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Tianjin, China

Liu J.,Tianjin Union Hospital | Liu J.,Tianjin Medical University | Cao J.-G.,Tianjin Medical University | Wang L.,Tianjin Medical University | Ma X.-L.,Tianjin Medical University
International Journal of Surgery | Year: 2014

Objective: A systematic review of randomized controlled trials was conducted to examine the efficacy of fibrin sealants for the reduction of postoperative blood loss and allogeneic red blood cell transfusion in total knee arthroplasty (TKA). Methods: Studies published through May 2013 were identified from PubMed, Embase, the Cochrane library, ScienceDirect, and other databases. Two independent reviewers assessed the quality of methodology using the Grade of Recommendations Assessment, Development and Evaluation approach and extracted data from literature. The mean difference (MD) of blood loss, hemoglobin loss, and risk ratios (RR) of transfusion rate and adverse events in the fibrin-treated and placebo groups were pooled throughout the study. The relevant data were analyzed using Stata 11.0 software. Results: Eight studies were included in the review, with a total sample size of 558 patients. The drainage blood loss [MD=-354.02mL, 95% confidence interval (CI) (-500.87 to-207.18); P<0.05], reduction in calculated total blood loss [MD=-402.12, 95% CI (-599.16 to-205.08); P<0.05], hemoglobin loss [MD=-0.86g/dL, 95% CI (-1.10g/dL to-0.61g/dL); P<0.05], and transfusion rate [RR=0.62, 95% CI (0.45-0.86); P<0.05] were all significantly reduced following treatment with fibrin sealants. There were no significant differences in the incidence of adverse events [RR=0.69, 95% CI (0.32-1.59); P>0.05] among the study groups. Conclusions: The results of the present meta-analysis suggest that fibrin sealants for patients undergoing TKA may reduce blood loss and maintain higher hemoglobin levels, particularly when fibrin sealants are used at higher dosage. Furthermore, fibrin sealants do not increase the risk of postoperative deep vein thrombosis, superficial infection, pulmonary embolism, and hematoma. Further evaluation is required to confirm our findings before fibrin sealants can be used in patients undergoing TKA. Level of evidence: II. © 2013 Surgical Associates Ltd. Source


Wang G.,Tianjin Union Hospital | Wang L.,Tianjin Union Hospital | Shi S.,Tianjin Union Hospital | Cao Y.,Tianjin Union Hospital | Tang T.,Tianjin Union Hospital
Chinese Journal of Clinical Oncology | Year: 2012

Objective: This study investigates the clinical applications of DNA ploidy analysis in the early screening or cervical carcinoma and compares it with traditional cytological diagnosis. Methods: A total of 4109 patients who were admitted to the Department of Gynecology of the Tianjin Union Hospital between April 2010 and May 2011 participated in this study. A combined application of liquid-based ultra-thin cell smearing technology and DNA ploidy analysis technique were administered to 2189 patients (Group A), whereas conventional cervical cytological diagnosis was administered to 1920 patients (Group B). The patients with positive results underwent cervical biopsies and histological examinations. Statistical analysis was conducted for the results of the two groups. Results: The conventional detection of cervical cytology obtained a positive rate of 2.61% (50/1920). All 50 cases underwent colposcopic biopsy, and positive results were determined in six cases (12%). Following DNA ploidy analysis combined with liquid-based cytology, 201 of the 2 189 cases (9.18%) tested positive, of which 183 underwent colposcopic biopsy, a positive rate of 68.3%. Significant differences were found between the two groups (P<0.05). Among the 135 cases subjected to both the DNA ploidy analysis with liquid-based cytology and the routine cervical cytology, 50 positive and 85 negative cases were found after the routine cervical cytologic diagnosis, whereas 74 positive and 61 negative cases were tested with the DNA ploidy analysis with liquid-based cytology. Cervical biopsy with a histological diagnosis level of cervical intraepithelial neoplasia II and above for the lesion was established as the evaluation standard. The sensitivity of liquid-based cytology detection was 32.3%, and the specificity was 97.3%. The sensitivity and specificity of DNA ploidy analysis technique were 62.4% and 82.6%, respectively. Both the sensitivity and specificity were statistically significant (P<0.05). Conclusion: The detection rate of the combined application of liquid - based cytology and DNA ploidy analysis technique for cervical cancer and precancerous lesion detection was significantly higher than that of conventional cervical cytology detection methods. Thus, the combined technique of DNA ploidy analysis and liquid-based cytology is the more sensitive method. Source

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