Leucine attenuates muscle atrophy and autophagosome formation by activating PI3K/AKT/mTOR signaling pathway in rotator cuff tears.

Rotator cuff tears (RCTs), the most common tendon injury, are always accompanied by muscle atrophy, which is characterized by excessive protein degradation. Autophagy-lysosome systems are the crucial proteolytic pathways and are activated in atrophying muscle. Thus, inhibition of the autophagy-lysosome pathway might be an alternative way to minimize skeletal muscle atrophy. In this present study, combined with a tendon transection-induced rat model of massive rotator cuff tears, HE staining and transmission electron microscopy methods, we found leucine supplementation effectively prevented muscle atrophy, muscle injury and autophagosome formation. Utilizing immunoblotting, we discovered that leucine supplementation is able to inhibit the rise in autophagy-related protein expression (including LC3, Atrogin-1, MuRF1, Bnip3 and FoxO3) driven by tendon transection. The PI3K/AKT/mTOR pathway that was essential in autophagosome formation and autophagy was blocked in atrophying muscle and reactivated in the presence of leucine. Once administrated with LY294002 (PI3K inhibitor) and Rapamycin (mTOR inhibitor), leucine mediated by the anti-atrophic effects was nearly blunted. These results suggest that leucine potentially attenuates tendon transection-induced muscle atrophy through autophagy inhibition via activating the PI3K/AKT/mTOR pathway.

Effects of alkaloids from Sophora flavescens on osteoblasts infected with Staphylococcus aureus and osteoclasts.

Chronic osteomyelitis is primarily caused by infection with Staphylococcus aureus (S. aureus). Antibiotics are commonly administered; however, it is a challenge to promote bone healing. The aim of this study was to investigate the in vitro effects of alkaloids from the herbal remedy Sophora flavescens (ASF) on rat calvarial osteoblasts (ROBs) infected with S. aureus and healthy osteoclasts. Cell proliferation and alkaline phosphatase, interleukin-6, and tumour necrosis factor-α activity was measured in infected ROBs; tartrate-resistant acid phosphatase was evaluated in osteoclasts via enzyme-linked immunosorbent assay. The mRNA and protein expression levels of bone morphogenetic protein 2, runt-related transcription factor 2, osteoprotegerin, and receptor activator of nuclear factor kappa-B ligand were assessed in infected ROBs through reverse transcription-polymerase chain reaction and western blotting analysis, respectively. Results indicated that ASF increased the viability of uninfected ROBs and infected ROBs treated with vancomycin via regulation of bone morphogenetic protein 2, runt-related transcription factor, osteoprotegerin, and receptor activator of nuclear factor kappa-B ligand mRNA and protein expression levels. In addition, the secretion of the inflammatory factor tumour necrosis factor-α was decreased and alkaline phosphatase activity was increased, inhibiting the viability of osteoclasts and tartrate-resistant acid phosphatase activity. Therefore, the herbal remedy ASF has potential as a new treatment for chronic osteomyelitis.

Flavonoids of Herba Epimedii Enhances Bone Repair in a Rabbit Model of Chronic Osteomyelitis During Post-infection Treatment and Stimulates Osteoblast Proliferation in Vitro.

Flavonoids are the active component of the Herba Epimedii (H. Epimedii), which is commonly used in Asia. This study is to investigate the effect of H. Epimedii on bone repair after anti-infection treatment in vivo. The bioactive-composition group of H. Epimedii (BCGE) contained four flavonoids with the total content of 43.34%. Rabbits with chronic osteomyelitis in response to injection with Staphylococcus aureus were treated with BCGE of 242.70 mg/kg/day intragastrically after vancomycin-calcium sulphate treatment. Micro-computerd tomography (CT), morphology, blood biochemistry and osteocalcin levels were assessed for effect evaluation. In addition, the rat calvarial osteoblasts infected with S. aureus were treated with vancomycin and BCGE. Cell viability, alkaline phosphatase activity, bone morphogenetic protein 2, Runt-related transcription factor 2, osteoprotegerin, receptor activator of nuclear factor-κB ligand mRNA levels and protein expression were assessed. Our results indicated that BCGE promoted bone repair via increasing the bone mass, the volume of bone, promoting osteocalcin secretion after vancomycin-calcium sulfate treatment. BCGE enhanced the cell proliferation, by regulating bone morphogenetic protein 2, runt-related transcription factor 2, and osteoprotegerin/receptor activator of nuclear factor κ-B ligand mRNA and protein expression to maintain the balance between bone formation and bone resorption. Therefore, BCGE is a potential adjuvant herbal remedy for the post-infection treatment of chronic osteomyelitis. Copyright © 2016 John Wiley & Sons, Ltd.

Synthesis of New Bis(3-hydroxy-4-pyridinone) Ligands as Chelating Agents for Uranyl Complexation.

Five new bis(3-hydroxy-4-pyridinone) tetradentate chelators were synthesized in this study. The structures of these tetradentate chelators were characterized by ¹H-NMR, (13)C-NMR, FT-IR, UV-vis, and mass spectral analyses. The binding abilities of these tetradentate chelators for uranyl ion at pH 7.4 were also determined by UV spectrophotometry in aqueous media. Results showed that the efficiencies of these chelating agents are dependent on the linker length. Ligand 4b is the best chelator and suitable for further studies.

Approach to Significantly Enhancing the Electrochromic Performance of PANi by In Situ Electrodeposition of the PANi@MXene Composite Film.

Electrochromic materials (ECMs) are capable of reversibly adjusting their transmittance or reflectance properties in response to changes in the external biasing voltages. In this study, we enhanced the electrochromic and electrochemical properties of polyaniline (PANi) effectively through the incorporation of MXene Ti2CTx using an in situ composite strategy. This improvement in the electrochromic and electrochemical properties observed can be attributed to the intermolecular forces between the aniline group of PANi and the terminal groups of MXene Ti2CTx sheets. The presence of hydrogen bonds between the PANi monomers and the MXene sheets was confirmed through theoretical calculations and photoluminescence results, which effectively improved the composite interfaces. Additionally, the PANi@MXene composite films were successfully prepared through a simple one-step in situ polymerization process, as verified by SEM and XPS characterization. The electrochemical studies revealed enhanced electronic conductivity, a high ion diffusion coefficient, and a narrow energy redox gap, all contributing to the excellent electrochemical properties observed. Overall, our results demonstrate that the MXene Ti2CTx composition effectively enhances the electrochromic performance of PANi. The PANi@MXene composite films exhibited a high optical modulation range, rapid switching response time, good thermal radiation regulation, and excellent operational stability. This composite strategy significantly improves the performance and practical applicability of ECMs.

Yoga is found hazardous to the meniscus for Chinese women.

OBJECTIVE: Yoga is becoming more and more popular in the female society while the concomitant sports injury is seldom mentioned. Many clinicians have noted that yoga may result in knee problems, which though requires more researches to corroborate. This investigation was conducted to ascertain the relationship between yoga and meniscus injury as well as the extent of impairment according to variant yoga practice periods. METHODS: Totally 819 women aged 20-49 years who practiced yoga or other popular sports including badminton, jogging, climbing hills, etc for at least one hour per day were selected to participate in this research. These subjects were required to complete a questionnaire and receive relevant physical examination. Magnetic resonance (MR) scan of the knee was recommended for the suspicious subjects for ultimate diagnosis. The subject with abnormal meniscus MR signals was defined as a case and matched with two controls in terms of age and body mass index (BMI). Altogether there were 273 cases and 546 controls. The nested case-control model was adopted to assess the risk of meniscus injury between variant exposures in practicing yoga and several other popular sports. Moreover, the 181 yoga subjects were subdivided into three groups according to different exercise durations, followed by further analysis with the variables of age, BMI and Lysholm score. RESULTS: Yoga was found associated with a higher risk (P equal to 0.008, OR equal to 1.621) of meniscus injury compared with badminton, jogging and climbing hills. The three yoga subgroups showed statistical difference between each other in terms of Lysholm score (P equal to 0.027) and BMI (P equal to 0.003). The subjects with longer-term yoga practice had lighter weight but lower Lysholm scores. CONCLUSIONS: Yoga perhaps exerts destructive impact on the meniscus for Chinese women, yet it needs further verifications. Furthermore, the female yoga players with longer exercise duration are more susceptible to meniscus injury though they can become leaner.

Toward Easy-to-Assemble, Large-Area Smart Windows: All-in-One Cross-Linked Electrochromic Material and Device.

Conventional electrochromic devices with a sandwich structure consist of multiple interfaces, which enhance electron trapping on the interfaces. Furthermore, crack generation in the electrochromic layer is inevitable due to repeated ion insertion and extraction during the service process. These problems increase the fabrication complexity and lead to poor performance and stability, which are severely limiting and prime concerns for the future development of the electrochromism field. Here, a strategy of synthesizing an all-in-one self-healing electrochromic material, TAFPy-MA, is presented, which has been utilized for the fabrication of a high-reliability, large-scale, and easy-assembly smart electrochromic window. The all-in-one self-healing electrochromic material can undergo in situ redox reactions with Li+ ions to reduce resistance transfer and avoid interface obstacles, and the reversible Diels-Alder cross-linking network structure can heal the cracks to improve the reliability of the electrochromic layer. High ion diffusivity (1.13 × 10-5 cm2 s-1), rapid color switching (3.9/3.7 s), high coloration efficiency (413 cm2 C-1), excellent stability (sustains 88.7% after 1000 cycles) and reliability (crack can be healed in 110 s), and large-scale smart windows (30 × 35 cm2) are achieved using the all-in-one electrochromic material, which exhibits fascinating and promising features for a wide range of applications in buildings, airplanes, etc.

[Case-control study on polymer polylactic acid absorbable medical film for preventing acromion adhesion after arthroscopic rotator cuff repair].

OBJECTIVE: To study effect of shoulder joint function after rotator cuff repair of polylactic acid absorbable membrane. METHODS: From September 2015 to December 2016, 50 patients diagnosed with rotator cuff tear were selected and divided into treatment group and control group. There were 25 patients in control group, including 12 males and 13 females, with an average age of (48.7±3.5) years old, who received simple arthroscopic rotator cuff repair. There were 25 patients in treatment group, including 11 males and 14 females, with an average age of(49.2±4.1) years old, who performed arthroscopic rotator cuff repair with implanting polylactic acid absorbable membraneon shoulder of rotator cuff. Preoperative and postoperative VAS score, ASES score and UCLA score were recorded and compared between two groups. RESULTS: At 6 months after operation, preoperative VAS score in control group was 5.48±1.12, and decreased as 1.28±0.84 after operation; ASES score before operation was 52.24±4.64, and improved to 86.92±3.20 after operation;preoperative UCLA score improved from 14.36±1.89 before operation to 30.72±1.28 after operation. In treatment group, VAS score decreased from 5.36±1.32 before operation to 1.40±0.71 after operation;preoperative ASES score was 51.04±4.09, and improved to 88.96±2.79 after operation; UCLA score improved from 15.12±1.81 before operation to 32.12±1.33 after operation. There was no significant difference in VAS score between two groups, and ASES score, UCLA score in treatment group was obviously better than control group. CONCLUSIONS: Application of polylactic acid absorbable medical membrane could obviously improve shoulder function, and effectively prevent acromion adhesion after arthroscopic rotator cuff repair.

Intelligent Biomimetic Chameleon Skin with Excellent Self-Healing and Electrochromic Properties.

Animals such as chameleons possess a natural ability to adjust their skin color as a preventive measure to deter any potential threat and to self-heal damaged skin tissues. Inspired by this, we present here a copolymer film possessing biomimetic properties that simultaneously integrates electrochromic triphenylamine and self-healing Diels-Alder groups. The flexible and stretchable copolymer film acts like natural chameleon skin, which exhibits significant color variation and also possesses excellent self-healing properties. These remarkable features make it a promising material for overcoming the crack-generation issue inherited by conventional biomimetic chameleon skin. Moreover, a flexible and wearable skin device based on the copolymer film with silver fabric as a electrode has also been fabricated. The electrochromic and self-healing properties were verified for the copolymer film, and it has been elucidated that the intelligent biomimetic "chameleon skin" was a new step toward the development of highly advanced biomimetic materials and devices.

Bone Tunnel Impaction Reduced the Tibial Tunnel Enlargement.

The purpose of this study was to investigate whether the bone tunnel impaction technique performed by dilators could dwindle the tibial tunnel enlargement after anterior cruciate ligament (ACL) reconstruction with hamstring tendon using both extracortical suspensory fixation devices at femoral and tibial site. Thirty-one consecutive patients undergoing primary ACL reconstruction with the hamstring autograft were enrolled in this research. Patients were randomly allotted to group A (bone tunnel impaction technique using dilators) or group B (regular extraction bone tunnel drilling). RESULTS: The average follow-up was 16.2 months. The mean femoral tunnel widening was 1.05 mm and 1.02 mm respectively in group A and B. The mean tibial tunnel widening was 0.61 mm and 1.08 mm respectively in group A and B. There was no statistical difference for tunnel enlargement between the two groups at the femoral site (P = 0.62) but significant difference at the tibial site (P < 0.0001). CONCLUSION: Bone tunnel impaction technique leaded to a reduction of tibial bone tunnel enlargement after ACL reconstruction with hamstring tendon using both extracortical suspensory fixation devices at femoral and tibial site.

PERPENDICULAR DOUBLE-PLATE FIXATION WITH LOCKING SYSTEM FOR ACROMION PEDICLE FRACTURE.

OBJECTIVE: : To describe the surgical technique and preliminary clinical outcomes in a series of open reduction internal fixation of basal acromion process fractures applying a double-plating technique. METHODS: : Nine consecutive patients, mean age 33.4 years old (range, 23-61 years old) with unilateral acromion fracture (Type 3 AO/OTA) with more than 1cm displacement who underwent fixation utilizing a locked double-plating technique, were evaluated on average at 7.8 months (range, 3-15 months) for outcomes related to pain, shoulder function, and surgical complications. RESULTS: : Eight patients recovered with complete radiographic union and favorable shoulder function. One case failed to be fully evaluated for more than 3 months follow-up. The overall scores of Constant, Shoulder Pain and Disability Index (SPADI) and DASH for the eight patients reviewed were 91.9± 6.31, 3.11± 3.79 and 5.2± 6.35, respectively. No post-operative infection or surgical hardware irritation was identified at final follow-up of these eight patients. CONCLUSION: : While more evidence is needed to justify its advantages over traditional implants, perpendicular double-plate with a locking system may be indicated for acromion pedicle fracture treatment, since it performed well for fracture healing and joint function rehabilitation. Level of Evidence IV, Therapeutic Study.

[Treatment of acromion base fractures with double plates internal fixation].

OBJECTIVE: To study clinical effects of double plates fixation for the treatment of acromion base fracutres. METHODS: From January 2010 to May 2012, 7 patients with acromion base fractures were treated with double plates ORIF surgical treatment. There were 5 males and 2 females, with an average age of 36.3 years old (ranged, 24 to 62 years old). All fractures were acuted and closed injuries. The duration from injury to surgery was 4.6 days (ranged, 2 to 10 days). Hardegger functional criterion, Visual Analogue Scale (VAS) and complications of the patients were documented analysis. RESULTS: All the patients were followed up,and the duration ranged from 4 to 13 months (averaged 8.9 months). The healing duration of fractures ranged from 8 to 14 weeks without any infection, shoulder instability, subacromial impingement syndrome, nonunion and failure of internal fixation. At the latest follow-up, the VAS ranged from 0 to 5. According to Hardegger criterion, 2 patients got an excellent result, 4 good and 1 poor. CONCLUSION: Double plates ORIF plays a positive role in the treatment of acromion base fractures, which reduces complications and maximally restore the function of shoulder.

Fixação perpendicular com dupla-placa e sistema de bloqueio para fratura de pedículo do acrômio / Perpendicular double-plate fixation with locking system for acromion pedicle fracture

Objetivo: Descrever a técnica cirúrgica e os resultados clínicos preliminares em uma série de cirurgias de redução aberta e fixação interna de fraturas do processo acrômio basais aplicando a técnica de dupla placa. Métodos: Nove pacientes consecutivos, com idade média de33,4 anos (intervalo, 23-61 anos) com fratura unilateral do acrômio (Tipo 3 AO/OTA) com mais de 1 cm de deslocamento submetidos afixação utilizando uma técnica de dupla placa bloqueada, tiveram os resultados avaliados em média após 7,8 meses (intervalo, 3-15 meses)referente à dor, função do ombro, e complicações cirúrgicas. Resultados:Oito pacientes se recuperaram com união radiográfica completa e função do ombro favorável. Um caso deixou de ser completamente avaliado por mais de 3 meses de seguimento. Os escores totais de Constant, dor no ombro e Disability Index (SPADI) e DASH para os oito pacientes revistos foram 91,9 ± 6,31, 3,11 ± 3,79 e 5,2 ± 6,35,respectivamente. Não houve infecção ou irritação decorrente das ferragens cirúrgicas no pós-operatório ao final do seguimento destes oito pacientes. Conclusão: Apesar de serem necessárias mais evidências para justificar suas vantagens sobre os implantes tradicionais, a dupla placa perpendicular com sistema de bloqueio pode ser indicada para tratamento de fratura do pedículo do acrômio, uma vez que apresentou bom desempenho na cicatrização óssea e reabilitação da função articular. Nível de Evidência IV, Estudo Terapêutico.

Objective: To describe the surgical technique and preliminaryclinical outcomes in a series of open reduction internal fixationof basal acromion process fractures applying a double-platingtechnique. Methods: Nine consecutive patients, mean age 33.4years old (range, 23–61 years old) with unilateral acromion fracture(Type 3 AO/OTA) with more than 1cm displacement whounderwent fixation utilizing a locked double-plating technique,were evaluated on average at 7.8 months (range, 3-15 months)for outcomes related to pain, shoulder function, and surgicalcomplications. Results: Eight patients recovered with complete radiographicunion and favorable shoulder function. One case failedto be fully evaluated for more than 3 months follow-up. The overallscores of Constant, Shoulder Pain and Disability Index (SPADI)and DASH for the eight patients reviewed were 91.9± 6.31, 3.11±3.79 and 5.2± 6.35, respectively. No post-operative infection orsurgical hardware irritation was identified at final follow-up ofthese eight patients. Conclusion: While more evidence is neededto justify its advantages over traditional implants, perpendiculardouble-plate with a locking system may be indicated for acromionpedicle fracture treatment, since it performed well for fracturehealing and joint function rehabilitation. Level of Evidence IV,Therapeutic Study.