| Part 1 The Component analysis of yellow and black humancholecystolithiasis Objective:We aim to explores new classification standard of human cholecystolithiasis through qualitative and quantitative study of its composition and provides evidence for future studies of etiology and pathogenesis for cholecystolithiasis. Method: We collected 30 cases of yellow gallbladder stones and 30 cases of black gallbladder stones.Then we used two different methods to classify these gallbladder stones, which was Fourier transform infrared spectrometer and UV/Vis/NIR spectrophotometer. At last, we also compared the differences between the two methods. Result:1.We found four types of waveforms using Fourier transform infrared spectrometer,which were cholesterol(40/60,66.67%), bilirubin(24/60,43.33%), hydroxy carbonate apatite(9/60,15.00%) and calcium carbonate(8/60,13.33%). Thus,we further divided 60 cases into 3 group, which were cholesterol group(34 cases of pure cholesterol waveform,56.67%),bilirubin group(15 cases of pure bilirubin waveform,25.00%),and mixed group(11 cases of mixed waveform,18.33%).2. Three types of waveforms were found among 30 cases of yellow gallbladder stones using Fourier transform infrared spectrometer for qualitative detection. They were cholesterol(30/30,100%), bilirubin(2/30,6.67%), hydroxy carbonate apatite(2/30,6.67%).4 types of waveforms were found among 30 cases of black gallbladder stones. They were bilirubin(22/30,73%), cholesterol(10/30,33.3%), hydroxy carbonate apatite(8/30,26.7%) and calcium carbonate(7/30,23.3%).3. We used UV/Vis/NIR spectrophotometer to detected the main component of 30 yellow gallbladder stones and found that they contained 59.55%(42.02%~75.46%)of cholesterol and 0.65%(0.47%~3.10%) of bilirubin,and the 30 black gallbladder stones contained 17.52(6.61%~32.94%) of cholesterol and 29.40%(7.69%~36.19%) of bilirubin.In comparison,yellow gallbladder stones contained more cholesterol than bilirubin(Z=4.720,P=0.000<0.05),While there was no significant differences between the content of cholesterol and bilirubin among all cases of black gallbladder stones(Z=1.759,P=0.079>0.05).The levels of cholesterol in the yellow gallbladder stones was higher than the black gallbladder stones(Z=4.753,P=0.000<0.05), and the levels of bilirubin was lower than the black gallbladder stones(Z=4.990,P=0.000<0.05).4.The distribution of the ascending content of cholesterol in all cases was in accordance with linear characteristics,The distribution of the ascending content of cholesterol in all cases was broken lines,with two Inflection point,5%and 25%.5. According to our new standard,the total 60 cases of gallbladder stones were classified as 31 cases of cholesterol stones,18 cases of bilirubin stones and 11 cases of mixed stones. There was no significant difference compared to the results of Fourier transform infrared spectrometer(P>0.05). Conclusion: 1. The content of cholesterol was higher than bilirubin in the yellow gallbladder stones.There were no significant difference between the content of cholesterol and bilirubin in the black gallbladder stones.2. Cholesterol was mainly distributed in the yellow gallbladder stones,and calcium carbonate,hydroxy carbonate apatite, bilirubin was mainly distributed in the black gallbladder stones.3. Calcium carbonate was only distributed in the black gallbladder stones.4. The type of the gallbladder stones depends on the content of bilirubin.Accoding to the characteristic of the distribution of both cholesterol and bilirubin,we creat a new Classification standard:the content of bilirubin in Cholesterol gallbladder stones is lower than 5%,the content of bilirubin in Bile pigment gallbladder stones is more than 25%,the rest belong to the mixed type.5. Fourier transform infrared spectrometer can be used as criteria for classification of the gallbladder stones for its convenience,lower cost and accuracy.PART 2 Analysis of elements in human cholecystolithiasis Objective: The distribution of the main elements of the detection of human cholecystolithiasis, provides a theoretical basis for the process and mechanism for the formation of human cholecystolithiasis. Methods: Classified the gallbladder stones according to the infrared and analyzed the distribution of six kinds of metal elements(Ca,Fe,Mg,Cu, Mn,Zn) and non-metallic element(P) in the gallbladder stones, using inductively coupled plasma emission spectrometer. Results:1. The elements distribution in each gallbladder stones group. The content of Ca in cholesterol group, mixed group, bile pigment group respectively was(18.07±14.51),(46.87±7.76),(45.73±5.90). The content of Mn in cholesterol group, mixed group, bile pigment group respectively was [0.06(0.05~0.16), 0.62(0.21~1.52), 0.52(0.31~0.85)]. The content of Mg in cholesterol group, mixed group, bile pigment group respectively was [1.23(1.15~1.40), 3.24(2.35~4.76), 3.85(3.01~5.68)]. The content of Fe in cholesterol group, mixed group, bile pigment group respectively was [1.50(1.41~1.58), 1.94(1.59~2.2), 3.01(2.58~4.12)]. The content of Cu in cholesterol group, mixed group, bile pigment group respectively was [0.11(0.10~0.15), 2.23(0.76~3.83), 2.76(1.92~4.86)]. The content of Zn in cholesterol group, mixed group, bile pigment group respectively was [0.11(0.10~0.15), 0.19(0.14~0.26), 0.34(0.28~0.53)]. The content of P in cholesterol group, mixed group, bile pigment group respectively was [0.63(0.33~1.99), 3.13(1.81~3.67), 1.88(1.61~3.62)]. Seven kinds of elements in the distribution of cholesterol group were lower than the mixed group and bile pigment group(P<0.05). There were no significant different between mixed group to bile pigment group(P>0.05).2. In the bile pigment group and mixed group, the content of Ca was more than other metal elements(P<0.05); the content of Fe, Mg, Cu were more than Mn, Zn(P<0.05); Fe, Mg, Cu elements’ content had no difference(P>0.05); Mn, Zn elements’ content had no difference(P>0.05). Conclusions:1. Ca,Fe,Mg,Cu,Mn,Zn,P may play an important role in the formation of hybrid and bile pigment gallbladder stones. 2. Ca plays an important role in the formation of gallbladder stones, especially in the hybrid and bile pigment gallbladder stones.3. Fe,Mg,Cu may have a more important role than Mn and Zn in the formation of hybrid and bile pigment gallbladder stones. |
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