日本和曼氏血吸虫抗原在间接血凝试验中与不同血吸虫病人血清的交叉反应

用间接血凝试验(IHA)比较不同抗原SjSEA、SmAWA和SmBW与日本、曼氏和埃及血吸虫病人血清的交叉反应。结果显示:3种抗原致敏的绵羊红细胞(SRBC)与其相应的血吸虫病人血清反应率分别为100％(SjSEA),96％(SmAWA)和98％(SmBW);与不同种血吸虫病人血清的交叉反应率在79％～95％,其中以SjSEA最高。结果提示:SjSEA除可用于诊断日本血吸虫病外,也可作为诊断曼氏和埃及血吸虫病的候选抗原。此外,本试验还发现IHA抗体滴度与病人排出的虫卵数量无相关关系。     

曼氏血吸虫与日本血吸虫交叉免疫原性的血清学实验研究

以曼氏血吸虫的虫卵和成虫免疫家兔后所产生的特异性抗体,可用以日本血吸虫虫卵、尾蚴和成虫为抗原分别进行的COP,CHR和ELACIEP测出,表明两种人体血吸虫存有显著的交叉抗原成分。应用此种血清交叉反应性,以检测抗异种人体血吸虫的抗体,似有效而可取的,可用以辅助诊断援外回国人员是否感染国外人体血吸虫病。     

曼氏迭宫绦虫虫卵孵化影响因素

目的 本研究探讨实验室条件下环境因素对曼氏迭宫绦虫虫卵孵化的影响,筛选有利因素,以提高曼氏迭宫绦虫虫卵孵化率。方法 在其他条件不变的情况下,分别研究自来水中的残留氯气、虫卵在粪便内滞留时间、不同的外部温度、长时间光照和摇晃孵育体系对孵育体系内虫卵孵化率的影响。结果 室温下,虫卵在自来水、脱氯水和去离子水中20 d的孵化率分别为21.4%、18.9%和20.6%,差异无统计学意义（P>0.05）;25 ℃静置孵育20 d,在粪便中滞留1、3、5、10、15 d的虫卵孵化率分别为22.0%、22.2%、13.7%、0.6%和-0.8%;4、20、25、30、37、40 ℃条件下,虫卵的孵化率分别为7.0%、8.7%、17.3%、22.0%、25.8%和26.1%;25 ℃静置孵育20 d,接受光照组虫卵孵化率为19.2%,无光照组28.5%,但差异无统计学意义（P>0.05）;30 ℃下孵育25 d,孵育体系接受规律摇晃的虫卵孵化率为33.1%,明显高于静置虫卵的孵化率7.2%,差异有统计学意义（P<0.05）。结论 自来水中的残留氯气不降低曼氏迭宫绦虫虫卵孵化率,在粪便中滞留小于3日的虫卵经淘洗入水可实现较高虫卵孵化率,提高孵育温度至30 ℃以上,摇晃孵育体系,避免长时间光照,有助于虫卵孵化率的提高。     

晚期血吸虫病患者肝内T细胞亚群的免疫组织化学检测

采用免疫组织化学技术检测了22例晚期血吸虫病（下称晚血）患者肝内T细胞亚群。发现晚血患者肝内T细胞可集中分布于虫卵肉芽肿外层或者散在分布于非肉芽肿部位的虫卵附近，广泛纤维化的区域无T细胞浸润。肉芽肿和非肉芽肿部位的T细胞均以CD8 T细胞（抑制性／细胞毒T细胞）为主。晚血患者肝脏病变以汇管区纤维化为主，浸润细胞不多，仅27．27％（6／22）患者肝内存在已被免疫调节了的慢性虫卵肉芽肿。提示晚血患者肝内细胞免疫反应很弱，肝内的CD 8T细胞可能主要是抑制性T细胞（Ts）。     

The intensity of Schistosoma mansoni in the fishing villages of Bugonga and Kitubulu in Entebbe Peninsula, Uganda

The intensity of Schistosoma mansoni infection in the fishing villages of Bugonga and Kitubulu, and the occurrence of snail intermediate host population in the two villages are described and compared. A total of five hundred and six faecal samples from both villages were examined by modified Kato's technique and the prevalence infection rate at Kitubulu was 40.3% with mean egg count of 187 eggs per gram(epg) while in Bugonga it was 32.4% and 126 epg respectively. The snail intermediate host for S. mansoni in the two villages was 2,750 Biomphalaria choanomphala at Kitubulu and 1,268 at Bugonga. But at Kitubulu in the vicinity of the village 185 Biomphalaria peifferi occurred in small localized population. The cercarial screening test conducted on 4,018 B. choanomphala and 185 B. peifferi from the two villages revealed higher snail infection rate for both mammalian and non-mammalian cercariae at Kitubulu than Bugonga. Variations in infection rates both among the inhabitants and host snail populations in the two villages are discussed.     

日本血吸虫谷胱甘肽-S-转移酶在虫卵阶段的定位

目的探讨谷胱甘肽-S-转移酶(Sj26GST)在虫卵阶段的表达、定位和重组蛋白(rSj26GST)的免疫诊断价值。方法从感染日本血吸虫尾蚴6周的兔肝脏中分离虫卵,分别用RT-PCR和免疫印迹(Western blotting)法检测Sj26GST基因在虫卵阶段的转录和翻译;同时用兔肝做免疫组化观察Sj26GST在虫卵内的分布。利用纯化的rSj26GST和日本血吸虫可溶性虫卵抗原(SEA),采用间接ELISA法检测急、慢性血吸虫病患者和正常人血清。结果RT-PCR从血吸虫虫卵中扩增670bp的基因片断,Western blotting证明在虫卵阶段Sj26GST的表达;同时免疫组化显示Sj26GST主要分布在虫卵内毛蚴两边的侧腺。rSj26GST检测急、慢性血吸虫病患者和正常人血清的阳性率分别为92%、80%和0;用SEA检测以上标本,阳性率分别为96%、84%和2%。结论Sj26GST是SEA的主要组分之一,能刺激机体产生高滴度的抗体;rSj26GST为抗原诊断日本血吸虫病显示出高度的敏感性和特异性,具有实用价值。     

未致敏小鼠实验性日本血吸虫虫卵肉芽肿中淋巴细胞的动态观察

将日本血吸虫虫卵经尾静脉注入正常小鼠,观察沉积在肺血管床形成的虫卵肉芽肿内淋巴细胞的动态变化。结果表明,注卵后第一天即见淋巴细胞浸润,随后,淋巴细胞均数及其所占反应细胞总数的构成比逐渐增加。酯酶染色结果表明,注卵后10天内酯酶染色阳性细胞高于阴性细胞数,第10天后发生逆转;至第35天时更为明显。     

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School,Wondo Genet,Southern Ethiopia

Objective

To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia.

Methods

In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni (S. mansoni) ova. Children who were found positive for S. mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration. Four weeks post-treatment, stool specimens were collected from the same children and examined following the same procedure as in the pre-treatment. Drug efficacy was determined based on cure and egg reduction rates.

Results

Pre-treatment prevalence of S. mansoni infection was 74.9% with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6% (P<0.000 1, OR: 8.33, CI: 5.3–13.1) and egg reduction rate of 68.2% (P=0.03, F=0.64). The cure rate showed significant association with age (χ²=11, P=0.004), the highest rate being observed in the 15–22 age group. 83% of S. mansoni infected children showed various treatment-related symptoms, the most frequent being headache, nausea, and abdominal pain. These symptoms were associated with age (P<0.001) and pre-treatment intensity of infection (P<0.05).

Conclusions

The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia. Hence, in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated, treatment failure, or reduced susceptibility of the parasite. Treatment-related side effects observed were transient and tolerable.     

江苏省盐城市2004—2018年血吸虫病防治效果分析

目的 分析评价盐城市2004—2018年血吸虫病防治工作,为制定防治策略提供依据。方法 收集2004—2018年盐城市血吸虫病防治工作报表并整理分析。结果 2004—2018年,盐城市调查钉螺面积累计110 491.12 hm²,药物巩固灭螺面积累计2 409.08 hm²,现有钉螺面积从2004年的40.03 hm²下降至2018年的1.03 hm²,无阳性钉螺;累计开展血吸虫病人群检查16.45万人,开展血检累计13.55万人,居民血吸虫病调查显示阳性人员1 134例,血检总阳性率为0.84%,无血吸虫病病例;开展粪检34 014例,无阳性人员;发现血吸虫病晚期病例5 248例,无急性期感染病例。开展牛血吸虫病感染检查1.38万头,总检查率为58.72%,无粪检阳性耕牛。2004—2018年全市累计建造无害化厕所 231 345户,圈养家畜2 278头,登记奶牛21 222头,治理河流8 761.59 km,整治土地82.82万亩,修建田间道路工程 3 618.87 km,修建灌、排（渠）、管道8 087.68 km。全市2004—2018年累计发放健康材料超70万份,受血防教育人数累计超过750万人次。2016—2018年血防知识知晓率和正确行为形成率均超过95%。结论 2004年至今,盐城市血吸虫病防治各项工作成效显著,为实现从传播阻断到消除血吸虫病的终极目标打下坚实基础。     

盐诱导激酶2与结直肠癌伴慢性血吸虫病淋巴结转移的相关性研究

目的：探究慢性血吸虫病影响结直肠癌的发生发展是否与盐诱导激酶2（SIK2）相关。方法：标本来自于2015年6月至2020年6月在芜湖市第二人民医院就诊并经临床和病理检查诊断为结直肠癌的363例手术患者,其中结直肠癌伴慢性血吸虫病（CRC-S）患者56例,结直肠癌不伴慢性血吸虫病（CRC-NS）患者307例。对患者临床资料和病理诊断结果进行统计,分析慢性血吸虫病与结直肠癌的相关性。利用免疫组化和蛋白质印迹法检测SIK2在各组结直肠癌标本中的分布和表达情况,分析SIK2与CRC-S患者肿瘤淋巴结转移的相关性。结果：CRC-S组淋巴结转移率（62.5%）高于CRC-NS组（47.2%）（P<0.05）。CRC-S伴淋巴结转移患者血吸虫卵主要分布在肿瘤组织（25/35,71.4%）,CRC-S不伴淋巴结转移患者血吸虫卵主要分布在癌旁组织（17/21,81.0%）,差异有统计学意义（χ²=14.243,P<0.01）。SIK2主要位于胞质溶胶,其在肿瘤组织中的表达高于癌旁组织。与CRC-NS组比较,CRC-S组SIK2表达显著增加,且伴淋巴结转移的患者SIK2表达水平高于不伴淋巴结转移的患者,虫卵位于肿瘤组织的患者SIK2表达水平高于虫卵位于癌旁组织的患者（均P<0.01）。结论：CRC-S患者淋巴结转移率更高,且虫卵位于肿瘤组织时,更容易发生淋巴结转移。SIK2的表达水平与是否伴发慢性血吸虫病、虫卵分布部位以及淋巴转移具有相关性。     

The potential of schistosomal skin test as a diagnostic method in the detection of schistosomiasis

One hundred and sixty seven volunteer medical students were exposed to intradermal skin tests for schistosomiasis. 35(21%) were positive. On further screening using routine stool and urine examinations, only 11(6.6%) were found to have eggs of Schistosoma mansoni. We conclude that although a useful procedure, schistosomal skin test should not be used alone for the diagnosis of schistosoma infections but should be complimented with the routine stool and urine examinations.     

ISOLATION OF SOME ANTIGENS FROM SCHISTOSOMA JAPONICUM AND THEIR CLINICAL SIGNIFICANCE

Six kinds of antigens from the eggs and adult worms of schistosoma japonicum were isolated. They included adult microsomal antigen (JAMA), aqueous soluble egg antigen (SEA), urea-soluble egg antigen (JEU) and its further fractionated products (JECt-D. They were analyzed by sodium polyacrylamide gel electrophoresis (SDS-PAGE), enzyme-linked immuno- electro-transfer blot (EITB) and kinetic-dependent enzyme-linked immunosorbent assay (K-ELISA). They were quantitatively assayed by K-ELISA for specific antigenic activities against sera of 39 patients with schistosomiasis japonica. The sera of patients with diseases other than schistosomiasis and 10 healthy adults were tested simultaneously as control. JEC:} was antigenically more active (A A460/min X 10-j than other antigens. Determinatin of the specific antibody (IgG) levels of S. japonicum by using JEC:i, etc as diagnostic antigens in 30 chronic patients re- vealed that the level of anti-JEC:: antibody was the highest (11.7_0.7A A460/min X 10-j. EITB test showed tbat only JEC:; exhibited no cross reactivity with sera from patients with parago nimiasis and clonorchiasis sinensis, and that all posi- tive bands of JEC; disappeared in patients cured of chronic schistosomiasis. These findings suggest that JEC:; might become a more satisfactory antigen in the serodiagnosis of schistosomiasis japonica.     

武汉市血吸虫病传播阻断后血吸虫病传播风险监测

目的 评估武汉市达到血吸虫病传播阻断后血吸虫病传播的潜在风险及风险因素特征,为防控策略的调整提供依据。方法 分析并比较2018年和2019年武汉市筛选出的90个风险监测重点村钉螺、野粪、哨鼠、现场环境和人畜活动情况的监测结果,评估武汉市达到血吸虫病传播阻断后的血吸虫病传播的潜在风险及其特征。结果 2018年和2019年分别查螺118 335框和187 987框,活螺平均密度由0.012 2只/0.11 m²下降至0.006 5只/0.11 m²,降幅达46.72%。两年内均无阳性钉螺。两年监测期间均采集到牛粪和羊粪,但2019年采集到的野粪总数量显著下降,平均野粪密度较2018年减少89.80%。野粪检测结果显示均为阴性。未监测到阳性哨鼠。监测期间内监测地带部分区域仍有垂钓休闲和旅游等人群活动。监测期间内所有风险监测重点村风险评级均为Ⅲ级（最低风险）。结论 武汉市达到血吸虫病传播阻断后血吸虫病传播风险处于较低水平,但钉螺、流动家畜野粪污染以及有螺地带人群活动等血吸虫病传播风险因素的作用不容忽视。需进一步加大风险监测力度,确保如期实现血吸虫病消除目标。     

Strongyloides fuelleborni kellyi and other intestinal helminths in children from Papua New Guinea: associations with nutritional status and socioeconomic factors

This survey examined the prevalence and intensity of Strongyloides fuelleborni kellyi and other intestinal helminths in children 5 years of age or under living near Kanabea, Papua New Guinea. Of 179 samples, 27% of the children tested positive for Strongyloides, with 81% of these children being a year or less in age. Overall, 68% of the children had one or more infections including Ascaris lumbricoides and hookworm (Necator americanus) as well as Strongyloides. Egg counts in the stools ranged from 100 to 98,300 eggs/ml for Strongyloides, 100 to 59,200 eggs/ml for Ascaris and 100 to 3400 eggs/ml for hookworm. There were significant associations between Strongyloides intensity and weight for age and weight for height such that children with higher intensities had, on average, lower z-scores. Relationships between the prevalence of helminth infections and socioeconomic factors were also observed. Logistic regression models showed that children living farther away from Kanabea (more than 2 hours' walking distance), in smaller households (5 or less people) and with uneducated mothers best predict children with Strongyloides. Two of these variables also predicted the presence of hookworm: maternal education and household size. However, in contrast to Strongyloides, a larger household size (6 or more people) was significantly associated with the presence of hookworm. House type was associated with the prevalence of Ascaris, with children living in houses with tin roofs being less likely to have Ascaris than those living in traditional houses. In addition, maternal education was associated with Ascaris intensity in those children with infection, such that the mean intensities were greater in children of uneducated mothers.     

Possible effects of Strongyloides fuelleborni-like infections on children in the Karimui area of Simbu Province

A parasitological survey of 75 children less than 5 years of age from the village of Yuro, 5km south-east of Karimui, revealed that 47 (63%) were infected with the Strongyloides species resembling S. fuelleborni; 42 (56%) were infected with hookworm. Poor compliance with an intervention study of thiabendazole therapy resulted in the abandonment of the proposed follow-up survey. However, with the small number of children who did comply, we found evidence to suggest a link between high Strongyloides egg count and poor nutritional status.     

常德市人群寄生虫感染现状调查

目的 进一步掌握常德市寄生虫感染情况,为制定科学防治对策提供科学依据.方法 对随即抽取的常德市人群采用改良加藤法检查土源性线虫卵、肝吸虫卵、血吸虫虫卵和其他寄生虫卵.结果 常德市人群寄生虫总感染率为19.96％,以蛔虫、鞭虫感染为主.未发现肝吸虫卵.血吸虫感染率男性高于女性,副业渔民血吸虫感染率高达28.36％.鞭虫、蛔虫、钩虫、姜片虫女性高于男性,学龄前儿童、学生、文盲最高.结论 副业渔民是血吸虫病重点防治人群,青少年、学龄前儿童、文盲是蛔虫、鞭虫、姜片虫防治重点人群.     

光镜和电镜下肠癌与血吸虫病肠的改变及其关系的探讨

The light and electron microscopic observations were carried out in 50 cases of colon specimens. No remarkable morphologic differences were found between the epithelial cells of the mucosa with schistosomiasis, colitis and the normal specimens. Cells of the colon carcinoma also showed no significant difference from those of the colon carcinoma associated with schistosomiasis. Atypical changes in the epithelial cells were not seen in the areas both adjacent to and remote from the carcinoma and in the egg deposit areas. Under LM, changes were manifested in various degrees in degeneration and disassociation of mucosal cells in colitis (1), schistosomiasis (1) and carcinoma associated with schistosomiasis (8). Under EM, changes in mucosal muscle cells were seen in colon carcinoma (2) and carcinoma associated with schistosomiasis (5). Proliferation of fibroblasts and hyperchromasia of the nuclei were noted in 3 cases of carcinoma associated with schistosomiasis. The pathological changes mentioned above were more prominent in cases of carcinoma associated with schistosomiasis than in those of colon carcinoma alone. The authors believed that the cause was non-specific changes induced by the toxin of the egg mechanical effects rather than a direct carcinogenic action of the eggs, and that the non-specific changes implied no direct relationship between the development of colon carcinoma and schistosomiasis.     

Clinics in diagnostic imaging (52). Spinal cord schistosomiasis

A 2-year-old Brazilian boy presented with bilateral leg weakness and constipation, followed by development of progressive paraparesis and bladder dysfunction. Neurological examination revealed flaccid paraparesis. Blood tests and CSF analysis showed eosinophilia. The MR examination revealed a spinal cord mass extending from T9 to L1 levels, with a heterogeneously-enhancing solid component and a cystic component. Stool tests for Schistosoma mansoni eggs were positive. The patient underwent surgery, the intramedullary mass was partially resected, and the diagnosis of spinal cord infection by Schistosoma mansoni was confirmed. After surgery, the patient was treated with praziquantel and oxamniquine. He was discharged with partial improvement of the lower extremity weakness and bowel/bladder function. The clinical and imaging features of spinal cord schistosomiasis are reviewed.     

输入性曼氏血吸虫病临床分析

目的提高对曼氏血吸虫病的临床诊断认识,减少误诊误治。方法报道2例曼氏血吸虫感染,并结合国内外文献报道的临床资料进行分析。结果曼氏血吸虫病是一种输入性血吸虫病,其可引起发热,胃肠道症状等急性血吸虫病的临床表现,确诊主要依据粪检或直肠黏膜活检找到曼氏血吸虫卵,吡喹酮等药驱虫治疗对大多数患者有效。结论对不明原因的发热,胃肠道综合征等的患者,在治疗效果不佳,且以常见病难以解释时,要注意询问患者的流行病学史,减少误诊误治。     

Schistosomiasis caused by Schistosoma mansoni in Baringo District, Kenya: case report

Schistosomiasis caused by Schistosoma mansoni has not been reported in Baringo District of Rift Valley Province. The intermediate host (Biomphalaria species) though has been reported to occur along the shores of the lakes in this region. Three children from Baringo District were diagnosed to have schistosomiasis caused by S. mansoni by finding ova in their stools. They gave no history of visiting an endemic area. There are many dams being built for land reclamation, creating favourable conditions for the spread of the disease, in presence of the intermediate and definitive host. Studies on the current status of the disease and malacology should be undertaken in order to control the spread of the disease at an early stage.