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Objective:To explore the value of 5G-based robotic remote ultrasound diagnosis system in musculoskeletal joint injuries.Methods:From March to December 2020, 58 volunteers at a training base who felt musculoskeletal pain or paresthesia were selected and performed both robotic remote ultrasound (remote ultrasound group) and conventional ultrasound (portable ultrasound group). The two types of examinations were compared, the consistency of the two diagnosis results was analyzed by the Kappa test, and the the difference of the diagnosis results was compared by McNemar test.Results:Among the 58 volunteers, 40 cases were positive by both methods and 11 volunteers had 2-3 positive results. There were 59 positive results in the remote ultrasound group and 64 positive results in the portable ultrasound group. The positive rate of the examination sites from high to low was knee joint>foot and ankle joint >hand and wrist joint >shoulder joint>elbow joint, calf and hip. The diagnosis results of the two groups were in good consistency (Kappa=0.782, P<0.001), and there was no statistically significant difference in the diagnosis results between the two groups (χ 2=3.2, P=0.063). Five more diseases with positive results were detected in the portable ultrasound group: 1 meniscus injury, 1 medial collateral ligament injury, 1 soft tissue injury around the metatarsal, 1 biceps tendinitis with effusion and 1 cubital ulnar nerve subluxation. Conclusions:The 5G-based robotic remote ultrasound system has good consistency with conventional ultrasound in the diagnosis of musculoskeletal injures. It can be applied to the ultrasound diagnosis of musculoskeletal joint injuries in remote areas.
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Objective To investigate the clinical application value of contrast-enhanced ultrasound (CEUS) in hepatic artery thrombosis (HAT) after pediatric liver transplantation. Methods Clinical data of 126 pediatric recipients undergoing liver transplantation were retrospectively analyzed. The incidence of HAT after pediatric liver transplantation was summarized. Color Doppler ultrasound and CEUS manifestations of HAT were compared. Results According to color Doppler ultrasound, 17 cases were highly suspected with HAT. Nine cases were highly suspected with HAT by CEUS, who were subsequently confirmed by CT angiography (CTA) or surgery. CEUS manifestations of HAT showed that hepatic artery was not seen surrounding the portal vein during the arterial phase or even portal venous phase. Hepatocyte necrosis occurred in 4 patients with HAT, and no perfusion of intrahepatic contrast agent was observed on CEUS. Conclusions CEUS yields high clinical application value in the diagnosis of HAT after pediatric liver transplantation. It has significant advantages compared with traditional CTA, which could be widely applied in clinical practice.
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Objective To evaluate the application value of quantitative parameters of contrast-enhanced ultrasound (CEUS) in evaluating the donor liver from donation after brain death (DBD). Methods Clinical data of 25 DBD donor livers and 10 healthy adult livers were retrospectively analyzed. CEUS examinations of DBD donor livers and healthy livers were collected. Quantitative parameters included the area under curve (AUC), maximum intensity (Imax), time to peak (TTP) and mean transit time (mTT), etc. Results Among 25 cases of DBD donor livers, 23 cases showed normal enhancement pattern, and the other 2 cases presented with abnormal enhancement pattern. Compared with the control group, the AUC, Imax and mTT values of DBD donor livers were significantly decreased (all P < 0.05). Conclusions CEUS quantitative parameters can be effective means to evaluate the micro-perfusion of DBD donor livers.
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Objective To investigate the safety and efficacy of radiofrequency ablation (RFA) combined with extracting blood from hemangiomas guided with CEUS for treating hepatic cavernous hemangiomas (HCH).Methods Data of 55 patients with 77 lesions of HCH underwent CEUS guided RFA combined with extracting blood from hemangiomas during January 2010 to December 2016 were retrospectively analyzed.Conventional ultrasound and CEUS were performed before therapy,in order to obtain the size and blood supply information of lesions,also performed immediately after treatment and 3 months later to calculate the volume of hemangiomas and the rate of hemangiomas after the treatment,as well as the rate of non-blood supply 3 months after the treatment.Then statistical analysis was done.Results The mean operation time was (31.53±15.89)min,and the blood extracting from hemangiomas was (135.36± 68.13)ml.There was positive correlation between the volume of hemangiomas before treatment and the blood extracting from hemangiomas (r=0.722,P＜0.05).No serious complication occurred among 55 cases,while mild complications happened in 9 cases (9/55,16.36 ％).The volume of hemangiomas decreased immediately and 3 months after treatment (both P＜0.05),and the rate of hemangiomas reducing was (48.76±32.58) ％ and (22.37±35.73) ％,respectively.The rate of non-blood supply 3 months after treatment was 96.10％ (74/77).Conclusion CEUS-guided RFA combined with extracting blood from hemangiomas is an effective and safe method,which has potential to become a first-line therapy.
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Objective To explore the effects of ICU admission time management on the prognosis of critically ill patients. Methods A total of 449 patients in ICU were selected and divided into experimental group (229 patients and 80 nurses) and control group (220 patients and 81 nurses). The experimental group was given ICU admission time management, and the control group was given routine nursing and grading nursing. The prognostic data including the cure rate, mortality and the incidence of complication were analyzed retrospectively. Results The scores of ICU early warning, critical patient care assessment, arrhythmia identification, intracavitary pressure monitoring and application, critically ill patients′communication factors and assessment of anxiety and depression were 50.00%(40/80), 51.25%(41/80), 48.75%(39/80), 47.50%(38/80), 48.75%(39/80), 46.25%(37/80) in experimental group, and those in control group were 7.41%(6/81), 6.17%(5/81), 9.88%(8/81), 8.64%(7/81), 7.41%(6/81), 6.17%(5/81), there were significant differences(χ2=29.42-40.07, P<0.01). Help role, education guidance, management ability, ensure quality, work role and the total score of the nurses′ position competence dimension in experimental group were (78.23 ± 10.25), (76.15 ± 10.89), (77.06 ± 11.88), (77.85 ± 10.93), (78.54 ± 10.29), (552.96±82.58) points respectively, and those in control group were (72.23±10.21), (70.23±11.20), (70.23± 12.03), (72.36±10.44), (73.52±10.81), (503.61±84.39) points, there were significant differences (t=5.041-7.420, P<0.01). There was no significant difference in diagnosis ability and diagnostic interventions (P>0.05). The cure rate, mortality and the incidence of complication in experimental group were 91.70%(210/229), 1.31%(3/229), 6.99%(16/229) , and those in control group were 70.00%(154/220), 6.82%(15/220), 25.00%(55/220), there were significant differences (χ2=34.44, 8.85, 27.35,P<0.01). ICU stay time in experimental group was (6.18±3.16) d, and that in control group was (11.52±3.39) d, there was significant difference(t=12.273,P<0.01). Conclusions Applying continuous special management in ICU admission time can increase the cure rate and decrease the hospitalization time and the incidence of complication.
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Objective To explore the effects of ICU admission time management on the prognosis of critically ill patients. Methods A total of 449 patients in ICU were selected and divided into experimental group (229 patients and 80 nurses) and control group (220 patients and 81 nurses). The experimental group was given ICU admission time management, and the control group was given routine nursing and grading nursing. The prognostic data including the cure rate, mortality and the incidence of complication were analyzed retrospectively. Results The scores of ICU early warning, critical patient care assessment, arrhythmia identification, intracavitary pressure monitoring and application, critically ill patients′communication factors and assessment of anxiety and depression were 50.00%(40/80), 51.25%(41/80), 48.75%(39/80), 47.50%(38/80), 48.75%(39/80), 46.25%(37/80) in experimental group, and those in control group were 7.41%(6/81), 6.17%(5/81), 9.88%(8/81), 8.64%(7/81), 7.41%(6/81), 6.17%(5/81), there were significant differences(χ2=29.42-40.07, P<0.01). Help role, education guidance, management ability, ensure quality, work role and the total score of the nurses′ position competence dimension in experimental group were (78.23 ± 10.25), (76.15 ± 10.89), (77.06 ± 11.88), (77.85 ± 10.93), (78.54 ± 10.29), (552.96±82.58) points respectively, and those in control group were (72.23±10.21), (70.23±11.20), (70.23± 12.03), (72.36±10.44), (73.52±10.81), (503.61±84.39) points, there were significant differences (t=5.041-7.420, P<0.01). There was no significant difference in diagnosis ability and diagnostic interventions (P>0.05). The cure rate, mortality and the incidence of complication in experimental group were 91.70%(210/229), 1.31%(3/229), 6.99%(16/229) , and those in control group were 70.00%(154/220), 6.82%(15/220), 25.00%(55/220), there were significant differences (χ2=34.44, 8.85, 27.35,P<0.01). ICU stay time in experimental group was (6.18±3.16) d, and that in control group was (11.52±3.39) d, there was significant difference(t=12.273,P<0.01). Conclusions Applying continuous special management in ICU admission time can increase the cure rate and decrease the hospitalization time and the incidence of complication.
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Objectives@#To establish SD rat model with type 2 diabetes mellitus (DM) and concomitant chronic periodontitis (CP) and to evaluate the influence of periodontitis on the vascular lesions of type 2 diabetes rats.@*Methods@#Totally 241 clean level SD rats were randomly divided into four groups, group A (normal control, NC, n=27), group B (DM, n=34), group C (CP, n=90) and group D (DM+CP, n=90). The rats of DM group were fed with high-fat and high-sugar diet for 8 to 10 weeks, and then were multiply injected with small dose streptozotocin under the condition of ice bath. Blood sugar levels after the injection were dynamically monitored at 72 h, 1 week, 2 weeks and 4 weeks, respectively. The CP model was established by means of ligation. Bilateral maxillary first and second molars were selected and ligated using 0.2 mm orthodontic wires binding with 4-0 surgical suture soaked with Porphyromonas gingivalis (Pg) suspension. After a period of 14 weeks, all the rats were put to death. Maxillary samples were subjected to methylene blue staining to observe alveolar bone loss. Bilateral carotid artery specimens were collected. The left carotid artery specimens were used to detect the prevalence of Pg using quantitative real-time PCR. The right carotid artery specimens were used to observe pathological changes.@*Results@#Blood sugar levels of rats in group B and D increased and changed sharply after Streptozotocin injection with in 1 week. Symptoms of 'more drink, more food and body weight loss’ appeared. The fasting blood glucose (FBG) was more than 7.8 mmol/L and (or) the random blood glucose (RBG) was more than 17.8 mmol/L. Both FBG and RBG became stable after 2 to 3 weeks. Levels of HbA1C in group B and D ([7.32±0.45]%, [9.41±0.45]%) were significantly higher than that of group A ([4.02±0.45]%) (P<0.01). Rats of group D were observed the most severe bone loss showing wider interdental space and furcation involvement. Pathological results of carotid artery tissues of group D showed the worst lesions including thinning and calcification of vessel walls, and breaking down or disappearance of elastic fibers. The prevalences of DNA of Pg in groups of A, B, C and D were 3/7, 3/7, 6/7 and 7/7, respectively. The bacteria numbers detected by quantitative real-time PCR in groups C and D were significantly higher than that of groups A and B (P<0.01).@*Conclusions@#Rat model of type 2 DM with periodontitis was successfully established in the present study. Carotid artery specimens from DM+CP model rats showed typical vascular lesions such as calcification and fiber disorders. Pg was found in all carotid specimens and the highest bacteria numbers were detected in the composite model rats. The Pg might play a role in the progress of diabetes vascular lesions.
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<p><b>OBJECTIVE</b>This study aimed to establish a SD rat model of chronic periodontitis (CP) merged with hyperlipidemia (HL), perform periodontal treatment, detect the expression of partial C-reactive protein (CRP) and Porphyromonas gingivalis (P. gingivalis) in the rat carotid artery, and explore the relationship between periodontitis and atherosclerosis.</p><p><b>METHODS</b>SD rats were randomly divided into three groups: control group (A), HL group (B), and CP+HL group (C). Group C rats were divided into natural process group (C1), scaling and root planning group (C2), and tooth extraction group (C3). Group C2 rats were randomly divided into C2-1 (scaling and root planning group) and C2-2 (scaling and root planning+minocyline+systemic antibiotics group). Group C3 rats were randomly divided into C3-1 (tooth extraction group) and C3-2 (tooth extraction+systemic antibiotic group). One rat from group B was randomly selected and sacrificed after 15 weeks. Subsequently, the carotid vascular tissue was collected for oil red O staining. Modeling was successful when foam cell formation was observed. Periodontal treatments were conducted twice, and euthanasia was performed after the experiment. Moreover, double-carotid artery bifurcation was carried out to detect the expression of CRP and P. gingivalis. Immunohistochemical and 16sRNA semiquantitative methods were used to detect the CRP expression and the relative contents of P. gingivalis, respectively.</p><p><b>RESULTS</b>Immunohistochemical results showed that the CRP-positive expression in groups B and C was significantly higher than that in group A (P<0.05). The CRP-positive expression in other group C rats were significantly lower than that in group C1 (P<0.05). The CRP-positive expression in group C2-2 was the lowest among the groups (P<0.05). The relative quantity of P. gingivalis in group C1 was the highest and significantly higher than that in groups A and B (P<0.05). The relative quantities of P. gingivalis in groups C2-1, C2-2, C3-1, and C3-2 were significantly lower than that in group C1 (P<0.05), and the quantity in group C3-2 was the lowest (P<0.05).</p><p><b>CONCLUSIONS</b>Rats with CP associated with HL will increase the CRP expression and oral bacteria quantity on carotid artery, and lesions will gradually aggravate. Interventions, such as periodontal basic treatment and tooth extraction, could improve carotid artery lesions. The basic treatment with local and systemic anti-inflammatory drugs exerts the most satisfactory effect on local CRP expression. Tooth extraction with antibiotics is an effective method on reducing oral bacteria in carotid artery. Periodontal basic treatment associated with local and systemic antiflammatory drugs can obviously improve the effect. .</p>
Subject(s)
Animals , Rats , Anti-Bacterial Agents , Therapeutic Uses , Atherosclerosis , C-Reactive Protein , Carotid Arteries , Chronic Periodontitis , Porphyromonas gingivalis , Rats, Sprague-Dawley , Root Planing , Tooth ExtractionABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of tooth extraction with antibiotics on atherosclerosis, and to examine the expression of serum interleukin 6(IL-6) and the pathological changes of the carotid artery in chronic periodontitis(CP) rats with or without atherosclerosis(As).</p><p><b>METHODS</b>A total of 44 SD rats were randomly divided into four groups, group A(normal control), group B(As), group C(CP), group D(CP+As). After model establishment, group C and group D were randomly divided into group C1/D1 (tooth extraction) and group C2/D2(tooth extraction with antibiotics) according to random number table and received the corresponding oral intervention treatment respectively. Serum IL-6 levels were determined by enzyme linked immunosorbent assay(ELISA) respectively one week before the intervention, one week after the first intervention, one, three, five weeks after the second intervention. The pathological changes of the carotid artery were accessed under light microscope.</p><p><b>RESULTS</b>At all sampling time points, the levels of serum IL-6 in group B, C, D were higher than that of group A, with group D1 being increased most obviously, significantly higher than that of group A(P< 0.001). One week after the second intervention, the content of IL-6 in group C and group D peaked[C1(127.0 ± 29.9) ng/L, C2: (120.6 ± 23.1) ng/L, D1: (175.1 ± 50.8) ng/L, D2: (160.5 ± 37.7) ng/L], and was significantly higher than that of group B[B: (43.4 ± 7.5) ng/L,P<0.001]. Then they all had varying degrees of decline, 5 weeks after the second intervention, group C1 and D1 were still higher than that of group B, but group C2 and D2 were lower than that of group B. At all sampling time points, the levels of serum IL- 6 in group C2/D2 were lower than those in group C1/D1, 5 weeks after the second intervention the difference was most obvious and statistically significant(P<0.001). Pathology showed that the carotid artery wall in group A was normal. The carotid artery wall was thickened in group B, inflammatory cells and foam cells could be seen, and elastic fibers disordered. The carotid artery wall in group C1 was uneven, foam cells and a small amount of inflammatory cells were visible, and elastic fiber disordered. Obvious thickening was not seen in the carotid artery wall of group C2, a small amount of foam cells and inflammatory cells were found, and elastic fiber mildly disordered. The carotid artery wall in group D1 was obviously uneven, calcium salt deposits were visible in the artery wall, a large amount of inflammatory cells and foam cells could be found, and elastic fiber disordered. Obvious thickening was not seen in the carotid artery wall of group D2, a small amount of inflammatory cells and a large amount of foam cells could be seen, and elastic fiber disordered.</p><p><b>CONCLUSIONS</b>Periodontitis and hyperlipidemia could increase the level of serum IL- 6 and the risk of the As. In chronic periodontitis rats with or without atherosclerosis, when periodontal inflammation was not controlled, tooth extraction may increase the risk of the As. At the time of tooth extraction, giving the anti-inflammatory treatment can reduce the risk to a certain extent.</p>
Subject(s)
Animals , Humans , Rats , Anti-Bacterial Agents , Pharmacology , Aorta , Chemistry , Pathology , Atherosclerosis , Blood , Carotid Arteries , Metabolism , Pathology , Chronic Periodontitis , Blood , Foam Cells , Pathology , Hyperlipidemias , Blood , Interleukin-6 , Blood , Random Allocation , Rats, Sprague-Dawley , Tooth ExtractionABSTRACT
Objective To investigate the characteristics of infection and risk factors after pediatric living donor liver transplantation (PLDLT).Method Form April 2005 to April 2014 the clinical data of 45 cases of PLDLT in General Hospital of Chinese People's Armed Police Forces were retrospectively investigated,and the difference between the patients after PLDLT with infection and those without infection was analyzed.Result Eighty-four infections occurred in 27 (60.0％) of 45 patients,including 25 cases of bacterial infections,14 cases of viral infections,and 3 cases of candida albicans infections.Most infections occurring within 3 months after PLDLT have been found to be caused by bacteria,viruses and fungi.The trough level of tacrolimus (Tac) was in target therapeutic window in 16/20 infected patients and more than 10 ng/mL in 4/20 infected patients within 3 months after PLDLT,and there were 12/16 infected patients with the trough level of Tac of more than 10 ng/mL 3 months post-PLDLT,with the difference being significant (P＜0.05).Multivariate analysis revealed that post-transplant infection was significantly related with the factors as weight＜10 kg,age ＜12 months,biliary intestinal anastomosis,pediatric end-stage liver disease (PELD) score,ChildPugh score,total bilirubin,blood loss per kg body weight and graft to recipient weight ratio (GRWR).Logistic regression analysis suggested that PELD score was independent risk factor of infection after PLDLT.Conclusion The infection after PLDLT has their special characteristics.The proper irnmunosuppressive protocol and control of above risk factors are helpful to decrease the incidence of infection after PLDLT.
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Objective To study the diagnosis,prophylaxis and treatment of splenic artery steal syndrome (SASS),and to evaluate their clinical outcomes in recipients who underwent orthotopic liver transplantation (OLT).Methods 1 385 consecutive patients who suffered from liver cirrhosis and had undergone OLT in our hospital between Jan,2004 and Dec,2013 were studied.We hypothesized that patients were at risk of SASS when the calibre of the splenic artery (SA) was 1.5 times larger than the common hepatic artery (CHA) together with splenomegaly (318 patients,23.0％).Further surveillance with Doppler ultrasound (DUS) was carried out immediately at CHA reperfusion during operation.When a sluggish peak systolic velocity (PSV) ＜ 30 cm/s or no flow was detected in a patent hepatic artery,prophylactic SA banding (SAB) was considered.127 patients (39.9％) who fulfilled these criteria were recruited to the intervention group to undergo SAB.Eventually,patients who developed SASS were treated with coil-embolization of the SA (SAE),re-anastomosis of the HA to aorta (HTA),ligation of SA (SAL) or splenectomy (SPT),or retransplantation.Results SAB resulted in immediately increase in the mean PSV of the HA from 19.3 ±5.5 cm/s to 45.9 ± 9.1 cm/s (P ＜ 0.05),and resistance index (RI) of the HA rehabilitated to reasonable levels (0.5 ～0.8),without any HA or biliary related complication in all the 127 patients.17 patients in the control group were identified to have SASS (8.9％).5 of these 17 patients required emergency treatment by coil-embolization.Of the remaining 12 patients,11 who developed hepatic artery thrombosis secondary to SASS required to undergo embolectomy or thrombolysis followed by HTA (4 patients),SAL (3 patients),SPT (5 patients).Three of these patients finally required re-OLT.All these patients obtained acceptable results by these salvage strategies,except 2 out of the 12 patients who died from liver failure.Conclusions SASS is an important but it is often and under-diagnosed cause of graft ischemia after OLT.Prophylactic SAB should be introduced to patients at risk of developing SASS in order to obtain satisfactory results.Coil-embolization of SA shortly after diagnosis is an effective salvage intervention to prevent further progression to develop devastating consequences.
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Objective To analyse our clinical experience in pediatric living donor liver transplantation (PLDLT).Methods The clinical data of 45 patients who underwent PLDLT in our hospital from April 2005 to April 2014 were retrospectively studied and their preoperative,intraoperative and postoperative data were analyzed.Results All donors recovered well.The graft to recipient weight ratio (GRWR) ranged from 1.0％ ～ 6.4％ (2.5％ ± 1.2％).Size reduction of graft were performed in 2 patients.An interposition venous conduit from the confluence of the native right and left portal vein (PV) to the graft PV was carried out in 1 patient,venous grafts for revascularization of the tributaries of the middle hepatic vein from segment Ⅴ and Ⅷ were used in 3 patients,and a venous patch for revascularization of the left hepatic vein was used in 2 patients.Hepatic artery re-reconstruction was performed in 3 patients after hypoperfusion was detected on intraoperative Doppler ultrasound.The postoperative complications included acute rejection (n =2),vascular complications (n =7),biliary complications (n =11),and infectious complications (n =27).The 1-,2-and 5-year survival rates were all 84.4％.Seven of 45 recipients died within one year post transplantation,with 3 patients who died of vascular complications,and 4 patients who died of infection.The differences in age [(50.8 ± 49.8) months vs (12.6 ± 14.9) months],body weight [(16.2 ± 10.5) kg vs (7.3 ± 1.7) kg],serum total bilirubin [(177.0 ± 126.5) μmol/L vs (301.9 ± 110.6)μmol/L],Pediatric end-stage liver disease (PELD) score (16.1 ± 12.1 vs 26.2 ± 11.3) and GRWR (2.2％ ± 0.8％ vs 4.2％ ± 1.6％) between the survival and the dead groups were significant (P ＜ 0.05).Conclusions PLDLT is an effective method to treat children with end-stage liver disease.Using a multidisciplinary approach in the preoperative management,excellent surgical techniques,and proper postoperative management are extremely helpful to improve postoperative survival rate.
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Objective TostudythevalueofordinarycolorDopplerflowimaging(CDFI)inthe diagnosis of hepatic artery thrombosis (HAT)in early stage after pediatric liver transplantation (PLT).Methods Clinicaldataof55childrenundergoingPLTintheGeneralHospitalofChinesePeople'sArmed Police Forces from April 2005 to May 2014 were analyzed retrospectively. Conventional hemodynamic monitoring was performed in all cases in the early stage after operation by CDFI. No intrahepatic arterial blood flow signal was observed by CDFI multi-angle examination and HAT was suspected. Computed tomography angiography (CTA)and surgical exploration were performed in the suspected HAT patients. The sensitivity and specificityofordinaryCDFIindiagnosingHATwerecalculatedbyChissstatisticalsoftware.Results Among the 55 PLT recipients,3 cases were suspected as HAT by CDFI,including 2 cases of HAT in the main hepatic artery,1 cases of HAT in the right hepatic artery. All cases were confirmed by CTA or surgical exploration.The incidence of HAT was 5% (3/55 ). The sensitivity and the specificity of CDFI in diagnosing HAT after PLTwereboth1.0,andfalsepositiveratewas0.Conclusions OrdinaryCDFIisthepreferredandmain method for hemodynamic examination after PLT. The experienced sonographer for transplantation can improve the accuracy in diagnosing HAT.
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<p><b>OBJECTIVE</b>To investigate the effect of periodontal mechanical treatment on serum interleukin-6 (IL-6) and carotid artery matrix metalloproteinase (MMP)-2 and MMP-9 expression in chronic periodontitis (CP) SD rats with atherosclerosis (As).</p><p><b>METHODS</b>Forty-four six-week-old male SD rats were randomly divided into three groups: control group (group A), As group (group B), As+CP group(group C). According to different periodontal interventions, group C was randomly subdivided into four groups: natural process group (C1), the periodontal mechanical treatment group (C2), the periodontal mechanical treatment+ local drugs group (C3), and the periodontal mechanical treatment+local and system drugs group (C4). Each group received the appropriate treatment and periodontal interventions. Serum IL-6 levels were determined by enzyme linked immunosorrbent assay (ELISA). MMP-2 and MMP-9 levels in the proximal aorta were examined by immunohistochemistry.</p><p><b>RESULTS</b>The gray value of MMP-2 and MMP-9 was basically the same in all groups. Compared with group A, the gray value of MMP-2 and MMP-9 of group B and C were decreased. C1 group showed the formation of atherosclerotic plaque and fibrous cap. Compared with group B (126.4 ± 2.0, 124.8 ± 2.8) , the gray value of group C1 (101.3 ± 2.4, 101.2 ± 4.1) was significantly weaker (P < 0.05). The staining depth of MMP-2 and MMP-9 of groups C1, C2, C3 and C4 were sequentially decreased, and the differences of gray value were statistically significant(P < 0.05). The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that of group A (P < 0.01). The levels of serum IL-6 in groups C2, C3, and C4 increased gradually and reached the peak 5 weeks after the establishment of model (P < 0.001). After that, the levels of serum IL-6 decreased gradually and was lower than baseline. The levels of serum IL-6 in groups C3 and C4 were significantly lower than that in group C2 7 weeks after the establishment of model(P < 0.01).</p><p><b>CONCLUSIONS</b>In rats with periodontitis and cardiovascular diseases, chronic periodontal inflammation may significantly increase the severity of As and promote the formation of atherosclerotic plaque. Mechanical periodontal therapy may cause short-term systemic inflammation and then reduce vascular inflammation in long term.With supplement use of local and systemic antibiotics, the mechanical periodontal therapy may get the vascular disease and systemic inflammation improved.</p>
Subject(s)
Animals , Male , Rats , Atherosclerosis , Carotid Arteries , Metabolism , Chronic Periodontitis , Metabolism , Therapeutics , Inflammation , Interleukin-6 , Matrix Metalloproteinase 2 , Matrix Metalloproteinase 9 , Periodontitis , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To establish chronic periodontitis model in SD rats, and to investigate the effect of oral intervention on atherosclerosis.</p><p><b>METHODS</b>Fifty male SD rats were randomly divided into three groups, group A (normal control), group B (atherosclerosis,As) and group C (chronic periodontitis, CP). Group C was further divided into group C1 (natural process), group C2 (simple mechanical treatment), group C3 (systemic antibiotics), group C4-1 (teeth extraction) and group C4-2 (teeth extraction+systemic antibiotics), each group consisted of 7 rats. Every group received oral intervention. Serum interleukin (IL)- 6 levels were detected in five different time points (1, 3, 5, 7, 9 weeks after a successful modeling) by enzyme linked immunosorbent assay. All animals were killed after 24 weeks. Matrix metalloproteinase (MMP)- 2, 9 in the proximal aorta was detected by immuno histochemistry.</p><p><b>RESULTS</b>The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that in group A (P < 0.01). Levels of serum IL-6 were increased gradually in each intervention group (C2, C3, C4-1, C4-2) and reached its peak at 5 weeks after modeling [C2:(62.3 ± 14.3) ng/L, C3:(58.2 ± 8.7) ng/L, C4-1:(127.0 ± 29.9) ng/L, C4-2:(120.6 ± 23.1) ng/L]. Compared with group B, group C4- 1 and C4- 2 increased most significantly (P < 0.01). Levels of serum IL- 6 decreased gradually. Eventually, group C2 [(28.6 ± 8.1) ng/L], C3 [(40.8 ± 15.1) ng/L] and C4-2 [(32.7 ± 11.1) ng/L] were significantly lower than group B (P < 0.05), and in group C2 IL- 6 was the lowest. Although levels of serum of IL-6 significantly decreased in group C4-1 [(72.8 ± 16.4) ng/L], but remained the highest. Immunohistochemistry showed that MMP-2, 9 were expressed in group B, C1 and C4-1, and significantly higher than in group A (183.0 ± 2.0, 181.3 ± 2.0), the gray value differences were statistically significant (P < 0.01). Group C4-1 (123.1 ± 2.9, 121.0 ± 3.2) was the strongest, group B (126.4 ± 2.0, 124.8 ± 2.8) and C1 (140.0 ± 2.2, 139.7 ± 3.2) were decreased (P < 0.01). While group C2(169.3 ± 3.4, 169.7 ± 2.3), C3 (149.0 ± 1.7, 145.1 ± 2.5) and C4-2 (157.7 ± 1.2, 155.8 ± 2.7) were significantly lower than group C1 (P < 0.01), and group C2 was close to normal.</p><p><b>CONCLUSIONS</b>Periodontitis could increase the risk of atherosclerosis in rats with chronic periodontitis. Periodontal mechanical treatment and teeth extraction may increase the risk of As in the short time. However, the risk would gradually reduce in a long time.</p>
Subject(s)
Animals , Male , Rats , Anti-Bacterial Agents , Pharmacology , Atherosclerosis , Carotid Arteries , Chronic Periodontitis , Interleukin-6 , Metabolism , Matrix Metalloproteinase 2 , Metabolism , Matrix Metalloproteinase 9 , Metabolism , Periodontitis , Rats, Sprague-Dawley , Tooth ExtractionABSTRACT
<p><b>OBJECTIVE</b>The aim of this study is to investigate the effects of serum high-sensitivity C-reactive protein (hsCRP) and the pathological changes in the carotid artery after periodontal mechanical therapy with local and systemic drugs in SD rats with chronic periodontitis (CP) associated with atherosclerosis (As).</p><p><b>METHODS</b>Thirty-five SD rats were randomly divided into two groups: control group (group A) and CP+As group (group B). Group B was further divided into the natural process group (B1), the periodontal mechanical treatment group (B2), the periodontal mechanical treatment plus local drugs group (B3), and the periodontal mechanical treatment plus local and systemic drugs group (B4). Each group comprised seven rats. Serum hsCRP levels were evaluated at baseline 1 week after the first periodontal therapy and 1, 3, and 5 weeks after the second periodontal therapy by enzyme linked immunosorbent assay (ELISA). The pathological lesion in the carotid artery plaque was stained with hematine and eosin.</p><p><b>RESULTS</b>The levels of serum hsCRP in group B1 increased gradually as time passed and became significantly higher than that of the other groups five weeks after periodontal therapy (P < 0.001). The levels of serum hsCRP in groups B2, B3, and B4 increased gradually and reached the peak 1 week after the second periodontal therapy. After that, the levels of serum hsCRP decreased gradually but were still higher than that of group A (P < 0.05). The levels of serum hsCRP in groups B3 and B4 were significantly lower than that in group B2 3 and 5 weeks after the second periodontal therapy (P < 0.001). Histologic sections revealed increased foam cell infiltration and disordered and destructed elastic fibers in groups B1 and B2. The thickness of the blood vessels in groups B3 and B4 was more uniform than that in groups B1 and B2. The elastic fibers in groups B3 and B4 were lined up in order.</p><p><b>CONCLUSION</b>Direct periodontal mechanical treatment results in acute, short-term, systemic inflammation and might increase the risk of atherosclerosis in SD rats. However, the levels of serum hsCRP decreased gradually 3 to 5 weeks after therapy. With periodontal mechanical treatment, the benefits of local and systemic drugs are associated with improvement in atherosclerotic lesion progression.</p>
Subject(s)
Animals , Male , Rats , Atherosclerosis , C-Reactive Protein , Carotid Arteries , Chronic Periodontitis , Rats, Sprague-DawleyABSTRACT
Objective To explore the diagnostic value of parametric imaging of contrast-enhanced ultrasound(CEUS) on recurrent hepatocellular carcinoma after liver transplantation.Methods CEUS images of 41 recurrent hepatocellular carcinoma after liver transplantation was analyzed by Sonoliver CAP software.The color code image,curve image and quantitative parameter of DVP of each recurrence lesion was recorded,then typed and analyzed statistically.Results The DVP patterns were classified into 3 types,they were washed out types,non-washed out types and negative types.The washed out types,non-washed out types and negative types on color code image and curve image of DVP were 70.73％ (29/41),24.39％ (10/41),4.88％ (2/41) and 63.41％(26/41),34.15％ (14/41) and 2.44％ (1/41) respectively.The maximum intensity,rise time,time to peak of the recurrence lesion and the surrounding liver parenchyma were (149.98± 65.29) ％,(12.32 ± 5.83)s,(13.01 ±6.07)s and (100±0.00)％,(26.10± 10.81)s,(29.69± 11.60)s respectively,and showed statistical differences (P ＜0.05).Conclusions The difference of blood perfusion between the recurrence lesion and the surrounding liver parenchyma can be displayed by DVP's dynamic,direct and quantitative imaging,which can be used to provide valuable information about the detection of intrahepatic lesion of recurrence after liver transplantation.
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Objective To evaluate the feasibility of real time elastosonography in estimating the characteristic of nodules in resected hepatocirrhosis specimens.Methods Thirty-eight reseeted hepatocirrhosis specimens underwent elastosonography.The nodules that have drawn attention were performed elastosonography through rhythmic pressing and releasing the probe by manual form on the liver.The hepatic strain on the region of interest was shown by chromatic scale.To compare nodules rigidity with surrounding hepatic tissues, hepatocirrhosis nodules were classified into hard nodules, medium rigidity nodules, mixture of hard and soft nodules, and soft nodules.All nodules were confirmed by pathology.Results Forty-four nodules of 38 hepatocirrhosis exemplar received real time elastosonography.Of 44 nodules, hard nodules were 18,of which 12 (66.7%) were hepatoeellular carcinomas, 2 (11.1%) were dysplasia nodules, 4 (22.2%) were regenerative nodules.Medium rigidity nodules were 7,all were regenerative nodules.Mixture of hard and soft nodules were 11, of which 8 (72.7%) were hepatocellular carcinomas, including 4 accompanied necrotic tissue, 1 (9.1%) was dysplasia nodules accompanied necrotic tissue, the other 2 (18.2%) were regenerative nodules accompanied necrotic tissue.And soft nodules were 8, of which 4(50.0%) were necrotic nodules, 1 (12.5%) was dysplasia nodules accompanied canceration, 1 (12.5%) was hepatocellular carcinoma,2(25.0 %) were regenerative nodules.Conclusions Real time elastosonography can effectively evaluate the comparative rigidity on hepatoeirrhosis nodules,and thus may have potential usefulness on estimating the characteristic of hepatocirrhosis nodules.
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Objective To probe into the value of micro-perfusion examination at the early stage after right lobe living donor liver transplantation by contrast-enhanced ultrasound(CEUS). Methods Twenty-six recipients of right lobe living donor liver transplantation received CEUS examination at 1,7,15 and 30 days respectively after operation using contrast medium SonoVue. Perfusion patterns were observed and analyzed considering operation method. Results Of 26 recipients, 15 cases showed normal perfusion patterns with normal hemodynamics; 11 cases showed abnormal perfusion patterns with abnormal hemodynamics:8 had conduit venous obstruction,4 high portal vein blood flow. The abnormal patterns was in the early arterial phase of enhancement process at the first day examination, showing hyper- and hypo- enhancement area compared with normal liver parenchyma. And the difference gradually disappeared in the subsequent examination. Conclusions Abnormal micro-perfusion patterns are highly related to abnormal inflow and outflow in the early post operation stage. The main reasons are conduit venous obstruction and excessive perfusion of portal vein. CEUS can be used as an effective method in evaluating the graft micro-perfusion.
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Objective To evaluate the value of intraoperative ultrasound on recipient with living donor liver transplantation.Methods Forty-five recipients with living donor liver transplantation were performed intraoperative ultrasound using Mylab 30 after the blood vessels were anatomized.Results Three cases of hepatic artery thrombosis,two cases of outflow occlusion,four cases of abnormal increasing of portal vein blood flow velocity and hemodynamics,and one case of portal vein anastomosis stenosis were found by intraoperative ultrasound.Conclusions Intraoperative ultrasound plays an important role for recipient in living donor liver transplantation.