Синтаксис. Словосочетания.

Синтаксис. Словосочетания.

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is formed in the liver

bile acids, electrolytes, bilirubin, cholesterol, and phospholipids

Bile flow

bile salts and electrolytes and the accompanying obligate passive movement of water

synthesizes water-soluble bile acids

not completely understood

Cholic and chenodeoxycholic acids

virtually complete conjugation

with both glycine and taurine

bile secreted in the fasting state

a concentrated solution

bile acids and sodium

stimulates the gallbladder

cholesterol, fats, and fat-soluble vitamins

are excreted in bile

are efficiently extracted

Chenodeoxycholic acid conjugates


Physiology of Bile Acid Metabolism

Bile is formed in the liver as an isosmotic solution of bile acids, electrolytes, bilirubin, cholesterol, and phospholipids. Bile flow is generated by the active transport of bile salts and electrolytes and the accompanying obligate passive movement of water.

The liver synthesizes water-soluble bile acids from water-insoluble cholesterol, but precise mechanisms are not completely understood. Cholic and chenodeoxycholic acids form in the liver in a ratio of about 2:1 and constitute 80% of bile acids. After virtually complete conjugation in the hepatocyte with both glycine and taurine, bile acids are excreted in bile, which flows from the intrahepatic collecting system into the proximal or common hepatic duct. About 50% of bile secreted in the fasting state passes into the gallbladder via the cystic duct; the rest flows directly into the distal or common bile duct. Up to 90% of water in gallbladder bile is absorbed as an electrolyte solution, principally via gallbladder mucosal intracellular pathways. Bile remaining in the gallbladder is thus a concentrated solution consisting primarily of bile acids and sodium.

During fasting, bile acids are concentrated in the gallbladder, and little bile acid-dependent bile flows from the liver. Food entering the duodenum initiates an exquisite hormonal and neural sequence. Cholecystokinin and perhaps other GI hormone peptides (eg, gastrin-releasing peptide) are released from duodenal mucosa; cholecystokinin stimulates the gallbladder to contract and the biliary sphincter to relax. Bile flows into the duodenum to mix with food contents and to perform its several functions: (1) Bile salts solubilize dietary cholesterol, fats, and fat-soluble vitamins to facilitate their absorption in the form of mixed micelles. (2) Bile acids induce water secretion by the colon as they enter that organ, thus promoting catharsis. (3) Bilirubin is excreted in bile as degradation products of heme compounds from worn-out RBCs. (4) Drugs, ions, and endogenously produced compounds are excreted in bile and subsequently eliminated from the body. (5) Various proteins important in GI function are secreted in bile.

Food entering the duodenum stimulates gallbladder contraction, releasing much of the body pool (total, 3 to 4 g) of bile acids into the small intestine. Bile acids are poorly absorbed by passive diffusion in the proximal small intestine; most of the pool reaches the terminal ileum, where 90% is absorbed into the portal venous circulation by active transport. Bile salts are efficiently extracted by the liver, promptly modified, and secreted back into bile.

Bile acids undergo enterohepatic circulation 10 to 12 times per day. During each pass, a small amount of primary bile acids reaches the colon, where anaerobic bacteria containing 7alpha-hydroxylase form secondary bile acids. Cholic acid is thus converted to deoxycholic acid, which is largely reabsorbed and conjugated. Chenodeoxycholic acid conjugates are converted in the colon to their secondary bile acid form, lithocholic acid. This insoluble secondary bile acid is partially reabsorbed; the rest is lost in the feces.


Синтаксис. Предложение.


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Anatomy of the Biliary Tract

1.     Other than absorptive functions of the normal gallbladder and bile storage mediation by the sphincters, the extrahepatic ductal system is a passive conduit.

2.     There are no functional smooth muscle fibers in the biliary duct walls.

3.     Ductal secretions stimulated by secretin contain a high concentration of bicarbonate and contribute variably to total bile volume.

4.     The ampulla of Vater consists of the terminal intramural segments of the biliary and pancreatic ducts and of the two or three sphincter segments and surrounding soft tissue.

5.     The sphincter of Oddi surrounds both ducts or their common channel, and each duct has its separate (inconstant) sphincter.

6.     The sphincters have a basal "tone" of up to 10 mm Hg and phasic spike activity that is independent of duodenal smooth muscle activity.

7.     These muscles respond to extremely small amounts of hormones, GI peptides, anticholinergics, and other drugs.

8.     Much is being learned about these important and finely tuned structures located at the nutritionally important confluence of bile, pancreatic juice, and food.

9.     Normal sphincter function results in timely release of bile and pancreatic enzymes during food passage; during fasting, however, gallbladder filling is facilitated.

10.  The two systems normally remain independent (ie, bile does not flow retrograde into the pancreatic duct).

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Опишите характер связи между простыми предложениями в составе сложных (союзная – бессоюзная; союз – союзное слово).

Представьте сложноподчиненные предложения в виде схем, определив тип придаточных.

Разберите предложения по составу и охарактеризуйте основу и второстепенные члены предложения.

Задание 2. Определите, каким членом предложения являются выделенные слова.

He asked  me to flex my left hand and warned me to expect a little prick as he inserted a kind of plastic valve into a vein in my arm.

It didn’t seem the right moment to complain about my reception.

A warm, drowsy feeling of wellbeing was beginning to come over me.

Nizar was looking at the x-rays of my knee holding them up before a lighted screen. 

My right leg, swaddled in bandages, was as big as an elephant’s.

After a few days on crutches, waiting for the swelling to subside, and several weeks of physiotherapy and controlled exercise I started to get the same intermittent pain as before.

I hadn’t been able to bring myself to watch it before.

There is no reason why the knee should be giving you any more pain.

I tore off the blindfold and hopped round the room cursing and blaspheming so terribly that I finally shocked myself into silence.

I cracked my knee, the right one needless to say, against the open drawer of the filing cabinet.


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