精子相关研究何去何从——实验精液学的未来

首先祝贺《世界卫生组织人类精液分析实验室技术手册》（简称手册）第5版的出版,这是迄今为止最完善的关于精液常规检测的手册。基于对1900名“新爸爸”的精液分析结果,WHO手册发布了有重要参考价值的精子质量检测参考值范围,还详细介绍了精子功能检测的方案,并增加了关于辅助生殖和冷冻保存时精液处理的新章节。该手册是关于精液常规检测的权威描述,有可能对该领域的未来以及手册未来发展版本的实验技术进行预测。如今,已可应用空前强大的分析技术检测包括精子在内的各类细胞的生化组成。事实上,精子是进行这种分析的完美载体,因为可获得非常纯净的精子悬液,精子天然游离存在,并可以在体外受精进而启动胚胎发育。在这些检测中各种组学技术的应用以及与此匹配的功能评估应该为精液质量缺陷的研究提供生化基础。这些信息将有助于了解男性不育症的原因,并制定合理的治疗方法和可能的预防措施。     

Saline infusion sonohysterogram as initial investigation of the endometrium and uterine cavity

The results of 54 consecutive saline infusion sonohysterograms (SIS) are presented. Sonohysterogram, in conjunction with Pipelle endometrial sampling, was found to be a reliable and accurate method of initial investigation of the endometrium and uterine cavity with good correlation with other methods of investigation. It was well tolerated in an outpatient setting, saved two out of three of the women from needing a hysteroscopy and curettage, and yielded information beyond that available from hysteroscopy and curettage.     

Textured insole effects on ankle movement discrimination while wearing athletic shoes

Aspects of athletic footwear were examined for their relationship to subjects' discrimination between different extents of inversion at the ankle. Testing was conducted separately on both feet with elite netballers who made discrete, active ankle movements while standing on an apparatus in an upright, non-restrained and weightbearing posture. Wearing conventional athletic socks only did not enhance discrimination over that achieved when barefoot. Movement discrimination scores were significantly worse when subjects wore their athletic shoes and socks, as compared to barefoot data collected at the same time. On the final occasion of testing, the addition of textured insoles to the shoes was found to restore movement discrimination back to barefoot levels. This outcome was interpreted in terms of enhanced cutaneous feedback, applying at the surface of the sole of the foot and the raised surface of the insole, serving to enhance feedback from movement. Across the 36 weeks of the study, movement discrimination scores for the barefoot condition showed significant improvement, a finding which is consistent with previous data gathered from athletes also engaged in wobbleboard training.     

重度肥胖对肺功能及运动试验中呼吸模式的影响

目的：研究重度肥胖对肺胖对肺功能及运动试验中呼吸模式的影响。方法：４２名女性受试者,正常体重组２０名,重度肥胖组２２名,进行肺功能及功率车运动试验测定。结果：肥胖组补呼气量、功能残气量、残气量及肺总量均比对照组显著降低（Ｐ〈０．０５）。肥胖组静息状态、无氧阈状态和极量运动状态的氧耗量均比对照组显著增高（Ｐ〈０．０５）,而公斤氧耗量比对照组显著降低（Ｐ〈０．０１）。无氧阈状态和极量运动状态时,肥胖组     

Permanent phenotypic correction of hemophilia B in immunocompetent mice by prenatal gene therapy

Hemophilia B, also known as Christmas disease, arises from mutations in the factor IX (F9) gene. Its treatment in humans, by recombinant protein substitution, is expensive, thus limiting its application to intermittent treatment in bleeding episodes and prophylaxis during surgery; development of inhibitory antibodies is an associated hazard. This study demonstrates permanent therapeutic correction of his disease without development of immune reactions by introduction of an HIV-based lentiviral vector encoding the human factor IX protein into the fetal circulation of immunocompetent hemophiliac and normal outbred mice. Plasma factor IX antigen remained at around 9%, 13%, and 16% of normal in the 3 hemophilia B mice, respectively, until the last measurement at 14 months. Substantial improvement in blood coagulability as measured by coagulation assay was seen in all 3 mice and they rapidly stopped bleeding after venipuncture. No humoral or cellular immunity against the protein, elevation of serum liver enzymes, or vector spread to the germline or maternal circulation were detected.     

Facial nerve palsy complicating Kawasaki disease

The diagnosis of Kawasaki disease, the most common cause of pediatric acquired heart disease, is difficult and often delayed for children whose age falls outside the typical range of 6 months to 5 years, especially in those with incomplete Kawasaki disease and atypical features. Delayed diagnosis is associated with an increased incidence of coronary artery pathology. Here we describe 2 cases of lower motor neuron facial nerve palsy complicating Kawasaki disease. In both cases the diagnosis of Kawasaki disease was not made acutely, and both patients developed extensive coronary artery lesions. These cases highlight the importance of considering Kawasaki disease in children with unexplained prolonged fever at any age, particularly those without full diagnostic criteria and with unusual features.     

Maintenance fluid management in paediatrics

Intravenous maintenance fluids are life sustaining and form one of the cornerstones of paediatric in-patient management. Similar to other medical therapies fluids come with side effects and the potential for significant associated morbidity and mortality. An appreciation of their side effect profiles in the context of paediatric physiology, particularly during critical illness, is essential in order to minimise the risks. This article summarises the history of paediatric fluid prescribing practice, highlighting the associated iatrogenic risks and provides a strategy for safer practice.     

Cognitive impairment, clinical course and treatment history in out-patients with bipolar affective disorder: relationship to tardive dyskinesia

Clinical, neuropsychological and psychopharmacological characteristics were investigated for their ability to distinguish individuals with and without involuntary movements (tardive dyskinesia), among a population of 40 out-patients with bipolar affective disorder and a history of exposure to neuroleptics and lithium. Impaired performance on a test of cognitive flexibility bore the primary association with both the presence and the severity of involuntary movements. The additional relationships identified emphasized further that individual vulnerability to involuntary movements appeared to be associated not with greater duration or dosage of treatment, but with features of the bipolar illness, including number and type of affective episodes, for which that treatment was prescribed.