2. Introduction to trematoda Assistanted Prof. Sheng

3. 2. Digestive system ： Compose with mouth 、 pharynx 、 esophagus 、 cecum MORPHOL OGY MORPHOL OGY 1. SHAPE ： Leaf-shape 、 tong-shape ， Oral sucker 、 ventral sucker

4. ovary 、 ootype 、 Uterine tube Seminal receptacle 、 Laurer’s canal 、 Egg’model 、 Me’glands 、 Vitelline glands and uterus. Strong, most of them are hermaphrodite 3. Reproductive system ：

5. ： testes 、 efferent ductule 、 deferential duct 、 seminal vesicle 、 prostate 、 penis 、 packet of penis.

6. a. adult parasite in human being and mammal,worm parasite in aquatic animal (example:snail) Life cycle complication ：

7. b. Growing process include: egg miracidium sporocyst redia cercaria metacercaria Young wormadult

8. do you know what disease you will suffer from by eating raw fish and shrimb

9. Clonorchis sinensis

10. morphology 1. adult  Shape:  Sucker:  Cecum:  Hermaphrodite:

11. 2. egg  Shape :  Size:  Colour:  Egg shell:  Content: operculum Shoulder peak miracidium Verrucous thing

12. Life cycle adult Egg Egg pass into water in feces Egg are swallow by snail and hatch by it miracidiumsporocystrediacercaria All these stages grow in snail metacercaria Cercaria leave snail and eated by fresh-water fish Man is infected by Eating uncooked fish Young worm adult

14. Pathogenesis and clinical maniefstation The pathogenesis Adult’s mechanical destruction Secretion and excretion’s toxicity It cause the sell of duct fall off and cause the sell have hyperplasia and inflammation The tissue fibre The worm blockage The duct wall become thickThe duct Become narrow Duct blockage Bile retention Duct expand They cause liver sell Atrophy, necrosis and cirrhosis cirrhosis

15. The diseases Blockage icterus Cholangitis and hepatitis Cholelithiasis cirrhosis Liver duct cancer Actute hemorrhagic necrosis of pancreas

16. Adult parasite in the bile

17. Adult crow in liver duct

18. Blockage icterus Adult in the duct

19. cholelithiasis

21. Ascites and epigastric

22. Liver parm

23. Spider-shape vein

24. Liver duct cancer

25. Actute hemorrhagic necrosis of pancreas

26. dwarf

27. No symptom

28. Clinical manifestation  Most of them have no obvious symptom  Some feel tiredness,hepatic enlargement, right upper quadrant mild pain,abdominal pain,anorexia, dizziness.  When it become serious the patient has ascites, unconscious and will die later.

29. Diagnosis Dialogue about case histories: a. Whether come from epedemiologic area b. Whether have the habit of eating raw fresh water fish or shrimp

30. 1.laboratory diagnosis : Detect eggs – make sure diagnosis a. Stool examination  Direct amear method  Nature sedimentation’method  Formalin –ether method b. The duodenum secretion examination

31. 2. Immunologic examination  IH test  IHA  ELISA 3. Ultrasonic wave examination

32. epidemiology Local epidemic Infective rate :1%~30%,some are 80% Epidemic area: Japan 、 Korea 、 Vinan 、 Thailand

33. China:

34. Epidemic factor:  Infective resource: patient and carrier, reservoir host  Spread way: egg pass into water in feces intermediate host exit,people have the habit of eating raw fish or raw shrimb  Susceptible people : all people

35. treatment 1.hygiene education Do not eat raw fish or raw shrimb Not let cat eat raw fish or raw shrimb too 2.treat the patient and carrier 3. Not let the feces pass into the fresh-water

36. Now do you still dare to eat the raw fish or raw shrimb ！ ？