2005-2013年甘肃省张掖市梅毒流行特征分析

目的 了解2005-2013年甘肃省张掖市梅毒流行病学特征分析.方法 采用描述流行病学方法对张掖市2005-2013年梅毒的三间分布进行统计分析.结果 2005-2013年共报告梅毒1 535例,年均报告发病率为13.62/10万,发病率呈逐年上升趋势.以隐性梅毒为主,占发病总数的76.55％;6个县区中发病率较高的是甘州区21.54/10万、肃南县19.88/10万,较低的是山丹县6.07/10万、民乐县3.05/10万;男女性别比为1.11：1; 70～79岁组、60 ～ 69岁组发病人数较多,分别占发病总数的24.50％、21.69％;发病人数较少的是0～9岁组、10～19岁组,分别占发病总数的0.20％、0.65％.1月发病最多,占发病总数的12.18％,10月、11月最少,各占6.51％.无明显的季节高峰.结论 张掖市梅毒疫情呈逐年上升趋势,尤其是2010-2011年呈现快速增长的趋势,要进一步规范诊断报告标准,开展高危重点人群健康教育和行为干预,控制疫情传播.     

中国大陆2010-2012年暗娼人群梅毒感染状况及性行为特征的Meta分析

目的：通过2010-2012年开展的针对暗娼人群调查的Meta分析，了解中国大陆暗娼人群的基本情况、性行为特征、梅毒的感染状况和3年间的变化趋势。方法：检索中国期刊全文数据库(CNKI)、万方数据库、中文科技期刊全文数据库(VIP)和Medline(PubMed)上已经发表的2010-2012年针对中国大陆暗娼人群梅毒感染状况的学术论文，采用Stata11.0软件对纳入的文献进行Meta分析。结果：共有65篇文献入选。2010-2012年中国大陆暗娼人群梅毒感染率为4.7%（95% CI,4.2%~5.3%）；2010-2012年梅毒合并感染率逐年上升，从2010年的4.4%（95% CI,3.6% ~ 5.1%）上升至2012年的8.6%（95% CI,6.6%~10.7%）。华东地区暗娼梅毒感染率最高，为7.0%（95% CI,5.7% ~ 8.4%）。最近一次性行为安全套使用合并率为82.0%（95% CI,79.7%~84.4%）。最近1个月性行为坚持使用安全套合并率为57.5%（95% CI,52.6%~62.5%），最近1个月性行为有时使用安全套合并率为35.8%（95% CI，29.6%~42.1%），最近1个月性行为从未使用安全套合并率为6.0%（95% CI,5.1%~6.9%）。结论：2010-2012年中国大陆暗娼人群梅毒感染率较高且呈上升趋势，尤其是华东地区。最近一次性行为安全套使用率处于较高水平，而最近1个月性行为坚持使用安全套率较相对较低。     

Late latent mucinous syphilis mimicking connective tissue disease

As evidenced by the Centers for Disease Control and Prevention (CDC) statistics, syphilis is yet again on the rise. It is known as the great mimicker because of its variable symptoms and how frequently it can be confused with other diseases. The different stages of syphilis (primary, secondary, latent, late latent and tertiary) are discussed. We describe a new histopathologic pattern of syphilis, one that mimics connective tissue disease and can represent a diagnostic pitfall. In this time and age, when syphilis is rising especially among the men who have sex with men subgroup, it is important to keep a high index of suspicion of syphilis even when clinically and histopathologically the findings on first glance may not appear characteristic.     

Secondary syphilis primarily presenting with multiple nodules on the scalp: Case report and published work review

Syphilis, a sexually transmitted disease caused by Treponema pallidum , manifests with a broad spectrum of clinical presentations that usually involves skin. Nodular secondary syphilis occurs rarely, and mostly manifests as disseminated papulonodules or plaques over the trunk and limbs. We report an extremely rare case of nodular secondary syphilis that primarily presented with multiple nodules on the scalp, resembling Rosai–Dorfman disease or cutaneous malignant metastasis. Immunohistochemistry confirmed T. pallidum spirochetes microscopically.     

87例妊娠梅毒患者临床特征和妊娠结局的回顾性分析

对我院2015年1月1日至2018年12月31日诊治的87例妊娠梅毒患者的临床资料进行回顾性分析，结果示潜伏梅毒80例，一期梅毒和二期梅毒患者分别为4例和3例。潜伏梅毒患者中RPR滴度≤1:4者59例，≥1:8者21例。一期梅毒和二期梅毒患者中RPR滴度≤1:4者1例，≥1:8者6例；87例患者中，72例（82.76%）在孕期进行了抗梅毒治疗。妊娠梅毒患者的不良妊娠结局发生率为23.53%，其中先天梅毒的发生率为3.80%。RPR滴度、梅毒诊断孕周及治疗情况与不良妊娠结局的发生相关(均P＜0.05)。     

219例妊娠合并梅毒母婴传播阻断疗效的分析

目的探究妊娠合并梅毒感染孕妇母婴阻断对妊娠结局及胎儿预后的影响。方法回顾性分析2015年1月至2017年12月大连医科大学附属妇产医院行孕期产检及分娩时诊断为妊娠合并梅毒的219例病例资料,根据是否进行母婴阻断及阻断的时机,将其分为早期规范干预组(孕周期<28周)187例,晚期规范干预组(28<孕周期≤35周)5例及未干预/未规范干预组(孕周期>35周)27例。观察两组患者的妊娠结局、胎儿预后以及胎儿梅毒血清学实验。结果纳入妊娠合并梅毒219例,其中接受规范化干预的患者192例(87.7%),未发生早产、新生儿死亡、死胎事件,发生先天性梅毒2例(1.0%)。未干预/未规范干预组27例患者中发生先天梅毒6例(22.2%)、早产4例(14.8%)、新生儿死亡2例(7.4%)、死胎4例(14.8%),明显高于规范干预组(P<0.05)。低血清TRUST滴度组妊娠合并梅毒患者均未发生早产、新生儿死亡、死胎,仅发生天性梅毒2例(1.5%)。其中,先天性梅毒、早产、死胎的发生于TRUST滴度成spearman正相关,具有统计学意义(P=0.011、0.023、0.001)。结论孕期规范的青霉素干预可明显避免妊娠合并梅毒患者发生不良妊娠事件。     

Infections at the bottom end of the gastrointestinal tract

This article concentrates on specific infections of the distal gastrointestinal (GI) tract, particularly those that are transmitted sexually, by anal intercourse. Syphilis, gonorrhoea and lymphogranuloma venereum (LGV) are age old and well known diseases, but the features may be unfamiliar to GI histopathologists. Every histopathology trainee will have seen Herpes simplex virus (HSV) infection of squamous epithelium (e.g. oesophagus, vulva and anus), but the HSV pseudotumour of the anus/perineum can present a pitfall to those who have not previously encountered this entity. Another, more recently described, entity that has a predilection for the ano-rectal region is Epstein–Barr Virus (EBV) positive mucocutaneous ulcer, and this also presents a diagnostic trap to the unwary.     

Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic,antenatal clinic,integrated counselling and testing centre,other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees

In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.     

梅毒在口腔黏膜表现的临床分析——附8例报告

目的:分析梅毒在口腔黏膜的临床表现。方法:总结8例以口腔梅黏膜病损为首发症状的梅毒患者的临床特征,并结合相关文献进行临床分析。结果:8例梅毒患者中7例表现为梅毒黏膜斑,好发部位为下唇;3例表现为梅毒性黏膜炎。1例在一期梅毒时期被误诊为复发性口疮。1例儿童因父母双方均为梅毒患者而间接感染结论:梅毒在口腔的首发症状以梅毒黏膜斑最为常见。口腔医生应掌握梅毒的口腔病损,并及时对患者家属进行梅毒筛查,以免误诊,漏诊。