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BMJ：多图展示手指损伤的各种可能——案例报道

2016-08-08 Seven L 译 MedSci原创

羊口疮病毒疱疹性瘭疽甲沟炎
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患者女，39岁，因右手食指无痛性肿胀2周就诊。2周前患者被羔羊咬伤手指后，渐渐发展为肿胀，但没有疼痛、感觉或运动变化。查体：体温和血流动力学稳定。右手食指运动、神经、血管无异常。手指在径向方面对甲襞近端有裂伤，约2 cm × 1.5 cm（如图所示）。腋窝没有明显的淋巴结肿大。本例患者有动物咬伤史，并且为无痛的蓝黑色斑丘疹病变，运动等功能未受限，所以患者可能诊断为羊口疮病毒感染。其诊断通常根据病史

患者女，39岁，因右手食指无痛性肿胀2周就诊。2周前患者被羔羊咬伤手指后，渐渐发展为肿胀，但没有疼痛、感觉或运动变化。

查体：体温和血流动力学稳定。右手食指运动、神经、血管无异常。手指在径向方面对甲襞近端有裂伤，约2 cm × 1.5 cm（如图所示）。腋窝没有明显的淋巴结肿大。



本例患者有动物咬伤史，并且为无痛的蓝黑色斑丘疹病变，运动等功能未受限，所以患者可能诊断为羊口疮病毒感染。其诊断通常根据病史和临床表现等即可确诊，当然也可以使用电子显微镜或DNA聚合酶链反应进行确诊；手指X线及伤口拭子试验可以用于鉴别诊断的排除。

附诊断和鉴别诊断图片：

1- 淤伤



2- 甲沟炎



3- 疱疹性瘭疽



4- 羊口疮病毒感染



5- 挤奶者结节



6- 角化棘皮瘤



7- 骨髓炎


（以上图片均来自BMJ）

原始出处：

David A Pettitt.et al.An unusual finger injury.BMJ 2016;353:i2680

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  1. 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time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140160, encodeId=88e5140160ba, content=形象直观，记忆深刻！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Tue Oct 04 23:30:48 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140037, encodeId=d0f014003e17, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, 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createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2017-07-20 gaoxiaoe

    #BMJ#

    0

  2. 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createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-10-11 inter158

    非常赞一图说明一切

    0

  3. 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createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-10-04 榄枷檬

    形象直观，记忆深刻！

    0

  4. 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time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140160, encodeId=88e5140160ba, content=形象直观，记忆深刻！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Tue Oct 04 23:30:48 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140037, encodeId=d0f014003e17, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-10-04 Carlos007

    图文并茂～非常棒！!

    0

  5. 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createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-10-04 Carlos007

    图文并茂～非常棒！!！

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1848065, encodeId=6dc11848065ff, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 20 09:35:00 CST 2017, time=2017-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144346, encodeId=2256144346ac, content=非常赞一图说明一切, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue Oct 11 15:00:47 CST 2016, 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createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-10-04 Carlos007

    图文并茂～非常棒！!

    0

  7. 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createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-08-27 ylzr123

    赞！文章有深度，值得收藏拜读。

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1848065, encodeId=6dc11848065ff, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 20 09:35:00 CST 2017, time=2017-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144346, encodeId=2256144346ac, content=非常赞一图说明一切, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue Oct 11 15:00:47 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140160, encodeId=88e5140160ba, content=形象直观，记忆深刻！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Tue Oct 04 23:30:48 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140037, encodeId=d0f014003e17, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:29:26 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140036, encodeId=2813140036ab, content=图文并茂～非常棒！!！, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:29:17 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140035, encodeId=2324140035e2, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-08-18 doctorJiangchao

    继续学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1848065, encodeId=6dc11848065ff, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 20 09:35:00 CST 2017, time=2017-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144346, encodeId=2256144346ac, content=非常赞一图说明一切, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue Oct 11 15:00:47 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140160, encodeId=88e5140160ba, content=形象直观，记忆深刻！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Tue Oct 04 23:30:48 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140037, encodeId=d0f014003e17, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:29:26 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140036, encodeId=2813140036ab, content=图文并茂～非常棒！!！, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:29:17 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140035, encodeId=2324140035e2, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-08-13 忠诚向上

    好好看下

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1848065, encodeId=6dc11848065ff, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Jul 20 09:35:00 CST 2017, time=2017-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144346, encodeId=2256144346ac, content=非常赞一图说明一切, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Tue Oct 11 15:00:47 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140160, encodeId=88e5140160ba, content=形象直观，记忆深刻！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Tue Oct 04 23:30:48 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140037, encodeId=d0f014003e17, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:29:26 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140036, encodeId=2813140036ab, content=图文并茂～非常棒！!！, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:29:17 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=140035, encodeId=2324140035e2, content=图文并茂～非常棒！!, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160923/IMG57E54D670B3C08868.jpg, createdBy=e90b1956497, createdName=Carlos007, createdTime=Tue Oct 04 16:28:55 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105479, encodeId=fe541054e92f, content=赞！文章有深度，值得收藏拜读。, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Aug 27 12:49:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100325, encodeId=8e28100325f0, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 14:50:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97971, encodeId=c5af9e971f1, content=好好看下, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 13 07:46:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97796, encodeId=a3f09e79649, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=dc0f1736772, createdName=1defde3am26(暂无匿称), createdTime=Fri Aug 12 16:07:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-08-12 1defde3am26(暂无匿称)

    受益匪浅

    0

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