泡状棘球蚴病16例临床病理学及免疫组化观察

目的:探讨泡状棘球蚴病临床病理学及免疫组化特征。方法:对16例泡状棘球蚴病变组织切片进行CD20、CD3、CD45RA、CD45RO、CD5染色,部分病例做了EMA、CD68、CK标记。结果:泡状棘球蚴病见于肝、脑、肺、胰腺和淋巴结等器官,免疫组化结果提示病变内散在浸润淋巴细胞中有T细胞和B细胞,泡球囊肿内生发上皮与角质膜不表达CK和EMA,增生的组织细胞表达CD68和EMA。结论:泡状棘球蚴病诊断依赖病理活检,术前穿刺活检或术中冰冻切片检查是行之有效的诊断方法。消灭传染源,切断传播途径综合防治该病。     

行腹腔镜术治疗18例肝包虫病患者的方法与疗效

目的 :探讨腹腔镜术治疗肝包虫的可行性。方法 :对近 5年已确诊为肝包虫病的 38例住院患者中 ,18例在腹腔镜下行内囊摘除术后 ,进行追踪随访治疗效果。结果 :18例中 12例术后随访 5年 ,2例随访 2年 ,均未见复发。结论 :腹腔镜下肝包虫内囊摘除术比较安全可靠 ,值得推广应用。     

多房棘球绦虫重组BCG-Em14-3-3疫苗对小鼠脾细胞凋亡的影响

目的检测多房棘球绦虫(Em)重组BCG-Em14-3-3疫苗对原头蚴攻击小鼠脾细胞凋亡的影响。方法用重组BCG-Em14-3-3疫苗免疫Balb/c小鼠8周后,用50个多房棘球绦虫原头蚴腹腔注射进行攻击,攻击感染后18周剖杀小鼠,分离脾细胞,用刀豆素A(ConA)刺激培养16～18h,然后用Annexin V-FITC染色法检测脾细胞凋亡。结果小鼠脾细胞原液组和ConA刺激组细胞凋亡发生率均显著低于磷酸缓冲液(PBS)对照组(P<0.05或<0.01);鼻腔黏膜接种组脾细胞凋亡率显著低于皮下注射组(P<0.01);重组BCG疫苗组脾细胞凋亡率显著低于pCD-Em10 DNA疫苗肌肉注射组(P<0.01)。结论多房棘球绦虫重组BCG-Em14-3-3疫苗可抑制感染鼠脾细胞发生凋亡,增加CD4~ T细胞亚群的数量,加强宿主抗多房棘球绦虫感染的保护性免疫反应。     

Fifteen year surveillance of echinococcal heart disease from a referral hospital in Greece

Ten cases of hydatid heart disease were treated over a 15-yearperiod (1980–1995). Cysts were located in the left ventricularwall (four patients), right ventricular wall (one patient),interventricular septum (one patient), interatnal septum (onepatient), right atrium (one patient), pericardial cavity (onepatient) and in multiple loci (one patient). Apart from twoasymptomatic cases, clinical manifestations included chest pain(four patients), anaphylactic shock (one patient), constrictivepericarditis (one patient), congestive heart failure (one patient)and arterial embolism (one patient). Computed tomography wasfound useful in the detection of hydatid cysts and also in thedetermination of their morphology. Magnetic resonance was performedin three patients, with satisfactory imaging. Three out of the10 patients died: rupture of pulmonary echinococcal cyst (onepatient), massive pulmonary hydatid embolism (one patient) andrupture of an undiagnosed hydatid cyst of the right atrium duringcannulation for cardiopulmonary bypass (one patient). One otherpatient experienced recurrent systemic embolism and became hemiplegic.Six patients were successfully treated. In five patients, thecysts were excised by open heart surgery, while in one by pericardiectomy.In addition, antiparasitic drugs were successfully used in twopatients with long-term satisfactory results. In conclusion, cardiac echinococcosis is associated with anincreased risk of potentially lethal complications. Newer techniquesof cardiac imaging have helped locate the cysts while surgicalremoval may offer cure. Some patients responded to specificlong-term drug treatment.     

治疗盆腔棘球蚴并发尿道瘘1例

1 病例 患者,男,78岁,新疆伊宁人,牧区农民.因尿频、尿急5月余,于2007年9月18日来本院就诊.体检发现腹部中下部隆起,可触及一个20 cm×18 cm包块,质硬,边界清.行盆腔CT检查,见盆腔有一巨大囊性占位病灶 (图1 A),囊内可见典型"玫瑰花结"样多个子囊形态.     

天祝藏族自治县包虫病流行病学调查报告

１９９０年１０月～１１月，在天祝藏族自治县的三个乡进行了包虫病的血清流行病学调查，共查１９３７人，阳性者６１人，感染率为３．１５％，带包囊者３５人，患病率为１．８１％。土族感染率最高，为５．６％。１０岁以下儿童感染率为０．９５％，随年龄增长，感染率逐渐升高，４１～５０岁最高，达１０．７９％，患病率为７．１９％。调查中发现２例病人，三项化检验查均为阴性，占５．７１％。     

包虫与囊虫间共同抗原的实验探讨

本文用E.gCF和C.cCF致敏血球检测了四种抗原(E.gCF、E.gPS、C.cCF和C.cSCW)免疫的小白鼠。结果发现:囊虫头节及囊壁不仅是囊虫特异性抗原的载体而且是与包虫发生交叉反应的共同抗原的主要来源;原头节共同抗原较少。包虫囊液特异性抗原性比囊虫囊液要强。     

Dynamic observation on IgG and its subclasses and IgE in sera of mice by immunization with mixed recombinant of BCG-Em Ⅱ/3 and BCG-Em14-3-3 vaccine of Echinococcus multilocularis

Objective To dynamically observe changes of IgG, its subclasses and IgE in sera of mice by immunization with mixed recombinant of BCG-Em Ⅱ/3 and BCG-Em14-3-3 vaccine of Echinococcus multilocularis (Era). Methods Forty Balb/c mice of 12-14 week old and 20-25 g weight were intranasally vaccinated by the vaccine, 4 mice were killed randomly by the weight on 0,2,4,6,8,10,12,14,16 and 18 weeks of immunization respectively, sera were gathered from the eyeball to measure IgG, its subclasses and IgE by routine ELISA. Results Levels of IgG, IgG2a and IgG2b in the sera of mice increased obviously on 2-18 weeks, reached the highest level on 10, 4 and 4 weeks respectively, the value was 0.095±0.033,0.022±0.001,0.023±0.003 respectively, as compared with the value on 0 week(0.030±0.013,0.012±0.004,0.013±0.004), the difference being statistically significant(q=2.95,4.87,2.81 respectively, P < 0.01 or P < 0.05); levels of IgG1, IgG3 and IgE in the sera of mice decreased remarkably on 2-18 weeks,came to the lowest level on 4,2,6 weeks respectively, the value was 0.031±0.004,0.136±0.002,0.114±0.002 respectively, as compared with the value on 0 week(0.192±0.007, 0.175±0.013,0.024±0.003), the difference being statistically significant (q =5.16,4.93,5.32 respectively, P < 0.01 or P < 0.05). Conclusion Helper T cell(TH) Ⅰ response is induced in mice by mixed recombinant of BCG-Em Ⅱ/3 and BCG-Em14-3-3 vaccine on early immunization.     

Echinococcus granulosus cattle strain identification in an autochthonous case of cystic echinococcosis in central Mexico

Echinococcosis is a frequent hepatic parasitic disease in several countries but it is practically absent in Mexico. A cattle strain of Echinococcus granulosus was identified by RAPD, PCR-RFLP and mitochondrial CO1 gene analysis in an autochthonous case. The parasite was obtained after a laparoscopic excision of a liver cyst from a patient that was symptomatic for 6 years but mis-diagnosed before hospitalization.     

宁夏2012年棘球蚴病流行现况调查分析

目的 掌握宁夏棘球蚴病流行范围与程度,为制定防控措施提供科学依据.方法 采用整群随机抽样方法,于2012年对宁夏22个县（市、区）抽样点的3周岁以上常住居民用B超检查棘球蚴患病情况,调查当地啮齿类动物和牛羊感染情况.收集居民家的犬粪,用双抗体夹心法检测粪抗原阳性率.结果 共调查71 952例,查出患者128例,患病率17.79/万.原州区、同心县和盐池县患病率较其他地区均高（P＜0.05）;人群分布以回族、70～岁、宗教人士、信仰佛教者和文盲文化程度者患病率为高（P＜0.05）;家犬粪抗原阳性率为302.57/万（237/7 833）.剖检5只无主犬,未发现感染棘球绦虫;绵羊患病率高于牛（X2=22.11,P＜0.05）;鼠体种未检出棘球绦虫.结论 宁夏棘球蚴流行较为严重,在原州区等部分地区高发,提示棘球蚴防治工作仍不容忽视,应加大防治力度.