BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnosti...BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.展开更多
BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this uniq...BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.展开更多
BACKGROUND Echinococcosis is prevalent in 9 provinces in Western and Northern China.An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.AIM To understand the ...BACKGROUND Echinococcosis is prevalent in 9 provinces in Western and Northern China.An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.AIM To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.METHODS Based on the China Information System for Disease Control and Prevention(CISDCP),echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022.The exclusion criteria included suspected cases,same case only counted once and cases not from Yunnan.A total of 705 cases were investigated,of which 397 cases were suitable for statistical analysis.In these 397 cases,epidemiological investigation was tracked in 187 cases.All data were inputted using double entry in the Excel database,with error correction by double-entry comparison.The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution.All statistical analyses were conducted using SPSS 17.0,including the chi-square test,linear regression test and logistic univariate and multivariate regression analyses.RESULTS A total of 397 cases were found in 89 counties in Yunnan Province.The number of cases in the top three prefectures were Dali(38.1%),Diqing(10.1%),and Kunming(8.3%),and the top five counties were Jianchuan(9.1%),Shangri La(8.3%),Eryuan(7.6%),Heqing(6.9%),and Dali Districts(5.0%).There were significant differences between the different areas.The case reporting rate by CISDCP(33.8%)was low;the first case was reported by CISDCP in 2002,and the highest number of cases was 50(2017).Confirmed and clinical cases accounted for 62.5%and 37.5%,respectively.However,90.9%of the cases of hydatid disease were reported by the hospital system,and only 9.1%of the cases of hydatid disease were found in the community through active screening.The difference between the two methods of case detection was statistically significant.Most of the cases of echinococcosis were found in farmers/herdsmen(75.1%)and students(9.1%).In addition,Han(43.6%)and Bai(26.2%)had a higher incidence of infection than other nationalities,and the liver(87.7%)and lung(6.8%)were the most common sites of cyst formation.Among the analyzed cases,187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1%of cases.The results of logistic regression analysis showed that the age group,education level,presence of dogs in the family(either previously or currently),and handwashing(occasionally or not)were factors related to echinococcosis infection.55.6%of cases were in endemic areas,and 44.4%of cases were in non-endemic areas.Among 83 cases in non-endemic areas,only 4 cases had been to endemic areas and had a history of living,working,travelling,or hunting in echinococcosis epidemic areas.CONCLUSION Cases of echinococcosis were reported throughout the entire Yunnan province,with the majority distributed in Western Yunnan,suggesting that echinococcosis control should be strengthened in this area.We suggest that an epidemiological investigation should be carried out in the future,based on the clues from newly discovered cases in hospitals or from the CISDCP.The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.展开更多
Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE)....Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.展开更多
BACKGROUND Hepatic alveolar echinococcosis(HAE)is a serious zoonotic infection that affects humans.It may have a tumor-like appearance at times.Percutaneous treatment of HAE patients is extremely relaxing for them.HAE...BACKGROUND Hepatic alveolar echinococcosis(HAE)is a serious zoonotic infection that affects humans.It may have a tumor-like appearance at times.Percutaneous treatment of HAE patients is extremely relaxing for them.HAE is a significant human zoonotic infection caused by the fox tapeworm Echinococcus Multilocularis larvae.It possesses the characteristics of an invasive tumor-like lesion due to its infiltrative growth pattern and protracted incubation period.The disease is endemic over central Europe,Asia,and North America.AIM To characterize HAE patients who were treated percutaneously,their outcomes,and the major technical features of percutaneous treatment in HAE.METHODS Patients who were treated with percutaneous cyst drainage and/or percutaneous biliary drainage were included in the study.Uncorrected abnormal coagulation values and solid or non-infected HAE with minor necrotic change were excluded.RESULTS Thirty-two patients underwent percutaneous cyst drainage,two patients underwent percutaneous biliary drainage,and four patients underwent percutaneous biliary drainage alone.Interventional radiology is utilized to drain echinococcal necrosis and abscesses within/without the liver,as well as diseased and clogged bile ducts.CONCLUSION Percutaneous drainage of cyst contents and/or biliary channels using a minimally invasive technique is a very beneficial.Percutaneous cyst drainage with albendazole therapy improves quality of life in patients who are unable to undergo surgery,even when the mass resolves with long-term treatment.展开更多
BACKGROUND Primary pelvic Echinococcus granulosus infection is clinically rare.The reported cases of pelvic Echinococcus granulosus infection are considered to be secondary to cystic echinococcosis in other organs.Sin...BACKGROUND Primary pelvic Echinococcus granulosus infection is clinically rare.The reported cases of pelvic Echinococcus granulosus infection are considered to be secondary to cystic echinococcosis in other organs.Single Echinococcus granulosus infection is very rare.CASE SUMMARY In this report,we presented a case of primary pelvic Echinococcus granulosus infection admitted to the First Affiliated Hospital of Xinjiang Medical University.We described the key diagnostic points and surgical treatment of this case.We also summarized the epidemiological characteristics and pathogenesis of the disease.CONCLUSION Our case may provide clinical data for the diagnosis and treatment of primary pelvic Echinococcus granulosus infection.展开更多
Echinococcosis is a zoonotic parasitic disease caused by Escherichia larvae.It frequently involves the liver(70%-75%),followed by the lungs(15%-20%),and occasionally the brain,heart,spleen,bone,and other organs.The ma...Echinococcosis is a zoonotic parasitic disease caused by Escherichia larvae.It frequently involves the liver(70%-75%),followed by the lungs(15%-20%),and occasionally the brain,heart,spleen,bone,and other organs.The main pathogenic forms of human echinococcosis currently include cystic echinococcosis(CE)and alveolar echinococcosis(AE).CE is globally distributed,while the distribution of AE is generally restricted to the northern hemisphere.In China,CE accounts for 75%of all echinococcosis cases.With rapid advances in surgical techniques in recent decades,the surgical strategy for CE has changed,especially with the continuous improvement of surgical methods and the expansion of surgical contraindications.To further understand the changes in surgical treatment strategies for hepatic CE,we interpreted and analyzed the existing literature addressing the surgical treatment of hepatic CE both domestically and abroad and briefly summarized them in chronological order.This review aims to provide a deeper understanding of the progress in the surgical treatment of hepatic CE to provide clearer avenues for its clinical diagnosis and treatment.展开更多
BACKGROUND The NOD-like receptor family pyrin domain-containing 3(NLRP3)inflammasome is a significant component of the innate immune system that plays a vital role in the development of various parasitic diseases.Howe...BACKGROUND The NOD-like receptor family pyrin domain-containing 3(NLRP3)inflammasome is a significant component of the innate immune system that plays a vital role in the development of various parasitic diseases.However,its role in hepatic alveolar echinococcosis(HAE)remains unclear.AIM To investigate the NLRP3 inflammasome and its mechanism of activation in HAE.METHODS We assessed the expression of NLRP3,caspase-1,interleukin(IL)-1β,and IL-18 in the marginal zone and corresponding normal liver of 60 patients with HAE.A rat model of HAE was employed to investigate the role of the NLRP3 inflammasome in the marginal zone of HAE.Transwell experiments were conducted to investigate the effect of Echinococcus multilocularis(E.multilocularis)in stimulating Kupffer cells and hepatocytes.Furthermore,immunohistochemistry,Western blotting,and enzyme-linked immunosorbent assay were used to evaluate NLRP3,caspase-1,IL-1β,and IL-18 expression;flow cytometry was used to detect apoptosis and reactive oxygen species(ROS).RESULTS NLRP3 inflammasome activation was significantly associated with ROS.Inhibition of ROS production decreased NLRP3-caspase-1-IL-1βpathway activation and mitigated hepatocyte damage and inflammation.CONCLUSION E.multilocularis induces hepatocyte damage and inflammation by activating the ROS-mediated NLRP3-caspase-1-IL-1βpathway in Kupffer cells,indicating that ROS may serve as a potential target for the treatment of HAE.展开更多
目的基于生物信息学表达分析去氢骆驼蓬碱对细粒棘球蚴中EgTP53蛋白(Echinococcus granulosus of Tumor protein p53,EgTP53)的影响。方法将EgTP53蛋白与去氢骆驼蓬碱进行分子对接,从美国国家生物技术信息中心数据库(National Center fo...目的基于生物信息学表达分析去氢骆驼蓬碱对细粒棘球蚴中EgTP53蛋白(Echinococcus granulosus of Tumor protein p53,EgTP53)的影响。方法将EgTP53蛋白与去氢骆驼蓬碱进行分子对接,从美国国家生物技术信息中心数据库(National Center for Biotechnology Information,NCBI)下载EgTP53的氨基酸序列,使用ProtParam蛋白分析工具进行EgTP53蛋白理化性质的预测,通过生信工具ProtScale进行疏水性的预测。使用SignalP5.0在线软件对信号肽进行预测,使用生物学在线软件工具TMHMM分析跨膜区域。借助NetPhos3.1在线软件预测磷酸化位点,利用SOMPA在线软件进行二级结构的预测。使用SWISS-MODEL在线软件对EgTP53的三级结构进行预测,采用IEDB在线软件进行B细胞抗原表位预测。使用MEGA6.0软件构建系统进化树并进行分析;采用实时荧光定量PCR技术检测去氢骆驼蓬碱作用后EgTP53蛋白的mRNA表达水平。结果分子对接结果显示,EgTP53与去氢骆驼蓬碱的对接能量为-4.44 kcal/mol,有良好的对接位点。生物信息学分析EgTP53氨基酸数量1108个,分子量121799.11,等电点9.29,属于亲水性蛋白,有一个信号肽,无跨膜区,有多个磷酸化位点,28个B细胞抗原表位。其中存在TUDOR蛋白结构域,存在2个BRCT保守蛋白结构域。EgTP53与亚洲带绦虫病、带状泡尾绦虫同属一个分支,与长膜带绦虫、矮小齿壳绦虫、微口膜壳绦虫同属绦虫纲,进化关系较近,与智人、家鼠、果蝇进化关系较远。实时荧光定量PCR结果显示去氢骆驼蓬碱干预组的EgTP53蛋白的mRNA表达较空白对照组明显上调。结论生物信息学分析表明EgTP53蛋白具有保守的功能结构域,对接点位稳定性良好,抗原表位多。展开更多
肝包虫病是一种呈全球性分布的人畜共患性疾病。超声作为该病的首选诊断方法,虽能及时发现大病灶位置并进行评价,但对早期小病灶的检测能力不佳。本文基于经预处理的高质量肝囊型包虫病超声图像小病灶数据集,提出了一种基于YOLOv7的检...肝包虫病是一种呈全球性分布的人畜共患性疾病。超声作为该病的首选诊断方法,虽能及时发现大病灶位置并进行评价,但对早期小病灶的检测能力不佳。本文基于经预处理的高质量肝囊型包虫病超声图像小病灶数据集,提出了一种基于YOLOv7的检测肝囊型包虫病5类分型超声图像中小病灶的方法,以实现肝包虫病的自动检测,提高临床诊断效率。首先,用硬件感知神经网络EfficientRep替换原特征提取主干,实现在保证精度和速度不受影响的前提下,提高对硬件设备的适配度;其次,用更优的WIoU(Wise-IoU)替换CIoU(Complete Intersection over Union),改善了YOLOv7网络的评价指标CIoU在作为损失函数时,梯度计算效果差,导致检测精度下降的问题;最后,在主干的最后第4层加入CBAM注意力,进一步提高了模型检测精度。本文在自建的肝囊型包虫病超声图像小病灶数据集上进行了训练,结果显示,改进后的模型平均精度均值为88.1%,相较原始的模型性能得到了提升,并超过了对比的其余主流检测方法。说明本模型能更高效地检测并分类肝囊型包虫病超声图像中小病灶的位置和类别,应用于临床上能节约医师资源、缩短报告时长、提高诊断效率。展开更多
文摘BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.
基金Supported by National Natural Science Foundation of China,No.82260412.
文摘BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.
基金Supported by Central Government Transfer Payment of ChinaOpen Project of Key Laboratory of Echinococcosis Control and Research of the National Health Commission of People’s Republic of China,No.2021WZK1001。
文摘BACKGROUND Echinococcosis is prevalent in 9 provinces in Western and Northern China.An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.AIM To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.METHODS Based on the China Information System for Disease Control and Prevention(CISDCP),echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022.The exclusion criteria included suspected cases,same case only counted once and cases not from Yunnan.A total of 705 cases were investigated,of which 397 cases were suitable for statistical analysis.In these 397 cases,epidemiological investigation was tracked in 187 cases.All data were inputted using double entry in the Excel database,with error correction by double-entry comparison.The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution.All statistical analyses were conducted using SPSS 17.0,including the chi-square test,linear regression test and logistic univariate and multivariate regression analyses.RESULTS A total of 397 cases were found in 89 counties in Yunnan Province.The number of cases in the top three prefectures were Dali(38.1%),Diqing(10.1%),and Kunming(8.3%),and the top five counties were Jianchuan(9.1%),Shangri La(8.3%),Eryuan(7.6%),Heqing(6.9%),and Dali Districts(5.0%).There were significant differences between the different areas.The case reporting rate by CISDCP(33.8%)was low;the first case was reported by CISDCP in 2002,and the highest number of cases was 50(2017).Confirmed and clinical cases accounted for 62.5%and 37.5%,respectively.However,90.9%of the cases of hydatid disease were reported by the hospital system,and only 9.1%of the cases of hydatid disease were found in the community through active screening.The difference between the two methods of case detection was statistically significant.Most of the cases of echinococcosis were found in farmers/herdsmen(75.1%)and students(9.1%).In addition,Han(43.6%)and Bai(26.2%)had a higher incidence of infection than other nationalities,and the liver(87.7%)and lung(6.8%)were the most common sites of cyst formation.Among the analyzed cases,187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1%of cases.The results of logistic regression analysis showed that the age group,education level,presence of dogs in the family(either previously or currently),and handwashing(occasionally or not)were factors related to echinococcosis infection.55.6%of cases were in endemic areas,and 44.4%of cases were in non-endemic areas.Among 83 cases in non-endemic areas,only 4 cases had been to endemic areas and had a history of living,working,travelling,or hunting in echinococcosis epidemic areas.CONCLUSION Cases of echinococcosis were reported throughout the entire Yunnan province,with the majority distributed in Western Yunnan,suggesting that echinococcosis control should be strengthened in this area.We suggest that an epidemiological investigation should be carried out in the future,based on the clues from newly discovered cases in hospitals or from the CISDCP.The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.
基金2021-2022 Qinghai Province“Kunlun Talents”Action Plan of Young and Middle-Aged Scientific and Technological Talents.
文摘Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.
文摘BACKGROUND Hepatic alveolar echinococcosis(HAE)is a serious zoonotic infection that affects humans.It may have a tumor-like appearance at times.Percutaneous treatment of HAE patients is extremely relaxing for them.HAE is a significant human zoonotic infection caused by the fox tapeworm Echinococcus Multilocularis larvae.It possesses the characteristics of an invasive tumor-like lesion due to its infiltrative growth pattern and protracted incubation period.The disease is endemic over central Europe,Asia,and North America.AIM To characterize HAE patients who were treated percutaneously,their outcomes,and the major technical features of percutaneous treatment in HAE.METHODS Patients who were treated with percutaneous cyst drainage and/or percutaneous biliary drainage were included in the study.Uncorrected abnormal coagulation values and solid or non-infected HAE with minor necrotic change were excluded.RESULTS Thirty-two patients underwent percutaneous cyst drainage,two patients underwent percutaneous biliary drainage,and four patients underwent percutaneous biliary drainage alone.Interventional radiology is utilized to drain echinococcal necrosis and abscesses within/without the liver,as well as diseased and clogged bile ducts.CONCLUSION Percutaneous drainage of cyst contents and/or biliary channels using a minimally invasive technique is a very beneficial.Percutaneous cyst drainage with albendazole therapy improves quality of life in patients who are unable to undergo surgery,even when the mass resolves with long-term treatment.
基金Supported by the Open Project of the State Key Laboratory of Pathogenesis and Prevention and Treatment of High Incidence Diseases in Central Asia jointly established by the Provincial Government and the Ministry,No.SKLHIDCA-2019-17.
文摘BACKGROUND Primary pelvic Echinococcus granulosus infection is clinically rare.The reported cases of pelvic Echinococcus granulosus infection are considered to be secondary to cystic echinococcosis in other organs.Single Echinococcus granulosus infection is very rare.CASE SUMMARY In this report,we presented a case of primary pelvic Echinococcus granulosus infection admitted to the First Affiliated Hospital of Xinjiang Medical University.We described the key diagnostic points and surgical treatment of this case.We also summarized the epidemiological characteristics and pathogenesis of the disease.CONCLUSION Our case may provide clinical data for the diagnosis and treatment of primary pelvic Echinococcus granulosus infection.
基金the Qinghai Province Talent Action Plan of KunlunNational Natural Science Foundation of China,No.82260412+2 种基金Basic Research Project of Qinghai Province,No.2020-wjzdx-27Qinghai Province 2022 Innovation Platform Construction Special Project,No.2022-ZJ-T01High-end Innovative Talent Project of Kunlun Talents of Qinghai Province in 2021.
文摘Echinococcosis is a zoonotic parasitic disease caused by Escherichia larvae.It frequently involves the liver(70%-75%),followed by the lungs(15%-20%),and occasionally the brain,heart,spleen,bone,and other organs.The main pathogenic forms of human echinococcosis currently include cystic echinococcosis(CE)and alveolar echinococcosis(AE).CE is globally distributed,while the distribution of AE is generally restricted to the northern hemisphere.In China,CE accounts for 75%of all echinococcosis cases.With rapid advances in surgical techniques in recent decades,the surgical strategy for CE has changed,especially with the continuous improvement of surgical methods and the expansion of surgical contraindications.To further understand the changes in surgical treatment strategies for hepatic CE,we interpreted and analyzed the existing literature addressing the surgical treatment of hepatic CE both domestically and abroad and briefly summarized them in chronological order.This review aims to provide a deeper understanding of the progress in the surgical treatment of hepatic CE to provide clearer avenues for its clinical diagnosis and treatment.
基金Supported by the National Major Research and Development Project of“Precision Medicine Research”,No.2017YFC0909900Qinghai Province Science and Technology Department Programme,No.2019-SF-131the Qinghai Province Health and Family Planning Commission Programme,No.2016-wjzd-04.
文摘BACKGROUND The NOD-like receptor family pyrin domain-containing 3(NLRP3)inflammasome is a significant component of the innate immune system that plays a vital role in the development of various parasitic diseases.However,its role in hepatic alveolar echinococcosis(HAE)remains unclear.AIM To investigate the NLRP3 inflammasome and its mechanism of activation in HAE.METHODS We assessed the expression of NLRP3,caspase-1,interleukin(IL)-1β,and IL-18 in the marginal zone and corresponding normal liver of 60 patients with HAE.A rat model of HAE was employed to investigate the role of the NLRP3 inflammasome in the marginal zone of HAE.Transwell experiments were conducted to investigate the effect of Echinococcus multilocularis(E.multilocularis)in stimulating Kupffer cells and hepatocytes.Furthermore,immunohistochemistry,Western blotting,and enzyme-linked immunosorbent assay were used to evaluate NLRP3,caspase-1,IL-1β,and IL-18 expression;flow cytometry was used to detect apoptosis and reactive oxygen species(ROS).RESULTS NLRP3 inflammasome activation was significantly associated with ROS.Inhibition of ROS production decreased NLRP3-caspase-1-IL-1βpathway activation and mitigated hepatocyte damage and inflammation.CONCLUSION E.multilocularis induces hepatocyte damage and inflammation by activating the ROS-mediated NLRP3-caspase-1-IL-1βpathway in Kupffer cells,indicating that ROS may serve as a potential target for the treatment of HAE.
文摘目的基于生物信息学表达分析去氢骆驼蓬碱对细粒棘球蚴中EgTP53蛋白(Echinococcus granulosus of Tumor protein p53,EgTP53)的影响。方法将EgTP53蛋白与去氢骆驼蓬碱进行分子对接,从美国国家生物技术信息中心数据库(National Center for Biotechnology Information,NCBI)下载EgTP53的氨基酸序列,使用ProtParam蛋白分析工具进行EgTP53蛋白理化性质的预测,通过生信工具ProtScale进行疏水性的预测。使用SignalP5.0在线软件对信号肽进行预测,使用生物学在线软件工具TMHMM分析跨膜区域。借助NetPhos3.1在线软件预测磷酸化位点,利用SOMPA在线软件进行二级结构的预测。使用SWISS-MODEL在线软件对EgTP53的三级结构进行预测,采用IEDB在线软件进行B细胞抗原表位预测。使用MEGA6.0软件构建系统进化树并进行分析;采用实时荧光定量PCR技术检测去氢骆驼蓬碱作用后EgTP53蛋白的mRNA表达水平。结果分子对接结果显示,EgTP53与去氢骆驼蓬碱的对接能量为-4.44 kcal/mol,有良好的对接位点。生物信息学分析EgTP53氨基酸数量1108个,分子量121799.11,等电点9.29,属于亲水性蛋白,有一个信号肽,无跨膜区,有多个磷酸化位点,28个B细胞抗原表位。其中存在TUDOR蛋白结构域,存在2个BRCT保守蛋白结构域。EgTP53与亚洲带绦虫病、带状泡尾绦虫同属一个分支,与长膜带绦虫、矮小齿壳绦虫、微口膜壳绦虫同属绦虫纲,进化关系较近,与智人、家鼠、果蝇进化关系较远。实时荧光定量PCR结果显示去氢骆驼蓬碱干预组的EgTP53蛋白的mRNA表达较空白对照组明显上调。结论生物信息学分析表明EgTP53蛋白具有保守的功能结构域,对接点位稳定性良好,抗原表位多。
文摘肝包虫病是一种呈全球性分布的人畜共患性疾病。超声作为该病的首选诊断方法,虽能及时发现大病灶位置并进行评价,但对早期小病灶的检测能力不佳。本文基于经预处理的高质量肝囊型包虫病超声图像小病灶数据集,提出了一种基于YOLOv7的检测肝囊型包虫病5类分型超声图像中小病灶的方法,以实现肝包虫病的自动检测,提高临床诊断效率。首先,用硬件感知神经网络EfficientRep替换原特征提取主干,实现在保证精度和速度不受影响的前提下,提高对硬件设备的适配度;其次,用更优的WIoU(Wise-IoU)替换CIoU(Complete Intersection over Union),改善了YOLOv7网络的评价指标CIoU在作为损失函数时,梯度计算效果差,导致检测精度下降的问题;最后,在主干的最后第4层加入CBAM注意力,进一步提高了模型检测精度。本文在自建的肝囊型包虫病超声图像小病灶数据集上进行了训练,结果显示,改进后的模型平均精度均值为88.1%,相较原始的模型性能得到了提升,并超过了对比的其余主流检测方法。说明本模型能更高效地检测并分类肝囊型包虫病超声图像中小病灶的位置和类别,应用于临床上能节约医师资源、缩短报告时长、提高诊断效率。
