JOS Case Reports最新文献_第9页

Treatment for the recurrent case of locking of the metacarpophalangeal joint of the thumb: A case report 拇指掌指关节锁定复发病例的治疗方法：病例报告

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-09-14 DOI: 10.1016/j.joscr.2023.09.003

Sara Sugiura, Yasuhiro Seki, Shinichi Shirasawa

引用次数: 0

Posterior spinal fusion for kyphoscoliosis in patients with Pompe disease under long-term enzyme replacement therapy: A case report 长期接受酶替代疗法的庞贝病患者脊柱后凸融合术：病例报告

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-10-31 DOI: 10.1016/j.joscr.2023.08.001

Yoshiki Yamada , Takashi Kamatani , Yusuke Hamada , Kazuma Kitaguchi , Masafumi Kashii

{"title":"Posterior spinal fusion for kyphoscoliosis in patients with Pompe disease under long-term enzyme replacement therapy: A case report","authors":"Yoshiki Yamada , Takashi Kamatani , Yusuke Hamada , Kazuma Kitaguchi , Masafumi Kashii","doi":"10.1016/j.joscr.2023.08.001","DOIUrl":"10.1016/j.joscr.2023.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Pompe disease (PD), an inherited glycogen storage disease, is essentially treated with enzyme replacement therapy (ERT). However, a standard treatment for spinal deformities secondary to PD has not been established.</p></div><div><h3>Case presentation</h3><p>A 16-year-old boy was diagnosed with PD at the age of 4 years, and ERT was started. He had severe kyphoscoliotic deformity for which he underwent posterior spinal correction and fusion surgery from T2 to L4. He had become able to sit for a longer period, and his pain was reduced. Three years postoperatively, radiographic parameters were maintained, with a good quality of life.</p></div><div><h3>Conclusions</h3><p>ERT has been associated with a longer survival rate, and management of spinal deformities is becoming more important for patients with PD surviving around puberty. Despite continuous ERT, PD progressively affects the entire spine. In this case, the fusion area was determined from the upper thoracic vertebra to the lower lumbar vertebra or pelvis according to the surgical strategy for neuromuscular scoliosis.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 169-173"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000394/pdfft?md5=3fd0f8c9e89fb66f2156312ee844ffd1&pid=1-s2.0-S2772964823000394-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total shoulder arthroplasty combined with superior capsular reconstruction using tensor fascia lata: A case report 全肩关节置换术联合阔筋膜张肌上囊重建1例

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-07-17 DOI: 10.1016/j.joscr.2023.07.001

Kenji Kawashima , Nobuo Terabayashi , Hiromi Asano , Haruhiko Akiyama

{"title":"Total shoulder arthroplasty combined with superior capsular reconstruction using tensor fascia lata: A case report","authors":"Kenji Kawashima , Nobuo Terabayashi , Hiromi Asano , Haruhiko Akiyama","doi":"10.1016/j.joscr.2023.07.001","DOIUrl":"10.1016/j.joscr.2023.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Recently, superior capsular reconstruction (SCR) has been suggested as an effective procedure for treating irreparable rotator cuff tears and for restoring superior glenohumeral stability of the shoulder joint. We present the case of a patient with osteonecrosis who was successfully managed with a combination of total shoulder arthroplasty (TSA) and SCR.</p></div><div><h3>Case presentation</h3><p>A 66-year-old woman presented with chronic right-sided shoulder pain. Preoperative radiographs revealed a collapsed humeral head and arthritic changes with glenohumeral joint space narrowing. Magnetic resonance imaging revealed massive rotator cuff tears. She was successfully treated with TSA and SCR using the tensor fascia lata (TFL) graft. At the two-year follow-up, an uneventful postoperative course was noted, and she was satisfied with her good functional outcomes and quality of life.</p></div><div><h3>Conclusions</h3><p>TSA and SCR using TFL may be performed successfully in non-elderly patients with osteoarthritis due to osteonecrosis and irreparable rotator cuff tears.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 118-121"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000266/pdfft?md5=59ea5609213d131af96b676c64a6def6&pid=1-s2.0-S2772964823000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75728504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Orthopaedic manifestations in childhood-onset Satoyoshi syndrome: A case report 儿童期发病中本氏综合征的骨科表现:1例报告

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-07-21 DOI: 10.1016/j.joscr.2023.07.003

Kenta Sawamura , Hiroshi Kitoh , Naoki Abe , Mahito Atobe , Hiroshi Kaneko , Akiko Kitamura

{"title":"Orthopaedic manifestations in childhood-onset Satoyoshi syndrome: A case report","authors":"Kenta Sawamura , Hiroshi Kitoh , Naoki Abe , Mahito Atobe , Hiroshi Kaneko , Akiko Kitamura","doi":"10.1016/j.joscr.2023.07.003","DOIUrl":"10.1016/j.joscr.2023.07.003","url":null,"abstract":"<div><h3>Background</h3><p>Satoyoshi syndrome is a rare multisystem disorder characterized by progressive painful muscle spasms, alopecia, and diarrhea. It causes short stature and severe joint deformities when it occurs in childhood.</p></div><div><h3>Case presentation</h3><p>A 16-year-old boy complained of painful muscle spasms of the limbs and trunk since the age of nine years. He visited us at the age of 13 years because of rickets-like radiological findings and lower limb deformity. He was diagnosed with Satoyoshi syndrome based on the characteristic clinical and radiological findings, including deteriorated muscle spasms, impaired growth, frequent diarrhea, and joint deformities with metaphyseal sclerosis and growth plate widening. Corrective surgeries were performed with guided growth of genu varum and ankle valgus deformities. The correction rate was extremely slow and limited improvement was observed at skeletal maturity.</p></div><div><h3>Conclusions</h3><p>Since Satoyoshi syndrome significantly disturbs longitudinal bone growth during childhood, guided growth surgery should be performed as early as possible.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 135-139"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000308/pdfft?md5=6f57c27e428a5edb67bcd4863a713457&pid=1-s2.0-S2772964823000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81429222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A multilocular discal cyst extending from the spinal canal to the extraforaminal region: A case report 从椎管延伸至椎间孔外的多发性椎间盘囊肿：病例报告

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-09-19 DOI: 10.1016/j.joscr.2023.09.006

Katsuhiko Ishibashi , Tomohide Segawa , Takeshi Kaneko , Yuichi Takano , Hiroki Iwai , Hirohiko Inanami , Hisashi Koga

{"title":"A multilocular discal cyst extending from the spinal canal to the extraforaminal region: A case report","authors":"Katsuhiko Ishibashi , Tomohide Segawa , Takeshi Kaneko , Yuichi Takano , Hiroki Iwai , Hirohiko Inanami , Hisashi Koga","doi":"10.1016/j.joscr.2023.09.006","DOIUrl":"10.1016/j.joscr.2023.09.006","url":null,"abstract":"<div><h3>Background</h3><p>Lumbar discal cysts are intraspinal extradural cysts communicating with the intervertebral disc. The usual location and morphology are in the caudal ventrolateral epidural space of the spinal canal, without extension to the neural foramen or crossing the midline and described as a well-defined homogeneous oval or spherical cyst on low and high signal intensities observed in lumbar lesions on T1-and T2-weighted magnetic resonance imaging, respectively. We report an unusual lumbar discal cyst in terms of the lesion location and morphology.</p></div><div><h3>Case presentation</h3><p>A 33-year-old-man presented with lower back and right anterior thigh pain. Magnetic resonance imaging revealed multilocular cystic lesions in the cranial ventrolateral epidural space at L2-L3 with low and high signal intensities on T1-and T2-weigted magnetic resonance imaging, respectively. We performed a full-endoscopic transforaminal cystectomy under general anesthesia.</p></div><div><h3>Conclusion</h3><p>Lumbar discal cysts should be considered a differential diagnosis for multilocular intraspinal cystic lesion.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 161-164"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000370/pdfft?md5=8d215b35258ad319879825b6cdf6187c&pid=1-s2.0-S2772964823000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135388733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ganglionic cyst in the piriformis muscle area manifested by sciatica and intermittent claudication 梨状肌区神经节囊肿，表现为坐骨神经痛和间歇性跛行

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-07-22 DOI: 10.1016/j.joscr.2023.06.008

Naoya Masuda, Shinobu Takahashi

{"title":"Ganglionic cyst in the piriformis muscle area manifested by sciatica and intermittent claudication","authors":"Naoya Masuda, Shinobu Takahashi","doi":"10.1016/j.joscr.2023.06.008","DOIUrl":"10.1016/j.joscr.2023.06.008","url":null,"abstract":"<div><h3>Background</h3><p>To describe who experienced sciatica and intermittent claudication caused by a ganglionic cyst that had developed in the area of the piriformis muscle, and their treatment plan.</p></div><div><h3>Case presentation</h3><p>A 61-year-old male with left lower limb pain and intermittent claudication. No evidence of nerve compression was detected on a spinal MRI. A hip MRI revealed a cystic lesion around the piriformis muscle, which was in contact with the sciatic nerve. It was a ganglionic cyst that had developed posterior to the hip joint. We performed to surgical intervention, to remove the cyst. Subsequently, the pain relieved over time. An MRI at the time of the final examination 2 years postoperatively indicated that the ganglion had almost completely disappeared, and the pain had improved.</p></div><div><h3>Conclusion</h3><p>When patients present with sciatica, a ganglionic cyst originating in the hip joint must be considered in the differential diagnosis as a rare cause.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 122-125"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000278/pdfft?md5=72dfc01d522693eeafd7ad0f6a26f25a&pid=1-s2.0-S2772964823000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89670848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technical tips for posterior scoliosis surgery after introduction of intrathecal baclofen therapy 引入鞘内巴氯芬疗法后脊柱后凸手术的技术提示

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-10-21 DOI: 10.1016/j.joscr.2023.08.004

Shimei Tanida , Masako Tsukanaka

{"title":"Technical tips for posterior scoliosis surgery after introduction of intrathecal baclofen therapy","authors":"Shimei Tanida , Masako Tsukanaka","doi":"10.1016/j.joscr.2023.08.004","DOIUrl":"10.1016/j.joscr.2023.08.004","url":null,"abstract":"<div><h3>Background</h3><p>Intrathecal baclofen (ITB) is an effective treatment for severe spasticity in children with neurological disorder. An intrathecal catheter and a pump are implanted to provide continuous administration of baclofen. Patients so treated have a high risk of developing severe scoliosis. With increasing introduction of ITB, more patients are undergoing posterior scoliosis surgery. Specific considerations are required in performing this surgery to avoid damage to the catheter and to secure control of spasticity.</p></div><div><h3>Case presentation</h3><p>Our patient is a 12-year-old girl with cerebral palsy who underwent scoliosis surgery after introduction of ITB. Here, we report technical tips for scoliosis surgery to preserve the original catheter, and enhance perioperative management of spasticity. In our patient, spasticity was well controlled throughout the admission, and the perioperative clinical course was uneventful.</p></div><div><h3>Conclusions</h3><p>Although extra attention and specific management are necessary, the indication of scoliosis surgery should be equally considered in patients with or without ITB.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 184-187"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000424/pdfft?md5=a0716bcec4d0757c6c5e8a7890669f8a&pid=1-s2.0-S2772964823000424-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe cervical kyphosis in a young adult with fixed dropped head syndrome, dysphagia, and myelopathy: A case report 一名患有固定垂头综合征、吞咽困难和脊髓病的年轻成年人出现严重颈椎后凸：病例报告

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-09-21 DOI: 10.1016/j.joscr.2023.09.005

Tatsuya Shibata , Hideki Ota , Yoshiharu Takemitsu , Yohei Iguchi , Yoshikuni Kida , Kenichi Tahara

{"title":"Severe cervical kyphosis in a young adult with fixed dropped head syndrome, dysphagia, and myelopathy: A case report","authors":"Tatsuya Shibata , Hideki Ota , Yoshiharu Takemitsu , Yohei Iguchi , Yoshikuni Kida , Kenichi Tahara","doi":"10.1016/j.joscr.2023.09.005","DOIUrl":"10.1016/j.joscr.2023.09.005","url":null,"abstract":"<div><h3>Background</h3><p>Several reports exist on syndromic cervical kyphosis in the elderly, including dropped head syndrome, degenerative spondylosis, and neurological diseases; however, it is rarely reported in young patients especially with complications.</p></div><div><h3>Case presentation</h3><p>We describe a case of a 25-year-old man who presented severe cervical kyphosis with dropped head syndrome, horizontal-gaze disorder, dysphagia, and myelopathy. The etiology of this cervical kyphosis was suspected to be as a result of a combination of an underlying developmental disorder and habitual, long-term cervical flexion postures while engaging in smartphone games. Combined anterior and posterior surgeries resulted in good outcomes and improved the patient's quality of life remarkably.</p></div><div><h3>Conclusion</h3><p>Cervical kyphosis awareness in young patients is crucial. Moreover, combined anterior and posterior approach provides secure, good results, and with less sequelae.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 157-160"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000369/pdfft?md5=2f4e0f1baf58d60c0ff0efb1d780dac1&pid=1-s2.0-S2772964823000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute osteomyelitis after the physeal injury of the distal phalanx of the hand (Seymour fracture): A report of two cases 手部远端指骨骨性损伤（西摩骨折）后的急性骨髓炎：两例病例报告

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-09-20 DOI: 10.1016/j.joscr.2023.09.007

Kie Yamamoto , Haruhiko Shimura , Hidetsugu Suzuki , Eriku Yamada , Koji Fujita , Akimoto Nimura

{"title":"Acute osteomyelitis after the physeal injury of the distal phalanx of the hand (Seymour fracture): A report of two cases","authors":"Kie Yamamoto , Haruhiko Shimura , Hidetsugu Suzuki , Eriku Yamada , Koji Fujita , Akimoto Nimura","doi":"10.1016/j.joscr.2023.09.007","DOIUrl":"10.1016/j.joscr.2023.09.007","url":null,"abstract":"<div><h3>Background</h3><p>Seymour fracture is a distal phalanx physeal injury in children that frequently causes nail plate base dislocation and open fracture. Herein, we report two cases of acute osteomyelitis following Seymour fracture.</p><p>Case Presentation Two boys, aged 12 and 16 years, injured their little finger and presented to a primary care doctor after 8 and 4 days, respectively. Radiographs revealed distal phalanx physeal injury, and the finger was immobilized. Injury site pain and redness increased, and radiographs revealed acute osteolysis after 17 and 11 days, respectively. Delayed presentation to the doctor and the absence of irrigation and antibiotic administration were common in both cases. Osteomyelitis site debridement, simple external fixation, and antibiotic administration were performed.</p></div><div><h3>Conclusions</h3><p>Two cases of acute osteomyelitis following Seymour fracture were treated using simple external fixation. Orthopedists and patients should not underestimate this injury.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 165-168"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000382/pdfft?md5=83eb3977760b98ea02ab77a775b4e4df&pid=1-s2.0-S2772964823000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135389960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pseudoaneurysms after osteosynthesis of hip fractures: A report of two cases and a review of the literature 髋部骨折植骨后假性动脉瘤:附2例报告及文献复习

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-07-18 DOI: 10.1016/j.joscr.2023.06.007

Kei Murata , Keita Nagira , Koji Ishida , Ikuta Hayashi , Masayuki Okuno , Hideki Nagashima

{"title":"Pseudoaneurysms after osteosynthesis of hip fractures: A report of two cases and a review of the literature","authors":"Kei Murata , Keita Nagira , Koji Ishida , Ikuta Hayashi , Masayuki Okuno , Hideki Nagashima","doi":"10.1016/j.joscr.2023.06.007","DOIUrl":"10.1016/j.joscr.2023.06.007","url":null,"abstract":"<div><h3>Background</h3><p>Pseudoaneurysm (PA) is a relative rare postoperative complication of hip fracture in the elderly, but notably is often detected late.</p></div><div><h3>Case</h3><p>We encountered two cases of pseudoaneurysms (PA) of deep femoral artery 8 or more months after hip fracture osteosynthesis. Case 1 was a noninfectious aneurysm that was treated with transcatheter arterial embolization (TAE) and progressed well, while case 2 was more difficult to treat because it was an infected aneurysm which required two surgeries in addition to TAE, as well as long-term antimicrobial therapy. The X-ray examinations for both cases revealed scalloping on the medial femoral 3 months after surgery.</p></div><div><h3>Conclusions</h3><p>TAE is beneficial in PA of deep femoral artery occurring after osteosynthesis of hip fractures, but it is difficult to treat if PA is complicated with infection. The finding of cortical scalloping of the medial side of the femur on X-ray after hip surgery can be useful to avoid overlooking of PA and provide appropriate treatment.</p></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"2 4","pages":"Pages 113-117"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772964823000254/pdfft?md5=7e08cdfbbf780fee8d222f0f5a0f1f76&pid=1-s2.0-S2772964823000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78160107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0