Jian-ke Pan

Component analysis of Chinese medicine and advances in fuming-washing therapy for knee osteoarthritis via unsupervised data mining methods.

OBJECTIVE To analyze the component law of Chinese medicines in fuming-washing therapy for knee osteoarthritis (KOA), and develop new fuming-washing prescriptions for KOA through unsupervised data mining methods. METHODS Chinese medicine recipes for fuming-washing therapy for KOA were collected and recorded in a database. The correlation coefficient among herbs, core combinations of herbs, and new prescriptions were analyzed using modified mutual information, complex system entropy cluster, and unsupervised hierarchical clustering, respectively. RESULTS Based on analysis of 345 Chinese medicine recipes for fuming-washing therapy, 68 herbs occurred frequently, 33 herb pairs occurred frequently, and 12 core combinations were found. Five new fuming-washing recipes for KOA were developed. CONCLUSION Chinese medicines for fuming-washing therapy of KOA mainly consist of wind-dampness-dispelling and cold-dispersing herbs, blood-activating and stasis-resolving herbs, and wind-dampness-dispelling and heat-clearing herbs. The treatment of fuming-washing therapy for KOA also includes dispelling wind-dampness and dispersing cold, activating blood and resolving stasis, and dispelling wind-dampness and clearing heat. Zhenzhutougucao (Herba Speranskiae Tuberculatae), Honghua (Flos Carthami), Niuxi (Radix Achyranthis Bidentatae), Shenjincao (Herba Lycopodii Japonici), Weilingxian (Radix et Rhizoma Clematidis Chinensis), Chuanwu (Radix Aconiti), Haitongpi (Cortex Erythrinae Variegatae), Ruxiang (Olibanum), Danggui (Radix Angelicae Sinensis), Caowu (Radix Aconiti Kusnezoffii), Moyao (Myrrha), and Aiye (Folium Artemisiae Argyi) are the main herbs used in the fuming-washing treatment for KOA.

The efficacy and safety of the Shaoyao Shujin tablet for knee osteoarthritis: study protocol for a randomized controlled trial

BackgroundKnee osteoarthritis (KOA) is a major public health issue causing chronic disability as well as a burden on healthcare resources. In China, a herbal drug tablet has been used as an effective and conventional therapy to alleviate clinical symptoms caused by KOA. However, evidence gathered from systematic reviews or randomized controlled trials that validated herbal drugs for the management of osteoarthritic pain is weak. The purpose of this study is to explore the efficacy and safety of the Shaoyao Shujin tablet for the management of KOA in a short-term study.Methods/DesignThis trial is a multicenter randomized, double-blind, placebo-controlled study. A total of 276 patients will be randomized into 3 groups: (1) the high-dose Shaoyao Shujin tablet group (HD group), (2) the low-dose Shaoyao Shujin tablet group (LD group), and (3) the placebo tablet group (control group). In the three groups, four tablets will be administered three times per day for 6 weeks. Follow-up will be at regular intervals during a 10-week period with the Western Ontario and McMaster Universities Index (WOMAC) score, visual analog scale (VAS) score, and rescue medication use assessed as outcome measures.DiscussionThis study will provide clinical evidence on the efficacy and safety of the Shaoyao Shujin tablet in treating KOA.Trial registrationChinese Cochrane Center ChiCTR-IPR-15006194, registered 4 April 2015.

Postoperative autotransfusion drain after total hip arthroplasty: a meta-analysis of randomized controlled trials

The use of a postoperative autotransfusion drain (PATD) to reduce allogenic blood transfusions in total hip arthroplasty (THA) remains controversial. Therefore, we conducted a meta-analysis to evaluate the efficacy and safety of this technique. Randomized controlled trials (RCTs) were identified from PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). Thirteen RCTs (1,424 participants) were included in our meta-analysis. The results showed that PATD reduced the rate of allogenic transfusions (RR = 0.56; 95% CI [0.40, 0.77]) and total blood loss (MD = −196.04; 95% CI [−311.01, −81.07]). Haemoglobin (Hb) levels were higher in the PATD group on postoperative day 1 (MD = 0.28; 95% CI [0.06, 0.49]), but no significant differences on postoperative days 2 or 3 (MD = 0.29; 95% CI [−0.02, 0.60]; MD = 0.26; 95% CI [−0.04, 0.56]; respectively). There were no differences in length of hospital stay (MD = −0.18; 95% CI [−0.61, 0.25]), febrile reaction (RR = 1.26; 95% CI [0.95, 1.67]), infection (RR = 0.95; 95% CI [0.54, 1.65]), wound problems (RR = 1.07; 95% CI [0.87, 1.33]), or serious adverse events (RR = 0.59; 95% CI [0.10, 3.58]). Our findings suggest that PATD is effective in reducing the rate of allogenic transfusion. However, the included studies are inadequately powered to conclusively determine the safety of this technique.

Do Chinese Researchers Conduct Ethical Research and Use Ethics Committee Review in Clinical Trials of Anti-Dementia Drugs? An Analysis of Biomedical Publications Originating from China

BACKGROUND Medical research using human participants must conform to the basic ethical principles found in the Declaration of Helsinki (DoH) of the World Medical Association. OBJECTIVE The purpose of this review was to assess whether journals in China have improved in regard to the fulfillment of ethical disclosure procedures for clinical trials of anti-dementia drugs. METHODS Four medical databases were searched for articles reporting clinical trials of oral anti-dementia drugs published in China in 2003, 2009, and 2014. The frequencies of reporting of informed consent from participants (ICP), approval of a regional ethical committee (REC), reference to DoH, and study registration were estimated respectively. Statistical analyses were conducted with SPSS v21 software. RESULTS Among those randomized controlled trials published in 2003, 2009, and 2014, disclosure of REC approval was present for 2.67%, 1.15%, and 6.84%; statements of ICP were included in 9.33%, 7.76%, and 17.34%; reference to DoH was found for 4.00%, 1.44%, and 7.45%; and study registration reporting was included in 2.67%, 2.59%, and 9.28%, respectively. Improvements to reporting rates between 2009 and 2014 were seen, with more than twice as many trials reporting REC approval, ICP, reference to DoH, and study registration compared with 2009. CONCLUSION Compared with 2003 and 2009, reporting rates for REC approval, ICP, reference to DoH, and study registration for clinical trials of anti-dementia drugs were enhanced in 2014 in the major medical journals of China. However, biomedical publications without definite statements of ethical considerations remain common, and this continues to be seen in Chinese journals. It is imperative that measures are taken to reinforce the ethical protection in clinical trials in China.

Continuous intra-articular infusion anesthesia for pain control after total knee arthroplasty: study protocol for a randomized controlled trial

BackgroundPostoperative pain control after total knee arthroplasty (TKA) remains a great challenge. The management of pain in the immediate postoperative period is one of the most critical aspects to allow speedier rehabilitation and reduce the risk of postoperative complications. Recently, periarticular infiltration anesthesia has become popular, but the outcome is controversial. Some studies have shown transient effects, “rebound pain”, or no effectiveness in pain control. Continuous intra-articular infusion technique has been introduced to improve these transient effects, but more clinical studies are needed. Furthermore, the potential risk of early periprosthetic joint infection is causing concerning. We plan to compare continuous intra-articular infusion anesthesia with epidural infusion anesthesia after TKA to assess the effectiveness of this technique in reducing pain, in improving postoperative function, and to look at the evidence for risk of early infection.Methods/designThis trial is a randomized, controlled study. Patients (n = 214) will be randomized into two groups: to receive continuous intra-articular infusion anesthesia (group C); and epidural infusion anesthesia (group E). For the first 3 postoperative days, pain at rest, active range of motion (A-ROM), rescue analgesia and side effects will be recorded. At 3-month and 6-month follow-up, A-ROM, C-reactive protein, erythrocyte sedimentation rate, and synovial fluid cell count and culture will be analyzed.DiscussionThe results from this study will provide clinical evidence on the efficacy of a continuous intra-articular infusion technique in reducing pain, postoperative functional improvement and safety. It will be the first randomized controlled trial to investigate infection risk with local anesthesia after TKA.Trial registrationClinicalTrials.gov identifier: ChiCTR-TRC-13003999

An exploration of the role of a fish-oriented diet in cognitive decline: a systematic review of the literature

Epidemiological studies have presented inconsistent evidence of the correlation between a fish-oriented dietary intake (FDI) and the risk of cognitive decline. To address these controversies, we performed this systematic review of prospective studies published in December 2016 and earlier using PubMed, Embase, and Web of Science. Two independent researchers conducted the eligibility assessment and data extraction; all discrepancies were solved by discussion with a third researcher. The pooled relative risks (RRs) focused on the incidence of events were estimated with 95% confidence intervals (CIs). Overall, nine studies containing 28,754 subjects were analyzed. When the highest and lowest categories of fish consumption were compared, the summary RR for dementia of Alzheimer type (DAT) was 0.80 (95%CI = 0.65–0.97); i.e., people with a higher intake of fish had a 20% (95%CI = 3–35%) decreased risk of DAT. Additionally, the dose-response synthesized data indicated that a 100-g/week increase in fish intake reduced the risk of DAT by an additional 12% (RR = 0.88, 95%CI = 0.79–0.99). Non-significant results were observed for the risk of dementia of all causes (DAC) and mild cognitive impairment (MCI). Limited evidence involving heterogeneity was found within subgroups or across studies. In conclusion, this review confirmed that a higher intake of fish could be correlated with a reduced risk of DAT. Further research, especially prospective studies that specifically quantify FDI, will help find a more accurate assessment of the different levels of dietary intake.

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

BackgroundAutologous blood transfusion drainage (ABTD) has been used for many years to reduce blood loss in total knee arthroplasty (TKA). We evaluate the current evidence concerning the efficiency and safety of ABTD used in TKA compared with conventional suction drainage (CSD).MethodsWe performed a systematic literature search of the PubMed, Embase, Cochrane Library and four Chinese databases. All randomized controlled trials (RCTs) that compared the effects of ABTD versus CSD in TKA were included in the meta-analysis.ResultsSixteen RCTs involving 1534 patients who compared the effects of ABTD versus CSD were included. Five of the RCTs were performed in Asia, ten in Europe, and one in North America. Patients in the ABTD group had a lower blood transfusion rate (OR: 0.25 [0.13, 0.47]; Z = 4.27, P < 0.0001) and fewer units transfused per patient (WMD: −0.68 [−0.98, −0.39]; Z = 4. 52, P < 0.00001) than did patients in the CSD group. Wound complications, deep vein thrombosis, febrile complications, post-operative hemoglobin days 5–8, drainage volume, and length of hospital stay did not differ significantly between the two types of drainage systems.ConclusionThis meta-analysis suggests that ABTD is a safe and effective method that yields a lower blood transfusion rate and fewer units transfused per patient in TKA compared with CSD.

Study on the distinguishing feature in use of Chinese drugs on cervical spondylosis patients in perimenopausal period through data mining methods

Objective: To analyze the distinguishing feature in use of Chinese drugs on cervical spondylosis patients in perimenopausal period through data mining methods. Methods: Chinese medicine recipes for cervical spondylosis patients in perimenopausal period were collected and recorded in the database, and then the correlation coefficient between herbs, core combinations of herbs were analyzed by using modified mutual information, complex system entropy cluster, respectively. Results: Based on the analysis of Chinese medicine recipes for cervical spondylosis patients in perimenopausal period, drugs with high-frequency occurrence in these recipes, frequently-used herb pairs and core combinations, et al. will been founded. Discussion: From the result, we may find the main Chinese medicines for cervical spondylosis patients in perimenopausal period, and the therapeutic principle for cervical spondylosis patients in perimenopausal period, and the method of treatment for cervical spondylosis patients in perimenopausal period. These data may help to reveals the relationship between cervical spondylosis and the physiological and pathology of the menopausal transition.

Research on the component law of Chinese medicine for knee osteoarthritis and the development of new recipes through unsupervised data mining methods

Objective: To analyze the component law of Chinese medicines for knee osteoarthritis, and develop new prescriptions for knee osteoarthritis through unsupervised data mining methods. Methods: Chinese medicine recipes for knee osteoarthritis were collected and recorded in the database, and then the correlation coefficient between herbs, core combinations of herbs and new prescriptions were analyzed by using modified mutual information, complex system entropy cluster and unsupervised hierarchical clustering, respectively. Results: Based on the analysis of 64 Chinese medicine recipes for knee osteoarthritis, 23 drugs with high-frequency occurrence in these recipes, 24 frequently-used herb pairs and 8 core combinations were founded, and 3 new recipes for knee osteoarthritis were developed. Conclusion: Chinese medicines for knee osteoarthritis were mainly consist of blood-activating and stasis-resolving medicinal, blood-activating and qi-moving medicinal, kidney-enriching and liver-nourishing medicinal. The treatment principle for knee osteoarthritis is to eliminate the pathogenic factors and reinforce the healthy qi. Radix Saposhnikoviae, Radix Salviae Miltiorrhizae, Fructus Chaenomelis, Caulis Spatholobi, Poria, Herba Asari, Radix Angelicae Pubescentis, Corthex Eucommiae, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Gentianae Macrophyllae, Radix Glycyrrhiz ae, Radix Achyranthis Bidentatae, Radix Clematidis, Radix Rehmanniae Preparata, Herba Taxilli, Radix Astragall, Rhizoma Chuanxiong, Radix Dipsaci and Rhizoma Drynariae are the main herbal drugs used in the treatment on knee osteoarthritis.

Research on the component law of Chinese medicine for gout and the development of new recipes through unsupervised data mining methods

Objective: To analyze the component law of Chinese medicines for gout, and develop new prescriptions for gout through unsupervised data mining methods. Methods: Chinese medicine recipes for gout were collected and recorded in the database, and then the correlation coefficient between herbs, core combinations of herbs and new prescriptions were analyzed by using modified mutual information, complex system entropy cluster and unsupervised hierarchical clustering, respectively. Results: Based on the analysis of 70 Chinese medicine recipes for gout, 22 drugs with high-frequency occurrence in these recipes, 26 frequently-used herb pairs and 5 core combinations were founded, and 3 new recipes for gout were developed. Conclusion: Chinese medicines for gout were mainly consist of blood-activating and stasis-dispelling medicinal, dampness-resolving medicinal, spleen fortifying and dampness draining medicinal, wind-dampness dispelling and heat clearing medicinal. The the treatment principle for gout is to eliminate the pathogenic factors. Radix Clematidis, Rhizoma Atractylodis, Rhizoma Dioscoreae Septemlobae, Semen Coicis, Cortex Phellodendri, Rhizoma Alismatis, Rhizoma Anemarrhenae, Radix Achyranthis Bidentatae, Radix Glycyrrhizae, Poria, Semen Plantaginis, and Rhizoma Atractylodis Macrocephalae are the main herbal drugs used in the treatment of gout.