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.     

氧疗对全麻后睡眠期脉搏血氧饱和度的影响

目的　观察全麻后睡眠期氧疗的效果和低氧血症发生的时间。方法　 6 0例ASAⅠ～Ⅱ级、年龄 2 5～ 84岁的患者随机分为睡眠期氧疗组和睡眠期非氧疗组 ,每组 30例。全麻苏醒拔管回病房后 ,Venturi面罩给氧 (FiO2 =31 % ) ,氧疗组持续 72h ,而非氧疗组在睡眠期则停止吸氧。观察手术前夜和术后第 1、2、3夜的脉搏血氧饱和度 (SpO2 )值 (S0 、S1 、S2 、S3 )。结果　氧疗组S2 低于S0 (P <0 .0 5 ) ,非氧疗组S1 和S2 明显低于S0 (P <0 .0 1 ) ,S3 低于S0 (P <0 .0 5 )。两组同时间比较 ,非氧疗组S3 低于氧疗组 (P <0 .0 5 ) ,且非氧疗组的S1 和S2 明显低于氧疗组的对应值 (P <0 .0 1 )。结论　全麻后睡眠期可发生低氧血症 ,氧疗能明显提高患者的SpO2 值     

光杖联合直接喉镜应用于老年患者气管插管的临床分析

目的:研究光杖联合直接喉镜对老年手术患者气管插管全麻诱导下的血流动力学与气道并发症的影响。方法:选择45例ASAⅠ-Ⅲ级拟行全麻手术的老年患者,男23例,女22例,年龄65-82岁,随机分成光杖组(A组)、直接喉镜组(B组)和光杖联合直接喉镜组(C组)。三组患者采用相同的全身麻醉诱导方法,分别记录麻醉诱导前(T0)、麻醉诱导后(T1)、插管即刻(T2)和插管后1min(T3)的收缩压(SBP)、舒张压(DBP)、心率(HR)和氧饱和度(SpO2)。记录插管时间和插管成功的例数,并观察并发症。结果:插管即刻(T2)HR、SBP、DBP、SpO2在B组与C组之间差异有统计学意义(P<0.05),插管后1min HR、SBP、DBP、SpO2在B组与C组之间差异有统计学意义(P<0.05),C组并发症少于A、B组,插管时间C组短于A、B组(P<0.05)。结论:在老年患者中光杖联合直接喉镜气管插管,成功率高,可以有效减轻气管插管的应激反应,对老年患者血流动力学影响较小。     

成年人心血管外科术后并发缺血性脑卒中的诊疗

目的 探讨成年人心血管外科术后并发缺血性脑卒中的早期诊断和治疗方法.方法 回顾性分析24例心血管外科术后并发缺血性脑卒中患者的临床资料.在循环、呼吸稳定的前提下,尽早检查以判定缺血性脑卒中类型,密切监测生命体征,注意意识、瞳孔、呼吸深浅及频率、四肢活动的变化.给予降温、脱水、抗凝、调脂、营养脑神经、β受体阻滞剂等药物治疗.治疗过程中维持水、电解质及酸碱平衡.结果 24例患者中男性占66.7％（16/24）.术后早发性缺血性脑卒中6例,术后迟发性缺血性脑卒中18例.冠状动脉旁路移植术12例,单纯瓣膜手术8例,夹层手术2例,其他手术2例.在院死亡2例,病死率8.3％（2/24）.结论 成年人心血管外科术后具有缺血性脑卒中临床表现者应尽早明确诊断,严密的监护与及时全面的治疗是缺血性脑卒中治疗的关键.     

线粒体相关内质网膜在肠缺血再灌注损伤中的研究进展

肠缺血再灌注损伤是外科手术或创伤患者高死亡率的重要原因之一.缺血再灌注可引起肠道细胞缺血、缺氧,致使细胞内Ca2+超载、线粒体内活性氧积聚、线粒体自噬、细胞凋亡等.这些细胞事件能够引起肠道细胞损伤,导致肠道屏障作用降低,细菌或毒素由肠道入血,引起全身炎症反应综合征,甚至多器官功能障碍综合征.线粒体相关内质网膜(MAM)...     

牛心包补片修补心脏缺损并雾化吸入伊洛前列环素降低肺动脉高压

背景：对于先天性心脏病合并肺动脉高压的治疗,传统降低肺动脉高压的药物效果确实,但存在不易监测、停药后反跳等现象;传统的心脏涤纶补片较易引起吻合口变形、血栓、栓塞、溶血和感染等并发症。 目的：观察应用戊二醛处理牛心包补片和雾化吸入伊洛前列环素治疗先天性心脏病合并肺动脉高压的效果。 方法：选择90例先天性心脏病合并肺动脉高压患者,术中采用戊二醛处理的牛心包补片修补心脏间隔缺损,术后雾化吸入伊洛前列环素30 ng/(min•kg),日间12 h按1次/4 h给药,夜间12 h按1次/6 h给药,连续给药2 d。记录每次吸入药物前、吸入后即刻、吸入30 min后平均动脉压、平均肺动脉压、体循环阻力指数与肺循环阻力指数,于随访期观察有无心包材料相关并发症和心功能情况。 结果与结论：90例患者复查超声心动图见活瓣均已关闭,无分流,心脏间隔缺损无回声中断,心脏收缩功能正常,未发现与牛心包补片相关的不良反应。所有患者不同时间点平均动脉压、体循环阻力指数比较差异无显著性意义。患者吸入药物后即刻平均肺动脉压、肺循环阻力指数明显低于吸入药物前(P < 0.01),吸入30 min后平均肺动脉压、肺循环阻力指数亦明显低于吸入药物前(P < 0.05)。表明应用戊二醛处理的牛心包补片和雾化吸入伊洛前列环素治疗先天性心脏病合并肺动脉高压安全、有效。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：