2-year survival estimation for decompensated cirrhosis patients of prognostic scoring systems.

OBJECTIVE: Prognostic models proposed for cirrhotic patients' survival have not been satisfactorily investigated in the Vietnam population, especially in the medium-term period. PATIENTS AND METHODS: In this prospective study, we enrolled a total of 904 patients admitted to Hepato-Gastroenterology Center, Bach Mai Hospital from December 2019 to November 2021 and calculated their CP, MELD, MELD-Na score, IMELD, Refit MELD, and Refit MELD-Na after 2-year follow-up to compare their survival prognosis. RESULTS: The mean age of the patients was 53.8 ±10.8 years, and males constituted 91%. Compared with the surviving group, deceased patients had statistically significant lower albumin, higher INR, serum bilirubin, and creatinine levels with higher means of all prognostic scores. RefitMELD score had the highest AUC (0.768), followed by MELD (0.766), and the lowest belonged to RefitMELDNa (0.669). CONCLUSIONS: In conclusion, deceased patients had significantly higher values of Child-Pugh score and all MELD-based scores than survival. RefitMELD is the most reliable scoring system to predict 2-year mortality in patients with decompensated liver cirrhosis.

Regulatory regions from the Brn4 promoter direct LACZ expression to the developing forebrain and neural tube.

To characterize cis-acting regulatory elements of the mouse POU-domain gene, Brain-4/Pou3F4, transgenic mouse pedigrees were generated that contained the LacZ reporter gene under the control of Brn4 5' flanking sequences. A six kilobase promoter region was identified that reproducibly directed expression of the reporter gene to the forebrain and neural tube of developing mouse embryos. Deletional analysis of this promoter region indicates that at least two positive cis-active elements can direct expression to the developing neural tube. These data characterize a transgenic promoter region that will be useful in directing expression to the developing neural tube during the ontogeny of the forebrain.

Laser light: its nature and its action on the eye.

Lasers produce a coherent, focused, monochromatic, high-energy form of light. Because laser surgery is more versatile and precise and is freer of complications than conventional surgery it has become widely accepted in ophthalmology over the past 10 years. Applications range from routine procedures in the fundus to recent, more delicate interventions in the cornea. The argon laser is the most widely used to treat extrafoveal chorioretinal diseases such as age-related macular degeneration and diabetic retinopathy; it has also been used successfully to treat glaucoma by iridectomy or trabeculoplasty. The krypton red laser is the argon laser's counterpart in the treatment of subfoveal and pigment-epithelium-related diseases. Posterior capsulotomy is the most widespread and successful intervention with the neodymium:yttrium-aluminum-garnet crystal laser; this laser is also used to cut vitreous traction bands and is increasingly used in iridectomy. Although the use of the excimer laser in corneal surgery is still largely investigational it has been shown to produce precise cuts in corneal layers for the correction of myopia or astigmatism. The variable-wavelength dye laser, capable of reaching a specific level in the retina or choroid, has offered exciting new developments, and it promises to soon be part of the ophthalmologist's armamentarium in the treatment of eye disease.