Objective To investigate the effect of intmopemtive intravenous penehyclidine hydrochloride on pulmonary function in patients undergoning thoracotomy.Methods Sixty ASA Ⅰ or Ⅱ patients aged 30-64 yr scheduled for elective radical esophagectomy for cancer were randomly divided into 2 group(n=30 each):penehyclidinc hydrochloride group and control group.Penehychdine hydrochloride 0.01 mg/kg(in nolmal saline 2 ml)was injected iv 20 min after opening the thoracic cavity in penehyclidine hydrochloride group.The equal vohlme of normal saline was injected iv in control group.Anesthesia was induced with fentanyl 2μg/kg,propofol 0.4μG/ml and rocuronium 0.6 mg/kg.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remlfentanyl 0.1μg·min-1,propofol 2.0-2.5 μg/ml and intermittent iv injecfion of rocuronium.The use of remifentanyl and pmpofol was stopped 5 min before operation.Dynamic lung compliance (Cd) and peak airway pressure were monitored and recorded immediately before penehychdine hydrechlofide administration (T0) and at 3 min(T1),5 min(T2),10 min(T3),30 min(T4),1 h(T5),2 h (T6)after penehyclidine hydrochloride administration.Results There was no significant difference in Cd and peak airway pressure among different time points in control group(P>0.05).Cd was significantly higher,while peak airway pressure lower at T1-6 than at T0 in penehychdine hydrochlofide group(P<0.05).Cd wag significantly higher,while peak airway pressure lower at T1-6 in penehyclidine hydrochloride group than in control group(P<0.05) .Conclusion Intraoperative intravenous penehyclidine hydrochloride can improve the pneumodynamics and is helpful for ventilation in patients undergoing thoracotomy.

OBJECTIVE To determine the effect of Kai-Xin-San(KXS)combined with fluoxetine on the intestinal flora and the expression of inflammatory factors in chronic unpredictable mild stress(CUMS)depression mice and to elucidate the antidepressant mechanism of regulating"intestine-brain"axis.METHODS CUMS depression mice model was established and the effect of com-bined medication on improving depression-like behaviors of mice was evaluated by determination of sucrose preference rate,immobile time of tail suspension and forced swimming.Additionally,the levels of inflammatory factors IL-6,IL-1β,TNF-α and LPS were de-termined in cortex,serum and intestine using the ELISA method.The composition of intestinal flora in mouse feces was analyzed by 16S rRNA sequence sequencing.Furthermore,Western blot assay was utilized to determine the expression levels of intestinal barrier proteins such as ZO-1,Occludin and Claudin-5.RESULTS The combination of KXS and fluoxetine resulted in a significant in-crease in sucrose preference rate(P<0.01)and decreased immobile time of tail suspension and forced swimming(P<0.05,P<0.01)in CUMS mice.The antidepressant effect of KXS combined with middle dose of fluoxetine was equivalent to that of high dose of fluoxe-tine alone.Meanwhile,the combination could significantly inhibit the up-regulation of inflammatory factors in the cortex,serum and small intestine of model animals(P<0.05,P<0.01).Intestinal flora analysis showed that the combination could improve the ratio of Gram-positive bacteria to negative bacteria in the intestinal tract of model animals,and the improvement of the relative abundance of intestinal bacteria Lachnospiraceae,Bifidobacterium,Ruminococcus,Blautia,Eubacterium,Intestinimonas,Erysipelotrichaceae,Alis-tipes,Desulfovibrionia and Coriobacteriaceae UCG-002 and so on in the model animals was significantly related to the alleviation of de-pression-like behavior and the down-regulation of cortical inflammatory factors(P<0.05,P<0.01).Furthermore,the combination treatment could significantly up-regulate the expression of intestinal barrier protein(P<0.01).CONCLUSION KXS combined with fluoxetine can alleviate depression-like behavior and reduce fluoxetine dosage in CUMS model animals.The combination of the two drugs may regulate the composition of intestinal flora,inhibit the expression of intestinal inflammatory factors,up-regulate intestinal barrier proteins,and thus reduce the expression of serum and central inflammatory factors,which may be the mechanism of their regu-lation of the gut brain axis in antidepressant action.

Objective To explore the anti-depression mechanism of Kai-Xin-San(KXS)via regulation of neurogenesis in hippocampus of depression-like mice.Methods The extracts of KXS were prepared and the anti-depression effects of KXS were evaluated by behavioral tests on chronic unpredictable mild stress(CUMS)induced depression-like mice.Evaluating depression-like behavior in CUMS mice through sucrose preference test,forced swimming test,tail suspension test,and other methods.Neurogenesis in hippocampus were determined by immunofluorescence assay.In addition,effects of KXS on regulating nestin expression and Wnt/b-catenin signaling pathway were explored by western blotting analysis.Amounts of cortisol,corticotropin-releasing factor(CRF),adrenocorticotropic hormone(ACTH),brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)were determined by ELISA tests.Mouse primary neural stem cells(NSC)was used to evaluate the effect of KXS on promoting its proliferation by immunofluorescence assay.In addition,effects of KXS on regulating nestin and Wnt/β-catenin signaling pathway were also explored by Western blotting analysis.Results KXS significantly ameliorated the depression-like behaviors in presence of increased sucrose preference rate and decreased immobile time of tail suspension and forced swimming.KXS significantly promoted the neurogenesis in the hippocampus and expressions of nestin,reduced the expressions of cortisol,CRF,ACTH,increased the expressions of BDNF,NGF,and regulated Wnt/β-catenin signaling pathway.KXS also promoted the proliferation of NSCs and expressions of nestin,enhanced the translocation of b-catenin into nucleus,and regulated the expressions of proteins of Wnt/β-catenin signaling pathway.Conclusion KXS promoted neurogenesis in hippocampus and regulated Wnt/β-catenin pathway,which might contribute to its antidepressant effect.

Objective To investigate the beneficial effect of Kai-Xin-San combined with fluoxetine in improving depression-like behaviors on chronic unpredictable mild stress(CUMS)induced depression model mice.Methods The present study aimed to assess the potential of Kai-Xin-San in combination with fluoxetine to ameliorate depression-like behaviors in a CUMS induced mouse depression model.Behavioral tests,such as the sucrose preference test were employed to evaluate the efficacy of the treatment.Additionally,the levels of suppressed stress factors were measured using the ELISA method.The morphology of hippocampal tissue was evaluated using the HE staining method,Nissl Staining and TUNEL staining methods.Furthermore,western blotting analysis was utilized to determine the expression levels of proteins such as Caspase-3,and Caspase-9.Results The co-administration of Kai-Xin-San and fluoxetine resulted in a significant increase in sucrose preference rate in model mice.This effect was comparable to that of fluoxetine alone at the standard clinical dose.Furthermore,the combination treatment up-regulated the levels of suppressed stress factors,reduced the apoptosis of hippocampus induced by depression and regulated the apoptosis signaling pathway in hippocampus.Conclusion The combination of Kai-Xin-San and fluoxetine has been shown to be an effective treatment for depression-like behavior in animal models,resulting in a reduction in the required clinical dosage of fluoxetine.This effect may be attributed to the up-regulation of neurotransmitter expression,inhibition of stress axis activation,and central nervous inflammation.