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Efficacy of a strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare

World Journal of Cardiovascular Diseases 2020年第3期10卷 117-130页

作者： Maria jesús Fernández-Luque Luis María sánchez-Gómez vicente Pastor y Aldeguer Carmen suárez-Fernández Belén sierra-García soledad Mayayo-vicente Marta Ruiz-López ángela Gallego-Arenas Rosa sánchez Alcalde Pilar Loeches-Belinchón Javier López-González Francisco Rodríguez-salvanés Blanca Novella-Arribas Dirección General de Investigación Docencia y Documentación Consejería de Sanidad Comunidad de Madrid Madrid Spain Instituto de Investigación sanitaria del Hospital Universitario de La Princesa (IP) Madrid Spain Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain Hospital Universitario de la Princesa SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Gerencia Asistencial de Atención Primaria D.G. de Coordinación de Asistencia Sanitaria SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Unidad de Evaluación de Tecnologías sanitarias de Madrid Procesos Integrados de Salud Consejería de Sanidad Madrid Spain

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

关键词： Randomized Controlled Trial Cluster Analysis Clinical Practice Guidelines Primary Healthcare Risk Factors Cardiovascular Diseases

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Improving Intelligibility and Pronunciation Through Phonics Instruction for 5th Grade EFL Learners of Chilean Public schools

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sino-Us English Teaching 2020年第2期17卷 43-57页

作者： Carolina Bustos Martínez María jesús Millar Zurita Universidad Austral de Chile ValdiviaChile

Based on the curriculum proposed by the Chilean Ministry of Education,schools are offered textbooks and complementary guides for teachers as a tool for the learning process of the *** in mind that the Ministry suggests a list of learning targets that must be accomplished at the end of the academic year,the author of said textbooks offers activities that are meant to fulfil these ***,and considering that one of the goals of the Ministry is that 5th grade students,at the end of their learning process,communicate an intelligible message with a proper pronunciation,a lack of activities and methodologies focused on the improvement of these aspects can be ***,this proposal will present teachers with phonics as a methodology that may help students improve intelligibility and the recognition and production of segmental aspects of pronunciation.

关键词： intelligibility pronunciation phonics 5th grade Chile

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Post-transplant plasma cell hepatitis in a liver transplant patient treated with pegylated interferon plus ribavirin

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Open Journal of Gastroenterology 2013年第7期3卷 307-310页

作者： Miguel Jiménez-Pérez Francisco Javier Rando-Munoz Rocío González-Grande Fernando González-Panizo Tamargo jesús de la Cruz Lombardo Juan Miguel Rodrigo López Román Manteca González Department of Gastroenterology and Hepatology Liver Transplantation Unit University Hospital Carlos Haya Málaga Spain

The recurrence of hepatitis C after a liver transplant remains an important cause of graft loss and retransplant. Antiviral therapy with peginterferon plus ribavirin (PEG-INF/RBv) can achieve a sustained viral response and histological improvement in a high percentage of cases. However, this treatment is not exempt from important side effects or from the possibility of precipitating rejection, with the resulting graft loss. We report the case of a liver transplant patient who received treatment with PEG-INF/RBv and developed plasma cell hepatitis as the presenting form of rejection.

关键词： Liver Transplantation C Hepatitis Treatment Plasmatic Cells Allograft Rejection Autoinmune Response

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局部晚期乳腺癌患者双时相18F-FDGPET/CT显像的纹理特征及基于标准摄取值的相关参数

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中华核医学与分子影像杂志 2018年第6期38卷 454-455页

作者：唐军 Ana María Garcia-vicente David Molina Julián Pérez-Beteta Mariano Amosalas Alicia Martínez-González Gloria Bueno María jesús Tello-Galán Angel soriano-Castrejón 上海交通大学医学院附属苏州九龙医院核医学科 Nuclear Medicine Department University General Hospital Ciudad RealSpain

目的探讨双时相18F-脱氧葡萄糖(FDG)PET/CT显像对纹理特征分析和基于标准摄取值(sUv)的相关参数的影响及其相互关系。方法该前瞻性研究纳入56例局部晚期乳腺癌(LABC)患者,患者均行常规18F-FDG PET/CT显像(注药后1 h显像,PET-1)和延迟显... 详细信息

目的探讨双时相18F-脱氧葡萄糖(FDG)PET/CT显像对纹理特征分析和基于标准摄取值(sUv)的相关参数的影响及其相互关系。方法该前瞻性研究纳入56例局部晚期乳腺癌(LABC)患者,患者均行常规18F-FDG PET/CT显像(注药后1 h显像,PET-1)和延迟显像(注药后3 h显像,PET-2)。图像经软件分割后计算得到基于sUv的相关参数[最大sUv(sUvmax)、平均sUv(sUvmean)和sUv峰值(sUvpeak)]、代谢肿瘤体积(MTv)和病灶糖酵解总量(TLG)。同时计算18项三维纹理特征分析参数,其中包括行程长度矩阵(RLM)特征、共生矩阵(CM)特征和能量特征(空间能量和总能量)。研究PET-1和PET-2上述参数的差别。结果 PET-1、PET-2间基于sUv的相关参数和MTv的差异有统计学意义,与PET-1相比,PET-2的sUv相关参数更高,但MTv更低。PET-1、PET-2间有明显差异的纹理特征分析参数为短行程增强(RsE)、低灰度行程增强(LGLRE)、短行程高灰度增强(sRHGLE)、行程百分比(RP)、长行程增强(LRE)、灰度非均匀性(GLNU)、同质性(HOM)和差异性(DIs)。纹理特征分析参数与MTv和TLG相关。结论双时相18F-FDG PET/CT显像图像的纹理特征分析参数间有明显差异。因此,18F-FDG PET/CT显像时应考虑到代谢特征的动态变化,即延迟显像时肿瘤组织表现出的异质性更强,且瘤体越大异质性越强。

关键词：双时相18F-FDG PET/CT 乳腺肿瘤肿瘤异质性纹理特征

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冰雹结构异质性的分析:大气条件及其潜在的环境意义

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AMBIO-人类环境杂志 2001年第7期30卷 452-454页

作者： jesús Martínez-Frías Millán Millán Nicolás García Fernando López-vera Antonio Delgado Roberto García 闵庆文 Departamento de Geologia Museo Nacional de Ciencias Naturales CsIC Jos Gutirraez Abascal 228006 Madrid spain Jos A. Rodrguez-Losada Emilio Reyes Juan A. Martn Rub Aurora Gmez-Coedo

冰雹是球状或不规则冰块形式的降水,它一般产生于与复合单体、超级单体和冷锋锋面有关的对流云中。冰雹开始时是一些微小的冰球,这些小冰球与周围的小水滴不断发生碰撞,当附着的小水滴冻结起来,这些小冰球就增大了。当一个冰块混合体的... 详细信息

冰雹是球状或不规则冰块形式的降水,它一般产生于与复合单体、超级单体和冷锋锋面有关的对流云中。冰雹开始时是一些微小的冰球,这些小冰球与周围的小水滴不断发生碰撞,当附着的小水滴冻结起来,这些小冰球就增大了。当一个冰块混合体的直径达到或超过5 mm时,就称为雹块。一般来说,雹块是存在过冷水滴的雷暴积雨云内部上升气流和下沉气流共同作用的结果。过冷却的水滴不断沉积在冰晶上,使其起生长为雹块,这一般经过了从软雹(第一阶段)到小冰雹、再到雹块的不同阶段。一个雹块在

关键词：冰雹固态降水雹块对流层顶对流层上限低层大气大气条件异质性

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不明原因发热患者的临床特征和实验室检查结果对18F-FDG PET/CT显像诊断效能的影响

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中华核医学与分子影像杂志 2018年第8期38卷 582-583页

作者：唐军 Ana María García-vicente María jesús Tello-Galán Mariano Amo-salas Juan Ros-Izquierdo German Andrés Jiménez-Londofio Beatriz La Rosa salas Guadalupe Prado-serrano Pradas Francisco José Pena-Pardo ngel soriano-Castrejón 上海交通大学医学院附属苏州九龙医院核医学科 Nuclear Medicine Department University General HospitalCiudad RealSpain

目的评价患者临床特征及实验室检查结果对18F-脱氧葡萄糖(FDG) PET/CT显像诊断不明原因发热(FUO)的影响。方法回顾性纵向分析FUO患者的PET/CT显像结果。参考标准为血清学检查、各种细菌培养或活组织检查结果,必要时参考其他实验室检查... 详细信息

目的评价患者临床特征及实验室检查结果对18F-脱氧葡萄糖(FDG) PET/CT显像诊断不明原因发热(FUO)的影响。方法回顾性纵向分析FUO患者的PET/CT显像结果。参考标准为血清学检查、各种细菌培养或活组织检查结果,必要时参考其他实验室检查或临床随访结果。收集患者PET/CT显像近几天内的临床特征、炎性标志物、蛋白质分析、血清学检查和细菌培养结果。根据不同病因最终诊断分为3组:第1组为感染或肿瘤,第2组为脉管炎、自身免疫性疾病或非感染性炎性疾病,第3组为未明确诊断的自限性发热或持续性发热。PET/CT显像结果分为阳性或阴性、有助于或无助于诊断发热来源。分析患者临床特征和实验室检查结果对PET/CT结果的影响。结果 67例患者最终诊断分组为:第1组25例,第2组20例,第3组22例。89.6%的患者炎性标志物阳性,28.4%的蛋白质检测阳性,20.9%的细菌培养结果阳性。67例患者中,PET/CT显像阳性52例,25例有助于诊断发热来源,其中对第1组和第2组帮助尤其大。PET/CT显像的灵敏度、特异性和准确性分别为84%、31%和61%。PET/CT显像结果与最终诊断(P=0.035)和细菌培养结果(P=0.037)相关,而与其他临床特征或实验室检查结果无明显相关性。结论18F-FDG PET/CT显像诊断FUO的灵敏度高,但特异性低,可能的原因是FUO的病原范围很广,也有一些是自限性发热。最有可能从PET/CT显像获益的患者是那些多种炎性标志物阳性的患者,这些患者有活动性病变的可能性更高。

关键词：不明原因发热(FUO) 18F-FDG PET/CT 炎性标志物诊断

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Dendritic cell deficiencies persist seven months after sARs-Cov-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： Alberto Pérez-Gómez Joana vitallé Carmen Gasca-Capote Alicia Gutierrez-valencia María Trujillo-Rodriguez Ana serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-Leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar sotomayor Cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-Rivas Alberto Fernández-villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel Ruiz-Mateos JoséMiguel Cisneros sonsoles salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez JoséManuel Lomas Claudio Bueno Rosario Amaya JoséAntonio Lepe Jerónimo Pachón Elisa Cordero Javier sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas verónica Alfaro-Lara Cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado Antonio Domínguez-Petit Alejandro Deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González Rocío González-León Carmen Grande-Cabrerizo sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero Luis Jara Carlos Jiménez-Juan silvia Jiménez-Jorge Mercedes Jiménez-sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés Rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín Francisco Ortega María Paniagua-García Amelia Peña-Rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain Department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of seville(IBis) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-surgical Unit of Respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain Department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular surgery Unit Virgen del Rocío University HospitalSevilleSpain Rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

severe Acute Respiratory syndrome Coronavirus(sARs-Cov)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COvID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COvID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after sARs-Cov-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COvID-19.

关键词： sARs-Cov-2 COvID-19 Dendritic cell Long-COvID

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Presence of Infectious Hypodermal and Haematopoietic Necrosis virus (IHHNv) in Native shrimps from southern Mexico

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Open Journal of Marine science 2017年第3期7卷 424-432页

作者： Ariadne Hernández-Pérez jesús Alejandro Zamora-Briseñ o Juan Antonio Pérez vega Richard Juan de Dios Mena-Loria Daniel Coronado-Molina Jorge Hernández-López Norma Angelica-López-Téllez Rossanna Rodríguez-Canul Laboratorio de Inmunología y Biología Molecular Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV-IPN) Unidad Mérida Yucatán México Centro de Investigaciones Biológicas del Noroeste Sonora México Centro Regional de Investigación Pesquera de Lerma Campeche Instituto Nacional de la Pesca (CRIP Lerma-INP) Campeche México

A survey for Infectious Hypodermal and Haematopoietic Necrosis virus (IHHNv) and White spot syndrome virus (Wssv) was performed during two catching seasons of native shrimps in the Yucatan Coast in the Gulf of Mexico. The mtDNA COI barcode identified two endemic species;the southern pink shrimp Penaeus notialis (Pérez Fantante, 1967) and the northern pink shrimp Penaeus brasiliensis (Latreille, 1987) (previously described as Farfantepenaeus brasiliensis). The prevalence of IHHNv was of 18.18% in 2016, and of 8.57% in 2017. All organisms tested negative for Wssv. This is the first identification of wild shrimps in the state of Yucatan Mexico by mtDNA COI barcode as well as the first identification of IHHNv in such species. The presence of IHHNv in wild shrimps populations has a potential of persisting in the coast of Yucatan with putative detrimental effect on local fisheries because once established in natural waters and hosts;such pathogens are almost impossible to eradicate.

关键词： IHHNv Wssv mtDNA COI Barcode Penaeus notialis Penaeus brasiliensis Yucatan Peninsula

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Health status of Urban Medium-Low-Income Elderly at the Community

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Open Journal of Endocrine and Metabolic Diseases 2018年第3期8卷 105-116页

作者： Lilia Cárdenas-Ibarra jesús Z. villarreal-Pérez Raúl Fernando Gutiérrez Herrera Perla Alejandra Mellado-Urbina Ana Laura Turner-Llaguno Adolfo Montemayor-Alatorre José Carlos Lira-Castillo Fernando J. Lavalle González Endocrinology service Dr. José E. González University Hospital Universidad Autónoma de Nuevo León (UANL) San Nicolás de los Garza Mexico Family Practice Department Dr. Jose E. Gonzalez University Hospital UANL San Nicolás de los Garza Mexico Medical school UANL San Nicolás de los Garza Mexico

Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low-income elders. Method: The study had cross-sectional design in population sample. subjects were urban men and women older than 59 years at the medium low income stratum at a developing country. survey was carried out from October 2008 to October 2009. All elder dwellers in randomly selected houses were surveyed;clinical exam after consent. Good Control: systolic/Diastolic Results: There were 162 elders, 53 (32.7%) were male, 99 (61.1%) were younger than 70 years. Forty nine (30.2%) had impaired mobility;among them 20 (55.6%) were bed or home restricted, and 29 (44.4%) needed help to go out. Unstable health condition was found in 36 (22.2%), with significantly more men 19 (52.8%) vs 34 (27.0%), X2 = 8.5, df1, P 0.05. The frequency, proportions for: known diagnosis, on treatment, and good control were 75 (69.4%), 55 (73.3%), 45 (60.0%) and 12 of 45 (26.7%) for hypertension;53 (49.1%), 47 (88.7%), 42 (79.2%) and 9 of 42 (21.4%) for diabetes. The most frequent unstable conditions were cardiovascular. Conclusions: Data suggest unstable health no association with the oldest old. The small proportion in good control of Diabetes and/or hypertension could explain the large frequency of elders with unstable health and prevention of reaching nonagenarian age.

关键词： Community Health Elderly Awareness Treatment and Control of Hypertension and Diabetes Mellitus Type 2

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西班牙的房地产泡沫：城市化与城市建设

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地理研究 2016年第7期35卷 1383-1396页

作者： Onofre Rullan jesus M. Gonzalez Perez 尹子潇顾朝林陈明玉西班牙巴利阿里群岛大学地理学系西班牙帕尔玛07122 清华大学建筑学院城乡规划系北京100084

聚焦于西班牙1996-2007年间的房地产泡沫,此次危机与西班牙前两次经历的地产泡沫有着相似的背景条件:将住房建设作为利好投机性投资。但几次泡沫供给结构却不同:此次住房供给主要为分散式,不同于以往的集中供应;旅游地产大量出现;房屋... 详细信息

聚焦于西班牙1996-2007年间的房地产泡沫,此次危机与西班牙前两次经历的地产泡沫有着相似的背景条件:将住房建设作为利好投机性投资。但几次泡沫供给结构却不同:此次住房供给主要为分散式,不同于以往的集中供应;旅游地产大量出现;房屋拥有型社会形成。作者认为供给结构的改变并非危机的主要原因,并提出了造成房地产泡沫的四个关键要素:符合一定条件的土地、土地规划的配合、充足的资金与可获得的土地所有权。结论是:政策的制定直接影响土地利用、发展规划、金融系统与个人资产、造成住房由使用品变为投机投资的对象、银行体系信用缺乏保障,最终导致了住房库存量陡增,大量房屋拆除事件与失业率攀升等经济和社会方面的不良影响。

关键词：房地产泡沫城市化建设土地规划西班牙

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