Prevalence of human and ovine hepatic hydatid disease diagnosed by ultrasound in Hobukesar Mongolian Autonomous County of Xinjiang / 中华流行病学杂志

Objective To investigate the prevalence of human and ovine hepatic hydatid disease in Hobukesar Mongolian Autonomous County of Xinjiang (HMACX) and to evaluate the related strategies for prevention and control of the disease.Methods A prevalence screening method was used to screen local residents and sheep for hydatid disease in HMACX.Based on B ultrasound images,the screening programs on people and sheep in different sites were carried and the findings were comparatively analyzed.Results Findings of B ultrasound images through screening program among human beings showed that the positive rates of hydatid diseaseas 4.4％ (23/521),of cystic echinococcosis and alveolar echinococcosis as 4.0％ (21/521) and 0.8％ (4/521) respectively.The infection rate on sheep was 3.8％ (7/180).The positive rates of human and ovine hepatic hydatid disease in Township Chagangule were higher than in other areas.There was no significant statistical difference noticed on human positive rates between Township Chagangule and other areas.Statistically,significant difference for positive rate in ovine was seen between Township Chagangule and Township Bayinaowa (x2=4.8259,P=0.0280).As intermediate host of hydatid disease,the infection rate in sheep was higher than that in human beings at Township Chagangule.Conclusion HMACX remained a highly endemic area for human and ovine hydatid disease.

Immune responses on allograft heart transplantation in inbred rats infected with Echinococcosis multilocularis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis (E. multilocularis) and is a rare but life-threatening disease. This disease commonly is characterized by an infiltrative, tumor-like growth of the E. multilocularis metacestode in the liver of human. Liver transplantation is an effective therapy for end-stage of hepatic AE, but the characteristics of host immunity associated with E. multilocularis infection with organ transplantation are poorly defined. We hereby aimed to study the immunological status and allograft heart survival in inbred rats with E. multilocularis infection.</p><p><b>METHODS</b>Rat models of AE were established by injecting the E. multilocularis suspension made from E. multilocularis infected tissues into the abdomen of Lewis (LEW) rats. Three months later, in the experimental group, allograft heart transplantation was performed from Brown-Norway (BN) rats to the E. multilocularis infected LEW rats. In the control group, we transplanted hearts from BN rats to healthy LEW rats. The influence of the disturbed immune system in E. multilocularis infected rats on the heart transplantation was assessed, including observation of allograft heart survival time, histopathological examination of grafts and immunohistochemical examination of infiltrating cells (CD4(+) T cells, CD8(+) T cells and eosinophile granulocytes), measurement of interleukin (IL)-4 and interferon (IFN)-γ in the serum by enzyme-linked immunosorbent assay (ELISA) and analysis of CD4(+)CD25(+) regulatory T cells in peripheral blood by fluorescence activated cell sorting (FACS) flow cytometric analysis.</p><p><b>RESULTS</b>The survival time of recipients in the experimental group was prolonged compared with those in the control group. The numbers of graft infiltrating CD8(+) T cells were decreased whereas the graft infiltrating eosinophil granulocytes (CD15(+)) were increased in grafts in the experimental group (P < 0.05). Furthermore, the proportion of CD4(+)CD25(+) regulatory T cells in the peripheral blood was 10.8% on average in the experimental group, which was significantly higher than that in the control group (6.1%). In addition, the level of serum IL-4 in E. multilocularis infected rats was higher than that in the control group rats, whereas the level of serum IFN-γ in experimental group was lower than that in the control group when graft rejection occurred (P < 0.05).</p><p><b>CONCLUSIONS</b>This study suggests that E. multilocularis infection could prolong the allograft survival time through the polarization of Th1/Th2-type cells and induction of CD4(+)CD25(+) regulatory T cells. This strategy may provide a new idea for establishing transplantation tolerance.</p>

Systemic review of fast-track surgery in patients undergoing laparoscopic colorectal resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of fast track surgery(FTS) in patients undergoing laparoscopic colorectal resection.</p><p><b>METHOD</b>Randomized controlled trials(RCT) or clinical controlled trials(CCT) on fast-track surgery in patients undergoing laparoscopic colorectal resection were obtained from databases including CNKI, Wanfang, PubMed, EMBACE, and Cochrane Library between January 2000 and March 2012. Meta-analysis was performed with RevMan 5.1.</p><p><b>RESULT</b>There were 6 RCTs and 7 CCTs including 1795 patients. There were 955 patients in the FTS group and 840 in the control group. The time to passage of flatus was shorter(WMD=-1.37, 95%CI:-1.55~-1.19, P<0.05), time to resumption of diet/drink was shorter(WMD=-2.62, 95%CI:-2.69~-2.55, P<0.05), length of postoperative hospital stay was decreased(WMD=-1.63, 95%CI:-1.92~-1.34, P<0.05) and the incidence of postoperative complications were less(OR=0.52, 95%CI:0.41~0.67, P<0.05) in the FTS group. However, there were no differences in readmission(P>0.05).</p><p><b>CONCLUSION</b>Fast-track surgery in patients undergoing laparoscopic colorectal resection can promote bowel function recovery, decrease the incidence of postoperative complications and length of hospital stay.</p>

Community survey, treatment and long-term follow-up for human cystic echinococcosis in northwest China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Human cystic echinococcosis (CE) is a parasitic zoonosis of major public health importance throughout the world. CE is endemic throughout central Asia including northwestern China. In China, CE has been reported in 21 provinces, autonomous regions and municipalities, covering approximately 87% of China's territories. It is most common in the pastoral and semi-pastoral western provinces and regions. This study aimed to reveal the natural history, curative effect and possible re-infection risk factors of human CE through long termed follow-up of treated and untreated CE cases in Hobukesar, Xingjiang, China.</p><p><b>METHODS</b>Follow-up studies on CE were performed twice in Hobukesar from August 2005 to October 2008, after an initial mass screening performed in 1995 and 1996. Ultrasound scan was the primary diagnostic method.</p><p><b>RESULTS</b>Among 24 patients with confirmed CE, 22 were treated (surgery in 19 and chemotherapy in three). Two recurrent cases and one re-infection case were subsequently found during follow-up. The CE type of one of the recurrent cases reverted from CE4 to CE3, as classified using World Health Organization (WHO) guidelines.</p><p><b>CONCLUSIONS</b>Ultrasound was required to differentiate primary, recurrent and re-infection cases during epidemiological investigation and follow-up of CE. Most patients did not change their habits, which may be one possible cause of reinfection. One recurrent case suggested that, despite initial suggestion from the WHO Informal Working Group on Echinococcosis, CE4-type cysts are not inactive.</p>

Therapeutic effect of osteogenically induced adipose derived stem cells on vascular deprivation-induced osteonecrosis of the femoral head in rabbits / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To explore the therapeutic effect of osteogenically induced adipose-derived stem cells (ADSCs) on vascular deprivation-induced osteonecrosis of the femoral head (ONFH) in rabbit model.</p><p><b>METHODS</b>Vascular deprivation-induced ONFH was established by intramuscular injection of methylpre- dnisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks after the establishment of vascular deprivation-induced ONFH, animals were randomly divided into three equal groups. In Group A (control), no therapy was given. In Group B, core decompression was performed by drilling a hole (1.2 mm in diameter) from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 multiply 10(7) osteogenically induced ADSCs were resuspended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-dimensional microstructure of the femoral head was evaluated by micro-computed tomography scans. Immunohistochemical analysis was performed to detect the expression of osteocalcin. Angiogenesis and repair of the femoral head were observed histologically.</p><p><b>RESULTS</b>In trabecular bone at the proximal femur region, the trabecular volume was higher in Group C (130.70 mm(3)+/-4.33 mm(3)) than that in Groups A (101.07 mm(3)+/-7.76 mm(3)) and B (107.89 mm(3)+/-8.68 mm(3), P less than 0.01). Bone volume was significantly increased in Group C (40.09 mm(3)+/-6.35 mm(3)) than in Groups A (29.65 mm(3)+/-4.61 mm(3)) and B (31.80 mm(3)+/-4.01 mm(3), P less than 0.01). The trabecular number was higher in Groups C (1.58+/-0.25) than other two groups (1.15+/-0.18, 1.16+/-0.21, P less than 0.01). Bone mineral density showed statistically significant difference between Groups C and A or B (375.38+/-23.06) mg HA/ccm, vs (313.73+/-19.30) mg HA/ccm and (316.09+/-16.45) mg HA/ccm, P less than 0.01). Histological examination indicated that there was more new bone formation in Group C than in other groups.</p><p><b>CONCLUSION</b>Treatment with autologous osteogeni-cally induced ADSCs transplantation results in an enhanced osteogenesis and microstructure of the vascular deprivation-induced osteonecrosis in rabbits.</p>