OBJECTIVETo determine the age-and education-corrected control values for the number connection test (NCT) and digit symbol test (DST) psychometric measures to increase their accuracy for diagnosis of minimal hepatic encephalopathy (MHE).

METHODSThe NCT Part A (NCT-A) and DST were administered to 843 healthy volunteers (age range:16-65 years; education:more than 1 year) and 429 patients with liver cirrhosis (with Child-Pugh classification of liver function). The normal values were defined as the mean ± 2 standard deviations (2SD);MHE was defined by abnormal results on at least one psychometric test. The statistical significance of differences in MHE diagnosis according to the various control values (age and education-corrected or not) was assessed by the chi-square test and logistic regression analysis.

RESULTSNCT-A and DST were found to be influenced by age (standard coefficient 0.405, P =0.000 and standard coefficient-0.527, P =0.000 respectively) and education (standard coefficient-0.347, P =0.000 and standard coefficient 0.405, P =0.000 respectively). Among the 120 patients with liver cirrhosis who were diagnosed with MHE (27.97%), 113 had abnormal NCT-A results (26.34%), 54 had abnormal DST results (12.59%),and 47 had abnormal results on both tests (10.96%). Among these 120 MHE-positive patients, 21 were classified as Child-Pugh A (19.81%), 46 as Child-Pugh B (23.71%), and 53 as Child-Pugh C (41.09%);the MHE-positive rate was significantly greater in the patients with Child-Pugh C classification than those with either Child-Pugh B or Child-Pugh A (P < 0.01). Logistic analysis showed that when the control data was corrected for age and education, the MHE diagnosis was related with liver function (P =0.000), regardless of age (P =0.328) and education (P =0.563). When the control data was uncorrected, the MHE diagnosis was not only influenced by liver function (P =0.000) but also by age (P =0.000) and education (P =0.005).

CONCLUSIONAge and education-corrected control values can increase the accuracy of MHE diagnosis by NCT-A and DST.

Age Distribution ; Hepatic Encephalopathy ; Humans ; Liver Cirrhosis ; Psychometrics

Objective To investigate the significance of serum IL-6,CRP,CA19-9 and CEA in patients with gastric cancer.Methods From January 2012 to April 2015,72 patients with gastric cancer in our hospital were selected as the cancer group,and 72 gastritis patients were selected the same period in our hospital for diagno-sis and treatment as the control group,two groups of serum IL-6,CRP,CA19-9 and CEA were given detec-tion,the prognosis and risk factors in the gastric cancer group were given analysis.Results The serum IL-6, CRP,CEA and CA199 contents in the gastric cancer group were(8.03 ± 0.98)pg/mL,(11.33 ± 1.45)mg/L, (90.93 ± 22.11)U/mL and(13.44 ± 5.03)ng/mL that were significantly higher than the control group of(1. 56 ± 0.44)pg/mL,(5.09 ± 1.22)mg/L,(28.98 ± 10.43)U/mL and(3.24 ± 0.34)ng/mL(P<0.05).Gastric cancer patients were followed up for 1 years,there were 62 patients survived,10 patients were mortality,the survival rate was 86.1%.Single factor Cox regression analysis results showed that the IL-6,CRP,CA19-9, CEA,lymph node metastasis were related to the prognosis in patients with gastric cancer(P< 0.05),Cox multivariate analysis showed that IL-6,CRP,CA19-9,CEA as the main independent risk factors(P<0.05). Conclusion The high expression of IL-6,CRP,CA19-9 and CEA in patients with gastric cancer,they are inde-pendent risk factorsfor the survival rate of gastric cancer,and they have good prognostic values for clinical de-tection.

Objective To investigate the changes of nutrients in colostrum， transitional milk， mature milk and late milk after storage at indoor temperature for 3 h， at 4 ℃ for 24 h， at -18 ℃ for 30 d， and at -18 ℃ for 90 d， so as to select the most suitable storage method of milk. Methods Fifteen pregnant women registered in the Shanghai Hongkou Liangcheng Village Street Community Health Service Center， who were expected to give birth from January to June in 2019， were selected. The breast milk of each woman was followed from delivery to 10 months after breast-feeding. Colostrum， transitional milk， mature milk and late milk were sampled， and each sample was divided into 5 parts. Changes in protein， fat， lactose， minerals， carbohydrates， vitamins and bacterial colony number of breast milk were detected according to 0 h（16-18 ℃）， 3 h （16-18 ℃）， 24 h （4 ℃） to 37 ℃， 30 d （-18 ℃） to 37 ℃ after thawing at 40 ℃ and 90 d （-18 ℃） to 37 ℃ after thawing at 40 ℃. Results The results showed that the nutritional components of milk in different stages decreased with time. However， there was no significant difference in the decline of nutritional components in different stages of milk after the same duration of time （ P >0.05）. Conclusion The milk at each stage can be stored， and the lactating mother can store the excess milk at any stage as she wishes.

Objective:To examine the effects of bilobalide on ischemia reperfusion injury (IRI) of skeletal muscle cells in rats.Methods:IRI of skeletal muscle cells in L6 rats was stimulated by culturing skeletal muscle cells in a hypoxia incubator for 4 hours, which were further cultured in a conventional incubator for 4 hours. The induced rat myoblasts were randomly divided into control group, ischemia reperfusion group and bilobalide group. Rat myoblasts in control group were cultured in the conventional incubator, and cells in ischemia reperfusion group were cultured in hypoxia incubator and conventional incubator alternatively to simulate IRI of skeletal muscle cells. After 4 hours of incubation in hypoxic incubator, L6 rat myoblasts in bilobalide group were replaced with medium containing 20 μmol/L bilobalide, and then put into conventional incubator for further culture. CCK-8 assay was used to test cell viability 48 hours later. Related test kits were used to examine the levels of lactate dehydrogenase (LDH), superoxide dismutase (SOD), xanthine oxidase (XOD), malondialdehyde (MDA) and intracellular calcium.Results:Compared with ischemia reperfusion group [(62.2±6.8)%], the viability of myoblasts was increased in bilobalide group [(86.5±5.6)%] ( P<0.05). Compared with ischemia reperfusion group [(265.3±35.2)U/mg], the level of LDH in myoblasts was decreased in bilobalide group [(125.4±16.9)U/mg] ( P<0.05). Compared with ischemia reperfusion group [(68.6±10.7)U/mg], the level of SOD in myoblasts was increased in bilobalide group [(98.5±8.4)U/mg] ( P<0.05). Compared with ischemia reperfusion group [(224.7±65.8)U/mg], the level of XOD in myoblasts was decreased in bilobalide group [(105.9±58.9)U/mg] ( P<0.05). Compared with ischemia reperfusion group [(198.2±35.7)U/mg], the level of MDA in myoblasts was decreased in bilobalide group [(100.4±25.3)U/mg] ( P<0.05). Compared with ischemia reperfusion group (2.5±0.3), the intracellular Ca 2+ concentration in cell supernatant was decreased in bilobalide group (1.6±0.3) ( P<0.05). But all the indexes tested above did not return to the level in control group ( P<0.05). Conclusion:Bilobalide can protect skeletal muscle cells from IRI by inhibiting oxidative stress reaction and calcium overload.