LCZ696, an Angiotensin Receptor-Neprilysin Inhibitor, Improves Cardiac Hypertrophy and Fibrosis and Cardiac Lymphatic Remodeling in Transverse Aortic Constriction Model Mice.

Cardiac hypertrophy and ventricular remodeling following heart failure are important causes of high mortality in heart disease patients. The cardiac lymphatic system has been associated with limited research, but it plays an important role in the improvement of myocardial edema and the promotion of fluid balance. LCZ696 is a novel combination of angiotensin and neprilysin inhibitors. Here, we studied the role played by LCZ696 during transverse aortic constriction (TAC) induced cardiac hypertrophy and changes in the lymphatic system. Mice undergoing aortic coarctation were constructed to represent a cardiac hypertrophy model and then divided into random groups that either received treatment with LCZ696 (60 mg/kg/d) or no treatment. Cardiac ultrasonography was used to detect cardiac function, and hematoxylin and eosin (H&E) and Masson staining were used to detect myocardial hypertrophy and fibrosis. The proinflammatory factors interleukin-6 (IL-6), IL-1ß, and tumor necrosis factor-α (TNF-α) were detected in the blood and heart tissues of mice. The protein expression levels of lymphatic-specific markers, such as vascular endothelial growth factor C (VEGF-C), VEGF receptor 3 (VEGFR3), and lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) were detected in mouse heart tissues. We also examined the colocalization of lymphatic vessels and macrophages by immunofluorescence. The results showed that LCZ696 significantly improved heart dysfunction, cardiac hypertrophy, and fibrosis and inhibited the expression of proinflammatory factors IL-6, IL-1ß, and TNF-α in the circulating blood and heart tissues of mice. LCZ696 also decreased the protein expression levels of VEGF-C, VEGFR3, and LYVE-1 in mouse heart tissues, ameliorated the transport load of lymphatic vessels to macrophages, and improved the remodeling of the lymphatic system in the hypertrophic cardiomyopathy model induced by TAC.

Distal tibial fracture: An ideal indication for external fixation using locking plate.

OBJECTIVE: To evaluate the feasibility and efficiency of one-stage external fixation by using locking plate in distal tibial fractures. METHODS: In this non-control prospective study, 28 patients with distal tibial fractures were included and underwent one-stage external fixation by using locking plate. There were 21 males and 7 females, with a mean age of 43 years (19-63). According to AO/OTA fracture classification, there were 9 cases of Type A1, 9 of Type A2, 10 of Type A3 fractures. There were 21 close and 7 open fractures. The locking plate was placed on the anteromedial aspect of the tibia with 4-5 bicortical screws inserted in both distal met- aphysis and diaphysis. The radiographic and clinic results were evaluated. RESULTS: All patients were followed up for the average of 16 months (ranging from 12 to 21 months). The average surgery duration was 38 (25-60) minutes. The mean time to fracture healing were 14.6 ± 2.67, 17.5 ± 3.66, and 18.4 ± 3.37 (p < 0.05) weeks in type A1, A2, and A3 fractures respectively. By the end of the follow-ups, the mean AOFAS score were 96.11 ± 2.32, 92.67 ± 1.80 and 92.00 ± 2.06 (p > 0.05) in type A1, A2, and A3 fractures respectively. None of nonunion, deep infection, or breakage of screw or plate were observed. CONCLUSIONS: Distal tibial fracture was the ideal indication for external fixation using locking plate. The external plating is characterized by ease of performance, less invasive, fewer soft tissue impingement, improved cosmesis, and convenient for removal.

Cardiac hypertrophy is positively regulated by long non-coding RNA PVT1.

The aim of this study was to determine whether long non-coding RNA PVT1 can participate in the regulation of cardiac hypertrophy. A C57BL/6 mouse cardiac hypertrophic model was established using transverse aortic constriction (TAC). The animals subjected to sham operation were used as controls. Transcripts of PVT1 were analyzed in hearts of model and sham control groups after TAC for 4 weeks using quantitative real-time PCR (qRT-PCR). Additionally, to investigate whether PVT1 was involved in cardiac hypertrophy, 1 µM angiotensin II (Ang II) was used to induce hypertrophy and PVT1 siRNA was performed in the cultured neonatal mouse cardiac cardiomyocytes. Cell size was measured by cell surface area and total protein content analyses in response to Ang II treatment. Moreover, some hypertrophic markers including atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP), and beta-myosin heavy chain (ß-MHC) were also quantified using qRT-PCR. As a result, PVT1 was up-regulated by 2.5-fold (P<0.05) in hypertrophic hearts after TAC for 4 weeks as compared to sham group. In addition, siRNA of endogenous PVT1 in cardiomyocytes significantly reduced (P<0.05) Ang II-induced increase of cell size in terms of cell surface area (by 5.6-fold) and total protein content (by 23.0%). PVT1 siRNA also obviously attenuated Ang II-induced ANP and ß-MHC expression by 40.9% and 41.5%, respectively (P<0.05), but had no effect on BNP mRNA expression. Our results demonstrated that PVT1 was essential for the maintenance of cell size of cardiomyocytes and might play a role in the regulation of cardiac hypertrophy.

Berberine attenuates adverse left ventricular remodeling and cardiac dysfunction after acute myocardial infarction in rats: role of autophagy.

The present study aimed to test the hypothesis that berberine, a plant-derived anti-oxidant, attenuates adverse left ventricular remodelling and improves cardiac function in a rat model of myocardial infarction (MI). Furthermore, the potential mechanisms that mediated the cardioprotective actions of berberine, in particular the effect on autophagy, were also investigated. Acute MI was induced by ligating the left anterior descending coronary artery of Sprague-Dawley rats. Cardiac function was assessed by transthoracic echocardiography. The protein activity/levels of autophagy related to signalling pathways (e.g. LC-3B, Beclin-1) were measured in myocardial tissue by immunohistochemical staining and western blot. Four weeks after MI, berberine significantly prevented cardiac dysfunction and adverse cardiac remodelling. MI rats treated with low dose berberine (10 mg/kg per day) showed higher left ventricular ejection fraction and fractional shortening than those treated with high-dose berberine (50 mg/kg per day). Both doses reduced interstitial fibrosis and post-MI adverse cardiac remodelling. The cardioprotective action of berberine was associated with increased LC-3B II and Beclin-1 expressions. Furthermore, cardioprotection with berberine was potentially related to p38 MAPK inhibition and phospho-Akt activation. The present in vivo study showed that berberine is effective in promoting autophagy, and subsequently attenuating left ventricular remodelling and cardiac dysfunction after MI. The potential underlying mechanism is augmentation of autophagy through inhibition of p38 MAPK and activation of phospho-Akt signalling pathways.

Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors.

OBJECTIVE: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. METHODS: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited.All patients underwent open reduction combined with suture anchors. Function was evaluated using the Constant- Murley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. RESULTS: Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19). After early range of motion exercises, 96.2% of the patients (25/26) could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100) and mean Taft shoulder rating was 10.7 points (range, 8-12) at 12 months. CONCLUSION: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation.

Berberine improves pressure overload-induced cardiac hypertrophy and dysfunction through enhanced autophagy.

Cardiac hypertrophy is a maladaptive change in response to pressure overload, and is also an important risk for developing heart failure. Berberine is known to have cardioprotective effects in patients with hypertension and in animal models of cardiac hypertrophy. In the current study, we observed that transverse aortic contraction (TAC) surgery induced a marked increase in heart size, the ratio of heart weight to body weight, cardiomyocyte apoptosis, myocardial fibrosis, and hypertrophic marker brain natriuretic peptide, all of which were effectively suppressed by berberine administration. In addition, berberine enhanced autophagy in hypertrophic hearts, which was accompanied by a decrease in heart size, cardiac apoptosis, and the attenuation of cardiac dysfunction. Furthermore, use of autophagy inhibitor 3-methyladenine (3-MA) blocked berberine-induced autophagy level, and abrogated the protection of berberine against heart hypertrophy, cardiac dysfunction, and apoptosis. Berberine ameliorated TAC-induced endoplasmic reticulum stress, which was also abolished by 3-MA. Moreover, berberine significantly inhibited the upstream signaling of autophagy, such as the mammalian target of rapamycin (mTOR), extracellular signal-regulated kinase (ERK1/2), and p38 mitogen-activated protein kinase (MAPK) phosphorylation. We conclude that berberine could attenuate left ventricular remodeling and cardiomyocyte apoptosis through an autophagy-dependent mechanism in a rat model of cardiac hypertrophy, which is, at least in part, associated with enhanced autophagy through inhibition of mTOR, p38 and ERK1/2 MAPK signaling pathways.

Enhanced xylene removal by photocatalytic oxidation using fiber-illuminated honeycomb reactor at ppb level.

The removal of volatile organic compounds (VOCs) at ppb level is one of the most critical challenges in clean rooms for the semiconductor industry. Photocatalytic oxidation is an innovative and promising technology for ppb-level VOCs degradation. We have designed a fiber-illuminated honeycomb reactor (FIHR) in which the removal efficiency of m-xylene is significantly enhanced to 96.5% as compared to 22.0% for UV irradiation only. The results indicate that photocatalysts not only play the role to substantially oxidize m-xylene, but also alter the chemical properties of xylene under UV illumination. Using the FIHR with Mn-TiO2 photocatalyst not only increased the m-xylene removal efficiency, but also increased the CO2 selectivity. Interestingly, Mn-TiO2 in FIHR also showed a very good reusability, 93% removal efficiency was still achieved in 72-h in reaction. Thus, the FIHR gave very high removal efficiency for xylene at ppb level under room temperature. The FIHR has great potential application in the clean room for the air purification system in the future.

Water and temperature effects on photo-selective catalytic reduction of nitric oxide on Pd-loaded TiO2 photocatalyst.

Photo-selective catalytic reduction (photo-SCR) of nitric oxide (NO) was studied in the presence of water. The incipient wetness impregnation was applied to prepare 1 wt% PdO/TiO2 photocatalyst. Steady-state photoreaction was carried out in a continuous-flow photoreactor with 0.55-1.6 v% water at 30-120 degrees C under UV-light intensity of approximately 200mW/cm(2). The C3H8/NO molar ratio in the feed ranged from 0.8 - 16.8 at a volume hourly space velocity (VHSV) from 330-1090 h(-1). The result indicates that the increase of temperature has played an important role in inhibiting NO transformation to NO2 under the humid condition. Another important factor for maximizing denitrification (reduction of nitrogen oxides, DeNOx) efficiency was C3H8/NO ratio. An increase of temperature at a suitable C3H8/NO ratio can minimize NO2 formation, which can lead to high NO removal efficiency of more than 90% at a temperature of 70-100 degrees C. In addition, the mechanism of palladium transformation during photoreaction is proposed, to explain the influence of Pd on the improvement of NO removal.

Artificial photosynthesis over crystalline TiO2-based catalysts: fact or fiction?

The mechanism of photocatalytic conversion of CO(2) and H(2)O over copper oxide promoted titania, Cu(I)/TiO(2), was investigated by means of in situ DRIFT spectroscopy in combination with isotopically labeled (13)CO(2). In addition to small amounts of (13)CO, (12)CO was demonstrated to be the primary product of the reaction by the 2115 cm(-1) Cu(I)-CO signature, indicating that carbon residues on the catalyst surface are involved in reactions with predominantly photocatalytically activated surface adsorbed water. This was confirmed by prolonged exposure of the catalyst to light and water vapor, which significantly reduced the amount of CO formed in a subsequent experiment in the DRIFT cell. In addition, formation of carboxylates and (bi)carbonates was observed by exposure of the Cu(I)/TiO(2) surface to CO(2) in the dark. These carboxylates and (bi)carbonates decompose upon light irradiation, yielding predominantly CO(2). At the same time a novel carbonate species is produced (having a main absorption at approximately 1395 cm(-1)) by adsorption of photocatalytically produced CO on the Cu(I)/TiO(2) surface, most likely through a reverse Boudouard reaction of photocatalytically activated CO(2) with carbon residues. The finding that carbon residues are involved in photocatalytic water activation and CO(2) reduction might have important implications for the rates of artificial photosynthesis reported in many studies in the literature, in particular those using photoactive materials synthesized with carbon containing precursors.

[Study on clinical anatomy of calcaneal fractures and its applications].

OBJECTIVE: To observe and analyze the intraoperative state of calcaneal fractures, and summarize the law of displacement after calcaneal fractures, so as to guide fracture reduction and fixation. METHODS: From March 2002 to March 2009, among 572 patients with calcaneal fractures, 427 patients were male and 145 patients were female, ranging in age from 17 to 73 years, averaged 37 years. The patients were injured from falling or road accidents, and all the patients were closed fracture. The 189 patients with complete clinical data were treated with reduction and fixation through the lateral approach after observation of displacement type of the fractures. RESULTS: Among 189 patients,the fractures were found at the lower part of the articular surface in all patients, which was hillock point of calcaneus; the fractures were found at the Gissans Corner in 134 patients, and the type include cross-sectional fracture or oblique fracture; the fractures were found at calcaneal tubercle in 118 patients, and the fractures were divided into two parts from top to bottom; the fractures were found at the distal part of calcaneus only in 67 patients. CONCLUSION: Calcaneal fractures show clear law of dislocation. Preoperative and intra-operative detailed analysis and evaluation, as well as reduction and fixation according to certain sequences can insure to get better operative effects.

Photocatalytic reduction of NO pollutant using an optical-fibre photoreactor at room temperature.

Photo-assisted catalytic reduction of nitric oxide (NO) was studied over different metal-loaded TiO2 catalysts at room temperature. The activities of metal-loaded (Pt, Ag, Cu) TiO2 photocatalysts, prepared by the sol-gel method, were compared in a batch system using CH4 as the reducing agent. The Pt/TiO2 catalyst showed the highest activity for NO reduction. Thus, Pt/TiO2 was coated on optical fibres and used in a continuous-flow optical-fibre photoreactor. The optical-fibre photoreactor provides light irradiation on the photocatalyst through the optical fibre, thus improving the efficiency ofphotoreactions. Ten per cent conversion of NO was found using CH4 as the reducing agent. The NO conversions increased to 90% in the presence of water vapour and oxygen. However, most NO was oxidized to NO2. Hydrogen had superior reducing capabilities over CH4 on Pt/TiO2 photocatalyst, and the conversion of NO reached 85%. But the conversion of NO was substantially decreased to less than 10% in the presence of water vapour and oxygen. Our research proposed an alternative way to reduce NO pollutant to N2 at room temperature using an optical-fibre photoreactor, which could possibly utilize sunlight in the future.

[Problems and solutions of plate internal fixation for the treatment of calcaneal fractures].

OBJECTIVE: To retrospective analysis operating procedures and results of calcaneal fractures treated with plate fixation, identify problems and propose measures to reduce surgical complications. METHODS: From June 2008 to April 2009, 156 patients were reviewed, including 121 males and 35 females, ranging in age from 18 to 59 years, with an average of 41 years. Thirty-two patients had bilateral calcaneal fractures. Twenty-three patients were surgically treated on both calcaneus at the same time. Total 179 calcaneus were treated with operation. The operation records of all patients were analyzed in order to find the problems and deficiencies. RESULTS: Among 179 calcaneal fractures, 31 feet (17.3%) had postoperative wound problems: wound infection and non-healing were found in 26 feet (14.5%), skin flap necrosis in 5 feet (2.8%). There were a lot of problems of plate internal fixation for the treatment of calcaneal fractures, including operation design, operative technique, as well as fracture reduction and fixation. CONCLUSION: The following methods are the only way to avoid operative complications for the treatment of calcaneal fractures: improved surgical technique, minimally invasive operation, simple and effective internal fixation.