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1.
目的评价唾液酸酶检测对细菌性阴道炎(Bacterial Vaginosis,BV)的诊断价值与临床应用,分析BV与其它阴道疾病的关系.方法以酶反应学原理检测阴道分泌物唾液酸酶的活性,同时以革兰氏染色法找线索细胞及白带常规检查作对照.结果在BV诊断中,唾液酸酶法阳性率为29.3%,革兰氏染色法为24.1%,两者之间有显著差异性(p<0.05).在滴虫性及念珠菌性阴道炎中,唾液酸酶阳性率分别为90.9%和22.2%.结论在BV诊断中,唾液酸酶法阳性率高于传统革兰氏染色法.虽然唾液酸酶法和其它方法一样存在交叉感染滴虫(6.2%)及念珠菌(7.4%)等病原体的问题,但其简便、快捷、可靠、结果易判读、特异性强,可批量操作,不失为一种临床上可行的好方法.  相似文献   

2.
深圳女性生殖道HR-HPV感染与常见阴道病原体感染的关系   总被引:1,自引:0,他引:1  
目的:调查深圳城区育龄妇女的高危型人乳头瘤病毒(HR-HPV)感染状况与生殖道常见阴道病原体感染的相关性。方法:2004年3月~2008年3月期间对深圳市城区育龄妇女1 943例进行宫颈癌筛查,包括问卷调查、妇科检查,收集阴道及宫颈分泌物。采用第二代杂交捕获(HC-2)法检测13种高危型HPV,检测阴道病原体。结果:深圳城区妇女HR-HPV DNA阳性381例,阳性率19.6%。滴虫性、细菌性阴道炎和外阴阴道假丝酵母菌病的患者HR-HPV的感染率分别为29.4%、31.4%、15.3%,患不同阴道炎的患者感染HR-HPV的机率差异有统计学意义(P<0.05)。细菌性阴道炎、滴虫性和外阴阴道假丝酵母菌病患者感染HR-HPV的OR值及OR值的95%CI分别是1.697(1.330~2.164)、1.589(0.892~2.568)、0.827(0.507~1.159)。结论:深圳城区妇女细菌性阴道病与生殖道HR-HPV感染具有正相关性,而滴虫性阴道炎、外阴阴道假丝酵母菌病与HR-HPV感染无明显相关性。  相似文献   

3.
妊娠期妇女生殖道感染与妊娠不良结局分析   总被引:7,自引:0,他引:7  
目的:探讨妊娠期妇女生殖道感染(reproductivetractinfection,RTI)的类型及对妊娠不良结局的影响。方法:回顾性分析2003年1月-2004年12月在我院住院孕产妇共5499例,进行生殖道病原菌检测,随机分为RTI患者(感染组)与正常孕产妇(对照组),分析妊娠合并生殖道感染与围产期并发症的关系。结果:在5499例围产期妇女中,RTI总患病率为28.23%,细菌性阴道病患病率13.18%,外阴念珠菌阴道病患病率11.16%,滴虫性阴道炎患病率1.87%,宫颈沙眼衣原体感染患病率1.42%,妊娠合并梅毒患病率0.27%,淋病患病率0.15%,尖锐湿疣患病率0.18%。感染组与对照组的死胎率分别为1.10%、0.13%(P<0.01),胎膜早破率分别为15.12%、4.67%(P<0.01),早产率分别为2.30%、0.20%(P<0.01),胎儿窘迫率分别为6.24%、2.67%(P<0.01),新生儿窒息率分别为2.23%、0.67%(P<0.01)。结论:预防妊娠期妇女生殖道感染应早期开展RTI常规检测和治疗。  相似文献   

4.
Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.
Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.
Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years(38.14 ± 5.9 years), Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority (46%) had used it for more than 3 years and most (75%) of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users (37.5%) complained of pruritus vulvae, 3 users (12.5%) lower abdominal pain, 1 user (4,2%) dyspareunia and vaginosis was made in 16 (66. 7%) and 1 (4.2%) dysuria. The diagnosis of bacterial vaginal candidiasis in 8 (33.3%). Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis (OR=1.29, 1.67 and 6.6, respectively), while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis (OR=1.67 and 4.2, respectively). Eight clients (33.3%) were treated for candidiasis with antifungals (3 empirically, and 5 after obtaining results of vaginal swab), 9 (37.5%) were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.
Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.  相似文献   

5.
Background  Previous studies have shown evidence of health-related risk behaviors among women who have sex with women (WSW), such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections (RTI)/sexually transmitted infections (STI).
Methods  Participants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests.
Results  We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% (206/224) of women reported sexual relations with women. The RTI rates were: gonorrhea (15.8%), chlamydia (3.5%), syphilis (0.5%), bacterial vaginosis (14.4%), hepatitis B virus (HBV) (0.9%), hepatitis C virus (HCV) (0.5%), and candidiasis (6.9%). No HIV or herpes simplex virus (HSV) positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency (odds ratio (OR)=2.1, 95% confidence interval (CI): 1.2–3.8) and genital-genital contact (OR=3.1, 95% CI: 1.3–7.2); factors associated with curable STI (excluding bacterial vaginosis, candidiasis, HBV and HCV) were non-Beijing local residency (OR=1.9; 95% CI: 1.2–3.0) and bleeding during or after sex (OR=18.1; 95% CI: 5.2–62.6); and the factor associated with RTI (including all the infections tested) was bleeding during or after sex (OR=37.8, 95% CI: 11.2–127.4).
Conclusions  Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planning corresponding prevention and interventions.
  相似文献   

6.
女性STD患者复发性外阴阴道念珠菌病复发原因探讨   总被引:2,自引:0,他引:2  
吴玉清  吴丹  农光鲜 《陕西医学杂志》2006,35(10):1279-1281
目的探讨女性STD患者复发性外阴阴道念珠菌病(RVVC)的复发原因及与STD的相关性。方法对130例RVVC患者进行问卷调查并进行性病检查,对350例女性STD患者只进行性病检查。结果RVVC复发因素在多个性伴侣、性生活较频、患病后未禁止性生活、合并其他STD、长期使用抗生素等因素中所占比例较高;各种性病阴道念珠菌检出率以尖锐湿疣最高(72.31%),滴虫病、细菌性阴道病最低(26.53%、19.05%)。两组阴道念珠菌培养,主要分离出白念珠菌(75.38%,81.55%),非白念珠菌有上升趋势,分别为26.15%和16.67%,两组比较有显著性差异(P<0.05)。结论性传播是RVVC复发的重要因素。RVVC与STD具有明显相关性,故在RVVC确诊之前必须常规作性病检查,以免漏诊。  相似文献   

7.
目的了解原发不孕与继发不孕妇女生殖道感染的情况及其病原体分布。方法对1462例不孕患者的临床资料进行回顾性分析,分为原发不孕组和继发不孕组,分别对其阴道分泌物、宫颈分泌物及血清进行生殖道感染相关病原体的检测。结果1462例不孕妇女中,原发不孕477例,继发不孕985例。共检出生殖道感染者655例,总体感染率为44.80%。原发不孕组中共检出生殖道感染者186例,感染率为3899%;继发不孕组中共检出生殖道感染者469例,感染率为47.61%。总体病原体检出率:依次为解脲支原体(25.72%)、阴道加德纳氏菌(15.87%)、假丝酵母菌(11.08%)、沙眼衣原体(506%)、人型支原体(2.33%)、阴道毛滴虫(075%)、梅毒螺旋体(055%)、淋球菌(0.34%)、人类免疫缺陷病毒(0.07%)。两组中衣原体感染率继发不孕组明显高于原发不孕组。其余病原体感染率差异无统计学意义。结论在不孕妇女中常规进行阴道分泌物病原体检测及血清梅毒螺旋体、HIV的检测非常重要。继发不孕妇女尤其要重视衣原体的检测。  相似文献   

8.
The efficacy of microbiological diagnosis in sexually transmitted diseases (STDs) has been evaluated in comparison with the clinical diagnosis. Amongst the clinical diagnoses of single STDs, syphilis, genital warts, gonorrhoea and herpes genitalis were the predominant ones. Syphilis was the most predominant infection in both the single and mixed STD infections in Chennai. Clinical diagnoses of trichomoniasis, genital chlamydiasis and genital herpes were more accurate and correlated well with laboratory investigations. On the other hand, clinical diagnoses of gonorrhoea, candidiasis and syphilis were less accurate. More over many of these cases, clinically diagnosed as single, infection, were also positive for other STDs in the laboratory investigations. Double infections were clinically diagnosed only in 7 cases as against 11 cases in microbiological tests and one triple infection diagnosed in microbiological tests was diagnosed only as single disease clinically. Therefore, the laboratory/microbiological investigations have been emphasised to have better accuracy of diagnosis of STDs.  相似文献   

9.
Anderson MR  Klink K  Cohrssen A 《JAMA》2004,291(11):1368-1379
Matthew R. Anderson, MD, MS; Kathleen Klink, MD; Andreas Cohrssen, MD

JAMA. 2004;291:1368-1379.

Context  Vaginal symptoms are one of the most common reasons for gynecological consultation. Clinicians have traditionally diagnosed vaginal candidiasis, bacterial vaginosis, and vaginal trichomoniasis using some combination of physical examination, pH, the wet mount, and the whiff test.

Objectives  To evaluate the role of the clinical examination and determine the positive and negative likelihood ratios (LRs) for the diagnosis of vaginal candidiasis, bacterial vaginosis, and vaginal trichomoniasis.

Data Sources  Using a structured literature review, we abstracted information on sensitivity and specificity for symptoms, signs, and office laboratory procedures. We chose published (1966 to April 2003) articles that appeared in the MEDLINE database and were indexed under the combined search terms of diagnosis with vaginitis, vaginal discharge, candidiasis, bacterial vaginosis, and trichomoniasis.

Study Selection  Included studies of symptomatic premenopausal women seen in primary care settings. Tests were evaluated only if they would provide diagnostic information during the office visit and were compared with an acceptable criterion standard.

Data Extraction  All 3 authors extracted the data and computed sensitivity and specificity from each article independently. The absence of standard definitions for symptoms and signs made it impossible to combine results across studies.

Data Synthesis  Symptoms alone do not allow clinicians to distinguish confidently between the causes of vaginitis. However, a patient's lack of itching makes candidiasis less likely (range of LRs, 0.18 [95% confidence interval {CI}, 0.05-0.70] to 0.79 [95% CI, 0.72-0.87]) and lack of perceived odor makes bacterial vaginosis unlikely (LR, 0.07 [95% CI, 0.01-0.51]). Similarly, physical examination signs are limited in their diagnostic power. The presence of inflammatory signs is associated with candidiasis (range of LRs, 2.1 [95% CI, 1.5-2.8] to 8.4 [95% CI, 2.3-31]). Presence of a "high cheese" odor on examination is predictive of bacterial vaginosis (LR, 3.2 [95% CI, 2.1-4.7]) while lack of odor is associated with candidiasis (LR, 2.9 [95% CI, 2.4-5.0]). Office laboratory tests, particularly microscopy of vaginal discharge, are the most useful way of diagnosing these 3 conditions.

Conclusions  The cause of vaginal complaints may be easily diagnosed when typical findings appear in microscopy. However, the poor performance of individual symptoms, signs, and office laboratory tests often makes it problematic to identify the cause of vaginal symptoms.

  相似文献   


10.
目的探讨全自动细菌性阴道病(BV)检测系统在BV诊断中的的临床应用价值。方法取943例疑为细菌性阴道病的阴道分泌物标本,同时用全自动BV检测系统和Amsel金标准法进行对比检测。结果采用全自动BV检测系统检测阳性率为18.2%,Amsel法检测阳性率为17.7%,两种方法比较差异无统计学意义(P>0.05)。两种方法同时检测阳性有161例,同时检测阴性有765例,符合率达到98.2%。与Amsel法比较,全自动BV检测系统诊断BV的灵敏性为96.4%,特异性为98.6%。结论全自动BV检测系统操作简便、快速,结果客观准确,适用于门诊病人的BV快速检测,值得推广使用。  相似文献   

11.
Maternal genital infections, particularly bacterial vaginosis has been implicated as a cause for preterm labour and adverse pregnancy outcomes. This prospective study aimed to study the association of bacterial vaginosis with preterm labour. The prevalence of bacterial vaginosis was studied in 60 women in preterm labour who had no recognisable cause for prematurity and in 60 term labour controls. Demographic factors, pregnancy outcome and reproductive history were also studied. Vaginal specimens for Gram-stain and culture were collected from posterior vaginal fomix and bacterial vaginosis was defined by evaluation of Gram-stained smear by Spiegel criteria. Bacterial vaginosis was diagnosed in 31.6% of women in preterm labour and in 15% of term labour controls ( p<0.05). In preterm labour group, preterm delivery occurred in 48 women (80%) out of which 18 women had bacterial vaginosis and term delivery occurred in only one woman with the condition. Anaerobes were significantly associated with bacterial vaginosis ( p<0.01) and were more common in women with preterm labour ( b>0.05). The results indicates that bacterial vaginosis has a significant association with preterm labour and adverse pregnancy outcome.  相似文献   

12.
目的探讨女性生殖道细菌性阴道炎患者与解脲支原体(Ureaplasma urealytcum,UU)感染的相互关系。方法用革兰氏和白带染色法筛选出105例细菌性阴道炎患者组和50例阴道菌群正常组,并对两组进行宫颈分泌物支原体培养,然后分析细菌性阴道炎患者解脲支原体感染的情况。结果细菌性阴道炎患者组UU检出率为36.2%,正常组UU检出率为24.0%,两者相比较差异有统计学意义(P〈0.01);细菌性阴道炎患者宫颈分泌物中含白细胞程度与UU感染率比较无显著相关性(P〉0.05)。结论女性生殖道细菌性阴道炎患者中的阴道菌群失调与支原体感染两者之间有相互关系,但其宫颈分泌物中白细胞数量与支原体感染无关。  相似文献   

13.
目的:比较克林霉素磷酸酯阴道凝胶与磺胺乳膏治疗细菌性阴道炎的疗效。方法:使用随机双盲试验,纳入无妊娠、无哺乳、16岁以上有细菌性阴道炎的患者,使用7 d克林霉素磷酸酯阴道凝胶与磺胺乳膏,治疗完成后5-10d及25-39d随访。结果:在25-39d随访时,80名接受克林霉素磷酸酯阴道凝胶患者中的70名,78名接受磺胺乳膏患者中的38名治愈或缓解( P<0.05)。大部分的差异出现在有病史组。副作用发生率在两组间无差异。结论:克林霉素磷酸酯阴道凝胶治疗细菌性阴道炎的疗效优于磺胺乳膏。  相似文献   

14.
目的评价臭氧治疗外阴阴道假丝酵母菌病(VVC)和细菌性阴道病(BV)的有效性和安全性。方法将72例VVC随机分为试验组36例接受臭氧治疗和对照组36例接受达克宁栓治疗;BV试验组36例接受臭氧治疗,对照组36例接受甲硝唑栓治疗。均于治疗前、治疗后第3d观察临床症状及体征,并进行阴道分泌物病原学检查。结果VVC治疗结束后第3d,试验组和对照组的痊愈率分别为58.3%和61.1%,有效率分别为83.3%和88.9%,症状平均缓解时间分别为2.58d和2.36d,念珠菌阴转率分别为94.4%和100%。两组之间比较差异均无统计学意义(P>0.05);BV组治疗结束后第3d,试验组和对照组的痊愈率分别为61.1%和63.4%,有效率分别为80.6%和88.9%,症状缓解时间分别为3.72d和3.53d,阴道分泌物BV蓝检测阴转率均为100%。两组比较差异均无显著性(P>0.05)。144例受试者中无不良事件与严重不良事件发生。结论臭氧治疗VVC和BV安全、有效。  相似文献   

15.
目的探讨线索细胞法检查对细菌性阴道病(BV)的诊断价值。方法对350例疑似BV患者的阴道分泌物分别用Amsel法、线索细胞法、Nugent评分法进行检测,以Amsel法的检测结果为标准,其他二种方法与之进行比较。结果Amsel法检出BV阳性217例,线索细胞法阳性225例,其中真阳性203例,Nugent评分阳性227例,其中真阳性207例。线索细胞法诊断BV的敏感度94.4%,特异度83.7%,诊断效率90.3%;Nugent评分敏感度95.8%,特异度85.1%,诊断效率91.7%。二种方法与Amsel法比较,以上指标差异均无统计学意义(均P〉0.05)。结论以线索细胞法作为诊断BV的标准,具有操作简便快速、结果准确、易于规范的特点,可作为阴道分泌物常规检查项目在临床开展应用。  相似文献   

16.
目的 探讨细菌性阴道炎和非细菌性阴道炎患者阴道人型支原体(Mh) 与阴道菌丛改变的关系。方法123(12.3% )例妇女Mh 培养阳性,873 例Mh 培养阴性为对照组。阴道炎Mh 培养阳性组中50 例有细菌性阴道炎,对照组中81 例妇女检出细菌性阴道炎。用Logistic 回归分析。结果 Mh 阳性组较对照组阴道有明显鱼腥臭味,氨试验阳性,阴道pH> 4.7,并出现线索细胞;Mh 阳性组阴道菌丛改变较大。结论 表明Mh 感染与生殖器症状与及阴道菌丛改变有关联。  相似文献   

17.
目的 探讨20例阴道内放置NuvaRing避孕环后微环境的变化。方法 对20例使用过避孕环的妇女(自身对照), 利用阴道炎五联检法和显微镜观察法处理带环前后不同周期的阴道分泌物, 并用放射免疫法检测阴道灌洗液中炎性因子IL-2和IL-8在带环前后不同浓度的变化。结果 与放置阴道避孕环前比较, 炎性因子IL-2和IL-8带环1个周期后浓度呈上升趋势(P<0.05);带环3、6个周期后IL-2、IL-8浓度逐渐下降并趋于正常(P>0.05)。经阴道五联检及显微镜下检测, 阴道分泌物的pH值、白细胞、乳酸杆菌、细菌性阴道病(BV)、霉菌性阴道炎(VVC)、滴虫性阴道炎(TV)各项与带环前无明显变化。结论 阴道放置避孕环后对炎性因子IL-2、IL-8初期有所影响, 但随着阴道对环的适应及机体自身的调节会使IL-2、IL-8逐渐趋于正常;同时阴道环对阴道分泌物中的乳酸环境无明显影响, 不会导致其他杂菌的生长。  相似文献   

18.
目的探讨山东省农村地区已婚育龄妇女细菌性阴道病的患病现状及危险因素,为制定干预措施提供参考依据。方法按经济水平分层整群随机抽样,对4个抽样点已婚育龄妇女进行细菌性阴道病流行病学调查。结果细菌性阴道病患病率为6·64%。主要危险因素为无专用的洗澡盆、巾,经期不使用消毒卫生巾,不知道淋病、梅毒、艾滋病、阴道滴虫可以经性生活传播等。结论农村育龄妇女细菌性阴道病患病率高与文化水平低、卫生知识知晓率低及不良的卫生行为有关。  相似文献   

19.
Background  Previous studies have shown evidence of health-related risk behaviors among women who have sex with women (WSW), such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections (RTI)/sexually transmitted infections (STI).
Methods  Participants were recruited through outreach in venues and online for a cross-sectional study. Data was collected using interviews and laboratory tests.
Results  We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% (206/224) of women reported sexual relations with women. The RTI rates were: gonorrhea (15.8%), Chlamydia (3.5%), syphilis (0.5%), bacterial vaginosis (BV) (14.4%), hepatitis B virus (HBV) (0.9%), hepatitis C virus (HCV) (0.5%), and candidiasis (6.9%). No HIV or herpes simplex virus (HSV) positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency [odds ratio (OR)=2.1, 95% confidence interval (CI): 1.2 to 3.8] and genital-genital contact (OR=3.1, 95% CI: 1.3 to 7.2); factors associated with curable STI (excluding BV, candidiasis, HBV and HCV) were non-Beijing local residency (OR=1.9; 95% CI: 1.2 to 3.0) and bleeding during or after sex (OR=18.1; 95% CI: 5.2 to 62.6); and the factor associated with RTI (including all the infections tested) was bleeding during or after sex (OR=37.8, 95% CI: 11.2 to 127.4).
Conclusions  Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planning corresponding prevention and interventions.
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20.
ObjectiveTo survey the prevalence and risk factors of HSV-2 among Chinese and Vietnamese female sex workers (FSW) in the border county of Hekou, Yunnan Province, China.MethodsA cross-sectional survey was conducted on demographics, sexual behavior, medical history, and drug use among FSWs. Laboratory samples were obtained to test for HSV-2 and other STIs such as HIV, Syphilis, Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Bacterial vaginosis, and Yeast infections. Cervicitis and genital warts were also diagnosed.ResultsOf the 345 FSWs who participated in this study, 112 (32.5%) were ethnic Chinese and 233 (67.5) were Vietnamese. Among FSWs in Hekou, the prevalence rates were 58.3% for HSV-2, 5.5% for HIV, and 4.1% for bacterial vaginosis (BV). Age <21 (OR: 0.5; 95% CI: 0.3, 0.8), duration of commercial sex work ≤3 months (OR: 0.5; 95% CI: 0.3, 0.8), oral and vaginal sex with the last client (as opposed to only vaginal sex) (OR: 1.6; 95% CI: 1.0, 2.7), HIV (OR: 11.4; 95% CI: 1.5, 87.2), and bacterial vaginosis (BV) (OR: 5.6; 95% CI: 1.2, 26.9) were significantly correlated with HSV-2 infection.ConclusionMultivariate analysis showed that several factors were significantly correlated with the high prevalence of HSV-2 in FSWs in the border area between China and Vietnam. Further studies and interventions are needed for HSV-2 epidemiology in the border area.  相似文献   

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