【Abstract】 Objective To evaluate the effect on repairing composite defect of mandible and skin by pre fabricatedmusculocutaneous flap including ectopic bone induced by BMP-2 and collagen in rabbits’ latissimus dorsimuscle. Meth ods Twenty-four rabbits (4-6 weeks old) were randomly divided into 3 groups: experimental, control and blank control group (n=8 in each group). Composite carriers composed of BMP-2 and collagen I sponge were implanted into latissimus dorsi muscle pouches of rabbits. The bone formation was evaluated with roentgenography, ALP staining, Von Kossa staining, HE staining, toluidine blue staining and CD31 immunohistochemical labell ing of microvessels. After 6 weeks, the mandibular defect of 8 mm in diameter with local skin defect of 2 cm × 3 cm was made in experimental group, and a musculocutaneous flap including ectopic-induced bone was prefabricated to transfer and repair the composite defect. The mandibular defect of 8 mm in diameter without local skin defect was made in control and blank control group. Free ectopic-induced bone was used for the repair of mandibular defect in control group, but repairing was not performed in blank control group. All the samples were detected 6 weeks after operation for tetracycl ine fluorescent staining, X-ray, histological examination and bone quantity analysis to evaluate the effect. Results Bone formation induced by BMP-2/collagen composites were found as woven bone between 4 to 6 weeks. It showed that cartilaginous osteogenesis was the mainly type of bone formation. Microvessels could beseen in the bony tissues. The composite defects of mandible and skin were healed well in the experimental group. Major bony tissue were seen in the control group, while it still remained bony defect in the blank control group. The bone quantity analysis in the experimental, control, and blank control group were (1.594 ± 0.674), (0.801 ± 0.036), and (0.079 ± 0.010) mm2, there were significant differences between each groups (P lt; 0.05). Conclusion Prefabrication of musculocutaneous flap including boneinduced by the composite of BMP-2 and collagen is feasible and prevalent. It can be regarded as vascularized bone graft and used in repairing composite defect of bone and skin.
Objective To investigate the therapeutic effect of continuous renal replacement therapy (CRRT) plus hemoperfusion (HP) on patients with diabetes and uremic encephalopathy. Methods Fifty-five patients with diabetes and uremic encephalopathy from January 2010 to December 2017 were retrospectively collected in this study and divided into CRRT plus HP (CRRT+HP) group (n=28) and hemodialysis (HD) plus HP (HD+HP) group (n=27). The changes of vital signs, related biochemical indicators before and after treatment and curative effects were compared between the two groups. Results The two groups were comparable in general. No significant differences were found in blood pressure or heart rate before and after treatment between the two groups (P>0.05). The incidence of hypotension events in CRRT+HP group was significantly lower than that in HD+HP group (P<0.05), and the effective rate of cardiac function improvement in CRRT+HP group was significantly higher than that in HD+HP group (P<0.05). After treatment, the blood urea nitrogen, creatinine, parathyroid hormone, β2-microglobulin, phosphorus, C-reactive protein and brain natriuretic peptide in the two groups were significantly decreased than those before treatment (P<0.05). Parathyroid hormone, β2-microglobulin, C-reactive protein and brain natriuretic peptide were significantly decreased in CRRT+HP group as compared with those in HD+HP group (P<0.05). The remission rate of uremic encephalopathy in CRRT+HP group was significantly higher than that in HD+HP group (P<0.05). Conclusions As compared with HD+HP pattern, CRRT+HP pattern is more stable in the hemodynamics, and more effective in the improvement of heart failure and the clearance of inflammatory mediators, middle molecular and macromolecular substances associated with uremic encephalopathy. CRRT+HP pattern is suitable for the treatment of patients with diabetes and uremic encephalopathy.