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中国罕见病现状

2018-08-23 罕见病发展中心(CORD)主任黄如方 罕见病发展中心(CORD)主任黄如方

国际确认的罕见病有五六千种,约占人类疾病的10%。在种类繁多的罕见病当中,约有80%是由于基因缺陷所导致的。从全球罕见病的发展来看,中国要比美国、加拿大、澳大利亚、法国、日本及巴西等国家要晚很多,在科研、诊治、权益保障、社会宣传等各方面都要薄弱。目前中国罕见病的现状主要有以下几点:一、罕见病医学研究、诊疗水平低下中国最早的有关罕见病的医学法规是在1999年出版的《药品注册管理办法》中提到罕见病

国际确认的罕见病有五六千种,约占人类疾病的10%。在种类繁多的罕见病当中,约有80%是由于基因缺陷所导致的。从全球罕见病的发展来看,中国要比美国、加拿大、澳大利亚、法国、日本及巴西等国家要晚很多,在科研、诊治、权益保障、社会宣传等各方面都要薄弱。目前中国罕见病的现状主要有以下几点:

一、罕见病医学研究、诊疗水平低下

中国最早的有关罕见病的医学法规是在1999年出版的《药品注册管理办法》中提到罕见病和治疗罕见病新药,但并未对“罕见病”的概念进行明确界定。2007年新版《药品注册管理办法》中对罕见病临床试验和审批有两条优惠措施,但依然未给出罕见病的具体定义或范围,这给罕见病相关研究和诊疗设置了第一个最为基础的障碍。

这直接导致了中国的医学专家、研究机构以及政府科研部门很难进行系统的科研,也使得研究罕见疾病的机构和专家很少,造成了目前医学研究和药物研发水平较低,大部分罕见病患者长期被误诊、漏诊,不能得到及时有效的治疗。

从我们目前的工作中了解到,很多罕见病在中国可能找不到具有权威的医学专家和诊疗机构,只有极少类的罕见病在中国能有权威的诊疗医生,而且每个疾病只有1,2个权威医生,中国这么大的国家和这么多的人口,再加上罕见病的诊疗的复杂性,病人的误诊、漏诊自然就产生了。

二、病人药物可及性程度低

从全球来看,人类已知的7000多种罕见病,绝大多数还没有有效的治疗方法。近40多年的科学研究,目前具有有效治疗方法的疾病类型也不足3%。而这种现象在中国尤其明显。罕见病药物研发和供应不足,药物申请审批无绿色通道,大多依赖进口等问题存在。

一些罕见病在国外已经有药可治,但由于政策原因还没有进入国内市场,国内患者只能望洋兴叹。比如黏多糖症(MPS)、庞贝氏症、法布瑞病、尼曼匹克病。

由于用药的患者人数太少,治疗罕见病的药物也被称为“孤儿药”,绝大多数孤儿药的价格都非常高昂,病人无力承担。比如治疗戈谢病的药物——思而赞(健赞生产)在中国每个患者平均每年需要200万人民币的药费,并且需要终身服药。治疗BH4缺乏症的药物——盐酸沙丙喋吟片(科望)(默克雪兰诺生产)患者平均每年需要20万人民币的药费。这些费用在中国的普通家庭是根本没有办法承担的。

还有像肺动脉高压、多发性硬化、地中海贫血、肢端肥大症、血友病、成骨不全症等疾病群体都需要非常大额的医疗费用,而在中国这样的病人家庭承担将非常沉重。

三、罕见病社会保障政策缺失

从上世纪八十年代开始,美国、欧盟、澳大利亚、日本、韩国、台湾等国家和地区都相继制定了罕见病相关法案,患者享有政府医疗保健计划和商业保险双重保障,实现了病者有其医,病者有其药。

比如美国早在1983年就颁布了《罕见病用药法案》(Orphan Drug Act,ODA),来保障病人的基本医疗权益。然而,中国国内目前还没有一部全国性的罕见病法律法规,罕见病药物没有纳入医保和商业保险范围内,近千万患者的健康权益没有得到保障。

中国从1999年开始在一些相关的法规中提到罕见病药品注册、临床试验和审批管理,但却没有具体的操作细节。除此之外,在病人用药和治疗、社会保障方面还没有一部针对罕见病的综合性法律。

从2006年全国人大代表孙兆奇第一次在全国人大会议上提交罕见病相关提案之后,每年包括瓷娃娃罕见病关爱中心在内的机构和个人(主要是医学背景的人大代表或政协委员)都向政府部门开展政策倡导,呼吁中国尽快出台罕见病法律。

令人欣慰的是,中国的有些省市在罕见病政策上首先走出了一步。2011年,上海在上海市少儿住院互助基金中对戈谢病、法布雷病、庞贝病、黏多糖贮积症等四种罕见病儿童给予每年不超过10万人民币的救助(2012年额度提高至20万人民币每年)。2011年设立了上海医学会罕见病专科分会。

山东省医科院成立罕见病重点实验室开展罕见病研究,最新消息,山东省即将设立省级的罕见病救助基金对罕见病患者开展社会救助。2011年10月,安徽省铜陵市出台罕见病医保新办法,从门诊、药物、转院三方面给予罕见病患者特殊照顾。

山东青岛市2012年7月颁布实施《关于建立城镇大病医疗救助制度的意见(试行)》,对重大疾病、罕见病的特殊用药社会保障政策进行积极的探索。

而在中国,单病种来看,目前血友病是众多罕见病中医疗保障政策最多的疾病,在中国东部和中部大部分省份都已经对血友病治疗进行了不同程度的医疗保障,在各个省都建立了省级血友病诊疗和登记中心,日前卫生部刚刚针对血友病等几种大病开始推行更大范围的医疗保障政策试点。

当然,罕见病法律的制定需要至少卫生部、社会保障部、财政部以及民政部4大部门的协调,另外一部罕见病法律的执行必须要有,对目前中国现有的罕见病群体及发病率有充分的医学病理的研究和统计,必须建立罕见病的诊疗和科研中心,必须有必要的医生和充足的药物,必须要有财政支付能力及中央财政结算方式。

四、病友家庭因病致贫现象普遍

由于罕见病的特点,用药人数非常少,所以治疗的药物价格自然就非常昂贵。造成中国病人家庭贫困的主要原因,是目前患者的医疗费无法得到政策的保障,昂贵的医疗费用几乎靠病人家庭自己承担。

另外由于病人自身从小在接受教育和就业层面面临困难或遭遇歧视,所以他们在获得经济收入方面的能力要比普通人更弱。也将导致贫困。

另外有一些疾病是在儿童时期就开始发病,父母中需要一方放弃工作来全职照顾孩子,而且孩子的病情是长期慢性的,此时家里就丧失了一个劳动力,也将导致贫困。

另外在我们的工作,也发现有很多家庭因为孩子患有罕见病,或者夫妻一方开始发病,有些家庭夫妻为此离婚,抛弃这个本已陷入困境的家庭,也将导致贫困。

五、社会歧视和排斥现象普遍

由于罕见病本身的疾病特征,很多病人在外貌、语言等方面出现异常,容易在接受教育、就业、婚恋等方面遭受歧视。在我们的工作中会发现有很多学校怕承担责任而拒绝让成骨不全症的孩子进入到学校,哪怕中国的法律有明确规定,保障所有的儿童有平等的受教育权。同样也存在很多公司或政府部门因为白化症患者全身白色毛发而拒绝录用或者进行排斥,同样也存在软骨发育不全症Achondroplasia患者因为矮小的身材很难找到普通人谈恋爱、结婚,克氏综合征患者因为无法生育而被恋人抛弃。其他还有比较典型的例子有:脊髓小脑共济失调SCA、黏多糖贮积症MPS、马凡氏综合征、肢端肥大症、特纳综合征等。

另外,罕见病患者经常受到各种歧视,也会导致患者社会融入困难,内心变得自卑、自闭。

六、病友家庭社会援助缺失

当家庭出现一个罕见病儿童时,或者当病人发现自己患有罕见病时,病人及家属首先都无法接受这个事实,继而产生很大的心理负担,会出现绝望、焦虑、恐惧、自卑、极度消极甚至自杀念头,而此时整个社会(亲人朋友、同事、医生、政府、社区)缺乏有效及时的心理疏导等社会援助,甚至在工作中,我们听到一些案例,有些病人去找医生看病,医生却说,这个病没得治了,在家等着吧。

在这些社会援助中,病人最需要的是找到自身疾病的病友组织,和全国其他的病友建立沟通,相互鼓励,相互支持,获得疾病和治疗的相关信息,参加积极有趣的活动,重新树立信心。

而不幸的是,目前中国的罕见病组织(RDNGO)数量少,且发展非常弱,他们为病人提供的服务非常有限。

七、社会宣传和公众认知不足

由于罕见病的发病率非常低,有些疾病是十万分之一,甚至是百万分之一。这使得包括医生在内的很多人对罕见病缺乏应有的了解。

早在四年前,绝大多数的社会公众都没有听说过“罕见病”这个词,更别提公众对罕见病知识的了解以及对该群体的认知。瓷娃娃罕见病关爱中心从2009年开始每年开展大量的宣传和倡导活动,使得公众慢慢开始有所了解,但整体来说,公众对罕见病的认知程度还非常低。

而在某种程度上,社会公众不了解罕见病,将直接影响到科研、政策的推进工作。特别是在中国,如果在社会舆论上对罕见病有充分的讨论,给政府缺位现象形成一定的压力,将有可能推动政府部门的政策制定,进而可能带动医学研究、疾病诊疗、社会援助、药价等方面的利好导向。

以上7点是我认为目前中国罕见病存在的较大问题。和罕见病病人相关的利益相关方有病友服务组织(RDNGO)、政府、医药企业、医生,而其中病友服务组织是其中最为重要的一个,它代表病人的利益,通过与其他利益相关方的协调与合作,为病人群体寻求援助以及维护权益。而在上面的第六条我们提到,RDNGO为病友家庭提供多方位的支持。

而目前中国的RDNGO的发展情况又是怎样的呢?

一、起步晚、数量少

目前在中国现有各类RDNGO约有60家左右,60%都是在2008年之后成立,30%在北京。这些RDNGO覆盖30多种罕见病类型,联系到的病人约有2万人左右。

血友病组织数量最多,近20家。由于血友病疾病本身的特征,病人需要使用血制品来维持生命,在20世纪末21世纪初,发生部分血友病人感染艾滋病(HIV/AIDS)和乙肝的现象,所以很多病人自发成立病人互助团体,开展政策倡导,维护自身合法权益。

二、组织化专业化程度低

大部分的组织发展较弱。组织化程度很低,很多组织没有注册、全职工作人员少甚至没有(90%以上的组织全职人员少于5人)、没有固定的办公场所、没有稳定的资金来源(80%以上的组织年度预算不足10万元人民币),甚至20%左右的组织只有一个名字,没有正式得对外开展工作,日常只是几个病友通过网络聊天工具(如MSN)进行不定期的信息沟通。

三、病人及家属发起成立

几乎是所有的RDNGO都是由病人及病人的家属发起成立,由病人及病人的家属组成一个核心管理委员会(也有一些医生参与其中),领导组织的策略制定、对外合作、病友服务及日常工作等。

我本人一直认为RDNGO的管理层一定要有病人及家属的参与,只有这样才能确保组织的工作是真正从病人实际的需求出发的,代表病人群体的利益,维护病人群体的权益。但在工作中,我们也发现RDNGO领导人自身的疾病将在很大程度上影响组织的工作和发展,有些领导人行动不便、容易疲惫、一旦发病、经济压力负担重以及照顾病人没有足够时间(这指病人家属)等各种原因,都直接影响到组织的可持续发展,在近一年里甚至出现组织关闭、没有领导人等严重问题。
这个问题还将继续考验中国RDNGO整体的发展。

四、社会资源有限

由于罕见病领域在中国NGO行业里是个新兴领域,大家对此普遍关注度很低,再加上社会公众对罕见病缺乏足够的了解,社会资源没有对这一领域进行有效的分配,使得需求和分配严重不协调,整个罕见病领域和RDNGO发展受到严重影响。

而目前关注整个罕见病领域,并为RDNGO提供能力建设支持的NGO只有一家,就是瓷娃娃罕见病关爱中心,虽然我们是一家比较规范的RDNGO,但我们自身获得的社会资源也非常有限,进而严重影响了我们为其他组织提供的服务质量。

我们利用好几年的时间,建立了中国罕见病发展网络(China Rare Disease Network),它是罕见病患者组织、罕见病群体和罕见病相关机构等自发组成的公益性、互助型学习网络,致力于促进罕见病组织交流合作,提高罕见病群体的话语权,推动中国罕见病事业的发展。网络成员为罕见病患者组织和专注于罕见病领域的机构。目前这个网络里面有40多家各类组织,我们定期开展咨询、能力建设、培训及项目资助等方面的支持。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=342706, encodeId=8995342e0693, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:19 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342705, encodeId=fe98342e05b2, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342704, encodeId=857e342e04f4, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:04:10 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342703, encodeId=76d1342e0378, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:51 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342702, encodeId=a748342e028b, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:21 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342701, encodeId=3a3c342e016f, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:14 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342700, encodeId=20fe342e00da, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:09 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342699, encodeId=762334269921, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:03:02 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342698, encodeId=23b734269881, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 21:02:58 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467348, encodeId=395e146e3481b, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Aug 24 15:00:00 CST 2018, time=2018-08-24, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

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    2018-09-04 青龙偃月

    好文章学习了!

    0

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    2018-08-24 syscxl

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