OBJECTIVE: To explore the therapeutic effect of Xuebijing on patients with acute paraquat poisoning (APP) by using systematic evaluation method. METHODS: PubMed, Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure (CNKI), VIP database (VIP) and China Biology Medicine (CBM) were searched using the computers to find the literatures published about the Xuebijing injection for the treatment of APP. Randomized controlled trials (RCT) were retrieved from the establishment of the database to August 2019. Patients in experimental group were treated with Xuebijing injection combined with conventional treatment, while the patients in control group were only given conventional treatment. The patients' outcome included the 14-day mortality, arterial oxygen saturation (SaO₂) and incidence of pulmonary fibrosis. In addition, the 6-month survival rate, alanine aminotransferase (ALT), serum creatinine (SCr), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) and superoxide dismutase (SOD) between the two groups were compared. The literature data were extracted by two researchers independently, and the quality of the literatures was evaluated according to the Cochrane 5.1 handbook. The Meta-analysis was performed by using RevMan 5.3 software. The results stability of Meta-analysis was tested by sensitivity analysis. The publication bias was analyzed through drawing of funnel diagram. RESULTS: Twenty-seven RCT studies in total were enrolled, of which 26 were in Chinese and 1 was in English. A total of 1 429 patients were enrolled, among whom 726 were in experimental group and another 703 were in control group. Meta-analysis showed that compared with the control group, the 14-day mortality [relative risk (RR) = 0.62, 95% confidence interval (95%CI) was 0.54 to 0.72, P < 0.000 01] and incidence of pulmonary fibrosis (RR = 0.67, 95%CI was 0.53 to 0.85, P = 0.000 9) of patients in the experimental group were significantly lowered, while SaO₂ at 7 days and 14 days were significantly increased [7 days: mean difference (MD) = 16.86, 95%CI was 9.89 to 23.83, P < 0.000 01; 14 days: MD = 16.51, 95%CI was 10.22 to 22.80, P < 0.000 01]. Compared with the control group, the survival rate within 6 months (RR = 1.55, 95%CI was 1.41 to 1.71, P < 0.000 01) and SOD (MD = 13.88, 95%CI was 7.43 to 20.33, P < 0.000 1) of patients in the experimental group were significantly increased, ALT at 14 days (MD = -78.35, 95%CI was -127.35 to -29.34, P = 0.000 5), SCr at 7 days and 14 days (7 days: MD = -135.13, 95%CI was -219.09 to -51.17, P = 0.002; 14 days: MD = -206.05, 95%CI = -290.13 to -121.96, P < 0.000 01), CRP (MD = -11.55, 95%CI was -17.77 to -5.33, P = 0.000 3), TNF-α (MD = -9.27, 95%CI was -15.48 to -3.96, P = 0.000 9) and MDA (MD = -1.27, 95%CI was -1.57 to -0.96, P < 0.000 01) were significantly lowered. The overall effect value of the parameters with high heterogeneity was not significantly changed after further Meta-analysis excluding any one of the studies, suggesting that the result was relatively stable. Funnel chart analysis was used to analyze the parameters from more than 10 articles enrolled, and it showed that there was publication bias. CONCLUSIONS Xuebijing injection can reduce the mortality of patients with APP, which may because that it can improve liver and kidney function, reduce inflammation and oxidative stress damage, inhibit pulmonary fibrosis and increase oxygenation level.
China ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Paraquat/poisoning* ; Poisoning/mortality* ; Prognosis

The poisoning information database (PIDB) provides clinical toxicological information on commonly encountered toxic substances in Korea. The aim of this study was to estimate the coverage rate of the PIDB by comparing the database with the distribution of toxic substances that real poisoning patients presented to 20 emergency departments. Development of the PIDB started in 2007, and the number of toxic substances increased annually from 50 to 470 substances in 2014. We retrospectively reviewed the medical records of patients with toxic exposure who visited 20 emergency departments in Korea from January to December 2013. Identified toxic substances were classified as prescription drug, agricultural chemical, household product, animal or plant, herbal drug, or other. We calculated the coverage rate of the PIDB for both the number of poisoning cases and the kinds of toxic substances. A total of 10,887 cases of intoxication among 8,145 patients was collected. The 470 substances registered in the PIDB covered 89.3% of 8,891 identified cases related to poisoning, while the same substances only covered 45.3% of the 671 kinds of identified toxic substances. According to category, 211 prescription drugs, 58 agricultural chemicals, 28 household products, and 32 animals or plants were not covered by the PIDB. This study suggested that the PIDB covered a large proportion of real poisoning cases in Korea. However, the database should be continuously extended to provide information for even rare toxic substances.
Adolescent ; Adult ; Aged ; Animals ; Animals, Poisonous ; Child ; Child, Preschool ; Databases, Factual ; Drugs, Chinese Herbal/poisoning ; Emergency Service, Hospital ; Female ; Humans ; Infant ; Male ; Middle Aged ; Pesticides/poisoning ; Plants, Medicinal/poisoning ; Poisoning/*epidemiology ; Prescription Drugs/poisoning ; Republic of Korea ; Retrospective Studies ; Young Adult

Drugs, Chinese Herbal ; therapeutic use ; Glycoproteins ; therapeutic use ; Humans ; Paraquat ; poisoning ; Poisoning ; drug therapy

Patients who overdose on aconite can present with life-threatening ventricular arrhythmia. Aconite must be prepared and used with caution to avoid cardiotoxic effects that can be fatal. We herein describe a case of a patient who had an accidental aconite overdose but survived with no lasting effects. The patient had prepared Chinese herbal medication to treat his pain, which resulted in an accidental overdose of aconite with cardiotoxic and neurotoxic effects. The patient had ventricular tachycardia, bidirectional ventricular tachycardia and ventricular fibrillation. Following treatment with anti-arrhythmic medications, defibrillation and cardiopulmonary resuscitation, he made an uneventful recovery, with no further cardiac arrhythmias reported.
Aconitine ; poisoning ; Adult ; Anti-Arrhythmia Agents ; therapeutic use ; Cardiopulmonary Resuscitation ; Cardiotoxicity ; Drug Overdose ; Drugs, Chinese Herbal ; poisoning ; Electric Countershock ; Electrocardiography ; Humans ; Male ; Tachycardia ; chemically induced ; Tachycardia, Ventricular ; chemically induced ; Treatment Outcome ; Ventricular Fibrillation ; chemically induced

This study was performed to review studies carried out in Korea reporting toxic reactions to traditional Chinese medicines (TCMs) as a result of heavy metal contamination. PubMed (1966-August 2013) and International Pharmaceutical Abstracts (1965-August 2013) were searched using the medical subject heading terms of "Medicine, Chinese Traditional," "Medicine, Korean Traditional," "Medicine, Traditional," "Metals, Heavy," and "Drug Contamination". For Korean literature, Korea Med (http://www.koreamed.org), the Korean Medical Database (http://kmbase.medric.or.kr), National Discovery for Science Leaders (www.ndsl.kr), Research Information Sharing Service (http://www.riss.kr), and Google Scholar were searched using the terms "Chinese medicine," "Korean medicine," "herbal medicine," and "metallic contamination" in Korean. Bibliographies of case reports and case series, identified using secondary resources, were also utilized. Only literature describing cases or studies performed in Korea were included. Case reports identified clear issues with heavy metal, particularly lead, contamination of TCMs utilized in Korea. No international standardization guidelines for processing, manufacturing and marketing of herbal products exist. Unacceptably high levels of toxic metals can be present in TCM preparations. Health care providers and patients should be educated on the potential risks associated with TCMs. International advocacy for stricter standardization procedures for production of TCMs is warranted.
*Drug Contamination ; Drugs, Chinese Herbal/*adverse effects/chemistry ; Humans ; Medicine, Chinese Traditional ; Medicine, Korean Traditional ; Metals, Heavy/*poisoning ; *Poisoning ; Republic of Korea ; Risk Assessment

A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.
Animals ; Carbon Tetrachloride Poisoning ; Chemical and Drug Induced Liver Injury ; blood ; etiology ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Glycodeoxycholic Acid ; blood ; Lysophosphatidylcholines ; blood ; Male ; Metabolomics ; Phenylalanine ; blood ; Plants, Medicinal ; chemistry ; Principal Component Analysis ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; Tryptophan ; blood

OBJECTIVETo investigate the effects of ancient Chinese medical formula Xiayuxue Decoction ([symbols; see text], XYXD) on activation of hepatic stellate cells (HSCs) and defenestration of sinusoidal endothelial cells (SECs) in CCl4-induced fibrotic liver of mice.

METHODSHigh performance liquid chromatography was used to identify the main components of XYXD and control the quality of extraction. C57BL/6 mice were induced liver fibrosis by CCl4 exposure and administered with XYXD for 6 weeks simultaneously. Liver tissue was investigated by hematoxylin-eosin and Sirius-red staining. Sinusoidal fenestrations were observed by scanning electronic microscopy and fluorescent immunohistochemistry of PECAM-1 (CD31). Whole liver lysates were detected of α-smooth muscle actin (α-SMA) and type-I collagen by Western blot. Primary rat HSCs-T6 cells were analyzed by detecting α-SMA, F-actin, DNA fragmentation through confocal microscopy, Western blot, terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) assay and cellomics arrayscan, respectively.

RESULTSAmygdalin and emodin in XYXD were identified. XYXD (993 mg/kg) inhibited Sirius red positive area up to 70.1% (P<0.01), as well as protein levels of α-SMA and type-I collagen by 42.0% and 18.5% (P<0.05) respectively. In vitro, XYXD (12.5 μg/mL, 50 μg/mL) suppressed the activation of HSCs and reversed the myofibroblastic HSCs into quiescent, demonstrated as inhibition of fluorescent F-actin by 32.3% and 46.6% (P<0.05). Besides, XYXD induced the apoptosis of HSC-T6 cells by 20.0% (P<0.05) and 49.5% (P<0.01), evidenced by enhanced TUNEL positivity. Moreover, ultrastructural observation suggested XYXD inhibited defenestration of SECs, which was confirmed by 31.1% reduction of protein level of CD31 (P<0.05).

CONCLUSIONSXYXD inhibited both HSCs activation and SECs defenestration which accompany chronic liver injuries. These data may help to understand the underlying mechanisms of XYXD for prevetion of chronic liver diseases.

Actins ; metabolism ; Animals ; Carbon Tetrachloride Poisoning ; drug therapy ; Collagen Type I ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Endothelium ; drug effects ; pathology ; Hepatic Stellate Cells ; drug effects ; pathology ; ultrastructure ; Liver Cirrhosis ; chemically induced ; drug therapy ; pathology ; Male ; Mice, Inbred C57BL ; Microscopy, Electron, Scanning ; Myofibroblasts ; drug effects ; pathology ; ultrastructure ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Primary Cell Culture ; Rats, Sprague-Dawley

No abstract available.
Adult ; Anemia, Hemolytic/diagnosis/*etiology/therapy ; Colic/diagnosis/*etiology/therapy ; Drug Contamination ; Drugs, Chinese Herbal/*adverse effects ; Female ; Humans ; Lead Poisoning/diagnosis/*etiology/therapy ; Risk Factors ; Treatment Outcome

OBJECTIVETo observe the effects of Guipi Pill (GPP) on bone marrow cell cycle of mice exposed to benzene and to explore its possible mechanisms for regulating hematopoiesis.

METHODSSeventy-two Kunming mice were randomly divided into 6 groups, i.e., the normal control group, the model group, the Western medicine treatment group, the large, middle, and small dose GPP groups, 12 in each group. The mice were exposed to manually simulated high concentrations of benzene fqr eight h every day, fourteen successive days, to replicate benzene intoxication model. Mice in the large, middle, and small dose GPP groups were administered with 8, 4, 2 mg/kg GPP per day respectively by gastrogavage. Mice in the Western medicine treatment group were administered with leucogen (at the daily dose of 1.5 mg/kg) and batyl alcohol (at the daily dose of 5 mg/kg) by gastrogavage. Mice in the model group and the normal control group were administered with normal saline by gastrogavage, once daily, for 3 successive weeks. The nucleated bone marrow cell count and the cell cycle of bone marrow cells were detected using flow cytometry.

RESULTSCompared with the normal control group, the nucleated bone marrow cell count obviously decreased in the model group (P <0.05). Compared with the model group, the nucleated bone marrow cell count obviously increased in the large and small dose GPP groups, and the Western medicine treatment group (P <0.01). Compared with the normal control group, the S phase cell ratio and proliferation index (PI) increased, and the G0/G1 phase cell ratio decreased in the model group, showing statistical difference (P <0.05). The G0/G1 phase cell ratio decreased, while the G2/M phase cell ratio and PI increased in the large dose GPP group. The S phase cell ratio decreased in the middle dose GPP group, showing statistical difference when compared with the model group (P <0.01, P <0.05). Compared with the Western medicine treatment group, the G2/M phase cell ratio and PI increased, and the G0/G1 phase cell ratio decreased in the large dose GPP group, showing statistical difference (P <0.01).

CONCLUSIONGPP could promote the recovery of hematopoietic functions of benzene exposed mice by ending off G1 or G2-phase arrest, accelerating G0/G1-S phase and S-G2/M phase transition, promoting the proliferation of bone marrow hematopoietic cells, and improving the peripheral hemogram.

Animals ; Benzene ; poisoning ; Bone Marrow Cells ; cytology ; drug effects ; Cell Cycle ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Female ; Male ; Mice ; Mice, Inbred Strains

It is valuable to establish a chemical-pharmacokinetic (PK)-pharmacodynamics (PD) fingerprint of traditional Chinese medicine (TCM) for comprehensively understanding the TCM integrated conception and revealing the material foundation. The chemical, metabolic in vitro, and PK/PD in vivo fingerprints of Schisandra chinensis (SC) alcoholic extract were established and comparatively analyzed using HPLC-UV-MS method, rat liver microsomes in vitro and CCl4 intoxicated rats in vivo. Four known effective lignans, schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin, were detected as the standard references in SC alcoholic extract with high concentration. SC alcoholic extract and four lignans when incubated with rat liver microsomes produced several metabolites in NAPDH-dependent manner. Chemical fingerprint of some components with bioactivities were also identified in PK and PD fingerprints in normal and ALI rats that explained the material foundation of SC alcoholic extract for multiple pharmacological effects. Schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin could be considered as the "PK marker" of SC alcoholic extract or its relevant preparations, while two metabolites of the four lignans, 7, 8-dihydroxy-schizandrin and another one (M(W) 432), could be recognized as drug-metabolism (DM) Marker. This work provides experimental data for the further studies of metabolism or material foundation of SC components.
Alanine Transaminase ; blood ; Animals ; Carbon Tetrachloride Poisoning ; Chemical and Drug Induced Liver Injury ; blood ; Chromatography, High Pressure Liquid ; Cyclooctanes ; isolation & purification ; pharmacokinetics ; pharmacology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacokinetics ; pharmacology ; Lignans ; isolation & purification ; pharmacokinetics ; pharmacology ; Male ; Microsomes, Liver ; metabolism ; Plants, Medicinal ; chemistry ; Polycyclic Compounds ; isolation & purification ; pharmacokinetics ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Schisandra ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Spectrophotometry, Ultraviolet