Ultrasonography predicts the results of labial salivary gland biopsy in patients with suspected Sjögren's syndrome: a matrix risk model.

OBJECTIVE: Although a positive result of labial salivary gland biopsy (LSGB) is critical for the diagnosis of Sjögren's syndrome, rheumatologists prefer assessing the non-invasive objective items and hope to learn the predicted probability of positive LSGB before referring patients with suspected Sjögren's syndrome to receive biopsy. This study aimed to explore the predictive value of combined B-mode ultrasonography (US) and shear-wave elastography (SWE) examination on LSGB results. METHODS: A derivation cohort and later a validation cohort of patients with suspected Sjögren's syndrome were recruited. All participants received clinical assessments, B-mode US and SWE examination on bilateral parotid and submandibular glands before LSGB. Positive LSGB was defined by a focus score ⩾1 per 4 mm2 of glandular tissue. RESULTS: In the derivation cohort of 91 participants, either the total US scores or the total SWE values of four glands significantly distinguished patients with positive LSGB from those with negative results (area under the curve (AUC) = 0.956, 0.825, both p < 0.001). The positive predictive value (PPV) was 100% in patients with total US scores ⩾9 or with total SWE values ⩾33 kPa. The negative predictive value (NPV) was 100% in patients with total US scores <5, but 68% in patients with total SWE values <27 kPa. A matrix risk model was derived based on the combination of total US scores and total SWE values. Patients can be stratified into high, moderate, and low risk of positive LSGB. In the validation cohort of 52 participants, the PPV was 94% in the high-risk subpopulation and the NPV was 93% in the low-risk subpopulation. CONCLUSION: A novel matrix risk model based on the combined B-mode US and SWE examination can help rheumatologists to make a shared decision with suspected Sjögren's syndrome patients on whether the invasive procedure of LSGB should be performed.

Endemic Variation of H9N2 Avian Influenza Virus in China.

Forty-two H9N2 subtype AIV strains were isolated from vaccinated commercial chickens in China from 2012 to 2015. Their HA genes had nucleotide sequence homology from 86.7% to 99.7%, and similarity to the classic vaccine strain was 88.6%-92.6%. A comparison was carried out with published HA genes (410 H9 strains) and whole genomes (306 strains) isolated in China during 2012-2015. Interestingly, 99.1% (448/452) of Chinese H9N2 AIV belonged to lineage h9.4.2, and 98.5% (445/452) of the viruses belonged to h9.4.2.5. Meanwhile, 99.6% (443/445) of lineage 9.4.2.5 viruses had PSRSSR↓GLF instead of PARSSR↓GLF motifs in the HA cleavage sites; 98.2% (444/452) of HA genes showed human receptor binding associated mutation Q226L. A total of 96.8% (337/348) of the viruses had three amino-acid deletions at 63-65 in the NA stalk, associated with enhanced virulence in chickens and mice; 97.1% (338/348) of M2 proteins had the S31N mutation associated with adamantane resistance in humans. Two H9 viruses isolated in this study were highly homologous to the human-origin H9N2 virus reported in 2013. The isolates were divided into four different genotypes (U, S, V, and W). Genotype S was the major one, accounting for 94.8% (330/348). Genotypes V and W were new reassortment genotypes, with genotype W recombined with the PB2 gene originating from the new wild waterfowl-like lineage. According to the cross-HI antibody titer data, HA gene evolution, and isolation history, the isolates were divided into A, B, and C antigenic groups successively. All the antigenic group viruses were found to circulate throughout China. This study emphasizes the importance of updated vaccine and strengthened veterinary biosecurity on poultry farms and trade markets.

Nanomechanical probing of the septum and surrounding substances on Streptococcus mutans cells and biofilms.

We report a unique bio-nanomechanical behavior at the septum (Z-ring) of Streptococcus mutans-containing biofilm through in situ measurements obtained by atomic force microscopy. A distinct serrated pattern on the releasing force-displacement curves can only be observed with the use of a sharp nanosized probe tip, and this was found at the septum of S. mutans. Further investigations suggested the serrated patterns could be due to the unfolding of some sub-surface divisome proteins. Seismometer measurements were conducted at the septum by placing an ultra-sensitive atomic force microscope probe on the surface. Unique periodic vibrations were observed at the septum under various biofilm conditions. This finding suggests the possibility of remodeling of the cell wall nanostructure at the septum of S. mutans.

Capillary-tube-based micro-plasma system for disinfecting dental biofilm.

PURPOSE: A low-temperature low-energy capillary-tube-based argon micro-plasma system was applied to disinfect Streptococcus mutans-containing biofilm. MATERIALS AND METHODS: The micro-plasma system uses a hollow inner electrode that is ignited by a radio-frequency power supply with a matching network. The energy content was analyzed using optical emission spectroscopy. The micro-plasma-induced effect on a biofilm cultured for 24 or 48 h with a working distance of ≈3 mm at low temperature was evaluated. The morphologies of the treated live/dead bacteria and the produced polysaccharides after micro-plasma treatment were examined. RESULTS: Scanning electron microscopy images and staining results show that most of the S. mutans on the treated biofilm were acutely damaged within a micro-plasma treatment time of 300 s. CONCLUSIONS: The number of living bacteria underneath the treated biofilm greatly decreased with treatment time. The proposed micro-plasma system can thus disinfect S. mutans on/in biofilms.