Oral and Maxillofacial Pathology

口腔颌面部病理学
  • 文章类型: Journal Article
    骨内动静脉畸形(AVM)是罕见的高流量血管畸形,可影响上颌骨或下颌骨。AVM可能会出现特异性和误导性的体征和症状。诊断通常是偶然的,出血可能是首发症状。射线照相,特征性特征少,易误诊。在这里,我们报告了一例年轻男性,该男性在下颌骨右侧受到动静脉瘘的影响,最初被误诊为囊性病变。患者接受了血管畸形的经动脉栓塞,随后手术切除了病变。1年随访显示下颌骨完全愈合,无复发。骨内动静脉畸形是罕见的实体。然而,由于它们的危害性,临床医师和放射科医师都必须意识到这一类型的病变,在进行溶骨性病变的鉴别诊断时,应始终考虑这一类型的病变.
    Intraosseous arteriovenous malformations (AVM) are uncommon high-flow vascular malformation that can affect the maxilla or mandible. AVM may present with aspecific and misleading signs and symptoms. The diagnosis is often accidental and bleeding may represent the first symptom. Radiographically, there are few characteristic features and misdiagnosis is easy. Here we report the case of a young male affected by arteriovenous fistula on the right side of the mandible initially misdiagnosed as a cystic lesion. The patient underwent transarterial embolization of the vascular malformation and subsequently the lesion was surgically removed. 1-year follow-up showed complete healing of the mandibular bone and absence of recurrence. Intraosseous arteriovenous malformations are rare entities. However, due to their harmfulness, both clinicians and radiologists must be aware of this type of lesion and should always consider them in the differential diagnosis of osteolytic lesions.
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  • 文章类型: Journal Article
    小儿口腔病理学包括影响儿童口腔的多种疾病和病症。在这项研究中,我们对沙特阿拉伯一个学术中心的数据集进行了分析,以调查儿科患者各种口腔病变的患病率。
    为了进行这项研究,我们分析了2012年1月至2022年12月期间在我们机构的口腔病理实验室接受活检的儿科患者(年龄范围:0-18岁)的口腔病理报告。我们收集的数据包括人口统计信息和诊断结果。进行统计分析以确定不同变量的患病率和相关性。
    该研究共分析了183例患有口腔疾病的儿科病例。观察到的最常见的情况是粘液囊肿(12%),根尖周围肉芽肿(7.7%),牙质囊肿(6.6%),和根性囊肿(6.6%)。一些情况显示,患病率因年龄和性别而异。例如,黏液囊肿在6-12岁的女性患者中更为普遍.
    这项回顾性研究为儿童口腔疾病的患病率和人口统计学特征提供了有价值的见解。通过了解该人群的患病率,并认识到与其他研究中引用的分布差异,我们强调了考虑区域和人口影响的重要性。需要进一步的前瞻性研究来调查可能导致这些变化的因素。
    UNASSIGNED: Pediatric oral pathology encompasses a wide range of diseases and conditions affecting the oral cavity in children. In this study we conducted an analysis on a dataset from one academic center in Saudi Arabia to investigate the prevalence of various oral lesions in pediatric patients.
    UNASSIGNED: To conduct this study we analyzed oral pathology reports of pediatric patients (age range: 0-18 years) who underwent biopsies at our institution\'s oral pathology laboratory between January 2012 and December 2022. The data we collected included demographic information and diagnostic findings. Statistical analysis was performed to determine the prevalence rates of and associations between different variables.
    UNASSIGNED: The study analyzed a total of 183 pediatric cases with oral pathologies. The most common conditions observed were mucocele (12 %), periapical granuloma (7.7 %), dentigerous cyst (6.6 %), and radicular cyst (6.6 %). Some conditions showed variations in prevalence based on age and gender. For example, mucoceles were more prevalent among patients who were 6-12 years of age and female.
    UNASSIGNED: This retrospective study provides valuable insights into the prevalence and demographic characteristics of pediatric oral pathologies. By understanding the prevalence of conditions in this population and recognizing differences in distribution compared with those cited in other studies, we highlighted the importance of considering regional and demographic influences. Further prospective studies are needed to investigate factors that may contribute to these variations.
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  • 文章类型: Journal Article
    分泌性癌是一种恶性涎腺肿瘤,通常表现为腮腺内的无痛性肿块。据报道涉及小腺体,但较少见。分泌性癌经常被错误分类为其他唾液腺模拟物,特别是,2010年之前的腺泡细胞癌。它首先被Skalova等人认可。作为一种分子上不同的唾液腺肿瘤,具有相同的融合基因以及在青少年乳腺癌中看到的组织学和细胞遗传学特征。分泌性癌通常作为其他低度唾液腺肿瘤进行治疗,预后良好;然而,已经记录了需要积极治疗干预的高级转化。针对该融合基因产物的生物制剂的最新研究为治疗这种恶性肿瘤提供了新的治疗选择。由于报道的病例数量有限,临床行为谱,分泌性癌的最佳治疗方法和长期治疗结果尚不清楚.我们报告了一个长期存在的分泌性癌,涉及粘膜颊褶皱的小唾液腺,这是在患者首次注意到数年后发现的。此案例揭示了在牙科就诊期间进行彻底临床检查的重要性,并回顾了该恶性肿瘤与其他模仿物的诊断区分,并讨论了其管理决策。
    Secretory carcinoma is a malignant salivary gland tumor, which typically presents as an indolent painless mass within the parotid gland. Involvement of the minor gland is reported but less common. Secretory carcinoma was often misclassified as other salivary gland mimics, particularly acinic cell carcinoma, prior to 2010. It was first recognized as a molecularly distinct salivary gland tumor harboring the same fusion gene as well as histologic and cytogenetic features seen in juvenile breast cancer. Secretory carcinoma is generally managed in the same way as other low-grade salivary gland neoplasms and has a favorable prognosis; however, high-grade transformation requiring aggressive therapeutic interventions have been documented. Recent studies of biologic agents targeting products of this fusion gene offer the promise of a novel therapeutic option for treatment of this malignancy. Due to the limited number of reported cases, the spectrum of clinical behavior, best practices for management, and long-term treatment outcomes for secretory carcinoma remain unclear. A long-standing secretory carcinoma involving minor salivary glands of the mucobuccal fold, which was detected years after it was first noted by the patient, is reported. This case brings to light the importance of a thorough clinical exam during dental visits and reviews diagnostic differentiation of this malignancy from other mimics and discusses decision making for its management.
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  • 文章类型: Meta-Analysis
    背景:由于AI算法可以分析患者数据,医疗记录,和成像结果来建议治疗计划和预测结果,它们有可能支持病理学家和临床医生诊断和治疗口腔颌面部病变,就像它被使用的其他生活领域一样。当前研究的目标是检查AI可能参与帮助从业者的口腔颌面病理学领域正在研究的所有趋势。
    方法:我们首先定义了调查主题中的重要术语。在此之后,像PubMed这样的相关数据库,Scopus,使用每个概念的关键词和同义词搜索WebofScience,比如“机器学习”,\"\"诊断,“\”治疗计划,\"\"图像分析,预测建模,\"和\"病人监测。\"对于更多的论文和来源,谷歌学者也被使用。
    结果:选择的9项研究中的大多数是关于如何利用AI诊断口腔恶性肿瘤。AI在创建预测模型方面特别有用,该模型可帮助病理学家和临床医生预测特定患者的口腔和颌面部病理学的发展。此外,预测模型准确地识别出患有口腔癌的高风险患者以及治疗后疾病复发的可能性.
    结论:在口腔颌面病理学领域,人工智能有可能提高诊断精度,个性化护理,并最终改善患者的预后。人工智能在医疗保健领域的发展和应用,然而,需要仔细考虑道德,legal,和监管挑战。此外,因为人工智能仍然是一种相对较新的技术,将其应用于该行业时必须谨慎。
    BACKGROUND: Since AI algorithms can analyze patient data, medical records, and imaging results to suggest treatment plans and predict outcomes, they have the potential to support pathologists and clinicians in the diagnosis and treatment of oral and maxillofacial pathologies, just like every other area of life in which it is being used. The goal of the current study was to examine all of the trends being investigated in the area of oral and maxillofacial pathology where AI has been possibly involved in helping practitioners.
    METHODS: We started by defining the important terms in our investigation\'s subject matter. Following that, relevant databases like PubMed, Scopus, and Web of Science were searched using keywords and synonyms for each concept, such as \"machine learning,\" \"diagnosis,\" \"treatment planning,\" \"image analysis,\" \"predictive modelling,\" and \"patient monitoring.\" For more papers and sources, Google Scholar was also used.
    RESULTS: The majority of the 9 studies that were chosen were on how AI can be utilized to diagnose malignant tumors of the oral cavity. AI was especially helpful in creating prediction models that aided pathologists and clinicians in foreseeing the development of oral and maxillofacial pathology in specific patients. Additionally, predictive models accurately identified patients who have a high risk of developing oral cancer as well as the likelihood of the disease returning after treatment.
    CONCLUSIONS: In the field of oral and maxillofacial pathology, AI has the potential to enhance diagnostic precision, personalize care, and ultimately improve patient outcomes. The development and application of AI in healthcare, however, necessitates careful consideration of ethical, legal, and regulatory challenges. Additionally, because AI is still a relatively new technology, caution must be taken when applying it to this industry.
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  • 文章类型: Case Reports
    麻风病是由耐酸杆菌麻风分枝杆菌(M.麻风病)和麻风病分枝杆菌。这些杆菌对皮肤和周围神经表现出独特的偏爱,尽管它们可能会影响体内的任何系统。最近,粘膜症状明显减轻,很大程度上归功于麻风病的及时诊断和治疗。尽管如此,由于口腔病变在疾病传播中起着至关重要的作用,因此它们仍然具有重要的流行病学意义。口腔表现,虽然罕见,在患有多杆菌麻风病的个体中经常遇到。慢性大型鸡是这种疾病极为罕见的表现,只有少数记录在案的病例报告和案例研究。本文旨在记录一例以慢性大型麻风病为唯一表现特征的麻风病异常罕见病例。
    Leprosy is a chronic debilitating disorder caused by the acid-fast bacilli Mycobacterium leprae (M. leprae) and Mycobacterium lepromatosis. These bacilli exhibit a distinctive predilection for the skin and peripheral nerves, although they can potentially impact any system in the body. Lately, there has been a notable reduction in mucosal symptoms, largely attributed to the timely diagnosis and treatment of leprosy. Nonetheless, oral lesions continue to hold significant epidemiological importance due to their crucial role in disease transmission. Oral manifestations, although rare, are frequently encountered in individuals afflicted with multi-bacillary leprosy. Chronic macrocheilia is an exceedingly rare manifestation of the disease, with only a few documented case reports and case studies. This article aims to document an exceptionally uncommon case of lepromatous leprosy with chronic macrocheilia as the sole presenting feature.
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  • 文章类型: Journal Article
    在牙科领域,无数的技术进步,包括远程牙科,虚拟现实(VR)人工智能(AI)和三维打印,得到了广泛的接受和严格的评估,不断证明其显著的有效性。这些创新开创了牙科领域的变革时代,影响了这个领域的方方面面。它们包括从口腔健康状况的诊断和探索到治疗计划的制定等活动,外科手术的执行,假肢的制造,甚至帮助患者分心,预后,和疾病预防。尽管已经取得了重大进展,人类好奇心推动的对新视野的不懈追求仍然没有减弱。未来的牙科前景有望彻底改变,其特点是牙科护理的可及性增强,治疗持续时间缩短。在这篇全面的综述文章中,我们深入研究了人工智能扮演的关键角色,VR,增强现实,混合现实,以及牙科领域的延伸现实,特别强调它们在口腔医学中的应用,口腔放射学,口腔外科,和口腔病理学。这些技术仅占目前牙科领域技术库的一小部分。彻底理解它们的优点和局限性对于在利用它们时做出明智的决策至关重要。
    In the realm of dentistry, a myriad of technological advancements, including teledentistry, virtual reality (VR), artificial intelligence (AI), and three-dimensional printing, have been extensively embraced and rigorously evaluated, consistently demonstrating their remarkable effectiveness. These innovations have ushered in a transformative era in dentistry, impacting every facet of the field. They encompass activities ranging from the diagnosis and exploration of oral health conditions to the formulation of treatment plans, execution of surgical procedures, fabrication of prosthetics, and even assistance in patient distraction, prognosis, and disease prevention. Despite the significant strides already taken, the relentless pursuit of new horizons fueled by human curiosity remains unabated. The future landscape of dentistry holds the promise of sweeping changes, notably characterized by enhanced accessibility to dental care and reduced treatment durations. In this comprehensive review article, we delve into the pivotal roles played by AI, VR, augmented reality, mixed reality, and extended reality within the realm of dentistry, with a particular emphasis on their applications in oral medicine, oral radiology, oral surgery, and oral pathology. These technologies represent just a fraction of the technological arsenal currently harnessed in the field of dentistry. A thorough comprehension of their advantages and limitations is imperative for informed decision-making in their utilization.
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  • 文章类型: Case Reports
    我们介绍了一例罕见的64岁患者的临床病例,其色素性病变位于左侧颊粘膜。据报道,在进食过程中出现轻微疼痛和不适的主观抱怨,并在食用热食时增加了敏感性。根据患者提供的信息,病变逐渐增大.据报道,以前的牙科手术史,即,根据相关适应症,拔除上颌骨左半部分有汞合金闭塞的牙齿。在口内检查期间,一个公寓,黑色病变,直径0.4厘米,在颊粘膜中观察到边界明确。牙齿25、26和27是在五到七年前拔除的。作为常规程序进行了端骨造影术。它没有显示任何可以解释患者症状的X射线造影区域。病变的症状性质以及阴性的放射学发现促使手术治疗和切除活检,随后进行组织学评估以排除口腔恶性肿瘤。进行切除。在接下来八天的随访检查中,病人的所有症状都消失了。病理报告的结论是“组织学发现和临床数据与汞合金纹身一致”。汞合金纹身是口腔粘膜最常见的医源性色素性病变,这是由于在软组织中植入汞合金颗粒而导致的,通常是无症状的。在这种情况下,不需要手术治疗。然而,在一些罕见的情况下,就像我们展示的那个,一些症状可能会出现并使诊断过程复杂化。在这些情况下,病变的完全切除将进行随后的组织学评估。牙齿的无创伤干预,用确定的汞合金填充物封闭,是防止口腔粘膜这种色素沉着的主要因素。
    We present a rare clinical case of a 64-year-old patient with a pigmented lesion localized in the left buccal mucosa. Subjective complaints of slight pain and discomfort in the process of eating and increased sensitivity when consuming hot food were reported. According to the information provided by the patient, the lesion had progressively increased in size. A history of previous dental manipulations was reported, namely, the extraction of teeth with amalgam obturations in the left half of the maxilla as per relevant indications. During the intraoral examination, a flat, black-colored lesion, 0.4 cm in diameter, with well-defined borders was observed in the buccal mucosa. Teeth 25, 26, and 27 were previously extracted five to seven years ago. An orthopantomography was performed as a routine procedure. It did not show any presence of X-ray contrast areas that could explain the symptoms of the patient. The symptomatic nature of the lesion as well as the negative radiological findings prompted surgical treatment and excisional biopsy with subsequent histological evaluation to rule out oral malignancy. An excision was performed. During the follow-up examination in the next eight days, all the symptoms of the patient were gone. The conclusion of the pathology report was \"histological findings and clinical data consistent with amalgam tattoo\". The amalgam tattoo is the most frequent iatrogenic pigmented lesion of the oral mucosa, which results from the implantation of amalgam particles in the soft tissues and it is usually asymptomatic. In this case, no surgical treatment is needed. However, in some rare cases, like the one we are presenting, some symptoms can occur and complicate the diagnostic process. In these cases, the complete excision of the lesion is to be performed with subsequent histological evaluation. The atraumatic intervention of teeth, obturated with definitive amalgam fillings, is a main factor for preventing this kind of pigmentation of the oral mucosa.
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  • 文章类型: Journal Article
    背景:牙源性肿瘤(OT)由异质性病变组成,可以是良性或恶性的,具有不同的行为和组织学。在这个分类中,成釉细胞瘤和成釉细胞癌(AC)由于其相似的特征和切开活检所代表的局限性,在日常组织病理学实践中代表了诊断挑战。从这些前提来看,我们希望测试基于人工智能(AI)的模型在口腔颌面病理学领域的鉴别诊断的有用性。将机器学习(ML)与显微镜和射线照相成像集成的主要优点是能够显着减少观察者内部和观察者之间的变异性并提高诊断的客观性和可重复性。
    方法:从巴西不同的口腔病理学诊断中心收集了30张数字化切片。在感兴趣区域中执行手动注释后,图像被分割并分成小的小块。在用于图像分类的监督学习方法中,三种型号(ResNet50、DenseNet、和VGG16)是调查的重点,以提供图像被分类为0类的概率(即,成釉细胞瘤)或第1类(即,成釉细胞癌)。
    结果:训练和验证指标未显示收敛,表征过拟合。然而,测试结果令人满意,ResNet50的精度平均值为0.75、0.71、0.84、0.65和0.77,精度,灵敏度,特异性,和F1得分,分别。
    结论:这些模型展示了强大的学习潜力,但缺乏泛化能力。模型学得很快,训练准确率达到98%。评估过程显示验证不稳定;然而,测试过程中可接受的性能,这可能是由于数据集小。首次调查为扩大合作以纳入更多互补数据提供了机会;以及,开发和评估新的替代模型。
    BACKGROUND: Odontogenic tumors (OT) are composed of heterogeneous lesions, which can be benign or malignant, with different behavior and histology. Within this classification, ameloblastoma and ameloblastic carcinoma (AC) represent a diagnostic challenge in daily histopathological practice due to their similar characteristics and the limitations that incisional biopsies represent. From these premises, we wanted to test the usefulness of models based on artificial intelligence (AI) in the field of oral and maxillofacial pathology for differential diagnosis. The main advantages of integrating Machine Learning (ML) with microscopic and radiographic imaging is the ability to significantly reduce intra-and inter observer variability and improve diagnostic objectivity and reproducibility.
    METHODS: Thirty Digitized slides were collected from different diagnostic centers of oral pathology in Brazil. After performing manual annotation in the region of interest, the images were segmented and fragmented into small patches. In the supervised learning methodology for image classification, three models (ResNet50, DenseNet, and VGG16) were focus of investigation to provide the probability of an image being classified as class0 (i.e., ameloblastoma) or class1 (i.e., Ameloblastic carcinoma).
    RESULTS: The training and validation metrics did not show convergence, characterizing overfitting. However, the test results were satisfactory, with an average for ResNet50 of 0.75, 0.71, 0.84, 0.65, and 0.77 for accuracy, precision, sensitivity, specificity, and F1-score, respectively.
    CONCLUSIONS: The models demonstrated a strong potential of learning, but lack of generalization ability. The models learn fast, reaching a training accuracy of 98%. The evaluation process showed instability in validation; however, acceptable performance in the testing process, which may be due to the small data set. This first investigation opens an opportunity for expanding collaboration to incorporate more complementary data; as well as, developing and evaluating new alternative models.
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  • 文章类型: Case Reports
    纤维增生性纤维瘤(DF)是一种罕见的,良性,但局部侵袭性骨肿瘤。它经常影响面部骨骼,下颌骨是最常见的受影响部位。选择的治疗方法是切除肿瘤,并切除周围的骨骼,这是由于其攻击行为。我们报告了一例DF,其中肿瘤在摘除后表现出消退和几乎完全的骨沉积。虽然DF有很高的复发率,患者在手术后31个月保持无病状态.
    Desmoplastic fibroma (DF) is a rare, benign, yet locally aggressive bone tumor. It frequently affects the facial bones, and the mandible is the most commonly affected site. Treatment of choice is the removal of the tumor with resection of surrounding bone due to its aggressive behavior. We report a case of DF where the tumor showed resolution and almost complete bone deposition following enucleation. Although DF has a high recurrence rate, the patient remains disease-free 31 months post-surgery.
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    文章类型: Journal Article
    目前,该国的口腔颌面部病理学(OMFP)状况不佳。本研究旨在调查现状,并从受益人的角度制定切实可行的方法来改善该专业未来的职业状况。
    这是一项描述性横断面研究。参与者是该国的口腔和颌面病理学家(200人),OMFP居民(9个人),和最后一年的牙科学生在全国六牙科学校在2020年(200个人)通过多中心设计。在第一阶段,相关的问卷是通过心理测量进行开发和评估的。问卷的可靠性,内部一致性,并对可重复性进行了计算和确认。在第二阶段,关于当前和未来状况的调查问卷以电子方式发送给研究组。数据采用描述性统计检验(平均值,标准偏差,百分比)和使用SPSS的Pearson检验。
    在第一阶段,在研究的初步设计之后,省略了23个内容效度比低于0.56、内容效度指数(CVI)低于0.79的变量。专家问卷的Cronbachα为0.75,组内相关系数(ICC)为0.83,学生和居民问卷的Cronbachα为0.95,ICC为0.80。第二阶段的结果表明,学生选择OMFP专业继续教育的倾向得分为5分的1.58±0.57。专家对该专业的专业活动的满意度从5分为2.7±1.52。学生选择这个专业的最重要原因是“有兴趣成为教师,”和“专业的困难”是不选择此专业的最可能原因。居民最重要的优先事项是“对专业感兴趣”,对专家来说是“成为教职员工”。“专家改变对专业态度的最重要原因被称为“高职业和职业责任感以及低收入”,得分为1.38±3.99。从专家的角度来看,“专业教育课程的基本修订”以5分的4.60±0.93被认为是最重要的修订方法。
    目前,该国OMPF专业的主要问题是“毕业生人数众多,缺乏目前的职业机会”。“相关专业部门的评估和验证,创造职业机会,有必要对教育课程进行根本修订,以培养有能力的专家。
    UNASSIGNED: At present, the status of oral and maxillofacial pathology (OMFP) in the country is not properly good. This study aimed to investigate the current status and develop practical approaches to improve occupational condition of the specialty in the future from the viewpoint of the beneficiaries.
    UNASSIGNED: This was a descriptive cross-sectional study. The participants were oral and maxillofacial pathologists of the country (200 individuals), OMFP residents (9 individuals), and final year dental students at six dentistry school of the country at 2020 (200 individuals) through multicenter design. At the first phase, the related questionnaires were developed and assessed psychometrically. Reliability of the questionnaires, internal consistency, and repeatability were computed and confirmed. At the second phase, the survey questionnaires on the current and future condition were sent electronically to the study groups. The data were analyzed using descriptive statistical tests (mean, standard deviation, percentage) and the Pearson test using SPSS.
    UNASSIGNED: At the first phase, after primary design of the study too, 23 variables with content validity ratio below 0.56 and content validity index (CVI) below 0.79 were omitted. The questionnaire for the specialists was confirmed with Cronbach\'s alpha of 0.75 and intraclass correlation coefficient (ICC) as 0.83, and the questionnaire for the students and the residents were confirmed with Cronbach\'s alpha of 0.95 and ICC of 0.80. Results of the second phase showed that score of tendency of students to select OMFP specialty to continue education was 1.58 ± 0.57 from 5. Satisfaction score of specialists on specialized activity of this specialty is 2.7 ± 1.52 from 5. The most important reason for the students to select this specialty was \"interest in being faculty member,\" and the \"difficulty of the specialty\" was the most probable reason for not selecting this specialty. The most important priority of the residents was \"interest in specialty\" and for the specialists was \"being faculty member.\" The most important reason to change attitude regarding the specialty by the specialists was mentioned as \"high occupational and profession responsibility as well as low income\" with the score of 1.38 ± 3.99. \"Fundamental revision in the educational curriculum of the specialty\" with a score of 4.60 ± 0.93 from 5 was considered as the most important revisionary approach from the viewpoint of specialists.
    UNASSIGNED: At present, the main problem regarding the OMPF specialty in the country is \"high number of graduates and lack of the present occupational opportunities.\" Evaluation and validation of the relevant specialized departments, producing occupational opportunities, and fundamental revision in the educational curriculum to train well-powered specialists are necessary.
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