Neuroprotection of Erythropoietin and Methylprednisolone against Spinal Cord Ischemia-Reperfusion Injury

Recent research based on various animal models has shown the neuroprotective effects of erythropoietin （EPO）. However, few studies have examined such effects of EPO in the clinic. In this study we enrolled patients with spinal cord ischemia-reperfusion （I-R） injury to investigate the clinical application of EPO and methylprednisolone （MP） for the neuroprotection against spinal cord I-R injury. Retrospective analysis of 63 cases of spinal cord I-R injury was performed. The Frankel neurological performance scale was used to evaluate the neurological function after spinal cord injury （SCI）, including 12 cases of scale B, 30 cases of scale C, and 21 cases of scale D. These cases were divided into 2 groups： group A （27 cases） got treatment with both EPO and MP; group B （36 cases） got treatment with MP only. The neurological function of patients after treatment was evaluated by American Spinal Cord Injury Association （ASIA） index score, and activity of daily living （ADL） of the patients was also recorded. All patients got follow-up and the follow-up period ranged from 24 to 39 months （mean 26 months）. There was no significance difference in neurological function between groups A and B before the treatment （P〉0.05）. However, the neurological function and ADL scores were significantly improved 1 week, 1 year or 2 years after the treatment compared to those before the treatment （P〈0.05）, and the improvement was more significant in group A than in group B （P〈0.05）. It is suggested that the clinical application of EPO and MP provides the neuroprotection against spinal cord I-R injury.

Xuebijing injection alleviates liver injury by inhibiting secretory function of Kupffer cells in heat stroke rats

OBJECTIVE： To evaluate the effects of Xuebijing （XBJ） injection in heat stroke （HS） rats and to inves- tigate the mechanisms underlying these effects. METHODS： Sixty anesthetized rats were random- ized into three groups and intravenously injected twice daily for 3 days with 4 mL XBJ （XBJ group） or phosphate buffered saline （HS and Sham groups） per kg body weight. HS was initiated in the HS and XBJ groups by placing rats in a simulated climate chamber （ambient temperature 40℃：, humidity 60% ）. Rectal temperature, aterial pressure, and heart rate were monitored and recorded. Time to HS onset and survival were determined, and serum concentrations of tumor necrosis factor （TNF）-α, in-terleukin （IL）-1β, IL-6, alanine-aminotransferase （ALT）, and aspartate-aminotransferase （AST） were measured. Hepatic tissue was harvested for patho- logical examination and electron microscopic ex- amination. Kupffer cells （KCs） were separated from liver at HS initiation, and the concentrations of se- creted TNF-α, IL-1β3 and IL-6 were measured. RESULTS： Time to HS onset and survival were signif- icantly longer in the XBJ than in the HS group. Moreover, the concentrations of TNF-α, IL-1β, IL-6, ALT and AST were lower and liver injury was milder in the XBJ than in the HS group. Heat-stress in- duced structural changes in KCs and hepatic cells were more severe in the HS than in the XBJ group and the concentrations of TNF-α, IL-1β and IL-6 se- creted by KCs were lower in the XBJ than in the HS group. CONCLUSION： XBJ can alleviate HS-induced sys- temic inflammatory response syndrome and liver injury in rats, and improve outcomes. These protec- tive effects may be due to the ability of XBJ to inhib- it cytokine secretion by KCs.

Curative effect of Xuebijing injection on severe pulmonary contusion

OBJECTIVE： To investigate the curative effects of Xuebijing （XBJ） injection, a Chinese patent medi- cine, on severe pulmonary contusion （PC）. METHODS： Sixty-three patients with PC were ran- domized to conventional therapy plus XBJ injec- tion （n=33） or conventional therapy alone （n=30）. Between groups differences in corticosteroid treat- ment, immune regulation therapy, hemofiltration, infusion volume, transfusion volume and antibiotic period were measured, as were intensive care unit（ICU）-free time, ventilation time, 28-day mortality rate and incidence of ventilation-associated pneu- monia （VAP）. Serum concentrations of procalcito- nin （PCT）, tumor necrosis factor-a （TNF-a）, interleu- kin （IL）-6, and 11_-10, white blood cell （WBC） counts and percentages of human leukocyte antigen DR/ CD14＋ （HLA-DR/CD14＋） peripheral blood mononu- clear cells were compared. Markers of ventilation were determined by blood gas analysis and ventila- tor parameters. RESULTS： WBC counts and serum concentrations of PCT, TNF-a, 11.-6 and IL-10 were reduced signifi- cantly more quickly, and CD14＋ percentage was in- creased significantly earlier, in the XBJ group than in the control group （P〈0.05 each）. The level of ven- tilation and oxygenation index were ameliorated earlier in the XBJ than in the control group （P〈 0.05）. XBJ treatment significantly reduced ICU-free time, ventilation time and incidence of VAP （P〈0.05 each）, but had no effect on 28-day mortality rate （P〉0.05）. CONCLUSION： XBJ treatment can shorten ICU-free and ventilation times and reduce the incidence of VAP, improving outcomes in patients with severe PC. XBJ may act by regulating inflammation and im- munity, alleviating systemic inflammatory response syndrome induced by trauma.