ebook img

Deqi Sensation in Different Kinds of Acupuncture PDF

176 Pages·2014·15.2 MB·English
by  
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview Deqi Sensation in Different Kinds of Acupuncture

Evidence-Based Complementary and Alternative Medicine Deqi Sensation in Different Kinds of Acupuncture Guest Editors: Cun-Zhi Liu, Gerhard Litscher, Fan-Rong Liang, Jian Kong, Lin-Peng Wang, and Lu Wang Deqi Sensation in Different Kinds of Acupuncture Evidence-Based Complementary and Alternative Medicine Deqi Sensation in Different Kinds of Acupuncture GuestEditors:Cun-ZhiLiu,GerhardLitscher,Fan-RongLiang, Jian Kong, Lin-Peng Wang, and Lu Wang Copyright©2014HindawiPublishingCorporation.Allrightsreserved. Thisisaspecialissuepublishedin“Evidence-BasedComplementaryandAlternativeMedicine.”Allarticlesareopenaccessarticles distributedundertheCreativeCommonsAttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninany medium,providedtheoriginalworkisproperlycited. Editorial Board M.A.Abdulla,Malaysia Jen-HweyChiu,Taiwan Ching-LiangHsieh,Taiwan JonAdams,Australia W.Chi-shingCho,HongKong JingHu,China ZurainiAhmad,Malaysia JaeYoulCho,Korea Sheng-TengHuang,Taiwan U.P.Albuquerque,Brazil Seung-HunCho,RepublicofKorea BennyTanKwongHuat,Singapore GianniAllais,Italy CheeYanChoo,Malaysia RomanHuber,Germany TerjeAlraek,Norway Li-FangChou,Taiwan AngeloAntonioIzzo,Italy SoulimanAmrani,Morocco RyowonChoue,RepublicofKorea SureshJadhav,India AkshayAnand,India Shuang-EnChuang,Taiwan KanokwanJarukamjorn,Thailand ShrikantAnant,USA J.-H.Chung,RepublicofKorea YongJiang,China ManuelArroyo-Morales,Spain EdwinL.Cooper,USA ZhengL.Jiang,China SyedB.Asdaq,SaudiArabia GregoryD.Cramer,USA StefanieJoos,Germany SeddighehAsgary,Iran MengCui,China SirajudeenK.N.S.,Malaysia HyunsuBae,RepublicofKorea RobertoN.Cuman,Brazil Z.Kain,USA LijunBai,China VincenzoDeFeo,Italy OsamuKanauchi,Japan SandipK.Bandyopadhyay,India R.DelaPuertaVa´zquez,Spain DaeGillKang,RepublicofKorea SarangBani,India MartinDescarreaux,USA WenyiKang,China VassyaBankova,Bulgaria AlexandraDeters,Germany Shao-HsuanKao,Taiwan WinfriedBanzer,Germany SivaS.Durairajan,HongKong KrishnaKaphle,Nepal VernonA.Barnes,USA MohamedEddouks,Morocco KenjiKawakita,Japan SamraBashir,Pakistan ThomasEfferth,Germany JongYeolKim,RepublicofKorea JairoKenuppBastos,Brazil TobiasEsch,USA YounChulKim,RepublicofKorea SujitBasu,USA SaeedEsmaeili-Mahani,Iran Cheorl-HoKim,RepublicofKorea DavidBaxter,NewZealand NianpingFeng,China YoshiyukiKimura,Japan Andre-MichaelBeer,Germany YibinFeng,HongKong JoshuaK.Ko,China AlvinJ.Beitz,USA JosueFernandez-Carnero,Spain ToshiakiKogure,Japan YongChoolBoo,RepublicofKorea JulianoFerreira,Brazil JianKong,USA FrancescaBorrelli,Italy FabioFirenzuoli,Italy NandakumarKrishnadas,India GloriaBrusotti,Italy PeterFisher,UK YiuWaKwan,HongKong IshfaqA.Bukhari,Pakistan W.F.Fong,HongKong KuangChiLai,Taiwan ArndtBu¨ssing,Germany JoelJ.Gagnier,Canada ChingLan,Taiwan RainerW.Bussmann,USA SiewHuaGan,Malaysia AlfredLa¨ngler,Germany RaffaeleCapasso,Italy Jian-LiGao,China LixingLao,HongKong OpherCaspi,Israel GabinoGarrido,Chile ClaraBik-SanLau,HongKong HanChae,Korea M.N.Ghayur,Pakistan Jang-HernLee,RepublicofKorea Shun-WanChan,HongKong AnwarulHassanGilani,Pakistan MyeongSooLee,RepublicofKorea Il-MooChang,RepublicofKorea MichaelGoldstein,USA TatleangLee,Singapore RajnishChaturvedi,India MahabirP.Gupta,Panama ChristianLehmann,Canada ChunTaoChe,USA SveinHaavik,Norway MarcoLeonti,Italy Tzeng-JiChen,Taiwan AbidHamid,India LawrenceLeung,Canada KevinChen,USA N.Hanazaki,Brazil KwokNamLeung,HongKong Jian-GuoChen,China K.B.Harikumar,India Ping-ChungLeung,HongKong HubiaoChen,HongKong CoryS.Harris,Canada ChunGuangLi,Australia YunfeiChen,China ThierryHennebelle,France Xiu-MinLi,USA Juei-TangCheng,Taiwan Seung-HeonHong,Korea PingLi,China EvanPaulCherniack,USA MarkusHorneber,Germany ShaoLi,China ManLi,China BeritSmestadPaulsen,Norway MayankThakur,Germany MinLi,China AndreaPieroni,Italy MenakaC.Thounaojam,India YongHongLiao,China RichardPietras,USA MeiTian,China SabinaLim,Korea WarisQidwai,Pakistan EvelinTiralongo,Australia Bi-FongLin,Taiwan XianqinQu,Australia StephanieTjen-A-Looi,USA WenChuanLin,China CassandraL.Quave,USA MichaThlTomczyk,Poland ChristopherG.Lis,USA RojaRahimi,Iran YaoTong,HongKong GerhardLitscher,Austria KhalidRahman,UK KarlWah-KeungTsim,HongKong I-MinLiu,Taiwan CheppailRamachandran,USA VolkanTugcu,Turkey KeLiu,China GamalRamadan,Egypt Yew-MinTzeng,Taiwan YijunLiu,USA KeRen,USA DawnM.Upchurch,USA Cun-ZhiLiu,China ManHeeRhee,RepublicofKorea MarynaVandeVenter,SouthAfrica GaofengLiu,China Mee-RaRhyu,RepublicofKorea SandyvanVuuren,SouthAfrica GailB.Mahady,USA Jose´LuisR´ıos,Spain AlfredoVannacci,Italy JurajMajtan,Slovakia PaoloRobertidiSarsina,Italy ManiVasudevan,Malaysia SubhashC.Mandal,India BasharSaad,PalestinianAuthority CarloVentura,Italy JeanineL.Marnewick,SouthAfrica SumairaSahreen,Pakistan WagnerVilegas,Brazil VirginiaS.Martino,Argentina OmarSaid,Israel PradeepVisen,Canada JamesH.McAuley,Australia LuisA.Salazar-Olivo,Mexico AristoVojdani,USA KarinMeissner,Germany Mohd.ZakiSalleh,Malaysia Shu-MingWang,USA AndreasMichalsen,Germany AndreasSandner-Kiesling,Austria Chong-ZhiWang,USA DavidMischoulon,USA AdairSantos,Brazil ChenchenWang,USA SyamMohan,SaudiArabia G.Schmeda-Hirschmann,Chile Y.Wang,USA J.Molnar,Hungary AndrewScholey,Australia KenjiWatanabe,Japan Vale´rioMonteiro-Neto,Brazil VeroniqueSeidel,UK JintanapornWattanathorn,Thailand Hyung-InMoon,RepublicofKorea SenthamilR.Selvan,USA JennyM.Wilkinson,Australia AlbertMoraska,USA TuhinadriSen,India DarrenR.Williams,RepublicofKorea MarkMoss,UK HongcaiShang,China HarukiYamada,Japan YoshiharuMotoo,Japan RonaldSherman,USA NobuoYamaguchi,Japan FraukeMusial,Germany KarenJ.Sherman,USA JunqingYang,China MinKyunNa,RepublicofKorea KuniyoshiShimizu,Japan Yong-QingYang,China RichardL.Nahin,USA KanShimpo,Japan EunJinYang,RepublicofKorea VitalyNapadow,USA Byung-CheulShin,Korea LingYang,China F.R.F.Nascimento,Brazil YukihiroShoyama,Japan XiufenYang,China S.Nayak,TrinidadAndTobago Chang-GueSon,Korea KenYasukawa,Japan RolandNdipNdip,SouthAfrica RachidSoulimani,France MinYe,China IsabellaNeri,Italy DidierStien,France M.Yoon,RepublicofKorea T.B.Nguelefack,Cameroon Shan-YuSu,Taiwan JieYu,China MartinOffenbaecher,Germany MohdRoslanSulaiman,Malaysia ZunjianZhang,China Ki-WanOh,RepublicofKorea VenilN.Sumantran,India HongQ.Zhang,HongKong YoshijiOhta,Japan JohnR.S.Tabuti,Uganda Wei-BoZhang,China OlumayokunA.Olajide,UK TokuTakahashi,USA Jin-LanZhang,China ThomasOstermann,Germany RabihTalhouk,Lebanon BoliZhang,China StaceyA.Page,Canada Wen-FuTang,China RuixinZhang,USA Tai-LongPan,Taiwan YupingTang,China HongZhang,China BhushanPatwardhan,India LayKekTeh,Malaysia HaiboZhu,China Contents DeqiSensationinDifferentKindsofAcupuncture,Cun-ZhiLiu,GerhardLitscher,Fan-RongLiang, JianKong,Lin-PengWang,andLuWang Volume2014,ArticleID121573,1page LocalAnesthesiaatST36toRevealRespondingBrainAreastodeqi,Ling-minJin,Cai-juanQin,LeiLan, Jin-boSun,FangZeng,Yuan-qiangZhu,Shu-guangYu,Hai-yanYin,andYongTang Volume2014,ArticleID987365,6pages AnExploratorySurveyofDeqiSensationfromtheViewsandExperiencesofChinesePatientsand Acupuncturists,Hong-WenYuan,Liang-XiaoMa,PengZhang,ChiLin,Dan-DanQi,JingLi,Si-YuanXin, Ni-JuanHu,Chun-HuaLi,Yu-QiLiu,JieHao,Jie-PingXie,HaiCui,andJiangZhu Volume2013,ArticleID430851,8pages AppraisaloftheDeqiConceptamongContemporaryChineseAcupuncturists,ShengChen, ShengnanGuo,FedericoMarmori,YanpingWang,QiZhao,BaokaiWang,EunhaeHa,YanhuanMiao, LiXiang,MingwenZhao,YuweiHuo,YinanNan,Li-anLiu,andJipingZhao Volume2013,ArticleID538476,7pages PeripheralandSpinalMechanismsofAcupointSensitizationPhenomenon,Pei-JingRong,ShaoyuanLi, HuiBen,LiangLi,Ling-LingYu,Chang-XiangCui,XiaLi,andBingZhu Volume2013,ArticleID742195,6pages EfficacyofAcupunctureforPrimaryInsomnia:ARandomizedControlledClinicalTrial,JingGuo, Lin-PengWang,Cun-ZhiLiu,JieZhang,Gui-LingWang,Jing-HongYi,andJin-LianCheng Volume2013,ArticleID163850,10pages InvestigatingtheEffectsofThreeNeedlingParameters(Manipulation,RetentionTime,andInsertion Site)onNeedlingSensationandPainProfiles:AStudyofEightDeepNeedlingInterventions, BertrandY.K.LoyeungandDeirdreM.Cobbin Volume2013,ArticleID136763,12pages TheCharacterizationofDeqiduringMoxibustioninStrokeRats,ZhimaiLv,ZhongyongLiu, DandanHuang,RixinChen,andDingyiXie Volume2013,ArticleID140581,4pages AcupunctureDe-qi:FromCharacterizationtoUnderlyingMechanism,Shi-PengZhu,LiLuo, LingZhang,Song-XiShen,Xiao-XuanRen,Meng-WeiGuo,Jia-MinYang,Xiao-YuShen,Yong-SiXu,BoJi, JiangZhu,Xiao-HongLi,andLu-FenZhang Volume2013,ArticleID518784,7pages TheObservationoftheChangeofTCECausedbyDifferentAcupunctureStimulation, TaoHuangandXinnongCheng Volume2013,ArticleID856905,6pages ComparativeEffectivenessoftheDeqiSensationandNon-DeqibyMoxibustionStimulation:A MulticenterProspectiveCohortStudyintheTreatmentofKneeOsteoarthritis,RixinChen, MingrenChen,JunXiong,TongshengSu,MeiqiZhou,JianhuaSun,ZhenhaiChi,BoZhang,andDingyiXie Volume2013,ArticleID906947,7pages IsDeqianIndicatorofClinicalEfficacyofAcupuncture?ASystematicReview,ShuoZhang,WeiMu, LuXiao,Wen-KeZheng,Chun-XiangLiu,LiZhang,andHong-CaiShang Volume2013,ArticleID750140,15pages DeqiSensationinPlaceboAcupuncture:ACrossoverStudyonChineseMedicineStudents, Zhao-huiLiang,Chang-caiXie,Zi-pingLi,Xiao-pingZhu,Ai-pingLu,andWen-binFu Volume2013,ArticleID620671,8pages EffectsofDeqionAutonomicBalanceinAdultTinnitusPatients:StudyDesignofaRandomized ControlledTrial,Qian-QianLi,Guang-XiaShi,Xin-XingFu,Li-LiHan,Li-YingLiu,Cun-ZhiLiu, Lin-PengWang,andNaHou Volume2013,ArticleID756012,6pages InfluenceoftheDeqiSensationbySuspendedMoxibustionStimulationinLumbarDiscHerniation: StudyforaMulticenterProspectiveTwoArmsCohortStudy,RixinChen,MingrenChen,JunXiong, TongshengSu,MeiqiZhou,JianhuaSun,ZhenhaiChi,BoZhang,andDingyiXie Volume2013,ArticleID718593,6pages CharacterizingAcupunctureDeQiinMildCognitiveImpairment:RelationswithSmall-World EfficiencyofFunctionalBrainNetworks,LijunBai,MingZhang,ShangjieChen,LinAi,MaoshengXu, DanWang,FeiWang,LihuaLiu,FangWang,andLixingLao Volume2013,ArticleID304804,8pages DeqiSensationsofTranscutaneousElectricalNerveStimulationonAuricularPoints,XiaolingWang, JiliangFang,QingZhao,YangyangFan,JunLiu,YangHong,HonghongWang,YunyaoMa,ChunhuaXu, ShanShi,JianKong,andPeijingRong Volume2013,ArticleID371543,5pages ALongitudinalStudyoftheReliabilityofAcupunctureDeqiSensationsinKneeOsteoarthritis, RosaB.Spaeth,StephanieCamhi,JaveriaA.Hashmi,MarkVangel,AjayD.Wasan,RobertR.Edwards, RandyL.Gollub,andJianKong Volume2013,ArticleID204259,12pages VisualizedCharacterizationforCerebralResponseofAcupunctureDeqi:ParadoxUnderway,JieYang, Ming-XiaoYang,FangZeng,XiWu,JiaoChen,Yan-QinLiu,YueFeng,andFan-RongLiang Volume2013,ArticleID894750,9pages CharacterizationofDeqiSensationandAcupunctureEffect,Xing-YueYang,Guang-XiaShi, Qian-QianLi,Zhen-HuaZhang,QianXu,andCun-ZhiLiu Volume2013,ArticleID319734,7pages AcupunctureDeQiinStableSomatosensoryStrokePatients:RelationswithEffectiveBrainNetworkfor MotorRecovery,LijunBai,FangyuanCui,YihuaiZou,andLixingLao Volume2013,ArticleID197238,9pages FactorsContributingtoDeQiinAcupunctureRandomizedClinicalTrials,YiYang,Lin-PengWang, LeiZhang,Li-ChenWang,JiaWei,Jia-JianLi,andYi-LeSun Volume2013,ArticleID329392,5pages Yes,ThereIsDeqiSensationinLaserAcupuncture,GerhardLitscher Volume2013,ArticleID198254,4pages Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2014, Article ID 121573, 1 page http://dx.doi.org/10.1155/2014/121573 Editorial Deqi Sensation in Different Kinds of Acupuncture Cun-ZhiLiu,1GerhardLitscher,2Fan-RongLiang,3JianKong,4 Lin-PengWang,5andLuWang2 1AcupunctureandMoxibustionDepartment,BeijingHospitalofTraditionalChineseMedicineAffiliatedtoCapitalMedicalUniversity, 23MeishuguanhouStreet,Dongcheng,Beijing100010,China 2StronachResearchUnitforComplementaryandIntegrativeLaserMedicine, ResearchUnitofBiomedicalEngineeringinAnesthesiaandIntensiveCareMedicine,TCMResearchCenterGraz, MedicalUniversityofGraz,Auenbruggerplatz29,8036Graz,Austria 3CollegeofAcupunctureandMassage,ChengduUniversityofTraditionalChineseMedicine,Chengdu,Sichuan610075,China 4DepartmentofPsychiatry,MassachusettsGeneralHospital(MGH),HarvardMedicalSchool,Charlestown,Boston,MA02129,USA 5SchoolofTraditionalChineseMedicine,CapitalMedicalUniversity,10Xitoutiao,Youanmen,Beijing100069,China CorrespondenceshouldbeaddressedtoCun-ZhiLiu;[email protected] Received30December2013;Accepted30December2013;Published9February2014 Copyright©2014Cun-ZhiLiuetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Thecurrentissueisthe2013issuewhichincludes21interest- ofDeqifromaphysiologicalaspect.Threereviewsarerelated ingpapers. to the recent advances in Deqi and acupuncture effects. AcupuncturestimulationelicitsDeqi,acompositeofuni- The current evidence base is not solid enough to draw any quesensationsthatisessentialforclinicalefficacyaccording conclusion regarding the predicative value of natural Deqi totraditionalChinesemedicine.Inrecentyears,clinicaltrials forclinicalefficacyorthetherapeuticvalueofmanipulation- ofacupuncturehavepaidincreasingattentiontotheevoca- facilitatedDeqi.SixpapersfocusonDeqiinmanualacupunc- tionofDeqi.Thephysiologicalmechanismthatproducesthe ture compared with other types of acupuncture, of which effectofDeqihasalsobeenexploredinseveralstudiesbutis 4 papers introduce the influence of the Deqi sensation by notwellunderstood. suspendedmoxibustionstimulation.Twopapersadoptran- Asmentionedabove,thisspecialissuecontains21papers, domizedcontrolledclinicaltrialandmulticenterprospective of which two papers are related to the characterization of cohort design to compare the clinical effectiveness of Deqi theDeqiduringacupuncturetreatment.Deqisensationoften sensation. occurs during acupuncture treatment and is believed to be Deqishouldbetakenintoaccountinclinicaltrials,and importantforasuccessfulacupuncturetherapy.Sofarthere more researches are required to understand the underlying existnoquestionnairesforchildren.E.Andersetal.createda mechanisms,asdescribedinthisspecialissue. sentencebasedquestionnaireforchildrenonthebasisofthe SouthamptonNeedleSensationquestionnaire(SNSQ).Three Cun-ZhiLiu papers study the interaction between Deqi and acupunc- GerhardLitscher turebyneuroimagingtechnology.Theyprovideevidenceto Fan-RongLiang understandneuralmechanismunderlyingacupuncture.Four JianKong papers are related to the physiological mechanism of Deqi. Lin-PengWang These papers describe current knowledge in understanding LuWang Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2014, Article ID 987365, 6 pages http://dx.doi.org/10.1155/2014/987365 Research Article Local Anesthesia at ST36 to Reveal Responding Brain deqi Areas to Ling-minJin,1Cai-juanQin,2LeiLan,2Jin-boSun,1FangZeng,2Yuan-qiangZhu,1 Shu-guangYu,2Hai-yanYin,2andYongTang2 1LifeSciencesResearchCenter,SchoolofLifeSciencesandTechnology,XidianUniversity,Xi’an,Shaanxi710126,China 2The3rdTeachingHospital,ChengduUniversityofTraditionalChineseMedicine,Chengdu,Sichuan610075,China CorrespondenceshouldbeaddressedtoHai-yanYin;[email protected];[email protected] Received5June2013;Accepted15December2013;Published16January2014 AcademicEditor:Cun-ZhiLiu Copyright©2014Ling-minJinetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Background.Developmentofnon-deqicontrolisstillachallenge.Thisstudyaimstosetupapotentialapproachtonon-deqicontrol byusinglidocaineanesthesiaatST36.Methods.FortyhealthyvolunteerswererecruitedandtheyreceivedtwofMRIscans.Onewas accompaniedwithmanualacupunctureatST36(DQgroup),andanotherwasassociatedwithbothlocalanesthesiaandmanual acupunctureatthesameacupoint(LAgroup).Results.ComparingtoDQgroup,morethan90percentdeqisensationswerereduced bylocalanesthesiainLAgroup.ThemainlyactivatedregionsinDQgroupwerebilateralIFG,S1,primarymotorcortex,IPL, thalamus,insula,claustrum,cingulategyrus,putamen,superiortemporalgyrus,andcerebellum.Surprisinglyonlycerebellum showedsignificantactivationinLAgroup.Comparedtothetwogroups,bilateralS1,insula,ipsilateralIFG,IPL,claustrum,and contralateralACCwereremarkablyactivated.Conclusions.LocalanesthesiaatST36isabletoblockmostofthedeqifeelingsand inhibit brain responses to deqi, which would be developed into a potential approach for non-deqi control. Bilateral S1, insula, ipsilateralIFG,IPL,claustrum,andcontralateralACCmightbethekeybrainregionsrespondingtodeqi. 1.Introduction kindsofshamacupuncturestrategieshavebeenemployedas non-deqicontrol,whichincludeon-invasiveplacebostimula- deqi,alsocalledneedlesensation,referstothesensationsof tion(VonFrey,StreitbergerNeedle,etc.)atthesameacupunc- soreness,numbness,fullness,heaviness,andsofortharound ture point or nonacupuncture point [7, 29, 31], superficial the acupoints of patients when the needle is inserted to needlingatthesameacupuncturepointornonacupuncture a certain depth. At the same time, the operator may feel point [9, 32], or needling at the nonacupuncture point or heavinessortensionaroundtheneedle.Asoneofthemost acupointunrelatedtotheresearchpurpose[20,22,23,33]. classicandimportantconceptsoriginatedfromNeijing(The However, clinical and neuroimaging studies demon- Yellow Emperor’s Classic of Internal Medicine), deqi has stratedthatacupuncturefeelingswereunabletobecompre- drawnincreasingattentionofresearchersrecently[1–5].The hensivelyinhibitedbyshamacupuncture[33,34].Therefore, studiesondeqimainlyfocusedonfourdirections:(1)identi- development of non-deqi control is still a challenge. Giving fyingtherelationshipbetweendeqiandacupunctureefficacy thefactthatbothlocalanestheticattheacupointandgeneral [6–10];(2)quantifyingthedeqisensationsandmakingdeqi anesthesia had been applied to explore the mechanism of visualizationandobjectification[11–13];(3)investigatingthe acupuncture in previous studies [35–38], we proposed that influence factors on deqi such as insertion site, insertion local anesthesia would be a potential strategy to be used as depth,puncturemanipulationandneedleretainingtime,and anapproachofnon-deqicontrol.Basedonthisidea,weset bodyposition[14–19];(4)exploringthemechanismsofdeqi up a non-deqi control of acupuncture using local lidocaine [20–31]. anesthesia at acupoint and evaluating with the scoring of Whateverdirectionofinvestigationsondeqi,itisessential subjects’feelingsandperformedfMRIscanningtoobtainthe toestablishanappropriatenon-deqicontrol.Todate,several changedbrainareas.

Description:
Acupuncturists, Hong-Wen Yuan, Liang-Xiao Ma, Peng Zhang, Chi Lin, Dan-Dan Qi, .. lected from a 3T Siemens scanner (Allegra, Siemens Medical.
See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.