Objective To investigate the related demographic and obstetrical factors of postpartum depressive symptoms.Methods The study was carried out in four hospitals selected by stratified sampling in Changsha city.The 320 nullipara women who met the designed including criteria at 6 weeks postpartum were recruited by cluster sampling from the four hospital.Three hundred and twenty nullipara women were assessed by using Edinburgh Postpartum Depression Scale(EPDS),self-designed demographic and obstetrical factors questionnaires.Results The study showed that the careers like cadre and clerisy were demographic risk factors(P=0.011,OR=0.886).There were four obstetrical risk factors,including assisted reproductive technology(ART)(P=0.005,OR=4.585),the time of the first stage of labor(P=0.024,OR=2.269),instrumental delivery(P=0.000,OR=49.767),and birth defect(P=0.000,OR=28.386).The normal delivery was a protective factor(P=0.003,OR=0.151).Conclusion Multiple factors are involved in the incidence of postpartum depression.Preventive intervention should be taken actively to prevent against postpartum depression.

Objective:To determine associations between postpartum depression (PPD) and plasma neurotransmitters.Methods:We conducted a case-control study nested to a prospective cohort established in 3 comprehensive tertiary hospitals in Changsha,Hunan,China from February to September 2007.The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to screen PPD,with a score of 13 or higher as the cut-off for PPD.The women with matched age but without PPD and delivery within 5 years were selected as controls.The levels of plasma monoamine neurotransmitters including serotonin (5-hydroxytryptamine,5-HT),dopamine (DA),and norepinephrine (NE),and peptide neurotransmitters including neuropeptide Y (NPY) and substance P (SP) in maternal blood samples taken at 2 weeks postpartum were measured and compared between PPD women (n=42) and controls (n=42).Results:Plasma levels of 5-HT and NPY were significantly lower while plasma levels of NE and SP were significantly higher in PPD women than those in the controls.For women with PPD,a negative correlation between NPY and NE (r=-0.36,P＜0.05) was observed.Conclusion:There are changes in plasma levels of neurotransmitters in women with PPD,and there are potential interactions between different neurotransmitters.

Pancreatic cancer is characterized by nerve invasion and a high mortality rate， and its pathological process depends on the complex interaction network between tumor and the nervous system. Based on the concept of “pancreatic cancer neuroecology”， this article analyzes the mechanism of action of peripheral motor nerve， sensory nerve， and central nerve in tumorigenesis， pain regulation， and cachexia formation and emphasizes the synergistic regulatory role of immune cells， Schwann cells， and extracellular matrix in the microenvironment of perineural invasion. At the same time， this article further elaborates on the metabolic interaction and chemotaxis between neuraxis and tumor， the effect on promoting chemotherapy resistance， and the dynamic relationship between neuroplasticity and tumor adaptability. In clinical practice， this article summarizes the key value of perineural invasion in prognostic evaluation， preoperative evaluation， and the selection of surgical strategy. In addition， this article reviews the basic research advances in the biomarkers and potential targets associated with perineural invasion in pancreatic cancer and points out the limitations of current model and transformation research. In the future， systematically analyzing the nerve-tumor-immune network and targeting its key nodes may provide multi-dimensional strategies and new breakthroughs for the precise intervention of pancreatic cancer， the reversal of drug resistance， and the relief of symptoms.