Oxidative Stress before and after Operation in Patients with Chronic Cholecystitis Containing Gallstone

To study the relationship of oxidative, antioxidative constituents and antioxidases in blood with chronic cholecystitis containing gallstone, levels of lipoperoxides (LPO), nitric oxide (NO), vitamin C(VC), vitamin E (VE) and β carotene (β CAR) in plasma as well as level of LPO, activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH Px) in erythrocytes were investigated by spectrophotometric assay in 107 patients with this condition (PCg) and 100 healthy volunteers (HVs). Compared with HVs group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of PCg group were significantly increased ( P <0.0001), while that of VC, VE and β CAR in plasma and the average activities of SOD, CAT and GSH Px in erythrocytes were significantly decreased ( P <0.0001). Linear regression and correlation analysis for 107 preoperative PCg showed that the value of LPO and NO in plasma and that of LPO in erythrocytes of PCg gradually increased ( P <0.0001), representing a significant linear positive correlation. The value of VC, VE and β CAR in plasma and that of SOD, CAT and GSH Px in erythrocytes of PCg gradually decreased ( P <0.0001), representing a significant linear negative correlation. Stepwise regression and correlation analysis for 107 preoperative PCg suggested that the closest correlation was observed between the course of disease and the value of NO and VC in plasma and that of SOD, GSH Px and LPO in erythrocytes, r =0.7306, F =32.1408, P <0.0001. Compared with the preoperative PCg group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of the postoperative PCg group were significantly decreased ( P <0.0001). Furthermore, the average value of VC in plasma and that of SOD, CAT and GSH Px in erythrocytes of the postoperative PCg group were significantly increased ( P <0.0001), whereas no significant difference was found between their average value of VE and β CAR in plasma. These findings suggested that oxidative stress was an aggravating pathological condition in PCg group. Therefore, we recommend that in treating PCg, antioxidants such as VC, VE, β CAR should be given in order to alleviate their potential oxidative damages.

Modified Ureterosigmoidostomy

Objective To introduce an operation procedure and evaluate the continence diversion results of the modified ureterosigmoidostomy after radical cystectomy. Methods Fourteen cases of bladder cancer or prostate carcinoma were operated on with modified Sigma pouch from Feb, 1998 to Dec, 1999. A longitudinal incision about 25 cm on the sigmoid wall was done to form a low pressure pouch. The vertex of the new pouch was fixed to sacrum. Both ends of ureters were anastomosed side to side and to form a big nipple and inserted into the top of pouch for 2 to 3 centimeters.Results It took about sixty five minutes to create a new low pressure pouch after radical cystectomy. Early complication of was found in two cases postoperatively, and cured with temporary colonostomy. Hydronephrosis and hypokalemia in one patient were cured by percutaneous anterograde ureter dilatation with balloon and oral replacement of potassium salt. All patients displayed urinary continence. No symptomatic renal infection or hypercholoraemic acidosis occurred. Conclusion Modified ureterosigmoidostomy is a safe procedure of urinary diversion and provides a big volume, low intravesical pressure pouch. The patients are free from the troublesome urine bag, intermittert catheterization, and upper urinary tracts are protected effectively. The quality of life is satisfied.

Comparative Study on the Efficacy of Yiweining (异位宁) and Gestrinone for Post-operational Treatment of Stage Ⅲ Endometriosis

Objective： To observe the clinical efficacy and safety of Yiweining （异位宁, YWN） and gestrinone （GT） in treating post-operational patients of stage Ⅲ endometriosis （EM-Ⅲ）. Methods： Fifty-two patients of EM-Ⅲ after operation were randomly assigned into three groups, the YWN group （20 patients） was treated through oral intake of YWN 200 ml, twice a day; the GT group （19 patients） treated with gestrinone 2.5 mg, twice every week, with the medication starting from the 7th post-operational day and lasting for 6 months. The control group （13 patients） was untreated. Six months was one therapeutic course, and follow-up study was carried out in the 6-30 months after the end of the medication. Results： The recurrence rate in the YWN group and the GT group were 5.0% and 5.3% respectively, showing insignificant difference between the two groups, but they were lower than that in the control group （30.7%, P〈0.05）. Besides, the adverse reaction rate in the YWN group was lower than that in the GT group （ 10.0% vs 31.6%, P〈 0.05）. Conclusion： Application of YWN to prevent the post-operational recurrence of endometriosis is effective and safe, and its efficacy is similar to that of GT.