Effect Of Xuebijing Injection Research Articles

Effect of Xuebijing injection on myocardium during cardiopulmonary bypass: A prospective, randomized, double blind trial.

BACKGROUNDCardiopulmonary bypass (CPB) is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery. However, perioperative cardiac injury related to CPB remains a severe complication in these patients. Cardiac protection is important for patients undergoing CPB. AIMTo evaluate the potential cardioprotective efficacy of the Chinese medicine preparation Xuebijing injection (XBJ) in patients undergoing CPB.METHODSSixty patients undergoing cardiac surgery with CPB were randomly allocated to the XBJ and control groups (saline). XBJ was administered intravenously three times: 12 h prior to surgery, at the beginning of the surgery, and 12 h after the second injection. Cardiac function was evaluated by echocardiography 48 h after surgery. Circulating inflammation- and oxidative-stress-related markers were measured. Clinical outcomes related to intensive care unit (ICU) stay were recorded.RESULTSCompared to control treatment, XBJ was associated with improved PaO2/FiO2 and cardiac systolic function, but reduced troponin I and creatine kinase fraction after surgery (all P < 0.05). The circulating concentrations of tumor necrosis factor-α, interleukin (IL)-1β and IL-8 in the XBJ group were significantly lower than those in the control group (all P < 0.05), whereas the circulating concentration of IL-10 was significantly higher in the XBJ group (P < 0.05). In addition, the lengths of ICU stay and hospitalization after surgery tended to be shorter in the XBJ group than in the control group, although the differences were not significant. CONCLUSIONPerioperative administration of XBJ was associated with attenuated cardiac injury during CPB, likely via anti-inflammatory and antioxidative mechanisms.

Paeoniflorin and Hydroxysafflor Yellow A in Xuebijing Injection Attenuate Sepsis-Induced Cardiac Dysfunction and Inhibit Proinflammatory Cytokine Production.

Sepsis-induced myocardial dysfunction is a major contributor to the poor outcomes of septic shock. As an add-on with conventional sepsis management for over 15 years, the effect of Xuebijing injection (XBJ) on the sepsis-induced myocardial dysfunction was not well understood. The material basis of Xuebijing injection (XBJ) in managing infections and infection-related complications remains to be defined. A murine cecal ligation and puncture (CLP) model and cardiomyocytes in vitro culture were adopted to study the influence of XBJ on infection-induced cardiac dysfunction. XBJ significantly improved the survival of septic-mice and rescued cardiac dysfunction in vivo. RNA-seq revealed XBJ attenuated the expression of proinflammatory cytokines and related signalings in the heart which was further confirmed on the mRNA and protein levels. Xuebijing also protected cardiomyocytes from LPS-induced mitochondrial calcium ion overload and reduced the LPS-induced ROS production in cardiomyocytes. The therapeutic effect of XBJ was mediated by the combination of paeoniflorin and hydroxysafflor yellow A (HSYA) (C0127-2). C0127-2 improved the survival of septic mice, protected their cardiac function and cardiomyocytes while balancing gene expression in cytokine-storm-related signalings, such as TNF-α and NF-κB. In summary, Paeoniflorin and HSYA are key active compounds in XBJ for managing sepsis, protecting cardiac function, and controlling inflammation in the cardiac tissue partially by limiting the production of IL-6, IL-1β, and CXCL2.

Effect of Xuebijing injection on inflammatory markers and disease outcome of coronavirus disease 2019

To observe the influence of Xuebijing injection on the inflammatory markers and prognosis of coronavirus disease 2019 (COVID-19) patients. Sixty severe COVID-19 patients admitted to Changsha Public Health Treatment Center (North Hospital of the First Hospital of Changsha City) from January to March in 2020 were randomly divided into routine treatment group, Xuebijing 50 mL group and Xuebijing 100 mL group, with 20 cases in each group. The routine treatment group was treated according to the National Health Commission's guide for COVID-19. On the basis of conventional treatment, Xuebijing injection was injected by 50 mL twice a day for 7 days in Xuebijing 50 mL group, while by 100 mL twice a day for 7 days in Xuebijing 100 mL group. The blood routine test, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acute physiology and chronic health evaluation II (APACHE II) score, 2019 novel coronavirus (2019-nCoV) nucleic acid test and disease classification of three groups before and 8 days after treatment were observed. (1) After treatment, the white blood cell count (WBC) and lymphocyte count (LYM) of three groups increased, meanwhile CRP and ESR decreased. Compared with routine treatment group, the WBC count of Xuebijing 100 mL group after treatment significantly increased (×109/L: 7.12±0.55 vs. 5.67±0.51, P < 0.05), and the levels of CRP and ESR in Xuebijing 50 mL and 100 mL groups significantly decreased [CRP (mg/L): 32.3±4.6, 28.0±6.2 vs. 37.3±5.9; ESR (mm/1 h): 45.9±5.7, 40.5±7.4 vs. 55.3±6.6, all P < 0.05]. Compared with Xuebijing 50 mL group, the increase of WBC, and the decrease of CRP and ESR were more significant in Xuebijing 100 mL group [WBC (×109/L): 7.12±0.55 vs. 5.82±0.49, CRP (mg/L): 28.0±6.2 vs. 32.3±4.6, ESR (mm/1 h): 40.5±7.4 vs. 45.9±5.7, all P < 0.05]. (2) After treatment, the APACHE II score of three groups decreased. In Xuebijing 100 mL group, the APACHE II score after treatment was significantly lower than those in routine treatment and Xuebijing 50 mL groups (12.3±1.5 vs. 16.5±1.6, 15.9±1.4, both P < 0.05). After treatment, the 2019-nCoV nucleic acid test in three groups partly turned negative, with 9 cases in routine treatment group, 8 cases in Xuebijing 50 mL group and 9 cases in Xuebijing 100 mL group, without significant difference (P > 0.05). The conditions of patients in the three groups were improved after treatment, among them, 8 cases in the routine treatment group were transformed into common type, 1 case into critical type; 9 cases and 12 cases of Xuebijing 50 mL group and 100 mL group were transformed into common type respectively. Xuebijing 100 mL group was improved more obviously than Xuebijing 50 mL group and routine treatment group (both P < 0.05). The Xuebijing injection can effectively improve the inflammatory markers and prognosis of severe COVID-19 patients.

Amelioration of paraquat-induced pulmonary fibrosis in mice by regulating miR-140-5p expression with the fibrogenic inhibitor Xuebijing.

Intravenous Xuebijing (XBJ) therapy suppresses paraquat (PQ)-induced pulmonary fibrosis. However, the mechanism underlying this suppression remains unknown. This work aimed to analyze the miR-140-5p-induced effects of XBJ injection on PQ-induced pulmonary fibrosis in mice. The mice were arbitrarily assigned to four groups. The model group was administered with PQ only. The PQ treatment group was administered with PQ and XBJ. The control group was administered with saline only. The control treatment group was administered with XBJ only. The miR-140-5p and miR-140-5p knockout animal models were overexpressed. The gene expression levels of miR-140-5p, transglutaminase-2 (TG2), β-catenin, Wnt-1, connective tissue growth factor (CTGF), mothers against decapentaplegic homolog (Smad), and transforming growth factor-β1 (TGF-β1) in the lungs were assayed with quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot analysis. The levels of TGF-β1, CTGF, and matrix metalloproteinase-9 (MMP-9) in the bronchoalveolar lavage fluid were assessed by enzyme-linked immunosorbent assay (ELISA). Hydroxyproline (Hyp) levels and pulmonary fibrosis were also scored. After 14 days of PQ induction of pulmonary fibrosis, AdCMV-miR-140-5p, and XBJ upregulated miR-140-5p expression; blocked the expressions of TG2, Wnt-1, and β-catenin; and decreased p-Smad2, p-Smad3, CTGF, MMP-9, and TGF-β1 expressions. In addition, Hyp and pulmonary fibrosis scores in XBJ-treated mice decreased. Histological results confirmed that PQ-induced pulmonary fibrosis in XBJ-treated lungs was attenuated. TG2 expression and the Wnt-1/β-catenin signaling pathway were suppressed by the elevated levels of miR-140-5p expression. This inhibition was pivotal in the protective effect of XBJ against PQ-induced pulmonary fibrosis. Thus, XBJ efficiently alleviated PQ-induced pulmonary fibrosis in mice.

Effect of Xuebijing injection on hematopoietic homeostasis of LPS induced sepsis in mice

Effect of Xuebijing injection on hematopoietic homeostasis of LPS induced sepsis in mice

Metabolomics approach in lung tissue of septic rats and the interventional effects of Xuebijing injection using UHPLC-Q-Orbitrap-HRMS.

Sepsis is the dysregulated host response to an infection which leads to life-threatening organ dysfunction. Metabolomic profiling in bio-fluid or tissue is vital for elucidating the pathogenesis of sepsis and evaluating therapeutic effects of medication. In this study, an untargeted metabolomics approach was applied to study the metabolic changes in lung tissue of septic rats induced by cecal ligation and puncture (CLP) and investigate the treatment effects of Xubijing injection (XBJ). Metabolomics analyses were performed on ultra-high performance liquid chromatography-Q Exactive hybrid quadrupole-orbitrap high-resolution accurate mass spectrometry (UHPLC-Q-Orbitrap-HRMS) together with multivariate statistical analysis. A total of 26 differential metabolites between CLP and sham-operated group were identified. The altered metabolic pathways included energy metabolism, amino metabolism, lipid metabolism, fatty acid metabolism and hormone metabolism. Among the 26-varied metabolites, 15 were significantly regulated after XBJ treatment. The metabolic pathway network of sepsis was drawn to interpret the pathological feature of lung damage caused by sepsis and the underlying regulating mechanism of XBJ on the molecular levels. Our findings display that LC-MS-based metabolomics is a useful tool for uncovering the underlying molecular mechanism of sepsis, and XBJ may exert therapeutic effect by regulating multiple metabolic pathways.

Xuebijing injection induces anti-inflammatory-like effects and downregulates the expression of TLR4 and NF-κB in lung injury caused by dichlorvos poisoning

BackgroundThe mechanism in lung injury caused by acute organophosphate pesticide poisoning (AOPP) and an effective treatment remains unclear. We aim to clarify how the inflammatory lung injury caused by AOPP might be modulated by Xuebijing (XBJ) injection. MethodsAOPP-induced lung injury model was induced by dichlorvos (DDVP) subcutaneous administration in rats and XBJ injection was administered by intraperitoneal injection after DDVP challenge. The effects of XBJ injection were assessed by lung histopathological analysis and lung injury scores, lung wet-to-dry weight ratios (WDR) and oxygenation, differential immune cell count in bronchoalveolar lavage fluid (BALF), IL-6 and TNF-α levels in blood, the levels of TLR4 and NF-κB proteins in lung tissue and blood acetylcholinesterase (AChE) activity. ResultsDDVP administration resulted in damage of lung histopathology and lower PaO2/FiO2 ratios (P < 0.05), which were notably attenuated by XBJ injection (P < 0.05). Total cell, macrophage, and neutrophils count in BALF and TNF-α and IL-6 levels in blood were significantly increased after DDVP exposure (P < 0.05), which were notably ameliorated by XBJ injection (P < 0.05). TLR4 and NF-κB protein in lung tissue expression after DDVP challenge were markedly increased (P < 0.05), and they were substantially downregulated by XBJ injection (P < 0.05). In addition, blood AChE activity was significantly decreased by DDVP administration (P < 0.05), however, there was no significant improvement after XBJ injection. ConclusionXBJ injection prevents DDVP poisoning induced lung injury by attenuating the inflammatory response. The protective effect appears to be mediated through downregulation of the TLR4 and NF-κB expression.

The effects of Xuebijing injection on apoptosis and expression of regulatory factors TNF-α、NF-κB and Caspase-3 expression in the lung tissues of acute paraquat-induced rats

Objective: To explore the mechanism of Xuebijing injection in the treatment of acute paraquat poisoning by means of studying the expression of TNF-alpha, NF-kappa B, Caspase-3 and the changes of cell apoptosis rate detected by TUNEL in the lung tissue of acute paraquat-induced rats. Methods: On the base of random number table, 126 Wister rats weighing 220 g to 270 g were divided into 3 groups: (1) Control group: 42 rats, (2) Poisoned group: 42 rats, (3) Treatment group: 42 rats. On 1(st)、3(rd)、7(th)、14(th)、21(st)、28(th)、and 35(th) day, six rats from each group were anaesthetized by intraperitoneal injection of chloral hydrate. To cut the chest and take the lung tissue samples. The expression levels of Tumor Necrosis Factor-alpha, Nuclear Factor-kappa B and Caspase-3 protein in lung tissue were detected by immunohistochemical staining, as well as apoptotic cell rate was detected by TUNEL staining. Results: The expression levels of Tumor Necrosis Factor-alpha, Nuclear Factor-kappa B, Caspase-3 protein and TUNEL staining in the lung tissue of the poisoned group was significantly higher than that of the control group (P<0.05) . Compared with the poisoned group, the expression of TNF-alpha, NF-kappa B, Caspase-3 and TUNEL in treatment group decreased significantly (P<0.05) , but they were still higher than those of the control group, and the difference was statistically significant compared with the control group (P<0.05) . Conclusion: Apoptosis and TNF-alpha, NF-kappa B and Caspase-3 play an important role in lung injury of paraquat-induced rats. Xuebijing injection can inhibit the expression of TNF-alpha, NF-kappa B, Caspase-3 in lung tissue, reduce the apoptosis rate and alleviate the damage of lung tissue in paraquat-poisoning rats.

Clinical study of therapeutic effect of Xuebijing injection on the treatment of vascular endothelial cell injury, microcirculation disorder and organ diysfunction in patients with sepsis

Objective To observe the clinical therapeutic effect of Xuebijing injection on vascular endothelial cell (VEC) injury, microcirculation disorder and organ dysfunction in patients with sepsis. Methods Seventy-three patients with sepsis were randomly divided into two groups: Xuebijing injection-treated group (40 cases) and control group (33 cases). Routine medicine therapy was applied in both groups.Additionally, the Xuebijing injection-treated group was treated with Xuebijing injection 100 ml and saline 100 ml by intravenous drip every 12 hours for consecutive 5 days.Vascular endothelial injury index, including soluble thrombomodulin(sTM), vascular endothelial growth factor 2 (VEGF-2), endothelial specific molecule 1 (ESM-1), microcirculation index of arterial blood lactic acid (Lac), central venous oxygen saturation (ScvO2), total microvessel density (TVD), the perfusion vascular density (PVD), proportion of perfused vessels (PPV) and microvessel flow index (MFI) of the two groups before and after therapy were observed and the sequential organ failure score (SOFA) was recorded before and after treatment. Results Senventy-three patients with sepsis had different degrees of increase in vascular endothelial damage markers, lactate and sequential organ failure scores in arterial blood, while the central venous blood oxygen saturation (ScvO2), the total vascular density of the sublingual microvasculature (TVD), perfused vessel density (PVD), proportion of perfused vessels (PPV) and microcirculatory flow index (MFI) decreased before treatment.After 5-day treatment, the above indicators of all patients were improved, the indexes in the Xuebijing injection group decreased significantly, compared with the control group , sTM ( (16.91±4.55) μg/L, (19.51±4.09) μg/L, t=-6.021, P<0.05), VEGF-2 (50.8(17.8, 127.7) ng/L vs.74.9(22.7, 155.1) ng/L, t=4.227, P<0.05), ESM-1 ( (10.20±2.43) μg/L vs.(14.80±3.52) μg/L, t=-4.113, P<0.05), Lac( (2.1±0.7) mmol/L vs.(3.7±1.1) mmol/L, t=2.366, P<0.05) and SOFA ( (5.9±2.1) vs.(8.7±2.6), t=-7.990, P<0.05). ScvO2 ( (0.771±0.153) % vs.(0.641±0.113) %, t=5.061, P<0.05), PVD ( (16.8±6.1) mm/mm2 vs.(12.1±5.1) mm/mm2, t=4.002, P<0.05), PPV ( (66.2±21.3) % vs.(50.4±19.3) %, t=-2.550, P<0.05) and MFI (6.2±2.4) vs.(3.8±2.2), t=-5.001, P<0.05) were significantly higher than those in the control group in the same period.sTM and PPV had a significant negative correlation (r=-0.755, P=0.000), PVD, PPV, ESM-1 and MFI were negatively correlated (r=-0.665, P=0.000; r=-0.600, P=0.000; r=-0.469, P=0.000), PPV, MFI and SOFA were negatively correlated (r=-0.798, P=0.000; r=-0.995, P=0.000); sTM, ESM-1 and SOFA were significantly positively correlated (r=0.883, P=0.000; r=0.881, P=0.000). Conclusion Vascular endothelial cell dysfunction probably plays an important role in the pathophysiology of sepsis and Xuebijing injection has therapeutic effect on sepsis by protecting vascular endothelial cell function. Key words: Sepsis; Xuebijing injection; Vascular endothelial cell; Microcirculation disorder

Effect of Xuebijing injection on procalcitonin in severe sepsis patients

Objective To investigate the effect of Xuebijing injection on the level of serum procalcitonin(PCT) in patients with severe sepsis and septic shock, and its effect on prognosis. Methods 64 patients with severe sepsis and septic shock were randomly divided into control group and treatment group by using a random number table, 32 cases in each group.All patients in the two groups were given cluster treatment, the patients in the treatment group received Xuebijing injection additionally.At the beginning of treatment and 3, 7 and 10-day after treatment, laboratory indicator of PCT was tested in venous blood, and Acute Physiology and Chronic Health Evaluation II(APACHE II) was recorded.Patients' stay time in ICU, total hospital time, mortality in 28 days and mortality in ICU were recorded. Results At 3, 7, 10-day after treatment, the levels of PCT of the two groups were (3.24±1.23)ng/mL vs.(3.96±1.35)ng/mL, (1.37±0.68)ng/mL vs.(1.84±0.71)ng/mL, (0.69±0.30)ng/mL vs.(0.91±0.42)ng/mL, and APACHE II scores were (16.21±7.03)points vs.(19.89±7.06)points, (14.02±5.71)points vs.(17.42±6.23)points, (11.06±4.02)points vs.(13.19±4.17)points, which of the treatment group were better than the control group, the differences were statistically significant(t=2.230, 2.704, 2.411, 2.089, 2.276, 2.080, all P<0.05). The stay time in ICU was (16.74±4.03)d vs.(19.25±4.26)d, and total hospital time was (25.39±4.58)d vs.(28.17±5.01)d, which in the treatment group were shorter than the control group, the differences were statistically significant(t=2.421, 2.327, all P<0.05). Conclusion Xuebijing injection can effectively reduce the levels of PCT in patients with severe sepsis and septic shock, and improve the condition in a certain degree. Key words: Sepsis; Xuebijing injection; Procalcitonin

Effects of xuebijing injection on cardiac function and structure in rats with myocardial hypoxia/reoxygenation injury

To investigate the protective effects of xuebijing (XBJ, Traditional Chinese Medicine Complex) injection on cardiac function in rats with myocardial hypoxia/reoxygenation(H/R) injury. The isolated langendorff perfused rat heart model was established. One hundred and thirty SD rats were randomly divided into sham group, hypoxia/reoxygenation group, low dose XBJ(XBJL) group, middle dose XBJ(XBJM) group and high dose XBJ(XBJH) group. All groups except sham group were divided into three subgroups according to reoxygenation time(0.5 h,1 h, 2 h) (n=10). In sham group, left ventricular development pressure(LVDP), maximal rates of increase/decrease of the left ventricular pressure(±dp/dtmax), left ventricular pressure (LVP), and heart rates (HR) were recorded after 20 minutes balance perfusion. The creatine kinase-MB (CK-MB) in myocardium was detected by ELISA. In other groups, after 20 minutes balance perfusion, we perfused ThomasⅡto stop the hearts from beating for 30 minutes, then reperfused the K-H until hearts recover beating. The microstructure of myocardium was observed under light microscopy. LVDP, ±dp/dtmax, LVP and HR were continuously recorded in other four groups and the concentrations of CK-MB in myocardium were measured by ELISA at different time points after reoxygenation. Microstructure of myocardium in each group were observed under light microscopy. LVDP, ±dp/dtmax, LVP and HR of other groups were significantly lower than those of sham group(P<0.05). The levels of CK-MB were higher than that of sham group(P<0.05). LVDP, ±dp/dtmax, LVP and HR of XBJL, XBJM and XBJH groups were higher than those of I/R group at corresponding time points after reoxygenation(P<0.05). The levels of CK-MB were lower than that of I/R group(P<0.05) and the cardiac function was improved. The middle dose of XBJ had the best protective effect. Xuebijing injection can effectively improve cardiac function and structure in rats with myocardial hypoxia/reoxygenation injury, and middle dose of XBJ is the best.

The effect of Xuebijing injection on vascular endothelial function and inflammatory factor in the patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To observe the effect of Xuebijing injection on vascular endothelial function and inflammatory factor in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 100 patients with AECOPD were randomly divided into the study and control groups, 50 patients in each group. The control group were given the conventional therapy. The study group were given the Xuebijing injection on the basis of the control group. Both The changes of lung function, vascular endothelial function and inflammatory factor were observed. Results The expression of FVC (3.23 ± 0.83 L vs. 2.79 ± 0.71 L, t=1.786), PEF (5.36 ± 0.51 L/s vs. 4.79 ± 0.46 L/s, t=1.904), FEV1/FVC (59.21 ± 4.38 vs. 54.94 ± 4.29, t=1.882), NO (3.84 ± 0.81 ng/ml vs. 2.97 ± 0.62 ng/ml, t=1.869) increased significantly in the study group than those in the control group after treatenmt (P<0.05). The VEGF (0.14 ± 0.04 ng/ml vs. 0.17 ± 0.05 ng/ml, t=2.097), TNF- (0.11 ± 0.03 ng/ml vs. 0.14 ± 0.02 ng/ml, t=1.903), IL-13 (107.27 ± 44.37 ng/ml vs. 136.54 ± 48.32 ng/ml, t=2.005) in the study group decreased significantly than those in the control group (P<0.05). Conclusions Xuebijing injection could significantly decrease inflammatory factor,and obviously improve vascular endothelial function and lung function, the clinical curative effect is distinct. Key words: Pulmonary disease, chronic obstructive; Xuebijing injection; Vascular endothelial function; Inflammatory factor

Effects of Xuebijing injection on microcirculation in septic shock

BackgroundThis study was conducted to investigate whether Xuebijing injection can rectify the dysfunction of microcirculation in septic shock and assessed the microcirculatory parameters directly via orthogonal polarization spectral and software AVA 3.0. Material and methodsAnesthetized and mechanically ventilated beagle dogs were modeled for septic shock via lipopolysaccharide (LPS) intravenous injection. They were divided randomly into four groups, control group accepted operation only for jejunostomy and cystostomy; LPS group accepted operation and LPS intravenous injection; saline group accepted operation, LPS intravenous injection, and saline resuscitation; XBJ group accepted operation, LPS intravenous injection, saline resuscitation, and Xuebijing injection infusion. The MAP was recorded via right femoral artery catheterization, at the same time, the blood gas analysis was taken via that pathway at the set time points. ScvO2 was obtained via right jugular vein catheterization at the related time points. Microcirculatory parameters were recorded by orthogonal polarization spectral via the jejunum stoma, and the microcirculation image was analyzed via the software AVA 3.0 later. ResultsXuebijing injection improved microcirculation of the jejunum villus in canine model of septic shock induced by endotoxin, especially for the proportion of perfused vessels. ConclusionsBased on the adequate fluid resuscitation, Xuebijing injection plays a helpful role of improving microcirculation in septic shock.

The effect of Xuebijing injection for severe acute pancreatitis: a Meta analysis

To assess the efficacy and safety of Xuebijing injection for the treatment of severe acute pancreatitis ( SAP ). An extensive search of related literatures from the Cochrane Library, EMBASE, China Biology Medicine ( CBM ), CNKI, VIP and Wanfang data up to March 2014 was performed. Randomized controlled trials ( RCTs ) regarding Xuebijing injection for the treatment of SAP were collected regardless of languages. Jadad scale was taken for quality evaluation of the included studies by two researchers. The patients in control group were given conventional treatment, and those of the Xuebijing group were given Xuebijing injection on the top of conventional treatment. The Cochrane Collaboration RevMan 5.2 software was used for data analysis regarding the effect of Xuebijing injection on the mortality, incidence of complication, effective rate, the length of stay in hospital, and the safety of the drug in patients with SAP. A total of 15 published reports meeting the inclusion criteria were enrolled. The methodological quality of the trials was low. Meta analysis showed that the mortality in Xuebijing group was significantly lower [ odds ratio ( OR ) = 0.37, 95% confidence interval ( 95%CI ) = 0.17 - 0.77, P = 0.008 ], and the incidence of complication was also significantly decreased ( OR = 0.26, 95%CI = 0.14 - 0.45, P < 0.000 01 ) as compared with those of control group. The effective rate in Xuebijing group was significantly higher than that of the control group [ relative risk ( RR ) = 0.85, 95%CI = 0.80-0.91, P < 0.000 01 ]. The length of stay in hospital in Xuebijing group was significantly shorter than that of the control group [ mean difference ( MD ) = -5.28, 95%CI = -6.69 to -3.86, P < 0.000 01 ]. Adverse reactions of Xuebijing injection were reported in 2 studies. The adverse reaction in one study was headache and nausea, which were relieved by adjusting the speed of intravenous infusion, and mild rash was reported in another case, and it disappeared after the withdrawal of Xuebijing. The currently available evidence shows that Xuebijing injection may have some therapeutic effect on SAP. Because of the low methodological quality of the included trials, multi-center and high-quality RCTs with large sample sizes are needed to provide stronger evidence.

Effect of Xuebijing injection (血必净注射液) on systemic lupus erythematosus in mice

To observe the effects of Xuebijing injection on dendritic cells (DCs) and T lymphocytes, and the potential mechanisms of its therapeutic effect on systemic lupus erythematosus (SLE). A widely used mouse model, SLE-prone BLLF1 mice aged 8-10 weeks, was employed. Mice were randomly divided into 4 groups: a normal group, a model group and two treatment groups treated with Xuebijing Injection with a dose of 6.4 mL/kg via intraperitoneal administration for SLE-prone BLLF1 mice aged 8 weeks (treatment A group) and 10 weeks (treatment B group). Renal tissue sections were stained with Masson's trichrome and periodic acid-silver methenamine. Histopathological changes in the kidney were evaluated by a light microscopy. The capacity of the DCs isolated from the spleen to stimulate the T cell proliferation in response to concanavalin A (Con A) was determined. Compared with the model group, levels of anti-dsDNA antibodies in the two treatment groups decreased remarkablly (P<0.01, P<0.05), and levels of serum creatinine and blood urea nitrogen increased (P<0.01, P<0.05). Pathological changes were found in the kidney in the model group. Histopathological abnormalities were alleviated in the two treatment groups. Treatment with Xuebijing injection also significantly upregulated the expression of CD80, CD86 and major histocompatibility class II by DCs compared with the model group (P<0.05). When splenic T lymphocytes from BLLF1 mice were co-cultured with DCs at ratios of 1:100, 1:150 and 1:200 for 3 and 5 days, the proliferation of T lymphocytes was suppressed compared with the normal group (P<0.05), but this was restored by Xuebijing Injection under the same conditions. In the model group, levels of tumor necrosis factor (TNF)-α in supernatants were significantly elevated compared with the normal group (P<0.01), interleukin-2 levels decreased (P<0.05), while these changes were significantly alleviated in the Xuebijing treatment groups. Xuebijing Injection alleviated renal injury in SLE-prone BLLF-1 mice. The mechanism might be through influencing T cell polarization mediated by DCs, and Xuebijing Injection might be a potential drug that suppresses immune dysfunction in patients with SLE.

Observation on the the effect of Xuebijing injection in the treatment of patients with severe pneumonia

Objective To investigate the effects of Xuebijing injection on T-lymphocyte subgroups and clinical efficacy in treatment of patients with severe pneumonia.Methods 60 patients with severe pneumonia were selected into the study.The patients were randomly divided into Xuebijing group (n =30) and control group (n =30).Patients in the control group were given routine therapy.The Xuebijing group received the treatment of routine therapy combined with Xuebijing injection.The changes of T lymphocyte subgroups and clinical efficacy were compared between the two groups.Results The levels of CD3,CD4,CD4/CD8 after treatment in Xuebijing group and control group were significantly higher than those of before treatment (t =4.95,4.89,4.96,3.13,3.11,3.09,all P ＜ 0.05),those in the Xuebijing group were significantly higher than control group (t =3.89,3.56,3.78,all P ＜ 0.05).The total effective rate in the Xuebijing group was 93.3％,which was significantly higher than 76.6％ in the control group (x2 =4.55,P ＜ 0.05).Conclusion Xuebijing injection combined with routine western medicine is quite effective in treatment severe pneumonia.Xuebijing can improve the immune function of patients. Key words: Pneumonia; Medicine, Chinese traditional; Lymphocytes subsets; Treatment outcome

Observation on the effect of Xuebijing injection in treatment of acute paraquat poisoning

Objective To observe the effect of Xuebijing injection on organs injury in patients with acute paraquat poisoning.Methods Thirty patients with paraquat poisoning were randomly divided into two groups.The improvement of liver and kidney function,SaO2,rate of death were observed and compared between the two groups.Results The ABG,SaO2,GGT and Crea were all improved significantly in the treatment group than control group.At last,two patients gave up their treatment,nine cases were cured,four cases died in treatment group.One patient gave up treatment,four cases were cured,ten cases died in control group.The total effective rate of the treatment group and control group was 60.0％,26.7％,the difference was significant(x2 =4.75,P＜0.05).Conclusion Xuebijing injection has very good clinical effect in multiple organ failure of paraquat poisoning,it is worthy of clinic application. Key words: Xuebijing; Paraquat poisoning; Curative effect

Effect of Xuebijing injection treatment on acute respiratory distress syndrome: a multicenter prospective randomized control clinical trial

To assess the therapeutic effect of Xuebijing injection on adult patients with acute respiratory distress syndrome (ARDS). A multicenter prospective randomized control study was conducted at 10 intensive care units in Jiangsu province. A total of 172 early ARDS patients were randomly divided into Xuebijing treatment and control groups. All patients received routine therapy of ARDS while additional Xuebijing injection 100 ml was administered in the treatment group intravenously for 7 days. Lung injury score, acute physiology and chronic health evaluation II (APACHE II) score, multiple organ dysfunction score (MODS) and PaO2/FiO2 of the patients was recorded before and after treatment. Mortality at 28 days and the duration of mechanical ventilation were compared between two groups. Ninety-one patients were assigned to receive Xuebijing injection and 81 patients as control; Mortality at Days 28 and 90, the duration of mechanical ventilation and ventilation free days showed no difference between two groups (P > 0.05). PaO2/FiO2 improved after randomization versus pre-treatment in all patients. There was no significant difference between two groups. Murray scores were not significantly different between two groups. In a subgroup analysis of patients with pulmonary infection, pulmonary contusion and extra-pulmonary cause, two groups had no difference in mortality at Day 28, mortality at Day 90, the duration of mechanical ventilation, ventilation free days and days of ICU stay (P > 0.05). The treatment of Xuebijing injection early in course of ARDS does not improve the mortality of ARDS patients. But it may improve lung function and oxygenation. Further studies are warranted.

Effect of Xuebijing injection on rabbits ischemia/reperfusion injury induced by femoral arterial disease

To investigate the changes in serum malondialdehyde (MDA), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), aspartate aminotransferase (AST) and creatinine (Cr) after the reproduction of ischemia/reperfusion (I/R) injury model, and the protective effects of liver and kidney with Xuebijing injection on acute I/R injury in rabbits. Sixty rabbits were divided into six groups with a random number: A, normal group; B, sham operated group; C, model group, and D, E, F groups (Xuebijing low, middle, high dosage treatment groups). I/R injury model was reproduced (after a 4-hour ischemia, the femoral vessels were reperfusion). Physiological saline (2 ml/kg) or 0.33, 0.66 and 1.32 g/kg Xuebijing injection were given at 0, 12, 36, 60 hours after operation via ear vein. MDA, IL-1β, TNF-α, AST and Cr were determined at 6, 12, 24 and 72 hours after reperfusion in each group. MDA, IL-1β, TNF-α at different time points, AST and Cr at 72 hours after reperfusion in C group were significantly higher than those in A group and B group. Compared with the C group, the above indexes were gradually decreased with does-dependence, the values of MDA (μmol/L), IL-1β (ng/L) and TNF-α (μg/L) in serum of group F at 6, 12, 24 and 72 hours after reperfusion were significantly lower (MDA: 9.74 ± 3.71 vs. 12.35 ± 4.64, 11.26 ± 4.14 vs. 12.82 ± 3.85, 9.72 ± 2.25 vs. 13.30 ± 2.83, 9.12 ± 2.72 vs. 13.10 ± 2.72; IL-1β: 83.49 ± 12.79 vs. 100.09 ± 17.53, 85.10 ± 11.75 vs. 102.64 ± 19.64, 75.97 ± 11.29 vs. 99.24 ± 14.62, 81.96 ± 14.81 vs. 99.59 ± 12.05; TNF-α: 8.95 ± 1.13 vs. 9.94 ± 1.29, 8.79 ± 1.80 vs. 9.56 ± 0.89, 8.27 ± 1.83 vs. 9.51 ± 1.32, 7.23 ± 1.39 vs. 9.23 ± 1.05, P < 0.05 or P < 0.01). The values of AST(U/L) and Cr (μmol/L) in serum of groups D, E and F at 24 hours and 72 hours after reperfusion were significantly lower (AST 24 hours: 24.00 ± 1.27, 23.80 ± 1.11, 22.90 ± 1.65 vs. 39.50 ± 1.73, 72 hours: 32.15 ± 1.95, 32.90 ± 1.77, 32.25 ± 2.25 vs. 52.86 ± 2.43; Cr 24 hours: 273.78 ± 17.04, 267.07 ± 19.59, 265.25 ± 15.59 vs. 347.60 ± 18.83, 72 hours: 437.38 ± 18.48, 343.77 ± 16.79, 351.48 ± 20.22 vs. 437.50 ± 19.86, all P < 0.01). It is demonstrated that I/R injury could dramatically lead to systemic inflammatory response and oxygen free radical injury. Xuebijing injection in higher dosage can reduce the systemic inflammatory response significantly, and also MDA level in serum. Xuebijing injection in low dosage, middle dosage and high dosage can produce protective effects against the damages to liver and kidney function.

Effect of Xuebijing injection on T helper 17 and CD4+ CD25+ regulatory T cells in patients with sepsis

To study the level and significance of T helper 17 (Th17) and CD4(+) CD25(+) regulatory T cells (Treg) in peripheral blood of patients with sepsis and to evaluate the effects of Xuebijing injection on them. ¹ Sixty-four patients with sepsis in intensive care unit (ICU) of Anhui Provincial Hospital were divided into three groups: sepsis group (n=26), severe sepsis group (n=21), and septic shock group (n=17). Eighteen healthy individuals served as controls. The comparison in the expression of Th17 and CD4(+)CD25(+) Treg within groups and the correlation between their levels and the severity of sepsis was made. ² Sixty-four patients were also randomly divided into two groups: routine group (n=25, received routine bundle treatment) and Xuebijing treatment group (n=39, received bundle treatment + Xuebijing treatment). Patients in Xuebijing treated group were given 50 ml Xuebijing injection two times per day in addition to routine bundle treatment. Seven days constituted one course of treatment. The expressions of Th17 and CD4(+) CD25(+) Treg of 64 patients on the 1 day and 7 days after treatment were detected by flow cytometry. The effects of Xuebijing injection on the patients were evaluated. ¹ The expression rate of Th17 and CD4(+)CD25(+) Treg was (0.84 ± 0.29)% and (0.43 ± 0.20)% respectively in control group, and they were lower than that of patients with sepsis (P<0.05). The expression rate of Th17 was higher in severe sepsis group [(3.18 ± 0.84)%] than that of other two groups (P <0.05). Moreover , The expression rate of CD4(+)CD25(+) Treg was highest [(3.28 ± 0.76)%] in septic shock group (P<0.05) , and it was positive correlated with acute physiology and chronic health evaluation II (APACHEII) score and blood lactate (r(1)=0.519, r(2)=0.451, both P =0.01) in all 64 patients. ² Compared with routine group, our study indicated that Xuebijing injection could reduce the abnormal expression of Th17 [(1.72 ± 0.69)% vs. (2.35 ± 0.81)%,P<0.05] and CD4(+)CD25(+) Treg [(1.78 ± 1.00)% vs. (2.30 ± 0.85)%,P<0.05] and decrease length of stay in ICU [(4.7 ± 2.6) days vs. (7.5 ± 4.3) days,P=0.002]. It also lowered 28-day mortality of patients with sepsis, but the difference between two groups was not significant (20.5% vs. 28.0%,P>0.05). The expression of Th17 and CD4(+)CD25(+) Treg was increased in sepsis patients and was positively correlated with severity of sepsis, suggesting that they may play an important role in pathogenesis of sepsis. Xuebijing injection could decrease the abnormal expression of Th17 and CD4(+) CD25(+) Treg and tend to decrease the fatality rate of sepsis.