Periprosthetic infection is one of catastrophic complications which appear anytime after joint arthroplasty. Resear?ches show that the patients′risk factors are the keys to affect prosthetic joint infection after primary hip and knee arthroplasty. The au?thor summarized new study progress about risk factors for prosthetic joint infection after primary hip and knee arthroplasty at home and abroad. To investigate risk factors for prosthetic joint infection, the condition were analyzed by investigator from the following three as?pects:the patients′features, comorbidity, and preoperative medication.

Objective To investigate the abilities of emotion recognition and social cognition in patients with idiopathic epilepsy and further explore the factors related to the impairments.Methods After 24-hour EEG monitoring,70 people with idiopathic epilepsy were administered with a neuropsychological battery for basic cognitive assessment and then were tested with the Eye Basic Emotion Discrimination Task (EBEDT) and the Eye Complex Emotion Discrimination Task (ECEDT).Results Compared with health controls,people with epilepsy got significantly lower score in recognizing happy (19.3±2.0 vs 19.9±0.2),angry (17.9±2.0 vs 18.9±1.0),sadness (18.1±2.3 vs 19.2±1.0),fear (16.4±1.9 vs 17.6±1.3),disgust (17.6±2.1 vs 18.6±1.2) and surprise (18.3±1.5 vs 19.1±1.1) (P＜0.05,respectively),as well as complex emotions ((23.3±4.2) vs (27.1±2.8),P＜0.05).There was no significant difference between the two groups in gender recognition (P＞0.05).Significant positive correlation was found between the total score of basic emotions and the mind reading (r=0.444,P=0.000) in the patient group.Correlation analysis revealed significant relation between the total correct number of emotion recognition and the level of anxiety,depression and the executive function in epilepsy group (P＜0.05,respectively).Significant associations were found between the ECEDT and the Digital Span test,the Stroop test,Beck Depression Index and Hamilton Anxiety Scale (P＜0.05,respectively).Conclusion People with epilepsy have general impairments of emotion recognition and theory of mind,the impairments may be associated with the state of mood disorder and the weakened executive function.

Objective To evaluate the efficacy and safety of Shuangyi Qushi Tongluo Capsules (SQTC) for the treatment of knee osteoarthritis (KOA).Methods A multi-center,randomized,parallel-controlled trial was carried out in 240 cases of KOA patients.The patients were divided into trial group (N =120) and control group (N =120),which was given SQTC,Xianlinggubao capsules respectively for 8 weeks.Before treatment,and 2,4 and 8 weeks after treatment,we recorded the scores of clinical symptoms and traditional Chinese medical syndromes,Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores and knee function scores.After treatment,the clinical efficacy and adverse reaction were observed.Results (1) After treatment for 8 weeks,the clinical efficacy of the trial group was superior to that of the control group (P ＜ 0.05).(2) The trial group had better effect on improving the visual analogue scale (VAS) scores of knee pain,VAS scores of limitation of motion and time for morning stiffness than the control group after treatment for 8 weeks(P ＜ 0.05 or P ＜ 0.01).(3) After treatment for 4 and 8 weeks,the trial group had better effect on improving scores of traditional Chinese medical syndromes,WOMAC scores and Japanese Orthopedic Association(JOA) scores than the control group (P ＜ 0.05 or P ＜ 0.01).(4) Before and after treatment,the results of blood,urine and stool routine examination,liver and kidney function,and electrocardiography showed no significant changes.Conclusion SQTC are effective and safe in treating KOA,and can start an effect shortly.

Objective To evaluate the effectiveness and safety of Shuangyi Qushi Tongluo Capsules ( SQTC) in treating ankylosing spondylitis (AS), and to explore the synergistic action of SQTC combined with sulfasalazine. Methods A randomized and parallel-controlled trial was carried out in 80 AS patients. The enrolled subjects were evenly randomized into testing group and control group. Both groups were given oral use of sulfasalazine enteric-coated tablets, and the testing group was additionally given oral use of SQTC, which is mainly composed of silky ant (Formica Fusca), black-winged Termitidae, Scorpio, Radix Ginseng, Radix Astragali, Rhizoma Atractylodis Macrocephalae, Radix Angelicae Sinensis, Flos Carthami, Radix Salviae Miltiorrhizae, Radix Achyranthis Bidentatae, Caulis Spatholobi, Herba Epimedii, and Radix Morindae Officinalis. The treatment for the two groups covered 24 weeks. On treatment week 4, 12, 24, we recorded the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), visual analog scale (VAS) scores of rachialgia, patients’ general assessment (PGA), VAS scores of night pain, spondylitis scores, Bath Ankylosing Spondylitis Functional Index ( BASFI) , Bath Ankylosing Spondylitis Metrology Index ( BASMI) , scores of the quality of life ( QOL) , erythrocyte sedimentation rate ( ESR) , C-reactive protein ( CRP). Moreover, the adverse reaction of the two groups was also monitored. Results ( 1) Compared with the control group, testing group had high ASAS 20 percentage on treatment week 4, 12 and 24 (P<0.05 or P<0.01). (2) After treatment for 12, 24 weeks, the observation indexes were much improved in the testing group ( P<0.05 or P<0.01 compared with the control group). ( 3) In the control group, one case ( 2.86%) had slight abnormal hepatic function, and one case (2.63%) in the testing group had slight gastrointestinal discomfort, the difference being insignificant (P>0.05). Conclusion SQTC are effective and safe in treating AS, starting an effect shortly and having synergistic effect on salfasalazine for the treatment of AS.

Objective To explore different aspects of empathy in patients with idiopathic generalized epilepsy and to study the effect of epileptiform discharges from different areas of the brain on empathy.Methods One hundred and fifty healthy controls and 62 patients with idiopathic generalized epilepsy were administered with a neuropsychological battery for basic cognitive assessment and an empathy scale after 24-hour electroencephalography monitoring.Results Compared with healthy controls,patients with epilepsy obtained significantly lower total scores and the cognitive empathy scores including perspectivetaking and fantasy subscale of the Interpersonal Reactivity Index-China (46.39 ± 9.74 vs 50.99 ± 9.97,t =-2.893,P=0.004; 23.31 ±7.10 vs 27.24 ±6.22,t =-3.974,P =0.000; 10.18 ±4.21 vs 11.84 ± 3.67,t =-2.838,P =0.005 ; 13.13 ± 4.46 vs 15.40 ± 3.84,t =-3.698,P =0.000,respectively).In contrast,the individuals with epilepsy did not score significantly different on the affective empathy,empathic concern and personal distress (P ＞ 0.05,respectively).Patients with frontal epileptiform discharges suffered the most on the total empathy scores,cognitive empathy and perspective-taking subscale when compared with other three groups of individuals (P ＜0.05,respectively),whereas the groups did not differ from each other in affective empathy,empathic concern and personal distress (P ＞0.05,respectively).No correlation was found between the empathy ability and other cognitive neuropsychological tests.Conclusions Patients with idiopathic generalized epilepsy is not associated with a general empathy deficit,but rather with a dissociated pattern combining impaired cognitive empathy and preserved affective one,which leads to a double-dissociation,supports the notion that affective and cognitive empathies are two distinct abilities.The activation of epileptiform discharges from the frontal lobe is a key factor that could diminish the empathy ability.

Objective To explore further the abilities of cerebellar lesions in skills of time estimation, and to test the hypothesis that cerebellum is involved in the special network of time perception. Methods Time reproduction was required for 3 time intervals of 600-milliseconds, 3 and 5 seconds with visual discrimination for control. Participants reproduce those time intervals after 1-second or 5-seconds of delay. Twenty-six patients with cerebellar lesions were compared to 26 healthy controls, matched for age, handedness, education. Results 600-milliseconds was overestimated by both cerebellar lesions and healthy controls, however, both 3-seconds and 5-seconds were underestimated. Patients with cerebellar lesions were significantly impaired on 600-milliseconds reproduction task ( delaying 1 s or 5 s, 1.37 ± 0.24, 1.26 ± 0.29 respectively, Z=-5.347, -4.230, both P<0.01). No group differences were found for the 3-seconds and 5-seconds time reproduction (delaying 1 s or 5 s, Z=-1.200,-0.092,-1.519, -0.723, all P>0.05). Conclusion The findings suggest that patients with cerebellar lesions perform poorly during measurement of the shorter interval, but show no impairment of longer intervals perception, supporting the hypotheses that cerebellum is specifically involved in the perception of sub-second intervals.

Objective To build predictive model of secondary mild cognitive impairment (MCI) in patients with painful diabetic neuropathy (PDN), and analyze its apply. Methods The patients with PDN were consecutively selected from March 2013 to March 2016. The relevant clinical data were recorded, and the patients were followed up for 1 year. According to the results of follow-up, secondary MCI risk indicators were predicted, and the time window of adverse outcomes event was validated. Results A total of 82 PDN patients completed the study, and secondary MCI occurred in 16 cases. Sixty-six cases had not secondary MCI. The Cox regression model multivariate analysis results showed that the independent influencing factors of secondary MCI was course of PDN, brief pain inventory (BPI) score and neuron-specific enolase (NSE) in patients with PDN (HR = 1.238, 1.336 and 1.450; P<0.05). The secondary time window of the MCI in PDN patients with the course of PDN ≥3.367 years, BPI score≥4.704 scores and NSE ≥ 7.420 μg/L was shorter, in whom BPI score and NSE had a higher evaluation ability. Conclusions The courses of PDN, BPI score and NSE are independent influencing factors of secondary MCI in PDN patients, and the BPI score≥4.704 scores and NSE≥7.420μg/L have a higher evaluation ability.

Objective: To evaluate chemiluminescence immunoassay (CLIA) for detecting blood levels of aldosterone and rennin with its diagnostic value of primary aldosteronism (PA) with comparison to radio immunoassay (RIA). Methods: According to American protocols of CLSI, we conducted a veriifcation study between RIA and CLIA for their precision, accuracy, linearity and reference ranges; meanwhile, taking clinical diagnosis as golden standard, examined renin activity or concentration and aldosterone concentration in 20 healthy volunteers and 40 hypertension patients by both RIA and CLIA, compared the ratios of ARR (aldosterone concentration/renin activity) or ADRR (aldosterone concentration/renin concentration) for the speciifcity and sensitivity of PA diagnosis. Results: Within-lot and between-lot accuracies of CLIA for detecting aldosterone levels were below 5% and 10%, the recoveries were 102% and 95% respectively. There was a good linear correlation in the range of aldosterone at (3-74) ng/dl and renin at (0.99-330) μIU/ml. In healthy volunteers, renin level was higher in 2 subjects, while aldosterone level and ADRR ratio were within normal references in all subjects by the manufacturer. In hypertension patients, the sensitivity and speciifcity for aldosterone and rennin detections by CLIA were at 85.7% and 97.0%, by RIA were at 85.7% and 94.0%. Conclusion: CLIA has the superiority of simple performance, repeatable and without radioactive contamination; it is recommended for replacing RIA as necessity.

Objective:To study whether sacral lymph nodes should be included in the target volume delineation for those patients with early (stageⅠB-ⅡA) uterus cervix cancer during postoperative radiotherapy. Methods:Forty-six patients with early uterus cervix cancer were given postoperative three dimensional conformal radiation therapy (3D-CRT) in our department for one month after radical resection. The patients were randomly divided into two groups. The sacral lymph nodes were not included in the target volume delineation in the treatment group. But they were delineated in control group. All the patents had no radiotherapy-related contraindications and signed the consent agreement. The patients were followed up. The local controlling rate and the incidence and degree of radioactive proctitis were compared between the two groups. Results:The local controlling rate of the two groups had no significant difference(t=0.000, P=1.000). The doses received by the 5% and 95% volume of the rectum(V_5, V_95), the average dose, and the minimum dose had significant difference between the two groups(t_(V5)=2.169, P_(V5)=0.041; t_(V95)=4.036, P_(V95)=0.001;t_(mean)=2.236, P_(mean)=0.036; t_(min)=2.265, P_(min=0.034), but the maximum dose received by the rectum had no obvious difference (t_(max)=0.518, P_(max)=0.610). The incidence of radioactive proctitis had significant difference between the two groups(t=2.174, P=0.190). Conclusion:For the early uterus cervix cancer patients who have recurrent risk after radical surgery, sacral lymph nodes should not be included in the delineation of target volume during 3D-CRT in order to decrease the incidence of radioactive proctitis.

Objective:To explore the effect of sarpogrelate on platelet function in patients at the bridging stage before coronary artery bypass grafting (CABG).
Methods: A total of 40 consecutive patients with peripheral artery stent and scheduled for CABG in our hospital from 2011-05 to 2013-04 were enrolled in this study. The patients were randomly divided into 2 groups, Low molecular weight heparin (LMWH) alone group, n=19 and Sarpogrelate+LMWH group, n=21. The medications started at 5-7 days before CABG and stopped at 24 h before CABG. The platelet inhibition rates (platelet aggregation induced by collagen+ serotonin) were examined and compared between 2 groups at the baseline (before randomization), 24h and 1h before CABG respectively.
Results: The platelet inhibition rates were similar between 2 groups at the baseline (87.33 ± 6.82) % vs (86.11 ± 6.87) %, P=0.577 and 1h before CABG (62.60 ± 12.39) % vs (56.19 ± 14.99) %, P=0.148. At 24h before CABG, the platelet inhibition rate in Sarpogrelate+LMWH group was higher than that in LMWH alone group (83.87 ± 8.99)%vs (63.13 ± 10.88)%, P<0.001. Compared with the baseline, the falling range of platelet inhibition was lower in Sarpogrelate+ LMWH group at 24h before CABG, (3.46 ± 6.18) % vs (22.98 ± 9.43) %, P<0.001 and the falling range was similar between 2 groups at 1h before CABG (24.73 ± 14.19)%vs (29.92 ± 14.28)%, P=0.257.
Conclusion: Sarpogrelate + LMWH may result better platelet inhibition rate with quicker recovery of platelet function upon the medication stopping, which might be a feasible management in patients at the bridging stage before CABG.