Factors determining perceptions of fairness in access to hospital outpatient departments in Taiwan.

Objectives To investigate the effects of four factors on perceptions of fairness in access to outpatient services: proportions of walk-in versus scheduled registration, consultation queues, regulations for late patients and particular categories of patients getting better access. Methods A total of 124 young adults were asked to consider nine different scenarios and report their views of the fairness of each one. Results As regards the balance of types of patients, 60% walk-in registration was seen as fair to both walk-in and scheduled patients. The fairness to both types of patients was higher in the queue with a 1:1 ratio of walk-in to scheduled patients. The policy that a late patient should wait for three on-time patients to be seen was considered to be fair to both on-time and late patients. Immediate consultation for some particular categories of patient (e.g. the elderly) was fair, but for other categories was unfair (e.g. paying an addition amount). Conclusions Fairness in outpatient care is based on equality and need principles. Shorter waiting time does not mean patients view the system as fairer.

New norditerpenoid alkaloids from Aconitum vilmorinianum Komarov.

Aconitum vilmorinianum Komarov is a local medicinal plant used in many well-known clinical preparations to treat rheumatism and pains in Yunnan Province, China. Phytochemical examination of the roots of A. vilmorinianum led to the isolation of three novel imine-type norditerpenoid alkaloids named vilmorrianines E-G (1-3), and a new natural alkaloid N-desethyl-N-formyl-8-O-methyltalatisamine (4), together with 14 known alkaloids. Their structures were elucidated on the basis of spectroscopic evidence. Vilmorrianine E is the first known norditerpenoid alkaloid containing both an imine group and a three-membered ring formed by C8, C9, and C10.

[Application of flow cytometry to the evaluation of semen quality].

OBJECTIVE: To evaluate the role of flow cytometry in semen assessment. METHODS: Semen samples from 104 infertile male patients (as the case group) and 10 fertilized donors (as the control group) were analyzed for the volume of ejaculate and sperm concentration, motility and atypical morphology by computer-assisted semen analysis (CASA), the viability, chromatin structure and mitochondrial membrane potential (MMP) of the sperm stained by SYBR-14/PI, AO and JC-1 respectively, and assessed with flow cytometry. The results were analyzed through SAS software. RESULTS: U tests indicated that the semen from the infertile patients had not only lower concentration (U = 2.51, P = 0.0143), lower motility (U = 3.44, P = 0.001) and higher rate of atypical morphology (U = -5.88, P < 0.0001), but also lower viability (U = 4.72, P < 0.0001), MMP (U = -2.53, P = 0.0309), and chromatin integrity (alpha t: U = -3.82, P = 0.0003; SD alpha t: U = -3.98, P = 0.0001; COMP alpha t: U = -3.57, P = 0.0005). The multiple stepwise regression analysis revealed that sperm motility was positively correlated with sperm membrane integrity (t = 1.66, P = 0.1016), sperm MMP (t = 3.33, P = 0.0014) and sperm acrosome integrity (t = 3.24, P = 0.0019), while sperm MMP was negatively correlated with the rates of sperm neck and tail defects (t = -3.44, P = 0.001). CONCLUSION: Flow cytometry plays a significant role in the evaluation of the quality of human sperm, and can be adopted as a useful tool in the diagnosis and treatment of male infertility.