Can J Cardiol:三思而后行!心脏病专家再次警告电子烟健康风险

2021-04-13 Sunny MedSci原创

电子烟同样危险!

time

电子烟(EC)发明后得到了广泛普及,也引起了巨大的争议,尽管它们的危害性不如烟草(TC),但它们也同样具有重大的潜在风险,且医疗界和公众可能都低估了这些风险。

近期,两位血管专家在《加拿大心脏病学杂志》(Canadian Journal of Cardiology)上回顾了吸烟与EC的心血管效应的最新研究。他们的结论是,不鼓励年轻的非吸烟者吸烟,应禁止针对青少年的电子烟,应通过并严格执行限制青少年使用的法律法规。

加州大学洛杉矶分校戴维格芬医学院的Arash Nayeri医学博士和Holly Middlekauff医学博士是美国加利福尼亚州洛杉矶市心内科专家,撰写这篇评论是为了向医生提供客观的信息,评估有关EC的可用科学数据,以便这些医生可以帮助他们的患者做出明智而周到的决定。

众所周知,TC具有致命性,在烟草使用者中致死率高达50%。它们是全球可预防的心血管疾病和死亡率的主要原因,预计到2030年,全世界每年致死人数将达800万人,其中大部分是由心血管疾病引起的。

自2007年以来,EC受到长期TC吸烟者和从未吸烟的年轻人的欢迎。有证据表明,EC的危害性不如TC,由于EC中缺乏多种TC产生的有毒副产物,这促使人们认为EC对健康有相对良性的认识。

这项最新研究基于12000多名参与者的50多项科学研究的综述得出结论,EC在戒烟方面比认证的尼古丁替代疗法(NRT)(例如贴剂或口香糖)更有效,并且比单独的行为支持更有效,从而提供了一种可能的替代方法,以替代致使尼古丁上瘾的成年吸烟者的致命香烟。但是,人们对于它们的某些成分(包括尼古丁)及其热降解副产物可能会产生不利影响。

研究者认为,我们青年时代的电子烟普及已变得如此流行,以至于正逼近公共健康危机。紧随其后的是吸大麻的快速崛起。实际上,与目前吸烟相比,使用大麻(包括吸烟)的年轻人更多。我们必须对此加以控制,而这样做的第一步就是认清事实。

心血管风险金字塔。尼古丁传递系统,包括尼古丁替代疗法(NRT),无烟烟草,电子烟(EC)和燃烧烟草,可归类为心血管损害的金字塔,按尼古丁传递的效力和伴随的非尼古丁有毒物质进行分层。NRT具有最小的心血管风险,可燃烟草制品具有最大的风险。无烟烟草制品和EC可能具有中等心血管风险。来源:Holly Middlekauff,MD

据计算,从TC转移到EC可以在10年内挽救1.6至660万美国人的生命。但是,作者指出,EC的长期风险仍然未知,建议在最短的有效时间内使用。他们还指出,通过使用“烟碱盐”,第四代设备“豆荚”可以输送与可燃香烟相似量的尼古丁。每个豆荚可能包含相当于一包香烟的尼古丁含量,因此与上一代设备相比,不吸烟者上瘾的风险更大。另一方面,这些类似豆荚的装置可以复制可燃香烟的尼古丁传送,因此对于那些想戒烟的尼古丁成瘾吸烟者可能更具吸引力。

作者指出,每天吸烟一到三支与每天吸烟一到三包烟具有几乎相同的心血管风险,因此,使用EC来减少吸烟(而非戒烟)并不是一种有效的策略。因此,他们建议想要戒烟且未通过认证的传统疗法的TC吸烟者可以考虑使用EC,但应使用它们完全替代TC。

Nayeri博士说:“只有谨慎行事,并且在用尽其他所有戒烟策略后,我们才应考虑建议我们的TC吸烟患者改用EC。” 转变为不受管制的EC,并将其作为戒烟设备的所有承诺,可能会导致无法预料的,潜在的致命后果。正如目前市场上没有质量控制的产品一样,EC并非灵丹妙药。”作者告诫道。

这组作者说,由于EC不是无害的,因此非吸烟者,尤其是青少年和年轻人,不应该使用它们。Middlekauff博士指出:“向从未吸烟的年轻人的直接营销以及成千上万种甜品和糖果味液体的开发已经无情地吸引了数百万儿童尝试。” 为了阻止年轻的非吸烟者使用电子烟,作者建议应禁止使用香精,应支持公共卫生的反电子烟运动,并应通过并严格执行限制将其提供给年轻人的法律法规。他们还强烈建议人们远离以盗版或黑市为基础的尼古丁或大麻类EC产品。

加拿大安大略省渥太华大学渥太华心脏研究所心脏预防和康复科医学博士,医学博士安德鲁·L·派珀(Andrew L. Pipe)在随附的社论中写道:“三思而后行” 。

Pipe博士指出,尽管在最近的临床研究中仅有有限的证据支持使用电子尼古丁传送系统(ENDS)戒烟,但在“现实世界”环境中成功戒烟的证据仍不明显。“尽管如此,使用含有已知量尼古丁和有限调味剂的电子尼古丁传送系统可能有助于将其用于戒烟,但是,由于缺乏适当的产品法规,这种临床用途在不久的将来不太可能。”

Pipe博士评论了加拿大的政策真空状况,这使得ENDS几乎不受管制地进入加拿大,而其他司法管辖区的情况则与此相反,他指出,政府缺乏对青年人的吸引力的考虑,也没有对其内容,市场营销和商品进行有限的监管,是在加拿大广泛使用和滥用ENDS的因素。父母,教育工作者,临床医生和加拿大心脏与中风基金会等健康组织的强烈抗议现在导致了监管提案。

“在未来几年中,我们是否将以不同形式的慢性无行为能力的呼吸系统疾病所带来的无法预料的负担来代替肺癌和其他与吸烟相关的癌症的负担?” 派珀博士总结说。“许多以乐观的好奇心期待电子尼古丁传送系统的到来的人现在认识到不幸的现实笼罩了他们在很大程度上不受管制的到来。也许有些跳跃-在他们看上去之前。”

原文出处:

Vaping, Smoking Cessation, and Harm Reduction? Look Before You Leap. DOI:https://doi.org/10.1016/j.cjca.2021.02.002

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    2021-04-15 医申

    长知识了

    0

  3. 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    2021-04-22 科研科研科研

    心脏病专家警告电子烟

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1782127, encodeId=b5231e821274d, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Mon Jan 31 05:16:40 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957194, encodeId=c96795e194e6, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a8d45480683, createdName=医申, createdTime=Thu Apr 15 09:22:24 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959494, encodeId=f483959494dc, content=心脏病专家警告电子烟, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:43:59 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958287, encodeId=052b95828e5e, content=不要养成任何的坏习惯!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:01:06 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958286, encodeId=03919582860c, content=吸烟有害健康…… , beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:56 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958285, encodeId=753f9582857e, content=还不如嚼口香糖, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:45 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958284, encodeId=1bb09582845c, content=电子烟就是个商家的噱头, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:29 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388809, encodeId=141613888097f, content=<a href='/topic/show?id=5d712e965af' target=_blank style='color:#2F92EE;'>#健康风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27965, encryptionId=5d712e965af, topicName=健康风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Apr 15 09:16:40 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956956, encodeId=c0309569563b, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4da5430578, createdName=ms5000000622595890, createdTime=Wed Apr 14 17:06:33 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956800, encodeId=be14956800c2, content=不要吸烟…, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f325410647, createdName=ms3000000449394493, createdTime=Wed Apr 14 09:09:38 CST 2021, time=2021-04-14, status=1, ipAttribution=)]
    2021-04-19 ZJYYY7

    不要养成任何的坏习惯!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1782127, encodeId=b5231e821274d, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Mon Jan 31 05:16:40 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957194, encodeId=c96795e194e6, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a8d45480683, createdName=医申, createdTime=Thu Apr 15 09:22:24 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959494, encodeId=f483959494dc, content=心脏病专家警告电子烟, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:43:59 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958287, encodeId=052b95828e5e, content=不要养成任何的坏习惯!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:01:06 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958286, encodeId=03919582860c, content=吸烟有害健康…… , beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:56 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958285, encodeId=753f9582857e, content=还不如嚼口香糖, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:45 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958284, encodeId=1bb09582845c, content=电子烟就是个商家的噱头, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:29 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388809, encodeId=141613888097f, content=<a href='/topic/show?id=5d712e965af' target=_blank style='color:#2F92EE;'>#健康风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27965, encryptionId=5d712e965af, topicName=健康风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Apr 15 09:16:40 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956956, encodeId=c0309569563b, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4da5430578, createdName=ms5000000622595890, createdTime=Wed Apr 14 17:06:33 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956800, encodeId=be14956800c2, content=不要吸烟…, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f325410647, createdName=ms3000000449394493, createdTime=Wed Apr 14 09:09:38 CST 2021, time=2021-04-14, status=1, ipAttribution=)]
    2021-04-19 ZJYYY7

    吸烟有害健康……

    0

  6. 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    2021-04-19 ZJYYY7

    还不如嚼口香糖

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1782127, encodeId=b5231e821274d, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Mon Jan 31 05:16:40 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957194, encodeId=c96795e194e6, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a8d45480683, createdName=医申, createdTime=Thu Apr 15 09:22:24 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959494, encodeId=f483959494dc, content=心脏病专家警告电子烟, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:43:59 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958287, encodeId=052b95828e5e, content=不要养成任何的坏习惯!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:01:06 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958286, encodeId=03919582860c, content=吸烟有害健康…… , beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:56 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958285, encodeId=753f9582857e, content=还不如嚼口香糖, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:45 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958284, encodeId=1bb09582845c, content=电子烟就是个商家的噱头, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:29 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388809, encodeId=141613888097f, content=<a href='/topic/show?id=5d712e965af' target=_blank style='color:#2F92EE;'>#健康风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27965, encryptionId=5d712e965af, topicName=健康风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Apr 15 09:16:40 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956956, encodeId=c0309569563b, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4da5430578, createdName=ms5000000622595890, createdTime=Wed Apr 14 17:06:33 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956800, encodeId=be14956800c2, content=不要吸烟…, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f325410647, createdName=ms3000000449394493, createdTime=Wed Apr 14 09:09:38 CST 2021, time=2021-04-14, status=1, ipAttribution=)]
    2021-04-19 ZJYYY7

    电子烟就是个商家的噱头

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1782127, encodeId=b5231e821274d, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Mon Jan 31 05:16:40 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957194, encodeId=c96795e194e6, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a8d45480683, createdName=医申, createdTime=Thu Apr 15 09:22:24 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959494, encodeId=f483959494dc, content=心脏病专家警告电子烟, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:43:59 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958287, encodeId=052b95828e5e, content=不要养成任何的坏习惯!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:01:06 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958286, encodeId=03919582860c, content=吸烟有害健康…… , beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:56 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958285, encodeId=753f9582857e, content=还不如嚼口香糖, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:45 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958284, encodeId=1bb09582845c, content=电子烟就是个商家的噱头, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:29 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388809, encodeId=141613888097f, content=<a href='/topic/show?id=5d712e965af' target=_blank style='color:#2F92EE;'>#健康风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27965, encryptionId=5d712e965af, topicName=健康风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Apr 15 09:16:40 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956956, encodeId=c0309569563b, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4da5430578, createdName=ms5000000622595890, createdTime=Wed Apr 14 17:06:33 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956800, encodeId=be14956800c2, content=不要吸烟…, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f325410647, createdName=ms3000000449394493, createdTime=Wed Apr 14 09:09:38 CST 2021, time=2021-04-14, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1782127, encodeId=b5231e821274d, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Mon Jan 31 05:16:40 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957194, encodeId=c96795e194e6, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a8d45480683, createdName=医申, createdTime=Thu Apr 15 09:22:24 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959494, encodeId=f483959494dc, content=心脏病专家警告电子烟, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:43:59 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958287, encodeId=052b95828e5e, content=不要养成任何的坏习惯!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:01:06 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958286, encodeId=03919582860c, content=吸烟有害健康…… , beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:56 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958285, encodeId=753f9582857e, content=还不如嚼口香糖, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:45 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958284, encodeId=1bb09582845c, content=电子烟就是个商家的噱头, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:29 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388809, encodeId=141613888097f, content=<a href='/topic/show?id=5d712e965af' target=_blank style='color:#2F92EE;'>#健康风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27965, encryptionId=5d712e965af, topicName=健康风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Apr 15 09:16:40 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956956, encodeId=c0309569563b, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4da5430578, createdName=ms5000000622595890, createdTime=Wed Apr 14 17:06:33 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956800, encodeId=be14956800c2, content=不要吸烟…, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f325410647, createdName=ms3000000449394493, createdTime=Wed Apr 14 09:09:38 CST 2021, time=2021-04-14, status=1, ipAttribution=)]
    2021-04-14 ms5000000622595890

    可以

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1782127, encodeId=b5231e821274d, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Mon Jan 31 05:16:40 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957194, encodeId=c96795e194e6, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a8d45480683, createdName=医申, createdTime=Thu Apr 15 09:22:24 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959494, encodeId=f483959494dc, content=心脏病专家警告电子烟, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210110/e6124a4b19bc40ce8afaae096d21126b/dd778ac260c9416eb87e7d08139507f5.jpg, createdBy=4d2f5079605, createdName=科研科研科研, createdTime=Thu Apr 22 18:43:59 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958287, encodeId=052b95828e5e, content=不要养成任何的坏习惯!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:01:06 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958286, encodeId=03919582860c, content=吸烟有害健康…… , beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:56 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958285, encodeId=753f9582857e, content=还不如嚼口香糖, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:45 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958284, encodeId=1bb09582845c, content=电子烟就是个商家的噱头, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Mon Apr 19 12:00:29 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388809, encodeId=141613888097f, content=<a href='/topic/show?id=5d712e965af' target=_blank style='color:#2F92EE;'>#健康风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27965, encryptionId=5d712e965af, topicName=健康风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu Apr 15 09:16:40 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956956, encodeId=c0309569563b, content=可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4da5430578, createdName=ms5000000622595890, createdTime=Wed Apr 14 17:06:33 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956800, encodeId=be14956800c2, content=不要吸烟…, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f325410647, createdName=ms3000000449394493, createdTime=Wed Apr 14 09:09:38 CST 2021, time=2021-04-14, status=1, ipAttribution=)]
    2021-04-14 ms3000000449394493

    不要吸烟…

    1

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