Objective:To investigate the related factors for unexpected positive intraoperative cultures (UPC) in patients undergoing aseptic hip revision and the long-term prosthesis survival rate in such patients.Methods:A retrospective cases series analysis was conducted in 397 patients who underwent aseptic hip revision surgery at the Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2021. There were 225 females and 172 males with an age ( M(IQR)) of 58(23) years (range:21 to 89 years) and a body mass index (BMI) of 25(6) kg/m 2 (range:15 to 39 kg/m 2). Based on the culture results of intraoperative specimens, patients were divided into culture-positive group (32 cases) and culture-negative group (365 cases). The clinical data were analyzed including gender, age, BMI, preoperative C-reactive protein, preoperative erythrocyte sedimentation rate, American Society of Anesthesiologists(ASA) classification, preoperative urinary bacteria, preoperative hypoproteinemia; comorbidities of diabetes mellitus, anemia, chronic obstructive pulmonary disease, cerebral infarction; history of allergy to antibiotics, smoking, drinking, previous prosthetic dislocation, previous surgical intervention; and time from symptom onset to admission, duration of surgery, etc. A univariate analysis was performed by Mann-Whitney U orχ2 test and the independent risk factors were identified by including the independent variables with P<0.20 in the univariate analysis in a logistic regression analysis of dichotomous variables. The study outcomes were defined as :(1) re-surgical treatment for any reason; (2)symptoms of infection such as sinus and incision seepage; (3) persistent excessive hip pain.The Kaplan-Meier survival curve was plotted using the study outcome of any cause as the endpoint event, and the log-rank test was used to compare the 10-year survival rate of the prosthesis in the culture-negative group with that in the culture-positive group. Results:Univariate analysis showed statistically significant differences between the culture-negative and culture-positive groups when comparing gender, BMI, ASA classification, and preoperative urinary bacterial results ( χ2=2.368, P=0.124; χ2=-1.648, P=0.098; χ2=14.128, P=0.003; and χ2=7.384, P=0.007). Logistic regression analysis showed that male, ASA classification Ⅳ, and positive preoperative urinary bacteria were independent risk factors for the development of UPC during aseptic hip revision( OR=2.35,95% CI:1.08 to 5.36, P=0.040; OR=37.32,95% CI:1.80 to 1 810.63, P=0.030; OR=4.11,95% CI:1.40 to 11.12, P=0.012). The follow-up time of the 397 patients included in this study was 70 (134) months (range:12 to 146 months). The Kaplan-Meier survival curves showed that the 10-year survival rates of the prostheses in the culture-negative and culture-positive groups were 95.7% and 75.0%, respectively. There was no statistically significant difference in the 10-year survival rate comparing the two groups ( P=0.661). Conclusions:UPC is more likely to occur in patients undergoing hip revision due to noninfectious factors in those who are male, have positive preoperative urinary bacteria, and have an ASA classification of Ⅳ. Intraoperative specimen culture results (negative or positive) do not affect 10-year prosthesis survival rate after hip revision.

Objective:To investigate the related factors for unexpected positive intraoperative cultures (UPC) in patients undergoing aseptic hip revision and the long-term prosthesis survival rate in such patients.Methods:A retrospective cases series analysis was conducted in 397 patients who underwent aseptic hip revision surgery at the Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2021. There were 225 females and 172 males with an age ( M(IQR)) of 58(23) years (range:21 to 89 years) and a body mass index (BMI) of 25(6) kg/m 2 (range:15 to 39 kg/m 2). Based on the culture results of intraoperative specimens, patients were divided into culture-positive group (32 cases) and culture-negative group (365 cases). The clinical data were analyzed including gender, age, BMI, preoperative C-reactive protein, preoperative erythrocyte sedimentation rate, American Society of Anesthesiologists(ASA) classification, preoperative urinary bacteria, preoperative hypoproteinemia; comorbidities of diabetes mellitus, anemia, chronic obstructive pulmonary disease, cerebral infarction; history of allergy to antibiotics, smoking, drinking, previous prosthetic dislocation, previous surgical intervention; and time from symptom onset to admission, duration of surgery, etc. A univariate analysis was performed by Mann-Whitney U orχ2 test and the independent risk factors were identified by including the independent variables with P<0.20 in the univariate analysis in a logistic regression analysis of dichotomous variables. The study outcomes were defined as :(1) re-surgical treatment for any reason; (2)symptoms of infection such as sinus and incision seepage; (3) persistent excessive hip pain.The Kaplan-Meier survival curve was plotted using the study outcome of any cause as the endpoint event, and the log-rank test was used to compare the 10-year survival rate of the prosthesis in the culture-negative group with that in the culture-positive group. Results:Univariate analysis showed statistically significant differences between the culture-negative and culture-positive groups when comparing gender, BMI, ASA classification, and preoperative urinary bacterial results ( χ2=2.368, P=0.124; χ2=-1.648, P=0.098; χ2=14.128, P=0.003; and χ2=7.384, P=0.007). Logistic regression analysis showed that male, ASA classification Ⅳ, and positive preoperative urinary bacteria were independent risk factors for the development of UPC during aseptic hip revision( OR=2.35,95% CI:1.08 to 5.36, P=0.040; OR=37.32,95% CI:1.80 to 1 810.63, P=0.030; OR=4.11,95% CI:1.40 to 11.12, P=0.012). The follow-up time of the 397 patients included in this study was 70 (134) months (range:12 to 146 months). The Kaplan-Meier survival curves showed that the 10-year survival rates of the prostheses in the culture-negative and culture-positive groups were 95.7% and 75.0%, respectively. There was no statistically significant difference in the 10-year survival rate comparing the two groups ( P=0.661). Conclusions:UPC is more likely to occur in patients undergoing hip revision due to noninfectious factors in those who are male, have positive preoperative urinary bacteria, and have an ASA classification of Ⅳ. Intraoperative specimen culture results (negative or positive) do not affect 10-year prosthesis survival rate after hip revision.

Objective:To analyze the factors influencing the alteration of inflammatory indicators in joint fluid following one-stage revision of periprosthetic joint infection (PJI).Methods:A total of 104 patients who underwent one-stage revision of PJI after primary hip arthroplasty at Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University from June 2017 to June 2023 were retrospectively analyzed. There were 59 males and 45 females, aged 60.57±13.41 years (range, 27-89 years). According to the results of joint fluid inflammation indicators on the 14th day after surgery, the patients with both white blood cell (WBC) count and polymorphonuclear cells (PMN) ratio higher than the median were defined as the fluctuation group, and the rest were the non-fluctuation group. There were 31 cases in the fluctuating group, aged 61.06±14.77 years (range, 28-89 years), and 73 cases in the non-fluctuating group, aged 60.36±12.90 years (range, 27-86 years). The age, sex, body mass index (BMI), previous comorbidities, previous surgical history, bacterial virulence, preoperative sinus tract, antibiotic allergy history, fever during postoperative medication, urine bacteria, preoperative erythrocyte sedimentation rate (ESR), preoperative C-reactive protein (CRP), synovial fluid WBC count and PMN proportion on postoperative day 1, 3, 5, 7, 9 and 14 were recorded. The variables with statistically significant differences in the above indicators were included in binary logistic regression analysis to determine the independent risk factors leading to the fluctuation of synovial fluid inflammatory indicators.Results:The WBC count of synovial fluid of 104 PJI patients was 2,434×10 6 (1,110×10 6, 4,266×10 6)/L and the proportion of PMN was 79.5%(64.3%, 90.0%) 14 days after operation. A total of 31 patients (fluctuation group) had higher joint fluid WBC count 4,824×10 6 (3,811×10 6, 11,485×10 6)/L and PMN proportion 90.1%(89.6%, 94.3%) than the median on the 14th day after operation. The remaining 73 patients were included in the non-fluctuation group, and the synovial fluid WBC count and PMN proportion were 2,434×10 6 (1,170×10 6, 4,222×10 6)/L and 79.5%(64.8%, 90.0%), respectively, 14 days after operation. There were no significant differences in age, body mass index, previous comorbidities, previous surgical history, preoperative sinus tract, antibiotic allergy history, postoperative fever or urine bacteria between the two groups ( P>0.05). There were significant differences in sex ratio and bacterial virulence between the two groups ( P<0.05). Sex ratio and bacterial virulence were included in a binary logistic regression analysis, which showed that sex being male ( OR=4.319, P=0.005) and joint fluid microbiological culture results being weakly virulent ( OR=7.529, P=0.036) were independent risk factors for the fluctuation of synovial fluid inflammatory indicators after primary revision of hip PJI. Conclusion:Weak virulence of pathogens and male gender are independent risk factors for the fluctuation of synovial fluid WBC count and PMN proportion after one-stage revision of hip PJI.

Objective:To analyze the factors influencing the alteration of inflammatory indicators in joint fluid following one-stage revision of periprosthetic joint infection (PJI).Methods:A total of 104 patients who underwent one-stage revision of PJI after primary hip arthroplasty at Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University from June 2017 to June 2023 were retrospectively analyzed. There were 59 males and 45 females, aged 60.57±13.41 years (range, 27-89 years). According to the results of joint fluid inflammation indicators on the 14th day after surgery, the patients with both white blood cell (WBC) count and polymorphonuclear cells (PMN) ratio higher than the median were defined as the fluctuation group, and the rest were the non-fluctuation group. There were 31 cases in the fluctuating group, aged 61.06±14.77 years (range, 28-89 years), and 73 cases in the non-fluctuating group, aged 60.36±12.90 years (range, 27-86 years). The age, sex, body mass index (BMI), previous comorbidities, previous surgical history, bacterial virulence, preoperative sinus tract, antibiotic allergy history, fever during postoperative medication, urine bacteria, preoperative erythrocyte sedimentation rate (ESR), preoperative C-reactive protein (CRP), synovial fluid WBC count and PMN proportion on postoperative day 1, 3, 5, 7, 9 and 14 were recorded. The variables with statistically significant differences in the above indicators were included in binary logistic regression analysis to determine the independent risk factors leading to the fluctuation of synovial fluid inflammatory indicators.Results:The WBC count of synovial fluid of 104 PJI patients was 2,434×10 6 (1,110×10 6, 4,266×10 6)/L and the proportion of PMN was 79.5%(64.3%, 90.0%) 14 days after operation. A total of 31 patients (fluctuation group) had higher joint fluid WBC count 4,824×10 6 (3,811×10 6, 11,485×10 6)/L and PMN proportion 90.1%(89.6%, 94.3%) than the median on the 14th day after operation. The remaining 73 patients were included in the non-fluctuation group, and the synovial fluid WBC count and PMN proportion were 2,434×10 6 (1,170×10 6, 4,222×10 6)/L and 79.5%(64.8%, 90.0%), respectively, 14 days after operation. There were no significant differences in age, body mass index, previous comorbidities, previous surgical history, preoperative sinus tract, antibiotic allergy history, postoperative fever or urine bacteria between the two groups ( P>0.05). There were significant differences in sex ratio and bacterial virulence between the two groups ( P<0.05). Sex ratio and bacterial virulence were included in a binary logistic regression analysis, which showed that sex being male ( OR=4.319, P=0.005) and joint fluid microbiological culture results being weakly virulent ( OR=7.529, P=0.036) were independent risk factors for the fluctuation of synovial fluid inflammatory indicators after primary revision of hip PJI. Conclusion:Weak virulence of pathogens and male gender are independent risk factors for the fluctuation of synovial fluid WBC count and PMN proportion after one-stage revision of hip PJI.

Objective To evaluate the efficacy and safety of prucalopride two mg once daily in the treatment of chronic constipation (CC) in China.Methods In this multicentre,randomised,placebo controlled,parallel-group,phase Ⅲ study,patients with CC received either two mg prucalopride or placebo,once daily,for 12 weeks.The primary efficacy endpoint was the proportion of patients reaching an average of three or more spontaneous complete bowel movements (SCBM) per week during the 12 week treatment.The key secondary efficacy endpoint was the percentage of patients reaching three or more SCBM/week during the first four weeks of treatment.Other efficacy assessments included the average number of SCBM/week; the median time to onset of first SCBM after intake of the first dose of trial medication and the average number of bisacodyl tablets or enemas used per week.Furthermore,the symptoms of constipation were assessed by patient assessment of constipation symptom (PAC-SYM) questionnaire.The quality of life was evaluated by patient assessment of constipation-quality of life (PAC-QOL) questionnaire.Safety assessments included adverse events,laboratory values and cardiovascular events.Results Four hundred and forty-six patients from China were screened,313 were treated and 295 completed 12-week study treatment.Averaged over 12 weeks,significantly higher proportion of patients on prucalopride two mg (39.4％,P＜0.01) had three or more SCBM/week compared with placebo (12.7％,x2 =29.50,P＜0.01).Over four weeks,significantly higher proportion of responders was also found in patients on prucalopride (40.0 ％vs 13.3 ％,x2 =28.58,P＜0.01).Prucalopride also significantly improved associated symptoms and quality of life (QOL).The most frequent treatment emergent adverse events were diarrhoea,nausea,abdominal pain,and headache,which were mild to moderate and transient,spontaneously resolved in a few days.Conclusion Prucalopride two mg once daily significantly improved bowel function,associated symptoms and satisfaction in CC over a 12-week treatment period,and was safe and well tolerated in Chinese patients.

Objective To evaluate the effect of ilaprazole enteric tablets on intragastric pH in duodenal ulcer patients. Methods A randomized, double blind, positive controlled clinical trial was carried out. A total of forty-two patients with duodenal ulcer were randomized into low dose ilaprazole group (5 mg/d), medium dose ilaprazole group (10 mg/d), high dose ilaprazole group(20 mg/d) and omeprazole group(20 mg/d). An ambulatory 24 hour intragastric pH study was performed at the fifth treatment day. Fraction time pH above 3, 4 or 5, median values of 24 hour diurnal pH and 12 hour nocturnal pH, the percentage of patients with total time pH above 3, 4 or 5 at least for 18 hours were evaluated. Results There were no significant differences of fraction time pH above 3 or 4, median values of 24 hour diurnal pH and 12 hour nocturnal pH and the percentage of patients with total time pH above 3, 4 or 5 at least for 18 hours among all the groups with different doses of ilaprazole and the omeprazole group. The fraction time pH above 5 in medium and high dose ilaprazole groups were (87.96 ± 12. 29)% and (89.86±15. 18)% respectively, which was higher than that in low dose ilaprazole group [(67. 17± 30. 16)%] and omeprazole group[(76. 14 ± 16. 75)%], P <0. 05. Conclusion Ilaprazole has a strong effect on intragastric acid control with a dose dependent trend.