ABSTRACT
PURPOSE: This meta-analysis was designed for examining the relative clinical safety and efficacy of normal stent (NS) and radioactive stent (RS) insertion in malignant hilar obstruction (MHO) patients. MATERIAL AND METHODS: Relevant studies published as of March 2022 were identified through searches of the Medline, Embase, Wanfang, and CNKI databases, and the pooled results of these studies were then analyzed. RESULTS: Eight studies including 258 and 247 patients that underwent NS and RS insertion, respectively, were incorporated into this meta-analysis. RS insertion was found to be associated with significant improvements in functional successful rate (p = 0.04), Δaspertate aminotransferase (AST, p = 0.0004), Δalanine aminotransferase (ALT, p = 0.002), stent patency (p < 0.00001), stent re-obstruction rate (p = 0.03), and OS (p < 0.00001) outcomes as compared to those associated with NS insertion. No differences in Δtotal bilirubin (TBIL, p = 0.38), cholangeitis rate (p = 0.45), cholecystitis rate (p = 0.84), or hemorrhage rate (p = 0.87) were observed when comparing patients that underwent RS and NS insertion. Substantial publication bias was observed for endpoints of cholecystitis and hemorrhage. CONCLUSIONS: These results suggest that relative to NS insertion, RS insertion can effectively prolong stent patency and OS in MHO cases.
Subject(s)
Bile Duct Neoplasms , Cholecystitis , Cholestasis , Humans , Cholestasis/complications , Cholestasis/surgery , Treatment Outcome , Stents , Cholecystitis/complicationsABSTRACT
A simple and new method for the simultaneous determination of procaine (Pro), lidocaine (Lid), ropivacaine (Rop) and bupivacaine (Bup) was developed using capillary electrophoresis separation with mixed micelles and electrochemiluminescence detection. The use of mixed micelles of 2.0 × 10(-3) mol/L sodium dodecyl sulfate (SDS) and 8.0 × 10(-3) mol/L Tween 20 greatly improved separation selectivity. The detection sensitivities of four drugs with a Pt working electrode were increased by modification of the Pt electrode with europium(III)-doped Prussian Blue analog (Eu-PB). Under optimal conditions, the four local anesthetics were well separated and detected. The limits of detection (LOD, S/N = 3) of Pro, Lid, Rop and Bup in standard solution are 2.5 × 10(-8) , 1.3 × 10(-8) , 3.0 × 10(-8) and 4.1 × 10(-8) mol/L, respectively. The limits of quantitation (LOQ, S/N = 10) of Pro, Lid, Rop and Bup are 2.3 × 10(-7) , 1.2 × 10(-7) , 3.7 × 10(-7) and 5.6 × 10(-7) mol/L in a human urine sample, and 8.5 × 10(-7) , 6.9 × 10(-7) , 2.8 × 10(-6) and 1.1 × 10(-6) mol/L in a human serum sample, respectively. The recoveries of four drugs at different spiked concentrations in human urine and serum samples were between 86.5 and 107.6%. The proposed method has been successfully applied to determine local anesthetics in biofluids.
