Effect Of Shenfu Injection Research Articles

Effect of shenfu injection in patients with septic shock: A systemic review and meta-analysis for randomized clinical trials

Ethnopharmacological relevanceShenfu injection (SFI) is a well-known Chinese herbal medicine widely used in the treatment of septic shock in China. Aim of the studyTo explore the clinical safety and effectiveness of combined application of Shenfu injection in the treatment of septic shock on the basis of routine western medical treatment. Materials and methodsRandomized controlled trials published before February 28, 2022 in patients with septic shock were searched in the Chinese Biomedical Literature Service System (SinoMed), Embase, PubMed, Cochrane Library, WOS, Scopus. Stata 15.0 and R 4.2.2 were used to meta-analyze sequential organ failure assessment (SOFA) score, case fatality rate, mean arterial pressure (MAP), arterial lactate (Lac). Adverse effects were analyzed by description. ResultsA total of 904 articles were searched and 56 RCTs were included, with a total of 4279 participants. Among them, there were 2148 cases in the SFI group and 2131 cases in the control group. The meta-analysis showed that, comparing with routine western medical therapy, the combined use of SFI could effectively reduce 24 h SOFA (MD = −0.79, 95%CI: (−1.12) - (−0.46)), 72 h SOFA (MD = −1.53, 95%CI: (−1.89) - (−1.17)) and 7 d SOFA (MD = −1.55; 95%CI: (−2.86) - (−0.24)). Besides, combined use of SFI could reduce 14 d case fatality rate (RR = 0.16, 95% CI: 0.07–0.37) and 28 d case fatality rate (RR = 0.82, 95% CI: 0.71–0.95). While SFI group showed almost the same effect in 7 d case fatality rate as control (RR: 0.76; 95% CI: 0.42–1.37; P = 0.37). SFI could increase 6 h MAP (MD = 6.40, 95% CI: 3.43–9.37) and 24 h MAP (MD = 4.79, 95% CI: 1.62–7.95). Additionally, SFI could decrease 6 h Lac (MD = −0.90, 95% CI: (−1.34) - (−0.45)), 24 h Lac (MD = −0.80, 95% CI: (−1.20) - (−0.40)), 48 h Lac (MD = −0.67, 95% CI: (-1.05) - (−0.29)). ConclusionsShenfu injection combined with RWT showed better therapeutic effect than RWT. SFI plus RWT can improve clinical prognosis of patients with septic shock.

Shenfu Injection Protects Brain Injury in Rats with Cardiac Arrest through Nogo/NgR Pathway.

The effect of Shenfu injection on brain injury after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) along with the underlying mechanism of axonal regeneration was explored. CA/CPR model in rats was established for subsequent experiments. A total of 160 rats were randomly divided into sham group, model group, conventional western medicine (CWM) group, Shenfu group, and antagonist group (n = 32 per group). After 3 hours, 24 hours, 3 days, and 7 days of drug administration, the modified Neurological Severity Score tests were performed. The ultrastructure of the brain and hippocampus was observed by electron microscopy. Real-time quantitative polymerase chain reaction (PCR), western blotting, and immunohistochemistry were used to detect Nogo receptor (NgR) expression in the hippocampus and cerebral cortex, and Nogo-NgR expression in CA/CPR model. Neurological deficits in the model group were severe at 3 hours, 24 hours, 3 days, and 7 days after the recovery of natural circulation, whereas the neurological deficits in CWM, antagonist, and Shenfu group were relatively mild. The ultrastructure of neuronal cells in Shenfu group had relatively complete cell membranes and more vesicles than those in the model group. The results of PCR and western blotting showed lower messenger ribonucleic acid and protein expression of NgR in Shenfu group than the model group and CWM group. Immunohistochemical examination indicated a reduction of Nogo-NgR expression in Shenfu group and antagonist group. Our results suggested that Shenfu injection reduced brain injury by attenuating Nogo-NgR signaling pathway and promoting axonal regeneration.

Effect of Shenfu Injection on Differentiation of Bone Marrow Mesenchymal Stem Cells into Pacemaker-Like Cells and Improvement of Pacing Function of Sinoatrial Node.

Sick sinus syndrome (SSS), a complex type of cardiac arrhythmia, is a major health threat to humans. Shenfu injection (SFI), a formula of traditional Chinese medicine (TCM), is effective in improving bradyarrhythmia. However, the underlying mechanism of SFI's therapeutic effect is subject to few systematic investigations. The purpose of the present research is to examine whether SFI can boost the differentiation effectiveness of bone marrow mesenchymal stem cells (BMSCs) into pacemaker-like cells and whether the transplantation of these cells can improve the pacing function of the sinoatrial node (SAN) in a rabbit model of SSS. BMSCs from New Zealand rabbits were extracted, followed by incubation in vitro. The flow cytometry was utilized to identify the expression of CD29, CD44, CD90, and CD105 surface markers. The isolated BMSCs were treated with SFI, and the whole-cell patch-clamp method was performed to detect hyperpolarization-the activated cyclic nucleotide-gated potassium channel 4 (HCN4) channel current activation curve. The SSS rabbit model was established using the formaldehyde wet dressing method, and BMSCs treated with SFI were transplanted into the SAN of the SSS rabbit model. We detected changes in the body-surface electrocardiogram and recorded dynamic heart rate measurements. Furthermore, transplanted SFI-treated BMSCs were subjected to HE staining, TUNEL staining, qPCR, western blotting, immunofluorescence, immunohistochemistry, and enzyme-linked immunosorbent assay to study their characteristics. Our results indicate that the transplantation of SFI-treated BMSCs into the SAN of SSS rabbits improved the pacing function of the SAN. In vitro data showed that SFI induced the proliferation of BMSCs, promoted their differentiation capacity into pacemaker-like cells, and increased the HCN4 expression in BMSCs. In vivo, the transplantation of SFI treated-BMSCs preserved the function of SAN in SSS rabbits, improved the expression of the HCN4 gene and gap junction proteins (Cx43 and Cx45), and significantly upregulated the expression of cAMP in the SAN, compared to the SSS model group. In summary, the present research demonstrated that SFI might enhance the differentiation capacity of BMSCs into pacemaker-like cells, hence offering a novel approach for the development of biological pacemakers. Additionally, we confirmed the effectiveness and safety of pacemaker-like cells differentiated from BMSCs in improving the pacing function of the SAN.

Effect of Shenfu injection on the level of acetylcholine in acute liver injury of young rats with sepsis.

Effect of Shenfu injection on the level of acetylcholine in acute liver injury of young rats with sepsis.

Effects of Shenfu injection on inflammatory factors and immune function in children with Mycoplasma pneumoniae: A protocol for a double-blind, randomized controlled trial.

Background:Mycoplasma pneumoniae (MP) is a common infectious respiratory disease in pediatrics, and macrolide antibiotics are the optimal treatment option. In recent years, there is a significant increase in the resistance of this pathogen to macrolide antibiotics, which makes the clinical treatment of this disease increasingly complex. Shenfu injection (SFI), a herbal extract injection, has advantages of improving immune function, reducing inflammatory reaction, improving curative effect and shortening the course of disease in the treatment of pediatric MP. However, there is a lack of rigorous clinical studies to evaluate the effects of SFI on inflammatory factors and immune function in children with MP.Methods:This study is a prospective, randomized, double-blind, placebo-controlled clinical trial protocol. The objective of this study is to evaluate the effect of SFI on inflammatory factors and immune function in children with MP. Patients meeting the inclusion criteria were randomized in a ratio of 1:1 to either the treatment group (azithromycin + 100 mL 5% glucose injection + 50 mL SFI) or the control group (azithromycin + 150 mL 5% glucose injection). Patients in both groups received the standard treatment for 7 days. The levels of inflammatory factor indexes (C-reactive protein, interleukin-6, interleukin-10, tumor necrosis factor-α) and immune function indexes (immunoglobulin G, immunoglobulin A, immunoglobulin M) in both groups were measured at the beginning of treatment, on the 3rd day of treatment and at the end of treatment. Besides, the time of improvement in clinical symptoms (duration of cough, time of disappearance of lung rales, time of fever reduction, and time of disappearance of lung X-ray infiltrative shadow) and adverse effects in both groups were recorded. Finally, the data were statistically analyzed by SPSS 20.0 software.Discussion:In this study, an evaluation was conducted on the effects of SFI on inflammatory factors and immune function in pediatric MP. The results of this experiment will provide a clinical basis for the adjuvant treatment of pediatric MP with SFI.Trial registration:OSF Registration number:

Effects of Shenfu injection on myocardial adenosine receptors in rats with myocardial ischemia-reperfusion postconditioning.

Shenfu injection (SFI) has been reported to have a protection against myocardial ischemia-reperfusion (MI/R) injury. However, the changes of adenosine receptors in MI/R postconditioning when pretreated with SFI are unclear. Forty-five rats were randomly divided into sham group (sham), MI/R postconditioning group (MI/R-post), low-dose SFI group (1mL/kg), middle-dose SFI group (2.5mL/kg), and high-dose SFI group (5mL/kg). In SFI groups, SFI was intravenously injected before reperfusion, and rats were treated with ischemic postconditioning after ischemia for 30min. After 24h of reperfusion, the levels of Ca2+ and cAMP in blood platelets were analyzed. Myocardial infarct volume and myocardial pathology were observed. The levels of adenosine receptor subtypes A1, A2b, and A3 in myocardium were analyzed using immunohistochemistry and Western blot. The oxidative stress-related indicators were also observed. Compared with the MI/R-post group, SFI ameliorated the MI/R injury by decreasing the myocardial infarct area, oxidative stress, and concentration of Ca2+ and cAMP (p < 0.01). Pretreatment with SFI enhanced the expression of adenosine receptors A1 and A2b in a dose manner compared with the MI/R-post group. In contrast, the levels of adenosine receptor A3 were increased after MI/R postconditioning compared with the sham group, and its expression continued to increase with the increase of SFI. Furthermore, the oxidative stress reduced with the concentrations of SFI. These results demonstrated that pretreatment with SFI might regulate the expression of adenosine receptors to improve the MI/R postconditioning.

Shenfu Injection: A Famous Chinese Prescription That Promotes HCN4 Activity in Bone Marrow Mesenchymal Stem Cells.

We investigated the effects of Shenfu Injection (SFI) on HCN4 activity in bone marrow mesenchymal stem cells (BMSCs). The sample of BMSCs was divided into six groups: a control group, a high-dose SFI group (0.25 ml/ml), a middle-dose SFI group (0.1 ml/ml), a low-dose SFI group (0.05 ml/ml), an adenovirus-encoded control vector group, and an adenovirus-encoded HCN4 group. Cell ultrastructure was observed using a transmission electron microscope. Quantitative reverse transcription PCR (RT-qPCR) was performed to detect HCN4 expression, and HCN4 activity was detected using the whole-cell patch clamp technique. An enzyme-linked immunosorbent assay was performed to detect cAMP content. Application of flow cytometry confirmed that the isolated cells showed BMSC-like phenotypes. Differentiation of BMSCs in both the SFI and the adenovirus-encoding HCN4 groups occurred according to the cellular ultrastructure. Application of the whole-cell patch clamp technique revealed that SFI could activate the inward pacing current of BMSCs in a concentration-dependent manner. The RT-qPCR results showed that HCN4 expression was significantly higher in the high-dose SFI group than in the medium- and low-dose groups, whereas the cAMP content in the overexpressed HCN4 group decreased significantly; this content in the high-dose SFI group increased significantly. In conclusion, SFI promotes HCN4 activity in BMSCs, which could explain its treatment effect when administered to patients with cardiovascular diseases.

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

ObjectiveTo investigate whether Shenfu Injection (SFI, 参附注射液) can alleviate post-resuscitation myocardial dysfunction by inhibiting the inflammatory response.MethodsAfter 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) mRNAs and proteins were determined by RT-PCR and Western blot, respectively.ResultsCompared 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).ConclusionsActivation 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.

Effect of shenfu injection on microcirculation in shock patients: A protocol for systematic review and meta-analysis.

Background:Shock is a major public health problem worldwide. At present, the morbidity and mortality of shock patients are relatively high. Vasomotor dysfunction is 1 of the key pathological aspects of shock. Shenfu injection has been widely used for the treatment of shock in China. Pharmacological studies have suggested that Shenfu injection can reduce peripheral circulation resistance and improve microcirculation. The purpose of this study is to evaluate the effect and safety of Shenfu injection on the microcirculation of patients with shock.Methods:This review summarizes and meta-analyzes randomized controlled trials of Shenfu injection for the treatment of shock.Searched the following electronic databases: PubMed, Cochrane Library, Embase, CNKI, VIP and Wanfang Data. The Cochrane risk assessment tool was used to evaluate the methodological quality of randomized controlled trials. All tests are analyzed according to the standards of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and Grading of Recommendations Assessment, Development, and Evaluation pro GDT web solution are used for data synthesis and analysis.Results:This review focuses on the effects of Shenfu injection on the microcirculation of shock patients (blood lactic acid level, arteriovenous oxygen saturation, arteriovenous carbon dioxide partial pressure difference, sublingual microcirculation), 28-day mortality, 28-day ICU hospitalization and adverse reaction rate.Conclusion:This review provides a clear basis for evaluating the impact of Shenfu injection on the microcirculation of shock patients, as well as the effectiveness and safety of the treatment.

Effect of Shenfu Injection on Isolated Empty Beating Hearts from Miniature Pigs.

ObjectiveTo investigate the effect of Shenfu (SF) injection on donor heart preservation.MethodsTwelve pigs were randomly divided into SF group (n=6) and control group (n=6). After eight hours of perfusion, the differences in hemoglobin, the expression of Bcl-2 and BAX, and changes in the myocardial ultrastructure were compared to illustrate the effects of SF injection in heart preservation.ResultsThe differences in free hemoglobin between the SF group and the control group were statistically significant (P=0.001), and there was significant interaction of groups with times (P=0.019), but the perfusion time may not be associated with the hemoglobin concentration (P=0.616). According to Western blotting analysis, the expression of Bcl-2 was higher in the SF group than in the control group, while the expression of BAX was not different between the two groups. As to ultrastructural changes, both groups exhibited mitochondrial swelling and myofilament lysis, but the degree of damage in the SF group was smaller.ConclusionOur study suggests that the application of SF injection for heart preservation may protect against cardiomyocytes and erythrocytes apoptosis, and Bcl-2 protein may play a role in these physiological processes.

Anti-Inflammatory Effects of Shenfu Injection against Acute Lung Injury through Inhibiting HMGB1-NF-κB Pathway in a Rat Model of Endotoxin Shock.

Shenfu injection (SFI), a Chinese herbal medicine with substances extracted from Ginseng Radix et Rhizoma Rubra and Aconiti Lateralis Radix Praeparata, is widely used as an anti-inflammatory reagent to treat endotoxin shock in China. However, the mechanism of SFI in endotoxin shock remains to be illuminated. High mobility group box 1 (HMGB1), a vital inflammatory factor in the late stage of endotoxin shock, may stimulate multiple signalling cascades, including κB (NF-κB), a nuclear transcription factor, as well as tumour necrosis factor (TNF)-α and interleukin (IL)-1β, among others in the overexpression of downstream proinflammatory cytokines. An investigation into the effects of SFI on the inhibition of the HMGB1-NF-κB pathway revealed the contribution of SFI to acute lung injury (ALI) in a rat model of endotoxin shock. To assess the anti-inflammatory activity of SFI, 5 ml/kg, 10 ml/kg, or 15 ml/kg of SFI was administered to different groups of rats following an injection of LPS, and the mean arterial pressure (MAP) at 5 h and the survival rate at 72 h were measured. 24 h after LPS injection, we observed pathological changes in the lung tissue and measured the mRNA expression, production, translocation, and secretion of HMGB1, as well as the expression of the NF-κB signal pathway-related proteins inhibitor of NF-κB (IκB)-α, P50, and P65. We also evaluated the regulation of SFI on the secretion of inflammatory factors including interleukin-1 beta (IL-1β) and TNF-α. SFI effectively prevented the drop in MAP, relieved lung tissue damage, and increased the survival rate in the endotoxin shock model in dose-dependent manner. SFI inhibited the transcription, expression, translocation, and secretion of HMGB1, increased the expression of toll-like receptor (TLR4), increased the production of IκB-α, and decreased the levels of P65, P50, and TNF-α in the lung tissue of endotoxin shock rats in a dose-dependent manner. Furthermore, SFI decreased the secretion of proinflammatory cytokines TNF-α and IL-1β. In summary, SFI improves the survival rate of endotoxin shock, perhaps through inhibiting the HMGB1-NF-κB pathway and thus preventing cytokine storm.

Effect of Shenfu injection on prognosis and quality of life of patients with vasovagal syncope

Objective To observe the effect of different doses of Shenfu injection on prognosis and quality of life for patients with vasovagal syncope (VVS). Methods A total of 126 patients were randomly divided into 3 groups. The control group (n=38) were treated by western medicine comprehensive therapy with tilting training. The low and high dose Shenfu injection groups were treated by Shenfu injection 40 ml/d (n=44) and 120 ml/d (n=44) on the treatment basis of control group. All the groups were treated for 14 days. The patients were followed up for 1 year after discharge. The relapse rate of syncope, quality of life social support rating scale (SSRS), effective rate of treatment, time of stable blood pressure, time of stable heart rate, recovery time of autonomic nervous disorder and adverse reactions were observed in each groups. Results The total effective rate was 47.4% (18/38) in the control group, 72.7% (32/44) in the low dose group, and 90.9% (40/44) in the high dose group. The difference between the three groups was statistically significant (χ2=18.997, P<0.01), and the total effective rate of Shenfu injection high-dose group was significantly higher than that of low-dose group (P<0.05). After treatment, there were significant differences in the recovery time of blood pressure, heart rate and autonomic nervous disorder among the three groups (F=19.165, 158.428, 33.405, P<0.01). The above indicators in the high dose group of Shenfu injection were significantly higher than the low dose group (t=-4.020, -5.180, -5.307, P<0.05). After 1 year of follow-up, the recurrence rate of the control group was 61.1% (11/18), the low-dose group was 18.8% (6/32), and the high-dose group was 5% (2/40), where there was significant difference among all the groups (χ2=20.886, P<0.01). The quality of life scores were compared for 1 year among the 3 groups, and the difference was statistically significant (F=23.025, P<0.01). Conclusions The Shenfu injection combined with Western medicine comprehensive therapy can improve the prognosis and quality of life of patients with VVS, and the improvement of each indicator of daily dosage of 120 ml is better than the daily dosage of 40 ml Shenfu injection. Key words: Syncope, vasovagal; Tilt-Table test; Shenfu injection; Quality of life; Prognosis

Protective effects of shenfu injection on cerebral ischemia reperfusion injury in rats

Objective To study the protective effect of shenfu injection on cerebral ischemia reperfusion injury in rats. Methods 120 male Sprague Dawley (SD) rats(320-350 g) were randomly divided into sham operation group, model control group, Nimodipine injection group, low, medium and high dose group of shenfu injection according to gender weight. 20 males in each group were given medicine once a day for 7 days before operation. The cerebral ischemia model was established by thread embolization after 5 days of administration. In the sham operation group, the other operations were the same as those in the model group except for carotid artery ligation and thread insertion. After 24 hours of perfusion, the neurological score, abdominal aorta blood flow, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GHS) levels in brain tissues were measured. Triphenyltetrazolium chloride (TTC) staining was used to calculate the area of cerebral infarction and pathological examination of brain tissues. Results Compared with the model control group, the middle and high dosage of shenfu injection could obviously improve the nerve function and increase the percentage of cerebral infarction area (P<0.05); the high dosage group of shenfu injection could obviously decrease the whole blood viscosity (P<0.01); the middle and high dosage of shenfu injection could obviously reduce the level of MDA in rat brain tissue (P<0.01) while increasing the levels of SOD and GSH (P<0.01), finally could significantly improve the pathological changes of brain issues such as mild swelling of nerve fibers, mild neuronal degeneration, inflammatory interstitial edema and inflammation. Conclusions Shenfu injection has obvious protective effect on cerebral ischemia reperfusion model in rats. Key words: SHENFU DECOCTION/TU; Ischemic preconditioning; Brain ischemia; Reperfusion injury/DT; Rats

Effect of Shenfu Injection on Slow Arrhythmia and Bone Marrow Mesenchymal Stem Cells

Effect of Shenfu Injection on Slow Arrhythmia and Bone Marrow Mesenchymal Stem Cells

Effect of Shenfu injection preconditioning on ventilator-induced brain injury in rats

Objective To investigate the effect of Shenfu injection preconditioning on ventilator-induced brain injury in rats. Methods Sixty healthy adult male Sprague-Dawley rats, weighing 300-320 g, were divided into 3 groups (n=20 each) using a random number table: control group (group C), ventilator-induced brain injury group (group VIBI) and Shenfu injection group (group SF). Rats were mechanically ventilated for 6 h with tidal volume of 40 ml/kg in VIBI and SF groups.Rats were mechanically ventilated for 6 h with tidal volume of 10 ml/kg in group C. Shenfu injection 20 ml/kg was injected intraperitoneally at 30 min before ventilation in group SF.Blood samples were collected at 2 and 6 h of ventilation for measurement of the concentrations of serum S100β protein (by enzyme-linked immunosorbent assay). Then the rats were sacrificed at the end of ventilation, and brains were removed for determination of the contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) (by enzyme-linked immunosorbent assay) and expression of glutamate decarboxylase (GAD) and γ-aminobutyric acid type A (GABAA) receptor in brain tissues (by Western blot). Results Compared with group C, the serum concentrations of S100β protein at each time point of ventilation and contents of IL-1β and TNF-α in brain tissues were significantly increased, and the expression of GAD and GABAA receptor was down-regulated in VIBI and SF groups (P<0.05). Compared with group VIBI, the serum concentrations of S100β protein at each time point of ventilation and contents of IL-1β and TNF-α in brain tissues were significantly decreased, and the expression of GAD and GABAA receptor was up-regulated in group SF (P<0.05). Conclusion Shenfu injection preconditioning can relieve ventilator-induced brain injury in rats, and the mechanism may be related to inhibiting inflammatory responses and activating GABA signaling pathway. Key words: SHENFU DECOCTION; Respiration, artificial; Brain injuries

Effects of Shenfu injection on chemotherapy-induced adverse effects and quality of life in patients with advanced nonsmall cell lung cancer: A systematic review and meta-analysis.

To investigate the efficacy of Shenfu injection (SFI) in reducing chemotherapy-induced adverse effects in nonsmall cell lung cancer (NSCLC) patients by conducting a meta-analysis. A systematic review of Cochrane Library, PubMed, Embase, CNKI, Chinese Biomedical Literature Database, VIP, and Wanfang Database was performed from their inception to December 2015. Eligible studies were randomized controlled trials (RCTs) comparing chemotherapy with or without SFI for patients with NSCLC. The main outcomes were improvement in chemotherapy-induced grade 3/4 marrow suppression (leukopenia, neutropenia, anemia, and thrombocytopenia) or gastrointestinal toxicities (nausea and vomiting, diarrhea, and constipation), quality of life, and T-lymphocytes subsets. Sixteen RCTs involving 948 patients were identified. Compared with chemotherapy alone, SFI plus chemotherapy had lower 3/4 grade toxicity for leukopenia (risk ratio [RR] 0.34; 95% confidence intervals [95% CIs] 0.21-0.55), thrombocytopenia (RR 0.36; 95% CI 0.19-0.71), anemia (RR 0.39; 95% CI 0.16-0.99), nausea and vomiting (RR 0.29; 95% CI 0.14-0.58), and diarrhea (RR 0.21; 95% CI 0.07-0.63), Moreover, SFI plus chemotherapy significantly increased Karnofsky Performance Status (weighted mean difference 11.34; 95% CI 7.26-15.42). Adjuvant treatment with SFI improves the quality of life, attenuates the chemotherapy-induced gastrointestinal toxicities and bone marrow suppression, thus improving compliance to chemotherapy in patients with NSCLC. As for limited English literature about SFI and NSCLC, only trials publishing in the Chinese were included in the meta-analysis. More well-designed multicenter RCTs are needed before a definitive conclusion can be drawn.

Effect of Shenfu injection on blood lactate and inflammatory factors in patients with severe infectious shock

Objective To investigate the effects of dopamine combined with norepinephrine on blood lactate and inflammatory factors in elderly patients with severe septic shock. Methods 116 patients with severe septic shock were randomly divided into control group and observation group according to the random number table method, 58 cases in each group.The control group was given the basic treatment of western medicine, the observation group was given Shenfu injection on the basis of the treatment of the control group.The patients were treated for 7 days.The heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), blood lactate (Lac), urine output, acute physiology and chronic health score (APACHEⅡ) were observed before and after treatment.The tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were measured before and after treatment.The changes of inflammatory cytokines were observed before and after treatment.The 28-day mortality and average length of hospital stay were observed. Results After treatment, the HR of the control group was not improved compared with before treatment[(121.32±11.85)beats/min vs.(123.65±14.05)beats/min, t=1.66, P=0.98]. The HR of the observation group decreased, and there was significant difference compared with before treatment [(96.55±10.65) beats/min vs.(123.60±13.98) beats/min, t=11.84, P=0.00]. The MAP and CVP of the two groups were higher than before treatment, and there were significant differences compared with before treatment (all P<0.05). The urine volume of the two groups was higher than before treatment, and that of the observation group was higher than the control group (t=20.40, P=0.00). The score of APACHEⅡ, TNF-α, IL-6 and CRP of the two groups were lower than before treatment, which of the observation group were lower than those of the control group (all P<0.05). The difference of 28-day mortality rate between the two groups was not statistically significant(13.79% vs.22.41%, χ2=1.45, P=0.23). The average hospital stay of the observation group was shorter than that in the control group [(23.39±5.81)d vs.(28.76±6.23)d, t=6.52, P=0.00]. Conclusion Dopamine combined with norepinephrine can improve the vital signs of patients with severe septic shock, reduce the concentration of lactate in blood, improve the level of inflammatory factors and heart index. Key words: Shock, septic; Shenfu injection; Lactic acid; Chemokines

Effects of Shen-Fu Injection () on apoptosis of regulatory T lymphocytes in spleen during post-resuscitation immune dysfunction in a porcine model of cardiac arrest.

To investigate whether Shen-Fu Injection (, SFI) reduces post-resuscitation immune dysfunction in a porcine model of cardiac arrest by modulating apoptosis of regulatory T lymphocytes (Treg) in the spleen. After 8-min untreated ventricular fibrillation and 2-min basic life support, 24 pigs were divided into 3 groups with a random number table, i.e. SFI group, epinephrine (EP) group, and saline (SA) group (8 in each group), which received central venous injection of SFI (1.0 mL/kg), EP (0.02 mg/kg) and SA, respectively. The same procedure without CA initiation was achieved in the sham-operated (sham) group (n=6). After successful return of spontaneous circulation (ROSC), apoptosis rate of splenic Treg was detected by flow cytometry; and the mRNA expression of forkhead/winged helix transcription factor (Foxp3) of splenic Treg was detected by real time-polymerase chain reaction; and the levels of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in porcine splenic Treg were detected by using enzyme-linked immunosorbent assay (ELISA). Compared with the sham group, the apoptosis rate of Treg was significantly decreased, and the levels of Foxp3 mRNA expression, IFN-γ, IL-4 and IFN-γ/IL-4 were increased in the SA group (P<0.05 or P<0.01). Compared with the EP and SA groups, SFI treatment increased the apoptosis rate of Treg and reduced the levels of Foxp3 mRNA expression, IFN-γ and IFN-γ/IL-4 (P<0.05). SFI has signifificant effects in attenuating post-resuscitation immune dysfunction by modulating apoptosis of Treg in the spleen.

Meta-analysis on effect of Shenfu injection in treating angina pectoris

To systematically evaluate the efficiency and safety of Shenfu injection in treating patients with angina pectoris. Retrievals were made in Embase, Pubmed, Cochrane Library, Clinical Trials.gov, CNKI, CBM, VIP and Wanfang (before September 2015) for randomized or semi-randomized controlled trials reporting data of Shenfu injection in the adjuvant treatment of angina pectoris. The quality of included trials was evaluated according to tool evaluation at cochrane.org. STATA version 12.0 was applied for Meta analysis after quality assessment of included studies. Finally, a total of 17 studies, including 16 randomized controlled trials (RCTs) and 1 controlled clinical trial (CCT) involving 1 309 patients, met the inclusion criteria, of which 659 patients received Shenfu injection treatment. Meta-analysis results showed that Shenfu injection treatment group significantly improved angina pectoris symptoms (OR=3.38, 95%CI： 2.47-4.64, P=0.000) and ischemic ST-T changes in electrocardiogram (OR=3.30, 95%CI： 2.22-4.90, P=0.000), compared with control group. In the Meta-regression analysis, the average age of patients was positively correlated with the improved clinical (β=0.17) and electrocardiogram (β=1.15) efficacies. Major complication rate of Shenfu injection was 3.4%, and no serious adverse events were reported. Current clinical evidence in this study proved that Shenfu injection could significantly improve clinical symptoms and ECG ischemic changes for angina pectoris patients, with a good safety.

Effect of Shenfu injection on immune function of mice bearing Lewis lung sarcoma with chemotherapy.

Chemotherapy damages immune system and has a lot of side effects. In this study, we investigate the function of Shenfu injection to reduce these unfavorable effects induced by chemotherapy on mice bearing Lewis lung sarcoma. Mice inoculated with Lewis lung sarcoma cells were divided into five groups: Lewis lung sarcoma control group, cyclophosphamide (CTX) group, and Shenfu injection (high, moderate, and low dose) + CTX group. After a 14-day treatment, the counting of peripheral blood cells, CD3+, CD4+, and CD8+ T lymphocytes were done, immunoglobulin (Ig) was measured, coefficients of spleen and thymus were calculated, and spleen T cell proliferation was evaluated in vitro. The CD4+/CD8+ and CD3+ T cells in high- and moderate-dose Shenfu groups were more than the CTX group (p < 0.05); spleen T cell proliferation of mice in high-dose Shenfu + CTX group is more prominent than the CTX group (p < 0.05); coefficients of spleen and thymus, WBC, and platelet (PLT) counting of mice in the CTX group were lower than control and high and moderate dose Shenfu + CTX groups. The level of serous IgG and IgM of all test groups shows no significant difference. Shenfu injection can improve cellular immune function and reduce myolosuppression of mice delivered with chemotherapy.