GABAA receptor antagonism in the ventrocaudal periaqueductal gray increases anxiety in the anxiety-resistant postpartum rat

Postpartum mammals show suppressed anxiety, which is necessary for their ability to appropriately care for offspring. It is parsimonious to suggest that the neurobiological basis of this reduced anxiety is similar to that of non-parturient animals, involving GABA_A receptor activity in sites including the midbrain periaqueductal gray (PAG). In Experiment 1, postpartum and diestrous virgin female rats received an intraperitoneal injection of the GABA_A receptor antagonist (+)-bicuculline (0, 2 and 4 mg/kg) and anxiety-related behavior was assessed with an elevated plus maze. The 4 mg/kg dose of (+)-bicuculline significantly increased anxiety-related behavior, particularly in the postpartum females. Experiment 2 revealed that bicuculline's action was within the central nervous system, because anxiety in neither dams nor virgins was significantly affected by intraperitoneal injection of bicuculline methiodide (0, 2 and 6 mg/kg), which does not readily cross the blood-brain-barrier. In Experiment 3, bicuculline methiodide (2.5 ng/side) was directly infused into the ventrocaudal PAG (cPAGv) and significantly increased dams' anxiety compared to saline-infused controls. These studies expand our knowledge of how GABA_A receptor modulators affect anxiety behaviors in postpartum rats to the widely-used elevated plus maze, and indicate that the postpartum suppression of anxiety is in part a consequence of elevated GABAergic neurotransmission in the cPAGv.     

哺乳期妇女应用醋酸甲羟孕酮长效避孕针临床效果观察

目的:观察醋酸甲羟孕酮长效避孕针(DMPA)在哺乳期妇女的使用效果。方法:经知情选择,自愿采用DMPA避孕,无禁忌证的哺乳期妇女252例,深部肌肉注射DMPA 150mg,3个月1次,以90天为1个观察周期,统计其避孕效果、乳量改变情况、月经及副反应。结果:①经3228个妇女月的观察,无一例妊娠,有效率达100％;②前3个观察周期,乳量增多比例明显增加,分别为20.9％、57.7％、61.1％;③用药后普遍存在闭经、出血反应,以点滴出血为主,随观察周期的增加,出血反应减少。结论:哺乳期妇女使用DMPA即能及时,完全避孕,又能增加乳量,提高母乳喂养率,且副反应小。是值得推广的哺乳期避孕方法。     

聚丙烯酰胺水凝胶注射隆乳术后哺乳期并发症的处理

目的 探讨聚丙烯酰胺水凝胶注射隆乳术后哺乳期并发症处理的有效方法.方法 对13例行聚丙烯酰胺水凝胶注射隆乳术后在哺乳期并发乳汁淤积、乳漏、急性乳腺炎等患者,采取手术切开清除水凝胶及淤积乳汁、放置引流管、术区加压包扎,并结合有效的药物抑制泌乳等措施予以治疗.结果 13例术后7～15 d全部治愈.随访3个月至4年,效果满意.结论 切开清除水凝胶及淤积乳汁、持续引流,结合有效的药物抑制泌乳措施,是治疗注射隆乳术后哺乳期并发症的有效方法.     

Hyperprolactinemia stimulates food intake in the female rat

Lactation in the rat is marked by extreme hyperphagia. The present study examined the possibility that elevated prolactin levels contribute to this increase. It also evaluated the effects of hyperprolactinemia on brown adipose tissue and carcass composition. Virgin Osborne-Mendel rats were made hyperprolactinemic via ectopic pituitary transplants (PIT, n = 9) or were sham-operated (SHAM, n = 8). Eight lactating rats (LACT) served as additional controls. Food intake, body weight and rectal temperature were recorded daily. Eleven days postsurgery (or 11-12 days postpartum), the rats were sacrificed, and brown fat (scapular, axillary, cervical and thoracic) was excised, weighed, and assayed for GDP binding, one indicator of thermogenic capacity. Carcasses were subjected to body composition analysis. Although prior to surgery, PIT and SHAM rats weighed the same, PIT rats gained significantly more weight during the experiment than did SHAMs. Percent body fat and food intake (both total intake and intake relative to metabolic body size) were significantly elevated in the PIT rats. GDP binding in both PIT and LACT rats was significantly less than in SHAMs. This was true whether GDP binding was expressed per mg mitochondrial protein or per total amount of mitochondrial protein recovered. These data confirm that brown fat thermogenic capacity is suppressed during lactation. They also demonstrate that elevations of serum prolactin, to levels that are well within physiological limits, are capable of stimulating food intake and white fat deposition in the female rat. It is presently unclear whether these results are a direct or an indirect effect of hyperprolactinemia.     

Sodium fluoride-induced hypoproteinemia and hypoglycemia in parental and F1-generation rats and amelioration by vitamins

Oral administration of sodium fluoride (NaF; 40 mg/kg body weight) daily from day 6 of gestation to day 21 of lactation caused, compared with the distilled water control (group 2), significant reductions in body weight and feed consumption as well as concentration of glucose and protein in the serum of P- and F₁-generation rats; however, sodium and potassium concentrations in the serum were significantly higher than those of the vehicle control (group 2). Administration of either vitamins C (50 mg/kg body weight/day), D (2 ng/0.2 ml olive oil/animal/day) or a combination of vitamins C+D+E along with NaF caused significant amelioration in body weight and feed consumption, as well as glucose, protein, sodium and potassium concentrations in the serum of P- and F₁-generation rats compared with the NaF-only treated group. Withdrawal of NaF treatment during lactation caused significant amelioration in feed consumption (days 15–21 only), sodium, potassium, glucose and protein concentrations in the serum of both P- and F₁-generation rats. Co- treatment with vitamin E (2 mg/0.2 ml olive oil/animal/day) caused significant amelioration in body weight (days 15 and 20 of gestation only), sodium, potassium, glucose (only in P-generation females) and protein (only in P-generation female) concentrations in the serum of rats than in NaF-treated rats alone. It is concluded that co-treatment with vitamins C, D and C+D+E were found more effective in ameliorating NaF-induced effects than vitamin E and withdrawal of NaF treatment during lactation.     

注射式隆乳术后哺乳期并发症的超声诊断价值

目的探讨超声在诊断注射式隆乳术后哺乳期并发症的价值.方法总结注射式隆乳术后并发哺乳期感染的超声声像图特征,结合临床、手术和病理结果进行相关的分析.结果患者的超声声像图类似急性乳腺炎和乳腺脓肿,手术及病理证实了感染的存在和对组织的损害,手术不能将假体完全清除.结论超声是诊断注射式隆乳术后哺乳期并发症的首选检查方法,术前能提供准确的定位和定性诊断,术后能准确评估治疗效果.     

普萘洛尔在甲状腺功能亢进症孕产妇中的应用

甲状腺功能亢进症(甲亢)和妊娠同时存在的病例临床并不少见,这类孕妇的药物治疗中,普萘洛尔的适应证和禁忌证大多教科书常常没有提及,因此值得讨论.少数文献报道该药可增加自然流产几率,并可致胎儿宫内发育迟缓、心动过缓、出生后呼吸窘迫等异常.相关动物试验显示,普萘洛尔可减缓心率,且对胎肺β受体的阻滞可能导致胎儿出生后呼吸窘迫.大部分学者认为,在常规剂量下,该药没有临床致畸性,应用于妊娠期是相对安全的.也有专家认为,普萘洛尔应尽量短期使用以减少其可能的副作用,如在抗甲状腺药物起效之前的数周以及甲状腺危象时应用.胎儿在出生以后因药物在体内重新分布导致血浆药物浓度升高,建议产前减少药物用量.而在哺乳期,婴儿经乳汁摄取的药物极少,治疗剂量的产妇哺乳是安全的.另外,普萘洛尔还可安全地用于保守治疗难以控制的妊娠剧吐.     

哺乳期乳腺炎患者临床分离株的病原调查及耐药性分析

目的 了解哺乳期乳腺炎患者临床分离株的病原分布及感染状况,来指导临床用药.方法 以无菌穿刺获得乳腺炎开放性脓液和封闭性脓肿标本,行需氧和厌氧培养,采用VITEK-2compact全自动微生物鉴定仪,用GPI、GNI、ANC鉴定卡、AST-GN13、AST-GP61药敏卡进行菌株的鉴定和药敏试验,以苯唑西林最低抑菌浓度（MIC）来判断耐甲氧西林/苯唑西林的金黄色葡萄球菌（MRSA）.结果 270例标本共分离细菌70株,其中G＋菌61株,厌氧菌4株,G＋杆菌3株,G-杆菌2株.G＋球菌中以葡萄球菌属细菌为主,其中金黄色葡萄球菌（SA）分离最多占46株.SA中34.8%产β内酰胺酶,对青霉索的耐药率为89.1%.MRSA检出率为10.8%.凝固酶阴性葡萄球菌中100%产β-内酰胺酶,对苯唑西林的耐药率为78.6%.结论 哺乳期乳腺炎患者以SA检出率最高,对青霉素有较高的耐药性,MRSA发生率较低.其次以凝固酶阴性葡萄球菌的检出率为高,对青霉素及苯唑西林均有较高的耐药性.未发现利奈唑烷、万古霉素和替考拉宁的耐药株.     

护理干预对减轻产后乳房胀痛的临床效果观察

目的探讨护理干预在减轻产后乳房胀痛中的应用效果。方法选择产后奶胀且常规定期产检的孕妇240例作为观察组,另选择同期未常规产检的孕妇190例作为对照组。对照组实施常规围生期护理,观察组在此基础上给予护理干预。比较2组产后3d内泌乳通畅情况、乳房胀痛情况、硬结情况以及产后4d泌乳量。结果观察组产妇泌乳通畅率明显高于对照组,乳房胀痛、硬结情况明显优于对照组,差异均有统计学意义(P<0.01)。观察组产后第2天、第3天、第4天泌乳量多于对照组,差异均有统计学意义(P<0.01)。结论护理干预可有效减少产后乳房胀痛,有效预防产后奶胀的发生,提高母乳喂养成功率,值得临床推广应用。     

Changing patterns of daily rhythmicity across reproductive states in diurnal female Nile grass rats (Arvicanthis niloticus)

A suite of changes in circadian rhythms have been described in nocturnal rodents as females go through pregnancy and lactation, but there is no information on such patterns in diurnal species. As the challenges faced by these two groups of animals are somewhat different, we characterized changes in activity and core body temperature (T_b) in female diurnal Nile grass rats (Arvicanthis niloticus) as they went through a series of reproductive states: virgin, pregnant, pregnant and lactating, lactating only, and post-weaning. The phase of neither rhythm varied, but the amplitude did. Females increased their overall levels of daily activity from early to late pregnancy, regardless of whether they were also lactating. The pattern of activity was less rhythmic during early than mid-lactation, in both non-pregnant and pregnant females, as a consequence of a decrease in daytime relative to nighttime activity. The T_b rhythm amplitude dropped from mid-pregnancy through mid-lactation, and there were rises in T_b troughs during the mid-light and mid-dark phases of the day, though pregnancy and lactation affected T_b at these times in somewhat different ways. This study demonstrates that rhythms in diurnal grass rats change during pregnancy and lactation in different ways than those of nocturnal species that have been studied to date and that the effects of pregnancy and lactation are not additive in any simple way.