Objective To survey and analyze the epidemiological and distribution situation of echinococcosis for human and livestock in Aba Prefecture of Sichuan Province. Methods According to the Standard WS257-2006 of Diagnose Hydatidosis which was published by the WHO, the residents from 141 countrysides of 13 counties where echinococcosis prevailed were examined by B-ultrasound. Sera anti-echinococcosis IgG of children under 12 years old and dejecta-antigen of dogs were examined by ELISA. Visceral of yaks and sheep were examined in slaughter places to make sure their infection. Results Human surveillance: 48 288 people were examined by B-ultrasound, 470 of which were patients. The positive rate was 0.97%; 19 people was Alveolar Echinococcus, and 451 people was Cystic Echinococcus. Sera of 5 372 children was examined, 358 of which were positive. The positive rate was 6.67%. Livestock surveillance: 5814 dejecta-antigens of dogs were examined, 989 of which were positive. The positive rate was 17.01%. 3 336 yaks and sheep were examined, 113 of which were positive. The rate was 3.39% (113/3 336). Conclusion Alveolar and Cystic Echinococcus exist and prevail among humans and cattles in Aba Prefecture of Sichuan Province, with a larger proportion of Cystic Echinococcus.
Thisstudyisbasedonaretrospectivereviewof48patientswithechinococcosisofliverwithemphasisonthedifferentialdiagnosisandtheselectionofsurgery.Causesofmisdiagnosisandtheevaluationofavariousoperationsonthisdiseasewerediscussed.Results:Thecommonmisdiagnosiswasduetoobscurehistoryandsymptoms,errorsonimmunologicaltests,lackofspecificmanifestationonradiologicalexaminationandtheforemostsymptomsofcomplications.Theoperativewaysmustbechoseninaccordancewitheachindividualdisease.Theimprovementofoperativetechniquessuchas“tumorfree”operation,irrigationwithhypertonicsalinesolution,infillingwithgreateromentum,applicationofbiojellycanincreasethetherapeuticeffectofoperation.Conclusion:Thekeypointofdifferentialdiagnosisistorecognizetheatypicalcases.Rationalselectionofoperationsandimprovementofoperativetechniquesandmethodsarethecrucialtoincreasethetherapeuticeffectofthisdisease.
Objective To study the cl inical characteristics of sacrum echinococcosis disease so as to provide a basis for its diagnosis and treatment. Methods Between July 1999 and August 2010, 14 cases of sacrum echinococcosis disease were treated and the cl inical data were analysed retrospectively. There were 6 males and 8 females with an average age of 28.7 years (range, 16-58 years). The median disease duration was 5.7 years (range, 6 months to 11 years). Twelve cases came from cattle area or had a history of close contact with dogs and sheep; 12 patients had a history of lung or l iver hydatid disease. The main clinical symptoms were lumbosacral and lower extremity pain, one or both lower extremities and perineal hypoesthesia, the gradual dysfunction of both lower extremities and neurogenic bladder and bowel, and decreased force of urination. The imaging examination showed multicystic bone erosion. The Casoni test was performed in 10 cases and the results were positive in 8 cases. The eight immunoserology markers of hydatidosis were detected in 4 cases, and the results were all positive. After entire debridement of the focus, defects were repaired with autogenous bone, allogeneic bone, artificial bone, or bone cement, and then albendazole was used as a routine treatment for 3 months. Results Incisions healed by first intention, and no compl ication occurred. All patients were followed up 6 months to 11 years with a median time of 5.7 years. The preoperative cl inical symptoms were rel ieved. Eight cases recurred at 6 months to 3 years after operation; after debridement (3 times in 5 and 5 times in 1) and the lesions marginal resection with a high-speed burr (2 cases), the symptoms were relieved in different degrees without recurrence. No hydatid disease occurred and spreaded. Conclusion The cl inical manifestation of sacrum is not typical, which is easy to be misdiagnosed. MRI is helpful to diagnosis sacrum echinococcosis disease; serological examination is the major method of identification diagnosis, and surgery is the main treatment method.
ObjectiveTo summarize the clinical features of an adult patient with occult cerebral alveolar echinococcosis with liver and lung infection. MethodsA Tibetan male patient in his middle age from the epidemic area of echinococcosis infection was diagnosed to have liver, lung and cerebral alveolar echinococcosis infection in Ganzi People's Hospital. He had the resection surgery, and the pathological result confirmed the primary diagnosis. We searched the literatures from January 1985 to December 2015 for occult cerebral alveolar echinococcosis and reviewed all the full texts in China Journal Full-text Database. Seventeen articles were qualified and 42 patients were reported. Combining with the relevant English literature using Medline, we analyzed the epidemic, pathophysiological and clinical manifestations of cerebral alveolar echinococcosis infection and explored the methods of prevention and treatment. ResultsAccording to the results of literature analysis, cerebral alveolar echinococcosis appeared often secondary to infection of other organs. Nervous system symptom concealed or progressed slowly; imaging and pathological tests were important for diagnosis. Resection surgery was the essential method of cure. ConclusionAlveolar echinococcosis can affect multiple organs. In patients without neurological symptoms, if other organs are found to be infected, it is important to screen patients with intracranial involvement. Because this kind of patients with intracranial lesions with hydatid are often secondary to other organ infection, active treatment in early phase is necessary in order to avoid further expansion of lesions and metastasis.
ObjectiveTo investigate the effect ofγ-ray irradiation on echinococcus protoscoleces before abdominal cavity implantation in mice. MethodsEchinococcus protoscoleces were cultured in vitro, and then divided into 5 groups, four groups receivedγ-ray irradiation with 10 Gy, 20 Gy, 40 Gy, and 80 Gy, respectively. The remaining control group was not irradiated. The protoscoleces were then implanted into the abdominal cavity of mice. Four months later, the incidence of echinococcosis was measured by detection of echinococcus antibody in the blood and then abdominal laparotomy was performed to isolate intraabdominal cysts, and the weight and structure of the echinococcus generated from the protoscoleces were measured and observed. ResultsAfter implantation of irradiated echinococcus protoscoleces in mice, the incidence of echinococcosis was 100% in the control group, 80.0% in the 10 Gy group, 33.3% in the 20 Gy group, 33.3% in the 40 Gy group, and 26.7% in the 80 Gy group. The echinococci had lower weight in the irradiated groups with 10 Gy (35.80 mg), with 20 Gy (0.00 mg), with 40 Gy (0.00 mg), and with 80 Gy (0.00 mg) as compared with the control group (157.80 mg). The echinococcus generated from the protoscoleces appeared calcification. Conclusionsγ-ray irradiation could inhibit the formation of echinococcus granulosus generated from protoscoleces, damage the structure of echinococcus generated from the protoscoleces. Irradiation might prevent echinococcosis recurrence after surgical removal of hydatid cysts.
ObjectiveTo summarize regional and body distributions, diagnosis, treatment, and prognosis of echinococcosis outside liver in China. MethodsThe published literatures about echinococcosis outside liver in China (not including Hong Kong, Macao and Taiwan regions) from 2000 to 2015 were searched in the databases of CNKI and Wanfang. Data were extracted by using a standardized form and a retrospective clinical analysis was performed. ResultsA total of 66 published literatures about echinococcosis outside liver and data of 884 cases reported were collected. The regional proportions of cases reported were different, five high regions were Xinjiang (68.73%), Tibet (8.77%), Ningxia (6.75%), Qinghai (6.41%), Gansu (5.62%). The organ distributions of cases reported were also different, five high organs were lung (61.09%), bone (9.95%), brain (9.73%), spleen (8.60%), and kidney (6.22%). The main clinical symptoms of patients with echinococcosis outside liver included general asymptoms and organ dysfunction, and the most common examinations were X-ray (30.77%), B ultrasound (7.47%),CT(17.43%), MR (1.59%), and laboratory (36.31%). The main therapy choice was operation (73.30%), and some patients were performed operation combined with drug therapy. ConclusionRegional distribution of echinococcosis outside liver is almost the same as total echinococcosis, and distributed more in organs rich in blood supply, its clinical diagnosis mainly depends on imaging and immunology examination, and operation is still the main therapy choice.
Objective To discuss the strategy of surgical treatment for cardiac cystic echinococcosis. Methods We retrospectively analyzed the clinical data of 26 patients diagnosed with cardiac cystic echinococcosis between February 1978 and April 2013 in our hospital. There were 11 females and 15 females at a mean age of 28.9±7.6 years ranging 8-60 years. All patients underwent endocyst-punctured cystectomy, enucleation of intact endocyst and total cyst resection. Results All 26 surgeries were successful and there was no perioperative mortality. The mean time of operation was 110±32 minutes, and the mean time of hospital stay was 8.1±2.3 days. The mean follow-up time of 22 patients was 75±11 months ranging 15-190 months. There were 4 patients who were lost to follow-up. There were three recurrences and one late death. Conclusions We should choose the proper surgical method based on the patients’ condition.There is a certain effect and a low recurrance for surgical treatment of cardiac cystic echinococcosis.
ObjectivesEchinococcosis is one of the 10 most economically burdened diseases recognized by WHO in the world, and China has the highest prevalence of echinococcosis. Thus, the present study was conducted to systematically review the economic burden of echinococcosis in Chinese population.MethodsDatabases including Web of Science, PubMed, CNKI, WanFang Data and VIP were electronically searched from January 1st, 2008 to December 31st, 2018 to collect studies on the economic burden of echinococcosis in China. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Excel 2013 software was used for data entry and statistical analysis.ResultsA total of 27 studies were included. The analysis showed that the average cost of echinococcosis was approximately 21 201.85 yuan. The average cost of cystic echinococcosis was approximately 13 817.21 yuan. The average cost of alveolar echinococcosis was approximately 39 880.72 yuan. The average hospitalization cost of echinococcosis generally tended to rise from 2008 to 2018. The average age of patients ranged from 8.6 to 59.21 years, with the average length of stay in hospital was 17.12 days. Many of the included studies showed that patients’ age, length of hospital stay, medical insurance, and therapeutic outcomes have an impact on the economic burden of echinococcosis.ConclusionsThe average hospitalization cost of patients with echinococcosis in China is high and shows an upward trend. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.