Objective To investigate the effect of echinococcus granulosus antigen B on the severity of streptozotocin induced diabetes mellitus.Methods Thirty male BALB/c mice were randomly divided into 3 groups:echinococcus granulosus antigen B group (group A,n =10),normal saline group (group B,n =10),control group (group C,n =10).Mouse in group A was injected by echinococcus granulosus antigen B and mouse in group B was given normal saline,Type 1 diabetes was induced.After 3 weeks,mice were executed and pancreases were scored on insulitis by HE staining.Serum IFN-γ and IL-4 levels were measured by ELISA.Results After 3 weeks of the establishment of diabetes model mouse body weight in group B and C decreased significantly compared with that in group A.Mouse mean blood glucose level in group A was significantly lower than that in group B and C.There were less than 40％ of islets with lymphocytic infiltration in group A,compared with 80％ in group B.The average Ridit was 0.423,0.519,and 0.561 in group A,B and C respectively,P ＜ 0.05.IL-4 level in group A was significantly higher than that in group B and group C [(71.6 ± 12.4) ng/ml,(12.6 ± 5.6) ng/ml,(14.2 ± 7.2) ng/ml,P ＜ 0.05].IFN-γ level in group B and group C were higher than that in group A [(276.1 ± 41.7) ng/ml,(352.2 ± 52.2) ng/ml,(358.1 ± 53.4) ng/ml,P ＜ 0.05].Conclusions Type 1 diabetes is organ specific T lymphocyte mediated autoimmune disease.Echinococcus granulosus antigen B has protective effects on diabetes mellitus in mice couteracting autoimmune injury to the islets by streptozotocin,probably by a mechanism related to immune deviation of Th1 to Th2.

OBJECTIVETo explore and compare the clinical effect and safety of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) in the treatment of cystic echinococcosis (CE1, CE2, and CE3).

METHODSA total of 269 cases treated with cystic echinococcosis (CE) in Xinjiang Medical University the First Affiliated Hospital from 1998 to 2008 were reviewed. 51 cases were excluded and 218 cases were enrolled in this research by retrospective case-control method. Among 110 cases were treated with L-ABZ and 108 cases were treated with T-ABZ for short-term (3 months) and long-term courses (6 months) respectively. The effects and safety of the two medicines were compared by analyzing the clinical symptoms, imaging check and serologic test results.

RESULTSIn short-term effect evaluation, the total effective rates and curative rates of L-ABZ group and T-ABZ group were 77.9% and 49.1% vs 28.4% and 13.9%, respectively. The effects of L-ABZ group was better than that of T-ABZ group, with remarkable difference in total effective rates and curative rates (x2 value was 19.581, 6.877, respectively, P is less than 0.05). In long-term effect evaluation, the total effective rates and curative rates of L-ABZ and T-ABZ group were 81.7% and 49.0% vs 47.6% and 20.6%, respectively. There was significant difference between L-ABZ group and T-ABZ group in total effective rates and curative rates (x2 value was 20.977, 15.049, respectively, P is less than 0.05). In T-ABZ group the short-term curative rates were 50.0% (15/30), 8.8% (8/91) and 33.3% (7/21) respectively in CE1, CE2, and CE3, the short-term total effective rates were 56.7% (17/30), 35.2% (32/91) and 61.9% (13/21) respectively in CE1, CE2, and CE3. The long-term curative rates were 58.3% (7/12), 28.6% (12/42) and 70.0% (7/10) respectively in CE1, CE2 and CE3, the long-term total effective rates were 75.0% (9/12), 69.0% (29/42) and 100.0% (10/10) respectively in CE1, CE2, and CE3. When compared with CE2, differences existed in CE1 (x2 = 24.887, 4.329; P is less than 0.05) and CE3 groups (x2 = 8.860, 5.076; P is less than 0.05) in terms of short-term effects. In L-ABZ group, the short-term curative rates were 47.4% (18/38), 12.2% (12/98) and 61.5% (8/13) respectively in CE1, CE2 and CE3, the short-term total effective rates were 92.1% (35/38), 65.3% (64/98) and 92.3% (12/13) respectively in CE1, CE2 and CE3, the long-term curative rates were 79.3% (23/29), 35.9% (23/64) and 50.0% (3/6) respectively in CE1, CE2 and CE3, the long-term total effective rates were 96.6% (28/29), 84.4% (54/64) and 100% (6/6) respectively in CE1, CE2 and CE3. When compared with CE2, there were significant differences in CE1 (x2 = 19.648, 9.930; P is less than 0.05) and CE3 groups (x2 = 18.880, 3.876; P is less than 0.05) in terms of short-term effect. In L-ABZ and T-ABZ groups, the drug-related adverse effects were 11.1% (12/108) and 12.7% (14/110) respectively without significant difference (x2 = 0.155, P is more than 0.05).

CONCLUSIONL-ABZ and T-ABZ were both effective anti-echinococcosis drugs without dominant side-effects. The clinical effect of L-ABZ was better than that of T-ABZ.

Adolescent ; Adult ; Aged ; Albendazole ; administration & dosage ; adverse effects ; therapeutic use ; Echinococcosis ; drug therapy ; Female ; Humans ; Liposomes ; administration & dosage ; Male ; Middle Aged ; Retrospective Studies ; Tablets ; administration & dosage ; Young Adult

Adolescent ; Adult ; Aged ; Child ; Echinococcosis, Hepatic ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To evaluate the timing of postoperative laparoscopic cholecystectomy (LC after ERCP for the treatment of gallstones.Method A retrospective analysis was made on 120 patients with choledocholithiasis and cholecystolithiasis from Feb 2015 to Feb 2018 in the First Affiliated Hospital of Xinjiang Medical University,including 62 patients receiving LC at 48-72 h after ERCP + EST (observation group),and 58 patients receiving LC at 72h after ERCP + EST (control group).The hospital stay,hospitalization costs,operation time,intraoperative blood loss,convertion to open laparotomy,the postoperative complications were compared between the two groups.Results The difference of age,gender,ERCP operation time,common bile duct stones diameter,postoperative complications were not statistically significant in two groups.Operation time,intraoperative blood loss,hospital stay,incidence of laparotomy and hospitalization costs in group A were significantly less than that in group B (P ＜ 0.05).Conclusions ERCP + EST followed by LC for choledocholithiasis with cholecystolithiasis within 48-72 hours were with shorter operation time,lower hospital costs,without an increase of postoperative complications compared with ERCP + EST followed by LC after 72 hours.

Objective:To identify the independent risk factors affecting the prognosis of gallbladder cancer after radical resection, and to develop and validate the nomogram of predictive model.Methods:The clinical data of 147 patients with gallbladder cancer treated in the First Affiliated Hospital of Xinjiang Medical University from January 2012 to January 2022 were retrospectively analyzed, including 53 males and 94 females, aged (61.45±10.76) years old. The patients were followed up by outpatient or telephone review. The Kaplan-Meier method and log-rank test were used for survival analysis. The variables of P<0.1 in univariate analysis were included in the minimum absolute convergence and selection operator (LASSO) regression model, and the predictive factors affecting the prognosis of gallbladder cancer were screened. The predictive model was established by multivariate Cox regression analysis, and a nanogram was constructed based on the multivariate Cox regression model. The discrimination of the model was evaluated by consistency index (C index), time-dependent C index curve, receiver operating characteristic curve and area under the curve (AUC). 500 times of Bootstrap sampling were conducted for the calibration of nomogram. Results:The median survival of patients with gallbladder cancer was 22.15 months, and the 1-, 2- and 3-year cumulative survival rates were 65.99%, 46.02% and 35.73%, respectively. LASSO regression analysis showed that age, abdominal pain, degree of differentiation, T stage, N stage, serum levels of CA-199 and total bilirubin were predictive factors affecting the prognosis of gallbladder cancer (all P<0.05). The prognosis prediction model was established by multivariate Cox regression analysis. The C-index was 0.856 (95% CI: 0.823-0.887). The AUC values for 1-year and 3-year survival probabilities are 0.939 and 0.944, respectively. The calibration chart indicates that this model has a good accuracy. The decision curve analysis confirmed that the net benefit of this model is significantly higher than two extreme situations, indicating its clinical applicability and patients’ benefits. Conclusion:The nomogram for postoperative prognosis of gallbladder cancer based on age, abdominal pain, degree of differentiation, T stage, N stage, serum levels of total bilirubin and CA-199 has a high accuracy, which might affect the treatment decision-making of patients with gallbladder cancer.

Objective:To study the impact of selective occlusion of hepatic arterial blood flow in external capsule excision for hepatic cystic echinococcosis.Methods:A retrospective analysis was conducted on the data of 80 patients with hepatic cystic echinococcosis who underwent surgical treatment from January 2017 to January 2019 in the First Affiliated Hospital of Xinjiang Medical University. There were 36 males and 44 females, with an average age of 47 years. All patients underwent external capsule excision of hepatic cystic echinococcosis. According to the type of intraoperative blood flow occlusion, the patients were divided into: group A ( n=42), selective occlusion of hepatic artery; group B ( n=38), Pringle’s maneuvre. The hospitalization stay, intraoperative blood loss, postoperative ventilation time and complications were compared between the two groups. The postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, and total bilirubin were compared between the two groups. Results:The intraoperative blood loss (215.7±29.6) ml, postoperative ventilation time (2.3±0.1)d, and hospital stay (11.6±1.0) d in group A were better than those in group B (254.8±20.6) ml, (3.2±0.2) d, (12.7±0.7) d, the differences were significant (all P<0.05). There were 4 patients (9.5%) who developed postoperative complications in group A and 5 patients (13.2%) in group B. There was no significant difference between the two groups ( P>0.05). Group A had better ALT, AST, albumin, and total bilirubin on day 3 after operation, and the differences were significant (all P<0.05). The ALT (62.8±5.2) U/L, AST (32.7±2.6) U/L, albumin (39.1±0.3) g/L, total bilirubin (12.1±0.5) μmol/L in Group A were better than group B (121.9±5.6) U/L, (53.9±8.0) U/L, (32.2±0.6) g/L, (19.3±0.9) μmol/L on day 5 after operation, the differences were significant (all P<0.05). Conclusion:Selective occlusion of the hepatic artery in external capsule excision for hepatic cystic echinococcosis was superior to the traditional Pringle’s maneuver in controlling intraoperative bleeding and postoperative liver function recovery.

Objective:To investigate the risk factors related to choledocholithiasis in gallstone patients.Methods:The clinical data of 140 patients with gallstones or gallstones complicated with choledocholithiasis treated at our hospital from Jan 2017 to Dec 2019 were analyzed retrospectively.Results:The results showed gallstones≥ 10 mm (χ 2=7.896, P=0.019), parapapillary diverticulum (χ 2=10.849, P=0.013), the number of gallstones (single vs. multiple) (χ 2=9.760, P=0.080), age ( t=2.767, P=0.006), diameter of common bile duct ( t=8.068, P=0.000), total bilirubin level ( t=2.372, P=0.019), alkaline phosphatase ( t=2.448, P=0.016), significantly related to the formation of common bile duct stones. Logistic regression analysis showed that gallstone ≥ 10 mm, common bile duct dilatation, parapapillary diverticulum and multiple gallstones were all independent risk factors for choledocholithiasis in gallstone patients. Conclusion:A variety of risk factors were responsible for the formation of choledocholithiasis in gallstone patients.

Objective:To analyze the treatment and the impact of brain metastases on patients with hepatic alveolar hydatid disease.Methods:The data of 11 patients with hepatic alveolar hydatidosis with brain metastases treated at the First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2019 were retrospectively analyzed. There were 7 males and 4 females. The age range was 19~49 years, with an average of 34 years. Of 11 patients, 7 were treated with surgery combined with drugs and 4 with drugs only. Analyze the treatment and results of patients.Results:Of the 7 patients who were treated with surgery and drugs, 2 patients underwent hepatectomy. They were treated with regular postoperative oral medication and were well on follow-up. Three patients underwent only brain surgery. On follow-up from 1 to 3 years, one patient developed pneumonia with atelectasis, another patient developed ascites and jaundice with physical decline. The third patient was stable and had an independent life. Two patients underwent partial hepatectomy and hydatidectomy, with one patient requiring repeated hydatidectomies. On follow-up for one of these 2 patients for 5 years, the patient was home bound and could not take care of himself. The other patient was followed up for 3 years and was stable, alive and able of self-care. Four patients were treated with albendazole liposome, including one patient who developed ascites, a second one with weight loss, physical decline, limb edema and a third one with pleural effusion, pelvic effusion and pneumonia. These patients were still alive with improvement of symptoms on supportive treatment.Conclusion:The treatment of hepatic alveolar hydatidosis with brain metastases is still mainly surgery and anti-hydatid drugs. The prognosis of most patients was poor. The surgical principle is neurosurgery first, followed by surgery on liver, lung, spleen and other organs involved by hydatid disease.

Objective: To invastigate how to differentiate the single cystic hepatic hydatidosis from single hepatic cysts. Methods: From Apr 2014 to Aug 2018 at the First Affiliated Hospital of Xinjiang Medical University, 30 cases of liver single cystic diseases were misdiagnosed·Relevant clinical data were compared including medical history, imaging features, immunological examination etc. Results: 18 cases of echinococcosis were misdiagnosed as hepatic cysts before operation, and 12 patients with hepatic cysts were misdiagnosed as hepatic cystic echinococcosis before operation.There were no significant differences between the two groups in eosinophil count (Eo#)(t=1.35, P>0.05), albumin (t=0.38, P>0.05), aspartate aminotransferase (t=0.99, P>0.05), and CT values(t=0.85, P>0.05). The results suggest that anti-EgCF antibody(χ²=4.26, P<0.05) and EgB antibody (χ²=7.26, P<0.05) are of significantly differential value in the identification of the two diseases. Conclusion Levels of anti-EgB and anti-EgCF antibodies to hepatic cystic echinococcosis are higher than that to single hepatic cysts.