Misoprostol vs. oxytocin for induction of labor at term.

Efficacy of misoprostol was studied for induction of labor at term. Seventy patients were randomized to Group A (n = 36, oral misoprostol 50 microg four hourly to maximum of 5 doses) and B (n = 34, continuous oxytocin infusion). Induction-delivery interval was shorter with misoprostol (7.7 +/- 2.8 h against 14.3 +/- 4.8 h with oxytocin) but the rates of vaginal delivery, cesarean, neonatal outcome variables were similar. Hence, misoprostol is an effective agent for induction of labor at term.     

Endometrial expression of vasopressin, oxytocin and their receptors in patients with primary dysmenorrhoea and healthy volunteers at ovulation

OBJECTIVE: To investigate gene expressions for neurohypophyseal and ovarian hormones as well as their receptors in the endometrium of women with primary dysmenorrhoea and healthy subjects at ovulation. STUDY DESIGN: A group of eight women with moderate to severe dysmenorrhoea and eight healthy subjects were compared in parallel between 18 and 35 years of age, regularly menstruating, non-overweight and nulliparous. The study was performed at The Department of Obstetrics and Gynecology, University Hospital of Lund, Sweden. Endometrial biopsies were taken around the time of ovulation, which was determined by repeated ultrasound examinations. Receptor and gene expressions for oxytocin and vasopressin in the tissue were measured. RESULTS: The gene expression for oxytocin receptor was significantly lower in dysmenorrhoic than in healthy women, in median 1.21 and 3.44 oxytocin-receptor/actin, respectively (p=0.048). The expressions for oxytocin peptide, vasopressin V1a receptor, oestrogen receptor alpha, beta and progesterone receptor did not differ between the two groups. Expression of vasopressin peptide was not detectable. CONCLUSION: A lower oxytocin receptor gene expression at mid-cycle could be involved in the aetiology of primary dysmenorrhoea. However, the importance of a paracrine effect of oxytocin and its receptor at ovulation warrants further investigation.     

Pharmacokinetics and Mode of Action of Tienilic Acid

A review of the absorption, distribution, metabolism and excretion of ticrynafen (tienilic acid) in 8 animal species, including man, is presented. Although some species effects are apparent, ticrynafen absorption is essentially complete following oral administration. The compound is extensively bound to plasma proteins, primarily albumin. Consequently, tissue concentrations are generally lower than plasma concentrations. Plasma and whole body clearance of ticrynafen is rapid due both to metabolism and to extensive renal excretion of the compound and its metabolites. Male/female differences in renal excretion occur, with a subsequent effect on ticrynafen metabolism.

Ticrynafen is an inhibitor of reabsorption of sodium and uric acid by the kidney. This inhibitory effect, within the renal tubular lumen, accounts for its diuretic and uricosuric activity and could account for its antihypertensive activity, although a direct effect has also been claimed.

Ticrynafen is also a classical example of a competitive inhibitor of organic acid transport in the kidney and other organs. Much of the drug-drug interaction involving ticrynafen is understandable due to its effect on transport. However, potentiation of anticoagulant activity appears to involve some direct effects upon warfarin metabolism although ticrynafen, in general, is not an enzyme inducer or inhibitor.

Toxicity of ticrynafen is low in all animal species.     

Vasopressin and oxytocin receptor systems in the brain: Sex differences and sex-specific regulation of social behavior

The neuropeptides vasopressin (VP) and oxytocin (OT) and their receptors in the brain are involved in the regulation of various social behaviors and have emerged as drug targets for the treatment of social dysfunction in several sex-biased neuropsychiatric disorders. Sex differences in the VP and OT systems may therefore be implicated in sex-specific regulation of healthy as well as impaired social behaviors. We begin this review by highlighting the sex differences, or lack of sex differences, in VP and OT synthesis in the brain. We then discuss the evidence showing the presence or absence of sex differences in VP and OT receptors in rodents and humans, as well as showing new data of sexually dimorphic V1a receptor binding in the rat brain. Importantly, we find that there is lack of comprehensive analysis of sex differences in these systems in common laboratory species, and we find that, when sex differences are present, they are highly brain region- and species-specific. Interestingly, VP system parameters (VP and V1aR) are typically higher in males, while sex differences in the OT system are not always in the same direction, often showing higher OT expression in females, but higher OT receptor expression in males. Furthermore, VP and OT receptor systems show distinct and largely non-overlapping expression in the rodent brain, which may cause these receptors to have either complementary or opposing functional roles in the sex-specific regulation of social behavior. Though still in need of further research, we close by discussing how manipulations of the VP and OT systems have given important insights into the involvement of these neuropeptide systems in the sex-specific regulation of social behavior in rodents and humans.     

Animal models of Central Diabetes Insipidus: Human relevance of acquired beyond hereditary syndromes and the role of oxytocin

The aim of this study was to review different animal models of Central Diabetes Insipidus, a neurobiological syndrome characterized by the excretion of copious amounts of diluted urine (polyuria), a consequent water intake (polydipsia), and a rise in the serum sodium concentration (hypernatremia). In rodents, Central Diabetes Insipidus can be caused by genetic disorders (Brattleboro rats) but also by various traumatic/surgical interventions, including neurohypophysectomy, pituitary stalk compression, hypophysectomy, and median eminence lesions. Regardless of its etiology, Central Diabetes Insipidus affects the neuroendocrine system that secretes arginine vasopressin, a neurohormone responsible for antidiuretic functions that acts trough the renal system. However, most Central Diabetes Insipidus models also show disorders in other neurobiological systems, specifically in the secretion of oxytocin, a neurohormone involved in body sodium excretion.Although the hydromineral behaviors shown by the different Central Diabetes Insipidus models have usually been considered as very similar, the present review highlights relevant differences with respect to these behaviors as a function of the individual neurobiological systems affected. Increased understanding of the relationship between the neuroendocrine systems involved and the associated hydromineral behaviors may allow appropriate action to be taken to correct these behavioral neuroendocrine deficits.     

脐静脉推注缩宫素联合舌下含化卡孕栓对剖宫产产后出血的疗效观察

目的探讨缩宫素联合卡孕栓对剖宫产产后出血的疗效。方法将剖宫产的180例产妇随机分为两组。观察组104例在胎儿娩出后脐静脉给缩宫素20 U,同时产妇含舌下化卡孕栓1 mg;对照组76例在胎儿娩出后均子宫体注射缩宫素10 U,同时产妇舌下含化卡孕栓1 mg。比较不同时段剖宫产产后出血量,所获数据采用方差分析、t检验和X2检验。结果子宫收缩效果、止血效果、术中、术后及总出血量比较P均<0.005。结论剖宫产术中脐静脉推注缩宫素联合舌下含化卡孕栓,预防剖宫产术后出血效果显著。     

Study of drug control over postoperative hemorrhage after selective caesarean section

Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.     

卡前列素氨丁三醇注射液与缩宫素在产后出血的临床预防效果分析

目的：研究卡前列素氨丁三醇注射液联合缩宫素预防产后出血的临床疗效。方法随机选取该院96例2015年1月一2016年2月收治的高危产妇,采用随机数字法分为对照组和观察组。观察组48例,娩出后给予卡前列素氨丁三醇注射液皮下注射联合缩宫素静脉滴注;对照组48例,仅注射缩宫素。观察两组患者产后出血量、出血率及不良反应。结果①观察组24 h内出血量明显低于对照组,出血例数少于对照组,出血率为2.1%,显著低于对照组16.7%,P＜0.05;②对照组和观察组均有数例患者发生血压升高、恶心、呕吐、心悸等不良反应,不良反应发生率分别为16.7%、10.4%,对照组略高于观察组,但差异无统计学意义,P＞0.05。结论卡前列素氨丁三醇注射液联合缩宫素预防产后出血效果较好,出血量、出血率均有显著改降低,不良反应未见增加,安全可靠。     

缩宫素结合米索前列醇治疗产后出血的临床分析

目的：探讨缩宫素结合米索前列醇治疗产后出血的临床价值。方法选择我中心2013年1月—2015年1月收治的100例产后出血患者为观察对象,随机将其分为对照组和试验组,对照组患者接受缩宫素治疗,试验组患者接受缩宫素结合米索前列醇治疗,比较分析2组患者的临床治疗效果。结果试验组产后24 h内平均出血量以及不良反应发生率均明显优于对照组（P<0.05）。结论产后出血患者接受缩宫素结合米索前列醇治疗,具有较高的有效性和安全性,因而临床应用价值较高。     

子宫肌瘤挖出术的垂体后叶素与催产素应用效果比较

目的：探讨子宫肌瘤挖出术中应用垂体后叶素与催产素的效果。方法选取行子宫肌瘤挖出术患者68例,按照数字随机法分为2组：观察组34例于术中应用垂体后叶素,对照组34例于术中应用催产素,对比2组的临床预后。结果观察组的手术时间、手术出血、术后住院时间、手术前后Hb差值均显著低于对照组（P<0.05）;观察组临床总有效率为94.12%,显著高于对照组的82.35%（P<0.05）;2组不良反应率及术后复发率比较差异均无统计学意义。结论子宫肌瘤挖出术中应用垂体后叶素相比于催产素能够降低术中出血,提高手术安全性和有效性,改善临床预后,且不良反应较少,值得临床推广应用。