超高倍显微分析仪在检查精液支原体中的应用

目的研究超高倍显微分析仪在检查不育症患者精液支原体中的临床价值。方法用清华同方多功能超高倍显微分析仪（简称TH仪）和培养法对188例不育症患者精液进行支原体检测分析。结果 TH仪法阳性率为45.7%,培养法阳性率45.2%,两种方法的检测结果无显著性差异（P〉0.05）。结论用TH仪镜检支原体活体,其快速、准确、简便、经济可作为一种支原体检测的筛查方法。     

精子核DNA及形态图像定量分析在男性不育中的应用

目的：探讨男性不育精子核ＤＮＡ及形态图像变化。方法：采用真彩色图像分析仪定量检测。结论：精子核ＤＮＡ及形态图像定量分析可作为精子功能评估方法,是男性不育诊断和疗效观察的可靠指标。结果：与正常生育组比较,精子静脉曲张组精子核宽有非常显著性差异（Ｐ〈０．０１）,ＤＮＡ积分光密度、平均灰度、面积、圆度有显著属于性差异（Ｐ〈０．０５）;不明原因不育组ＤＮＡ积分光密度、平均灰度有非常显著性差异（Ｐ〈０．０１）;慢性疽旬腺炎组精子核长、核宽、尾长有非常显著性差异（Ｐ〈０．０１）,圆度有显著性差异（Ｐ〈０．０５）。     

福建地区5680例男性不育患者精子参数和精子DNA完整性分析

目的探讨福建地区男性不育与精液参数和精子DNA完整性关系。方法对5680例男性不育患者和3200例健康体检者进行精液参数和精子DNA完整性检测。采用SQA-V全自动精子分析仪进行精液常规分析,精子形态采用改良巴氏染色法,精子DNA完整性检测采用精子染色质扩散试验(SCD),用DNA断裂指数(DFI)表示。结果不育患者精子精子密度、活动率、精子形态和DFI与对照组比较差异有统计学意义(P0.05);两组的精液量、精液p H值差异无统计学意义(P0.05)。结论精子密度、活动率、精子形态和DFI的异常是引起福建地区男性患者不育的最主要原因。     

两种冷冻保护剂对形态正常精子百分率影响

目的比较甘油和甘油-卵黄-柠檬酸钠(GYC)两种冷冻保护剂对精子形态影响.方法应用甘油和GYC两种冷冻保护剂(CPM)对精液标本进行速冻和缓慢冷冻保存,应用计算机精液分析仪进行精子形态分析.结果冷冻复温后形态正常精子百分率与冷冻前比较的形态正常精子百分率比较明显下降(P<0.001);速冻与缓慢冷冻法中两种保护剂间形态正常精子百分率比较均无显著性差异(P>0.05). 结论冷冻保存易造成形态正常精子百分率下降,两种保护剂对精子形态没有影响.     

三种精液优化方法对宫腔内人工授精临床结局的影响

目的探讨直接上游法、密度梯度离心法、密度梯度离心后上游法三种精液优化方法对宫腔内人工授精(IUI)结局的影响。方法对2015年1月至2018年12月在我院生殖中心接受宫腔内人工授精治疗的患者资料进行回顾性分析,根据精液优化方法的不同将患者分为3组,A组:采用直接上游法;B组:采用密度梯度离心法;C组:采用密度梯度离心后上游法,比较三种精液优化方法处理后的精子质量参数与临床妊娠结局。结果处理前的精子活力及精子正常形态率三组间无统计学意义(P0.05),处理后,所有患者前向运动精子量均在1000万条以上,三组的精子活力及正常形态率均不同程度升高,A组及C组的活力及正常形态率均高于B组,有统计学差异(P0.05);C组的精子活力及正常形态率稍高于A组,但无统计学差异(P0.05)。A组及C组临床妊娠率高于B组,有统计学差异(P0.05);A组临床妊娠率高于C组,但无统计学差异(P0.05)。结论三种精液优化方法均可显著改善精子质量参数,上游法及密度梯度离心后上游法在改善精子活力及正常形态率方面优于梯度离心法,行IUI后临床妊娠率也较高。     

厦门地区332例男性不育患者精液常规结果分析

目的对厦门地区男性不育患者的精液进行常规分析,了解厦门地区男性不育患者精液质量的现状。方法采用SQA-V全自动精子质量分析仪对332例不孕不育中心就诊的男性不育患者及107例正常生育者进行精液常规项目分析及统计。结果精子密度、a+b级精子活动率比例、正常精子形态百分率三项指标与正常对照组差异有统计学意义(P<0.05)。结论男性不育症患者的精液精子密度、a+b级精子活动率比例、正常形态精子百分率三项指标与正常对照组均较正常者低。     

五种不同的职业对男性精液质量的影响

目的探讨五种不同职业对精子DNA完整性和精子参数的影响。方法将就诊的1658例男性不育患者按照职业分为司机组、放射科医生组、工人组,飞行员组和厨师组;将856例正常生育组做为健康对照组。采用SQA-V全自动精子分析仪进行精液常规分析,精子形态采用改良巴氏染色法,精子DNA完整性检测采用精子染色质扩散试验(SCD),用DNA断裂指数(DFI)表示。结果司机组、放射科医生组、工人组,飞行员组和厨师组的精子密度、活动率、精子形态和DFI与对照组比较差异有统计学意义(P0.05);而精液量、精液p H值差异无统计学意义(P0.05)。结论司机、放射科医生、工人,飞行员和厨师的职业可以影响精液质量,从而导致男性不育。     

放射科医生职业与男性精液参数的相关性研究

目的探讨从事放射科医生职业对精子DNA完整性和精子参数的影响。方法将就诊的460例男性不育患者分为放射科医生组218例和非放射科医生组242例;将放射科医生组分为10年组85例和10年组133例,将520例正常生育组做为健康对照组。采用SQA-V全自动精子分析仪进行精液常规分析,精子形态采用改良巴氏染色法,精子DNA完整性检测采用精子染色质扩散试验(SCD),用DNA断裂指数(DFI)表示。结果放射科医生组和非放射科医生组的精子密度、活动率、精子形态和DFI与对照组比较差异有统计学意义(P0.05);放射科医生组工作者组的精子密度、活动率、精子形态和DFI与非放射科医生组比较差异有统计学意义(P0.05);三组的精液量、精液p H值差异无统计学意义(P0.05);10年组与10年组相比,精子密度、活动率、精子形态和DFI均显著降低(P0.05)。结论长期从事放射科医生职业影响精液质量,工龄对精子质量的影响存在时效性,从而导致男性不育。     

精液白细胞与精子形态的相关性研究

目的探讨精液白细胞与精子形态之间的关系。方法按WHO精液检测方法对192例不育患者进行精子形态分析和精液白细胞检测。结果白细胞精子症组正常精子形态百分率低于非白细胞精子症组（P〈0．05）,且白细胞精子症组头部缺陷数和尾部缺陷数较非白细胞精子症组增加,差异有统计学意义。结论精液中过多的白细胞可导致精子形态异常,是男性不育重要的原因之一。     

不育井下煤矿工人精液质量分析

目的探讨煤矿井下工作环境对精子参数和精子DNA完整性的影响。方法 90名不育井下煤矿工人为实验组,并对工龄1-5年和5年井下煤矿工人的精液质量进行比较;将60例正常生育男性做为健康对照组。采用CASA全自动精子分析仪进行精液常规分析,精子形态采用改良巴氏染色法,精子DNA完整性检测采用精子染色质扩散试验(SCD),用DNA断裂指数(DFI)表示。结果实验组精子浓度、活动率、精子形态和DFI与对照组比较差异有统计学意义(P0.05);而精液体积、精液p H值,液化时间差异无统计学意义;发现工龄5年组与工龄1-5年组相比活动率、精子形态和DFI差异显著(P0.05)。结论煤矿井下工作环境可以影响精液质量,从而导致男性不育。     

男性不育患者年龄对精子形态及精子DNA完整性的影响分析

目的探讨男性不育患者年龄对精子形态及精子DNA完整性的影响。方法将231例男性不育患者按年龄分为A组（25—40岁）及B组（≥40岁）,对其进行精子形态学分析及精子DNA完整性检测。结果A组精子畸形率及精子DNA碎片指数（DFI）明显低于B组（P〈0．05）,两组差别有显著性意义。结论男性年龄对精子形态及精子DNA完整性有一定的影响,应引起临床关注。     

Acid-fast bodies in faecal smears stained by the modified Ziehl-Neelsen technique

The modified Ziehl-Neelsen (ZN) stain has proved useful in the laboratory diagnosis of cryptosporidiosis and, more recently, for the laboratory diagnosis of cyclospora. Apart from cryptosporidia and cyclospora, many other organisms and artefacts are present in faeces, and may be seen in faecal smears stained by the modified ZN method. Described here is the presence of such organisms and artefacts in faecal samples submitted to the routine microbiology laboratory of a district general hospital. Over 6000 faecal smears were examined using the modified ZN method, with an incidence of cyclospora and cryptosporidium of approximately 0.1% and 1%, respectively. Other organisms and artefacts were observed, with an incidence ranging from 0.1% to 1%. It is emphasised that the identification of known gastrointestinal tract pathogens should not rely solely on the results of their staining reactions. It is essential that criteria such as morphology and size be taken into account to differentiate organisms with similar staining reactions.     

Microscopic diagnosis of amebiasis: an obsolete method but necessary in the developing world

Molecular biology-based diagnosis offers the best approach to detect amebiasis, but remains impractical in the clinical laboratories from the developing world. In these areas, the microscopic diagnosis remains the routine method. It is imperative that a series of fresh stool specimens be examined. The use of a concentration method should become a routine procedure. Permanent stained smears is the most critical and reliable diagnostic method for the microscopic detection of intestinal protozoa. If the direct or concentrate wet mounts were considered as a preliminary examination; and the use of iron-hematoxylin stained smears become a routine procedure, many of the misdiagnosis that frequently occur could be avoided. The iron-hematoxylin stained preparation is the method of choice for the microscopic detection of E. histolytica/E. dispar and other intestinal protozoa.     

厦门地区男性低生育能力患者年龄与精子DNA完整性关系的探讨

目的为了研究厦门地区男性低生育能力患者年龄和精子DNA完整性之间的关系。方法 353例男性不育患者分为40岁(含40岁)以上组和40岁以下组,患者的精子采用染色质扩散的方法进行精子DNA碎片分析。结果 40岁(含40岁)以上组的精子DNA碎片率的检出值明显高于40岁以下组(DNA碎片指数分别是27.83±2.06 and 24.81±6.77%,P<0.05)结论厦门地区男性低生育能力的患者的年龄对精子DNA完整性有极大的影响。     

Routine Pap smears for the diagnosis of bacterial vaginosis.

This study investigated the role of Papanicolaou (Pap) smears in determining the presence of bacterial vaginosis (BV). Pap results, vaginal Gram stains, signs, symptoms, and wet mounts were evaluated. Vaginal smears for Gram stain and routine Pap smears were collected from 420 consecutive patients. Ninety-three percent of patients with Pap smears showing only coccobacilli had a corresponding BV-positive Gram stain. Pap smears with mixed bacterial patterns had 22-71% positive Gram stains depending on the types of bacteria present. Only 10 of 70 symptomatic patients and 13 of 132 with cervicitis or discharge had a positive Gram stain and/or an altered bacterial pattern. All positive wet mounts had positive Gram stains and coccobacilli only on Pap smears. The most specific diagnosis of BV with Pap smears requires coccobacilli only. This reiterates the Bethesda system criteria. Clinical signs, physical symptoms, and wet-mount examinations were noncontributory in this study.     

Wet mount microscopy reflects functional vaginal lactobacillary flora better than Gram stain

AIM: The status of vaginal lacto-bacillary flora, an indicator of possible genital infection and pregnancy complications, can be assessed on wet mount or Gram stained specimens. The former is quick, the latter more routine. The accuracy of the two preparative techniques to detect normal vaginal lacto-bacillary microflora was compared for 646 patients. The effect of delay in transport medium before Gram staining was also investigated. METHODS: Patients presented with infectious vaginitis or for a routine prenatal visit. After placement of a speculum, duplicate smears were taken from the upper vaginal vault and examined fresh or after Gram staining. Lacto-bacillary grades from both methods were compared with lactate concentration in vaginal rinses. In a subgroup of 238 patients, Gram staining was performed both on fresh smears and those that had been transported in Stuart's growth medium. RESULTS: Higher lacto-bacillary grades (more disrupted flora) were diagnosed 2.9 times more frequently on Gram stained specimens than on wet mounts (p < 0.0001), a difference even more pronounced after transport in Stuart's medium (relative risk, 4.2; p < 0.0001). Lacto-bacillary grades assessed on wet mounts correlated better with vaginal lactate concentration than those assessed on Gram stains. CONCLUSIONS: Easier recognition of lacto-bacillary morphotypes on wet mounts than on Gram stains might result from the loss of lactobacilli by the process of fixation or Gram staining. Wet mount microscopy of vaginal smears for assessment of lacto-bacillary grades, rather than Gram staining, is strongly recommended.     

Cytology of serous effusions. An investigation into the usefulness of cell blocks versus smears.

Approximately half of 351 body-cavity effusions from 263 patients were examined prospectively in paraffin-embedded cell blocks and in smears, while the other half were examined in smears alone. The number of suspect and positive fluids obtained with the combined cell block-and-smear technic was double that of specimens examined in smears only. No false-positive case was found. Tumors were subsequently demonstrated in 38% of the patients who had negative or atypical cytologic reports. Smears stained with the Papanicolaou technic generally have good definition of malignant cellular changes, wheras cell blocks are particularly useful when the cytologic abnormalities are misleading, such as in reactive mesothelial cells, or obscure, as in occasional well-differentiated adenocarcinomas. It is recommended that both cell blocks and smears be used in evaluating all fluids submitted to the cytology laboratory.     

Scanning electron microscopy in oral cytology

Sixty-three cell smears from oral mucosa were studied by scanning electron microscopy. Among them, smears from ten healthy controls showed three kinds of cells: flat (superficial) cells with linear anastomosing microridges and microvilli; polygonal (intermediate) cells with well-defined crests between their faces and numerous microvilli; and round (parabasal) cells entirely covered by microvilli. Twenty-five smears from patients with untreated squamous-cell carcinoma showed enlarged polymorphous cells (round, globular, and elongated); microvilli, variable in their dimensions, were irregularly distributed on their surfaces. Eighteen smears from patients with severe epithelial dysplasia showed polymorphous cells with discontinuous but obvious edges separating their faces and with irregular microvilli and ridges. Nine smears were also performed in patients with various other mucosal lesions (lichen planus, leukoplakia, white sponge naevus, pemphigus vulgaris, and herpes). All of these smears were studied comparatively between examination of smears and biopsies by light microscopy. The smears were truly reliable, particularly for distinguishing between dysplastic and tumoral cells.     

Filamentous bacteria masquerading as fungi: a diagnostic pitfall in direct smear interpretation with report of two cases

Bacteria, particularly Gram-negative bacilli, can develop abnormal morphology after the administration of subinhibitory concentrations of antibacterial agents. Filamentation is a common response in which bacteria replicate but incompletely divide, leading to long slender chains that resemble fungal hyphae. Pathologists are frequently consulted to examine direct smears of body fluids, which often contain microorganisms. Antibiotic-related filamentous morphology may resemble fungal hyphae and this potential misinterpretation can lead to inappropriate treatment for presumed fungal infections. Two cases are described in which direct smears of body fluids were examined by on-call pathology residents who misinterpreted filamentous bacteria as fungal organisms, with one case leading to the initiation of antifungal medication. Although well-established within the field of microbiology, many residents and practising pathologists are less familiar with antibiotic-related bacterial morphology, as it may not be routinely encountered. It is important for pathologists to be aware of this phenomenon in order to avoid misinterpretation.