Lancet:钙过敏症-案例报道

2016-05-09 Mechront 译 MedSci原创

患者男,59岁,因腿部出现不愈合的溃疡伴疼痛入院。入院前2个月内患者无外伤性病变。患者有有终末期肾病,进行血液透析治疗。查体:双侧足背动脉可扪及,没有慢性静脉功能不全的表现。X线:软组织弥漫性钙化,呈血管网状模式。皮肤组织活检:血管硬化,血栓形成;硝酸银染色阳性提示钙沉积。诊断:钙过敏症。治疗:停用苯丙香豆素,使用西那卡塞 、每日血液透析、硫代硫酸钠和磷酸盐治疗。4周后,患者的皮肤状况好转,患者出

患者男,59岁,因腿部出现不愈合的溃疡伴疼痛入院。入院前2个月内患者无外伤性病变。



患者有有终末期肾病,进行血液透析治疗。

查体:双侧足背动脉可扪及,没有慢性静脉功能不全的表现。

X线:软组织弥漫性钙化,呈血管网状模式。

皮肤组织活检:血管硬化,血栓形成;硝酸银染色阳性提示钙沉积。



诊断:钙过敏症。

治疗:停用苯丙香豆素,使用西那卡塞 、每日血液透析、硫代硫酸钠和磷酸盐治疗。4周后,患者的皮肤状况好转,患者出院。

钙过敏症是一种会导致组织坏死的动脉系统动脉中层钙化综合征。皮肤活检和影像学特征有助于诊断,但阴性结果不一定排除诊断。发病机制仍不清楚。本案例中与该疾病相关的危险因素有:终末期肾脏疾病、继发性甲状旁腺功能亢进、口服抗凝药苯丙香豆素。有报告称,与骨骼疾病相关的低水平的甲状旁腺激素也有导致钙过敏症的可能。不过目前对于该疾病还没有标准化的治疗。

原始出处:

Qian Zhou,Jakob Neubauer, et al.Calciphylaxis.The Lancet.DOI: http://dx.doi.org/10.1016/S0140-6736(14)60235-X

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  1. 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    2017-03-18 howi
  2. 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    2016-08-29 ylzr123

    深入学习,好文值得点赞!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1828473, encodeId=f90718284e379, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Mar 18 18:00:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106935, encodeId=1cca10693560, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106936, encodeId=2e9d1069364b, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85873, encodeId=3267858e394, content=挺新病例分享,目前自己还没在临床上遇到。, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 14:14:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516439, encodeId=5f1e151643936, content=<a href='/topic/show?id=0c06940668a' target=_blank style='color:#2F92EE;'>#过敏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94066, encryptionId=0c06940668a, topicName=过敏症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def310968681, createdName=ms1948154235210413, createdTime=Wed May 11 00:00:00 CST 2016, time=2016-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85338, encodeId=c79285338ab, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:52:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85263, encodeId=0d638526336, content=多么时候我们的病例讨论也能发, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85264, encodeId=adde85264fc, content=我们要学习的还有很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85262, encodeId=76e585262c5, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:33:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85150, encodeId=9ea68515098, content=很不错啊 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Mon May 09 23:08:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-08-29 ylzr123

    深入学习,好文值得点赞!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1828473, encodeId=f90718284e379, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Mar 18 18:00:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106935, encodeId=1cca10693560, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106936, encodeId=2e9d1069364b, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85873, encodeId=3267858e394, content=挺新病例分享,目前自己还没在临床上遇到。, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 14:14:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516439, encodeId=5f1e151643936, content=<a href='/topic/show?id=0c06940668a' target=_blank style='color:#2F92EE;'>#过敏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94066, encryptionId=0c06940668a, topicName=过敏症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def310968681, createdName=ms1948154235210413, createdTime=Wed May 11 00:00:00 CST 2016, time=2016-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85338, encodeId=c79285338ab, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:52:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85263, encodeId=0d638526336, content=多么时候我们的病例讨论也能发, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85264, encodeId=adde85264fc, content=我们要学习的还有很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85262, encodeId=76e585262c5, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:33:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85150, encodeId=9ea68515098, content=很不错啊 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Mon May 09 23:08:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-15 Lisa971

    挺新病例分享,目前自己还没在临床上遇到。

    0

  5. 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  6. [GetPortalCommentsPageByObjectIdResponse(id=1828473, encodeId=f90718284e379, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Mar 18 18:00:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106935, encodeId=1cca10693560, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106936, encodeId=2e9d1069364b, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85873, encodeId=3267858e394, content=挺新病例分享,目前自己还没在临床上遇到。, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 14:14:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516439, encodeId=5f1e151643936, content=<a href='/topic/show?id=0c06940668a' target=_blank style='color:#2F92EE;'>#过敏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94066, encryptionId=0c06940668a, topicName=过敏症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def310968681, createdName=ms1948154235210413, createdTime=Wed May 11 00:00:00 CST 2016, time=2016-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85338, encodeId=c79285338ab, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:52:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85263, encodeId=0d638526336, content=多么时候我们的病例讨论也能发, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85264, encodeId=adde85264fc, content=我们要学习的还有很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85262, encodeId=76e585262c5, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:33:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85150, encodeId=9ea68515098, content=很不错啊 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Mon May 09 23:08:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 1dd8a7c5m95(暂无匿称)

    值得阅读,学习!

    0

  7. 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    2016-05-10 lu2996

    多么时候我们的病例讨论也能发

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1828473, encodeId=f90718284e379, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Mar 18 18:00:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106935, encodeId=1cca10693560, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106936, encodeId=2e9d1069364b, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85873, encodeId=3267858e394, content=挺新病例分享,目前自己还没在临床上遇到。, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 14:14:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516439, encodeId=5f1e151643936, content=<a href='/topic/show?id=0c06940668a' target=_blank style='color:#2F92EE;'>#过敏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94066, encryptionId=0c06940668a, topicName=过敏症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def310968681, createdName=ms1948154235210413, createdTime=Wed May 11 00:00:00 CST 2016, time=2016-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85338, encodeId=c79285338ab, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:52:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85263, encodeId=0d638526336, content=多么时候我们的病例讨论也能发, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85264, encodeId=adde85264fc, content=我们要学习的还有很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85262, encodeId=76e585262c5, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:33:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85150, encodeId=9ea68515098, content=很不错啊 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Mon May 09 23:08:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 lu2996

    我们要学习的还有很多

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1828473, encodeId=f90718284e379, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Mar 18 18:00:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106935, encodeId=1cca10693560, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106936, encodeId=2e9d1069364b, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85873, encodeId=3267858e394, content=挺新病例分享,目前自己还没在临床上遇到。, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 14:14:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516439, encodeId=5f1e151643936, content=<a href='/topic/show?id=0c06940668a' target=_blank style='color:#2F92EE;'>#过敏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94066, encryptionId=0c06940668a, topicName=过敏症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def310968681, createdName=ms1948154235210413, createdTime=Wed May 11 00:00:00 CST 2016, time=2016-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85338, encodeId=c79285338ab, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:52:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85263, encodeId=0d638526336, content=多么时候我们的病例讨论也能发, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85264, encodeId=adde85264fc, content=我们要学习的还有很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85262, encodeId=76e585262c5, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:33:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85150, encodeId=9ea68515098, content=很不错啊 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Mon May 09 23:08:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 lu2996

    学习中

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1828473, encodeId=f90718284e379, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Mar 18 18:00:00 CST 2017, time=2017-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106935, encodeId=1cca10693560, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106936, encodeId=2e9d1069364b, content=深入学习,好文值得点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 17:09:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85873, encodeId=3267858e394, content=挺新病例分享,目前自己还没在临床上遇到。, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun May 15 14:14:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516439, encodeId=5f1e151643936, content=<a href='/topic/show?id=0c06940668a' target=_blank style='color:#2F92EE;'>#过敏症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94066, encryptionId=0c06940668a, topicName=过敏症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def310968681, createdName=ms1948154235210413, createdTime=Wed May 11 00:00:00 CST 2016, time=2016-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85338, encodeId=c79285338ab, content=值得阅读,学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Tue May 10 12:52:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85263, encodeId=0d638526336, content=多么时候我们的病例讨论也能发, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85264, encodeId=adde85264fc, content=我们要学习的还有很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:34:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85262, encodeId=76e585262c5, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c1b91651063, createdName=lu2996, createdTime=Tue May 10 11:33:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85150, encodeId=9ea68515098, content=很不错啊 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Mon May 09 23:08:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-09 stead

    很不错啊

    0