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 clinical effects of intraoperative transesophageal echocardio-graphy(TEE)in different surgical methods for nephrectomy combined with Mayo Ⅲ-Ⅳ inferior vena cave(IVC)tumor thrombectomy.Methods:In the study,28 patients who did surgery of nephrectomy and Mayo Ⅲ-Ⅳ IVC thrombectomys in Peking University Third Hospital from 2022 January to 2024 February were included.Of the 28 patients,16 patients did robotic surgery,2 patients did laparoscopic surgery,and 10 patients did open surgery.All patients'clinical data were collected.Results:Intra-operative TEE was used in 9 robotic surgeries,of which 7 cases showed image changes compared with preoperative image results.Intraoperative TEE indicated that tumor thrombus entered the right atrium in 2 cases,showed that tumor thrombus grade rose from Mayo Ⅲ to Mayo Ⅳ in 2 cases,and indicated that tumor thrombus adhered to IC wall in 3 cases.All of these surgical plans were timely adjusted.Intra-operative TEE was used in 6 cases of open surgery,and 4 cases of them showed Mayo grade changes com-pared with preoperative image results.Intraoperative TEE indicated that tumor thrombus adhered to the IVC wall in 3 cases,and tumor thrombus adhered to the IVC wall with thrombus in one case.The surgi-cal plans were adjusted,and the tumor thrombus was left or segmentally removed.Laparoscopic surgery did not use intraoperative TEE.The effects of intraoperative TEE included:the combination of explora-tion and TEE monitoring was used in open surgery,and tumor thrombus removal process was fully moni-tored by intraoperative TEE in the robotic surgery.Intraoperative TEE real-time monitored circulatory sta-tus and cardiac function changes.Conclusion:In different surgical methods for nephrectomy com-bined with Mayo Ⅲ-Ⅳ tumor thrombectomy,intraoperative TEE can re-determine the tumor thrombus grade and degree of tumor thrombus adhered to IVC,track the tumor thrombus removal process in real-time,and monitor circulatory status and cardiac function changes.Intraoperative TEE plays an important role in different surgical methods,but its clinical application is still insufficient.Intraoperative TEE is recommended to such type of surgeries.

Objective:To investigate the levels of microRNA (miR) -106b-5p and miR-760 in the serum of early lung cancer patients, and the clinical value of the combination of them and low-dose spiral CT in the diagnosis of early lung cancer.Methods:Ninety early lung cancer patients (lung cancer group) who underwent treatment in Cangzhou People's Hospital of Hebei Province from January 2022 to March 2023 were collected as research subjects, meantime, 90 patients with benign pulmonary lesions (benign pulmonary nodules) diagnosed by pathology were selected as the control group. The levels of miR-106b-5p and miR-760 in the serum of two groups were compared, the results of low-dose spiral CT examination were analyzed; receiver operating characteristic curve was drawn to determine the optimal cut-off values of serum miR-106b-5p and miR-760; four grid table method was applied to analyze the diagnostic efficacy of serum miR-106b-5p, miR-760 combined with low-dose spiral CT for early lung cancer.Results:The level of miR-106b-5p in lung cancer group was higher than that in control group (1.39±0.31 vs. 1.04±0.30), serum miR-760 level was lower than that in control group (0.75±0.24 vs. 1.02±0.26), with statistically significant differences ( t=7.70, P<0.001; t=7.24, P<0.001). The area under curve (AUC) of miR-106b-5p, miR-760 and low-dose spiral CT in the diagnosis of early lung cancer was 0.83, 0.81 and 0.82, the accuracy was 76.67%, 77.22% and 81.67%, the sensitivity was 84.44%, 81.11% and 76.67%, and the specificity was 68.89%, 73.33% and 86.67%, respectively. The AUC, accuracy, sensitivity, and specificity of serum miR-106b-5p, miR-760 combined with low-dose spiral CT in diagnosing early lung cancer were 0.96, 90.00%, 94.44%, and 85.56%, respectively. The accuracy of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 and low-dose spiral CT ( χ2=11.52, P=0.001; χ2=10.72, P=0.001; χ2=5.14, P=0.023), the sensitivity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 and low-dose spiral CT ( χ2=4.77, P=0.029; χ2=7.46, P=0.006; χ2=11.51, P=0.001), the specificity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 ( χ2=7.11, P=0.008; χ2=4.12, P=0.042) . Conclusion:The serum level of miR-106b-5p is significantly increased in early lung cancer patients, while the serum level of miR-760 is significantly reduced. The combination of miR-106b-5p, miR-760 and low-dose spiral CT has high diagnostic value for early lung cancer.

Objective To explore the relationship between serum adiponectin (APN) concentration and insulin resistance(IR) in elderly pregnancy patients(GDM) with gestational diabetes mellitus.Methods Data of 120 cases of elderly pregnancy patients with gestational diabetes mellitus admitted from Jan.2011 to Dec.2016 were retrospective analyzed.The relationship between serum APN concentration and IR was assayed.Healthy subjects and normal pregnancy patients in our Department were taken as the control.Results The concentration of APN was lower while the CysC,BNP,IGF1,IGF2 and IGFIR were higher in elderly pregnancy patients with gestational diabetes mellitus than those in the control group with a significant difference (P＜0.05).At the same time,Spearman analysis results showed that the serum APN was negatively related with IR while CysC,BNP,IGF1,IGF2 and IGFIR were positively related with IR (P＜0.05).Conclusion Theserumconcentrationofadiponectin and visfatin were negatively related with insulin resistance in elderly pregnancy patients with GDM.