| Obstrctive:The mechanism of bile reflux gastritis had not been defined until now. The aim of this study was to investigate the pathogenesis of gastric mucosa injury caused by duodenogastric reflux. Methods:We succeed in inserting ployethylene-tube into common hepatic duct, common bile duct and duodenum of adult Sprague-Dawley(SD) rats(16, weight>250g, half of female and male) to collect bile, the mixture of bile, pancreatic juice and the mixture of bile, pancreasic juice and duodenal juice.The other 36 SD rats were randomly divided into five groups and were infused into the stomach of rats with bile(group A, 8), the mixture of blie, pancreatic juice (group B, 8)and the mixture of bile, pancreasic juice and duodenal juice(group C, 6), 0.9% saline((group D, 6) and nothing(group E,8), respectively. Immunohistochemical staining was used detect the expression of toumor necrosis factor(TNF-α), endothelin-1(ET-1), interleukin4 (IL-4), interleukin1β(IL-1β) and nitric oxide synthase2(NOS2) in gastric mucosa of the rats. Cell apoptosis in gastric mucosa was determined by TUNEL and transmission electron microscope(TEM). Results: 1 The result of TUNEL showed that the apoptic cells were seen intensively in group A, B and C,froming a apoptosis zone . These cells could be seen in surface of the neck of fundic gland. The apoptosis index(AI) in group A,B and C were 16.29±4.87, 16.62±4.71 and 10.51±4.05,respectively. The AI in group D and E were 3.45±2.21 and 2.64±2.02 . The AI in group A, B and C was significantly higher than that of group D and E (p<0.05). The AI in group A, B was higher than that of group C (p<0.05).There was no difference between other groups. 2 The expression of TNF-α: The expression of TNF-αin gastric mucosa of group A, B and C could be mainly seen in the body and base of fundic gland, while group D and E only could be seen in base of fundic gland. The expression index in group A (2.08±1.40) was the highest, while the group E (0.73±0.17) was the lowest. The expression index in group A, B and C were higher than those in group D and E (p<0.05), There was no difference between other groups. 3 The expression of ET-1: The expression of ET-1 in gastric mucosa of A, B and C rats could be almost seen in all layers of gastric mucosa but most in the body and base of fundic gland. The expression index in group C rats(5.12±0.49) was the highest, while the group E (1.53±0.45) was the lowest. The expression index in group A, B and C rats were higher than that in group E (p<0.05). The expression index in group B and C rats were higher than that in group D (p<0.05). Therewas no difference between other groups. 4 The expression of IL-4: The expression of IL-4 in gastric mucosa of group A, B and C rats could be almost seen in all layers of gastric mucosa but most in the body and base of fundic gland. The expression index in group A, B, C and D ( 2.36 ±0.04, 3.13 ±0.96, 2.76 ±0.01 and 2.26 ±0.89,respectively) was the higher than that in the group E (1.14±0.33) (p<0.05). There was no difference between other groups. 5 The expression of IL-1β: The expression of IL-1βin gastric mucosa of group A, B and C could be almost seen in all layers of gastric mucosa but most in the body and base of fundic gland. The expression index in group C (2.77±0.99) was the highest, while the group E (1.01±0.54) was the lowest. The expression index in group A, B and C were higher than those in group D and E (p<0.05). There was no difference between other groups. 6 The expression of NOS2: The expression of NOS2 in gastric mucosa of group A, B and C could be almost seen in all layers of gastric mucosa but most in the body and base of fundic gland. The expression index in group C (3.67±0.11) was the highest, while the group E (0.93±0.50) was the lowest. The expression index in group A, B and C were higher than those in group D and E (p<0.05). There was no difference between other groups. Conclusion: 1 Bile, the mixture of blie,pancreatic juice... |
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