全髋关节置换术中局部注射混合镇痛液疗效的临床对照试验

目的：研究全髋关节置换术中向关节周围局部注射混合镇痛液的疗效。方法：将76例行全髋关节置换术的患者分成2组，38例患者术中关节周围注射混合镇痛液，另38例不注射。术后采用直观模拟疼痛量表（VAS）评估患者疼痛程度；所有患者术后24h内使用患者自控镇痛泵（PCA），于不同时间点分别记录PCA的用量。结果：在麻醉后恢复室及术后4h，患者VAS疼痛评分注射组比对照组明显低。患者PCA使用量，与对照组6h及12h相比，注射组使用量明显少；术后24h内PCA使用总量注射组也比对照组明显少。注射组患者未观察到任何与混合镇痛液相关的不良反应。结论：全髋关节置换术中向关节周围注射混合镇痛液能够显著降低患者术后疼痛并减少镇痛泵的用量。     

Lack of association of single nucleotide polymorphism in LRCH1 with knee osteoarthritis susceptibility

A genetic association of knee osteoarthritis (OA) and a C/T transition single nucleotide polymorphism (SNP) (rs912428) located in intron 1 of the LRCH1 gene has recently been reported in European Caucasians; however, the results are inconsistent. Our objective was to evaluate the association in different knee OA populations. Three case-control association studies were conducted in Han Chinese, Japanese, and Greek Caucasian populations. The LRCH1 SNP was genotyped in patients who had primary symptomatic knee OA with radiographic confirmation and in matched controls, and the association was examined. We performed a meta-analysis for the studies together with results of two previous papers using the DerSimonian–Laird procedure and calculated the power of the pooled studies by the software R. A total of 1,145 OA patients and 1,266 controls were genotyped. No significant difference was detected in genotype or allele frequencies between knee OA and control groups in the three populations (all P > 0.05). Association was not observed even after stratification by gender and Kellgren/Lawrence (K/L) scores. Meta-analysis also supported the lack of association between LRCH1 and knee OA. The strong heterogeneity between original and replication studies was detected in Caucasian populations. However, a tendency for the increase of TT genotype was observed in the European populations (OR = 1.46, P = 0.06). The powers for European and Asian replication studies were less than 0.8. Our results suggest that there is no association between LRCH1 and knee OA. However, lack of association should be concluded by further replication studies. Qing Jiang and Dongquan Shi contributed equally to this work.     

COVID-19疫情下普通患者脊柱外科手术的围手术期管理专家共识

新型冠状病毒(SARS-CoV-2)感染引起的2019冠状病毒病(COVID-19)目前呈世界大流行趋势,中国的疫情已经得到控制,现阶段的主要任务是防止外源性输入病例及无症状感染者导致的二次爆发[1-2]。因疫情发展趋势尚不明朗,病毒可能长期存在,在抗疫常态化背景下,如何在全面复工、复产的形势下,安全开展医疗工作成为医疗行业当前关注的重点。     

新型冠状病毒感染者脊柱外科急诊手术的围手术期管理专家共识

自2019年12月以来,已有200余个国家和地区相继报道了新型冠状病毒感染病例,世界卫生组织（WHO）于2020年3月12日宣布新型冠状病毒全球大流行,截至6月18日,全球已累计有824万余人感染,44万余人死亡,对全世界医疗、政治和经济领域影响巨大^［1-2］。WHO将其命名为“2019冠状病毒感染性疾病”（COVID-19）,病原体被命名为重症急性呼吸综合征冠状病毒2（SARS-CoV-2）^［3-6］。按照《中华人民共和国传染病防治法》,COVID-19被纳入乙类传染病,采取甲类传染病的预防控制措施^［7］。