Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury

AIM： To investigate the effect of shenfu injection on gastrointestinal microcirculation after myocardial ischemic-reperfusion （IR） injury in rabbits and probe into the mechanism. METHODS： Forty healthy flap-eared white rabbits were randomly divided into 4 groups： IR injury control group （group Ⅰ ）, shenfu injection 5 mL/kg per h group （group Ⅱ）, shenfu injection 10 mL/kg per h group （group Ⅲ） and shenfu injection 20 mL/kg per h group （group Ⅳ）. The four groups were treated with Lactated Ringer＇s solution, shenfu injection 5, 10, and 20 mL/ kg per h were infused intravenously 30 min before experiment respectively. The values of hemodynamics [mean arterial pressure （MAP）, heart rate （HR）, gastric intramucosal partial pressure of carbon dioxide （PCO2）, blood gas analysis and pH] were measured and compared with those before myocardial ischemia, 60 min after myocardial ischemia and 60, 90, and 180 rain after reperfusion. RESULTS： The MAP, HR and gastric intramucosal pH were （70.50 ± 4.50） kPa, （165 ± 14） beats per rain, 7.032 ± 0.024 in group Ⅰ 60 min after myocardial ischemia, which were significantly decreased compared with those before myocardial ischemia （88.50 ± 9.75 kPa, 217 ± 18 beats per rain, 7.112 ± 0.035, P 〈 0.05）. The MAP, HR and gastric intramucosal pH were significantly decreased in group Ⅰ 60, 90, and 180 min after reperfusion （61.50 ± 5.25 kPa, 133 ± 31 beats per rain, 6.997 ± 0.025） compared with those before reperfusion respectively （P 〈 0.05）, whereas the values were insignificantly different in groups Ⅱ, Ⅲ or Ⅳ after reperfusion, compared with those before reperfusion, and there were no significant differences between groups Ⅱ, Ⅲ, and Ⅳ after reperfusion. CONCLUSION： Pre-infusion of shenfu injection has a protective effect on gastrointestinal microcirculation after myocardial IR injury in rabbits, in a dose independent manner.

Improvement of Quality of Life with Shenfu Injection (参附注射液) in Non Small Cell Lung Cancer Patients Treated with Gemcitabine plus Cisplatin Regimen

Objective： To observe the effect of Shenfu injection （参附注射液, SFI） in treating non small cell lung cancer （NSCLC） patients on quality of life with gemcitabine （GEM） plus cisplatin （GP） regimen. Methods： Thirty-four patients were ready to receive GP regimen chemotherapy for treating NSCLC disease, according to lot-drawing, they were divided into SFI pre-treatment group （18 cases） and SFI post-treatment group （ 16 cases）. SFI pre-treatment group： During the first treatment course, chemotherapy was begun with SFI 60 ml, intravenous dripping on the 3rd day, once daily, consecutively for 10 days; on the 1st day, GP regimen （GEM 1250 mg/m^2 , intravenous dripping, on the 1st and 8th day; cisplatin 70 mg/m^2 on the 2nd day; 21 days as one cycle） was carried out; in the second treatment course GP regimen was merely given to serve as the self-control. SFI post-treatment group： the medicament sequence order was reversed from that of pre-treatment group. Using dual international quality of life （QOL） scores, the effect of SFI on the patients＂ QOL was observed through randomized self pre- and post- crossover control. Results： The QOL in the 34 patients after being treated by SFI in combination with GP chemotherapy regimen in one group, and GP chemotherapy regimen alone in the other, was improved in different degrees, with significant difference （P〈0.01）; comparision of SFI combined with GP chemotherapy regimen with GP chemotherapy alone showed that QOL in patients was significantly different （P〈0.01）. Conclusion： SFI could improve QOL in patients with NSCLC who were treated with GP regimen.

Effect of Shenfu injection on ischemia-reperfusion injury of rat liver graft

BACKGROUND: It is reported that Shenfu injection (an injection prepared from traditional Chinese medicines red ginseng and aconite root) can decrease the extent of ischemia-reperfusion injury to many organs, such as the heart and kidney. We therefore investigated the effect of Shenfu injection on ischemia-reperfusion injury of rat liver graft and its mechanism. METHODS: Male Sprague Dawley (SD) rats were used as a model for isogeneic orthotopic liver transplantation. Sixty rats were randomly devided into two groups (30 in each group). The recipient was given intravenous Shenfu injection immediately before the removal of the liver in the Shenfu group and normal saline of the same volume in the control group. At 3, 6 and 24 hours after the reperfusion, blood and hepatic tissue were taken for examination. RESULTS: The levels of superoxide dismutase (SOD) and nitric oxide (NO) increased more significantly in the Shenfu group than in the control group (P <0.05). The levels of serum liver enzymes, hyaluronic acid (HA), malondialde-hyde (MDA), tumor necrosis factor-alpha(TNF-α), inter-leukin-1 (IL-1), endothelin -1 (ET-1) and liver cell apopto-sis index were lower in the Shenfu group than in the control group (P <0. 05). Microscopic examination revealed that the morphological changes of hepatic tissue were more severe in the control group than in the Shenfu group. CONCLUSIONS: Shenfu injection has protective effect on ischemia-reperfusion injury of rat liver graft. It inhibits the production of oxygen free radical and the activation of Kupffer cells, decreases apoptosis of liver cell, and improves microcirculation.

Effect of Shenfu injection on microcirculation effect index in early-and middle-stage of cardiogenic shock rats

OBJECTIVE Shenfu injection(SFI)is an effective treatment of cardiogenic shock,the pathology of the central link was microcirculation disturbance.However,whether the microcirculation status of the early-and mid-stage of cardiogenic shock has any difference is unclear.This study aimed to observe the effect of SFI on the microcirculatory disturbance in mesentery for early-and mid-stage of cardiogenic shock rat.METHODS The early-and mid-stage model of cardiogenic shock was established by ligating the ending or root of left anterior descending coronary arteries(LADCA).The rats were randomly divided into 9 groups,ie control group,early-stage model group,mid-stage model group,3 early medicated groups and 3 mid medicated groups(the dosage was 1,3.33,10 mL·kg^(-1) SFI for cardiogenic shock rats of early-and mid-stage,respectively).Parameters in mesenteric microcirculation,such as velocity of RBCs in venules,diameters of venules,the count of leukocyte adhesion and vascular permeability which calculated by FITC-dextran leakage were observed through an GeneandiM2 inverted intravital microscope and high-speed video camera system.RESULTS The cardiogenic shock induced by ligating the LADCA resulted in a number of responses in microcirculation,including a significant increase in the counts of adhesive leukocytes,narrowing of the vascular diameter,decrease in the velocity of RBCs and dextran efflux.All of the above parameters for early-stage cardiogenic shock rats were attenuated by the treatment with SFI,especially the dosage of 10 mL·kg^(-1).While SFI had no apparent time-effect on the vascular diameter and vascular permeability in mesentery for mid-stage cardiogenic shock rats.CONCLUSION The microcirculation status of the early-and mid-stage of cardiogenic shock rats were quite different.The efficacy of early treatment with SFI was more obvious than the mid administration,which could provide experimental and theoretical basis for the patients with cardiogenic shock in an earlier time.

Shenfu injection plus vinorelbine for elderly patients with non-small cell lung cancer in promoting the quality of life: a randomized controlled clinical trial

Objective： The present study aimed to investigate the efficacy of Shenfu injection plus vinorelbine on the promotion of the quality of life （QOL） in elderly non-small cell lung cancer （NSCLC） patients. Methods： A randomized single blind trial method was used. Forty-six patients with stage IIIB-IV of HSCLC were randomly divided into experimental group and control group. In the experimental group, the patients were treated with 50 mL Shenfu injection from day 1 to 14, plus vinorelbine （NVB） 25 mg/m^2 on day 1 and 8. In the control group, the patients were only treated with NVB 25 mg/m^2 on day 1 and 8. After two cycle＇s of treatment, QOL, efficacy and toxicity were observed. Results： The QOL was enhanced in both experimental group and control group. However, the difference of KPS after treatment in the experimental group was markedly higher than in the control group （14 ± 10 vs. 8 ± 10, t = 2.116, P = 0.04）, improvement rate of QOL was better than in the control group （76.2% vs. 45.0%, χ^2 = 4.188, P = 0.041）, treatment related toxicity in the experimental group was also markedly lower than in the control group （χ^2 = 3.866, P = 0.049）, but the difference of efficacy between the two groups was not significant （14.3% vs. 15.0%, χ^2 = 0.161, P = 0.688）. Conclusion： Shenfu injection plus vinorelbine can enhance QOL in elderly NSCLC patients.

Therapeutic Effect of Shenfu Injection (参附注射液) on Secondary Aplastic Anemia of Tumor Patients after Chemotherapy

Objective: To explore the effect of Shenfu Injection (参府注射液, SFI) on the secondary aplastic anemia (AA) of tumor patients after chemotherapy (CT). Methods: The 15 cases of SFI treated group, 10 cases of control group, 25 cases of SFI + granulocyte-macrophage colony stimulating factor (GM-CSF) treated group and the group of 23 GM-CSF-treated tumor cases of secondary AA after CT were compared, with their increasing rate and the rebound speed of neutrophil, platelet, bone marrow nucleated RBC, granulocyte, and megakaryocyte all being investigated. Results: The increasing rate and rebound speed of granulocyte, platelet, and the increasing rate of bone marrow nucleated RBC, granulocyte, megakaryocyte were obviously higher than those of the control, and the clinical manifestations were also obviously improved. The increasing rate of platelet, bone marrow nucleated RBC, megakaryocyte of the SFI + GM-CSF group were higher than those of the group which used GM-CSF alone, while the increasing rate of granulocyte in blood and bone marrow in both groups was similar. Conclusion: Significant efficacy was shown in SFI for the treatment of secondary AA of tumor patients after CT.

Protective Effect of Shenfu Injection on Rats with Chronic Heart Failure Induced by Doxorubicin

[Objectives] To determine the protective effect of Shenfu injection( SFI) on chronic heart failure( CHF) in rats induced by doxorubicin. [Methods] CHF was induced by doxorubicin via intraperitoneal injection in rats. The cardiac function parameters,the heart index,the serum brain natriuretic peptide( BNP) level and cardiac histopathology were measured 4 weeks after Shenfu injection treatment. [Results]Shenfu injection remarkably improved the heart index and cardiac histopathology,increased the heart rate( HR),left ventricular systolic pressure( LVSP),maximum rising rate of left ventricular pressure( + dp/dtmax) and dropping rate of left ventricular pressure(-dp/dtmax),reduced the left ventricular end-diastolic pressure( LVEDP) and serum BNP level of rats with CHF induced by doxorubicin. [Conclusions]Shenfu injection exerts protective effect on CHF induced by doxorubicin.

Exploration on the Effect and Mechanism of Shenfu Injection (参附注射液) on Resuscitation from General Anesthesia

Objective: To investigate the effect and the mechanism of Shenfu injection (SFI, ) on the resuscitation from general anesthesia . Methods: Forty patients who received selective abdominal surgery with general anesthesia for 3-4 hrs and ASA grade Ⅰ-Ⅱ were divided into two groups, the trial group and the control group, 20 patients in each group. After being sent into the postanesthesia care unit (PACU), the trial group was treated with intravenous dripping of SFI 1.0 ml/kg and the control group was treated with intravenous dripping of equal volume of normal saline. All patients were observed in double blindly manner, the self ventilation recovery time, extubation time, the time of leaving PACU and their Glasgow coma scale (GCS) were recorded and compared. 2 ml of peripheral venous blood were taken to determine the plasma β-endorphin (β-EP) content at the time points of before (T1), 5min (T2), 15min (T3) and 30 min (T4) after dripping. Results: The self ventilation recovery time, extubation time and time of leaving PACU in the trial group were all shorter than those in the control group (P<0 01), the GCS in the trial group was better than that in the control group (P<0 01). The plasma content of β-EP raised gradually along the recovering of patients consciousness, as compared with the content before dripping (T1), it showed insignificant difference at time point T2 but significant difference at T3 and T4, comparison at the corres ponding time point showed that the content at T1 and T2 were similar in the two groups (P>0 05), but at T3 and T4, the content was higher in the trial group than that in the control group respectively (P<0 01). There was insignificant difference between T1 and before treatment ( P>0 05), but significant difference was found when compared T3, T4 and before treatment (P<0 01).Conclusion: SFI could accelerate the resuscitation after general anesthesia, the mechanism may be related with its action in raising plasma β-EP level.

Systematic Evaluation and Meta-Analysis of the Efficacy and Safety of Shenfu Injection in the Treatment of Septic Cardiomyopathy

Objective:To evaluate the efficacy and safety of Shenfu injection in the treatment of septic cardiomyopathy.Methods:Literatures on Shenfu injection for the treatment of sepsis published from the establishment of each database to December 31,2020,were searched by computer;Cochrane risk-of-bias tool was used for evaluating the quality of literatures,and Review Manager 5.4 software was used for meta-analysis.Results:Twenty random controlled trials(RCTs)were included,with a total of 1,179 patients;the meta-analysis showed that the routine treatment of Western medicine combined with Shenfu injection can reduce the 28-day mortality,the length of hospital stay,cardiac troponin I(cTnI),and N-terminal pro-brain natriuretic peptide(NT-proBNP)as well as improve the left ventricular ejection fraction(LVEF)with low incidence of adverse reactions.Conclusion:Western medicine combined with Shenfu injection can further reduce myocardial injury in patients with sepsis and improve cardiac function as well as the prognosis of patients with septic cardiomyopathy.

Meta-analysis of the Effect of Shenfu Injection on Immune Function in Patients with Sepsis

Objective:To systematically evaluate the effects of Shenfu Injection on immune function of sepsis patients by meta-analysis.Methods:The randomized controlled trials of Shenfu Injection in the treatment of sepsis published from 2000 to February 2021 were searched in CNKI,WanFang database and VIP database.The control group was treated with routine treatment;The experimental group was treated with Shenfu Injection on the basis of routine treatment.The included literature was evaluated by Cochrane bias risk evaluation table,and Shenfu Injection was used to treat patients with sepsis with RevMan 5.3 software.The results of meta-analysis were as reported.Conclusion:However,due to the limitation of the quality and quantity of the included research,multi center,large sample volume and high-quality RCT are still needed to verify the research results.

Effectiveness and safety of Shenfu injection in septic patients with hypoperfusion:A multi-center,open-label,randomized,controlled trial

Background:To evaluate the effectiveness and safety of the Shenfu injection(SFI)combined with standard bundle treatment in septic patients with hypoperfusion.Method:This study was a multi-center,randomized,open-label,controlled trial conducted in four teaching hos-pitals in China.The septic patients with hypoperfusion and traditional Chinese medicine(TCM)syndrome with Yang-Qi deficiency were enrolled from January 2019,through September 2020.Eligible patients were randomly allocated in a 1:1 ratio to either receive 60 mL of SFI infusion per day plus standard treatment(SFI group)or stan-dard bundle treatment alone(control group).The primary outcome was 28-day all-cause mortality.Secondary outcomes were 90-day all-cause mortality time to weaning from mechanical ventilation,time to weaning from vasopressors,time to discharge from the ICU and hospital,and laboratory results after randomization.Results:A total of 188 patients completed the trail.This study revealed that the results of the SFI group and the control groups were not statistically significant in 28-day all-cause mortality(10.6%vs.20.2%,respectively;P=0.106).The infusion of SFI was associated with a significant reduction in the duration of vasopressor use(median=4.0 days,interquartile range[IQR]:2.0 days-6.0 days vs.median=5.0 days,IQR:3.0 days-8.0 days,respectively;P=0.043).Patients in the SFI group had statistically greater reductions in plasma lactate levels compared with those in the control group at the first 12 h(median=1.1 mmol/L,IQR:0.3-2.0 mmol/L vs.median=0.0 mmol/L,IQR:−0.2 to 0.8 mmol/L,respectively;P<0.001)and 24 h(median=1.4 mmol/L,IQR:0.3-2.2 mmol/L vs.median=0.4 mmol/L,IQR:−0.4 to 1.6 mmol/L,respectively;P=0.001).Conclusion:SFI plus standard therapy did not significantly decrease 28-day all-cause mortality for septic patients with hypoperfusion and TCM syndrome with Yang-Qi deficiency.

Therapeutic Effects of Shenfu Injection in Shock

Shock is the clinical manifestation of acute circulatory failure,which results in inadequate utilization of cellular oxygen.It is a common condition with high mortality rates in intensive care units.The intravenous administration of Shenfu Injection(SFI)may attenuate inflammation,regulate hemodynamics and oxygen metabolism;inhibit ischemia-reperfusion responses;and have adaptogenic and antiapoptotic effects.In this review,we have discussed the clinical applications and antishock pharmacological effects of SFI.Further in-depth and large-scale multicenter clinical studies are warranted to determine the therapeutic effects of SFI on shock.

Shenfu injection protects against myelosuppression from chemotherapy

Cyclophosphamide is used to treat a variety of tumors. However, the success of the treatment is limited due to severe myelosuppression caused by cyclophosphamide. Administration of cyclophosphamide could significantly decrease white blood cells （WBCs）, platelets, red blood cells （RBCs）, as well as hemoglobin level. The aim of this research is to investigate the protective role of Shenfu injection against cyclophosphamide induced myelosuppression. The results showed that Shenfu injection can markedly enhance the level of WBCs, platelets, RBCs, and hemoglobin of myelosuppressed rat. The level of WBCs, platelets, RBCs, and hemoglobin were increased by 70%-100%, 80%-90%, 10%-20% and 10%-20%, respectively. Furthermore, the protective role of Shenfu injection against myelosuppression was confirmed by the microscopic observation of bone marrow sections. In conclusion, Shenfu injection has a potential protective effect against cyclophosphamide-induced myelotoxicity.

Cardioprotection of Shenfu Injection(参附注射液) against Myocardial Ischemia/Reperfusion Injury in Open Heart Surgery

Objective： To investigate the protective effect of Shenfu Injection （参附注射液, SFI） against myocardium ischemia/reperfusion injury （IRI） in mitral valve replacement （MVR） with cardiopulmonary bypass （CPB）. Metheds： Forty patients undergoing selective MVR were randomly assigned to the control group and trial Groups Ⅰ, Ⅱ,Ⅲ, and Ⅳ according to the different administrations of SFI, 8 patients in each group. The changes of systolic blood pressure （SBP）, mean blood pressure （MBP）, diastolic blood pressure （DBP） in each group were monitored, respectively. The recovering percentage of spontaneous heart beat, the heart rate （HR） and cardiac rhythm as well as the abnormal duration of ECG-ST segment were recorded after the restoration of heart beat. The serum concentration of cardiac troponin Ⅰ （cTnl）, malondialdehyde （MDA） and the activity of superoxide dismutase （SOD） were determined as well. Results： （1） The SBP, MBP and DBP values, the recovering rate of spontaneous heart beat, HR, ECG-ST, atrioventricular block and ventricular arrhythmia were significantly improved in group Ⅳ compared with any other groups. （2） Compared with the control group, the postoperative serum contents of cTnl and MDA were significantly decreased, but the activity of SOD was significantly increased in group Ⅳ. Cenclusiens： SFI had a certain protective effect against myocardium IRI. Moreover, better efficacy was seen with the administration of 1.5 mL/kg SFI into CPB priming fluid and pumping 1.5 mL/kg SFI via CPB as soon as the clamped aorta was unclamped.

Shenfu Injection(参附注射液) Suppresses Inflammation by Targeting Haptoglobin and Pentraxin 3 in Rats with Chronic Ischemic Heart Failure

Objective： To investigate the regulatory effects of Shenfu Injection （SFI, 参附注射液） on hemodynamic parameters and serum proteins in rats with post-infarction chronic heart failure （CHF）. Methods： Forty-five healthy Wistar rats were randomized into three groups： sham, heart failure （model） and SFI group. The CHF was induced by left coronary artery ligation. Seven days after the surgical operation, animals in the sham group and the model group received saline （6.2 mL/kg/d）, while animals in the SFI group received SFI （6.2 mL/kg.d） intraperitoneally. Four weeks later, cardiac hemodynamic parameters were measured via the carotid route. The expression of serum proteins was analyzed by two-dimensional electrophoresis and matrixassisted laser desorption/ionization time-of-flight mass spectrometer （MALDI-TOF MS）. Results： Recording of hemodynamic parameters showed that left ventricular systolic pressure （LVSP）, maximum rate of left ventricular pressure （＋dp/dtmax） rise, and maximum rate of left ventricular pressure （-dp/dtmax） decrease, while the left ventricular end diastolic pressure （LVEDP） rose in the model group compared to those in the sham group （P〈0.05）. The results of the MALDI-TOF MS indicated that haptoglobin （HP）, pentraxin 3 （PTX3） and alpha-1- antitrypsin were up-regulated, while serum albumin and 40S ribosomal protein were down-regulated in the model group （P〈0.05）. Compared with the model group, LVSP, ＋dp/dtmax and -dp/dtmax were higher, while LVEDP was lower in the SFI group （P〈0.05）. Expression levels of HP and PTX3 were lower than in the model group （P〈0.05）. Conclusion： SFI could improve hemodynamic function and decrease inflammatory reactions in the pathophysiology of CHF. The serum proteins HP and PTX3 could be potential biomarkers for chronic ischemic heart failure, and they could also be the serum protein targets of SFI.

Pharmacokinetic evaluation of Shenfu Injection in beagle dogs after intravenous drip administration

Shenfu Injection (SFI) is a well-defined Chinese herbal formulation that is obtained from red ginseng and processed aconite root. The main active constituents in SFI are ginsenosides and aconitum alkaloids. In this work, ginsenosides (ginsenoside Rg 1, ginsenoside Rbl and ginsenoside Rc) and aconitum alkaloids (benzoylmesaconine and fuziline) were used as the index components to explore the pharmacokinetic behavior of SFI. A selective and sensitive HPLC MS/MS method was developed for the quantification of ginsenosides and aconitum alkaloids in dog plasma and was used to characterize the pharmacokinetics of the five index components after intravenous drip of three different dosages of SFI in beagle dogs. The pharmacokinetic properties of the index components were linear over the dose range of 2-8 mL/kg. (C) 2016 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND

Role of Shenfu Injection(参附注射液) in Rats with Systemic Inflammatory Response Syndrome

Objective： To investigate the role of Shenfu Injection （参附注射液, SFI） in rats with systemic inflammatory response syndrome （SIRS）. Methods： The SIRS rat model was induced by the intravenous injection of lipopolysaccharide （LPS）. Forty-five male Wistar rats were randomly divided into 3 groups, the sham operative control group （control group, n=5）, the SIRS model group （model group, n=20） and the SFI treatment group （SFI group, n=20）. LPS was injected through the external jugular vein （12 mg/kg, 6 mg/mL） to all rats except for those in the control group, and SFI （10 mL/kg） was given to those in the SF group only once through intraperitoneal injection, while the normal saline （10 mL/kg） was given to those in the model group. For those in the control group, normal saline was given through the external jugular vein （2 mL/kg） and intraperitoneal injection （10 mL/kg）. Then, rats in the model group and SFI group were divided into 4 subgroups according to the time points, i.e., 1 h, 2 h, 4 h and 6 h subgroups, 5 rats in each group. The activity of nuclear factor of κB （NF-κB） of in blood mononuclear cells and the plasma levels of tumor necrosis factor- α （TNF- α ） and interleukin 6-（IL-6） were determined using enzyme-linked immunoabsordent assay （ELISA） at 1 h, 2 h, 4 h and 6 h after modeling. Histopathologic changes of the lung and liver were observed under a light microscope. Results： Compared with the control group, the activity of NF-κB in mononuclear cells and the plasma level of TNF-α were obviously increased at each time points （all P〈0.01）, reaching the peaks at 2 h after modeling. The plasma level of IL-6 increased gradually as time went by in the model group （P〈0.01）. Pathological examination showed pulmonary alveoli hemorrhage, edema and inflammatory cell infiltration in the lung tissue, and angiotelectasis, congestion, and local necrosis in the liver tissue in the model group. Compared with the model group, the activity of NF- κB and the levels of TNF-α and IL-6 in plasma decreased significantly in the SFI group （P〈0.01）, and the pathological injury in the lungs and liver was significantly alleviated. Conclusion： SFI plays a protective role by inhibiting the activity of NF-κB, and reducing the expressions of TNF-α and IL-6 in SIRS rats.

Therapeutic Effects of Shenfu Injection(参附注射液) on Post-Cardiac Arrest Syndrome

Survival rates after cardiac arrest have not changed substantially over the past 5 decades. Post- cardiac arrest （CA） syndrome （PCAS） is the primary reason for the high mortality rate after successful restoration of spontaneous circulation （ROSC）. Intravenous administration of Shenfu Injection （参附注射液, SFI） may attenuate post-CA myocardial dysfunction and cerebral injury, inhibit systemic ischemiaJreperfusion responses, and treat underlying diseases. In this article, we reviewed the therapeutic effects of SFI in PCAS. SFI might be useful in the treatment of PCAS, incorporating the multi-link and muff-target advantages of Chinese medicine into PCAS management. Further experimental and clinical research to verify the therapeutic effects of SFI in PCAS is required.

Effects of Shenfu Injection(参附注射液)on Inflammatory Response during Post-Resuscitation Myocardial Dysfunction after Cardiac Arrest in Swine

Objective:To investigate whether Shenfu Injection(SFI,参附注射液)can alleviate post-resuscitation myocardial dysfunction by inhibiting the inflammatory response.Methods:After 8 min of ventricular fibrillation and 2 min of basic life support,24 pigs were randomly divided into 3 groups(n=8),which were given intravenous bolus injections of SFI(1.0 mL/kg),epinephrine(EP,0.02 mg/kg)and normal saline(SA),respectively.The animals were sacrificed at 24 h after restoration of spontaneous circulation(ROSC),and serum interleuking-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were measured by enzyme-linked immunosorbent assay(ELISA);expressions of Toll-like receptor 4(TLR4)/nuclear factor kappa B(NF-κB)m RNAs and proteins were determined by RT-PCR and Western blot,respectively.Results:Compared with the EP and the SA groups,the ultrastructure of myocardial cells were slightly damaged and the systolic function of the left ventricle was markedly improved in the SFI group at 24 h after ROSC(P<0.05).In addition,compared with the EP and SA groups,the SFI group also showed significantly reduced levels of serum IL-6 and TNF-α,protein and mRNA levels of myocardial NF-κB and TLR4(P<0.05).Conclusions:Activation of TLR4/NF-κB signaling pathway may be involved in the pathological mechanisms of post-resuscitation myocardial dysfunction.SFI may block NF-κB-mediated inflammatory response by reducing the activity of NF-κB and the level of TNF-α,thus playing a protective role in post-resuscitation myocardial dysfunction.

Effects of Shenfu Injection(参附注射液)on Cerebral Metabolism in A Porcine Model of Cardiac Arrest

Objective： To investigate the effects of Shenfu Injection （参附注射液, SFI） on cerebral metabolism in a porcine model of cardiac arrest （CA）. Methods： Thirty Wuzhishan minipigs were randomly assigned to the control group （n=6）, epinephrine group （Fp group, n=12） and SFI group （n=12）. After 8 min of untreated ventricular fibrillation （VF）, pigs in the EP group or SFI group were administered with either i=p （0.02 mg/kg） or SFI （1.0 mL/kg）, respectively. After successful resuscitation, cerebrospinal fluid （CSF） levels of glucose, pyruvate, lactate, glutamate and glycerol were measured at 1, 6, 12 and 24 h after recover from spontaneous circulation （ROSC）. In addition, neurologic deficit score （NDS） was calculated at 24 h after ROSC. Surviving pigs were killed at 24 h after ROSC, and the brain tissue was obtained for ultra-microstructure examination. Results： Compared with the EP group, CSF glucose and pyruvate levels were higher （all P〈0.01）, and lactate levels were lower in the SFI group （P〈0.01）. Meanwhile, CSF glutamate and glycerol levels in the SFI group were lower in comparison to the EP group （all P〈0.05）. In addition, SFI decreased NDS at 24 h after ROSC （P〈0.01）, and alleviated the histopathological damage of the brain. Conclusions： SFI could alleviate brain injury after CA, which may be associated with improving cerebral metabolism.