{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:27:27Z","timestamp":1778567247854,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"content-version":"vor","delay-in-days":169,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2017ZC0133"],"award-info":[{"award-number":["2017ZC0133"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81703856"],"award-info":[{"award-number":["81703856"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evidence-Based Complementary and Alternative Medicine"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Sini Decoction (SND) is composed of <jats:italic>Aconitum carmichaelii<\/jats:italic> Debeaux, <jats:italic>Zingiber officinale<\/jats:italic> Roscoe, and <jats:italic>Glycyrrhiza uralensis<\/jats:italic> Fisch, having been used in China for centuries for collapsing phrase of disease. Studies reported that SND could alleviate inflammatory response, ameliorate microcirculatory disturbances, and improve shock reversal and adrenal gland glucocorticoid stress response during sepsis shock, yet the underlying mechanism is still elusive. Toll\u2010like receptor (TLR) 4 is demonstrated to be crucially correlated with the corticosterone secretion and the impaired adrenal glucocorticoid responses in sepsis. <jats:italic>Materials and Methods<\/jats:italic>. SND at dose of 10 g\/kg (in low\u2010dose SND group, LD\u2010SND) and 20 g\/kg (in high\u2010dose SND group, HD\u2010SND) was administered to CLP rats. Four days later, overall survival rates of rats were calculated; rat serum and adrenal glands were collected. Basic serum corticosterone levels were determined, and the increase of corticosterone after 0.8 ug\/kg ACTH injection was checked to detect the adrenocortical sensitivity to ACTH. The protein and mRNA expression of TLR4 in adrenal glands were measured to study the impact of SND on TLR4 expression. mRNA levels of IL\u201010 and TNF\u2010a in adrenal glands and IL\u201010 and TNF\u2010a levels in serum were also determined to study the cytokines profile. <jats:italic>Results<\/jats:italic>. SND improved the cumulative survival rate of CLP rats up to 4 days (P &lt; 0.05 with HD\u2010SND) and adrenocortical sensitivity to 0.8 ug\/kg ACTH stimulation (<jats:italic>P<\/jats:italic> &lt; 0.05 at 60 mins, 31.02 \u00b1 19.23 ng\/ml in LD\u2010SND group and 32.18 \u00b1 14.88 ng\/ml in HD\u2010SND group versus 5.03 \u00b1 13.34 ng\/ml in CLP group), with a significant decrease of protein (P &lt; 0.05, 29.6% in LD\u2010SND group and 27.8% in HD\u2010SND group), mRNA expression of TLR4 (P &lt; 0.05, 32.9% in LD\u2010SND group and 36.1% in HD\u2010SND group), mRNA expression of IL\u201010 (P &lt; 0.05, 32.0% in LD\u2010SND group and 29.6% in HD\u2010SND group), TNF\u2010a in adrenal glands (P &lt; 0.05, 26.0% in LD\u2010SND group and 25.3% in HD\u2010SND group), and TNF\u2010a level in serum (P &lt; 0.05, 100.20 \u00b1 19.41 pg\/ml in LD\u2010SND group and 92.40 \u00b1 11.66 pg\/ml in HD\u2010SND group versus 134.40 \u00b1 27.87 pg\/ml in CLP group). <jats:italic>Conclusion<\/jats:italic>. SND increased overall survival rate within 4 days and attenuated adrenal insufficiency in septic rats by downregulating TLR4 mRNA and protein expression in adrenal tissue, inhibiting adrenal production of TNF\u2010<jats:italic>\u03b1<\/jats:italic> and IL\u201010, and improving adrenal responsiveness. Our results suggest that SND is able to ameliorate adrenal stress responses in a local immune\u2010adrenal crosstalk way involving downregulated expression of TLR4 in adrenal tissue. SND might be a promising treatment for adrenal insufficiency prevention in prolonged sepsis.<\/jats:p>","DOI":"10.1155\/2018\/5186158","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T23:34:32Z","timestamp":1529451272000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Sini Decoction Improves Adrenal Function and the Short\u2010Term Outcome of Septic Rats through Downregulation of Adrenal Toll\u2010Like Receptor 4 Expression"],"prefix":"10.1155","volume":"2018","author":[{"given":"Fang","family":"Lai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3389-6782","authenticated-orcid":false,"given":"Gengbiao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4957-979X","authenticated-orcid":false,"given":"Shutao","family":"Mai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7074-8936","authenticated-orcid":false,"given":"Xiaolian","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7388-1433","authenticated-orcid":false,"given":"Wenting","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-4737","authenticated-orcid":false,"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1225-1088","authenticated-orcid":false,"given":"Dongping","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-9753","authenticated-orcid":false,"given":"Yanna","family":"Weng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-5034","authenticated-orcid":false,"given":"Jiongdong","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5333-4149","authenticated-orcid":false,"given":"Yi","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1189-2222","authenticated-orcid":false,"given":"Jiyang","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-0433","authenticated-orcid":false,"given":"Yun","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,19]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002255"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199710303371807"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-015-0125-0"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000839"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0704(05)70150-0"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000259465.92018.6E"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200103000-00026"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000207340.24290.3C"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066610393456"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0b013e318228ed18"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000275387.51629.ED"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000000318"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.7.862"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.14799"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3899-6"},{"key":"e_1_2_11_16_2","volume-title":"Pharmacopoeia of the People\u2019s Republic of China","author":"National Pharmacopoeia Council","year":"2015"},{"key":"e_1_2_11_17_2","first-page":"43","article-title":"The effect of Sini Decoction on inflammatory cytokines in Sepsis Shock","volume":"12","author":"Xu M. 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