ABSTRACT
Objective:To investigate the effect of smoking on surgical site infection (SSI) after spinal surgery, and to provide evidence-based information for preventing the occurrence of SSI after spinal surgery.Methods:Literature searches were independently conducted in PubMed, EMBASE, CNKI, Wanfang and other databases from January 2000 to June 2020 by two researchers. Stata13.0 software was used to analyze the included literatures. Statistical analysis and subgroup analysis were preformed based on different population, research types, and adjustments.Results:44 literatures were finally included, involving 79 601 samples including 3 016 cases in the infected group. Compared with non-smokers, the combined odds ratio ( OR) of SSI in smokers after spinal surgery was 1.45 (95% CI: 1.25~1.68). The results of subgroup analysis showed that the risk of SSI in the yellow population and smokers after spinal surgery was 1.69 times that of the control group (95% CI: 1.35~2.12), and no such association was found in the white population. Smokers in the case-control studies and cohort studies had a higher risk of SSI after spinal surgery than that of the control group. Regardless of whether the effect size was adjusted, smokers had a higher risk of SSI after spinal surgery than that of the control group. Conclusions:This study has the advantages of using the latest data, including more literature, and analyzing ethnicity for the first time. The results show that smokers have a higher risk of SSI after spinal surgery. Clinically, patients should be encouraged to quit smoking to reduce the risk of SSI after spinal surgery. However, when to quit smoking to achieve the maximum benefit still needs further research.
ABSTRACT
Objective:To investigate the enhancing effect of bone marrow stroma cell(BMSC)on the functional recovery of injured spinal cord by observing the formation of gliotic scar,cavity volume and the cascade of apoptosis of neural cells.Methods:Eighty spinal cord injury(SCI)rat models were made and randomly divided into two groups:group A(n=40),the control group without any treatment;group B(n=40),the injured animals treated with BMSC implantation.The behavioral evaluation was performed using Basso,Beattie and Bresnahan(BBB)scoring system.Scores were recorded at time points of 1,2,4,6 and 8 weeks after transplantation.After 8 weeks,rats were sacrificed.The immunoreactivity of Nogo-A,glial fibrillary acidic protein(GFAP)and the cavity area were measured.The cell apoptosis was detected by TUNEL methods at 1,2,3,7 and 14 days after injury.Results:Compared with control group,treated animals gained higher scores after 8 weeks of transplantation.The number and the size of reactive astrocytes,the average volume of cavity,TUNEL positive cells,the expression of Nogo-A and GFAP reduced significantly in group B compared with those of group A(P＜ 0.05).Conclusion:BMSC possess effects on repairing injured spinal cord and promoting functional recovery through various mechanisms.