印尼复方穿心莲发酵蜂蜜汤剂“JAMSI”对高血糖患者的即刻降糖功效临床验证

目的:研究印尼复方穿心莲发酵蜂蜜汤剂JAMSI(由印尼PT Mahkotadewa Indonesia公司生产;印尼食品药品管理局注册号:TR053649111)对高血糖患者的即刻降糖功效。方法:本研究设计为对高血糖患者治疗前对治疗后的降糖功效评价,研究患者来自参观本产品展览台的来宾,他们必须患有高血糖或糖尿病并愿意参与本研究。检测临时毛细血管血血糖使用德国制造的Accu-Chek Active血糖检测仪在服用JAMSI汤剂前及服用后1 h。所获得的配对血糖数据按统计学一边t检验法分析并总结,统计学意义界限α=0.05。结果:在两次展览中即2013年2月16—23日在雅加达,获得34位合格患者为本研究患者,性别上分为20女和14男,其中20位正在服用降血糖西药。患者年龄最小22岁,最老74岁,平均(52.26±10.10)岁,糖尿史由1~33年,平均(9.36±8.27)年。患者的平均毛血管血血糖浓度在服用JAMSI汤剂前是(243.03±97.97)mg/dL,而服用后1 h是(197.94±100.01)mg/dL,两者差异有统计学意义(P0.01)。按服用前血糖浓度高于200 mg/dL的患者对比服用前血糖浓度低于200 mg/dL的患者分析结果显示服用JAMSI后降低血糖幅度在前者比后者更明显(表3)。而在正在服用降血糖西药者与没有服用降血糖药者之间降血糖幅度差异无统计学意义(P0.05)。结论:受检验的印尼复方穿心莲发酵蜂蜜汤剂JAMSI显示非常显著的即刻降血糖功效;此外在被研究的患者中没有发现任何严重不良反应。有关该药剂的中长期效果有待继续研究证明。     

Effect of Aqueous and Ethanolic Extracts of Pimpinella anisum L. Seeds on Milk Production in Rats

Pimpinella anisum L. (P. anisum) is used as a galactagogue in traditional medicine; hence, the effect of aqueous and ethanolic extracts of P. anisum seeds on milk production in rats was evaluated. The milk production was assessed by measuring the pups' weights during the suckling period. The intraperitoneal LD₅₀ values of P. anisum aqueous and ethanolic extracts were 4.93 and 3.77 g/kg, respectively. The aqueous (1 g/kg) and ethanolic extracts (1 g/kg) increased the milk production significantly (p < 0.001), with about 68.1% and 81% more milk being produced, respectively, than in the control group. The pups gained weight during the study period with the aqueous (0.5 and 1 g/kg, p < 0.05) and ethanolic (0.5 and 1 g/kg, p < 0.01) extracts. Thus, P. anisum aqueous and ethanolic extracts can increase milk production in rats.     

Comparison of mid‐infrared transmission spectroscopy with biochemical methods for the determination of macronutrients in human milk

The variability of human milk (HM) composition renders analysis of its components essential for optimal nutrition of preterm fed either with donor's or own mother's milk. To fulfil this requirement, various analytical instruments have been subjected to scientific and clinical evaluation. The objective of this study was to evaluate the suitability of a rapid method for the analysis of macronutrients in HM as compared with the analytical methods applied by cow's milk industry. Mature milk from 39 donors was analysed using an infrared human milk analyser (HMA) and compared with biochemical reference laboratory methods. The statistical analysis was based on the use of paired data tests. The use of an infrared HMA for the analysis of lipids, proteins and lactose in HM proved satisfactory as regards the rapidity, simplicity and the required sample volume. The instrument afforded good linearity and precision in application to all three nutrients. However, accuracy was not acceptable when compared with the reference methods, with overestimation of the lipid content and underestimation of the amount of proteins and lactose contents. The use of mid‐infrared HMA might become the standard for rapid analysis of HM once standardisation and rigorous and systematic calibration is provided.     

牛奶蛋白诱导的过敏性直肠结肠炎患儿喂养干预研究

目的 评估牛奶蛋白过敏性直肠结肠炎患儿的营养风险;观察喂养干预方案的变化及疗效,探讨个体化喂养干预方案的选择时机.方法 回顾性分析2012年1月至2013年7月湖南省儿童医院确诊为牛奶蛋白过敏性直肠结肠炎的171例患儿临床资料,其中非母乳喂养组139例(81.3％).干预方案:母乳喂养组继续母乳喂养32例,非母乳喂养组中游离氨基酸配方干预36例(21.1％),深度水解配方干预103例(60.2％),观察喂养干预2周的疗效,随访8周、12周、24周时喂养干预配方变化及0、3、6个月营养风险评估情况.结果 171例患儿中,男∶女=1.5∶1.0;平均年龄(4.1±1.3)个月.疗效观察:干预2周共显效147例(86.0％),其中母乳喂养组显效率为79.2％,与游离氨基酸配方组及深度水解配方组比较差异无统计学意义(P＞0.05).随访0.5年内干预配方改变:8周:母乳喂养组30例继续母乳喂养,游离氨基酸配方粉喂养21例(12.3％),深度水解配方粉85例(49.7％),适度水解配方35例(20.5％);12周:母乳喂养23例(13.5％),游离氨基酸配方粉喂养16例(9.4％),深度水解配方粉喂养56例(32.7％),适度水解配方喂养76例(44.4％);24周:母乳喂养21例(12.3％),游离氨基酸配方粉喂养7例(4.1％),适度水解配方喂养13例(7.6％),普通配方喂养130例(76.0％).于0、3、6个月进行营养风险评估(STAMP营养风险评估表),3组在不同时期的风险评分均值比较差异均无统计学意义(P均＞0.05).结论 牛奶蛋白过敏性直肠结肠炎患儿营养风险较低,不同的喂养干预方式对患儿的营养状态无明显影响.继续母乳喂养可有效回避牛奶过敏,人工喂养患儿干预后2周左右症状可获缓解,50％左右在3个月以上可获得部分免疫耐受,故可根据其诱导免疫耐受情况进行个体化喂养干预,减轻经济负担.     

Immune regulatory cytokines in the milk of lactating women from farming and urban environments

Peroni DG, Pescollderungg L, Piacentini GL, Rigotti E, Maselli M, Watschinger K, Piazza M, Pigozzi R, Boner AL. Immune regulatory cytokines in the milk of lactating women from farming and urban environments.
Pediatr Allergy Immunol 2010: 21: 977–982.
© 2010 John Wiley & Sons A/S Children living on farms have fewer allergies. It is unclear whether breastfeeding in different environments contributes to preventing allergies by exposing offspring to different cytokines that can modulate immune responses. The aim of this study was to quantify and compare levels of Transforming Growth Factor‐β1 (TGF‐β1) and Interleukin‐10 (IL‐10) in the colostrum and mature milk of mothers living in towns at sea level (references) and mothers on farms. Milk samples were collected within 3 days postpartum (colostrum) and at the first month of the baby’s life (mature milk). Sixty‐nine reference mothers and 45 farm mothers participated in the study. TGF‐β1 concentrations were significantly higher both in the colostrum (p < 0.05) and in mature milk (p < 0.05) of farm mothers. In the reference mothers, a significant decrease in TGF‐β1 concentrations was observed between colostrum (650, range 0–8000 pg/ml) and mature milk (250, range 0–8000 pg/ml) (p < 0.05). In farm mothers, TGF‐β1 concentrations were 1102 pg/ml (range 0–14,500) in colostrum and remained high in mature milk (821 pg/ml, range 0–14,650). IL‐10 concentrations were higher in the mature milk of farm mothers (p < 0.05). No significant differences in IL‐10 were observed between colostrum and mature milk in the control group (15 pg/ml, range 0–1800, and 0 pg/ml, range 0–230) or in farm mothers (9.5 pg/ml, range 0–1775, and 14.2 pg/ml, range 0–930), respectively. Exposure to a farm environment is associated with higher concentrations of TGF‐β1 and IL‐10 in breast milk when compared to exposure to an urban environment. Higher cytokine concentrations in breast milk may influence early modulation of the development of an immune response, leading to a reduced prevalence of allergy‐related diseases in farm children.     

BSACI guideline for the diagnosis and management of cow's milk allergy

This guideline advises on the management of patients with cow's milk allergy. Cow's milk allergy presents in the first year of life with estimated population prevalence between 2% and 3%. The clinical manifestations of cow's milk allergy are very variable in type and severity making it the most difficult food allergy to diagnose. A careful age‐ and disease‐specific history with relevant allergy tests including detection of milk‐specific IgE (by skin prick test or serum assay), diagnostic elimination diet, and oral challenge will aid in diagnosis in most cases. Treatment is advice on cow's milk avoidance and suitable substitute milks. Cow's milk allergy often resolves. Reintroduction can be achieved by the graded exposure, either at home or supervised in hospital depending on severity, using a milk ladder. Where cow's milk allergy persists, novel treatment options may include oral tolerance induction, although most authors do not currently recommend it for routine clinical practice. Cow's milk allergy must be distinguished from primary lactose intolerance. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for clinicians in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking the panel of experts in the committee reached consensus. Grades of recommendation are shown throughout. The document encompasses epidemiology, natural history, clinical presentations, diagnosis, and treatment.     

中医辨证施护在促进初产妇乳汁分泌中的应用

目的分析在初产妇中运用中医辩证施护对乳汁分泌的促进价值。方法择取2018年1月—2019年1月医院180例分娩后1周之内的初产妇,将其按数字随机分为对照组和研究组,每组90例,对照组实施常规护理,研究组实施中医辩证施护,对照分析两组护理效果。结果从泌乳始动时间来看,研究组早于对照组,P<0.05;从母乳分泌量来看,研究组母乳分泌量多的产妇占比高于对照组,分泌量少的产妇占比低于对照组,P<0.05;从母乳喂养自我效能评分来看,产前两组对比,差异无统计学意义,P>0.05,产后研究组评分高于对照组,P<0.05。结论在初产妇中运用中医辩证施护可促进乳汁分泌,不仅泌乳始动时间缩短,母乳分泌量增多,而且母乳喂养自我效能得到改善。