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盘点:近期中医药的研究进展一览

2017-08-31 MedSci MedSci原创

结果:研究共纳入了23名女性和21名男性红细胞生成性原卟啉症患者,他们的平均年龄为37.6岁。T-评分的平均SD为:腰椎,-1.12;股骨颈,-0.82(P<0.001)。23.1%的患者出现了骨量减少,35.9%的患者出现了骨质疏松症的现状。基于参考亚组的预期患病率分别为15%和0.6%。维生素D缺乏症的患病率为50%(定义为25羟-维生素D水平小于50 nmol/L)。自评BPAQ评分平均为1

中医(Traditional Chinese Medicine),一般指以中国汉族劳动人民创造的传统医学为主的医学,所以也称汉医。是研究人体生理、病理以及疾病的诊断和防治等的一门学科。

中医具有完整的理论体系,其独特之处,在于“天人合一”、“天人相应”的整体观及辨证论治。

中医一直是国内外研究的热点,尤其是中医针灸和中医治疗肿瘤及慢性病研究,梅斯医学小编为您盘点了8月中医药研究的国内外进展。

一、中医针灸


据《美国医学会杂志·外科学卷》16日发表的一项新研究,针灸可帮助全膝关节置换患者减少并延缓阿片类镇痛药物的使用。

研究由美国斯坦福大学的副教授蒂娜·埃尔南德斯-布萨尔等人完成,方式是对此前39项随机临床试验的结果进行综合分析,共包括2391名全膝关节置换患者。

埃尔南德斯-布萨尔等人表示,这是第一次全面评估常见无药物干预措施在全膝关节置换术后镇痛的有效性,相关措施包括关节持续被动训练、术前运动、冰疗、电疗和针灸。

研究表明,针灸和电疗在改善术后镇痛和减少阿片类药物方面效果较好,而其他措施的效果不甚理想,持续被动训练和术前运动则均无助于减缓疼痛和减少阿片类药物使用。

埃尔南德斯-布萨尔等人在论文结论中写道:“我们的研究提供了适当但临床意义显着的证据,表明针灸和电疗可能有助于减少和延缓使用阿片类药物……而其他干预手段则缺少证据支持。”

阿片类药物依赖在美国已成为一种流行病,术后疼痛管理不善是导致阿片类药物依赖的原因之一。在这种情况下,美国对针灸等非药物治疗减少疼痛的兴趣大幅增加,但对这些干预措施的有效性却一直缺少共识。

Tedesco D, Gori D, Desai KR,et al.Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis.JAMA Surg. 2017 Aug 16:e172872. doi: 10.1001/jamasurg.2017.2872. [Epub ahead of print]


为了调查在妇科腹腔镜手术患者中,术前24小时进行电针(EA)治疗术后恶心呕吐(PONV)和术后疼痛的可行性和有效性。

研究人员进行了一项随机对照试验,40名计划进行妇科腹腔镜手术的患者被随机分配到常规护理组(UC组)和EA组(每组20例)。两组均接受常规治疗包括麻醉诱导后静脉注射地塞米松(5mg),以及手术结束前静脉注射盐酸托烷司琼(5mg)。在EA组的患者的双侧内关穴(PC6)和足三里穴(ST36),于术前24h内接受EA。研究人员记录了术后6小时、12小时和24小时的恶心呕吐及疼痛的发生率和严重程度。首次肛门排气也被记录下来。使用Bonferroni校正后的独立样本t检验对数据进行分析。

结果:手术后六小时,电针组和常规护理组分别有15%和20%的患者经历了术后恶心。EA组和UC组术后呕吐的发生率分别为5%和20%。两组在术后12小时,PONV的发生率均降低到零,同时,在任何时间段观察到的PONV在两组均无统计学意义的差异。

在手术后6小时,电针组的术后疼痛评分较常规护理组显著降低(电针:1.9 ± 8;UC:2.9 ± 9,P=0.001)。术后12小时和24小时,两组患者的疼痛评分没有差异。

电针组在术后出现第一次肛肠排气的时间比UC组短(电针:20.3±6.1小时;UC:26.4±5.2小时,P =0.002)。常见的电针相关的不良反应是轻微的,不需要就医。患者能耐受电针治疗。

总之,为了减轻术后疼痛,在术前24小时内进行电针治疗是可行的、安全的。术前进行一次EA也可能加快肠胃蠕动。未来需要通过电针最佳强度试验进一步研究术前电针对术后恶心呕吐的疗效。

Li S, Zheng M,et al.Effects of Electroacupuncture Administered 24hours Prior to Surgery on Postoperative Nausea and Vomiting and Pain in Patients Undergoing Gynecologic Laparoscopic Surgery: A Feasibility Study.Explore (NY). 2017 Jun 30. pii: S1550-8307(17)30236-7. doi: 10.1016/j.explore.2017.06.002. [Epub ahead of print]

二、中医与肿瘤


在中国,高黄芩(Scutellaria altissima L.)是一种常见的治疗炎症的中药。高黄芩甙(Scutellarin)是一种从中药高黄芩中分离出的活性黄酮苷,既往的研究发现它对脑血管疾病和炎症的生化指标的有益处。然而,在前列腺癌中,高黄芩甙的抗增殖作用和机制尚未完全阐明。

7月发表在Oncol Rep上的一篇研究中,来自山东的研究人员探讨了高黄芩甙是否能抑制癌细胞增殖,并进一步探讨了这种抑制作用的分子机制。

通过研究,研究人员发现:高黄芩甙能增强前列腺癌细胞对顺铂的敏感性。MTT法的结果表明,高黄芩甙治疗的前列腺癌患者体内的细胞活力显著降低。流式细胞仪的分析结果表明,高黄芩甙能抑制细胞增殖,通过促进细胞G2/M期阻滞和诱导细胞凋亡。研究人员采用Western印迹法观察了G2/M期阻滞和细胞凋亡的潜在机制。使用彗星试验和γH2AX免疫细胞组化分析检测在PC3细胞中高黄芩甙和/或顺铂造成的DNA损伤的程度。

结果表明,高黄芩甙能诱导前列腺癌细胞凋亡是通过激活caspase级联反应。细胞凋亡过程中,bax/bcl-2比值增加,线粒体膜电位去极化,细胞周期G2/M期阻滞。此外,在前列腺癌细胞中,高黄芩甙能改变细胞周期和细胞凋亡调控基因的蛋白表达,通过下调Cdc2、蛋白B1和bcl-2以及上调caspase-3、caspase-9和Bax。

本研究的数据证实了高黄芩甙对前列腺癌PC3细胞的细胞毒性,也提供了一种新的发现——高黄芩甙可以作为前列腺癌细胞化疗的增敏素。

总而言之,本研究的结果表明,高黄芩甙作为一种新的前列腺癌患者抗肿瘤药物具有潜在的价值。

Gao C, Zhou Y,et al.Cytotoxic and chemosensitization effects of Scutellarin from traditional Chinese herb Scutellaria altissima L. in human prostate cancer cells.Oncol Rep. 2017 Jul 24. doi: 10.3892/or.2017.5850. [Epub ahead of print]


近年来的研究表明,从中药中提取的大黄素对多种癌症,包括结肠癌有抗癌作用。然而,目前还没有很好的理解大黄素的这一抗癌机制。为了进一步认识大黄素的抗癌作用,研究者开展了一系列试验。

研究者首先证实了大黄素治疗能够抑制结肠癌细胞的活性以及诱导细胞的凋亡。然后进一步的实验发现大黄素也能诱导自噬,同时自噬是诱导细胞凋亡所必不可少的。更有趣的是,大黄素治疗导致了结肠癌细胞线粒体功能障碍以及ROS在细胞中的大量积累。最后,研究者证明了ROS的积累是大黄素诱导的自噬和凋亡所必需的。

结论:大黄素通过诱导自噬进一步诱导了克隆癌细胞的凋亡,其中ROS生成是细胞死亡的本质。这项研究结果提高了我们对大黄素抑制结肠癌的认识,同时也为结肠癌的治疗提供了新的理论依据。

Wang, Y., Q. Luo, X. He, et al., Emodin Induces Apoptosis of Colon Cancer Cells via Induction of Autophagy in a ROS-Dependent Manner. Oncol Res, 2017.


根据临床经验,将传统中药添加到铂类化疗(PBT)中能改善转移性非小细胞肺癌患者的生活质量,但该临床经验仍缺乏前瞻性验证。

研究人员根据临床反应评价将中药加入以PBT疗法后的影响。为了安全起见,研究过程中每个小组至少招收了28名病人。在一项前瞻性随机对照试验,61例特定的IIIB-IV期肺癌患者(PBT+安慰剂组,n = 32;PBT+中药组,n = 29)确定为连续患者,这些患者符合东部肿瘤协作组(ECOG)表现评分(PS)= 0-1和中医证属气阴两虚。这61例患者是从最初的154个连续的IIIB-IV期肺癌患者中挑选出来的。患者接受住院治疗并在治疗的整个2个月里接受严格控制/调查,以确保患者使用/不使用中药/安慰剂。研究人员对比了患者接受治疗前后的恶心/呕吐的发生率、肺癌治疗功能评价量表(FACT-L)评估的生活质量,以及脑电图改善和稳定率变化。

治疗前,在PBT+安慰剂组和PBT+中药组之间,患者的临床病理和生存质量特征没有差异(P>0.10)。仅有的副作用包括:PBT+中药组中某些患者在前2周会出现暂时性、轻度的胃/腹部胀满,但在安慰剂组也出现了该种情况(17% vs 13%,p>0.10)。治疗期间,PBT+中药组 vs PBT+安慰剂组:恶心发生率,17% vs 75%;呕吐率,14% vs 56%(p<0.0001和0.002)。

此外,脑电图改善和稳定率在PBT+中药组为90%,在PBT+安慰剂组为69%(P = 0.04)。经过2个月的治疗,PBT+中药组的患者,FACT-L社会/家庭评分和功能量表情况均比安慰剂组更好(P = 0.02和0.03)。相反,在PBT+安慰剂组的患者中,生活质量变量总分、身体和情绪评分量表评分在PBT治疗后更差(P = 0.03,0.0001和0.003)。

结论:在ECOG-PS = 0-1的IIIB-IV期非小细胞肺癌患者中,在证属气阴两虚以及接受铂类为基础的化疗者的化疗过程中加入中药治疗,能提高其生活质量。这类患者占所有转移NSCLC患者的40%,本研究的结果表明在铂类化疗中加入中药会对这类患者造成显著的临床影响。

Guo H, Liu JX,et al.In Metastatic Non-small cell Lung Cancer Platinum-Based Treated Patients, Herbal Treatment Improves the Quality of Life. A Prospective Randomized Controlled Clinical Trial.Front Pharmacol. 2017 Jul 17;8:454. doi: 10.3389/fphar.2017.00454. eCollection 2017.


肾细胞癌(简称肾癌)是泌尿系统中恶性度较高的肿瘤,也是最常见的肿瘤之一,是起源于肾实质泌尿小管上皮系统的恶性肿瘤,又称肾腺癌。男女发病率有明显差异,据统计,男女之比为2:1。肾癌的发病率随年龄增大而升高,有资料显示,肾癌的高发年龄在40~55岁。信号转导和转录激活因子3(STAT3)是转录因子,在控制细胞生长、存活、血管生成和免疫功能中起重要作用,也是人类癌症中最常激活的STAT家族成员之一。

有研究报道,STAT3在不同类型的肾细胞癌(RCC)中被持续激活,并且可以作为预后标记, STAT3抑制剂WP1066,能够对RCC细胞系和异种移植小鼠模型发挥抗癌作用。Cryptotanshinone(隐丹参酮),是从丹参根中提取的天然化合物,被认为是潜在的STAT3抑制剂。因此研究人员探究了隐丹参酮在RCC的中的作用及作用方式。

结果显示隐丹参酮可显著抑制癌细胞生长,同时通过抑制Tyr705上STAT3的磷酸化及阻断核易位来促进癌细胞凋亡,并且p-Akt、CyclinD1、c-myc、MEKK2,HGF表达下调,细胞周期被阻滞于G0/G1期,从而抑制癌细胞增殖。此外,cleaved-Caspase-3的水平升高,而Bcl-2和Survivin下调,导致细胞凋亡增加。体内试验研究结果显示,隐丹参酮在A498异种移植小鼠模型中能够有效抑制肿瘤发生。

该研究结果阐明了隐丹参酮在RCC中的功能,并展现了应用隐丹参酮作为RCC治疗策略的强大潜力。

Chen Z, et al. Cryptotanshinone inhibits proliferation yet induces apoptosis by suppressing STAT3 signals in renal cell carcinoma. Oncotarget. 2017 Jul 25;8(30):50023-50033. doi: 10.18632/oncotarget.18483.


卵巢癌是女性生殖器官常见的恶性肿瘤之一,发病率仅次于子宫颈癌和子宫体癌而列居第三位。化疗耐药的发展是卵巢癌长期存活率不佳的主要原因。在很多卵巢癌治疗中,尽管初次化疗取得了成功,但随着复发成为不治之症。

研究提示,雌激素受体β(ERβ)是参与多种肿瘤抑制相关途径的基因调控的转录因子,卵巢癌细胞表达作为肿瘤抑制因子的ERβ。并且近期研究提示甘草素(Liq)和S-牛尿酚可作为ERβ天然特异性激动剂。Liq是从植物甘草中分离出来的物质,S-牛尿酚是一种通过生物转化从大豆异黄酮黄豆苷原中分离得到的化合物,这两种物质对于ERβ的亲和力要远远大于对于ERα的亲和力,并且在其他疾病的研究中,Liq和S-牛尿酚显示安全、耐受性良好、并具有高依从性。

研究人员调查了Liq和S-牛尿酚在卵巢癌中的作用。结果显示,这两种天然ERβ激动剂在细胞活力和存活测定中具有显著的抑制癌细胞生长、减少迁移和侵袭、促进癌细胞凋亡的作用,并且在耐药卵巢癌细胞模型和致敏卵巢癌细胞模型中对顺铂和紫杉醇的治疗显示出肿瘤抑制功能。分析显示ERβ激动剂调节包括NF-κB通路在内的几种肿瘤抑制途径,免疫沉淀测定显示ERβ与NF-κB的p65亚基相互作用,ERβ过表达降低NF-κB靶基因的表达。此外,在异种移植物测定中,ERβ激动剂降低肿瘤生长并促进癌细胞凋亡。

该研究结果表明天然ERβ激动剂Liq和S-牛尿酚,通过抗炎和促凋亡作用显著抑制卵巢癌细胞生长和增殖,具有作为卵巢癌治疗新型治疗剂的潜力。

Liu J, et al. Therapeutic utility of natural estrogen receptor beta agonists on ovarian cancer. Oncotarget. 2017 Jul 25;8(30):50002-50014. doi: 10.18632/oncotarget.18442.


许多研究表明姜黄素能有效抑制体内外的前列腺癌细胞的增殖、侵袭和肿瘤发生。

本研究中,CD44+/CD133+人前列腺癌干细胞(HuPCaSC)是从前列腺癌细胞株Du145和22RV1分离出来的。姜黄素对这些细胞的抑制作用是体外抑制这些细胞的细胞增殖和侵袭,抑制细胞周期。

研究发现,细胞周期蛋白(Ccnd1和Cdk4) 和干细胞标记物(Oct4、CD44和CD133)的表达水平在姜黄素治疗的HuPCaSC细胞中降低。微阵列分析和Northern印迹杂交(Northern blot)表明,在姜黄素治疗的HuPCaSC细胞中miR-145过度表达。通过生物信息学分析、生物信息学分析和荧光素酶活性分析得到的竞争性内源RNA(ceRNA) 机制的研究表明,lncRNA-ROR和OCT4 mRNA都含有miR-145的结合位点,且lncRNA-ROR和OCT4 mRNA之间竞争与microRNA直接结合。姜黄素能诱导miR-145的高表达,抑制lncRNA-ROR的表达。

在裸鼠体内,姜黄素治疗的HuPCaSC的致瘤性显著降低。总之,减少内源性lncRNA-ROR的表达能有效提高HuPCaSC细胞中miR-145的现有浓度,而miR-145能通过降低Oct4的表达进而防止细胞增殖减少。特别是,研究人员认为lncRNA-ROR可能是一个ceRNA,从而激活核转录因子Oct4的脱抑制。

因此,姜黄素通过ceRNA对miR-145的作用和lncRNA-ROR共同造成抑制HuPCaSC细胞的增殖、体外侵袭和致瘤性的作用。

Liu T, Chi H,et al.Curcumin suppresses proliferation and in vitro invasion of human prostate cancer stem cells by ceRNA effect of miR-145 and lncRNA-ROR.Gene. 2017 Aug 23. pii: S0378-1119(17)30645-5. doi: 10.1016/j.gene.2017.08.008. [Epub ahead of print]

三、中医与皮肤病、神经系统疾病


青黛是我国的传统药材,性咸、寒,具有清热解毒、凉血、消斑的作用。 含靛蓝5%~8%,靛玉红0。1%,以及靛棕、靛黄。2014年发表在《皮肤科文献》上的研究中,来自台北长庚纪念医院的Yin-Ku Lin博士的研究团队,用青黛治疗那些对西药无反应的银屑病患者5年,发现42个患者中无一出现副作用,且在为期12周的试验结束之后,有31名患者的银屑病斑块消失或者接近消失。

在上述研究中,Lin把青黛跟凡士林,黄蜡(药用辅料)和橄榄油混合制成了青黛软膏。近日,Lin把该配方进行了改进,命名为Lindioil软膏。而靛玉红是青黛的有效成分。

在这项随机、双盲试验中,患者表现为慢性斑块型银屑病持续时间长达1年,且病变<体表面积(BSA)的20%,他们被随机分配,接受含200μg/g、100μg/g、50μg/g或10μg/g靛玉红的Lindioil软膏,每日两次,维持8周;之后接受一个为期12周的安全/观察期。主要终点是从基线到8周时的变化的平均百分比在银屑病皮损面积和严重程度指数(PASI)评分的平均百分比变化以及实现PASI评分降低75%和90%的比重(分别为PASI 75和PASI 90)。

第8周时的结果表明,200μg/g组的PASI评分下降幅度最大(69.2%,95%置信区间[CI] 82.8-55.5),其次依次是100μg/g组(63.1%,95% CI 73.5-52.8),10μg/g组(53.4%,95% CI 64.0-42.8),和50μg/g组(50.3%,95% CI 63.2-37.4),P值在各组之间=0.0445)。在200μg/g组的受试者中达到PASI 75和PASI 90的比例最高,分别为:56.5%,P = 0.0474;30.4%,P = 0.0098。在20周的研究过程中,没有严重的治疗相关的不良事件。

结论:Lindioil软膏中200μg/g靛玉红是目前为止的研究发现的治疗局部银屑病的最有效浓度。

Lin YK, See LC,et al.Comparison of indirubin concentrations in indigo naturalis ointment for psoriasis treatment: a randomized, double-blind, dosage-controlled trial.Br J Dermatol. 2017 Aug 17. doi: 10.1111/bjd.15894. [Epub ahead of print]


商陆(Phytolacca esculenta),为商陆科植物商陆Phytolacca acinosa Roxb.或垂序商陆Phytolacca americana L.的干燥根。具有逐水消肿,通利二便之功效,外用具有解毒散结之功效。常用于水肿胀满,二便不通;外治痈肿疮毒。

商陆皂苷甲(EsA)是一个从商陆根中分离出的皂苷。既往的研究发现,EsA可能对类风湿性关节炎、肾小球肾炎、自身免疫疾病等炎症性疾病有益。那商陆皂苷甲是否也对神经炎性疾病有效?

本研究的目的是探讨EsA对脂多糖(LPS)预处理的BV2小神经胶质细胞和原代培养的小胶质细胞的药理作用。

研究结果表明,在BV2小胶质细胞和原代培养的小胶质细胞中,EsA预处理能显著降低LPS诱导的一氧化氮(NO)、前列腺素E2(PGE2)的产生,以及抑制LPS介导的炎症介质的表达的上调,如一氧化氮合酶(iNOS),环氧合酶-2(COX-2)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-12(IL-12)和肿瘤坏死因子-α(TNF-α)。

此外,在LPS刺激的BV2细胞中,EsA明显抑制核因子-κB p65的易位(NF-κB p65κ),通过阻断 IκB-α的磷酸化和降解。在LPS刺激的BV2细胞中,EsA还降低丝裂原活化蛋白激酶(MAPK)的磷酸化水平,以及抑制NOD样受体PYRIN结构域蛋白3(NLRP3)炎性小体介导的Caspase-1激活。同时,在原代培养的小胶质细胞中,EsA还降低了Aβ1-42诱导的IL-1和IL-6的产生。

研究人员认为,商陆皂苷甲可能是一个有希望治疗神经炎性疾病的药物。

Yang H, Chen Y,et al.Esculentoside A exerts anti-inflammatory activity in microglial cells.Int Immunopharmacol. 2017 Aug 23;51:148-157. doi: 10.1016/j.intimp.2017.08.014. [Epub ahead of print]

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  1. [GetPortalCommentsPageByObjectIdResponse(id=239791, encodeId=4a6b239e917b, content=非常好的文章.学习了非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Sep 02 19:25:41 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239767, encodeId=8c6c239e6721, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat Sep 02 15:17:15 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380852, encodeId=d910138085241, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1409035, encodeId=f4e8140903511, content=<a href='/topic/show?id=2c1c35262a9' target=_blank style='color:#2F92EE;'>#医药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35262, encryptionId=2c1c35262a9, topicName=医药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f62754598, createdName=cathymary, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239251, encodeId=ae1123925176, content=感谢整理和分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrslYMXZjklHMDc8sLw4ibVIkib2GJxC1wn4swHicEtFIDAVjOXsVF4jZDrPUmVCpSXWXrQIAg1ARhL6seFibXtjJJsp/0, createdBy=f2072051120, createdName=Austin55, createdTime=Fri Sep 01 08:38:36 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239221, encodeId=b46223922110, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Sep 01 07:12:56 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239214, encodeId=d8102392141a, content=这篇咨询不错哦.值得学习.对于临床工作和科研思路都很有帮助., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 01 07:07:21 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239190, encodeId=7fec23919033, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 01 06:34:52 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239165, encodeId=b94b239165ce, content=好好看下.内容丰富, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Sep 01 05:34:11 CST 2017, time=2017-09-01, status=1, ipAttribution=)]
    2017-09-02 天涯183

    非常好的文章.学习了非常好的文章.学习了

    0

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    2017-09-02 1e17414fm02(暂无匿称)

    学习

    0

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    2017-09-02 cathymary
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    2017-09-01 Austin55

    感谢整理和分享.学习了

    0

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    2017-09-01 明月清辉

    谢谢分享.学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=239791, encodeId=4a6b239e917b, content=非常好的文章.学习了非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Sep 02 19:25:41 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239767, encodeId=8c6c239e6721, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat Sep 02 15:17:15 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380852, encodeId=d910138085241, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1409035, encodeId=f4e8140903511, content=<a href='/topic/show?id=2c1c35262a9' target=_blank style='color:#2F92EE;'>#医药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35262, encryptionId=2c1c35262a9, topicName=医药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f62754598, createdName=cathymary, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239251, encodeId=ae1123925176, content=感谢整理和分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrslYMXZjklHMDc8sLw4ibVIkib2GJxC1wn4swHicEtFIDAVjOXsVF4jZDrPUmVCpSXWXrQIAg1ARhL6seFibXtjJJsp/0, createdBy=f2072051120, createdName=Austin55, createdTime=Fri Sep 01 08:38:36 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239221, encodeId=b46223922110, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Sep 01 07:12:56 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239214, encodeId=d8102392141a, content=这篇咨询不错哦.值得学习.对于临床工作和科研思路都很有帮助., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 01 07:07:21 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239190, encodeId=7fec23919033, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 01 06:34:52 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239165, encodeId=b94b239165ce, content=好好看下.内容丰富, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Sep 01 05:34:11 CST 2017, time=2017-09-01, status=1, ipAttribution=)]
    2017-09-01 李东泽

    这篇咨询不错哦.值得学习.对于临床工作和科研思路都很有帮助.

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=239791, encodeId=4a6b239e917b, content=非常好的文章.学习了非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Sep 02 19:25:41 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239767, encodeId=8c6c239e6721, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat Sep 02 15:17:15 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380852, encodeId=d910138085241, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1409035, encodeId=f4e8140903511, content=<a href='/topic/show?id=2c1c35262a9' target=_blank style='color:#2F92EE;'>#医药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35262, encryptionId=2c1c35262a9, topicName=医药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f62754598, createdName=cathymary, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239251, encodeId=ae1123925176, content=感谢整理和分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrslYMXZjklHMDc8sLw4ibVIkib2GJxC1wn4swHicEtFIDAVjOXsVF4jZDrPUmVCpSXWXrQIAg1ARhL6seFibXtjJJsp/0, createdBy=f2072051120, createdName=Austin55, createdTime=Fri Sep 01 08:38:36 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239221, encodeId=b46223922110, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Sep 01 07:12:56 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239214, encodeId=d8102392141a, content=这篇咨询不错哦.值得学习.对于临床工作和科研思路都很有帮助., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 01 07:07:21 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239190, encodeId=7fec23919033, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 01 06:34:52 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239165, encodeId=b94b239165ce, content=好好看下.内容丰富, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Sep 01 05:34:11 CST 2017, time=2017-09-01, status=1, ipAttribution=)]
    2017-09-01 刘煜

    学习了谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=239791, encodeId=4a6b239e917b, content=非常好的文章.学习了非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Sep 02 19:25:41 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239767, encodeId=8c6c239e6721, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Sat Sep 02 15:17:15 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1380852, encodeId=d910138085241, content=<a href='/topic/show?id=9281e34519b' target=_blank style='color:#2F92EE;'>#研究进展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73451, encryptionId=9281e34519b, topicName=研究进展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1409035, encodeId=f4e8140903511, content=<a href='/topic/show?id=2c1c35262a9' target=_blank style='color:#2F92EE;'>#医药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35262, encryptionId=2c1c35262a9, topicName=医药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=36f62754598, createdName=cathymary, createdTime=Sat Sep 02 14:55:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239251, encodeId=ae1123925176, content=感谢整理和分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/iaqwic5175nrslYMXZjklHMDc8sLw4ibVIkib2GJxC1wn4swHicEtFIDAVjOXsVF4jZDrPUmVCpSXWXrQIAg1ARhL6seFibXtjJJsp/0, createdBy=f2072051120, createdName=Austin55, createdTime=Fri Sep 01 08:38:36 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239221, encodeId=b46223922110, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Sep 01 07:12:56 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239214, encodeId=d8102392141a, content=这篇咨询不错哦.值得学习.对于临床工作和科研思路都很有帮助., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Sep 01 07:07:21 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239190, encodeId=7fec23919033, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Fri Sep 01 06:34:52 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239165, encodeId=b94b239165ce, content=好好看下.内容丰富, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Sep 01 05:34:11 CST 2017, time=2017-09-01, status=1, ipAttribution=)]
    2017-09-01 忠诚向上

    好好看下.内容丰富

    0

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