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1.
目的通过分析首次体外受精-胚胎移植(IVF-ET)治疗周期全部非优质胚胎新鲜周期与复苏周期胚胎移植的相关数据,探讨首次IVF-ET治疗周期全部非优质胚胎的移植价值及策略。方法回顾性分析2014年1月至2019年1月在安徽省妇幼保健院生殖医学中心首次IVF-ET获得的全部胚胎为非优质胚胎的周期、首次行新鲜周期移植或复苏周期移植的347个周期,其中首次移植第3天(D3)新鲜周期胚胎共179个周期,首次移植D3复苏周期胚胎共107个周期,首次移植第5天(D5)新鲜周期胚胎5个周期,首次移植D5复苏周期胚胎56个周期,对其移植后的临床相关情况进行分析。结果在首次IVF-ET治疗获得全部胚胎为非优质胚胎的周期中,首次D3新鲜周期胚胎移植的临床妊娠率、种植率、流产率分别为34.63%(62/179)、22.78%(72/316)和12.90%(8/62),首次D3复苏周期胚胎移植的临床妊娠率、种植率、流产率分别为30.84%(33/107)、23.28%(44/189)和21.21%(7/33),两组比较,差异均无统计学意义(P0.05);首次D5新鲜周期胚胎移植临床妊娠率、种植率、流产率分别为60.00%(3/5)、50.00%(3/6)和0(0/3),首次D5复苏周期胚胎移植临床妊娠率、种植率、流产率分别为48.21%(27/56)、40.85%(29/71)和18.52%(5/27),两组比较,差异均无统计学意义(P0.05);首次D5新鲜周期移植临床妊娠率、种植率分别为60.00%(3/5)和50.00%(3/6),首次D3新鲜周期临床妊娠率、种植率分别为34.63%(62/179)和22.78%(72/316),两组比较,差异均有统计学意义(P0.05);首次D5复苏周期移植临床妊娠率、种植率分别为48.21%(27/56)和40.85%(29/71),首次D3复苏周期临床妊娠率、种植率分别为30.84%(33/107)和23.28%(44/189),两组比较,差异均有统计学意义(P0.05)。结论在首次IVF-ET治疗获得全部胚胎为非优质胚胎的周期中,首次复苏周期D3胚胎移植与新鲜周期D3胚胎移植的临床妊娠结局相当,新鲜囊胚移植与复苏囊胚移植均可获得较高的妊娠率,临床上应根据患者不同情况,选择适宜的移植策略,避免胚胎浪费。  相似文献   

2.
激光辅助孵化在冻融胚胎移植中的临床研究   总被引:1,自引:0,他引:1  
张琪瑶  管群  孔风云  任兰青  孙伟 《生殖与避孕》2007,27(9):581-584,597
目的:探讨激光辅助孵化对冻融胚胎移植周期中胚胎种植率的影响。方法:分析192个冻融胚胎移植周期,其中行激光辅助孵化后移植86个周期(激光组),常规冻融胚胎移植106个周期(常规组),比较二组患者临床妊娠率和胚胎种植率。结果:激光组的临床妊娠率为31.4%,与常规组的23.6%比较,无统计学差异(P>0.05);胚胎种植率为19.2%,显著高于常规组的12.0%(P<0.05);特别当透明带厚度≥17mm时,激光组胚胎种植率显著高于常规组(P<0.05)。结论:在冻融胚胎移植前对透明带厚度≥17mm的胚胎行激光辅助孵化有助于提高胚胎种植率。  相似文献   

3.
目的:观察胚胎早期卵裂用于预测体外受精-胚胎移植妊娠结局的价值。方法:2009年8月至2011年5月在我院生殖中心首次因输卵管因素行常规体外受精-胚胎移植治疗的136个周期,授精25~27h后观察2PN受精卵是否出现早期卵裂,第3天行胚胎移植时分为移植胚胎中有早期卵裂胚胎组(A组)和无早期卵裂胚胎组(B组)。A组含有1个早期卵裂胚胎的为A1组,有2个早期卵裂胚胎的为A2组,有3个早期卵裂胚胎的为A3组。比较各组之间优胚率、种植率及妊娠率。结果:有早期卵裂的胚胎优胚形成率(63.3%)高于无早期卵裂的胚胎优胚率(49.0%),差异有统计学意义(P<0.01);移植胚胎中有早期卵裂胚胎组(A组)种植率、妊娠率高于无早期卵裂胚胎组(B组)(35.9%vs 22.2%;53.2%vs 33.7%),A1组种植率高于A2组(23.3%vs 45.7%),差异均有统计学意义(P<0.05)。结论:观察胚胎早期卵裂可预测胚胎发育潜能,有利于提高体外受精-胚胎移植种植率。  相似文献   

4.
体外受精移植胚胎数对临床妊娠率的影响   总被引:3,自引:0,他引:3  
目的探讨将移植胚胎数由3枚减为2枚对体外受精临床妊娠率和多胎发生率的影响。方法选择2002年8月至2004年8月在南京大学医学院附属鼓楼医院生殖医学中心进行体外受精,年龄≤35岁的妇女共424个周期,其中2胚胎组235个周期,3胚胎组189个周期。比较两组胚胎种植率、临床妊娠率和多胎发生率。结果2胚胎组和3胚胎组胚胎种植率与临床妊娠率差异无显著性意义(40.85%和40.92%,59.57%和67.20%,P>0.05)。2胚胎组单胎妊娠率明显高于3胚胎组(64.29%和40.16%,P<0.01),而三胎妊娠率明显降低(1.43%和22.83%,P<0.01),但两组双胎妊娠率差异无显著性意义(34.29%和37.01%,P>0.05)。结论对年轻妇女,胚胎移植数由3枚减为2枚,并不降低体外受精妊娠率。但明显降低了多胎妊娠特别是高序多胎妊娠的发生率。  相似文献   

5.
目的:探讨常规体外受精(IVF)和卵胞浆内单精子注射(ICSI)周期中异常受精胚胎的临床利用价值。方法:回顾性分析2013年4月至2015年6月在白求恩国际和平医院生殖中心接受体外受精-胚胎移植(IVF-ET)治疗(包括常规IVF和ICSI)的955个周期的实验室和临床数据。结果:ICSI周期双原核(2 PN)受精率显著高于IVF周期2 PN受精率(88.20%vs 72.04%,P0.01),而ICSI周期的未见原核(0 PN)、单原核(1 PN)及多原核受精率均低于IVF周期(P0.01),差异有统计学意义。第5天(D5)0 PN的囊胚形成率和可利用囊胚率显著高于2 PN和1 PN组(P0.01)。新鲜移植周期和冻融卵裂胚移植周期,0 PN组种植率和临床妊娠率显著低于2 PN组(P0.01),但是冻融囊胚移植周期,0 PN组的种植率和临床妊娠率与2 PN组相比,差异均无统计学意义(P0.05)。结论:IVF/ICSI周期中没有2 PN胚胎可供选择移植时,可选择0 PN胚胎,囊胚培养是合理利用异常受精胚胎的有效手段。  相似文献   

6.
周云  姜宏  冯翠娥 《生殖与避孕》2016,(4):284-287,298
目的:探讨超声介入硬化治疗输卵管积液对冻融胚胎移植(frozen-thawed embryo transfer,FET)周期妊娠结局的影响。方法:回顾性分析输卵管积液的输卵管性不孕接受体外受精-胚胎移植(IVF-ET)未妊娠或未移植且有冷冻胚胎的患者FET周期的临床资料,按积液的处理方式分组:A组(观察组)121个周期,FET前行超声介入硬化治疗;B组(对照组)60个周期,FET前行输卵管近端结扎。结果:A、B组胚胎种植率(20.06%vs 20.63%)、临床妊娠率(40.50%vs38.33%)、流产率(14.29%vs 13.04%)、异位妊娠率(6.12%vs 0.00%)组间差异均无统计学意义(P0.05)。结论:输卵管积液超声介入硬化治疗可获得与输卵管近端结扎治疗近似的FET临床结局,且简单、经济、基本无创。  相似文献   

7.
目的:通过分析复融新鲜胚胎混合周期移植的妊娠结局,探寻改善高龄、反复助孕失败患者妊娠结局的方法。方法:回顾分析2014年4月至2016年4月在河南省人民医院生殖医学研究所行常规体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSIET)患者的临床资料。根据移植胚胎类型、数量,设置A组(新鲜周期移植D3新鲜胚胎1枚及D3冷冻复苏胚胎1枚,36个周期)、B组(复苏周期移植D3冷冻复苏胚胎1枚,62个周期)和C组(复苏周期移植D3冷冻复苏胚胎2枚,62个周期)、D组(新鲜周期移植D3新鲜胚胎1枚,62个周期)和E组(新鲜周期移植D3新鲜胚胎2枚,62个周期)。比较各组的胚胎种植率、生化妊娠率、临床妊娠率、多胎率和流产率等指标。结果:5组患者中,混合周期患者的既往助孕周期数显著高于其他各组(P<0.05)。5组的妊娠结局、早期流产率、流产率及新生儿出生性别比差异无统计学意义(P>0.05),生化妊娠率、临床妊娠率、胚胎种植率、异位妊娠率、畸形率比较,差异有统计学意义(P<0.05)。A组能获得相对较高的生化妊娠率、临床妊娠率和胚胎种植率。结论:对于可利用胚胎数目较少的高龄反复种植失败的患者,可依据情况建议其采用混合周期移植以改善妊娠结局。  相似文献   

8.
目的探讨在薄型子宫内膜患者中新鲜胚胎移植与冻融胚胎移植(FET)妊娠结局的差异。方法回顾性分析接受体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)治疗采用长方案胚胎移植h CG注射日与冻融周期胚胎移植内膜转化日的内膜厚度≤7 mm的患者共592个周期的临床资料。将移植周期按胚胎是否冻融分为新鲜胚胎移植组(n=173)和FET组(n=419)。比较组间的胚胎种植率、临床妊娠率、流产率、多胎率和异位妊娠率有无差异。结果新鲜胚胎移植组患者平均移植胚胎(2.1±0.4)枚,与FET组患者平均移植胚胎(2.1±0.5)枚比较,组间有统计学差异(P0.05);按照移植胚胎数分为3个亚组,新鲜胚胎移植组1枚胚胎者,妊娠率为7.7%,2枚者为30.2%,3枚者为23.8%;FET组1枚胚胎者15.6%,2枚者为34.9%,3枚者为41.6%,新鲜胚胎移植组与FET组间差异均无统计学意义(P0.05)。组间着床率、流产率、异位妊娠率等结果也均无统计学差异(P0.05)。移植3枚胚胎新鲜组多胎率(80.0%)高于FET组(29.7%)(P0.05)。新鲜胚胎移植组多胎率3个亚组间有统计学差异(P0.05),FET组妊娠率和流产率3个亚组间均有统计学差异(P0.05)。将移植胚胎数作为协变量,纳入Logistics回归模型对结果变量进行分析,说明周期类型与临床妊娠率间无显著相关性(OR=0.726,95%CI=0.504~1.104)。结论子宫内膜厚度≤7 mm的薄型内膜患者新鲜胚胎移植和FET妊娠结局相似,选择新鲜周期移植不影响妊娠结局并可缩短治疗周期,降低总费用。  相似文献   

9.
目的分析不同超促排卵方案新鲜胚胎移植和冻融胚胎移植的临床妊娠结局,探讨全部胚胎冷冻技术在临床应用中的价值。方法回顾性分析行胚胎移植的525个周期患者的临床资料,其中253个周期为新鲜胚胎移植周期,272个周期为同期的复苏胚胎移植周期。纳入的促排卵方案包括促性腺激素释放激素激动剂(GnRH-a)长方案组(A组)和GnRH-a短方案组(B组)。分别比较两组中新鲜胚胎移植和冻融胚胎移植(FET)的妊娠结局,以及新鲜胚胎移植周期和复苏胚胎移植周期中2种方案妊娠结局。结果 A组中,新鲜胚胎移植周期(A1组)和FET周期(A2组)的临床妊娠率分别为45.95%和47.71%(P0.05);B组中,新鲜胚胎移植周期(B1组)和FET(B2组)的临床妊娠率分别为27.94%和46.30%(P0.05);A1组和B1组的受精率和可用胚胎率组间无统计学差异(P0.05),A组的平均获卵数、临床妊娠率和胚胎种植率显著高于B组(P0.05);A2组和B2组的临床妊娠率和胚胎种植率均无统计学差异(P0.05)。结论 FET并不能显著改善长方案患者的临床妊娠结局,但可显著提高短方案组的临床妊娠率,提示短方案患者可考虑采用全部胚胎冷冻。  相似文献   

10.
影响冷冻胚胎移植妊娠率相关因素分析   总被引:11,自引:1,他引:11  
目的: 探讨影响冷冻胚胎移植妊娠率的相关因素。 方法: 对129个接受冷冻胚胎移植患者的临床资料进行回顾性分析。结果: 129个冷冻胚胎移植周期,临床妊娠率27.1%,胚胎种植率12.8%;三种不同移植方案、常规体外受精(IVF)、单精子卵母细胞浆内注射(ICSI)所冻存的胚胎移植临床妊娠率无显著性差异(P>0.05)。<30、30~34、35~44岁三个年龄组胚胎种植率有显著差异(P<0.05);临床妊娠率以30~34岁组为最高(38.6%),35~44岁组明显下降(13.6%),三年龄组比较有显著性差异(P<0.05)。移植≥2个胚胎的子宫内膜厚度、平均移植胚胎数、累积胚胎评分、累积胚胎评分/胚胎移植数以及至少移植有1个4-细胞I级胚胎者,妊娠组与非妊娠组均有显著性差异(P<0.01)。 结论:患者的年龄、子宫内膜厚度、移植胚胎数目、胚胎形态及生长速率是影响冷冻胚胎移植妊娠率的重要因素。  相似文献   

11.
OBJECTIVES: Recent reports suggest ultrasound (US) guided embryo transfer (ET) improves pregnancy rates. Using the ovum donation model to eliminate confounding variables, we assessed the impact of US guided ET on pregnancy rates, implantation rates, and multiple gestation rates. METHODS: All women who underwent IVF-ET cycles using donated oocytes from November 1997 to September 1998 (n = 137) were evaluated retrospectively. ET from November 1997 to April 1998 were performed without US, while all ET from May 1998 to September 1998 were performed using transvaginal or transabdominal US. ET was further categorized as easy or difficult. Difficult ET was defined as requiring at least two attempts and/or the presence of blood on the catheter and/or > 5 min. RESULTS: Pregnant patients (n = 73) were similar with respect to the number and morphology of the embryos transferred compared to non-pregnant patients (n = 65). US guidance significantly improved implantation and pregnancy rates in cycles with easy transfers [28.8 vs. 18.4% and 63.1 vs. 36.1%, respectively (P < 0.05)] without impacting multiple pregnancy rates. CONCLUSION: US guided ET is simple and reassuring and appears to significantly improve pregnancy outcomes in ovum donation cycles by optimizing the placement of embryos.  相似文献   

12.
Purpose : To determine the impact of transabdominal ultrasound guidance on embryo transfer during IVF therapy. Methods : Retrospective analysis of 823 consecutive embryo transfers. Three hundred and sixty-seven procedures performed with transabdominal ultrasound guidance were compared to 456 cases performed with the clinical touch method. Results : Ultrasound-guided embryo transfer yielded higher, but not statistically significant, clinical pregnancy (48% vs. 44%) and implantation rates (22% vs. 20%). The incidence of multiple pregnancies, ectopic and multiple pregnancy rates were similar. The frequency of negative factors typically associated with difficult transfers, such as requirement of use of tenaculum, and presence of blood or mucus in the catheter tip, were significantly lower in the ultrasound-guided group in comparison with the clinical touch group. Ultrasound-guided embryo transfer was associated with a significantly increased easiness of transfer performance; 95% of the transfers were rated as very easy in the ultrasound-guidance group compared to 87% in the clinical touch group. The use of a soft pass catheter was the only variable independently and significantly associated with pregnancy success (odds ratio = 2.74). Conclusion(s) : Ultrasound-guidance facilitates embryo transfer and in combination with the use of a soft catheter should be implemented to optimize embryo transfer results.  相似文献   

13.
OBJECTIVE: To determine whether transabdominal ultrasound guidance during embryo transfer (ET) is a useful tool for increasing pregnancy rates in patients undergoing oocyte donation.DESIGN: Prospective, randomized, controlled trial.SETTING: In vitro fertilization academic center.PATIENT(S): Three hundred seventy-four infertile patients undergoing oocyte donation.INTERVENTION(S): Transabdominal ultrasound-guided ET.MAIN OUTCOME MEASURE(S): We measured the pregnancy rate and implantation rate after transabdominal ultrasound-guided ET versus the rates in a control group who did not receive transabdominal ultrasound-guided ET.RESULT(S): Clear visualization at ultrasound during ET was achieved in 90.8% of the patients who had ultrasound-guided ET. A similar number of easy transfers were performed in both the ultrasound-guided and the control groups (84.5% vs. 86.6%). The pregnancy rate was comparable between the groups (59.9% ultrasound vs. 55.1% control), as was the implantation rate (30.6% ultrasound vs. 26.3% control). No differences were found in the miscarriage rate (10.7% ultrasound vs. 9.1% control) or in the multiple pregnancy rate (21.4% ultrasound vs. 22.5% control). Although all ectopic pregnancies occurred in the group that did not receive ultrasound guidance, the differences were not statistically significant (0 vs. 2.7%).CONCLUSION(S): We could not show any benefit in terms of pregnancy rate in oocyte recipients for whom ET was performed under direct transabdominal ultrasound visualization of the endometrial cavity. There was a lower ectopic pregnancy rate when ultrasound guidance was used, but this rate was not statistically significant in comparison with the pregnancy rate without ultrasound guidance.  相似文献   

14.
ObjectiveDuring an in vitro fertilization treatment cycle, having embryos retained in the catheter after embryo transfer is a relatively uncommon and frustrating event. The reported incidence of retained embryos varies between 1% and 8%. It can be difficult to explain this unwanted event to patients. We wished to determine the incidence and the effect on pregnancy rates of having embryos retained in the transfer catheter, followed by immediate completion of transfer.MethodsWe performed a retrospective chart review of all IVF cycles with embryos retained in the transfer catheter, followed by repeat transfer, between October 2009 and March 2012. We reviewed IVF cycles with or without ICSI, and included fresh and frozen embryo transfer cycles. All embryos were transferred on the third day after oocyte retrieval. Transabdominal ultrasound was used for guidance during the embryo transfer.ResultsA total of 49 IVF treatment cycles with retained embryos that required re-transfer were identified. This represented 7.5% (49/652) of all IVF cycles with embryo transfer during that period. The clinical pregnancy rate in the repeat transfer group was 30.6% (15/49). The clinical pregnancy rate in all cycles in the same time period was 34.8% (227/652). These rates were not significantly different (P = 0.521).ConclusionHaving to re-transfer embryos retained in the transfer catheter does not have any significant effect on clinical pregnancy rates during IVF treatment cycles.  相似文献   

15.
OBJECTIVE: To compare the implantation and pregnancy rates after cleavage stage embryo transfer (ET) with transfer of blastocyst-stage (days 5-6) embryos. STUDY DESIGN: Prospective randomized trial at an assisted reproduction unit in a university hospital. Women with six or more follicles at the last ultrasound scan before oocyte aspiration were randomized for transfer of a maximum of two embryos after 2-3 days (n = 80) or after 5-6 days (n = 64) of culture. Embryo quality, implantation and pregnancy rates were evaluated. Statistical significance was tested with the Chi-square test and Fisher's exact test. RESULT(S): No significant difference was observed in implantation rates (21.1% versus 20.9%, respectively) and clinical pregnancy rates (36.7% versus 32.5% respectively) after blastocyst and cleavage stage transfers for the two groups. The pregnancy rate among subjects who had at least one good quality embryo transferred was 37.5% per day 2-3 ET and 60% per day 5-6 ET. CONCLUSION(S): The overall implantation and pregnancy rates after embryo transfer at cleavage stage and at blastocyst stage transfer were not statistically different. Women who had at least one good quality blastocyst (n = 25) had a high pregnancy rate (60% per ET). Blastocyst transfer is a good alternative for couples with many good quality embryos on day 2 after insemination.  相似文献   

16.
Purpose: To investigate the effect of ultrasound-guided embryo transfer on the rate of implantation and clinical pregnancy.Methods: A prospective randomized trial was performed to compare ultrasound-guided embryo transfer with the traditional method. A total of 330 patients were randomly divided into two groups on the day of embryo transfer. For the cases (n = 178), ultrasound-guided was used; controls (n = 152) was performed using routine methods.Results: The rate of implantation and clinical pregnancy for the cases (19.6 and 37.1%, respectively) was significantly higher than for the controls (12.6 and 25%, respectively; p < 0.05).Conclusion: Ultrasound-guided embryo transfer can significantly increase the rate of implantation and clinical pregnancy, and should be recommended as a routine procedure in the process of in vitro fertilization and embryo transfer (IVF-ET).  相似文献   

17.
18.
目的:探讨阴道超声评估子宫内膜容受性的价值。方法:对1680例处于排卵期的不孕症患者,应用阴道超声检测卵泡大小、内膜厚度,并按照内膜超声图像分为A、B、C3型,将子宫内膜厚度、类型与妊娠结局进行对照分析。结果:A型内膜占66.07%,妊娠率12.61%;B型内膜占25.00%,妊娠率9.52%;C型内膜占8.93%,妊娠率6.67%。各组成功妊娠的内膜类型以A型为主,占73.68%(140/190)。不同子宫内膜类型的妊娠率差异有统计学意义,两两比较表明,A型妊娠率高于C型(χ2=4.4546,P=0.0348),差异有统计学意义,A型与B型及B型与C型的妊娠率均无统计学差异(χ2值及P值分别为2.8005、0.0942及2.2883、1.1275)。按A型子宫内膜厚度不同分为5组,其中厚度在8~10.9mm妊娠率最高,妊娠例数占总妊娠例数的92.86%(130/140),高于厚度<8mm组和>11mm组,差异有统计学意义。按B型子宫内膜厚度不同分为5组,其中7~8.9mm组妊娠率高于其余各组,差异有统计学意义。结论:子宫内膜适合着床的理想厚度是8~10.9mm,A型内膜更适合着床。阴道B超监测子宫内膜类型与厚度在评估内膜容受性、指导临床调整用药及自然受孕或人工助孕等方面有主要价值。  相似文献   

19.
Background:  Embryo transfer is one of the most critical steps affecting the success of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer. It has been reported that uterine contraction caused by touching the uterine fundus at the time of embryo transfer decreased the pregnancy rate. It was demonstrated that there is a significant rise in the pregnancy rate by adequate positioning of embryos. Transabdominal ultrasound-guided embryo transfer has been reported to improve the pregnancy rate compared with the clinical touch method. The improvement of the pregnancy rate under ultrasound guidance can be attributed to the accurate positioning of the embryos aided by good visualization without touching the uterine fundus. However, sometimes difficulties are encountered when visualizing the tip of the catheter in cases where the patient has a retroflexed uterus.
Methods:  In the present study, we investigated the difference in the pregnancy rates and in the implantation rates between transabdominal ultrasound-guided group and trans-rectal ultrasound-guided group in retroflexed cases.
Results and Conclusion:  We found that the pregnancy rate and the implantation rate were higher among the trans-rectal group compared with the transabdominal group in retroflexed cases. The difference between the two groups was statistically significant. (Reprod Med Biol 2003; 2 : 159–163)  相似文献   

20.
OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture. DESIGN: Prospective randomized study. SETTING: Fertility center. PATIENT(S): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80). INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. MAIN OUTCOME MEASURE(S): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer. RESULT(S): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group. CONCLUSION(S): Acupuncture seems to be a useful tool for improving pregnancy rate after ART.  相似文献   

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