上海市某三甲医院寄生虫病住院病例分析

目的分析上海市某三甲医院寄生虫病住院病例流行病学特征及临床特征。方法采用回顾性调查方法,对该院2011～2016年间确诊的寄生虫病住院病例资料进行分析。结果该院2011～2016年共收治207例15种寄生虫病住院病例,主要病种为肺吸虫病(20.77%)、囊虫病(20. 29%)、曼氏裂头蚴病(18. 36%)、华支睾吸虫病(9.18%)。食源性寄生虫病占总数的85.99%。2011～2016年病例数依次为31例、28例、35例、35例、32例、46例。上海本地户籍病例占35.27%,外省市籍64.25%,外籍0.48%。男女性别比1.88∶1。以汉族为主,占96.92%。年龄最小为1岁,最大92岁,病例数主要集中在≥20岁各年龄组,占总数93.23%。囊虫病、曼氏裂头蚴、肺吸虫病、华支睾吸虫、弓形虫病、棘球蚴病、旋毛虫病、舌形虫病、卡氏肺囊虫肺炎、大片吸虫感染以血清学(抗体)诊断为主。肠道绦虫病、疟疾、人芽囊原虫病、阿米巴痢疾、钩虫病以病原学诊断为主。超过半数的患者无明确的流行病学史。不同病种嗜酸性粒细胞增多情况不同。结论食源性寄生虫病是目前危害较为广泛的寄生虫病,为明确诊断应开展全套寄生虫免疫学检查或相关寄生虫检测。     

肠蛔虫致急腹症58例

作者统计了195 5～1990年我院收治的5 8例肠蛔虫致急腹症病例资料,其中胆道蛔虫病3 2例,蛔虫性肠梗阻2 4例,蛔虫致急性阑尾炎和蛔虫致十二指肠溃疡穿孔各1例。患者多数为儿童( 7～15岁) ,占70 .69% ( 4 1/ 5 8) ;青壮年( 16～60岁) 15例,占2 5 .86% ;60岁以上2例,占3 .45 %。现将患者的临床症状、体征及治疗情况总结报告如下。1　胆道蛔虫病3 2例胆道蛔虫病患者的症状和体征主要表现为上腹部阵发性剧痛,扪诊右上腹部有轻度压痛,B超检查可见胆道扩张,有虫体影像。其中2 9例经用止痛和解除胆道扩约肌痉挛的药物或服用乌梅汤后症状缓解,随即在…     

硫酸镁治疗胆道蛔虫病36例观察

胆道蛔虫病是蛔虫感染的常见合并症之一,主要表现为剑突下阵发性钻凿样剧烈疼痛,腹部体征轻微。近4年我们试用硫酸镁治疗胆道蛔虫病,并对其疗效进行观察,结果如下。一般资料 1995年10月～1999年10月在我院住院的胆道蛔虫病人,共36例,其中男20例,女16例;5～15岁12例,15～45岁24例;病程1天内27例,2～3天9例。患者均有典型的胆道     

肠蛔虫所致血液学表现54例分析

肠蛔虫病是人体最常见的肠道寄生虫病,该病感染率高,通常为慢性感染过程,一般无明显症状,常被忽视。但蛔虫在人体内寄生危害大,引起的合并症多,严重者可危及生命。而蛔虫所致血液系统症状、体征、血细胞的减少等症状易与某些血液病混淆,常被误诊。现将我院从1997年2月至1998年10月诊治的以贫血、出血、血细胞减少为主要临床表现的肠蛔虫病54例分析如下:1　临床资料11　一般资料本组病例均系我院血液专科门诊诊治的患者54例。男性16例,占296%,女性38例,占704%。年龄1～72岁,其中,14～20岁12例,占222%,21～30岁21例,占389%,31～40岁13例,占241…     

应用ERCP诊治53例胆道蛔虫病临床效果观察

目的观察内镜逆行胰胆管造影术(ERCP)诊治胆道蛔虫病临床效果,为胆道蛔虫病临床治疗提供科学依据。方法收集2010年1月至2015年5月本院应用ERCP诊治的53例胆道蛔虫病例相关临床资料,并进行回顾性分析。通过取虫成功率、取虫时间、住院天数、并发症以及超声复查发现蛔虫情况等指标对ERCP诊治胆道蛔虫病效果进行观察评价。结果取虫成功率为100%。其中4例乳头嵌塞型病例直接采用网篮或圈套器取虫,取虫平均时间为4.5 min;49例胆管腔内型病例经乳头气囊扩张,采用网篮取虫,平均取虫时间为14.6 min。超声复查均未发现胆道蛔虫,平均住院时间为4.8 d。53例胆道蛔虫病例术后发生并发症8例(15.09%),无消化道出血、穿孔等严重并发症。结论应用ERCP诊治胆道蛔虫病临床效果良好,手术并发症少,值得临床推广。     

肠蛔虫致急腹症58例

作者统计了1955～1990年我院收治的58例肠蛔虫致急腹症病例资料，其中胆道蛔虫病32例，蛔虫性肠梗阻24例，蛔虫致急性阑尾炎和蛔虫致十二指肠溃疡穿孔各1例。患者多数为儿童(7～15岁)，占70．69％(41／58)；青壮年(16～60岁)15例，占25．86％；60岁以上2例，占3．45％。现将患者的临床症状、体征及治疗情况总结报告如下。     

内镜下逆行胰胆管造影技术诊治成人胆道蛔虫病19例的临床分析

目的 探讨内镜下逆行胰胆管造影(ERCP)在成人胆道蛔虫病诊断、治疗中的临床应用.方法 回顾性分析沈阳军区总医院内镜科2005年1月至2012年12月收治的19例经ERCP诊断、治疗的成人胆道蛔虫病患者的临床资料.结果 胆道蛔虫病患者共19例.其中男11例,女8例;平均年龄(62.7±10.8)岁.居住于农村8例,城乡结合部7例,城镇4例;全部病例均有生食蔬菜、瓜果习惯.19例患者中发现活体蛔虫9例,同时存在胆总管结石4例.胆总管内已死亡蛔虫残体石化10例,同时存在胆总管较大结石5例.全部患者均经内镜成功取出蛔虫和胆总管结石.术后出现高淀粉酶血症3例,未见其他并发症.结论 成人胆道蛔虫病的发病以中老年为主,易并发胆管结石,ERCP是治疗胆道蛔虫病的有效方法.     

左旋咪唑、硝苯吡啶加甘露醇治疗胆道蛔虫35例

我科参考赖运庆、候凤英治疗胆道蛔虫的方法,并在其基础上采用左旋咪唑、硝苯毗啶加甘露醇治疗胆道蛔虫取得了非常显著的疗效。 本组 35例胆道蛔虫患者均为2000年3月至2002年4月住院患者,住院时间6h到7d,其中男23例,女12例,年龄14～71岁,病程2h～5d。上腹痛35例,伴呕吐19例,其中呕出蛔虫1例,合并胆石症5例,黄疸4例,合并急性胰腺炎1例。35例均经B超证实为胆道蛔虫。     

中西结合治疗胆道蛔虫病71例报告

中西结合治疗胆道蛔虫病７１例报告青岛医学院（２６６０１２）崔泰来，张玉杰胆道蛔虫病是因肠蛔虫进入胆道而引起的并发症，好发于青年、儿童和妇女妊娠期，我们应用中西结合方法治疗本病，临床效果良好，现将资料完整的７１例及实验研究总结如下。１一般资料本组病例中...     

无痛性甲状腺炎18例误诊分析

无痛性甲状腺炎易与Graves病相混淆,很容易误诊、漏诊,以致错误治疗,招致严重后果。现将我院近年收治的18例误诊病例分析如下。1临床资料18例均为本院门诊、住院患者。男4例,女14例,男女之比为1∶3.5;年龄20～59岁,平均40岁。发病前有上感病史者12例,劳累3例,3例无诱因。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.