《性传播疾病STD双语教学张喜.ppt》由会员分享，可在线阅读，更多相关《性传播疾病STD双语教学张喜.ppt（21页珍藏版）》请在taowenge.com淘文阁网|工程机械CAD图纸|机械工程制图|CAD装配图下载|SolidWorks_CaTia_CAD_UG_PROE_设计图分享下载上搜索。
1、LOGOSexually Transmitted DiseaseWomens Hospital,School of Medicine Womens Hospital,School of Medicine Zhejiang University Zhejiang University Prof.Lin JunProf.Lin JunSexually transmitted disease,STDvSTD is used to denote disorders spread principally by sexual intercourse or behavior similar to that.
2、vForms of transmission:Sexual transmissionIndirect contact transmission blood touchiatrogenic(医源性)transmissionSTD surveillanceSTD surveillance in ChinavvSyphilis Syphilis vvGonorrhea Gonorrhea vvAIDS AIDS vvNongonococcal urethritis(NGU,Nongonococcal urethritis(NGU,非淋菌性尿道炎非淋菌性尿道炎)vvCondyloma acuminat
3、a(Condyloma acuminata(尖锐湿疣尖锐湿疣)vvChancroid(Chancroid(软下疳软下疳)vvLymphogranuloma venereum(Lymphogranuloma venereum(性病性淋巴肉芽肿性病性淋巴肉芽肿)vvGenital herpes(Genital herpes(生殖器疱疹生殖器疱疹)Sexually transmitted disease,STDSexually transmitted disease,STDPathogens：vBacteriavVirusvSpirochete(螺旋体)vMycoplasmavChlamydiavP
4、rotozoa(原虫)vFungi(真菌)vEctoparasite(寄生虫)Sexually transmitted disease,STD Gonorrhea vPathogen：Neisseria gonorrhoeaevTransmission：primarily by sexual contactvInvasion：columnar epithelium and transitional epithelium cervix,urethra upper reproductive tractGonorrheaClinical findings：Incubation period：1-10
5、 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 circulationGonorrheaDiagnosis：According to bad sexual encounter,clin
6、ical findings and laboratory findingsGram-negative diplococci(双球菌)can be seen microscopically in secretions.Culture is the best standard.PCRGonorrheaTreatment：Principles:promptly、full dose、antibiotics availablevthird generation cephalosporinsvquinolones Criterion of cure：Under the situation of no se
7、xual 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.GonorrheaSexually transmitted disease,STD SyphilisvPathogen：Treponema pallidum vTransmission：sexually transmissionind
8、irect contact transmission blood touchfrom infected mother to fetusSyphilisClinical 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 syphilis：diffuse bilaterally symmetric extragenital pap
9、ulosquamous 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)lesionsSyphilissecondary syphilisvcondyloma latum(扁平湿疣)secondary syphilis:vpapulosquamous (丘疹疹鳞屑性皮疹)SyphilisTertiary syphilisSyphilisLaboratory findings:1.Identification of t
10、he 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 cerebrospinal fluid(脑脊液脑脊液)SyphilisTreatment：penicil
11、linCriterion of cure：Clinical cureSerologic cureSexually transmitted disease,STD Condyloma acuminata （尖锐湿疣）（尖锐湿疣）vPathogen:human papilloma virus(HPV)mainly Types 6 and 11 low-risk HPVvTransmission：sexually transmissionCondyloma acuminata Clinical FindingsSymptomsneoplasm：vulvae,cervix,vagina,periana
12、l 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 acuminataCondyloma acuminata Laboratory Findings Cytology：koilocytosis(挖空细胞)dyskeratosis(角化不良细胞)parakeratos
13、is(角化不全细胞)Acetic acid test(醋酸试验)white（+）Colposcope(阴道镜)Pathology：hyperplasia of squamous epitheliumPCR:HPV detectCondyloma acuminata TreatmentThere is no cure for HPV although lesions can be removed.nExternal medicine Podophyllin(0.5%足叶草脂毒素酊,鬼臼毒素).Trichloroacetic acid(50%三氯醋酸)nPhysical therapy Microwave Laser therapy CryotherapynExcisionnInterferon LOGO