Protective Role Of Enteric-coated HuDiCapsules Against Radiation-induced Intestinal Injury

Part 1Protective Role of Enteric-coated Hu Di Capsules against RadiationInduced Intestinal Injury in MiceWith the improvement of living standards in China,the average life expectancy gradually increased,the morbidity and mortality of cancer is also increasing year by year.Cancer serious threat to human life and health,the current treatment mainly includes radiotherapy,chemotherapy and surgical treatment.Radiation-induced intestinal injury(RIII)is one of the most common complications of clinical pelvic,abdominal and retroperitoneal malignant tumors after radiotherapy.Intestinal epithelial cells are sensitive to radioactivity,radioactive damage,prone to proliferation inhibition,apoptosis and mutation and necrosis,seriously affecting the prognosis of patients with malignant tumor radiotherapy.Acute radiation-induced intestinal injury in the late manifestation of intestinal obstruction,intestinal necrosis,intestinal perforation and intestinal fistula formation,and even directly lead to death in patients with chronic radiation bowel injury,the incidence of acute radiation-induced intestinal injury in the clinical manifestations of nausea,vomiting,abdominal pain,diarrhea,severe mucus,There is no exact treatment of clinical means,so to find safe and effective treatment of radiation-induced intestinal injury drugs is the clinical treatment of malignant tumors in the urgent need to solve the problem.Enteric-coated Hu Di capsules clinical mainly used for the treatment of non-specific ulcerative colitis,chronic bacillary dysentery hot syndrome,abdominal pain,diarrhea pus and blood,tenesmus and other diseases,with heat,temperature,cooling blood effect.The main components of the enteric-coated Hu Di capsules include cinnabar seven,Polygonumcuspidatum,Hedyotisdiffusa,Beiqiu,two-color solution of blood grass,gruel(charcoal),white and licorice.Therefore,this study can be used to protect mice from acute radiation-induced intestinal injury,to provide a clinical treatment program.Objectives: To investigate the protection of enteric-coated Hu Di capsules on RIII,this study was designed to explore the prevention and improvement mechanism of the capsules in mice RIII.Methods: The mice were irradiated with SPF grade pure C57BL/6 male mice and irradiated with 9MV electron beam of Varian Clinic600 linear accelerator.Based group exposure dose for single 10 Gy,mortality in mice experiment exposure dose of 20 Gy The mice were divided into normal group,radiotherapy group,radiotherapy group after enteric-coated Hu Di capsules,radiotherapy group before enteric-coated Hu Di capsules,radiotherapy group before administration.The NO content of mouse small intestine were divided into normal group,model group(irradiated group),low dose group,middle dose group and high dose group.D-xylose absorption test: After 2 days of irradiation,mice were given orally 100 ?l of 5% D-xylose solution,and the mouse urine was collected after 2 hours.By comparing the D-xylose content in the urine,Can the capsule group improve the absorption of D-xylose in mice.The mice were sacrificed 4days after irradiation,and the small intestine parts of the mice were taken as paraffin sections.The pathological features of the small intestine were observed under the microscope,And then double immunohistochemical staining,analysis of intestinal vascular apoptosis,as well as intestinal microvessel density determination.The determination of NO in the small intestine homogenate of mice was determined by the Bi-Yun-Tian NO kit.Results: The enteric-coated Hu Di capsules can protect mice from radiation-induced intestinal injury,which is contributed from its suppression on the NO synthesis in small intestine.Furthermore,our experimental results provide the basis for our future clinical study.Conclusions: The enteric-coated Hu Di capsules can protect mice from radiationinduced intestinal injury,which is contributed from its suppression on the NO synthesis in small intestine.Furthermore,our experimental results provide the basis for our future clinical study.Part 2:Protective Effect of Enteric-coated Hu Di Capsules on Acute Radiation-Induced Intestinal Injury of Cervical CancerObjective: Radiation-induced intestinal injury(RIII)is a common complication in the patients after abdominal and pelvic radiotherapy;however,it lacks effective treatment modalities currently.Based on our experimental study,we try to evaluate the protection of enteric-coated Hu Di capsules in cervical cancer patients with RIII.Methods:in this study,the patients were divided into two groups according to the principle of randomization in the treatment of 100 patients with stage ?B-?B radical radiotherapy for cervical cancer from June 2015 to July 2017.Group A(treatment group): At the beginning of radical radiotherapy to give oral administration of enteric-coated Hu Di capsules(4 pills,3 times / day),4 to 6 weeks;Group B(control group): radical radiotherapy alone.The frequency,extent of injury and time of occurrence of radioactive injury were observed.Two groups of patients before and after radiotherapy colonoscopy and MRE examination,to collect the complete picture and description,measuring mucosal thickness.(EORTC QLQ-C30)and the European Cancer Research and Treatment Center(EORTC QLQ-CX24)were used to investigate the changes of quality of life before and after radiotherapy,and the quality of life was measured before and after treatment Assessment,and assessment of the role of enteric-coated Hu Di capsules can protect RIII.Results: The results showed that the treatment group showed 8 cases(16%)of intestinal injury,of which 3(6%)cases ?~? degree of injury,injury occurred in the radioactive treatment of 9 to 22 days,an average of 17 days;control group 16 cases of intestinal injury(32%),of which 7(14%)cases ?~? degree of injury,injury occurred in radiation therapy for 5 to 24 days,an average of 11 days.And patients after radiotherapy,colonoscopy results showed a small radiation after treatment of small intestine mucosal edema,ulcers,white fur increased,and even blood spots,suggesting that patients with radiation enteritis,enteric-coated Hu Di capsules group of patients with mild inflammation.The thickness of the mucosa was(1.7 ± 0.37 mm;4.8 ± 0.52mm)before and after treatment in the control group.The thickness of the mucosa was(1.8 ± 0.35 mm;2.6 ± 0.41 mm)before and after radiotherapy in treatment group.Patients with radiotherapy after treatment of poor quality of life questionnaire showed lower than before treatment,especially nausea and vomiting,loss of appetite,constipation,diarrhea and other gastrointestinal damage,and A group after treatment,in nausea and vomiting,appetite,constipation,diarrhea Scores were significantly lower than those in group B.Conclusion: Radiation-induced intestinal injury(RIII)is a common complication in the patients after abdominal and pelvic radiotherapy;however,it lacks effective treatment modalities currently.Based on our experimental study,we try to evaluate the protection of enteric-coated Hu Di capsules in cervical cancer patients with RIII.