ABSTRACT
BACKGROUND:Although the clinical application of Masquelet technology has achieved extensive success,the research on optimizing all aspects of Masquelet technology is still being carried out.The focus of doctors is to speed up bone healing and shorten bone healing time after bone grafting. OBJECTIVE:To observe the effect of calcium phosphate combined with recombinant human bone morphogenetic protein-2 in repairing tibial infectious bone defects. METHODS:Thirty-one patients with tibial infectious bone defects were selected from The People's Hospital of Jianyang City from June 2017 to June 2022.They were treated with the Masquelet membrane induction technique.During the second stage of operation,they were divided into a control group(n=15)and a study group(n=16)according to different bone graft materials.Patients in the control group were implanted with autologous bone/allogeneic bone particles,and those in the study group were implanted with calcium phosphate combined with recombinant human bone morphogenetic protein-2/autologous bone particles.Six months after the second stage operation,peripheral blood inflammatory indexes such as white blood cell count,C-reactive protein,and erythrocyte sedimentation rate were detected.Imaging bone healing time,bone healing X-ray score,bone defect healing classification,and adjacent joint function were recorded.The presence of nail track infection,implant absorption,pain,and infection in the bone extraction area were observed. RESULTS AND CONCLUSION:(1)White blood cell count,erythrocyte sedimentation rate,and C-reactive protein levels of the two groups 6 months after the second stage operation were significantly lower than those before the first stage operation(P<0.05).There was no significant difference in each index between the two groups(P>0.05).(2)Bone healing time in the study group was shorter than that in the control group(P<0.05).(3)The Samantha X-ray score of the study group 6 months after the second stage operation was higher than that of the control group(P<0.05).The excellent and good rate of bone defect healing and adjacent joint function of the study group was higher than that of the control group(P<0.05).There was no significant difference in the recurrence rate and complication rate between the two groups(P>0.05).(4)These findings indicate that the effect of calcium phosphate combined with recombinant human bone morphogenetic protein-2 during the second stage operation of the Masquelet membrane induction technique in the treatment of tibial infectious bone defect is good and safe.
ABSTRACT
OBJECTIVE:To investigate the early changes of ECG,cTnⅠ,LDH,α-HBDH and CKMB in patients with anthra-cyclines chemotherapy-induced heart damage after breast cancer surgery,and to explore their significances in the diagnosis of early heart damage. METHODS:Medical information of 152 cases of anthracyclines chemotherapy after breast cancer surgery in our hos-pital during Jan. 2015-Jun. 2016 were analyzed retrospectively. According to diagnosis criteria of drug-induced cardiotoxicity,the occurrence of heart damage was evaluated during hospitalization and 1-year follow-up. According to evaluation results,those pa-tients were divided into heart damage group(50 cases)and control group(102 cases). The early changes of ECG,cTnⅠ,LDH, CKMB and α-HBDH were analyzed before chemotherapy(T0),24 h after first chemotherapy(T1),24 h after second chemothera-py(T2),24 h after forth chemotherapy. RESULTS:At T1,T2,T3,the proprotion of ECG abnormalities in heart damage group was significantly higher than control group;the serum levels of cTnⅠ,LDH,CKMB andα-HBDH in heart damage group were signifi-cantly higher than control group, with statistical significance (P<0.01). CONCLUSIONS:For anthracyclines chemotherapy drugs-induced heart damage after breast cancer surgery,early regular monitoring of ECG,cTnⅠ,LDH,CKMB and α-HBDH can improve the efficiency of early diagnosis of heart damage,and improve prognosis.