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Introduction
An estimated 200 million patients undergo anesthesia and surgery worldwide each year (1). Volatile anesthetics, such as isoflurane, desflurane and sevoflurane, are usually used in general anesthesia. The differences in the chemical structures of volatile anesthetics result in diverse physicochemical properties leading to different biological effects, with particularly different effects on neuronal cells (2). Depending on the experimental conditions used, sevoflurane can be neuroprotective in anesthesia (3). However, in certain conditions, particularly in animal models with neonatal sevoflurane exposure, sevoflurane can exert relevant neurotoxicity effects (4). Additionally, increasing studies have demonstrated that exposure to individual anesthetic drugs, including volatile anesthetics, triggers significant damage in the developing brain (5). Furthermore, sevoflurane has been reported to induce cell damage in various neuronal and non-neuronal cells and tissues (6). Thus, volatile anesthetic, such as sevoflurane, can be a risk for cell injury, particularly for neuronal injury during anesthesia. Therefore, understanding the pathological mechanisms of the neurotoxic effects of sevoflurane is of great importance for developing effective methods of anesthesia.
Traditional Chinese medicine has been developed in China over 5,000 years, providing health care services to Chinese people and worldwide. An in vitro study demonstrated that traditional Chinese medicine may be effective for the treatment and prevention of central nervous system diseases (7). Thus, the effect of traditional Chinese medicine on nerve cell protection has become a major topic of research in the Chinese neuroscience community, and an important part of medical research worldwide.
Panax Notoginseng Saponins (PNS) is the active ingredient of the Chinese herb Sanqui, which is predominantly cultivated in the Yunnan and Guangxi provinces of China (8). The medicinal properties of the Panax Notoginseng root include relieving swelling, promoting blood clotting and alleviating pain (9). It has been reported that PNS has a number of biological activities including immunomodulatory effects, antioxidation and anticancer properties (10). Additionally, it has been demonstrated that PNS has neuroprotective effects following stroke through reducing the apoptosis of nerve cells and neurotoxicity (11). Another study suggested that PNS promoted angiogenesis and the synthesis and release of neurotrophic factors (12). However, the effect of PNS on anesthesia-induced neurotoxicity effects remains to be elucidated.
In the present study, nerve cells were separated from the hippocampus of day 16 embryonic mice and used to...