The Correlation Between Manganese Content In Gallstones And Gallstone Compositions

Cholelithiasis is a world-wide common disease with a higher prevalence rate.The gallbladder is an important organ in the body that stores bile and regulates the flow of bile.The current technological advance cannot still prevent high recurrence rate of 60–70%because of multiple types of gallstones and different pathogenesis,which urgently needs the precision identification of gallstone compositions and the precision medicine.The gallstone samples in this project were from 58 patients（27 men and 31 women,ages 27-82 years）,all of whom had undergone gallstone surgery in the Department of Digestive Surgery of Jilin People’s Hospital.From perspectives of materials science,a new style of technical combination（abbreviated EXI）consisting of electron spin resonance（ESR）,X-ray diffraction（XRD）and Infrared spectra（IR）will be developed to give new insight to the above study on the correlations.This project uses this technique to focus on the key scientific question of the association between trace Mn²⁺and calcium carbonate in Ca CO₃-containing gallstones（GCCC）,and establishes a Mn²⁺-GCCC association model.The main research contents are as follows:1.Among the 58 gallstone patients,14 gallstone samples（24.14%）were GCCC,and 10 of them were analyzed using XRD,IR and ESR.The sextet ESR signal and the（104）main XRD peak at 2θ=～29.4°were employed as two probes to explore the relationship between trace Mn²⁺and calcite.The moderate and strong correlations between the trace Mn²⁺ions and the calcite polymorph were discovered in mixed gallstones consisting of cholesterol and calcium carbonate as well as in calcium carbonate gallstones,respectively.The correlations between Mn²⁺and calcite,the structural preference of Mn²⁺to the calcite polymorph in calcium carbonate gallstones are discussed.2.Gallstones were examined for 58 patients in Jilin,Jilin.It was found that gallstones from only one who suffered from cholecystectomy were composed of 20spheroidal stones and they rarely exhibited three different types of surface appearances.Six representative powder samples were analyzed for gallstones compositions and Mn²⁺using X-ray diffraction（XRD）/Infrared（IR）and electron spin resonance（ESR）,respectively.The results suggested that all gallstones from this patient were identified by XRD to be gallstones consisting mainly of cholesterol and Ca CO₃（GCCC）.They rarely exhibited three different kinds of surface appearances corresponding to different concentration of trace Mn²⁺in calcite(C_Mn²⁺/C_Cal):18 dark/light brown spheres with smooth surfaces and C_Mn²⁺/C_Cal=0–6μg/g/%,a yellowish-brown huge sphere with a rougher surface and C_Mn²⁺/C_Cal=30μg/g/%,and an ashy sphere composed of tens of microspheres with the roughest surface and C_Mn²⁺/C_Cal=60μg/g/%.The difference in surface appearance showed significant association with C_Mn²⁺/C_Cal,and its increase made the gallstone’s surface change from smooth to rough and to fade in color.The unbalanced and competitive Mn²⁺accumulation could occur occasionally in individual stones owing to different affinities to Mn²⁺,resulting in the formation of a huge stone and an ashy sphere.These two aberrations caused by higher C_Mn²⁺/C_Cal played an important role in suppressing the crystalline growth of the majority of dark/light brown spheres.GCCC from a patient might have a prominent Mn²⁺partitioning feature corresponding to different surface appearances.3.(Ca_1-xMn_x)CO₃（x=0.0001～0.005）powder（abbreviated CMC）was prepared at different sintering temperatures by solid-phase reaction method,which was used to explore the formation mechanism of calcium carbonate gallstones in the human body.CMC powders were characterized using XRD and ESR techniques.XRD showed that500°C/5 h was suitable condition for the synthesis of pure calcite phase CMC powder.ESR analysis showed that all CMC powders contained six-line characteristic signals of Mn²⁺,and the Mn²⁺response gradually increased with the increase of calcite content in CMC powder,indicating that there was a correlation between Mn²⁺concentration and calcite content in CMC powder.Mn²⁺can be used as an important indicator of calcite content in calcium carbonate gallstones,which provides new insights for studying the formation mechanism of calcium carbonate gallstones.4.In order to prevent the high recurrence rate after gallbladder-preserving lithotomy in patients with gallstone disease,postoperative diet therapy is proposed in this project.We surveyed 60 foods that are common in daily life.By drying treatment,it is made into powder for ESR.We found the sextet ESR signal of Mn²⁺in 18 foods,and the content of anise Mn²⁺in the flavoring agent was the highest,about 22.3μg/g.The content of Mn²⁺in black beans was the highest,about 16.2μg/g.The Mn²⁺content of vegetables was only 3-5μg/g;No sextet ESR signal of Mn²⁺was detected in the fruits and meat foods involved in the experiments in this chapter.Since the Mn²⁺content is closely related to calcium carbonate gallstones,it is possible to provide some dietary recommendations for patients with this type of stone disease who have undergone gallstone-preserving lithotomy.