血铅浓度对精子质量的影响探讨

大量研究报告表明,在过去50年间人类精子质量不断下降,主要表现为精子密度、活力和活率下降,精子畸形发生率升高.然而,至今对引起人类精子质量下降的因素却知之甚少.铅和镉是已知的两种雄(男) 性生殖毒物.铅发现有男(雄) 性生殖毒作用,主要引起接触铅男工精子质量下降以及男性不育与妻子自发流产率上升.本文针对铅对精液质量的影响、铅与微量元素的关系、精子密度、活力、畸形发生率、血铅浓度对性激素的影响做了探讨.     

中山地区男性不育患者精液质量分析

目的对中山地区男性不育患者的精液进行常规分析,了解中山地区男性不育患者精液质量的现状。方法按照《世界卫生组织人类精液检查与处理实验室手册》（第5版）的标准,应用西班牙人类精液分析微机辅助智能系统（CASA）对2012年10月～2013年6月来中山市博爱医院生殖中心就诊的2224例不育男性患者的精液进行常规检测和采用改良巴氏染色法分析精子正常形态率。结果2224例不育男性精液中正常者1113例（31．61％）,异常者1521例（68．39％）,其中液化异常964例（43．35％）,pH值异常124例（5．58％）,精子总数异常1002例（45．05％）,精子浓度异常556例（25．0％）,精子存活率异常1031例（46．36％）,精子总活力（PR＋NP）异常1208例（54．31％）,无精子症372例（16．72％）,精子正常形态率异常1021例（45．91％）。结论精子总活力、存活率下降,精子总数减少,精子正常形态率下降和精液液化不良是引起中山地区男性患者不育的主要原因,临床上应加于重视。     

不育伴畸精子症患者精子中性染色体的非整倍性一例分析报告

精子是人类生殖和繁衍的基础。精子的受精能力和精子的正常形态结构密切相关，研究已经证实畸形精子越多，受精率越低。正常人精液中也有一定量的畸形精子，但是不会超过20％～40％，如果正常形态精子小于30％则称为畸形精子症，将严重影响受精能力和生育能力，可导致男性不育。国外已经有研究证实畸精症患者的精子形成中遗传分裂出现异常，而国内研究畸形精子染色体的报道较缺乏。本文通过双色荧光原位杂交分析了一例畸形精子达96．6％的不育男性精子的性染色体，对其非整倍性进行了研究。     

精液白细胞对精液主要参数及精子功能的影响分析

目的探讨精液白细胞含量与精液主要参数和指标的关系。方法按照WHO人类精液实验室手册要求检测精液中的白细胞、主要参数、精子形态分析、精子顶体酶活性、精浆抗体（AsAb）、解脲支原体等，分析精液白细胞与男性不育相关因素的关系。结果238例男性不育患者中有75例（31．5％）精液中白细胞〉1×10^6个／ml，设为白细胞精子组；163例（68．5％）患者精液中白细胞≤1×10^6个／ml，设为非白细胞精子组。白细胞精子组的精子密度、精子活动率、a＋b级活力精子率、精子顶体酶阳性率均低于非白细胞精子组（P〈0．05）；而精子畸形率、精浆抗体（AsAb）、解脲支原体阳性率均高于非白细胞精子组（P〈0．05）。两组的精液量、pH值和液化时间差异无显著性。结论精液中白细胞含量与精液质量有密切的关系，是导致男性不育的重要原因。     

云南地区7046例男性精液质量和年龄关系的探讨

目的讨论云南地区男性年龄对精液质量的影响,建议云南男性合适生育年龄,提高优生优育。方法选择1-9月期间来我院生殖遗传科实验室进行精液检测的7046例患者作为研究对象,分析男性精液质量情况,并根据年龄进行分组,≤25岁、25岁～30岁、30岁～35岁、35岁～40岁、40岁,共5组,分析比较各组精液参数。结果 7046例男性患者中,精液质量分析均正常者占54.04%(3808/7046);精液质量异常者占45.96%(3238/7046),无精子症患者占5.52%(389/7046)。与正常组相比,异常组的精子活力、精液密度、精液量有极显著差异(P0.01),而液化时间无差异(P0.05)。40岁组与其他组相比,其总活力(PR+NP)、前向运动精子(PR)、精子密度、精液量、液化时间具有极显著差异(P0.01)。虽然精子活力在35岁时开始下降,但35岁以前无显著差异,精子活力在40岁以后下降趋势明显且具有显著差异(P0.01);而精液密度和液化时间随年龄的增高而增高。结论云南地区男性精液质量随着年龄的增加而下降,精子活力在35岁时开始下降,在40岁以后下降明显且具有显著差异,提示云南地区男性的最佳生育年龄在35岁以前。     

不育厨师精液质量参数及精子DNA完整性分析

目的探讨不育厨师精液常规质量参数和精子畸形率、精子DNA碎片率等指标。方法对生殖门诊52名不育厨师（观察组）和49名育前体检者（对照）行精液常规和DNA碎片率等检测。结果观察组精液液化异常率、精子畸形率、DNA碎片率都显著高于对照组;精子浓度、前向运动精子比率显著低于对照组。结论厨师职业暴露会影响精液质量,导致男性不育,应加强保护和防范。     

X、Y精子分离与优生

本文建立并采用精子上游优选法成功地从精液中分离出高纯度的Ｙ精子，Ｙ精子的纯度从处理前的４９％上升到８８％，同时ａ级和ｂ级精子密度从处理前的４９．９％上升到９２．７％，精子呈现非常活跃的前向直线运动；正常形态的精子也从处理前的５２．９％上升到９７．４％，精子畸形率明显下降，精液质量得到了明显的提高。     

4479例不孕夫妻男性患者精液检测结果分析

目的研究近年来云南省男性生殖力的变化。方法使用计算机辅助精子分析(CASA)技术,按照WHO技术规范,对自2012至2016年到我生殖中心就诊的4479例不孕症夫妻男性患者的精液进行精液常规检测,并对其结果进行统计与分析。结果4479位男性患者的平均年龄为34岁;2012~2016年间我省男性精液常规中精液量、快速前向运动精子、前向运动精子及精子活动率4项参数变化不明显;精子密度及精子总数2项参数下降趋势明显。结论我省男性患者精液部分参数下降趋势明显。     

Y染色体AZF基因缺失与原发性无精子症的相关性研究

原发性无精子症患者除有精子异常，精液检查发现无精子外，其余情况包括睾丸体积、内分泌功能、其他精液检查指标等均正常，即患者出现精子异常的原因不明。原发性无精子症原因极其复杂，除输精管梗阻、腮腺炎病毒感染等明确病因外，研究认为遗传缺陷是其中的重要因素之一，因此有关原发性无精子症的遗传因素分析日益受到重视。分子生物学的研究证实，人类Y染色体长臂上存在着控制精子生成的基因一无精子因子AZF，原发性无精子症患者检测到了不同比率、不同区域的AZF基因缺失，表明Y染色体AZF基因缺失与原发性无精子症密切相关。     

绍兴地区281例男性婚检者精液常规检测结果分析

目的了解281例绍兴地区婚前体检人员男性精液质量状况。方法应用WLJY-9000伟力彩色精子质量分析系统对281例男性婚检人员精液的量、外观、粘稠度、pH值、液化时间、精子密度、活率、活动力进行分析。结果281例婚检者，精液量异常的为25例，占8．9％，液化异常31例，占11．0％，pH值异常36例，占12．8％，精予密度异常48例，占17．1％，精子活率异常29例，占10．3％，精子活动力a级〈25％或（a＋b）级〈50％共有56例，占19．9％。结论婚检人群的生殖健康知识知晓情况较差，全民应重视婚前检查，进一步提高人口素质及优生优育。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.