Detection of cytomegaloviral DNA in human milk cells and cell free milk whey by nested PCR

Human cytomegalovirus (HCMV) DNA can be detected in different compartments of human milk. A protocol for the preparation of milk whey free of fat and cells for the detection of human cytomegalovirus (HCMV) by nested PCR is presented. This is based upon the experience of the separation of more than 200 milk specimens of healthy seropositive breast feeding mothers. HCMV DNA could be detected in freshly centrifuged and filtrated milk whey specimens without contamination by cellular DNA. In limiting dilution experiments using HCMV plasmid DNA, the effect of different DNA extraction procedures from native milk and milk whey on the detection limit of cytomegaloviral DNA was demonstrated. About 200 viral genome equivalents/ml in milk whey or native milk were detectable by classical organic phenol/chloroform extraction or a spin column method, respectively. The detection of viral DNA in milk cells depended on a minimum number of milk cells (10⁵–2×10⁵) available for DNA extraction. In contrast to the findings of cytomegaloviral DNA in native sera or plasma of immunosuppressed patients we failed to amplify low level viral DNA from native breast milk by nested PCR due to an inhibition of Taq polymerase by lipid components. Finally, the course of cell associated and cell free DNAlactia was monitored. Analyzing sequential milk specimens, in some cases the presence of HCMV DNA in colostrum could be demonstrated. DNAlactia of milk cells and whey was partially discordant. Onset (week 1–4 after delivery) and duration (2 weeks up to more than 3 months) of DNAlactia showed distinct individual patterns. The methods described, allow further analysis of the mechanisms involved in the postnatal HCMV transmission by breast feeding seropositive mothers.     

孕产妇初乳及外周血矿物质含量及相关性分析

目的了解孕产妇初乳及外周血矿物质含量及其相关性。方法选取2019年5月在首都医科大学附属复兴医院生产的80名孕产妇为研究对象,收集其初乳及外周血。后采用微波消解-电感耦合等离子体质谱及原子荧光光谱测定其中9种矿物质含量,后利用SPSS 21.0探讨初乳中矿物质间及其与外周血之间的相关性。结果检测的9种矿物质中,初乳钠、钾、铁、镁、锌、铜、硒及锰含量低于外周血(P<0.05),而钙含量[(259.56±7.99)μg/mL]高于外周血[(32.76±3.31)μg/mL](P<0.05);钠、铁及硒与其在外周血含量呈显著正相关性(钠:r=0.272,P=0.019;铁:r=0.271,P=0.020;硒:r=0.341,P=0.003);同时初乳中一些矿物质之间亦存在显著相关性,如钾与锰(r=-0.236,P=0.043)、钾与镁(r=0.400,P<0.001)、钠与硒(r=0.509,P<0.001)、钙与铁(r=0.251,P=0.031)、镁与铜(r=0.395,P=0.001)及锌与硒(r=0.310,P=0.007)。结论研究结果提示某些矿物质元素可通过各种转运机制从血到母乳,实现积累效应;且该类元素间亦存在某些交互作用,可见维持母乳中各种矿物质元素间的动态平衡对于子代健康是非常重要的。     

剖宫产术后自控镇痛对母婴的影响

目的　观察剖宫产术后产妇自控镇痛对母婴的影响。方法　 2 0 0 2年 1月至 2 0 0 3年 1月首都医科大学附属复兴医院将剖宫产产妇 2 16例分为观察组和对照组 ,两组均为连续硬膜外麻醉 ,手术结束时 ,观察组将自控镇痛泵接在硬膜外管上。术后分别取产妇肘静脉血、初乳、尿及新生儿尿 ,测定吗啡含量 ;观察镇痛效果及副反应。结果　与对照组比较观察组镇痛效果明显 (P <0 0 5 )。观察组血吗啡质量浓度 5 0～ 12 6 0 μg/L ,初乳吗啡质量浓度 5 0～ 33 6 μg/L ,91 8%的产妇尿吗啡呈阳性 ,12 7%的新生儿尿吗啡呈阳性。随访 1年两组婴儿的体格及发育商比较 ,P >0 0 5。结论　剖宫产术后硬膜外腔应用吗啡镇痛 ,对产妇及新生儿是安全可行的     

初乳口腔免疫疗法联合水床式鸟巢护理在极低出生体重儿中的应用

目的探讨在极低出生体重儿中应用初乳口腔免疫疗法联合水床式鸟巢护理的效果。方法将2019年4月至2020年4月期间我院收治的62例极低出生体重儿纳入研究,并通过随机数字表法分为两组,给予对照组(n=31)常规护理,给予试验组(n=31)初乳口腔免疫疗法联合水床式鸟巢护理。观察两组新生儿并发症、体重变化,调查喂养情况、住院时间和产妇满意度。结果试验组的恢复出生体重时间短于对照组,体重增长高于对照组,差异有统计学意义(P0.05)。试验组的并发症发生率低于对照组,差异有统计学意义(P0.05)。试验组开始喂养时间、达全肠道喂养时间以及住院时间均短于对照组,差异有统计学意义(P0.05)。试验组护理总满意率高于对照组,差异有统计学意义(P0.05)。结论初乳口腔免疫疗法联合水床式鸟巢护理应用于极低出生体重儿中,可促进新生儿生长发育,改善喂养情况,降低并发症风险,缩短住院时间,产妇满意度较高,值得推广。     

Compartmentalization of small ruminant lentivirus between blood and colostrum in infected goats

The compartmentalization of small ruminant lentivirus (SRLV) subtype A (Maedi-Visna virus) and B (caprine arthritis-encephalitis virus) variants was analyzed in colostrum and peripheral blood mononuclear cells of four naturally infected goats. Sequence analysis of DNA and RNA encompassing the V4-V5 env regions showed a differential distribution of SRLV variants between the two compartments. Tissue-specific compartmentalization was demonstrated by phylogenetic analysis in three of the four cases. In these animals colostrum proviral sequences were clustered relative to the blood viral sequences. In one goat, the blood and colostrum-derived provirus sequences were intermingled, suggesting trafficking of virus between the two tissues or mirroring a recent infection. Surprisingly, the pattern of free virus variants in the colostrum of all animals corresponded only partially to that of the proviral form, suggesting that free viruses might not derive from infected colostral cells. The compartmentalization of SRLV between peripheral blood and colostrum indicates that lactogenic transmission may involve specific viruses not present in the proviral populations circulating in the blood.     

NICU早产儿初乳喂养现状及影响因素分析

目的 了解NICU早产儿初乳喂养的现状,并探讨其影响因素。方法 采取便利抽样法,选取2020年1月—2021年12月在温州市某三级甲等医院产科出生并入住NICU的851例早产儿为调查对象,根据生后7 d内是否接受初乳喂养分为初乳喂养组与无初乳喂养组;按初乳喂养量占比,初乳喂养组又分为高、中等及低比例初乳喂养组,回顾性分析早产儿初乳喂养率及其影响因素。结果 接受初乳喂养的早产儿共374例（43.95%）。其中,低比例初乳喂养126例（33.69%）、中等比例初乳喂养183例（48.93%）、高比例初乳喂养65例（17.38%）。二分类Logistic回归分析结果显示,新生儿科护士初乳喂养宣教次数>2次（OR=1.846）、父亲支持母乳喂养（OR=1.349）、产科护士初乳喂养宣教次数>2次（OR=2.467）及母亲产后24 h内泵乳次数≥12次（OR=2.724）是NICU早产儿初乳喂养的保护因素,母亲为初中及以下文化水平（OR=0.278）、母亲孕期存在健康问题（OR=0.462）是危险因素（P<0.05）。多分类有序Logistic回归分析结果显示,低比例、高比例初...     

Essential fatty acids in human colostrum

We analyzed the colostrum of 11 mothers, consuming a normal hospital diet, for total fat content and various fatty acids. Three of the mothers had given birth four weeks prematurely. Total fat content of the colostrum ranged from 2.16 to 3.65 g/100 ml. The major fatty acids were palmitic acid (16:0) and oleic acid (18:1) (24.3 and 39.7% (w/w), respectively). The dominating polyunsaturated fatty acid was linoleic acid (18:2n-6) (11.5% of the total fatty acids). Linolenic acid (18:3n-3) and docosahexaenoic acid (22:6n-3) accounted for 0.7 and 0.6%, respectively, of the sum of total fatty acids. The ratio of polyunsaturated to saturated fatty acids was 0.42, ranging from 0.28 to 0.5, and the ratio of n-6/n-3 fatty acids was 6:1. Linoleic acid and linolenic acid were positively correlated with each other (p < 0.02), whereas palmitic acid was negatively correlated with oleic acid (p < 0.05). We conclude that the average human colostrum contains the recommended level and balance of the essential fatty acids required by the newborn baby.     

Does age at the start of breast feeding influence infantile diarrhoea morbidity? A case–control study in periurban Guinea–Bissau

Colostrum protects the newborn from intestinal infection by its content of secretory immunoglobulin A and other immediately acting factors. It may also induce maturation of the child's gastrointestinal immune defences, thus contributing to the protection against diarrhoeal disease later in infancy. To test this hypothesis, a case–control study on breast feeding and diarrhoea was carried out in a periurban community in Guinea–Bissau. The child's age at the start of breast feeding was ascertained soon after birth ( n = 279). Subsequent cases of acute diarrhoea ( n = 66) were identified at 3–monthly examinations, and four concurrent controls were randomly selected among attendants. Three separate estimates of association showed that the cases tended to have started breast feeding later after birth than the diarrhoea–free controls, but no single test was statistically significant. Early breast feeding might have consequences for diarrhoeal morbidity after the neonatal period.     

Breastfeeding and concentrations of HCB and p,p'-DDE at the age of 1 year

Exposure to organochlorine compounds (OCs) occurs both in utero and through breastfeeding. Levels of hexachlorobenzene (HCB) in the cord serum of newborns from a population located in the vicinity of an electrochemical factory in Spain are among the highest ever reported. We aimed to assess the degree of breast milk contamination in this population and the subsequent exposure of children to these chemicals through breastfeeding. A birth cohort including 92 mother-infant pairs (84% of all births in the study area) was recruited between 1997 and 1999 in five neighboring villages. OCs were measured in cord serum, colostrum, breast milk, and children's serum at 13 months of age. Concentrations of OCs were detected and quantified in all colostrum and milk samples. The concentrations in mature milk were lower than those encountered in colostrum. At 13 months of age the highest concentration of OC was found for dichlorodiphenyl dichloroethane (p,p'-DDE), in contrast to what these children presented at birth, where HCB was the highest compound. Those infants who were breastfed had higher concentrations at the age of 1 than those who were formula fed (2.13 ng/mL of HCB among formula feeders vs 4.26 among breast feeders, and 1.95 of p,p'-DDE vs 6.00 (P<0.05)). Long-term breastfeeding leads to a dose-response increase of the concentrations in children's serum during the first year of life.     

初乳中酶活性及生物活性因子含量的动态变化及其意义

目的　探讨人初乳中超氧化物歧化酶 (SOD)、淀粉酶 (AM)和碱性磷酸酶 (ALP)活性及表皮生长因子 (EGF)和胰岛素样生长因子 1(IGF 1)含量的变化规律及其临床意义。方法　分别采用改良邻苯三酚自氧化法、碘 淀粉比色法和磷酸苯二钠法 ,测定 2 0例产妇的 118份初乳 (泌乳第 1～ 7天 )中SOD、AM和ALP活性 ;采用放射免疫法测定EGF和IGF 1含量。结果　初乳中SOD活性在开始泌乳的前 1～ 4天由 (18 7± 2 2 )kU/L上升到 (2 2 5± 2 9)kU/L ,然后下降 ,第 7天为 (11 2± 2 1)kU/L ,前 4天活性显著高于第 7天 (P <0 0 5或P <0 0 1)。AM和ALP活性在开始泌乳的 1周内逐渐下降 ,分别由 (15 5± 12 )kU/L和 (10 5± 17)kU/L ,下降到 (17± 4 )kU/L和 (5 4± 9)kU/L ,前 4天的AM活性显著高于第 7天 (P <0 0 5或P <0 0 1) ,第 1天的ALP活性显著高于第 7天 (P <0 0 5 )。初乳中EGF和IGF 1含量在开始泌乳的前 4天快速下降 ,分别由 (10 5± 11) μg/L和(2 5 9± 2 7) μg/L下降到 (40± 5 )μg/L和 (5 6± 1 3) μg/L ,在泌乳的第 4～ 7天变化较小。泌乳前 3天 ,EGF含量显著高于第 7天 (P<0 0 5或P <0 0 1) ,第 1天的IGF 1含量显著高于第 7天 (P <0 0 1)。结论初乳中具有高活性的SOD、AM和ALP ,且富含EGF和I