1.The co-expression of human epidermal growth factor 2 and collagen Ⅳ in human breast cancer tissues detected by quantum dots-based immunofluorescence technique and its clinical significance
Jie MA ; Shengrong SUN ; Chuang CHEN ; Jinzhong SUN ; Yi TU ; Min FANG ; Yan LI
Chinese Journal of General Surgery 2014;29(10):775-778
Objective By using quantum dots-based double-color imaging method to simultaneously label human epidermal growth factor 2 (HER2) on breast cancer cell membrane and the type Ⅳ collagen in the extracellular matrix.To monitor the degree of malignancy of breast cancer and the invasive and metastatic potential.Methods The co-expressions of HER2 and the type Ⅳ collagen in breast cancer of 54 cases were detected and quantified by quantum dots-based double-labeling immunofluorescent histochemistry,and its correlation with clinical pathology parameters and prognosis were analyzed.Results With the increasing HER2 expression level,a progressive decrease in collagen Ⅳ around the cancer nest,the expression of HER2 and the type Ⅳ collagen value was negatively correlated (r =-0.980,P < 0.05) ; the expression of HER2 and collagen Ⅳ was associated with lymph note metastasis,pathological stage (TNM) and disease-free survival(P < 0.05).The expression of HER2 and the type Ⅳ collagen between different age groups,menopause and estrogen receptor (ER) and progesterone receptor (PR) were not significantly different (P > 0.05).Conclusions Quantum dots-based double-color imaging method provides direct observable evidence to support the degradation of HER2 and the type Ⅳ collagen expression,which may help in determining the degree of malignancy and evaluating prognosis.
2.Study on the chemical constituents of the fruits of Psidium guajava
Yue YU ; Xing-yan SUN ; Kai-ling XU ; Chuang-jun LI ; Jin-hua WANG ; Dong-ming ZHANG
Acta Pharmaceutica Sinica 2022;57(8):2416-2422
italic>Psidium guajava Linn. is an evergreen shrub or small tree of
3.Small interfering RNA suppression of transducer and activator of transcription 3 (STAT3) signaling pathway: inhibitory effect on proliferation of human esophageal squamous carcinoma cells.
Xin-hua WANG ; Shan-shan LI ; Ai-hua YAN ; Yang SUN ; Chuang-xin LU ; Yan-ping GUO
Chinese Journal of Pathology 2007;36(6):379-383
OBJECTIVETo investigate the efficiency of blockage of constitutively activated STAT3 signaling by small interfering RNA (siRNA), and to explore the inhibitory effects on the proliferation of human esophageal squamous carcinoma cells (EC9706 and Eca109).
METHODSEC9706 and Eca109 were transfected with chemical synthesized STAT3 siRNA (100 nmol/L). RT-PCR and Western blot were used to detect STAT3 mRNA and protein expression, including phosphorylated-STAT3 (p-STAT3) before and after the transfection respectively. The changes of DNA-binding activity and cell proliferation were evaluated by electrophoretic mobility gel shift assay and MTT, respectively. Stages of cell cycle were determined by flow cytometry.
RESULTSExpression levels of STAT3 mRNA and STAT3, p-STAT3 proteins were progressively inhibited by STAT3 siRNA at various time points after transfection. STAT3-DNA-binding activity was suppressed after transfection evidenced by electrophoretic mobility gel shift assay. The cell cycle was arrested at G(0)/G(1) phase along with a significant inhibition of cell proliferation after STAT3 siRNA treatment.
CONCLUSIONSTAT3 siRNA specifically and efficiently blocks the constitutively activated STAT3 signaling pathway in human esophageal squamous carcinoma cells, resulting in cell cycle arrest and proliferation inhibition.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Esophageal Neoplasms ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Phosphorylation ; RNA Interference ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; STAT3 Transcription Factor ; genetics ; metabolism ; Signal Transduction ; Transfection
4.Efficacy of bevacizumab combined with raltitrexed in the treatment of unresectable hepatocellular carci-noma and its influence on adverse reactions and survival rate
Hua WANG ; Yue HEI ; Miao SUN ; Yan-Chuang SUN ; Juan HAN ; Juanhua SUN
The Journal of Practical Medicine 2024;40(21):3061-3066
Objective To investigate the efficacy of bevacizumab combined with raltitrexed in the treatment of unresectable hepatocellular carcinoma(HCC)and its effect on adverse reactions and survival rate.Methods A retrospective analysis was performed on 71 patients with unresectable hepatocellular carcinoma admitted to the oncology department of our hospital from February 2020 to June 2022.Among them,35 cases were treated with raltitrexed as control group,and 36 cases were treated with bevacizumab combined with raltitrexed as observation group.All patients received transcatheter arterial chemoembolization(TACE).After 1 month of treatment,the short-term treatment effect of the two groups was evaluated.The adverse reactions of the two groups were observed.Follow-up review was performed to record progression free survival(PFS)and overall survival(OS)in both groups.Results After 1 month of treatment,the disease control rate(DCR)and objective response rate(ORR)of control group were 74.29%and 45.71%respectively.The DCR and ORR of observation group were 83.33%and 55.56%respectively.There was no significant difference in short-term efficacy between the two groups(P>0.05).Following treatment,the vascular endothelial growth factor(VEGF)level in the observation group was considerably lower than in the control group(P<0.05).After treatment,18 months of follow-up,OS curve showed:observation group OS was 50.00%,control group OS was 31.40%;PFS curve showed:observation group PFS was 43.33%,control group PFS was 26.92%.Using the Log-rank test,between the two groups,there was a statistically significant difference in OS(χ2=4.381,P=0.036),although there was no statistically significant difference in PFS between the two groups(χ2=3.264,P=0.071).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Bevacizumab combined with raltitrexed can reduce tumor neovascularization,inhibit tumor growth and spread,prolong the survival time of patients,and do not increase adverse drug reactions.
5.Mucosa advancement flap anoplasty in treatment of chronic anal fissures: a prospective, multicenter, randomized controlled trial.
Zhenyi WANG ; Hua LIU ; Jianhua SUN ; Xuming MAO ; Weixiang XU ; Yingge WU ; Haiyan ZHANG ; Lijuan ZHU ; Wei JIN ; Jiong WU ; Ying LI ; Chuang WU ; Zailong JIANG ; Li SHI ; Yan LI ; Wei DONG
Journal of Integrative Medicine 2011;9(4):402-409
Background: Anal fissure is one of the most common anal-rectum diseases, and approximately 10 percent patients with chronic anal fissure ultimately receive surgery. Relieving postoperative pain and protecting functions of the sphincter are central issues for coloproctologists. Objective: To evaluate the efficacy and safety of anoplasty in the treatment of chronic anal fissures. Design, setting, participants and interventions: In this prospective, multicenter, randomized controlled trial, 120 adult patients with chronic anal fissure were referred from Department of Coloproctology of Yueyang Hospital of Integrated Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Municipal Hospital of Traditional Chinese Medicine. The patients were enrolled from January 2009 to April 2010 and randomly divided into study (mucosa advancement flap anoplasty, abbreviated as anoplasty) group and control (fissurectomy) group. The two groups were assessed separately, and the main outcome measures were observed for 2 weeks, with a short-term follow-up for 6 weeks. Main outcome measures: Degree of pain, haemorrhage and anal canal pressure were observed and recorded preoperatively, and on the third day, the fourteenth day and the sixth week postoperatively. The wound healing time was also recorded. Surgical complications of the two groups were recorded and compared on the third day and the sixth week postoperatively. The curative effects associated with the surgery were analyzed on the fourteenth day and the sixth week after surgery and the therapeutic results were evaluated. Results: Three patients were dropped out due to the early discharge from hospital and losing connection (1 in study group and 2 in control group). Overall the surgery showed that the anoplasty group had better results than the fissurectomy group in the curative effect on the sixth week after operation (P<0.05). Time of wound healing in the anoplasty group was (17.22±4.41) d and was better than (21.24±7.44) d of the fissurectomy group (P<0.05). Concerning the relief of wound pain, the anoplasty group achieved better results than the fissurectomy group at the third day, the fourteenth day and the sixth week after operation (P<0.05). Anoplasty reduced bleeding and had better efficacy than the fissurectomy at the third day and the fourteenth day after operation (P<0.05), however, there was no statistical difference at the sixth week after operation (P>0.05). There were no significant differences in relieving the anal canal pressure (P>0.05) and the surgical complications (dysuria, edema of anal margin, fever, infection, anal incontinence and anal deformation) between the two groups (P>0.05). None of the patients suffered postoperative complications by the sixth week after operation. Furthermore, there was no recurrence in either of the two groups at six weeks after operation. Conclusion: The results indicate that anoplasty for chronic anal fissures has advantages such as better therapeutic effects, less postoperative pain, a shorter healing time and no incidence of anal incontinence.
6.Detection of viral pathogens and allergens in infants and young children at high risk of asthma during a wheezing episode.
Ting WANG ; Rong ZHANG ; Hui-Ming SUN ; Li HUANG ; Zheng-Rong CHEN ; Mei-Juan WANG ; Can-Hong ZHU ; Wei JI ; Yong-Dong YAN ; Yu-Qing WANG ; Chuang-Li HAO
Chinese Journal of Contemporary Pediatrics 2019;21(6):505-510
OBJECTIVE:
To investigate the viral etiology and allergen distribution in infants and young children at high risk of asthma during a wheezing episode.
METHODS:
A total of 135 infants and young children at high risk of asthma were enrolled who were admitted due to asthmatic bronchitis or asthmatic bronchopneumonia between April 2016 and August 2017. Fluorescent probe PCR was used to measure influenza A (Flu A), respiratory syncytium virus (RSV), adenovirus (ADV), parainfluenza virus (PinF), human rhinovirus (HRV), human partial lung virus (hMPV) and human bocavirus (HBoV) in nasopharyngeal aspirates. ImmunoCAP was used to measure inhaled allergens, food allergens, and total IgE concentration.
RESULTS:
Among the 135 patients, the overall virus detection rate of nasopharyngeal aspirates was 49.6%, and HRV had the highest detection rate of 25.2%, followed by HBoV (9.6%), RSV (8.1%), PinF (5.9%), Flu-A (3.7%), ADV (1.5%) and hMPV (0.7%). The 1-3 years group had a significantly higher detection rate of HRV than the <1 year group (P<0.05). The positive rate of allergen screening was 59.3%, with 44% for inhaled allergens and 89% for food allergens. Among the inhaled allergens, dust mites had the highest positive rate of 77%, followed by mould (37%), pollen (26%) and animal dander (9%). Among the food allergens, egg white had a positive rate of 73% and milk had a positive rate of 68%. The <1 year group had a significantly higher positive rate of inhaled allergens than the 1-3 years group (P<0.05). The 1-3 years age group had a significantly higher level of T-IgE than the <1 year group (P<0.05). The positive virus group had a significantly higher positive rate of inhaled allergens than the non-virus group (P<0.05). The children with the second wheezing episode had significantly higher positive rates of inhaled allergens and food allergens and level of T-IgE than those with the first wheezing episode (P<0.05). The children with the second wheezing episode also had significantly higher positive rates of dust mites and mould than those with the first wheezing episode (P<0.05).
CONCLUSIONS
Early HRV infection and inhaled allergen sensitization are closely associated with the development of wheezing in infants and young children at high risk of asthma.
Allergens
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Animals
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Asthma
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Child
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Child, Preschool
;
Egg Hypersensitivity
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Humans
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Infant
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Pyroglyphidae
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Respiratory Sounds
7.Establishment of Mice Model with Dampness-syndrome Ischemic Stroke
Kunhong LI ; Shuang WU ; Jiawei YANG ; Yu WANG ; Yaqiong WANG ; Minzhen DENG ; Yan HUANG ; Jingbo SUN ; Chuang LI ; Yan LI ; Xiao CHENG
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(10):1492-1497
Objective To establish an animal model of dampness-syndrome in mice (single model) and evaluate its characteristics of dampness-syndrome. The above-mentioned mice with dampness syndrome were used to construct mice model of ischemic stroke (double model) and observe the effect of dampness-pathogenic on the outcome of stroke. Methods Healthy C57BL/6J male mice were randomly divided into dampness-syndrome (including sham-surgery group and ischemic stroke group,with 10 mice in each group) and non dampness-syndrome groups (including sham-surgery group and ischemic stroke group,with 10 mice in each group). The dampness-syndrome group was fed with high-fat diet and the non dampness-syndrome group was fed with normal diet for 12 weeks. After the mice model of dampness-syndrome was successfully established,transient middle cerebral artery occlusion/reperfusion (tMCAO/R) surgery was used to replicate an ischemic stroke mice model. Evaluation indicators for dampness-syndrome mice model:the general status including body weight,morphology,posture,activity status,and physical characteristics,the histopathological observation of the aorta (oil red O staining,Masson-trichrome staining) and liver (HE staining,oil red O staining),electron microscopic observation of the tongue tissue (scanning electron microscopy,electron microscopy),blood lipid levels[total cholesterol(TC),triglycerides(TG)]and liver coefficient. Evaluation indicators for ischemic stroke mice model:neurological function score and the cerebral infarction volume ratio. Results Compared with the non dampness-syndrome group,the mice in the dampness-syndrome group showed an increased in body weight,poor hair color,sparse hair,fatigue and laziness,mental atrophy,anorexia and lethargy. It was observed that the aortic lumen was narrowed,the intima was significantly thickened,lipid plaque deposition was increased,and foam cells were visible. A large amount of red lipid droplets appeared in liver cells. There were obvious lipid infiltration and diffuse steatosis. Increased keratosis of the mucosal layer of tongue tissue,the thicker stratum corneum,lipofuscin,and bacteria on the tongue surface were found. Serum TG and TC levels significantly increased(P<0.01),and the liver coefficient significantly decreased (P<0.001). Compared with non dampness-syndrome group (sham-surgery group),neurological function score and the cerebral infarction volume ratio in dampness-syndrome ischemic stroke group obviously increased (P<0.001). Conclusion High-fat feeding for 12 weeks combined with tMCAO/R modeling can successfully establish a mice model with dampness-syndrome ischemic stroke,and the neurological function score and cerebral infarction volume in the dampness-syndrome ischemic stroke group was more severe than that in the non dampness-syndrome ischemic stroke group.
8.Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China.
Chun-Hua LIU ; Hui WANG ; Si-Cong PENG ; Wen-Xiang WANG ; Rong JIAO ; Sha PAN ; Tian-Jiao ZHU ; Xiao-Ying LUAN ; Xiao-Fang ZHU ; Su-Ying WU ; De-Guo WEI ; Bing-Feng FU ; Rui-Hong YAN ; Shu-Jie YANG ; Ya-Hui LUO ; Gui-Ping LI ; Min YANG ; De-Zhao JIA ; Chuang GAO ; Xiong-Fei XIAO ; Li XIONG ; Jie SUN ; Jia-Peng XIAO ; Bo-Wen LI ; Yan-Ni LI ; Lian-Hong ZHANG ; Tian-Guo LI ; Min CHENG ; Jian-Xin XIA ; Shi-Wen XIA
Chinese Journal of Contemporary Pediatrics 2021;23(12):1208-1213
OBJECTIVES:
To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia.
METHODS:
A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis.
RESULTS:
Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%,
CONCLUSIONS
Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.
Asphyxia
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Asphyxia Neonatorum/epidemiology*
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Humans
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Hyperglycemia
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Infant, Newborn
;
Prognosis
;
Retrospective Studies
9.A prospective multicenter and real-world study on the diagnostic value of combination of number connection test-B and line tracing test in mild hepatic encephalopathy
Junqing YAN ; Hongmei ZU ; Jing WANG ; Xiaoqing GUO ; Xiaoyan LI ; Shanghao LIU ; Huiling XIANG ; Zhaolan YAN ; Tong DANG ; Haiying WANG ; Jia SUN ; Lei HUANG ; Fanping MENG ; Qingge ZHANG ; Guo ZHANG ; Yan HUANG ; Shaoqi YANG ; Shengjuan HU ; Jigang RUAN ; Yiling LI ; Chuang LEI ; Ying SONG ; Zhangshu QU ; Ruichun SHI ; Qin LIU ; Yijun LIU ; Qiaohua YANG ; Xuelan ZHAO ; Caiyan ZHAO ; Chenxi WU ; Qian SHEN ; Manqun WU ; Yayuan LIU ; Dongmei YAN ; Chuan LIU ; Junliang FU ; Xiaolong QI
Chinese Journal of Digestion 2022;42(10):659-666
Objective:To investigate the diagnostic value of independent and combined subtests of the psychometric hepatic encephalopathy score (PHES) in mild hepatic encephalopathy(MHE) of patients with liver cirrhosis, so as to optimize the PHES.Methods:This was a prospective, multicenter and real-world study which was sponsored by the National Clinical Research Center of Infectious Diseases and the Portal Hypertension Consortium. Twenty-six hospitals from 13 provinces, autonomous regions and municipalities countrywide participated in this study, induding Tianjin Third Central Hospital, the Fourth People′s Hospital of Qinghai Province, the Second Affiliated Hospital of Baotou Medical College, the Third People′s Hospital of Taiyuan, the Fifth Medical Center of PLA General Hospital and so on. From October 2021 to February 2022, outpatients and hospitalized patients with liver cirrhosis and no obvious hepatic encephalopathy were consecutively enrolled. All patients received 5 PHES subjects in the same order: number connection test(NCT)-A, NCT-B, digit symbol test(DST), line tracing test(LTT) and serial dotting test(SDT), and the scores were calculated. The total score of PHES <-4 was taken as the cut-off value for diagnosing MHE. Compare the differences in each subtest between MHE group and non-MHE group. Receiver operating characteristic curve(ROC) and area under the curve(AUC) was performed to assess the diagnostic value of independent and combined subtests in MHE. Mann-Whitney U test and DeLong test were used for statistical analysis. Results:A total of 581 patients with liver cirrhosis were enrolled, 457 were diagnosed as MHE, and the incidence of MHE was 78.7%. The results of NCT-A, NCT-B, SDT, LTT, DST of MHE group were 60.00 s(47.01 s, 88.00 s), 90.45 s(69.32 s, 125.35 s), 74.00 s(57.65 s, 96.60 s), 74.72(60.00, 98.61) and 27.00(20.00, 36.00), respectively. Compared those of non-MHE group(34.00 s(29.15 s, 44.48 s), 50.00 s(40.98 s, 60.77 s), 50.00 s(41.07 s, 63.03 s), 46.23(38.55, 59.42) and 42.00(34.00, 50.75)), the differences were statistically significant( Z=12.37, 12.98, 9.83, 11.56, 10.66; all P<0.001). The AUC(95% confidence interval(95% CI)) of subtests of PHES NCT-B, NCT-A, LTT, DST and SDT alone in MHE diagnosis were 0.880(0.849 to 0.910), 0.862(0.828 to 0.896), 0.838(0.799 to 0.877), 0.812(0.772 to 0.851) and 0.788(0.743 to 0.832), respectively. The combination of 2 PHES subtests significantly increased the diagnostic efficacy. Among them the diagnostic efficacy of the combination of NCT-B and LTT was the best, the AUC(95% CI) was 0.924(0.902 to 0.947), the specificity was 91.9% and the sensitivity was 79.2%, which was better than a single PHES subtest (NCT-A, NCT-B, SDT, LTT and DST) and the combination of NCT-A and DST(AUC was 0.879, 95% CI0.847 to 0.910) which was recommended by guidelines on the management of hepatic encephalopathy in cirrhosis, the differences were statistically significant ( Z=3.78, 3.83, 5.57, 5.51, 5.38, 2.93; all P<0.01). Furthermore, compared between the combination of NCT-B and LTT and the combination of 3 subests of PHES, only the diagnostic efficacy of combination of NCT-B, LTT and SDT (AUC was 0.936, 95% CI 0.916 to 0.956) was better than that of the combination of NCT-B and LTT, the difference was statistically significant( Z=2.32, P=0.020). Conclusion:Based on the diagnostic efficacy and clinical feasibility of PHES subtests and their combinations, the combination of NCT-B and LTT is recommended for the diagnosis of MHE.
10.Diagnostic value of a combined serology-based model for minimal hepatic encephalopathy in patients with compensated cirrhosis
Shanghao LIU ; Hongmei ZU ; Yan HUANG ; Xiaoqing GUO ; Huiling XIANG ; Tong DANG ; Xiaoyan LI ; Zhaolan YAN ; Yajing LI ; Fei LIU ; Jia SUN ; Ruixin SONG ; Junqing YAN ; Qing YE ; Jing WANG ; Xianmei MENG ; Haiying WANG ; Zhenyu JIANG ; Lei HUANG ; Fanping MENG ; Guo ZHANG ; Wenjuan WANG ; Shaoqi YANG ; Shengjuan HU ; Jigang RUAN ; Chuang LEI ; Qinghai WANG ; Hongling TIAN ; Qi ZHENG ; Yiling LI ; Ningning WANG ; Huipeng CUI ; Yanmeng WANG ; Zhangshu QU ; Min YUAN ; Yijun LIU ; Ying CHEN ; Yuxiang XIA ; Yayuan LIU ; Ying LIU ; Suxuan QU ; Hong TAO ; Ruichun SHI ; Xiaoting YANG ; Dan JIN ; Dan SU ; Yongfeng YANG ; Wei YE ; Na LIU ; Rongyu TANG ; Quan ZHANG ; Qin LIU ; Gaoliang ZOU ; Ziyue LI ; Caiyan ZHAO ; Qian ZHAO ; Qingge ZHANG ; Huafang GAO ; Tao MENG ; Jie LI ; Weihua WU ; Jian WANG ; Chuanlong YANG ; Hui LYU ; Chuan LIU ; Fusheng WANG ; Junliang FU ; Xiaolong QI
Chinese Journal of Laboratory Medicine 2023;46(1):52-61
Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.