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Background: To provide evidence that the Chinese herbal medicine (CHM) PSORI-CM01 combined with Western medicine reduces the relapse rate of psoriasis vulgaris (PV), we plan to conduct a large-scale randomized control trial (RCT). In order to improve and perfect the RCT, this pilot study was designed to determine the feasibility and the potential of a modified protocol for the full-scale RCT.Methods: Eligible patients with psoriasis vulgaris (PV) were enrolled into a randomized comparison in which all subjects received topical sequential therapy and PSORI-CM01 or placebo for 12 weeks. The primary outcome measure was the relapse rate. Treatment response was computed from Psoriasis Area and Severity Index (PASI), body surface area (BSA), and Dermatology Life Quality Index (DLQI). The secondary outcome measures included time to relapse, time to onset, rebound rate, PASI score, pruritus scores on the Visual Analog Scale (VAS), BSA, DLQI and SF-36 (short form health survey), and incidence of serious adverse events (SAEs).Results: Six of 7 (86 %) subjects reached the PASI-50 in the CHM group compared with nine of 10 (90 %) in the placebo group during the treatment period. Among the subjects who reached PASI-50, one out of six subjects (17 %) relapsed in the CHM group during the treatment period compared with six out of nine patients in the placebo group (67 %). No subjects met the rebound criteria. Changes to baseline in the PASI scores were not significantly different between the two groups (t = 1.764, P = 0.098).Conclusion: Oral PSORI-CM01 combined with topical sequential treatment showed a smaller recurrence rate (P = 0.118) than placebo combined with the same topical therapy for moderate-to-severe PV in this pilot study.Trial Registration: Chinese Clinical Trial Registry ( http://www.chictr.org.cn/searchproj.aspx ) ChiCTR-TRC-13003233 ; date of registration: 15 April 2013. [ABSTRACT FROM AUTHOR]

Background: Ethyl chloride spray as a common cooling modality has been widely used in acute sports injuries and joint injection procedures. Several clinical studies reported that use of ethyl chloride has positive effects on swelling, pain reduction and recovery from sports injuries. The main aim of present study was to analyze whether postoperative use of ethyl chloride spray benefits results after primary total knee arthroplasty (TKA).Methods: Between April 1, 2014 and October 21, 2015, 306 subjects undergoing primary TKA used ethyl chloride spray for improving recovery from the damage from surgery. After exclusion of 31 subjects due to adverse events including periprosthetic joint infection (PJI), deep venous thrombosis (DVT), acute myocardial infarction, finally 275 subjects' data regarding pain score, knee range of motion (ROM), knee girth, time of being able to reach 90° knee flexion and analgesic consumption were analyzed.Results: Significant differences in pain score, knee ROM at each time point and knee girth at on 21st and 28th postoperatively were detected without increased incidence of adverse events. Besides, time of being able to reach 90° knee flexion and analgesic consumption in the treatment group were significantly decreased in comparison to the control group.Conclusion: Use of ethyl chloride spray can help patients recovery from the damage from TKA safely. [ABSTRACT FROM AUTHOR]

Background: B-type natriuretic peptide (BNP) is a well-known biomarker to predict cardiac events following orthopedic procedures. However, further information regarding BNP can be completed. The present study aims to determine which of preoperative, postoperative or the difference between them (DVPPB) can best predict adverse cardiac events following TKA procedure and detect possible risk factors of high level of BNP.Methods: Between Jan. 2012 and Jan. 2014. 1120 included patients in 3 institutions have a minimum of 2-years follow-up. All clinical characteristics related to TKA procedure were put in total joint arthroplasty registry system and analyzed finally. The cut-off value of BNP predicting patients at increased risks of cardiac events after TKA was evaluated by the Receiver Operating Characteristic (ROC) curve analysis.Results: Our results reveal DVPPB in comparison to preoperative and postoperative BNP can best predict cardiac events following primary TKA, and the optimal cut-off value was 825.5 pg/ml with the highest Youden index of 0.62. Cigarette smoking, ASA III/IV/V, prior history of cardiac events, general anesthesia, surgery time, and tourniquet time are risk factors for DVPPB > 825.5 pg/ml.Conclusions: DVPPB in comparison to preoperative and postoperative BNP can best predict cardiac events following primary TKA. Cigarette smoking, ASA III/IV/V, prior history of cardiac events, general anesthesia, surgery time, and tourniquet time are risk factors for DVPPB > 825.5 pg/ml. We hope these results could be helpful to optimize health care among patients undergoing primary TKA. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty (TKA) is primarily preformed among the elderly population who is commonly affected by cardiovascular and cerebrovascular diseases. Atrial fibrillation (AF) is a very common heart disease and its prevalence increases significantly with age. Therefore, we decided to evaluate the outcomes of patients with AF following TKA and analyze the risk factors of AF patients who underwent postoperative complication.Methods: We designed a retrospective cohort study using data from three institutions in China. We evaluated a total of 453 AF patients who received primary TKA and 453 matched control patients. Comparisons of specific parameters between AF and non-AF cohorts were performed.Results: Our results demonstrated that AF patients had significantly higher odds of more intraoperative bleeding, periprosthetic joint infection (PJI), post-operative cerebral stroke (POCS), post-operative cardiovascular events (POCE) and worse SF-36 physical component score and mental score at mean 24-month after surgery, but had no increased incidence of post-operative gastrointestinal events, DVT and PE in comparison to patients without AF than those without AF disease. Additionally, multivariate logistic regression analysis was used to identify risk factors of patients who underwent severe complication. Smoking, diabetes mellitus and persistent AF were common risk factors of PJI, POCS, and POCE. Heart rate＞70/min and absence of Beta blocker use were common risk factors of POCS and POCE. Absence of LMWH bridging was risk factor of POCS. BMI >25 kg/m2 and hypertension were risk factors of POCE.Conclusions: These findings should be taken into consideration when discussing the expected outcomes of AF patients after TKA. AF disease impaired SF-36 physical component score (PCS) and mental component score (MCS) of patient after TKA. [ABSTRACT FROM AUTHOR]