Comparison of Shenfu Injection () and epinephrine on catecholamine levels in a porcine model of prolonged cardiac arrest / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the effects of Shenfu Injection (SFI) and epinephrine (EPI) on catecholamine levels in a porcine model of prolonged cardiac arrest (CA).</p><p><b>METHODS</b>After 8 min of untreated ventricular fibrillation, 24 Wuzhishan miniature pigs were randomly assigned to one of the three groups (n=8 per group) and received central venous injection, respectively: SFI group (1 mL/kg), EPI group (20 μg/kg EPI), and normal saline (NS) group. Cardiac output (CO), maximum rate of increase/decrease in left ventricular pressure (±dp/dt), serum levels of EPI, norepinephrine (NE), and dopamine (DA) were determined at baseline and at 0.5, 1, 2, and 4 h after restoration of spontaneous circulation.</p><p><b>RESULTS</b>The duration of cardiopulmonary resuscitation was shorter in the EPI and SFI groups than in the NS group (P<0.05). The EPI level increased significantly after restoration of spontaneous circulation (ROSC) in all three groups, and was significantly different between the EPI group and the other two groups immediately after ROSC (both P<0.01), but these differences gradually disappeared over time. There were no significant differences in NE or DA levels among the three groups, and there were no correlations between catecholamine levels and CO or dp/dt (P>0.05).</p><p><b>CONCLUSIONS</b>SFI did not significantly affect endogenous catecholamine levels during cardiopulmonary resuscitation after prolonged ventricular fibrillation. However, SFI improved oxygen metabolism, and produced a better hemodynamic status compared with EPI. SFI might be a potentially vasopressor drug for the treatment of CA.</p>

Shen-Fu Injection () alleviates post-resuscitation myocardial dysfunction by up-regulating expression of sarcoplasmic reticulum Ca(2+)-ATPase / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the effect of Shen-Fu Injection (SFI) and epinephrine on the expression of sarcoplasmic reticulum Ca(2+) ATPase 2a (SERCA2a) in a pig model with post-resuscitation myocardial dysfunction.</p><p><b>METHODS</b>Ventricular fibrillation (VF) was electrically induced in Wu-zhi-shan miniature pigs. After 8 min of untreated VF and 2 min of cardiopulmonary resuscitation (CPR), all animals were randomly administered a bolus injection of saline placebo (SA group, n=10), SFI (0.8 mg/kg, SFI group, n=10) or epinephrine (20 μg/kg, EPI group, n=10). After 4 min of CPR, a 100-J shock was delivered. If the defibrillation attempt failed to attain restoration of spontaneous circulation (ROSC), manual chest compressions were rapidly resumed for a further 2 min followed by a second defibrillation attempt. Hemodynamic variables were recorded, and plasma concentrations of catecholamines were measured. Adenylate cyclase (AC), cyclic adenosine monophosphate (cAMP) and the expressions of β1-adrenoceptor (AR) and SERCA 2a were determined.</p><p><b>RESULTS</b>Cardiac output, left ventricular dp/dtmax and negative dp/dtmax were significantly higher in the SFI group than in the SA and EPI groups at 4 and 6 h after ROSC. The expression of β1-AR and SERCA2a at 24 h after ROSC were significantly higher in the SFI group than in the SA and EPI groups (P<0.05 or P<0.01).</p><p><b>CONCLUSIONS</b>The administration of epinephrine during CPR decreased the expression of SERCA2a and aggravated postresuscitation myocardial function (P<0.01). SFI attenuated post-resuscitation myocardial dysfunction, and the mechanism might be related to the up-regulation of SERCA2a expression.</p>

Risk factor analyses for the return of spontaneous circulation in the asphyxiation cardiac arrest porcine model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Animal models of asphyxiation cardiac arrest (ACA) are frequently used in basic research to mirror the clinical course of cardiac arrest (CA). The rates of the return of spontaneous circulation (ROSC) in ACA animal models are lower than those from studies that have utilized ventricular fibrillation (VF) animal models. The purpose of this study was to characterize the factors associated with the ROSC in the ACA porcine model.</p><p><b>METHODS</b>Forty-eight healthy miniature pigs underwent endotracheal tube clamping to induce CA. Once induced, CA was maintained untreated for a period of 8 min. Two minutes following the initiation of cardiopulmonary resuscitation (CPR), defibrillation was attempted until ROSC was achieved or the animal died. To assess the factors associated with ROSC in this CA model, logistic regression analyses were performed to analyze gender, the time of preparation, the amplitude spectrum area (AMSA) from the beginning of CPR and the pH at the beginning of CPR. A receiver-operating characteristic (ROC) curve was used to evaluate the predictive value of AMSA for ROSC.</p><p><b>RESULTS</b>ROSC was only 52.1% successful in this ACA porcine model. The multivariate logistic regression analyses revealed that ROSC significantly depended on the time of preparation, AMSA at the beginning of CPR and pH at the beginning of CPR. The area under the ROC curve in for AMSA at the beginning of CPR was 0.878 successful in predicting ROSC (95% confidence intervals: 0.773∼0.983), and the optimum cut-off value was 15.62 (specificity 95.7% and sensitivity 80.0%).</p><p><b>CONCLUSIONS</b>The time of preparation, AMSA and the pH at the beginning of CPR were associated with ROSC in this ACA porcine model. AMSA also predicted the likelihood of ROSC in this ACA animal model.</p>

Therapeutic effects of Shenfu Injection on post-cardiac arrest syndrome / 中国结合医学杂志

Survival rates after cardiac arrest have not changed substantially over the past 5 decades. Postcardiac arrest (CA) syndrome (PCAS) is the primary reason for the high mortality rate after successful restoration of spontaneous circulation (ROSC). Intravenous administration of Shenfu Injection (, SFI) may attenuate post-CA myocardial dysfunction and cerebral injury, inhibit systemic ischemia/reperfusion responses, and treat underlying diseases. In this article, we reviewed the therapeutic effects of SFI in PCAS. SFI might be useful in the treatment of PCAS, incorporating the multi-link and multi-target advantages of Chinese medicine into PCAS management. Further experimental and clinical research to verify the therapeutic effects of SFI in PCAS is required.

Effects of chest compressions on cardiorespiratory function in a non-arrested porcine model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The effects of chest compressions to hemodynamic and respiratory parameters during hands-only cardiopulmonary resuscitation (CPR) in a non-arrested patient who suddenly collapses are confusing. In this research, we investigated the effects of chest compressions in a non-arrested porcine model.</p><p><b>METHODS</b>Fourteen male domestic pigs were randomized into sham control group (SHAM group, only anesthetized and instrumented without chest compression, n = 6) or chest compression group (CC group, 2 minutes of chest compressions, n = 8). Continuous hemodynamic parameters, dynamic lung compliance (Cdyn), and blood gas analysis outcomes were recorded. Serum levels of catecholamine were measured at baseline and 2 minutes, 30 minutes, 4 hours, and 24 hours after chest compressions. Chest computed tomography (CT) was performed at 30 minutes and 24 hours. Conventional histopathology evaluation was performed.</p><p><b>RESULTS</b>After two minutes of chest compressions in the CC group, heart rate and extravascular lung water increased significantly; mean arterial pressure, stroke volume, and global ejection fraction significantly decreased. Cdyn significantly decreased to valley levels at 30 minutes and slowly recovered. Compared with the baseline, serum levels of catecholamine significantly increased at 2 minutes and rapidly decreased 24 hours later. At 30 minutes after chest compressions, chest CT showed local exudation, which was absorbed 24 hours later.</p><p><b>CONCLUSIONS</b>This research showed that 2 minutes of chest compressions causes various heart and lung tissue damage in the normal a normal porcine model. It also impacts the hemodynamic and Cdyn.</p>

Relationship between intrathoracic pressure and hemodynamics during cardiopulmonary resuscitation in a porcine model of prolonged cardiac arrest / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The influences of intrathoracic pressure (ITP) to hemodynamic and respiratory parameters during cardiopulmonary resuscitation (CPR) are confusing. In this research, we investigated the phasic changes of ITP during CPR and reveal the relationships among the hemodynamics, respiratory parameters, and ITP.</p><p><b>METHODS</b>After 8 minutes of untreated ventricular fibrillation, which was induced in twenty intubated male domestic pigs, 12 minutes of 30: 2 CPR was performed. Continuous respiratory variables, hemodynamics, ITP and blood gas analysis were measured during CPR. After that, defibrillation was done and prognostic indicators after CPR was recorded.</p><p><b>RESULTS</b>Average ITP at baseline was -(14.1 ± 1.6) mmHg (1 mmHg = 0.133 kPa). When gasping inspirations were going on, it decreased sharply to near -50 mmHg. ITP fluctuated up and down quickly from near -20 mmHg to 20 mmHg when compressions were performed. These phasic changes became mild as the CPR was performed, the contrast of high and low ITP decreased to (12.95 ± 2.91) mmHg at the end of 12 minutes of CPR. Total alveolus minute volume decreased too, because of the decrease of compression and gasp related ventilations. Curve correlation was found between the tidal volume of compression and ITP: ITP = 607.33/(1 + 3134 × e(-0.58 × TV)), (e: natural constant, R(2) = 0.895). Negative correlations were found between the right atrial diastolic pressure and ITP (r = -0.753, P < 0.01); and positive correlations were found between the coronary perfusion pressure and ITP (r = 0.626, P < 0.01).</p><p><b>CONCLUSIONS</b>ITP is one of the key factors which can influence the prognosis of CPR. Correlations were found between the changes of ITP and the tidal volumes of compressions, right atrial diastolic pressure and coronary perfusion pressure during CPR. More positive ITP during compression and more negative during decompression were good to ventilation and perfusion.</p>

The Short Term Effect of Glutathione on Anti-Oxidative Stress in Patients with Coronary Heart Disease / 中华高血压杂志

Objective To study the therapeutical effect of glutathione(GL),a powerful antioxidant on the symptoms and ECG in patients with coronary heart disease and its mechanisms.Methods Eighty-five subjects with coronary heart disease were recruited(45 male and 40 female).The patients were randomized to receive GL (240 mg,ivgtt,qd,for 14 days,n=44)on the top of conventional treatment(aspirin+?-blocks+ACEI)or conven- tional treatement alone(control,n=41).The serum MDA,SOD,NO levels were determined.Electrocardio- graphy(ST stage,T wave)was examined.Results GL significantly improved clinical symptoms scores(2.0+0.5 vs control:1.5+0.5,P

Tanscraniai doppler ultrasonography examination in diagnosis of the early cerebrovascular diseases in aged dia- betic patients / 中国实用内科杂志

Objective To evaluate the role of TCD examination in diagnosis of the early cerebrovascular diseases in aged diabetic patients.Methods 179 cases of aged type Ⅱ diabetic patients were divided into three groups(PDR,BDR and NDB)according to their retinopathy.TCD and retina examination were performed in all patients and the data be analysed. Results (1)The systolic peak flow velocity(Vp) of MCA、ACA、ICA and BA were significant increased in diabetic pa- tients than in normal control group(P