Lancet Child Adolesc Health:咳嗽管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽情况

2020-07-30 MedSci原创 MedSci原创

儿童慢性(至少持续4周)咳嗽是发病的一个重要原因。在观察性研究和随机对照试验(RCT)中评估了一种治疗儿童咳嗽的算法,招募了中位咳嗽持续时间为16周的儿童转诊到专科中心。我们调查了一旦咳嗽持续4周以上

儿童慢性(至少持续4周)咳嗽是发病的一个重要原因。在观察性研究和随机对照试验(RCT)中评估了一种治疗儿童咳嗽的算法,招募了中位咳嗽持续时间为16周的儿童转诊到专科中心。我们调查了一旦咳嗽持续4周以上,在非专科设置中更早地应用基于证据的咳嗽管理算法,是否能较通常的护理更好的改善咳嗽。

 

我们进行了一项多中心、单盲RCT研究,嵌套在一项前瞻性队列研究中,研究对象是澳大利亚的儿童(小于15岁),他们因急性呼吸道疾病伴有咳嗽而到三个初级保健或三个医院急诊科就诊。如果儿童被诊断为潜在的慢性病(不包括哮喘),或患有免疫抑制性疾病,或在之前30天内服用免疫调节药物超过2周,或有严重症状需要住院治疗,则被排除在外。随访8周;在第28天出现持续咳嗽的儿童被随机分配到咳嗽管理算法或常规护理。使用计算机生成的permuted块(块大小为4个),以1:1的分配方式,根据表现原因、研究部位和咳嗽持续时间(4周至<6周vs≥6周)对随机化进行分层。主要结果是在第56天时咳嗽解决的儿童比例(如果儿童自第28天以来至少有3个日夜没有咳嗽或其日夜平均咳嗽评分减少75%以上,则定义为解决)。通过修正的意向治疗分析(ITT)计算绝对风险差异(RDabsolute)。

 

2015年7月7日至2018年10月31日期间,1018名儿童被筛选,509名儿童被纳入队列研究,在ITT分析的115名儿童中,57名儿童被随机分配到干预组,58名儿童被分配到对照组。儿童的中位年龄为1-6岁(IQR 1-0-4-5);115名儿童中45名(39%)为土著人,59名(51%)为男孩。到第56天,干预组57名儿童中有33名(58%)停止咳嗽,而对照组58名儿童中有23名(40%)找到解决咳嗽的方法;57名接受干预的儿童中有12名(21%)和58名接受对照的儿童中有13名(22%)咳嗽解决情况不明。假设咳嗽结果不明的儿童在第56天仍在咳嗽,RDabsolute为18-3%(95% CI 0-3-36-2);获益所需的治疗次数为5次(95% CI 3-364);调整后的几率比为1-5(95% CI 1-3-1-6),有利于干预组。

 

总之,该研究表明,基于证据的咳嗽管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况。然而,需要更大规模的研究来证实初级保健中的这些发现。

 

原始出处:

 

Kerry-Ann F O'GradyKeith Grimwood, et al., Effectiveness of a chronic cough management algorithm at the transitional stage from acute to chronic cough in children: a multicenter, nested, single-blind, randomised controlled trial. Lancet Child Adolesc Health. 2019 Dec;3(12):889-898. doi: 10.1016/S2352-4642(19)30327-X. 

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    2020-12-31 howi
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    2021-04-12 shizhenshan
  4. [GetPortalCommentsPageByObjectIdResponse(id=1662018, encodeId=748216620186b, content=<a href='/topic/show?id=260c9e210e' target=_blank style='color:#2F92EE;'>#ILD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9721, encryptionId=260c9e210e, topicName=ILD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b79025361884, createdName=ms3994565386320060, createdTime=Thu Dec 31 06:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830763, encodeId=e22c1830e6347, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Dec 31 13:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861393, encodeId=e0b7186139363, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Mon Apr 12 14:20:11 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783168, encodeId=87ac1e8316805, content=<a href='/topic/show?id=855a464292' target=_blank style='color:#2F92EE;'>#child#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4642, encryptionId=855a464292, topicName=child)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8ebc122, createdName=yankaienglish, createdTime=Thu Feb 11 00:20:11 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813367, encodeId=589c81336e54, content=<a href='/topic/show?id=f9783980828' target=_blank style='color:#2F92EE;'>#咳嗽#</a>管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况,不太清楚如何算法?, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39808, encryptionId=f9783980828, topicName=咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Aug 26 09:30:51 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813311, encodeId=423581331176, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Wed Aug 26 08:32:43 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395878, encodeId=452513958e8e8, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621862, encodeId=c51d1621862a8, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033907, encodeId=5423103390e09, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Jul 30 23:20:11 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1662018, encodeId=748216620186b, content=<a href='/topic/show?id=260c9e210e' target=_blank style='color:#2F92EE;'>#ILD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9721, encryptionId=260c9e210e, topicName=ILD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b79025361884, createdName=ms3994565386320060, createdTime=Thu Dec 31 06:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830763, encodeId=e22c1830e6347, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Dec 31 13:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861393, encodeId=e0b7186139363, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Mon Apr 12 14:20:11 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783168, encodeId=87ac1e8316805, content=<a href='/topic/show?id=855a464292' target=_blank style='color:#2F92EE;'>#child#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4642, encryptionId=855a464292, topicName=child)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8ebc122, createdName=yankaienglish, createdTime=Thu Feb 11 00:20:11 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813367, encodeId=589c81336e54, content=<a href='/topic/show?id=f9783980828' target=_blank style='color:#2F92EE;'>#咳嗽#</a>管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况,不太清楚如何算法?, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39808, encryptionId=f9783980828, topicName=咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Aug 26 09:30:51 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813311, encodeId=423581331176, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Wed Aug 26 08:32:43 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395878, encodeId=452513958e8e8, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621862, encodeId=c51d1621862a8, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033907, encodeId=5423103390e09, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Jul 30 23:20:11 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
    2020-08-26 lovetcm

    #咳嗽#管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况,不太清楚如何算法?

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1662018, encodeId=748216620186b, content=<a href='/topic/show?id=260c9e210e' target=_blank style='color:#2F92EE;'>#ILD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9721, encryptionId=260c9e210e, topicName=ILD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b79025361884, createdName=ms3994565386320060, createdTime=Thu Dec 31 06:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830763, encodeId=e22c1830e6347, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Dec 31 13:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861393, encodeId=e0b7186139363, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Mon Apr 12 14:20:11 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783168, encodeId=87ac1e8316805, content=<a href='/topic/show?id=855a464292' target=_blank style='color:#2F92EE;'>#child#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4642, encryptionId=855a464292, topicName=child)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8ebc122, createdName=yankaienglish, createdTime=Thu Feb 11 00:20:11 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813367, encodeId=589c81336e54, content=<a href='/topic/show?id=f9783980828' target=_blank style='color:#2F92EE;'>#咳嗽#</a>管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况,不太清楚如何算法?, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39808, encryptionId=f9783980828, topicName=咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Aug 26 09:30:51 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813311, encodeId=423581331176, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Wed Aug 26 08:32:43 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395878, encodeId=452513958e8e8, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621862, encodeId=c51d1621862a8, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033907, encodeId=5423103390e09, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Jul 30 23:20:11 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
    2020-08-26 14818eb4m67暂无昵称

    👍

    0

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1662018, encodeId=748216620186b, content=<a href='/topic/show?id=260c9e210e' target=_blank style='color:#2F92EE;'>#ILD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9721, encryptionId=260c9e210e, topicName=ILD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b79025361884, createdName=ms3994565386320060, createdTime=Thu Dec 31 06:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830763, encodeId=e22c1830e6347, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Dec 31 13:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861393, encodeId=e0b7186139363, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Mon Apr 12 14:20:11 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783168, encodeId=87ac1e8316805, content=<a href='/topic/show?id=855a464292' target=_blank style='color:#2F92EE;'>#child#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4642, encryptionId=855a464292, topicName=child)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8ebc122, createdName=yankaienglish, createdTime=Thu Feb 11 00:20:11 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813367, encodeId=589c81336e54, content=<a href='/topic/show?id=f9783980828' target=_blank style='color:#2F92EE;'>#咳嗽#</a>管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况,不太清楚如何算法?, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39808, encryptionId=f9783980828, topicName=咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Aug 26 09:30:51 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813311, encodeId=423581331176, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Wed Aug 26 08:32:43 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395878, encodeId=452513958e8e8, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621862, encodeId=c51d1621862a8, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033907, encodeId=5423103390e09, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Jul 30 23:20:11 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1662018, encodeId=748216620186b, content=<a href='/topic/show?id=260c9e210e' target=_blank style='color:#2F92EE;'>#ILD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9721, encryptionId=260c9e210e, topicName=ILD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b79025361884, createdName=ms3994565386320060, createdTime=Thu Dec 31 06:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830763, encodeId=e22c1830e6347, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Thu Dec 31 13:20:11 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861393, encodeId=e0b7186139363, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Mon Apr 12 14:20:11 CST 2021, time=2021-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783168, encodeId=87ac1e8316805, content=<a href='/topic/show?id=855a464292' target=_blank style='color:#2F92EE;'>#child#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4642, encryptionId=855a464292, topicName=child)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8ebc122, createdName=yankaienglish, createdTime=Thu Feb 11 00:20:11 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813367, encodeId=589c81336e54, content=<a href='/topic/show?id=f9783980828' target=_blank style='color:#2F92EE;'>#咳嗽#</a>管理算法可以改善社区儿童在慢性咳嗽早期阶段的咳嗽解决情况,不太清楚如何算法?, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39808, encryptionId=f9783980828, topicName=咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Aug 26 09:30:51 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813311, encodeId=423581331176, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Wed Aug 26 08:32:43 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395878, encodeId=452513958e8e8, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621862, encodeId=c51d1621862a8, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sat Aug 01 11:20:11 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033907, encodeId=5423103390e09, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Jul 30 23:20:11 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
    2020-07-30 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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