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2024年全国皮肤病防治学术年会

作者：柯吴坚南方医科大学皮肤病医院

Background: The ability to accurately identify the absolute risk of neurosyphilis diagnosis for syphilis patients would allow preventative and therapeutic interventions to be delivered to patients at high-risk, sparing patients at low-risk from unnecessary care. We aimed to develop, validate, and evaluate the clinical utility of simplified clinical diagnostic models for neurosyphilis diagnosis in syphilis patients without HIV ***: We developed and validated machine learning models with a uniform set of predictors based on six authoritative diagnostic guidelines across four continents to predict neurosyphilis using routinely collected data from real-world clinical practice in China and the United States. Model performance was measured through both internal and external validation in terms of discrimination and calibration, and clinical utility was evaluated using decision curve ***: The final simplified clinical diagnostic models included neurological symptoms, cerebrospinal fluid(CSF) protein, CSF white blood cell, and CSF venereal disease research laboratory test/rapid plasma reagin. The models showed good calibration with rescaled Brier score of 0.989(95% CI 0.984-0.995) and excellent discrimination(the minimum value of area under the receiver operating characteristic curve, 0.843;95% CI 0.809-0.877) when externally validated. Decision curve analysis demonstrated that the models were useful across a range of neurosyphilis probability thresholds between 0.33 and 0.66 compared to the alternatives of managing all syphilis patients as if they do or do not have ***: The simplified clinical diagnostic models comprised of readily available data show compelling performance, are transportable across clinical settings,and have clinical utility over a broad range of probability thresholds. The models with a uniform set of predictors can simplify the sophisticated clinical diagnosis of neurosyphilis, and guide decisions on

关键词： Neurosyphilis syphilis Clinical diagnostic model Risk-differentiated Diagnosis

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Associations of toluidine red unheated serum test response to the treatment of syphilis in pregnancy and congenital syphilis: a 10-year real-world study

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Chinese Medical Journal 2022年第13期135卷 1563-1569页

作者： Jin Wei Mengyao Pang Wenhui Lun Department of Dermatology and Venereology The Diagnostic and Therapeutic Center for Infectious DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China.

Background: So far, there is a paucity of real-world data on the syphilis serological responses to the first-line treatment during pregnancy, and there is no relevant study on the necessity of anti-syphilis treatment during pregnancy for those patients who have been treated for syphilis before pregnancy for the prevention of mother-to-child transmission, which might provide valuable insight into treatment effectiveness and optimal management of pregnant women with ***: A retrospective study on 10 years of real-world data was performed for accumulative 410 Chinese pregnant women with syphilis. The descriptive statistics were conducted in the study, and toluidine red unheated serum test (TRUST) titer responses to penicillin treatment in syphilis-infected pregnant women, and the associations with congenital syphilis were investigated. We divided the patients into two groups according to the history of anti-syphilis treatment before pregnancy (patients diagnosed with syphilis who had received anti-syphilis treatment before pregnancy, and patients screened and diagnosed with syphilis during pregnancy who had no previous history of anti-syphilis treatment).Results: The rate of congenital syphilis in this study was 6.2% (25/406). There was no significant difference in the rate of congenital syphilis between patients who received anti-syphilis treatment before pregnancy and those who did not. Secondary syphilis and high baseline serum TRUST titer (≥1:8) in pregnant women were independent risk factors for congenital ***: For the prevention of congenital syphilis, anti-syphilis treatment during pregnancy for syphilis seropositive pregnant women is needed, regardless of whether the patient has received anti-syphilis treatment before pregnancy, especially for those patients with secondary syphilis or high baseline serum TRUST titer, thus, timely surveillance, early diagnosis to timely treatment, and close syphilis reexamination during posttreatment

关键词： syphilis Pregnant syphilis Toluidine red unheated serum test(TRUST)

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Eliminating Mother-to-Child Transmission of syphilis: Chinese Practice before and during COVID-19 Pandemics

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Chinese Medical Sciences Journal 2022年第1期37卷 67-72页

作者： Fangzhi Du Ruili Zhang Qianqiu Wang Institute of Dermatology Chinese Academy of Medical Sciences&Peking Union Medical CollegeNational Center for STD ControlChina Centers for Disease Control and PreventionNanjing 210042China Department of Dermatology the Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210003China

Mother-to-child transmission(MTCT)of syphilis remains a leading cause of stillbirth and death among neonates in many developing *** 2007,World Health Orgernization launched the global elimination of MTCT(EMTCT)of *** the high burden of congenital syphilis,China subsequently released the specific national EMTCT policies and programs to reduce MTCT of *** congenital syphilis incidence rate per 100,000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in ***,due to the global pandemic of COVID-19,the current measures for eliminating MTCT of syphilis are greatly *** this article,we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years,the remarkable achievements by the policy support under the leadership of the *** the context of COVID-19 pandemics,strengthening emergency response to the regional outbreaks of COVID-19,adopting safe,rapid,early and high-quality clinical care for 100%of pregnant women to receive prenatal syphilis testing services,ensuring the availability of Benzathine penicillin for the treatment,and strengthening the closed-loop management of pregnant women and newborns infected with syphilis are the key measures to determine the effectiveness of MTCT for *** from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.

关键词： mother-to-child transmission syphilis COVID-19 China

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A Markov based model to estimate the number of syphilis cases among floating population

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Infectious Disease Modelling 2022年第1期7卷 243-251页

作者： Chentong Li Jiawei Liu Yingying Zhang Huan Lei Jinhu Xu Yao Rong Guangdong Key Laboratory of Modern Control Technology Institute of Intelligent ManufacturingGuangdong Academy of ScienceGuangzhouGuangdong510070PR China Department of Ecology and Evolution University of ChicagoChicagoIL60637USA College of Science Northwest Agriculture and Forestry UniversityYanglingShaanxi712100PR China School of Sciences Xi'an University of TechnologyXi'anShaanxi710049PR China School of Mechanical Engineering and Automation Harbin Institute of TechnologyShenzhenGuangdong518055PR China

syphilis is a sexually transmitted disease that spreads widely around the world,infecting tens of millions of people every *** China,syphilis not only causes more than 1 million infections every year,but also has its own characteristics in spreading pattern:this disease always spreads with the migration of floating *** have been many related investigations and studies on the transmission of syphilis with the floating population in China,but the study of quantitative modeling in this field is very *** this paper,based on the Markov process model and datasets collected in Zhejiang Province,China,we construct a new model to analyze the transmission and immigration process of *** results show that immigrant patients are one of the sources of infection of syphilis in Zhejiang province,and the infection rate is remarkable which should not be *** using the PRCC method to analyze the relationship between parameters and infected cases,we also find two main effective measures that can control the spread of syphilis and reduce the infection rate:the self-attention of infected persons,and the use of sexual protection *** the increasing frequent exchanges of people among different countries and regions,studying the transmission of diseases with the floating populations has become more and more *** method we use in this paper gives a new insight studying this issue,providing a quantitative research method using the data of diagnosed *** the methods and models in this paper can be extendly used in the studies of other diseases where immigrant patients should be considered.

关键词： syphilis Markov process Immigrant workers Sexual workers

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Clinical Features and Corrected Factors with Neurosyphilis in HIV/syphilis Co-Infected Patients Based on Stage of syphilis

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International Journal of Dermatology and Venereology 2022年第2期5卷 61-67页

作者： Yuan-Yuan Wang Mei Shi Zhi-Fang Guan Lei Zhang Xin Gu Hai-Kong Lu Teng-Fei Qi Li-Yan Ni Juan Wu Wei Zhao Rui-Rui Peng Lin Zhu Ping-Yu Zhou Sexually Transmitted Disease Institute Shanghai Skin Disease HospitalClinical School of Anhui Medical UniversityShanghai 200050China Sexually Transmitted Disease Institute Shanghai Skin Disease HospitalTongji UniversitySchool of MedicineShanghai 200050China China-Australia Joint Research Center for Infectious Diseases School of Public HealthXi’an Jiaotong University Health Science CentreXi’anShaanxi 710049China Melbourne Sexual Health Centre Alfred HealthMelbourne 3800Australia Central Clinical School Faculty of MedicineNursing and Health SciencesMonash UniversityMelbourne 3800Australia Department of Epidemiology and Biostatistics College of Public HealthZhengzhou UniversityZhengzhouHenan 450001China.

Objective: Neurosyphilis is challenging to diagnose, especially in patients with human immunodeficiency virus (HIV)/syphilis co-infection. The aim of this study was to profile the clinical features of neurosyphilis and evaluate the correlation between neurosyphilis and clinical or laboratory factors among patients with HIV/syphilis ***: We retrospectively analyzed the data of 479 HIV/syphilis co-infected patients examined between August 2009 and September 2018. A multivariate logistic regression model was used to identify factors correlated with ***: The overall prevalence of neurosyphilis was 21.7%. The prevalence of neurosyphilis differed among patients with primary (11.1%), secondary (20.1%), and latent syphilis (29.1%). The prevalences of neurosyphilis in patients with serological non-response and serofast patients were 26.1% and 6.3%, respectively, while 12.5% of patients with serological relapse had neurosyphilis. Patients with secondary and latent syphilis had serum rapid plasma reagin (RPR) titers (per unit) of 1.44-fold [95% confidence interval (CI): 1.08-1.93,P= 0.014] and 2.73-fold (95%CI: 1.49-5.00,P= 0.001), respectively, which increased the risk of confirmed neurosyphilis. Among patients with latent syphilis, a serum RPR titer of ≥1:32 and peripheral blood CD4 cell count of ≤350/mL were significantly associated with neurosyphilis, with adjusted odds ratios of 9.45 (95%CI: 1.86-48.03,P= 0.007) and 3.75 (95%CI: 1.11-12.66,P= 0.033), ***: A serum RPR titer of ≥1:32 and a peripheral blood CD4 cell count of ≤350/mL have predictive value in screening for neurosyphilis among HIV-positive patients with latent syphilis.

关键词： human immunodeficiency virus syphilis neurosyphilis correlated factors

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syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

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Journal of Biosciences and Medicines 2023年第7期11卷 50-65页

作者： Mbanya Gladice Mbanya Njunda Anna Longdoh Ngouakam Hermann Simon Eyongabane Ako Department of Medical Laboratory Science Faculty of Health Science University of Buea Buea Cameroon Centre for Research on Health and Priority Pathologies Institute of Medical Research and Medicinal Plants Studies (IMPM) Yaoundé Cameroon Department of Public Health and Hygiene Faculty of Health Science University of Buea Buea Cameroon Department of Pharmaceutical Studies School of Health Science Biaka University Institute of Buea Buea Cameroon Centre for Research on Emerging and Re-Emerging Diseases (CREMER) Institute of Medical Research and Medicinal Plants Studies (IMPM) Yaoundé Cameroon

syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infecti

关键词： syphilis HIV STI Pregnant Women Post First-Antenatal Care Screening ELISA Buea

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Historical perspective of syphilis in the past 60 years in China： eliminated, forgotten, on the return

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Chinese Medical Journal 2013年第14期126卷 2774-2779页

作者： CHEN Xiang-sheng YIN Yue-ping WANG Qian-qiu WANG Bao-xi National Center for STD Control and Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing Jiangsu 210042 China

syphilis （historically called lues） is a sexually transmitted disease （STD） caused by the spirochete bacteriumTreponema pallidum subspecies pallidum. syphilis had many alternate names, such as the ＂great pox＂ in order to distinguish it from smallpox, and was given many national attributions, such as the French pox, the English pox, and the Italian pox, due to the disease often being spread by foreign sailors and soldiers during their frequent,

关键词： syphilis epidemic elimination control

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Epidemiological characteristics of syphilis in Nanchong City from 2017 to 2021

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Life Research 2022年第3期5卷 15-20页

作者： Shuangshuang Che Bo Zhang Qin Zhang Xincai Wei Peng Wu Hongbin Lan Xueqian Lin Center for Disease Control and Prevention of Nanchong City SichuanNanchongChina Center for Disease Control and Prevention of Wenjiang District SichuanChengduChina Chengdu Medical College SichuanChengduChina

This study analysed the epidemiological characteristics of the syphilis epidemic in Nanchong City of Sichuan Province to provide a theoretical basis for syphilis prevention and *** syphilis epidemic data reported in the China Disease Control and Prevention Information System within the Nanchong City from 2017 to ***-squared test and linear trend Chi-squared test were used to analyse the distribution of syphilis in terms of time,region,population and development *** 2017 to 2021,a total of 16,819 syphilis cases were reported in Nanchong City,with an average incidence rate of 52.35×10^(-5).The number of reported cases and the incidence rate showed an increasing trend and then *** were 8315 males with an incidence rate of 51.45×10^(-5) and 8504 females with an incidence rate of 53.26×10^(-5).The male to female ratio is 0.98:*** age group is mainly middle-aged and older people over 50 years *** are primarily farmers,houseworkers and unemployed ***:In the past five years,the incidence of syphilis has first increased and then decreased in Nanchong City,but the epidemic situation remains *** order to effectively curb syphilis epidemic as soon as *** is necessary to increase comprehensive intervention efforts for high-risk groups,propose feasible measures to control the *** effective coordination mechanism needs to be established and extensively mobilise the whole society to participate in publicity and *** the same time,develop an efficient follow-up service to control the spread of syphilis and to improve the health of syphilis patients.

关键词： syphilis epidemiology control measures Nanchong China

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Usefulness of Positron Emission Tomography in Patients with syphilis： A Systematic Review of Observational Studies

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Chinese Medical Journal 2017年第9期130卷 1100-1112页

作者： Jian-Hua Chen Xin Zheng Xiu-Qin Liu Department of Neurology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China Clinical Pharmacology Research Center Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China

Background： Diagnosis of syphilis is difficult. Follow-up and therapy evaluation of syphilitic patients are poor. Little is known about positron emission tomography （PET） in syphilis. This review was to systematically review usefulness of PET for diagnosis, disease extent evaluation, follow-up, and treatment response assessment in patients with syphilis. Methods： We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, ***, and three Chinese databases （SinoMed, Wanfang, and CNKI） for English and Chinese language articles from inception to September 2016. We also collected potentially relevant studies and reviews using a manual search. The search keywords included the combined text and MeSH terms ＂syphilis＂ and ＂positron emission tomography＂. We included studies that reporting syphilis with a PET scan before and/or after antibiotic treatment. The diagnosis of syphilis was based on serological criteria or dark field microscopy. Outcomes include pre- and post-treatment PET scan, pre- and post-treatment computed tomography, and pre- and post-treatment magnetic resonance imaging. We excluded the articles not published in English or Chinese or not involving humans. Results： Of 258 identified articles, 34 observational studies were included. Thirty-three studies were single-patient case reports and one study was a small case series. All patients were adults. The mean age of patients was 48.3 ~ 12.1 years. In primary syphilis, increased fluorodeoxyglucose （FDG） accumulation could be seen at the site of inoculation or in the regional lymph nodes. In secondary syphilis with lung, bone, gastrointestinal involvement, or generalized lymphadenopathy, increased FDG uptake was the most commonly detected changes. In tertiary＇ syphilis, increased glucose metabolic activity, hypometabolic lesions, or normal glucose uptake might be seen on PET. There were five types of PET scans in neurosyphilis. A repeated PET scan after treatment revealed apparent or compl

关键词： Diagnosis: Positron Emission Tomography syphilis Therapeutics

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HIV and syphilis infections among street-based female sex workers in China, 2010-2012

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Chinese Medical Journal 2014年第4期127卷 707-711页

作者： Li Dongmin Wang Lu Lin Wen Li Peilong Wang Lan Guo Wei Ge Lin Ding Zhengwei Cui Yan Wang Ning Division of Epidemiology National Center for Acquired Immune Definciency Syndrome/Sexually Transmitted Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China Santa Clara County Public Health Department California 95126USA

Background Female sex workers （FSW） were high-risk population for HIV and other sexually transmitted diseases （STD） earlier,and now are an important driver of the HIV/AIDS epidemic in *** surveillance for FSW was set up to monitor the trend of HIV prevalence and risk behavior-related HIV *** study collected the data on street-based FSW from HIV sentinel surveillance system to understand HIV and syphilis infections,risk behaviors,and intervention in China from 2010 to *** The study population was the street-based FSW who were recruited for the national HIV integrated biological and behavioral surveillance between 2010 and *** information,HIV-related risk behaviors,and HIV and syphilis testing results were described and trend analysis was *** Between 2010 and 2012,the number of street-based FSW surveyed was 3725,3425,and 3335,*** knowledge awareness rate significantly increased from 74.6% in 2010 to 76.8% in 2011 and 82.2% in 2012 （P 〈0.01）.More FSW consistently used condom in the last month （49.0% in 2010; 51.0% in 2011; and 59.0% in 2012） and in the last commercial sex （72.0% in 2010; 78.5% in 2011; and 80.0% in 2012） over *** proportions of individuals who received HIV testing in the last year were 31.2% （2010）,37.0% （2011）,and 36.9% （2012）（P-trend 〈0.01）.HIV prevalence rate changed from 1.5% in 2010 to 1.4% in 2011 and 2.3% in 2012 （P-trend=0.01）.syphilis prevalence rate was 6.9%,7.2%,and 7.1% in the same *** top three provinces with the highest average HIV prevalence rates over the 3 years were Guangxi （5.9%）,Yunnan （4.2%）,and Sichuan （1.2%）.Conclusions Street-based FSW are at high risk of HIV and syphilis *** efforts need to target streetbased FSW who are of old age and minority,who use illicit drugs and have syphilis infection.

关键词： street-based female sex worker HIV syphilis prevalence risk behaviors

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