Effect of Ageing on the Common Bile Duct Diameter.

INTRODUCTION: The aim of the study was to determine if the common bile duct (CBD) diameter increases physiologically with age and investigate whether gallstones lead to changes in CBD diameter. METHOD: Our study is composed of 721 patients in 2 groups: 517 asymptomatic patients and 204 gallstones patients who underwent MRCP. Their CBD diameter was measured at its widest visible portion on MRCP. Simple linear regression of the average of these measurements was used to investigate the relationship between age and CBD diameter in both populations. Subjects were further divided into 8 subgroups age-wise, respectively, and their means compared decade-wise using ANOVA. Furthermore, each subgroup mean from both populations was compared with each other using a t test. RESULTS: Among the 517 subjects, the mean CBD diameter was 5.3663 mm ± 1.43546 and correlated with age (p < 0.01), dilating at 0.07 mm/year. The mean diameter of our oldest group was 7.9 mm, resulting in a plausible upper limit of 8 mm for the asymptomatic population. The mean CBD diameter of the cholelithiasis population was 5.6738 mm ± 1.40986 and also correlated with age (p < 0.01). The mean CBD diameter of the age groups from the cholelithiasis population was larger than that from the asymptomatic population, but none were statistically significant. CONCLUSION: Although the CBD increases physiologically with age, there is no significant difference in CBD size between the general population and the cholelithiasis patients at any particular age. Gallstones do not independently dilate the CBD.

Combined Signature of the Urinary Microbiome and Metabolome in Patients With Interstitial Cystitis.

Interstitial cystitis (IC) is a clinical syndrome characterized by frequency, urgency, and bladder pain or pelvic pain; however, the underlying pathophysiological mechanisms and diagnostic markers are unknown. In this study, microbiome and metabolome analysis were used to explain the urine signatures of IC patients. Urine samples from 20 IC patients and 22 control groups were analyzed by using 16S rRNA sequence and liquid chromatography coupled with mass spectrometry. Four opportunistic pathogen genera, including Serratia, Brevibacterium, Porphyromonas, and Citrobacter, were significantly upregulated in IC group. The altered metabolite signatures of the metabolome may be related to sphingosine metabolism, amino acid metabolism, and fatty acid biosynthesis. Meanwhile, the associations were observed between different metabolites and microbiomes of IC. The present study suggests that the combined signatures of IC in urine microbiome and metabolome may become its prospective diagnostic markers.

Nrf2 Pathway Ameliorates Bladder Dysfunction in Cyclophosphamide-Induced Cystitis via Suppression of Oxidative Stress.

OBJECTIVE: To investigate the protective effect and molecular mechanism of nuclear factor E2-related factor 2 (Nrf2) pathway in interstitial cystitis (IC). METHODS: We established a mouse model of IC by cyclophosphamide (CYP) in wild-type mice and Nrf2 gene knockout mice. We examined the histological and functional alterations, the changes of oxidative stress markers, and the expression of the antioxidant genes downstream of Nrf2 pathway. RESULTS: After CYP administration, the mice showed urinary frequency and urgency, pain sensitization, decreased contractility, bladder edema, and oxidative stress disorder. Notably, the Nrf2-/- CYP mice had more severe symptoms. The mRNA and protein levels of antioxidant genes downstream of Nrf2 pathway were significantly upregulated in the Nrf2+/+ CYP mice, while there were no significant changes in the Nrf2-/- CYP mice. CONCLUSION: Nrf2 pathway protects bladder injury and ameliorates bladder dysfunction in IC, possibly by upregulating antioxidant genes and inhibiting oxidative stress.