Enhanced levels of immunoreactive β-casomorphin-8 in milk of breastfeeding women with mastitis

An incorrect, superficial suckling technique in breastfeeding frequently leads to milk congestion and sometimes mastitis. In the present study we have examined whether milk congestion may affect levels of the atypical opioid β-casomorphin-8 in milk and in plasma. We also investigated whether the rate of acute psychosis during the first half year after parturition has declined in Sweden over the years. Milk and plasma samples were collected for peptide analysis from 14 women with mastitis and 10 controls. We found that in a group of 14 late cases of mastitis (median 48 days post partum) the detected mean level of β-casomorphin-8 in milk was significantly higher and somewhat higher in plasma at the acute stage compared with 2–3 weeks later, after recovery when the symptoms had disappeared, as well as compared to the control subjects. Swedish official statistics show that the incidence of acute psychosis in the first month and in the first half year after birth has declined by a half during the last 30 years. A relationship between postpartum psychosis and elevated β-casomorphin-8 levels in CSF has been suggested from earlier studies. In this study, milk congestion led to enhanced levels of β-casomorphin-8 in milk, which may be related to postpartum psychosis and probably also to ‘the postnatal blues’.     

Cook双球囊联合改良B-Lynch缝合术对产后出血的治疗效果观察

目的:探讨Cook双球囊联合改良B-Lynch缝合术对产后出血的治疗效果。方法:选取2015年6月～2018年6月在我院经剖宫产术分娩并发生产后出血的产妇81例进行回顾性分析。根据术中止血方法的不同分为两组,对照组40例采用Cook双球囊进行止血,观察组41例在对照组的基础上应用改良B-Lynch缝合术进行止血。对两组患者的手术相关指标、止血成功率、子宫切除率、术后恢复情况和并发症发生情况进行比较。结果:观察组的术中出血量、术后24 h出血量和输血量显著低于对照组(P0.05),止血时间显著短于对照组(P0.05);观察组患者的止血成功率显著高于对照组(P0.05),子宫切除率和切口恢复时间显著低于对照组(P0.05),两组患者的住院时间和并发症发生率比较无统计学差异(P0.05)。结论:Cook双球囊联合改良B-Lynch缝合术对剖宫产产后出血患者的临床效果显著优于单用Cook双球囊,且安全性较高。     

乳杆菌活菌胶囊在配合治疗产后滴虫性阴道炎中的价值

目的探讨应用乳杆菌活菌胶囊在配合治疗产后滴虫性阴道炎中的作用。方法将90例患滴虫性阴道炎的产后妇女随机分为2组,研究组应用甲硝唑400 mg,每日2次,连服7 d,同时每日晚塞1粒乳杆菌活菌胶囊入阴道,连用10 d;对照组应用甲硝唑400 mg,每日2次,连服7 d。2组患者14 d后复查并检查白带常规,对其临床治愈率、白带清洁度、pH进行比较。30 d后随访检查滴虫性阴道炎复发情况。结果用药后研究组治愈率高于对照组,2组差异有统计学意义(P<0.05);研究组、对照组pH均有降低,但研究组pH低于对照组,2组差异有统计学意义(P<0.05);用药后研究组阴道清洁度I、II度比率高于对照组,研究组复发率低于对照组,差异均有统计学意义(P<0.05)。结论产妇应用乳杆菌活菌胶囊配合治疗滴虫性阴道炎可提高治愈率,改善阴道微环境并降低复发率。     

经会阴实时三维盆底超声评估不同分娩方式对产后女性前腔室结构和盆膈裂孔的影响

摘要 目的：探讨经会阴实时三维盆底超声评估不同分娩方式对产后女性前腔室结构和盆膈裂孔的影响。方法：回顾性分析2015年1月至2019年10月在我院接受检查的100例产妇的诊治资料。根据分娩方式的不同,将患者分为经阴道分娩组（n=55）和剖宫产分娩组（n=45）。比较两组产妇在静息状态和Valsalva状态下的前腔室和盆膈裂孔超声参数。结果：在静息状态下,两组的膀胱颈位置、逼尿肌厚度、膀胱后角和尿道倾斜角相比无差异（P>0.05）。经阴道分娩组在Valsalva状态下的膀胱颈移动度和尿道旋转角均大于剖宫产分娩组,尿道内口漏斗形成率和膀胱膨出率均高于剖宫产分娩组（P<0.05）。在Valsalva状态下,经阴道分娩组的盆膈裂孔前后径、左右径、面积和周长均大于剖宫产分娩组（P<0.05）;在静息状态下,两组的上述指标相比,差异均无统计学意义（P>0.05）。结论：应用经会阴实时三维盆底超声技术观察产妇前腔室结构和盆膈裂孔的参数变化,可评估产妇盆底功能受损的程度,经阴道分娩对其影响较大。     

Influences of diet during gestation on potential postpartum reproductive performance and milk production of beef heifers

The influences of nutritional protein and energy during early and mid pregnancy on milk production and postpartum reproductive parameters were determined in 70 beef heifers of two composite breeds (Bos indicus X Bos taurus). At artificial insemination (AI), heifers were divided into four dietary treatment groups identified by the level of protein, and to a lesser extent energy, fed during the first and second trimesters: high/high (HH), high/low (HL), low/high (LH), and low/low (LL). Milk production was lower in the heifers receiving high treatment in first trimester than that in heifers receiving the low treatment (P = 0.01). Milk production was negatively associated with dam body condition score (BCS; P = 0.01), nonesterified fatty acids (P = 0.001), and leptin (P = 0.02) and positively associated with urea (P < 0.001) concentrations during lactation. Increased dietary protein in the first trimester increased or decreased concentrations of colostral protein dependent upon genotype (P = 0.03). Colostral protein was positively associated with bovine pregnancy associated glycoprotein from late gestation (P = 0.007). Milk fat was negatively associated with BCS (P = 0.007) and influenced by genotype (P = 0.003). Dietary treatment did not affect the postpartum reproductive performance of beef heifers. Gestation length (P < 0.001) and the postpartum interval to first estrus (PPI; P = 0.02) were positively associated with calf size. Placental size was negatively associated with placental expulsion time (P < 0.01). Prepartum BCS of the heifers was negatively associated with PPI (P = 0.01). Overall, high levels of nutrition during early gestation are detrimental to milk production in beef heifers.     

不同分娩方式对产妇产后心理和生理的影响

目的:探讨不同分娩方式对产妇产后心理和生理的影响.方法:随机选择2011年1月～2011年12月在苏大附一院分娩的初产妇400例,其中剖宫产、阴道自然分娩各200例,对两组产妇产后42天心理状况、恶露持续时间、泌乳情况进行调查.结果:两种分娩方式对产妇产后42天发生焦虑和抑郁心理的影响无明显差别(P＞0.05);阴道自然分娩组产后恶露持续时间短于剖宫产组,差异有显著意义(P＜0.01).有抑郁、焦虑情绪的产妇泌乳始动时间显著长于正常产妇,24h泌乳量显著少于正常产妇(P＜0.01).结论:剖宫产对产妇身体生理创伤大过阴道自然分娩,应严格控制剖宫产的适应症,鼓励阴道自然分娩.     

电针阴部神经刺激疗法联合Kegel盆底康复训练对产后压力性尿失禁患者盆底肌力、尿流动力学和生活质量的影响

摘要 目的：探讨电针阴部神经刺激疗法联合Kegel盆底康复训练对产后压力性尿失禁（SUI）患者盆底肌力、尿流动力学和生活质量的影响。方法：选取2019年6月~2021年11月期间于我院就诊的产后SUI患者109例,按照入院就诊奇偶顺序分为两组,其中对照组54例,接受Kegel盆底康复训练,研究组55例,接受电针阴部神经刺激疗法联合Kegel盆底康复训练。对比两组疗效、漏尿量、尿失禁程度、盆底肌力、尿流动力学和生活质量。结果：研究组的临床总有效率高于对照组（P<0.05）。两组治疗后盆底肌肌力各指标（手测肌力和Ⅰ类肌纤维最大值、Ⅱ类肌纤维平均值）均升高,且研究组高于对照组（P<0.05）。两组治疗后漏尿量、尿失禁程度评分均下降,且研究组低于对照组（P<0.05）。两组治疗后尿流动力学相关指标[腹压漏尿点压（AL-PP）、最大尿流率（Qmax）和最大尿道闭合压力（MUCP）]均升高,且研究组高于对照组（P<0.05）。两组治疗后尿失禁生活质量量表（I-QOL）各维度（限制性行为、心理影响、社交活动受限）评分及总分均升高,且研究组高于对照组（P<0.05）。结论：电针阴部神经刺激疗法联合Kegel盆底康复训练可有效改善产后SUI患者的盆底肌肌力和尿失禁情况,减少漏尿量,同时可促进尿流动力学恢复,进而提高患者的生活质量。     

Effect of PGF2α and GnRH on the reproductive performance of postpartum dairy cows subjected to synchronization of ovulation and timed artificial insemination during the warm or cold periods of the year

This study was designed to evaluate the reproductive performance of lactating dairy cows (Holstein Friesian) after the injection of PGF_2α analogue on Day 15 postpartum, and GnRH analogue on Day 23 after artificial insemination (AI) with Presynch (two injections of PGF_2α, administered 14 days apart starting at 30–35 days postpartum) + Ovsynch-based (GnRH–7 days–PGF_2α–2 days–GnRH–16–20 hours–timed artificial insemination) treatments, during the warm and cold periods of the year. All the cows (n = 313) were assigned to one of the four groups including: M₁ (n = 72) in which the cows were treated with PGF_2α on Day 15 postpartum + Presynch-Ovsynch + GnRH on Day 23 post-AI; M₂ (n = 41) in which the cows received PGF_2α on Day 15 postpartum + Presynch-Ovsynch; M₃ (n = 100) including the cows that got Presynch-Ovsynch; and control group (n = 100) including the cows that were not treated and were inseminated at natural estrus. Pregnancy diagnosis was performed 28 to 35 days post-insemination by means of ultrasound. The results showed that treatment with PGF_2α on Day 15 postpartum significantly decreased the days to conception and the number of services per conception (P < 0.01) and it also improved the first service conception rate (P < 0.1) only in cows that were treated with M₂ protocol. Whereas, the days to first service was not influenced by the treatment of PGF_2α on Day 15 postpartum (P > 0.05). In contrast, administration of GnRH on Day 23 post-AI increased the days to conception and the number of service per conception (P < 0.01) and tended to decrease the first service conception rate (P < 0.1) in cows that were treated with M₁ compared with M₂ protocol. Therefore, it was concluded that Presynch-Ovsynch protocol could be more reproductive and beneficial when a single treatment with PGF_2α was administered at 15 days postpartum (15 days after the PGF_2α, Presynch-Ovsynch protocol was initiated). Interestingly, the administration of a GnRH agonist on Day 23 post-AI not only did not improve the reproductive performance of the cows receiving first postpartum timed artificial insemination after Presynch-Ovsynch protocol but also reduced that.     

认知疗法联合舍曲林治疗产后抑郁症患者的临床疗效研究

目的：探讨认知疗法合并舍曲林治疗产后抑郁症患者的临床疗效。方法：将本院2011年10月至2012年7月收治的76例产后抑郁症患者按随机数字表法分为认知疗法合并舍曲林治疗组（试验组,38例）和舍曲林单独治疗组（对照组,38例）,进行临床随机双盲对照试验,采用17项汉密尔顿抑郁量表（HamiltonDepressionRatingScale,HAMD）、临床整体量表一疗效总评估量表（ClinicalGlobalImpression,CGI）评价和比较两组的临床疗效。结果：（1）试验组的有效率显著高于对照组,差异有统计学意义[92．11％VS81．58％）,P〈0．01],试验组第2、3阶段的临床有效率均显著高于对照组,差异有统计学意义（P〈0．05）。（2）与治疗前相比,两组患者治疗后的HAMD、CGI．SI总分均降低,差异有统计学意义（P〈0．01）;治疗第1、2、3阶段,试验组HAMD、CGI—SI减分值均显著高于对照组,差异有统计学意义（P〈0．05）。结论：认知疗法联合舍曲林治疗产后抑郁症的短期治疗内疗效显著优于舍曲林单独治疗。     

产后逐瘀胶囊联合米非司酮治疗产后恶露不尽的临床疗效观察

摘要 目的：探讨产后逐瘀胶囊联合米非司酮对产后恶露不尽的治疗效果。方法：选取2018年6月~2020年12月期间青海红十字医院接受诊治的128例产后恶露不尽患者,根据随机数字表法分为对照组和观察组各64例。对照组给予米非司酮治疗,在对照组的基础上观察组另加服产后逐瘀胶囊治疗,对比两组疗效、子宫三径、凝血功能指标、平均恶露干净时间、恶露量以及不良反应情况。结果：观察组的总有效率高于对照组（P<0.05）。两组治疗2周后的子宫三径比治疗前缩小,且观察组较对照组更小（P<0.05）。两组治疗2周后纤维蛋白原（FIB）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）均下降,且观察组低于对照组（P<0.05）。观察组的恶露量少于对照组,平均恶露干净时间短于对照组（P<0.05）。两组不良反应对比无明显差异（P>0.05）。结论：产后逐瘀胶囊联合米非司酮治疗产后恶露不尽疗效可靠,能够有效阻止恶露,促进子宫复旧,改善机体凝血功能,且安全性较好。