Journal of investigative medicine high impact case reports最新文献_第10页

Concurrent Coccidioidomycosis and Mycobacterium abscessus Infection in Chronic Obstructive Pulmonary Disease. 慢性阻塞性肺疾病并发球虫菌病和脓肿分枝杆菌感染。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-04-28 DOI: 10.1177/23247096251334229

Lakshmi Kattamuri, Angelica Zambrano, Sparsha Reddy Duvvuru, Kunal Sharma, Abhizith Deoker

{"title":"Concurrent Coccidioidomycosis and Mycobacterium abscessus Infection in Chronic Obstructive Pulmonary Disease.","authors":"Lakshmi Kattamuri, Angelica Zambrano, Sparsha Reddy Duvvuru, Kunal Sharma, Abhizith Deoker","doi":"10.1177/23247096251334229","DOIUrl":"https://doi.org/10.1177/23247096251334229","url":null,"abstract":"Coccidioidomycosis, endemic in the southwestern United States, can lead to severe pulmonary complications, particularly in chronic obstructive pulmonary disease (COPD) patients with poor lung reserves. Mycobacterium abscessus has a predisposition for structurally damaged lungs, commonly causing difficult-to-treat bronchiectasis and cavitary lesions. We present the case of a 58-year-old patient with advanced COPD and a remote history of pulmonary coccidioidomycosis diagnosed 30 years earlier, who was found to have sputum and radiographic evidence of M. abscessus cavitary lung disease 4 years prior to admission, but was lost to follow-up. The current presentation is attributed to the progression of untreated M. abscessus infection and reactivation of latent Coccidioides infection. Despite the initiation of antifungal and antibiotic therapy, the subsequent course was complicated by the development of bronchopleural fistula and worsening respiratory failure, leading to an unfavorable outcome. This case highlights the diagnostic challenges associated with overlapping clinical and radiologic features of concurrent infections and devastating outcomes in patients with COPD. Prompt diagnostic testing and prolonged comprehensive therapy are of paramount importance in managing such complex infections.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251334229"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Bumpy Ride Through a Turbulent Airway: But Not Always-A Case Report of Tracheobronchopathia Osteochondroplastica. 湍流气道的颠簸之旅：但并非总是如此——气管支气管病骨软骨增生一例报告。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-07-17 DOI: 10.1177/23247096251357757

Maneesh Gaddam, Shivendra Tangutoori, Dedeepya Gullapalli, Shyam Ganti, Muhammad Hakim, Ajsza Matela

{"title":"A Bumpy Ride Through a Turbulent Airway: But Not Always-A Case Report of Tracheobronchopathia Osteochondroplastica.","authors":"Maneesh Gaddam, Shivendra Tangutoori, Dedeepya Gullapalli, Shyam Ganti, Muhammad Hakim, Ajsza Matela","doi":"10.1177/23247096251357757","DOIUrl":"10.1177/23247096251357757","url":null,"abstract":"Tracheobronchopathia osteochondroplastica (TPO) is a rare, benign condition characterized by the presence of submucosal cartilaginous and osseous nodules protruding into the anterior and lateral walls of the tracheobronchial lumen, sparing the posterior membranous wall. These nodules are incidentally discovered on imaging and bronchoscopy performed for unrelated respiratory symptoms. The exact etiopathogenesis is unclear, with various hypotheses proposed. The most widely accepted one is that chronic inflammation leads to cartilaginous and osseous metaplasia of the tracheobronchial submucosa. TPO is rare, with the prevalence further underestimated due to the incidental nature of the diagnosis. Clinically, patients may be asymptomatic or can have nonspecific symptoms such as chronic cough, dyspnea, and recurrent respiratory infections. Suspicion of the diagnosis arises upon incidental identification of nodules in the tracheobronchial lumen. Diagnosis is established through bronchoscopic visualization of characteristic nodular lesions sparing the posterior wall and can be confirmed by histopathologic examination showing submucosal cartilage formation and ossification. Management is generally conservative, focusing on symptomatic relief and treatment of infections. Severe cases with significant airway obstruction may warrant advanced bronchoscopic procedures or surgical interventions. Despite its benign nature, TPO can mimic other serious tracheal diseases. Awareness of this condition is essential for accurate diagnosis and appropriate management. We present a case of a 65-year-old asymptomatic chronic smoker who was found to have tracheal nodules on thoracic imaging. Bronchoscopic evaluation was consistent with TPO, with histopathology reaffirming the diagnosis.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251357757"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diabetic Myonecrosis: Lessons in Recognizing and Treating a Rare Complication. 糖尿病性肌坏死：认识和治疗罕见并发症的经验教训。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-31 DOI: 10.1177/23247096251331890

Brandon Garten, Mark Schwade, Saleh Alkathiri, Lane Perry

{"title":"Diabetic Myonecrosis: Lessons in Recognizing and Treating a Rare Complication.","authors":"Brandon Garten, Mark Schwade, Saleh Alkathiri, Lane Perry","doi":"10.1177/23247096251331890","DOIUrl":"10.1177/23247096251331890","url":null,"abstract":"Diabetic myonecrosis is a rare complication of poorly controlled diabetes that presents as spontaneous limb pain and swelling. It is associated with other microvascular diabetic complications such as nephropathy or retinopathy and is frequently misdiagnosed given its resemblance to infectious and vascular complications. We present a case of a 49-year-old male with poorly controlled type 2 diabetes and a history of recurrent thigh pain. This was initially treated as cellulitis, but the patient experienced persistent severe pain despite multiple rounds of antibiotics. Imaging with MRI ultimately confirmed a diagnosis of diabetic myonecrosis. The patient was successfully managed with a combination of aspirin, insulin therapy, and a multimodal pain regimen, leading to significant clinical improvement. This condition poses a diagnostic challenge due to its rarity and nonspecific presentation, often leading to delays in appropriate treatment. Prompt diagnosis with exclusionary testing and imaging, followed by appropriate management, can prevent severe complications. Additional research is needed to establish a standardized protocol for treating this condition.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251331890"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Distinctive Case of Hemophagocytic Lymphohistiocytosis in Chronic Lymphocytic Leukemia. 慢性淋巴细胞白血病中的嗜血细胞淋巴组织细胞增多症独特病例

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-23 DOI: 10.1177/23247096251326465

Jayalekshmi Jayakumar, Manasa Ginjupalli, Fiqe Khan, Meher Ayyazuddin, Muhammad Ashar Ali, Giovannie Isaac Coss, Asmat Ullah

{"title":"A Distinctive Case of Hemophagocytic Lymphohistiocytosis in Chronic Lymphocytic Leukemia.","authors":"Jayalekshmi Jayakumar, Manasa Ginjupalli, Fiqe Khan, Meher Ayyazuddin, Muhammad Ashar Ali, Giovannie Isaac Coss, Asmat Ullah","doi":"10.1177/23247096251326465","DOIUrl":"10.1177/23247096251326465","url":null,"abstract":"Chronic lymphocytic leukemia (CLL) is an indolent malignancy characterized by the accumulation of dysfunctional B-cell lymphocytes. Complications such as hemophagocytic lymphohistiocytosis (HLH) can arise, particularly during disease progression. HLH has been increasingly reported as a complication of CLL, often triggered by factors such as superimposed infections, chemotherapy, Richter transformation, or disease progression. This case explores HLH as an initial presentation of undiagnosed CLL without any identifiable trigger. We present the case of a 65-year-old woman who presented with a high-grade fever, sore throat, and pancytopenia. Despite broad-spectrum antibiotic treatment, her condition deteriorated. Investigations revealed elevated ferritin levels, low natural killer cell activity, and other findings consistent with HLH. Flow cytometry and bone marrow biopsy ultimately confirmed the diagnosis of CLL. HLH is characterized by the hyperactivation of immune cells and is known to be triggered by a variety of factors, including infections and malignancies. In this case, the absence of identifiable triggers raises important questions about the underlying pathophysiology linking HLH with CLL. While previous reports have highlighted HLH as a complication of CLL, typically secondary to infection or treatment, this case is particularly noteworthy due to the unexplained onset of HLH in the absence of such triggers. This case underscores the need for heightened awareness of HLH as a potential manifestation of underlying malignancy, especially in non-septic patients presenting with unexplained fever and pancytopenia. In addition, the simultaneous presentation of normal pressure hydrocephalus emphasizes the complex interplay of inflammatory processes in CLL. Further research is needed to explore the relationship between inflammation and the pathogenesis of CLL.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251326465"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-Dose Insulin Euglycemic Therapy in Concomitant Beta-Blocker and Calcium Channel Blocker Overdose. β受体阻滞剂和钙通道阻滞剂合用过量的高剂量胰岛素治疗。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-07-11 DOI: 10.1177/23247096251352371

Varun Roperia, Ahmed Zia Kiani, Naveen Jayakumar

{"title":"High-Dose Insulin Euglycemic Therapy in Concomitant Beta-Blocker and Calcium Channel Blocker Overdose.","authors":"Varun Roperia, Ahmed Zia Kiani, Naveen Jayakumar","doi":"10.1177/23247096251352371","DOIUrl":"10.1177/23247096251352371","url":null,"abstract":"Beta-blockers and calcium channel blockers are among the most commonly used drugs in the adult population, and the National Poison Data System annual reports note 11 075 beta-blocker overdoses and 6256 calcium-channel blocker overdoses in 2022. Poisoning with these medications presents clinically with profound bradycardia, depression of myocyte contractility, and vasodilation resulting in hemodynamic instability often refractory to initial vasopressor treatment. Herein we present a case of concomitant beta-blocker and calcium-channel blocker overdose with hypotension refractory to vasopressors successfully managed with high-dose insulin euglycemic therapy. Close monitoring is required to prevent adverse effects from therapy, which are predictable: hypokalemia and hypoglycemia often result from the use of up to hundreds of units of insulin per hour, as was done in this case. Frequent monitoring is required to safely utilize high-dose insulin euglycemic therapy, which has a good safety profile when appropriate monitoring is utilized.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251352371"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atypical Presentation of Giant Pheochromocytoma Managed With Minimally Invasive Surgery. 微创手术治疗巨大嗜铬细胞瘤的不典型表现。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-07-18 DOI: 10.1177/23247096251358668

Vania Rodriguez, Ramya Sridhar, Alex Manzano, Aliaa Al Sabbagh, Lydia Howard, Paul Baker, Preetika Mauyra

{"title":"Atypical Presentation of Giant Pheochromocytoma Managed With Minimally Invasive Surgery.","authors":"Vania Rodriguez, Ramya Sridhar, Alex Manzano, Aliaa Al Sabbagh, Lydia Howard, Paul Baker, Preetika Mauyra","doi":"10.1177/23247096251358668","DOIUrl":"10.1177/23247096251358668","url":null,"abstract":"Giant pheochromocytomas are rare tumors, typically exceeding 7 cm in size. Most are noncatecholamine secreting due to tumor necrosis and connective tissue content. Their presentation can range from classic hyperadrenergic symptoms to vague gastrointestinal complaints. Larger tumors are associated with higher risks of metastasis, mortality, and perioperative complications. Our case presents a 31-year-old female who presented with the chief complaint of vomiting, associated with intermittent palpitations and elevated blood pressure, with subsequent imaging revealing an 8.7 cm right adrenal mass. Complete resection of the mass showed a 10 × 7 × 3.9 cm mass that occupied the entire adrenal medulla, consistent with a giant pheochromocytoma. This case contributes to the evidence supporting a minimally invasive approach as well as individualized management of giant pheochromocytomas. Furthermore, it emphasizes the importance of a high clinical suspicion in the context of vague symptoms.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251358668"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Management for Emphysematous Gastritis: Is It Time for a Standardized Approach? 气肿性胃炎的医疗管理：是标准化方法的时候了吗？

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-08-13 DOI: 10.1177/23247096251365750

Mohammad Adam, Aron Evans, Islam Mohamed, Fouad Jaber, Nisha Patel, Alexandra Roman, Sadeddin Esmat

引用次数: 0

Endometriosis Presenting as a Malignant Appearing Cecal Mass. 子宫内膜异位症表现为恶性盲肠肿块。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-08-28 DOI: 10.1177/23247096251363014

Akanksha Togra, M Ammar Kalas, Keith Garrison, Alejandro Robles

引用次数: 0

Refractory Vasospasm Presenting as Acute Myocardial Infarction. 难治性血管痉挛表现为急性心肌梗死。

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-03-14 DOI: 10.1177/23247096251325426

Nismat Javed, Emamuzo Obaro Otobo, Ankita Gore, Maulin Patel, Nisha Ali, Amandeep Singh, Nassim Krim, Preeti Jadhav

{"title":"Refractory Vasospasm Presenting as Acute Myocardial Infarction.","authors":"Nismat Javed, Emamuzo Obaro Otobo, Ankita Gore, Maulin Patel, Nisha Ali, Amandeep Singh, Nassim Krim, Preeti Jadhav","doi":"10.1177/23247096251325426","DOIUrl":"10.1177/23247096251325426","url":null,"abstract":"Refractory coronary artery spasm is a challenging condition with many complications, including acute myocardial infarction. We present the case of an elderly woman who developed refractory coronary artery vasospasm requiring extensive hemodynamic support. She had an abnormal electrocardiogram. She was diagnosed with severe coronary artery vasospasm that initially responded to intracoronary nitroglycerin. However, the course was complicated by arrhythmias and cardiogenic shock following an additional episode of vasospasm that required higher concentrations of nitroglycerin. Notably, this case is relatively less documented in women and within the South Bronx population. Refractory coronary artery spasm is a critical condition that can lead to life-threatening outcomes. Prompt and effective treatment is essential, especially for high-risk patients, to prevent cardiac ischemia. Given the significant dangers of delayed or insufficient treatment, it is crucial to manage coronary artery spasms proactively to enhance patient outcomes and avoid severe complications. In addition, this diagnosis should be strongly considered in women, with an emphasis on following guidelines for managing cases of acute myocardial infarction.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251325426"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

MALToma with a 'B'-Not for Benign, but for Bronchus-Associated: A Rare Case of Bronchus-Associated Lymphoid Tissue Lymphoma. 带“B”的MALToma -不是良性的，而是支气管相关的：一例罕见的支气管相关淋巴组织淋巴瘤

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Journal of investigative medicine high impact case reports Pub Date : 2025-01-01 Epub Date: 2025-08-20 DOI: 10.1177/23247096251366125

Maneesh Gaddam, Dedeepya Gullapalli, Shyam Ganti, Sunil Badami, Kinnera Sahithi Urlapu

{"title":"MALToma with a 'B'-Not for Benign, but for Bronchus-Associated: A Rare Case of Bronchus-Associated Lymphoid Tissue Lymphoma.","authors":"Maneesh Gaddam, Dedeepya Gullapalli, Shyam Ganti, Sunil Badami, Kinnera Sahithi Urlapu","doi":"10.1177/23247096251366125","DOIUrl":"10.1177/23247096251366125","url":null,"abstract":"Bronchus-associated lymphoid tissue (BALT) lymphoma is a rare subtype of extra-nodal marginal zone B-cell lymphomas, accounting for less than 5% of cases. It is typically indolent and often discovered incidentally through imaging studies performed for unrelated reasons. We present the case of a 72-year-old male with a known history of thoracic aortic dilatation, who was found to have a spiculated right upper lobe (RUL) pulmonary nodule on surveillance imaging. He remained asymptomatic, with no constitutional or respiratory symptoms. Positron emission tomography imaging demonstrated mildly increased uptake (standardized uptake value 2.4) of the RUL nodule, and no mediastinal or hilar lymphadenopathy. Bronchoscopic biopsy with histopathology and immunohistochemistry revealed a low-grade B-cell non-Hodgkin's lymphoma, with CD20 and BCL2 positivity. Flow cytometry confirmed monoclonal B-cell proliferation, and fluorescence in situ hybridization analysis identified the BIRC3-MALT1 translocation, consistent with BALT lymphoma. The patient was staged as IE, and a decision was made for conservative management with active surveillance, given the localized and asymptomatic nature of his disease. While treatment options may include surgery, radiotherapy, immunotherapy, or chemotherapy, there is no consensus on the optimal approach due to the rarity and heterogeneous presentation of this lymphoma. In many early-stage cases without symptoms, a \"watch and wait\" strategy is reasonable. This case underscores the importance of including BALT lymphoma in the differential diagnosis of incidental pulmonary nodules and highlights the need for greater awareness and research to establish standardized treatment protocols, with each case adding valuable insight to guide future management strategies.","PeriodicalId":16198,"journal":{"name":"Journal of investigative medicine high impact case reports","volume":"13 ","pages":"23247096251366125"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0