Korean Journal of Internal Medicine最新文献_第2页

Health effects of air pollution on chronic respiratory diseases. 空气污染对慢性呼吸道疾病的健康影响。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2025.423

Yong Suk Jo, Jin Woo Song

{"title":"Health effects of air pollution on chronic respiratory diseases.","authors":"Yong Suk Jo, Jin Woo Song","doi":"10.3904/kjim.2025.423","DOIUrl":"10.3904/kjim.2025.423","url":null,"abstract":"Exposure to both outdoor and indoor air pollution poses significant global public health challenges at all life stages. As the respiratory system serves as the primary entry route for inhaled pollutants, extensive evidence has demonstrated the detrimental effects of various air pollutants on respiratory health. Air pollution is a well-established risk factor for the development, exacerbation, and mortality of chronic respiratory diseases (CRDs), including airway diseases such as asthma, chronic obstructive pulmonary disease, interstitial lung disease, and lung cancer. This review summarizes the epidemiological evidence linking air pollution to the incidence and progression of CRDs and examines the impact of air quality control interventions. With the growing recognition that air pollution is a potentially preventable risk factor contributing to high morbidity and mortality, increasing attention has been directed toward protective strategies. We discuss the recent evidence on non-pharmacological interventions aimed at reducing air pollution exposure, both at the individual and social levels, and emphasize the ongoing need for integrated efforts to improve air quality and respiratory health.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"831-846"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Heart failure with preserved ejection fraction in women: a sex-specific clinical review. 女性保留射血分数的心力衰竭：一项性别特异性临床综述。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2026.086

Soo-Jin Kim, Mi-Seung Shin

{"title":"Heart failure with preserved ejection fraction in women: a sex-specific clinical review.","authors":"Soo-Jin Kim, Mi-Seung Shin","doi":"10.3904/kjim.2026.086","DOIUrl":"10.3904/kjim.2026.086","url":null,"abstract":"Heart failure with preserved ejection fraction (HFpEF) affects approximately half of the current heart failure population and demonstrates marked sex-related differences in pathophysiology, clinical presentation, and therapeutic response. These distinctions reflect the divergent biological pathways that shape disease expression in women and men. In women, disease expression is frequently linked to cardiometabolic stress, vascular dysfunction, and heightened ventricular-arterial coupling, often manifesting as concentric remodeling and a pronounced symptom burden. By contrast, men more commonly exhibit an ischemia-associated phenotype characterized by adverse remodeling and diffuse myocardial fibrosis. These biological differences influence the clinical presentation, biomarker interpretation, imaging findings, and long-term outcomes. Although most pharmacological therapies demonstrate broadly comparable efficacy between sexes, selected neurohormonal interventions and lifestyle-based strategies may yield differential benefits, underscoring the importance of sex- and phenotype-informed management. The recognition of sex-related heterogeneity in HFpEF may refine diagnostic algorithms, improve therapeutic targeting, and inform the design of future precision-based clinical trials.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"819-830"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Concomitant cryoglobulinaemic vasculitis alongside ANCA-associated vasculitis: concurrence or coincidental individual occurrence. 伴随性冷球蛋白性血管炎与anca相关的血管炎：并发或偶然的个体发生。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2025.094

Jeong Yeop Whang, Jang Woo Ha, Jihye Chung, Yong-Beom Park, Jaewoo Song, Younhee Park, Sang-Won Lee

{"title":"Concomitant cryoglobulinaemic vasculitis alongside ANCA-associated vasculitis: concurrence or coincidental individual occurrence.","authors":"Jeong Yeop Whang, Jang Woo Ha, Jihye Chung, Yong-Beom Park, Jaewoo Song, Younhee Park, Sang-Won Lee","doi":"10.3904/kjim.2025.094","DOIUrl":"10.3904/kjim.2025.094","url":null,"abstract":"Background/aims: Cryoglobulinaemic vasculitis (CryoVas) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) share the common characteristic of being small vessel vasculitides but exhibit significant differences in pathologic findings. This study investigated the incidence rate of cryoglobulinaemia and the concurrence of AAV and CryoVas in AAV patients without chronic viral hepatitis or haematologic malignancies.Methods: Among the 324 patients diagnosed with AAV, 136 with available cryoglobulin test results were included. Their clinical data were reviewed, and clinical and laboratory data, including AAV-specific indices at diagnosis, were recorded. Repeated cryoglobulinaemia was defined as cryoglobulin positivity in sera on at least two occasions separated by an interval of ≥ 12 weeks. The classification criteria for CryoVas were applied to all 136 patients with AAV.Results: The median age of the patients was 61.0 years (50.0-69.0), and 41.2% were male patients. Of the 136 patients, 75, 31, and 30 were diagnosed with microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic GPA, respectively. Cryoglobulin was detected in sera of only two patients, yielding a detection rate of 1.5%. Both patients exhibited repeated cryoglobulinaemia and presented with red skin spots, constitutional symptoms, articular involvement, and vascular involvement; enabling their classification as having CryoVas alongside MPA. Additionally, one patient displayed peripheral neuropathy, reduced serum C4 levels, and rheumatoid factor positivity.Conclusion: This study represents the first demonstration that the incidence rates of cryoglobulinaemia and CryoVas are 1.5% in patients with AAV without chronic viral hepatitis or haematologic malignancies.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"952-960"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Population-specific rare variants influence age at diagnosis in Korean inflammatory bowel disease. 人群特异性罕见变异影响韩国炎症性肠病的诊断年龄。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2026.055

Mina Cho, DongHwan Shin, Jongwook Yu, Jae Hee Cheon, Ju Han Kim

{"title":"Population-specific rare variants influence age at diagnosis in Korean inflammatory bowel disease.","authors":"Mina Cho, DongHwan Shin, Jongwook Yu, Jae Hee Cheon, Ju Han Kim","doi":"10.3904/kjim.2026.055","DOIUrl":"10.3904/kjim.2026.055","url":null,"abstract":"Background/aims: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is increasing in East Asia. Most known susceptibility loci, identified primarily in Europeans, remain insufficient to explain clinical heterogeneity in Asians. We performed whole-exome sequencing in Korean IBD patients to identify population-specific variants influencing age at diagnosis.Methods: We analyzed 341 Korean IBD patients (192 CD, 149 UC) from three cohorts. Case-control analysis with external controls was confounded by platform heterogeneity, so we used a within-case Cox proportional hazards model instead. Variants were prioritized using a dual-threshold strategy. Gene-level analysis identified subtype-specific pathways, and disease progression was assessed in patients with longitudinal data (n = 206).Results: We identified 12 novel rare variants (minor allele frequency < 0.01 in gnomAD) predominantly observed in East Asian populations. One variant in GSG1 (rs146166808) reached genome-wide significance (p = 3.39 × 10-8); carriers showed accelerated disease onset and increased risk of aggressive progression (OR = 12.52, p = 0.050). Subtype-specific analyses identified two variants for CD (GSG1, CYP2D6) and five for UC (including IGLL1). Gene-level analysis revealed distinct genetic architectures: CD showed enrichment for axon guidance pathways (p = 0.000065), whereas UC showed enrichment for calcium signaling and tissue maintenance pathways (p = 0.00068).Conclusion: We identified population-specific rare variants influencing disease onset and progression in Korean IBD. Distinct genetic architectures underlying CD and UC provide insight into IBD heterogeneity and potential therapeutic targets in this population.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"847-857"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and immunologic features of adult primary antibody deficiency according to IVIGRT exposure. 成人一抗缺乏症的临床和免疫学特征。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2026.072

Jung-Eun Han, Hyun Young Lee, Haeng Jun Kim, Yoo Seob Shin, Yeong-Min Ye, Hae-Sim Park

{"title":"Clinical and immunologic features of adult primary antibody deficiency according to IVIGRT exposure.","authors":"Jung-Eun Han, Hyun Young Lee, Haeng Jun Kim, Yoo Seob Shin, Yeong-Min Ye, Hae-Sim Park","doi":"10.3904/kjim.2026.072","DOIUrl":"10.3904/kjim.2026.072","url":null,"abstract":"Background/aims: Primary antibody deficiency (PAD) in adults is increasingly recognized, but remains underdiagnosed and undertreated. We described the clinical and immunologic features of adult patients with PAD according to real-world exposure to intravenous immunoglobulin replacement therapy (IVIGRT) and explored whether the Ajou-PAD score reflects treatment decisions in routine clinical practice.Methods: We conducted a retrospective cohort study at Ajou University Hospital (January 1, 2020-November 18, 2024), screening adults (age ≥ 18 yr) diagnosed with PAD, and excluding those with IVIGRT exposure before diagnosis. After 1:1 propensity score matching by age and sex, clinical and laboratory findings between the IVIGRT-exposed and -unexposed groups were compared. The discriminatory performance of the Ajou-PAD score, a composite index integrating clinical and immunologic parameters, was evaluated for IVIGRT exposure using receiver operating characteristic analysis.Results: The final matched cohort included 602 patients (301 per group). Immunoglobulin G subclass 3 deficiency (IgG3SCD) was the most prevalent phenotype and more frequent in the IVIGRT-exposed group than in the IVIGRT-unexposed group. The Ajou-PAD score showed modest discriminatory performance for IVIGRT exposure (AUC = 0.61; 95% CI, 0.56-0.65).Conclusion: In Korean adults with PAD, IgG3SCD was the most prevalent phenotype and was more common among patients receiving IVIGRT in routine clinical practice. The Ajou-PAD score showed modest discriminatory performance for IVIGRT exposure and should be considered an exploratory adjunct rather than a standalone tool for treatment decision-making.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"940-951"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing multiple diagnostic modalities for small bowel evaluation: a strategic approach. 优化小肠评估的多种诊断方式：一种战略方法。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2025.402

Dong Jun Oh, Yun Jeong Lim

{"title":"Optimizing multiple diagnostic modalities for small bowel evaluation: a strategic approach.","authors":"Dong Jun Oh, Yun Jeong Lim","doi":"10.3904/kjim.2025.402","DOIUrl":"10.3904/kjim.2025.402","url":null,"abstract":"Over the past two decades, the small bowel, once considered a diagnostic \"blind spot,\" has become fully and comprehensively accessible. This review summarizes recent advances in the main diagnostic modalities: capsule endoscopy (CE), device-assisted enteroscopy (DAE), computed tomography enterography (CTE), magnetic resonance enterography (MRE), and intestinal ultrasound (IUS). CE provides a noninvasive assessment of mucosal abnormalities, whereas DAE offers the added benefits of tissue sampling and therapeutic intervention. CTE and MRE provide complementary cross-sectional information on mural inflammation, strictures, and extraintestinal involvement. IUS has emerged as a valuable, radiation-free technique for repeated bedside monitoring. We review the diagnostic performance, strengths, and limitations of each modality in key clinical scenarios, including suspected small bowel bleeding, Crohn's disease, and tumors. Finally, we highlight the importance of an integrated, patient-centered approach to optimize the evaluation of small bowel disease and to guide clinical decision-making.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"785-798"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current insights into the diagnosis and management of small bowel bleeding. 目前对小肠出血的诊断和治疗的见解。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2026.008

Sang Hyun Kim, Ja Seol Koo

{"title":"Current insights into the diagnosis and management of small bowel bleeding.","authors":"Sang Hyun Kim, Ja Seol Koo","doi":"10.3904/kjim.2026.008","DOIUrl":"10.3904/kjim.2026.008","url":null,"abstract":"Small bowel bleeding accounts for 5-10% of gastrointestinal (GI) hemorrhage and remains a diagnostic challenge because of its diverse etiologies and subtle clinical presentation. Advances in small bowel imaging have refined the diagnostic approach and have led to the replacement of the term obscure GI bleeding with suspected small bowel bleeding (SSBB) when findings on upper and lower endoscopy are unrevealing. The initial evaluation requires careful assessment of clinical history, comorbidities, medication use, and physical findings, which may help direct suspicion toward specific etiologies such as inflammatory bowel disease, Meckel's diverticulum, angioectasia, or small bowel neoplasms. Small bowel capsule endoscopy (SBCE) is currently recommended as the first-line investigation in stable patients because it offers high diagnostic accuracy, facilitates subsequent deep enteroscopy, and significantly influences clinical management. Device-assisted enteroscopy, including double-balloon, single-balloon, and spiral enteroscopy, provides both diagnostic confirmation and therapeutic intervention, and its diagnostic yield is optimized when performed within 48-72 hours of bleeding. Cross-sectional imaging modalities, such as computed tomography (CT) and CT angiography, serve complementary roles, particularly in hemodynamically unstable patients or when SBCE is negative or contraindicated. Endoscopic therapy, most commonly argon plasma coagulation, remains the primary treatment for small bowel angioectasia; however, rebleeding is common, and long-term outcomes remain suboptimal. Supportive measures, including iron supplementation and blood transfusion, are essential components of care. Pharmacologic therapies, such as thalidomide or octreotide, show potential benefit; however, they are not routinely recommended. A structured, multimodal diagnostic and therapeutic strategy is therefore essential for the optimal management of SSBB.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"808-818"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of antiplatelet treatment in patients with clopidogrel nonresponders with or without carriage of CYP2C19 polymorphism. 携带或不携带CYP2C19多态性的氯吡格雷无反应患者抗血小板治疗的比较

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2017.363.r1

Yun Myoung Ko, Jeong Kyung Kim, Jeong Hee Kim, Sang-Ho Park, Rak Kyeong Choi

引用次数: 0

Treadmill exercise-induced E/e' elevation as a predictor of cardiovascular event in end-stage renal disease on peritoneal dialysis. 跑步机运动诱导的E/ E升高作为腹膜透析终末期肾病患者心血管事件的预测因子

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2016.254.r1

Jong Ho Shin, Ki-Woon Kang, Jung Ho Kim, Jung Yeon Chin, Nae Yu Kim, Sang Hyun Park, Won Ho Kim, Yu Jeong Choi, Kyung Tae Jung

引用次数: 0

Parathyroid hormone-related protein-mediated hypercalcemia of malignancy: insights from a multicenter clinical data warehouse. 恶性肿瘤甲状旁腺激素相关蛋白介导的高钙血症：来自多中心临床数据仓库的见解。

IF 2.2 4区医学

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI: 10.3904/kjim.2026.092

Jinyoung Kim, Yuri Shin, Jeonghoon Ha, Chaiho Jeong, Jeongmin Lee, Kwanhoon Jo, Jang Won Son, Jae-Seung Yun, Ihnsuk Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Ki-Ho Song, Ki-Hyun Baek

{"title":"Parathyroid hormone-related protein-mediated hypercalcemia of malignancy: insights from a multicenter clinical data warehouse.","authors":"Jinyoung Kim, Yuri Shin, Jeonghoon Ha, Chaiho Jeong, Jeongmin Lee, Kwanhoon Jo, Jang Won Son, Jae-Seung Yun, Ihnsuk Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Ki-Ho Song, Ki-Hyun Baek","doi":"10.3904/kjim.2026.092","DOIUrl":"10.3904/kjim.2026.092","url":null,"abstract":"Background/aims: Parathyroid hormone-related protein (PTHrP) is a major mediator of hypercalcemia in patients with malignancy; however, understanding of PTHrP-mediated hypercalcemia remains limited because available evidence has largely been derived from small case series.Methods: We retrospectively analyzed electronic medical records from eight hospitals affiliated with The Catholic University of Korea. Adult patients (> 20 years) with confirmed malignancy and albumin-corrected hypercalcemia (≥ 10.5 mg/dL) between 2013 and 2022 were identified and classified as having PTHrP-mediated hypercalcemia (PTHrP > 1.1 pmol/L) or hypercalcemia due to other causes (PTHrP ≤ 1.1 pmol/L).Results: Among the 289 patients reported to have PTHrP-mediated hypercalcemia, median age was 66 years (interquartile range [IQR], 59-75) and median plasma PTHrP level was 6.1 pmol/L (IQR, 3.5-11.5). Solid tumors accounted for 86% of cases, while hematologic malignancies accounted for the other 14%. The most common cancer types were lung cancer (30%, n = 87), head and neck cancer (11%, n = 31), and multiple myeloma (8%, n = 24). Median survival after the onset of hypercalcemia was 46 days (95% confidence interval [CI], 36-61) in patients with PTHrP-mediated hypercalcemia. Compared with the 169 patients with hypercalcemia due to other causes, PTHrP-mediated hypercalcemia was associated with a higher risk of mortality after adjustment for age, corrected calcium level, and cancer type (adjusted hazard ratio, 4.0; 95% CI, 2.9-5.4).Conclusion: PTHrP-mediated hypercalcemia occurs across a broad spectrum of malignancies and is associated with worse clinical outcomes.","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"41 5","pages":"907-915"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0