ObjectiveTo explore the feasibil ity to repair defect on the neck and chest with the rectus abdominis flap which pedicle is lengthened by measuring the width, thickness, and the intercostal space of the inferior costicartilage using CT angiography (CTA). MethodsThirty cases receiving CTA and three-dimensional reconstruction between July and December 2013 were included in the study. Of 30 cases, 17 were male and 13 were female, aged 44-70 years (mean, 56 years). The width and thickness of the 3rd to 7th costicartilages and the distance of the 3rd to 6th intercostal spaces were measured, and the lengthened pedicle was calculated after the 4th to 7th costicartilage was cut off. Between July 2012 and November 2013, the lengthened pedicle of the rectus abdominis flap was cl inically used to repair the defect on the neck and chest in 4 cases. ResultsThe pedicle of the rectus abdominis flap was about 6 cm in length. When the left 7th, 6th, 5th, and 4th costicartilages were cut off, the average pedicle was lengthened by 4.07, 7.99, 12.50, and 17.48 cm respectively; when the right 7th, 6th, 5th, and 4th costicartilages were cut off, the average pedicle was lengthened by 4.63, 10.82, 16.64, and 22.05 cm respectively. In 4 flaps which were cl inically used to repair defects, 3 flap completely survived, 1 flap had partial necrosis. Three patients were followed up 6 months, and the appearance and texture of the flap were satisfactory; 1 patient failed to be followed up. ConclusionResecting the inferior costicartilage can prolong the pedicle of the rectus abdominis flap, therefore it can be used to repair defect on the upper chest and the neck.
ObjectiveTo understand the burden of stroke disease and age-period-cohort effects in China from 1990 to 2021, and to provide scientific basis for formulating relevant prevention and treatment strategies. MethodsBased on GBD2021 data, the Joinpoint regression model was used to analyze the trend of incidence rate, mortality and DALYs rate of stroke, and the APC model was used to analyze the impact of age, period and birth cohort on the incidence and mortality of stroke. ResultsFrom 1990 to 2021, the standardized incidence rate, standardized mortality rate and standardized DALYs rate of stroke in China showed an overall downward trend, with AAPC of −0.37% (95%CI −0.45% to −0.29%), −1.79% (95%CI −1.99% to −1.59%), and −1.93% (95%CI −2.07% to −1.80%), respectively. The results of the age-period-cohort model showed that the incidence and mortality risks of stroke increased with age; The risk of female onset remained stable in the early stage but increased rapidly in the later stage, while the risk of male mortality showed a slight upward trend; The risk of onset and death generally decreased with the passage of the birth cohort. Hypertension had always been the primary risk factor for stroke, and metabolic factors such as high blood sugar had become the main factors affecting disease burden. ConclusionThe burden of stroke disease in China is still relatively heavy, and differentiated intervention measures should be developed for different age and gender groups based on controllable risk factors, especially focusing on the elderly and male population.