張 影,周 月,嚴(yán)尚學(xué),魏 偉
研究報告
類風(fēng)濕關(guān)節(jié)炎復(fù)合高血壓疾病模型的建立及評價
張 影,周 月,嚴(yán)尚學(xué)*,魏 偉
類風(fēng)濕關(guān)節(jié)炎(rheumatiod arthritis, RA)是一種常見的系統(tǒng)性自身免疫病,以對稱性關(guān)節(jié)腫脹、疼痛、炎癥細(xì)胞浸潤、滑膜襯里層細(xì)胞增生為主要病理特征,多數(shù)患者伴有骨與軟骨破壞,并最終導(dǎo)致殘疾[1]。中國每年發(fā)病人數(shù)高達(dá)500萬,發(fā)病率約為0.32%~ 0.36%,有200余萬人致殘[2]。
研究表明,RA患者的血管內(nèi)皮功能異常、動脈硬化程度和動脈粥樣硬化斑塊數(shù)量明顯增加[3,4],其高血壓(hypertension, HT)發(fā)生率比一般人群高達(dá)30%[5];RA伴發(fā)高血壓患者的心血管器官損傷(如左心室異常、舒張功能不全、系統(tǒng)性動脈順應(yīng)性降低)發(fā)生率也比非高血壓RA患者的發(fā)生率顯著升高[6,7],這些研究提示了RA既可導(dǎo)致心血管疾病的發(fā)生發(fā)展,同時,高血壓也成為增加RA患者心血管疾病發(fā)生率與死亡率的主要風(fēng)險因素。HT與RA相互交叉影響,探索其防治措施及其病理機(jī)制成為目前的研究熱點(diǎn)。
佐劑性關(guān)節(jié)炎(adjuvant arthritis, AA)模型動物在臨床表現(xiàn)、病理學(xué)、免疫學(xué)改變等方面與人RA有許多相似特征,是研究RA病理機(jī)制和篩選評價治療RA藥物的理想動物模型[8]。兩腎一夾(two kidney one clip, 2K1C)高血壓模型是一種模擬人類腎性高血壓的經(jīng)典動物模型[9]。在本研究中,我們首次將這兩個動物模型建成類風(fēng)濕關(guān)節(jié)炎復(fù)合高血壓疾病(arthritis-hypertension disease, AHD)模型,并探索AHD模型的病理特點(diǎn),以期更好地研究RA與HT之間的相互影響及病理機(jī)制。
1.1 實(shí)驗(yàn)動物及分組
SPF級雄性SD大鼠,40只,體重(160±10)g,5~6周齡,購置并飼養(yǎng)于安徽醫(yī)科大學(xué)實(shí)驗(yàn)動物中心[SCXK(皖)2011-002][SYXK(皖)2011-007]。40只SD大鼠隨機(jī)分為正常組8只、AA組10只、高血壓(HT)組10只、AHD組12只。本實(shí)驗(yàn)符合動物倫理和福利要求,實(shí)驗(yàn)方案按照“3R”原則得到本單位實(shí)驗(yàn)動物倫理委員會批準(zhǔn)。
1.2 主要試劑與儀器
卡介苗,購自成都生物制品研究所有限公司;YLS-7B型足趾容積測量儀,創(chuàng)博環(huán)球生物科技有限公司產(chǎn)品;ALC-NIBP型無創(chuàng)血壓測量分析系統(tǒng),上海奧爾科特生物科技有限公司產(chǎn)品。
1.3 實(shí)驗(yàn)方法
1.3.1 AA大鼠模型的建立[10]
卡介苗80℃水浴恒溫滅活1 h,與滅菌的液體石蠟充分研磨成濃度為10 mg/mL完全弗氏佐劑,于大鼠左后足跖注射0.1 mL致炎。
1.3.2 高血壓大鼠模型的建立[11]
采用手術(shù)法建立2K1C高血壓大鼠模型。大鼠術(shù)前禁食過夜,自由飲水。3%戊巴比妥鈉溶液按0.2 mL/100 g體重腹腔注射麻醉大鼠,外科手術(shù)暴露出左腎動脈,用內(nèi)徑為0.25 mm銀夾將左腎動脈縮窄,縫合皮膚,術(shù)后肌肉注射青霉素抗感染治療3 d。
1.3.3 AHD模型的建立
在建立2K1C高血壓大鼠模型的基礎(chǔ)上,同時于大鼠左后足跖注射0.1 mL完全弗氏佐劑致炎建立模型。
1.3.4 炎癥指標(biāo)測定、關(guān)節(jié)炎指數(shù)、致炎率的測定
關(guān)節(jié)腫脹度測定:致炎前用足爪容積測量儀測量大鼠足爪(非致炎側(cè))容積,炎癥出現(xiàn)后,每隔3 d測一次足爪容積,關(guān)節(jié)腫脹度(mL)=|致炎后足爪容積-致炎前足爪容積|[12]。
關(guān)節(jié)炎指數(shù)評分:炎癥出現(xiàn)后,每隔3 d進(jìn)行關(guān)節(jié)炎指數(shù)評分,觀察每組大鼠的繼發(fā)病變。關(guān)節(jié)炎指數(shù)評分標(biāo)準(zhǔn):0=正常;1=踝關(guān)節(jié)出現(xiàn)紅斑和輕微腫脹;2=踝關(guān)節(jié)到跖關(guān)節(jié)或掌關(guān)節(jié)紅斑和輕微腫脹;3=踝關(guān)節(jié)到跖趾關(guān)節(jié)或掌關(guān)節(jié)出現(xiàn)紅斑和中度腫脹;4=踝關(guān)節(jié)到趾關(guān)節(jié)出現(xiàn)紅斑和重度腫脹。每只大鼠最多評16分[12]。
致炎率計算:每組大鼠非致炎側(cè)出現(xiàn)紅腫的百分率,致炎率(%)=每組炎癥大鼠數(shù)量 / 每組動物總數(shù)量×100%。
1.3.5 高血壓判定標(biāo)準(zhǔn)
造模前用血壓測量儀測量尾動脈壓6次,取平均值作為基線壓,造模后每周測量一次。血壓高于基線20 mmHg且高于140 mmHg被認(rèn)為2K1C高血壓模型成功[11]。
1.3.6 病理學(xué)檢查
第35天處死大鼠,取大鼠胸主動脈、踝關(guān)節(jié)和脾臟組織,10%福爾馬林固定、HE染色鏡檢。在鏡下用cellSens Entry軟件測量胸主動脈的中膜厚度、橫切面積和管腔直徑[13];觀察大鼠踝關(guān)節(jié)中滑膜細(xì)胞增殖、細(xì)胞浸潤、血管翳生成及骨與軟骨破壞等病理變化;以及脾臟生發(fā)中心數(shù)量、淋巴細(xì)胞浸潤、白髓增生、紅髓浸潤的病理改變[14]。
1.4 統(tǒng)計學(xué)方法
2.1 AHD模型關(guān)節(jié)腫脹度、關(guān)節(jié)炎指數(shù)、致炎率和血壓值的變化情況
AA、AHD組大鼠免疫后第11天,右后足趾開始腫脹,隨著病程延長,關(guān)節(jié)腫脹度和關(guān)節(jié)炎指數(shù)逐漸升高,第20~23天關(guān)節(jié)炎指數(shù)處于較高水平,第27天后,關(guān)節(jié)炎指數(shù)開始降低,但關(guān)節(jié)腫脹仍維持較高水平。與AA組比較,AHD模型大鼠關(guān)節(jié)腫脹度、關(guān)節(jié)炎指數(shù)明顯升高(詳見圖1A、B)。與AA組相比,AHD模型大鼠炎癥發(fā)病率有升高趨勢(詳見圖1C)。手術(shù)法造模后第2周,HT模型及AHD模型大鼠血壓開始升高,隨著病程延長,血壓值逐漸升高且第4周達(dá)到平穩(wěn)值,與HT組相比,AHD模型大鼠血壓值明顯升高(詳見圖1D)。篩選成模大鼠后各組只數(shù):正常組8只,AA組7只,HT組9只,AHD組10只。
2.2 AHD模型大鼠胸主動脈結(jié)構(gòu)變化情況
如圖2所示,與正常組相比,HT、AHD模型大鼠血管中膜厚度、橫截面積明顯增加,管腔直徑明顯降低;與HT組大鼠相比,AHD模型大鼠血管中膜厚度、橫截面積明顯增加,管腔直徑明顯降低,提示HT、AHD模型大鼠出現(xiàn)胸主動脈血管重構(gòu),AA炎癥可加重2K1C引起的高血壓大鼠血管損傷。
注:與正常組比較,*P < 0.05,**P < 0.01;與AA組比較,#P < 0.05,##P < 0.01;與HT組比較,&P < 0.05。圖1 AHD模型足爪腫脹、關(guān)節(jié)炎指數(shù)、致炎率和血壓值的變化情況Note.Compared with the normal group,*P < 0.05,**P < 0.01; Compared with the AA group,#P < 0.05,##P < 0.01; Compared with the HT group,&P < 0.05.Fig.1 Changes of paw swelling, arthritis index, the incidence of inflammation and blood pressure of AHD model rats
注:A:正常組;B:AA組;C:HT組;D:AHD組。與正常組比較,**P < 0.01;與HT組比較,&P < 0.05。圖2 AHD模型大鼠胸主動脈結(jié)構(gòu)變化情況Note.A:Normal group; B:AA group; C:HT group; D: AHD group. Compared with the normal group,**P< 0.01; Compared with the HT group,&P< 0.05.Fig.2 Structural changes of thoracic aorta in the AHD model rats
注:A:正常組;B:AA組;C:HT組;D:AHD組。A、C:箭頭指正常關(guān)節(jié)腔及正常軟骨表面;B:箭頭指軟骨被嚴(yán)重破壞,關(guān)節(jié)腔大量炎癥細(xì)胞增生、浸潤;D:箭頭指關(guān)節(jié)腔有大量細(xì)胞浸潤、血管翳生成、骨與軟骨被破壞;與正常組比較,**P < 0.01;與AA組相比,#P < 0.05。圖3 AHD模型大鼠關(guān)節(jié)病理變化情況Note.A:Normal group; B:AA group; C:HT group; D: AHD group. A, C: Arrows point to normal articular and normal cartilage surfaces; B: Arrows point to the cartilage was severely damaged, a large number of inflammatory cell were present, infiltrating the joint cavity; D:Arrows point to the joint cavity showing a large number of cell infiltration, pannus formation, and bone and cartilage destruction. Compared with the normal group,**P < 0.01; Compared with the AA group,#P < 0.05.Fig.3 Pathological changes of the joints in AHD model rats
注:A:正常組;B:AA組;C:HT組;D:AHD組。W:白髓;R:紅髓;L:淋巴濾泡;GC:生發(fā)中心。與正常組相比,**P < 0.01;與AA組相比,#P < 0.05。圖4 AHD模型大鼠脾臟病理變化情況Note.A:Normal group; B:AA group; C:HT group; D: AHD group. W:White pulp; R:Red pulp; L:Lymphoid follicles; GC: Germinal centers. Compared with the normal group,**P < 0.01; Compared with the AA group,#P < 0.05.Fig.4 Pathological changes of spleen in the AHD model rats
2.3 AHD模型大鼠關(guān)節(jié)病理變化情況
關(guān)節(jié)病理檢查結(jié)果表明(圖3),與正常組相比,AA、AHD大鼠關(guān)節(jié)明顯腫脹,關(guān)節(jié)腔大量滑膜細(xì)胞增生、炎癥細(xì)胞浸潤、血管翳生成、骨與軟骨被破壞。與AA大鼠相比,AHD模型大鼠關(guān)節(jié)病理評分明顯升高。正常組和HT組大鼠關(guān)節(jié)組織無明顯病理改變。提示,AA、AHD大鼠出現(xiàn)了明顯的關(guān)節(jié)炎癥,且2K1C引起的高血壓可加重關(guān)節(jié)炎癥病理改變。
2.4 AHD模型大鼠脾臟病理變化情況
脾臟組織病理檢查結(jié)果顯示(圖4),與正常組相比,AA、AHD大鼠脾臟組織生發(fā)中心數(shù)量增加、大量淋巴細(xì)胞浸潤、白髓彌漫性增生、紅髓浸潤。與AA組相比,AHD模型大鼠脾臟組織病理評分明顯升高。正常組和HT組動物脾臟組織無明顯病理改變。提示,AA、AHD大鼠具有明顯的脾臟病理變化,2K1C引起的高血壓可加重AA大鼠的脾臟病理改變。
大量臨床研究表明[6,7,15-17],RA患者的心血管功能發(fā)生了異常改變,而高血壓等心血管疾病則是導(dǎo)致RA患者死亡的最重要因素之一,RA與HT二者互相影響加重了病情發(fā)展,建立AHD疾病模型對研究二類疾病關(guān)聯(lián)的發(fā)病機(jī)制以及篩選和研究治療藥物作用具有重要意義。有報道闡述了RA與HT二類疾病之間的相互作用機(jī)制,表明炎癥條件下升高的C-反應(yīng)蛋白(CRP)水平減少內(nèi)皮細(xì)胞一氧化氮(NO)、增加內(nèi)皮素-1的產(chǎn)生,引起血管收縮、血壓升高;而升高的血壓導(dǎo)致粘附分子、促炎因子的表達(dá)并進(jìn)入循環(huán)系統(tǒng),升高CRP的水平,誘發(fā)炎癥反應(yīng)[18]。
在本研究中,AHD模型大鼠血壓明顯升高,關(guān)節(jié)腫脹,關(guān)節(jié)腫脹指數(shù)、關(guān)節(jié)病理、主動脈血管損傷、脾臟病理變化明顯,且模型大鼠的血清中血管緊張素Ⅱ、腫瘤壞死因子α等炎癥介質(zhì)水平顯著升高(結(jié)果未附),具有RA和高血壓動物模型的典型特征,提示AHD模型成功建立。
AA模型是經(jīng)典的RA動物模型[10,19],造模第11天右后非致炎側(cè)足爪開始腫脹,第20天關(guān)節(jié)炎指數(shù)處于較高水平,第23天關(guān)節(jié)腫脹處于較高水平,第27天后關(guān)節(jié)腫脹開始緩解但仍維持較高水平,關(guān)節(jié)炎指數(shù)開始降低。手術(shù)法誘導(dǎo)的2K1C高血壓模型大鼠[20,21]在造模第2周血壓開始升高,第4~5周血壓可達(dá)穩(wěn)定值,第7~8周后血壓逐漸下降。因此,AHD大鼠的模型癥狀評價以造模第27~35天為宜。
本研究還初步觀察了RA和HT對各自疾病模型的影響。實(shí)驗(yàn)結(jié)果表明,與AA大鼠相比,AHD模型大鼠足爪腫脹度、關(guān)節(jié)腫脹指數(shù)明顯升高且關(guān)節(jié)炎發(fā)病病程早、發(fā)病率高,脾臟病理評分也明顯升高,提示高血壓可能加速了RA的炎癥進(jìn)程;與HT組大鼠相比,AHD模型大鼠血壓值明顯升高,胸主動脈的中膜厚度、橫截面積明顯增加,管腔直徑明顯降低,提示RA的炎癥過程加重了HT模型大鼠的血管損傷,導(dǎo)致血壓進(jìn)一步升高。
綜上,AHD模型癥狀明顯,操作簡單,是研究RA與高血壓的疾病病理機(jī)制、篩選治療藥物的理想動物模型。
[1] Wei F, Xu S, Jia X, et al. BAFF and its receptors involved in the inflammation progress in adjuvant induced arthritis rats[J].Int Immunopharmacol, 2016, 31:1-8.
[2] Essouma M, Noubiap JJ. Is air pollution a risk factor for rheumatoid arthritis?[J]. J Inflamm (Lond), 2015, 12:48.[3] Stamatelopoulos KS, Kitas GD, Papamichael CM, et al. Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study[J]. Arterioscler Thromb Vasc Biol, 2009, 29(10):1702-1708.
[4] S?dergren A, Karp K, Boman K, et al. Atherosclerosis in early rheumatoid arthritis: very early endothelial activation and rapid progression of intima media thickness[J]. Arthritis Res Ther, 2010, 12(4):R158.
[5] Han C, Robinson DW Jr, Hackett MV, et al. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis[J]. J Rheumatol, 2006, 33(11):2167-2172.
[6] Midtb? H, Gerdts E, Kvien TK, et al. The association of hypertension with asymptomatic cardiovascular organ damage in rheumatoid arthritis[J].Blood Press, 2016, 25(5):298-304.
[7] Rudominer RL, Roman MJ, Devereux RB, et al. Independent association of rheumatoid arthritis with increased left ventricular mass but not with reduced ejection fraction[J]. Arthritis Rheum, 2009, 60(1):22-29.
[8] 宋珊珊,張玲玲,魏偉.實(shí)驗(yàn)性關(guān)節(jié)炎動物模型建立及病理機(jī)制研究進(jìn)展[J].中國藥理學(xué)通報, 2011, 27(12): 1648-1652.
[9] Cervenka L, Vaněková I, MalJ, et al. Genetic inactivation of the B2 receptor in mice worsens two-kidney, one-clip hypertension: role of NO and the AT2 receptor[J]. J Hypertens, 2003, 21(8):1531-1538.[10] Wang D, Hu S, Wei Wet al. AngiotensinⅡ type 2 receptor correlates with therapeutic effects of losartan in rats with adjuvant-induced arthritis[J]. J Cell Mol Med, 2013, 17(12):1577-1587.
[11] 王文靖, 潘毅, 楊濤. 兩腎一夾型高血壓大鼠模型的改良及評價[J].中國實(shí)驗(yàn)方劑學(xué)雜志, 2012, 18(1): 203-205.
[12] 李培培, 解國雄, 宋珊珊, 等. 大鼠佐劑性關(guān)節(jié)炎模型表現(xiàn)特征及評價指標(biāo)[J].中國新藥雜志, 2012, 28(5): 453-457.
[13] Huang LL, Pan C, Wang L, et al. Protective effects of grape seed proanthocyanidins on cardiovascular remodeling in DOCA-salt hypertension rats[J]. J Nutr Biochem, 2015, 26(8): 841-849.
[14] Zhang L,Li P,Song S,et al. Comparative efficacy of TACI-Ig with TNF-alpha inhibitor and methotrexate in DBA/1 mice with collagen-induced arthritis[J]. Eur J Pharmacol,2013, 708(1-3):113-123.
[15] Sandoo A, Kitas GD, Carroll D, et al. The role of inflammation and cardiovascular disease risk on microvascular and macrovascular endothelial function in patients with rheumatoid arthritis: a cross-sectional and longitudinal study[J].Arthritis Res Ther, 2012, 14(3):R117.
[16] Ikdahl E, Rollefstad S, Hisdal J, et al. Sustained improvement of arterial stiffness and blood pressure after long-term rosuvastatin treatment in patients with inflammatory joint diseases: results from the RORA-AS Study[J]. PLoS One, 2016, 11(4): e0153440.[17] Amaya-Amaya J, Montoya-Sánchez L, Rojas-Villarraga A. Cardiovascular involvement in autoimmune diseases[J]. Biomed Res Int, 2014,(3):367359.
[18] Panoulas VF, Metsios GS, Pace AV, et al. Hypertension in rheumatoid arthritis[J]. Rheumatology (Oxford), 2008, 47(9):1286-1298.
[19] Chang Y, Jia X, Wei W, et al. CP-25, a novel compound, protects against autoimmune arthritis by modulating immune mediators of inflammation and bone damage[J]. Sci Rep, 2016,6:26239.
[20] Yu TT, Guo K, Chen HC, et al. Effects of traditional Chinese medicine Xin-Ji-Er-Kang formula on 2K1C hypertensive rats: role of oxidative stress and endothelial dysfunction[J]. BMC Complement Altern Med, 2013,13:173.
[21] Maia RC,Sousa LE,Santos RA, et al. Time-course effects of aerobic exercise training on cardiovascular and renal parameters in 2K1C renovascular hypertensive rats[J]. Braz J Med Biol Res, 2015, 48(11):1010-1022.
(安徽醫(yī)科大學(xué)臨床藥理研究所,抗炎免疫藥物教育部重點(diǎn)實(shí)驗(yàn)室,安徽省抗炎免疫藥物協(xié)同創(chuàng)新中心,合肥 230032)
目的 建立類風(fēng)濕關(guān)節(jié)炎復(fù)合高血壓疾病(arthritis-hypertension disease, AHD)大鼠模型,并對該模型的特點(diǎn)進(jìn)行評價。方法 實(shí)施外科手術(shù)用0.25 mm銀夾縮窄大鼠左腎動脈建立高血壓(hypertension, HT)模型,同時于大鼠左后足跖注射0.1 mL完全弗氏佐劑致炎建立AHD模型。無創(chuàng)血壓測量分析系統(tǒng)測量尾動脈壓。足爪容積測量儀測量大鼠非致炎側(cè)關(guān)節(jié)腫脹度,并分析關(guān)節(jié)炎指數(shù)與炎癥發(fā)生率。第35天處死大鼠,收集胸主動脈、踝關(guān)節(jié)及脾臟組織HE染色并進(jìn)行病理學(xué)檢查。結(jié)果 AHD模型大鼠關(guān)節(jié)明顯腫脹,關(guān)節(jié)腔大量滑膜細(xì)胞增生、炎癥細(xì)胞浸潤、血管翳形成,脾臟生發(fā)中心數(shù)量增加、大量淋巴細(xì)胞浸潤、白髓彌漫性增生、紅髓浸潤。關(guān)節(jié)炎指數(shù)、炎癥發(fā)生率以及關(guān)節(jié)、脾臟組織病理評分較佐劑性關(guān)節(jié)炎(adjuvant arthritis, AA)大鼠明顯升高;同時,AHD模型大鼠血壓顯著升高,胸主動脈中膜厚度、橫截面積明顯增加,管腔直徑明顯降低,且其血壓值和血管損傷程度較HT大鼠明顯升高或加重。結(jié)論 用完全弗氏佐劑足跖皮內(nèi)注射法合并外科手術(shù)縮窄左腎動脈法可成功建立大鼠AHD模型。
類風(fēng)濕關(guān)節(jié)炎復(fù)合高血壓;佐劑性關(guān)節(jié)炎;高血壓
Establishment and evaluation of a rat model of arthritis-hypertension disease
ZHANG Ying, ZHOU Yue, YAN Shang-xue*, WEI Wei
(Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti- inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center ofAnti-inflammatory and Immune Medicine, Hefei 230032, China)
Objective To establish and evaluate a rat model presenting symptoms of arthritis-hypertension disease (AHD). Methods A total of forty healthy 5-6 week-old male SD rats were used in this study. Hypertension was induced by constriction of the left renal artery by two kidney one clip (2K1C) with a 0.25 mm silver clamp, and AHD model was established by injecting 0.1 mL complete Freund adjuvant to the left hind paw. Tail artery pressure was measured with a non-invasive blood pressure measurement system. The degree of swelling in the non-inflammatory joint of rats was measured with a paw volume measuring instrument, the arthritis index and incidence of inflammation were evaluated. The rats were sacrificed on the 35thday. The thoracic aorta, ankle joint and spleen tissues were examined by pathology using HE staining. Results The joint of AHD model rat was significantly swollen, extensive synovial cell hyperplasia, inflammatory cell infiltration, vascular pannus formation, and bone and cartilage destruction. The number of germinal centers in spleen was increased, and a large number of lymphocyte infiltration, diffuse proliferation of white pulp, and red pulp infiltration were present. The arthritis index, incidence of inflammation and histopathological scores of the joint and spleen were significantly higher than adjuvant arthritis (AA) rats; meanwhile, the blood pressure of AHD model rat was significantly increased, the thickness and cross-sectional area of thoracic aorta were significantly increased, while the lumen diameter was significantly reduced. The blood pressure and vascular injury were significantly increased or aggravated compared with the HT rats. Conclusions A rat model of arthritis-hypertension disease is successfully established by using complete Freund adjuvant intradermal injection to the footpad and surgery to narrow the left renal artery.
Arthritis hypertension disease; Adjuvant arthritis; Hypertension
國家自然科學(xué)基金(81330081,81302784,81673444);安徽省自然科學(xué)基金(1508085MH182);安徽醫(yī)科大學(xué)博士科研資助基金(XJ201534)。
張影(1991-),女,碩士,研究方向:抗炎免疫藥理學(xué)。E-mail:1374393895@qq.com
嚴(yán)尚學(xué)(1973-),男,副研究員,碩士生導(dǎo)師,研究方向:抗炎免疫藥理學(xué)。E-mail:yan-shx@163.com
R-33
A
1671-7856(2017) 08-0034-06
10.3969.j.issn.1671-7856. 2017.08.007
2016-12-08