Pathogenic factors and pathogenesis of congenital hypertrophic pyloric stenosis / 国际儿科学杂志

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.

Meta analysis of incidence of postoperative complications for the modified posterior sagittal anorectoplasty treatment of intermediate or high anorectal malformations / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To 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.</p><p><b>METHODS</b>Cases 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.</p><p><b>RESULTS</b>Thirteen 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.</p><p><b>CONCLUSION</b>The 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.</p>