Clinical Journal of Gastroenterology最新文献_第3页

Real-time diagnosis of a lesion of the anal canal observed by endocytoscopy. 内吞镜观察肛管病变的实时诊断。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2025-01-06 DOI: 10.1007/s12328-024-02073-z

Taishi Okumura, Kinichi Hotta, Daisuke Aizawa, Kenichiro Imai, Sayo Ito, Kazunori Takada, Tadakazu Shimoda, Hiroyuki Ono

引用次数: 0

The first case of primary malignant melanoma of the esophagus to achieve pathologic complete response after preoperative ipilimumab + nivolumab followed by resection. 首例食管原发性恶性黑色素瘤患者在术前使用伊匹单抗+nivolumab并切除食管后获得病理完全反应。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-10-31 DOI: 10.1007/s12328-024-02050-6

Ryo Shibayama, Kentoku Fujisawa, Yusuke Ogawa, Hayato Shimoyama, Yu Ohkura, Aya Honda, Shusuke Haruta, Harushi Udagawa, Masaki Ueno, Yutaka Takazawa

{"title":"The first case of primary malignant melanoma of the esophagus to achieve pathologic complete response after preoperative ipilimumab + nivolumab followed by resection.","authors":"Ryo Shibayama, Kentoku Fujisawa, Yusuke Ogawa, Hayato Shimoyama, Yu Ohkura, Aya Honda, Shusuke Haruta, Harushi Udagawa, Masaki Ueno, Yutaka Takazawa","doi":"10.1007/s12328-024-02050-6","DOIUrl":"10.1007/s12328-024-02050-6","url":null,"abstract":"Primary malignant melanoma of the esophagus is a rare disease with a poor prognosis. Surgical resection is common, but there is no consensus on perioperative treatment. Studies have reported the efficacy of programmed cell death-1 inhibitors (e.g., nivolumab, pembrolizumab) and anti-cytotoxic T-lymphocyte-associated antigen 4 agents (e.g., ipilimumab) in treating malignant melanoma. Here, we present the first case of primary malignant melanoma of the esophagus with lymph node metastases treated with nivolumab and ipilimumab followed by resection, achieving a pathologic complete response. A 75-year-old man presented with dysphagia. Esophagogastroduodenoscopy revealed a black, elevated lesion in the mid-thoracic esophagus. Biopsy confirmed primary malignant melanoma of the esophagus, showing tumor cells with melanin deposition, positive for HBM45 and S-100 staining. Computed tomography showed enlarged lymph nodes in the subclavian and mediastinum regions, suggesting metastases. After two courses of preoperative chemotherapy with ipilimumab and nivolumab, which significantly shrank the tumor, the patient underwent robot-assisted subtotal esophagectomy and 3-field lymph node dissection. Histopathological examination revealed no tumors or lymph node metastases, confirming a pathologic complete response. Given the rarity and poor prognosis of primary malignant melanoma of the esophagus, this case provides valuable insights for treatment strategies.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"29-36"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rectal 5-aminosalicylic acid induced pancreatitis in a patient with newly diagnosed ulcerative colitis. 5-氨基水杨酸致直肠溃疡性结肠炎1例。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-11-29 DOI: 10.1007/s12328-024-02063-1

Carl Cosgrave, Irene Lu, Jack Shembrey, Neel Heerasing

引用次数: 0

Intracholecystic papillary neoplasm associated with an invasive carcinoma with cholecystocolonic fistula: a case report. 胆囊内乳头状肿瘤合并浸润性癌合并胆囊结肠瘘1例。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-12-12 DOI: 10.1007/s12328-024-02079-7

Tetsushi Azami, Yuichi Takano, Naoki Tamai, Jun Noda, Masataka Yamawaki, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Takafumi Ogawa, Masatsugu Nagahama

{"title":"Intracholecystic papillary neoplasm associated with an invasive carcinoma with cholecystocolonic fistula: a case report.","authors":"Tetsushi Azami, Yuichi Takano, Naoki Tamai, Jun Noda, Masataka Yamawaki, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Takafumi Ogawa, Masatsugu Nagahama","doi":"10.1007/s12328-024-02079-7","DOIUrl":"10.1007/s12328-024-02079-7","url":null,"abstract":"Intracholecystic papillary neoplasm and cholecystocolonic fistula are both relatively rare diseases. Here, we report a case of a preoperative intracholecystic papillary neoplasm associated with invasive carcinoma and a transverse colonic fistula of the gallbladder. A 79-year-old female patient presented to our hospital with persistent right upper quadrant pain for several months and was suspected to have intracholecystic papillary neoplasm associated with an invasive carcinoma by computed tomography and endoscopic ultrasound. A gallbladder tumor biopsy was pathologically diagnosed as intracholecystic papillary neoplasm. Preoperative cholecystocolonic fistula diagnosis enabled planning not only for cholecystectomy, but also for transverse colon partial resection. Pathological examination of the resected specimen revealed intracholecystic papillary neoplasm associated with an invasive carcinoma with subserosal invasion. No malignant findings were observed in the fistula. This is a rare condition, but the presence or absence of cholecystocolonic fistula should be considered before performing intracholecystic papillary neoplasm surgery.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"188-194"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of hepatocellular carcinoma arising from the intraductal hepatic bile duct without parenchymal lesion. 一例由肝导管内胆管引发的肝细胞癌，无实质病变。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-10-22 DOI: 10.1007/s12328-024-02054-2

Yu Nakashima, Kazuhiro Hiramatsu, Masahide Fukaya, Taro Aoba, Atsuki Arimoto, Hiromasa Yamashita, Yoshifumi Arai, Takehito Kato

{"title":"A case of hepatocellular carcinoma arising from the intraductal hepatic bile duct without parenchymal lesion.","authors":"Yu Nakashima, Kazuhiro Hiramatsu, Masahide Fukaya, Taro Aoba, Atsuki Arimoto, Hiromasa Yamashita, Yoshifumi Arai, Takehito Kato","doi":"10.1007/s12328-024-02054-2","DOIUrl":"10.1007/s12328-024-02054-2","url":null,"abstract":"Hepatocellular carcinoma (HCC) rarely presents as an intraductal tumor with no parenchymal lesions. Here, we present a case of HCC arising from an intrahepatic bile duct. A 74-year-old man who had been treated with direct-acting antiviral therapy for hepatitis C virus infection was referred to our hospital because of elevated serum prothrombin levels induced by vitamin K absence II (PIVKA-II). Initial imaging revealed no findings suspicious of HCC; however, repeat CT six months later revealed dilation of the intrahepatic bile ducts in the lateral segment of the liver. Cholangiography revealed a significant stricture of B3, and biopsy suggested adenocarcinoma. A left hepatectomy was performed with a preoperative diagnosis of intrahepatic cholangiocarcinoma. Although a surface nodule on the lateral segment of the liver, suspicious for intrahepatic metastasis, was found intraoperatively, radical resection was performed. Histopathological examination revealed a tumor filling the intrahepatic bile duct from the stump to the peripheral bile duct, with no infiltration into the liver parenchyma. The surface nodule is a dilated peripheral bile duct filled with a tumor with no extrabiliary invasion. Immunohistochemistry suggested HCC. No tumor lesions were observed in the hepatic parenchyma, and the tumor was finally diagnosed as HCC stemming from the biliary epithelium.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"195-201"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of non-occlusive mesenteric ischemia following hepatocellular carcinoma rupture. 一例肝癌破裂后非闭塞性肠系膜缺血病例。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-10-18 DOI: 10.1007/s12328-024-02051-5

Ivana Radosavaljevic, Takao Miwa, Masafumi Kawade, Shinji Unome, Kenji Imai, Koji Takai, Fuminori Yamaji, Tetsuya Fukuta, Shusuke Nomura, Masahito Shimizu

{"title":"A case of non-occlusive mesenteric ischemia following hepatocellular carcinoma rupture.","authors":"Ivana Radosavaljevic, Takao Miwa, Masafumi Kawade, Shinji Unome, Kenji Imai, Koji Takai, Fuminori Yamaji, Tetsuya Fukuta, Shusuke Nomura, Masahito Shimizu","doi":"10.1007/s12328-024-02051-5","DOIUrl":"10.1007/s12328-024-02051-5","url":null,"abstract":"Hepatocellular carcinoma (HCC) rupture is a severe complication, yet there is limited literature on cases complicated by subsequent non-occlusive mesenteric ischemia (NOMI). A 77-year-old man presented to our hospital with abdominal pain and shock. Arterial phase computed tomography (CT) hepatic arteriography revealed a 77-mm HCC in the left lobe with active extravasation, and the feeding artery was embolized. Although the abdominal pain initially subsided after the procedure, it recurred the next day. A contrast-enhanced CT scan revealed pneumatosis intestinalis and decreased enhancement of the small intestinal wall. The patient underwent resection of the affected segment of the small intestine and was ultimately diagnosed with NOMI based on pathological findings. This is the first reported case of NOMI following HCC rupture. Given the high mortality associated with these conditions, clinicians should be aware of this rare complication and ensure comprehensive evaluation and timely intervention to improve patient outcomes.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"119-124"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of esophagogastric submucosal hematoma with hemorrhagic shock. 一例食管胃黏膜下血肿伴失血性休克病例。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-11-21 DOI: 10.1007/s12328-024-02069-9

Yumiko Kaise, Kaname Uno, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Waku Hatta, Tomoyuki Koike, Hideki Ota, Kei Takase, Atsushi Masamune

{"title":"A case of esophagogastric submucosal hematoma with hemorrhagic shock.","authors":"Yumiko Kaise, Kaname Uno, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Waku Hatta, Tomoyuki Koike, Hideki Ota, Kei Takase, Atsushi Masamune","doi":"10.1007/s12328-024-02069-9","DOIUrl":"10.1007/s12328-024-02069-9","url":null,"abstract":"A 70-year-old woman had been taking steroids for granulomatosis with polyangiitis since the age of 60 years and warfarin for deep vein thrombosis since the age of 63 years. She was admitted to the emergency unit of our hospital in a shock vital with complaints of sudden onset of epigastralgia, nausea, and melena. Laboratory data revealed anemia, hypoalbuminemia, and coagulation disorders. Enhanced computed tomography demonstrated extravasation in the middle part of the gastric body in an extensive submucosal hematoma extending from the upper esophagus to the entire gastric body. Emergency esophagogastroduodenoscopy depicted a large submucosal hematoma and a large amount of fresh blood in the stomach; however, active bleeding was not identified. Two sessions of interventional radiology treatment in the emergency department, followed by an intensive care, successfully treated the patient without any complications. We report a unique case of a sudden-onset esophagogastric submucosal hematoma with hemorrhagic shock requiring an intensive care and interventional radiology treatment. In this case, the extensive warfarization and the fragility in vascular and connective tissue components in the submucosa due to the long-term steroid therapy and the granulomatosis with polyangiitis-related alteration might comprehensively cause severe esophagogastric submucosal hematoma even without any apparent triggers.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"48-52"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of gastric/duodenal diffuse large B cell lymphoma observed during the administration of tacrolimus/azathioprine for dermatomyositis. 他克莫司/硫唑嘌呤治疗皮肌炎期间发生胃/十二指肠弥漫性大B细胞淋巴瘤1例。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-12-05 DOI: 10.1007/s12328-024-02077-9

Ayako Yamamoto, Ayumi Ito, Shinichi Nakamura, Tomoaki Higuchi, Masayoshi Harigai, Akihito Shinohara, Tomoko Yamamoto, Yoji Nagashima, Katsutoshi Tokushige

{"title":"A case of gastric/duodenal diffuse large B cell lymphoma observed during the administration of tacrolimus/azathioprine for dermatomyositis.","authors":"Ayako Yamamoto, Ayumi Ito, Shinichi Nakamura, Tomoaki Higuchi, Masayoshi Harigai, Akihito Shinohara, Tomoko Yamamoto, Yoji Nagashima, Katsutoshi Tokushige","doi":"10.1007/s12328-024-02077-9","DOIUrl":"10.1007/s12328-024-02077-9","url":null,"abstract":"The patient was diagnosed with amyopathic dermatomyositis complicated with interstitial pneumonia (IP) at age 35. She had been treated with prednisolone and maintained on tacrolimus (TAC) + azathioprine (AZA). Eight years later, she experienced epigastric pain, and esophagogastroduodenoscopy (EGD) led to a diagnosis of duodenal ulcer. The pain did not improve, so she visited our hospital, where she presented with malaise, anemia, and weight loss. An EGD revealed submucosal tumor-like protrusions in the anterior and posterior walls of the gastric antrum and punched-out ulcers with auricle-like marginal swelling on the inside of the protrusions. Irregular-shaped punched-out ulcers were also observed in the duodenal bulb. Lymphoma was suspected, and biopsy was performed. Histopathology showed diffuse large, atypical lymphocytes with enlarged nuclei, and immunohistochemical staining revealed CD20-positive cells. Diffuse large B cell lymphoma (DLBCL) was diagnosed, which was considered as lymphomas arising in immune deficiency/dysregulation. After discontinuing TAC + AZA for three months, the gastrointestinal symptoms improved, and on EGD, the duodenal lesions had disappeared, with only a shallow depression covered with regenerated epithelium remaining in the posterior wall of the gastric antrum. Seven months later, the patient underwent follow-up EGD, and the disappearance of lymphoma cells was confirmed histopathologically by biopsy. Repeated and detailed endoscopic examination should be considered in an immunosuppressed patient with treatment-resistant gastric or duodenal ulcers.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"67-73"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of needle tract seeding of pancreatic adenosquamous carcinoma after a single endoscopic ultrasound-guided tissue acquisition. 单次内窥镜超声引导组织采集后胰腺腺鳞癌针道播种病例。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-11-21 DOI: 10.1007/s12328-024-02068-w

Taro Hanaoka, Kosuke Okuwaki, Nobuyuki Nishizawa, Masafumi Watanabe, Kai Adachi, Akihiro Tamaki, Tomohisa Iwai, Mitsuhiro Kida, Yusuke Kumamoto, Chika Kusano

{"title":"A case of needle tract seeding of pancreatic adenosquamous carcinoma after a single endoscopic ultrasound-guided tissue acquisition.","authors":"Taro Hanaoka, Kosuke Okuwaki, Nobuyuki Nishizawa, Masafumi Watanabe, Kai Adachi, Akihiro Tamaki, Tomohisa Iwai, Mitsuhiro Kida, Yusuke Kumamoto, Chika Kusano","doi":"10.1007/s12328-024-02068-w","DOIUrl":"10.1007/s12328-024-02068-w","url":null,"abstract":"Needle tract seeding (NTS) is a rare complication of endoscopic ultrasound-guided tissue acquisition (EUS-TA). Herein, we report the case of an 83 year-old man who presented with a solid mass in the pancreatic tail, measuring 35 mm in diameter, with cystic degeneration. EUS-TA was performed using a 22-gauge biopsy needle, with a single puncture via the stomach; however, no definitive pathological diagnosis was achieved. Due to the strong suspicion of malignancy, surgery was performed at the patient's request, and the postoperative pathological diagnosis was pancreatic adenosquamous carcinoma. One year after surgery, computed tomography revealed a string of bead-like nodules within the gastric wall. Esophagogastroduodenoscopy revealed three submucosal, tumor-like raised lesions aligned in a row on the upper posterior wall of the gastric body. EUS detected a solid mass with cystic degeneration. Histological findings from EUS-TA specimens were consistent with those from the pancreatic resection specimen, leading to a diagnosis of NTS. Although reports of NTS have been increasing in recent years, cases of NTS occurring after only a single puncture remain extremely rare. This case clearly demonstrates that NTS can occur even after a single puncture, highlighting the importance of obtaining thorough informed consent regarding this risk prior to performing EUS-TA.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"234-241"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The improvement of a refractory enterocutaneous fistula with colchicine in a patient with Crohn's disease who had an MEFV gene mutation. 一名克罗恩病患者因 MEFV 基因突变，使用秋水仙碱后难治性肠瘘得到改善。

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Clinical Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-11-20 DOI: 10.1007/s12328-024-02061-3

Yoshihiro Yokoyama, Kotaro Akita, Yuki Hayashi, Tomoe Kazama, Hiroki Kurumi, Katsuyoshi Matusoka, Hiroshi Nakase

{"title":"The improvement of a refractory enterocutaneous fistula with colchicine in a patient with Crohn's disease who had an MEFV gene mutation.","authors":"Yoshihiro Yokoyama, Kotaro Akita, Yuki Hayashi, Tomoe Kazama, Hiroki Kurumi, Katsuyoshi Matusoka, Hiroshi Nakase","doi":"10.1007/s12328-024-02061-3","DOIUrl":"10.1007/s12328-024-02061-3","url":null,"abstract":"Enterocutaneous fistulas (ECFs) occurring in the setting of Crohn's disease (CD) are difficult to cure with medical treatment alone and affects a patient's quality of life. A 39-year-old man was diagnosed with an ileocolitis-type CD in 2007. His inflammation was insufficiently controlled despite the administration of an anti-tumor necrosis factor-alpha antibody. Therefore, he underwent subtotal colectomy, terminal ileal resection, and ileostomy for multiple colon and anal stenoses in Dec 2015. The patient subsequently received ustekinumab; however, purulent discharge was observed from a postoperative scar around the umbilicus in July 2019. In July 2021, enteroscopy and magnetic resonance imaging (MRI) showed an ECF extending from the small intestine to the umbilicus. Upon referral to our hospital, laboratory data showed elevated C-reactive protein (CRP) and serum amyloid A (SAA). After receiving colchicine, his purulent discharge disappeared, and his CRP and SAA levels rapidly decreased. Enteroscopy and MRI performed 1 year and 5 months after the administration of colchicine revealed ECF closure. Genetic analysis revealed that the patient harbored an MEFV exon 1 (E84K) mutation.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"81-88"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0