华支睾吸虫病的逆行胰胆管造影和乳头括约肌切开治疗

目的 探讨内镜下逆行胰胆管造影(ERCP)和乳头括约肌切开术(EST)对华支睾吸虫病诊断和治疗的价值。方法 胆汁中找到华支睾吸虫成虫或虫卵的62例作为诊断观察组，其中47例伴梗阻性黄疸者行EST，为EST组；同期行ERCP检查的1283例非华支睾吸虫病患者为诊断对照组；同期34例因单纯华支睾吸虫性梗阻性黄疸手术者为外科手术组。结果62例华支睾吸虫病患者全部有弥漫性肝内胆管末端囊性扩张，而非华支睾吸虫病患者无一出现此征象。EST组治疗后1～2周，胆总管平均直径和血清总胆红素、碱性磷酸酶、γ—GT均明显降低。EST和外科手术的治疗有效率及并发症发生率差异无显著性，但EST组需输血人数、平均住院日和平均费用却明显低于外科手术组。结论 对临床怀疑华支睾吸虫病的患者，如果传统方法不能确诊，应行ERCP检查，其影像学特征是弥漫性肝内胆管末端囊性扩张，同时可抽吸胆汁检测华支睾吸虫成虫或虫卵，对出现梗阻性黄疸者，EST应作为首选的治疗手段。     

广州珠三角地区家猫自然感染华支睾吸虫的调查及豚鼠模型的构建

目的了解广州珠三角地区家猫自然感染华支睾吸虫状况,观察豚鼠感染华支睾吸虫后肝组织病理变化。方法解剖当地家猫,取肝脏,检查华支睾吸虫感染情况,阳性肝脏收集成虫,并取肝组织制作切片;采集阳性鱼,分离华支睾吸虫囊蚴,经口感染豚鼠,60个囊蚴／只,60d后解剖豚鼠,检查肝脏,收集成虫,取病变肝组织制作切片,作病理检查。实验设未感染对照组。结果当地猫华支睾吸虫自然感染率为41．47％（214／516）;感染豚鼠华支睾吸虫成虫网收率50．83％（305／600）。与对照组比较,实验组豚鼠肝脏肿大,边缘呈球状隆起,部分肝叶表面可见水泡状凸起病变,水泡内液清亮;病变组织横切面可见胆管管壁增厚,管腔内有华支睾吸虫成虫寄生;镜下可见华支睾吸虫虫卯切面,周围大量炎症细胞浸润,胆管管壁增厚,管周纤维组织增生伴胆管扩张,肝小叶结构破坏。结论广州珠三角地区家猫华支睾吸虫感染率较高。豚鼠是华支睾吸虫合适的终末宿主,且肝脏病变明显。     

华支睾吸虫感染病人B型超声的诊断价值

目的 探讨B超在华支睾吸虫病中的诊断价值。方法对145例已临床确诊的华支睾吸虫病病人进行B超检查，观察超声诊断的特点。结果其中85例有明显的B超改变，肝内胆管均匀扩张和肝内胆管壁增厚，超声回声增强并呈等号状为其典型的特征。结论B超对华支睾吸虫病的诊断有一定的临床意义，特别是在流行区内，是确诊的最简单方法。     

肝胆B超病理改变与华支睾吸虫感染的相关性探讨

目的 探讨肝胆B超病理改变与华支睾吸虫感染的关系,为华支睾吸虫病诊断和治疗提供参考依据。 方法 对2010年1月至2013年12月,在武宣县人民医院行腹部B超检查发现的疑似华支睾吸虫感染者,采用粪检和酶联免疫法（ELISA）进行华支睾吸虫病原学和血清学检测。 结果 共检测疑似华支睾吸虫感染者113例,虫卵阳性率为64.60%（73例）,血清抗体阳性率为66.37%（75例）。男性虫卵阳性率高于女性,50岁以上年龄组虫卵阳性率高于50岁以下组,差异均有统计学意义（[χ2]= 3.554、6.267,P均< 0.05）。感染者的肝胆B超病理改变程度与华支睾吸虫感染度呈正相关（[χ2]= 64.952,P < 0.01）。 结论 肝胆B超病理改变可能由华支睾吸虫感染引起,B超检查发现肝胆有病理改变者,应进一步进行华支睾吸虫病原学和血清学检测。     

广州珠三角地区家猫自然感染华支睾吸虫的调查及豚鼠模型的构建北大核心CSCD

目的了解广州珠三角地区家猫自然感染华支睾吸虫状况,观察豚鼠感染华支睾吸虫后肝组织病理变化。方法解剖当地家猫,取肝脏,检查华支睾吸虫感染情况,阳性肝脏收集成虫,并取肝组织制作切片;采集阳性鱼,分离华支睾吸虫囊蚴,经口感染豚鼠,60个囊蚴/只,60d后解剖豚鼠,检查肝脏,收集成虫,取病变肝组织制作切片,作病理检查。实验设未感染对照组。结果当地猫华支睾吸虫自然感染率为41.47%(214/516);感染豚鼠华支睾吸虫成虫回收率50.83%(305/600)。与对照组比较,实验组豚鼠肝脏肿大,边缘呈球状隆起,部分肝叶表面可见水泡状凸起病变,水泡内液清亮;病变组织横切面可见胆管管壁增厚,管腔内有华支睾吸虫成虫寄生;镜下可见华支睾吸虫虫卵切面,周围大量炎症细胞浸润,胆管管壁增厚,管周纤维组织增生伴胆管扩张,肝小叶结构破坏。结论广州珠三角地区家猫华支睾吸虫感染率较高。豚鼠是华支睾吸虫合适的终末宿主,且肝脏病变明显。     

兔中华分支睾吸虫病肝细胞及毛细胆管超微结构观察报告

本文报告两例华支睾吸虫感染兔的肝组织透射电镜观察结果。肝细胞主要变化是胞浆内胆色素颗粒增多,粗面内浆网扩张,次级溶酶体增多。毛细胆管扩张,其内微绒毛变形、不规则、甚至消失。作者认为这些超微结构改变属于肝内郁胆,与华支睾吸虫胆道寄生引起胆道不完全性梗阻有关。因此,严重的华支睾吸虫感染对肝细胞有损伤作用。     

华支睾吸虫感染合并肝门部胆管癌一例报告

华支睾吸虫感染引起原发性胆管细胞性肝癌已见报道。但是，华支睾吸虫感染致肝门部胆管癌却很少见〔１〕。作者于１９９３年７月收治一例。患者男性，５６岁，朝鲜族。２０年前生活在辽宁省本溪县农村，喜食生鱼。入院前５ｄ出现黄疸，逐渐加深。Ｂ超提示肝内胆管扩张，肝...     

两种粪检方法检查华支睾吸虫卵的效果比较

两种粪检方法检查华支睾吸虫卵的效果比较安徽省寄生虫病防治研究所芜湖２４１０００陈大林作者用倒置沉淀法和改良加藤氏法比较检查蒙城县立仓乡３００名中小学生感染华支睾吸虫的情况，结果如后。倒置沉淀法的华支睾吸虫卵检出率为１３·３３％（４０／３００）；改良加...     

肝吸虫感染致胆管损伤及胆管癌的相关研究进展

[摘要]　肝吸虫是一种重要的食源性寄生虫，包括华支睾吸虫、后睾吸虫和肝片吸虫等，其成虫寄生在肝胆管或胆管内，可引起以肝胆管损伤为主要病变的肝脏疾病。肝吸虫已被WHO明确列为胆管癌的I类致癌物。在我国广泛流行的主要是华支睾吸虫，因此本文将以华支睾吸虫为例，结合最新研究进展，分别从虫体（虫体机械刺激和排泄分泌物毒性损伤作用）和宿主（免疫应答反应、胆汁淤积、肠肝循环障碍、肠道菌群失衡等）两方面系统阐述肝吸虫感染致胆管系统病变以及胆管癌发生发展的致病机制。     

华支睾吸虫感染小鼠模型的建立及比较

目的观察3个品系小鼠分别感染不同剂量华支睾吸虫囊蚴后其粪便巾虫卵检出率及肝组织的病理变化。方法分别以10、20、30个囊蚴／鼠经口感染BALB／c（Ⅰ）、C57BL／s（Ⅱ）、昆明鼠（Ⅲ）各3组。同时设不感染对照组。于感染后第20～30d采用NaOH消化法粪检虫卵，感染30d后剖杀部分小鼠，取肝脏作组织切片。各组剩余小鼠继续观察至感染后12周。结果BALB／c（Ⅰ）、C57BL／s（Ⅱ）、昆明鼠（Ⅲ）粪检虫卵阳性率分别为79．17％、12．50％和37．50％，差异有显著性（P〈0．005）。受染BALB／c和昆明鼠肉眼可见肝脏肿大，镜下均见胆管扩张、管壁增厚、炎细胞浸润，并随感染度增加程度加重，C57BL／s肝脏未见明显病理改变。结论BABL／c对华支睾吸虫感染的敏感性最高，昆明鼠次之，C57BL／6不敏感。动态观察小鼠宿主状态及相关研究的适宜感染剂量为每鼠30个囊蚴。     

Long on QT and low on calcium

Acquired lengthening of the QT interval due to hypocalcaemia is a rare cause of arrhythmia in childhood. Early recognition, rapid institution of appropriate cardiac monitoring, and replacement therapy are essential. An endocrinal work-up may be necessary to exclude primary disorders of calcium metabolism. We report four cases documenting the varied clinical spectrum in which hypocalcaemic-induced prolongation of the QT interval and arrhythmia can occur in childhood.     

Influence of Smoking on Basal and on Vagally and Maximally Stimulated Gastric Acid and Pepsin Secretion

Published data show that smokers have greater basal or peak acid and pepsin outputs, but the mechanisms underlying these effects are unknown. To confirm this and to determine whether these findings extend to, and implicate, any vagal overactivity, gastric secretions collected for 1 h basally, 1 h after 15 min of modified sham feeding (MSF), and 1 h after pentagastrin (6 μg/kg subcutaneously) were analyzed for acid and pepsin content in 204 subjects, 104 with duodenal ulcer (66 smokers) and 101 without (57 smokers). Maximal acid outputs (MAO, μeq/kg/h, x + SEM) were higher in smokers than in non-smokers in both duodenal ulcer (DU) (623 + 35 versus 491 + 35, p < 0.005) and non-DU (502 + 32 versus 376 + 20, p < 0.005). Basal and MSF secretions were generally increased in smokers but, when expressed as a percentage of MAO, were not different in smokers and non-smokers (18% versus 17% and 43% versus 39%, respectively, in DU, and 13% versus 16% and 40% versus 36% in non-DU). Maximal pepsin outputs (units + 10 ²/kg/h) were also higher in smokers than in non-smokers (DU, 129 + 7.9 versus 105 + 9.5, p = 0.05, and non-DU, 101 + 7.5 versus 77 + 10, p = 0.05). Basal and MSF secretions as a percentage of maximal pepsin output were not different in smokers versus non-smokers. Multivariate logistic regression shows that smoking was most strongly associated with MAO and sham feeding outputs, but the duration-intensity (pack-years) of smoking was associated only with elevated MAO. We conclude that smoking is associated with increased maximal acid and pepsin output in both DU and non-DU populations. Smoking does not seem to affect independently vagal stimulation of gastric secretion.     

Effects of therapeutic paracentesis on systemic and hepatic hemodynamics and on renal and hormonal function

Thirteen patients with cirrhosis and tense ascites (six with and seven without peripheral edema) underwent 4- to 15-liter paracentesis without intravenous "colloid" replacement. Cardiac output increased from 6.6 +/- 0.7 liters per min at baseline to 8.2 +/- 0.7 liters per min (p less than 0.003) 1 hr after large-volume paracentesis completion and fell to 7.5 +/- 0.69 liters per min (p less than 0.05 vs. baseline, p less than 0.02 vs. 1 hr) 24 hr after large-volume paracentesis completion. There was no change in mean arterial pressure or mean pulmonary artery pressure. Central venous pressure fell from 9.1 +/- 0.8 mm Hg at baseline to 8.6 +/- 1.4 mm Hg 1 hr post-large-volume paracentesis to 6.8 +/- 1.0 mm Hg (p less than 0.005 vs. baseline, p less than 0.02 vs. 1 hr value) at 24 hr, and pulmonary capillary wedge pressure fell from 13.1 +/- 0.9 to 11.1 +/- 1.3 mm Hg 1 hr after large-volume paracentesis and to 9.89 +/- 1.2 (p less than 0.01 vs. baseline, p less than 0.03 vs. 1 hr after large-volume paracentesis) at 24 hr. Heart rate fell from 90 +/- 3.0 to 85 +/- 2.9 beats per min (p less than 0.01) 1 hr after large-volume paracentesis completion, but increased to 89 +/- 2.5 beats per min (p less than 0.02 vs. 1 hr after large-volume paracentesis) at 24 hr.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of particle size on quartz-induced hemolysis and on lung inflammation and fibrosis

To assess the role of crystal size in biologic responses, we quantitated red blood cell lysis and lung inflammation and fibrosis in the mouse using 4 alpha-quartz preparations with average diameters of 1, 5, 7.8, and 11.2 microns. When compared on the basis of identical crystal surface areas, the 1-micron fraction was more hemolytic than the other 3 fractions. The three larger fractions had equivalent membranolytic activities. After 6 weeks of postintratracheal instillation of the crystals into mice, the 1-micron-diameter crystal fraction increased wet lung weights by 1.25 x that of saline controls, while a 1.75 x increase was found for the three larger crystal fractions. A similar response was found when evaluating fibrosis development by determining lung hydroxyproline levels. Measurement of the percentage of the crystal dose remaining in the lungs revealed that the biologic differences observed were not due to a difference in the clearance of the smaller crystal fraction. Thus, larger crystals of alpha-quartz produce a greater degree of inflammation and fibrosis when instilled into the lung than those of 1 micron diameter, even though the smaller crystals are more membranolytic in vitro and appear to be cleared from the lung at the same rate as the larger crystals.