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厦门第二医院影像科主任郭岗:AI如何给医生减负

2017-09-13 佚名 雷锋网

人工智能与医疗的结合受业界瞩目,而医疗影像则被认为是AI与医疗的融合中,最有可能率先实现商业化的领域。

7月20日,国务院发布关于人工智能的发展规划,其中就要求发展“智能医疗”。理想中的智慧医疗场景是:病人进入医院,在大厅里可以通过机器人来咨询要挂哪个科;医生在跟病人的问诊过程中,系统可以自动将问诊语音转化为文字,并通过自然语言理解技术转化为结构化的电子病历;同时,人工智能系统将给出医生诊断和治疗的建议;病人去做影像检查,人工智能系统会辅助医生阅片。

人工智能与医疗的结合受业界瞩目,而医疗影像则被认为是AI与医疗的融合中,最有可能率先实现商业化的领域。

医疗大数据中有超过80%的数据来自于医疗影像,大量的影像数据读取客观要求更为高效、准确的技术手段,而人工智能恰好可以满足要求。于是,具备技术和数据优势的科技巨头纷纷以“AI+医疗影像”为突破口,布局医疗领域。

影像科的痛点:看不完的片子

9月1日,以“架构·人机同行”为主题的IBMSystems创行者高峰论坛在北京召开。IBM全球及大中华区硬件系统部负责人,金融、医疗、制造等领域的企业、合作伙伴共同参与。

医学影像作为医生诊断过程的重要参考依据,承担了不可替代的作用。影像科医生为什么会走上AI之路?其中存在一些颇为无奈的客观原因。患者在发生重病、大病的时候,第一时间想到的是去三甲医院就诊,因为只有大医院才有先进的设备、优秀的医疗团队、妥善的治疗方案。但,也正是医疗资源的不均衡,影像科医生特有的工作环境和工作压力,使得影像科医生所承载的压力越来越大。

厦门市第二医院医学影像科主任郭岗

厦门市第二医院医学影像科主任郭岗表示,影像科每天要接诊600-700位患者,每个患者的片子从几十张到几百张甚至上千张,都需要医生用肉眼去观察。每个患者平均花费的时间10-15分钟,600、700个病人就要170多个小时。而每个医生每天工作8小时,至少要21个人不停的看。“医生每天在眼力和脑力的强大压力下也非常容易疲劳疲惫,正是因为这些疲劳和疲惫,也很容易造成对片子的漏诊和误诊,引起一些不必要的医患关系的紧张。”

厦门二院为什么会与IBM牵手?

影像科为什么能够最先和AI进行合作?郭教授认为,海量的片子绝大部分是常见病和多发病,这种片子的特征,有比较典型的影像表现和规律性,诊断上不是太难。这是人工智能介入的一个很好的基础。

同时,鉴于影像科医生巨大的工作负担,如何把医生从繁重甚至简单重复的工作中解脱出来,有更多的时间进行精准医疗和教学研究也成为一个必要的需求。郭教授向雷锋网表示,医学院的医生都承担着科研任务,需要有更多的时间去提高服务质量和医疗效率。“所以我们想如何和人工智能合作,有一套辅助诊断的系统,帮助我们提高效率。也正是基于这种考量,IBM具有完整的场景,固定的硬件,同时有一套完善的解决方案。还有一点也是我今天一直关注的,数据的安全。正是因为这些,IBM打动了我们,所以我们就开始合作了。”

IBM:“平台+服务”的集成解决方案

在工作环境的巨大压力下,影像科医生寻求人工智能进行辅助筛查也成为了一种必然的选择。在这点上,厦门市第二医院选择了与IBM进行合作,采用其人工智能解决方案。

IBM今年推出的认知系统(CognitiveSystems)借助拥有CPU:GPUNVLink的面向高性能计算的IBMPowerSystems架构,提供人工智能相关工作负载所需的高性能计算力。据了解,认知系统集成了PowerAI深度学习框架,提供预编译的主流深度学习软件工具包,针对NVidiaGPU及NVLink优化性能。而认知系统中包含的BlueMind深度学习平台具有深度学习功能,基于Spark大数据平台框架,以较高的并行效率和扩展性能进行深度学习平台的资源管理、调度。

IBM全球副总裁、IBM中国系统开发中心总经理谢东在论坛上表示,IBM推出的人工智能集成解决方案有几大特点。

第一是“平台+服务”。平台是硬件软件一体化的方案,包括Power、PowerAI、BlueMind等等。谢东表示,“我们觉得光有一个平台推向行业用户还不够,需要服务来支撑,在行业的专业人员和平台之间有一个桥梁,所以我们就有实验室服务团队来帮助实现。这就是‘平台+服务’,这是我们这个解决方案的特点,是针对每个行业定制打造的。”

第二,成熟完整,易于使用。成熟完整在于,AI不光是模型训练,每个行业都有特定的问题,从数据的准备、模型的选择、模型的训练、在线的实施、在线应用等等设计一体化的方案,“IBM的解决方案帮助了行业用户端到端生命周期的管理。”同时这个解决方案也要易于使用,“既然是一个新系统,很多行业专家并不具有IT使用经验,我们希望他专注于专业问题,致力于模型训练,易于使用的环境能够大大提高他们的效率。”

第三,技术领先且开放。技术领先体现在几个方面,一个是硬件平台,基于Power、基于GPU、基于FPGA加速,同时还有很多新的训练方法,可以大幅度提高训练的速度和精准性。IBM在面向企业级客户需要考虑到系统的弹性,在企业中一开始业务规模相对较小,然后训练更多的业务模型,使得系统得到扩展延伸。第二就是开放,行业用户可以把IBM人工智能的技术融入到这个平台上。同时平台又向开源社区开放,所以很多新的模型、新的设计架构都可以融入到解决方案中来使用。

双方将成立智能医学影像联合实验室

在此次会上了解到,厦门市第二医院将会与IBM共同成立智能医学影像的联合实验室,基于IBM认知系统的架构能力及组件探索3D影像识别、CT智能化检测、磁共振智能化研究等方面的应用前景。

郭教授表示,合作最终的目的是减少国家和患者看病的成本,另一方面是提高医院的服务效率和医疗水平。双方前期的合作已经可以缩短影像科的就诊时间,在某种程度上减少了成本。一旦系统可以应用到临床,病人可能在基层医院也可以享受到专家级的水平,无形中就可以给国家、给病人减少成本。

郭教授向雷锋网透露,双方接下的合作将在完善目前开发设备的基础上,再开发基于CT的人工智能的平台,基于磁共振的人工智能平台以及基于科研的人工智能平台。“现在基于CT的人工智能平台是热点,但是目的不同,这个处于科研和前瞻性研究阶段。基于磁共振、科研的平台一旦成功了以后,可以通过大数据、格式化的研究,做到提前干预、提前治疗,帮助医生提高工作效率和准确率。尤其是缓解基层医院医护人员缺乏的问题,同时对国家的分级诊疗政策非常有积极作用,可以带来很好的社会和经济效益。”

IBM大中华区硬件系统部Linux系统技术总监徐宁

IBM大中华区硬件系统部Linux系统技术总监徐宁表示,IBM现在做的是二维图像,但是现在医疗界包括深度学习领域都在看三维,这是一个难点,包括三维图形怎么标注,后续还可以做相应的的测量工作,希望在三维上能够有所突破。

IBM认知医疗的战略落子

人工智能是IBM在2014年后的重点关注领域,IBM在AI领域布局围绕Watson和类脑芯片展开,试图打造AI生态系统。IBM的Watson是认知计算系统中的代表,也是IBM认知计算技术的一个具体表现。从十四年前的“深蓝”到如今的Watson,IBM一直没有停下挑战人工智能极限的脚步。今年,IBM就推出了一系列认知系统,其中包括由BlueMind深度学习云平台、PowerAI深度学习框架和使用NVLink技术的IBMPowerSystemS822LC服务器等组成的一套软硬件整合的解决方案。

目前,医疗行业对认知计算和AI等技术大致有两类较为突出的需求:一类是亟需一个具备数据挖掘能力和应用能力的平台来解决医疗业务实操中所面临的难题;另一类是怎样构建和优化针对某一具体医疗场景的算法能力,如针对医学影像AI领域。

IBM中国研究院认知交互技术总监秦勇此前曾表示:“从纵向看,IBM的AI不是纯软件,其中既有底层的神经元芯片,也有服务AI的Power服务器,还包括Watson的API等,所以IBM构建的是AI的整体架构,重点是帮助客户迎接现实的各种挑战。”

PowerAI自然不是IBM认知基础架构平台解决方案的全部,在过去十年中,IBM用Watson引领了认知计算的复苏,旨在为企业寻找AI“快捷键”。IBM随后采用了POWER8,OpenPOWER,CAPI和OpenCAPI基础设施,用于AI公共和私用云实施。IBM现在正在使用PowerAI完成AI圈子,用于想要使用AI但要有特定深度学习框架的企业。

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    2018-02-03 xqptu
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1660668, encodeId=5ce3166066863, content=<a href='/topic/show?id=803c3e216cf' target=_blank style='color:#2F92EE;'>#厦门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37216, encryptionId=803c3e216cf, topicName=厦门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a25130440, createdName=xqptu, createdTime=Sat Feb 03 04:37:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924073, encodeId=661c19240e369, content=<a href='/topic/show?id=a57b503051c' target=_blank style='color:#2F92EE;'>#影像科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50305, encryptionId=a57b503051c, topicName=影像科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85df2500173, createdName=654699882_84926986, createdTime=Sat Aug 18 22:37:00 CST 2018, time=2018-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1803712, encodeId=ca611803e1297, content=<a href='/topic/show?id=e95ae581426' target=_blank style='color:#2F92EE;'>#第二医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75814, encryptionId=e95ae581426, topicName=第二医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Sun Jun 10 03:37:00 CST 2018, time=2018-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766524, encodeId=8f471e6652405, content=<a href='/topic/show?id=bc80e48144f' target=_blank style='color:#2F92EE;'>#科主任#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74814, encryptionId=bc80e48144f, topicName=科主任)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9f3637838032, createdName=446798725_87912777, createdTime=Sun Jan 21 09:37:00 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648984, encodeId=f2c0164898481, content=<a href='/topic/show?id=5f36312836f' target=_blank style='color:#2F92EE;'>#减负#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31283, encryptionId=5f36312836f, topicName=减负)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7d6323702474, createdName=cnxcy, createdTime=Fri Jul 13 08:37:00 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244122, encodeId=6c4124412246, content=不错.科技提升临床水平, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Sep 15 02:05:44 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243847, encodeId=b9e924384e14, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Sep 14 09:11:23 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243689, encodeId=f785243689d2, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Wed Sep 13 23:39:03 CST 2017, time=2017-09-13, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1660668, encodeId=5ce3166066863, content=<a href='/topic/show?id=803c3e216cf' target=_blank style='color:#2F92EE;'>#厦门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37216, encryptionId=803c3e216cf, topicName=厦门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a25130440, createdName=xqptu, createdTime=Sat Feb 03 04:37:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924073, encodeId=661c19240e369, content=<a href='/topic/show?id=a57b503051c' target=_blank style='color:#2F92EE;'>#影像科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50305, encryptionId=a57b503051c, topicName=影像科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85df2500173, createdName=654699882_84926986, createdTime=Sat Aug 18 22:37:00 CST 2018, time=2018-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1803712, encodeId=ca611803e1297, content=<a href='/topic/show?id=e95ae581426' target=_blank style='color:#2F92EE;'>#第二医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75814, encryptionId=e95ae581426, topicName=第二医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Sun Jun 10 03:37:00 CST 2018, time=2018-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766524, encodeId=8f471e6652405, content=<a href='/topic/show?id=bc80e48144f' target=_blank style='color:#2F92EE;'>#科主任#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74814, encryptionId=bc80e48144f, topicName=科主任)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9f3637838032, createdName=446798725_87912777, createdTime=Sun Jan 21 09:37:00 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648984, encodeId=f2c0164898481, content=<a href='/topic/show?id=5f36312836f' target=_blank style='color:#2F92EE;'>#减负#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31283, encryptionId=5f36312836f, topicName=减负)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7d6323702474, createdName=cnxcy, createdTime=Fri Jul 13 08:37:00 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244122, encodeId=6c4124412246, content=不错.科技提升临床水平, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Sep 15 02:05:44 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243847, encodeId=b9e924384e14, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Sep 14 09:11:23 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243689, encodeId=f785243689d2, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Wed Sep 13 23:39:03 CST 2017, time=2017-09-13, status=1, ipAttribution=)]
    2018-07-13 cnxcy
  6. [GetPortalCommentsPageByObjectIdResponse(id=1660668, encodeId=5ce3166066863, content=<a href='/topic/show?id=803c3e216cf' target=_blank style='color:#2F92EE;'>#厦门#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37216, encryptionId=803c3e216cf, topicName=厦门)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a25130440, createdName=xqptu, createdTime=Sat Feb 03 04:37:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1924073, encodeId=661c19240e369, content=<a href='/topic/show?id=a57b503051c' target=_blank style='color:#2F92EE;'>#影像科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50305, encryptionId=a57b503051c, topicName=影像科)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85df2500173, createdName=654699882_84926986, createdTime=Sat Aug 18 22:37:00 CST 2018, time=2018-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1803712, encodeId=ca611803e1297, content=<a href='/topic/show?id=e95ae581426' target=_blank style='color:#2F92EE;'>#第二医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75814, encryptionId=e95ae581426, topicName=第二医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7eeb2500172, createdName=haouestc, createdTime=Sun Jun 10 03:37:00 CST 2018, time=2018-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766524, encodeId=8f471e6652405, content=<a href='/topic/show?id=bc80e48144f' target=_blank style='color:#2F92EE;'>#科主任#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74814, encryptionId=bc80e48144f, topicName=科主任)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9f3637838032, createdName=446798725_87912777, createdTime=Sun Jan 21 09:37:00 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648984, encodeId=f2c0164898481, content=<a href='/topic/show?id=5f36312836f' target=_blank style='color:#2F92EE;'>#减负#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31283, encryptionId=5f36312836f, topicName=减负)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7d6323702474, createdName=cnxcy, createdTime=Fri Jul 13 08:37:00 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=244122, encodeId=6c4124412246, content=不错.科技提升临床水平, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Sep 15 02:05:44 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243847, encodeId=b9e924384e14, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Sep 14 09:11:23 CST 2017, time=2017-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243689, encodeId=f785243689d2, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Wed Sep 13 23:39:03 CST 2017, time=2017-09-13, status=1, ipAttribution=)]
    2017-09-15 1de3b290m83(暂无匿称)

    不错.科技提升临床水平

    0

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    2017-09-14 139****5926

    好好文章学习了

    0

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    2017-09-13 130****4638

    学习了谢谢分享

    0

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