Recently, varicella‐zoster virus (VZV) reactivation has been observed after the administration of coronavirus disease 2019 (COVID‐19) vaccines. Autoimmune inflammatory rheumatic diseases (AIIRDs) patients are at a higher risk for VZV reactivation for immunocompromised status. The study aimed to investigate the adverse events (AEs), especially VZV reactivation, following vaccination against  severe acute respiratory syndrome coronavirus‐2 in a Chinese cohort of AIIRD patients. A cross‐sectional survey using an online questionnaire was conducted among AIIRD patients and healthy controls (HCs). Multivariate logistic regression was used to identify potential factors associated with VZV reactivation. 318 AIIRD patients and 318 age and sex‐matched HCs who got COVID‐19 inactivated vaccines were recruited. The main AIIRDs are rheumatoid arthritis (31.8%) and systemic lupus erythematous (23.9%). Most of patients (85.5%) had stable disease and 13.2% of them had aggravation after vaccination. Compared to HCs, patients had higher rates of rash (p = 0.001), arthralgia (p < 0.001) and insomnia (p = 0.007). In addition, there were 6 (1.9%) AIIRD patients and 5 (1.6%) HCs reported VZV reactivation after the COVID‐19 vaccination (p = 0.761). Multivariate logistic regression analysis illustrated that diabetes mellitus (odd ratio [OR], 20.69; 95% confidence interval [CI], 1.08−396.79; p = 0.044), chronic hepatitis B virus infection (OR, 24.34; 95% CI, 1.27−466.74; p = 0.034), and mycophenolate mofetil (OR, 40.61; 95% CI, 3.33−496.15; p = 0.004) independently identified patients with VZV reactivation. Our findings showed that the inactivated COVID‐19 vaccination was safe for AIIRD patients though some patients could suffer from VZV reactivation.

Objective To investigate the relationship between hyperuricemia and coronary heart disease (CHD) risk based on the Framingham risk score (FRS) in a middle-aged and elderly Chinese population.MethodsThis cross-sectional study enrolled patients undergoing routine check-ups at Xiangya Hospital between October 2013 and November 2014. Hyperuricemia was defined as uric acid ≥416 mmol/l for males and ≥360 mmol/l for females. A 10-year CHD risk was calculated from FRS. A multivariable logistic analysis model was used to evaluate associations.ResultsOf the 6347 patients, 3415 (53.8%) were male, 1543 (24.3%) had a CHD risk ≥10% (i.e. intermediate and high risk) and the prevalence of hyperuricemia was 18.1% (n = 1148). After adjusting for potential confounding factors, the 10-year CHD risk was increased in patients with hyperuricemia compared with those without hyperuricemia by 0.28 times in the total population (odds ratio [OR] 1.28; 95% confidence interval [CI] 1.09, 1.48), by 0.25 times in the male population (OR 1.25; 95% CI 1.06, 1.47) and by 2.76 times in the female population (OR 3.76; 95% CI 2.08, 6.79).ConclusionHyperuricemia was positively associated with a 10-year risk of CHD suggesting that it might be an independent CHD risk factor in middle-aged and elderly individuals.

ObjectivesTo evaluate the efficacy and safety of intra-articular (IA) bupivacaine administered for pain relief after joint arthroplasty.DesignMeta-analysis.MethodsA systematic review was conducted to identify the randomised controlled trials using IA bupivacaine for postoperative pain relief from MEDLINE, Cochrane Library and EMBASE databases (up to October 2015). The standardised mean difference (SMD), the relative risk (RR) and their corresponding 95% CIs were calculated using the RevMan statistical software.ResultsA total of 11 randomised controlled trials were included. Statistically significant differences between IA bupivacaine and placebo were observed for the mean visual analogue scale (VAS) values (SMD −0.55; 95% CI −0.89 to −0.22; p<0.001) and narcotic consumption (SMD −0.32; 95% CI −0.55 to −0.08; p=0.008) during the period of 24 hours postoperatively and narcotic consumption during the period between 24 and 48 hours postoperatively (SMD −0.32; 95% CI −0.55 to −0.08; p=0.009). However, there was no significant difference in the mean VAS pain score during the period between 24  and 48 hours postoperatively (SMD −0.09, 95% CI −0.30 to 0.11; p=0.37) and in the incidence of adverse effects 24–72 hours postoperatively (RR 0.97; 95% CI 0.60 to 1.57; p=0.91).ConclusionsThe administration of IA bupivacaine after joint arthroplasty is effective for pain relief without increasing adverse effects.

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