Analysis of Change in Sperm Quality of Chinese FertileMen druing 1981～1996

By literature search, 114 papers for fertile m ale sperm quality including 256 set data w ere collected from 9 292 personsand 11 726 assaysinvolving 39 citiesand coun- ties. Results of analysis show ed a decrease in m ean concentration of sperm from 103.02×106 /m l (1983) to 83.84×106/m l (1996), sperm m otility w as decreased from 75.11(1982) to 67.27(1996) and percentage of sperm w ith norm alm or- phology w asreduced from 85.02(1983) to 77.89(1996), thusshow ing thedefi- nite negative correlation and being statistically significant (P< 0.05). Total sperm countsw ere decreased from 355.34×106(1984) to 262.26×106(1996) and the m ean sem inalvolum ew asdecreased from 3.31 m l(1981) to 2.97 m l(1996), both tending to decline butnotbeing statistically significant(P> 0.05). Itisinteresting to notethat although Chinese sperm quality is better, itdeclines significantly faster than thatof w estern countriesatthesam eperiod. Itispossible thatthe decline of sperm quality is due to problem of environm entalquality. Theauthorssuggesttheemphasisof basicre- search in relevantfields.

Effect of low level, short wavelength ultraviolet radiation on sperm chromatin

Objective:To evaluate the effects of low level ultraviolet (UV) radiation on sperm chromatin structure.Methods:The target study was divided into three groups: (i) males with proven fertility (n=40 ) was taken as GroupⅠ (control);(ii) Oligoasthenozoospermic (OAT) cases as GroupⅡ (n=36);(iii) males with unexplained infertility (MUI) cases (n=42) as GroupⅢ. Specific techniques were used to study the impact of UV radiation (Pre and Post UV exposure) on the sperm nuclear DNA viz. Aniline blue staining was for detection of immature chromatin. Chromomycin A3 fluorescence staining was used to determine protamine-DNA dissociation by intense fluorescence of protamine deficient sperm cells and neutral comet assay was for evaluation of DNA fragmentation. Statistical analysis was carried out using Student'st-test (GraphPad Prism Version-6). Level of significance was considered atP<0.05.Results: The data revealed that spermatozoa of OAT and MUI cases when exposed to UV-radiation showed higher percentage of immature sperm compared with normal fertile individuals. Higher percentage of Chromomycin A3 fluorescence in OAT and MUI cases revealed impaired DNA-protamine binding with subsequent DNA fragmentation after exposure to UV.Conclusions:In the present study, sperm chromatin is at higher risk of DNA fragmentation in the infertile (OAT and MUI) cases due to UV irradiation (254 nm). Hence, short duration UV exposure is detrimental to sperm DNA which could affect ensuing generations.

不孕妇女生殖道感染病原体检测分析

目的分析不孕妇女生殖道感染的病原体分布和支原体药敏。方法对260例不孕妇女(试验组)的阴道分泌物和宫颈分泌物进行相关病原体的实验室检查,并与260例妊娠妇女(对照组)进行比较。结果试验组妇女生殖道感染的病原体阳性率为61.2%。病原体检出前3位依次为支原体(47.7%)、假丝酵母菌(30.0%)和细菌性阴道病(BV)病原菌(16.7%);BV病原菌、支原体和pH值在不孕妇女与对照组间差异具有统计学意义(P<0.05),其他病原体和生殖道清洁度在试验组与对照组间差异无统计学意义(P>0.05)。多西环素和米诺环素对解脲支原体的敏感率高达90%以上,喹诺酮类药物对解脲支原体的敏感率低于40%。结论 BV病原菌和支原体感染是引起妇女不孕的重要因素,须加强监测,合理使用抗菌药物。

从脾胃论治肥胖型PCOS

由于脾胃为后天之本,脾胃的运化功能失调造成痰湿内阻,而现代人的生活不规律,暴饮暴食等易造成肥胖症发生率的不断增高。肥胖型PCOS患者的内分泌及血糖血脂代谢紊乱,造成胰岛素抵抗、高脂血症等,影响LH、LH/FSH、T、E_2的分泌,最终导致不孕。

宫腔镜266例临床应用

目的 :利用宫腔镜直视下对宫内患疾进行诊断和治疗 ,探讨其临床价值。方法 :自 1998年 6月至 2 0 0 0年 6月对 2 6 6例不孕不育、子宫异常出血、输卵管妊娠治疗、宫内节育环 (IUD)取出、宫腔异物取出、内膜息肉摘除等的诊断和治疗。年龄范围 2 0～ 6 4岁 ,平均 30 .8岁。发病时间 1～ 9年 ,于月经干净后 2～ 7d进行检查或手术。结果 :84例异常子宫出血病人中 ,正常宫腔 2 8例 (2 1% ) ,异常出血 6 6例 (79% ) ,80例做病理检查 ,符合率达 90 %以上 ;不孕不育 16 0人 ,子宫因素检查异常 2 6例 (16 .3% ) ;输卵管不通 6 5例 (4 0 .6 % )。其中 ,53例经通液成功 ,随访 1～ 3年 ,已有 2 5例成功怀孕 ;11例输卵管妊娠治疗手术 10例成功 ,1例失追踪 ;6例宫内节育环有 5例成功取出 ,1例异位于腹腔 ;人流漏吸 2例及宫腔异物 2例均一次成功取出。结论 :宫腔镜诊疗各种宫内疾病成功率高 ,安全性大 ,无并发症。

左氧氟沙星联合宫腔灌注甲硝唑治疗不孕症伴慢性子宫内膜炎患者的临床效果

目的探讨左氧氟沙星联合宫腔灌注甲硝唑对不孕症合并慢性子宫内膜炎(chronic endometritis,CE)患者的临床效果。方法本研究采用病例对照研究方法。选取徐州市中心医院2018年3月至2021年3月收治的82例不孕症伴CE患者临床资料,应用随机数字表法分为观察组和对照组,各41例。对照组给予盐酸左氧氟沙星口服治疗,观察组在对照组治疗基础上联合甲硝唑氯化钠注射液宫腔灌注治疗,两组均治疗14 d。比较两组治疗前后血清C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和单核细胞趋化蛋白1(monocyte chemotactic protein 1,MCP-1)水平,半年内自然妊娠率、总有效率和治疗期间不良反应发生率。呈正态分布的计量资料以x±s表示,两组间比较采用独立样本t检验,组内治疗前后比较采用配对t检验;非正态分布的计量资料以M(Q_(1),Q_(3))表示,组间比较采用Wilcoxon秩和检验;计数资料以例(%)表示,组间比较采用χ^(2)检验。结果治疗前,两组患者血清CRP、TNF-α和MCP-1水平比较差异均无统计学意义(均P>0.05);治疗14 d后,两组患者血清CRP、TNF-α、MCP-1水平均低于治疗前,且观察组均低于对照组[(4.12±1.90)ng/L比(6.36±1.63)ng/L,(47.28±9.10)ng/L比(62.79±9.34)ng/L,(212.04±24.82)ng/L比(326.15±27.38)ng/L],差异均有统计学意义(t值分别为5.61、7.62、19.77,均P<0.001)。治疗14 d后,观察组总有效率和自然妊娠率均高于对照组[95.12%(39/41)比78.05%(32/41),53.66%(22/41)比31.71%(13/41)],差异均有统计学意义(χ^(2)值分别为5.14、5.96,P值分别为0.023、0.044)。治疗期间两组不良反应发生率比较差异无统计学意义(P=0.457)。结论左氧氟沙星联合宫腔灌注甲硝唑治疗不孕症合并CE患者具有较好的临床效果,可显著改善机体的炎性状态,降低血清炎症因子水平,提高6个月内自然妊娠率,且不增加不良反应发生情况。