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NEJM:随地大小便,阴茎被蛇咬病例报道

2015-09-19 MedSci MedSci原创

一名46岁的农民来急诊科就诊,主诉其在开阔地域小便的时候,不小心被蛇咬伤阴茎。据了解,咬伤该男子的这条毒蛇名叫“gunas”,这是黎凡特毒蛇在当地的名称。经体格检查,该男子目前的生命体征正常,但是在阴茎被咬伤的伤口处出现了严重的肿胀和出血性的大疱形成(如图A所示)。实验室检查结果显示,初始凝血酶原时间为17s(参考值,< 12s),活化部分凝血活酶时间为34s(参考值,<24s),纤维蛋白原

一名46岁的农民来急诊科就诊,主诉其在开阔地域小便的时候,不小心被蛇咬伤阴茎。


据了解,咬伤该男子的这条毒蛇名叫“gunas”,这是黎凡特毒蛇在当地的名称。

经体格检查,该男子目前的生命体征正常,但是在阴茎被咬伤的伤口处出现了严重的肿胀和出血性的大疱形成(如图A所示)。



实验室检查结果显示,初始凝血酶原时间为17s(参考值,< 12s),活化部分凝血活酶时间为34s(参考值,<24s),纤维蛋白原水平为80mg/dml(参考范围,200到400)。阴茎背部多普勒超声检查显示动静脉血管流动正常。

最后,该男子接受多价抗蛇毒血清治疗(抗蛇毒血清能中和眼镜蛇,金环蛇,和蝰蛇中的毒素),用药后无不良反应。

在接受了36小时治疗后,该男子的出凝血功能恢复正常,随后办理出院。出院4天后,其阴茎上的大疱开始坏死结痂(如图B所示)。

在接下来的2周内对其进行随访,该男子已经完全康复。

请大家思考:为什么这样的病例能发表在NEJM上,有哪些特点?

原始出处:

Hussain T, Jan RA.IMAGES IN CLINICAL MEDICINE. A Viper Bite. N Engl J Med. 2015 Sep 10;373(11):1059

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    2017-01-03 医张生

    太诱惑了。蛇?忍不住要口。???

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=167733, encodeId=621216e733d3, content=太诱惑了。蛇?忍不住要口。???, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Tue Jan 03 19:14:21 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167662, encodeId=d86316e66272, content=确实有点不可思议!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jan 03 10:38:40 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137921, encodeId=d4a113e9219e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHuBzGfFa0ZqPJYqr8iciaolWKTYMBxib5icxqsU2OEBYjj5ticwp82e8Zwx1luhoXzErojvkibyVwMF6O/0, createdBy=daf91941768, createdName=double19999, createdTime=Fri Sep 30 12:03:28 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818736, encodeId=e3841818e3631, content=<a href='/topic/show?id=13e79843e98' target=_blank style='color:#2F92EE;'>#随地大小便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98437, encryptionId=13e79843e98, topicName=随地大小便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 26 21:24:00 CST 2016, time=2016-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81998, encodeId=5fec819987f, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81997, encodeId=a52c8199ec2, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81999, encodeId=56998199959, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82000, encodeId=9ad78200021, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82001, encodeId=f9ba8200189, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82002, encodeId=3289820024a, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=)]
    2017-01-03 cqykthl

    确实有点不可思议!

    0

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    2016-09-30 double19999

    值得关注

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=167733, encodeId=621216e733d3, content=太诱惑了。蛇?忍不住要口。???, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Tue Jan 03 19:14:21 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167662, encodeId=d86316e66272, content=确实有点不可思议!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jan 03 10:38:40 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137921, encodeId=d4a113e9219e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHuBzGfFa0ZqPJYqr8iciaolWKTYMBxib5icxqsU2OEBYjj5ticwp82e8Zwx1luhoXzErojvkibyVwMF6O/0, createdBy=daf91941768, createdName=double19999, createdTime=Fri Sep 30 12:03:28 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818736, encodeId=e3841818e3631, content=<a href='/topic/show?id=13e79843e98' target=_blank style='color:#2F92EE;'>#随地大小便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98437, encryptionId=13e79843e98, topicName=随地大小便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 26 21:24:00 CST 2016, time=2016-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81998, encodeId=5fec819987f, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81997, encodeId=a52c8199ec2, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81999, encodeId=56998199959, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82000, encodeId=9ad78200021, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82001, encodeId=f9ba8200189, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82002, encodeId=3289820024a, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=)]
    2016-04-24 忠诚向上

    继续努力

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=167733, encodeId=621216e733d3, content=太诱惑了。蛇?忍不住要口。???, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Tue Jan 03 19:14:21 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167662, encodeId=d86316e66272, content=确实有点不可思议!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jan 03 10:38:40 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137921, encodeId=d4a113e9219e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHuBzGfFa0ZqPJYqr8iciaolWKTYMBxib5icxqsU2OEBYjj5ticwp82e8Zwx1luhoXzErojvkibyVwMF6O/0, createdBy=daf91941768, createdName=double19999, createdTime=Fri Sep 30 12:03:28 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818736, encodeId=e3841818e3631, content=<a href='/topic/show?id=13e79843e98' target=_blank style='color:#2F92EE;'>#随地大小便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98437, encryptionId=13e79843e98, topicName=随地大小便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 26 21:24:00 CST 2016, time=2016-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81998, encodeId=5fec819987f, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81997, encodeId=a52c8199ec2, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81999, encodeId=56998199959, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82000, encodeId=9ad78200021, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82001, encodeId=f9ba8200189, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82002, encodeId=3289820024a, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=)]
    2016-04-24 忠诚向上

    继续努力

    0

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    2016-04-24 忠诚向上

    继续努力

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=167733, encodeId=621216e733d3, content=太诱惑了。蛇?忍不住要口。???, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Tue Jan 03 19:14:21 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167662, encodeId=d86316e66272, content=确实有点不可思议!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jan 03 10:38:40 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137921, encodeId=d4a113e9219e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHuBzGfFa0ZqPJYqr8iciaolWKTYMBxib5icxqsU2OEBYjj5ticwp82e8Zwx1luhoXzErojvkibyVwMF6O/0, createdBy=daf91941768, createdName=double19999, createdTime=Fri Sep 30 12:03:28 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818736, encodeId=e3841818e3631, content=<a href='/topic/show?id=13e79843e98' target=_blank style='color:#2F92EE;'>#随地大小便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98437, encryptionId=13e79843e98, topicName=随地大小便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 26 21:24:00 CST 2016, time=2016-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81998, encodeId=5fec819987f, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81997, encodeId=a52c8199ec2, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81999, encodeId=56998199959, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82000, encodeId=9ad78200021, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82001, encodeId=f9ba8200189, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82002, encodeId=3289820024a, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=)]
    2016-04-24 忠诚向上

    继续努力

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=167733, encodeId=621216e733d3, content=太诱惑了。蛇?忍不住要口。???, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Tue Jan 03 19:14:21 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167662, encodeId=d86316e66272, content=确实有点不可思议!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jan 03 10:38:40 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137921, encodeId=d4a113e9219e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHuBzGfFa0ZqPJYqr8iciaolWKTYMBxib5icxqsU2OEBYjj5ticwp82e8Zwx1luhoXzErojvkibyVwMF6O/0, createdBy=daf91941768, createdName=double19999, createdTime=Fri Sep 30 12:03:28 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818736, encodeId=e3841818e3631, content=<a href='/topic/show?id=13e79843e98' target=_blank style='color:#2F92EE;'>#随地大小便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98437, encryptionId=13e79843e98, topicName=随地大小便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 26 21:24:00 CST 2016, time=2016-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81998, encodeId=5fec819987f, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81997, encodeId=a52c8199ec2, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81999, encodeId=56998199959, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82000, encodeId=9ad78200021, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82001, encodeId=f9ba8200189, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82002, encodeId=3289820024a, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=)]
    2016-04-24 忠诚向上

    继续努力

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=167733, encodeId=621216e733d3, content=太诱惑了。蛇?忍不住要口。???, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Tue Jan 03 19:14:21 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=167662, encodeId=d86316e66272, content=确实有点不可思议!, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue Jan 03 10:38:40 CST 2017, time=2017-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137921, encodeId=d4a113e9219e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuHuBzGfFa0ZqPJYqr8iciaolWKTYMBxib5icxqsU2OEBYjj5ticwp82e8Zwx1luhoXzErojvkibyVwMF6O/0, createdBy=daf91941768, createdName=double19999, createdTime=Fri Sep 30 12:03:28 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1818736, encodeId=e3841818e3631, content=<a href='/topic/show?id=13e79843e98' target=_blank style='color:#2F92EE;'>#随地大小便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98437, encryptionId=13e79843e98, topicName=随地大小便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Mar 26 21:24:00 CST 2016, time=2016-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81998, encodeId=5fec819987f, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81997, encodeId=a52c8199ec2, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=81999, encodeId=56998199959, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82000, encodeId=9ad78200021, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82001, encodeId=f9ba8200189, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82002, encodeId=3289820024a, content=继续努力, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Apr 24 07:46:00 CST 2016, time=2016-04-24, status=1, ipAttribution=)]
    2016-04-24 忠诚向上

    继续努力

    0

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