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INTRODUCTION AND OBJECTIVES: Cirrhotic patients with acute variceal hemorrhage (AVH) have high short-term mortality. Established prognostic scores are seldom applicable clinically, partially because they need external validation or contain subjective variables. We aimed to develop and validate a practical prognostic nomogram based on objective predictors to predict prognosis for cirrhotic patients with AVH. PATIENTS AND METHODS: We enrolled 308 AVH patients with cirrhosis from our center as the derivation cohort to develop a new nomogram using logistic regression and validated it in cohorts of patients from Medical Information Mart for Intensive Care (MIMIC) III (n = 247) and IV (n = 302). RESULTS: International normalized ratio (INR), albumin (ALB) and estimated glomerular filtration rate (eGFR) were identified as predictors for inpatient mortality and a nomogram was constructed based on them. The nomogram discriminated well in both derivation and MIMIC-III/-IV validation cohorts with the area under the receiver operating characteristic curves (AUROCs) of 0.846 and 0.859/0.833, respectively and showed a better agreement between expected and observed outcomes (Hosmer-Lemeshow tests, all comparisons, P > 0.05) than other scores in all cohorts. Our nomogram had the lowest Brier scores (0.082/0.114/0.119 in training/MIMIC-III/MIMIC-IV) and highest R2 (0.367/0.393/0.346 in training/MIMIC-III/MIMIC-IV) compared to the recalibrated model for end-stage liver disease (MELD), MELD-hepatic encephalopathy (MELD-HE) and cirrhosis acute gastrointestinal bleeding (CAGIB) scores in all cohorts. CONCLUSIONS: We developed a practical prognostic nomogram using easily verified indicators available in initial patient evaluation, which may serve as a reliable tool to accurately predict inpatient mortality for cirrhotic patients with AVH.
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Doença Hepática Terminal , Varizes Esofágicas e Gástricas , Humanos , Prognóstico , Nomogramas , Pacientes Internados , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/complicações , Doença Hepática Terminal/complicações , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Índice de Gravidade de Doença , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Estudos RetrospectivosRESUMO
Genomic resources remain scarce for bacteria isolated from oligotrophic caves. We sequenced the genomes of five Proteobacteria isolated from Lechuguilla Cave in New Mexico. Genome-based phylogeny indicates that each strain belongs to a distinct genus. Two Rhizobiaceae isolates possess genomic potential for the biosynthesis of acyl-homoserine lactone.
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Brazilin is an active compound of Caesalpinia sappan L. (Leguminosae), which possesses pro-apoptotic and anti-inflammation potentials depending on the specific cell type. However, it is largely unknown whether autophagy is implicated in the mechanism underlying its chemotherapeutic and anti-inflammatory effects in rheumatoid arthritis (RA). Here, we show that treatment of RA fibroblast-like synoviocytes (FLS) with brazilin results in enhanced level of autophagic flux, evidenced by accumulation of autophagosome and increased level of lipidated LC3 (LC3-II), which is mainly mediated by enhanced production of reactive oxygen species (ROS). Interestingly, long-term exposure of brazilin was able to restore cell survival against the cytotoxity, exclusively in RA FLS, but not in normal fibroblast. Importantly, such a restoration from brazilin-induced cytotoxity in RA FLS was completely abrogated after co-treatment with autophagy inhibitors including NH4Cl or chloroquine. Furthermore, we found that the pretreatment of RA FLS with brazilin reduced LPS- or TNF-induced NF-κB activation and the secretion of inflammatory cytokines in parallel with the enhanced autophagic flux. Such anti-NF-κB potentials of brazilin were drastically masked in RA FLS when autophagy was suppressed. These results suggest that brazilin is capable of activating autophagy exclusively in RA FLS, and such inducible autophagy promotes cell survival and limits inflammatory response.
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Anti-Inflamatórios/farmacologia , Artrite Reumatoide/tratamento farmacológico , Autofagia/efeitos dos fármacos , Benzopiranos/farmacologia , Fibroblastos/efeitos dos fármacos , Fibroblastos/patologia , Membrana Sinovial/citologia , Animais , Anti-Inflamatórios/química , Artrite Reumatoide/imunologia , Artrite Reumatoide/patologia , Benzopiranos/química , Caesalpinia/química , Células Cultivadas , Fibroblastos/citologia , Fibroblastos/imunologia , Humanos , Camundongos , NF-kappa B/imunologia , Células NIH 3T3 , Espécies Reativas de Oxigênio/imunologia , Membrana Sinovial/efeitos dos fármacos , Membrana Sinovial/imunologia , Membrana Sinovial/patologiaRESUMO
The aims to study the femoral offset and its relationship to femoral neck-shaft angle and torsion angle. One hundred paired (50 males and 50 females) Chinese femurs were used to measure the femoral offset, femoral neck-shaft angle and torsion angle. The data were analyzed by SPSS software. Femoral offsets were male right 44.40±4.56 mm, left 42.70±4.95 mm; female right 39.90±6.00 mm, left 38.90±6.18 mm. Femoral torsion angles were male right 6.02±10.85°, left 7.08±9.30°; female right 10.02±11.69, ° left 6.02±10.85°. Neck-shaft angles were male right 131.80±4.36°, left 134.00±4.78°; female right 132.10±5.94°, left 132.80±4.93°. There were no sexual differences in the two femoral angles (P>0.05) while there was a significant sexual difference in the femoral offset (P<0.01). The differences between left and right femoral offset and neck-shaft angle were significant (P<0.01). Clinically, our results indicate that FO could be obtained using the regression equation when the torsion angle and/or neck-shaft angle is measured.
El objetivo fue estudiar el desplazamiento femoral y su relación con el ángulo cuello-diáfisis femoral y el ángulo de torsión. Se utilizaron 100 pares de fémures (50 hombres y 50 mujeres) y se tomaron las medidas del desplazamiento femoral, ángulo cuello-diáfisis femoral y ángulo de torsión. Los datos fueron analizados con el software SPSS. El desplazamiento femoral en los hombres fue 44,40±4,56 mm en el lado derecho y 42,70±4,95 mm en el lado izquierdo, y en las mujeres, fue de 39,90±6,00 mm y 38,90±6,18 mm para el lado derecho e izquierdo, respectivamente. El ángulo de torsión femoral del lado derecho en los hombres fue 6,02±10,85° y 7,08±9,30° del izquierdo; mientras que en las mujeres, fue de 10,02±11,69° y 6,02±10,85° para el lado derecho e izquierdo, respectivamente. Los ángulos cuello-diáfisis fueron 131,80±4,36° en el lado derecho, y 134,00±4,78° en el izquierdo, para los hombres, mientras que en las mujeres fueron de 132,10±5,94° en el lado derecho y 132,80±4,93° en el izquierdo. No hubo diferencias según sexo en los dos ángulos femorales (P>0,05), mientras que si hubo una diferencia significativa en el desplazamiento femoral (P<0,01). Las diferencias entre el desplazamiento femoral izquierdo y derecho, y el ángulo cuello-diáfisis fueron significativas (P<0,01). Clínicamente, nuestros resultados indican que el desplazamiento femoral podría obtenerse utilizando la ecuación de regresión cuando se mide el ángulo de torsión o el ángulo cuello-diáfisis.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Fêmur/anatomia & histologia , Anormalidade TorcionalRESUMO
Here, we report the whole-genome sequences and annotation of five oligotrophic bacteria from two sites within the Lechuguilla Cave in the Carlsbad Caverns National Park, NM. Three of the five genomes contain an acyl-homoserine lactone signal synthase ortholog (luxI) that is involved in cell-to-cell communication via quorum sensing.
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Here we report the whole-genome sequences of three endophytic bacteria, Enterobacter sp. strain DC1, Enterobacter sp. strain DC3, and Enterobacter sp. strain DC4, from root tubers of the yellow yam plant, Dioscorea cayenensis. Preliminary analyses suggest that the genomes of the three bacteria contain genes involved in acetoin and indole-3-acetic acid metabolism.
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Enterobacter sp. strain SST3 is an endophytic bacterium isolated from Saccharum spp. Here we present its annotated draft genome that may shed light on its role as a bacterial endophyte of sugarcane. To our knowledge, this is the first genome announcement of a sugarcane-associated bacterium from the genus Enterobacter.