Cysts

囊肿
  • 文章类型: English Abstract
    这项研究的目的是探讨产前磁共振成像(MRI)在评估胎儿先天性囊性肺病中的实用价值,评估病变的相对大小和肺发育状况,并尝试在后处理中利用MRI的强度来获得病变大小和肺部发育状况的评估指标,可以预测这些胎儿出生后可能面临的预后。我们回顾性收集并分析了诊断为先天性囊性肺病的胎儿数据。这些胎儿的产前超声检查导致诊断他们怀疑患有先天性囊性肺病,并且随后的产前MRI证实了诊断。对胎儿进行随访以跟踪其出生时的状况(产后呼吸窘迫,机械通气,等。),胎儿是否接受了手术治疗,以及手术治疗后胎儿的恢复。随访胎儿的恢复情况,探讨产前MRI检查评估胎儿先天性肺囊性疾病的可行性,初步探讨产前MRI对先天性肺囊性疾病胎儿预后的预测价值。
    MRI胎儿图像收集自2018年5月至2023年3月在四川大学华西第二医院就诊的孕妇,通过产前超声和随后的MRI诊断为胎儿先天性肺囊性疾病。对先天性囊性肺病胎儿MRI图像进行后处理,获得胎儿肺部病变体积,胎儿受累的肺容积,健康的肺容量,和胎儿头围测量。肺和肝脏的信号强度,病变体积/受影响的肺体积,病变体积/总肺体积,囊性体积比(CVR),并测量双侧肺-肝信号强度比。结合胎儿出生后6个月的随访结果,进一步分析MRI后处理采集指标对先天性囊性肺病胎儿预后评估的可行性和价值。采用Logistic回归模型对产妇年龄、MRI时的孕周,CVR,和双侧肺-肝信号强度比,并评估这些指标是否与不良预后相关。受试者工作特征(ROC)曲线用于评估单独通过MRI计算获得的参数以及与预测出生后不良预后的多种指标相结合的参数的价值。
    我们收集了2018年5月至2023年3月间通过胎儿MRI诊断为先天性囊性肺病的胎儿共67例,并排除了6例受影响肺部无正常肺组织的病例,11例胎儿诱导,3例失孕。最后,纳入47例先天性囊性肺病胎儿,其中30例预后良好,17例预后不良。预后良好组与预后不良组胎儿患侧和健侧肺、肝的信号强度比值差异有统计学意义(P<0.05),健康侧肺和肝脏的信号强度比高于患侧肺和肝脏的信号强度比。进一步分析表明,CVR(比值比[OR]=1.058,95%置信区间[CI]:1.014-1.104),患侧和健康侧的肺-肝信号强度比之间的差异(OR=0.814,95%CI:0.700-0.947)与先天性囊性肺病胎儿的出生预后不良相关。此外,ROC曲线分析显示,联合应用病变体积/受累肺体积和观察到的受累肺与健康肺和肝脏之间信号强度比值的差异,比单参数判断更准确地预测先天性囊性肺病患儿的预后。曲线下面积为0.988,截止值为0.33,对应灵敏度为100%,特异性为93.3%,95%CI为0.966-1.000。
    基于先天性囊性肺病胎儿的MRI,我们获得了病变体积的信息,病变体积/受影响的肺体积,病变体积/总肺体积,CVR,和双侧肺-肝信号强度比值差异,所有这些都在预测先天性囊性肺病胎儿的不良预后方面显示出一定的临床价值。此外,在组合指数中,病变体积/受累肺体积和双侧肺-肝信号强度比差异是先天性囊性肺病胎儿预后不良的更有效预测因子。在预测先天性囊性肺病胎儿的不良预后方面有较好的疗效。这为进一步评估先天性囊性肺病胎儿的肺发育提供了一种新的有效的预测方法。有助于提高对先天性囊性肺病胎儿预后的评估和预测。
    UNASSIGNED: The aim of this study is to explore the practical value of prenatal magnetic resonance imaging (MRI) in the assessment of congenital cystic lung disease in fetuses, to evaluate the relative size of the lesion and the status of lung development, and to make an attempt at utilizing the strength of MRI in post-processing to obtain assessment indicators of the size of the lesion and the status of lung development, with which predictions can be made for the prognosis that these fetuses may face after birth. We retrospectively collected and analyzed the data of fetuses diagnosed with congenital cystic lung disease. Prenatal ultrasound examination of these fetuses led to the diagnosis that they were suspected of having congenital cystic lung disease and the diagnosis was confirmed by subsequent prenatal MRI. The fetuses were followed up to track their condition at birth (postnatal respiratory distress, mechanical ventilation, etc.), whether the fetuses underwent surgical treatment, and the recovery of the fetuses after surgical treatment. The recovery of the fetuses was followed up to explore the feasibility of prenatal MRI examination to assess fetal congenital pulmonary cystic disease, and to preliminarily explore the predictive value of prenatal MRI for the prognosis of fetuses with congenital pulmonary cystic disease.
    UNASSIGNED: MRI fetal images were collected from pregnant women who attended the West China Second University Hospital of Sichuan University between May 2018 and March 2023 and who were diagnosed with fetal congenital pulmonary cystic disease by prenatal ultrasound and subsequent MRI. Fetal MRI images of congenital cystic lung disease were post-processed to obtain the fetal lung lesion volume, the fetal affected lung volume, the healthy lung volume, and the fetal head circumference measurements. The signal intensity of both lungs and livers, the lesion volume/the affected lung volume, the lesion volume/total lung volume, the cystic volume ratio (CVR), and the bilateral lung-liver signal intensity ratio were measured. The feasibility and value of MRI post-processing acquisition indexes for evaluating the prognosis of fetuses with congenital cystic lung disease were further analyzed by combining the follow-up results obtained 6 months after the birth of the fetus. Logistic regression models were used to quantify the differences in maternal age, gestational week at the time of MRI, CVR, and bilateral lung-to-liver signal intensity ratio, and to assess whether these metrics correlate with poor prognosis. Receiver operating characteristic (ROC) curves were used to assess the value of the parameters obtained by MRI calculations alone and in combination with multiple metrics for predicting poor prognosis after birth.
    UNASSIGNED: We collected a total of 67 cases of fetuses diagnosed with congenital cystic lung disease by fetal MRI between May 2018 and March 2023, and excluded 6 cases with no normal lung tissue in the affected lungs, 11 cases of fetal induction, and 3 cases of loss of pregnancy. In the end, 47 cases of fetuses with congenital cystic lung disease were included, of which 30 cases had a good prognosis and 17 cases had a poor prognosis. The difference in the difference between the signal intensity ratios of the affected and healthy sides of the lungs and livers of the fetuses in the good prognosis group and that in the poor prognosis group was statistically significant (P<0.05), and the signal intensity ratio of the healthy side of the lungs and livers was higher than the signal intensity ratio of the affected side of the lungs and livers. Further analysis showed that CVR (odds ratio [OR]=1.058, 95% confidence interval [CI]: 1.014-1.104), and the difference between the lung-to-liver signal intensity ratios of the affected and healthy sides (OR=0.814, 95% CI: 0.700-0.947) were correlated with poor prognosis of birth in fetuses with congenital cystic lung disease. In addition, ROC curve analysis showed that the combined application of lesion volume/affected lung volume and the observed difference in the signal intensity ratio between the affected and healthy lungs and liver predicted the prognosis of children with congenital cystic lung disease more accurately than the single-parameter judgment did, with the area under the curve being 0.988, and the cut-off value being 0.33, which corresponded to a sensitivity of 100%, a specificity of 93.3%, and a 95% CI of 0.966-1.000.
    UNASSIGNED: Based on the MRI of fetuses with congenital cystic lung disease, we obtained information on lesion volume, lesion volume/affected lung volume, lesion volume/total lung volume, CVR, and bilateral lung-to-liver signal intensity ratio difference, all of which showing some clinical value in predicting the poor prognosis in fetuses with congenital cystic lung disease. Furthermore, among the combined indexes, the lesion volume/affected lung volume and bilateral lung-to-liver signal intensity ratio difference are more effective predictors for the poor prognosis of fetuses with congenital cystic lung disease, and show better efficacy in predicting the poor prognosis of fetuses with congenital cystic lung disease. This provides a new and effective predictive method for further assessment of pulmonary lung development in fetuses with congenital cystic lung disease, and helps improve the assessment and prediction of the prognosis of fetuses with congenital cystic lung disease.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    关于全血烟酰胺腺嘌呤二核苷酸(NAD+)水平与纳贝囊肿之间的关联知之甚少。本研究旨在评估中国健康女性NAD+水平与纳博托囊肿之间的关系。
    采用多因素logistic回归分析NAD+水平与纳博培囊肿的相关性。
    平均年龄为43.0±11.5岁,NAD+的平均水平为31.3±5.3μmol/L。Nabothian囊肿发生在184名(27.7%)参与者中,100名(15.0%)和84名(12.6%)参与者中有单个和多个囊肿,分别。从NAD的Q1到Q4,纳博代囊肿的总患病率从37.4%逐渐下降到21.6%,单个和多个纳博代囊肿的患病率在NAD四分位数中也有所下降。与最高NAD+四分位数(≥34.4μmol/L)相比,NAD+Q1的95%置信区间的校正比值比为1.89(1.14~3.14).随着NAD+水平的增加,总囊肿和单囊肿的风险线性降低,而在28.0至35.0μmol/L的NAD水平下,多发性纳博代囊肿的风险降低更快。
    低NAD+水平与总的和多个纳博托囊肿的风险增加相关。
    UNASSIGNED: Little is known about the association between whole-blood nicotinamide adenine dinucleotide (NAD +) levels and nabothian cysts. This study aimed to assess the association between NAD + levels and nabothian cysts in healthy Chinese women.
    UNASSIGNED: Multivariate logistic regression analysis was performed to analyze the association between NAD + levels and nabothian cysts.
    UNASSIGNED: The mean age was 43.0 ± 11.5 years, and the mean level of NAD + was 31.3 ± 5.3 μmol/L. Nabothian cysts occurred in 184 (27.7%) participants, with single and multiple cysts in 100 (15.0%) and 84 (12.6%) participants, respectively. The total nabothian cyst prevalence gradually decreased from 37.4% to 21.6% from Q1 to Q4 of NAD + and the prevalence of single and multiple nabothian cysts also decreased across the NAD + quartiles. As compared with the highest NAD + quartile (≥ 34.4 μmol/L), the adjusted odds ratios with 95% confidence interval of the NAD + Q1 was 1.89 (1.14-3.14) for total nabothian cysts. The risk of total and single nabothian cysts linearly decreased with increasing NAD + levels, while the risk of multiple nabothian cysts decreased more rapidly at NAD + levels of 28.0 to 35.0 μmol/L.
    UNASSIGNED: Low NAD + levels were associated with an increased risk of total and multiple nabothian cysts.
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  • 文章类型: Case Reports
    背景:原发性玻璃体囊肿是一种临床变异,由出生时玻璃体腔内存在囊泡来描述。这种特殊的疾病往往并不常见,和潜在的机制有助于其发病机制仍然模糊。
    方法:一名37岁男性患者的右眼视力模糊和漂浮物,症状学在三个月前首次发现。裂隙灯检查时,有色素的,圆形,发现1个直径大小的乳突块漂浮在玻璃体中。使用一系列多模态成像技术对漂浮物进行了细致的检查。其他潜在条件,包括囊虫病,弓形虫病,和肿瘤,通过血液检查等综合诊断检查被最终排除在外,肝脏超声,和头颅磁共振成像(MRI),导致诊断为原发性玻璃体囊肿。患者未报告任何其他不适,也未接受任何后续干预或治疗。
    结论:我们提供了一个诊断为原发性玻璃体囊肿的患者的详尽病例报告。在疾病的表征中结合多模式图像可以促进医生的丰富理解。
    BACKGROUND: Primary vitreous cyst is a clinical variant delineated by the existence of a vesicle within the vitreous cavity from birth. This particular disease tends to be uncommon, and the underlying mechanisms contributing to its pathogenesis remain obscure.
    METHODS: A 37-year-old male patient manifested blurry vision and floaters in his right eye, a symptomology first noticed three months prior. Upon slit-lamp examination, a pigmented, round, 1 papilla diameter-sized mass was discerned floating in the vitreous. A meticulous examination of the floaters was conducted using an array of multimodal imaging techniques. Other potential conditions, including cysticercosis, toxoplasmosis, and tumors, were conclusively excluded through comprehensive diagnostic tests such as blood examinations, liver ultrasound, and cranial magnetic resonance imaging (MRI), resulting in the diagnosis of a primary vitreous cyst. The patient did not report any other discomforts and did not receive any subsequent interventions or treatments.
    CONCLUSIONS: We furnish an exhaustive case report of a patient diagnosed with a primary vitreous cyst. The incorporation of multimodal images in the characterization of the disease anticipates facilitating an enriched comprehension by medical practitioners.
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  • 文章类型: Journal Article
    肝囊腺瘤是一种罕见的疾病,约占所有囊性病变的5%,恶性转化的趋势很高。囊腺瘤的术前诊断困难,有些囊腺瘤一开始容易误诊为肝囊肿。肝囊肿是一种比较常见的肝病,其中大多数是良性的,但是大的肝囊肿会导致胆管受压,导致肝功能异常。为了更好地了解囊腺瘤和肝囊肿的微环境之间的差异,我们对囊腺瘤和肝囊肿样本进行了单核RNA测序.此外,我们对肝囊肿进行了空间转录组测序。根据细胞核RNA测序数据,总共确定了七种主要细胞类型。在这里,我们描述了囊腺瘤和肝囊肿的肿瘤微环境,特别是免疫细胞和基质细胞的转录组特征和调节因子。通过推断拷贝数变化,发现囊腺瘤中肝星状细胞的恶性程度较高。假时间轨迹分析显示肝细胞在肝囊肿和囊腺瘤中的动态转化。囊腺瘤的免疫浸润高于肝囊肿,T细胞在囊腺瘤中比肝囊肿具有更复杂的调节机制。免疫组织化学证实了囊腺瘤特异性T细胞免疫调节机制。这些结果提供了囊腺瘤和肝囊肿的单细胞图谱,揭示了囊腺瘤比肝囊肿更复杂的微环境,为囊腺瘤和肝囊肿的分子机制研究提供了新的视角。
    Hepatic cystadenoma is a rare disease, accounting for about 5% of all cystic lesions, with a high tendency of malignant transformation. The preoperative diagnosis of cystadenoma is difficult, and some cystadenomas are easily misdiagnosed as hepatic cysts at first. Hepatic cyst is a relatively common liver disease, most of which are benign, but large hepatic cysts can lead to pressure on the bile duct, resulting in abnormal liver function. To better understand the difference between the microenvironment of cystadenomas and hepatic cysts, we performed single-nuclei RNA-sequencing on cystadenoma and hepatic cysts samples. In addition, we performed spatial transcriptome sequencing of hepatic cysts. Based on nucleus RNA-sequencing data, a total of seven major cell types were identified. Here we described the tumor microenvironment of cystadenomas and hepatic cysts, particularly the transcriptome signatures and regulators of immune cells and stromal cells. By inferring copy number variation, it was found that the malignant degree of hepatic stellate cells in cystadenoma was higher. Pseudotime trajectory analysis demonstrated dynamic transformation of hepatocytes in hepatic cysts and cystadenomas. Cystadenomas had higher immune infiltration than hepatic cysts, and T cells had a more complex regulatory mechanism in cystadenomas than hepatic cysts. Immunohistochemistry confirms a cystadenoma-specific T-cell immunoregulatory mechanism. These results provided a single-cell atlas of cystadenomas and hepatic cyst, revealed a more complex microenvironment in cystadenomas than in hepatic cysts, and provided new perspective for the molecular mechanisms of cystadenomas and hepatic cyst.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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  • 文章类型: Review
    背景:克唑替尼,口服第一代酪氨酸激酶抑制剂(TKI),对于间变性淋巴瘤激酶(ALK)阳性重排的非小细胞肺癌(NSCLC),优于全身化疗。然而,据报道,接受克唑替尼治疗的患者肾和肝囊肿的发生率增加.
    方法:这里,我们描述了一例71岁的中国女性在接受原发性和转移性NSCLC的克唑替尼治疗期间出现肾脏和肝脏多个囊性病变的病例.克唑替尼治疗3个月后CT扫描发现肾和肝囊肿,停用克唑替尼后,其自发且显着消退。
    结论:根据文献回顾和我们在本病例报告中的经验,我们得出的结论是,克唑替尼相关肾囊肿(CARC)在影像学上具有恶性和脓肿的特征,因此,病理确认是必要的,以避免不适当的治疗决定。此外,使无进展生存期(PFS)的患者受益,对于发生CARC的NSCLC患者,建议从克唑替尼转为阿来替尼.
    BACKGROUND: Crizotinib, an oral first-generation tyrosine kinase inhibitor (TKI), is superior to systemic chemotherapy for the treatment of non-small cell lung cancer (NSCLC) with positive rearrangement of anaplastic lymphoma kinase (ALK). However, an increased incidence of renal and hepatic cysts has been reported in the patients on crizotinib treatment.
    METHODS: Here, we describe a case of a 71-year-old Chinese women developed multiple cystic lesions in kidney and liver during crizotinib treatment for the primary and metastatic NSCLC. The renal and hepatic cysts were noted by CT scan 3 months after crizotinib treatment, which were spontaneously and significantly regressed after stopping crizotinib.
    CONCLUSIONS: Based on literature review and our experience in this case report, we concluded that crizotinib-associated renal cyst (CARCs) has features of malignancy and abscess in radiographic imaging, and thus, pathological confirmation is necessary to avoid inappropriate treatment decision. In addition, to benefit the patients with progress-free survival (PFS), switching from crizotinib to alectinib is recommended for the treatment of NSCLC patients who developed CARCs.
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  • 文章类型: Case Reports
    Objective:To analyze and summarize the clinical characteristics, diagnosis, treatment and prognosis of benign upper airway space occupancy in infants. Methods:The clinical data of 141 cases with begin upper airway space from January 2012 to January 2022 were analyzed. Among them, 101 were male and 68 were female, the age is 0-3 years old. In which there were 24 newborns. The clinical characteristics, auxiliary examination and treatment results were summarized and analyzed. Results:The main clinical manifestations of 141 infants were dyspnea and/or laryngeal wheezing, including 116 cases of congenital cyst of tongue, 15 cases of hair polyps, 4 cases of nasopharyngeal second pharyngeal fissure cysts, 2 cases of congenital laryngeal cysts, 2 cases of pharyngeal bronchial cyst, 1 case of nasopharyngeal teratoma and 1 case of myofibroma. All the infants had completed the corresponding examination and treatment. The diagnosis was clear, and there was no missed diagnosis or misdiagnosis. Among them, 19 infants with congenital cyst of tongue were given cyst puncture to relieve dyspnea. 2 cases of congenital cyst of tongue recurred half a year after operaion, and then they underwent reoperation. The prognosis of the remaining infants were good. Conclusion:The most common occupying of benign upper airway space occupancy is cyst, and low-temperature plasma resection under endoscope is the main treatment method. Timely puncture therapy is also a safe and effective treatment for infants who are dyspnea and life threatening.
    目的:分析和总结婴幼儿上气道良性占位的临床特点、诊断、治疗及预后。 方法:回顾性分析2012年1月—2022年1月我院诊治的141例上气道良性占位患儿的临床资料。其中男85例,女56例;年龄0~3岁,其中新生儿24例。对其临床特点、辅助检查、治疗结果进行总结和分析。 结果:141例患儿主要临床表现为呼吸困难和(或)喉喘鸣,其中先天性舌根囊肿116例,毛息肉15例,鼻咽部第二鳃裂囊肿4例,先天性喉小囊囊肿2例,咽部支气管源性囊肿2例,鼻咽部畸胎瘤1例,肌纤维瘤1例。所有患儿都完成相应检查和治疗,诊断明确,无漏诊或误诊,其中19例舌根囊肿患儿行囊肿穿刺术,术后随访2例先天性舌根囊肿患者,因其术后半年复发故行二次手术,其他患儿预后良好。 结论:婴幼儿上气道良性占位,以囊性肿物多见,内镜辅助下低温等离子切除病变为主要治疗方式,对于呼吸困难严重且生命危急的患儿及时的穿刺治疗也是一种安全有效的治疗方法。.
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  • 文章类型: Case Reports
    背景:视网膜囊肿是罕见的眼底病变,基本上是位于或起源于视网膜的充满液体的腔,直径大于正常视网膜厚度。迄今为止,很少有巨大视网膜囊肿出血伴视网膜裂开的病例报道。
    方法:一名没有其他病史的32岁女性患者在严重咳嗽后3天内出现视力下降。右眼的最佳矫正视力为0.5。全面的眼科检查,包括裂隙灯眼底镜检查,眼睛的超声扫描,光学相干层析成像扫描,并进行了眼眶磁共振成像。眼科检查显示右眼有III级前房血细胞和III级玻璃体出血,视网膜鼻侧有一个大疱疹囊肿。囊肿投射到玻璃体中,里面隐约可见大量出血。囊肿清晰可见,周围观察到浅表视网膜限制脱离。超声显示右眼视网膜囊肿伴视网膜脱离。实验室检测结果不显著。保守治疗3个月后,患者的囊内出血明显吸收,但是囊肿腔的大小没有任何明显的变化。巩膜外加压扣带术联合外引流囊内液体,手术后患者的视力逐渐恢复到正常的1.0,视网膜看起来变平了.该患者最终被诊断为右眼患有视网膜裂孔的巨大视网膜囊肿。推测原因是剧烈咳嗽导致视网膜囊肿破裂和出血,类似于动脉夹层破裂的机制。据我们所知,此病例因重度咳嗽引起的视网膜囊肿破裂出血,经手术治疗后恢复良好,以前从未报道过。
    结论:伴有视网膜裂孔的巨大囊性视网膜出血非常罕见。眼眶磁共振成像和眼部B超对其诊断至关重要,和选择适当的外科手术是必要的,以最大限度地受益于受影响的患者。
    BACKGROUND: Retinal cysts are rare lesions of the fundus that are essentially fluid-filled cavities located or originating in the retina, with a diameter larger than the normal retinal thickness. To date, there have been few case reports of giant retinal cyst hemorrhage with retinoschisis.
    METHODS: A 32-year-old woman with no other medical history complained of decreased vision for 3 days after a severe cough. The best-corrected visual acuity in the right eye was 0.5. A comprehensive ophthalmological examination including slit-lamp fundoscopy, ultrasound scan of the eye, optical coherence tomography scan, and orbital magnetic resonance imaging was performed. Ophthalmological examination revealed grade III anterior chamber blood cells and grade III vitreous hemorrhage in the right eye and a large herpetic cyst on the nasal side of the retina. The cyst projected into the vitreous, with a large amount of hemorrhage vaguely visible within it. The cyst was clearly visible, and a superficial retinal limiting detachment was observed around it. Ultrasound showed a retinal cyst with retinal detachment in the right eye. Laboratory test results were unremarkable. After 3 months of conservative treatment, the patient\'s intracystic hemorrhage was significantly absorbed, but the size of the cyst cavity did not show any significant change. Scleral buckling with external compression combined with external drainage of the intracystic fluid was performed, the patient\'s visual acuity was gradually restored to a normal 1.0 after the operation, and the retina appeared flattened. The patient was finally diagnosed with a giant retinal cyst with retinoschisis in the right eye. The presumed cause was heavy coughing leading to rupture and hemorrhage of the retinal cyst, similar to the mechanism of rupture of an arterial dissection. To the best of our knowledge, this case of retinal cyst rupture and hemorrhage caused by heavy coughing with good recovery after external surgical treatment has never been reported before.
    CONCLUSIONS: Giant cystic retinal hemorrhage with retinoschisis is very rare. Orbital magnetic resonance imaging and ocular B-scan ultrasound are essential for its diagnosis, and the selection of an appropriate surgical procedure is necessary to maximize the benefit for affected patients.
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