Atmospheric PM2.5 exposure on semen quality in adult men in Taizhou / 预防医学

Objective@#To explore the effects of ambient fine particulate matter（PM2.5）exposure on semen quality in healthy adult men .@*Methods@#The semen quality data were collected from the pre-pregnancy check outpatient of Taizhou Central Hospital from August 2014 to December 2017,excluding the patients with any disease of reproductive system. The data of daily pollutant concentration of this area during the same period were also collected to estimate the exposures of PM2.5,PM10,SO2,NO2,O3 and CO during 90 days before each semen examination. Logistic regression model was applied to estimate the association between PM2.5 exposure and semen quality .@*Results@#A total of 3 456 healthy adult men were included in this study. The median （interquartile range）of the total sperm count of the 3 456 subjects was 161.00（122.00）×106,and 94.40% of the subjects could reach the lower reference limit for sperm count. The median（interquartile range）of the sperm concentration was 22.20（18.80）×106/mL,and 69.50% of the subjects were qualified. The median（interquartile range）of the sperm vitality was 55.30%（23.37%）,and 44.10% of the subjects were qualified. The median（interquartile range）of daily average concentration of PM2.5 at 0-90 days before semen examination was 37.82（12.33）μg/m3. The results of multivariate logistic regression model showed that,with each 12.33 μg/m3 increase of PM2.5 exposures at 0-90 days before semen examination,the odds ratios of unqualified sperm concentration,sperm motility and sperm vitality were 1.236（95%CI：1.041-1.466）,1.493（95%CI：1.260-1.770）and 1.462（95%CI：1.246-1.715）,respectively .@*Conclusion@#The results suggested that high concentration of ambient PM2.5 exposure during the sperm development period negatively affects sperm concentration,sperm motility and sperm vitality.

Changes of the internal operation mechanism and improvement of performance of public hospitals ;without drug price addition / 中华医院管理杂志

The paper reviewed the history of drug price addition system and its impact on hospital management. Based on such facts,authors stated that the significance of abolishing drug price addition helped hospital management not to run their hospitals as a business, helped medical practitioners to make their clinical decisions based on medical needs, and to make the health care service deserve the professionals′value and contributions. Following the abolishment, the hospitals need to reform their internal operating mechanisms before they can achieve better performance.