Objective To investigate the association of bacterial translocation (BT) with cachexia in colonic cancer patients.Methods From September 2015 to May 2017 the clinical data of 292 colon cancer patients were studied at Qingdao Municipal Hospital.The bacteria in peripheral blood and mesenteric lymph nodes were detected by bacterial culture,and the bacterial DNA in peripheral blood was detected by PCR technique to determine the occurrence of bacterial translocation.Intestinal epithelial T-cell subsets and NK cells were evaluated using flow cytometry.Western blot and immunofluorescence were used to check tight junction proteins Occludin,Claudins-2,Zonula occluden-2 in intestinal epithelium.Fluorescence in situ hybridization and immunohistochemistry were used to detect the translocated bacteria and endotoxin.Results Compared with noncachectic patients,cachectic patients had a significandy higher BT ratio (27.8％ vs.7.2％,x2 =20.871,P ＜ 0.001).BT in the intestinal mucus layer was associated with lower levels of T-cell subsets and NK cells in the intestinal epithelium in BT(+) patients (CD3 + T:36.69％ ±5.87％ vs.41.63％ ±5.03％,CD4+T:44.08％ ±5.12％ vs.49.58％ ±7.01％,CD8+T:65.68％ ±5.51％ vs.61.43％ ± 5.58％,CD4+ T/CD8+ T:0.71％ ± 0.21％ vs.0.91％ ±0.23％,NK:27.86％ ± 3.93％ vs.34.69％ ± 4.52％,all P ＜ 0.01).Endotoxin was detected within the small intestinal wall in BT(+) patients and claudin-2 expression increased (0.63 ± 0.13 vs.0.21-± 0.06,t =-2.936,P ＜ 0.01),whereas Occludin and Zonula occluden-2 expressions decreased (0.37 ± 0.13 vs.0.84±0.17,0.16±0.07 vs.0.58±0.19,t=2.151,2.111,bothP＜0.05).Conclusions BTmay contribute to the development of colon cancer cacheria,and tight junction could be the gateway of BT.

In the surgical treatment of hemorrhoids, rectal prolapse, rectal cancer, anal fissures, or anal fistulas, inadvertent damage to the nerves or muscles responsible for bowel control may potentially lead to varying degrees of fecal incontinence (FI). Surgeons need to conduct preoperative assessments based on the patient's individual condition to select an appropriate surgical plan, aiming to minimize the incidence of postoperative FI and improve the patient's postoperative quality of life as much as possible while effectively treating the disease. Additionally, the proficiency of the surgeon's skills, appropriate preoperative dietary adjustments for the patient, regular bowel habits, and exercises targeting the pelvic floor muscles all contribute to reducing the incidence of postoperative FI in patients. For patients who have already developed FI after surgery, on the basis of suitable diet, regular bowel habits, and medication, clinical practitioners can adopt such methods as biofeedback, pelvic floor muscle exercise, sacral nerve stimulation, percutaneous tibial nerve stimulation, acupuncture, injectable bulking agents, anal or vaginal inserts, transanal irrigation, surgical interventions, psychological support, etc., to individualized treatment for patients' conditions. This article, combining the literature, summarizes the current status of common diseases that may lead to postoperative FI. It elaborates on strategies for the prevention and treatment of postoperative FI, aiming to serve as a reference for peers in the field.

In the surgical treatment of hemorrhoids, rectal prolapse, rectal cancer, anal fissures, or anal fistulas, inadvertent damage to the nerves or muscles responsible for bowel control may potentially lead to varying degrees of fecal incontinence (FI). Surgeons need to conduct preoperative assessments based on the patient's individual condition to select an appropriate surgical plan, aiming to minimize the incidence of postoperative FI and improve the patient's postoperative quality of life as much as possible while effectively treating the disease. Additionally, the proficiency of the surgeon's skills, appropriate preoperative dietary adjustments for the patient, regular bowel habits, and exercises targeting the pelvic floor muscles all contribute to reducing the incidence of postoperative FI in patients. For patients who have already developed FI after surgery, on the basis of suitable diet, regular bowel habits, and medication, clinical practitioners can adopt such methods as biofeedback, pelvic floor muscle exercise, sacral nerve stimulation, percutaneous tibial nerve stimulation, acupuncture, injectable bulking agents, anal or vaginal inserts, transanal irrigation, surgical interventions, psychological support, etc., to individualized treatment for patients' conditions. This article, combining the literature, summarizes the current status of common diseases that may lead to postoperative FI. It elaborates on strategies for the prevention and treatment of postoperative FI, aiming to serve as a reference for peers in the field.