oral pathology

口腔病理学
  • 文章类型: Case Reports
    术后上颌囊肿(POMC)是上皮衬里的囊肿,可在上颌窦区域的手术或创伤后发展。这种情况是由于上颌骨的鼻窦粘膜受困,很少在下颌骨中,由于上颌窦附近的创伤或器械。文献表明,POMC,或外科纤毛囊肿,在鼻窦区域创伤或外科手术后5个月至56年可能出现延迟并发症。尽管它有可能在当地进行侵略性破坏,它通常以最小的症状出现。此临床病例报告描述了30岁男性中此类囊肿的发生,并讨论了这种罕见病理的诊断和处理。
    A postoperative maxillary cyst (POMC) is an epithelium-lined cyst that can develop following surgery or trauma in the maxillary antral region. This condition arises from the entrapment of the sinonasal mucosa in the maxilla, and rarely in the mandible, due to trauma or instrumentation near the maxillary sinus. Literature indicates that POMCs, or surgical ciliated cysts, can appear as delayed complications from five months to 56 years after trauma or surgical procedures in the sinus area. Despite its potential for aggressive local destruction, it often presents incidentally with minimal symptoms. This clinical case report describes the occurrence of such a cyst in a 30-year-old male and discusses the diagnosis and management of this rare pathology.
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  • 文章类型: Case Reports
    植物性骨水泥发育不良(FCOD)很少与骨病变有关,包括单纯性骨囊肿(SBC)。文献中仅报道了少数显示这两个不同实体同时出现的病例。本文报告了FCOD内的两例新的SBC。第一例涉及一名37岁的黑人女性,在右下颌第三磨牙的顶点周围有一个大的射线可透性病变,下颌牙齿周围伴有多处骨骨质损伤。手术探查发现一个空的骨腔,确认SBC的诊断。刮除骨壁以刺激愈合,在9个月的随访中观察到有希望的结果。第二例涉及一名44岁的黑人女性,在左下颌第三磨牙的拔除部位出现射线可透病变,而在右第一下颌磨牙的顶端区域出现轻微的射线可透/射线不透病变。手术探查证实了左下颌第三磨牙区域的SBC,并进行了骨活检。组织病理学分析证实FCOD。再次使用骨壁刮除来通过增加出血来促进愈合。在30个月的随访中,出现了新的发育不良病变,最初的SBC已经完全愈合,在左下颌第二前磨牙的根尖区域似乎出现了新的SBC。这些病例强调了在明确的射线可透病变的鉴别诊断中考虑SBC的重要性,并证明了SBC相关FCOD的手术干预可以产生良好的结果。从这些案例中,我们了解到准确诊断以避免不必要治疗的迫切需要,以及定期随访以监测复发或新病灶的价值.
    Florid cemento-osseous dysplasia (FCOD) can rarely be associated with bone lesions, including simple bone cysts (SBCs). Only a few cases showing the co-occurrence of these two distinct entities have been reported in the literature. This article reports two new cases of SBCs within FCOD. The first case involves a 37-year-old Black female with a large radiolucent lesion around the apex of the right third mandibular molar, accompanied by multiple cemento-osseous lesions around the mandibular teeth. Surgical exploration revealed an empty bone cavity, confirming the diagnosis of an SBC. Curettage of the bone walls was performed to stimulate healing, with promising results observed at the nine-month follow-up. The second case concerns a 44-year-old Black female presenting with a radiolucent lesion at the site of extraction of the left third mandibular molar and a slightly painful radiolucent/radio-opaque lesion in the apical region of the right first mandibular molar. Surgical exploration confirmed an SBC in the region of the left third mandibular molar and a bone biopsy was made. Histopathological analysis confirmed FCOD. Curettage of the bone wall was again used to promote healing through increased bleeding. At the 30-month follow-up, new dysplastic lesions had appeared, the initial SBC had healed completely, and a new SBC seemed to have developed in the apical region of the left second mandibular premolar. These cases highlight the importance of considering SBCs in the differential diagnosis of well-defined radiolucent lesions and demonstrate that surgical intervention for SBC-associated FCOD can yield favorable outcomes. From these cases, we learn the critical need for accurate diagnosis to avoid unnecessary treatments and the value of regular follow-up to monitor for recurrence or new lesions.
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  • 文章类型: Journal Article
    内质网(ER)是蛋白质合成的关键,运输,和折叠,以及钙的储存,脂质和类固醇合成,和碳水化合物代谢。内质网应激(ERS)发生在错误折叠或未折叠的蛋白质由于蛋白质分泌增加或折叠受损而在内质网腔中积累时。虽然ERS在疾病发病机制中的作用已被广泛研究,大多数研究都集中在口外疾病上,ERS在口腔疾病中的作用尚不清楚。本文综述了ERS在口腔疾病和口腔纤维化发病机制中的作用。到2023年7月,在MEDLINE数据库(通过PubMed)中使用与ERS相关的特定术语对文献进行了系统搜索,口腔疾病,和纤维化。研究结果以表格和叙述形式进行了总结。新出现的证据表明ERS显著有助于口腔疾病和纤维化的发病机理。ERS诱导的蛋白质折叠和未折叠的蛋白质反应的失调可导致口腔组织中的细胞功能障碍和炎症。了解ERS与口腔疾病发病机制之间的关系可以为管理口腔健康和纤维化相关并发症提供新的治疗靶标。
    The endoplasmic reticulum (ER) is crucial for protein synthesis, transport, and folding, as well as calcium storage, lipid and steroid synthesis, and carbohydrate metabolism. Endoplasmic reticulum stress (ERS) occurs when misfolded or unfolded proteins accumulate in the ER lumen due to increased protein secretion or impaired folding. While the role of ERS in disease pathogenesis has been widely studied, most research has focused on extraoral diseases, leaving the role of ERS in intraoral diseases unclear. This review examines the role of ERS in oral diseases and oral fibrosis pathogenesis. A systematic search of literature through July 2023 was conducted in the MEDLINE database (via PubMed) using specific terms related to ERS, oral diseases, and fibrosis. The findings were summarized in both table and narrative form. Emerging evidence indicates that ERS significantly contributes to the pathogenesis of oral diseases and fibrosis. ERS-induced dysregulation of protein folding and the unfolded protein response can lead to cellular dysfunction and inflammation in oral tissues. Understanding the relationship between ERS and oral disease pathogenesis could offer new therapeutic targets for managing oral health and fibrosis-related complications.
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    文章类型: Journal Article
    临床决策和生物医学研究在很大程度上依赖于成像技术来可视化组织形态。为了详细检查组织,有必要使用特殊的组织化学染色来增强对比度。这项荟萃分析旨在评估这些染色在诊断口腔病理标本中的敏感性和特异性。我们在8个数据库中进行了搜索,包括EMBASE,PubMed,WebofScience,Scopus,ProQuest,奥维德,Cinahl,还有Cochrane,到2022年6月。在87,393项研究中,我们选择了41篇文章纳入我们的研究。结果表明,特殊组织化学染色的特异性和敏感性分别为86%,置信区间(CI)95%:80%-90%和83%,CI95%:75%-89%,分别。在评估的污渍中,甲苯胺蓝,巴帕尼科洛,银染,Giemsa,克,Feulgen,高碘酸希夫(PAS)是最常用的恶性肿瘤检测,癌前病变,发育不良,和念珠菌病。分别分析每种染色的特异性和敏感性,考虑到标本的类型。甲苯胺蓝是最常用的特殊组织化学染色,特别有效,为了检测恶性肿瘤,CI95%:88%-99%的特异性为97%,CI95%:56%-89%的敏感性为76%。总之,特殊的组织化学染色可有效诊断口腔病变,表现出合理的特异性和敏感性,尤其是在癌前病变和恶性病变的情况下。根据我们研究中的评论文章,银染被鉴定为高度敏感,而Giemsa和Papanicolaou染色表现出最高的特异性。
    Clinical decision-making and biomedical research heavily rely on imaging techniques to visualize tissue morphology. To examine tissues in detail, it is necessary to use special histochemical stains to enhance contrast. This meta-analysis aimed to assess the sensitivity and specificity of these stains in diagnosing oral pathologic specimens. We conducted a search in 8 databases, including EMBASE, PubMed, Web of Science, Scopus, ProQuest, Ovid, Cinahl, and Cochrane, up to June 2022. Of 87,393 studies, 41 articles were selected for inclusion in our study. The results revealed that the specificity and sensitivity of the special histochemical stains were 86% with confidence interval (CI) 95%: 80%-90% and 83% with CI 95%: 75%-89%, respectively. Among the stains evaluated, toluidine blue, Papanicolaou, silver stain, Giemsa, Gram, feulgen, and periodic acid-Schiff (PAS) were the most frequently used for the detection of malignancy, premalignant lesions, dysplasia, and candidiasis. The specificity and sensitivity of each stain were analyzed individually, considering the type of specimen. Toluidine blue was the most commonly utilized special histochemical stain, particularly effective, for detecting malignancy, with a specificity of 97% with CI 95%: 88%-99% and sensitivity of 76% with CI 95%: 56%-89%. In conclusion, special histochemical stains are effective in diagnosing oral lesions, exhibiting reasonable specificity and sensitivity, especially in cases of premalignant and malignant lesions. Based on the reviewed articles in our study, the silver stain was identified as highly sensitive, while Giemsa and Papanicolaou stain exhibited the highest specificity.
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  • 文章类型: Journal Article
    目的:分析在口腔医学和病理学领域的高影响因子期刊上发表的文章的作者身份的性别不平等和趋势。
    方法:从2000年至2022年发表的原始文章中检索了第一作者和最后作者的性别和国家。进行泊松回归模型以及分类和回归树(CART)分析。
    结果:共分析了6595项研究的第一作者身份,和6627的最后作者身份。第一作者中只有39.2%(CI95%38.0-40.3)和最后作者中的24.1%(CI95%23.1-25.1)是女性。在整个23年的评估中,女性始终面临代表性不足的问题。女性第一作者不是少数的唯一地区是拉丁美洲。由女性担任最后一位作者,女性在第一作者中的患病率增加了42%(PR=1.42,CI95%[1.30-1.54])。CART最重要的判别变量是第一作者区域。
    结论:尽管在此期间,代表性不足的情况略有下降,2020年后,第一作者和最后作者的性别差距都有扩大的趋势。至关重要的是实施旨在吸引、retaining,在科学领域提升女性,同时还积极监测实现性别平等的进展。
    OBJECTIVE: To analyze gender inequities and trends in the authorship of articles published in high-impact factor journals of the field of Oral Medicine and Pathology.
    METHODS: The gender and country of first and last authors were retrieved from original articles published between 2000 and 2022. Poisson regression models and classification and regression tree (CART) analysis were performed.
    RESULTS: A total of 6595 studies were analyzed for first authorship, and 6627 for last authorship. Only 39.2% (CI 95% 38.0-40.3) of the first authors and 24.1% (CI 95% 23.1-25.1) of the last authors were females. Females consistently faced underrepresentation throughout the 23-year evaluation. The only region where female first authors are not a minority is Latin America. Having a female as the last author increased the prevalence of females in the first author position by 42% (PR = 1.42, CI 95% [1.30-1.54]). The most important discriminant variable by CART was the first author region.
    CONCLUSIONS: Although a slight decrease in underrepresentation was noted over the period, after 2020, the gender gap tended to widen for both first and last authors. It is crucial to implement measures aimed at attracting, retaining, and advancing women in the field of science, while also actively monitoring advancements toward achieving gender equity.
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  • 文章类型: Journal Article
    口腔局灶性粘液病(OFM)是1974年首次描述的罕见病变,但病因尚不清楚。临床上,OFM表现为无症状性结节性病变,临床特征与其他软组织损伤的相似性使诊断变得困难。这项研究的目的是整合人口统计学,临床,和组织病理学特征从以前发表的OFM病例纳入系统评价。在以下数据库中进行了无发布日期限制的电子搜索:Embase,PubMed,Medline,WebofScience,还有Scopus.包括以英文发表并提供足够的临床和组织病理学信息的OFM病例报告或病例系列。这项系统评价确定了来自12个国家的42项研究,包括113例OFM。这种病变影响了女性多于男性,通常在生命的第四个十年。牙龈是最常见的解剖位置,其次是味觉。临床表现最常见的是无症状结节。影像学检查显示,大多数病例没有骨骼受累。手术切除是大多数病例的首选治疗方法,仅报告了一例复发病例。总之,OFM是一种罕见的病理学,其诊断依赖于组织病理学分析。该病变可作为口腔良性软组织病变的鉴别诊断。尤其是那些影响牙龈的。
    Oral focal mucinosis (OFM) is a rare lesion first described in 1974, but the aetiology remains unknown. Clinically, OFM presents as an asymptomatic nodular lesion and the similarity of clinical features to other soft tissue injuries makes the diagnosis difficult. The aim of this study was to integrate the demographic, clinical, and histopathological characteristics from previously published cases of OFM into a systematic review. Electronic searches without publication date restriction were performed in the following databases: Embase, PubMed, Medline, Web of Science, and Scopus. Case reports or case series of OFM published in English and presenting enough clinical and histopathological information were included. This systematic review identified 42 studies from 12 countries, comprising 113 cases of OFM. This lesion affected more females than males, usually in the fourth decade of life. The gingiva was the most common anatomical location, followed by the palate. Clinical presentation was most often an asymptomatic nodule. Imaging exams revealed that most cases did not have bone involvement. Surgical removal was the treatment of choice for most cases and only one recurrent case was reported. In conclusion, OFM is an uncommon pathology, and its diagnosis depends on histopathological analysis. The lesion could be included as a differential diagnosis of benign soft tissue lesions of the oral cavity, especially those affecting the gingiva.
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  • 文章类型: Case Reports
    外植体间充质软骨黏液样肿瘤(ECT)是一种罕见的软组织肿瘤,具有独特的组织发生,表现出对舌背的偏爱。分子证据表明,它可能源于外胚间充质多能细胞从神经c迁移到舌头,这些细胞可能最终增殖并经历粘液样和软骨样分化。本文说明了一例16岁的女性患者,她的舌背结节,已经存在了四年。进行了手术切除,组织病理学分析显示,在含有软骨样区域的松散基质中,由多边形和梭形细胞组成的粘液样瘤变。在免疫组织化学研究中,肿瘤细胞GFAP和S-100蛋白阳性,确认ECT的诊断。经过5年的随访,患者没有复发的证据。虽然罕见,由于其独特的临床特征,ECT可以直接诊断,组织病理学,和免疫组织化学特征。临床医生和病理学家应该熟悉这种肿瘤,以避免误诊。
    Ectomesenchymal chondromyxoid tumor (ECT) is a rare soft tissue tumor with peculiar histogenesis, exhibiting a predilection for the dorsum of the tongue. Molecular evidence suggests that it may originate from the migration of ectomesenchymal pluripotent cells from the neural crest to the tongue, where these cells may eventually proliferate and undergo myxoid and chondroid differentiation. This article illustrates a case of a 16-year-old female patient who presented with a nodule on the dorsum of her tongue, which had been present for four years. Surgical excision was performed, and histopathological analysis revealed a myxoid neoplasia composed of polygonal and spindle cells within a loose stroma containing chondroid areas. Tumor cells were positive for GFAP and S-100 proteins on immunohistochemical study, confirming the diagnosis of ECT. After a 5-year follow-up, the patient has shown no evidence of recurrence. Although rare, ECT can be diagnosed straightforwardly due to its distinctive clinical, histopathological, and immunohistochemical features. Clinicians and pathologists should become familiar with this tumor in order to avoid misdiagnosis.
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  • 文章类型: Case Reports
    脂肪瘤是人体最常见的间质瘤之一,在40至60岁之间表现出更高的患病率。然而,原发性口内脂肪瘤是罕见的。粘液样脂肪瘤,以丰富的粘液成分为特征,是一种特别罕见的脂肪瘤组织学亚型.这项研究提出了两例发生在常见年龄范围之外的粘液样脂肪瘤,一个在67岁男性的右颌下区域,另一个在3岁儿童的下唇。通过这些病例报告,目的是引入粘液样脂肪瘤,一种影响面部区域的罕见亚型,并提供一个简短的审查,以协助鉴别诊断,强调病理评估的重要性。即使在年龄组和解剖位置通常不与脂肪瘤相关,强调仔细评估的必要性至关重要。
    Lipomas are one of the most common mesenchymal tumors in the human body, exhibiting a heightened prevalence between the ages of 40 and 60 years. However, primary intraoral lipomas are rare. Myxoid lipoma, which is characterized by abundant mucoid components, is a particularly rare histological subtype of lipoma. This study presents two cases of myxoid lipoma that occurred outside the common age range for occurrence, one in the right submandibular area of a 67-year-old male and the other in the lower lip of a 3-year-old child. Through these case reports, the aim was to introduce myxoid lipoma, a rare subtype affecting facial areas, and provide a brief review to assist in the differential diagnosis, emphasizing the importance of pathological assessment. Even in age groups and anatomical locations not typically associated with lipomas, it is crucial to emphasize the necessity of careful evaluation.
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  • 文章类型: Journal Article
    背景:牙囊肿,被认为是发展起源,良性牙源性囊肿的特征是逐渐生长的速度。它们在男性中的发生率是女性的两倍。这些囊肿被认为是影响颌骨的最常见的发育性囊肿,在20至40岁的个体中具有典型表现,而在幼儿中很少发现。值得注意的是,牙质囊肿有可能达到显著的尺寸,导致下颌无痛扩大和随后的变形。
    目的:评估10年经验的牙科囊肿的临床病理特征和治疗。
    方法:从经过十年的各种牙病囊肿手术治疗的患者的回顾记录中报告了一些具有挑战性的病例,2012-2022年,仅选择经组织学证实的病例,除了拉希德,拉马迪教学医院,拉齐,伊拉克的Zuhur私人医院和私人诊所。
    结果:76例患者被纳入本临床病理研究。受影响的最高年龄组为≤18岁(68.4%),54%是男性,下颌骨受影响程度(63.1%)高于上颌骨(36.9%)。对30.3%的病例应用了袋化,而69.7%的患者进行了眼球摘除。
    结论:本案例研究证实了对X光片进行细致检查的重要性以及与未发现和未治疗的疾病相关的后果。对口腔病理学的全面了解是牙医的宝贵资源,促进准确诊断,适当的推荐,以及为努力在不同年龄段实现最佳口腔健康的患者提供预期指导。
    BACKGROUND: Dentigerous cysts, deemed of developmental origin, are benign odontogenic cysts characterized by a gradual growth rate. Their occurrence is twice as prevalent in men compared to women. These cysts are recognized as the most frequent developmental cysts affecting the jaws, with a typical manifestation in individuals aged 20 to 40, while infrequently identified in young children. Notably, dentigerous cysts have the potential to attain significant dimensions, resulting in painless enlargement of the jaw and subsequent deformation.
    OBJECTIVE: To assess the clinicopathological features and management of ten years of experience with dentigerous cysts.
    METHODS: A challenging cases were reported from reviewed records of the patients who were treated by the surgical intervention of various dentigerous cysts throughout the period of ten years, 2012-2022 and only histologically confirmed cases were selected, at Ramadi Teaching Hospital in addition to Rashid, Razi, Zuhur Private Hospitals and private clinics in Iraq.
    RESULTS: 76 patients were included in this clinicopathological research. The highest age group affected was ≤ 18 years (68.4%), 54% were male, the mandible was more affected (63.1%) than the maxilla (36.9%). Marsupialization was applied to 30.3% of the cases, while enucleation was carried out in 69.7%.
    CONCLUSIONS: The significance of meticulous examination of radiographs and the consequences associated with undetected and untreated ailments is affirmed by this case study. A comprehensive understanding of oral pathology serves as a valuable resource for dentists, facilitating accurate diagnosis, appropriate referrals, and the provision of anticipatory guidance to patients striving to achieve optimal oral health across various age groups.
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  • 文章类型: Journal Article
    背景:口腔鳞状细胞癌(OSCC)是全球最常见的癌症之一。OSCC诊断的延迟可能对管理和患者预后产生重大影响。口腔管理中最关键的因素之一是及时的组织病理学最终诊断。周转时间(TAT)被认为是质量性能评估的最重要组成部分。尽管计算机化取得了进步,但许多实验室仍在努力改善其TAT,运输系统,和分析技术。目的:本研究旨在评估OSCC病例的TAT,评估平均TAT周期,评估任何TAT延迟,并探讨TAT延误背后的原因。材料和方法:Saveetha牙科学院和医院的OSCC报告,钦奈,从2022年1月1日至2022年12月31日的一年内,从牙科信息档案软件(DIAS)检索,并记录了平均TAT。Further,还观察到TAT延迟的病例数,列出了他们拖延的原因。使用IBMSPSSStatisticsforWindows执行描述性统计和图形表示,V.23.0(IBM公司,Armonk,NY,美国)。进行单向ANOVA,其中显著性设定为小于0.05的p值。
    结果:检索到230例OSCC病例,并纳入本研究的TAT评估。230例,161例(70%)为切口活检,69例(30%)为切除活检。只有7例(4%)切口病例和7例(10%)切除活检显示TAT延迟。TAT延迟的最常见原因是需要更深的切片和骨标本的脱钙。在161例切口病例中,只有48人(29%)接受了切除和进一步治疗。在69例切除病例中,有21例(30%)是来自其他私人机构的转介病例。12个月的总平均TAT对于切开活检为3.24±0.41天,对于切除活检为11.88±2.07天。单因素方差分析显示统计学显著的p值小于0.00001。
    结论:我们的研究揭示了TAT延迟的具体挑战和改善TAT的机会。这可以导致OSCC报告的更快的TAT,进一步改善患者护理,并启用及时治疗。这项研究量化了OSCC病例的TAT,并确定了工艺改进的关键领域。这些发现可以为简化诊断工作流程的策略提供信息,减少延误,并最终提高对OSCC患者的及时护理。
    BACKGROUND: Oral squamous cell carcinoma (OSCC) is one of the most common cancers worldwide. A delay in the diagnosis of OSCC can have a drastic impact on management and patient outcomes. One of the most crucial elements in oral management is the timely histopathological final diagnosis. Turnaround time (TAT) is regarded as the most important component of the quality performance evaluation. Many labs have struggled to improve their TATs despite advancements in computerization, transport systems, and analytical technologies.  Aim: This study aimed to assess the TAT of OSCC cases, assess the mean TAT period, evaluate any TAT delays, and explore the reasons behind the TAT delays.  Materials and methods: OSCC reports in Saveetha Dental College and Hospitals, Chennai, for one year from January 1, 2022, to December 31, 2022, were retrieved from the Dental Information Archival Software (DIAS), and the mean TAT was noted. Further, the number of cases with delay in TAT was also observed, and the reason for their delay was listed. Descriptive statistics and graphical representation were performed utilizing IBM SPSS Statistics for Windows, V. 23.0 (IBM Corp., Armonk, NY, USA). One-way ANOVA was performed with a significance set at a p-value less than 0.05.
    RESULTS: 230 OSCC cases were retrieved and included in the TAT evaluation for this study. Among 230 cases, 161 (70%) were incisional and 69 (30%) were excisional biopsies. Only seven (4%) incisional cases and seven (10%) excisional biopsies showed a delay in TAT. The most common reason for the delay in TAT was the requirement for deeper sections and decalcification of bone specimens. Out of 161 incisional cases, only 48 (29%) have undergone excision and further treatment. Twenty-one out of 69 (30%) excisional cases were found to be referral cases from other private institutions. The overall average TAT for 12 months was 3.24 ± 0.41 days for incisional biopsies and 11.88 ± 2.07 days for excisional biopsies. One-way ANOVA revealed a statistically significant p-value of less than 0.00001.
    CONCLUSIONS: Our study sheds light on specific challenges in TAT delay and opportunities for the improvement of TAT. This can result in faster TAT of OSCC reports, further improve patient care, and enable prompt treatment. This study quantified the TAT for OSCC cases and identified critical areas for process improvement. The findings can inform strategies to streamline diagnostic workflows, reduce delays, and ultimately improve the timely delivery of care to patients with OSCC.
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