Objective To evaluate the feasibility and efficacy of twin grasper combined with endoloops on closing acute stomach perforation.Methods Two experimental porcines of stomach perforation underwent endoscopic closure by twin grasper combined with endoloops.Survival conditions and closure of perforating were observed.Results Mild infection and abdominal adhesions were observed in one week after operation.The nylon rope fell off and an ulcer-like lesion was presented in the closed position.The methylene blue leak test was negative.Histologic examination revealed chronic inflammatory cells infiltration,granulation,fibroplasias,and regenerative mucous membrane crawling toward the center of perforation.Conclusion The technique of twin grasper combined with nylon ropes in closing the acute stomach perforation is feasible and effective.

Objective To investigate the associations of Toll-like receptors (TLRs) mRNA expressions and their downstream signaling pathways in peripheral blood mononuclear cells with clinical outcomes in patients with cerebral infarction.Methods Ninety patients with cerebral infarction of anterior circulation,admitted to our hospital fiom May 2015 to December 2015,were chosen.Quantitative real-time PCR was performed to measure the expressions ofTLR2,TLR4,TLR3,TLR7,TLR8 and TLR9 and downstream signaling molecules Toll-like receptors related molecule (TRAM),interferon regulatory factor 3 (IRF-3),and interferon beta (IFN-β) in peripheral blood mononuclear cells.Good functional outcome was defined as modified Rankin Scale (mRS) scores≤ 2 90 d after onset.National Institutes of Health Stroke Scale (NIHSS) on admission was used to evaluate the severity of stroke,and infarct volume 7-14 d after onset was measured on MR imaging.The baseline characteristics (TLRs,population information,risk factors,stroke types,clinical and imaging data) were compared between patients with good and bad functional outcomes.Multi-factor Logistics regression analysis was performed.Results TLR3 and TLR7 mRNA expressions were correlated with good functional outcome at acute cerebral infarction,and only TLR3 expression was correlated with good functional outcome at sub-acute phase.TLR3 mRNA expression,C-reactive protein (CRP) level,and NIHSS scores on admission were positively correlated with good outcome (OR=4.435,P=0.001;OR=l.12,P=0.033;OR=1.961,P=0.000).The expressions of TLR3 and IRF-3 were both inversely correlated with NIHSS scores and cerebral infarction volume;IFN-β mRNA expression was positively correlated to TLR3 expression (r=0.392,P=0.000);IFN-β expression and IRF level were positively correlated (r=0.347,P=0.01).Conclusion The TLR3 expression is correlated with good functional outcome in peripheral blood mononuclear cells of patients with cerebral infarction,which may play a crucial role in the survival of neurons after ischemia through spuring the extraction of anti-inflammatory factor IFN-β.

Brain Ischemia ; pathology ; physiopathology ; Humans ; Neoplasm Proteins ; metabolism ; Pyroptosis ; physiology ; Signal Transduction ; physiology