Objective To investigate the diagnosis and surgical treatment of co-infection with hepatic cystic and alveolar echinococcosis, so as to provide insights into the diagnosis and treatment of these patients. Methods The clinical data of patients with co-infections of hepatic cystic and alveolar echinococcosis in Qinghai Provincial People’s Hospital between 2017 and 2018 were retrospectively analyzed. Results Three patients were diagnosed with co-infection of hepatic cystic and alveolar echinococcosis. One patient was diagnosed by preoperative CT scan, and confirmed intraoperatively. The other two cases were diagnosed as cystic echinococcosis by preoperative color ultrasonography and imaging examinations, and were definitively diagnosed as co-infection of hepatic cystic and alveolar echinococcosis by intraoperative examination of the lesion morphology and postoperative pathology. Two patients were given radical surgery, and another case was given removal of the internal capsule and subtotal excision of the outer capsule of Echinococcus granulous in the liver following exploration. Conclusions Co-infection with hepatic cystic and alveolar echinococcosis is easy for missed diagnosis and misdiagnosis prior to operation, and the definitive diagnosis may be made by means of imaging examinations combined with postoperative pathology. The surgery is relatively complicated and difficult for patients with co-infection of hepatic cystic and alveolar echinococcosis, and individualized surgical treatment regimen should be employed for patients with various types of infections.

To establish an UPLC-MS method for the simultaneous content determination of 4 saponins and 8 flavonoids, in order to analyze the effect of Astragali Radix directionally processed with organic acid on the content of glycosides and aglycones. The separation was carried out on ACQUITY UPLC HSS T_3(2.1 mm×100 mm, 1.8 μm), the mobile phase was eluted with the mixture of 0.1 mol·L~(-1) formic acid water solution and 0.1 mol·L~(-1) formic acid acetonitril in a gradient mode. The detection wavelength was 260 nm, the flow rate was 0.5 mL·min~(-1), the column temperature was 30 ℃, and the injection volume was 2 μL. Mass spectrometry analysis was performed with an electrospray ionization(ESI) source in a positive ion mode. The 12 constituents showed good linear relations within their own ranges(R~2≥0.999 2),with good average recoveries. The results showed no significant change in saponins but both qualitative and quantitative changes in flavonoids after directional processing of Astragali Radix with organic acid. The established method can provide methodological reference for analyzing the effect of Astragali Radix directionally processed with organic acid on glycosides and aglycones.
Astragalus propinquus ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Phytochemicals/analysis* ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

Objective To understand the prevalence and risk factors of Blastocystis hominis infection in inpatients in Jiangjin District, Chongqing City. Methods A cross-sectional study was conducted in a community hospital in Jiangjin District, Chongqing City, and the inpatients were surveyed by questionnaires. After obtaining the informed consent from the inpatients or legal guardians, the stool and blood samples were collected and examined by microscopy and PCR from April 17 to May 1, 2018. The univariate analysis and logistic regression analysis were used to analyze the risk factors of the B. hominis infection. Results A total of 198 hospitalized patients were investigated, and the infection rate of B. hominis was 10.61% (21/198), and the infection rate of the females (12.10%) was higher than that of the males (8.11%), but the difference was not statistically significant. The highest rate of infection was 19.23% in the age group of 10 to 20 years, followed by 17.74% in the age group of 60 years and above, and the lowest rate was 2.38% in the age group of 20 to 40 years. The difference in infection rates of B. hominis among the different age groups was statistically significant (P < 0.05). The infection rate of B. hominis in the people who used dry pail latrines was 33.30%, which was higher than that of the people who used water flush toilets (9.10%) (P < 0.05). The genotypes of B. hominis were ST1, ST3, ST6 and ST7, and ST6 and ST3 being the most predominant genotypes which accounted for 47.62% (10/21) and 38.10% (8/21) respectively, and among the infected males, the genotypes were only ST3 and ST6. The multiple logistic regression analysis showed that among the factors affecting B. hominis infection, only keeping pets was a risk factor [OR = 3.798, 95% CI (1.245, 11.581), P < 0.05]. Conclusion A high prevalence of B. hominis infection is found in the inpatients in Jiangjin District, Chongqing City, the predominant genotypes are ST6 and ST3, and keeping pets may be one of the main risk factors.

Alveolar echinococcosis is a parasitic zoonosis that severely damages human health. Currently, radical surgical resection is the first choice for hepatic alveolar echinococcosis. For the advanced hepatic echinococcosis patients with refractory radical resection, the palliative surgery combined with chemotherapy, liver transplantation, drug therapy, and radiofrequency microwave ablation may provide comprehensive tools. This article reviews the current situation and progress of comprehensive treatments for hepatic alveolar echinococcosis.

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.

Objective To evaluate cerebral parenchymal atrophy of patients with Alzheimer's disease(AD)through the compara-tive analysis of the volume and morphology of the brain ventricle between patients with AD and normal elderly.Methods 20 patients with AD and 20 normal elderly people were scanned at 3.0T MR,and lateral ventricle section images were achieved,and the lateral ventricle volume and the anterior horn,posterior horn and temporal horn of the lateral ventricle were calculated by analyzing the re-construction of section images with MIMICS software from Belgian.Results As compared with normal elderly group,the patients with AD exhibited significantly increased the volume of left ventricular volume(LV),right ventricular volume (RV)and total vol-ume (TV)(P<0.05).Angle of bilateral anterior horn and temporal horn but not posterior horn of the lateral ventricle in patients with AD were significantly higher than that in normal elderly (P<0.05).The volume of the left,right and total cerebral ventricle, the angle of the anterior horn of the left and right lateral ventricle and the angle of the temporal horn of the left and right lateral ven-tricle were negatively correlated with MMSE (P<0.05).Conclusion Patients with AD exhibites significantly greater volume and an-gle of the lateral ventricular than normal elderly people.These related data measured can predict brain parenchymal atrophy of pa-tients with AD more conveniently and accurately.

Objective To investigate the expression and compare the significance of interleukin-17 ( IL-17 ) A-F in patients with chronic hepatitis B ( CHB) and hepatitis B virus ( HBV) cirrhosis.Methods The stools and serum samples of 66 patients with CHB and 50 patients with HBV cirrhosis were collected, and the serum samples of 30 healthy volunteers were collected.HBV DNA in stool and serum were detected by real -time quantitative polymerase chain reaction ( PCR ) .IL-17A-F, IL-1β, IL-6 and CXC chemokine ligand 13 ( CXCL-13) were detected by ELISA.Liver function was detected by automatic bio-chemical analyzer.Results The expression of serum IL -17 A -F in patients with CHB or HBV cirrhosis were significantly higher than those in healthy volunteers ( P <0.01 ) , but no difference between patients with CHB and cirrhosis (P>0.05).In patients with CHB, IL-17A-F were positively correlated with IL-1β, IL-6 and CXCL-13, and ne-gatively correlated with total bilirubin.IL-17C was positively correlated with total bile acid.IL-17B, IL -17D and IL -17E were positivelycorrelated with stool HBV DNA.In patients with HBV cirrhosis, IL -17B was positively correlated with IL -1β.IL-17C was positively correlated with aspartate aminotransferase and alkaline phosphatase.IL-17D was positively correlated with alkaline phosphatase.IL -17 A -F had no correlation with serum HBV DNA and stool HBV DNA ( P>0.05) .Conclusion There were high expressions of serum IL -17A -F in patients with CHB and HBV cirrhosis, but the clinical significance of IL-17A-F was different.