[Tooth loss and multivariable analysis after 5-year non-surgical periodontal treatment on molars with furcation involvement].

OBJECTIVE: To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment, and to analyze the factors that affected the tooth loss. METHODS: A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed. RESULTS: (1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007), while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%. CONCLUSION: The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.

[Short-term clinical efficacy of a collagen matrix and free gingival graft in augmenting keratinized mucosa around dental implants].

Objective: To compare the short-term outcomes of a collagen matrix (CM) and free gingival graft (FGG) in augmenting keratinized mucosa around dental implants. Methods: Nineteen partially edentulous patients who had undergone implant surgery or implant review from June 2017 to June 2018 at Department of Periodontology, Peking University School and Hospital of Stomatology with lack of keratinized mucosa at buccal aspect of implants (<2 mm) were recruited in this study. According to the width of keratinized mucosa (KW) pre-operation, 9 patients including 5 males and 4 females were assigned into control group (KW<0.5 mm) which performed free gingival graft (17 implants) and 10 patients including 3 males and 7 females were assigned into experimental group (KW≥0.5 mm) which used collagen matrix as the grafts (15 implants). The KW at buccal aspect of each implant were measured pre-operation and 2 weeks, 1 month, 2 months, 3 months after surgery respectively. Each of the patients was required to fill out a questionnaire using a visual analogue scale to assess the postoperative morbidity. Results: The KWs around implants were increased significantly during the 3 months follow-up period in both groups (P<0.01). At 3 months after surgery, KW gain in control group was (3.44±1.64) mm, in experimental group was (2.30±0.82) mm, the difference between two groups was statistically significant (P<0.05). Meantime, the total shrinkage of KW in control group [(34±25)%] and experimental group [(51±11)%] also showed a statistically significant difference (P<0.01). However, by using collagen matrix as the grafts, augmented tissues had a much more comparable appearance with adjacent tissues than that in control group. And the patients of experimental group experienced much less postoperative bleeding than those of control group. Conclusions: Both collagen matrix and free gingival graft can significantly increase the KW around implants within the 3 months post-surgery follow-up period. There were more KW gain and less shrinkage in group FGG than that in group CM. However, surgery time were reduced and the postoperative bleeding were less in group CM than in group FGG as no harvesting procedure was needed.

[The association between the prognosis and the localization and expressionof heparanase in human laryngeal squamous cell carcinoma].

Objective:The aim of this study is to explore the expression of heparanase(HPA) in human laryngeal squamous cell carcinoma and its correlation with the clinical pathologic features, such as clinical stage, T grade, lymph node metastasis and cellular differentiation. At the same time, to evaluate the relationship between heparanse localization and expression in human laryngeal squamous cell carcinoma (HLSCC) and tumor prognosis and patients survival. Method: The expression levels of HPA in HLSCC tissues of 73 cases and benign lesions of 38 cases(control) were detected via immunohistochemistry. The correlation of HPA expression with various clinical pathologic features was evaluated with single factor analysis.The Fisher exact test and chisquare tests were used to compare categorical data. Univariate survival was evaluated by KaplanMeier curves and tested using logrank test. Multivariate Cox proportionalhazards regression was used to evaluate independent prognostic factors associated with survival. Result: The positive expression rate of HPA in 73 HLSCC patients and benign lesions of 38 cases were 76.71%（56/73）and 21.05%（8/38）respectively（P<0.05）. The clinical pathologic analysis showed that HPA level had a relationship with the clinical stage, T grade, cellular differentiation and lymph node metastasis(P<0.05), while not with gender, age and clinical types(P>0.05). Survival analysis showed that the patients with high HPA expression had significantly poorer outcome as compared with the patients with low HPA expression. The medium survival time and the 5year survival rate were 24 months and 43.33% in highheparanase group, 56 months and 61.54% in the lowheparanase group and 65 months and 70.59% in the noneheparanse group(P=0.010). The survival was related to clinical stage, T grade, lymph node metastasis, and cellular differentiation(P<0.05), but not with age, sex and clinical types(P>0.05).In multivariate Cox proportionalhazards regression analysis, the results suggested that lymph node metastasis, hepanranase expression level and heparanase localization were independent prognosis factor for HLSCC. Moreover, hepanranase localization correlated with patient outcome. Kaplan Meier analysis demonstrated statistically significantly difference for 5-years overall survival rate between the patients with HPA nuclear staining and the patients with HPA cytoplasmic staining(P<0.05).Conclusion:HPA was related with worse overall survival and could be considered as a potential marker of poor prognosis. Cytoplasmic staining of heparanase inversely correlated with patients survival and predicts poor prognosis, whereas nuclear heparanase predicts a favourable outcome.

Effectiveness of bacterial infection-related cytokine profile (BIRCP) determination for monitoring pathogen infections in children with hemopathy in the bone marrow inhibition phase.

Serum cytokine profiles were analyzed before and after infection in children with hemopathy in the bone marrow inhibition phase to explore the utility of cytokine variations for detecting infections. Serum Th1/Th2 cytokine levels, including tumor necrosis factor, interleukin (IL)-2, IL-4, IL-6, IL-10, and interferon, were quantitatively determined by cytometric bead array technology in 480 cases (230 children) of children with hemopathy in the bone marrow inhibition phase with signs of infection, such as fever, and without, to establish baseline and affected levels for comparison with healthy control children. We used the cytokine profile of infected, blood culture-positive children to establish a bacterial infection-related cytokine profile (BIRCP) for predicting infections by pathogens in blood culture-negative children. Overall, 82.9% of children with Gram-negative bacterial infections were accompanied by marked increases of IL-6 and IL-10 levels [>10 times (means ± SD)], whereas only a mild increase of IL-6 levels occurred in Gram-positive bacteria-infected children [>2 times (means ± SD)] and only a mild increase of IFN-γ levels occurred in fungal culture-positive children [>2 times (means ± SD)]. Gram-positive bacterial and fungal infections did not cause a marked increase in IL-6 or IL- 10 levels. The effective rate (86.05%, N = 43) of infectious cases predicted by BIRCP was significantly higher than that obtained using traditional methods for selecting antibiotics based on clinical indications (65.45%, N = 55, P < 0.05). In summary, BIRCP can be used to predict the infections by pathogens in children with hemopathy and to select appropriate antibiotics.

Relationship between plasma inflammatory markers and plaque fibrous cap thickness determined by intravascular optical coherence tomography.

OBJECTIVE: The purpose of this study was to evaluate the relationship between human plaque fibrous cap thickness detected by intravascular optical coherence tomography (OCT) and the plasma levels of inflammatory factors in patients with coronary artery disease (CAD). METHODS AND RESULTS: OCT was used to measure the fibrous cap thickness of coronary artery atherosclerotic plaques in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP). Plasma levels of inflammatory factors including highly sensitive C-reactive protein (hs-CRP), IL-18 and tumour necrosis factor alpha (TNFalpha) were detected by ELISA, and peripheral white blood cell (WBC) counts were performed. The results demonstrated that the plasma levels of inflammatory factors and WBC count were correlated inversely with fibrous cap thickness (r = -0.775 for hs-CRP, r = -0.593 for IL-18, r = -0.60 for TNFalpha and r = -0.356 for WBC count). Patients with cap thickness less than 65 microm (defined to be thin cap fibroatheromas; TCFA) had higher plasma levels of inflammatory factors as well as WBC counts than those with thicker fibrous caps. Receiver operator characteristic (ROC) curves for hs-CRP, IL-18, TNFalpha and WBC count, which displayed the capability of prediction about TCFA, showed the area under the curves were 0.95, 0.86, 0.79 and 0.70 (p<0.05), respectively. ROC curve analysis confirmed that an hs-CRP cut-off at 1.66 mg/l would detect TCFA with a sensitivity of 96% and a specificity of 90%, and was the strongest independent predictor of TCFA. CONCLUSION: There is an inverse linear correlation between fibrous cap thickness and plasma levels of inflammatory markers. The plasma hs-CRP concentration is the strongest independent predictor of TCFA.