首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 15 毫秒
1.

Purpose

To compare estimates of 24-hour intraocular pressure (IOP) peak timing and variation obtained using a contact lens sensor (CLS) and using a pneumatonometer.

Methods

Laboratory data collected from 30 healthy volunteers (ages, 20-66 years) in a randomized, controlled clinical trial were analyzed. Participants were housed for 24 hours in a sleep laboratory. One randomly selected right or left eye was fitted with a CLS that monitored circumferential curvature in the corneoscleral region related to the change of IOP. Electronic output signals of 30 seconds were averaged and recorded every 5 minutes. In the contralateral eye, habitual IOP measurements were taken using a pneumatonometer once every two hours. Simulated 24-hour rhythms in both eyes were determined by cosinor fitting. Simulated peak timings (acrophases) and simulated data variations (amplitudes) were compared between the paired eyes.

Results

Bilateral change patterns of average 24-hour data for the group were in parallel. The simulated peak timing in the CLS fitted eye occurred at 4:44 AM ± 210 min (mean ± SD) and the IOP peak timing in the contralateral eye at 4:11 AM ± 120 min (P=0.256, Wilcoxon signed-rank test). There was no significant correlation between the simulated data variations in the paired eyes (P=0.820, linear regression).

Conclusions

The 24-hour CLS data showed a simulated peak timing close to the 24-hour IOP peak timing obtained using the pneumatonometer. However, the simulated variations of 24-hour data in the paired eyes were not correlated. Estimated 24-hour IOP rhythms using the two devices should not be considered interchangeable.  相似文献   

2.
Compliance with antihypertensive treatment can be increased by using medications that are taken only once daily. There is, however, concern as to whether the efficacy of such drugs is sufficient to cover 24 h. Ambulatory blood pressure monitoring (ABPM) is an ideal technique to assess the effect of this kind of drug and to determine over- or undertreatment. In this study three drugs were examined as once-a-day preparations. Thirty-six patients were treated with three different doses of bisoprolol, as an example of the β,-selective beta-blockers; 12 patients were treated with a combination of the AChE-inhibitor enalapril and hydrochlorothiazide; eight patients were treated with nifedipine once per day, a new galenic form of nifedipine, as an example of the calcium-channel blockers. In each group we saw a significant downward shift over the entire 24-h curve. Our results also show that using 24-h blood pressure monitoring devices can help establish an appropriate dose, avoid over- and undertreatment, and control the total burden of the patient.  相似文献   

3.
The effect of three antidepressant drugs, imipramine hydrochloride, clomipramine hydrochloride and zimelidine dihydrochloride on plasma free and total TRY concentrations has been examined.

The drugs were administered to male Wistar rats in the drinking water at a concentration of 200μgml-1 for up to 15 days. The effects of TRY concentration were complex and, after 2 days, inconsistent. After 14 days, the overall effect of imipramine was to lower free TRY levels and abolish 24-hr variation in free TRY concentration. Zimelidine and clomipramine tended to increase free TRY, particularly at 1300h so that the overall effect was to delay the peak in plasma-free TRY until later in the day. The possible significance of these findings to the mechanism of action of antidepressant drugs in clinical practice is discussed.  相似文献   

4.

Purpose

To study performance of a contact lens sensor (CLS) for 24-hour monitoring of IOP-related short-term patterns and compare with IOP obtained by pneumatonometry.

Methods

Prospective clinical trial. Thirty-one healthy volunteers and 2 glaucoma patients were housed for 24 hours in a sleep laboratory. One randomly selected eye was fitted with a CLS (Triggerfish, Sensimed, Switzerland), which measures changes in ocular circumference. In the contralateral eye, IOP measurements were taken using a pneumatonometer every two hours with subjects in the habitual body positions. Heart rate (HR) was measured 3 times during the night for periods of 6 minutes separated by 2 hours. Performance of CLS was defined in two ways: 1) recording the known pattern of IOP increase going from awake (sitting position) to sleep (recumbent), defined as the wake/sleep (W/S) slope and 2) accuracy of the ocular pulse frequency (OPF) concurrent to that of the HR interval. Strength of association between overall CLS and pneumatonometer curves was assessed using coefficients of determination (R2).

Results

The W/S slope was statistically significantly positive in both eyes of each subject (CLS, 57.0 ± 40.5 mVeq/h, p<0.001 and 1.6 ± 0.9 mmHg/h, p<0.05 in the contralateral eye). In all, 87 CLS plots concurrent to the HR interval were evaluated. Graders agreed on evaluability for OPF in 83.9% of CLS plots. Accuracy of the CLS to detect the OPF was 86.5%. Coefficient of correlation between CLS and pneumatonometer for the mean 24-h curve was R2 = 0.914.

Conclusions

CLS measurements compare well to the pneumatonometer and may be of practical use for detection of sleep-induced IOP changes. The CLS also is able to detect ocular pulsations with good accuracy in a majority of eyes.

Trial Registration

ClinicalTrials.gov NCT01390779  相似文献   

5.
《Endocrine practice》2010,16(5):770-777
ObjectiveTo determine the dose-response and time course of action of a single dose of dexamethasone on plasma glucose and insulin dynamics in healthy adults.MethodsParticipants included healthy adults who met the following inclusion criteria: 18 to 65 years of age, body mass index of 18 to 25 kg/m2, no family history of diabetes mellitus, not taking any medication known to affect glucose tolerance, and nonpregnant state for female participants. Each participant underwent 3 sequential blocks of 75-g oral glucose tolerance tests (OGTTs) on days 1, 2, and 3; this sequence was repeated on 3 different occasions separated by more than 2 weeks. On the first day of each block, participants reported to the research center after a 10- to 12-hour overnight fast, and fasting baseline blood samples for glucose, insulin, and C-peptide were obtained. Baseline (0 mg) OGTT was then performed with a 75-g glucose load, and blood samples were collected at 30, 60, 90, and 120 minutes for measurements of glucose, insulin, and C-peptide. After the baseline OGTT on day 1, a single dose of either 2-, 4- or 8-mg of dexamethasone was administered orally. Twenty-four and 48 hours later, participants returned for additional OGTTs.ResultsTen healthy volunteers (4 male and 6 female) were enrolled. The effect of dexamethasone was maximal 24 hours after 8-mg dexamethasone compared with the effect observed after no dexamethasone administration. At 60 minutes during the OGTT (following 8-mg dexamethasone), blood glucose increased from 127 ± 7.1 mg/dL (6.35 ± 0.36 mmol/L) to 176 ± 19 mg/dL (8.8 ± 0.95 mmol/L), insulin increased from 49.3 ± 3.2 μIU/mL (342 ± 22 pmol/L) to 119.7 ± 10.1 μIU/mL (831 ± 70 pmol/L), and C-peptide increased from 6376 ± 510 pg/L (1913 ± 153 pmol/L) to 10 143 ± 1016 pg/L (3043 ± 305 pmol/L); the 60-minute levels returned towards baseline at 48 hours. Smaller changes were observed with 2- and 4-mg dexamethasone. Twenty-four hours after 8-mg dexamethasone, there was a 2.2- and 1.5-fold increase in homeostasis model assessment of insulin resistance and homeostasis model assessment of β cell, respectively, and a 2.5-fold decrease in the Matsuda sensitivity index.ConclusionsA single oral dose of 8-mg dexamethasone increases blood glucose, insulin, and C-peptide levels maximally at 24 hours, 1 hour following 75-g OGTT. A dexamethasone stress test might identify persons at increased risk for type 2 diabetes. (Endocr Pract. 2010:16:770-777)  相似文献   

6.
Age-stiffening of ocular tissues is statistically linked to glaucoma in the elderly. In this study, the effects of age-stiffening on the lamina cribrosa, the primary site of glaucomatous nerve damages, were modeled using computational finite element analysis. We showed that glaucomatous nerve damages and peripheral vision loss behavior can be phenomenologically modeled by shear-based damage criterion. Using this damage criterion, the potential vision loss for 30 years old with mild hypertension of 25mmHg intraocular pressure (IOP) was estimated to be 4%. When the IOP was elevated to 35mmHg, the potential vision loss rose to 45%; and age-stiffening from 35 to 60 years old increased the potential vision loss to 52%. These results showed that while IOP plays a central role in glaucomatous damages, age-stiffening facilitates glaucomatous damages and may be the principal factor that resulted in a higher rate of glaucoma in the elderly than the general population.  相似文献   

7.
Some factors influencing food intake and subjective responses to meals were assessed in 2 groups (n=40 and n=36) of healthy university students. Both groups were studied for 6 days and included both “structured” and “unstructured” times. A questionnaire was completed by all subjects at 3 h intervals while awake. The questionnaires asked the subjects to state the factors that led them to choose to eat or not to eat a meal in the previous 3 h. If they ate a meal, they were required to describe the type of meal eaten and their responses to it—their hunger before it, their enjoyment of the meal itself, and their degree of satisfaction afterwards. Subjects were also asked to describe the type of meal that they would like to have eaten (the desired meal) in the absence of any restraints due to time pressure, cost, and so on. In the first group, 3 “structured” (working) and 3 “unstructured” (rest) days were chosen. Consistant with our previous studies, structured days, as compared to unstructured days, were associated with smaller meals and less positive subjective responses to them. Also, the meals that were eaten were often smaller than those that were desired, or were even missed altogether, due to time pressure. Not only were the meals eaten on unstructured days larger and rated, to by the subjects more positively, but also there was an additional positive effect if the meal played a social role. In the second group, 6 days were chosen, during which there were structured and unstructured 3 h periods. Many of the findings (with regard to reasons for eating or not eating a meal, and the effect of meal size upon subjective responses to it, for example) were the same as in the first group. However, the effect of structured vs. unstructured 3 h periods was significantly less marked than the effect of structured vs. unstructured days that had been found in the first group, and effects due to social factors and time pressure were less reliably present. The results indicate that food intake is affected by whether the whole or only part of the day is “structured” or “unstructured.” These findings might be relevant to some problems faced by the workforce, in general, and by night workers, in particular.  相似文献   

8.
Serious adverse cardiovascular events, including myocardial infarction, sudden cardiac death, and stroke, frequently result from rupture of atherosclerotic plaques with superimposed thrombosis and exhibit a pronounced circadian rhythmicity, peaking in the morning hours. Two potentially synergistic mechanisms play a pathogenic role in the circadian variation of arterial thrombotic events. A morning surge in sympathetic activity alters hemodynamic forces and predisposes vulnerable coronary atherosclerotic plaques to rupture. Day–night variations of hemostatic and fibrinolytic factors result in morning hypercoagulability and hypofibrinolysis, promoting intraluminal thrombus formation at the same time when the risk for plaque rupture is highest. Diabetic patients have a very high cardiac event rate but fail to show normal circadian fluctuations in the occurrence of myocardial infarction. Alterations in the circadian variation autonomic tone, blood pressure, and the thrombotic–thrombolytic equilibrium have been documented in diabetic patients. These include reduced or absent 24-h periodicity in autonomic tone, fibrinolytic activity, and thrombotic tendency, and a blunted decline in nocturnal blood pressure. Disruption of these circadian rhythms explains the lack of significant circadian distribution of cardiac events in diabetic patients. Moreover, the loss of these normal biorhythms results in a continuous susceptibility to thrombotic events throughout the day and may contribute to the excess cardiovascular mortality and morbidity in these patients. (Chronobiology International, 18(1), 109–121, 2001)  相似文献   

9.
To assess to what extent the presence of an ectopic pituitary differentially affected circulating prolactin (PRL) and gonadotropin levels at different times of the year, rats kept under 12h light, 12h dark (12:12 LD) photoperi-ods and receiving a pituitary graft or a sham operation in summer or winter were examined 3 months later. In both male and female sham-operated rats, a circadian variation in serum PRL levels was found, with an acrophase varying from 21:53h to 00:54h and the mesor and amplitude higher in spring than autumn in males and higher in autumn than in spring in females. After grafting a pituitary, changes in serum PRL related to time of day were no longer observed. In pituitary-grafted male rats killed during spring, serum PRL levels were higher than controls at only a few time points throughout the 24h cycle, whereas in rats killed during autumn, there were no significant differences in PRL levels between grafted and control rats. Pituitary-grafted female rats killed during spring showed serum PRL levels significantly higher than those of sham-operated rats, while in female rats killed in autumn, PRL levels of pituitary-grafted and sham-operated rats did not differ. Significant variations of luteinizing hormone (LH) related to time of day were found in sham-operated male rats only, with acrophases at 23:52h and 00:24h for spring and autumn, respectively, and the mesor and amplitude of the rhythm significantly higher in autumn. Pituitary transplants suppressed 24h variations in circulating LH and depressed its levels during the two seasons examined. As far as follicle-stimulating hormone (FSH), pituitary grafts decreased circulating levels, with the extent of decrease higher during autumn than in spring. The results indicate that some endocrine consequences of the grafting of an ectopic pituitary are dependent on time of year.  相似文献   

10.
Rhinitis and rhinosinusitis are multifactorial disease processes in which bacteria may play a role either in infection or stimulation of the inflammatory process. Rhinosinusitis has been historically studied with culture-based techniques, which have implicated several common pathogens in disease states. More recently, the NIH Human Microbiome Project has examined the microbiome at a number of accessible body sites, and demonstrated differences among healthy and diseased patients. Recent DNA-based sinus studies have suggested that healthy sinuses are not sterile, as was previously believed, but the normal sinonasal microbiome has yet to be thoroughly examined. Middle meatus swab specimens were collected from 28 consecutive patients presenting with no signs or symptoms of rhinosinusitis. Bacterial colonization was assessed in these specimens using quantitative PCR and 16S rRNA pyrosequencing. All subjects were positive for bacterial colonization of the middle meatus. Staphylococcus aureus, Staphylococcus epidermidis and Propionibacterium acnes were the most prevalent and abundant microorganisms detected. Rich and diverse bacterial assemblages are present in the sinonasal cavity in the normal state, including opportunistic pathogens typically found in the nasopharynx. This work helps establish a baseline for understanding how the sinonasal microbiome may impact diseases of the upper airways.  相似文献   

11.
To assess to what extent the presence of an ectopic pituitary differentially affected circulating prolactin (PRL) and gonadotropin levels at different times of the year, rats kept under 12h light, 12h dark (12:12 LD) photoperi-ods and receiving a pituitary graft or a sham operation in summer or winter were examined 3 months later. In both male and female sham-operated rats, a circadian variation in serum PRL levels was found, with an acrophase varying from 21:53h to 00:54h and the mesor and amplitude higher in spring than autumn in males and higher in autumn than in spring in females. After grafting a pituitary, changes in serum PRL related to time of day were no longer observed. In pituitary-grafted male rats killed during spring, serum PRL levels were higher than controls at only a few time points throughout the 24h cycle, whereas in rats killed during autumn, there were no significant differences in PRL levels between grafted and control rats. Pituitary-grafted female rats killed during spring showed serum PRL levels significantly higher than those of sham-operated rats, while in female rats killed in autumn, PRL levels of pituitary-grafted and sham-operated rats did not differ. Significant variations of luteinizing hormone (LH) related to time of day were found in sham-operated male rats only, with acrophases at 23:52h and 00:24h for spring and autumn, respectively, and the mesor and amplitude of the rhythm significantly higher in autumn. Pituitary transplants suppressed 24h variations in circulating LH and depressed its levels during the two seasons examined. As far as follicle-stimulating hormone (FSH), pituitary grafts decreased circulating levels, with the extent of decrease higher during autumn than in spring. The results indicate that some endocrine consequences of the grafting of an ectopic pituitary are dependent on time of year.  相似文献   

12.
We monitored the circadian profiles of Cortisol, systolic and diastolic blood pressure (SBP and DBP) and heart rate (HR) in 33 matched normotensive subjects, 32 patients with essential hypertension and 16 patients with Cushing's Syndrome (8 pituitary adenomas, 6 adrenal adenomas and 2 adrenal carcinomas). Each subject underwent serial blood drawings at 4-hr intervals along the 24-hr cycle. BP and HR were automatically recorded every 30 min. Data were analyzed by conventional statistics and by chronobiological procedures (cosinor rhythmometry). Both the control subjects and essential hypertensives showed a circadian profile of BP and HR characterized by a peak in the early afternoon and a clear nocturnal fall (rhythm detection: P< 0.001). The rhythmicity of BP was disrupted in patients affected by Cushing's Syndrome, whereas the 24-hr oscillation of HR was preserved (P < 0.001). Our data are compatible with the view that glucocorticoids are involved in the control of BP circadian rhythm, whereas HR is not under their control.  相似文献   

13.
14.
目的:通过检测兰州地区健康体检者空腹血脂水平了解本地区人群血脂水平现状及血脂异常情况,建立本地区血脂参考值。方法:采用全自动生化分析仪检测兰州市2328名健康体检者,血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。比较不同年龄、性别血脂水平差异。结果:本地区2328名被检者,女性TC平均(4.54±0.94)mmol/L,TG中位数1.24mmol/L、HDL-C平均(1.34±0.26)mmol/L、LDL-C平均(2.61±0.76)mmol/L;男性TC平均(4.52±0.84)mmol/L、TG中位数1.56mmol/L mmol/L、HDL-C平均(1.20±0.23)mmol/L LDL-C平均(2.76±0.72)mmol/L,血脂水平随年龄增加逐渐升高(P<0.05)。血脂参考范围为女性TC:2.70~6.38 mmol/L、TG:0.52~3.66 mmol/L、HDL-C:0.83~1.85 mmol/L、LDL-C:1.12~4.10 mmol/L男性:TG:2.87~6.17 mmol/L、0.65~4.00 mmol/L、0.75~1.65 mmol/L、1.35~4.17 mmol/L。男性高TC、高TG、低HDL-C和高LDL-C患病率为18.2%、42.8%、19.6%和28%,女性高TC、高TG、低HDL和高LDL的患病率分别为22.1%、25.5%、2.7%和23.5%。结论:兰州地区血脂水平随年龄、性别、地区不同存在较大差异,临床上不能采用统一标准衡量,而应根据本地区建立的参考值诊断高脂血症。积极控制血脂水平、降低高脂血症患病率预防心脑血管疾病发生。  相似文献   

15.
BackgroundTai Chi may be efficient for healthy adults to improve the cardiorespiratory fitness, but there is no systematic evaluation for its effectiveness.ObjectiveTo systematically assess the effectiveness of Tai Chi on cardiorespiratory fitness in healthy adults.MethodsSeven electronic databases were searched from their inception to October 2013. The controlled trails including randomized controlled trial (RCT), non-randomized controlled trial (NRCT), self-controlled trial (SCT), and cohort study (CS) testing Tai Chi exercise against non-intervention control conditions in healthy adults that assessed any type cardiorespiratory fitness outcome measures were considered. Two reviewers independently performed the selection of the studies according to predefined criteria. The risk of bias was assessed using Cochrane criteria. RevMan 5.2 software was applied for data analysis.ResultsTwenty studies (2 RCTs, 8 NRCTs, 3 SCTs, and 7 CSs) with 1868 participants were included, but most of them belonged to low methodological quality. The results of systematic review showed that Tai Chi exercise had positive effect on majority outcomes of cardio function (Blood pressure: n = 536, SPB SMD = -0.93, 95% CI -1.30 to -0.56, P < 0.00001; DBP SMD = -0.54, 95% CI -0.90 to -0.18, P < 0.00001; heart rate at quiet condition: n = 986, SMD = -0.72, 95% CI -1.27 to -0.18, P = 0.010; stroke volume: n = 583, SMD = 0.44, 95% CI 0.28 to 0.61, P < 0.00001; cardio output: n = 583, MD = 0.32 L/min, 95% CI 0.08 to 0.56, P = 0.009), lung capacity (FVC at quiet condition: n = 1272, MD = 359.16 mL, 95% CI 19.57 to 698.75, P = 0.04 for less than one year intervention, and MD = 442.46 mL, 95% CI 271.24 to 613.68, P<0.0001 for more than one year intervention; V·O2peak: n = 246, SMD = 1.33, 95% CI 0.97 to 1.70, P < 0.00001), and cardiorespiratory endurance (O2 pulse at quiet condition: n = 146, SMD = 1.04; 95% CI 0.69 to 1.39; P < 0.00001; stair test index at quiet condition: n = 679, SMD = 1.34, 95% CI 0.27 to 2.40, p = 0.01). No adverse events were reported.ConclusionsThe results are encouraging and suggest that Tai Chi may be effective in improving cardiorespiratory fitness in healthy adults. However, concerning the low methodological quality in the included studies, more larger-scale well-designed trails are needed till the specific and accurate conclusions can be perorated.  相似文献   

16.
17.
18.
PurposeTo compare intraocular pressure (IOP) reduction and to develop a predictive surgery calculator based on the results between trabectome-mediated ab interno trabeculectomy in pseudophakic patients versus phacoemulsification combined with trabectome-mediated ab interno trabeculectomy in phakic patients.MethodsThis observational surgical cohort study analyzed pseudophakic patients who received trabectome-mediated ab interno trabeculectomy (AIT) or phacoemulsification combined with AIT (phaco-AIT). Follow up for less than 12 months or neovascular glaucoma led to exclusion. Missing data was imputed by generating 5 similar but non-identical datasets. Groups were matched using Coarsened Exact Matching based on age, gender, type of glaucoma, race, preoperative number of glaucoma medications and baseline intraocular pressure (IOP). Linear regression was used to examine the outcome measures consisting of IOP and medications.ResultsOf 949 cases, 587 were included consisting of 235 AIT and 352 phaco-AIT. Baseline IOP between groups was statistically significant (p≤0.01) in linear regression models and was minimized after Coarsened Exact Matching. An increment of 1 mmHg in baseline IOP was associated with a 0.73±0.03 mmHg IOP reduction. Phaco-AIT had an IOP reduction that was only 0.73±0.32 mmHg greater than that of AIT. The resulting calculator to determine IOP reduction consisted of the formula -13.54+0.73 × (phacoemulsification yes:1, no:0) + 0.73 × (baseline IOP) + 0.59 × (secondary open angle glaucoma yes:1, no:0) + 0.03 × (age) + 0.09 × (medications).ConclusionsThis predictive calculator for minimally invasive glaucoma surgery can assist clinical decision making. Only a small additional IOP reduction was observed when phacoemulsification was added to AIT. Patients with a higher baseline IOP had a greater IOP reduction.  相似文献   

19.
The effect of light intensity on the phase response curve (PRC) and the period response curve (τRC) of the nocturnal field mouse Mus booduga was studied. PRCs and τRCs were constructed by exposing animals free-running in constant darkness (DD), to fluorescent light pulses (LPs) of 100 lux and 1000 lux intensities for 15min duration. The waveform of the PRCs and τRCs evoked by high light intensity (1000 lux) stimuli was significantly different compared to those constructed using low light intensity (100 lux). Moreover, a weak but significant correlation was observed between phase shifts and period changes when light stimuli of 1000 lux intensity were used; however, the phase shifts and period changes in the 100 lux PRC and τRC were not correlated. This suggests that the intensity of light stimuli affects both phase and period responses in the locomotor activity rhythm of the nocturnal field mouse M. booduga. These results indicate that complex mechanisms are involved in entrainment of circadian clocks, even in nocturnal rodents, in which PRC, τRC, and dose responses play a significant role.  相似文献   

20.
目的:通过巩膜外静脉烧烙术建立慢性高眼压模型,研究小鼠慢性高眼压状态下视网膜神经节细胞的凋亡情况.方法:取C57BL/6J小鼠30只.3只作为空白对照组,其余27只右眼为实验眼,左眼为对照眼.术前用iCare眼压计测量眼压,按巩膜外静脉烧烙法建立慢性高眼压模型,术后用iCare眼压计每日监测眼压.分剐取空白对照组6眼,术后1w、4 w造模成功的小鼠各8只16眼眼球,石蜡切片行Tunel法,荧光显微镜下采集图像.小鼠眼压的组间比较采用t检验.结果:给予巩膜外静脉烧烙术后1d、1w、4w小鼠慢性高眼压眼眼压(11.15±0.98、10.65±0.95、10.35±1.05)与对照眼(6.40±0.95、6.35±1.05、6.50±1.15)相比,差异有统计学意义(t=10.77~18.08,P<0.001).Tunel法结果显示,正常小鼠空白对照组未见明显凋亡的视网膜神经节细胞.慢性高眼压组术后1w、4w可见Tunel阳性表达.而对照组术后1w及4w均未见Tunel阳性表达.结论:巩膜外静脉烧灼法能诱导出持续的肯定的小鼠慢性高眼压模型,慢性高眼压状态下小鼠视网膜神经节细胞发生凋亡,细胞凋亡是小鼠慢性高眼压状态下视网膜神经节细胞损伤的主要方式.  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