[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.

Energetic Geodesic Acoustic Modes Associated with Two-Stream-like Instabilities in Tokamak Plasmas.

An unstable branch of the energetic geodesic acoustic mode (EGAM) is found using fluid theory with fast ions characterized by their narrow width in energy distribution and collective transit along field lines. This mode, with a frequency much lower than the thermal GAM frequency ω_{GAM}, is now confirmed as a new type of unstable EGAM: a reactive instability similar to the two-stream instability. The mode can have a very small fast ion density threshold when the fast ion transit frequency is smaller than ω_{GAM}, consistent with the onset of the mode right after the turn-on of the beam in DIII-D experiments. The transition of this reactive EGAM to the velocity gradient driven EGAM is also discussed.

[Experimental study on ergonomical color matching design of virtual crew cabin layout in manned spacecraft].

Objective. To approach general principles of color matching for crew module layout and to provide its ergonomical evaluation with basic data. Method. First, according to some ergonomic rules a virtual reality experimental system was set up, then 64 subjects of different ages and with some background of spaceflight were offered a color matching example according to their own choice in advance. Finally, all the hues, saturations, and lightnesses of the selected colors and their total number were statistically analyzed by SPSS 8.0 software. Result. After choosing the colors for items (standard cabinets, floor, handrails, supports and etc.) in the crew cabin, the mean kinds of color hue matching in the cockpit was 5. In addition, above half of subjects endorsed the example colors but its saturation and lightness were a little higher than those of the example every time. Although its distribution was discrete, there still was a common agreement on color matching (about 50%). Conclusion. When the color matching of crew module in long time flight was ergonomically designed, generally, cool and warm hues should be taken into consideration, and their total number need be controlled to be under 5 so as to satisfy human psychological characters.

[DNA content analysis and prognostic evaluation of thymoma].

To assess the prognostic value of DNA content, we performed flow cytometric studies using paraffin-embedded archiaval material from 52 patients who underwent surgical resection due to thymoma from 1961 to 1989. The results showed clinical stage and DNA content were prognostic factors independent of each other (P = 0.034 and P = 0.026). The 5- and 10-year survival rates of the patients with diploid (100% and 98%) were better than those of aneuploid (85% and 44%) (P < 0.01). The aneuploid patients with DI (DNA Index) < 1.2 had more favorable 5-year survival rate (100%) than those with DI > 1.2 (74.1%) (P < 0.01). Pathohistological type, myasthenia gravis and PI were not related to prognosis (P > 0.05). The DNA content and PI of the three recurrent thymomas which were all aneuploid had no statistical variation between two operations (P > 0.05).