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 analyze the efficacy of endoscopic surgical repair in the treatment of type Ⅲ laryngeal clefts and to explore the feasibility of the treatment for type Ⅲ laryngeal clefts. Methods:The clinical data of 6 children with type Ⅲ laryngeal clefts who underwent endoscopic surgical repair in our department from June 2018 to January 2023 were analyzed retrospectively. The operation was performed under combined intravenous and general anesthesia,preserving the spontaneous breathing of the children. With the assistance of 4 mm/0° endoscope, radiofrequency knife or laryngeal scissors were used to make fresh wounds along the edge of laryngeal clefts,and cotton pads infiltrated with adrenaline （1:10 000） were used to compress the wound. 6-0 PDP suture was used to suture 3-6 stitches according to the extent of laryngeal clefts. Modified barium swallowing test （MBS） was performed 3 months after operation. Results:All the children were successfully treated with endoscopic surgical repair. After surgery, 2 cases were transferred to pediatric intensive care unit （ICU） for 7 days of monitoring, and the rest were transferred back to the general ward. There were no postoperative complications. The symptoms of dysphagia, laryngitis and recurrent pneumonia were improved in all children. According to the follow-up results of postoperative MBS,no aspiration was found in all children, and 2 children had intermittent cough when drinking large amounts of water. During the follow-up, there were 2 cases of recurrence, and the cracks were completely repaired after the second endoscopic surgical repair treatment,and no recurrence has been observed so far. Conclusion:Endoscopic surgical repair can be applied to some children with type Ⅲ laryngeal clefts with less intraoperative bleeding and fewer operative complications. It can significantly improve the symptoms such as swallowing dysfunction and recurrent pneumonia. It is a safe and effective surgical treatment.
Child ; Humans ; Laryngoscopy/methods* ; Laryngoscopes ; Retrospective Studies ; Larynx/surgery* ; Pneumonia ; Congenital Abnormalities/surgery*

Objective:To investigate the clinical manifestations and the effect of peroral endoscopic-assisted laryngeal microsurgery for children with laryngeal neurofibroma, and to provide clinical reference for the diagnosis and treatment of this disease. Methods:The clinical data of 4 children with laryngeal tumors admitted to the Department of Otorhinolaryngology, Children's Hospital of Chongqing Medical University from January 2021 to June 2023 were retrospectively analyzed. Laryngeal tumors were removed by peroral endoscopic-assisted laryngeal microsurgery. One case underwent tracheotomy at the same time, and one case was simultaneously performed with laryngeal T tube placement and tracheotomy. Results:Surgical resection is the best treatment for laryngeal neurofibroma, and laryngeal microsurgery should be actively used for patients with surgical indications.This surgical method has the advantages of good efficacy, minimal invasion, aesthetics and preservation of laryngeal function, which not only ensures safety, but also improves the quality of life after surgery, and has the value of development and promotion.
Child ; Humans ; Laryngeal Neoplasms/pathology* ; Laryngoscopy/methods* ; Microsurgery/methods* ; Retrospective Studies ; Quality of Life ; Neurofibroma/diagnosis*

At present, there is no unified gold standard for the treatment of laryngeal clefts. Type Ⅰ laryngeal clefts with mild symptoms can be treated conservatively, such as thick diet feeding and using proton pump inhibitor to control reflux, while Ⅱ-Ⅳ laryngeal clefts mostly requires surgical intervention.There are many different surgical methods for the treatment of laryngeal clefts, including injection laryngoplasty, endoscopic surgical repair of laryngeal clefts and open laryngoplasty through anterior cervical approach. How to choose a more suitable surgical plan for children is a problem worth discussing. This article will review the literature on the surgical treatment of laryngeal clefts both domestically and internationally, and summarize the current situation and challenges of surgical treatment of laryngeal clefts.
Child ; Humans ; Congenital Abnormalities/surgery* ; Endoscopy ; Laryngoplasty/methods* ; Laryngoscopy/methods* ; Larynx/surgery*

Objective:To study and summarize the effectiveness of the case-based three-dimensional teaching method in clinical probation teaching of otolaryngology for international students.Methods:We divided a total of 190 international medical students in grades 2014 and 2015 from Chongqing Medical University in 2014 and 2015 into control group (92 students) and experimental group (98 students). The control group used the traditional case-based teaching method, while the experimental group used the case-based three-dimensional teaching method. After the semester was over, teaching effectiveness was evaluated through comprehensive examination and a questionnaire survey. SPSS 21.0 was used to perform the t-test and Fisher's exact test. Results:The examination score of the experimental group was significantly higher than that of the control group [(81.68±4.45) vs. (77.80±5.10), P<0.05]. The experimental group had a significantly higher degree of satisfaction than the control group ( P<0.05). Conclusion:The case-based three-dimensional teaching method has advantages in improving the learning interest and academic performance of international students.

MOOCs (massive open online courses) is a new curriculum model and teaching form emerging in recent years in the field of education. The characteristics and advantages of MOOCs can make up for the deficiencies in the traditional teaching of pediatric otolaryngology & head and neck surgery, and improve the quality of the course of Otolaryngology-Head and neck surgery in children. In the implementa-tion, the course teaching is divided into four modules, "theoretical teaching module" "case discussion and interaction module" "after-school question answering and feedback module" and "clinical practice module"respectively. These modules are closely linked and connected, which can help enhance interacting with students, feedback teaching effect timely, and then improve the teaching quality and students' self-learning ability, thus make it possible to better cultivate pediatric clinical specialists.

In Chongqing Medical University,Introduction to Clinical Medicinewas first launched in 2002. In this article, based on the summary of 2014 to 2015, we summarized respectively from teaching material construction, evaluation system with combination of formative assessment and summative assess-ment, network support platform, teaching quality monitoring system, and student questionnaire survey and evaluation. Through the study of the course, 99.5% (836/840) of the students think their team conscious-ness and cooperation ability were improved, 94.2% (791/840) of the students consider this course can im-prove their innovative ability of self-learning, 87.0% (731/840) of the students think it is beneficial to the improvement of their self expression ability and more than 78.0% of the students think they have achieved the goal of early clinical contact, expanding knowledge, and enhancing the basic professional quality.

Objective To study the percentage depth dose difference (PDD) between Monte Carlo method and the measurement method.Methods Based on the detail treatment head structure designing by the manufacture,the BEAMnrc Monte Carlo code was used to simulate the 6 MV photon beams of a Siemens Primus linear accelerator.DOSXYZnrc program generated 6 MV X-ray parameters such as PDD,and it was measured by MP3 three-dimensional water of PTW corporation phantom.The deviation of PDD was calculated using formulas ((measured value-simulation algorithm value)/measured value × 100％).Results Distance from the surface of the water was less than 1.2 cm,the deviation of PDD was ＞ 2％.Distance from the surface greater than 1.2 cm,the deviation of PDD was ＜ 2％.Conclusion In the built-up areas,PDD obtained by the Monte Carlo simulation algorithm is more accurate.

Objective Due to the superior performance,Carbon-Carbon composites,although still at their early stage of development,have gained more and more attention and showed great application potential.Methods According to the National Standard,the biological safety evaluation of carbon-carbon composites were done in the following aspects:cytotoxicity test,acute systemic toxicity test,haemolysis test,pyrogen test,intramuscular implantation test.Results test results showed the biological safety evaluation of carbon-carbon composites well meet the requirement of the national standard with fine biological compatibility.Conclusion The experiment results demonstrate that carbon-carbon composites can be put in clinical application

ObjectiveTo investigate the impact of metal plate on radiation dose distribution by Monte Carlo (MC) code. MethodsThe metal plates with 0. 4 thick were placed in water at 5 cm, all the plate irradiated with 6 MV X-ray were simulated by MC code, SSD =100 cm. The percentage depth dose with or without metal implants were compared. ResultsThe surface absorbed doses on incident plane of stainless steel plate and titanium plate were increased by 19. 6％ and 15.7％ respectively as compared water,the dose influence was less than 1.5％ more than 0. 3 cm outside the incidence plane. The doses on the exit surface of stainless steel plate and titanium plate were lowered by 8. 6％ and 8. 2％ when compared with water, the dose impacts of this places where were from the exit surface of stainless steel plate 、titanium plate more than 1.2 cm,0. 9 cm were less than 1.5％. The surface absorbed doses on incident plane of stainless steel plate were increased by 3.9％ respectively as titanium plate, the dose of the exit surface of stainless steel plate and titanium plate was similar. Conclusions MC method is a fast and accurate calculation method. The influence of metal plate on the radiotherapy dose distribution is significant. Under the such condition, the impact of stainless steel plate is much more than that of titanium alloy plate.