遗传和环境因素则会引发其发生。遗传因素是参与免疫细胞对不同病原体的反应和识别的基因的突变。研究最多的表观遗传和环境因素是吸烟(易患克罗恩病,对溃疡性结肠炎有保护作用)、缺乏维生素D、饮食中富含糖、类黄酮和纤维含量低。诊断通常通过内窥镜检查和活检确定。最近的技术可以进行活体活检,如内吞镜检查或共聚焦激光内窥镜检查,与传统方法相比,准确率达到100%。治疗包括几种药物,最好结合饮食和生活方式的改变。如果出现并发症或无反应性疾病,必须考虑手术治疗,如溃疡性结肠炎可以通过切除整个结肠来治愈。这篇综述的目的是介绍IBD的最新病理发现,以及现代诊断和治疗方法。
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引用次数: 5
Anxiety sensitivity, uncertainty and recursive thinking: A continuum on Cyberchondria conditions during the Covid Outbreak 焦虑敏感性、不确定性和递归思维:新冠疫情期间网络病症的连续体
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p7887
C. Mento, Maria Catena Silvestri, Pilar Amezaga, Maria R. Anna Muscatello, Valentina Romeo, Antonio Bruno, C. Cedro
Background. Cyberchondria is a term used to refer to excessive surfing the web looking for health care information, excessive checking behavior being related to health-related anxiety. This period of quarantine for the Covid-19 pandemic is increasing the pathological use of the internet, and the excessive surfing the web looking for health care information. Another dimension related to the Covid-19 outbreak refers to uncertainty intolerance, for this reason being necessary for the healthcare professionals to provide clear and linear information. Aim. The aim of this review is to identify the psychological correlations connected to cyberchondria in the quarantine period. Methods. Following the PRISMA guidelines, we carried out a systematic review of the literature on PubMed. The terms used for the search were “Cyberchondria” OR “Anxiety” AND “Quarantine”. Results. As resulting from the reviewed literature, there is a relationship between anxiety for one’s own state of health and cyberchondria, with negative psychological effects of quarantine, including post-traumatic stress symptoms, depression, anxiety, low mood, irritability, insomnia, uncertainty, emotional exhaustion, this condition being associated with hypervigilance, and catastrophic misinterpretation of bodily signs. Conclusion. In the light of this and according to the literature, it would be desirable that research can further explore the factors influencing the increase in cyberchondria in the future.
背景。Cyberchondria指的是过度上网寻找医疗信息,过度查看信息的行为与健康相关的焦虑有关。新冠肺炎疫情的隔离期增加了对互联网的病态使用,以及过度上网寻找医疗信息的现象。与Covid-19疫情有关的另一个方面是不确定性不容忍,因此医疗保健专业人员必须提供清晰和线性的信息。的目标。本综述的目的是确定隔离期间与网络疑病症相关的心理相关性。方法。按照PRISMA的指导方针,我们对PubMed上的文献进行了系统的综述。用于搜索的术语是“网络病症”或“焦虑”和“隔离”。结果。根据文献综述,对自身健康状况的焦虑与网络疑病症之间存在联系,并与隔离的负面心理影响有关,包括创伤后应激症状、抑郁、焦虑、情绪低落、易怒、失眠、不确定、情绪衰竭,这种情况与过度警惕和对身体体征的灾难性误解有关。结论。鉴于此,并根据文献,未来的研究可以进一步探讨影响网络疑病症增加的因素。
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引用次数: 0
Diet and Food chemicals increasing the risk of colorectal cancer – literature review 饮食和食品化学物质增加结直肠癌癌症风险——文献综述
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p118124
M. Tudosie, Andreea Pauna, C. Stefani, I. Staicu
Colorectal cancer is a common form of cancer nowadays. There are many risk factors in the pathogenesis of colorectal cancer. The malignant proliferation is caused by one or more genetic mutations, which activate oncogenes and deactivate tumor suppressor genes. Some factors cannot be changed, such as a person's age or family history. An essential aspect in the pathogenesis of colorectal cancer is the choice of lifestyles, such as a high-fat diet, smoking, and excess alcohol. Carcinogens can be either natural or chemical. The mechanisms by which carcinogens initiate tumor formation are genetic or non-genotoxic. The most common form of colorectal cancer is found in people who ingest chemicals that, once ingested, reach the large intestine, thus causing malignant lesions. The Western diet and the metabolic syndrome are risk factors for colorectal cancer, due to gut microbiota changes and low-grade chronic inflammation. Among the most important diet carcinogens are nitrosamines, hydrazines, organophosphates, acetaldehyde, and heterocyclic amines. Screening programs, especially among people over 50 years of age, and with multiple risk factors are extremely important in detecting colorectal cancers in the early stages and in improving the long-term prognosis in such patients.
结直肠癌癌症是目前癌症的一种常见形式。癌症大肠癌的发病机制中存在许多危险因素。恶性增殖是由一个或多个基因突变引起的,这些突变激活致癌基因并使肿瘤抑制基因失活。有些因素是无法改变的,比如一个人的年龄或家族史。结直肠癌癌症发病机制的一个重要方面是生活方式的选择,如高脂肪饮食、吸烟和过量饮酒。致癌物质可以是天然的,也可以是化学的。致癌物质引发肿瘤形成的机制是遗传或非遗传毒性的。癌症最常见的形式是摄入化学物质的人,一旦摄入化学物质,就会进入大肠,从而导致恶性病变。由于肠道微生物群变化和轻度慢性炎症,西方饮食和代谢综合征是结直肠癌癌症的危险因素。最重要的饮食致癌物包括亚硝胺、肼类、有机磷酸酯、乙醛和杂环胺。筛查计划,特别是在50岁以上的人群中,具有多种风险因素,对于早期发现结直肠癌和改善此类患者的长期预后极为重要。
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引用次数: 3
The obstetrical management of HIV-positive pregnancy 艾滋病毒阳性妊娠的产科管理
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p111117
M. Loghin, Petre Gorescki, R. Sima, L. Pleș, D. Balan, I. Păunică, O. Bălălău
The human immunodeficiency virus (HIV) infection is a real public health problem in both developing and developed countries. HIV infection has not been treated efficiently for a long time, with HIV-positive women at increased risk of transmitting the infection to their newborns. Without the appropriate treatment, the evolution of the infection is relatively fast. Due to the antiretroviral treatment, the progression of the disease is blocked during the period of asymptomatic infection, and the risk of neonatal transmission is very low. HIV-positive patients undergoing antiretroviral therapy develop undetectable viremia and, in such situations, patients no longer have a risk of transmitting the infection. The antiretroviral medication is a combination of several classes of drugs (protease inhibitors, nucleoside and non-nucleoside reverse transcriptase inhibitors, integrase inhibitors and CCR5 inhibitors) whose aim is to stop the viral replication at different stages. The infection is most often transmitted in the perinatal period, so it is very important that we know the maternal viremia and choose the type of birth with the lowest risk of transmitting the infection to the fetus. For this reason, any HIV-positive patient with detectable viremia at childbirth should receive treatment during labor and delivery, with a nucleoside or non-nucleoside reverse transcriptase inhibitor that crosses the fetal-placental barrier.
人类免疫缺陷病毒(艾滋病毒)感染是发展中国家和发达国家的一个真正的公共卫生问题。长期以来,艾滋病毒感染没有得到有效治疗,艾滋病毒阳性妇女将感染传染给新生儿的风险增加。如果没有适当的治疗,感染的演变相对较快。由于抗逆转录病毒治疗,在无症状感染期间阻断了疾病的进展,新生儿传播的风险非常低。接受抗逆转录病毒治疗的艾滋病毒阳性患者会出现无法检测到的病毒血症,在这种情况下,患者不再有传播感染的风险。抗逆转录病毒药物是几类药物(蛋白酶抑制剂,核苷和非核苷逆转录酶抑制剂,整合酶抑制剂和CCR5抑制剂)的组合,其目的是在不同阶段阻止病毒复制。这种感染最常在围产期传播,因此了解母体病毒血症并选择将感染传播给胎儿的风险最低的分娩方式非常重要。因此,任何在分娩时可检测到病毒血症的hiv阳性患者都应在分娩和分娩期间接受治疗,使用核苷或非核苷类逆转录酶抑制剂,通过胎儿-胎盘屏障。
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引用次数: 2
The VESPA Project: Virtual Reality Interventions for Neurocognitive and Developmental Disorders VESPA项目:神经认知和发育障碍的虚拟现实干预
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p1627
Emanuele Merlo, Liam Myles, Salvatore Pappalardo
VESPA is a financed project supported by the Sicilian Regional Research and Development funds, and it is structured by the development, research and validation of Virtual Reality (VR) based application for the diagnosis and treatment of neurocognitive conditions. In particular, this article presents its characteristics, referred to as the first (2013-2015) and second (2021-ongoing) generations of VESPA, with particular reference to literature regarding the VR technology application and development, the VR treatment of neurocognitive conditions and prior versions of this intervention. Through a comprehensive review of the research conducted over the last 5 years, evidence has emerged supporting VESPA’s aim and scopes, highlighting how the application of VR can be considered to add value to typical rehabilitation/therapeutic paths. VESPA project generations are then presented in detail, including specific session/task battery characteristics, 2.5D, 3D and 5D typologies, system usability and architecture and pathological domain-based dynamics and features. The discussion about VESPA will highlight the current advantages along with limitations and future directions.
VESPA是一个由西西里地区研究与发展基金资助的项目,其结构是基于虚拟现实(VR)的神经认知疾病诊断和治疗应用程序的开发、研究和验证。特别是,本文介绍了其特征,即第一代(2013-2015年)和第二代(2021年)VESPA,特别参考了有关VR技术应用和发展、神经认知疾病的VR治疗以及该干预的早期版本的文献。通过对过去5年进行的研究进行全面回顾,已经出现了支持VESPA目标和范围的证据,强调了VR的应用如何被认为为典型的康复/治疗路径增加价值。然后详细介绍了VESPA项目的生成,包括特定的会话/任务电池特性、2.5D、3D和5D类型、系统可用性和架构以及基于病理域的动力学和特征。关于VESPA的讨论将突出当前的优势、局限性和未来的方向。
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引用次数: 1
Acetaminophen, a therapeutic or an extremely toxic remedy – a review 对乙酰氨基酚,一种治疗或剧毒的药物-回顾
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p102110
Genica Caragea, Oana Avram, Andreea Pauna, A. Costea, M. Tudosie
When a new coronavirus appeared in the late 2019, identified as the cause of several cases of pneumonia in Wuhan, Paracetamol was initially reported to be the preferable antipyretic medication, choice which was detrimental to the use of other drugs. People have resorted to buying large stocks of Paracetamol and some have used it in large doses, regardless of the consequences. However, the Paracetamol (Acetaminophen) overdose remains the leading cause of death or transplantation due to acute liver failure in many parts of the world. This review aims at presenting the pharmacokinetics, the clinical signs, and the risk factors for systemic toxicity associated with Paracetamol overdose, as well as the current therapeutic approach. Paracetamol is primarily metabolized in the liver, by glucuronidation and sulfation. In case of a Paracetamol overdose, a large amount of NAPQI is conjugated with glutathione, and this process is due to a major depletion of glutathione, thus leading to hepatic necrosis, renal failure, and encephalopathy. The evaluation of serum acetaminophen levels by analytical methods is extremely useful both for the diagnosis and the therapy monitoring.
当2019年底出现一种新的冠状病毒,并被确定为武汉多例肺炎的原因时,最初有报道称扑热息痛是首选的退烧药,这不利于其他药物的使用。人们纷纷购买大量扑热息痛,有些人甚至不顾后果大剂量服用。然而,在世界许多地方,对乙酰氨基酚(扑热息痛)过量仍然是因急性肝衰竭而导致死亡或移植的主要原因。本文综述了扑热息痛过量的药代动力学、临床体征、全身毒性的危险因素以及目前的治疗方法。扑热息痛主要在肝脏中通过葡萄糖醛酸化和磺化代谢。在扑热息痛过量的情况下,大量的NAPQI与谷胱甘肽结合,这一过程是由于谷胱甘肽的大量消耗,从而导致肝坏死、肾功能衰竭和脑病。分析方法评价血清对乙酰氨基酚水平对诊断和治疗监测都有重要意义。
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引用次数: 5
The surgical management of pancreatic pseudocysts – outcomes on a group of seven patients 胰腺假性囊肿的外科治疗——一组7名患者的结果
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-04-10 DOI: 10.22543/7674.91.p168174
Mihai Faur, A. Moisin, A. Sabău, D. Sabau
The pancreatic pseudocyst represents the main complication that occurred 3 to 6 weeks after an outbreak of acute or chronic pancreatitis represented by a collection containing pancreatic enzymes without their own epithelial wall. In the present paper, we present a study performed on 7 patients admitted to the Surgical Department of Sibiu County Emergency Clinical Hospital who were diagnosed with pancreatic pseudocyst between 2016 and 2020, and the drainage of the mini-invasive pancreatic pseudocyst by an incision in the right lumbar area, in the case of a 53-year-old patient known to have a history of multiple cardiac defects, the pancreatic pseudocyst being discovered approximately 6 months before, for which the patient underwent conservative treatment, and who had 5 resuscitated cardio-respiratory arrests throughout the evolution.
胰腺假性囊肿是急性或慢性胰腺炎爆发后3至6周发生的主要并发症,表现为胰腺酶集合没有自己的上皮壁。在本文中,我们对2016年至2020年期间在泗水县急诊临床医院外科确诊为胰腺假性囊肿的7例患者进行了研究,并在右腰区切口引流微创胰腺假性囊肿,其中53岁的患者已知有多种心脏缺陷史,胰腺假性囊肿约6个月前被发现。为此,患者接受了保守治疗,在整个进化过程中有5次心肺骤停复苏。
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引用次数: 4
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Journal of Mind and Medical Sciences
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