Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health. Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023. Their demographic data and physical exercise data were surveyed with questionnaires. Total sperm count, sperm concentration, total sperm motility, forward movement and normal sperm morphology were analyzed with computer aided analysis. Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality. Results After adjustment for confounding factors such as age, body mass index, alcohol consumption and smoking, logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity (OR=2.103, OR=2.229). Compared with the participants with physical exercise ≤10 min per session, those with >20 min per session had a lower risk of abnormal semen quality (OR=0.357, 0.256, 0.289 for exercise time for >20~30, >30~60, >60 min, respectively). There was no statistical significance between physical exercise frequency and semen quality (P>0.05). The participants having exercise well were at a lower risk for abnormal semen quality (OR=0.711). Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration (β=7.474, 95%CI: 4.800~10.149, P<0.05); the time of physical exercise per session was an influencing factor for total sperm count (β=20.632, 95%CI: 7.634~33.629); the intensity of physical exercise (β=-1.461, 95%CI: -2.392~-0.530) and time of physical exercise per session (β=2.608, 95%CI: 1.404~3.812, P<0.05) were influencing factors for percentage of forward motility sperm (P<0.05); and physical exercise intensity (β=-1.934, 95%CI: -3.238~-0.630), time of physical exercise per session (β=4.211, 95%CI: 2.525~5.897) and frequency of physical exercise (β=-2.008, 95%CI: -3.480~-0.536) were influencing factors of total sperm motility (P<0.05). Conclusion Physical exercise may affect semen quality, greater intensity of physical exercise may be a risk factor for abnormal semen quality, and longer physical exercise time may be related to improving semen quality. Therefore, proper physical exercise can help improve semen quality.

目的 探讨睾丸显微取精术(M-TESE)治疗非梗阻无精子症(NOA)的临床特点、预后情况及应用进展.方法 回顾分析山东省妇幼保健院生殖医学中心2018年1月～12月行M-TESE治疗NOA的11例病例,分析取精成功率与睾丸体积(B超测量)、血清卵泡刺激素(FSH)、黄体生成激素(LH)、睾酮(T)及病因的相关性,以及预后情况,硬膜外麻醉下行M-TESE;睾丸组织病理学用HE染色,卵细胞浆内单精子显微注射(ICSI)及体外受精胚胎移植(IVF-ET)按手术室及胚胎实验室规范进行.结果 11例NOA不育患者行M-TESE,其中严重睾丸发育不良5例、Klinefelter综合征2例、AZFc.d区缺失1例、睾丸炎并严重微结石1例、特发性无精子症1例、隐睾1例,5例获取到精子,获精率45.5％;结合ICSI及IVF-ET,5例怀孕,其中2例自然流产,3例出生4个正常健康儿.M-TESE术后6个月FSH、LH及T较术前差异无统计学意义.结论 M-TESE是NOA不育患者获取精子助孕的有效手段,并且对体内的性激素水平未造成明显影响.

目的 观察自拟补肾促孕方联合来曲唑治疗肾阴虚型多囊卵巢综合征不孕症的临床疗效.方法 选择肾阴虚型多囊卵巢综合征不孕症患者52例,随机分为治疗组26例和对照组26例.经过前期规范治疗达到促排卵标准,治疗组采用自拟补肾促孕方+来曲唑方案联合促排卵助孕治疗,对照组采用六味地黄丸+来曲唑方案联合促排卵助孕治疗,3个促排卵周期为1个疗程.观察两组治疗前后肾阴虚证候评分,HCG日子宫内膜厚度、形态及性激素水平,累计临床妊娠率和早期自然流产率.结果 两组治疗后肾阴虚证候评分均较治疗前降低(P均<0.01),且治疗组治疗后肾阴虚证候评分低于对照组(P<0.05).治疗组HCG日子宫内膜厚度大于对照组,形态优于对照组,雌二醇水平高于对照组(P均<0.05).治疗组、对照组累计妊娠率分别为50.0％(13/26)、34.62％(9/26),早期自然流产率分别为7.69％(1/13)、11.11％(1/9),两组比较P均>0.05.结论 自拟补肾促孕方联合来曲唑可以改善由多囊卵巢综合征引起的不孕症患者肾阴虚临床证候,改善HCG日子宫内膜厚度及形态,可在一定程度提高患者累计临床妊娠率.

目的 探究TWIST2对卵巢癌细胞氧化应激和凋亡的作用及相关机制.方法 收集2018年6月至2019年10月在山东省妇幼保健院进行治疗的30例卵巢癌患者的癌组织和癌旁组织,将pcDNA3.1-TWIST2质粒(TWIST2组)和pcDNA3.1阴性对照质粒(阴性对照组)分别转染卵巢癌细胞(SK-OV-3和HO-8910),未转染质粒组为空白对照组.通过实时荧光定量PCR(qRT-PCR)和免疫印迹(Western blot)实验检测组织和细胞中TWIST2 mRNA和蛋白质的表达量;细胞计数试剂盒CCK-8检测TWIST2组、阴性对照组和空白对照组的细胞活力;Western blot实验检测3组的凋亡相关蛋白caspase-3、Bax和Bcl-2,AMPK/mTOR通路相关蛋白FGF21、p-AMPK和p-mTOR的蛋白表达水平;试剂盒检测3组活性氧(ROS)基因、ATP的水平和超氧化物歧化酶(SOD)的酶活性.通过检测不同处理组的细胞凋亡率和ROS水平,研究TWIST2与FGF21的相互作用.结果 TWIST2在卵巢癌组织和卵巢癌细胞中的表达量显著低于癌旁组织和正常卵巢上皮细胞的表达量(P＜0.05).与空白对照组和阴性对照组相比,TWIST2组的细胞活力显著降低,细胞凋亡率显著提高(P＜0.05);ROS的水平显著升高,SOD酶活力、ATP水平、NAD+/NADH水平显著降低(P＜0.05).TWIST2可以抑制FGF21、p-AMPK、p-mTOR蛋白的表达(P＜0.05);在TWIST2组中加入FGF21或AMPK激动剂时,p-AMPK、p-mTOR蛋白表达水平显著升高,卵巢癌细胞的凋亡率和ROS水平显著降低(P＜0.05),TWIST2与FGF21的表达量呈负相关(r=一0.625 4,P＜0.01).结论 TWIST2能够促进卵巢癌细胞氧化应激和凋亡,其作用机制是通过调控FGF21介导的AMPK/mTOR通路来实现的.

OBJECTIVE:To explore normalized and reasonable strategies of assisted reproductive technology (ART) for patients with end-stage renal disease (ESRD) under ethical supervision based on the experience with a case of ART for an ESRD male.METHODS:A male patient with ESRD successfully fathered a child through in vitro intracytoplasmic sperm injection (ICSI) in our center. We performed an epidemiological analysis, reviewed the relevant literature and explored the feasibility, ethical issues and strategies of ART for male patients with ESRD.RESULTS:ESRD affected the reproductive hormone levels, sperm quality and erectile function of the patient. Considering the contradictions between the reproductive right and the uncertainty of disease prognosis of the patient and the health of the offspring and his wife, we comprehensively evaluated the physical and mental conditions of the patient, obtained the informed consent, submitted the case to the Ethics Committee of Reproductive Medicine.CONCLUSIONS:With respect to ART for ESRD patients, importance should be attached to their rights of reproduction and choice of reproductive technology. In the process of ART, the physical conditions of the patient ought to be evaluated comprehensively and rigorously, and the related ethical principles followed strictly.

去医院就诊的备孕妈妈会发现,医生在为您确定好治疗方案后,会建议开始服用多种维生素,不用多,一天一片.那么,为什么需要服用多种维生素呢? 健康膳食和均衡营养是成功妊娠所必需的物质基础.世界卫生组织推荐,孕妇每日叶酸供应量为400微克,即0.4毫克.但是只服用叶酸还不够,还需要配合多种维生素帮助叶酸吸收.因此,《中国孕妇、乳母、0～6岁儿童膳食指南(2006)》推荐:当各种原因使膳食不能满足其营养需要时,可在医生指导下合理使用维生素和矿物质补充剂,这也是各位备孕妈妈需要服用多种维生素的原因.

子宫内膜异位症也是女性不孕的常见原因之一.据统计,子宫内膜异位症女性不孕的发病率高达25％～40％,几乎为健康育龄女性的20倍. 说起子宫内膜异位症,大家可能都感到很陌生,对于卵巢巧克力囊肿和子宫腺肌病也许有所耳闻.没错,它们是子宫内膜异位症的两种常见类型.

很多朋友有了生育计划,做了各种优生优育的功课,努力了好几个月,肚子没有动静,便慌了神,开始怀疑自己或者配偶有问题.尤其是单独二胎政策放开以后,很多重新有了生育计划的妈妈们,年龄已经超过30岁甚至35岁,计划妊娠2个月没有受孕就来检查,实在有些操之过急.据统计,健康的25岁女性,平均需要6个月才能怀孕.那么,什么情况才会被界定为不孕不育呢? 一般认为,育龄夫妇双方同居1年以上,有正常性生活,在没有采用任何避孕措施的情况下,未能成功怀孕才称为不孕不育,可以去医院就医.需要提醒的是,很多患者去就诊时,会被告知检查时间不合适.下面就来了解一下不孕不育检查的最佳时间.

随着我国全面放开二孩消息的发布,二孩"生"或"不生"的话题荣登百度搜索引擎榜首.相当一部分想生二孩的夫妇年过35岁,已过了生育旺盛期,属于高危妊娠人群,而高龄产妇会伴随着围产期风险增加,流产率和出生缺陷率增高等问题.如何更好的备孕二孩呢?

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的探索缺氧缺血性脑病（hypoxic-ischemic encephalopathy,HIE）与母亲怀孕年龄及血清中高迁移率蛋白-1（high mobility group box protein 1,hmgb1）水平相关性,为有效预防和减少HIE的发生提供依据。方法随机选取山东大学第二医院于2012年3月—2014年3月收治的住院患者60例为病例组,同期60名正常新生儿为对照组。采用酶联免疫-双抗体夹心法测定病例组和对照组的血清hmgb1水平,并记录其孕母年龄,进行统计学分析。结果病例组母亲怀孕平均年龄较大,为（33.5±4.7）岁,高龄产妇的比例明显高于对照组;出生后2h内病例组各种程度HIE患儿（重、中、轻）的血清hmgb1水平均高于对照组,病情越严重,hmgb1在血清中的含量越高（174.88±9.12）ng/m L,且恢复正常的时间越长。结论 HIE与母亲怀孕年龄及血清中hmgb1水平相关,高龄产妇易导致HIE,hmgb1是早期临床检测HIE病情严重程度的指标之一。</span>

全世界每年大约有500万缺陷儿出生,其中85％在发展中国家. 我国是世界上出生缺陷的高发国家之一,每年出生80万～120万缺陷儿.出生缺陷已逐渐成为发展中国家婴幼儿死亡的主要原因,严重的出生缺陷可导致新生儿和儿童死亡或终身残疾.我国每年因神经管畸形造成的直接经济损失超过2亿元,先天愚型的治疗费超过20亿元,先天性心脏病的治疗费高达120亿元.

有资料显示,全世界约80％的成年女性都不同程度感染过妇科炎症.妇科炎症多见于21 ～40岁的女性,其中阴道炎发病率最高,其次是慢性宫颈炎、慢性盆腔炎等.由于妇科炎症广泛发生于女性群体中,以至于很多女性在认识以及治疗上存在这样或那样的误区. 误区1 忽视治疗 近年来,妇科炎症发病人群趋向年轻化,发病年龄不断提前,逐渐蔓延至未婚的年轻女性.因为“太常见”,往往被患者忽视.如果拖着不治,不仅承受越来越大的痛苦,严重降低生活质量,而且炎症可能进一步累及整个生殖系统.另外,妇科炎症往往多个器官(盆腔、子宫、附件、阴道)同时发病,交叉感染也不容忽视.