Annales de cardiologie et d'angeiologie最新文献

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Promising long-term surgical outcomes of aortic valve replacement in patients with important isolated aortic regurgitation and severe left ventricular dysfunction [主动脉瓣置换术在严重孤立主动脉回流和严重左心室功能障碍患者的长期前景]。
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/j.ancard.2024.101859
A. Soufiani , Z. Agoumy , M. Tribak , S. El Mhadi , Z. Fassi Fehri , H. Chraibi , L. Bakamel , O. Soussi , H. El Assili , K. Berrag , J. Raoui , FZ Hattab , Z. Idrissi , S. Essebany , H. Leghlimi , F. Lachhab , N. Fellat , R. Fellat , A. Bensouda , A. Chaib , S. Moughil
{"title":"Promising long-term surgical outcomes of aortic valve replacement in patients with important isolated aortic regurgitation and severe left ventricular dysfunction","authors":"A. Soufiani ,&nbsp;Z. Agoumy ,&nbsp;M. Tribak ,&nbsp;S. El Mhadi ,&nbsp;Z. Fassi Fehri ,&nbsp;H. Chraibi ,&nbsp;L. Bakamel ,&nbsp;O. Soussi ,&nbsp;H. El Assili ,&nbsp;K. Berrag ,&nbsp;J. Raoui ,&nbsp;FZ Hattab ,&nbsp;Z. Idrissi ,&nbsp;S. Essebany ,&nbsp;H. Leghlimi ,&nbsp;F. Lachhab ,&nbsp;N. Fellat ,&nbsp;R. Fellat ,&nbsp;A. Bensouda ,&nbsp;A. Chaib ,&nbsp;S. Moughil","doi":"10.1016/j.ancard.2024.101859","DOIUrl":"10.1016/j.ancard.2024.101859","url":null,"abstract":"<div><h3>Background</h3><div>Surgical management of patients with severe aortic regurgitation (AR) in the setting of significantly impaired left ventricle (LV) function generally carries very high operative risk. The aim of this study is to assess the short and long-term outcomes of aortic valve replacement (AVR) in a selected young Moroccan population.</div></div><div><h3>Materiel and methods</h3><div>This is a retrospective study between January 2008 and June 2022 including all patients who underwent AVR for massive isolated AR with an LV ejection fraction EF ≤35%.</div></div><div><h3>Results</h3><div>In this center, a total of 3820 patients were operated for valvular disease, from which 110 had important AR. Overall, 42 patients of 110 patients had an LV ejection fraction≤35%, and benefited from AVR. Rheumatic cause was predominant (50%). Preoperative characteristics find an average age of 46.3 ±14.4 years with male prevalence. Only two deaths are noted in the immediate postoperative period. At the 15 years follow-up, the survival was 86.8%. Clinical improvement was present in the majority of patients. The mean LVEF post-AVR has increased by an average of 16% with proof of reverse remodeling.</div></div><div><h3>Conclusions</h3><div>In this series, patients benefited largely from AVR with good postoperative outcomes. The global operative mortality was acceptable (4.7%). The long-term survival (86.8%) was better than that described in the western series. Therefore, our results should encourage a surgical approach for those patients.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101859"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coronarographie et étiologies de l'insuffisance cardiaque à fraction d’éjection ventriculaire gauche altérée au Sénégal [在塞内加尔左心室射血分数受损的心力衰竭的冠状造影和病因]。
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/j.ancard.2024.101860
Yassine Rabab, Ndao Serigne Cheikh Tidiane, Ka Mame Madjiguene, Mboup Waly Niang, Fall Aissatou, Dia Khadidiatou, Mboup Mouhamed Chérif
{"title":"Coronarographie et étiologies de l'insuffisance cardiaque à fraction d’éjection ventriculaire gauche altérée au Sénégal","authors":"Yassine Rabab,&nbsp;Ndao Serigne Cheikh Tidiane,&nbsp;Ka Mame Madjiguene,&nbsp;Mboup Waly Niang,&nbsp;Fall Aissatou,&nbsp;Dia Khadidiatou,&nbsp;Mboup Mouhamed Chérif","doi":"10.1016/j.ancard.2024.101860","DOIUrl":"10.1016/j.ancard.2024.101860","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure is a major public health problem because of the number and duration of hospitalizations. Patients with heart failure may have mixed etiologies that are not mutually exclusive, and etiologies vary between high-income and developing countries. The aim of our work was to study the contribution of coronary angiography in the etiological investigation of heart failure with impaired LVEF in the cardiology department of HPD.</div></div><div><h3>Methodology</h3><div>This was a descriptive and analytical cross-sectional study with retrospective data collection on 103 patients hospitalized in the cardiology department of DAKAR's Hospital Principal presenting with heart failure with impaired LVEF and who underwent coronary angiography from January 2019 to December 2022.</div></div><div><h3>Results</h3><div>Our study included 103 patients with a clear male predominance 79.6% and a sex ratio of 3.7. Their mean age was 64±13.5 years. Diabetes was prevalent at 24.3% (<em>p</em>=0.033). All patients had impaired segmental and/or global left ventricular kinetics. Mean ejection fraction was 28.1±6.8. The right radial route was predominantly used 83.7% of the time, and there were no procedural incidents or accidents. Diabetes was significantly associated with coronary involvement (<em>p</em>=0.033). Coronary angiography was normal in 37.8% of patients and showed tri-truncular lesions in 19.4% of patients and bi-truncular lesions in 17.4%.</div><div>We found 91 significant lesion and 67 non-significant lesion. A total of 41 patients had ischemic heart disease, equivalent to 39.8%.</div></div><div><h3>Conclusion</h3><div>Our study shows that ischemic heart disease plays an important role in the etiology of heart failure with impaired LVEF, and that coronary angiography should be performed routinely.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101860"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sommaire 摘要
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/S0003-3928(25)00010-1
{"title":"Sommaire","authors":"","doi":"10.1016/S0003-3928(25)00010-1","DOIUrl":"10.1016/S0003-3928(25)00010-1","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101871"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tamponnade due à la rupture d'un tératome mature : un cas rare [由成熟畸胎瘤破裂引起的卫生棉条:罕见病例]。
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/j.ancard.2024.101855
I. Atlas, M. Khaldi, S. Hayar, M. Haboub, S. Arous, E.M. Benouna, A. Drighil, R. Habbal
{"title":"Tamponnade due à la rupture d'un tératome mature : un cas rare","authors":"I. Atlas,&nbsp;M. Khaldi,&nbsp;S. Hayar,&nbsp;M. Haboub,&nbsp;S. Arous,&nbsp;E.M. Benouna,&nbsp;A. Drighil,&nbsp;R. Habbal","doi":"10.1016/j.ancard.2024.101855","DOIUrl":"10.1016/j.ancard.2024.101855","url":null,"abstract":"<div><h3>Introduction</h3><div>Mature teratomas, a diverse group of germ cell tumors, rarely present with complications such as rupture.</div></div><div><h3>Case presentation</h3><div>We present a case of a 27-year-old male who was admitted to our hospital with acute dyspnea. A tamponade was diagnosed and the patient underwent a pericardial puncture. Further radiological investigations revealed a large mediastinal teratoma with evidence of rupture, leading to pericardial effusion. Surgical intervention was performed, which involved pericardial drainage and complete resection of the teratoma. Histopathological examination confirmed the diagnosis of a mature teratoma. The patient made a full recovery postoperatively.</div></div><div><h3>Discussion</h3><div>This rare case underscores the importance of early recognition and prompt surgical management in patients with ruptured mediastinal teratomas to prevent complications. We discuss the clinical presentation, diagnostic workup, and surgical approach to aid in the understanding and management of similar cases.</div></div><div><h3>Conclusion</h3><div>Mature teratomas are relatively rare benign tumors that rarely present with complications such as tamponade. Management of tamponade remains the same, and complete surgical removal of the teratoma is essential. In general, the outcome is favorable after surgical treatment.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101855"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Les enjeux des nouvelles technologies numériques sur le système de santé marocain : cas du service de cardiologie -B- du Centre Hospitalier Universitaire Ibn Sina (CHUIS) Rabat [新数字技术对摩洛哥卫生系统的挑战:以b大学医院中心Ibn Sina Rabat的心脏病科为例]。
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/j.ancard.2024.101858
Kaoutar Chafiq , Kaoutar Dib , Ahmed Zahidi , Mohamed Cherti , Anass Doukkali , Kaoutar El Menzhi
{"title":"Les enjeux des nouvelles technologies numériques sur le système de santé marocain : cas du service de cardiologie -B- du Centre Hospitalier Universitaire Ibn Sina (CHUIS) Rabat","authors":"Kaoutar Chafiq ,&nbsp;Kaoutar Dib ,&nbsp;Ahmed Zahidi ,&nbsp;Mohamed Cherti ,&nbsp;Anass Doukkali ,&nbsp;Kaoutar El Menzhi","doi":"10.1016/j.ancard.2024.101858","DOIUrl":"10.1016/j.ancard.2024.101858","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Nous vivons dans l’ère des innovations technologiques de l'information (TI) dans le secteur de la santé, cela a induit à l'appropriation de nouveaux modèles d'organisation qui modifient en profondeur la pratique de la médecine.&lt;/div&gt;&lt;div&gt;Notre étude vise à déterminer les enjeux des nouvelles technologies numériques sur le système de santé marocain, cas du service de cardiologie - B - du centre Hospitalier Universitaire Ibn Sina.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Matériels et méthodes&lt;/h3&gt;&lt;div&gt;Il s'agit d'une étude monocentrique observationnelle descriptive analytique menée au niveau du service de cardiologie- B- durant 6 mois, à partir du 1&lt;sup&gt;er&lt;/sup&gt; septembre 2022. Des questionnaires ont été distribués en support papier au personnel médical affilié ou effectuant leurs stages, utilisant un dispositif numérique au sein du service.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Trente-et-un (31) réponses ont été collectées, soit un taux de participation de 78 %; l’âge des enquêtés varie entre 21 et 55 ans avec une moyenne de 30,3 ± 8,71 ans et une prédominance féminine de (67,7 %). Près de la moitié des professionnels de santé de notre échantillon 42 % étaient des résidents. Le dispositif numérique le plus déployé est le Système Informatique Hospitalier (SIH) dans 80,6 %; 93,5 % des répondants constataient le gain du temps est un des avantages de la télémédecine et 71 % des répondants qui affirmaient que le meilleur suivi des patients situés dans des zones enclavées afin d’éviter un renoncement aux soins. 74,2 % des enquêtés considéraient que les problèmes techniques constituaient un frein face au déploiement des actes à distance contre 22,2 % pour un diagnostic faible ; 64,5 % des sondés constataient que la formation serait un levier majeur pour intégrer plus d'acte à distance dans leurs pratiques et 54,5 % des enquêtés sont pour des créneaux d'horaire adaptés.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Les avantages perçus par les répondants de ces outils numériques sont nombreux bien qu'il y ait des freins empêchant la transformation digitale d'atteindre son plein potentiel. Le recours aux nouvelles technologies numériques dans ce secteur de santé répond à des enjeux positifs en termes d'efficience d'ordre organisationnel et éducationnel, cela implique la coordination de tous les acteurs. Le service de cardiologie – B - est un espace propice à la mise en place de nouvelles technologies numériques.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;We live in the era of information technology (IT) innovations in the health sector, this has led to the appropriation of new organizational models which are profoundly changing the practice of medicine.&lt;/div&gt;&lt;div&gt;Our study aims to determine the challenges of new digital technologies in the Moroccan health system, the case of the cardiology department - B - of the Ibn Sina University Hospital Center.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This is a single-center observational descriptive-ana","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101858"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial board / Ours rédaction 编委会/我们的组织
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/S0003-3928(25)00008-3
{"title":"Editorial board / Ours rédaction","authors":"","doi":"10.1016/S0003-3928(25)00008-3","DOIUrl":"10.1016/S0003-3928(25)00008-3","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101869"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to “Office white-coat effect tail: A useful tool in family practice?” [Annales de cardiologie et d'angéiologie 73/2 (2024) 101733] “办公室白大褂效应尾巴:家庭实践中的有用工具?”[Annales de cardiologie et d' angsamiologie 73(2024) 101733]。
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2025-02-01 DOI: 10.1016/j.ancard.2024.101861
X. Humbert , E. Touze , J. Le Bas , L. Schonbrodt , P.-A. Couette , S. De Jaegher , A. Pithon , J. Alexandre , P.-E. Puddu
{"title":"Corrigendum to “Office white-coat effect tail: A useful tool in family practice?” [Annales de cardiologie et d'angéiologie 73/2 (2024) 101733]","authors":"X. Humbert ,&nbsp;E. Touze ,&nbsp;J. Le Bas ,&nbsp;L. Schonbrodt ,&nbsp;P.-A. Couette ,&nbsp;S. De Jaegher ,&nbsp;A. Pithon ,&nbsp;J. Alexandre ,&nbsp;P.-E. Puddu","doi":"10.1016/j.ancard.2024.101861","DOIUrl":"10.1016/j.ancard.2024.101861","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101861"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial board / Ours rédaction 编辑部 / Ours rédaction
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2024-11-20 DOI: 10.1016/S0003-3928(24)00122-7
{"title":"Editorial board / Ours rédaction","authors":"","doi":"10.1016/S0003-3928(24)00122-7","DOIUrl":"10.1016/S0003-3928(24)00122-7","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 6","pages":"Article 101844"},"PeriodicalIF":0.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sommaire 目录
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2024-11-20 DOI: 10.1016/S0003-3928(24)00124-0
{"title":"Sommaire","authors":"","doi":"10.1016/S0003-3928(24)00124-0","DOIUrl":"10.1016/S0003-3928(24)00124-0","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 6","pages":"Article 101846"},"PeriodicalIF":0.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact de l’éducation thérapeutique des patients sur l'observance thérapeutique chez des patients traités par des anti-vitamines K [治疗教育对接受抗维生素 K 治疗的患者坚持治疗的影响]。
IF 0.3
Annales de cardiologie et d'angeiologie Pub Date : 2024-11-09 DOI: 10.1016/j.ancard.2024.101841
Fatma Saïd, Ines Naceur, Mériem Jebri, Tayssir Ben Achour, Monia Smiti, Mohamed Habib Houman
{"title":"Impact de l’éducation thérapeutique des patients sur l'observance thérapeutique chez des patients traités par des anti-vitamines K","authors":"Fatma Saïd,&nbsp;Ines Naceur,&nbsp;Mériem Jebri,&nbsp;Tayssir Ben Achour,&nbsp;Monia Smiti,&nbsp;Mohamed Habib Houman","doi":"10.1016/j.ancard.2024.101841","DOIUrl":"10.1016/j.ancard.2024.101841","url":null,"abstract":"<div><h3>Introduction</h3><div>Therapeutic education of the patient (TPE) treated with AVK has improved the safety and efficiency of this treatment by establishing a new doctor-patient relationship. The objective of our study was to assess the impact of a TPE program on adherence in patients treated with AVK.</div></div><div><h3>Methods</h3><div>We conducted a prospective interventional study between January and September 2020, including two groups of patients hospitalized for a first thromboembolic: a G1 group with conventional service support and a G2 group with an ETP program created during this work. Each patient was assessed after three months of adherence to VKA.</div></div><div><h3>Results</h3><div>The two groups had comparable epidemiological and clinical characteristics. After three months, we found a level of adherence in the G2 group.</div></div><div><h3>Conclusion</h3><div>The implementation of an ETP practice in patients treated with AVK allowed a better patient compliance with a better involvement in the management. This practice should be codified through the development of a national FTE repository.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 6","pages":"Article 101841"},"PeriodicalIF":0.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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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