Breast disease最新文献

Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia. 作为医疗质量指标的乳腺癌前哨结节：评估哥伦比亚的统计数据。

Breast disease Pub Date : 2024-04-08 DOI: 10.3233/bd-230059

Mario Arturo González Mariño

{"title":"Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia.","authors":"Mario Arturo González Mariño","doi":"10.3233/bd-230059","DOIUrl":"https://doi.org/10.3233/bd-230059","url":null,"abstract":"BACKGROUND\u0000Sentinel lymph node biopsy in breast cancer is considered the standard of staging in cases of clinically negative lymph nodes. Its omission in favor of axillary dissection generates significant morbidity.\u0000\u0000\u0000OBJECTIVE\u0000To determine the total number of sentinel node biopsy procedures in breast cancer in Colombia from 2017 through 2020, model and analyze them as if they were performed only in stage I breast cancer patients, and integrate their results into the concepts of quality of medical care.\u0000\u0000\u0000METHODS\u0000Search in a database of the Ministry of Health and Social Protection of Colombia with sentinel lymph node biopsy codes, and filters of breast cancer and year. Their results are contrasted with the number of cases in stage I of breast cancer.\u0000\u0000\u0000RESULTS\u0000Breast cancer TNM staging was reported in 22154 cases, 3648 stage I. In the same time frame, the number of sentinel lymph node biopsies for breast cancer in Colombia was 1045, 28.64% of the total cases reported in stage I.\u0000\u0000\u0000CONCLUSIONS\u0000Colombia is far from complying with the standard indicator of sentinel lymph node biopsy. It is recommended to concentrate breast cancer cases in hospitals that provide the conditions for its performance.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"217 1","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730977","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

Telangiectasias induced by combination tucatinib and ado-trastuzumab emtansine in a patient with metastatic breast cancer. 一名转移性乳腺癌患者因联合使用图卡替尼和ado-trastuzumab emtansine而诱发远端血管瘤。

Breast disease Pub Date : 2024-04-01 DOI: 10.3233/bd-230053

Gabriella F Rodriguez, Anuj Shah, A. Maderal

{"title":"Telangiectasias induced by combination tucatinib and ado-trastuzumab emtansine in a patient with metastatic breast cancer.","authors":"Gabriella F Rodriguez, Anuj Shah, A. Maderal","doi":"10.3233/bd-230053","DOIUrl":"https://doi.org/10.3233/bd-230053","url":null,"abstract":"BACKGROUND\u0000Tucatinib is a tyrosine kinase inhibitor currently used in salvage therapy for human epidermal growth factor receptor 2 (HER2)-positive breast and colorectal cancer. The use of tucatinib alone or in combination with ado-trastuzumab emtansine (T-DM1) in the treatment of advanced HER2-positive cancers is rapidly expanding.\u0000\u0000\u0000OBJECTIVE/METHODS\u0000We report the case of a 66-year-old female who presented to the dermatology clinic with a one-year history of widespread telangiectasias that began after initiation of combination chemotherapy with tucatinib and T-DM1 for metastatic HER2-positive invasive ductal carcinoma.\u0000\u0000\u0000RESULTS\u0000The patient's lesions regressed upon cessation of combination therapy and reappeared in the setting of tucatinib re-initiation, with gradual improvement over the following four months following electrocautery to the affected regions.\u0000\u0000\u0000CONCLUSIONS\u0000We postulate that telangiectasias may be a previously unreported dermatologic side effect of combination treatment with tucatinib and T-DM1. Electrocautery is a safe and effective procedure to reduce the appearance of telangiectasias and improve patient satisfaction during chemotherapy.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"182 3","pages":"61-64"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761384","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 role of platelet rich plasma enriched fat graft for correction of deformities after conservative breast surgery. 富血小板血浆脂肪移植对乳房保守手术后畸形矫正的作用。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-230057

Ahmed Shaaban, Medhat Anwar, Rabie Ramadan

{"title":"The role of platelet rich plasma enriched fat graft for correction of deformities after conservative breast surgery.","authors":"Ahmed Shaaban, Medhat Anwar, Rabie Ramadan","doi":"10.3233/BD-230057","DOIUrl":"10.3233/BD-230057","url":null,"abstract":"Background: Fat transfer has been widely used after breast conservative surgery (BCS) where it aims to recover shapes as a simple, inexpensive, biocompatible method but the technique is not without complications. Platelet Rich Plasma (PRP) is a promising approach to enhance fat graft survival and subsequently improve the outcome. The aim of this study was to evaluate the effect of enriching fat graft with PRP for delayed correction of deformities after conservative surgery for breast cancer regarding esthetic outcome and incidence of complications.Methods: The current study included 50 female patients who were scheduled for delayed lipofilling for correction of deformities after conservative surgery for breast cancer. The studied patients were randomly allocated into 2 groups: Group I (G I) included 25 patients scheduled for PRP enriched lipoinjection and Group II (G II) included 25 patients scheduled for lipoinjection without PRP as a control group.Results: Number of sessions of lipoinjection was significantly less in G I in comparison to G II (P = 0.024). During the 2nd session; the amounts of fat injected and harvested were significantly less in G I in comparison to G II (P = 0.049 and 0.001 respectively). Recipient site complications were significantly more evident in G II in comparison to G I (P = 0.01). Surgeon and patient satisfactions were significantly more evident in GI in comparison to G II (P = 0.005 and 0.029 respectively).Conclusion: The addition of PRP to fat grafts is a simple, cost-effective and safe method to improve esthetic outcome and decrease complications.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"111-118"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956233","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

Primary breast sarcomas: A 13 case-series study treated in university hospital in central Tunisia over a 25-year period. 原发性乳腺肉瘤：突尼斯中部大学医院 25 年间治疗的 13 个病例系列研究。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-230037

Fadoua Bouguerra, Samia Kanoun Belajouza, Emna Mziou, Rym Zanzouri, Hayfa Chahdoura, Sabrine Tbessi, Nadia Bouzid, Sameh Tebra Mrad

{"title":"Primary breast sarcomas: A 13 case-series study treated in university hospital in central Tunisia over a 25-year period.","authors":"Fadoua Bouguerra, Samia Kanoun Belajouza, Emna Mziou, Rym Zanzouri, Hayfa Chahdoura, Sabrine Tbessi, Nadia Bouzid, Sameh Tebra Mrad","doi":"10.3233/BD-230037","DOIUrl":"10.3233/BD-230037","url":null,"abstract":"Aim: To retrospectively study the therapeutic modalities of primary breast sarcomas in view of the data of a local Tunisian experience.Methods: It is a monocentric, descriptive, retrospective study including 13 cases of primary breast sarcoma treated over a period of 25 years (1995-2020) in the oncological radiotherapy department of a university hospital in Sousse, Tunisia.Results: In our study, 13 cases of non-metastatic breast sarcomas that has been identified, divided into ten cases of phyllodes sarcomas and three cases of non-phyllodes sarcomas.Surgically, all our patients had a mastectomy. Among them, seven underwent a lymph node procedure: five underwent axillary lymph node dissection, and two others had primary axillary lymph node biopsy. For the adjuvant treatment, all the patients included in our study received radiotherapy and seven received chemotherapy. Local recurrence occurred on the operative scar in one patient after completion of radiation therapy. Metastatic relapse was described in five patients. The time to onset of metastases varied between two months and five years. Nevertheless, a complete remission was noted in 6 patients with a follow-up varying from four years to 20 years. Two patients were lost to follow-up.Conclusion: Breast sarcomas remain a very rare entity of aggressive tumors.The therapeutic approach is poorly codified. For this reason, the therapeutic decision should always be discussed in a multidisciplinary assessment.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"51-59"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326355","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

Physical activity and quality of life in breast cancer survivors. 乳腺癌幸存者的体育锻炼和生活质量。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-249005

Nurul Qisti Agussalim, Mardiana Ahmad, Prihantono Prihantono, Andi Nilawati Usman, Sitti Rafiah, Dinah Inrawati Agustin

{"title":"Physical activity and quality of life in breast cancer survivors.","authors":"Nurul Qisti Agussalim, Mardiana Ahmad, Prihantono Prihantono, Andi Nilawati Usman, Sitti Rafiah, Dinah Inrawati Agustin","doi":"10.3233/BD-249005","DOIUrl":"10.3233/BD-249005","url":null,"abstract":"Objectives: We reviewed the literature on breast cancer patients' physical activity and quality of life. This paper should urge health services and breast cancer survivors to continue appropriate physical activity and assess its advantages.Design: A systematic review was conducted.Data sources: This systematic review used online databases: PubMed, Web of Science, Scopus, and Google Scholar. A search from the beginning of 2018-2024 was conducted.Review method: Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as \"Quality of life\", \"Breast cancer\", \"Chemotherapy\", \"Treatment side effects\", \"Patient experience\", \"Psychosocial well-being\", \"Physical functioning\", \"Emotional distress\", and \"Supportive care\". We reviewed and included all English-language publications. A narrative synthesis was conducted to present the results of the studies.Results: The search using the keywords yielded a total of 135 studies. Each result was filtered again according to the inclusion and exclusion criteria, resulting in a final total of 15 studies to be included in the systematic review.Conclusion: The evidence supports the benefits of physical activity in enhancing the quality of life for breast cancer survivors, indicating that further prospective and intervention studies are needed.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"161-171"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320560","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

Parametric optimization and comparative study of machine learning and deep learning algorithms for breast cancer diagnosis. 用于乳腺癌诊断的机器学习和深度学习算法的参数优化和比较研究。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-240018

Parul Jain, Shalini Aggarwal, Sufiyan Adam, Mohsin Imam

{"title":"Parametric optimization and comparative study of machine learning and deep learning algorithms for breast cancer diagnosis.","authors":"Parul Jain, Shalini Aggarwal, Sufiyan Adam, Mohsin Imam","doi":"10.3233/BD-240018","DOIUrl":"10.3233/BD-240018","url":null,"abstract":"Breast Cancer is the leading form of cancer found in women and a major cause of increased mortality rates among them. However, manual diagnosis of the disease is time-consuming and often limited by the availability of screening systems. Thus, there is a pressing need for an automatic diagnosis system that can quickly detect cancer in its early stages. Data mining and machine learning techniques have emerged as valuable tools in developing such a system. In this study we investigated the performance of several machine learning models on the Wisconsin Breast Cancer (original) dataset with a particular emphasis on finding which models perform the best for breast cancer diagnosis. The study also explores the contrast between the proposed ANN methodology and conventional machine learning techniques. The comparison between the methods employed in the current study and those utilized in earlier research on the Wisconsin Breast Cancer dataset is also compared. The findings of this study are in line with those of previous studies which also highlighted the efficacy of SVM, Decision Tree, CART, ANN, and ELM ANN for breast cancer detection. Several classifiers achieved high accuracy, precision and F1 scores for benign and malignant tumours, respectively. It is also found that models with hyperparameter adjustment performed better than those without and boosting methods like as XGBoost, Adaboost, and Gradient Boost consistently performed well across benign and malignant tumours. The study emphasizes the significance of hyperparameter tuning and the efficacy of boosting algorithms in addressing the complexity and nonlinearity of data. Using the Wisconsin Breast Cancer (original) dataset, a detailed summary of the current status of research on breast cancer diagnosis is provided.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"257-270"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341958","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

Chemotherapy induced alopecia in breast cancer patients: A monocentric prospective study. 乳腺癌患者化疗诱发的脱发：单中心前瞻性研究

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-240019

Wala Ben Kridis, Olfa Boudawara, Afef Khanfir

{"title":"Chemotherapy induced alopecia in breast cancer patients: A monocentric prospective study.","authors":"Wala Ben Kridis, Olfa Boudawara, Afef Khanfir","doi":"10.3233/BD-240019","DOIUrl":"10.3233/BD-240019","url":null,"abstract":"Introduction: Alopecia is one of the main adverse events of chemotherapy in breast cancer. However, its impact is often ignored and underestimated by clinicians. Our aim was to evaluate the quality of life of breast cancer patients with chemotherapy induced alopecia.Methods: We conducted a prospective study including 72 breast cancer patients who developed alopecia on or after stopping chemotherapy in the last 6 months. Clinical information and characteristics of alopecia were assessed using a self-prepared questionnaire. DLQI score was used to evaluate patients' quality of life.Results: We interviewed a total of 72 women with a mean age of 53.5 ± 6 years. Alopecia appeared soon after the first course in 62.5%. All patients actively tried to hide induced hair fall (either by a hat in 6.9% or by a headscarf in 93.1%). Quality of life was impacted in 97.2% of patients with a median DLQI score of 6.5. Women who did not underwent mastectomy were significantly more bothered by hair loss than those who had radical surgery (78.1% vs 55%, p = 0.04). Working status was a significant predictor factor of a bad quality of life due to alopecia (100% in working women vs 58.3% in homemaker or retired patients, p = 0.006).Conclusion: Chemotherapy induced alopecia had a negative impact on quality of life of patients with breast cancer, especially in working women and those who did not have radical surgery. Prior wearing of headscarves did not impact significantly the DLQI score.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"251-255"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104476","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

Clinicopathological analysis of 38 male patients diagnosed with breast cancer. 对 38 名确诊为乳腺癌的男性患者进行临床病理分析。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-230050

Seniha Irem Sahin, Serdar Balci, Gulnur Guler, Kadri Altundag

{"title":"Clinicopathological analysis of 38 male patients diagnosed with breast cancer.","authors":"Seniha Irem Sahin, Serdar Balci, Gulnur Guler, Kadri Altundag","doi":"10.3233/BD-230050","DOIUrl":"10.3233/BD-230050","url":null,"abstract":"Background: Male breast cancer (MBC) accounts for one percent of all breast cancers. Due to the lack of awareness and routine screening programs, most patients present with systemic disease at the time of diagnosis with low overall survival.Objectives: This study aims to investigate the prognostic factors of male breast cancer and its correlation with established prognostic parameters and patient outcomes.Methods: Thirty-eight male breast cancer patients are identified from the MKA Breast Cancer Clinic database, and their corresponding clinical and pathological characteristics are obtained. Cut-off values of 1% and 10% are applied to further classify ER and PR results.Results: Older men are more likely to develop MBC than younger men and are more likely to have spread to axillary lymph nodes. Invasive ductal carcinoma is a more common histologic type in MBC. All the tested patients have ER and PR positivity. Distant metastasis developed in 17/38 (44.7%) patients. Bone metastasis is seen commonly in metastatic MBC.Conclusions: According to our cohort, MBC is seen in older males, presents in later stages, and shows hormone receptor positivity and a tendency to bone involvement. MBC is a heterogenous but distinct biological entity requiring a specific clinical and pathological approach.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740459","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

Impact of the COVID-19 pandemic on breast cancer pathological stage at diagnosis in Tunisian patients. COVID-19 大流行对突尼斯患者诊断时乳腺癌病理阶段的影响。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-230051

Meriam Triki, Mouna Zghal, Houda Ben Ayed, Saadia Makni, Maroua Bouhamed, Semi Fendri, Slim Charfi, Tahya Boudawara, Manel Mellouli

{"title":"Impact of the COVID-19 pandemic on breast cancer pathological stage at diagnosis in Tunisian patients.","authors":"Meriam Triki, Mouna Zghal, Houda Ben Ayed, Saadia Makni, Maroua Bouhamed, Semi Fendri, Slim Charfi, Tahya Boudawara, Manel Mellouli","doi":"10.3233/BD-230051","DOIUrl":"10.3233/BD-230051","url":null,"abstract":"Background: Breast cancer (BC) patients' diagnosis and management was affected by a global reorganization after the Coronavirus disease 2019 (COVID-19). Our study aimed to assess the impact of the pandemic on the pathological stage of newly diagnosed patients with BC compared to pre-pandemic and to identify predictive factors of tumor advanced stage.Methods: Pathological records of all consecutive newly operated BC patients between March 2020 and December 2021 were reviewed retrospectively. Clinical and pathological prognostic factors of BC were collected and compared between pre-pandemic and pandemic periods. Then, predictive factors of tumor advanced stage were identified.Results: Of the 225 cases included in the analysis, 98.7% were females and 1.3% were males. The median time from first histological diagnosis to first surgical treatment was enlarged by 42 days with a significant difference between the two periods (p = 0.002). Newly diagnosed BC patients during the COVID-19 pandemic were operated at a more advanced stage (54.1% vs 36.2%, p = 0.007), had a greater lymphovascular invasion (p = 0.002), lymph node metastasis (p = 0.015) and are more commonly of IBC NST histological type (p = 0.005). Moreover, multivariate analyses showed that the pandemic period (AOR = 2.28; p = 0.016) and the lympho-vascular invasion (p < 0.001) were independently associated with advanced stage of tumors.Conclusion: Our findings proved an increase in alarming rates of advanced stage BC associated with the COVID-19 crisis. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm.","PeriodicalId":9224,"journal":{"name":"Breast disease","volume":"43 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740460","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

Erratum to: Clinical significance of Notch receptors in triple negative breast cancer. 勘误：三阴性乳腺癌中 Notch 受体的临床意义。

Breast disease Pub Date : 2024-01-01 DOI: 10.3233/BD-229041

Heer Shah, Mittal Mistry, Nupur Patel, Hemangini Vora

引用次数: 0