Objective: In the manuscript titled Monoamine Oxidase-B Inhibitor Rasagiline Effects on Motor and Non-Motor Symptoms in Individuals with Parkinsons Disease: A Systematic Review and Meta-Analysis, the objective was to ...Objective: In the manuscript titled Monoamine Oxidase-B Inhibitor Rasagiline Effects on Motor and Non-Motor Symptoms in Individuals with Parkinsons Disease: A Systematic Review and Meta-Analysis, the objective was to conduct a systematic review with meta-analysis to investigate the effects that Rasagiline has on motor and non-motor symptoms in individuals with PD. Introduction: Rasagiline is a second-generation monoamine oxidase-B (MAO-B) inhibitor used both as monotherapy and adjunctive therapy for Parkinsons Disease (PD). Methods: A systematic literature search and meta-analysis were performed with randomized control trials that investigated the effects of Rasagiline on motor and non-motor symptoms in individuals with PD. The systematic search was conducted in PubMed, Cochrane, and EBSCO databases. Methodological quality was assessed using the Cochrane Grading Recommendations Assessment, Development and Evaluation approach. Results: Fourteen studies were included in our review. There were trivial to small and statistically significant improvements in motor symptoms for individuals with PD treated with Rasagiline compared to placebo. Non-motor symptoms showed no significant improvement with Rasagiline compared to placebo in five of six meta-analyses. Results were based on very low to moderate certainty of evidence. Conclusion: 1 mg/day Rasagiline significantly improved Parkinsonian motor symptoms in individuals with PD compared with placebo. For all outcomes, the 1 mg/day Rasagiline group was favored over the placebo group.展开更多
Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects a...Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).展开更多
BACKGROUND Stapes ankylosis is a rare cause of conductive hearing loss,and stapes suprastructure fixation is extremely rare with fewer than 30 reported cases.Patients usually visit the clinic with non-progressive cond...BACKGROUND Stapes ankylosis is a rare cause of conductive hearing loss,and stapes suprastructure fixation is extremely rare with fewer than 30 reported cases.Patients usually visit the clinic with non-progressive conductive hearing loss that typically began in the early years of life.CASE SUMMARY Herein,we report a case of a 37-year-old female with an isolated stapedial suprastructure fixation.The patient presented with unusual fluctuating auditory symptoms of tinnitus,ear fullness and mixed hearing loss.Pre-operative temporal bone computed tomography findings and operative findings revealed an isolated stapedial suprastructure fixation with monopod stapes caused by elongated pyramidal eminence.The hearing threshold recovered completely,and fluctuating auditory symptoms disappeared after the surgery.CONCLUSION This is the first report of stapedial suprastructure fixation with fluctuating auditory symptoms.Successful results are expected with surgical treatment.展开更多
Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs i...Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs in PD have been accumulated growing attentions and its amelioration may also give beneficial effect for PD patients’ and their care givers’ quality of life. In this mini-review, I overviewed non-motor symptoms and signs in PD.展开更多
<strong>Background: </strong>Parkinson’s disease (PD) remains a challenge for neurologists, particularly in its advanced stages when non-motor symptoms become a burden for the patient. While motor symptom...<strong>Background: </strong>Parkinson’s disease (PD) remains a challenge for neurologists, particularly in its advanced stages when non-motor symptoms become a burden for the patient. While motor symptoms may be satisfactorily controlled with levodopa therapy or continuous levodopa/carbidopa intestinal gel (LCIG) administration, autonomic, sleep and mental disorders are hard to treat. During the last years, researchers have shifted their interest more to non-motor symptoms, PD being now considered a complex multiorgan impairment. <strong>Objective:</strong> The aim of this study was to describe non-motor symptoms in 40 Romanian patients diagnosed with PD, under conventional and LCIG administration treatment. <strong>Methods: </strong>A cross-sectional observational study was conducted, consisting of two groups of 20 patients each: the first group comprised PD patients who received conventional Levodopa treatment, while the second group was formed of patients receiving LCIG therapy. Various data concerning patient’s age, gender, duration of illness, comorbidities, motor and non-motor symptoms were recorded. The data were processed in SPSS v.20. <strong>Results: </strong>Subjects under continuous LCIG administration, although showing amelioration of motor symptoms, complained more frequently of constipation, mental, and sleeping disorders (statistically significant). Regarding anosmia, orthostatic hypotension, hypersalivation, urinary incontinence and restless legs syndrome, no statistical significant difference was observed between the two groups (p > 0.05). <strong>Conclusion:</strong> Nowadays, more research is conducted on non-motor symptoms in PD patients, as therapeutic measures try to limit these burdens, in order to improve patient’s quality of life.展开更多
Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. It is a complex syndrome with heterogeneous aetiologies, pathogenesis and manifestations. Patients with PD may...Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. It is a complex syndrome with heterogeneous aetiologies, pathogenesis and manifestations. Patients with PD may present with motor symptoms and various non-motor symptoms (NMSs). NMSs have been reported in almost every diagnosed case of PD and usually precede motor symptoms. Multiple factors have been proved to be associated with the occurrence of NMSs in PD, among which genetic differentiation is a featured one. With the development of sequencing techniques, an increasing number of NMS-related genetic factors have been identified. This article reviews some of the latest discoveries in this regard.展开更多
目的:探讨急性脑梗死(acute cerebral infarction,ACI)溶栓患者术后临床症状反复发作的相关影响因素。方法:采用回顾性调查方法对2019年1月—2023年2月在张家港市第二人民医院神经内科诊治的90例ACI溶栓患者资料进行分析,以术后出现偏...目的:探讨急性脑梗死(acute cerebral infarction,ACI)溶栓患者术后临床症状反复发作的相关影响因素。方法:采用回顾性调查方法对2019年1月—2023年2月在张家港市第二人民医院神经内科诊治的90例ACI溶栓患者资料进行分析,以术后出现偏瘫、失语等临床症状反复发作的56例(62.22%)为观察组,未出现临床症状反复发作的34例(37.78%)为对照组,并对其进行单因素分析、logistic回归分析及受试者工作特征(receiver operating characteristic,ROC)曲线分析,研究ACI溶栓患者术后临床症状反复发作的相关因素。结果:单因素分析分析结果显示,两组性别、年龄、吸烟史、高血压史、糖尿病史、发病时间、血清生化指标比较,差异无统计学意义(P>0.05);两组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、心房颤动、梗死部位水平比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,NIHSS评分、心房颤动及梗死部位为ACI溶栓患者术后临床症状反复发作的独立危险因素(P<0.05)。ROC曲线分析结果显示,NIHSS评分、心房颤动及梗死部位的ROC曲线下面积(area under curve,AUC)分别为0.899、0.637、0.654,敏感度较高。结论:ACI溶栓患者术后临床症状反复发作与脑卒中神经缺损程度、心房颤动及梗死部位有关。展开更多
There are many documented sex differences in the clinical course,symptom expression profile,and treatment response of Parkinson’s disease,creating additional challenges for patient management.Although subthalamic nuc...There are many documented sex differences in the clinical course,symptom expression profile,and treatment response of Parkinson’s disease,creating additional challenges for patient management.Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease,the effects of sex on treatment outcome are still unclear.The aim of this retrospective observational study,was to examine sex differences in motor symptoms,nonmotor symptoms,and quality of life after subthalamic nucleus deep brain stimulation.Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00±8.01 years(55 men and 35 women).Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test,and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex.We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation.Restless legs syndrome was alleviated to a greater extent in men than in women.Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation.Furthermore,Hoehn-Yahr stage was positively correlated with the treatment response in men,while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women.In conclusion,women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms,non-motor symptoms,and quality of life.We found sex-specific factors,i.e.,Hoehn-Yahr stage and levodopa equivalent dose,that were related to motor improvements.These findings may help to guide subthalamic nucleus deep brain stimulation patient selection,prognosis,and stimulation programming for optimal therapeutic efficacy in Parkinson’s disease.展开更多
Background Although the validity of non-motor symptoms screening questionnaire (NMSQuest) for Parkinson's disease has been verified in several recent researches, the specificity of the questionnaire is still in dou...Background Although the validity of non-motor symptoms screening questionnaire (NMSQuest) for Parkinson's disease has been verified in several recent researches, the specificity of the questionnaire is still in doubt. This study aimed to compare the non-motor symptoms (NMS) in Parkinson's disease (PD) with a medically ill control group. Methods In this study, the first comprehensive clinic-based NMS screening questionnaire for PD developed by the Parkinson's Disease Non-Motor Group (PDNMG) was used. Data from 90 PD patients and 270 sex-and age-matched control subjects, including stroke (n=90), heart disease (n=-90) and diabetes (n=-90) were analyzed. Results Compared with control group, NMS was more common in PD; on an average, most PD patients reported more than 12 non-motor items. There was a correlation of total NMS score in PD patients with Hoehn & Yahr Staging, but not with age, sex distribution, disease duration, or age at disease onset. Additionally, depression, constipation and impaired olfaction which occurred prior to the motor symptoms of PD were reported in this study. Conclusions NMS are more common in PD patients. There are some NMS that occurred at the preclinical stage of PD and might predict the onset of motor symptoms of PD patients.展开更多
目的探讨伴与不伴幻听的儿童少年首发精神分裂症患者在静息状态下大脑功能磁共振低频振幅(amplitude of low-frequency fluctuation,ALFF)特点及其与精神症状之间的关系。方法收集10~16岁首发精神分裂症患者52例,根据阳性症状量表(posit...目的探讨伴与不伴幻听的儿童少年首发精神分裂症患者在静息状态下大脑功能磁共振低频振幅(amplitude of low-frequency fluctuation,ALFF)特点及其与精神症状之间的关系。方法收集10~16岁首发精神分裂症患者52例,根据阳性症状量表(positive symptoms scale,SAPS)中听幻觉条目评分将患者分为幻听组26例(听幻觉≥3分)和非幻听组26例(听幻觉<3分),并纳入35名健康对照。对所有被试静息态功能磁共振扫描数据进行ALFF分析,用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评估患者症状。结果与对照组比较,幻听组ALFF振幅降低的脑区是左侧枕叶、左侧颞叶(P<0.05,AlphaSim校正),ALFF升高的脑区是左侧额叶(P<0.05,AlphaSim校正);非幻听组相比对照组ALFF增高的脑区是左侧额叶、右侧尾状核(P<0.05,AlphaSim校正);幻听组相较于非幻听组ALFF增高的脑区有右侧枕叶(P<0.05,AlphaSim校正)。幻听组右侧枕叶的ALFF值与PANSS阳性症状分(r=0.448,P=0.022)及总分(r=0.407,P=0.039)呈正相关;非幻听组右侧枕叶ALFF值与一般病理症状分呈正相关(r=0.630,P=0.001)。结论儿童少年首发精神分裂症患者在静息状态下左侧额叶和右侧尾状核功能增强,左侧枕叶和左侧颞叶功能降低;伴与不伴幻听的儿童少年精神分裂症患者在静息状态下枕叶功能存在差异,且与精神症状有相关性。展开更多
文摘Objective: In the manuscript titled Monoamine Oxidase-B Inhibitor Rasagiline Effects on Motor and Non-Motor Symptoms in Individuals with Parkinsons Disease: A Systematic Review and Meta-Analysis, the objective was to conduct a systematic review with meta-analysis to investigate the effects that Rasagiline has on motor and non-motor symptoms in individuals with PD. Introduction: Rasagiline is a second-generation monoamine oxidase-B (MAO-B) inhibitor used both as monotherapy and adjunctive therapy for Parkinsons Disease (PD). Methods: A systematic literature search and meta-analysis were performed with randomized control trials that investigated the effects of Rasagiline on motor and non-motor symptoms in individuals with PD. The systematic search was conducted in PubMed, Cochrane, and EBSCO databases. Methodological quality was assessed using the Cochrane Grading Recommendations Assessment, Development and Evaluation approach. Results: Fourteen studies were included in our review. There were trivial to small and statistically significant improvements in motor symptoms for individuals with PD treated with Rasagiline compared to placebo. Non-motor symptoms showed no significant improvement with Rasagiline compared to placebo in five of six meta-analyses. Results were based on very low to moderate certainty of evidence. Conclusion: 1 mg/day Rasagiline significantly improved Parkinsonian motor symptoms in individuals with PD compared with placebo. For all outcomes, the 1 mg/day Rasagiline group was favored over the placebo group.
文摘Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).
文摘BACKGROUND Stapes ankylosis is a rare cause of conductive hearing loss,and stapes suprastructure fixation is extremely rare with fewer than 30 reported cases.Patients usually visit the clinic with non-progressive conductive hearing loss that typically began in the early years of life.CASE SUMMARY Herein,we report a case of a 37-year-old female with an isolated stapedial suprastructure fixation.The patient presented with unusual fluctuating auditory symptoms of tinnitus,ear fullness and mixed hearing loss.Pre-operative temporal bone computed tomography findings and operative findings revealed an isolated stapedial suprastructure fixation with monopod stapes caused by elongated pyramidal eminence.The hearing threshold recovered completely,and fluctuating auditory symptoms disappeared after the surgery.CONCLUSION This is the first report of stapedial suprastructure fixation with fluctuating auditory symptoms.Successful results are expected with surgical treatment.
文摘Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs in PD have been accumulated growing attentions and its amelioration may also give beneficial effect for PD patients’ and their care givers’ quality of life. In this mini-review, I overviewed non-motor symptoms and signs in PD.
文摘<strong>Background: </strong>Parkinson’s disease (PD) remains a challenge for neurologists, particularly in its advanced stages when non-motor symptoms become a burden for the patient. While motor symptoms may be satisfactorily controlled with levodopa therapy or continuous levodopa/carbidopa intestinal gel (LCIG) administration, autonomic, sleep and mental disorders are hard to treat. During the last years, researchers have shifted their interest more to non-motor symptoms, PD being now considered a complex multiorgan impairment. <strong>Objective:</strong> The aim of this study was to describe non-motor symptoms in 40 Romanian patients diagnosed with PD, under conventional and LCIG administration treatment. <strong>Methods: </strong>A cross-sectional observational study was conducted, consisting of two groups of 20 patients each: the first group comprised PD patients who received conventional Levodopa treatment, while the second group was formed of patients receiving LCIG therapy. Various data concerning patient’s age, gender, duration of illness, comorbidities, motor and non-motor symptoms were recorded. The data were processed in SPSS v.20. <strong>Results: </strong>Subjects under continuous LCIG administration, although showing amelioration of motor symptoms, complained more frequently of constipation, mental, and sleeping disorders (statistically significant). Regarding anosmia, orthostatic hypotension, hypersalivation, urinary incontinence and restless legs syndrome, no statistical significant difference was observed between the two groups (p > 0.05). <strong>Conclusion:</strong> Nowadays, more research is conducted on non-motor symptoms in PD patients, as therapeutic measures try to limit these burdens, in order to improve patient’s quality of life.
文摘Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. It is a complex syndrome with heterogeneous aetiologies, pathogenesis and manifestations. Patients with PD may present with motor symptoms and various non-motor symptoms (NMSs). NMSs have been reported in almost every diagnosed case of PD and usually precede motor symptoms. Multiple factors have been proved to be associated with the occurrence of NMSs in PD, among which genetic differentiation is a featured one. With the development of sequencing techniques, an increasing number of NMS-related genetic factors have been identified. This article reviews some of the latest discoveries in this regard.
文摘目的:探讨急性脑梗死(acute cerebral infarction,ACI)溶栓患者术后临床症状反复发作的相关影响因素。方法:采用回顾性调查方法对2019年1月—2023年2月在张家港市第二人民医院神经内科诊治的90例ACI溶栓患者资料进行分析,以术后出现偏瘫、失语等临床症状反复发作的56例(62.22%)为观察组,未出现临床症状反复发作的34例(37.78%)为对照组,并对其进行单因素分析、logistic回归分析及受试者工作特征(receiver operating characteristic,ROC)曲线分析,研究ACI溶栓患者术后临床症状反复发作的相关因素。结果:单因素分析分析结果显示,两组性别、年龄、吸烟史、高血压史、糖尿病史、发病时间、血清生化指标比较,差异无统计学意义(P>0.05);两组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、心房颤动、梗死部位水平比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,NIHSS评分、心房颤动及梗死部位为ACI溶栓患者术后临床症状反复发作的独立危险因素(P<0.05)。ROC曲线分析结果显示,NIHSS评分、心房颤动及梗死部位的ROC曲线下面积(area under curve,AUC)分别为0.899、0.637、0.654,敏感度较高。结论:ACI溶栓患者术后临床症状反复发作与脑卒中神经缺损程度、心房颤动及梗死部位有关。
基金support by the National Nature Science Foundation of China,Nos.81830033,61761166004(both to JGZ)。
文摘There are many documented sex differences in the clinical course,symptom expression profile,and treatment response of Parkinson’s disease,creating additional challenges for patient management.Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease,the effects of sex on treatment outcome are still unclear.The aim of this retrospective observational study,was to examine sex differences in motor symptoms,nonmotor symptoms,and quality of life after subthalamic nucleus deep brain stimulation.Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00±8.01 years(55 men and 35 women).Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test,and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex.We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation.Restless legs syndrome was alleviated to a greater extent in men than in women.Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation.Furthermore,Hoehn-Yahr stage was positively correlated with the treatment response in men,while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women.In conclusion,women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms,non-motor symptoms,and quality of life.We found sex-specific factors,i.e.,Hoehn-Yahr stage and levodopa equivalent dose,that were related to motor improvements.These findings may help to guide subthalamic nucleus deep brain stimulation patient selection,prognosis,and stimulation programming for optimal therapeutic efficacy in Parkinson’s disease.
文摘Background Although the validity of non-motor symptoms screening questionnaire (NMSQuest) for Parkinson's disease has been verified in several recent researches, the specificity of the questionnaire is still in doubt. This study aimed to compare the non-motor symptoms (NMS) in Parkinson's disease (PD) with a medically ill control group. Methods In this study, the first comprehensive clinic-based NMS screening questionnaire for PD developed by the Parkinson's Disease Non-Motor Group (PDNMG) was used. Data from 90 PD patients and 270 sex-and age-matched control subjects, including stroke (n=90), heart disease (n=-90) and diabetes (n=-90) were analyzed. Results Compared with control group, NMS was more common in PD; on an average, most PD patients reported more than 12 non-motor items. There was a correlation of total NMS score in PD patients with Hoehn & Yahr Staging, but not with age, sex distribution, disease duration, or age at disease onset. Additionally, depression, constipation and impaired olfaction which occurred prior to the motor symptoms of PD were reported in this study. Conclusions NMS are more common in PD patients. There are some NMS that occurred at the preclinical stage of PD and might predict the onset of motor symptoms of PD patients.
文摘目的探讨伴与不伴幻听的儿童少年首发精神分裂症患者在静息状态下大脑功能磁共振低频振幅(amplitude of low-frequency fluctuation,ALFF)特点及其与精神症状之间的关系。方法收集10~16岁首发精神分裂症患者52例,根据阳性症状量表(positive symptoms scale,SAPS)中听幻觉条目评分将患者分为幻听组26例(听幻觉≥3分)和非幻听组26例(听幻觉<3分),并纳入35名健康对照。对所有被试静息态功能磁共振扫描数据进行ALFF分析,用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评估患者症状。结果与对照组比较,幻听组ALFF振幅降低的脑区是左侧枕叶、左侧颞叶(P<0.05,AlphaSim校正),ALFF升高的脑区是左侧额叶(P<0.05,AlphaSim校正);非幻听组相比对照组ALFF增高的脑区是左侧额叶、右侧尾状核(P<0.05,AlphaSim校正);幻听组相较于非幻听组ALFF增高的脑区有右侧枕叶(P<0.05,AlphaSim校正)。幻听组右侧枕叶的ALFF值与PANSS阳性症状分(r=0.448,P=0.022)及总分(r=0.407,P=0.039)呈正相关;非幻听组右侧枕叶ALFF值与一般病理症状分呈正相关(r=0.630,P=0.001)。结论儿童少年首发精神分裂症患者在静息状态下左侧额叶和右侧尾状核功能增强,左侧枕叶和左侧颞叶功能降低;伴与不伴幻听的儿童少年精神分裂症患者在静息状态下枕叶功能存在差异,且与精神症状有相关性。