Nemotoda Cestoda Trematoda,Medical helminth,Liver Fluke.Vocabulary,Dioecism daii:sizm雌雄异体 Hermaphroditic h:mfrditik雌雄同体 Miracidium mairsidim毛蚴 Sporocyst sp:rsist胞蚴 Encyted metacercaria mets:kri囊蚴 Rediae 雷蚴 Cercariae 尾蚴 Encyst-excyst 成囊-脱囊,Liver Fluke.Vocabulary,Bile 胆汁 Clonorchiasis klun:kaisis 肝吸虫病 Intrahepatic bile duct 肝胆管 Pancreatic 胰腺的 Gall bladder 胆囊 Faeces fi:si:z 粪便 Diarrhoea da r腹泻 putrescentpju:tresnt 坏死,Liver Fluke.Vocabulary,Hepatocirrhosis heptusirusis 肝硬化 Atrophy trfi萎缩 ascites saiti:z腹水,Trematodes, Flukes,General characters, Mophology,General characters,Leave-shaped,flat Hermaphroditic (except Schistosome)have mouth but no anusWith oral sucker and ventral sucker Most flukes egg has a operculum,Adult wormseggs,cercaria,Rediae,Sporocyst,Miracidia,encysted metacercaria,Life cycle,Definitive host,Second intermediate host,First intermediate host,General characters,Mophology,metagenesis,asexual generation,Sexual generation,General characters,Mophology,Life cycle,More than 30 species of flukes parasitic in human body, all belong to Phylum Platyminthes (扁形动物门）Class Trematoda（吸虫纲）Order Digenea （复殖目）,General characters species of flukes,Flukes endemic in china,Clonorchis sinensis 华支睾吸虫Paragonimus westermani 卫氏并殖吸虫Schistosoma japonicum 日本血吸虫Fasciolopsis buski 布氏姜片吸虫Pagumogonimus skrjabini 斯氏狸殖吸虫,General characters species of flukes,华支睾吸虫(Clonorchis sinensis),introduction,肝吸虫(liver fluke）, causing Clonorchiasis,Firstly found in a Indian Chineses bile duct in 1874.,MorphologyLife cyclePathogenesisDiagnosisPrevalence Prophylaxis,肝吸虫(liver fluke）,华支睾吸虫(Clonorchis sinensis),Liver flukeMorphology,10-253-5mm,Oral sucker,Ventral sucker,Spermary睾丸,Uterus 子宫,Intestine branch,1.Adult worm,Gullet 咽,Overy 卵巢,1.Adult worm,Liver flukemorphology,Sesame like, broadly ovoid,Light yellowish-brown,2.egg,2917um，,size color shape shell Containing,With a distinct convex operculum,a miracidium inside the egg,Liver flukemorphology,2.egg,卵盖operculum,肩峰shoulder,卵壳 shell,毛蚴 miracidium,疣状突起 tiny knob,Liver flukemorphology,size color shape shell Containing,蠕虫卵中我最小， 形似芝麻棕黄色。 上有盖来下有疣， 肩峰明显内毛蚴。,2.egg,Liver flukemorphology,Miracidium,Liver flukemorphology,3.Other stage,Liver flukemorphologyother stages,sporocyst,3.Other stage,rediae,Liver flukemorphologyother stages,Generation cell,Unmature Cercariae,3.Other stage,Cercariae,Liver flukemorphologyother stages,3.Other stage,Liver flukemorphologyother stages,Fresh water fish,Encysted metacercariae in fish musculature,3.Other stage,Liver fluke life cycle,First intermidiate host,Second intermidiate host,Definitive host,shrimp,Cyprinidae,snail,Liver fluke life cycle,Adult worms,egg,miracidium,Sporacyst,rediae,cercariae,Encycted mtacercariae,尾蚴,雷蚴,胞蚴,毛蚴,囊蚴,猫25-30d 鼠21d,100d,25时，30-40d,童虫成虫卵,Liver fluke life cycle,1.host,纹沼螺 长角涵螺赤豆螺,(1) the first intermediate host fresh water snail,Liver fluke life cycle,1.host,(1) the first intermediate host fresh water snail,(2) the second intermediate host fresh water fish (family Cyprinidae鲤科),Liver fluke life cycle conclusion,(3) Definitive host human，cat,dog, pig, rat, et al.,1.Host,(1)the first intermediate host fresh water snail,(2) the second intermediate host fresh water fish (family Cyprinidae),Liver fluke life cycle conclusion,1.Host2.Infection stage and method,infection stage-encysted metacercariae infection way-ingestion of raw, under cooked, pickled fish harbouring metacercariae,Liver fluke life cycle conclusion,1.Host2.Infection stage and method3.Excrete way in human body,Inmature worm,common bile duct blood stream abdomen antrum,Bile passages,Liver fluke life cycle conclusion,through,1.Host 2.Infection stage and method 3.Excrete way in human body 4.Parasiting position,Adult worms are parasitic in bile ducts,Liver fluke life cycle conclusion,1. host 2.infection stage and method3.passing way in human body4.parasitized position 5.leaving body stage and method,eggs exit the bile duct and are excreted in the faeces,Liver fluke life cycle conclusion,Pathogenetic stage Pathogenetic mechenism Symptomology,Liver fluke pathogenicity,Immature adult worm Mature adult worm Eggs,Liver fluke pathogenicity,pathogenetic stage Pathogenetic mechanism Symptomology,metablites and mechanical effects causesproliferative and inflammatory reactions in the biliary epithelium of the bile ducts.,Encapsulating fibrosis of the ducts,Bile ducts are dilated at the points where the flukes are attached to the inner lining,pathogenetic stage Pathogenetic mechanism Symptomology,Liver fluke pathogenicity,chronic infection, hepatic cells near the bile passages become denaturalized and putrescent (坏死)，causing hepatic tissue atrophy(萎缩) apparently.,late period, causing hepatocirrhosis(肝硬化) and ascites (腹水).,