Postural assessment

体位评估
  • 文章类型: Journal Article
    众所周知,即使在静态条件下,背包佩戴者也需要进行一些调整以保持姿势稳定性。很少有研究探索改变脚的位置与后中线距离可变的外加载荷的影响。
    因此,这项研究的目的是确定佩戴背包时固定负荷水平位置的变化是否会影响从男性和女性以自己选择的自然脚位站立的脚迹中得出的特定变量。
    150名健康志愿者被指示在四个条件下采取自然的姿态:无重量的背包,重量(体重的5%)的背包放置在0厘米处,20厘米,和40厘米的距离后体。针对每种条件进行足部描迹。支持基础(BoS)英尺宽度(FW),并计算开脚角度(FOA)。
    在负载条件下BoS显着下降(0厘米,20厘米和40厘米)与卸载相比。FW和FOA的重要发现支持了这一点,即一旦施加负荷,反应就是接近脚并减少“脚趾”。
    人们为应对增加的背包负荷而减少BoS的这种反应似乎与直觉相反,并提出了这是否是适应不良的问题。通过进一步调查的澄清将告知背包佩戴者应对这种对负载的本能反应并增加姿势稳定性。
    UNASSIGNED: It is known that even under static conditions a backpack wearer will need to make some adjustments to maintain postural stability. There is a paucity of research exploring the impact of altering the position of the feet with imposed loads of variable distance from the posterior midline.
    UNASSIGNED: Therefore, the aim of this study was to determine if changes in the horizontal position of a fixed load when wearing a backpack affect specific variables derived from foot tracings of males and females standing with their self-selected natural feet position.
    UNASSIGNED: 150 healthy volunteer participants were instructed to adopt a natural stance across four conditions: Backpack with no weight, backpack with a weight (5% of body mass) placed at 0 cm, 20 cm, and 40 cm distance from the posterior body. Foot tracings were made for each condition. Base of Support (BoS), Feet Width (FW), and Feet Opening Angle (FOA) were calculated.
    UNASSIGNED: The BoS significantly decreased in loaded conditions (0 cm, 20 cm and 40 cm) compared to unloaded. This was supported by FW and FOA significant findings that once the load was imposed the response was to approximate the feet and reduce \'toeout\'.
    UNASSIGNED: This reaction of people to reduce their BoS in response to added backpack load appears counter intuitive and raises the question of whether this is maladaptive. Clarification by further investigation will inform backpack wearers to counter this instinctive response to load and increase postural stability.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    虽然一些研究支持利用平片来测量脊柱的生物力学对准以进行预后和治疗,关于这些程序在保守护理中的价值和利用,有不同的观点。对保守和非保守脊柱护理方法的评估显示,整形外科医生之间的影像学利用和解释存在巨大差异。初级保健医生,脊椎指压医生,和物理治疗师,这可能解释了文献中不同的观点和理由。提供了研究摘要,以探索通过脊柱平片(PROTS)识别的任何独特的生物力学参数,以及这些测量与患者健康的关系。了解通过使用PROTS的生物力学评估提供的任何独特价值,可以帮助脊椎指压医师确定在临床实践中适当使用放射学程序,以及如何与其他保守和非保守脊柱医疗保健专业人员协调努力以改善患者健康。
    While some research supports utilizing plain radiography for measuring biomechanical alignment of the spine for prognosis and treatment, there are contrasting viewpoints regarding both the value and utilization of these procedures in conservative care. Evaluation of both conservative and non-conservative approaches to spinal care revealed vast differences in radiographic utilization and interpretation between orthopedic surgeons, primary care physicians, chiropractic physicians, and physical therapists, which may account for the different viewpoints and rationales in the literature. A research summary is provided to explore any unique biomechanical parameters identified with plain radiography of the spine (PROTS) and how these measurements may relate to patient health. Understanding any unique value provided through biomechanical assessment utilizing PROTS may help chiropractic physicians determine the appropriate use of radiographic procedures in clinical practice and how to coordinate efforts with other conservative and non-conservative spinal healthcare professions to improve patient health.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:摄影测量法通常用于评估站立的静态姿势对准。通常会指示患者自我选择自然的脚部位置,但目前尚不清楚该位置是否可以在重复评估中持续复制。
    目的:确定人们是否可以在不同的日子里在三个疗程中以直立站立的方式复制自己选择的自然双脚姿势。
    方法:在几天之间测试-重测可靠性。
    方法:大学实验室。
    方法:三个变量-支持基础(BoS),脚宽(FW),脚张开角(FOA)-使用既定程序从150名参与者(18-30岁)的脚迹中测量。评估BoS数据的系统偏差(方差分析),以及绝对(变异系数-CV%)和相对(组内相关系数-ICC)可靠性。
    结果:在三个测试阶段的BoS数据中存在系统偏差。BoS数据的CV%为15.2%。BoS数据的ICC(95%CI)为0.84(0.79-0.87)。在每个会话中,BoS与FOA和FW之间分别存在中等程度的相关性。
    结论:如果临床医生希望允许患者使用自己选择的自然脚位来重复摄影测量评估其静态姿势对准,则最好将脚的位置标准化,例如,通过创建一个病人的自我选择的自然脚位置的跟踪。
    Photogrammetry is often used to evaluate standing static postural alignment. Patients are often instructed to self-select a natural feet position but it\'s unclear whether this position can be consistently replicated across repeated assessments.
    To determine whether people can replicate a self-selected natural feet position in upright standing across three sessions on different days.
    Between days test-retest reliability.
    University laboratory.
    Three variables - Base of Support (BoS), Foot Width (FW), Feet Opening Angle (FOA) - were measured from foot tracings of 150 participants (18-30 years) using established procedures. BoS data were assessed for systematic bias (Analysis of Variance), and absolute (Coefficient of Variation - CV%) and relative (Intraclass Correlation Coefficient - ICC) reliability.
    There was systematic bias in the BoS data across the three testing sessions. The CV% for the BoS data was 15.2%. The ICC (95% CI) for the BoS data was 0.84 (0.79-0.87). There were moderate-large correlations between the BoS and both FOA and FW respectively within each session.
    If clinicians want to allow patients to use their self-selected natural feet position for repeated photogrammetric assessment of their static postural alignment it would be better to standardise the position of the feet, for example, by creating a tracing of a patient\'s self-selected natural feet position.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    从很小的时候,人们暴露于可能导致肌肉骨骼疾病的危险因素,如腰痛,颈部疼痛和脊柱侧弯。早期的医学筛查可能会使其发病率降至最低。该研究旨在改进处理患者图像的软件,使用特定的解剖部位来获得可能的肌肉骨骼问题的风险指标。这个项目分为四个阶段。首先,选择标记和身体指标进行姿势评估.第二,评估了软件检测标记和运行优化测试的能力。第三,我们从人群中获取数据,使用临床软件验证结果.第四,对分类器与采集数据的性能进行了分析。使用直径为20mm的绿色标记来优化软件。通过斑点检测方法使用不同类型的相机进行姿势评估。在优化测试中,角度参数是影响最大的参数。获得的数据表明,姿势分析结果在统计学上是等效的。对于分类器,研究人群中有16名受试者没有姿势问题的证据,25有轻度证据,16有中度至重度证据。总的来说,使用二元分类和训练/测试分割验证方法提供了更好的结果。
    From an early age, people are exposed to risk factors that can lead to musculoskeletal disorders like low back pain, neck pain and scoliosis. Medical screenings at an early age might minimize their incidence. The study intends to improve a software that processes images of patients, using specific anatomical sites to obtain risk indicators for possible musculoskeletal problems. This project was divided into four phases. First, markers and body metrics were selected for the postural assessment. Second, the software\'s capacity to detect the markers and run optimization tests was evaluated. Third, data were acquired from a population to validate the results using clinical software. Fourth, the classifiers\' performance with the acquired data was analyzed. Green markers with diameters of 20 mm were used to optimize the software. The postural assessment using different types of cameras was conducted via the blob detection method. In the optimization tests, the angle parameters were the most influenced parameters. The data acquired showed that the postural analysis results were statistically equivalent. For the classifiers, the study population had 16 subjects with no evidence of postural problems, 25 with mild evidence and 16 with moderate-to-severe evidence. In general, using a binary classification with the train/test split validation method provided better results.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Randomized Controlled Trial
    背景:血流限制(BFR)训练可改善肌肉力量和功能结果,但是这种技术在康复领域的本体感受意义仍然未知。
    目的:本研究旨在评估BFR在稳定性和平衡性能方面的影响。
    方法:在这项试点随机交叉研究中,纳入健康年轻人,并随机分为A组和B组,两组均接受了佩戴和不佩戴BFR装置的体位评估.A组的研究参与者接受了佩戴BFR的姿势基线评估,然后移除BFR进行进一步评估。而B组的受试者在没有BFR和BFR的情况下进行基线评估。机器人平台Hunova评估了稳定性和平衡性能,平衡错误评分系统(BESS),自我报告的感知平衡(7点李克特量表),和不适感自我评估。此外,记录了安全性.
    结果:纳入14名受试者,随机分为A组(n:7)和B组(n:7)。在Hunova机器人平台上进行的静态条件下的平衡测试中,睁眼(OE)的平均距离RMS(均方根)显示出显着差异,前后(AP)躯干振荡范围与OE,具有OE的中外侧(ML)平均振荡速度,闭眼总偏移AP范围(CE)(BFR:3.44±1.06;无BFR:2.75±0.72;p=0.041)。此外,弹性平衡试验显示Romberg指数存在差异(BFR:0.16±0.16;无BFR:0.09±0.07;p=0.047)。未报告不良事件。
    结论:综合来看,我们的数据显示,BFR影响健康受试者的平衡表现.需要进一步的研究来更好地表征BFR治疗在特定康复方案中的可能作用。
    BACKGROUND: Blood flow restriction (BFR) training improves muscle strength and functional outcomes, but the proprioceptive implications of this technique in the rehabilitation field are still unknown.
    OBJECTIVE: The present study aimed at assessing the effects of BFR in terms of stabilometric and balance performance.
    METHODS: In this pilot randomized cross-over study, healthy young adults were included and randomly assigned to Groups A and B. Both groups underwent a postural assessment with and without wearing a BFR device. Study participants of Group A underwent postural baseline assessment wearing BFR and then removed BFR for further evaluations, whereas subjects in Group B performed the baseline assessment without BFR and then with BFR. Stabilometric and balance performance were assessed by the robotic platform Hunova, the Balance Error Scoring System (BESS), the self-reported perceived balance (7-point Likert scale), and discomfort self-rated assessment. Moreover, the safety profile was recorded.
    RESULTS: Fourteen subjects were included and randomly assigned to Group A (n: 7) and Group B (n: 7). Significant differences were shown in balance tests in static conditions performed on the Hunova robot platform in terms of average distance RMS (root-mean-square) with open eyes (OE), anteroposterior (AP) trunk oscillation range with OE, mediolateral (ML) average speed of oscillation with OE, and total excursion AP range with closed eyes (CE) (BFR: 3.44 ± 1.06; without BFR: 2.75 ± 0.72; p= 0.041). Moreover, elastic balance test showed differences in Romberg index (BFR: 0.16 ±0.16; without BFR: 0.09 ± 0.07; p= 0.047). No adverse events were reported.
    CONCLUSIONS: Taken together, our data showed that BFR affects balance performance of healthy subjects. Further studies are needed to better characterize the possible role of BFR treatment in the context of a specific rehabilitation protocol.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们提出了一种基于相机的人体参数测量方法,并开发了人体姿势评估系统。该方法结合了传统的接触式测量方法和非接触式测量方法,克服了时间上的一些缺点,费用,以及早期方法的专业性。整个测量系统由一台计算机组成,高清摄像机,以及在测量之前应用于参与者身体的粘性点。相机捕获人体的三重视图图像。然后提取人体轮廓和人体骨骼的关节点,以定位骨骼特征点。最后,人体参数的测量和提取。实验结果表明,全局姿势评估系统为人体姿势评估提供了定量指导,它彻底改变了人类姿势的评估方式。体位评估系统对疾病的早期诊断和医疗康复治疗具有重要意义。本文受版权保护。保留所有权利。
    We present a camera-based human body parameters measurement approach and develop a human postural assessment system. The approach combines the conventional contact measurement method and the non-contact measurement method to overcome some shortcomings in terms of time, expense, and professionalism in early methods. The entire measurement system consists of a computer, a high-definition camera, and the sticky points that are applied to the participant\'s body before the measurement. The camera captures the triple view image of human body. Then, the human body outline and the joint points of the human skeleton are extracted to locate the bone feature points. Finally, measurements and extractions of the human parameters are made. Experimental results demonstrate that the global postural assessment system provides quantitative guidance for human postural evaluation, and it completely changes how human postural is evaluated. The postural assessment system is significant for early diagnosis of diseases and medical rehabilitation treatment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在为视障人士(VIP)恢复定向和行动能力(O&M)方面,时空步态和姿势参数的测量对于康复者评估独立行动的表现和改善具有特别的意义。在目前世界范围内的康复实践中,这种评估是在视觉上进行估计的人中进行的。本研究的目的是提出一种基于可穿戴惯性传感器的简单架构,用于定量估计行驶距离,步进检测,步态速度,步长和姿势稳定性。使用绝对取向角计算这些参数。根据选定的生物力学模型对两种不同的传感结构进行步态测试。验证测试包括五个不同的步行任务。有9名视障志愿者进行了实时采集,志愿者在他们的住所中以不同的步态速度在室内和室外行走。本文还介绍了五个行走任务中志愿者的地面真实步态特征以及对行走任务中自然姿势的评估。选择了一种建议的方法来显示所有旅行实验中计算参数的最低绝对误差:在7至45m之间进行45次步行任务,总共步行了1039m和2068步;步长测量为4.6±6.7cm,平均为56cm(11.59Std),步数为1.5±1.6相对误差,这损害了行进距离和步态速度的测量,绝对误差为1.78±1.80m和7.1±7.2cm/s,分别。结果表明,所提出的方法及其体系结构可以用作为O&M训练设计的辅助技术的工具,以评估步态参数和/或导航,并且放置在背部区域的传感器足以检测到明显的姿势变化,在步行任务中的倾向和平衡。
    In rehabilitating orientation and mobility (O&M) for visually impaired people (VIP), the measurement of spatio-temporal gait and postural parameters is of specific interest for rehabilitators to assess performance and improvements in independent mobility. In the current practice of rehabilitation worldwide, this assessment is carried out in people with estimates made visually. The objective of this research was to propose a simple architecture based on the use of wearable inertial sensors for quantitative estimation of distance traveled, step detection, gait velocity, step length and postural stability. These parameters were calculated using absolute orientation angles. Two different sensing architectures were tested for gait according to a selected biomechanical model. The validation tests included five different walking tasks. There were nine visually impaired volunteers in real-time acquisitions, where the volunteers walked indoor and outdoor distances at different gait velocities in their residences. The ground truth gait characteristics of the volunteers in five walking tasks and an assessment of the natural posture during the walking tasks are also presented in this article. One of the proposed methods was selected for presenting the lowest absolute error of the calculated parameters in all of the traveling experimentations: 45 walking tasks between 7 and 45 m representing a total of 1039 m walked and 2068 steps; the step length measurement was 4.6 ± 6.7 cm with a mean of 56 cm (11.59 Std) and 1.5 ± 1.6 relative error in step count, which compromised the distance traveled and gait velocity measurements, presenting an absolute error of 1.78 ± 1.80 m and 7.1 ± 7.2 cm/s, respectively. The results suggest that the proposed method and its architecture could be used as a tool for assistive technology designed for O&M training to assess gait parameters and/or navigation, and that a sensor placed in the dorsal area is sufficient to detect noticeable postural changes that compromise heading, inclinations and balancing in walking tasks.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:BHOHB系统(BhohbS.r.l.,意大利)是一种便携式非侵入性基于照相标记的姿势检查设备。
    目的:评估BHOHB系统的重测可靠性,并将其可靠性与光电系统进行比较(SMART-DX700,BTS,意大利)。
    方法:指导30名志愿者在C7,T6,T12,L3和S1椎骨的棘突上用五个标记直立站立,以确定背侧后凸和腰椎前凸(矢状面)角度。在大转子上放置了三个标记,髂棘顶端和股骨外侧髁检测骨盆倾斜。最后,定义肩峰和棘突(额面)之间的角度,在左右肩峰上放置了两个标记。在两个连续的记录过程中,使用BHOHB和光电系统同时记录姿势角。
    结果:与光电系统相比,BHOHB系统显示出所有角度(ICC:0.92-0.99,SEM:0.78-3.33〇)的出色可靠性以及更短的处理时间。对于通过光电系统检测到的所有角度也发现了优异的可靠性(ICC:0.91-0.99,SEM:0.84〇-2.80〇)。
    结论:BHOHB系统作为一种可靠的非侵入性和用户友好的设备来监测脊柱姿势,特别是在需要重复考试的科目中。
    BACKGROUND: The BHOHB system (Bhohb S.r.l., Italy) is a portable non-invasive photographic marker-based device for postural examination.
    OBJECTIVE: To assess the test-retest reliability of the BHOHB system and compare its reliability with an optoelectronic system (SMART-DX 700, BTS, Italy).
    METHODS: Thirty volunteers were instructed to stand upright with five markers on the spinous processes of C7, T6, T12, L3 and S1 vertebrae to define the dorsal kyphosis and lumbar lordosis (sagittal plane) angles. Three markers were placed on the great trochanter, apex of iliac crest and lateral condyle of the femur to detect pelvic tilt. Finally, to define angles between the acromion and the spinous processes (frontal plane), two markers were placed on the right and left acromion. Postural angles were recoded simultaneously with BHOHB and optoelectronic systems during two consecutive recording sessions.
    RESULTS: The BHOHB system revealed excellent reliability for all the angles (ICCs: 0.92-0.99, SEM: 0.78∘-3.33∘) as well as a shorter processing time compared to the optoelectronic system. Excellent reliability was also found for all the angles detected through the optoelectronic system (ICCs: 0.91-0.99, SEM: 0.84∘-2.80∘).
    CONCLUSIONS: The BHOHB system resulted as a reliable non-invasive and user-friendly device to monitor spinal posture, especially in subjects requiring repeat examinations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:博客,环保垃圾锻炼是慢跑与垃圾收集的结合。参与规划的人携带行李来收集垃圾。在一侧上具有重量的行走导致身体的相对侧为了稳定而接合,并且在活动期间也暴露于重复弯曲。
    目的:本研究的目的是评估迷雾活动的姿势和生理方面。
    方法:36名受试者弯腰收集垃圾,半蹲,分别采取全蹲和弓步姿势。使用快速全身评估(REBA)分析姿势。plogning的生理方面,以及慢跑和慢跑期间身体活动评估的比较,使用PolarM430光学心率监测器进行了调查。使用SPSS版本23进行统计学分析。
    结果:发现全蹲(5.13±0.59)和弓步(6.64±1.15)姿势的平均值±SD与其他两种姿势(例如弯腰(10.31±0.88)和半蹲(8.11±1.40))相比,风险得分较低。来自Kruskal-Wallis和事后检验的分析表明,姿势之间没有显着的相互作用(p<0.05)。配对样本t检验表明,慢跑和慢跑的能量消耗相似(p>0.05)。但燃烧卡路里的脂肪百分比更多(p<0.05)。然而,由于活性的心血管应变%的平均值为(99.261%),因此plogning可被认为是一种剧烈活性。
    结论:需要人体工程学干预措施在最大程度地减少肌肉骨骼相关损伤和任务的身体劳损方面发挥至关重要的作用。
    BACKGROUND: Plogging, an environment friendly trash workout is a combination of jogging with litter collection. People who are involved in the plogging carry a baggage for collecting the litter. Walking with a weight on one side causes the opposite side of the body to engage for stability and are also exposed to repetitive bending during the activity.
    OBJECTIVE: The purpose of this study is to evaluate the postural and physiological aspects of plogging activity.
    METHODS: Thirty six subjects performed the litter collection in stoop, semi-squat, full squat and lunge postures respectively. Postures were analyzed using Rapid Entire Body Assessment (REBA). Physiological aspects of plogging, as well as a comparison of physical activity assessment during jogging and plogging, were investigated using a Polar M430 optical heart rate monitor. Statistical analysis were performed using SPSS version 23.
    RESULTS: Mean±SD of full squat (5.13±0.59) and lunge (6.64±1.15) posture was found to have lesser risk score in comparison with the other two postures such as stoop (10.31±0.88) and semi-squat (8.11±1.40). Analysis from the Kruskal-Wallis and post hoc test showed that there is no significant interaction between the postures (p < 0.05). Paired Sample t-test showed that the energy expenditure for plogging and jogging are found to be similar (p > 0.05), but the fat percentages of calories burned is more in plogging (p < 0.05). Howerver plogging can be considered as a strenous activity as the % Cardiovascular strain of the activity had a mean value of (99.261%).
    CONCLUSIONS: Ergonomic interventions are needed to play a vital role in minimizing the musculoskeletal related injuries and the physical strain of the task.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:姿势评估的非侵入性方法是用于跟踪和监测姿势偏差进展的工具。不同的基于计算机的方法已经被用来评估人类的姿势,包括基于图像和传感器的移动应用程序。然而,这样的解决方案仍然需要手动识别解剖点。本研究旨在展示和验证NLMeasurer,姿势评估的移动应用程序。此应用程序利用了PoseNet,一种基于计算机视觉和机器学习的解决方案,用于估计人体姿态和识别解剖点。从确定的点来看,NLMeasurer计算姿势度量。
    方法:20名参与者在解剖标志上使用表面标记进行正面拍摄。然后,表面标记被移除,并拍摄了新照片。照片由两名考官分析,使用NLMeasurer和经过验证的生物摄影测量软件计算了6个姿势测量值。单样本t检验和BlandAltman程序用于评估方法之间的一致性,并使用组内相关系数(ICC)来评估评估者之间和内部的可靠性。
    结果:使用NLMeasurer计算的姿势测量值与生物摄影测量软件一致。此外,对于大多数没有表面标记的照片,评分者之间和评分者之间的可靠性都很好。
    结论:NLMeasurer被证明是评估正面视图中姿势测量的有效工具方法。在特定解剖标志上使用表面标记(即,耳朵,髂棘和脚踝)可以促进这些标志的数字识别,并提高使用NLMeasurer进行姿势测量的可靠性。
    OBJECTIVE: Non-invasive methods for postural assessment are tools used for tracking and monitoring the progression of postural deviations. Different computer-based methods have been used to assess human posture, including mobile applications based on images and sensors. However, such solutions still require manual identification of anatomical points. This study aims to present and validate the NLMeasurer, a mobile application for postural assessment. This application takes advantage of the PoseNet, a solution based on computer vision and machine learning used to estimate human pose and identify anatomical points. From the identified points, NLMeasurer calculates postural measures.
    METHODS: Twenty participants were photographed in front view while using surface markers over anatomical landmarks. Then, the surface markers were removed, and new photos were taken. The photos were analyzed by two examiners, and six postural measurements were computed with NLMeasurer and a validated biophotogrammetry software. One-sample t-test and Bland Altman procedure were used to assess agreement between the methods, and Intraclass Correlation Coefficient (ICC) was used to assess inter- and intra-rater reliability.
    RESULTS: Postural measurements calculated using the NLMeasurer were in agreement with the biophotogrammetry software. Furthermore, there was good inter- and intra-rater reliability for most photos without surface markers.
    CONCLUSIONS: NLMeasurer demonstrated to be a valid tool method to assess postural measurements in the frontal view. The use of surface markers on specific anatomical landmarks (i.e., ears, iliac spines and ankles) can facilitate the digital identification of these landmarks and improve the reliability of the postural measurements performed with NLMeasurer.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号