Adenoid

腺样体
  • 文章类型: Journal Article
    目的:腺样体肥大导致鼻咽气道(NA)通气受损。然而,很难评估NA的通气条件。因此,本研究旨在分析基于计算流体力学模拟的鼻咽气道阻力(NARES),以及在头颅测量锥形束计算机断层扫描图像上测量的鼻咽气道深度(NAD)和腺样体肥大分级,并确定NAD和分级与NARES之间的关系,以最终使用头颅测量评估NA是否存在气道阻塞缺陷.
    方法:Cephalogram图像是根据2012年9月至2023年3月在正畸诊所接受正畸检查的102名儿童(41名男孩;平均年龄:9.14±1.43岁)的锥形束计算机断层扫描数据生成的,并使用3DNA模型基于计算流体动力学分析测量NAD和腺样体等级和NARES值。使用非线性回归分析来评估NARES与NAD之间的关系以及相关系数来评估等级与NARES之间的关系。
    结果:NARES与NAD的立方成反比(R2=0.786,P<0.001),表明这些变量之间存在显著的关系。当距离NAD小于5mm时,电阻NARES显著增加。然而,腺样体4级(75%肥大)分布广泛。
    结论:这些研究结果表明,NA的通气条件可以基于头影图像的简单评估来确定。头颅测量图像上小于5mm的NAD导致NA阻塞,具有显著增加的气流阻力。
    OBJECTIVE: Adenoid hypertrophy causes impaired nasopharyngeal airways (NA) ventilation. However, it is difficult to evaluate the ventilatory conditions of NA. Therefore, this study aimed to analyze the nasopharyngeal airway resistance (NARES) based on computational fluid dynamics simulations and the nasopharyngeal airway depth (NAD) and adenoid hypertrophy grade measured on cephalometric cone-beam computed tomography images and determine the relationship between NAD and grade and NARES to ultimately assess using cephalometric measurements whether NA has airway obstruction defects.
    METHODS: Cephalogram images were generated from cone-beam computed tomography data of 102 children (41 boys; mean age: 9.14 ± 1.43 years) who received orthodontic examinations at an orthodontic clinic from September 2012 to March 2023, and NAD and adenoid grade and NARES values were measured based on computational fluid dynamics analyses using a 3D NA model. Nonlinear regression analyses were used to evaluate the relationship between NARES and NAD and correlation coefficients to evaluate the relationship between grade and NARES.
    RESULTS: NARES was inversely proportional to the cube of NAD (R2 = 0.786, P < 0.001), indicating a significant relationship between these variables. The resistance NARES increased substantially when the distance NAD was less than 5 mm. However, adenoid Grade 4 (75 % hypertrophy) was widely distributed.
    CONCLUSIONS: These study findings demonstrate that the ventilatory conditions of NA can be determined based on a simple evaluation of cephalogram images. An NAD of less than 5 mm on cephalometric images results in NA obstruction with substantially increased airflow resistance.
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  • 文章类型: Journal Article
    毛状息肉,被认为是一种非常不寻常的先天性咽部异常,许多学者认为是从胚胎阶段的外胚层和中胚层产生的。这些生长物通常具有梨或香肠的形状,被带束,它们的尺寸范围在0.5到6厘米之间。它们通常为灰白色或粉红色。本文讨论了一名12岁的女性,她在鼻咽壁左侧的咽鼓管入口处生长,通过颈部软组织的计算机断层扫描扫描确定;怀疑是源自左咽鼓管的毛状息肉。通过病理证实了毛状息肉的诊断。咽鼓管上的多毛息肉,在这种情况下,表现出不规则的形状,底部很宽,使它看起来像腺样体;因此,增加其被误诊为残余腺样组织的风险。
    Hairy polyps, considered a highly unusual congenital anomaly of the pharynx, are believed by many scholars to arise from the ectoderm and mesoderm during the embryonic stage. These growths often have a pear or sausage shape, are pedunculated, and their size ranges between 0.5 and 6 cm. They are typically grayish white or pink in color. This article discusses a 12-year-old female who had a growth at the Eustachian tube\'s entrance on the left side of the nasopharyngeal wall, as identified by a computed tomography scan of the neck soft tissue; it was suspected to be a hairy polyp originating from the left Eustachian tube. The diagnosis of a hairy polyp was confirmed through pathology. The hairy polyp at the Eustachian tube, in this case, showed an irregular form with a wide base, making it look similar to an adenoid; thus, increasing the risk of it being misdiagnosed as residual adenoid tissue.
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  • 文章类型: Journal Article
    腺样组织是一线宿主防御的次级淋巴器官,尤其是在童年。维持平衡的细胞活性需要内质网(ER)。ER功能受损,发生蛋白质积累,导致ER压力,在许多疾病的病因中起作用。
    我们的目的是研究内质网应激与腺样体疾病之间的关系,从而阐明免疫相关疾病的机制。
    54例(>3岁)因慢性腺样体炎(CA)或腺样体肥大(AH)而接受腺样体切除术的儿科患者被纳入本前瞻性研究,平行组临床研究。根据腺样体的大小将其分为两组(CA或AH),并通过实时PCR和蛋白质印迹分析评估ER应激途径和凋亡途径标志物。
    ER应激途径标志物在CA和AH组之间存在显着差异。CA患儿的ER应激标志物水平高于AH组(ATF-4,ATF-6和GRP78的p<.001,而EDEM1,CHOP的p<.05,EIF2AK3,ERNI,和GRP94)。凋亡途径标志物水平(BAX和BCL-2)在组间没有差异。
    内质网应激有助于腺样体组织疾病的发病机制和腺样体疾病的发病机制,这是免疫反应的一部分。这些结果可能指导免疫系统疾病的新的和替代的治疗方法的发展。
    腺样组织是一线宿主防御的次级淋巴器官,尤其是在童年。维持平衡的细胞活性需要内质网(ER)。ER功能受损,发生蛋白质积累,导致ER压力,在许多疾病的病因中起作用。我们调查了内质网应激与腺样体组织疾病之间的关系。内质网应激有助于腺样体疾病的发病机制和腺样体疾病的发病机制,这是免疫反应的一部分。这些结果可能指导免疫系统疾病的新的和替代的治疗方法的发展。
    UNASSIGNED: Adenoid tissue is a first-line host defense secondary lymphoid organ, especially in childhood. The endoplasmic reticulum (ER) is required to maintain balanced cellular activity. With impaired ER functions, protein accumulation occurs, resulting in ER stress, which plays a role in the etiopathogenesis of many diseases.
    UNASSIGNED: We aimed to investigate the relationship between ER stress and adenoid tissue disorders, thereby elucidating the mechanisms of immunity-related diseases.
    UNASSIGNED: Fifty-four pediatric patients (>3 years old) who underwent adenoidectomy for chronic adenoiditis (CA) or adenoid hypertrophy (AH) were enrolled in this prospective, parallel-group clinical study. Adenoids were divided into two groups (CA or AH) based on their size and evaluated for ER stress pathway and apoptosis pathway markers by Real-time PCR and Western blot analysis.
    UNASSIGNED: ER stress pathway markers significantly differed between the CA and AH groups. Children with CA had higher ER stress marker levels than the AH group (p < .001 for ATF-4, ATF-6, and GRP78, and p < .05 for EDEM1, CHOP, EIF2AK3, ERNI, and GRP94). Apoptosis pathway marker levels (BAX and BCL-2) were not different between groups.
    UNASSIGNED: ER stress contributes to the etiopathogenesis of adenoid tissue diseases and the pathogenesis of adenoid tissue disorders, which are part of the immune response. These results may guide the development of new and alternative treatments for immune system disorders.
    Adenoid tissue is a first‐line host defense secondary lymphoid organ, especially in childhood. The endoplasmic reticulum (ER) is required to maintain balanced cellular activity. With impaired ER functions, protein accumulation occurs, resulting in ER stress, which plays a role in the etiopathogenesis of many diseases. We investigated the relationship between ER stress and adenoid tissue disorders. ER stress contributes to the etiopathogenesis of adenoid tissue diseases and the pathogenesis of adenoid tissue disorders, which are part of the immune response. These results may guide the development of new and alternative treatments for immune system disorders.
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  • 文章类型: Journal Article
    腺样体肥大是一种常见的儿童疾病;其标准治疗方法是腺样体切除术。由于更少的并发症和更多的便利,对医疗管理的需求正在增加。本研究探讨了莫米松鼻喷雾剂口服孟鲁司特治疗腺样体肥大的效果。
    这是一个随机的,双盲,在转诊教学医院进行的安慰剂对照研究(德黑兰,伊朗)从2020年9月到2021年9月。纳入2至14岁的临床和放射学发现腺样体肥大的儿童。将患者随机分为两组:口服孟鲁司特莫米松鼻喷雾剂(病例组)或安慰剂莫米松(对照组)。然后,比较干预前和干预后2个月的临床评分。
    96名患者完成了研究[62.5%为男性(n=60)]。其中,病例组51例,对照组45例。干预后各组临床评分明显下降(P<0.001),但病例组的临床评分下降与对照组无显著差异(p=0.576).
    结果表明,莫米松和孟鲁司特的联合疗法在治疗腺样体肥大方面与莫米松和安慰剂具有相同的疗效。将孟鲁司特加到莫米松中没有额外的作用。
    UNASSIGNED: Adenoid hypertrophy is a common childhood disease; its standard treatment is adenoidectomy. The desire for medical management is increasing due to fewer complications and more convenience. The present study investigated the effect of adding oral montelukast to mometasone nasal spray in treating adenoid hypertrophy.
    UNASSIGNED: This was a randomized, double-blind, placebo-controlled study conducted at a referral teaching hospital (Tehran, Iran) from September 2020 to September 2021. Children aged 2 to 14 years with clinical and radiological findings of adenoid hypertrophy were enrolled. Patients were randomly divided into two groups: mometasone nasal spray with oral montelukast (case group) or mometasone with placebo (control group). Then, the clinical scores were compared before and two months after the intervention.
    UNASSIGNED: Ninety-six patients completed the study [62.5% male (n=60)]. Of these, 51 were in the case and 45 in the control group. The clinical score in each group decreased significantly after the intervention (P<0.001), but the decrease in clinical score in the case group was not significantly different from the control (p=0.576).
    UNASSIGNED: The results showed that the combination therapy with mometasone and montelukast has the same efficacy as mometasone and placebo in treating adenoid hypertrophy. Adding montelukast to mometasone has no additional effect.
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  • 文章类型: Journal Article
    调查社交媒体Twitter和Instagram上与腺样体切除术相关的公开帖子。这项研究旨在调查患者和护理人员在社交媒体上的态度和看法,通过关于腺样体切除术的社交媒体帖子的主题内容分析。
    非真实世界的定性研究。
    Twitter和Instagram社交媒体平台。
    2月之间上传的公共帖子,2021年和2月,2023年使用标签“#腺样体切除术,搜索了“”和“#腺样体切除恢复”。如果与腺样体切除术无关或使用非英语语言,则将其排除在外。相关岗位按患者或护理人员以及术前或术后进行人口统计学分层。并分类为相关主题进行分析。结果以员额总数衡量。
    共分析了394个相关帖子。使用P<0.05的显著性阈值。与护理人员相比,患者发布了更多关于手术疼痛(P=0.002)和外观问题(P=0.048)的帖子。与患者本人相比,护理人员发布了更多关于病情意识的帖子(P<0.001),并且显着(P<0.001)更有可能在其帖子中传播阳性。女性护理人员的帖子更有可能提到恐惧,而男性看护者提供教育的可能性更大(P=0.002)。
    患者可能会担心外观和心理健康,而护理人员更有可能传播信息和积极性。男性和女性护理人员也可能以不同的方式使用社交媒体。更好地了解患者和护理人员的担忧可能会优化医生的互动和参与。
    UNASSIGNED: To survey the social media outlets Twitter and Instagram for public posts related to adenoidectomy surgery. This study aims to investigate the attitudes and perceptions of patients and caregivers on social media, through thematic content-analysis of social media posts regarding adenoidectomy.
    UNASSIGNED: Non-real world qualitative study.
    UNASSIGNED: Twitter and Instagram social media platforms.
    UNASSIGNED: Public posts uploaded between February, 2021 and February, 2023 using the hashtags \"#adenoidectomy,\" and \"#adenoidectomyrecovery\" were searched. Posts were excluded if they were unrelated to adenoidectomy or were in a non-English language. Relevant posts were stratified demographically as patient or caregiver and pre- or postoperative, and categorized into relevant themes for analysis. Outcomes were measured as the total number of posts.
    UNASSIGNED: A total of 394 relevant posts were analyzed. A significance threshold of P < 0.05 was used. Patients posted significantly more posts regarding procedure pain (P = 0.002) and concern for appearance (P = 0.048) compared to caregivers. Caregivers posted significantly (P < 0.001) more posts regarding condition awareness and were significantly (P < 0.001) more likely to spread positivity in their posts compared to patients themselves. Posts made by female caregivers were more likely to reference fear, while those made by male caregivers were more likely to provide education (P = 0.002).
    UNASSIGNED: Patients may worry about appearance and mental health while caregivers are more likely to spread information and positivity. Male and female caregivers may also use social media differently. A better understanding of patient and caregiver concerns may optimize physician interaction and involvement.
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  • 文章类型: Case Reports
    腺样鳞状细胞癌是鳞状细胞癌的一种罕见变异型。主要报道在头部和颈部的阳光照射区域。在文学中,鳞状细胞癌的腺样体变体在嘴唇和舌头中被报道。记录的颊粘膜病例很少。在这个案例报告中,我们描述了鳞状细胞癌的腺样体变体,这是一种罕见的癌症。
    Adenoid squamous cell carcinoma is a rare variant of squamous cell carcinoma. It is mainly reported in the sun-exposed areas of the head and neck. In literature, adenoid variants of squamous cell carcinoma are reported in the lip and tongue. Documented cases of buccal mucosa are very few. In this case report, we describe an adenoid variant of squamous cell carcinoma, which is an unusual presentation of a rare carcinoma.
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  • 文章类型: Journal Article
    在本研究中,我们证明SARS-CoV-2可以感染腭扁桃体,腺样体,无COVID-19症状,近期无上呼吸道感染史的儿童分泌物。我们研究了在2020年10月至2021年9月期间因打鼾/OSA或复发性扁桃体炎而接受扁桃体切除术的48名儿童。鼻细胞刷,洗鼻剂,通过RT-qPCR检测手术获得的扁桃体组织碎片,免疫组织化学(IHC),流式细胞术,和中和测定。我们检测到SARS-CoV-2存在于27%的患者中的至少一个测试样本中。IHC显示上皮表面和滤泡外和滤泡区域的淋巴样细胞中存在病毒核蛋白,腺样体和腭扁桃体。此外,SARS-CoV-2非结构蛋白NSP-16的IHC表明在53.8%的SARS-CoV-2感染的组织中存在病毒复制。流式细胞术显示CD20+B淋巴细胞是最多的感染表型,其次是CD4+淋巴细胞和CD123树突状细胞,CD8+T淋巴细胞,和CD14+巨噬细胞。此外,图IF表明感染的扁桃体组织具有增加的ACE2和TMPRSS2的表达。NGS测序证明来自不同组织的扁桃体中存在不同的SARS-CoV-2变体。SARS-CoV-2抗原检测不仅限于扁桃体,还可以在嗅觉区域的鼻细胞中检测到。腭扁桃体和腺样体是SARS-CoV-2在儿童中延长RNA存在的部位,即使没有COVID-19症状。重要性这项研究表明,不同谱系的SRS-CoV-2可感染1/4扁桃体切除术儿童的扁桃体和腺样体。这些发现为SARS-CoV-2发病机制领域带来了进步,通过显示扁桃体可能是长期感染的部位,即使没有近期COVID-19症状的证据。SARS-CoV-2感染B和T淋巴细胞,巨噬细胞,树突状细胞可能会干扰这些次级淋巴器官中免疫反应的产生。此外,在默默地感染儿童的呼吸道分泌物中,SARS-CoV-2RNA的脱落引发了人们的担忧,即在出现由其他病因引起的急性呼吸道感染症状时,可能存在诊断混乱.
    In the present study, we show that SARS-CoV-2 can infect palatine tonsils, adenoids, and secretions in children without symptoms of COVID-19, with no history of recent upper airway infection. We studied 48 children undergoing tonsillectomy due to snoring/OSA or recurrent tonsillitis between October 2020 and September 2021. Nasal cytobrushes, nasal washes, and tonsillar tissue fragments obtained at surgery were tested by RT-qPCR, immunohistochemistry (IHC), flow cytometry, and neutralization assay. We detected the presence of SARS-CoV-2 in at least one specimen tested in 27% of patients. IHC revealed the presence of the viral nucleoprotein in epithelial surface and in lymphoid cells in both extrafollicular and follicular regions, in adenoids and palatine tonsils. Also, IHC for the SARS-CoV-2 non-structural protein NSP-16 indicated the presence of viral replication in 53.8% of the SARS-CoV-2-infected tissues. Flow cytometry showed that CD20+ B lymphocytes were the most infected phenotypes, followed by CD4+ lymphocytes and CD123 dendritic cells, CD8+ T lymphocytes, and CD14+ macrophages. Additionally, IF indicated that infected tonsillar tissues had increased expression of ACE2 and TMPRSS2. NGS sequencing demonstrated the presence of different SARS-CoV-2 variants in tonsils from different tissues. SARS-CoV-2 antigen detection was not restricted to tonsils but was also detected in nasal cells from the olfactory region. Palatine tonsils and adenoids are sites of prolonged RNA presence by SARS-CoV-2 in children, even without COVID-19 symptoms. IMPORTANCE This study shows that SRS-CoV-2 of different lineages can infect tonsils and adenoids in one quarter of children undergoing tonsillectomy. These findings bring advancement to the area of SARS-CoV-2 pathogenesis, by showing that tonsils may be sites of prolonged infection, even without evidence of recent COVID-19 symptoms. SARS-CoV-2 infection of B and T lymphocytes, macrophages, and dendritic cells may interfere with the mounting of immune responses in these secondary lymphoid organs. Moreover, the shedding of SARS-CoV-2 RNA in respiratory secretions from silently infected children raises concern about possible diagnostic confusion in the presence of symptoms of acute respiratory infections caused by other etiologies.
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  • 文章类型: Case Reports
    虽然非常罕见,囊性腺样癌(CAC)应被视为由支气管腺引起的任何肺肿瘤的鉴别诊断。诊断通常通过组织学检查来确认,治疗主要基于手术干预。在这份报告中,我们介绍了一例82岁男性肺部原发性CAC的病例.
    Although very rare, cystic adenoid carcinoma (CAC) should be considered as a differential diagnosis for any lung tumor arising from the bronchial glands. The diagnosis is typically confirmed through histological examination, and treatment is primarily based on surgical intervention. In this report, we present the case of an 82-year-old male with primary CAC of the lung.
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  • 文章类型: Journal Article
    简介:牙源性肿瘤包括一组异质性病变,范围从错构瘤性病变到恶性肿瘤。组织学表现的显着变化可能会误导其准确的诊断和分类。成釉细胞瘤通常很容易理解并且易于诊断,但是自从Broca在1867年对牙源性肿瘤进行分类以来,分类系统一直在变化。多年来,它已被世界卫生组织修改,有许多补充和遗漏。这种动态变化是基于分子和遗传研究的结果和结论,最后一次修改是在2017年。病例报告:我们介绍了2例32岁和60岁女性报告面部肿胀,显示存在明显的组织病理学发现,并被诊断为成釉细胞瘤伴有牙样或腺样成釉细胞瘤。文献检索显示缺乏不同形式的成釉细胞瘤,这些成釉细胞瘤显示形成导管样结构和牙质。结论:由于缺乏相关研究和对患者的随访,生物学行为仍未被探索,因此强调此类病例很有趣。了解新实体的发病机制和组织病理学特征将有助于及时诊断,治疗计划和扩大病变范围。
    在线版本包含补充材料,可在10.1007/s12070-023-03534-6获得。
    Introduction: Odontogenic tumors encompass a heterogeneous group of lesions that range from hamartomatous lesions to malignancy. Considerable variation in histologic presentation can mislead their accurate diagnosis and categorization. Ameloblastoma is generally well understood and is easy to diagnose but there has been a constant change in the classification systems ever since Broca classified odontogenic tumors in the year 1867. Over the years, it has been modified by the World Health Organization with many additions and omissions. This dynamic change is based on the result and conclusions of molecular and genetic studies with the last modification in 2017. Case Report: We present two cases of females aged 32 and 60 years who reported with facial swellings, revealed the presence of distinct histopathological findings and were diagnosed as ameloblastoma with dentinoid or adenoid ameloblastoma. Literature search revealed dearth of distinct forms of ameloblastoma that show the formation of duct like structures and dentinoid. Conclusion: It is interesting to highlight such cases as the biological behavior is still unexplored due to paucity of relevant studies and follow up of patients. Understanding the pathogenesis and the histopathological characteristics of the newer entities will enable the prompt diagnosis, treatment plan and expanding the spectrum of the lesions.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-03534-6.
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  • 文章类型: English Abstract
    Objective:To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods:From March 2021 to March 2022, 240 children underwent cone beam computed tomography(CBCT) in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results:For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors(P>0.05). The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union(MIOU) s (86.32±0.54)%; Dice Similarity Coefficient(DSC): (92.91±0.23)%; Accuracy: (95.92±0.25)%; Precision: (91.93±0.14)%; and the model evaluation index of Adenoid volume: MIOU: (86.28±0.61)%; DSC: (92.88±0.17)%; Accuracy: (95.90±0.29)%; Precision: (92.30±0.23)%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/(AV+NAV) in 240 children of different age groups(P<0.05), and the correlation coefficient of 9-13 years old was 0.74. Conclusion:The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability.
    目的:探讨基于U-Net网络的深度学习模型对儿童腺样体及鼻咽气道的全自动图像分割效果。 方法:2021年3月-2022年3月在深圳大学总医院耳鼻咽喉头颈外科因睡眠打鼾或张口呼吸进行锥形束计算机断层扫描(CBCT)检查的患儿240例,选取其中52例进行鼻咽部和腺样体人工标注,再由深度学习模型训练与验证。将模型应用于剩余188例数据后,比较所有240例数据常规二维指标及深度学习三维指标间的差异。 结果:对于52例建模以及训练数据集,深度学习预测结果与人工标注结果差异均无统计学意义(P>0.05),模型评价指标鼻咽气道容积的均交并比为(86.32±0.54)%;相似系数为(92.91±0.23)%;准确度为(95.92±0.25)%;精准度为(91.93±0.14)%;腺样体体积的均交并比为(86.28±0.61)%;相似系数为(92.88±0.17)%;准确度为(95.90±0.29)%;精准度为(92.30±0.23)%。240例不同年龄段患儿二维指标A/N和三维指标AV/(AV+NAV)之间均呈正相关性(P<0.05),9~14岁的相关系数达0.74。 结论:基于U-Net网络的深度学习模型对儿童腺样体及鼻咽气道全自动图像分割效果良好,为今后进一步研究导致OSA的腺样体肥大的三维诊断标准提供有利的大数据计算模型。.
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