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Assessment of duodenogastric reflux by combined continuous intragastric pH and bilirubin monitoring

World Journal of Gastroenterology 2002年第2期8卷 382-384页

作者： Fei Dai Jun Gong Ru Zhang Jin-Yan Luo You-Ling Zhu Xue-Qin Wang,Department of Gastroenterology,Second Hospital of Xi’ an Jiaotong University,Xi’an 710004,Shaanxi Province,China Department of Gastroenterology Second Hospital of Xi'an Jiaotong University 157 Xiwu LU Xi'an 710004 Shaanxi Province China. jiangdf@***

AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS: 30 healthy volunteers were divided into two groups: standard diet group (Group 1) 18 cases, free diet group (Group 2)12 cases. Each subjects were subjected to simultaneous 24-hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000). RESULTS: There was no difference of preprandial phase bilirubin absorbance between two groups. The absorbance of postprandial phase was significantly increased in group 2 than group 1. There was no difference between preprandial phase and postprandial phase absorbance in group 1. Postprandial phase absorbance was significantly higher in group 2. In a comparison of bile reflux with intragastric pH during night time, there were 4 types of reflux: Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33.3%, pH increase with unchanged absorbance 36.3%, and both unchanged in 10.8%. Linear regression analysis showed no correlation between percentage total time of pH0.14, r=0.068 Preflux and bile reflux. They can not substitute for each other. The detection of DGR is improved if the two parameters are combined simultaneously.

关键词： Adult Aged Bilirubin Diet duodenogastric reflux Female Fiber Optics Humans Hydrogen-Ion Concentration Male Middle Aged Postprandial Period Random Allocation Research Support, Non-U.S. Gov't

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Bioactive Fatty Acids Reduce Development of Gastric Cancer Following duodenogastric reflux in Rats

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Surgical Science 2012年第1期3卷 34-42页

作者： Bjorn Jostein Christensen Kjetil Berge Hege Wergedahl Pavol Bohov Rolf Kristian Berge Einar Svendsen Asgaut Viste Department of Surgical Sciences University of BergenBergenNorway Department of Gastrointestinal and Acute Surgery Haukeland University HospitalBergenNorway Institute of Medicine University of BergenBergenNorway Faculty of Education Section for Food and HealthBergen University CollegeBergenNorway Department of Heart Disease Haukeland University HospitalBergenNorway The Gade Institute Section of PathologyUniversity of BergenBergenNorway Department of Pathology Haukeland University HospitalBergenNorway

Background: Bioactive fatty acids such as the eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and the modified fatty acid analogue, tetradecylthioacetic acid (TTA), are known to influence inflammatory processes in the body. Our aim was to investigate if diets containing fish oil (FO) enriched with bioactive fatty acids could affect inflammation and development of glandular stomach carcinogenesis in a duodenogastric reflux (DGR) animal model. We also wanted to evaluate if a high-fat diet might increase the risk of developing gastric cancer compared to a low-fat diet. Methods: 185 rats operated on with a gastroenterostomy were randomly allocated to 5 different treatment groups given: low-fat, high-fat, high-fat + FO, high-fat + TTA or high-fat + FO + TTA. The stomachs were removed after 50 weeks and examined by light microscopy with hematoxylin and eosin staining (HE). Immunohistochemical staining against COX-2, PCNA and p53 was performed when adenocarcinomas were found. The plasma fatty acid profile was determined. Results: Adenocarcinomas developed in 21% of animals fed the low-fat diet, 35% in the high-fat group, 16% in the high-fat + TTA group, 21% in the high-fat + FO group and 8.6% in the high-fat + FO + TTA treatment group. COX-2 and PCNA were positive whereas p53 was negative in the majority of the samples. The anti-inflammatory fatty acid index increased after treatment with FO and in combination with FO and TTA. Conclusion: FO and TTA in combination with a high-fat diet significantly lower the risk of developing adenocarcinomas in rats subjected to duodenogastric reflux. This is most likely due to a selective modulation of inflammation.

关键词： Bioactive Fatty Acids Cancer duodenogastric reflux Experimental Fish Oil Gastric Carcinogenesis Glandular Stomach Immunohistochemistry Rats TTA

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Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

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World Journal of Gastroenterology 2009年第3期15卷 334-338页

作者： Luigi Monaco Antonio Brillantino Francesco Torelli Michele Schettino Giuseppe Izzo Angelo Cosenza Natale Di Martino Department of General and Gastrointestinal Surgery School of MedicineSecond University of NaplesPiazza Miraglia 2Naples 80138Italy

AIM:To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease(GERD) patients with persistent symptoms who are non-responsive to medical ***:Sixty-five patients(40 male,25 female;mean age,50 ± 7.8 years) who continued to report symptoms after 8 wk of high-dose proton pump inhibitor(PPI) therapy,as well as 18 patients with Barrett's esophagus,were *** patients filled out symptom questionnaires and underwent endoscopy,manometry and combined pH-metry and ***:There were 4 groups of patients:22(26.5%) without esophagitis,24(28.9%) grade A-B esophagitis,19(22.8%) grade C-D and 18(21.6%) Barrett's *** was present in 71 patients(85.5%) and regurgitation in 55(66.2%),with 44(53%) reporting simultaneous heartburn and *** prevalence of pathologic acid reflux in the groups without esophagitis and with grades A-B and C-D esophagitis was 45.4%,66.6% and 73.6%,*** prevalence of pathologic bilirubin exposure in these 3 groups was 53.3%,75% and 78.9%,*** overall prevalence of bile reflux in non-responsive patients was 68.7%.Pathologic acid and bile reflux was observed in 22.7% and 58.1% of non-esophagitic patients and esophagitic patients,***:The high percentage of patients poorly responsive to PPI therapy may result from poor control of duodenogastroesophageal *** patients without esophagitis have simultaneous acid and bile reflux,which increases with increasing esophagitis grade.

关键词： Gastroesophageal reflux disease duodenogastric reflux Bile reflux Bilirubin Barrett's esophagus

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Carcinogenic potential of duodenal reflux juice from patients with long-standing postgastrectomy

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World Journal of Gastroenterology 2001年第3期7卷 376-380页

作者： Zhe Fu Ma~1 Zhong Yu Wang~1 Jun Ran Zhang~2 Peng Gong~1 Hai Long Chen~1 ~1Departrnent of General Surgery,First Hospital,Dalian Medical University,Dalian 116011,China ~2Department of Radiation Oncology,Massachusetts General Hospital and Harvard Medical School,Charlestown,MA 02129,USADr.Zhe Fu Ma graduated from Shanxi Medical College in 1993,nowPh.D.,M.D.in Department of Surgery,Dalian Medical University,majoring gastroenteric cancer,having 4 papers published.Correspondence to:Dr.Zhe Fu Ma.Department of General Surgery,First Hospital,Dalian Medical University,Dalian 116011,China Tel.0086-411-4720334 Department of General Surgery First Hospital Dalian Medical University Dalian 116011 China. mazhefu@***

AIM: To determine whether study on the carcinogenic potential of reflux juice from patients with remote gastrectomy could clarify the inherent relationship between duodenal reflux and gastric stump cancer. METHODS: A total of 37 reflux juice samples (13 Billroth I, 24 Billroth II) were employed in the present study. A two-stage transformation assay using BALB/c 3T3 cells was carried out to test the initiating or promoting activity of these samples. RESULTS: Two of 18 (11.1%) reflux samples exerted initiating activities, whereas 9/19 (47.4%) samples enhanced the MNNG-initiating cell transformation, suggesting the duodenal reflux juice might more frequently possess the tumor-promoter activity (P = 0.029). In addition, there was no difference in initiating activities of the samples irrespective of surgical procedures (P = 0.488), while Billroth II samples exhibited stronger tumor-promoter activity than Billroth I samples (P = 0.027). Furthermore, the promoter activities were well correlated with the histological changes of the stomas (r(s) = 0.625, P = 0.004), but neither their cytotoxicities nor initiating activities had this correlation (Probabilities were 0.523 and 0.085, respectively). CONCLUSION: The duodenal reflux juice from patients with remote postgastrectomy did have carcinogenic potential, and suggested that tumor-promoting activity should principally account for the high incidence of gastric cancer in gastrectomy patients. In contrast, it is difficult to explain the high stump-cancer incidence with the N-nitroso compounds theory-a popular theory for the intact stomach carcinogenesis, and it seemed to be justified to focus chemo-prevention of this cancer on the tumor-promoting potential of reflux juice.

关键词： Gastrectomy Gastric Juice 3T3 Cells Adult Aged Animals Carcinogens Cell Transformation, Neoplastic duodenogastric reflux Female Gastric Stump Gastritis Humans Male Mice Mice, Inbred BALB C Middle Aged Stomach Neoplasms

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Effect of bile salts and bile acids on human gastric mucosal epithelial cells

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Journal of Nanjing Medical University 2008年第4期22卷 217-223页

作者： Yinxue Song Jun Gong Department of Digestive Second Hospital of Xi＇ an Jiaotong University Xi＇ an 710004 Shaanxi Province China

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 n

关键词： bile salts bile acid duodenogastric reflux gastric mucosal epithelial cells apoptosis

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