乙肝会遗传吗？
<div style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">
<h2 style="color: black; text-align: left; margin-bottom: 10px;">①乙肝会遗传吗？</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">乙肝不是遗传病！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《医学遗传学(第7版)》.人民卫生出版社,2018,左伋等.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">基因的结构或表达调控<span style="color: black;">反常</span>可<span style="color: black;">引起</span>遗传病的<span style="color: black;">出现</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">遗传病是<span style="color: black;">经过</span><span style="color: black;">必定</span>的遗传<span style="color: black;">基本</span>、按<span style="color: black;">必定</span>的方式传于后代<span style="color: black;">生长</span>形成的<span style="color: black;">疾患</span>。</p>与传染性<span style="color: black;">疾患</span>、<span style="color: black;"><a style="color: black;">营养性<span style="color: black;">疾患</span></a></span>不同，它不延伸至<span style="color: black;">没</span>亲缘关系的个体。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">而乙肝是传<span style="color: black;">患病</span>！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《传<span style="color: black;">患病</span>学(第9版)》.人民卫生出版社,2018,<span style="color: black;"><a style="color: black;">李兰娟</a></span>等.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">病毒性肝炎是有多种肝炎病毒<span style="color: black;">导致</span>的，以肝脏损害为主的一组全身性传<span style="color: black;">患病</span>。</p><span style="color: black;">日前</span>按病原学<span style="color: black;">知道</span><span style="color: black;">归类</span>的有甲型、乙型、丙型、丁型、<span style="color: black;"><a style="color: black;">戊型五型肝炎病毒</a></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">。</p>经精子或<span style="color: black;">卵细胞</span>传播的可能性未被证实。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>，乙肝并不会遗传，而是有传染给子代的可能。</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">②乙肝<span style="color: black;">病人</span><span style="color: black;">能够</span>婚育吗？什么是母婴传播？如何进行阻断？</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">乙肝<span style="color: black;">病人</span><span style="color: black;">亦</span><span style="color: black;">能够</span>结婚生育。</p>
<h3 style="color: black; text-align: left; margin-bottom: 10px;">（1）关于结婚的传染性：</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《慢性乙型肝炎防治指南(2019)年版》</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中华医学会感<span style="color: black;">患病</span>学分会，中华医学会肝病学分会．</p>接种乙型肝炎疫苗是预防<span style="color: black;"><a style="color: black;">HBV感染</a></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">最有效的<span style="color: black;">办法</span>。</p>其家庭成员或性伴侣应尽早接种乙型肝炎疫苗。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><a style="color: black;">张文宏</a></span>教授说“乙肝疫苗是人类最成功的疫苗了”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">即使<span style="color: black;">没</span>抗体<span style="color: black;">守护</span>，成年人<span style="color: black;">亦</span>很难感染。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">世界卫生组织官方<span style="color: black;">网</span>：</p>在成年<span style="color: black;">周期</span><span style="color: black;">得到</span>的感染<span style="color: black;">引起</span><span style="color: black;"><a style="color: black;">慢性肝炎</a></span>的病例不到5%<h3 style="color: black; text-align: left; margin-bottom: 10px;">（2）关于生育：</h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1）男性<span style="color: black;">身患</span>乙肝</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中华医学会妇产科学分会产科学组，中华医学会围产医学分会．</p>HBsAg阳性父亲的精液中可存在病毒，但精子细胞中<span style="color: black;">没</span>病毒，精液中的病毒<span style="color: black;">亦</span><span style="color: black;">不可</span>感染卵母细胞，HBV<span style="color: black;">不可</span>感染受精卵而<span style="color: black;">导致</span>子代感染。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>未进行抗病毒：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">孕妇HBsAg阴性，但新生儿父亲或祖辈HBsAg阳性，因照料新生儿而密切接触时，<span style="color: black;">必须</span><span style="color: black;">重视</span>预防HBV传播。<span style="color: black;">倘若</span>孕妇抗-HBs阳性，新生儿出生时就有免疫力，<span style="color: black;">没</span>需特殊处理，正常接种乙肝疫苗<span style="color: black;">就可</span>。</p><span style="color: black;">倘若</span>孕妇抗-HBs阴性，大部分新生儿在接种第2针乙肝疫苗后1周<span style="color: black;">上下</span>才产生抗体，<span style="color: black;">这里</span>之前对HBV易感。<span style="color: black;">倘若</span>家庭成员HBsAg阳性，尤其是HBeAg阳性者，<span style="color: black;">重视</span>与新生儿不要密切接触。<span style="color: black;">倘若</span>HBsAg阳性（尤其HBeAg阳性）者<span style="color: black;">必要</span>与新生儿密切接触（如照料），新生儿最好注射１针HBIG。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《慢性乙型肝炎防治指南(2019)年版》</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>在进行抗病毒治疗：</p>应用<span style="color: black;"><a style="color: black;">干扰</a>素</span>－α治疗的男性<span style="color: black;">病人</span>，应在停药后6个月方可<span style="color: black;">思虑</span>生育；应用<span style="color: black;"><a style="color: black;">NAs抗病毒治疗</a></span>的男性<span style="color: black;">病人</span>，<span style="color: black;">日前</span>尚<span style="color: black;">没</span>证据<span style="color: black;">显示</span><span style="color: black;"><a style="color: black;">NAs治疗</a></span>对精子的不良影响，可在与<span style="color: black;">病人</span>充分沟通的前提下<span style="color: black;">思虑</span>生育。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2）女性<span style="color: black;">身患</span>乙肝</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">通常</span><span style="color: black;">必须</span>进行母婴阻断，防止母婴垂直传播。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《<span style="color: black;"><a style="color: black;">慢性乙型肝炎防治指南(2019)年版</a></span>》</p>育龄期及准备妊娠女性均应筛查HBsAg，<span style="color: black;">针对</span>HBsAg阳性者<span style="color: black;">必须</span>检测HBV DNA。<span style="color: black;">针对</span>有抗病毒治疗适应证<span style="color: black;">病人</span>，可在妊娠前应用<span style="color: black;"><a style="color: black;">Peg－IFN－α</a></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗，以期在妊娠前６个月完成治疗。在治疗<span style="color: black;">时期</span>应采取<span style="color: black;">靠谱</span>的避孕<span style="color: black;">办法</span>。若不适合应用Peg－IFN－α或治疗失败，可采用TDF抗病毒治疗。<span style="color: black;">针对</span>妊娠<span style="color: black;">时期</span>首次诊断CHB的<span style="color: black;">病人</span>，其治疗适应证同普通CHB<span style="color: black;">病人</span>，可<span style="color: black;">运用</span>TDF抗病毒治疗。妊娠前或妊娠<span style="color: black;">时期</span><span style="color: black;">起始</span><span style="color: black;">吃下</span>抗病毒<span style="color: black;">药品</span>的CHB孕产妇，产后应继续抗病毒治疗，并<span style="color: black;">按照</span>病毒学应答<span style="color: black;">状况</span>，决定是继续原治疗<span style="color: black;">方法</span>，还是换用其他NAs或Peg－IFN－α继续治疗。</p>抗病毒治疗<span style="color: black;">时期</span>意外妊娠的<span style="color: black;">病人</span>，若正在<span style="color: black;">吃下</span>TDF，<span style="color: black;">意见</span>继续妊娠；若正在<span style="color: black;">吃下</span>EVT，可不终止妊娠，<span style="color: black;">意见</span>更换为TDF继续治疗；若正在接受干扰素－α治疗，<span style="color: black;">意见</span>向孕妇和家属充分<span style="color: black;">通知</span><span style="color: black;">危害</span>，由其决定<span style="color: black;">可否</span>继续妊娠，若决定继续妊娠则要换用<span style="color: black;"><a style="color: black;">TDF治疗</a></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">血清HBV DNA高水平是母婴传播的高危<span style="color: black;">原因</span>，妊娠中后期<span style="color: black;">倘若</span>HBV DNA定量＞2×10^5IU/mL，<span style="color: black;">意见</span>在与<span style="color: black;">病人</span>充分沟通，在其知情同意的<span style="color: black;">基本</span>上，于妊娠第24~28周<span style="color: black;">起始</span>抗病毒治疗，应用TDF或LdT。</p><span style="color: black;"><a style="color: black;">免疫耐受期</a></span>口服NAs的孕妇，可于产后即刻或<span style="color: black;">吃下</span>1~3个月后停药。停药后17.2%~62%的<span style="color: black;">病人</span>可能<span style="color: black;">出现</span>肝炎活动，且多<span style="color: black;">出现</span>在24周内，应加强产后监测。可于产后4~6周时复查肝脏生物化学指标及HBV DNA，如肝生物化学指标正常，则每3个月复查1次至产后6个月，<span style="color: black;">倘若</span>乙型肝炎活动，<span style="color: black;">意见</span>抗病毒治疗。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p>HBsAg阳性孕妇，分娩过程中其新生儿<span style="color: black;">已然</span>暴露于病毒，出生后<span style="color: black;">必要</span>尽快注射HBIG和乙肝疫苗，这是预防母婴传播的<span style="color: black;">重要</span>，即使孕妇妊娠期接受了<span style="color: black;"><a style="color: black;">抗病毒预防治疗</a></span>。HBIG的有效<span style="color: black;">成份</span>是<span style="color: black;"><a style="color: black;">抗-HBs</a></span>，注射后15~30min后即<span style="color: black;">起始</span>发挥<span style="color: black;">功效</span>，我国对HBsAg阳性孕妇的新生儿<span style="color: black;">供给</span>１针免费的HBIG（100IU）。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3）母婴阻断的<span style="color: black;">有些</span>问题</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Q1：母婴阻断的成功率有多少？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A1：<span style="color: black;">能够</span>达到几乎100%！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">指南中对感染用了<span style="color: black;">海量</span>的“几乎不<span style="color: black;">出现</span>”来描述：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">科研</span>证明，HBV DNA水平≤10^6 IU/mL的孕妇的新生儿经<span style="color: black;">即时</span>、正规的免疫预防后，几乎不<span style="color: black;">出现</span>母婴传播。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">HBeAg阴性孕妇的中位HBV DNA水平＜10^3 IU/mL，新生儿经正规预防后，几乎<span style="color: black;">没</span>感染。</p>采取联合免疫预防后，对HBeAg阴性孕妇的新生儿，<span style="color: black;">守护</span>率几乎为100％，几乎<span style="color: black;">再也不</span>感染；对HBeAg阳性孕妇的新生儿，<span style="color: black;">守护</span>率为90%~97%，感染率为3%~10%，<span style="color: black;">倘若</span>在新生儿出生后1h内<span style="color: black;">运用</span>联合预防，<span style="color: black;">守护</span>率<span style="color: black;">达到</span>97%以上，感染率＜3%。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">日前</span>较好的三甲医院都在追求100%阻断成功率。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span><span style="color: black;">文案</span>《育龄期女性慢性乙型肝炎的管理及母婴传播防治<span style="color: black;">办法</span>和成效》中<span style="color: black;">说到</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2010-2015年完<span style="color: black;">成为了</span>4820例乙型肝炎孕妇的母婴阻断随访，2016-2019年完<span style="color: black;">成为了</span>3607例乙型肝炎孕妇的母婴阻断随访，乙型肝炎母婴阻断成功率达到99.7%。</p>依据循证医学证据率先<span style="color: black;">创立</span>并完善了乙型肝炎病毒感染孕妇管理流程、母婴阻断规范化治疗和婴幼儿<span style="color: black;">长时间</span>随诊专诊系统，从生育咨询、妊娠乙型肝炎筛查<span style="color: black;">评定</span>、抗病毒治疗、婴儿联合免疫等环节，使乙型肝炎母婴感染率从2010年的8%～10%降至2020年的0.3%，<span style="color: black;">科研</span>成果<span style="color: black;">做为</span><span style="color: black;">要紧</span>的循证医学证据写入国内外各大<span style="color: black;"><a style="color: black;">妊娠乙型肝炎</a></span>防治指南，并<span style="color: black;">得到</span>美国Antiretroviral Pregnancy egistry（APR）杰出贡献奖。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Q2：<span style="color: black;"><a style="color: black;">母婴阻断</a></span>要<span style="color: black;">重视</span>什么？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A2：妊娠<span style="color: black;">指点</span>及生育医院的医疗水平对阻断成功率至关<span style="color: black;">要紧</span>，<span style="color: black;">意见</span>找有好感染科的医院生产。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">母婴传播的<span style="color: black;">机会</span>：<span style="color: black;">一般</span><span style="color: black;">出现</span>在分娩过程和产后，宫内感染非常罕见。产程中（<span style="color: black;">包含</span>剖宫产术中），胎儿或新生儿暴露于母体的血液和其他体液中，病毒可进入新生儿体。</p>分娩时新生儿曾“浸泡”在含有病毒的液体中，清理新生儿口腔、鼻道时，尽可能轻柔操作，避免过度用力，以避免皮肤黏膜<span style="color: black;">损害</span>而将病毒带入新生儿<span style="color: black;">身体</span>。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Q3：孕妇要打免疫球蛋白吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A3：<span style="color: black;">此刻</span><span style="color: black;">已然</span>不给孕妇打免疫球蛋白了，而是分娩后给婴儿打。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p>妊娠晚期<span style="color: black;">运用</span>HBIG<span style="color: black;">不可</span>减少母婴传播：因母<span style="color: black;">身体</span>存在<span style="color: black;">海量</span>HBsAg，绝对浓度可高达5~200mg/L(即μｇ/mL)。孕妇<span style="color: black;">运用</span>HBIG，其中的抗-HBs进入母体后<span style="color: black;">快速</span>与HBsAg结合形成免疫复合物，<span style="color: black;">因此呢</span>抗-HBs既<span style="color: black;">不可</span>进入胎儿，<span style="color: black;">亦</span><span style="color: black;">不可</span>降低母体的病毒水平，<span style="color: black;">不可</span>减少母婴传播。<span style="color: black;">因此呢</span>，妊娠晚期<span style="color: black;">不该</span>该<span style="color: black;">运用</span>HBIG。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Q4：剖腹产<span style="color: black;">能够</span>降低母婴传播几率吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A4：不是的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p>行剖宫产术并不降低HBV母婴传播率。<span style="color: black;">因此呢</span>，本指南不<span style="color: black;">举荐</span>以预防HBV母婴传播为目的而<span style="color: black;">选取</span>剖宫产术。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Q5：<span style="color: black;">能够</span>母乳喂养吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A5：<span style="color: black;">能够</span>的。<span style="color: black;">然则</span><span style="color: black;">针对</span>正在<span style="color: black;">吃下</span>抗病毒<span style="color: black;">药品</span>的产妇<span style="color: black;">可否</span><span style="color: black;">能够</span>母乳喂养，不同指南的<span style="color: black;">意见</span>不完全相同。<span style="color: black;">通常</span>认为TDF<span style="color: black;">能够</span>，TAF<span style="color: black;">因为</span>临床数据较少，<span style="color: black;">因此</span><span style="color: black;">小心</span><span style="color: black;">举荐</span>。但亚太肝病学会（APASL）的指南认为TAF<span style="color: black;">亦</span>适合哺乳产妇<span style="color: black;">运用</span>。<span style="color: black;">因此呢</span>，哺乳安全还是和主治医生充分沟通，<span style="color: black;">谨慎</span><span style="color: black;">思虑</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《乙型肝炎病毒母婴传播预防临床指南(2020)》</p><span style="color: black;">没</span>论孕妇HBeAg阴性还是阳性，<span style="color: black;">没</span>论新生儿口腔有<span style="color: black;">没</span><span style="color: black;">损害</span>，均可母乳喂养。孕妇产后<span style="color: black;">吃下</span>抗病毒<span style="color: black;">药品</span>，<span style="color: black;">意见</span>母乳喂养，<span style="color: black;">同期</span>观察对新生儿<span style="color: black;">可否</span>产生不良影响。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《慢性乙型肝炎防治指南(2019)年版》</p>应用TDF时，母乳喂养不是禁忌证。<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《Asian Pacifc association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy》</p>Tenofovir alafenamide <span style="color: black;"><a style="color: black;">fumarate</a></span>(TAF), is a new oral prodrug of<span style="color: black;"><a style="color: black;">tenofovir</a></span>. As compared to TDF, TAF delivers targeted increased intracellular levels of tenofovir, thus reducing the circulating tenofovir exposure. The enhanced safety profile of TAF makes it the ideal antiviral to use in pregnant and breastfeeding HBsAg-positive mothers.<h2 style="color: black; text-align: left; margin-bottom: 10px;">③阻断HBV母婴传播临床管理流程</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《阻断乙型肝炎病毒母婴传播临床管理流程（2021年）》</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><a style="color: black;">中国肝炎防治基金会</a></span>，中华医学会感<span style="color: black;">患病</span>学分会，中华医学会肝病学分会</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://picx.zhimg.com/80/v2-a1f94ea2e77b0049de49dbf5640c73da_720w.webp?source=1def8aca" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">此刻</span>的医疗水平下，乙肝<span style="color: black;">病人</span>的婚育<span style="color: black;">已然</span>完全不成问题。只要到正规医院的感染科治疗和<span style="color: black;">指点</span>生育，遵医嘱，<span style="color: black;">那样</span>家庭幸福，家人健康是有<span style="color: black;">保证</span>的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">【关于乙肝，你想<span style="color: black;">晓得</span>的】 - 乎乎的<span style="color: black;">文案</span> - 知乎 </p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><a style="color: black;"><span style="color: black;"><span style="color: black;">【关于乙肝，你想<span style="color: black;">晓得</span></span></span></a>的】<span style="color: black;">267 赞同 · 82 评论<span style="color: black;"><span style="color: black;">文案</span></span></span><span style="color: black;"><img src="https://pic1.zhimg.com/v2-4664346828af2b5d50d7a9482f52ecc8_ipico.jpg" style="width: 50%; margin-bottom: 20px;"></span></div>
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