脑囊虫病的诊治

为探讨脑囊虫病的诊断与治疗方法,采用大剂量吡喹酮疗法:即50mg/kg/d,分三次口服,总疗程剂量为300mg/kg,共3个疗程,每疗程间隔2～3月.3个疗程结束后复查头颅CT或MRI,病灶消失,随访1a无癫痫发作.     

220例脑囊虫病的影像学诊断分析

目的 了解脑囊虫病患者抗囊虫治疗后的疗效以及囊尾蚴在脑影像学上的转归.方法 参照脑囊虫病影像学诊断标准对220例该病患者进行分型分析,比较不同型脑囊虫病抗囊虫药物治疗后的脑影像特征及治疗效果.结果 抗囊虫治疗前脑MRI表现为不同类型的脑囊虫病患者,治疗后脑组织内囊尾坳在MRI影像上出现不同的转归.脑实质型患者大部分抗囊...     

脑囊虫病脑电图与CT的对比分析

目的：对脑囊虫病患者的ＥＥＧ及头颅ＣＴ资料进行对比分析,以探讨其临床意义。方法：对５８例脑囊虫病患者进行常规ＥＥＧ及头颅ＣＴ检查。结果：ＥＥＧ异常率为７２％,主要表现为额、中央及前颞区弥漫性不规则复型慢波。ＣＴ的异常率为５０％,多表现为散在的点、片状高或低密度灶。二者比较差异有显著性。结论：脑囊虫病患者ＥＥＧ异常率显著高于ＣＴ,临床上二者结合有利于该病的早期诊断及治疗     

吡喹酮治疗慢性血吸虫病的疗效观察和护理

目的：探讨吡喹酮治疗慢性血吸虫病的临床疗效。方法选取我站2010年5月~2014年5月收治的慢性血吸虫病患者106例为研究对象,给予吡喹酮口服治疗,同时进行保肝护理,随访3年,观察患者的临床症状改善状况,并定期进行腹部B超检查及血清特异性抗体检测,观察患者的不良反应。结果在服药结束后连续3年随访观察该106例患者,通过血清学特异性抗体检查发现,患者在治疗完成后及服药后第1年内阴转2例(1.89%),第2年阴转12例(11.32%),第3年阴转59例(55.66%)。肝功能异常和B超情况也明显好转。结论吡喹酮在慢性血吸虫病的治疗上具有较高的应用价值,疗效确切,且不良反应轻微,可以大力推广应用。     

脑囊虫病人的脑电图观察

目的 :探讨脑囊虫病人的脑电图变化。方法 :对 381例脑囊虫病人的脑电图检查结果进行分析。结果 :2 38例脑囊虫病人的脑电图异常 ,异常率为 6 2 5 %。在异常脑电图中 ,轻度异常占44 1%、中度异常占 39 5 %、重度异常 16 4% ;并对治疗 2～ 4个疗程的 16 7例脑囊虫病人进行脑电图复查 ,脑电图正常和明显好转者占 88 1%。结论 :脑电图检查对脑囊虫病的诊断和评估疗效具有重要的价值。     

脑囊虫病患儿的脑电图与头颅CT结果对比分析

囊虫病是较广泛地流行的寄生虫病 ,脑囊虫病是其中最严重的一个类型 ,占囊虫病的 6 0 %～ 80 %。现将 1995年 3月至 2 0 0 1年 3月我院收治的 2 36例儿童脑囊虫病的脑电图(ＥＥＧ)和头颅ＣＴ结果分析如下。1　临床资料一般资料 :2 36例患儿中 ,男 137例 (5 8 1% ) ,女 99例(41 9% ) ,发病年龄 1岁零 1个月～ 3岁 36例 (15 3% ) ,3～ 7岁 89例 (37 7% ) ,7～ 14岁 111例 (47 9% )。白族 16 7例(71% ) ,汉族 4 5例 (19% ) ,其它民族 2 4例 (10 % )。农村 180例 (76 2 % ) ,城市 5 6例 (2 3 8% )。病程 2～ 7年。临床表现及生化检查 :首发症…     

脑囊虫病患者癫发生的相关因素分析

本文对我院 1992年 3月至 2 0 0 0年 4月收治的 6 4例脑囊虫病患者中有癫发作的 42例总结报告如下 ,并对脑囊虫病患者癫发生的相关因素进行分析。1　病例资料一般资料 :本组均符合脑囊虫病诊断标准[1] 。 6 4例中有各类型癫发作者 42例 (6 6 % ) ,其中男性 2 7例 ,女性 15例 ,男 :女 =1 8:1。年龄 14～ 74岁 ,平均 34 8岁 ,其中 2 0～5 0岁 30例 (70 % )。病程 4天～ 2 0年 ,其中 1个月以内 8例(19% ) ,1个月～ 1年内 15例 (36 % ) ,1～ 5年内 10例 (2 4% ) ,5～ 10年内 6例 (14% ) ,10年以上 3例 (7% )。癫类型 :全身强直阵挛发作 …     

脑囊虫病的诊断与治疗——20例临床,头颅CT,手术和病理

目的 探讨脑囊虫病的诊断及外科治疗.方法 分析脑囊虫病20例临床资料,其中18例行脑囊虫切除术,1例行颞肌下减压术,1例行测脑室腹腔分流术.结果 在18例脑囊虫切除术中,17例治愈,1例明显好转.结论 本病的治疗原则上应先药物治疗,但如出现颅内高压,脑积水时应及早手术治疗,并对不同部位、不同类型的病变提出了不同的治疗方法,并强调术后还应给予驱虫治疗.     

脑囊虫病患者粘附分子和细胞因子水平检测

本文检测了30例未经治疗的脑囊虫病患者血清中可溶性细胞粘附分子(sICAM)、白细胞介素8(IL-8)、可溶性白细胞介素2受体(sIL-2R)以及患者外周血单个核细胞(PBMC)体外诱导IL-2、IFN-γ及TNF-α的活性,同时也检测了CD11a、CD11b和CD18在患者PBMC表面的表达,以30例正常人作对照,探讨了脑囊虫病人粘附分子、细胞因子水平的变化及在免疫调节中的作用.结果显示脑囊虫病患者血清中sICAM-I水平及患者PBMC体外诱导IL-2、IFN-γ水平显著低于正常对照组,患者血清中IL-8、sIL-2R及患者PBMC体外诱导TNF-α水平明显高于正常对照组,患者组的CD11b阳性细胞百分比显著高于对照组,但是患者PBMC表面CD11a的表达量比对照组低,而CD18的表达在两组间无显著性差异.     

吡喹酮治疗人体包虫病80例临床观察

包虫病是由人体感染棘球绦虫的幼虫所导致的疾病,又称棘球蚴病,它是一种人畜共患的流行性寄生虫病,主要是因为人误食了经犬绦虫污染后的食物,绦虫卵在十二指肠肠液的作用下,进行孵化,最后进入肠壁,通过门静脉进入肝脏,再由右心到达肺部,最终通过肺经过左心到达全身。本地区是畜牧业为主的地区,所以也是包虫病流行的原因之一,包虫病对人类的健康威胁较大,手术治疗沿用近百年,且在不断改进,但复发率较高,加之手术的其他并发症,仍不太理想。近年来药物治疗虽也有一定发展,但效果不甚满意。本文作者用口服吡喹酮治疗人体包虫病,疗效显著,与手术相比更安全。     

Cerebral cysticercosis in a european patient: Problems of disease activity and therapeutic implications

Summary The case of a German patient who was treated with two courses of praziquantel for parenchymal cerebral cysticercosis (CC) is reported. Efficacy of the treatment could not reliably be distinguished from the natural course of the disease. After a brief review of the literature concerning problems with assessment of the activity of CC, the criteria recommending praziquantel therapy are discussed.Abbreviations CC cerebral cysticercosis - CNS central nervous system - CSF cerebrospinal fluid - CT computed tomography - ELISA enzyme-linked immunosorbent assay - ICP intracranial pressure - IHA indirect hemagglutination test - PRZ praziquantel     

脑猪囊尾蚴病的临床病理诊断

目的：探讨脑猪囊尾蚴病的临床病理特点及诊断方法。方法：复习12例脑猪囊尾蚴病的病理切片、病史及临床资料。结果：男女发病性别比3：1，平均年龄22岁。临床以癫痫发作为主要症状9例，颅内高压2例，痴呆1例。5例见到猪囊尾蚴，7例虫体崩解的陈旧性病变均找到形态不一的石灰小体。结论：脑猪囊尾蚴病以青年男性多见，癫痫发作为主要症状。病理诊断除找到囊尾蚴外，组织中散在的石灰小体是陈旧性病变的重要诊断依据。     

心理咨询门诊焦虑症疗效影响因素研究

为了解影响焦虑症治疗效果的有关因素，将焦虑症患者临床资料进行回归分析，结果显示，患者年龄越大，ＳＣＬ－９０阳性症状均分越低，在常规剂量内药物剂量越大而疗效越好．提示不良心理状态影响疗效，药物治疗对焦虑症是必需的。     

垂体泌乳素瘤性不孕症的药物治疗效果探讨

目的探讨单纯药物治疗垂体泌乳素微腺瘤(瘤体直径<1.0cm)和巨腺瘤(瘤体直径>1.0cm)所致不孕症的效果。方法选择32例垂体性不孕患者,其中微腺瘤22例,巨腺瘤10例,用溴隐亭治疗。部分病例加用克罗米酚和hCG或hMG辅助治疗。结果31例妊娠,30例足月分娩。产后随诊治疗30例,其中4例腺瘤消失,22例瘤体明显缩小,4例无明显改变。结论对于瘤体不是太大,无压迫症状的不孕患者,单纯用药物保守治疗也能取得较满意的效果,不一定非要选择手术治疗,以确保患者达到希望生育的目的。     

Fine needle aspiration in the diagnosis of subcutaneous cysticercosis

Human cysticercosis commonly manifests as subcutaneous and intramuscular nodules. The current study highlights the role of fine needle aspiration cytology (FNAC) in the diagnosis of subcutaneous cysticercosis. One hundred and twenty two patients with subcutaneous swellings, diagnosed as cysticercus or suspicious of parasitic inflammation on FNAC, were included in the present study. The relevant clinical data, cytomorphological findings, and histopathological findings, wherever available were evaluated. In 57 cases, a definite evidence of cysticercus was obtained in the form of fragments of parasite bladder wall, hooklets, or intact larva. Out of these, biopsy correlation was available in 10 cases, eight of which failed to reveal any parasite. In 65 cases, larval fragments could not be identified on aspirates, and the diagnosis of parasitic inflammation was suggested on the basis of other cytomorphological findings, which are discussed. In 22 of these cases, a biopsy correlation was available, which revealed definite parasitic elements in six cases and the remaining 16 cases were reported as suggestive of parasitic cysts. Thus, to conclude, FNAC is a reliable and cost effective procedure for the diagnosis of subcutaneous parasitic nodules. It obviates the need for a subsequent histopathological examination, as the parasite may not be demonstrated even on biopsy specimens.     

The effect of praziquantel on calcium in Hymenolepis diminuta

Praziquantel (PZ) at concentrations down to 5 × 10^?8 M induced a rapid contraction of Hymenolepis diminuta musculature. This effect was accompanied by a strong inhibition of ⁴⁵Ca²⁺ incorporation which showed some dependence on Ca²⁺ concentration. Ca²⁺ efflux experiments showed that PZ markedly stimulated the release of Ca²⁺ from tapeworms preloaded with ⁴⁵Ca²⁺, with the effluxed Ca²⁺ being derived from a small fast pool and a larger slow pool. This stimulatory effect appeared, like PZ-induced muscle contraction, to be independent of external Ca²⁺. By carrying out ⁴⁵Ca²⁺ exchange experiments under near equilibrium conditions and atomic absorption spectroscopy it could be demonstrated that PZ resulted in a net excretion of endogenous Ca²⁺. In PZ-induced contracted worms adenylate nucleotide levels and the adenylate energy charge were not significantly different from those of untreated control worms. Also, PZ had no effect on Ca²⁺-stimulated ATPase activity of the tapeworm's tegumental brush border. Nor did the drug alter the activities of Ca²⁺-ATPases in whole homogenates of worms or mitochondria, microsomal or soluble fractions. Although the mechanism of PZ-induced changes in Ca²⁺ transport was not elucidated, it is suggested that the sustained release of endogenous Ca²⁺ may affect the sequence of excitation-contraction coupling and that such interference may cause the observed massive contraction of the tapeworm's musculature.     

药物定量脑电图对短暂性脑缺血发作病人疗效判断的研究

目的 :采用药物定量脑电图检测观察静脉滴注尼莫通对短暂性脑缺血发作 (TIA)病人脑功能的改善作用。方法 :对 30例TIA病人用静滴尼莫通 5 0ml治疗 ,比较治疗前后定量脑电图主频、θ、δ频段相对功率值的动态变化 ,并设置年龄匹配的对照组 2 5例进行比较。结果 :对照组与治疗组治疗前及治疗后主频、θ、δ相对功率值有显著性差异。治疗组治疗前与对照组比较 ,主频呈现慢波化 (后移 ) ,θ、δ相对功率值明显升高 ,治疗后与治疗前比较主频大部分前移 ,θ、δ相对功率值明显下降。结论 :TIA病人定量脑电图显示慢波化趋势 ,存在明显的脑电生理功能障碍。用定量脑电图的指标可以客观判断尼莫通对TIA病人有明确的疗效。     

Use of wogonin as a cooperative drug with praziquantel to better combat schistosomiasis

BackgroundSchistosomiasis is one of the most devastating tropical diseases in the world. Currently, praziquantel (PZQ) represents the best pharmacological option for the treatment of schistosomiasis as it effectively kills the worm. However, the inability to reverse established liver damages often makes treatment futile. In the current study, we investigate whether combining the use of wogonin, a compound that was found to be liver-protective, with PZQ can attribute to the greatest beneficial effect in Schistosoma mansoni-infected mice.MethodsTo determine the protective effect of PZQ-wogonin treatment on S. manosni-infected mice, histopathological analysis was done to evaluate the granuloma size and fibrotic areas in the liver. Western blotting was performed to analyze several injuries-related markers including fibrotic markers, inflammasomes, and apoptotic markers. Scanning electron microscopy was done to evaluate the effect of wogonin on the worms, and the worm and egg burden was calculated.ResultsOur results showed that PZQ-wogonin treatment significantly improved liver histopathology of S. mansoni-infected mice. Further analysis showed that PZQ-wogonin combinations are more effective in reducing fibrosis, inflammation, and apoptosis in the liver than that of individual drug use. Furthermore, our results revealed that wogonin is anthelmintic; and it works better with PZQ in reducing hepatic egg burden, further lessen the disease progression.ConclusionIn general, this combinatorial strategy may represent a new and effective approach to schistosomiasis treatment.     

Ultrastructural investigations on the effect of praziquantel on the tegument of five species of cestodes

AdultHymenolepis diminuta, H. microstoma, H. nana, Echinococcus multilocularis, andTaenia (Hydatigera)taeniaeformis have been exposed in vitro in media containing 0.1 to 100 g praziquantel/ml. Already after 5 min characteristic tegumental lesions, that were restricted to the growth zone of the neck region, were recognized using both scanning and transmission electron microscopy. Within the tegument numerous vacuoles were formed that released their contents to the exterior and finally caused destruction of the tegument. Proglottides of the central or posterior strobilar portions were never damaged.Larvae ofT. taeniaeformis (cysticerci) andE. multilocularis (alveolar cysts) were studied employing the same methods both after in vitro exposure to and after in vivo treatment of their hosts with praziquantel. Strobilocerci ofT. taeniaeformis developed identical tegumental lesions after contact with praziquantel whether incubated in vitro or treated in vivo. The wall of the bladder containing the larva remained unaffected. Evaginated protoscolices ofE. multilocularis were damaged by in vitro contact with praziquantel while invaginated protoscolices remained intact. After in vivo exposure there were some fully developed evaginated and damaged protoscolices whereas all invaginated protoscolices and the cyst wall with its germinative layer were unaffected.

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Zusammenfassung AdulteHymenolepis diminuta, H. microstoma, H. nana, Echinococcus multilocularis undTaenia (Hydatigera)taeniaeformis wurden in vitro in Medien inkubiert, die 0,1–100 g Praziquantel/ml enthielten. Mit Hilfe der Scanning-und der Transmissionselektronenmikroskopie konnten charakteristische Schäden des Teguments ausschließlich im Bereich der Sprossungszone schon nach 5 min nachgewiesen werden. Es entstanden hier zahlreiche Vakuolen, die ihren Inhalt nach außen abgaben und so schließlich das Tegument zerstörten. Proglottiden der mittleren und hinteren Strobilaabschnitte wurden niemals derartig geschädigt.Larven vonT. taeniaeformis (Strobilocercen) undE. multilocularis (alveoläre Cysten) wurden mit den gleichen Methoden in vitro sowie nach in vivo-Behandlung in ihren Wirten untersucht. Es zeigte sich, daß der Strobilocercus vonT. taeniaeformis sowohl nach Inkubation in vitro wie nach in vivo-Behandlung mit Praziquantel gleichartige charakteristische Schäden aufwies, die umhüllende Blasenwand allerdings niemals. BeiE. multilocularis ergab sich, daß bereits evaginierte Protoscolices in vitro geschädigt wurden, nicht dagegen die invaginierten Protoscolices.In vivo wurden einige voll entwickelte evaginierte und geschädigte Protoscolices gefunden, während die invaginierten und die Brutkapsel mit dem Keimepithel offenbar intakt blieben.

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Abbreviations B Bubbles - BL Basement layer - CM Circular musculature - LM Longitudinal musculature - M Microtriches - MI Mitochondria - P Proglottis - R Rostellum - S Sucker - SC Scolex - SEM Scanning electron microscopy - TD Tegumentary disks - TEM Transmission electron microscopy - TG Tegument - TGC Tegumental cell - V Vacuoles