Immune, health and endocrine characteristics of depressed postpartum mothers

The purpose of the study was to examine demographic, immune, endocrine, stress and health characteristics of depressed mothers, measured between 4 and 6 weeks postpartum, and compare them to non-depressed mothers. The top decile (N=25) of Profile of Mood States depression scores was used to categorize mothers as depressed and these data were then compared to means of the remaining mothers (N=175) in a study of stress and immunity during the postpartum. Depressed mothers were younger, had smaller birth weight infants, and their babies experienced more illness symptoms at 4-6 weeks postpartum. Depressed mothers were less likely to be breastfeeding and had lower serum prolactin levels. Depressed mothers were more likely to smoke, to have daytime sleepiness, and more symptoms of infection than non-depressed mothers. Depressed mothers also had higher perceived stress, postpartum stress, and negative life event reports. There was evidence suggesting that depressed mothers had a downregulated hypothalamic-pituitary-adrenocortical (HPA) axis, in that salivary cortisol was lower in depressed mothers. Depressed mothers also had lower serum levels of Interferon-gamma (IFN-gamma) and a lower IFN-gamma/Interleukin-10 (IL-10) ratio in both sera and in whole blood stimulated cultures, suggesting a depressed Th1/Th2 ratio in depressed mothers. The data supports the possibility that postpartum depression may be associated with a dysregulated HPA axis and possible depressed cellular immunity.     

Effects of artificial eggs on prolactin secretion, steroid levels, brood patch development, incubation onset and clutch size in the yellow-eyed penguin (Megadyptes antipodes)

Several studies have shown that the transition from egg laying to incubation behavior in birds is associated with changes in plasma levels of prolactin and steroid hormones. However, any effect of the tactile and visual input provided by eggs at initiating these hormonal changes has not been fully investigated in wild birds. A few days before yellow-eyed penguins, Megadyptes antipodes, started egg laying, we placed an artificial egg into their nests or under cages next to their nest. We then investigated the effect of the tactile and/or visual stimulus of such an artificial egg on prolactin secretion, steroid hormone levels (total androgen, estradiol and progesterone), brood patch development, incubation onset and clutch size in these penguins. Prolactin levels rose in females in response to having an artificial egg in the nest, while they declined considerably in males. Total androgen concentrations in males were less than 7% of those of control males and the levels prior to egg placement. Brood patch width increased in both males and females. Additionally, an egg in the nest caused yellow-eyed penguin pairs to attend and sit prone on their nest more frequently. Females that initiated egg laying 1 or 2 days after placement of the artificial egg in the nest, laid a full clutch of two eggs, while most other females that were exposed to an artificial egg in their nest, laid only a single egg. In contrast, the visual stimulus of an artificial egg alone (that was placed under a cage) did not influence hormone levels, brood patch development, incubation behavior or clutch size. The stimulation of an egg in the nest influences prolactin and total androgen levels in yellow-eyed penguins, particularly in males. While brood patch development and incubation behavior were initiated and egg laying was terminated in response to an artificial egg in the nest, the exact endocrine mechanisms underlying these physiological and behavioral changes remain poorly understood. We encourage further studies on other bird species taking an experimental approach to investigate the direct influence of hormones in initiating brood patch development and incubation behavior. Moreover, such experimental studies will widen our understanding of the endocrine mechanisms that regulate clutch size.     

Hormonal and reproductive factors in relation to melanoma in women: current review and meta-analysis

A number of studies have focused on possible relationships between characteristics of female endocrine status and melanoma (CM) risk; however, the link between melanoma, oral contraceptive (OC) and hormonal replacement therapy (HRT) use, and reproductive factors remains controversial. A comprehensive, systematic bibliographic search of the medical literature was conducted to identify relevant studies. Random effects models were used to summarise results. Subgroup, meta-regression and sensitivity analyses have been carried out to explore sources of between-study variation and bias. We included thirty-six observational studies published in the last 30 years. Summarising a total of 5626 melanoma cases, we did not find any significant melanoma risk associated with OC and HRT use. Several reproductive factors were also investigated, summarising data on 16787 melanoma cases. We found a significantly increased melanoma risk for late age at first birth, and women with more than one child may be at a lower risk for melanoma; however, socio-economic confounders were found to play a significant role in explaining this association. This study confirmed no increased risk of CM with the use of oral contraceptives and hormone replacement therapy: exogenous female hormones do not contribute to an increased risk of CM. In contrast, significant associations of CM with parity and age at first pregnancy were observed in this meta-analysis finds and warrant further research.     

卵巢早衰患者血清抗苗勒管激素水平测定及其临床意义

目的探讨卵巢早衰患者血清抗苗勒管激素（AMH）水平的变化及其临床意义。方法卵巢早衰患者25例,酶联免疫吸附试验（ELISA）检测其血清AMH水平。20例健康妇女做为正常对照。结果卵巢早衰患者血清AMH水平明显低于正常对照组（P〈0．01）,其中有20例患者血清AMH水平为0pmol／L。对另5例血清中测得AMH的卵巢早衰患者做人工周期,再hMG／hCG促排卵,其中2例有卵泡发育,1例妊娠。结论卵巢早衰患者血清AMH水平明显下降或测不到,测定患者血清AMH水平对诊断卵巢早衰及指导治疗具有一定意义。     

体外冲击波对兔缺血坏死股骨头血管内皮生长因子表达的研究

目的观察体外冲击波疗法(ESWT)对兔缺血坏死股骨头中血管内皮生长因子(VEGF)表达及毛细血管增生的影响。方法选取体质量3~4 kg健康新西兰大白兔30只,采用脂多糖和甲泼尼龙制造股骨头缺血坏死模型,每只兔子左股骨头接受冲击波治疗,设为实验组,右股骨头不做任何处理,设为对照组。在冲击波治疗后1、2、4、8、12周处死动物取双侧股骨头通过苏木素-伊红(HE)染色观察股骨头愈合的病理改变,免疫组织化学观察VEGF表达的改变,毛细血管密度(MVD)观察新生毛细血管含量。结果实验组股骨头VEGF在ESWT治疗后第2周开始表达,第4周达到高峰,第12周仍很高,VEGF表达最强的区域在坏死后增殖区,对照组虽有VEGF表达,但数量较实验组明显减少。在ESWT治疗后4、8、12周,实验组股骨头MVD显著高于对照组。结论ESWT可以促进兔缺血坏死股骨头VEGF的表达,进而促进毛细血管增生,增加坏死股骨头的血供。     

环境雌激素双酚A对小鼠生殖内分泌激素的影响

目的观察双酚A对小鼠体内生殖内分泌激素水平的影响。方法采用放射免疫法分别测定不同剂量双酚A腹腔注射染毒3d及相同剂量双酚A一次染毒后30min、4、12、24、36、48和72h的小鼠血清雌二醇（E：）和睾丸组织睾酮（T）水平。结果不同剂量双酚A染毒3d后,各染毒组T含量明显低于阴性对照组（P〈0．05）,且随着染毒剂量的增加而明显降低;雄性和雌性小鼠血清E2浓度随染毒剂量的增加而逐渐升高,当剂量达到80umol／kg时,明显高于阴性对照组（P〈0．05）。相同剂量双酚A一次染毒后0．5～12h内,小鼠睾丸组织T及血清E2水平迅速下降,之后缓慢上升,72h内可恢复正常水平。结论双酚A对小鼠具有内分泌干扰作用,可引起小鼠组织睾酮水平下降及血清雌二醇水平升高。     

Prevention and Treatment of Cardiovascular Disease in Women: The Obstetric‐Gynecologist's Point of View

It has been confirmed that cardiovascular disease (CVD) is the leading cause of morbidity and mortality not only in men but also in women. The most recent American Heart Association (AHA) and European Atherosclerosis Society (EAS) recommendations specifically address women. This is in response to the majority of studies that primarily involved men. Ideal cardiovascular health has been defined for women, and new factors were added to the traditional risk factors. As stated by the American and European Menopause Societies (NAMS and EMAS), hormone replacement therapy (HRT) is no longer believed to be protective for CVD; on the contrary, women benefit just as much as men from statins to lower their risk of heart disease. At the onset of menopause, women exhibit an increase in cholesterol and an increased risk of CVD. Unfortunately, hyperlipidemia is largely undertreated in women, although the rate of hypercholesterolemia among women is similar to that of men. More aggressive intervention is recommended for persons with multiple risk factors and/or monogenic dyslipidemias. In women affected by familial hypercholesterolemia in the homozygous and compound forms, treatment such as lipoprotein apheresis is also suggested. There is evidence for the use of these techniques even in pregnancy. An update on the most recent guidelines issued by AHA, EAS, NAMS and EMAS for the prevention of CVD in women along with a brief overview on the use of lipoprotein apheresis in women during pregnancy is reported.     

促卵泡生成素、黄体生成素和胰岛素对多囊卵巢病人颗粒细胞甾体激素分泌的影响

目的研究在促卵泡生成素（ＦＳＨ）、促黄体生成素（ＬＨ）和胰岛素（ＩＮＳ）刺激作用下多囊卵巢综合症（ＰＣＯＳ）病人与正常卵巢的颗粒细胞甾体激素产生的异同。方法对１８例月经周期正常妇女卵泡期的３３个卵泡和８例ＰＣＯＳ的１００个卵泡的颗粒细胞行体外培养，利用放射免疫法测定培养液中的甾体激素水平，比较了两组颗粒细胞在ＦＳＨ、ＬＨ和ＩＮＳ刺激作用下雌二醇（Ｅ２）和孕酮（Ｐ）的产生。结果ＰＣＯＳ病人的颗粒细胞在基础状态下，ＦＳＨ和ＩＮＳ刺激作用下Ｅ２产生量明显高于对照组（Ｐ＜００５～００１），在ＦＳＨ、ＬＨ和ＩＮＳ刺激作用下ＰＣＯＳ组产生的Ｐ量明显高于对照组（Ｐ＜００５～００１）；ＩＮＳ能明显的增强ＦＳＨ和ＬＨ对颗粒细胞的刺激作用；外周胰岛素拮抗的ＰＣＯＳ病人的颗粒细胞对ＩＮＳ刺激仍然敏感。结论ＰＣＯＳ病人的颗粒细胞甾体激素合成酶在体内时可能已被活化，ＰＣＯＳ病人的高ＩＮＳ和高ＬＨ血症可能起关键作用     

连苏止呕胶囊对化疗呕吐家鸽胃肠激素影响的实验研究

目的　对连苏止呕胶囊抗化疗呕吐的内在机制加以探讨。方法　采用家鸽腹腔注射顺铂法制造模型 ,用放免试剂盒检测胃肠激素。结果　连苏止呕胶囊高剂量组能明显升高外周血中表皮生长因子 (EGF)的含量 (P <0 0 5 ) ,连苏止呕胶囊低剂量组、高剂量组能明显降低外周血中胃泌素(Gas)的含量 (P <0 0 5 ,P <0 0 1) ,连苏止呕胶囊高剂量组能明显降低外周血中血管活性肠肽(VIP)的含量 (P <0 0 5 )。结论　连苏止呕胶囊对胃肠粘膜起到了一定保护作用 ,对胃肠运动具有改善作用 ,这可能是该药抗化疗呕吐尤其是迟发性呕吐的机制所在