Objective:To examine the safety and effectiveness of a novel domestic transcatheter aortic valve system in addressing severe aortic valve stenosis.Methods:This prospective, multicenter, single-arm target-value clinical trial enrolled patients with severe aortic stenosis meeting inclusion criteria from 13 Chinese centers between July 2021 and April 2022. The primary endpoint was all-cause mortality at 1-year post-procedure. Secondary endpoints included safety outcomes (30-day all-cause mortality, 1-year major adverse cardiovascular events, device success) and efficacy parameters (transvalvular pressure gradient, paravalvular leak severity, New York Heart Association(NYHA)class improvement, and quality of life). Survival analysis was performed using the Kaplan-Meier analysis.Results:The study included 134 patients, 85 males and 49 females, with an age of (73.6±5.6)years (range: 65.1 to 91.8 years). Bicuspid aortic valve morphology was present in 59.7% (80/134). Device success rate was 99.3%, with one case converted to open surgery due to coronary obstruction. All-cause mortality was 0.8% (95% CI: 0.1% to 5.3%) at both 30-day and 1-year follow-up, significantly lower than the 25% target value ( P<0.01). Permanent pacemaker implantation rates remained 2.2% (3/134) at both timepoints. Stroke incidence was 0.7% (1/134) at 30 days and 1.5% (2/134) at 1 year. Myocardial infarction rates were 0.7% (1/134) at both intervals. The postoperative transvalvular pressure gradient of the aortic valve was (6.6±3.1) mmHg(1 mmHg=0.133 kPa) (range: 4 to 8 mmHg). Among the patients, 32 cases (23.9%) had mild paravalvular leakage, 4 cases (3.0%) had moderate paravalvular leakage, and no severe paravalvular leakage was observed. NYHA class Ⅰ and Ⅱ patients increased from 18.7% preoperatively to 99.3% postoperatively. Conclusion:The novel domestic transcatheter aortic valve system demonstrates satisfactory 1-year safety and efficacy outcomes in treating severe aortic stenosis.

Objective:To analyze the application effects of case-based learning (CBL) + Seminar teaching method based on Toulmin model in the education and teaching of clinical medicine innovation class.Methods:A total of 60 students from the clinical medicine innovation class at The Second Affiliated Hospital of Guangzhou Medical University from September 2021 to September 2023 were selected as research objects. These students were divided into control group ( n=30) and research group ( n=30) according to different teaching programs. The traditional teaching method was adopted in the control group, and the CBL + Seminar teaching method based on Toulmin model was adopted in the research group. The two groups were compared in terms of clinical knowledge, clinical skill, and clinical case analysis scores; changes in clinical thinking ability after teaching; and satisfaction with the teaching process. SPSS 22.0 was used for t-test and chi-square test. Results:The research group significantly outperformed the control group in clinical knowledge [(89.59±3.46) points vs. (83.23±3.02) points], clinical skill [(88.87±3.23) points vs. (83.62±3.13) points], and clinical case analysis [(89.73±3.51) points vs. (82.62±3.19) points] ( t=7.58, 6.39, 8.21, P<0.001). The clinical thinking ability after teaching was significantly higher in the research group compared to the control group [(258.49±13.36) points vs. (242.56±13.02) points] ( t=4.67, P<0.001). The overall satisfaction rate of teaching was significantly higher in the research group compared to the control group (100.00% vs. 80.00%, χ2=4.63, P=0.031). Conclusions:The CBL + Seminar teaching method based on Toulmin model can effectively improve student learning performance and clinical thinking ability, demonstrating a promising application value in the education and teaching of clinical medicine innovation class.

Objective:To analyze the application effects of case-based learning (CBL) + Seminar teaching method based on Toulmin model in the education and teaching of clinical medicine innovation class.Methods:A total of 60 students from the clinical medicine innovation class at The Second Affiliated Hospital of Guangzhou Medical University from September 2021 to September 2023 were selected as research objects. These students were divided into control group ( n=30) and research group ( n=30) according to different teaching programs. The traditional teaching method was adopted in the control group, and the CBL + Seminar teaching method based on Toulmin model was adopted in the research group. The two groups were compared in terms of clinical knowledge, clinical skill, and clinical case analysis scores; changes in clinical thinking ability after teaching; and satisfaction with the teaching process. SPSS 22.0 was used for t-test and chi-square test. Results:The research group significantly outperformed the control group in clinical knowledge [(89.59±3.46) points vs. (83.23±3.02) points], clinical skill [(88.87±3.23) points vs. (83.62±3.13) points], and clinical case analysis [(89.73±3.51) points vs. (82.62±3.19) points] ( t=7.58, 6.39, 8.21, P<0.001). The clinical thinking ability after teaching was significantly higher in the research group compared to the control group [(258.49±13.36) points vs. (242.56±13.02) points] ( t=4.67, P<0.001). The overall satisfaction rate of teaching was significantly higher in the research group compared to the control group (100.00% vs. 80.00%, χ2=4.63, P=0.031). Conclusions:The CBL + Seminar teaching method based on Toulmin model can effectively improve student learning performance and clinical thinking ability, demonstrating a promising application value in the education and teaching of clinical medicine innovation class.

Objective:To examine the safety and effectiveness of a novel domestic transcatheter aortic valve system in addressing severe aortic valve stenosis.Methods:This prospective, multicenter, single-arm target-value clinical trial enrolled patients with severe aortic stenosis meeting inclusion criteria from 13 Chinese centers between July 2021 and April 2022. The primary endpoint was all-cause mortality at 1-year post-procedure. Secondary endpoints included safety outcomes (30-day all-cause mortality, 1-year major adverse cardiovascular events, device success) and efficacy parameters (transvalvular pressure gradient, paravalvular leak severity, New York Heart Association(NYHA)class improvement, and quality of life). Survival analysis was performed using the Kaplan-Meier analysis.Results:The study included 134 patients, 85 males and 49 females, with an age of (73.6±5.6)years (range: 65.1 to 91.8 years). Bicuspid aortic valve morphology was present in 59.7% (80/134). Device success rate was 99.3%, with one case converted to open surgery due to coronary obstruction. All-cause mortality was 0.8% (95% CI: 0.1% to 5.3%) at both 30-day and 1-year follow-up, significantly lower than the 25% target value ( P<0.01). Permanent pacemaker implantation rates remained 2.2% (3/134) at both timepoints. Stroke incidence was 0.7% (1/134) at 30 days and 1.5% (2/134) at 1 year. Myocardial infarction rates were 0.7% (1/134) at both intervals. The postoperative transvalvular pressure gradient of the aortic valve was (6.6±3.1) mmHg(1 mmHg=0.133 kPa) (range: 4 to 8 mmHg). Among the patients, 32 cases (23.9%) had mild paravalvular leakage, 4 cases (3.0%) had moderate paravalvular leakage, and no severe paravalvular leakage was observed. NYHA class Ⅰ and Ⅱ patients increased from 18.7% preoperatively to 99.3% postoperatively. Conclusion:The novel domestic transcatheter aortic valve system demonstrates satisfactory 1-year safety and efficacy outcomes in treating severe aortic stenosis.

Objective:To investigate the diagnostic value of ultrasonic measurement of optic nerve sheath diameter (ONSD) and optical disk elevation (ODE) for intracranial hypertension in patients with cerebral venous sinus thrombosis(CVST).Methods:A total of 50 patients with CVST who underwent lumbar puncture and ONSD examination in the Department of Neurology and Emergency Department of Xuanwu Hospital, Capital Medical University from January 2021 to December 2021 were retrospectively enrolled. After lumbar puncture, the patient′s initial intracranial pressure was recorded. Normal ICP was defined as ICP between 80 and 200 mmH 2O, and increased ICP was defined as ICP>200 mmH 2O. Fifty patients with CVST were divided into normal ICP group (14 cases) and increased ICP group (36 cases). The differences of baseline data, ONSD and ODE between the two groups were compared, and the receiver operating characteristic (ROC) curve was generated. The area under the curve (AUC) and the diagnostic cut-off value of ONSD were analyzed. Spearman correlation analysis was used to analyze the correlation between ONSD, ODE, CVST involvement range scores and intracranial pressure. Results:①There were no significant differences in gender, age and body mass index between the normal ICP group and the increased ICP group (all P>0.05). ②The ONSD and ODE in the increased ICP group were higher than those in the normal ICP group, and the differences were statistically significant [(4.83±0.33)mm vs (4.21±0.21)mm, (0.67±0.44)mm vs (0.24±0.29)mm, all P<0.001]. Spearman correlation analysis showed that ONSD and ODE were positively correlated with intracranial pressure ( rs=0.74, 0.51, all P<0.001). ③The extent of CVST involvement in the intracranial hypertension group was higher than that in the normal intracranial pressure group, and the difference was statistically significant [5.0(3.0, 7.5) vs 2.5(2.0, 5.0), P=0.015]. Spearman correlation analysis showed that CVST involvement score was positively correlated with intracranial pressure ( rs=0.43, P<0.001). ④In the diagnosis of intracranial hypertension in patients with cerebral venous sinus thrombosis, the AUC of ONSD was 0.935, the best diagnostic threshold of ONSD was 4.5 mm, the sensitivity was 0.81, and the specificity was 0.93. Conclusions:ONSD and ODE measured by ultrasound are reliable imaging methods to identify intracranial hypertension in patients with CVST.

Objective:To explore the clinical effect of the V-Y plasty of musculocutaneous flap in repairing the excessive width of inner canthus deformity.Methods:Retrospective analysis was performed between July 2018 and June 2021 in patients treated with this method. V-Y design along the inner corner of the eye before operation. The key points of operation are the elevated under the orbicularis oculi muscle. The skin orbicularis oculi muscle flaps are formed on both sides of the incision. After the V-Y of the outside myocutaneous flap is advanced and formed at the new medial canthus point, the V-Y of the orbicularis oculi muscle and the skin are sutured in layers. The degree of reduction of the inner canthus width, epicanthal fold shape, incision scarring, and patient satisfaction was followed up. All patients were measured at the preoperative and postoperative review to record data of the intercanthal distance, and used paired t-test for statistical analysis. P<0.05 was statistically significant. Results:83 patients, including 81 female patients and 2 males, with an average age of 28 years (19 to 56 years) were followed up from 3 months to 2 years, with an average of 1 year. The overexposure of the tear caruncle was significantly reduced, the asymmetry of the bilateral inner corners has been improved, the shape of the epicanthal folds reverted to its natural appearance and the old scars became inconspicuous; patient satisfaction evaluation: very satisfied 34.94% (29/83), satisfied 54.22% (45/83), relatively dissatisfied 6.02% (5/83), dissatisfied 4.82% (4/83). Among the 4 cases of dissatisfaction, 2 cases were due to insufficient correction and were re-operated to obtain satisfactory result, 1 case was improved by reoperating due to excessive correction which led to the reduction of inner canthal distance, 1 case regrets surgery the next day after surgery and cannot accept the appearance and strongly requires removal and restoration. The distance between intercanthal distance of the patients was 28.8 mm to 38.0 mm, average (33.58±3.34) mm before the operation, and 32.2 mm to 41.5 mm, average (37.47±2.90) mm after the operation, an average increase of 3.89 mm ( t=-15.78, P<0.001) after the operation. Conclusions:The V-Y plasty of musculocutaneous flap is suitable for the repair of excessive width of inner canthus deformity after epicanthoplasty. The design idea is simple, the postoperative effect is reliable, and the postoperative satisfaction rate of patients is high.

Objective:To explore the clinical effect of the V-Y plasty of musculocutaneous flap in repairing the excessive width of inner canthus deformity.Methods:Retrospective analysis was performed between July 2018 and June 2021 in patients treated with this method. V-Y design along the inner corner of the eye before operation. The key points of operation are the elevated under the orbicularis oculi muscle. The skin orbicularis oculi muscle flaps are formed on both sides of the incision. After the V-Y of the outside myocutaneous flap is advanced and formed at the new medial canthus point, the V-Y of the orbicularis oculi muscle and the skin are sutured in layers. The degree of reduction of the inner canthus width, epicanthal fold shape, incision scarring, and patient satisfaction was followed up. All patients were measured at the preoperative and postoperative review to record data of the intercanthal distance, and used paired t-test for statistical analysis. P<0.05 was statistically significant. Results:83 patients, including 81 female patients and 2 males, with an average age of 28 years (19 to 56 years) were followed up from 3 months to 2 years, with an average of 1 year. The overexposure of the tear caruncle was significantly reduced, the asymmetry of the bilateral inner corners has been improved, the shape of the epicanthal folds reverted to its natural appearance and the old scars became inconspicuous; patient satisfaction evaluation: very satisfied 34.94% (29/83), satisfied 54.22% (45/83), relatively dissatisfied 6.02% (5/83), dissatisfied 4.82% (4/83). Among the 4 cases of dissatisfaction, 2 cases were due to insufficient correction and were re-operated to obtain satisfactory result, 1 case was improved by reoperating due to excessive correction which led to the reduction of inner canthal distance, 1 case regrets surgery the next day after surgery and cannot accept the appearance and strongly requires removal and restoration. The distance between intercanthal distance of the patients was 28.8 mm to 38.0 mm, average (33.58±3.34) mm before the operation, and 32.2 mm to 41.5 mm, average (37.47±2.90) mm after the operation, an average increase of 3.89 mm ( t=-15.78, P<0.001) after the operation. Conclusions:The V-Y plasty of musculocutaneous flap is suitable for the repair of excessive width of inner canthus deformity after epicanthoplasty. The design idea is simple, the postoperative effect is reliable, and the postoperative satisfaction rate of patients is high.

Objective: To introduce the SVF-gel as a filling, and the application of SVF-gel for the treatment of horizontal neck wrinkles. Methods: This investigation presented a retrospective study of 30 patients (age ranged from 25 to 56 years, with mean 36 years) in Guangzhou Eye-Nose-Fat Cosmetic Plastic Clinic from December 2017 to June 2019. We used the SVF-gel injection for horizontal neck wrinkles for the patients. The effectiveness was observed 1 to 6 months later. Results: No serious complications occurred in all patients. Postoperative evaluation of horizontal neck wrinkles showed that the swelling time lasted for 1-3 days, and the satisfactory rate of the doctors and patients after one month was 83.33% and 86.67%, and that after 6 months was 86.67 % and 83.33%, respectively. Conclusions SVF-gel is an effective treatment for horizontal neck wrinkles.

Objective To evaluate the clinical result of Hering's law in the correction of asymmetric bilateral ptosis.Methods From January 2014 to July 2016,165 cases divided into 2 groups with asymmetric bilateral ptosis in mild and moderate ptosis were corrected with aponeurosis advancement type correction:A group of 15 cases,in which the surgery does not consider the influence of Hering's law,the first correction of mild side,and then corrected the heavier side;B group of 150 cases,in which the Hering's law was applied,the first correction of severe side so that the margin reached the edge of the cornea is tangent or low 0.5-1.0 mm,and then corrected mild side.That the difference of symmetry between the two sides of the palpebral fissure was less than 0.5 mm,and the follow-up was more than 3 months.The Pearson chi square test was used to compare the differences between the two groups.Results In this group,165 cases were followed up for 3-24 months,10 cases (66.67％) was satisfactory in group A (15 cases);145 cases (96.67％) was satisfactory in group B (150 cases);After 3 months,all the failure cases got satisfactory result by using the Hering's law in corrective surgery again.The P value of chi square test between groups was less than 0.05.Conclusions The application of Hering's law in the correction of asymmetry bilateral ptosis is more satisfactory.

Objective]To measure and compare the MRI artifacts caused by common metal ic dental materials and common ceramic dental materials on different field-strength magnets.[Methods] A total of 3 common metal ic dental materials and 2 common ceramic dental materials were tested with 0.35T, 1.5T and 3.0T MR imagers. The artifact areas on these 3 different field-strength magnets were measured and statistical y compared. [Results]Zirconia in three field magnetic resonance(NMR) in T1 and T2 as no artifacts, casting porcelain, metal al oy, nickel chromium al oy and CoCr-al oy in three fields magnetic resonance(NMR) in T1 and T2 as al can produce different degree of artifacts, and artifacts area increased in turn. Cobalt chromium al oy and nickel chromium al oy measurements on the high side, the cobalt chromium al oy than other four kinds of materials on the high side( P<0.05),high nickel-chromium al oy was precious metal al oy, casting porcelain( P<0.05). [Conclusions]Commonly used metal ic dental materials could cause MR artifacts and image degradation. Compared with that on 0.35T, the artifact was increased on 1.5T magnet. Compared with that on 1.5T, the artifact was increased on 3.0T magnet.