ocular manifestations

眼部表现
  • 文章类型: Journal Article
    背景:成骨不全症(OI)是一种结缔组织疾病,其中1型胶原蛋白有缺陷。眼睛是一种富含1型胶原蛋白的结构,并且受到疾病的严重影响。许多威胁视力的眼病与OI有关。在患有OI的个体中,这些疾病的发作也倾向于在较早的年龄发生。尽管对这些风险进行了研究,OI患者的适当眼科筛查或护理指南尚不清楚.因此,本范围审查的目的是探索和描述现有的眼科筛查和护理指南,以指导OI患者的护理.
    方法:进行了基于JoannaBriggs研究所(JBI)方法的范围审查。与研究馆员协商完成了对数据库(PubMed和Medline)的搜索。共有256项研究输入用于筛选。筛选符合纳入和排除标准的主要来源,提取,并使用Covidence进行分析。
    结论:共有12篇主要文章符合纳入和排除标准,包含病例报告,病例系列和队列研究。尽管存在与OI对眼睛的影响相关的失明风险,主要文献未能提供旨在早期识别疾病的详细筛查和护理指南.我们根据审查结果提供一般性建议,以指导OI患者的眼科护理,并呼吁专家召集全球制定筛查指南。有必要对眼科筛查进行进一步的研究,以通过早期发现和治疗来限制这些威胁视力的风险。OI的标准化眼科筛查指南仍然是一个研究领域。
    BACKGROUND: Osteogenesis imperfecta (OI) is a connective tissue disorder in which the Type 1 collagen is defective. The eye is a structure rich in collagen Type 1 and is heavily impacted by the disease. Many vision-threatening eye diseases have been associated with OI. The onset of these diseases also tend to occur at an earlier age in individuals with OI. Despite the research on these risks, appropriate ophthalmological screening or care guidelines for individuals with OI remain unknown. As such, the purpose of this scoping review was to explore and describe existing ophthalmological screening and care guidelines to orient OI patient care.
    METHODS: A scoping review based on the Joanna Briggs Institute (JBI) methodology was conducted. A search of databases (PubMed and Medline) was completed in consultation with a research librarian. A total of 256 studies were imported for screening. Primary sources matching the inclusion and exclusion criteria were screened, extracted, and analyzed using Covidence.
    CONCLUSIONS: A total of 12 primary articles met inclusion and exclusion criteria, containing case reports, case series and cohort studies. Despite the risk of blindness associated with the consequences of OI on the eye, the primary literature fails to provide detailed screening and care guidelines aimed at identifying disease early. We provide general recommendations based on the review findings to guide the ophthalmological care of patients with OI and call upon the experts to convene globally to create screening guidelines. Further investigations of ophthalmological screening are warranted to limit these vision-threatening risks with early detection and treatment. Standardized ophthalmological screening guidelines for OI remain an area for research.
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  • 文章类型: Journal Article
    眼部表现通常是潜在系统性疾病的关键指标,提供有价值的诊断和预后信息。这篇综合综述旨在阐明眼部症状和全身状况之间复杂的相互作用。强调早期识别和跨学科合作在患者管理中的重要性。该综述涵盖了各种系统性疾病,包括心血管,自身免疫,传染性,神经学,内分泌,血液学,遗传,皮肤病学,胃肠,肝,肾,和结缔组织疾病,突出他们的具体眼部表现。诊断方法,包括眼科检查技术,成像模式,和实验室测试,进行了讨论,以提高诊断准确性。此外,审查概述了当前的管理和治疗策略,强调需要多学科的护理方法。还探讨了新兴疗法和未来的研究方向,强调在这一领域不断创新的必要性。这篇综述旨在改善临床实践,促进综合医疗保健,并通过提供全身性疾病中眼部表现的详细概述,最终提高患者的预后。
    Ocular manifestations often serve as critical indicators of underlying systemic diseases, providing valuable diagnostic and prognostic information. This comprehensive review aims to elucidate the complex interplay between ocular symptoms and systemic conditions, emphasising the importance of early recognition and interdisciplinary collaboration in patient management. The review encompasses various systemic diseases, including cardiovascular, autoimmune, infectious, neurological, endocrine, hematologic, genetic, dermatologic, gastrointestinal, hepatic, renal, and connective tissue disorders, highlighting their specific ocular manifestations. Diagnostic approaches, including ophthalmologic examination techniques, imaging modalities, and laboratory tests, are discussed to enhance diagnostic accuracy. Furthermore, the review outlines current management and treatment strategies, emphasising the need for a multidisciplinary approach to care. Emerging therapies and future research directions are also explored, underscoring the necessity of continued innovation in this field. This review aims to improve clinical practices, promote integrative healthcare, and ultimately enhance patient outcomes by providing a detailed overview of ocular manifestations in systemic diseases.
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  • 文章类型: Case Reports
    后巩膜炎是一种罕见的炎症性眼部疾病,影响巩膜的后段,在女性中更为普遍。其临床表现,通常是非特异性的,包括眼痛,头痛,和视力丧失。由于缺乏对视力构成潜在威胁的特定症状,误诊很常见。病因通常与风湿病有关,如类风湿性关节炎(RA),系统性红斑狼疮(SLE),和抗中性粒细胞胞浆抗体(ANCA)相关血管炎。后巩膜炎提出了诊断挑战,模仿许多其他眼部疾病,因此有必要进行全面的临床眼科检查。实验室研究,包括炎症标志物和风湿性疾病标志物,可以识别潜在的全身性疾病。成像,包括B超和磁共振成像(MRI),有助于准确诊断。治疗包括非甾体抗炎药(NSAID),以及用于轻度疾病的局部皮质类固醇和用于严重疾病的全身性皮质类固醇。对于难治性病例,生物治疗变得越来越重要。涉及眼科和风湿病的多学科方法对于这种潜在的视力威胁疾病的管理至关重要。该病例报告重点介绍了一名46岁的女性,有RA相关的后巩膜炎病史。
    Posterior scleritis is a rare inflammatory eye condition affecting the posterior segments of the sclera and is more prevalent in females. Its clinical presentation, often nonspecific, includes ocular pain, headache, and vision loss. Misdiagnosis is common due to a lack of specific symptoms posing a potential threat to vision. The etiology is often tied to rheumatic diseases, such as rheumatoid arthritis (RA), systemic erythematous lupus (SLE), and anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. Posterior scleritis poses diagnostic challenges, mimicking many other ocular conditions, hence necessitating a thorough clinical eye exam. Laboratory studies, including inflammatory markers and markers of rheumatic diseases, may identify underlying systemic diseases. Imaging, including B-scan ultrasound and magnetic resonance imaging (MRI), aids in accurate diagnosis. Treatment involves non-steroidal anti-inflammatory drugs (NSAID), as well as topical corticosteroids for mild disease and systemic corticosteroids for severe disease. Biologic therapy has become increasingly significant for refractory cases. A multidisciplinary approach involving ophthalmology and rheumatology is crucial in the management of this potential sight-threatening disease. This case report highlights a 46-year-old woman with a history of RA-associated posterior scleritis.
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  • 文章类型: Journal Article
    由SARS-CoV-2引起的COVID-19通常表现为发烧和呼吸急促等症状,但也会影响其他器官。越来越多的证据表明潜在的眼部并发症。在这篇文章中,我们旨在系统回顾COVID-19的眼部表现。
    我们进行了系统评价,以探讨COVID-19的眼部表现。我们搜索了包括PubMed在内的在线数据库,Embase,Scopus,和WebofScience至2023年9月4日。经过两个阶段的筛选过程并应用纳入/排除标准,符合条件的文章被推进到数据提取阶段.PRISMA检查表和纽卡斯尔-渥太华量表(NOS)用于质量和偏倚风险评估。
    我们从42篇文章中选择并提取了数据。大多数研究都是横断面的(n=33),在土耳其进行的次数最多(n=10)。最常见的眼部表现是结膜炎,在24篇文章中报道,其次是畏光,燃烧,化疗,瘙痒,和眼部疼痛。大多数研究报告从这些表现中完全恢复;然而,一项研究提到两名患者的视力丧失。
    一般来说,COVID-19的眼部表现似乎可以自发或通过支持治疗解决。对于更严重的病例,医疗和手术都被采用了,结果表明,完全复苏是可以实现的。
    UNASSIGNED: COVID-19 caused by SARS-CoV-2, commonly presents with symptoms such as fever and shortness of breath but can also affect other organs. There is growing evidence pointing to potential eye complications. In this article, we aim to systematically review the ocular manifestations of COVID-19.
    UNASSIGNED: We conducted a systematic review to explore the ocular manifestations of COVID-19. We searched online databases including PubMed, Embase, Scopus, and Web of Science up to September 4, 2023. After a two-stage screening process and applying inclusion/exclusion criteria, eligible articles were advanced to the data extraction phase. The PRISMA checklist and Newcastle-Ottawa Scale (NOS) were used for quality and bias risk assessments.
    UNASSIGNED: We selected and extracted data from 42 articles. Most of the studies were cross-sectional (n = 33), with the highest number conducted in Turkey (n = 10). The most frequent ocular manifestation was conjunctivitis, reported in 24 articles, followed by photophobia, burning, chemosis, itching, and ocular pain. Most studies reported complete recovery from these manifestations; however, one study mentioned visual loss in two patients.
    UNASSIGNED: In general, ocular manifestations of COVID-19 appear to resolve either spontaneously or with supportive treatments. For more severe cases, both medical treatment and surgery have been employed, with the outcomes suggesting that complete recoveries are attainable.
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  • 文章类型: Journal Article
    Takayasu动脉炎(TA)是一种血管炎,其中炎症在大血管中发展,尤其是主动脉及其分支.我们的研究旨在确定TA中眼部表现的患病率和类型。2022年12月,使用三个电子数据库(PubMed,Scopus,和WebofScience)。从每篇文章中提取以下数据:第一作者的姓名;患者的年龄,性别,和起源(大陆);与TA诊断相关的情况;患者给出的症状;报告的眼部表现;并给予治疗。最终分析基于从122例病例中收集的数据。视网膜缺血,接着是视神经病变,白内障,和视网膜动脉阻塞,是与该疾病相关的最普遍的眼部疾病。全身性类固醇治疗,血管手术,甲氨蝶呤主要用于治疗无脉性疾病。患者大多抱怨视力逐渐下降,突然视力丧失,眼痛,和黑病。出现视力下降/丧失症状的患者应考虑诊断为大动脉炎。眼痛,或视网膜缺血的迹象,视神经病变,或早期白内障形成。正确的诊断对于确保患者在没有明显延迟的情况下接受治疗至关重要。
    Takayasu\'s arteritis (TA) is a type of vasculitis in which inflammation develops in large vessels, especially in the aorta and its branches. Our study aims to determine the prevalence and type of ocular manifestations in TA. A systematic literature search was conducted in December 2022 using three electronic databases (PubMed, Scopus, and Web of Science). The following data were extracted from each article: the name of the first author; the patient\'s age, sex, and origin (continent); circumstances connected with the diagnosis of TA; symptoms given by the patients; reported ocular manifestations; and administered treatment. The final analysis was based on data collected from 122 cases. Retinal ischemia, followed by optic neuropathy, cataract, and retinal artery occlusion, were the most prevalent eye conditions associated with the disease. Systemic steroid therapy, vascular procedures, and methotrexate were mainly used to treat pulseless disease. Patients mostly complained of gradual vision acuity loss, sudden vision acuity loss, ocular pain, and amaurosis fugax. The diagnosis of Takayasu\'s arteritis should be considered in patients presenting symptoms of visual decline/loss, ocular pain, or signs of retinal ischemia, optic neuropathy, or early cataract formation. A proper diagnosis is crucial to ensure the patient receives treatment without significant delay.
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  • 文章类型: Journal Article
    背景:准确估计水痘引起的眼部病变的患病率将使卫生部门能够在持续的水痘大流行期间更有效地分配资源。这项荟萃分析的目的是评估全球水痘患者眼科表现的患病率。
    方法:在七个数据库中进行了系统搜索-PubMed,Scopus,WebofScience,EMBASE,ProQuest,EBSCOHost,和Cochrane-for2022年12月12日或之前发表的研究。通过随机效应模型估计眼科表现的合并患病率。进行了研究的偏倚风险评估和亚组分析以解释异质性。
    结果:总体而言,包括12项研究,有3239例确诊的水痘病例,其中755例患者报告了眼科表现。眼科表现的合并患病率为9%(95%置信区间(CI),3-24).来自欧洲的研究报告,眼部表现的患病率非常低,为0.98%(95%CI0.14-2.31)。与非洲的研究相比,非洲的患病率高得多,为27.22%(95%CI13.69-43.26)。
    结论:在全球范围内观察到,水痘患者眼部表现的患病率差异很大。非洲有水痘流行国家的医护人员应注意眼部表现,以便早期发现和管理。
    BACKGROUND: The accurate estimation of the prevalence of mpox-induced ophthalmic lesions will enable health departments to allocate resources more effectively during the ongoing mpox pandemic. The aim of this meta-analysis was to estimate the global prevalence of ophthalmic manifestations in mpox patients.
    METHODS: A systematic search was carried out in seven databases-Pub Med, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane-for studies published on or before 12 December 2022. The pooled prevalence of ophthalmic manifestations was estimated by the random effects model. Risk of bias assessment of the studies and sub-group analysis to explain heterogeneity were undertaken.
    RESULTS: Overall, 12 studies were included, with 3239 confirmed mpox cases, among which 755 patients reported ophthalmic manifestations. The pooled prevalence of ophthalmic manifestations was 9% (95% confidence interval (CI), 3-24). Studies from Europe reported a very low prevalence of ocular manifestations of 0.98% (95% CI 0.14-2.31), compared to studies from Africa with a substantially higher prevalence of 27.22% (95% CI 13.69-43.26).
    CONCLUSIONS: A wide variation in the prevalence of ocular manifestations among mpox patients was observed globally. Healthcare workers involved in mpox-endemic African countries should be aware of ocular manifestations for early detection and management.
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  • 文章类型: Journal Article
    深度学习(DL)是医学人工智能(AI)中备受瞩目的新技术,用于构建针对各种疾病的筛查和诊断算法。眼睛为观察神经血管病理生理变化提供了窗口。以前的研究表明,眼部表现表明全身状况,揭示了疾病筛查和管理的新途径。已经开发了用于基于眼部数据识别全身性疾病的多种DL模型。然而,不同研究的方法和结果差异很大。本系统综述旨在总结现有研究,并概述基于DL的基于眼科检查筛查系统性疾病的算法的当前和未来方面。我们在PubMed®中进行了彻底的搜索,Embase,和WebofScience发布到2022年8月的英语文章。在收集的2873篇文章中,62人被纳入分析和质量评估。所选研究主要利用眼睛外观,视网膜数据,和眼球运动作为模型输入,涵盖了广泛的全身性疾病,如心血管疾病,神经退行性疾病,和全身健康特征。尽管报告的表现不错,大多数模型缺乏疾病特异性和公众对实际应用的通用性。这篇综述总结了利弊,并讨论了在现实世界的临床场景中基于眼部数据实施AI的前景。
    Deep learning (DL) is the new high-profile technology in medical artificial intelligence (AI) for building screening and diagnosing algorithms for various diseases. The eye provides a window for observing neurovascular pathophysiological changes. Previous studies have proposed that ocular manifestations indicate systemic conditions, revealing a new route in disease screening and management. There have been multiple DL models developed for identifying systemic diseases based on ocular data. However, the methods and results varied immensely across studies. This systematic review aims to summarize the existing studies and provide an overview of the present and future aspects of DL-based algorithms for screening systemic diseases based on ophthalmic examinations. We performed a thorough search in PubMed®, Embase, and Web of Science for English-language articles published until August 2022. Among the 2873 articles collected, 62 were included for analysis and quality assessment. The selected studies mainly utilized eye appearance, retinal data, and eye movements as model input and covered a wide range of systemic diseases such as cardiovascular diseases, neurodegenerative diseases, and systemic health features. Despite the decent performance reported, most models lack disease specificity and public generalizability for real-world application. This review concludes the pros and cons and discusses the prospect of implementing AI based on ocular data in real-world clinical scenarios.
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  • 文章类型: Journal Article
    猴痘(MPVX)感染与多器官表现有关。因此,猴痘感染的早期和晚期并发症尤其值得关注,促使卫生系统破译威胁性后遗症及其可能的对策。本文将回顾目前和以前爆发的临床体征和症状,鉴别诊断,详细检查和治疗MPXV感染的眼部表现。不常见但相当大的MPXV并发症之一是眼部受累。这些损伤被分类为(1)更频繁和良性的病变和(2)不太常见和威胁视力的后遗症。结膜炎,眼睑炎和畏光是最简单的报告表现。此外,MPXV可以表现为眼睛发红,额叶头痛,眼眶和眼周皮疹,流泪和眼部放电,结膜下结节和,不那么频繁,如角膜炎,角膜溃疡,浑浊,穿孔和失明。在当前的爆发中,眼部表现不那么频繁,并且可以说不那么严重。尽管有可能被低估,观察性调查的新证据表明,本次疫情中眼部受累的发生率约为1%,而在流行国家以前的疫情中,眼部受累的发生率为9-23%.天花免疫史是预防这些并发症的保护因素。尽管缺乏明确和既定的治疗,对于MPXV眼部并发症,可以考虑常规润滑和预防性使用局部抗生素等简单疗法.在严重的情况下,及时给予特定的抗病毒药物也可能是有效的。猴痘通常具有轻度至中度的严重程度和自我限制的病程。然而,及时识别和正确管理该疾病可以降低永久性眼部后遗症和疾病发病率的风险。
    Monkeypox (MPVX) infection has been associated with multiorgan presentations. Thus, monkeypox infection\'s early and late complications are of particular concern, prompting health systems to decipher threatening sequels and their possible countermeasures. The current article will review the clinical signs and symptoms of the present and former outbreaks, differential diagnoses, workup and treatment of the ocular manifestations of MPXV infection in detail. One of the uncommon yet considerable MPXV complications is ocular involvement. These injuries are classified as (1) more frequent and benign lesions and (2) less common and vision-threatening sequels. Conjunctivitis, blepharitis and photophobia are the most uncomplicated reported presentations. Moreover, MPXV can manifest as eye redness, frontal headache, orbital and peri-ocular rashes, lacrimation and ocular discharge, subconjunctival nodules and, less frequently, as keratitis, corneal ulceration, opacification, perforation and blindness. The ocular manifestations have been less frequent and arguably less severe within the current outbreak. Despite the possibility of underestimation, the emerging evidence from observational investigations documented rates of around 1% for ocular involvement in the current outbreak compared to a 9-23% incidence in previous outbreaks in the endemic countries. The history of smallpox immunization is a protective factor against these complications. Despite a lack of definite and established treatment, simple therapies like regular lubrication and prophylactic use of topical antibiotics may be considered for MPXV ocular complications. Timely administration of specific antivirals may also be effective in severe cases. Monkeypox usually has mild to moderate severity and a self-limited course. However, timely recognition and proper management of the disease could reduce the risk of permanent ocular sequelae and disease morbidity.
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  • 文章类型: Journal Article
    新型严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)导致2019年12月在中国爆发严重冠状病毒病(COVID-19),并在全球范围内造成巨大的健康和经济问题。SARS-CoV-2可以通过附着于位于人细胞上的血管紧张素转换酶2受体来攻击呼吸系统。有临床证据表明眼部表现与SARS-CoV-2感染密切相关。事实上,眼睛可能是一种新的感染途径,寻找保护眼睛的方法可以进一步降低感染的风险。本文就COVID-19的眼部并发症、可能的发病机制、和预防策略,以保护眼科从业人员和患者通过审查目前可用的文献主题。
    UNASSIGNED: The novel severe acute respiratory syndrome coronavins 2 (SARS-CoV-2) led to the severe Corona Virus Disease 2019 (COVID-19) outbreak that started in December 2019 in China and caused enormous health and economic problems worldwide. Over time, SARS-CoV-2 has demonstrated the capacity for mutation. As the most prevalent new coronavirus variety worldwide, the Omicron variant has supplanted the Delta variant. The COVID-19 primarily damages the immune system and the lungs, but it can also harm other organs secondarily, depending on the patients\' co-existing conditions.
    UNASSIGNED: COVID-19 is associated with ophthalmic manifestations such as conjunctival congestion, tear overflow, and conjunctival edema, with the majority of eye complications occurring in patients with severe infection. The virus may make a patient more susceptible to thrombotic conditions that affect venous and arterial circulation. Meanwhile, it can lead to efferent complications and mucormycosis which is more common in patients with diabetes or who have critical or severe SARS-CoV-2 infection. Significantly, there are a number of ocular side effects following the COVID-19 vaccination, such as herpetic keratitis and facial nerve palsy, which have been reported. These side effects may be caused by the vaccinations\' propensity to trigger autoimmune symptoms or thromboembolic events. At present, large-scale nucleic acid testing mainly relies on nasopharyngeal swabs and throat swabs. Tear samples and conjunctival swabs may be helpful samples for the diagnosis of ocular SARS-CoV-2 infection. The eye could be a new route of infection, and finding ways such as effective environmental disinfection, scientific administrative control management, qualified personal protection and other measures to protect the eyes could further reduce the risk of infection.
    UNASSIGNED: This review aims to sum up the ocular complications of COVID-19, the possible pathogenesis, and preventive strategies to protect ophthalmology practitioners and patients by reviewing the currently available literature on the topic.
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  • 文章类型: Journal Article
    基孔肯雅病毒(CHIKV)可引起长期持续的症状和表现。然而,关于哪些眼部感染最常见的信息很少。我们进行了系统评价(在国际前瞻性系统评价登记册中注册;无CRD42020171928),以确定CHIKV感染最常见的眼部表现及其与性别和年龄的关系。直到2020年9月发表的文章选自PubMed,Scielo,Cochrane和Scopus数据库。仅包括CHIKV感染患者和眼部改变的研究。评论,描述性研究,或者那些没有研究CHIKV的人类眼部表现的人,那些患有其他疾病和感染的患者,没有相关数据的摘要和研究被排除.选择了25项研究纳入。他们的偏见风险通过改良的纽卡斯尔-渥太华量表进行评估。CHIKV感染最常见的眼部症状包括眼部疼痛,炎症和视力下降,而结膜炎和视神经炎是该病最常见的表现。这些主要发生在42±9.5岁的女性个体中。关于CHIKV引起的眼部表现的少数可用报告强调,需要在该领域进行进一步研究,以收集与CHIKV感染有关的更多实质性证据。眼睛和年龄/性别。尽管如此,数据强调,眼部改变是有意义的CHIKV感染的发生,可显著影响生活质量.
    The Chikungunya virus (CHIKV) can cause long lasting symptoms and manifestations. However, there is little information on which ocular ones are most frequent following infection. We performed a systematic review (registered in the International Prospective Register of Systematic Reviews; no CRD42020171928) to establish the most frequent ocular manifestations of CHIKV infection and their associations with gender and age. Articles published until September 2020 were selected from PubMed, Scielo, Cochrane and Scopus databases. Only studies with CHIKV-infected patients and eye alterations were included. Reviews, descriptive studies, or those not investigating the human ocular manifestations of CHIKV, those with patients with other diseases and infections, abstracts and studies without relevant data were excluded. Twenty-five studies were selected for inclusion. Their risk of bias was evaluated by a modified Newcastle-Ottawa scale. The most frequent ocular symptoms of CHIKV infection included ocular pain, inflammation and reduced visual acuity, whilst conjunctivitis and optic neuritis were the most common manifestations of the disease. These occurred mostly in individuals of 42 ± 9.5 years of age and woman. The few available reports on CHIKV-induced eye manifestations highlight the need for further research in the field to gather more substantial evidence linking CHIKV infection, the eye and age/gender. Nonetheless, the data emphasizes that ocular alterations are meaningful occurrences of CHIKV infection which can substantially affect quality of life.
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