1.Visualization analysis of studies on Oncomelania hupensis control from 2005 to 2024
Wen ZHU ; Huatang LUO ; Hao WANG ; Yuelin XIONG ; Cong LIU
Chinese Journal of Schistosomiasis Control 2026;38(1):84-91
Objective To analyze Chinese and English publications pertaining to Oncomelania hupensis control from 2005 to 2024, so as to decipher the research status and hotspots of O. hupensis control. Methods Chinese and English publications pertaining to O. hupensis control from 2005 to 2024 were retrieved in the Web of Science Core Collection Database and China National Knowledge Infrastructure. The annual number of publications was analyzed from 2005 to 2024, and the author and institution cooperation networks were mapped using the software CiteSpace 6.3.1. Keywords were extracted from publications to map the co-occurrence, burst and timeline of keywords to identify the research hotspots of O. hupensis control. Results A total of 158 English publications and 771 Chinese publications were included for bibliometric analyses. The overall output of English publications was relatively small from 2005 to 2024, the annual average publication was 7.90 publications. Parasites & Vectors was the most productive journal by the number of publications (21 publications). The three most productive authors included Li Shizhu (24 publications), Zhou Xiaonong (13 publications), and Yang Kun (12 publications), and the three most productive institutions included Chinese Center for Disease Control and Prevention (49 publications), the WHO (27 publications), and Fudan University (25 publications). The annual average number of Chinese publications was high from 2005 to 2015 (57.73 publications), and reduced to 15.11 publications during the period from 2016 to 2024, with Chinese Journal of Schistosomiasis Control as the most productive journal (241 publications). The three most productive authors included Wang Wanxian (18 publications), Sun Qixiang (16 publications), and Dai Jianrong (16 publications), and the three most productive institutions included Jiangsu Institute of Parasitic Diseases (55 publications), Chinese Center for Disease Control and Prevention (47 publications), and Hubei Uni-versity (38 publications). Among the 158 English publications, molluscicidal effect, climate change, geographic information, biological control, machine learning were current research hotspots, and the Yangtze River and elimination were emerging research hotspots. Among the 771 Chinese publications, molluscicidal effect, niclosamide, comprehensive management, molluscicide, effectiveness evaluation, marshland, and endophyte were current research hotspots, and the future research hotspots shifted to molluscicidal effect and pyriclobenzuron. Conclusions Limited attention is paid to the research on O. hupensis control across the world. The Yangtze River, elimination, molluscicidal effect, and pyriclobenzuron may be future research hotspots. High attention is recommended to be paid to the research on O. hupensis control, and development of diverse approaches for O. hupensis control is of urgent needs. We should continue to attach importance to the control research of O. hupensis and strengthen the exploration of diverse snail extermination and control methods.
2.Effectiveness of the integrated schistosomiasis control programme in Wuhan City from 2005 to 2023
Shuai WANG ; Huatang LUO ; Yang LI ; Hao WANG ; Cong LIU ; Yuelin XIONG ; Jiajing ZHANG ; Wen ZHU
Chinese Journal of Schistosomiasis Control 2025;37(2):176-183
Objective To evaluate the effectiveness of the integrated schistosomiasis control programme in Wuhan City from 2005 to 2023, so as to provide insights into precision control and elimination of schistosomiasis. Methods The integrated measures for schistosomiasis control implemented by health, agriculture, water resources, and forestry departments of Wuhan City, and the epidemiological data of schistosomiasis in Wuhan City were collected from 2005 to 2023, and the prevalence of human schistosomiasis, prevalence of Schistosoma japonicum infections in humans and bovines, areas of S. japonicum-infected snail habitats, areas of snail habitats in inner embankments, and actual areas of snail habitats were retrieved. In addition, the trends in prevalence of schistosomiasis in humans and livestock and snail status were evaluated in Wuhan City from 2005 to 2023 using Mann-Kendall test and a Joinpoint regression model. Results Mann-Kendall test revealed a tendency towards a decline in the prevalence of human schistosomiasis (Z = -4.41, P < 0.01), prevalence of S. japonicum infections in humans (Z = -4.89, P < 0.01) and bovines (Z = -4.50, P < 0.01), areas of S. japonicum-infected snail habitats (Z = -3.91, P < 0.01), areas of snail habitats in inner embankments (Z = -2.28, P = 0.02), and actual areas of snail habitats (Z = -5.95, P < 0.01) in Wuhan City from 2005 to 2023. Joinpoint regression analysis showed an average annual reduction of 8.58% in the prevalence of human schistosomiasis in Wuhan City from 2005 to 2023 [average annual percent change (AAPC) = -8.58%, 95% confidence interval (CI): (-10.02%, -6.65%), P < 0.01], with two joinpoints in 2013 and 2016, respectively, and the tendency towards a decline showed statistical significance during the period from 2013 through 2016 [annual percent change (APC) = -34.41%, 95% CI: (-40.36%, -20.01%), P < 0.01]. The prevalence of S. japonicum human infections appeared an average annual reduction of 51.91% in Wuhan City from 2005 to 2023 [AAPC = -51.91%, 95% CI: (-58.12%, -44.25%), P < 0.01], with two joinpoints in 2014 and 2017, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.17%, 95% CI: (-99.17%, -90.87%), P < 0.01]. The prevalence of S. japonicum infections in bovines appeared an average annual reduction of 53.12% in Wuhan City from 2005 to 2023 [AAPC = -53.12%, 95% CI: (-59.65%, -42.44%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.63%, 95% CI: (-99.44%, -90.93%), P < 0.01]. The areas of S. japonicum-infected snail habitats appeared an average annual reduction of 47.09% in Wuhan City from 2005 to 2023 [AAPC = -47.09%, 95% CI: (-52.92%, -38.26%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2011 through 2014 [APC = -97.27%, 95% CI: (-98.65%, -88.06%), P < 0.01]. The areas of snail habitats in inner embankments appeared an average annual reduction of 4.45% in Wuhan City from 2005 to 2023 [AAPC = -4.45%, 95% CI: (-5.18%, -3.82%), P < 0.01], with three joinpoints in 2011, 2015 and 2018, respectively, and statistical significance was seen in the tendency towards a decline during the period from 2005 through 2011 [APC = -16.38%, 95% CI: (-20.15%, -14.25%), P < 0.01]. In addition, the actual areas of snail habitats appeared an average annual reduction of 2.65% in Wuhan City from 2005 to 2023 [AAPC = -2.65%, 95% CI: (-2.89%, -2.40%), P < 0.01], with a joinpoint in 2013, and the tendency towards a decline showed statistical significance during the period from 2013 through 2023 [APC = -4.06%, 95% CI: (-4.66%, -3.58%), P < 0.01]. Conclusions The integrated schistosomiasis control programme achieved significant effectiveness in Wuhan City from 2005 to 2023, with a tendency towards a decline in morbidity due to schistosomiasis in humans and livestock and snail status. The integrated schistosomiasis control strategy with emphasis on management of the source of S. japonicum infections should continue to be implemented to consolidate the schistosomiasis control achievements and achieve the goal of schistosomiasis elimination in the city.
3.A survey on the cognition of mpox expertise among relevant clinicians in China
Zewei CHEN ; Wenqian ZHU ; Yuelin WU ; Shiqing LIANG ; Xiaoli YUE ; Jing LI ; Jiahui ZHANG ; Xiangdong GONG
Chinese Journal of Epidemiology 2025;46(2):239-244
Objective:To investigate and evaluate the correct cognition and influencing factors of mpox expertise among relevant Chinese clinicians and to provide a reference for prevention and control.Methods:A cross-sectional survey was conducted among clinicians in relevant departments using a structured questionnaire compiled by ourselves through a non-random network recruitment method. The content includes demography, clinical specialties, and characteristics of medical institutions, and 37 questions to evaluate the professional cognition of mpox etiology, clinical characteristics, transmission, prevention, and control. Using the modified Bloom's cutoff point to determine the correct answer is greater than or equal to 26 entitled correct cognition. A logistic regression model was used to analyze the factors influencing the correct cognition rate.Results:A total of 4 332 clinicians in 23 provinces (autonomous regions, municipality) in China were investigated by online questionnaires and 4 276 effective questionnaires were collected, with an effective rate of 98.71%. The mean age of the respondents was (39.46±9.54) years old, 61.18% were female. The overall correct cognition rate of mpox expertise was 62.04% (95% CI: 60.59%-63.50%), the correct cognition rates of mpox etiology, clinical characteristics, transmission, prevention and control were 48.25% (95% CI: 46.68%-49.82%), 78.66% (95% CI: 77.38%-79.95%), 68.56% (95% CI: 67.10%-70.02%), respectively. Multivariate logistic regression analysis showed that the relevant factors affecting the overall correct cognition of mpox expertise among Chinese clinicians included gender (female: OR=1.54, 95% CI: 1.31-1.80), region (eastern region: OR=1.46, 95% CI: 1.18-1.79; midwestern region: OR=1.24, 95% CI: 1.04-1.49), professional title (deputy senior: OR=1.43, 95% CI:1.16-1.76; senior: OR=1.72, 95% CI:1.30-2.28), the clinical field (the clinical fields of dermatology and venereal diseases: OR=1.78, 95% CI: 1.42-2.23). Conclusions:The overall correct cognition rate of mpox expertise among relevant Chinese clinicians was low. It was essential to conduct mpox knowledge training for clinicians in males, northeast regions, junior professional title and the clinical fields other than dermatology and venereal diseases to improve their correct cognition rates and epidemic prevention and control ability.
4.Association between big five personality traits, emotional coping information acquisition ability, and depression symptom in Chinese adults
Yuelin YU ; Lei FENG ; Weiwei WANG ; Xuequan ZHU
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(11):1037-1042
Objective:To explore the association between big five personality traits, emotional coping information acquisition ability, and depressive symptoms among Chinese adults, providing theoretical support for behavioral intervention strategies targeting individuals with different personality traits and depressive symptoms.Methods:Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR), a cross-sectional survey conducted from July to September 2021 across 120 cities in China, with 9 966 adults involved. The big five inventory-10 (BFI-10) and patient health questionnaire-9 (PHQ-9) were used to assess personality traits and depressive symptoms, respectively. Emotional coping information acquisition ability was evaluated using a four-point Likert scale. Multivariable binary Logistic regression analysis was performed using R 4.3.1 software to examine associations among big five personality, emotion-coping information acquisition ability, and depressive symptoms.Results:Among the 9 966 surveyed adults, 1 213 individuals(12.2%) who met the PHQ-9 criteria were assessed to have positive depressive symptoms. Difficulties in acquiring emotional coping information were reported by 1 934 individuals(19.4%). The scores of extraversion, agreeableness, neuroticism, openness and conscientiousness in big five personality traits were 6.26±1.58, 7.00±1.49, 6.26±1.49, 6.41±1.52 and 6.91±1.60, respectively. Inter-group comparisons reported statistically significant differences in the five major personality traits between the negative and positive group of depressive symptoms ( χ2=215.39, P<0.05). Logistic regression analysis showed that poor emotional coping information acquisition ability ( B=0.304, OR(95% CI)=1.36(1.15-1.59)) and dominant traits of extraversion ( B=0.597, OR(95% CI)=1.82(1.55-2.13)) or openness ( B=0.321, OR(95% CI)=1.38(1.10-1.72)) were significant risk factors for depression. Conclusions:Chinese adults with big five personality mainly presented as extroversion and openness traits, and with poor emotional coping and information acquisition abilities might be associated with depressive symptoms.
5.Regulation of N-methyl berbamine on intracellular calcium homeostasis
Dongning YANG ; Shi ZHOU ; Yuelin LI ; Junmeng ZHU ; Liying HAO ; Huiyuan HU
Journal of China Medical University 2025;54(2):97-102
Objective To explore the regulatory role of N-methyl berbamine(N-MB)in intracellular calcium homeostasis in H9c2 car-diomyocytes,and,thereby,clarify the possible mechanism of the myocardial protective effect of N-MB.Methods Binding of N-MB to CaV1.2 channels was simulated using the MOE software,and the binding affinity and binding mode were determined.The hCaV1.2 gene was transfected into HEK293 cells,and the effect of N-MB(30 μmol/L)on the CaV1.2 current was detected using the whole-cell patch clamp technique.In addition,a Fluo 3-AM fluorescent probe was loaded into H9c2 cardiomyocytes,and the effect of N-MB(3,30 μmol/L)on intracellular calcium ion concentration was observed under a laser confocal microscope.The effect of N-MB(3,30 μmol/L)on the expression of Ca2+regulation-related genes Cacna1c,Cacnb2,Ryr2,Serca2a,and Ncx1 in H9c2 cardiomyocytes was examined using real-time quantitative PCR.Results N-MB was predicted to bind to CaV1.2 channels.The binding sites mainly involved Phe1191,Thr1420,and Asn771,and the binding modes were H-donor,pi-pi,and pi-H.N-MB(30 μmol/L)significantly inhibited CaV1.2 currents,with an inhibition rate of 76.09%±7.41%.The fluorescence intensity of intracellular Ca2+level in H9c2 cardiomyocytes was significantly enhanced with N-MB treatment(3,30 μmol/L,P<0.01).Compared with the control group,differences in the expression of Cacna1c,Serca2a,and Ncx1 in H9c2 cardiomyocytes were not significant after N-MB(3,30 μmol/L)intervention(P>0.05),whereas the expression of Cacnb2 significantly reduced(P<0.001)and the expression of Ryr2 significantly increased(P<0.05).Conclusion N-MB binds to CaV1.2 calcium channels.N-MB may regulate intracellular calcium homeostasis by inhibiting calcium currents by decreasing the gene expression of CaV1.2 calcium channels.Additionally,N-MB may also increase intracellular Ca2+concentration by promoting the expression of Ryr2,which could be the mechanism underlying the myocardial protective effect of N-MB.
6.Development and validation of an XGBoost-based prediction model for acute liver injury in statin users
Xianglong MENG ; Yuelin YU ; Yexiang SUN ; Peng SHEN ; Zhiqin JIANG ; Yu ZHU ; Yueqi YIN ; Siyan ZHAN ; Shengfeng WANG
Chinese Journal of Pharmacoepidemiology 2025;34(8):867-876
Objective To develop and validate a prediction model to identify high-risk individuals who are at-risk to develop acute liver injury(ALI)within 180 days in new statin users,and to support early clinical intervention.Methods Data were sourced from the Yinzhou Regional Health Information Platform,covering statin initiators aged 18 years and older from January 1,2010,to October 31,2021.The dataset was divided into a derivation cohort and a temporal validation cohort based on the time of statin initiation.Predictors were selected using LASSO regression,and the model was constructed using the extreme gradient boosting(XGBoost)algorithm combined with cost-sensitive learning.Model performance was evaluated using Brier scores,Harrell's C-index,and calibration curves.Results A total of 126,440 statin initiators were included,with 90,542 in the derivation cohort and 35,898 in the validation cohort.Within 180 days of initial statin use,412(0.33%)patients developed ALI,including 305(0.34%)in the derivation cohort and 107(0.30%)in the validation cohort.The final model incorporated 16 predictors,which included demographic characteristics,lifestyle factors,family history,medical history,statin use,and concomitant medication use.The model demonstrated excellent overall performance[Brier score=0.0043,95%CI(0.0038,0.0049)],discrimination[Harrell's C-index=0.761,95%CI(0.725,0.794)],and calibration in internal validation.In temporal validation,the model also performed well[Brier score=0.0044,95%CI(0.0036,0.0052),Harrell's C-index=0.703,95%CI(0.614,0.781)].Conclusion This study develope and validate a prediction model for ALI in statin users,providing clinicians with a reliable tool for individualized risk assessment.This model can help achieve risk stratification and reduce the occurrence of ALI.
7.Association between big five personality traits, emotional coping information acquisition ability, and depression symptom in Chinese adults
Yuelin YU ; Lei FENG ; Weiwei WANG ; Xuequan ZHU
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(11):1037-1042
Objective:To explore the association between big five personality traits, emotional coping information acquisition ability, and depressive symptoms among Chinese adults, providing theoretical support for behavioral intervention strategies targeting individuals with different personality traits and depressive symptoms.Methods:Data were obtained from the Psychology and Behavior Investigation of Chinese Residents (PBICR), a cross-sectional survey conducted from July to September 2021 across 120 cities in China, with 9 966 adults involved. The big five inventory-10 (BFI-10) and patient health questionnaire-9 (PHQ-9) were used to assess personality traits and depressive symptoms, respectively. Emotional coping information acquisition ability was evaluated using a four-point Likert scale. Multivariable binary Logistic regression analysis was performed using R 4.3.1 software to examine associations among big five personality, emotion-coping information acquisition ability, and depressive symptoms.Results:Among the 9 966 surveyed adults, 1 213 individuals(12.2%) who met the PHQ-9 criteria were assessed to have positive depressive symptoms. Difficulties in acquiring emotional coping information were reported by 1 934 individuals(19.4%). The scores of extraversion, agreeableness, neuroticism, openness and conscientiousness in big five personality traits were 6.26±1.58, 7.00±1.49, 6.26±1.49, 6.41±1.52 and 6.91±1.60, respectively. Inter-group comparisons reported statistically significant differences in the five major personality traits between the negative and positive group of depressive symptoms ( χ2=215.39, P<0.05). Logistic regression analysis showed that poor emotional coping information acquisition ability ( B=0.304, OR(95% CI)=1.36(1.15-1.59)) and dominant traits of extraversion ( B=0.597, OR(95% CI)=1.82(1.55-2.13)) or openness ( B=0.321, OR(95% CI)=1.38(1.10-1.72)) were significant risk factors for depression. Conclusions:Chinese adults with big five personality mainly presented as extroversion and openness traits, and with poor emotional coping and information acquisition abilities might be associated with depressive symptoms.
8.A survey on the cognition of mpox expertise among relevant clinicians in China
Zewei CHEN ; Wenqian ZHU ; Yuelin WU ; Shiqing LIANG ; Xiaoli YUE ; Jing LI ; Jiahui ZHANG ; Xiangdong GONG
Chinese Journal of Epidemiology 2025;46(2):239-244
Objective:To investigate and evaluate the correct cognition and influencing factors of mpox expertise among relevant Chinese clinicians and to provide a reference for prevention and control.Methods:A cross-sectional survey was conducted among clinicians in relevant departments using a structured questionnaire compiled by ourselves through a non-random network recruitment method. The content includes demography, clinical specialties, and characteristics of medical institutions, and 37 questions to evaluate the professional cognition of mpox etiology, clinical characteristics, transmission, prevention, and control. Using the modified Bloom's cutoff point to determine the correct answer is greater than or equal to 26 entitled correct cognition. A logistic regression model was used to analyze the factors influencing the correct cognition rate.Results:A total of 4 332 clinicians in 23 provinces (autonomous regions, municipality) in China were investigated by online questionnaires and 4 276 effective questionnaires were collected, with an effective rate of 98.71%. The mean age of the respondents was (39.46±9.54) years old, 61.18% were female. The overall correct cognition rate of mpox expertise was 62.04% (95% CI: 60.59%-63.50%), the correct cognition rates of mpox etiology, clinical characteristics, transmission, prevention and control were 48.25% (95% CI: 46.68%-49.82%), 78.66% (95% CI: 77.38%-79.95%), 68.56% (95% CI: 67.10%-70.02%), respectively. Multivariate logistic regression analysis showed that the relevant factors affecting the overall correct cognition of mpox expertise among Chinese clinicians included gender (female: OR=1.54, 95% CI: 1.31-1.80), region (eastern region: OR=1.46, 95% CI: 1.18-1.79; midwestern region: OR=1.24, 95% CI: 1.04-1.49), professional title (deputy senior: OR=1.43, 95% CI:1.16-1.76; senior: OR=1.72, 95% CI:1.30-2.28), the clinical field (the clinical fields of dermatology and venereal diseases: OR=1.78, 95% CI: 1.42-2.23). Conclusions:The overall correct cognition rate of mpox expertise among relevant Chinese clinicians was low. It was essential to conduct mpox knowledge training for clinicians in males, northeast regions, junior professional title and the clinical fields other than dermatology and venereal diseases to improve their correct cognition rates and epidemic prevention and control ability.
9.Development and validation of an XGBoost-based prediction model for acute liver injury in statin users
Xianglong MENG ; Yuelin YU ; Yexiang SUN ; Peng SHEN ; Zhiqin JIANG ; Yu ZHU ; Yueqi YIN ; Siyan ZHAN ; Shengfeng WANG
Chinese Journal of Pharmacoepidemiology 2025;34(8):867-876
Objective To develop and validate a prediction model to identify high-risk individuals who are at-risk to develop acute liver injury(ALI)within 180 days in new statin users,and to support early clinical intervention.Methods Data were sourced from the Yinzhou Regional Health Information Platform,covering statin initiators aged 18 years and older from January 1,2010,to October 31,2021.The dataset was divided into a derivation cohort and a temporal validation cohort based on the time of statin initiation.Predictors were selected using LASSO regression,and the model was constructed using the extreme gradient boosting(XGBoost)algorithm combined with cost-sensitive learning.Model performance was evaluated using Brier scores,Harrell's C-index,and calibration curves.Results A total of 126,440 statin initiators were included,with 90,542 in the derivation cohort and 35,898 in the validation cohort.Within 180 days of initial statin use,412(0.33%)patients developed ALI,including 305(0.34%)in the derivation cohort and 107(0.30%)in the validation cohort.The final model incorporated 16 predictors,which included demographic characteristics,lifestyle factors,family history,medical history,statin use,and concomitant medication use.The model demonstrated excellent overall performance[Brier score=0.0043,95%CI(0.0038,0.0049)],discrimination[Harrell's C-index=0.761,95%CI(0.725,0.794)],and calibration in internal validation.In temporal validation,the model also performed well[Brier score=0.0044,95%CI(0.0036,0.0052),Harrell's C-index=0.703,95%CI(0.614,0.781)].Conclusion This study develope and validate a prediction model for ALI in statin users,providing clinicians with a reliable tool for individualized risk assessment.This model can help achieve risk stratification and reduce the occurrence of ALI.
10.Regulation of N-methyl berbamine on intracellular calcium homeostasis
Dongning YANG ; Shi ZHOU ; Yuelin LI ; Junmeng ZHU ; Liying HAO ; Huiyuan HU
Journal of China Medical University 2025;54(2):97-102
Objective To explore the regulatory role of N-methyl berbamine(N-MB)in intracellular calcium homeostasis in H9c2 car-diomyocytes,and,thereby,clarify the possible mechanism of the myocardial protective effect of N-MB.Methods Binding of N-MB to CaV1.2 channels was simulated using the MOE software,and the binding affinity and binding mode were determined.The hCaV1.2 gene was transfected into HEK293 cells,and the effect of N-MB(30 μmol/L)on the CaV1.2 current was detected using the whole-cell patch clamp technique.In addition,a Fluo 3-AM fluorescent probe was loaded into H9c2 cardiomyocytes,and the effect of N-MB(3,30 μmol/L)on intracellular calcium ion concentration was observed under a laser confocal microscope.The effect of N-MB(3,30 μmol/L)on the expression of Ca2+regulation-related genes Cacna1c,Cacnb2,Ryr2,Serca2a,and Ncx1 in H9c2 cardiomyocytes was examined using real-time quantitative PCR.Results N-MB was predicted to bind to CaV1.2 channels.The binding sites mainly involved Phe1191,Thr1420,and Asn771,and the binding modes were H-donor,pi-pi,and pi-H.N-MB(30 μmol/L)significantly inhibited CaV1.2 currents,with an inhibition rate of 76.09%±7.41%.The fluorescence intensity of intracellular Ca2+level in H9c2 cardiomyocytes was significantly enhanced with N-MB treatment(3,30 μmol/L,P<0.01).Compared with the control group,differences in the expression of Cacna1c,Serca2a,and Ncx1 in H9c2 cardiomyocytes were not significant after N-MB(3,30 μmol/L)intervention(P>0.05),whereas the expression of Cacnb2 significantly reduced(P<0.001)and the expression of Ryr2 significantly increased(P<0.05).Conclusion N-MB binds to CaV1.2 calcium channels.N-MB may regulate intracellular calcium homeostasis by inhibiting calcium currents by decreasing the gene expression of CaV1.2 calcium channels.Additionally,N-MB may also increase intracellular Ca2+concentration by promoting the expression of Ryr2,which could be the mechanism underlying the myocardial protective effect of N-MB.

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