Effectiveness of liposome bupivacaine for postoperative pain control in total knee arthroplasty: A PRISMA-compliant meta-analysis of randomized controlled trials.

BACKGROUND: Adequate pain control after total knee arthroplasty (TKA) enables quicker recovery and reduces readmissions and treatment costs. The aim of this study was to determine the effect of liposomal bupivacaine (LB) for postoperative pain control in patients prepared for TKA. METHODS: We searched for the reports that evaluating the effect of liposomal bupivacaine for postoperative pain control in patients prepared for TKA between March 1983 and May 2017 in the electronic database Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, and Ovid. The main outcomes were visual analog scale (VAS) at 24, 48, and 72 hours. The secondary outcomes were total morphine consumption, the length of hospital stay, range of motion, and the occurrence of nausea. RESULTS: Seven randomized controlled trials (RCTs) enrolling 825 patients, with 413 in the LB group and 412 in the control group, were included in this meta-analysis. Our results suggested that administration LB was associated with a reduction of VAS by 4.22 points at 72 hours after TKA (WMD = -4.22, 95% CI -7.47, -0.97, P = .011) on a 100-point VAS. What's more, LB can decrease the occurrence of nausea when compared with traditional bupivacaine by 18.3% (risk ratio  = 0.70, 95% confidence interval 0.55, 0.89, P = .003). LB was associated with an increase of the range of motion than traditional bupivacaine (P < .05). There was no significant difference between the VAS at 24, 48 hours, total morphine consumption and the length of hospital stay. CONCLUSIONS: Administration with LB was associated with pain-relieving effects and reduces the morphine-related complications (nausea). Due the limited number of the included RCTs, large number and high quality RCTs are still need to identify the effects of LB for pain control after TKA.

[Analysis on the SARS-CoV genome of PUMC01 isolate].

OBJECTIVE: To perform variation and phylogenetics analysis on the SARS-CoV genome sequence (PUMC01) isolated in the Peking Union Medical College Hospital. METHODS: The cDNA library of SARS-CoV (PUMC01 isolate) was constructed by means of random-priming strategy. Random selected plasmid was sequenced and the genome sequence of SARS-CoV-PUMC01 was assembled by conventional methods (The Genebank Accession No. of SARS-CoV-PUMC01 is AY350750). The variation and phylogenetics analysis were performed by comparing the PUMC01 sequence with other SARS-CoV isolates. RESULTS: Ten variation sites were found by comparing PUMC01 isolate with Tor2 and Urbani isolates. In phylogenetic analysis of 18 SARS-CoV isolates, two classes were observed and there is different differential time between these two classes and the different isolates in each class. CONCLUSIONS: The evidence of phylogenetic analysis of different SARS-CoV isolates from different region is instructive for understanding the clinical relations between the different isolates and the transmission chain of SARS-CoV.