ObjectiveTo systematically review the diagnostic value of HLA-B27 for ankylosing spondylitis (AS) in China. MethodsWe searched PubMed, The Cochrane Library (Issue 4, 2015), EMbase, CNKI, CBM, VIP and WanFang data from inception to April 2015, to collect diagnostic studies about HLA-B27 for AS in China. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then meta-analysis was performed using Meta-Disc 1.4 software. Pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and area under the curve (AUC) of summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Subgroup analysis was stratified by detection methods of HLA-B27. ResultsA total of 18 studies involving 22 comparisons, with 3 670 AS patients and 28 389 health controls were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.92 (95%CI 0.90 to 0.93), 0.94 (95%CI 0.94 to 0.95), 16.22 (95%CI 13.63 to 19.29), 0.08 (95%CI 0.06 to 0.10), and 256.49 (95%CI 168.25 to 391.00), respectively. The AUC of SROC was 0.98. The result of subgroup analysis showed that there was no significant difference for flow cytometry (FCM) and Polymerase Chain Reaction with Sequence-Specific Primer (PCR-SSP) in HLA-B27 detection for AS (Z=7.915, P=0.960). ConclusionCurrent evidence indicates that HLA-B27 detection is of great diagnostic value for AS. At present, FCM and PCR-SSP shows no significant difference in HLA-B27 detection for AS. Due to the limitation of the quality of included studies, and the exclusion of the suspected patients, higher quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy and safety of traditional Chinese medicine (TCM) therapies versus non-steroidal anti-inflammatory drugs (NSAIDs) for knee osteoarthritis (KOA). MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 5, 2015), EMbase, CNKI, CBM, VIP and WanFang Data from inception to 14 June 2015, to collect randomized controlled trials (RCTs) about TCM therapies for KOA. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then network meta-analysis was performed using Stata 12.0 and WinBUGS 1.4.3 softwares. ResultsA total of 56 RCTs involving 7256 patients were included, in which 19 different treatment strategies were investigated. All were short-term efficacy studies. Our work yielded 33 direct and 138 indirect comparisons, among which 76 were demonstrated statistically significant. The result of meta-analysis showed that, the TCM-based therapy group had lower complication rates, compared with the NSAIDs group. TCM internal application+acupuncture+fumigation, internal application+fumigation+moxibustion, acupuncture+massage, TCM extra-apply+massage, massage+fumigation+moxibustion, and massage+fumigation were the top six in terms of treatment effect. NSAIDs ranked 18th. ConclusionThe safety and effectiveness of TCM therapies are generally better than NSAIDs except moxibustion, particularly more remarkable for the top six TCM therapies. TCM comprehensive therapies are superior over mono-modality therapies. Due to the limitation of the present studies, the long-term efficacy of TCM therapies needs further investigation, and our findings also need to be verified by large-scale and well-designed RCTs.