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1、Sexually Transmitted Disease,Womens Hospital,School of Medicine Zhejiang University Prof.Lin Jun,Sexually transmitted disease,STD,STD is used to denote disorders spread principally by sexual intercourse or behavior similar to that.Forms of transmission:Sexual transmissionIndirect contact transmissio
2、n blood touchiatrogenic(医源性)transmission,STD surveillance in ChinaSyphilis Gonorrhea AIDS Nongonococcal urethritis(NGU,非淋菌性尿道炎)Condyloma acuminata(尖锐湿疣)Chancroid(软下疳)Lymphogranuloma venereum(性病性淋巴肉芽肿)Genital herpes(生殖器疱疹),Sexually transmitted disease,STD,Sexually transmitted disease,STD,Pathogens：Ba
3、cteriaVirusSpirochete(螺旋体)MycoplasmaChlamydiaProtozoa(原虫)Fungi(真菌)Ectoparasite(寄生虫),Sexually transmitted disease,STD,Gonorrhea Pathogen：Neisseria gonorrhoeaeTransmission：primarily by sexual contactInvasion：columnar epithelium and transitional epithelium cervix,urethra upper reproductive tract,Gonorr
4、hea,Clinical findings：Incubation period：1-10 days50%70%patients are asymptomatic.1.Lower genital tract infection:endocervicitis urethritisbartholinitis(前庭大腺炎)2.Upper genital tract infection:pelvic inflammatory disease(PID)3.Disseminated gonococcal infection(DGI)pass by blood circulation,Gonorrhea,Di
5、agnosis：According to bad sexual encounter,clinical findings and laboratory findingsGram-negative diplococci(双球菌)can be seen microscopically in secretions.Culture is the best standard.PCR,Gonorrhea,Treatment：Principles:promptly、full dose、antibiotics availablethird generation cephalosporinsquinolones
6、Criterion of cure：Under the situation of no sexual life and 2 weeks after the whole therapy,the clinical symptoms and signs have gone.The 4-7d after cure,the smear testing and culture of secretion in cervical canals are negative.,Gonorrhea,Sexually transmitted disease,STD,SyphilisPathogen：Treponema
7、pallidum Transmission：sexually transmissionindirect contact transmission blood touchfrom infected mother to fetus,Syphilis,Clinical findings：1.Primary syphilis：chancre(硬下疳)indurated,firm,painless papule or ulcer with raised borders on labia,vulva,vagina,cervix,anus,lips,or nipples2.Secondary syphili
8、s：diffuse bilaterally symmetric extragenital papulosquamous eruption(丘疹鳞屑性皮疹),condyloma latum(扁平湿疣)3.Tertiary syphilis：cardiac，neurologic(神经的),ophthalmic(眼的),and auditory(耳的)lesions,Syphilis,secondary syphiliscondyloma latum(扁平湿疣),secondary syphilis:papulosquamous(丘疹疹鳞屑性皮疹),Syphilis,Tertiary syphili
9、s,Syphilis,Laboratory findings:1.Identification of the organism Darkfield microscopy examination(暗视野显微镜检查)Treponema pallidum(梅毒螺旋体)2.Serologic examination a.Nontreponemal tests(非梅毒螺旋体抗原试验)VDRL,RPR syphilis screening(筛查)b.Treponemal tests(梅毒螺旋体抗原试验)TPPA,TPHA syphilis confirmation(确诊)3.Examination of
10、cerebrospinal fluid(脑脊液),Syphilis,Treatment：penicillinCriterion of cure：Clinical cureSerologic cure,Sexually transmitted disease,STD,Condyloma acuminata（尖锐湿疣）Pathogen:human papilloma virus(HPV)mainly Types 6 and 11 low-risk HPVTransmission：sexually transmission,Condyloma acuminata,Clinical FindingsS
11、ymptomsneoplasm：vulvae,cervix,vagina,perianal area(肛周)vulvar pruritusvulvar burning sensationpostcoital bleedingSigns：Tiny,isolated or clustering pink papules(丘疹)are present at first,then get together just like comb shape(鸡冠状).,Condyloma acuminata,Condyloma acuminata,Laboratory Findings Cytology：koi
12、locytosis(挖空细胞)dyskeratosis(角化不良细胞)parakeratosis(角化不全细胞)Acetic acid test(醋酸试验)white（+）Colposcope(阴道镜)Pathology：hyperplasia of squamous epitheliumPCR:HPV detect,Condyloma acuminata,TreatmentThere is no cure for HPV although lesions can be removed.External medicine Podophyllin(0.5%足叶草脂毒素酊,鬼臼毒素).Trichloroacetic acid(50%三氯醋酸)Physical therapy Microwave Laser therapy CryotherapyExcisionInterferon,Thank You!,
