BACKGROUND: Hibiscus Mutabilis L. Is a very effective Chinese traditional herb for non-specific inflammation in the clinic adopted by Professor Wei Zhixin, the eminent expert in Traumatology Department in China, lasting for near 60 years. In order to explain its pharmaceutical mechanism, the research of Hibiscus Mutabilis L. Was carried on in the model of ischemic reperfusion injury to explain its mechanism on anti-inflammation.OBJECTIVE: To observe the protection of the effective fraction of Hibiscus Mutabilis L. (MFR) on renal ischemic reperfusion injury in rats to probe into the mechanism of MFR on anti-inflammation.DESIGN: Randomized and controlled study on experimental animal.SETTING: A Municipal Institute of Traumatology and Orthopedic Department.MATERIALS: The experiment was performed in the Key Experiment Room (Institute of Traumatology and Orthopedic Department, Shanghai) of State Administration of Traditional Chinese Medicine, in which, 55 male Wistar rats were employed.METHODS: The rat model of renal ischemic reperfusion was adopted and MFR was applied for gastric perfusion to determine serum blood urea nitrogen(BUN) and serum creatinine(Scr) and the level of interleukin-1 (IL-1).MAIN OUTCOME MEASURES: ① Changes in serum BUN and Scr; ②Effect of MFR on level of serum IL-1.RESULTS: After MFR treatment, the renal function was improved remarkably after ischemic reperfusion in rats. In sham-operation group, serun BUN was (6.72 ± 1.30) mmol/L and serum Scr was (38.40 ± 6.23) μmol/L. In 24hours of reperfusion after one-hour ischemia, BUN was(60. 72±4.64)mmol/L in the control and(47.34 ± 8.32) mmol/L in the MFR treatment group, and the significant difference presented between two groups(t=2.562, P ＜ 0.05) .Serum Scr was(347.95±95) μmol/L and(518.20 ± 41.15) μmol/L in the treatment group and the control respectively, indicating significant difference ( t = 3.69, P ＜ 0.01 ) . Concerning to the effect on IL-1, in 1 hour of reperfusion after 1 hour renal ischemia,IL-1 was( 122.79 ±27.56) ng/L in the MER treatment group,(180. 28 ±33. 15) ng/L in the control group, indicating that IL-1 level in the treatment group was remarkably superior to that in the control group(t = 2.98, P ＜ 0.05). In 3 hours of reperfusion after 1 hour ischemia, level of IL-1 in the treatment group and control group was(15.58±8.59) ng/L and (34. 13±± 10. 02) ng/L respectively, indicating significant difference( t = 3.14, P＜ 0.05).CONCLUSION: MFR provides protection on renal ischemic reperfusion injury, which probably is related to its inhibition on IL-1 formation.

Objective To observe the effect of Shenmai injection combined with enteral nutrition (EN) on immune function in patients with severe cardiac insufficiency. Methods Fifty-seven patients with severe cardiac insufficiency admitted to the Department of Critical Care Medicine of Taizhou Hospital of Zhejiang Province from June 2015 to June 2018 were divided into an EN group (31 cases) and an EN group combined with Shenmai injection group (26 cases). The EN group was given EN on the basis of routine western medicine treatment, while in the EN combined with Shenmai injection group was treated additionally by intravenous drip of Shenmai injection 100 mL/d on the basis of above EN group treatment. The efficacies of the two groups were evaluated after consecutive 7-day treatment in the two groups. The changes in levels of subsets of T-lymphocytes (CD3+, CD4+, CD8+, CD4+/CD8+) and immunosuppressive cells CD14+ monocyte human leukocyte antigen DR (HLA-DR) were observed before and after treatment. Results After treatment, the levels of T-cell subsets CD3+, CD4+, CD4+/CD8+ and CD14+ monocytes HLA-DR in the peripheral blood of the two groups were significantly higher than those before treatment [CD3+: EN group was 0.539±0.126 vs. 0.379±0.093,Shenmai injection group was 0.652±0.185 vs. 0.393±0.091; CD4+: EN group was 0.402±0.121 vs. 0.275±0.066,Shenmai injection group was 0.524±0.168 vs. 0.281±0.077; CD4+/CD8+:EN group was 1.83±0.70 vs. 1.11±0.70,Shenmai injection group was 2.81±0.91 vs. 1.19±0.58; CD14+HLA-DR:EN group was (43.3±7.1)% vs. (35.4±5.7)%,Shenmai injection group was (54.9±6.2)% vs. (36.1±8.3)%]; After treatment, CD8+ in EN group decreased (0.223±0.052 vs. 0.253±0.081), while CD8+ in shenmai injection group increased (0.288±0.051 vs. 0.259±0.078), and the increase degrees of the above-mentioned indexes in EN combined with Shenmai injection group were more obvious than those in the EN group after treatment [CD3+: 0.652±0.185 vs. 0.539±0.126, CD4+: 0.524±0.168 vs. 0.402±0.121, CD8+: 0.288±0.051 vs. 0.223±0.052, CD4+/CD8+: 2.81±0.91 vs. 1.83±0.70, CD14+HLA-DR: (54.9±6.2)%, (43.3±7.1)%, all P < 0.05]. Conclusion The combined use of Shenmai injection and early EN can improve the immune function of T-lymphocytes in patients with severe cardiac insufficiency. The mechanism may be related to the enhancement of the activation of T lymphocytes and promotion of the CD14+ monocytes increase and immune function.