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An anti-fibrosis mechanism study on effects of difference in iron load levels on activation and apoptosis of hepatic stellate cells

Yuan JIANG ; Ling ZHANG ; Yuanqi DENG ; Jinyang HE

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2013;(6):369-373. doi:10.3969/j.issn.1008-9691.2013.05.013

Objective To investigate the anti-fibrosis mechanism from effects of difference in iron load levels on activation and apoptosis of hepatic stellate cells(HSCs). Methods According to the difference in iron load levels in HSCs,HSC-T6 cells were divided into four groups:blank control,iron deposition model,50μmol/L desferrioxamine and 25 μmol/L desferrioxamine groups. Quantitative polymerase chain reaction(PCR)was applied for the detection of collagen type Ⅰ and transforming growth factor-β1(TGF-β1)mRNA expressions of HSC-T6 cells. Immunohistochemical assay was used for the detection of α-smooth muscle actin(α-SMA)expression. The method of terminal deoxynucleotidyl transferase(TdT)-mediated dUTP nick end labeling(TUNEL)was used for the examination of apoptosis of HSC-T6 cells. Under electron microscope,the ultrastructures of HSC-T6 cells were observed. Results Compared with the blank control group,despite the TGF-β1 mRNA expression in iron deposition model group was increased,no statistical significant difference was seen(1.594±0.168 vs. 1.477±0.126, P>0.05),whereas collagen type I mRNA expression was significantly enhanced(1.354±0.076 vs. 1.197±0.104, P<0.01). Both 50μmol/L and 25μmol/L desferrioxamine could down-regulate collagen type I and TGF-β1 mRNA expressions,and the action of 50μmol/L desferrioxamine was superior to that of 25μmol/L desferrioxamine(collagen typeⅠmRNA:0.391±0.076 vs. 0.688±0.060,TGF-β1 mRNA:0.421±0.068 vs. 0.714±0.090,both P<0.01). Iron deposition could induce HSCs to expressα-SMA in great amount,while apoptosis could be seen scarcely in iron deposited HSCs. By desferrioxamine therapy,α-SMA expression of HSCs was decreased significantly,but some of the cells underwent apoptosis. Conclusion Different iron load levels inside HSCs can induce activation or apoptosis of the cells,showing that iron plays an important role in regulating the process of HSCs activation and apoptosis and revealing that desferrioxamine possesses the potential action for treatment of liver fibrosis.

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The clinical effect of cefoperazone sulbactam associated with tigecycline on pulmonary infection caused by pan drug-resistant Acinetobacter baumannii

Mingyuan MA ; Jie XU ; Na YU ; Guomin HUANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2013;(6):349-352. doi:10.3969/j.issn.1008-9691.2013.06.007

Objective To approach the clinical effect of cefoperazone sulbactam associated with tigecycline for treatment of patients with severe pulmonary infection caused by pan drug-resistant Acinetobacter baumannii in intensive care unit(ICU). Methods Retrospectively,the treatments of 88 patients with sepsis and pulmonary infection caused by pan drug-resistant Acinetobacter baumannii admitted in ICU from January,2011 to June,2013 were analyzed,among them antibiotics were used for 82 patients,and the rest 6 patients did not use antibiotics because of family refusal or abandonment of therapy. The patients having used antibiotics were divided into three groups:A group(27 patients)received cefoperazone sulbactam,B group(30 patients)received cefoperazone sulbactam associated with amikacin,and C group(25 patients)received cefoperazone sulbactam associated with tigecycline, antimicrobial treatment being for 7-15 days. The venous blood was collected to determine the changes in white blood cell count(WBC),C-reactive protein(CRP)and procalcitonin(PCT)before and after therapy. The rate of bacteriological efficiency,successful weaning of mechanical instrument,28-day mortality rate and clinical efficacy were observed after therapy in three groups. Results Before therapy,the comparisons of levels of WBC,CRP and PCT among three groups were of no statistically significant difference(all P>0.05),and they were decreased obviously after therapy in three groups among which they were decreased most significantly in C group〔WBC(×109/L):17.01±5.35 vs. 20.40±6.54,18.28±6.41;CRP(mg/L):64.6±8.4 vs. 68.3±12.7,70.0±13.4;PCT(μg/L):20.84±7.26 vs. 36.14±10.12,52.66±13.47,P<0.05〕. The rates of bacteriological efficiency and successful weaning in C group were increased more significantly than those in either A or B groups after therapy(bacteriological efficiency:76.00%vs. 44.44%,46.67%,χ2=9.750,P=0.006;rate of successful weaning:72.00%vs. 40.74%, 43.33%,χ2=12.083,P=0.009),and 28-day mortality rate in C group was much lower than those in A and B groups (24.00% vs. 48.15%,36.67%,χ2=11.510,P=0.030). The total clinical efficiency in C group was much higher than those in A and B groups(76.00%vs. 44.44%,46.67%,both P<0.05). Conclusion Cefoperazone sulbactam associated with tigecycline has significant clinical therapeutic effect in patients with pulmonary infection caused by pan drug-resistant Acinetobacter baumannii in ICU,as it can decrease inflammatory reaction,increase the rates of successful weaning and survival.

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The effect of Xuebijing injection on B-type natriuretic peptide level of rabbits with acute pulmonary thromboembolism

Li CHEN ; Lan LI ; Bo LV ; Yue HAN ; Ruifeng HUANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2013;(6):345-348. doi:10.3969/j.issn.1008-9691.2013.06.006

Objective To explore the therapeutic effect and possible mechanisms of Xuebijing injection for treatment of acute pulmonary thromboembolism(APE)in rabbits. Methods Twenty-four New Zealand rabbits with big ears were randomly divided into control group,model group and Xuebijing group(each n=8). The model of APE was performed by re-infusing of autologous blood clots. After the model was established,in the rabbits of the Xuebijing group,Xuebijing injection 1 mL/kg was injected into the ear marginal vein,twice daily for consecutive 7 days. In the model and control groups,the same amount of normal saline was given via the same route. The changes in plasma levels of B-type natriuretic peptide(BNP)were detected by enzyme-linked immunosorbent assay(ELISA) at the time points of 8 hours and 1,3,5,7 days,and after 7 days the lungs of the rabbits were removed for the lung histopathological examination. Results The BNP levels of the model group and Xuebijing group were significantly higher compared with the level of control group at 8 hours after embolization,the model group being the most significant(all P<0.05). On day 3,the BNP levels of the model group and Xuebijing group reached their peaks,and then gradually decreased,but the level of model group was significantly higher than that of Xuebijing group(ng/L:581.1±144.6 vs. 251.5±22.5,P<0.05). On day 7,the BNP level of Xuebijing group fell to the level of the control group(ng/L:78.5±9.4 vs. 50.9±11.5),the level of the model group also decreased,but it was still much higher than that of the Xuebijing group(ng/L:214.1±47.6 vs. 78.5±9.4,P<0.05). Histopathological examination showed Xuebijing could significantly reduce the infarct size with mild inflammatory cell infiltration,but the infarct size of the model group was obviously bigger than that of the Xuebijing group and accompanied by relatively more inflammatory cell infiltration. Conclusion Xuebijing injection can significantly reduce the plasma BNP level of the rabbits with pulmonary embolism,and in the mean time ameliorate the degree of inflammatory infiltration in the lung tissue and infarct.

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Effects of Liuwei Buqi capsules on CD4+CD25+forkhead box protein 3+regulatory T cells,helper T cells in patients with chronic obstructive pulmonary disease

Chengyang WANG ; Xiangguo LIU ; Jieqiong WANG ; Jiabing TONG ; Zegeng LI

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2013;(6):326-331. doi:10.3969/j.issn.1008-9691.2013.06.002

Objective To observe the effects of Liuwei Buqi capsules on CD4+CD25+forkhead box protein 3+(Foxp3+)regulatory T cells(Tregs),helper T cells(Ths)in patients with chronic obstructive pulmonary disease (COPD). Methods Eighty COPD patients admitted into the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2012 to May 2013 were randomly divided into a traditional Chinese medicine (TCM)experimental group(40 cases)and a western medicine control group(40 cases);there were 40 research volunteers enrolled as healthy controls. After admission,both the TCM experimental group and western medicine control group were given conventional western medicine comprehensive treatment. Additionally,in the TCM experimental group,Liuwei Buqi capsules were given orally once 3 pills(0.4 g/pill)and twice a day,while in the western medicine control group nifedipine was given,once 10 mg and 3 times a day,30 days constituting one therapeutic course for both groups. BODE evaluation means that the body mass index(B),the degree of airflow obstruction(O),the scores of dyspnea(D)and excercise capacity(E)of COPD patients were evaluated. A spirometer was used to observe the changes in the patient's pulmonary function to detect the dyspnea score. The γ-interferon(IFN-γ),interleukin (IL-4 and IL-17)in serum were detected by enzyme-linked immunosorbent assay(ELISA). The expression of Treg of peripheral blood was detected by flow cytometry. Results Compared with healthy control group,lung function parameters,IL-4,CD4+CD25+Treg and CD4+CD25+Foxp3+Treg of peripheral blood were increased,while dyspnea score,BODE score,the expressions of IFN-γ,Th1/Th2,IL-17 in serum were decreased significantly in the COPD group(P<0.05 or P<0.01). After treatment,compared with those before treatment in the two groups, the forced expiratory volume in 1 second(FEV1),FEV1/forced vital capacity(FVC),IL-4,CD4+CD25+Treg, CD4+CD25+Foxp3+ Treg were all increased,while dyspnea score,BODE score,IFN-γ,Th1/Th2,IL-17 were all decreased(P<0.05 or P<0.01),and the peak expiratory flow(PEF)was decreased in western medicine control group and increased in TCM experimental group. After treatment,the comparisons of ratio of FEV1/FVC〔(78.12±14.96)%vs.(67.52±10.39)%〕,BODE score(1.07±0.72 vs. 1.77±0.74),IL-17(μg/L:40.80±8.97 vs. 48.22±6.51) Th1/Th2(1.05±0.23 vs. 1.42±0.21)and CD4+CD25+Foxp3+ Treg〔(6.61±2.26)% vs.(5.25±2.03)%〕between the two groups were all of statistical significant difference(all P<0.05). Conclusion Liuwei Buqi capsules can improve COPD symptoms by up-regulating the expressions of CD4+CD25+Foxp3+ Treg,IL-4,and down-regulating the expressions of IFN-γ,IL-17 to correct the balance of Th1/Th2 in patients with COPD.

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The association between plasma N-terminal pro-B-type natriuretic peptide and extravascular lung water index in patients with septic shock

Suozhu WANG ; Lijuan LI ; Lei ZHAO ; Bo SHENG ; Xuyun GU ; Wei CHEN

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(1):58-62. doi:10.3969/j.issn.1008-9691.2014.01.017

Objective To study the dynamic change in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and its correlation with extravascular lung water index (EVLWI) in patients with septic shock. Methods Sixty-two patients with septic shock admitted to Department of Critical Care Medicine of Beijing Shijitan Hospital were enrolled. The patients were divided into survival group(39 cases)and non-survivors group (23 cases)according to 28-day prognosis. Venous blood was collected after intensive care unit(ICU)admission. The changes in plasma NT-proBNP and hemodynamics indexes levels were analyzed to evaluate their predictive value for clinical outcomes. Results Acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score(23.2±2.5 vs. 28.1±2.6),sequential organ failure assessment(SOFA score:7.74±2.80 vs. 12.43±3.00)and hemodynamics indexes including EVLWI〔ml/kg:7.0(6.0,8.0)vs. 9.0(7.0,12.0)〕,blood lactate(mmol/L):3.60±2.30 vs. 10.40±2.70)and NT-proBNP〔ng/L:945.0(228.0,1 246.0)vs. 5 471.0(3 308.0,11 174.0)〕in survivors were significantly lower than those in non-survivors,and cardiac index〔CI(L?min-1?m-2):4.23±0.85 vs. 3.31±0.74〕, global ejection fraction(GEF:0.205±0.054 vs. 0.149±0.054)were significantly higher than those in non-survivors (P<0.05 or P<0.01). Correlation analysis showed a positive correlation was found between NT-proBNP and EVLWI (r=0.277,P=0.010),and negative correlations were found between NT-proBNP and CI(r=-0.367,P=0.001), GEF(r=-0.259,P=0.017). No correlation was found between NT-proBNP and GEDVI,SVRI. Receiver operating characteristic curve(ROC curve)analysis showed that the area under the ROC curve(AUC)for plasma NT-proBNP predicting the outcome of septic shock patients was 0.869±0.042,95% confidence interval(95%CI)was 0.786-0.952,with the maximum sum of sensitivity and specificity 1.695 to determine NT-proBNP predicting septic shock patient's death cut-off value was 2 071 ng/L,under this cut-off value,the sensitivity was 81.4% and specificity,88.1%. The maximum AUC for EVLWI predicting the outcome of patients with septic shock was 0.690,cut-off value was 7.5 mL/kg,under this cut-off value,the sensitivity was 69.8% and specificity,66.7%. Maximum AUC for CI predicting the outcome of patients with septic shock was 0.785,cut-off value was 3.48 L?min-1?m-2,under this cut-off value,the sensitivity was 69.8%and specificity,66.7%. Maximum AUC for GEF predicting the outcome of septic shock patients was 0.794,cut-off value 0.175,under this cut-off value,the sensitivity was 76.2% and specificity, 81.4%. Multivariate analyses showed CI and NT-proBNP levels were independent predictors of the prognosis〔CI:P=0.001,odds ratio(OR)=9.183,95%CI 2.362-35.694;NT-proBNP:P=0.024,OR=1.000,95%CI 0.999-1.000〕. Conclusion The plasma NT-proBNP level which is correlated significantly to EVLWI can evaluate the severity of septic shock and can predict the prognosis of such patients.

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The effects of Xuebijing injection on ATPase of diaphragm in rats with acute organophosphorus poisoning

Guoxin HE ; Xuming TANG ; Xia ZHENG ; Shenghua PAN ; Haixu WENG ; Wenchao LUO ; Hailin LI

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(1):55-57. doi:10.3969/j.issn.1008-9691.2014.01.016

Objective To investigate the changes in ATPase activity of diaphragm in rats with acute organophosphorus poisoning (AOPP) and to explore the effect of Xuebijing injection on the ATPase activity. Methods 24 clean healthy Spraue-Dawley(SD)rats were divided into control group,model group and Xuebijing treatment group by means of random number table,with 8 rats in each group. AOPP model was established by intra-gastrical administration of 50 mg/kg oxide dimethoate. In Xuebijing treatment group,after oxide dimethoate administration,intraperitoneal injection of Xuebijing(10 mL/kg)was given at the same time,while in control group and model group,equal amount of normal saline(NS)was injected via the same route. The rats were sacrificed at 6 hours after model formation,and their diaphragms were taken sterilely. The activities of Na+-K+-ATPase and Ca2+-ATPsae of diaphragms were detected by enzyme linked immunosorbent assay(ELISA). The histopathological changes in diaphragms of rats were observed with light microscopy. Results 6 hours after intoxication,the diaphragm Na+-K+-ATPase activity of rats in model group was markedly lower than that in control group(mmol?h-1?g-1:5.22±0.74 vs. 9.98±0.37,P<0.01),while the Na+-K+-ATPase activity in Xuebijing treatment group(6.93±1.14) was markedly higher than that in model group(P<0.05). The diaphragm Ca2+-ATPase activity of rats in model group was markedly lower than that in control group(mmol?h-1?g-1:7.45±0.74 vs. 12.08±0.74,P<0.01),while the Ca2+-ATPase activity in Xuebijing treatment group(9.35±1.67)was obviously higher than that in model group(P<0.05)after intoxication for 6 hours. Light microscope observation indicated that there were swelling and necrosis in diaphragm in model group,while in Xuebijing treatment group no necrosis was found. Conclusion The diaphragm was degenerated and necrotic in AOPP rats,Xuebijing injection can lessen the injury in such rats,and the curative effect may be related to the improvement of the Na+-K+-ATPase and Ca2+-ATPsae activities of diaphragm.

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Effect of early continuous renal replacement therapy on patients with severe sepsis

Qinhan LIN ; Ming ZHANG ; Jun CHEN ; Haibo ZHOU ; Guodong HUANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(1):46-49. doi:10.3969/j.issn.1008-9691.2014.01.013

Objective To evaluate the effect of early continuous renal replacement therapy(CRRT)on patients with acute kidney injury(AKI)induced by severe sepsis. Methods A prospective study was conducted. 160 patients with AKI induced by severe sepsis admitted to intensive care unit(ICU)of Qingyuan People's Hospital between October 2009 and June 2013 were enrolled. According to the starting time of CRRT,the patients were randomly divided into two groups:an earl y treatment group and a regular treatment group(each,80 cases). All patients were treated in accordance with the principle of the cluster of severe sepsis. In early treatment group,the patents began to receive CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment over 6 hours,but the curative effect was not ideal. In the regular treatment group,the patients began to apply CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment persistently over 24 hours or difficultly corrected acidosis or heart failure developed. The changes in urine output,creatinine,saturation of blood oxygen,and albumin,and 28-day survival rate,length of ICU stay,time of organ support were measured and compared between the two groups to evaluate the therapeutic significance of the early CRRT. Results The mean length of ICU stay(day:6.5±1.7 vs. 8.2±1.6),length of organ support(day:5.3±1.8 vs. 6.0±1.4),the recovery time of urine amount(day:3.4±0.9 vs. 4.8±0.5)in early treatment group were significantly shorter than those in regular treatment group(all P<0.01);recovery ratio of urine in 1 week in early treatment group was significantly higher than that in regular treatment group(46.2%vs. 28.8%,P<0.05). The creatinine recovery ratio in 1 week in early treatment group was lower than that in regular treatment group(55.0%vs 78.8%),but there was no statistically significant difference(P>0.05). Early treatment group and regular treatment groups of creatinine recovery time were similar(day:5.1±1.3 vs. 5.2±1.2). 28-day survival rate in early treatment group was higher than that in regular treatment group(41.2%vs. 35.0%),but there was no statistically significant difference(P>0.05). Conclusion It is found that there is no evidence to suggest that early CRRT may improve the prognosis of the patients with AKI induced by severe sepsis,but it may be in favor of shortening the time of urine recovery,length of stay in ICU,length of organ support and length of dialysis.

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Effects of hemoperfusion combined with hemodialysis on micro inflammation and malnutrition status in patients with maintenance of hemodialysis patients with maintenance of hemodialysis

Yanmei XU ; Chuanwen XU

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(1):42-45. doi:10.3969/j.issn.1008-9691.2014.01.011

Objective To evaluate the effects of blood perfusion(HP)combined with hemodialysis(HD)on micro inflammation and malnutrition status in patients with maintenance of hemodialysis(MHD). Methods Eighty MHD patients admitted to blood purification center of Wuhan Puai Hospital in Hubei Province were enrolled and randomly divided into two groups. Pure HD group underwent conventional HD for 4 hours,3 times a week,and based on the weekly HD series,the HD+HP group took additionally HP once a week,the therapeutic course in both groups being consecutive 12 weeks. Blood was collected before and after treatment for detection of interleukin-6. (IL-6) and tumor necrosis factor-α(TNF-α) levels by enzyme-linked immunosorbent assay (ELISA), and the serum high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels were determined with electrochemiluminescence immunoassay,and the changes in nutritional indexes of hemoglobin(Hb),total protein(TP), albumin(Alb),transferrin(TRF)were observed. Results Compared with the indexes before treatment,in HD+HP group,hs-CRP(ng/L:5.65±2.21 vs. 13.91±2.10),IL-6(ng/L:50.10±6.65 vs. 101.22±21.32),TNF-α(ng/L:80.21±9.41 vs. 197.64±25.47),Hcy(μmol/L:13.31±2.21 vs. 40.96±9.42)were significantly decreased (all P<0.05),and Hb(g/L:106.65±22.21 vs. 92.01±12.10),TP(g/L:62.10±22.65 vs. 51.22±11.32),Alb (g/L:38.21±6.41 vs. 30.84±5.47),TRF(μg/L:196.31±22.21 vs. 161.96±15.42)were significantly increased (all P<0.05);but the above parameters in HD group did not change significantly(all P>0.05). There were statistical significant differences in above indexes after treatment between HD+HP group and HD group〔hs-CRP (ng/L):5.65±2.21 vs. 13.22±1.10,IL-6(ng/L):50.10±6.65 vs. 100.32±25.24,TNF-α(ng/L):80.21±9.41 vs. 196.87±24.54,Hcy(μmol/L):13.31±2.21 vs. 37.23±8.33,Hb(g/L):106.65±22.21 vs. 94.22±13.10,TP (g/L):62.10±22.65 vs. 51.32±12.32,Alb(g/L):38.21±6.41 vs. 32.87±4.54,TRF(μg/L):196.31±22.21 vs. 162.23±15.33,all P<0.05〕. Conclusion HP combined with HD in the treatment of MHD can improve the micro inflammation and malnutrition state in patients with MHD.

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Effect of atorvastatin on serum ferritin levels in elderly male patients with acute coronary syndrome

Yanmin LIANG ; Jin JIN ; Xiaomei JIANG ; Ying TIAN ; Xiuxia LI ; Ying ZHANG ; Tianhao ZHANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(1):39-41. doi:10.3969/j.issn.1008-9691.2014.01.010

Objective To explore the effect of atorvastatin application on serum ferritin(SF)levels in elderly male patients with acute coronary syndrome(ACS)and its clinical significance. Methods 120 elderly male patients treated in Department of Cardiology in Cangzhou People's Hospital were randomly divided into treatment group and control group(60 cases in each group). All the patients in the two groups took the standard treatment of coronary heart disease,and the patients in treatment group were additionally given atorvastatin 20 mg orally,once-daily for 1 month. After 1 month of treatment,the changes in SF and lipid levels before and after treatment were determined. Results The total cholesterol(TC),low density lipoprotein(LDL)and SF levels of the two groups after treatment were significantly decreased compared with those before treatment. After treatment,triacylglycerol (TG)was decreased,and high-density lipoprotein(HDL)was increased significantly in treatment group,while in the control group,after treatment TG was increased and HDL was decreased. Compared between treatment and control groups after treatment,the differences in SF,TC,TG,HDL and LDL levels were statistically significant〔SF(μg/L):174.33±99.87 vs. 255.66±100.34,TC(mmol/L):4.23±0.60 vs. 5.15±0.56,TG(mmol/L):1.98±0.64 vs. 2.00±1.03,HDL(mmol/L):1.13±0.14 vs. 1.09±0.22,LDL(mmol/L):2.45±0.33 vs. 3.35±0.50,P<0.05 or P<0.01〕. Conclusion In elderly male hospitalized patients with ACS,the level of SF is significantly higher than normal,after atorvastatin specification treatment,the blood fat and SF levels are significantly lower,thus the SF inducing myocardial damage may be reduced and the risk of recurrence of acute coronary events can be decreased.

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Clinical observation on effect of Xuebijing injection for treatment of patients with diabetic nephropathy

Ying XU ; Bin HAN ; Guobing CHEN ; Ling ZHONG ; Haiyan WU

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(1):35-38. doi:10.3969/j.issn.1008-9691.2014.01.009

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

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