AFLP

AFLP
  • 文章类型: Journal Article
    念珠菌的感染比例,近似梭菌复合体的成员,近年来在全球范围内有所增加,和医院爆发已经在几个国家报告。本研究旨在建立基于微卫星位点的分型方法,该方法能够有效区分拟态梭菌分离株。分析三个参考念珠菌基因组序列以鉴定重复基因座。选择含有超过8个双或更多个核苷酸重复的DNA序列。最初总共确定了51个基因座,和基因座特异性引物被设计和测试与20个流行病学无关的分离株。四个位点具有优越的重现性,特异性,并确定了分子分型的分辨率,和综合鉴别力(DP,基于20个流行病学无关的分离株),这四个基因座为1.0。通过持续测试三个菌株,每个菌株一式三份,证明了可重复性,和稳定性,通过测试10个连续段落来证明。然后,我们从中国医院侵袭性真菌监测网研究中收集了48株正骨梭菌非重复临床分离株,以比较基于微卫星的分型与内部转录间隔区(ITS)和扩增片段长度多态性(AFLP)分型分析的DP,使用ATCC96139作为参考菌株。这49个分离株被细分为12个微卫星类型(COMT1-12),六种AFLP类型,和三种ITS类型,虽然所有具有相同COMT的分离株都属于一致的AFLP和ITS类型,证明了我们微卫星型方法的高DP。根据我们的结果,在中国发现COMT12是主要类型,COMT5是第二大的,是导致医院爆发的原因。这种微卫星型方法是区分拟态梭菌的有价值的工具,对于流行病学研究确定菌株相关性和监测传播至关重要。
    The infection proportion of Candida orthopsilosis, a member of the C. parapsilosis complex, has increased globally in recent years, and nosocomial outbreaks have been reported in several countries. This study aimed to establish microsatellite loci-based typing method that was able to effectively distinguish among C. orthopsilosis isolates. Three reference C. orthopsilosis genome sequences were analyzed to identify repeat loci. DNA sequences containing over eight bi- or more nucleotide repeats were selected. A total of 51 loci were initially identified, and locus-specific primers were designed and tested with 20 epidemiologically unrelated isolates. Four loci with excellent reproducibility, specificity, and resolution for molecular typing purposes were identified, and the combined discriminatory power (DP, based on 20 epidemiologically unrelated isolates) of these four loci was 1.0. Reproducibility was demonstrated by consistently testing three strains each in triplicate, and stability, demonstrated by testing 10 successive passages. Then, we collected 48 C. orthopsilosis non-duplicate clinical isolates from the China Hospital Invasive Fungal Surveillance Net study to compare the DP of the microsatellite-based typing with internal transcribed spacer (ITS) and amplified fragment length polymorphism (AFLP) typing analyses, using ATCC 96139 as a reference strain. These 49 isolates were subdivided into 12 microsatellite types (COMT1-12), six AFLP types, and three ITS types, while all the isolates with the same COMT belonged to consistent AFLP and ITS type, demonstrating the high DP of our microsatellite-type method. According to our results, COMT12 was found to be the predominant type in China, and COMT5 was the second largest and responsible for causing a nosocomial outbreak. This microsatellite-type method is a valuable tool for the differentiation of C. orthopsilosis and could be vital for epidemiological studies to determine strain relatedness and monitor transmission.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    孢子丝菌(Ophiostomatales)包括对人类和其他哺乳动物以及环境真菌具有致病性的物种。分子系统发育的发展改变了我们对流行病学的看法,主机协会,和孢子丝菌的毒力。孢子丝菌病的经典剂,申克氏孢子虫,现在包括几个物种嵌套在一个临床进化枝与巴西链球菌,S、globosa,还有S.luriei.为了获得更精确的疫情动态视图,结构,以及孢子丝虫种群内部和种群之间的遗传变异的起源,我们应用了三组歧视性AFLP标记(#3EcoRI-GA/MseI-TT,#5EcoRI-GA/MseI-AG,和#6EcoRI-TA/MseI-AA)和大量人类的交配类型分析,跨越主要流行区的动物和环境分离株。从188个样品中体外扩增出451个多态位点,并显示出较高的多态性信息含量(PIC=0.1765-0.2253),标记指数(MI=0.0001-0.0002),有效复用比(E=15.1720-23.5591),分辨能力(Rp=26.1075-40.2795),鉴别力(D=0.9766-0.9879),期望杂合度(H=0.1957-0.2588),和平均杂合度(Havp=0.000007-0.000009),证明AFLP标记对孢子丝菌的特异性有效。使用程序结构的分析表明三个遗传簇匹配巴西链球菌(种群1),S、申克(人口2),和S.globosa(人口3),在所有人群中都存在混合模式。AMOVA显示高度结构化的簇(PhiPT=0.458-0.484,P<0.0001),在(46-48%)和(52-54%)种群之间具有大致相等的遗传变异性。异性恋是唯一的交配策略,申克S.的MAT1-1或MAT1-2同态分布没有显着偏斜(1:1比例)(χ2=2.522;P=0.122),支持随机交配。相比之下,在以MAT1-1分离株为主的球形链球菌(χ2=9.529;P=0.0020)中发现了偏态分布,巴西链球菌的区域差异突出显示,在里约热内卢(χ2=14.222;P=0.0002)和伯南布哥(χ2=7.364;P=0.0067),与南里奥格兰德州MAT1-1的患病率相比(χ2=7.364;P=0.0067)。流行病学趋势揭示了由于巴西链球菌通过创始人效应引起的猫传播的孢子丝菌病的地理扩展。这些数据支持里约热内卢是导致这种疾病传播到巴西其他地区的起源中心。我们重建源头的能力,传播,从分子数据中对正在进行的疫情的演变为旨在缓解疾病进展的决策提供了高质量的信息。其他用途包括监视,快速诊断,案例连接,并指导获得适当的抗真菌治疗。
    Sporothrix (Ophiostomatales) comprises species that are pathogenic to humans and other mammals as well as environmental fungi. Developments in molecular phylogeny have changed our perceptions about the epidemiology, host-association, and virulence of Sporothrix. The classical agent of sporotrichosis, Sporothrix schenckii, now comprises several species nested in a clinical clade with S. brasiliensis, S. globosa, and S. luriei. To gain a more precise view of outbreaks dynamics, structure, and origin of genetic variation within and among populations of Sporothrix, we applied three sets of discriminatory AFLP markers (#3 EcoRI-GA/MseI-TT, #5 EcoRI-GA/MseI-AG, and #6 EcoRI-TA/MseI-AA) and mating-type analysis to a large collection of human, animal and environmental isolates spanning the major endemic areas. A total of 451 polymorphic loci were amplified in vitro from 188 samples, and revealed high polymorphism information content (PIC = 0.1765-0.2253), marker index (MI = 0.0001-0.0002), effective multiplex ratio (E = 15.1720-23.5591), resolving power (Rp = 26.1075-40.2795), discriminating power (D = 0.9766-0.9879), expected heterozygosity (H = 0.1957-0.2588), and mean heterozygosity (Havp  = 0.000007-0.000009), demonstrating the effectiveness of AFLP markers to speciate Sporothrix. Analysis using the program structure indicated three genetic clusters matching S. brasiliensis (population 1), S. schenckii (population 2), and S. globosa (population 3), with the presence of patterns of admixture amongst all populations. AMOVA revealed highly structured clusters (PhiPT = 0.458-0.484, P < 0.0001), with roughly equivalent genetic variability within (46-48 %) and between (52-54 %) populations. Heterothallism was the exclusive mating strategy, and the distributions of MAT1-1 or MAT1-2 idiomorphs were not significantly skewed (1:1 ratio) for S. schenckii (χ2 = 2.522; P = 0.1122), supporting random mating. In contrast, skewed distributions were found for S. globosa (χ2 = 9.529; P = 0.0020) with a predominance of MAT1-1 isolates, and regional differences were highlighted for S. brasiliensis with the overwhelming occurrence of MAT1-2 in Rio de Janeiro (χ2 = 14.222; P = 0.0002) and Pernambuco (χ2 = 7.364; P = 0.0067), in comparison to a higher prevalence of MAT1-1 in the Rio Grande do Sul (χ2 = 7.364; P = 0.0067). Epidemiological trends reveal the geographic expansion of cat-transmitted sporotrichosis due to S. brasiliensis via founder effect. These data support Rio de Janeiro as the centre of origin that has led to the spread of this disease to other regions in Brazil. Our ability to reconstruct the source, spread, and evolution of the ongoing outbreaks from molecular data provides high-quality information for decision-making aimed at mitigating the progression of the disease. Other uses include surveillance, rapid diagnosis, case connectivity, and guiding access to appropriate antifungal treatment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    副球菌病(PCM)是一种威胁生命的全身性真菌感染,是从环境中吸入副球菌繁殖体后获得的。主要病原体包括巴西疟原虫复合体(系统发育定义的物种S1,PS2,PS3和PS4)和卢兹疟原虫的成员。蛋白质编码基因座的DNA测序(例如,GP43,ARF,和TUB1)是由于缺乏稳健的表型标记而识别副球菌物种的参考方法。因此,开发信息丰富且具有成本效益的新分子标记是提供高质量信息以探索副科植物遗传多样性的关键。我们报告了使用新的扩增片段长度多态性(AFLP)标记和交配型分析来对副球菌物种进行基因分型。生物信息学分析生成了144个计算机AFLP图谱,突出两个区分性引物对组合(#1EcoRI-AC/MseI-CT和#2EcoRI-AT/MseI-CT)。在体外使用组合#1和#2来对从南美洲广大地区回收的165个副球菌分离株进行基因分型。考虑到体外总体评分的AFLP标记(67-87个片段),多态性信息含量值(PIC=0.3345-0.3456),标记指数(MI=0.0018),有效复用率(E=44.6788-60.3818),分辨能力(Rp=22.3152-34.3152),鉴别力(D=0.5183-0.5553),期望杂合度(H=0.4247-0.4443),和平均杂合度(Havp=0.00002-0.00004),证明了AFLP标记可用于形成副球菌并解剖深层和精细遗传结构。分子方差分析(AMOVA)显示,总遗传变异(65-66%)是由于巴西疟原虫复合体和路兹疟原虫之间的变异性(PhiPT=0.651-0.658,P<0.0001),支持高度结构化的人口。异性恋是唯一的交配策略,巴西假单胞菌的MAT1-1或MAT1-2同态分布没有明显偏斜(比例为1:1)。str。(χ2=1.025;P=0.3113),委内瑞拉疟原虫(χ2=0.692;P=0.4054),和P.lutzii(χ2=0.027;P=0.8694),支持每个物种内的随机交配。相比之下,美洲疟原虫(χ2=8.909;P=0.0028)和restrepiensis(χ2=4.571;P=0.0325)的分布呈偏态,MAT1-1占优势。地理分布证实了美洲疟原虫,P.restrepiensis,和P.lutzii比以前想象的更普遍。巴西P.s.str.是迄今为止拉丁美洲国家中出现最广泛的血统,发生在巴西的所有地区。我们新的DNA指纹分析被证明是快速的,可重复,高度歧视,为了深入了解分类法,生态学,和副球菌的流行病学,指导疾病控制策略以减轻PCM。
    Paracoccidioidomycosis (PCM) is a life-threatening systemic fungal infection acquired after inhalation of Paracoccidioides propagules from the environment. The main agents include members of the P. brasiliensis complex (phylogenetically-defined species S1, PS2, PS3, and PS4) and P. lutzii. DNA-sequencing of protein-coding loci (e.g., GP43, ARF, and TUB1) is the reference method for recognizing Paracoccidioides species due to a lack of robust phenotypic markers. Thus, developing new molecular markers that are informative and cost-effective is key to providing quality information to explore genetic diversity within Paracoccidioides. We report using new amplified fragment length polymorphism (AFLP) markers and mating-type analysis for genotyping Paracoccidioides species. The bioinformatic analysis generated 144 in silico AFLP profiles, highlighting two discriminatory primer pairs combinations (#1 EcoRI-AC/MseI-CT and #2 EcoRI-AT/MseI-CT). The combinations #1 and #2 were used in vitro to genotype 165 Paracoccidioides isolates recovered from across a vast area of South America. Considering the overall scored AFLP markers in vitro (67-87 fragments), the values of polymorphism information content (PIC = 0.3345-0.3456), marker index (MI = 0.0018), effective multiplex ratio (E = 44.6788-60.3818), resolving power (Rp = 22.3152-34.3152), discriminating power (D = 0.5183-0.5553), expected heterozygosity (H = 0.4247-0.4443), and mean heterozygosity (H avp  = 0.00002-0.00004), demonstrated the utility of AFLP markers to speciate Paracoccidioides and to dissect both deep and fine-scale genetic structures. Analysis of molecular variance (AMOVA) revealed that the total genetic variance (65-66 %) was due to variability among P. brasiliensis complex and P. lutzii (PhiPT = 0.651-0.658, P < 0.0001), supporting a highly structured population. Heterothallism was the exclusive mating strategy, and the distributions of MAT1-1 or MAT1-2 idiomorphs were not significantly skewed (1:1 ratio) for P. brasiliensis s. str. (χ2 = 1.025; P = 0.3113), P. venezuelensis (χ2 = 0.692; P = 0.4054), and P. lutzii (χ2 = 0.027; P = 0.8694), supporting random mating within each species. In contrast, skewed distributions were found for P. americana (χ2 = 8.909; P = 0.0028) and P. restrepiensis (χ2 = 4.571; P = 0.0325) with a preponderance of MAT1-1. Geographical distributions confirmed that P. americana, P. restrepiensis, and P. lutzii are more widespread than previously thought. P. brasiliensis s. str. is by far the most widely occurring lineage in Latin America countries, occurring in all regions of Brazil. Our new DNA fingerprint assay proved to be rapid, reproducible, and highly discriminatory, to give insights into the taxonomy, ecology, and epidemiology of Paracoccidioides species, guiding disease-control strategies to mitigate PCM.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Published Erratum
    [This corrects the article DOI: 10.3389/fmed.2021.719906.].
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    Acute fatty liver of pregnancy (AFLP) is a rare but potentially life-threatening hepatic disorder that leads to considerable maternal and fetal mortality. To explore the risk factors for maternal and fetal mortality in AFLP and develop new predictive models, through this retrospective study, we analyzed the demographic characteristics, clinical symptoms, and laboratory findings of 106 patients with AFLP who were admitted to Shandong Provincial Hospital. Risk factors for maternal and fetal mortality were analyzed by univariate and multivariate logistic regression analysis. The new models based on the multivariate logistic regression analysis and the model for end-stage liver disease (MELD) were tested in AFLP. The receiver operating characteristic curve (ROC) was applied to compare the predictive efficiency, sensitivity, and specificity of the two models. Prenatal nausea (p = 0.037), prolonged prothrombin time (p = 0.003), and elevated serum creatinine (p = 0.003) were independent risk factors for maternal mortality. The ROC curve showed that the area under the curve (AUC) of the MELD was 0.948, with a sensitivity of 100% and a specificity of 83.3%. The AUC of the new model for maternal mortality was 0.926, with a sensitivity of 90% and a specificity of 94.8%. Hepatic encephalopathy (p = 0.016) and thrombocytopenia (p = 0.001) were independent risk factors for fetal mortality. Using the ROC curve, the AUC of the MELD was 0.694, yielding a sensitivity of 68.8% and a specificity of 64.4%. The AUC of the new model for fetal mortality was 0.893, yielding a sensitivity of 100% and a specificity of 73.3%. Both the new predictive model for maternal mortality and the MELD showed good predictive efficacy for maternal mortality in patients with AFLP (AUC = 0.926 and 0.948, respectively), and the new predictive model for fetal mortality was superior to the MELD in predicting fetal mortality (AUC = 0.893 and 0.694, respectively). The two new predictive models were more readily available, less expensive, and easier to implement clinically, especially in low-income countries.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Comparative Study
    絮状表皮生长因子是人类浅表真菌感染的最常见因子之一,与毛癣菌属和小孢子菌属相比,它具有独特的生态特征,很少引起头发感染。到目前为止,絮状大肠杆菌是表皮植物属的唯一代表性物种,它被称为嗜人性皮肤癣菌。为了进一步揭示毒力因子的基因组序列和线索,因此,在这项研究中,我们对絮状芽孢杆菌(CGMCC(F)E1d)的基因组进行了测序,并与其他皮肤癣菌进行比较基因组分析。结果表明,与其他皮肤癣菌相比,絮凝剂具有最大的基因组大小和相似的GC含量。预测了总共7565个基因。通过与最接近的石膏N.物种进行比较,我们的研究揭示了粘附因子的数量和结构,分泌的蛋白酶和LysM结构域可能与絮凝大肠杆菌的致病和生态特性有关。在基因组数据中也检测到交配基因。此外,我们进行了AFLP分析,试图讨论絮凝剂的种内差异,但基因型与地理分布之间没有显著关系。在上面,我们的研究为今后对絮凝剂的研究提供了更深入的理解和坚实的基础。
    Epidermophyton floccosum is one of the most common agents of human superficial fungal infections, compared with genus Trichophyton and Microsporum, it possesses uniqueness in ecology traits and rarely causing hair infections. E. floccosum is so far the only representative species of genera Epidermophyton, and it is known as anthropophilic dermatophytes. To further reveal the genome sequences and clues of virulence factors, thus in this study, we sequenced the genome of E. floccosum (CGMCC (F) E1d), and performed comparative genomic analysis with other dermatophytes. It is revealed that E. floccosum owns the largest genome size and similar GC content compared with other dermatophytes. A total of 7565 genes are predicted. By comparing with the closest species N. gypseum, our study reveals that number and structure of adhesion factors, secreted proteases and LysM domain might contribute to the pathogenic and ecological traits of E. floccosum. Mating genes is also detected in genome data. Furthermore, we performed AFLP analysis trying to discuss intraspecific differences of E. floccosum, but no significant relationship is found between genotype and geographical distribution. Upon above, our study provides a deeper understanding and strong foundation for future researches about E. floccosum.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    Seeds, the reproductive organs of plants, are common as trace evidence from crime scenes. Seed evidence could be grouped into several categories based on the types of crimes they are associated with, including child abuse, homicides and drugs. Most commonly, seeds are examined microscopically and identified to the plant species level to show a linkage between persons and places. More recently, forensic researchers have evaluated the potential for extracting and typing DNA from seeds to further individualize the samples. As a model system, tomato seeds were examined microscopically after different cooking treatments and assessed for the potential to DNA type seeds for variety identification. A sufficient quantity and quality of DNA were recovered from uncooked, digested and undigested tomato seeds for amplified fragment length polymorphism (AFLP) analysis; however, any form of cooking destroyed the seed DNA. A simple microscopic analysis was able to distinguish between a cooked tomato seed versus an uncooked seed. This article is intended to provide an overview of case examples and current techniques for the forensic examination of seeds as plant-derived evidence.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    小麦茎锈病,由普契氏菌引起。小麦(Pgt),是一种真菌,在小麦生产中引起毁灭性的冈麦茎锈病。快速鉴定Pgt的生理小种对于预防小麦茎锈病非常重要。在本文中,我们开发了一种分子方法来鉴定Pgt最普遍的种族,作为传统使用的宿主特异性方法的补充。扩增片段长度多态性(AFLP)被用作分析中国和Ug99Pgt六个常见生理种族的DNA多态性的手段。总的来说,64对引物用于AFLP筛选种族特异性分子标记。一对引物-即,E7/M7(5'-GACTGCGTACCAATTCGG-3\'/5'-GATGAGTCCTGAGTAACGG-3\')产生了种族34MKG的独特条带,将其纯化并克隆到pGEM-T载体中进行测序。然后,我们设计了一种新的引物对(序列表征的扩增区标记)来扩增171bp的片段,并证实该标记对34MKG具有高度特异性。这些结果为监测不同品种的Pgt提供了新的工具,以改善中国小麦茎锈病的防治。
    Wheat stem rust, caused by Puccinia graminis f. sp. tritici (Pgt), is a fungus that causes the devastating fungalwheat stem rust disease in wheat production. Rapid identification of the physiological races of Pgt are very importance for the prevention of wheat stem rust. In this paper we developed a molecular method to identify the most prevalent race of Pgt, as a supplement for traditionally used host-specific methods. Amplified fragment length polymorphism (AFLP) was employed as a means of analyzing DNA polymorphisms in six common physiological races of Pgt in China and Ug99. In total, 64 pairs of primers were used for AFLP screening of race-specific molecular markers. One primer pair-namely, E7/M7 (5\'-GACTGCGTACCAATTCG G-3\'/5\'-GATGAGTCCTGAGTAACGG-3\')-yielded a unique band for the race 34MKG that was purified and cloned into the pGEM-T vector for sequencing. We then designed a new primer pairs (sequence-characterized amplified region marker) to amplify the 171-bp fragment and confirmed that the marker was highly specific for 34MKG. These results provide a new tool for monitoring different races of Pgt for improved control of wheat stem rust in China.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    A droplet-vitrification protocol was described for cryopreservation of shoot tips of kiwifruit \'Yuxiang\' (Actinidia chinensis var. deliciosa). No significant differences were found in root formation and shoot growth between the in vitro-derived shoots (the control) and cryo-derived ones when cultured in vitro. No significant differences were detected in survival and vegetative growth between the in vitro-derived plants (the control) and cryo-derived ones after re-establishment in greenhouse conditions. Inter-simple sequence repeat (ISSR) and amplified fragment length polymorphism (AFLP) did not detect any polymorphic bands in the cryo-derived shoots when cultured in vitro and the cryo-derived plants after re-establishment in greenhouse conditions. These data indicate rooting ability, vegetative growth and genetic stability are maintained in the cryo-derived kiwifruit plants recovered from the droplet-vitrification cryopreservation. Methylation sensitive amplification polymorphism (MSAP) detected 12.8% and 1.6% DNA methylation in the cryo-derived shoots when cultured in vitro and the cryo-derived plants after re-established in greenhouse conditions, respectively. This droplet-vitrification was applied to five cultivars and three rootstocks belonging to A. chinensis var. deliciosa, A. chinensis var. chinensis, A. macrosperma, A. polygama and A. valvata. The highest (68.3%) and lowest (22.5%) shoot regrowth were obtained in A. macrosperma and A. chinensis var. chinensis \'Jinmi\', respectively, with an average of 46.4% shoot regrowth obtained across the eight genotypes. The droplet-vitrification protocol described here can be considered the most applicable cryopreservation method so far reported for the genus Actinidia. Results reported here provide theoretical and technical supports for setting up cryo-banks of genetic resources of Actinidia spp.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    Wet bubble disease, caused by Mycogone perniciosa, is a major threat to Agaricus bisporus production in China. In order to understand the variability of in genetic, pathogenicity, morphology, and symptom production of the fungus, 18 isolates of the pathogen were collected from diseased A. bisporus in different provinces in China. The isolates were characterized by a combination of morphological, cultural, and molecular pathogenicity testing on different strains of A. bisporus and amplified fragment length polymorphism (AFLP) analysis. The 18 isolates were identified by Koch\'s postulate and confirmed different pathogenic variability among them. The yellow to brown isolates were more virulent than the white isolates. AFLP markers clustered the isolates into two distinct groups based on their colony color, with a high level of polymorphism of Jaccard similarities ranges from 0.39% to 0.64%. However, there was no evidence of an association between the genetic diversity and the geographical origin of the isolates. Through knowledge of the genetic diversity, phenotypic virulence of M. perniciosa is a key factor for successful breeding of resistant strains of A. bisporus and developing of an integrated disease management strategy to manage wet bubble disease of A. bisporus.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

公众号