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Background. Shenfu injection (SFI) has shown a remarkable therapeutic effect in patients with chronic heart failure (CHF) during the acute phase of symptom aggravation since it became commercially available in 1987. However, the therapeutic effect of SFI has not been validated in a standard clinical study. As a pilot clinical trial, this study aimed to evaluate the safety and efficacy of SFI for treatment of CHF patients during the acute phase. Methods. A total of 160 patients experiencing acute phase CHF were enrolled in this study and randomly assigned to receive the placebo (placebo group, 150 ml glucose (GS)) or SFI (SFI group, 50 ml SFI + 100 ml GS) in addition to their standard medications for CHF treatment. The treatment lasted for 7 ± 1 days, and the follow-up continued for 28 ± 3 days after treatment. The primary endpoints were New York Heart Association (NYHA) classification and Traditional Chinese Medicine (TCM) syndrome scores. Results. After 7±1 days of treatment, the efficacy of SFI according to improvements in NYHA and TCM syndrome scores in the SFI group (78.38% and 89.19%, respectively) was significantly higher than that in the placebo group (61.43% and 60.00%, respectively; P<0.05). The SFI group had a longer increase in amplitude than the placebo group (113.00 m versus 82.99 m, P<0.05). The incidence of adverse events and other safety indices showed no significant differences between the two groups. Conclusion. SFI combined with conventional therapy for treatment of CHF during acute symptom aggravation ameliorated the cardiac dysfunction and clinical symptoms and improved the patients’ quality of life without any significant AEs compared with the conventional therapy alone.

The crystal structure of Na 3 MnF 6 has been investigated at high pressures by means of single-crystal x-ray diffraction, and its Mn(III) coordination environment has been studied by means of single-crystal optical absorption spectroscopy using diamond anvil techniques. Compressibility data (unit cell parameters) were collected in the pressure range from ambient to 4.06 GPa, and structural refinements based on single-crystal diffraction data were performed at 0.12, 0.91, 2.27, and 2.79 GPa. The monoclinic space group symmetry (P2 1 /n) is retained in the entire pressure range, but, at increasing pressure, a discontinuous phase transition is observed at ∼2.2 GPa. This is interpreted as an effect of a reversible, isosymmetric phase transition with a hysteresis width of 0.5 GPa, observed when the pressure is successively lowered. The structure refinements show that the phase transition involves a reorientation of the static prolate distortion of the coordination around manganese(III). The angle between the elongation axis (z) of the MnF 6 3octahedron with [0 0 1] flips from ∼20°at ambient pressures to ∼70°at 2.79 GPa. Polarized single-crystal absorption spectra of Na 3 MnF 6 show drastic changes of the polarization of bands due to spinallowed d-d transitions in Mn(III) when passing the transition pressure, which confirm the results of the singlecrystal structure refinements. A possible explanation for this transition is discussed in terms of structure packing arguments. The isothermal bulk modulus at ambient pressure and its pressure derivative were determined to B 0 ) 47.8(1) GPa and B 0 ′ ) 1.2(1), respectively.

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