Chinese herbal medicine Xianling Gubao capsule for knee osteoarthritis: A protocol for systematic review and meta-analysis.

BACKGROUND: Knee osteoarthritis (KOA) is the most prevalent degenerative joint disease among populations over 60 years old, and is the most common cause of musculoskeletal pain and disability worldwide. Xianling Gubao capsule (XLGBC), a Chinese patent medicine, is widely used for treatment of osteoporosis. Meanwhile, according to the theory of homotherapy for heteropathy, XLGBC is increasingly applied in the clinical practice of KOA. However, no systematic review has found that XLGBC is as effective in treatment of KOA as it is in treatment of osteoporosis. Therefore, we will conduct a systematic review of XLGBC in KOA treatments. METHODS: All randomized controlled trials assessing the validity of XLGBC therapy for KOA will be retrieved from the following seven databases, including the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan Fang Database, and Chinese Scientific Journal Database. The primary outcome measures are the visual analogue scale pain score, and a comprehensive evaluation including the Western Ontario and McMaster Universities Arthritis Index scores, Lysholm scores, and Bristol scores. And the secondary outcome measures include cure rate and adverse events. The procedure such as retrieval and selection of literature, data extraction, evaluation of risk of bias, and assessment of reporting bias will be executed by 2 reviewers independently. The data synthesis for meta-analysis will be conducted by Review Manager 5.4 software. RESULTS: A high-quality evidence of XLGBC for the treatment of KOA will be generated from the aspects of safety and efficacy. CONCLUSION: This systematic review will provide evidence to help us confirm the clinical efficacy of XLGBC in the treatment of KOA. OSF REGISTRATION NUMBER: Registration DOI 10.17605/OSF.IO/QD5SY.

Evidence of Chinese herbal fumigation for knee osteoarthritis: A protocol for systematic review and meta-analysis.

BACKGROUND: Knee osteoarthritis (KOA) is the most common cause of musculoskeletal pain and disability worldwide. Chinese herbal fumigation, an external therapy, is commonly used for the treatment of KOA, while there is no systematic review or meta-analysis designed to evaluate the effects of Chinese herbal fumigation on KOA. METHODS: Seven databases including Cochrane Central Register of Controlled Trials, EMBASE, PubMed, China National Knowledge Infrastructure, Wanfang data, VIP, and Chinese Biomedical Literature Database will be searched up to October 31, 2020. Data that meet the inclusion criteria will be extracted and analyzed by using RevMan V.5.3 software. Two reviewers will assess quality of the included studies based on the Cochrane Collaboration risk of bias tool. The funnel plot and Begg test will be used to evaluate publication bias. And Grading of Recommendations Assessment, Development and Evaluation will be employed to assess the quality of evidence. RESULTS: This study will provide high-quality evidence for Chinese herbal fumigation for the treatment of KOA in terms of effectiveness and safety. CONCLUSION: This systematic review will provide evidence to help us confirm the clinical efficacy of Chinese herbal fumigation in the treatment of KOA.

Electroacupuncture for the Prevention of Postoperative Cognitive Dysfunction Among Older Adults Undergoing Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Postoperative cognitive dysfunction (POCD) is a common surgical complication in elderly patients undergoing hip and knee replacement. Electroacupuncture (EA) may have a protective effect on postoperative cognitive function, but relevant evidence remains uncertain. Objective: To systematically evaluate the evidence of EA for the prevention of POCD after total joint arthroplasty. Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and Chinese Biomedical Literature Database (CBM) databases were searched until May 1, 2021. Randomized controlled trials (RCTs) in which patients undergoing hip and knee replacement pretreated with EA for preventing POCD were included. The risk of bias was assessed by the Cochrane Collaboration tool. Meta-analysis was performed using Review Manager version 5.4. Results: A total of 11 RCTs with 949 patients were identified. Meta-analysis showed that compared with controls, EA pretreatment significantly reduced the incidence of POCD at 1, 3, and 7 days and 3 and 6 months after the operation. EA was also superior in improving the Mini-Mental State Examination (MMSE) scores on the third postoperative day, but not on the first postoperative day. Neuron-specific enolase (NSE) and interleukin-1ß (IL-1ß) in the EA group were significantly lower than that in the control group. There was no difference in S100ß between the EA group and the control group. Compared to the control group, tumor necrosis factor-α (TNF-α) levels were not significantly lower in the EA group at postoperative hour 0, while significantly decreased at postoperative hours 24 and 48. Conclusion: Our results suggest that EA pretreatment is an effective adjunctive therapy for reducing the incidence of POCD for patients receiving total joint replacement surgery. Its effect was embodied in improving the MMSE scores and NSE, IL-1ß, and TNF-α levels, whereas it had no significant effect on S100ß levels. Meanwhile, the benefits of EA for improving POCD need further strengthening and support from more large-scale, high-quality, and good-homogeneity RCTs. Systematic Review Registration: https://osf.io/xb3e8.

Gas chromatography-mass spectrometry and high-performance liquid chromotagraphy analysis of the drug absorption characteristics in the buccal mucosa via a circulating device.

The aim of the present study was to investigate the characteristics of Su Xiao Jiu Xin dripping pill absorption in the buccal mucosa of healthy volunteers. This pill is a traditional Chinese medicine that is widely used as an emergency treatment for cardiovascular and cerebrovascular diseases. It is sublingually administered and can be absorbed in the buccal mucosa. In the present study, a method was developed to investigate the absorption characteristics in the buccal mucosa of healthy volunteers via a circulating device by gas chromatography-mass spectrometry and high-performance liquid chromatography. The five main efficacy components associated with cardiovascular and cerebrovascular diseases, which are borneol, isoborneol, ligustilide, n-butylphthalide and ferulic acid, were detected and rapidly absorbed. Among these components, four exhibited good absorption, thus confirming that the method developed is efficient for analysis of the absoption characteristics.