[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fL7YEiN2lYIE4Gx2mVvGgntP1fPOwVIJqLlHkkDfD-qY":8,"$famRfQjJekAGj7LMcBv5QKwrVVpGe8Cpy0eBi5C7TcyY":55,"$f27UTOC8czep5x6to53KiNtcF9LTu1iKnmsiEaMjaey8":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},66609,867660,[],"https://ystcdn.venuertc.com/learnMaterial/ystApp//BpMwG8byHGzwHSvExUdJYJDx5D0BmHht.png","孙彩萍","绍兴市人民医院","肿瘤内科","主任医师",40,0,"胆囊恶性肿瘤的科学认知与应对策略","","https://ystcdn.venuertc.com/venue/AI/e1abeada-c2c4-4344-9a54-25a8120026f4.jpg","\n\u003Cdiv class=\"cholecyst_tumor_container\">\n  \u003Ch1 id=\"material_title\" class=\"cholecyst_tumor_title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">\n    胆囊恶性肿瘤的科学认知与应对策略\n  \u003C/h1>\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg01\">\n    \u003Ch2 class=\"cholecyst_tumor_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 什么是胆囊恶性肿瘤？\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Cp>\n        在饭桌上，有人说“肝胆相照”，其实胆囊是一个不起眼的小朋友，帮我们储存和调节消化液，每天默默工作。胆囊恶性肿瘤，简单来说，就是胆囊里长出了异常细胞，这些细胞本不该在那儿，却开始抢地盘，甚至影响整个身体。又因胆囊本身体积小，被发现时多数已是晚期，成为不少患者心头的隐忧。对这个问题不妨多花几分钟了解，不管你此刻身体健康，还是有家人已经在关注胆囊问题，多一份了解就能多一份主动权。   \n      \u003C/p>\n      \u003Cp>\n        胆囊肿瘤有良性和恶性之分，恶性肿瘤就是我们俗称的“胆囊癌”，它主要出现在胆囊的内壁，会慢慢侵犯周围组织。根据美国国家糖尿病、消化和肾脏疾病研究所的数据，胆囊癌相对少见，每年发病率并不高，但正因为隐匿才更容易被忽略。\u003Cspan class=\"cholecyst_tumor_emoji\">🔎\u003C/span>\n      \u003C/p>\n      \u003Cdiv class=\"cholecyst_tumor_tip\">其实，将胆囊癌视作身体的小警钟，及时关注才能减少困扰。\u003C/div>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg02\">\n    \u003Ch2 class=\"cholecyst_tumor_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 胆囊恶性肿瘤的警示信号有哪些？\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Cp>\n        说起来，胆囊癌早期往往“悄无声息”，没有显著不适。轻微变化其实容易混淆，比如偶尔觉得右上腹有点闷、消化有点不好，大多数人只当是肠胃小问题。皮肤微微发黄、眼白偶尔些许变色，这些症状早期很轻，不容易引起重视。\u003Cspan class=\"cholecyst_tumor_emoji\">🟡\u003C/span>\n      \u003C/p>\n      \u003Cp>\n        但进入明显阶段，这些信号会持续且加重：腹部疼痛不再只是偶尔，而是一天多次甚至持续，需要用药才能缓解；体重明显减轻，常常两三个月瘦了一圈；食欲下降，怎么吃都觉得没味，有些人会出现皮肤明显发黄、瘙痒，并且乏力。小便颜色变深，或者大便颜色变浅，摸腹部时甚至能感觉到包块。\u003Cbr>\n        \u003Cspan class=\"cholecyst_tumor_emoji\">⚠️\u003C/span>\n      \u003C/p>\n      \u003Cp>\n        有位中年男性患者，刚开始只是感觉饭后右上腹微闷，两年后手术切除胆囊，恢复期未觉异常，但一年后又开始胸壁疼痛，并且腋窝淋巴结肿大，检查发现已转移。这个例子提醒我们，腹部和皮肤的小异常如果持续出现、越来越明显，不能拖延，建议及时到医院消化科或肿瘤科检查。\u003Cbr>\n      \u003C/p>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg03\">\n    \u003Ch2 class=\"cholecyst_tumor_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 胆囊恶性肿瘤的形成原因是什么？\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>慢性炎症反复刺激：\u003C/strong>\n          胆囊结石是最常见的“幕后推手”。石头长期摩擦胆囊壁，会慢慢让细胞发生变化，从而引起异常细胞滋生。美国印第安人及慢性胆囊炎患者被发现胆囊癌概率更高（Merck Manual, Saiman & Nguyen, 2023）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>家族基因和年龄：\u003C/strong>\n          基因有时也会“添把火”。年龄大于65岁，尤其有家族肝胆疾病史的人群，发生率略高。研究显示，高龄患者诊断时常晚期，疗效受限。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>生活习惯因素：\u003C/strong>\n          高脂肪饮食、长期肥胖和部分环境暴露（如接触某些化学物质）会增加胆囊负担，增加风险（Jain SK, et al., 2015, World J Gastroenterol）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>某些慢性疾病：\u003C/strong>\n          比如原发性硬化性胆管炎（PSC），本身是一种胆道疾病，但合并胆囊癌的可能性翻倍。胆囊聚积息肉较大时，即使是良性也需警惕演变。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        上述原因往往是多因素叠加，单独某一点并不意味着一定会得病，但如果多项重叠，需更关注胆囊健康。引用数据显示，大约85%的胆囊癌患者合并胆结石（Saiman & Nguyen, 2023），这说明长期的慢性刺激不可忽视。\n      \u003C/p>\n      \u003Cdiv class=\"cholecyst_tumor_tip\">\n        其实，了解原因有助于理解胆囊健康，不必焦虑，但有风险因素要更主动关注。\n      \u003C/div>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg04\">\n    \u003Ch2 class=\"cholecyst_tumor_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 如何诊断胆囊恶性肿瘤？\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Cp>\n        如果有持续或进展的右上腹症状，医生会建议影像学检查来判断是否有异常。常用的检查方式如下：\u003Cspan class=\"cholecyst_tumor_emoji\">🤖\u003C/span>\n      \u003C/p>\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>超声检查：\u003C/strong>第一步常用，方便、无创，能看出胆囊形态变化，发现肿物或结石。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>CT或MRI：\u003C/strong>进一步分析肿物具体情况，判断肿瘤有无扩散或占位效应。先进的MRCP（磁共振胰胆管成像）更适合细致观察胆道结构（Saiman & Nguyen, 2023）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>肿瘤标志物：\u003C/strong>抽血查肿瘤指标，比如CA19-9、CEA等，但这些结果只能辅助判断，绝不能单独作为诊断依据。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>活检：\u003C/strong>对于影像上不确定的情况，通过细针穿刺或者手术取组织做病理，是最终确诊的“金标准”。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        有时还需要内镜逆行胰胆管造影（ERCP）来采集样本和疏通阻塞。以上检查建议由消化科、肿瘤科医生根据具体情况做决定，长期有胆囊炎或结石史、出现腹部持续不适的人群，建议每年做一次超声筛查比较合适。如果出现皮肤和眼白持续发黄、腹部疼痛逐渐加重，不宜拖延，应尽快到医院进行相关检查。\n      \u003C/p>\n      \u003Cdiv class=\"cholecyst_tumor_tip\">\n        检查手段很多，具体选择要听医生安排，切忌盲目自查自诊。\n      \u003C/div>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg05\">\n    \u003Ch2 class=\"cholecyst_tumor_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 胆囊恶性肿瘤的治疗预期是什么？\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Cp>\n        胆囊癌的治疗以手术为主，早期发现时通过胆囊切除有可能治愈。但多数患者确诊时已是晚期，此时治疗目标以控制症状和延长生存期为主（Nguyen, 2023，Merck Manual）。\n      \u003C/p>\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>手术切除：\u003C/strong>早期局限型可直接切除胆囊，有些特殊情况下会做联合肝脏部分切除。对早期患者效果较好。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>支架及对症治疗：\u003C/strong>晚期或有胆管阻塞时，医生会通过内镜插管植入支架，减少黄疸和疼痛，改善瘙痒等不适。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>化疗及放疗：\u003C/strong>尤其在肿瘤晚期，控制肿瘤进展和症状。尽管不能治愈，但可改善生活质量。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>靶向及免疫治疗：\u003C/strong>近年来个别患者可用新型药物，但临床效果因人而异，还需要进一步的研究和数据支持。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        举例来说，前文提到那位已婚男性患者，患有原发性高血压，在胆囊癌术后进行了两年多的恢复，后续因复发和转移需要多种药物维持，并结合镇痛、降压、辅助输液等方案。这个病例说明晚期胆囊癌可通过对症药物改善生活质量，但不易彻底治愈。\n      \u003C/p>\n      \u003Cp>\n        整体上，胆囊恶性肿瘤的生存期与发现时间密切相关。早发现早治疗为最佳路径。美国妙佑医疗（Mayo Clinic）指出，早期手术切除胆囊癌，五年生存率可达约80%；而晚期则大幅下降，多数维持在20%以下（Mayo Clinic, “Gallbladder Cancer,” 2023）。\n      \u003C/p>\n      \u003Cdiv class=\"cholecyst_tumor_tip\">\n        医疗过程需要耐心配合，家属支持和正规肿瘤科辅助同样重要。\n      \u003C/div>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg06\">\n    \u003Ch2 class=\"cholecyst_tumor_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 如何在日常生活中维护胆囊健康？\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Cp>\n        胆囊健康其实离不开细节。说生活调理，不只是饮食习惯，更包括合理运动和情绪管理。这里强调正面做法，帮你远离不必要的胆囊负担。\u003Cspan class=\"cholecyst_tumor_emoji\">🌱\u003C/span>\n      \u003C/p>\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>多吃新鲜蔬菜：\u003C/strong>丰富纤维能帮助胆囊排空、减少结石风险，建议每餐有两份绿色蔬菜。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>优质蛋白摄入：\u003C/strong>比如鱼、豆制品类，这些食材不加重胆囊负担，有助细胞修复，对于术后或慢性炎症期的身体尤为有益。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>规律作息与适度运动：\u003C/strong>每天轻度运动30分钟，比如快走、游泳，让胆汁流通更顺畅，减少胆道拥堵。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>科学管理慢病：\u003C/strong>高血压、糖尿病病人，要在医生指导下规范服药，避免因疾病合并症加重胆囊损伤。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>定期医疗随访：\u003C/strong>有结石、家族病史或曾经手术者，每年做一次超声检查，有过早期症状者遵医嘱复查。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        最后，保持良好心态同样重要。研究发现，长期压力、失眠也会影响消化系统功能，从而间接作用于胆囊（Jain SK et al., World J Gastroenterol, 2015）。所以，偶尔给自己放松的空间，不仅帮你远离焦虑，对身体同样有好处。\n      \u003C/p>\n      \u003Cdiv class=\"cholecyst_tumor_tip\">\n        日常吃好、睡好、动起来，胆囊也会更健康！\n      \u003C/div>\n    \u003C/div>\n  \u003C/div>\n\n  \u003Cdiv class=\"cholecyst_tumor_section cholecyst_tumor_bg07\">\n    \u003Ch2 class=\"cholecyst_tumor_subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">参考文献\u003C/h2>\n    \u003Cdiv class=\"cholecyst_tumor_text\">\n      \u003Col>\n        \u003Cli>\n          Saiman, Y., & Nguyen, M. (2023). \u003Cem>Biliary Tract and Gallbladder Tumors\u003C/em>. Merck Manual, Consumer Version. Retrieved from \u003Ca href=\"https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/tumors-of-the-biliary-tract-and-gallbladder/overview-of-biliary-tract-and-gallbladder-tumors\" target=\"_blank\">https://www.merckmanuals.com/home/\u003C/a>\n        \u003C/li>\n        \u003Cli>\n          Mayo Clinic. (2023). \u003Cem>Gallbladder Cancer – Symptoms & Causes\u003C/em>. Mayo Clinic Foundation for Medical Education and Research. Available at: \u003Ca href=\"https://www.mayoclinic.org/diseases-conditions/gallbladder-cancer/symptoms-causes/\" target=\"_blank\">https://www.mayoclinic.org/\u003C/a>\n        \u003C/li>\n        \u003Cli>\n          Jain SK, Singh P, et al. (2015). \u003Cem>Gallbladder cancer epidemiology, pathogenesis, and molecular genetics: Current knowledge and future perspectives\u003C/em>. World Journal of Gastroenterology, 21(26), 8322-8332. DOI: \u003Ca href=\"https://doi.org/10.3748/wjg.v21.i26.8322\" target=\"_blank\">10.3748/wjg.v21.i26.8322\u003C/a>\n        \u003C/li>\n      \u003C/ol>\n    \u003C/div>\n  \u003C/div>\n\u003C/div>\n\n\u003Cstyle>\n.cholecyst_tumor_container {\n  max-width: 800px;\n  margin: 30px auto 30px auto;\n  padding: 24px 32px 40px 32px;\n  background-color: #f8f9fa;\n  font-family: 'Helvetica Neue', Arial, 'PingFang SC', 'Microsoft YaHei', sans-serif;\n  color: #313942;\n  border-radius: 18px;\n  box-shadow: 0px 4px 20px #e9ecef;\n}\n.cholecyst_tumor_title {\n  text-align: center;\n  font-size: 36px;\n  font-weight: 700;\n  line-height: 48px;\n  letter-spacing: 2px;\n  color: #286681;\n  margin-bottom: 40px;\n  padding-top: 14px;\n}\n.cholecyst_tumor_subtitle {\n  font-size: 26px;\n  margin-bottom: 18px;\n  font-weight: 600;\n  color: #318ca2;\n  line-height: 1.4;\n  padding: 12px 0 4px 0;\n  border-bottom: 1px solid #e2e6ea;\n  text-shadow: 0px 1px 3px #d7ecec;\n}\n\n.cholecyst_tumor_text {\n  font-size: 18px;\n  line-height: 1.8;\n  margin-bottom: 18px;\n  margin-top: 0px;\n  padding: 2px 6px 8px 12px;\n}\n.cholecyst_tumor_text p {\n  padding-bottom: 8px;\n}\n.cholecyst_tumor_text ul {\n  padding-left: 20px;\n  margin-top: 8px;\n}\n.cholecyst_tumor_text ul li {\n  margin-bottom: 9px;\n  line-height: 1.7;\n}\n.cholecyst_tumor_text ol {\n  margin-left: 22px;\n  margin-bottom: 8px;\n  padding-bottom: 6px;\n}\n.cholecyst_tumor_text a {\n  color: #218aae;\n  text-decoration: underline;\n}\n.cholecyst_tumor_tip {\n  background: linear-gradient(90deg, #e8f5e9 30%, #c5e1e4 100%);\n  border-left: 6px solid #40abd7;\n  padding: 12px 18px;\n  border-radius: 8px;\n  font-weight: 500;\n  font-size: 17px;\n  margin-top: 7px;\n  color: #217c99;\n  margin-bottom: 8px;\n}\n\n.cholecyst_tumor_emoji {\n  font-size: 22px;\n  margin-left: 5px;\n  vertical-align: middle;\n}\n\n/* 淡雅背景图渐变风格 */\n.cholecyst_tumor_section {\n  margin-bottom: 34px;\n  padding: 20px 18px 26px 22px;\n  border-radius: 12px;\n  box-shadow: 0px 2px 12px #f2fcfc;\n  position: relative;\n}\n\n/* chapter背景渐变风格 */\n.cholecyst_tumor_bg01 {\n  background: linear-gradient(120deg, #e1eafd 65%, #f1faee 100%);\n}\n.cholecyst_tumor_bg02 {\n  background: linear-gradient(110deg, #d6e8f5 70%, #fcfcf3 100%);\n}\n.cholecyst_tumor_bg03 {\n  background: linear-gradient(90deg, #f0efea 60%, #e7f3e6 100%);\n}\n.cholecyst_tumor_bg04 {\n  background: linear-gradient(100deg, #e5f3fa 70%, #f8edea 100%);\n}\n.cholecyst_tumor_bg05 {\n  background: linear-gradient(120deg, #f8ecff 80%, #eef9fc 100%);\n}\n.cholecyst_tumor_bg06 {\n  background: linear-gradient(100deg, #e3f1e8 75%, #f8fce7 100%);\n}\n.cholecyst_tumor_bg07 {\n  background: linear-gradient(110deg, #f9eaea 80%, #e8f5fe 100%);\n}\n\n@media only screen and (max-width: 510px) {\n  .cholecyst_tumor_container {\n    max-width: 98vw;\n    padding: 10px 2vw;\n  }\n  .cholecyst_tumor_title {\n    font-size: 27px;\n    line-height: 32px;\n    padding-top: 7px;\n    margin-bottom: 24px;\n  }\n  .cholecyst_tumor_subtitle {\n    font-size: 19px;\n    margin-bottom: 10px;\n    padding: 6px 0 2px 0;\n  }\n  .cholecyst_tumor_text {\n    font-size: 16px;\n    padding: 2px 3px 8px 8px;\n  }\n  .cholecyst_tumor_tip {\n    font-size: 15px;\n    padding: 8px 13px;\n    margin-top: 5px;\n  }\n  .cholecyst_tumor_section {\n    padding: 10px 7px 15px 7px;\n    margin-bottom: 20px;\n  }\n}\n\u003C/style>\n\n","\n\u003Cdiv class=\"cholecyst_tumor_container\">\n  \u003Ch1 id=\"material_title\" class=\"cholecyst_tumor_title\" sty",526,"2025-09-17 13:47:23","胆囊癌, 胆囊恶性肿瘤, 胆囊健康, 如何诊断胆囊癌, 胆囊癌治疗","了解胆囊恶性肿瘤的重要性，识别其警示信号，掌握诊断与治疗方案，为自身及家人健康把关。","2025-09-27 10:08:44",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},[],[]]