Treatment of Male Infertility

Following is authors’ experience in treating male infertility, such as oligospermia, poor sperm motility, failure of seminal fluid to liquefy or autoimmunity. Oligospermia Oligospermia falls into the category of jing shao (精少scant semen), jing qing (精清thin semen) or xu lao (虚劳 consumption) in TCM. This condition is caused by insufficiency of the kidney-essence due to constitutional insufficiency or excessive sexual activity exhausting the kidney-essence, or due to lack of source of generation and transformation of kidney-essence resulting from depletion and/or deficiency of qi and blood. Decrease in the sperm     

Volume of residual urine as an indication for surgical treatment of benign prostatic hyperplasia

Objective To study the volume of residual urine as related to the surgical indication for BPH. Methods Urodynamic study was carried out in 103 BPH patients who were assigned to group A(no residual urine), group B( residual urine< 60 ml) and group C( residual urine 60 - 100 ml). Results Qmax, URA, DR and DI were not significantly different between group C and group B (P > 0.05) but significantly different between group C and A or between B and A(P<0.05). Conclusion The conventional conception that surgical intervention is indicated when the residual urine being > 60 ml should be strictly followed. Early surgical intervention should be undertaken if the bladder outlet obstruction or bladder function deteriorated by BPH causing residual urine. Other causes such as neurogenic should be ruled out before surgery. 10 refs,2 tabs.     

Comparison of main lactobacillus species between healthy women and women with bacterial vaginosis

Background The normal microbial flora of the vagina plays an important role in preventing genital and urinary tract infections in women. Thus an accurate understanding of the composition and ecology of the ecosystem is important to understanding the etiology of these diseases. This study aimed to compare the characteristics of main lactobacillus species between healthy women and women with bacterial vaginosis （BV） by quantitative culture and PCR methods. Main lactobacillus species include L. crispatus , L. gasseri, L. jensenii and L. iners.
Methods A total of 150 Women attending Gynecology Outpatient Clinic of Beijing Friendship Hospital, were diagnosed as having BV because three or more of the following criteria were met （standard of Amsel＇s composite criteria）： homogeneous discharge, elevated vaginal pH （pH 〉4.5）, production of amines, and presence of ＂clue＂ cells. Those with less than three of the criteria were considered as healthy. Simultaneously, smears were made of vaginal fluid and Gram stained, then were assessed qualitatively as normal （grade Ⅰ）, intermediate （grade Ⅱ）, or consistent with BV （grade Ⅲ）. Gardnerella vaginalis were identified by using Vitek 2 Compact and PCR methods. Lactobacillus species were identified by PCR methods. Gardnerella vaginalis and lactobacilli colony counts were determined by calculating the most number of colonies of each species in the appropriate plates （colonies between 10 and 300）, corrected by the dilution of the sample in the plates, and multiplied by 10 （to account for plating 100 μl）, in order to get colony forming units per milliliter of vaginal secretion.
Results BV was diagnosed in 31% （46/150） patients using the composite criteria, the remainder being regarded as healthy. The majority of patients with BV had a smear assessed as grade Ⅲ （91%, 42/46） and minority of them had a smear assessed as grade Ⅱ（9%, 4/46）. The majority of healthy women had a smear assessed as grade Ⅰ （64%, 67/104）. Smears assessed as grade Ⅱwere found （36%, 37/104） among patients diagnosed as healthy, with less than three of the composite criteria. L. crispatus was cultured from 94% of healthy women and 83% of women with BV, with the former colonies count average value of 106 and the latter of 103. L. gasseri, L. iners, and L. jensenfi were cultured from 85%, 68% and 43% of healthy women; and 28%, 89% and 44% of BV women, respectively.
Conclusions The quantities of four lactobacillus species except L. jensenii had a significant difference between healthy women and women with BV. Our results provide support for the negative association between L. iners and L. gasseri. Although L. crispatus were existent both in healthy and BV positive women＇s vagina, the numbers of L. crispatus were significantly different for the dominant number in healthy women. Smears of vaginal fluid and Gram stain play an important guiding role in bacteria culture.     

Discussion of Glasser＇s ＂Quality World＂ among Medical Students Benefited Group Dynamics

Purpose： The aim of this study is to analyze the Glasser＇s ＂Quality World＂ as it is discussed among the medical students and to see if there is any relationship between it and their academic/creativity scores. It also seeks if this discussion is of any benefit to the group dynamics. Methods： Participants were 205 medical students, 4 to 7 students were allocated as a group. They were asked to fill an open answer to 4 categories of＂Quality World＂ （the people we most want to be with, the things we most want to own or experience, the idea or system of belief that govern much of our behavior, and the places we most want to visit or live） and discuss them in an open forum. Torrance Tests of Creative Thinking were performed to the students. They answered the Likert scale question whether discussing the ＂Quality World＂ with peers benefited the group dynamics or not. Results： Among 205 students, 50.2% wanted to be with adoring people; followed by entertainers and artists （18%）, 51.7% wanted to own material wealth; spiritual values were second in importance （21%）, 27.3% considered family, friends, and lovers most valuable; followed by happiness （21%）, 52.2% wished for an overseas trip; trip to the mountains, seas, or deserts was next in importance （14.1%）. Most of the respondents answered that discussing ＂Quality World＂ benefited their group dynamics. Conclusion： We suggest that discussing Glasser＇s ＂Quality World＂ might be a useful tool to gain understanding among the health personnel in small group activities and increase group dynamics.     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究:津液辨证(英文)

Intraditional Chinese medicine (TCM),the so-called津液refers to all the fluid and liquid flowingand maintaining inside the human body.In Chineselanguage,津液is a phrase composed of twoChinese characters which describes two differentkinds of fluid or liquid in the human body .According to the theory of TCM,津refers to thepart of fluid that is thin in texture and flowss moothly inside the body while液refers to thepart of fluid that is thick in texture and mainlymaintains in the joints of the body to nourish andlubr...     

SIGNIFICANCE OF THE QUANTITATIVE DETERMINATION OF "FIBRIN DEGRADATION PRODUCTS" IN RENAL DISEASES

For 2 years the immunohemagglutination inhibition test, using glutaraldehyde-treated human "O" red blood cells as the carrier of antigen (fibrinogen), has been done to determine the fibrin and/or fibrinogen degradation products (FDP) in the blood and urine of patients with renal diseases. FDP was present in appreciable amounts in the urine of 68TO of 136 patients with nephritis, while among 24 patients with ne- phrosis, only 17To showed weakly positive results 《1.25 yg/ml). The results of the determination of blood FDP were inconsistent. Thus, only urine FDP determination seems to be of value in diagnosing nephritis and in differentiating it from nephrosis. The fact that the amount of urine FDP did not correlate with the amount of blood FDP or the degree of proteinuria indicates that the urine FDP in nephritis is not a result of leakage from the blood to the urine, but pro- bably forms locally in the kidneys. Thus, coagu- lation and fibrinolysis seem to play a role in the pathogenesis of nephritis but not in nephrosis. Urine FDP determination is also of value in diagnosing rejection of transplanted kidneys.     

Progress of experimental study on treatment of psoriasis by Chinese medicinal monomer and single or compound recipe in Chinese materia medica

Psoriasis is a common,chronic,recurrent inflammatory skin disorder whose etiology is still unknown.It is believed that a multiple-gene inheritance is involved and it also involves various factors such as immunity,inflammation,cell proliferation,apoptosis,neural media,etc.Since cytokines are key mediators in inflammation,a number of Chinese medicines(CMs)have been reported to have certain antagonist effects on pro-inflammatory cytokines such as tumor necrosis factor-α(TNF-α),platelet active factor(PAF)and interleukin-8(IL-8).Some researches on CMs have made significant breakthroughs in psoriasis by intervening with cytokines.Abnormalities with keratinocyte proliferation and apoptosis are considered to be present in patients with psoriasis and a number of studies show that the mechanism of CMs on psoriasis may be through the inhibition of the keratinocyte proliferation and induction of apoptosis.Other studies also show that the inhibition of fibroblast-secreted cytokines could regulate keratinocyte proliferation and differentiation and reduce the level of Calcitonin gene-related peptide(CGRP)in plasma and in lesions so as to slow down the process of inflammation and proliferation in psoriasis.The most commonly used models for psoriasis are the scaled tails or the vaginal epithelium of mice in China.They were used to observe the histopathological changes after the model mice were treated with CMs with the inhibition on the mitosis of vaginal epithelium or promotion of granular layer in rat tail taken as the indices of clinical efficacy.A variety of signs occur in psoriasis patients with TCM blood-stasis syndrome type and the effect of CMs in activating blood circulation to remove blood stasis on psoriasis suggested that the mechanism of CMs may be partially correlated to hemorrheology and microcirculation.Along with the continuous development of the biosciences,some TCM theories for psoriasis have been confirmed by laboratory studies.However,the exploration into traditional Chinese medicines'biomechanics in psoriasis and the therapeutic mechanism of CMs by integrative medicine still requires further studies.     

SURYEY DISTRIBUTION OF MODERN-TRAINED PHYSICIANS IN CHINA

The problem of the distribution of physicians is vitally related t。 the medical profession as well as to the public. The recent report of the Committee on the Costs of Medical Care for the American People (6) reveals that the medical facilities in the United States are not dis- tributed primarily according to needs, but rather according to real or supposed abilify of patients to pay for service. As a result, many cam- munihes in that country are undersupplied with practitioners, hospitals and other facilities, while others have a surplus. For example, in igzg there was one physician to every l,431 persons in South Carolina, as contrasted with one to every 571 in California and one to every 621 in New York State. Furthermore, the same report shows that there is als。 a maldistribution by type, as indicated by the fact that approximately 45 per cent of the physicians in America have completely or partially limited their practice to a specialty, although, in the opinion of the Committee, apparently the needs of the people could be met adequately if not more than 18 per cent of physicians were specialists.     

Validation of diagnostic algorithms for syndromic management of sexually transmitted diseases

Objective To validate our revised syndromic algorithms of the management of sexually transmitted diseases and determine their sensitivity,specificity,positive predictive value and cost-effectiveness.Methods Patients with either urethral discharge,vaginal discharge or genital ulcer,were selected during their first visits to three urban sexually transmitted disease clinics in Fujian Province,China,They were managed syndromically according to our revised flowcharts.The etiology of the syndromes was detected by laboratory testing.The data were analyzed using EPI INFO V6.0 software.Results A total of 736 patients were enrolled into the study.In male patients with urethral discharge,the sensitivities for gonococcal and chlamydial infections were 96.7% and 100%,respectively,using the syndromic approach.The total positive predictive value was 73%.In female patients with vaginal discharge,the sensitivity was 90.8%,specificity 46.9%,positive predictive value 50.9%,and negative predictive value 89.3% for the diagnosis of gonorrhea and/or chlamydial infection by syndromic approach.In patients with genital ulcer,the sensitivities were 78.3% and 75.8%,specificities of 83.6% and 42.9%,and positive predictive values of 60.0% and 41.0% for the diagnosis of syphilis and genital herpes, respectively,using the syndromic approach,Cost-effectiveness analysis indicated that the average cost of treatment for a patient with urethral discharge was RMB 46.03 yuan using syndromic management,in comparison with RMB 149.19 yuan by etiological management.Conclusions The syndromic management of urethral discharge was relatively effective and suited clinical application.The specificity and positive predictive value for syndromic management of vaginal discharge are not satisfactory.The revised flowchart of genital ulcer syndrome could be suitable for use in clinical settings.Further validation and revision are needed for syndromic approaches of vaginal discharge and genital ulcer.     

Antifertility Effect of Sperm Coating Protein in Rat Seminal Vesicle by Isoimmunization

This paper reports that seminal vesicle protein Ⅱ (SVP Ⅱ) secreted by rat was used as an antigen in the isoimmunization of rat for the observation of its antifertitity effect. The pregnancy rate was decreased to 7.7% in rats immunized passively with rabbit anti-SVP Ⅱ serum, as compared to 76.9% in rats injected with normal rabbit serum. The antifertility effect of active immunization was found to be related to the titer number of anti-SVP Ⅱ serum. The high anti-SVP Ⅱ liter and its significant antifertility effect demonstrate that the sperm coating protein can be used as an vaccine for fertility inhibition.     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：内科疾病（五）

肝着 liver fixity： a diseased condition arising when qi and blood of the liver meridian become depressed and stagnant     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：八纲辨证（三）

The Chinese characters 寒 and 热, 虚, and 实 are quite common concepts in Chinese language. However in traditional Chinese medicine （TCM）, they are used as four principles in syndrome differentiation. In terms of translation, 寒 and 热 are very easy to understand and can be simply translated as ＂cold＂ and ＂heat＂. But the transla- tion of 虚 and 实 used to be a problem. For a quite long time in translation practice,     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：八纲辨证（一）（英文）

The so-called eight principles include阴,阳,表,里,寒,热,虚,实which are usually transliterated and translated as yin,yang,exterior, interior,cold,heat,deficiency and excess.These eight principles serve as a theoretical basis for treatment based on syndrome differentiation. These eight principles are easy to understand, translate and standardize.     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：各科辨证（二）

外伤瘀滞证pattern/syndrome of stasis and stagnation due to traumatic injury：a pattern/syndrome attributedtotraumaticinjury causinglocal stagnation of qi and blood,manifested by local ecchymosis,pain and tendernessIn Chinese language,瘀and滞are two concepts which are si milar to each other in meaning under certain context,     

中医研究生循证医学教学探索

循证医学（EBM）是一种将医学研究、临床经验、患者意愿相结合,依据证据来制定临床决策的方法学。将其引入临床医学实践,可以帮助患者得到合适的治疗,帮助医生提高临床水平,改善医患关系;将其引入中医研究,可以为临床研究提供方法学,促进中医走向世界;将其引人中医教育,可以调动学生的积极性,     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：病因部分（二）

In the previous issue, we have introduced some of the Chinese medical terms about causes of diseases included in WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region （abbreviated as WHO Standard） and International Standard Chinese-English Basic Nomenclature of Chinese Medicine compiled by World Federation of Chinese Medicine Societies （abbreviated as WFCMS Standard）. We have also made brief comments on international standardization of the English translation of these terms according to the studies made in the book entitled International Standardization of English Translation of Traditional Chinese Medicine：     

中医发展现状及思考

2009年新年伊始,上海中医药大学出版社出版了上海中医药大学附属曙光医院专家、教授编著的《诊余感悟》一书。该书的主编邀请到了前中国社会科学院副院长、中欧国际工商学院名誉院长刘吉教授作序。序中刘教授从哲学的高度就中医药学的学科性质、科学内涵、潜在危机及如何现代化等中医药发展所面临的问题提出自己的真知灼见,掷地有声。本刊约请刘教授略作修改后予以发表。     

关于WHO/ICTM术语问题的几点建议

2008年,世界卫生组织（World Health Organization,WHO）启动了＂疾病名称国际分类第11版＂（International Classification of Diseases-11,ICD-11）的修订工作[1]。与ICD前10版不同的是,在第11版的修订工作中,专门设置了第23章,拟将传统医学纳入其中。但就目前的发展来看,能纳入其中的,只有源自中国的传统医学,即中医药学。     

现代中医师承与临床医学专业学位衔接培养模式的探索与实践

2009年4月,国务院发布了《关于扶持和促进中医药事业发展的若干意见》（国发[2009]22号）。在加强中医药人才队伍建设中,该文件明确提出,要总结中医药师承教育经验,制订师承教育标准和相关政策措施,探索不同层次、不同类型的师承教育模式,丰富中医药人才培养方式和途径,落实名老中医药专家学术经验继承人培养与专业学位授予相衔接的政策。