[Diagnosis and treatment of basal cell adenoma of parotid gland]

Objective:To investigate the clinical features, diagnosis and treatment experience of basal cell adenoma (BCA).Method:The clinical data of 7 patients with basal cell adenoma of the parotid gland from the Second Affiliated Hospital of Medical University of Anhui from March 2012 to June 2016 were retrospectively analyzed. Combined with literature review, the experience of diagnosis and treatment was discussed.Result:Seven BCA were mostly diagnosed as pleomorphic adenoma and adenomatous lymphoma before operation using parotid ultrasound, fine needle aspiration cytology and parotid enhanced CT, and no patients was diagnosed as BCA prior to the operation. Four cases were diagnosed as BCA, 1 case was diagnosed as adenoma, 1 case was diagnosed as low-grade malignant tumor, and 1 case was not able to identify benign or malignant tumor by intraoperative fast frozen pathological examination. There were no obvious complications after the operation, and only 2 cases of mild facial paralysis returned to normal in 1 month, and no recurrence was found in the follow-up 18-69 months. Conclusion:Basal cell adenoma of the parotid gland is a rare benign tumor of parotid gland, the lack of specific clinical manifestations and signs, preoperative ultrasonography, fine needle aspiration cytology and parotid gland enhanced CT scan can not confirm the diagnosis, although they have some limitations, they are of great value in the localization, qualitative and differential diagnosis of BCA in the parotid gland. The diagnosis mainly depends on intraoperative, postoperative pathology and immunohistochemical examination. The treatment is mainly surgical excision, and the prognosis is better.

[HIV prevalence and risk factors among left-behind women in high HIV epidemic rural areas of Yunnan province]

OBJECTIVE

To understand the status of HIV infection and risk factors among those left-behind women (LBW) in high HIV epidemic rural areas.

METHODS

A cross-sectional investigation was conducted between March and May, 2015 in Dehong and Lincang prefectures, Yunnan province, where HIV appeared highly epidemic. Probability Proportion to Size (PPS) sampling method was used, and 500 cases were involved and tested for HIV antibody.

RESULTS

The total rate of HIV infection among LBW was 8.2% (41/500). The rate of HIV infection among LBWs whose husbands were on medication was 22.7% (30/132). Data from Multi-factor logistic regression analysis showed that the risk factors of HIV infection were: being minorities, education background lower than junior high school, widowed, living in Lincang prefecture, husband infected with HIV but did not consistently use condoms,etc. The rate of HIV infection among other LBWs was 2.8% (10/363). Data from Multi-factor logistic regression analysis showed that the risk factors of HIV infection would include: aged between 30-40 years, being minorities, education background lower than junior high school, divorced, living in Dehong prefecture, having had multiple-sex partners, husband coming home less than once a year,etc. The rate of HIV infection among drug users whose husbands did not take HIV medication was 20.0% (1/5).

CONCLUSION

HIV prevalence among LBWs in highly HIV epidemic areas was high, and the major risk factors related to their husbands were: being drug users or with HIV infected. Further effort should be made on consistently use of anti-HIV drugs and prevention of inter-marital sexual transmission. Comprehensive intervention should be carried out for LBWs who were having lower education background, being minority and having multiple-sex partners.

[Effect of artemether on phosphoglucomutase, aldolase, phosphoglycerate mutase and enolase of Schistosoma japonicum harbored in mice]

OBJECTIVE

To study the effect of artemether (Art) on phosphoglucomutase (GPM), aldolase (ALD), phosphoglycerate mutase (PGM) and enolase (ENO) of Schistosoma japonicum harbored in mice.

METHODS

Mice infected with S. japonicum cercariae for 4-5 wk were treated ig with Art 100 mg/kg or 300 mg/kg and killed 24 h or 48 h after treatment for collection of worms. The activities of GPM, ALD, PGM and ENO in female and male worms were measured by the formation of NADPH or consumption of NADH.

RESULTS

After the worms were exposed in vivo to Art 100 mg/kg for 24 h, the GPM, ALD, PGM and ENO activities in female worms were significantly decreased by 15%, 19%, 50% and 46%, respectively, while in male worms only the PGM and ENO activities were markedly decreased by 22% and 32%, respectively. Following exposure of the worms to Art 100 mg/kg for 48 h, the GPM and ALD activities in male worms were also significantly reduced by 21% and 18%, respectively, while the activities of GPM, ALD, PGM and ENO in female worms and those of PGM and ENO in male worms declined progressively with time. After the worms were exposed in vivo to Art 300 mg/kg for 24-48 h, all the activities of the above-mentioned enzymes in female and male worms declined significantly in a time-related pattern.

CONCLUSION

Art showed an apparently inhibitory effect on GPM, ALD, PGM and ENO in female schistosomes.

Effect of artemether on phosphorylase, lactate dehydrogenase, adenosine triphosphatase, and glucosephosphate dehydrogenase of Schistosoma japonicum harbored in mice

AIM

To study the effect of artemether (Art) on phosphorylase (PP), lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G-6-PDH), and adenosine triphosphatase (ATPase) of S japonicum.

METHODS

Mice infected with S. japonicum cercariae for 32-38 d were treated i.g. with Art 100-300 mg.kg-1 and killed 24-72 h after treatment for collection of schistosomes. The activities of PP, LDH, and G-6-PDH were measured by the formation of NADH or NADPH. The activity of ATPase was measured by the rate of release of inorganic phosphate (Pi) from ATP at 37 degrees C.

RESULTS

After infected mice were treated i.g. with Art 300 mg.kg-1 for 24-48 h, the activities of total PP and PPa (active form) increased markedly in both male and female worms, while PPb (inactive form) showed no or only a slight increase. At 24-72 h after the above-mentioned mice were treated i.g. with Art 100-300 mg.kg-1, the inhibitory rates of LDH and G-6-PDH were 9%-59% (male) and 41%-75% (female) as well as 22%-42% (male) and 74%-89% (female), respectively. When Art 300 mg.kg-1 was given to infected mice for 24 h, only the activity of Mg(2+)-ATPase showed marked inhibition in both male and female worms. At 48 h, the Ca(2+)-ATPase, Mg(2+)-ATPase, and Na(+)-K(+)-ATPase were all inhibited, the inhibitory rates of 17% (male) and 19% (female), 32% (male) and 48% (female) as well as 29% (male) and 44% (female), respectively.

CONCLUSION

In schistosomes, the increase in the activity of AMP-independent PPa induced by Art may enhance the decomposition of glycogen and the inhibition of LDH by Art could reduce the formation of lactate. Moreover, Art exerts a potent inhibition on the G-6-PDH activity of the female S japonicum.

Effect of artemether on glyceraldehyde-3-phosphate dehydrogenase, phosphoglycerate kinase, and pyruvate kinase of Schistosoma japonicum harbored in mice

AIM

To study the effect of artemether (Art) on glyceraldehyde-phosphate dehydrogenase (GAPDH), phosphoglycerate kinase (PGK), and pyruvate kinase (PK) of S japanicum.

METHODS

Mice infected with schistosome cercariae for 32-38 d were treated ig with Art 100-300 mg.kg-1 and killed 24-72 h after medication for collection of schistosomes. The activities of GAPDH, PGK, and PK of the worms were determined by measuring the formation of NADH or consumption of NAD. The lactate content of the worms was also measured.

RESULTS

After the infected mice were treated ig with Art 300 mg.kg-1 for 24 h, the inhibition rates of GAPDH were 13% (Male) and 21% (Female), and 48 h later the inhibition rates of the enzyme were 6% (Male) and 28% (Female). When Art 300 mg.kg-1 was given to infected mice for 24 h and 48 h, the inhibition rates of PGK were 60% (Male) and 48% (Female) as well as 75% (Male) and 62% (Female), respectively. Similar results were seen in PK activity. At 72 h after treatment the reduction rate of lactate content in Female worm was 72%, while that of Male was 48%.

CONCLUSION

In the glycolytic pathway of both Male and Female schistosomes, PGK and PK activities were inhibited by Art. The GAPDH activity of Female worms was also susceptible to Art, While that of Male worms showed only temporary inhibition after treatment with Art. The Art reduced lactate content more in Female than in Male worms.

Preventive effect of artemether in rabbits infected with Schistosoma japonicum cercariae

AIM

To study the effect of artemether (Art) for prevention of schistosomal infection.

METHODS

Rabbits with single infection or reinfection with Schistosoma japonicum cercariae were treated intramuscularly (i.m.) or intragastrically (i.g.) with Art 5 -20 mg.kg-1 on d 7-15 after the first infection, followed by various regimens.

RESULTS

When rabbits were injected i.m. Art 7.5 mg.kg-1 (i.e., one half of the effective dose given i.g. on d 7) followed by once every week for twice, the female worm reduction rate was only 42%. In infected rabbits treated i.g. with Art 10-20 mg.kg-1 given in the same administration schedule, the female worm reduction rates were > 91%. When Art 15 mg.kg-1 was given to rabbits on d 7-14 and the following dose of the drug was given at intervals of 7-14 d, the female worm reduction rates were > 94%. In rabbits reinfected with cercariae, the female reduction rate of Art given i.g. once a week for 3 times since d 8 after the first infection was 96% which was similar to that given once a week twice since d 14 after the first infection.

CONCLUSION

Art should be given i.g. on d 7-15 after infection, followed by repeated dosing once every 7-15 d for a total of 3 doses. Art given i.g. daily for 2 consecutive days or given at 1-wk intervals since 7-15 d after infection also showed preventive effect.

Effect of artemether on glucose uptake and glycogen content in Schistosoma japonicum

AIM

To study the effect of artemether (Art) on glucose uptake and glycogen content in schistosomes.

METHODS

Schistosomes recovered from mice treated intragastrically with Art 300 mg.kg-1 for 24-48 h, were incubated in the drug-free medium containing [U-14C]glucose 11.1 MBq.L-1. The glycogen content, [U-14C]glucose uptake, and incorporation of [U-14C]glucose into worm glycogen in both male and female worms were determined.

RESULTS

When above-mentioned schistosomes were exposed to drug-free medium containing [U-14C]glucose for 1-24 h, the glycogen contents of male and female worms decreased 27%-61% and 39%-78%, respectively. Only 3 out of 6 male worm groups showed 23%-35% decrease in glucose uptake, while much less glucose uptake was found in female worms in all groups with reduction rates of 18%-38%. Apart from 2 male groups no apparent change in the incorporation of [U-14C]glucose into the worm glycogen was seen.

CONCLUSIONS

Art-induced glycogen reduction in schistosomes was related to an inhibition of glycolysis rather than an interference with glucose uptake.

Effect of mebendazole and praziquantel on glucosephosphate isomerase and glyceraldehydephosphate dehydrogenase in Echinococcus granulosus cyst wall harbored in mice

AIM

To study effects of antihydatid drugs on glucosephosphate isomerase (GPI) and glyceraldehydephosphate dehydrogenase (GAPDH) in Echinococcus granulosus cyst wall.

METHODS

Mice infected with the parasite for 8-10 months were treated i.g. with mebendazole (Meb) or praziquantel (Pra). The activities of GPI and GAPDH in the cysts were measured by the formation of NADH or NADPH.

RESULTS

GPI activity in the cyst wall was 197 +/- 103 U, while that of GAPDH was 25 +/- 13 U. When infected mice were treated i.g. with Meb 25-50 mg.kg-1.d-1 for 7-14 d, no apparent effect on the GAPDH activity in the cyst was found. In mice treated i.g. with praziquantel (Pra) 500 mg.kg-1.d-1 for 14 d, the GAPDH activity in the cyst wall was inhibited by 26.5%. As to GPI activity only the group treated i.g. with Meb 25 mg.kg-1.d-1 for 14 d showed 33.2% inhibition of the enzyme in the collapsed cyst wall.

CONCLUSION

GPI and GAPDH are not the major targets attacked by the antihydatid drug.

Early treatment of schistosomal infection with artemether and praziquantel in rabbits

Artemether (Art, beta-methyl ether of artemisinin) first synthesized by Shanghai Institute of Materia Medica, Chinese Academy of Sciences, is effective against not only malaria but also schistosomiasis. When rabbits infected with Schistosoma japonicum cercariae for 7 d were treated ig with Art 10 mg.kg-1, the total worm reduction rates were 74.6-76.7%. If Art (10 mg.kg-1) was given once weekly after the first treatment for 3-4 times, the total worm reduction rate was > 98%, and most of the rabbits were free from female worms. When praziquantel (Pra) was given ig 40 mg.kg-1 to rabbits on d 21 after infection, and repeated once every week for 3 wk, most rabbits showed a total worm reduction rate > 98% with their livers showing normal or mild changes, and their parameters relevant to acute schistosomiasis were negative as compared to the controls. Hence Art and Pra are suggested to be used in field trial for control of acute schistosomiasis or reduction of the intensity of schistosomal infection.

Effect of early treatment of artemether against schistosomiasis in mice

When artemether (Art) was given ig to mice on the day of infection with Schistosoma japonicum cercariae at a single dose of 300 mg.kg-1 and followed by the repeated dosing at 2-3 wk intervals, the total and female worm reduction rates as compared with the control were evident. In mice treated ig with Art on d7 at the same dosage and repeated once every wk for 4 times, the female worm reduction rates were about or over 90%, and part of the animals was free from female worm. Nevertheless, the liver appearance of some treated animals was similar to that of the normal mouse. The results indicated that if Art was given in the early stage after infection, it could be expected to protect the host from schistosomal infection or reduce the intensity of infection.

Early treatment of schistosomal infection with praziquantel in mice

The first single dose of praziquantel (Pra) was given ig to mice on the day of infection with Schistosoma japonicum cercariae, or 7 d, 14 d, and 21 d after infection. Afterwards, the same dose of Pra was given once at 1-3 wk intervals for 2-3 times. The prophylactic effect was estimated by the reduction of average number of total and female worms, the number of mice without female worm, and the gross change of the liver. When mice were treated with Pra 300-500 mg.kg-1 initially on d 21 after infection and repeated once every 1-2 wk for 2-3 times, almost all the female worms lodged in the host were killed, showing that either the host was protected from the infection of schistosomes or a great decrease in the intensity of the infection resulted.

[Study on cadmium load and calcium deficit]

The effects of cadmium given by intraperitoneal injection on calcium absorption and calcium balance in rats were investigated. The results showed that intestinal calcium absorption rate decreased steadily with increasing cadmium load. When the cadmium load exceeded 9.0 mg, the average calcium absorption fell into negative value and thus led most of the rats to calcium deficit. It suggested that the negative calcium balance in rats was caused mainly by way of fecal excretion rather than the urinary route, since the calcium loss via the intestinal tract surpassed that via the urinary tract. The excess of urinary calcium (hypercalciurea), which appeared concurrently with that of feacl one's has, however, the same significance of indicating the calcium loss, so it can be referred to an indicator of calcium deficit. Our results gave no support to the view that calcium deficit and skeletal lesion were resulted from the calcium loss by urinary way. In the study, we found that there was negative correlation between cadmium burden and calcium balance, and there was remarkable dose-response relationship between cadmium burden and the rate of calcium deficit.

[Effect of artemether against Schistosoma japonicum]

Artemether (beta-methyl ether of artemisinin) first synthesized by Shanghai Institute of Materia Medica, Chinese Academy of Sciences(1), appears in colorless crystal and is more lipid-soluble than artemisinin. When artemether was given ig or im to mice infected with Schistosoma japonicum for 32-35 d at the dosage of 1/10-1/2 LD50. Its effects in the two administration routes were similar. After artemether 200 mg.kg.d-1 ig or 100 mg.kg-1.d-1 im for 1-2 d was given to mice infected with S japonicum cercariae at different intervals, d 7 schistosomules were more susceptible to the drug with worm reduction rates of 73.9-92.0%. The d 35 adult worms also exhibited susceptibility to the drug and the worm reduction rates were 47.0-70.1%, but less susceptibility to the drug in other developmental stages of schistosomes. The major morphological alteration of adult worms induced by artemether was sustained shrinkage accompanied by atrophy and degeneration of the worm's reproductive glands, eg, the testis in males and ovary as well as vitelline gland in females. The in vitro tests indicated that artemether showed apparent effects on different stages of schistosomes only when a higher concentration of 40 micrograms.ml-1 was used.

[Relationship between the effects of praziquantel on mice and rabbits with different intensities of Schistosoma japonicum infection and humoral immunity levels of the host]

Rabbits were infected with 48-52, 198-202 and 498-502 cercariae of Schistosoma japonicum and treated ig with single doses of praziquantel (40 mg/kg) 4 and 8 wk post infection. The worm reduction rates of the 8 wk groups were 87.9, 92.2 and 97%, respectively. These values were significantly higher than 48.5, 52.3 and 58.6% for the corresponding 4 wk groups. The serum antibody titres of the 8 wk post infection rabbits were apparently higher than those of the 4 wk rabbits. Meanwhile, for the same duration of infection, the specific antibody levels in the heavy worm burden groups were also higher than those in the light worm burden groups. The results obtained in the mice infected with S. japonicum at different intensities and treated ig with single doses of praziquantel at 300 mg/kg at different durations were similar to the results in the rabbits. The correlation between efficacy and specific antibody level was confirmed by calculating the coefficient of correlation with r values of 0.454-0.983 (P less than 0.01). The results also indicated that heavy infections with S. japonicum were still more responsive to praziquantel treatment. In addition, the effect of praziquantel on worms was closely related to the specific antibody response in the host.