| Background:Cholelithiasis is a common disease in our country. It means that under the effect of various factors of precipitation and coagulation, some components such as bile pigment, cholesterol, bile salts, etc become the stones in biliary system. When the stones occur in the common bile duct, it is called choledocholithiasis. Most are pigment stones or mixed gallstones. In our natural populations, the incidence of cholelithiasis is 10% or so, and the autopsy report shows that domestic cholelith disease incidence is 7%. With the accelerating rhythm of our life, the changes in eating habits, the incidence of CBDS increases year by year, and the age of onset is becoming younger and younger. Besides, the complication including biliary obstruction, biliary tract infection not only seriously affect our work and life, but also cause varying degrees of damage to our body, even life threatening. At present, the researches of reasons of gallstones formation mechanisms are forcing on the aspects of bile cholesterol supersaturated, gall bladder dysfunction, abnormal expression of mucin, high calorie diet, hereditary and genetic regulation factors and so on. Also some animal experiments and clinical researches reported that bacterial infections had association with the formation of bile mud and gallstones. However, the authentic mechanism is still unclear. On the other hand, the acute cholangitis caused by gallstones is very dangerous. If not treated in time, it will lead to irreversible damage to human viscera. So it’s important to analysis the bile bacterial microenvironment in patients with common bile duct stones. Moreover, for the clinical treatment of gallstone complications, it will be more significant.Objection:Understand the difference of bacterial microenvironment between the CBDS and non-CBDS patients and further explore gallstone formation mechanisms. Study the components of bacteria in patients with gallstones merged cholangitis to guide the clinical medication and treatments.Methods:Continuously selecting 28 patients from May 2015 to January 2016 in our department. Including 15 CBDS patients and 13 non-CBDS patients. Collecting their bile samples during the ERCP treatment. And then analysis these specimens with 16SrDNA high-throughput sequencing. Using statistical methods such as Alpha, Beta diversity index, PCA or PCoA to analyze the difference between groups.Results:During the 28 bile samples,3 specimens were negative, which means that there was little bacteria could be detected. While the other 25 specimens were positive with enough bacteria that could be used to create database.1. The average total tags are 33938. And the average OTUs (Operational Taxonomic Units) are 709. In the level of genus, the relative abundances of Escherichia (22.35%), Shewanella (9.05%), Clostridium (2.00%), Stenotrophomonas (1.15%) are significant higher than other bacteria.2. Comparison of gallstone groups with Wilcoxon rank-sum test in Alpha diversity analysis, the difference between CBDS and non-CBDS is not significant (P= 0.152, P=0.904). The same results occur when using the Beta diversity analysis (P= 0.184).3. The difference of bacterial abundance between the various degrees cholangitis is significant between the moderate cholangitis and mild cholangitis group (P=0.011), also between moderate and control group (P=0.004).But the bacterial abundance between the mild cholangitis group and the control group has no significant difference (P=0.674). There are also no significant differences of diversity between each groups (P>0.05)Conclusion:The differences between CBDS and non-CBDS patients’bile are not significant. Which tell us that the formation of stones may have nothing to do with the abundance and diversity of biliary bacteria colonization. The difference of bacteria diversity between gallstones merge with cholangitis and patients without cholangitis does not have clinical statistical significance. But the bacterial abundance of different degrees of cholangitis has significant difference. Prompting that the clinical severe classification of cholangitis may have relationship with the amounts of bacterial infection but not types. |
