The Research On Mechanism Of Sheng Ji Tong Qiao Thermo-sensitive Gel In Promoting Hemostasis And Mucosal Repair After Sinus Surgery

1 Objective:?To explore hemostasis of SHENG JI TONG QIAO Thermo-sensitive Gel;?To explore the action and mechanism of mucosal neovascularization of SHENG JI TONG QIAO Thermo-sensitive Gel.?To determine the mechanism of promoting the mucosal repair of sinusitis after endoscopic sinus surgery of SHENG JI TONG QIAO Thermo-sensitive Gel.2 Methods: 2.1 Animal experiment?In vitro coagulation test of rabbit:Compared with the blank controlgroup,Thermosensitive Chitosan Gel group,low dose of SHENG JI TONG QIAO Thermo-sensitive Gel group and high dose of SHENG JI TONG QIAO Thermo-sensitive Gel group of in vitro coagulation time by test tube method and plasma calcium recovery time(RT)determination.?Rabbit liver wound hemostasis test:Compared with the blank control group,Thermosensitive Chitosan Gel group,low dose of SHENG JI TONG QIAO Thermo-sensitive Gel group and high dose of SHENG JI TONG QIAO Thermo-sensitive Gel group of using to bleeding the wound to stop the blood flow time by traumatic bleeding model of rabbit liver surface.?Western blot:Putted the Thermosensitive Chitosan Gel,the low dose of SHENG JI TONG QIAO Thermo-sensitive Gel and the high dose of SHENG JI TONG QIAO Thermo-sensitive Gel on sinus respectively by experimental model of rabbit's sinus mucosal injury.Take the sinus mucosa after 48 hours,and detected the expression of RAS,ERK and VEGF in sinus mucosa by western blot.?RT-PCR:Putted the Thermosensitive Chitosan Gel,the low dose of SHENG JI TONG QIAO Thermo-sensitive Gel and the high dose of SHENG JI TONG QIAO Thermo-sensitive Gel on sinus respectively by experimental model of rabbit's sinus mucosal injury.Take the sinus mucosa after 48 hours,and measured the average expression levels of RAS,ERK and VEGF mRNA in the mucosa.2.2 Clinical trials For the two groups of patients who meet the clinical trial requirements,routine nasal endoscopic sinus surgery,and filled the cavity by expansion sponge and SHENG JI TONG QIAO Thermo-sensitive Gel respectively.Other treatments in the two groups were consistent in perioperative period.Recorded the subjective symptoms of pain within 48 h after surgery by VAS,and compared the total bleeding volume(after 48h)of postoperative patients.2.3 Results processing Processed the above observation data,and obtain the corresponding conclusions by statistical analysis.3 Results 3.1 Animal experiment?In vitro coagulation test of rabbit:Compared with the blank control group,Thermosensitive Chitosan Gel and low dose of SHENG JI TONG QIAO Thermo-sensitive Gel group,we found that the high group of SHENG JI TONG QIAO Thermo-sensitive Gel had have effects on shorten the clotting time significantly,the differences were statistically significant(P<0.01).?Rabbit liver wound hemostasis test:Compared with blank control group,Thermosensitive Chitosan Gel and low dose of SHENG JI TONG QIAO Thermo-sensitive Gel group,we found the high group of SHENG JI TONG QIAO Thermo-sensitive Gel can significantly shorten the wound hemostasis time in hemostasis test of rabbit liver,the differences were statistically significant(P<0.01).?Western blot:The expression levels of RAS,ERK and VEGF in the mucosal mucosa of rabbits with drug treatment were higher than those in the blank control group.Compared the Thermosensitive Chitosan Gel and low dose of SHENG JI TONG QIAO Thermo-sensitive Gel group,the expression of RAS,ERK and VEGF in the mucosal mucosa was lower in rabbits of high dose of SHENG JI TONG QIAO Thermo-sensitive Gel group,the differences were statistically significant(P<0.05).?RT-PCR:The average expression levels of RAS,ERK and VEGF mRNA in the mucosal mucosa of rabbits with drug treatment were higher than those in the blank control group.Compared the Thermosensitive Chitosan Gel and low dose of SHENG JI TONG QIAO Thermo-sensitive Gel group,the average expression levels of RAS,ERK and VEGF mRNA in the mucosal mucosa was lower in rabbits of high dose of SHENG JI TONG QIAO Thermo-sensitive Gel group,the differences were statistically significant(P<0.05).3.2 Clinical trials?The points of pain VAS:There were significant differences in postoperative pain VAS scores between the two groups,the score of the treatment group(SHENG JI TONG QIAO Thermo-sensitive Gel)was significantly lower than the control group(expansion sponge),the differences were statistically significant(P<0.01).?Total bleeding volume:The total amount of bleeding in the treatment group(SHENG JI TONG QIAO Thermo-sensitive Gel)was significantly lower than that in the control group(expansion sponge),the differences were statistically significant(P<0.01).4 Conclusions 4.1 The SHENG JI TONG QIAO Thermo-sensitive Gel have hemostasis obviously.It may play a hemostatic effect through the activation of internal and external coagulation system.4.2 The SHENG JI TONG QIAO Thermo-sensitive Gel have promoting postoperative intraoperative mucosal repair of rabbits role.The possible mechanism is to regulate the release of inflammatory factors by regulating the Ras / ERK signaling pathway to regulate the expression of VEGF in the postoperative mucosa,thereby promoting the promotion of angiogenesis,improve the wound local blood supply,and thus promote the repair of mucous membranes.