First center hospital of Tianjin

of Tianjin, China

First center hospital of Tianjin

of Tianjin, China

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Ren Z.,First Center Hospital of Tianjin | Qin L.,First Center Hospital of Tianjin | Wang J.Q.,First Center Hospital of Tianjin | Li Y.,First Center Hospital of Tianjin | And 2 more authors.
Experimental and Clinical Endocrinology and Diabetes | Year: 2015

Background: The question of which treatment should be preferred for the treatment of Graves' disease is debatable, and pairwise meta-analyses could not obtain hierarchies of these treatments. Our intention was to integrate the evidence to provide hierarchies of the comparative efficacy of 4 treatments (radioiodine, radioiodine+prednisone, antithyroid drugs and surgery). Methods: We conducted a Bayesian-framework network meta-analysis of randomized controlled trials (RCTs) to compare 4 treatments in patients with Graves' disease. The eligible RCTs were identified by searching Amed, the British Nursing Index, Embase, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Google scholar, SIGLE, the National Technical Information Service, the National Research Register (UK) and the Current Controlled Trials databases. The data for 2 outcomes (e.g., ophthalmopathy and recurrence) were independently extracted by 2 authors. Results: A total of 4 RCTs were ultimately included. Radioiodine+prednisone therapy showed statistical significance in reducing the incidence of new or deteriorative ophthalmopathy comparing with the other 3 therapies. Compared with radioiodine, therapy with antithyroid drugs therapy as well as surgery significantly decreased the incidence of new or deteriorative ophthalmopathy. Radioiodine therapy significantly reduced the rate of recurrence when compared to therapy with antithyroid drugs or surgery. For decreasing the incidence of new or deteriorative ophthalmopathy, the 4 treatments were ranked as follows: radioiodine+prednisone therapy, therapy with antithyroid drugs, surgery and radioiodine therapy. For reducing the rate of recurrence, 3 treatments were ranked as follows: radioiodine therapy, therapy with antithyroid drugs and surgery. Conclusions: Radioiodine+prednisone therapy might have the least probability of leading to an exacerbation or new appearance of ophthalmopathy, and radioiodine therapy might have the least probability of causing a recurrence. © Georg Thieme Verlag KG.


Shi Y.,Tianjin Medical University | Shi Y.,Medical College Affiliated Hospital of Chinese Peoples Armed Police Force | Zhao Y.,The First Peoples Hospital of Yinchuan | Liu J.,First Center Hospital of Tianjin | And 2 more authors.
Journal of Renal Nutrition | Year: 2014

Metabolic bone disease (MBD) is a common complication of chronic kidney disease (CKD). The currently accepted international guidelines for treatment of CKD-MBD has been published, unfortunately adequate control of serum markers of disorder, especially hyperphosphatemia, is poorly achieved. Whether educational intervention is an effective way for improving CKD-MBD remains controversial. A systematic review of educational intervention versus routine care to improve patients with CKD-MBD was conducted. All randomized controlled trials (RCTs) and quasi-RCTs examining the efficacy of educational intervention to improve patients with CKD-MBD were included. We performed a comprehensive search of several databases and sources to identify eligible trials. In addition, we searched unpublished studies by tracking the SIGLE (System for Information on Grey Literature) database. Finally, 8 RCTs and 2 quasi-RCTs containing 775 participants were included in our systematic review. The result of our study revealed that the educational intervention to patients with CKD-MBD led to an improvement of the serum phosphorus and calcium by phosphate product. Educational intervention is a beneficial supplement method in improving CKD-MBD and putting off deterioration of the disease. © 2014 National Kidney Foundation, Inc.


Zhai W.,Institute of Hematology and Blood Diseases Hospital | Zhang X.,Institute of Hematology and Blood Diseases Hospital | Wei J.,Institute of Hematology and Blood Diseases Hospital | Deng Q.,First center hospital of Tianjin | And 8 more authors.
International Journal of Infectious Diseases | Year: 2015

Objectives: Febrile neutropenia (FN) is a common but lethal complication of chemotherapy in hematological malignance. The aim of this study was to identify the prognostic risk factors for antibiotic treatment outcome in PN patients, and provide the optimal choice for the initial empirical antibiotic treatment. Methods: 227 consecutive FN hematologic malignancies from four hospitals in Northeast China were enrolled. The outcome of antibiotic therapy was investigated until 14 days after the onset of FN. The factors affecting antibiotic therapy outcome were evaluated using Univariate analysis and Multivariate logistic regression analysis. Results: Among all patients, 27 patients did not achieve favorable outcome either clinically or bacteriologically. It was shown that the risk factors for poor FN therapy outcome were associated with prolonged duration of neutropenia over 9 days during FN (P=0.019), slow neutrophil recovery (P=0.039), respiratory infection (P=0.005), and that initial monotherapy with drugs recommended by the guidelines indicated better outcome (P=0.009). Additionally, patients with multi-bacterial infection, as well as further ANC decrease after fever, had a poor prognosis. Conclusions: Our results indicate that early application of antibiotics and prevention of respiratory infection as well as good clinical care are able to improve clinical outcomes from empirical antibiotic treatment in FN patients with hematological malignances. © 2015 The Authors.


Xie S.,Tianjin Medical University | Ji Q.,First Center Hospital of Tianjin | Hou J.,Tianjin Medical University | Zhang Y.,Tianjin Medical University | Shen W.,First Center Hospital of Tianjin
Chinese Journal of Radiology (China) | Year: 2014

Objective: To evaluate the effect of liver function on liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd- EOB- DTPA) -enhanced MRI.Methods: Sixty- seven patients who suffered from cirrhosis and received enhanced MRI with Gd- EOB- DTPA were retrospectively analyzed, and divided into three subgroups according to Child-Pugh score(45 patients in group A, 20 in group B, 5 in group C). All the individuals of both groups had MRI before injection, and hepatobiliary phase images were obtained at 5, 10, and 20 minutes after bolus administration of Gd- EOB- DTPA. The relative enhancement(RE) was calculated by dividing the signal intensity of liver(SI) at t min after injection(SIt) by precontrast SI(SI0). The total serum bilirubin level(TB), serum albumin level(Alb) and prothrombin time(PT) were recorded. The one- way ANOVA was used to compare the RE among three groups at 5, 10 and 20 minutes. SNK was used for further pairwise comparison. The effect of liver function on RE was assessed with the generalized linear model. Pearson correlation coefficients were measured between each biochemical test result(TB, Alb, PT) and RE at different time points.Results: The RE at 5, 10 and 20 minutes were 1.59 ± 0.20, 1.65 ± 0.22, 1.69 ±0.25 of group A; 1.47 ± 0.14, 1.48 ±0.18, 1.50 ± 0.22 of group B, 1.35 ± 0.07, 1.27 ± 0.06, 1.26 ± 0.06 of group C. There were statistically significant differences of RE among groups at 5, 10 and 20 minutes(F=5.854, 11.207, 9.666, P < 0.01). Statistically pairwise comparison differences of RE were found between group A and C at 5, 10 and 20 minutes(P < 0.01), between B and C at 10 and 20 minutes(P < 0.05), between A and B at 10 minutes(P < 0.05). There were statistically significant differences of TB, Alb and PT among groups(P < 0.01). RE at 10 and 20 minutes had moderate negative correlation with TB(r=-0.483, -0.500; P < 0.01), low negative correlation with PT(r=- 0.326, - 0.351;P < 0.01) and weak positive correlation with Alb(r=0.290, 0.292;P < 0.05).Conclusions: There are differences of RE among patients with different liver function, and the RE is associated with TB, Alb and PT. Thus, it may allow us to estimate the liver function. Copyright © 2014 by the Chinese Medical Association


PubMed | First Center Hospital of Tianjin, the First Peoples Hospital of Yinchuan, Tianjin Medical University and Medical College Affiliated Hospital of Chinese Peoples Armed Police Force
Type: Journal Article | Journal: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation | Year: 2014

Metabolic bone disease (MBD) is a common complication of chronic kidney disease (CKD). The currently accepted international guidelines for treatment of CKD-MBD has been published, unfortunately adequate control of serum markers of disorder, especially hyperphosphatemia, is poorly achieved. Whether educational intervention is an effective way for improving CKD-MBD remains controversial. A systematic review of educational intervention versus routine care to improve patients with CKD-MBD was conducted. All randomized controlled trials (RCTs) and quasi-RCTs examining the efficacy of educational intervention to improve patients with CKD-MBD were included. We performed a comprehensive search of several databases and sources to identify eligible trials. In addition, we searched unpublished studies by tracking the SIGLE (System for Information on Grey Literature) database. Finally, 8 RCTs and 2 quasi-RCTs containing 775 participants were included in our systematic review. The result of our study revealed that the educational intervention to patients with CKD-MBD led to an improvement of the serum phosphorus and calcium by phosphate product. Educational intervention is a beneficial supplement method in improving CKD-MBD and putting off deterioration of the disease.

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