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1.
大黄对脓毒症大鼠肠道细菌及其移位的影响   总被引:11,自引:1,他引:10  
目的 探讨大黄对脓毒症大鼠肠道细菌及其毒素移位的防治作用.方法 104只健康SD大鼠被随机分为4组,正常对照组8只,烫伤组、脓毒症组、大黄组各32只,后3组又分为治疗前及治疗后1、3、9 d亚组,每个亚组8只.采用大鼠背部烫伤模型,烫伤后24 h分两次腹腔注射内毒素(20 mg/kg)进行"二次打击",烫伤组和脓毒症组分别于腹腔注射生理盐水或内毒素打击24 h后腹腔注射头孢曲松120 mg/kg,间隔12 h,分两次给予,大黄组内毒素打击后24 h在给予头孢曲松治疗的同时予以大黄50 mg/kg灌胃,每日2次.分别于治疗前及治疗1、3、9 d取大肠内容物及肝脏、肺脏、肠系膜淋巴结、血液,进行细菌定量培养和菌种鉴定.结果 烫伤大鼠头孢曲松治疗前大肠内容物肠杆菌数量较正常对照组变化不显著[(5.86±0.62)10g cfu/g比(5.52±0.41)log cfu/g];内毒素"二次打击"后肠杆菌数量[(8.96±0.73)10g cfu/g]明显增加(P<0.01),虚用头孢曲松治疗后3 d、9 d肠杆菌数量[(4.43±0.64)log cfu/g,(5.82±0.99)log cfu/g]明显减少(P均<0.01),大肠杆菌减少或消失,代之以铜绿假单胞菌为优势菌群;大黄组肠杆菌数量[(8.24±1.32)log cfu/g]下降不显著,且大肠杆菌比例增加,铜绿假单胞菌等数量减少.大黄在烫伤脓毒症早期能抑制肠道细菌移位率(1 d移位率40.62%比6.25%,P<0.05).结论 大黄对刨伤、脓毒症大鼠胃肠道微生态环境有一定的保护作用,能减弱广谱抗生素对肠道菌群的选择作用,同时在脓毒症早期能抑制肠道细菌的移位.  相似文献   

2.
目的 探讨烧伤脓毒症时动物心肌内蛋白酶体核心亚基C2亚基m RNA表达及蛋白降解的变化及意义。方法 雄性Wistar大鼠4 5只,随机分为烫伤组、脓毒症组及对照组。烫伤组大鼠使用沸水致背部30 %总体表面积 度烫伤;脓毒症组大鼠用同样方法烫伤后,立即腹腔注射内毒素(6 m g/ kg)制成烫伤脓毒症大鼠模型。通过高效液相荧光法检测心肌内三甲基组氨酸(3MH)的含量,用核糖核酸印迹杂交(Northern杂交)检测心肌内蛋白酶体C2亚基m RNA表达的变化。结果 脓毒症大鼠烫伤后2 h和6 h,单位心肌内3MH含量较对照组和烫伤组均显著升高(P均<0 .0 1) ;烫伤组大鼠伤后2 h与对照组比较差异无显著性(P>0 .0 5 ) ,而伤后6 h较对照组显著升高(P<0 .0 1)。脓毒症大鼠伤后2 h和6 h心肌内蛋白酶体C2亚基m RNA表达较对照组和烫伤组均显著升高(P均<0 .0 1) ,烫伤组大鼠伤后2 h和6 h较对照组也均显著升高(P均<0 .0 1)。结论 严重烫伤特别是合并内毒素攻击后,早期动物心肌细胞内泛素蛋白酶体途径活性呈持续增强现象,蛋白降解率显著增加。这可能是烧伤脓毒症时心功能异常的蛋白代谢机制。  相似文献   

3.
大剂量维生素C对肠黏膜屏障的保护作用   总被引:8,自引:0,他引:8  
目的 研究大剂量维生素C对烫伤后大鼠肠黏膜屏障的保护作用。方法 选用大鼠烫伤模型 ,烫伤面积为30 % ,深度为Ⅲ度。大鼠随机分为 4组 ,即烫伤组、模拟烫伤组、维生素C治疗组和安慰剂治疗组。观察维生素C对烫伤大鼠肠道细菌易位、血浆内毒素水平和肠黏膜内超氧化物歧化酶 (SOD)的影响。结果 严重烫伤可致肠黏膜屏障破坏 ,肠道内细菌易位至肝、脾、肠系膜淋巴结 ;维生素C可降低细菌易位的发生率和易位量 ,与烫伤组有显著差异 (P <0 0 5 ) ;且烫伤可致血浆内毒素水平明显升高 ,尤以烫伤后 10h显著 ,而 2 4h后有所下降 ;维生素C可明显抑制肠道内内毒素的吸收 (P <0 0 1) ;此外 ,维生素C对烫伤后肠黏膜内氧自由基有明显的清除作用。结论 维生素C对烫伤大鼠肠黏膜屏障有明显的保护作用 ,能抑制肠道细菌易位和肠道内内毒素吸收。  相似文献   

4.
目的研究TNF-α和TLR-4在呼吸机相关肺损伤大鼠肠道细菌移位中的作用。方法将24只SD大鼠随机分为3组,健康对照组(C组)、呼吸机相关肺损伤组(VILI组)、肠道抗生素组(AMP+VILI组),VILI组、AMP+VILI组以大潮气量机械通气制造大鼠呼吸机相关肺损伤模型,通气1 h后,改为小潮气量机械通气,AMP+VILI组在胃内灌入氨苄西林,3~4 h一次,共3次,造模后12 h,测大鼠回肠组织湿/干重比值,取肺脏、肝脏、胰腺、脾脏、肾脏、肠系膜淋巴结组织及回肠内容物行细菌培养及菌种鉴定,用real-time PCR检测回肠组织中TNF-αm RNA表达,ELISA测定回肠组织及0 min,30 min,1 h,2 h,4 h,6 h,8 h,12 h血清中TNF-α浓度,Western blot检测回肠黏膜组织中TLR-4的表达。结果 VILI组回肠组织TNF-αm RNA的表达较健康对照组上调(P<0.05),TNF-α、TLR-4浓度较C组升高(P均<0.05),细菌移位至肺及肠系膜淋巴结,其他器官未检测到移位的细菌;AMP+VILI组回肠组织中TNF-αm RNA的表达较VILI组下调(P<0.05),TNF-α、TLR-4浓度较VILI组降低,细菌移位减少(P均≥0.05)。结论呼吸机相关肺损伤中肠道细菌主要移位到损伤的肺,TNF-α、TLR-4浓度在呼吸机相关肺损伤大鼠肠道细菌移位中可能具有重要作用。抑制肠道细菌移位可能缓解呼吸机相关肺损伤。  相似文献   

5.
目的 :探讨烫伤延迟复苏后肠上皮细胞凋亡对肠道内毒素和细菌移位的影响。方法 :Wistar大鼠 110只 ,30 %总体表面积 ( STBA) 度烫伤 ,立即或伤后 6 h进行复苏。观察伤后肠上皮细胞凋亡率 ( ap% )变化 ,并测定了门静脉和体循环内毒素及肠系膜淋巴结 ( ML N)细菌移位率和移位量变化。结果 :电泳、原位末端标记( TU NEL )法和电镜均观察到伤后肠上皮凋亡梯形带和凋亡阳性细胞增多。延迟复苏组肠上皮细胞凋亡发生早且更严重 ;其门静脉内毒素水平及 ML N细菌移位量均显著高于立即复苏组 ( P<0 .0 1) ;门静脉内毒素变化与肠黏膜 ap%成显著正相关 (烫伤后立即复苏组 r=0 .936 ,P<0 .0 1;烫伤后延迟复苏组 r=0 .899,P<0 .0 5 )。结论 :烫伤后延迟复苏使肠黏膜上皮发生病理性凋亡 ,可能导致肠道细菌和内毒素移位增加。  相似文献   

6.
目的:探讨氢气饱和生理盐水对内毒素(LPS)诱导的小鼠急性肺损伤(ALI)的早期保护作用。方法:将小鼠随机分为正常对照组、氢气饱和生理盐水对照组(H2组)、内毒素损伤组(LPS组)、氢气饱和生理盐水治疗组(LPS+H2组),1或2 h后检测肺湿干重比、肿瘤坏死因子α(TNF-α)和白细胞介素-10(IL-10)m RNA表达量。结果 :与正常对照组相比,LPS组的湿干重比显著增加(P<0.01),TNF-αm RNA表达量持续增加(P<0.01),IL-10 m RNA表达量在2 h时才增加(P<0.05)。与LPS组同一时间相比,LPS+H2组湿干重比降低(P<0.05),TNF-αm RNA表达量先降低(P<0.01),后差异无显著性(P>0.05),IL-10 m RNA表达量差异均无显著性(P>0.05)。结论:LPS诱导的ALI早期,腹腔注射氢气饱和生理盐水能够抑制促炎因子的早期表达,从而减轻内毒素诱导的小鼠急性肺损伤。  相似文献   

7.
目的 探讨亚低温对大鼠内毒素性急性呼吸窘迫综合征(ARDS)肺部炎症反应的影响.方法 大鼠腹腔注射内毒素(LPS,1 mg/kg),16 h后再气管内滴注LPS(3 mg/kg)建立ARDS模型.72只雄性SD大鼠随机分为3组:对照组(C组)、ARDS组(A组)、亚低温组(M组),分别于ARDS时及ARDS后2、4、6 h处死动物,观察肺组织病理形态;计算肺湿质量/干质量(W/D)比值;检测肺组织中TNF-α、IL-8、IL-1β、IL-6含量.结果 3组动物肺组织病理形态有明显的不同.肺W/D:A组、M组均明显高于C组(P<0.01),M组较A组明显降低(P<0.01).肺组织TNF-α、IL-8、IL-1β、IL-6含量:A组、M组明显高于C组(P<0.01),M组明显低于A组(P<0.01).结论 亚低温治疗可减轻内毒素性ARDS大鼠肺部炎症反应.  相似文献   

8.
目的 探讨丹参对大鼠烫伤后内毒素移位的影响及其机制。方法 采用 30 %TBSA深Ⅱ度烫大鼠模型 ,检测伤前及伤后 3、6、12、2 4、4 8h大鼠血浆内毒素 (LPS)含量、肠黏膜血流量 (IMBF)、肠组织内一氧化氮 (NO)和内皮素 (ET)含量。结果 ①伤后血浆LPS含量显著增高 (P <0 0 1) ,但治疗组显著低于烫伤组 (P <0 0 5 ,P <0 0 1) ;②伤后IMBF显著下降 (P <0 0 1) ,但治疗组下降幅度明显小于烫伤组 (P <0 0 5 ,P <0 0 1) ;③伤后肠组织内ET、NO含量均升高 ,尤以ET升高幅度较大 ,ET/NO比值上升 (P <0 0 5 ,P <0 0 1)。但治疗组与烫伤组相比较 ,ET含量降低、NO含量升高 ,ET/NO比值下降 (P <0 0 5 ,P <0 0 1)。结论 丹参能有效防治烫伤后内毒素移位 ,其作用机制可能与影响肠组织内ET、NO含量 ,调节ET/NO比值进而改善肠黏膜血液循环有关。  相似文献   

9.
双歧杆菌对烫伤大鼠肠道黏膜机械及生物屏障的改善作用   总被引:13,自引:3,他引:13  
目的 :探讨严重烫伤后补充外源性双歧杆菌对肠黏膜机械及生物屏障的保护作用及其对肠道细菌或内毒素移位的影响。方法 :70只 Wistar大鼠按随机数字表法分为烫伤对照组 ( BC)、烫伤治疗组 ( BT)和假伤对照组 ( NC)。BT组伤后灌饲双歧杆菌悬液 ( 5× 10 1 2 CFU/ L) 1.5 ml,2次 / d。观察细菌或内毒素移位、肠黏膜菌群和肠黏膜损伤情况等。结果 :1伤后 3 d,BC、BT组细菌移位率分别为 42 %和 16 % ( P=0 .0 0 40 ) ,5 d分别为30 %和 6 % ( P=0 .0 0 2 0 ) ;伤后 1d,BC组内毒素水平显著高于 BT组。 2 BC组回盲部黏膜菌群中双歧杆菌量仅为 NC组的 1/ 10~ 1/ 6 0 ,BT组双歧杆菌量明显增多 ;BC组大肠杆菌量在 1、3 d增加约 2 0~ 30倍 ,但 3 d后BT组大肠杆菌量显著减少并接近正常水平。 3回肠黏膜损伤以 1、3d最为明显 ,BC组伤后 5 d损伤评分仍明显高于 NC组 ( P<0 .0 5 ) ;BT组 3d时已明显修复 ,5 d已与 NC组无明显差异。结论 :补充外源性双歧杆菌能促进烫伤后受损肠黏膜屏障和生物屏障修复 ,有效防治肠道细菌或内毒素移位。  相似文献   

10.
目的 观察丙酮酸乙酯(EP)预先给药对内毒素性急性肺损伤(ALI)大鼠肺组织巨噬细胞炎症蛋白-2表达的影响,探讨丙酮酸乙酯可能的保护机制.方法 静脉注射脂多糖(LPS)5 mg/kg,复制大鼠ALI模型.雄性SD大鼠30只随机分为三组:A组为对照组,B组为LPS组,C组为EP+LPS组,于静脉注射LPS前1 h腹腔内注射EP(40 mg/kg).所有动物于注射LPS或生理盐水后6 h颈动脉放血处死,RT-PCR法测定肺组织巨噬细胞炎症蛋白-2 mRNA的表达;酶联免疫吸附法测定肺组织TNF-α和IL-1B的含量.结果 与A组相比,B组、C组肺组织巨噬细胞炎症蛋白-2 mRNA表达增加,肺组织TNF-α和IL-1B含量上升(P<0.05);与B组相比,C组肺组织巨噬细胞炎症蛋白-2 mRNA表达降低,肺组织TNF-α和IL-1B含量降低(P<0.05).结论 丙酮酸乙酯通过下调大鼠LPS诱导的肺组织巨噬细胞炎症蛋白-2表达,降低了TNF-α和IL-1B的释放,减轻ALI大鼠肺部的炎症反应.  相似文献   

11.
Through real time ultrasonography, it is possible to display the splenic vein, the superior mesenteric vein, the vena porta, and the intrahepatic portal and systemic veins. In jaundice, it is of the utmost importance to carefully identify the vena porta before making a diagnosis of common bile duct enlargement. It is also necessary, when confronted with a pattern of apparently enlarged intrahepatic ducts, to conduct a thorough study of possible confluences of the ducts with the vena porta or vena cava to be certain that the ducts are not part of the portal or systemic venous network. Without such differentiation, portal enlargement caused portal hypertension, systemic venous enlargement caused cardiac insufficiency, or even nonpathological wide veins may lead to an erroneous diagnosis of obstructive jaundice.  相似文献   

12.
Objective. To evaluate the Procalcitonin (PCT) clearance during continuous veno-venous hemodiafiltration (CVVHD).?Design. Case report?Setting. Surgical intensive care unit?Patient. 51-year-old man, who had undergone total thyroidectomy about ten years before owing to multiple endocrine neoplasia 2 (MEN 2), suffering from multiple organ dysfunction syndrome (MODS) with acute renal failure after severe trauma caused by a traffic accident.?Measurements and main result. The samplings of prefilter (afferent) and post-filter (efferent) blood and of ultradiafiltrate were 6 times performed during 24 h of CVVHD to calculate the PCT clearance of hemdiafiltration.?During the first half period of CVVHD the serum PCT concentration did not decrease, though PCT had been eliminated from serum. On the other hand during the latter half period of it the serum PCT value decreased (from 46.8 ng/ml to 29.4 ng/ml) and the amount of the eliminated PCT from serum was about 100 ng per minute and its clearance was 2.3 ∼ 3.4 ml/min.?Conclusion. The CVVHD could eliminate PCT from serum. First it was brought about by the adsorption by the filter menbrane and then by ultradiafiltration. Received: 25 February 1999/Final revision received: 31 May 1999/Accepted: 9 June 1999  相似文献   

13.
BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) to platelet transfusions have been linked to the presence of cytokines in supernatant plasma. Cytokine concentration is directly related to WBC content and storage time. This study evaluated the effect of limiting the storage time of random-donor platelet concentrates on the FNHTR rate. STUDY DESIGN AND METHODS: FNHTR rates were calculated retrospectively for single-donor apheresis platelet (SDP) and pooled random-donor platelet (PP) transfusions given during three consecutive 5-month study periods (November 1995 to February 1997) to patients on a single hematology/oncology/bone marrow transplant unit. Transfusion practice policies were: Baseline Period, SDPs preferred; Study Period A, PPs preferred; and Study Period B, < or =3-day-old PPs preferred. FNHTR rates were calculated from physicians' interpretations of reported reactions and the total number of SDP and PP transfusions in each period. SDPs were collected on two cell separators. All platelet components were filtered at issue in the laboratory by WBC-reduction filters. RESULTS: FNHTR rates for PP transfusions were: baseline, 11.1 percent (3/27); Study Period A, 4.6 percent (22/481); and Study Period B, 1.1 percent (3/282). The rates for SDP transfusions were 0. 15 percent (1/650), 0.75 percent (2/267), and 0.36 percent (1/273), respectively. The FNHTR rate for < or =3-day-old PPs was significantly less than the rate for older PPs (p = 0.0086 for Study Period A vs. Study Period B), and was not significantly different than that for SDPs (p = 0.33 for PPs vs. SDPs in Study Period B). CONCLUSION: Limiting transfusion of PPs to those stored 相似文献   

14.
目的 研究多西紫杉醇(TXT)联合顺铂(DDP)方案二线治疗进展期胃癌的疗效和毒副作用.方法 既往应用FOLFOX4或XELOX方案化疗进展的晚期胃癌患者36例,采用多西紫杉醇(艾素)35 mg/m2,第1、8天,静滴;顺铂20 mg/m2,第1~5天,静滴,21 d为1个周期.结果 36例患者中,CR 0例,PR 10例,SD 12例,PD 14例,客观有效率(CR+PR)27.8%,中位生存期6.5个月,中位肿瘤进展时间4.4个月.毒副作用主要为中性粒细胞减少.结论 多西紫杉醇联合顺铂方案二线治疗进展期胃癌有效率较高,有生存优势,毒副作用可耐受.  相似文献   

15.
BACKGROUND: Septic platelet transfusion reactions (SPTRs) are the most common, serious risk of transfusion. Because SPTRs result from donor skin flora or asymptomatic bacteremia, the use of single-donor platelets (SDPs) has been proposed to reduce the risk of SPTRs from the risks with pools of platelet concentrates (PCs). STUDY DESIGN AND METHODS: Beginning in 1986, all febrile transfusion reactions were evaluated by culture of the platelet bag. Confirmed SPTRs were identified by isolation of the same bacteria from the bag and the patient's blood or by positive Gram's stain of the bag that confirmed a positive platelet culture. In 1987, a program to minimize PC use in favor of SDP use was initiated as a means of reducing SPTRs. RESULTS: In 12 years, the use of SDPs increased from 51.7 percent to 99.4 percent of all platelet transfusions at one institution. SPTRs fell from three events in 1 year to the current rate of one event per year. The incidence of SPTRs decreased from 1 in 4,818 transfusions to 1 in 15,098 transfusions. The rate of SPTRs due to PCs was 5.39 times higher than that of SPTRs due to SDPs (95% CI, 1.89,12.9). CONCLUSION: The use of SDPs is a simple means of reducing SPTRs. Other measures such as sterilization will be required to eliminate all SPTRs.  相似文献   

16.
目的:支气管哮喘是小儿最常见的慢性疾病,目前研究已经证实它是一种慢性气道应变性炎症性疾病,本主要研究不同哮喘状态下,机体的一个主要的内分泌系统中的垂体-甲状腺轴的功能状态。方法:选择4-10岁的儿童作为研究对象,将他们分为正常对照组(40例),轻中度哮喘组(32例),重度哮喘组(15例)和缓解期组(23例)四组:用放射免疫分析法由专人测定上述四组儿童促甲状腺素(TSH),三碘甲腺原氨酸(T3),甲状腺素(T4),结果:对四组垂体-甲状腺轴相关激素TSH,T3和T4的测定结果显示:重度哮喘组T3,T4,明显减轻,而轻中度哮喘组,缓解期组的T3,T4与正常组相比无明显差异。结论:轻中度哮喘和哮喘缓解期垂体一甲状腺功能基本正常,一般不会产生正常甲状腺病态综合征,而重度哮喘存在甲状腺功能的紊乱。  相似文献   

17.
目的对胶体金免疫层析测定试条检测随机尿HC-G的结果进行分析与评价。方法采用胶体金免疫层析测定法和放射免疫分析法对120份育龄妇女随机尿HCG进行测定。结果胶体金免疫层析试条对随机尿HCG的检测范围为120.0~427570mIU/ml,灵敏度为120.0mIU/ml,当尿HCG浓度大于427,570mIU/ml时,该试条出现带现象,与尿中LH无交叉反应。结论胶体金免疫层析试条具有操作简单、快速等优点,与放射免疫法相比,存在灵敏度低和带现象问题,在日常应用中应加以注意。  相似文献   

18.
纳洛酮对心肺脑复苏作用的评价   总被引:20,自引:0,他引:20  
目的 :①观察研究纳洛酮在心肺脑复苏中的作用机理及实际疗效 ;②研究心搏骤停患者血中 β -内啡肽 (以下简称 β -EP)与正常人的差异。 方法 :①随机划分急诊和住院抢救的心搏骤停患者为纳洛酮复苏组与常规复苏组两组。前者以常规复苏为基础 ,再给予纳洛酮2 0mg加生理盐水 2 0ml静注 ,并可间隔 30min多次重复使用。②对常规复苏组和对照组 2 0例健康体检者均抽静脉血 5ml入专用抗凝管离心取血清存放于冰箱、集中一次测定 β -EP。 结果 :纳洛酮组复苏成功率 42 9% ,常规组复苏成功率 14 3% ,纳洛酮组复苏成功率显著高于常规组(P <0 0 5 )。心搏骤停患者血中 β -EP含量较正常人明显增高。 结论 :纳洛酮作为阿片受体纯拮抗剂 ,从多个环节中促进了心肺脑诸器官复苏 ,故临床应用纳洛酮可明显提高心肺脑复苏成功率  相似文献   

19.
BACKGROUND: The use of a platelet additive solution (PAS-II, Baxter) may have benefits over plasma for storage of platelets. It was the aim of this study to develop a method to produce WBC-reduced platelet concentrates (PCs) in PAS-II with >240 x 10(9) platelets and <1 x 10(6) WBCs per unit, which can be stored for 5 days at pH >6.8 and that will give sufficient platelet increments after transfusion: a 1-hour CCI of >7.5 and a 20-hour CCI of >2.5. STUDY DESIGN AND METHODS: PCs were made from five pooled buffy coats and 250 g of PAS-II. After centrifugation the PCs were WBC-reduced with a filter (Autostop BC, Pall Biomedical) and stored in a 1000-mL polyolefin container. CCIs were assessed in stable hemato-oncologic patients after 5-day old PCs were transfused. RESULTS: Routinely produced PCs contained a median of 310 x 10(9) platelets (n = 5,363) with 3.5 percent containing <240 x 10(9) platelets, in a median volume of 320 mL (n = 11,834). The median number of WBCs was <0.03 x 10(6) (n = 694). The WBC count exceeded 1 x 10(6) in three PCs, but it was always <5 x 10(6), giving 99-percent confidence that more than 99.5 percent of the units will contain <1 x 10(6) WBCs. The pH remained >6.8 on Day 8, provided the concentration was below 1.1 x 10(9) platelets per mL (n = 32). After 28 transfusions in 28 patients, the 1-hour CCI was 12.6 +/- 4.3 (mean +/- SD, with 2/28 CCIs <7.5) and the 20-hour CCI was 8.9 +/- 5.6 (with 4/28 CCIs <2.5). Limitations of this study include the absence of a control group of patients receiving platelets stored in plasma and of in vivo radiolabeled survival studies, but a comparison of these data with previously published data suggested that the in vivo survival of platelets stored in PAS-II is less than that of platelets stored in plasma. CONCLUSION: The WBC-reduced PCs conformed to specifications. These WBC-reduced PCs could be stored at least 5 days with maintenance of pH, and they gave sufficient increments after transfusion to patients.  相似文献   

20.
以幽门螺杆菌DNA为模板,采用聚合酶链反应设计了5个特异性寡核苷酸引物的一个共引物,分析检测了62株幽门螺杆菌空泡形成细胞毒素基因S1a、S1b、M1型和M2型,检测结果均为S1a/M2实验显示胃十二指肠疾病与空泡形成细胞毒素基因无相关关系。  相似文献   

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