老年人痴呆或认知障碍多由一种以上年龄相关的常见脑部疾病所致。阿尔茨海默病(Alzheimer's disease,AD)是其中最常见的神经变性疾病,且是全球前10位死因中唯一无法治愈或缺乏长期对症疗效的疾病,给个人、家庭和全球经济都带来了巨...老年人痴呆或认知障碍多由一种以上年龄相关的常见脑部疾病所致。阿尔茨海默病(Alzheimer's disease,AD)是其中最常见的神经变性疾病,且是全球前10位死因中唯一无法治愈或缺乏长期对症疗效的疾病,给个人、家庭和全球经济都带来了巨大的负担。早期及时发现和干预是对抗AD的最佳策略。在过去的30年中,许多研究都提出了降低痴呆风险的方法,2020年《柳叶刀》杂志的痴呆预防报告已阐明通过应对风险因素可以预防或延缓超过40%的痴呆。然而,目前全球医疗体系尚未具备早期或及时发现AD的足够能力。最近的一项研究发现,只有不到10%的轻度认知障碍(mild cognitive impairment,MCI)是在初级医疗机构中诊断出来的。近来,抗淀粉样蛋白β(Amyloid beta,Aβ)抗体药物lecanemab和donanemab被批准上市用于早期AD治疗,以及30年的随访研究证明改善风险因素显著减少AD痴呆的发病率并延长了寿命,使得人们对AD早期识别的关注迅速增加。阿尔茨海默病防治协会(China Association for Alzheimer's Disease,CAAD)认识到居家早期和及时发现AD的重要性,并成立了一个由协会成员、临床医生和研究人员组成的全球AD多领域专家团队,就以下目标达成共识:①为个人、家庭、社区、协会和组织提供专家指导意见;②介绍用于认知障碍和痴呆居家筛查的数字工具和可用资源,并为AD高危人群或疑似患者制定下一步应对策略;③讨论现有可用或将来可能的居家筛查适宜AD生物标志物;④为未来的改进和全球应用建立可行性框架。专家组对于当前可用的证据、工具和资源进行综述,并进一步考量其在AD居家筛查中的价值。展开更多
Intracytoplasmic sperm injection （ICSI） is the recommended treatment in many cases of male-factor infertility. Several studies have demonstrated a positive correlation between optimal sperm morphology and positive I...Intracytoplasmic sperm injection （ICSI） is the recommended treatment in many cases of male-factor infertility. Several studies have demonstrated a positive correlation between optimal sperm morphology and positive ICSI outcomes. In fact, spermatozoa with severe abnormalities of the head are well documented to be associated with low fertilisation, implantation and pregnancy rates. However, a spermatozoon which is classified as ＇normal＇ by microscopic observation at low magnification could contain ultrastructural defects that impair both the fertilisation process and embryonic development. The intracytoplasmic morphologically selected sperm injection （IMSI） procedure changed the perception of how a spermatozoon suitable for injection should appear. Sperm selection is carried out at x 6000 magnification, allowing improved assessment of the sperm nucleus. Currently, standardized clinical indications for I MSI are lacking and the candidates are selected on the grounds of their medical history or of a careful analysis of the sperm suspension. Further prospective randomized studies are needed to confirm the advantages of IMSI in specific groups of patients. In addition to providing a brief overview of the IMSI procedure, this study aims to review the literature, which explains the theoretical basis and the clinical outcomes of this technique. Several reports show that IMSI is associated with improved implantation and clinical pregnancy rates as well as lower abortion rates when compared to ICSI. Although a possible correlation between the sperm＇s abnormal nucleus shape, increased DNA fragmentation and negative laboratory and clinical outcomes has been long investigated, the results are conflicting.展开更多
Semen from 10 932 male partners of infertile couples was analysed and sperm parameter trends were evaluated at the Reproduction Biology Laboratory of the University Hospital of Marseille （France） between 1988 and 20...Semen from 10 932 male partners of infertile couples was analysed and sperm parameter trends were evaluated at the Reproduction Biology Laboratory of the University Hospital of Marseille （France） between 1988 and 2007. After 3-6 days of abstinence, semen samples were collected. Measurements of seminal fluid volume, pH, sperm concentration, total sperm count, motility and detailed morphology of spermatozoa were performed. Sperm parameters were analysed on the entire population and in men with normal total numeration （ 〉~ 40 million per ejaculate）. The whole population demonstrated declining trends in sperm concentration （1.5% per year）, total sperm count （1.6% per year）, total motility （0.4% per year）, rapid motility （5.5% per year） and normal morphology （2.2% per year）. In the group of selected samples with total normal sperm count, the same trends of sperm quality deterioration with time were observed. Our results clearly indicate that the auality of semen decreased in this population over the study period.展开更多
文摘老年人痴呆或认知障碍多由一种以上年龄相关的常见脑部疾病所致。阿尔茨海默病(Alzheimer's disease,AD)是其中最常见的神经变性疾病,且是全球前10位死因中唯一无法治愈或缺乏长期对症疗效的疾病,给个人、家庭和全球经济都带来了巨大的负担。早期及时发现和干预是对抗AD的最佳策略。在过去的30年中,许多研究都提出了降低痴呆风险的方法,2020年《柳叶刀》杂志的痴呆预防报告已阐明通过应对风险因素可以预防或延缓超过40%的痴呆。然而,目前全球医疗体系尚未具备早期或及时发现AD的足够能力。最近的一项研究发现,只有不到10%的轻度认知障碍(mild cognitive impairment,MCI)是在初级医疗机构中诊断出来的。近来,抗淀粉样蛋白β(Amyloid beta,Aβ)抗体药物lecanemab和donanemab被批准上市用于早期AD治疗,以及30年的随访研究证明改善风险因素显著减少AD痴呆的发病率并延长了寿命,使得人们对AD早期识别的关注迅速增加。阿尔茨海默病防治协会(China Association for Alzheimer's Disease,CAAD)认识到居家早期和及时发现AD的重要性,并成立了一个由协会成员、临床医生和研究人员组成的全球AD多领域专家团队,就以下目标达成共识:①为个人、家庭、社区、协会和组织提供专家指导意见;②介绍用于认知障碍和痴呆居家筛查的数字工具和可用资源,并为AD高危人群或疑似患者制定下一步应对策略;③讨论现有可用或将来可能的居家筛查适宜AD生物标志物;④为未来的改进和全球应用建立可行性框架。专家组对于当前可用的证据、工具和资源进行综述,并进一步考量其在AD居家筛查中的价值。
文摘Intracytoplasmic sperm injection （ICSI） is the recommended treatment in many cases of male-factor infertility. Several studies have demonstrated a positive correlation between optimal sperm morphology and positive ICSI outcomes. In fact, spermatozoa with severe abnormalities of the head are well documented to be associated with low fertilisation, implantation and pregnancy rates. However, a spermatozoon which is classified as ＇normal＇ by microscopic observation at low magnification could contain ultrastructural defects that impair both the fertilisation process and embryonic development. The intracytoplasmic morphologically selected sperm injection （IMSI） procedure changed the perception of how a spermatozoon suitable for injection should appear. Sperm selection is carried out at x 6000 magnification, allowing improved assessment of the sperm nucleus. Currently, standardized clinical indications for I MSI are lacking and the candidates are selected on the grounds of their medical history or of a careful analysis of the sperm suspension. Further prospective randomized studies are needed to confirm the advantages of IMSI in specific groups of patients. In addition to providing a brief overview of the IMSI procedure, this study aims to review the literature, which explains the theoretical basis and the clinical outcomes of this technique. Several reports show that IMSI is associated with improved implantation and clinical pregnancy rates as well as lower abortion rates when compared to ICSI. Although a possible correlation between the sperm＇s abnormal nucleus shape, increased DNA fragmentation and negative laboratory and clinical outcomes has been long investigated, the results are conflicting.
文摘Semen from 10 932 male partners of infertile couples was analysed and sperm parameter trends were evaluated at the Reproduction Biology Laboratory of the University Hospital of Marseille （France） between 1988 and 2007. After 3-6 days of abstinence, semen samples were collected. Measurements of seminal fluid volume, pH, sperm concentration, total sperm count, motility and detailed morphology of spermatozoa were performed. Sperm parameters were analysed on the entire population and in men with normal total numeration （ 〉~ 40 million per ejaculate）. The whole population demonstrated declining trends in sperm concentration （1.5% per year）, total sperm count （1.6% per year）, total motility （0.4% per year）, rapid motility （5.5% per year） and normal morphology （2.2% per year）. In the group of selected samples with total normal sperm count, the same trends of sperm quality deterioration with time were observed. Our results clearly indicate that the auality of semen decreased in this population over the study period.
