OBJECTIVE: To investigate the incidence and potential risk factors associated with postoperative spinal epidural hematoma (SEH) following anterior cervical spine surgery (ACSS). METHODS: A retrospective analysis was conducted on the clinical data of patients who underwent ACSS for cervical spondylosis at Peking University Third Hospital between March 2013 and February 2022. Patients who developed postoperative SEH were categorized as the SEH group, while those in the cohort without SEH were randomly selected as the non-SEH group by individually matching with the same operator, same gender, same surgery year, and similar age (±5 years) at a ratio of 4 ∶ 1. The general condition, preoperative comorbidities, anticoagulant or antiplatelet therapy, preoperative coagulation and platelet counts, American society of Anesthesiologists physical status classification, cervical spondylosis classification, preoperative modified Japanese Orthopaedic Society score and cervical disability index score, surgical modality, surgical segment levels, ossification of the posterior longitudinal ligament among the surgical level, surgery duration, estimated blood loss, postoperative drainage volume, preoperative mean arterial pressure, mean arterial pressure during postoperative awakening periods, hospital stay and hospitalization cost were compared between the two groups. A bivariate Logistic regression model was applied to screen out the independent risk factors and calculate the odds ratios of indicators associated with SEH. Receiver operating characteristic curve and area under the curve (AUC) were used to describe the discrimination ability of the indicators. RESULTS: A total of 85 patients were enrolled in the study, including 17 patients in the SEH group and 68 patients in the non-SEH group. Seventeen patients with SEH underwent hematoma evacuation, and all of them were successfully treated and discharged from the hospital. Corpectomy (OR=7.247; 95%CI: 1.962-26.766; P=0.003) and the highest mean arterial pressure during awakening (OR=1.056; 95%CI: 1.002-1.113; P=0.043) were independent risk factors for SEH. The AUC values were 0.713 (95%CI: 0.578-0.848) and 0.665 (95%CI: 0.51-0.82) respectively. The patients with SEH had longer hospital stays (P < 0.001) and greater hospitalization costs (P=0.035). CONCLUSION Corpectomy and elevated maximum mean arterial pressure during awakening are independent risk factors for the development of postoperative SEH following ACSS. High-risk patients should be closely monitored during the perioperative period.
Humans ; Risk Factors ; Cervical Vertebrae/surgery* ; Retrospective Studies ; Hematoma, Epidural, Spinal/epidemiology* ; Incidence ; Male ; Female ; Postoperative Complications/etiology* ; Spondylosis/surgery* ; Logistic Models ; Length of Stay ; Middle Aged

OBJECTIVETo construct a universal, highly attenuated orf virus expression vector for exogenous genes using green fluorescent protein (GFP) as the reporter gene.

METHODSThe flanking regions of the ORFV132 of orf virus DNA were amplified by PCR to construct the shuttle plasmid pSPV-132LF-EGFP-132RF. The shuttle plasmid was transfected into OFTu cells and GFP was incorporated into orf virus IA82Delta 121 by homologous recombination. The recombinant IA82Delta121-V was selected by green fluorescent signal. The deletion gene was identified by PCR and sequencing. The effects of ORFV132 knockout were evaluated by virus titration and by observing the proliferation of the infected vascular endothelial cells in vitro.

RESULTSThe recombinant orf virus IA82Delta121-V was obtained successfully and quickly, and the deletion of ORFV132 did not affect the replication of the virus in vitro but reduced its virulence.

CONCLUSIONGreen fluorescent protein is a selectable marker for rapid, convenient and stable selection of the recombinant viruses. Highly attenuated recombinant orf virus IA82Delta121-V can serve as a new expression vector for exogenous genes.

Cells, Cultured ; Endothelial Cells ; metabolism ; Gene Deletion ; Genes, Reporter ; Genetic Vectors ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Humans ; Orf virus ; Plasmids ; Transfection

Objective To investigate the role of Ca 2+ signaling in the overexpression of detrusor smooth muscle cell connexin 43 by cyclic stretch in vitro. Methods The detrusor smooth muscle cells (DSMC) grown on collagen-coated silicone membranes were subjected to cyclic stretch-relaxation. The Cx43 mRNA in DSMC were detected with RT-PCR, and the concentration of intracellular free Ca 2+ in DSMC was measured by confocal microscopy in conjunction with the calcium indicator, Fura-3 (Molecular Probes). Results The overexpression of Cx43 mRNA induced by cyclic stretch was significantly inhibited by EGTA.The increase of intracellular free Ca 2+ induced by stretch was also inhibited completely by EGTA, 61.95% by GdCl3, 29.98% by Nifedipine, 87.98% by Ryanodine and Thapsigargin. Conclusion The stretch-induced Ca 2+ entry, via the Ca 2+-induced Ca 2+ release mechanism, may play an important role in DSMC connexin 43 overexpression induced by cyclic stretch.