妇产科

订阅

MedSci主页 / 所有栏目 / 妇产科

Hum Reprod Update：早期妊娠中孕囊、胎盘和胎儿致畸的作用机制

2021-03-08 MedSci原创 MedSci原创

早期妊娠致畸机制
关注

与胚胎相比，胎盘可能更直接地通过其代偿和高度进化的机制来保护和确保胎儿的存活和未来的生殖成功。

在胚胎学和畸胎学这两个密切相关的领域中，孕囊（GS）和胎盘是最基本的概念。胎盘可以是致畸剂进入胎儿组织的屏障，也可以是转运体。在妊娠早期，与致畸效应相关的分子机制（包括胎盘和胚胎）的已发表数据和理论范围有限。

有研究者提出四种机制来模拟致畸原，这些研究考虑了相关的生物发育学，并应用有向无环图(DAGs)——一种因果推理的流行病学工具作为分析工具。这四种机制包括:(1)直接致畸作用，(2)胎盘分子介导，(3)胎盘前胚胎致畸作用和(4)多步骤介导。研究者以己烯雌酚(DES)为主要例子来说明这四种致畸机制如何应用于具有复杂病理生理学的典型致畸原。除了DES外，研究者还对叶酸、巨细胞病毒(CMV)、邻苯二甲酸盐和孕妇肥胖分别进行了一项半结构化的文献综述，对两个成熟的致畸原和两个非传统的致畸原进行了研究。该研究结果近日发表在Human Reproduction Update期刊上。

研究者通过一项非系统的叙述性综述确定了关于致畸原的信息。对于每个致畸剂，研究者纳入了回答以下五个问题的论文:(1)为什么能确定这些暴露因素是致畸剂?(2)生物学机制是否有共识?(3）是否有胎盘机制的报告证据?(4)能否建立胎盘机制的理论模型?以及(5)这些知识能否为未来胎盘-胎儿畸形发生的测量和建模工作提供信息?

通过对5种被认为对妊娠早期有害的暴露的文献的回顾，研究者制定了4种分析策略来探索出生队列研究中的妊娠早期胎盘机制：胎盘转移和对胎儿的直接影响（DES和母体肥胖）、通过靶向胎盘分子途径（DES和邻苯二甲酸酯）产生的间接效应、通过胚胎和胚外组织层分化中断（叶酸缺乏）产生的胎盘前效应以及涉及母体的多步骤机制，胎盘和胎儿免疫功能和炎症（DES和CMV）。致畸剂（灰点）在妊娠早期破坏发育的四种不同方式示意图：

（A） 第一类，致畸剂对胚胎发育的直接影响。妊娠10-12周的结构表现。

（B） 第二类，胎盘分子介导。在10-12周妊娠期间，致畸原运动和结构的表现。

（C） 第三类，胚胎致畸性。在受孕后第一个月和胎盘绒毛形成前，畸胎原进入结构的表现。

（D） 第四类，多步骤调解。在怀孕的头三个月，畸胎原进入细胞和结构的表现。

（E） 滋养层栓溶解和母体血液开始流入绒毛间隙的过程的一部分。

（F） 不同组织和细胞类型的增大，其中致畸剂可引起分子和/或形态效应。

pixabay.com

与胚胎相比，胎盘可能更直接地通过其代偿和高度进化的机制来保护和确保胎儿的存活和未来的生殖成功。这里的机制指的是通过消除暴露源和改善营养等一般健康干预措施。而直接改变胎盘的激素分泌则有可能走上与DES实验相似的道路，并带来潜在的悲惨后果。

这篇综述的意义在于提供一种因果方法来对怀孕期间大量潜在有害的接触进行分类，特别是早期妊娠阶段（妊娠前3个月）。也将促进对早期妊娠机制的了解，以便研究人员有效地将环境暴露与儿童健康结果联系起来。

参考文献：Jennifer J Adibi, Alexander J Layden, Rahel L Birru, Alexandra Miragaia, Xiaoshuang Xun, Megan C Smith, Qing Yin, Marisa E Millenson, Thomas G O’Connor, Emily S Barrett. First trimester mechanisms of gestational sac placental and foetal teratogenicity: a framework for birth cohort studies . Human Reproduction Update, dmaa063, https://doi.org/10.1093/humupd/dmaa063

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (8)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-04-21 ms4468361851264128

    #Update#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-11-02 hmwwww

    #孕囊#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-07-14 12157a75m71暂无昵称

    有点复杂

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-04-23 Ms🧐🧐🧐🧐🧐🧐

    老实说，没大看懂o(╥﹏╥)o

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-03-10 liuyong2981

    #胎盘#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-03-10 lhlxtx

    #早期妊娠#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-03-10 sunylz

    #PRO#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1796638, encodeId=e6021e96638bd, content=<a href='/topic/show?id=6f28181514b' target=_blank style='color:#2F92EE;'>#Update#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18151, encryptionId=6f28181514b, topicName=Update)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Wed Apr 21 00:45:59 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754531, encodeId=6e7c1e545319d, content=<a href='/topic/show?id=b5fc4525628' target=_blank style='color:#2F92EE;'>#孕囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45256, encryptionId=b5fc4525628, topicName=孕囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=839236715746, createdName=hmwwww, createdTime=Tue Nov 02 11:45:59 CST 2021, time=2021-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=999556, encodeId=191099955689, content=有点复杂, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/202401/4e06e234dc414a70b34bb04d3b72196b.jpg, createdBy=4ea72246892, createdName=12157a75m71暂无昵称, createdTime=Wed Jul 14 21:45:59 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959819, encodeId=595f959819ba, content=老实说，没大看懂o(╥﹏╥)o, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200606/779634fdc8944a13a6da20900ae58236/e941130f9cc742b19b7379e5a172b9c0.jpg, createdBy=97c65381808, createdName=Ms🧐🧐🧐🧐🧐🧐, createdTime=Fri Apr 23 17:28:09 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406890, encodeId=bfcd1406890a9, content=<a href='/topic/show?id=2aca8365e2c' target=_blank style='color:#2F92EE;'>#胎盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83657, encryptionId=2aca8365e2c, topicName=胎盘)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTItxfbnwF4Yku2j227me6wl2EGarBoTicR3tHxrMtib5tnyyEEsgxlHkk8JAS4ZjHsEF7PxhBwh1QwQ/132, createdBy=c8162575557, createdName=liuyong2981, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464316, encodeId=61631464316b7, content=<a href='/topic/show?id=5069593e079' target=_blank style='color:#2F92EE;'>#早期妊娠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59370, encryptionId=5069593e079, topicName=早期妊娠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24476662947, createdName=lhlxtx, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1602346, encodeId=b0721602346f0, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a60b18898917, createdName=sunylz, createdTime=Wed Mar 10 12:45:59 CST 2021, time=2021-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039395, encodeId=7385103939594, content=机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿肿, createdTime=Tue Mar 09 00:45:59 CST 2021, time=2021-03-09, status=1, ipAttribution=)]
    2021-03-09 肿肿

    机制研究离临床仍然有距离，不过与临床结合思考，仍然有帮助的，不能仅仅是纯临床思维，转化思维同样重要

    0