Congenital hypertrophic pyloric stenosis(CHPS)is a common congenital gastrointestinal malformation in infants and young children.The incidence of CHPS has been reported to be 1 to 10 per 10000 live births and CHPS is more common in boys with a sex ratio of 5:1 in our country.Hypertrophic pylori muscle leads to gastric outlet obstruction which causes frequent vomiting.Serious vomiting affects children's growth and even threats to life.The specific pathogenic factors and mechanism of CHPS are still unclear,and studies suggest that it is possiblely related to the abnormalities of the pylori muscle development,the neural innervation,the nerve cell development and the gastrointestinal hormone level.Recently,researches suggest that both environmental factors and genetic factors play a certain role in the pathogenesis of CHPS.This article reviews the research progress of pathogenic factors and pathogenesis of CHPS.

Objective To explore the effect of telomerase reverse transcriptase(TERT) gene transfected bone marrow stem cell(BMSC)on the memory function and hippocampal CA1 region synaptic plasticity in vascular dementia rat.Methods A total of 60 rats were randomly divided into the negative control group(group A),model group(group B),conventional BMSC group(group C) and transfected BMSC group(group D).The related indicators in each group were detected by using the Morris maze test,RTPCR and Western blot respectively.Results The escape latency period in the group C and group D was significantly longer than that in the group B,which in the group D was significantly longer than that in the group C.Compared with the group A,the expressions of brain-derived neurotrophic factor(BDNF)mRNA,TERT mRNA,SYP mRNA and protein in the group B,group C and group D were significantly decreased.The synaptic cleft arrange in group A was clear with more SYN positive ceils.The synaptic cleft in the group D was clearer,and the number of SYN positive cells was close to that in group A.Conclusion TERT transfected BMSC has obvious therapeutic effect on vascular dementia rats and its mechanism may be related to the promotion of BDNF,TrkB expression and the improvement of synaptic plasticity.

OBJECTIVE:To investigate therapeutic efficacy and safety of leosimendan in the treatment of acute left heart failure (ALHF) and its effects on left ventricular function indexes and serum markers.METHODS:A total of 110 patients with acute left ventricular function selected as research objects from No.251 Hospital of PLA during Jan.2014-Dec.2015,and then were divided into control group (53 cases) and observation group (57 cases) according to random number table.Both groups received routine therapy.Control group was additionally given Dopamine hydrochloride injection or Dobutamine hydrochloride injection as cardiotonic on the basis of routine therapy.Observation group was additionally given Levosimendan injection with initial dose of 10 μg/kg+0.9％ Sodium chloride injection 50 mL,ivgtt (10 min),and then with micro pump infusion at the rate of 0.1 g/(kg· min) for continuous 24 h.Both groups were treated for continuous 7 d.Clinical efficacies of 2 groups were observed,and the levels of left ventricular function indexes (PER,PFR,LVEF,LVSF) level,serum marker (NT-proBNP) and galectin-3 (Gal-3) before and after treatment,the occurrence of ADR was recorded.RESULTS:Two cases were withdrawn from the study due to death (one case in each group).Finally,a total of 108 cases were included,involving 52 cases in control group and 56 cases in observation group.Clinical total response rate of observation group (94.64％) was higher than that of control group (86.54％),but without statistical significance (P＞0.05).Before treatment,there was no statistical significance in left ventricular function indexes or serum markers levels between 2 groups (P＞ 0.05).After treatment,the levels of left ventricular function indexes were improved significantly in 2 groups,and LVEF and LVSF of observation group were significantly higher than those of control group,with statistical significance (P＜0.05).NT-proBNP and Gal-3 of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).No obvious ADR was found in 2 groups during treatment.CONCLUSIONS:Leosimendan in the treatment of ALHF have the similor clinical efficacy with dopamine,but helps to strengthen the left heart pump function,reduce heart failure markers levels with good safety.

OBJECTIVETo evaluate the incidence of postoperative complications of children with intermediate or high anorectal malformations treated by one-stage modified posterior sagittal anorectoplasty(PSARP) by meta-analysis.

METHODSCases with intermediate or high anorectal malformations treated by one-stage modified PSARP nearly a decade at home and abroad were collected by searching in Wanfang Data, CNKI, and PubMed database, then all the papers that recorded the number of cases of postoperative complications were screened out according to inclusion and exclusion criteria. Meta package in RevMan 3.2.5 software was used to perform the meta analysis for rate, and logit conversion method was applied to calculate the merger of the rates. Firstly, heterogeneity inspection was carried out. If the result was P>0.05, it was the homogeneity between the instructions included in the literatures, the fixed effect model was chosen. If the results was P<0.05, the random effect model was chosen. Then rank correlation test was used to estimate the number of research to evaluate publication bias. If P was 0.05 or less, the difference was statistically significant.

RESULTSThirteen related articles were selected and added up to 566 cases with intermediate or high anorectal malformations treated by one-stage modified PSARP. The merged rate of the complications was 28%(95%CI: 19% to 40%). The three highest rate of complications were 8%(95%CI:4% ~ 14%) of corrupt dung, 7%(95%CI:5% ~11%)of fecal incontinence and 5%(95%CI:3% ~ 10%) of rectal mucosa prolapse.

CONCLUSIONThe most common postoperative complications of children with intermediate or high anorectal malformations treated by one-stage modified PSARP are rectal corrupt dung and fecal incontinence.

Objective? To understand the attitude toward hospice care and its infLuencing factors among undergraduate nursing students majoring in TraditionaL Chinese Medicine (TCM), and to provide basis for nursing educators to formuLate hospice care training strategies. Methods? Using convenient sampLing method, a totaL of 827 undergraduate nursing students from 3 TCM universities in Shandong, Shanxi and He'nan provinces were seLected as subjects from September to October 2018. The generaL information questionnaire and the Chinese version of FrommeLt Attitude Toward Care of the Dying (FATCOD) were used. MuLtipLe Linear regression was used to anaLyze infLuencing factors. ResuLts? The totaL score of FATCOD among the 827 undergraduate TCM nursing students was (101.32±9.15). Univariate Linear regression resuLts showed that gender, singLe-chiLd status, wiLLingness to choose nursing major, attitudes toward nursing, the situation where students discussed death with famiLy, experience with funeraLs, experience with terminaL reLatives, wiLLingness to take care terminaL patients were aLL factors that couLd affect the attitudes toward hospice care among nursing students (t/F=-3.066,-2.783, 3.289, 12.577, 10.638, 2.680, -2.251, 8.697;P＜0.05). MuLtipLe Linear regression anaLysis resuLts showed that gender, singLe-chiLd status, attitudes toward nursing, wiLLingness to take care terminaL patients, experience with funeraLs, the situation where students discussed death with famiLy, experience with terminaL reLatives have an impact on the attitude toward hospice care (P＜ 0.05). ConcLusions? The attitude toward hospice care among undergraduate TCM nursing students needs to be further improved. Educators shouLd adopt various methods of teaching to carry out death education according to the infLuencing factors, and to cuLtivate proper perception of death and improve the enthusiasm for hospice care.