胸部临床解剖实物图谱（第2版）

*章 胸 壁

图1-1 胸廓前面观 Anterior aspect ofthe thoracic cage

图1-2 胸廓侧面观 Lateral aspect of the thoracic cage

图1-3 胸廓后面观 Posterior aspect ofthe thoracic cage

图1-4 胸骨（前、侧面观） Sternum (anterior and lateral aspects)

图1-5 肋骨Rib

图1-6 胸椎（上面、侧面观） Thoracic vertebra (superior and lateralaspects)

乳腺切口的选择及解剖层次

图1-7 女性乳腺手术入路切口（一） Incision ofthe female breast surgery (1)

图1-8 女性乳腺手术入路切口（二） Incision of the femalebreast surgery (2)

图1-9 女性乳腺（一）Female breast (1)

图1-10 女性乳腺（二）Female breast (2)

开胸手术前外侧手术入路的解剖层次

图1-11 胸部前外侧手术入路切口（一） Anterolateral incision of the thorax (1)

图1-12 胸部前外侧手术入路切口（二）Anterolateral incisionof the thorax (2)

图1-13 胸大肌Pectoralis major

图1-14 锁胸筋膜、胸小肌  Clavipectoral fascia andpectoralis minor

图1-15 锁骨下静脉Subclavian vein

锁骨下静脉穿刺术的应用解剖学要点

图1-16 前锯肌Serratus anterior

图1-17 胸前壁（成人） Anterior wall of the thorax (adult)

图1-18 胸前壁（儿童） Anterior wall of the thorax (child)

图1-19 胸前壁内侧面血管 Blood vessels on the medial surface of theanterior thoracic wall

胸骨角的应用解剖学要点

开胸手术后外侧切口手术入路的解剖层次

图1-20 胸部后外侧手术入路切口（一）Posterolateralincision of the thorax (1)

图1-21 胸部后外侧手术入路切口（二）Posterolateral incision of the thorax (2)

图1-22 胸部后外侧手术入路切口（三）Posterolateralincision of the thorax (3)

图1-23 胸背部浅层结构 Superficial structure of thethoracodorsal region

图1-24 背浅部结构 Superficial structures ofthe back

图1-25 胸背部深层结构 Deep structures of the thoracodorsal region

图1-26 胸后壁内侧面血管 Blood vessels on the medialsurface of the posterior thoracic wall

图1-27 膈的左侧面观 Left aspect of the diaphragm

图1-28 膈的右侧面观 Right aspect of thediaphragm

图1-29 胸前皮瓣（一） Anterior thoracic skin flap (1)

图1-30 胸前皮瓣（二） Anterior thoracic skin flap (2）

胸前皮瓣的应用解剖学要点

图1-31 左胸大肌皮瓣 Skin flap over left pectoralis major

图1-32 右胸大肌皮瓣 Skin flap over right pectoralis major

图1-33 胸大肌皮瓣 Skin flap over pectoralis major

图1-34 胸大肌肌瓣（一）Pectoralis major flap (1)

图1-35 胸大肌肌瓣（二）Pectoralis major flap (2)

胸大肌肌（皮）瓣的应用解剖学要点

图1-36 胸侧皮瓣 Lateral thoracic skin flap

图1-37 肋间皮瓣Intercostal skin flap

侧胸皮瓣的应用解剖学要点

图1-38 前锯肌（皮）瓣Serratus anterior (skin) flap

前锯肌瓣乳房再造或丰乳术的应用解剖学要点

图1-39 背阔肌（皮）瓣Latissimusdorsi(skin) flap

背阔肌肌瓣的应用解剖学要点

图1-40 斜方肌皮瓣 Skin flap over trapezius

图1-41 斜方肌皮瓣（X线片）Skin flap over trapezius (X-ray film)

图1-42 斜方肌肌皮瓣 Trapezius (skin) flap

图1-43 斜方肌瓣（X线片） Trapezius flap (X-ray film)

斜方肌肌皮瓣的应用解剖学要点

图1-44 肋骨瓣Costal bone flap

图1-45 肋软骨（肋弓）瓣 Costal cartilage (costal arch) flap

肋骨骨瓣的应用解剖学要点

第二章 胸膜、胸膜腔和肺

图2-1 肋胸膜前面观（带胸廓） Anterior aspect of thecostal pleura (with thoracic cage)

图2-2 肋胸膜左侧面观（带胸廓） Left aspect of the costalpleura (with thoracic cage)

图2-3 肋胸膜右侧面观（带胸廓） Right aspect of the costalpleura (with thoracic cage)

图2-4 肋胸膜前面观 Anterior aspect of the costal pleura

图2-5 肋胸膜左侧面观 Left aspect of the costal pleura

图2-6 肋胸膜右侧面观 Right aspect of the costal pleura

图2-7 肋纵隔隐窝Costomediastinal recess

图2-8 肋膈隐窝（左侧面观）Costodiaphragmatic recess (Leftaspect)

胸膜腔穿刺术的应用解剖学要点

图2-9 肺的位置（前面观） Localization oflungs (anterior aspect)

图2-10 肺的后面观（心包外肺门结构） Posterior aspect of lungs (hilum of lungoutside of the pericardium)

图2-11 肺根结构Structures of the root of lung

图2-12 左肺根前面观 Anterior aspect of the rootofleft lung

图2-13 左肺根后面观 Posterior aspect of the root of left lung

图2-14 左侧胸腔大体观（胸腔镜下观）Overview of the left thoracic cavity (VATS)

图2-15 左肺动脉及其分支（胸腔镜下观一） Left pulmonary artery andbranch(VATS-1)

图2-16 左肺静脉及其分支（胸腔镜下观二） Left pulmonary vein andbranch(VATS-2)

图2-17 左侧肺门结构（心包外） Structures of the left hilumof lung (outside of the pericardium）

图2-18 左肺门内结构前面观 Anterior aspect of the hilum of left lung

图2-19 左侧肺门内结构 Structures in the hilum of left lung

图2-20 右肺根前面观 Anterior aspect of the rootof right lung

图2-21 右肺根后面观 Posterior aspect of the root of right lung

图2-22 右侧胸腔镜下大体观 overview of the thoracic cavity through VATS

图2-23 右肺动脉及其分支（胸腔镜下观一）Right pulmonary artery and branch(VATS-1)

图2-24 右肺静脉及其分支（胸腔镜下观二）Right pulmonary vein and branch(VATS-2)

图2-25 右侧肺门结构（心包外） Structures of the righthilum oflung (outside of the pericardium)

图2-26 右侧肺门内结构 Structures of the hilum of right lung

图2-27 右肺尖与胸膜顶 Apex of the right lung and cupula of pleura

图2-28 肺尖、胸膜顶水平切 Horizontal section throughapex of the lung and cupula of pleura 34

图2-29 肺尖与第1肋Apex of lung and the first rib

图2-30 经肺门胸部横断面 Transverse section of the thoraxthrough the hilum oflung

图2-31 经腋中线胸部冠状切 Coronary section of the thorax throughmidaxillary line

图2-32 胸部X线正位片Orthophoria X-ray film of thethorax

图2-33 胸部X线侧位片 Lateral X-ray film of thethorax

第三章 纵隔

图3-1 成人纵隔前面观 Anterior aspect of the mediastinum (adult)

图3-2 儿童纵隔前面观 Anterior aspect of the mediastinum (child)

心包穿刺术的应用解剖学要点

图3-3 纵隔前面观（肋骨、肺已切除）Anterior aspect of themediastinum

(ribs and lungswere cut off）

图3-4 纵隔前面观（一）（胸骨、肋骨已切除）

Anterior aspect of the mediastinum (1)(sternum and ribs were cut off)

图3-5 纵隔前面观（二）（胸骨、肋骨已切除）

Anterior aspect of the mediastinum (2)(sternum and ribs were cut off)

图3-6 胸腺的形态 Morphology of the thymus

图3-7 纵隔左侧面观（一） Left aspect of the mediastinum (1)

图3-8 纵隔左侧面观（二）Left aspect of the mediastinum (2)

图3-9 纵隔右侧面观（一） Right aspect of the mediastinum (1)

图3-10 纵隔右侧面观（二） Right aspect of the mediastinum (2)

胸外心按压术的应用解剖学要点

图3-11 后纵隔前面观 Anterior aspect of the posterior mediastinum

图3-12 纵隔后面观 Posterior aspect of the mediastinum

图3-13 纵隔后面观，示左肺根 Posterior aspect of the mediastinum to showthe root of the left lung

图3-14 纵隔后面观，示右肺根 Posterior aspect of the mediastinum to showthe root of the right lung

图3-15 纵隔前面观 Anterior aspect of the mediastinum

图3-16 左侧纵隔胸膜 Left mediastinal pleura

图3-17 右侧纵隔胸膜 Right mediastinal pleura

图3-18 动脉导管三角 Triangle of ductusarteriosus

图3-19 上纵隔结构（一） Structures of the superior mediastinum (1)

图3-20 上纵隔结构（二） Structures of the superior mediastinum (2)

图3-21 前纵隔上部浅层结构 Superficial structures of the upper part ofanterior mediastinum

图3-22 气管、支气管前面观 Anterior aspect of the trachea and bronchi

图3-23 气管、支气管后面观 Posterior aspect of the trachea and bronchi

图3-24 气管隆嵴Carina oftrachea

气管隆嵴的应用解剖学要点

图3-25 气管、支气管的位置毗邻 Localization and adjacent structures of thetrachea andbronchi

图3-26 支气管、食管和主动脉的位置 Localization of the bronchi, esophagus andaorta

图3-27 气管、支气管冠状切面 Coronal section of the trachea and bronchi

图3-28 支气管动脉 Arteries of the bronchus

图3-29 支气管的神经分布（后面观） Nerve supply of the bronchus (posterioraspect)

图3-30 支气管淋巴结 Bronchial lymph nodes

经支气管动脉介入治疗的应用解剖学要点

图3-31 食管的动脉分布（后面观） Arteries of the esophagus (posterior aspect)

图3-32 食管的神经支配（后面观） Nerves of the esophagus (posterior aspect）

图3-33 胸导管胸段（后面观） Thoracic segment ofthoracic duct (posterioraspect)

图3-34 心后面观（胸导管） posterior aspect of theheart(thoracic duct)

图3-35 胸段下腔静脉 Thoracic part of inferior vena cava

图3-36 肺循环的血管 Blood vessels of the pulmonary circulation

图3-37 心底大血管 Great vessels on cardiac base

图3-38 肺循环的血管（升主动脉已切除）

Blood vessels of the pulmonarycirculation (ascending aorta was cut off) 图3-39 肺循环的血管（上腔静脉已切除）

Blood vessels of the pulmonarycirculation (superior vena cava was cut off) 图3-40 动脉韧带 Arterial ligament

图3-41 动脉导管三角（侧面观）Ductusarterious triangle (lateralaspect)

图3-42 食管上三角（侧面观） Superior esophagus triangle (lateral aspect)

图3-43 白交通支和灰交通支 White and grey communicating branches

图3-44 心包前面观（一） Anterior aspect of the pericardium (1)

图3-45 心包前面观（二） Anterior aspect of the pericardium (2)

图3-46 心包后面观 Posterior aspect of the pericardium

图3-47 心的外形前面观（心包前部已切除）

Anterior aspect of the heart(anterior part of the pericardium was cut off)

图3-48 心包后面观（心已取出） Posterior aspect of the pericardium (heartwas taken out)

图3-49 左心房在体后面观 Posterior aspect of the left atrium inthoracic cavity

图3-50 左心房后面观（心包已切开）

Posterior aspect of the leftatrium (pericardium was opened)

图3-51 成人心的位置前面观 Anterior aspect of the position of adult’sheart

图3-52 儿童心的位置前面观 Anterior aspect of the position of child’sheart

图3-53 心前面观（一） Anterior aspect of the heart(1)

图3-54 心前面观（二） Anterior aspect of the heart (2)

图3-55 心右侧面观（一） Right aspect of the heart(1)

图3-56 心右侧面观（二） Right aspect of the heart (2)

图3-57 心左侧面观（一） Left aspect of the heart (1)

图3-58 心左侧面观（二） Left aspect of the heart (2)

图3-59 心后面观（一） Posterior aspect of the heart (1)

图3-60心后面观（二） Posterior aspect of the heart(2)

图3-61心后面观（三） Posterior aspect of theheart (3)

图3-62 心底面观Basal aspect of the heart

图3-63右心的位置 Localization of theright part of heart

图3-64 右心房和右心室腔 Right atrium and rightventricle cavity

图3-65 右心房内结构（一） Internal structure of the right atrium(1)

图3-66 右心房内结构（二） Internal structure of the right atrium (2)

图3-67 右心房内结构（三） Internal structures of the right atrium (3)

卵圆窝的应用解剖学要点

图3-68 右房室瓣Right atrioventricular valve

图3-69 右房室瓣心房面观 Atrial-side aspect of the rightatrioventricular valve

图3-70 右房室口上面观 Superior aspect of the right ventricularorifice

图3-71 右心房、右心室 Right atrium and right ventricle

图3-72 右心室内结构（一） Internal structures of the rightventricle (1)

图3-73 右心室内结构（二） Internal structures of the right ventricle(2)

图3-74 左、右心室腔Left ventricle and right ventricle

图3-75 右心室流出道结构 Structures of the outflow path of rightventricle

图3-76 右心室流出道 Outflow path ofright ventricle

图3-77 右心室流入道和流出道Inflow and outflow path ofright ventricle

图3-78 右心室内节制索（隔缘肉柱）（一）

Moderator band of right ventricle(septomarginaltrabecula) (1)

图3-79 右心室内节制索（隔缘肉柱）（二）

Moderator band of right ventricle(septomarginaltrabecula)(2)

图3-80 心腔内注射进针的部位和层次

Positions and layers of theintracavitary administration into the heart

右心室内注射术的应用解剖学要点

图3-81 室间隔右侧面观 Right aspect of theinterventricular septum

图3-82 室间隔膜部形态（透射照像法一）

Morphology of the membranouspart of interventricular septum (transmission method, 1）

图3-83 室间隔膜部形态（透射照像法二）

Morphology of the membranouspart of interventricular septum (transmission method, 2)

图3-84 室间隔膜部形态（透射照像法三）

Morphology of the membranouspart of interventricular septum (transmission method, 3)

图3-85 室间隔膜部形态（心冠状切面一）

Morphology of themembranous part of interventricular septum (coronary section, 1)

图3-86 室间隔膜部形态（心冠状切面二）

Morphology of the membranouspart of interventricular septum (coronary section, 2)

室间隔膜部的应用解剖学要点

图3-87 左心房后面观 Posterior aspect of the left atrium

图3-88 左心房内结构后面观（左心房后壁已切开）

Posterior aspect of the leftatrium (posterior wall of the left atrium wasopened）

图3-89 左心房、左心室 Left atrium and left ventricle

图3-90 二尖瓣复合体 Mitral complex

图3-91 左房室口上面观 Superior aspect of the left atrioventricularorifice

图3-92 左房室瓣心室面观Ventriculsurface-side aspectof the left atrioventricular valve

图3-93 左房室瓣展平观（一） Spread aspect of thethe leftatrioventricular valve (1)

图3-94 左房室瓣展平观（二） Spread aspect of the leftatrioventricular valve (2)

图3-95 左房室瓣心房面观（透射照像法）

Atrial-side aspect of the leftatrioventricular valve (transmission method)

图3-96 左房室瓣心室面观（透射照像法）

Ventricular-side aspect of theleft atrioventricular valve (transmission method)

图3-97 左房室瓣前尖扫描电子显微镜照片，×2000

Anterior cusp of leftatrioventricular valve under scanning electronmicroscopy,×2000

图3-98 二尖瓣前尖扫描电子显微镜照片，剥除瓣膜表面心内膜层，×800

Anterior cusp of leftatrioventricular valve under scanning electronmicroscopy, endocardium has beendivested, ×800

图3-99 二尖瓣前尖扫描电子显微镜照片，矢状切面，×1280

Anterior cusp of leftatrioventricular valve under scanning electronmicroscopic, sagittal section, ×1280

图3-100 二尖瓣前尖组织结构（一） VG染色，石蜡切片，3.2×4

Structure the of anterior cuspof left atrioventricular valve (1)VG staining,paraffin section, 3.2×4

图3-101 二尖瓣前尖组织结构（二） VG染色，石蜡切片，3.2×4

Structure of the anteriorcusp of left atrioventricular valve (2)VG staining,paraffin section, 3.2×4

图3-102 瓣膜内有髓神经纤维（透射电子显微镜照片），×3000

Myelinated nerve fibers of the valvetransmission electronmicroscopy, ×3000

图3-103 左心室内部结构 Structures of the left ventricle

图3-104 左心室流出道结构（一） Structures of the outflow path ofleftventricle (1)

图3-105 左心室流出道结构（二） Structures of the outflow path of leftventricle (2)

图3-106 左心室流入道和流出道Inflow and outflow path ofleft ventricle

图3-107 左心室流入、流出道 Inflow and outflow path ofleft ventricle

图3-108 腱索（一） Chordae tendineae(1)

图3-109 腱索（二） Chordae tendineae(2)

图3-110 腱索（三） Chordae tendineae(3)

图3-111 腱索纵切面观，VG染色，石蜡切片，3.2×4

Longitudinal section of the chordaetendineae, VG staining,paraffin section, 3.2×4

图3-112 腱索扫描电子显微镜照片（一）示腱索表面内皮细胞排列，×400

Chordinaetendineae under scanning electronmicroscopy (1), showing arrangementof endothelial cells on chordae tendineae, ×400

图3-113 腱索扫描电子显微镜照片（二），×300

Chordinaetendineae under scanning electronmicroscopy (2), ×300

图3-114 腱索扫描电子显微镜照片（三）示胶原纤维的形态，×1960

Chordinaetendineae under scanning electronmicroscopy (3), showing morphologyof collagenous fibers, ×1960

图3-115 腱索扫描电子显微镜照片（四）示弹力纤维，×3000

Chordinaetendineae under scanning electronmicroscopy (4), showing elasticfibers, ×3000

腱索的应用解剖学要点

图3-116 心房肌、心室肌后面观Posterior aspect of theatrial and ventricular myocardium

图3-117 右心房肌（前外侧面观） Right atrium (anterolateral aspect)

图3-118 心房肌（前上面观） Atrial myocardium(anterosuperior aspect)

图3-119 心肌袖组织切片（VG染色） Slice of myocardial sleeve(VG staining)

图3-120 心纤维环（上面观） Fibrous ring of heart(superior aspect)

图3-121 心室肌（后面观）Venticular myocardium(posterior aspect)

图3-122 心室肌的排列层次（左心室前外侧壁）

Layers of ventricularmyocardium(anterolateral wall of left ventricle)

图3-123 心尖部心肌的形态 Morphology of the cardiac apical myocardium

图3-124 心室肌横切面 Cross section of the ventricular myocardium

图3-125 左心室肌矢状切面 Longitudinal section of the left ventricularmyocardium

图3-126 左心室肌（透射电子显微镜照片），×4000

Myocardium of the leftventricle (transmission electronmicroscopicphoto), ×4000

图3-127 心浅丛 Superficial cardiac plexus

图3-128 窦房结的位置（一）Position of the sinuatrial node (1)

图3-129 窦房结的位置（二）石蜡切片，H-E染色，3.3×4

Position of thesinuatrial node (2) Paraffin section, H-E staining, 3.3×4

图3-130 房室结的位置 Position of theatrioventricular node

图3-131 房室结的动脉（起始于右冠状动脉）

Artery of the atrioventricularnode (arising from right coronary artery)

图3-132 房室结的位置，Masson染色，×40

Position of theatrioventricularnode, Masson staining, ×40

图3-133 心肌袖（心房肌）内的传导组织 箭头示传导组织，横纹不发达

Conducting tissue in themyocardial sleeve (atrial muscle)

Arrows show the conductingtissue with incompletely developed striations

图3-134 心肌袖（心房肌）传导组织内的P细胞 透射电子显微镜照片，×5000

P cell in the conductingtissue of myocardial sleeve (atrial myocardium), transmission electronmicroscopic photo, ×5000

图3-135 右心房动脉（上面观） Arteries of the right atrium (superior aspect)

图3-136 右心房动脉（前外侧面观）Arteries of the rightatrium(anterolateral aspect)

图3-137 左心房动脉（上面观） Arteries of the left atrium (superior aspect)

图3-138 左心房动脉（前面观） Arteries of the left atrium (anterior aspect)

图3-139 左心房动脉（后面观一） Arteries of the left atrium (posterior aspect1)

图3-140 左心房动脉（后面观二） Arteries of the left atrium (posterior aspect2)

图3-141 左冠状动脉（心房已切除） Left coronary artery (atria have been resected)

图3-142 左冠状动脉左前外侧面观（一）

Left anterolateral aspect ofthe left coronary artery (1)

图3-143 左冠状动脉左前外侧面观（二）

Left anterolateral aspect of the left coronary artery (2)

图3-144 左冠状动脉左前外侧面观（三）

Left anterolateral aspect ofthe left coronary artery (3)

图3-145 左冠状动脉左前外侧面观（四）

Left anterolateral aspect ofthe left coronary artery (4)

图3-146 右冠状动脉前面观 Anterior aspect of the right coronary artery

图3-147 心肌桥（左室前壁） Myocardial bridge (anterior wall of leftventricle)

壁冠状动脉的应用解剖学要点

图3-148 心尖部的动脉吻合 Arterial anastomosis of the cardiac apex

图3-149 乳头肌血供  Blood supply of the papillary muscles

图3-150 乳头肌血供（钼靶X线片）

Blood supply of the papillary muscles (molybdenum target X-ray film)

图3-151 动脉圆锥支Branch of arterialconus

图3-152 心室膈面的动脉分布（左优势型一）

Arteries of the diaphragmatic surface ofventricles (left-dominant type 1 )

图3-153 心室膈面的动脉分布（左优势型二）

Arteries of the diaphragmatic surface ofventricles (left-dominant type 2 )

图3-154 心室膈面动脉分布（右优势型一）

Arteries of the diaphragmatic surface ofventricles (right-dominant type 1 )

图3-155 心室膈面动脉分布（右优势型二）

Arteries of the diaphragmatic surface ofventricles (right-dominant type 2 )

图3-156 心室膈面动脉分布（右优势型三）

Arteries of the diaphragmatic surface ofventricles (right-dominant type 3 )

图3-157 心室膈面动脉分布（右优势型四）

Arteries of the diaphragmatic surface ofventricles (right-dominant type 4 )

图3-158 心室膈面动脉分布（均衡型一）

Arteries of the diaphragmatic surface ofventricles (balanced type 1 )

图3-159 心室膈面动脉分布（均衡型二）

Arteries of the diaphragmatic surface ofventricles (balanced type 2)

图3-160 心室膈面动脉分布（均衡型三）

Arteries of the diaphragmatic surface ofventricles (balanced type 3)

图3-161 心室膈面动脉分布（均衡型四）

Arteries of the diaphragmatic surface ofventricles (balanced type 4)

图3-162 心室膈面动脉分布（均衡型五）

Arteries of the diaphragmatic surface ofventricles (balanced type 5 )

图3-163 胸部动脉铸型Cast of the thoracic arteries

图3-164 心冠状动脉数字减影血管造影图 DSA of the coronary artery

冠状动脉分布类型的应用解剖学要点

图3-165 心大静脉Great cardiac vein

图3-166 左缘静脉Left marginal vein

图3-167 冠状窦（一） Coronary sinus (1)

图3-168 冠状窦（二） Coronary sinus (2)

图3-169 心的血管铸型（前面观）Vascular cast of theheart (anterior aspect)

图3-170 心的血管铸型（后面观）Vascular cast of the heart(posterior aspect)

图3-171 心的横切面（经冠状沟平面）

Transverse section of the heart (through coronary sulcus level)

图3-172 心的冠状切面（经主动脉瓣）

Coronary sectionof the heart (through aortic valve)

图3-173 心的冠状切面（经肺动脉干）

Coronary section of the heart(through pulmonary trunk)

图3-174 胸上部水平切面

Transverse section of the superior part ofthorax

图3-175 经肺动脉干胸部横断面

Transverse section of the thorax through pulmonary trunk

图3-176 经动脉圆锥的胸部冠状切面

Coronary section of the thorax through conusarteriosus

图3-177 经升主动脉的胸部冠状切面

Coronary section of the thorax through ascending aorta

图3-178 经室间隔的胸部矢状切面

Sagittal section of the thorax through interventricular septum

图3-179 经主动脉根部的CT检查（X线片)

X-ray film of the CT examination through the root of aorta

图3-180 右前瓣斜位心长轴MRI检查（X线片）

Right anterior oblique section through long axis of the heart (X-rayfilm of MRI examination）

图3-181 体轴冠状位的MRI检查(X线片)

X-ray film of MRI examination through coronary axis of body

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英文索引