Questions about sexually transmitted diseases

Sexually transmitted diseases are a group of diseases transmitted through sexual contact.

At present, there are more than 20 kinds of diseases listed as sexually transmitted diseases by WTO, which are divided into 7 categories according to pathogenic microorganisms. In addition to the above-mentioned classic sexually transmitted diseases, it also includes nongonococcal urethritis, AIDS, condyloma acuminatum, molluscum contagiosum, genital herpes, genital candidiasis, trichomoniasis, bacterial vaginosis, pubic lice, scabies, hepatitis B and tinea cruris.

Another definition: STD, as its name implies, is a sex-related disease. In the past, people called sexually transmitted diseases "sexually transmitted diseases", referring to diseases caused by sexual relations between men and women. But some people confuse sexually transmitted diseases with sexual dysfunction and other diseases. Strictly speaking, all diseases that can be transmitted through sexual relations can be called "sexually transmitted diseases". Sexual relations here include genital intercourse and all other forms of sexual contact. In the past, only syphilis and gonorrhea were common, while lymphogranuloma and chancre were rare. It's very different now. The World Health Organization stipulates that all diseases transmitted through sexual contact are called sexually transmitted diseases. In addition to the above four kinds, there is also a Shigella caused by AIDS, genital herpes simplex (also known as herpes Ⅱ), trichomonal urethritis, hepatitis B, nongonococcal urethritis, condyloma acuminatum, crabs, scabies, vaginal and vulvar infections, chlamydia trachomatis infections and gastrointestinal infections. It is reported that there are as many as 25 kinds of sexually transmitted diseases in the United States. Some scholars in our country advocate that the types of sexually transmitted diseases, such as hepatitis B and trichomoniasis, should not be classified as sexually transmitted diseases.

Brief introduction of several common sexually transmitted diseases;

First of all, gonorrhea

Gonorrhea is the oldest sexually transmitted disease, and its symptoms have been described in the Old Testament in 1500 BC. Greek medicine Saint Hippocrates (400 BC) called gonorrhea "Venus disease", which was caused by sex. Neisseria gonorrhoeae was isolated from 1879.

The prevalence of gonorrhea is often related to war, and the number of military casualties caused by gonorrhea sometimes exceeds the number of war casualties. There were gonorrhea pandemics in World War I and World War II. It was not until 1950s that the widespread use of penicillin curbed its widespread popularity. After 1970s, due to the influence of western sexual indulgence, gonorrhea spread widely again. At present, gonorrhea patients rank first among sexually transmitted diseases in China. Most patients develop symptoms within 3-5 days after infection, and can also survive after 1 day or two weeks.

After a man suffers from gonorrhea, he can discharge a thin and light powdery secretion from the urethral orifice, which will soon become thicker and have various colors, which can be white, yellow or yellow-green. At this time, it has become purulent secretion, and a large number of purulent marks can be seen on underwear. There may be edema around the urethral orifice, burning sensation when urinating, and swollen inguinal lymph nodes. Because male gonorrhea's early symptoms are severe, he will actively seek treatment. If not treated in time, it will spread to the urethra and cause accessory gonad infection. There are also many male patients with mild or asymptomatic symptoms, which is an important source of infection for transmitting gonorrhea to women.

About 60-80% of female gonorrhea patients have no symptoms at the initial stage, so they don't know that they are infected. Women infected with gonorrhea can invade the cervix first and discharge a small amount of purulent secretions, which is not easy to detect because of the small amount. Symptoms will also spread to the vulva and urethra, and there will be a burning sensation when urinating. Because the disease is not easy to be detected by patients in the early stage, the treatment is naturally not timely, so it is not surprising that it spreads upward through the uterus. Untreated gonorrhea has become one of the most common causes of female infertility.

Non-genital gonorrhea infection includes oropharynx, anus and rectum. Eyes are the most common infection site of newborns, so it has become a routine nursing measure to drop other antibiotics such as silver nitrate or erythromycin into the eyes of newborns after delivery. If left untreated and infected, it will lead to blindness in children. The reason why gonorrhea is difficult to control is mainly due to the drug resistance of pathogenic bacteria, short incubation period, rapid spread and great difficulty in treatment and prevention. Penicillin is the main treatment, and antibiotics such as probenecid, spectinomycin or cephalosporin can be combined. If the treatment is proper and sufficient, the symptoms can be obviously improved or disappeared in a short time.

Second, nonspecific reproductive tract infection.

Nonspecific reproductive tract infection is nongonococcal urethritis and a common sexually transmitted disease. Chlamydia trachomatis and Ureaplasma urealyticum are the main pathogens. At present, the enzyme-labeled diagnostic kit for chlamydia is imported from abroad, and its principle is enzyme-linked immunosorbent assay (ELISA). Preliminary examination shows that its incidence rate has exceeded gonorrhea, which is consistent with foreign reports. However, the early symptoms of female nonspecific reproductive tract infection are not obvious, and it is prone to serious complications, such as endometritis, salpingitis, pelvic inflammatory disease, etc., which will lead to infertility, ectopic pregnancy, abortion and so on. The preliminary investigation shows that the infection rate of women who take oral contraceptives and use intrauterine devices is higher, while men who use condoms are rarely infected. The reason is that contraceptives can increase the number of sensitive columnar epithelium, or hormones may stimulate the growth of chlamydia in cervical epithelium. Even if sexual dysfunction is excluded, the incidence of nonspecific reproductive tract infection in women taking oral contraceptives is significantly higher. Studies have shown that condoms are the only contraceptive method that can reduce the spread of mycoplasma infection. Vaginal diaphragm and cervical cap have similar preventive effects, and are not as easy to break as condoms, which can provide some protection for women who are unwilling to use condoms.

Third, genital herpes.

Genital herpes has mild symptoms, including herpes, edema or pain. Women are prone to labia, herpes often exists in clusters, and the pain is aggravated after the blister breaks. Course of disease 1-2 weeks, recurrence. There are 600,000 new patients in the United States every year, so the number of patients per year can reach 5 million-10/00000. For herpes simplex virus type II, there is no specific antiviral drug. Acyclovir can only prevent or reduce the recurrence of symptoms, but it cannot really cure the disease.

The long-term risk associated with genital herpes is that the incidence of cervical cancer can increase by 8 times, so infected women should have cervical smear cytology every six months.

Fourth, crabs.

Crabs are small, mostly parasitic in pubic hair and feed on human blood. Life expectancy is about 30 days, but only 24 hours after leaving the human body. There are many ways of transmission, except sexual intercourse, but also through sheets, towels, sleeping bags and so on. Pubic itching is the main symptom. The treatment method is shaving, thoroughly changing clothes and boiling disinfection.

Verb (abbreviation of verb) chancre

Chancroid is an acute, selective and localized disease caused by Haemophilus Dukley, which can be inoculated by itself. It usually invades the genital area and presents as a painful ulcer, often accompanied by purulent lesions of inguinal lymph nodes. The incubation period is 2-4 days, which often occurs in the navicular fossa and urethral orifice below the vaginal orifice. The ulcer boundary is obvious, round, oval or amorphous. The bottom of the ulcer is rough and covered with purulent secretions. Peripheral inflammation is obvious, red and swollen, and it feels extremely painful. It can heal itself after 6-8 weeks. Early medication can prevent the occurrence of scrofula (inguinal lymph node abscess), and sulfonamides, tetracycline, erythromycin and chloramphenicol are also effective. Penicillin is ineffective. It is not advisable to cut the transverse sputum, and the pus can be repeatedly extracted and injected.

Six, gonorrhea lymphogranuloma

Serotype chlamydia trachomatis, formerly known as the fourth venereal disease, mainly invades inguinal lymph nodes and their surrounding skin. Stellate abscess of lymph nodes is a characteristic manifestation, and sulfonamides and tetracycline have special effects.

Seven, trichomoniasis

Trichomonas vaginalis is a unicellular organism. Trichomoniasis can spread between men and women, so it is a sexually transmitted disease. If a diagnosis is to be made, both sides must be treated at the same time. The leucorrhea of patients with trichomoniasis is obviously increased, which is foamy, white or yellow, and has a foul smell. Examining vaginal secretions under a microscope, trichomonas with four flagella can be found. Oral metronidazole is effective.

Eight. AIDS

"AIDS" is a transliteration of the English abbreviation AIDS, which is called acquired immunodeficiency syndrome in medicine. Aids is a virus infection, and the patients mainly include homosexuals (75%), heroin injectors (15%), Haitian immigrants in the United States (5%), hemophiliacs who often receive concentrated anti-hemophilia globulin therapy (1%) and others (4%). Its initial manifestations are similar to the common cold and pharyngitis. Half of the patients may have symptoms such as systemic lymphadenopathy and hepatosplenomegaly, but these symptoms are not specific. There are two unique symptoms: one is multiple hemorrhagic sarcoma of the skin, and the other is complicated by some diseases rarely seen by ordinary people, such as pneumocystis pneumonia, toxoplasmosis, atypical mycobacteria and mold infection, with an incidence rate of 25-50%. AIDS is called the plague because its spreading speed and spreading area are amazing. The transmission route of AIDS is basically similar to that of hepatitis B, and its virus can exist in blood, semen, saliva, tears and milk. Sexual transmission is the most common mode of transmission of AIDS, especially among homosexual or heterosexual promiscuous people, but it is not the only mode of transmission. Research by the Centers for Disease Control in the United States shows that saliva can inactivate HIV, so the detection rate of virus in saliva is low and the transmission rate of saliva is low. Although oral genital contact is not a harmful behavior, the risk of infection it brings can never be ruled out, because semen, blood and so on will always be in contact. Condoms can only limit the contact of semen, but can't completely protect it. Therefore, it cannot be safe just because it is used.

So far, there are140,000 HIV carriers in the world, of which more than 2 million people have developed into AIDS patients, and there are 300,000 AIDS patients in the United States alone. The mortality rate of AIDS is surprising: 36% within one year after diagnosis, 5 1% within two years and 70% within three years. Unlike cancer, AIDS can be controlled or delayed by surgery, chemotherapy and radiotherapy. Because there is no preventive vaccine and no specific medicine for treatment. According to the World Health Organization, if there is no breakthrough in research, by the end of this century, the number of AIDS patients will reach100000, and the number of virus-infected people will reach 40 million to1200 million. China's foreign aid medical staff tried Chinese medicine to treat AIDS in the United States and Africa, and achieved gratifying results, which are currently under further study.

Some people regard AIDS as God's punishment for homosexuality, but the facts show that this statement is far from scientific judgment, because the spread between heterosexuals has increased day by day, and it has surpassed the spread between homosexuals. Besides, homosexuality exists at home and abroad. Why doesn't the past exist? It didn't appear until after the 1980s. At present, some scientists have suggested that HIV is not the only cause of AIDS, so is the vaccine and drug research aimed at it aimless? ! They may not only be ineffective, but also have adverse effects. It has been suggested that environmental pollution, the disappearance of ozone layer and the enhancement of radiation in outer space are important factors that induce the enhancement of virus toxicity.

Nine, syphilis

Syphilis is one of the ancient sexually transmitted diseases. Penicillin is a powerful weapon to treat syphilis, but its radical cure is still a difficult thing. Syphilis is characterized by no symptoms for 3 weeks. After 3 weeks, the genitals began to appear hard papules, and then festered to form ulcers. The edge of the ulcer is hard and bulged, which is called "hard chancre". Pay attention to distinguish it from chancre and genital herpes. It will be six weeks before a diagnosis can be made through a blood test. Some people have no symptoms, but they are at risk of infecting others and developing into cerebral syphilis in the later stage. Check the blood regularly, and treat it in time if it is positive.

Before AIDS appeared, syphilis was the most harmful sexually transmitted disease, and its clinical manifestations were extremely complicated, which could invade various organs and tissues of the body. Early invasion of skin and mucosa, late in addition to mucosa and skin, especially easy to invade the heart and central nervous system. There are no advanced cases at present. In the late 1960s, there were still cases of advanced syphilis such as syphilitic heart disease and gummosis in China.

Generally, as long as there is no redness after 1 week, there is no problem. Don't worry. Amoxicillin is of little use for sexually transmitted diseases. As long as cephalosporins are taken continuously for 3 days, the incidence rate can be minimized.