Experimental Study Of Colonic Microflora Imbalance In Patients With Obstructive Jaundice

Obstructive jaundice:bile is obstructed in biliary system, which can not flow into the duodenum, but accumulate and even reflux to the blood. Obstructive jaundice and the complications it caused are closely related to intestinal flora, inducing systemic multi-system disease. UDCA is a kind of surface-active agent, which plays an important role in inhibiting the growth of Gram-negative bacteria. It can break down toxins of the body, and also destroy the biological function of the Gram-negative bacteria. However, there is a lack of bile salts in patients with obstructive jaundice, also with the function of inhibiting the growth of harmful bacteria. As the intestinal immune function goes down, the imbalance of intestinal flora and the G-bacteria leads to a great amount of toxins, bacteria colonizing and endotoxin produced, all these metabolites reflux into blood via the portal vein and thoracic duct, inducing sepsis and multiple organ dysfunction syndrome. Eventually leading to systemic inflammation and infection.There is an apparent change in the structure of the intestinal flora between patients with obstructive jaundice and normal ones. The main lies in the dominant bacteria. But it is unclear how the structural of flora changes perioperative, how to manage a targeted therapy in infection and inflammation perioperatively, and whether preoperative bilirubin level is related to the occurance of infection. Aiming to solve all these problems and guiding clinical treatment, we retrospectively analyzed the variation in structural of flora in obstructive jaundice patients perioperatively. ObjeCtive:This paper aims to explore the variation of the structure of the intestinal flora between healthy people and patients with obstructive jaundice perioperatively, thus finding which kinds of the intestinal flora changs most obviously.Methods:A retrospective analysis of 30 patients was conducted. They were divided into three groups depending on the severity of jaundice. No jaundice Group A (healthy control group) (n=10), total bilirubin (TIBL)≤17.1μmol/L; mild jaundice is group B (mild jaundice group) (n=10),17.1μmol/L≤total bilirubin (TIBL)≤ 171μmol/L; moderate jaundice by group C (moderate jaundice) (n=10),340 u mol/L≥TIBL≥171 umol/L by group C (moderate jaundice group) (n=10). The first stool specimens after admission was obtained and the total fecal bacteria DNA was extracted. After polymerase chain reaction (Polymerase chain reaction PCR) amplification, denaturing gradient gel electrophoresis (Denaturing gradient gel electrophoresis DGGE) was administered and dynamic structural changes of flora was observed using Quantity One software analysis gel bands. Similarance, diversity of flora structure, principal component analysis (Principal component analysis PCA) analysis, BLAST tools and Nucleotide collection of significant change in the band tapping sequenced using the NCBI genes were compared within (nr/nt) database and identified bacterial species.Results:Significant differences of colonic microflora were found between patients with obstructive jaundice and healthy people; advantage intestinal flora in obstructive jaundice patients was significant lower than the control group. With the extension of time and degree of obstruction deepened, a descending trend was found in numbers, richness, diversity was found in obstructive jaundice patients Performance characteristic changes in patients with obstructive jaundice colonic microflora is:two kinds of Bacteroides and one kind of Streptococcus were significantly increased, three kinds of Bacteroides bacteria and one kind of true relative abundance decreased, three kinds of uncultured had significantly decreased the relative abundance of bacteria (p<0.05).Conclusions:There is a significantly difference of colonic microflora between patients with obstructive jaundice and healthy ones:two kinds of Bacteroides and one kind of Streptococcus were significantly increased, three kinds of Bacteroides bacteria and one kind of true relative abundance was decreased, the relative abundance of three kinds of uncultured bacteria was significantly decreased.