2020年11月24日星期二

hemorrhoids treatment cream,Live interview: three-stage therapy for condyloma acuminatum

    China Family Network Live Interview

    October 29, 2013

    Three-stage therapy for condyloma acuminatum

    Wu Yan: In the first stage, we have to remove the warts. Everyone knows that condyloma acuminata is a wart-like growth on the external genitalia. The surface can look like a cauliflower. When we treat this disease, the first step is to remove the wart. There are many ways to remove them, including laser, surgery, electrocautery, and freezing, including some topical drugs. We know that some corrosive drugs, such as podophyllotoxin, can be used on the surface of the wart of condyloma acuminata. Falling off. The effects of these treatments are basically very good, but it solves the problem of the first step. It only solves the problem of removing the condyloma acuminatum. This problem is easy to solve. There are many methods at present, whether it is single use or comprehensive Use, the effect is good, no matter whether the warts are single or multiple, or scattered, or inside the lumen, such as condyloma acuminata at the urethra or cervical canal, and vaginal wall Condyloma acuminatum can be solved better. 2013-10-29 20:119DQ stenographer

    Wu Yan: A very important point of genital warts is recurrence. If the amount of the virus is large and the area of ​​the abdomen of the virus is very wide, then the recurrence rate must be high. The second aspect is the body’s immunity. This immunity should mainly include two In one aspect, one is local immunity, which refers to the tissue and surrounding parts of the wart body, and the local immune function. It has been proved through domestic and foreign literature studies that local immune function can cause recurrence of condyloma acuminatum. In addition, the weakened immune function of the whole body can also cause condyloma acuminatum to recur easily. For example, for HIV-infected patients, condyloma acuminatum is not easy to treat, because HIV-infected patients have low immunity, which will cause the virus to reproduce more easily and spread across a wider range. When the immunity is very low, it is not only easy to grow Warts, and this HPV infection has a higher chance of causing cancer than people with normal immune function. So one is local systemic immunity and the other is the virus itself. Both of these can cause recurrence of genital warts. After the body is removed, a considerable part of condyloma acuminatum will relapse. How high is the recurrence rate? Research reports at home and abroad are inconsistent, but the range fluctuates between 20% and 80%, and some are even higher or lower. However, most studies believe that more than half of the condyloma acuminata may recur, so the recurrence cycle is different. Some relapse in a relatively short time, and some relapse after many years. I once had a patient, After ten years, there is a relapse again, and there is another patient who relapsed after about five or six years. It really shows that condyloma acuminatum is a disease that is easy to relapse. We must not only treat the symptoms, but also find ways to cure the root cause. The first step is to treat the symptoms, which is to remove the warts on the surface, remove the warts on the surface, and remove the warts by the various methods mentioned above. After removing the warts, we will proceed to the second step, which is to prevent recurrence. So far, The treatment of condyloma acuminatum is not very accurate in the world. There is a definite method to prevent recurrence, but it can reduce the recurrence rate of the virus. I will give you a brief introduction to some of the commonly used methods, mainly in several aspects. One is photodynamic therapy. Photodynamic therapy is a relatively new treatment technology developed in recent years. It can indeed alleviate the recurrence of warts in patients to a considerable extent. Photodynamic therapy is mainly based on high energy. The laser and photosensitizer work together, so how can it be treated? After removing the wart, apply a photosensitizer to the surface of the wart tissue. Usually, the drug is put on cotton yarn and then applied to the surface of the skin. , And then pack it outside. After about two or three hours of packing, we will irradiate with a special high-energy laser. This laser will cause some changes in the photosensitizer. This photosensitizer is special, that is, there are more warts. The part that contains the virus, or the part that contains the virus, it is more specific absorption, but not much photosensitizer is absorbed in normal tissues. This will give us a guide. To a certain extent, it is a targeted therapy. We cannot distinguish which part of the skin is problematic and which part is okay. However, if it is targeted, the part that absorbs the photosensitizer is often the diseased part. Under the irradiation of this laser, cells or tissues Under the irradiation of the laser, the energy will change after absorbing the photosensitizer, which leads to the destruction of tissues or cells. At this time, invisible warts can be removed to a considerable extent, which is what we call the latent condyloma acuminatum Infection, or let the virus clear. 2013-10-29 20:189DQ stenographer

    Wu Yan: Photodynamics is mainly due to the high cost. Many people have reported that after the medical reform, medical treatment has become more and more expensive. In fact, a very important factor is the inflation factor. Everything is expensive. In fact, sometimes we should think of, Chinese cabbage has increased a lot of money, but our medicines are decreasing in price, including some countries’ policies to separate medicines. In general, medicines are reduced in price and mandatory price reductions. And now some hospitals have implemented medicines through medical reforms. In the past, when the medicine was used to support the doctor, the hospital had to add 10% to 15% after the medicine was introduced. In addition to the addition, it was the income of some other medical treatments. There was no special allocation of a lot of money to the hospital. Maintain normal operations, including the salaries and benefits of doctors and nurses. Now we need to abolish the use of medicines for medical care and increase the cost of diagnosis and treatment. However, the price of medicines has come down. It is indeed a good news for the common people. However, considering the factor of inflation, but in general It seems that seeing a doctor is more expensive than before. In this context, photodynamic therapy is not a good choice. Although the method is good, these treatments are not mainly recommended in our clinical work, because if it is too expensive , The patient is also unacceptable. 2013-10-29 20:209DQ stenographer

    Wu Yan: The other is the injection at the base of the wart body. On the one hand, some immune enhancers can be used, including thymosin or other immune enhancers. On the other hand, you can use interferon or interleukin, which is actually a kind of Cytokines also have the effect of enhancing immunity, but they also have anti-tumor, anti-proliferative, and even anti-viral effects. These effects are the characteristics of condyloma acuminata virus and are prone to relapse when the body's immune function is low. Features. In our clinical work, we have also been constantly observing. After summarizing the experience and lessons of local treatment, we have also found that, in general, the difference in recurrence between local injections and people without local injections is quite obvious. Of course This is also done with the support of relevant research at home and abroad. 2013-10-29 20:229DQ stenographer

    Wu Yan: The third thing is to remove the warts, such as podophyllotoxin. After the warts are removed, some people will dilute the wart-removing drugs or pack them in order to prevent further recurrence of the warts. There are also drugs such as imiquimod, which also have the effect of preventing recurrence. Different methods have different effects and different recurrence rates. Of course, the need to pay is mainly financial, as well as time and energy. The cost is different. Generally speaking, the photodynamic method is done three or four times. The effect is good for most people. However, if it is like a local injection method, the number of visits may be slightly more, especially for some patients outside the city. It may be more troublesome. Not all people can accept this kind of treatment. It is indeed inconvenient. If local injection is done in sensitive areas, some people will also worry about pain or the impact on organ and tissue function, but as long as it is Properly operated, the overall effect is good, and the side effects are completely controllable. 2013-10-29 20:239DQ stenographer

    Wu Yan: The third stage is follow-up and consolidation. We should not use photodynamics, local injection, or topical drugs because the warts have been removed in the first stage. This can prevent recurrence. At that time, you can sit back and relax, and you can take it lightly. In fact, this is far from the case. Some people with genital warts may have recurrence after several years. At this time, long-term observation is required, at least three months, most It is good for more than six months, or as long as one year. If it has not relapsed for more than six months, we can basically assume that it has not relapsed. Today we are talking about a three-stage treatment, which can make the treatment have a better effect. The first stage is to remove the warts, whether it is laser, freezing, electrocautery, or topical drugs. The second stage is to prevent recurrence, including Some local injections, including some topical drugs, photodynamic therapy, and even other methods. The third is follow-up monitoring to consolidate the curative effect. At this stage, we need to observe regularly. This observation includes our own observation. , Including going to the doctor to observe, how to observe by yourself? Let me introduce you to a more useful method, you can buy white vinegar, white vinegar at around 5 degrees, if you have had genital warts before, using white vinegar can help to a certain extent to identify which parts of the body have warts, or have sub-spots Infected, under normal circumstances, 5 degrees white vinegar cannot be compared with glacial acetic acid, but it can also play a part of the role. After applying it, if there is a whitish place within a few minutes, then there may be warts or There is a viral infection, or there is a subclinical infection, this is a relatively effective method.In addition to this method, it is to find a doctor. The doctor can see if there are warts, and the other can be tested, that is, it can be tested for HPV, which is the detection of human papillomavirus. If it is a wart, it can pass pathology. An experienced doctor can judge whether there is condyloma acuminata by looking at the examination, but for areas without warts, or cases where warts have been treated, or patients with warts, his sexual partner should consider Knowing whether there is an infection can make a preliminary judgment by detecting HPV. Some hospitals can do this testing method, some hospitals can’t do it, some hospitals can only do high-risk types, some can do both high-risk and low-risk types, some hospitals use qualitative methods, and some hospitals do it. It is a quantitative or even semi-quantitative method. The situation in different hospitals is different. This test can classify the virus into high-risk and low-risk. There are more than 100 subtypes of HPV, and it is common to cause condyloma acuminatum. Ten types can be divided into two categories, one is low-risk type, the other is high-risk type, low-risk type mainly causes condyloma acuminatum, or warts on other parts of the body, and high-risk type is cancer. Danger is the risk of cervical cancer for women, and the risk of penile cancer for men. High-risk and low-risk can be tested separately. You only need to go to the hospital for a doctor to do an examination. Depending on the situation, there may be more than 200 to more than 300 for one test. This test is still very useful, especially for spouses. Screening of patients, or tracking of recurrence after treatment, can be performed by detecting HPV, which is painless. Through follow-up after treatment, at least six months of follow-up, there is no recurrence of warts. We can consider it to be relatively safe. The recurrence rate in the future is very low, but we should also pay attention to the recurrence of this virus. It has a lot to do with the immune function, so don't take it lightly. During the follow-up phase, we should also do some moderate exercises and exercises regularly to get a good rest. 2013-10-29 20:369DQ stenographer

    Wu Yan: In addition, HPV in the oral cavity, the safety of medicines, and topical smearing methods are not suitable for the oral cavity. Treatment is more troublesome. The best way is prevention. I hope everyone has sex, especially when you have sex. Now that this kind of mobile network is developed, outings are softened, and various APP applications have made one-night stands or extramarital sex more versatile than before, and it is easier and more convenient. In fact, this is satisfying the curiosity of some people. The heart, while satisfying the desires of some people, is also risky. This risk is the risk of contracting various diseases. We feel that all kinds of sexually transmitted diseases are on the rise, and it is also a wake-up call. I still think we should give confidence to patients with condyloma acuminatum. Most of the patients treated in our hands can be cured in our experience. It may take a while, maybe one or two months, even two or three months. , But in the end the curative effect of patients is very good, and the recurrence rate is also very low, we need to remind the majority of patients, if you have this disease, do not worry too much, try to go to a regular hospital, most of the patients can be Recovery in a relatively short time. 2013-10-29 20:409DQ stenographer

    Moderator: Does syphilis infection have to come into contact with the body fluids of syphilis patients to get syphilis? As long as there is no contact with any body fluids of the patient, it will not be infected? Does the route of infection require body fluid contact? 2013-10-29 20:419DQ stenographer

    Wu Yan: In fact, what he said is reasonable. Skin contact is not necessarily the body fluids we understand, including semen and vaginal secretions. It may also be tissue fluids, such as skin damage, because patients with syphilis have The skin itself has broken skin and the vulva has ulcers. This ulcer contains some tissue fluid and a large amount of Treponema pallidum. Once the other party comes in contact with it, it may be infected. Therefore, these transmission routes of syphilis are directly indirectly in contact with body fluids. It is related, but we must also consider that in the eyes of doctors, not everyone has such a deep understanding of body fluids. Some people think that they have sex and are wearing condoms. Why do they still get syphilis? I don’t know how to get the infection. In the past few days, there have been several cases of such patients. It is a female who has found syphilis during pregnancy. It is not clear. The male is not checked, and the female is very high. How did these cases get infected? It is not particularly clear. Sometimes I can ask, sometimes it is not convenient to ask too deeply, and she is not willing to ask, especially when she is accompanied by her family. So don’t consider whether body fluids are not body fluids, whether there is blood contact, whether there is sexual contact, whether there is the possibility of mother-to-child transmission, it does not mean that contact with body fluids must be infected with syphilis.It depends on what kind of body fluids, the most important thing is whether the other party has syphilis. There are important conditions for the spread of the disease. The first is the source of infection. The other party must be a patient with syphilis, not to say that it is only syphilis antibody positive. It must be a patient with syphilis. Treponema pallidum is found in the blood or tissue, or the RPR or TRUST titers found in the serum are relatively high. At this time, it means that there is a syphilis infection. Regular treatment, after a long period of observation, there is no recurrence, but if the antibody of Treponema pallidum in the blood is positive, there may not be an infection. Even if there is contact with blood or body fluids, the infection may not necessarily occur. You need to pay attention this problem. 2013-10-29 20:459DQ stenographer

    Moderator: Male 42 has had genital herpes for three years. He has had ten recurrences. For each relapse, he took valacyclovir to control it. Now he has mild fibrosis caused by alcohol in his liver. I don't dare to take valacyclovir anymore for fear of affecting the liver. I wonder if I should not take medicine for this relapse? How much does valacyclovir affect my liver in this condition? Thank you 2013-10-29 20:459 DQ stenographer

    Wu Yan: This recurrence rate is still very common in genital herpes. The recurrence rate is high or low. If it is more than 6 times, it is considered frequent recurrence. If it is less than 6 times a year, the recurrence is not so frequent. For frequent relapses, the treatment plan is different. If it is frequent relapses, we recommend immunosuppressive therapy and long-term antiviral drugs. Infrequent recurrences, less than 5 times a year, can be considered to be treated only when they relapse. There are long and short periods of taking valacyclovir at home and abroad. The longest one or two years, even two or three years, have been taking valacyclovir, and there are even longer ones. In general, valacyclovir The safety of this medicine is relatively good. The first thing to consider for long-term side effects is not the liver, but the kidneys. Patients with kidney function problems may have further poor kidney function, but for normal people, As long as you drink plenty of water or observe regularly, it shouldn’t be a big problem. We also treat many patients with genital herpes, and quite a few patients have been treated for a long time, for example, more than half a year. For patients from other places, we also recommend regular renal function tests. At present, no patients with severe renal function have been found. As for the liver problems you mentioned, the most important thing is related to alcoholic cirrhosis, not eating It is caused by valacyclovir. The instructions of valacyclovir do not particularly emphasize the impact on the liver. A mild impact on the liver cannot be ruled out, but the impact is limited. 2013-10-29 20:489DQ stenographer

    Moderator: If it is condyloma acuminata, will it dissipate after taking amoxicillin and washing with diluted potassium permanganate water~? In the previous two days, there were two similar bumps in the coronary sulcus that seeped yellow water~ my friend said it was condyloma acuminata~ I would I went home and did a vinegar whitening test as stated on the Internet~ Both bumps were white~ I took two tablets of anti-inflammatory drugs and washed them with diluted potassium permanganate water~ Then the bumps disappeared today~ Just The skin is broken and still seeping yellow water~ How do I feel like balanitis~ Guiqiu the doctor probably inferred~ Is the vinegar whitening test caused by the whitening of the vinegar soaking and the broken skin part 2013-10-29 20:489DQ stenographer

    Wu Yan: First of all, amoxicillin is useless for condyloma acuminata, and potassium permanganate is not very useful for cleaning. Amoxicillin is an anti-bacterial drug and has no effect on viruses. Unless condyloma acuminata has a bacterial infection, eat it again. Too much does not do him any good. Potassium permanganate washing is nothing more than the wrinkled part of the condyloma acuminata, where some bacteria or other microorganisms multiply, which is useful, but these methods are completely ineffective on the condyloma acuminata itself. As for the situation you just mentioned, the acetic acid really turned white after a day or two. If it is really genital warts, the protrusions will not disappear. If this is the case, genital warts will not be so difficult to treat. . Acetic acid white test is one of the methods to judge condyloma acuminatum, but sometimes there will be false positives, such as local inflammation, or damaged parts, it is also possible that the acetic acid white test is positive, and even the blisters are long and local It's white, so I think you disappeared so quickly, and there is indeed damage and water seepage, I think it is more likely to be a local skin damage, rather than genital warts, but I said it doesn’t count, because I didn’t see it. , I can only push, you should go to the local hospital for a regular checkup as much as possible. 2013-10-29 20:529DQ stenographer

    Moderator: Hello, I want to ask how long genital warts will grow after sex. I have a long urethra. It was done with freezing in the hospital. My foreskin is too long. There are small spots on the glans at the crown of the foreskin. That little bit was there before. There is also a bad smell. Are those small spots condyloma acuminata? Ask the doctor for some advice, what should I pay attention to. What kind of medicine should you take. It’s been a little bit for nearly a year and I haven’t grown up. Is the foreskin too long? 2013-10-29 20:529 DQ stenographer

    Wu Yan: Usually the incubation period of condyloma acuminata is three months, and it takes three months to grow a wart from the infection. As short as 3 weeks or 4 weeks, it can be as long as several months, seven or eight months, eighty-nine months. Months are possible. This patient has the urethra orifice, and it was done, but there are also many small spots in the coronary sulcus. I don’t know how long you have it. It was before this sex or before the first sex. There is a difference. Yes, there is a foul smell, which is often a manifestation of infection. Mixed infections, including mold infections, and various other bacteria infections, may be smelly, so I think this patient can perform some local cleaning, Disinfection. If there is some smell or even secretions, clean it first to remove the infection. If the wart is still there, you should consult a doctor while it is relatively clean. If there is water leakage, the doctor should also can not see clearly. I haven't grown up for nearly a year. From your situation, I think it may not be condyloma acuminatum. Condyloma acuminatum does grow very slowly. If it really grows after sex, it will grow in a period of time. It is relatively fast. Some people will disappear after a period of time, and some will continue to grow up. If there is no change in one year, the probability of condyloma acuminata is relatively small. If the foreskin is too long, it is easy to cause bacterial and viral infections. It may cause one of the reasons for your local peculiar smell. If the foreskin is too long, it can lead to a local proliferative reaction, including some people. Fungal papules or balanitis are related to the irritation of inflammation to a certain extent, so I suggest that after cleaning the part and improving the local hygiene, go to the hospital and let the doctor show it to you. a bit. 2013-10-29 20:559DQ stenographer

    Moderator: Pale red papules, the penis, foreskin, glans have large rice grains, and the number is gradually increasing. What is the reason? How did it cause it and how to treat it? 2013-10-29 20:569DQ stenographer

    Wu Yan: I am more inclined to the manifestations of foreskin balanitis. When possible, I should try my best to have my sexual partner or spouse undergo corresponding examinations. One treatment is external washing, and some disinfecting drugs are used to wash externally. 2013-10-29 20:579DQ stenographer

    Moderator: How to treat genital warts in the mouth? I had oral sex with Don five months ago without a condom, and now I find small bumps on the cavity wall. Could it be genital warts? Will it also be in the throat? If there are any, how can they be treated? How is the laser in the throat? 2013-10-29 20:579DQ stenographer

    Wu Yan: There are indeed more patients with condyloma acuminata in chewing gum than before. It is because of oral sex and without a condom. On the one hand, you can check whether there is HPV virus in the mouth. This kind of examination is non-invasive, and the examination without trauma is relatively speaking. It is easier to accept. In this case, HPV testing can be done first. Biopsy, local anesthesia, or treatment can still be done if conditions permit. Now the oral cavity, especially the larynx, and the back of the oral cavity, if there is edema It is very troublesome. In order to protect themselves, many doctors are unwilling to perform, especially many operations on the larynx. The doctors are also very cautious, because once there is edema of the larynx and local bleeding, it will be sucked into the lungs. Pulmonary embolism is very troublesome. There is a pharyngeal reflex in the throat. If you want to vomit, stretch your fingers behind your tongue. Once rubbed, there will be a pharyngeal reflex. If you do this treatment, the patient has a strong pharyngeal reflex, so put the probe Pushed away, sometimes it is very troublesome to do. The more exposed parts, the more intuitive parts are still easy to do. 2013-10-29 21:029DQ stenographer

    Moderator: Three months ago, I found out that I had small bumps on the bottom, which showed signs of growth. I suspect it is condyloma acuminatum, and I haven't been to the hospital yet. . Recently, genital warts have become dry and hard. . What is this situation? Not the so-called fester. Is it possible to be fake? What kind of help do you want to get: 1. Is it good for treatment after 3 months? 2. Can I treat myself at home without going to the hospital? 3. I know that I cannot have a relationship with the opposite sex now. 2013-10-29 21:029DQ stenographer

    Wu Yan: Men are not prone to pseudogenital warts, while women have pseudogenital warts in the labia minora. Other parts are not called pseudogenital warts. Three months is good or not, the earlier the treatment, the better, the later the treatment, the more difficult it is to treat. The average incubation period of condyloma acuminatum is three months. Three months should not be difficult to treat. It can be done at home, but it must Under the guidance of a doctor, there are some topical medicines and corrosive topical medicines. After the point is finished, the wart can be slowly corroded. This kind of treatment can be done at home, but it must be under the guidance of a doctor, otherwise It is possible that the normal skin is injured, which is very likely to happen. The third question is whether you can have a relationship with the opposite sex now. I suggest you go to the hospital first, do the corresponding examination, and do pathology if necessary. If it is a venereal disease, do not have a relationship with the opposite sex. If it is a common disease, it will happen with the opposite sex. Sexual relations are okay. 2013-10-29 21:059DQ stenographer

    Moderator: I have condyloma acuminatum. The doctor asked me to take interferon for a week and the menstruation was cleaned up by laser. The side effects of interferon are a bit unbearable. Like a bad cold, I can’t work normally. I am afraid of pain after laser I am afraid of recurrence. Is there any topical medication that can be used to treat? There is a wart on the vaginal opening. Will the topical medication affect the interferon? 2013-10-29 21:059DQ stenographer

    Wu Yan: Interferon does have side effects, especially when the first and second shots are used for the first time. The side effects are more obvious. Just like a more severe cold, you won’t be shot directly before the laser. It requires anesthesia. , Including local anesthesia and even general anesthesia, it is impossible to make you stand up abruptly. There are some external medications. Podophyllotoxin can be considered. If the warts are relatively concentrated or not particularly large, use External medicines such as podophyllotoxin are fine, but we do not recommend you to use them yourself. You need your husband or your boyfriend to help you, otherwise it is easy to burn the normal skin around you. The drug and interferon are synergistic and can be used at the same time. 2013-10-29 21:089DQ stenographer

    Moderator: Hello, Dr. Wu, I was undergoing a gynecological vaginal ultrasound examination in a local hospital (Level A) some time ago. At that time, the nurse who was doing vaginal overtime put a disposable condom on the vaginal ultrasound probe. Recently, I read some information. The hpv virus and condyloma acuminatum virus particles are so small that they can be transmitted through the gaps in the condom molecules. If so, is it unsafe even if there is a condom on the probe? Have you ever been infected with hpv and condyloma acuminata due to vaginal ultrasound? 2013-10-29 21:089DQ stenographer

    Wu Yan: No, when doing ultrasound, using a condom is a good method, because it is more convenient than sterilizing the probe. If everyone uses condoms when doing ultrasound, there is no risk of infectious diseases. Some viruses are small. It may be through condom molecules. In theory, it is possible. However, there are conditions. First, there is surface tension between condom molecules. When there is surface tension, the virus is difficult to get out. Second, these If things really want to go out, it needs a lot of internal pressure, or in the case of violent shocks, sometimes violently thrown, it does not rule out the possibility of being able to go out, but how can such a situation occur with ultrasound? , There is no pressure, no vibration, no other more intense activities, so don’t worry about this problem, don’t worry at all. 2013-10-29 21:109DQ stenographer

    Moderator: Does syphilis spread only when it comes into contact with body fluids or syphilis fluid? Yesterday I went to the hospital to get blood, and queued to the blood collection place. The older sister in front of me was to check for syphilis. After she took the blood, the toilet paper under her arms fell to the floor. I helped her pick it up and threw it into the trash. In this hospital, a piece of toilet paper must be placed under the blood sample. Then I drew blood and pressed the alcohol cotton ball on my needle wound with this hand. I threw the cotton ball and touched the needle wound with this hand. I don’t know if there is any bodily fluid on the toilet paper of the eldest sister in front, which can infect syphilis. ? 2013-10-29 21:109DQ stenographer

    Wu Yan: There are three main aspects of syphilis. The first is that it is contagious during sex. The second is the blood route. Transfusion of his blood to others. The third is transmission to children. Other than that, other conditions are not. It may be contagious. In this case, you will worry about whether the blood will be or not. I believe you, when you take toilet paper, there will be no blood, because you will definitely avoid blood, and you must see that there is no blood. Will pick, even if there is blood, it will not take the blood, so it is very safe. 2013-10-29 21:129DQ stenographer

    Moderator: Is Treponema pallidum a body fluid? Will it not be infected with syphilis without any contact with body fluids? 2013-10-29 21:129DQ stenographer

    Wu Yan: Treponema pallidum has nothing to do with body fluids. Treponema pallidum is a pathogen, just like bacteria, viruses, fungi, mycoplasma, chlamydia, and spirochetes. These are parallel relationships. Treponema pallidum is the most common type of spirochete. It is a microorganism, not a microorganism. A body fluid. 2013-10-29 21:139DQ stenographer

    Moderator: Dr. Wu, I found that the wart body was treated by laser for 3 times in September around the outside of the perianal area, and there was no recurrence in about a month. However, on October 11, I found that the inside of the perianal area was close to the anal mouth New warts appear. Would you like to know if the warts here have been subclinically infected just before or are they infected from the outside of the perianal area? Because I have done photodynamics three times and have relapsed, I feel very stressed. 2013-10-29 21:139DQ stenographer

    Wu Yan: In my experience, it is not a relapse, but there are two situations at the beginning. One is that there is no inspection at all at the beginning, and it may happen at the beginning. Second, it is possible that you checked it at that time, but because the virus is located in different parts, it is also possible that the local immune status is different. You have to have a way to bring it in. If you have same-sex sexual behavior, you can bring it in at the beginning, so In general, it tends to be infected at the beginning. Photodynamic, depending on what you mean, according to his description, only external photodynamics, perianal photodynamics, and intra-anal photodynamics were not done. In fact, it is more troublesome in China. It is more difficult to treat at least four times. Condyloma acuminatum in these areas, including the anus, because the folds are uneven, and some people have hemorrhoids. Hemorrhoids are bulging. Sometimes it is difficult to tell whether it is hemorrhoids or genital warts, and whether the hemorrhoids are inside. It's easy to find, so the condyloma acuminata in the anus is really difficult. 2013-10-29 21:179DQ stenographer

    Moderator: Dr. Wu, I am HIV-infected, cd4:204, anti-viral treatment for more than 1 month, the eutopic part is in the anus, the operation (electric cautery) performed 3 months ago may have recurred recently. Is it suitable to continue the operation in a situation like mine? Do I usually need to pay attention to anything? 2013-10-29 21:179DQ stenographer

    Wu Yan: In your case, one month of antiviral treatment will gradually increase your CD4, but the warts in the anus may recur in a short period of time after treatment, and the recurrence rate is higher than the average People should be taller. In addition to looking inside the anal orifice, besides looking at the perianal area, you also need to see whether there is inside the anus. You can do this several times. It is also recommended that you consider taking photodynamic therapy, because such treatment can solve your latent virus problem to a greater extent. In addition, it is also recommended that you, in addition to improving immunity through antiviral therapy, will also benefit in the short term. You can use drugs that boost your immunity, which will help you heal faster. 2013-10-29 21:189DQ stenographer

    Moderator: Can I suppress the virus by taking pidotimod? 2013-10-29 21:189DQ stenographer

    Wu Yan: This is a drug that enhances immunity. It does not directly inhibit the virus. It is to fight the virus by enhancing immunity and letting immunity, instead of fighting the virus on its own, but immunity enhancement is not a matter of overnight. It takes a long time. Persistence. 2013-10-29 21:199DQ stenographer

    Moderator: I went to the hospital for HPV biopsy after 1 week of uncoated sex with a patient with genital warts. All the results were negative, and no warts were found to grow out for 1 and a half months. Can the possibility of infection be ruled out? 2013-10-29 21:199DQ stenographer

    Wu Yan: Go for a checkup after a week. This negative does not explain the problem. The average incubation period is three months. Based on your current situation, the possibility of genital warts is partially ruled out. However, if HPV is not found for a longer period of time, and no warts grow, the possibility of elimination is greater. 2013-10-29 21:209DQ stenographer

    Moderator: Is there any difference between anal genital warts and flat warts? Before I got warts on the anus, the right side of the anus was a bit itchy and painful like a small soybean-sized ulcer. I disinfected it with povidone-iodine solution and it was fine, but After a few days, the anus film was moist and the surface was white. I continued to sterilize it. After 2 weeks, 3 sesame-sized warts grew on the anus. What's wrong with this? 2013-10-29 21:209DQ stenographer

    Wu Yan: It is difficult to determine what the problem is with a wart that is too small. Condyloma acuminata and flat warts that grow on the anus are really not distinguishable. It is best to have a pathological examination. At the same time, check for HPV, flat warts and condyloma acuminatum, regardless of pathology. , Or virus subtypes, both may be close. It is impossible to fully understand which problem is through this.However, the characteristics of condyloma acuminatum tend to grow faster, and there are more parts, and there are more points in multiple parts. Flat warts will grow slower and more single. There is another thing to pay attention to, flat genital warts It is a manifestation of syphilis. It seems that sometimes it is not easy to distinguish it from genital warts. We have had such cases. After a long period of treatment outside, they were treated as genital warts. Actually, they are flat genital warts of syphilis. This is something that needs attention. of. 2013-10-29 21:229DQ stenographer

    Moderator: What are the main items of the pathological examination? The cauliflower tumor is about one centimeter, do I have genital warts? If it is true, can lupus erythematosus patients with low immunity like me be cured? 1. I did a colposcopy. 2 Inspection results: a cauliflower-like mass was seen at the vaginal opening, the epithelium became white after applying 3% acetic acid; the surface of the cervix was flushed with red spots, the epithelium became white after applying 3% acetic acid, and the iodine test was negative 2013- 10-29 21:229DQ stenographer

    Wu Yan: The recurrence of condyloma acuminata is closely related to weakened immune function. If you take these medicines, it will lead to weakened immune function. Of course, there is a possibility of recurrence. Moreover, the wart body grows faster and grows larger, less than 1 cm. Small, it is really embarrassing to treat this kind of situation. You can use some immunity-enhancing drugs, but it conflicts with the immunosuppressive agent itself. I think there is no problem in diagnosing genital warts outside. Possibly, because it is very likely to be brought in through sex, you should pay close attention to the problem of your cervix. Whether it is or not, I am not counting here. Only by doing an examination can we judge. 2013-10-29 21:259DQ stenographer

    Moderator: How many ways are there for transmission of genital herpes? I just got TPPA and the result has not come out yet, but the doctor said it should be. I was prescribed a recombinant human interferon. I don’t know how to get it. 2013-10-29 21:259DQ stenographer

    Wu Yan: Genital herpes is a viral infection. Viral infections are very troublesome. Diseases like AIDS, condyloma acuminatum, genital herpes, and viral infections are not easy. The treatment of genital herpes can be done with interferon. It can be used for external use or injection. Your TPPA is not directly related to genital herpes. TPPA is used to screen for syphilis. Genital herpes needs to be checked for antibodies. Antibodies of type 1 and type 2 herpes. As for how to get it, many people don't know, but most of it has something to do with direct or indirect sexual behavior. 2013-10-29 21:279DQ stenographer

    Moderator: Doctor, what kind of medicine does genital warts take? No pain, no itch, just smell 2013-10-29 21:279DQ stenographer

    Wu Yan: The main manifestation of condyloma acuminatum is long things. It is really painless and itchy. When it is severely infected, there are some bacteria on the surface of the wet part. It may be itchy or smelly. At this time, you can use some external washing Anti-inflammatory drugs can also be taken, but these drugs are useless for condyloma acuminatum itself. There is only one class of drugs that can be useful for condyloma acuminata, which is to enhance immunity. Other antiviral drugs are not taken by mouth, but Local injection, or infusion. 2013-10-29 21:279DQ stenographer

    Moderator: About 10 years [never had a formal treatment, maybe some other diseases have been treated with penicillin] Hello! When I was in 2004, the doctor said that my blood test for TPPA was positive for syphilis, and then I went to the Chronic Prevention Station to test the titer and it was negative. If I said that I didn’t need treatment, I had no treatment. I don’t know when I got the infection anyway. Calculate it should be about 10, because I have been married for 8 years, and my husband tested both negative in the first two days. My result is that the USR stock solution is positive. Tp-Ab is 1:1280. What I want to know is that I am now Isn't it late latent syphilis? Is this result serious? Please give me a detailed answer! What I want to know is, can I still get a thorough treatment? I am currently undergoing once-a-week penicillin treatment (doctors say 3 weeks). Will the cerebrospinal fluid test be very painful? It sounds scary! 2013-10-29 21:289DQ stenographer

    Wu Yan: It should be protofold positive. We look at the severity of the disease, not TP, but the indicators of RPR and TRUST. Your current indicators should be very low, whether it is latent syphilis, or just serum If the antibody is positive, you got it in 2004, almost 10 years ago. At that time, the TP was positive and the doctor said that there is no need for treatment. If it was checked in 2004 and it was already negative, your infection time was at least 2003, or Longer,It takes more than a year to become negative after treatment, so you may be infected with syphilis a year or even a year ago, but it can be cured without formal treatment. Syphilis has this characteristic, but your goodness is not completely good. , You also checked it once at that time. The doctor told you that it’s okay, so you don’t check it. In fact, it should be checked three times and it is recommended to check it three times every three months. It takes about half a year to check three times, and all of them are negative, so we can think It's really negative, and you only checked it once. After ten years, it will be 1:1. In fact, you may be 1:1 10 years ago, but syphilis fluctuates. Experienced people judge it to be 1 :2, or even 1:2. If you have no experience and the judgment is a little bit biased, it is also possible to judge 1:1 as negative. Therefore, the result of 1:1 is likely to be 1:1, negative, 1 : There is a fluctuation between 2 and this fluctuation is also very common. It has something to do with the test, because the lower it is, the more difficult it is to judge. This situation is nothing. You have been married for so many years and infected at least 10 years ago. During your period There has been no problem, indicating that it is not contagious. If it is contagious, your husband must have a problem. If it is after the infection, more than two years, irregular treatment, sexual contact is not contagious, so you don’t have to worry too much about this problem, it is not very meaningful to test cerebrospinal fluid now, because you are unlikely to have a problem with cerebrospinal fluid, and It doesn’t make much sense for you to undergo treatment, because you are probably a phenomenon of serum fixation, like a wound. The wound has healed and no longer bleeds or exudates, but there are scars. You know you have suffered in the past. Injury, instead of getting injured now, this is serum fixation. There are also doctors who suggest that if you have never had a regular treatment, you might as well get regular treatment. Long-acting penicillin once a week is not a problem, as long as the body is not allergic. 2013-10-29 21:339DQ stenographer

    Moderator: Netizens, due to time constraints, today's live broadcast is over. Thank you, Mr. Wu Yan. Good night, netizens. 2013-10-29 21:34

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