Pharmacological effects of bioactive agents in earthworm extract:A comprehensive review

This review compiles information from the literature on the chemical composition,pharmacological effects,and molecular mechanisms of earthworm extract(EE)and suggests possibilities for clinical translation of EE.We also consider future trends and concerns in this domain.We summarize the bioactive components of EE,including G-90,lysenin,lumbrokinase,antimicrobial peptides,earthworm serine protease(ESP),and polyphenols,and detail the antitumor,antithrombotic,antiviral,antibacterial,anti-i nflammatory,analgesic,antioxidant,wound-healing,antifibrotic,and hypoglycemic activities and mechanisms of action of EE based on existing in vitro and in vivo studies.We further propose the potential of EE for clinical translation in anticancer and lipid-modifying therapies,and its promise as source of a novel agent for wound healing and resistance to antibiotic tolerance.The earthworm enzyme lumbrokinase embodies highly effective anticoagulant and thrombolytic properties and has the advantage of not causing bleeding phenomena due to hyperfibrinolysis.Its antifibrotic properties can reduce the excessive accumulation of extracellular matrix.The glycolipoprotein extract G-90 can effectively scavenge reactive oxygen groups and protect cellular tissues from oxidative damage.Earthworms have evolved a well-developed defense mechanism to fight against microbial infections,and the bioactive agents in EE have shown good antibacterial,fungal,and viral properties in in vitro and in vivo experiments and can alleviate inflammatory responses caused by infections,effectively reducing pain.Recent studies have also highlighted the role of EE in lowering blood glucose.EE shows high medicinal value and is expected to be a source of many bioactive compounds.

LUtarjet-limit unique coracoid osteotomy Latarjet(With video)

Background:The Latarjet procedure is an effective technique for the treatment of recurrent anterior shoulder dislocation with glenoid bone loss.However,the inevitable destruction of the coracoacromial arch may result in humeral head translation.The aim of the study is to introduce a modified Latarjet technique with coracoacromial arch preservation as well as its short term clinical outcomes.Methods:We propose a novel individualized flexible arthroscopic suture button fixation Latarjet technique called‘LUtarjet’with video.Precise measurements of the coracoid process,glenoid deficiency and osteotomy plane were made preoperatively.Only three arthroscopic portals were needed and limit unique coracoid osteotomy was performed with coracoacromial arch preser-vation.The mini window splitting of the subscapularis was performed from the posterior to the anterior direction and the split window was as small as 8-10 mm in length.Results:A total of 27 patients(25.6±5.4 years)were included in the study.The average surgical durationwas 55.6±6.3 min and the mean follow-up timewas 8.1±1.5 months.The functional score was significantly improved at the last follow-up.Radiologic evidence showed that the bone graft healing was placed in the desired position.No complications were found.Conclusions:We present a fast,easy,accurate,safe arthroscopic‘LUtarjet’technique called FEAST that can simplify the arthroscopic Latarjet process and achieve a satisfactory bone graft position and satisfactory short-term clinical outcomes.Level of evidence:IV,case series.