WS 236-2003 Diagnostic criteria and management principles for genital herpes
Some standard content:
Chapter 2 of this standard is mandatory, and the rest is recommended. Foreword
S236—2003
Genital herpes simplex disease setInfection caused by genital herpes simplex virus (FPT) is prone to recurrence. In recent years, the incidence of genital herpes virus (FPT) in my country has increased rapidly, and it has become one of the most common sexually transmitted diseases. In order to provide reliable diagnosis and appropriate treatment for genital herpes virus (FPT) victims, and to understand the current situation and trend of genital herpes virus (FPT) addiction in my country, and to provide reliable evidence for treatment, this standard is specially formulated. In the process of formulating this standard, the diagnosis and treatment standards for STDs and recommended treatment plans issued by the Ministry of Health of the People's Republic of China in August 2000, the diagnostic standards for genital herpes virus (FPT) issued by the Centers for Disease Control and Prevention of the United States in September 1996, and the relevant parts of the recently published treatment guidelines for sexually transmitted diseases (2018) by the Centers for Disease Control and Prevention of the United States are studied. The appendix to this standard is a regulatory appendix. The appendix to this standard is an informative appendix. This standard is proposed by the Ministry of Health's Centers for Disease Control and Prevention. This standard was drafted by: Institute of Leprosy, Chinese Academy of Medical Sciences, National Leprosy Control Center. The main drafters of this standard are: Lai Kaohong, You Changgeng. This standard was made by the Ministry of Health and entrusted to the Office of Communicable Disease Supervision and Administration of the Ministry of Health. 1
1 Scope
Diagnosis criteria and treatment principles of genital herpes This standard is intended to define the diagnosis criteria and treatment principles of genital herpes. This standard may be used by all levels of disease treatment institutions, medical insurance institutions and prevention and control institutions across the country. 2 Diagnostic criteria
2.1 History of contact Www.bzxZ.net
History of frequent sexual contact or sexual contact:
2.2 Clinical manifestations
2.2.1 Mainly divided into two clinical types: primary and recurrent: 2.2.2 Primary rapid ejaculation period
2.2.2.1 Incubation period 2d~20d (average 6):
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2.2.2.2 There are clustered or scattered small water moles on the genitals or anus, which are small-4r: ulcerated or ulcerated, and the patient feels pain. 2.2.2.3 Lymph nodes along the sulcus are swollen and have pressure. 2.2.2.4 Often accompanied by fever, headache, fatigue and other personal symptoms: 2.2.2.5 Course of disease: 1~3 weeks.
2.2.2.6 Based on the history of similar attacks
2.2.3 Variant of vesicular ulcer
2.2.3.1 The primary vesicular ulcer subsides and can be reversed: Compared with the primary vesicular ulcer, the local symptoms and skin lesions are milder, the swelling of the calyx is rare, the systemic symptoms are few, and the course of the disease is shorter. 2.2.3.2 Precautionary pain, with local burning, tingling or other prodromal symptoms. 2.2.3.3 There are small vesicles around the vesicular ulcer or the vesicular ulcer, which are superficial and break quickly, and the subjective symptoms are mild. 2.2.3.4 The course of the disease is about 1 week to 3 weeks.
2.2.3.5 If there has been any inflammation, 2.3 Laboratory examination
2.3.1 Cytological examination (including slides) The slides can be made into prints, and the slides can be stained with chromatin or fusion. Under the microscope, the multinucleated cells or intranuclear lesions with characteristic characteristics can be found. 2.3.2 Pathological examination: Take samples from the skin to show the virus, and use the monoclonal immunofluorescence test (TFA) or alcohol-linked immunosorbent assay (ELISA) to detect the virus. 2.3.3 Pathological culture: Take samples from the lesions for typical culture, and find the characteristic cytopathic lesions with the virus isolated from the lesions. 2.4 Case classification
2.4.1 Clinical diagnosis: The cases are listed in 2.1 and 2.2. 2.4.2 In addition to the equipment and equipment of 2.1.2, the confirmed cases also have the following items: 3. Treatment principles
3.1 Treatment principles
Timely and adequate use of anti-disease drugs to alleviate symptoms, shorten the course of the disease and control the spread and spread of the disease. 3.2 Clinical treatment criteria
Herpes vulgaris is an incurable lesional disease. After treatment, the skin of the affected area completely subsides, the pain, and the affected lymph nodes disappear.
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The swelling and pain disappear, which is the clinical diagnosis.
3.3 Management and prevention
3.3.1 General management of the first diagnosed case of herpes vulgaris should be reported 3.3.2 Prognosis Although the prevention of herpes vulgaris is similar to that of venereal diseases, it has its own characteristics. There is no clinically available vaccine in China yet, so the prevention of genital herpes mainly includes two aspects: consultation and education. 3.3.2.1 Consultation includes the following contents: a) Inform patients of the natural course of the disease, strengthen their awareness of the recurrent asymptomatic period and prevent the sexual transmission of herpes simplex virus!
Tell patients the possible relapse triggers of the disease, such as stress, depression or anxiety, and avoidance of relapse triggers to reduce relapse.
All patients of childbearing age (including male patients) are at risk of contracting the virus: d
Tell patients with primary infection: Viral treatment can shorten the course of disease relapse, and appropriate viral control can reduce the risk of relapse.
3.3.2.2 Health-sensitive patients
Health education should be provided to patients and high-risk groups to encourage them to change their sexual behavior, avoid extramarital sexual contact, and use safe methods.
A.1 Specimen collection
A: 1.1 Required sites for specimen collection
(Normative records)
Laboratory diagnosis of simple viral infection in the genital tract WS236——2003
The lesions of genital herpes occur in the genitals, anus and their surrounding areas. The common affected areas for male patients are the foreskin, coronal sulcus, glans penis, and penis shaft. The less common areas are the scrotum, perianal area, anus, vagina, and femoral area. The most common affected areas for sexually active patients are the groin, pubis, perineum, anus, vagina, and vagina. The less common areas are the anus, inguinal sulcus, and femoral area. Among homosexual men, the most common five areas are the anus, anus, and femoral area. The course of primary genital herpes is 2 weeks, and the duration of disease is almost 13 days. The course of primary genital herpes is 1-2 weeks, and the duration of disease is also about 4 days. When taking samples, try to take samples of the affected area and the lesion to increase the positive rate of the test. After taking the samples, put the samples into a container containing 1mL~2mL of virus transport fluid or HaInk The sample is collected and sent to the vial for examination (for culture), or directly removed for histological examination or direct immunofluorescence examination of the disease rate. A1.2 Methods of specimen collection
A, 1.2.1 Samples are extracted from mature ulcers or boils using a tuberculin syringe and a 25-gauge (C.5-mm diameter) needle: injected into a small dropper containing 1ml~2ml of tuberculin transport fluid or II-ank solution, or sampled with cotton seeds or jelly beads after removing the ulcer.
A.1.2.2 When collecting samples, first remove the skin or dirt on the surface of the ulcer. Then use cotton swabs or swabs to swab or scrape the base of the ulcer and the uninvolved parts, especially the parts adjacent to the ulcer to obtain tissue or cold samples. A1.2.3 Collection of other diseases When collecting skin lesions other than ulcers and boils, first use a cotton swab to swab the ulcer with a cotton ball. Use a cotton swab to remove local dirt, and then use a cotton swab to tear off the red spots and take the skin epithelial cells, or take the skin and subclavian tissue. When collecting urethral specimens, insert the male urethra into the urethra for 2m4, and wait for 105 seconds before taking the female cervical sac. When collecting cervical sac specimens, first use a cotton swab to remove the sticky surface of the cervix, and then use another cotton swab to swab the cervix for 1m~2cm to check for stains. After 20s, take the white.
A.1.3 Specimen transportation
After the specimen is collected, if it cannot be examined immediately, the specimen should be transported to a virus transport center as soon as possible, and the fever should be removed. Ice bath or 4 for inspection. 4.1.4 Specimen preservation
Specimens used for disease culture can be temporarily stored in 4 refrigeration if they are collected on the same day (within 24 hours). If they cannot be inoculated on the same day, they should be placed on low-humidity ice.
A.2 Cytological examination
A.2.1 ISV infection can produce characteristic cytopathic changes in the cells. Take cells for smear and observe the changes in cells under a microscope. At the same time, observe the morphology of the diseased cells, which is helpful for diagnosis. A.2.2 Methods
A.2.2.1 For specimens, use a cotton swab or a surgical knife to obtain a fine tissue fluid from the base of the tumor or the base of the tumor, and apply it directly and gently on a glass slide to make a slide, and dry it in the room. A.2.2.2 For fixation of skin and mucosal specimens, use ethanol to fix for 5 minutes. For cervical specimens, use dead ethanol to fix for 10 minutes. A.2.2.3 For staining, after the specimens are fixed, use the Tmrk slide staining method to examine the skin and mucosal specimens, that is, use Giemsa stain or Wright-Gimsa stain to stain negatively for 1 minute. For cervical specimens, use the Papanicolaou staining method to stain. After the specimens are stained for 5 minutes, observe the results under a light microscope (oil microscope). Infection test results in balloon-like sperm or plasma effusion, and the infected group may be combined into multiple giant cells, sometimes with intranuclear inclusion bodies A.2.4 Precautions
For primary herpes simplex virus (HSV) infection, microscopic examination is easy to succeed. Early skin lesions have better results. The number of HSV-infected cells in the lesions with specific characteristics is reduced at most. With the healing of the lesions, the number of HSV-infected cells is small. 4.2.5 Clinical significance
The examination shows that the lesions have spread or the lesions have spread to the whole body, sometimes intermittently. However, the sensitivity of this examination is antigen detection. The VA detection method or the disease detection method has a duration of 0 to 0 months, and there are no specific conditions. Other herpes simplex virus (such as varicella zoster) infection can cause the disease.
A.3 Antigen detection
AL3.1 Overview
The use of immunological methods to detect HSV antigens is the most commonly used rapid diagnostic method at present. This method is based on anti-IISV antibodies (monochromatin or polychromatin). Monochromatin is commonly used as the basis, including immunofluorescence, immunostaining and alcohol-linked immunosorbent assay (FITA). It is now used as a test for direct fluorescent recognition of HSV. 3.2 Principle: Fluorescent dyes such as 5-fluorophore thermocycline (FTTC) and reductamine are combined with isotropic anti-HSV antibodies. Under certain conditions, they will combine with the corresponding HSV antibodies in the specimen to form a luminescent antigen-protein complex. The light emitted by the complex can be observed under a fluorescence microscope, indicating the presence of ISV in the specimen.
A, 3.3 Method
A. 3.3. 1 The method of H
scanning is the same as that of cytological examination.
rinse the sample in ethanol solution for 3 times at pH 7.2>A.3.3.3, change to 37% or 1% ethanol for 1 min, dry it
A.3.3.5, stain
add HT-labeled HSV fluorescent monoclonal antibody as a limit, and stain it for 30 min.in-1.
4.3.3.6, rinse it in deionized water for 3 times, each time for 1 min., and then rinse it once with distilled water, dry it for 37% or 1% ethanol:
4.3.3. On the 10th day, 9% oil and 10% P1% group were added. The results were observed under a fluorescence microscope (purple line length 1nm). Results and recording methods: 4, 3. 3. 9
for fluorescence: suspicious for fluorescence, weak for inflammation. Clear for fluorescence, bright for fluorescence; 1 "+-++++ for fluorescence bright, H fan Guohua,
A3.4 Results
, green light was visible in the nucleus of the cells and the nucleus, and the cells were dyed red or green when the light was on.
A.3.5 Note the rate items
.3.5.1, The test should be carried out in accordance with the requirements of the test kit. The test kit should be equipped with a negative standard for each test.
3.3.5.2 The samples should be selected with good specificity and reliable quality. It is best to select single clonogenic antibodies. A.3.6 Clinical significance
The immunofluorescence method can be used to isolate and culture the pathogen-free bacteria in a culture medium with a sensitivity of 7%. The results show that the immunofluorescence method can be used to isolate and culture the pathogen-free bacteria in a culture medium with a sensitivity of 7%. The commonly used methods for HV detection in clinical practice are as follows: 1
A.4 Virus culture
A, 4.1-Principle
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HV is cultured through tissue culture, and the cytopathic effect (cytopathic effect) of the affected cells is observed, and the pathogenesis of the disease is further determined. PE is usually a characteristic change of HSV, but the virus to be tested, such as varicella nodular herpes virus (VZV) and cytomegalovirus (CMV), can also cause similar (PE), so it is necessary to identify and confirm the presence of the virus through immunological methods: such as immunofluorescence, immunoassay, enzyme-linked immunosorbent assay, etc.) and biological methods (DNA restriction endonuclease, TN4 probe molecular mutagenesis technology) to perform pathogen typing. A.4.2 Materials
A.4.2.1 Primary cell lines from multiple brain slices, including African green kidney renal cell (Vr), high frequency brain Hc-1 cells, A-cells (MR5), Basque hamster cells (BHK), primary immune kidney cells (IRK), human foreskin cells (TIFF), etc. Each laboratory can make its own cell lines based on their own cell types. 4.4.2.7 Cell growth medium: RPMI540 culture medium containing 16% calf serum. Ingredients: RPMI16IU, 4, 50U/L of each hormone, 100% calf serum, 2AR/mT bovine serum, 23x/rtl, HFPF 0.(26×->ml/1. Prepare 3.0g of sodium iodine and add 2×10-t/: 1c90m water and adjust pH to 7.3. Remove by positive pressure and store at 1: or -20℃. A.4.2.3 Cell culture medium with RPMIJ64 sterilized with % micro-blood. Prepared by adding fetal bovine serum to the culture medium with a killing rate of 10 to 2A4.3 method
A.4.3.1 Standard Virus isolation and culture method
A.4.3.1.1 Collect the frozen cells from the filter, quickly incubate in 37* water, add them to the flask containing the growth medium, and replace with fresh growth medium after the cells adhere to the wall. Culture for 2-3 days. After the cells form a monolayer, discard the culture medium. Add appropriate amount of gelatin to the monolayer of spores for 37 minutes to 10 minutes to allow the cells to completely disperse. Then add the growth medium and use Drive the cells to the source point, count the cells with a hemocytometer, and then release them with growth medium to reach the required cell concentration (about 1n/m1. After the result, divide them into 24-well culture plates, add 1.5mL of cells to each well, and incubate them in a 55% carbon dioxide (C) and 37% moist air environment for 11-2 hours. After the cells have basically grown into a half layer (about % cell confluence), they can be inoculated. 4.3.1.2 Specimen inoculation: Inoculate the clinical specimens in 1. Vortex the sample evenly, if it is stored, take it out at -7℃ and quickly thaw the water source, then separate it, aspirate the culture medium of the cell monolayer, add 250 μL of standard wood to each well, inoculate 12 wells of each specimen. Incubate in 5% carbon monoxide (37) environment for 1-2 hours to remove the source of stimulation, add vitamin D to each well, and then culture in an environment with air for 3 days-7 months. For the urethra, urethra and diseased specimens, they should be replaced every 7 days (note that some samples should be kept for inspection to avoid culture contamination or operational errors). 4.3.1.3 Observation of cytopathic effects (JI) is used to judge the initial culture results. When culturing diseased cells, PE should be observed every day. For those with negative or delayed positive results, the supernatant should be collected or replaced with fresh cells every 7 days. (PF is recorded by light PF, 1+ is less than 2% The standard for cell outflow is 2% to 31% of the cells showing CPE. If the virus transmission rate is less than 50% and the cells show CPE, collect the culture medium and inoculate it into fresh brain cells. When the cells show pure PE, collect the cells and supernatant. Keep the supernatant in a fresh refrigerator. Keep the supernatant in a fresh refrigerator. 5. The clinical diagnosis and typing of the disease are usually performed by monoclonal antibody immunofluorescence. The method is to extract the cell slides and make duplicate samples. The virus is used for typing. The method is described in IISV antibody test (indirect immunofluorescence method), WS236-2003, A.4, 3, 2. The improved virus isolation and culture method. The standard virus isolation and culture method usually takes 2 days. It can take up to 1 day. In order to shorten the detection time and improve the detection rate, people have The standard virus isolation and culture method was improved, and the detection time was extended to 16h~48h. There are two types of improved virus isolation and culture: one method combines culture with immunological technology (usually immunofluorescence technology); the other method is to increase the chance and efficiency of virus transmission by centrifugation after inoculation of clinical specimens. Both methods can be used at the same time. A.4.4 Results
A.4.4.1 When culturing the virus, the CIE of the virus was 2.5V after the standard conversion.HSV-induced IE has certain characteristics. Typical CPE is characterized by granulomatous proliferation, cell swelling, and subsequent cellular fusion. Ballooning of single cells or multinucleated giant cells can be seen at the time of inoculation. Early PE is focal, but the amount of disease in the specimen is mostly normal.
A.4.4.2 IISV requires 121~1xh to be effective in multi-sensitive cells. Cell mutation can occur as early as 16~24 days after inoculation. The CPE should be based on the selected cell line and the amount of virus or the virus inoculated). CPE of each stage of ESV clinical stage appears 24h-48h after inoculation. CFE of 8~% C-positive specimens appears 2d-4d after inoculation. And 95% of the samples are collected on the day after inoculation. CFF appears within 7 days, and only 5% of the specimens show CIE more than 7 days later. A.4.4.3 When immunofluorescence analysis and analysis of monoclonal antibodies are performed, wide fluorescence can be seen in the nuclei of positive cells, while negative cells will turn red and red, without inflammation. A.4.4.4 When CPE appears, it can be declared as "HSV culture positive". When confirmed or confirmed by immunological or other methods, it can be declared as "HSV culture positive" and the corresponding ISV type. A.4.5 Precautions
A.4.5.1 HSV has different irritation to different tissues. Sensitive cells should be selected for culture, and the cells should be highly active
4.4.5.2 Clinical specimens can be collected from white skin lesions, tissues, uterus or uterine tissues. Do not use lubricants before sampling. Do not use lubricants quickly when sampling: For example, calcium carbonate is toxic to algae. Do not allow the specimen to be retained during transportation. Instead, place the swab in the culture medium after washing the specimen. A4.5.3 The inoculated specimen contains live virus 1. The infection source is the main cause of the infection. The location of the clinical specimen at different stages of the disease will affect the sensitivity of HSV culture. Try to obtain water or thaw the specimen for inoculation and culture. 4.5.4 Correct labeling and transportation of specimens. The specimens should be collected as soon as possible. Specimens that cannot be inoculated within 4 hours should be stored in a refrigerator instead of just in an ordinary box. 4.5.5 When inoculating, pay attention to the sterile state to avoid contamination by damp bacteria and high bacteria. A.4. Product steam bed drop meaning
cell culture The HV test is highly sensitive and specific for the disease. As long as there is 1 to 1 infectious disease in the specimen, it can be detected. The sensitivities of SV isolation and culture are 4,87%, 73% and 27% respectively for genital herpes, skin cancer, infection and tooth infection.
B.1 Treatment objectives
(Informative Appendix)
Pretreatment and treatment plan for genital herpes
The treatment of genital herpes should be based on its clinical condition. The purpose of emergency treatment is to relieve symptoms, shorten the discharge time, reduce transmission channels, shorten the course of the disease, prevent or reduce complications!
) Prevent or reduce complications,
R,2 Treatment and treatment plan
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B.2.1 Asymptomatic clinical type of single organ infection does not require drug treatment. Symptomatic treatment will include both specialized treatment and local treatment. Comprehensive treatment should focus on anti-disease treatment and local treatment, including wound healing and prevention of secondary infection.
B.2.2 As cattle breeding is a lifelong recurrent disease, there is no complete cure, which often causes stress, anxiety, poor kidney function, and psychological factors. The natural history of the disease. Therefore, in the involution period, timely medical evaluation and social and psychological information should be given, and comprehensive treatment measures such as drug treatment should be taken to minimize the recurrence of the disease. B.3 Treatment drugs and treatment plans
R.3.1 The main drugs in the treatment are open-chain biological drugs, including liximab, fentanyl, pancreatic and chloramphenicol. The effective drugs for the treatment of resistant pain include citinib and tadalafil (ciinwir). These antibiotics can alleviate the symptoms and follow the course of the disease. Try to reduce the number of cards. Add charcoal to reduce the risk of latent infection. B.3.2 Antiviral treatment
H.3.2.1 Clinical examination includes clinical diagnosis of genital herpes simplex virus B.3.2.1.1 Axuvir 20mg, 4 large 3 times or 339mg, 3 times a day: or 250g, 3 times a day: both are bottles, dd.
H,3,2.1.2 For patients with painful enteritis, stomatitis, pharyngitis, etc., the dosage can be appropriately increased or the treatment can be up to 10d~~14: B. 3.2.1.3 For patients with HSV infection or inflammatory diseases who do not follow the strict medical treatment, you can give A-200mg~cg: pulse 81 times a day or until the clinical manifestations disappear. B.3.2.2 Anti-disease treatment for the onset of pain, it is best to start taking the medicine within 24 hours before the onset of symptoms or skin tenderness, which can be: 200mg of A-200mg every 5 times, or 300mg of A-200mg every 2 times, or 12mg~250mg of A-200mg every day. Average fire 1, the best course is 5d
R.3.2.3 Relapse (relapse 5 times each time> or heart rate of grade 5 delayed organ failure) should be treated with long-term antibiotics: 400mR of Viagra 2 times: or 300mR of Viagra 1 time; or 12F.r~-255mR of Viagra 2 times, which need to be given continuously for a long time, and the course is 4 months~1 year. B.3.2.L Immunodeficiency patients with H1V/41 infection can continue to take appropriate doses of drugs until clinical resolution. If the above-mentioned treatment is not effective or the symptoms persist, the following should be added: All resistant The dosage of the drug is 40mg/kg~60mg/kg: once every 8h, until clinical relief: B.3.2.5 Pregnant women need to take cyclohexidine. The use of drugs such as cyclohexidine is still controversial: Recently, it is advocated that those who have single-organ blister can take cyclohexidine. Considering the risk of postpartum complications and possible life-threatening, cyclohexidine should be taken for treatment. For pregnant women with short-term recurrence or newly infected herpes, it is recommended to stop taking cyclohexidine to avoid active supplements. To reduce the rate of birth: for pregnant women with a history of recurrent abortion: for pregnant women with no signs of recurrence in the first month of the year, axillary treatment can be performed. For pregnant women with active abortion or recurrent abortion, retrograde cesarean section can be performed before rupture of membranes under the premise of special precautions, but cesarean section cannot completely eliminate the occurrence of newborn nausea: for those with no active abortion, they can be classified according to the type of disease, and whether they have fever, sleepiness, weakness during feeding, and close monitoring can be carried out to ensure the treatment of severe symptoms. B.3.2.6 Neonatal herpes pain
Opiate 3m/(k·l)~6-/k·.intravenous The drip therapy is small ~ 21dH.3.3 Local treatment
The skin can be cleaned with blue salt or 3% acid in advance, and the disinfectant should be kept active. For external use, 3 Kekenwei box, 1 Xingpengxixiaoshiruchun, etc., but the efficacy of local treatment is far inferior to that of systemic drugs. Strong literature
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E2] Vesancrt M, Pimsineal, K a.lio A. Vaheri A. Derearlor. f herpus sirvdik virua DNAin cerebrospiaal Jluidl samples iging the zolyruerus rliain reaetinn and mizrop-ate hybridizaliaa.J Virol Methods,1996;59,1-11[25]Pcelirg RW, Sja-lius.PF, Sraully transmitted eliseasrs: methods and proteerile, NryJrrmy:Hunana Pre55, 1s99.71.75[26] Coaan- MA, Berger TG , Coales TI, et nl. Gerni..l eraes: Al Cowean FM, Muttluy P, (uilalina far thc managenent of herpen sirus iafurlicm in rueg-Tamuy.SexTrar.amInf,l995,74.9394Lzh_Narler SN, Prober CG. Herpesvirus nfceior.s uf the vu vn, Semin Dermarol, 1996, 5:8S
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_21] Pereira FA.Herjce iuplex: avoleing caurepts. J Am Acar Ijermatol, lute ; 35,50s-52022I Aghley R I., C orep L. 11sY type srecilic aatibndy tests: pa.ieuts urr inaty, are clini-tians?GeniteurinMed.1997;7a.23a.236_z3JAssley Kl., .aharatory tcehniyucs in llir riugnnsis or herpcs simp.ex iaecrinn, Cienirourinad, 1593: 69.174-133
E2] Vesancrt M, Pimsineal, K a.lio A. Vaheri A. Derearlor. f herpus sirvdik virua DNAin cerebrospiaal Jluidl samples iging the zolyruerus rliain reaetinn and mizrop-ate hybridizaliaa.J Virol Methods,1996;59,1-11[25]Pcelirg RW, Sja-lius.PF, Sraully transmitted eliseasrs: methods and proteerile, NryJrrmy:Hunana Pre55, 1s99.71.75[26] Coaan- MA, Berger TG , Coales TI, et nl. Gerni..l eraes: Al Cowean FM, Muttluy P, (uilalina far thc managenent of herpen sirus iafurlicm in rueg-Tamuy.SexTrar.amInf,l995,74.9394Lzh_Narler SN, Prober CG. Herpesvirus nfceior.s uf the vu vn, Semin Dermarol, 1996, 5:8S
Mcmer O, Tyrinug $k. LunarerJR viral intertiors. JAm Acec Dermuu., 199hig 33.[ss
279-381
Memer OM, Tyrirg Sk. Artv.re] agers in durm Inlneyt caren: status aud [ulure pros[30-
pects.Int J Lcrmaul,935, 84,f97 50i1.A serosurvey af Haernephitny dnereyi.xyphilis,and herne. -inpi+x vras tyrr 2 uul hcir assusiat:on witt. human inrunadefizizncy viru: aecg fen.ale 3ex workris \ 1.ipi. 23,237-242[t5_Ross Jl), Strith IW, Elioa RA. .aa1 32312.
Suisitt S, Staw I, Iso'an ti, e: al. Pereira FA.Herjce iuplex: avoleing caurepts. J Am Acar Ijermatol, lute; 35,50s-52022I Aghley R I., C orep L. 11sY type srecilic aatibndy tests: pa.ieuts urr inaty, are clini-tians?GeniteurinMed.1997;7a.23a.236_z3JAssley Kl ., .aharatory tcehniyucs in llir riugnnsis or herpcs simp.ex iaecrinn, Cienirourinad, 1593: 69.174-133
E2] Vesancrt M, Pimsineal, K a.lio A. Vaheri A. Derearlor. iging the zolyruerus rliain reaetinn and mizrop-ate hybridizaliaa.J Virol Methods,1996;59,1-11[25]Pcelirg RW, Sja-lius.PF, Sraully transmitted eliseasrs: methods and proteerile, NryJrrmy:Hunana Pre55, 1s99.71.75 [26] Coaan- MA, Berger TG, Coales TI, et nl. rueg-Tamuy.SexTrar.amInf,l995,74.9394Lzh_Narler SN, Prober CG. Herpesvirus nfceior.s uf the vu vn, Semin Dermarol, 1996, 5:8S
Mcmer O, Tyrinug $k. LunarerJR viral intertiors. JAm Acec Dermuu., 199hig 33.[ss
279-381
Memer OM, Tyrirg Sk. Artv.re] agerts in durm Inlneyt caren: status aud [ulure pros[30-
pects.Int J Lcrmaul,935, 84,f97 50i1.A serosurvey af Haernephitny dnereyi.xyphilis,and herne. -inpi+x vras tyrr 2 uul hcir assusiat:on witt. human inrunadefizizncy viru: aecg fen.ale 3ex workris \ 1.ipi. 23,237-242[t5_Ross Jl), Strith IW, Elioa RA. .aa1 32312.
Suisitt S, Staw I, Iso'an ti, e: al. Pereira FA.Herjce iuplex: avoleing caurepts. J Am Acar Ijermatol, lute; 35,50s-52022I Aghley R I., C orep L. 11sY type srecilic aatibndy tests: pa.ieuts urr inaty, are clini-tians?GeniteurinMed.1997;7a.23a.236_z3JAssley Kl ., .aharatory tcehniyucs in llir riugnnsis or herpcs simp.ex iaecrinn, Cienirourinad, 1593: 69.174-133
E2] Vesancrt M, Pimsineal, K a.lio A. Vaheri A. Derearlor. iging the zolyruerus rliain reaetinn and mizrop-ate hybridizaliaa.J Virol Methods,1996;59,1-11[25]Pcelirg RW, Sja-lius.PF, Sraully transmitted eliseasrs: methods and proteerile, NryJrrmy:Hunana Pre55, 1s99.71.75 [26] Coaan- MA, Berger TG, Coales TI, et nl. rueg-Tamuy.SexTrar.amInf,l995,74.9394Lzh_Narler SN, Prober CG. Herpesvirus nfceior.s uf the vu vn, Semin Dermarol, 1996, 5:8S
Mcmer O, Tyrinug $k. LunarerJR viral intertiors. JAm Acec Dermuu., 199hig 33.[ss
279-381
Memer OM, Tyrirg Sk. Artv.re] agerts in durm Inlneyt caren: status aud [ulure pros[30-
pects.Int J Lcrmaul,935, 84,f97 50i1.1-11[25]Pcelirg RW, Sja-lius.PF, Sraully transmitted elisears: methods and proteerile, NryJrrmy:Hunana Pre55, 1s99.71.75[26] Coaan- MA, Berger TG, Coales TI, et nl. Gerni.. l eraes: Al ntegrated upreach to manzgeutont Am Acae Dermatul, 1995; 5;Gn'iorF2y] Cowean FM, Muttluy P, (uilalina far thc managenent of herpen sirus iafurlicm in rueg-Tamuy.SexTrar.amInf,l995,74.9394Lzh_Narler SN, Prober CG. Herpesvirus nfceior.s uf the vu vn, Semin Dermarol, 1996, 5:8S
Mcmer O, Tyrinug $k. LunarerJR viral intertiors. JAm Acec Dermuu., 199hig 33.[ss
279-381
Memer OM, Tyrirg Sk. Artv.re] agerts in durm Inlneyt caren: status aud [ulure pros[30-
pects.Int J Lcrmaul,935, 84,f97 50i1.1-11[25]Pcelirg RW, Sja-lius.PF, Sraully transmitted elisears: methods and proteerile, NryJrrmy:Hunana Pre55, 1s99.71.75[26] Coaan- MA, Berger TG, Coales TI, et nl. Gerni.. l eraes: Al ntegrated upreach to manzgeutont Am Acae Dermatul, 1995; 5;Gn'iorF2y] Cowean FM, Muttluy P, (uilalina far thc managenent of herpen sirus iafurlicm in rueg-Tamuy.SexTrar.amInf,l995,74.9394Lzh_Narler SN, Prober CG. Herpesvirus nfceior.s uf the vu vn, Semin Dermarol, 1996, 5:8S
Mcmer O, Tyrinug $k. LunarerJR viral intertiors. JAm Acec Dermuu., 199hig 33.[ss
279-381
Memer OM, Tyrirg Sk. Artv.re] agerts in durm Inlneyt caren: status aud [ulure pros[30-
pects.Int J Lcrmaul,935, 84,f97 50i1.
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