46例横纹肌内猪囊尾蚴病的病理观察

对４６例横纹肌内猪囊尾蚴病进行了病理学观察。病理检查发现，２４例以囊性结节就诊者，囊虫存活并见头节；另２２例中３例见完整死虫，１例见虫体残骸，１８例仅为肉芽肿而无虫体。对本病的病理变化与虫体存活、死虫及无虫体的关系作了简要讨论。     

46例横纹肌内猪囊尾蚴病的病理观察

对４６例横纹肌内猪囊尾蚴病进行了病理学观察，病理检查发现，２４例以囊性结节就诊者囊虫存活并见头节，另２２例，中３例见完整死虫，１例见虫体残骸，１８例仅为肉芽肿而无虫体。对本病的病理变化与虫体存活，死虫及无虫体体的关系作了简要讨论。     

CT联合MRI在脑囊虫病初诊及复查的运用探究

目的 探讨CT联合MRI在脑囊虫病初诊及复查中的应用效果。方法 回顾性分析金华市人民医院及贵州省从江县人民医院2020年5月至2022年5月收治的73例脑囊虫病患者的临床资料,所有患者在初诊时均行CT平扫联合MRI检查,比较两种图像表现。所有患者接受吡喹酮口服治疗,10 d为一个疗程,停药观察45 d,再进行下一疗程的治疗,每个疗程治疗前后复查CT及MRI,直至虫体影像学显示钙化,观察复查过程中CT及MRI影像学表现。结果 经CT检查确诊为脑囊肿病65例,经MRI检查确诊为脑囊虫病72例,两种检查的确诊率比较,差异具有统计学意义(P<0.05);脑实质型CT表现为幕上半球低密度,全脑肿胀,伴有多发小囊型,大小5～10 mm;单发性大囊型无实性结节,边界清晰;多发钙化型,多数仅表现为钙化;脑室型CT表现为脑室形态异常,有局限性不对称扩大,脉络丛有一定程度的位移,部分可见囊壁钙化;脑膜型CT表现为侧裂池、鞍上池轻度占位,蛛网膜下腔扩大,脑室对称性扩大,CT无法判断脑囊虫病各期。存活期MRI表现为囊性病灶,大小2～8 mm,内部见偏心性等T1、短T2信号头节,周围有轻度的水肿;变性死亡...     

177例脑囊虫病误诊原因分析

目的了解脑囊虫病的误诊原因,减少误诊率,提高诊断率及治疗效果。方法通过回顾性病例分析,从鉴别诊断学方面对脑囊虫病的误诊原因进行了分析。结果177例误诊病例中脑囊虫病误诊为其他疾病者132例(74.58%),其他脑部疾病误诊为脑囊虫病者45例(25.42%),其中脑肿瘤与脑囊虫病相互误诊病例达43例(24.29%);小脓肿型脑囊虫病误诊率最高,误诊病例为63例(35.59%)。结论对脑囊虫病缺乏足够的认识,忽视了对流行病学资料的分析;对脑部症状未作详细的鉴别诊断;缺乏特殊的检查条件是误诊的主要原因。     

78例脑囊虫病患者脑脊液中循环抗原检测与脑CT改变

目前,脑囊虫病的诊断中,脑CT检查和抗体测定已被广泛应用。该病特异性抗原的检测起步较晚,尤其是应用单克隆抗体检测循环抗原与比较能客观地反映脑组织中囊虫病变新老程度的脑CT检查之间的关系尚未见报道。本文通过对78例脑囊虫病患者CSF中CAg的检测与脑CT囊虫各期变化的系统分析,发现了它们之间的内在联系。材料和方法一、材料 78例患者均按马云祥1985年诊断标准确诊的脑囊虫病住院病例。其中,男60例,女18例。年龄10～64岁,平均37.7岁。病程最短15d,最长16年,平均4年。高颅压患者(≥1.96kPa)33例(42.3％)。头痛61例(78.2％),癫痫54例(69.2％),皮下结节27例     

囊虫性脑内小脓肿40例诊治分析

囊虫性脑内小脓肿４０例诊治分析廉辰１郑万忠１陈静歧１李雪松２王玉新３１．河北省邯郸市中医院（０５６００１）２．河北省邯郸钢铁总厂职工医院３．河北省邯郸市第一医院我院自１９９２年～１９９５年１２月收治囊虫性脑内小脓种４０例，采用中、西药结合治疗，取得满...     

小脓肿型脑囊虫病5例临床分析

小脓肿型脑囊虫病５例临床分析哈尔滨医科大学附属二院（１５００８６）郝艳秋胡孟瑛赵颖黑龙江省虎林市妇幼保健院丛桂风黑龙江省虎林市迎春林业局医院王兰近年来随着计算机体层成像（ＣＴ）的发展，对脑囊虫病的诊断准确性越来越高。而小脓肿型的脑囊虫病，不仅在临床上...     

脑囊虫病脑CT误诊为胶质细胞瘤86例分析

在脑囊虫病的 CT诊断中 ,“囊虫性小脓肿型”脑囊虫病被误诊为胶质细胞瘤而手术者不乏其例。如何判断这两种病因、治疗手段及预后截然不同的疾病 ,是值得重视的问题 ,现将 86例脑囊虫病 CT误诊为胶质瘤病例分析如下。临床资料86例中 ,男 5 2例 ,女 34例 ,年龄 8～ 5 2岁 ,其中 10岁以内者 35例 ,11～ 18岁 31例 ,19～ 5 2岁 2 0例。病程 3d～ 2年。其中 3d～ 1月 40例 ,1月～半年 34例 ,半年～ 2年 12例。主要临床表现为 :癫痫大发作者 48例 ,局限性发作者 2 0例 ,伴有一侧肢体活动受限者 42例 ,伴有头痛、呕吐、复视者32例。症状呈发作性…     

脑囊虫病160例的CT分析

目的 :为正确诊断脑囊虫病及合理治疗提供依据。方法 :对 160例脑囊虫病 CT进行分析。结果 :根据 CT检查结果将脑囊虫病分为脑实质型、脑室型、脑膜型和混合型等 4型 ;其中脑实质型又分轻度、中度、重度 3类 ,轻度预后好 ,重度预后差。结论 :脑囊虫病病灶的部位和数量与病情的轻、重及预后有关。 CT检查对脑囊虫病的诊断具有重要价值。     

寄生虫病的诊断进展

随着免疫学、分子生物学以及影像学等新技术、新方法的建立和应用,寄生虫病的诊断已从单纯的病原形态学诊断和简单的血清学试验发展到分子水平。现将近年来寄生虫病的诊断进展作一简述。一、影像学诊断进展1.超声诊断超声作为一种非介入的检查方法,近年来已广泛用于血吸虫病流行区现场诊断,并有虫种鉴别的价值,如超声发现门脉管壁增厚表明可能为曼氏血吸虫病;肝脏呈现鱼鳞状或网络状超声图像可能为日本血吸虫病;膀胱壁有钙化则多为埃及血吸虫病。通过超声检查,还可对病变损伤程度以及进展状态作出判断。此外,超声扫描还能查出直径2cm 的包虫和无症状虫囊携带者。2.电子计算机断层摄影(CT)诊断进展 CT诊断现已为某些寄生虫病诊断的重要手段。CT 不仅对脑囊虫病的活动期、非活动期和混杂期作出判断,尚可分型,其中脑内小脓肿(CysticercoticScesses)的新概念日益受到国内外学者的重视。3.磁共振(MR)MR 在寄生虫病诊断中的应用与 CT 相似,但分辨力更好,明显优于 CT。如 MR将脑囊虫病分为明显的4期10型,对指导临床治     

Comparative Study on Presentation of Biliary Ascariasis with Dead and Living Worms

Background/Aim:

Ascariasis is a common parasitic infestation in Asia and Latin America. The most serious presentation is biliary and pancreatic ascariasis (BPA). The aim of the present study was to compare the clinical presentation of BPA with dead worms with that with living worms.

Materials and Methods:

We included 138 consecutive cases of BPA that occured during the period January 2005 to July 2009. All the patients had endoscopically proven BPA consisting of living or dead worms. Comparison was done by chi-square and independent t tests.

Results:

The age (mean ± SD) of the patients was 36.8 ± 16.1 years. Prevalence ratio between male and female patients was 1:5. Ninety eight patients contained living worms and 40 had dead worms. Males were more prone to develop dead worm BPA. The commonest presentation was biliary colic (131; 94.9%); others were acute cholangitis (30; 21.7%), obstructive jaundice (19; 13.8%), choledocholithiasis (20; 14.5%), acute pancreatitis (10; 7.2%), acute cholecystitis (6; 4.3%), liver abscess (2; 1.4%), hepatolithiasis (3; 2.2%), stricture of common bile duct (2; 1.4%), pancreatic abscess (1; 0.7%) and cirrhosis of liver (1; 0.7%). Choledocholithiasis, hepatolithiasis, liver abscess and cirrhosis were associated only with dead worms. We could successfully remove all the worms with endoscopic interventions, but 5 patients required surgical intervention as there were strictures and stones within the biliary tree or Ascaris were in gallbladder. Recurrences of stone and cholangitis occurred only in those with dead worms.

Conclusion:

Biliary ascariasis with dead worms is more dangerous than that with living worms. Endoscopic or surgical intervention may be required repeatedly in those with dead worms.     

Presentation and endoscopic management of biliary ascariasis

Ascaris lumbricoides is a common parasite and the most serious and dramatic presentation is hepatobiliary and pancreatic ascariasis (HPA). Therefore, this study was planned prospectively to elucidate the clinical presentation of HPA and evaluate the efficacy and safety of endoscopic intervention. In this study we documented 77 consecutive patients with HPA from January 2000 to November 2005. All the patients had endoscopically proven HPA. A total of 77 patients were included in the study. The age ranged from 6 to 80 years, with the third decade most commonly (28.6%) affected. Females were 6 times more likely to be affected than males. The commonest presentation was biliary colic (97.4%); other presentations were acute cholangitis (15.6%), obstructive jaundice (9.1%), acute pancreatitis (6.5%), choledocholithiasis (6.5%), acute cholecystitis (6.5%) and liver abscess (2.6%). In this report 51 (66.2%) had living, 10 (13%) had dead and 16 (20.8%) had both living and dead worms. Choledocholithiasis was associated only with dead worms. From one to 23 worms were found in the biliary tree. In 94.8% of cases we had to remove the worm by wide papillotomy followed by basket extraction. We did not experience any major complications during or following the procedures. Three patients had recurrent HPA during the course of follow-up (1 to 12 months). The majority of patients with HPA presented with biliary colic. This should be kept in mind in the management of an acute abdomen, especially in tropical countries. Endoscopic extraction is a safe and effective procedure for the treatment of HPA.     

麦地那龙线虫病在我国首次发现

从安徽阜阳农村一位12岁男性儿童的左则腹壁脓肿内检获1条雌性虫体标本,其大小为166.0×1.3mm,从虫体子宫内检出大量的尾部细长的幼虫,幼虫大小平均为636.0×18.9um。虫体经形态学和切片观察,证实是一条雌性麦地那龙线虫成虫。这是我国首次发现麦地那龙线虫感染人体病例。     

囊虫散胶囊治疗脑实质型脑囊尾蚴病的临床研究

目的观察囊虫散胶囊治疗脑实质型脑囊尾蚴病的临床疗效。方法选择脑实质型囊尾蚴病300例，随机分为3组，分别用吡喹酮，囊虫散胶囊及囊虫散胶囊＋吡喹酮治疗，对疗效、不良反应、治疗前后囊尾蚴钙化灶变化进行对比分析；囊虫散注射皮肌囊尾蚴结节，观察囊虫散胶囊杀灭囊尾蚴作用。结果囊虫散胶囊组治愈率82．1％，吡喹酮组治愈率67．4％，中西药结合组87．6％，差异有显著性（P〈0．01）。不良反应发生率，囊虫散胶囊组最低。囊虫散注射皮肌囊尾蚴结节，杀虫总有效率为97．6％（41／42）。结论囊虫散胶囊治疗脑实质型脑囊尾蚴病效果显著，不仅具有杀虫作用，同时促进死虫吸收，而且不良作用小，安全可靠。     

Value of the color test in assessing the viability of cysts of Acanthamoeba sp

The eosin colour test estimating the viability of cysts was compared with the method of in vitro excystation on agar substrate (NNE). Single cysts were studied, isolated from populations stored under sterile conditions in water at 4 degrees C for a period ranging from a few days to 16 years. It has been found that the inoculations of single cysts (805 cysts) on the NNE substrate allow a precise determination of the percentage of living cysts. All the cysts stained with eosin, incubated on such a substrate proved to be dead, while the non-staining cysts ex-cistated with varying percentage. Thus, among the non-staining cysts of Acanthamoeba after 2-4 years of storage at 4 degrees C 89.2% excystated while the remaining ones were dead. After 16 years of storage only 29.8% nostaining cysts excystated. Very similar values (89.6 and 28.5% respectively) were obtained when determining the percentage of living cysts with the colour test. The eosin test has proved to be a good method of the estimation of the viability of cysts of Acanthamoeba.     

Metronidazole ("Flagyl") in dracunculiasis: a double blind study.

Two-hundred and twenty-nine cases dracunculiasis were selected for a double-blind trial of metronidazole against placebo. A cure rate of 85% was observed with metronidazole. A dosage of 400 mg metronidazole three times daily for 10-20 days appears suitable. Even with secondarily infected lesions, it was unnecessary to administer any other chemotherapeutic agent. In most cases symptomatic relief, especially of pain and pruritus, was obtained within two weeks. In patients with only subcutaneous worms, metronidazole did not apparently prevent the development of lesions and seemed to stimulate the worm to emerge quickly, with resultant less severe lesions. Complete cure was delayed in patients with multiple lesions, where worms reached the emergence state at different times. There did not appear to be any direct relationship between severity of the disease and response to metronidazole. If the worm was broken during treatment with metronidazole, no abscess formed nor was there any local inflammation. Metronidazole was very well tolerated even when administered for 20 to 25 days. No serious side-effects or toxic effects were observed.     

口服三苯双脒不同疗程抗小鼠旋毛虫成囊期幼虫的效果观察

目的比较以不同疗程口服300mg/（kg.d）三苯双脒抗小鼠横纹肌中旋毛虫成囊期幼虫的效果。方法 40只8周龄BALB/c小鼠被随机均分为5组,每只小鼠口饲感染旋毛虫成囊期幼虫50条。感染后第29d,分别以不同疗程（连续给药2、4、6、8 d）口服三苯双脒300mg/（kg.d）治疗,对照组不治疗。记录小鼠健康状况。停药后第7d,颈椎脱臼处死小鼠。肌肉压片法观察小鼠膈肌、咬肌、胸肌、腓肠肌中成囊期幼虫存活情况,计数总虫数、活虫数和死虫数。另取40只8周龄BALB/c小鼠,随机均分为5组,分别用不同疗程治疗后的小鼠膈肌成囊期幼虫50条口饲感染,感染后第29d,肌肉压片法计数膈肌中成囊期幼虫。结果实验期间,各组小鼠健康状况良好,未见药物不良反应。随着疗程的增加,4个部位肌肉中幼虫总虫荷和活虫数均呈下降趋势,而死虫数呈上升趋势。与对照组相比,2 d及2 d以上疗程组膈肌、咬肌和腓肠肌中成囊期幼虫总虫数和存活虫数均显著减少（P〈0.05、P〈0.01）,6 d疗程组和8 d疗程组胸肌总虫数显著减少（P〈0.05、P〈0.01）。随着疗程的增加,膈肌、咬肌、胸肌和腓肠肌的幼虫死亡率呈上升趋势,其中6 d疗程组分别为96.16%、98.06、99.13%和98.56%（P〈0.01）,8 d疗程组为99.62%~100%（P〈0.01）。疗效验证性感染表明,6 d（37.5%）和8 d（12.5%）的感染率显著低于对照组（100%）和2 d（100%）疗程组（P〈0.01）。2 d及以上疗程组小鼠平均虫荷和平均减虫率均显著低于对照组（P〈0.01）。结论口服TBD 300mg/（kg.d）,连续给药6 d或8 d,无不良药物反应,可有效杀死肌肉中的成囊期幼虫,为适宜疗程。     

Septic metastatic lesions of pyogenic liver abscess. Their association with Klebsiella pneumoniae bacteremia in diabetic patients

Septic metastatic endophthalmitis from Klebsiella pneumoniae liver abscess, first reported in seven cases treated at the Veterans General Hospital, Taipei, Taiwan, between 1981 and 1985, was seen in six similar cases at the same hospital in the subsequent 2 years. We conducted a retrospective search for factors that might be associated with these complications of pyogenic liver abscess. A total of 23 cases with septic metastatic lesions from pyogenic liver abscess were found between 1981 and 1987, and 164 cases of pyogenic liver abscess without septic metastatic lesions were identified as a comparison group. Klebsiella pneumoniae liver abscess, bacteremia, and the underlying diabetes mellitus were significantly more common in the study group than in the comparison group. Of the 23 patients with septic metastatic lesions, there were 14 cases (60.8%) of endophthalmitis or uveitis, 10 cases (43.4%) of pulmonary abscess and/or emboli, six cases (26.0%) of brain abscess and/or purulent meningitis, five cases (21.7%) of bacteriuria and/or prostate abscess, two cases (8.6%) of osteomyelitis and/or pyogenic arthritis, and one case (4.3%) of psoas abscess.     

三种淡水螺与广州管圆线虫相容性的实验研究

目的 比较福寿螺、中国圆田螺、铜锈环棱螺等3种食用淡水螺与广州管圆线虫的相容性。 方法 在相同条件下，用广州管圆线虫福建株感染3种螺，1、3、6、12及24 h后，随机抽样各20只，分别饲养于置有滤水器、水温（24±1）℃ 的玻璃缸内。记录感染2周内各组螺死亡数。第15天开始解剖，记录螺软体重量和感染虫数。同时设不感染螺对照组。 结果 3种螺感染后第1周死亡数达高峰。感染率和死亡率与螺的种类及感染时间均无相关性。虫负荷与虫密度，福寿螺感染6、12及24 h均显著高于感染1 h的（P值均<0.05）；铜锈环棱螺，感染24 h的均显著高于感染 1、3、6及12 h的（P值均<0.05）；中国圆田螺，感染1、3、6、12及24 h各组间差异均无显著性（P值均>0.05）。福寿螺感染6、12及24 h的虫负荷均显著高于铜锈环棱螺和中国圆田螺（P值均<0.05）。 感染6、12及24 h，福寿螺及铜锈环棱螺虫密度均高于中国圆田螺（P值均<0.05）。 结论 3种螺对广州管圆线虫均易感并有较高的相容性， 其中福寿螺的相容性较强。     

肺包虫囊肿破裂误诊38例分析

目的提高对肺包虫囊肿破裂的认识。方法回顾性分析肺包虫囊肿破裂38例误诊的临床资料。结果38例肺包虫囊肿破裂均经手术和病理诊断证实，误诊1—8个月。误诊为肺炎11例，肺脓肿4例，肺结核13例，肺肿瘤6例，胸膜炎2例，液气胸2例。临床表现有突发性呛咳，咳清水样痰液并混有粉皮样薄碎片，或咳脓痰，发热。Casoni试验均阳性。X线检查：右肺包虫囊肿26枚，左肺包虫囊肿12枚。病灶呈模糊大片状阴影18例，类圆形阴影8例，肺包虫囊肿顶见“新月征”4例，“水上浮莲征”4例，液气胸2例，胸腔积液2例。经抗感染等综合治疗后，手术除包虫内囊29例，包虫囊肿肺叶切除9例，38例全部治愈。结论肺包虫囊肿破裂可被误诊为其他疾病，常误诊为肺炎和肺结核。