| Objective: To investigate the influences of microecological agent supplement by gut on inflammatory response, clinical outcome, intestinal barrier function and the microecology of patients with colorectal carcinoma underwent surgical procedures.Methods: Forty patients with colorectal carcinoma were randomly divided into two groups, and received regular treatment (control group, n=20), or microecological agent supplement (experimental group, n=20). All patients underwent radical colorectomy. The incidence rates of SIRS and infectious complications such as postoperative infection of peripheral blood and wound, pulmonary infection and central vena catheter-related infection were evaluated respectively. Postoperative recovery of peristalsis and the incidence rate of diarrhea were monitored, the duration of hospitalizing and postoperative fever was analyzed. The structure of intestinal epithelial in the colon and ileum was observed by microscope. The levels of transmembrane binding protein (occludin) and IgA in colon and terminal ileum were detected by immunohistochemistry method. Transepithelial resistances of colon and terminal ileum of both groups were tested by Ussing chamber system. The bacteria DNA fingerprint spectrums of feces were analyzed by randomly amplified polymorphic DNA technique. Real-time quantitative PCR was performed after DNA extraction from patients'peripheral blood samples in the 1st day after operation, with target 16SrRNA gene of most pathogenic bacteria. Data were stored on a Microsoft Excel spreadsheet, and statistical analysis was performed using SPSS for Windows Version 10.0 (SPSS Inc., Chicago, IL, USA). Qualitative data were compared using the two-tailed chi-square test. Quantitative data were expressed as medians plus range or means, with standard deviation (SD) of the mean. Differences between means were evaluated using analysis of paired t-tests, as appropriate. A P-value of 0.05 or less was considered to indicate statistical significance.Results: There were no significance of the incidence rates of SIRS and postoperative infection of peripheral blood and wound, pulmonary infection and central vena catheter-related infection between the two groups. Postoperative recovery of peristalsis was earlier in the experimental group, and the incidence rate of diarrhea was significantly lower in the experiment group than in the control group. The duration of hospitalizing and postoperative fever was also shorter in the experimental group(P<0.05). The intestinal epithelial injuries in the colon and ileum were observed in both groups. The expression levels of occludin and IgA of colon were significantly higher in experimental group(17.55±3.80%, 7.0±1.95%, respectively)compared with those of the control group(15.25±2.79%, 5.65±1.25%,respectively). The expression levels of occludin and IgA in terminal ileum were higher in the experimental group (17.33±2.08%, 7.5±0.7%,respectively)compared with those of the control group(14.25±2.21%,5.95±1.0%), but there was no significance. The bands of DNA fingerprint spectrum were significantly decreased in the control group. Transepithelial resistance of the control group was lower than the experimental group, but there was no significance between two group (P>0. 05). The bacterial DNA positive rate in experimental group(10%)is significantly lower than in the control group(35%) (P<0.05).Conclusion: Microecological agent can shorten the postoperative recovery of peristalsis and the duration of hospitalizing and postoperative fever. It can also increase the levels of occludin and IgA of intestinal mucosa, improve the intestinal microecology, decrease the positive rate of peripheral bacterial DNA.
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