Single semen analysis as a predictor of semen quality： clinical and epidemiological implications

It is generally thought that a single ejaculate is a bad predictor of semen quality of a subject, because of significant intra-individual variation. Therefore, we investigated the degree to which the results of a first semen analysis differ from that of a second analysis among men from a how the two different semen results mirrored the overall general population in Norway. In addition, we analysed semen quality assessment. A total of 199 volunteers participated in the study and delivered two semen samples with an interval of 6 months. The semen parameters were determined according to the World Health Organization （WHO） 1999 guidelines, which were also used to determine whether semen quality was normal or abnormal. In addition, the DNA fragmentation index （DFI） was determined using the Sperm Chromatin Structure Assay. The two samples from each individual were very similar with regard to standard semen parameters and DFI （rs： 0.67-0.72）, and there were no significant systematic differences between the two samples. The result of the first sample （normal/abnormal） was highly predictive of the overall conclusion based on the two samples （sperm concentration： in 93% of the cases （95% confidence interval [CI]： 89%-96%）; sperm motility： in 85% of the cases （95% CI： 79%-89%）; overall semen quality： in 85% of the cases （95% CI： 80%-90%）. In epidemiological studies, one ejaculate is a sufficient indicator of semen quality in a group of subjects. In a clinical situation, when the question is whether the semen quality is normal or not, the first ejaculate will, in at least 85% of cases, give a correct overall conclusion.

Analysis of DNA Content of Various Types of Spermatogenic Cells in Rat after Testicular Heating with Flow Cytometry

To measure DNA contents of spermatogenic cells and analyze the efficiency of spermatogenesis after testicular heating in rat Methods Eighty adult male Sprague-Dawley rats were randomly divided into experimental group （43 ℃, 30 min） and control group （22 ℃, 30 min）. According to day 0.5, 1, 3, 6, 10, 25, 35 and 50 after local testicular heating, every group was divided into 8 subgroups： experimental subgroups （n=6） and control subgroups （n=4）. DNA contents of various types of germ cells were observed with flow cytometry （FCM） in all groups. Results Compared with control groups, percentages of 4C cell （primary spermatocyte） in 0.5-35 d groups and percentages of 1C cell （spermatid and sperm） in 6-50 d groups significantly decreased in experimental groups （P〈0.05）, and percentages of 2C cell （spermatogonium and second spermatocyte） in 3 -35 d experimental groups increased significantly after heating （P〈0.05）. 4C：2C in all of 8 experimental groups and 1C：2C in 3-35 d experimental groups were down （P〈0. 05）, and in 1 d experimental group 1C：4C was up after heating （P〈0.05）. Conclusions After being heated, the number of spermatocyte firstly decreased, and then that of spermatid and sperm decreased too. Heat influences several stages in spermatogenesis and results in suppression of spermatogenesis. Flow cytometry is an effective method for researching on the change of spermatogenesis and has significance on mechanism about changing of spermatogenic cells induced by heat.

Effects of Local Testicular Heating on Bcl-2 and Bax Protein Expression in Spermatogenic Cells in Rats

Objective To investigate the expression of Bcl-2 and Bax in spermatogenic cells induced by local testicular heating in rats Methods Forty adult male SD rats were divided into experimental group and control group at random. According to day 0.5, 1, 3 and 6 after local testicular heating, each group was divided into 4 subgroups： experimental subgroup （n=6） and control subgroup （n=4）. The expression of Bcl-2 and Bax in the spermatogenic cells was detected on day 0.5, 1, 3 and 6 after heat exposure by using immunohistochemistry. Results Compared with control groups, the ratio of positive cells and content of Bcl-2 positive cells significantly decreased in all experimental subgroups （P〈0.01）. The content of Bax positive cells increased in all experimental subgroups （P〈0.01）, the ratio of positive cells which had no significant difference （P〉0.05） except 6 d group decreased （P〈0.01 ）. Redistribution of Bax from a cytoplasmic to perinuclear or nuclear localization could be observed after heating. Conclusions Expression of Bcl-2 would decrease and Bax would increase with redistribution in spermatogenic cells in rats after heating. The change of Bcl-2 and Bax expression in spermatogenic cells would be correlated with the spermatogenic cell apoptosis induced by heating.

乳腺癌术后患者的生活质量和满意度调查

目的调查不同手术方法(保乳手术、根治手术以及保乳或根治术后的重建手术)的乳腺癌患者术后的生活质量以及满意度。方法选择自2005年1月至2006年10月在德国汉诺威医科大学附属医院妇女保健中心接受手术治疗的乳腺癌患者共180例,分别给予调查问卷,包括EORTC QLQ-C30、EORTC QLQ-BR23以及自行设计的关于对术后外形满意度的问卷。所有患者在被调查时均没有局部和远处的转移。结果112例(62.2%)回信患者中,保乳组、根治组以及重建组各76、20、16例,保乳组患者较根治组和重建组有较好的身体映像(BI)(P=0.004,P=0.003),重建组患者比保乳组有较大的经济困难(FD)(P=0.006)和较多的对前景的看法(FP)(P=0.039);保乳组患者和根治组、重建组相比对术后乳房的外形有较好的自我评价(P=0.001,P<0.001)和较不明显的术后疤痕(P=0.003,P=0.019),对外形结果的满意比较显示重建组的患者认为术后双侧乳房形状的差异明显大于保乳组(P=0.005),双侧乳房大小的差异、对乳头乳晕的位置和形状是否满意方面两组之间的比较无明显的统计学意义(P=0.077,P=0.272)。结论和根治组以及重建组相比较,保乳组的患者有较好的术后生活质量和满意度。

子宫内膜癌腹腔镜术后切口转移:2例病例报道

Although studies have reported good results with laparoscopicassisted vaginal hysterectomy (LAVH) to treat endometrial cancer, it has been associated with recurrent disease at trocar insertion sites. Long- term follow- up is necessary to detect possible adverse effects of this technique. We present two case reports of stage IIB endometrial cancer with port- site metastasis 39 and 48 months after initial surgery with LAVH. Although LAVH is a good technique to treat patients with endometrial cancer, port- site metastasis is a possible complication and should be taken into consideration until a randomized study shows the long- term benefits and risks of laparoscopic over standard treatment.

美国西班牙裔妇女子宫体癌分期、诊断和主要治疗模式的研究

Objectives. To evaluate the demographic characteristics, clinico- pathological features, and patterns of care of uterine cancer among Hispanic women living in the United States. Methods. The National Cancer Institute (NCI)’ s Surveillance, Epidemiology, and End Results Program (SEER), was used to identify 1618 Hispanic, 17,814 non- Hispanic white (NHW), and 1477 non- Hispanic black (NHB) women diagnosed with primary carcinoma of the uterus during 1996- 2000. Data derived from hospital registries was analyzed, for differences in case presentation, staging, and primary treatment by race/ethnicity and age. Statistical analysis was performed using the IBM PC packages, Stata, and the SAS system. Results. Hispanic women were statistically significantly more likely to present with uterine cancer at a younger age compared to non- Hispanic groups. Hispanic women with early stage disease (stage I- II) were also statistically significantly more likely to be younger than 55 years at the time of diagnosis (NHW: OR = 0.40, 95% CI: 0.35- 0.45; P =0.0000, NHB: OR = 0.45, 95% CI: 0.38- 0.55; P = 0.0000).Hispanics were statistically significant less likely than NHB to present with advanced stage disease, high tumor grade, and receive radiation therapy for uterine cancer. Conclusions. Hispanic women are more likely to be diagnosed with uterine cancer at a younger age than other ethnic groups. The etiologic factors related to this presentation have yet to be precisely defined. Additional epidemiological and demographic studies, addressing such factors as body mass index and other medical co- morbidities, are needed to identify opportunities for improved cancer prevention and control in this population of women.