| Background The case fatality rate of AOPP complicated with cardiovascular injury increases with the aggravated degree of organ dysfunction.The heart damage,cardiac arrhythmia,cardia insufficiency and microcirculation disturbance have great impact on the entire pathogenetic condition,which become one of the main causes of death in organophosphate poisoning patient.The Xuebijing Injection has the pharmacologic action of eliminating inflammatory mediator,improving microcirculation,protecting organism and regulation of immune response.In clinical,it has good therapeutic effect on infection,sepsis and multiple organ injury.Toxic substance is a powerful stimulating factor for organism.It can trigger the production and release of generous inflammatory mediators.It can also induce systemic inflammatory "waterfall-like" reaction.Whether complicating with bacterial infection or not,excessive inflammatory response to cardiovascular injury happened and even multiple organ injury can occur.Therefore,we assume that using Xuebijing Injection in AOPP complicated with cardiovascular injury may have good effect. NF-κB is an important transcription factor of complex inflammatory reaction, inappropriate or excessive enhancement the activity of NF-κB can cause many diseases related with inflammation.Therefore inhibiting NF-κB signaling pathway may be one of the mechanisms of Xuebijing Injection having a role in AOPP complicated with cardiovascular injury.Cardiac injury markers such as myocardial enzyme often show abnormal changes after AOPP complicated with cardiovascular injury.It can be one of the indexes to observe the damage prognosis.Objectives①to observe the therapeutic effect of Xuebijing Injection on AOPP complicated with cardiovascular injury;②to investigate the influence of Xuebijing Injection on NF-κB activation of PMN in test group;③to investigate the influence of Xuebijing Injection on the changes of myocardial enzyme activity;④to discuss the relation between the prognosis of acute organophosphate poisoning and the degree of NF-κB activation.Accordingly,we investigate the mechanism which make the Xuebijing Injection increase the successful rate of AOPP complicated with cardiovascular injury.Methods 70cases of AOPP complicated with cardiovascular injury in emergency departments of our hospital and the affiliated hospital of Taishan medical college were selected from January,2007 to June,2008,and divided into positive control group (35cases) and test group(35cases) at random.Negative control group(20cases)was healthy.Positive control group was treated with routine therapeutics and test group was treated with Xuebijing Injection plus routine therapeutics.Furthermore,the test group was divided into two subgroups according to the treatment dosage, 100mLgroup and 150mLgroup.All patients in treatment course were phlebotomized according to the designed time.PMNs were gathered through deposition and centrifugation.Utilizing immunohistochemical method(ABC method),we could observe NF-κB translocation into nucleolus with optical microscope,and analyse NF-κB activation degree in half-quantitative analysis with image analysis system.We recorded the myocardial enzyme activity instantly and on the seventh day of patients' hospitalization.Every parameters were demonstrated with(?)±S.Two sample-means were compared by t-test.Two sample-rates were compared byχ~2-test.SPSS13.0 software was used to carry on statistical analysis.Difference was regarded as significant when P＜0.05.Results①The death rate of the test group was lower than the positive control group,and the difference was significant,(P＜0.05);②The NF-κB activation degree of positive control group was higher than that of test group,and the difference was significant,(P＜0.05);③Xuebijing Injection suppressed the activation of NF-κB on dosage,and the difference was significant,(P＜0.05);④The degree of myocardial enzyme recovery of the test group was superior to that of the positive control group and it had dose dependent with Xuebijing Injection,and the difference was significant,(P＜0.05).Conclusion Xuebijing Injection plus routine therapeutics has obvious therapeutic effect on improving the prognosis and can increase the remedy successful rate of AOPP complicated with cardiovascular injury.Its possible mechanism is inhibiting NF-κB signaling pathway,then reducing NF-κB combination with DNA binding sequence in nucleus and decreasing the release of its downstream inflammation factors which are adjusted by NF-κB.This inhibitory effect is dose-dependent.No matter the restrained degree of NF-κB activation,or the recovery of myocardial enzyme activity,large dose of Xuebijing Injection has better therapeutic effect.Our experiment has proved the mechanism that Xuebijing Injection can increase the remedy successful rate and improve the prognosis is probable to inhibit NF-κB signaling pathway.The large dose of Xuebijing Injection has better therapeutic effect and it deserves further clinical applications.
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