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1.
鼻咽癌骨转移核素骨显像特点   总被引:3,自引:0,他引:3  
鼻咽癌 (NPC)是常见的头颈部恶性肿瘤之一 ,占全部恶性肿瘤的 3 0 .97% ,占头颈部恶性肿瘤的 78.0 8% [1] 。NPC较早发生骨转移 ,核素骨显像对诊断骨转移病灶有较高的灵敏度。一、资料与方法15 1例NPC患者均经临床及病理检查确诊。其中低分化癌 89例 ,鳞状细胞癌 11例 ,中分化癌 1例 ,泡状核细胞癌 1例 ,余 49例病理分类不详。按常规行全身及头颅正侧位骨显像。颅底骨显像正常标准为 :双侧颅底骨放射性分布对称 ,颅底放射性摄取均匀。阳性 :颅中凹放射性浓聚较邻近颅骨或颈椎明显增高或颅底左右放射性分布不对称[2 ] 。二、结果与…  相似文献   

2.
目的 分析骨恶性纤维组织细胞瘤(BMFH)99Tcm-MDP全身骨显像的影像特点,评价其对BMFH的诊断价值.方法 回顾性分析经手术病理证实的BMFH患者15例[男11例,女4例,年龄23~60(50.4±12.8)岁].所有患者术前均行99Tcm-MDP全身骨显像及X线检查,其中12例行CT检查,7例行MRI检查.以骨骼出现放射性异常浓聚灶或稀疏、缺损区为阳性.总结BMFH全身骨显像特点,并将显像结果与其他影像学结果进行比较.结果 15例BMFH患者全身骨显像结果均阳性,股骨阳性占66.7%(10/15),其中股骨下段占46.7%(7/15),骶骨、胫骨、肱骨、桡骨各占6.7%(1/15),多骨多发病灶占6.7%(1/15);15例患者共发现病灶27处,其中63.0% (17/27)表现为放射性浓聚伴稀疏、缺损区,37.0%(10/27)仅见放射性浓聚.15例患者X线检查发现病灶20处;12例行CT检查,7例行MRI检查,CT及MRI所示异常部位在全身骨显像中均呈阳性.结论 99Tcm-MDP全身骨显像示:BMFH好发于股骨,以股骨下段多见,病灶呈异常放射性浓聚,其内或伴有放射性分布稀疏、缺损区;该方法可作为BMFH的辅助诊断检查,有助于了解有无多骨病变及有无转移.  相似文献   

3.
目的 探讨乏氧显像剂99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)在骨转移瘤诊断中的应用价值.方法 27例骨痛患者,其中19例经病理检查证实为骨转移瘤(未行放化治疗),8例为骨良性病变.所有患者均行99Tcm-亚甲基二膦酸盐(MDP)显像,2 d后注射99Tcm-HL91740 MBq,注射4 h后依据99Tcm-MDP显示的病灶进行断层显像,利用感兴趣区(ROI)技术,计算肿瘤与对侧正常组织的放射性(T/N)比值.采用SPSS 11.0软件进行t检验.结果 19例骨转移患者99Tcm-MDP显像提示的85处病灶,有79处99Tcm-HL91显像呈异常放射性浓聚;经病理检查或临床证实的8例骨良性疾病中,99Tcm-MDP显像提示的12处病灶99Tcm-HL91显像全部呈阴性.HL91断层显像骨转移组和骨良性疾病组的T/N比值分别为1.877±0.288和0.735±0.236,差异有统计学意义(t=13.065,P<0.05).肺癌、前列腺癌骨转移病灶的T/N比值分别为1.915±0.344和1.825±0.175,2种病理类型间差异无统计学意义(t=1.378,P>0.05).结论 99Tcm-HL91显像在骨骼良恶性病变的鉴别中可能有一定价值.  相似文献   

4.
目的:评价99mTc(V)-DMSA显像在骨转移瘤诊断中的意义。材料和方法:对91例疑骨转移瘤患者行99mTc(V)DMSA全身显像,并与99mTc-MDP全身骨显像及其它检查对比。结果:74例证实存在骨转移瘤者,99mTc.MDP骨显像均显示异常放射性浓聚,99mTc(V)-DMSA显像72例显示了与99mTc-MDP显像某些相同部位的放射性浓聚,2例99mTc(V)DMSA显像阴性。17例骨良性病变,99mTc-MDP骨显像显示轻度异常放射性浓聚,而99mTc(V)-DMSA显像却未见异常的放射性浓聚。结论:99mTc(V)-DMSA诊断骨转移瘤的特异性比99mTc-MDP骨显像高,在骨良恶性肿瘤鉴别诊断中具有重要的临床价值。  相似文献   

5.
目的探讨肺肿瘤99Tcm-氮-二(N-乙基-N-乙氧基二硫代氨基甲酸盐)[N(NOEt)2]SPECT显像病变部位与对侧对应正常肺组织放射性比值(T/N)与术后病理组织中P-糖蛋白(P-gp)和肿瘤增殖细胞核抗原(PCNA)表达间的关系.方法对22例(20例为术前未经药物治疗的肺癌,2例为肺良性病变)患者进行手术,取肿瘤标本,经常规石蜡切片,用免疫组织化学技术检测病变组织P-gp和PCNA表达,并与术前99Tcm-N(NOEt)2 SPECT显像T/N比值对比.结果22例患者中,20例肺恶性肿瘤99Tcm-N(NOEt)2 SPECT显像均表现为异常放射性浓聚,T/N比值为1.29±0.04;2例肺良性病变99Tcm-N(NOEt)2显像T/N比值为1.08±0.13,其中1例为假阳性.22例患者除1例肺腺癌仅P-gp表达阴性外,其余患者P-gp、PCNA均呈阳性表达.22例患者99Tcm-N(NOEt)2SPECT延迟显像T/N比值与术后病理组织中P-gp和PCNA表达程度均无关(r值分别为0.123和-0.145,P均>0.05,双侧),且病理组织中P-gp与PCNA表达程度也无关(r=0.062,P>0.05,双侧).结论肿瘤细胞摄取99Tcm-N(NOEt)2与其P-gp和PCNA表达程度无关.  相似文献   

6.
目的 探讨骨显像在滑膜炎、痤疮、脓疱病、骨肥厚、骨炎(SAPHO)综合征诊断中的临床价值.方法 回顾性分析8例SAPHO综合征的临床表现及99Tcm-MDP骨显像结果.结果 8例SAPHO综合征患者骨显像均阳性,前上胸壁异常放射性浓聚灶7例,单侧骶髂关节受累3例,颈、胸、腰椎体受累2例,肱骨及手足小关节受累1例,且发现了4处无症状的病灶.结论 骨显像的部分特征性表现有助于早期诊断及发现全身没有症状的病灶.  相似文献   

7.
目的 分析99Tcm-MDP全身骨显像肝脏异常显影的可能原因。方法 回顾性分析2013年1月至2015年7月于我院核医学科行99Tcm-MDP全身骨显像患者中肝脏异常显影20例,显像结果与其他影像学检查和(或)病理结果、实验室检查进行对比分析。结果 20例肝脏异常显影的患者中,原发性肝损伤3例、继发性肝损伤17例[其中包括多发性骨髓瘤引发肝功能异常1例,恶性肿瘤化疗后肝功能异常8例,肿瘤肝转移7例(结肠癌肝转移5例、肝癌肝内转移1例、肺癌肝转移1例)、慢性肾衰竭铁剂治疗后肝脏摄取1例]。结论 99Tcm-MDP全身骨显像肝脏异常显影的原因较多,除显像技术原因外,应警惕各种原因导致的肝脏损伤,为患者提前进行临床干预提供一定参考。  相似文献   

8.
患者男,48岁,间断咳嗽、咳痰2个月余.胸部CT示:右肺上叶肿物,直径10 cm左右,堵塞上叶支气管,诊断为右肺上叶占位,右肺癌?支气管镜检查示:右肺上叶支气管开口处见大块状白色坏死物完全阻塞支气管开口,于该处取活组织病理检查示:右肺上叶肿瘤.术前全身99Tcm-MDP骨显像示:双股骨及胫骨骨皮质放射性摄取明显增强,以双股骨下段明显,诊断为肺性肥大性骨关节病(hypertrophic pulmonary osteoarthropathy,HPOA;图1a).患者行右半"河蚌"切口肺上叶袖式切除术+胸腔淋巴结清扫+肋间神经冷冻术.术后病理证实为:鳞状细胞癌(简称鳞癌)伴神经内分泌化、多中心坏死、支气管周围淋巴结转移癌.术后给予吉西他滨+顺铂化疗5次.术后6个月再行99Tcm-MDP全身骨显像示:双股骨及胫骨骨皮质放射性基本消失,双下肢HPOA基本缓解(图1b).  相似文献   

9.
目的 对比分析99Tcm 甲氧基异丁基异腈 (MIBI)和99Tcm 亚甲基二膦酸盐 (MDP)对骨良恶性病变的诊断价值和疗效评估。方法  6 1例临床拟诊骨良恶性病变患者分别进行 2项骨显像 ,其中 6例恶性肿瘤患者分别进行化疗前后显像。显像后均经手术、病理检查对比分析。结果 99Tcm MIBI显像 :73 %恶性肿瘤病灶肉眼见中、高度MIBI浓聚 ,6 0 %良性病灶肉眼未见MIBI聚集。恶性病灶部位与对侧正常组织放射性计数比值 (L C)即99Tcm MIBI摄取比值 (3 0 8± 1 6 7)明显高于良性病灶(1 36± 0 6 4) ,P <0 0 1。99Tcm MDP显像 :大多数恶性或良性病灶肉眼见中、高度MDP浓聚 ,但恶性病灶99Tcm MDPL C(3 76± 1 37)与良性病灶L C(3 10± 1 0 5 )比较差异无显著性 (P >0 0 5 )。化疗可以抑制99Tcm MIBI摄取 ,99Tcm MIBI摄取程度与99Tcm MDP比较能较好反应治疗效果。结论 99Tcm MIBI对鉴别诊断良恶性骨病和评估疗效有较好的应用价值 ,与99Tcm MDP显像联合应用可更全面地提供信息  相似文献   

10.
^99Tc^m—MDP骨显像对SAPHO综合征的诊断价值   总被引:1,自引:0,他引:1  
目的 探讨骨显像在滑膜炎、痤疮、脓疱病、骨肥厚、骨炎(SAPHO)综合征诊断中的临床价值.方法 回顾性分析8例SAPHO综合征的临床表现及99Tcm-MDP骨显像结果.结果 8例SAPHO综合征患者骨显像均阳性,前上胸壁异常放射性浓聚灶7例,单侧骶髂关节受累3例,颈、胸、腰椎体受累2例,肱骨及手足小关节受累1例,且发现了4处无症状的病灶.结论 骨显像的部分特征性表现有助于早期诊断及发现全身没有症状的病灶.  相似文献   

11.
目的 探讨肿瘤患儿骨显像中骨外软组织肿瘤摄取99Tcm-亚甲基二膦酸盐(MDP)的特点,以及其与肿瘤组织病理学的关系。 方法 回顾性分析2008年12月至2018年12月在上海交通大学医学院附属新华医院和同济大学附属第十人民医院行骨显像的33例肿瘤患儿的临床资料,其中男患儿21例、女患儿12例,年龄3个月~10岁。根据病理学结果将肿瘤类型分为母细胞瘤、间叶组织肿瘤和生殖细胞肿瘤3大类。根据骨显像等影像学结果,将骨外软组织肿瘤的最高放射性浓聚程度从低到高分为“+”、“++”和“+++”, 分析骨显像的特点及其与肿瘤病理学的关系。软组织肿瘤摄取99Tcm-MDP的多组间比较采用Kruskal-Willis H秩和检验。 结果 33例患儿中母细胞瘤26例(78.8%,包括神经母细胞瘤15例、肾母细胞瘤6例、肝母细胞瘤4例和胰母细胞瘤1例)、间叶组织肿瘤5例(15.2%,包括骨肉瘤肺转移灶3例、恶性肾外横纹肌样瘤1例和左大腿脉管瘤1例)和生殖细胞肿瘤2例(6.0%),软组织肿瘤的3种类型摄取99Tcm-MDP程度的差异无统计学意义(H=1.993,P=0.369)。所有患儿骨外软组织肿瘤骨显像内部特点为钙化、坏死和其他特点(含有骨化基质或实性肿块无明显坏死及钙化),摄取99Tcm-MDP为“+” 的6例(6/33,18.2%)、 “++”的11例(11/33,33.3%)和 “+++”的16例(16/33,48.5%),肿瘤内钙化伴坏死、钙化、坏死和其他原因引起的99Tcm-MDP摄取程度的差异无统计学意义(H=2.313,P=0.315)。不同病理类型的肿瘤摄取99Tcm-MDP为“+”的6例(18.2%,包括母细胞瘤5例、间叶组织肿瘤1例)、“++”的11例(33.3%,包括母细胞瘤9例、间叶组织肿瘤2例)和“+++”的16例(48.5%,包括母细胞瘤12例、间叶组织肿瘤2例、生殖细胞肿瘤2例)。 结论 骨显像时患儿骨外软组织肿瘤摄取99Tcm-MDP多提示为恶性肿瘤,以神经母细胞瘤最常见,其程度与组织病理学分类无明显相关性。  相似文献   

12.
The aim of this study was to establish the value of 99Tcm(V)-DMSA scintigraphy in the detection of metastatic bone lesions and compare the results to 99Tcm-MDP bone scintigraphy. Thirty-four patients presenting with metastatic bone disease (Group 1) and 12 controls with degenerative skeletal lesions (Group 2) were studied. Conventional bone scanning and 99Tcm(V)-DMSA whole-body scanning were performed on all patients. All scans were interpreted visually. Furthermore, lesion-to-normal bone ratios (L/N) in vertebral metastases on the 4 and 24 h bone scans were obtained in 58 lesions of cancer patients and in 23 benign (degenerative) vertebral lesions of the control group. 99Tcm-MDP L/N ratios at 24 h (3.08 +/- 0.32) were significantly higher than those at 4 h (2.48 +/- 0.24) in the malignant foci (P < 0.001). No significant difference was observed in benign lesions (P > 0.05). In 167 (164 metastatic, 3 traumatic) of 186 99Tcm-MDP positive lesions (90%) of Group 1, 99Tcm(V)-DMSA uptake was observed. The remaining 19 lesions (10%) were 99Tcm(V)-DMSA negative. Fourteen of these 19 sites were diagnosed as benign. The remaining five foci were malignant. In four lung cancer metastases showing no 99Tcm-MDP uptake, 99Tcm(V)-DMSA uptake was observed. There was no 99Tcm(V)-DMSA accumulation in any of the 99Tcm-MDP positive degenerative lesions of Group 2. All quantitatively evaluated (n = 42) vertebral metastatic foci and two compression fractures in Group 1 showed 99Tcm(V)-DMSA accumulation and an increased 99Tcm-MDP L/N ratio at 24 h. A total of 36 degenerative lesions (Groups 1 and 2) and one compression fracture (Group 1) showed neither 99Tcm(V)-DMSA uptake nor an increased 99Tcm-MDP L/N ratio at 24 h. Our results indicate that quantitative 4/24 h analysis of vertebral lesions on 99Tcm-MDP scans has a similar diagnostic value to 99Tcm(V)-DMSA imaging in the detection of bone metastases. However, the accumulation of 99Tcm(V)-DMSA in four lung cancer metastases showing no 99Tcm-MDP uptake is encouraging and justifies further research in patients with proven bone metastases and negative bone scans.  相似文献   

13.
^99Tc^m—MDP SPECT/CT骨显像对脊柱良恶性病变的鉴别诊断   总被引:2,自引:0,他引:2  
目的探讨^99Tc^m-MDPSPECT/CT骨显像对脊柱良、恶性病变的鉴别诊断价值。方法回顾性分析52例全身骨显像示脊柱局灶性放射性异常浓聚者的SPECT/CT影像资料,并与病理结果对照。由2位核医学科医师用盲法阅片方法分别对SPECT图像和SPECT/CT融合图像进行病变良性、可能良性、可能恶性和恶性的判断。分别计算SPECT和SPECT/CT诊断结果中可能良性和可能恶性的百分比,并对2位阅片者的分析结果进行一致性分析,计算Kappa值和95%的可信区间。分析SPECT和SPECT/CT诊断结果与病理结果的一致率及95%可信区间。结果2位阅片者分析SPECT图像,诊断为不确定(可能恶性和可能良性)的比例分别为73.1%(38/52)和67.3%(35/52),一致率为63.5%,Kappa值为0.62,95%可信区间为0.49~0.76;2位阅片者分析SPECT/CT图像,诊断为不确定的比例分别为25.0%(13/52)和13.5%(7/52),一致率为78.9%,Kappa值为0.81,95%可信区间为0.72~0.91。SPECT诊断与病理结果的一致率为76.9%,95%可信区间为63.8%~86.2%;SPECT/CT诊断与病理结果的一致率为94.2%,95%可信区间为84.3%~97.9%。结论在全身骨平面显像基础上,对脊柱病变再行SPECT/CT显像,可以获得更多诊断信息。不同阅片者对SPECT/CT融合图像分析结果的一致性、SPECT/CT诊断病变良恶性与病理结果的一致性均较SPECT好。  相似文献   

14.
目的 比较99Tcm-亚甲基二膦酸盐(99Tcm-MDP)全身骨显像、99Fcm-MDPSPECT-CT与18F-FDG SPECT-CT诊断脊柱转移瘤的临床价值.方法 对行常规99Tcm-MDP全身骨显像的88例肿瘤患者同时行99Tcm-MDP SPECT-CT,同期(2周内)行18F-FDG SPECT-CT.回顾...  相似文献   

15.
目的:估算 99Tc m-亚甲基二膦酸盐(MDP)骨显像患者对公众及核医学技师产生的照射剂量。 方法:选取2019年9至12月于四川大学华西医院行 99Tc m-MDP骨显像的64例患者进行回顾性研究,其中男性38例、女性26例,年龄24~82(55.1±12....  相似文献   

16.
To compare the measured uptake of 99Tcm-methylene diphosphonate (99Tcm-MDP) in those scaphoid fractures seen on both 16 detector multislice CT and scintigraphy, with those seen only on scintigraphy. Over a 12 month period a total of 51 patients with suspected fracture underwent both conventional 99Tcm-MDP scintigraphy and 16 detector multislice CT on the same day. The 99Tcm-MDP uptake was then quantified in patients with identified fracture. This was measured by placing a region of interest (ROI) over the fracture site and the mean and maximum number of counts were compared with those in a similar size ROI placed over background bone activity. A total of 23 fractures were identified on scintigraphy of which 16 were also detected on CT (concordant). In seven cases the fracture was not seen on CT, even in retrospect (discordant). In the discordant cases, follow-up radiographs and MRI (where available) also failed to demonstrate a fracture. The mean fracture count to background bone activity ratio averaged 7.7 (range 3.2-18.5) for concordant fractures and 3.8 (range 1.7-5.3) for discordant fractures (t-test p=0.04). The maximum fracture count to background bone activity ratio averaged 12.7 (range 4.3-27.7) for concordant fractures and 6.3 (range 2.6-9.5) for discordant fractures (t-test p=0.03). It is speculated whether these discordant fractures with less 99Tcm-MDP uptake may represent a less severe injury such as bone bruise.  相似文献   

17.
Bone scintigraphy was performed in 17 patients with previously known lung metastases of osteosarcoma. 99Tcm-MDP uptake was observed in all primary bone lesions but lung metastatic lesions were positive in only six patients (35%). 99Tcm-MDP uptake by lung metastases was significantly correlated with bone and osteoid formation in the metastatic lesions and preoperative serum ALPase values. These clinical observations were confirmed by using nude mice transplanted with human lung metastatic osteosarcoma. 99Tcm-MDP scintigraphy appears to be useful for detecting lung metastases of osteosarcoma only in a selected group of patients.  相似文献   

18.
目的 建立99Tcm标记白细胞介素11(IL11)类似物环九肽,即环状肽半胱氨酰-甘氨酰-精氨酰-精氨酰-丙氨酰-甘氨酰-甘氨酰-丝氨酰-半胱氨酸[c(CGRRAGGSC)]的方法,探讨标记物用于前列腺癌骨转移IL11受体(IL11R)显像的可行性.方法 采用间接法,用99Tcm标记c(CGRRAGGSC)制备99Tcm-DTPA-环九肽[99Tcm-DTPA-Bz-NH-SA-c(CGRRAGGSC),简称99Tcm-DTPA-IL11RR].利用纸层析法及高效液相色谱(HPLC)测定标记率和稳定性.将99Tcm-DTPA-IL11RR(0.74 MBq/只)经正常ICR小鼠尾静脉注射后,观察其在小鼠体内生物学分布,计算血、脑、心、肝、脾、肺、肾、胃、小肠、肌肉、甲状腺、骨骼、胰腺每克组织百分注射剂量率(%ID/g).γ显像动态(5只小鼠)观察99Tcm-DTPA-IL11RR在荷人PC-3前列腺癌骨转移瘤BALB/c裸鼠模型体内0.5,1,2,4,6,8和24 h表现,与99Tcm-亚甲基二膦酸盐(MDP)骨显像比较,采用感兴趣区(ROI)法计算99Tcm-DTPA-IL11RR显像肿瘤/对侧正常骨骼放射性(T/NT)比值,并用此2种显像剂进行裸鼠骨折模型显像比较.进行体内竞争抑制显像(3只荷瘤裸鼠),观察标记物生物学活性.对计量资料数据行单因素方差分析.结果 99Tcm-DTPA-IL11RR标记率90.7%,HPLC即时测放化纯为(99.57±0.09)%,室温放置1,2,3,4,6,8和24 h,放化纯依序为(99.29±0.18)%,(98.95±0.78)%,(98.67±0.11)%,(96.53±0.91)%,(95.20±0.70)%,(88.38±0.22)%和(36.17±1.29)%.标记物经正常ICR小鼠尾静脉注射后主要经肾排泄,各时相重要组织脏器普遍摄取较低,肌肉和脑最低,4 h骨骼、肝摄取达峰值,分别为(1.910±0.109)和(0.366±0.030)%ID/g.注射后24 h体内放射性消失.模型鼠γ动态显像示脊柱骨髓、四肢关节髓腔轻度显影,体内放射性清除迅速;瘤灶放射性持续摄取,4 h最明显,延续至6~8 h;24 h全身影像极淡.以ROI法测量的模型鼠0.5,1,2,4,6,8和24 h T/NT比值分别为1.17±0.17,2.20±0.29,3.20±0.15,3.67±0.23,13.61±0.85,9.45±0.37和3.33±0.30(F=621.54,P<0.05).骨折模型99Tcm-MDP显像示骨折处放射性摄取,99Tcm-DTPA-IL11RR显像未见摄取.体内竞争抑制实验示环九肽对瘤体显像具有抑制作用.结论 99Tcm-DTPA-IL11RR标记率高,稳定性好,有望成为前列腺癌等富含IL11R的骨转移特异分子靶向显像剂.  相似文献   

19.
The study aim was to assess the safety, biodistribution, tissue kinetics, and tumor uptake of the (99m)Tc-labeled neurotensin (NT) analog NT-XI. METHODS: Four patients presenting ductal pancreatic adenocarcinoma were studied with (99m)Tc-NT-XI. Patients were followed by scintigraphy up to 4 h and by continued blood and urinary sampling until surgery 18-22 h after injection. Surgical tissue samples were analyzed for radioactivity uptake and NT receptor expression. RESULTS: No side effects were observed on injection of (99m)Tc-NT-XI. Blood biologic half-lives alpha and beta were 35 min (range, 17-62 min) and 230 min (range, 107-383 min), respectively. Repeated whole-body scintigraphy performed in 2 patients showed a single exponential decrease of whole-body activity with half-lives of 101 and 232 min. Tracer elimination was mainly renal, with 92% and 98% of activity counted in urine in the first 20 h. Kidney, liver, spleen, and bone marrow activity uptake was observed in all patients. Tumor was not visualized in the first 3 patients but could be localized by tomoscintigraphy in the pancreas head region of patient 4. In vitro tissue analysis showed high expression of NT receptor in the tumor of patient 4, correlated with the highest tumor radioactivity uptake and the highest tumor-to-fat radioactivity ratio. In vitro receptor expression was also positive in a second patient having a tumor characterized by very low cellularity; however, the remaining 2 tumors lacked NT receptor expression. CONCLUSION: Injection of (99m)Tc-NT-XI was well tolerated. The in vivo tumor uptake appeared specific as it was observed in the 1 patient with a pancreatic tumor that expressed high amounts of NT receptor. The results are compatible with preclinical animal results and in favor of further development of radiolabeled NT analogs for diagnosis or therapy of cancer.  相似文献   

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