Sclerosis

硬化
  • 文章类型: Review
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  • 文章类型: Journal Article
    目的:探讨腰椎退行性疾病患者的改变与终板硬化的关系。
    方法:本网络荟萃分析是基于2020年系统评价和荟萃分析的优先报告项目进行的。本研究已在国际前瞻性系统评价登记册(CRD42024497370)注册。我们对PubMed进行了系统的搜索,WebofScience,Embase,中国国家知识基础设施,中国科技期刊数据库,和万方数据库从成立到2023年12月22日。应用STATA13.0和RevMan5.3进行荟萃分析。
    结果:根据MC的类型,共将7项研究共1510个终板分为6组。单型组终板硬化率明显低于混合型组。I型MC(MC1)的终板硬化率明显低于II型MC(MC2)。MC2中的终板硬化率明显低于Ⅲ型MC(MC3)。MC1/2的终板硬化率显著低于MC2/3。在MC1/2和MC1/3之间或在MC2/3和MC1/3之间没有检测到显著差异。为了降低终板硬化率,不同类型MC的顺序为MC1>MC2>MC1/2>MC2/3≈MC1/3>MC3。
    结论:终板硬化在各种MC中均有发生。随着MC等级的提高,终板硬化的发病率逐渐增高。混合型MCs的终板硬化率明显大于MC2,明显低于MC3。混合型终板硬化率,包括MC3(MC1/3和MC2/3),显著大于MC1/2。
    To explore the relationship between modic changes (MCs) and endplate sclerosis in patients with lumbar degenerative disease.
    This network meta-analysis was performed on the basis of Preffered Reporting Items for Systematic Reviews and Meta-Analysis 2020 statement. This study was registered at the International Prospective Register of Systematic Reviews (CRD42024497370). We performed a systematic search of the PubMed, Web of Science, Embase, China national knowledge infrastructure, China Science and Technology Journal Database, and Wanfang databases from inception to December 22, 2023. STATA13.0 and RevMan 5.3 were applied to perform the meta-analysis.
    Seven studies with a total of 1510 endplates were divided into 6 groups according to the type of MCs. The endplate sclerosis rate in the single-type group was significantly lower than that in the mixed-type group. The endplate sclerosis rate in the type I MC (MC1) was significantly lower than that in the type II MC (MC2). The endplate sclerosis rate in the MC2 was significantly lower than that in the type III MC (MC3). The endplate sclerosis rate in the MC1/2 was significantly lower than that in the MC2/3. No significant difference was detected between MC1/2 and MC1/3 or between MC2/3 and MC1/3. For decreasing the endplate sclerosis rate, the order of the different types of MCs was MC1>MC2>MC1/2>MC2/3≈MC1/3>MC3.
    Endplate sclerosis occurs in all kinds of MCs. With increasing grade of MCs, the incidence of endplate sclerosis gradually increased. The endplate sclerosis rate in mixed-type MCs was significantly greater than that in MC2 and significantly lower than that in MC3. The endplate sclerosis rate in the mixed-type, including MC3 (MC1/3 and MC2/3), was significantly greater than that in the MC1/2.
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  • 文章类型: Case Reports
    硬化性苔藓(LS)是一种罕见的,慢性,炎性皮肤粘膜疾病主要见于病因不明的女性。它表现为通常位于肛门生殖器区域的白色硬化斑块。婚外LS不那么普遍,影响口腔粘膜的LS非常罕见,文献中仅报道了39例活检确诊病例。由于它的几个模仿条件,组织学检查通常需要明确的诊断,特别是在口服LS患者中。目前尚无口服LS的循证治疗建议;然而,大多数病例在使用局部或病灶内皮质类固醇治疗后倾向于改善。我们报告了一例从耳鼻喉科转诊的58岁女性,用于评估存在1年的下唇粘膜上无症状的白色硬化斑块。穿刺活检后,患者被诊断为唇粘膜LS。局部和病灶内皮质类固醇治疗2个月后,病情改善。本病例报告提高了对口腔LS的认识,并有助于了解这种罕见疾病。
    Lichen sclerosus (LS) is an uncommon, chronic, inflammatory mucocutaneous disorder found predominantly in females with unknown etiology. It presents as a white sclerotic plaque commonly located on the anogenital area. Extragenital LS is less prevalent, and LS affecting the oral mucosa is extremely rare, with only 39 biopsy-confirmed cases reported in the literature. Due to its several mimicking conditions, histological examination is usually required for a definitive diagnosis, particularly in patients with oral LS. Current evidence-based treatment recommendations for oral LS are unavailable; however, most cases tend to improve after treatment with topical or intralesional corticosteroids. We report a case of a 58-year-old female referred from the otolaryngology department for evaluating an asymptomatic whitish sclerotic plaque on the lower lip mucosa that had existed for 1 year. Following a punch biopsy, the patient was diagnosed with LS of labial mucosa. The condition improved after 2 months of treatment with topical and intralesional corticosteroids. The present case report raises awareness in recognizing oral LS and contributes to knowledge of this rare disorder.
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  • 文章类型: Case Reports
    硬化性多囊腺瘤(SPA)是一种罕见的肿瘤性唾液腺病变,迄今为止,全世界仅报道了约100例。该病变与几种恶性和其他良性肿瘤相混淆,例如大汗腺导管内癌(IC),涎管癌(SDC),慢性硬化性唾液腺炎,多囊性遗传性疾病(PDD),多形性腺瘤(PA),腺泡细胞癌(ACC),和粘液表皮样癌(MEC)。我们介绍了一名23岁男性患者的SPA病例,该患者表现为腮腺肿块缓慢增长。进行细针抽吸(FNA),然后完全切除肿瘤,图像与SPA一致。我们讨论了案例的发现,并简要回顾了有关SPA的文献。
    Sclerosing polycystic adenoma (SPA) is a rare neoplastic salivary gland lesion with only about 100 cases reported worldwide so far. The lesion is confused with several malignant and other benign tumors such as apocrine intraductal carcinoma (IC), salivary duct carcinoma (SDC), chronic sclerosing sialadenitis, polycystic dysgenetic disease (PDD), pleomorphic adenoma (PA), acinic cell carcinoma (ACC), and mucoepidermoid carcinoma (MEC). We present a case of SPA for a 23-year-old male patient presenting with a slowly growing parotid mass. Fine needle aspiration (FNA) followed by total excision of the tumor was performed and the picture was consistent with SPA. We discuss the findings of the case and briefly review the literature on SPA.
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  • 文章类型: Meta-Analysis
    目的:我们进行了系统评价和荟萃分析,以评估2013年ILAE共识指南分类的不同海马硬化(HS)亚型颞叶癫痫的术后癫痫发作和记忆结局。
    方法:遵循PRISMA和MOOSE指南,我们搜索了PubMed,Embase,WebofScience,和Cochrane图书馆从2013年1月1日至2023年8月6日。包括报告不同HS亚型中癫痫发作和记忆结果的观察性研究。我们使用纽卡斯尔-渥太华量表评估偏倚风险,并使用GRADE方法对证据质量进行评级。手术后≥1年的癫痫发作自由和改善的结果(Engel1或ILAE1-2级)被定义为原发性和继发性癫痫发作结果。使用DerSimonian和Laird方法进行随机效应荟萃分析,以获得具有95%置信区间(CI)的合并风险比(RR)。由于各种评估工具,对记忆障碍进行了叙述性审查。
    结果:15项2,485例患者的队列研究符合癫痫发作结局的荟萃分析。包括六个具有术后记忆结果详细信息的队列。癫痫发作自由的汇总RR,具有中度到实质性的异质性,HS2型和1型之间为0.98(95%CI0.84至1.15),3型和1型之间为1.11(95%CI0.82至1.52),非HS和HS组之间为0.80(95%CI0.62至1.03)。不同亚型间改善结局差异无统计学意义(P>0.05)。根据等级,证据质量被认为是低到非常低。长期癫痫发作结果(术后≥5年)和记忆障碍仍存在争议。
    结论:在不同的HS病理亚型中发现相似的术后癫痫发作结果和不一致的术后记忆变化。多种因素,包括但不限于病理变化,可能会影响术后癫痫发作和认知结果。
    We conducted a systematic review and meta-analysis to evaluate postoperative seizure and memory outcomes of temporal lobe epilepsy with different hippocampal sclerosis (HS) subtypes classified by International League Against Epilepsy (ILAE) Consensus Guidelines in 2013. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines, we searched PubMed, Embase, Web of Science, and Cochrane Library from January 1, 2013 to August 6, 2023. Observational studies reporting seizure and memory outcomes among different HS subtypes were included. We used the Newcastle-Ottawa scale to assess the risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to grade the quality of evidence. Seizure freedom and improved outcome (Engel 1 or ILAE class 1-2) ≥1 year after surgery were defined as the primary and secondary seizure outcome. A random-effects meta-analysis by DerSimonian and Laird method was performed to obtain pooled risk ratio (RRs) with 95% confidence interval (CIs). The memory impairment was narratively reviewed because of various evaluation tools. Fifteen cohort studies with 2485 patients were eligible for the meta-analysis of seizure outcome. Six cohorts with detailed information on postoperative memory outcome were included. The pooled RRs of seizure freedom, with moderate to substantial heterogeneity, were .98 (95% CI = .84-1.15) between HS type 2 and type 1, 1.11 (95% CI = .82-1.52) between type 3 and type 1, and .80 (95% CI = .62-1.03) between the no-HS and HS groups. No significant difference of improved outcome was found between different subtypes (p > .05). The quality of evidence was deemed to be low to very low according to GRADE. The long-term seizure outcome (≥5 years after surgery) and memory impairment remained controversial.
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  • 文章类型: Systematic Review
    背景:可穿戴传感器技术具有改善多发性硬化症(MS)患者的监测并及时告知疾病管理决策的潜力。在MS患者中使用可穿戴传感器技术的证据正在积累,但通常仅限于特定的患者亚组。临床或实验室设置,和功能域。
    目的:这篇综述旨在全面概述所有使用可穿戴传感器进行评估的研究,监视器,并量化MS患者在日常活动或受控实验室环境中的运动功能,并阐明过去几十年的技术进步。
    方法:我们系统地回顾了可穿戴传感器的研究,以评估患有MS的人的运动表现。我们扫描了PubMed,Scopus,Embase,和WebofScience数据库,直到2022年12月31日,考虑搜索术语“多发性硬化症”以及与可穿戴技术相关的术语,并包括所有评估运动功能的研究。将相关研究的结果类型系统地映射到9个预定义类别中(与临床评分或其他指标的关联;测试重测可靠性;组差异,3种类型;对变化或干预的反应能力;以及对研究参与者的可接受性),通过9个问题确定报告质量。我们遵循PRISMA(系统审查和荟萃分析的首选报告项目)报告指南。
    结果:在1251个确定的出版物中,308人被包括:176人(57.1%)在现实世界中,107(34.7%)在实验室环境中,和25(8.1%)在混合背景下。大多数出版物研究了身体活动(196/308,63.6%),其次是步态(81/308,26.3%),灵巧或震颤(38/308,12.3%),和余额(34/308,11%)。在实验室环境中,结果指标包括(除临床严重程度评分外)2分钟和6分钟步行测试,定时25英尺步行测试,超时,走,爬楼梯,平衡测试,手指到鼻子的测试,在其他人中。可穿戴放置的最受欢迎的解剖学标志是腰部,手腕,下背部。三轴加速度计是最常用的(229/308,74.4%)。已经观察到嵌入在智能手机和智能手表中的传感器数量激增。总的来说,报告质量很好。
    结论:使用可穿戴传感器进行持续监测可以优化MS患者的管理,但是在临床上完全采用数字监测仍然存在一些障碍。尽管报告的结果可能存在发表偏倚和巨大的异质性,我们的综述概述了用于MS患者的可穿戴传感器技术的当前文献,并强调了缺点,例如缺乏协调,报告方法和结果的透明度,和有限的数据可用性的研究社区。在临床常规和临床试验中越来越多地实施可穿戴传感器技术,需要解决这些限制。这对于MS患者的临床研究和日常管理的进一步进展至关重要。
    背景:PROSPEROCRD42021243249;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=243249。
    Wearable sensor technologies have the potential to improve monitoring in people with multiple sclerosis (MS) and inform timely disease management decisions. Evidence of the utility of wearable sensor technologies in people with MS is accumulating but is generally limited to specific subgroups of patients, clinical or laboratory settings, and functional domains.
    This review aims to provide a comprehensive overview of all studies that have used wearable sensors to assess, monitor, and quantify motor function in people with MS during daily activities or in a controlled laboratory setting and to shed light on the technological advances over the past decades.
    We systematically reviewed studies on wearable sensors to assess the motor performance of people with MS. We scanned PubMed, Scopus, Embase, and Web of Science databases until December 31, 2022, considering search terms \"multiple sclerosis\" and those associated with wearable technologies and included all studies assessing motor functions. The types of results from relevant studies were systematically mapped into 9 predefined categories (association with clinical scores or other measures; test-retest reliability; group differences, 3 types; responsiveness to change or intervention; and acceptability to study participants), and the reporting quality was determined through 9 questions. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines.
    Of the 1251 identified publications, 308 were included: 176 (57.1%) in a real-world context, 107 (34.7%) in a laboratory context, and 25 (8.1%) in a mixed context. Most publications studied physical activity (196/308, 63.6%), followed by gait (81/308, 26.3%), dexterity or tremor (38/308, 12.3%), and balance (34/308, 11%). In the laboratory setting, outcome measures included (in addition to clinical severity scores) 2- and 6-minute walking tests, timed 25-foot walking test, timed up and go, stair climbing, balance tests, and finger-to-nose test, among others. The most popular anatomical landmarks for wearable placement were the waist, wrist, and lower back. Triaxial accelerometers were most commonly used (229/308, 74.4%). A surge in the number of sensors embedded in smartphones and smartwatches has been observed. Overall, the reporting quality was good.
    Continuous monitoring with wearable sensors could optimize the management of people with MS, but some hurdles still exist to full clinical adoption of digital monitoring. Despite a possible publication bias and vast heterogeneity in the outcomes reported, our review provides an overview of the current literature on wearable sensor technologies used for people with MS and highlights shortcomings, such as the lack of harmonization, transparency in reporting methods and results, and limited data availability for the research community. These limitations need to be addressed for the growing implementation of wearable sensor technologies in clinical routine and clinical trials, which is of utmost importance for further progress in clinical research and daily management of people with MS.
    PROSPERO CRD42021243249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=243249.
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  • 文章类型: Systematic Review
    在这次系统审查中,我们旨在评估硬化性多囊腺瘤(SPA)的临床病理特征。PubMed,Scopus,EMBASE,丁香花,WebofScience,并检索灰色文献以获取唾液腺SPA病例。在61篇精选文章中发现了130例SPA。SPA主要影响平均年龄为44.6岁的成人腮腺,有点偏爱女性。病变通常表现为无痛的坚硬肿块,具有长期的演变过程。组织学上,它们是明确界定的病变,由腺泡和导管元件组成,具有各种细胞形态学特征,周围有致密的胶原基质。PI3K是与SPA相关的最常见的基因突变。SPA是一种良性疾病,主要影响女性患者的腮腺,通常通过手术切除治疗,预后良好。
    In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched to access cases of SPA in salivary glands. One hundred and thirty cases of SPA were found across 61 selected articles. SPA affected mainly the parotid gland of adults with a mean age of 44.6 years old, with a slight preference for females. The lesion was usually presented as a painless firm mass with a long period of evolution. Histologically, they are well-delimitated lesions composed of acinar and ductal elements with a variety of cytomorphologic features surrounded by a densely collagenized stroma. PI3K was the most common gene mutation related to SPA. SPA is a benign condition that mainly affects the parotid gland of female patients and it is usually treated by surgical resection with a good prognosis.
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  • 文章类型: Meta-Analysis
    目的:评估多发性硬化症(MS)女性性功能障碍(SD)的合并患病率。
    方法:我们系统地搜索了PubMed,Scopus,EMBASE,WebofScience,谷歌学者和灰色文学到2021年10月。搜索策略包括:(\"多发性硬化症\"或\"MS\"""或\"性障碍"或\"性障碍"或\"性障碍"或"(性障碍和性障碍)或"或"或"或"性障碍\\性障碍\\性障碍\"或"或"或"性障碍\"或"(性障碍\性障碍\性障碍\性障碍\或"或"或"或"或
    结果:我们通过文献检索找到了2150篇文章,删除重复项之后,1760仍然存在。还有56篇文章需要进行荟萃分析。MS患者中SD的合并患病率估计为61%(95CI:56-67%)(I2:95.7%,P<0.001)。MS患者性高潮障碍的合并患病率估计为29%(95CI:20-39%)(I2:85.3%,P<0.001)。MS女性发生SD的合并几率估计为3.05(95CI:1.74-5.35)(I2:78.3%,P<0.001)。MS患者阴道润滑减少的合并患病率估计为32%(95CI:27-37%)(I2=94.2%,P<0.001)。合并的性欲降低的患病率为48%(95CI:36-61%)(I2:92.6%,P<0.001)。唤醒问题的合并患病率为40%(95CI:26-54%)(I2:97.4%,P<0.001)。性交满意度的总患病率为27%(95CI:8-46%)(I2:99%,P<0.001)。
    结论:本系统评价和荟萃分析的结果表明,MS女性中SD的合并患病率为61%,与对照组相比,SD的发生率为3.05。
    To estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS).
    We systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar and also gray literature up to October 2021. The search strategy includes: (\"Multiple Sclerosis\" OR \"MS\" OR \"Disseminated Sclerosis\" OR (Disseminated AND Sclerosis) OR (Sclerosis AND Multiple)) AND (\"Sexual Dysfunction\" OR (Sexual AND Dysfunction) OR (Sexual AND Dysfunctions) OR (Sexual AND Disorders) OR (Sexual AND Disorder) OR \"Sexual Dysfunctions\" OR \"Sexual Disorders\" OR \"Sexual Disorder\" OR \"Psychosexual Dysfunctions\" OR (Dysfunction AND Psychosexual) OR (Dysfunctions AND Psychosexual) OR \"Psychosexual Dysfunction\" OR \"Psychosexual Disorders\" OR (Disorder AND Psychosexual) OR (Disorders AND Psychosexual) OR \"Psychosexual Disorder\" OR \"Hypoactive Sexual Desire Disorder\" OR \"Sexual Aversion Disorder\" OR (Aversion Disorders AND Sexual) OR (Disorders AND Sexual Aversion) OR \"Sexual Aversion Disorders\" OR \"Orgasmic Disorder\" OR (Disorders AND Orgasmic) OR \"Orgasmic Disorders\" OR \"Sexual Arousal Disorder\" OR (Arousal Disorders AND Sexual) OR (Disorders AND Sexual Arousal) OR \"Sexual Arousal Disorders\" OR \"Frigidity\").
    We found 2150 articles by literature search, after deleting duplicates 1760 remained. Fifty-six articles remained for meta-analysis. The pooled prevalence of SD in MS patients estimated as 61% (95%CI:56-67%) (I2:95.7%, P < 0.001). The pooled prevalence of Anorgasmia in MS patients estimated as 29% (95%CI:20-39%) (I2:85.3%, P < 0.001). The pooled odds of developing SD in MS women estimated as 3.05(95%CI: 1.74-5.35) (I2:78.3%, P < 0.001). The pooled prevalence of decreased vaginal lubrication in MS patients estimated as 32%(95%CI:27-37%) (I2 = 94.2%, P < 0.001). The pooled prevalence of reduced libido was 48%(95%CI:36-61%) (I2:92.6%, P < 0.001). The pooled prevalence of arousal problems was 40%(95%CI: 26-54%) (I2:97.4%, P < 0.001). The pooled prevalence of intercourse satisfaction was 27% (95%CI: 8-46%) (I2:99%, P < 0.001).
    The result of this systematic review and meta-analysis show that the pooled prevalence of SD in women with MS is 61% and the odds of developing SD in comparison with controls is 3.05.
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  • 文章类型: Journal Article
    脊椎血管瘤是罕见的良性肿瘤。它们主要发生在胸部,通常无症状,在放射学检查中偶然发现;然而,有些是有症状的,侵略性,并逐渐增加大小。已经提出了各种治疗方法用于它们的管理。本研究旨在回顾治疗管理,专注于乙醇硬化疗法。从一开始到2023年1月,使用关键字“血管瘤”搜索PubMed数据库,“脊柱或椎骨”,和“乙醇”。检索了20项研究,包括两个字母。脊柱治疗的第一份报告发表于1994年。乙醇硬化疗法可有效治疗椎体血管瘤。它独立执行或与其他技术结合执行,如使用骨水泥和手术的椎体成形术。治疗在局部或全身麻醉下在荧光透视或计算机断层扫描指导下进行。通过单侧或双侧椎弓根缓慢注射总共10-15mL乙醇。治疗的并发症包括手术期间的低血压和心律失常,手术后立即瘫痪,和延迟的压缩性骨折。这篇综述可以完善关于乙醇硬化疗法的知识,这是一种可以采用的治疗选择。
    Vertebral hemangiomas of the spine are rare benign tumors. They occur primarily in the thoracic region and are often asymptomatic and found incidentally on radiological examination; however, some are symptomatic, aggressive, and gradually increase in size. Various therapeutic approaches have been proposed for their management. This study aimed to review the therapeutic management, focusing on ethanol sclerosis therapy. The PubMed database was searched from inception to January 2023 using the keywords \"hemangioma\", \"spine OR vertebra\", and \"ethanol\". Twenty studies were retrieved, including two letters. The first report of spinal therapy was published in 1994. Ethanol sclerosis therapy is effective in treating vertebral hemangiomas. It is performed independently or in combination with other techniques, such as vertebroplasty using cement and surgery. The therapy is performed under local or general anesthesia with fluoroscopic or computed tomography guidance. A total of 10-15 mL of ethanol is slowly injected via unilateral or bilateral pedicles. Complications of the therapy include hypotension and arrhythmia during the procedure, paralysis immediately after the procedure, and delayed compression fractures. This review could enable the refinement of knowledge regarding ethanol sclerosis therapy, which is a treatment option that could be adopted.
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  • 文章类型: Review
    Kimura病(KD)是一种罕见的淋巴增生性纤维炎症性疾病,通常影响头颈部的皮下组织和淋巴结。该病症是涉及2型T辅助细胞因子的反应性过程。尚未描述并发恶性肿瘤。如果没有组织活检,与淋巴瘤的鉴别诊断可能具有挑战性。这里,我们介绍了1例72岁的台湾男性中报告的右颈淋巴管KD和嗜酸性粒细胞性结节性硬化型霍奇金淋巴瘤并存的病例。
    Kimura\'s disease (KD) is a rare lymphoproliferative fibroinflammatory disorder that commonly affects the subcutaneous tissue and lymph nodes of the head and neck. The condition is a reactive process involving T helper type 2 cytokines. Concurrent malignancies have not been described. Differential diagnosis with lymphoma can be challenging without tissue biopsy. Here, we present the first reported case of coexisting KD and eosinophilic nodular sclerosis Hodgkin lymphoma of the right cervical lymphatics in a 72-year-old Taiwanese man.
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