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Objective:To observe multiple locus variable-number tandem repeat analysis (MLVA) typing of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province, and to explore the relationship between the strains and strains previous isolated from Qinghai Province. Methods:Blood samples of Himalayan marmot were collected in Qinghai-Tibet Plateau of Qinghai Province from March 2019 to October 2020. Pathogens were isolated and cultured from Brucella antibody positive samples identified by using the rose bengal test (RBT). Conventional biological methods and molecular biological methods (BCSP31-PCR and AMOS-PCR) were used for strain identification. At the same time, MLVA method was used to genotype the isolated strains, and cluster analysis was used to analyze the genetic relationships between the strains based on the genotype of 70 Brucella isolated from different hosts in Qinghai Province. Results:A total of 1 466 blood samples of Himalayan marmot were collected from Qinghai-Tibet Plateau. Two strains of Brucella were isolated and cultured from 64 RBT-positive samples, named QH2013054 and QH2013062, respectively. They were identified as Brucella ovis biotype Ⅲ by conventional and molecular biological methods. The MLVA genotyping results showed that QH2013054 and QH2013062 were different at the Bru16 locus, indicating different MLVA genotypes. Cluster analysis showed that strain QH2013054 had the same MLVA genotype as 7 strains, among which 6 strains were from 3 farmers and 3 sheep from the same family in Gonghe County, and 1 strain was from a farmer in Menyuan Hui Autonomous County. The strain QH2013062 had the same MLVA genotype as 4 strains, including 3 strains from 3 farmers in Menyuan Hui Autonomous County and 1 strain from a farmer in Tu Autonomous County of Huzhu. Conclusions:The strains of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province have the same MLVA genotype as some strains of Brucella isolated from humans and sheep in Qinghai Province. It is speculated that the host humans, sheep and Himalayan marmot in Qinghai-Tibet Plateau may have a common source of infection.
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[ Abstract] Objective To investigate the relationship between single nucleotide polymorphism (SNP) Fok (rs2228570 / rs10735810) of vitamin D receptor (VDR) gene and hypertensive disorder complicating pregnancy (HDCP) in Han nationality women of Qinghai province. Methods A total of 137 Han nationality HDCP subjects (HDCP group) and 146 Han nationality normal pregnant subjects (control group) were selected from Qinghai province. The Fok polymorphism typing in HCDP group and control group was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) . The mutation was confirmed by sequencing. SPSS 19. 0 statistical software was used to test whether there were significant differences between two groups in general clinical data, genotype and allele frequency distribution. Results The frequency of FF Ff ff genotype of Fok in HDCP group and control group were 51. 82%, 37. 96%, 10. 22% and 34. 93%, 43. 15%, 21. 92% respectively (
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@#Abstract: Objective To investigate the clustered regularly interspaced short palindromic repeats (CRISPR) genotypes and regional distribution of Yersinia pestis strains in the natural plague foci of Hainan Tibetan Autonomous Prefecture of Qinghai Province (referred to as "Hainan prefecture") and provide a scientific basis for plague prevention and control in this area. Methods A total of 36 representative Yersinia pestis strains, which were isolated from different host animals and insect vectors from 1954 to 2009 in Hainan Prefecture, were selected as experimental subjects. The DNAs were extracted using the traditional sodium dodecyl sulfate decomposition and phenol-chloroform method. Three pairs of CRISPR primers (YPa, Ypb, YPc) were used for PCR amplification, sequencing and analysis of the DNA of the tested strains, respectively, as a means to identify the CRISPR genotypes of Yersinia pestis in Hainan Prefecture. Results A total of 17 spacers were observed among 36 strains of Yersinia pestis, including 9 of YPa, 5 of YPb and 3 of YPc. All strains were divided into 5 CRISPR gene clusters (Cb2, Cb4 ', Ca7, Ca7 ', Ca35 ') and 6 genotypes (G1, G9, G22, G22-A1 ', G26-A1 ', G26-A1 'A4 -). The G26-a1 ' was the main genotype, which was distributed in Gonghe, Guide and Xinghai County, and the G22 is the second type, which was distributed in Gonghe and Guide County. Conclusions The genetic polymorphism of CRISPR loci of Yersinia pestis strains in Hainan was high, and the regional distribution characteristics of Yersinia pestis strains with different genotypes were significant.
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Objective: To analyze the epidemiological characteristics of pneumoconiosis in Qinghai Province from 2011 to 2020, and to provide a basis for the formulation of prevention and control strategy. Methods: In April 2021 , the cases of pneumoconiosis were monitored by the Occupational Disease and Health Hazard Factors Monitoring Information System in Qinghai Province from 2011 to 2020. The distribution of pneumoconiosis, the composition of diseases and the working years exposed to dust were analyzed. Results: All 1026 cases of pneumoconiosis were newly diagnosed in Qinghai Province from 2011 to 2020, silicosis and coal worker pneumoconiosis were the main diseases (78.36% ,804/1026). Stage Ⅰ pneumoconiosis were 484 (47.17%,484/1026) cases. 359 (34.99%,359/1026) cases, 315 (30.70%,315/1026) cases and 252 (24.56%, 252/1026) cases had been diagnosed respectively in Xining City, Haidong City and Haixi Prefecture; 628 (61.21%,628/1026) cases and 418 (40.74%, 418/1026) cases engaged in mining industry and large-sized enterprise, respectively. The working years exposed to dust in silicosis cases were shorter than that in coal worker pneumoconiosis and other pneumoconiosis (P <0.05). Conclusion: The pneumoconiosis area and industry focus in Qinghai Province is obvious. The supervision and adninistration of small and micro scale employers should be strengthened to protect the health rights and interests of workers, especially for the key area and industry.
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Humans , Anthracosis/epidemiology , China/epidemiology , Coal Mining , Dust , Health Services Accessibility , Human Rights , Pneumoconiosis/epidemiology , Silicosis/epidemiologyABSTRACT
@#Abstract: Objective To analyze the pathogenic characteristics and epidemiological significance of human plague related strains in Qinghai Province in recent 30 years, so as to provide scientific basis for on-the-spot disposal and prevention and control measures of plague outbreak in Qinghai Province. Methods A total of 35 strains of Yersinia pestis isolated from 29 typical human plague outbreaks in Qinghai Province from 1980 to 2011 were selected and studied by biochemical fermentation experiments. Virulence factors detection of Fraction 1 antigen (Fra1), virulence antigen (VW), pigmentation (Pgm) and Yersinia pestis Ⅰ (PstⅠ), determinants and genotyping of differential regions (DFRs) were used to study the pathogenic characteristics. At the same time, according to the epidemic situation of human and animal plague in Qinghai Province in recent years, the current situation of plague prevention and control and epidemic characteristics were analyzed. Results The biotypes of 35 strains of Yersinia pestis were classical, and the biotypes of 29 strains (82.86%) were of Qinghai-Tibet Plateau type, mainly distributed in southern Qinghai and around lake areas, 2 strains (5.71%) belonged to Qilian Mountains type, mainly distributed in Qilian mountains, and 6 genotypes were identified by DFR. Among them, 16 were type 5, 12 were type 8, 2 were type 10, 1 was type 36, 3 were type 30 and 1 was type 1b, the strains of type 5 and 1b were mainly distributed around the lake and the southern foot of Qilian Mountains, while the strains of type 8, 10, 36 and 30 were mainly distributed in the southern part of Qinghai. Conclusions The pathogen of Yersinia pestis in Qinghai Plateau has complex biochemical types, the epidemic situation among animals is continuous year after year, the situation of prevention and control is serious, the occurrence and prevalence of plague seriously endanger people's health and social development, so it is necessary to do a solid job in the prevention and control of plague to ensure the safety of people's lives.
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Objective:To investigate the genotypes of clustered regularly interspaced short palindromic repeats (CRISPR) of Yersinia pestis ( Y. pestis) and it's regional distribution in the plague natural foci of Qinghai-Tibet Plateau. Methods:In this study, 1 004 strains of Y. pestis isolated from different hosts and vectors in different regions from 1954 to 2011 were selected as experimental objects, which preserved in Qinghai Institute for Endemic Disease Prevention and Control, and DNA of Y. pestis was extracted by traditional phenol-chloroform method. Three CRISPR loci (YPa, YPb and YPc) were amplified by PCR and sequenced, respectively, and the CRISPR sequences were compared with the CRISPRDictionary database recently reported in the literature to identify CRISPR spacer. For the spacer discovered for the first time at each CRISPR locus, Blast sequence alignment was performed in the National Center for Biotechnology Information (NCBI) database to speculate the source of gene sequence. Genotyping of Y. pestis from Qinghai-Tibet Plateau was performed based on the polymorphism of CRISPR spacer array. Results:A total of 53 spacers were found in 1 004 strains of Y. pestis, of which 6 spacers were newly discovered, namely a105, a106, a107, b51, b52 and c14. The 1 004 strains of Y. pestis were divided into 10 groups with 44 different CRISPR genotypes, and 15 new genotypes were found. The dominant genotypes of Y. pestis were G26-a1', G7, G22, G24-a1', G22-a1', G9 and G26-a1'a60 in Himalayan Marmot plague natural foci, and G37-a6' in Qinghai Microtinae plague natural foci. Conclusion:The CRISPR genotypes of Y. pestis in the plague natural foci of Qinghai-Tibet Plateau are high diverse and have significant regional distribution characteristics.
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Objective:To analyze the results of serum erythropoietin (EPO) in adults patients with Kaschin-Beck disease (KBD) in Qinghai Province.Methods:According to the "Diagnosis of Kaschin-Beck Disease" (WS/T 207-2010), by using clinical examination and X-ray, adults over 20 years old in KBD areas of Xinghai County and Guide County, Hainan Tibetan Autonomous Prefecture, Qinghai Province, were divided into KBD case group ( n = 109) and internal control group ( n = 95) in July 2019. At the same time, healthy people were selected as external control group ( n = 90) in Xunhua County. Then 2 ml fasting cubital venous blood was collected from the target population to separate serum. The serum EPO level was determined by enzyme-linked immunosorbent assay (ELISA). Results:There was no significant difference in age and sex ratio among the 3 groups ( F = 0.73, P = 0.484; χ 2 = 1.03, P = 0.611). There was significant difference in serum EPO levels among the 3 groups [KBD case, internal and external control groups: (30.74 ± 26.23), (19.73 ± 11.53) and (10.83 ± 4.48) U/L, F = 26.51, P < 0.001]. Multiple comparisons showed that there were statistically significant differences in serum EPO levels between KBD case group and the internal and external control groups ( P < 0.05), but there was no significant difference between the internal and external control groups ( P > 0.05). Conclusions:The serum EPO level in adult KBD patients in Qinghai Province is increased significantly.
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Objective:To investigate the prevalence and the risk factors of Helicobacter pylori( H. pylori) infection in Qinghai Province with a multi-center cross-sectional study. Methods:From May to December in 2021, stratified sampling was conducted in Xining City, Haidong agricultural district, Hainan Tibetan Autonomous Prefecture, Haibei Tibetan Autonomous Prefecture and Yushu Tibetan Autonomous Prefecture by 20 centers, including the Affiliated Hospital of Qinghai University, Qinghai Red Cross Hospital and Qinghai Renji Hospital, etc. A questionnaire survey was carried out among the individuals undergoing routine health checkups. The questionnaire included general information, lifestyle and family history, etc. 13C-urea breath test was performed to diagnose H. pylori infection. Chi-square test, trend Chi-square test, segmentation method and multivariate logistic regression analysis were performed for statistical analysis. Results:The infection rate of H. pylori in Qinghai area was 53.6% (2 531/4 724). The age distribution of infection was statistically significant ( χ2=15.95, P=0.007), the infection rate in individuals aged 15 to<30 was higher than that of individuals aged 60 to< 75 (57.6%, 626/1 086 vs.49.5%, 231/467), and the difference was statistically significant ( χ2=8.83, P=0.003). With the increase of age, the infection rate decreased in female over 30 years old ( χ2trend=5.89, P=0.015). There were statistically significant differences in H. pylori infection rate among different ethnic groups ( χ2=28.13, P<0.001); the infection rate of Tibetan population was higher than that of Han population (62.9%, 313/498 vs. 51.5%, 1 804/3 503), and the difference was statistically significant ( χ2=22.56, P<0.001). The H. pylori infection rate in people living at an altitude >3 500 m was higher than that of people living at an altitude between 1 500 m and 3 500 m (61.8%, 327/529 vs. 52.5%, 2 204/4 195), and the difference was statistically significant ( χ2=16.25, P<0.001). Compared with those without corresponding habits, the infection rate of H. pylori was higher in smokers (62.1%, 1 081/1 740 vs. 48.6%, 1 450/2 984), in people who had the habit of eating hand grabbed mutton (55.4%, 967/1 744 vs. 52.5%, 1 564/2 980), raw garlic (55.5%, 968/1 744 vs. 52.4%, 1 563/2 980), spicy food (55.6%, 1 471/2 647 vs. 51.0%, 1 060/2 077), sweet food (55.2%, 1 187/2 149 vs. 52.2%, 1 344/2 575), the infection rate of tea drinkers was lower (50.5%, 1 135/2 247 vs. 56.4%, 1 396/2 477), and the differences were statistically significant ( χ2=80.94, 3.89, 9.63, 4.36, 4.13 and 16.19, all P<0.05). The results of logistic regression analysis indicated that Tibetan ( OR=1.379, 95% confidence interval (95% CI) 1.120 to 1.699), the Hui people ( OR=1.362, 95% CI 1.117 to 1.662), living at an altitude over 3 500 m ( OR=1.355, 95% CI 1.107 to 1.657), smoking ( OR=1.847, 95% CI 1.629 to 2.094), and spicy food ( OR=1.224, 95% CI 1.084 to 1.382) were independent risk factors of H. pylori infection (all P<0.05). Conclusions:The infection rate of H. pylori in Qinghai Province is higher than the average level in inland China. The infection rate of people with different ages, nationalities, altitudes of residence, occupations, living and eating habits were different. The infection rate of female over 30 years old is decreasing year by year. The infection risk is high in Hui people and Tibetan, spicy food lovers, smokers and people living at an altitude >3 500 m.
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Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.
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Objective To investigate the treatment status of patients over 65 years old with hypertension and multimorbidity in Qinghai, so as to provide reference for clinical treatment. Methods A total of 530 patients aged over 65 years old with hypertension involved multimorbidity in Qinghai were enrolled. The main disease types and polypharmacy were analyzed. Living with Medicines Questionnaire (LMQ) was used to assess the medical burden of patients, and the potentially inappropriate medication (PIM) was measured using screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria. Various indexes were analyzed, including age, gender, working status, marital status, educational level, solitary life, primary caregiver, sources of income, types of diseases, number of drugs per prescription and ways of obtaining prescriptions. The independent factors of irrational drug use in patients with hypertension and multimorbidity were discussed. Results ① Among the 530 subjects, the proportion of patients complicated with two diseases, three diseases, and four or more diseases was 71.70%, 20.00% and 8.30%, respectively. ② The top five combination types of multimorbidity were hypertension with coronary heart disease (26.04%), hypertension with dyslipidemia (16.04%), hypertension with diabetes (13.02%), hypertension with coronary heart disease and dyslipidemia (7.55%), hypertension with coronary heart disease and diabetes (3.96%).③ The types of drugs per prescription ranged from 1 to 11, with an average of 6.13 types, and the multiple medication rate reached 83.02% (440/530). ④ LMQ scale indicated that drug burden of patients with multimorbidity was at moderate to severe degree. ⑤ Taking STOPP/START as standard, the incidence of PIM was 32.64%.⑥ Multivariate Logistic regression analysis showed that education level and prescription obtained from secondary or above level hospitals were protective factors for PIM in patients with hypertension and multiple diseases, while the type of medication was a risk factor for PIM. Conclusion The elderly patients with hypertension and multiple diseases in Qinghai have a high multiple medication rate, and are in a state of moderate to severe drug burden, moreover, the PIM rate is also relatively high, so clinical standardization of drug use and reduction of drug burden are of vital importance.
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Qinghai province is located in the northeastern part of the Tibetan Plateau, and is an underdeveloped province of inland China. Chinese government gives high priority to the improvement of the wellbeing of Qinghai people, and have provided great supports in aspects of policy, funding, and professional resource to the development of health care and medical system in Qinghai. Great progress has been made, and wellness of residents in Qinghai has been significantly improved. This article reviews the strategies and measures from central and provincial government in improving health care of Qinghai province under the leadership of the Communist Party of China.
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Humans , China , Delivery of Health Care , GovernmentABSTRACT
Objective To investigate the relationship between preeclampsia (PE) and polymorphism of aldosterone synthase gene (CYP11B2) promoter region-344T/C in Qinghai Province. Methods A total of 120 PE subjects and 155 normal pregnancy subjects were studied. The genotype of CYP11B2 was analyzed by polymerase chain reaction fragment length polymorphism (PCR-RFLP). The mutation was confirmed by sequencing. Results The frequencies of CYP11B2 TT, CT and CC genotype in the PE group were 43.0%, 45.6%, and 11.4%, and in the control group were 51.0%, 45.1%, and 3.9%, respectively. There was difference in frequency distribution of CYP11B2 genotype between the PE and control groups. The frequency of C allele in the PE group was higher than the control group (χ
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Qinghai-Tibet Plateau is one of the major plague foci in China. Himalayan marmot (hereinafter referred to as the marmot) is the main host animals of the foci. Effective identification and monitoring of its habitat in Qinghai-Tibet Plateau is important for active prevention and effective control of the marmot plague epidemic. Spatial information technology is an important means for rapid identification and effective monitoring of marmot. This review analyzed the factors that affect the distribution patterns of marmot habitat, including topographical features, soil properties, vegetation types and cover, climatic conditions and human activities, and reviewed and summarized the progress and shortcomings of relevant research on identifying and monitoring marmot habitat based on spatial information technologies such as remote sensing and geographic information system. Meanwhile, combined with the emerging low-altitude remote sensing, crowdsource data acquisition, machine learning and other big data mining methods, from the perspective of multi-source data, integration of emerging technologies and comprehensive evaluation system, the new ideas of using spatial information technology to quickly identify and effectively monitor the habitat of marmot, was discussed. It is expected to provide technical support for prediction and effective control of marmot plague in Qinghai-Tibet Plateau under the background of changing global climate and increasing human activities.
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Objective To investigate the relationship between angiotensin converting enzyme (ACE) and angiotensinogen (AGT) gene expression, gene polymorphism and pregnancy-induced hypertension in Qinghai. Methods A total of 210 pregnant hypertensive patients (HDCP group) and 220 normal pregnant women (CK group) were enrolled. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect AGT M235T and ACE I/ D gene polymorphism. Results The proportions of ACE gene DD, ID, and Ⅱ in CK group were 28. 15%, 47. 73%, and 24. 09%, respectively. The HDCP group was 33. 81%, 51. 90%, and 14. 29%, respectively (P < 0. 05). The frequency distribution of ACE I/ D polymorphic alleles I and D was different between HDCP group and CK group(P<0. 05). D allele frequency was higher in HDCP group than in CK group (
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A serous membrane covering the liver and the hepatic parenchyma, consists of hepatocytes, arteries, veins, hepatic sinusoids and biliary ductuli. There are erythrocytes, thrombocytes, melanin particles and Kupffer cell in the hepatic sinusoids and the blood vessels. The gall bladder wall consists of a mucous layer a muscle layer and a serous layer. The bottom of the epithelium abounds with round or oval secretory. In liver, immunohistochemistry results show that AQP1 have intense reaction in hepatic lobule, Kupffer cells (Macrophagocytus stellatus), hepatocytes, portal tract, blood islands, vein and artery, but almost no reaction of AQP2 was detected. In gallbladder, mucous epithelium, endothelial cells from vein and artery all have strong AQP1 expression, AQP2 showed minor diffused positive reaction in gallbladder, which suggesting that AQP1 may have the main role in the absorption and transportation of fluid in hepatobiliary system of Qinghai Lizard.
Una membrana serosa cubre el hígado y el parénquima hepático el cual está formado por hepatocitos, arterias, venas, sinusoides hepáticos y conductos biliares. Se encuentran eritrocitos, trombocitos, partículas de melanina y células de Kupffer en los sinusoides hepáticos y en los vasos sanguíneos. La pared de la vesícula biliar presenta tres capas: mucosa, muscular y serosa. En el hígado, la inmunohistoquímica mostró que AQP1 tiene una reacción intensa en el lóbulo hepático, células de Kupffer, hepatocitos, tracto portal e islotes sanguíneos. En venas y arterias, no se detectó reacción alguna de AQP2. En la vesícula biliar, el epitelio mucoso, las células endoteliales venosas y arteriales tuvieron una importante expresión de AQP1, sin embargo, AQP2 mostró una reacción positiva difusa menor, lo que sugiere que la AQP1 podría tener una función principal en la absorción y transporte de líquido en el sistema hepatobiliar del Lagarto Qinghai.
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Animals , Aquaporins/metabolism , Gallbladder/metabolism , Liver/metabolism , Lizards , Immunohistochemistry , Aquaporin 1/metabolism , Aquaporin 2/metabolism , Gallbladder/ultrastructure , Liver/ultrastructureABSTRACT
Objective To investigate the clinical characteristics of patients with advanced hepatic alveolar echinococcosis, so as to provide more evidence for the diagnosis and treatment of advanced hepatic alveolar echinococcosis. Methods The clinical records of 175 cases with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from 2012 to 2017 were retrospectively reviewed. Results Among the 175 cases with hepatic alveolar echinococcosis, the male to female ratio was 1∶1.6, and the mean age was (38.6 ± 12.9) years (range, 11 to 69 years). 93.7% of the patients (164 cases) were Tibetan, and 79.4% (139 cases) were from Guoluo Prefecture. 73.7% (129 cases) were herdsmen, and 58.3% (102 cases) were illiterate. The major clinical symptoms included upper abdominal pain, yellowing of skin and mucosa, and scleral icterus. 69.1% of the lesions were located in bilateral livers, and 63.4% of the cases have 2 and more lesions. 53.7% of the cases have their inferior vena cava involved by the lesions. In addition, the most affected neighboring organ was diaphragmatic muscle (21.7%), and lung was the most affected distant metastatic site (40.6%). Conclusions Advanced hepatic alveolar echinococcosis is highly prevalent in Guoluo Prefecture, Qinghai Province. Screening of this disease is required in this region and rational treatment scheme should be developed.
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Objective To investigate the clinical characteristics of patients with advanced hepatic alveolar echinococcosis, so as to provide more evidence for the diagnosis and treatment of advanced hepatic alveolar echinococcosis. Methods The clinical records of 175 cases with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from 2012 to 2017 were retrospectively reviewed. Results Among the 175 cases with hepatic alveolar echinococcosis, the male to female ratio was 1∶1.6, and the mean age was (38.6 ± 12.9) years (range, 11 to 69 years). 93.7% of the patients (164 cases) were Tibetan, and 79.4% (139 cases) were from Guoluo Prefecture. 73.7% (129 cases) were herdsmen, and 58.3% (102 cases) were illiterate. The major clinical symptoms included upper abdominal pain, yellowing of skin and mucosa, and scleral icterus. 69.1% of the lesions were located in bilateral livers, and 63.4% of the cases have 2 and more lesions. 53.7% of the cases have their inferior vena cava involved by the lesions. In addition, the most affected neighboring organ was diaphragmatic muscle (21.7%), and lung was the most affected distant metastatic site (40.6%). Conclusions Advanced hepatic alveolar echinococcosis is highly prevalent in Guoluo Prefecture, Qinghai Province. Screening of this disease is required in this region and rational treatment scheme should be developed.
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Objective To observe the changes of inflammatory factors after the hepatic cystic echinococcosis surgery and explore the intervention effect of ulinastatin on postoperative inflammatory factors. Methods Sixty patients with hepatic cystic echinococcosis were selected and randomly divided into a control group and ulinastatin intervention group according to whether or not use ulinastatin. The peripheral venous blood was extracted in all the patients and the levels of IL-6, IL-8, IL-9, and IL-10 were detected by the ELISA method on the day before operation, 1 day, 3 days, 5 days and 7 days after operation, respectively. The data was statistical analyzed to detect the relationships between/among the inflammatory factors mentioned above and ulina-statin and time. Results The variation of the levels of IL-6, IL-8, IL-9, and IL-10 were changed by the intervention of ulina-statin at different time. The differences of the levels of IL-6, IL-8, IL-9, and IL-10 between the ulinastatin intervention group and the control group were not significant on the day before operation, 1 day and 3 days after operation (t = -1.15 to 1.82, all P > 0.05), but the levels of IL-6, IL-8, IL-9, and IL-10 of the ulinastatin intervention group were significantly lower than those of the control group and there were statistically significant differences 5 days and 7 days after the operation (t = 3.22 and 23.51, both P<0.05) . Conclusion Ulinastatin has a good effect in inhibiting the inflammatory factors and can protect and repair the postoperative hepatic injury as well in patients with hepatic cystic echinococcosis.
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Objective To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases. Methods The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People’s Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed. Results The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257–2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients. Conclusions The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.
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Objective To amplify and sequence Coxl and Nadl genes in Echinococcus multilocularis isolates from Qinghai Province, and to create phylogenetic trees and molecular clocks, so as to provide evidence for estimating the evolutionary relationships and origins of E. multilocularis in Qinghai Province. Methods Twenty-two post-surgical specimens of patients with hepatic alveolar echinococcosis were sampled from Qinghai Provincial People’s Hospital in 2017. The Coxl and Nadl genes were amplified from E. multilocularis samples and sequenced. Then, the gene sequences were aligned to the Coxl and Nadl genes of Echinococcus species in GenBank database. The intra-species variation was observed, and the phylogenetic tree and molecular clock were created. Results All E. multilocularis samples shared more than 99% genetic homology with the sequences of Coxl and Nadl genes from the E. multilocularis Asian strain in the GenBank database. A total of 6 genotypes were identified, including 2 isolates that had no 100% homology with the sequences of known genes in the GenBank database. Phylogenetic tree analysis revealed remarkable clustering of the E. multilocularis samples with the E. multilocularis Asian strain, and the E. multilocularis isolates from Qinghai Province were estimated to date back to 94 000 years ago by the molecular clock. Conclusions The present study characterizes 6 E. multilocularis genotypes in Qinghai Province, including 2 novel genotypes. Asian strain is the predominant strain of E. multilocularis in Qinghai Province, and the E. multilocularis isolates from Qinghai Province date back to 94 000 years ago.