参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

参附注射液对糖尿病大鼠心肌缺血再灌注时PTEN和P13 K表达的影响

Objective To investigate the effect of Shenfu injectio (SFI) on the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and phosphatidylinositol 3-kinase (PI3K) during myocardial ischemia-reperfusion (IR) in diabetic rats.Methods Thirty adult male diabetic SD rats weighing 220-280 g were used in this study. Diabetes mellitus was induced with intraperitoneal streptozotocin 60 mg/kg and confirmed by fasting blood glucose > 16.7 mmol/L. The animals were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II IR and group Ⅲ SFI. Myocardial IR was produced by occlusion of left anterior descending branch (LAD) of coronary artery for 30 min followed by 120 min reperfusion in group IR and SFI. LAD was exposed but not occluded in group S.SFI was infused iv at 10 ml·kg-1 ·h-1 before opening the thoracic cavity and at 3ml·kg-1·h-1 after opening the thoracic cavity in group SFI until the end of operation. Equal volume of Lactated Ringer's solution and hydroxyethyl starch was infused instead of SFI in group S and IR. The rats were killed and hearts removed at 120 min of reperfusion for microscopic examination and determination of cardiomyocyte apoptosis (by TUNEL)and expression of PTEN and PDK (by immunohistochemical method). PTEN/PI3K ratio, myocardial infarct size of left ventricle and apoptosis index were calculated.Correlation between apoptosis index and PTEN/PI3K ratio was analyzed. Results Myocardial infarct size and apoptosis index were significantly increased, while expression of PTEN and PI3K was up-regulated in group IR and SFI as compared with group S ( P < 0.05 or 0.01) . PTEN/PI3K ratio was significantly decreased in group SFI as compared with group S (P< 0.05). Myocardial infarct size and apoptosis index were significantly decreased, PTEN expression was down-regulated, PI3K expression was up-regulated and PTEN/PI3K ratio was significantly decreased in group SFI as compared with group IR( P < 0.05) . Myocardial pathological damage was attenuated in group SFI as compared with group IR. Apoptosis index was positively correlated to PTEN/PI3K ratio (r =0.452,P <0.05) .Conclusion SFI can attenuate myocardial IR injury via down-regulating the expression of PTEN,up-regulating the expression of PBK and activating PI3K/Akt signal pathway in diabetic rats.     

舒芬太尼延迟预处理对兔心肌缺血再灌注损伤的影响

Objective To investigate whether delayed preconditioning with sufentanil can protect against myocardial ischemia and reperfusion (IR) injury and the possible mechanism. Methods Thirty-six male New Zealand white rabbits 8-18 months old weighing 2.0-2.4 kg were used in this study. The animals were anesthetized with iv etomidate 2 mg/kg, tracheostomized and mechanically ventilated (VT 10-12 ml/kg, RR 20-25 bpm, FiO2 100%). Carotid artery and jugular vein were cannulated for BP and HR monitoring and fluid administration.Myocardial ischemia was induced by 30 min of occlusion of anterior descending branch of left coronary artery followed by 3 h of reperfusion. The animals were randomly assigned to one of 5 groups based on the sufentanil and/or naloxone the animals received 24 h before myocardial ischemia: group Ⅰ received normal saline (group IR,n=9); greup Ⅱ sufentanil 5 μg/kg (group S1, n=6); group Ⅲ sufentanil 10 μg/kg (group S2, n=9); group Ⅳ naloxone 10 mg/kg (group N, n =6) and group Ⅴ naloxone 10 mg/kg + sufentanil 5 μg/kg (group NS, n =6). Myocardial infarct size was measured using triphenyl tetrazolium (TIC) staining. Myocardial apoptosis was detected by TUNEL, and Bcl-2 and Bax protein expression was determined by immuno-histochemistry in group IR and S2. Results Sufentanil produced a dose-dependent reduction in infarct size as compared with group IR.Naloxone had no effect on infarct size but partially abolished sufentanil-induced cardio-protection. Sufentanil significantly decreased myocardial apoptosis and Bax protein expression but increased Bcl-2 protein expression as compared with group IR. Conclusion Sufentanil produces a delayed preconditioning against myocardial IR injury through activating opioid receptors and inhibiting cadiomyocyte apoptosis.     

胫骨干骨折的手术治疗对策

目的：明确不同固定器械在胫骨干不同骨折类型固定中的特点，以指导临床应用。方法：68例胫骨干骨折，行加压钢板螺钉、交锁髓内钉、单侧外固定架固定后，作临床疗效分析。结果：加压钢板固定组42例，感染5例，骨不连1例，平均愈合时间3．8个月；交锁髓内钉固定组13例，无感染及骨不连，平均愈合时间5．4个月；单侧外固定架组13例，骨不连1例，踝关节背伸受限3例，平均愈合时间4．5个月。结论：胫骨骨折交锁髓内钉固定并发症少，功能恢复好，适用范围广，但要注意及时进行动力加压。加压钢板及外固定架固定应选择各自的最佳适应证，以达到理想的疗效。     

Faculty of Anaesthetists of the Royal College of Surgeons of Ireland

The Faculty of Anaesthetists of the Royal College of Surgeons of England, 35–43 Lincoln's Inn Fields, London WC2A 3PN. Telephone: 01-405 3474.     

Surgical correction of rupture of aneurysm of the sinus of Valsalva

Operations were performed on 48 patients with aneurysms of the thoracic aorta, one of them had a rupture of aneurysm of the noncoronary sinus followed by the formation of a fistula between the aorta and the right atrium. The fistula was ligated by an access through the right atrium with good nearest and long-term results.