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1.
摘要 目的:探究老年心力衰竭患者的脑利钠肽(Brain natriuretic peptide,BNP)、左室舒张末径(Left ventricular end diastolic diameter,LVEDD)、左室射血分数(Left ventricular ejection fraction,LVEF)水平与心脏功能的关系。方法:选择2019年3月-2020年12月于我院接受治疗的150例老年心力衰竭患者,按照其BNP水平将其分为A(BNP水平<94 pg/mL,43例)、B(BNP水平94~349.9 pg/mL,40例)、C(BNP水平350~988.9 pg/mL,44例)、D(BNP水平≥989 pg/mL,23例)4组,对比4组患者LVEDD、LVEF水平、血同型半胱氨酸(Homocysteine,HCY)水平,对比4组患者不同心功能分级比率,对比4组患者随访2个月心脏不良事件发生率,最后分析BNP、LVEDD和LVEF与心力衰竭患者心功能分级相关性。结果:A、B、C、D四组患者LVEDD、HCY呈递增趋势,LVEF呈递减趋势,C、D两组患者的LVEDD、HCY水平明显高于A、B两组(P<0.05),C、D两组LVEF水平明显低于A、B两组患者(P<0.05);A、B、C、D四组患者心功能分级逐渐加重,A组患者I级70例,II级27例,B组患者II级60例,III级29例,C组III级68例,IV级20例,D组III级3例,IV级43例,各组间对比心功能分级差异具有统计学意义(P<0.05);A、B、C、D四组患者心脏不良事件发生率分别为4.12 %、11.24 %、26.14 %,43.48 %,不良事件发生率逐渐升高,差异具有统计学意义(P<0.05);BNP、LVEDD与心功能分级呈正相关(r=0.878、0.564,P<0.05),LVEF与心功能分级呈负相关(r=0.781,P<0.05)。结论:BNP、LVEDD与LVEF指标可以作为心力衰竭评估指标,能够对心力衰竭患者心脏功能及预后进行评估。  相似文献   

2.
摘要 目的:研究血清和肽素(Copeptin)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、沉默信息调节因子2相关酶1(SIRT1)与慢性心力衰竭(CHF)患者心功能及短期预后的关系。方法:选取我院2018年2月~2020年2月收治的175例CHF患者,将其按照美国纽约心功能(NYHA)分级的差异分作Ⅱ级组56例,Ⅲ级组62例,Ⅳ级组57例。另取我院同期健康体检人员50例作为对照组。比较各组血清Copeptin、suPAR、SIRT1水平及心功能指标,并进行相关性分析。此外,对所有CHF患者进行为期1年的随访,按照预后差异分作预后不良组61例及预后良好组114例。以单因素、多因素Logistic回归分析CHF患者预后的影响因素。结果:与对照组相比,CHF患者的血清Copeptin、suPAR水平及左心室舒张末期内径(LVEDD)升高,而SIRT1水平及左心室射血分数(LVEF)降低(P<0.05);不同心功能等级的CHF患者间比较,随着心衰程度的加重,血清Copeptin、suPAR水平及LVEDD升高,而SIRT1水平及LVEF降低(P<0.05)。Pearson相关性分析结果显示,CHF患者血清Copeptin、suPAR水平与LVEDD均呈正相关,而与LVEF呈负相关(P<0.05);血清SIRT1水平与LVEDD呈负相关,而与LVEF呈正相关(P<0.05)。单因素分析结果显示,预后不良组年龄、LVEDD、血清Copeptin、suPAR水平均高于预后良好组,而LVEF和SIRT1水平低于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,年龄偏大、LVEDD偏高、LVEF偏低、血清Copeptin、suPAR水平过高以及血清SIRT1水平过低均是CHF患者短期预后不良的危险因素(P<0.05)。结论:血清Copeptin、suPAR、SIRT1与CHF患者的心功能及短期预后密切相关。  相似文献   

3.
摘要 目的:探讨急性心力衰竭患者血清miRNA-21、肌红蛋白(MYO)、心肌肌酸激酶同工酶(CK-MB)与心功能和预后的关系。方法:选择2018年2月至2019年2月于我院接诊的95例急性心力衰竭患者为研究对象(病例组),另选择同期在我院进行检查的80例健康人为对照组,分析两组患者血清miRNA-21、MYO、CK-MB、左心室射血分数(LVEF)、左心房内径(LAD)、左心室舒张末期内径(LVEd)水平变化情况及和预后相关性。结果:病例组患者血清miRNA-21、MYO、CK-MB水平显著高于对照组,差异显著(P<0.05);病例组患者LAD、LVEd水平显著高于对照组,LVEF水平显著低于对照组,差异显著(P<0.05);II级患者血清miRNA-21、MYO、CK-MB水平显著低于III级、IV级患者,III级患者血清miRNA-21、MYO、CK-MB水平显著低于IV级患者,差异显著(P<0.05);预后良好组患者血清miRNA-21、MYO、CK-MB水平显著低于预后不良组,差异显著(P<0.05);Spearman相关分析显示,血清miRNA-21、MYO及CK-MB和LVEF之间均呈负相关,血清miRNA-21、MYO及CK-MB和LAD、LVEd之间均呈正相关,(P<0.05);Logistic 回归分析结果显示,血清miRNA-21、MYO及CK-MB及LVEF、LAD、LVEd为急性心力衰竭患者预后的影响因素(P<0.05)。结论:急性心力衰竭患者血清miRNA-21、MYO、CK-MB的表达升高,其与心功能和预后密切相关。  相似文献   

4.
摘要 目的:研究急诊超声心动图联合血清氨基末端脑钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)和肌酸激酶同工酶(CK-MB)诊断急性心肌梗死(AMI)的临床价值。方法:将2019年12月至2020年6月期间我院收治的82例AMI患者纳入研究,记作病变组。另取同期于我院进行体检的健康者80例作为对照组。比较两组各项超声心动图指标水平,血清NT-proBNP、cTnI和CK-MB水平。分析超声心动图指标与血清NT-proBNP、cTnI和CK-MB的相关性。以受试者工作特征(ROC)曲线分析超声心动图联合血清NT-proBNP、cTnI和CK-MB水平诊断AMI的效能。结果:病变组左心室射血分数(LVEF)低于对照组,而左室舒张末期内径(LVEDD)高于对照组(P<0.05)。病变组血清NT-proBNP、cTnI和CK-MB水平均高于对照组(P<0.05)。Pearson检验显示LVEF与血清NT-proBNP、cTnI和CK-MB均呈负相关(r=-0.514、-0.578、-0.532,均P<0.05),LVEDD与血清NT-proBNP、cTnI和CK-MB均呈正相关(r=0.625、0.594、0.575,均P<0.05)。超声心动图联合血清三项诊断AMI的曲线下面积、灵敏度以及特异度均高于超声心动图、血清三项单独诊断。结论:超声心动图联合血清NT-proBNP、cTnI和CK-MB诊断AMI的价值较高,具有一定的临床应用价值。  相似文献   

5.
摘要 目的:探讨老年慢性心力衰竭(CHF)患者血清可溶性肿瘤生成抑制因子2(sST2)、可溶性尿激酶纤溶酶原激活物受体(suPAR)、结缔组织生长因子(CTGF)与心功能的关系及其联合检测对心血管事件(CVE)的预测价值。方法:选取2019年1月~2022年1月我院收治的150例老年CHF患者(CHF组),其中纽约心脏病协会(NYHA)分级Ⅱ级49例、Ⅲ级72例、Ⅳ级29例,根据随访6个月是否发生CVE分为CVE组(n=34)和非CVE组(n=116),另选取同期在我院进行体检的110例健康体检志愿者作为对照组。通过超声心动图检查左室收缩末期内径(LVESD)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD),酶联免疫吸附试验法检测血清sST2、CTGF、suPAR水平。多因素Logistic回归分析老年CHF患者发生CVE的影响因素,Pearson或Spearman相关性分析老年CHF患者血清sST2、CTGF、suPAR水平与超声心功能指标和NYHA分级的相关性,受试者工作特征(ROC)曲线分析血清sST2、CTGF、suPAR对老年CHF患者发生CVE的预测价值。结果:CHF组血清sST2、CTGF、suPAR水平和LVESD、LVEDD高于对照组,LVEF低于对照组(P<0.05)。NYHA分级Ⅱ级、Ⅲ级、Ⅳ级老年CHF患者血清sST2、CTGF、suPAR水平均依次升高(P<0.05)。 老年CHF患者血清sST2、CTGF、suPAR水平与LVEF呈负相关,与LVESD、LVEDD、NYHA分级呈正相关(P均<0.05)。NYHA分级≥Ⅲ级(OR=2.318)、N末端B型钠尿肽前体(NT-proBNP)升高(OR=1.104)、sST2升高(OR=1.641)、CTGF升高(OR=1.644)、suPAR升高(OR=1.892)为老年CHF患者CVE发生的独立危险因素,LVEF升高(OR=0.839)为其独立保护因素,差异均有统计学意义(P<0.05)。血清sST2、CTGF、suPAR单独与联合预测老年CHF患者发生CVE的曲线下面积分别为0.788、0.782、0.771、0.936。结论:老年CHF患者血清sST2、CTGF、suPAR水平升高与心功能异常和CVE发生密切相关,联合检测血清sST2、CTGF、suPAR水平对老年CHF患者发生CVE的预测价值较高。  相似文献   

6.
摘要 目的:分析心脏彩超检查联合血清B型钠尿肽(BNP)、白蛋白(ALB)、胱抑素C(CysC)在慢性心力衰竭(CHF)患者预后评估中的临床价值。方法:选取2017年6月-2018年5月我院收治的123例CHF患者,心脏彩超检查左心室射血分数(LVEF)、左心房内径(LAD)和左心室内径(LVD),实验室检测血清BNP、ALB、CysC水平。按照3年随访后患者是否死亡分为死亡组35例和存活组88例,收集临床资料,采用多因素Logistic回归分析CHF患者预后的影响因素。采用受试者工作特征(ROC)曲线分析心脏彩超检查联合血清BNP、ALB、CysC对CHF患者预后的评估价值。结果:死亡组患者的LAD、LVD及血清BNP、CysC水平高于存活组患者,而LVEF及血清ALB水平低于存活组患者(P<0.05)。心脏彩超指标LVEF、LAD、LVD及血清BNP、ALB、CysC是CHF患者预后的影响因素(P<0.05)。心脏彩超指标LVEF、LAD、LVD联合血清BNP、ALB、CysC检测对CHF患者预后评估的ROC曲线下面积(AUC)(0.95CI)为0.857(0.771~0.938),灵敏度及特异度分别为0.914(32/35)、0.795(70/88),均明显高于上述各指标单独检测。结论:心脏彩超指标LVEF、LAD、LVD和血清BNP、ALB、CysC均为CHF患者预后的影响因素,且联合检测对患者预后的评估价值较高,具有一定的临床应用价值。  相似文献   

7.
摘要 目的:探讨超声心动图参数联合血清N末端B型脑钠肽前体(NT-pro BNP)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、正五聚体蛋白-3(PTX-3)预测慢性心力衰竭(CHF)患者预后的临床价值。方法:选取2019年1月-2021年10月联勤保障部队第909医院收治的122例CHF患者作为CHF组,同期选取50例体检健康者作为对照组。比较两组超声心动图参数和血清NT-pro BNP、suPAR、PTX-3水平。CHF患者出院后随访12个月,根据预后情况分为预后不良组和预后良好组,并比较两组超声心动图参数和血清NT-pro BNP、suPAR、PTX-3水平。受试者工作特征(ROC)曲线分析超声心动图参数联合血清NT-pro BNP、suPAR、PTX-3对CHF患者预后不良的预测价值。结果:与对照组比较,CHF组左心室舒张末期直径(LVEDD)、左心室收缩末期直径(LVESD)、NT-pro BNP、suPAR、PTX-3显著升高(P<0.05),左心室射血分数(LVEF)显著降低(P<0.05)。122例CHF患者出院后随访12个月,其中预后不良患者35例、预后良好患者83例。与预后良好组比较,预后不良组LVEDD、LVESD、NT-pro BNP、suPAR、PTX-3显著升高(P<0.05),LVEF显著降低(P<0.05)。ROC曲线分析结果显示,LVEDD、LVESD、LVEF联合NT-pro BNP、suPAR、PTX-3预测CHF预后不良的效能最高,显著优于各项指标单独预测。结论:超声心动图参数LVEDD、LVESD、LVEF联合血清NT-pro BNP、suPAR、PTX-3预测CHF患者预后不良的价值较高,可作为预测CHF患者预后的辅助指标。  相似文献   

8.
摘要目的:探讨老年慢性心力衰竭(CHF)肿瘤坏死因子琢(TNF-α)以及脑利钠肽水平的变化,并对其进行相关性分析。方法:选 择老年CHF患者59 例,根据心功能分级,Ⅱ级19 例,Ⅲ级25 例,Ⅳ级15 例;另选心功能正常的老年人36例。所有入选者予以血 清BNP、TNF-α测定,并采用彩色多普勒超声测定左心室舒张末内径并计算左室射血分数(LVEF)。结果:与对照组比较,CHF组 心功能Ⅲ、Ⅳ级患者TNα-琢水平明显升高(P<0.05),心功能Ⅱ、Ⅲ、Ⅳ级患者血BNP水平明显升高(P<0.05),并随心功能分级加 重而增加。血TNF-α水平与BNP 呈正相关(r=0.57,P<0.05)。CHF患者中血清TNF-α和BNP 水平与LVEF比较均呈负相关 (r=-0.48, r=-0.64, P<0.05)。结论:老年CHF患者血TNF-α显著升高,并与BNP及LVEF关系密切,是反应CHF患者心功能恶化 的重要预测指标。  相似文献   

9.
摘要 目的:探讨扩张型心肌病(DCM)血清微小核糖核酸(miR)-210、β2微球蛋白(β2-MG)及转化生长因子-β1(TGF-β1)水平特点,分析其诊断DCM以及预测DCM预后的价值。方法:选择2016年8月至2018年8月我院收治的105例DCM患者(DCM组),同期63例健康体检者(对照组),根据随访期间是否发生心源性死亡将DCM患者分为生存组(76例)与死亡组(29例)。检测血清miR-210、β2-MG、TGF-β1表达水平、超声心动图指标及其它实验室指标水平,Pearson分析DCM患者血清miR-210,β2-MG及TGF-β1与超声心动图和其它实验室指标之间相关性,受试者工作特征(ROC)曲线分析miR-210、β2-MG及TGF-β1诊断DCM以及预测DCM预后的价值。结果:DCM组血清miR-210、β2-MG、TGF-β1、高敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、B型脑钠肽(BNP)水平,左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、E峰至室间隔距离(EPSS)、收缩末期容积(LVESV)高于对照组(P<0.05),左心室射血分数(LVEF)低于对照组(P<0.05)。死亡组血清miR-210、β2-MG及TGF-β1水平高于生存组(P<0.05)。DCM患者血清miR-210、β2-MG及TGF-β1水平与CK-MB、cTnI、BNP、LVEDD、LVEDV、EPSS、LVESV呈正相关(P<0.05),与LVEF呈负相关(P<0.05),TGF-β1与hs-CRP呈正相关(P<0.05)。miR-210、β2-MG及TGF-β1诊断DCM、预测DCM预后的曲线下面积(AUC)分别为0.600、0.639、0.615;0.628、0.632、0.634,联合三项指标诊断DCM、预测DCM预后的AUC为0.885、0.863。结论:DCM患者血清miR-210、β2-MG、TGF-β1水平均增高,且与左心重构、心肌损伤以及预后不良有关,可作为DCM诊断以及预后预测的辅助指标。  相似文献   

10.
摘要 目的:探讨老年慢性心力衰竭(CHF)患者甲状腺激素(TH)水平与认知功能、心功能及心血管事件的关系。方法:将我院2018年6月~2020年6月收治的140例老年CHF患者纳入研究,检测患者TH指标[血清三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]水平。按蒙特利尔认知评估量表(MoCA)评分将患者分为认知障碍组(MoCA评分<26分)、非认知障碍组(MoCA评分≥26分),比较两组各TH指标与MoCA评分。比较不同纽约心脏病协会(NYHA)分级患者的TH指标与心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]。根据患者住院期间是否发生心血管事件分为心血管事件组和非心血管事件组,比较两组各TH指标。经Pearson线性相关分析TH指标与MoCA评分、心功能指标的相关性。结果:认知障碍组血清T3、FT3水平及MoCA评分较非认知障碍组明显降低(P<0.05)。Ⅲ级、Ⅳ级组的血清T3、FT3水平及LVEF较Ⅰ级、Ⅱ级组显著降低,其中Ⅳ级组低于Ⅲ级组(P<0.05)。Ⅲ级、Ⅳ级组的LVEDD、LVESD较Ⅰ级、Ⅱ级组明显升高,且Ⅳ级组高于Ⅲ级组(P<0.05)。心血管事件组血清T3、FT3水平较非心血管事件组显著降低(P<0.05)。Pearson线性相关分析显示:血清T3、FT3水平与MoCA评分、LVEF呈正相关(均P<0.05),与LVEDD、LVESD呈负相关(均P<0.05)。结论:老年CHF患者血清T3、FT3水平下调与其认知功能、心功能降低及心血管事件的发生密切相关,通过检测其血清T3、FT3水平,有利于进一步了解其病情变化。  相似文献   

11.
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《环境昆虫学报》2014,(5):790-804
综述了白蚁螱客的主要种类、共生关系及相关机制的研究进展。白蚁螱客中,已报道的动物种类达170种。在与动物的共生关系中存在偏利共生(宾主共栖和异种共栖)、互利共生和无关共生三种;在与微生物的共生关系中,存在与内生菌(原生动物、细菌、真菌和放线菌)和外生菌(蚁巢伞菌等)间的互利关系。指出了白蚁与螱客研究中存在的问题,给出了解决方案,并提出了今后可能的研究热点或方向,为白蚁的综合利用(如纤维素酶)及今后研究物种间的协同进化提供了基础资料。  相似文献   

13.
To elucidate accumulation of minerals in human iliac arteries with aging, the content of minerals was analyzed by inductively coupled plasma atomic emission spectrometry. Bilateral common, internal, and external iliac arteries of 16 men and 8 women, ranging ages from 65 to 93 yr, were examined. It was found that an extremely high accumulation of calcium and phosphorus occurred in the common iliac artery at old age, being higher than that of the internal and external iliac arteries. It should be noted that the accumulation of calcium and phosphorus is the highest in the common iliac artery among the human arteries examined to date. Regarding sexual differences, the content of calcium and phosphorus in the common and internal iliac arteries was higher in women than in men, whereas their content in the external iliac artery was lower in women than in men.  相似文献   

14.
New sulfur derivatives of phosphoramidite ligands were synthesized and the impact of the sulfur unit on the spectroscopic properties of their rhodium and iridium complexes was investigated. The new ligands Bn2NPSCH2CH2Sa(P-Sa) (Bn = benzyl, 4), Bn2NPSCHCHSa(CH2)3CaH2(P-Sa)(Ca-Sa) (6) and Bn2NP(4-XC6H4OMe)2 (X = S, 7a; X = O, 7b) were converted to the rhodium and iridium complexes trans-[Rh(CO)Cl(L)2] (L = 4, 6, 7), [RhCl(COD)(L)] (L = 4, 6, 7), [IrCl(COD)(7a)] and [IrCl2Cp∗(6)]. For comparison, some phosphoramidite complexes of these formulations also were synthesized. The new metal complexes were spectroscopically analyzed. For the carbonyl complexes, the νCO IR stretching frequencies were lower than for the corresponding phosphite and phosphoramidite ligands. The 1JPRh coupling constants for the rhodium complexes with the new ligands were also smaller than for the respective phosphoramidite and phosphite complexes. Finally, the 1JPSe coupling constants of the selenides of the new ligands were lower than those of the phosphoramidite ligands but higher than for PPh3. The spectroscopic data reveal that the new thio ligands 4, 6 and 7a are more electron donating than phosphites and phosphoramidites but less electron donating than PPh3.  相似文献   

15.
Astrocytes transport the monocarboxylate acetate, but synaptosomes do not. The reason for this is unknown, because both preparations express monocarboxylate transporters (MCT). The transport and metabolism of lactate, another monocarboxylate, was examined in these two preparations, and the results were compared to those for acetate. Lactate transport is more rapid in astrocytes than in synaptosomes, but of lower affinity (Kms of 17 and 4 mM, respectively). Lactate (0.2 mM) is metabolized to CO2 more rapidly in synaptosomes than in astrocytes (rates of 0.37 and 0.07 nmol x mg protein(-1) x min(-1), respectively). The reason for this is unclear, but cellular differences in lactate dehydrogenase isotype expression may be involved. Acetate is metabolized to CO2 more rapidly in astrocytes than in synaptosomes (rates of 0.43 and 0.02 nmol x mg protein(-1) x min(-1), respectively). This is likely due to cellular differences in the expression of monocarboxylate transporter subtypes.  相似文献   

16.
The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications.  相似文献   

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The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection.The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemic leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE2, PGD2, PGF, TXB2 and 6-keto-PGF. In all types studied PGE2 and TXB2 were the major products formed. The identification of PGE2 and TXB2 was confirmed by GC/MS with multiple ion monitoring.The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology.  相似文献   

19.
Cytoskeleton and mitochondrial morphology and function   总被引:10,自引:0,他引:10  
It has been well established that the cytoskeleton is an essential modulator of cell morphology and motility, intracytoplasmic transport and mitosis, however cytoskeletal linkage to the organelles has not been unequivocally demonstrated. Indeed, cytoskeleton appears to be essential in determining and modulating gene phenotype as a function of cellular environment. According to recent studies, the organization of the cytoskeleton network together with associated protein(s) could be essential in regulating mitochondrial function and particularly the permeability of the mitochondrial outer membrane to ADP. The aim of this chapter is to summarize the main properties of the cytoskeletal environment of mitochondria and the possible role(s) of this network in mitochondrial function in myocytes.  相似文献   

20.
Many patients have sensitivities to multiple species of storage and house dust mites. It is not clear if this is because patients have multiple sensitivities to species-specific mite allergens or if these mites share many cross-reacting allergens. Our objective was to further define the cross-allergenicity between several species of storage and house dust mites using crossed-immunoelectrophoresis (CIE), crossed-radioimmunoelectrophoresis (CRIE), immunoblotting, and ELISA. CIE and CRIE reactions revealed that storage mites shared two cross-antigenic molecules and one of these bound IgE in a serum pool from mite allergic patients. Antibody in anti-sera built to each species of mite recognized many SDS–PAGE resolved proteins of other mite species and this suggested the potential for other cross-reactive allergens. Among patient sera, IgE bound to many different proteins but few had IgE that bound to a protein with common molecular weights across the mite species and this suggested mostly species-specific allergens. Antiserum built to each mite species precipitated one protein in shrimp extracts that bound anti-Der p 10 (tropomyosin) and IgE in the serum pool. Anti-Der p 10 showed strong binding to shrimp tropomyosin but very little to any of the mite proteins. ELISA showed the mite extracts contained very little tropomyosin. The storage and dust mites investigated contain mostly species-specific allergens and very small amounts of the pan-allergen tropomyosin compared to shrimp and snail.  相似文献   

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