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1.
OBJECTIVE: To evaluate the effects of diet restriction on development of radiographic evidence of hip joint osteoarthritis in dogs. DESIGN: Longitudinal cohort study. ANIMALS: 48 Labrador Retrievers from 7 litters. PROCEDURES: Forty-eight 6-week-old puppies from 7 litters were paired with littermates by sex and weight, and each pairmate was randomly assigned to 1 of 2 groups of 24 dogs each. Starting at 8 weeks of age, 1 group was fed ad libitum (control fed) and the other was fed 25% less (restricted fed) of the same diet for life on a pairwise basis. The dogs' hip joints were radiographed in the standard ventrodorsal hip-extended view at multiple intervals prior to 1 year of age and at annual intervals thereafter on the basis of birth anniversary. A board-certified radiologist unaware of group assignment scored the radiographs for evidence of osteoarthritis. RESULTS: Prevalence of radiographic evidence of hip joint osteoarthritis in all dogs increased linearly throughout the study, from an overall prevalence of 15% at 2 years to 67% by 14 years. Restricted-fed dogs had lower prevalence and later onset of hip joint osteoarthritis. Median age at first identification of radiographic evidence of hip joint osteoarthritis was significantly lower in the control-fed group (6 years), compared with the restricted-fed group (12 years). CONCLUSIONS AND CLINICAL RELEVANCE: Restricted feeding delayed or prevented development of radiographic signs of hip joint osteoarthritis in this cohort of Labrador Retrievers. Lifetime maintenance of 25% diet restriction delayed onset and reduced severity of hip joint osteoarthritis, thus favorably affecting both duration and quality of life. In addition, the data indicated that development of hip joint osteoarthritis was not bimodal in these dogs but occurred as a continuum throughout life.  相似文献   

2.
Forty-eight 8-week-old Labrador Retrievers were allotted to 2 groups of 24 dogs each; 1 group was fed ad libitum and the other group was given 25% less of the same feed until the dogs were 2 years old. Radiography of the hip joints was done when the dogs were 30, 42, 54, 78, and 104 weeks old. Subluxation was measured by the Norberg angle on radiographs made with the dog in the standard (extended limb) position. Independent of age at which the radiography was done, there was less subluxation of the femoral heads in the limit-fed dogs. Using the Swedish method of hip joint evaluation on the same radiographs, it was found that fewer dogs on limited food intake had signs of hip dysplasia. Radiographs done when dogs were 2 years old, for all the methods used (Norberg angle in standard and frog-limb position, the Orthopedic Foundation for Animals [OFA] score, and the Swedish score), revealed less hip dysplasia (less joint subluxation and less degenerative joint disease) in the limit-fed dogs. Using the OFA method, 7 of the 24 limit-fed dogs and 16 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. Similarly, using the Swedish method, 5 of the 24 limit-fed dogs and 18 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. The food-intake-related differences were significant both for the OFA score and for the Swedish score.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

3.
OBJECTIVE: To determine the relationship between a circumferential femoral head osteophyte (CFHO) and osteoarthritis characteristic of canine hip dysplasia, and to ascertain whether CFHO, like osteoarthritis, varies between diet-restricted and control-fed dogs. DESIGN: Longitudinal cohort study. ANIMALS: 48 Labrador Retrievers. PROCEDURES: Dogs were paired by size, sex, and litter and assigned to 1 of 2 equal groups at 2 months of age. The control-fed group was fed ad libitum, and the diet-restricted group was fed 25% less on a pairwise basis of the same diet for life. The dogs' hip joints were radiographed yearly for life. Each radiograph was evaluated for radiographic signs of osteoarthritis characteristic of hip dysplasia and for the presence and severity of a CFHO. RESULTS: 41 of the 48 (85.4%) dogs had a CFHO, which was detected at a median age of 5.4 years, and 33 of those 41 (80.5%) developed radiographic evidence of osteoarthritis. Nineteen (79.2%) dogs in the diet-restricted group and 22 (91.7%) in the control-fed group had a CFHO at a median age of 9 and 3 years, respectively. Of the dogs with a CFHO, 12 (63.2%) in the diet-restricted group and 20 (90.0%) in the control-fed group developed radiographic evidence of osteoarthritis characteristic of hip dysplasia at a median age of 11 and 6.5 years, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated a relationship between the CFHO and subsequent development of radiographic signs of osteoarthritis. If a CFHO is present in Labrador Retrievers, it might be considered an early indicator of osteoarthritis.  相似文献   

4.
Objective— To report effects of age and lifetime food restriction on development and progression of shoulder joint osteoarthritis (OA) in Labrador retriever dogs.
Study Design— Longitudinal life-span, cohort study.
Animals— Labrador retriever dogs (n=48).
Methods— Littermates were paired (gender, weight) to make 24 pairs of genetically similar dogs. Each diet-restricted (DR) pair-mate was fed daily 75% of the same diet consumed by its control-fed (CF) pair-mate for life. Shoulders were evaluated radiographically at years 6, 8, and end of life (EOL). At EOL shoulders were evaluated grossly and by histopathology for OA.
Results— Radiographic evidence of shoulder OA was identified in 78% of dogs. Severity of radiographic shoulder OA at 6 ( P <.03) and 8 years ( P <.02) was significantly lower among DR dogs compared with CF dogs. Pooled gross evaluation results revealed 40 of 46 dogs had cartilage erosion on the caudal aspect of the humeral head. By EOL, 91% of dogs had histopathologic changes consistent with OA.
Conclusion— There was a high overall prevalence of radiographic, gross, and histologic OA among dogs. Substantial disparity was found between radiographic evidence of OA (at EOL) and characteristic changes visible by gross and histologic examination.
Clinical Relevance— Radiographic evaluation correlates poorly with severity of shoulder joint pathology. The benefits of DR on shoulder OA are consistent with the demonstrated effect of DR in delaying species- and strain-specific diseases of aging.  相似文献   

5.
OBJECTIVE: To determine the radiographic methods that best predict the development of osteoarthritis in the hip joints of a cohort of dogs with hip dysplasia and unaffected dogs. ANIMALS: 205 Labrador Retrievers, Greyhounds, and Labrador Retriever-Greyhound crossbred dogs. PROCEDURE: Pelvic radiography was performed when the dogs were 8 months old. Ventrodorsal extended-hip, distraction, and dorsolateral subluxation (DLS) radiographs were obtained. An Orthopedic Foundation for Animals-like hip score, distraction index, dorsolateral subluxation score, and Norberg angle were derived from examination of radiographs. Osteoarthritis was diagnosed at the time of necropsy in dogs > or = 8 months of age on the basis of detection of articular cartilage lesions. Multiple logistic regression was used to determine the radiographic technique or techniques that best predicted development of osteoarthritis. RESULTS: A combination of 2 radiographic methods was better than any single method in predicting a cartilage lesion or a normal joint, but adding a third radiographic method did not improve that prediction. A combination of the DLS score and Norberg angle best predicted osteoarthritis of the hip joint or an unaffected hip joint. All models that excluded the DLS score were inferior to those that included it. CONCLUSIONS AND CLINICAL RELEVANCE: A combination of the DLS score and Norberg angle was the best predictor of radiographic measures in 8-month-old dogs to determine whether a dog would have normal or osteoarthritic hip joints.  相似文献   

6.
OBJECTIVE: To determine the relationship between the caudolateral curvilinear osteophyte (CCO) and osteoarthritis associated with hip dysplasia in dogs. DESIGN: Longitudinal cohort study. ANIMALS: 48 Labrador Retrievers from 7 litters. PROCEDURE: In each of 24 sex- and size-matched pairs fed the same diet, a restricted-fed dog was fed 25% less than a control dog for life. The dogs' hips were evaluated in the standard ventrodorsal hip-extended radiographic projection at 16, 30, and 52 weeks of age and then yearly for life. Histologic examination of hip joint tissues was performed on 45 dogs. RESULTS: Median age at death was 11.2 years. Adjusting for feeding group, dogs with a CCO were 3.7 times as likely to develop radiographic signs of osteoarthritis than those without a CCO. Stratified by diet, 100% of the control dogs with a CCO developed radiographic signs of osteoarthritis and 55% of restricted-fed dogs with a CCO developed radiographic signs of osteoarthritis. The CCO was the first radiographic change seen in 22 of 29 (76%) dogs with osteoarthritis. Overall, 35 of 37 (95%) dogs with a CCO had histopathologic lesions of osteoarthritis. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate a relationship between a CCO on the femoral neck and subsequent development of radiographic signs of osteoarthritis in Labrador Retrievers evaluated over their life span. A CCO is an important early radiographic indication of osteoarthritis associated with canine hip dysplasia.  相似文献   

7.
Observations based on necropsy findings in 89 dogs with osteochondrosis are presented. Osteochondrosis was most common in the elbow joint, followed by the shoulder joint, the stifle and the hock joint. There were 59 male and 30 female dogs, and the mean age was 2 years. The high frequency of bilateral lesions and the occurrence of osteochondrosis in more than one pair of joints in 25 of the 89 dogs indicates that general factors are important. The various manifestations of osteochondrosis and their frequency are reported. Various local factors believed to be important for the occurrence of the lesions within the joints are also considered.  相似文献   

8.
Summary

Observations based on necropsy findings in 89 dogs with osteochondrosis are presented. Osteochondrosis was most common in the elbow joint, followed by the shoulder joint, the stifle and the hock joint. There were 59 male and 30 female dogs, and the mean age was 2 years. The high frequency of bilateral lesions and the occurrence of osteochondrosis in more than one pair of joints in 25 of the 89 dogs indicates that general factors are important.

The various manifestations of osteochondrosis and their frequency are reported. Various local factors believed to be important for the occurrence of the lesions within the joints are also considered.  相似文献   

9.
Objective-To assess joint kinematics in dogs with osteoarthritis of the hip joints during walking up an incline or down a decline and over low obstacles and to compare findings with data for nonlame dogs. Animals-10 dogs with osteoarthritis of the hip joints (mean ± SD age, 6.95 ± 3.17 years; mean body weight, 34.33 ± 13.58 kg) and 8 nonlame dogs (3.4 ± 2.0 years; 23.6 ± 4.6 kg). Procedures-Reflective markers located on the limbs and high-speed cameras were used to record joint kinematics during walking up an incline or down a decline and over low obstacles. Maximal flexion, extension, and range of motion of the hip joints were calculated. Results-Osteoarthritis of the hip joints reduced extension of both hip joints and flexion of the contralateral hind limb, compared with flexion of the lame hind limb, during walking down a decline. Walking up an incline resulted in decreased extension of the stifle joint in both hind limbs of osteoarthritic dogs; extension was significantly decreased for the lame hind limb. During walking over low obstacles, maximal flexion of the stifle joint was increased significantly for the contralateral hind limb. Maximal flexion was increased in both tarsal joints. Conclusions and Clinical Relevance-Osteoarthritis of the hip joints led to complex changes in the gait of dogs, which involved more joints than the affected hip joint alone. Each exercise had specific effects on joint kinematics that must be considered when planning a rehabilitation program.  相似文献   

10.
Primary flexor enthesopathy is a recently recognized elbow disorder and should be considered in the differential diagnosis of elbow lameness. For treatment planning purposes, it is important to make a distinction between primary and concomitant forms of the disease. The purpose of this prospective study was to compare radiographic findings for dogs with primary flexor enthesopathy (n = 17), concomitant flexor enthesopathy (n = 24), elbow dysplasia (n = 13), and normal dogs (n = 7). All dogs underwent a complete radiographic examination and each radiographic image was evaluated for the presence or absence of following characteristics: irregular medial humeral epicondyle, spur and calcified body. Additionally, the presence or absence of other elbow disorders (medial coronoid process disease, osteochondritis dissecans, ununited anconeal process, incongruity, subtrochlear sclerosis, and osteoarthritis) was recorded. Radiographic characteristics of flexor enthesopathy were found in 86% of painful joints in the primary flexor enthesopathy group and in 100% of painful joints in the concomitant flexor enthesopathy group. Radiographic characteristics of flexor enthesopathy were not found in sound elbow and elbow dysplasia groups. Frequencies and details of individual radiographic characteristics did not differ between primary and concomitant flexor enthesopathy groups. Findings support the use of radiography as a first screening method for detection of flexor enthesopathy, but not as a technique for distinguishing primary vs. concomitant forms.  相似文献   

11.
Total joint replacement has evolved over the past 50 years from a concept that was first attempted in people suffering from osteoarthritis to a commonly applied practice in veterinary medicine. Although many questions have been answered, several controversies still exist, with many implant and technical options being explored. Currently, total hip and elbow replacement are commercially available options viable for use in dogs. These options are detailed in this article.Joint replacement for other canine joints (ie, knee, hock, shoulder) that develop osteoarthritis likely will be developed in the near future.  相似文献   

12.
Computed tomography (CT) is an established technique for detecting shoulder lesions in dogs, however the clinical significance of shoulder CT lesions often remains uncertain. The purposes of this retrospective study were to describe the prevalence of CT lesions in both shoulder joints for 89 dogs presenting with thoracic limb lameness and to compare CT lesions with clinical characteristics. For all included dogs, results of a full orthopedic examination, other diagnostic tests, and signalment data were available in medical records. Multilevel, multivariable logistic regression was used to test clinical significance of the most prevalent CT lesions and determine factors associated with their presence. Computed tomographic lesions were detected in one or both shoulder joints for 51/89 dogs (57.3%). Mineralization of one or more surrounding peri‐articular soft‐tissue structures was identified in 31.5% of dogs, with supraspinatus muscle/tendon mineralization being the most frequently identified (24.7%). The prevalence of humeral head osteochondrosis was 9 and 21.3% of dogs had shoulder osteoarthritis. Border collies (odds ratio [OR] 9.3; 95% CI 1.39–62.1, P = 0.02) and dogs with shoulder pain (OR 4.3; 95% CI 1.08–17.1, P = 0.04) had increased risk of osteochondrosis lesions. Border collies (OR 8.4; 95% CI 1.27–55.6; P = 0.03) and older animals (OR 1.04; 95% CI 1.02–1.1, P < 0.001) had increased risk of osteoarthritis lesions. Female entire dogs had an increased risk of supraspinatus mineralization lesions (OR 6.8; 95% CI 1.55–29.5, P = 0.01). Findings indicated that shoulder CT lesions are common in dogs with thoracic limb lameness, and that some CT lesions are not associated with shoulder pain.  相似文献   

13.
Heritability of hip dysplasia was estimated to be about 0.4 to 0.5 when based on the radiographic evaluations of the hip joints of 2,404 German Shepherd Dogs born at The Armed Forces Dog Training Center in Sweden. The material included all dogs in 401 litters born at the Center from 1965 through 1973 that reached the age of 15 months. To be expected with such high heritability, frequency of hip dysplasia in the offspring was shown to be affected by the hip joint status of sire and dam as well as by the hip joint status of their parents and littermates. Even matings between sires with normal hip joints and dams with only slight dysplasia resulted in significantly higher frequency of hip dysplasia in the offspring, when compared with the frequency if both sires and dams had normal hip joints. Frequency of hip dysplasia in the progeny of sires with normal hip joints varied greatly. Since 1973, selection of the breeding stock has been based on hip joint status (phenotype) of the breeding animals and of their relatives as well as on what had become known about frequency of hip dysplasia in the litters already born (progeny testing). In this way, frequency of hip dysplasia in 347 dogs born at the Center during 1975 was lowered to 28%. This figure should be compared with the figure of 50%, which represents the frequency of hip dysplasia in the kennel up to 1970, when selection was not as strict as could be expected in a well-controlled kennel.  相似文献   

14.
OBJECTIVE: To evaluate a method for experimental induction of osteoarthritis in the hip joints of dogs. ANIMALS: 12 mixed-breed dogs. PROCEDURE: A unilateral triple pelvic osteotomy was performed. In 6 dogs, the iliac osteotomy was repaired with 45 degrees of internal rotation, reducing coverage of the femoral head by the acetabulum. In the other 6 dogs, the fragments were repaired in anatomic alignment. Radiography, force plate evaluations, and subjective lameness evaluations were performed before and after surgery. Dogs were euthanatized 7 months after surgery, and samples of cartilage and joint capsule were examined histologically. RESULTS: Subjective lameness scores, radiographic appearance of the hip joints, and Norberg angles were not significantly different between groups; however, force plate evaluations did reveal significant differences in vertical ground reaction forces. Femoral head coverage was significantly decreased with rotation of the acetabulum. Mild inflammatory changes were discernible in the joint capsule and articular cartilage of some dogs in both groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that 45 degrees internal rotation of the acetabulum does not consistently induce biologically important osteoarthritic changes in the hip joints of dogs.  相似文献   

15.
OBJECTIVE: To examine effects of restricted food intake on estrous cycle frequency, interestrus interval, and pseudopregnancy prevalence in dogs. ANIMALS: 28 female Labrador Retrievers. PROCEDURE: Dogs were paired by body weight when they were 6 weeks old and fed so that the limit-fed pair-mate received 75% of the amount of food offered to its maintenance-fed counterpart. Estrous cycle, interestrus interval, and pseudopregnancy data were recorded. RESULTS: Mean annual frequency of estrous cycles and duration of interestrus intervals did not differ between feeding groups. Prevalence of clinically evident pseudopregnancy was significantly greater among females that were maintenance fed, although results of endocrinologic testing did not identify a mechanism for this observation. CONCLUSIONS AND CLINICAL RELEVANCE: Pseudopregnancy in dogs can be influenced by physiologic factors related to nutrition. Clinicians should consider a variety of physiologic and environmental factors when evaluating reproductive function in dogs.  相似文献   

16.
This study investigated kinematic patterns in clinically normal German Shepherd dogs (GSDs) compared to those with hip dysplasia and with no clinical signs of lameness. Two groups of GSDs, including 10 clinically healthy dogs (G1) and 10 with hip dysplasia (G2), were trotted on a treadmill at a constant speed. Kinematic data were collected by a 3-camera system and analysed by a motion-analysis program. Flexion and extension joint angles and angular velocities were determined for the shoulder, elbow, carpal, hip, stifle, and tarsal joints.Within each group, the differences between the right and left limbs in all kinematic variables were not significant. Minimum angle, angular displacement and minimum angular velocity did not differ between groups. Significant differences were observed in the maximum angular velocity and maximum angle of the hip joint (dysplastic > healthy), and in the maximum angular velocity of the carpal joint (healthy > dysplastic). It was concluded that, when trotting on a treadmill, dysplastic dogs with no signs of lameness may present joint kinematic alterations in the hind as well as the forelimbs.  相似文献   

17.
OBJECTIVE: To compare the bone mineral density (BMD) of the proximal portion of the femur in dogs with and without early osteoarthritis secondary to hip dysplasia. ANIMALS: 24 dogs (3 Greyhounds, 6 Labrador-Greyhound crossbreeds, and 15 Labrador Retrievers). PROCEDURE: Computed tomography (CT) of the pelvis, including a bone-density phantom, was performed for each dog. Centrally located transverse CT slices and a computer workstation were used to identify 16 regions of interest (ROIs) in the proximal portion of the femur. For each ROI, the mean Hounsfield unit value was recorded; by use of the bone-density phantom and linear regression analysis, those values were converted to equivalent BMD (eBMD). Mean eBMD values for the subchondral and nonsubchondral ROIs in dogs with and without osteoarthritis (determined at necropsy) were compared. A mixed-model ANOVA and post hoc linear contrasts were used to evaluate the effects of osteoarthritis, breed, and sex on the BMD value. RESULTS: At necropsy, osteoarthritis was detected in 14 hip joints in 9 dogs; all lesions included early cartilage fibrillation. After adjusting for breed and sex, eBMD in subchondral ROIs 8 and 12 (adjacent to the fovea) were 8% and 6% higher, respectively, in osteoarthritis-affected dogs, compared with unaffected dogs; in the nonsubchondral ROIs, eBMD was 10% higher in osteoarthritis-affected dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with findings in unaffected dogs, increased eBMD in hip joints of dogs with early osteoarthritis supports a strong relationship between the subchondral and epiphyseal regions and articular cartilage in the pathogenesis and progression of osteoarthritis.  相似文献   

18.
OBJECTIVE: To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia. DESIGN: Case series. ANIMALS: 52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy. PROCEDURE: A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone). RESULTS: In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions > or = grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions.  相似文献   

19.
OBJECTIVE: To define the ultrasonographic appearance of the elbow joint of dogs and to develop an ultrasonographic imaging protocol to reliably accomplish complete evaluation of that joint. ANIMALS: 11 clinically normal mixed-breed dogs. PROCEDURE: Ultrasonographic observations (by use of a 5 to 10 MHz linear array probe) were made of 22 elbow joints in cadaveric forelimbs from clinically normal dogs. Images in standard anatomic planes were recorded with a multi-image camera, on videotape, or onto a computer. The anatomic plane of the ultrasonographic beam and position of the ultrasonographic probe were also recorded. Dissection of each elbow joint was performed, and anatomic features were correlated with ultrasonographic images. RESULTS: Structures clearly identified ultrasonographically included the lateral and medial humeral epicondyles, the humeroradial and humeroulnar joints, anconeal process, medial coronoid process, hyaline cartilage covering the proximal articular surface of the radius, collateral ligaments, tendons of triceps brachii and supinator muscles, and the supinator tendon and sesamoid in the supinator cartilage. An ultrasonographic imaging protocol for examination of the elbow joint was developed. CONCLUSIONS AND CLINICAL RELEVANCE: Precise correlations were established between the gross anatomic appearance of the elbow joint and the ultrasonographic images of its component structures. The ultrasonographic imaging protocol will enable complete examination of all regions of the joint for detection of pathologic lesions.  相似文献   

20.
OBJECTIVE: To quantify the passive contribution of the biceps brachii muscle-tendon unit to the limits of elbow joint extension during shoulder joint flexion in horses. SAMPLE POPULATION: Normal right forelimb specimens from 6 Thoroughbred cadavers. PROCEDURE: Specimens included the scapula, humerus, radius-ulna, biceps brachii muscle-tendon unit, and stabilizers of the shoulder and elbow joints. Specimens were mounted to a rigid board by transfixation pins through the humerus and instrumented for mechanical manipulation of the limb and joint angle and load measurements. Flexion and extension limits of shoulder and elbow joint ranges of motion were measured in each joint separately, while the other joint was fixed. Measurements were made before and after transection of the biceps brachii muscle-tendon unit. RESULTS: The biceps brachii muscle-tendon unit limited elbow joint extension when the shoulder joint was fixed in flexion, limited shoulder joint flexion when the elbow joint was fixed in extension, and inhibited shoulder joint extension to a lesser degree when the elbow joint was fixed at midrange angles of 75 degrees to 90 degrees. CONCLUSIONS AND CLINICAL RELEVANCE: Clinical manipulation of the elbow joint into hyperextension during shoulder joint flexion is indicative of biceps brachii injury.  相似文献   

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