Prophylactic effect of albendazole in experimental peritoneal hydatidosis.

To determine the effectiveness of prophylactic short-term administration of albendazole in experimental peritoneal hydatidosis this substance was given at a dose of 15 mg/kg for 96 hours prior to scolex implantation. In contrast to the 81.8% of the controls, only 11.1% of the experimental animals developed intraperitoneal hydatidosis over a period of 18 weeks (p < 0.001). The newly defined cyst index was also decreased from 2.09 to 0.22 by the administration of albendazole (p < 0.005). It is concluded that albendazole, when given for 96 hours prior to any suspected intraperitoneal spillage of viable hydatid cyst contents could significantly reduce secondary peritoneal hydatidosis.     

Immune status during albendazole therapy for hydatidosis.

Immunological monitoring of cystic hydatid patients undergoing medico-surgical management has revealed that it is possible to assess individual host responses throughout therapy and subsequently be guided by the results obtained. The analysis has involved the demonstration of variation in haemagglutination antibodies, specific IgG and IgM immunoglobulins and circulating immune complexes before, during, and months after albendazole therapy.     

Results of alcohol and albendazole injections in hepatic hydatidosis: experimental study

BACKGROUND: Percutaneous drainage with alcohol injection for hydatid cysts has been commonly used in the last two decades. Albendazole is the drug of choice in the medical treatment of hydatidosis, and has also been used as an intraoperative scolicidal solution. The side-effects of its local application are not well known and have not been investigated. The purpose of the present study was to investigate the effects of the intracystic injections of alcohol and albendazole solutions on the hydatid cysts and hepatobiliary system of rabbits. METHODS: There were three groups of eight rabbits: a control group, an alcohol group and an albendazole group. In all groups hepatic hydatidosis was obtained. The control group received no therapeutic procedure. Cyst liquid was aspirated, and alcohol or albendazole solutions were injected in the other two study groups. alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) levels, echinococcus indirect hemagglutination (IHA) tests, and the size and volume of the residual cysts were investigated. Liver was histopathologically evaluated. RESULTS: The ALT, AST, GGT, and alkaline phosphatase (ALP) levels were significantly higher in the alcohol group, whereas echinococcus IHA level was highest in the control group than in the study groups. Albendazole had similar effects but of a lesser degree (P < 0.01). After therapy, the cyst volume was greater in the control than in the albendazole group (P < 0.01). In histopathological evaluation hepatocellular necrosis, portal inflammation and fibrosis were most severe in the alcohol group (P < 0.01). Conclusions: Alcohol and albendazole solutions are effective as scolicidal solutions. Higher scolicidal effect and lesser side-effects on hepatobiliary system are the advantages of albendazole solution.     

Dual treatment of albendazole in hepatic hydatidosis: New therapeutic modality in 52 cases

BACKGROUND: Hepatic hydatidosis still remains as a serious problem in general surgery. Recurrence and/or secondary hydatidosis rates are up to 25% in the cases treated with surgery alone. Albendazole is the most commonly used drug in the medical treatment of echinococcosis. The aim of the present study was to evaluate the effect of albendazole using the intraoperative and perioperative periods as dual therapy. METHODS: Fifty-two cases of hepatic hydatidosis were evaluated and treated by dual treatment of albendazole together with surgery. Perioperative albendazole treatment was given in a dose of 12-15 mg/kg per day in four divided doses. The treatment started 2-28 days before the surgery when the diagnosis was established and continued for 2-24 months (4.76 +/- 3.25) postoperatively in a cyclic monthly form. A total of 1.7 microg/mL albendazole solution was used as a protoscolicidal agent in the cystic cavity intraoperatively. In the postoperative period serology, ultrasonography and computed tomography evaluations were done. The follow-up period was 5-92 months (mean: 62.48 months). RESULTS: There was no recurrence in the present study. One patient died in the 6th postoperative week due to cerebral hydatidosis and multiple organ failure. Early and late morbidity rates were 7.69 and 9.61%, respectively. CONCLUSIONS: Dual albendazole treatment is effective in the prevention of recurrences and/or secondary hydatidosis.     

Induction of protective immunity against murine secondary hydatidosis

Significant protective immunity against secondary hydatidosis in mice was achieved by immunization with a preparation of surface molecules of E. granulosus protoscoleces with Freund's incomplete adjuvant (PSEx-IFA). Study of PSEx-IFA immunogenicity demonstrates that glucidic epitopes evoke mainly IgM responses while peptidic epitopes evoke mainly IgG responses; however both types of epitopes elicit both types of responses. Analysis of the possible association between susceptibility or resistance to infection and antibody responses after challenge was also performed. Cyst fluid antigen (CFAg) specific antibody titres on month eight after challenge correlated with number and size of cysts. On the other hand no correlation was observed between protection and PSEx specific IgG titres either on the day of challenge or one month later. Nonetheless, immunoblot analysis revealed that some PSEx molecules were recognized on day 30 after challenge only by sera from immunized mice.     

苦参碱联合阿苯达唑治疗小鼠继发性棘球蚴病效果观察

目的 评价中药苦参碱单独及联合阿苯达唑使用治疗小鼠继发性棘球蚴病的效果.方法 将感染棘球蚴的昆明小鼠分为4组:苦参碱组、阿苯达唑组、联合用药组、对照组,每组10只.在对小鼠进行药物治疗90 d后,检测各组小鼠棘球蚴湿重、抑囊率,并利用光镜、电镜对棘球蚴组织进行形态结构和超微结构观察.结果 苦参碱组、阿苯达唑组、联合用药组、对照组棘球蚴湿重分别为(0.32±0.12)、(0.31±0.10)、(0.05±0.03)、(1.16±0.43)g,苦参碱组及联合用药组对小鼠棘球蚴的抑囊率分别达到72.4%和95.7%,显示联合用药组明显优于苦参碱组(P<0.05).上述4组包囊组织Ⅲ级病理损伤率分别为40.9%(9/22)、43.5%(10/23)、91.3%(21/23)、9.5%(2/21).与对照组比较,其他3组包囊组织Ⅲ级病理损伤率明显增高(P均<0.01),且联合用药组最为明显.结论 苦参碱对小鼠棘球蚴的增长有明显的抑制作用,尤其联合阿苯达唑使用治疗效果较好,说明两种药物具有协同治疗作用.     

健康教育对缺血性脑卒中患者二级预防他汀类药物依从性的观察

目的:评估健康教育对缺血性脑卒中患者在二级预防中他汀类药物依从性的影响。方法:将2012年1月至2012年4月,于北京安贞医院普内科住院治疗的缺血性脑卒中患者124例,应用临床随机对照研究,分为干预组(60例)和对照组(64例),对干预组进行规范的健康教育,对照组仅给予一般的科普宣教,观察两组患者随访3个月、6个月及1年时的他汀类药物使用情况。结果:完成随访117例,干预组57例,对照组60例,健康教育组患者他汀类药物使用率在3个月、6个月及1年时明显高于对照组(分别为76.3%vs.49.2%,P=0.004;70.7%vs.43.5%,P=0.003;64.9%vs.33.3%,P=0.001)。健康教育能明显提高无高血压、糖尿病、冠心病、脑卒中病史,非医保患者血管共病个数较少者他汀类药物的使用率。结论:健康教育能明显提高缺血性脑卒中患者他汀类药物的依从性,且对无血管性危险因素,血管共病个数较少的患者影响显著。健康教育对非医保患者长期坚持他汀类药物的使用起到显著促进作用。     

Immunoglobulin and cytokine profile in murine secondary hydatidosis

We have investigated specific immune responses in BALB/c mice with experimentally induced secondary hydatidosis. Following intraperitoneal inoculation of brood capsules containing Echinococcus granulosus-protoscoleces, the course of the infection was followed for 513 days. The sera of the mice were screened for the presence of a number of cytokines, and for specific antibodies. During the first 129 days of infection, high levels of cytokines TNFα, IL-α, IFNγ, IL-6, andIL-10 and specific IgGl andIgG3 isotypes were detected, as compared to uninfected controls. The levels oflgM and IgG2a were slightly increased following infection, and remained elevated throughout the period of observation. The levels of IL-lα and specific immunoglobulin of all isotypes except IgM and IgG2α, were significantly decreased 103 days post infection fp.i.), whereas TNFα was sharply decreased 129 days p.i. During the period of 129 to 209 days of infection there was an increase in secreted IL-10, and a slow decrease in the levels of IL-6 andlFN-γ. Levels of IgM, IgG, IgGl, and IgG2a plateaud during this period, whereas IgG3 and TNFα showed a peak at day 190 p.i. These data suggest the induction of Th2 antibody-mediated immunity with a parallel expansion of Thl-mediated inflammatory responses as important mechanism of host defence against the metacestode.     

Recurrent pulmonary microemboli secondary to primary cardiac hydatidosis

Primary cardiac hydatid cysts are rarely diagnosed and seldom rupture to lungs via pulmonary vein resulting in multifocal cystic lesions. We report a rare instance of an interventricular hydatid cyst. A 19-year-old patient was admitted with dyspnea and multiple homogenous opacities with different sizes in his chest X-ray and contrast enhanced thorax computed tomography. We considered recurrent pulmonary microemboli, although neither systemic embolisation nor intravascular cyst of pulmonary arteries was detected. Due to extensive distribution of the pulmonary cysts, only the cardiac cyst was taken surgically. The patient remains in our care without any pulmonary improvement despite appropriate medical treatment.     

1 230例胸部包虫病的外科治疗效果

棘球蚴病(Hydatidosis),又称包虫病,是细粒棘球绦虫幼虫寄生人体组织器官所致的疾病。胸部包虫病包括肺、胸膜腔、纵隔、胸壁、肝顶部、心肌、心包等组织的包虫囊肿。目前该病仍以手术治疗为主,化学药物治疗还处于临床验证阶段。为了提高胸部包虫病的治疗水平,现将我院1957年6月～2002年12月手术治疗的1230例胸部包虫病病例资料总结如下。1临床资料1.1一般资料本组胸部包虫病1230例,男764例(62.1%),女466例(37.9%)。年龄2～69岁,40岁以下913例(74.2%)。绝大多数为农牧民和儿童,其中小儿胸部包虫病233例(18.9%),农牧区患者879例(71.5%)。1.2…     

“生命网”在冠心病患者二级预防中的有益作用

目的 通过"生命网"(HCN)系统对冠心病(CHD)患者的积极干预,探讨HCN在CHD二级预防中的有益作用.方法 将546例CHD患者分为HCN系统随访组及对照组,观察HCN随访组血脂、血糖指标的变化及两组出院后半年的临床事件.结果 随访6个月后,随访组血清总胆固醇、低密度脂蛋白胆固醇、甘油三酯和血糖水平均显著下降;血清高密度脂蛋白胆固醇较基线水平增高.随访组再发冠脉事件、再入院及死亡较对照组明显减少.结论 HCN管理系统可以一定程度地提高CHD患者的生活质量,减少不良心血管事件的发生,从而在CHD二级预防中发挥有益作用.     

川芎嗪和阿苯达唑联合治疗小鼠继发性泡球蚴病的疗效观察

目的通过观察中药川芎嗪和阿苯达唑单用及联合使用对小鼠继发性泡球蚴病的疗效,探讨中西药结合治疗泡球蚴病的新途径。方法应用川芎嗪和阿苯达唑对小鼠继发性泡球蚴病治疗60d后,检测小鼠泡球蚴湿重、脾脏指数、抑囊率、血清TNF-α和SOD含量以及肝组织匀浆中NO和NOS的含量,并对泡球蚴组织进行病理组织学和超微结构观察。结果川芎嗪和阿苯达唑单用及联合使用对小鼠泡球蚴的抑制率分别为66.71%、85.59%和95.44%,差异有统计学意义(χ2=28.520,P<0.05);脾脏指数、血清TNF-α含量、肝脏NO、NOS含量与模型组比较差异有统计学意义(F=8.614,P<0.05);血清SOD含量川芎嗪组和川芎嗪 阿苯达唑组与模型对照组比较差异有统计学意义(F=7.359,P<0.05)。结论1)川芎嗪和阿苯达唑对小鼠泡球蚴的生长均有明显抑制作用;2种药物联合使用具有协同治疗效果;2)川芎嗪能显著改善阿苯达唑对小鼠肝功能的损伤。     

他汀类药物在缺血性脑血管病二级预防中的疗效观察

目的 观察他汀类药物在缺血性脑血管病二级预防中的作用.方法 将59例患者随机分成治疗组和对照组,进行2年跟踪观察.治疗组给予阿司匹林加他汀类口服,对照组给予阿司匹林口服.结果 治疗组缺血性脑血管病复发率明显低于对照组.结论 他汀类药物在缺血性脑血管病二级预防中起重要作用.     

Encysted peritoneal hydatidosis in a child -- the effectiveness of pre-operative therapy with a combination of praziquantel and albendazole

A child with encysted peritoneal hydatidosis was found to be completely cured after 3 months of combined therapy with praziquantel and albendazole followed by resection of a huge peritoneal cyst and the removal of numerous, dead, daughter cysts.     

口服甲苯咪唑控制肠道线虫病效果分析

为探索在市场经济条件下 ,如何在短期内有效地控制农村社区肠道线虫病的流行 ,从 1 997年至 2 0 0 0年 ,我们选择了石庄镇石南村为试点村 ,在肠道线虫病传播季节前 ,进行农村社区群众口服甲苯咪唑咀嚼片 1次 ,连续 3年 ,取得了明显效果 ,使村民肠道线虫感染率大幅度下降 ,达到了卫生部要求的有效控制目标。1　材料和方法1 .1　试点村概况石庄镇石南村位于如皋市西南部 ,全村 1 4个村民小组 ,有 2 31 6人 ,耕地面积 995 km2 ,其中旱地面积 2 1 5 km2 。村民使用露天粪坑 ,人粪用于旱地蔬菜的追肥。 1 997年人均收入 2 1 1 4元。另选择冒圩村…     

Primary muscle hydatidosis of the thigh: management of a complicated case with combination adjunctive albendazole and praziquantel chemotherapy.

A patient had primary muscle hydatidosis of the thigh that was not detected radiologically or by fine-needle aspiration before surgery. The risk of dissemination during the initial exploratory procedure was high. Treatment consisted of formal muscle resection and combination therapy with albendazole and praziquantel. Clinical features of muscle hydatidosis and the role of adjunctive chemotherapy are reviewed.     

Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatidosis caused by Echinococcus granulosus

Summary objective  To compare the effects of a combined medication of albendazole (10 mg/kg/day) plus praziquantel (25 mg/kg/day) to those of albendazole alone at different doses (10 and 20 mg/kg/day).
method  The protoscoleces9 viability was studied in a consecutive series of patients affected by intra-abdominal hydatidosis caused by Echinococcus granulosus . In all cases the drugs were given during the month prior to surgery.
results  A significant increase of patients with nonviable protoscoleces was observed in the group treated with the scolicides combination compared to those treated with albendazole alone, both at a dose of 10 mg/kg/day ( P = 0.004) and at a dose of 20 mg/kg/day ( P = 0.03). Albendazole sulphoxide levels in serum and in cyst fluid were higher in patients given the combined therapy than in those who received only albendazole (10 mg/kg/day: P = 0.016; 20 mg/kg/day: P = 0.034). Levels in the cysts were not significantly different probably due to the sample size; nevertheless a lineal relation between the values obtained in serum and inside the cysts could be discerned in the patients treated with the combined medication.
conclusion  Albendazole plus praziquantel is more effective than monotherapy with albendazole in the preoperative treatment of intra-abdominal hydatidosis.     

阿苯达唑和地塞米松对广州管圆线虫病疗效的动物试验

目的观察阿苯达唑和地塞米松治疗广州管圆线虫病的效果,探讨药物的作用机制。方法:以Balb/c小鼠为动物模型,在感染后不同时间,用不同剂量的阿苯达唑治疗,并设立地塞米松进行联合治疗对照组。小鼠于感染后第22d解剖,计数脑组织中存活虫体,以减虫数统计药物疗效;同时观察脑组织切片病理变化;应用透射电镜观察阿苯达唑对虫体超微结构的影响,对药物的作用机制进行探讨。结果阿苯达唑为治疗广州管圆线虫病的有效药物,感染早期用药效果显著。杀虫药和地塞米松的合用可有效减轻脑部炎症反应。阿苯达唑主要通过虫体体壁及肠道吸收而发挥作用。结论阿苯达唑和地塞米松的联合应用可以有效治疗广州管圆线虫病。     

Design of a recombinant antigen for the diagnosis and prevention of larval hydatidosis

The paper deals with the design of recombinant vector make-ups, with the expression of Echinococcus hybrid proteins, and with the study of their immunogenic properties. Theoretical rationale is given for the choice of the parasitic gene superexpression system (E. coli cells of SG 13009 strain--recombinant plasmid pQE/EgF). The authors show that the use ofpolymerase chain reaction with oligonucleotide primers homologous to the structures of unique genes coding for Echinococcus antigen is promising for the run of the preparative quantities of fragments of these genes. They consider the basic stages of obtaining hybrid EgF antigen: the isolation of genomic DNA from Echinococcus protoscolexes; the run of preparative quantities of an EgF DNA fragment; the obtaining of vector pQE plasmid DNA; the design of a recombinant make-up; the screening of positive clones; the recombinant plasmid expression of hybrid protein and its purification. The commission tests of EgF antigen in enzyme immunoassay using 93 human serum samples revealed the following: the sensitivity and specificity were 83.8 and 77.4%, respectively. The recombinant protein of EgF was found to exert a significant protective action on the development of E. multilocularis larvocysts in non-inbred albino mice.