There are two possibilities for TPPA positive and TRUST negative: 1, the patient had syphilis, after treatment with medication or due to other diseases with antibiotics, after the application of antibiotics, the patient’s TRUST turned negative and did not appear positive, which is a possibility. 2, after infection with syphilis, TPPA showed positive, while TRUST did not appear positive yet due to the relatively early infection, or due to The first segment of the antibody response and did not appear positive, mainly these two cases.