1.What is syphilis? Syphilis is a chronic sexually transmitted disease caused by the pale spirochete, with an incubation period of 9-90 days and an average of 3 weeks. Syphilis spirochete is a very fragile pathogen, like cold and fear of heat, leaving the body is not easy to survive. However, the syphilis pathogen can invade multiple organs of the body, showing multiple signs and symptoms throughout the body. On the other hand, syphilis can remain asymptomatic for many years and is called latent syphilis. Syphilis in pregnant women during pregnancy can cause premature birth, miscarriage, stillbirth and neonatal syphilis. Syphilis is increasing year by year, according to statistics, China’s annual average increase of 13.37%, 29 to 39 years old is the high incidence of people. 2.How is syphilis infection and transmission? (1) Sexual contact transmission: This transmission route accounts for about 95%. Syphilis spirochetes from minor mucosal breaks invade the body, a large number of skin, mucous membranes, saliva, breast milk, semen, urine, so either sexual intercourse, anal sex or oral sex can be infected. Untreated patients are the most infectious in the early stages of infection, with the prolongation of the disease, the infectiousness will decrease. (2) Mother-to-child transmission: Pregnant women with syphilis can transmit the pathogen to the fetus through the placenta and develop congenital syphilis. (3) Other routes: such as blood, kissing, breastfeeding, contact with infected patients’ belongings, etc. 3.What are the manifestations of syphilis? Syphilis has more clinical symptoms and can be clinically divided into three stages, each with its own clinical manifestations. (1) Stage I syphilis: The main manifestation is hard chancre and enlarged lymph nodes nearby, which usually appear 2-4 weeks after unclean sexual intercourse. The hard chancre most often occurs in the coronal groove, glans, foreskin, and ties of the male penis, but can also appear on the lips, throat, tongue, breasts, fingers, etc. In male homosexual patients, it can appear in the anus and rectum. The hard chancre starts as a dark red patchy rash, which expands and bulges into a papule in 2-3 days, and forms a vesicle or shallow ulcer of 1-2 cm, with a small amount of plasma exudate on its surface, containing a large number of syphilis spirochetes, which is highly contagious. A few days to a week after the appearance of the hard chancre, the inguinal lymph nodes become enlarged. The hard chancre usually disappears spontaneously within 3-8 weeks if untreated, leaving no trace or only mild atrophy and pigmentation, while the enlarged lymph nodes can last for several months. (2) Stage II syphilis usually occurs 7-10 weeks after infection or 6-8 weeks after the appearance of hard chancre. In the early stage, flu-like symptoms such as vomiting, generalized lymph node enlargement, fever and headache will appear. As the disease progresses, skin and mucous membrane damage, bone and nerve destruction gradually appear. Syphilis rash is a characteristic of stage II syphilis, the rash is widely distributed and symmetrical, usually without conscious symptoms, if there is anal and external yang cancer itchy and painful, often suggest the emergence of fan flat warts. Secondly, about 10% of patients may develop hair loss. Then again, bone pain, eye inflammation, nerve damage symptoms (such as headache, hemiplegia, aphasia) gradually appear. (3) Stage III syphilis:Also known as late syphilis, most of them appear 3-4 years after infection. The skin lesions caused by stage III syphilis often form a small number of hard nodes with a large diameter, of which gum-like swelling is a typical manifestation of late syphilis, and other symptoms are similar to those of stage II syphilis. Stage III syphilis is the main cause of syphilis disability and death. 4.How to diagnose syphilis? ①History: history of unclean sexual intercourse or spouse with syphilis infection, history of indirect infection or chance of mother-to-child transmission. ②The above-mentioned typical clinical manifestations. ③Non-syphilis spirochete test (such as RPR), specific syphilis spirochete test (such as TPHA), etc. If RPR or TPHA is positive, it indicates that syphilis infection may be present and further examination should be performed, such as taking part of the exudate from vulvar ulcers to test for syphilis spirochetes under a microscope. However, many diseases may be positive for RPR and TPHA, such as systemic lupus erythematosus, rheumatoid arthritis, and liver cirrhosis. Similarly a negative RPR and TPHA does not necessarily rule out syphilis. This is because early syphilis sometimes does not have any positive results. Therefore those who suspect syphilis should be retested 4 weeks after the first test. Some syphilis patients should also undergo cerebrospinal fluid examination to rule out neurosyphilis, especially asymptomatic neurosyphilis. 5.How to treat syphilis? The main treatment is medication. Penicillin is the main drug used to treat syphilis. Syphilis spirochetes are very sensitive to penicillin. If the patient is allergic to penicillin, tetracycline, erythromycin, doxycycline or third generation cephalosporin can be used. As the cardiovascular system and nervous system are often invaded in stage I syphilis, the disability and death rate is high, therefore, syphilis emphasizes early diagnosis, early treatment and regular treatment is very important. 6.How to judge the prognosis and treatment effect? After the treatment of syphilis, how to judge whether it is cured or not is usually determined by the serological test of syphilis, generally used in hospitals are RPR (rapid plasma reactin ring card test) and TPPA (syphilis spirochete particle agglutination test). The TPPA test has a high sensitivity and specificity. Once the test is positive, it usually remains positive for life regardless of treatment or disease activity, and its titer changes are not related to syphilis activity. For those diagnosed with syphilis, a quantitative RPR test should be done before treatment. A decrease in titer can only be judged when there is a difference of more than 2 dilutions between the titer of two quantitative tests. After regular treatment, patients with syphilis should have their RPR retested every three months, and then every six months after six months, with a follow-up of 2 to 3 years, to observe and compare the current RPR titer changes with the previous ones. A fourfold or more decrease in titer 3 to 6 months after treatment indicates that the treatment is effective. The titer may continue to decrease or even turn negative. If the results of three to four consecutive tests are negative, the patient is considered to be clinically cured of syphilis. 7.How to prevent syphilis? Firstly, health education and publicity should be strengthened to avoid unsafe sexual behavior, and secondly, the following preventive measures and precautions should be taken. (1) It is necessary to track the sexual partners of syphilis patients, conduct preventive examinations, carry out treatment if necessary, and prohibit sexual intercourse before curing. (2) Pregnant women with syphilis should be given timely and effective treatment to prevent the infection of syphilis to the fetus. Unmarried people infected with syphilis should be cured before marriage. (3) For those who need to donate blood, they should go to regular blood collection points and need to do a comprehensive blood test before donating blood to prevent infection. If blood transfusion is needed, the transfusion unit should show the certificate of the transfused blood to prevent unnecessary troubles. (4) Syphilis patients should pay attention to the combination of work and rest, perform the necessary functional exercise, and maintain a good state of mind to facilitate recovery. (5) Pay attention to the details of life to prevent the infection of others: early syphilis patients have a strong contagious, late syphilis, although the contagiousness gradually decreases, but also need to be careful to protect. The actual fact is that you will not be able to get a lot of money for your own personalized products. The actual fact is that you will be able to get a lot more than just a few of the most popular and most popular items.