Modern Rheumatology最新文献_第10页

Nationwide epidemiological survey of polyarteritis nodosa in Japan in 2020. 2020 年日本多发性结节炎全国流行病学调查。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae010

Mai Kawazoe, Toshihiro Nanki, Keigo Saeki, Hideki Ishikawa, Yoshikazu Nakamura, Soko Kawashima, Shuichi Ito, Masanari Kodera, Naoko Konda, Shinya Kaname, Masayoshi Harigai

引用次数: 0

Early full weight-bearing and gait exercise after cemented total ankle arthroplasty with a modified anterolateral approach. 采用改良前外侧入路的骨水泥全踝关节置换术后早期完全负重和步态锻炼。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae005

Manabu Sakata, Makoto Hirao, Takaaki Noguchi, Gensuke Okamura, Yusei Higuchi, Yuki Tabuse, Yuki Etani, Kosuke Ebina, Hideki Tsuboi, Akira Miyama, Koichiro Takahi, Kenji Takami, Shigeyoshi Tsuji, Seiji Okada, Jun Hashimoto

{"title":"Early full weight-bearing and gait exercise after cemented total ankle arthroplasty with a modified anterolateral approach.","authors":"Manabu Sakata, Makoto Hirao, Takaaki Noguchi, Gensuke Okamura, Yusei Higuchi, Yuki Tabuse, Yuki Etani, Kosuke Ebina, Hideki Tsuboi, Akira Miyama, Koichiro Takahi, Kenji Takami, Shigeyoshi Tsuji, Seiji Okada, Jun Hashimoto","doi":"10.1093/mr/roae005","DOIUrl":"10.1093/mr/roae005","url":null,"abstract":"Objectives: According to the conventional postoperative procedure after total ankle arthroplasty (TAA), mobilization and weight-bearing is currently started after completion of wound healing. Recently, early mobilization for dorsiflexion after TAA with modified antero-lateral approach was reported to be feasible and safe. To investigate the further possibility of expediting rehabilitation, this study evaluated the feasibility and safety of early full weight-bearing and gait exercise after cemented TAA.Materials and methods: This retrospective, observational study investigated 23 consecutive ankles (OA: 14 ankles, RA: 9 ankles) that had received cemented TAA with a modified antero-lateral approach. These ankles were divided into three groups 1. conventional postoperative protocol, 2. early dorsiflexion protocol, 3. early dorsiflexion+full weight-bearing protocol. Postoperative wound complications were observed and recorded. Number of days for hospitalization was also evaluated.Results: No postoperative complications related to wound healing were observed even after early full weight-bearing and gait exercise. Days for hospitalization was significantly shortened in early full weight-bearing and gait exercise group (group 3) from 35-38 days to 24 days.Conclusions: Within this small number of cases, early full weight-bearing and gait exercise from 7 days after cemented TAA was feasible and safe with the modified antero-lateral approach. Combination of early dorsiflexion mobilization and weight-bearing/gait exercise contributed to shortening the hospitalization day. Innovations in postoperative procedures for rehabilitation after TAA can be expected.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1258-1264"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

lncRNA OIP5-AS1 promotes mitophagy to alleviate osteoarthritis by upregulating PPAR-γ to activate the AMPK/Akt/mTOR pathway. LncRNA OIP5-AS1通过上调PPAR-γ激活AMPK/Akt/mTOR通路，促进有丝分裂以缓解骨关节炎。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae015

Zhilu Sun, Jie Tang, Ting You, Bihong Zhang, Yu Liu, Jing Liu

{"title":"lncRNA OIP5-AS1 promotes mitophagy to alleviate osteoarthritis by upregulating PPAR-γ to activate the AMPK/Akt/mTOR pathway.","authors":"Zhilu Sun, Jie Tang, Ting You, Bihong Zhang, Yu Liu, Jing Liu","doi":"10.1093/mr/roae015","DOIUrl":"10.1093/mr/roae015","url":null,"abstract":"Objectives: Osteoarthritis (OA) is the most common chronic joint degenerative disease. Herein, we investigated long non-coding RNA Opa-interacting protein 5-antisense transcript 1's (OIP5-AS1) in regulating mitophagy during OA.Methods: RNA immunoprecipitation and RNA pull-down verified the relationship between molecules. Cell counting kit-8 detected cell viability. Enzyme-linked immunosorbent assay evaluated inflammatory cytokines secretion. Flow cytometry measured the contents of reactive oxygen species (ROS) and calcium. Immunofluorescence staining analysed TOMM20 and LC3B levels. JC-1 staining was adopted to measure mitochondrial membrane potential. The changes of mitophagy were analysed by transmission electron microscopy.Results: Lipopolysaccharide (LPS) treatment contributed to the decrease of chondrocyte viability, and calcium level and inhibited mitochondrial membrane potential, while elevating the secretion of inflammatory factors, ROS, and TOMM20 expression. OIP5-AS1 overexpression inhibited LPS-induced chondrocyte injury and activated mitophagy. OIP5-AS1 upregulated the peroxisome proliferator-activated receptor-γ (PPAR-γ) mRNA level to regulate adenosine monophosphate-activated protein kinase (AMPK)/v-akt murine thymoma viral oncogene homolog (Akt)/mammalian target of rapamycin (mTOR) signalling by interacting with FUS. PPAR-γ overexpression alleviated LPS-induced chondrocyte injury by activating AMPK/Akt/mTOR signalling. PPAR-γ knockdown reversed the promotion of OIP5-AS1 upregulation on mitophagy.Conclusions: OIP5-AS1 promotes PPAR-γ expression to activate the AMPK/Akt/mTOR signalling, thereby enhancing mitophagy and alleviating OA progression.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1265-1276"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osteoporosis and osteopenia in patients with psoriatic arthritis: A single-centre retrospective study. 银屑病关节炎患者的骨质疏松症和骨质疏松症：一项单中心回顾性研究。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae028

Kenji Takami, Mari Higashiyama, Shigeyoshi Tsuji

{"title":"Osteoporosis and osteopenia in patients with psoriatic arthritis: A single-centre retrospective study.","authors":"Kenji Takami, Mari Higashiyama, Shigeyoshi Tsuji","doi":"10.1093/mr/roae028","DOIUrl":"10.1093/mr/roae028","url":null,"abstract":"Objective: It is known that fracture risk is increased in patients with psoriatic arthritis (PsA); however, there is no consensus on the association with osteoporosis. The purpose of this study was to elicit the rate of osteoporosis and the risk factors of osteoporosis in patients with PsA at our institution.Methods: The data in this study were extracted from 163 patients with PsA. Osteoporosis and osteopenia were defined based on the WHO definition. Osteoporosis was also diagnosed when a fragility vertebral compression fracture was observed.Results: The osteoporosis and osteopenia rates for PsA patients were 11.7% and 33.1%, respectively. The rates of osteoporosis and osteopenia in males were particularly high compared to previous reports, at 9.3% and 34.3%, respectively. Trabecular bone score was considered age-appropriate for both males and females. Body mass index and Trabecular bone score were significantly lower in patients with osteoporosis.Conclusions: In patients with PsA, males are at elevated risk of osteoporosis and associated fragility fractures even if they are under 50 years. Body mass index was significantly lower in osteoporotic cases, suggesting the importance of bone mineral density testing and treatment in such cases.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1252-1257"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of articular cartilage degeneration in patients with osteonecrosis of the femoral head using T2 mapping magnetic resonance imaging. 利用 T2 映射磁共振成像评估股骨头坏死患者的关节软骨退化情况。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae020

Hiroki Kaneta, Takeshi Shoji, Hideki Shozen, Shinichi Ueki, Nobuo Adachi

{"title":"Evaluation of articular cartilage degeneration in patients with osteonecrosis of the femoral head using T2 mapping magnetic resonance imaging.","authors":"Hiroki Kaneta, Takeshi Shoji, Hideki Shozen, Shinichi Ueki, Nobuo Adachi","doi":"10.1093/mr/roae020","DOIUrl":"10.1093/mr/roae020","url":null,"abstract":"Objectives: To evaluate and characterise articular cartilage degeneration in patients with osteonecrosis of the femoral head (ONFH) using T2 mapping magnetic resonance imaging.Methods: We reviewed 35 patients with ONFH (20 males and 15 females, mean age: 45.7 ± 12.9 years) without obvious cartilage abnormalities on plain magnetic resonance imaging (ONFH group) and 25 healthy volunteers (9 males and 16 females, mean age: 42.9 ± 5.8 years) (control group). All patients underwent T2 mapping magnetic resonance imaging after ONFH onset. The region of interest was defined as the weight-bearing portion of the articular cartilage in the femoral head and acetabulum in the coronal view.Results: The T2 values of the articular cartilage of the acetabulum and femoral head, including necrotic and normal regions, were significantly higher in the ONFH group than those in the control group. These T2 values of the acetabulum and femoral head in Stages 3A and 2 were significantly higher in the ONFH group than those in the control group.Conclusions: The articular cartilage of the acetabulum and femoral head can deteriorate after the onset of ONFH, which may affect the natural history of ONFH and ONFH treatment. Our findings suggest the need for early intervention in joint preservation surgery.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1246-1251"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of systemic lupus erythematosus with residual disease activity by switching from belimumab to anifrolumab. 从贝利木单抗转用阿尼单抗，成功治疗有残余疾病活动的系统性红斑狼疮。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae038

Masataka Umeda, Kanako Kojima, Toru Michitsuji, Yoshika Tsuji, Toshimasa Shimizu, Shoichi Fukui, Remi Sumiyoshi, Tomohiro Koga, Shin-Ya Kawashiri, Iwamoto Naoki, Takashi Iagawa, Mami Tamai, Tomoki Origuchi, Masako Furuyama, Masahiko Tsuboi, Naoki Matsuoka, Akitomo Okada, Toshiyuki Aramaki, Atsushi Kawakami

引用次数: 0

Efficacy of golimumab in rheumatoid arthritis patients at high risk of a poor prognosis: Post hoc analysis of GO-FORTH study using cluster analysis. 戈利木单抗对预后不良风险高的类风湿关节炎患者的疗效：利用聚类分析对GO-FORTH研究进行事后分析

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae037

Teita Asano, Yutaka Ishii, Hiroaki Tsuchiya, Junya Masuda

{"title":"Efficacy of golimumab in rheumatoid arthritis patients at high risk of a poor prognosis: Post hoc analysis of GO-FORTH study using cluster analysis.","authors":"Teita Asano, Yutaka Ishii, Hiroaki Tsuchiya, Junya Masuda","doi":"10.1093/mr/roae037","DOIUrl":"10.1093/mr/roae037","url":null,"abstract":"Objectives: Our objective was to assess the efficacy of golimumab (GLM) in patients with poor prognostic factors (PPFs).Methods: This is a post hoc analysis of GO-FORTH Phase 2/3 study. Cluster analysis was used to determine a patient population with high-risk patterns based on seven PPFs suggested by the European Alliance of Associations for Rheumatology recommendations and limited physical function. Radiographic progression, disease activity, and physical function and associated factors were evaluated over 52 weeks.Results: Overall, 261 rheumatoid arthritis patients were classified into three clusters characterised by high disease activity, high C-reactive protein levels, and limited physical function at baseline. GLM showed suppression of progressive modified total sharp score and decreases in Disease Activity Score 28-joint counts with erythrocyte sedimentation rate and Health Assessment Questionnaire - Disease Index, in all the clusters. In Cluster C that showed almost all the PPF characteristics, a higher rate of change in modified total sharp score ≤0 was observed in GLM 100 mg group than in GLM 50 mg group (63.9% versus 46.5%). C-reactive protein concentration and physical limitation were associated with radiographic progression of Cluster C in GLM treatment.Conclusions: GLM was effective in rheumatoid arthritis patients in a subpopulation at high risk of PPF in GO-FORTH study. A dose of 100 mg may be more beneficial in preventing radiographic progression in this population.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1125-1134"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of medication withdrawal in patients with non-systemic juvenile idiopathic arthritis in Japan using a web-based survey. 通过网络调查评估日本非系统性幼年特发性关节炎患者的停药情况。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae016

Takasuke Ebato, Takayuki Kishi, Keiji Akamine, Tomo Nozawa, Tomoyuki Imagawa, Yuki Bando, Takako Miyamae

{"title":"Evaluation of medication withdrawal in patients with non-systemic juvenile idiopathic arthritis in Japan using a web-based survey.","authors":"Takasuke Ebato, Takayuki Kishi, Keiji Akamine, Tomo Nozawa, Tomoyuki Imagawa, Yuki Bando, Takako Miyamae","doi":"10.1093/mr/roae016","DOIUrl":"10.1093/mr/roae016","url":null,"abstract":"Objectives: Although treatments for juvenile idiopathic arthritis (JIA) have seen considerable advancements, there remains a lack of clear guidelines on withdrawing medications. This study aimed to investigate the current strategies for discontinuing non-systemic JIA treatment.Methods: A web-based questionnaire was distributed to members of the Pediatric Rheumatology Association of Japan.Results: According to 126 responses, the most significant factors influencing JIA treatment tapering were the duration of clinically inactive disease, medication toxicity, and a history of arthritis flares. Respondents were often cautious about discontinuing medication if symptoms, e.g. 'morning stiffness' or 'intermittent joint pain', persisted. Among subtypes, oligoarticular JIA was more amenable to treatment tapering, whereas rheumatoid factor-positive polyarticular JIA proved less amenable. Most respondents started medication tapering after a continuous clinical inactive duration exceeding 12 months, and >50% of them required >6 months to achieve treatment discontinuation. Additionally, 40% of the respondents consistently underwent imaging before treatment tapering.Conclusions: The relative risks of treatment continuation and withdrawal should be considered, and decisions should be made accordingly. To obtain improved understanding of and more robust evidence for the optimal strategies for safely discontinuing JIA treatment, it is crucial to continue investigations including long-term outcomes.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1231-1237"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae017

Atsuko Murashima, Kayoko Kaneko, Hiroshi Oguro, Yukiko Mori, Mikako Goto, Shuko Mishima, Tatsuhiko Anzai, Kunihiko Takahashi

{"title":"Pregnancy-related issues from the perspective of patients with inflammatory rheumatic diseases - Results from a survey of the members of the National Association for Inflammatory Rheumatic Diseases.","authors":"Atsuko Murashima, Kayoko Kaneko, Hiroshi Oguro, Yukiko Mori, Mikako Goto, Shuko Mishima, Tatsuhiko Anzai, Kunihiko Takahashi","doi":"10.1093/mr/roae017","DOIUrl":"10.1093/mr/roae017","url":null,"abstract":"Objectives: This study aimed to clarify the issues related to pregnancy in patients with inflammatory rheumatic diseases (RDs) and to provide useful information for developing medical services from patients' perspectives.Methods: A survey involving approximately 5000 members of the Patients Association for Collagen Vascular Diseases Japan was conducted using a questionnaire that was sent and returned by mail. The questionnaire items included age at the time of the survey, types of RDs, association of RDs with pregnancy/childbirth outcomes, and pregnancy-related supports and hindrances.Results: We received 491 completed questionnaires. The most common RD was systemic lupus erythematosus (n = 309). Approximately 60% of participants had a history of childbirth. Approximately 60% of participants had previously experienced pregnancy-related challenges due to RDs. These included concerns about the influence of drugs on babies, genetic transmission, and active disease. Patients with active disease at the time of conception were more likely to experience disease exacerbation during pregnancy, but this did not correlate with whether the pregnancy was planned.Conclusion: This study revealed that many patients with RDs experienced pregnancy-related challenges and needed appropriate support based on appropriate information. The findings here should help rheumatologists, healthcare providers, and public agencies provide counselling and information.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1162-1169"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and effectiveness of certolizumab pegol in Japanese patients with rheumatoid arthritis: Up to 3-year results from a postmarketing surveillance study. 日本类风湿性关节炎患者使用certolizumab pegol的安全性和有效性：一项上市后监测研究的长达三年结果。

IF 1.8 4区医学

Modern Rheumatology Pub Date : 2024-10-15 DOI: 10.1093/mr/roae019

Hideto Kameda, Keiichiro Nishida, Toshihiro Nanki, Akira Watanabe, Yukiya Oshima, Shigeki Momohara

{"title":"Safety and effectiveness of certolizumab pegol in Japanese patients with rheumatoid arthritis: Up to 3-year results from a postmarketing surveillance study.","authors":"Hideto Kameda, Keiichiro Nishida, Toshihiro Nanki, Akira Watanabe, Yukiya Oshima, Shigeki Momohara","doi":"10.1093/mr/roae019","DOIUrl":"10.1093/mr/roae019","url":null,"abstract":"Objectives: To report up to 3-year safety and effectiveness of certolizumab pegol (CZP) in Japanese patients with rheumatoid arthritis from a postmarketing surveillance study.Methods: Patients enrolled previously completed 24 weeks of CZP in the 24-week postmarketing surveillance study. Adverse drug reactions (ADRs) were recorded for patients who received ≥1 CZP dose. Effectiveness outcomes were 28-joint Disease Activity Score with erythrocyte sedimentation rate and European Alliance of Associations for Rheumatology response. Week 24-156 safety and Week 0-52 effectiveness data are reported here.Results: A total of 781 patients were enrolled, with 735 and 376 patients evaluated for safety and effectiveness, respectively. Within the safety set, 17.8% (131/735) of patients reported ADRs; 9.4% (69/735) reported serious ADRs. Among patients with history of respiratory, thoracic, and mediastinal disorders, 38.4% (28/73) reported ADRs. The most frequent ADRs were infections and infestations (11.8%; 87/735); skin and subcutaneous tissue disorders (1.9%; 14/735); respiratory, thoracic, and mediastinal disorders (1.6%; 12/735). Mean 28-joint Disease Activity Score with erythrocyte sedimentation rate reduced from 4.6 (Week 0) to 2.8 (Week 52). At Week 52, 51.8% (161/311) of patients achieved European Alliance of Associations for Rheumatology Good response.Conclusions: The long-term safety and effectiveness of CZP in the real-world setting in Japan were consistent with previously reported data; no new safety signals were identified.","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":"1103-1114"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0