Meta-Analysis of the Diagnostic Efficacy of the Luminex xTAG Respiratory Viral Panel FAST v2Assay for Respiratory Viral Infections

Purpose@#Acute respiratory viral infections pose significant morbidity and mortality, making it essential to diagnose respiratory viral infections rapidly. In this study, the diagnostic efficacy of the Luminex xTAG Respiratory Virus Panel (RVP) FAST v2 test was evaluated on respiratory viral infections. @*Materials and Methods@#Information was retrieved from electronic databases, including Embase, Web of Science, PubMed, and Cochrane Library, for systematic review. Studies that fulfilled predefined inclusion criteria were included. After the extraction of information, statistical software was utilized for quality evaluation, data analysis, and assessment of publication bias. @*Results@#Eighty groups in fourfold tables from nine articles were included to perform statistical analyses. Therein, the mean specificity and mean sensitivity of Luminex xTAG RVP FAST v2 test for the detection of respiratory viral infections were 0.99 (0.98–0.99) and 0.88 (0.87–0.90), respectively. Additionally, the negative and positive likelihood ratios were 0.14 (0.11–0.19) and 87.42 (61.88– 123.50), respectively. Moreover, the diagnostic odds ratio and area under the curve of summary receiver operating characteristic were 714.80 and 0.9886, respectively. @*Conclusion@#The Luminex xTAG RVP FAST v2 test could be a reliable and rapid diagnostic method for multiple respiratory viral infections.

Clinical study on new risk assessment and prediction system for early osteonecrosis of the femoral head / 中国骨伤

OBJECTIVE@#To establish a risk assessment and prediction system for early osteonecrosis of the femoral head (ONFH) in order to predict the collapse risk.@*METHODS@#The risk assessment system for early necrosis and collapse of femoral head was established based on the combination of Steinberg stage, ABC typing and the proportion of the proximal sclerotic rim. Firstly, Steinberg stage system was applied. ABC typing was applied to predict risk in stage I, type C was risk free, type B was low risk, type A and type BC were medium risk, type A-C and type AB were high risk. The classification of proximal sclerotic rim was first applied when the Steinberg stage was Ⅱ-Ⅲ, and type 2 was expected to be low risk. If the classification of proximal sclerotic rimwas type 1, then the ABC typing was applied, type C was risk-free, type B was low risk, type A and type BC were medium risk, type A-C and type AB were high risk. According to this prediction system, the collapse risk of femoral head in 188 cases(301 hips) were predicted by retrospective analysis. All the hips were enrolled at the out-patient department of orthopedic in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. The consistency of the prediction results of three doctors and one doctor at different times were evaluated.@*RESULTS@#Among them, 136 cases were male, 52 were female. 75 cases were single hip, 113 were double hip. The age of the patients wa 19 to 64(42.61±12.07) years. The natural course of disease was 0.33 to 5.00(3.62±1.93) years. 206 hips in 301 hips had collapsed, with a collapse rate of 68.44%. In the risk-free group, none hip had collapsed, with a collapse rate of 0%. In the low-risk group, 9 hip in 91 hips had collapsed, with a collapse rate of 9.89%. In the medium-risk group, 12 hip in 19 hips had collapsed, with a collapse rate of 63.16%. And in the high risk group, 185 hips in 190 hips had collapsed, with a collapse rate of 97.37%. They were significantly differences in their collapse rate (@*CONCLUSION@#The risk assessment and prediction system for early ONFH selects different methods to predict the risk of collapse according to the imaging characteristics of different stages, which is combines with the comprehensive assessment of multiple risk factors. The system is applicable to a wide range, simple operation and convenient for clinical application.

Effect of Huoxue Ointment on Osteoarthritis Caused by Knee Joint Injury in Rabbits / 中国实验方剂学杂志

Objective:To investigate the efficacy and anti-inflammatory and analgesic effect of Huoxue ointment on osteoarthritis of the knee caused by knee joint injury in rabbits. Method:A total of 60 big ear white rabbits were selected, with half male and half female. Ten rabbits were randomly selected by weight and set as normal control group. For the remaining rabbits, the injury of articular cartilage and anterior cruciate ligament were caused in the femoral ankle joint surface of the right hind knee joint, so as to establish an animal model of knee osteoarthritis in rabbits. For the normal control group, the skin was cut open and immediately sutured. Two weeks after the operation, rabbits were randomly divided into model control group according to body weight，positive voltaren group (1 cm·kg-1·d-1), and high-dose (6 g·kg-1·d-1), medium-dose (3 g·kg-1·d-1) and low-dose(1.5 g·kg-1·d-1) Huoxue ointment groups, with 10 animals in each group. Interleukinin-1β （IL-1β） in rabbit articular cavity fluid and peripheral blood were measured, contents of tumor necrosis factor-α （TNF-α） and free radical nitric oxide（NO）, rabbit articular cartilage was examined by histopathology, in order to study the efficacy of Huoxue ointment on rabbit knee arthritis. The model of increased permeability of capillaries in abdominal cavity of mice induced by acetic acid and the model of foot swelling of rats induced by carrageenan were used to determine the absorbance of mice peritoneal fluid and the rat foot swelling value, and study the anti-inflammatory effect of huoxue ointment. A total of 120 SPF ICR mice and 60 SD rats were selected, with half male and half female. The mice were randomly divided according to body weight into model control groups, positive Voltaren group (3 cm·kg-1·d-1), and high-dose (16 g·kg-1·d-1), medium-dose (8 g·kg-1·d-1), low-dose (4 g·kg-1·d-1) Huoxue ointment groups，with 12 animals in each group. The rats were randomly divided into the model control group, positive voltaren group (2 cm·kg-1·d-1), and high-dose (8 g·kg-1·d-1), medium-dose (4 g·kg-1·d-1), low-dose (2 g·kg-1·d-1) Huoxue ointment groups，with 10 animals in each group. Result:The tested dose of Huoxue ointment，the levels of IL-1β, TNF-α and NO in rabbit serum and joint fluid were decreased to varying degrees, and the effect was significant in the high-dose group (P<0.05). According to the pathological examination, the tested dose of Huoxue ointment, knee cartilage and synovial tissue lesions were significantly lower than those of the model control group (P<0.05)，the value of peritoneal fluid concentration and the foot swelling in medium and high-dose Huoxue ointment groups were significantly lower than those in the model control group (P<0.05). The analgesic effect of tail shaking in mice, and the pain threshold rate of the high-dose Huoxue ointment group were significantly higher than those of the model control group (P<0.05)， the analgesic effect lasted for 4 hours, the foot tenderness of rats in the large and medium-dose Huoxue ointment groups was significantly higher than that in the model control group (P<0.05). Conclusion:Huoxue ointment has obvious joint repair and anti-inflammatory and analgesic effects on osteoarthritis of knee caused by knee joint injury in rabbits.

Analysis of alcohol extract and water extract of Polygonum capitatum by UPLC-Q-TOF-MS / 中国中药杂志

In this study, we used Ultra Performance Liquid Chromatography-Time-of-Flight Mass Spectrometry(UPLC-TOF-MS)to identify the chemical constituents in both ethanol and water extract of Polygonum capitatum. A Waters ACQUITY UPLC BEH C₁₈ column(2.1 mm×100 mm,1.7 μm) was used for separation. The mobile phase was consisted of(A) 0.10% formic acid in water and(B)0.10% formic acid in acetonitrile, and the flow rate was 0.35 mL•min⁻¹. ESI source in negative ion mode was used for MS detection. Structural identification was carried out according to the accurate mass and matching with database. The results showed that flavonoids, polyphenols and lignans were the main components in both extracts. However, the chemical compositions of both extracts were different, e.g. there are less hydrolyzable tannins, loss of ellagic acid and more anthocyanins in ethanol extract. In a conclusion, this study provides an important scientific basis for identifying the active ingredients in P. capitatum, which also help to reveal the pharmacological effect of P. capitatum.

Study on the Distribution of Constitutions of Chinese Medicine in Patients with Osteonecrosis of Femoral Head / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the distribution of constitution types of Chinese medicine (CM) in patients with osteonecrosis of femoral head (ONFH).</p><p><b>METHODS</b>Totally 130 ONFH patients were recruited. Constitution types of CM were identified in all patients. Distribution features of constitution types of CM in ONFH patients were observed. The differences of distribution in gender, age, single or bilateral hips, course of disease, staging, cause, and region were also analyzed.</p><p><b>RESULTS</b>Seventy patients were of complicated constitutions, while 60 patients were of single constitution. Among the 60 single constitution cases, yang-deficiency constitution [18 (13.9%)], damp-heat constitution [10 (7.7%)], blood-stasis constitution [7 (5.4%)], and qi-deficiency constitution [7 (5.4%)] were mainly distributed. Of the complicated constitutions, yang-deficiency dominated constitution occupied the top ratio [30 (23.1%)], followed by blood-stasis dominated constitution [15 (11.5%)], damp-heat dominated constitution [9 (6.9%)]. By putting them together, yang-deficiency constitution occupied the top constitution of CM [48 (36.9%)], followed by blood-stasis constitution [ 22 (16.9%)] and damp-heat constitution [19 (14.6%)]. The aforesaid three constitutions accounted for 68.5% of the total. There were no statistical distribution differences in gender, age, single or bilateral hips, course of disease, staging, or cause.</p><p><b>CONCLUSION</b>Yang-deficiency constitution, damp-heat constitution, and blood-stasis constitution were liable constitutions of CM in ONFH patients.</p>

Case-control study on the treatmentof the fifth metatarsal base fractures by cardboard compression pad versus short leg plaster / 中国骨伤

<p><b>OBJECTIVE</b>To compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.</p><p><b>METHODS</b>From June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.</p><p><b>RESULTS</b>All patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.</p><p><b>CONCLUSION</b>Using paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.</p>

Clinical observation of jianpi bushen formula to prevent collapse of osteonecrosis of femoral head / 中国中药杂志

To observe the clinical effect of Jianpi Bushen formula to prevent the collapse of osteonecrosis of femoral head (ONFH) of type phlegm and blood stasis obstructing the collaterals. 50 cases (including 73 hips) of non-collapse ONFH (ARCO I, II, III a) were selected from the out-patient department of orthopedic in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All the cases fit for diagnostic criteria were given Jianpi Bushen formula and followed up. Staging criteria was ARCO classification. Harris score evaluated the hip function. The mean follow-up time was 4.2 years (3-5.4 years). After a mean of 4.2 years (3-5.4 years) followed-up, 12 hips collapse occurred while 61 hips not (the non-collapse rate was 83.56%). Collapse did not occurred among the all 7 hips at stage ARCO I (the non-collapse rate was 100%). Among the 49 hips at stage ARCO II, 9 hips collapse occurred while 40 hips not (the non-collapse rate was 81.63%). Among the 17 hips at stage ARCO III a, 3 hips collapse occurred while 14 hips not (the non-collapse rate was 82.35%). Kaplan-Meier analysis showed the average survival time of non-collapse was 5 years (4. 8-5.2 years). The 3 year survival rate of non-collapse was 92.5%. The 4 year survival rate was 74% and the condition tended to be stability trend. The Harris score was 71.93 +/- 11.25 before treatment and 81.63 +/- 12.16 after treatment, significantly different. These results suggest that: Jianpi Bushen formula is an effective method for treating ONFH of type phlegm and blood stasis obstructing the collaterals. It can delay or prevent the collapse of femoral head and significantly improve the hip function.

Case-control study on arthroscopy and manipulation for the treatment of derangement of patellofemoral joint / 中国骨伤

<p><b>OBJECTIVE</b>To compare the therapeutic effects of arthroscopy and manipulation of Traditional Chinese medicine (TCM) in the treatment of patellofemoral joint disease.</p><p><b>METHODS</b>The patients met with the criteria of patellofemoral joint disease were divided into manipulation of TCM group and arthroscopy group randomly, 31 patients in each group. There were 31 patients in manipulation of TCM group, including 4 males and 27 females, with an average age of (52.83 +/- 5.79) years old; and the patients were treated with manipulation. There were 31 patients in arthroscopy group, including 8 males and 23 females, with an average age of (54.14 +/- 6.12) years old; the patients were treated with arthroscopy. The HSS knee joint score, fitness angle of patellofemoral joint and lateral angle of patellofemoral joint in X-ray were compared in each group and between the two groups before and after treatment respectively.</p><p><b>RESULTS</b>The two therapeutics had equally efficacious in which improved HSS score significantly. After treatment, the HSS scores in manipulation of TCM group and arthroscopy group were 94.80 +/- 7.26 and 88.65 +/- 5.79 separately, the score in manipulation of TCM group was higher than that of arthroscopy group. Comparing with the arthroscopy group, lateral angle of patellofemoral joint with weight-hearing position were improved significantly in manipulation of TCM group.</p><p><b>CONCLUSION</b>Arthroscopy and manipulation of TCM have equally efficacious in the treatment of patellofemoral joint disease, but manipulation has advantage of minimal trauma, and is better to treat patella extraversion.</p>

Correlational on tibial intercondylar hyperplasia with the area of abnormal signalanterior cruciate ligament in patients with knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVES</b>To investigate whether tibial intercondylar hyperplasia can cause anterior cruciate ligament (ACL) injuries.</p><p><b>METHODS</b>From February 2009 to October 2012, 58 cases (including 70 knees) with knee osteoarthritis (KOA) without trauma history were selected from the out-patient department of orthopaedics in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All cases were tested by MRI scanning, then vertical height of the medial and lateral intercondylar spine in coronal position and the area of abnormal signal of ACL in sagittal position were tested from patients. Correlation between the height of intercondylar spine and the area of abnormal signal of ACL were analyzed.</p><p><b>RESULTS</b>Fives cases of 58 cases( 70 knees) were excluded from episome in knee joint, and other 65 knees were in accordance with the inclusion criteria. Among them, there were 10 males and 48 females aged from 39 to 79 years old with an average of 61 years old. The vertical height of the medial intercondylar spine was (10.02 +/- 1.46) mm and lateral was (8.92 +/- 1.69) mm. The area of abnormal signal ACL was (318.42 +/- 130.10) mm2. There was positive correlation between the height of medial intercondylar spine and the area of abnormal signal of ACL (r=0.06, P=0.00). But there was no correlation between lateral intercondylar spine and the area of abnormal signal of ACL (P=0.10).</p><p><b>CONCLUSION</b>The height of medial intercondylar spine and the area of abnormal signal of ACL is positively correlated. The clinical significance is in study, while the clinical meaning still need further study.</p>

Research on the distribution difference of MRI signals in osteonecrosis of the femoral head patients of different TCM syndrome types / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the distribution difference of magnetic resonance imaging (MRI) signals in osteonecrosis of the femoral head (ONFH) patients of different TCM syndrome types.</p><p><b>METHODS</b>Recruited 29 ONFH patients were assigned to the tendon and vessel stagnation group (14 cases) and the Gan-Shen deficiency group (15 cases) according to TCM syndrome typing. The distribution difference of their MRI signals of MRIT1WI, T2WI + fs, T1 and T2 combined signal were compared.</p><p><b>RESULTS</b>There was statistical difference in T1W1 signal distribution between the two TCM syndrome types (P = 0.04). There was no statistical difference in T2WI + fs or T1 and T2 combined signal between the two TCM syndrome types (P = 0.42, P = 0.15). MRI signals in the tendon and vessel stagnation group were mainly manifested as fat-like signals,while they were mainly manifested as mixed signals in the Gan-Shen deficiency group.</p><p><b>CONCLUSION</b>Distribution difference of MRI signals exists between ONFH patients of different TCM syndrome types.</p>

Meta-analysis on efficacy and safety of external use of tradition Chinese medicines and western medicines in treating knee osteoarthritis / 中国中药杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of the external use of tradition Chinese medicine (TCM) in treating knee osteoarthritis.</p><p><b>METHOD</b>By computer retrieval of MEDLINE, CNKI and VIP database on data from the establishment of database to May 2011,all of the randomized controlled trials on the external use of TCMs in treating knee osteoarthritis with western medicines as the control drugs were collected to screen out literatures in line with the inclusion standards. The quality of the included literatures was strictly assessed, and a meta-analysis was conducted by RevMan 5.1 software.</p><p><b>RESULT</b>Totally 25 RCTs involving 2 159 patients were included [1152 patients in the TCM group (TCMG), 1007 patients in the western medicine group (WMG)], in which 21 articles were brought into the analysis on efficacy. The results of meta-analyses showed that the efficient rates of the TCMG and the WMG were 92.35% (941/ 1019) and 81.19% (712/877), respectively, OR = 2.88 [2.16-3.83], with a hypothesis testing on total effect of Z = 7.20 (P < 0.00001)], suggesting that the external use of TCMs had a better efficacy than the WMG. A total of 25 literatures were brought into the analysis on adverse effect. The adverse effects rate of the TCMG and the WMG were 1.30% (15/1 152) and 5.36% (54/1007), respectively, OR = 0.40 [0.11-1.38], Z = 1.46 (P = 0.15)], indicating no significant difference between them. The sub group analysis shows that compared with the external use of western medicines,the adverse effect rate of the two groups are similar [(1.87% (11/589): 1.60% (9/564)], OR = l.12 [0.48-2.58], Z = 0.26 (P = 0.80). But as for inhibitors NSAIDS and COX-2 for oral,the adverse effect rate of the TCMG was lower than that of the WMG [(1.07% (4/375): 15.46% (45/291)], OR = 0.11 [0.01-0.87], Z = 2.09 (P = 0.04).</p><p><b>CONCLUSION</b>The efficacy of the external use of TCMs in treating OA is better than that of western medicines. The adverse effect rates of the external use of TCMs is equivalent to that of western medicines, and significantly lower than that of oral western medicines. But because of the poor quality of the included literatures, the final conclusion for the efficacy of TCMs in treating knee osteoarthritis could not be reached only based on this Meta-analysis and remain to be proved with the results of high-quality clinical studies.</p>

Study on the relationship between clinical syndromes and X-ray manifestation of knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To study the relationship between clinical syndromes and X-ray manifestation of knee osteoarthritis (KOA), so as to provide evidence for clinical diagnosis and treatment.</p><p><b>METHODS</b>Seventy-eight patients (108 knees) with KOA from out-patient clinic of orthopedic were collected, aged from 41 to 77, including 65 females (89 knees) and 13 males (19 knees). Questionnair investigation of Lequesne index was performed among all these patients and the Lequesne index was calculated. And all these patients were divided into two groups, mild group (Lequesne index < or = 8) and severe group (Lequesne index > 8). Weight-bearing anteriorposterior and lateral plain film of knee joint and patellofemoral Skyline plain flim was taken. Joint space narrowing, osteophyte formation, subchondral osteosclerosis and subchondral cystic degeneration were evaluated. The lower limb alignment and lateral patella angle were detected. The correlation of the Lequesne index and X-ray manifestation was analyzed by logistic regression analysis.</p><p><b>RESULTS</b>There were significant differences between mild and severe groups in the following indexes: lateral tibiofemoral joint space narrowing, the medial retropatellar space narrowing, medial and lateral tibia osteophytes, medial and tibial femur femur osteophytes, medial and lateral trochlea osteophytes, lateral patella osteophytes, tibia introcondylar osteophytes (P<0.05). The results of the logistic regression analysis showed that the lateral femur osteophytes were the most important radiologic manifestation to evaluate the severity degree of KOA,with the minimum associated probability (0.009) and the maximum wald value (6.779).</p><p><b>CONCLUSION</b>When evaluating the severity degree of KOA,the joint space narrowing and osteophytes are the most sigenificant radiologic manifestation which includs the lateral tibiofemoral joint space narrowing, the medial retropatellar space narrowing, medial and lateral tibia osteophytes, medial and lateral femur osteophytes, medial and lateral trochlea osteophytes, lateral patella osteophyte, tibial intercondylar osteophyte.</p>