Concentration Changes of MedroxyprogesteroneAcetate in Serum and Milk in Lactating Woman Who Used Depo Geston

Objective To determine the concentration changes of medroxyprogesterone acetate （MPA） in serum and milk in the Chinese lactating women who used Depo Geston Methods Ten postpartum and breastfeeding women received an injectable contraceptive of Depo Geston （depo medroxyprogesterone acetate, DMPA, 150 mg/ampoule）. Serum and milk samples were collected in the 1^st, 2^st, 4^th, 6^th, 8^th 10^th and 12^th week after contraceptive injection. The concentrations of medroxyprogesterone acetate （MPA） in serum and milk were determined by radioimmunoassay. Results The highest MPA concentration in serum was observed at the 1^st week and then the level of serum MPA decreased obviously at the 2^na and 4^th week. After the 4^th week, the decline of serum MPA level slowed down. The concentration of milk MPA reached the highest level at 1^th week. But at the 2^nd week the average level of MPA in milk dropped by half The MPA concentration in the milk was changed in the range of 5.2-8.3 ng/mL in the following 10 weeks. During observation, the average ratios of concentration and area under curve （AUC） in milk/serum were both 0.55. There was a wide variation in MPA concentrations and ratios of milk/serum between subjects. Conclusion MPA concentrations maintained a certaim level at the 12^th week after DMPA injection. However, whether mather＇s intake of DMPA during feeding period has effect on children＇s growth, espcially pubertal growth, deserves further studies.     

母乳对儿童哮喘的作用

母乳因为有着众多的优点,而成为婴儿期营养的最佳饮食,且一直被认为对儿童哮喘具有预防的作用。然而,随着近年的一些研究发现,此作用有待商榷。一些研究认为,母乳可能减少感染和特应性变态反应,因此而降低儿童哮喘的发生率;另一些研究认为,母乳对儿童哮喘发生无显著影响,甚至可能增加晚期哮喘的发生率;还有一些研究认为,母亲患有哮喘,其母乳可能增加儿童哮喘的患病率等。但对众多文献进行分析后,仍鼓励至少4～6个月纯母乳喂养。本文就以上进行研究相关论述。     

长效醋酸甲孕酮降低大鼠子宫内膜异位症模型中内膜RANTES的表达

目的：探讨长效醋酸甲孕酮(DMPA)对大鼠实验性子宫内膜异位症模型中正常T细胞表达和分泌的受激活调节因子RANTES表达的影响。方法：参照Jones方法建立大鼠子宫内膜异位症动物模型,将建模成功的大鼠随机分为对照组和DMPA治疗组,采用EI．ISA法检测两组子宫在位内膜、异位内膜和血清中RANTES的水平。结果：DMPA治疗组在位、异位内膜和血清中RANTES水平(中位数)分别为89．2,199．4,6 871．5 ng／L;对照组在位、异位内膜和血清中RANTES水平(中位数)分别为141．8,401．8,7 523．3 ng／L。DMPA治疗组在位内膜RAN—TES的水平与对照组比较,差异有显著性(P％0．05)；其异位内膜RANTES的水平与对照组比较,差异有极显著性(P<0．01)；两组血清中的RANTES水平差异无显著性(P>0．05)。结论：DMPA能有效降低子宫内膜异位症模型中内膜RANTES的表达。DMPA可能通过下调内膜RANTES的表达,抑制盆腔的炎性反应,从而缓解子宫内膜异位症患者的盆腔疼痛。     

消化过程中的火力控制对奶粉蛋白质测定的影响

目的分析和探讨消化过程中的规范操作对奶粉蛋白质测定的重要意义。方法对比分析69份奶粉样品经两次不同火力控制的消化处理后其蛋白质的测定结果。结果消化过程中对火力控制的不规范操作可导致平均9.21 g/100g的蛋白质损失。结论消化过程的火力控制对奶粉蛋白质测定影响很大;开展岗位实际操作培训具有重要意义。     

Injectable contraception

When deciding on the choice of a contraceptive, it is necessary to determine whether the method is to be permanent or reversible. If permanent, then the menstrual irregularities, the weight gain, headaches and subjective side effects of depot medroxyprogesterone acetate (DMPA) would suggest that it is not the most appropriate contraceptive for use up to the onset of menopause. Indeed there would be difficulty, given the frequent incidence of amenorrhea, in determining when this had occurred. If the contraception required is to be reversible, then it would be essential to inform the women that, provided she is of proven fertility, her chance of becoming pregnant after the use of DMPA is severely limited for 12 months after her last injection, and that she will have a conception rate of 75% by 15 months and 95% by 24 months. Very few women planning further pregnancies would tolerate that sort of delay in return of fertility, which makes the reliable spacing of their pregnancies impossible. DMPA seems not be the most appropriate agent for permanent contraception, for nulliparous women, for lactating women, or for women planning to space their pregnancies as accurately as possible. Sensitive discussion and accurate information on the advantages, disadvantages and relative reliability of all the available methods of contraception (hormonal, chemical, mechanical, barrier, and natural methods) should enable the woman, in consultation with her sexual partner and her medical practitioner, to choose the method most appropriate to her current and future needs. On the basis of the most recent information about DMPA, it is doubtful that DMPA will ever be the most appropriate choice.     

Palmitic and linoleic acids impair endothelial progenitor cells by inhibition of Akt/eNOS pathway

BACKGROUND: Endothelial progenitor cells (EPCs) are involved in adult neovasculogenesis and maintenance of vascular integrity. Scarce data have been provided for the individual effect of elevated free fatty acids (FFAs) on EPCs. This study was designed to investigate the association between Akt/eNOS signal pathway changes and the proliferation/function of EPCs in the presence of palmitic and linoleic acids. METHODS: After 14-day culture, EPCs were stimulated with different concentrations of palmitic and linoleic acids, with or without SNP, L-NAME, or LY294002. The proliferation and ability of adhesion, migration and tube structure formation of EPCs were observed and the level of phosphorylated Akt protein expression and eNOS protein expression were assayed. RESULTS: Incubation with palmitic and linoleic acids at concentrations of 0.2 muM or higher inhibited EPCs proliferation, significantly reduced migratory rate, reduced adhesion to fibronectin and impaired ability of EPCs to form tube structure in a dose-dependent manner. A simultaneous dose-dependent NO generation and Akt phosphorylation decrease as well as eNOS expression reduction at protein levels were also observed. However, all of the detrimental effects were attenuated by pretreating EPCs with SNP, NO donor. AKT and eNOS inhibitor, LY294002 and L-NAME, respectively, augmented palmitic and linoleic acids inhibitory effects on EPCs. CONCLUSIONS: These findings suggest that palmitic and linoleic acids downregulated AKT/eNOS signal pathway, which contributed to overall poor function and decrease proliferation of EPCs. These changes induced by palmitic and linoleic acids in signaling offer a novel explanation for the overall poor function of EPCs in diabetes mellitus.     

Pertubation with lignocaine--a possible new treatment for women with endometriosis and impaired fertility

The causal relationship between reduced fertility and early stage endometriosis without pelvic adhesions is unclear. Peritoneal fluid from patients with endometrial peritoneal implants contains more leukocytes with an increased capacity to phagocytose spermatozoa. Peritoneal fluid supplemented with lignocaine has a reduced sperm phagocytosis capacity. The present clinical study with low-dose lignocaine pertubation sought to evaluate any clinical effect on fertility. An overall pregnancy rate of 30% was noted in contrast to the natural pregnancy rate for women with endometriosis which is <5%. To confirm these findings a larger study and further dose-ranging are in progress. Up to now the most effective way of increasing fertility for women with endometriosis or unexplained infertility is in vitro fertilisation (IVF). The pertubation treatment with lignocaine is inexpensive and less invasive. Its mechanism is thought to be reduced phagocytosis of the spermatozoa. Another explanation could be a regressive effect directly on the endometriotic implants, taking into account the reduced menstrual pain and increased pregnancy rate after all treatments have been completed. The finding may provide a minimal invasive and more cost-effective alternative to current treatments.     

B超介导下穿刺诊断与治疗卵巢巧克力囊肿

目的 探讨B超介导下囊肿穿刺术对卵巢巧克力囊肿的诊断价值和治疗意义。方法 对52例临床诊断巧克力囊肿患者在B超下行肿囊穿刺术，以囊液性状和涂片病理作出诊断，同时对部分诊断囊肿者囊腔内注入甲孕酮。随访12个月以上。结果 经穿刺术校正诊断7例（13．46％）。穿刺术使患者近期症状缓解率达100％，甲孕酮可使复发率显著减低。复发病例可行第二次穿刺术并加甲孕酮治疗仍有效。结论 B超下的囊肿穿刺术是对卵巢巧克力囊肿的一种可行的微创性诊断与治疗方法，甲孕酮囊腔内给药和术后维持治疗能有效地控制症状和促使异位病灶萎缩。     

Nutrient composition of milk produced by mothers of preterm infants in Nigeria

Nutrient composition was determined in breast milk obtained by manual expression from 12 mothers who delivered prematurely (mean 32 weeks) and 15 mothers who delivered at term (mean 39.4 weeks), on days 3, 7, 14, 21 and 28 postpartum. Complete 24-hour milk expressed by five term mothers and seven preterm mothers on days 7, 14, 21 and 28 lactational ages was also recorded. In both preterm and term mothers' milk, lactose and fact concentrations increased with lactational age, while protein and mineral concentrations decreased. The preterm mothers' milk contained higher concentrations of protein, fat and minerals and lower concentrations of lactose than term mothers's milk. The fat and caloric density of milk of the mothers in this study, who were mostly of low social class, was lower than that reported from Western countries. The implication of this finding for feeding premature infants in developing countries is discussed.     

Preliminary validation of tumor cell attachment inhibition assay for developmental toxicants with mouse S180 cells

lNTRoDLJcnoNThecoordinationbetweencell-cellandcell-extracellularmatrix(ECM)interactionsplayanimpoItantroleinpatternformation,differentiationandmorPhogenesis.TheseinteractionsareverycomPlexandrelyonthebiophysicalstabilityofthecellsurface(Damskyetal.ll993;Martins-GreenandBissell,l995).Anyagentdisturbingcellsurfacefunctionmayinterferewiththoseinteractions,regardlessofthemechanismsofaction,andInaybeapo-tentialdevelopmentaltoxicant.Becauseitisverydifficulttocomprehensivelystudyinvicoeffectso…     

Depo medroxyprogesterone acetate (DMPA) and combined oral contraceptives and cervical carcinoma in-situ in women aged 50 years and under

Most low-resource settings depend on hormonal contraceptives for their family planning programmes and cervical cancer occurs in higher frequency in these populations. To determine whether hormonal contraception use increases cervical carcinoma in-situ (CIS) risk, a case-control study was conducted in the Kingston and St Andrew Corporate area of Jamaica, using 119 cases from the Jamaica Tumour Registry and 304 population controls matched on year of Papanicolaou (Pap) smear and clinic where Pap smear was obtained. While CIS cases were more likely to have 'ever used' combined oral contraceptives (COC) (OR = 1.4, 95% CI: 0.8, 2.5), depo-medroxyprogesterone acetate (DMPA) use was similar. Compared to women who never used hormonal contraceptives, the risk of CIS was elevated in: women who had used COCs five years or more (OR = 2.1, 95% CI: 1.0, 4.6), women who first used COC for less than 10 years prior to the interview (OR = 1.8, 95% CI: 0.9, 3.7) and women who were 18 to 24 years old when they first used COCs (OR = 1.8, 95% CI: 0.9, 3.4). Similarly, compared to women who never used DMPA, the risk of CIS was elevated in: women using DMPA five years or more (OR = 1.9, 95% CI: 0.7, 4.8), women reporting use within a year prior to interview (OR = 2.8, 95% CI: 0.7, 10.7) and women who initiated use of DMPA when they were 20 and 24 years old (OR = 1.4, 95% CI: 0.7, 3.1). These results suggest that if hormonal contraceptive use confers any risk of CIS, it is confined to long-term users. Increased risk in some groups, however, warrant further study.     

Anticonvulsants in pregnancy

OBJECTIVE: To review the potential problems and their management associated with the use of anticonvulsant drugs during pregnancy. DATA SOURCES: Studies published between 1968 and 1990 assessing the effect of pregnancy on the pharmacokinetics of anticonvulsant drugs, the teratogenicity of anticonvulsants, breast feeding and anticonvulsants and use of the oral contraceptive pill in patients taking anticonvulsant medication, were reviewed. RESULTS OF DATA SYNTHESIS: In general, plasma levels fall during pregnancy and rise during the puerperium. A number of factors including possible reduced absorption, increased volume of distribution, reduced protein binding, increased clearance and noncompliance, contribute to this fall in plasma concentration. All anticonvulsants are potentially teratogenic. The incidence of fetal malformations is higher in patients treated with multiple anticonvulsant drugs and on higher dosages with higher plasma levels. Anticonvulsants are excreted in low concentrations in breast milk. All anticonvulsants except valproic acid have been associated with failure of the oral contraceptive pill. This is due to liver enzyme induction of these drugs. CONCLUSION: As plasma levels of anticonvulsants fall during pregnancy, concentrations should be monitored regularly. Due to the fall in protein binding, marginally low total plasma levels of highly protein bound drugs may not reflect reduced unbound levels, and hence an increase in dosage may not be required. In order to reduce teratogenicity, one should aim to use a single anticonvulsant drug and the lowest dosage able to achieve seizure control. In general, breast feeding is not contraindicated.     

Preventively enteral application of immunoglobulin enriched colostrums milk can modulate postoperative inflammatory response

Several studies demonstrated acute inflammatory response following traumatic injury. Inflammatory response during surgical interventions was verified by a significant increase of endotoxin plasma levels and a decrease of the endotoxin neutralizing capacity (ENC). However, the incidence of elevated endotoxin levels was significantly higher (89%) than detected bacterial translocation (35%). Thus parts or products of Gram-negative bacteria seem to translocate more easily into the blood circulation than whole bacteria. Along with the bacterial translocation, the inflammatory response correlated directly with the severity of the surgical intervention. In comparison after major and minor surgery Interleukin-6 (IL-6) and C-reactive protein (CRP) was also significantly different. Similar effects in mediator release were shown during endovascular stent graft placement and open surgery in infrarenal aortic aneurysm. Open surgery demonstrated a significant stronger endotoxin translocation and a decrease of ENC. Strategies to prevent translocation seem to be sensible. Colostrum is the first milk produced by the mammary glands within the first days after birth. It contains a complex system of immune factors and has a long history of use in traditional medicine. Placebo-controlled studies verified that prophylactic oral application of immunoglobulin-enriched colostrum milk preparation diminishes perioperative endotoxemia, prevents reduction of ENC and reduces postoperative CRP-levels, suggesting a stabilization of the gut barrier. This effect may be caused by immunoglobulin transportation by the neonatal receptor FcRn of the mucosal epithelium.In conclusion, there is an association of perioperative endotoxemia and the subsequent increase in mediators of the acute phase reaction in surgical patients. A prophylactic oral application of colostrum milk is likely to stabilize the gut barrier i.e. reduces the influx of lipopolysaccharides arising from Gram-negative bacterial pathogens and inhibits enterogenic endotoxemia. This appears to be a major mechanism underlying the therapeutic effect in patients at risk for Gram-negative septic shock.     

血清源酸热稳定多肽对伤口组织细胞增殖作用的研究

目的：研究一种对酸热稳定的多肽制剂对伤口组织细胞增殖反应的作用及机理。方法：利用从猪血清中分离出的一组对酸热稳定的多肽（ＡＨＳＰ）以及从国外购得的牛血清除大分子蛋白后的多肽成分，观察两种多肽制剂在培养的伤口组织修复细胞及人表皮细胞增殖和细胞总蛋白合成能力中的作用。结果：当Ｓｏｌｃｏｓｅｒｙｌ和ＡＨＳＰ的浓度低于７％时，其对伤口修复细胞和人离体培养的表皮细胞的增殖和蛋白合成能力随浓度增加而增加，浓度     

Macrolide antibiotics directly reduce active oxygen generation by neutrophils in human peripheral blood

Since a "low-dose and long-term" administration of erythromycin (EM) was reported to be effective in patients with chronic respiratory diseases, including diffuse panbronchiolitis (DPB), the modulation of host defense responses by EM has attracted much attention. Despite considerable controversy, it was recently demonstrated that macrolides reduced neutrophil function. In this study, we investigated the effects of EM, a 14-membered ring macrolide, azithromycin (AZM), a 15-membered ring macrolide, and rokitamycin (RKM), a 16-membered ring macrolide, on neutrophil function in terms of active oxygen generation of neutrophils in the absence and presence of mononuclear cells in vitro. EM and AZM significantly suppressed active oxygen generation by neutrophils in the absence of mononuclear cells at low concentration (0.5 microgram/ml. p < 0.05). At the next step, to confirm that EM and AZM directly reduced active oxygen generation by neutrophils, we investigated whether mononuclear cells affected this effect of EM and AZM. In the presence of mononuclear cells pretreated with EM or AZM, both antibiotics suppressed active oxygen generation at concentrations ranging from 0.5 to 20 micrograms/ml. However, the inhibition rates induced by EM and AZM at low concentrations were not so different between the absence and the presence of mononuclear cells. These results indicated that EM and AZM have direct effects on the active oxygen generation by neutrophils and those effects that were not influenced by mononuclear cells. This inhibitory effect may be responsible for the therapeutic efficacy of these 14-membered and 15-membered ring macrolides in patients with DPB.     

Fatty acid composition and possible health effects of coconut constituents

The link between excessive consumption of dietary saturated fats and coronary heart disease (CHD) is now well established. Because of its high content of saturated fatty acids, the consumption of foods containing coconut oil may therefore be a risk factor for CHD. While the fatty acid composition of coconut oil is well established, relatively little is known about the other constituents of coconut: the milk, water, cream and meat fractions. In this study, we show that while the water fraction is low in lipid content, the milk contains about 24% of the fat content of oil and the cream and meat fractions about 34%. The other coconut constituents contain significant amounts of medium-chain triglycerides that are formed from fatty acids of chain length 8:0 to 14:0. It is these fatty acids, primarily 14:0, that are thought to be atherogenic. On the other hand, medium-chain triglycerides may be advantageous under some circumstances in that they are absorbed intact and do not undergo degradation and re-esterification processes. As a result, medium-chain triglycerides provide a ready source of energy and may be useful in baby foods or in diet therapy. Nevertheless, the possible negative effects of the saturated fatty acids and the absence of the essential fatty acid linolenic acid from all coconut constituents suggest that the coconut milk, oil and cream should not be used on a regular basis in adults.     

The excretion of nicotine in breast milk and urine from cigarette smoking: its effect on lactation and the nursing

A study was conducted to determine the effects of nicotine on lactation and the nurslings. 55 white volunteers between 18-36 years of age, both multiparas and primiparas, who smoke habitually were studied. Nicotine was found to be present in all milk and urine specimens obtained from smoking mothers. Comparison with nonsmoking mothers showed that no specimen of their urine or milk contained nicotine. 11-17 times more nicotine was contained in the urine than in the milk samples. There was a correlation between the amount of nicotine in either the urine or the milk and the number of cigarettes smoked. 20% of the mothers in the study had insufficient milk to continue lactation, but this was no higher than the usual percentage of women who fail to sustain lactation. The nurslings were apparently unaffected by the nicotine they ingested with their breast milk. It is suggested that a tolerance to nicotine may prevent the nicotine from affecting either the mothers' ability to nurse or the infants.     

饮奶行为在家庭社会经济状况与儿童青少年体重指数间的中介作用

目的: 研究家庭社会经济状况(socio-economic status, SES)与儿童青少年体重指数(body mass index, BMI)z评分的关系,以及家庭SES如何通过影响儿童青少年的饮奶行为作用于儿童青少年的BMI z评分。方法: 采用分层整群抽样的方法按城市中学、城市小学、乡村中学、乡村小学各抽取4所学校,共有2 496名学生及其家长作为研究对象。通过7 d饮食行为问卷得到学生每周饮奶次数和日均饮奶份数。采用父母最高文化程度和家庭月收入反映家庭SES。利用统计软件SPSS 18.0中PROCESS插件程序分析儿童青少年饮奶行为在家庭SES和儿童青少年BMI z评分关系中的中介作用。结果: 父母最高文化程度、家庭月收入与儿童青少年BMI均呈正相关(P值分别为 0.001, 0.038)。总人群的日均饮奶份数为(0.92±0.84)份,每周饮奶次数为(4.43±2.70)次。小学生、城市、父母最高文化程度、家庭月收入、非肥胖与每周饮奶次数和日均饮奶份数多有关(P值均 < 0.05)。儿童青少年饮奶行为在家庭SES与儿童青少年BMI z评分关系中起部分中介作用。每周饮奶次数在父母最高文化程度和家庭月收入与BMI z评分关系中的中介效应占总效应的比例分别为-6.57%和-10.21%。日均饮奶份数在父母最高文化程度和家庭月收入与BMI z评分关系中的中介效应占总效应的比例分别为-3.63%和-5.86%。结论: 我国儿童青少年饮奶行为还有待提高;儿童青少年饮奶行为在家庭高SES与儿童青少年高BMI z评分关系中起部分中介作用,为儿童青少年肥胖的保护因素;未来还需对其他饮食或运动行为进行研究,以探索家庭SES与儿童青少年BMI z评分关系之间的机制,从而进行有针对性的干预。     

Inhibitive effect of cremophor RH40 or tween 80-based self-microemulsiflying drug delivery system on cytochrome P450 3A enzymes in murine hepatocytes

This study examined the effect of self-microemulsiflying drug delivery system (SMEDDS) containing Cremophor RH40 or Tween 80 at various dilutions on cytochrome P450 3A (CYP3A) enzymes in rat hepatocytes, with midazolam serving as a CYP3A substrate.The particle size and zeta potential of microemulsions were evaluated upon dilution with aqueous medium.In vitro release was detected by a dialysis method in reverse.The effects of SMEDDS at different dilutions and surfactants at different concentrations on the metabolism of MDZ were investigated in murine hepatocytes.The cytotoxicity of SMEDDS at different dilutions was measured by LDH release and MTT technique.The effects of SMEDDS on the CYP3A enzymes activity were determined by Western blotting.Our results showed that dilution had less effect on the particle size and zeta potential in the range from 1:25 to 1:500.The MDZ was completely released in 10 h.A significant decrease in the formation of 1’-OH-MDZ in rat hepatocytes was observed after treatment with both SMEDDS at dilutions ranging from 1:50 to 1:250 and Cremophor RH 40 or Tween 80 at concentrations ranging from 0.1% to 1% (w/v), with no cytotoxicity observed.A significant decrease in CYP3A protein expression was observed in cells by Western blotting in the presence of either Cremophor RH40 or Tween 80-based SMEDDS at the dilutions ranging from 1:50 to 1:250.This study suggested that the excipient inhibitor-based formulation is a potential protective platform for decreasing metabolism of sensitive drugs that are CYP3A substrates.