TEMPORAL TRENDS IN HUMAN SEMEN PARAMETERS IN NEW ENGLAND IN THE UNITED STATES, 1989-2000

The current study explores trends in semen parameters in New England in the United States. A retrospective review was performed of 551 semen analysis records from 1989 to 2000 at Vincent Memorial Andrology Laboratory of Massachusetts General Hospital. After age adjustment, semen pH and motility significantly increased 0.05 units/year and 2.33%/year, respectively, while sperm with normal morphology decreased 0.33%/year. Sperm concentration showed a small upward trend. The year of birth in the present study ranged from 1932 to 1981; 2% were born between 1932 and 1941, 13% between 1942 and 1951, 48% between 1952 and 1961, 36% between 1962 and 1971, and 1% were born between 1972 and 1981. There were significant positive relationships between year of birth and semen volume (0.04 mL/1-year interval increase in year of birth) and motility (0.61 percent/1-year interval increase in year of birth), as well as with sperm concentration and morphology. Overall, there were temporal and year of birth trends in several human semen parameters.     

血小板假性异常的影响因素分析

目的探讨血细胞分析仪测定血小板的影响因素,排除"假性增高"和""假性降低"情况。方法使用血细胞分析仪在不同条件下对血小板进行测定,同时采用手工计数,并将二者检测结果进行对比分析。结果采血不当、血小板体积异常、小红细胞数量、溶血标本及放置时间等因素均可造成血小板假性异常。结论全自动血细胞分析仪并不能完全代替手工法,对血小板计数与直方图不符的标本应手工计数或重新采血,以确保结果的准确性。     

克林霉素磷酸酯注射液药品说明书所致用药风险定性评估

目的:评估国产克林霉素磷酸酯注射液说明书与国外原研药说明书差异所致用药风险,探索仿制药风险管理研究模式,促进合理用药。方法:引入基于矩阵法和层次分析法的安全风险评估模型,通过Borda序值法计算风险总值,定性评估克林霉素磷酸酯注射液国内外说明书差异可能导致的用药风险。结果:国产克林霉素磷酸酯注射液说明书与国外原研药说明书差异较大,可能导致不合理用药、药物致伪膜性结肠炎(CDAD)误诊、患者用药依从度不高、患者不能自我发现CDAD等5方面的风险,综合风险总值为3.7,风险较高。结论:我国克林霉素磷酸酯注射液说明书与国外原研药说明书存在较大差异,差异造成用药安全高风险。     

Making Every Contact Count: an evaluation

Objectives

To conduct an initial evaluation of a behaviour change programme called ‘Making Every Contact Count’ (MECC).

Study design

Retrospective interview study.

Methods

In depth qualitative interviews with key stakeholders engaged in the delivery of MECC which were digitally recorded, transcribed and analysed thematically using framework analysis.

Results

The responses of those involved were generally favourable and although the ‘intuitive’ nature of the idea of Making Every Contact Count clearly resonated with interviewees, the take up was variable across different organisations.

Conclusions

The approach to MECC described here was based on some of the principles outlined in the NICE Guidance on behaviour change published in 2007. The report shows that MECC has considerable potential for changing staff behaviour in relation promoting health enhancing behaviour among members of the general public coming into contact with services.     

Performance in population models for count data,part I: maximum likelihood approximations

There has been little evaluation of maximum likelihood approximation methods for non-linear mixed effects modelling of count data. The aim of this study was to explore the estimation accuracy of population parameters from six count models, using two different methods and programs. Simulations of 100 data sets were performed in NONMEM for each probability distribution with parameter values derived from a real case study on 551 epileptic patients. Models investigated were: Poisson (PS), Poisson with Markov elements (PMAK), Poisson with a mixture distribution for individual observations (PMIX), Zero Inflated Poisson (ZIP), Generalized Poisson (GP) and Negative Binomial (NB). Estimations of simulated datasets were completed with Laplacian approximation (LAPLACE) in NONMEM and LAPLACE/Gaussian Quadrature (GQ) in SAS. With LAPLACE, the average absolute value of the bias (AVB) in all models was 1.02% for fixed effects, and ranged 0.32–8.24% for the estimation of the random effect of the mean count (λ). The random effect of the overdispersion parameter present in ZIP, GP and NB was underestimated (−25.87, −15.73 and −21.93% of relative bias, respectively). Analysis with GQ 9 points resulted in an improvement in these parameters (3.80% average AVB). Methods implemented in SAS had a lower fraction of successful minimizations, and GQ 9 points was considerably slower than 1 point. Simulations showed that parameter estimates, even when biased, resulted in data that were only marginally different from data simulated from the true model. Thus all methods investigated appear to provide useful results for the investigated count data models.     

Do normal leucocyte count and C‐reactive protein value exclude acute appendicitis in children?

The present study aimed to determine the role of leucocyte count and C-reactive protein (CRP) measurements in the diagnosis of acute appendicitis in children. In particular, children with acute appendicitis but normal leucocyte count and CRP level were sought. The present study protocol was identical to those used in earlier studies on adult patients with suspected acute appendicitis. The mean preoperative leucocyte count and CRP value in 100 consecutive children with an uninflamed appendix at appendicectomy (group A) and in 100 consecutive patients with acute appendicitis (group B) were calculated. The numbers of patients with (i) both values normal, (ii) only leucocyte count raised, (iii) only CRP level raised, and (iv) both values raised were calculated in both groups A and B. Leucocyte count effectively (p     

CD83~+成熟树突细胞和CD11b~+耐受性树突细胞在人颈动脉粥样硬化病变中的分布

目的探讨CD83+成熟树突细胞(mDC)和CD11b+耐受性树突细胞(tolDC)在人颈动脉粥样硬化病变中的分布。方法收集颈动脉狭窄患者行颈动脉内膜剥脱术的颈动脉内膜标本20例,常规石蜡切片,HE染色,免疫组织化学染色观察CD83和CD11b阳性反应血管树突状细胞的分布。结果 CD83+mDC和CD11b+tolDC主要分布在颈动脉内膜斑块、泡沫细胞以及新生血管周围,成熟的CD83+mDC细胞密度(8.34±1.20)个细胞/HPF较CD11b+tolDC细胞密度(5.31±1.24)个细胞/HPF高。结论 CD83+mDC和CD11b+tolDC在人颈动脉粥样硬化动脉内膜均有分布,mDC的增多和tolDC的减少可能与人颈动脉粥样硬化发生发展有关。     

Thrombocytosis in active rheumatoid arthritis. Relation to other parameters of inflammatory activity and confounding effect of automated cell counting

Summary The magnitude of thrombocytosis and the possible confounding effect of platelet clumping, an in vitro artifact resulting in spuriously low platelet counts, in active rheumatoid arthritis (RA) was evaluated by a prospective survey of 57 consecutive patients, 60% of whom had thrombocytosis. Five cases (9%) of platelet clumping, assessed by H6000 pictures, were found. A low-grade platelet loss in may of the samples anticoagulated by EDTA was suggested by comparison with platelet counts obtained in parallel blood samples anticoagulated by citrate. Thus, the possibility of spuriously low platelet counts due to laboratory artifacts must always be taken into consideration in RA patients. The relation between thrombocytosis and other estimates of disease activity was also studied. The platelet count in citrated blood in active RA was significantly correlated with ESR, acute phase plasma proteins, and neutrophil, basophil and monocyte counts. In a multivariate regression model, however, only the correlation with haptoglobin (p=0.06) approached significance.     

Psychosocial factors and T lymphocyte counts in Brazilian peacekeepers

OBJECTIVE:

To investigate the associations between psychosocial factors and peripheral blood CD4 and CD8 T lymphocyte numbers in Brazilian peacekeepers.

METHODS:

Venous blood was collected from 759 peacekeepers who had just returned from a peace mission in Haiti. Among the 759 soldiers, 642 individuals completed the psychosocial measures. CD4 and CD8 T lymphocyte counts were measured by flow cytometry using a commercially available kit. Psychosocial factors, including military peace force stressors, clinical stress, anxiety and depression, were recorded. As a reference for T lymphocyte numbers, we measured T lymphocyte counts in 75 blood donors from the Instituto de Biologia do Exército, Rio de Janeiro.

RESULTS:

The median numbers of CD4 and CD8 T lymphocytes in the blood donors were 819 cells/µl and 496 cells/µl, respectively, with a CD4:CD8 ratio of 1.6. Significantly (p<0.05) lower CD4 T cell counts (759 cells/µl) were recorded for peacekeepers, with similar CD8 levels (548 cells/µl) and smaller CD4:CD8 ratios (1.3, p<0.001) compared to blood donors. These differences were due to a group of 14 military personnel with CD4 and CD8 medians of 308 and 266 cells/µl, respectively. Only one (7.1%) of these 14 individuals was diagnosed with clinical stress compared with 13.5% of the individuals with normal levels of CD4 T lymphocytes. One individual out of 628 (0.16%) had a Lipp''s Stress Symptom Inventory score of 3, indicating near exhaustion.

CONCLUSION:

The prevalence of psychological disorders was low and there were no associations with CD4 or CD8 T cell numbers.