CDS 2016:李光伟教授谈糖尿病预防,生活方式干预还是药物干预

2016-11-18 MedSci MedSci原创

糖尿病的洪流无情地冲刷着伟大祖国的每一寸土地。从大东北到大西南的每个城市和农村无一能幸免,我们每乘坐一次飞机、一次汽车、甚至每乘坐一次电梯都可能有糖尿病人相伴……无数指南推动的“每天服用20片药”,“三年放五枚支架”的治疗没能阻挡糖尿病害人的脚步,反而掏空了人们的腰包。活到70岁以上者:DM中占56%,NGT中占78%,糖尿病人群任何死亡比血糖正常者要提前10年。中国大庆地区筛查糖尿病人群心血管死

糖尿病的洪流无情地冲刷着伟大祖国的每一寸土地。从大东北到大西南的每个城市和农村无一能幸免,我们每乘坐一次飞机、一次汽车、甚至每乘坐一次电梯都可能有糖尿病人相伴……

无数指南推动的“每天服用20片药”,“三年放五枚支架”的治疗没能阻挡糖尿病害人的脚步,反而掏空了人们的腰包。

活到70岁以上者:DM中占56%,NGT中占78%,糖尿病人群任何死亡比血糖正常者要提前10年。



中国大庆地区筛查糖尿病人群心血管死亡与血糖正常者比较



如果未干预,平均年龄45岁IGT不干预20年后,严重视网膜病变的有17%,全因死亡33%,心梗或脑卒中44%,恶化为糖尿病93%



但是6年的积极生活方式干预糖尿病发病率下降,其中饮食干预下降31%,运动干预的下降46%,饮食+运动干预的下降42%。



之后,中国的试验在许多国家被成功地复制和发扬,从而掀起了世界性糖尿病预防的热潮,毫无疑问,健康的生活方式可以在世界各国预防糖尿病。

之后,对大庆糖尿病预防研究中所有参与者进行了20年的随访发现,干预组糖尿病发生平均延后了3.6年。



之后,生活方式干预长期的后效应被其他国家研究证实。生活方式干预23年(1986-2009)对累计全因死亡和累计心血管死亡的影响也有非常大。IGT人群中糖尿病发生越推迟,死亡率也就越低,也就是说:越早进展为糖尿病死亡越多。


研究组在23年随访后发现“糖尿病预防居然降低了心血管死亡”,实现了长期的梦想。《柳叶刀》杂志评论这种无需高科技的干预措施有很大的强力,特别是对于糖尿病快速增加的发展中国家。

在本次会议上,梅斯医学的编辑有幸对李教授进行的简短的提问

梅斯医学:对于生活方式干预,具体要怎么实施?

李光伟教授:生活方法干预是很困难的,但是我们不应该因为困难就不去做,如果不去做,那我们就会无路可走。在国外,药物干预比生活方式干预的成本便宜,因为国外药物比较便宜,人力比较贵。但是在国内,恰恰相反,药物干预在中国很难实现,药物干预十几年的成本也是很大的,所以生活方式干预就是很有必要的。

这方面需要国家组织专门的机构,经过培训,证明有能力承担有效的干预工作并取得卫生行政部门的资格认可。

梅斯医学:二甲双胍最近被美国引进,这个药物有何潜质?

李光伟教授:二甲双胍在中国使用有大约80年了,美国引进了是二甲双胍,是因为这个药便宜,而且在安全控糖,减重,降血压血脂,炎症治疗,抗衰老,癌症预防等方面都证明有效。而其他药物比如DPP4i,现在还没有相关的研究证明其对降糖的效果,还需要进一步的研究。

最后李教授用了一首诗词将糖尿病的现状说的透彻,并结束了精彩的演讲

甘脆肥浓 胖杀群群猛士
龙车凤撵 瘫痪代代英豪
岐黄妙手 虽能救急救苦
少吃多动 才是防糖正道

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    2018-02-05 Tulipzyz

    大庆研究很厉害.影响深远

    0

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likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4420, encryptionId=5dfe4420fc, topicName=CDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec25412, createdName=yangpeizhi, createdTime=Sun Nov 20 10:56:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157004, encodeId=3f3515e004eb, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:18:40 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157003, encodeId=e34415e003bd, content=继续关注, 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/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=285392, encodeId=aaf1285392ba, content=大庆研究很厉害.影响深远, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef621732290, createdName=Tulipzyz, createdTime=Mon Feb 05 14:50:58 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2045469, encodeId=d318204546965, content=<a href='/topic/show?id=a982e680663' target=_blank style='color:#2F92EE;'>#糖尿病预防#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76806, encryptionId=a982e680663, topicName=糖尿病预防)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Sun Jan 01 10:56:00 CST 2017, time=2017-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1640757, encodeId=c8a11640e577b, content=<a href='/topic/show?id=73b88e73171' target=_blank style='color:#2F92EE;'>#药物干预#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87731, encryptionId=73b88e73171, topicName=药物干预)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0e22719928, createdName=ms6980045490879608, createdTime=Sun Jul 30 00:56:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157360, encodeId=5a7e15e360e0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Tue Nov 22 00:36:06 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157359, encodeId=d7a015e359c1, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Tue Nov 22 00:36:01 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157159, encodeId=2e1e15e15962, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Nov 21 00:02:49 CST 2016, time=2016-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157061, encodeId=7e2115e061fd, content=健康宣教很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Sun Nov 20 13:31:10 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377605, encodeId=2ec613e7605e0, content=<a href='/topic/show?id=5dfe4420fc' target=_blank style='color:#2F92EE;'>#CDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4420, encryptionId=5dfe4420fc, topicName=CDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec25412, createdName=yangpeizhi, createdTime=Sun Nov 20 10:56:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157004, encodeId=3f3515e004eb, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:18:40 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157003, encodeId=e34415e003bd, content=继续关注, 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/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
    2016-11-22 童小孩

    继续关注

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=285392, encodeId=aaf1285392ba, content=大庆研究很厉害.影响深远, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef621732290, createdName=Tulipzyz, createdTime=Mon Feb 05 14:50:58 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2045469, encodeId=d318204546965, content=<a href='/topic/show?id=a982e680663' target=_blank style='color:#2F92EE;'>#糖尿病预防#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76806, encryptionId=a982e680663, topicName=糖尿病预防)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Sun Jan 01 10:56:00 CST 2017, time=2017-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1640757, encodeId=c8a11640e577b, content=<a href='/topic/show?id=73b88e73171' target=_blank style='color:#2F92EE;'>#药物干预#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87731, encryptionId=73b88e73171, topicName=药物干预)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0e22719928, createdName=ms6980045490879608, createdTime=Sun Jul 30 00:56:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157360, encodeId=5a7e15e360e0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Tue Nov 22 00:36:06 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157359, encodeId=d7a015e359c1, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Tue Nov 22 00:36:01 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157159, encodeId=2e1e15e15962, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Nov 21 00:02:49 CST 2016, time=2016-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157061, encodeId=7e2115e061fd, content=健康宣教很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Sun Nov 20 13:31:10 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377605, encodeId=2ec613e7605e0, content=<a href='/topic/show?id=5dfe4420fc' target=_blank style='color:#2F92EE;'>#CDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4420, encryptionId=5dfe4420fc, topicName=CDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec25412, createdName=yangpeizhi, createdTime=Sun Nov 20 10:56:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157004, encodeId=3f3515e004eb, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:18:40 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157003, encodeId=e34415e003bd, content=继续关注, 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/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
    2016-11-22 童小孩

    继续关注

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=285392, encodeId=aaf1285392ba, content=大庆研究很厉害.影响深远, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef621732290, createdName=Tulipzyz, createdTime=Mon Feb 05 14:50:58 CST 2018, time=2018-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2045469, encodeId=d318204546965, content=<a href='/topic/show?id=a982e680663' target=_blank style='color:#2F92EE;'>#糖尿病预防#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76806, encryptionId=a982e680663, topicName=糖尿病预防)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Sun Jan 01 10:56:00 CST 2017, time=2017-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1640757, encodeId=c8a11640e577b, content=<a href='/topic/show?id=73b88e73171' target=_blank style='color:#2F92EE;'>#药物干预#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87731, encryptionId=73b88e73171, topicName=药物干预)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de0e22719928, createdName=ms6980045490879608, createdTime=Sun Jul 30 00:56:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157360, encodeId=5a7e15e360e0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Tue Nov 22 00:36:06 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157359, encodeId=d7a015e359c1, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Tue Nov 22 00:36:01 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157159, encodeId=2e1e15e15962, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Nov 21 00:02:49 CST 2016, time=2016-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157061, encodeId=7e2115e061fd, content=健康宣教很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Sun Nov 20 13:31:10 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377605, encodeId=2ec613e7605e0, content=<a href='/topic/show?id=5dfe4420fc' target=_blank style='color:#2F92EE;'>#CDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4420, encryptionId=5dfe4420fc, topicName=CDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec25412, createdName=yangpeizhi, createdTime=Sun Nov 20 10:56:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157004, encodeId=3f3515e004eb, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:18:40 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157003, encodeId=e34415e003bd, content=继续关注, 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/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
    2016-11-21 童小孩

    继续关注

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Mon Nov 21 00:02:49 CST 2016, time=2016-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157061, encodeId=7e2115e061fd, content=健康宣教很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Sun Nov 20 13:31:10 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377605, encodeId=2ec613e7605e0, content=<a href='/topic/show?id=5dfe4420fc' target=_blank style='color:#2F92EE;'>#CDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4420, encryptionId=5dfe4420fc, topicName=CDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec25412, createdName=yangpeizhi, createdTime=Sun Nov 20 10:56:00 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157004, encodeId=3f3515e004eb, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:18:40 CST 2016, time=2016-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157003, encodeId=e34415e003bd, content=继续关注, 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/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
    2016-11-20 susice

    健康宣教很重要

    0

  8. 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level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
    2016-11-20 yangpeizhi
  9. 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level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K3j7ibEWPiarwpqibEYqqX9yVibV5uebib0O7hQSOPmqGrb5FfyDbLsLawnz7ShAb5ibtiayWgI5ClMTh5v/0, createdBy=a47c1614293, createdName=童小孩, createdTime=Sun Nov 20 08:17:13 CST 2016, time=2016-11-20, status=1, ipAttribution=)]
    2016-11-20 童小孩

    继续关注

    0

  10. 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