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A comprehensive review on the pancreatic lipase inhibitory peptides: A future anti-obesity strategy 胰脂肪酶抑制肽研究综述:未来的抗肥胖策略
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-05-01 DOI: 10.29333/ejgm/12943
Y. Tan, C. Gan, Muhammad Hakimin Shafie, P. Yap, A. Mohd Rodhi, Ashfaq Ahmad, V. Murugaiyah, M. Abdulla, E. Johns
Dysregulation of lipid homeostasis contributes to obesity and can directly lead to several critical public health concerns globally. This paper aimed to present a brief review of related properties and the use of pancreatic lipase inhibitors as the future weight loss drug discovery and development procured from a wide range of natural sources. A total of 176 pancreatic lipase inhibitory peptides were identified from recent publications and peptide databases. These peptides were classified into three categories according to their peptide length and further analyzed using bioinformatic approaches to identify their structural activity relationship. Molecular docking analyses were conducted for each amino acid at the terminal position of the peptides to predict the binding affinity between peptide-enzyme protein complexes based on intermolecular contact interactions. Overall, the observations revealed the features of the inhibitory peptides and their inhibitory mechanisms and interactions. These findings strived to benefit scientists whose research may be relevant to anti-obesity drug development and/or discovery thereby support effective translation of preclinical research for humans’ health being.
脂质稳态失调导致肥胖,并可直接导致全球几个关键的公共卫生问题。本文旨在简要介绍胰脂肪酶抑制剂的相关性质和用途,作为未来减肥药的发现和开发,从广泛的天然来源获得。从最近的出版物和肽数据库中共鉴定出176种胰脂肪酶抑制肽。根据这些肽的长度将其分为三类,并利用生物信息学方法进一步分析它们的结构活性关系。对肽末端的每个氨基酸进行分子对接分析,基于分子间接触相互作用预测肽-酶蛋白复合物之间的结合亲和力。总的来说,观察结果揭示了抑制肽的特征及其抑制机制和相互作用。这些发现努力使那些研究可能与抗肥胖药物开发和/或发现相关的科学家受益,从而支持有效地转化为人类健康的临床前研究。
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引用次数: 1
Breastfeeding friendly pharmacy from pharmacists perspective 药剂师视角下的母乳喂养友好药房
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-05-01 DOI: 10.29333/ejgm/12940
Mea’ad M Harahsheh, T. Mukattash, S. Al-shatnawi, Rana K. Abu‐Farha, D. D'Arcy, A. Jarab, S. Abuhammad
Objective: The primary goals of our research were to explore pharmacists’ perception of breastfeeding friendly pharmacy (BFPh) requirements and factors associated with their awareness about these requirements.Methods: A cross-sectional study design was conducted using a self-administered survey. A convenience sample (n=381) of community pharmacists, was recruited through social media resources. Data were entered and analyzed using SPSS software version 35. The frequency or percentages were used for categorical variables while means and standard deviations were used for continuous variables. Also, linear regression analysis was used to evaluate factors affecting pharmacists’ awareness about BFPh requirements.Results: The majority of recruited pharmacists were female (n=329, 86.4%), aged between 23 to 30 years of age (78.7%, n=300). The most common steps to describe a pharmacy as a BFPh from the perspective of surveyed pharmacists were training all pharmacy staff to develop the necessary skills (n=239, 62.7%)) followed by informing all pregnant women about the benefits of breastfeeding (n=225, 59.1%)) and having a written policy on feeding infants and young children according to the recommendations of the WHO and in compliance with the international code (n=209, 54.9%)). Furthermore, pharmacists aging 40 years or less showed a significantly higher awareness about BFPh requirements compared to those aging above 40 years (beta=-0.013, p= 0.045). In addition, 37% (n=142) of pharmacists perceived that answering general questions or concerns on general medication intake while breastfeeding babies is their major role in breastfeeding support.Conclusion: Breastfeeding support is a promising area for promoting professional pharmacy services. Training all pharmacy staff and informing all pregnant about the benefit of breastfeeding are the most common two steps to describe a pharmacy as BFPh. Additionally, the awareness of BFPh requirement was associated with pharmacists age. Future focus should be placed on implementing BFPh project in Jordanian pharmacies, where the steps of this project are modified in line with the capabilities of pharmacies in Jordan within governmental pharmaceutical control.
目的:本研究的主要目的是探讨药剂师对母乳喂养友好型药房(BFPh)要求的认知,以及与他们对这些要求的认知相关的因素。方法:采用自行调查的方法进行横断面研究设计。通过社交媒体资源招募了一个方便样本(n=381)的社区药剂师。数据输入并使用SPSS软件版本35进行分析。频率或百分比用于分类变量,而平均值和标准差用于连续变量。此外,还采用线性回归分析来评估影响药剂师对BFPh要求的认识的因素。结果:大多数招募的药剂师是女性(n=329,86.4%),年龄在23至30岁之间(78.7%,n=300)。从受访药剂师的角度来看,将药房描述为BFPh的最常见步骤是培训所有药房工作人员发展必要的技能(n=239,62.7%),然后告知所有孕妇母乳喂养的好处(n=225,59.1%),并根据世界卫生组织和符合国际规范(n=209,54.9%)。此外,与40岁以上的药剂师相比,40岁及以下的药剂师对BFPh要求的认识明显更高(β=0.013,p=0.045)。此外,37%(n=142)的药剂师认为,在母乳喂养婴儿时回答有关一般药物摄入的一般问题或担忧是他们在母乳喂养支持中的主要作用。结论:母乳喂养支持是促进专业药学服务的一个很有前途的领域。培训所有药房工作人员并告知所有孕妇母乳喂养的好处是将药房描述为BFPh最常见的两个步骤。此外,对BFPh要求的认识与药剂师的年龄有关。未来的重点应放在约旦药店实施BFPh项目上,该项目的步骤将根据约旦药店在政府药品控制范围内的能力进行修改。
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引用次数: 1
Relationship between homocysteine and cognitive impairment in elderly patients with chronic kidney disease 老年慢性肾脏病患者同型半胱氨酸与认知障碍的关系
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-05-01 DOI: 10.29333/ejgm/13024
Y. Elgazzar, Tomader T Abdel-Rahman, H. Sweed, Ramy M Mahmoud, Heba Y Kamel
Aim: To investigate the association of serum homocysteine levels with cognitive function in elderly patients with chronic kidney disease (CKD).Methods: A case-control study on 200 elderlies >60 years who were distributed into two groups: group 1 (cases): 100 patients with CKD and group 2 (controls): 100 subjects who do not have CKD. All subjects undergo comprehensive geriatric assessment, cognitive assessment, and biochemical investigations including serum homocysteine.Results: The odds ratio of having impaired clinical dementia rating scores is 3.1 for CKD cases compared to controls. CKD patients have almost 3 times the risk of having cognitive impairment [OR=3.1; 95% CI (1.6-6.0)]. The mean serum homocysteine (18.2 μmol/L) among CKD showed a highly statistically significance compared to controls (10.1 μmol/L). Performance of multiple cognitive domains was reduced in association with elevated homocysteine levels. By using linear regression model for the factors independently related to cognitive performance among studied CKD cases, it was found that diabetes mellitus, educational level, age, and serum homocysteine level were strongly associated with consortium to establish a registry for Alzheimer’s disease neuropsychological battery total scores. Respecting the percentage variance explained by each significant variable (R2), serum homocysteine level is an independent significant variable predictor with the total scores.Conclusion: The main features of cognitive impairment in CKD patients are executive dysfunction and memory impairment. Poor cognitive function in CKD patients was related with a higher homocysteine level independently.
目的:探讨老年慢性肾脏病(CKD)患者血清同型半胱氨酸水平与认知功能的关系。所有受试者都接受了全面的老年评估、认知评估和包括血清同型半胱氨酸在内的生化调查。结果:CKD患者与对照组相比,临床痴呆评分受损的比值比为3.1。CKD患者发生认知障碍的风险几乎是对照组的3倍[OR=3.1;95%CI(1.6-6.0)]。CKD患者的平均血清同型半胱氨酸(18.2μmol/L)与对照组(10.1μmol/L)相比具有高度统计学意义。多个认知领域的表现与同型半胱氨酸水平升高有关。在所研究的CKD病例中,通过使用与认知表现独立相关的因素的线性回归模型,发现糖尿病、教育水平、年龄和血清同型半胱氨酸水平与建立阿尔茨海默病神经心理电池总分登记的联合体密切相关。考虑到每个显著变量(R2)解释的百分比方差,血清同型半胱氨酸水平是总分的独立显著变量预测因子。结论:CKD患者认知功能障碍的主要特征是执行功能障碍和记忆障碍。CKD患者认知功能差与高同型半胱氨酸水平独立相关。
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引用次数: 0
Perception and awareness of osteoporosis and its related risk factors among women: A cross-sectional study 女性对骨质疏松症及其相关危险因素的认知和认识:一项横断面研究
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-05-01 DOI: 10.29333/ejgm/13010
Manal Ayyash, K. Jaber, Rajaa Daghash, Rana K. Abu‐Farha, E. Alefishat
Objectives: This study was designed to assess the awareness of women of the risk factors and preventive measures of osteoporosis.Methods: This is a cross-sectional study that was conducted in Jordan. During the study period, a convenience sample of women were invited to participate via a survey link communicated through social media. Linear regression was used to screen independent variables affecting participants’ awareness of osteoporosis, its risk factors, and preventive measures.Results: 426 women agreed to participate in this study, with a median age of 38.5 years (IQR=16.0). Results showed that women have a median awareness score of 5.0 out of 9.0 (IQR=4.0) about osteoporosis risk factors, whereas women with higher educational levels (diploma or higher) and those with medical-related degrees have a higher awareness about osteoporosis risk factors compared to others (p≤0.05).Medical websites were the primary source used to obtain information about osteoporosis by the participating women (n=236, 55.4%). Also, results showed that more than 90% of the women believed that osteoporosis is a chronic silent disease that makes your bones less dense and more fragile (n=418, 98.1%), and that bone strength may increase by taking vitamin D and calcium (n=405, 95.0%).Conclusion: This study showed that women had an intermediate level of awareness of osteoporosis and prevention measures. The importance of medical websites and social media as sources of information was also demonstrated. More public targeted campaigns are needed to promote awareness of osteoporosis, its risk factors, prevention, and treatment.
目的:本研究旨在评估妇女对骨质疏松症危险因素和预防措施的认识。方法:这是一项在约旦进行的横断面研究。在研究期间,一个方便的女性样本被邀请通过社交媒体传播的调查链接参与。采用线性回归筛选影响参与者骨质疏松意识、危险因素和预防措施的自变量。结果:426名女性同意参加本研究,中位年龄为38.5岁(IQR=16.0)。结果显示,女性对骨质疏松危险因素的知知度中位数为5.0分(IQR=4.0分),而高学历(大专及以上学历)和医学相关学历的女性对骨质疏松危险因素的知知度高于其他人群(p≤0.05)。医学网站是受访女性获取骨质疏松信息的主要来源(n=236, 55.4%)。此外,结果显示,超过90%的女性认为骨质疏松症是一种慢性隐性疾病,它会使你的骨骼密度降低,变得更脆弱(n=418, 98.1%),而骨骼强度可以通过服用维生素D和钙来增加(n=405, 95.0%)。结论:本研究表明,女性对骨质疏松症的认知及预防措施处于中等水平。报告还显示了医疗网站和社交媒体作为信息来源的重要性。需要更多有针对性的公众活动来提高人们对骨质疏松症及其危险因素、预防和治疗的认识。
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引用次数: 0
The use of opioid in treating a patient with kratom use disorder: A case report 阿片类药物治疗卡痛使用障碍一例报告
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-05-01 DOI: 10.29333/ejgm/13056
Husna Hassan, N. Draman, Raihan Hassan, N. Ali, Salziyan Badrin
Kratom is a botanical plant product that is used around the world, particularly in Southeast Asia. It is believed that it has potential benefits as a painkiller and for relieving fatigue. Specifically, kratom can produce an opioid effect, which makes it addictive. We report a 26-year-old man who presented to the clinic for treatment of kratom use disorder. He was willing to be treated because he could no longer withstand the withdrawal effect and the financial cost of his addiction. Our team successfully initiated treatment using buprenorphine-naloxone (suboxone) in pill form to treat his kratom use disorder. The patient also received non-pharmacological treatment such as psychoeducation, psychotherapy, and motivational interviews. He was successfully treated with suboxone and within a week he was kratom free and happy.
Kratom是一种植物产品,在世界各地都有使用,特别是在东南亚。人们相信它有作为止痛药和缓解疲劳的潜在好处。具体来说,克拉托姆可以产生阿片类药物效应,使其上瘾。我们报告一个26岁的男子谁提出到诊所治疗克拉通使用障碍。他愿意接受治疗,因为他再也无法承受戒断效应和毒瘾带来的经济成本。我们的团队成功地开始使用丁丙诺啡-纳洛酮(suboxone)药丸形式治疗他的kratom使用障碍。患者还接受了非药物治疗,如心理教育、心理治疗和动机访谈。他成功地接受了苏博松的治疗,一周之内,他就恢复了自由和快乐。
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引用次数: 0
Posterior reversible encephalopathy syndrome: A conundrum of nephrotic syndrome complication 后部可逆性脑病综合征:肾病综合征并发症的难题
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.29333/ejgm/12835
Mohd Puad Munirah, Noraini Mohamad, M. N. Norhayati, Azzahra Nurul Azman
Nephrotic syndrome is a kidney disease with proteinuria, hypoalbuminemia, and edema. One rare, potentially life-threatening complication of nephrotic syndrome is posterior reversible encephalopathy syndrome (PRES). Sudden episodes of neurological symptoms such as headache, confusion, seizures, or focal neurological deficits with radiological findings of white matter abnormalities in the parietal and occipital lobes characterize it. Multiple factors predispose an individual with nephrotic syndrome to PRES, such as uncontrolled hypertension, reduced serum albumin levels, administration of drugs (cyclosporine, tacrolimus), anasarca, disturbed body fluid status and renal insufficiency. Here, we report a case of PRES in a seven-year-old girl with nephrotic syndrome who presented with high blood pressure while admitted to the ward. Her neurological symptom rapidly recovered after the control of hypertension. Recurrence of acute severe hypertension, nephrotic state (edema/ hypoalbuminemia), and renal insufficiency may lead to recurrent PRES. Thus, early treatment of trigger factors, especially of hypertension, is vital to reduce the episodes of PRES.
肾病综合征是一种伴有蛋白尿、低白蛋白血症和水肿的肾脏疾病。后可逆性脑病综合征(PRES)是一种罕见的、可能危及生命的肾病综合征并发症。神经系统症状的突然发作,如头痛、精神错乱、癫痫发作或局灶性神经功能缺损,并伴有顶叶和枕叶白质异常的影像学表现。多种因素使肾病综合征患者易患PRES,如高血压不受控制、血清白蛋白水平降低、服用药物(环孢素、他克莫司)、阿纳沙卡、体液状态紊乱和肾功能不全。在这里,我们报告一例PRES在一个7岁的女孩肾病综合征谁提出了高血压,而入院。她的神经症状在高血压得到控制后迅速恢复。急性重度高血压、肾病状态(水肿/低白蛋白血症)和肾功能不全的复发均可导致PRES复发,因此,早期治疗诱发因素,特别是高血压的诱发因素,对于减少PRES的发作至关重要。
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引用次数: 1
Burden and risk factors of anxiety disorders among Arabic pediatric population: A systematic review 阿拉伯儿科人群焦虑症的负担和危险因素:一项系统综述
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.29333/ejgm/12850
A. Alkhateeb
Aim: In the general population, where 6 to 20% of individuals experience anxiety disorders, children also experience a higher burden of anxiety. We undertook a systematic review In order to examine and summarize the results from studies that estimated the prevalence of anxiety and/or its associated risk factors in the pediatric populations of Arab nations, primarily the gulf countries.Methods: Any study that focused on the pediatric population and completed in Arab nations to determine the incidence of anxiety and/or its risk factors among children under the age of 18. The review had 13 articles were included.Results: The results of the systematic review found that there was a wide variation in the prevalence of anxiety among children. At least 30.2% of the children were found to suffer from anxiety and the prevalence could go up to 60% in some countries with a higher prevalence among girls than boys. Associated factors of anxiety were diverse including exposure to environmental tobacco smoke, parenting style, living with parents suffering from mental disorders, school type, and being female.Conclusion: The findings of the review demonstrate the higher prevalence of anxiety among children as almost at least one-third of children suffer from anxiety in the Gulf countries. The program managers and the respective government of these Arab countries need to devise some strategies and interventions that not only focus on the children but also their environment.
目的:在普通人群中,6%至20%的人患有焦虑症,儿童也会经历更高的焦虑负担。我们进行了一项系统综述,以检查和总结评估阿拉伯国家(主要是海湾国家)儿科人群焦虑患病率和/或相关风险因素的研究结果。方法:在阿拉伯国家完成的任何以儿科人群为重点的研究,以确定18岁以下儿童的焦虑发生率和/或其风险因素。该综述共收录了13篇文章。结果:系统综述的结果发现,儿童焦虑的患病率存在很大差异。至少30.2%的儿童患有焦虑症,在一些女孩患病率高于男孩的国家,焦虑症的患病率可能高达60%。焦虑的相关因素多种多样,包括接触环境烟草烟雾、养育方式、与患有精神障碍的父母一起生活、学校类型和身为女性。结论:该综述的结果表明,海湾国家儿童中焦虑的患病率较高,因为几乎至少有三分之一的儿童患有焦虑症。这些阿拉伯国家的项目管理者和各自的政府需要制定一些战略和干预措施,不仅关注儿童,还关注他们的环境。
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引用次数: 0
HIV therapy adherence and outcomes in Peruvian military personnel over a 30-year period 秘鲁军事人员30年来HIV治疗依从性和结果
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.29333/ejgm/12776
G. De la Cruz Ku, Christian Rojas Contreras, Diego Chambergo-Michilot, J. Torres-Roman, F. Príncipe-Meneses, Flavia Rioja Torres, Fátima Campana Zamudio, Gonzalo Pérez Pachas, Alfredo Huamán Modesto, V. Chavez
Objectives: We aimed to describe the sociodemographic, clinical, and therapeutic characteristics of Peruvian military personnel diagnosed with HIV. Furthermore, we determined the frequency of highly active antiretroviral therapy (HAART) adherence, the complications and mortality.Methods: We retrospectively reviewed the medical records of patients diagnosed with HIV, confirmed by Western blot at a single institution from 1989-2020. Descriptive analyses were performed for all the variables using mean and standard deviation (SD) in the case of quantitative variables, and frequency and percentage for qualitative variables.Results: Of the 161 patients included, 95.7% were males and the mean age was 39.59 years (SD= 16.45 years). Most had college or higher education (67.7%) and were on active duty at diagnosis (77%). 35.4% had AIDS at diagnosis; 28.6% opportunistic infections; and 8.1% tuberculosis. The median follow-up was five years. 94.4% of the patients received HAART as the principal treatment; of these, 88.8% was adherent to treatment, and death was reported in 6.8%. There were no factors associated with adherence.Conclusions: Although the sociodemographic characteristics of Peruvian military personnel are similar to those of other countries, our findings suggest that Peruvian military personnel present higher adherence to HAART compared to previous studies in other military populations from South American countries. Further studies are recommended to assess specific factors attributed to these successful outcomes in the military personnel that can be applied in other hospitals.
目的:我们旨在描述被诊断为艾滋病毒感染的秘鲁军事人员的社会人口统计学、临床和治疗特征。此外,我们还确定了高活性抗逆转录病毒疗法(HAART)的依从性、并发症和死亡率。方法:我们回顾性回顾了1989-2020年在一家机构通过蛋白质印迹证实的HIV患者的医疗记录。在定量变量的情况下,使用平均值和标准差(SD)对所有变量进行描述性分析,定性变量的频率和百分比进行描述性分析。结果:161例患者中,95.7%为男性,平均年龄39.59岁(SD=16.45岁)。大多数人受过大学或高等教育(67.7%),并在确诊时担任现役(77%)。35.4%在诊断时患有艾滋病;机会性感染28.6%;结核8.1%。中位随访时间为5年。94.4%的患者接受HAART作为主要治疗;其中88.8%的患者坚持治疗,6.8%的患者死亡。没有与坚持治疗相关的因素。结论:尽管秘鲁军事人员的社会人口学特征与其他国家相似,但我们的研究结果表明,与之前对南美国家其他军事人员的研究相比,秘鲁军事人员对HAART的依从性更高。建议进行进一步的研究,以评估军事人员取得这些成功的具体因素,这些因素可以应用于其他医院。
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引用次数: 0
Monkeypox or hand-foot-and-mouth-disease: A case report 猴痘或手足口病:一例报告
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.29333/ejgm/12896
Siti Syafiqah Sainuddin, A. Abdul Kadir, Rosnani Zakaria
Monkeypox is a rare disease originating in Africa and has recently gained the spotlight globally because of the increasing cases reported in Western Europe and North America. However, since July 2022, the World Health Organization has declared this disease a public health emergency of international concern as the cases were rising globally. We report a case of the severe form of rashes of hand-foot-and-mouth-disease to distinguish it from current outbreaks of the monkeypox virus. Hopefully, this case report will aid primary care physicians in their ability to recognize and distinguish between a severe hand-foot-and-mouth-disease rash and an infection with the monkeypox virus. So, effective management and treatment may aid patients in enhancing their quality of life.
猴痘是一种起源于非洲的罕见疾病,由于西欧和北美报告的病例不断增加,最近在全球引起了关注。然而,自2022年7月以来,随着全球病例不断增加,世界卫生组织宣布该病为国际关注的突发公共卫生事件。我们报告了一例严重形式的手足口病皮疹,以区别于目前暴发的猴痘病毒。希望本病例报告能够帮助初级保健医生识别和区分严重手足口病皮疹和猴痘病毒感染。因此,有效的管理和治疗可以帮助患者提高生活质量。
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引用次数: 0
An atypical presentation of urolithiasis with pyonephrosis in a child: A case report 一例儿童尿路结石并发脓肾症的非典型表现
IF 2.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-03-01 DOI: 10.29333/ejgm/12852
Siti Nur Syakinah Md Sabudin, L. H. Yaacob, N. Draman
Background: Childhood urolithiasis is previously rare but increasingly recognized nowadays. Presentation varies, and often children, do not present with the classical symptoms commonly seen in adults.Case report: This case was initially presented to the emergency department with atypical symptoms of nephrolithiasis. Therefore, he was treated for acute appendicitis before an ultrasound abdomen revealed there is gross hydronephrosis, which is secondary to pelvic-ureteric junction obstruction. CT abdomen was then proceeded, found right nephrolithiasis and vesicoureteric calculus with right hydroureter and gross hydronephrosis. Retrograde pyelography (RPG), ureteroscopy (URS), and insertion of the stent for right pelvic-ureteric junction obstruction were performed and subsequently, he developed complications.Conclusion: The initial presentation of this case is common however not a classical presentation of renal stone. Therefore, evaluation of the symptoms and initial investigations should be done properly, so that we will not miss this common disease with the rare presentation, especially in children.
背景:儿童尿石症以前很罕见,但现在越来越被人们所认识。表现形式各不相同,通常儿童不会出现成年人常见的典型症状。病例报告:该病例最初以肾结石的非典型症状出现在急诊科。因此,他接受了急性阑尾炎的治疗,随后腹部超声显示有严重的肾积水,这是继发于肾盂输尿管交界处梗阻。然后进行腹部CT检查,发现右肾结石和膀胱输尿管结石,并伴有右输尿管积水和严重肾积水。进行了逆行肾盂造影(RPG)、输尿管镜检查(URS)和右肾盂输尿管连接处梗阻支架置入术,随后出现并发症。结论:该病例的最初表现是常见的,但不是肾结石的典型表现。所以,应该对症状进行评估和初步调查,这样我们就不会错过这种罕见的常见疾病,尤其是在儿童中。
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引用次数: 0
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Electronic Journal of General Medicine
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