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Gamma oscillations of visual cortex underlying emotion and cognition deficits associated with suicide attempt in major depressive disorder 视觉皮层的伽马振荡是与重度抑郁障碍患者自杀未遂相关的情绪和认知障碍的基础
Nature mental health Pub Date : 2024-06-21 DOI: 10.1038/s44220-024-00269-3
Zhongpeng Dai, Wei Zhang, Hongliang Zhou, Siqi Zhang, Zhilu Chen, Zhijian Yao, Qing Lu
{"title":"Gamma oscillations of visual cortex underlying emotion and cognition deficits associated with suicide attempt in major depressive disorder","authors":"Zhongpeng Dai, Wei Zhang, Hongliang Zhou, Siqi Zhang, Zhilu Chen, Zhijian Yao, Qing Lu","doi":"10.1038/s44220-024-00269-3","DOIUrl":"10.1038/s44220-024-00269-3","url":null,"abstract":"Altered neural oscillations in response to negative or positive emotional stimuli may be related to severe clinical symptoms in patients with major depressive disorder, particularly high suicidality. However, the underlying neurobiological mechanisms of this aberrant oscillatory activity and its potential emotional and cognitive functions remain unclear. Here we conducted a cross-sectional study of 107 participants, including 40 healthy controls and 67 patients with major depressive disorder (33 with suicide attempts and 34 without). All participants underwent an emotional expression recognition task during the magnetoencephalography scanning and completed neurocognitive assessments. Time–frequency characteristics and phase connections were analysed and compared between groups in sensor and source space using cluster-based permutation tests. The association between abnormal oscillatory features and neurocognitive performance was also evaluated. We found that increased gamma oscillations (50–70 Hz) of the visual cortices were considerably associated with suicide attempts in depression. Moreover, gamma-band source power in happy or sad conditions could predict individualized suicide risk. Gamma-band phase connections under the happy or sad condition were related to deficits in large-scale cognitive functions. Overall, gamma oscillations of the visual areas induced by the emotional stimuli were reliable biomarkers for identifying suicide attempts in depressive patients. Abnormal gamma-band connection involving visual cortex under both happy and sad expressions were significantly correlated with broad cognitive deficits. The authors investigate neural oscillations, measured by magnetoencephalography, in response to emotionally valenced stimuli as a potential biomarker characterizing individuals with major depressive disorder who had previously made a suicide attempt.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 8","pages":"924-934"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968608","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
Stress-resilience impacts psychological wellbeing as evidenced by brain–gut microbiome interactions 抗压能力影响心理健康,大脑-肠道微生物组的相互作用证明了这一点
Nature mental health Pub Date : 2024-06-21 DOI: 10.1038/s44220-024-00266-6
Eric An, Desiree R. Delgadillo, Jennifer Yang, Rishabh Agarwal, Jennifer S. Labus, Shrey Pawar, Madelaine Leitman, Lisa A. Kilpatrick, Ravi R. Bhatt, Priten Vora, Allison Vaughan, Tien S. Dong, Arpana Gupta
{"title":"Stress-resilience impacts psychological wellbeing as evidenced by brain–gut microbiome interactions","authors":"Eric An, Desiree R. Delgadillo, Jennifer Yang, Rishabh Agarwal, Jennifer S. Labus, Shrey Pawar, Madelaine Leitman, Lisa A. Kilpatrick, Ravi R. Bhatt, Priten Vora, Allison Vaughan, Tien S. Dong, Arpana Gupta","doi":"10.1038/s44220-024-00266-6","DOIUrl":"10.1038/s44220-024-00266-6","url":null,"abstract":"The brain–gut microbiome (BGM) system plays an influential role on mental health. We characterized BGM patterns related to resilience using fecal samples and multimodal magnetic resonance imaging. Data integration analysis using latent components showed that the high-resilience phenotype was associated with lower depression and anxiety symptoms, higher frequency of bacterial transcriptomes (related to environmental adaptation, genetic propagation, energy metabolism and anti-inflammation), increased metabolites (N-acetylglutamate, dimethylglycine) and cortical signatures (increased resting-state functional connectivity between reward circuits and sensorimotor networks; decreased gray-matter volume and white-matter tracts within the emotion regulation network). Our findings support a multi-omic signature involving the BGM system, suggesting that resilience impacts psychological symptoms, emotion regulation and cognitive function, as reflected by unique neural correlates and microbiome function supporting eubiosis and gut-barrier integrity. Bacterial transcriptomes provided the highest classification accuracy, suggesting that the microbiome is critical in shaping resilience, and highlighting that microbiome modifications can optimize mental health. The authors evaluated and integrated compositional and functional microbiota data using fecal samples taken from healthy individuals and multimodal neuroimaging.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 8","pages":"935-950"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968556","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 shortage of child psychiatrists in mainland China 中国大陆儿童精神科医生短缺问题
Nature mental health Pub Date : 2024-06-18 DOI: 10.1038/s44220-024-00273-7
Zhongliang Jiang, Cody Abbey, Ji Chen, Zhi Yang, Hui Xu, Anyi Zhang, Xianbin Wang, Wenyan Zhang, Yonghua Cui, Huan Wang, Ying Li
{"title":"The shortage of child psychiatrists in mainland China","authors":"Zhongliang Jiang, Cody Abbey, Ji Chen, Zhi Yang, Hui Xu, Anyi Zhang, Xianbin Wang, Wenyan Zhang, Yonghua Cui, Huan Wang, Ying Li","doi":"10.1038/s44220-024-00273-7","DOIUrl":"10.1038/s44220-024-00273-7","url":null,"abstract":"This Comment was conducted to clarify the current number of child psychiatrists in mainland China, to analyze the reasons for the shortages and to provide constructive suggestions for solving the current shortage.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 7","pages":"741-744"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141608122","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
Dissociable effects of dopaminergic medications on depression symptom dimensions in Parkinson disease 多巴胺能药物对帕金森病患者抑郁症状的不同影响。
Nature mental health Pub Date : 2024-06-17 DOI: 10.1038/s44220-024-00256-8
Harry Costello, Anette-Eleonore Schrag, Robert Howard, Jonathan P. Roiser
{"title":"Dissociable effects of dopaminergic medications on depression symptom dimensions in Parkinson disease","authors":"Harry Costello, Anette-Eleonore Schrag, Robert Howard, Jonathan P. Roiser","doi":"10.1038/s44220-024-00256-8","DOIUrl":"10.1038/s44220-024-00256-8","url":null,"abstract":"Depression in Parkinson disease (PD) is common, is disabling and responds poorly to standard antidepressants. Motivational symptoms of depression are particularly prevalent in PD and emerge with loss of dopaminergic innervation of the striatum. Optimizing dopaminergic treatment for PD can improve depressive symptoms. However, the differential effect of antiparkinsonian medication on symptom dimensions of depression is not known. Using data from a large (n = 412) longitudinal study of patients with newly diagnosed PD followed over 5 years, we investigated whether there are dissociable effects of dopaminergic medications on different depression symptom dimensions in PD. Previously validated ‘motivation’ and ‘depression’ dimensions were derived from the 15-item geriatric depression scale. Dopaminergic neurodegeneration was measured using repeated striatal dopamine transporter imaging. We identified dissociable associations between dopaminergic medications and different dimensions of depression in PD. Dopamine agonists were shown to be effective for treatment of motivational symptoms of depression. In contrast, monoamine oxidase-B inhibitors improved both depressive and motivation symptoms, albeit the latter effect is attenuated in patients with more severe striatal dopaminergic neurodegeneration. In this Article, the authors investigate dissociable effects of dopaminergic medications and different depression symptom dimensions in patients with Parkinson disease, suggesting a role for dopamine agonists as a potential treatment.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 8","pages":"916-923"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918274","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
Prescription psychostimulant use, admissions and treatment initiation and retention in pregnant people with opioid use disorder 患有阿片类药物使用障碍的孕妇使用处方精神兴奋剂、入院、开始治疗和继续治疗的情况
Nature mental health Pub Date : 2024-06-11 DOI: 10.1038/s44220-024-00270-w
Kevin Y. Xu, Tiffani D. M. Berkel, Caitlin E. Martin, Hendrée E. Jones, Ebony B. Carter, Jeannie C. Kelly, Carrie M. Mintz, Frances R. Levin, Richard A. Grucza
{"title":"Prescription psychostimulant use, admissions and treatment initiation and retention in pregnant people with opioid use disorder","authors":"Kevin Y. Xu, Tiffani D. M. Berkel, Caitlin E. Martin, Hendrée E. Jones, Ebony B. Carter, Jeannie C. Kelly, Carrie M. Mintz, Frances R. Levin, Richard A. Grucza","doi":"10.1038/s44220-024-00270-w","DOIUrl":"10.1038/s44220-024-00270-w","url":null,"abstract":"While attention deficit hyperactivity disorder is common among people with addiction, the risks and benefits of attention deficit hyperactivity disorder medication in pregnant people with opioid use disorder are poorly understood. Here, using US multistate administrative data, we examined 3,247 pregnant people initiating opioid use disorder treatment, of whom 5% received psychostimulants. Compared to peers not receiving psychostimulants, the psychostimulant cohort had greater buprenorphine (adjusted relative risk 1.81 (1.50–2.18)) but lower methadone initiation (adjusted relative risk 0.39 (0.19–0.78)). Among psychostimulant recipients who initiated buprenorphine, we observed lower buprenorphine discontinuation associated with the psychostimulant cohort compared to nonrecipients (adjusted hazard ratio 0.77 (0.67–0.88)). In within-person case-crossover analyses, person-days defined by psychostimulant fills were associated with fewer substance use disorder-related admissions compared to days without fills (odds ratio 0.50 (0.33–0.76)). Overall, our data suggest that psychostimulant use in pregnancy may be associated with increased buprenorphine initiation, decreased methadone initiation and improved buprenorphine retention. Decreased substance use disorder-related admissions were associated with person-days of psychostimulant receipt, although other risks of psychostimulant use in pregnancy warrant further investigation. In this Article, the authors present data showing that pregnant people seeking treatment for opioid use disorder who receive psychostimulant medication for attention deficit hyperactivity disorder were more likely to initiate and adhere to treatment with buprenorphine.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 7","pages":"801-808"},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141357384","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
Reflecting on LGBT+ mental health 反思女同性恋、男同性恋、双性恋和变性者的心理健康问题
Nature mental health Pub Date : 2024-06-11 DOI: 10.1038/s44220-024-00274-6
{"title":"Reflecting on LGBT+ mental health","authors":"","doi":"10.1038/s44220-024-00274-6","DOIUrl":"10.1038/s44220-024-00274-6","url":null,"abstract":"June marks the month-long observance of Pride, when individuals, institutions and organizations come together to celebrate through jubilant displays of the rainbow flag, by sharing personal experiences and memories, and by demonstrating support for lesbian, gay, bisexual, transgender, questioning/queer, intersex, asexual (LGBT+) communities and allies.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 6","pages":"629-630"},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44220-024-00274-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141308923","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
An integrated understanding of the mechanisms linking social stigma to mental health among marginalized populations 综合理解社会鄙视与边缘化人群心理健康之间的关联机制
Nature mental health Pub Date : 2024-06-10 DOI: 10.1038/s44220-024-00264-8
David M. Frost, Diego Castro
{"title":"An integrated understanding of the mechanisms linking social stigma to mental health among marginalized populations","authors":"David M. Frost, Diego Castro","doi":"10.1038/s44220-024-00264-8","DOIUrl":"10.1038/s44220-024-00264-8","url":null,"abstract":"This Perspective presents a model that integrates mechanisms that explain the association between stigma and mental health that are shared across multiple stigmatized populations. By distinguishing among mediating, protective and intensifying factors, the model can be used to achieve two broad aims: to understand the similarities and differences in common and/or comparable mechanisms that explain the effect of stigma on mental health; and to understand how mechanisms linking stigma to mental health are experienced by individuals at the intersection of multiple stigmatized statuses. Applications and opportunities for new research within and across a variety of stigmatized populations are discussed in relation to these aims. In this Perspective, the authors present an integrative model aimed at understanding and explaining the mechanisms that account for the impact of stigma on the mental health of multiple marginalized populations.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 6","pages":"645-654"},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141308939","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
Associations between stock market fluctuations and stress-related emergency room visits in China 中国股市波动与压力相关急诊就诊之间的关联
Nature mental health Pub Date : 2024-06-07 DOI: 10.1038/s44220-024-00267-5
Sumit Agarwal, Siyu Chen, Haonan He, Xinfei Huang, Teng Li
{"title":"Associations between stock market fluctuations and stress-related emergency room visits in China","authors":"Sumit Agarwal, Siyu Chen, Haonan He, Xinfei Huang, Teng Li","doi":"10.1038/s44220-024-00267-5","DOIUrl":"10.1038/s44220-024-00267-5","url":null,"abstract":"Here we study the relationship between stock market fluctuations and emergency room visits in China. Using daily emergency room visit records from the three largest hospitals in Beijing from 1 January 2009 to 31 December 2012, we find that a one percentage point decrease in daily market returns (Growth Enterprises Index) is associated with 0.185 (P = 0.040, confidence interval (CI) = 0.009 to 0.361, or 0.7%) increased cases of cardiovascular diseases and 0.020 (P = 0.060, CI = 0 to −0.041, or 2.5%) increased cases of mental disorders on that day. Moreover, a one percentage point increase in daily market returns (Growth Enterprises Index) is associated with 0.035 (P = 0.007, CI = 0.010 to 0.059, or 3.3%) increase in cases of alcohol abuse on that day. The health effects are highly nonlinear, instantaneous and more salient for older people and males. By contrast, diseases that are less related to psychological stress (for example, infections and parasitic diseases) are not significantly affected by market fluctuations. A back-of-the-envelope calculation suggests that a ten percentage point decrease in daily market returns is associated with an approximately RMB 35 million increase in national medical expenses related to emergency room services. The authors investigate the association between stock market fluctuations as measured by daily market returns and emergency room visits for mental health disorders and physical illnesses, finding the greatest effects among older people and men.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 8","pages":"909-915"},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141371572","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
Early detection of dementia with default-mode network effective connectivity 通过默认模式网络有效连接早期发现痴呆症
Nature mental health Pub Date : 2024-06-06 DOI: 10.1038/s44220-024-00259-5
Sam Ereira, Sheena Waters, Adeel Razi, Charles R. Marshall
{"title":"Early detection of dementia with default-mode network effective connectivity","authors":"Sam Ereira, Sheena Waters, Adeel Razi, Charles R. Marshall","doi":"10.1038/s44220-024-00259-5","DOIUrl":"10.1038/s44220-024-00259-5","url":null,"abstract":"Altered functional connectivity precedes structural brain changes and symptoms in dementia. Alzheimer’s disease is the largest contributor to dementia at the population level, and disrupts functional connectivity in the brain’s default-mode network (DMN). We investigated whether a neurobiological model of DMN effective connectivity could predict a future dementia diagnosis at the single-participant level. We applied spectral dynamic causal modeling to resting-state functional magnetic resonance imaging data in a nested case–control group from the UK Biobank, including 81 undiagnosed individuals who developed dementia up to nine years after imaging, and 1,030 matched controls. Dysconnectivity predicted both future dementia incidence (AUC = 0.82) and time to diagnosis (R = 0.53), outperforming models based on brain structure and functional connectivity. We also evaluated associations between DMN dysconnectivity and major risk factors for dementia, revealing strong relationships with polygenic risk for Alzheimer’s disease and social isolation. Neurobiological models of effective connectivity may facilitate early detection of dementia at population level, supporting rational deployment of targeted dementia-prevention strategies. Altered patterns of effective connectivity in the brain’s default-mode network predicted both future dementia incidence and time to diagnosis.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 7","pages":"787-800"},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44220-024-00259-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141376743","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
Assessing rates and predictors of cannabis-associated psychotic symptoms across observational, experimental and medical research 通过观察、实验和医学研究评估大麻相关精神病症状的发生率和预测因素
Nature mental health Pub Date : 2024-06-03 DOI: 10.1038/s44220-024-00261-x
Tabea Schoeler, Jessie R. Baldwin, Ellen Martin, Wikus Barkhuizen, Jean-Baptiste Pingault
{"title":"Assessing rates and predictors of cannabis-associated psychotic symptoms across observational, experimental and medical research","authors":"Tabea Schoeler, Jessie R. Baldwin, Ellen Martin, Wikus Barkhuizen, Jean-Baptiste Pingault","doi":"10.1038/s44220-024-00261-x","DOIUrl":"10.1038/s44220-024-00261-x","url":null,"abstract":"Cannabis, one of the most widely used psychoactive substances worldwide, can give rise to acute cannabis-associated psychotic symptoms (CAPS). While distinct study designs have been used to examine CAPS, an overarching synthesis of the existing findings has not yet been carried forward. To that end, we quantitatively pooled the evidence on rates and predictors of CAPS (k = 162 studies, n = 210,283 cannabis-exposed individuals) as studied in (1) observational research, (2) experimental tetrahydrocannabinol (THC) studies, and (3) medicinal cannabis research. We found that rates of CAPS varied substantially across the study designs, given the high rates reported by observational and experimental research (19% and 21%, respectively) but not medicinal cannabis studies (2%). CAPS was predicted by THC administration (for example, single dose, Cohen’s d = 0.7), mental health liabilities (for example, bipolar disorder, d = 0.8), dopamine activity (d = 0.4), younger age (d = −0.2), and female gender (d = −0.09). Neither candidate genes (for example, COMT, AKT1) nor other demographic variables (for example, education) predicted CAPS in meta-analytical models. The results reinforce the need to more closely monitor adverse cannabis-related outcomes in vulnerable individuals as these individuals may benefit most from harm-reduction efforts. The authors synthesize data from previous literature on observational, experimental and medicinal cannabis research to assess rates and predictors of cannabis-associated psychotic symptoms.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"2 7","pages":"865-876"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44220-024-00261-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141271244","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
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