Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 13 de 13
Filtrar
1.
Biochem Pharmacol ; 210: 115457, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36806583

RESUMEN

NOD-like receptor protein 3 (NLRP3) inflammasomes trigger the inflammatory cascades and participate in various inflammatory diseases, including noise-induced hearing loss (NIHL) caused by oxidative stress. Recently, the anti-inflammatory traditional medicine oridonin (Ori) has been reported to provide hearing protection in mice after noise exposure by blocking the NLRP3-never in mitosis gene A-related kinase 7 (NEK7)-inflammasome complex assembly. Using RNA sequencing analysis, we further elucidated that interleukin 1 receptor type 2 (IL1R2) may be another crucial factor regulated by Ori to protect NIHL. We observed that IL1R2 expression was localized in spiral ganglion neurons, inner and outer hair cells, in Ori-treated mouse cochleae. Additionally, we confirmed that ectopic overexpression of IL1R2 in the inner ears of healthy mice using an adeno-associated virus delivery system significantly reduced noise-induced ribbon synapse lesions and hearing loss by blocking the "cytokine storm" in the inner ear. This study provides a novel theoretical foundation for guiding the clinical treatment of NIHL.


Asunto(s)
Oído Interno , Pérdida Auditiva Provocada por Ruido , Otitis , Ratones , Animales , Pérdida Auditiva Provocada por Ruido/tratamiento farmacológico , Pérdida Auditiva Provocada por Ruido/etiología , Pérdida Auditiva Provocada por Ruido/patología , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Oído Interno/metabolismo , Oído Interno/patología , Inflamación/complicaciones , Antiinflamatorios/farmacología , Otitis/complicaciones , Receptores de Interleucina-1
2.
Nat Prod Res ; 35(1): 49-56, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31342796

RESUMEN

Three new flavonoids, pinocembrin-7-O-[3″-O-galloyl]-ß-D-glucose (1), pinocembrin-7-O-[2″-O-galloyl-4″,6″-hexahydroxydiphenoyl]-ß-D-glucose (2), 2',6'-dihydroxydihydrochalcone-4'-O-[2″-O-galloyl-4″,6″-hexahydroxydiphenoyl]-ß-D-glucopyranoside (3), and 12 known compounds (4-15) were isolated from Penthorum Chinense Pursh. The structures of all compounds were established mainly by NMR and MS experiments as well as the necessary chemical evidence. The anti-hyperlipidemic activities of the three new flavonoids were predicted by molecular docking.


Asunto(s)
Flavonoides/química , Flavonoides/farmacología , Hipolipemiantes/farmacología , Magnoliopsida/química , Flavonoides/aislamiento & purificación , Hipolipemiantes/química , Espectroscopía de Resonancia Magnética , Simulación del Acoplamiento Molecular , Estructura Molecular , Extractos Vegetales/química
3.
Trials ; 21(1): 560, 2020 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-32571395

RESUMEN

BACKGROUND: Knee osteoarthritis (KOA) seriously reduces quality of life and is a major threat to the health of the middle-aged and elderly. This study aimed to assess the efficacy of Miao crossbow needle therapy vs. acupuncture for KOA therapy. METHODS: This multicenter, randomized controlled trial was performed at three hospitals between April 2016 and December 2016. The patients were randomized to receive crossbow needle (CN) or acupuncture (AT). All treatments were completed within 46 days. Evaluation of treatment was conducted on the 46th, 62nd, and 77th days. The primary endpoint was change of Western Ontario and McMaster Osteoarthritis Index (WOMAC) score on the 46th day. The secondary endpoints included WOMAC score, the Lysholm knee score, the Japanese Orthopedic Association (JOA) knee score, visual analog scale (VAS), and the MOS 36-item short-form health survey (SF-36), on the 46th, 62nd, and 77th day. RESULTS: Finally, data of 301 participants were analyzed for the efficacy of treatment. Compared with AT, there was a larger change of WOMAC score in the CN group after treatment [- 25.0 (95% CI - 27.0, - 23.0) vs. - 18.8 (95% CI - 20.8, - 16.9), P < 0.001]. In the CN group, the WOMAC score was lower at all three time points (P = 0.008, P = 0.003, P < 0.001 respectively), while the Lysholm knee score (P = 0.03) and JOA score (P = 0.013) were higher and the VAS score (P = 0.011) was lower on the 77th day. CONCLUSION: Both Miao crossbow needle therapy and acupuncture reduced the WOMAC score. Miao crossbow needle therapy can be an alternative method for treating patients with knee osteoarthritis. TRIAL REGISTRATION: ChiCTR, ChiCTR-INR-16008032. Registered on 12 March 2016.


Asunto(s)
Terapia por Acupuntura/métodos , Medicina Tradicional China/métodos , Agujas , Osteoartritis de la Rodilla/terapia , Manejo del Dolor/métodos , Anciano , Femenino , Estudios de Seguimiento , Humanos , Articulación de la Rodilla , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Calidad de Vida , Resultado del Tratamiento
4.
Int J Mol Sci ; 19(9)2018 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-30154382

RESUMEN

Pinocembrin-7-O-ß-d-glucoside (PCBG), pinocembrin (PCB), and 5-methoxy-pinocembrin-7-O-ß-d-glucoside (MPG) are three flavonones isolated from Penthorum chinense Pursh (P. chinense). The effects of the three flavonones on hepatic steatosis and their molecular mechanisms in HepG2 cells were investigated in this study for the first time. A model of hepatic steatosis in HepG2 cells was induced by free fatty acid (FFA), and co-treated with the three flavonones as mentioned. Intracellular lipid droplets were detected by Oil Red O staining. PCB, PCBG, and MPG suppressed oxidative stress by decreasing malondialdehyde (MDA) levels and increasing superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities. The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were ameliorated. Moreover, these flavonones enhanced the phosphorylation of AMP-activated protein kinase (AMPK) and the expression of silent mating type information regulation 2 homolog 1 (SIRT1) and peroxisome proliferator-activated receptor α (PPARα), and reduced the expression of sterol regulatory element binding protein-1c (SREBP1c) and the downstream targets fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), and stearoyl-CoA desaturase 1 (SCD1). Molecular docking was used to predict the interaction and combination patterns between the three flavonones and the enzymes above. The results revealed that the SIRT1/AMPK pathway is involved in the functions of the three flavonones, and the most effective flavonone against hepatic steatosis might be PCBG, followed by MPG and PCB. Therefore, the three flavonones from P. chinense were found to exert preventive effects against hepatic steatosis by regulating the SIRT1/AMPK pathway.


Asunto(s)
Proteínas Quinasas Activadas por AMP/metabolismo , Hígado Graso/metabolismo , Hígado Graso/patología , Flavonoles/farmacología , Extractos Vegetales/farmacología , Transducción de Señal/efectos de los fármacos , Sirtuina 1/metabolismo , Antioxidantes/metabolismo , Biomarcadores , Hígado Graso/tratamiento farmacológico , Hígado Graso/genética , Regulación Enzimológica de la Expresión Génica/efectos de los fármacos , Células Hep G2 , Humanos , Metabolismo de los Lípidos/efectos de los fármacos
5.
BMC Complement Altern Med ; 16(1): 412, 2016 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-27776556

RESUMEN

BACKGROUND: Alkaloids from Piper longum (PLA), extracted from P. longum, have potent anti-inflammatory effects. The aim of this study was to investigate whether PLA could protect dopaminergic neurons against inflammation-mediated damage by inhibiting microglial activation using a lipopolysaccharide (LPS)-induced dopaminergic neuronal damage rat model. METHODS: The animal behaviors of rotational behavior, rotarod test and open-field test were investigated. The survival ratio of dopaminergic neurons and microglial activation were examined. The dopamine (DA) and its metabolite were detected by high performance liquid chromatography (HPLC). The effects of PLA on the expression of interleukin (IL)-6, interleukin (IL)-1ß and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay (ELISA). Reactive oxygen species (ROS) and nitric oxide (NO) were also estimated. RESULTS: We showed that the survival ratio of tyrosine hydroxylase-immunoreactive (TH-ir) neurons in the substantia nigra pars compacta (SNpc) and DA content in the striatum were reduced after a single intranigral dose of LPS (10 µg) treatment. The survival rate of TH-ir neurons in the SNpc and DA levels in the striatum were significantly improved after treatment with PLA for 6 weeks. The over-activated microglial cells were suppressed by PLA treatment. We also observed that the levels of inflammatory cytokines, including TNF-α, IL-6 and IL-1ß were decreased and the excessive production of ROS and NO were abolished after PLA treatment. Therefore, the behavioral dysfunctions induced by LPS were improved after PLA treatment. CONCLUSION: This study suggests that PLA plays a significant role in protecting dopaminergic neurons against inflammatory reaction induced damage.


Asunto(s)
Alcaloides/farmacología , Neuronas Dopaminérgicas/efectos de los fármacos , Piper/química , Extractos Vegetales/farmacología , Alcaloides/química , Animales , Modelos Animales de Enfermedad , Inflamación/metabolismo , Lipopolisacáridos/administración & dosificación , Lipopolisacáridos/toxicidad , Masculino , Enfermedad de Parkinson , Extractos Vegetales/química , Ratas , Ratas Sprague-Dawley
6.
Zhongguo Zhong Yao Za Zhi ; 41(16): 3084-3089, 2016 Aug.
Artículo en Chino | MEDLINE | ID: mdl-28920353

RESUMEN

Piperine, piperlonguminine and pellitorine are three major amide alkaloids from Piper longum, showing a variety of pharmacological activities. In order to investigate the different metabolism pathways of these compounds in five species of liver microsomes in vitro, the data of full mass spectrum, and MS2, MS3 spectra of these three alkaloids were collected and analyzed by using ultra-high-performance liquid chromatography coupled with a LTQ-orbitrap mass spectrometer (UHPLC-LTQ-Orbitrap MS); gragment ion information was collected and combined with fragmentation regularities of mass spectra and accurate mass spectrometry data of metabolites, to compare the metabolism difference of three amide alkaloids in liver microsomes of human, rhesus monkey, Beagle dogs, rats and mice. 3 metabolites of piperine, 2 metabolites of piperlonguminine and 1 metabolite of pellitorine were identified quickly. The results showed that the major metabolic pathways of these amide alkaloids in liver microsomes were methylenedioxy group demethylation and oxidation reaction, and metabolic rates were different between species. This study provides basis for further research on in vivo metabolism of piperine analogues from Piper longum.


Asunto(s)
Alcaloides/metabolismo , Microsomas Hepáticos/metabolismo , Piper/química , Animales , Cromatografía Líquida de Alta Presión , Perros , Humanos , Macaca mulatta , Espectrometría de Masas , Ratones , Ratas , Especificidad de la Especie
7.
Zhongguo Zhong Yao Za Zhi ; 40(7): 1330-3, 2015 Apr.
Artículo en Chino | MEDLINE | ID: mdl-26281557

RESUMEN

Twelve compounds were isolated from the aerial parts of Achillea alpina by column chromatographies on silica gel, Sephadex LH-20, and semi-preparative HPLC. The structures were elucidated on the basis of spectral analysis. The compounds were identified as pellitorine(1), 8,9-dehydropellitorine(2), (E,E)-2,4-undecadien-8, 10-diynoic acid isobutylamide(3), (E,E)-2,4-tetradecadien-8,10-diynoic acid isobutylamide(4),sintenin(5), 4',5,7,8-tetramethoxyflavone(6), chrysoplenetin(7), formononetin(8), aurantiamide(9), asperglaucide(10), artemetin(11), and eupatorin(12). compounds 1-5 were isolated from this plant for the first time, and compounds 6-10 were isolated from the genus Achillea for the first time.


Asunto(s)
Achillea/química , Medicamentos Herbarios Chinos/química , Cromatografía Líquida de Alta Presión , Medicamentos Herbarios Chinos/aislamiento & purificación , Estructura Molecular , Espectrometría de Masa por Ionización de Electrospray
8.
Food Chem ; 177: 191-6, 2015 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-25660876

RESUMEN

A simple, effective and suitable UFLC-ESI-MS/MS method was firstly developed to simultaneously determine five characteristic constituents (piperine, piperlonguminine, Δα,ß-dihydropiperlonguminine, pellitorine and piperanine) of Piper longum L. The total alkaloids of P. longum L. was prepared. The alkaloid contents of Piper nigrum L. and P. longum L. were compared. The analysis was carried out in multiple reaction monitoring scan mode. The method showed a good specificity, linearity (R(2)>0.995), stability (RSD<2.53%), repeatability (RSD<2.58%), and recovery (90.0-103.5%). The limits of detection and limits of quantification of five alkaloids were in the range of 0.02-0.03 and 0.05-0.10 ng/mL, respectively. The intra- and inter-day precision was less than 9.30% and 9.55%, respectively. The validation results confirmed that the method could simultaneously determine the target alkaloids in the sample. Furthermore, the identities of the alkaloids were verified by HPLC-ESI-MS/MS. Compared with P. nigrum, P. longum had lower piperine content but was enriched in the other four alkaloids.


Asunto(s)
Alcaloides/análisis , Cromatografía Líquida de Alta Presión/métodos , Espectrometría de Masas/métodos , Piper nigrum/química , Espectrometría de Masas en Tándem/métodos , Extractos Vegetales/química
9.
Zhongguo Zhong Yao Za Zhi ; 39(9): 1660-5, 2014 May.
Artículo en Chino | MEDLINE | ID: mdl-25095380

RESUMEN

OBJECTIVE: To discuss the protective effect of alkaloids from Piper longum (PLA) in rat dopaminergic neuron injury of 6-OHDA-induced Parkinson's disease and its possible mechanism. METHOD: The rat PD model was established by injecting 6-OHDA into the unilateral striatum with a brain solid positioner. The PD rats were divided into the PLA group (50 mg x kg(-1) x d(-1)), the madorpa group (50 mg x kg(-1) x d(-1)) and the model group, with 15 rats in each group. All of the rats were orally given drugs once a day for 6 weeks. Meanwhile, other 15 rats were randomly selected as the sham operation group, and only injected with normal saline in the unilateral striatum. The behavioral changes were observed with the apomorphine (APO)-induced rotation and rotary rod tests. The number of tyrosine hydroxylase (TH)-positive cells in rat substantia nigra and the density of TH-positive fibers in striatum were detected by tyrosine hydroxylase immunohistochemistry. The content of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione (GSH), catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and nitric oxide synthase (NOS) in rat substantia nigra and striatum were measured by the spectrophotometric method. RESULT: After being induced by APO, PD rats showed obvious rotation behaviors, with decreased time stay on rotary rod and significant reduction in the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. The activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity significantly decreased, whereas the activities of NOS and the content of MDA, NO significantly increased. PLA could significantly improve the behavioral abnormality of PD rats and increase the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. It could up-regulate the activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity, and decrease the content of NOS and the content of MDA, NO. CONCLUSION: Alkaloids from P. longum shows the protective effect in substantia nigra cells of 6-OHDA-induced PD model rats. Its mechanism may be related with their antioxidant activity.


Asunto(s)
Alcaloides/farmacología , Neuronas Dopaminérgicas/efectos de los fármacos , Enfermedad de Parkinson Secundaria/prevención & control , Piper/química , Administración Oral , Alcaloides/administración & dosificación , Animales , Apomorfina/farmacología , Catalasa/metabolismo , Agonistas de Dopamina/farmacología , Neuronas Dopaminérgicas/metabolismo , Neuronas Dopaminérgicas/patología , Glutatión/metabolismo , Glutatión Peroxidasa/metabolismo , Masculino , Malondialdehído/metabolismo , Actividad Motora/efectos de los fármacos , Neostriado/efectos de los fármacos , Neostriado/metabolismo , Óxido Nítrico/metabolismo , Óxido Nítrico Sintasa/metabolismo , Oxidopamina , Enfermedad de Parkinson Secundaria/inducido químicamente , Enfermedad de Parkinson Secundaria/fisiopatología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Sustancia Negra/efectos de los fármacos , Sustancia Negra/metabolismo , Superóxido Dismutasa/metabolismo , Tirosina 3-Monooxigenasa/metabolismo
10.
Artículo en Chino | MEDLINE | ID: mdl-24148951

RESUMEN

OBJECTIVE: To observe the effects of maternal exposure to nano-alumina during pregnancy on the neurodevelopment in offspring mice. METHODS: Female ICR mice began to be exposed to nano-alumina 10 d before mating, and the nano-alumina exposure lasted till offspring mice were born. All the female mice were randomly divided into 5 groups: solvent control group (saline), nano-carbon group (11.76 mg/ml), micro-alumina group (50 mg/ml), 50 nm alumina group (50 mg/ml), and 13 nm alumina group (50 mg/ml). All the mice were treated by nasal drip (10 µl/time) 3 times daily till offspring mice were born. Physiological indices, reflex and sensory function test, endurance test, Morris water maze test, positioning and navigation test, and open field test were used to evaluate the neurodevelopment of newborn mice. RESULTS: On day 28, the body weight of 13 nm alumina group (16.73±4.04 g) was significantly lower than that of solvent control group (20.45±2.50 g) (P<0.01); the 13 nm alumina group had significantly delayed time to ear opening compared with the solvent control group (4.91±0.78 d vs 4.45±0.50 d, P<0.01); compared with the solvent control group, the nano-carbon group, micro-alumina group, 50 nm alumina group, and 13 nm alumina group had significantly delayed time to eruption of teeth (10.05±0.23 d vs 10.32±0.48 d, 10.75±0.45 d, 10.32±0.47 d, and 10.79±0.49 d, P<0.05 or P<0.01). On days 4 and 7 after birth, compared with the solvent control group, other groups had significantly decreased proportions of mice which passed the cliff avoidance test (P < 0.05 or P < 0.01). On days 12 and 14 after birth, compared with the solvent control group, the nano-carbon group, 50 nm alumina group, and 13 nm alumina group had significantly reduced pre-suspension time in the endurance test (P < 0.05 or P < 0.01). The Morris water maze and positioning and navigation tests showed that the 13 nm alumina group had a significantly increased 5 d incubation period compared with the solvent control group (P < 0.05); compared with the solvent control group, other groups had significantly reduced numbers of platform crossings (P < 0.05 or P < 0.01). The open field test showed that the nano-carbon group and 13 nm alumina group had reduced numbers of rearings compared with the solvent control group (P < 0.05); compared with the solvent control group, other groups had significantly reduced numbers of modifications (P < 0.01). CONCLUSION: Maternal exposure to nano-alumina (13 nm) during pregnancy has inhibitory effects on the physical development and early behavioral development in newborn mice and can also inhibit the learning and memory abilities and adaptability to new environment in offspring mice. The neurodevelopmental toxicity of nano-alumina to newborn mice increases as the particle sizes of nano-alumina decrease, which has been demonstrated by the endurance test and number of rearings.


Asunto(s)
Óxido de Aluminio/toxicidad , Animales Recién Nacidos , Exposición Materna , Animales , Conducta Animal , Peso Corporal , Femenino , Aprendizaje por Laberinto , Ratones , Ratones Endogámicos ICR , Actividad Motora , Nanoestructuras/toxicidad , Embarazo
11.
Dev Neurobiol ; 69(2-3): 153-61, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19067324

RESUMEN

The Smads are a group of related intracellular proteins critical for transmitting the signals to the nucleus from the transforming growth factor-beta superfamily at the cell surface. Knockout of the Smad5 is embryonic lethal. However, the Smad5 knockout of single allele (+/-) could survive. We used Smad5 heterozygous knockout (+/-) to determine the role of Smad5 in the development of inner ear morphology and function. In situ hybridization showed that Smad5 was expressed predominantly in hair cells, spiral ganglion, and supporting cells. Measurements of hearing thresholds using auditory brainstem response showed that Smad5 defect resulted in progressive hearing loss between 4 and 24 weeks after birth. Morphological examination revealed apoptosis in the inner ear, with significant loss of outer hair cells in adult Smad5 mutant mice. Our results indicated that deficiency in the Smad5-mediated signaling resulted in apoptosis of hair cells, suggesting Smad5 is a gene that may be related with presbycusis.


Asunto(s)
Apoptosis/genética , Cóclea/patología , Células Ciliadas Auditivas/patología , Pérdida Auditiva/genética , Proteína Smad5/deficiencia , Proteína Smad5/metabolismo , Estimulación Acústica/métodos , Factores de Edad , Animales , Animales Recién Nacidos , Umbral Auditivo/fisiología , Cóclea/crecimiento & desarrollo , Cóclea/ultraestructura , Células Ciliadas Auditivas/ultraestructura , Etiquetado Corte-Fin in Situ/métodos , Ratones , Ratones Noqueados , Microscopía Electrónica/métodos
12.
Artículo en Chino | WPRIM | ID: wpr-257161

RESUMEN

<p><b>OBJECTIVE</b>To find a better therapy for extensive cerebral infarction.</p><p><b>METHODS</b>Sixty cases with extensive cerebral infarction were treated by surgical decompression. After operation, they were randomly divided into an acupuncture plus medication group and a medication group, 30 cases in each group. The patients in the medication group were treated by routine western medicine, and the patients in the acupuncture plus medication group by the routine western medicine plus acupuncture 2 days after operation with Danzhong (CV 17), Zhongwan (CV 12), Qihai (CV 6), Zusanli (ST 36), Xuehai (SP 10) and Shuigou (GV 26) selected. They were treated for 10 days. The nervous functions were assessed by Chinese Stroke Nerve-function Rating Scale and criteria for clinical therapeutic effect.</p><p><b>RESULTS</b>After surgical decompression, the death rate was 20.0%; after operation, acupuncture could significantly improve the neurological functional deficit degree of the patient. The total effective rate of 40.0% in the acupuncture plus medication group was better than 13.3% in the medication group (P<0.05).</p><p><b>CONCLUSION</b>The surgical decompression is able to decrease the death rate of extensive cerebral infarction; after the operation, acupuncture and western medicine have cooperative effect on extensive cerebral infarction with a good therapeutic effect.</p>


Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Puntos de Acupuntura , Terapia por Acupuntura , Infarto Cerebral , Quimioterapia , Terapéutica , Sistema Nervioso
13.
Zhonghua Er Bi Yan Hou Ke Za Zhi ; 39(8): 483-5, 2004 Aug.
Artículo en Chino | MEDLINE | ID: mdl-15563084

RESUMEN

OBJECTIVE: Vestibular evoked myogenic potential (VEMP) has been utilized in clinic to test the function of saccule. In the present study, 3 stimulus modes were applied to 21 normal adults and intended to draw in a clinical test protocol. METHODS: The normal latency and amplitude of VEMPs of 21 normal subjects were recorded and the ratio of bilateral amplitudes and asymmetry were calculated. RESULTS: The response to binaural clicks were similar to the response of the monaural clicks. The interindividual variation in amplitude were large, but the latency varied little. CONCLUSIONS: VEMPs is a stable myogenic potentials. Monaural and binaural clicks stimulus can be used in clinical practice. The latter is appropriate for normal hearing subjects. Amplitude measurement is probable to evaluate the asymmetry of bilateral saccular function and may reveal saccule lesion.


Asunto(s)
Potenciales Vestibulares Miogénicos Evocados , Nervio Vestibular/fisiología , Estimulación Acústica , Adolescente , Adulto , Electromiografía , Femenino , Humanos , Masculino , Pruebas de Función Vestibular , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA