Journal of Manipulative and Physiological Therapeutics最新文献

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IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01

引用次数: 0

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01

引用次数: 0

National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey 美国成年人脊骨神经科治疗使用和支出的全国趋势：2007-2016 年医疗支出小组调查分析》。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2024.08.005

Baojiang Chen PhD , Henry S. Brown PhD , David Douphrate PhD , Jud Janak PhD , Kelley Pettee Gabriel MS, PhD , Trent Peng PhD, DC, MS

Objective

This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years.

Methods

Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined. Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time. Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported.

Results

A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care (p < .05), number of visits (p < .05) and utilization rate (P < .05) from 2007 to 2016. A similar trend was not found for chiropractic expenditure during this period (P > .05). The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year. Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female (56.3%-60.4%), White persons (90.1%-93.5%), and privately insured (77.3%-82.8%). The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions (45.4%-58.1%), inflammatory/degenerative disc or joint conditions (21.2%-26.8%) and head and neck complaints (9.8%-13.7%).

Conclusion

The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016. Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period. Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health.

研究目的本研究旨在对年龄≥18岁的美国成年人进行代表性抽样调查，以了解脊骨神经治疗的使用和支出趋势：方法：研究了来自医疗支出面板调查（MEPS）的连续横截面数据（2007-2016年）。对加权描述性统计进行分析，以获得脊骨神经治疗利用率和支出的全国估计值，并使用时间序列线性回归评估随时间变化的趋势。同时还报告了与脊骨神经治疗使用相关的社会人口特征和肌肉骨骼诊断：从2007年到2016年，接受脊骨神经治疗的成年人数量（P < .05）、就诊次数（P < .05）和使用率（P < .05）均呈明显的统计学增长趋势。在此期间，脊骨神经治疗支出未发现类似趋势（P > .05）。平均就诊次数为每年8.3次，每次平均花费86.94美元，每人每年平均花费721.43美元。每年接受脊骨神经科治疗的成年患者平均年龄在 48.6 岁至 51.2 岁之间，主要为女性（56.3%-60.4%）、白人（90.1%-93.5%）和私人投保者（77.3%-82.8%）。与脊骨神经科治疗相关的最常见肌肉骨骼疾病诊断为腰背疾病（45.4%-58.1%）、椎间盘或关节炎症/退行性病变（21.2%-26.8%）以及头颈部不适（9.8%-13.7%）：研究结果表明，从2007年到2016年，成人脊骨神经治疗使用者的数量、就诊次数和脊骨神经治疗使用率在统计学上呈显著增长趋势。与此相反，我们发现同期脊骨神经治疗的年度总支出在统计学上呈负增长趋势。这一分析结果表明，虽然脊骨神经治疗似乎在不断增长，但可能仍未得到充分利用，因此应加大力度确保其持续增长，并在肌肉骨骼健康管理中发挥更大作用。

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引用次数: 0

Predictors of Utilization Frequency of and Expenditure Amount for Chiropractic Care in U.S. Adults: A Retrospective Cohort Study 美国成年人脊骨神经治疗使用频率和支出金额的预测因素：回顾性队列研究

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2024.08.004

Baojiang Chen PhD , Henry S. Brown PhD , David Douphrate PhD , Jud Janak PhD , Kelley Pettee Gabriel MS, PhD , Trent Peng PhD, DC, MS

Objective

This study aimed to evaluate the prospective associations of baseline personal characteristics with utilization frequency and expenditure of chiropractic care in US adults (≥18 years).

Methods

Data are from the 1358 respondents to the 2014 to 2016 Medical Expenditure Panel Survey who utilized chiropractic care. Individual, familial, health-related, and behavioral factors were included as covariates in the multivariate analytic model. Poisson and multinominal logistic regressions were modeled to examine the associations between the predictors and chiropractic utilization and expenditure.

Results

The mean annual number of visits was 8.2 visits (95% confidence interval [CI]: 7.9, 8.5), with annual expenditure of $677.43 U.S. dollars (95% CI: $595.47-$759.39) and $84.84 (95% CI: $77.89-$91.78) per visit. Female sex was associated with a 19% higher number of visits (rate ratio [RR] = 1.19, 95% CI: 1.01, 1.41) than males. Publicly insured and uninsured were associated with a 44% higher (RR = 1.44, 95% CI: 1.14, 1.82) and 36% lower (RR = 0.64, 95% CI: 0.48, 0.86) visit frequency, respectively, than those privately insured. Rheumatoid arthritis was associated with 7.38 times the risk of high expenditure (95% CI: 2.61, 24.67) than medium expenditure, compared to no arthritis. Relative to physically active individuals, physical inactivity was associated with a 27% higher visit frequency (RR = 1.27, 95% CI: 1.09, 1.49) and an 82% higher risk (relative risk ratio = 1.82, 95% CI: 1.05, 3.14) of high expenditure than low expenditure.

Conclusion

This analysis found distinct usage and expenditure patterns that vary according to specific baseline predictors. Female sex, being publicly insured, having rheumatoid arthritis, and physically inactive were associated with variance in expenditure. Results from this study may help identify chiropractic patients with tendencies for higher utilization or spending and may indirectly assist in predicting patients with slower response to care.

研究目的本研究旨在评估美国成年人（≥18 岁）的基线个人特征与脊骨神经治疗使用频率和支出的前瞻性关联：数据来自2014年至2016年医疗支出小组调查中1358名使用脊骨神经治疗的受访者。个人、家庭、健康相关和行为因素作为协变量被纳入多变量分析模型。通过泊松和多项式逻辑回归模型来研究预测因素与脊骨神经治疗使用率和支出之间的关系：年平均就诊次数为8.2次（95% 置信区间[CI]：7.9, 8.5），年花费为677.43美元（95% CI：595.47-759.39美元），每次就诊花费为84.84美元（95% CI：77.89-91.78美元）。女性的就诊次数比男性高 19%（比率比 [RR] = 1.19，95% CI：1.01, 1.41）。与私人投保者相比，公共投保者和未投保者的就诊次数分别高出 44%（RR = 1.44，95% CI：1.14, 1.82）和低 36%（RR = 0.64，95% CI：0.48, 0.86）。与没有关节炎的人相比，类风湿性关节炎的高支出风险是中等支出风险的 7.38 倍（95% CI：2.61, 24.67）。与身体活跃的人相比，身体不活跃的人就诊频率高 27%（相对风险比 = 1.27，95% CI：1.09, 1.49），高支出风险比低支出高 82%（相对风险比 = 1.82，95% CI：1.05, 3.14）：这项分析发现，不同的基线预测因素会导致不同的使用和支出模式。女性性别、是否有公共保险、是否患有类风湿性关节炎以及是否不运动与支出的差异有关。这项研究的结果可能有助于识别有较高使用率或支出倾向的脊骨神经科患者，并可间接帮助预测对治疗反应较慢的患者。

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引用次数: 0

Traction Loading Human Coracohumeral Ligaments With 20 and 40 Newton Forces and Sustained Creep Deformation: A Preliminary Cadaveric Investigation 在20和40牛顿力的牵引下人体喙肱韧带持续蠕变：初步的尸体研究。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.10.030

John F. Hoops ScD , Carla M. James ScD , Charles Nichols ScD , Jean-Michel Brismee ScD , Peter J. Rundquist PhD , Lee Atkins PhD , Stéphane Sobczak PhD

Objectives

The purpose of this study was to determine if different force magnitudes, loading cycle repetitions, and loading speeds alter creep deformation (CD) during cyclical traction loading of human cadaveric coracohumeral ligaments (CHL).

Methods

Fifteen unembalmed human cadaveric CHL specimens were assigned to 3 groups based on maximal force and loading speed: (1) 40Nslow: 40N; 0.83 mm/s; (2) 20Nslow: 20N; 0.83 mm/s; (3) 20Nfast: 20N; 2.5 mm/s. All specimens underwent 360 cycles of traction loading in a material testing system. The material testing system collected CD during loading at 60-cycle intervals. Micrometer measurements determined CD 60 minutes after loading. Friedman’s ANOVA was used to compare within-group CD changes, and Kruskal-Wallis ANOVA was used to compare between-group CD differences.

Results

All groups demonstrated increased CD during 360 cycles (P < .003) without differences between groups at any 60-cycle interval (P > .05). Sixty minutes after loading, CD was 7% (±5) in the 20Nslow, 15% (±12) in the 40Nslow, and 13% (±7) in the 20Nfast groups without between-group differences (P = .353).

Conclusion

Cyclical traction loading cadaveric CHL specimens with 20N and 40N forces increased CD without a difference between groups. Creep deformation was partially retained 60 minutes after loading. No CD differences were found using 20N loads at 2 different loading speeds.

目的：本研究的目的是确定在人类尸体喙肱韧带（CHL）的周期性牵引加载过程中，不同的力大小、加载循环次数和加载速度是否会改变蠕变变形（CD）。方法：将15例未经防腐处理的人尸CHL标本按最大受力和加载速度分为3组：(1)40Nslow: 40N；0.83毫米/秒;(2) 20Nslow: 20N；0.83毫米/秒;(3) 20Nfast: 20N；2.5毫米/秒。所有试件在材料测试系统中进行了360次牵引加载。材料测试系统在加载过程中以60个周期的间隔收集CD。千分尺测量加载后60分钟的CD。采用Friedman’s ANOVA比较组内CD变化，采用Kruskal-Wallis ANOVA比较组间CD差异。结果：所有组在360个周期内CD均增加（P < 0.003），而在任何60个周期内组间差异无统计学意义（P < 0.05）。加载后60分钟，20Nslow组CD为7%（±5），40Nslow组CD为15%（±12），20Nfast组CD为13%（±7），组间差异无统计学意义（P = .353）。结论：20N和40N力的循环牵引加载尸体CHL标本，CD在两组间无明显差异。加载后60分钟，蠕变部分保留。在2种不同加载速度下使用20N负载时，CD无差异。

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引用次数: 0

Angular Kinematic Analysis of Supine Cervical Thrusts Performed by Chiropractors and Chiropractic Students on Mannequins 脊医和脊医学生在人体模型上进行仰卧颈椎推举的角运动学分析。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.10.033

Mackenzie A. Keller DC , Brent S. Russell MS, DC , Ronald S. Hosek PhD, DC, MPH , Edward F. Owens Jr MS, DC

Objective

The purpose of this study was to examine characteristics of cervical axial rotation and other motion components during cervical spine manipulation.

Methods

Eleven doctors of chiropractic (DCs), 10 chiropractic students with patient experience, and 16 inexperienced students from our institution each performed 4 thrusts on a mannequin. The thrust measured is an essential component of chiropractic cervical spine manipulation, also known as a chiropractic adjustment. The mannequin was designed for chiropractic education and outfitted with inertial measurement units for motion capture. Data were analyzed in Excel for rotation, lateral bending, and flexion-extension at thrust onsets and peaks. Differences between groups were analyzed in R (R Foundation) using Kruskal-Wallis tests, followed by Dunn tests for pairwise comparisons.

Results

Mean rotation for DCs was 19.3° at thrust onset and 33.9° at peak; mean peak lateral bending and cervical extension were 32.0° and 10.4°, respectively. On average, 14.6° of rotation occurred in 144 milliseconds between onset and peak, with rotational velocity and acceleration maximum values of 192.9°/s and 4427°/s², respectively. Most student characteristics were similar, but DCs’ acceleration means were significantly higher (Kruskal-Wallis P = .019), and experienced students used significantly greater lateral bending at onset (Kruskal-Wallis P = .049) and peak (P = .023).

Conclusion

Mean axial rotation for DCs during chiropractic cervical spinal adjustments was less than 34° at peak; most other measures were similar to previously reported findings.

目的：本研究的目的是研究颈椎推拿过程中颈椎轴向旋转和其他运动部件的特征。方法：我院11名捏脊医生、10名有临床经验的捏脊学生和16名无临床经验的捏脊学生分别对人体模型进行4次推力。测量的推力是捏脊颈椎手法的重要组成部分，也称为捏脊调整。该人体模型是为脊椎按摩教育设计的，并配备了用于运动捕捉的惯性测量单元。在Excel中分析了推力开始和峰值时的旋转、侧弯和屈伸数据。采用Kruskal-Wallis检验分析组间差异，随后采用Dunn检验进行两两比较。结果：DCs的平均旋转在推力开始时为19.3°，峰值为33.9°；平均侧弯峰和颈椎伸展峰分别为32.0°和10.4°。在144毫秒内，平均发生14.6°旋转，转速和加速度最大值分别为192.9°/s和4427°/s2。大多数学生的特征相似，但DCs的加速度平均值明显更高（Kruskal-Wallis P = 0.019），经验丰富的学生在开始时（Kruskal-Wallis P = 0.049）和峰值时（P = 0.023）使用了更大的侧向弯曲。结论：颈椎整复过程中DCs的平均轴向旋转峰值小于34°；大多数其他测量结果与先前报道的结果相似。

{"title":"Angular Kinematic Analysis of Supine Cervical Thrusts Performed by Chiropractors and Chiropractic Students on Mannequins","authors":"Mackenzie A. Keller DC , Brent S. Russell MS, DC , Ronald S. Hosek PhD, DC, MPH , Edward F. Owens Jr MS, DC","doi":"10.1016/j.jmpt.2025.10.033","DOIUrl":"10.1016/j.jmpt.2025.10.033","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to examine characteristics of cervical axial rotation and other motion components during cervical spine manipulation.</div></div><div><h3>Methods</h3><div>Eleven doctors of chiropractic (DCs), 10 chiropractic students with patient experience, and 16 inexperienced students from our institution each performed 4 thrusts on a mannequin. The thrust measured is an essential component of chiropractic cervical spine manipulation, also known as a chiropractic adjustment. The mannequin was designed for chiropractic education and outfitted with inertial measurement units for motion capture. Data were analyzed in Excel for rotation, lateral bending, and flexion-extension at thrust onsets and peaks. Differences between groups were analyzed in R (R Foundation) using Kruskal-Wallis tests, followed by Dunn tests for pairwise comparisons.</div></div><div><h3>Results</h3><div>Mean rotation for DCs was 19.3° at thrust onset and 33.9° at peak; mean peak lateral bending and cervical extension were 32.0° and 10.4°, respectively. On average, 14.6° of rotation occurred in 144 milliseconds between onset and peak, with rotational velocity and acceleration maximum values of 192.9°/s and 4427°/s<sup>2</sup>, respectively. Most student characteristics were similar, but DCs’ acceleration means were significantly higher (Kruskal-Wallis <em>P</em> = .019), and experienced students used significantly greater lateral bending at onset (Kruskal-Wallis <em>P</em> = .049) and peak (<em>P</em> = .023).</div></div><div><h3>Conclusion</h3><div>Mean axial rotation for DCs during chiropractic cervical spinal adjustments was less than 34° at peak; most other measures were similar to previously reported findings.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 490-501"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Swimming and Running Exercise-Induced Changes in Muscle Fibers, Bone Structure, and Oxidative Stress in Aging Rats 游泳和跑步运动对衰老大鼠肌纤维、骨结构和氧化应激变化的影响。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.10.048

Mahmut Sürmeli PhD , Fikret Gevrek PhD , Elif Azize Özşahin Delibaş PhD , Funda Demirtürk PhD , Eylem Tütün Yümin PhD

Objective

The purpose of this study was to investigate the effects of weight-bearing and nonweight-bearing aerobic exercises on bone morphometry, muscle fiber types, and oxidative stress markers.

Methods

Eighteen 15-month-old male rats were divided into control, swimming, and running groups (n = 6 each). After a 2-week adaptation period, the exercise groups underwent 8 weeks of moderate-intensity swimming or running. Blood, gastrocnemius muscle, and femur bone samples were collected postexercise. Parameters analyzed included total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) in blood, muscle fiber types by immunohistochemistry, and bone characteristics by histostereology.

Results

OSI values were similar across groups (P > .05), but oxidative stress was elevated in the exercise groups. The ratio of type I fibers was higher in the exercise groups compared to controls (P < .05) and similar between swimming and running groups (P > .05). Type IIa fiber ratio was highest in the control group and lowest in the running group (P < .05). Bone surface area, trabecular thickness, and cortical thickness were greater in the running group than in controls (P < .05). The swimming group had a higher distal femur bone area and trabecular width than controls (P < .05), but no significant differences were found between the exercise groups (P > .05).

Conclusions

Weight-bearing and nonweight-bearing exercises had a significant effect on muscle fiber composition, bone structure, and oxidative stress in elderly rats. Running particularly enhanced bone surface area and thickness, while swimming also benefited bone health. Both exercises increased oxidative stress and antioxidant capacity.

目的：研究负重和非负重有氧运动对骨形态、肌纤维类型和氧化应激指标的影响。方法：15月龄雄性大鼠18只，随机分为对照组、游泳组和跑步组，每组6只。经过2周的适应期后，运动组进行了8周的中等强度游泳或跑步。运动后采集血液、腓肠肌和股骨标本。分析的参数包括血液中总氧化状态（TOS）、总抗氧化状态（TAS）、氧化应激指数（OSI）、免疫组织化学测定的肌纤维类型和组织体学测定的骨骼特征。结果：各组间OSI值相似（P < 0.05），但运动组氧化应激升高。与对照组相比，运动组I型纤维的比例更高（P < 0.05），游泳组和跑步组之间相似（P < 0.05）。IIa型纤维比例以对照组最高，跑步组最低（P < 0.05）。跑步组骨表面积、骨小梁厚度、骨皮质厚度均显著高于对照组（P < 0.05）。游泳组股骨远端骨面积和股骨小梁宽度均高于对照组（P < 0.05），运动组间差异无统计学意义（P < 0.05）。结论：负重和非负重运动对老年大鼠肌纤维组成、骨骼结构和氧化应激有显著影响。跑步尤其能增加骨骼表面积和厚度，而游泳也有益于骨骼健康。这两种运动都会增加氧化应激和抗氧化能力。

{"title":"Effects of Swimming and Running Exercise-Induced Changes in Muscle Fibers, Bone Structure, and Oxidative Stress in Aging Rats","authors":"Mahmut Sürmeli PhD , Fikret Gevrek PhD , Elif Azize Özşahin Delibaş PhD , Funda Demirtürk PhD , Eylem Tütün Yümin PhD","doi":"10.1016/j.jmpt.2025.10.048","DOIUrl":"10.1016/j.jmpt.2025.10.048","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the effects of weight-bearing and nonweight-bearing aerobic exercises on bone morphometry, muscle fiber types, and oxidative stress markers.</div></div><div><h3>Methods</h3><div>Eighteen 15-month-old male rats were divided into control, swimming, and running groups (n = 6 each). After a 2-week adaptation period, the exercise groups underwent 8 weeks of moderate-intensity swimming or running. Blood, gastrocnemius muscle, and femur bone samples were collected postexercise. Parameters analyzed included total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) in blood, muscle fiber types by immunohistochemistry, and bone characteristics by histostereology.</div></div><div><h3>Results</h3><div>OSI values were similar across groups (<em>P</em> > .05), but oxidative stress was elevated in the exercise groups. The ratio of type I fibers was higher in the exercise groups compared to controls (<em>P</em> < .05) and similar between swimming and running groups (<em>P</em> > .05). Type IIa fiber ratio was highest in the control group and lowest in the running group (<em>P</em> < .05). Bone surface area, trabecular thickness, and cortical thickness were greater in the running group than in controls (<em>P</em> < .05). The swimming group had a higher distal femur bone area and trabecular width than controls (<em>P</em> < .05), but no significant differences were found between the exercise groups (<em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>Weight-bearing and nonweight-bearing exercises had a significant effect on muscle fiber composition, bone structure, and oxidative stress in elderly rats. Running particularly enhanced bone surface area and thickness, while swimming also benefited bone health. Both exercises increased oxidative stress and antioxidant capacity.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 617-630"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01

引用次数: 0

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01

引用次数: 0

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01

引用次数: 0

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