I. What kind of pathogens cause syphilis? How is it transmitted? What is the difference in outcome between the different routes of transmission? Syphilis (syphilis) is a systemic chronic infectious disease caused by Treponema pallidum (TP), mainly through sexual intercourse, the invasion site is mostly the pubic area. There are several ways of transmission: 1, sexual contact transmission: more than 95%, including anal and oral sex infection; 2, fetal transmission: pregnant women with syphilis can be infected with syphilis through the placenta and the fetus. Infection usually occurs after the fourth month of pregnancy; 3, blood-borne transmission. 4.Other A few patients can be infected by direct non-sexual contact with the skin and mucous membranes of syphilis patients, and a very small number of patients can be indirectly infected by contact with underwear, bedding, towels, razors, cutlery and medical equipment with syphilis spirochetes. Congenital syphilis is transmitted from the placenta and no hard chancre occurs; congenital syphilis has some characteristic symptoms that are not present in acquired syphilis; early lesions of congenital syphilis are more severe than those of acquired syphilis, but later stages are less severe; cardiovascular involvement is rare, but skeletal and sensory systems such as eyes and nose are more commonly involved. Blood-borne transmission is similar to congenital syphilis, and there is no clinical manifestation of Phase I syphilis. Second, how is syphilis typed and staged? What are the characteristics of each? Syphilis can be divided into acquired syphilis and congenital syphilis according to the route of infection. Syphilis can be divided into early syphilis and late syphilis according to the development of the disease Syphilis serology false positive reaction: no syphilis spirochete infection, but syphilis seropositive, can be divided into technical false positive and biological false positive. Technical false positives are caused by the techniques of specimen preservation, delivery and laboratory operations, such as repeated tests, and tests in patients without syphilis can turn negative; biological false positives are caused by patients with other diseases or changes in physiological conditions, and positive syphilis seropositivity caused by other spirochetes, such as Pinta, Yaws, regression fever, rat bite, etc., is not a false positive reaction, but a true positive reaction. Rather, they are true positives. False positive syphilis serology occurs mainly in non-spirochete antigen serology, and less frequently in spirochete antigen serology. Serum fixation: Patients with syphilis who have undergone anti-syphilis treatment do not turn negative for a certain period of time for non-spirochete antigen serologic tests (e.g., RPR or USR tests). Serum resistance in patients with early syphilis is often associated with inadequate or irregular treatment, relapse, reinfection, or with neurologic syphilis. Serum resistance in late syphilis is related to the type of syphilis and the timing of the start of treatment; these patients are not able to reduce their serum titers after regular anti-syphilis treatment, even if more treatment is given. Early syphilis includes stage I, stage II, and latent syphilis within 2 years of disease. Irregular and incomplete treatment of early syphilis may result in the following consequences: 1. recurrence of syphilis; 2. serum fixation; 3. cardiovascular, central nervous system or other late syphilis damage; 4. becoming a source of infection and endangering sexual partners. At present, penicillin is still the drug of choice for the treatment of syphilis, other antibiotics such as tetracycline hydrochloride, erythromycin and doxycycline can also be used with reliable efficacy in case of penicillin allergy. Especially for patients who have positive penicillin skin test and must use it (such as pregnant women with syphilis), desensitization should be performed as much as possible before treatment. This desensitization therapy is only effective for type I metaplasia, but not for type IV metaplasia. Penicillin therapy must be administered within 12 hours of the completion of desensitization, and if this time period is exceeded, desensitization therapy must be repeated. There are two types of desensitization, oral and intravenous, and oral is generally considered safer. Desensitization should be carried out under close supervision with certain medical equipment, and the dose should be gradually increased. Gonorrhea is a purulent inflammatory disease caused by the bacterium Neisseria gonorrhoeae. The lesions occur mainly in the genitourinary tract of men and women and are mostly transmitted through unclean sexual intercourse. Neisseria gonorrhoeae, also known as Neisseria gonorrhoeae, is a Gram-staining negative diplococcus, which resembles a kidney, arranged in pairs, 0.6~0.8μm in size, without flagella, without pods, without forming budding cells, often in multinucleated granulocytes in the acute phase, and outside multinucleated granulocytes in the chronic phase. Gonococci like moisture and fear of dry, aerobic growth, rapid reproduction, the optimal temperature for culture 35 ~ 36oc, more than 38.5 oc or less than 30 oc will not grow. The isolated gonococcus has poor resistance to external physical and chemical conditions, and can only survive in clothing and bedding for about 18~24 hours, and die in dry environment for 1~2 hours, and die immediately at 56 oc. It is also very sensitive to general disinfectants. Incubation period is generally 2~10 days, average 3~5 days, weakness, drinking, sexual intercourse, etc. can shorten the incubation period, improper treatment can make the incubation period longer.