Dehydroepiandrosterone sulphate improves cholestasis-associated fatigue in bile duct ligated rats

Abstract:  Fatigue is a common debilitating symptom in patients with primary biliary cirrhosis (PBC). The mechanism of fatigue is still poorly understood. However, it has been reported that levels of the steroid dehydroepiandrosterone sulphate (DHEAS) are reduced in plasma of patients with PBC, and substitutive therapy has been suggested to improve fatigue symptoms experienced during the course of this disease. In this study, we tested the effect of DHEAS on whole body fatigue in rats following bile duct ligation (BDL). Fatigue was estimated by the time spent on an electrified grid as a result of falling off a treadmill and by performance of rats on an infrared beam monitor which allows the assessment of travelled distance and stereotypic movement activities. On day 5 after BDL surgery, cholestatic rats exhibited increased whole body fatigue as reflected by significantly increased time spent on the electrified grid, reduced travelled distance and reduced stereotypic movements. Administration of 5 mg kg⁻¹ of DHEAS to BDL rats for three consecutive days significantly normalized their behaviour. Fatigue scores were also found to be reduced in cirrhotic rats 4 weeks after BDL surgery, and DHEAS treatment for 3 days reduced fatigue scores at this stage. Dehydroepiandrosterone sulphate treatment was sufficient to increase brain levels of DHEAS in the BDL rats in a manner that is significantly and highly correlated with those of plasma DHEAS and brain dehydroepiandrosterone (DHEA). Substitutive therapies with DHEAS or DHEA could represent novel approaches in the management of fatigue due to cholestasis-induced liver failure.     

手法复位加柯氏针固定治疗桡骨远端不稳定性骨折

目的 探讨桡骨远端不稳定性骨折的最佳治疗方式。方法 透视下手法复位柯氏针经皮穿刺、交叉贯穿固定桡骨远端不稳定性骨折69例分析。结果 固定后透视骨折对位对线良好。追踪观察3～8周，无骨折再移位，随访4～12个月，平均6个月，优26例，良43例，优良率100％。结论 本方法仅需有透视机，手枪钻的基层单位，在门诊条件下，局部麻醉下就可开展，对患者的损伤小，并发症少，愈合快，费用低，是一个值得推广的方法。     

急性心肌梗死心率变异与预后及临床的关系

目的　为探索急性心肌梗死 (AMI)时心率变异性 (HRV)变化规律及对AMI预后的临床意义。方法　检测 10 3例AMI患者症状发生 2 4小时内及 3周时的HRV时域及频域指标 ,并与 90例正常人进行对比。结果　AMI患者HRV明显低于对照组 (P <0 0 5 ) ;合并糖尿病、高血压病等 ,年龄大、梗死面积大、Killip分级差 ,HRV较小。发生心脏事件者HRV明显低于不发生心脏事件者。 结论　提示AMI时自主神经系统功能失衡 ,诱发心脏电生理紊乱 ,影响预后。     

Survivin在宫颈癌中的表达及临床意义

目的研究凋亡抑制因子survivin在早期宫颈癌组织中的表达和意义。方法用免疫组织化学链霉菌抗生物素蛋白-过氧化酶连接法(SP法)检测53例早期宫颈癌(ICC)和10例癌旁正常宫颈上皮(NEC)中survivin表达情况。结果(1)宫颈癌组织survivin阳性表达率67.9%。在癌旁正常宫颈组织未发现阳性表达。(2)survivin的表达与年龄、FIGO分期、病理分级、淋巴结转移、术前治疗及预后密切相关(P<0.05),与组织学类型无相关性(P>0.05)。结论survivin可能在宫颈癌的发生发展过程中起关键作用,检测其表达水平,对于宫颈癌的诊断、恶性程度及预后的判断有一定价值。     

前列腺电切术处理膀胱颈口的技巧

目的总结前列腺电切术的技巧。方法腰麻后，膀胱截石位，辨认膀胱颈口，采用标记法找到前列腺与内括约肌交界点1、2，内下倾电切，避开内括约肌，切至包膜。如存在后唇抬高，坚决切平之，此结构的切除不会带来严重后果，反之则会出现术后梗阻。已经切破颈口包膜，应适当保留破口周围的前列腺组织，以便产生一定的牵拉张力，同时注意术中不要有高压力的灌注。若有输尿管间嵴肥厚，可做楔形切除。结果520例患者术后11例排尿困难行二次电切，2例完全性尿失禁，l例大出血改开放性手术。全部14例问题患者均为我科开展TURP手术早期2年内发生，与技术因素密切相关。结论我们所处理的520例前列腺电切术经过这样的严格要求，术后并发尿失禁及出血已极大降低，获得良好效果，值得推广。