Saudi Journal of Kidney Diseases and Transplantation最新文献_第6页

Cost of Drivers among Patients in the First Year after Kidney Transplantation - A Retrospective Study. 肾移植后第一年患者的驾驶成本 - 一项回顾性研究。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-09-01 Epub Date: 2024-03-11 DOI: 10.4103/1319-2442.397200

Glennis Fiona J Javelosa-Tan, Benita S Padilla, Concesa B Cabanayan-Casasola, Irina M Rey-Roxas, Carlo Irwin A Panelo

{"title":"Cost of Drivers among Patients in the First Year after Kidney Transplantation - A Retrospective Study.","authors":"Glennis Fiona J Javelosa-Tan, Benita S Padilla, Concesa B Cabanayan-Casasola, Irina M Rey-Roxas, Carlo Irwin A Panelo","doi":"10.4103/1319-2442.397200","DOIUrl":"https://doi.org/10.4103/1319-2442.397200","url":null,"abstract":"The cost of kidney transplantation (KT) and its follow-up care greatly exceeds the mean annual family income. Governmental support during the post-transplant period is needed. This study aimed to identify the drivers of cost during the 1st year after KT. The records of 129 adult Filipino KT recipients over 2 years in a single center were reviewed to determine the total cost for the 1st year after KT, such as diagnostics, medications, supplies, and professional fees. Univariate and multivariate analyses were carried out to determine the economic impact of the baseline characteristics, comorbidities, and events after KT. The direct costs of care were significantly higher among patients aged >40 years (P = 0.009), those with diabetic kidney disease as the primary renal disease (P <0.0001), and those with a high Charlson comorbidity index (P = 0.001). Multivariate regression analysis showed that patients with diabetes mellitus paid US$ 6813.6 more, and those hospitalized for any infection spent US$ 3877.4 more than those without comorbid conditions or complications. The results showed that diabetes mellitus and hospitalization for any infection significantly impacted the cost of follow-up care. Health-care policies that can aid patients after KT are needed to minimize expenditures and avoid complications.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence and Risk Factors of Chronic Kidney Disease in the General Population in Abidjan, Côte d'Ivoire: A Cross-sectional Study. 科特迪瓦阿比让普通人群中慢性肾病的患病率和风险因素：一项横断面研究。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-09-01 Epub Date: 2024-03-11 DOI: 10.4103/1319-2442.397204

Kouamé Hubert Yao, Sery Patrick Diopoh, Serge Didier Konan, Monlet Cyr Guehi, Sira Kamagate, Kolo Ouattara, Mohamed Ibrahim Alex Moudachirou

{"title":"Prevalence and Risk Factors of Chronic Kidney Disease in the General Population in Abidjan, Côte d'Ivoire: A Cross-sectional Study.","authors":"Kouamé Hubert Yao, Sery Patrick Diopoh, Serge Didier Konan, Monlet Cyr Guehi, Sira Kamagate, Kolo Ouattara, Mohamed Ibrahim Alex Moudachirou","doi":"10.4103/1319-2442.397204","DOIUrl":"https://doi.org/10.4103/1319-2442.397204","url":null,"abstract":"Chronic kidney disease (CKD) is a major cause of morbidity and mortality worldwide, but few studies are available on CKD in Cote d'Ivoire. We aimed to assess the prevalence of CKD and identify its associated factors in the general population in Abidjan in 2016 in a cross-sectional study that included 1418 subjects. We did not receive laboratory data for 38 subjects, including serum creatinine data. Of the 1380 remaining subjects, 138 cases of CKD were included in the study (10% prevalence). We observed a female predominance (sex ratio = 0.81), and the mean age was 43.7 ± 14.5 years. Histories of hypertension (HTN) (29.7%) and diabetes (10.1%) were reported. The main clinical signs were high blood pressure (51.4%), obesity (21%), proteinuria (37.9%), and hematuria (37.4%). The glomerular filtration rate (GFR) was <60 mL/min in 8.2% of cases according to the Modification of Diet in Renal Disease equation, in 8.6% according to the CKD Epidemiology Collaboration equation, and in 12.6% according to the Cockroft-Gault (CG) equation. The other laboratory signs were hyperglycemia (51.4%), hypercholesterolemia (34.1%), and hyperlipidemia (21%). In the multivariate analysis, factors such as female sex (P = 0.013), age >55 years (P = 0.02), a history of HTN (P = 0.001), hypercholesterolemia (P = 0.010), and hyperlipidemia (P = 0.009) were associated with the risk of CKD. The prevalence of CKD was high in our study. The CG equation should not be used to estimate the GFR in the general population. Prevention involves managing modifiable risk factors.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Sensitivity and Specificity of Serum Phospholipase A2 Receptor Antibodies in Diagnosing Primary Membranous Nephropathy in Patients with Adult Nephrotic Syndrome and its Correlation with Serum Phospholipase A2 Receptor Staining in Kidney Biopsies. 血清磷脂酶 A2 受体抗体诊断成人肾病综合征患者原发性膜性肾病的敏感性和特异性及其与肾活检中血清磷脂酶 A2 受体染色的相关性。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-09-01 Epub Date: 2024-03-11 DOI: 10.4103/1319-2442.397203

Deepesh Vellakampadi, Ravishankar Bonu, Vishwanath Siddini, Mahesh Vankalakunti

{"title":"The Sensitivity and Specificity of Serum Phospholipase A2 Receptor Antibodies in Diagnosing Primary Membranous Nephropathy in Patients with Adult Nephrotic Syndrome and its Correlation with Serum Phospholipase A2 Receptor Staining in Kidney Biopsies.","authors":"Deepesh Vellakampadi, Ravishankar Bonu, Vishwanath Siddini, Mahesh Vankalakunti","doi":"10.4103/1319-2442.397203","DOIUrl":"https://doi.org/10.4103/1319-2442.397203","url":null,"abstract":"Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome (NS) in nondiabetic adults, with about 70%-80% of cases of MN being primary MN (pMN). Many studies have shown that serum phospholipase A2 receptor (PLA2R) antibodies are a diagnostic and prognostic biomarker for pMN, with a pooled diagnostic sensitivity and specificity of 54%-82% and 89%-100%, respectively, resulting in PLA2R staining and serum PLA2R antibodies being incorporated in the management algorithms of MN. We studied the sensitivity and specificity of serum PLA2R antibodies for diagnosing pMN and its correlation with PLA2R staining in kidney biopsies in a prospective observational study of 58 adult NS subjects undergoing a kidney biopsy. Serum PLA2R antibodies were determined by indirect immunofluorescence (IF) before the biopsy. Kidney biopsies were sent for light microscopy and IF examinations. Biopsy samples with MN histology were stained for PLA2R antigens. Out of the 58 adult NS subjects, 28 were diagnosed with pMN and one with secondary MN. Serum PLA2R antibodies were positive in 12 subjects with pMN, and one had focal segmental glomerulosclerosis not otherwise specified, giving a sensitivity of 42.8% and specificity of 96.7% for diagnosing pMN. There was a significant association between glomerular staining for PLA2R (24 of 28 subjects) and a diagnosis of pMN by kidney biopsy, with a sensitivity of 82.8%. Cohen's kappa agreement between glomerular staining for PLA2R and a diagnosis of MN was 0.83 (0.57-1.08).","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Sodium-glucose Cotransporter 2 Inhibitors in Patients with Chronic Kidney Disease. 在慢性肾病患者中使用钠-葡萄糖共转运体 2 抑制剂。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-09-01 Epub Date: 2024-03-11 DOI: 10.4103/1319-2442.397211

Ahmed M Alkhunaizi, Hanan Khairalla

{"title":"Use of Sodium-glucose Cotransporter 2 Inhibitors in Patients with Chronic Kidney Disease.","authors":"Ahmed M Alkhunaizi, Hanan Khairalla","doi":"10.4103/1319-2442.397211","DOIUrl":"https://doi.org/10.4103/1319-2442.397211","url":null,"abstract":"Chronic kidney disease (CKD) is a common complication in patients with diabetes mellitus. Recently, the class of sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) has been shown to have cardiovascular and renal benefits. The extent of the use of SGLT2-Is in patients with CKD is unknown. The objective of this study was to describe the prescription pattern of empagliflozin (the only available agent) in patients with CKD at Johns Hopkins Aramco Healthcare. This was a retrospective single-center analysis of patients with CKD over 2 years between January 1, 2020, and December 31, 2021. The prescription pattern of empagliflozin for adults (≥18 years) with CKD was determined quarterly. Among 2528 patients with CKD, 119 (5%) patients were prescribed empagliflozin during the first quarter of 2020. The number of patients steadily increased and reached 16% by the end of the study period. Despite the overwhelming evidence of their benefits, the overall utilization of SGLT2-Is was poor. Physicians' education is paramount to increase awareness about the benefits of SGLT2-Is as renoprotective and lifesaving medications.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful Management of Recurrent Tunneled Dialysis Catheter Infections with the Hemodialysis Reliable Outflow Graft Device. 使用血液透析可靠流出移植装置成功治疗复发性隧道透析导管感染。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-09-01 Epub Date: 2024-03-11 DOI: 10.4103/1319-2442.397206

Spyros Papadoulas, Panagiotis Kitrou, Polyzois Tsantrizos, Evangelos Papachristou, Paraskevi G Apostolopoulou, Moulakakis G Konstantinos, Kakkos K Stavros

引用次数: 0

Association between Hypertension and Atrial Fibrillation in Patients on Hemodialysis. 血液透析患者高血压与心房颤动之间的关系

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395447

Alanoud Husain Almuhana, Lolo Ibrahim Alkhwaiter, Abeer Alghamdi, Alreem Alsaleem, Arwa Almehrij, Mubarak Abdalla, Abdulla Ahmed Al Sayyari

{"title":"Association between Hypertension and Atrial Fibrillation in Patients on Hemodialysis.","authors":"Alanoud Husain Almuhana, Lolo Ibrahim Alkhwaiter, Abeer Alghamdi, Alreem Alsaleem, Arwa Almehrij, Mubarak Abdalla, Abdulla Ahmed Al Sayyari","doi":"10.4103/1319-2442.395447","DOIUrl":"10.4103/1319-2442.395447","url":null,"abstract":"This study aimed to evaluate the prevalence and the association between hypertension (HTN) and atrial fibrillation (AF) in hemodialysis (HD) patients. A chart review-based, cross-sectional study was conducted on HD patients who had received HD for at least 6 months. Demographic, hemodynamic, and laboratory data were retrieved from the BestCare system, and the main outcomes were blood pressure before and after dialysis, and the presence of AF. Our sample consisted of 304 HD patients; 162 (53%) were male, and the mean age was 63 ± 18 years. Sixty-eight (20%) had AF, of whom 44 (64.7%) were male, with a mean age of 73 ± 12 years. The risk of AF increased by 0.4 [odds ratio: 1.04; 95% confidence interval (CI): 1.02-1.06; P <0.001] for every year of age. Almost the entire sample (66.45%, n = 202) was hypertensive, and those patients had a mean age of 64 ± 17 years, and nearly one-third had a body mass index in the obese category (28.7%, n = 58). In addition, with every increase in the Charlson comorbidity index score by two points, there was a 40% increased risk of developing HTN (OR: 2.47; 95% CI: 1.17-5.18; P = 0.017). The risk factors for the development of HTN and AF in HD patients were found to be increasing age for AF and female sex for HTN. The presence of HTN and diabetes increased the risk of developing AF seven-fold after HD.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing the Effect of Local Application of Peppermint and Cold Compresses on the Severity of Pain from Venipuncture in Dialysis Patients: A Parallel Randomized Clinical Trial Study. 比较局部应用薄荷和冷敷对透析患者静脉穿刺疼痛严重程度的影响：平行随机临床试验研究》。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395444

Bita Koushki, Mahboobeh Khajeh, Hossein Bagheri, Seyedeh Solmaz Talebi, Hossein Ebrahimi

{"title":"Comparing the Effect of Local Application of Peppermint and Cold Compresses on the Severity of Pain from Venipuncture in Dialysis Patients: A Parallel Randomized Clinical Trial Study.","authors":"Bita Koushki, Mahboobeh Khajeh, Hossein Bagheri, Seyedeh Solmaz Talebi, Hossein Ebrahimi","doi":"10.4103/1319-2442.395444","DOIUrl":"10.4103/1319-2442.395444","url":null,"abstract":"Pain at the injection site is one of the most common complaints in the clinic and is the most important symptom affecting the quality of life of hemodialysis (HD) patients. The aim of this study was to determine the effect and compare the topical application of peppermint and cold compresses on the intensity of pain caused by the insertion of a needle into the fistula of HD patients. In this parallel randomized clinical trial, 99 HD patients were assigned to three groups receiving peppermint, a cold compress, or a control using six blocks. For the peppermint group, 20 min before the needle's insertion, a peppermint gel was used; for the cold compress group, an ice pack was used; and for the control group, the usual method was applied. The patients' pain was assessed with the Visual Analog Scale immediately after the needle's insertion. The results showed that after the intervention, the mean and standard deviation of the pain score in the intervention groups receiving peppermint (4.81 ± 1.13) or a cold compress (4.78 ± 1.13) were significantly less than those of the control group (8.42 ± 1.22) (P <0.001), but there was no statistically significant difference between the peppermint group and the cold compress group (P = 0.91). The use of peppermint, which is a cheap and uncomplicated herbal medicine, and a cold compress, which is easy to use and available, is recommended to reduce the severity of pain caused by venipuncture in HD patients.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence and Risk Factors of New-onset Diabetes after Transplant in East Africans. 东非人移植后新发糖尿病的患病率和风险因素。

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395449

Salsabil Osman Nasir, Helen McCarthy, Ihab Abdel-Rahim Mohamed Ahmed

{"title":"Prevalence and Risk Factors of New-onset Diabetes after Transplant in East Africans.","authors":"Salsabil Osman Nasir, Helen McCarthy, Ihab Abdel-Rahim Mohamed Ahmed","doi":"10.4103/1319-2442.395449","DOIUrl":"10.4103/1319-2442.395449","url":null,"abstract":"Very little is known about the prevalence of new-onset diabetes after transplant (NODAT) in sub-Saharan and Eastern Africans. Most of the data are related to African Americans and to North and South Africans. The aims of this study were to examine the prevalence of NODAT in Sudanese renal transplant recipients, compare it with the published literature, and identify the risk factors for developing NODAT. In total, 150 patients who received a living-related kidney transplant between January 2015 and January 2016 were included in this study. Patients with diabetic nephropathy and pretransplant diabetes were excluded. Follow-up was for 2 years after the transplant. The variables studied were age, sex, body mass index, a family history of diabetes mellitus (DM), pretransplant steroid therapy, dyslipidemia, and hepatitis C virus infection. Twenty- three patients (15.3%) developed NODAT during the study period. The mean age of the patients who developed NODAT was 39 ± 14 years, and the mean time to develop NODAT was 5.78 ± 5.9 months. In the multivariate analysis, the risk factors for developing NODAT were a family history of DM (P = 0.01) and pretransplant steroid therapy (P = 0.01). The prevalence of NODAT in this study was 15.3%, which is in line with the reported literature from North Africa. However, it was significantly lower than the reported prevalence in African Americans.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 and Long-term Follow-up of a Rhodococcus equi Brain Abscess in a Renal Transplant Recipient. 成功治疗肾移植受者马尾罗杆菌脑脓肿并进行长期随访

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395453

Zaheer Udin Babar, Asma Nasim, Sunil Kumar Dodani, Tahir Aziz

引用次数: 0

Acute Kidney Injury in Acute Myocardial Infarction and Its Outcome at 3 and 6 Months. 急性心肌梗死急性肾损伤及其 3 个月和 6 个月后的预后

IF 0.5

Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395445

Jaspreet Kaur, Nidhi Bhardwaj, Sreenivas Reddy, Sanjay D'Cruz

{"title":"Acute Kidney Injury in Acute Myocardial Infarction and Its Outcome at 3 and 6 Months.","authors":"Jaspreet Kaur, Nidhi Bhardwaj, Sreenivas Reddy, Sanjay D'Cruz","doi":"10.4103/1319-2442.395445","DOIUrl":"10.4103/1319-2442.395445","url":null,"abstract":"Epidemiological data on the prevalence of acute kidney injury (AKI) in acute coronary syndrome are sparse, with most studies having been conducted retrospectively. This study prospectively analyzed the incidence of AKI in patients with acute myocardial infarction (AMI) and to identify the risk factors for AKI and their renal outcome at 3 and 6 months. This was a prospective and observational study, which enrolled 120 patients presenting with their first episode of AMI to our hospital and consented to the study. Renal function tests were performed at admission, at 48 h, and at follow-up at 3 and 6 months. The majority of the patients underwent a percutaneous coronary intervention (59.2%), 21.7% received thrombolytic therapy, and 19.2% were managed conservatively. At 48 h, 11 patients had AKI. At 3 months, 8 patients had died, and renal dysfunctions were seen in 9 out of 112 patients. At 6 months, 12 patients out of 112 had renal dysfunction. There was no difference in the incidence of AKI in patients with an estimated glomerular filtration rate above and below 60 mL/min/1.73 m2. Killip Class 4 and diabetes mellitus were associated with an increased incidence of renal dysfunction in AMI patients. The type of treatment and the use of a contrast agent in the coronary intervention did not affect the development of AKI. According to this study, if indicated, a percutaneous coronary intervention should not be denied to patients for fear of developing AKI. This needs to be examined in larger randomized trials.","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0