Endoplasmic reticulum stress was induced by the accumulation and aggregation of unfolded proteins due to stresses that disturbed the cellular energy levels, the redox state, or Ca²⁺ concentration, and leading to the unfolded protein response (UPR) pathway. The hepatic UPR was activated in several forms of liver disease. Recent data showed that the role of the UPR in hepatic cells have identified molecular mechanisms that may underlie the association between UPR activation and liver disease. SERP1 was known as ribosome-associated membrane protein 4 (RAMP4), was homologous to yeast suppressor of SecY 6 protein (YSY6p) which suggested a role in pathways controlling membrane protein biogenesis at the ER level. Expression of SERP1 was enhanced during cellular stress, causing accumulation of unfolded proteins in the ER.By interaction with the molecular chaperone calnexin, SERP1/RAMP4 could control biogenesis of membrane proteins and take participate in the endoplasmic reticulum stress.Objective To study the effects of stress-associated endoplasmic reticulum protein 1(SERP1) on the endoplasmic reticulum stress induced by the tunicamycin in HepG2 cells.

The tunicamycin was used to induce endoplasmic reticulum stress in the HepG2 cells.We divided the cells into 5 groups: normal control group, tunicamycin treated group, tunicamycin + 0.25μg/μl SERP1 transfected group, tunicamycin + 0.25μg/μl SERP1 transfected group, tunicamycin + 0.5μg/μl SERP1 transfected group, tunicamycin + 1μg/μl SERP1 transfected group. Each experiment was repeated three times.MTT was used to detect the effect on the survival rate of the HepG2 cells and selected the optimal concentration and time of tunicamycin treatment.Western blot was used to detect the standard of expression of endoplasmic reticulum stress spcific mark proteins, glucose-regulated protein 78(GRP78), C/EBP homologous protein (CHOP) and calnexin.

Compared with the control group, the expression levels of GRP78, CHOP and calnexin were significantly increased in the tunicaymicin treated group, which were 3.8 times, 1.3 times and 1.4 times respectively. With the increasing amount of transfection, SERP1 over expression was found to relieve the expression of GRP78 12%(1.838±0.29, 1.6±0.132, P>0.05), 24% and 30%(1.838±0.29, 1.40±0.11, 1.27±0.21, F=50.56, P<0.01)compared with the tunicamycin group, the expression of CHOP were decreased by 23%, 29% and 34%(1.0±0.15, 0.79±0.07, 0.72±0.55, 0.67±0.14, F=9.532, P<0.01)respectively and calnexin were decreased by 5%(1.20±0.18, 1.15±0.13, P>0.05)、24%和28%(1.20±0.18, 0.92±0.07, 0.87±0.18, F=8.116, P<0.01)respectively, which were induced by tunicamycin treatment.

SERP1 overexpression could attenuate the ER stress induced by tunicamycin, and may reduce the cell damage mediated by the ER stress.

To investigate the specific clinical manifestations, surgery treatment of internal and external growth of thoracolumbar intraspinal schwannomas and provide evidences for early diagnosis and treatment.

From March 2011 to July 2013, medical records of seven patients with spinal schwannoma were retrospectively reviewed, which were first diagnosed with non-spinal diseases.

Among seven patients, two patients admitted to urology for the first time, one patient in department of hepatobiliary surgery, two cases in department of gynecology, one patient in department of pain, one case in department of physiotherapy.Patients got the right diagnosis after proper consultation and further examination.Among seven patients, five patients with different degree of spinal canal nerve compression symptoms including leg pain, numbness, weakness while two cases with no obvious symptoms.It may be neurogenic tumors by CT and MRI examination.Schwannoma were confirmed by postoperative pathological examination.In the following 1.3 years, basic symptoms disappeared, it didn′t appear recurnence and new symptoms.

Parts of the internal and external growth of thoracolumbar intraspinal schwannomas have their specific clinical manifestations: abdominal mass oppression for initial symptoms, while spinal nerve compression symptoms appear later.Thinking of the possibility of the disease and relevant examination are the keys to the appropriate diagnosis and treatment.Combined extracapsular resection inside and outside the spinal canal is an effective way for internal and external growth of thoracolumbar intraspinal schwannomas.

To explore the diagnostic cutoff value of the Silverman Anderson score(SA) predict to preterm infant with respiratory failure(RF).

From January 2013 to December 2013, 160 cases of the preterm infants with RF who needed for oxygen therapy were randomly selected from the Huaian Maternity and Child Healthcare Hospital.SA scores of all preterm infants at admission were respectively recorded, while extracting radial arterial for blood gas analysis. The diagnosis of RF were determined by comprehensive analysis. The diagnostic cutoff of the SA predicting preterm RF were confirmed by receiver operating characteristic (ROC) curve.

RF rate was 63.8%.SA score was 5.24±1.22. The area under the ROC curve was 0.91, area of the standard error was 0.023. 95% confidence interval area was 0.866-0.955.There was statistically significance in SA value for the diagnosis of preterm RF(P=0.000). The higher value of SA was, the greater the likelihood of preterm RF was. When the dangers of missed diagnosis rate is equal to that of misdiagnosis rate, the optimal SA diagnostic cutoff value was 5.5, the sensitivity was 67.6%, misdiagnosis rate was 3.4% and missed diagnosis rate was 37.1%.When sensitivity and misdiagnosis were rate dominant, the optimal SA diagnostic cutoff value was 4.5, the sensitivity was 93.1%, misdiagnosis rate was 31.0% and missed diagnosis rate was 14.9%.

The SA score can early predict preterm RF. It might help the clinicians to rapidly assess the severity extent of preterm infants with RF and give appropriate measures to the preterm infants at the bedside.Therefore, it might improve the quality of treatment of the preterm infants with RF.

To investigate the clinical tests of white blood cell of different types of epilepsy patients who treated with valproate, to analyse the rules and characteristics of hematological toxicity, and to explore its possible mechanism.

Sixty-one patients with epilepsy, taken fasting peripheral blood immediately after the use of valproate monotherapy, and peripheral hemogram measurement was detected by SYSMEX automatic blood cell analyzer, including red blood cell, hemoglobin, white blood cell, platelet count.

There were various manifestations of hematological toxicity of sixty-one patients with epilepsy, The number of white blood cell in fifty-five patients decreased among them, the number of red blood cell in three patients decreased, and the platelet count decreased significantly in ten patients.After being treated with sodium valproate.After using valproate treatment, white blood cell count reduced in all types, the differences were statistically significant.But there was no statistical difference among the types of white blood cell.

Sodium valproate can cause leucocyte count, red blood cell count and platelet levels decrease in some patients with partial epilepsy and the decrease of white blood cells count has nothing to do with different types of eplepsy.

To study the effects of repiratory frequency and tidal volume for CO₂ pneumoperitoneum on respiratory system and gastric intramucosal pH of aged patients during laparoscopic cholecystectomy.

Forty-two patients were divided into group A(f=12, Vt=9ml/kg, n=22) and group B(f=14, Vt=7ml/kg, n=20). PPEAK, P_ETCO₂ and pHi were monitored before pneumoperitoneum (T1) 20min after pneumoperitoneum (T2) and relieving pneumoperitoneum (T3) respectively.

PPEAK, P_ETCO₂ at T2 were significantly higher than that at T1 in the same groups (P<0.05). pHi of B group at T2 was significantly lower than that at T1(P<0.05). There were significant difference of T2 indexes in group A compared with group B(P<0.05).

The method of proper frequency rate and tidal volume in CO₂ pneumoperitoneum may act positively for respiratory system and pHi of aged patients during laparoscopic cholecystectomy .

To analyze the relationship between body mass index, lipid profile and non-alcoholic fatty liver disease (NAFLD).

A population-based, cross-sectional study was carried out in 10 000 clients of health examination in the population of Hefei area in 2012. Body mass index (BMI), history of alcohol intake and past medical history were recorded. Subjects were divided into four groups according to the levels of BMI, clinical indicators included serum lipids, and fasting blood glucose and the rate of non-alcoholic fatty liver disease were compared among the four groups. Distribution of BMI of the masses in Hefei region was analyzed. The relationships between BMI and the incidences of hyperlipidemia and non-alcoholic fatty liver disease were discussed.

(1)The occurring rate of obesity and overweight was 60%, normal weight was 38.3%. (2)The incidence of overweight and obesity was distinct in different age groups (χ²=161.733, P=0.000). (3)Except for high density lipoprotein-cholesterol, indicators included triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood sugar and uric acid levels in overweight and obesity groups were significantly higher than those in normal group. (4)With the increasing of BMI, the incidence of non-alcoholic fatty liver disease and hyperlipidemia were increased. (5)Factors including BMI, gender (male), triglyceride, total cholesterol were independent risk for non-alcoholic fatty liver disease, whereas high density lipoprotein cholesterol was a protective factor. (6)ROC analysis demonstrated that the best cut off value of BMI in predicting the incidence of non-alcoholic fatty liver disease was 24.85 or 24.95 in male and 24.95 in female.

Overweight and obesity are the risk factors for the prevalence of NAFLD and hyperlipidemia. Management of weight and targeted interventions rectifying the metabolism disorders at the earliest opportunity, which may contribute to reduce the risk of hyperlipidemia and NAFLD.