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JAMA Neurol：自发性脊髓损伤患者特征及诊断标准

2018-09-25 zhangfan MedSci原创

脊髓损伤患SCIMRI
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研究基于确诊的自发性脊髓损伤患者特点，提出了自发性脊髓损伤临床、实验室以及MRI诊断标准，对临床实践及患者针对性治疗提供了依据

脊髓梗死(SCI)是一种严重致残性疾病，在缺乏如主动脉手术等刺激事件的情况下，其诊断较为困难。自发性脊髓损伤患者常常被误诊为横向脊髓炎。由于缺乏脊髓损伤的诊断标准其临床护理和研究进展缓慢。近日研究人员就自发性脊髓损伤的特点进行描述，并依此提出相应的诊断标准。

研究人员就1997-2017年间梅奥诊所SCI患者资料进行分析，133名成年自发性SCI患者纳入研究作为建立诊断标准的依据，280名疑似患者作为验证队列。

133名自发性SCI患者平均年龄60岁，其中101人(76%)存在血管风险因素。大部分患者在12小时内脊髓功能损失度快速达到峰值（102例，77%），部分患者脊髓功能逐步下降（31例，23%）。126名患者出现感觉丧失 (95%)，49名患者选择性影响疼痛感或体温 (39%)。30例患者(24%)初始脊柱磁共振成像(MRI)检查结果正常。特征性MRI T2高信号类型包括猫头鹰眼征(82例[65%])和铅笔样高信号(50例[40%])；96例钆增强检查患者中有37例(39%)呈线状特征，均位于前灰质。验证性MRI特征包括扩散加权成像/表观扩散系数限制(19/29[67%])，邻近夹层/闭塞(16/82[20%])和椎体梗死(11例[9%])。89例脑脊液检查中有7例(8%)表现为轻度炎症。依据上述特征，研究人员提出了提出了明确的、很可能的和可能的SCI的诊断标准。验证队列中，9人符合(3%)可能标准，无患者符合很可能标准。

研究基于确诊的自发性脊髓损伤患者特点，提出了自发性脊髓损伤临床、实验室以及MRI诊断标准，对临床实践及患者针对性治疗提供了依据。

原始出处：

Nicholas L. Zalewski et al. Characteristics of Spontaneous Spinal Cord Infarction and Proposed Diagnostic Criteria. JAMA Neurol. September 24.2018.

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    2018-11-15 yinhl1978

    #Neurol#

    0

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    2018-09-27 spoonycyy

    #诊断标准#

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    2018-09-27 ms3046638856685384

    #损伤#

    0

  4. 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createdName=spoonycyy, createdTime=Thu Sep 27 00:28:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397629, encodeId=9c44139e629f0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Thu Sep 27 00:28:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530576, encodeId=c1a615305e660, content=<a href='/topic/show?id=ed4a860e872' target=_blank style='color:#2F92EE;'>#自发性#</a>, beContent=null, 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encodeId=ad3634655e50, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:12 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346556, encodeId=75cc346556e9, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:09 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346555, encodeId=e39234655547, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346554, encodeId=cc46346554a4, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:02 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-27 sodoo

    #自发性#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2000593, encodeId=3adf20005930d, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Nov 15 14:28:00 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385016, encodeId=62801385016b5, content=<a href='/topic/show?id=354691625f1' target=_blank style='color:#2F92EE;'>#诊断标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91625, encryptionId=354691625f1, topicName=诊断标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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encodeId=ad3634655e50, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:12 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346556, encodeId=75cc346556e9, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:09 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346555, encodeId=e39234655547, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346554, encodeId=cc46346554a4, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:02 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-27 guojianrong

    #患者特征#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2000593, encodeId=3adf20005930d, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Nov 15 14:28:00 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385016, encodeId=62801385016b5, content=<a href='/topic/show?id=354691625f1' target=_blank style='color:#2F92EE;'>#诊断标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91625, encryptionId=354691625f1, topicName=诊断标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86078, encryptionId=ed4a860e872, topicName=自发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584a12117168, createdName=sodoo, createdTime=Thu Sep 27 00:28:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1623144, encodeId=66ae16231443d, content=<a href='/topic/show?id=e3935305e39' target=_blank style='color:#2F92EE;'>#患者特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53057, encryptionId=e3935305e39, topicName=患者特征)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=450a20505925, createdName=guojianrong, createdTime=Thu Sep 27 00:28:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346557, encodeId=ad3634655e50, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:12 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346556, encodeId=75cc346556e9, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:09 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346555, encodeId=e39234655547, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346554, encodeId=cc46346554a4, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:02 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 xiaotao112411

    学习学习学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2000593, encodeId=3adf20005930d, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Nov 15 14:28:00 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385016, encodeId=62801385016b5, content=<a href='/topic/show?id=354691625f1' target=_blank style='color:#2F92EE;'>#诊断标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91625, encryptionId=354691625f1, topicName=诊断标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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encodeId=ad3634655e50, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:12 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346556, encodeId=75cc346556e9, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:09 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346555, encodeId=e39234655547, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346554, encodeId=cc46346554a4, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:02 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 xiaotao112411

    学习学习学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2000593, encodeId=3adf20005930d, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Nov 15 14:28:00 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385016, encodeId=62801385016b5, content=<a href='/topic/show?id=354691625f1' target=_blank style='color:#2F92EE;'>#诊断标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91625, encryptionId=354691625f1, topicName=诊断标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86078, encryptionId=ed4a860e872, topicName=自发性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584a12117168, createdName=sodoo, createdTime=Thu Sep 27 00:28:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1623144, encodeId=66ae16231443d, content=<a href='/topic/show?id=e3935305e39' target=_blank style='color:#2F92EE;'>#患者特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53057, encryptionId=e3935305e39, topicName=患者特征)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=450a20505925, createdName=guojianrong, createdTime=Thu Sep 27 00:28:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346557, encodeId=ad3634655e50, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:12 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346556, encodeId=75cc346556e9, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:09 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346555, encodeId=e39234655547, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346554, encodeId=cc46346554a4, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:02 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 xiaotao112411

    学习学习学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2000593, encodeId=3adf20005930d, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Nov 15 14:28:00 CST 2018, time=2018-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385016, encodeId=62801385016b5, content=<a href='/topic/show?id=354691625f1' target=_blank style='color:#2F92EE;'>#诊断标准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91625, encryptionId=354691625f1, topicName=诊断标准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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encodeId=ad3634655e50, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:12 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346556, encodeId=75cc346556e9, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:09 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346555, encodeId=e39234655547, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346554, encodeId=cc46346554a4, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:50:02 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 xiaotao112411

    学习学习学习

    0

  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346553, encodeId=10eb346553aa, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/05/dc628308c49d4aa82335673176ebb6d3.jpg, createdBy=153c1955083, createdName=xiaotao112411, createdTime=Tue Sep 25 11:49:58 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 xiaotao112411

    学习学习学习

    0

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