NEJM:他汀不能预防心脏手术后房颤(STICS研究)

2016-05-05 MedSci MedSci原创

5月5日,由国家心血管病中心阜外医院心血管外科郑哲研究团队与英国牛津大学合作开展的关于心脏手术围手术期使用他汀药物治疗房颤的大规模随机对照双盲临床试验——STICS研究结果发表于国际医学领域的顶级权威期刊《新英格兰医学杂志》STICS ClinicalTrials.gov number, NCT01573143.)。 房颤是最为常见的心律失常性疾病,有关资料显示我国房颤患者人数达8

5月5日,由国家心血管病中心阜外医院心血管外科郑哲研究团队与英国牛津大学合作开展的关于心脏手术围手术期使用他汀药物治疗房颤的大规模随机对照双盲临床试验——STICS研究结果发表于国际医学领域的顶级权威期刊《新英格兰医学杂志》(STICS ClinicalTrials.gov number, NCT01573143.)。

房颤是最为常见的心律失常性疾病,有关资料显示我国房颤患者人数达800万,房颤可使患者脑卒中发生率增加5倍,心衰发生率增加3倍。术后房颤是心脏手术术后最常见的并发症之一,发生率高达35%至50%。其所造成的患者血流动力学不稳定,能够显著增加脑卒中、心血管死亡的发生风险,同时会对患者康复造成不利影响,延长住院时间并增加医疗费用。

既往研究显示,高胆固醇水平也是影响心血管疾病发生发展的重要危险因素。持续服用他汀药物降低低密度脂蛋白胆固醇(LDL-C)是预防心血管事件的重要举措。阜外医院前期开展的心脏预防研究(HPS)结果显示,应用辛伐他汀降低LDL-C对血管合并症和死亡有积极的预防作用。另一方面,与心脏手术和体外循环相关的氧化应激和炎症反应是术后房颤发生的罪魁祸首。心房NADPH氧化酶2(NOX2)活性是预测术后新发房颤的独立因子,心房NOX2活性越强,房颤的发生率也越高。研究表明,他汀不仅可以通过竞争性抑制HMG-CoA还原酶而起到降低LDL-C的作用,还可抑制NOX2活性,其抗炎、抗氧化应激的作用也逐步为基础和临床研究所证实。


 



已有的小规模临床研究显示,他汀类药物能够降低心脏术后房颤的发生,减少心肌损伤,改善左心室功能,保护肾功能,缩短重症监护和住院时间。“目前欧洲冠脉再血管化治疗指南(2014)推荐搭桥手术后应接受他汀治疗维持LDL-C<70mg/dl,美国冠状动脉旁路移植指南(2011)及冠状动脉旁路移植二级预防指南(2015)亦强烈建议所有行搭桥手术的患者围术期接受他汀治疗,除非患者有明确用药禁忌。”STICS研究主要负责人,阜外医院郑哲教授提到,“尽管他汀药物在心脏手术,特别是冠状动脉旁路移植术围术期的应用已成为业内共识,其降低心脏术后并发症的效益仍众说纷纭,且药物作用机制也尚未完全阐明”。

STICS研究以心脏手术领域他汀药物治疗的现存争议为核心,在研究设计之初就备受业内关注。研究的英国方合作者,牛津大学的Barbara Casadei教授是国际知名的房颤疾病发生机制和临床治疗研究领域专家。阜外医院郑哲教授领衔的心血管外科研究团队凭借丰富的国际合作临床研究开展经验,从患者入选、治疗干预、样本采集等各环节严密把关,保障该研究的顺利进行。研究曾入选2014年8月在巴塞罗那召开的欧洲心脏病学学会(ESC)年会六大亮点研究,并被特邀在2015年中国心脏大会开幕式上作了主题报告。

STICS研究是严格按照国际标准设计实施的随机、双盲、安慰剂对照临床试验,从设计到完成历时超过5年。研究共纳入阜外医院1922例窦性心律无房颤史且拟择期接受心脏手术的患者。受试者均在术前8天开始服用瑞舒伐他汀(20 mg/d),在术后第5天停药。主要研究终点为术后房颤发生率(Holter ECG监测)和心肌损伤(术后第6,24,48,120小时肌钙蛋白水平)。次要研究终点为术后重症监护时间、心脑血管事件、左心室射血分数、肾功能、LDL-C以及NT-proBNP水平。研究发现,与安慰剂相比,瑞舒伐他汀确实可以显著降低LDL-C水平,但并没有降低术后肌钙蛋白水平(102 ng-hr/mL versus 100 ng-hr/mL, P=0.80)和房颤的发生率(21% vs 20%,P=0.72),也没有缩短住院时间,相反还会增加肾功能损伤(24.7% vs 19.3%,P=0.0047)。

郑哲教授认为,尽管研究结论可能受到研究人群、样本量和他汀种类等因素的影响,但研究的整体结论和亚组分析结果对临床现有认识和实践仍具有重要的提示作用。“我们必须意识到,一方面,现有的研究证据难以全面支持临床指南中关于他汀药物在心脏手术围术期的应用规范,更新后的欧洲再血管化治疗指南确实对他汀治疗策略有所细化,但依旧面临客观证据不足的窘境;另一方面,心脏手术的不同类型、患者个体的差异等因素应对他汀药物的个性化使用起到指导作用,以实现治疗效益的准确化和最大化。”

据悉,STICS研究是国家心血管病中心阜外医院获准设立国家心血管疾病临床医学研究中心后完成的又一项高水平、标准化国际合作临床研究,同时也是中国学者在国际心血管领域取得的又一杰出成果。该研究是全球范围内迄今为止最大规模评价他汀药物在心脏手术围术期应用有效性的临床研究,采用术后连续、客观监测的房颤和心肌损伤为研究终点,研究结论打破了国际上以往他汀治疗降低心脏术后并发症的传统观点,为现行的临床指南和诊疗常规提出了挑战并提供了全新的参考和借鉴,这必将为他汀药物围手术期治疗的进一步规范和后续研究的开展起到积极而重要的推动作用。

原始出处:
Zhe Zheng, M.D., Raja Jayaram, M.D., Lixin Jiang, M.D., Jonathan Emberson, Ph.D., Yan Zhao, M.D., Qi Li, M.D., Juan Du, M.D., Silvia Guarguagli, M.D., Michael Hill, D.Phil., Zhengming Chen, D.Phil., Rory Collins, M.B., B.S., and Barbara Casadei. Perioperative Rosuvastatin in Cardiac Surgery.N Engl J Med 2016; 374:1744-1753

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (11)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    要是用的再便宜点就好了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    用不起啊

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    积分积分

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    好难搞到

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    学习了,很好的

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    这个app真好

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-10 stead

    临床和科研的完美结合

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-09 QQ6709219e

    好文章,值得深究学习

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=2066832, encodeId=8a6c2066832e8, content=<a href='/topic/show?id=fe1a6106394' target=_blank style='color:#2F92EE;'>#术后房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61063, encryptionId=fe1a6106394, topicName=术后房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Oct 22 06:44:00 CST 2016, time=2016-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85200, encodeId=b969852001b, content=要是用的再便宜点就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85201, encodeId=b47d85201e3, content=用不起啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85202, encodeId=8727852021e, content=积分积分, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85203, encodeId=c38385203e1, content=好难搞到, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, 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=Tue May 10 06:43:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85197, encodeId=8af78519e2d, content=学习了,很好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85198, encodeId=a5598519866, content=这个app真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85199, encodeId=24198519986, content=临床和科研的完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, 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=Tue May 10 06:42:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85123, encodeId=c8b485123a7, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85124, encodeId=2b95851247d, content=好文章,值得深究学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Mon May 09 20:53:00 CST 2016, time=2016-05-09, status=1, ipAttribution=)]
    2016-05-09 QQ6709219e

    好文章,值得深究学习

    0

相关资讯

血脂血压正常的人群应否接受他汀与降压治疗?——关注HOPE-3研究结论

作者:河北省人民医院  郭艺芳 刚刚在ACC年会上揭晓了HOPE-3研究结果,表明无心血管疾病的中等风险水平的人群降压治疗无益,但他汀治疗可显著降低主要终点事件发生率。近年来,关于不同心血管危险水平人群的降压目标值一直是国内外学者广泛关注的热点。自2013年以来,欧美国家颁布的多部指南性文件均不同程度的放宽了高危人群的血压控制目标。然而在刚过去的2015年度,SPRINT研

NEJM:他汀类药物可显著降低中度危险人群的心血管疾病风险

先前的试验表明,使用他汀类药物降低胆固醇可减少无心血管疾病人群的心血管事件风险。这些试验主要包括胆固醇或炎性标志物升高的人群,主要是白人。但他汀类的益处是否可以延伸到无心血管疾病的中度危险人群,不同种族人群尚不清楚。

Circulation: 应用他汀药物后,血脂和冠心病发生风险之间的相关性减弱

背景:2001年胆固醇治疗指南发表后,US冠心病成人中他汀类药物的应用增加。方法:研究者收集REGARDS研究中的9578名受试者及KPSC中346 595人,2003年到2007年间的血脂水平,评估血脂和CHD之间的相关性。研究者也收集了1987到1989 ARIC研究中14 590名受试者的血脂水平,对其进行相同的分析。分析限制在45到64岁间,没有CHD,也没有服用他汀类药物的黑人和白人。基

Eur J Clin Pharmacol:卒中前,应用他汀类药物可降低卒中的严重程度

背景:卒中是一个重要的健康问题,发病率和死亡率较高。各种危险因素和心血管药物治疗组影响卒中的发生率,但是药物应用和卒中的严重程度之间的关系尚不清楚。目标:确定卒中前心血管药物使用是否与卒中严重程度相关。方法:回顾性分析布一个数据库中的数据,1974名在鲁塞尔UZ总医院住院的疑似卒中患者。应用NHISS分数评估卒中的严重程度。第一,多变量线性回归模型包括心血管药物组。第二,获得临床可以解释的结果,所

Neurology:应用他汀类药物可降低卒中后出血的风险

目标:评估急性缺血性卒中(AIS)发生前后应用他汀类药物治疗对急性脑出血(ICH)的风险,急性后期ICH的风险及90天死亡率的影响。方法:研究者从虚拟国际卒中试验档案(VISTA)这一国际资料库的临床试验数据中选取数据。应用倾向评分匹配,研究者回顾性比较先前应用他汀治疗的患者和AIS后3天开始应用他汀类治疗的患者。主要预后为急性症状型ICH(sICH),任何急性ICH,急性后期ICH和随访3个月的

PLoS Med:别再迷信他汀药物 真正降低结直肠癌风险的是胆固醇

根据一项发表在国际学术期刊Plos Medicine上的大型病例对照研究,长期服用具有降胆固醇作用的他汀类药物并不能降低病人患结直肠癌的风险。这项对超过10万人的药物使用记录进行的观察分析表明,真正影响结直肠癌风险的是胆固醇水平而非饱受争议的他汀类药物。宾夕法尼亚大学Perelman医学院的Ronac Mamtani表示:“之前人们以为他汀类药物具有癌症预防作用,但事实可能并非如此。虽然相比于未服