孕激素受体与分娩发动

人类分娩发动的原因十分复杂,其中功能性孕激素撤退学说倍受关注.妊娠期间,高浓度孕激素维持子宫的静止状态,很多哺乳动物分娩时孕激素水平是下降的,但人类分娩发动时血中孕激素水平并不下降.目前认为,可能是孕激素受体表达异常导致孕激素功能下降.重点阐述孕激素核受体及膜受体的结构、亚型及表达,并对核受体及膜受体在分娩发动过程中的作用机制及其调节因素进行综述.     

雌、孕激素受体分布变化对分娩发动的影响

雌、孕激素与相应受体结合,发挥特定的生物学效应在分娩发动中的作用日益受到重视.它们有可能是参与分娩发动起始环节的一部分.目前研究已经证实,孕激素能够抑制雌激素的作用,通过维持子宫的静息状态来维持妊娠.正常足月妊娠末至分娩发动前,孕激素的表达水平并未显著降低;而孕激素受体亚型A/B的比值增加,抑制了活性型孕激素受体亚型B的转录活性,同时也诱导雌激素受体的表达增加.从而介导功能性孕激素撤退和雌激素功能的激活,子宫的静息状态被打破,开始协调收缩,分娩发动.因此,雌激素受体/孕激素受体的表达变化在分娩发动的环节中可能比雌、孕激素有着更为重要的意义.     

功能性孕激素撤退与分娩发动

人类对分娩发动机制尚不清楚,因对分娩机制缺乏了解而无法主动选择合适时机计划分娩以降低母儿死亡率.目前,关于分娩发动机制有几种假说,其中功能性孕激素撤退学说因孕激素在妊娠中的重要作用而倍受关注,即人类分娩发动时局部组织孕激素的功能下调,而不是孕激素水平下降.孕激素受体-A/孕激素受体-B值升高是功能性孕激素撤退的基础,孕激素受体-B可上调孕激素激活基因的表达,而孕激素受体-A则下调孕激素的反应活性,即孕激素受体-A/孕激素受体-B值升高削弱孕激素对雌激素的调节性抑制作用,使得雌激素受体的表达增加,进而上调雌激素的功能及促收缩基因的表达,从而使子宫失去静止状态而诱发分娩.     

雌、孕激素受体的表达对分娩发动的影响

目的 检测雌、孕激素受体在自然临产经阴道分娩以及选择性剖宫产产妇胎盘组织中的表达,探讨雌、孕激素受体的表达对分娩发动的影响及机制.方法 运用免疫组化法检测22例自然临产经阴道分娩产妇(实验组)胎盘组织中雌、孕激素受体的表达情况;以18例选择性剖宫产为对照组,并结合临床资料对实验数据进行统计学分析.结果 ①实验组和对照组产妇胎盘组织中孕激素受体阳性率分别为(73.79±13.09)%和(74.02±14.40)%,两组经比较差异无统计学意义(t=0.094,P>0.05):②实验组和对照组产妇胎盘组织中的雌激素受体阳性表达率分别为(86.11±14.90)%和(82.65±14.30)%,两组经比较雌激素受体表达水平变化不大,差异无统计学意义(t=-1.374,P>0.05).结论 人类妊娠末期至分娩发动前,雌、孕激素受体在产妇妊娠组织中的表达水平均无显著下降.功能性孕激素撤退可能就是分娩发动的启动因素.     

孕激素受体与分娩发动

人类分娩发动的原因十分复杂,其中功能性孕激素撤退学说倍受关注。妊娠期间,高浓度孕激素维持子宫的静止状态,很多哺乳动物分娩时孕激素水平是下降的,但人类分娩发动时血中孕激素水平并不下降。目前认为,可能是孕激素受体表达异常导致孕激素功能下降。重点阐述孕激素核受体及膜受体的结构、亚型及表达,并对核受体及膜受体在分娩发动过程中的作用机制及其调节因素进行综述。     

CRH-Rs与应激、分娩的关系研究进展

促肾上腺皮质激素释放激素受体在妊娠分娩过程中发挥着重要作用 ,其受促肾上腺皮质激素释放激素影响 ,介导一系列病理生理反应。研究促肾上腺皮质激素释放激素受体的水平与分娩的关系 ,探索其结构 ,及其在应激、分娩中的病理生理学作用有着重要意义。     

拉玛泽减痛分娩法的效果观察

目的 运用"拉玛泽减痛分娩法"减轻产痛和缩短产程,减少并发症的发生.方法 对参加"拉玛泽减痛分娩法"学习的35例产妇与同期没有采取"拉玛泽减痛分娩法"的35例产妇作对照,并作统计分析.结果 "拉玛泽减痛分娩法"既可减轻疼痛也可以缩短产程.     

CRH-Rs与应激、分娩的关系研究进展

促肾上腺皮质激素释放激素受体在妊娠分娩过程中发挥着重要作用，其受促肾上腺皮质激素释放激素影响，介导一系列病理生理反应。研究促肾上腺皮质激素释放激素受体的水平与分娩的关系，探索其结构，及其在应激、分娩中的病理生理学作用有着重要意义。     

品管圈在提高产妇镇痛分娩宣教中的应用

目的探索品管圈活动在提高产妇镇痛分娩宣教效果中的应用效果。方法由医院麻醉科,产科共4名医生,2名护士联合组成一个"圈",确定以"提高产妇入院镇痛分娩知晓率"为活动主题,运用PDCA循环,分析影响产妇入院镇痛分娩宣教知晓率的因素并采取相应的措施,实施质量持续改进。结果产妇入院镇痛分娩宣教知晓率由活动前的18. 1%提高到活动后的98. 2%,目标达成率为156%。结论通过品管圈活动,运用质量控制手法,提高了医护人员镇痛分娩积极性,提高了产妇镇痛分娩知晓率。     

妊娠和分娩痛调节中的阿片肽机制

在人和动物的妊娠及分娩中均见母体的疼痛阈值增加,模拟妊娠时的性激素变化也可明显诱导镇痛作用。脊髓内源性ｋ及δ阿片受体系统激活是妊娠和分娩镇痛所必需的,且二者之间有明显的协调镇痛作用,而在基础条件下起主要作用的μ阿片受体镇痛系统似乎不参与妊娠镇痛。ｋ或／和δ阿片受体类新型镇痛药将有希望用于妊娠和分娩镇痛。     

胎盘促肾上腺皮质激素释放激素的作用与调控

胎盘分泌的大量下丘脑内分泌激素促肾上腺素皮质激素释放激素 ,是妊娠期母体血浆促肾上腺素皮质激素释放激素的主要来源。胎盘促肾上腺素皮质激素释放激素可能通过与前列腺素、催产素、皮质激素和雌激素等内分泌激素的相互作用 ,对分娩启动起着重要的作用。妊娠期母体血浆促肾上腺素皮质激素释放激素水平与早产及某些妊娠期疾病关系密切。胎盘促肾上腺素皮质激素释放激素的分泌受促肾上腺素皮质激素释放激素结合蛋白、环磷酸腺苷、糖皮质激素、催产素、孕激素、雌激素、前列腺素、一氧化氮和某些神经递质等多因素的调控。     

促肾上腺皮质激素释放激素受体的研究进展

促肾上腺皮质激素释放激素及其相关肽通过激活G-蛋白藕联的促肾上腺皮质激素释放激素受体在人体多系统中发挥作用.妊娠和非妊娠子宫肌及子宫底、子宫下段CRH结合能力和功能的不同可能与不同受体亚型表达多少相关.促肾上腺皮质激素释放激素受体拮抗剂的研发为治疗可卡因戒断反应、焦虑症和抑郁症开辟了新方向.     

Cell surface adhesion molecules: structure, function, clinical aspects]

Intercellular and cell-matrix interactions play a crucial role in several physiological and pathological processes. These relationships are based on different cell adhesion molecules. Although adhesion receptors exhibit structural diversity, cell adhesion mechanisms are basically similar to each other. Details of receptor functions (e.g. the exact mechanisms of signal transduction) is poorly understood. In this paper authors summarize data on different cell adhesion antigens and also describe a few important biological features to collect more data on the complex interactions of these molecules.     

Adhesion molecules: relevance to basic and clinical research]

Adhesion molecules play a major role in many biological and pathological processes and are essential to the development and construction of tissue architecture. During inflammatory processes, adhesion molecules are also pivotally involved in both cell migration and cell activation through the involvement in the two reverse directional signaling; 1) the expression or function of adhesion molecules is regulated through "inside-out" signaling which is induced by the stimulation such as cytokines, 2) adhesion molecules not only function as a glue but also transduce extracellular information into cytoplasmic organelle through "outside-in" signaling, which induces cellular activation. The concept concerning adhesion molecules would bring enormous benefits to clarify pathological processes of various inflammatory diseases and cancer metastasis as well as the new pharmacological approaches to these diseases.     

Effects of corticotropin-releasing hormone receptor antagonists on the ethanol-induced increase of dynorphin A1-8 release in the rat central amygdala

Neurons in the central amygdala (CeA) co-express dynorphin and corticotropin-releasing hormone (CRH). Moreover, the activity of both the CRH and dynorphin systems in CeA is altered by alcohol treatments, effects suggesting interactions between the CRH and dynorphin systems. Thus, the objectives of the present study were to investigate the effects of (1) activating CRH receptors (CRHRs) by microinjection of CRH in CeA and (2) blocking CRHRs by local microinjections of CRHR antagonists in the CeA on the alcohol-induced changes in the extracellular concentrations of dynorphin A1-8 with in vivo microdialysis experiments. Microdialysis probes with a microinjection port were implanted in the CeA of alcohol-naïve Sprague–Dawley rats. Microinjections of CRH or antalarmin, a CRH receptor type 1 (CRHR1) antagonist, or anti-sauvagine-30, a CRH receptor type 2 (CRHR2) antagonist, at the level of CeA were followed by an intraperitoneal injection of either saline or 2.8 g ethanol/kg body weight. The content of dynorphin A1-8 was determined in dialyzate samples obtained prior to and following the various treatments using a specific radioimmunoassay. Activation of CRHRs in CeA induced an increase in the extracellular concentrations of dynorphin A1-8. Moreover, acute alcohol administration increased the extracellular concentrations of dynorphin A1-8 in CeA, an effect that was attenuated by blocking CRHR2 with anti-sauvagine-30 microinjection but not blocking CRHR1 with antalarmin microinjection. Therefore, the findings suggest an interaction between the CRH and dynorphin A1-8 systems at the level of CeA in response to acute alcohol exposure.     

CRH及其受体-1在分娩发动中的作用

目的比较早产及足月分娩剖宫产产妇血清肾上腺皮质激素释放激素（CRH）水平及子宫下段中促肾上腺皮质激素释放激素受体-1（CRH-R1）的表达情况,分析其在分娩发动中的作用。方法按难免早产、足月分娩发动、足月分娩未发动分为3组,术前测定血清中CRH水平,于剖宫产中取子宫下段平滑肌,用免疫组化的方法检测CRH-R1在子宫下段的表达。结果3组间CRH水平差异无统计学意义（P〉0．05）,均为孕期较高水平。难免早产组、足月分娩发动组CRH-R1在子宫下段肌层中呈高表达状,其表达指数明显高于足月分娩未发动组（t值分别为5．000、6．295,均P〈0．05）。难免早产组、足月分娩发动组CRH-R1在子宫下段肌层中的表达差异无统计学意义（P〉0．05）。结论CRH为参与人类分娩启动因子之-。母体血浆CRH水平有望作为早产预测和预后指标,其作用的发挥还有赖于子宫体中CRH-R1的表达。     

血浆促肾上腺皮质激素释放激素与妊娠期疾病关系的临床研究

目的:探讨治疗早产药物,早产、贫血、肝功能损害及妊娠期胆汁淤积症对妊娠期血浆促肾上腺皮质激素释放激素(CRH)水平的影响。方法:以放射免疫方法测定正常妊娠以及早产等妊娠期疾病时母体CRH水平的变化。结果:各孕周早产孕妇血浆CRH较正常对照孕妇显著升高(P<0.05)。经有效药物治疗后,血浆CRH明显回落。贫血、肝功能损害及足月妊娠合并胆汁淤积症可使血浆CRH水平升高(P<0.05)。孕37周前妊娠合并胆汁淤积症对血浆CRH水平无影响(P>0.05)。结论:妊娠期血浆CRH水平与早产关系密切,有可能成为预测早产的有效指标。以血浆CRH水平预测早产时,应注意排除贫血及肝功能损害的影响。     

妊娠晚期静脉滴注小剂量缩宫素引产的护理

目的　探讨妊娠晚期静脉滴注小剂量缩宫素引产的护理。　方法　缩宫素 2 .5IU加入 5 %葡萄糖注射液5 0 0ml中 (浓度 0 .5 % )静脉滴注 ,视宫缩情况增减滴速 ,必要时增加浓度 ,最大滴速不超过 40滴 /min ,最大浓度 1% ,一日用量不超过 10 0 0ml。　结果　引产总成功率 92 .86% ,临产平均时间 ( 3 .0 8± 1.2 8)h ,总产程 ( 8.5 8± 2 .41)h。　结论掌握引产指征 ,规范缩宫素静滴引产护理操作 ,可有效降低母儿患病率。     

催产素及受体基因与抑郁症相关性的研究进展

目的 分析催产素及其受体基因与抑郁症的相关性及在治疗中的作用。方法 在Web of Science、PubMed、CNKI、万方和维普数据库中以“催产素”(“oxytocin”、“OT”)、“催产素受体基因”(“oxytocin receptor gene”)和“抑郁症”(“depression”、“depressive disorder”)为主题词进行检索,截至2019年筛选纳入文献38篇。结果 催产素及受体基因可能通过抑制下丘脑-垂体-肾上腺轴、促进海马神经细胞增殖分化及遗传效应等机制对抑郁症发挥作用,但由于作用的复杂性及研究因素的差异,导致目前研究结论不一致。结论 催产素及受体基因与抑郁症有一定的相关性和治疗潜力,但仍需进一步深入研究证实。     

Effect of fatty acids on expression of endothelial leukocyte adhesion molecules

Summary.Background: With respect to linoleic acid both beneficial and proatherogenic effects have been described. However, the effect on expression of cell adhesion molecules on human coronary artery endothelial cells (HCAEC) is not yet established. The aim of the experiments was to evaluate the influence of linoleic acid in comparison with palmitic acid regarding the cytokine-induced expression of endothelial leukocyte adhesion molecules (intercellular cell adhesion molecule-1 ICAM-1, vascular cell adhesion molecule-1 VCAM-1, E-selectin).Methods: HCAEC were cultured in microvascular endothelial cell growth medium. In the experiments, the cells were preincubated with linoleic acid and palmitic acid, respectively (10 µmol/l, 2 days) or under control conditions, after which interleukin- 1 (IL-1, 10 ng/ml in the test medium) was added for 1 day. The monoclonal antibodies used were fluorescein isothiocyanate (FITC)- labeled anti-ICAM-1, FITC-labeled anti-VCAM-1, and FITC-labeled anti-E-selectin. Expression was analyzed by flow cytofluorimetry. Next, to examine the effects of fatty acids on adhesion of monocytes to endothelial cells, adhesion experiments with the monocytic U 937 cell line were performed.Results and conclusions: IL-1 increased ICAM-1,VCAM-1, and E-selectin expression compared to controls. Incubation with IL-1 together with linoleic acid reduced the expression of ICAM-1 and VCAM-1 in contrast to palmitic acid. Furthermore, in the presence of linoleic acid a tendency of diminished adhesion of monocytes is seen.The results indicate that a reduced expression of cell adhesion molecules may be relevant to the antiatherogenic effects of linoleic acid. This is in contrast to the properties of palmitic acid.