我国人体结膜吸吮线虫病的研究

结膜吸吮线虫病是由结膜吸吮线虫引起的人兽共患病,人体病例最早在我国北京和福建发现。除我国外,在亚洲的印度、缅甸、泰国、菲律宾、印尼、日本、朝鲜和俄罗斯的远东地区均有人体病例报道。犬等动物是结膜吸吮线虫的终宿主和保虫宿主,冈田氏绕眼果蝇是其中间宿主和传播媒介。     

我国结膜吸吮线虫病流行因素及传播机制的研究

目的为探讨我国结膜吸吮线虫病流行因素和传播机制。方法我们调查了安徽淮北地区的犬、猫和野兔自然感染结膜吸吮线虫成虫和变色纵眼果蝇、家蝇自然感染结膜吸吮线虫幼虫情况,并用结膜吸吮线虫初产蚴喂饲变色纵眼果蝇、家蝇实验感染的观察。结果检查犬305只,阳性234只占76.7％;猫14只阳性4只占28.6％;野兔59只中阳性6只,占10.2％。检查变色纵眼果蝇（Amiotavariegata）737只,自然感染结膜吸吮线虫幼虫者12只占1.6％。于1989年我们证实变色纵眼果蝇为结膜吸吮线虫中间宿主,而家蝇并不是。幼虫在果蝇体内发育过程为：被食入的初产的24h内脱去鞘膜。第2—3d钻过胃肠壁入血腔,多数幼虫侵入雄果蝇睾丸或雌蝇血腔壁形成“虫泡囊”。在囊内经腊肠期、感染前期和感染期连续发育并蜕二次皮。感染期蚴钻破虫泡囊,移行到头部和口器。当感染的果蝇再次呼吸终宿主（犬、猫及人）泪液时,幼虫进入眼结膜囊内,经2次蜕皮发育为成虫。感染后35d,雌虫开始产出初产蚴。成虫寿命可达30个月以上。结论结膜吸吮线虫最重要的保虫宿主是犬,其中间宿主是变色纵眼果蝇,在流行区传播媒介为该种果蝇。     

人体结膜吸吮线虫病与犬的感染关系的研究

目的阐明五河地区人体结膜吸吮线虫病与犬的感染关系。方法调查结膜吸吮线虫病的传播媒介和采取控制养犬前后本病流行情况。结果通过调查,于1989年证明了结膜吸吮线虫病的传搔媒介为变色纵眼果蝇(Amita variegata);1985～1992年于五河县发现婴幼儿病例17例,其间家犬感染本虫阳性率为86.9%。而控制养犬后调查换代家犬31只未见感染,人体病例亦不再出现。结论流行区控制养犬后消灭了传染源,经7年跟踪观察,该地区达到了消灭结膜吸吮线虫病的目标。     

结膜吸吮线虫实验室感染大绕眼果蝇

在安徽黄山地区捕捉有绕眼习性的果蝇,将结膜吸吮线虫初产蚴混于果汁中,实验室喂饲感染果蝇,常温饲养20 d后,检查果蝇的感染情况。结果显示,大绕眼果蝇（Amiota magna）和冈田绕眼果蝇（A. okadai）的阳性率分别为30%（30/100）和21.6%（55/255）,两者间的差异无统计学意义（χ²=0.058 4, P>0.05）。将采自大绕眼果蝇的结膜吸吮线虫感染期幼虫接种家兔,35 d后在兔结膜囊内检获结膜吸吮线虫成虫及其初产蚴,表明在实验室条件下,结膜吸吮线虫可感染大绕眼果蝇。     

结膜吸吮线虫病流行病学研究进展

结膜吸吮线虫病是人畜共患的眼部疾病之一.该病多分布在亚洲许多国家.近年来随着全球变暖等气候变化,结膜吸吮线虫感染在国内外持续增多,流行范围不断扩大.以往欧洲的意大利和法国曾经报道过犬、猫和狐狸有感染病例,也出现了人感染病例的报告,引起研究者们的广泛关注.该文针对结膜吸吮线虫病的流行病学特征、治疗和预防等的研究进行了综述.     

我国结膜吸吧线虫病流行因素及传播机制的研究

目的 为探讨我国结膜吸吮线虫病流行因素和传播机制。方法 我们调查了安徽淮北地区的犬、猫和野兔自然感染结膜吸吮线虫成虫和变色从眼果蝇、家蝇自然感染结膜吸吮线虫幼虫情况，并用结膜吸吧线虫初产蚴喂饲变色纵眼蝇、家蝇实验感染的观察。结果 检测犬３０５只，阳性２３４只占７６．７％；猫１４只阳性４只占２８．６％；野兔５９只中阳性６只，占１０．２％。检查变色纵眼果蝇（Ａｍｉｏｔａ ｖａｒｉｅｇａｔａ）７３７只，     

结膜吸吮线虫生活史的进一步研究(英)

目的 进一步研究我国结膜吸吮线虫(Thelazia callipaeda)生活史及其中间宿主。 方法 采集自然感染的家蝇和冈田氏绕眼果蝇(Amiota okadai),检出线虫幼虫,分别接种动物;用结膜吸吮线虫初产蚴分别喂饲实验室繁殖的第二代家蝇和冈田氏绕眼果蝇。 结果 自流行区采集冈田氏绕眼果蝇493只,从其体内检获34条幼虫,接种2只家兔和1只家犬眼内,经18～44 d观察,获成虫11条。结膜吸吮线虫初产蚴在冈田氏绕眼果蝇消化道内脱鞘,钻过肠壁进入血腔,在雄蝇睾丸和雌蝇血腔膜形成虫泡囊。幼虫经2次蜕皮(需14～17 d)发育为感染性幼虫,然后经颈部移行至喙。当果蝇吸食人及犬、猫眼部分泌物时进入终宿主眼内,经2次蜕皮发育为成虫后,产出幼虫。成虫寿命可达30个月以上。 结论 我国结膜吸吮线虫的中间宿主为冈田氏绕眼果蝇。     

结膜吸吮线虫生活史的进一步研究(英)

目的 进一步研究我国结膜吸吮线虫(Thelazia callipaeda)生活史及其中间宿主。 方法 采集自然感染的家蝇和冈田氏绕眼果蝇(Amiota okadai),检出线虫幼虫,分别接种动物;用结膜吸吮线虫初产蚴分别喂饲实验室繁殖的第二代家蝇和冈田氏绕眼果蝇。 结果 自流行区采集冈田氏绕眼果蝇493只,从其体内检获34条幼虫,接种2只家兔和1只家犬眼内,经18～44 d观察,获成虫11条。结膜吸吮线虫初产蚴在冈田氏绕眼果蝇消化道内脱鞘,钻过肠壁进入血腔,在雄蝇睾丸和雌蝇血腔膜形成虫泡囊。幼虫经2次蜕皮(需14～17 d)发育为感染性幼虫,然后经颈部移行至喙。当果蝇吸食人及犬、猫眼部分泌物时进入终宿主眼内,经2次蜕皮发育为成虫后,产出幼虫。成虫寿命可达30个月以上。 结论 我国结膜吸吮线虫的中间宿主为冈田氏绕眼果蝇。     

传播结膜吸吮线虫的果蝇[Amiota (Phortica) okadai]生态习性研究

目的为进一步了解结膜吸吮线虫不同地区媒介果蝇某些生态习性差异。方法用实验室饲养的媒介果蝇在食物上产卵,以产卵数代表对食物的亲疏的关系;观察和捕获现场媒介果蝇绕眼次数及侵袭人眼的数量,测定侵袭眼的频率和强度;初冬季节用结膜吸吮线虫初产蚴,喂饲感染媒介果蝇,经越冬(150d)后剖检,获得感染期幼虫感染家兔,观察其感染力。结果实验表明媒介果蝇嗜食水果类如苹果、梨、香蕉、油桃等和瓜蔬类如冬瓜、胡萝卜等。厌恶大蒜、韭菜等芳香蔬菜和鸡肠、鱼肠等动物内脏。各地区媒介果蝇绕眼、袭眼特性不同:山区果蝇袭眼更频繁;媒介果蝇感染结膜吸吮线虫后能越冬,其寿命长达150 d,幼虫在蝇体内能保持完好的感染力。结论各地区的媒介果蝇食性近似;山区的果蝇绕眼、袭眼能力较强;果蝇感染结膜吸吮线虫后能够越冬至次年仍保持传病能力。本文还讨论了亚欧果蝇的属种名问题。     

贵州省遵义地区人体结膜吸吮线虫线粒体DNA分析

目的通过线粒体DNA测序及亲缘关系分析初步确定贵州省遵义地区结膜吸吮线虫的来源。方法采集2016年贵州省遵义地区7例人体结膜吸吮线虫病例患者中取出的虫体,提取DNA,PCR扩增结膜吸吮线虫线粒体DNA COX1序列,与已发表的结膜吸吮线虫线粒体DNA COX1序列进行比对和系统进化分析。结果自结膜吸吮线虫患者所得虫体扩增的COX1基因存在差异,人体感染的虫株之间存在较低的遗传变异。结论遵义地区是新的结膜吸吮线虫病流行区,其结膜吸吮线虫流行株包含了亚洲及欧洲两种来源,至少有4种单倍体型。     

换代犬与阻断结膜吸吮线虫病流行关系的研究

冒的为了探寻控制结膜吸吮线虫病流行的有效措施。方法采取对现症病人所在村的传染源犬、传播媒介冈田氏饶眼果蝇(A.o)感染结膜吸吮线虫(T.c)进行调查和实行换代犬后的犬及A.o感染T.c追踪调查,将前后调查结果进行比较。结果 1981～1992年安徽淮北地区连续出现T.c病人,这时对宿县芦岭、泗县大庄、五河县城郊病人所在村犬进行了检查,当时感染T.c分别占63.6％(14/22)、75.0％(12/16)和86.1％(19/231)。同时重点检查了五河城郊A.o蝇737只,阳性12只,其感染率为1.6％。其中个别A.o带有T.c感染期幼虫达20余条。于1998年即实行换代犬之后 5年,再查五河城郊及泗县大庄家犬计31只,全部阴性。此期间无新病例。同时查五河城郊A.o果蝇206只,也全部阴性。表明换代犬已失去原先犬群那种强力传染源作用。于 1998～1999年在合肥郊区一新病例居住村,对犬进行检查,犬感染T.c占79.2％(19/24),查犬时即取出虫体,为犬治病。此时进行健康教育,群众易于接受,采用换代大及拴养犬措施,预防该病。于2000年再去检查该村犬12只,阳性8只,占66.7％,犬的感染率及感染度虽较前2年有所降低,但其传染源作用的下降,明显不如其他实行群众性换代犬措施地区的效果好。结论对结膜吸吮线虫病流行区,在健康教育基础上,果断实行换代大措施,是阻断本病传播的最有效方法。     

Questionnaire-Based Survey Conducted in 2011 concerning Endoscopic Management of Barrett's Esophagus in East Asian Countries

Background/Aims: Endoscopic definitions and management of Barrett's esophagus vary widely among countries. To examine the current situation regarding diagnosis, epidemiology, management and treatment of Barrett's esophagus in East Asian countries using a questionnaire-based survey. Methods: Representative members of the Committee of the International Gastrointestinal Consensus Symposium developed and sent a questionnaire to major institutions in China, South Korea, Japan, Thailand, Indonesia, and the Philippines. Results: A total of 56 institutions in the 6 countries participated in the survey. We found that the presence of specialized columnar metaplasia is considered to be important for diagnosing Barrett's esophagus in East Asian countries except for Japan. C&M criteria have not been well accepted in East Asia. The palisade vessels are mainly used as a landmark for the esophagogastric junction in Japan. The prevalence of long segment Barrett's esophagus is extremely low in East Asia, while the prevalence of short segment Barrett's esophagus is very high only in Japan, likely due to different diagnostic criteria. Conclusion: Among East Asian countries, we found both similarities and differences regarding diagnosis and management of Barrett's esophagus. The findings in the present survey are helpful to understand the current situation of Barrett's esophagus in East Asian countries.     

Endoscopic submucosal dissection-current success and future directions

More than 10 years have passed since endoscopic submucosal dissection (ESD) was first developed in Japan. ESD enables en bloc complete resection of superficial gastrointestinal neoplasms regardless of the size and location of the lesions. With improvements in techniques and devices, excellent therapeutic results have been achieved despite the inherent technical difficulties of this procedure. ESD aiming for curative treatment can be performed for gastrointestinal neoplasms without risk of lymph node metastasis. Accurate histopathologic examination of the resected specimen is required to determine the risk of lymph node metastasis, for which en bloc resection is beneficial. Owing to the high success rate of en bloc complete resection and accurate histopathologic examination, tumour recurrence rates after ESD are reported to be very low in Japan. Excellent results of ESD in a large number of cases have also been reported from other Asian countries such as South Korea, Taiwan and China. Although scepticism exists among Western clinicians regarding the application of ESD, it is developing slowly and reports indicate promising results in some European countries. With further development of technologies, such as endoscopic robotics, ESD could become the worldwide treatment of choice for early gastrointestinal neoplasms.     

Taenia solium taeniosis/cysticercosis in Asia: epidemiology,impact and issues

Several reports of patients with cysticercosis from many countries in Asia such as India, China, Indonesia, Thailand, Korea, Taiwan and Nepal are a clear indicator of the wide prevalence of Taenia solium cysticercosis and taeniosis in these and other Asian countries. However, epidemiological data from community based studies are sparse and available only for a few countries in Asia. Cysticercosis is the cause of epilepsy in up to 50% of Indian patients presenting with partial seizures. It is also a major cause of epilepsy in Bali (Indonesia), Vietnam and possibly China and Nepal. Seroprevalence studies indicate high rates of exposure to the parasite in several countries (Vietnam, China, Korea and Bali (Indonesia)) with rates ranging from 0.02 to 12.6%. Rates of taeniosis, as determined by stool examination for ova, have also been reported to range between 0.1 and 6% in the community in India, Vietnam, China, and Bali (Indonesia). An astonishingly high rate of taeniosis of 50% was reported from an area in Nepal populated by pig rearing farmers. In addition to poor sanitation, unhealthy pig rearing practices, low hygienic standards, unusual customs such as consumption of raw pork is an additional factor contributing to the spread of the disease in some communities of Asia. Undoubtedly, cysticercosis is a major public health problem in several Asian countries effecting several million people by not only causing neurological morbidity but also imposing economic hardship on impoverished populations. However, there are wide variations in the prevalence rates in different regions and different socio-economic groups in the same country. It is important to press for the recognition of cysticercosis as one of the major public health problems in Asia that needs to be tackled vigorously by the governments and public health authorities of the region.     

结膜吸吮线虫海藻糖酶筛选及其生物信息学分析

目的　筛选结膜吸吮线虫基因组注释数据,鉴定海藻糖酶基因,并研究其编码蛋白的生物学特性。方法　 基于结膜吸吮线虫基因组筛选出海藻糖酶基因并进行PCR验证,通过生物信息学方法分析该基因编码蛋白的结构特征,包括疏水区、跨膜区、信号肽及结构域,以及编码蛋白质的二级、三级结构及其抗原表位。对其编码的氨基酸序列进行同源比对,利用MEGA X软件构建系统发育树,通过STRING数据库对其蛋白互作网络进行预测。 结果　从结膜吸吮线虫基因组中筛选鉴定出1条具有完整编码区的海藻糖酶基因序列,其长度为1 638 bp,编码545个氨基酸;预测其编码蛋白大小为63 478.48 ku,为分泌蛋白;其5′区域包含一个信号肽,无跨膜区,推测具有7个抗原表位。以STRING数据库中线虫蛋白互作网络信息为参考,对结膜吸吮线虫海藻糖酶基因的蛋白质互作网络进行预测,共鉴定出包括10个基因在内的27个互作关系。结论　从结膜吸吮线虫基因组中筛选出1条海藻糖酶基因并对其编码蛋白进行了生物信息学分析,从而为该蛋白的生物学功能研究及结膜吸吮线虫病疫苗候选分子筛选奠定了基础。     

Observations on the epidemiology of gastrointestinal and liver cancers in the Asia–Pacific region

Gastric cancer (GC) has long been thought to be an Asian type of cancer that is broadly associated with poverty, whereas colorectal cancer (CRC) has been thought to be a Western type of cancer associated with affluence. The incidence of GC has declined dramatically in the West but has a very high incidence in East Asia. The age‐standardized incidence rates (ASR) have also declined. The decrease in the incidence of GC is associated with the decrease in the prevalence of Helicobacter pylori (H. pylori) infection worldwide. The discrepancy between a high H. pylori infection rate and a low GC incidence is seen chiefly among southern Asians of Indian origin and has been aptly termed the “Indian enigma”. CRC is a new emerging cancer in this region. Some of the highest CRC ASR have been reported from Asian countries, in many of which it has now surpassed that of GC. Liver cancer is also an important cancer in the Asia–Pacific region. The highest ASR worldwide is reported from the Asian countries of Mongolia, Korea and Japan. The predominant underlying etiology across the region has been hepatitis B virus infection, except in Japan, where hepatitis C is an important cause of hepatocellular carcinoma (HCC). With mass vaccination of hepatitis B at birth and improved public health measures in many countries, hepatitis B and C are set to decline with time. However, the exponential increase in obesity and consequent non‐alcoholic fatty liver disease portends a future epidemic of fatty liver‐related HCC.     

Asbestos in Asia

Asbestos is a global killer. Despite lessons learned in the developed world on the use of asbestos and its hazardous pulmonary consequences, its use continues to increase in Asia. Although some countries such as Japan, Korea and Singapore have curtailed the use of this mineral, there are numerous countries in Asia that continue to mine, import and use this fibre, particularly China, which is one of the largest consumers in the world. Numerous factors ranging from political and economic to the lack of understanding of asbestos and the management of asbestos‐related lung disease are keys to this observed trend. Awareness of these factors combined with early intervention may prevent the predicted Asian ‘tsunami’ of asbestos diseases.     

提高对自身免疫性胰腺炎的诊断水平

自身免疫性胰腺炎（AIP）是慢性胰腺炎中的一种特殊类型,好发于老年人,以血清中高IgG4水平、胰腺组织中有大量分泌IgG4的浆细胞浸润、胰腺肿大和胰管不规则狭窄为特征,甾类激素治疗有效,根据影像学、血清学、组织学和对甾类激素治疗的反应可作出诊断,但均无特异性。日本、韩国、美国相继制定了AIP的诊断标准,并提出了所谓的AIP亚洲诊断标准。目前我国AIP的病例报道不多,对该病的认识尚处于初始阶段,他国的诊断标准可作为我国AIP研究的良好借鉴。