| Bladder cancer is a common tumor in urology.In recent years,the incidence of the disease in China has gradually increased.The incidence of bladder cancer is related to smoking,long-term chemical production,exposure to chemical agents or long-term chronic inflammation in the bladder.Bladder cancer is classified into non-muscle invasive bladder cancer(NMIBC)and myometrial invasive bladder cancer(MIBC)according to the International Union Against Cancer(UICC)7th Edition TNM staging method.75% of bladder cancer is non-Myometrial invasive bladder cancer.Transurethral resection of bladder tumor is the preferred treatment for non-muscle invasive bladder cancer(TURBt),and Total cystectomy is the main treatment for myometrial invasive bladder cancer.Although the tumor tissue has been removed by surgery,bladder tumor recurrence is still unavoidable,so it is a world problem to prevent postoperative recurrence of bladder cancer.In order to effectively kill residual tumors and reduce the recurrence rate,both domestic and foreign urological guidelines advocate postoperative intravesical chemotherapy.At present,there are many types of perfusion drugs used in clinical practice,including cytotoxic drugs and immunological preparations.Although these drugs can reduce the postoperative recurrence of bladder cancer in the actual application process,they also produce local or systemic toxic side effects,and the chemotherapy drugs are generally expensive,which undoubtedly increases the economic burden of patients.Traditional Chinese medicine is a treasure of the motherland's culture,and the traditional Chinese medicine treatment has a long history and is profound and profound,and has a good clinical effect in the treatment of many diseases.Traditional Chinese Medicine Compound Xiaoxiaoling Injection was developed by Professor Shi Zhaojun,Department of Anorectal Surgery,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,based on the theory of TCM,which can be used for acne and rectal polyps.It is mainly used for the treatment of anorectal diseases such as hemorrhoids and rectal polyps.However,in recent years,it has been reported in the literature that it has an inhibitory effect on the growth of liver cancer,gastric cancer and bladder cancer.Based on this,we have applied for two grants since 2006 to observe the clinical efficacy and safety of Xiaozhiling combined with hydroxycamptothecin in the prevention and treatment of postoperative recurrence of bladder cancer,and to explore the effect of Xiaozhiling on inhibiting bladder tumor growth.The mechanism is now reported as follows.The first part the clinical efficacy of Xiaozhiling in preventing postoperative recurrence of bladder cancerOBJECTIVE: To observe the clinical efficacy and safety of Xiaozhiling combined with hydroxycamptothecin in the prevention of postoperative recurrence of bladder cancer.METHODS: A total of 65 patients with non-muscle invasive bladder cancer were enrolled in our hospital from June 2012 to June 2016,with an average age of 64.4710.21 years.All patients underwent transurethral resection of bladder tumors.All patients underwent adjuvant intravesical chemotherapy to prevent recurrence.In the experimental group,34 patients received bladder infusion chemotherapy with Xiaozhiling injection combined with hydroxycamptothecin(xiaolingling 10 ml + hydroxycamptothecin20mg);31 patients in the control group received only hydroxycamptothecin(20mg)intravesical infusion chemotherapy.In order to avoid medical risks,Xiaozhiling was not separately observed in clinical studies.The patients returned to hospital in March,June,and December to review hematuria,liver and kidney function,urinary CT and cystoscopy.RESULTS: The tumor recurrence rate was 14.71%(5/34)in the experimental group at 1 year follow-up,and 12(35.29%)patients had adverse drug reactions.The 1-year recurrence rate of the control group was 38.71%(12/31),and 10 cases(32.26%)showed adverse drug reactions.Conclusion: The tumor recurrence rate in the experimental group was significantly lower than that in the control group at 1 year.The difference between the two groups was statistically significant(P<0.05),indicating that Xiaozhiling has biological effects against bladder cancer.The incidence of adverse drug reactions in the experimental group was not significantly different from that in the control group(P>0.05),and the treatment of Xiaozhiling bladder perfusion was safe and reliable.Second the mechanism of Xiaozhiling against bladder cancerOBJECTIVE: To study the possible mechanism of Xiaozhiling in inhibiting the growth of bladder cancer.METHODS: The results of clinical studies showed that Xiaozhiling injection may have anti-bladder cancer biological effects.Under the support of Hubei Provincial Natural Science Foundation,the following research is used to explore the possible mechanism of anti-cancer effect of Xiaozhiling.1.Cell proliferation inhibition assay(CCK8)was used to analyze the inhibitory effect of Xiaozhiling on the proliferation of human bladder tumor EJ cells;2.Flow cytometry and AO/EB fluorescence staining were used to analyze the apoptosis of human bladder cancer EJ cells induced by Xiaozhiling;3.Western blot was used to detect the regulation of Caspase-3,Bcl-2 and Bax protein expression in human bladder cancer EJ cells by Xiaoyanling.4.Establish a subcutaneous bladder cancer model of C57 mice.The mice were divided into experimental group,positive control group and negative control group,respectively.They were given Xiaozhiling injection,cisplatin(2.5mg/kg)and normal saline100 ul intratumor.Injection,measurement of tumor volume and changes in body weight of the mice,the experimental period was 20 days.Results:1.Cell proliferation inhibition assay(CCK8): Xiaozhiling can inhibit the proliferation of human bladder cancer EJ cells,and the drug inhibition effect is time-and concentration-dependent;2,flow cytometry and AO / EB fluorescence staining: Xiaozhiling can induce apoptosis in human bladder cancer EJ cells.The rate of apoptosis is positively correlated with the duration of drug action and drug concentration.3,Western blot(Western blot)showed that Xiaozhiling can increase the expression of Caspase3 protein,Bax protein,and reduce the expression of Bcl-2 protein.4.The results of subcutaneous tumor inhibition experiments showed that Xiaozhiling injection and cisplatin could significantly inhibit the growth of subcutaneous tumors.There was no significant difference between the Xiaozhiling group and the cisplatin group(P>0.05).Tissue necrosis and ulceration occurred in the subcutaneous injection site of the Qiling group mice,and finally scars were formed.in conclusion:1.Xiaozhiling injection can inhibit the proliferation of human bladder cancer EJ cells and induce the apoptosis of EJ cells.The occurrence of apoptosis may be related to the high expression of caspase-3 and bax protein in EJ cells induced by Xiaozhiling and the decrease of bcl-2.Protein expression is related.2,Xiaozhiling can inhibit the growth of subcutaneous tumors in C57 mice,but its drugs have certain toxic side effects,which can cause ulceration-like changes in tissues. |
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