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1.
The purpose of this study was to examine acute exercise-induced changes on muscle power output and surface electromyography (sEMG) parameters (amplitude and spectral indices of muscle fatigue) during a dynamic fatiguing protocol. Fifteen trained subjects performed five sets consisting of 10 leg presses (10RM), with 2 min rest between sets. Surface electromyography was recorded from vastus medialis (VM) and lateralis (VL) and biceps femoris (BF) muscles. A number of EMG-based parameters were compared for estimation accuracy and sensitivity to detect peripheral muscle fatigue. These were: Mean Average Voltage, median spectral frequency, Dimitrov spectral index of muscle fatigue (FInsm5), as well as other parameters obtained from a time–frequency analysis (Choi–Williams distributions) such as mean and variance of the instantaneous frequency and frequency variance. The log FInsm5 as a single parameter predictor accounted for 37% of the performance variance of changes in muscle power and the log FInsm5 and MFM as a two factor combination predictor accounted for 44%. Peripheral impairments assessed by sEMG spectral index FInsm5 may be a relevant factor involved in the loss of power output after dynamic high-loading fatiguing task.  相似文献   

2.
The purpose of this study was to investigate the sensitivity of new surface electromyography (sEMG) indices based on the discrete wavelet transform to estimate acute exercise-induced changes on muscle power output during a dynamic fatiguing protocol. Fifteen trained subjects performed five sets consisting of 10 leg press, with 2 min rest between sets. sEMG was recorded from vastus medialis (VM) muscle. Several surface electromyographic parameters were computed. These were: mean rectified voltage (MRV), median spectral frequency (Fmed), Dimitrov spectral index of muscle fatigue (FInsm5), as well as five other parameters obtained from the stationary wavelet transform (SWT) as ratios between different scales. The new wavelet indices showed better accuracy to map changes in muscle power output during the fatiguing protocol. Moreover, the new wavelet indices as a single parameter predictor accounted for 46.6% of the performance variance of changes in muscle power and the log-FInsm5 and MRV as a two-factor combination predictor accounted for 49.8%. On the other hand, the new wavelet indices proposed, showed the highest robustness in presence of additive white Gaussian noise for different signal to noise ratios (SNRs). The sEMG wavelet indices proposed may be a useful tool to map changes in muscle power output during dynamic high-loading fatiguing task.  相似文献   

3.
A novel approach to fatigue assessment during dynamic contractions was proposed which projected multiple surface myoelectric parameters onto the vector connecting the temporal start and end points in feature-space in order to extract the long-term trend information. The proposed end to end (ETE) projection was compared to traditional principal component analysis (PCA) as well as neural-network implementations of linear (LPCA) and non-linear PCA (NLPCA). Nine healthy participants completed two repetitions of fatigue tests during isometric, cyclic and random fatiguing contractions of the biceps brachii. The fatigue assessments were evaluated in terms of a modified sensitivity to variability ratio (SVR) and each method used a set of time-domain and frequency-domain features which maximized the SVR. It was shown that there was no statistical difference among ETE, PCA and LPCA (p > 0.99) and that all three outperformed NLPCA (p < 0.0022). Future work will include a broader comparison of these methods to other new and established fatigue indices.  相似文献   

4.
Melting curves of human plasma measured by differential scanning calorimetry (DSC), known as thermograms, have the potential to markedly impact diagnosis of human diseases. A general statistical methodology is developed to analyze and classify DSC thermograms to analyze and classify thermograms. Analysis of an acquired thermogram involves comparison with a database of empirical reference thermograms from clinically characterized diseases. Two parameters, a distance metric, P, and correlation coefficient, r, are combined to produce a 'similarity metric,' ρ, which can be used to classify unknown thermograms into pre-characterized categories. Simulated thermograms known to lie within or fall outside of the 90% quantile range around a median reference are also analyzed. Results verify the utility of the methods and establish the apparent dynamic range of the metric ρ. Methods are then applied to data obtained from a collection of plasma samples from patients clinically diagnosed with SLE (lupus). High correspondence is found between curve shapes and values of the metric ρ. In a final application, an elementary classification rule is implemented to successfully analyze and classify unlabeled thermograms. These methods constitute a set of powerful yet easy to implement tools for quantitative classification, analysis and interpretation of DSC plasma melting curves.  相似文献   

5.
The effect of muscular fatigue on temporal and spectral features of muscle activities and motor performance, i.e., kinematics and kinetics, has been studied. It is of value to quantify fatigue related kinematic changes in biomechanics and sport sciences using simple measurements of joint angles. In this work, a new approach was introduced to extract kinematic changes from 2D phase portraits to study the fatigue adaptation patterns of subjects performing elbow repetitive movement. This new methodology was used to test the effect of load and repetition rate on the temporal changes of an elbow phase portrait during a dynamic iso-inertial fatiguing task. The local flow variation concept, which quantifies the trajectory shifts in the state space, was used to track the kinematic changes of an elbow repetitive fatiguing task in four conditions (two loads and two repetition rates). Temporal kinematic changes due to muscular fatigue were measured as regional curves for various regions of the phase portrait and were also expressed as a single curve to describe the total drift behavior of trajectories due to fatigue. Finally, the effect of load and repetition rate on the complexity of kinematic changes, measured by permutation entropy, was tested using analysis of variance with repeated measure design. Statistical analysis showed that kinematic changes fluctuated more (showed more complexity) under higher loads (p=0.014), but did not differ under high and low repetition rates (p=0.583). Using the proposed method, new features for complexity of kinematic changes could be obtained from phase portraits. The local changes of trajectories in epochs of time reflected the temporal kinematic changes in various regions of the phase portrait, which can be used for qualitative and quantitative assessment of fatigue adaptation of subjects and evaluation of the influence of task conditions (e.g., load and repetition rate) on kinematic changes.  相似文献   

6.
Assessment of neuromuscular fatigue is essential for early detection and prevention of risks associated with work-related musculoskeletal disorders. In recent years, discrete wavelet transform (DWT) of surface electromyography (SEMG) has been used to evaluate muscle fatigue, especially during dynamic contractions when the SEMG signal is non-stationary. However, its application to the assessment of work-related neck and shoulder muscle fatigue is not well established. Therefore, the purpose of this study was to establish DWT analysis as a suitable method to conduct quantitative assessment of neck and shoulder muscle fatigue under dynamic repetitive conditions. Ten human participants performed 40 min of fatiguing repetitive arm and neck exertions while SEMG data from the upper trapezius and sternocleidomastoid muscles were recorded. The ten of the most commonly used wavelet functions were used to conduct the DWT analysis. Spectral changes estimated using power of wavelet coefficients in the 12–23 Hz frequency band showed the highest sensitivity to fatigue induced by the dynamic repetitive exertions. Although most of the wavelet functions tested in this study reasonably demonstrated the expected power trend with fatigue development and recovery, the overall performance of the “Rbio3.1” wavelet in terms of power estimation and statistical significance was better than the remaining nine wavelets.  相似文献   

7.
Prediction of traumatic and mild traumatic brain injury is an important factor in managing their prevention. Currently, the prediction of these injuries is limited to peak linear and angular acceleration loading curves derived from laboratory reconstructions. However it remains unclear as to what aspect of these loading curves contributes to brain tissue damage. This research uses the University College Dublin Brain Trauma Model (UCDBTM) to analyse three distinct loading curve shapes meant to represent different helmet loading scenarios. The loading curves were applied independently in each axis of linear and angular acceleration and their effect on currently used predictors of TBI and mTBI was examined. Loading curve shape A had a late time to peak, B an early time to peak and C had a consistent plateau. The areas under the curve for all three loading curve shapes were identical. The results indicate that loading curve A produced consistently higher maximum principal strains and Von Mises stress than the other two loading curve types. Loading curve C consistently produced the lowest values of maximum principal strain and Von Mises stress, with loading curve B being lowest in only 2 cases. The areas of peak Von Mises stress and Principal strain also varied depending on loading curve shape and acceleration input.  相似文献   

8.
The aim of the study was to examine whether six weeks of endurance training minimizes the effects of fatigue on postural control during dynamic postural perturbations. Eighteen healthy volunteers were assigned to either a 6-week progressive endurance training program on a cycle ergometer or a control group. At week 0 and 7, dynamic exercise was performed on an ergometer until exhaustion and immediately after, the anterior–posterior centre of pressure (COP) sway was analyzed during full body perturbations. Maximal voluntary contractions (MVC) of the knee flexors and extensors, muscle fiber conduction velocity (MFCV) of the vastus lateralis and medialis during sustained isometric knee extension contractions, and power output were measured. Following the training protocol, maximum knee extensor and flexor force and power output increased significantly for the training group with no changes observed for the control group. Moreover, the reduction of MFCV due to fatigue changed for the training group only (from 8.6% to 3.4%). At baseline, the fatiguing exercise induced an increase in the centre of pressure sway during the perturbations in both groups (>10%). The fatiguing protocol also impaired postural control in the control group when measured at week 7. However, for the training group, sway was not altered after the fatiguing exercise when assessed at week 7. In summary, six weeks of endurance training delayed the onset of muscle fatigue and improved the ability to control balance in response to postural perturbations in the presence of muscle fatigue. Results implicate that endurance training should be included in any injury prevention program.  相似文献   

9.
In this paper, we propose a force estimation model to compute the handgrip force from SEMG signal during fatiguing muscle contraction tasks. The appropriate frequency range was analyzed using various combinations of a wavelet scale, and the highest accuracy was achieved at a range from 242 to 365 Hz. After that, eight healthy individuals performed a series of static (70%, 50%, 30%, and 20% MVC) and dynamic (0–50% MVC) muscle contraction tasks to evaluate the performance of this technique in comparison with that of former method using the Root Mean Square of the SEMG signal. Both methods had comparable results at the beginning of the experiments, before the onset of muscle fatigue. However, differences were clearly observed as the degree of muscle fatigue began to increase toward the endurance time. Under this condition, the estimated handgrip force using the proposed method improved from 17% to 134% for static contraction tasks and 40% for dynamic contraction tasks. This study overcomes the limitation of the former method during fatiguing muscle contraction tasks and, therefore, unlocks the potential of utilizing the SEMG signal as an indirect force estimation method for various applications.  相似文献   

10.
The effect of fatigue as a result of a standard submaximal dynamic exercise on maximal short-term power output generated at different contraction velocities was studied in humans. Six subjects performed 25-s maximal efforts on an isokinetic cycle ergometer at five different pedaling rates (60, 75, 90, 105, and 120 rpm). Measurements of maximal power output were made under control conditions [after 6 min of cycling at 30% maximal O2 uptake (VO2max)] and after fatiguing exercise that consisted of 6 min of cycling at 90% VO2max with a pedaling rate of 90 rpm. Compared with control values, maximal peak power measured after fatiguing exercise was significantly reduced by 23 +/- 19, 28 +/- 11, and 25 +/- 11% at pedaling rates of 90, 105, and 120 rpm, respectively. Reductions in maximum peak power of 11 +/- 8 and 14 +/- 8% at 60 and 75 rpm, respectively, were not significant. The rate of decline in peak power during the 25-s control measurement was least at 60 rpm (5.1 +/- 2.3 W/s) and greatest at 120 rpm (26.3 +/- 13.9 W/s). After fatiguing exercise, the rate of decline in peak power at pedaling rates of 105 and 120 rpm decreased significantly from 21.5 +/- 9.0 and 26.3 +/- 13.9 W/s to 10.0 +/- 7.3 and 13.3 +/- 6.9 W/s, respectively. These experiments indicate that fatigue induced by submaximal dynamic exercise results in a velocity-dependent effect on muscle power. It is suggested that the reduced maximal power at the higher velocities was due to a selective effect of fatigue on the faster fatigue-sensitive fibers of the active muscle mass.  相似文献   

11.
In addition to the role of muscle coactivation, a major question in the field is how antagonist activation is controlled to minimize its opposing effect on agonist muscle performance. Muscle fatigue is an interesting condition to analyze the neural adjustments in antagonist muscle activity and to gain more insights into the control mechanisms of coactivation. In that context, previous studies have reported that although the EMG activity of agonists and antagonists increase in parallel, the ratio between EMG activities in the two sets of muscles during a fatiguing submaximal contraction decreased progressively and contributed to a reduction in the time to task failure. In contrast, more recent studies using a novel normalization procedure indicated that the agonist/antagonist ratio remained relatively constant, suggesting that the fatigue-related increase in coactivation does not impede performance. Current knowledge also indicates that peripheral mechanisms cannot by themselves mediate the intensity of antagonist coactivation during fatiguing contractions, implying that supraspinal mechanisms are involved. The unique modulation of the synaptic input from Ia afferents to the antagonist motor neurones during a fatiguing contraction of the agonist muscles further suggests a separate control of the two sets of muscles.  相似文献   

12.
Evaluation of diagnostic performance is typically based on the receiver operating characteristic (ROC) curve and the area under the curve (AUC) as its summary index. The partial area under the curve (pAUC) is an alternative index focusing on the range of practical/clinical relevance. One of the problems preventing more frequent use of the pAUC is the perceived loss of efficiency in cases of noncrossing ROC curves. In this paper, we investigated statistical properties of comparisons of two correlated pAUCs. We demonstrated that outside of the classic model there are practically reasonable ROC types for which comparisons of noncrossing concave curves would be more powerful when based on a part of the curve rather than the entire curve. We argue that this phenomenon stems in part from the exclusion of noninformative parts of the ROC curves that resemble straight‐lines. We conducted extensive simulation studies in families of binormal, straight‐line, and bigamma ROC curves. We demonstrated that comparison of pAUCs is statistically more powerful than comparison of full AUCs when ROC curves are close to a “straight line”. For less flat binormal ROC curves an increase in the integration range often leads to a disproportional increase in pAUCs’ difference, thereby contributing to an increase in statistical power. Thus, efficiency of differences in pAUCs of noncrossing ROC curves depends on the shape of the curves, and for families of ROC curves that are nearly straight‐line shaped, such as bigamma ROC curves, there are multiple practical scenarios in which comparisons of pAUCs are preferable.  相似文献   

13.
局部肌肉疲劳的表面肌电信号复杂度和熵变化   总被引:6,自引:0,他引:6  
目的 在于探讨静态和动态疲劳性运动过程中肱二头肌和腰部脊竖肌表面肌电(surface electromyography,sEMG)信号的Lempel-Ziv复杂度和Kolmogorov熵的变化规律。18名男性大学生志愿者被随机分为肱二头肌和腰部脊竖肌运动负荷组,分别完成静态和动态疲劳运动负荷试验。运动负荷期间连续记录sEMG信号,在对运动负荷时间和重复次数进行标准化处理后,截取相应时段的sEMG信号,计算Lempel-Ziv复杂度和Kolmogorov熵,观察它们随肌肉疲劳发展的变化规律。研究结果表明,无论是静态还是动态疲劳运动条件下,被检肌肉sEMG信号的复杂度和熵均随着运动负荷时间呈现明显的单调递减型变化。该变化可能与神经系统渐进性协调众多运动单位同步收缩的‘协同效应”有关。  相似文献   

14.
Ageing is associated with a higher fatigue resistance during submaximal or maximal fatiguing contractions. The present study aimed to investigate the contribution of the central and peripheral fatigue to the age-related differences in fatigue development of the plantar flexor muscles. Therefore, the voluntary activation, rest twitch moment and voluntary plantar flexor moment were examined before during as well as 2, 5 and 10min after a fatiguing task. This consisted of intermittent isometric submaximal plantar flexor contractions at equal intensity for both young and old adults (considering the age-related differences in muscle inhibition). Consequently, possible differences between young and old adults in voluntary activation during the maximal contraction utilised for determining the intensity of the fatiguing task, which can influence fatigue development, have been taken into account. The plantar flexors moment was calculated using inverse dynamics and the voluntary activation was measured using the twitch interpolation technique. Changes in voluntary activation and rest twitch moment during the fatiguing task were used to assess central and peripheral fatigue, respectively. In both young and old adults, peripheral ( approximately 20%) as well as central fatigue ( approximately 9%) contributed to the time to task failure. Old adults demonstrated greater time to task failure than young ones, but similar voluntary activation behaviour during the fatiguing task. We concluded that, the age-related enhancement in fatigue resistance is not attributable to voluntary activation but is linked to mechanisms located within the working muscle.  相似文献   

15.
The aim of the present study was to examine whether or not the compliance of the gastrocnemius medialis (GM) tendon and aponeurosis is influenced by submaximal fatiguing efforts. Fourteen elderly male subjects performed isometric maximal voluntary plantarflexion contractions (MVC) on a dynamometer before and after two fatiguing protocols. The protocols consisted of: (1) submaximal concentric isokinetic contractions (70% isokinetic MVC) at 60 degrees /s and (2) a sustained isometric contraction (40% isometric MVC) until failure to hold the defined moment. Ultrasonography was used to determine the elongation and strain of the GM tendon and aponeurosis. To account for the axis misalignment between ankle and dynamometer, the kinematics of the leg were captured at 120 Hz. The maximum moment decreased from 85.9+/-17.9 Nm prior fatigue to 79.2+/-19 Nm after isokinetic fatigue and to 69.9+/-16.4 Nm after isometric fatigue. The maximal strain of the GM tendon and aponeurosis before fatigue, after isokinetic and after isometric fatigue were 4.9+/-1.1%, 4.4+/-1.1% and 4.3+/-1.1% respectively. Neither the strain nor the elongation showed significant differences before and after each fatiguing task at any 100 N step of the calculated tendon force. This implies that the compliance was not altered after either the isokinetic or the isometric fatiguing task. Therefore it was concluded that the strains during the performed submaximal fatiguing tasks, were too small to provoke any structural changes in tendon and aponeurosis.  相似文献   

16.
The purpose of this study was to determine whether the human diaphragm, like limb muscle, has a threshold of force output at which a metaboreflex is activated causing systemic vasoconstriction. We used Doppler ultrasound techniques to quantify leg blood flow (Q(L)) and utilized the changes in mouth twitch pressure (DeltaP(M)T) in response to bilateral phrenic nerve stimulation to quantify the onset of diaphragm fatigue. Six healthy male subjects performed four randomly assigned trials of identical duration (8 +/- 2 min) and breathing pattern [20 breaths/min and time spent on inspiration during the duty cycle (time spent on inspiration/total time of one breathing cycle) was 0.4] during which they inspired primarily with the diaphragm. For trials 1-3, inspiratory resistance and effort was gradually increased [30, 40, and 50% maximal inspiratory pressure (MIP)], diaphragm fatigue did not occur, and Q(L), limb vascular resistance (LVR), and mean arterial pressure remained unchanged from control (P > 0.05). The fourth trial utilized the same breathing pattern with 60% MIP and caused diaphragm fatigue, as shown by a 30 +/- 12% reduction in P(M)T with bilateral phrenic nerve stimulation. During the fatigue trial, Q(L) and LVR were unchanged from baseline at minute 1, but LVR rose 36% and Q(L) fell 25% at minute 2 and by 52% and 30%, respectively, during the final minutes of the trial. Both LVR and Q(L) returned to control within 30 s of recovery. In summary, voluntary increases in inspiratory muscle effort, in the absence of fatigue, had no effect on LVR and Q(L), whereas fatiguing the diaphragm elicited time-dependent increases in LVR and decreases in Q(L). We attribute the limb vasoconstriction to a metaboreflex originating in the diaphragm, which reaches its threshold for activation during fatiguing contractions.  相似文献   

17.
This study compares a non-linear (neural network) and a linear (linear regression) power mapping using a set of features of the surface electromyogram recorded from the vastus medialis and lateralis muscles. Fifteen healthy participants performed 5 sets of 10 repetitions leg press using the individual maximum load corresponding what they could perform 10 times (10RM) with 120 s of rest between them. The following sEMG variables were computed from each extension contraction and used as inputs to both approaches: mean average value (MAV), median frequency (Fmed), the spectral parameter proposed by Dimitrov (FInsm5), average (over the observation interval) of the instantaneous mean frequency obtained from a Choi–Williams distribution (MFM), and wavelet indices ratio between moments at different scales (WIRM1551, WIRM1M51, WIRM1522, WIRE51, and WIRW51). The non-linear mapping (neural network) provided higher correlation coefficients and signal-to-noise ratios values (although not significantly different) between the actual and the estimated changes of power compared to linear mapping (linear regression) using the sEMG variables alone and a combination of WIRW51 and MFM (obtained by a stepwise multiple linear regression). In conclusion, non-linear mapping of force loss during dynamic knee extension exercise showed higher signal-to-noise ratio and correlation coefficients between the actual and estimated power output compared to linear mapping. However, since no significant differences were observed between linear and non-linear approaches, both were equally valid to estimate changes in peak power during fatiguing repetitive leg extension exercise.  相似文献   

18.
Interaction of fatigue and hypercapnia in the canine diaphragm   总被引:1,自引:0,他引:1  
We studied 10 open-chest dogs and measured the pressure across the diaphragm (Pdi) in each period of the protocol during stimulation at frequencies of 1, 20, 50, and 80 Hz. Three ranges of arterial PCO2 (PaCO2) were examined: less than or equal to 26, 36-50, and greater than or equal to 89 Torr. The diaphragm was fatigued with repetitive phrenic stimulation (30 Hz). During the fatiguing activity, five of the animals were subjected to hypercapnia and the other five to hypocapnia. A frequency-Pdi curve was generated for each period in the protocol. The data show that 1) fatiguing to 50% of the initial Pdi value during hypercapnia was significantly more rapid than during hypocapnia; 2) both the prefatigue and postfatigue mean Pdi values over all interactions of frequency, fatigue, and PaCO2 were unaffected by the fatiguing environment (hypercapnia vs. hypocapnia); 3) the percent reduction of Pdi by hypercapnia was the same at all four frequencies; 4) hypocapnia did not alter either the pre- or postfatigue frequency-Pdi curve; and 5) one-half relaxation time, unaffected by PaCO2, was prolonged by fatigue. We conclude that the hypercapnic diaphragm has less endurance than the hypocapnic diaphragm and that although both fatigue and hypercapnia decrease Pdi, they appear to be separate entities working through different mechanisms.  相似文献   

19.
The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique) and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R2≤0.82) of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R2≤0.73) for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.  相似文献   

20.
This study aimed to investigate mechanisms of neuromuscular fatigue during maximal concentric and isometric leg extensions inducing similar torque decrements. Nine physically active men performed two separate fatiguing sessions maintained until similar torque decreases were obtained. The first session, only conducted under isokinetic concentric conditions (CON), consisted of three series of 30 maximal voluntary concentric knee extensions (60 degrees/s). The second session, exclusively isometric (ISO), mimicked the torque decreases registered during the CON session while performing three long-lasting ISO contractions. Maximal voluntary torque, activation level (twitch interpolation technique), electromyographic activity (root mean square and median frequency) of the vastus lateralis muscle, and electrically evoked doublet-twitch mechanical properties were measured before and at the end of each of the three series. After the three series, similar torque decrements were obtained for both fatiguing procedures. The total fatiguing contraction durations were not different among procedures. With equivalent voluntary torque decrements, the doublet-twitch amplitude reduction was significantly greater (P<0.01) during the two first series of the CON procedure compared with ISO. No difference was observed for the third series. Although no difference was recorded with fatigue for median frequency changes between CON and ISO, activation levels and root mean square values demonstrated greater reductions (P<0.05) for all three series during the ISO procedure compared with CON. Performing CON or ISO fatiguing exercises demonstrated different fatigue origins. With CON exercises, peripheral fatigue developed first, followed by central fatigue, whereas with ISO exercises the fatigue pattern was inverted.  相似文献   

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