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Objective: To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis., Methods: Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis., Results: Flow cytometry detected a higher percentage of CD4 + CXCR5 + T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4 + CXCR5 + PD-1 + T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4 + CXCR5 + ICOS + PD-1 + T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4 + CRCR5 + ICOS + T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis ( P > 0.05)., Conclusions: The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

The hepatic echinococcosis is an anthropozoonosis and caused by the larva of Echinococcus . The main pathogenic type of Echinococcus in China is E. granulosus and E. multilocularis , which cause cystic echinococcosis and alveolar echinococcosis respectively. At present, the treatment of hepatic echinococcosis has made great progress, but there are still some difficulties in the treatment of complex echinococcosis, especially of the cases existing one or more complications, and the focus of infection encroaching the hepatic portal, important vessels and bile vessel. This paper based on the literature reports and clinical experiences in recent years, puts forward the surgical treatment strategy for complex hepatic echinococcosis.

Objective: To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases., Methods: The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People's Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed., Results: The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257-2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients., Conclusions: The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

Echinococcosis is a zoonotic parasitic disease caused by the larvae of Echinococcus granulosus and E. multiltilocularis , which mainly violate the liver. And the surgical treatment is an important method to cure the disease at present. However, there are many surgical methods for the treatment of hepatic echinococcosis, and different surgeries with different indications and risks. With the standard of precision surgery and no tumor surgery, the surgical operation is more precise. The innovation of surgical methods makes the operation of curing complex hepatic echinococcosis become true. This paper reviews the surgical methods and indications in clinical practice so as to provide some help for better choice.

Objective: To determine the susceptibility genes and resistance genes in HLA-DRB1 alleles in Tibetan patients with cystic and alveolar hydatid diseases, so as to provide the references for the research of the genetic characteristics and infection mechanism of Tibetan hydatid diseases., Methods: The case control method was applied. The Tibetan patients with cystic and alveolar hydatid diseases (63 and 73 cases respectively) in Yushu and Guoluo Tibetan Autonomous Prefecture, and unrelated healthy people (60 cases) in this area were selected as the study subjects. The polymerase chain reaction-sequence based typing (PCR-SBT) technique was applied for genotyping of HLA-DRB1, and the comparison of the gene frequency., Results: The frequency of HLA-DRB1*04 in the alveolar/cystic echinococcosis group was lower than that in the control group ( χ 2 = 4.71, 4.31, both P < 0.05)., Conclusions: HLA-DRB1*04 genotypes may be associated with the resistance of cystic and alveolar echinococcosis and its resistance genes.