OBJECTIVE: To establish a liquid chromatography-tandem mass chromatography (LC-MS/MS) method for the simultaneous screening for 22 poisonous alkaloids in blood. METHODS: This method involves a liquid-liquid extraction (LLE) followed by liquid chromatography-tandem mass spectrometry with multi-ple-reaction monitoring (MRM). After blood was extracted with buprenorphine as the internal standard, the target compounds were analyzed with LC-MS/MS-ESI in the positive ionization mode. RESULTS: Identification was based on the compound's retention time and two precursor-to-product ion transitions. The limits of detection ranged from 0.1 ng/mL to 20 ng/mL in blood. CONCLUSION The method was sufficiently selective and sensitive to detect poisonous alkaloids and can be applied in forensic and clinical toxicology.
Aconitine/blood* ; Alkaloids/chemistry* ; Chromatography, Liquid/methods* ; Colchicine/blood* ; Forensic Medicine ; Humans ; Sensitivity and Specificity ; Strychnine/blood* ; Tandem Mass Spectrometry/methods*

OBJECTIVETo investigate the difference of hypaconitine concentration in serum between normal and cold-deficiency mice after administration of aconite decoction. To analyze how the toxic dose of aconite decoction correlate to the metabolic environment.

METHODPrepared cold-deficiency mice model, treated normal and cold-deficiency mice with aconite decoction for 14 days continuously, and then detected hypaconitine concentration in serum by HPLC along with survival ratio of mice on the first, seventh and fourteenth day.

RESULTAfter administration of aconite decoction for 14 days, the hypaconitine concentration in serum of cold-deficiency mice is close to that in normal mice. It showed aconite decoction has the ability of regulating metabolism environment, the hypaconitine concentration in serum of normal mice was higher on the seventh and fourteenth day than that on first day. It showed that aconite decoction can disturb metabolism environment of normal mice. It was also been observed that the range of variation of hypaconitine concentration in cold-deficiency mice was minor than that in normal mice during the fourteen days' administration.

CONCLUSIONThe difference of serum concentration in normal and cold-deficiency mice showed that there were different metabolic environments in two mice models, and the metabolic environment changed during administration. These results showed that the different toxic doses of aconite decoction were partially due to the different metabolic environments.

Aconitine ; administration & dosage ; analogs & derivatives ; blood ; pharmacokinetics ; Aconitum ; chemistry ; Animals ; Cold Temperature ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; pharmacokinetics ; Male ; Mice ; blood ; physiology ; Mice, Inbred ICR

Aconite, derived from the roots of certain aconitum species (Racunculaceae), is widely distributed in Korea. Aconitine, an extremely toxic substance present in aconite, has pharmacological effects, including anti-inflammatory, analgesic, and positive inotropic actions. Due to its relatively low safe dose, we sometimes encounter cases of serious aconite intoxication. The toxic compound mainly affects the CNS, heart, and muscle tissues, resulting primarily in cardiovascular complications. Aconite poisoning presents with a combination of neurological, cardiovascular, and gastrointestinal features. The main cause of death is severe cardiotoxicity causing refractory ventricular tachyarrhythmias and asystole. As there is no specific antidote, management of aconite poisoning is supportive. All patients require close monitoring of blood pressure and cardiac rhythm since ventricular arrhythmias may occur during the first 24 hours of poisoning, resulting in sudden deterioration in the patient's clinical condition. Extracorporeal membrane oxygenation (ECMO) has traditionally been utilized for perioperative cardiac failure and cardiomyopathies. More recently, the indications for ECMO have expanded to patients with acute cardiovascular decompression including intractable arrhythmias. We report on a patient who developed life threatening ventricular tachyarrhythmia after ingestion of herbal tablets containing aconite alkaloids. Our patient was resuscitated with intravenous infusion of amiodarone, repeated cardioversion/defibrillation, and mechanical circulatory support with ECMO.
Aconitine ; Aconitum* ; Alkaloids ; Amiodarone ; Arrhythmias, Cardiac* ; Blood Pressure ; Cardiomyopathies ; Cause of Death ; Decompression ; Eating ; Extracorporeal Membrane Oxygenation* ; Heart ; Heart Arrest ; Heart Failure ; Humans ; Infusions, Intravenous ; Korea ; Poisoning ; Tablets ; Tachycardia ; Tachycardia, Ventricular

OBJECTIVETo observe the effect of Shenfu injection (SFI) and influence on T-lymphocyte subset, serum level of interferon-gamma(IFN-gamma), tumor necrosis factor-alpha(TNF-alpha), interleukin-2(IL-2) in patients with chronic aplastic anemia (CAA) based on treating with stanozol and cyclosporin A.

METHOD60 patients with CAA were randomly divided into two groups, 30 patients in the SFI group were treated with SFI (100 mL which contains Ginsenoside 0.8 mg x mL(-1) and aconitine 1.8 microg x mL(-1) by adding it in 500 mL of 5% glucose every day) plus stanozol and cyclosporin A and 30 patients in the control group treated with slanozol and cyclosporin A alone for 2 months. The clinical efficacy was observed. The change of T-lymphocyte subset analyzed by flow cytometry and the levels of serum IFN-gamma, TNF-alpha, IL-2 measured with ELISA method were also observed before and after treatment.

RESULTAfter treatment, the total effective rate of the SFI group was higher than that in the control group, but it did not showing significant difference. The CD4/CD8 levels were significantly increased (1.76+/-0.49, P< 0.01) and CD8 levels were significantly lowered (22.57+/-6.30, P < 0.01) in the SFI group after treatment. Serum levels of lFN-gamma, TNF-alpha and IL-2 were lower in both groups, and the level of TNF-alpha and IL-2 in the SFI group (0.710+/-0.213) ng x L(-1) and (0.639+/-0.247) ng x L(-1) was significantly lowered than that in the control group (P < 0.05, P < 0.01).

CONCLUSIONSFI might believe the hemopoietic inhibition so as to promote the recovery of hemopoietic function through improving the T-lymphocyte subset and reducing the release of hemopoietic negative regulatory factors such as IFN-gamma, TNF-alpha and IL-2.

Aconitine ; administration & dosage ; Adolescent ; Adult ; Aged ; Anemia, Aplastic ; blood ; drug therapy ; immunology ; CD4-CD8 Ratio ; Cyclosporine ; therapeutic use ; Drug Combinations ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Ginsenosides ; administration & dosage ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Kidney Diseases ; blood ; drug therapy ; immunology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Stanozolol ; therapeutic use ; Tumor Necrosis Factor-alpha ; metabolism ; Yang Deficiency ; blood ; drug therapy ; immunology

OBJECTIVETo investigate the action of Shen-Fu Injection (SFI) in regulating the expression of the serum complements and inflammatory cytokines synthesized and released in response to the stress of global ischemia accompanying cardiac arrest (CA) and resuscitation.

METHODSThirty pigs were randomly divided into the sham (n=6) and 3 returns of spontaneous circulation (ROSC) groups (n=24). After 8-min untreated ventricular fibrillation and 2-min basic life support, 24 pigs of the ROSC groups were randomized into three groups (n=8 per group), which received central venous injection of SFI (SFI group), epinephrine (EP group), or saline (SA group). Hemodynamic status and blood samples were obtained at 0, 0.5, 1, 2, 4, 6, 12, and 24 h after ROSC.

RESULTSSerum concentrations of specific activation markers of the complement system C3, C4 and C5b-9 were increased during cardiopulmonary resuscitation through 24 h after ROSC. There were intense changes of various pro-inflammatory cytokines and anti-inflammatory cytokines as early as 0.5 h after CA. Compared with the EP and SA groups, SFI treatment reduced the proinflammatory cytokines levels of interleukin (IL)-6, IL-8 and tumor necrosis factor α (TNF-α, P<0.05), and increased the anti-inflammatory cytokine levels of IL-4 and IL-10 (P<0.05). Further, SFI treatment decreased the values of C3, C4 and C5b-9 compared with the EP and SA groups.

CONCLUSIONSSFI, derived from the ancient Chinese medicine, has significant effects in attenuating post-resuscitation immune dysfunction by modulating the expression of complements and cytokines levels. The current study provided an experimental basis for the clinical application of a potential pharmacologic target for post resuscitation immune dysfunction.

Aconitine ; chemistry ; pharmacology ; Animals ; Cardiopulmonary Resuscitation ; Complement Activation ; drug effects ; Complement System Proteins ; metabolism ; Cytokines ; blood ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Ginsenosides ; chemistry ; pharmacology ; Hemodynamics ; drug effects ; Inflammation Mediators ; metabolism ; Injections ; Male ; Models, Animal ; Oxygen ; metabolism ; Survival Analysis ; Sus scrofa