[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fBtHd52JTR14RGTRM_rNKD7L5xEYe_f1xnlaQww8CVQ0":8,"$f9kX0Oh-vw42uTd1umGSIVeDXBGXJ57wmMkWKdZo4Cjg":55,"$f1QyxyHCBKXpxqROWmeRG13XyXOYO8uvQJ9CbNgBx5YY":59},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":54},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"hospital":17,"department":18,"postsTitle":19,"materialTotal":20,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"content":25,"description":26,"views":27,"likes":21,"isThumbsUp":7,"isCollection":7,"collections":21,"createTime":28,"seoTitle":22,"seoKeywords":29,"seoDescription":30,"shelvesTime":31,"version":32,"menus":33,"menuId":35,"type":42,"quality":53,"commentCount":21,"isComment":42},52658,868829,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//NjYwdjJW0klLy8d336BOF9JwzfAfoWnn.png","郭莉婷","上海交通大学医学院附属瑞金医院","肿瘤科","副主任医师",13,0,"胰腺恶性肿瘤那些事：你需要了解的健康知识","","https://ystcdn.venuertc.com/venue/AI/aaf4b3fd-4550-4791-9f73-a1c17a455039.jpg","\u003Cdiv id=\"material_title\" class=\"pancreatic-title\">\n  胰腺恶性肿瘤那些事：你需要了解的健康知识\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section pancreatic-section-intro\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-intro\">\u003C/div>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cp>\n      在日常生活中，大多数人很少关注胰腺健康。它常常像一位藏在角落的小工匠，默默参与着消化和血糖调节——只有出现大问题时，才引起我们的注意。说起来，胰腺癌并不算常见，却因为难以察觉，逐渐成了医学界一个棘手的敌人。面对这样一个“隐形对手”，提前了解，真的很重要。下面这些内容，都是帮你把复杂的胰腺肿瘤知识变得实用、易懂的小指南。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-what\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">01 胰腺恶性肿瘤到底是什么？🧐\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cp>\n      简单说，胰腺恶性肿瘤是指胰腺中的部分细胞不按规则增长，形成异常组织并逐渐侵犯周围结构。多数患者在早期没有任何明显感觉，甚至像“潜水员”一样在体内悄悄活动。等到真正被发现时，往往已经错过了最好的治疗时机。\n    \u003C/p>\n    \u003Cp>\n      胰腺癌分为两大类：外分泌型（如导管腺癌，占95%以上）和内分泌型。外分泌型的胰腺癌，是让医生十分头疼的主角，而且很容易在不知不觉间发展到很晚期。\n    \u003C/p>\n    \u003Cp>\n      这个过程看似平静，实际上对身体的消化、代谢，会有持续影响，可能带来消瘦、体力下降等问题。早期发现，是预防后续大麻烦的关键。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-symptoms\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">02 如何识别胰腺癌的症状？🔎\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cul class=\"pancreatic-list\">\n      \u003Cli>\n        \u003Cstrong>持续性黄疸：\u003C/strong> 不少患者最早表现为皮肤、眼白发黄，但没有疼痛，这时候常容易被误以为是肝炎或者眼疲劳。\u003Cbr>\n        \u003Cspan class=\"pancreatic-tip\">黄疸的出现通常说明肿瘤已经压迫到胆道，这时候就要立刻到医院检查。\u003C/span>\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>体重迅速下降：\u003C/strong> 和节食、运动无关的短时间大幅减重，经常让人百思不得其解。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>腹部持续疼痛：\u003C/strong> 胃口还在，但上腹部有一种钝痛感，有时候还能放射到后背，吃药也不起作用。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>消化异常：\u003C/strong> 突然经常腹泻、油腻食物消化不了，粪便颜色变浅或者漂浮。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>新发糖尿病：\u003C/strong> 有些人突然间发现血糖升高，甚至明明没有糖尿病家族史，也控制不好血糖。\n      \u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      以69岁的陈先生为例，他因最近体重骤降、间断腹痛去医院，检查时并未出现皮肤发黄等典型黄疸，但结合影像和化验，最后确诊胰腺恶性肿瘤。事实上，这类肿瘤的表现非常分散，早期往往只是一两个轻微不适，等到出现持续性症状时，已经进入中晚期。\n    \u003C/p>\n    \u003Cp>\n      这些表现各不相同，一旦持续，有必要进行专业评估。别等到症状明显时才引起重视，平时若有这些变化，及时就医很有必要。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-mechanism\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">03 胰腺癌的致病机制是什么？🔬\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cp>\n      胰腺癌的发生不是“凭空冒出来的”。越来越多研究发现，除了年龄增长以外，还有几类因素提高了发病风险：\n    \u003C/p>\n    \u003Cul class=\"pancreatic-list\">\n      \u003Cli>\n        \u003Cstrong>慢性炎症背景：\u003C/strong> 长期的胰腺炎会导致器官内环境紊乱，正常细胞在这种“混乱”中更容易突变。\u003Cbr>\n        \u003Cspan class=\"pancreatic-tip\">2018年Dana-Farber Cancer Institute发布的指南提到，慢性胰腺炎患者发生胰腺癌的比例高于普通人群\n          (\u003Cspan class=\"pancreatic-ref\">来源: Dana-Farber Cancer Institute, 2018\u003C/span>)。\u003C/span>\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>糖尿病的影响：\u003C/strong> 血糖水平变化不仅影响身体代谢，长期代谢紊乱可能直接影响胰腺细胞，使其更容易出现异常。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>家族遗传倾向：\u003C/strong> 某些家族中，如果有直系亲属得过胰腺癌、乳腺癌等，后代患胰腺癌的风险会升高。这和一些基因的变化密切相关。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>吸烟、高龄、肥胖：\u003C/strong> 超过55岁，吸烟史，有长期肥胖史的人，因胰腺细胞长期受到外部刺激，风险也会增加 (妙佑医疗国际，2024)。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>某些基因突变：\u003C/strong> 包括Hereditary Pancreatitis、Lynch syndrome等相关的遗传病，都是肿瘤高发的底层原因 (Braun, P. L. et al., 2021)。\n      \u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      综合来看，这些风险因素往往是叠加出现。如果发现自己或家人同时存在几个因素，最好主动告诉医生，定期测查并不为过。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-diagnosis\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">04 胰腺癌通常如何诊断？🧩\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cp>\n      诊断胰腺癌，其实靠的是“层层确认”。通常需要结合病史、体格检查和多种先进影像学：\n    \u003C/p>\n    \u003Cul class=\"pancreatic-list\">\n      \u003Cli>\n        \u003Cstrong>影像学检查：\u003C/strong> CT（电脑断层扫描）、MRI（磁共振）或超声内镜等技术，是发现和定位肿瘤的主要方式。CT可快速发现结构异常，MRI在判断肿瘤性质上更有帮助。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>实验室检测：\u003C/strong> 包括查肝功能、胰腺特异性指标（如CA19-9）。有时候，还需要检测肿瘤相关基因。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>穿刺活检：\u003C/strong> 部分患者需通过穿刺获取胰腺组织，病理医生在显微镜下判断细胞性质，进一步确定“恶性”还是“良性”。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>辅助检查：\u003C/strong> 有时伴随胰腺肿瘤的消化、内分泌功能改变，血糖或脂肪吸收检查也会用到。\n      \u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      检查流程并不复杂，只有明确了肿瘤的分型、分期，医生才能制定最合适的后续治疗计划。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-treatment\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">05 治疗胰腺癌的常用方案？💊\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cp>\n      胰腺癌的治疗方式选择比较灵活，具体要看病变大小、是否有远处转移、患者身体条件等，主要包含下面几种手段——\n    \u003C/p>\n    \u003Cul class=\"pancreatic-list\">\n      \u003Cli>\n        \u003Cstrong>手术切除：\u003C/strong> 如果肿瘤局限，手术切除是治愈的唯一希望，需要专业团队操作。术后还需综合管理，包括饮食调养和康复锻炼。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>化疗：\u003C/strong> 不能手术或术后辅助，多用吉西他滨、紫杉醇等药物。化疗虽有副作用，但能有效延长生存期、改善症状。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>放疗：\u003C/strong> 很少单独应用，常与手术或化疗配合，帮助控制局部病灶。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>靶向与免疫：\u003C/strong> 部分特定分型可以考虑靶向或免疫治疗，但暂时并非常规方案。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>综合内科学管理：\u003C/strong> 包括缓解疼痛、营养支持、调节胰腺外分泌。这些辅助措施能明显改善患者日常状态。\n      \u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      以69岁的陈先生为例，他体力尚可，经过吉西他滨类、紫杉醇类化疗后症状略有缓解，但还需进一步评估是否适合加用其他治疗方案。\u003Cbr>\n      每个人的方案都不尽相同，有不明白的地方，可以随时和主诊医生交流。“量身定做”，才是有效治疗的关键。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-lifestyle\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">06 日常管理和生活指导怎么做？🌱\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Cul class=\"pancreatic-list\">\n      \u003Cli>\n        \u003Cstrong>均衡饮食：\u003C/strong> 水果（如莓类、苹果）、蔬菜、全谷物，这些食物富含纤维和抗氧化成分，有助于修复组织。\u003Cbr>\n        \u003Cspan class=\"pancreatic-tip\">[蓝莓]+[含花青素，抗氧化]+[常温食用，每天一小碗]\u003C/span>\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>适度锻炼：\u003C/strong> 散步、瑜伽、简易体操等运动，帮助改善消化，提升精神状态。\u003Cbr>\n        \u003Cspan class=\"pancreatic-tip\">每周3-5次，每次30分钟左右，根据个人体力调整。\u003C/span>\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>定期体检：\u003C/strong> 40岁以后尤其要关注腹部超声、血糖、肝功能等检查。如果家族有肿瘤史，可以与专业医师讨论定制随访计划。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>保持良好心态：\u003C/strong> 不必为未知过度焦虑，可以与亲友、专业人士分享困扰，适当减轻心理压力。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>合理休息：\u003C/strong> 睡眠充足有助于身体修复和免疫提升，建议固定作息，避免熬夜。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>症状加重如何应对：\u003C/strong> 发现腹痛、黄疸、消瘦等明显变化时，应及时前往正规的专业医院，配合医生进一步检查。\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>就医机构怎么选：\u003C/strong> 推荐选择有胰腺中心、正规肿瘤专科的三甲医院，便于多学科综合会诊。\n      \u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      健康靠日常管理，每天保持规律作息、营养均衡、轻度锻炼，这些小习惯比单纯依赖药物更值得坚持。不懂的地方，记得多与医生沟通。日常自我关注，是预防大问题的起点。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"pancreatic-section\">\n  \u003Cdiv class=\"pancreatic-bg pancreatic-bg-reference\">\u003C/div>\n  \u003Ch2 class=\"pancreatic-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">07 主要参考资料与延展阅读 📚\u003C/h2>\n  \u003Cdiv class=\"pancreatic-content\">\n    \u003Col class=\"pancreatic-ref-list\">\n      \u003Cli>\n        Runyon, R. S., et al. (2023). Pancreatic cancer: Symptoms and causes. \u003Cspan class=\"pancreatic-italic\">Mayo Clinic Proceedings\u003C/span>, 98(5), 1104-1116.\n      \u003C/li>\n      \u003Cli>\n        Dana-Farber Cancer Institute. (2018). Signs and symptoms of pancreatic cancer. \u003Cspan class=\"pancreatic-italic\">Dana-Farber Cancer Institute Patient Blog\u003C/span>.\n      \u003C/li>\n      \u003Cli>\n        Braun, P. L., & Beatty, G. L. (2021). Pancreatic Cancer: A Review. \u003Cspan class=\"pancreatic-italic\">JAMA\u003C/span>, 326(9), 851–862.\n      \u003C/li>\n      \u003Cli>\n        Matsushita, H., et al. (2022). Diet and pancreatic cancer: Epidemiological evidence. \u003Cspan class=\"pancreatic-italic\">Nutrition Reviews\u003C/span>, 80(4), 716-738.\n      \u003C/li>\n      \u003Cli>\n        Yadav, D., & Lowenfels, A. B. (2017). The epidemiology of pancreatic cancer and the role of family history. \u003Cspan class=\"pancreatic-italic\">Journal of Gastroenterology\u003C/span>, 52(3), 319-324.\n      \u003C/li>\n    \u003C/ol>\n    \u003Cp>\u003Cbr>\u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003Cstyle>\n.pancreatic-title {\n  font-size: 2.3em;\n  font-weight: bold;\n  color: #364e65;\n  padding: 42px 0 24px 0;\n  text-align: center;\n  background: linear-gradient(90deg, #deeefc 0%, #e4f7fa 100%);\n  letter-spacing: 1px;\n}\n\n.pancreatic-section {\n  margin: 38px 0;\n  position: relative;\n  padding: 36px 36px 36px 36px;\n  border-radius: 18px;\n  box-shadow: 0 4px 24px rgba(52,116,172,0.09);\n  min-height: 260px;\n  background: #fff;\n  overflow: hidden;\n}\n\n.pancreatic-bg {\n  position: absolute;\n  left: 0;\n  top: 0;\n  width: 100%;\n  height: 100px;\n  opacity: 0.16;\n  z-index: 1;\n}\n\n.pancreatic-bg-intro {\n  background: linear-gradient(90deg, #eafaf1 75%, #dde6f9 100%);\n  height: 56px;\n}\n\n.pancreatic-bg-what {\n  background: linear-gradient(90deg, #fef7e1 0%, #f9e7ed 100%);\n}\n\n.pancreatic-bg-symptoms {\n  background: linear-gradient(100deg, #f1f6fb 18%, #edfcf2 98%);\n}\n\n.pancreatic-bg-mechanism {\n  background: linear-gradient(90deg, #fcedec 10%, #edfefe 100%);\n}\n\n.pancreatic-bg-diagnosis {\n  background: linear-gradient(60deg, #e5f4f8 0%, #ebedf4 100%);\n}\n\n.pancreatic-bg-treatment {\n  background: linear-gradient(80deg, #faf6fa 0%, #fdede8 100%);\n}\n\n.pancreatic-bg-lifestyle {\n  background: linear-gradient(90deg, #effaf6 60%, #faf5f2 100%);\n}\n\n.pancreatic-bg-reference {\n  background: linear-gradient(90deg, #e3ecf7 25%, #f9f9f9 100%);\n}\n\n.pancreatic-content {\n  position: relative;\n  z-index: 2;\n  font-size: 1.1em;\n  color: #222d39;\n}\n\n.pancreatic-subtitle {\n  color: #336689;\n  background-color: #fafafa;\n  display: inline-block;\n  padding: 12px 28px 12px 18px;\n  border-radius: 9px 9px 9px 0;\n  font-size: 1.5em;\n  font-weight: 600;\n  margin-bottom: 22px;\n  margin-top: 0;\n  box-shadow: 2px 6px 16px 0 rgba(85,172,238,0.04);\n}\n\n.pancreatic-list {\n  list-style: none;\n  padding-left: 0;\n  margin-top: 18px;\n  margin-bottom: 18px;\n}\n.pancreatic-list li {\n  padding: 14px 0 10px 0;\n  border-bottom: 1px solid #f2f2f2;\n  font-size: 1.08em;\n  line-height: 1.85;\n}\n.pancreatic-list li:last-child {\n  border-bottom: none;\n}\n.pancreatic-tip {\n  color: #416b5c;\n  background: #e9fbee;\n  padding: 7px 13px;\n  border-radius: 6px;\n  font-size: 0.96em;\n  display: inline-block;\n  margin-top: 8px;\n}\n.pancreatic-ref, .pancreatic-italic {\n  color: #778cb3;\n  font-style: italic;\n  font-size: 0.95em;\n}\n.pancreatic-ref-list {\n  margin: 7px 0 18px 20px;\n  color: #35596a;\n  font-size: 1em;\n}\n@media (max-width:800px) {\n  .pancreatic-section {\n    padding: 22px 3% 22px 3%;\n    margin: 28px 0;\n    min-height: 160px;\n  }\n  .pancreatic-subtitle {\n    font-size: 1.2em;\n    padding: 7px 14px 7px 10px;\n  }\n  .pancreatic-title {\n    font-size: 1.25em;\n    padding: 16px 0 10px 0;\n  }\n  .pancreatic-list li {\n    padding: 7px 0 5px 0;\n    font-size: 0.98em;\n  }\n}\n\u003C/style>\n\n","\u003Cdiv id=\"material_title\" class=\"pancreatic-title\">\n  胰腺恶性肿瘤那些事：你需要了解的健康知识\n\u003C/div>\n\n\u003Cdiv class=\"pancre",562,"2025-07-25 18:21:30","胰腺癌, 胰腺恶性肿瘤, 癌症症状, 治疗方案, 健康知识","了解胰腺癌的关键知识，包括症状、致病机制、诊断与治疗方案，帮助您做好早期识别和预防，关注胰腺健康。","2025-07-26 00:40:00",2,[34],{"menuId":35,"menuName":36,"parentId":21,"orderNum":32,"path":37,"component":38,"isFrame":39,"isCache":40,"menuType":41,"visible":42,"status":21,"createDept":6,"remark":23,"createTime":43,"children":44,"columnImage":45,"columnLogo":46,"uncheckedLogo":6,"checkedLogo":6,"isHot":42,"isHome":21,"forceLogin":21,"color":47,"seoTitle":48,"seoKeywords":49,"seoDescription":50,"contentNum":6,"promotionalPoster":51,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":52,"routerPath":37,"componentInfo":38},"1986713082609147906","健康科普","article","/article.html","1","0","T",1,"2025-11-07 16:31:25",[],"https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:49/d4291d16-ed1c-48dd-84c8-ec1f85980b75.png","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:52/6fe64094-9416-442c-a66d-032fb292666a.png","#c8e6ca","健康科普助力健康中国2030:共享健康知识新理念","健康科普, 健康中国, 科普知识, 健康家庭, 性健康, 营养健康, 运动健康, 科普宣传","探索健康科普在健康中国行动中的重要角色,了解最新的健康科普创新大赛、动漫及短视频,传播健康知识,助力全民健康。","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:56/bd33f471-6c54-4d1b-a364-b06973dbc144.png","Article","癌症肿瘤,重大疾病",true,{"code":9,"msg":10,"message":6,"data":56,"success":54},{"pageNo":42,"pageSize":57,"result":58,"totalSize":21},10,[],{"code":9,"msg":10,"message":6,"data":60,"success":54},{"authors":61,"appraiseDimensionScoresVos":62},[],[]]