Rare presentation of multi-organ abdominal echinococcosis: report of a case and review of literature

Hydatid disease, which is also known as cystic echinococcosis, is a zoonotic infection caused by the cestode tapeworm Echinococcus granulosus and rarely by Echinococcus multilocularis. In this report we describe an unusual case of a 19-year-old woman who was admitted to our hospital for abdominal pain, nausea, and vomiting. Computed tomography revealed multi-organ abdominal echinococcosis. The patient recovered after undergoing surgery to excise the cyst. The diagnosis, clinical features, treatment, and prevention in this case of multi-organ abdominal echinococcosis are discussed, in light of the relevant literature.     

Curcumin prevents the non-alcoholic fatty hepatitis via mitochondria protection and apoptosis reduction

Background: Non-alcoholic fatty hepatitis (NASH) is highly prevalent, mitochondria damage is the main pathophysiological characteristic of NASH. However, treatment for mitochondria damage is rarely reported. Methods: NASH model was established in rats, the protective effects of curcumin were evaluated by histological observation; structure and function assessments of mitochondria; and apoptotic genes expression. Results: NASH rats treated with curcumin displayed relatively slight liver damage when compared with NASH livers. The average mitochondrial length and width of NASH (12.0 ± 3.2 and 5.1 ± 1.1 micrometers) were significantly longer than that of normal (6.2 ± 2.1 and 2.1 ± 1.5 micrometers) and NASH treated with curcumin (7.4 ± 1.2 and 3.2 ± 1.5 micrometers) rats. The average malondialdehyde (MDA) and 4-hydroxy nonyl alcohol (HNE) levels in liver homogenates of NASH rats (4.23 ± 0.22 and 19.23 ± 2.3 nmol/Ml) were significantly higher than these in normal (1.32 ± 0.12 and 3.52 ± 0.43 nmol/mL) and NASH treated with curcumin (1.74 ± 0.11 and 4.66 ± 0.99 nmol/mL) rats. The expression levels of CytC, Casp3 and Casp8 of the NASH livers were significantly higher than normal and NASH treated with curcumin rats livers. Conclusion: Our data demonstrated that curcumin prevents the NASH by mitochondria protection and apoptosis reduction and provided a possible novel treatment for NASH.     

Blood donation in China: sustaining efforts and challenges in achieving safety and availability

China has entered a new phase in blood safety and availability through persistent efforts in the past decades. Based on national data from 2008 to 2012, we present a comprehensive review on the blood services ranging from policy and organization, supply, donors, screening and processing, and clinical use to government response in contemporary China. Current evidence suggests that the Chinese blood industries, after continual efforts in reforms on the legal framework and national management system, have been in a relatively steady but bottleneck stage. Although the blood industries have had an impressive track record on management and resolving problems, such as low availability, limited donors, deficient laboratory tests, shortage of blood products, and unnecessary clinical usage of blood still exist nationwide. While medical technology and services have seen a rapid increase in progress in recent years, they have not coordinated with the development of the national health care system. This article presents an analysis with detailed data, rich contents, and recent response from the Chinese government, allowing readers to appreciate how China, a country with more than 19.13% of the world's population, has long endeavored to improve safety and availability of blood. Meantime, the article sincerely welcomes the guidance on policymaking and technical assistance from the international community. Data in this article do not include those of Hong Kong, Macao, or Taiwan.     

Therapeutic effects of transarterial infusion of lipiodol and ethanol in various ratios in a rabbit VX2 tumor model

PUSRPOSE

We aimed to evaluate the therapeutic effect and safety of transcatheter arterial embolization with various volume ratios of lipiodol and ethanol in a rabbit VX2 tumor model to identify the optimal volume ratio.

METHODS

Eighteen adult male New Zealand white rabbits implanted with VX2 tumors in their left liver lobes were randomly divided into six groups based on volume ratios of lipiodol to ethanol: group A, 3:1; group B, 2:1; group C, 1:1; group D, 1:2; group E, 1:3; and group F, 1:4. Pre- and post-treatment unenhanced magnetic resonance imaging was used to detect tumor formation and evaluate tumor growth rates. Liver samples were harvested one week after the procedure, and apoptosis index of tumor tissues was evaluated by pathologic examination and TUNEL assay.

RESULTS

Tumor size decreased in groups B, C, and D, but increased in groups A, E, and F. Tumor growth rates in groups A–F were 0.40±0.03, −0.11±0.21, −0.08±0.09, −0.12±0.07, 0.06±0.12, and 0.05±0.09, respectively. The change in tumor size was significantly different in group A compared with the rest of the groups, but no significant difference was observed among groups B–F. Apoptosis indexes of the six groups were 4.7±2.1%, 6.7±2.1%, 11.7±3.1%, 11.0±2.0%, 10.7±3.2%, and 12±3%, respectively. Apoptosis index was significantly lower in group A compared with groups C–F (P < 0.05). Apoptosis index of group B was significantly lower than groups C and F. There was no significant difference among the other groups.

CONCLUSION

The volume ratios of lipiodol to ethanol ranging from 2:1 to 1:4 were equally effective, the ratios 2:1 and 1:3 had equal safety, and the ratios 1:1 and 1:2 indicated better long-term therapeutic effect. Increasing ethanol in the mixture caused more severe liver injury. Optimal efficacy and safety was achieved with a lipiodol to ethanol volume ratio of 1:1.Hepatocellular carcinoma (HCC) is one of the most common solid malignancies in the world (1). Transarterial chemoembolization (TACE) is widely used to treat HCC patients who are not suitable candidates for curative treatments (2–5). The most common embolic agent used in TACE is lipiodol, which can be mixed with surgical glues (cyanoacrylates) or with ethanol for interventional procedures. Ethanol was confirmed to be effective in occluding the hepatic arterial system, but it can cause perisinusoidal fibrosis (6). Transarterial ethanol ablation (TEA) with a mixture of lipiodol-ethanol has been shown to be an effective treatment for HCC (7). Yu et al. (8) reported that the embolization efficacy and treatment effectiveness of TEA were probably superior to those of TACE for HCC, and a decreased proportion of ethanol (33% by volume) in the mixture was suggested. Lipiodol-ethanol mixtures with reduced ethanol proportions have been shown to be associated with decreased endothelial damage while maintaining effective delivery of the mixtures to tumor vasculature (9). However, the optimal ratio between lipiodol and ethanol that should be used for TEA remains controversial.In the present study, we aimed to determine the efficacy and optimum volume ratio of lipiodol-ethanol mixture in a rabbit VX2 hepatoma model.     

Endothelial dysfunction in acute brain injury and the development of cerebral ischemia

Cerebral ischemia (CeI) is a major complicating event after acute brain injury (ABI) in which endothelial dysfunction is a key player. This study evaluates cellular markers of endothelial function and in vivo reactive hyperemia in patients with ABI and their relationship to the development of cerebral ischemia. We studied cellular markers of endothelial dysfunction and the peripheral reactive hyperemia index (RHI) in 26 patients with ABI at admission and after 6 and 12 days, and compared these with those of healthy volunteers (n = 15). CeI was determined clinically or by computer tomography. In patients with ABI, RHI at admission was significantly reduced compared with healthy subjects (P = 0.003), coinciding with a decrease in circulating endothelial progenitor cells (EPC; P = 0.002). The RHI recovered in eight patients without development of CeI, but failed to fully recover by day 12 in three of four patients who developed CeI. Despite recovery of the RHI within 12 days in these patients (P = 0.003), EPC count remained significantly lower after 12 days in patients with ABI (P = 0.022). CD31⁺ T cells and endothelial microparticles were not different between controls and patients. No differences were noted in cellular markers of endothelial dysfunction in patients developing CeI and those not. In conclusion, patients with ABI exhibit impaired microvascular endothelial function measured as RHI and a decreased circulating level of EPC. © 2015 Wiley Periodicals, Inc.     

刮痧配合放痧治疗轻度高血压临床观察

目的:观察刮痧配合放痧对轻度(Ⅰ级)高血压病的即刻降压作用。方法:本组轻度(Ⅰ级)高血压患者30例与正常血压者30例进行对照,两组均选取督脉、足太阳经、手阳明经、足阳明经的相关区域和穴位进行3遍刮痧之后再放痧,记录每次刮痧及放痧后的血压值以及每次刮痧后大椎穴区的皮肤温度变化。每周治疗1次,共治疗4次。结果:第1遍、第2遍刮痧和第3遍刮痧以及放痧后均有明显的降压作用(均P<0.01);且刮痧配合放痧的降压作用最为显著(P<0.01);3遍刮痧后的大椎穴区皮肤温度均有显著性升高(均P<0.01)。结论:单纯刮痧或配合放痧对轻度(Ⅰ级)高血压具有较好的降压作用,刮痧的这种降压效应可能与其对体表经络、穴位的温热刺激有关。     

Transmission Risk from Imported Plasmodium vivax Malaria in the China–Myanmar Border Region

Malaria importation and local vector susceptibility to imported Plasmodium vivax infection are a continuing risk along the China–Myanmar border. Malaria transmission has been prevented in 3 border villages in Tengchong County, Yunnan Province, China, by use of active fever surveillance, integrated vector control measures, and intensified surveillance and response.