Syphilis, a more dangerous sexually transmitted disease

　　Syphilis is an ancient sexually transmitted disease disease , first appeared in America, and later introduced to Europe. It was introduced to my country via the coast of Guangdong in the early 17th century, and then spread. Before liberation, syphilis was widely spread in my country. According to reports, the incidence rate of syphilis in some big cities was as high as 4.5-10.1%, and in some minority areas it was as high as 48%. At that time, syphilis had a high reputation and was commonly known as "bayberry sore" and "flower or willow disease". After liberation, our government took decisive measures to close brothels and ban prostitutes, combined with vigorous mass sexually transmitted diseases Prevention and treatment, it only took more than ten years to control the epidemic of syphilis and other sexually transmitted diseases. Since then, most STD prevention and treatment institutions have been closed down, and STD courses have been canceled in medical schools. Many young and middle-aged medical staff have never seen early syphilis, and most young people have not even heard of this disease.

　　However, in recent years, syphilis, like other sexually transmitted diseases, has made a resurgence in our country and is spreading rapidly. In order to effectively control the spread of sexually transmitted diseases, the health department has decided that all medical units must restore the status of sexually transmitted diseases when conducting physical examinations before marriage, blood transfusions, military service, recruitment, and all walks of life including tourism, catering services and individual vendors. Among the relevant examination items, one of them is serological examination of syphilis, such as VDRL glass slide test, FTA-ABC test and MHA-TP test. Of course, it also includes the examination of Treponema pallidum under a dark field microscope. So what exactly is syphilis? What clinical Performance? How to spread? And how to treat it?

　　Syphilis is AIDS One of the most feared sexually transmitted diseases before it appeared, it is also a difficult disease to deal with. Syphilis is caused by a disease that moves a little like sperm It is infected by microorganisms called Treponema pallidum. They are afraid of dryness and oxygen, so their vitality outside the human body is very low. They will die quickly when exposed to dryness and sunlight. Common disinfectants such as mercury chloride (1:1000) and hot soapy water can kill them in a short time. Boiling will cause immediate death. Therefore, syphilis will not be transmitted through public facilities such as car handles and stair handrails. Treponema pallidum can survive for a long time in moist environments. Syphilis is mainly transmitted through sexual contact. In addition to genital-to-genital contact, contact between sexual organs, lips, and hands should also be considered. The routes of infection also include indirect infection through kissing, sharing tableware, medical staff examining patients, and contact with patient blood. Therefore, in Hospital The instruments used in examinations and surgeries for syphilis patients should be specially and strictly sterilized.

　　As early as 1636, Chen Sicheng recorded syphilis in the book "Mild Sore Secret Records": "Mold sores are only seen as a symptom, and are often unable to be treated externally. A closer look at the scriptures reveals that it has not been mentioned in ancient times. The root cause started before the dance, and originated in Lingnan. As a result, it has spread throughout the country, causing widespread disasters." "When the poison is felt, it is often violent...", "It enters the marrow and destroys the muscles, flows through the meridians, and attacks the internal organs, or seeks out holes and orifices... It starts with rickets, followed by bone pain, loss of eyebrows and hair, and even blindness and ear closure." “What's more, it may infect the wife and children, resulting in loss of life and good health, and the disease may be transferred to the children. ”Syphilis can also be passed from mother to mother through placental blood fetus , thus leading to premature birth , death, or delivery of congenital syphilis baby。

　　Syphilis is a chronic infectious disease that starts as a systemic infection with a slow course and invades various organs and tissues of the human body as it develops. It can also lie dormant for many years or even have no clinical manifestations for life. Syphilis can be divided into acquired syphilis (acquired) and congenital syphilis based on the source of infection. In the long-term course of acquired syphilis, symptoms appear and disappear due to changes in the body's resistance and reactivity. Generally it can be divided into phases one, two and three. The first stage is the chancre stage, the second stage is the macule stage, collectively called early syphilis, which is highly contagious, and the third stage is the late stage, which is less contagious.

　　Treponema pallidum enters the human body from the damaged skin and mucous membranes and spreads throughout the body through blood circulation 2-3 days later. After the incubation period of about 3 weeks, hard chancre occurs. At first, the affected area is reddish, and then induration gradually appears, with a diameter of about 1 cm, single, and occasionally 2 or 3. Most of them appear near the coronal sulcus of the penis, and occasionally occur on the body of the penis, labial frenulum, urethra, and pubic bone. When transmitted through non-sexual intercourse, it can be seen on the lips, tongue, anus, fingers of medical workers, etc. The surface of the chancre may be ulcerated and eroded. In the early stage of chancre, there are many spirochetes, but the serum reaction is negative. After 4-6 weeks, the lymph nodes throughout the body become swollen, and the serum reaction turns positive, indicating that the body has reacted to Treponema pallidum. Due to local immunity, chancre can "heal on its own without treatment." The spirochetes latent in the body continue to multiply and enter the blood circulation in large numbers about 3 months after infection, producing widespread secondary early-onset syphilis rash. The rash is mostly red, brown or cyan roseola or macular syphilis. It usually occurs on the front, sides and upper limbs of the body. It is symmetrical, not fused, round, oval or slightly irregular in shape. Because the body has a certain degree of immunity, the second stage of latent syphilis can also "cure without treatment" and enter a dormant latent state again, which is called second stage latent syphilis. If it is not completely cured, it will recur within 2 or 4 years after infection, which is called secondary recurrent syphilis. The rashes are less numerous and darker in color. In addition, flat condyloma may appear on the anus and external genitalia, which are papillary flaky lesions with surface erosion and exudate. Mucosal plaques with gray and white surrounding congestion may occur on the epithelium of the oral cavity and vagina. There are a large number of spirochetes in the above lesions, which are extremely contagious. In addition, there are hair loss , joint pain, periostitis and other benign symptoms of temporary involvement occur. Various damages in this period can still "self-heal", and the period is 4 years. If it exceeds 4 years, it will enter the third stage, or late stage syphilis.

　　The damage of late-stage syphilis is not limited to the skin and mucous membranes, but can invade any internal organ or tissue. It is highly destructive, has a long course, and can be life-threatening. The serological reaction is mostly positive, but the infection is low. Late-stage cutaneous and mucosal syphilis is divided into two types: nodular syphilis rash and syphilioma, which mostly occur on the head, forearms, shoulder blades, etc. ； The latter is called gummy swelling. The nodules are as big as walnuts, few in number, round in shape, and higher than the skin. The center gradually softens and ruptures, forming a round or multi-annular ulcer with a chiseled edge and thick gum-like secretion. It commonly occurs on the scalp, forehead, and calves. Gum-like swelling on the palate and nose can cause perforation of the hard palate and nasal septum, forming a saddle nose.

　　Visceral damage may occur 10-20 years after syphilis infection, mainly syphilis heart disease, aortic aneurysm, tuberculosis, paralytic dementia, etc.

　　Survivors of fetal-transmitted syphilis or congenital syphilis may develop wedge-shaped incisors, keratitis, neurological deafness, etc.

　　Since humans have no innate immunity to syphilis and there is no preventive vaccine, the best prevention is to pay attention to sexual hygiene, stay clean and avoid sexual confusion and sexual indulgence. Even if a patient is completely cured, contact with someone with syphilis can lead to reinfection.