RESUMO
Background: Endostar and platinum were widely used in the treatment of malignant pleural effusion (MPE), but there was no unified conclusion on which scheme is the best. The aim of this study was to systematically evaluate the efficacy and cost-effectiveness of Endostar, cisplatin, lobaplatin, Endostar combined with cisplatin, and Endostar combined with lobaplatin in the treatment of MPE so as to provide a reference for clinical treatment. Methods: A comprehensive literature search was performed of sources on PubMed, Web of Science, and other databases published up to and including November 23, 2021, and screened out randomized controlled trial (RCT) concerning the efficacy of 5 interventions of pleural perfusion for MPE. The Cochrane Collaboration tool was used for assessing the risk of bias, and a network meta-analysis was performed with Addis software based on the Bayesian framework. A decision tree model was used to complete a cost-effectiveness analysis that was based on the direct medical costs and the probabilities were determined from the network meta-analysis. The one-way sensitivity analysis was presented with a tornado chart. In the probabilistic sensitivity analysis, the cost-effectiveness acceptability curve was obtained after Monte Carlo simulation. Results: A total of 55 studies were included, comprising 3,379 total patients, excluding the unclear part, we evaluated as low risk of bias. According to the network meta-analysis, Endostar combined with lobaplatin had the highest effectiveness, followed by Endostar combined with cisplatin, Endostar, cisplatin, and lobaplatin. In the incremental cost-effectiveness ratio (ICER) analysis, lobaplatin and Endostar were excluded as inferior schemes. With cisplatin as the comparison, the ICER of Endostar combined with cisplatin was yuan renminbi ¥22,648.31. With Endostar combined with cisplatin as the comparison, the ICER of Endostar combined with lobaplatin was ¥236,502.67. The results of sensitivity analysis and cost-effectiveness analysis were basically consistent. Conclusions: Endostar combined with lobaplatin had the highest effectiveness, but its ICER was relatively too high to be acceptable. Therefore, cisplatin alone and Endostar combined with cisplatin were more cost-effective, and clinicians can choose the optimal treatment scheme based on the willingness to pay (WTP) of different patients with comprehensive consideration of effectiveness and economy.
RESUMO
Soybean is the most important genetically modified (GM) oilseed worldwide. Regulations relating to the approval of biotech soybean varieties and product labeling demand accurate and reliable detection techniques to screen for GM soya. High-quality extracted DNA is essential for DNA-based monitoring methods. Thus, four widely used protocols (SDS, CTAB, DP305, and DNeasy Plant Mini Kit) were compared in the present study to explore the most efficient DNA extraction method for raw soya matrix. The SDS-based method showed the highest applicability. Then crucial factors influencing DNA yield and purity, such as SDS lysis buffer component concentrations and organic compounds used to isolate DNA, were further investigated to improve the DNA obtained from raw soybean seeds, which accounts for the innovation of this work. As a result, lysis buffer (2% SDS (w/v), 150 mM NaCl, 50 mM Tris/HCl, 50 mM EDTA, pH 8.0) and organic reagents including chloroform/isoamyl alcohol (24:1, v/v) (C: I), isopropanol, and ethanol corresponding to the extraction and first and second precipitation procedures, respectively, were used in the optimized SDS method. The optimized method was verified by extracting approximately 2020-2444 ng DNA/mg soybean with A260/280 ratios of 1.862-1.954 from five biotech and non-biotech soybean varieties. Only 0.5 mg of soya was required to obtain enough DNA for PCR amplification using the optimized SDS-based method. These results indicate that the screening protocol in the present study achieves the highest suitability and efficiency for DNA isolation from raw soya seed flour.
