Neurodegenerative diseases are associated with neuronal cell death through apoptosis. Apoptosis is tightly associated with the overproduction of reactive oxygen species (ROS), and high glucose levels contribute to higher oxidative stress in diabetic patients. Hesperidin, a natural active compound, has been reported to scavenge free radicals. Only a few studies have explored the protective effects of hesperidin against high glucose−induced apoptosis in SH−SY5Y neuronal cells. Glucose stimulated neuronal cells to generate excessive ROS and caused DNA damage. In addition, glucose triggered endoplasmic reticulum stress and upregulated cytoplasmic as well as mitochondrial calcium levels. Hesperidin inhibited glucose−induced ROS production and mitigated the associated DNA damage and endoplasmic reticulum stress. The downregulation of antiapoptotic protein Bcl−2 following glucose treatment was reversed by a hesperidin treatment. Furthermore, hesperidin repressed the glucose−induced Bcl−2−associated X protein, cleaved caspase−9, and cleaved caspase−3. Hesperidin also suppressed the glucose−induced phosphorylation of extracellular signal−regulated kinase and c−Jun N−terminal kinase. The current results confirmed that hesperidin could protect neuronal cells against glucose−induced ROS. Mechanistically, hesperidin was shown to promote cell viability via attenuation of the mitogen−activated protein kinase signaling pathway.

Background: We have applied an anterior locking compression mini plate in addition to a conventional superior locking compression plate for the treatment of wedge or multifragmentary clavicular fractures. Methods: Medical and radiologic data were retrospectively reviewed for patients who underwent surgical fixation with an anterior locking compression mini plate and conventional anatomical locking compression plate in a clavicle fracture of AO/OTA 15.2 B and 15.2 C. The primary outcome was bone union, and the secondary outcome was postoperative complications associated with the procedure. The functional outcomes included the Visual Analog Scale (VAS), University of California at Los Angeles Shoulder Scale (UCLASS), and Constant Shoulder Scale (CSS). Results: Nineteen patients with AO/OTA 15.2 B and 2 C clavicular fractures were followed for an average of 16 months (range: 12–30). The average patient age was 41 (range: 21–76) years, and 17 male and 2 female patients were included. The most common cause of clavicle fractures was sports activity (36.8%). A total of 10 patients had AO/OTA classification 15.2 C, and 9 patients had AO/OTA classification 15.2 B clavicular fractures. Primary fracture union healing was observed in all 19 (100%) patients, and the average time to bone union was 11 weeks (range: 7~21). There was no fixation failure or postoperative infection. The mean VAS, UCLASS, and CSS scores at the final follow-up were 0.6, 33.4, and 65 on a 75-point scale (87 on a 100-point scale), respectively. Conclusions: Dual plating using an anterior mini plate with a superior LCP could be considered as an option to minimize soft-tissue injury in comminuted mid-shaft clavicle fractures.