• 文章类型: Journal Article
    结论:研究论文探讨了锡金地区孕妇肠道寄生虫感染的负担和相关因素,印度,被归类为被忽视的热带病,影响全球15亿人,热带地区的比率较高。这些感染会带来重大的健康风险,导致贫血,孕产妇-围产期健康状况不佳,和延续世代营养不良和反复感染。一项针对锡金100名孕妇的横断面研究旨在确定肠道寄生虫病的负担和相关的社会人口统计学因素。与类似的研究相比,它报告的患病率较低,以贾第鞭毛虫为主要寄生虫。该研究发现肠道寄生虫病和贫血之间存在显著联系。总之,本文建议对血红蛋白水平低的孕妇进行常规筛查和驱虫,强调怀孕期间对肠道寄生虫病的健康教育和认识,尤其是在资源有限的环境中。遵守印度的孕期驱虫国家指南至关重要。
    CONCLUSIONS: The research paper explores the burden and associated factors of intestinal parasitic infections among pregnant women in Sikkim, India, categorized as neglected tropical diseases affecting 1.5 billion globally, with higher rates in tropical regions. These infections pose significant health risks, causing anemia, poor maternal-perinatal health, and perpetuating generational undernutrition and recurrent infections. A cross-sectional study of 100 pregnant women in Sikkim aimed to determine the burden of intestinal parasitosis and associated sociodemographic factors. It reported a lower prevalence compared to similar studies, with Giardia Lamblia as the dominant parasite. The study found a significant link between intestinal parasitosis and anemia. In conclusion, the paper recommends routine screening and deworming for pregnant women with low hemoglobin levels, emphasizing health education and awareness about intestinal parasitosis during pregnancy, especially in resource-limited settings. Adherence to India\'s National Guidelines for Deworming during pregnancy is crucial.
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  • 文章类型: Journal Article
    由于营养不足和贫血在印度持续普遍存在,社会经济弱势群体继续首当其冲。奥里萨邦是印度数量最多的特别脆弱的部落群体(PVTG)的所在地。该研究旨在提供有关奥里萨邦所有PVTG的营养不良和贫血状况的全面报告。
    从2018年8月至2019年2月,对分布在奥里萨邦12个地区的13个PVTG(N=1461,683名男性和779名女性)进行了一项基于社区的横断面研究。
    在五岁以下儿童中,体重不足的患病率为75.26%,发育迟缓占55.42%,在女孩中,消瘦占60.00%,所有形式的营养不良都较高。在5至19岁年龄段的儿童和青少年中,瘦身的患病率为46.7%。在20岁以上的个体中,男性体重不足的患病率为37.7%,女性为44.3%,女性为36.5%,男性为35.8%。育龄妇女贫血患病率较高。
    研究表明,PVTG中的营养不良和贫血仍然很高,尤其是五岁以下儿童和育龄妇女。随着该国朝着到2030年实现可持续发展目标(SDG)的方向前进,需要设计和实施国家和州的卫生政策。特别关注这些弱势群体。
    UNASSIGNED: As undernutrition and anemia persist to be prevalent in India, the socioeconomically disadvantaged groups continue to take the greater brunt. Odisha is home to the largest number of particularly vulnerable tribal groups (PVTGs) in India. The study aimed to provide a comprehensive report on the undernutrition and anemia status of all the PVTGs of Odisha.
    UNASSIGNED: A community-based cross-sectional study was conducted among (N = 1461, 683 males and 779 females) 13 PVTGs spread across 12 districts of Odisha from August 2018 to February 2019.
    UNASSIGNED: Among the under-five children, the prevalence of underweight was observed in 75.26%, stunting in 55.42%, and wasting in 60.00% and all forms of undernutrition were higher among girls. Among children and adolescents belonging to the age group of 5 to 19 years, the prevalence of thinness was 46.7%. In individuals above the age of 20, the prevalence of underweight among males was 37.7% and females was 44.3% and severe anemia was present in 36.5% of females and 35.8% of males. Women in the reproductive age have a higher prevalence of anemia.
    UNASSIGNED: The study shows that undernutrition and anemia remain high in the PVTGs, especially among the under-five children and women in the reproductive age. As the country heads toward fulfilling Sustainable Development Goals (SDG) by 2030, national and state health policies need to be designed and implemented, giving special focus to these vulnerable groups.
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  • 文章类型: Journal Article
    进行系统评价和荟萃分析以确定贫血的患病率。缺铁(ID),中国孕妇缺铁性贫血(IDA)。共收集了2010年1月至2020年12月期间发表的722篇关于妊娠期贫血的文章。对包括1,376,204名孕妇在内的57项符合条件的研究进行了系统评价和荟萃分析,以确定贫血的患病率和不同亚组的患病率.结果表明,贫血的患病率,ID,中国孕妇中的IDA为30.7%(95%CI:26.6%,34.7%),45.6%(95%CI:37.0%,54.2%),和17.3%(95%CI:13.9%,20.7%),分别。所有患病率随着妊娠的进展而增加。贫血的患病率有相当大的地区差异,ID,和IDA。一般来说,在该国经济较发达的东部地区,患病率较低,东部地区的ID患病率高于西部地区。农村地区贫血和IDA患病率高于城市地区,但城市地区的ID患病率较高。总之,贫血患病率的地区差异和城乡差异表明,需要更多针对具体环境的干预措施来预防和治疗贫血.研究发现,饮食因素是贫血的主要原因之一,含铁补充剂和营养咨询可以成为降低贫血患病率的有效干预措施,ID,和IDA在中国孕妇中。
    The systematic review and meta-analysis were conducted to ascertain the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among Chinese pregnant women. A total of 722 articles on maternal anemia during pregnancy published between January 2010 and December 2020 were compiled, and a systematic review and meta-analysis were conducted on 57 eligible studies including 1,376,204 pregnant women to ascertain the prevalence of anemia and the prevalence in different subgroups. The results showed that the prevalence of anemia, ID, and IDA among pregnant women in China were 30.7% (95% CI: 26.6%, 34.7%), 45.6% (95% CI: 37.0%, 54.2%), and 17.3% (95% CI: 13.9%, 20.7%), respectively. All prevalence increased with the progression of the pregnancy. There were sizable regional variations in the prevalence of anemia, ID, and IDA. Generally, lower prevalence was observed in the economically more advanced eastern region of the country, while the prevalence of ID was higher in the eastern region than that in the western region. The prevalence of anemia and IDA in rural areas was higher than that in urban areas, but ID prevalence was higher in urban areas. In conclusion, the regional differences and urban-rural disparities in the prevalence of anemia indicate the need for more context-specific interventions to prevent and treat anemia. It was found that dietary factors were one of the major causes of anemia, and iron-containing supplements and nutrition counseling could be effective interventions to reduce the prevalence of anemia, ID, and IDA among Chinese pregnant women.
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  • 文章类型: Journal Article
    在本研究中,我们进行了安慰剂对照,双盲,在平行组比较试验中,在季前训练期间,向长跑运动员服用蛹虫草(CM)菌丝体提取物16周,并调查贫血的血液检测指标.结果表明,在研究期间,CM组(n=11)血清铁蛋白水平的变化率适度增加,但安慰剂组(n=11)下降。与安慰剂组相比,在测试食物摄入后4周和8周时,CM组的水平显着增加(p<0.05)。此外,实验摄食后8周,与安慰剂组相比,CM组血红蛋白和血细胞比容的变化率显着增加(p<0.05)。这些观察结果表明,摄入含有虫草菌丝体提取物的测试食物有望有效维持长跑运动员的血红蛋白和血细胞比容水平,可能是通过抑制铁储存的减少,血清铁蛋白反映了这一点,在赛季前训练期间。此外,注册时,安慰剂组和CM组的肌酸激酶水平均高于正常范围.有趣的是,与安慰剂组相比,CM组的肌酸激酶水平在测试食物摄入后16周时显着降低(p<0.05)。这些结果表明,冬虫夏草菌丝体提取物对长跑运动员中观察到的肌肉损伤具有保护作用,并可能抑制肌肉损伤。一起,这些观察结果表明,蛹虫草菌丝体提取物不仅对贫血的标志物具有改善作用,而且季前训练中长跑运动员的肌肉损伤也是如此。
    In the present study, we conducted a placebo-controlled, double-blind, parallel-group comparison trial in which an extract of Cordyceps militaris (CM) mycelium was administered to long-distance runners for 16 weeks during the pre-season training period and blood test markers for anemia were investigated. The results indicated that the change rates of serum ferritin levels were moderately increased in the CM group (n = 11) but decreased in the placebo group (n = 11) during the study period, and the levels were significantly increased in the CM group compared with those in the placebo group at 4 weeks and 8 weeks after the test food intake (p < 0.05). Moreover, the change rates of hemoglobin and hematocrit were significantly increased in the CM group compared with those in the placebo group at 8 weeks after the test food intake (p < 0.05). These observations suggest that the intake of test food containing Cordyceps militaris mycelium extract is expected to effectively maintain the hemoglobin and hematocrit levels in long-distance runners, possibly via the suppression of the decrease in iron storage, which is reflected by serum ferritin, during pre-season training. Furthermore, the levels of creatine kinase were increased above the normal range in both the placebo and CM groups at registration. Interestingly, the creatine kinase levels were significantly decreased in the CM group compared with those in the placebo group at 16 weeks after the test food intake (p < 0.05). These results suggest that Cordyceps militaris mycelium extract exhibits a protective action on the muscle damage observed in long-distance runners and may suppress muscle injury. Together, these observations suggest that Cordyceps militaris mycelium extract exhibits an improving effect on the markers for not only anemia, but also muscle injury in long-distance runners during pre-season training.
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  • 文章类型: Journal Article
    在孟加拉国,营养不良和微量营养素缺乏如贫血被认为是重大的公共卫生挑战。增加鱼类消费是解决这些问题的完善的基于食物的干预措施。本文记录了基于社区的鱼辣酱生产的建立,并报告了其消费对孟加拉国农村150名孕妇和哺乳期妇女(PLW)中上臂围(MUAC)和血红蛋白(Hb)水平的影响。使用当地可用的成分开发了鱼酸辣酱,然后进行了一系列实验室测试,包括营养成分,保质期和食品安全。基于社区的鱼酸辣酱生产过程旨在:(1)提供当地可用的加工原料;(2)建立两个鱼干燥点;(3)启动基于社区的生产点;(4)由六名女性营养领域促进者将鱼酸辣酱分发给PLW,为期一年。然后,针对选定的150PLW设计了干预前后的研究,每天接受30克鱼酸辣酱,持续12个月。使用单向方差分析分析了消费前后平均MUAC和Hb水平的差异。食用30克鱼酸辣酱会导致目标PLW中Hb水平和MUAC的平均值显着增加。
    Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: (1) supply locally available ingredients for processing; (2) establish two fish drying sites; (3) initiate a community-based production site; and (4) distribute fish chutney to PLW for one year by six women nutrition field facilitators. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30 g of fish chutney daily for 12 months. Differences in mean MUAC and Hb levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30 g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.
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  • 文章类型: Journal Article
    婴儿出生大小是预测早期生长不良和微量营养素缺乏的重要临床参数。然而,它们对儿童贫血的影响尚不清楚.我们的目的是探讨出生体重之间的关系,冠部-鞋跟长度,和儿童早期贫血的头围,以及潜在的修改因素。这项基于人群的前瞻性队列研究包括204,556名在28-42周胎龄分娩的单胎活产参与者。使用逻辑回归模型来估计婴儿出生大小及其Z评分与五岁以下贫血的相关性。有26,802(13.10%)五岁以下的儿童被诊断患有贫血。与没有贫血的儿童相比,贫血患儿的出生体重较低,头围较小,冠足跟长度较长(所有p值<0.05).在调整了混杂因素后,不仅是出生体重(β系数,-0.008;95%CI,-0.011--0.004;p<0.001)和头围(β系数,-0.004;95%CI,-0.007--0.001;p=0.009),而且相关的Z评分与儿童贫血呈负相关,而冠跟长度的趋势则相反。我们进一步发现叶酸使用和母亲职业与婴儿出生大小的显着相互作用。总之,出生时大小异常的婴儿与儿童贫血的风险显著相关,可以通过在怀孕和母亲职业期间使用叶酸来修改。
    Infant birth sizes are vital clinical parameters to predict poor growth and micronutrient deficiency in early life. However, their effects on childhood anemia remain unclear. We aimed to explore the associations between birth weight, crown-heel length, and head circumference with anemia in early childhood, as well as potential modification factors. This population-based prospective cohort study included 204,556 participants with singleton live births delivered at gestational ages of 28-42 weeks. A logistic regression model was used to estimate the associations of the measures of infant birth size and their Z-score with anemia under five years old. There were 26,802 (13.10%) children under five years old who were diagnosed has having anemia. Compared with children who did not have anemia, children who had anemia had a lower birth weight and smaller head circumference and a longer crown-heel length (all p-values < 0.05). After adjusting for confounders, not only birth weight (β coefficient, -0.008; 95% CI, -0.011--0.004; p < 0.001) and head circumference (β coefficient, -0.004; 95% CI, -0.007--0.001; p = 0.009), but also the related Z-scores were negatively associated with childhood anemia, while the trends for crown-heel length were the opposite. We further found significant interactions of folic acid use and maternal occupation with infant birth sizes. In conclusion, infants having abnormal sizes at birth are significantly associated with the risk for childhood anemia, which can be modified by folic acid use during pregnancy and maternal occupation.
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  • 文章类型: Journal Article
    背景/目标:贫血是终末期肾病(ESKD)中常见的多因素合并症,与发病率和QoL差相关。除了促红细胞生成素形成不足,缺铁(ID)有助于贫血的发展。用当前的ID定义来鉴定需要补充铁的患者是困难的,因为没有良好的生物标志物可用于检测实际的铁需求。因此,需要新的诊断工具来指导治疗。方法:我们进行了一项前瞻性队列研究,分析了20例贫血性ESKD患者的基于MRI的R2*弛豫测定法的组织铁含量,并与20例其他健康个体进行了比较。结果:ESKD患者的肝脏明显升高(90.1s-1vs.36.1s-1,p<0.001)和脾脏R2*值(119.8s-1vs.19.3s-1,p<0.001)与其他健康个体相比,而它们的胰腺和心脏R2*值没有显着差异。在20名ESKD患者中,17具有升高的脾脏和12具有升高的肝脏R2*值。KDIGO指南(侧重于血清铁参数)建议在7例脾脏升高的患者和4例肝脏R2*值升高的患者中补充铁。结论:这些发现突出表明,与对照组相比,ESKD患者的肝脏尤其是脾脏铁浓度明显更高。组织铁过载与经典的铁参数不同,表明需要补充铁。MRI引导的组织铁分布测量可能有助于指导贫血ESKD患者的治疗。
    Background/Objectives: Anemia is a frequent multifactorial co-morbidity in end-stage kidney disease (ESKD) associated with morbidity and poor QoL. Apart from insufficient erythropoietin formation, iron deficiency (ID) contributes to anemia development. Identifying patients in need of iron supplementation with current ID definitions is difficult since no good biomarker is available to detect actual iron needs. Therefore, new diagnostic tools to guide therapy are needed. Methods: We performed a prospective cohort study analyzing tissue iron content with MRI-based R2*-relaxometry in 20 anemic ESKD patients and linked it with iron biomarkers in comparison to 20 otherwise healthy individuals. Results: ESKD patients had significantly higher liver (90.1 s-1 vs. 36.1 s-1, p < 0.001) and spleen R2* values (119.8 s-1 vs. 19.3 s-1, p < 0.001) compared to otherwise healthy individuals, while their pancreas and heart R2* values did not significantly differ. Out of the 20 ESKD patients, 17 had elevated spleen and 12 had elevated liver R2* values. KDIGO guidelines (focusing on serum iron parameters) would recommend iron supplementation in seven patients with elevated spleen and four patients with elevated liver R2* values. Conclusions: These findings highlight that liver and especially spleen iron concentrations are significantly higher in ESKD patients compared to controls. Tissue iron overload diverged from classical iron parameters suggesting need of iron supplementation. Measurement of MRI-guided tissue iron distribution might help guide treatment of anemic ESKD patients.
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  • 文章类型: Journal Article
    ATP结合盒(ABC)转运蛋白是48个膜蛋白,其中一些具有显著的生理和临床重要性。一些ABC转运蛋白参与氯离子转运等功能,胆红素,生殖激素,胆固醇,和铁。因此,这些功能的遗传或生理破坏表现在各种疾病过程中,如囊性纤维化,丹吉尔病,和铁粒幼细胞性贫血.在其他病因中,原发性铁粒幼细胞性贫血是由ATP结合盒-7(ABCB7)中的基因突变引起的,ABC运输车家族的成员。没有多少文章专门解决由ABC转运蛋白引起的疾病过程。以前在现有文献中报道的一些用于研究铁粒幼细胞性贫血的测试方法需要更新。这里,我们阐述了ABCB7作为临床上重要的ABC转运体和罕见的参与者在铁粒幼细胞性贫血疾病过程中的相关性。铁粒幼细胞性贫血的其他遗传和继发性病因,不涉及ABCB7蛋白的突变,也有描述。我们回顾了病理生理学,临床课程,症状,诊断,和治疗铁粒幼细胞性贫血,重点是实验室检测的现代技术。
    The ATP-binding cassette (ABC) transporters are a vast group of 48 membrane proteins, some of which are of notable physiological and clinical importance. Some ABC transporters are involved in functions such as the transport of chloride ions, bilirubin, reproductive hormones, cholesterol, and iron. Consequently, genetic or physiological disruption in these functions is manifested in various disease processes like cystic fibrosis, Tangier disease, and sideroblastic anemia. Among other etiologies, primary sideroblastic anemia results from a genetic mutation in the ATP-binding cassette-7 (ABCB7), a member of the ABC transporter family. There are not many articles specifically tackling the disease processes caused by ABC transporters in detail. Some testing methodologies previously reported in the available literature for investigating sideroblastic anemia need updating. Here, we expound on the relevance of ABCB7 as a clinically important ABC transporter and a rare participant in the disease process of Sideroblastic anemia. The other genetic and secondary etiologies of sideroblastic anemia, which do not involve mutations in the ABCB7 protein, are also described. We review the pathophysiology, clinical course, symptoms, diagnosis, and treatment of sideroblastic anemia with a focus on modern technologies for laboratory testing.
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  • 文章类型: Journal Article
    背景与目的:脓毒症治疗指南建议延长美罗培南输注时间。然而,研究提供了关于长期输注优于间歇性输注的有争议的数据。在我们看来,这可能与年龄有关,这可能会扭曲最终的数据,因为老年人有与年龄有关的特征。在我们的研究中,我们分析了通气状态,患者的实验室检查和生命体征,并进行微生物培养。材料与方法:这是自2022年6月至2023年6月进行的前瞻性单中心病例系列调查。这项研究的目的是评估骨科干预后严重感染并发症的老年患者持续输液的有效性。主要终点是28天存活和新的多药耐药菌株的出现。次要终点是长期死亡率和ICU住院时间。结果:3例患者(中位年龄65岁,女性100%)接受了美罗培南的连续输注。两名病人出院时还活着,一名患者在住院第105天死亡。在一名患者中观察到多重耐药细菌。结论:在合并假体周围感染和贫血的老年患者中,使用美罗培南连续输注治疗化脓性脓毒症并发症可能会导致这些病例报告的临床改善。然而,使用这种输注技术的新的泛耐药菌株的出现和总死亡率仍不清楚.Further,老年人需要高质量的RCT。
    Background and Objectives: The prolonged infusion of meropenem is recommended by guidelines for the treatment of sepsis. However, studies provide controversial data on the advantages of prolonged infusions over intermittent ones. In our opinion, this can be related to age, which possibly distorts the final data, as older people have age-related characteristics. In our study, we analyzed the ventilatory status, laboratory tests and vital signs of the patient and carried out microbiological cultures. Materials and Methods: This was a prospective single-center case series investigation conducted from June 2022 to June 2023. The objective of this study was to evaluate the effectiveness of continuous infusion in elderly patients with severe infectious complications after orthopedic interventions. The primary endpoints were 28-day survival and the emergence of new multidrug-resistant strains. Secondary endpoints were long-term mortality and length of stay in the ICU. Results: Three patients (median age 65, 100% female) received a continuous infusion of meropenem. Two patients were alive at hospital discharge, and one patient died on the 105th day of hospitalization. Multi-resistant bacteria were observed in one patient. Conclusions: The use of a continuous meropenem infusion in the complex treatment of purulent-septic complications in elderly patients with periprosthetic infection and anemia probably led to clinical improvement in these case reports. However, the emergence of new pan-resistant strains and overall mortality using this infusion technique remains unclear. Further, high-quality RCTs for the elderly are needed.
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  • 文章类型: Journal Article
    在过去的十年里,在发展中国家,五岁以下儿童的多发病率已成为一个新出现的健康问题。贫血多重性的研究,疟疾,尼日利亚儿童的营养不良(MAMM)没有得到显著关注。这项研究旨在调查哪些危险因素与尼日利亚6至59个月儿童的多发病率相关。这项研究使用了两项全国代表性的横断面调查,2018年尼日利亚人口和健康调查和2018年国家人类发展报告。使用一系列多级混合效应有序逻辑回归模型来研究儿童/父母/家庭变量之间的关联(在1级),社区相关变量(二级)和地区相关变量(三级),和多患病结果(没有疾病,只有一种疾病,两种或多种疾病)。结果显示,48.3%(4917/10,184)的6-59个月儿童样本显示两种或更多种疾病结果。作为一个女孩,完成高等教育的母亲,母亲贫血,家庭财富的五分之一是最富有的,社区财富地位的比例很高,该地区在南部,和居住地为农村是MAMM的重要预测因素(p<0.05)。在这项研究中发现的MAMM的患病率高得令人无法接受。如果没有紧急采取适当行动,尼日利亚实现SDG-3的能力将面临严重危险。因此,适当的政策是必要的,为创建/发展综合护理模式铺平道路,以改善这一问题。
    In the last ten years, multimorbidity in children under the age of five years has become an emerging health issue in developing countries. The study of multimorbidity of anaemia, malaria, and malnutrition (MAMM) among children in Nigeria has not received significant attention. This study aims to investigate what risk factors are associated with the prevalence of multimorbidity among children aged 6 to 59 months in Nigeria. This study used two nationally representative cross-sectional surveys, the 2018 Nigeria Demographic and Health Survey and the 2018 National Human Development Report. A series of multilevel mixed-effect ordered logistic regression models were used to investigate the associations between child/parent/household variables (at level 1), community-related variables (at level 2) and area-related variables (at level 3), and the multimorbidity outcome (no disease, one disease only, two or more diseases). The results show that 48.3% (4917/10,184) of the sample of children aged 6-59 months display two or more of the disease outcomes. Being a female child, the maternal parent having completed higher education, the mother being anaemic, the household wealth quintile being in the richest category, the proportion of community wealth status being high, the region being in the south, and place of residence being rural were among the significant predictors of MAMM (p < 0.05). The prevalence of MAMM found in this study is unacceptably high. If suitable actions are not urgently taken, Nigeria\'s ability to actualise SDG-3 will be in grave danger. Therefore, suitable policies are necessary to pave the way for the creation/development of integrated care models to ameliorate this problem.
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