Vitamin D receptor genotype and risk of osteoporotic hip fracture in elderly women of Utah: an effect modified by parity

Introduction The associations between vitamin D receptor (VDR) Bsm I and Fok I genotypes, parity, and risk of osteoporotic hip fracture were evaluated in a statewide population-based case-control study in Utah.Methods Women age 50–89 years with hip fracture (n=882) were ascertained via surveillance of 18 Utah hospitals from 1997 to 2001. Age-matched controls were randomly selected (n=897). Participants were interviewed in their homes, and blood samples were collected for genotyping.Results In logistic regression analyses that controlled for multiple confounders, Bsm I VDR genotype but not Fok I genotype was associated with risk of osteoporotic hip fracture (OR bb vs. BB genotype: 0.68; 95% CI: 0.50, 0.95). In similar analyses, no overall association was observed between parity status and risk of osteoporotic hip fracture. However, the effect of VDR genotype was modified by parity status. Among nulliparous women (n=140), Bsm I genotype was not associated with risk of hip fracture (OR bb vs. BB: 0.82; 95% CI: 0.28, 2.4); among primiparous women (n=133), bb genotype was associated with increased risk of hip fracture (OR bb vs. BB: 3.30; 95% CI: 0.96, 11.29); among multiparous women (n=1,400), bb genotype was associated with decreased risk of hip fracture (OR bb vs. BB: 0.59; 95% CI: 0.42, 0.84).Conclusion VDR Bsm I genotype was associated with risk of hip fracture in Utah women, and this effect was modified by parity status. Hormonal or lifestyle factors related to parity may underlie this interaction.     

Nipple sensitivity and lactation in two methods of breast reduction

Two methods of breast reduction were performed between 1981 and 1986. One was wedge resection of the breast in which nipple and gland were disconnected. The other was the tangential and circumferential breast reduction, in which the nipple remained in continuity with the gland. For each method, there were 21 patients. The mean follow-up was 5 years and 9 months. In both groups, 8 patients had 11 children, but only the tangential reduction patients lactated. They also had better subjective nipple sensitivity whereas objectively the differences were rather small.     

Effect of Postnatal Ethanol Exposure on Expression of Differentiation Antigens of Murine Splenic Lymphocytes

Ethanol is a recognized immunosuppressive agent in the chronic alcoholic. However, the effects of ethanol exposure on the developing immune system have not been extensively investigated. This study evaluated the effects of early postnatal ethanol exposure, via breast milk, on splenic lymphocyte differentiation antigen expression in offspring reared by ethanol-fed mice. Maternal mice were fed a liquid diet containing 20% ethanol-derived calories during pregnancy (E-P), pregnancy and lactation (E-PL), or lactation (E-L). Ad libitumfed (C) and pair-fed (PF) control groups, fed a control liquid diet, were included. Expression of differentiation antigens on splenic lymphocytes from 21-day-old offspring reared by females in 1 of the 3 ethanol exposure conditions was evaluated by flow cytometry. Offspring reared by E-P females had similar numbers of splenic lymphocytes as offspring reared by C and pair-fed during pregnancy (PF-P) females. In contrast, offspring reared by E-PL and E-L females had fewer splenic lymphocytes than both PF-PL and PF-L (respectively), and C offspring. The number of Thy 1.2⁺, CD4⁺, CD8⁺, and IgG⁺ (B-cell) splenic lymphocytes was reduced in E-PL and E-L offspring compared with PF and C offspring. E-P offspring had fewer CD4⁺ and IgG⁺ splenic lymphocytes than C, but not PF-P, offspring. The percentage of Thy 1.2⁺ splenic lymphocytes was significantly reduced among E-PL and E-L offspring compared with PF-PL and PF-L (respectively), and C offspring. These results suggest that ethanol exposure of female mice during pregnancy, pregnancy and lactation, or lactation alone, alters the phenotypic development of splenic lymphocytes of offspring reared by these females. The greatest effect on differentiation antigen expression occurred when females consumed ethanol during the period of lactation. We speculate that direct exposure of the nursing offspring to ethanol via the breast milk was responsible for the reductions in specific splenic lymphocyte populations. These data demonstrate that mice reared by females fed ethanol during the early postnatal period have a marked depletion of each of the major subpopulations of splenic lymphocytes, and that Thy 1.2⁺ lymphocytes are differentially sensitive to ethanol.     

Energetic limits on reproduction: Maternal food intake

We examined the factors influencing maternal food intake and pup growth in Norway rats. Mother rats allowed pups in naturally large litters to grow at a slower rate than pups in naturally small litters. Pups reared by dams in a warm ambience (26°C) gained weight more slowly than dams at 22°C, and maternal food intake but not weight gain was depressed in the high ambient temperature. Pup growth at 18°C was unimpaired, with those dams eating no more and gaining no less weight than dams at 22°C. Nest material, however, was found to be essential for the successful rearing of young at cooler ambient temperatures. While restriction of food during gestation resulted in a marginally lower weight gain for the pups during the first 2 weeks postpartum, the dams appeared not to mobilize corporal stores or increase their food intake during lactation. Heavy body weight mothers did not eat any more, nor did they gain any less weight nor rear larger pups than light body weight dams. Rat mothers increased their consumption of a diet diluted with non-nutritive fiber to equal the nutritive intake of their controls, with their pups not differing in their growth rate. Pups reared by dams eating a high quality diet grew faster than pups with dams on the control diet. Food intake by mother rats is required during lactation relative to the amount of milk that is delivered to the pups, rather than to an absolute amount of food. Lactating females with a concurrent pregnancy neither increase their food intake nor appear to mobilize their corporal stores to deal with the added energetic drain of pregnancy. Indeed, their young grew somewhat more quickly than pups nursed by dams that were simply lactating. Taken as a whole, these results suggest that Norway rat dams apparently do not monitor and defend a maximal pup growth rate. Rather, rat dams seem to continue to defend their own homeostasis, and by doing so, allow the young to grow and survive under a wide variety of circumstances.     

Behavioral insensitivity to progesterone during lactation in female rats

Lactating female rats failed to display sexual receptivity after receiving 50 μg of estradiol benzoate followed by 1 mg of progesterone. Lactating rats appear to be insensitive to progesterone, based on several experiments. In ovariectomized control rats receiving moderate estrogen priming (1 μg EB for 3 days), progesterone greatly facilitated sexual receptivity; similarly estrogen-primed lactating females showed no responsiveness to progesterone injections, even at a high dose of progesterone (10 mg). Consistent with this reduced behavioral responsiveness to progesterone, lactating females had significantly reduced nuclear progestin receptor levels after an injection of 1 mg progesterone compared to ovariectomized controls. On the other hand, both ovariectomized controls and lactating rats responded with high levels of receptivity to 3 days of priming with 10 μg of estradiol benzoate (without progesterone). Lactating females treated for 3 days with a moderate dose (1 μg) of estradiol benzoate showed slightly reduced receptivity compared to ovariectomized controls; this result could reflect a reduced sensitivity to estrogen but is more likely related to the somewhat lower serum levels of estradiol and consequently lower nuclear estrogen receptors in lactating females compared to ovariectomized controls. The possibility of reduced sensitivity to estrogen leading to a reduced sensitivity to progesterone cannot be eliminated (since animals respond to progesterone only after estrogen priming); however, the reported results favor the idea that lactating females are primarily refractory to progesterone and do not have a generalized insensitivity to estrogen.     

Olfactory control of aggression in lactating female housemice.

Wild female lactating mice were tested for aggression toward strange wild male mice doused with either the test female's own urine (Owns), the urine of other wild females (Novels), or water (Controls). Treatment effects were assessed against an aggression index comprised of 5 different behaviors shown to be related by a factor analysis. Females aggressed more toward Novel-scented opponents than toward either Owns or Controls, the latter 2 conditions failing to differ statistically. It was concluded that an olfactorily-mediated mechanism controls the recognition of intruders by aggressive lactating housemice.     

Effects of hormones and lactation on gerbils that seldom scent mark spontaneously

Mongolian gerbils scent mark by rubbing low-lying objects with a ventral scent gland. In males and females that regularly scent mark, the behavior is regulated by gonadal steroid hormones, but the influence of hormones on the scent marking behavior of low- or zero-marking gerbils was unclear. The studies reported here demonstrate that injections of testosterone or of estrogen plus progesterone can stimulate scent marking in some low-marking females but fail to do so in others. Lactation was much more effective for inducing scent marking, but again not all females responded. Although most low- or zero-marking females regularly scent marked while lactating, lactation exaggerated premating differences in marking levels. Very few zero-marking male gerbils exhibited scent marking when castrated and treated with testosterone. In both sexes, scent gland size responded to hormone stimulation even when marking behavior did not.     

The maternal pheromone and bile acids in the lactating rat

Bile was drawn from virgin rats and from postpartum rats that were with young for 5, 12, 21, and 30 days, respectively. The bile thus drawn was analyzed enzymatically after chromatographic separation to test an hypothesis relating cholic acid and one of its metabolites, deoxycholic acid, to the appearance of the maternal pheromone. Our finding that cholic acid, but not deoxycholic acid, reached a peak that was tied specifically to the period of pheromonal emission led us to advance a revised hypothesis. We now think that cholic acid alone, or more likely a cholic metabolite other than deoxycholic acid, underlies the appearance of the pheromone.     

复旦大学附属妇产科医院609份药品说明书中有关妊娠期及哺乳期妇女用药标注调查

目的：了解药品说明书中有关妊娠期及哺乳期妇女用药的标注情况,促进药品说明书规范化管理,为临床安全用药提供参考依据。方法：收集我院调剂药房药品说明书,对有关妊娠期及哺乳期妇女用药标注情况进行统计分析,按照不同分类方法进行比较。结果：所调查的药品说明书中,国产化学药及生物制品有关妊娠期及哺乳期妇女用药标注率分别为95.91％和80.56％,进口药为98.02％和87.13％,国产中成药为68.38％和6.84％。妊娠期及哺乳期妇女用药无明确指导意见的分别占26.11％和49.26％。“权衡利弊”“慎用”及“遵医嘱”等类似表述在用药指导建议中最为常见。结论：药品监管部门、生产企业和医疗卫生机构应重视目前部分药品说明书标注存在的问题,积极采取措施加以改进和完善。     

哺乳期急性乳腺炎四级预防方案的可行性

目的:探讨哺乳期急性乳腺炎不同阶段的最佳治疗方法及四级预防方案的可行性。方法:0级预防是通过指导围产期母乳喂养,防止发生乳头皲裂和乳汁淤积;1级预防是在乳汁淤积期,采用"理疗+乳腺按摩+电动奶泵吸奶"三联治疗,防止进展为哺乳期急性乳腺炎的急性炎症期;2级预防是在哺乳期急性乳腺炎的急性炎症期采用"理疗+乳腺按摩+电动奶泵吸奶+敏感抗生素治疗"四联疗法,防止形成乳腺脓肿;3级预防是指在乳腺脓肿期,采用微创治疗方法,最大限度保留母乳喂养功能。结果:0级预防:研究组病变发生率为16%,对照组32%(P0.05);1级预防:研究组治疗总有效率91.8%;对照组总有效率65.1%(P0.01)。2级预防:"理疗+乳腺按摩+电动奶泵吸奶+敏感抗生素治疗"的四联疗法效果最好;3级预防:穿刺抽脓和置管冲洗引流是乳腺脓肿有效的微创治疗方法。结论:哺乳期急性乳腺炎四级预防方案可以指导临床在哺乳期急性乳腺炎的不同阶段采用有针对性的预防和治疗措施,防止病情向下一阶段发展,最大限度减轻病人的痛苦和保留母乳喂养功能。