Xuewei Cao

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.

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

Clinical effectiveness and micro-perfusion alteration of Jingui external lotion in patients with knee osteoarthritis: study protocol for a randomized controlled trial

BackgroundKnee osteoarthritis is a major cause of disability in the aging population. Based on pathological, magnetic resonance imaging (MRI) and arthroscopy studies, progressive osteoarthritis involves all tissues of the joint and includes bone marrow lesions, synovial proliferation, fat pad inflammation, and high subchondral bone turnover. Recent research suggests that abnormal perfusion in bone marrow lesions, fat pads, and subchondral bone is associated with pain in knee osteoarthritis, and that dynamic contrast-enhanced MRI is a promising method for studying micro-perfusion alteration in knee osteoarthritis. Traditional Chinese Medicine approaches have been employed for thousands of years to relieve knee osteoarthritis pain. Among herbal medicines, the Jingui external lotion is the preferred and most commonly used method in China to reduce pain in patients with knee osteoarthritis; however, there is a lack of validated evidence for its effectiveness. The purpose of this study is to explore the effectiveness of Jingui external lotion for the management of painful knee osteoarthritis in a short-term study. In addition, we will assess micro-perfusion alteration in the patellar fat pad as well as the femur and tibia subchondral bone via dynamic contrast-enhanced MRI.Methods/designThis trial is a randomized, controlled study. A total of 168 patients will be randomized into the following two groups: 1) the Jingui external lotion group (treatment group); and 2) the placebo lotion group (control group). In both groups, lotion fumigation and external washing of the patients’ knees will be administered twice a day for 14 consecutive days. Follow-up will be at regular intervals during a 4-week period with a visual analog scale to assess pain, and additional characterization with the Western Ontario and McMaster Universities Index score; rescue medication will be recorded as the extent and time pattern. In addition, micro-perfusion alteration in the patellar fat pad, femur and tibia subchondral bone will be assessed via dynamic contrast-enhanced MRI.DiscussionThis study will provide clinical evidence of the efficacy of Jingui external lotion in treating knee osteoarthritis, and it will be the first randomized controlled trial to investigate micro-perfusion alteration of knee osteoarthritis with Traditional Chinese Medicine external lotion via dynamic contrast-enhanced MRI.Trial registrationClinicalTrials.gov identifier: ChiCTR-TRC-14004727; 31 May 2014.

Clinical Characteristics and Treatment of Spontaneous Osteonecrosis of Medial Tibial Plateau: A Retrospective Case Study

Background: In a small proportion of cases, spontaneous osteonecrosis of the knee (SONK) involves the medial tibial plateau (MT). Here, we introduced the clinical characteristics of spontaneous osteonecrosis of the MT and unicompartmental knee arthroplasty (UKA) as the favorable treatment for this situation based on a retrospective case study. Methods: Patients with spontaneous osteonecrosis of the MT, confirmed by magnetic resonance imaging (MRI) at Guangdong Provincial Hospital of Chinese Medicine (China) from March 2015 to June 2016, were included as a case serial and analyzed retrospectively. All patients underwent Oxford Medial UKA. The characteristics of their lesions, corresponding treatment, and results of follow-up were presented. The lesion scores and grade were determined according to the criteria of Ficat and Arlet. Results: In total, 22 patients (5 men, 17 women; mean age, 64.1 years) with spontaneous osteonecrosis of the MT were analyzed. The lesion stages assessment showed that 3 (14%) were Stage II, 10 (45%) were Stage III, 7 (32%) were Stage IV, and 2 (9%) were Stage V. In the sagittal plane, 7 (32%) were in the anterior region (MTa) and 15 (68%) were central (MTc). The lesion volume averaged 2.24 ± 0.79 cm3 (range: 1.57–3.08 cm3). Seventeen patients (77%) had Level III posterior medial meniscus root tears (MMRTs). All the patients underwent UKA. Average follow-up was 30.0 ± 6.4 months with a range of 23.0–38.0 months. The visual analog scale score was 7.78 ± 0.67 before surgery while decreased to 2.22 ± 1.09 at the final follow-up (P < 0.001). The Hospital for Special Surgery scores of pre-/post-surgery were 65.67 ± 5.45 and 84.10 ± 4.20, respectively (P < 0.001). Conclusions: SONK often occurs in the anterior and central tibial plateau due to abnormal stresses. Most of the patients had Level III posterior medial meniscus root tears. MRI is recommended for suspected cases to identify SONK at an early stage. The use of the Oxford Medial UKA for SONK of the MT is reliable both immediately and at follow-up.

The influence of acupuncture therapy on early rehabilitation following anterior cruciate ligament reconstruction: A randomized controlled trial

The purpose of this study was to determine whether acupuncture is effective in reducing pain and swelling around the knee and improving range of motion (ROM) during the early rehabilitation after anterior cruciate ligament(ACL) reconstruction. Following ACL reconstruction, 80 patients were randomly assigned to either an acupuncture treatment group (Group A) or a control group (Group C). In Group A, the complementary treatment of acupuncture was performed three times week from postoperative day 7 until postoperative day 21. Outcome measures were:1) pain as assessed by a visual analog scale; 2) reduction of swelling around the knee as indicated by its circumference at the center of the patella; and 3) ROM of the affected knee.

Mutual information mining for component law and development of new recipes for rheumatoid arthritis

To analyze the component law of Chinese medicines for rheumatoid arthritis, and develop new prescriptions for rheumatoid arthritis through mutual Information mining methods. Chinese medicine recipes for rheumatoid arthritis 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. Based on the analysis of 63 Chinese medicine recipes for rheumatoid arthritis, 30 drugs with high-frequency and the distribution of Four Qi and Five Flavors of Chinese medicines occurrence in these recipes,34 frequently-used herb pairs and 9 core combinations were founded, and 3 new recipes for rheumatoid arthritis were developed. Chinese medicines for rheumatoid arthritis were mainly consist of blood-activating and stasis-dispelling edicinal, wind-dampnessdispelling and heatclearing medicinal, heat-clearing and detoxicating medicinal, tonifying and replenishing medicinal. So, the therapeutic principle for rheumatoid arthritisis to reinforce the healthy qi and eliminate the pathogenic factors. Radix Gentianae Macrophyllae, Rhizoma Chuanxiong, Radix Glycyrrhizae,Radix Angelicae Pubescentis,Radix Paeoniae Alba,Radix Angelicae Sinensis,Radix Achyranthis Bidentatae,Ramulus Cinnamomi,Rhizoma Et Radix Notopterygii and Radix Astragali are the main herbal drugs used in the treatment of rheumatoid arthritis.

Mutual information mining for component law and development of new recipes for ankylosing spondylitis

To analyze the component law of Chinese medicines for ankylosing spondylitis, and develop new prescriptions for ankylosing spondylitis through mutual information mining methods. Chinese medicine recipes for ankylosing spondylitis 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. Based on the analysis of 61 Chinese medicine recipes for ankylosing spondylitis, 26 drugs with high-frequency and the distribution of Four Qi and Five Flavors of Chinese medicines occurrence in these recipes, 23 frequently-used herb pairs and 12 core combinations were founded, and 6 new recipes for ankylosing spondylitis were developed. Chinese medicines for ankylosing spondylitis were mainly consist of kidney yang-tonifying Medicinal, blood-activating and stasis-dispelling edicinal, wind-dampness dispelling and cold dispersing medicinal. The therapeutic principle for ankylosing spondylitis is to reinforce the healthy qi and eliminate the pathogenic factors. Radix Rehmanniae Praeparata, Radix Glycyrrhizae, Radix Paeoniae Rubra, Rhizoma Chuanxiong, Radix Achyranthis Bidentatae, Radix Angelicae Sinensis, Rhizoma Cibotii, Radix Dipsaci, Herba Taxilli, Corthex Eucommiae, Radix Angelicae Pubescentis and Radix Astragali are the main herbal drugs used in the treatment of ankylosing spondylitis.

Therapeutic effectiveness evaluation on Shishi manipulation for knee osteoarthritis

To evaluate the therapeutic efficacy and clinical characteristics of ShiShi manipulation in treating knee osteoarthritis. A randomized, controlled trail was performed, 60 patients were randomized into 2 groups to receive either (l)group A, ShiShi manipulation was adopted(N=30), or (2) group B, glucosamine hydrochloride (PuLi capsule) was given to take medicine orally(N=30). Courses of treatment in each group were 4 weeks without exception, follow-up review was arranged every two weeks. WOMAC index was adopted to evaluate general curative efficacy, total scale, pain scale, stiff scale, function scale at 2 weeks and 4 weeks of treatment. Compared with before treatment, group A showed a statistical difference in total scale at 2 weeks and 4 weeks follow-up, while group B showed a statistical difference at 4 weeks follow-up. General curative efficacy, pain scale, function scale in group A were significantly better than group B at 2 weeks and 4 weeks follow-up(P <;0.05), while stiffness scale was similar. ShiShi manipulation can obviously alleviate the clinical symptoms of knee osteoarthritis. also it shows better and rapid therapeutic efficacy than PuLi capsule. We assume that ShiShi manipulations worthy of widely applied in treatment of knee osteoarthritis as a complementary medicine.

Study on the law of ancient herbs in the treatment of osteoarthritis

To discover the therapy regularity and compatibility law of ancient herbs in the treatment of osteoarthritis, by means of ancient prose retrieval tools of ZhongHuaYiDian (Dictionary of TCM classics), we applied frequency, factor, cluster analysis to analyze all the herbs in the related literature from the Han Dynasty to articles in the Late Qing Dynasty. We found that the treatment principle was to reinforce the healthy qi and eliminate the pathogenic factors, reinforce the healthy qi, which includes tonifying qi and replenishing blood; eliminate the pathogenic factors including dispelling wind-dampness and cold, and at the same time also using other method of treatment, such as release the exterior, activate blood, drain dampness, regulate qi, and warm the interior. Achyranthes root, cinnamon, white peony root, aconite, radix saposhnikoviae, rhizomaligusticichuanxiong, glycyrrhiza and angelica sinensis are the main herbal medicines in the treatment of osteoarthritis.