| Objective ①Investigate the effects of prophylactic drugs on TACE healing,and analyze their effects and necessity.②Explore the protective effects of Sinomenine on injury of liver cells and make preliminary cytological studies on the development of new clinical indications.Methods ①Based on the previous literature and previous clinical investigations,a clinical information questionnaire for TACE patients was developed.The results of the patients included in the statistics are then entered into a computer and a database is established.Investigate the related factors of adverse events after TACE,and make a statistical analysis of the need for routine preventive medication.②The pre-experiment tested the effect of sinomenine on cell viability after treatment of HepG2 with different concentrations and time,and the maximum harmless dose was screened by CCK8 detection.Add sinomenine with different concentrations to HepG2 for 2h pretreatment,and then add CCL4 for 24h.Cell activity was measured by CCK8,ROS concentration was measured by ROS kits,inflammatory factors TNF-a,IL-1 β,IL-6 in serum were detected by ELISA kit,and cell apoptosis was detected by Tunel and Western Blotto to analyze the protective effect of sinomenine on liver injury.Results ①Clinical redultsThe non-prevented antibacterial drugs group was the study object,and the high-risk factors of TACE surgical site infection were analyzed.There were no significant differences in the 9 symptom variables.13 cases in non-preventive medication group had surgical site infections,with an infection rate of 26.53%;22 cases had surgical site infections preventive medication group,with an infection rate of 17.6%.Cefoxitin is used most frequently.A comparative analysis of the non-preventive medication group and the prophylactic medication group showed no statistically significant difference in infection rates(P=0.134).A statistical analysis of the fever within one week after surgery showed that the prophylactic use of antibacterial drugs had no significant effect on the proportion of patients with elevated body temperature and the number of days per person.Thirteen symptom variables were set for statistical analysis of abnormal liver function one week after operation and smoking and drinking history has an impact on liver function within one week after surgery.(P=0.023,P=0.037),showing a positive correlation.The proportion(87.5%)of patients with preventive use of liver-protective drugs in the normal liver function group was higher than that in the abnormal liver function group(85.71%),but there was no statistical difference.Therr were 116 patients in the normal liver group had used liver-protectives.Comparing the timing of treatment with normal liver function group and abnormal group one week after operation,the difference was statistically significant(P=0.043).Morphine needle was used as high as 42%,which is symptomatic treatment after surgery,that has hidden safety hazards.②In vitro resultsThe CCL4-induced cell activity had been improved and showed a gradient increase to different Sinomenine extent,and the difference was statistically significant(p<0.05);compared with the control group,the levels of TNF-α,IL-1β,IL-6 and ROS in the CCL4 group were significantly increased,and the difference was statistically significant(p<0.05);the levels of TNF-α,IL-1β,IL-6 and ROS of the CCL4-induced group with variably dosed sinomenine were all decreased;compared with the control group,the expression of bax,cleaved caspase3 in the CCL4 group was significantly increased,and the expression of bcl-2 was decreased,and the difference was statistically significant(p<0.05);the levels of bax,cleaved caspase3 of the CCL4-induced group with variably dosed sinomeninegroup was significantly reduced,and the expression of bcl-2 was increased.Conclusions Prophylactic use of antibacterial drugs does not significantly reduce the incidence of postoperative infections at the surgical site,and does not significantly affect the incidence and days of postoperative fever.The history of tobacco and alcohol was significantly related to the recovery of liver function one week after operation,so it was importment tocontrol the intake of tobacco and alcohol.The preventive use of liver-protective drugs before surgery had less significance in improving postoperative ALT than the postoperative use on the day of surgery.Morphine was used more frequently after surgery,with poor results and hidden dangers.Cell research had proven that Sinomenine had a protective effect on liver cell injury.Based on its analgesic characteristics,it provided preliminary evidence for the development of new indications and new applications of Sinomenine in clinic. |
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