促进生殖健康,实现新千年发展目标

公元2000年全球189个国家共同发表的新千年宣言中，提出了全球新千年发展目标(Millennium Development Goals，MDGs)，这为衡量世界各国社会可持续发展提供了一个框架。新千年发展目标中包括8项内容：①消除极端贫困与饥饿；②普及初等教育；③促进男女平等及保证妇女权益；④降低儿童死亡率；⑤保证孕产妇健康；⑥征服HIV／AIDS、疟疾及其他疾病；     

未婚成年男子3759名生殖健康现状调查报告

本文对 375 9名未婚成年男子作婚前生殖健康状况调查 ,报告如下 :资料和方法资料来自 2 0 0 0年 1月～ 10月本院婚保科男婚检室婚前医学检查记录。自的全部资料及的完整。采用妇幼保健信息统计方法 ,对每位接受婚前医学检查者按照卫生部制定的婚前检查标准及项目进行检查 ,检查项目及辅助检查结果进行分类统计。重点对男性生殖系统疾病检出情况进行统计分析。外生殖器的测量采用婚前医学检查中规定检测器进行测量。睾丸容积采用睾丸容积测量器检测睾丸容积。对睾丸容积小于 10ｍｌ、精索静脉曲张及隐睾的男子 ,增加精液常规 ,以判断生精功能…     

男性生殖健康面临的挑战

近年来对男性生育能力的研究 ,带动了对男性生殖健康的全面关注。我国男性生殖健康的现状并不乐观。本文讨论了男性生殖健康的改变及可能原因 ,以及关注婴幼儿及儿童、青少年男性的生殖健康、男性泌尿生殖系统感染性疾病的发生率有增加的趋势、有关男性不育的研究亟待深化、男性避孕尚无满意方法、男性性功能障碍的诊治现状不能满足社会需求、男性更年期研究刚刚起步、重视生活方式和习惯的调整。关注男性生殖健康任重而道远 ,是医务人员和全社会的共同责任     

北京市石景山区1006例男性泌尿生殖健康调查

目的:了解30～60岁男性泌尿生殖健康状况,为提高男性泌尿生殖健康水平提供依据。方法:按照分层、随机抽样原则,于2008年10月至2009年2月在北京市石景山区抽取年龄30～60岁男性无业人员、出租车司机、机关干部共1 006例提供泌尿生殖健康调查。结果:有效调查1 006例。身体质量指数(BMI)≥24 kg/m2者占72.7%;高血压者占40.0%;国际前列腺症状评分异常者占85.5%;慢性前列腺炎症状评分异常者占75.6%;国际勃起功能指数异常者占66.3%;男性更年期问卷(AMS)量表异常者占10.7%;处于焦虑状态者占17.1%,处于抑郁状态者占25.1%。空腹血糖>6.1 mmol/L占34.9%;总胆固醇>5.07 mmol/L占44.3%;甘油三脂>1.71 mmol/L占46.6%;总睾酮(17.9±7.2)nmol/L,<12 nmol/L者占21.3%,<8 nmol/L者占3.4%;游离睾酮水平(36.5±15.1)pmol/L。结论:北京市石景山区30～60岁男性生殖健康状况令人担忧。     

广州市流动人口男性生殖健康现状及需求调查

目的 了解我市流动人口男性生殖健康现状及生殖保健需求,为制定流动人口相关政策提供参考依据.方法 采用描述流行病学方法,分层多级抽样法,结合IIEF-EF、NIH-CPSI设计问卷调查的形式,抽取广州市7个区男性常住流动人口进行集中、现场问卷调查.结果 759例以青壮年为主的男性流动人口中44.27%的人有不同程度的ED.49.67%的男性流动人口承认曾接受过不同形式的有偿不洁性服务.53.75%的人有不同程度的慢性前列腺炎尿道刺激症状.结论 流动人口男性的生殖健康现状不容乐观,他们的生殖健康水平及心理健康问题亟需有关部门的高度关注及相关政策支持.     

心理因素与男性生殖健康

生殖健康是 2 1世纪医学界关注的焦点。对心理因素与男性生殖健康关系的研究 ,将有助于揭示男科疾病发生的规律。本文剖析了男性不良心理因素产生的社会根源 ,阐述了心理因素对男性生殖健康影响的途径 ,提出了有关心理问题的干预措施。     

青年官兵男性生殖健康小样本调查与干预对策分析

部队是一个男性集中、封闭式管理的特殊群体。男性生殖健康与性健康问题,是与部队公共卫生相关密切的一项重要课题,它不仅关系到官兵的身心健康,更关系到部队的管理与建设。由于部队的特殊性质,如何开展好此项工作,使青年官兵保持良好的身心状态,适应部队这个特定的环境,是值得我们男科工作者认真思考并探讨解决的。为此,我们于2005年5月对驻穗某部队男性官兵进行了一次男性生殖健康状况的小     

工作环境对男性生殖健康的影响

过去的许多文献曾提出一个严峻的问题 :在世界范围内 ,无论动物还是人类的精子数量都在下降。工业和环境污染物如雌激素、热、各种化学物品以及电子和辐射能对生殖系统都有损害。美国国家职业健康研究所 (ＮＩＯＳＨ )和ＨｅａｌｔｈＲｅｇｉｓｔｒｙｏｆＴｏｘｉｃＥｆｆｅｃｔｓｏｆＣｈｅｍｉｃａｌＳｕｂｓｔａｎｃｅｓ列出了 10 4 ,0 0 0多种理化因子 ,其中 95%并未就其对生殖系统的影响进行过研究。尽管如此 ,ＮＩＯＳＨ还是列出了 10类国家职业病或职业损伤可造成不育症。由于对这些因素所知甚少 ,我们就更应去研究 ,并在工作中避免…     

上海市核心家庭避孕情况、满意程度及生殖健康服务利用情况调查

目的了解上海市核心家庭中育龄对象的避孕情况、对避孕方法的满意程度以及生殖健康服务的利用情况,发现存在的问题,为进一步实施干预措施,提高家庭的生殖健康水平提供依据。方法通过面对面方式对1,060个符合标准的核心家庭中的成员进行问卷调查,分析核心家庭成员的避孕情况、避孕方法的满意程度以及生殖健康服务的利用情况。结果调查对象避孕方法的总体使用率为90.66%;其中使用率最高的避孕方法为宫内节育器,其次是避孕套;调查对象对女性目前所使用的避孕方法是比较满意的;2,120名调查对象中,过去一年曾去生殖健康相关门诊寻求生殖健康服务的有375人(17.74%);其中接受过避孕节育方面咨询的有264人(70.40%)。结论调查对象避孕方法构成上存在避孕率高、宫内节育器使用率(54.25%)高、绝育率极低、避孕套使用率(25.66%)较高的特点。绝大多数对象对目前使用的避孕方法感到满意或基本满意。但是在过去一年中接受过生殖健康相关服务的对象所占比例较低。因此,今后相关部门应该开展广泛的针对性的宣传教育,打破这种生殖健康需求“沉默”的局面,提高核心家庭育龄成员的生殖健康水平。     

Reproductive health care in the Gelukspan Health Ward.

Reproductive health care, namely family planning, antenatal care (ANC), labour care and postnatal care, was studied in the Gelukspan health ward of Bophuthatswana in 1985-1986. Only a minority of the women interviewed (20%) had planned their last pregnancy, but most had attended for ANC (93%) and had had supervised deliveries in a hospital or clinic (80%). Most (97%) knew of modern methods of fertility control but only a minority (37%) were using them. Planned pregnancies were more likely to be reported by married women (73% of 37 v. 9% of 173; P = 0.0000) who left school at an earlier age (16.0 +/- 5.9 years v. 17.0 +/- 3.9 years; P = 0.0462). If unmarried, women who had planned their pregnancy were more likely to be maintained by the father of the child (15% v. 4%; P = 0.0134). They were also less likely to have left school because of the pregnancy (20% v. 50%; P = 0.0001). Unmarried women with supervised deliveries are more likely to have financial support from the father of the child. Maternal school education is positively related to attendance for ANC, attendance for supervised labour and utilisation of modern methods of fertility control. There seems to be an intricate relationship between the different outcomes measured. ANC attenders were more likely to have supervised deliveries. Both groups were more likely to start attending for child health care earlier and more frequently. Our results are discussed.     

婚孕前健康体检教育对优生优育的影响

目的探讨婚孕前健康体检教育对优生优育的影响。方法对照组未实施任何婚孕前健康体检教育措施;研究组于婚前给予针对性的婚孕前健康体检教育措施,比较两组的婚前检查率、孕前检查率、新生儿结局。结果研究组婚前检查率86.40%、孕前检查率93.40%,均显著高于对照组婚前检查率43.00%、孕前检查率73.20%（P〈0.05）;研究组新生儿遗传类疾病发病率为0.96%、传染性疾病（母体传播所致）发生率为2.64%,均显著低于对照组新生儿遗传类疾病发病率5.23%、传染性疾病（母体传播所致）发病率14.49%（P〈0.05）。结论积极实施婚孕前健康体检教育可显著提高婚检及孕前检查率,保障母婴生活质量及生命安全,有利于获得更为满意的优生优育工作效果。     

Survival compared to the general population and changes in health status among intensive care patients

In order to evaluate intensive care, all adult patients (980) admitted to a multidisciplinary intensive care unit (ICU) during 1 year were followed prospectively. The ICU mortality was 9.6%. One year after admission the survival was 73.6%. By that time the surviving patients had a further survival that was 96% of that of the general population. Of the 1-year survivors, 22.3% had deteriorated in health status compared to 3 months before the stay in ICU. In the admission groups with high mortality the survivors had a more pronounced deterioration in health status. Increased age and length of stay in the ICU were associated with higher mortality but not with changes in health status. We conclude that the outcome of intensive care can be evaluated by studying only the survival, since the survival rate is correlated to changes in health status among survivors in the different admission groups. One year after admission most of the surviving patients had regained their previous health status and their further survival was almost the same as that of the general population.     

Assessing health status and health care utilization in adolescents with chronic kidney disease

Few validated health status measures have been assessed in children with chronic kidney disease (CKD). The objective was to assess the validity of a generic health status measure, the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), in adolescents with CKD. A case-control study was performed (1) to assess scores on the CHIP-AE in adolescents with CKD compared with two control groups of age-, socioeconomic-, and gender-matched peers and (2) to compare health of patients who had chronic renal insufficiency (CRI), were on dialysis, and were posttransplantation. Seven pediatric nephrology centers recruited 113 patients (mean age, 14 yr; 39 CRI, 21 dialysis, 53 posttransplantation). Compared with 226 control subjects, patients with CKD had lower overall satisfaction with health and more restriction in activity. Positively, patients with CKD had more family involvement, better home safety and health practices, and better social problem-solving skills and were less likely to participate in risky social behaviors or socialize with peers who engaged in risky behavior. Patients who received dialysis were less physically active and experienced more physical discomfort and limitations in activities than did transplant or CRI patients. It is concluded that patients with CKD have poorer functional health status than age-matched peers. Among CKD patients, dialysis patients have the poorest functional health status. These results suggest that the CHIP-AE can be used to measure functional health status in adolescent patients with CKD.     

The aging male population and medical care for benign prostatic hyperplasia in Canada

Background:

The male Canadian population is aging and more men will be seeking medical care for benign prostatic hyperplasia (BPH). We examined the projected increase in older Canadian males between 2005 and 2018 to evaluate urologic health-care needs.

Methods:

We used Statistics Canada population projections to derive predictions of the male population aged 50 or more from 2005 to 2018 and results from the Olmsted County Study of Urinary Symptoms to estimate numbers of males aged ≥50 with moderate to severe lower urinary tract symptoms (msLUTS) in the same period. Data from the Canadian Institute for Health Information were used to estimate the number of urologists in 2018.

Results:

The number of Canadian men aged ≥50 is projected to rise between 2005 and 2018 by 39.5% and the number with msLUTS by 41.3%. However, the number of practicing urologists in Canada in 2018 is likely to be similar to the 584 practicing in 2007. An increase in the number of urologists proportional to the increase in men aged ≥50 with msLUTS would require 799 urologists in 2018.

Interpretation:

Little opportunity exists to expand the number of trainees in urology. Other alternatives must be sought to deal with increased numbers of older men with msLUTS. Initial management of BPH has moved towards being a responsibility of primary care physicians, but they appear to view BPH as a quality-of-life issue. It is crucial that urologists work closely with primary care physicians to ensure that the management of LUTS progression is optimized.     

Reproductive health comprehensive evaluating model

Objective: To evaluate the reproductive health status. Methods: Seventy-eight reproductive health indexes were set and six criteri-ons, i.e. importance, specialty, sensitivity, representativity, credibil-ity and accessibility, which were used to screen the indexes, were de-termined in the study. Results: According to the criterions, com-bining subjective and objective methods, 19 comprehensive evaluatingindexes were selected by the six methods. Analysis of coefficient ofvariation was used to screen the indexes in "Method 1", based on thecriterion of sensitivity; sample cluster and rank correlation coefficientanalysis were adopted in "Method 2", based on the criterions of im-portance and sensitivity; cluster and rank correlation coefficient analy-sis were employed in "Method 3", based on the criterions of represen-tativity and specialty; analysis of correlation coefficient and ratio ofdeviation were used in "Method 4", based on the criterion of credibili-ty; expert-counseling was used in "Method 5" and "     

广州市流动人口妇女母婴保健知识调查分析

目的:了解广州市流动妇女孕产期保健知识的知晓率.方法:采用整群抽样的方法问卷调查流动妇女对母婴保健相关知识的知晓率.结果:(1)流动人口对母婴保健相关知识应答的正确率从45.8%至94.5%不等,正确率最高的是"怀孕后应到医院进行产前检查",最低的是"怀孕后应该3月内到医院进行首次产检";(2)母婴保健相关知识知晓率与收入和文化程度成正相关,与职业、婚姻状况和小孩数量没有直接的关系;(3)最容易被流动妇女接受的方法是社区小范围的宣教.结论:广州市流动孕产妇的母婴保健相关知识知晓率偏低,与流动人口的经济收入、文化程度呈正相关,需要加大各种形式的宣传力度.     

Reproductive parameters of male dromedary and bactrian camels

Functional anatomy of male reproductive organs and reproductive physiology of dromedary and bactrian camels are quite similar except for some differences in the seasonal pattern of reproductive events: left testes bigger than right; scrotum not pendulous; vas deferens very convoluted with 2 mm diameter; prostate divided into 2 parts by septum, with many ducts; bulbourethral (Cowper's) glands well developed and seminal vesicle absent; fibroelastic penis has "prescrotal" sigmoid flexure and the glans resembles crochet needle; triangular-shaped prepuce directed posteriorly to open to the rear, and can move cranially or caudally during erection or urination, respectively; semen ejaculate, 1-12 mL in volume with little gelatinous material, coagulates and liquifies within minutes; total sperm/ejaculate 6 x 10(9) sperm/mL; semen contains PGE1, PGE(2x,LH), estradiol progesterone/other metabolites; semen collected by AV used for bulls with long copulation time; ovulation induced 36-48 h after mating or insemination; sperm of a short life of 1-6 h at 0.4 degrees C, is prolonged in presence of mucopolysaccharide gel; fresh semen inseminated. Topics of future research on endocrinology of reproduction, gonadal physiology, semen biology assisted reproductive technology, and gene transfer to germ cells of camels are outlined. The prevention and control of STD is an important component of camel stud management to improve reproductive performance in this species.