To determine the predictive performance of cholinesterase compared to existing prognostic models in evaluating liver function in patients with chronic hepatitis D. METHODSIn an observational, cross-sectional and retro...To determine the predictive performance of cholinesterase compared to existing prognostic models in evaluating liver function in patients with chronic hepatitis D. METHODSIn an observational, cross-sectional and retrospective study, consecutive patients with hepatitis D cirrhosis were evaluated. Demographic, clinical and laboratory parameters were recorded. Serum cholinesterase levels were correlated with existing scoring models for chronic liver disease and Liver function tests. Receiver operating characteristic (ROC) curves were constructed to find an optimal cholinesterase level predicting ascites, Child Turcotte Pugh (CTP) score ≥ 10, model for end stage liver disease (MELD) score ≥ 15, baseline-event-anticipation (BEA) score for hepatitis D ≥ 5 and the aspartate transaminase to Platelet Ratio Index (APRI) ≥ 1.5. RESULTSThis study investigated 233 patients with chronic liver disease due to hepatitis D; 192 were male, median age 42 (16-69 years). Fifty patients had ascites and 15 had encephalopathy. One hundred and sixty-seven (71.7%) were in Child class A, 52 (22.3%) in Child class B and 14 (5.0%) in class C. A MELD score of 15 or more was seen in 24 patients. Cholinesterase levels correlated well with the INR, albumin, CTP score, MELD, MELD sodium, BEA and APRI scores (P < 0.001 each). Area under the ROC curve for ascites, CTP ≥ 10, MELD ≥ 15, BEA ≥ 5, APRI ≥ 1.5 was 0.836, 0.966, 0.913, 0.871 and 0.825 respectively (P < 0.001 each). Cut off values of cholinesterase (IU/L) for predicting ascites, CTP ≥ 10, MELD ≥ 15, BEA ≥ 5 and APRI ≥ 1.5 were < 3812, < 2853, < 2829, < 4719 and < 3954 with a sensitivity of 80%, 100%, 91.67%, 82.50%, 58.0% and specificity of 81.97%, 84.79%, 87.56%, 77.06% and 55.64% respectively. CONCLUSIONSerum cholinesterase demonstrates promising correlations with serum albumin, INR and CTP, MELD, BEA and APRI scores and is predictive of liver reserves in hepatitis D cirrhosis.展开更多
The energy crisis has become a significant bottleneck in the country’s economic progress.But to end this age old problem,we have to capitalize on the chance,China Pakistan Economic Corridor(CPEC)investment provides,t...The energy crisis has become a significant bottleneck in the country’s economic progress.But to end this age old problem,we have to capitalize on the chance,China Pakistan Economic Corridor(CPEC)investment provides,to its full potential.This study aims to help Pakistani government in selecting the best set of CPEC energy priority projects to be completed in the first wave of development.The second part of the research guides the small/medium scale industry and business owners to select the best available alternative for tackling the energy shortfall while CPEC projects are in the process of materialization.Forecasting electricity shortfall decrease and its impact on various economic/industrial sectors(like services,industrial,textile and agriculture)is also performed to gauge the effect of CPEC on the economy using linear regression.For decision analysis,the MCDM techniques employed are(AHP)along with(TOPSIS).This research generated a new list of recommended CPEC energy priority projects which are more evenly distributed across the country,catering more,to interest of the country as a whole.We also concluded solar panels to be the best alternative for small scale businesses,as short term solution while CPEC projects are under construction.展开更多
BACKGROUNDMalnutrition affects 40%-90% of patients with cirrhosis of the liver. L3 skeletalmuscle index (L3SMI) is presently accepted as the most objective and quantitativemeasure available for sarcopenia, a surrogate...BACKGROUNDMalnutrition affects 40%-90% of patients with cirrhosis of the liver. L3 skeletalmuscle index (L3SMI) is presently accepted as the most objective and quantitativemeasure available for sarcopenia, a surrogate marker of malnutrition. L3SMIapplication is, however, limited by non-availability of computed tomographyscanning in remote areas, cost, need for extensive training, and the risk ofexposure to radiation. Therefore, an alternative dependable measure with wideravailability is needed. Malnutrition causes sarcopenia not only in skeletal musclesbut also in other muscular structures such as the psoas muscle, diaphragm andtongue. We therefore hypothesised that the tongue, being easily accessible forinspection and for measurement of thickness using ultrasonography, may be usedto document sarcopenia.AIMTo measure and compare tongue thickness in healthy individuals and in patientswith cirrhosis of the liver and to study its correlation with conventionalprognostic scores for patients with cirrhosis of the liver.METHODSTongue thickness was measured using ultrasonography. One hundred twentysubjects of either gender aged 18 to 65 years were studied, with 30 subjects in eachgroup. The tongue thickness was compared between groups based on “ChildTurcotte Pugh” (CTP) scores. The correlations between measured tonguethickness and “Model for end stage liver disease” (MELD) score and between age and measured tongue thickness were also assessed.RESULTSMean tongue thickness (mean ± SD) in patients with CTP class A, B and C was4.39 ± 0.39 cm, 4.19 ± 0.53 cm, and 3.87 ± 0.42, respectively, and was 4.33 ± 0.49 cmin normal healthy individuals. Significant differences were seen in tonguethickness between patients with CTP class C and those with CTP class A and B (P< 0.05). Patients with CTP class C also had a significantly reduced tonguethickness than normal individuals (P < 0.05). However, no significant differencewas seen in tongue thickness between patients with CTP class A and B andnormal individuals. A statisti展开更多
Brittleness is a critical issue hindering the potential application of the X_2YZ-type full Heusler alloys in several fields of state-of-the-art technologies.To realize optimization of brittleness or design a ductile H...Brittleness is a critical issue hindering the potential application of the X_2YZ-type full Heusler alloys in several fields of state-of-the-art technologies.To realize optimization of brittleness or design a ductile Heuser alloy,it is greatly urgent to identify the key materials factors deciding brittleness and establish an empirical rule to effectively evaluate ductility.For this purpose,by using a machine learning and human analysis cooperation approach,the brittleness of the X_2YZ-type Heusler alloys was systematically studied.Results showed that the ductility is majorly decided by 6 key materials factors in the studied alloys.Using these 6 factors,a machine learning model to predict the Pugh's ratio k was constructed.Further analyses showed that the crystal structure of the X component could be the most critical factor deciding the ductility.The X component has the face-centered cubic(FCC)structure for most of the alloys with superior ductility.To effectively estimate ductility and guide materials design,an empirical formula of k=mEWF_(m+n)G_(m)+k_(0)was established based on the known information of electron work function(EWF)and shear modulus(G)of the X,Y,and Z elements where the subscript m represents the weight-average value.The coefficients of m(negative)and n(positive)were confirmed to have opposite signs,which can be explained based on the relations between the ductility and the deformation/fracture resistance.This work is expected to deepen the understanding in ductility and promote the design of advanced ductile Heusler alloys.展开更多
High-hardness rock-salt structured transitional metal carbides(TMC)are attracting substantial interest as potential next-generation thermal protection materials.However,the intrinsic brittleness of TMC ceramics impede...High-hardness rock-salt structured transitional metal carbides(TMC)are attracting substantial interest as potential next-generation thermal protection materials.However,the intrinsic brittleness of TMC ceramics impedes their performance in aerodynamically harsh environments.In this work,a promising strategy is proposed to introduce plasticity in TaC–HfC solid solutions by manipulating carbon deficiency.The approach combines density-functional theory(DFT)with experiments and takes Pugh's ratio(k)as the criteria.Depletion of carbon atoms in TaC–HfC solid solutions results in the de-localizing of valence electrons,deviation of spatial modulus along different crystal plane directions,and leading to significant elastic anisotropy.The carbon deficient Ta_(0.8)Hf_(0.2)C_(0.8) is predicted to be a‘softer phase’with reduced modulus and Pugh's ratio(k=0.58).A series of Ta1–xHfxCy(x=0.2 and 0.8,y=0.8,0.9,and 1.0)bulk ceramics are experimentally fabricated by an excessive metal alloying method.Trigonal and hexagonal close-packed structured carbides are derived when the carbon deficiency y decreased to 0.7.The indentation modulus drops from 641.8±14.8 GPa for Ta_(0.8)Hf_(0.2)C_(1.0) to 555.8±9.9 GPa for Ta0.8Hf0.2C0.8.The specific stoichiometric composition of Ta_(0.8)Hf_(0.2)C_(0.8) is experimentally verified to possess both plasticity(k=0.41)and ultra-high nanohardness(41.3±1.3 GPa).展开更多
Hepatocellular carcinoma(HCC)is the most common primary liver cancer.For advanced HCC,sorafenib was considered the standard of care for more than ten years.Recently the atezolizumab and bevacizumab combination has bec...Hepatocellular carcinoma(HCC)is the most common primary liver cancer.For advanced HCC,sorafenib was considered the standard of care for more than ten years.Recently the atezolizumab and bevacizumab combination has become standard of care for these patients without contraindications to either immune checkpoint inhibitors or antiangiogenic therapy.We now review the practical aspects of the atezolizumab and bevacizumab combination,including current evidence,indications,contraindications,management of adverse events,sequencing of this combination,areas of current knowledge gaps and future areas of active clinical research of this combination for busy clinicians in clinical practice.展开更多
This paper presents the development process relating to the conceptual design of glass/renewable natural fibrereinforced polymer hybrid composite motorcycle side cover.Motorcycle side cover is a component frequently m...This paper presents the development process relating to the conceptual design of glass/renewable natural fibrereinforced polymer hybrid composite motorcycle side cover.Motorcycle side cover is a component frequently made from plastic or steel that functions on covering the motorcycle parts,components and systems such as frame,battery,electrical systems and mechanical systems.Function Analysis Systems Techniques(FAST)is used to identify the functions of motorcycle side cover.The right-side cover of motorcycle model SYM E-Bonus 110 has been physically studied to identify the competitive benchmarking criteria.The functions and competitive benchmarking criteria are then compiled and integrated with the environmental requirements to identify the Product Design Specifications(PDS).The coir fibre has been selected from six identified dominant renewable natural fibre used for automotive component through integration of Ranking Method and Quality Based Selection(QBS).Then the polypropylene matrix is selected after shortlisting the existing thermoplastic that is used with coir fibre and has high suitability for injection moulding manufacturing.The polypropylene matrix is then evaluated using Weighted Evaluation Matrix(WEM)by comparing to benchmark material which is Acrylonitrile Butadiene Styrene(ABS).After that,the conceptual design development of glass/renewable coir fibre-reinforced polypropylene motorcycle side cover is carried out using an integrated Theory of Inventive Problem Solving(TRIZ)and Morphological Chart,followed by final conceptual design selection using integration of Pugh Scoring Method and QBS.The conceptual design development intended on improving the biodegradability to reduce pollution to the environment.However,the usage of glass/coir fibre-reinforced polypropylene hybrid composite may increase the weight due to higher density.Four innovative design concepts have been developed and the selected final concept design has the most minimum number of ribs and minimum thickness with the same ratio of glass展开更多
Congenital heart disease(CHD), one of the main causes of infant mortality, should be screened as early as possible. However, the current screening method, auscultation, strongly depends on the doctors’ experience,and...Congenital heart disease(CHD), one of the main causes of infant mortality, should be screened as early as possible. However, the current screening method, auscultation, strongly depends on the doctors’ experience,and the contradiction between limited medical resource and growth of population becomes sharp. This study presents a systematic approach for the conceptual design of a novel screening system. Research and interview are carried out to determine user requirements. Quality function deployment(QFD) with consideration of related products, patent and research is implemented to find out the key user requirements of existing screening device and the order of design descriptors. With the key requirements confirmed, several concepts which focus on satisfying the key requirements are brought out. The final concept of the screening system is chosen by the application of Pugh decision matrix. The implementation of the conceptual design shows that the designed system satisfies the user requirements well.展开更多
AIM:To investigate the prevalence of minimal hepatic encephalopathy(MHE)and to assess corresponding health-related quality of life(HRQoL)in hospitalized cirrhotic patients in China.METHODS:This multi-center cross-sect...AIM:To investigate the prevalence of minimal hepatic encephalopathy(MHE)and to assess corresponding health-related quality of life(HRQoL)in hospitalized cirrhotic patients in China.METHODS:This multi-center cross-sectional study included 16 teaching hospitals,which were members of "Hepatobiliary Cooperation Group,Society of Gastroenterology,Chinese Medical Association",from different areas of China carried out between June and October in 2011.All the eligible hospitalized cirrhotic patients(n = 538)were required to complete triplicate number connection tests combined with one digit symbol test for diagnosing MHE.Patients' clinical examination data were complemented by a modified questionnaire assessing HRQoL.Written informed consent was obtained from each patient.RESULTS:Male was predominant(68.6%)in 519 patients who met the criteria of the study,with a mean age of 49.17 ± 11.02 years.The most common cause of liver cirrhosis was chronic hepatitis B(55.9%).The prevalence of MHE was 39.9% and varied by ChildPugh-Classification score(CPC-A:24.8%,CPC-B:39.4% and CPC-C:56.1%,P < 0.01).MHE(P < 0.01)and higher CPC scores(P < 0.01)were associated with a high HRQoL scores(reflecting poorer quality of life).The prevalence of MHE was proportionate to CPC(P = 0.01)and high quality of life scores(P = 0.01).CONCLUSION:Hospitalized cirrhotic patients have a high prevalence of MHE that is proportionate to the degree of liver function and HRQoL impairment.展开更多
文摘To determine the predictive performance of cholinesterase compared to existing prognostic models in evaluating liver function in patients with chronic hepatitis D. METHODSIn an observational, cross-sectional and retrospective study, consecutive patients with hepatitis D cirrhosis were evaluated. Demographic, clinical and laboratory parameters were recorded. Serum cholinesterase levels were correlated with existing scoring models for chronic liver disease and Liver function tests. Receiver operating characteristic (ROC) curves were constructed to find an optimal cholinesterase level predicting ascites, Child Turcotte Pugh (CTP) score ≥ 10, model for end stage liver disease (MELD) score ≥ 15, baseline-event-anticipation (BEA) score for hepatitis D ≥ 5 and the aspartate transaminase to Platelet Ratio Index (APRI) ≥ 1.5. RESULTSThis study investigated 233 patients with chronic liver disease due to hepatitis D; 192 were male, median age 42 (16-69 years). Fifty patients had ascites and 15 had encephalopathy. One hundred and sixty-seven (71.7%) were in Child class A, 52 (22.3%) in Child class B and 14 (5.0%) in class C. A MELD score of 15 or more was seen in 24 patients. Cholinesterase levels correlated well with the INR, albumin, CTP score, MELD, MELD sodium, BEA and APRI scores (P < 0.001 each). Area under the ROC curve for ascites, CTP ≥ 10, MELD ≥ 15, BEA ≥ 5, APRI ≥ 1.5 was 0.836, 0.966, 0.913, 0.871 and 0.825 respectively (P < 0.001 each). Cut off values of cholinesterase (IU/L) for predicting ascites, CTP ≥ 10, MELD ≥ 15, BEA ≥ 5 and APRI ≥ 1.5 were < 3812, < 2853, < 2829, < 4719 and < 3954 with a sensitivity of 80%, 100%, 91.67%, 82.50%, 58.0% and specificity of 81.97%, 84.79%, 87.56%, 77.06% and 55.64% respectively. CONCLUSIONSerum cholinesterase demonstrates promising correlations with serum albumin, INR and CTP, MELD, BEA and APRI scores and is predictive of liver reserves in hepatitis D cirrhosis.
文摘The energy crisis has become a significant bottleneck in the country’s economic progress.But to end this age old problem,we have to capitalize on the chance,China Pakistan Economic Corridor(CPEC)investment provides,to its full potential.This study aims to help Pakistani government in selecting the best set of CPEC energy priority projects to be completed in the first wave of development.The second part of the research guides the small/medium scale industry and business owners to select the best available alternative for tackling the energy shortfall while CPEC projects are in the process of materialization.Forecasting electricity shortfall decrease and its impact on various economic/industrial sectors(like services,industrial,textile and agriculture)is also performed to gauge the effect of CPEC on the economy using linear regression.For decision analysis,the MCDM techniques employed are(AHP)along with(TOPSIS).This research generated a new list of recommended CPEC energy priority projects which are more evenly distributed across the country,catering more,to interest of the country as a whole.We also concluded solar panels to be the best alternative for small scale businesses,as short term solution while CPEC projects are under construction.
文摘BACKGROUNDMalnutrition affects 40%-90% of patients with cirrhosis of the liver. L3 skeletalmuscle index (L3SMI) is presently accepted as the most objective and quantitativemeasure available for sarcopenia, a surrogate marker of malnutrition. L3SMIapplication is, however, limited by non-availability of computed tomographyscanning in remote areas, cost, need for extensive training, and the risk ofexposure to radiation. Therefore, an alternative dependable measure with wideravailability is needed. Malnutrition causes sarcopenia not only in skeletal musclesbut also in other muscular structures such as the psoas muscle, diaphragm andtongue. We therefore hypothesised that the tongue, being easily accessible forinspection and for measurement of thickness using ultrasonography, may be usedto document sarcopenia.AIMTo measure and compare tongue thickness in healthy individuals and in patientswith cirrhosis of the liver and to study its correlation with conventionalprognostic scores for patients with cirrhosis of the liver.METHODSTongue thickness was measured using ultrasonography. One hundred twentysubjects of either gender aged 18 to 65 years were studied, with 30 subjects in eachgroup. The tongue thickness was compared between groups based on “ChildTurcotte Pugh” (CTP) scores. The correlations between measured tonguethickness and “Model for end stage liver disease” (MELD) score and between age and measured tongue thickness were also assessed.RESULTSMean tongue thickness (mean ± SD) in patients with CTP class A, B and C was4.39 ± 0.39 cm, 4.19 ± 0.53 cm, and 3.87 ± 0.42, respectively, and was 4.33 ± 0.49 cmin normal healthy individuals. Significant differences were seen in tonguethickness between patients with CTP class C and those with CTP class A and B (P< 0.05). Patients with CTP class C also had a significantly reduced tonguethickness than normal individuals (P < 0.05). However, no significant differencewas seen in tongue thickness between patients with CTP class A and B andnormal individuals. A statisti
基金financially supported by the National Natural Science Foundation of China(Nos.51801020,51922026,51975111)the Fundamental Research Funds for the Central Universities(Nos.N2002005,N2105001)the 111 Project of China(Nos.BP0719037,B20029)。
文摘Brittleness is a critical issue hindering the potential application of the X_2YZ-type full Heusler alloys in several fields of state-of-the-art technologies.To realize optimization of brittleness or design a ductile Heuser alloy,it is greatly urgent to identify the key materials factors deciding brittleness and establish an empirical rule to effectively evaluate ductility.For this purpose,by using a machine learning and human analysis cooperation approach,the brittleness of the X_2YZ-type Heusler alloys was systematically studied.Results showed that the ductility is majorly decided by 6 key materials factors in the studied alloys.Using these 6 factors,a machine learning model to predict the Pugh's ratio k was constructed.Further analyses showed that the crystal structure of the X component could be the most critical factor deciding the ductility.The X component has the face-centered cubic(FCC)structure for most of the alloys with superior ductility.To effectively estimate ductility and guide materials design,an empirical formula of k=mEWF_(m+n)G_(m)+k_(0)was established based on the known information of electron work function(EWF)and shear modulus(G)of the X,Y,and Z elements where the subscript m represents the weight-average value.The coefficients of m(negative)and n(positive)were confirmed to have opposite signs,which can be explained based on the relations between the ductility and the deformation/fracture resistance.This work is expected to deepen the understanding in ductility and promote the design of advanced ductile Heusler alloys.
基金supported by the National Natural Science Foun-dation of China(nos.52073299,51902329)Shanghai Sailing Pro-gram(no.22YF1455700)+4 种基金Natural Science Foundation of Shanghai(no.20ZR1465400)Youth Innovation Promotion Association(CAS,no.2022251)T.Cs.and J.D.acknowledge the financial support of projects:VEGA 2/0174/21T.Cs.was supported by the project Strengthecs(no.H2020-MSCA-IF)of the Slovak Academy of SciencesJ.D.gratefully acknowledge the support of ESET and Alexander von Humboldt Foundations.
文摘High-hardness rock-salt structured transitional metal carbides(TMC)are attracting substantial interest as potential next-generation thermal protection materials.However,the intrinsic brittleness of TMC ceramics impedes their performance in aerodynamically harsh environments.In this work,a promising strategy is proposed to introduce plasticity in TaC–HfC solid solutions by manipulating carbon deficiency.The approach combines density-functional theory(DFT)with experiments and takes Pugh's ratio(k)as the criteria.Depletion of carbon atoms in TaC–HfC solid solutions results in the de-localizing of valence electrons,deviation of spatial modulus along different crystal plane directions,and leading to significant elastic anisotropy.The carbon deficient Ta_(0.8)Hf_(0.2)C_(0.8) is predicted to be a‘softer phase’with reduced modulus and Pugh's ratio(k=0.58).A series of Ta1–xHfxCy(x=0.2 and 0.8,y=0.8,0.9,and 1.0)bulk ceramics are experimentally fabricated by an excessive metal alloying method.Trigonal and hexagonal close-packed structured carbides are derived when the carbon deficiency y decreased to 0.7.The indentation modulus drops from 641.8±14.8 GPa for Ta_(0.8)Hf_(0.2)C_(1.0) to 555.8±9.9 GPa for Ta0.8Hf0.2C0.8.The specific stoichiometric composition of Ta_(0.8)Hf_(0.2)C_(0.8) is experimentally verified to possess both plasticity(k=0.41)and ultra-high nanohardness(41.3±1.3 GPa).
文摘Hepatocellular carcinoma(HCC)is the most common primary liver cancer.For advanced HCC,sorafenib was considered the standard of care for more than ten years.Recently the atezolizumab and bevacizumab combination has become standard of care for these patients without contraindications to either immune checkpoint inhibitors or antiangiogenic therapy.We now review the practical aspects of the atezolizumab and bevacizumab combination,including current evidence,indications,contraindications,management of adverse events,sequencing of this combination,areas of current knowledge gaps and future areas of active clinical research of this combination for busy clinicians in clinical practice.
文摘This paper presents the development process relating to the conceptual design of glass/renewable natural fibrereinforced polymer hybrid composite motorcycle side cover.Motorcycle side cover is a component frequently made from plastic or steel that functions on covering the motorcycle parts,components and systems such as frame,battery,electrical systems and mechanical systems.Function Analysis Systems Techniques(FAST)is used to identify the functions of motorcycle side cover.The right-side cover of motorcycle model SYM E-Bonus 110 has been physically studied to identify the competitive benchmarking criteria.The functions and competitive benchmarking criteria are then compiled and integrated with the environmental requirements to identify the Product Design Specifications(PDS).The coir fibre has been selected from six identified dominant renewable natural fibre used for automotive component through integration of Ranking Method and Quality Based Selection(QBS).Then the polypropylene matrix is selected after shortlisting the existing thermoplastic that is used with coir fibre and has high suitability for injection moulding manufacturing.The polypropylene matrix is then evaluated using Weighted Evaluation Matrix(WEM)by comparing to benchmark material which is Acrylonitrile Butadiene Styrene(ABS).After that,the conceptual design development of glass/renewable coir fibre-reinforced polypropylene motorcycle side cover is carried out using an integrated Theory of Inventive Problem Solving(TRIZ)and Morphological Chart,followed by final conceptual design selection using integration of Pugh Scoring Method and QBS.The conceptual design development intended on improving the biodegradability to reduce pollution to the environment.However,the usage of glass/coir fibre-reinforced polypropylene hybrid composite may increase the weight due to higher density.Four innovative design concepts have been developed and the selected final concept design has the most minimum number of ribs and minimum thickness with the same ratio of glass
基金the Three-Year Action Plan of Promoting Clinical Skills and Clinical Innovation in Shanghai Shenkang Medical Center(No.16CR3079B)the Special Program for Innovation Methodology of the Ministry of Science and Technology of China(No.2016IM010100)
文摘Congenital heart disease(CHD), one of the main causes of infant mortality, should be screened as early as possible. However, the current screening method, auscultation, strongly depends on the doctors’ experience,and the contradiction between limited medical resource and growth of population becomes sharp. This study presents a systematic approach for the conceptual design of a novel screening system. Research and interview are carried out to determine user requirements. Quality function deployment(QFD) with consideration of related products, patent and research is implemented to find out the key user requirements of existing screening device and the order of design descriptors. With the key requirements confirmed, several concepts which focus on satisfying the key requirements are brought out. The final concept of the screening system is chosen by the application of Pugh decision matrix. The implementation of the conceptual design shows that the designed system satisfies the user requirements well.
文摘AIM:To investigate the prevalence of minimal hepatic encephalopathy(MHE)and to assess corresponding health-related quality of life(HRQoL)in hospitalized cirrhotic patients in China.METHODS:This multi-center cross-sectional study included 16 teaching hospitals,which were members of "Hepatobiliary Cooperation Group,Society of Gastroenterology,Chinese Medical Association",from different areas of China carried out between June and October in 2011.All the eligible hospitalized cirrhotic patients(n = 538)were required to complete triplicate number connection tests combined with one digit symbol test for diagnosing MHE.Patients' clinical examination data were complemented by a modified questionnaire assessing HRQoL.Written informed consent was obtained from each patient.RESULTS:Male was predominant(68.6%)in 519 patients who met the criteria of the study,with a mean age of 49.17 ± 11.02 years.The most common cause of liver cirrhosis was chronic hepatitis B(55.9%).The prevalence of MHE was 39.9% and varied by ChildPugh-Classification score(CPC-A:24.8%,CPC-B:39.4% and CPC-C:56.1%,P < 0.01).MHE(P < 0.01)and higher CPC scores(P < 0.01)were associated with a high HRQoL scores(reflecting poorer quality of life).The prevalence of MHE was proportionate to CPC(P = 0.01)and high quality of life scores(P = 0.01).CONCLUSION:Hospitalized cirrhotic patients have a high prevalence of MHE that is proportionate to the degree of liver function and HRQoL impairment.
