OBJECTIVES: To analyze sex and age distribution of global disease burden of calcific aortic valve disease (CAVD) from 1990 to 2021. METHODS: CAVD data during 1990-2021 were obtained from the IHME website for Global Burden of Disease (GBD). The prevalence, mortality, years lived with disability (YLDs), and disability-adjusted life years (DALYs) were analyzed by gender and age groups. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC). RESULTS: In 2021, there were 13.32 million CAVD patients and 142 000 deaths caused by CAVD globally. Age-standardized prevalence was higher in males (193.2/10⁵) than that in females (128.9/10⁵). Patients in 65-<85 age group accounted for 64.0% of total cases, while those ≥85 years old accounted for 16.1%. From 1990 to 2021, prevalence increased in both sexes with an AAPC of 0.72% for males and 0.57% for females, respectively. Prevalence grew fastest from 2000 to 2010, slowed thereafter, and declined from 2015 to 2021. In <65 years old, the mortality of males was 2.4 times higher than that of females, while in ≥85 years old, mortality of females (117.3/10⁵) exceeded that of males (99.1/10⁵). YLD rates increased with age, and were higher in males for all age groups. DALY rates decreased overall but increased in ≥85 years old, with a greater increase in females. CONCLUSIONS There are significant gender and age disparities in global disease burden of CAVD, with the elderly, especially super-elderly females deserving particular attention. It is recommended to develop personalized intervention strategies for these populations.
Humans ; Male ; Female ; Aged ; Calcinosis/mortality* ; Prevalence ; Global Burden of Disease ; Aged, 80 and over ; Middle Aged ; Aortic Valve/pathology* ; Aortic Valve Stenosis/epidemiology* ; Age Distribution ; Adult ; Disability-Adjusted Life Years ; Sex Distribution ; Global Health ; Aortic Valve Disease/epidemiology* ; Sex Factors

Objective:To explore the clinical efficacy and safety of unilateral biportal endoscopic (UBE) and percutaneous transforaminal endoscopic discectomy (PTED) techniques in treating recurrent lumbar disc herniation (RLDH).Methods:This study is a retrospective cohort study. The clinical data were retrospectively collected from 68 patients who underwent surgical treatment for RLDH at Department of Mini-invasive Spinal Surgery, the Third People′s Hospital of Henan Province from June 2020 to June 2023. The patients were divided into the UBE group (38 cases) and the PTED group (30 cases) based on the surgical technique used. The drainage volume, surgery duration, and postoperative complications for revision surgeries in both groups were recorded. Visual analogue scale(VAS) and Oswestry disability index (ODI) were used to assess back pain and leg pain degrees and improvements preoperatively, 3 days postoperatively, 3 months postoperatively, and at the final follow-up. The modified Macnab criteria were used to evaluate outcomes at the final follow-up. The data comparison was conducted using independent sample t-test, repeated measures analysis of variance, χ2 test or Fisher's exact test. Results:All surgeries were successfully completed. The surgery duration in the UBE group was significantly shorter than in the PTED group, with statistically significant differences ((50.9±10.5)minutes vs.(55.9±12.5)minutes, t=1.234, P=0.001). All patients were followed up for more than 1 year, with a follow-up period of (18.1±5.6) months (range: 12 to 29 months). Both groups showed a significant reduction in VAS and ODI for back and leg pain at all postoperative time points compared to preoperative scores (all P<0.05). However, there were no statistically significant differences in VAS of low back pain, lower limb pain score and ODI score over time between the groups (all P>0.05). At the final follow-up, the UBE group had an excellent and good rate of 92.1% (35/38); the PTED group had an excellent and good rate of 86.6% (26/30)( χ2=0.727, P=0.867). One patient in the UBE group and three in the PTED group experienced cerebrospinal fluid leaks, and one patient in the PTED group experienced postoperative leg numbness; all were discharged after conservative treatment. At the final follow-up, lumbar X-rays, CT, and MRI evaluations showed no recurrence or instability at the surgical segments. Conclusions:Both UBE and PTED can achieve good clinical outcomes in the treatment of RLDH through continuous visualization. The choice of surgical method for RLDH should be more precisely tailored to the individual.

Objective:To explore the clinical efficacy and safety of unilateral biportal endoscopic (UBE) and percutaneous transforaminal endoscopic discectomy (PTED) techniques in treating recurrent lumbar disc herniation (RLDH).Methods:This study is a retrospective cohort study. The clinical data were retrospectively collected from 68 patients who underwent surgical treatment for RLDH at Department of Mini-invasive Spinal Surgery, the Third People′s Hospital of Henan Province from June 2020 to June 2023. The patients were divided into the UBE group (38 cases) and the PTED group (30 cases) based on the surgical technique used. The drainage volume, surgery duration, and postoperative complications for revision surgeries in both groups were recorded. Visual analogue scale(VAS) and Oswestry disability index (ODI) were used to assess back pain and leg pain degrees and improvements preoperatively, 3 days postoperatively, 3 months postoperatively, and at the final follow-up. The modified Macnab criteria were used to evaluate outcomes at the final follow-up. The data comparison was conducted using independent sample t-test, repeated measures analysis of variance, χ2 test or Fisher's exact test. Results:All surgeries were successfully completed. The surgery duration in the UBE group was significantly shorter than in the PTED group, with statistically significant differences ((50.9±10.5)minutes vs.(55.9±12.5)minutes, t=1.234, P=0.001). All patients were followed up for more than 1 year, with a follow-up period of (18.1±5.6) months (range: 12 to 29 months). Both groups showed a significant reduction in VAS and ODI for back and leg pain at all postoperative time points compared to preoperative scores (all P<0.05). However, there were no statistically significant differences in VAS of low back pain, lower limb pain score and ODI score over time between the groups (all P>0.05). At the final follow-up, the UBE group had an excellent and good rate of 92.1% (35/38); the PTED group had an excellent and good rate of 86.6% (26/30)( χ2=0.727, P=0.867). One patient in the UBE group and three in the PTED group experienced cerebrospinal fluid leaks, and one patient in the PTED group experienced postoperative leg numbness; all were discharged after conservative treatment. At the final follow-up, lumbar X-rays, CT, and MRI evaluations showed no recurrence or instability at the surgical segments. Conclusions:Both UBE and PTED can achieve good clinical outcomes in the treatment of RLDH through continuous visualization. The choice of surgical method for RLDH should be more precisely tailored to the individual.

Background::Dilated cardiomyopathy (DCM) has a high mortality rate and is the most common indication for heart transplantation. Our study sought to develop a multiparametric nomogram to assess individualized all-cause mortality or heart transplantation (ACM/HTx) risk in DCM patients.Methods::The present study is a retrospective cohort study. The demographic, clinical, blood test, and cardiac magnetic resonance imaging (CMRI) data of DCM patients in the tertiary center (Fuwai Hospital) were collected. The primary endpoint was ACM/HTx. The least absolute shrinkage and selection operator (LASSO) Cox regression model was applied for variable selection. Multivariable Cox regression was used to develop a nomogram. The concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.Results::A total of 218 patients were included in the present study. They were randomly divided into a training cohort and a validation cohort. The nomogram was established based on eight variables, including mid-wall late gadolinium enhancement, systolic blood pressure, diastolic blood pressure, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-diastolic volume index, free triiodothyronine, and N-terminal pro-B type natriuretic peptide. The AUCs regarding 1-year, 3-year, and 5-year ACM/HTx events were 0.859, 0.831, and 0.840 in the training cohort and 0.770, 0.789, and 0.819 in the validation cohort, respectively. The calibration curve and DCA showed good accuracy and clinical utility of the nomogram.Conclusions::We established and validated a circulating biomarker- and CMRI-based nomogram that could provide a personalized prediction of ACM/HTx for DCM patients, which might help risk stratification and decision-making in clinical practice.

Consumptive thirst such as dry mouth and polydipsia,frequent urination polyuria,fear of heat and hyperhidrosis and loss of other body fluids,yin deficiency and internal heat expression,and irritability and other abnormal emotional symptoms are common.The Synopsis of Golden Chamber need to be further explored for the treatment of miscellaneous diseases.The dialectical thought has a high clinical application value.Lily disease treatment recommendations in the Synopsis of Golden Chamber are explored.The symptoms of lily disease are varied and uncertain,which are caused by the scattering and wandering aimlessly of heat pathogen.The pathogenesis of lily disease can be examined through external symptoms such as bitter taste in mouth,red urine,and faint and rapid pulse.Diabetes is also closely related to yin deficiency and internal heat,and the pathogenesis of the two is similar.Mental symptoms are common characteristics of lily disease and diabetes.The method taken from the Synopsis of Golden Chamber and Baihe-like prescriptions for the treatment of diabetes are effective.By identifying different patterns,symptoms,and indicators,we can select lily bulb,common anemarrhena,rhizome,figwort root,unprocessed rehmannia root,and other drugs to treat diabetes,in order to improve our understanding of lily disease and provide new ideas for diabetes treatment.

Objective:To analyze the distribution of pathogenic microorganisms of abdominal infection in patients after pancreaticoduodenectomy and the influencing factors of postoperative abdominal infection.Methods:The clinical data of 108 patients with pancreatic diseases, including ampullary tumors, pancreatic tumors, duodenal tumors, and malignant tumors of the common bile duct, who underwent pancreaticoduodenectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from May 2019 to December 2022 were retrospectively analyzed. Among them, 65 were males, 43 were females, aged (59.28±17.88) years old. Patients who underwent pancreaticoduodenectomy were categorized into two distinct cohorts based on the occurrence of abdominal infection within a 30-day postoperative period: the infected group ( n=37) and the non-infected group ( n=71).General data, laboratory test indicators, pathogen types and drug susceptibility test results of patients were collected. Logistic regression was used to analyze the influencing factors of postoperative pancreaticoduodenal abdominal infection. Results:The postoperative abdominal infection rate was 34.26% (37/108), and a total of 105 pathogenic bacteria were detected, including 43 gram-negative bacteria (40.95%), 36 gram-positive bacteria (34.29%) and 26 fungi (24.76%). The top five pathogens were Enterococcus faecium, Candida albicans, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Staphylococcus haemolyticus. The drug sensitivity results showed that no tigecycline and vancomycin-resistant Enterococcus faecium strains. The sensitivity rate of Candida albicans to amphotericin B was 100%, and the resistance rate to fluconazole was only 4.8%. The resistance rates of Stenotrophomonas maltophilia to cefoperazone-sulbactam and levofloxacin are 11.1% and 33.3%, respectively. The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem are 71.4% and 28.6%, respectively. Multivariate logistic regression analysis showed that postoperative intra-abdominal bleeding ( OR=10.997, 95% CI: 1.995-13.840, P=0.004) and pancreatic fistula ( OR=16.832, 95% CI: 1.938-146.174, P=0.010) were risk factors for the occurrence of abdominal infection after pancreatoduodenectomy. Conclusion:Non-fermented gram-negative bacteria, enterococcus and Candida albicans were the main pathogenic microorganisms in abdominal infection after pancreatoduodenectomy, and postoperative abdominal hemorrhage and pancreatic fistula were independent risk factors.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To investigate the value of ultrasound guided preoperative percutaneous portal vein puncture indocyanine green (ICG) in laparoscopic anatomic liver S8 resection.Methods:The clinical data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anabolic S8 hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2023 to December 2023 were retrospectively analyzed, including 13 males and 2 females with the age of (57.77±11.53) years. Clinical data such as China liver cancer staging (CNLC), target portal vein puncture operation time, operation time, intraoperative blood loss, postoperative complications and perioperative death were recorded.Results:Among the 15 patients, 11 were CNLC Ia stage and 4 were CNLC Ib stage. The operation time of target portal vein puncture for the 15 patients was (11.33±4.51) min, and they all successfully completed percutaneous portal vein puncture ICG fluorescence injection under ultrasound guidance. However, the dyeing effect was not up to expectations for 2 patients. All patients completed laparoscopic anatomical resection of the liver S8 segment, including 6 cases of resection of the liver S8 segment, 8 cases of resection of the posterior segment of the liver S8 segment, and 1 case of resection of the anterior segment of the liver S8 segment. The operative time of laparoscopic anabolic S8 hepatectomy was 181.3 (119.0, 237.0) min, the intraoperative blood loss was 203.3 (100.0, 300.0) ml, there was no intraoperative blood transfusion, and the postoperative hospital stay was (12.00±3.88) d. No positive surgical margin was found in postoperative pathology, and the tumor diameter of 15 patients was (3.29±1.10) cm. No complications of Clavien-Dindo grade Ⅲ or above occurred after surgery, and no perioperative death occurred, and only 1 patient developed pulmonary infection after surgery.Conclusion:Preoperative ultrasound-guided percutaneous portal vein puncture ICG can effectively assist laparoscopic anatomic S8 hepatectomy in patients with hepatocellular carcinoma.

Objective:To investigate the value of ultrasound guided preoperative percutaneous portal vein puncture indocyanine green (ICG) in laparoscopic anatomic liver S8 resection.Methods:The clinical data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anabolic S8 hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2023 to December 2023 were retrospectively analyzed, including 13 males and 2 females with the age of (57.77±11.53) years. Clinical data such as China liver cancer staging (CNLC), target portal vein puncture operation time, operation time, intraoperative blood loss, postoperative complications and perioperative death were recorded.Results:Among the 15 patients, 11 were CNLC Ia stage and 4 were CNLC Ib stage. The operation time of target portal vein puncture for the 15 patients was (11.33±4.51) min, and they all successfully completed percutaneous portal vein puncture ICG fluorescence injection under ultrasound guidance. However, the dyeing effect was not up to expectations for 2 patients. All patients completed laparoscopic anatomical resection of the liver S8 segment, including 6 cases of resection of the liver S8 segment, 8 cases of resection of the posterior segment of the liver S8 segment, and 1 case of resection of the anterior segment of the liver S8 segment. The operative time of laparoscopic anabolic S8 hepatectomy was 181.3 (119.0, 237.0) min, the intraoperative blood loss was 203.3 (100.0, 300.0) ml, there was no intraoperative blood transfusion, and the postoperative hospital stay was (12.00±3.88) d. No positive surgical margin was found in postoperative pathology, and the tumor diameter of 15 patients was (3.29±1.10) cm. No complications of Clavien-Dindo grade Ⅲ or above occurred after surgery, and no perioperative death occurred, and only 1 patient developed pulmonary infection after surgery.Conclusion:Preoperative ultrasound-guided percutaneous portal vein puncture ICG can effectively assist laparoscopic anatomic S8 hepatectomy in patients with hepatocellular carcinoma.

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is highly contagious and can cause death in severe cases. As reported by the World Health Organization (WHO), as of 6:36 pm Central European Summer Time (CEST), 12 August 2022, there had been 585 950 285 confirmed cases of COVID-19, including 6 425 422 deaths (WHO, 2022).
Humans ; COVID-19 ; SARS-CoV-2 ; Mental Health ; Cohort Studies ; Quality of Life ; China/epidemiology* ; Health Personnel ; Hospitals ; Lung