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evidence-based orthobiologic practice:Current evidence review and future directions

World Journal of Orthopedics 2024年第10期15卷 908-917页

作者： Madhan Jeyaraman Naveen Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu Department of Orthopedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of research Methods Orthopedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Orthopedic Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia Department of Orthopedics Government Medical College and HospitalKarur 639004Tamil NaduIndia Department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia

The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of *** biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing *** offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative *** evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes *** global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive *** their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant *** dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective *** efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.

关键词： Orthobiologics Platelet-rich plasma Stem cells Musculoskeletal regeneration Regenerative medicine evidence-based medicine

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Effect of Health Education based on Integrative Therapy of Chinese and Western medicine for Adult Patients with Type 2 Diabetes Mellitus： A Randomized Controlled Study

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Chinese Journal of Integrative medicine 2018年第2期24卷 94-102页

作者： SHI Mai LIU Zhao-lan ZHU Yan-bo XU Mei-yan DUAN Xue-ying SHI Hui-mei JIANG Bo ZHANG Xiao-mei YU Xiao-han School of Management Beijing University of Chinese Medicine Beijing 100029 China Department of clinical Nutrition China-Japan Friendship Hospital Beijing 100029China Centre for evidence-based medicine Beijing University of Chinese Medicine Beijing 100029 China Department of clinical Nutrition the Central Hospital of China Aerospace Corporation Beijing 100049 China Department of clinical Nutrition. Yan-Hua Hosoital. Beiiina 100250 China

Objective： To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus（T2DM） from the aspects of knowledge, attitude and practice（KAP）, health-related quality of life（HRQo L）, body mass index（BMI） and glucose control. Methods： Patients were individually randomized into intervention group（receiving integrative education, n=120） and control group（receiving usual education, n=120）. The primary outcome was the changes in glycosylated hemoglobin A1c（HbA1c） levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models（HLMs） were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQo L scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. Results： HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group（all P〈0.01）; and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group（P〈0.01）. There were significant between-group differences from baseline to 3 months（P=0.044）, from 6 to 9 months（P〈0.01） and from 9 to 12 months（P〈0.01）. Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQo L scores respectively（all P〈0.05）. The number in the intervention group of normal weight increased from 56 at baseline to 81（6 months）, 94（12 months）, the number in the control group were 63（baseline）, 69（6 months）, 70（12 months）, the χ~2 of hierarchical analysis of BMI were 6.93（P=0.075）, 10.31（P=0.016）, 15.53（P〈0.01）, respectively. Conclusion： Health education based on integrative therapy of Chinese and Western medicine is beneficial to the contr

关键词： type 2 diabetes mellitus health education Chinese medicine glycosylated hemoglobin A1c health-related quality of life

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Will partial splenic embolization followed by splenectomy increase intraoperative bleeding?

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 318-330页

作者： Long Huang Qing-Lin Li Qing-Sheng Yu Hui Peng Zhou Zhen Yi Shen Qi Zhang Department of No.1 Surgery The First Hospital Affiliated to Anhui University of Traditional Chinese MedicineHefei 230031Anhui ProvinceChina Anhui University of Traditional Chinese medicine Anhui University of Traditional Chinese MedicineHefei 230038Anhui ProvinceChina Department of Surgery The Second Hospital Affiliated to Anhui University of Traditional Chinese MedicineHefei 230061Anhui ProvinceChina

BACKGROUND Partial splenic embolization(PSE)has been suggested as an alternative to splenectomy in the treatment of ***,some patients may experience recurrence of hypersplenism after PSE and require ***,there is a lack of evidence-based medical support regarding whether preoperative PSE followed by splenectomy can reduce the incidence of *** To investigate the safety and therapeutic efficacy of preoperative PSE followed by splenectomy in patients with cirrhosis and *** Between January 2010 and December 2021,321 consecutive patients with cirrhosis and hypersplenism underwent splenectomy at our *** on whether PSE was performed prior to splenectomy,the patients were divided into two groups:PSE group(n=40)and non-PSE group(n=281).Patient characteristics,postoperative complications,and follow-up data were compared between *** score matching(PSM)was conducted,and univariable and multivariable analyses were used to establish a nomogram predictive model for intraoperative bleeding(IB).The receiver operating characteristic curve,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA)were employed to evaluate the differentiation,calibration,and clinical performance of the *** After PSM,the non-PSE group showed significant reductions in hospital stay,intraoperative blood loss,and operation time(all P=0.00).Multivariate analysis revealed that spleen length,portal vein diameter,splenic vein diameter,and history of PSE were independent predictive factors for IB.A nomogram predictive model of IB was constructed,and DCA demonstrated the clinical utility of this *** groups exhibited similar results in terms of overall survival during the follow-up *** Preoperative PSE followed by splenectomy may increase the incidence of IB and a nomogram-based prediction model can predict the occurrence of IB.

关键词： Partial splenic embolization Splenectomy Hypertension,Portal Liver Cirrhosis Intraoperative bleeding

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Effect of Jianpi Bushen Sequential Formula on Adjuvant Chemotherapy of Colon Cancer:Study Protocol for a Randomized Controlled Trial

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Chinese Journal of Integrative medicine 2021年第12期27卷 891-895页

作者： ZHANG Tong FEI Yu-tong XU Yun SUN Ling-yun HE Bin YAN Shao-hua TANG Mo YAN Yun-zi MAO Jun YANG Yu-fei Department of Oncology Xiyuan Hospital of China Academy of Chinese Medicine SciencesBeijing(100091)China Centre for evidence-based Chinese medicine Beijing University of Traditional Chinese MedicineBeijing(100029)China Integrative medicine service Memorial Sloan Kettering Cancer CenterNew York(10041 NY 212)United States

Background The side effects of chemotherapy-induced nausea and vomiting(CINV)and myelosuppression reduce the cancer patients’adherence to *** Chinese patients choose Chinese medicine(CM)during chemotherapy to reduce side effects;however,the evidence is *** efficacy of a CM herbal treatment protocol,Jianpi Bushen Sequential Formula(健脾补肾续贯方,JBSF)will be evaluated on chemotherapy completion rate among patients with colon *** A multi-center double-blind randomized controlled trial(RCT)will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine(CAPEOX).Patients will be randomized 1:1 to receive the JBSF or placebo *** primary outcome is the overall chemotherapy completion *** secondary outcomes include individual chemotherapy completion rate,4-cycle completion rate of chemotherapy,time to treatment failure,relative dose intensity and treatment ***-up visits will be scheduled before every and after last *** This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer.(Trial registration:clinical ***,***03716518)。

关键词： Chinese medicine Jianpi Bushen Sequential Formula Liujun Anwei Formula Qitu Erzhi Formula colon cancer chemotherapy induced nausea and vomiting myelosuppression

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Standard Protocol Items for clinical Trials with Traditional Chinese medicine 2018: Recommendations, Explanation and Elaboration(SPIRIT-TCM Extension 2018)

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Chinese Journal of Integrative medicine 2019年第1期25卷 71-79页

作者： DAI Liang CHENG Chung-wah TIAN Ran ZHONG Linda LD LI You-ping LYU Ai-ping CHAN An-wen SHANG Hong-cai BIAN Zhao-xiang Hong Kong Chinese medicine clinical Study Centre School of Chinese Medicine Hong Kong Baptist University Institute of Digestive Diseases Longhua Hospital Shanghai University of Traditional Chinese Medicine Chinese evidence-based medicine Centre Sichuan University Women's Col ege research Institute Women's Col ege Hospital University of Toronto Key Laboratory of Chinese Internal medicine of Ministry of Education and Beijing Dongzhimen Hospital Beijing University of Chinese Medicine

Traditional Chinese medicine(TCM) is one of the oldest systems of medicine. More and more attention has been paid to TCM application, but the variable quality of clinical trials with TCM impedes its widespread acceptance. The Standard Protocol Items: Recommendations for Interventional Trials(SPIRIT) 2013 Statement has established guidelines for designing clinical trials to ensure that the trial results are accurate and reliable. However, there are difficulties when applying SPIRIT 2013 Statement to trials with TCM, due to the unique theory and the characteristic of TCM intervention. An Extension to the original SPIRIT was developed to ensure the quality of trial design with TCM. As Chinese herbal formulae, acupuncture and moxibustion are common and representative interventions in TCM practice, the executive working group determined that the SPIRIT-TCM Extension focus on these three interventions. Extension was developed through initiation, 3 rounds of Delphi consensus survey, and finalizing expert meeting. Seven items from the SPIRIT 2013 Statement were modified, namely, "title", "background and rationale", "objectives", "eligibility criteria", "interventions", "outcomes", and "data collection methods". The Extension includes the introduction of the concept of TCM pattern and 3 major TCM interventions, with examples and explanations. The SPIRIT-TCM Extension 2018 provides suggestion for investigators in designing high quality TCM clinical trials. It is expected that wide dissemination and application of this extension ensure continuous improvement of TCM trial quality throughout the world.

关键词： SPIRIT traditional Chinese medicine clinical trial extension recommendation

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Differences in Contents and Formation Methods of clinical Questions in Chinese and Korean clinical Practice Guidelines of Acupuncture-Moxibustion:Scoping Review

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Chinese Journal of Integrative medicine 2023年第12期29卷 1133-1141页

作者： ZHAO Nan-qi LIU Ya-li DING Nan YUAN Jing-yun MOU Dong-xiao DONG Guo-feng WANG Xin WU Xiao-dong Institute of Acupuncture-Moxibustion China Academy of Chinese Medical SciencesBeijing(100700)China Center for clinical Epidemiology and evidence-based medicine Beijing Children's HospitalCapital Medical UniversityBeijing(100045)China College of Acupuncture and Massage Beijing University of Chinese MedicineBeijing(100029)China

Objective:To analyze the differences in the needs of users and the value orientation of clinical practice guidelines(CPGs)by comparing the contents and formation methods of clinical questions in Chinese and Korean CPGs of acupuncture-moxibustion(Acup-Mox).Methods:The full text of CPGs was systematically searched from the official websites of Chinese and Korean traditional medicine societies and Acup-Mox associations,with the topic"Acup-Mox for treating diseases"and the retrieval time up to September 28,*** researchers screened the CPGs independently,and extracted the guidelines'topics,content,quantity and formation methods of clinical *** quantitative data were collected by counting the frequency,and the qualitative data were classified and described by thematic ***:A total of 29 guidelines were included in this study,including 20 Chinese guidelines(305 questions)and 9 Korean guidelines(223 questions).The differences lie in the aspects of content and diversity,and formation *** for content and diversity,Chinese guidelines focused mainly on the questions related to treatment such as the operation of specific intervention(86,28.2%),efficacy of intervention(78,25.6%),and also involving questions in diagnosis,prevention,and *** the clinical questions in Korean guidelines were concentrated to efficacy of intervention(218,97.8%).As for formation method,in Chinese guidelines,questions were usually collected directly from clinicians,and then determined and optimized by *** Korean guidelines,frequently used clinical Acup-Mox interventions would be screened *** the expert group would set up corresponding intervention control measures so as to form clinical questions related to treatment ***:The differences reflect the different needs of clinical practitioners,and the different aims or concepts in developing Acup-Mox guidelines between China and South *** guidelines emphasized promoting oper

关键词： association of acupuncture-moxibustion clinical practice guidelines clinical questions optimize

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Sini decoction as an adjuvant therapy for angina pectoris:a systematic review of randomized controlled trials

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Journal of Traditional Chinese medicine 2017年第1期37卷 12-22页

作者： Wu Jin Yuan Dongchao Yang Mingqian Xia Wei Zhang Zhe Zhang Huiyong Fei Yutong Yang Guanlin Key Laboratory of Ministry of Education for Traditional Chinese medicine Viscera-State Theory and Applications Liaoning University of Traditional Chinese MedicineShenyang 110847China the First clinical Medical School Liaoning University of Traditional Chinese MedicineShenyang 110847China Department of Scientific research Management the Affiliated Hospital of Liaoning University of Traditional Chinese MedicineShenyang 110032China Hematological Department the Affiliated Hospital of Liaoning University of Traditional Chinese MedicineShenyang 110032China evidence-based Chinese medicine Center for clinical research and Evaluation School of Preclinical MedicineBeijing University of Traditional Chinese MedicineBeijing 100029China 不详

OBJECTIVE: To systematically assess the effects and safety of Sini decoction as an adjuvant therapy for patients with angina ***: We searched Pub Med, Excerpt Medica Database, the Cochrane library, Wanfang Database,China National Knowledge Infrastructure Database,China Science and Technology Journal Database from the date of its inception until August 1, in2014. Available literatures were selected according to the inclusion criteria. Two reviewers finished data extraction, checked the data and assessed the methodological quality of studies, *** Review Manage Software 5.1.0 was used for data ***: Six trials involving 453 participants were eligible. None of the trials reported the mortality due to angina pectoris. The secondary outcomes showed that Sini decoction, together with nitroglycerin when necessary, may have some effects on reducing the number of angina attacks and the amount of nitroglycerin. But in terms of reducing the duration of angina and improvement of electrocardiogram, there were no statistical differences between Sini decoction group and isosorbide dinitrate group. Only one reported that no adverse events were ***: based on this systematic review, Sini decoction can reduce the dosage of nitroglycerin, when compared with isosorbide dinitrate *** there were no enough evidence in the papers to draw any conclusions for the safety of Sini decoction.

关键词： Angina pectoris Coronary disease Sini decoction Randomized controlled trial Meta-analysis

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Psychosocial Stress Modifies the Acute Cardiac Health Effects of Traffic-Related Air Pollution

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Environment & Health 2024年第1期2卷 11-22页

作者： Tongjun Guo Wanzhou Wang Xi Chen Huaqi Guo Kai Wang Yating Ma Hongyan Deng Xianggui Li Anqi Shan Qian Wu Yaoyan Li Hongyu Li Qisijing Liu Juan Chen Yang Lan Jian Lei Furong Deng Zhiwei Sun Xinbiao Guo Shaowei Wu Yan Wang Naijun Tang Department of Occupational and Environmental Health Sciences School of Public HealthPeking UniversityBeijing 100191China Department of Occupational and Environmental Health Tianjin Key Laboratory of EnvironmentNutrition and Public HealthSchool of Public HealthTianjin Medical UniversityTianjin 300070China Department of Respiratory and Critical Care medicine The Ninth People’s Hospital of Shanghai Jiao Tong University School of MedicineShanghai 200025China Department of Occupational and Environmental Health School of Public HealthXi’an Jiaotong University Health Science CenterXi’anShaanxi 710049China Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health Xi’anShaanxi 710049China Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province Xi’anShaanxi 710049China Institute of Social Psychology School of Humanities and Social SciencesXi’an Jiaotong UniversityXi’anShaanxi 710049China Qinglongqiao Community Health service Centre Beijing 100091China Key Laboratory of Environment and Genes Related to Diseases(Xi’an Jiaotong University) Ministry of EducationXi’an 710061China School of Public Health Shanghai Jiao Tong University School of MedicineShanghai 200025China Department of HAI Management Tianjin Huanhu HospitalTianjin 300060China Office for National clinical research Center for Geriatric Diseases Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijing 100005China research Institute of Public Health School of MedicineNankai University300071 TianjinChina Department of Toxicology and Sanitary Chemistry School of Public HealthCapital Medical UniversityBeijing 100069China Beijing Key Laboratory of Environmental Toxicology Capital Medical UniversityBeijing 100069China The Ninth People’s Hospital of Shanghai Jiao Tong University School of medicine Shanghai 200011China

Previous studies have shown that exposure to black carbon(BC,a tracer of traffic-related air pollution)and psychosocial stress are both associated with adverse cardiac effects,but whether psychosocial stress could modify the cardiac effects of BC is *** investigate the potential modifying effect of psychosocial stress on the associations between acute exposure to BC and typical cardiac health variables,real-time personal 24 h measurements were conducted in a repeated-measure study among adults with elevated blood pressure(high-risk group)and a panel study among normal adults(low-risk group)in *** cardiac health variables included ST-segment depression events,heart rate,and heart rate variability(HRV)*** Stress Scale,State Anxiety Inventory and Self-rating Depression Scale were used to assess the recent psychosocial stress status of the participants,and a composite stress index was established based on these *** linear mixed-effects model was used to analyze the associations between BC exposure and cardiac health variables and potential effect modification by psychosocial stress.A total of 9724 h measurements among 97 participants in the repeated-measure study and 20224 h measurements among 87 participants in the panel study were included in the final *** BC exposure was significantly associated with increased ST-segment depression events and heart rate and decreases in HRV in both *** marginal effects of acute BC exposure on most cardiac health variables generally tended to be amplified under higher vs low levels of psychosocial stress in both studies,with the composite stress index apparently modifying the associations of BC exposure with most ST-segment depression events and HRV *** findings suggest that psychosocial stress may increase the participants’cardiac susceptibility to BC exposure,which could be helpful for the identification of susceptible individuals in the context of traff

关键词： Air pollution Black carbon Cardiac health Effect modification Psychosocial stress

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Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

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World Journal of Gastroenterology 2024年第38期30卷 3326-3335页

作者： Chun-Ying Qu Fei-Yu Zhang Yi Zhang Ming-Ming Li Zheng-Hong Li Mei-Hong Cai Lei-Ming Xu Feng Shen Wen Wang Wu-Lian Lin Feng-Yu Gao Hao Zhang Guang-Yu Chen Department of Gastroenterology&Endoscopy Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of Gastroenterology The 900th Hospital of the People’s Liberation Army Joint Service Support ForceFuzhou 350025Fujian ProvinceChina Department of Endoscopy Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao UniversityJinan 250014Shandong ProvinceChina Department of Endoscopy Baoshan People’s Hospital of Yunnan ProvinceBaoshan 678000Yunnan ProvinceChina Department of Gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural *** To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and *** This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL *** patients were followed-up for 12 ***-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile *** One hundred and ninety-five patients were enrolled,with 98 in the EFSB *** was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),Pgroup at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,Pgroup than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

关键词： Internal hemorrhoids Endoscopic therapy Polidocanol foam Sclerotherapy Rubber band ligation Sclerobanding

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Evolution of gastrointestinal endoscopy in the mainland of China

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Chinese Medical Journal 2009年第19期122卷 2220-2223页

作者： BAI Yu LI Zhao-shen evidence-based medicine group Department of Gastroenterology Digestive Endoscopy Center Center of clinical Epidemiology Changhai Hospital Second Militaby Medical University Shanghai 200433 China

INVENTION OF GASTROINTESTINAL ENDOSCOPYGastrointestinal endoscopy is an important diagnostic and therapeutic tool in our daily medical practice. The evolution of endoscopic technologies from simple tubes to the flexi... 详细信息

关键词： evolution endoscopy, gastrointestinal China

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