乙型肝炎病毒血清学标志物阳性的产妇乳汁母婴传播的研究

采用固相放射免疫法（ＲＩＡ）检测８８例产妇血清乙型肝炎标志物（ＨＢＶ－Ｍ）阳性的初乳，其中ＨＢＶ－Ｍ（＋）者２０例，阳性检出率为２２．７３％，表明血清ＨＢＶ－Ｍ（＋）产妇乳汁中存在ＨＢＶ－Ｍ，且大三阳者排毒率最高，达３０．７７％。同时对初乳ＨＢＶ－Ｍ（＋）者２０例及ＨＢＶ－Ｍ（－）者２０例进行动态监测过渡乳及成熟乳，结果初乳ＨＢＶ－Ｍ（－）者过渡乳和成熟乳ＨＢＶ－Ｍ可为阳性，说明动态观察乳汁中ＨＢＶ－Ｍ很有必要。     

活性初乳素对吸臭氧小鼠的抗衰老作用

小鼠吸臭氧以后,使机体的助氧化-抗氧化系统平衡失调,引起了体温、体重和体力下降,免疫器官萎缩与自由基代谢有关的酶(MAO-B、MDA)活性改变,产生了一系列衰老现象,服用了活性初乳素以后,明显改善上述症状,达到抗衰老目的。     

牛初乳提取物对小鼠免疫功能的影响

目的：探讨牛初乳提取物对小鼠免疫功能的影响。方法：根据免疫毒理学方法原理,用二硝基氟苯诱导小鼠迟发性变态反应（DTH）：测定小鼠血清溶血（HC50）;进行小鼠碳廓清试验（MMI）。结果：每天补充牛初乳提取物250mg/kg体重时,20天后能明显增强小鼠细胞免疫功能、体液免疫功能和单核--巨噬细胞吞噬功能。结论：牛初乳提取物对小鼠免疫功能有增强作用。     

速泌通乳贴对初产妇产后缺乳的临床观察

目的探讨速泌通乳贴对初产妇产后泌乳的影响,为临床产后缺乳提供有效方法。方法以70例足月初产妇为研究对象,随机分为速泌通乳贴组（35例）和生乳灵组（35例）,以生乳灵组为对照,观察速泌通乳贴对初产妇泌乳量、泌乳始动时间及产后48h血清泌乳素（PRL）的影响。结果两组泌乳量积分随治疗时间的推移,呈上升趋势。两组泌乳量积分在治疗开始后第2天、第3天、第7天分别比较,差异具有统计学意义（P〈0．05）。两组泌乳始动时间比较,差异具有统计学意义（P〈0．01）。两组产后48h血清PRL比较,差异具有统计学意义（P〈0．01）。结论速泌通乳贴能明显增加初产妇的泌乳量,提前泌乳始动时间,提升产后48h血清PRL,延缓乳汁分泌减少,保证婴幼儿营养需要。     

剖宫产术后两种镇痛方法对产妇泌乳及产后恢复的影响

【目的】探讨剖宫产术后两种阵痛方法对产妇泌乳及产后恢复的影响。【方法】分析2008年1月至2010年12月本院收治的120例健康足月产妇择期在联合椎管内麻醉下施行剖宫产术的临床资料。术后在知情同意的原则下,按镇痛方式的不同,随机分为行0．2％罗比卡因（5 mL／h）的硬膜外自控镇痛（PCEA）组（A组）和曲马多10 mg／kg ＋氟哌利多5 mg 的静脉自控镇痛（PCIA ）组（B组）,每组60例。两组均持续48 h镇痛。观察产妇血浆泌乳素（PRL ）水平、初乳时间、肠蠕动恢复时间及并发症发生情况。【结果】两组术后PRL 水平均较术前明显升高（ P ＜0．01）,A组PRL高于B组,术后24 h有显著性差异（ P ＜0．05）,48 h有极显著性差异（P ＜0．01）。A组初乳时间、肠蠕动恢复时间较B组均提前（P ＜0．05）,A组术后生命体征平稳,无恶心呕吐、头痛、肢体麻木发生,B组术后有5例出现恶心呕吐、头痛、盗汗现象,无其他不适。【结论】剖宫产术后罗比卡因PCEA镇痛效果确切安全,更能促进PRL分泌,有利于产妇泌乳,哺乳。     

不同分娩方式产妇产后血清催乳素水平、自评泌乳量及初乳中生长因子浓度

目的:比较自然分娩与剖宫产产妇产后2～5天自评泌乳量、产后6～24h血清中催乳素(PRL)以及初乳中胰岛素样生长因子-1(IGF-1)、表皮生长因子(EGF)浓度的差异。方法:在医院产科对招募的志愿者收集产后6～24h的血清及产后2～5天的初乳。采用化学发光免疫分析法测定自然分娩组与剖宫产组PRL的含量,采用生物素-亲和素酶联免疫吸附试验测定两组初乳中IGF-1和EGF的浓度。结果:自然分娩组产后血清PRL浓度为(361.67±80.74)ng/ml,剖宫产组为(221.94±90.82)ng/ml,两组之间差异有统计学意义(P0.05)。产后2～3天,剖宫产组初乳中IGF-1浓度高于自然分娩组(P0.05),而自评泌乳量低于自然分娩组(P0.05)。产后4～5天,两组IGF-1浓度及自评泌乳量差异无统计学意义(P0.05)。产后2～5天,剖宫产组EGF浓度略高于自然分娩组,但两组差异无统计学意义(P0.05)。结论:剖宫产组产妇早期初乳中较高的IGF-1以及血清中较低的PRL水平与泌乳延迟和泌乳量相关,建议剖宫产后产妇仍应坚持早接触、早吸吮,提倡早期母乳喂养。     

两种不同的母婴同室对母乳成分的影响──初乳中锌铁钙硒的研究

测定了母婴同室正常产妇初乳中的锌、铁、钙和硒的浓度，结果符合联合国卫生组织的母乳微量元素范围。在温馨爱屋（在丈夫陪伴的家庭化母婴同室病房）里休养的产妇的初乳中锌、铁、钙和硒的含量明显地高于一般母婴同室病房的产妇。     

Phagocytosis of Giardia lamblia trophozoites by human colostral leukocytes

AIM: To determine the phagocytic activity of the polymorphonuclear and mononuclear cells present in human colostrum, and to verify the influence of opsonins in the adherence, ingestion and killing of Giardia lamblia trophozoites. METHODS: Polymorphonuclear and mononuclear phagocytes were incubated with G. lamblia trophozoites, in the presence as well as the absence of supernatant of human colostrum (the source of opsonins) for 30, 60 and 120 min. The trophozoites/phagocytes ratio was 1:1, and the percentage of phagocytosed trophozoites was determined by microscopic examination of acridine orange-stained cells. RESULTS: The mononuclear phagocytes presented more functional activity than the polymorphonuclear. The highest indexes of adherence (77.6 +/- 5.1), ingestion (68.9 +/- 5.5) and killing (48.5 +/- 4.9) were obtained through the incubation of mononuclear cells in the presence of colostrum supernatant for 120 min. CONCLUSION: The phagocytes of human colostrum were able to ingest G.lamblia trophozoites and presented microbicidal activity in vitro, suggesting that these phagocytes may act as an additional mechanism of protection against infant giardiasis through breastfeeding.     

Antenatal breast expression: A critical review of the literature

Objective

to critically review literature related to the practice of antenatal breast expression (ABE) and the reasons for this practice.

Method

a critical review of available literature was undertaken by accessing Internet and library resources. Articles were to be documented in English. No restrictions were placed on dates due to the important historical background of this topic. Keywords used to refine the search included antenatal breast expression, colostrum, antenatal breast-feeding education and midwives and International Board Certified Lactation Consultants (IBCLC).

Findings

the literature search discovered ABE has been performed historically to prepare breasts for breast-feeding postnatally. It is presently being taught to store colostrum to prevent neonatal hypoglycaemia or hasten production of Lactogenesis 2. Studies relating to nipple stimulation were also critically appraised due to concerns of premature labour.

Conclusions

the safety and efficacy of ABE has yet to be demonstrated. The three studies related to the benefits teaching of this skill were small in size with methodological flaws. Trials related to nipple stimulation were also found to have substantial limitations. The reasons for and physicality of performing ABE vs. nipple stimulation differed markedly. While recent teaching of ABE has been encouraged through available commentaries, case studies and policies (in view of the documented positive effects of early colostrum administration), the benefits of this practice are yet to be substantiated.

Implications for practice

large, credible RCTs are needed to confirm efficacy and safety of this technique. A survey exploring the prevalence of ABE practices is also indicated and to explore the information currently provided by midwives to women in their care.     

Hyperimmune bovine colostrum in the treatment of shigellosis in children: a double-blind, randomized, controlled trial

Immunological approaches have been considered as an alternative therapeutic option for the treatment of enteric infections over the past few years. Hyperimmune bovine colostrum (HBC) is a potentially innovative immunological option in the management of shigellosis together with traditional antibiotic therapy. Children aged 1-12 y with a history of bloody mucoid diarrhoea of less than 5 d duration were enrolled after their stool specimen was found to be positive for Shigella dysenteriae type 1 antigen by a rapid diagnostic fluorescent antibody staining test. They were randomized to receive either HBC containing very high titres of antibody against S. dysenteriae type 1 antigen or bovine colostrum (BC) without any antibody. The study group received 100 ml of HBC three times a day orally for 3 d and control group received BC. Children also received pivmecillinam in a dose of 50 mg kg -1 d -1 in four divided doses orally for 5 d. Admission characteristics of the 34 children in the HBC group and 35 in the BC group were comparable. No significant differences were observed in duration of diarrhoea, fever, anorexia, abdominal pain, tenesmus, stool frequency or visible blood in the stool between the groups. Two (6%) children in the study and five (14%) in the control group remained stool culture positive for S. dysenteriae type 1, even after 5 d of sensitive antimicrobial therapy.

Conclusion: The results indicate that HBC as an adjuvant is unable to show any beneficial effect in reducing the stool frequency, duration or severity of childhood shigellosis due to S. dysenteriae type 1 infection.