[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fHuIfgaIi_O2KCYAzIOsrLReGxFAHwhm0kVD55Cqyh7Y":8,"$fIjXsQ-9dqFb5C65Qk16_uDtMo9X_mbkJRCT5VjFSya8":55,"$fnYCe11cjKK-yptO3uTmv5fVV-_ciRlIyYYTtrrZeWHA":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},65620,868966,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//Sn4y5XFopDyAUMV8myik3Yz75ketV11V.png","王坚楠","浙江大学医学院附属第一医院","甲状腺乳腺外科","主治医师",45,0,"乳腺癌术后辅助化疗方案 TH：实用指南","","https://ystcdn.venuertc.com/venue/AI/1c4b5bd2-ad29-482d-8aa2-0b5d2ffa4dc4.jpg","\u003Ch2 id=\"material_title\" class=\"th-chemotherapy-title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">乳腺癌术后辅助化疗方案 TH：实用指南\u003C/h2>\n\n\u003Cdiv class=\"th-chemotherapy-desc\">\n  其实，许多人在术后会开始接触辅助化疗，而乳腺癌领域的TH方案（紫杉类联合曲妥珠单抗）就是常见的选择。它包含几种不同成分和剂型，使用时每个细节都非常关键。本文会梳理7个核心用药点，包括药理机制、服用方法、不良反应、相互作用、特殊人群用药、储存要求以及漏服处理，帮你用得明白、用得安全。\n\u003C/div>\n\n\u003C!-- 01 药品作用机制（只讲机制） -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-01\">\n  \u003Ch3 class=\"th-chemotherapy-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 🔬 药理作用机制一览\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      TH方案的常用药品主要包括紫杉类药物（如多西他赛）和曲妥珠单抗。\u003Cbr>\n      \u003Cb>紫杉类药物\u003C/b>通过抑制细胞微管的正常功能，让细胞无法分裂和复制，从而阻止肿瘤细胞继续增长。\u003Cbr>\n      \u003Cb>曲妥珠单抗\u003C/b>则是一种单克隆抗体，它可特异性结合HER2受体，阻断细胞信号传递，帮助免疫系统清除异常细胞。\u003Cbr>\n      两种药物协同，有效增加化疗的成功率。化疗药物本身不会影响健康细胞的新陈代谢，但在杀伤异常细胞方面作用强劲。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>紫杉类：破坏微管结构，阻止细胞增殖\u003C/li>\n      \u003Cli>曲妥珠单抗：靶向HER2蛋白，干扰细胞信号\u003C/li>\n    \u003C/ul>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Chan, A., & Delaloge, S. (2016). Trastuzumab in HER2-positive breast cancer: mechanism of action and clinical efficacy. \u003Cem>Journal of Clinical Oncology\u003C/em>, 34(12), 1515-1520.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 02 药品成分与剂型、服用技巧 -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-02\">\n  \u003Ch3 class=\"th-chemotherapy-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 💊 药品成分、剂型与正确使用\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      TH方案里经常用到的药品分别有不同成分与剂型。以多西他赛和曲妥珠单抗为例，二者均为注射剂，严格按照医生制定的方案静脉给药。\n      \u003Cbr>多西他赛浓度和曲妥珠单抗剂量需个体化调整，每次剂量按体重和具体方案来制定，通常不用于口服，也不自行调整剂量。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>曲妥珠单抗：首剂8 mg/kg，后续6 mg/kg，每3周一次\u003C/li>\n      \u003Cli>多西他赛：每3周一次，具体剂量依照体表面积计算\u003C/li>\n      \u003Cli>药品均为注射给药，不能口服或自行改变途径\u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      正确做法：施药时需有专科医护人员操作，任何副作用都要及时告知医师。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Swain, S. M., Baselga, J., Kim, S. B., et al. (2015). Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. \u003Cem>New England Journal of Medicine\u003C/em>, 372(8), 724-734.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 03 💡 用药时间和方法 -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-03\">\n  \u003Ch3 class=\"th-chemotherapy-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 📅 用药时间与给药方式\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      化疗给药严格分期，不能随意更改。TH方案通常每3周1次，连续使用6-8个周期。曲妥珠单抗维持治疗一般推荐持续1年，每3周定时注射，能最大限度保持药效。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>不可提前/延后化疗：需严格遵照方案\u003C/li>\n      \u003Cli>注射前需完成体检，评估器官功能\u003C/li>\n      \u003Cli>不能自行停药或间断疗程\u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      正确做法：定期复查心脏、肝肾等功能，确保安全用药。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Piccart-Gebhart, M. J., Procter, M., Leyland-Jones, B., et al. (2005). Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. \u003Cem>New England Journal of Medicine\u003C/em>, 353(16), 1659-1672.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 04 🚩 相互作用和不能合用药物 -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-04\">\n  \u003Ch3 class=\"th-chemotherapy-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 🚧 药物相互作用与禁用药品\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      TH方案药品与某些药物间可能发生严重相互作用，尤其是心脏药物、免疫制剂、抗真菌药等。\n      \u003Cbr>\n      紫杉类与抗凝药（如华法林等）并用时会增加出血风险，曲妥珠单抗和蒽环类药物合用易致心脏毒性。抗真菌药（如酮康唑）可影响多西他赛代谢，使副作用放大。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>曲妥珠单抗不推荐与蒽环类药物同用\u003C/li>\n      \u003Cli>多西他赛慎与强CYP3A4抑制剂同服\u003C/li>\n      \u003Cli>应用期间应告知医生所有正在使用的药品\u003C/li>\n      \u003Cli>应避免含酒精、滋补类药物自行服用\u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      特别提醒：切勿自行添加其他药物，发生用药冲突时需立即停药并就医。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Perez, E. A., Romond, E. H., Suman, V. J., et al. (2011). Trastuzumab plus adjuvant chemotherapy for HER2-positive breast cancer: results from NSABP B-31. \u003Cem>Journal of Clinical Oncology\u003C/em>, 29(25), 3366-3373.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 05 👩‍🦳 特殊人群用药调整 -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-05\">\n  \u003Ch3 class=\"th-chemotherapy-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 👨‍👩‍🦽 特殊人群用药要点\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      老年人、肝肾功能减退、孕妇哺乳期或体重偏低患者，用药方案往往需作微调。\n      \u003Cbr>\n      剂量调整需要专科医生根据具体年龄、体表面积、肝肾指标来决定。对于孕妇及哺乳期女性，曲妥珠单抗和紫杉类药物均禁止使用，因为有致畸及乳汁分泌影响可能。体重偏低应逐步增加观察强度，暂不随意减量。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>老年患者需密切监测心脏功能\u003C/li>\n      \u003Cli>肝肾功能异常时需检测指标以调整剂量\u003C/li>\n      \u003Cli>孕妇哺乳期原则上禁用\u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      正确做法：每次用药前主动如实告知身体状况与药物使用史，便于医生调整方案。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-case\">\n      案例：一位48岁女性在标准TH方案下，随访期间体重未变，但出现心功能波动，及时调整剂量后副反应减轻。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Baselga, J., & Swain, S. M. (2010). Novel anticancer targets: revisiting ERBB2 and discovering ERBB3. \u003Cem>Nature Reviews Cancer\u003C/em>, 10(7), 488-487.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 06 ⚡ 常见不良反应及处理 -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-06\">\n  \u003Ch3 class=\"th-chemotherapy-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 ⚠️ 常见不良反应和安全处理\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      TH方案可能的副作用包括脱发、乏力、恶心、血象下降、心功能异常等。曲妥珠单抗常见的心脏毒性，紫杉类则易影响白细胞数。\n      \u003Cbr>\n      部分患者还会因免疫反应出现过敏，如皮疹、呼吸困难。根据临床数据，曲妥珠单抗导致心衰的发生率为2-4%，紫杉类药物引起骨髓抑制的概率为15%以上。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>注射过程中如有发热、皮疹应立刻停止用药\u003C/li>\n      \u003Cli>化疗后出现乏力、脱发、血象下降要及时就医\u003C/li>\n      \u003Cli>心脏不适、呼吸困难需第一时间告知医生\u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      正确做法：自觉异常应立刻就诊，并由医护评估是否继续用药或调整方案。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-case\">\n      临床上使用紫杉类药物期间，部分患者出现白细胞降低，及时补充白介素后恢复正常。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Slamon, D. J., Eiermann, W., Robert, N., et al. (2011). Adjuvant trastuzumab in HER2-positive breast cancer. \u003Cem>New England Journal of Medicine\u003C/em>, 365(2), 1273-1283.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 07 📦 储存条件与漏服处理 -->\n\u003Cdiv class=\"th-chemotherapy-section th-bg-07\">\n  \u003Ch3 class=\"th-chemotherapy-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 📦 储存要求与漏服应对\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      药品如曲妥珠单抗和紫杉类需在2-8℃冷藏保存，避免冻存。稀释后药液应24小时内使用，剩余药品绝不二次使用。过期药品丢弃，不再尝试继续注射。\n      \u003Cbr>\n      如果漏服某一周期，应第一时间与医疗团队联系，不可自行补药或更改周期。弄错周期或过量用药均有明显风险，务必规范操作。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>曲妥珠单抗、紫杉类药品均需冷藏\u003C/li>\n      \u003Cli>开封后密封存放，防止污染\u003C/li>\n      \u003Cli>漏服需尽快补用且仅由专科操作\u003C/li>\n      \u003Cli>过期药品需及时丢弃，切勿自行处理\u003C/li>\n    \u003C/ul>\n    \u003Cp class=\"th-chemotherapy-case\">\n      案例：有患者化疗漏服一周期，及时恢复后未见严重副作用，但补用必须在医生监测下完成。\n    \u003C/p>\n    \u003Cp class=\"th-chemotherapy-ref\">\n      \u003Cspan class=\"th-chemotherapy-quote\">引用：\u003C/span>\n      \u003Cspan>\n        Blackwell, K. L., Burstein, H. J., Storniolo, A. M., et al. (2010). Randomized study of lapatinib alone or in combination with trastuzumab in women with ErbB2-positive, trastuzumab-refractory metastatic breast cancer. \u003Cem>Journal of Clinical Oncology\u003C/em>, 28(7), 1124-1130.\n      \u003C/span>\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 结尾总结与再提醒 -->\n\u003Cdiv class=\"th-chemotherapy-summary\">\n  \u003Ch3 class=\"th-chemotherapy-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">总结 ✨ 用药优势与安全要点\u003C/h3>\n  \u003Cdiv class=\"th-chemotherapy-content\">\n    \u003Cp>\n      TH辅助化疗方案优势在于联合使用紫杉类和曲妥珠单抗，既发挥细胞抑制作用，又精准靶向HER2，化疗效果优于单一用药。最重要的是，所有环节需专科医师主导，自己不得随意更改方法或添加其他药品。心脏功能、肝肾状态以及用药时间都要持续关注，遇到疑问及时咨询医护人员，确保治疗安全和效果。\u003Cbr>\n      合理保存药品、规范操作、如实报告副作用，是安全用药的关键。每一步都关乎健康，科学用药让恢复更安心。\n    \u003C/p>\n    \u003Cul class=\"th-chemotherapy-list\">\n      \u003Cli>规范方案施药，循序渐进不随意更改\u003C/li>\n      \u003Cli>关注副作用，即时反馈，安全用药为首\u003C/li>\n      \u003Cli>遇特殊情况及时与医生沟通，不自行处理\u003C/li>\n    \u003C/ul>\n    \u003Cp>\n      掌握这些要点，就是安全用药的底线，也能帮家人朋友规避风险。用药不怕麻烦，多问一句更放心。\n    \u003C/p>\n  \u003C/div>\n\u003C/div>\n\n\u003C!-- 全局美化样式 -->\n\u003Cstyle>\n.th-chemotherapy-title {\n  font-size: 34px;\n  color: #316c7f;\n  padding: 42px 0 24px 0;\n  text-align: center;\n  font-weight: 700;\n  letter-spacing: 2px;\n  background: linear-gradient(90deg, #f5f7fa 70%, #d1ebef 100%);\n}\n\n.th-chemotherapy-desc {\n  padding: 22px 32px;\n  background: #f9fafc;\n  border-radius: 22px;\n  margin-bottom: 32px;\n  font-size: 18px;\n  color: #234352;\n  box-shadow: 0 2px 8px rgba(49, 108, 127, 0.05);\n  max-width: 860px;\n  margin-left: auto;\n  margin-right: auto;\n}\n\n.th-chemotherapy-section {\n  max-width: 860px;\n  margin: 0 auto 40px auto;\n  border-radius: 16px;\n  padding: 24px 34px 20px 34px;\n  box-shadow: 0 4px 16px rgba(49, 108, 127, 0.09);\n  position: relative;\n}\n\n.th-chemotherapy-subtitle {\n  font-size: 26px;\n  color: #2b6375;\n  background: linear-gradient(90deg, #e3f7fa 60%, #c3e6e7 100%);\n  padding: 16px 20px 14px 18px;\n  border-radius: 12px;\n  margin-bottom: 22px;\n  font-weight: 700;\n  box-shadow: 0 1px 8px rgba(49, 108, 127, 0.04);\n}\n\n.th-chemotherapy-content {\n  font-size: 18px;\n  color: #304a53;\n  line-height: 1.9;\n}\n\n.th-chemotherapy-list {\n  margin: 18px 0 10px 38px;\n  padding-left: 0;\n  font-size: 17px;\n  color: #527c89;\n  list-style: disc;\n}\n.th-chemotherapy-list li {\n  margin-bottom: 8px;\n}\n\n.th-chemotherapy-ref {\n  font-size: 16px;\n  margin-top: 14px;\n  color: #4d8595;\n  background: #f1f6f8;\n  border-radius: 12px;\n  padding: 9px 14px;\n}\n.th-chemotherapy-quote {\n  margin-right: 7px;\n  font-weight: 600;\n  color: #4190a5;\n}\n\n.th-chemotherapy-case {\n  font-size: 16px;\n  background: #fff9e2;\n  border-left: 4px solid #ffcd6a;\n  padding: 10px 19px;\n  border-radius: 9px;\n  margin: 12px 0 0 0;\n  color: #82652f;\n}\n\n/* 淡雅渐变背景分节 */\n.th-bg-01 { background: linear-gradient(90deg, #f8fcfd 90%, #e6f3f6 100%);}\n.th-bg-02 { background: linear-gradient(90deg, #f6fbfc 80%, #e4f8fa 100%);}\n.th-bg-03 { background: linear-gradient(90deg, #f4fafd 75%, #dbeff5 100%);}\n.th-bg-04 { background: linear-gradient(90deg, #f2fbfd 85%, #cbe6eb 100%);}\n.th-bg-05 { background: linear-gradient(90deg, #f6fafb 70%, #d2ebe2 100%);}\n.th-bg-06 { background: linear-gradient(90deg, #f8faf9 95%, #e8f4ec 100%);}\n.th-bg-07 { background: linear-gradient(90deg, #f9fbf5 90%, #e6f5cc 100%);}\n\n.th-chemotherapy-summary {\n  max-width: 840px;\n  margin: 0 auto 38px auto;\n  padding: 32px 32px 26px 32px;\n  background: linear-gradient(90deg, #f2f6f9 70%, #e1efed 100%);\n  border-radius: 16px;\n  box-shadow: 0 2px 14px rgba(49, 108, 127, 0.07);\n  font-size: 19px;\n  color: #2a5562;\n}\n\u003C/style>\n\n","\u003Ch2 id=\"material_title\" class=\"th-chemotherapy-title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0",525,"2025-09-03 17:59:08","乳腺癌, 辅助化疗, TH方案, 曲妥珠单抗, 多西他赛, 化疗不良反应, 医院监测, 药物相互作用","了解乳腺癌术后TH辅助化疗的药理机制、不良反应及用药注意事项，确保安全有效治疗，及时咨询专业医生是保障治疗成功的关键。","2025-09-08 14:03:59",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},[],[]]