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Objective: The study potato juice and dexamethasone made of a mixture of coated prevention to fluorouracil chemotherapy phlebitis effect and mechanism. Methods: 1. Animal experiments: select the same species, the general level of rabbits 46 (conventional animal laboratories), 24 female, 22 male, weighing 2.0-3.3kg months of age 3-6 months, according to the random allocation divided into four groups: A group (Tu dexamethasone 18 potato juice mixture), group B (applicator group) 18 5 C group (Tu dexamethasone solution), D group ( coated potato juice) 5. Four groups were the end of in the rabbit ear vein site the dose 12mg/kg / day, the amount of fluid 10ml/kg / day, given intravenous bolus fluorouracil (5-Fu) continuous chemotherapy 3, A, C group and Group D at the above design requirements during chemotherapy in 5-Fu administration after the 0,30,60,90,120,180,240,360,480 of minutes from the puncture point, 0.5 cm in diameter round The skin begins to smear the drug, 3-4cm coated vertical direction along the venous return, coated with 1.5-cm laterally from the outside edge of the ear to the inside of the ear vein. The group smear respective preventive medications. After chemotherapy instead of a daily 8:00 start painting above preventive medicine, painted once every 120 minutes, five times a day, 72 hours after the stop. Visually observed and the occurrence of inflammation of the blood vessels and surrounding tissue of the puncture rate, and record, and then rabbits were sacrificed since the last puncture pinholes above 1.5cm along the vessel at reflux direction clipping the blood vessels and surrounding tissue (take long 3cm width to puncturing a blood vessel center, on each side are 0.5cm), quickly placed in 10% formalin solution and fixed for the producer and HE staining was observed under a microscope, the infiltration of inflammatory cells of the vascular wall, the vessel wall is damaged, the fibrous tissue of the vessel wall hyperplasia, vascular thrombosis, perivascular hemorrhage, and perivascular tissue edema incidence. Pairwise comparisons among groups using Fisher's exact, P <0.05 for the difference was significant. 2 immunohistochemistry: Group A and Group B cut tissue sections, 3 - aminopropyl triethylsilane (APES, SIGMA) siliconized glass plate mounted piece placed after baking in the oven at 56 ℃ 48h IHC staining. Light microscopy, brown particles appeared calm, for the expression of ICAM-1 and VEGF-positive cells within the cytoplasm of vascular endothelial cells. Each group were calculated positive cells accounted for a percentage of the vascular endothelial cells, comparing differences of P <0.05 was significant. 3 clinical observation: clinical observation of intravenous chemotherapy with 5-Fu 100 cases of gastrointestinal cancer, which observation group (E group, n = 50), given potato juice and ground dexamethasone made from a mixture of external application, the control group ( F group, 50 patients) applicator, to compare chemotherapy phlebitis happens. Pairwise comparisons between groups using Fisher's exact test, P <0.05, significant difference. Results: 1 Animal experiments: the naked eye observation: the incidence of phlebitis, group A was 11.11% (2/18), group B 100.00% (18/18), 80.00% (4/5) group C, D The group was 80.00% (4/5). The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group compared with significant differences (P <0.0001); groups A and C group, the difference was significant (P = 0.008); A Group D, differences have significant, P = 0.008; Comparison of group B and C group, differences without significantly with sex, P = 0.217; Comparison of group B and D groups, differences without significantly with sex, P = 0.217; C group and D group, the difference was not statistically significant, P = 1. Microscopy results: the incidence of vascular wall inflammatory cell infiltration, group A 50.00% (9/18), group B 100.00% (18/18), 60.00% (3/5) C group D group 100.00 % (5/5). The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group comparison, the difference was significant, P = 0.001; groups A and C group, the difference was not significant (P = 1); A Compare and D group differences without significantly with sex, P = 0.116; Comparison of group B and C group, the difference was significant, P = 0.04; B group and D group can not compare; C group and D group comparison, the difference without significantly with sex , P = 0.444. The incidence of damage to the vessel wall, A group of 11.11% (2/18), group B 66.67% (12/18), group C, 100.00% (5/5), D group was 60.00% (3/5) . The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group compared with significant differences (P = 0.002); groups A and C group, the difference was significant (P = 0.001); A Group D, differences have significant, P = 0.048; Comparison of group B and C group, differences without significantly with sex, P = 0.272; Comparison of group B and D group, the difference without significantly with sex, P = 1; C group and D group, the difference was not statistically significant, P = 0.444. The incidence of vascular wall of fibrous tissue hyperplasia A group was 61.11% (11/18) in group B of 100.00% (18/18), C group was 100.00% (5/5), D group was 40.00% (2 / 5). The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group comparison, the difference was significant, P = 0.008; groups A and C group, the difference was not statistically significant, P = 0.272; A Compare and D group differences without significantly with sex, P = 0.618; B group and C group can not compare; Comparison of group B and D group, the difference was significant, P = 0.006; in group C and D group comparison, the difference without significantly with sex , P = 0.167. The intravascular thrombosis incidence of group A, 5.56% (1/18), group B 61.11% (11/18), C group was 100.00% (5/5), D group was 40.00% (2/5 ). The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group comparison, the difference was significant, P = 0.001; groups A and C group, the difference was significant, P <0.0001; A Compare and D group differences without significantly with sex, P = 0.107; Comparison of group B and C group, differences without significantly with sex, P = 0.272; Comparison of group B and D groups, differences without significantly with sex, P = 0.618; C group and D group, the difference was not statistically significant, P = 0.167. Perivascular hemorrhage, the incidence of group A was 11.11% (2/18), group B 72.22% (13/18), 40.00% (2/5) C group D group was 80.00% (4/5) . The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group compared with significant differences (P <0.0001); groups A and C group, the difference was not statistically significant, P = 0.194; A Group D, differences have significant, P = 0.008; Comparison of group B and C group, differences without significantly with sex, P = 0.297; Comparison of group B and D group, the difference without significantly with sex, P = 1; C group and D group, the difference was not statistically significant, P = 0.524. Perivascular edema incidence of group A was 5.56% (1/18), group B 66.67% (12/18), group C, 40.00% (2/5), D group was 80.00% (4/5 ). The Fisher exact test for each group pairwise comparison analysis, draw: A group and B group compared with significant differences (P <0.0001); groups A and C group, the difference was not significant, P = 0.107; A Group D, differences have significant, P = 0.003; Comparison of group B and C group, differences without significantly with sex, P = 0.343; Comparison of group B and D group, the difference without significantly with sex, P = 1; C group and D group, the difference was not statistically significant, P = 0.524. Immunohistochemical staining results: group A and group B, ICAM-1 positive cells in comparison: ICAM-1 positive cells percentage of the group A than in group B, the difference was significant, P <0.0001; VEGF-positive cells of group A and group B percentages compare: VEGF positive cells of group A than in group B, the difference was significant, P <0.0001 2 clinical cases observed: E group did not occur phlebitis number of cases to 44 cases, the number of cases of phlebitis six cases of phlebitis incidence of 12.00% (6/50); 4 cases did not occur in the F group, occurred in 46 patients, phlebitis rate was 92.00% (46/50). Statistical analysis using Fisher's exact incidence of phlebitis, group E is lower than the F group, the difference was significant (P <0.0001). Conclusion: The results of the animal experiments and clinical applications: line made of potato juice and dexamethasone mixture coated in accordance with the prescribed method, from the appearance in reducing the incidence of phlebitis caused by 5-Fu, is superior to simple smear potato juice, dexamethasone and not Applicator. Animal experiments, from the microscopic observation, the inhibition rate is superior to simple smear potato juice, dexamethasone, and not applicator. Immunohistochemical results further reflect the prevention and treatment of the mixture of potato juice and Dexamethasone made rabbit superficial phlebitis The inhibition of vascular injury intracellular adhesion molecule-1 and vascular endothelial growth factor is related to the rise.
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