The value of ultrasonography combined with clinical features for predicting carotid imaging progression of Takayasu's arteritis: a prospective cohort study.

OBJECTIVES: To identify valuable ultrasonography findings combined with clinical markers for predicting carotid progression of Takayasu's arteritis (TAK) on imaging during a 1-year follow-up period. METHODS: From May 2016 to June 2019, 77 Chinese TAK patients with carotid artery involvement were enrolled in the present study. The patients' clinical characteristics and serological test and carotid ultrasonography results were recorded at baseline and each visit. Carotid progression was evaluated by ultrasonography every 3 months during the 1-year follow-up. Baseline clinical characteristics and ultrasonography results for predicting progression on imaging were identified. RESULTS: Sixteen (20.8%) patients presented with carotid progression on imaging during the 1-year follow-up period. The patients in the progressive group were younger (23.4±3.7 vs. 32.3±9.8 years, p<0.01) than those in the non-progressive group. At baseline, the vessel wall was thicker in the progressive group than in the non-progressive group (2.4±0.8 vs. 1.9±0.5 mm, p=0.041). Furthermore, the proportion of patients with refractory disease (87.5% vs. 16.4%, p<0.01) was higher in the progressive group than in the non-progressive group. Patients with a thickened carotid wall (≥1.9 mm), refractory disease, and younger age (≤30 years) might be at a high risk of carotid progression on imaging (75%, AUC: 0.93, sensitivity: 75%, specificity: 93.4%). CONCLUSIONS: Younger patients with early vascular structural changes at baseline as well as refractory disease seemed more likely to show carotid progression on imaging.

Prediction of cervical lymph node metastasis with contrast-enhanced ultrasound and association between presence of BRAFV600E and extrathyroidal extension in papillary thyroid carcinoma.

OBJECTIVE: This study aimed to evaluate the correlation between cervical lymph node metastasis (CLNM) and each of the ultrasound features, immunohistochemical factors, and B-type Raf (BRAFV600E) mutation. METHODS: A retrospective analysis was performed on 405 patients with single papillary thyroid carcinoma (PTC) nodules, all of whom underwent preoperative sonographic examinations, including gray-scale ultrasound, color Doppler ultrasound, and contrast-enhanced ultrasound (CEUS). All PTC patients were evaluated using 14 clinical and sonographic features, eight immunohistochemical factors, and BRAFV600E. Multivariate analyses were performed to identify the risk factors for CLNM, and an equation for CLNM was established. The diagnostic value of each modality was compared with a receiver operating characteristic (ROC) curve. RESULTS: Among the 405 PTC nodules removed surgically, CLNM was confirmed in 138 patients, whereas extrathyroidal extension was confirmed in 185 patients. Multivariate analyses indicated significant differences between CLNM and non-CLNM groups in three conventional ultrasound features (p < 0.05), whereas other sonographic features, eight immunohistochemical factors, and BRAFV600E did not indicate significant differences. A ROC curve of 0.757 in the equation exhibited a significant difference compared with the solo factors (p < 0.05 for all). Hyper or isoechoic enhancement at peak time on CEUS was associated with CLNM, whereas the presence of the BRAFV600E mutation was associated with extrathyroidal extensions although BRAF appeared to be uncorrelated with CLNM in the present study. CONCLUSION: Intensity at peak time, homogeneity, and size are the three most significant features in predicting CLNM in PTC patients, and the presence of the BRAFV600E mutation was associated with extrathyroidal extensions when PTCs showed a hyper or isoechoic enhancement at peak time in CEUS.

High-Throughput Sequencing Reveals a Potentially Novel Sulfurovum Species Dominating the Microbial Communities of the Seawater-Sediment Interface of a Deep-Sea Cold Seep in South China Sea.

In the Formosa cold seep of the South China Sea (SCS), large amounts of methane and sulfide hydrogen are released from the subseafloor. In this study, we systematically investigated the microbial communities in the seawater-sediment interface of Formosa cold seep using high-throughput sequencing techniques including amplicon sequencing based on next-generation sequencing and Pacbio amplicon sequencing platforms, and metagenomics. We found that Sulfurovum dominated the microbial communities in the sediment-seawater interface, including the seawater close to the seepage, the surface sediments, and the gills of the dominant animal inhabitant (Shinkaia crosnieri). A nearly complete 16S rRNA gene sequence of the dominant operational taxonomic units (OTUs) was obtained from the Pacbio sequencing platforms and classified as OTU-L1, which belonged to Sulfurovum. This OTU was potentially novel as it shared relatively low similarity percentages (<97%) of the gene sequence with its close phylogenetic species. Further, a draft genome of Sulfurovum was assembled using the binning technique based on metagenomic data. Genome analysis suggested that Sulfurovum sp. in this region may fix carbon by the reductive tricarboxylic acid (rTCA) pathway, obtain energy by oxidizing reduced sulfur through sulfur oxidizing (Sox) pathway, and utilize nitrate as electron acceptors. These results demonstrated that Sulfurovum probably plays an important role in the carbon, sulfur, and nitrogen cycles of the Formosa cold seep of the SCS. This study improves our understanding of the diversity, distribution, and function of sulfur-oxidizing bacteria in deep-sea cold seep.

Contrast-enhanced ultrasound (CEUS) for the diagnosis of hypoechoic hepatic hemangioma in clinical practice.

AIM: To investigate the specific findings and characteristics of real-time contrast-enhanced ultrasound (CEUS) in hypoechoic hepatic hemangioma. METHODS: A total of 101 lesions in 83 patients were included. Analysis was made of the relationship between tumor size and CEUS enhance patterns in arterial phase, portal phase and delayed phase, phase changes, echoic changes in perfusion regression stage and filling defect. RESULTS: CEUS showed a lesion detection rate of 92.7%. In regression stage, only 46.5% lesions were fully filled. Enhancement of the lesions was categorized into Pattern I, peripheral nodular enhancement and centripetal filling (68.3%); Pattern II, peripheral ring enhancement and centripetal filling (27.7%); and Pattern III, overall rapid enhancement (4.0%). The most common phase changes were "fast-in slow-out" (74.3%). More than half (61.4%) lesions were hyperechoic in regression stage. Among all the lesions, 4 (3.9%) lesions regressed to hypo-echo in portal phase and 2(2.0%) in delayed phase). The frequent enhancement in tumors >3.0 cm was of Pattern I or II, "fast-in slow-out" or "slow-in slow-out" phase change, and hyperechoic or isoechoic change in perfusion regression stage, but in those ≤3.0 cm, the enhancement was of Pattern III, "fast-in fast-out" phase change and hypoechoic change in perfusion regression stage. The differences were statistically significant (p < 0.05). The percentage of lesions with complete filling on CEUS in the larger hypoechoic hepatic hemangiomas was significantly lower than that of smaller ones (p < 0.01). CONCLUSIONS: CEUS has high diagnostic value in hypoechoic hepatic hemangiomas mainly characterized by peripheral nodular or ring enhancement, centripetal filling, and "fast-in slow-out" and "slow-in slow-out" phase changes.

Value of contrast-enhanced ultrasonography of the carotid artery for evaluating disease activity in Takayasu arteritis.

AIMS: To assess the value of contrast-enhanced ultrasonography (CEUS) for monitoring disease activity of Takayasu arteritis (TA). METHODS: TA patients were recruited in a Chinese TA clinical center from January 2016 to September 2017. The physician global assessment was used as the referential standard for disease activity. Clinical data, acute phase reactants, and CEUS scans were simultaneously recorded at baseline and after a 3-month therapy. RESULTS: A total of 84 TA patients were enrolled, and 47 (55.95%) cases were active at baseline. Macaroni sign and entire artery involvement were characteristic findings of CEUS in TA. The average vascular full thickness of the carotid artery in active TA patients was significantly higher than that in inactive patients (2.36 ± 0.86 vs. 1.79 ± 0.49 mm; p = 0.001). Severe neovascularization (grade 2) was observed in 29 active cases (61.70%) and in 9 inactive cases (24.32%) (p = 0.001). Receiver operating characteristic analysis showed that the combination of CEUS parameters (cutoff of thickness was 1.75 mm or neovascularization grade 2) and erythrocyte sedimentation rate (ESR) (cutoff of 20 mm/H) could help differentiate between active and inactive TA patients with a sensitivity and specificity of 81.1% and 81.5%, respectively. Youdon's index was 0.626. Furthermore, our study found that patients with decreased ESR and C-reactive protein (CRP) still had a progression of vascular wall inflammation at 3 months of follow-up. CONCLUSIONS: The evaluation of vascular inflammation by CEUS is more sensitive than acute phase reactants. Neovascularization can still be observed in the vascular lesion sites of those who have reached clinical remission after treatment. Thus, CEUS can be used as an alternative method to assess disease activity for TA patients.

Porphyromonas gingivalis infection accelerates intimal thickening in iliac arteries in a balloon-injured rabbit model.

BACKGROUND: Current epidemiologic data suggest that a localized infection (periodontitis) can disseminate into the distant tissues, and subgingival bacteria can migrate in the bloodstream, thereby contributing to independent systemic disease processes. To test this hypothesis, we investigated the effect of repeated systemic inoculations with Porphyromonas gingivalis (Pg) on intimal hyperplasia in iliac arteries in a rabbit model of balloon injury. METHODS: One week after single balloon injury to the iliac artery, 30 male New Zealand rabbits were randomly assigned to intravenous inoculation with 100 microl live Pg (10(7) colony-forming units; n = 15) or vehicle (n = 15) once weekly for 4, 8, or 12 consecutive weeks. Arteries were fixed by perfusion and removed for analysis of neointimal lesion formation. We measured intimal and medial lesion areas in iliac artery cross-sections as well as the intimal/medial ratio (I/M). We also analyzed Pg 16S ribosomal DNA amplification with polymerase chain reaction, systemic proinflammatory mediators with enzyme-linked immunosorbent assay, and immunolocalization of macrophages in the balloon-injured arteries. RESULTS: At 12 weeks, iliac intimal hyperplasia was accelerated, and I/M was significantly increased in Pg-inoculated animals (I/M 3.961 +/- 0.536 in the Pg group versus 3.585 +/- 0.353 in the control animals; P <0.01). Pg-inoculated animals also had significant increases in macrophage infiltration at 12 weeks, C-reactive protein levels at all time points, and interleukin-6 levels at 12 weeks. Moreover, Pg ribosomal DNA was found in the injured arteries of Pg-inoculated animals, but only after 12 weeks. CONCLUSION: Long-term systemic challenge with Pg, an oral pathogen, may accelerate intimal hyperplasia in balloon-injured iliac arteries.

[Diagnosis of atypical liver abscesses with real-time contrast-enhanced ultrasound].

OBJECTIVE: To investigate the value of real-time harmonic contrast-enhanced ultrasound (CEUS) in the diagnosis of atypical liver abscesses. METHODS: We used Technos DU8 system with CEUS technique to examine 32 patients with suspected liver masses. Mechanical index was set at 0.08- 0.11. The contrast agent SonoVue was injected as a bolus (2.4 ml, < 5s) in the antecubital vein. RESULTS: A total of 36 lesions were studied in 32 patients, including 30 patients with single nodule and 2 patients with multiple nodules. All lesions with liver abscess were confirmed by biopsy. The whole-enhanced pattern in all lesions was clearly displayed in the arterial phase after the administration of SonoVue. The mean time of the beginning enhancement was (14.48 +/- 3.62) s, the mean peak enhancement time was (22.92 +/- 4.35) s, and the mean time of hypoechoic appearance of lesion was (80.30 +/- 35.30) s. The lesions with hypoechoic pattern (37.5%, 12/32) and isoechoic pattern (62.5%, 20/32) in the portal phase were detected by CEUS. The characteristic sign with honeycomb pattern on CEUS was shown in 30 (93.8%) liver abscess lesions. CONCLUSION: CEUS is valuable in the diagnosis of atypical liver abscesses.

Xanthogranulomatous cholecystitis: contrast-enhanced ultrasound features and differential diagnosis from wall-thickening gallbladder carcinoma.

OBJECTIVE: The purpose of this study is to evaluate the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of Xanthogranulomatous cholecystitis (XGC). MATERIAL AND METHODS: Patients of 17 XGCs and 43 wall-thickening gallbladder carcinomas (GBCs) were enrolled in this study. Firstly, we compared the ability of conventional ultrasound (CUS) and CEUS in detecting gallbladder (GB) features. Secondly, XGCs and GBCs features were compared on CEUS. Finally, all valuable indicators were ranked by Odds ratio. RESULTS: Significant differences were found in detecting GB wall thickness, GB stones, and hypoechoic nodules frequencies by CEUS and CUS. The mean GB wall thickness was 8.53 mm on CEUS, whereas the thickness measured 9.47 mm on CUS (p=0.011). GB stones and hypoechoic nodules were detected in 43 cases (71.7%) and 21 cases (30.0%) on CEUS, respectively, compared to 29 cases (48.3%) and 8 cases (13.3%) on CUS (p=0.009, p=0.027), respectively. Secondly, hypoenhancement time was longer in XGC (mean 78.9 s) than in GBC (mean 56.0 s) (p=0.002). Diffuse GB wall thickening, continuous inner wall, and hypoechoic nodules in the GB wall were observed in 12 patients (70.6%), 12 patients (70.6%) and 10 patients (58.8%) with XGC, respectively, compared to detection in 10 patients (23.3%), 4 patients (9.3%) and 11 patients (25.6%) by GBC (p=0.001, p=0.000 and p=0.015), respectively. Thirdly, the continuous inner wall was the most valuable indicator, with ORs of 23.4. The second valuable indicator was hypoenhancement time >80.5 s, with ORs of 11.9. CONCLUSIONS: CEUS demonstrated superior detection of GB wall thickness, GB stone and hypoechoic nodules compared to CUS. A continuous inner wall, hypoenhancement times greater than 80.5 s, diffuse thickening, and hypoechoic nodules were valuable indicators in XGCs.

[Research advances in ecological stoichiometry of marine plankton].

Ecological stoichiometry can be simply defined as: The biology of elements from molecules to the biosphere, which spans all levels of the environment and of the life. It's a new idea to build a unified theory and becomes an inevitable trend to develop the ecological science. Marine ecosystems, which contribute to 50% of the biosphere biomass, are the important component of the global biogeochemical cycles. Marine zooplankton plays an important role in the material circulation and energy flow of marine ecosystems and serves as a connecting link between the preceding and the following in a more precise understanding of the key elemental cycles. However, research on ecological stoichiometry of marine plankton is fragmentary and rare. This article summarized the ecological phenomena and mechanisms of limiting elements affecting marine plankton, the response of biochemical substances to nutrition limitation, and the food chain transmission and feedback of nutrition limitation. Meanwhile, we also put forward some perspectives for future research of ecological stoichiometry of plankton in China' s seas.

Prevalence and quantification of the uncommon Archaea phylotype Thermoplasmata in chronic periodontitis.

OBJECTIVE: Chronic periodontitis is a chronic inflammatory disease of the periodontal tissues and is caused by invasion of certain types of bacteria and Archaea, with Methanobrevibacter oralis as the predominant archaeon. In this study, we investigated the prevalence and quantity of the newly discovered Archaea phylotype Thermoplasmata in patients with chronic periodontitis. METHODS: Subgingival plaque samples were obtained from 49 patients with chronic periodontitis and 45 periodontally healthy subjects. Qualitative analyses of Archaea and class Thermoplasmata were carried out by amplification of 16S rRNA genes in DNA extracts from plaque samples, and all the samples were quantitatively analyzed by real-time polymerase chain reaction (PCR). RESULTS: The prevalence of Archaea in patients with chronic periodontitis was 69.4% according to the conventional PCR results, but was 87.8% according to real-time PCR. In the control group, three samples were detected as positive, but none of these were confirmed in qualitative analyses. The prevalence of class Thermoplasmata was 18.4% by nested PCR and 24.5% by quantitative PCR in the chronic periodontitis group. The prevalence of Thermoplasmata was significantly lower than that of total Archaea. The relative abundances of Archaea and Thermoplasmata varied among samples. Thermoplasmata were not the predominant archaeons in the subgingival dental plaque. Among the clinical parameters of patients with periodontitis, probing depth was positively associated with Archaea detection. CONCLUSIONS: The existence of Archaea was correlated closely with the presence of chronic periodontitis. Thermoplasmata represented a minor archaeon in periodontal infection.

Tissue elasticity quantification by acoustic radiation force impulse for the assessment of renal allograft function.

Acoustic radiation force impulse (ARFI) quantification, a novel ultrasound-based elastography method, has been used to measure liver fibrosis. However, few studies have been performed on the use of ARFI quantification in kidney examinations. We evaluated renal allograft stiffness using ARFI quantification in patients with stable renal function (n = 52) and those with biopsy-proven allograft dysfunction (n = 50). ARFI quantification, given as shear wave velocity (SWV), was performed. The resistance index (RI) was calculated by pulsed-wave Doppler ultrasound, and clinical and laboratory data were collected. Morphologic changes in transplanted kidneys were diagnosed by an independent pathologist. Mean SWV was more significantly negatively correlated with estimated glomerular filtration rate (eGFR) (r = -0.657, p < 0.0001) than was RI (r = -0.429, p = 0.0004) in transplanted kidneys. Receiver operating characteristic curve analysis revealed that the sensitivity and specificity of quantitative ultrasound in the diagnosis of renal allograft dysfunction were 72.0% and 86.5% (cutoff value = 2.625), respectively. The latter values were better than those of RI, which were 62.0% and 69.2% (cutoff value = 0.625), respectively. The coefficient of variation for repeat SWV measurements of the middle part of transplanted kidney was 8.64%, and inter-observer agreement on SWV was good (Bland-Altman method, ICC = 0.890). In conclusion, tissue elasticity quantification by ARFI is more accurate than the RI in diagnosing renal allograft function.

Evaluation of renal urothelial carcinoma by contrast-enhanced ultrasonography.

PURPOSE: To observe ultrasonographic features of urothelial carcinoma in renal pelvis and evaluate contrast-enhanced ultrasound (CEUS) in diagnosis. MATERIALS AND METHODS: Fifty-two patients with urothelial carcinoma underwent preoperative conventional US, colour Doppler flow imaging (CDFI) and CEUS. RESULTS: Of 52 total lesions, 41 (78.8%) could be clearly identified by US, and 49 (94.2%) were enhanced by CEUS. Among US-imaged lesions, 39 (95.1%) were solid tumours, and two (4.9%) were mixed solid-cystic; 25 (61.0%) were isoechoic, 11 (26.8%) hypoechoic, and five (12.2%) hyperechoic. Analysis of tumour blood flow by CDFI characterised 17 avascular lesions (41.5% of total), 16 hypovascular (39.0%), and 8 hypervascular (19.5%). The resistance index ranged from 0.65 to 0.88 (mean of 0.71). Enhancement was seen in 49 lesions after injection of SonoVue. A slow enhancement pattern was observed in 36 lesions (73.5%) relative to renal cortex, and 13/49 (26.5%) showed simultaneous enhancement. At peak enhancement, 38 lesions (77.6%) were hypo-enhanced, six (12.2%) iso-enhanced, and five (10.2%) hyper-enhanced. There were 12 lesions with intertumoural necrosis or haemorrhage (24.5%) that were heterogeneously enhanced, and 37 (75.5%) were homogeneously enhanced. A fast washout pattern was observed in 46 lesions (93.9%), synchronous washout in two (4.08%), and slow washout in one (2.04%). CONCLUSIONS: Slow-in, fast-out, and hypo-enhancement properties are associated with renal urothelial carcinoma and may thus have diagnostic value. We found that CEUS is able to identify tumours that are ambiguous by conventional US, and it thus significantly improves the confidence of diagnosis.

[A clinical study of osteotome sinus floor elevation and simultaneous implant placement in the periodontally compromised patients].

PURPOSE: To study the clinical effect of osteotome sinus floor elevation (OSFE) combined with simultaneous implant placement in the treatment of edentulous posterior maxilla subject to insufficient bone height in the periodontally compromised patients. METHODS: Forty-seven Straumanns implants were placed in the posterior maxilla in 35 patients with the procedure of OSFE. The final prostheses were restored after 3 to 6 months. The follow-up period was 6 to 30 months. Radiographs were taken and PD, PLI, BOP were measured and analyzed. RESULTS: The overall survival rate was 95.74% during the study period. Forty-five out of the 47 implants were clinically stable and loaded without pain or any subjective sensation. The perforation ratio of the membrane was 4.26%. The average of PD around the implants was (3.22±1.07) mm. The average of the marginal bone loss was (1.38±0.59) mm. CONCLUSIONS: OSFE without bone graft proves to be an effective and predictable treatment for atrophic edentulous posterior maxillary region in patients with periodontitis, but the long-term effect needs further observation.

Hepatic angiomyolipoma: contrast patterns with SonoVue-enhanced real-time gray-scale ultrasonography.

This study was conducted to retrospectively evaluate the pattern of contrast enhancement with SonoVue on gray-scale ultrasonography of hepatic angiomyolipoma (HAML). Imaging features of 33 pathologically proven HAML lesions in 33 patients who underwent baseline ultrasound and contrast-enhanced ultrasonography (CEUS) were assessed retrospectively. All lesions were enhanced in the arterial phase and showed whole-tumor filling in. Thirty-two of 33 (97%) lesions showed early positive enhancement in the arterial phase. Twenty-three of these exhibited isoechoic or hyperechoic features in the portal phase. HAML demonstrate characteristic manifestations with SonoVue-enhanced real-time gray-scale ultrasonography.

Standardized ultrasound hepatic/renal ratio and hepatic attenuation rate to quantify liver fat content: an improvement method.

Accurate measures of liver fat content are essential for investigating the role of hepatic steatosis in the pathophysiology of multiple metabolic disorders. No traditional imaging methods can accurately quantify liver fat content. [(1)H]-magnetic resonance spectroscopy (MRS) is restricted in large-scale studies because of the practical and technological issues. Previous attempts on computer-aided ultrasound quantification of liver fat content varied in method, and the ultrasound quantitative parameters measured from different ultrasound machines were hardly comparable. We aimed to establish and validate a simple and propagable method for quantitative assessment of liver fat content based on the combination of standardized ultrasound quantitative parameters, using [(1)H]-MRS as gold standard. Totally 127 participants were examined with both ultrasonography (US) and [(1)H]-MRS. Ultrasound hepatic/renal echo-intensity ratio (H/R) and ultrasound hepatic echo-intensity attenuation rate (HA) were obtained from ordinary ultrasound images using computer program. Both parameters were standardized using a tissue-mimicking phantom before analysis. Standardized ultrasound H/R and HA were positively correlated with the liver fat content by [(1)H]-MRS (r = 0.884, P < 0.001 and r = 0.711, P < 0.001, respectively). Linear regression analysis showed ultrasound H/R could modestly predict the amount of liver fat (adjusted explained variance 78.0%, P < 0.001). The addition of ultrasound HA slightly improved the adjusted explained variance to 79.8%. Difference of estimated liver fat contents between different ultrasound machines and operators was reasonably well. Thus, computer-aided US is a valid method to estimate liver fat content and can be applied extensively after standardization of ultrasound quantitative parameters.

Gram-negative periodontal bacteria induce the activation of Toll-like receptors 2 and 4, and cytokine production in human periodontal ligament cells.

BACKGROUND: Periodontitis is a bacterially induced chronic inflammatory disease. Toll-like receptors (TLRs), which could recognize microbial pathogens, are important components in the innate and adaptive immune systems. Both qualitatively and quantitatively distinct immune responses might result from different bacteria stimulation and the triggering of different TLRs. This study explores the interaction of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) with TLR2 and TLR4. METHODS: We studied the gene expression changes of TLR2 and TLR4 and cytokine production (interleukin-1ß, -6, -8, -10, and tumor necrosis factor-alpha) in human periodontal ligament cells (HPDLCs) stimulated with heat-killed bacteria or P. gingivalis lipopolysaccharide (LPS) in the presence or absence of monoclonal antibodies to TLR2 or TLR4 (anti-TLR2/4 mAb). RESULTS: Both test bacteria and 10 microg/ml P. gingivalis LPS treatment increased the gene expression of TLR2 and TLR4 and cytokine production in HPDLCs. In addition, these upregulations could be blocked by anti-TLR2/4 mAb. However, the expression of TLR4 mRNA in HPDLCs stimulated with 1 microg/ml P. gingivalis LPS was not increased. No differences were found in the cytokine production caused by 1 microg/ml P. gingivalis LPS treatment in the presence or absence of anti-TLR4 mAb. CONCLUSION: These patterns of gene expression and cytokine production indicate that Gram-negative periodontal bacteria or their LPS might play a role in triggering TLR2 and/or TLR4, and be of importance for the immune responses in periodontitis.

[The effect of periodontal initial therapy on chronic periodontitis and subgingival periodontal pathogen].

PURPOSE: To evaluate the effect of periodontal initial therapy on clinical parameters and subgingival periodontal pathogen in patients with chronic periodontitis. METHODS: One hundred and twenty patients with chronic periodontitis were included. Probing depth (PD), attachment loss (AL), plaque index (PLI) and gingival index (GI) were evaluated at baseline and after-initial therapy. P.g and A.a in subgingival plaque were investigated by real-time PCR. Data was statistically analyzed by SAS6.12 software for Student's t test. RESULTS: The PD, AL, PLI and GI were significantly decreased after periodontal initial therapy (P<0.01), and meanwhile the ratio of P.g versus total bacteria was significantly decreased after-initial therapy (P<0.05). However, the change of ratio of A.a versus total bacteria was not significant (P>0.05). CONCLUSION: Periodontal initial therapy could effectively control the inflammation of chronic periodontitis, and decrease the ratio of P.g in subgingival plaque.

[Identification and quantitative analysis of Archaea involved in periodontal disease].

OBJECTIVE: To make qualitative and quantitative analysis of Archaea in subgingival plaque sample and to investigate the relationship between periodontal disease and Archaea. METHODS: Subgingival plaque was collected from 23 patients with aggressive periodontitis, 29 with chronic periodontitis, 35 with plaque-induced gingivitis and 38 healthy controls. Qualitative and quantitative analysis of methanogenic archaea was performed by amplification of the 16S rRNA genes in the DNA extracted from the plaque samples. RESULTS: Archaea were found in 65% of aggressive periodontitis patients, 72% of chronic periodontitis, 26% of gingivitis and zero of healthy subjects. Quantitative analysis showed the average abundance of archaeal 16S rRNA gene in Archaea-positive patients was different among the three groups. The average 16S rRNA gene copy number from per microg wet plaque was 6.66 x 10(6) in aggressive periodontitis sufferers, 4.47 x 10(6) in chronic periodontitis and 1.78 x 10(6) in gingivitis groups. The prevalence of Archaea and the average Archaea 16S rRNA gene numbers in periodontitis groups were higher than those in gingivitis group (P < 0.05). CONCLUSIONS: This suggests that Archaea may be implicated as causative agents for periodontitis.

[Effect of TLR4 on expressions of p-IRAK1 and p-IkappaB-alpha in HPDLCs stimulated by lipopolysaccharide].

PURPOSE: To evaluate the effect of TLR4 on expressions of p-IRAK1 and p-IkappaB-alpha in HPDLCs stimulated by lipopolysaccharide. METHODS: Western blot and image analysis were used to detect the levels of p-IRAK1 and p-IkappaB-alpha in HPDLCs stimulated by 1 microg/ml LPS after 2.5,5,10 and 15 minutes, and to detect the levels of these proteins in HPDLCs stimulated by 1 microg/ml LPS after pretreatment with monoclonal antibody of TLR4. Statistical analysis was performed with SPSS10.0 software package for one-way ANOVA. RESULTS: The expressions of p-IRAK1 and p-IkappaB-alpha in HPDLCs were enhanced after stimulation of LPS. The gray scale values of protein band at 0 minute were 0.054, 0.19 respectively, significantly increased to 0.785, 0.809 after 5 minutes (P<0.05). After pretreatment with monoclonal antibody of TLR4, the expressions of these proteins weakened compared with those without pretreatment. The gray scale values of protein band significantly decreased from 0.82,0.874 to 0.099,0.201, respectively (P<0.05). CONCLUSIONS: TLR4 is involved in the signaling transduction in HPDLCs stimulated with LPS, and might be involved in the progression of periodontis.

Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue.

OBJECTIVE: The purpose of this study was to evaluate the usefulness of a contrast-enhanced contrast-specific ultrasonographic technique with a low mechanical index for characterization of focal liver lesions. METHODS: Contrast-specific ultrasonography was used to assess 144 patients with 147 focal liver lesions: 87 primary liver carcinomas, 27 hemangiomas, 16 focal nodular hyperplasias, 5 hepatic abscesses, 3 inflammatory pseudotumors of the liver, and 9 metastases. A sulfur hexafluoride gas-based contrast agent was used with a mechanical index of 0.08 to 0.11. RESULTS: On contrast-enhanced ultrasonography, the typical hemodynamic pattern of primary liver carcinoma was the whole-lesion enhancement or mosaic enhancement in the arterial phase with an enhancement defect in the late phase (sensitivity, 92.0%; specificity, 86.7%). The most common enhancement pattern of hemangioma was that enhancement appeared in the periphery first and progressively filled into the lesion center (sensitivity, 96.3%; specificity, 97.5%). The enhancement pattern of focal nodular hyperplasia was that the whole lesion enhanced early and rapidly in the arterial phase with a centrifugal radiating configuration and appeared isoechoic or hyperechoic until the late phase (sensitivity, 87.6%; specificity, 94.5%). The central scar was detected in 31.3% of cases in the late phase. The specific enhancement of a hepatic abscess was the honeycomblike enhancement in all phases (sensitivity, 80.0%; specificity, 100%). No enhancement of a lesion in all phases was specific for an inflammatory pseudotumor of the liver. CONCLUSIONS: Contrast-enhanced real-time ultrasonography is a promising approach in the noninvasive characterization of focal liver lesions and can be useful as a first-line imaging technique clinically when a focal liver lesion is detectable on ultrasonography.