1.Phenylpropanoids from roots of Berberis polyantha.
Dong-Mei SHA ; Shuai-Cong NI ; Li-Niu SHA-MA ; Hai-Xiao-Lin-Mo MA ; Xiao-Yong HE ; Bin HE ; Shao-Shan ZHANG ; Ying LI ; Jing WEN ; Yuan LIU ; Xin-Jia YAN
China Journal of Chinese Materia Medica 2025;50(6):1564-1568
The chemical constituents were systematically separated from the roots of Berberis polyantha by various chromatographic methods, including silica gel column chromatography, HP20 column chromatography, polyamide column chromatography, reversed-phase C_(18) column chromatography, and preparative high-performance liquid chromatography. The structures of the compounds were identified by physicochemical properties and spectroscopic techniques(1D NMR, 2D NMR, UV, MS, and CD). Four phenylpropanoids were isolated from the methanol extract of the roots of B. polyantha, and they were identified as(2R)-1-(4-hydroxy-3,5-dimethoxyphenyl)-1-propanone-O-β-D-glucopyranoside(1), methyl 4-hydroxy-3,5-dimethoxybenzoate(2),(+)-syringaresinol(3), and syringaresinol-4-O-β-D-glucopyranoside(4). Compound 1 was a new compound, and other compounds were isolated from this plant for the first time. The anti-inflammatory activity of these compounds was evaluated based on the release of nitric oxide(NO) in the culture of lipopolysaccharide(LPS)-induced RAW264.7 macrophages. At a concentration of 10 μmol·L~(-1), all the four compounds inhibited the LPS-induced release of NO in RAW264.7 cells, demonstrating potential anti-inflammatory properties.
Plant Roots/chemistry*
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Animals
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Mice
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Berberis/chemistry*
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RAW 264.7 Cells
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Macrophages/immunology*
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Drugs, Chinese Herbal/isolation & purification*
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Nitric Oxide/metabolism*
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Molecular Structure
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Anti-Inflammatory Agents/isolation & purification*
2.Research progress of the effect of psychosocial adaptation on quality of life in patients with vascular malformation
Mengyin CHENG ; Guangzhen HU ; Niu NI ; Yan ZHENG
Chinese Journal of Plastic Surgery 2025;41(11):1219-1223
Patients with vascular malformation was prone to a series of maladaptive psychosocial, which not only impaired the disease prognosis, but also increased their psychological and economic burden, thus affecting their well-being and quality of life. Therefore, psychosocial adaptation was of great significance to improve the quality of life of patients with vascular malformations. This study was to review the status quo of the psychosocial adaptation, the status quo of quality of life, and the impact of psychosocial adaptation on quality of life among patients with vascular malformation, in order to provide theoretical basis for improving the quality of life of patients with vascular malformation.
3.Characteristics of drug resistance genes in HIV-infected individuals and AIDS patients in Fuyang,2023—2024
Xiaohui YANG ; Jingyi NIU ; Jie NI ; Yanhai WANG
Chinese Journal of Experimental and Clinical Virology 2025;39(4):487-495
Objective:To analyze the distribution of human immunodeficiency virus 1(HIV-1)genotypes and antiretroviral drug resistance patterns among individuals infected with HIV and patients with acquired immunodeficiency syndrome(AIDS)in Fuyang,with the aim of informing the optimization of antiretroviral therapy strategies.Methods:Blood samples were collected from HIV/AIDS patients who failed antiviral treatment in Fuyang from 2023 to 2024,as well as newly reported HIV-infected individuals who were first diagnosed and did not receive antiviral treatment. The HIV-1 pol gene was amplified and sequenced. Genotypic resistance was assessed using the Stanford University HIV Drug Resistance Database,and analyses were conducted on HIV-1 subtypes and drug resistance-associated mutations.Results:A total of 571 HIV/AIDS patients were included in this study,comprising 320 newly reported HIV-infected individuals and 251 HIV/AIDS patients who failed antiviral treatment. Both groups were predominantly male,middle-aged and elderly individuals over 45 years old,and heterosexual contact was the primary transmission route. The most prevalent HIV-1 subtypes differed between groups:CRF07_BC(36.88%,118/320)dominated among newly reported HIV-infected patients,whereas subtype B(43.03%,108/251)was predominant in HIV/AIDS patients who failed antiviral treatment. The drug resistance rate was significantly lower in newly reported HIV-infected patients(15.63%,50/320)compared to the HIV/AIDS patients who failed antiviral treatment(38.25%,96/251; χ2=37.825, P<0.001). Non-nucleoside reverse transcriptase inhibitors(NNRTIs)exhibited the highest resistance rates in both cohorts. Compared to newly reported HIV-infected patients,HIV/AIDS patients who failed antiviral treatment showed a significantly higher prevalence of drug resistance mutations( P<0.001),with greater diversity in mutation patterns. Key resistance-associated mutation site demonstrated statistically significant differences in mutation rates between the two groups( P<0.05). The results of the molecular transmission network showed that the proportion of elderly people over 60 years old and patients with CRF07_BC and B subtypes was higher among the networked cases in the two groups of newly reported and antiviral treatment failure. Conclusion:The study revealed a diverse distribution of HIV-1 subtypes among HIV/AIDS patients in Fuyang. NNRTIs exhibited the most prominent resistance challenges,accompanied by diversified resistance mutation profiles. These findings highlight the need for enhanced surveillance of resistance to curb the spread of resistant strains and improve clinical outcomes.
4.Research progress of the effect of psychosocial adaptation on quality of life in patients with vascular malformation
Mengyin CHENG ; Guangzhen HU ; Niu NI ; Yan ZHENG
Chinese Journal of Plastic Surgery 2025;41(11):1219-1223
Patients with vascular malformation was prone to a series of maladaptive psychosocial, which not only impaired the disease prognosis, but also increased their psychological and economic burden, thus affecting their well-being and quality of life. Therefore, psychosocial adaptation was of great significance to improve the quality of life of patients with vascular malformations. This study was to review the status quo of the psychosocial adaptation, the status quo of quality of life, and the impact of psychosocial adaptation on quality of life among patients with vascular malformation, in order to provide theoretical basis for improving the quality of life of patients with vascular malformation.
5.Characteristics of drug resistance genes in HIV-infected individuals and AIDS patients in Fuyang,2023—2024
Xiaohui YANG ; Jingyi NIU ; Jie NI ; Yanhai WANG
Chinese Journal of Experimental and Clinical Virology 2025;39(4):487-495
Objective:To analyze the distribution of human immunodeficiency virus 1(HIV-1)genotypes and antiretroviral drug resistance patterns among individuals infected with HIV and patients with acquired immunodeficiency syndrome(AIDS)in Fuyang,with the aim of informing the optimization of antiretroviral therapy strategies.Methods:Blood samples were collected from HIV/AIDS patients who failed antiviral treatment in Fuyang from 2023 to 2024,as well as newly reported HIV-infected individuals who were first diagnosed and did not receive antiviral treatment. The HIV-1 pol gene was amplified and sequenced. Genotypic resistance was assessed using the Stanford University HIV Drug Resistance Database,and analyses were conducted on HIV-1 subtypes and drug resistance-associated mutations.Results:A total of 571 HIV/AIDS patients were included in this study,comprising 320 newly reported HIV-infected individuals and 251 HIV/AIDS patients who failed antiviral treatment. Both groups were predominantly male,middle-aged and elderly individuals over 45 years old,and heterosexual contact was the primary transmission route. The most prevalent HIV-1 subtypes differed between groups:CRF07_BC(36.88%,118/320)dominated among newly reported HIV-infected patients,whereas subtype B(43.03%,108/251)was predominant in HIV/AIDS patients who failed antiviral treatment. The drug resistance rate was significantly lower in newly reported HIV-infected patients(15.63%,50/320)compared to the HIV/AIDS patients who failed antiviral treatment(38.25%,96/251; χ2=37.825, P<0.001). Non-nucleoside reverse transcriptase inhibitors(NNRTIs)exhibited the highest resistance rates in both cohorts. Compared to newly reported HIV-infected patients,HIV/AIDS patients who failed antiviral treatment showed a significantly higher prevalence of drug resistance mutations( P<0.001),with greater diversity in mutation patterns. Key resistance-associated mutation site demonstrated statistically significant differences in mutation rates between the two groups( P<0.05). The results of the molecular transmission network showed that the proportion of elderly people over 60 years old and patients with CRF07_BC and B subtypes was higher among the networked cases in the two groups of newly reported and antiviral treatment failure. Conclusion:The study revealed a diverse distribution of HIV-1 subtypes among HIV/AIDS patients in Fuyang. NNRTIs exhibited the most prominent resistance challenges,accompanied by diversified resistance mutation profiles. These findings highlight the need for enhanced surveillance of resistance to curb the spread of resistant strains and improve clinical outcomes.
6.Value of intraperitoneal soluble interleukin-6 receptor in predicting ultrafiltration insufficiency in peritoneal dialysis patients
Han LI ; Wei NIU ; Xinyu SU ; Yiwei SHEN ; Hao YAN ; Zhenyuan LI ; Zanzhe YU ; Jiangzi YUAN ; Na JIANG ; Jiaying HUANG ; Zhaohui NI ; Leyi GU ; Wei FANG
Chinese Journal of Nephrology 2024;40(6):442-450
Objective:To investigate the value of soluble interleukin-6 (IL-6) receptor (sIL-6R) level in predicting ultrafiltration insufficiency in peritoneal dialysis (PD) patients.Methods:It was a prospective cohort study. The patients who received continuous ambulatory PD and regular follow-up between November 2016 and July 2018 in the PD Center of Renji Hospital, School of Medicine, Shanghai Jiao Tong University were enrolled. Enzyme-linked immunosorbent assay was used to determine dialysate sIL-6R and its appearance rate (AR) was calculated. Patients were divided into high sIL-6R AR group and low sIL-6R AR group according to median value of sIL-6R AR and prospectively followed up until death, PD cessation, or the end of the study (December 31, 2022). Multiple linear regression was used to analyze the related factors of sIL-6R AR. Kaplan-Meier method and log-rank test were used to compare the survival rate difference of ultrafiltration insufficiency between high sIL-6R AR group and low sIL-6R AR group. Multivariate Cox regression and multivariate competing risk models were used to assess the risk factors associated with occurrence of ultrafiltration insufficiency.Results:A total of 198 PD patients were enrolled, including 115 (58.1%) males, with age of (54.9±13.7) years old and PD duration of 22.5 (6.6, 65.0) months. The sIL-6R AR of the cohort was 2 094.7 (1 672.4, 2 920.9) pg/min. Compared with low sIL-6R AR(<2 094.7 pg/min)group, high sIL-6R AR(>2 094.7 pg/min)group had older age ( t=-3.269, P=0.001), higher body mass index ( t=-3.248, P=0.001), proportion of combined diabetes mellitus ( χ2=8.890, P=0.003), 24 h glucose exposure ( Z=-2.257, P=0.024), 24 h ultrafiltration capacity ( Z=-2.515, P=0.012), 4 h dialysate creatinine to serum creatinine ratio ( t=-2.609, P=0.010), mass transfer area coefficient of creatinine ( Z=-2.308, P=0.021), IL-6 AR ( Z=-3.533, P<0.001) and solute glycoprotein 130 AR ( Z=-8.670, P<0.001), and lower serum albumin ( t=2.595, P=0.010) and residual renal function ( t=2.133, P=0.033). Multiple linear regression analysis showed that body mass index ( β=0.194, P=0.005), serum albumin ( β=-0.215, P=0.002) and dialysate lg[IL-6 AR] ( β=0.197, P=0.011) were independently correlated with sIL-6R AR. By the end of the study, 57 (28.8%) patients developed ultrafiltration insufficiency. Kaplan-Meier analysis showed that high sIL-6R AR group had a significantly inferior ultrafiltration insufficiency-free survival rate than that in low sIL-6R AR group (log-rank χ 2=5.375, P=0.020). Multivariate Cox regression analysis and multivariate competing risk models showed that high dialysate sIL-6R AR (>2 094.7 pg/min) was an independent influencing factor of ultrafiltration insufficiency ( HR=2.286 , 95% CI 1.254-4.165 , P=0.007 ; SHR=2.074, 95% CI 1.124-3.828, P=0.020) in PD patients. Conclusions:Dialysate sIL-6R level was associated with body mass index, serum albumin and dialysate IL-6 level. Dialysate sIL-6R may be a predictive factor of ultrafiltration insufficiency in PD patients.
7.HUVEC-Based OGD/R Injury Model to Study the Effect of Danggui-Chuanxiong Herb Pair Medicine on the Main Pharmacological Components on VEGF-PI3K-AKT/NF-κB Signaling Pathway
Qiuru JI ; Wenjuan NI ; Xiaoyan WANG ; Shuqi ZHANG ; Yali WU ; Lu NIU ; Kun LI ; Weixia LI ; Jinfa TANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(3):691-703
Objective To study the effects of Danggui-Chuanxiong herb pair medicine on vasoactive substances,adhesion factors,inflammatory factors,and VEGF-PI3K-AKT/NF-κB signaling pathways,in order to elucidate the mechanism of Danggui-Chuanxiong herb pair on the treatment of ischemic stroke(IS).Methods The oxygen glucose deprivation/reoxygenation(OGD/R)model of human umbilical vein endothelial cells(HUVEC)was constructed,and the cell viability was detected by cell proliferation kit(CCK-8 method)to explore the optimal modeling time of seven components;The release of lactate dehydrogenase(LDH)was detected by cytotoxicity kit;The expression of related cytokines was detected by enzyme-linked immunosorbent assay(ELISA);The mRNA expression of key proteins in the signaling pathway was detected by reverse transcription-polymerase chain reaction(RT-PCR).Results Reoxygenation after 6 h of oxygen-glucose deprivation of HUVEC is the best modeling time.High-dose chlorogenic acid group,ferulic acid group,senkyunolide H,low-dose and medium-dose butylidenephthalide group,medium-dose and high-dose senkyunolide A and ligustilide groups significantly decreased LDH leakage rate(P<0.05,P<0.01);The expression of IL-6 in the cells of the partial dose group of chlorogenic acid,caffeic acid,butenylphthalide,senkyunolide H and senkyunolide A was significantly increased,the expression of IL-1 in the cells of the partial dose group of chlorogenic acid,ferulic acid and senkyunolide A was significantly decreased,the expression of VEGF,ICAM-1 and VCAM-1 in the cells of the partial dose group of chlorogenic acid,ferulic acid and senkyunolide H was significantly decreased,the expression of NF-κB in the cells of the partial dose group of chlorogenic acid,ferulic acid,senkyunolide H and ligustilide was significantly decreased,the expression of PAI-1 in the cells of ferulic acid and senkyunolide H partial dose group decreased significantly(P<0.05,P<0.01);The mRNA relative expression levels of ERK,VEGF,NF-κB,VEGFR2 and MMP9 were significantly down-regulated in the cells of chlorogenic acid,ferulic acid,caffeic acid,butylidenephthalide and senkyunolide A partial dose group,while the mRNA relative expression levels of AKT were significantly up-regulated in the cells of senkyunolide H and senkyunolide A partial dose groups(P<0.05,P<0.01).Conclusion The medicinal components of Danggui-Chuanxiong herb pair may play a role in IS by inhibiting the mRNA expression of adhesion factor,inflammatory factor and key protein of VEGF-PI3K-AKT/NF-κB signaling pathway in HUVEC.
8.Impact of rehabilitation exercise intervention mode based on cardiac function classification on clinical effect and quality of life in CHF patients
Juan LI ; Hui CAO ; Lin-Na HUI ; Yan-Ling WANG ; Dan NIU ; Yan-Rong ZHANG ; Ya-Ni ZHANG ; Xia DU ; Wen-Ting LI
Chinese Journal of cardiovascular Rehabilitation Medicine 2024;33(3):270-276
Objective:To explore the impact of rehabilitation exercise intervention mode based on cardiac function classification on clinical effect and quality of life(QOL)in patients with chronic heart failure(CHF).Methods:A total of 160 CHF patients who visited our hospital from Dec 2021 to Jan 2023 were selected,and 154 cases were fi-nally enrolled.According to the random number table method,patients were divided into study group and control group with 77 cases in each group.Control group received routine nursing program,while the study group received rehabilitation exercise intervention based on cardiac function classification on the basis of control group,both groups were intervened for three months.Clinical total effective rate,and cardiopulmonary function,serum oxidative stress indicators and MLHFQ score before and after intervention were compared between two groups.Results:Total effective rates of study subgroups of class Ⅱ and Ⅲ were significantly higher than those of control group(class Ⅱ:100.00%vs.83.78%;class Ⅲ:97.37%vs.80.00%)(P<0.05 both).Compared with control subgroup of classⅢ after intervention,there were significant rise in peak VO2[(16.98±2.03)ml·min-1·kg-1 vs.(18.61±2.41)ml·min-1·kg-1],LVEF[(41.73±4.53)%vs.(48.03±5.22)%]and 6MWD[(351.34±61.00)m vs.(391.53±64.42)m](P<0.01 all);and significant reductions in LVEDd[(57.55±3.91)mm vs.(53.18±3.07)mm],LVESd[(35.90±2.91)mm vs.(30.50±2.67)mm],levels of LPO[(6.00±0.99)mg/L vs.(3.95±0.61)mg/L],MPO[(3.83±0.58)mg/L vs.(2.03±0.28)mg/L],and MLHFQ total score[(57.05±4.57)points vs.(45.29±3.94)points]in study subgroup of class Ⅲ(P=0.001 all).Compared with control subgroup of class Ⅱ after intervention,there were significant rise in peak VO2,LVEF and 6MWD,and significant reductions in LVEDd,LVESd,levels of LPO,MPO and MLHFQ score in study subgroup of class Ⅱ,P<0.05 or<0.01.There was no significant difference in the incidence rate of adverse events during follow-up between two groups(3.90%vs.6.49%,P=0.717).Conclusion:Rehabilitation exercise intervention based on cardiac function classifi-cation can significantly improve cardiopulmonary function,inhibit oxidative stress response in vivo and improve quality of life in CHF patients,which is worthy of promotion and application in clinical practice.
9.High-throughput screening of novel TFEB agonists in protecting against acetaminophen-induced liver injury in mice.
Xiaojuan CHAO ; Mengwei NIU ; Shaogui WANG ; Xiaowen MA ; Xiao YANG ; Hua SUN ; Xujia HU ; Hua WANG ; Li ZHANG ; Ruili HUANG ; Menghang XIA ; Andrea BALLABIO ; Hartmut JAESCHKE ; Hong-Min NI ; Wen-Xing DING
Acta Pharmaceutica Sinica B 2024;14(1):190-206
Macroautophagy (referred to as autophagy hereafter) is a major intracellular lysosomal degradation pathway that is responsible for the degradation of misfolded/damaged proteins and organelles. Previous studies showed that autophagy protects against acetaminophen (APAP)-induced injury (AILI) via selective removal of damaged mitochondria and APAP protein adducts. The lysosome is a critical organelle sitting at the end stage of autophagy for autophagic degradation via fusion with autophagosomes. In the present study, we showed that transcription factor EB (TFEB), a master transcription factor for lysosomal biogenesis, was impaired by APAP resulting in decreased lysosomal biogenesis in mouse livers. Genetic loss-of and gain-of function of hepatic TFEB exacerbated or protected against AILI, respectively. Mechanistically, overexpression of TFEB increased clearance of APAP protein adducts and mitochondria biogenesis as well as SQSTM1/p62-dependent non-canonical nuclear factor erythroid 2-related factor 2 (NRF2) activation to protect against AILI. We also performed an unbiased cell-based imaging high-throughput chemical screening on TFEB and identified a group of TFEB agonists. Among these agonists, salinomycin, an anticoccidial and antibacterial agent, activated TFEB and protected against AILI in mice. In conclusion, genetic and pharmacological activating TFEB may be a promising approach for protecting against AILI.
10.Establishment of an Engineered Bacterial Membrane Biomimetic Nanodrug Delivery System and Its Role in the Treatment of Glioma
Yinzhen ZHAO ; Yulin LI ; Jiao LI ; Mingli NI ; Jichuang WANG ; Xiaojun WANG ; Lei CHENG ; Wenge NIU ; Yingfu ZHANG ; Yunlong WANG
Journal of Sichuan University (Medical Sciences) 2024;55(4):861-871
Objective To develop engineered bacterial membrane biomimetic nanoparticles,Angiopep-2 E.coli membrane(ANG-2 EM)@PDA-PEI-CpG(ANG-2 EM@PPC),for efficient targeted drug delivery in the treatment of glioma,and to provide theoretical and technical support for targeted glioma therapy.Methods The expression of inaX-N-angiopep-2 engineered bacteria was constructed in the laboratory,and ANG-2 EM was obtained through lysozyme treatment and ultrafiltration centrifugation.ANG-2 EM@PPC was prepared by ultrasonication of bacterial membranes.Western blotting,agarose gel electrophoresis,and transmission electron microscopy(TEM)were used to verify the preparation.Particle size and Zeta potential were measured to investigate the stability of ANG-2 EM@PPC.Regarding cell experiments,CCK-8 assay was performed to determine the effect of ANG-2 EM@PPC on the survival rate of neutrophils.A flow chamber model was designed and constructed,and the uptake efficiency of neutrophils was measured by flow cytometry to investigate the hitchhiking efficiency of ANG 2 EM@PPC on neutrophils in inflammatory environment.Neutrophil death patterns were characterized by fluorescence microscopy,and flow cytometry and Western blotting were performed to examine neutrophil apoptotic bodies and the proportion of apoptotic bodies produced.Regarding animal experiments,a mouse model of in situ glioma was established and the inflammatory environment of tumor tissue was verified.The tumor model mice were divided into three groups,including DiR group,EM@PPC group,and ANG-2 EM@PPC group(all n=3),which were injected with DiR,ANG-2 EM@PDA-PEI-CpG,and EM@PDA-PEI-CpG via the tail vein,respectively(all at 10 mg/kg).Fluorescence images of organs and the brain were used to examine the distribution of the three formulations in vivo and in the brain.The tumor model mice were further divided into PBS group,PDA group,PC group,PPC group,EM@PPC group,and ANG-2 EM@PPC group(all n=4),which were injected with PBS,PDA,PC,PPC,EM@PPC,and ANG-2 EM@PPC injected via the tail vein,respectively(all at 10 mg/kg).Imaging was performed in vivo to observe tumor regression,and the survival rate and body mass of mice were measured to evaluate in vivo pharmacodynamics.TUNEL staining(brain tissue)and HE staining(brain,heart,liver,spleen,lung and kidney tissues)were performed to evaluate the therapeutic effect.Results The results of TEM showed successful preparation of engineered bacterial membrane biomimetic nanoparticles,with PPC exhibiting a distinct shell-core structure and a shell thickness of about 8.2 nm.Due to the coating of ANG-2 EM,the shell thickness of ANG-2 EM@PPC increased to about 9.6 nm,with a clear bacterial membrane layer on the surface.Stability was maintained for at least one week.ANG-2 EM@PPC had no significant effect on the activity of neutrophils according to the findings from the CCK-8 assay.Flow cytometry showed that ANG-2 EM@PPC uptake is enhanced in activated neutrophils and hitchhiking on neutrophils was more efficient in the stationary state than that in the flowing condition.Compared with the EM@PPC group,the neutrophil hitchhiking ability of the ANG-2 EM@PPC group was enhanced(uptake efficiency 24.9%vs.31.1%).Fluorescence microscopy showed that ANG-2 EM@PPC changed the death pathway of neutrophils from neutrophil extracellular traps-osis(NETosis)to apoptosis.Western blot confirmed the production of neutrophil apoptotic bodies,and flow cytometry showed that the production rate was as high as 77.7%.Animal experiments showed that there was no significant difference in the distribution of engineered bacterial membrane biomimetic nanoparticles in the organs(heart,liver,spleen,lungs,and kidney)in the DiR group,the EM@PPC gropu,and the ANG-2 EM@PPC group(P>0.05),but there was higher distribution in the brain tissue in EM@PPC and ANG-2 EM@PPC groups compared to the DiR group(P<0.05).Engineered bacterial membrane biomimetic nanoparticles crossed the blood-brain barrier(BBB),and exhibited high affinity to and internalization by neutrophils located in brain tumors.Compared with PBS,PDA,PC,and PPC groups,the survival rate and body mass of mice in the EM@PPC group were improved,tumor fluorescence intensity was weakened,and apoptotic cells were increased.These trends were even more prominent in the ANG-2 EM@PPC group.No abnormality was found in the HE staining of any group.Conclusion An ANG-2 EM@PPC nanodelivery system with inflammation response characteristics was successfully prepared,capable of crossing BBB and targeting the tumor inflammatory microenvironment to improve the anti-glioma efficacy.This study provides a new drug delivery strategy for glioma treatment and offers a new idea for targeted drug delivery in the non-invasive inflammatory microenvironments in other central nervous system diseases.

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