Archives of Dermatological Research最新文献

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Delayed regional metastasis from small face/scalp cutaneous squamous carcinoma: outcomes and predictors 小面部/头皮皮肤鳞状癌的延迟区域转移:结果和预测因素
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-12 DOI: 10.1007/s00403-025-04224-9
Courtney B. Shires, John D. Boughter, Christopher P. Golembeski, Nicholas M. Sharp, Arabella T. Hall, Merry E. Sebelik
{"title":"Delayed regional metastasis from small face/scalp cutaneous squamous carcinoma: outcomes and predictors","authors":"Courtney B. Shires,&nbsp;John D. Boughter,&nbsp;Christopher P. Golembeski,&nbsp;Nicholas M. Sharp,&nbsp;Arabella T. Hall,&nbsp;Merry E. Sebelik","doi":"10.1007/s00403-025-04224-9","DOIUrl":"10.1007/s00403-025-04224-9","url":null,"abstract":"<div><p>Objective: CSCC (cutaneous squamous cell carcinoma) of the face/scalp generally has a favorable outcome. However, patients with delayed regional metastasis from scalp/facial CSCC do very poorly. Historically, prophylactic treatment of the N0 neck for the T1-T2 (as staged in the AJCC 7th edition) face/scalp cancers has not been recommended. This study aims to determine predictors of delayed regional metastases in &lt; 4 cm CSCC of the face and scalp. Methods: We retrospectively analyzed medical records of patients diagnosed regional metastasis of CSCC of the scalp/face at least 6 months after the diagnosis of the primary CSCC at a tertiary academic head and neck clinic during a period between 2012 and 2018. Results: A total of 50 patients with CSCC of the face/scalp were diagnosed and treated for delayed cervical lymph node metastasis during a 6-year period. All patients were male. Areas affected were the scalp, cheeks, and forehead. No patient had neck lymph node metastases at initial presentation for their scalp/face cancer. The presence of perineural invasion in the primary tumor was the only observed predictor of delayed neck lymph node recurrence. We did not observe an association between diameter/depth of the primary skin tumor or lymphovascular invasion and the presence of regional lymph node recurrence. Conclusion: In our review, perineural invasion (PNI) was the one factor predictive of delayed regional lymph node metastasis. This observation confirms the use of PNI to upstage even small CSCC to T3. Prophylactic treatment of the neck in patients with small scalp/face cancers with PNI should be strongly considered, especially in the age of immunotherapy.</p></div>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00403-025-04224-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Actigraphy, a valuable tool for objective sleep evaluation in psoriasis: a review 活动描记术:银屑病患者客观睡眠评价的重要工具
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-12 DOI: 10.1007/s00403-025-04187-x
Katerina Vlami, Kleoniki Pantelidi, Maria Dalamaga, Evangelia Papadavid
{"title":"Actigraphy, a valuable tool for objective sleep evaluation in psoriasis: a review","authors":"Katerina Vlami,&nbsp;Kleoniki Pantelidi,&nbsp;Maria Dalamaga,&nbsp;Evangelia Papadavid","doi":"10.1007/s00403-025-04187-x","DOIUrl":"10.1007/s00403-025-04187-x","url":null,"abstract":"<div><p>Psoriasis, a form of chronic inflammatory skin disease, shows wide variations in severity and comorbidities. Considering the relatively clear scientific evidence concerning its great physical and psychological effects, researchers began to use actigraphy as a scientific monitoring tool for its bidirectional relationship with sleep. To evaluate the usefulness of actigraphy as a means to diagnose sleep disturbances in psoriatic patients. We performed a systematic review using PubMed, Scopus and Google Scholar to look at the use of actigraphy in research into psoriasis and sleep disorders. This review covered publications through February 2024. Included records were primary and secondary research papers. Actigraphy consistently revealed strong links between pruritus nighttime arousal, and poorer subjective sleep, although next-day psoriasis symptoms did not always worsen. Systematic analyses emphasized actigraphy’s role in measuring nocturnal scratching, supported by emerging smartwatch apps. Psoriatic arthritis studies likewise reported significant sleep disruptions, though evidence remains limited. From these studies, actigraphy presented as a useful tool in both clinical and research contexts, for diagnosing and monitoring sleep disorders among psoriatic patients. Actigraphy is an important test for psoriatic sleep disorders, providing useful objective data. This way the bridge between psoriasis and sleep be clearly understood, and treatment methods improved.</p></div>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00403-025-04187-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of digit ratio (2D:4D) and its relationship with skin sebum level in patients with basal cell carcinoma 基底细胞癌患者手指比值(2D:4D)及其与皮肤皮脂水平的关系
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-12 DOI: 10.1007/s00403-025-04225-8
Ismail Can, Fatma Tuncez Akyurek
{"title":"Evaluation of digit ratio (2D:4D) and its relationship with skin sebum level in patients with basal cell carcinoma","authors":"Ismail Can,&nbsp;Fatma Tuncez Akyurek","doi":"10.1007/s00403-025-04225-8","DOIUrl":"10.1007/s00403-025-04225-8","url":null,"abstract":"<div><h3>Introduction</h3><p>The main factor in the development of basal cell carcinoma (BCC) is UV (ultraviolet) exposure. In most cases of BCC there is upregulation of the ‘Sonic Hedgehog’ (SHH) pathway components. Some recent studies have shown that overactivity of the SHH pathway leads to an increase in the number of sebocytes in the skin. Sex differences in tumor formation suggest a possible role of sex hormones in the development of skin cancers.</p><h3>Objective</h3><p>We aimed to evaluate the 2D:4D ratio and its relationship with skin sebum level in patients with BCC.</p><h3>Methods</h3><p>Finger length measurements were made using digital calipers. Skin sebum levels were measured using sebumeter.</p><h3>Results</h3><p>The study included 64 patients with BCC(mean age 67) and 64 healthy subjects(mean age 71) aged 37–92 years. T score (average of sebum levels on forehead, nose and chin) and total sebum score (TSS) were higher in patients with BCC. U score (average of sebum levels of right and left cheeks) was similar in patients and control group. In male subjects, T score, U score and TSS were significantly higher in the patient group. In female subjects, there was no significant difference between the patient and control groups in T score, U score and TSS. The 2D:4D ratio in both hands was similar in the patient and control groups. When evaluated according to the localization of the lesions, the T score and the TSS were found to be higher in male subjects with BCC lesions in the T region than in the control group. In the female patient group, the T score was found to be significantly higher than in the control group.</p><h3>Conclusion</h3><p>There was no correlation between BCC and 2D:4D ratio. We found that skin sebum levels were higher in male patients with BCC compared to the control group. Defining the relationship between BCC and sebum levels may play an important role in the evaluation of the occurrence and prognosis of the disease.</p></div>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821972","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
Usage of thermal spring water for optimal skin health: bridging traditional therapy with modern dermatology 使用温泉水为最佳的皮肤健康:桥梁传统疗法与现代皮肤病学
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04189-9
Pedro Emanuel Rocha, Maria José Alves, Cátia Fidalgo, Daniela Correia, Silvia Pedrosa, Ana Raquel Madureira
{"title":"Usage of thermal spring water for optimal skin health: bridging traditional therapy with modern dermatology","authors":"Pedro Emanuel Rocha,&nbsp;Maria José Alves,&nbsp;Cátia Fidalgo,&nbsp;Daniela Correia,&nbsp;Silvia Pedrosa,&nbsp;Ana Raquel Madureira","doi":"10.1007/s00403-025-04189-9","DOIUrl":"10.1007/s00403-025-04189-9","url":null,"abstract":"","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818128","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
Energy-based device innovations including laser and non-laser therapies in hidradenitis suppurativa treatment 基于能量的设备创新,包括激光和非激光治疗化脓性汗腺炎
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04184-0
Sino Mehrmal, Mojahed Mohammad K. Shalabi, Seo Won Cho, Stanislav N. Tolkachjov, Alexander B. Aria
{"title":"Energy-based device innovations including laser and non-laser therapies in hidradenitis suppurativa treatment","authors":"Sino Mehrmal,&nbsp;Mojahed Mohammad K. Shalabi,&nbsp;Seo Won Cho,&nbsp;Stanislav N. Tolkachjov,&nbsp;Alexander B. Aria","doi":"10.1007/s00403-025-04184-0","DOIUrl":"10.1007/s00403-025-04184-0","url":null,"abstract":"<div><p>Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is often difficult to treat. When initial medical treatments fail, surgical interventions, including laser and non-laser procedures, may be considered. This review examines recent studies investigating the effectiveness of these procedures, focusing on publications since March 2019. The review included English-language case reports, studies, and clinical trials sourced from PubMed using search terms such as “hidradenitis suppurativa,” “Nd: YAG,” “photodynamic therapy,” “intense pulsed light,” “alexandrite,” “diode,” “CO2,” “radiofrequency,” “ablative,” “fractionated,” “laser,” and “hair removal.” Review articles and animal studies were excluded. The review found strong evidence supporting the use of Nd: YAG and CO2 lasers for reducing inflammatory lesions and excising sinus tracts. Alexandrite lasers also showed promise, with 50% of treated patients achieving a Hidradenitis Suppurativa Clinical Response (HiSCR) at 15 weeks, increasing to 70% by week 30. Fractional radiofrequency (RF) microneedling and radiofrequency-intense pulsed light (RF-IPL) combinations led to reduced inflammation and improved tissue remodeling by weeks 6 and 24, respectively. Both intralesional and traditional photodynamic therapy (PDT) approaches demonstrated efficacy in reducing lesion size and associated symptoms. In conclusion, various laser and non-laser energy-based therapies show promise for managing HS, particularly in cases refractory to conventional treatments. Further research with robust study designs is warranted to optimize treatment protocols and establish long-term efficacy.</p></div>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818190","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 modified Wendan Decoction combined with acupuncture on inflammatory factors and immune function in urticaria patients 温胆汤加味配合针刺对荨麻疹患者炎症因子及免疫功能的影响
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04210-1
Zan Tian, Jianlong Dong, Yanjun Wang
{"title":"Effects of modified Wendan Decoction combined with acupuncture on inflammatory factors and immune function in urticaria patients","authors":"Zan Tian,&nbsp;Jianlong Dong,&nbsp;Yanjun Wang","doi":"10.1007/s00403-025-04210-1","DOIUrl":"10.1007/s00403-025-04210-1","url":null,"abstract":"<div><p>This study aimed to explore the effects of modified Wendan Decoction combined with acupuncture on serum inflammatory markers and immune function in patients suffering from urticaria. A total of 150 urticaria patients admitted to our hospital were randomly assigned to two groups: the observation group (<i>n</i> = 75) and the control group (<i>n</i> = 75). The control group received levocetirizine tablets, while the observation group was treated with modified Wendan Decoction along with acupuncture. Following treatment, the observation group demonstrated a higher clinical efficacy compared to the control group, with a statistically significant difference (<i>P</i> &lt; 0.05). Both groups experienced reductions in symptom scores, including erythema, burning sensation, pruritus, wheals, fever accompanied by epigastric pain, nausea and vomiting, fatigue, and poor appetite. However, the observation group showed significantly lower symptom scores than the control group (<i>P</i> &lt; 0.05). Additionally, levels of IL-4, IL-10, IL-25, IL-33, and IFN-γ decreased in both groups after treatment, but the observation group exhibited lower levels than the control group, again with a statistically significant difference (<i>P</i> &lt; 0.05). The recurrence rate was notably lower in the observation group compared to the control group (<i>P</i> &lt; 0.05). The combination of modified Wendan Decoction and acupuncture effectively reduces serum inflammatory markers and enhances immune function in patients with urticaria. This treatment demonstrates significant clinical effectiveness and holds potential for broader application in clinical settings.</p></div>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818191","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
Disparities in acne prescription patterns in underrepresented groups: insights from the all of us database 在代表性不足的群体中痤疮处方模式的差异:来自我们所有人数据库的见解
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04208-9
Nithya Krishnamurthy, Jeremy Orloff, Austin J. Piontkowski, Camille M. Powers, Benjamin Ungar, Nicholas Gulati
{"title":"Disparities in acne prescription patterns in underrepresented groups: insights from the all of us database","authors":"Nithya Krishnamurthy,&nbsp;Jeremy Orloff,&nbsp;Austin J. Piontkowski,&nbsp;Camille M. Powers,&nbsp;Benjamin Ungar,&nbsp;Nicholas Gulati","doi":"10.1007/s00403-025-04208-9","DOIUrl":"10.1007/s00403-025-04208-9","url":null,"abstract":"","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818192","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
Atopic dermatitis and bullous pemphigoid: shared pathogenic mechanisms and potential pathways linking the two conditions 特应性皮炎和大疱性类天疱疮:共同的致病机制和连接两种情况的潜在途径
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04203-0
Zhe Fan, Ya-Gang Zuo
{"title":"Atopic dermatitis and bullous pemphigoid: shared pathogenic mechanisms and potential pathways linking the two conditions","authors":"Zhe Fan,&nbsp;Ya-Gang Zuo","doi":"10.1007/s00403-025-04203-0","DOIUrl":"10.1007/s00403-025-04203-0","url":null,"abstract":"","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821982","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
Low-density lipoprotein receptor-related protein-1 and nitrative stress in psoriasis vulgaris: a cross-sectional study 寻常型银屑病低密度脂蛋白受体相关蛋白-1与营养应激:一项横断面研究
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04194-y
Işıl Yağmur, Ergül Belge Kurutaş, Perihan Öztürk
{"title":"Low-density lipoprotein receptor-related protein-1 and nitrative stress in psoriasis vulgaris: a cross-sectional study","authors":"Işıl Yağmur,&nbsp;Ergül Belge Kurutaş,&nbsp;Perihan Öztürk","doi":"10.1007/s00403-025-04194-y","DOIUrl":"10.1007/s00403-025-04194-y","url":null,"abstract":"<div><p>Hyperlipidemia is a risk factor for cardiovascular diseases, and low serum lipid levels may play a protective role. Low-density lipoprotein receptor-related protein-1 (LRP1) is a receptor involved in lipid metabolism, cellular signal transduction, and inflammation processes. Nitrosative stress (NO, 3-NT) may also contribute to the pathophysiology of dermatological diseases. To date, no published study has investigated the concentrations of nitrosative stress biomarkers, such as 3-NT and NO, along with LRP1 levels in patients with psoriasis vulgaris. This study aims to assess the relationship between lipid profiles, nitrosative stress markers (NO, 3-NTx), and LRP1 levels with disease severity in psoriasis vulgaris patients. The study included 50 patients with psoriasis vulgaris and 50 healthy individuals. Serum lipid profiles (total cholesterol, triglycerides, LDL, HDL, VLDL) were measured using a colorimetric enzyme method on an autoanalyzer, while NO, 3-NTx, and LRP1 levels were determined via ELISA. The severity of psoriasis was evaluated using the Psoriasis Area Severity Index (PASI). Data on disease duration, medication use, smoking, alcohol consumption, and weight were recorded. Total cholesterol, triglyceride, and LDL levels were significantly higher in psoriasis vulgaris patients compared to healthy controls (<i>p</i> &lt; 0.05). Increased NO and 3-NTx levels were identified as indicators of oxidative stress. A positive correlation was found between LRP1, NO, 3-NTx levels, and PASI scores. Altered lipid profiles and increased oxidative stress in psoriasis vulgaris patients are associated with cardiovascular risk. The correlation between LRP1, NO, and 3-NTx levels and disease severity suggests that these biomarkers may serve as potential monitoring tools in psoriasis management. Further studies are needed to determine their therapeutic and clinical significance.</p></div>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818127","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
Exploring the link between inflammatory cytokines and pressure ulcers using Mendelian randomization 利用孟德尔随机化方法探索炎症细胞因子与压疮之间的联系
IF 1.8 4区 医学
Archives of Dermatological Research Pub Date : 2025-04-11 DOI: 10.1007/s00403-025-04223-w
Can Huang, Maowu Cao, Xiangbin Zhu, Na Li, Kunfu Ouyang, Zhen Han, Guiqin Wu
{"title":"Exploring the link between inflammatory cytokines and pressure ulcers using Mendelian randomization","authors":"Can Huang,&nbsp;Maowu Cao,&nbsp;Xiangbin Zhu,&nbsp;Na Li,&nbsp;Kunfu Ouyang,&nbsp;Zhen Han,&nbsp;Guiqin Wu","doi":"10.1007/s00403-025-04223-w","DOIUrl":"10.1007/s00403-025-04223-w","url":null,"abstract":"","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818124","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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