RESUMO
Introduction: Between 42% and 77% of patients with distal malignant biliary obstruction (MBO) suffer from pancreatic carcinoma (PC). Aim: To analyse the clinical efficacy of stenting accompanied by high-intensity focused ultrasound (HIFU) ablation in patients with distal MBO from PC. Material and methods: Relevant articles published through March 2021 were identified in the Pubmed, Cochrane Library, Embase, Wanfang, VIP, and CNKI databases. RevMan v5.3 and Stata v12.0 were used for the meta-analysis. Results: Twenty-nine articles were initially identified, and 5 of these were eventually included. These articles described 142 patients who underwent biliary stenting alone and 132 patients who underwent biliary stenting with HIFU ablation. The pooled Δ total bilirubin (TBIL) values were comparable between the 2 treatment groups (p = 0.10). The pooled stent dysfunction rate was significantly greater in the group with stenting alone (p = 0.03), and the pooled HR for the stent patency duration indicated that the duration of stent patency was increased in the stenting with HIFU ablation group (p < 0.0001). Overall survival rates were significantly longer in the stenting with HIFU ablation group (p < 0.0001). HIFU ablation was associated with an 80% pooled clinical response rate. The pooled cholangitis (p = 0.47) and pancreatitis (p = 0.56) rates were comparable between the 2 groups. Funnel plots did not reveal any significant evidence of endpoint-associated publication bias. Conclusions: Stenting with HIFU ablation increased both stent patency and overall survival in patients with distal MBO caused by PC compared to stenting alone.
RESUMO
Based on an extensive collection of information and experimental data, this paper studied the carbon cycle in ten kinds of forest ecosystem in Guangzhou, China, aimed to explore the carbon cycling patterns in, southern subtropical forest ecosystems. For the test ecosystems, their carbon density ranged from 108.35 to 151.85 t C x hm(-2), with 10. 85-48.86 t C x hm(-2) in tree layer and 87.74-99.01 t C x hm(-2) in soil layer (0-60 cm), being lower than the national average. There were 4. 41-9. 15 t C x hm(-2) x a(-1) flowed from atmosphere to vegetation stratum, 0. 74-2.06 t C x hm(-2) x a(-1) from vegetation stratum to soil, and 3.94-5.42 t C x hm(-2) x a(-1) from soil to atmosphere, i.e., the forest systems absorbed 0.47-4.97 t C x hm(-2) x a(-1) from atmosphere. The net ecosystem production (NEP) varied with forest stand, being higher for broadleaved forest than coniferous forest, mixed forest than pure forest, and natural secondary forest than artificial forest.
