第四集 - 食物中毒
Character Highlight??角色介紹
Eosinophil??嗜酸性粒細(xì)胞

Eosinophils are white blood cells that are closely related to neutrophils. Those two, together with basophils, constitutes the granulocytes, so named for their appearance, composed of numerous secretory granules which contain various antimicrobial weaponry.
嗜酸性粒細(xì)胞是白細(xì)胞,和中性粒細(xì)胞關(guān)系很近。它倆,再加上 嗜堿粒細(xì)胞,組成了“顆粒性白血球”。這個(gè)名字是根據(jù)它們的外觀來(lái)的:它們帶有許多分泌顆粒,內(nèi)部裝有各種武器,用來(lái)對(duì)抗微生物。
Let me break down their name. In typical histological slides (IE, human tissue prepared to examine under the microscope), dyes are required to stain the tissue for study. Otherwise, human tissue would all look colorless except for the few pigments we express (hemoglobin, melanin, bile...). These chemical stains are meant to target different properties of tissue to stain it distinctively. The most common of these is called the hematoxylin & eosin stain which stains acidic (basophilic) tissues with hematoxylin (blue), and basic (acidophilic) tissues with eosin (red). An eosinophil is so named because it takes up a lot of this eosin dye--hence the character's pink garb, and the basophil's blue garb. Actually, blood smears are usually stained with the "Romanowsky method"...but that doesn't matter right now.
說(shuō)說(shuō)它們的名字。我們?cè)陲@微鏡下觀察人類(lèi)的組織時(shí),通常需要染料。否則,組織看起來(lái)都是無(wú)色的,當(dāng)然,少數(shù)幾個(gè)自帶顏料的(比如血紅蛋白,黑色素,膽汁...)的除外。這些化學(xué)染料會(huì)根據(jù)細(xì)胞的特性,染上不同的顏色。最常見(jiàn)的染色法是“蘇木精- 曙紅染色”,它們給酸性的組織染上蘇木精(藍(lán)色),給堿性的組織染上曙紅(紅色),所以自古紅藍(lán)出cp嘛(劃掉)。嗜酸性粒細(xì)胞(英文叫“嗜曙紅細(xì)胞”)叫這個(gè)名字,就是因?yàn)樗梢晕赵S多曙紅染料。正因如此,嗜酸性穿的是粉衣服,嗜堿性穿的是藍(lán)衣服。

The Eosinophil's twin tails? It's actually a visual representation of the cell's two lobules!
嗜酸性粒細(xì)胞的雙馬尾?那就是它細(xì)胞上的葉片。

The role that eosinophils play is multifaceted, but the most historically significant would be in defense against parasitic infection. Usually, these are large helminths--worms of various types that are too big to be phagocytosed by macrophages. Eosinophils migrate towards them, attracted to antibodies bound on their surface, and degranulate, releasing their antimicrobial payload.
嗜酸性粒細(xì)胞的工作多種多樣,但是最重要的是它能防御寄生蟲(chóng)感染。它們通常對(duì)抗的是蠕蟲(chóng) - 就是各種的蟲(chóng)子,因?yàn)轶w型太大,無(wú)法被巨噬細(xì)胞吃掉。嗜酸性粒細(xì)胞向它們移動(dòng),吸附到它們表面的抗體上,然后“脫?!保尫趴刮⑸镂淦?。
The most significant of this payload would be major basic protein, which is...somehow toxic to helminths, though 2 textbooks and a wikipedia article aren't telling me how exactly. Let's call her spear MBP? You may think that antiparasitic defense is quite insignificant nowadays, and it is, thanks to public sanitation and pest control. But spend an hour reading about neglected tropical diseases and you'll understand how serious they were in our evolutionary history.
在這些武器中,最重要的一個(gè)是“主要堿性蛋白(MBP)”,它對(duì)蠕蟲(chóng)有毒性。但我查遍了2本教科書(shū)和維基都沒(méi)搞明白,這毒性怎么來(lái)的。要不就把她的戟看成MBP好了。
你也許覺(jué)得,現(xiàn)在這個(gè)社會(huì),抗寄生蟲(chóng)已經(jīng)不重要了。的確,這要感謝公共衛(wèi)生部和害蟲(chóng)管理部。但如果你花點(diǎn)時(shí)間,讀讀那些‘不起眼’的熱帶病,你就知道寄生蟲(chóng)在我們歷史上,曾經(jīng)有多嚴(yán)重。

Eosinophils also play a role in mediating allergic reaction, and their concentration in tissues not actively infected by parasites is a hallmark for disease there (examples: eosinophilic esophagitis, lupus, various dermatitides...). They are also implicated in a number of cancers, but so are all of the immune cells, really (except mature platelets and erythrocytes).
嗜酸性粒細(xì)胞也會(huì)參與調(diào)節(jié)“過(guò)敏反應(yīng)”。在未被寄生蟲(chóng)感染的組織里,嗜酸性粒細(xì)胞的濃度,是判斷疾病的重要標(biāo)志(例子:嗜酸性食道炎,狼瘡,各種皮炎等……)。它們還會(huì)參與對(duì)抗一些癌癥,不過(guò)所有的免疫細(xì)胞都會(huì)參與的(除了成熟的血小板和紅細(xì)胞)

第四集 - 食物中毒
Oh, we start in the stomach. You remember how I talked about the innate immune system last time? Well, the gastrointestinal system has many elements that contribute to innate (or really, passive) immunity. The GI tract is, arguably, exposed to the outside world! The most obvious defense is stomach acid, yes, but we also express lots of antibodies on the mucosae, and secrete many other antimicrobial peptides. It's a harsh environment. From a non-immunologic perspective, the stomach's main role is in digestion, but specifically digestion of protein, as the chief cells of the stomach produce an enzyme called pepsin, which degrades protein, while the parietal cells secrete hydrochloric acid.
片頭就是胃。還記得上回我們說(shuō)過(guò)“自發(fā)性免疫系統(tǒng)”不?腸胃系統(tǒng)有許多東西都屬于自發(fā)性免疫。消化道,那是直接通向外部世界的!這里最明顯的防御系統(tǒng)是胃酸,但是胃黏膜上也有許多抗體,胃還會(huì)分泌許多抗微生物的蛋白質(zhì)。那里環(huán)境險(xiǎn)惡。不看免疫作用的話,胃的主要作用是消化,特別是消化蛋白質(zhì)。胃的主細(xì)胞會(huì)產(chǎn)生“胃蛋白酶”,用來(lái)降解蛋白質(zhì),而壁細(xì)胞則分泌鹽酸。

Digestion of carbohydrates and fats, however, are the job of the pancreas. The stomach also plays an important role in regulating the release of food for absorption in the small intestine. See how rocky and rough the walls are? Those are a nod to gastric rugae, folds of gastric mucosa that can flatten out when the stomach is distended.
但是,消化糖類(lèi)和脂肪,就是胰的工作了。胃也控制著食物的釋放,以便小腸的吸收。看到這些墻有多糙了不?它們象征著“胃皺褶”,它們是“胃粘膜”的皺紋,一旦胃撐開(kāi),它們就攤平了。
You don't have THAT much acid in your stomach relative to food! Remember that acid is harmful to all tissues, and the gastric lining is constantly A) replenishing itself and B) secreting mucin to offset these effects. The regulation of acid secretion is controlled by a complex interaction of hormones, which are sensitive to things like the presence of caloric content in the food you eat, as well as the physical distension of the stomach, and even the brain in anticipation of eating food.
你身體里的酸可沒(méi)這么多(相對(duì)于食物的量來(lái)說(shuō))?。∵€記得吧,酸危害所有組織;為此,胃黏膜會(huì)不斷地 1)自我更新 2)分泌粘液素抵消傷害。荷爾蒙控制胃酸的分泌,過(guò)程很復(fù)雜,并且會(huì)受很多因素的影響;比如你吃的東西的卡路里含量,胃本身的擴(kuò)張,甚至當(dāng)你腦子覺(jué)得馬上會(huì)有吃的時(shí),也會(huì)影響它。

Lol, neutrophil, are you really surprised at the presence of bacteria here? Hope you don't go anywhere near the colon.
哎呦我的天白血球,這里出現(xiàn)細(xì)菌,你真心覺(jué)得吃驚?那你可千萬(wàn)別去大腸。
Not sure who this blue & gray aquatic looking guy is. Maybe Vibrio (cholera)? Pure conjecture.
不太清楚這個(gè)藍(lán)灰色的水生物是誰(shuí)。也許是“霍亂弧菌”?瞎猜的
Eosinophils are always present in the gastric submucosa. As are lymphocytes and macrophages, despite this asshat's commentary. Actually, neutrophils are the ones you wouldn't expect to see in healthy gastric tissue. If we are looking at a stomach biopsy and we see neutrophils (known as active inflammation), we start searching for H. Pylori infection. Hey, maybe this guy is H. Pylori? He should be chilling out just within the edge of the tank then.
胃黏膜下層總會(huì)有嗜酸性細(xì)胞,淋巴球和巨噬細(xì)胞也會(huì)在那里。其實(shí)嘛,健康的胃里,中性粒細(xì)胞是最不應(yīng)該出現(xiàn)的。如果我們做胃的活體切片檢查,并且看到了中性粒細(xì)胞的話(叫“活動(dòng)性炎癥”),我們會(huì)去找“幽門(mén)螺桿菌感染”。哎,也許這家伙是“幽門(mén)螺桿菌”?他應(yīng)該會(huì)在水箱*的邊上活動(dòng)才是。
*注:指胃部的水族館

I do not know what to make of the commentary that eosinophils are "weak". They do not play a significant role in general antibacterial defense, but bacteria wouldn't really enjoy bathing in major basic protein, either. I bet the nearby stromal or epithelial cell talking smack wouldn't appreciate being hit by it too.
不明白為啥說(shuō)“嗜酸性細(xì)胞”很弱。的確,它們?cè)谝话愕目咕^(guò)程中作用不大,但是細(xì)菌也不喜歡泡在堿性的蛋白質(zhì)(嗜酸性細(xì)胞是堿性的)里。我估計(jì)在旁邊噴她的“基質(zhì)細(xì)胞”或者是“上皮細(xì)胞”也不喜歡撞上她。

Oh, and I wonder what these "chef" cells are. They seem to be packaging/preparing food for supply, which we could argue is the job of the liver (hepatocytes). Or maybe they represent the absorptive enterocytes that take up the nutrients.
我也在想這些“廚子”細(xì)胞是什么。他們好像在準(zhǔn)備食物,貌似肝臟(肝細(xì)胞)的工作?;蛘?,它們代表了吸收養(yǎng)分的“吸收性腸上皮細(xì)胞"。

A new character again! Mast cells are related to basophils, but are tissue-resident instead of circulating (EDIT: This is a common misconception that is still perpetuated in the medical pedagogy. Please see these articles for a more comprehensive review of the relationship between basophils and mast cells). They play a major role in mediating allergic hypersensitivity through the release of histamine, which has many effects including but not limited to vasodilation and gastric acid release. For a professional analysis, please see this dissertation. Also, I have never heard of them called "fat cells", I think that's translational. (confirmed)
又一個(gè)新角色登場(chǎng)!肥大細(xì)胞和嗜堿粒細(xì)胞有關(guān),但是它們住在組織里,而不是循環(huán)系統(tǒng)里(注:這其實(shí)是醫(yī)學(xué)教育領(lǐng)域里常見(jiàn)的誤解。想要了解肥大細(xì)胞和嗜堿粒細(xì)胞的關(guān)系,請(qǐng)參考更全面的文章)。它們通過(guò)釋放“組胺”(histamine),調(diào)節(jié)過(guò)敏反應(yīng)。這會(huì)引發(fā)一系列反應(yīng),包括“血管舒張”和“胃酸釋放”。另外,我從沒(méi)聽(tīng)過(guò)它們叫“肥大”細(xì)胞,應(yīng)該是翻譯的問(wèn)題。*
*up注:實(shí)際上“肥大細(xì)胞”的英語(yǔ)“mast cell”,來(lái)自于德文的mast,意思就是胖)

They just keep coming. Basophils are the third granulocytes, and they are the least common and least well-understood of the three, but they too probably play a role in hypersensitivity/allergic reactions. They are not phagocytic like neutrophils and eosinophils, but do degranulate. This guy is dressed like he's from S.T.A.L.K.E.R., wonder if that's an allusion to how he's always wandering. As a pathologist (in training) I rarely give a shit about their presence, they make up less than 1% of white cells in circulation. Basophilia, or abundance of basophils, hearkens a particular leukemia (CML). See this actual article for a review of basophil functions.
新角色層出不窮。嗜堿粒細(xì)胞是第三種粒細(xì)胞(顆粒性白血球),它也是三種細(xì)胞中,最不常見(jiàn)、人們了解最少的那個(gè)。它很可能也協(xié)調(diào)了過(guò)敏反應(yīng)。它不會(huì)像中性粒細(xì)胞和嗜酸細(xì)胞那樣吃掉細(xì)菌,但是它會(huì)“脫粒”(釋放殺掉細(xì)菌的東西)。這家伙穿的像“尾行”的人一樣,可能是因?yàn)樗偸锹o(wú)目的地走來(lái)走去吧。作為一個(gè)在陪的病理學(xué)家,我都不想鳥(niǎo)它,因?yàn)檫@家伙在循環(huán)系統(tǒng)里,占的白血球比例還不到1%。嗜堿粒細(xì)胞,或者說(shuō)一大堆嗜堿細(xì)胞,標(biāo)志了某種白血?。–ML,慢性髓細(xì)胞性白血病)。想大概了解它的作用嗎?那就讀文章吧。(但up懶得放鏈接了)

Someone posed a question in the other thread if the platelets use a "buddy system"...not that I'm aware of.
有人問(wèn)血小板是不是有“哥們兒”系統(tǒng),據(jù)我所知,沒(méi)有。
Okay, my guess on the first guy is wrong, lol. Vibrio is a genus of gram-negative bacilli with a distinctive flagellum which are known to inhabit aquatic environments and cause GI illness, especially with contaminated seafood. The most famous of these is Vibrio cholerae, which causes cholera, a disease characterized by profuse watery diarrhea (mediated by the cholera toxin) that can be fatal if fluid balance is not maintained. There have been several major epidemics of vibrio in human history, and even now there are 3-5 million cases per year, with maybe 100,000 deaths per year (most of them children in underdeveloped nations). I am unaware of what species this guy is, but note that there are many subspecies that each have unique geographic distributions. Maybe it's Vibrio vulnificus? Parahaemolyticus?
第一個(gè)家伙我猜錯(cuò)了哪?;【菞U菌屬的,革蘭氏陰性。它有獨(dú)特的鞭毛,它住在有水的地方,會(huì)引起腸胃性疾病,尤其當(dāng)它出現(xiàn)在壞掉的海鮮,就更容易引發(fā)病情。最有名的家伙就是“霍亂孤菌”,它會(huì)引起霍亂;這種疾病的特點(diǎn)是嚴(yán)重腹瀉(由霍亂毒素傳達(dá)),如果流失液體過(guò)多的話,就會(huì)致死。人類(lèi)歷史上有過(guò)好幾次大型孤菌感染,即便是現(xiàn)在,每年也有300-500萬(wàn)個(gè)病例,每年死亡人數(shù)可能是10萬(wàn)(大部分都是不發(fā)達(dá)國(guó)家的兒童)。我不知道這個(gè)家伙的種類(lèi)是什么,但是注意,每一個(gè)亞種都分布在獨(dú)特的地理位置。也許是創(chuàng)傷孤菌?副溶血弧菌?

Neutrophils are NOT phagocytosed by any vibrio species. Neutrophils are generally larger than vibrio; we just need to be sure that big fuzzy doesn't represent something else. This makes for a cool display, however.
中性粒細(xì)胞不能被任何孤菌吃掉。中性粒細(xì)胞一般比孤菌要大。我們得確定下這個(gè)毛茸茸的家伙不代表別的東西。不過(guò)真是一場(chǎng)好戲啊。

Next bug! Anisakis! Wait, wtf is Anisakis? It's not even in my medical microbio textbook. It must not be common in the west. Thankfully, review articles are available...Anisakis is a marine nematode (worm), and like most parasites it has a complex life cycle, infecting many marine animals. Humans are an incidental host, that is, we do not normally play a role in their life cycle, and ending up in a human usually represents a reproductive "dead-end" for the bug. At any rate, if it ends up in a human, it causes gastrointestinal pain from the resulting inflammation. It doesn't really do much else in the GI tract besides leech nutrients and shit out eggs. It seems more common in Japan and Portugal than in the west, though it is not a disease that is reportable to the CDC, so its incidence here may be underestimated.
下個(gè)蟲(chóng)子!海獸胃線蟲(chóng)!等下,這他喵的是啥?我教科書(shū)里都沒(méi)有。在西方應(yīng)該不常見(jiàn)。不過(guò),好在有文獻(xiàn)……海獸胃線蟲(chóng)是海洋類(lèi)線蟲(chóng),和其他寄生蟲(chóng)一樣,它有復(fù)雜的生命周期,可以感染許多海洋動(dòng)物。人類(lèi)是它的意外宿主,也就是,我們一般不摻和進(jìn)它的生活。對(duì)于這蟲(chóng)子來(lái)說(shuō),進(jìn)入到人體就意味著沒(méi)后代了。不管怎樣,如果它最終到達(dá)人體,會(huì)導(dǎo)致發(fā)炎引起的腸胃痛。除了榨取營(yíng)養(yǎng)、排卵之外,它在消化道也沒(méi)什么大的作用。比起西方,它在日本和葡萄牙更常見(jiàn)。盡管這病不需要上報(bào)給疾控中心,但是它在美國(guó)的發(fā)生概率可能比預(yù)想的多。

Gross. That's a whale stomach, btw, an intended host for the worm.
呃,這是鯨魚(yú)的胃。哦,這也是蟲(chóng)子的原始宿主。
Aw shit, the host is ralphing. Emesis is a physiologic process by which we uhh...you know what? You know damn well what it does and why it happens.
宿主在嘔吐。嘔吐是一種生理現(xiàn)象,會(huì)讓我們……不說(shuō)了,你們都他喵的知道這代表啥

Breaking through the gastric wall? Whoa whoa whoa. Generally, GI parasites are not capable of breaking through the GI wall, which has several layers of muscle. That would constitute a perforation, which is life-threatening as the GI contents can then spill into the normally sterile peritoneal space. Some parasites can cause erosion and bleeding, but perf'ing your host is probably not a smart idea for the parasite, which would prefer to lay low. Looking now, there are a few case reports, but they result from extreme bulk effect (so many parasites that the tube erupts). (per /u/Rathurue: The parasite worm does not invade through gastric wall. However, they do show at the computer screen (14:11) that the worm invades through the mucosal layer of the stomach, to be specific at the bottom of gastric pit.)
穿透胃壁?哇哇哇。一般來(lái)說(shuō),消化道的寄生蟲(chóng)不能穿透消化壁,因?yàn)樗泻脦讓蛹∪饨M成。除非發(fā)生了胃穿孔,那可是致命的,因?yàn)槭车览锏臇|西可以飛濺到毫無(wú)保護(hù)的腹膜上。有些寄生蟲(chóng)的確可以引起腐蝕和流血,但是它們給宿主打洞可不夠機(jī)智,因?yàn)榧纳x(chóng)喜歡低調(diào)。出現(xiàn)了一些事故報(bào)告,但是問(wèn)題主要來(lái)自于“膨脹效應(yīng)(bulk effect)”(寄生蟲(chóng)太多導(dǎo)致管道破裂)。(更正:寄生蟲(chóng)沒(méi)有打破胃壁,計(jì)算機(jī)屏幕上表明,它們打穿了胃的一層黏膜,具體說(shuō),是‘胃小凹’的底部)

Yay, eosinophil took out the parasite! In reality it would take a lot more than one, all of which would mob the everloving shit out of any parasite, gradually taking it out (or at least slowing it down) via toxic effect of their granules. See below.
耶,嗜酸性細(xì)胞干掉寄生蟲(chóng)!現(xiàn)實(shí)里,需要的嗜酸性細(xì)胞可不止一個(gè),它們得一起才能把寄生蟲(chóng)踢走,通過(guò)它們顆粒上的毒性慢慢把寄生蟲(chóng)趕出去(或者減緩寄生蟲(chóng)的速度)。見(jiàn)下圖。

Lol, that view of the stomach. Evidently this anisakis organism is huge. That hole at the top is the cardiac sphincter, or the gastroesophageal junction, where food is dropped in from the esophagus.
噗,胃的風(fēng)景獨(dú)好。能看出這只海獸胃線蟲(chóng)夠大的。頂上的那個(gè)洞是“賁門(mén)括約肌”,又叫“胃食管連接部”,就是食物從食道里掉下去的地方。


Summary
總結(jié)
A myriad of gastrointestinal insults from contaminated seafood. How would the average person fare? Well, vibrio is no joke, as we have discussed, but how severe an infection results depends in part on the inoculum, or really how many of the organisms you ingest. For some bugs, it takes a large inoculum. For some, it only takes a few (famously, Shigella only takes 10 or so organisms to cause symptomatic infection). I could totally believe your immune system could fight off a small Vibrio party unassisted. Anisakis, however, I can only make conjecture about. It is generally unclear to modern medicine whether or not GI parasitic infections can usually self-resolve. Many come to clinical attention, due to weight loss or prolonged GI symptoms that do not resolve, resulting in some tests (either endoscopic examination of the GI tract, or microscopic examination of the stool for the eggs & segments of the parasite) and usually resulting in a one or two-time dose of an antiparasitic agent (eg Albendazole).
壞掉的海鮮引發(fā)的一系列腸胃問(wèn)題。普通人如何應(yīng)對(duì)呢?我們說(shuō)過(guò),孤菌不是小事,但是感染的嚴(yán)重性部分取絕于(疫苗)接種,就是你吃進(jìn)去多少病菌。對(duì)于有些寄生蟲(chóng),需要大量疫苗。而另外一些只需要少量(痢疾桿菌只需要10幾個(gè)細(xì)菌就可以引發(fā)“癥狀性感染”)。我完全相信你的免疫系統(tǒng)可以自我抵抗一小撮孤菌。但海獸胃線蟲(chóng)就不一定了?,F(xiàn)在醫(yī)學(xué)還不能確定食道寄生蟲(chóng)感染,是否能完全交給身體自行解決。許多病情都需要護(hù)理,因?yàn)橛畜w重下降和長(zhǎng)期性的腸胃癥狀。醫(yī)生會(huì)讓你去做一些檢測(cè)(要么是食道的內(nèi)鏡檢查,要么是通過(guò)顯微鏡檢查shit里的寄生蟲(chóng)卵/碎片),通常會(huì)吃一次,或者兩次的抗寄生蟲(chóng)藥(比如阿苯達(dá)唑)
Antimicrobial resistance is generally not a concern in parasites, which are much larger and more complex than bacteria or viruses and take much longer to evolve significant resistance. Truly, most parasites belong to kingdom Animalia, and have more in common with us than they do with bacteria. It would be impressive (impossible?) for a single eosinophil to take down an entire worm, that's for sure.
寄生蟲(chóng)一般沒(méi)有抗藥性,因?yàn)樗鼈儽燃?xì)菌或者病毒要大得多,復(fù)雜得多,需要更長(zhǎng)的時(shí)間來(lái)進(jìn)化出抗藥性。許多寄生蟲(chóng)都是動(dòng)物界的成員,比起細(xì)菌來(lái)說(shuō),和我們?nèi)祟?lèi)更類(lèi)似。可以肯定的是,一個(gè)嗜酸性細(xì)胞,基本不可能獨(dú)自干掉整個(gè)蟲(chóng)子的。
生物類(lèi)單詞:
food poisoning? 食物中毒
eosinophil? 嗜酸性粒細(xì)胞
basophil? ?嗜堿粒細(xì)胞
granulocyte? 粒細(xì)胞,有粒白細(xì)胞
histology? 組織學(xué)(研究細(xì)胞的學(xué)科)
stain 染色
hematoxylin & eosin stain? ?蘇木精- 曙紅染色
melanin? 黑色素
parasite? 寄生蟲(chóng)
helminth? 腸蟲(chóng),蠕蟲(chóng)
phagocytose? 巨噬
degranulate? 脫粒
infection??
public sanitation? 公共衛(wèi)生部
allergy? ?過(guò)敏
lupus? ?狼瘡
gastrointestinal system? 腸胃系統(tǒng)
GI tract? ?消化道
mucosae? ?胃黏膜
pepsin? ?胃蛋白酶
carbohydrate? 碳水化合物
pancrea? 胰
intestine? 小腸
colon? 結(jié)腸
gastric? ?胃的
submucosa? 粘膜下層
biopsy? ?活組織檢查
stromal cell? 基質(zhì)細(xì)胞
epithelial cell? 上皮細(xì)胞
hepatocyte? 肝細(xì)胞
mast cell? 肥大細(xì)胞
histamine? 組胺
leukemia? ?白血病
toxin? 毒素
gastroenteritis? 胃腸炎
Vibrio cholerae? 霍亂孤菌
epidemic? ?流行病
Anisakis? 海獸胃線蟲(chóng)
host? 宿主
emesis? 嘔吐
perforation? 穿孔
inoculum? ?疫苗接種