Tianjin Gongan Hospital

Heping, China

Tianjin Gongan Hospital

Heping, China

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Gu E.,Tianjin University of Traditional Chinese Medicine | Lu J.,Tianjin Gongan Hospital | Xing D.,Tianjin Gongan Hospital | Chen X.,Tianjin University of Traditional Chinese Medicine | And 3 more authors.
International Journal of Rheumatic Diseases | Year: 2015

Objectives: The objective of the present meta-analysis was to investigate whether the combined evidence shows an association between the STAT4 rs7574865 polymorphism and RA. Methods: A systematic search of all relevant studies published through April 2013 was conducted using MEDLINE, EMBASE, OVID, and ScienceDirect. The observational studies that were related to an association between the STAT4 rs7574865 polymorphism and RA were identified. The association between the STAT4 rs7574865 polymorphism and RA susceptibility was assessed using genetic models. Results: Seventeen case-control studies with a total of 28 comparisons (25 300 RA patients and 26 326 controls) met the inclusion criteria. A meta-analysis was conducted for genotype TT versus GT+GG, GT+TT versus GG, TT versus GG and T-allele. The meta-analysis showed an association between RA and the STAT4 rs7574865 TT genotype, GT+TT genotype and T-allele in all subjects. Stratification of RA patients according to ethnic group showed that the TT genotype, GT+TT genotype and T-allele were significantly associated with RA in Europeans, Asians, Africans and Latin Americans. A subgroup analysis according to the absence or presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies revealed that the association between the STAT4 rs7574865 polymorphism and RA may be independent of the presence of RF and anti-CCP antibodies. Conclusions: This meta-analysis demonstrated that the STAT4 rs7574865 polymorphism confers susceptibility to RA in major ethnic groups. The association may not be dependent on the presence of RF and anti-CCP antibodies © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.


Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | Wang J.,Tianjin Medical University | Ma J.-X.,Tianjin Medical University | And 5 more authors.
Journal of Clinical Neuroscience | Year: 2013

Ossification of the posterior longitudinal ligament (OPLL) is a pathological ectopic ossification of this ligament that usually occurs in the cervical spine. For patients with cervical OPLL and neurological symptoms, surgical intervention is necessary but not always effective. Various prognostic factors influence the surgical outcome. The results of studies identifying these prognostic predictors are often inconclusive or contradictory. These predictors have not been well identified or summarized. The present study was designed to identify the prognostic predictors for the surgical outcome of cervical OPLL based on the available evidence in the literature. Non-interventional studies were searched in Medline, Embase, Science Direct, OVID and the Cochrane library. Forty-two observational studies involving 2791 patients were included. The quality of the included studies was assessed with a modified quality assessment tool, which was originally designed for use with observational studies. The effects of the studies were combined with the study quality score using a model of best-evidence synthesis. There was strong evidence for five predictors: (i) age, (ii) duration of symptoms, (iii) pre-operative neurological score, (iv) transverse area of the spinal cord, and (v) intramedullary high signal intensity on the T2-weighted MRI. We also identified eight predictors with moderate supporting evidence, seven with limited evidence, four with conflicting evidence and four predictors without supporting evidence. While there is no conclusive evidence regarding the surgical outcomes following cervical OPLL, these data provide evidence to guide the clinician in choosing an optimal therapeutic strategy for patients with cervical OPLL. Further research is necessary to fully evaluate the effects of the predictors described in this study. © 2012 Elsevier Ltd. All rights reserved.


Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | Ma J.-X.,Tianjin Medical University | Ma X.-L.,Tianjin Medical University | And 8 more authors.
European Spine Journal | Year: 2013

Objective: To identify the independent risk factors, based on available evidence in the literature, for patients developing surgical site infections (SSI) after spinal surgery. Methods: Non-interventional studies evaluating the independent risk factors for patients developing SSI following spinal surgery were searched in Medline, Embase, Sciencedirect and OVID. The quality of the included studies was assessed by a modified quality assessment tool that had been previously designed for observational studies. The effects of studies were combined with the study quality score using a best-evidence synthesis model. Results Thirty-six observational studies involving 2,439 patients with SSI after spinal surgery were identified. The included studies covered a wide range of indications and surgical procedures. These articles were published between 1998 and 2012. According to the quality assessment criteria for included studies, 15 studies were deemed to be high-quality studies, 5 were moderate-quality studies, and 16 were low-quality studies. A total of 46 independent factors were evaluated for risk of SSI. There was strong evidence for six factors, including obesity/BMI, longer operation times, diabetes, smoking, history of previous SSI and type of surgical procedure. We also identified 8 moderate-evidence, 31 limited-evidence and 1 conflictingevidence factors. Conclusion: Although there is no conclusive evidence for why postoperative SSI occurs, these data provide evidence to guide clinicians in admitting patients who will have spinal operations and to choose an optimal prophylactic strategy. Further research is still required to evaluate the effects of these above risk factors. © Springer-Verlag 2012.


Xing D.,Tianjin Hospital | Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | Chen Y.,Tianjin Hospital | And 8 more authors.
European Spine Journal | Year: 2013

Objective: The optimal timing of stabilization in patients with traumatic thoracolumbar fractures remains controversial. There is currently a lack of consensus on the timing of surgical stabilization, which is limited by the reality that a randomized controlled trial to evaluate early versus late stabilization is difficult to perform. Therefore, the objective of this study was to determine the benefits, safety and costs of early stabilization compared with late stabilization using data available in the current literature. Methods: An electronic literature search was performed in Medline, Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials for relevant studies evaluating the timing of surgery in patients with thoracolumbar fractures. Two reviewers independently analyzed and selected each study on the basis of the eligibility criteria. The quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE). Any disagreements were resolved by consensus. Results: Ten studies involving 2,512 subjects were identified. These studies demonstrated that early stabilization shortened the hospital length of stay, intensive care unit length of stay, ventilator days and reduced morbidity and hospital expenses for patients with thoracic fractures. However, reduced morbidity and hospital expenses were not observed with stabilization of lumbar fractures. Owing to the very low level of evidence, no conclusion could be made regarding the effect of early stabilization on mortality. Conclusions: We could adhere to the recommendation that patients with traumatic thoracolumbar fractures should undergo early stabilization, which may reduce the hospital length of stay, intensive care unit length of stay, ventilator days, morbidity and hospital expenses, particularly when the thoracic spine is involved. Individual patient characteristics should be concerned carefully. However, the definite conclusion cannot be made due to the heterogeneity of the included studies and low level of evidence. Further prospective studies are required to confirm whether there are benefits to early stabilization compared with late stabilization. © 2012 Springer-Verlag Berlin Heidelberg.


Ma J.,Tianjin University | Ma J.,Tianjin Medical University | Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | And 6 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2012

Background: The use of a percutaneous compression plate (PCCP) provides a minimally invasive technique for the fixation of stable intertrochanteric femoral fractures. It has several theoretically potential advantages over the dynamic hip screw (DHS) such as shorten incision and lower incidence of wound infection. Hypothesis: PCCP have several advantages than DHS, such as reduced blood loss, transfusion, mortality, shorter operative time, and lower incidence of complications. This systematic review and meta-analysis was performed to identify the clinical outcomes and safety of patients with stable intertrochanteric hip fractures operated on using PCCP compared with DHS. Materials and methods: A systematic search of all studies published through April 2012 was conducted using the Medline, Embase, Sciencedirect, OVID and the Cochrane Central database. The randomized controlled trials (RCTs) and quasi-randomised control trials (qRCTs) that compared PCCP with DHS in treating adult patients with stable intertrochanteric hip fractures and provided data on safety and clinical effects were identified. Demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. Results: Nine studies encompassing 914 patients met the inclusion criteria. Overall, the result of meta-analysis indicated that over DHS, PCCP allowed significantly shorter operative time, reduced blood loss as well as transfusion, diminished incidence of cardiovascular events. However, there were no significant differences in length of hospitalization, rate of walking without help, early mortality and other complications. Discussion: Significant differences favoring PCCP were found with regard to operative time, blood loss, transfusion and lower incidence of cardiovascular events. However, owing to the limitations of this systematic review, future RCTs are still needed to confirm this data and the clinical efficiency of PCCP. Level of evidence: Level II: low-powered prospective randomized trial. © 2012.


Ma X.-L.,Tianjin Medical University | Ma X.-L.,Tianjin Hospital | Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | And 4 more authors.
European Spine Journal | Year: 2012

Objective To assess the safety and efficacy of balloon kyphoplasty (KP) compared with percutaneous vertebroplasty (VP) and provide recommendations for using these procedures to treat osteoporotic vertebral compression fractures (OVCF). Methods A systematic search of all studies published through March 2012 was conducted using the MEDLINE, EMBASE, OVID, ScienceDirect and Cochrane CENTRAL databases. The randomized controlled trials (RCTs) and non-randomized controlled trials that compared KP to VP and provided data on safety and clinical effects were identified. Demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. The evidence quality levels and recommendations were assessed using the GRADE system. Results Twelve studies encompassing 1,081 patients met the inclusion criteria. Subgroup meta-analyses were performed according to the study design. In the RCT subgroup, there were significant differences between the two procedures in short-term visual analog scale (VAS), long-term kyphosis angles, operative times and anterior vertebrae heights. In the cohort study subgroup, there were significant differences between the two procedures in short- and longterm VAS, short- and long-term Oswestry Disability Index (ODI), cement leakage rates, short- and long-term kyphosis angles, operative times and anterior vertebrae heights. However, there were no significant differences in long-term VAS or adjacent vertebral fracture rates in the RCT subgroup. There were no significant differences in short- or long-term VAS, short- or long-term ODI, cement leakage rates, adjacent vertebral fracture rates, short- or long-term kyphosis angles or anterior vertebrae heights in the CCT subgroup, and the adjacent vertebral fracture rates did not differ significantly in the cohort study subgroup. The overall GRADE system evidence quality was very low, which lowers our confidence in their recommendations. Conclusions KP and VP are both safe and effective surgical procedures for treating OVCF. KP may be superior to VP in patients with large kyphosis angles, vertebral fissures, fractures in the posterior edge of the vertebral body or significant height loss in the fractured vertebrae. Due to the poor quality of the evidence currently available, highquality RCTs are required. © Springer-Verlag 2012.


Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | Ma X.-L.,Tianjin Medical University | Ma X.-L.,Tianjin Hospital | And 4 more authors.
Journal of Clinical Neuroscience | Year: 2013

There is no consensus on whether anterior cervical arthroplasty or anterior cervical discectomy and fusion (ACDF) is the optimal treatment for single-level cervical radiculopathy or myelopathy. We conducted a meta-analysis of randomized controlled trials to compare the safety and efficacy of anterior cervical arthroplasty with ACDF. Eight studies met the inclusion criteria. Overall, there were significant differences between these two treatment approaches in the arm visual analog scale (VAS) scores [mean difference (MD) = -4.86, 95% confidence interval (CI) = -6.42 to -3.30], neck VAS scores (MD = -7.90, 95% CI = -10.36 to -5.44), overall success rate [odds ratio (OR) = 1.84, 95% CI = 1.43 to 2.36], neurological success rate (OR = 1.75, 95% CI = 1.20 to 2.55), and incidence of reoperation [risk ratio (RR) = 0.50, 95% CI = 0.26 to 0.97]. However, there were no significant differences in the neck disability index (NDI) scores (MD = -3.81, 95% CI = -8.12 to 0.51), number of adverse events (RR = 0.77, 95% CI = 0.48 to 1.23), or radiological success rate (OR = 0.87, 95% CI = 0.36 to 2.09). Based on this meta-analysis, cervical arthroplasty is a safe and effective surgical procedure for treating single-level cervical radiculopathy or myelopathy. © 2013 Elsevier Ltd. All rights reserved.


Xing D.,Tianjin Hospital | Xing D.,Tianjin Gongan Hospital | Ma X.L.,Tianjin Hospital | Ma X.L.,Tianjin Medical University | And 4 more authors.
PLoS ONE | Year: 2013

The accurate diagnosis of periprosthetic joint infections (PJI) is crucial for therapy and the prevention of complications. No diagnostic test of PJI is 100% accurate. The aim of this study was to assess the use of anti-granulocyte scintigraphy using 99 mTc-labeled monoclonal antibodies to diagnose PJI after total joint arthroplasty. A systematic search of all relevant studies published through January 2013 was conducted using the MEDLINE, EMBASE, OVID, and ScienceDirect databases. Observational studies that assessed the accuracy of the anti-granulocyte scintigraphy with monoclonal antibodies or antibody fragments labeled with technetium 99 m in diagnosis for PJI and provided data on specificity and sensitivity were identified. Standard methods recommended for meta-analysis of diagnostic accuracy were used. Nineteen studies were eligible for inclusion. The results demonstrated that the area under the summary receiver operator curve was 0.88, and the diagnostic accuracy (Q*) was 0.81. Additionally, the diagnostic odds ratio (DOR) was 18.76 with a corresponding 95% confidence interval of 10.45-33.68. The pooled sensitivity and specificity of the diagnostic method for the diagnosis of PJI were 83% and 79%, respectively, while the pooled positive likelihood ratio (PLR) was 3.56, and the negative likelihood ratio (NLR) was 0.26. Anti-granulocyte scintigraphy using 99 mTc-labeled monoclonal antibodies has a reasonable role in the diagnosis of PJI after total joint arthroplasty. Due to the limitations of the present meta-analysis, additional high-quality original studies are required to confirm the predictive value. © 2013 Xing et al.


Xing D.,Tianjin Medical University | Xing D.,Tianjin Gongan Hospital | Ma J.-X.,Tianjin Medical University | Ma X.-L.,Tianjin Medical University | And 5 more authors.
Journal of Clinical Neuroscience | Year: 2013

A meta-analysis was conducted to assess the safety and efficacy of balloon kyphoplasty (KP) compared to percutaneous vertebroplasty (VP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Ten studies, encompassing 783 patients, met the inclusion criteria. Overall, the results of the meta-analysis indicated that there were significant differences between the two groups in the long-term kyphosis angle (mean difference [MD] = -2.64,95% confidence interval [CI] = -4.66 to -0.61; p = 0.01), the anterior height of the vertebral body (MD = 3.67, 95% CI = 1.40 to 5.94; p = 0.002), and the cement leakage rates (risk ratio [RR] = 0.70, 95% CI = 0.52 to 0.95; p = 0.02). However, there were no significant differences in the short-term visual analog scale (VAS) scores (MD = -0.57, 95% CI -1.33 to 0.20; p = 0.15), the longterm VAS scores (MD = -0.99, 95% CI = -2.29 to 0.31; p = 0.14), the short-term Oswestry Disability Index (ODI) scores (MD = -6.54, 95% CI = -14.57 to 1.48; p = 0.11), the long-term ODI scores (MD = -2.01, 95% CI = -11.75 to 7.73; p = 0.69), the operation time (MD = 4.47, 95% CI = -0.22 to 9.17; p = 0.06), the short-term kyphosis angle (MD = -2.25, 95% CI = -5.14 to 0.65; p = 0.13), or the adjacent-level fracture rates (RR = 1.52, 95% CI = 0.76 to 3.03; p = 0.24). This meta-analysis demonstrates that KP and VP are both safe and effective surgical procedures for treating OVCF. Compared with VP, KP can significantly relieve a long-term kyphosis angle, improve the height of the vertebral body, and reduce the incidence of bone cement leakage. However, because of the limitations of this meta-analysis, a large randomized controlled trial is required to confirm our findings. © 2012 Elsevier Ltd. All rights reserved.


Wang X.,Xinjiang Medical University | Wang F.,Peoples Hospital of Kelamayi | Tian G.,Tianjin gongan Hospital
Chinese Journal of Clinical Oncology | Year: 2013

Objective: To analyze the DKK1 expression in breast cancer cell line MDA-MB-231 and examine its effect on the migration and invasion of the cell line. Method: DKK1 expression in the breast cancer tissues was detected immunohistochemically, and DKK1 distribution in the breast cancer cells was observed using immunofluorescence. Western blot was used to investigate DKK1 expression in breast cancer tissues and their matched normal breast tissues. A eukaryotic expression vector of DKK1 was constructed and transfected into MDA231 cell line. The migration and invasion ability of the cells were observed through scratch assay and Boyden chamber, respectively. Results: Immunohistochemical staining showed that DKK1 in the transfected lymph node or non-lymph node was highly expressed in the breast cancer tissues (P<0.05). The positive DKK1 expression in lymph node metastasis was less significant than those in non-lymph node transfected cells. Immunofluorescence localization results showed a remarkable bright red granular fluorescence in the cytoplasm of the MDA231 cell line. Western blot analysis showed that the DKK1 protein expression in carcinoma tissues were obviously higher than that in matched normal breast tissues. The migration and invasion ability of DKK1- overexpressed MDA231 cell was lower than those of MDA231 cell transfected with pCMV-Tag-2b empty vector. Conclusion: Negative correlation was found between DKK1 expression and the migration and invasion ability in breast cancer cells.

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