[Trend analysis of the burden of ischemic heart disease in China, 1990 to 2015].

Objective: The objective of this study is to analyze the trend of burden of ischemic heart disease (IHD) in China between 1990 and 2015. Methods: Data were collected from the results of 2015 Global Burden of Disease Study. We arranged and analyzed the mortality and disability-adjusted life year (DALY) for IHD by sexes, ages and provinces (excluding Taiwan, China) in China between 1990 and 2015. The age-standardized rates were determined using the average world population age structure in the period of 2010-2035 as a reference, and the changes of the related indicators were calculated. Results: In 2015, IHD caused 1 461 thousand deaths, and its age-standardized death rate was 114.8 per 100 000. Number of DALYs from IHD were 25 765 thousand in 2015, with the age-standardized DALY rate at 1 760.2 per 100 000. From 1990 to 2015, the age-standardized death rate for IHD in China increased by 13.3% but age-standardized DALY rate decreased by 3.9%. Number of IHD DALYs among male (16 664 thousand) was higher than it among female (9 101 thousand) in China in 2015, and 83.5% of total DALYs from IHD occurred among people aged over 50 years old. Province with highest age-standardized death rate was Heilongjiang, with rate at 187.4 per 100 000 in 2015. Qinghai (54.0%) increased most and Macao (-52.3%) decreased most from 1990 to 2015. Province with highest age-standardized DALY rate was Xinjiang, with rate at 3 040.8 per 100 000 in 2015. Qinghai (33.2%) increased most while Macao (-59.0%) decreased most between 1990 and 2015. Conclusion: Burden of IHD in China increased remarkably from 1990 to 2015, especially among males and people aged over 50 years old. The differences among provinces were obvious.

Applied anatomy of the anterolateral femoral flap.

A study of the source of the blood supply to the anterolateral femoral flap was carried out on 42 lower limbs of adult cadavers (among them 35 cadavers with injection of red latex and 1 with india ink into the arteries and 6 vascular cast specimens), and the surface locations of the vascular pedicle were detected on 50 healthy adults. It was found that the descending branch of the lateral circumflex femoral vessel was an ideal axial vessel. There are constant perforating branches of the myocutaneous artery or cutaneous branches from the intermuscular space to the anterolateral femoral skin. The area extends about 12 x 30 cm. Within the flap, the anterior branch of the anterolateral cutaneous nerve of the high is located. This flap has been widely used for free transplantation in China since 1983 with satisfactory results.

[Reconstruction of perforated defects].

12 cases of perforated defect were successfully repaired with lining flaps and covering tissues since 1982. The writers emphasized that the perforated defects happened more frequently on maxillo-face than on others. This paper reported 7 out of 12 cases. After the carcinomas or other tumors had been excised or treated by radiotherapy the defect of local skin may occur easily. Operations should be performed as early as possible no matter infections or scars exist. If every difficult present repairing operation shall finished on early and is not restricted with infection and scars. On the maxillofacial and neck region the sternocleidomastoid or latissimus dorsi myocutaneous flaps should be selected as the covering tissues.

[Implantation of mammary prosthesis through a periareolar incision].

In the past, the mammary prosthesis has always been implanted through anteroaxillary incisions or lateral incision. These incisions are relatively obvious and the scars are prominent. Since October 1988, the authors have used the periareolar incision to perform mammary prosthesis implantation in 15 cases, 28 breasts. The skin and subcutaneous tissue are incised along the edge of the areola and the tissue are split along the direction of mammary ducts and that of the musculus pectoralis major. Then a cavity is made underneath the pectoralis major muscle and a prosthesis is implanted. According to the patient's demand regarding the size of breast, the volume may be increased or lessened. In this operation the incision is small, the scar is not obvious, and the dissection is easy. The method is used only when an inflatable breast silicon prosthesis is used. During the operation due attention should be paid to the size and position of the prosthesis so that two breasts are symmetrical.

[Study on transplantation of anterolateral femoral skin flap with high site direct cutaneous artery].

OBJECTIVE: To study the availability of transplantation of anterolateral femoral skin flap with absence of the first branch of musculocutaneous artery. METHODS: One hundred and sixty cases of anterolateral femoral skin flap transplantation in the past 15 years were reviewed, to investigate the relationship between the outcome of the transplantation and the types, distribution, original point, diameter of blood vessels. Among the 160 cases, there were 10 cases, 6.3% in total, of skin flap transplantation with the pedicle of high site direct cutaneous femoral artery, ranging from 10 cm x 14 cm to 12 cm x 18 cm in size, applied to repair soft tissue defect. RESULTS: There were 149 cases, among the 160 cases, survived and all the 10 cases of femoral skin flap transplantation with high site anterolateral cutaneous artery survived. CONCLUSION: The femoral skin flap with high site anterolateral cutaneous artery has good blood supply, larger size available, and easier operation. When the first branch of descending anterolateral femoral artery is absent, the femoral skin flap with high site anterolateral cutaneous artery is an optimal alternative.