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Aim: To examine the tolerance of type 1 diabetic hearts to ischemia and reperfusion injury. Myocardial contents of 27‐kDa and 70‐kDa heat shock proteins (hsp) as well as phosphorylated hsp27 were also determined. Methods: Hearts from hyperglycemic rats 3 weeks after streptozocin injection and age‐matched normal rats were subjected to ischemia and reperfusion in vitro. Cardiac function and electrocardiogram were recorded throughout experiments. Myocardial heat shock proteins were detected with Western blot. Results: Despite depressed systolic function at the baseline, diabetic hearts exhibited considerable enhancement in postischemic heart function, manifested by an increase in the maximal rate of left ventricular pressure rise and fall (post‐ischemic dp/dtmax and dp/dtmin were 560±117 and ‐313±68 mmHg/s in control, n=7, 1249±57 and ‐1204±36 mmHg/s in diabetes, n=10, P < 0.01). Reperfusion ventricular fibrillation in the diabetic group were attenuated compared with controls (1.5±0.3 vs 7.2±2.1 min in control, P < 0.01). The increased heart resistance to ischemia in diabetes was associated with hyperglycemia and accompanied by enhanced expression of myocardial phosphorylated hsp27 with normal aortic vessel relaxation. Cardioprotection was abrogated by metabolic correction with insulin and accompanied by phospho‐hsp27 reduction. Conclusion: Heart resistance to ischemia is increased in type 1 diabetes, and hyperglycemia may present a mild yet stressful stimulus leading to upregulation of endogenous stress protein, which may play a potential role in cardioprotection and compensate for detrimental effects of hyperglycemia in diabetes.

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ObjectiveTo evaluate the clinical application of the minimally invasive modified pedicle screw–rod fixator for unstable pelvic ring injuries, including its feasibility, merits, and limitations.MethodsTwenty-three patients (13 males, 10 females; average age, 36.3 years) with unstable pelvic ring injuries underwent anterior fixation using a modified pedicle screw–rod fixator with or without posterior fixation using a transiliac internal fixator. The clinical findings were assessed using Majeed scores. The quality of reduction was evaluated using the Matta criteria.ResultsClinical results at 1 year postoperatively were excellent in 14 patients, good in 7, and fair in 2. The two patients with fair results had intermittent pain at the sacroiliac joint because of the posterior implant. One woman complained of persistent pain at the pubic tubercle during sexual intercourse. Iatrogenic neuropraxia of the unilateral lateral femoral cutaneous nerve occurred in three patients. Unilateral femoral nerve palsy occurred in one patient. The quality of fracture reduction was excellent in 12 patients, good in 8, and fair in 3. Heterotopic ossification occurred in eight patients; all were asymptomatic.ConclusionsMinimally invasive modified pedicle screw-rod fixation is an effective alternative treatment for pelvic ring injuries.