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什么是牛奶?牛奶就是小牛犢每天吃的香甜的飯;什么是健康?健康就是不生病。我喜歡香醇的牛奶,更喜歡健康快樂(lè)地生活。
“早一杯,晚一杯,常喝牛奶身體好。”媽媽總是這樣對(duì)我說(shuō),她說(shuō):“早上喝一杯牛奶可以提精神,一天都有勁;晚上喝一杯牛奶能讓你很快進(jìn)入夢(mèng)想,睡個(gè)好覺(jué)!”雖然媽媽總是要求我多喝牛奶,可我以前從來(lái)都不主動(dòng)喝,因?yàn)槲蚁胛叶?0歲了,怎么還能像小嬰兒似的天天喝奶呢,讓人多笑話呀。這個(gè)暑假我在家看了一期中央電視臺(tái)的《健康之路》節(jié)目,有兩個(gè)健康專家向觀眾們介紹牛奶對(duì)人的好處,他們說(shuō):牛奶里面含有和人體很接近的優(yōu)質(zhì)蛋白質(zhì),含有的25種氨基酸是其他任何一種動(dòng)物性食物都無(wú)法比擬的。牛奶還含有很豐富的鈣,而且是最容易被人體所吸收的。其他益處還包括比如睡前喝牛奶有益于睡眠,美國(guó)科學(xué)家還提出牛奶可以預(yù)防腫瘤等疾病。牛奶里面含有的抗體可以增加人體的抵抗力,經(jīng)常喝牛奶可以增加免疫力。除了講解外,專家還讓觀眾看了他們的試驗(yàn):就是跟蹤調(diào)查北京地區(qū)的中小學(xué)生,喝牛奶的孩子在骨骼發(fā)育和身高明顯高與不喝的孩子??戳诉@個(gè)節(jié)目,我嚇了一大跳,原來(lái)我個(gè)子矮都是因?yàn)橐郧安粣?ài)喝牛奶。
從那天開(kāi)始,我每天早晚都主動(dòng)到冰箱里取牛奶,喝完牛奶再做別的事情,媽媽說(shuō)這是我本次暑假里的最大收獲。
我在這個(gè)暑假里收獲很多,可以說(shuō)是一籮又一籮。
放暑假了,我不用去上學(xué),自已掌握的時(shí)間就更多了。我不像其它的小朋友那樣玩電腦、看電視……而是去學(xué)一些課外知識(shí)。我參加了奧數(shù)班,英語(yǔ)班、游泳班.而且還到一位老師家學(xué)習(xí)寫作呢。雖然每天的時(shí)間都安排得滿滿的,但我一點(diǎn)也不覺(jué)得辛苦,反而過(guò)得很充實(shí)。我覺(jué)得自已解答數(shù)學(xué)題的能力增強(qiáng)了;積累的英語(yǔ)單詞量更加豐富了;作文的表達(dá)能力也有了一定的提高;游泳的技能更是得到了飛速的進(jìn)步。
我最大的收獲是觀看奧運(yùn)節(jié)目。我利用休息的時(shí)間來(lái)打開(kāi)電視,看奧運(yùn)節(jié)目。我從電視里看見(jiàn)了許多出色的運(yùn)動(dòng)員,他們拿了很多獎(jiǎng)牌,當(dāng)記者問(wèn)他們拿到了這枚金牌,想說(shuō)些什么的時(shí)候,運(yùn)動(dòng)員們就會(huì)說(shuō):“我為了拿這枚金牌,付出了許多汗水和許多精力。我覺(jué)得想要取得成功就一定要付出努力。”他們的話讓我思考了很久很久。
這個(gè)假期我對(duì)我們阜新市清河門的佰特英語(yǔ)輔導(dǎo)學(xué)校進(jìn)行了一次社會(huì)調(diào)查,主要是針對(duì)他們的完善教學(xué)模式做一下了解,進(jìn)而學(xué)習(xí)他們的方式方法,不僅鍛煉了自己同時(shí)也受益匪淺。從佰特人身上我深刻的體會(huì)到了一種精神,那就是堅(jiān)持的精神。
從小到大我們一直在用“堅(jiān)持”二字激勵(lì)自己,當(dāng)我們學(xué)習(xí)困乏時(shí),我們需要堅(jiān)持;當(dāng)我們長(zhǎng)跑時(shí),我們需堅(jiān)持;當(dāng)我們接近成功卻要放棄時(shí),我們需要堅(jiān)持......堅(jiān)持無(wú)處不在,在某種程度上講它是我們的精神支柱,今天我明白只要堅(jiān)持,我們一定能行!
曾經(jīng)看到過(guò)這樣一個(gè)故事。
新生開(kāi)學(xué)。
“今天只學(xué)一件最容易的事情,每人把胳膊盡量往前甩,然后再盡量往后甩,每天做300下。”老師說(shuō)。
一個(gè)月以后有90%人堅(jiān)持。
又過(guò)一個(gè)月有僅剩80%。
一年以后,老師問(wèn):“每天還堅(jiān)持300下的請(qǐng)舉手!”整個(gè)教室里,只有一個(gè)人舉手,他后來(lái)成為了世界上偉大的哲學(xué)家。
這是個(gè)真實(shí)的故事,讓我們記住他的名子吧!他就是柏拉圖,一個(gè)偉大的哲學(xué)家。
從這個(gè)故事中可以發(fā)現(xiàn):成功沒(méi)有秘訣,貴在堅(jiān)持不懈。任何偉大的事業(yè),成于堅(jiān)持不懈,毀于半途而廢。其實(shí),世間最容易的事是堅(jiān)持,最難的,也是堅(jiān)持。說(shuō)它容易,是因?yàn)橹灰敢?,人人都能做到;說(shuō)它難,是因?yàn)槟苷嬲龍?jiān)持下來(lái)的,終究只是少數(shù)人。巴斯德有句名言“告訴你使我達(dá)到目標(biāo)的奧秘吧,我唯一的力量就是我的堅(jiān)持精神?!?/p>
大學(xué)來(lái)到學(xué)校參加工作以來(lái),亦曾有過(guò)放棄的念頭,但總被他們的執(zhí)著和堅(jiān)持感動(dòng)。曾在《我的期貨夢(mèng)想》中看到“我喜歡期貨的神奇和魔力,經(jīng)過(guò)無(wú)數(shù)綠肥紅瘦的日子,前方的路充滿荊棘和考驗(yàn),堅(jiān)持不懈才會(huì)有夢(mèng)想和希望。”如今的我,也在努力并堅(jiān)持著,不過(guò)是想做得更好而已。
人的一生又何嘗不是如此?從“昨夜西風(fēng)調(diào)碧樹(shù),獨(dú)上高樓,望盡天涯路?!钡健耙聨u寬終不悔,為伊消得人憔悴?!痹俚健氨娎飳にО俣?,驀然回首,那人卻在燈火闌珊處?!倍紤?yīng)該堅(jiān)持,堅(jiān)持生命的困惑、領(lǐng)悟和真諦。只有如此,在你到暮年的時(shí)候,細(xì)細(xì)回想起來(lái),才會(huì)覺(jué)得沒(méi)有虛度曾經(jīng)美好的年華,才會(huì)覺(jué)得自己的整個(gè)生命都充滿價(jià)值。
>> 建好農(nóng)家書(shū)屋工程 豐富農(nóng)村文化生活 農(nóng)家書(shū)屋對(duì)留守兒童的教育服務(wù) 盼“農(nóng)家書(shū)屋”成為留守兒童的家 把農(nóng)家書(shū)屋辦成留守兒童的溫馨家園 希望農(nóng)家書(shū)屋成為留守兒童的家 圖書(shū)館關(guān)懷農(nóng)村留守兒童的文化生活刻不容緩 農(nóng)家書(shū)屋:留守兒童的“第二個(gè)家” 農(nóng)家書(shū)屋 鄉(xiāng)村的文化糧倉(cāng) 試論“農(nóng)家書(shū)屋”的建設(shè) 淺談“農(nóng)家書(shū)屋”的建設(shè) 農(nóng)家書(shū)屋的建設(shè)與發(fā)展 農(nóng)家書(shū)屋建設(shè)的幾點(diǎn)思考 試論農(nóng)家書(shū)屋的建設(shè) 結(jié)對(duì)關(guān)愛(ài)活動(dòng)豐富留守兒童課余文化生活 公共文化建設(shè)之農(nóng)家書(shū)屋淺論 從農(nóng)村留守婦女文化生活現(xiàn)狀談鄉(xiāng)鎮(zhèn)圖書(shū)館建設(shè) 基于農(nóng)村文化公共產(chǎn)品供需的農(nóng)家書(shū)屋模式解讀 父親的農(nóng)家書(shū)屋 治理困境下的鄉(xiāng)村文化建設(shè)研究:以農(nóng)家書(shū)屋為例 論基層文化設(shè)施農(nóng)家書(shū)屋的建設(shè)實(shí)踐與經(jīng)驗(yàn) 常見(jiàn)問(wèn)題解答 當(dāng)前所在位置:.
[2] 法制網(wǎng). 農(nóng)村留守兒童缺失親情關(guān)愛(ài)重慶市人大調(diào)研組建議完善配套政策破除體制機(jī)制障礙[EB/OL]. [2012-04-11]. http://.cn/bm/content/2012-04/11/ content_3487364.htm?node-20731.
[3] [英] 愛(ài)德華?泰勒. 原始文化[M]. 連樹(shù)生,譯. 上海:上海文藝出版社,1992:1.
[4] 中國(guó)科協(xié),全民科學(xué)素質(zhì)行動(dòng)計(jì)劃大綱[N]. 中國(guó)教育報(bào),2003-02-14(7).
[5] 蔡璐,伍藝. 農(nóng)村公共文化信息服務(wù)網(wǎng)絡(luò)平臺(tái)的構(gòu)建[J]. 農(nóng)業(yè)現(xiàn)代化研究,2009(2):203-206.
[6] 武渝生.“農(nóng)家書(shū)屋”建設(shè)的重慶實(shí)踐[J]. 重慶社會(huì)科學(xué),2012(3):94.
【關(guān)鍵詞】: 火焰原子吸收 測(cè)定降水 鉀鈉鈣鎂
中圖分類號(hào):P426.6 文獻(xiàn)標(biāo)識(shí)碼:A 文章編號(hào):
用空氣—乙炔火焰原子吸收法測(cè)定降水中的鉀鈉鈣鎂時(shí),存在著一定的電離干擾和共存離子的化學(xué)抑制干擾。
在高溫火焰中,鉀鈉不僅易發(fā)生電離而且彼此也互有影響,在分析試樣中需加入一定量更易電離的銫鹽作消電離劑,以消除電離干擾。
鈣鎂則受到水樣中存在的鋁、硅酸鹽、磷酸鹽和硫酸鹽的抑制,其原子化效率明顯降低而產(chǎn)生負(fù)干擾。此時(shí)我們需加入一定量鍶、鑭或其它釋放劑來(lái)消除干擾。
但究竟這個(gè)消電離劑和釋放劑的加入量多少更合適,能使樣品測(cè)試準(zhǔn)確度更高,我們做了具體的實(shí)驗(yàn)來(lái)驗(yàn)證。
1實(shí)驗(yàn)
1.1儀器和主要試劑:島津的 AA-6701F原子吸收分光光度計(jì);鉀、鈉、鈣、鎂空心陰極燈;50毫升具塞比色管。
鉀、鈉、鈣、鎂標(biāo)準(zhǔn)使用液濃度分別為鉀濃度:0、0.5、1.0、2.0、3.0、4.0、5.0mg/L鈉:0、0.25、0.5、1.0、1.5、2.0、3.0mg/L鈣:0、0.5、1.0、2.0、3.0、4.0、5.0mg/L鎂:0、0.1、0.2、0.3、0.4、0.5、0.6mg/L。
鉀鈉消電離劑:1%硝酸銫水溶液(稱取2.9 g硝酸銫(CsNO3)溶于水,定容至200毫升 ,此溶液1.0毫升含10毫克銫)
鈣鎂釋放劑:1%鍶鹽溶液(稱取3.0g氯化鍶(CrCL2.6H2O)溶于水,定容至100毫升 ,此溶液1.0毫升含10毫克鍶)
做鈣、鎂時(shí),國(guó)際方法GB11905-89選用的釋放劑氧化鑭,其水溶性差,配制過(guò)程中得用硝酸溶液溶解,蒸至近干,加10毫升硝酸溶液及適量水,微熱溶解,冷卻后用水定容。這樣配制出的鑭鹽實(shí)際做樣過(guò)程中空白太高。在本實(shí)驗(yàn)中我們選用的是氯化鍶,其水溶性好,配制方便,且空白較好。
儀器參數(shù)的調(diào)試根據(jù)不同型號(hào)儀器自行選擇,這里不做贅述。
1.2實(shí)驗(yàn)具體數(shù)據(jù)
2實(shí)驗(yàn)結(jié)論
根據(jù)以上圖表測(cè)試數(shù)據(jù)可以看出,加入不同量的消電離劑,鉀鈉的測(cè)試結(jié)果是有區(qū)別的,從圖中可明顯看出,加入量過(guò)多或過(guò)少,其測(cè)試準(zhǔn)確度均不夠理想。這一點(diǎn)在鈣鎂的測(cè)試中也有充分體現(xiàn)。測(cè)試數(shù)據(jù)顯示只有加入0.5毫升的消電離劑和測(cè)鈣鎂用的釋放劑,就是說(shuō)在測(cè)試樣品中使得銫鹽、鍶鹽溶液的濃度保持在0.1毫克每毫升,此時(shí)其測(cè)試結(jié)果最為理想。
3其它注意事項(xiàng)
一定要注意選用試劑的純度。我們有一次做降水鉀鈉含量的檢測(cè),方法是用原子吸收火焰法,我們的具體方法是按照所需的濃度來(lái)配置了標(biāo)準(zhǔn)溶液,為了消除電離,在標(biāo)準(zhǔn)溶液和空白及供試液(都為50ml)中都加入了0.5ml的1%硝酸銫水溶液,結(jié)果在測(cè)量的時(shí)候發(fā)現(xiàn)空白很高吸光度都達(dá)到1.2幾了,以致于影響了其他的測(cè)量無(wú)法正常進(jìn)行。
所以測(cè)試前必須先檢查一下這些試劑的純度。具體做法是看不加抗干擾劑的空白情況。如果正常,就基本可以確定是試劑不純了。
另外用原子吸收測(cè)定鉀鈉時(shí),通常當(dāng)有較高空白時(shí),若排除了試劑不純的原因, 或者是容器或水污染造成的原因外,那主要是由于蒸餾水產(chǎn)生,測(cè)鉀鈉時(shí)不能用去離子水,要用純凈水或雙蒸水。
扣空白是有一定要求的,空白太大會(huì)掩蓋樣品信號(hào)。當(dāng)測(cè)試低含量的鈉時(shí),空白影響的效果就更明顯。一定要在樣品處理過(guò)程加帶空白并在測(cè)量時(shí)做扣除。
在抗干擾劑使用劑量的選用同時(shí),我們?cè)谟迷游兆鲡浐外c時(shí),由于其靈敏度很高,要注意器皿、試劑、塵埃等均會(huì)帶來(lái)污染,如果是測(cè)痕量鈉,全程都用塑料器皿。如果是要做高濃度的鉀鈉,目前通用的方法是將燃燒頭轉(zhuǎn)動(dòng)一個(gè)小角度,減小吸收光程去做,簡(jiǎn)單易行。
由于鉀鈉鈣鎂之間有相互影響因素,加入抗干擾劑效果不是很好時(shí),建議采用標(biāo)準(zhǔn)加入法對(duì)四種元素進(jìn)行測(cè)定,這樣更能保證結(jié)果的準(zhǔn)確性。
參考文獻(xiàn):
[Abstract] Objectives: To evaluate the efficacy of high ligation of varicocele to varicocele-associated severe spermacrasia or azoospermia patients. Methods: 20 varicocele-associated severe spermacrasia (sperm density less than 2 million per ml )or azoospermia patients(the former is 12 cases , the latter is 8 cases, gas pains of scrotum is 5 cases)with high ligation of varicocele, sperm quality and gonadal hormones (FSH, LH, T, E2, PRL)of these cases were measured and contrasted before operation and 2, 4, 8 months after operation. 10 varicocele-associated severe spermacrasiaor azoospermia patients refused high ligation of varicocele as control group. Results: Compared with the before operation and 2, 4, 8 months after operation , the sperm quality and gonadal hormones no significant difference(P>0.05), but the scrotum gas pains of the patients markedly release or disappear. Compared with the experimental group and control group, the sperm quality and gonadal hormones no significant difference(P>0.05). Conclusions: The high ligation of varicocele on varicocele-associated severe spermacrasia or azoospermia are inefficiency.It is not to recommend that these patients who want to improve their sperm quality to received the operation.
Key words: Varicocele ; High ligation of varicocele; Treatment; Sperm quality; Gonadal hormone
摘要:[目的]評(píng)估精索靜脈曲張高位結(jié)扎術(shù)對(duì)精索靜脈曲張致重度少精或無(wú)精患者的治療效果。[方法] 精索靜脈曲張致重度少精(密度小于2百萬(wàn)/毫升)或無(wú)精患者20例(其中前者12例、后者8例,伴陰囊墜脹感共有5例)為實(shí)驗(yàn)組,術(shù)前(術(shù)前3天內(nèi))分析和血清性腺激素(FSH、LH、T、E2和PRL)的變化分別與術(shù)后2月、4月、8月行對(duì)比分析。并選用10名精索靜脈曲張致重度少精或無(wú)精且不同意手術(shù)患者作為對(duì)照組。[結(jié)果] 實(shí)驗(yàn)組患者術(shù)前和術(shù)后2月、4月、8月分析和性腺激素均無(wú)明顯變化,差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05),實(shí)驗(yàn)組與對(duì)照組相比亦無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。但5例陰囊墜脹感患者不適癥狀均明顯減輕或消失。 [結(jié)論] 本研究認(rèn)為手術(shù)治療對(duì)改善此類患者質(zhì)量無(wú)明顯效果,不建議對(duì)重度少精或無(wú)精,期望改善質(zhì)量患者行手術(shù)治療。
關(guān)鍵詞:精索靜脈曲張;精索靜脈高位結(jié)扎術(shù);治療;質(zhì)量;性激素
中圖分類號(hào):R 699.8 文獻(xiàn)標(biāo)識(shí)碼:A
Varicocele (VC) is a common disease of young men, the incidence is about 15% in young and middle-aged men[1]. It is a common cause of male infertility, male sterility brings a lot of damage to some families, for which VC need surgical treatment is always controversial, the effect of surgical treatment in patients with different types of VC perform very inconsistent, but most of the studies didn't have clearly classified for patients with VC. This study focuses on the value of surgical treatment to varicocele-associated severe spermacrasia or azoospermia patients.
1 MATERIALS AND METHODS
1. 1 Materials: 20 varicocele-associated severe spermacrasia (sperm density less than 2 million per ml ) or azoospermia patients have been diagnosed by the Affiliated Hospitla of Qingdao University in August 2012 to August 2013(excluding other causes of severe spermacrasia or azoospermia, among them the former is 12 cases , the latter is 8 cases, gas pains of scrotum is 5 cases), 10 varicocele-associated severe spermacrasiaor azoospermia patients refused high ligation of varicocele as control group. The age is 17 to 35 years old, the average age is 23 years old; The course of disease: 3 months to 4 years.
1.2 Research methods
1.2.1 Surgery methods: high ligation of varicocele, surgery time 20 to 40 minutes.
1.2.1 Sperm analysis (sperm quantity, sperm density, percentage of normal sperm, a + b grade sperm vitality) and gonadal hormones(FSH, LH, T, E2, PRL)with radioimmunoassay were measured before operation and 2, 4, 8 months after operation, review and follow-up the patients to realize their condition after surgery.
1.3 Statistical processing: The data are expressed as mean±standard deviation (). Comparisons between groups were made by means of the independent Student's t test, all analyses were analysed with SPSS11.5 software.
2 RESULTS
2. 1 Contrast sperm analysis before and after operation
Sperm volume of sperm analysis have no obvious statistical significance (t=0.00, P> 0.05) before operation and 2, 4, 8 months after operation; There was no obvious statistical significance (t=1.808, P=0.087>0.05) about normal sperm percentage by comparing preoperation with postoperative 2, 4, 8 months; There was no obvious statistical significance(t=1.786, P=0.09>0.05)about a+b grade sperm vitality by comparing preoperation with postoperative 2, 4, 8 months; Sperm density before operation and 2, 4, 8 months after operation have no obvious statistical significance (t=0.784, P=0.443> 0.05). Table 1, 2
Table 1 Analysis results of sperm quality preoperation and postoperation (2, 4, 8 months)
Grouping
Sperm volume(ml)
Percentage of normal sperm %
sperm motility(a+b)%
sperm density
(millions/ml)
Preoperation
3.20±0.95
3.68±3.57
2.90±3.03
1.17±0.83
Postoperation(2 months)
3.20±1.15
2.73±2.11
2.30±2.05
1.16±0.84
Postoperation(4 months)
3.02±1.25
3.54±3.10
2.70±2.86
1.20±0.79
Postoperation(8 months)
2.97±1.19
2.95±2.55
2.81±2.59
1.14±0.81
Compared with the preoperation and postoperation (2, 4, 8 months), the sperm quality no significant difference(P>0.05)
Table 2 Analysis results of sperm quality before diagnosis and after diagnosis (2, 4, 8 months)
Grouping
Sperm volume(ml)
Percentage of normal sperm %
sperm motility(a+b)%
sperm density
(millions/ml)
Before diagnosis
3.15±0.78
3.05±3.41
2.86±2.97
1.13±0.82
After diagnosis(2 months)
3.01±0.95
2.96±2.23
2.66±2.14
1.15±0.79
After diagnosis(4 months)
2.96±1.05
3.42±3.09
2.70±2.97
1.18±0.81
After diagnosis(8 months)
3.11±1.22
2.98±2.34
2.84±2.60
1.17±0.77
Compared with the before diagnosis and after diagnosis (2, 4, 8 months), the sperm quality no significant difference(P>0.05); Compared with the experimental group and control group, the sperm quality no significant difference(P>0.05)
2.2 Comparative analysis of gonadal hormone before and after operation
There was no obvious statistical significance(t = 0.134, P = 0.895 > 0.05)of FSH compared with the before operation and 2,4,8 months after operation;There was no obvious statistical significance(t = 0.782, P = 0.444 > 0.05) of LH compared with the before operation and 2,4,8 months after operation; There was no obvious statistical significance(T = 0.427, P = 0.674 > 0.05) of T compared with the before operation and 2,4,8 months after operation; There was no obvious statistical significance(t = 1.62, P = 0.122 > 0.05)of PRL compared with the before operation and 2,4,8 months after operation; There was no obvious statistical significance(t = 1.643, P = 0.117 > 0.05) of E2 compared with the before operation and 2,4,8 months after operation.(table 3, 4)
Table 3 Analysis results of gonadal hormone preoperation and postoperation (2, 4,8 months)
Grouping
FSH(IU/L)
LH(IU/L)
T(ng/ml)
PRL(ng/ml)
E2(pg/ml)
Preoperation
5.88±3.16
5.18±1.39
6.52±4.18
28.49±11.26
28.52±12.80
Postoperation(2 months)
5.90±3.42
5.00±1.30
6.61±4.12
26.89±9.36
30.22±15.19
Postoperation(4 months)
5.62±3.08
5.32±1.44
6.19±3.40
27.25±9.04
29.43±14.36
Postoperation(8 months)
5.85±3.46
4.96±1.37
6.39±3.42
27.66±11.64
29.07±13.73
Compared with the preoperation and postoperation (2, 4, 8 months), the gonadal hormones no significant difference(P>0.05)
Table 4 Analysis results of gonadal hormone before diagnosis and after diagnosis (2, 4,8 months)
Grouping
FSH(IU/L)
LH(IU/L)
T(ng/ml)
PRL(ng/ml)
E2(pg/ml)
Before diagnosis
5.45±3.22
5.23±1.23
6.36±4.02
26.15±10.76
29.55±12.01
After diagnosis(2 months)
5.64±3.44
5.26±1.37
6.13±4.38
27.84±9.55
30.48±14.17
After diagnosis(4 months)
5.43±3.12
5.14±1.59
6.55±3.76
25.32±9.66
28.55±13.33
After diagnosis(8 months)
5.66±3.77
5.11±1.47
6.10±3.55
27.13±11.17
29.39±12.10
Compared with the before diagnosis and after diagnosis (2, 4, 8 months), the gonadal hormones no significant difference(P>0.05); Compared with the experimental group and control group, the gonadal hormones no significant difference(P>0.05)
3 DISCUSSION
Young male of infertility patients that caused by VC is still more, often occur in the patients that diagnosed VC late and did not receive surgical treatment before puberty . Its main treatment is still surgery, some patients use drug as auxiliary treatment, but results are various. On pathology, VC can undermine the anatomy and function of testis gradually, which may be related to poor testicular blood flow, metabolic disorders of testicular tissue , temperature, increased toxins from the blood and germocyte apoptosis induced by immune factors [2]. The main surgical treatment is high ligation of varicocele(HLV), some reports discuss the clinical effect of the surgery, but the clinic still have controversy about whether VC patients need active surgical treatment or not and which patients should be treated.
This experiment collects , follow-ups 20 cases that varicocele-associated severe spermacrasia or azoospermia patients successfully who received HLV operation ,tests and records the change of sperm analysis , serum gonadal hormone (FSH, LH, T, E2, PRL) in the preoperative 3 days , 2 months after operation, 4 months after operation and 8 months after operation ,and studys , compares , statistical analyzes the above indexes .Result found that sperm count, density and energy of patients have not marked improvement after surgery, postoperative serum gonadal hormone has not obvious change compared with preoperative serum gonadal hormone.PRL in preoperation and postoperation were significantly higher than normal, but other hormones are all in normal range. Compared with the experimental group and control group, the sperm quality and gonadal hormones no significant difference(P>0.05).
Agarwal A and other people carry out Meta analysis about sperm quality of varicocele-associated infertile patients that received surgical treatment , prove that sperm vitality, sperm density and normal morphology sperm percentage all have obvious increase after surgery[3]. SHI Qing and other people apply three kinds of HLV operation to 120 cases of VC , the study found that every sperm indication of three groups patients have not statistical significance before operation, postoperative indications that sperm analysis of three groups were significantly improved compared with preoperation[4]. But none of the above studies according to the pre-operative sperm quality of patients adopt detailed grouping. Peria Zarzuelo E researched 266 cases of two or three degree VC patients that received HLV operation, found that 6 cases of patients have persistent VC , 23 cases of patients produce the main complications - hydrocele, but overall sperm quality has improved significantly after surgery , thought VC need operative treatment[5]. However,Gu Xiang and other people found that high ligation of varicocele is very effective to the patients whose total number of sperm is more than 5×106 ,while unsatisfactory for improving sperm quality of severe spermacrasia or azoospermia patients(the total number of moving sperm< 5x106) by analyzing preoperative sperm result and postoperative sperm activity , restoring index of reproductive function varicocele-associated infertile patients[6]. LI Yajun and other people apply microsurgical ligation of varicocele to 150 cases of asymptomatic varicocele-associated infertility patients from their hospital , preoperative sperm survival rate is 45.31±12.32(%),sperm density is 13.14±8.06(106/ml),3 months after operation is 44.32±11.89(%)、13.65±8.21(106/ml), no obvious change between preoperation and postoperation[7]. But Pasqualotto FF and some people research thought that apply ligation of varicocele to varicocele-associated severe spermacrasia or azoospermia patients can improve the total number of moving sperm and pregnancy rate [8]. This study found that the surgical treatment for varicocele-associated severe spermacrasia or azoospermia patients has no obvious effect, conforms to the research of Gu Xiang et al .
Pasqualoto found that the plasma concentrations of LH and T without obvious difference among three groups of patients ,Serum FSH concentration of group 1 was significantly higher than group 2 and group 3 by retrospectively analyzed infertile male with VC(group 1) ,fertile male without VC(group 2) and fertile male with VC(group 3). And also found that every index has no obvious difference between the VC patients who have no fertility problems and normal men , so he consider whether suggesting VC patients found occasionally in clinic to received treatment deserving consider[9]. WANG Yixin studied 64 cases of varicocele-associated infertile patients , found that sperm survival rate, sperm density is lower than the normal group, FSH, LH and T are all in the normal range, serum gonadal hormones had no statistical difference between preoperation and postoperation, but the postoperative sperm quality improved obviously. And they also found that sperm quality of the patients whose FSH are higher before operation had no obvious improvement ,while whose FSH are normal before operation had statistical difference. They think that according to gonadal hormones measure combined sperm analysis , testicle examination can estimate damage degree of testicle , have certain reference value for the judgment of the operative prognosis [10]. LU Yanfen and some people measured peripheral blood reproductive hormone levels from 93 cases of patients with different varicose degree , found that FSH levels increased, but the three reproductive hormones LH, PRL, T have no statistical significance compared with normal group as the VC degree aggravating , thought that the number of patients with abnormal reproductive hormone levels increased as VC degree aggravating . Reproductive hormone levels had certain reference value which on reflecting the pathophysiological changes of testicular tissue caused by VC[11] .
This study found that postoperative serum gonadal hormone of varicocele-associated severe spermacrasia or azoospermia patients had no obvious change compared with preoperative serum gonadal hormone, PRL in preoperation and postoperation were significantly higher than normal, but other hormones are all in normal range.Serum PRL is a kind of polypeptide hormone , secreted by the anterior pituitary, can promote leydig cells produce gonadotrophin, enhance the number of LH receptor [12]. Physiological levels of PRL can maintain the high level of the T in the testicle, affect the physiological function of deputy sexual gland ,while FSH and T are the main endocrine hormones that start and maintain spermatogenesis[13] , both of them promote testicular seminiferous tubule development, spermatogenesis and mature together , affect the health and reproductive capacity of male offspring directly [14].Serum endocrine hormone measure of azoospermia patients is mainly measure the serum FSH, LH, T and PRL, to confirm whether the testicular function damaged and its damage degree. In this study ,the average of PRL is higher, considering related to testicular damage caused by VC, spermatogenesis ability dropping, PRL feedback-elevated , HLV has no obvious effectin for improving sperm quality and gonadal hormone of severe spermacrasia or azoospermia patients , but the unwell symptoms of five cases of patients who combined scrotum gas pains were significantly reduced or disappeared.
It always exist controversy on varicocele treatment of teenagers. Considering the higher morbidity, some patients were suggested receiving selective treatment . This study thinks that the surgical treatment has no obvious effect for sperm quality of such patients , it is not recommended for severe spermacrasia or azoospermia patients who expect to improve sperm quality to receive surgical treatment, these patients can also consider surgery if they expect to improve the gas pains of scrotum .
References
[1] WU Jieping, Wu Jieping’s General Urology [M]. Beijing: science and technology press, 2004. 846
[2] Bozhedomov VA, Teodorovich OV. Epidemiology and causes of autoimmune male infertility[J]. Urologiia,2005,(1):35-44
[3] Agarwal A, Deepinder F, Cocuzza M, et al. Efficacy of varicocelectomy in improving semen parameters new meta-analytical approach [J]. Urology, 2007, 70(3): 532-538
[4] Shi Qing, Zhu Hai, Wang Xinsheng et al, Comparison of 3 microsurgical approaches to the treatment of varicocele: report of 120 cases [J], National Journal of Andrology 2013, 12 (10) : 931-934
[5] Peria Zarzuelo E, Caffaratti Sfulcini J, Garat Barredo JM,The treatment of varicocele in adolescents[J].Arch Esp Urol.2004 Nov;57(9):995-1002
[6] GU Xiang, CHEN Jiacun, SUN Xiaoqing etc , The Value of Preoperative Semen Analysis as a Restore Index of Fertilizing Capacity after Varicocelectomy [J], National Journal of Andrology , 2006 Feb, 12 (2) : 145-147
[7] LI Yajun, The clinical study about microsurgical ligation of varicocele treating asymptomatic varicocele-associated infertility[J], contemporary medical in August 2011,17(24), 251 :69-69
[8] Pasqualotto FF, Lucon AM, de Goes PM, et al. Testicular growth, sperm concentration, percentmotility, and pregnancy outcome after varicocelectomy based on testicular histology [J]. Fertil Steril 2005,83(2): 362-366
[9] Pasqualotto FF, Lucon AM, de Goes PM, et al. Semen Profile, testicular volume, and hormonal leavls in infertile Patients with varicoceles compared with fertile men with and without varicoceles [J]. Fe rtil Steril 2005: 83 (l): 74-77
[10] WANG Yixin BO Juanjie, QIAN Xianming,et al. Changes of serum inhibinB of infertility man with varicocele before and after surgery [J], journal of reproductive medicine in March 1998, 7 (1) 13-17
[11] LuYanFen Zhang Shouxin Zhao Junjie, reproductive hormone level and the degree of the varicocele study [J], the relation of the contemporary medical volume on March 18, 2012 7 270 109-110
[12] Gorona G,Rastrelli G,Boddi V,et al. Prolactin levels independently predict major cardiovascular events in patients with erectile dysfunction [J]. Int J Androl,2011,34(3): 217-224
[13] Tang Wenhao, Jiang Hui, horse firm, Lin etc, Male infertility patients with the relationship between sperm morphology analysis and reproductive hormones study [J]. National Journal of Andrology, 2012, 19 (3) : 243-247
[14] Deng Yunshan, Zhou Jinfang, Li Xiayun etc, kirin pill combined bromine hidden pavilion in the treatment of idiopathic hyperprolactinemia is little weak sperm disease clinical research [J], National Journal of Andrology, 2013 Oct, 19 (10) : 940-944
作者:賈月峰 (1982-) 碩士 主治醫(yī)師 泌尿外科學(xué)
My holiday summer
It was the first day of our summer holiday. All of us were very happy. Why? Because we have one months to do things we love to do. We are free.
Although we have some homework. But we can finish them in several days. And the rest time we can make good use of. My god! We have been very tired after hard studying. In summer holidays I want to have full sleepand eat good food in order to replenish myself.
Last but not the least I will have a good rest.
【參考譯文】
這是第一天,我們的暑假。我們大家都非常高興。為什么?因?yàn)槲覀冇幸粋€(gè)月的事我們都愛(ài)做的事。我們很空閑。
雖然我們有一些功課。但是,我們可以完成他們的若干天。其余的時(shí)間我們可以好好利用。我的上帝!我們已經(jīng)很疲憊后很難學(xué)習(xí)。在夏季假期,我希望能有充分的很好吃的食物,以補(bǔ)充自己。
最后但并非最不重要,我會(huì)好好休息。
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My summer vacation plan
I am going back to my hometown this summer.I will take a good rest when I get home after a year's hard work. I will eat all the nice foods I have been missing for so many years. I will find a good badminton coach to help me improve my skills.And I will try to see all my childhood friends and pay a visit to my high school teacher, who has played an important role in my life.In August, I will have this Yangzi river cruise with my parents. Right now, I keep thinking all the fun things that I would like to do in summer: chatting on line, dancing, going to the beach, clothes shopping, reading one or two nice books, seeing some nice movies,more and more....Summer vacation is the best time of the year. I can plan lots of fun things and I can carry them out. It is like I can do whatever I want.Oh, I just can't wait for it! ·暑假第一天 ·暑假見(jiàn)聞 ·暑假一日游 ·暑假趣事的作文 ·暑假計(jì)劃作文
·英語(yǔ)作文:暑假的收獲 ·暑假記事作文3篇 ·暑假游記作文3篇 ·暑假英語(yǔ)小作文
今天距離暑假放假已經(jīng)過(guò)去了半月有余,我一直在思考,我是否荒廢了時(shí)光?把整天用來(lái)學(xué)習(xí)的時(shí)間用去玩游戲,卻冠冕堂皇地用休息,緩和心態(tài)這般無(wú)知的說(shuō)法去掩飾。我很想說(shuō)出沒(méi)有這個(gè)詞,但事實(shí)也許并非我想的那樣簡(jiǎn)單,累,是我對(duì)暑假生活的最初印象。
可這也是沒(méi)有辦法的事,一年之后,不,還無(wú)須到一年,我就要參加人生中第二次決定命運(yùn)的考試——中考。我的心情可謂是百般焦急,我不愿輸,也不敢輸,更不能輸。為此,我唯有拼搏努力,為考上理想的高中而奮斗??蛇@并非光說(shuō)嘴皮子就可以改變的,想要在短時(shí)間內(nèi)提升我的成績(jī),暑假的時(shí)間必然不可浪費(fèi),故我的生活逐漸變得枯燥無(wú)味,卻又如同機(jī)械一般精準(zhǔn)。
過(guò)不了多久,我就得過(guò)著這樣一種生活——每天出去散步,散完步回來(lái)就做作業(yè),隨后就去上補(bǔ)習(xí)班,開(kāi)啟一天的學(xué)習(xí)生涯??晌矣钟惺裁崔k法呢?努力耕耘不一定會(huì)有收獲,但不耕耘,就一定不會(huì)有收獲。故唯有拼過(guò),方才能不會(huì)后悔,無(wú)聊而又無(wú)奈的一天!