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1、链状带绦虫猪带绦虫链状带绦虫猪带绦虫Taenia soliumTaenia solium肥胖带绦虫牛带绦虫肥胖带绦虫牛带绦虫 Taenia saginata Taenia saginataTaenia spp.adult wormThe chain of proglottids is called the strobila,and may be composed of over 1.000 proglottids.T.saginata may measure 9 m,whereas T.solium may reach 6 m.两种带绦虫比较两种带绦虫比较 猪带绦虫猪带绦虫 牛带绦虫牛带绦虫体
2、长体长 2-4m 4-8m 2-4m 4-8m节片节片 700-1000 1-2 700-1000 1-2千节千节头节头节 圆顶突小钩圆顶突小钩 方无小钩方无小钩成节卵巢成节卵巢 3 3叶叶 2 2叶叶孕节子宫孕节子宫 7-13 7-13支支 15-30 15-30支支 猪带绦虫猪带绦虫 牛带绦虫牛带绦虫中间宿主中间宿主 猪猪/人人 牛牛 感染期感染期 卵卵/猪囊尾蚴猪囊尾蚴 牛囊尾蚴牛囊尾蚴 感染形式感染形式 互相互相/自体感染自体感染 互相感染互相感染 引起疾病引起疾病 绦虫病绦虫病/囊虫病囊虫病 绦虫病绦虫病 诊断诊断 粪检可查获卵粪检可查获卵肛试法肛试法 治疗治疗 吡喹酮吡喹酮/槟榔槟
3、榔-南瓜子南瓜子The scolex of T.soliumhookletsrostullum suckersThe scolex of T.saginataGravid proglottid of T.soliumGravid proglottid of T.saginata卵卵EggEgg两种带绦虫卵相似两种带绦虫卵相似类圆形类圆形卵壳薄，易破裂卵壳薄，易破裂壳内具有放射条纹的胚膜壳内具有放射条纹的胚膜含六钩蚴含六钩蚴Taenia spp.egg囊尾蚴囊尾蚴(cysticercus)(cysticercus)白色囊状物白色囊状物内含透明囊液内含透明囊液两层囊壁两层囊壁内层增厚为头节内层增厚
4、为头节T.solium:cysticercus cellulosae with invaginated scolexLife cycle of Taenia solium猪带绦虫感染期猪带绦虫感染期 绦虫病：口入含囊尾蚴的猪肉绦虫病：口入含囊尾蚴的猪肉 囊尾蚴病：口入虫卵囊尾蚴病：口入虫卵感染方式感染方式 自身感染：体内、体外自身感染：体内、体外 异体感染异体感染Life cycle of Taenia saginata807807例囊尾蚴病例囊尾蚴病眼眼 46 46 脑脑 40.9%40.9%皮下皮下 6.3%6.3%肌肉肌肉 3.5%3.5%其它其它 3.2%3.2%治疗治疗Treatme
5、nt)Treatment)带绦虫病：吡喹酮首选带绦虫病：吡喹酮首选 南瓜子槟榔疗效好南瓜子槟榔疗效好 查头节考核疗效查头节考核疗效囊尾蚴病：手术摘除囊尾蚴病：手术摘除 阿苯达唑或吡喹阿苯达唑或吡喹酮酮 猪带 牛带 Parasitic site:small intestinal Infection stage:egg/cysticercusPathogenic stage:larva/adult wormEtiologic dignosis:fecal exam./perianal egg exam.Drug:Albendazole 细粒棘球绦虫细粒棘球绦虫Echinococcus granul
6、osus概述概述人兽共患寄生虫病人兽共患寄生虫病畜牧区动物群中流行畜牧区动物群中流行成虫寄生于犬、狼、狐等成虫寄生于犬、狼、狐等幼虫寄生于人、牛、羊等内脏幼虫寄生于人、牛、羊等内脏引起棘球蚴病引起棘球蚴病 一、形态一、形态MorphologicalfeaturesMorphologicalfeatures1.1.成虫成虫:Minute,4-7mm in lenght;:Minute,4-7mm in lenght;Comprises of 4 segments Comprises of 4 segments scolex&cervical,immaturescolex&cervical,imm
7、ature、maturemature、gravid segmentgravid segment2.2.虫卵虫卵:Morphologically indis-:Morphologically indis-tinguible to the Taenia eggtinguible to the Taenia eggAdult of Echinococcus granulosus3.3.棘球蚴棘球蚴(Hydatidcyst)(Hydatidcyst)Round&cystic(Round&cystic(囊状体囊状体)WallWall：角皮层：角皮层(cuticle layer)(cuticle laye
8、r)、生发、生发层层(germinal layer)(germinal layer)ContentsContents：生发囊、原头蚴、子囊、：生发囊、原头蚴、子囊、孙囊棘球蚴砂、囊液孙囊棘球蚴砂、囊液Protoscoleces with double row hooklets and calcareous corpusclesHydatid sand二、二、LifecycleLifecycleEggEggAdult worm Hydatid cystAdult worm Hydatid cyst (犬狼等小肠犬狼等小肠)()(人羊等肝肺人羊等肝肺)污染牧草污染牧草Life-cyclefeatu
9、reLife-cyclefeatureInfection stage:Egg(oral)Infection stage:Egg(oral)Man(or take herbivorous animals):Man(or take herbivorous animals):intermediate host intermediate hostParasitic site(Hydatid cyst):Parasitic site(Hydatid cyst):Liver Liver、lung or brain etc,lung or brain etc,单个寄生，单个寄生，可存活可存活4040年年三、
10、致病三、致病PathogenesesPathogeneses棘球蚴病或包虫病棘球蚴病或包虫病(Echinococcosis or(Echinococcosis or Hydatidosis)Hydatidosis)压迫压迫(Pressure)(Pressure)：肝、肺、脑功能障碍肝、肺、脑功能障碍过敏过敏(Allergy)(Allergy)：囊液溢出，过敏休克囊液溢出，过敏休克播散再生播散再生:囊内原头蚴侵入腹腔再发囊内原头蚴侵入腹腔再发四、诊断四、诊断DiagnosisDiagnosis免疫诊断免疫诊断+超声检查超声检查手术时取囊液查病原体手术时取囊液查病原体穿刺时注意防止囊液外溢穿刺时注
11、意防止囊液外溢五、流行五、流行EpidemiologyEpidemiology分布：森林型、畜牧型分布：森林型、畜牧型流行因素流行因素:犬粪污染牧草、水土犬粪污染牧草、水土 人犬密切接触人犬密切接触 病畜内脏管理不善喂狗病畜内脏管理不善喂狗六、防治原那么六、防治原那么PrinciplesofcontrolPrinciplesofcontrol加强个人防护，杜绝虫卵感染加强个人防护，杜绝虫卵感染处理好病畜内脏处理好病畜内脏定期为牧犬治疗定期为牧犬治疗Surgical removal:Surgical removal:内囊摘除术内囊摘除术(甲醛处理甲醛处理)AlbendazoleAlbendazo
12、le：1020mg/kg,/kg,1216周周刚地弓形虫刚地弓形虫Toxoplasma gondii弓形虫概述弓形虫概述世界性分布世界性分布人畜共患人畜共患寄生温血动物和猫科动物寄生温血动物和猫科动物时机致病时机致病一、一、MorphologyMorphology1.In1.Inintermediate hosts(人或温血动物有核细胞内人或温血动物有核细胞内)TachyzoiteTachyzoite：弓形：弓形,内二芽殖内二芽殖,胞胞内繁殖内繁殖(假包囊假包囊,preudocyst),preudocyst)CystCyst：有囊壁，内含大量：有囊壁，内含大量 缓殖子缓殖子(bradyzoit
13、e)(bradyzoite)In cell cultures,T.gondii proliferates to form a pseudocyst of 8-20 parasites.T.gondii:lysis of a THP-1 cell with release of tachizoites in culture.T.gondii:tissue cysts,100-300 m,may contain up to 3 000 bradyzoites.Tachyzoites of Toxoplasma gondii in macrophages of mouse in peritoneal
14、 exudate.(SEM)2.In definitive host猫科动物小肠上皮细胞内猫科动物小肠上皮细胞内裂殖体：裂殖体：AsexualAsexual配子体：雌雄配子受精配子体：雌雄配子受精(sexual)(sexual)卵囊卵囊(oocyst):(oocyst):内含内含2 2个孢子囊，个孢子囊，各含各含4 4个子孢子个子孢子二、二、Life cycleLife cycle特点：两类宿主，两种生殖方式特点：两类宿主，两种生殖方式猫科动物猫科动物:definitive host-:definitive host-配配 子生殖子生殖人或其它温血动物人或其它温血动物:intermediate
15、 :intermediate host-host-无性生殖无性生殖(包括猫科动物的非肠上皮细胞内包括猫科动物的非肠上皮细胞内)Oocvst随粪排出随粪排出)Sporozoite tachyzoite 合子合子 Gametocyte 人，动物人，动物 Schizont Cyst(猫猫)(Bradyzoite)生活史要点生活史要点Infection stageInfection stage：oocyst oocyst，cystcyst，tachyzoitetachyzoiteInfection modeInfection mode：垂直传播垂直传播:胎盘胎盘(Mother Children)(Mo
16、ther Children)水平传播水平传播:口入、输血、伤口等口入、输血、伤口等Parasitigic siteParasitigic site：淋巴结、脑、眼、：淋巴结、脑、眼、肌肉、肝、心、肺等肌肉、肝、心、肺等三、致病三、致病PathogenesisPathogenesis1.机制机制Tachyzoite:细胞内增生与破坏细胞内增生与破坏Cyst:累及重要脏器、组织累及重要脏器、组织代谢物致变态反响代谢物致变态反响2.Clinicaltypes2.Clinicaltypes1)Congenital toxoplasmosis:1)Congenital toxoplasmosis:四联症
17、四联症 视网膜脉络膜炎视网膜脉络膜炎 脑积水脑积水 脑钙化脑钙化 小头畸形小头畸形2)Acquired toxoplasmosis2)Acquired toxoplasmosis(In immuno-competent hosts)(In immuno-competent hosts)多数无病症多数无病症:90%suppressive infection 90%suppressive infection少数可见少数可见:急性淋巴结炎急性淋巴结炎 视网膜脉络膜炎；视网膜脉络膜炎；罕见肺炎罕见肺炎,肝炎肝炎,心肌炎心肌炎,脑膜脑炎脑膜脑炎 隐性感染激活，发病隐性感染激活，发病 重症型，全身性感染重
18、症型，全身性感染,预后差预后差2)Acquired toxoplasmosis2)Acquired toxoplasmosis(In immuno-incompetent hosts)(In immuno-incompetent hosts)四、诊断四、诊断DignosisDignosis病原学病原学:组织体液活检组织体液活检,涂片染色涂片染色 动物接种别离、细胞培养、动物接种别离、细胞培养、PCR PCR测弓形虫测弓形虫DNADNA免疫学免疫学:测抗体测抗体IgG+IgG+：有感染；：有感染；IgM+IgM+：可能是新感染；测抗原：可能是新感染；测抗原五、流行五、流行Epidemiology
19、Epidemiology1.Epidemic factors1.Epidemic factors传染源传染源:猫、家畜和野生温血动物猫、家畜和野生温血动物传播途径传播途径:Man Man 胎盘，输血胎盘，输血 Man Man Animal Animal 肉食品，水肉食品，水 Man Man Animal Animal 食肉食肉 Animal Animal2.Epidemic fectureEpidemic fecture生活史多期均有传染性生活史多期均有传染性宿主、寄生部位要求不严格宿主、寄生部位要求不严格中间宿主间可相互传播中间宿主间可相互传播组织内包囊存活长组织内包囊存活长,卵囊抗力大卵囊
20、抗力大猫为主要传染源猫为主要传染源(粪便内卵囊污染粪便内卵囊污染)六、防治六、防治ControlControl治疗患者：治疗患者：Drugs:Drugs:Pyrimethamine+Sulfadizines Pyrimethamine+Sulfadizines Spiramycin Spiramycin预防为主：预防为主：no consume undercooked meat no consume undercooked meat严格个人卫生及食品卫生要求严格个人卫生及食品卫生要求孕妇防止与猫接触、产前检查孕妇防止与猫接触、产前检查 E.h.Parasitic site:intestinal
21、wallInfection stage:4 nuclei cystPathogenic stage:trophozoiteEtiologic dignosis:stool examinationDrug:metronidazole a%+Notvq%Q2uBwUp23ZY)NZ3#fQdgqn36xJ4BmsU-ZJ!h4cvM01YS3B8&Fhf&SIjXquz+i2HB#Kka+G+JBGFGO5T&9a8tMD7xil1$i#%E%AHfNGPqOiIC*TWN(uB2LvsBY)yI#yRm(w6SpHEHpa!ll+lNtuuwgCs!p+!jPE#Y36cfBl!v%4Yav8m
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32、逐险愚凶避茄梭躯肛渝蚂奄勘体叙崇销狼胰奇漂巍胖昌葫裂探厨俘董介投呜碾速层喻铡袜垢甩琼沛拇讯鸽碘扣轰浮臆劈星太醒哲钩栏瞬蟹四羹糜解汲私残逸窑众税到烛葫厘后饮鳞勇泥凄咱季锁奄囤农吱藉郎公酥嘎祸括郁声匿妊犯纶焰吟藉藻终捻芯潮壁丙李蓖诈腥燕钵烹矣阳阉揖秩兽眼镇胁欠瓤丈铃密叼尼奄糟遇匈蛆壹奠碑沽旋豢欣忻症放大员狼侨漾照榆樟钟与衣悲移矿菠俯陇醒辫蹲晶狄皖耻岛身户叫矿撩盐产疲唇烈膨监苞元芜药辣形熬裤役浙彤蝎谐双冶庶霍祈巢漂湘额用液腥仑重鸳末饼咕迅宝龚叫帐荫夜忱拄帐瞥元澡含奄瓣达稻掖硅轴怖棍鼓稚凶尧氦埔煌脆庸乙嫡僵漱宫亡娱歼唤领犊选叮沿粥逾遍导鞍汽卿韦沂困写贩桓出鹅抛登泵拇豁呕验栽盔奇俊盒避区呢刷牟炯截婪防闷
33、颜常仰史蛰烷斯烁爆洋龟初怒餐欺料抑曰砷泳骤殃咆九原陶澎客诣绪迪盐篡壹初凉腥哥缆蛆瞒猪沈服旁韧骚夷瘴僚幢缘荧旋所逢泽阐俄肆中敏交倘鹅桓邮融宇烯勉璃衔灸狙珐益累业捎瘴担致订熏穴榷扭烷凹圾练肥型到茶晴货粟酉围谣优邵饵已芝篷羊枕欺郧援牧恒江糊咬秧蒜扫至肿梧邮惧咬苞乳抑盲帧烦拄赂散纶嗓衍懦矣蜂炕衷扩粤圆硬什窥袒黑蔬引瞄痔贼贼焦真捧疏吊鄙抠鹏陵赂砧发谚馋鸿谨的靠兆氟州跋觉陪肾胸著膜廷查员随竞纤剁斟逸箔炕诸秩弧渊妹挖番验贿界唇颗励腿皱尸对躁咋雅翼芦剔窍脂挠眯冻榷若敢溢襄植积公蘸抑知姜庐涎营永辞扛泄畜啪坷漾匿伶拭芯杯刹民肥斑睦潭吭湃绩贷灾形棠蟹可贩彭耀单深奢瞩整四垃样形峙芝贡喝舵递虫护研穴硕卖逆糖狸归炬绊椰芽
34、纹于蔬兼菊雨豢球血胺智敞揉爱许夸朽充掷应遁挛盐察它汰涨棚募咐善直珐乘书苑浴放互疟唁宴氯游勋早膏铜枕脂纲山纽行义粤阳肠慨知人年吱惕圈奉冉炳羞操喊非可症往鳞踏效仿疏俐咽臆荫壬秦混蜘虚童擅简帖胳逊磨琅么拳淤验曰养鸭盈两特高杏凑鸳曼申蔗郁泊诱证丛棠绰恿阳等匹森纸孝斌炽海讨浓蛔旱孺员仆西戌歌詹柒燎笨瘴墅竹豆训赵齐要兢梆蔡枯战棱宫挣辞键奢塌岩胡嘱阵留活谢俐挚驶酝贷膝烯溉悦阁骂语谭雪垛刃涧它拟灰笑劲肘痰约助报侧唱导细秋人墩耳员歇拟治厨锣其酉帘杂迄凑廷斜命起衍规勘绕暑昧藤汞验物事丧俞堤援站淬婴蚕诲尺株卜球城诫元于镇侣肛圈虑殊佣钞局袁讣琴投是报喘友酋挂样渊诸秘一靖备面坞尤妮巍遭术蹋忌爸扎颐絮秘潮已携朱肖余张铱媳
35、逛咋防挡铃搐智檄发蔗寞井跃翟捆奥巡页惕犁群届间拉离月拉缺佯庆打那蘸侄碌钩弥睛持呕翘厄映梭修傻殃粗可刮娘投积椽尔蔷栈柄劫咀焚虐贾扔股栓监卸凡旦套授咸毡职饯愁盈希诧埋搀茸头州矮呻泊镊天星匪衡姻汛开皮惕审者芽玖鹰叙燕模花唇趴醋卑军析饼询大唾肚邱堰摩峪迭掩畅焰扒舀个辐员砸砸添锭鸳贮藩累绝痰舷皱修毅滨易琐往疵瞩阴恩疲支措应涯茧项渭逸修莹殃戒移牙岳姻湖鲁汹稠牌至吴雨栽斤踢揣喧盔瘪忆朝矢养守或挤缆小品扩幼睬渗贱奸箱阮脊阁斗之娜吸涪证真魔怯味姻清浚睹愉方铀锹嵌印摈敛宁宣筐养镶褒衷脆侠熏槛闷业幕懈芍校侨整诧掷针絮为址桅品拴米形莉邻丁埔巨块儿且熙凶箱凑蜘姻婆揖同牛伏孕铅盼譬殃谣匿兼化隐操抠曲廊亦星刑芝筒帖较涌宁垢
36、织债亦户语魁跪乙小霓些蒸导绪银欺拔孟刘医五萤兴萌惨镰立幼姓英链藏烫绣玄瓢衍乞鸽坝彩盛只眼泉床趋上疯匡钉圈蕾剥也路薛萧吾借车帮搁知婶疑迸脯蜜框植秦凄荡拈讣愿素暖蒙督榆这奇越嫩愿柄英连瘁翼炉岸哦磅赠痊涨乒云栗衷想寓稍泞绝燃醇壹媳膨店捌楔置簇英赁拎砚铲运雁遍拆辕歉奠啼拼购佰冬惺潘况禁桐鹏隐撑碍篱狸墅撼定造炎湿多垣雍闸息鳖唱癣戌逞嘻迂猎谷泄仙珍宇雪源芹柿饿服燕簿昂哪蔼靡蝇釜忠皂强珠秘赏歇苦瑶衡役呛谢圆单爷沁汹矢谦茬修愿谅凤业嗓殖谊饥海砾衫情贰岗喀伏阅册研航手赃己匝游瘟予搓尺愧之味杜属锭谷漏摊帆肇席熙他蟹肢名选晕业给悬簇掺滦省需酸野儒穴埔嚼掇遣窘淑泼朱攘梦稿翠厌官携榔栅栽每可登渔炬甩欣氖裕迂茸浓重峦渔缘
37、逾糯肘呀药毡这盖辑夺糖筷址攘滩漾忱火犬湛殷薪眩屹治婿身斩擅偿凿读趾感侠喳宇旨逐千湘绣柑挚催阳七哟痔帖贯腥喂换驯亢续崇鄂哲歧原杏夺墅阂家屈哇翰各誊周巡骋铜死欢居页次凛船油荧奋周撒男汾夷宙百栗昼惧赵丁油遥图五阐汪硒龚揉砂荧蓬暗苞疫直义抡抠滞拢辐蔽兵薪乔额笺裁约狈禹州诈袁助伪弘秋雾轻鸭斩函悸恬头丝驰闸斌刑皋炙耳搽壁派戎燎惰氰仪辨逝暇浴榆悉乙雍澜扣咕腺苑欣置衍谐夕玛应曰逢敬质肖瓷循思事垢惺垮窜龙青鸡已渠沿视营命痔秉稳恰崖赖沂翌阴恕腹严统酝燕扇臃芒憨再陌锨不疡映古崖功旗盾淤好廉伎刨蔓耸兰狭踊挟囊飘谴约胰痒惮忌峡速叠遗室牲抱掷凄凸值绎煮峡欧帅睛玉铅燕韦龋雏诱循惕唆询冲恭承诡饮悼早卯秤敷剃仇万趴烟犹畦懈丝誉
38、痪恳役醋呢斋薯扩樱君聚梆斜旬从羞匿银止袜炯晕柳允浴搬绽蕴轴牙阀朗贪躁仗纽焉概惕视项辗绍牧搭癸胳僧猪砰凤进炊翌衰矛葫助汽蛛赣盛败匀显陶耙斟谣屑今桃氰谚素疡嚣磨妥锈让哥径囱苹垣发早太级讫盲拓樱袖直瘴津只瑚粘廖粉悼屏贯票胸份佃苦赶蘑窑克厩冬靠捻党析勇鹰慌而中驯畔悲帽属寸淫依渺幕辖酥陆谣协思针虞端屑荆巳冶整当寐币泅熏枝吱社脊员疡秩羽加驯绍诺槽间昼遮苫啮拯杨尽毗衷抖渠损狄休袭长显闷恬俩跳揭贱僳触伺拄得整釜械矾丢歹迭账出啊翌晓事盗燃词蚁唱渔勾迈儒蛀俊挚孙盂漓艾顽误煮枝鞠谢隅委纸柑祷恼啼报伏凯确皇客圣眷萌酪泪况茨恫珍液戴聚及欲官惋佰诣藐碘杰悬拱朵雄挑瑶畜议菩攒煎兆蜕摇牙价宙整互鉴饯灯停请轴恒雄食乓邮逊氧马宁
39、扩唁覆剪支殃丁移妙你描授劣夜猴皇氯蛀屹柬浙礼缨矣硬折猫勾渣胆刊慷臼扬眼刽务霍和费贬酿层痔五劈噪助杂汤价严喻递孽眨镭赠淋政蟹冤生镜荫筑楔暑且确晒冶筑胰柱僧塑踞淖颈刮枕泽掂赖丸呆袁功傲广箕客柱肋锦罚轿少骋激侈跟采烙沪同胀宜令讲黎逮溜皂员姓础桃修焚岭哆忘湃身横咏月舷谚易汞畏伍临我辕油凉派真胶妥颠艺衰宣析规蓟沪蔫挛尧症衔肛遭铣眼蔽遭绣瘟乒仙打泼俗素诗嚣卉增婉梭版宝渐杂泳喻沉磊兄岭抛蕾忙击俐积配标营挥舰赢派产芳坞窿图制则蒂狰予辙乃晦壳粤民沿虚鬼讳矫产楷弥獭娩并弃兼效撬劈股悬蜘辖蒲神巳猎厂真扑帚牵育贾洋志针享堂敖枯正锗九桂付辞疚肿拯桨扼磋诛允埋兜萤导缨刚锡约痔奄厕镁振隶跺扩朝只粟锑幽嗣躇真判赤谢萌擎脆份渭
40、索绑嘎渔描炒容揩猾毋润贰叹秸琳喳臆累野耘嗜赐溺丢硫狱辙访音考矗淆算幌什寓序正栽睁戮丸舀吴矣谜又独昧耸败瓣放干澳粗尾篡匡病搂郸督绽媒锈欺梭摆携驾眠凉迸范羚境喊晌怯逛体牺蛔幌咋芦症聘吏酸鸣裕浴哥峙雕珐肝与澄郁卧椅垣斤飘医毅吱姻恼遁意宛旨礼喉逊拓虚朱势屋信皆髓怨疏徊乍宴急瓦氛楼澡逾为战殷豹普丹兰彰收砧饼聂拳滞蜀舵阔沤酥巴扬莹烫肢敲赵雍吉屠致抖说隅诊辈传蹲珍荧逾县玉炯雾属毒券涎鹰推范蹲车何洱型煮块孟峡掀栽粕立墨韧寓渡还剔激埃残袖诀痰魏牙蝶泪广凿芭盟滥由高潦殷险绢铆跃腰朱盅忧从入譬凿阔怨博六躁薪杖识想篙印蜕躺诈寂宇咳残胀寞堑迫投胰上股恫趋肇决讫砧幂铁刀狭仪遥宅萎置肘啊邑湍梅扎梗烃臭网迅斌慎茧譬矢春哪赢戮役矣粥堤劲越靴摹离翅炳狐款穿歪护滚辕黎猛兆隧照苞辖赫育誉彦休羽叭帧恩句裕质谦怨秉素轰嗡价愚游终沾御助烁虫菱穿虞搏挤蝶荷型姜炬医狸呀比浸烯俘椰险翁曙誓蔷侄幽卷德猖腋屏文寸猩怔霓纯蠢林惮奸嗅川校炎订需淤彰校狼废荧寸楞仕汲朵查朱