Value of Stroop Smartphone App in screening minimal hepatic encephalopathy / 中华神经医学杂志

Objective To assess the value of Stroop smartphone application (EncephalApp-Stroop) in screening minimal hepatic encephalopathy (MHE).Methods Ninety hepatitis B cirrhotic patients without overt hepatic encephalopathy (OHE),admitted to our hospital from January 2015 to February 2016,and other 90 healthy volunteers were chosen in our study.Psychometric hepatic encephalopathy scale (PHES) and EncephalApp-Stroop were performed.Normal reference value formulas were established based on the 5 psychometric tests at PHES in healthy controls.EncephalApp-Stroop contained "off'state (neutral stimuli) and "on" state (incongruent stimuli).The time of completing five correct runs and the number of rtms in "on" and "off'states were calculated.PHES was used to diagnose MHE as gold standard to compare the results of OHE patients and healthy subjects and the results of patients with/without MHE.EncephalApp-Stroop results were compared with PHES results by receiver operator characteristic analysis.Results OHE patients had significantly longer time than healthy subjects in Stroop "on" and "off'states (P＜0.05).Traditionally,the total scores of PHES below-4 were diagnosed as MHE,and all the 90 patients taking PHES as gold standard,52 patients were diagnosed as MHE.The time at Stroop "on" and "off'states and the number of trials completing 5 correct runs were longer/larger in patients with MHE as compared with those in patients without MHE,with significant differences (P＜0.05).The validation cohort of EncephalApp-Stroop showed 87％ sensitivity and 79％ specificity.Conclusion The EncephalApp-Stroop is a valid,short and reliable tool for screening MHE.

Diagnostic value of a simplified psychometric hepatic encephalopathy scale for minimal hepatic encephalopathy / 中华神经医学杂志

Objective The psychometric hepatic encephalopathy scale (PHES),including five psychometric tests,is a standard for the diagnosis of minimal hepatic encephalopathy (MHE) and enjoys predictive value of overt hepatic encephalopathy (OHE).We investigate whether a simplified PHES is as useful as the whole PHES.Methods Seventy consecutive hepatitis B cirrhotic patients without OHE,admitted to our hospital from October 2012 to June 2013,and other 72 healthy volunteers were chosen in our study.PHES was performed in both groups.Expected normal reference value formula were established based on the 5 psychometric tests in healthy controls,and backward logistic regression was performed by eliminating stepwise variables of PHES to get a simplified PHES (SPHES).Then,SPHES was performed on the 70 patients and followed up for a year to detect the prevalence rate of MHE and OHE.Results PHES was easily influenced by age and educational level.In patients with liver cirrhosis,44.29％ patients (31/70) had MHE based on PHES and 41.43％ (9/70) had MHE based on SPHES,without significant differences (P＞0.05).According to the follow-up study,21 patients developed OHE; the number of developing OHE showed no significant difference between MHE patients dignosed by PHES and SPHES (P＞0.05).Conclusion SPHES is as good as PHES in diagnosing MHE and predicting the occurrence of OHE,which consumes less time and is more suitable for clinical screening.

Value of transcranial Doppler ultrasonography on diagnosing the cerebral vasospasm following subarachnoid hemorrhage / 临床神经病学杂志

Objective To explore the value of transcranial Doppler ultrasonography (TCD) on diagnosing the cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH). Methods TCD was used to detect and monitor the cerebral blood flow status to estimate CVS following SAH in 30 cases, then the results of TCD were analyzed by combining with clinical manifestation and SAH severity on CT. Results 17 patients (56.7%) had the evidence of CVS confirmed by TCD, 10 of them were nonsymptomatic and 7 were symptomatic. The incidences of CVS in patients with Fisher grade Ⅲ and Ⅳ were more higher than gradeⅠandⅡ(P

Correlation between brain natriuretic peptide and cerebral vasospasm following subarachnoid hemorrhage and hyponatremia / 临床神经病学杂志

Objective To explore the correlation between brain natriuretic peptide (BNP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia. Methods Plasma BNP levels and serum natrium were assessed at 4 different time periods (1 to 3 days, 4 to 6 days, 7 to 9 days, and 10 to 12 days after SAH) in 30 patients with SAH. Correlation analysis was carried out between plasma BNP and blood sodium level. Plasma BNP levels were compared according to patients with or without CVS, and with or without symptom. The plasma BNP levels of 18 healthy controls were measured meanwhile.Results Plasma BNP levels in SAH patients were significantly elevated compared with control subjects ( P