[Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study].

Objective: To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test. Methods: This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ (2) test. A kappa test was used to compare the consistency between groups. Results: After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea (Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences (P < 0.001). Conclusion: The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

Giant isotropic magneto-thermal conductivity of metallic spin liquid candidate Pr2Ir2O7 with quantum criticality.

Spin liquids are exotic states with no spontaneous symmetry breaking down to zero-temperature because of the highly entangled and fluctuating spins in frustrated systems. Exotic excitations like magnetic monopoles, visons, and photons may emerge from quantum spin ice states, a special kind of spin liquids in pyrochlore lattices. These materials usually are insulators, with an exception of the pyrochlore iridate Pr2Ir2O7, which was proposed as a metallic spin liquid located at a zero-field quantum critical point. Here we report the ultralow-temperature thermal conductivity measurements on Pr2Ir2O7. The Wiedemann-Franz law is verified at high fields and inferred at zero field, suggesting no breakdown of Landau quasiparticles at the quantum critical point, and the absence of mobile fermionic excitations. This result puts strong constraints on the description of the quantum criticality in Pr2Ir2O7. Unexpectedly, although the specific heats are anisotropic with respect to magnetic field directions, the thermal conductivities display the giant but isotropic response. This indicates that quadrupolar interactions and quantum fluctuations are important, which will help determine the true ground state of this material.

The ambient pollen distribution in Beijing urban area and its relationship with consumption of outpatient anti-allergic prescriptions.

OBJECTIVE: The impact of pollen exposure on allergy medication is poorly characterized. We aim to study the main kind of ambient pollen in Beijing urban area and the correlation with outpatient anti-allergic prescriptions throughout one year in a tertiary hospital. MATERIALS AND METHODS: With a modified volumetric trap, ambient pollens were sampled from January to December 2015. Meanwhile, information on 15 anti-allergic medication prescriptions in outpatient pharmacy was obtained and analyzed by generalized linear model. RESULTS: The total quantity of pollens amounted to 76164 grains in 2015. Two peaks of pollen concentration were observed, which happened from March to April 2015, and from August to September 2015. Consumption of antihistamines, LATRA, nasal sprays, and SABA showed two peaks trend in accordance with pollen distribution (p<0.01). ICS+LABA showed no seasonal peak without a significant correlation with pollen counts (p>0.05). Medication peak was higher in autumn than spring (p<0.01). CONCLUSIONS: The ambient pollen distribution was in accordance with the anti-allergic prescription amount with the two-peak season. The autumn medication peak was higher than spring peak, which clarified that outpatients were more sensitive to autumn pollen compared with spring pollen.

[Association between airborne pollen distribution and allergic diseases in Beijing urban area].

Objective:The aim of this study is to investigate the impact of airborne pollen in urban Beijing area on the consultation rate of allergic diseases. Method:A modified pollen sampler was used to monitor the distribution of main airborne pollen during Jan 1st 2015 to Dec 31 2015.The consultation rate of allergic rhinitis and asthma was obtained meanwhile among allergy, ENT and pneumology department. Relationship between pollen and consultation rate was analyzed by Pearson index. Result:①Through the whole year of 2015 the total quantity of pollens amounted to 76164 grains. Two pollen peaks were observed which happened in spring (March 29.7%, April 34.8%) and autumn (August 9.9%, September 10.5%). The main airborne pollens in spring were cypress, sycamore, and poplar, while in autumn were artemisia, Chenopodiaceae, and Humulus. ②The peak consultation season of allergic rhinitis was presented in March to April and August to September with a positive correlation between allergy and ENT department (r=0.625, P<0.05). Consultation peak of asthma was observed in allergy department but not pneumology department. ③Allergic rhinitis and asthma consultation rate was higher in autumn than spring while the pollen distribution was the opposite. No correlation was found between consultation rate and pollen distribution P>0.05. Conclusion:The airborne pollen distribution was in accordance with consultation rate in allergy department. The pollen count in spring was higher than autumn in Beijing urban area with a consultation peak in autumn inversely. This indicates a higher sensitization ability of autumn pollen compared with spring pollen.

[Studies on pyridonecarboxylic acids as antibacterial agents. XII. Synthesis and antibacterial activity of 6-chloro-1-cyclopropyl-7-(1-piperazinyl)-1, 4-dihydro-4-oxo-quinoline-3-carboxylic acid and analogues].

Sixteen pyridonecarboxylic acids, characterized by having a chlorine atom and a cyclopropyl group at the 6- and 1-position respectively, substituted amino groups at the 7-position, and some substituted groups (chloro, nitro, amino, dimethylamino) at the 8-position, were synthesized. In vitro antibacterial activities of these compounds were tested. The fluoroquinolones ciprofloxacin and norfloxacin were included for comparative purposes. The results showed that both 11 Ca and 11 Cc were 4-8 times more active than ciprofloxacin and norfloxacin against S. aureus-15 in vitro, but with the same activity as ciprofloxacin against E. coli-22 and P. aeruginosa-29.

Quality of life after intensive care with the sickness impact profile.

OBJECTIVES: a) to validate the structure of the Sickness Impact Profile scale (SIP) when applied to intensive care patients after discharge from the hospital; b) to explore the influence of age upon the various components of quality of life. DESIGN: Prospective study. SETTING: Patients admitted to 36 Dutch ICUs. METHODS: 6,247 patients out of 13,000 consecutive admissions to the ICUs answered a SIP questionnaire 6 months after discharge from the hospital. The 3,655 returned questionnaire were analyzed after aggregating the respondents into 6 age groups: from group 1: 17-29 up to group 4: > 70 years of age. INTERVENTION: Self-administration of SIP one year after discharge, measuring 5 independent categories (IC) and two dimensions: physical (PD) and psychosocial (PSD). RESULTS: The total SIP-score oscillated between 5.8 +/- 8.2 (group I) and 10.5 +/- 9.5 (group 4). Group 3 had also a high score (9.4 +/- 11.2). Overall, the quality of life of patients was dominated by dysfunction on the categories composing the physical dimension, with exception of patients with ages between 30 and 50 years, in which dysfunction on the categories composing the psychosocial dimension was dominant. The structure of the SIP in the study was similar to that described to the original instrument. CONCLUSIONS: The study validated the use of the SIP QOL-instrument on patients after intensive care. Age influenced consistently the various components of quality of life.

CT-guided stereotactic injection of radionuclide in treatment of brain tumors.

140 patients with brain tumor were treated by CT-guided stereotactic injections of radionuclides, such as Aurum-198 (198 Au), Phosphorus-32 (32 P) and Yttrium-90 (90Y). Of these patients aged from 3 to 67 years (average 37), 64 were male and 76 female. Astrocytoma was found in 75 patients, craniopharyngioma in 46, metastatic carcinoma in 7, meningioma in 5, germinoma in 4 and pituitary adenoma in 3. The tumors were located in the deep part or functionally critical area of the brain. After 267 times of injection of colloidal isotopes, no major adverse effects or complications occurred. Follow-up for 6 to 48 months showed improvement in symptoms in 104 (74.3%) patients and CT scanning showed the diminished tumors.

[Stereotactic intracavitary irradiation of huge cystic craniopharyngiomas].

From Jan. 1988 to June 1990, 32 patients with huge cystic craniopharyngiomas were treated by CT-guided stereotactic injection of phosphorus-32. Among them, 14 were male and 18 female. Their ranged 3 to 56 years (average 20 years). The history of illness varied from 1 to 8 years (average 2.8 years). All patients were confirmed pathologically, eleven of them had recurrent tumor after craniotomy. The volume of cystic tumor varied from 14 to 126ml (average 32ml). 1.2-5.6mCi (average 2.3mCi) of 32P were injected in each time. 65 injections were successfully performed. There were neither deaths nor serious complications. Follow-up time ranged from 12 to 24 months. The clinical symptoms of these patients were improved in 27 patients and volumes of the tumors were reduced on CT scans. The effective rate was 84.4%. We conclude that this technique is simple, efficient and safe for the treatment of huge cystic craniopharyngiomas.

CT-guided stereotactic injection of radionuclide for treatment of brain tumors.

The authors report on 40 brain tumor patients treated with CT-guided stereotactic injection of 198Au and 32P. Among the 40 cases were astrocytoma in 23 cases, craniopharyngioma in 9, meningioma in 4, pituitary adenoma in 2, and pinealoma and metastatic carcinoma each in 1 case. The tumors were all located in deep or important areas of the brain which were difficult to deal with by conventional operation. 62 injections of colloidal isotopes were performed, and all were successful. No major adverse effects or complications occurred on follow-up of 6-12 months, 28 patients were improved in their clinical symptoms, and CT scanning showed that the tumor sizes were diminished. The effective rate is 70%.

CT-guided stereotactic evacuation of hypertensive intracerebral hematoma.

From January 1986 to June 1989, the CT-guided stereotactic evacuation was performed in 38 cases of hypertensive intracerebral hematoma with satisfactory result. 24 patients were male and 14 female. The age ranged from 37 to 78 years, with an average of 55. 24 cases had their hematoma in internal capsule, 7 in cerebellum, 5 in subcortex, and 2 in brain stem. The interval between the occurrence of hemorrhage and evacuation of hematoma was 24 hours or less in 18 cases, 2-3 days in 14 and 4-7 days in 6. The volume of hematoma was estimated by CT scanning being more than 100 ml in 6 cases whereas much less in 2 cases of the brain stem.

Evacuation of hypertensive intracerebral hematoma by a stereotactic technique.

30 patients with a hypertensive intracerebral hematoma were treated by stereotactic evacuation between 1986 and 1988. There were 20 males and 10 females; their ages ranged from 37 to 78 years. The time interval from onset to operation was in 16 patients 24 days and in 14 patients 2-7 days. In 19 patients the hematoma was found in the internal capsule, in 5 in the cerebellum, in 4 in the subcortex, and in 2 in the brain stem. The operation was performed with a Leksell computed tomography guided stereotactic apparatus and a Backlund hematoma evacuator. More than 80% of the hematoma could be aspirated in 20 patients and 60-80% in 10. 29 patients are alive, and 1 patient died.

Clinical application of tympanometry in aviators.

Tympanometry is a new procedure in determining the status of the middle ear and can be helpful in assessing the function of the eustachian tube. Of 274 male aviators examined, 174 were normal, 40 cases had acute aerotitis media, and 60 cases had chronic aerotitis media. Impedance audiometry and pure tone audiometry were carried out by means of an electroacoustic impedance bridge and audiometer, respectively. Altitude chamber test was also performed. This study presents the results of tympanometry and inflation-deflation test in aviators. The normal average static compliance is 0.75 cc. Most normal aviators and patients with chronic aerotitis media in remission show a type A tympanogram, whereas type B and type C tympanograms are characteristic of acute aerotitis media. It is of interest that patients with chronic aerotitis media do not response normally to the inflation-deflation tympanometric tests. Tympanometry has been proved to be a very useful adjunct in the evaluation of the aerotitis media in aviators.