orofacial pain

口面部疼痛
  • 文章类型: Journal Article
    背景:颞下颌关节紊乱病(TMD)包括一系列口面疾病,其特征是颞下颌关节和周围结构的疼痛和功能障碍。吸烟已被认为是影响TMD患病率和强度的潜在因素。然而,由于研究结局的差异,这种关系的性质和程度尚不清楚.本系统综述旨在巩固现有研究结果,阐明吸烟与TMD疼痛强度之间的关系。
    方法:对电子数据库进行了全面搜索,以确定截至2023年6月发表的相关研究。包括调查吸烟与TMD疼痛之间关系的研究。数据提取由两名评审员进行。使用新城堡-渥太华量表进行质量评估。审查经理5.4用于定量分析结果。
    结果:该综述包括采用类似TMD评估技术的四项研究。所有研究都报告了烟草使用者的TMD疼痛强度升高,非吸烟者表现出较低的疼痛强度。纳入研究的质量良好。Meta分析结果显示,吸烟组TMD疼痛强度高于不吸烟组,加权平均差(WMD)为0.65(BPM)(95%CI:[0.10,1.19],p=.02)。
    结论:本系统综述提供了关于吸烟和TMD症状的现有文献的综合。这些发现强调了吸烟与TMD疼痛之间关系的多面性,强调其临床相关性和需要量身定制的干预措施。需要进一步的研究来阐明潜在的机制和潜在的调节因素,有助于对这种复杂的联系有更细致的理解。
    BACKGROUND: Temporomandibular disorders (TMDs) encompass a spectrum of orofacial conditions characterised by pain and dysfunction in the temporomandibular joint and surrounding structures. Tobacco smoking has been posited as a potential factor influencing the prevalence and intensity of TMD. However, the nature and extent of this relationship remain unclear due to variations in study outcomes. This systematic review aimed to consolidate existing research findings to elucidate the association between tobacco smoking and TMD pain intensity.
    METHODS: A comprehensive search of electronic databases was conducted to identify relevant studies published up to June 2023. Studies investigating the relationship between tobacco smoking and TMD pain were included. Data extraction was conducted by two reviewers. Quality assessment was performed using the New Castle-Ottawa scale. Review Manager 5.4 was used to quantitatively analyse the results.
    RESULTS: The review included four studies employing similar TMD assessment techniques. All studies reported elevated TMD pain intensity among tobacco users, with non-smokers exhibiting lower pain intensity. The quality of the included studies was good. Meta-analytic results showed that TMD pain intensity was higher in the smokers group compared to the non-smokers group, with a weighted mean difference (WMD) of 0.65 (BPM) (95% CI: [0.10, 1.19], p = .02).
    CONCLUSIONS: This systematic review provides a comprehensive synthesis of the existing literature on tobacco smoking and TMD symptoms. The findings underscore the multifaceted nature of the relationship between smoking and TMD pain, highlighting its clinical relevance and the need for tailored interventions. Further research is warranted to elucidate underlying mechanisms and potential moderating factors, contributing to a more nuanced understanding of this complex association.
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  • 文章类型: Journal Article
    背景:颞下颌关节紊乱病(TMD)经常引起口面部疼痛和功能障碍,从保守疗法到侵入性外科手术的治疗选择。这项系统评价的目的是分析和比较保守药物的疗效和安全性。诊断为TMD和椎间盘移位的患者的微创干预和外科手术。
    方法:遵循PRISMA建议,PubMed,Scopus,和WebofScience数据库被搜索随机临床试验(RCT)。将数据合成在表格中,并通过Cochrane偏倚风险2(RoB2)工具进行评估。
    结果:38项RCT,大多数是适度的RoB,被选中。保守的方法,包括物理治疗和咬合装置,导致症状和功能的改善。药物治疗在减轻疼痛和改善功能方面表现出有效性;然而,它们可能有不良的副作用。微创和侵入性治疗也证明了疗效,尽管大多数试验未显示其优于保守治疗.
    结论:TMD的主要方法应该是保守的,根据患者投诉和特征量身定制的多模式治疗计划。治疗目标应集中在症状控制和功能恢复上。对于诊断准确、病因明确的病例,应保留手术治疗。
    BACKGROUND: Temporomandibular disorders (TMDs) frequently cause orofacial pain and dysfunction, with treatment options spanning from conservative therapies to invasive surgical procedures. The aim of this systematic review was to analyze and compare the efficacy and safety profiles of conservative, minimally invasive interventions and surgical procedures in patients diagnosed with TMDs and disc displacement.
    METHODS: Following PRISMA recommendations, PubMed, Scopus, and Web of Science databases were searched for randomized clinical trials (RCT). Data were synthesized in a table and evaluated through the Cochrane risk of bias 2 (RoB 2) tool.
    RESULTS: Thirty-eight RCTs, most with moderate RoB, were selected. Conservative approaches, including physical therapy and occlusal devices, led to an improvement in symptoms and function. Pharmacological treatments demonstrated effectiveness in reducing pain and improving function; however, they can have undesirable side effects. Minimally invasive and invasive treatments also demonstrated efficacy, although most trials did not show their superiority to conservative treatments.
    CONCLUSIONS: The primary approach to TMDs should be a conservative, multimodal treatment plan tailored to patient complaints and characteristics. Treatment goals should focus on symptom control and functional recovery. Surgical treatment should be reserved for cases with a precise diagnosis and a clear etiology.
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  • 文章类型: Journal Article
    目的:本系统综述总结了随机对照试验(RCT)报告的结果,旨在评估与颞下颌关节紊乱病(DC/TMD)相关的耳鸣患者的不同治疗方法,以及影响治疗结果的可能预测因素。
    方法:电子数据库Medline,WebofScience,截至2023年3月,系统搜索了拉丁美洲和加勒比健康科学文献(LILAC)。本研究仅包括具有全文的RCT。所选RCT的资格是基于PICO模型(参与者,干预,比较器,结果),和任何年龄的受试者,性别或种族,当显示耳鸣和TMD时,通过DC/TMD标准诊断。
    结果:在总共635篇文章中,仅纳入5项RCT,共纳入329名参与者的数据.两项RCT重点研究了多学科方法在患有TMD的耳鸣患者中的疗效;两项RCT检查了预测多学科口面治疗后阳性结果的预后指标;一项RCT分析了Nd:YAG激光低水平激光治疗的有效性。
    结论:多学科非侵入性方法是治疗TMD患者耳鸣的最有效方法。基线耳鸣严重程度,性别,生活质量,年龄,和耳鸣持续时间被认为是诊断为DMT和转诊耳鸣的患者临床结局的预测因素。
    OBJECTIVE: This systematic review summarised the results reported in randomised controlled trials (RCTs) aimed at evaluating the different treatment approaches in patients with tinnitus associated with temporomandibular disorders (TMD) evaluated with the diagnostic criteria of temporomandibular disorders (DC/TMD), and the possible predictive factors influencing treatment outcomes.
    METHODS: The electronic databases Medline, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACs) were searched systematically up to March 2023. Only RCTs with full texts were included in this study. The eligibility of the RCTs selected was based on the PICO model (participants, intervention, comparators, outcomes), and subjects of any age, sex or ethnicity, were included when showing both tinnitus and TMD, diagnosed through DC/TMD criteria.
    RESULTS: From a total of 635 articles, only five RCTs were included and the data from a total of 329 participants were examined. Two RCTs focused on the efficacy of the multidisciplinary approach among people with tinnitus who have TMD; two RCTs examined prognostic indicators predicting a positive outcome after multidisciplinary orofacial treatment; one RCT analysed low-level laser therapy\'s effectiveness with Nd:YAG laser.
    CONCLUSIONS: A multidisciplinary non-invasive approach is the most efficacious treatment for tinnitus in patients diagnosed with TMD. Baseline tinnitus severity, gender, quality of life, age, and tinnitus duration were considered predictive factors of clinical outcomes in patients diagnosed with DMTs and referring tinnitus.
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  • 文章类型: Journal Article
    背景:幼年特发性关节炎(JIA)是儿童时期最常见的风湿性疾病,和颞下颌关节(TMJ)涉及39%-78%的患者。
    目的:本系统评价的目的是评估保守治疗方法改善JIA患儿和青少年TMJ关节炎的有效性。
    方法:PubMed,Scopus,从一开始到2024年2月25日,对WebofScience进行了系统搜索,以确定观察性研究,这些研究表明参与者被诊断为影响TMJ的JIA,颞下颌关节炎的康复方法作为干预措施,和TMJ关节炎的临床或放射学评估作为结果。
    结果:在478篇适合标题/摘要筛选的论文中,共纳入13项研究。这些研究评估了关节内(IA)皮质类固醇(CS)注射的有效性,IA英夫利昔单抗注射液,关节穿刺术单独或与IACS注射相结合,咬合夹板,功能电器,和物理治疗。IACS注射的有效性在8项研究中显示。IA英夫利昔单抗注射似乎并未显着改善TMJ关节炎。
    结论:这项系统评价的结果表明,保守治疗,尤其是IACS注射,可能有效改善JIA患者的TMJ关节炎。应进行更高水平的证据和更具代表性的样本的进一步研究。
    BACKGROUND: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%-78% of patients.
    OBJECTIVE: The aim of this systematic review was to assess the effectiveness of conservative approaches in improving TMJ arthritis in children and adolescents affected by JIA.
    METHODS: PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2024, to identify observational studies presenting participants with a diagnosis of JIA affecting the TMJ, rehabilitative approaches for TMJ arthritis as interventions, and clinical or radiological assessment of TMJ arthritis as outcome.
    RESULTS: Of 478 papers suitable for title/abstract screening, 13 studies were included. The studies evaluated the effectiveness of intra-articular (IA) corticosteroid (CS) injections, IA infliximab injections, arthrocentesis alone or in combination with IACS injections, occlusal splint, functional appliance, and physiotherapy. The effectiveness of IACS injections was shown in eight studies. IA infliximab injections did not appear to significantly improve TMJ arthritis.
    CONCLUSIONS: Results of this systematic review suggested that conservative treatments, especially IACS injections, might be effective in improving TMJ arthritis in patients affected by JIA. Further studies with a higher level of evidence and more representative samples should be conducted.
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  • 文章类型: Journal Article
    当前的系统评价旨在评估当前关于局部应用辣椒素以减轻与灼口综合征(BMS)相关的症状的作用的证据。PubMed,OvidSP,和Cochrane从1980年到2022年进行了搜索,以确定相关文献。总共942种图书(PubMed,84;奥维德·SP,839;科克伦,19)被取回,其中936项根据标题和摘要被排除在外。共有11项研究进一步评估全文分析,其中7人被排除在外。因此,包括4篇文章进行数据的定性综合。辣椒素作为漱口水可以在治疗与灼口有关的症状中具有潜在的应用。现有研究的质量是中等到较低的,计划进行一项精心设计的随机多中心研究,将辣椒素与其他活性剂进行比较,以获得更明确的结论。
    This current systematic review aimed to evaluate the current evidence on the effect of topical capsaicin application to alleviate symptoms related to burning mouth syndrome (BMS). PubMed, Ovid SP, and Cochrane were searched from 1980 to 2022 to identify relevant literature. A total of 942 titles (PubMed, 84; Ovid SP, 839; Cochrane, 19) was retrieved, of which 936 were excluded based on the title and abstract. A total of 11 studies were further evaluated for full text analysis, of which 7 were excluded. As a result, 4 articles were included for qualitative synthesis of data. Capsaicin as a mouthwash can have potential application in the treatment of symptoms related to burning mouth. The quality of available studies is moderate to low, and a well-designed randomized multicentric study comparing capsaicin with other active agents is planned to obtain more definitive conclusions.
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  • 文章类型: Journal Article
    口面部疼痛的发生通常伴有共病,例如抑郁症。尽管以前的研究表明口面部疼痛和心理因素之间存在双向相关性,一些研究仍然提供了矛盾的结果。
    本系统综述旨在为已发表文献中关于口面部疼痛和抑郁之间的关联提供科学证据。
    当前的研究是一项系统的文献综述(PROSPERO注册号:CRD42023438596)是通过回顾横断面研究来进行的,这些研究调查了口面部疼痛与抑郁之间的关联。文章选择是根据系统审查和荟萃分析(PRISMA)指南的首选报告项目进行的。文章搜索是通过使用三个数据库进行的,即PubMed,ScienceDirect,和Scopus使用布尔运算符方法。文章筛选是通过应用纳入和排除标准进行的,以及重复检查,适用性检查,和兼容性检查。经过审查的文章通过了乔安娜·布里格斯研究所(JBI)的偏见风险评估表。以定性方法分析提取的数据。
    对5557名参与者进行的12项研究被纳入最终审查。在分析了所有文章之后,揭示了口面部疼痛与抑郁之间的相关性。大多数文章显示口面疼痛和抑郁之间存在正相关,其余的研究显示,与没有口面疼痛的患者相比,口面疼痛患者的抑郁评分明显更高。
    这项系统评价的结果表明,口面部疼痛与抑郁之间存在不同程度的相关性。纳入潜在的抑郁症状治疗,治疗口面部疼痛患者时,应该是治疗计划的一部分。
    UNASSIGNED: The occurrence of orofacial pain is often accompanied by comorbid conditions such as depression. Even though previous studies suggested a bidirectional correlation between orofacial pain and psychological factors, some studies still provided contradictory results.
    UNASSIGNED: This systematic review aimed at providing scientific evidence regarding the association between orofacial pain and depression in published literature.
    UNASSIGNED: The current study is a systematic literature review (PROSPERO registration no. CRD42023438596) that was conducted by reviewing cross-sectional studies that investigated the association between orofacial pain and depression. Article selection was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Articles searching was performed by using three databases, namely PubMed, ScienceDirect, and Scopus using the Boolean operator method. Article screening was carried out by applying the inclusion and exclusion criteria, as well as duplication checking, suitability checking, and compatibility checking. Reviewed articles went through the risk of bias evaluation form from the Joanna Briggs Institute (JBI). Extracted data were analyzed in a qualitative method.
    UNASSIGNED: Twelve studies that were conducted on 5557 participants were included in the final review. After all articles were analyzed, the correlation between orofacial pain and depression was revealed. Most articles revealed a positive correlation between orofacial pain and depression, and the rest showed how orofacial pain patients showed significantly higher depression scores compared to those individuals without orofacial pain.
    UNASSIGNED: The results of this systematic review suggested a correlation between orofacial pain and depression with varying degrees. Incorporating potential depressive symptoms\' treatment, when treating orofacial pain patients, should be part of the treatment plan.
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  • 文章类型: Journal Article
    关于颞下颌关节紊乱病(TMD)发病率的文献通常报道了社会人口统计学因素,例如性别和年龄。然而,其他社会人口统计学因素在TMD中的作用和患病率尚不明确.因此,本范围综述旨在报告TMD患者中社会人口统计学因素的患病率.在PubMed和WebofScience数据库中进行了系统的搜索,以确定成人人群的临床试验,使用TMD研究诊断标准(RDC/TMD)或TMD诊断标准(DC/TMD),并报告TMD患者的社会人口统计学数据。27项符合标准的研究纳入本综述。纳入研究中评估的最常见的社会人口统计学因素是年龄,种族,教育,工作,收入,和婚姻状况。在纳入的研究中,观察到年轻和离婚个体的TMD患病率较高。然而,教育水平的结果相互矛盾,就业不被认为是TMD的危险因素。虽然这篇综述有方法论上的局限性,它表明TMD发病率与某些社会人口统计学因素之间存在关联;然而,需要进一步的研究来更确定这种关系。
    The literature on Temporomandibular Disorders (TMD) incidence commonly reports sociodemographic factors such as gender and age. However, the role and prevalence of other sociodemographic factors in TMD are not well defined. Therefore, this scoping review aimed to report the prevalence of sociodemographic factors in TMD patients. A systematic search was conducted in the PubMed and Web of Science databases to identify clinical trials in adult populations, using the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD) and reporting sociodemographic data in TMD patients. Twenty-seven studies meeting the criteria were included in this review. The most commonly reported sociodemographic factors assessed in the included studies were age, race, education, job, income, and marital status. TMD prevalence was observed to be higher among younger and divorced individuals among the included studies. However, conflicting results were found for education level, and employment was not considered a risk factor for TMD. Although this review has methodological limitations, it suggests an association between TMD incidence and certain sociodemographic factors; nevertheless, further studies are needed to establish this relationship more conclusively.
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  • 文章类型: Systematic Review
    背景:本系统综述调查了轻度认知障碍(MCI)或痴呆患者口面部疼痛的患病率。
    方法:搜索在五个数据库中进行(Medline(Ovid),Embase(Ovid),CINAHL,Scopus和LILACS),在三个灰色文献来源和包含的文章参考列表中。三名独立审稿人进行了研究选择,质量评估和数据提取。使用国立卫生研究院工具评估偏倚风险。使用随机效应模型计算患病率。采用亚组分析和荟萃回归分析研究结果的异质性。
    结果:数据库和灰色文献搜索导致12246个结果,其中包括9项研究;通过引文搜索选择了另外4项。总样本包括6115名痴呆症患者和84名MCI患者。所有研究都有较高的偏倚风险。痴呆参与者口面疼痛的总体估计汇总患病率为19.0%(95%CI,11.0%-27.0%;I2,97.1%,P<.001)。只有一项研究包括MCI参与者,其中口面部疼痛的患病率为20.5%。亚组分析表明,不同的诊断来源可能解释了异质性。在80岁以上或居住在疗养院的痴呆症参与者中,口面部疼痛的患病率更高。Meta回归分析显示年龄与口面部疼痛的患病率之间存在非线性关系。
    结论:来自主要研究的汇总数据显示,10名痴呆患者中有2名患有口面部疼痛。需要进一步的研究来澄清MCI患者的严重程度。
    BACKGROUND: This systematic review investigated the prevalence of orofacial pain in patients with mild cognitive impairment (MCI) or dementia.
    METHODS: The search was conducted in five databases (Medline (Ovid), Embase (Ovid), CINAHL, Scopus and LILACS), in three grey literature sources and in included articles\' reference lists. Three independent reviewers performed study selection, quality appraisal and data extraction. The risk of bias was assessed with the National Institutes of Health tool. Prevalence was calculated using the random-effects model. Subgroup analysis and meta-regression were used to explore the heterogeneity of results.
    RESULTS: The database and grey literature search led to 12 246 results, from which nine studies were included; a further four were selected through citation searching. The total sample comprised 6115 patients with dementia and 84 with MCI. All studies had high risk of bias. The overall estimated pooled prevalence of orofacial pain among dementia participants was 19.0% (95% CI, 11.0%-27.0%; I 2, 97.1%, P < .001). Only one study included MCI participants, among which the prevalence of orofacial pain was 20.5%. Subgroup analysis demonstrated that the different sources of diagnosis might explain the heterogeneity. A higher prevalence of orofacial pain was observed in dementia participants aged over 80 years or living in nursing homes. Meta-regression analysis showed a nonlinear relationship between age and the prevalence of orofacial pain.
    CONCLUSIONS: The pooled data from the primary studies revealed that 2 out of 10 patients with dementia have orofacial pain. Further research is needed to clarify the magnitude in individuals with MCI.
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  • 文章类型: Journal Article
    背景:神经肽在调节疼痛和炎症中起关键作用。尽管越来越多的证据进一步揭示了不同神经肽在口面痛觉和传递中的新功能和机制,缺乏对口面部区域神经肽疼痛调节的系统描述,尤其是在三叉神经系统中.
    目的:本综述旨在总结几种关键神经肽,并更好地了解它们在口面炎症和疼痛中的主要调节作用。
    方法:我们回顾并总结了与降钙素基因相关肽(CGRP)相关的最新研究,P物质(SP),阿片类肽(OP),甘丙肽(GAL)和其他神经肽的功能和机制以及口面疼痛控制的有希望的目标。
    结果:许多神经肽在三叉神经感觉系统中明确表达,并在口面疼痛的转导和发病机理中具有关键功能。功能,可能的细胞和分子机制已经被介绍和讨论。已经评估了神经肽及其激动剂或拮抗剂,它们被广泛研究为口面疼痛的潜在治疗选择。
    结论:各种神经肽在口面疼痛中发挥重要但不同的作用(伤害感受或镇痛),机制不同。总之,CGRP,SP,NPY,NKA,HK-1,VIP主要发挥促炎和伤害性作用,而OP,GAL,OXT,OrxA主要对口面部疼痛有抑制作用。
    BACKGROUND: Neuropeptides play a critical role in regulating pain and inflammation. Despite accumulating evidence has further uncovered the novel functions and mechanisms of different neuropeptides in orofacial pain sensation and transmission, there is deficient systematic description of neuropeptides\' pain modulation in the orofacial region, especially in the trigeminal system.
    OBJECTIVE: The present review aims to summarise several key neuropeptides and gain a better understanding of their major regulatory roles in orofacial inflammation and pain.
    METHODS: We review and summarise current studies related to calcitonin gene-related peptide (CGRP), substance P (SP), opioid peptide (OP), galanin (GAL) and other neuropeptides\' functions and mechanisms as well as promising targets for orofacial pain control.
    RESULTS: A number of neuropeptides are clearly expressed in the trigeminal sensory system and have critical functions in the transduction and pathogenesis of orofacial pain. The functions, possible cellular and molecular mechanisms have been introduced and discussed. Neuropeptides and their agonists or antagonists which are widely studied to be potential treatment options of orofacial pain has been evaluated.
    CONCLUSIONS: Various neuropeptides play important but distinct (pro-nociceptive or analgesic) roles in orofacial pain with different mechanisms. In summary, CGRP, SP, NPY, NKA, HK-1, VIP mainly play proinflammatory and pro-nociceptive effects while OP, GAL, OXT, OrxA mainly have inhibitory effects on orofacial pain.
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  • 文章类型: Journal Article
    面部疼痛是一种复杂的经历,由不同的特征组成,涉及生活的各个方面。它已经证明了一种联系,尤其是慢性的,在焦虑等情况下,抑郁症,和睡眠障碍,通过仍未完全阐明的路径。深入了解口面疼痛及其对个人生活的影响对于规划准确的诊断和治疗方法至关重要。这篇综述旨在全面概述构成疼痛体验的组成部分,它对个人生活的影响,多维疼痛评估的不同工具,以及每个工具的具体应用。使用PubMed进行了全面审查,Scopus,和WebofScience电子数据库。95项研究,包括观察性研究,临床试验,病例对照研究,和病例报告,被纳入本综述并进行了分析。面部疼痛评估利用几种方法,从临床评估到评定量表,问卷,和每日日记。选择正确的仪器需要评估所经历的疼痛类型,患者的特征和完成特定任务的能力,最后,评估工具的特点。
    Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual\'s life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual\'s life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case-control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient\'s characteristics and abilities to complete particular tasks, and finally, of the assessment tool features.
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