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Shenfu injection on hypoxic-ischemic brain damage in neonatal rat ATF4
Hypoxic-ischemic brain damage (HIBD) occur in approximately 6 per 1,000 live births, 25% -30% of the survivors may leave some type of long-term sequelae. The study found that hypoxia, ischemia, low sugar, the ATP depletion, a large number of free radicals such as calcium overload can trigger endoplasmic reticulum stress (ERS), the start of the unfolded protein response (of UPR). Eukaryotic activate the transcription factor (ATF4) is the key factor of the PKR-like endoplasmic reticulum kinase (the PERK)-mediated UPR pathway. Shenfu injection main components of ginseng saponin and Aconitum alkaloids have a protective effect on brain injury.

But see note whether the injection from the cerebral protective effects by reducing the ERS, has yet to see the related reports.In the normal state, the PERK dimerization sites immunoglobulin binding protein (the Bip) cover, no endonuclease activity. ERS, a large number of Bip protein was used in conjunction with the unfolded protein PERK free, polymerization, phosphoric acid, so that the PERK itself to activate the substrate and catalyze eIF2 phosphorylation. Involved in mammalian cell protein translation initiation complex formation, eIF2 protein A, B, C, three kinds of subunits, A serine can be phosphorylated in. Phosphorylated eIF2 can inhibit the GDP-GTP exchange function, making the eIF2 can not be reused, reducing the start codon recognition rate, thus inhibiting protein synthesis in the boot process to reduce the level of translation. Although eIF2 phosphorylation lead to overall translational repression, but it can still specifically induced increase ATF4 mRNA translation. ATF4 expression, including the endoplasmic reticulum stress in cells is dependent on PERK-mediated eIF2 phosphorylation.ATF4 to regulate C / EBP homologous protein, growth arrest and DNA damage inducible protein 34 and activating transcription factor 3 (of ATF3) expression, which, of ATF3 also promote CHOP and GADD34 expression. CHOP and endoplasmic reticulum stress-induced apoptosis by down-regulating expression of Bcl-2 expression, increase Bim expression, depletion of glutathione, the promotion of ROS generation, activation of caspase-3, ultimately leading to cell apoptosis.Results found that the the HIBD ischemia in neonatal rat lateral prefrontal cortex of eIF2, ATF4 protein levels increase, showed that of eIF2, the ATF4 involved in the the HIBD pathological physiological processes. The HIBD likely to start the PERK-mediated UPR pathway.
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The effects of Shenfu Injection (SFI) on the heart have also been studied during those years. It seemed to have showed promising results on myocardial tissue and overall circulation.

One study, headed by Yang Wu published their paper around midyear of 2010. They investigated the traditional Chinese medicine (Shenfu) if it could attenuate an injury caused by diabetes which is known as myocardial ischemia-reperfusion (MI/R). They performed tests to several groups of diabetic rats including a group preconditioned with Shenfu injection. After the study, they found out that those which were preconditioned with the medicine, had a significantly lesser infarct size, apoptosis, caspase-3 protein expression, MDA level in myocardial tissues, and plasma level of CK and LDH but increased p-Akt, p-eNOS, bcl-2 protein expression, and SOD activity compared to the other groups. Their conclusion was that Shenfu Injection preconditioning actually protects hearts of diabetic patients from ischemia-reperfusion injury via P13K/Akt-dependent pathway.

Another study, performed by Song Wen-Ting and company, tried to use the Shenfu medication for heart failure. They published their research at the end of 2011. Though China has been using (SFI) for heart failure cases, the scientist’s purpose of the study was to determine how safe and effective the medication was.

Trials were conducted using local electronic databases and English ones. Patients with heart failure were placed into groups were some were on standard treatment and the other with routine treatment plus SFI. The results revealed that the latter showed better heart rate, walking distance, and even mortality results. Also, ultrasonic cardiography identified improved heart function of those with the combined SFI therapy. No serious adverse effects were reported. The study therefore was concluded that SFI appears to be an effective treatment for heart failure.

Another study conducted this year by Zhi-jun Guo and Chun-sheng Li had their research published as the Therapeutic Effects of Shenfu Injection on Post-cardiac Arrest Syndrome (PCAS). They have stated that for the past 50 years, cardiac arrest survival rates have not changed substantially which may be the reason why they delved in further with the topic. Their study comprises the discussion of how SFI can attenuate post-cardiac arrest myocardial dysfunction and cerebral injury. Also, they presented how SFI may be useful in PCAS treatment.
Lyka Candelario, RN
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Shenfu injection on hypoxic-ischemic brain damage in neonatal rat ATF400