Many studies have found that probiotics or synbiotics can be used in patients with diarrhea or inflammatory bowel disease for the prevention and treatment of some pathologies by improving gastrointestinal barrier function. However, there are few studies availing the use of probiotics in patients with colorectal cancer. To lay the foundation for the study of nutritional support in colorectal cancer patients, a meta-analysis has been carried out to assess the efficacy of probiotics on the intestinal mucosa barrier in patients with colorectal cancer after operation.To estimate the efficacy of probiotics on the intestinal mucosa barrier in patients with colorectal cancer after operation, a meta-analysis of randomized controlled trials has been conducted.Databases including PubMed, Ovid, Embase, the Cochrane Central Register of Controlled Trials, and the China National Knowledge Infrastructure have been searched to identify suitable studies. Stata 12.0 was used for statistical analysis, and sensitivity analysis was also conducted. Six indicators were chosen to evaluate probiotics in protecting the intestinal mucosa barrier in patients with colorectal cancer. Ratios of lactulose to mannitol (L/M) and Bifidobacterium to Escherichia (B/E), occludin, bacterial translocation, and levels of secretory immunoglobulin A (SIgA), interleukin-6 (IL-6), and C-reactive protein (CRP) were chosen to evaluate probiotics in protecting the intestinal mucosa barrier in patients with colorectal cancer.Seventeen studies including 1242 patients were selected for meta-analysis, including 5 English studies and 12 Chinese studies. Significant effects were found in ratios of L/M (standardized mean difference = 3.83, P = 0.001) and B/E (standardized mean difference = 3.91, P = 0.000), occludin (standardized mean difference = 4.74, P = 0.000), bacterial translocation (standardized mean difference = 3.12, P = 0.002), and levels of SIgA (standardized mean difference = 2.91, P = 0.004) and CRP (standardized mean difference = 4.21, P = 0.000), but no significant effects were found for levels of IL-6 (standardized mean difference = 1.33, P = 0.184).Probiotics can effectively protect the intestinal mucosa physical and biological barrier in patients with colorectal cancer after operation. However, to evaluate the protective effect on intestinal mucosal barrier, further studies on the type and concentration of the probiotics, duration of therapy, and the therapeutic route are required.

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An enriched environment (EE) is an animal housing technique in which animals are given increased amounts of space, physical activity, and social interaction. Currently, researchers studying EE focus mainly on its effects within the context of neurological diseases. However, little is known about how EE affects the intestinal mucosal barrier. This study assessed the effects of EE on the intestinal mucosal barrier in rats with colorectal cancer. A rat model of 1,2-dimethylhydrazine (DMH)-induced colorectal cancer was used. The rats were housed in eight conditions for eight weeks: EE, large cages containing eight rats with stimulating objects; enlarged space and socially enriched conditions (ES), large cages containing eight rats; enlarged space and cognition enriched conditions (EC), large cages containing one rat with stimulating objects; enlarged space enriched conditions (E), large cages containing one rat; cognition and socially enriched conditions (CS), four to five rats housed in standard cages containing stimulating objects; cognition enriched conditions (C), rats housed individually in small-size cages containing stimulating objects; socially enriched conditions (S), standard cages containing four rats; and normal conditions (blank group, B). We determined the weight of each rat, measured the intestinal mucosa and plasma levels of tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), interleukin 10 (IL-10), ghrelin, corticotropin-releasing factor (CRF), occludin, bacterial translocation (BT), and secretory immunoglobulin A (SIgA), and assessed the morphology of the intestinal mucosa. On the whole, the combination of cognitive stimulus and social support was better than the combination of three factors in maintenance of the intestinal mucosal immune barrier and brain–gut peptide. The combination of all three factors and combination of cognitive training and social support were more effective than any single factor. Future studies are needed to study the effects of an EE on body weight, brain–gut peptide, and the intestinal mucosa biological barrier. Impact statement An enriched environment (EE) is an animal housing technique where animals are given increased amounts of space, physical activity, and social interaction. Presently, researchers studying EEs focus mainly on their effects within the context of neurological diseases. However, little is known about how EEs affect the intestinal mucosal barrier. This study assessed the effects of an EE on the intestinal mucosal barrier in rats with colorectal cancer.

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