Ventilation catheter-assisted airway stenting under local anaesthesia for patients with airway stenosis: initial clinical experience.

PURPOSE: This report details our preliminary results of ventilation catheter-assisted airway stenting under local anaesthesia for airway stenosis. MATERIALS AND METHODS: Fifteen consecutive patients with airway stenosis underwent ventilation catheter-assisted airway stenting under local anaesthesia. A 4F angiographic catheter was used as the ventilation catheter. During the treatment, the distal tip of the ventilation catheter was placed across the stenosis into one of the main bronchi and the proximal tip of the catheter was linked to the oxygen tube for oxygen supplementation. Airway stenting was performed under ventilation support. Patients maintained autonomous respiration throughout the procedures. Data on technical success, clinical outcome and follow-up were collected and analysed. RESULTS: Ventilation catheter-assisted airway stenting under local anaesthesia was technically successful and well tolerated in all patients. Respiratory difficulty was improved in all patients after treatment. The average Hugh-Jones classification grade, arterial oxygen saturation value, and respiratory rate improved from 4.20 ± 0.68, 80.60 ± 3.83%, and 30.33 ± 2.02 times/min, respectively, before stenting to 1.47 ± 0.52 (P < 0.001), 94.93 ± 1.33% (P < 0.001), and 18.07 ± 1.33 times/min (P < 0.001), respectively, after stenting. After 2-11 months (average 5.73 ± 2.40 months) of follow-up, one patient experienced re-stenosis of the stent. The mean survival time of the 15 patients was 162.00 ± 71.60 days (range 55-320 days). CONCLUSIONS: Ventilation catheter-assisted airway stenting under local anaesthesia can be an effective, simple and safe method for airway stenosis.

Comparison osteopontin vs AFP for the diagnosis of HCC: a meta-analysis.

BACKGROUNDS: Osteopontin (OPN) has been reported as one of the most promising markers for hepatocellular carcinoma (HCC). The goal of this meta-analysis was to evaluate the clinical value of the plasma OPN versus alpha-fetoprotein (AFP) in the diagnosis of HCC. METHODS: A comprehensive literature search of PubMed, Foreign Medical Journal Service, Chinese Science Journals Database, and Google Scholar was conducted on articles published before 1st October 2013. The sensitivity, specificity, and other measures of accuracy of OPN in the diagnosis of HCC were pooled using random effects models. The methodological quality of each study was assessed by QUADAS (quality assessment for studies of diagnostic accuracy). Statistical analysis was performed by employing Meta-Disc 1.4 and Stata, version 12. Summary receiver operating characteristic curves were used to summarize overall test performance. RESULTS: Seven studies were included in our meta-analysis. The summary estimates for OPN and AFP in the diagnosis of HCC in these studies as follows: sensitivity, 0.86 (0.79-0.91) vs 0.66 (0.53-0.76), specificity, 0.86 (0.69-0.94) vs 0.95 (0.87-0.98), positive likelihood ratio (PLR), 6.10 (2.43-15.32) vs 13.25 (4.69-37.49), negative likelihood ratio (NLR), 0.16 (0.09-0.28) vs 0.36 (0.26-0.51), diagnostic odds ratio (DOR), 38.52 (8.99-165.08) vs 36.75 (11.04-122.32), and the area under the curve (AUC), 0.92 vs 0.87. CONCLUSION: Our study demonstrates that OPN has a comparable accuracy to AFP for the diagnosis of HCC, while the value of OPN in combination with AFP for HCC detection deserves further investigation.