ABSTRACT
Objective To investigate the effect of suberoylanilide hydroxamic acid (SAHA) on sufentanil postconditioning-induced cardioprotection in rats with type 2 diabetes mellitus (T2DM).Methods Male SPF Sprague-Dawley rats,weighing 250-300 g,aged 5-6 weeks,were used in the study.T2DM was induced by high-fat diet (4 weeks) and intraperitoneal 1％ streptozotocin 35 mg/kg,and confirmed by fasting blood glucose level≥ 16.7 mmol/L.Forty rats with T2DM were divided into 5 groups (n=8 each) using a random number table:sham operation group (grou T2DM-S);ischemia-reperfusion group (group T2DM-I/R);sufentanil postconditioning group (group T2DM-SP);SAHA group (group T2DM-SA);SAHA plus sufentanil postconditioning group (group T2DM-SASP).In T2DM-SA and T2DM-SASP groups,SAHA 25 mg/kg was injected intraperitoneally once a day for 5 consecutive days before operation.Their hearts were excised and retrogradely perfused in a Langendorff apparatus.The hearts were subjected to 30 min of global ischemia followed by 120 min of reperfusion to establish the model of ischemia/reperfusion injury.At 30 min of equilibration and 30,60 and 120 min of reperfusion,the left ventricular systolic pressure (LVSP),heart rate (HR),and the maximum rate of increase and decrease of ventricular pressure (±dp/dtmax) were recorded.At 120 min of reperfusion,the left ventricular mass (LVM) and infarct size (IS) were measured,and IS/LVM ratio was calculated.The expression of glycogen synthesis kinase 3β (GSK-3β) and phosphorylated GSK-3β (p-GSK-3β) in the myocardium was detected by Western blot.Results Compared with group T2DM-S,the LVSP,HR and ±dp/dtmax were significantly decreased,the IS and IS/LVM ratio were significantly increased,and the expression of myocardial p-GSK-3β was significantly down-regulated in group T2DM-I/R (P＜0.05).Compared with group T2DM-I/R,the ±dp/dtmax was significantly increased,the IS and IS/LVM ratio were significantly decreased,and the expression of myocardial p-GSK-3β was significantly up-regulated in group T2DM-SASP (P＜0.05),and no significant change was found in the parameters mentioned above in T2DM-SA and T2DM-SP groups (P＞0.05).Compared with group T2DM-SP,the ±dp/dt was significantly increased,the 1S and IS/LVM ratio were significantly decreased,and the expression of myocardial p-GSK-3β was significantly upregulated in group T2DM-SASP (P＜0.05).Conclusion SAHA can improve cardioprotection induced by sufentanil postconditioning to some extent in the rats with T2DM.
ABSTRACT
Objective To evaluate the effect of multimodal warming regimen on the development of intraoperative hypothermia in the patients undergoing precise hepatectomy.Methods Sixty patients of both sexes,aged 28-64 yr,weighing 44-89 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ (Child-Pugh A),undergoing precise hepatectomy,were equally and randomly assigned into control group (group C) and muhi-model warming group (group M) using a random number table.A bed sheet was covered on the body exposed,and the abdominal cavity was washed using the room-temperature peritoneal layage fluid in group C.In group M,after admission to the operating room,the room temperature was raised to 25-26 ℃,the mattress was prewarmed using the medical heating blanket,the temperature was maintained at 40 ℃ during operation,the lower body was simultaneously covered using the forced-air warming system,and the temperature was maintained at 37-39 ℃;the solution used for infusion was warmed to 37 ℃ before anesthesia;the incisional area was washed with 0.9％ sodium chloride injection which was prewarmed to 37 ℃ during operation.The development of hypothermia,hypotension and respiratory depression was recorded during operation.Before induction of anesthesia,at 1 h after anesthesia,at the end of operation,and at 5 min before discharge from postanesthesia care unit (PACU),blood gas analysis was performed,and the pH value,base excess and lactate level were recorded.The intraoperative blood loss,emergence time,duration of PACU stay,and occurrence of shivering,agitation,nausea and vomiting were also recorded.Results Compared with group C,the incidence of intraoperative hypothermia,and shivering,agitation,nausea and vomiting in PACU were significantly decreased,the emergence time and duration of PACU stay were significantly shortened,the pH value was significantly increased at 5 min before discharge from PACU,and the base excess and lactate level were significantly decreased at the end of operation and 5 min before discharge from PACU in group M (P＜0.05 or 0.01).Conclusion Multimodal warming regimen can raise the quality of recovery from anesthesia and decrease the development of intraoperative hypothermia in the patients undergoing precise hepatectomy.
ABSTRACT
Objective To evaluate the effect of sufentanil postconditioning on acetylated histon H3 (Ac-H3) expression during myocardial ischemia-reperfusion (I/R) in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (S group),I/R group,and sufentanil postconditioning group (SP group).Myocardial I/R was induced by 30 min occlusion of the left anterior descending branch of the coronary artery followed by 120 min reperfusion in anesthetized rats.Sufentanil 1 μg/kg was injected through the femoral vein at 5 min before reperfusion in group SP,while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 120 min of reperfusion,and the myocardial specimens were obtained from the anterior wall of the left ventricle for determination of myocardial infarct size and cell apoptosis (by TUNEL),and myocardial specimens were obtained from the apex for detection of Ac-H3 expression (using Western blot).Apoptotic index was calculated.Results Compared with S group,the myocardial infarct size and apoptotic index were significantly increased,and Ac-H3 expression was down-regulated in I/R and SP groups (P＜0.05).Compared with I/R group,the myocardial infarct size and apoptotic index were significantly decreased,and Ac-H3 expression was up-regulated in SP group (P＜ 0.05).Conclusion Sufentanil postconditioning attenuates myocardial I/R injury through up-regulating AcH3 expression and restoring histone acetylation in rats.