Ultrasonic diagnosis of patients with clonorchiasis and preliminary study of pathogenic mechanism

Objective:To discuss the liver function damage mechanism of patients with clonorchiasis by analyzing the ultrasound characteristics,liver function,change of the serum inflammatory factors and cell apoptosis factors.Methods:Color Doppler ultrasound technique was adopted to detect the portal vein and blood flow change of patients with clonorchiasis;ELISA was used to determine the level of different serum inflammatory factors.The levels of serum total bilirubin,serum albumin and glutamic-pyruvic transaminase were detected by automatic biochemical analyzer.Western blot was used to determine the expression of proteins relevant to apoptosis.Results:Compared with the health control group,the trunk diameter of portal vein and the thickness of spleen,as well as the hepatic artery pulsation index of clonorchiasis patients increased obviously,the mean blood flow velocity of portal vein(P<0.05 or P<0.01) decreased.The content of total bilirubin and transaminase in plasma increased significantly,but albumin decreased(P<0.05).Levels of TNF-α,IL-6 and IFN-γ increased remarkably,and the level of every factor was significantly different among patients with Child-Pugh Ⅰ,Child-Pugh Ⅱ and Child-Pugh Ⅲ classification of liver function(P<0.05 or P<0.01).With the exacerbation of liver dysfunction,levels of TNF-α,IL-6 and IFN-γ gradually increased(P<0.05).Compared with the healthy control group,the expression quantity of apoptosis protein Fas,FasL,Bax and Caspase-3 increased significantly(P<0.05 or P<0.01),but Bcl-2 decreased(P<0.05).Conclusions:Changes of ultrasonic characteristics and liver dysfunction,caused by liver fluke infection,may be related to that both inflammatory response and apoptosis response have participated in the pathogenic process and liver damage course of clonorchiasis.

SERODIAGNOSIS OF CLONORCHIASIS BY ENZYME—LINKED IMMUNOSORBENT ASSAY WITH HRP—SPA

In thes paper the authors used the Horseradish peroxidase labelledstaphylococcal protein A(HRP—SPA)in ELISA,for the detection of Clo-norchis sinensis infection.Serum tests were made on 116 confirmed cases ofclonorchiasis,103(88.8%)of them showed positive,while only 6(4.4%)werepositive among 138 healthy people.Samples were collected on filter paperstrips,111(95.7%)cases were positive among 116 comfirmed cases tested,but only 2(1.5%)were positive out of 138 healthy persons.The resultswere similar to those obtained by sheep antihuman IgG.Animal experimentalso showed that the SPA—ELISA can be used for the diagnosis ofclonorchiasis.In an endemic area,stool egg positive rate was 8.8%(62/703).whenchecked with SPA—ELISA,the rate of conformity in both filter paperstrips and stool examinations was 90.3(56/62).Among 641 serum testsfrom individuals negative in stool examinations,only 35(5.5%)reactedpositively.The authors suggested—that SPA—ELISA with soluble Clo-norchis antigens could be used in a large scale seroepidemiological surveyin endemic areas.

Current status and perspectives of Clonorchis sinensis and clonorchiasis: epidemiology, pathogenesis, omics, prevention and contro

Clonorchiasis,caused by Clonorchis sinensis(C.sinensis),is an important food-borne parasitic disease and one of the most common zoonoses.Currently,it is estimated that more than 200 million people are at risk of C.sinensis infection,and over 15 million are infected worldwide.C.sinensis infection is closely related to cholangiocarcinoma(CCA),fibrosis and other human hepatobiliary diseases;thus,clonorchiasis is a serious public health problem in endemic areas.This article reviews the current knowledge regarding the epidemiology,disease burden and treatment of clonorchiasis as well as summarizes the techniques for detecting C.sinensis infection in humans and intermediate hosts and vaccine development against clonorchiasis.Newer data regarding the pathogenesis of clonorchiasis and the genome,transcriptome and secretome of C.sinensis are collected,thus providing perspectives for future studies.These advances in research will aid the development of innovative strategies for the prevention and control of clonorchiasis.

The global epidemiology of clonorchiasis and its relation with cholangiocarcinoma

This paper reviews the epidemiological status and characteristics of clonorchiasis at global level and the etiological relationship between Clonorchis sinensis infection and cholangiocarcinoma(CCA).A conservative estimation was made that 15 million people were infected in the world in 2004,of which over 85%distributed in China.The epidemiology of clonorchiasis is characterized by rising trend in its prevalence,variability among sexes and age,as well as endemicity in different regions.More data indicate that C.sinensis infection is carcinogenic to human,and it is predicted that nearly 5000 CCA cases attributed to C.sinensis infection may occur annually in the world decades later,with its overall odds ratio of 4.47.Clonorchiasis is becoming one major public health problem in east Asia,and it is worthwhile to carry out further epidemiological studies.

Clonorchiasis control: starting from awareness

Clonorchiasis is caused by infection with food-borne liver fluke,namely Clonorchis sinensis,which is also considered to be a neglected tropical disease.It is estimated that over 10 million people are infected with C.sinensis in China and,subsequently,several thousand new cholangiocarcinoma cases occur annually.On May 18,2014,China Central Television broadcasted an episode on the habit of raw-fish eating and its potential to cause clonorchiasis in a programme called Health on the tip of the tongue.Here,I briefly introduce the content of the episode and discuss its significance for clonorchiasis control in China.

Time to tackle clonorchiasis in China

Recent publication of the global epidemiology of clonorchiasis and its relationship with cholangiocarcinoma in the journal of Infectious Diseases of Poverty has stressed the importance of Clonorchis sinensis infection.To further demonstrate its threat on public health,especially in China,comparisons between clonorchiasis and hepatitis B are made in terms of epidemiology,clinical symptoms and carcinogenicity,disability,as well as changing trends.Furthermore,major problems and prioritized researches are argued,from basic biology to intervention.Imbalance between the majority of infected population and the minority of researches in China urges for more work from Chinese scientists and international cooperation.

飞行员华支睾吸虫病一例

一、临床资料患者男性，46岁，运输机飞行员，飞行时间3000h。因体检时发现嗜酸性细胞增多1个月，于2010年4月人我院。患者在2010年3月疗养体检时，血常规嗜酸性细胞0．174，嗜酸性细胞计数1．8×10。／L。入院后查体：体温35．80C，心率78次／min，呼吸16次／min，血压120／80mmHg（1mm Hg=0．133kPa）。

Marked elevation of serum alpha-fetoprotein following Clonorchis sinensis infection: A rare case report

Clonorchiasis,also known as the liver fluke disease,is caused by eating raw freshwater fish or shrimps that contain Clonorchis sinensis cyst larvae,which mainly involves the hepatobiliary system.Chronic abdominal pain and distention,loss of appetite,and hepatomegaly are the most common clinical manifestation.Persistent infection with Clonorchis sinensis would result in chronic inflammation,epithelial hyperplasia,and periductal fibrosis and even progress to cholangiocarcinoma.Nevertheless,the majority of the infected people are asymptomatic or mildly symptomatic,contributing to its high misdiagnosis rate.Alpha-fetoprotein(AFP)is a well-known biomarker for hepatocellular carcinoma(HCC).A high level of AFP can also be caused by several benign diseases,causing confusion and influ-encing treatment decisions.So far,clonorchiasis with a markedly elevated level of AFP has been rarely reported.We present a case of clonorchiasis with a high level of AFP in a 52-year-old man.We hope to raise clinical awareness of this food-borne disease.Clonorchiasis should be considered in patients with extremely high levels of AFP,excluding HCC and germ cell tumors,especially if the patient has a history of ingesting raw freshwater fish or shrimps.