| Objective: Spontaneous rupture of caused surgery, traumaby which can lead to the serious disease complications “Anaphylactic shock”, if disposal incorrectly can cause serious consequences, and even death. At present for the study of hydatid induced anaphylactic shock are few and are duplicated in the allergic animal model based on can not represent the clinical, making has been around the study of perioperative hydatid induced anaphylactic shock in a standstill. If the clinical cases can by reviewing the research survey clear peri operative risk factors for hydatid induced anaphylactic shock, of anticipatory hydatid surgery patients with reasonable advance prevention to reduce incidence rate and improve the prognosis. At present, it is believed that the allergic reaction is a multiple genes by synergistic effect, by the interaction of genetic factors and environmental factors of immunity genetic disease, by quite a number ofminor genes participate in environmental factors and collaborative and the incidence of. Interaction between genes, multiple genes and the environment may play a role in promoting the occurrence of allergic diseases. Gene chip technology can analyze the gene characteristics of specific cases from many angles. By scanning analysis, the results show that gene expression difference, thus providing reference to elucidate the hydatid anaphylactic shock caused by the molecular genetic pathogenesis, early gene diagnosis and drug sensitivity gene screening. Methods:(1) January 2008- September 2013, the First Affiliated Hospital of Xinjiang Medical University were treated scheduled to undergo surgery hydatid disease patients. 16 cases of anaphylactic shock. Control group: 43 cases of anaphylactic shock cases did not occur. All patient demographics, imaging, clinical data, immunology aggregated comparison reveals perioperative anaphylactic shock caused by hydatid disease in patients with clinical and immunological risk factors.(2) for two cases of recurrent hydatid induced anaphylactic shock in patients with immunological characteristics and perioperative management for analysis to find out the law.(3) Eg collected from naturally infected sheep slaughterhouse liver fresh protoscolex(PSC), over 1% pepsin digestion to detect the activity of parasites and counted at 37 ℃, 5% CO2 under in vitro conditions, different time points of culture take appropriate random sample was observed under inverted microscope, photographed and recorded protoscolex growth and development, culture vesicles observed ultrastructure by transmission electron microscopy; respectively obtained in vitro Eg microcapsules per mouse 50 doses of microcapsules were inoculated by intraperitoneal injection method C57 mice to establish mouse model of secondary infection.(4) the establishment of hydatid secondary infection mouse model to simulate the clinical use of hydatid cyst fluid of mice sensitized mice established hydatid anaphylaxis model of mouse lung tissue by cDNA microarray. Results:(1) the level of IL-4 and the size of the cyst is the perioperative cause independent risk factors of hydatid disease caused by anaphylactic shock. When preoperative IL-4 levels greater than 415.67ng/ml of the threshold occurrence risk for peri operative hydatid induced anaphylactic shock, the sensitivity was 75.0%, specificity of 97.7%.(2) when the size of the cyst is larger than 7.8 cm, the risk of intraoperative cyst rupture is larger, the sensitivity is 81.3%, and the specificity is 76.7%, when the size of the cyst is larger than cm.(3) when patients’ age add 1 years, the risk of patients with allergic shock is reduced to 0.962 times the original. IL-4 difference for each additional 1. The risk of patients with allergic shock increased 1.014 times the original; IL-10 difference for each additional 1. The risk of patients with allergic shock reduced 0.677 times as much as that of the original, which suggests that if patients with hydatid cyst of Echinococcus granulosus quasi hydatid surgery and preoperative cyst diameter over 7.8cm patients, the preoperative IL-4 decreased or increased IL-10 method to reduce or avoid the occurrence of anaphylactic shock.(4) for the first time, hydatid surgery occurred in patients with allergic shock. Before the second surgery eosinophil eosinophil and basophil cell of be addicted to is still higher than the basic level, and anti Egb antibody resistance and EgCF presents the +++, preoperative IgG levels increased obviously.(5) hydatid disease caused by allergic shock differs from the type I allergic reaction, in addition to the elevated levels of IgE, also with the increase of IgG1 levels; accompanied by a medium with varying degrees of increased release, such as histamine, PAF and TXB2.(6) through the gene expression spectrum analysis showed that: in allergic reactions to the differentially expressed genes in genes associated with metabolism, participate in inflammatory reaction of the gene, and apoptosis related gene, and immune response related genes with; and related pathways in MAPK signal pathway, G protein coupled receptor pathway, peanut arachidonic acid metabolism pathway, Wnt pathway, Spliceosome pathway, TGF beta signaling pathway are involved in the allergic. Conclusion:(1) IL-4 levels greater than 415.67ng/ml, the cyst size greater than 7.8 centimeters is a independent risk factor for hydatid induced anaphylactic shock in operation period.(2) for the first time, hydatid surgery occurred in patients with allergic shock. Before the second surgery eosinophil and basophil cell is still higher than the basic level, and anti Egb antibody and EgCF presents the +++, preoperative IgG levels increased obviously. There is still the possibility of the occurrence of second allergic shock.(3) hydatid disease induced anaphylactic shock in addition to the elevated levels of IgE, also with the increase of IgG1 levels; accompanied by medium increased release, such as histamine, PAF and TXB2.(4) in the perioperative period, as far as possible, the choice of complete resection of the external capsule, to avoid the occurrence of liquid spill in the capsule of allergic shock.(5) infected with Echinococcus granulosus and cyst fluid of allergic reaction induced by murine lung gene expression profile changes involving multiple gene expression regulatory pathways, and the current of these genes only stay in the shallow level analysis. |
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