Alveolar echinococcosis is a kind of parasitic disease caused by Echinococcus multilocularis infecting the human body. It is characterized by tumor-like, invasive growth, serious disease and high fatality rate. Even though the number of patients is limited, they require life-long treatment because of the serious condition, many complications, and treatment difficulties. At present, there are three clinical treatment options for alveolar echinococcosis, including surgical treatment(radical hepatectomy, palliative resection, liver transplantation), intervention treatment(ultrasound or CT-guided intervention, endoscopic intervention), and anti-infective drug treatment. This article analyzes the advantages and disadvantages of the above-mentioned schemes, and provides a basis for correct selection of treatment methods for alveolar echinococcosis.

As a treatment method for advanced hepatic alveolar echinococcosis (AE),liver transplantation has been gradually performed.One patient with hepatic AE recurrence after liver transplantation was admitted to the Fourth Hospital of PLA in November 2012.The patients received liver transplantation in 2006 for the treatment of hepatic AE.Recurrent lesions were found in the head of the pancreas and the right lung.The patient was also associated with liver dysfunction.Liver function was improved obviously after liver-protective treatment,and continuous albendazole treatment was giving to the patient.Based on a full discussion of the patient,we thought that hepatic AE patients who met the following conditions could receive liver transplantation:(1) Severe hepatic insufficiency.(2) Inability to receive radical liver resection.(3) Absence of extra-hepatic metastasis of AE.Albendazole should be administered for at least 2 years after liver transplantation,and the patient should be monitored for a minimum of 10 years for the prevention of possible recurrence of AE.

Objective To explore the effects of Sodium Ferulateon treating patients with plateau derived chronic cor pulmonale in acute ecacerbation phase at high altitude.Methods Forty-one cases with plateau derived chronic cor pulmonale were randomly divided into treatment group (22 cases) and control group (19 cases).All the patients in the two groups were given the same routine treatments including anti-infection,expectorant,balancing hydro-electrolytic discord,persistent inspiration of low-flow oxygen and inhalation by ultrasonic nebulization.Patients in treatment group were plus given the Sodium Ferulate at dose of 300 mg by intravenous drop once daily for 2 weeks.Hemorrheology,hepatic and renal function were examined.Results After treatment,the level of whole blood viscosity and plasma viscosity in treatment group were (4.91 ± 1.60) mPa · s and (1.56 ± 0.49) mPa · s,lower than that before treatment ((5.78 ± 1.65) mPa · s and (1.87 ± 0.65) mPa · s,P =0.042,0.041).There were no significant difference in the control group in terms of whole blood viscosity and plasma viscosity.There was not abnormal change of hepatic and renal function of two groups after treatment.Conclusion Sodium Ferulate therapy was effective to treatment of the plateau derived chronic cor pulmonale in acute ecacerbation phase.

The surgical treatment methods for alveolar echinococcosis include radical resection (radical hepatectomy), palliative resection (palliative hepatectomy), and autologous and allogeneic liver transplantation. Radical hepatectomy is the most effective treatment method for alveolar echinococcosis. However, due to the lack of obvious symptoms in the early stages of alveolar echinococcosis, most patients are already in the middle and late stages of treatment, losing the opportunity for radical resection. Palliative hepatectomy for the treatment of alveolar echinococcosis is related to the prognosis and residual lesion volume, the efficacy of removing more than 90% of the lesion and continuously taking albendazole is almost equivalent to that of radical resection. For patients with alveolar echinococcosis who are no longer resectable and have no brain metastasis, allogeneic or autologous liver transplantation is feasible, and continuous treatment with albendazole is recommended after surgery. This article reviews the current status and progress of surgical treatment for alveolar echinococcosis, in order to provide reference for the correct surgical selection of alveolar echinococcosis.