Objective：To explore the effect of bile salt and bile acid on cultured eternalized human gastric mucosa epithelium GES-1 cells. Methods：Cultured eternalized human gastric mucosa epithelium GES-1 cells were treated w...Objective：To explore the effect of bile salt and bile acid on cultured eternalized human gastric mucosa epithelium GES-1 cells. Methods：Cultured eternalized human gastric mucosa epithelium GES-1 cells were treated with media containing 6 different kinds of bile salts and 3 different kinds of bile acids and their mixture with different concentrations： GCDC（glycochenodeoxychoμte）, GDC （glycodeoxychoμte）, GC（glycochoμte）, TCDC（taurochenodeoxychoμte）, TDC（taurodeoxychoμte）, TC （taurochoμte）, LCA （lithocholicacid）, CA（cholic acid）, DCA（deoxycholic acid）（50 μ mol/L,250 μ mol/L,500 μ mol/L,1000 μ mol/L）, DY（mixture of bile salts） and DS（mixture of bile acids）（250 μ mol/L,500 μ mol/L,1000 μ mol/L,1500 μ mol/L, 2000 μ mol/L）, in comparison with the control group（in normal media without bile salts and bile acids）. Cell proliferation was assessed by MTT（3-[4,5-Dimethylthiaolyl]-2,5- diphenyl-tetrazolium bromide） assay for 72 hours with different concentrations and the apoptotic cells were assayed by flow cytometry （FCM） with Annex V-FITC conjugated with propidium iodide（PI） staining for 24 hours with different concentrations（1500,2000 μt mol/L）. Results：There was no significant difference in morphology and cell proliferation in GC group after 24-72 h. Low concentration（50 μ mol/L） of GCDC, GDC, TCDC, TDC and TC accelerated gastric epithelial cell growth in a dosage-time dependent manner. At middle concentration （250-500 μ mol/L）, it showed positive effect after 24-48 h, while negative effect after 72 h. At high concentration（1000 μ mol/L）, it accelerated gastric epithelial cell growth after 24h and show consistent inhibition even leading to necrosis after 48-72 h. LCA and CA showed a positive effect on the concentration of 50 μ mol/L after 24-72 h, while 250-1000 μ mol/L showed a trend towards apoptosis after 24-72 h. At 50-500 μmol/L, DCA showed proliferation after 24 h and apoptosis after 48-72 h, but showed necrosis after 24-72 h at 1000 μmol/L. DY and DS could facilitate normal gastric mucosa epithelial cell growth at low concentration （250-500 μ mol/L）, however at 1000-2000 μ mol/L the trend shifted from apoptosis to necrosis. FCM with Annexin-V conjugated with PI staining revealed that GCDC, GDC, GC, TCDC, TDC, TC, LCA, CA, DCA, DY and DS induced apoptosis of human gastric mucosal epithelial cells. They were all significantly higher than that of the control（P 〈 0.05）, but there was no significant difference in GC group （P 〉 0.05）. The bile salts induced apoptosis in a time-dose-dependent manner. Conclusion：Our results suggested that bile acid and bile salt is the trigger of injury in human gastric mucosal epithelial cells.展开更多
Obesity is a global health epidemic with considerable economic burden.Surgical solutions have become increasingly popular following technical advances leading to sustained efficacy and reduced risk.Sleeve gastrectomy ...Obesity is a global health epidemic with considerable economic burden.Surgical solutions have become increasingly popular following technical advances leading to sustained efficacy and reduced risk.Sleeve gastrectomy accounts for almost half of all bariatric surgeries worldwide but concerns regarding its relationship with gastroesophageal reflux disease(GERD)has been a topic of debate.GERD,including erosive esophagitis,is highly prevalent in the obese population.The role of pre-operative endoscopy in bariatric surgery has been controversial.Two schools of thought exist on the matter,one that believes routine upper endoscopy before bariatric surgery is not warranted in the absence of symptoms and another that believes that symptoms are poor predictors of underlying esophageal pathology.This debate is particularly important considering the evidence for the association of laparoscopic sleeve gastrectomy(LSG)with de novo and/or worsening GERD compared to the less popular Roux-en-Y gastric bypass procedure.In this paper,we try to address 3 burning questions regarding the inter-relationship of obesity,GERD,and LSG:(1)What is the prevalence of GERD and erosive esophagitis in obese patients considered for bariatric surgery?(2)Is it necessary to perform an upper endoscopy in obese patients considered for bariatric surgery?And(3)What are the long-term effects of sleeve gastrectomy on GERD and should LSG be done in patients with pre-existing GERD?展开更多
AIM To assess the relationship between gastric acid output (GAO) and both pattern of gastroesophageal reflux (GER) and esophageal lesions, and to evaluate the role of GAO and other potential pathogenetic factors in t...AIM To assess the relationship between gastric acid output (GAO) and both pattern of gastroesophageal reflux (GER) and esophageal lesions, and to evaluate the role of GAO and other potential pathogenetic factors in the development of esophagitis. METHODS Gastric acid secretory testing and 24 h intraesophageal pH monitoring were performed in 31 patients with esophagitis and concomitant duodenal ulcer (E+DU) and compared with those of 72 patients with esophagitis (E) alone. RESULTS The GAO in patients with E+DU was significantly higher than in patients with E ( P <0 05). There was no significant difference between the two groups of patients as to endoscopicl findings and parameters of GER ( P >0 05). A multiple regression analysis with stepwise deletion showed that the pre sence of hiatal hernia (HH), GER in upright position and age appeared to correlate significantly with the presence of esophagitis. CONCLUSIONS No parallel relationship between GAO and severity of GER or esophageal lesions exists in patients with E+DU, and that GAO is not a major pathogenetic factor in GER disease.展开更多
目的探析胃液及外周血的总胆汁酸(total bile acid,TBA)水平对胆汁反流性胃炎(bile reflux gastritis,BRG伴有胃黏膜肠上皮化生(gastric intestinal metaplasia,GIM)的诊断效能。方法选取2020年6月至2022年6月临海市第二人民医院收治的...目的探析胃液及外周血的总胆汁酸(total bile acid,TBA)水平对胆汁反流性胃炎(bile reflux gastritis,BRG伴有胃黏膜肠上皮化生(gastric intestinal metaplasia,GIM)的诊断效能。方法选取2020年6月至2022年6月临海市第二人民医院收治的150例BRG患者作为研究对象,根据是否发生GIM分为观察组(GIM发生,n=89)和对照组(GIM未发生,n=61)。观察组中,又将28例BRG伴GIM作为不完全型GIM组,61例完全型GIM作为完全型GIM组。检测两组患者的胃液及外周血TBA,采用受试者操作特征(receiver operator characteristic,ROC)曲线分析胃液及外周血TBA水平在诊断BRG伴GIM的诊断效能。结果观察组胃液及外周血的TBA水平均显著高于对照组(P<0.05)。ROC分析显示,胃液TBA水平诊断BRG伴GIM的曲线下面积(area under the curve,AUC)为0.836,敏感度为81.97%,特异性为83.15%;外周血TBA水平诊断BRG伴GIM的AUC为0.753,敏感度为62.30%,特异性为82.02%。不完全型GIM组胃液及外周血TBA水平显著高于完全型GIM组(P<0.05)。ROC曲线分析结果显示,胃液TBA水平诊断BRG伴GIM患者不同分型的AUC为0.952,敏感度为89.47%,特异性为96.08%;外周血TBA水平诊断BRG伴GIM患者不同分型的AUC为0.766,敏感度为76.37%,特异性为80.39%。结论胃液及外周血TBA对BRG伴GIM及GIM不同分型均具有较好诊断效能,且外周血TBA检测的侵入性小,对于辅助人群诊断BRG伴GIM及GIM不同分型具有明显的现实意义。展开更多
基金the Clinical Key Programs of Ministry of Public Health(No.20012130)
文摘Objective：To explore the effect of bile salt and bile acid on cultured eternalized human gastric mucosa epithelium GES-1 cells. Methods：Cultured eternalized human gastric mucosa epithelium GES-1 cells were treated with media containing 6 different kinds of bile salts and 3 different kinds of bile acids and their mixture with different concentrations： GCDC（glycochenodeoxychoμte）, GDC （glycodeoxychoμte）, GC（glycochoμte）, TCDC（taurochenodeoxychoμte）, TDC（taurodeoxychoμte）, TC （taurochoμte）, LCA （lithocholicacid）, CA（cholic acid）, DCA（deoxycholic acid）（50 μ mol/L,250 μ mol/L,500 μ mol/L,1000 μ mol/L）, DY（mixture of bile salts） and DS（mixture of bile acids）（250 μ mol/L,500 μ mol/L,1000 μ mol/L,1500 μ mol/L, 2000 μ mol/L）, in comparison with the control group（in normal media without bile salts and bile acids）. Cell proliferation was assessed by MTT（3-[4,5-Dimethylthiaolyl]-2,5- diphenyl-tetrazolium bromide） assay for 72 hours with different concentrations and the apoptotic cells were assayed by flow cytometry （FCM） with Annex V-FITC conjugated with propidium iodide（PI） staining for 24 hours with different concentrations（1500,2000 μt mol/L）. Results：There was no significant difference in morphology and cell proliferation in GC group after 24-72 h. Low concentration（50 μ mol/L） of GCDC, GDC, TCDC, TDC and TC accelerated gastric epithelial cell growth in a dosage-time dependent manner. At middle concentration （250-500 μ mol/L）, it showed positive effect after 24-48 h, while negative effect after 72 h. At high concentration（1000 μ mol/L）, it accelerated gastric epithelial cell growth after 24h and show consistent inhibition even leading to necrosis after 48-72 h. LCA and CA showed a positive effect on the concentration of 50 μ mol/L after 24-72 h, while 250-1000 μ mol/L showed a trend towards apoptosis after 24-72 h. At 50-500 μmol/L, DCA showed proliferation after 24 h and apoptosis after 48-72 h, but showed necrosis after 24-72 h at 1000 μmol/L. DY and DS could facilitate normal gastric mucosa epithelial cell growth at low concentration （250-500 μ mol/L）, however at 1000-2000 μ mol/L the trend shifted from apoptosis to necrosis. FCM with Annexin-V conjugated with PI staining revealed that GCDC, GDC, GC, TCDC, TDC, TC, LCA, CA, DCA, DY and DS induced apoptosis of human gastric mucosal epithelial cells. They were all significantly higher than that of the control（P 〈 0.05）, but there was no significant difference in GC group （P 〉 0.05）. The bile salts induced apoptosis in a time-dose-dependent manner. Conclusion：Our results suggested that bile acid and bile salt is the trigger of injury in human gastric mucosal epithelial cells.
文摘Obesity is a global health epidemic with considerable economic burden.Surgical solutions have become increasingly popular following technical advances leading to sustained efficacy and reduced risk.Sleeve gastrectomy accounts for almost half of all bariatric surgeries worldwide but concerns regarding its relationship with gastroesophageal reflux disease(GERD)has been a topic of debate.GERD,including erosive esophagitis,is highly prevalent in the obese population.The role of pre-operative endoscopy in bariatric surgery has been controversial.Two schools of thought exist on the matter,one that believes routine upper endoscopy before bariatric surgery is not warranted in the absence of symptoms and another that believes that symptoms are poor predictors of underlying esophageal pathology.This debate is particularly important considering the evidence for the association of laparoscopic sleeve gastrectomy(LSG)with de novo and/or worsening GERD compared to the less popular Roux-en-Y gastric bypass procedure.In this paper,we try to address 3 burning questions regarding the inter-relationship of obesity,GERD,and LSG:(1)What is the prevalence of GERD and erosive esophagitis in obese patients considered for bariatric surgery?(2)Is it necessary to perform an upper endoscopy in obese patients considered for bariatric surgery?And(3)What are the long-term effects of sleeve gastrectomy on GERD and should LSG be done in patients with pre-existing GERD?
文摘AIM To assess the relationship between gastric acid output (GAO) and both pattern of gastroesophageal reflux (GER) and esophageal lesions, and to evaluate the role of GAO and other potential pathogenetic factors in the development of esophagitis. METHODS Gastric acid secretory testing and 24 h intraesophageal pH monitoring were performed in 31 patients with esophagitis and concomitant duodenal ulcer (E+DU) and compared with those of 72 patients with esophagitis (E) alone. RESULTS The GAO in patients with E+DU was significantly higher than in patients with E ( P <0 05). There was no significant difference between the two groups of patients as to endoscopicl findings and parameters of GER ( P >0 05). A multiple regression analysis with stepwise deletion showed that the pre sence of hiatal hernia (HH), GER in upright position and age appeared to correlate significantly with the presence of esophagitis. CONCLUSIONS No parallel relationship between GAO and severity of GER or esophageal lesions exists in patients with E+DU, and that GAO is not a major pathogenetic factor in GER disease.
文摘目的探析胃液及外周血的总胆汁酸(total bile acid,TBA)水平对胆汁反流性胃炎(bile reflux gastritis,BRG伴有胃黏膜肠上皮化生(gastric intestinal metaplasia,GIM)的诊断效能。方法选取2020年6月至2022年6月临海市第二人民医院收治的150例BRG患者作为研究对象,根据是否发生GIM分为观察组(GIM发生,n=89)和对照组(GIM未发生,n=61)。观察组中,又将28例BRG伴GIM作为不完全型GIM组,61例完全型GIM作为完全型GIM组。检测两组患者的胃液及外周血TBA,采用受试者操作特征(receiver operator characteristic,ROC)曲线分析胃液及外周血TBA水平在诊断BRG伴GIM的诊断效能。结果观察组胃液及外周血的TBA水平均显著高于对照组(P<0.05)。ROC分析显示,胃液TBA水平诊断BRG伴GIM的曲线下面积(area under the curve,AUC)为0.836,敏感度为81.97%,特异性为83.15%;外周血TBA水平诊断BRG伴GIM的AUC为0.753,敏感度为62.30%,特异性为82.02%。不完全型GIM组胃液及外周血TBA水平显著高于完全型GIM组(P<0.05)。ROC曲线分析结果显示,胃液TBA水平诊断BRG伴GIM患者不同分型的AUC为0.952,敏感度为89.47%,特异性为96.08%;外周血TBA水平诊断BRG伴GIM患者不同分型的AUC为0.766,敏感度为76.37%,特异性为80.39%。结论胃液及外周血TBA对BRG伴GIM及GIM不同分型均具有较好诊断效能,且外周血TBA检测的侵入性小,对于辅助人群诊断BRG伴GIM及GIM不同分型具有明显的现实意义。
