Detection of venom after antivenom is not associated with persistent coagulopathy in a prospective cohort of Russell's viper (Daboia russelii) envenomings.

Abstract:

BACKGROUND:Venom recurrence or persistence in the circulation after antivenom treatment has been documented many times in viper envenoming. However, it has not been associated with clinical recurrence for many snakes, including Russell's viper (Daboia spp.). We compare the recovery of coagulopathy to the recurrence or persistence of venom in patients with Russell's viper envenoming. METHODOLOGY/PRINCIPAL FINDINGS:The study included patients with Russell's viper (D. russelii) envenoming presenting over a 30 month period who had Russell's viper venom detected by enzyme immunoassay. Demographics, information on the snake bite, and clinical effects were collected for all patients. All patients had serum collected for venom specific enzyme immunoassay and citrate plasma to measure fibrinogen levels and prothrombin time (international normalised ratio; INR). Patients with venom recurrence/persistence were compared to those with no detectable recurrence of venom. There were 55 patients with confirmed Russell's viper envenoming and coagulopathy with low fibrinogen concentrations: 31 with venom recurrence/persistence, and 24 with no venom detected post-antivenom. Fibrinogen concentrations increased and INR decreased after antivenom in both the recurrence and non-recurrence patients. Clinical features, laboratory parameters, antivenom dose and length of hospital were similar for both groups. Pre-antivenom venom concentrations were higher in patients with venom recurrence/persistence with a median venom concentration of 385 ng/mL (16-1521 ng/mL) compared to 128 ng/mL (14-1492 ng/mL; p = 0.008). CONCLUSION:Recurrence of Russell's viper venom was not associated with a recurrence of coagulopathy and length of hospital stay. Further work is required to determine if the detection of venom recurrence is due to the venom specific enzyme immunoassay detecting both venom-antivenom complexes as well as free venom.

journal_name

PLoS Negl Trop Dis

authors

Maduwage K,O'Leary MA,Scorgie FE,Shahmy S,Mohamed F,Abeysinghe C,Karunathilake H,Lincz LF,Gnanathasan CA,Isbister GK

doi

10.1371/journal.pntd.0003304

subject

Has Abstract

pub_date

2014-12-18 00:00:00

pages

e3304

issue

12

eissn

1935-2727

issn

1935-2735

pii

PNTD-D-14-01215

journal_volume

8

pub_type

杂志文章
  • Human plague associated with Tibetan sheep originates in marmots.

    abstract::The Qinghai-Tibet plateau is a natural plague focus and is the largest such focus in China. In this area, while Marmota himalayana is the primary host, a total of 18 human plague outbreaks associated with Tibetan sheep (78 cases with 47 deaths) have been reported on the Qinghai-Tibet plateau since 1956. All of the ind...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0006635

    authors: Dai R,Wei B,Xiong H,Yang X,Peng Y,He J,Jin J,Wang Y,Zha X,Zhang Z,Liang Y,Zhang Q,Xu J,Wang Z,Li W

    更新日期:2018-08-16 00:00:00

  • Neglected patients with a neglected disease? A qualitative study of lymphatic filariasis.

    abstract:BACKGROUND:Lymphatic filariasis (LF) is a so-called neglected tropical disease, currently overshadowed by higher-profile efforts to address malaria, tuberculosis, and HIV/AIDS. Despite recent successes in arresting transmission, some 40 million people who already have the disease have been largely neglected. This study...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0000128

    authors: Perera M,Whitehead M,Molyneux D,Weerasooriya M,Gunatilleke G

    更新日期:2007-11-21 00:00:00

  • An investig-ation into the epidemiology of chikungunya virus across neglected regions of Indonesia.

    abstract:BACKGROUND:Chikungunya virus (CHIKV) is an important emerging and re-emerging public health problem worldwide. In Indonesia, where the virus is endemic, epidemiological information from outside of the main islands of Java and Bali is limited. METHODOLOGY/PRINCIPAL FINDINGS:Four hundred and seventy nine acutely febrile...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0008934

    authors: Stubbs SCB,Johar E,Yudhaputri FA,Yohan B,Santoso MS,Hayati RF,Denis D,Blacklaws BA,Powers AM,Sasmono RT,Myint KSA,Frost SDW

    更新日期:2020-12-21 00:00:00

  • Achievements and challenges of lymphatic filariasis elimination in Sierra Leone.

    abstract:BACKGROUND:Lymphatic filariasis (LF) is targeted for elimination in Sierra Leone. Epidemiological coverage of mass drug administration (MDA) with ivermectin and albendazole had been reported >65% in all 12 districts annually. Eight districts qualified to implement transmission assessment survey (TAS) in 2013 but were d...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0008877

    authors: Bah YM,Paye J,Bah MS,Conteh A,Redwood-Sawyerr V,Sonnie M,Veinoglou A,Koroma JB,Hodges MH,Zhang Y

    更新日期:2020-12-28 00:00:00

  • Zika virus like particles elicit protective antibodies in mice.

    abstract::Mosquito-borne Zika virus (ZIKV) typically causes a mild and self-limiting illness known as Zika fever. Since its recent emergence in 2014 in the American continent, ZIKV infection during pregnancy has been closely associated with a wide range of congenital abnormalities. To date, no vaccines or antivirals are publicl...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0006210

    authors: Salvo MA,Kingstad-Bakke B,Salas-Quinchucua C,Camacho E,Osorio JE

    更新日期:2018-02-05 00:00:00

  • Molecular evidence for a functional ecdysone signaling system in Brugia malayi.

    abstract:BACKGROUND:Filarial nematodes, including Brugia malayi, the causative agent of lymphatic filariasis, undergo molting in both arthropod and mammalian hosts to complete their life cycles. An understanding of how these parasites cross developmental checkpoints may reveal potential targets for intervention. Pharmacological...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0000625

    authors: Tzertzinis G,Egaña AL,Palli SR,Robinson-Rechavi M,Gissendanner CR,Liu C,Unnasch TR,Maina CV

    更新日期:2010-03-09 00:00:00

  • Strengths and weaknesses of Global Positioning System (GPS) data-loggers and semi-structured interviews for capturing fine-scale human mobility: findings from Iquitos, Peru.

    abstract::Quantifying human mobility has significant consequences for studying physical activity, exposure to pathogens, and generating more realistic infectious disease models. Location-aware technologies such as Global Positioning System (GPS)-enabled devices are used increasingly as a gold standard for mobility research. The...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0002888

    authors: Paz-Soldan VA,Reiner RC Jr,Morrison AC,Stoddard ST,Kitron U,Scott TW,Elder JP,Halsey ES,Kochel TJ,Astete H,Vazquez-Prokopec GM

    更新日期:2014-06-12 00:00:00

  • Emerging trends of Zika apprehension in an epidemic setting.

    abstract:BACKGROUND:French Guiana is a territory that has a decades-long history of dengue outbreaks and more recently, in 2014, a chikungunya outbreak. Zika virus (ZIKV) emerged in late 2015 and subsequently led to an important outbreak. METHODOLOGY/PRINCIPAL FINDINGS:A cross-sectional phone survey was conducted among the gen...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0006167

    authors: Fritzell C,Raude J,Kazanji M,Flamand C

    更新日期:2018-01-25 00:00:00

  • Polyphenol-Rich Diets Exacerbate AMPK-Mediated Autophagy, Decreasing Proliferation of Mosquito Midgut Microbiota, and Extending Vector Lifespan.

    abstract:BACKGROUND:Mosquitoes feed on plant-derived fluids such as nectar and sap and are exposed to bioactive molecules found in this dietary source. However, the role of such molecules on mosquito vectorial capacity is unknown. Weather has been recognized as a major determinant of the spread of dengue, and plants under abiot...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0005034

    authors: Nunes RD,Ventura-Martins G,Moretti DM,Medeiros-Castro P,Rocha-Santos C,Daumas-Filho CR,Bittencourt-Cunha PR,Martins-Cardoso K,Cudischevitch CO,Menna-Barreto RF,Oliveira JH,Gusmão DS,Alves Lemos FJ,Alviano DS,Oliveira PL,Low

    更新日期:2016-10-12 00:00:00

  • Spatio-temporal Genetic Structuring of Leishmania major in Tunisia by Microsatellite Analysis.

    abstract::In Tunisia, cases of zoonotic cutaneous leishmaniasis caused by Leishmania major are increasing and spreading from the south-west to new areas in the center. To improve the current knowledge on L. major evolution and population dynamics, we performed multi-locus microsatellite typing of human isolates from Tunisian go...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0004017

    authors: Harrabi M,Bettaieb J,Ghawar W,Toumi A,Zaâtour A,Yazidi R,Chaâbane S,Chalghaf B,Hide M,Bañuls AL,Ben Salah A

    更新日期:2015-08-24 00:00:00

  • Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures.

    abstract::Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011-2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0004215

    authors: Tseroni M,Baka A,Kapizioni C,Snounou G,Tsiodras S,Charvalakou M,Georgitsou M,Panoutsakou M,Psinaki I,Tsoromokou M,Karakitsos G,Pervanidou D,Vakali A,Mouchtouri V,Georgakopoulou T,Mamuris Z,Papadopoulos N,Koliopoulos G,

    更新日期:2015-11-19 00:00:00

  • Differential Gene Expression and Infection Profiles of Cutaneous and Mucosal Leishmania braziliensis Isolates from the Same Patient.

    abstract:BACKGROUND:Leishmaniasis is a complex disease in which clinical outcome depends on factors such as parasite species, host genetics and immunity and vector species. In Brazil, Leishmania (Viannia) braziliensis is a major etiological agent of cutaneous (CL) and mucosal leishmaniasis (MCL), a disfiguring form of the disea...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0004018

    authors: Alves-Ferreira EV,Toledo JS,De Oliveira AH,Ferreira TR,Ruy PC,Pinzan CF,Santos RF,Boaventura V,Rojo D,López-Gonzálvez Á,Rosa JC,Barbas C,Barral-Netto M,Barral A,Cruz AK

    更新日期:2015-09-14 00:00:00

  • NOD2 receptor is crucial for protecting against the digestive form of Chagas disease.

    abstract::Digestive and cardiodigestive forms of Chagas' disease are observed in 2% to 27% of the patients, depending on their geographic location, Trypanosoma cruzi strain and immunopathological responses. The aim of this work was to evaluate the role of NOD2 innate immune receptor in the pathogenesis of the digestive system i...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0008667

    authors: Pereira NS,Queiroga TBD,da Silva DD,Nascimento MSL,Andrade CM,Souto JT,Ricci MF,Arantes RME,Zamboni DS,Chiari E,Câmara ACJD,Galvão LMDC,Guedes PMM

    更新日期:2020-09-28 00:00:00

  • Geographic distribution and mortality risk factors during the cholera outbreak in a rural region of Haiti, 2010-2011.

    abstract:BACKGROUND:In 2010 and 2011, Haiti was heavily affected by a large cholera outbreak that spread throughout the country. Although national health structure-based cholera surveillance was rapidly initiated, a substantial number of community cases might have been missed, particularly in remote areas. We conducted a commun...

    journal_title:PLoS neglected tropical diseases

    pub_type: 历史文章,杂志文章

    doi:10.1371/journal.pntd.0003605

    authors: Page AL,Ciglenecki I,Jasmin ER,Desvignes L,Grandesso F,Polonsky J,Nicholas S,Alberti KP,Porten K,Luquero FJ

    更新日期:2015-03-26 00:00:00

  • Therapeutic control of leishmaniasis by inhibitors of the mammalian target of rapamycin.

    abstract::Leishmaniasis is a serious global health problem affecting many people worldwide. While patients with leishmaniasis can be treated with several agents, drug toxicicty and the emergence of resistant strains render available treatments ineffective in the long run. Inhibitors of the mammalian target of rapamycin (mTOR) h...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0006701

    authors: Khadir F,Shaler CR,Oryan A,Rudak PT,Mazzuca DM,Taheri T,Dikeakos JD,Haeryfar SMM,Rafati S

    更新日期:2018-08-22 00:00:00

  • Virulence of invasive Salmonella Typhimurium ST313 in animal models of infection.

    abstract::Salmonella Typhimurium sequence type (ST) 313 produces septicemia in infants in sub-Saharan Africa. Although there are known genetic and phenotypic differences between ST313 strains and gastroenteritis-associated ST19 strains, conflicting data about the in vivo virulence of ST313 strains have been reported. To resolve...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0005697

    authors: Ramachandran G,Panda A,Higginson EE,Ateh E,Lipsky MM,Sen S,Matson CA,Permala-Booth J,DeTolla LJ,Tennant SM

    更新日期:2017-08-04 00:00:00

  • Dramatic changes in gene expression in different forms of Crithidia fasciculata reveal potential mechanisms for insect-specific adhesion in kinetoplastid parasites.

    abstract::Kinetoplastids are a group of parasites that includes several medically-important species. These human-infective species are transmitted by insect vectors in which the parasites undergo specific developmental transformations. For each species, this includes a stage in which parasites adhere to insect tissue via a hemi...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0007570

    authors: Filosa JN,Berry CT,Ruthel G,Beverley SM,Warren WC,Tomlinson C,Myler PJ,Dudkin EA,Povelones ML,Povelones M

    更新日期:2019-07-29 00:00:00

  • Prevalence and risk factors for Taenia solium cysticercosis in school-aged children: A school based study in western Sichuan, People's Republic of China.

    abstract:BACKGROUND:Taenia solium cysticercosis affects millions of impoverished people worldwide and can cause neurocysticercosis, an infection of the central nervous system which is potentially fatal. Children may represent an especially vulnerable population to neurocysticercosis, due to the risk of cognitive impairment duri...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0006465

    authors: Openshaw JJ,Medina A,Felt SA,Li T,Huan Z,Rozelle S,Luby SP

    更新日期:2018-05-08 00:00:00

  • Head and neck mycetoma: the mycetoma research centre experience.

    abstract::Mycetoma is a unique neglected tropical disease which is endemic in what is known as the "mycetoma belt". The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less f...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0003587

    authors: Fahal A,Mahgoub el S,El Hassan AM,Jacoub AO,Hassan D

    更新日期:2015-03-13 00:00:00

  • Correction: Growing evidence of Plasmodium vivax across malaria-endemic Africa.

    abstract::[This corrects the article DOI: 10.1371/journal.pntd.0007140.]. ...

    journal_title:PLoS neglected tropical diseases

    pub_type: 已发布勘误

    doi:10.1371/journal.pntd.0007525

    authors: PLOS Neglected Tropical Diseases Staff.

    更新日期:2019-06-28 00:00:00

  • Second external quality assurance study for the serological diagnosis of hantaviruses in Europe.

    abstract::Hantaviruses are endemic throughout the world and hosted by rodents and insectivores. Two human zoonoses, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS), are caused by hantaviruses and case fatality rates have reached 12% for HFRS and 50% for HPS in some outbreaks. Symptomatic han...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0001607

    authors: Escadafal C,Avšič-Županc T,Vapalahti O,Niklasson B,Teichmann A,Niedrig M,Donoso-Mantke O

    更新日期:2012-01-01 00:00:00

  • The global burden of alveolar echinococcosis.

    abstract:BACKGROUND:Human alveolar echinococcosis (AE) is known to be common in certain rural communities in China whilst it is generally rare and sporadic elsewhere. The objective of this study was to provide a first estimate of the global incidence of this disease by country. The second objective was to estimate the global di...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,评审

    doi:10.1371/journal.pntd.0000722

    authors: Torgerson PR,Keller K,Magnotta M,Ragland N

    更新日期:2010-06-22 00:00:00

  • The impact and cost-effectiveness of controlling cholera through the use of oral cholera vaccines in urban Bangladesh: A disease modeling and economic analysis.

    abstract:BACKGROUND:Cholera remains an important public health problem in major cities in Bangladesh, especially in slum areas. In response to growing interest among local policymakers to control this disease, this study estimated the impact and cost-effectiveness of preventive cholera vaccination over a ten-year period in a hi...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0006652

    authors: Khan AI,Levin A,Chao DL,DeRoeck D,Dimitrov DT,Khan JAM,Islam MS,Ali M,Islam MT,Sarker AR,Clemens JD,Qadri F

    更新日期:2018-10-09 00:00:00

  • Estimating the cost of illness and burden of disease associated with the 2014-2015 chikungunya outbreak in the U.S. Virgin Islands.

    abstract::Chikungunya virus (CHIKV), an alphavirus that causes fever and severe polyarthralgia, swept through the Americas in 2014 with almost 2 million suspected or confirmed cases reported by April 2016. In this study, we estimate the direct medical costs, cost of lost wages due to absenteeism, and years lived with disability...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0007563

    authors: Feldstein LR,Ellis EM,Rowhani-Rahbar A,Hennessey MJ,Staples JE,Halloran ME,Weaver MR

    更新日期:2019-07-19 00:00:00

  • Integrated seroprevalence-based assessment of Wuchereria bancrofti and Onchocerca volvulus in two lymphatic filariasis evaluation units of Mali with the SD Bioline Onchocerciasis/LF IgG4 Rapid Test.

    abstract:BACKGROUND:Mali has become increasingly interested in the evaluation of transmission of both Wuchereria bancrofti and Onchocerca volvulus as prevalences of both infections move toward their respective elimination targets. The SD Bioline Onchocerciasis/LF IgG4 Rapid Test was used in 2 evaluation units (EU) to assess its...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0007064

    authors: Dolo H,Coulibaly YI,Dembele B,Guindo B,Coulibaly SY,Dicko I,Doumbia SS,Dembele M,Traore MO,Goita S,Dolo M,Soumaoro L,Coulibaly ME,Diallo AA,Diarra D,Zhang Y,Colebunders R,Nutman TB

    更新日期:2019-01-30 00:00:00

  • B1 cells protect against Schistosoma japonicum-induced liver inflammation and fibrosis by controlling monocyte infiltration.

    abstract::During Schistosoma infection, lack of B cells results in more severe granulomas, inflammation, and fibrosis in the liver, but the mechanisms underlying this pathology remain unclear. This study was to clarify the mechanisms underpinning the immunomodulation of B cells in mice infected with Schistosoma japonicum (S. ja...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0007474

    authors: Yong L,Tang Y,Ren C,Liu M,Shen J,Hou X

    更新日期:2019-06-13 00:00:00

  • The invasive Asian bush mosquito Aedes japonicus found in the Netherlands can experimentally transmit Zika virus and Usutu virus.

    abstract:BACKGROUND:The Asian bush mosquito Aedes japonicus is invading Europe and was first discovered in Lelystad, the Netherlands in 2013, where it has established a permanent population. In this study, we investigated the vector competence of Ae. japonicus from the Netherlands for the emerging Zika virus (ZIKV) and zoonotic...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0008217

    authors: Abbo SR,Visser TM,Wang H,Göertz GP,Fros JJ,Abma-Henkens MHC,Geertsema C,Vogels CBF,Koopmans MPG,Reusken CBEM,Hall-Mendelin S,Hall RA,van Oers MM,Koenraadt CJM,Pijlman GP

    更新日期:2020-04-13 00:00:00

  • Risk of Intestinal Parasitic Infections in People with Different Exposures to Wastewater and Fecal Sludge in Kampala, Uganda: A Cross-Sectional Study.

    abstract:BACKGROUND:There are health risks associated with wastewater and fecal sludge management and use, but little is known about the magnitude, particularly in rapidly growing urban settings of low- and middle-income countries. We assessed the point-prevalence and risk factors of intestinal parasite infections in people wit...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0004469

    authors: Fuhrimann S,Winkler MS,Kabatereine NB,Tukahebwa EM,Halage AA,Rutebemberwa E,Medlicott K,Schindler C,Utzinger J,Cissé G

    更新日期:2016-03-03 00:00:00

  • Kala-azar elimination in a highly-endemic district of Bihar, India: A success story.

    abstract:BACKGROUND:Visceral leishmaniasis (VL) or Kala-azar has been a major public health problem in Bihar, India, for several decades. A few VL infected districts including Vaishali have reported >600 cases annually. Hence, in 2015, the Government of India entrusted ICMR-Rajendra Memorial Research Institute of Medical Scienc...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章

    doi:10.1371/journal.pntd.0008254

    authors: Kumar V,Mandal R,Das S,Kesari S,Dinesh DS,Pandey K,Das VR,Topno RK,Sharma MP,Dasgupta RK,Das P

    更新日期:2020-05-04 00:00:00

  • The additional benefit of residual spraying and insecticide-treated curtains for dengue control over current best practice in Cuba: Evaluation of disease incidence in a cluster randomized trial in a low burden setting with intensive routine control.

    abstract:BACKGROUND:Aedes control interventions are considered the cornerstone of dengue control programmes, but there is scarce evidence on their effect on disease. We set-up a cluster randomized controlled trial in Santiago de Cuba to evaluate the entomological and epidemiological effectiveness of periodical intra- and peri-d...

    journal_title:PLoS neglected tropical diseases

    pub_type: 杂志文章,随机对照试验

    doi:10.1371/journal.pntd.0006031

    authors: Toledo ME,Vanlerberghe V,Rosales JP,Mirabal M,Cabrera P,Fonseca V,Gómez Padrón T,Pérez Menzies M,Montada D,Van der Stuyft P

    更新日期:2017-11-08 00:00:00