BACKGROUND:Hypoxia and ischemia induce neuronal damage,decreased neuronal numbers and synaptophysin levels,and deficits in leing and memory functions.Previous studies have shown that lycium barbarum polysaccharide,the most effective component of barbary wolfberry fruit,has protective effects on neural cells in hypoxia-ischemia.OBJECTIVE:To investigate the effects of Naotan Pill on glutamate-treated neural cells and on cognitive function in juvenile rats following hypoxia-ischemia.DESIGN,TIME AND SETTING:The randomized,controlled,in vivo study was performed at the Cell Laboratory of Lanzhou University,Lanzhou Institute of Mod Physics of Chinese Academy of Sciences,and Department of Traditional Chinese Medicine of Gansu Provincial Rehabilitation Center Hospital,China from December 2005 to August 2006.The cellular neurobiology,in vitro experiment was conducted at the Institute of Human Anatomy,Histology,Embryology and Neuroscience,School of Basic Medical Sciences,Lanzhou University,and Department of Traditional Chinese Medicine of Gansu Provincial Rehabilitation Center Hospital,China from March 2007 to January 2008.MATERIALS:Naotan Pill,composed of barbary wolfberry fruit,danshen root,grassleaf sweetflag rhizome,and glossy privet fruit,was prepared by Gansu Provincial Rehabilitation Center,China.Rabbit anti-synaptophysin,choline acetyl transferase polyclonal antibody,streptavidin-biotin complex kit and diaminobenzidine kit (Boster,Wuhan,China),as well as glutamate (Hualian,Shanghai,China) were used in this study.METHODS:Cortical neural cells were isolated from neonatal Wistar rats.Neural cell damage models were induced using glutamate,and administered Naotan Pill prior to and following damage.A total of 54 juvenile Wistar rats were equally and randomly assigned into model,Naotan Pill,and sham operation groups.The left common carotid artery was ligated,and then rat models of hypoxic-ischemic injury were assigned to the model and Naotan Pill groups.At 2 days following model induction,rats in the Naotan Pill group were administered Naotan Pill suspension for 21 days.In the model and sham operation groups,rats received an equal volume of saline.MAIN OUTCOME MEASURES:Neural cell morphology was observed using an inverted phase contrast microscope.Survival rate of neural cells was measured by MTT assay.Synaptophysin and choline acetyl transferase expression was observed in the hippocampal CA1 region of juvenile rats using immunohistochemistry.Cognitive function was tested by the Morris water maze.RESULTS:Pathological changes were detected in glutamate-treated neural cells.Neural cell morphology remained normal after Naotan Pill intervention.Absorbance and survival rate of neural cells were significantly greater following Naotan Pill intervention,compared to glutamate-treated neural cells (P<0.05).Synaptophysin and choline acetyl transferase expression was lowest in the hippocampal CA1 region in the model group and highest in the sham operation group.Significant differences among groups were observed (P<0.05).Escape latency and swimming distance were significantly longer in the model group compared to the Naotan Pill group (P<0.05).CONCLUSION:Naotan Pill exhibited protective and repair effects on glutamate-treated neural cells.Naotan Pill upregulated synaptophysin and choline acetyl transferase expression in the hippocampus and improved cognitive function in rats following hypoxia-ischemia.