ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1682854
A Fatal Intractable Ventricular Fibrillation Triggered by Improper Use of Xiaozhong Jiuwei Powder: Integrated LC-MS Chemical Profiling Unveils the Cardiotoxic Culprits
Provisionally accepted
- 1Tianjin University, Tianjin, China
- 2School of Disaster and Emergency Medicine, Tianjin, China
- 3People's Hospital of Changji Hui Autonomous Prefecture, Xinjiang, Changji, China
- 4Department of Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- 5The Key Laboratory of Xinjiang Endemic and Ethnic Diseases and Department of Biochemistry, Shihezi University School of Medicine, Shihez, China
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Acute poisoning from toxic substances significantly endangers human health, with poisoning-induced cardiac arrest representing a critical public health concern. Xiaozhong Jiuwei Powder (XZJWP), a traditional Chinese medicine (TCM) formulation used in Mongolian Medicine, is known for its antipyretic, analgesic, and anti-inflammatory properties. However, improper use of XZJWP can lead to severe adverse effects. In this study, we report a fatal case of refractory ventricular fibrillation in a patient admitted to our hospital in autumn 2023, following the improper use of XZJWP. Despite intensive treatment, the patient succumbed to the condition one week later. To identify the toxic chemicals responsible for this outcome, a comprehensive chemical profiling of XZJWP was conducted using UPLC-Q-Orbitrap-HRMS. Our analysis identified 292 compounds, categorized into 24 major groups, with several toxic alkaloids detected. Notably, diester-diterpenoid alkaloids (DDAs), including aconitine, mesaconitine, and hypaconitine, were identified as key toxic compounds known to cause neurotoxicity and cardiotoxicity. These findings warrant caution in using XZJWP and other aconite-containing TCMs, emphasizing the need for public education on safe use and improved clinical management of related poisonings. The study provides crucial guidance for healthcare professionals in diagnosing and treating such toxicities.
Keywords: Xiaozhong Jiuwei Powder, Cardiac arrest, UHPLC-Q-Exactive-Orbitrap MS, Aconitum alkaloids, Toxicity
Received: 28 Aug 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Abudu, Yang, Zhang, Sidike, Guo, Fan and Wubuli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Haojun Fan, haojunfan86@163.com
Ayixiamuguli Wubuli, ayixiamugu18@mails.ucas.ac.cn
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