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简介：Aim:TocomparetherecoveryrateofmorphologicallynormalandchromatincondensedspermatozoafromnativesemensamplesusingtheSpermPrepTMfiltrationcolumnsandPercollgradientcentrifugationandtodeterminetheinfluenceofthetwoprocessingtechniquesonfertilizationandpregnancyratesinanIVF-ETprogram.Methods:Sixteensemensamplesobtainedfrompatient'shusbandwereincludedinthisstudy.Eachwasdividedintotwoaliquots.ThefirstaliquotwasprocessedwithSpermPrepTMfiltrationcolumnsandthesecond,Percollgradientcentrifugation.Smearsweremadebeforeandaftersemenprocessingwithbothmethodsfortheevaluationofchromatincondensation(chromomycineCMA3)aswellasmorphology(strictcriteria)ofspermatozoa.Onehundredandseventyoocyteswereretrievedfromthepatientsandtheoocytesfromeachpatientweresubdividedintotwosets:onesetwasinseminatedusingspermatozoaprocessedwithSpermPrepTMandtheotherinseminatedaftersemenprocessingwithPercollgradientcentrifugation.Resuits:ThePercollmethodyieldedasignificantlyhigherpercentageofchromatincondensed(90.8±6.5%vs82.3±8.8%,P=0.017)andmorphologicallynormalspermatozoa(12.9±7.4%vs6.9±4.8%,P=0.001)incomparisontoSpermPrepTM.Whereas,spermcountrecoveryratewassignificantlyhigheraftertheuseofSpermPrepTMthanafterthePercollgradientcentrifugation.Thefertilizationratewassimilarbetweenthetwomethods.Conclusion:SemenprocessingwithPercollshouldberecommendedforintracytoplasmicsperminjectionasthenaturalselectionisbypassedandtheSpermPrepTMtechniquecouldberecommendedfor1VFandIUIprogramsasthespermconcentrationplaysamoresignificantroleintheseprocedures.

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简介：ObjectivesTostudywhetherchangeofBNPlevelsreflectthechangeofcardiacfunctionandtoinvestigatetheshort-termprognosticpotentialofBNPandQOLinpatientswithCHF.Methods96consecutivepatientsadmittedwithCHFbetweenSeptember2002andJanuary2003werestudied,uponentrythestudy,BNPlevelsweremeasured,Patientsadministeredthedisease-specificqualityoflifequestionnaireMinnesotalivingwithheartfailurequestionnaire(LiHFe)within1day.BNPlevelsandadministeringLiHFewererepeatedthreemonthslater.ResultsBNPlevelswereincreasedproportionaltotheseverityofcardiacfunction.PhysicaldomainandtotalscoreofLiHFeweresignificantlycorrelatedtotheseverityofCHF(p＜0.05).BNPlevelsweredecreasedinimprovinggroup(p=0.032).IndeterioratinggroupBNPlevelsincreased(P=0.043).Kaplan-meieranalysisaccordingtoBNPlevelcutoffpoint150ng/l,thelifecurveofhigherBNPlevelgroupwassignificantlylowerthanthelowergroup(p=0.001).Inunivariatelogisticregression,NYHAclass,BNP,LVEF,LVEDD,heartsize,totalscoreofLiHFe,physicaldomainofLiHFeandtheemotionaldomainofLiHFewereallsignificantprognosticfactorsofCHF(p＜0.05forall).Whileinmultipleregression,onlyBNPlevel(p=0.036)andtheemotionaldomainofLiHFe(p=0.025)wereindependentprognosticfactors.ConclusionsChangeofBNPreflectsthetreatmentefficacyofCHF.BNPandQOLarethetwomajorshort-timeprognosticfactorsofthechronicheartfailurepatients.

简介：PolysaccharidesfromnumeroustraditionalChinesemedicineshavebeenprovenasthebioactiveingredientsandarehenceusedasthequalitycontrolmarkers.However,theassessmentcriteriaalwaysshowapoorspecificity,duetothelackofmaticcomparisonamongtheanalogousherbs.Inthepresentstudy,twosimilarmaterials,namelysea-tangleandsargassum,wereselectedasthemodelherbstodevelopmorespecificmethodsforqualitycontrol.Twowell-establishedmethods,determinationofthetotalpolysaccharidescontentandmonosaccharidescompositionanalysis,werebothemployed.Baseduponthequantitativeresults,theevaluationcriteriaofthepolysaccharidescontentsofnotlessthan2.0%and1.7%wereproposedforsea-tangleandsargassum,tively.NineidenticalmonosaccharidederivativesappearedontheHPLCchromatogramsofthehydrolysisandderivatizedsolutionsofthetwodrugs.Principalcomponentanalysisandorthogonalpartialleastsquaresdiscriminantanalysisusingthepeakareasofmonosaccharidesderivativesasthevariableswereperformed,andtheresultsindicatedthatmannuronicacidandxylosewiththeoppositeconcentrationsinthetwodrugswerethedifferentialcomponents.Adiscriminativecriterionusingthepeakarearatioofthesetwomonosaccharidesderivativeswasproposedforthequalitativeidentification.Inconclusion,amorespecificandquantitativequalitycontrolmethodwasdevelopedforsea-tangleandsargassum.

简介：AbstractObjective:To evaluate the effect of morphologic factors on survival rate (SR), pregnancy rate (PR), and implantation rate (IR) of human embryo vitrification following frozen embryo transfer (FET) on day 3 post-ovulation.Methods:Women undergoing FET (n = 921) with embryos cryopreserved by vitrification between 2012 and 2013 were enrolled in this retrospective cohort study.Results:Embryos with >9 blastomeres yielded the highest SR of 100%. Lower SR was observed in embryos with 5 to 6 (57.5%) and 4 blastomeres (41.4%). In terms of blastomere symmetry, the SR of embryos with equally sized blastomeres was significantly higher than that of embryos with unequally sized cells (82.5% vs. 64.6%, P < 0.05). As fragmentation increased, SR decreased from 92.1% to 20.6% (P < 0.05). Significant differences were observed among groups when analyzing PR and IR according to the 3 embryonic parameters before vitrification. Embryos with 13 to 16 blastomeres yielded the highest PR (39.5%) and IR (24.1 %). The PR and IR of embryos with blastomeres of equal size were significantly higher than those with unequally sized blastomeres (36.5% vs. 21.7%, 23.7% vs. 12.4%, P < 0.05). After warming, embryos with 13 to 16 blastomeres yielded the highest PR and IR (40.9% and 24.2%, respectively). The PR and IR were observed to grow with an increase in the percentage of intact blastomeres (23.2%-38.2%, 14.2%-23.2%).Conclusions:These results show that vitrification methods do not effectively improve survival outcomes for embryos of poor quality and it is needed to develop a comprehensive vitrification protocol that considers all the practical aspects, including the current limitation regarding cleavage-stage embryos of poor quality.

简介：During2004,atotalof124batchesofHIVantibodyELISAsfromdomesticandoverseasmanufacturers,comprisingapproximately60milliontests,weretestedforqualityandreleasedforscreeningbloodinChina.Theinter-andintra-batchvariation,specificity,andsensitivitywereevaluatedusingalaboratorypanelandclinicalsamples.Theinter-batchvariationwaslessthan15%andonly2of12assayshadintra-batchvariationoflessthan20%for4dilutionsofacontrolspecimen.257samplesconfirmedpositiveforHIVantibodyand4826negativesamplesfromdifferentregionsinChinawereusedtoevaluatethesensitivityandspecificityoftheassays.Theresultsshowedthatthesensitivityisintherangefrom93.7%to100%forassayssampleddirectlyfromthemanufacturers,and91.4%-99.6%forthoseretrievedfromtheconsumers;thespecificitywasintherangefrom97.88%to99.97%.ThetestingenvironmentmayvaryindifferentregionsofChina.Therefore,manufacturersshouldproviderobustassaystosatisfytherequirementsofthesediverseenvironments,andespeciallyreducetheintra-assayvariationandimprovethestabilityofthekits.

简介：NocathiacinI,aglycosylatedthiopeptideantibiotic,displaysexcellentantibacterialactivitiesagainstmultidrugresistantbacterialpathogens.Previously,anovelnocathiacinIformulationforintravenousadministrationhasbeensuccessfullydevelopedanditsaqueoussolubilityisgreatlyenhancedforclinicalapplication.ThepurposeofthepresentstudywastoincreasethefermentationtiterofnocathiacinIandreduceoreliminateanalogousimpuritiesbyscreeningthemediumingredientsusingresponsesurfacemethodology.Afterasysmaticoptimization,awater-solublemediumcontainingquality-controllablecomponentswasdevelopedandvalidated,resultinginanincreaseintheproductionofnocathiacinIfrom150to405.8mg·L-1at150-Lscale.Meanwhile,theanalogousimpuritiesexistedinreportedprocessesweregreatlyreducedoreliminated.Usingoptimizedmediumforfermentation,nocathiacinIwithpharmaceuticallyacceptablequalitywaseasilyobtainedwitharecoveryof67%.Inconclusion,theresultsfromthepresentstudyofferapracticalandefficientfermentationprocessfortheproductionofnocathiacinIasatherapeuticagent.

简介：AbstractBackground:In recent years, visual quality has been extensively investigated in various conditions. In this community-based population study, we analyzed the effects of aging, refraction, and Lens Opacification Classification System III (LOCSIII) score on retinal imaging quality in healthy Chinese adults.Methods:This cross-sectional study was conducted on sub-group subjects from The Handan Eye Study between October 2012 and January 2013. Healthy subjects over 30-years-old with logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) less than 0 were included. Retinal image quality was measured by optical quality analysis system (OQAS) and recorded as modulation transfer function cutoff frequency (MTFcutoff), OQAS value (OV) 100%, OV20%, OV9%, Strehl ratio (SR), and objective scatter index (OSI). The correlation between age, spherical equivalent refraction (SE), LOCSIII score, and optical quality parameters were investigated by multivariate analysis.Results:Among 1108 verified subjects, 690 subjects (1380 eyes) met the inclusion criteria. Their age ranged from 30 to 76 years, SE ranged from -4.75 to 2.75 D. They were divided into five age groups (30-39, 40-49, 50-59, 60-69, and ≥70 years) for further analysis. After multivariate analysis by mixed-effect linear model, SR (t = -3.03, P = 0.002), OV20% (t = -2.39, P = 0.017), and OV9% (t = -3.16, P = 0.001) significantly decreased with the increasing age, whereas logMAR BCVA (t = 4.42, P < 0.001) and OSI (t = 4.46, P < 0.001) significantly increased with age. As SE increased, SR (t = 2.74, P = 0.01), OV20% (t = 2.31, P = 0.02), and OV9% (t = 2.79, P = 0.005) significantly elevated, and OSI (t = -3.38, P < 0.001) significantly decreased. With the increase in cortical opacity score, all optical quality parameters except for SR significantly decreased, including MTFcutoff (t = -2.78, P = 0.01), OV100% (t = -2.78, P = 0.005), OV20% (t = -2.60, P = 0.009), and OV9% (t = -2.05, P = 0.04). As posterior sub capsular opacity score increased, MTFcutoff (t = -2.40, P = 0.02) and OV100% (t = -2.40, P = 0.01) significantly decreased, while OSI (t = 7.56, P < 0.001) significantly increased.Conclusions:In healthy Chinese adult population, optical quality-related parameters significantly decrease with the increasing age, and OSI significantly increases with age. In normal BCVA subjects, optical quality is significantly impacted by cortical and posterior sub capsular opacity rather than by nuclear opacity.

简介：AbstractBackground:Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3-5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3-5) and moderate scoliosis (Cobb angle 20°-40°).Methods:From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation.Results:In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = -3.918, P = 0.001), and 3.7 ± 0.4 (t = -6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = -2.825, P = 0.088) and mental health domain (t = -3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = -1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group.Conclusions:For AIS patients with a Risser 3-5 and a Cobb angle 20°-40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.

简介：AbstractBackground:Patients’ recovery after surgery is the major concern for all perioperative clinicians. This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients’ recovery of gastrointestinal (GI) function and quality of life after colorectal surgeries, an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored.Methods:A prospective randomized controlled clinical trial was conducted, patients were recruited from January 2018 to September 2019 in this study. Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery (S-ERAS) group or enhanced recovery after surgery based on pre-operative rehabilitation (group PR-ERAS). In the group PR-ERAS, on top of recommended peri-operative strategies for enhanced recovery, formatted rehabilitation exercises pre-operatively were carried out. The primary outcome was the quality of GI recovery measured with I-FEED scoring. Secondary outcomes were quality of life scores and strength of handgrip; the incidence of adverse events till 30 days post-operatively was also analyzed.Results:A total of 240 patients were scrutinized and 213 eligible patients were enrolled, who were randomly allocated to the group S-ERAS (n = 104) and group PR-ERAS (n = 109). The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS (79.0% vs. 64.3%, P < 0.050). The subscores of life ability and physical well-being at post-operative 72 h were significantly improved in the group PR-ERAS using quality of recovery score (QOR-40) questionnaire (P < 0.050). The strength of hand grip post-operatively was also improved in the group PR-ERAS (P < 0.050). The incidence of bowel-related and other adverse events was similar in both groups till 30 days post-operatively (P > 0.050).Conclusions:Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery. Newer, more surgery-specific rehabilitation recovery protocol merits further exploration for these patients.Trial Registration:ChiCTR.org.cn, ChiCTR-ONRC-14005096

简介：AbstractBackground:Worldwide, the volume and availability of digestive endoscopy have undergone dramatic development in recent years, with increasing attention on quality assurance. We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions.Methods:We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually. The questionnaires included the personnel, annual volume, and quality indicators of endoscopy. An endoscopy quality index (EQI) was developed based on recorded quality indicators using principal component analysis to determine the relative weight.Results:From 2015 to 2019, 806, 1412, 2644, 2468, and 2541 hospitals were respectively enrolled in this study. The average annual volume of endoscopy increased from 12,445 to 16,206 (1.30-fold) and from 2938 to 4255 (1.45-fold) in tertiary and secondary hospitals, respectively. The most obvious growth was observed in diagnostic colonoscopy (1.44-fold for all hospitals after standardization). The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3% (55,210/448,861) to 17.7% (85,429/482,647) and from 11.4% (69,411/608,866) to 16.9% (107,192/634,235), respectively. The adenoma detection rate of diagnostic colonoscopy increased from 14.9% (2,118,123/14,215,592) to 19.3% (3,943,203/20,431,104). The EQI model included 12 quality indicators, incorporating 64.9% (7.792/12) of the total variance into one comprehensive index. According to the EQI measurements, the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals.Conclusions:Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality. The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.

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简介：AIMTo评估关于光质量的培植根据包括的decentering.METHODSThis的不同的度估计了的V4c可植入的collamer透镜(洞ICL)的临床的结果收到了常规ICL的49只眼睛和收到了洞ICL的94只眼睛。收到了洞ICL的眼睛根据decentering的度被划分成三个组：组织1，在从学生中心的1条洞直径(HD)以内的中央洞；组织2，在到2HD的1HD以内的中央洞；并且组织3，在到3HD的2HD以内的中央洞。视觉尖酸(VA)，intraocular压力(IOP)，和球形的等价物(SE)价值在1wk被估计，1并且在外科以后的3mo。在surgery.RESULTSThere不是在VA，IOP，和SE的重要差别在之中以后，眼睛的调整转移功能，Strehl比率，客观散布索引，和更高的顺序错误(HOA)在3mo为4公里学生被测量常规并且洞ICL组。关于HOA，为昏迷和球形的错误的价值没显示出差别。全部的HOA和翘摇价值在比在组1的组2是显著地更高的(P=0.02，0.03，分别地)。在surgery.CONCLUSIONOur结果建议洞ICL培植提供等价于由常规ICL提供了那的令人满意的视觉质量以后，在关于在3mo的另外的光优秀参数的组之中没有重要差别，不管decentering的中央洞和度的存在。

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简介：从5210个精子银行施主的精液被分析，在精液质量的趋势在在2008和2014之间的山东人的精子银行被评估。在节制的2-7天以后，精液样品是镇定的。精液体积的大小，精子集中，精子前面的活动性，和全部的精子计数被执行。在精液体积有重要衰退趋势，精子集中，精子前面的活动性，和全部的精子数。我们的结果显示在精子施主的这个队的精液的质量在学习时期期间减少了。

简介：AbstractBackgroundIt remains unclear about the association of muscle mass, strength, and quality with death in the general Chinese population of diverse economical and geographical backgrounds. The present study aimed to comprehensively examine such associations across different regions in China.MethodsBased on the China Kadoorie Biobank study, the present study included 23,290 participants who were aged 38 to 88 years and had no prevalent cardiovascular diseases or cancer. Muscle mass and grip strength were measured using calibrated instruments. Arm muscle quality was defined as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength, and arm muscle quality were defined as the sex-specific lowest quintiles of muscle mass index, grip strength, and arm muscle quality, respectively. Cox proportional hazards models yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of all-cause mortality in relation to muscle mass, strength, and quality.ResultsDuring a median follow-up of 3.98 years, 739 participants died. The HR (95% CI) of all-cause mortality risk was 1.28 (1.08-1.51) for low appendicular muscle mass index, 1.38 (1.16-1.62) for low total muscle mass index, 1.68 (1.41-2.00) for low grip strength, and 1.41 (1.20-1.66) for low arm muscle quality in models adjusted for sociodemographic characteristics, lifestyle factors, and medical histories.ConclusionLow muscle mass, grip strength, and arm muscle quality are all associated with short-term increased risks of mortality, indicating the importance of maintaining normal muscle mass, strength, and quality for general Chinese adults.

简介：长期的前列腺炎能影响精子质量。以前的研究证明了transrectal微波thermotherapy(TRMT)在精子上与长期的前列腺炎，而是效果在病人导致征兆的地势小心地没被调查。当过去常与长期的nonbacterial前列腺炎对待病人时，这研究在症状的消除和精子的质量上评估TRMT的影响。六十个病人在学习被注册。TRMT治疗在5天被管理，1h每天。精液检查被执行预告的处理并且立即在5天的治疗的结论。另外，它被重复1个月，3个月，和6个月以后。治疗症状消除功效用健康长期的前列腺炎症状索引(NIH-CPSI)的国家研究所被评估。在治疗以后，全面NIH-CPSI分数与预告的处理的那些相比是更低的。另外，在表示prostatic分泌物的白血房间和卵磷脂在治疗以后是正常的。精子计数在治疗以后到23.8%3个月被减少，精子活动性被10.3%在治疗以后立即减少，并且精子畸形被17.2%增加。精子体积和PH没被影响。然而，在治疗和畸形性率在在治疗以后的6个月也是更低的以后，精子质量恢复了。TRMT是为有nonbacterial的病人的一种有利、安全的治疗选择长期的前列腺炎。它能在精子质量上减轻病人症状和影响在短期。

简介：AIM:ToinvestigatetheChineseversionoftheLowVisionQualityofLifeQuestionnaire(CLVQOL)asaninstrumentforobtainingclinicallyimportantchangesaftercataractsurgery.METHODS:PatientsunderwentcataractsurgeryinShanghaiGeneralHospital,ShanghaiJiaoTongUniversity,whofittheinclusioncriteriawererecruited.TwoCLVQOLswereadministered,includingapreoperativeCLVQOLandaCLVQOLattheendofthe3mofollow-upperiod,andwerecompletedusingface-to-faceinterviewsorphoneinterviewsconductedbytrainedinvestigators.Theminimalclinicallyimportantdifference(MCID)wascalculatedusingananchor-basedmethodandadistributionmethod.Inaddition,theresponsivenessofthequestionnairewasmeasured.RESULTS:Atotalof155residentswereenrolled.Theaveragevisualacuity(VA)preoperativelywas0.08(SD=0.05),anditincreasedto0.47(SD=0.28)attheendoffollowup.StatisticallysignificantpositivechangesintheCLVQOLscoresindicatedsignificantimprovementofvisionrelatedqualityoflifeaftercataractsurgery.Withthelargervaluebetweenthetworesultsasthefinalvalue,theMCIDvaluesoftheCLVQOL(scoresofthefourscalesaswellasthetotalscore)were8.94,2.61,4.34,3.10and17.63,respectively.TheCLVQOLhasbothgoodinternalandexternalresponsiveness.CONCLUSION:CLVQOLscoresareappropriateinstrumentsforobtainingclinicallyimportantchangesaftercataractsurgery.Thisstudyisaneffectiveexplorationforestablishingcataractsurgeryefficacystandards,whichhelpsclinicalandscientificresearchworkersinophthalmologytogainamorein-depthunderstandingwhenusingCLVQOL.

简介：这研究的目的是调查一种关系是否在颈的粘液和精子质量和类脂化合物在移植以后满足的正常ovulatory在白血球的低数字的存在之间存在。实时、能动、词法上正常的精子，电脑辅助的精子分析(房屋)估计的运动参数，和流动cytometry测量的导致ionophore的acrosome反应的百分比在移植前后被决定。有紫外察觉的高效的液体层析被用来测量精子类脂化合物内容，包括各种各样的diacyl亚种。在solubilized粘液样品发现的白血球的数字用一个haemocytometric方法被数。总的来说，在颈的粘液样品的白血球的存在显著地没影响精子活动性和形态学，精子运动学的参数，或在鞘磷脂或胆固醇的精子内容。在移植以后，相反，在各种各样的精子diacyls和导致的acrosome反应的水平的减少少些显著地在比在粘液样品包含104个白血球没有的粘液样品或稀罕白血球被读而导致的acrosome反应的水平更高。现在的数据建议在正常ovulatory发现颈的粘液的白血球的底层能影响精子类脂化合物remodelling/capacitation的过程。