湖南长沙地区育龄期女性生殖健康状况的调查

目的通过流行病学调查,了解湖南长沙地区育龄期女性生殖健康状况。方法选取进行健康体检的1 010名20~49岁育龄期女性进行问卷调查、常规妇科检查及阴道超声,将数据进行统计学分析。结果 (1)长沙地区育龄期女性初潮平均年龄、首次分娩平均年龄、平均体重指数(BMI)指数分别为(13.78±1.36)岁、(24.95±3.01)岁、(22.01±5.45)kg/m2。该地区女性避孕方式中工具、宫内节育器及绝育术所占比例分别为39.14%、27.35%、21.10%。该地区超重及肥胖(BMI≥24)占21.58%。未婚人工流产率、已婚人工流产率分别为12.24%、50.77%,重复人工流产率45.68%。(2)不孕症、子宫肌瘤、卵巢囊肿、慢性盆腔炎、月经紊乱的患病率分别为11.09%、9.8%、3.1%、5.8%、39.41%。(3)月经紊乱患病率人工流产组(54.31%)高于非人工流产组(37.01%),慢性盆腔炎患病率人工流产组(8.84%)高于非人工流产组(3.18%),差异均有统计学意义(P0.05)。经期延长发病率:节育器使用者(14.75%)高于未使用者(9.43%),差异有统计学意义(P0.05)。结论长沙地区育龄期女性超重及肥胖比例、未婚女性及已婚女性人工流产率较低;育龄期女性采用避孕方式主要为工具、宫内节育器及绝育术。人工流产可能引起育龄期女性月经紊乱、盆腔炎。宫内节育器的使用可能引起经期延长发病率升高。     

苏州和嘉兴地区门诊就诊妇女人工流产现状及影响因素调查

目的　了解苏州和嘉兴地区育龄妇女的人工流产 (人流 )现状及其影响因素 ,为现有的生殖健康服务机构提供生殖健康服务与教育提供依据。　方法　分层抽取江苏省苏州市、浙江省嘉兴市的市、县 (区 )、乡三级不同类别的生殖健康服务机构 1 0 0所。对2 0 0 0年 4～ 9月间就诊的育龄妇女进行自填式问卷调查。　结果　本次共调查了 1 850名育龄妇女 ,自我报告 53 .80 %有人流史 ,人流次数最多的 5次 ,平均 ( 1 .3 6± 0 .65)次 ;2 5.0 0 %有婚前人流史 ,婚前人流次数最多达 5次 ,平均 ( 1 .2 7± 0 .52 )次。性病防治所就诊妇女的人流次数明显高于其他机构就诊的妇女。影响人流次数和婚前人流次数的危险因素分析发现 ,避孕失败、妇女结婚年龄和有阴道炎史是影响人流次数和婚前人流次数的共同因素 ,多性伴、初次性行为年龄小 ,有性病病史、生殖道感染相关知识少等是人流次数的危险因素。　结论　两地区不同类别的生殖健康服务机构就诊妇女中有较高的人流率 ,妇女年龄、避孕失败、生殖道感染史、初次性行为年龄小以及相关知识得分等是影响妇女人流的主要危险因素。     

溶菌酶快速检测法在男性生殖道感染性不育诊断中的应用

男性生殖道感染对男性生殖功能的影响已引起人们重视,许多学者认为,一些难以解释的男性不育可能是由于难以诊断的或亚临床期男性生殖道感染所致。但临床检查中缺乏快速、准确的检测方法,为此,我们用辣根过氧化物酶(HRP)标记M. lysodeikticus的快速酶标记法,检测生育、不育男性精浆溶菌酶含量,并就精浆溶菌酶含量与精液细菌培养、白细胞计数、抗精子抗体(ASAb)和精浆免疫抑制物(SPIM)之间的关系进行了初步调查,现报告如下。一、材料与方法 1.受检对象生育组(n=37)为妻子怀孕6～8个月的健康男性,平均年龄27.0岁;不育组(n=107)     

不育男性生殖道沙眼衣原体、解脲支原体感染与精子凋亡关系

目的 :探讨不育男性生殖道沙眼衣原体 ( CT)、解脲支原体 ( UU)感染与精子凋亡的关系。方法 :采用流式细胞术 ( FCM)检测生殖道 UU、CT感染者和未感染者精子凋亡情况。结果 :CT、UU阳性和阴性组精子凋亡率 ( PAS)分别为 ( 1 4 .54± 3 .90 ) %、( 8.3 7± 6.3 0 ) %、( 1 5.2 6± 6.56) %、( 9.2 5± 4.0 3 ) % ,CT+UU双阳性精子凋亡率高达( 2 2 .2 1± 6.52 ) % ,各组与正常生育组比较 ,差异非常显著 ( P<0 .0 1 )。阳性组与相应阴性组比较差异显著 ( P<0 .0 5)。结论 :生殖道 UU、CT感染可明显增加精子凋亡 ,提示引起男性不育的诸多因素可能因精子细胞凋亡所致。     

男性不育患者生殖道溶脲脲原体感染对精液质量影响的研究

目的:了解男性不育患者生殖道溶脲脲原体感染情况,探讨男性不育患者生殖道溶脲脲原体感染对精液质量、附属性腺功能的影响及可能机制。方法:本研究对202例确诊的男性不育患者的精液标本进行溶脲脲原体培养,对精液参数及精浆α-葡萄糖苷酶、酸性磷酸酶和果糖进行检测,分析生殖道溶脲脲原体感染对精液参数及精浆生化指标的影响。结果:男性不育患者生殖道溶脲脲原体感染率为33.7%;生殖道溶脲脲原体感染阳性组和阴性组间精液量相差不显著[(2.93±1.32)mlvs(2.86±1.52)ml,P=0.774];阳性组精子密度较阴性组患者明显偏低[(84.37±52.92)×106/mlvs(101.90±43.90)×106/ml,P=0.025];阳性组精子活率较阴性组患者明显偏低[(44.62±22.13)%vs(51.83±19.88)%,P=0.036];阳性组患者精子活力明显低于阴性患者[(38.40±15.61)%vs(44.45±15.47)%,P=0.020];两组精液pH值均在正常值范围内,但阳性组明显高于阴性组(7.32±0.10vs7.19±0.29,P=0.003);阳性组与阴性组除侧摆幅度、向前运动、直线运动和摆动性等4项指标相差不显著外,对曲线运动性、直线速度、平均路径速度、平均移动角度)和鞭打频率等5项指标均有影响;阳性组精浆α-葡萄糖苷酶较阴性组明显降低[(40.0±18.7)U/mlvs(47.9±21.0)U/ml,P=0.026],Uu感染阳性组α-葡萄糖苷酶降低的相对危险性是阴性组的2.12倍;两组间精浆酸性磷酸酶和果糖水平无统计学差异(P均>0.05)。结论:在男性不育患者中,生殖道溶脲脲原体感染是精液质量下降的重要危险因素;生殖道溶脲脲原体感染可导致附睾分泌α-葡萄糖苷酶下降,但对前列腺酸性磷酸酶及果糖无明显影响,而这种感染对前列腺和精囊危害相对有限。     

昆明地区高校知识妇女生殖道感染调查

随着妇女寿命的延长 ,提高生命质量已成为当今世界关注的问题 ,妇女生殖健康正受到国际社会的重视及研究 ,保证妇女在各个生理时期的健康、安全、幸福 ,是生殖健康的内容之一。本研究试图了解高校知识女性的生殖道感染状况 ,找出在生殖健康方面的服务需要和现有的社区保健系统存在的问题 ,以便制定向该人群提供生殖健康的优质服务的社区规划。　　一、对象与方法1 .研究对象及背景特征 :资料来源于昆明地区部分具有大学学历以上、在高等院校任教的知识女性的妇科检查 ,于 1 999年 4～ 8月 ,共调查了四个学校已婚妇女 80 4名。年龄 2 3～ 6 0…     

东莞市1812名流动男性勃起功能障碍流行病学调查

目的了解东莞市流动人口男性勃起功能障碍(ED)患病率及其相关影响因素。方法采用整群、多级、分层、随机的抽样方法,对东莞市男性流动人口进行集中、现场问卷调查,问卷内容包括人口学信息(年龄、体质量、身高和文化程度等)、生殖健康信息接受情况(性知识来源、手淫、阴茎夜间勃起情况等)、性生活情况(性欲、性生活频率、射精潜伏时间等)以及国际勃起功能指数-5(IIEF-5)。结果完成调查人数共1 952名,回收问卷1 835份,回收率94.0%;有效问卷1 812份,有效应答率92.8%。本组ED患病率为64.2%,15岁~、26岁~、36岁~、46岁~和156-~60岁5组中,ED患病率分别为72.7%、62.3%、61.7%、67.1%、75.0%。多因素分析结果显示已婚同居和收入与ED的发病相关。结论东莞市流动人口男性ED患病率为64.2%,以轻症ED为主;年龄大于56岁的患病率最高;年龄、文化程度、收入和同居情况是影响ED患病率的主要危险因素,已婚同居和收入与ED发病相关。     

高原环境对青年男性精子DNA损伤的影响

目的:探讨长期高原作业是否能造成精子DNA的损伤。方法:以53例驻守低海拔地区的部队官兵为对照组,51例高海拔地区的部队官兵为观察组进行调查和对照研究,通过单细胞凝胶电泳技术和染色质扩散实验,检测精子DNA的损伤情况。结果:观察组在进入高原前的各项指标与对照组之间均无明显差异(P>0.05)。观察组的总彗星细胞发生率、各级彗星细胞发生率(G1、G2、G3)和DNA异常精子百分率在进入高原地区前分别为:(5.56±3.98)%、(3.72±1.85)%、(1.57±1.07)%、(0.27±0.34)%和(16.59±12.07)%,进入高原地区半年后均有升高,分别为:(11.15±8.59)%、(5.97±3.26)%、(3.83±2.13)%、(1.35±1.53)%和(22.03±15.33)%,与半年前相比差异显著(P<0.05);二级彗星细胞发生率(G2)和DNA异常精子百分率在1年后有所下降,分别为(3.32±1.83)%和(20.54±15.52)%,但仍比进入高原地区前有明显升高(P<0.05)。结论:长期在高原地区作业可引起精子DNA损伤,但对生育潜能的影响有待进一步研究。加强高原地区作业人员的男性生殖健康预防保健工作仍然十分重要。     

基层计划生育服务站就诊妇女生殖道感染现状及危险因素的研究

为了解基层计划生育服务站就诊妇女生殖道感染现状及其危险因素 ,应用分层抽样的方法 ,选取市、区、县和乡级计划生育服务站为研究现场 ,对研究期间来现场就诊或寻求计划生育服务的育龄妇女进行问卷调查、妇科检查和实验室检查。结果 :基层计划生育服务站就诊妇女盆腔炎、附件炎、宫颈炎和阴道炎的病史报告率分别为 5.1%、17.0 %、15.5%和 2 0 .1% ;检出率分别为附件炎 10 .5%、宫颈炎 38.3%、滴虫性阴道炎7.3%、念珠菌性阴道炎 7.6 %。单因素 Logistic回归模型分析发现 ,年龄、受教育年数、结婚年限、人工流产 (人流 )次数、经期有性生活、性病知识得分以及使用避孕套等是就诊妇女生殖道感染的主要危险因素。多因素 Logistic回归模型分析发现 ,影响生殖道感染的危险因素主要有就诊地点、艾滋病知识得分、年龄、人流次数以及丈夫年龄和职业等。结果表明 ,基层计划生育就诊妇女有较高的生殖道感染率 ,并存在多种危险因素。     

年龄对健康人伤口愈合的影响

有研究发现手术病人的伤口愈合不佳与年龄有关。但很少有研究验证是否单单年龄因素可致伤口愈合的生理性损害。作者通过健康志愿者研究了年龄对伤口愈合的影响,着重于伤口愈合的两个方面,即上皮化和纤维化的研究。上皮化研究:年轻组(平均年龄33.6±2.3岁;n=9),年老组(平均年龄72.2±0.7岁;n=15)。无菌局麻下于大腿前用植皮刀取一2×2cm大小片状层厚的皮肤。伤口上皮化程度由每天拍照来评定。经两个观察者确认,上皮层完全愈合的这一天认为是伤口愈合。纤维化研究:年轻组(平均年龄31.4±1.6岁;n=10),年老组(平均年龄72.2±0.7岁;n=15)。无菌局麻下皮下放置一个长约7cm的多聚4-氟乙烯(PTEE)管,14天后拔管。取2cm导管行羟脯氨酸和α-氨基氮的分析。因为羟脯氨酸是胶原的必需氨基酸,在其他纤维成分中少见,它的水平与胶原总量相关。另取1cm导管行DNA分析。导管腔切面染色后制成切片行感染、血管化、纤维化的程度检查。     

Analysis on the reproductive health situation of unmarried floating young women in cities

Objective: To understand the prevalence of RTIs/STIs, the incidence of sex violence and the KAP of the sex and reproductive health among unmarried floating young women.Methods: During Ocb.2002 to Feb.2003, in the maternal and child health hospital of Beijing, Shenzhen, Nanning and Zhengzhou, 1,219 unmarried floating young women who wanted termination of pregnancy and was under 24 years old before induced abortion received gynecological and laboratory examination. At the same time, they also answered a self-questionnaire. Results: The mean age of all respondents was (22.0±1.6) years old. The respondents' average age of having first sexual activity was (20.3±1.8) years old. The rate of induced abortion history was 38.7%. 17.5% of young women had never used contraception. The incidence of sex violence was 15.6%. The prevalence of RTIs and STIs was 56.1% and 9.7%, respectively. Young women were lack of the knowledge about reproductive health care. Conclusions: The reproductive health situation of unmarried floating young women was serious, especially on sex violence and RTIs/STIs and higher rate of induced abortion.     

常熟市未婚男青年生殖健康现状及服务需求调查

目的 :了解常熟市未婚男青年的生殖健康教育、性心理行为、避孕与婚前妊娠、人流现状 ,探索如何引导、教育未婚男青年正确接受和对待婚前生殖健康教育、性与避孕等问题 ,为进一步宣传教育提供依据。　方法 :采用社会心理行为学方法 ,随机调查有婚前性生活史者 5 10人。　结果 :6 1.2 %的人认为性与避孕知识教育应在学校获得 ,而实际只有 15 3%的人获得 (P <0 .0 1)。现实中获得性与避孕知识多来源于书刊及宣传小册子的人占 87.6 %。与恋人发生性关系时以反正要结婚 (39.4 % )和出于好奇 (32 .7% )居多。同居现象达 86 .8%。知道避孕方法中以避孕套最多 (81.2 % ) ,但知道某种方法却不一定使用该方法。首次性交采用避孕措施比例较低 (34.8% ) ;只有 39.7%的人每次都采用避孕方法 ,结果有 2 7.1%的人使女方怀孕 ,导致部分未婚女青年 (2 2 .4 % )上环避孕。不采用避孕措施的主要原因是怕麻烦 (6 3.6 % ) ;避孕药具主要来源是在药店购买 (5 9.8% )。　结论 :常熟市婚前性行为发生率较高 ,导致婚前妊娠人流等现象较重。应采取多种方式 ,对未婚男青年进行生殖健康教育     

Sexual and reproductive health service needs of university/college students: updates from a survey in Shanghai, China

AIM: To promote the provision of reproductive health services to young people by exploring the attitudes and perceptions of university students in Shanghai, China, toward reproductive health. METHODS: From July 2004 to May 2006, 5 243 students from 14 universities in Shanghai took part in our survey. Topics covered the demands of reproductive health-care services, attitudes towards and experience with sex, exposure to pornographic material, and knowledge on sexual health and sexually transmitted infections (STIs)/AIDS. RESULTS: Of the 5 067 students who provided valid answer sheets, 50.05% were female and 49.95% were male, 14.86% were medical students, and 85.14% had non-medical backgrounds. A total of 38.4% of respondents had received reproductive health education previously. The majority of students supported school-based reproductive health education, and also acquired information about sex predominantly from books, schoolmates, and the Internet. Premarital sexual behavior was opposed by 17.7% of survey participants, and 37.5% could identify all the three types of STIs listed in the questionnaire. Although 83.7% knew how HIV is transmitted, only 55.7% knew when to use a condom and 57.8% knew that the use of condoms could reduce the risk of HIV infection. CONCLUSION: The reproductive health service is lagging behind current attitudes and demands of university students. Although students' attitudes towards sexual matters are liberal, their knowledge about reproductive health and STIs/AIDS is still limited. It is therefore necessary to provide effective and confidential reproductive health services to young people.     

Disclosure of sexual orientation to health professionals in China: results from an online cross‐sectional study

Background : Many men who have sex with men (MSM) in China are “in the closet.” The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals. Methods : A nationwide cross‐sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio‐demographic information, sexual behaviours, HIV/STI testing history, and self‐reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider. Results : A total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone‐based, sex‐seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25–2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50–4.51 for HIV, and aOR = 4.92, 95% CI: 3.47–6.96 for STIs, respectively) or self‐reported as living with HIV (aOR = 1.59, 95% CI: 0.93–2.72). Conclusion : Over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.     

Access to safe abortion: building choices for women living with HIV and AIDS

In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. Of the estimated 21.6 million unsafe abortions occurring worldwide in 2008 (around one in 10 pregnancies), approximately 21.2 million occurred in developing countries, often due to restrictive abortion laws and leading to an estimated 47,000 maternal deaths and untold numbers of women who will suffer long‐term health consequences. Despite this context, little research has focused on decisions about and experiences of women living with HIV with regard to terminating a pregnancy, although this should form part of comprehensive promotion of sexual and reproductive health rights. In this paper, we explore the existing evidence related to global and country‐specific barriers to safe abortion for all women, with an emphasis on research gaps around the right of women living with HIV to choose safe abortion services as an option for dealing with unwanted pregnancies. The main focus is on the situation for women living with HIV in Brazil, Namibia and South Africa as examples of three countries with different conditions regarding women's access to safe legal abortions: a very restrictive setting, a setting with several indications for legal abortion but non‐implementation of the law, and a rather liberal setting. Similarities and differences are discussed, and we further outline global and country‐specific barriers to safe abortion for all women, ending with recommendations for policy makers and researchers.     

Prevalence of male and female sexual problems, perceptions related to sex and association with quality of life in a Chinese population: a population-based study

The prevalence of sexual problems (SP) and sexual satisfaction and their associations with sex-related perceptions and quality of life (QOL) were investigated by interviewing 3257 and 1568 Chinese adults in Hong Kong by a specially designed computerized telephone-interviewing method. SP was prevalent among male (50.9%) and female (54%) respondents; approximately 50% were dissatisfied with their sexual life. Of respondents, 23.9% of men and 5.9% of women perceived sex as important and 52.5% for men and 33.8% of women reported adequate sexual knowledge. The prevalence of SP ranged from 3.4% (pain) to 29.7% (premature orgasm) for men and 6.9% (anxiety) to 24.7% (lack of interest) for women. Prevalence of erectile and lubrication problems were 9.6 and 23.6%, respectively. Sex-related knowledge, perceived importance of sex, perceived physical health status, sexual satisfaction were predictors of SP. Gender differences and strong cultural influences appear to exist. Moreover, SP and sexual satisfaction were associated with mental health and vitality QOL and overall life satisfaction.     

Report from 24 hours reproductive health hotline in Shanghai:a preliminary analysis on first 9 months hotline data

<正> Objectives:To study reproductive health needs of Shanghai people,and to developappropriate measures to meet their needs.Methods:Statistical analysis of 24 hours reproductive health hotline data 4,000random sampled sex questions,comparing answers from different gender and differentquestions (sex questions vs other non-sex questions).Results:During the first 9 months a total of 44,216 calls were received by medicalstaff.The callers included various age groups (aged 12-78),different marital status,from Shanghai and outside.In total,the numbers of men and women on hotline callswere almost same.The contents of the hotline counseling covered all aspects of repro-ductive health care;among them,the issue concerning male and female sex problemsand prenatal and infant health care constituted 26.5% and 34% respectively.Men askedquestions about sex more frequently than women,whereas women asked questions moreabout baby care.Questions about sex problems were asked more often in the lateevening until next early morning.Conclusions:Shanghai people showed higher needs in sexual health care,prenatalcare and baby care.When they came across some related problems or confusions,theywould like to receive the professional instant counseling.Relevant health care pro-grammes should be established in order to meet the fertile-aged public's reproductivehealth needs.     

Fear of sexually transmitted infections among women with male migrant partners -- relationship to oscillatory migration pattern and risk-avoidance behaviour.

BACKGROUND: In South Africa, former apartheid laws encouraged rural males seeking employment to migrate to urban areas, moving weekly, monthly or annually between their rural families and urban workplaces. The combination of the migrant labour system and long family separations caused an explosion of serious health consequences, among others sexually transmitted infections (STIs) in the migrant population. OBJECTIVE: To describe some correlates of male migration patterns for the rural women left behind, especially the fear of STIs that this engendered in them and their risk-avoidance behaviour. Setting and subjects. In KwaZulu-Natal, 208 prenatal patients who were partners of oscillating male migrant workers were interviewed to determine their demographic and behavioural characteristics, and their fear of STIs. RESULTS: Thirty-six per cent of the rural women said that they were afraid of contracting STIs from their returning migrant partners. Women who saw their partners infrequently were more fearful of STI transmission, and were less able to have sexual communication. However, almost none of the women protected themselves, while only 8% used condoms, primarily for contraceptive purposes. CONCLUSIONS: These results reflect the gender-based power relationships of South African male migrants and their rural partners, the social and economic dependency of the women on their migrant partners, and the women's social responsibility to bear children. The results point to the need to go beyond interventions that simply seek to modify behaviour without altering the forces that promote risk taking and discourage risk reduction, and the need to develop appropriate interventions to curb STIs and decrease HIV.