性传播疾病STD双语教学张喜.ppt

SexuallyTransmittedDisease,WomensHospital,SchoolofMedicineZhejiangUniversityProf.LinJun,Sexuallytransmitteddisease,STD,STDisusedtodenotedisordersspreadprincipallybysexualintercourseorbehaviorsimilartothat.Formsoftransmission:SexualtransmissionIndirectcontacttransmissionbloodtouchiatrogenic(医源性)transmission,STDsurveillanceinChinaSyphilisGonorrheaAIDSNongonococcalurethritis(NGU,非淋菌性尿道炎)Condylomaacuminata(尖锐湿疣)Chancroid(软下疳)Lymphogranulomavenereum(性病性淋巴肉芽肿)Genitalherpes(生殖器疱疹),Sexuallytransmitteddisease,STD,Sexuallytransmitteddisease,STD,Pathogens：BacteriaVirusSpirochete(螺旋体)MycoplasmaChlamydiaProtozoa(原虫)Fungi(真菌)Ectoparasite(寄生虫),Sexuallytransmitteddisease,STD,GonorrheaPathogen：NeisseriagonorrhoeaeTransmission：primarilybysexualcontactInvasion：columnarepitheliumandtransitionalepitheliumcervix,urethraupperreproductivetract,Gonorrhea,Clinicalfindings：Incubationperiod：1-10days50%70%patientsareasymptomatic.1.Lowergenitaltractinfection:endocervicitisurethritisbartholinitis(前庭大腺炎)2.Uppergenitaltractinfection:pelvicinflammatorydisease(PID)3.Disseminatedgonococcalinfection(DGI)passbybloodcirculation,Gonorrhea,Diagnosis：Accordingtobadsexualencounter,clinicalfindingsandlaboratoryfindingsGram-negativediplococci(双球菌)canbeseenmicroscopicallyinsecretions.Cultureisthebeststandard.PCR,Gonorrhea,Treatment：Principles:promptly、fulldose、antibioticsavailablethirdgenerationcephalosporinsquinolonesCriterionofcure：Underthesituationofnosexuallifeand2weeksafterthewholetherapy,theclinicalsymptomsandsignshavegone.The4-7daftercure,thesmeartestingandcultureofsecretionincervicalcanalsarenegative.,Gonorrhea,Sexuallytransmitteddisease,STD,SyphilisPathogen：TreponemapallidumTransmission：sexuallytransmissionindirectcontacttransmissionbloodtouchfrominfectedmothertofetus,Syphilis,Clinicalfindings：1.Primarysyphilis：chancre(硬下疳)indurated,firm,painlesspapuleorulcerwithraisedbordersonlabia,vulva,vagina,cervix,anus,lips,ornipples2.Secondarysyphilis：diffusebilaterallysymmetricextragenitalpapulosquamouseruption(丘疹鳞屑性皮疹),condylomalatum(扁平湿疣)3.Tertiarysyphilis：cardiac，neurologic(神经的),ophthalmic(眼的),andauditory(耳的)lesions,Syphilis,secondarysyphiliscondylomalatum(扁平湿疣),secondarysyphilis:papulosquamous(丘疹疹鳞屑性皮疹),Syphilis,Tertiarysyphilis,Syphilis,Laboratoryfindings:1.IdentificationoftheorganismDarkfieldmicroscopyexamination(暗视野显微镜检查)Treponemapallidum(梅毒螺旋体)2.Serologicexaminationa.Nontreponemaltests(非梅毒螺旋体抗原试验)VDRL,RPRsyphilisscreening(筛查)b.Treponemaltests(梅毒螺旋体抗原试验)TPPA,TPHAsyphilisconfirmation(确诊)3.Examinationofcerebrospinalfluid(脑脊液),Syphilis,Treatment：penicillinCriterionofcure：ClinicalcureSerologiccure,Sexuallytransmitteddisease,STD,Condylomaacuminata（尖锐湿疣）Pathogen:humanpapillomavirus(HPV)mainlyTypes6and11low-riskHPVTransmission：sexuallytransmission,Condylomaacuminata,ClinicalFindingsSymptomsneoplasm：vulvae,cervix,vagina,perianalarea(肛周)vulvarpruritusvulvarburningsensationpostcoitalbleedingSigns：Tiny,isolatedorclusteringpinkpapules(丘疹)arepresentatfirst,thengettogetherjustlikecombshape(鸡冠状).,Condylomaacuminata,Condylomaacuminata,LaboratoryFindingsCytology：koilocytosis(挖空细胞)dyskeratosis(角化不良细胞)parakeratosis(角化不全细胞)Aceticacidtest(醋酸试验)white（+）Colposcope(阴道镜)Pathology：hyperplasiaofsquamousepitheliumPCR:HPVdetect,Condylomaacuminata,TreatmentThereisnocureforHPValthou