Acta Otorhinolaryngologica Italica最新文献_第8页

Type IV optic nerve and Onodi cell: is there a risk of injury during sphenoid sinus surgery? IV 型视神经和奥诺迪细胞：蝶窦手术中是否存在损伤风险？

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2024-02-01 Epub Date: 2023-12-29 DOI: 10.14639/0392-100X-N2462

Gian Luca Fadda, Anastasia Urbanelli, Alessio Petrelli, Marta Trossarello, Letizia Nitro, Alberto Maria Saibene, Eugenio De Corso, Dario Gned, Marco Panfili, Giovanni Cavallo

{"title":"Type IV optic nerve and Onodi cell: is there a risk of injury during sphenoid sinus surgery?","authors":"Gian Luca Fadda, Anastasia Urbanelli, Alessio Petrelli, Marta Trossarello, Letizia Nitro, Alberto Maria Saibene, Eugenio De Corso, Dario Gned, Marco Panfili, Giovanni Cavallo","doi":"10.14639/0392-100X-N2462","DOIUrl":"10.14639/0392-100X-N2462","url":null,"abstract":"Objective: This study aims to determine the prevalence and types of Onodi cells through computed tomography and investigate the relationship between Onodi cell and the surrounding structures, paying particular attention to the risky proximity to the optic nerve canal.Methods: In this study, 430 computed tomography scans of paranasal sinuses were analysed to establish the prevalence and different types of Onodi cells. Furthermore, the relationship between Onodi cell and different patterns of sphenoid sinus pneumatisation and surrounding structures were investigated. Special attention was paid to the relationship between Onodi cell and the optic nerve canal, particularly in cases when the optic nerve canal was bulging by more than 50% into the Onodi cell (Type IV).Results: The Onodi cell was detected in 21.6% of cases, with the most common being Type I (48.5% right, 54.3% left). Type IV bulging of the optic nerve canal into the Onodi cell was observed in 47.1% of cases on the right side, 41.2% on the left side and bilateral in 11.7% of cases.Conclusions: In our series, we observed a high prevalence of Type IV optic nerve bulging into the Onodi cell. For this reason, we suggest that clinicians should always try to identify it in a pre-operative setting with computed tomography to avoid catastrophic consequences during endoscopic sinus surgery approaching the sphenoid area.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"36-41"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073042","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

Management of nasal vestibule carcinomas: recommendations by the Oncological Committee of the Italian Society of Otorhinolaryngology - Head and Neck Surgery. 鼻前庭癌的治疗：意大利耳鼻咽喉-头颈外科协会肿瘤委员会的建议。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2024-02-01 DOI: 10.14639/0392-100X-N2786

Francesco Bussu, Luca Tagliaferri, Michaele Francesco Corbisiero, Cecilia Lotto, Raul Pellini, Pierre Guarino, Giuseppe Mercante, Andrea Galuppi, Francesco Cariti, Giovanni Almadori, Francesco Longo, Luca Calabrese, Jacopo Galli, Livio Presutti, Piero Nicolai, Gabriele Molteni

{"title":"Management of nasal vestibule carcinomas: recommendations by the Oncological Committee of the Italian Society of Otorhinolaryngology - Head and Neck Surgery.","authors":"Francesco Bussu, Luca Tagliaferri, Michaele Francesco Corbisiero, Cecilia Lotto, Raul Pellini, Pierre Guarino, Giuseppe Mercante, Andrea Galuppi, Francesco Cariti, Giovanni Almadori, Francesco Longo, Luca Calabrese, Jacopo Galli, Livio Presutti, Piero Nicolai, Gabriele Molteni","doi":"10.14639/0392-100X-N2786","DOIUrl":"10.14639/0392-100X-N2786","url":null,"abstract":"Objective: Squamous cell carcinoma of the nasal vestibule (NV SCC) is a head and neck malignancy for which there is no established consensus on most aspects of clinical management. The purpose of this document is to give updated recommendations that incorporate recent evidence on its clinical characteristics and the high efficacy of brachytherapy as primary treatment modality.Methods: A working group consisting of the members of the Scientific Committee for Oncology and Reconstructive Surgery of the Italian Society of Otorhinolaryngology Head and Neck Surgery and radiation oncologists expert in brachytherapy was formed to achieve a consensus.Results: Consensus was reached on a set of recommendations, proposing a refined anatomical definition of the nasal vestibule, a novel T staging system of the NV SCC, and brachytherapy as standard of care, with a new method for catheter implantation.Conclusions: The Committee emphasises the critical role of an accurate classification in clinical practice and encourages further research to validate the novel staging system and further improve treatment strategies. Where appropriate, it is recommended that patients be referred to centres with specific experience in brachytherapy for NV SCC.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 1","pages":"13-20"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989035","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

Laryngopharyngeal reflux and idiopathic vocal fold scars. 咽喉反流和特发性声带瘢痕。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2024-02-01 Epub Date: 2023-12-29 DOI: 10.14639/0392-100X-N2625

Giovanna Cantarella, Jerome R Lechien, Lorenzo Pignataro, Mirko Aldè, Ludovica Battilocchi, Maria Rosaria Barillari

引用次数: 0

Validity and reliability of the Questionnaire of Olfactory Disorders for Italian-speaking patients with olfactory dysfunction. 针对讲意大利语的嗅觉功能障碍患者的嗅觉障碍问卷的有效性和可靠性。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2024-02-01 DOI: 10.14639/0392-100X-N2736

Luigi Angelo Vaira, Giancarlo Tirelli, Davide Rizzo, Francesco Uderzo, Francesco Avanzini, Franco Trabalzini, Nicoletta Rivelli, Doris Burger, Luca Calabrese, Paolo Solla, Francesco Bussu, Miguel Mayo-Yáñez, Jerome R Lechien, Giacomo De Riu, Paolo Boscolo-Rizzo

{"title":"Validity and reliability of the Questionnaire of Olfactory Disorders for Italian-speaking patients with olfactory dysfunction.","authors":"Luigi Angelo Vaira, Giancarlo Tirelli, Davide Rizzo, Francesco Uderzo, Francesco Avanzini, Franco Trabalzini, Nicoletta Rivelli, Doris Burger, Luca Calabrese, Paolo Solla, Francesco Bussu, Miguel Mayo-Yáñez, Jerome R Lechien, Giacomo De Riu, Paolo Boscolo-Rizzo","doi":"10.14639/0392-100X-N2736","DOIUrl":"10.14639/0392-100X-N2736","url":null,"abstract":"Objective: To translate and validate an Italian version of the Questionnaire of Olfactory Disorders (IT-QOD).Materials and methods: This is a prospective, multicentre study that involved patients with olfactory dysfunction (OD). Both cases and controls underwent administration of the IT-QOD, Sino-Nasal Outcome Test-22 (SNOT-22) and psychophysical evaluation of orthonasal and retronasal olfactory function.Results: The IT-QOD was administered to 96 patients and 38 controls. The Cronbach's alpha exceeded 0.90, indicating satisfactory internal consistency. The test-retest reliability was found to be high for both parosmia (rs = 0.944) and life quality (rs = 0.969). Patients with OD had significantly higher IT-QOD scores compared to healthy individuals (p < 0.001), indicating strong internal validity. The external validity was also satisfactory, as shown by the significant correlation with SNOT-22 (rs = -0.54) and the threshold, discrimination, and identification score (rs = -0.63).Conclusions: The IT-QOD was demonstrated to be reliable and valid to assess the impact of OD on the quality of life of Italian-speaking patients.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 1","pages":"42-51"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989037","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

Indirect laryngeal surgery of vocal fold polyps: a dying or evolving art? 声带息肉的喉间接手术：濒临消亡还是不断发展的艺术？

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2023-12-01 Epub Date: 2023-07-28 DOI: 10.14639/0392-100X-N2487

Ognjen Cukic, Dejan Radaljac, Nenad Arsovic, Milan Jovanovic, Zoran Milutinovic

{"title":"Indirect laryngeal surgery of vocal fold polyps: a dying or evolving art?","authors":"Ognjen Cukic, Dejan Radaljac, Nenad Arsovic, Milan Jovanovic, Zoran Milutinovic","doi":"10.14639/0392-100X-N2487","DOIUrl":"10.14639/0392-100X-N2487","url":null,"abstract":"Objective: Vocal fold polyps (VFPs) are the most common benign laryngeal lesions that require surgery and are routinely managed by microlaryngoscopy (MLS) under general anaesthesia. Prior to introduction of MLS, VFPs were removed using indirect laryngoscopic surgery (ILS) in local anaesthesia, a procedure that required substantial surgical skill to operate with an unmagnified mirror view of the larynx. With the adoption of wireless endoscopy equipment and personal computers, we tried to simplify this technique so that it can be easily performed in the office. This study aimed to assess the effectiveness of ILS by comparing voice outcomes with MLS.Materials and methods: ILS and MLS were performed in six patients each. Treatment outcomes were measured using a voice self-assessment and objective acoustic analysis. The total cost of both procedures was calculated.Results: Both techniques allowed successful removal of VFPs in all patients, without significant intergroup differences in voice outcomes. The cost of ILS was significantly lower.Conclusions: Despite the pilot nature of the study and the small sample size, our data indicate the potential value of this technique which, considering its simplicity and economic value could be used as an alternative to MLS in carefully selected patients.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"424-429"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274169","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

Treatment and outcomes of minor salivary gland cancers of the larynx and trachea: a systematic review. 喉和气管小涎腺癌的治疗和结果：一项系统综述。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2023-12-01 Epub Date: 2023-10-10 DOI: 10.14639/0392-100X-N2635

Claudia Montenegro, Davide Mattavelli, Davide Lancini, Alberto Paderno, Elisa Marazzi, Vittorio Rampinelli, Michele Tomasoni, Cesare Piazza

{"title":"Treatment and outcomes of minor salivary gland cancers of the larynx and trachea: a systematic review.","authors":"Claudia Montenegro, Davide Mattavelli, Davide Lancini, Alberto Paderno, Elisa Marazzi, Vittorio Rampinelli, Michele Tomasoni, Cesare Piazza","doi":"10.14639/0392-100X-N2635","DOIUrl":"10.14639/0392-100X-N2635","url":null,"abstract":"Objectives: Malignant minor salivary glands carcinomas (MiSGC) of the larynx and trachea are rare tumours and published evidence is sparse. We conducted a systematic review to describe shareable treatment strategies and oncological outcomes of these neoplastic entities.Methods: Full text English manuscripts published from January 1st 2000 to December 14th 2022 were included. Data on demographics, treatments and outcomes were collected. A pooled analysis of 5-year overall survival (OS) was performed.Results: Seventeen articles and 365 patients met the inclusion criteria. The most common subsites involved were subglottic and distal trachea. Adenoid cystic carcinoma was, by far, the most frequent histotype. The first-choice treatment strategy was surgery (86.8%), while adjuvant treatments were delivered in 57.4% of patients. Only 12.9% were treated with definitive radiotherapy with/without chemotherapy. The mean follow-up was 68.3 months. One hundred nine (34.9%) deaths were recorded and 62.4% were cancer-related. Five-year OS ranged from 20% to 100% and, at pooled analysis, it was 83% (range, 78-87%).Conclusions: In case of MiSGC of the larynx and trachea, surgery remains the mainstay of treatment. Adjuvant treatments are frequently delivered. Survival estimates are good overall, but highly heterogeneous.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"365-374"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181737","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

Assessment of middle ear function after conventional or endoscopic microdebrider assisted adenoidectomy. 常规或内窥镜微型ebrider辅助腺样体切除术后中耳功能评估。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2023-12-01 Epub Date: 2023-10-10 DOI: 10.14639/0392-100X-N2593

Oj Giri, S Vijendra Shenoy, Navya Parvathareddy, Praneetha Puvvula, Deeksha Shetty, Nayanika Reddy

{"title":"Assessment of middle ear function after conventional or endoscopic microdebrider assisted adenoidectomy.","authors":"Oj Giri, S Vijendra Shenoy, Navya Parvathareddy, Praneetha Puvvula, Deeksha Shetty, Nayanika Reddy","doi":"10.14639/0392-100X-N2593","DOIUrl":"10.14639/0392-100X-N2593","url":null,"abstract":"Objectives: To compare pre- and post-operative pure tone audiometric and impedance audiometric analysis following conventional and endoscopic microdebrider assisted adenoidectomy and compare the outcomes.Methods: Patients diagnosed with chronic adenoiditis were divided in groups of 25 each. Patients in the first group underwent conventional curettage adenoidectomy, while those in second group underwent endoscopic microdebrider assisted adenoidectomy. Pre- and post-operative pure tone and impedance audiometry were performed for all patients and outcomes were compared.Results: The endoscopic microdebrider assisted method resulted in significantly better outcomes compared to conventional curettage. Criteria such as hearing threshold (p value 0.004 at second follow-up), peak pressure (p value 0.045 at first follow-up) and tympanogram (p value 0.016) showed that the endoscopic method was better, while peak compliance (p value 0.340 at first follow-up) did not show any significant difference between groups.Conclusions: The endoscopic microdebrider assisted method for adenoidectomy has a definite advantage of better visualisation resulting in better clearance of tissue, leading to enhanced middle ear function compared to conventional curettage.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"417-423"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181731","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

Normative data for interpreting the SNOT-22. 解释SNOT-22的规范性数据。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2023-12-01 Epub Date: 2023-10-10 DOI: 10.14639/0392-100X-N2279

Michaela Plath, Matthias Sand, Carlo Cavaliere, Peter K Plinkert, Ingo Baumann, Karim Zaoui

{"title":"Normative data for interpreting the SNOT-22.","authors":"Michaela Plath, Matthias Sand, Carlo Cavaliere, Peter K Plinkert, Ingo Baumann, Karim Zaoui","doi":"10.14639/0392-100X-N2279","DOIUrl":"10.14639/0392-100X-N2279","url":null,"abstract":"Objectives: The Sino-Nasal Outcome Test 22 (SNOT-22) is a validated patient-reported outcome instrument to evaluate the health-related quality of life (HRQoL) in patients with chronic rhinosinusitis (CRS). There are no published normative SNOT-22 scores, limiting its interpretation.Methods: Symptom scores from 1,000 SNOT-22 questionnaires were analysed by principal component analysis (PCA) and exploratory factor analyses. Data were derived from a survey with 1,000 healthy Europeans (reference cohort) who were recruited using the Respondi panel for market and social science research. This subsample was quoted to the population distribution of the German Microcensus and selected from a non-probability panel.Results: The overall normative SNOT-22 score can be detected to be 20.2 ± 19.44. Male (18.49 ± 19.15) and older (> 50 years old; 18.3 ± 17.49) participants had overall lower SNOT-22 mean results than females (21.8 ± 19.6) and younger (21.4 ± 20.55) participants, indicating higher levels of satisfaction. PCA proposed two SNOT-22 domains (\"physiological well-being\" and \"psychological well-being\"), which explained 65% of the variance.Conclusions: These are the first published (German) normative scores for the SNOT-22 and provide a clinical reference point for the interpretation of data.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"390-399"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181736","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

Expression profiles of MMP-9 and EMMPRIN in chronic rhinosinusitis with nasal polyps. 慢性鼻炎伴鼻息肉患者体内 MMP-9 和 EMMPRIN 的表达谱。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2023-12-01 Epub Date: 2023-07-28 DOI: 10.14639/0392-100X-N2197

Spyridon Lygeros, Gerasimos Danielides, George C Kyriakopoulos, Foteini Tsapardoni, Katerina Grafanaki, Constantinos Stathopoulos, Vasileios Danielides

{"title":"Expression profiles of MMP-9 and EMMPRIN in chronic rhinosinusitis with nasal polyps.","authors":"Spyridon Lygeros, Gerasimos Danielides, George C Kyriakopoulos, Foteini Tsapardoni, Katerina Grafanaki, Constantinos Stathopoulos, Vasileios Danielides","doi":"10.14639/0392-100X-N2197","DOIUrl":"10.14639/0392-100X-N2197","url":null,"abstract":"Objective: Metalloproteinases (MMPs) are implicated in tissue remodeling in chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to evaluate the expression profiles of MMP-9 and the extracellular matrix metalloproteinase inducer (EMMPRIN) in nasal polyps compared to healthy mucosa.Methods: Tissue samples from 37 CRSwNP patients undergoing functional endoscopic sinus surgery and mucosal specimens from 12 healthy controls were obtained intra-operatively. MMP-9 and EMMPRIN mRNA levels were assessed by reverse transcription-polymerase chain reaction and their protein expression by Western blot analysis.Results: MMP-9 mRNA expression levels were significantly elevated in CRSwNP compared to controls (p < 0.05). MMP-9 protein levels presented an increasing trend but with no statistical significance (p > 0.05). No statistically significant difference in EMMPRIN mRNA and protein levels was identified.Conclusions: Upregulation of MMP-9 in nasal polyps is evident and highlights its role in the pathogenesis of CRSwNP. The lack of concordance between MMP-9 mRNA and protein levels may be attributed to post-translational gene expression regulation. Although EMMPRIN expression was not significantly different between the two groups, its role remains to be elucidated. MMP-9 may be a valuable biomarker and treatment target in CRSwNP.","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"400-408"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888761","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

Deep learning in endoscopy: the importance of standardisation. 内窥镜检查中的深度学习：标准化的重要性。

IF 2 4区医学

Acta Otorhinolaryngologica Italica Pub Date : 2023-12-01 Epub Date: 2023-10-10 DOI: 10.14639/0392-100X-N2580

Alberto Paderno, Francesca Pia Villani, Alessandra Sordi, Claudia Montenegro, Sara Moccia

引用次数: 0