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NEJM：脾脏移位-病例报道

2020-11-19 MedSci原创 MedSci原创

呕吐腹痛脾脏移位
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脾脏移位是脾脏韧带松弛导致的罕见病。随着脾脏的移动，可能导致脾门内或脾门附近结构的扭曲，包括胰腺尾巴，这可能会导致急性胰腺炎。对于这种情况的明确治疗是脾切除术。

患者为一名36岁的妇女因腹痛和呕吐1天，而到急诊就诊。她患有溃疡性结肠炎以及因原发性硬化性胆管炎而导致的肝硬化，她的手术史包括全结肠切除术，胆囊切除术和阑尾切除术。

体格检查发现腹部弥漫性压痛。实验室检查发现脂肪酶水平为682 IU/L（参考范围为5至50）。腹部计算机断层扫描发现脾脏位于右下象限（如图A星号所示），胰尾部位于下方和右侧。在本次就诊前两天，患者已通过磁共振胆胰胰管造影术进行了肝细胞癌的常规筛查，该检查显示脾脏位于腹部左侧（如图B星号所示），以及胰腺正常，未见胆结石。

脾脏移位是脾脏韧带松弛导致的罕见病。随着脾脏的移动，可能导致脾门内或脾门附近结构的扭曲，包括胰腺尾巴，这可能会导致急性胰腺炎。对于这种情况的明确治疗是脾切除术。

该患者接受了肠胃外疼痛控制治疗和补液治疗，腹痛和呕吐得以缓解。由于该患者正在进行肝移植评估，因此推迟了脾切除术。

原始出处：

Alexander Wester,et al.Wandering Spleen.N Engl J Med.2020;https://www.nejm.org/doi/full/10.1056/NEJMicm2003627

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    2020-11-26 海盗船长

    好文章！

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-21 追逐着

    学习病例

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-20 ms3000001818868558

    非常好的病例

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 Baodongxu

    学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 旺医

    顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 ms4000001317950635

    好的

    0

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    2020-11-19 124c4ba8m65暂无昵称

    学习中

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 titiwangsunny

    谢谢

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 ms8000001960994722

    666

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=902531, encodeId=f46090253189, content=好文章！, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqgjrd5sqia9SxoRDrrHyGx1rdtniayrW3OZxZq1ZFwnic0zYSSLeowYhMR0cNFfhHbRZuPcJQfMd9WQ/132, createdBy=22452183242, createdName=海盗船长, createdTime=Thu Nov 26 16:51:54 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900963, encodeId=ff9b9009639c, content=学习病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200925/715f77a9a29d4907967d9aff0401c7dd/e9332ce2f0474cf4bcce214162b301b2.jpg, createdBy=07f32537611, createdName=追逐着, createdTime=Sat Nov 21 10:29:16 CST 2020, time=2020-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900695, encodeId=1d5d90069534, content=非常好的病例, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201124/2e41e368c07d43d294a6e1733a82ef72/41673fa4f0584c08b9e0741da72c3008.jpg, createdBy=a36e5436504, createdName=ms3000001818868558, createdTime=Fri Nov 20 07:58:07 CST 2020, time=2020-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900455, encodeId=e20790045529, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210315/480e12f811f44bc39b347d2521d56e86/67d0e6d503124ea685205b567af3dffd.jpg, createdBy=f9435296193, createdName=Baodongxu, createdTime=Thu Nov 19 13:14:56 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035500, encodeId=a2e410355000b, content=顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 19 11:14:12 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900405, encodeId=aed190040569, content=好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3055395222, createdName=ms4000001317950635, createdTime=Thu Nov 19 10:24:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900397, encodeId=cb0b90039e1c, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68692513618, createdName=124c4ba8m65暂无昵称, createdTime=Thu Nov 19 09:54:25 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900388, encodeId=11d29003883d, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6a51476719, createdName=titiwangsunny, createdTime=Thu Nov 19 09:38:15 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900379, encodeId=58049003e9f8, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/797a4bfb014344ef9aaf61d4e9e70516/9b7bea42f7d4451eb7049db4faed2274.jpg, createdBy=2cba5436368, createdName=ms8000001960994722, createdTime=Thu Nov 19 09:25:37 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900369, encodeId=a268900369d6, content=学习中, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201119/b67c8afa4ea8415488135a3c0aeb7e2a/64ac537f3a264073af97e54401434211.jpg, createdBy=a3c05436358, createdName=ms3000000722898900, createdTime=Thu Nov 19 08:57:50 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 ms3000000722898900

    学习中

    0

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