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Objective:To investigate the clinical efficacy and adverse reactions of Xingnaojing injection combined with insulin pump in treatment of severe craniocerebral injury (STBI) complicated with diabetes mellitus.Methods:Data of 102 patients with STBI combined with diabetes mellitus admitted from Jan. 2017 to Jan. 2020 in the Surgical Intensive Care Unit of Yantaishan Hospital were prospectively analyzed. Their average age was (48.27±4.20) years. They were randomly divided into group A (34 cases, treated with simple decompression) , group B (34 cases, treated with insulin pump combined decompression) and group C (34 cases, treated with Xingnaojing injection and insulin pump combined decompression) . Fasting blood glucose (FPG) , 2 h postprandial blood glucose level (2 h PG) , interleukin 2 (IL-2) , interleukin 6 (IL-6) , serum high sensitivity C-reactive protein (hs CRP) and glasgow coma scale (GCS) was different, and the incidence of adverse reactions was recorded. SPSS 23.0 statistical software was used for data processing. The measurement data were mean±standard deviation, and t test was used; the counting data were expressed in (%) and χ 2 inspection was used. Results:After treatment, there was no significant difference in 2 h PG, FPG, IL-2, IL-6, hs CRP or GCS scores between group A and group B ( P>0.05) . After treatment, the levels of 2 h PG and FPG were (8.89±1.74) mmol/L and (7.53±1.59) mmol/L in group C, (7.30±1.62) mmol/L and (6.25±1.50) mmol/L in group A, (7.32±1.64) mmol/L and (6.29±1.56) mmol/L in group B. The levels in group C were higher than those in group A and group B ( P<0.05) . The levels of IL-2, IL-6 and hs CRP in group C were (792.74±86.58) ng/L, (8.82±1.73) ng/L and (7.95±1.44) mg/L respectively. The three indexes were (880.85±90.29) ng/L, (13.85±2.20) ng/L and (14.02±2.28) mg/L respectively in group A; (875.37±89.72) ng/L, (13.34±2.18) ng/L, and (13.37±2.26) mg/L respectively in group B. Group C was lower than group A and group B ( P<0.05) . The GCS score of group C was 11.45±2.23 (points) , and that of group A and group B were 8.09±1.52 (points) and 8.73±1.56 (points) respectively. Group C was higher than that of group A and group B ( P<0.05) . Compared with group A and group B, the incidence of adverse reactions in group C was lower, and the difference was statistically significant ( P<0.05) . Conclusion:Xingnaojing injection and insulin pump combined with decompression are of great significance in reducing adverse reactions and improving the safety of clinical treatment.
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To overview of systematic reviews/Meta-analysis of Xingnaojing Injection(XNJ) in the treatment of intracerebral hemorrhage(ICH). The systematic reviews concerning XNJ in the treatment of ICH were retrieved from four Chinese databases, four English databases, Chinese Clinical Trial Registry and ClinicalTrail.gov, with the retrieval time set from their inception to September 2020. Following the independent screening and data extraction by two researchers, a measurement tool to assess systematic evaluation 2(AMSTAR 2) and grades of recommendation, assessment, development and evaluation(GRADE) system were used to evaluate the metho-dological, reporting and evidence qualities of the 10 included systematic reviews. The results showed that XNJ was superior to the wes-tern medicine or conventional treatment in improving the effective rate and National Institutes of Health stroke scale(NIHSS) score, Barthel index(BI), and Glasgow coma scale(GCS) score and Chinese stroke scale(CSS) score, and reducing the mortality and cerebral hematoma volume, without inducing obvious adverse reactions. In general, the methodological, reporting and evidence qualities of the 10 included systematic reviews were poor. The AMSTAR 2 scores showed that key items No. 2 and No. 16 failed to meet the stan-dard, resulting in poor methodological quality. There was only one outcome indicator graded by GRADE as intermediate quality, 43% indicators as low quality, 42% indicators as extremely low quality, and none as high quality. These available evidences have suggested that the methodological, reporting and evidence qualities of the systematic evaluation concerning XNJ for the treatment of ICH need to be improved. Most evidences support that XNJ was better than the western medicine or conventional treatment in the treatment of ICH, but the methodological quality and the reliability of outcome indicators in relevant systematic review were low. More high-quality studies are still required for further verification.
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Humans , Cerebral Hemorrhage/drug therapy , Drugs, Chinese Herbal , Meta-Analysis as Topic , Reproducibility of Results , Systematic Reviews as Topic , United StatesABSTRACT
There have been many clinical trials, systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke, but with fewer comprehensive descriptions. In this study, an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice. CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science were retrieved through computers. A total of 6 literatures were included in this study. By AMSTAR-2 checklist and GRADE, the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated. The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews. According to the results of GRADE evaluation, among 55 outcomes, there were 2 outcomes with a medium quality, 4 outcomes with a low quality and 49 outcomes with an extremely low quality. The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke. This therapy could improve the total efficacy, neurological deficit scores, hemodynamic and hemodynamic parameters. However, the methodolo-gical quality of all literatures was extremely low. The evidence levels of outcomes were between extremely low to medium. The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies. In the future, relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.
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Humans , Brain Ischemia/drug therapy , Drugs, Chinese Herbal , Ischemic Stroke , Stroke/drug therapy , Systematic Reviews as TopicABSTRACT
To analyzed the actual clinical application of Xingnaojing Injection in treating cerebral infarction in the real world, selected HIS(hospital information system) database of inpatients in 39 hospitals across the country, and conducted descriptive analysis and association rule analysis on the information of 11 674 patients with cerebral infarction using Xingnaojing Injection. The results showed that the average age of the patients was 69.69 years. TCM syndrome of phlegm stasis and collaterals stagnation was the most(37.56%), followed by wind-phlegm obstruction of collaterals(19.01%). Virtual syndrome accounted for 21.06%. Intravenous drip was the most important route of administration(96.50%). Iv infusion single dose of 10-20 mL(52.44%), other off-label doses accounted for a larger proportion(47.56%). Continuous use of the drug within 3 days(55.45%), 15-28 days accounted for 6.96%, >28 days accounted for 0.89%. The top 10 Western drugs used in combination mainly include antihypertensive drugs, acid-suppressing drugs to protect stomach, drugs to improve brain circulation, drugs to protect brain nerves and drugs to fight infection. The top 10 of Chinese patent medicines are mainly activating blood circulation and removing stasis, clearing heat and clearing the surface, etc. According to the analysis of association rules, three types of clinical drug use modes for the combination of Chinese and Western medicine were obtained, mainly including the first type: Xingnaojing Injection+nifedipine(nifedipine, nifedipyridine, Lixinping)+levoflo-xacin+Huayu Tongmai agent. The second category: Xingnaojing Injection+omeprazole+edaravone+Huayu Tongmai agent; The third category: Xingnaojing Injection+ganglioside and ganglioside derivatives+edaravone+Huayu Tongmai agent. The results show that Xingnaojing Injection is not a standard drug in the treatment of cerebral infarction. At the same time, the combined use of drugs is mainly recommended by the guidelines and conventional treatment drugs, reflecting the clinical application of integrated traditional Chinese and Western medicine.
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Aged , Humans , Cerebral Infarction , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Medicine, Chinese TraditionalABSTRACT
@#Objective: To observe whether an Xingnaojing 醒脑静 injection could improve the prognosis of patients, by increasing rifampicin penetration through the blood-brain barrier. Methods: Patients with severe tuberculous meningitis were enrolled in this study. The concentrations of Xingnaojing in cerebrospinal fluid and blood in patients treated with Xingnaojing and control were determined by high performance liquid chromatography. The changes in cerebrospinal fluid and the improvement of clinical symptoms and signs, were evaluated two weeks after admission. The long-term prognosis of the patients in the two groups were evaluated by the Glasgow Outcome Scale (GOS). Results: The concentration of rifampicin in cerebrospinal fluid was significantly higher in the Xingnaojing group (1.77±0.17 μg/mL), than in the control group (1.27±0.16 μg/mL, p<0.05). The difference in concentration of rifampicin in the blood was not significant (P>0.05). The short-term effective rate of the Xingnaojing group was 92.5% (37/40), which was significantly higher than that of the control group (80%, 32/40, p<0.05). After 6 months, 75% (30/40) of the Xingnaojing group had good prognosis according to the GOS score, whereas that of the control group was 50% (20/40) showing significantly better long-term treatment effect of the Xingnaojing group compared to the control group (P<0.05). Conclusion: Xingnaojing injection improved rifampicin penetration into the central nervous system. The increase in rifampicin concentration in cerebrospinal fluid improved outcomes in patients with severe tuberculous meningitis.
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In this study, Tabu search algorithm was used to analyze the effect of Xingnaojing Injection in the treatment of cerebral hemorrhage in the real world. Through the analysis of the results, the therapies based on the pathogeny of cerebral hemorrhage were screened out: Xingnaojing Injection+hemostatic drugs for promoting blood circulation and removing stasis. Cerebral hemorrhage complicated with brain edema: combined with mannitol or mannitol+aescin. The patients with relevant complications in the acute stage of cerebral hemorrhage could select according to the indications: ①Aminocycline+Oxiracetam+Piperacillin Sodium Sulbactam Sodium+Sodium Lactate Ringer; ②Aminocycline+Oxiracetam+Nifedipine+Captopril+Metoclopramide+Cimetidine; ③Insulin+Pantoprazole+So-dium Nitroprusside. The combined therapies for patients of the stable stage with complicating diseases could select according to the indications: ① Monosialotetrahexosyl Ganglioside Sodium+Deproteinized Calf Blood Serum+Nitroglycerin+Compound Potassium Dihydrogn Phosphate; ② Edaravone+Gangliosides+Captopril+Levofloxacin+Tanreqing Injection+Aminophylline. The analysis of subgroup module of drugs for promoting blood circulation and removing blood stasis suggested that the safety of traditional Chinese medicine should be paid attention to in the treatment of cerebral hemorrhage. This study was based on the data of the real world, but with some problems, such as lack of data and confounding factors. The summarized medication plan is only for the reference of clinicians. The clinical application shall be based on the specific situation of patients and the clinical benefits and risks, and pay attention to the incompatibility.
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Humans , Algorithms , Brain Edema , Cerebral Hemorrhage , Drugs, Chinese Herbal , Medicine, Chinese TraditionalABSTRACT
In this study, Tabu search algorithm was used to analyze the drug combination of Xingnaojing Injection in the treatment of brain injury and complications in the real world, and the clinical drug combination of Xingnaojing Injection in the treatment of brain injury and complications was selected and summarized. The combination of Xingnaojing Injection, Namefen and Citicoline were recommended in the treatment of brain injury and complications. For brain edema and nerve injury, Mannitol/Glycerol Fructose/Furosemide+Tetrahexose Monosialate Ganglioside Sodium should be recommended. For those with pulmonary infection, Xingnaojing Injection+Xiyanping+Ambroxol Hydrochloride+Tanreqing Injection should be recommended. For those with shock, Hydroxyethyl Starch+Dopamine Hydrochloride/Dobutamine Hydrochloride+Sodium Bicarbonate should be recommended. The combination reflected the characteristics of Chinese and Western medicine. The above medication regimen was only for clinicians' reference. The clinical application should be based on patients' specific conditions, clinical benefits and risks, as well as the incompatibility. On the basis of the findings, further studies can be carried out for prospective clinical efficacy evaluation and safety evaluation for a specific subgroup module.
Subject(s)
Humans , Algorithms , Drugs, Chinese Herbal , Injections , Medicine, Chinese Traditional , Prospective StudiesABSTRACT
To explore the population characteristics and clinical application characteristics of patients with cerebral hemorrhage treated with Xingnaojing Injection in real world. The model was established by Apriori algorithm, and the general information and medication information of 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection were analyzed by using Clementine 12.0 in the databases of information systems of 33 class Ⅲ grade A hospitals in China. The results showed that among the 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection, the median age was 59 years old. And the male to female ratio was about 1.74∶1. Most of them did manual labor(31.26%), and were hospitalized in winter(27.46%), especially during the Cold Dew(5.1%). The majority of the patients were in a stable condition(50.94%), and preferred neurosurgery department(48.82%). 29.03% of patients were hospitalized for 15-28 days, and 42.47% of patients spent 10 000-50 000 Yuan of hospitalization expenses. The single dose of Xingnaojing Injection was 10-20 mL at most(46.03%). And the course of medication was mostly 3 days or less(68.60%). Lidocain was the most frequently used Western medicine in drug combination(5.05%), and Huayu Tongmai Ji was the most frequently used traditional Chinese medicine in drug combination(10.73%). The most frequently used one type of traditional Chinese medicine combined with one type of Western medicine was Huayu Tongmai Ji + Dexamethasone(8.08%). The most frequently used two Western medicines in drug combination were Omeprazole + Dexamethasone(5.07%). Prilosec + Dexamethasone + Lidocaine(3.35%) were three Western drugs with the most frequent combination. When the dosage was 10-20 mL and the number of days of treatment was > 15 days, the largest number of the patients was cured and improved(44.78%, 45.85%). The results showed that cerebral hemorrhage patients treated with Xingnaojing Injection were mostly middle-aged and elderly people, with more males than females. Brain hemorrhage often occurred in winter and spring. Xingnaojing Injectiont was often combined with glucocorticoids, proton pump inhibitors and cardiovascular drugs to prevent cerebral hemorrhage complications. The clinical medication met the guidelines for the treatment of cerebral hemorrhage. Some patients had over-treatment use, which can provide a reference for clinicians in treating cerebral hemorrhage.
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Aged , Female , Humans , Male , Middle Aged , Cerebral Hemorrhage , China , Drugs, Chinese Herbal , Medicine, Chinese TraditionalABSTRACT
Objective:To investigate the compatible stability of Xingnaojing injection in combination with 9 common medicines, and to provide a reference for clinical application of this injection. Method:According to the clinical application, Xingnaojing injection was mixed with 9 common medicines and placed in the room under dark and light conditions for 6 h. The appearance of compatible solutions was observed, and the HPLC fingerprint was analyzed by similarity evaluation and principal component analysis(PCA). Result:There were no significant changes in the appearance of compatibility of Xingnaojing injection and 9 common medicines, including piracetam and sodium chloride injection, sodium chloride injection and others. The similarities of fingerprint among compatibility of Xingnaojing injection and 9 common medicines were >0.98 at 0 h of compatibility, 6 h of placement and 6 h of illumination. The results of PCA showed that 9 groups of compatible solutions were clustered into 2 categories, the compatibility of Xingnaojing injection and 8 groups including piracetam and sodium chloride injection clustered into one category, and the relative peak areas of the characteristic components of Xingnaojing injection did not change significantly after compatibility, the compatibility of Xingnaojing injection and Danshen Chuanxiongqin injection clustered into another category, the relative peak areas of some characteristic components of Xingnaojing injection increased after compatibility of 0 h and 6 h,and it was more obvious after 6 h of illumination. Conclusion:The compatibility of Xingnaojing injection and 8 common medicines including piracetam and sodium chloride injection has good stability, while the compatibility has stability problems after Xingnaojing injection mixed with Danshen Chuanxiongqin injection. It is suggested that clinical attention should be paid to their compatibility and rational combination of medicines.
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Objective To investigate the effect of Xingnaojing injection combined with ambroxol hydrochloride on precalcitonin (PCT),C-reactive protein (CRP) and white blood cell count (WBC) in the elderly patients with severe pneumonia,and to observe the clinical effect.Methods From December 2013 to March 2015,94 cases of severe pneumonia in Zhejiang Quhua Hospital were selected and divided into treatment group and control group according to the random digital table method,with 47 cases in each group.The control group was treated with ambroxol hydrochloride,while the treatment group was treated with Xingnaojing injection on the basis of the control group.The main symptom scores,blood gas analysis indicators,PCT,CRP and WBC changes and therapeutic effects were compared between the two groups before and after treatment.Results After treatment,the fever score and cough score in the treatment group [(1.03 ± 0.25) points,(1.12 ± 0.29) points] were significanly lower than those in the control group [(2.17 ± 0.42) points,(2.34 ± 0.71) points] (t =15.989,10.905,all P ＜ 0.05).After treatment,the PaO2 of the treatment group [(89.47 ± 8.41) mmHg] was higher than that of the control group [(76.39 ± 5.63) mmHg],while PaCO2 [(48.37 ± 7.19) mmHg] was lower than that in the control group [(63.27 ± 3.48) mmHg],the differences were statistically significant (t =8.860,12.780,all P ＜ 0.05).After treatment,the serum levels of PCT,CRP and WBC in the treatment group were (5.41 ± 0.97) ng/L,(48.98 ± 8.97) mg/L,(7.82 ± 1.23) × 109/L,respectively,which were significanly lower than those in the control group [(7.98 ± 1.47) ng/L,(76.45 ± 12.54) mg/L and (12.56 ± 1.89) × 109/L] (t =10.004,12.214,14.410,all P ＜ 0.05).The total effective rate in the treatment group(91.49％) was higher than that in the control group (72.34％),and there was statistically significant difference (x2 =5.817,P ＜ 0.05).Conclusion Xingnaojing injection combined with ambroxol can reduce the changes of serum PCT,CRP and WBC in the elderly patients with severe pneumonia,and the curative effect is significant.It is worthy of clinical study.
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OBJECTIVES@#To investigate the effectiveness and safety of Xingnaojing Injection (XNJ, ) compared with naloxone for the treatment of acute alcohol intoxication (AAI), and provide the latest evidence through evidence-based approach.@*METHODS@#Seven electro-databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure Databases, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database (VIP) and Wanfang Database were searched from the inception to January 2018. Randomized controlled trials (RCTs) comparing XNJ with naloxone for patients with AAI and reporting at least one of the below outcomes were included: patients' conscious recovery time, stay length in emergency department, disappearance time of the ataxia symptom, the severity of the symptoms, the blood alcohol content as well as the adverse events. Methodological quality of included trials was assessed using the risk of bias tool which recommended by the Cochrane Collaboration. Meta-analysis was conducted by Review Manager 5.3 software.@*RESULTS@#Totally 141 trials with 13,901 patients were included in this review, all of them were assessed as unclear or high risk of bias. Results showed that on the basis of routine therapy, standard dose XNJ (10-20 mL) may have similar results with naloxone on the recovery time of consciousness (MD 12 min, 95% CI 7.2-17.4 min) and disappearance time of symptoms (MD 6 min, 95% CI-13.8-25.8 min) for patients with AAI. Larger dose of XNJ Injection (21-40 mL) may speed up the time (almost 1 h earlier). Combination of XNJ and naloxone seemed superior to the naloxone alone for all the relevant outcomes. The average difference of time in consciousness recovery was 2 h and the number of AAI patients whose consciousness recovery within 1 h was above 50% the combination group than in the control group (RR 1.42, 95% CI 1.29 to 1.56). No severe adverse events or adverse reactions of XNJ were reported in the included trials.@*CONCLUSIONS@#Low quality of evidence showed XNJ may have equal effect as naloxone and may achieve better effect as add-on intervention with naloxone for patients with AAI. We failed to evaluate the safety of XNJ Injection due to the insufficient evidence in this review. Registration number. in PROSPERO (No. CRD42018087804).
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OBJECTIVE Xingnaojing injection(XNJ)is an extracts of Angong Niuhuang Pill that is a well-known traditional Chinese medicine used for the treatment of septicemia and stroke.This study aims to investigate the effect of XNJ on intestinal mucosal barrier in septicemia and intracerebral hem-orrhage(ICH)mice models.METHODS The septicemia mice models were induced by intravenous in-jection with lipopolysaccharide(20 mg·kg-1).And the ICH mice models were made by intrastriatal injec-tion of bacterial collagenase. The septicemia animals were treated intravenously with XNJ at dose of 2.5,5,10,or 15 mL·kg-1.The ICH animals were treated intravenously with XNJ at dose of 10 mL·kg-1. Thereafter, the permeability of intestinal mucosa was assayed by FITC-D method. RESULTS Com-pared with the control group(44.72±4.30),the permeability of intestinal mucosa in the mice in septice-mia group (233.68±28.18) was significantly increased (P<0.01). Treatment with XNJ at dose of 5, 10, and 15 mL·kg-1reduced the permeability of intestinal mucosa (150.45 ± 17.52,139.21 ± 17.05,132.55 ± 18.88,respectively, P<0.01)except 2.5mL·kg-1(240.71±21.42,P>0.01);Compared with sham group (57.88±7.31),the permeability of intestinal mucosa in the mice of ICH(282.25±23.78)was significantly in-creased(P<0.01). Treatment with XNJ (10 mL·kg-1)in the mice of ICH group ameliorated the change of permeability in intestinal mucosa (148.83±15.86, P<0.01). CONCLUSION XNJ exhibits the protec-tive effect on the intestinal mucosal barrier in septicemia and ICH, which will prevent the endotoxin to penetrate the intestinal mucosa and then to enter the circulation in infections and stress.
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OBJECTIVE: To explore the effects of Xingnaojing injection combined with modified large bone flap decompression on postoperative intracranial pressure (ICP) and serum inflammatory factors in patients with severe traumatic brain injury (STBI).METHODS: In retrospective analysis, STBI patients were selected from Wuhan Municipal Third Hospital during May 2014-Nov. 2016, and then divided into control group and observation group according to therapy plan, with 32 cases in each group. Control group received modified large bone flap decompression and rountine postoperative infection. Observation group was given Xingnaojing injection 30 mL, once a day, after modified large bone flap decompression, for consecutive 30 d. ICP levels and GCS score were compared between 2 groups 3, 5, 7 d after surgery. The levels of serum inflammatory factors (hs-CRP, TNF-α, IL-2, IL-6) were compared before surgery and 7 d after surgery. SF-36 score were observed before surgery and one month after surgery. GOS grading and the incidence of complication were observed one month after surgery. RESULTS: There was no statistical significance in baseline information between 2 groups (P>0. 05). Before surgery, there was no statistical significance in GCS score, serum inflammatory factor level or SF-36 score between 2 groups (P>0. 05). GOS grading of observation group was better than that of control group after surgery (P<0. 05). Compared with control group, the levels of ICP in observation group were decreased significantly 3, 5, 7 d after surgery (P<0. 05), while GCS score was increased significantly (P<0. 05); 7 d after surgery, the levels of serum inflammation factors were decreased significantly (P<0. 05). SF-36 score was increased significantly one month after surgery (P<0. 05), and the incidence of incisional hernia and acute encephalocele were decreased significantly (P<0. 05); there was no statistical significance in the incidence of delayed hematoma, hydrocephalus or interstitial brain edema (P>0. 05). CONCLUSIONS: Prognosis effect of Xingnaojing injection combined with modified large bone flap decompression may be better than modified large bone flap decompression alone in the treatment of STBI, and there is difference between them.
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In this study, different batches of Xingnaojing injection products were first selected for pseudoallergic mice test, and the results showed that after injection of 6.6-fold clinical dose Xingnaojing injection, the mice showed a slight pseudoallergic reaction, while other mice injected with other batches of injections showed no obvious pseudoallergic reaction. Therefore, it is preliminarily believed that this mice model can effectively indicate the risk of pseudoallergic reactions in the clinical application of Xingnaojing injections. In addition, by changing some of the processes, a high concentration of Xingnaojing injection was prepared for mice pseudoallergic test and guinea pig systemic allergy test. The results showed no significant type Ⅰ allergic reaction in guinea pigs. Mild pseudoallergic reactions occurred in mice after a 6.6-fold clinical dose injection. Therefore, it is considered that for sensitive or idiosyncratic people, the concentration of certain chemical components in Xingnaojing injection will increase after entering the body, which may increase the risk of pseudoallergic reaction. However, due to the limitations of test models, the risk of Xingnaojing injection to induce allergic reactions cannot be ruled out. Finally, by increasing the content of borneol and Tween and (or) sodium chloride in Xingnnaojing Injection and testing its pseudoallergic reactions, the results showed that the combination of these three ingredients may produce new trace sensitization substance and induce pseudoallergic reactions.
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This paper aimed to explore the molecular mechanism of Xingnaojing injection and its scientific connotation of compatibility mechanism from a new perspective on bioinformatics and network biology. Based on the analysis function of intergrative pharmacology platform V1.0, the compatibility mechanism of this prescription was investigated by constructing the herbs-compounds-targets network. Seven hundreds and ninety-five targets from the prescription were screened out, then 302 hub nodes were included in drug targets-disease targets network. Enrichment analysis showed that it was related to MAPK cascade, negative/positive regulation of apoptotic process and other biological functions as well as PI3K/AKT, neurotrophin and other signal pathways. The target functions of different drugs were similar, complementing each other, and belonging to the common signaling pathway with asynergistic effect. Based on analysis of core components-key targets-main pathway network, among totally 25 core components and 29 key targets, musk had 15 and 25 respectively.SLC1A2, AR, PGR, CAT, NMDA receptors and other targets were associated with cerebral infarction. Musk, gardenia and borneol compatibility can play a bidirectional regulation of apoptosis; musk and gardenia showed synergistic effect on Ras signaling pathway, indicating that musk was the main ingredient of the injection and the other three drugs played the role of assistance. This study could not only provide the bioinformatics support in compatibility mechanism of Xingnaojing injection, but also provide theoretical support for its formula rationality.
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OBJECTIVE@#To elucidate the action mechanism of Xingnaojing Injection (, XNJI) for sepsis, and to target screen the potential bioactive ingredients.@*METHODS@#An integrated protocol that combines in silico target screen (molecular docking) and database mapping was employed to find the potential inhibitors from XNJI for the sepsis-related targets and to establish the compound-target (C-T) interaction network. The XNJI's bioactive components database was investigated and the sepsis-associated targets were comprehensively constructed; the 3D structure of adenosine receptor A2a and 5-lipoxygenase proteins were established and evaluated with homology modeling method; system network pharmacology for sepsis treatment was studied between the bioactive ingredients and the sepsis targets using computational biology methods to distinguish inhibitors from non inhibitors for the selected sepsis-related targets and C-T network construction.@*RESULTS@#Multiple bioactive compounds in the XNJI were found to interact with multiple sepsis targets. The 32 bioactive ingredients were generated from XNJI in pharmacological system, and 21 potential targets were predicted to the sepsis disease; the biological activities for some potential inhibitors had been experimentally confirmed, highlighting the reliability of in silico target screen. Further integrated C-T network showed that these bioactive components together probably display synergistic action for sepsis treatment.@*CONCLUSIONS@#The uncovered mechanism may offer a superior insight for understanding the theory of the Chinese herbal medicine for combating sepsis. Moreover, the potential inhibitors for the sepsis-related targets may provide a good source to find new lead compounds against sepsis disease.
Subject(s)
Humans , Arachidonate 5-Lipoxygenase , Metabolism , Computer Simulation , Drug Evaluation, Preclinical , Drugs, Chinese Herbal , Chemistry , Pharmacology , Therapeutic Uses , Injections , Phytochemicals , Therapeutic Uses , Receptor, Adenosine A2A , Metabolism , Reproducibility of Results , Sepsis , Drug Therapy , MetabolismABSTRACT
OBJECTIVE:To explore clinical efficacy and safety of Ulinastatin injection combined with Xingnaojing injec-tion in the treament of severe craniocerebral injury(CCI). METHODS:A total of 120 severe CCI patients selected from our hospital during Sept. 2014-Nov. 2015 were divided into ulinastatin group,Xingnaojing group and combination group according to therapy plan,with 40 cases in each group. Three groups were given routine treatment timely after admission. On the basis of routine treatment,Ulinastatin group additionally received Ulinastatin injection 200 000 U,ivgtt,bid;Xingnaojing group addi-tionally received Xingnaojing injection 20 mL,ivgtt,qd;combination group additionally received Ulinastatin injection com-bined with Xingnaojing injection,same usage as above(with 1 h intervals). Three groups received therapy for consecutive 14 d. Serum inflammatory factors(CRP,IL-1,IL-6,TNF-α),serologic indexes of craniocerebral injury [neuron specific enolase (NSE),myelin basic protein(MBP),S100B protein(S100B)] and GCS scores before and after treatment as well as GOS scores after treatment were all observed in 3 groups. The occurrence of ADR was recorded during treatment. RESULTS:Before treatment,there was no statistical significance in serum inflammatory factors,serologic indexes of craniocerebral injury or GCS scores among 3 groups(P>0.05). Compared to before treatment,inflammatory factors of 3 groups were decreased signifi-cantly after treatment,the ulinastatin group was significantly lower than the Xingnaojing group,combination group was signifi-cantly lower than two single drug groups,with statistical significance(P<0.05). Levels of serologic indexes of craniocerebral injury and GCS scores of 3 groups were improved significantly,and the combination group was significantly better than the two single drug groups,with statistical significance(P<0.05). There was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). Six months after treatment,GOS score of combination group(4.17±0.81)was significantly better than those of ulinastatin group(3.05±0.97)and Xing-naojing group(2.97 ± 0.89),with statistical significance (P<0.05);there was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). During treatment,the incidence of ADR in combination group(27.50%)was significantly lower than ulinastatin group(50.00%)and Xingnaojing group(42.50%),with statistical significance(P<0.05);there was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). CONCLUSIONS:Ulinastatin injection combined with Xingnaojing injection can sig-nificantly decrease serum inflammatory factor levels,relieve craniocerebral injury,protect cerebral tissue and improve short-term prognosis with good safety.
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OBJECTIVE:To explore clinical efficacy and safety of Ulinastatin injection combined with Xingnaojing injec-tion in the treament of severe craniocerebral injury(CCI). METHODS:A total of 120 severe CCI patients selected from our hospital during Sept. 2014-Nov. 2015 were divided into ulinastatin group,Xingnaojing group and combination group according to therapy plan,with 40 cases in each group. Three groups were given routine treatment timely after admission. On the basis of routine treatment,Ulinastatin group additionally received Ulinastatin injection 200 000 U,ivgtt,bid;Xingnaojing group addi-tionally received Xingnaojing injection 20 mL,ivgtt,qd;combination group additionally received Ulinastatin injection com-bined with Xingnaojing injection,same usage as above(with 1 h intervals). Three groups received therapy for consecutive 14 d. Serum inflammatory factors(CRP,IL-1,IL-6,TNF-α),serologic indexes of craniocerebral injury [neuron specific enolase (NSE),myelin basic protein(MBP),S100B protein(S100B)] and GCS scores before and after treatment as well as GOS scores after treatment were all observed in 3 groups. The occurrence of ADR was recorded during treatment. RESULTS:Before treatment,there was no statistical significance in serum inflammatory factors,serologic indexes of craniocerebral injury or GCS scores among 3 groups(P>0.05). Compared to before treatment,inflammatory factors of 3 groups were decreased signifi-cantly after treatment,the ulinastatin group was significantly lower than the Xingnaojing group,combination group was signifi-cantly lower than two single drug groups,with statistical significance(P<0.05). Levels of serologic indexes of craniocerebral injury and GCS scores of 3 groups were improved significantly,and the combination group was significantly better than the two single drug groups,with statistical significance(P<0.05). There was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). Six months after treatment,GOS score of combination group(4.17±0.81)was significantly better than those of ulinastatin group(3.05±0.97)and Xing-naojing group(2.97 ± 0.89),with statistical significance (P<0.05);there was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). During treatment,the incidence of ADR in combination group(27.50%)was significantly lower than ulinastatin group(50.00%)and Xingnaojing group(42.50%),with statistical significance(P<0.05);there was no statistical significance between ulinastatin group and Xingnaojing group(P>0.05). CONCLUSIONS:Ulinastatin injection combined with Xingnaojing injection can sig-nificantly decrease serum inflammatory factor levels,relieve craniocerebral injury,protect cerebral tissue and improve short-term prognosis with good safety.
ABSTRACT
Objective To investigate the effect of acupoint injection of Xingnaojing injection on the intelligence development and hemorheology in children with mental retarded cerebral palsy.Methods Sixty patients with cerebral palsy complicated with mental retardation were selected from March 2015 to January 2017 in Anyang Maternal and Child Health Care Hospital.The patients were divided into observation group and control group according to the treatment methods,thirty cases in each group.The patients in the control group were treated with routine treatment and rehabilitation training;based on these,the patients in the observation group were treated with acupoint injection of Xingnaojing injection.The developmental quotient (DQ) was calculated by the children's neuropsychological development scale.The therapeutic effects,intelligence and haemorheology improvement of patients in the two groups were evaluated.Results There was no significant difference in DQ score between the two groups before treatment (t =0.545,P ＞ 0.05).The DQ score after treatment was significantly higher than that before treatment in the two groups (t =9.386,10.057;P ＜ 0.05).The DQ score in the observation group was significantly higher than that in the control group after treatment (t =3.641,P ＜ 0.05).There was no significant difference in hemorheological indexes between the two groups before treatment (P ＞ 0.05).The high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit,platelet adhesion rate and fibrinogen level after treatment were significantly lower than those before treatment in the two groups (P ＜ 0.05).The high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit,platelet adhesion rate and fibrinogen level in the observation group were significantly lower than those in the control group after treatment (P ＜ 0.05).The total effective rate in the control group and observation group was 66.67％ (20/30) and 90.00％ (27/30) respectively,the total effective rate in the observation group was significantly higher than that in the control group (x2 =4.812,P ＜ 0.05).Conclusion Acupoint injection of Xingnaojing injection can significantly improve the intelligence,hemorheology and therapeutic effect in children with cerebral palsy complicated with mental retardation.
ABSTRACT
OBJECTIVE:To investigate the effects and safety of Xingnaojing injection combined with butylphthalide on neuro-logical function,cognitive function,coagulation function and living activity. METHODS:A total of 106 patients with middle cere-bral artery infarction in Wuhan University People's Hospital during Jun. 2014-Dec. 2015 were divided into control group and obser-vation group according to random number table,with 53 cases in each group. Besides routine symptomatic treatment,control group was given Butylphthalide soft capsules 0.2 g,po,tid. Observation group was additionally given Xingnaojing injection 20 mL added into 0.9% Sodium chloride injection 250 mL,ivgtt,qd. Both groups were treated for 14 d. The neurological function score (NI-HSS,NFDS),cognitive function score (MoCA,MMSE),coagulation function indexes (PT,APTT,FIB),BI score were ob-served in 2 groups before and after treatment. The occurrence of secondary remote damage and ADR were recorded. RESULTS:Eight patients withdrew from the study,including 3 patients of control group and 5 of observation group. Before treatment,there was no statistical significance in neurological function scores(NIHSS,NFDS),cognitive function scores(MoCA,MMSE),coag-ulation function indexes or BI scores between 2 groups (P>0.05). After treatment,NIHSS,NFDS scores and FIB of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than the control group,with statistical significance (P0.05). CONCLUSIONS:For middle cerebral artery infarction,the application of Xingnaojing injection combined with butylphthalide can reduce the risk of remote damage,promote the recovery of neurological function and cognitive func-tion,and improve coagulation function and living activity with good safety.