肝包虫病的诊治方法研究进展

肝包虫病是流行于世界畜牧业发达地区的常见人畜共患性寄生虫病。文章介绍了肝包虫病的症状体征、诊断依据,以及各种治疗方法,以期对该病的防治提供参考。     

西藏地区农牧民生活习俗与包囊虫病的关系调查

目的　探讨西藏地区农、牧民生活习俗与包囊虫病的关系。方法　自制问卷对 7个县 2 40个家庭 163 1名成员与包囊虫感染有关的生活习俗进行调查分析。结果　饭前便后洗手的人仅有 16 1%,餐具一般都用天然水洗 ,大部家庭用天然绵羊绒擦洗茶具。大多数人都喝过河溪水 ,池塘水 ,人人都吃半生不熟的肉 ,半数以上的吃生肉和生血肠 ,绝大多数人喝未经消毒的鲜牛、羊奶。 10 0 %家庭养狗 ,所有人员与狗、羊、牛、马接触密切。包囊虫病人占调查人数 0 43 %( 7/ 163 1) ,有典型症状者占 0 67%( 11/ 163 1)。结论　当地居民感染包囊虫与不良生活习俗有关     

肝包虫病合并HBV感染患者Th17、CD4+细胞表面PD-1/PD-L1的表达水平及意义

目的探讨肝包虫合并乙型肝炎病毒(HBV)感染患者辅助性T细胞17(Th17)、CD4⁺细胞表面程序性死亡分子-1/程序性死亡分子1配体(PD-1/PD-L1)的表达水平及其临床意义。方法选取2014年9月一2019年9月新疆医科大学第一附属医院收治的肝包虫病患者作为研究对象﹐其中100例肝包虫病合并HBV感染患者为合并HBV感染组,肝包虫病无HBV感染患者88例为非HBV感染组﹐采用流式细胞仪检测外周血Th17,CD4⁺细胞表面PD-1,PD-L1表达水平。结果合并HBV感染组患者乙型肝炎家族史,B~C Child分级占比均高于非HBV感染组(P<0.05);肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST),γ-谷氨酰转肽酶(γ-GT)]水平以及Th17 PD-1、Th17 PD-L1,CD,PD-1,CD4⁺PD-L1表达水平均高于非HBV感染组(P<0.05);Child分级A级肝包虫病患者的Th17 PD-1,Th17 PD-L1,CD4⁺PD-1,CD4⁺PD-L1表达水平均低于Child分级B~C级患者(P<0.05)。结论HBV感染会影响肝包虫病患者的肝功能及外周血Th17,CD4⁺细胞表面PD-1,PD-L1表达水平,肝功能严重程度可能与外周血Th17,CD4⁺细胞PD-1,PD-L1表达存在关系。     

阿苯达唑脂质体治疗肝、腹部细粒棘球蚴病的动物实验研究

应用阿苯达唑脂质体（ＬｉｐｏｓｏｍａｌＡｌｂｅｎｄａｚｏｌｅ，Ｌ－ＡＢＺ）联合西咪替丁（Ｃｉｍｅｔｉｄｉｎｅ，ＣＭＤ）治疗继发性感染细粒棘球蚴（Ｅｃｈｉｎｏｃｏｃｃｕｓｇｒａｎｕｌｏｓｕｓ，Ｅ．ｇ．），并比较单纯或联合用药的优劣。经囊减重率、药物浓度监测、病理及超微结构指标观察，结果表明：（１）阿苯达唑脂质体治疗包虫病的效果优于单纯阿苯达唑，尤其联合西米替丁效果更佳（囊减重率９５．７４％）；（２）脂质体包封阿苯达唑具有靶器官作用，可提高肝药浓度（１．５～２倍），使囊组织及囊液有较高浓度有效成分直接发挥抗包虫的作用；（３）西咪替丁可改变阿苯达唑代谢过程，提高药物浓度在小鼠体内分布，具有明显的抗包虫协同作用     

Cystic Hydatidosis of the Rib–Case Report and Review of the Literature

The hydatid disease is a zoonosis endemic to rural countries, such as those in the Mediterranean region, South America, North Africa, Central Asia and China. Hydatid cysts commonly affect liver and lungs, but less than 100 cases of costal hydatidosis have been reported in the literature. While diagnosis of the disease in commonly affected organs is relatively easy, uncommon locations can prove to be challenging as is the case with costal hydatidosis. Imaging techniques can suggest the diagnosis, but sometimes it remains uncertain until surgery. The treatment is surgical, assisted by long-time Albendazole chemotherapy. We present a rare case of costal hydatidosis, the first one to be reported in Romania according to our review of the literature.     

空间插值法在人群包虫病患病率预测中的应用

目的探索不同空间插值方法在人群包虫病患病率预测中的应用并比较其效果。方法以四川、西藏、甘肃和青海四省(区)青藏高原地区2012年全国包虫病流行情况调查获得的124个藏区县的人群包虫病患病率数据为基础,使用Arcgis10.0软件,采用局部多项式插值法、反距离权重插值法和kriging插值法进行空间插值,比较青海省治多县和玛多县人群包虫病患病率推算的效果。结果 3种方法预测的精度各有优势,对青海省治多县和玛多县人群包虫病患病率误差最小的为Kriging插值方法,预测的患病率分别为2.04%和5.28%。结论空间插值方法可用于青海省治多县和玛多县人群包虫病患病率预测,以Kriging插值法的预测效果较好。     

Multidisciplinary imaging of liver hydatidosis

Liver hydatidosis is a parasitic endemic disease affecting extensive areas in our planet, a significant stigma within medicine to manage because of its incidence, possible complications, and diagnostic involvements. The diagnosis of liver hydatidosis should be as fast as possible because of the relevant complications that may arise with disease progression, involving multiple organs and neighboring structures causing disruption, migration, contamination. The aim of this essay is to illustrate the role of imaging as ultrasonography (US), multi detector row computed tomography, and magnetic resonance imaging (MRI) in the evaluation of liver hydatidosis: the diagnosis, the assessment of extension, the identification of possible complications and the monitoring the response to therapy. US is the screening method of choice. Computed tomography (CT) is indicated in cases in which US is inadequate and has high sensitivity and specificity for calcified hydatid cysts. Magnetic resonance is the best imaging procedure to demonstrate a cystic component and to show a biliary tree involvement. Diagnostic tests such as CT and MRI are mandatory in liver hydatidosis because they allow thorough knowledge regarding lesion size, location, and relations to intrahepatic vascular and biliary structures, providing useful information for effective treatment and decrease in post-operative morbidity. Hydatid disease is classified into four types on the basis of their radiologic appearance.     

Examination of murine antibody response to secondary hydatidosis using ELISA and immunoelectrophoresis

Summary Antibody responses in mice with up to 64 weeks of secondary Echinococcus granulosus hydatidosis were examined by ELISA using hydatid protoscolex antigen (Px), Antigen 5 (Ag5) and Antigen B (AgB), and by immunoelectrophoresis (IEP) using sheep hydatid cyst fluid (SHCF). Anti-Px IgG antibodies, evident from 3–5 days post infection (p.i.), increased steadily until 16 weeks and maintained a high level afterwards. Anti-Ag5 IgG antibodies were negligible up to two weeks, but they showed a small increase around 2–3 weeks which was followed by a big increase around 16 weeks p.i. The high level of anti-Ag5 IgG antibodies persisted to the end of experiment. The level of anti-AgB IgG antibodies remained relatively low throughout infection. Anti-Px IgM antibodies appeared in the early period of infection, but became insignificant as the infection proceeded. Specific IgM antibodies to Ag5 and AgB showed two waves of increase, one between 3 days to 4 weeks p.i. and the other between 16 weeks to 46 weeks p.i. The level of IgA antibodies to Ag5 and AgB was low and only a moderate amount of anti-Px IgA antibodies was detected. Generally, a higher level of serum antibodies are associated with a larger number of mature cysts. Serum samples from 5 of 8 mice harbouring hydatid cysts formed 1–3 bands with SHCF in IEP, including Arc 5, but a precipitation arc with AgB was not observed. Analysis of hydatid cyst fluid from the infected mice (MHCF) in IEP also failed to demonstrate AgB. Despite the high levels of antihydatid antibodies generated in the infected mice, protoscoleces appeared to be unhindered in their growth to mature cysts.     

肝脏包虫病患者对延续护理服务需求的质性研究

目的了解肝脏包虫病患者出院后对延续性护理的需求。方法于2019年1月采用现象学研究方法,对12例肝脏包虫病患者进行半结构式个人深度访谈,运用Colaizzi内容分析法对资料进行分析,并凝练主题。结果肝脏包虫病患者对延续性护理需求的主题分别为:疾病健康指导、专业化生活方式指导、可及的卫生服务资源和便捷的延续服务渠道、获取经济支持的需求。结论肝脏包虫病患者对延续性护理需求尤为迫切且方面多样,上级医院应结合社区医院、乡镇卫生院,制定以肝脏包虫病患者云随访平台为依托的延续性护理,提高肝脏包虫病患者的生存质量。