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BMJ Open:全结肠切除术可降低高血压风险

2016-01-03 Seven L 译 MedSci原创

如果肠道菌群参与动脉粥样硬化性心脑血管疾病的发展(CVDs),那么全结肠切除术是否可以降低心血管疾病的长期风险。研究组进行了一样研究,对全结肠切除术后患者和其他不改变肠道菌群或CVD风险的手术患者进行了CVD风险比较。该研究纳入了1530名年龄≥45岁全结肠切除术后存活1000天且没有CVDs的患者,同时对其匹配不含CVDs行其他手术的5个对照组。5个随机对照组患者来自于骨科手术、胃肠道手术、与胃

如果肠道菌群参与动脉粥样硬化性心脑血管疾病的发展(CVDs),那么全结肠切除术是否可以降低心血管疾病的长期风险?研究组进行了一样研究,对全结肠切除术后患者和其他不改变肠道菌群或CVD风险的手术患者进行了CVD风险比较。

该研究纳入了1530名年龄≥45岁的全结肠切除术后存活1000天且没有CVDs的患者,同时对其匹配不含CVDs行其他手术的5个对照组。5个随机对照组患者来自于骨科手术、胃肠道手术、与胃肠道和CVDs不相关的其他手术(n=22 950)。初始结局指标是CVD事件(高血压病、急性缺血性心脏病、慢性缺血性心脏病、心律失常、心力衰竭、脑血管病、其他动脉疾病)的发生。

Cox风险比例模型分析显示,全结肠切除术后患者与对照组相比,综合CVD风险并没有降低 (HR=0.94, 95% CI 0.85 to 1.04),对结局指标相关的7个心血管领域中,只有高血压病的风险在全结肠切除组下降(HR=0.85, 0.73 to 0.98)。

研究结果表明,全结肠切除术不会降低一般CVD风险,但是可以降低高血压病风险。以后还需要更多的研究评估肠道菌群和CVD间联系。

原始出处:

Jensen AB, Ajslev TA,et al.Long-term risk of cardiovascular and cerebrovascular disease after removal of the colonic microbiota by colectomy: a cohort study based on the Danish National Patient Register from 1996 to 2014.BMJ Open. 2015 Dec 15;5(12):e008702.

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    2016-03-07 feather89
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    2016-03-08 gaoxiaoe
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    2016-01-13 马克6212

    好的

    0

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    2016-01-09 medsic

    风险不大吗?

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1706541, encodeId=695d1e0654186, content=<a href='/topic/show?id=0df2e87477d' target=_blank style='color:#2F92EE;'>#结肠切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78747, encryptionId=0df2e87477d, topicName=结肠切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a89f31292094, createdName=12498568m60暂无昵称, createdTime=Wed Feb 24 15:01:00 CST 2016, time=2016-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725994, encodeId=13de1e2599475, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Mar 07 09:01:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847841, encodeId=5491184e84105, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Mar 08 19:01:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=56938, encodeId=b2095693845, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569601E65B8046777.jpg, createdBy=90c91679211, createdName=马克6212, createdTime=Wed Jan 13 16:06:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54890, encodeId=25d654890cd, content=风险不大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=180, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54891, encodeId=7dcd54891d1, content=哦,, beContent=null, objectType=article, channel=null, level=null, likeNumber=193, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52457, encodeId=54145245e35, content=和肠道菌群的最新研究不谋而合, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151022/IMG5628D6F14DBD16799.jpg, createdBy=ed8e1658452, createdName=靶细胞, createdTime=Wed Jan 06 17:32:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52405, encodeId=a141524059c, content=好东西,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Wed Jan 06 13:31:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51973, encodeId=61dc519e36a, content=提示高血压的风险又多了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed101627734, createdName=Messichen1992, createdTime=Tue Jan 05 10:14:00 CST 2016, time=2016-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51776, encodeId=99ee51e7685, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6081676206, createdName=1de22f45m90(暂无匿称), createdTime=Mon Jan 04 16:14:00 CST 2016, time=2016-01-04, status=1, ipAttribution=)]
    2016-01-09 medsic

    哦,

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1706541, encodeId=695d1e0654186, content=<a href='/topic/show?id=0df2e87477d' target=_blank style='color:#2F92EE;'>#结肠切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78747, encryptionId=0df2e87477d, topicName=结肠切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a89f31292094, createdName=12498568m60暂无昵称, createdTime=Wed Feb 24 15:01:00 CST 2016, time=2016-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725994, encodeId=13de1e2599475, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Mar 07 09:01:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847841, encodeId=5491184e84105, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Mar 08 19:01:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=56938, encodeId=b2095693845, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569601E65B8046777.jpg, createdBy=90c91679211, createdName=马克6212, createdTime=Wed Jan 13 16:06:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54890, encodeId=25d654890cd, content=风险不大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=180, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54891, encodeId=7dcd54891d1, content=哦,, beContent=null, objectType=article, channel=null, level=null, likeNumber=193, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52457, encodeId=54145245e35, content=和肠道菌群的最新研究不谋而合, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151022/IMG5628D6F14DBD16799.jpg, createdBy=ed8e1658452, createdName=靶细胞, createdTime=Wed Jan 06 17:32:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52405, encodeId=a141524059c, content=好东西,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Wed Jan 06 13:31:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51973, encodeId=61dc519e36a, content=提示高血压的风险又多了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed101627734, createdName=Messichen1992, createdTime=Tue Jan 05 10:14:00 CST 2016, time=2016-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51776, encodeId=99ee51e7685, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6081676206, createdName=1de22f45m90(暂无匿称), createdTime=Mon Jan 04 16:14:00 CST 2016, time=2016-01-04, status=1, ipAttribution=)]
    2016-01-06 靶细胞

    和肠道菌群的最新研究不谋而合

    0

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    2016-01-06 andruhn

    好东西,学习了!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1706541, encodeId=695d1e0654186, content=<a href='/topic/show?id=0df2e87477d' target=_blank style='color:#2F92EE;'>#结肠切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78747, encryptionId=0df2e87477d, topicName=结肠切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a89f31292094, createdName=12498568m60暂无昵称, createdTime=Wed Feb 24 15:01:00 CST 2016, time=2016-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725994, encodeId=13de1e2599475, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Mar 07 09:01:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847841, encodeId=5491184e84105, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Mar 08 19:01:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=56938, encodeId=b2095693845, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569601E65B8046777.jpg, createdBy=90c91679211, createdName=马克6212, createdTime=Wed Jan 13 16:06:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54890, encodeId=25d654890cd, content=风险不大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=180, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54891, encodeId=7dcd54891d1, content=哦,, beContent=null, objectType=article, channel=null, level=null, likeNumber=193, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52457, encodeId=54145245e35, content=和肠道菌群的最新研究不谋而合, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151022/IMG5628D6F14DBD16799.jpg, createdBy=ed8e1658452, createdName=靶细胞, createdTime=Wed Jan 06 17:32:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52405, encodeId=a141524059c, content=好东西,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Wed Jan 06 13:31:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51973, encodeId=61dc519e36a, content=提示高血压的风险又多了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed101627734, createdName=Messichen1992, createdTime=Tue Jan 05 10:14:00 CST 2016, time=2016-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51776, encodeId=99ee51e7685, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6081676206, createdName=1de22f45m90(暂无匿称), createdTime=Mon Jan 04 16:14:00 CST 2016, time=2016-01-04, status=1, ipAttribution=)]
    2016-01-05 Messichen1992

    提示高血压的风险又多了一点

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1706541, encodeId=695d1e0654186, content=<a href='/topic/show?id=0df2e87477d' target=_blank style='color:#2F92EE;'>#结肠切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78747, encryptionId=0df2e87477d, topicName=结肠切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a89f31292094, createdName=12498568m60暂无昵称, createdTime=Wed Feb 24 15:01:00 CST 2016, time=2016-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725994, encodeId=13de1e2599475, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Mar 07 09:01:00 CST 2016, time=2016-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847841, encodeId=5491184e84105, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Mar 08 19:01:00 CST 2016, time=2016-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=56938, encodeId=b2095693845, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=171, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160113/IMG569601E65B8046777.jpg, createdBy=90c91679211, createdName=马克6212, createdTime=Wed Jan 13 16:06:00 CST 2016, time=2016-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54890, encodeId=25d654890cd, content=风险不大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=180, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=54891, encodeId=7dcd54891d1, content=哦,, beContent=null, objectType=article, channel=null, level=null, likeNumber=193, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32ba1611217, createdName=medsic, createdTime=Sat Jan 09 20:53:00 CST 2016, time=2016-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52457, encodeId=54145245e35, content=和肠道菌群的最新研究不谋而合, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151022/IMG5628D6F14DBD16799.jpg, createdBy=ed8e1658452, createdName=靶细胞, createdTime=Wed Jan 06 17:32:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=52405, encodeId=a141524059c, content=好东西,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=69b61619007, createdName=andruhn, createdTime=Wed Jan 06 13:31:00 CST 2016, time=2016-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51973, encodeId=61dc519e36a, content=提示高血压的风险又多了一点, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed101627734, createdName=Messichen1992, createdTime=Tue Jan 05 10:14:00 CST 2016, time=2016-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=51776, encodeId=99ee51e7685, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6081676206, createdName=1de22f45m90(暂无匿称), createdTime=Mon Jan 04 16:14:00 CST 2016, time=2016-01-04, status=1, ipAttribution=)]
    2016-01-04 1de22f45m90(暂无匿称)

    非常好的文章

    0

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