首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到17条相似文献,搜索用时 234 毫秒
1.
目的:探讨封包联合窄波UVB治疗寻常型银屑病疗效及护理方法。方法:自2010年2月至2011年8月到我院治疗的142例寻常型银屑病患者分为两组,治疗组予封包联合窄波UVB治疗并配合精心护理,对照组仅予封包治疗,两组均在治疗6周后观察症状及体征的变化。患者治疗后随访半年。结果:治疗组较对照组第4周PASI评分(4.33±3.23 vs 6.24±3.35)和第6周PASI评分(2.32±2.02 vs 3.68±2.52)明显降低,有统计学差异(P<0.05)。治疗组与对照组有效率分别为85.89%和67.19%,差异有显著统计学意义(P<0.01)。随访半年结果治疗组复发率较对照组少(P<0.05)。结论:封包联合窄波UVB治疗寻常型银屑病并配合精心护理能够取得良好的临床治疗效果。  相似文献   

2.
摘要 目的:研究中药药浴联合卤米松乳膏对银屑病患者角质层神经酰胺及屏障功能的影响。方法:本研究招募2020年3月~2021年5月在我院皮肤门诊科就诊的80例银屑病患者,所有患者经临床病理确诊寻常型银屑病。其中男性患者52例,女性患者28例,患者年龄23~72岁,平均年龄48.29±6.33岁。实验分为两组:对照组(常规药物治疗)和观察组(中药药浴联合卤米松乳膏进行治疗)。观察患者病情康复情况,据PASI评分比较银屑病患者的总体严重程度,通过DLQI评分和VAS评估患者皮肤干燥和脱屑,通过电容检测和经表皮失水评估银屑病患者皮肤的水化程度和屏障功能,通过反相-液相色谱-质谱法分析患者角质层细胞中神经酰胺Cer和Cer([NP]/[NS])。通过蛋白印迹检测患者病变区域VEGFR-1和VEGFR-2的蛋白表达。结果:(1)根据PASI比较银屑病患者的总体严重程度,治疗前3周,两组患者PASI评分比较无差别(P>0.05),第5周、8周和12周观察组较对照组的PASI评分降低(P<0.05)。(2)观察组较对照组DLQI和VAS评分降低(P<0.05)。(3)观察组较对照组病患者病变皮肤的电容增大,经表皮水分降低(P<0.05)。(4)观察组组较对照组Cer含量和Cer([NP]/[NS])升高(P<0.05)。(5)观察组较对照组VEGFR-1和VEGFR-2的蛋白表达降低。结论:中药药浴联合卤米松乳膏通过提高银屑病患者Cer的含量和Cer([NP]/[NS]比率,维持角质层细胞的屏障功能,从而改善患者的皮肤干燥和瘙痒,角质层神经酰胺及屏障功能。  相似文献   

3.
目的:探讨5%环孢菌素霜对银屑病合并代谢综合征患者外周血IL-17、IL-18水平及PASI评分的影响。方法:选择我院收治的寻常型银屑病合并代谢综合症患者68例,分为实验组和对照组。对照组予以复方甘草酸苷和卡泊三醇治疗,实验组在此基础上加用制备好的5%环孢菌素霜,观察并比较两组患者治疗前后外周血IL-17及IL-18水平的变化情况以及血压、空腹血糖、血脂及PASI评分结果。结果:与治疗前比较,两组患者治疗后IL-17及IL-18水平、血压、FPG、TG及PASI评分均显著降低,而HDL-C明显升高,差异均具有统计学意义(P0.05);与对照组比较,实验组治疗后IL-17及IL-18水平、血压、FPG、TG及PASI评分较低,而HDL-C较高,差异均具有统计学意义(P0.05)。结论:5%环孢菌素霜辅助治疗可调节银屑病合并代谢综合征患者外周血IL-17、IL-18水平,降低其PASI评分,改善患者机体代谢紊乱状态,对银屑病合并代谢综合症有显著临床疗效。  相似文献   

4.
目的:比较银屑灵联合阿维A治疗寻常型银屑病的疗效及安全性.方法:96例寻常型银屑病患者随机分为3组:银屑灵治疗组(32例)、阿维A治疗组(32例)与银屑灵联合阿维A治疗组(32例).其中,银屑灵组每天服用银屑灵30g;阿维A治疗组初始剂量为每天服用阿维A25mg,每5天后剂量增加15mg/d,直至剂量为55mg/d后维持该剂量;银屑灵联合阿维A治疗组的用药方式为二者单独用药的叠加;持续服药8周,采用银屑病严重程度评分评价3组患者治疗前后的疗效并记录不良反应.结果:持续服药8周后,三组治疗效果由好到差依次为:银屑灵联合阿维A胶囊治疗组、阿维A胶囊治疗组、银屑灵治疗组.PASI评分发现三组治疗前后的差异均有统计学意义(P<0.05),治疗前后银屑灵联合阿维A胶囊治疗组与其它两组对应的时间点的PASI评分的差异均有统计学意义(P<0.05).结论:银屑灵联合阿维A胶囊治疗寻常型银屑病的疗效高,相对安全,值得推广使用.  相似文献   

5.
目的:对比微创经椎间孔入路与传统后路手术治疗腰椎结核的临床疗效,评价微创经椎间孔入路治疗腰椎结核的安全性及 有效性。方法:回顾性分析本院2012 年10 月-2013 年3 月收治的单节段腰椎结核患者73 例,所有患者均为单节段病变,以腰痛 为主,无神经压迫症状,死骨和脓肿范围不大。其中43 例采用传统开放手术,30 例采用微创手术,于围术期分别记录两组患者的 手术时间、术中出血量及术后引流量,术后1、3、6 和12 月时采用疼痛视觉模拟评分(VAS)和Oswestry 功能障碍指数(ODI)进行疗 效评估,末次随访时记录并比较两组患者的融合率。结果:所有患者术后腰痛明显减轻,发热患者体温在2 周内恢复正常。微创手 术组的手术时间、术中出血量及术后引流量分别为240± 30 min、520± 50 mL 和630± 110 mL,均明显少于传统手术组的180± 35 min、350± 50 mL和320± 80 mL (P<0.05)。在术前、术后1 月、3 月、6 月、12 月和末次随访时,微创手术组腰痛VAS评分分别 为8.7± 1.2 分、4.5± 1.1 分、3.5± 1.1 分、2.0± 1.4 分、1.3± 0.5 分和1.2± 0.5 分,ODI 评分分别为(77± 6)%、(31± 5)%、(23± 8)%、(14± 6)%、(8± 4)%和(7± 3)%;传统手术组VAS评分分别为8.5± 1.1 分、2.7± 0.7 分、2.1± 0.6 分、1.9± 0.7 分、1.1± 0.4 分 和1.1± 0.4 分,ODI 评分分别为(78± 5)%、(23± 6)%、(14± 7)%、(12± 5)%、(7± 2)%和(7± 2)%。其中,术后1 个月和3个月, 微创组腰痛VAS 评分和ODI评分均明显低于开放组(P<0.05)。术后6 个月、12 个月和末次随访时,两组患者腰痛VAS 评分和 ODI评分差异无统计学意义(P>0.05)。末次随访时所有病例均获得骨性融合。结论:微创经椎间孔入路手术治疗单节段腰骶椎结 核,可获得与传统后路手术相同的临床疗效,且手术时间短,术中出血量及术后引流量较少,具有较高的安全性。  相似文献   

6.
摘要 目的:探讨雷公藤多苷片联合NB-UVB对寻常型银屑病炎症水平、血脂指标及卒中风险的影响。方法:选择2020年1月到2021年12月来我院诊治的寻常型银屑病患者72例,根据随机数字表法,将72例患者分为对照组(36例)与观察组(36例),对照组患者给予NB-UVB的全身照射治疗,观察组在对照组基础上给予雷公藤多苷片治疗,对比两组的治疗效果,对比两组患者治疗前、治疗12周时的PASI评分,对比两组患者治疗前、治疗12周的血清IL-22、IL-17、TNF-α及YKL-40水平,对比两组患者治疗前、治疗12周的血清血脂水平,对比两组患者治疗12周时的卒中风险程度,对比两组患者治疗期间的不良反应发生情况。结果:观察组有效98.33%明显较对照组86.67%高,P<0.05。治疗前,两组的PASI评分对比无差异(P>0.05);治疗12周时,两组的PASI评分降低明显,且观察组明显较对照组低(P<0.05)。治疗前,两组的血清IL-22、IL-17、TNF-α及YKL-40水平对比无统计学意义,治疗12周时,两组的血清IL-22、IL-17、TNF-α及YKL-40水平明显降低,且观察组明显较对照组低(P<0.05)。治疗前,两组患者的血清血脂水平对比无统计学意义(P>0.05);治疗12周后,观察组的总胆固醇、甘油三酯、低密度脂蛋白水平明显降低,高密度脂蛋白水平明显升高,且观察组与对照组对比有统计学意义(P<0.05),对照组与治疗前对比无统计学意义(P>0.05);治疗12周时,观察组的卒中风险程度明显较对照组低(P<0.05)。治疗期间,两组患者均完成治疗,无明显不良反应。结论:与单独应用NB-UVB相比,雷公藤多苷片联合NB-UVB可降低寻常型银屑病患者的炎症水平,改善血脂指标水平,降低患者的卒中风险。  相似文献   

7.
近年来人们越来越重视肠道菌群在肠源性疾病的发生、发展及防治中所发挥的作用。脆弱拟杆菌(Bacteroides fragilis,BF)是定殖于人体肠道中的共生菌,对肠道健康有多种影响,是健康人群及腹泻、腹膜炎、腹内脓肿、败血症、炎症性肠病等临床病例最常见的肠道微生物。随着人们对脆弱拟杆菌的深入研究,发现脆弱拟杆菌与炎症性肠病(inflammatory bowel disease,IBD)、结直肠癌(colorectal cancer,CRC)有密切关系。通过对脆弱拟杆菌与IBD、CRC之间的关系进行综述,探究脆弱拟杆菌在IBD、CRC促进、调控及防治中的作用,为IBD、CRC的早期干预和治疗提供新思路,为开发基于脆弱拟杆菌的药物提供数据与思路。  相似文献   

8.
目的:探讨寻常型银屑病患者血清白介素17(IL-17)、白介素18(IL-18)、血管内皮生长因子(VEGF)的表达及与病情严重程度的相关性。方法:选取2015年8月到2017年4月在我院接受治疗的寻常型银屑病患者86例为研究组,另选取同期在我院体检结果为健康的志愿者40例作为健康对照组,并根据临床症状和病情变化对研究组患者进行分组,其中进行期银屑病组32例,静止期银屑病组24例,退行期银屑病组30例。对比研究组和健康对照组血清中IL-17、IL-18、VEGF水平,对比不同严重程度的寻常型银屑病患者血清中IL-17、IL-18、VEGF水平和PASI评分,采用Spearman相关性分析IL-17、IL-18、VEGF的表达与PASI评分的相关性。结果:研究组患者血清中的IL-17、IL-18、VEGF水平显著高于健康对照组(P0.05),进行期银屑病组患者血清中IL-17、IL-18、VEGF水平和PASI评分显著高于静止期银屑病组和退行期银屑病组,静止期银屑病组患者血清中IL-17、IL-18、VEGF水平和PASI评分显著高于退行期银屑病组(P0.05),Spearman相关性分析结果显示,研究组患者血清中IL-17、IL-18、VEGF水平与PASI评分均呈正相关(P0.05)。结论:寻常型银屑病患者血清中IL-17、IL-18、VEGF水平异常升高,且其水平与病情严重程度有关,对上述三种指标进行监测有助于临床治疗寻常型银屑病。  相似文献   

9.
目的:探讨他克莫司和卡泊三醇软膏治疗四肢斑块状银屑病的疗效和安全性。方法:选取2011年4月至2013年8月于我院诊治的84例四肢斑块状银屑病患者,将患者随机分为A组和B组,每组各42例,分别采用他克莫司和卡泊三醇软膏治疗。评定PASI以及疗效指数,并对用药过程中患者的不良事件进行观察记录。结果:A、B两组患者治疗后各时间点PASI评分与治疗前相比较均显著降低,差异有统计学意义(P0.05);但同一时间组间对比,差异并无统计学意义(P0.05)。A组银屑病患者的总有效率为64.29%,与B组的69.05%相比,差异无统计学意义(P0.05)。结论:他克莫司与卡泊三醇软膏治疗四肢斑块状银屑病均安全有效,且二药相比,疗效相当。  相似文献   

10.
目的:探讨沙利度胺治疗银屑病的疗效及对患者血清肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)的影响。方法:选择2014年6月至2016年6月我院收治的80例中重度寻常型银屑病患者为研究对象,将其完全随机化分为实验组和对照组,各40例。实验组口服沙利度胺,对照组口服甲氨蝶呤,均治疗10周。采用银屑病皮损面积和严重指数评分标准(PASI评分)评价治疗效果,采用酶联免疫吸附试验(ELISA)测定血清TNF-α、VEGF和bFGF水平,并进行安全性评价。结果:实验组治疗有效率为72.50%,高于对照组的47.50%,而不良反应发生率为5.00%,低于对照组的20.00%,差异具有统计学意义(P0.05)。两组治疗后血清TNF-α、VEGF和bFGF水平明显低于治疗前,且实验组治疗后血清TNF-α、VEGF和b FGF水平低于对照组,差异具有统计学意义(均P0.05)。结论:沙利度胺治疗银屑病具有较好疗效,且不良反应发生率较低,其作用机制可能与抑制患者血清中TNF-α、VEGF和bFGF的表达有关。  相似文献   

11.
Abstract

The purpose of the study was to analyze the relationship between the serum concentration of soluble tumour necrosis factor-α type 1 (sTNF-R1), the severity of plaque-type psoriasis and therapeutic response. We compared sTNF-R1 in 25 patients treated with narrowband ultraviolet B (NB-UVB) radiation and 25 patients treated with systemic photochemotherapy (psoralen plus UVA – PUVA). The pretreatment Psoriasis Area and Severity Index (PASI) score and sTNF-R1 concentration were 16.32±5.26 and 1.99±0.40 ng ml?1, respectively, in the group treated with NB-UVB, and 17.22±3.48 and 2.07±0.31 ng ml?1, respectively, in the group treated with PUVA. The concentration of sTNF-R1 in healthy controls was 1.49±0.34 ng ml?1 (p<0.05 compared with patients with psoriasis). The pretreatment PASI score correlated with sTNF-R1 in both treatment groups (r=0.46 and r=0.44, p<0.05). NB-UVB and PUVA gave similar therapeutic effects (the PASI score after 20 treatments was 4.42±1.67 in the NB-UVB-treated group and 5.55±2.10 in PUVA-treated patients); however, the sTNF-R1 concentration at the same time differed significantly: 1.52±0.37 ng ml?1 and 1.98±0.39 ng ml?1 (p<0.001), respectively. Moreover, the decline in sTNF-R1 in both treatment groups was significant only in patients in whom the duration of skin lesions was less than 3 months. The results suggest that the value of serum sTNF-R1 concentration as a marker of response to phototherapy may depend on duration of skin lesions and the treatment method.  相似文献   

12.
Transforming growth factor-β1 (TGFβ1) is thought to be an inhibitor of the keratinocyte hyperproliferation associated with psoriasis. The aim of this study was to evaluate plasma TGFβ1 and TGFβ2 concentrations in psoriatic patients as possible indicators of treatment efficacy. TGFβ concentrations were measured in the plasma of 26 patients with psoriasis using an enzyme immunoassay and analysed with respect to the psoriasis area and severity index (PASI) before and after treatment with salicylic acid and/or sulphur followed by dithranol ointment. Baseline plasma concentrations of both TGFβ1 and TGFβ2 (20.3±2.2 ng ml?1 and 0.14±0.02 ng ml?1, respectively) did not differ significantly from control values (18.3±1.6 ng ml?1 and 0.14±0.03 ng ml?1, respectively). However, a significant positive correlation (r=0.69) between the baseline PASI and TGFβ1, but not TGFβ2, values was demonstrated. The pretreatment TGFβ1 concentration in patients with a PASI ≥15 (26.6±3.2 ng ml?1) was significantly higher than control values. There were no significant elevation of pretreatment TGFβ1 concentrations in patients with a PASI<15, or with respect to TGFβ2 in both groups. Treatment caused a significant decrease in TGFβ1, but only in patients with a PASI≥15. Patients with baseline TGFβ1 concentrations exceeding the mean of the control group had a PASI value that was significantly higher than that of patients with a TGFβ1 concentration below the mean of the controls. These results confirmed an association between plasma TGFβ1 concentration and psoriasis severity, and demonstrated its normalization during treatment. Measurement of TGFβ1 in plasma should be considered as a possible biomarker of psoriasis activity during its management.  相似文献   

13.
Abstract

The aim of the study was to assess plasma and scales levels of interleukin (IL) 18 collected from psoriatic patients with different disease activity. IL-18 concentrations were measured using an enzyme immunoassay in the plasma and scales of 34 patients with chronic plaque type psoriasis. IL-18 levels were analysed with respect to plasma-transforming growth factor β1 (TGF-β1), the disease duration and the duration of the present relapse, and psoriasis area and severity index (PASI). Plasma IL-18 concentration varied from 90 to 1300 pg ml?1 and means (368.2±42.4 pg ml?1) were significantly elevated in comparison with healthy controls (205.9±31.8 pg ml?1). The presence of IL-18 was also demonstrated in scales from skin lesions. Treatment caused a significant decrease of plasma IL-18 concentration to 250.2±13.8 pg ml?1. There was a significant correlation between plasma IL-18 levels and PASI values (r=0.554). There was no correlation between IL-18 concentration in scales and PASI, between IL-18 concentrations in plasma and scales, and between plasma IL-18 and the disease duration or duration of present relapse. Plasma TGF-β1 concentration demonstrated a significant correlation with PASI (r=0.353), but not with IL-18 levels in plasma (r=0.063) and scales (0.141). The sum of plasma levels of IL-18 and TGF-β1 divided by the optimal coefficient demonstrated a statistically significant correlation with the highest r-value. The findings confirm an association between plasma IL-18 concentration and psoriasis severity. Moreover, it was shown that combined measurement of IL-18 and TGF-β1 in plasma can be considered as a possible biomarker of psoriasis activity.  相似文献   

14.
BackgroundRed blood cell distribution width (RDW) is frequently increased in inflammatory disorders, and the magnitude of its elevation correlates with disease severity. This study was hence aimed to explore RDW values in patients with psoriasis.MethodsThe study population consisted of 366 adult patients with mild to severe plaque psoriasis and 366 age- and sex-matched blood donor controls. For each psoriatic patient, demographic, clinical, and laboratory data were regularly collected.ResultsRDW and MCV were significantly higher in psoriatic patients compared to controls (13.95 vs. 13.40% and 90.4 vs. 89 fL; both p<0.01). In order to assess whether RDW elevations were related to psoriasis severity, we divided our psoriatic patient population into two groups based on a PASI cut-off of 10. No significant differences were observed between the two groups (i.e., PASI>10 and 10) in terms of RDW (p=0.36). Adopting different PASI cut-offs (i.e. 3, 5, 7, 12) did not result in statistically significant differences (p=0.93, 0.48, 0.22, 0.42, respectively). In linear regression analysis, no significant correlation was found between RDW and PASI or CRP, nor with age, gender, or the psoriasis comorbidities listed in Table I. Furthermore, no significant difference in RDW values was noted between psoriatic patients with and without PsA (p=0.27).ConclusionsThe results of this study confirm that RDW is elevated in psoriatic patients, though the magnitude of its increase did not appear to be associated with disease severity.  相似文献   

15.
目的:观察关节镜手术联合胫骨高位截骨(HTO)治疗内侧膝关节骨关节炎(KOA)的临床疗效。方法:本研究为回顾性研究,将2018年2月~2020年9月间在我院接受治疗的内侧KOA患者63根据手术方式的不同分为A组和B组,分别为30例和33例。A组进行HTO手术,B组进行关节镜手术联合HTO治疗。术前、术后6周、术后12周采用美国纽约特种外科医院(HSS)评分、视觉模拟量表(VAS)评分评价两组患者膝关节功能、疼痛情况。采用36项简明健康状况调查表(SF-36)评价两组患者术前与术后12周的生活质量变化情况。记录两组术后并发症发生情况。术前、术后12周采用MB-Ruler软件测量两组患者机械胫骨近端内侧角(mMPTA)、解剖股胫角(aFTA)。结果:术后6周、术后12周,B组HSS评分高于A组,VAS评分低于A组(P<0.05)。术后12周,B组SF-36量表各维度评分高于A组(P<0.05)。术后3周,B组mMPTA、aFTA小于A组(P<0.05)。两组术后并发症发生率组间对比无差异(P>0.05)。结论:相对于单纯的HTO手术,关节镜手术联合HTO治疗内侧KOA患者,可有效促进膝关节功能改善,减轻疼痛症状,调整下肢力线,近期疗效肯定。  相似文献   

16.
《Chronobiology international》2012,29(12):1733-1740
ABSTRACT

Background: Jet-lag may affect air-travelers crossing at least two time-zones and has several health-care implications. It occurs when the human biological rhythms are out of synch with respect to the day-night cycle at the country destination. Its effect in psoriasis is missing. We aimed to evaluate the effect of Jet-lag in psoriatic patients’ management. Methods: This is a prospective observational study that enrolled psoriatic patients that underwent a flight: patients who experienced jet-lag were compared to patients who did not experience jet-lag. Before the flight, a dermatologist recorded clinical and demographical data with particular attention to Psoriasis Area Severity Index (PASI) and Disease Activity in Psoriatic Arthritis (DAPSA). Patients performed Self-Administered Psoriasis Area Severity Index (SAPASI), the Dermatology Life Quality Index (DLQI) and the pruritus Visual Analog Scale (VAS) scores. After the flight, patients completed the SAPASI, DLQI and pruritus-VAS scores. Results: The sample recruited comprised of 70 psoriatic patients aged 42.4 ± 9.7 years (median 42.5 years). Thirty (42.9%) were males, mean BMI was 25.5 ± 2.2 kg/m2. Average disease duration was 15.2 ± 7.1 years, and 20 (28.6%) subjects had developed PsA. Average hours of flight were 5.4 ± 3.5 (median 3.5 h), with 34 (48.6%) subjects reporting jet-lag. At the multivariate regression analysis, the change in the SAPASI score resulted correlated with jet-lag (regression coefficient 1.63, p = .0092), as well the change in the DLQI score (regression coefficient = 1.73, p = .0009), but no change on the pruritus VAS scale was found. Conclusions: The present study suggests that jet-lag may influence disease severity and DLQI scores, but not itch in psoriatic patients.  相似文献   

17.
Psoriasis and psoriatic arthritis are inflammatory diseases that respond well to anti-tumour necrosis factor-α therapy. To evaluate the effects of anti-tumour necrosis factor-α treatment on expression of adhesion molecules and angiogenesis in psoriatic lesional skin and synovial tissue, we performed a prospective single-centre study with infliximab therapy combined with stable methotrexate therapy. Eleven patients with both active psoriasis and psoriatic arthritis received infusions of infliximab (3 mg/kg) at baseline, and at weeks 2, 6, 14 and 22 in an open-label study. In addition, patients continued to receive stable methotrexate therapy in dosages ranging from 5 to 20 mg/week. Clinical assessments, including Psoriasis Area and Severity Index (PASI) and Disease Activity Score (DAS), were performed at baseline and every 2 weeks afterward. In addition, skin biopsies from a target psoriatic plaque and synovial tissue biopsies from a target joint were taken before treatment and at week 4. Immunohistochemical analysis was performed to detect the number of blood vessels, the expression of adhesion molecules and the presence of vascular growth factors. Stained sections were evaluated by digital image analysis. At week 16, the mean PASI was reduced from 12.3 ± 2.4 at baseline to 1.8 ± 0.4 (P ≤ 0.02). The mean DAS was reduced from 6.0 ± 0.5 to 3.6 ± 0.6 (P ≤ 0.02). We found some fluctuations in DAS response as compared with the change in PASI, with the latter exhibiting a steady decrease over time. After 4 weeks the cell infiltrate was reduced in both skin and synovium. There was a significant reduction in the number of blood vessels in dermis and synovium at week 4. A significant reduction in the expression of αvβ3 integrin, a marker of neovascularization, was also found in both skin and synovium at week 4. In addition, a significant reduction in the expression of adhesion molecules was observed in both skin and synovium at week 4. We also observed a trend toward reduced expression of vascular endothelial growth factor in both skin and synovium. In conclusion, low-dose infliximab treatment leads to decreased neoangiogenesis and deactivation of the endothelium, resulting in decreased cell infiltration and clinical improvement in psoriasis and psoriatic arthritis.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号