Iatrogenic gastrointestinal perforation is one of the severe adverse events of endoscopic therapeutic procedure. For acute iatrogenic perforation,management by endoscopic techniques is a simple and rapid modality to close the perforation with minimal invasiveness and avoiding the traditional surgical trauma. Endoclips,suture with special instruments,covered stents,degradable sheets combined with tissue adhesive,and combined endoscopic techniques such as snares combined with endoclips,are the major endoscopic therapeutic modalities for closure of iatrogenic gastrointestinal perforation. In this article,the current status and progress of endoscopic management for acute iatrogenic gastrointestinal perforation were reviewed.

Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide scientific evidence for the development of control strategies. Methods According to "The National Technical Scheme for Endemic Disease Control in 2007", 19 counties were chosen to carry out the epidemiological investigation in 2008. Water and urinary fluoride were determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 were diagnosed by Dean method and skeletal fluorosis of adults over the age of 16 were examined clinically and by X-rays. Results In 19 counties, 186 villages were surveyed, 44 villages were found with mean water fluoride ≤ 1.00 mg/L, accounting for 23.66%(44/186);the value ＞ 1.00 mg/L in 142 villages,accounting for 76.34% (142/186);maximum water fluoride 8.88 mg/L. Total detection rate of dental fluorosis of children aged 8 to 12 was 66.35% (4518/6809), dental fluorosis index was 1.55, and defect rate was 15.39%(1048/6809). Children with urinary fluoride ＞ 1.40 mg/L was 83.29%(2149/2580), and the maximum value was 31.92 mg/L. Detection rates of skeletal fluorosis clinically and by X ray among adults over 16 years were 6.37%(5577/87 607) and 20.23% (229/1132), respectively. Conclusions Endemic fluorosis in Shandong province is still serious, prevention efforts need to be further increased.

Objective To investigate the molecular mechanism of solanine-induced apoptosis of prostate cancer cells Du145 and LNCaP.Methods The effects of solanine on the viability of Du145 and LNCaP cells were evaluated by MTT assay.The generation of intracellular reactive oxygen species (ROS) and solanine-induced apoptosis were measured by flow cytometry.The protein levels of p38 and p-p38 expressions were examined by Western blot.Results Solanine significantly inhibited the viability of Du145 and LNCaP cells in a dose-dependent manner (P＜0.01).The inhibition of solanine on cell viability was suppressed by the ROS scavenger NAC.ROS generation,apoptosis and phosphorylation of p38 were induced by treatment with solanine at 40 μmol/L for 24 h.The expression of p38 and solanine-induced apoptosis were suppressed by NAC and SB203580.Conclusion Solanine induces the apoptosis of human prostate cancer cell via the RO.S-p38 signaling pathway.

Objective To explore the neuroprotective effect of cyclosporine A against cerebral ischemia in a rat model of cerebral ischemia reperfusion. Methods Fifty-two adult male SD rats, weighted 250-280 gram, were randomly divided into three groups: the sham group (group A, n=6), PBS control group (group B, n=23) and cyclosporine A group (group C, n=23). Group C received hypodermic injection of cyclosporine A 10mg/kg daily after surgery and group B re?ceived equal volume of PBS instead. Modified Neurological Severity(mNss)scores were used to assess the neurological deficits at 3, 7, 14, 21 and 30 days following cerebral ischemia. The infarct volume were measured 3 days after reperfu?sion. The neurons, reactive microglia and astrocytes around the infract area were detected by immunofluorescence at 3 and 30 days after surgery. Results Modified Neurological Severity scores were significantly lower in group C than group B at the third(P=0.003),seventh (P=0.011),Fourteenth (P=0.000),twenty-first (P=0.003) and thirtieth (P=0.004) days after surgery. cyclosporine A reduced infarct volume, reactive microglia and astrocytes while increased survived neurons (P<0.001) in ischemic penumbra 3 and 30 days after reperfusion (all P<0.001). Conclusion Continuous injection of cyclosporine A not only protects neurons against ischemia damage but also improves neurological functional recovery af?ter acute stage of damage, possibly through reduction of reactive microglia cells and proliferation of astrocytes.

Objective To study the expression level and clinical significance of bcl-XL gene in childhood medulloblastoma.Methods The expression of Bcl-XL protein and bcl-XL mRNA were determined by immunohistochemical staining and in situ hybridization in 41 samples of medulloblastoma tissues,as well as 20 normal brain tissues.Results The positive rate of Bcl-XL protein(90.2%) and bclXL mRNA(95.1%) in medulloblastoma group were significantly higher than those in normal human brain tissues(all P

Objective To report a ileal ureteric replacement surgery for bilateral long segment ureter injury.Methods Data from a patient suffered bilateral long segment uretercic stenosis was reviewed.A 32-year-old female,who underwent radical surgery of cervical cancer and postoperative radiotherapy 1 year ago,complained intermittent low back pain for 11 months and was found renal function abnormality for 3 months.Ultrasound showed bilateral hydronephrosis,and the CT urography showed bilateral middle-lower ureteral stenosis.Preoperative diagnosis was bilateral hydronephrosis with bilateral ureteral obstruction.The patient underwent bilateral ileal ureteric replacement under general anesthesia.Results The surgical procedure was successful and the postoperative recovery was favorable.The operation time was 180 min,and blood loss was 100 ml.The abdominal cavity drainage tube was removed 8 days and the urinary catheter was removed 9 days postoperatively.During 8 months' follow up,the patient showed resolved flank pain with stable serum creatinine.No complication was reported.The CTU 2 months postoperatively showed the hydronephrosis was relieved with normal functioning kidneys.Conclusion Bilateral ileal ureteric replacement surgery might be an effective procedure and viable option for bilateral long segment ureteric injuries.

Objective To examine neuroinflammation,oxidative damage and neuron loss in the contralateral parie-tal lobecortex of TBI model mice, and to investigate effects of berberine chloride on such secondary damage.Methods TBI model was established by a weight-drop hitting device and mice in berberine group were administered intragastrically with berberine chloride (50mg/kg.day) for 21 days.Immunofluorescence staining was used to assess activity of microglia and astrocyte.Immunohistochemistry was used to assess DNA oxidative damage, neuron loss and expression of COX-2 and iN-OS.Results Activation of microglia and astrocyte, expressions of COX-2 and iNOS and DNA oxidative damage were ob-viously increased by TBI,(19.82 ±1.88)and(16.96 ±1.69)、(13.79 ±4.32)and(8.67 ±0.96)、(27.86 ±5.38) and (16.00 ±7.59)、(31.92 ±6.57)and(24.79 ±2.78)respectively (P<0.01 or P<0.05).Activation of microglia and ex-pressions of COX-2 and iNOS were significantly suppressed by berberine ,(15.49 ±1.88)and(19.82 ±1.88)、(16.83 ± 7.89)and(27.86 ±5.38)、(26.25 ±2.41)and(31.92 ±6.57) respectively(P<0.01 or P<0.05).There was no differ-ence in neuron loss among three groups, (49.05 ±4.38),(48.56 ±3.56)and (47.75 ±4.14) respectively (P>0.05). Conclusions TBI can cause neuroinflammation and oxidative damage but not neuron loss in the contralateral parietal lobe cortex.Berberine chloride can significantly suppress neuroinflammtion in the contralateral parietal lobe cortex after TBI.

Objective To investigate the clinical value of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the treatment and therapeutic effect evaluation of patients with an exacerbation of chronic obstructive pulmonary disease.Methods The levels of serum sTREM-1,procalcitonin (PCT) and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay (ELISA) in 49 exacerbation of chronic obstructive pulmonary disease (COPD) subjects [acute exacerbation of chronic obstructive pulmonary disease (AECOPD) group],49 stable COPD subjects(sCOPD group) after treatment and 49 healthy volunteers as healthy control group.The levels of sTREM-1,PCT and CRP in different groups were compared and the relationship between the level of sTREM-1 in AECOPD and sCOPD groups,and PCT,and CRP was analyzed,respectively.Results The content of sTREM-1,PCT and CRP between different groups had significant difference(P ＜0.05).The level of sTREM-1 in both AECOPD and sCOPD groups was significantly positive correlated with PCT (P ＜ 0.05) and negative correlated with CRP (P ＞ 0.05).Conclusions For guiding the treatment and curative effect evaluation of patients with AECOPD,sTREM-1 has important clinical reference value.

Objective To investigate the influence of anti-depression therapy on cardiac function and short-term prognosis in elderly patients with congestive heart failure (CHF) and the safety and effectiveness of fluoxetine in these patients.Methods Ninety six elderly hospitalized patients with CHF accompanied with depressive disorder were randomly divided into two groups:fluoxetine (20mg once daily)and placebo treated groups based on the routine cardiac drug therapy for 3 months. Results The prevalence rate of depressive disorder in elderly patients with CHF was 31.1%.The length of stay of fluoxetine group was shorter than that of placebo group.The post-treatment depressive exponents of self-rating depression scale(SDS)in fluoxetine group (51.39%?8.63)was lower than those in pretreatment and in placebo group.The improvement of cardiac function in fluoxetine group(53.4%?4.5%) was much better than that of placebo group (P

Serum cortisol and plasma ACTH were determined in 10 patients with severe sepsis and 12 with septic shock on day 1,3,5 after diagnosis were made,and the data were compared with 12 control patients. To evaluate the hypothalamic-pituitary-adrenal(HPA)axis function in patients with severe sepsis and septic shock,1?g ACTH stimulation test was applied after hormone concentrations were obtained on day 1.Compared with the control patients,ACTH level was significantly higher in patients with severe sepsis and lower in septic shock(P