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1.
J Org Chem ; 89(8): 5371-5381, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38551317

RESUMO

A facile and eco-friendly photoinduced dehydrogenative amination of quinoxalin-2(1H)-ones with aliphatic amines without any metal, strong oxidant, and photocatalyst has been established for the first time. This reaction proceeding efficiently with air as the sole oxidant at room temperature obtains a wide range of 3-aminoquinoxaline-2(1H)-ones in high yields with excellent functional group tolerance. The mechanistic studies show an interesting involvement of quinoxalin-2(1H)-ones as a photosensitizer, which eliminates the requirement for external photocatalysts.

2.
Org Lett ; 25(50): 8970-8974, 2023 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-38085538

RESUMO

The progress of efficient and sustainable approaches for decarboxylative coupling reactions is synthetically appealing due to the structural diversity, lack of toxicity, and widespread commercial accessibility of carboxylic acids. However, the decarboxylation reaction still encounters challenges related to the utilization of oxidants, catalysts, and prefunctionalization conditions. We report herein a mild method that facilitates direct electron transfer between alkyl carboxylic acids and excited-state substrates for C-H alkylation of quinoxalin-2(1H)-ones without the involvement of any catalyst or additive.

3.
Front Public Health ; 11: 1322019, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38131020

RESUMO

Background: With the intensification of global climate warming, extreme low temperature events such as cold spells have become an increasingly significant threat to public health. Few studies have examined the relationship between cold spells and mortality in multiple Chinese provinces. Methods: We employed health impact functions for temperature and mortality to quantify the health risks of the first winter cold spell in China on November 26th, 2022, and analyzed the reasons for the stronger development of the cold spell in terms of the circulation field. Results: This cold spell was a result of the continuous reinforcement of the blocking high-pressure system in the Ural Mountains, leading to the deepening of the cold vortex in front of it. Temperature changes associated with the movement of cold fronts produced additional mortality risks and mortality burdens. In general, the average excess risk (ER) of death during the cold spell in China was 2.75%, with a total cumulative excess of 369,056 deaths. The health risks associated with temperatures were unevenly distributed spatially in China, with the ER values ranging from a minimum of 0.14% to a maximum of 5.72%, and temperature drops disproportionately affect southern regions of China more than northern regions. The cumulative excess deaths exibited the highest in eastern and central China, with 87,655 and 80,230 respectively, and the lowest in northwest China with 27,474 deaths. Among the provinces, excess deaths pronounced the highest in Shandong with 29,492 and the lowest in Tibet with only 196. Conclusion: The study can provide some insight into the mortality burden of cold spells in China, while emphasising the importance of understanding the complex relationship between extreme low temperature events and human health. The outcomes could provide valuable revelations for informing pertinent public health policies.


Assuntos
Clima , Temperatura Baixa , Humanos , Temperatura , Estações do Ano , China/epidemiologia
4.
Sci Rep ; 13(1): 17717, 2023 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-37853161

RESUMO

Ambient pollutants, particularly fine particulate matter (PM2.5) and ozone (O3), pose significant risks to both public health and economic development. In recent years, PM2.5 concentration in China has decreased significantly, whereas that of O3 has increased rapidly, leading to considerable health risks. In this study, a generalized additive model was employed to establish the relationship of PM2.5 and O3 exposure with non-accidental mortality across 17 districts and counties in Jilin Province, China, over 2015-2016. The health burden and economic losses attributable to PM2.5 and O3 were assessed using high-resolution satellite and population data. According to the results, per 10 µg/m3 increase in PM2.5 and O3 concentrations related to an overall relative risk (95% confidence interval) of 1.004 (1.001-1.007) and 1.009 (1.005-1.012), respectively. In general, the spatial distribution of mortality and economic losses was uneven. Throughout the study period, a total of 23,051.274 mortalities and 27,825.015 million Chinese Yuan (CNY) in economic losses were attributed to O3 exposure, which considerably surpassing the 5,450.716 mortalities and 6,553,780 million CNY in economic losses attributed to PM2.5 exposure. The O3-related health risks and economic losses increased by 3.75% and 9.3% from 2015 to 2016, while those linked to PM2.5 decreased by 23.33% and 18.7%. Sensitivity analysis results indicated that changes in pollutant concentrations were the major factors affecting mortality rather than baseline mortality and population.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Ambientais , Ozônio , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Ozônio/efeitos adversos , Ozônio/análise , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , China/epidemiologia , Poluentes Ambientais/análise
5.
Environ Sci Pollut Res Int ; 30(8): 21661-21670, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36272008

RESUMO

Epidemiological studies have proven that extreme temperatures have a significant threat to public health. This study aimed to investigate the association between extreme temperatures and circulatory mortality from January 1, 2014, to December 31, 2016, in Harbin, a city with a cold climate in Northeast China. We set a maximum lag of 27 days to evaluate the hysteresis effects of different temperatures on circulatory mortality using a distributed lag nonlinear model (DLNM). Results indicated that daily mean temperature and circulatory mortality presented approximately an L-shaped, and the cumulative relative risks (RRs) decreased continuously as the temperature increased in both low and high temperatures. Extremely low temperature showed a hysteresis and durability on circulatory mortality, with the largest RR of 1.023 (95%CI: 1.001-1.046) at lag 26, and RR of the cumulative cold effect of 0-27 days was 1.302 (95%CI: 1.160-1.462). The effect of extremely high temperatures presented more acute and intense, with the largest RR of 1.033 (95%CI: 1.004-1.063) at lag 0. RR of the cumulative hot effect of 0-3 days was 1.056 (1.008-1.106). In addition, females were more susceptible to extremely low temperatures, while males were more vulnerable to extremely high temperatures. This study demonstrated that extremely low temperatures have a stronger effect on circulatory mortality than extremely high temperatures in Harbin.


Assuntos
Temperatura Baixa , Temperatura Alta , Masculino , Feminino , Humanos , Temperatura , Cidades , China , Mortalidade
6.
Sci Rep ; 11(1): 12129, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108571

RESUMO

Particulate matter (PM) has been proved to be a risk factor for the development of circulatory system diseases (CSDs) around the world. In this study, we collected daily air pollutants, emergency room (ER) visits for CSDs, and meteorological data from 2009 to 2012 in Beijing, China. After controlling for the long-term trend and eliminating the influence of confounding factors, the generalized additive model (GAM) was used to evaluate the short-term effects of PM10 on CSDs and cause-specific diseases. The results showed that for every 10 µg/m3 increase in PM10, the largest effect estimates in ER visits of total CSDs, arrhythmia, cerebrovascular diseases, high blood pressure, ischemic heart disease and other related diseases were 0.14% (95% CI: 0.06-0.23%), 0.37% (95% CI: - 0.23 to 0.97%), 0.20% (95% CI: 0.00-0.40%), 0.15% (95% CI: 0.02-0.27%), 0.18% (95% CI: 0.02-0.35%) and 0.35% (95% CI: - 0.04 to 0.79%), respectively. When NO2 or SO2 was added into the model, the effect estimates of PM10 were mostly attenuated, while in those models with PM2.5 added, the effect estimates of PM10 were mostly increased. Stratified analysis indicated that PM10 had a greater effect on males and the elderly.


Assuntos
Doenças Cardiovasculares/epidemiologia , Transtornos Cerebrovasculares/epidemiologia , Material Particulado/efeitos adversos , Estações do Ano , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Transtornos Cerebrovasculares/etiologia , Transtornos Cerebrovasculares/patologia , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
7.
Environ Sci Pollut Res Int ; 28(35): 49278-49288, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33932207

RESUMO

Under the global climate warming, extreme weather events occur more and more frequently. Epidemiological studies have proved that extreme temperature is strongly correlated with respiratory diseases. We evaluated extreme-temperature effect on respiratory emergency room (ER) visits for 5 years in Lanzhou, a northwest temperate climate city of China from January 1st, 2013, to August 31st, 2017. We built a distributed lag non-linear model (DLNM) to evaluate the lag effect up to 30 days. Results showed the relative risk (RR) of respiratory disease always reached the maximum at lag 0 day and decreased to 1.0 at lag 5 days. Extremely low temperature showed the lag effect of 22 days and the maximum RR was 1.415 (95% CI 1.295-1.546) at lag 0 day. Extremely high temperature showed the lag effect of 7 days and the maximum RR was 1.091 (95% CI 1.069-1.114) at lag 0 day. The elders (age > 65 years) were at the greatest risk to extreme temperatures and the response were very acute. Children (age ≤ 15 years) were at the lowest risk but the lag effect lasted the longest lag days than other subgroups. Males showed longer-term lag effect and higher RR than females. Our study indicated that the extremely low temperature has a significantly greater effect on respiratory diseases than extremely high temperature.


Assuntos
Temperatura Baixa , Transtornos Respiratórios , Adolescente , Idoso , Criança , China , Cidades , Feminino , Temperatura Alta , Humanos , Masculino , Temperatura
8.
Environ Sci Pollut Res Int ; 28(33): 45087-45095, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33856634

RESUMO

The outbreak of coronavirus disease 2019 (COVID-19) continues to spread worldwide and has led to recession, rising unemployment, and the collapse of the health-care system. The aim of this study was to explore the exposure-response relationship between daily confirmed COVID-19 cases and environmental factors. We used a time-series generalized additive model (GAM) to investigate the short-term association between COVID-19 and environmental factors by using daily meteorological elements, air pollutant concentration, and daily confirmed COVID-19 cases from January 21, 2020, to February 29, 2020, in Shanghai, China. We observed significant negative associations between daily confirmed COVID-19 cases and mean temperature (Tave), temperature humidity index (THI), and index of wind effect (K), whereas air quality index (AQI), PM2.5, PM10 NO2, and SO2 were significantly associated with the increase in daily confirmed COVID-19 cases. A 1 °C increase in Tave, one-unit increase in THI, and 10-unit increase in K (lag 0-7 days) were associated with 4.7, 1.8, and 1.6% decrease in daily confirmed cases, respectively. Daily Tave, THI, K, PM10, and SO2 had significant lag and persistence (lag 0-7 days), whereas the lag and persistence of AQI, PM2.5, and NO2 were significant at both lag 0-7 and 0-14 days. A 10-µg/m3 increase in PM10 and 1-µg/m3 increase in SO2 was associated with 13.9 and 5.7% increase in daily confirmed cases at lag 0-7 days, respectively, whereas a 10-unit increase in AQI and a 10-µg/m3 increase in PM2.5 and NO2 were associated with 7.9, 7.8, and 10.1% increase in daily confirmed cases at lag 0-14 days, respectively. Our findings have important implications for public health in the city of Shanghai.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China , Humanos , Material Particulado/análise , SARS-CoV-2
9.
Environ Pollut ; 280: 116957, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33773305

RESUMO

This systematic review and meta-analysis was performed to obtain updated evidence regarding the short-term effect of ozone on respiratory mortality in China. We systematically searched the Embase, PubMed, Scopus, Web of Science, China National Knowledge Internet, and Wanfang databases for relevant studies. After screening based on the inclusion criteria, 12 studies with 19 estimates were selected for further meta-analysis. The results revealed that respiratory mortality significantly increased by 0.55% (95% confidence interval: 0.24%-0.85%; Q = 39.47, I2 = 54.4%, P = 0.002, tau2 < 10-5) for every 10-µg/m3 increase in the maximum 8-h average concentration of ozone. Furthermore, differences in combined estimates were observed between various regions and lag structures. The combined effect of single-day lags was generally larger than that of multiday lags; the estimate of mortality for the population in the north was larger than that for the population in the south. The sensitivity analysis demonstrated that the main findings were stable; funnel plots with Egger's and Begg's tests indicated no significant publication bias in our analysis.


Assuntos
Ozônio , Doenças Respiratórias , China/epidemiologia , Humanos , Ozônio/análise
10.
Environ Geochem Health ; 43(10): 4123-4138, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33774778

RESUMO

Recently, particulate matter pollution has been worsening, which has been affecting the asthma visits in children. In this study, we assessed the short-term effects of PM10 and PM2.5 on asthma visits in children in Shanghai, China from January 1, 2009 and December 31, 2010, using a generalized additive model. We controlled the confounding factors, such as long-term trends, week day effect, and weather elements. The lag effects of different age subgroups (≤ 2 yr, 3-5 yr, and 6-18 yr subgroups) were performed. The results showed significant effects of PM10 and PM2.5 on asthma visits in children, though the seasonal lags varied for the three age subgroups. In general, the effect of PM2.5 on asthma visits in children was stronger and more acute than that of PM10. PM2.5 showed the highest relative risk of 1.192 at lag 0 day in summer; and PM10 showed the highest relative risk of 1.073 at lag 3 day in autumn. Overall, particulate matter pollution showed a greater effect on relatively younger children. In particular, the ≤ 2 yr subgroup showed the highest seasonal relative risk of PM10. Especially, seasonal relative risk of PM10 in autumn for the ≤ 2 yr subgroup was much higher than that for the other two subgroups. The 3-5 yr and 6-18 yr subgroups showed the highest seasonal relative risk of PM2.5 in summer and winter, respectively. But the pediatric visits data we obtained cannot reflect the true prevalence of asthma and multiple visits. Thus, selection bias may exist in our analysis.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Asma/epidemiologia , Asma/etiologia , Criança , China/epidemiologia , Hospitais , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise
11.
Environ Sci Pollut Res Int ; 27(34): 42335-42345, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32833174

RESUMO

The Intergovernmental Panel on Climate Change (IPCC) reported that global climate change has led to the increased occurrence of extreme weather events. In the context of global climate change, more evidence indicates that abnormal meteorological conditions could increase the risk of epidemiological mortality and morbidity. In this study, using a systematic review, we evaluated a total of 175 studies (including 158 studies on outdoor environment and 17 studies on indoor environment) to summarize the impact of outdoor and indoor environment on human health in China using the database of PubMed, Web of Science, the Cochrane Library, and Embase. In particular, we focused on studies about cardiovascular and respiratory mortality and morbidity, the prevalence of digestive system diseases, infectious diseases, and preterm birth. Most of the studies we reviewed were conducted in three of the metropolises of China, including Beijing, Guangzhou, and Shanghai. For the outdoor environment, we summarized the effects of climate change-related phenomena on health, including ambient air temperature, diurnal temperature range (DTR), temperature extremes, and so on. Studies on the associations between temperature and human health accounted for 79.7% of the total studies reviewed. We also screened out 19 articles to explore the effect of air temperature on cardiovascular diseases in different cities in the final meta-analysis. Besides, modern lifestyle involves a large amount of time spent indoors; therefore, indoor environment also plays an important role in human health. Nevertheless, studies on the impact of indoor environment on human health are rarely reported in China. According to the limited reports, adverse indoor environment could impose a high health risk on children.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Nascimento Prematuro , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Pequim , Criança , China , Cidades , Mudança Climática , Feminino , Humanos , Recém-Nascido , Gravidez
12.
Environ Sci Pollut Res Int ; 27(30): 38029-38037, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32621192

RESUMO

Extreme air temperature directly affected human health. However, the short-term effect of extreme air temperature on the incidence of cardiovascular diseases has rarely been reported in China. In this study, we focused on Beijing, China, and assessed the effects of cold/warm days and nights on the number of hospital emergency room (ER) visits for cardiovascular diseases from 2009 to 2012. We used a generalized additive model (GAM) to estimate the association between extreme air temperature and the number of hospital ER visits for cardiovascular diseases. We divided the entire study group into two gender subgroups and three age subgroups. The results showed that the short-term effect of extreme air temperature on hospital ER visits for cardiovascular diseases was more profound in females and the elderly (aged ≥ 75 years). Among all the study subgroups, the highest relative risk (RR) of cardiovascular diseases associated with extremely cold days, warm days, cold nights, and warm nights was 3.0% (95% CI, 1.6%-4.4%), 0.8% (95% CI, - 0.9%-2.6%), 2.8% (95% CI, 1.6%-4.2%), and 1.8% (95% CI, 0.6%-4.3%), respectively. Overall, the effect of extremely low air temperature (during both days and nights) on the incidence of cardiovascular diseases was stronger and more acute than that of extremely high air temperature.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Doenças Cardiovasculares , Idoso , Pequim , China , Temperatura Baixa , Serviço Hospitalar de Emergência , Feminino , Humanos , Temperatura
13.
Environ Sci Pollut Res Int ; 27(5): 4849-4857, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31845269

RESUMO

Sudden temperature changes between neighboring days (T24h) have adverse effects on human health. In this study, we used a time series analysis to evaluate the impact of T24h on the number of hospital admissions for chronic obstructive pulmonary disease (COPD) from 2009 to 2012 in Changchun (the capital of Northeast China's Jilin province). We performed the analysis in a generalized additive model (GAM), and the controlling factors included long-term trends, day of the week effect, and the selected weather elements. We divided the entire study group into two gender subgroups (males and females) and two age subgroups (aged < 65 years and aged ≥ 65 years). T24h showed the greatest effect on the entire study group at lag 3 days. In particular, the greatest effect of T24h on females (males) occurred at lag 1 day (lag 3 days); the greatest effect of T24h on the aged ≥ 65 years (aged < 65 years) occurred at lag 1 day (lag 6 days). This indicates that temperature changes between neighboring days have a relatively more acute effect on the elderly and the females than on the younger people and the males. When T24h is less than zero, the highest RR of the number of hospital admissions for COPD occurred at lag 4 days during the warm season (1.025, 95% CI: 0.981, 1.069) and lag 3 days during the cold season (1.019, 95% CI: 0.988, 1.051). When T24h is greater than zero, the highest RR of the number of hospital admissions for COPD occurred at lag 6 days during the warm season (1.026, 95% CI: 0.977, 1.077) and lag 5 days during the cold season (1.021, 95% CI: 0.986, 1.057). The results of this study could be provided to local health authorities as scientific guidelines for controlling and preventing COPD in Changchun, China.


Assuntos
Poluição do Ar , Doença Pulmonar Obstrutiva Crônica , Idoso , Poluição do Ar/análise , China , Cidades , Temperatura Baixa , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Temperatura
14.
Environ Sci Pollut Res Int ; 27(2): 1436-1448, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31748999

RESUMO

To evaluate the correlations between diurnal temperature range (DTR) and the number of outpatient visits for common cold from Jan. 1, 2008, to Dec. 31, 2010, in the Shanghai metro area; we used a distributed lag non-linear model together with a Poisson regression model. The controlling factors included long-term trends and day of the week in outpatient visits for common cold and the selected weather elements. The entire study group was divided into three different age subgroups, including ≤ 15, 15-65, and ≥ 65 years old. We found some non-linear J-patterns between DTR and daily outpatient visits for common cold. At lag 0 day, the number of outpatient visits for common cold would increase by 11.1% per 1 °C increase in DTR. The greater the DTR, the more it affects outpatient visits for common cold, especially for the ≥ 65 years age group. In addition, DTR plays a more important role in outpatient visits for common cold in spring and winter compared with other seasons of the year. Our study showed that DTR is a risk factor that contributes to common cold. Results in this study can provide scientific evidence for the local authorities in improving preventive measures of the healthcare system.


Assuntos
Resfriado Comum/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pacientes Ambulatoriais , Temperatura , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar/análise , China/epidemiologia , Temperatura Baixa , Resfriado Comum/diagnóstico , Humanos , Pessoa de Meia-Idade , Estações do Ano , Adulto Jovem
15.
Environ Sci Pollut Res Int ; 26(27): 27832-27841, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31342347

RESUMO

Recent epidemiological studies pointed out that air pollution has a significant impact on pediatric asthma. Shanghai is one of the biggest cities in China, and the short-term effect of atmospheric particulate matter on the incidence of pediatric asthma has become a hot topic. From January 1, 2009, to December 31, 2010, we used daily measurements of pollutant concentrations, daily weather data, and daily records of pediatric asthma hospital visits from local authorities to evaluate the short-term effect of air pollution on pediatric asthma incidence in Shanghai, China. We used a generalized additive model (GAM) in the analysis, and the controlled confounding factors include long-term trends, day-of-the-week effects, and weather elements. We divided the entire study group into different age-subgroups. In addition, we took a variety of lag models into consideration. The results showed a strong connection between concentrations of fine particulate matter (PM2.5) and pediatric asthma hospital visits from 2009 to 2010 in Shanghai, China. For the entire study group, the greatest relative risk (RR) of PM2.5 on pediatric asthma hospital visits was 1.060 on a lag of 4 days. As for the three different age-subgroups, the greatest RR of PM2.5 on pediatric asthma hospital visits was 1.061 (at a lag of 5 days), 1.071 (at a lag of 4 days), and 1.052 (at a lag of 2 days), for the under-2-year-olds, 3-to-5-year-olds, and the 6-to-18-year-olds, respectively. The overall short-term effect of PM2.5 on pediatric asthma hospital visits was relatively stronger in younger children. Within the year, we detected the strongest seasonal effect of PM2.5 on pediatric asthma hospital visits in Summer. When adding other air pollutants in the analysis model, RR of PM2.5 on pediatric asthma hospital visits would be increased.


Assuntos
Poluição do Ar/análise , Asma/epidemiologia , Poluentes Ambientais/análise , Material Particulado/análise , Criança , China , Cidades , Humanos , Incidência , Lactente , Risco , Estações do Ano , Tempo (Meteorologia)
16.
Zhongguo Zhen Jiu ; 28(1): 33-6, 2008 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-18257186

RESUMO

OBJECTIVE: To probe and systematize the ancient cauterization with pyropuncture needle for evacuation of pus. METHODS: One hundred and eight cases of body surface abscess were randomly divided into 2 groups. The cauterization group (n=84) were treated by drainage with electric cauterization and the incision group (n=24) by drainage with incision. Clinical therapeutic effect, the healing time and the scar area of the wound were compared between the two groups. RESULTS: All of the patients in the two groups were effective with a similar therapeutic effect (P > 0.05); the cauterization group in the healing time and the scar area of the wound was superior to the incision group (P < 0.05). CONCLUSION: Electric cauterization for evacuation of pus has advantages of rapid healing and small scar area of wound.


Assuntos
Abscesso/terapia , Cauterização/métodos , Medicina Tradicional Chinesa , Dermatopatias/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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