Gynecological Endocrinology最新文献

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The administration of human amniotic epithelial cells in premature ovarian insufficiency: From preclinical to clinical. 人类羊膜上皮细胞在卵巢早衰中的应用:从临床前到临床
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-07-22 DOI: 10.1080/09513590.2024.2382818
Xiaojing Zhao, Zhongna Yu, Xinrun Wang, Xiaojing Li, Yang Liu, Liang Wang
{"title":"The administration of human amniotic epithelial cells in premature ovarian insufficiency: From preclinical to clinical.","authors":"Xiaojing Zhao, Zhongna Yu, Xinrun Wang, Xiaojing Li, Yang Liu, Liang Wang","doi":"10.1080/09513590.2024.2382818","DOIUrl":"https://doi.org/10.1080/09513590.2024.2382818","url":null,"abstract":"<p><p>Premature ovarian insufficiency (POI) or premature ovarian failure (POF) is a multifactorial disorder occurring in reproductive-age women, characterized by elevated levels of follicle-stimulating hormone (FSH) and irregular or absent menstrual cycles, often accompanied by perimenopausal symptoms and infertility. While assisted reproductive technology can address the reproductive aspirations of some POI-affected women, it is hindered by issues such as exorbitant expenses, substantial risks, and poor rates of conception. Encouragingly, extensive research is exploring novel approaches to enhance fertility, particularly in the realm of stem cell therapy, showcasing both feasibility and significant potential. Human amniotic epithelial cells (hAECs) from discarded placental tissues are crucial in regenerative medicine for their pluripotency, low immunogenicity, non-tumorigenicity, accessibility, and minimal ethical concerns. Preclinical studies highlight the underlying mechanisms and therapeutic effects of hAECs in POI treatment, and current research is focusing on innovative interventions to augment hAECs' efficacy. However, despite these strides, overcoming application challenges is essential for successful clinical translation. This paper conducted a comprehensive analysis of the aforementioned issues, examining the prospects and challenges of hAECs in POI, with the aim of providing some insights for future research and clinical practice.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2382818"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of growth hormone therapy on the onset and progression of pubertal development in girls with idiopathic short stature. 生长激素疗法对特发性矮身材女孩青春期发育的起始和进展的影响。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-05-28 DOI: 10.1080/09513590.2024.2358227
Feng Zhu, Qi Xu, Lingxiao Huang, Jieqian Zhu, Lina Huang, Yu Zhang
{"title":"Effects of growth hormone therapy on the onset and progression of pubertal development in girls with idiopathic short stature.","authors":"Feng Zhu, Qi Xu, Lingxiao Huang, Jieqian Zhu, Lina Huang, Yu Zhang","doi":"10.1080/09513590.2024.2358227","DOIUrl":"10.1080/09513590.2024.2358227","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the impact of growth hormone (GH) therapy on the onset and progression of puberty in girls with idiopathic short stature.</p><p><strong>Methods: </strong>This study included 541 girls aged between 4.5 and 10.6 years who were receiving GH treatment, monitored over a 22-year follow-up period. Of these, 126 girls have been followed up to the onset of menarche. The participants were divided into two groups: a ISS control group (<i>n</i> = 66) and a group receiving daily GH treatment at a dose of 0.15 iu/kg (<i>n</i> = 60). We assessed the pubertal development and GH usage of these girls every three months.</p><p><strong>Results: </strong>(1) There was no significant difference in the onset of puberty between the growth hormone (GH) treatment group and the control group; however, the average duration of puberty was longer in the treatment group compared to the control group. (2) During puberty, there were no significant differences in height growth between the treated and untreated groups. (3) The duration of GH treatment showed a significant negative correlation with the age at onset of gonadal development and the age at menarche in females within the treatment group.</p><p><strong>Conclusion: </strong>GH treatment does not seem to accelerate the onset of puberty but may extend its duration, without significantly impacting height growth during puberty. Additionally, longer GH treatment duration is linked to earlier gonadal development and menarche in females.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2358227"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Menopausal symptoms and the awareness of menopausal-related information in low-income mid-aged women from Guayaquil, Ecuador. 厄瓜多尔瓜亚基尔低收入中年妇女的更年期症状和对更年期相关信息的了解。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-04-02 DOI: 10.1080/09513590.2024.2333418
Danny Salazar-Pousada, Valeria Ortega-Uscocovich, Cecibel Ramírez-Morán, Peter Chedraui
{"title":"Menopausal symptoms and the awareness of menopausal-related information in low-income mid-aged women from Guayaquil, Ecuador.","authors":"Danny Salazar-Pousada, Valeria Ortega-Uscocovich, Cecibel Ramírez-Morán, Peter Chedraui","doi":"10.1080/09513590.2024.2333418","DOIUrl":"10.1080/09513590.2024.2333418","url":null,"abstract":"<p><strong>Objective: </strong>To assess menopausal symptoms and determine awareness of menopausal related information in mid-aged women.</p><p><strong>Methods: </strong>This was a cross-sectional study in which 140 women aged 40 to 60 years from Guayaquil, Ecuador were surveyed with the short 10-item Cervantes Scale (CS-10) and a questionnaire containing personal data and questions assessing awareness of menopause related information.</p><p><strong>Results: </strong>The mean age of the sample was 48.0 ± 5.6 years. More than half of surveyed women had low education and non-urban residency, none were on menopausal hormone therapy, 33.6% had hypertension, 35% were postmenopausal, 78.6% had an increased body mass index (overweight/obese) and 92.9% had abdominal obesity (waist > 88 cm). The average CS-10 score was 15.3 ± 9.0 with a median of 14.0. The three most frequent menopausal symptoms were muscle-joint pain (75.0%), changes in skin texture (74.3%) and vaginal dryness (71.4%). Regarding awareness of information related to the menopause, it was found that 98.6% of women had no idea about what the menopause is and the average age of its onset. Interestingly, although 61.4% knew that during the menopause there is weight gain, 57.9% were sedentary. Married, postmenopausal, older and less educated women presented higher mean total CS-10 scores. Contrarily, those with less awareness of menopause related information present lower scores.</p><p><strong>Conclusion: </strong>In this low-income mid-aged female sample there was a high rate of non-awareness regarding information related to the menopause, including an unhealthy cardiometabolic profile. There is a need for educational programs aimed to increase awareness in this high-risk population in relation to the surveyed aspects in order to improve their health status and prevent chronic conditions.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2333418"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of various controlled ovarian hyperstimulation protocols and surgery on pregnancy outcomes in women with endometriosis. 各种控制性卵巢过度刺激方案和手术对子宫内膜异位症妇女妊娠结局的影响。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-07-21 DOI: 10.1080/09513590.2024.2381504
Han Zeng, Yanbin Wang
{"title":"Effects of various controlled ovarian hyperstimulation protocols and surgery on pregnancy outcomes in women with endometriosis.","authors":"Han Zeng, Yanbin Wang","doi":"10.1080/09513590.2024.2381504","DOIUrl":"https://doi.org/10.1080/09513590.2024.2381504","url":null,"abstract":"<p><p>Endometriosis is a common gynecological condition in women of childbearing age that causes symptoms such as menstrual changes and dysmenorrhea, and is also a major cause of infertility. Therefore, women with endometriosis usually need to use assisted reproductive technology (ART), such as <i>in vitro</i> fertilization or intracytoplasmic sperm injection, to increase their chances of conceiving. Numerous clinical observations and studies have indicated that endometriosis can affect the success of ART, such that women with endometriosis who use ART have a lower live-birth rate than those without endometriosis who use ART. Therefore, this article reviews the impact of various controlled ovarian hyperstimulation protocols and surgery on the pregnancy outcomes of women with endometriosis using ART to explore the selection of individualized treatment.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2381504"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome. 抗氧化剂 N-乙酰半胱氨酸治疗多囊卵巢综合征综述。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-07-22 DOI: 10.1080/09513590.2024.2381498
Pu Yifu
{"title":"A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome.","authors":"Pu Yifu","doi":"10.1080/09513590.2024.2381498","DOIUrl":"10.1080/09513590.2024.2381498","url":null,"abstract":"<p><p>N-acetylcysteine (NAC), a compound known for its cysteine and glutathione precursor properties, has been used in therapeutic applications for many years. Recently, there has been increasing interest in exploring the potential benefits of NAC in addressing polycystic ovary syndrome (PCOS). However, the exact mechanisms underlying NAC's therapeutic and clinical uses remain not fully understood. This review aims to specifically investigate how NAC offers protection against PCOS. This involved an extensive systematic review of the literature, and it made use of PubMed, Embase, and Web of Science databases. By analyzing key findings from over 100 research papers, the potential mechanisms through which NAC produces its effects were explored and summarized. Most studies suggest that NAC, whether used on its own or in combination with other medications, has the potential to counteract oxidative stress, utilize its anti-inflammatory and anti-apoptotic properties, and offer benefits in managing PCOS. Moreover, NAC might have the potential to influence specific signaling pathways in insulin target cells and β cells. Diverse biological effects of NAC indicate its potential usefulness as a supplementary or therapeutic approach for managing PCOS. As a result, additional research is required to explore its potential in addressing PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2381498"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Statement of retraction: Impact of unilateral versus bilateral laparoscopic ovarian drilling on ovarian reserve and pregnancy rate: a randomized clinical trial. 撤回声明:单侧与双侧腹腔镜卵巢钻孔术对卵巢储备和妊娠率的影响:随机临床试验。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-11-16 DOI: 10.1080/09513590.2024.2429931
{"title":"Statement of retraction: Impact of unilateral versus bilateral laparoscopic ovarian drilling on ovarian reserve and pregnancy rate: a randomized clinical trial.","authors":"","doi":"10.1080/09513590.2024.2429931","DOIUrl":"https://doi.org/10.1080/09513590.2024.2429931","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2429931"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Statement of Retraction: Minimal stimulation or clomiphene citrate as first-line therapy in women with polycystic ovary syndrome: a randomized controlled trial. 收缩声明:最小刺激或克罗米芬柠檬酸盐作为多囊卵巢综合征女性的一线治疗:一项随机对照试验。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2023-11-07 DOI: 10.1080/09513590.2023.2272096
{"title":"Statement of Retraction: Minimal stimulation or clomiphene citrate as first-line therapy in women with polycystic ovary syndrome: a randomized controlled trial.","authors":"","doi":"10.1080/09513590.2023.2272096","DOIUrl":"10.1080/09513590.2023.2272096","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":" ","pages":"2272096"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71480837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of subclinical hypothyroidism on hormonal and metabolic profiles and ovarian morphology in patients with polycystic ovary syndrome: a cross-sectional study. 亚临床甲状腺机能减退对多囊卵巢综合征患者荷尔蒙和代谢状况以及卵巢形态的影响:一项横断面研究。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-06-04 DOI: 10.1080/09513590.2024.2358219
Dongmei Shi, Juan Du, Huixian Kang, Liping Feng, Fang Liu
{"title":"The effect of subclinical hypothyroidism on hormonal and metabolic profiles and ovarian morphology in patients with polycystic ovary syndrome: a cross-sectional study.","authors":"Dongmei Shi, Juan Du, Huixian Kang, Liping Feng, Fang Liu","doi":"10.1080/09513590.2024.2358219","DOIUrl":"https://doi.org/10.1080/09513590.2024.2358219","url":null,"abstract":"<p><strong>Objectives: </strong>Polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) are prevalent gynecological conditions. However, the interrelationship between the two remains elusive. This study aims to elucidate the association between these conditions and determine the potential impact of SCH on the physiological and metabolic characteristics of patients with PCOS.</p><p><strong>Methods: </strong>This cross-sectional study enrolled 133 patients with PCOS from our Hospital. Participants were categorized into two groups: those with PCOS + SCH (<i>n</i> = 58) and those with PCOS (<i>n</i> = 75). Serum hormonal levels, metabolic markers, ovarian volume, and follicle count were compared between the groups.</p><p><strong>Results: </strong>There was a significant difference in BMI between the two groups, with a higher prevalence of obesity in the PCOS + SCH group (<i>p</i> = .014). Compared to the PCOS group, patients with PCOS + SCH had significantly higher levels of TSH (<i>p</i> < .001), triglycerides (<i>p</i> = .025), and HOMA-IR (<i>p</i> < .001), while LH levels were significantly lower (<i>p</i> = .048). However, multivariate linear regression analysis revealed that TSH, triglycerides, LH, and HOMA-IR were not determinants for the occurrence of SCH in patients with PCOS. Additionally, there was a notable reduction in follicle count in the left ovary for the PCOS + SCH group compared to the PCOS group (<i>p</i> = .003), and the overall follicle diameter of the PCOS + SCH group was also smaller (<i>p</i> = .010).</p><p><strong>Conclusion: </strong>SCH may exert effects on the physiological and metabolic profiles of patients with PCOS. Further investigation into the relationship between these disorders is warranted to delineate their clinical implications.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2358219"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protective effect of Yunkang oral liquid via regulating androgen receptor in polycystic ovary syndrome rats. 云康口服液通过调节雄激素受体对多囊卵巢综合征大鼠的保护作用
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-07-26 DOI: 10.1080/09513590.2024.2368845
Xiang Zheng, Chuanjie Zhou, Wanfeng Xu, Jiujie Jia, Bo Li, Guiyuan Lv, Suhong Chen
{"title":"Protective effect of Yunkang oral liquid via regulating androgen receptor in polycystic ovary syndrome rats.","authors":"Xiang Zheng, Chuanjie Zhou, Wanfeng Xu, Jiujie Jia, Bo Li, Guiyuan Lv, Suhong Chen","doi":"10.1080/09513590.2024.2368845","DOIUrl":"10.1080/09513590.2024.2368845","url":null,"abstract":"<p><p><b>Objectives:</b> This study aimed to explore the effect and mechanism of Yunkang oral liquid (YK) on polycystic ovary syndrome (PCOS). <b>Methods:</b> PCOS model rats were prepared by injecting exogenous androgen dehydroepiandrosterone, and YK was administered simultaneously for 28 days during modeling. The morphology of ovaries and uterus was observed using H&E staining, and serum levels of testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were determined by radioimmunoassay. Additionally, serum lipids (TG, HDL-c), blood glucose (GLU), and aminotransferase (AST, ALT) levels were detected. The expression of androgen receptor (AR) protein was determined by Western blotting. <b>Results:</b> YK treatment resulted in reduced serum levels of T, LH and FSH, ameliorated ovarian polycystic-like pathological changes and uterine morphology in PCOS rats, and decreased serum TG, GLU, AST and ALT levels, elevated serum HDL-c levels, and improved abnormalities of glycolipid metabolism accompanying PCOS. Moreover, YK decreased the expression of ovarian AR in PCOS rats. <b>Conclusions:</b> This study indicates that YK may protect the ovaries by inhibiting the expression of AR, which could be a potential treatment for PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2368845"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on the combination of myo-inositol/d-chiro-inositol for the treatment of polycystic ovary syndrome. 肌醇/二千-肌醇联合疗法治疗多囊卵巢综合征的最新进展。
IF 2 4区 医学
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-01-18 DOI: 10.1080/09513590.2023.2301554
Iñaki Lete, Ainara Martínez, Irene Lasaga, Eva Centurión, Amaia Vesga
{"title":"Update on the combination of myo-inositol/d-chiro-inositol for the treatment of polycystic ovary syndrome.","authors":"Iñaki Lete, Ainara Martínez, Irene Lasaga, Eva Centurión, Amaia Vesga","doi":"10.1080/09513590.2023.2301554","DOIUrl":"10.1080/09513590.2023.2301554","url":null,"abstract":"<p><p>In this article, we present a narrative review on the use of inositol in the treatment of polycystic ovary syndrome (PCOS). Of the different inositols that exist, only myo-inositol (MYO) and D-chiro inositol (DCI) have been studied in the treatment of PCOS. The results of the studies show that there is insufficient or controversial evidence to recommend the use of DCI alone, while MYO alone shows positive results and, above all, the MYO/DCI combination is effective when used at a ratio of at least 40:1, but there is enough rationale to further study ratios such as 66:1 to 100:1 as other possible effective combinations.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"40 1","pages":"2301554"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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