Perinatal depression and infant and toddler neurodevelopment: A systematic review and meta-analysis.

Many studies have focused on the effect of perinatal depression on neurodevelopment among children and adolescents. However, only a few studies have explored this relationship in infants and toddlers with inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between perinatal depression and infant and toddler neurodevelopment during the first two postnatal years. Twenty-three studies were included in this meta-analysis. Perinatal depression was associated with poorer cognitive (Cohen's d = -0.19, SE= 0.06, 95% CI = -0.30 to -0.08), language (Cohen's d = -0.24, SE = 0.09, 95% CI = -0.40 to -0.07), and motor (Cohen's d = -0.15, SE = 0.05, 95% CI = -0.26 to -0.05) development. Subgroup analyses showed that the types of maternal depression (prenatal depression vs. postnatal depression), the method of measuring maternal depression (rating scale vs. diagnostic interview), and the time interval between assessment of exposure and outcome had an impact on the observed effect about neurodevelopment of infants and toddlers. In addition, the results of our study pointed to a stronger significant association between prenatal depression and cognitive, language, and motor delays in infants and toddlers, whereas the association between postnatal depression and cognitive, language, and motor delays in infants and toddlers was not statistically significant. In conclusion, this study provided convincing evidence that the perinatal window is a sensitive period for offspring neurodevelopment.

Multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures.

Objectives: To retrospectively evaluate a multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures in the emergency department. Methods: The records of patients with pelvic fractures complicated with multiple fractures treated in our hospital from February 2020 to April 2021 were selected, of which 34 patients received conventional trauma first aid mode control group) and 34 patients received multidisciplinary joint first aid mode (study group). We compared pelvic function (Majeed functional score) and fracture reduction outcomes, as well as serum inflammatory factor levels and complication rates after treatment between the two groups. Results: The Majeed score in the study group (90. 15 ± 6.83) was higher than that in the control group (75. 47 ± 5.35), and the differences were statistically significant(P<0.05). The value for combined excellent and good rates of fracture reduction in the study group (85.29%, 29/34) was significantly higher than that in the control group (58.82%, 20/34), and the difference was statistically significant(P<0.05). We found similar levels of TNF-a and IL-6 between the two groups at admission(P>0.05); however, the serum levels of TNF-a and IL-6 in the study group were lower than those in the control group on the fifth day after admission, and the difference was statistically significant (P<0.05 or P<0.01). The incidence of complications in the study group (17.64%, 6/34) was significantly lower than that in the control group (61.76%, 21/34), the difference was statistically significant(P<0.05). Conclusion: The multidisciplinary cooperative first aid model for the treatment of patients with pelvic and multiple fractures can effectively shorten the treatment time, increase the excellent functional rehabilitation rate, inhibit the release of inflammatory factors, and reduce the incidence of complications (such as infections), when compared to the conventional trauma emergency system.

[Dynamic effects of adjunct peritoneal resuscitation on the early intestinal injury of rats after hemorrhagic shock].

OBJECTIVE: To investigate the dynamic effects of adjunct peritoneal resuscitation ( APR ) on the early intestinal injury of rats with hemorrhagic shock, and explore its possible mechanisms. METHODS: According to random number table, 96 male Wistar rats were assigned randomly into control group, shock group, Ringer solution APR group and dialysate APR group. Each group was further divided into three time points, namely 1, 2, and 6 hours after resuscitation, with 8 rats for each time point. The model of hemorrhagic shock was reproduced. The rats in the shock group received shed blood plus twice amount of normal saline as conventional intravenous resuscitation ( CIR ). Besides CIR, at the beginning of resuscitation, those rats in Ringer solution APR and dialysate APR groups were given 100 mL/kg of Ringer solution or 2.5% glucose-based peritoneal dialysis solution intravenously, respectively. The rats in four groups were sacrificed at 1, 2 and 6 hours after resuscitation, respectively. Plasma activity of diamine oxidase ( DAO ) was detected by ultraviolet spectrophotometry colorimetry. Intestinal pathological changes were observed under light microscope, and the grading of the intestinal mucosal damage ( GIMD ) score was estimated. The expressions of nuclear factor-ΚB ( NF-ΚB ) and heat shock protein 70 ( HSP70 ) mRNA in the intestinal tissue were determined with reverse transcription-polymerase chain reaction ( RT-PCR ), and the wet/dry weight ratios ( W/D ) of the remaining intestinal tissue were measured. RESULTS: Compared with the control group, plasma activity of DAO, GIMD score, expressions of NF-ΚB and HSP70 mRNA and W/D ratios of intestinal tissue at 1 hour after resuscitation were increased significantly in the shock group. Except the expression of NF-ΚB mRNA reached the peak level at 2 hours after resuscitation, all the other parameters increased with time. Compared with the shock group, plasma activity of DAO ( U/L: 8.78±0.76 vs. 13.30±1.37, 9.67±0.92 vs. 16.56±1.61, 10.53±0.84 vs. 18.31±1.72,all P<0.05 ), GIMD score ( 1.36±0.31 vs. 3.51±0.66, 2.28±0.40 vs. 4.02±0.76, 2.47±0.38 vs. 4.76±0.77, all P<0.05 ), the expressions of NF-ΚB mRNA in the intestine tissue ( gray value: 0.658±0.062 vs. 0.765±0.067, 0.945±0.077 vs. 1.158±0.096, 0.761±0.062 vs. 0.912±0.082, all P<0.05 ), and W/D ratios ( 3.91±0.26 vs. 4.34±0.33, 3.96±0.32 vs. 4.51±0.40, 4.37±0.33 vs. 4.99±0.43, all P<0.05 ) at 1, 2, 6 hours after resuscitation in the dialysate APR group were decreased significantly, but the expressions of HSP70 mRNA were increased significantly ( gray value: 0.717±0.054 vs. 0.635±0.056, 0.853±0.068 vs. 0.745±0.071, 1.258±0.111 vs. 1.108±0.105, all P<0.05 ). The activity of DAO and GMID score at 1 hour after resuscitation in the Ringer solution APR group were decreased significantly compared with the shock group, while the differences of the other parameters between the Ringer solution APR group and shock group showed no statistical significance. CONCLUSIONS: APR with 2.5% glucose-based peritoneal dialysis solution can significantly mitigate the early intestinal injury secondary to hemorrhagic shock, and the mechanism may be associated with enhancement of the expressions of HSP70 mRNA and inhibition of the expressions of NF-ΚB mRNA.