CN113081180A - Duodenal papilla incision knife capable of synchronously and finely rotating knife head - Google Patents
Duodenal papilla incision knife capable of synchronously and finely rotating knife head Download PDFInfo
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- CN113081180A CN113081180A CN202110377776.5A CN202110377776A CN113081180A CN 113081180 A CN113081180 A CN 113081180A CN 202110377776 A CN202110377776 A CN 202110377776A CN 113081180 A CN113081180 A CN 113081180A
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- steel wire
- flexible shaft
- knife
- synchronously
- duodenal papilla
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- 230000002183 duodenal effect Effects 0.000 title claims abstract description 51
- 229910000831 Steel Inorganic materials 0.000 claims abstract description 71
- 239000010959 steel Substances 0.000 claims abstract description 71
- 238000007459 endoscopic retrograde cholangiopancreatography Methods 0.000 claims abstract description 13
- 238000004519 manufacturing process Methods 0.000 claims abstract description 11
- 210000001096 cystic duct Anatomy 0.000 claims description 6
- 210000003228 intrahepatic bile duct Anatomy 0.000 claims description 6
- 230000001360 synchronised effect Effects 0.000 claims description 3
- 210000004283 incisor Anatomy 0.000 claims 1
- 238000003780 insertion Methods 0.000 claims 1
- 230000037431 insertion Effects 0.000 claims 1
- 238000002627 tracheal intubation Methods 0.000 abstract description 13
- 210000002445 nipple Anatomy 0.000 abstract description 5
- 230000001154 acute effect Effects 0.000 abstract description 2
- 210000004351 coronary vessel Anatomy 0.000 abstract 1
- 238000005520 cutting process Methods 0.000 description 10
- 210000001198 duodenum Anatomy 0.000 description 10
- 238000004804 winding Methods 0.000 description 5
- 210000001953 common bile duct Anatomy 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 210000000013 bile duct Anatomy 0.000 description 2
- 239000000470 constituent Substances 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 239000007769 metal material Substances 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 210000000277 pancreatic duct Anatomy 0.000 description 2
- 238000003825 pressing Methods 0.000 description 2
- 230000001105 regulatory effect Effects 0.000 description 2
- 208000016222 Pancreatic disease Diseases 0.000 description 1
- 208000031481 Pathologic Constriction Diseases 0.000 description 1
- 206010071229 Procedural haemorrhage Diseases 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000007630 basic procedure Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000003445 biliary tract Anatomy 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000011846 endoscopic investigation Methods 0.000 description 1
- 210000000232 gallbladder Anatomy 0.000 description 1
- 238000010197 meta-analysis Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000000496 pancreas Anatomy 0.000 description 1
- 208000024691 pancreas disease Diseases 0.000 description 1
- 238000007464 sphincterotomy Methods 0.000 description 1
- 230000036262 stenosis Effects 0.000 description 1
- 208000037804 stenosis Diseases 0.000 description 1
- 239000004575 stone Substances 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses a duodenal papilla incision knife capable of synchronously and finely rotating a knife head, which comprises a duodenal papilla incision knife (1) and a steel wire spring ring (2). A simulated steel wire flexible shaft manufacturing process is characterized in that a duodenal papilla incision knife (1) is used for replacing a central steel wire of an existing steel wire flexible shaft, a steel wire flexible shaft core integrating the incision knife (1) and a steel wire spring ring (2) is manufactured, a duodenal side view mirror clamp channel (3) is used as a matched sleeve of the steel wire flexible shaft core, and the steel wire flexible shaft core is arranged in the steel wire flexible shaft sleeve, so that the incision knife capable of synchronously and finely rotating a knife head can effectively transmit torque, and when nipple intubation, EST (acute test protocol) or over-selection guide wire is turned to carry, the knife head is synchronously and accurately adjusted to a target axial direction by rotating an incision knife operation end capable of synchronously and finely rotating the knife head, and the success rate of ERCP (percutaneous transluminal coronary artery control) treatment is improved. The invention has the characteristics of convenient and accurate operation and high success rate of the operation, and is suitable for popularization and application.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a duodenal papilla incision knife capable of synchronously and finely rotating a knife head.
Background
With the increase of biliary calculus and other diseases of the biliary-pancreatic system, endoscopic techniques represented by Endoscopic Retrograde Cholangiopancreatography (ERCP) are widely applied, which lays a foundation for minimally invasive treatment of biliary-pancreatic diseases, greatly improves the success rate of treatment, and reduces the occurrence of complications. During the course of ERCP, successful intubation of the duodenal papilla is the basic procedure for performing the operation, and duodenal papilla sphincterotomy (EST) is one of the main techniques for removing the calculus by expanding the papilla. Whether nipple cannula or EST operation is performed, the duodenal papilla incision knife is an indispensable treatment tool in the operation.
Generally, the bile duct opening is in the 11-point direction, the pancreatic duct opening is in the 1-point direction, but the axial direction of the pancreatic duct and the bile duct papilla has large individual difference, or is straight or bent, papilla intubation difficulty occurs in partial patients, and about 10% of ERCP patients can cause ERCP operation failure due to selective intubation difficulty [ document: shao LM, Chen QY, Chen MY, et al, Nitrogycerin in the prediction of post ERCP panicatities: a meta-analysis [ J ]. Dig Dis Sci,2010,55:1 ]. Difficult intubation becomes one of the major technical bottlenecks that limit the success of ERCP, and for patients with difficult intubation, the direction of the knife head of the duodenal papilla incision knife needs to be continuously adjusted during the operation to increase the success chance of intubation. The gastroduodenal tube of the existing duodenal papilla incision knife is made of a slender plastic material, so that the carry direction is determined when the endoscope is inserted, and the adjustment cannot be performed. In addition, in the case of the line EST operation, since the papilla cannot be cut at an assumed angle using a duodenal papilla cutter, the risk of intraoperative hemorrhage and perforation increases. In addition, for some special patients with gallbladder, left or right intrahepatic lesions, after the nipple intubation is successful, the over-selected guide wire is sent to the lesion part by means of the incision knife to complete other operations, such as expansion of the stenosis part, stone removal, stent placement and the like; however, due to the axial inconsistency between the common bile duct and the cystic duct and the left and right intrahepatic bile ducts and the non-rotatability of the existing duodenal papilla incision knife, the over-selected guide wire is difficult to be sent to the part from the common bile duct to complete the subsequent operation.
The Chinese patent application: CN 106859736A discloses rotatable duodenal papilla incision sword, including outer tube, outer tube handle and incision sword, the incision sword is located the inside of outer tube, the one end of outer tube is equipped with the outer tube handle, outer tube and incision sword are the gear shape. The device is at the outer tube that increases a metal material of current duodenal papilla incision sword outside, the device the outer tube has certain elasticity and toughness, can move the duodenal papilla incision sword in the outer tube and rotate when rotatory, and then when going duodenal papilla intubate or the super select seal wire turns to and gets into the cystic duct, the left and right sides intrahepatic bile duct, can carry out accurate rotation according to the pipe direction to satisfy the operation requirement. However, the metal outer sleeve of the device can not effectively conduct torque only by means of elasticity and toughness of the metal outer sleeve, cannot realize synchronous rotation of two ends of the metal outer sleeve, and cannot drive the duodenal papilla incision knife to synchronously rotate. Therefore, the device cannot achieve the effect of accurately regulating the direction of the operating end of the incision knife to the distal tool bit when being used.
Disclosure of Invention
In order to overcome the defect that the rotating direction of the cutter head at the far end cannot be accurately regulated and controlled by the operating end of the duodenal papilla incision cutter in the prior art, the invention provides the duodenal papilla incision cutter capable of synchronously and finely rotating the cutter head; thereby meeting the requirement of carrying in the direction of nipple intubation, EST operation or over-selection guide wire and increasing the success rate of ERCP operation.
One of the technical solutions adopted to solve the above technical problems of the present invention is:
a duodenal papilla incision knife capable of synchronously and finely rotating a knife head comprises a duodenal papilla incision knife 1 and a steel wire spring ring 2.
Preferably, the duodenal papilla incision knife 1 is an existing duodenal papilla incision knife.
Preferably, the steel wire spring coil 2 is formed by winding a plurality of layers of steel wire bundles 4-7.
More preferably, the duodenal papilla incision knife 1 and the wire spring coil 2 are wound to form a wire flexible shaft core.
Because the steel wire flexible shaft core needs to be arranged in a matched flexible shaft sleeve with a smooth and hard inner wall when transmitting torque.
Further preferably, the duodenum side-view mirror clamp 3 with a smooth and hard inner wall is used as a steel wire flexible shaft sleeve.
One of the technical solutions adopted to solve the above technical problems of the present invention is:
the manufacturing process of the existing steel wire flexible shaft is simulated to manufacture the steel wire flexible shaft core.
Preferably, the cutting knife 1 is used for replacing a central steel wire of the existing steel wire flexible shaft, and the steel wire spring coil 2 is wound along the outer wall of the cutting knife 1 to manufacture a flexible shaft core integrating the cutting knife 1 and the steel wire spring coil 2.
One of the technical solutions adopted to solve the above technical problems of the present invention is:
based on the principle that the flexible shaft core can transmit torque along different axial directions, the steel wire flexible shaft core is arranged in the steel wire flexible shaft sleeve, so that the cutting knife capable of synchronously and finely rotating the knife head can effectively transmit the torque.
Preferably, the application is the application of accurately and synchronously adjusting the cutter head to the target axial direction by rotating the operation end of the incision cutter capable of synchronously and finely rotating the cutter head of the invention when a duodenal papilla intubation, an EST operation or an over-selection guide wire is sent into a cystic duct and left and right intrahepatic bile ducts from a common bile duct in an ERCP operation.
The invention has the beneficial effects that:
the invention provides a duodenal papilla incision knife capable of synchronously and finely rotating a knife head; the cutting knife is used for replacing the existing central steel wire of the steel wire flexible shaft to manufacture the shaft core of the steel wire flexible shaft and is arranged in the shaft sleeve of the steel wire flexible shaft, so that the cutting knife capable of synchronously and finely rotating the knife head can effectively transmit torque; when duodenal papilla intubation and EST operation or over-selection guide wires are turned to enter the cystic duct and the left and right intrahepatic bile ducts, the distal cutter head is adjusted to synchronously and finely rotate to the target axial direction by slightly rotating the operation end of the incision knife, so that the success rate of the ERCP operation is improved. The invention has the characteristics of convenient and accurate operation, high success rate and simple manufacturing process, and is suitable for popularization and application.
Drawings
Other objects and results of the present invention will be more readily understood by reference to the following three drawings. The drawings of these figures are illustrated below:
FIG. 1 is a schematic structural view of a duodenal papilla incising knife capable of synchronously and finely rotating a knife head of the invention, which is arranged in a clamping channel of a side view mirror for duodenum;
FIG. 2 is a cross-sectional view taken along line A-A of FIG. 1;
FIG. 3 is an anatomical structure of a duodenal papilla incising knife of the present invention with a synchronized fine rotary knife head.
Wherein 1 represents a duodenal papilla incision knife, 2 represents a steel wire spring coil, 3 represents a duodenal side-view mirror channel, and 4, 5, 6 and 7 represent steel wire bundles in each layer.
The same reference numbers in all figures indicate similar or corresponding features or functions.
Detailed Description
The technical solutions of the present invention will be described in further detail with reference to the accompanying drawings and the detailed description.
The embodiments described below are each a preferred specific example of the present invention. The numerical values, shapes, materials, constituent elements, connection forms of constituent elements, and the like shown in the following examples are merely examples and do not limit the spirit of the present invention. Among the components of the following examples, components that are not described in the embodiments showing the uppermost concept of the present invention will be described as arbitrary components constituting a more preferred embodiment.
The same components are denoted by the same reference numerals, and description thereof may be omitted.
Referring to fig. 1-3, the duodenal papilla incision knife capable of synchronously and finely rotating the knife head is characterized by comprising a duodenal papilla incision knife 1 and a steel wire spring coil 2.
The duodenal papilla incision knife 1 is an existing duodenal papilla incision knife.
The steel wire spring coil 2 is formed by winding a plurality of layers of steel wire bundles 4-7 along the outer wall of the incision knife 1.
The duodenal papilla incision knife 1 and the steel wire spring coil 2 are wound into a steel wire flexible shaft core, and the steel wire flexible shaft core needs to be arranged in a matched steel wire flexible shaft sleeve when transmitting torque.
The steel wire flexible shaft sleeve is a duodenum side-view mirror forceps channel 3.
The invention provides a duodenal papilla incision knife capable of synchronously and finely rotating a knife head; the cutting knife 1 is used for replacing the center steel wire of the existing steel wire flexible shaft to manufacture a steel wire flexible shaft core, the steel wire flexible shaft core is arranged in the steel wire flexible shaft sleeve, and the cutting knife capable of synchronously and finely rotating the knife head can effectively transmit torque based on the working principle that the steel wire flexible shaft can transmit torque along different axial directions; when duodenal papilla intubation and EST operation or over-selection guide wires are turned to enter the cystic duct and the left and right intrahepatic bile ducts, the distal tool bit is synchronously and accurately rotated to the target axial direction by slightly rotating the operating end of the incision knife, so that the success rate of the ERCP operation is improved.
The incision knife 1 is used for replacing a central steel wire of the existing steel wire flexible shaft, a steel wire spring coil 2 is wound along the outer wall of the incision knife 1 to form a flexible shaft core integrating the incision knife 1 and the steel wire spring coil 2, and a duodenum sideview mirror clamp 3 is used as a matched sleeve of the flexible shaft core.
The first step is as follows: designing a flexible shaft core, simulating a manufacturing process of a steel wire flexible shaft, replacing a center steel wire of the existing steel wire flexible shaft with a cutting knife 1 to manufacture the flexible shaft core, and spirally winding a plurality of layers of steel wire bundles 4-7 around the cutting knife 1; for example, 4 layers of steel wire bundles 4-7 are wound, the twisting directions of the steel wires of the adjacent layers are opposite, and each layer of steel wire bundles 4-7 is formed by winding 4, 5, 7 and 8 flat steel wires side by side from inside to outside in a mode of firstly rotating rightwards and then rotating leftwards. The steel wire bundles 4-7 are No. 70 steel, the twisting direction is universal, the outer layer steel wire bundles need to be deformed in advance by a pre-deformer, the pressing tile needs to be pressed to be proper in tightness when the flexible shaft core is manufactured, the pressing tile is made of Cr12 steel, and the requirement of tightness and flatness when the shaft is pressed is met.
The second step is that: the flexible shaft sleeve is designed, and the flexible shaft core can synchronously and effectively transmit torque only when being arranged in the flexible shaft sleeve, so that a matched sleeve of the flexible shaft core is required to be designed. Because the flexible shaft sleeve can not be compressed and deformed in the process of transmitting torque and is in smooth contact with the flexible shaft core, only restraint counter forces along the normal direction of the contact surface exist between the flexible shaft sleeve and the flexible shaft core. The inner wall of the duodenoscope side-view mirror clamp path 3 is made of smooth metal materials, so the duodenoscope side-view mirror clamp path 3 is designed to be used as a flexible shaft sleeve.
The third step: the relative size of a flexible shaft core and a flexible shaft sleeve is designed, and the flexible shaft core is formed by winding a steel wire spring coil 2 along the outer wall of a incision knife 1 and needs to be arranged in the flexible shaft sleeve when in work, so that the outer diameter of the steel wire spring coil 2 is designed to be smaller than the inner diameter of a duodenum sideview mirror clamp path 3 used in the operation, and the inner diameter of the steel wire spring coil 2 is equal to the outer diameter of the incision knife 1; for example, the duodenum side mirror forceps channel 3 used in the operation has an inner diameter of 4.2mm, the incision knife 1 has an outer diameter of 7F, and the wire coil 2 may be designed to have an outer diameter of 3.3mm to 4.0mm and an inner diameter of 7F. Because the flexible shaft core does not need to enter the pancreas and the biliary tract through the duodenum sideview mirror clamp 3, the length of the shaft core designed by the invention is equal to or close to that of the used duodenum sideview mirror clamp 3; for example, the length of the duodenum side mirror forceps 3 used in the operation is 2m, and the length of the shaft core can be designed to be about 2 m. The operative end of the incision knife 1 need not be modified.
And fourthly, specifically, the duodenum sideview mirror clamp 3 is used as a flexible shaft sleeve, the flexible shaft core manufactured in the invention is inserted into the sleeve, and when the direction of the incision knife head capable of synchronously and finely rotating the knife head is required to be changed, the distal end knife head can be synchronously and finely rotated to the target axial direction by rotating the operation end, so that the success chance of nipple intubation is increased, the occurrence of EST (acute stegnosis) complications is reduced, and the carry difficulty of the over-selection guide wire is reduced.
The above description is only a preferred embodiment of the present invention, and the scope of the present invention is not limited thereto, and any simple modifications or equivalent substitutions of the technical solutions that can be obviously obtained by those skilled in the art within the technical scope of the present invention are within the scope of the present invention.
Claims (6)
1. A duodenal papilla incision knife capable of synchronously and finely rotating a knife head is characterized by comprising a duodenal papilla incision knife and a steel wire spring ring.
2. The duodenal papilla incision knife capable of synchronously and finely rotating the knife head as claimed in claim 1, wherein the duodenal papilla incision knife and the wire spring coil are made into a wire flexible shaft core, and the wire flexible shaft core needs to be placed in a matched wire flexible shaft sleeve when torque is transmitted.
3. The duodenal papilla incision knife capable of synchronously and finely rotating the knife head as claimed in claim 2, wherein the duodenal papilla incision knife is used to replace a central steel wire of an existing steel wire flexible shaft by simulating a manufacturing process of the existing steel wire flexible shaft, and the steel wire spring ring is wound to manufacture the steel wire flexible shaft core integrating the duodenal papilla incision knife and the steel wire spring ring.
4. The duodenal papilla incisor with synchronous and fine rotating cutter head as claimed in claim 2, characterized in that the steel wire flexible shaft sleeve is a duodenal side-view mirror forceps channel.
5. The duodenal papilla incision knife capable of synchronously and finely rotating the knife head is characterized in that the shaft core of the steel wire flexible shaft is arranged in a clamping channel of the duodenal side-view mirror, and the incision knife capable of synchronously and finely rotating the knife head can be applied to effectively transmit torque based on the working principle that the shaft core of the steel wire flexible shaft can transmit torque in different axial directions.
6. The application of claim 5, which is the application of adjusting the knife head to the target axial direction precisely and synchronously by rotating the operation end of the incision knife capable of synchronously and finely rotating the knife head of the invention when the insertion of the papillary duct, EST operation or over-selection guide wire is turned to enter the cystic duct and the left and right intrahepatic bile ducts in ERCP operation.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110377776.5A CN113081180A (en) | 2021-04-08 | 2021-04-08 | Duodenal papilla incision knife capable of synchronously and finely rotating knife head |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202110377776.5A CN113081180A (en) | 2021-04-08 | 2021-04-08 | Duodenal papilla incision knife capable of synchronously and finely rotating knife head |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN113081180A true CN113081180A (en) | 2021-07-09 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202110377776.5A Pending CN113081180A (en) | 2021-04-08 | 2021-04-08 | Duodenal papilla incision knife capable of synchronously and finely rotating knife head |
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| Country | Link |
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| CN (1) | CN113081180A (en) |
Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH02104371A (en) * | 1988-06-13 | 1990-04-17 | Samuel Shiber | Atelectomy apparatus |
| EP0410602A1 (en) * | 1989-07-24 | 1991-01-30 | Lake Region Manufacturing Co. Inc. | Hollow lumen cable apparatus |
| EP1454588A2 (en) * | 2003-03-03 | 2004-09-08 | Olympus Corporation | Force transmission coil for flexible endoscopic instrument and medical treatment tool using said coil |
| WO2013081227A1 (en) * | 2011-12-02 | 2013-06-06 | 인큐메덱스 엘엘씨 | Microcoil assembly |
| CN105769297A (en) * | 2016-05-28 | 2016-07-20 | 黄永德 | Duodenal papilla incision knife |
| CN106859736A (en) * | 2017-02-23 | 2017-06-20 | 中南大学湘雅医院 | Rotatable duodenal papilla incision knife |
| WO2019161140A1 (en) * | 2018-02-15 | 2019-08-22 | Boston Scientific Scimed, Inc. | Atherectomy medical device |
| CN112494079A (en) * | 2019-09-16 | 2021-03-16 | 李升锦 | Spiral sampling puncture biopsy needle |
-
2021
- 2021-04-08 CN CN202110377776.5A patent/CN113081180A/en active Pending
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH02104371A (en) * | 1988-06-13 | 1990-04-17 | Samuel Shiber | Atelectomy apparatus |
| EP0410602A1 (en) * | 1989-07-24 | 1991-01-30 | Lake Region Manufacturing Co. Inc. | Hollow lumen cable apparatus |
| EP1454588A2 (en) * | 2003-03-03 | 2004-09-08 | Olympus Corporation | Force transmission coil for flexible endoscopic instrument and medical treatment tool using said coil |
| WO2013081227A1 (en) * | 2011-12-02 | 2013-06-06 | 인큐메덱스 엘엘씨 | Microcoil assembly |
| CN105769297A (en) * | 2016-05-28 | 2016-07-20 | 黄永德 | Duodenal papilla incision knife |
| CN106859736A (en) * | 2017-02-23 | 2017-06-20 | 中南大学湘雅医院 | Rotatable duodenal papilla incision knife |
| WO2019161140A1 (en) * | 2018-02-15 | 2019-08-22 | Boston Scientific Scimed, Inc. | Atherectomy medical device |
| CN112494079A (en) * | 2019-09-16 | 2021-03-16 | 李升锦 | Spiral sampling puncture biopsy needle |
Non-Patent Citations (1)
| Title |
|---|
| 谢娟等: "十二指肠乳头针形刀开窗术和辅助法在困难性ERCP中的应用", 《中南医学科学杂志》 * |
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