Phytochemical Analysis and Antioxidant and Antidiabetic Activities of Extracts from Bergenia ciliata, Mimosa pudica, and Phyllanthus emblica.

Diabetes is a metabolic disorder of high blood sugar levels which leads to various chronic health-related complications. The digestive enzymes α-amylase and α-glucosidase play a major role in the hydrolysis of starch to glucose; hence, inhibiting these enzymes is considered an important strategy for the treatment of diabetes. Medicinal plants such as Bergenia ciliata, Mimosa pudica, and Phyllanthus emblica are commonly used in traditional remedies due to their numerous health benefits. This study aimed to determine the phytochemicals as well as TPC and TFC contents in these plant extracts along with their antioxidant and enzyme inhibitory activity against α-glucosidase and α-amylase. The ethyl acetate extracts of selected plants have shown higher TPC and TFC contents. The aqueous extract of B. ciliata (IC50: 16.99 ± 2.56 µg/mL) and ethyl acetate extract of P. emblica (IC50: 11.98 ± 0.36 µg/mL) and M. pudica (IC50: 21.39 ± 3.76 µg/mL) showed effective antioxidant activities. Furthermore, ethyl acetate extract of B. ciliata showed significant inhibitory activity against α-amylase and α-glucosidase with IC50 values of 38.50 ± 1.32 µg/mL and 3.41 ± 0.04 µg/mL, respectively. Thus, secondary metabolites of these medicinal plants can be repurposed as effective inhibitors of digestive enzymes.

Antidiabetic, Antimicrobial, and Molecular Profiling of Selected Medicinal Plants.

Natural products have been the center of attraction ever since they were discovered. Among them, plant-based natural products were popular as analgesics, anti-inflammatory, antidiabetic, and cosmetics and possess widespread biotechnological applications. The use of plant products as cosmetics and therapeutics is deep-rooted in Nepalese society. Although there are few ethnobotanical studies conducted, extensive research of these valuable medicinal plants has not been a priority due to the limitation of technology and infrastructure. Here, we selected 4 traditionally used medicinal plants to examine their bioactive properties and their enzyme inhibition potential. α-Glucosidase and α-amylase inhibitory activities were investigated using an in vitro model followed up by antioxidant and antimicrobial activities. The present study shows that ethyl acetate fraction of Melastoma melabathrium (IC50 9.1 ± 0.3 µg/mL) and water fraction Acacia catechu (IC50 9.0 ± 0.6 µg/mL) exhibit strong α-glucosidase inhibition. Likewise, the highest α-amylase inhibition was shown by crude extracts of Ficus religiosa (IC50 29.2 ± 1.2 µg/mL) and ethyl acetate fractions of Shorea robusta (IC50 69.3 ± 1.1 µg/mL), and the highest radical scavenging activity was shown by F. religiosa with an IC50 67.4 ± 0.6 µg/mL. Furthermore, to identify the metabolites within the fractions, we employed high-resolution mass spectrometry (LC-HRMS) and annotated 17 known metabolites which justify our assumption on activity. Of 4 medicinal plants examined, ethyl acetate fraction of S. robusta, ethyl acetate fraction of M. melabathrium, and water or ethyl acetate fraction of A. catechu extracts illustrated the best activities. With our study, we set up a foundation that provides authentic evidence to the community for use of these traditional plants. The annotated metabolites in this study support earlier experimental evidence towards the inhibition of enzymes. Further study is necessary to explore the clinical efficacy of these secondary molecules, which might be alternatives for the treatment of diabetes and pathogens.

Bilaterally Threaded, Minimal Invasive, Elastic Locking Intramedullary Nailing (ELIN) for the Treatment of Clavicle Fractures.

OBJECTIVE: To evaluate and present the effectiveness of this innovatively designed, elastic locking intramedullary nail (ELIN) in fixation of clavicle fractures. METHODS: The study included 38 patients from July 2014 to July 2017. All of them received intramedullary fixation treated with ELIN, 22 were males and 16 females. The mean age of the patients was 54 years. There were twenty right-side and 18 left-side clavicular fractures. Radiographs were taken to assess the fracture type: 21 were type A, 16 type B, and one type C. General anesthesia or cervical block was given to all patients. A small incision of 3-5 cm was given only to those who needed mini-open reduction. The administration of ELIN and reduction of the fracture was made sure with a C arm machine. After a follow-up of 8 to 33 months, the clinical outcomes were assessed and evaluated. The constant scores and disabilities of the arm, shoulder and hand questionnaire (DASH) were used to determine the outcomes and functional status of the patients. The study was done accordingly to the guidelines provided by the ethics committee. RESULTS: Mean operation time was 25.63 min. Mean follow-up time was 16.5 months. The rate of closed reduction and open reduction was 84% and 16% respectively. There was no shortening of the clavicle. There was no breakage of the nail, though bending of the nail occurred in one patient. Superficial skin infection occurred in three patients at insertion points or the nail tip which was embedded subcutaneously. Skin erosion with nail exposure occurred in a patient with no significant infection. All the other patients had excellent shoulder function. A mini scar was observed in seven patients all the other patients had no scar. Asymmetry was observed in three patients. The mean Constant score was 98.47 and the mean DASH score was 1.55 at the last follow-up. The implant was removed in all the patients. CONCLUSION: Clavicular fractures treated with ELIN is minimally invasive, which presents a safe and novel surgical technique with less complications and a high success rate, excellent aesthetic and quick recovery after surgery. ELIN restores the micro-dynamic stress at the fracture ends and promotes fracture healing, keeps intact the fracture hematoma and maintains the blood supply, accelerates healing and thus leads to faster osseous healing and better restoration of clavicle length.

Comparison of curative effect of elastic locking intramedullary nail and anatomic locking plate in the treatment of mid?shaft clavicular fracture / 中华骨科杂志

Objective To compare the curative effect between Elastic Locking Intramedullary Nail (ELIN) and Anatomic Locking Plate (ALP) for the treatment of fracture in the mid?shaft of clavicle (Classification AO/OTA:2A/2B). Methods Data of 47 cases of 2A/2B clavicular fractures who were treated with operation from January 2014 to December 2016 were retrospectively analyzed. The patients were divided into ELIN group and ALP group according to different fixation methods. There were 23 cases in ELIN group, 14 male and 9 female, aged from 19 to 85 years (average, 55.26 years).14 cases on the left side and 9 cases on the right side. There were 6 cases of type 2A and 17 cases of type 2B. There were 24 cases in the ALP group, 18 male and 6 fe?male, aged from 15 to 71 years (average, 51.25 years). 16 cases on the left side and 8 cases on the right side. There were 9 cases of type 2A and 15 cases of type 2B. The operation time, intraoperative blood loss, length of skin incision, fracture healing time, ex?traction time of internal fixation, Constant?Murley score of shoulder joint, disabilities of the arm, shoulder, and hand (DASH) score, and complication incidence were compared between the two groups. Results All the operations were successfully performed. The mean follow?up for the patients in the ELIN group was 19.35 weeks (range, 14-23 weeks). The mean follow?up for the patients in the ALP group was 53.13 weeks (range, 28-76 weeks). In the ELIN group, the operative time was 20.78 ± 7.71 min, the intraopera? tive blood loss was 13.26±9.72 ml, the length of incision was 1.57±1.24 cm, the fracture healing time was 10.39±2.39 weeks, the extraction time of internal fixation was 13.17±2.37 weeks, the Constant?Murley score of shoulder joint was 99.09±1.86, and the DASH score was 1.20±2.47. In the ALP group, the operative time was 57.79±11.56 min, the intraoperative blood loss was 69.17± 46.24 ml, the length of incision was 9.67±2.90 cm, the fracture healing time was 14.21±4.05 weeks, the extraction time of internal fixation was 47.38±10.46 weeks, the Constant?Murley score of shoulder joint was 98.00±2.17, and the DASH score was 0.89±1.65. The operation time (t=12.856, P=0.000), intraoperative blood loss (t=5.791, P=0.000) in the ELIN group were less than that of ALP group. The length of incision was significantly smaller in ELIN group than that of ALP group (t=12.549, P=0.000). The frac?ture healing time was earlier in ELIN group than that of ALP group (t=3.566, P=0.002). The extraction time of internal fixation was obviously earlier in ELIN group than that of ALP group (t=15.603, P=0.000). Constant?Murley score of shoulder joint and DASH score showed no significant difference. No delayed healing, no infection was found in the ELIN group, however skin irritation and tail bursitis were found in 6 cases, 3-6 weeks after the operation. The dressing was changed, kept clean. Skin irritation and tail bursitis disappeared, after the extraction of the internal fixation. There were 2 cases of delayed healing in the ALP group. After pro?longed observation, the 2 cases healed. The healing time was extended to 24 and 27 weeks, respectively. There was 1 case of infec?tion, 1 case of poor skin healing in the ALP group. The infected patient was treated with debridement and sensitive antibiotics, and the patient with poor skin healing was treated with dressing change. All the patients had wound healing about 4 weeks after sur?gery. 2 cases of skin irritation in the ALP group disappeared, after the extraction of the internal fixation. Conclusion Both ALP and ELIN are effective methods for the treatment of mid?shaft clavicular fracture. ELIN group has the advantages of more minimal?ly invasive, faster union, shorter internal fixation time, better appearance, and lower medical cost. However, the ELIN group also had skin irritation and temporary bursitis.

The antegrade angle-stable locking intramedullary nail for type-C distal femoral fractures: a thirty four case experience.

INTRODUCTION: This is a retrospective study that provides initial experience and verifies the effectiveness of the newly-designed antegrade interlocking angle-stable intramedullary nail (IAIN) combined with half-threaded cancellous screws in the management of type-C (AO/OTA classification) distal femoral fractures. METHODS: During a period of 30 months, 34 patients (mean age 43.1 years) with type-C (AO/OTA classification) fractures of the distal femur were treated with IAIN and half-threaded cancellous screws were reviewed. Peri-operative and post-operative parameters were analyzed. RESULTS: All of the fractures healed in a mean time of 12.6 weeks with no incidences of malunion, nonunion or infection. No secondary failure of fixation occurred. Partial weight bearing was initiated in an average of 7.4 weeks post-operatively, with full weight bearing initiated in 13.8 weeks. All of the patients, except for one, gained full extension. The mean flexion of the knee joint was 110.1°, while the mean Hospital for Special Surgery (HSS) knee score was 85.2. CONCLUSION: The IAIN and half-threaded cancellous screws provided a reliable fixation that facilitated uncomplicated outcomes and uneventful early mobilization in treating type-C fractures of the distal femur.

Intramedullary nailing for proximal tibial fractures: anatomy, biomechanics and design principles of the nail / 中国组织工程研究

BACKGROUND: The complexity of the anatomic structure of proximal tibia made it difficult for treatment with intramedullary nailing and rate of complications was high. With the improved design and fixation technique of the intramedullary nails, the excellent and good rate of application of this technique is also increasing. Using intramedullary nailing to treat proximal tibial fractures is getting popular. OBJECTIVE: To summarize the latest techniques of intramedullary nailing for proximal tibial fractures. METHODS: 742 literatures were retrieved with keywords of "proximal tibial fracture" and "intramedullary nail" in English and Chinese respectively from PubMed, Web of science, WanFang and CNKI database. By analyzing their titles and summaries, based on the relevance to the subject, 57 articles were selected for this review after excluding 685 articles. RESULTS and CONCLUSION: (1) Due to the complexity of the anatomic structure of the proximal tibia and the limitations of both the fixation techniques and the structure of traditional intramedullary nails, rates of complications were high when intramedullary techniques were used to treat proximal tibial fractures. (2) With the development of intramedullary nail technique, newly designed intramedullary nails appeared, which increased proximal intramedullary nails, improved the position and direction of lock pin. Holding power was strong on the proximal fracture blocks. (3) The introduction of techniques such as combining with plates, Poller screws and improved approval increased the strength of the fixation of proximal tibial fractures. (4) Most of the biomechanical tests have proven that compared to other techniques, intramedullary nailing provides better stability. The intramedullary nailing has advantages of being minimal invasion, less blood transport damage, strong fixation, early postoperative activity and short healing time. It is especially effective for multi-level tibial fractures and proximal tibial fractures with severe soft tissue damages. (5) Deep knowledge of the anatomic structure of the proximal tibia and nailing procedure can help surgeons achieve satisfactory clinical results.