Maternal Zinc Intakes and Homeostatic Adjustments during Pregnancy and Lactation

Zinc plays critical roles during embryogenesis, fetal growth, and milk secretion, which increase the zinc need for pregnancy and lactation. Increased needs can be met by increasing the dietary zinc intake, along with making homeostatic adjustments in zinc utilization. Potential homeostatic adjustments include changes in circulating zinc, increased zinc absorption, decreased zinc losses, and changes in whole body zinc kinetics. Although severe zinc deficiency during pregnancy has devastating effects, systematic reviews and meta-analysis of the effect of maternal zinc supplementation on pregnancy outcomes have consistently shown a limited benefit. We hypothesize, therefore, that zinc homeostatic adjustments during pregnancy and lactation improve zinc utilization sufficiently to provide the increased zinc needs in these stages and, therefore, mitigate immediate detrimental effects due to a low zinc intake. The specific questions addressed are the following: How is zinc utilization altered during pregnancy and lactation? Are those homeostatic adjustments influenced by maternal zinc status, dietary zinc, or zinc supplementation? These questions are addressed by critically reviewing results from published human studies on zinc homeostasis during pregnancy and lactation carried out in different populations worldwide.     

补血益母丸哺乳期暴露对大鼠亲代和子代发育毒性的研究

目的 观察补血益母丸对哺乳期的亲代母鼠及子代生长发育的影响,探讨其安全性。方法 妊娠大鼠100只,随机分为4组,即对照组（去离子水）和补血益母丸低、中、高剂量（3.8、11.4、34.2 g生药/kg）组,每组25只。F₀母鼠于哺乳期第0天开始ig给药,连续给药至哺乳期结束,每日l次。F₀母鼠观察一般状况、体质量、摄食量、分娩及哺乳情况;F1代大鼠观察仔鼠的外观、体质量、生理发育、神经反射、行为及生殖功能等。结果 未发现补血益母丸对F₀母鼠哺乳期以及胚胎和F1代大鼠生长发育有明显毒性和干扰作用。结论 补血益母丸对F₀代母鼠哺乳期及F1子代均无明显毒性,未见毒性反应的剂量（NOAEL）为34.2 g生药/kg,相当于临床人用剂量的53倍。     

Expression of glucose transporters in lactating human mammary gland epithelial cells

Summary Background. Human milk contains 60–80 g/l lactose and and oligosaccharides. To synthesize this large amount of carbohydrates, the lacting mammary gland has a high demand for precursor molecules. such as glucose and galactose. Aim of the study. In the present study we investigated the molecular basis for the uptake of glucose and galactose into the human mammary gland. Methods. Using RT-PCR, Southern and Western blotting we analyzed the expression of SGLT1 (sodium glocose cotransporter 1) and GLUT1 (sodium independent glucose transporter) in epithelial cells isolated from fresh human milk. Results. Southern blot analysis of the amplications revealed the expression of SGLT1 mRNA but not of GLUT1 mRNA in milk epithelial cells. Using Western blotting, SGLT1 protein was identified in human milk cells. Conclusions. Our findings indicate that 1) the cell fraction isolated from fresh human milk is a suitable model for investigating gene expression in the human mammary gland and 2) lactating human mammary gland epithelial cells are supplied with monosaccharides mainly via SGLT1. Received: 11 January 2000, Accepted: 5 July 2000     

Reduction in Maternal Energy Intake during Lactation Decreased Maternal Body Weight and Concentrations of Leptin,Insulin and Adiponectin in Human Milk without Affecting Milk Production,Milk Macronutrient Composition or Infant Growth

Maternal diet has the potential to affect human milk (HM) composition, but very few studies have directly assessed the effect of maternal diets on HM composition. The primary aim of this study was to assess the effect of improving dietary quality in lactating women over 2 weeks on the concentrations of macronutrients and metabolic hormones in HM. The secondary aims were to assess the impact of the dietary intervention on 24 h milk production, maternal body composition and infant growth. Fifteen women completed a 1-week baseline period followed by a 2-week dietary intervention phase targeted towards reducing fat and sugar intake. Maternal anthropometric and body composition and infant growth measurements were performed weekly. Total 24 h milk production was measured before and after the dietary intervention, and HM samples were collected daily. Maternal intakes of energy (−33%), carbohydrate (−22%), sugar (−29%), fat (−54%) and saturated fat (−63%) were significantly reduced during the dietary intervention. HM insulin, leptin and adiponectin concentrations were 10–25% lower at the end of the dietary intervention, but HM concentrations of macronutrients were unaffected. Maternal body weight (−1.8%) and fat mass (−6.3%) were significantly reduced at the end of the dietary intervention, but there were no effects on 24 h milk production or infant growth. These results suggest that reducing maternal energy, carbohydrate, fat and sugar intake over a 2-week period is associated with significant reductions in HM insulin, leptin and adiponectin concentrations. These changes may be secondary to decreases in maternal weight and fat mass. The limited studies to date that have investigated the association between metabolic hormone concentrations in HM and infant growth raise the possibility that the changes in HM composition observed in the current study could impact infant growth and adiposity, but further studies are required to confirm this hypothesis.     

中毒咨询热线知晓率及认知程度调查分析

目的了解中毒救治专业人员对全国中毒咨询热线的知晓和认可情况,为进一步改进中毒咨询服务内容和方式提供建议。方法对3个省份共400名临床医生进行现场问卷调查并对结果进行统计学分析。结果现场发放问卷400份,回收有效问卷375份,回收率93.75%;高、中、初级职称比例分别为32.80%、40.00%、23.20%;被调查医生中53.60%知晓区域性或全国中毒咨询热线,知晓途径主要通过网络媒体、专业期刊、产品标签及114查询等途径;有中毒救治咨询服务需求时仅2.50%的被调查者会第一时间向中毒咨询服务热线求助,希望获得的主要信息是毒物成分及健康影响;有98.66%的调查者认为有必要开展中毒咨询服务,希望提供毒物数据库查询、专业书籍、信息推送等多种形式的信息服务。结论中毒咨询服务的实际知晓率低,应加强普及专业培训,针对专业人员信息需求提供规范化、多种形式的中毒信息服务。     

Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

In August 2012, the Centers for Disease Control and Prevention, in partnership with the Association of Maternal and Child Health Programs, convened a meeting of national subject matter experts to review key clinical elements of anthrax prevention and treatment for pregnant, postpartum, and lactating (P/PP/L) women. National experts in infectious disease, obstetrics, maternal fetal medicine, neonatology, pediatrics, and pharmacy attended the meeting, as did representatives from professional organizations and national, federal, state, and local agencies. The meeting addressed general principles of prevention and treatment for P/PP/L women, vaccines, antimicrobial prophylaxis and treatment, clinical considerations and critical care issues, antitoxin, delivery concerns, infection control measures, and communication. The purpose of this meeting summary is to provide updated clinical information to health care providers and public health professionals caring for P/PP/L women in the setting of a bioterrorist event involving anthrax.     

母鼠孕期及哺乳期骨骼铅水平及其与甲状旁腺激素的关系

[目的]研究母体孕期和哺乳期骨骼铅动员的规律及机制。[方法]36只雌性昆明小鼠通过饮水暴露于醋酸铅（含铅元素10.0mol/L）4周后怀孕,分别在孕期的第1、7和14天,哺乳期的第1、10和21天取股骨、全血和血清,用石墨炉原子吸收法测定铅含量,用放射免疫法测定总血清甲状旁腺激素（parathyroid hormone,PTH）含量,分别与同日龄非染铅母鼠比较。[结果]自孕中期开始,铅暴露组母鼠的血铅（blood lead）及血清总PTH水平开始明显上升,血钙、骨钙及骨铅水平开始明显下降;血铅水平在哺乳期末上升至（0.38±0.02）μmol/L,较孕初期上升65.22%（P〈0.05）;骨铅水平（femur lead）在哺乳期末下降至（269.14±9.78）nmol/g,较孕初期下降28.45%（P〈0.05）;血钙、骨钙水平在哺乳期末分别下降至（1.85±0.07）mmol/L、（12.74±0.38）mmol/g,较孕初期分别下降18.50%、17.75%（P〈0.05）;在孕中期,血清总PTH水平上升至（6.04±0.50）μg/L,较孕初期上升103.37%（P〈0.05）,直至哺乳期末仍维持在较高水平;两组的血铅、骨铅、血钙、骨钙及血清总PTH水平在观察期内各个阶段均有明显差异（P〈0.05）;铅暴露组血铅水平与血清总PTH水平之间有正相关关系（r=0.790,P〈0.0001）。[结论]母鼠孕期及哺乳期骨骼铅动员可能与血清PTH水平的变化有关。     

母乳中脂联素水平及其影响因素的研究

【目的】调查母初乳和成熟乳中脂联素水平并探讨其与母婴之间的关系。【方法】应用ELISA测定母乳脂联素水平,分析母乳脂联素与母亲体质指数(body mass index,BMI)及母、脐血糖、胰岛素水平的关系。【结果】母乳中含有丰富的脂联素,初乳中脂联素水平(27.9μg/L,5.7-367.1μg/L)明显高于成熟乳(10.9μg/L,3.0-179.6μg/L)(P<0.01)。进一步,母初乳中脂联素水平与母亲妊娠晚期BMI呈临界相关(r=0.33,P=0.069),与母血脂联素水平呈显著正相关(r=0.53,P<0.01),母初乳脂联素水平亦与脐血糖(r=0.52,P<0.01)及脐血胰岛素水平正相关(r=0.53,P<0.01)。【结论】母乳中含有丰富的脂联素,且与母血及母亲BMI相关。母乳中持续存在的脂联素在母乳喂养儿代谢发育中可能有着潜在的意义。     

电针少泽穴治疗产后缺乳46例临床观察

目的评价电针少泽穴治疗产后缺乳的临床疗效,探讨电针对不同证型、不同年龄患者的影响。方法选取产后缺乳患者92例,随机分为治疗组46例,对照组46例。治疗组电针双侧少泽穴,对照组电针双侧商阳穴。均5次为1个疗程,共治疗2个疗程,并随访1个月。结果治疗组总有效率100%,对照组为69.6%,两组比较差异有显著性意义(P<0.01)。对于不同证型、不同年龄的患者,治疗组在提高泌乳量、维持催乳素水平方面均明显优于对照组,两组比较差异有显著性意义(P<0.01)。结论电针少泽穴治疗产后缺乳临床疗效显著。