The grades for the above four components were weighted in proportion to their importance. Thus, HE grade awarded a weighting factor of three, while the other variables were each assigned a factor of one. The HE index was defined as the total of the weighted grades, and had a possible Tipifarnib myeloid range of 0 to 23 points, i.e., HE index=(grade of mental state) �� 3+(grade of number connection test)+(grade of flapping tremor)+(grade of blood ammonia).21 Efficacy of treatment Efficacy was graded as ‘improved’, ‘unchanged’, or ‘worsened’. A decrease of HE index by at least one point was defined as ‘improved’, and increment of the HE index by one point or more was defined as ‘worsened’. Statistical analysis All data are expressed as means��SD. Statistical evaluations were performed using SAS version 6.

12 for Windows (SAS Institute Inc., Cary, NC). Statistical analyses were made using the Student’s T-test, the paired T-test, Fisher’s exact test, and the Chi-square test. This study satisfied a statistical power of 0.8. A probability level of p < 0.05 was considered to be significant throughout. RESULTS Comparison of therapeutic responses to rifaximin and lactulose Table 3 compares the therapeutic effects of rifaximin and lactulose. Mean blood levels and grades of blood NH3 significantly decreased with both rifaximin (p < 0.01) and lactulose treatment (p �� 0.01). Mean blood NH3 concentrations were similar after both forms of therapy (Fig. 1A). Mental state was significantly improved by rifaximin (1.3��0.3) and by lactulose (1.5��0.5) (p < 0.01 and p < 0.01, respectively).

Grades of flapping tremor and NCT were improved to nearly equal degrees by rifaximin and lactulose treatment (Table 3). Mean HE indexes improved both in the rifaximin group (10.0��4.2, p=0.000) and in the lactulose group (11.3��5.0, p=0.000) (Fig. 1B). No significant difference was found between the two groups in terms of the grades of HE components at any given time. Fig. 1 (A) Changes in grade of blood ammonia level with Rifaximin (solid line) or Lactulose (dotted line) treatment. Grade of blood ammonia was significantly decreased at the end of the treatment with respect to pre-treatment values in both groups (p < ... Table 3 Changes in HE Index and HE-related Parameters after Treatment Clinical efficacy At the completion of treatment, blood NH3 and HE grades improved in 25 (78.1%) and 26 (81.

3%), respectively, of the 32 patients in the rifaximin group. In the lactulose group, 13 (59.1%) of the 22 patients showed reduced blood ammonia grades and 16 cases (72.7%) improved HE grades. These group differences were not statistically Entinostat significant (Table 4). Clinical efficacy was determined using HE index improvement. Rifaximin was considered effective in 27 of 32 patients (84.4%) and lactulose in 21 of 22 patients (95.4%), which was not significantly different (p=0.315) (Table 4).