Effects of modified triangular flap for third molar extraction on distal periodontal health of second molar: A randomized controlled study.

Objective: The aim of this study was to assess the effect of flap design for impacted mandibular third molar extraction on the distal periodontal tissue of their neighbors clinically, immunologically, and microbiologically. Study design: This randomized controlled study comprised 100 patients who were allocated randomly to receive either a triangular flap or a modified triangular flap. The distal periodontal pocket depth, plaque index, bleeding on probing, the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and the level of interleukin-1ß, interleukin-8 and matrix metalloproteinase-8 of adjacent second molars were measured at baseline, and 1, 4 and 8 weeks after surgery. Results: After 1 and 4 weeks, distal periodontal conditions of adjacent second molars deteriorated, along with an increase in subgingival microbiota and inflammatory factors in both groups. And compared to the modified triangular flap group, the triangular flap group significantly increased (p < 0.05). Prevotella intermedia, interleukin-1ß and probing depth were positively correlated in both groups. After 8 weeks, they returned to the preoperative level. Conclusions: In this study, both flap designs for impacted mandibular third molar extractions was associated with worse clinical periodontal indices, increased inflammatory biomarkers of gingival crevicular fluid, and more subgingival pathogenic microbiota within 4 weeks. But compared with the triangular flap, the modified triangular flap was better for distal periodontal health of adjacent second molars, which provides certain directions for clinical treatment.

[Diagnostic Value of American Thyroid Association Guidelines,American College of Radiology Thyroid Imaging Reporting and Data System,and Chinese Thyroid Imaging Reporting and Data System Alone and Combined With BRAFV600E Mutation in Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance].

Objective To explore the diagnostic efficacy of American Thyroid Association(ATA)guidelines,American College of Radiology Thyroid Imaging Report and Data System(ACR-TIRADS),and Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)alone and combined with BRAFV600E mutation in atypia of undetermined significance/follicular lesion of undetermined significance(AUS/FLUS).Methods A total of 138 patients who underwent ultrasound-guided fine needle aspiration(FNA)in the Chinese PLA General Hospital from January 2020 to May 2023 were selected.The clinicopathological and ultrasound characteristics were retrospectively analyzed for each nodule.Each nodule underwent preoperative BRAFV600E mutation testing and was diagnosed according to the ATA guidelines,ACR-TIRADS,and C-TIRADS.The diagnostic efficacy of ATA guidelines,ACR-TIRADS,and C-TIRADS alone and combined with BRAFV600E mutation was assessed based on the results of histopathological diagnosis.Results The 138 AUS/FLUS thyroid nodules included 45(32.6%)benign ones and 93(67.4%)malignant ones.The patient age(t=1.444,P=0.151),gender(χ2=0.259,P=0.611),and location of nodules(χ2=2.055,P=0.358)had no statistical significance for the differentiation between benign and malignant nodules,while nodule size(Z=2.500,P=0.012),echo(χ2=14.693,P<0.001),composition(χ2=17.075,P<0.001),aspect ratio ≥1(χ2=9.477,P=0.002),and microcalcification(χ2=6.892,P=0.009)were of significance for the differentiation.When applied alone,BRAFV600E mutation showed high specificity(95.56%)and positive predictive value(95.65%).Among the three ultrasound grading systems,ACR-TIRADS had the highest sensitivity(χ2=37.923,P<0.001;χ2=40.462,P<0.001)and accuracy(χ2=81.595,P<0.001;χ2=76.912,P<0.001),while C-TIRADS had the highest specificity(χ2=11.746,P<0.001;χ2=21.235,P<0.001).However,the three systems showed no statistically significant difference in the diagnostic efficiency when applied alone(Z=1.177,P=0.239;Z=0.213,P=0.831;Z=1.016,P=0.310).The combination of BRAFV600E mutation with ACR-TIRADS or C-TIRADS improved the diagnostic efficacy of BRAFV600E mutation in distinguishing the benign and malignant AUS/FLUS nodules(Z=2.107,P=0.035;Z=2.752,P=0.006).The combination of ATA guidelines with BRAFV600E mutation increased the diagnostic accuracy of BRAFV600E mutation(χ2=20.679,P<0.001),while it had no statistically significant difference in distinguishing the benign and malignant AUS/FLUS nodules(Z=1.321,P=0.186).The combination of ATA guidelines,ACR-TIRADS,or C-TIRADS with BRAFV600E mutation improved the diagnostic efficacy of ultrasound grading systems for AUS/FLUS nodules(Z=2.770,P=0.006;Z=2.770,P=0.006;Z=2.890,P=0.004).Specifically,ACR-TIRADS combined with BRAFV600E mutation showed the highest sensitivity(χ2=4.712,P=0.030;χ2=4.712,P=0.030),while C-TIRADS combined with BRAFV600E mutation showed the highest accuracy(χ2=77.627,P<0.001;χ2=85.827,P<0.001).However,there were no statistically significant differences in diagnostic performance between the combinations(Z=1.276,P=0.202;Z=0.808,P=0.419;Z=1.615,P=0.106).Conclusion ATA guidelines,ACR-TIRADS,and C-TIRADS combined with BRAFV600E mutation can improve the diagnostic efficacy of BRAFV600E mutation or ultrasound grading system alone in AUS/FLUS nodules,which can facilitate the further management and treatment of such patients.

Diagnostic Value of Color Doppler Ultrasound and Contrast-Enhanced Ultrasound in the Artery Steal Syndrome After Orthotopic Liver Transplantation.

Purpose: This study aimed to investigate the application of color Doppler ultrasound (CDU) and contrast-enhanced ultrasound (CEU) in the early diagnosis of arterial steal syndrome (ASS) after orthotopic liver transplantation (OLT). Patients and Methods: A total of 1827 patients received OLT in our department between January 2007 and December 2021, and CDU and CEU were performed after surgery. Ultrasonographic data were collected and further analyzed. ASS was confirmed by digital subtraction angiography (DSA), and the use of splenic artery embolization was dependent on the DSA findings and clinical conditions. The ultrasonographic data were collected before and after embolization. Results: ASS was found in 23 patients (23/1827; 1.26%). CDU: the portal vein velocity was higher than normal in 17 patients (52.83±21.74 cm/s); the hepatic artery flow signals disappeared in 7 patients; the hepatic artery velocity was 13.57±5.85 cm/s in 16 patients. In 23 patients, the spleen artery velocity was 170.12±32.04 cm/s. CEU: the hepatic artery was observed in 7 patients without hepatic artery flow signals on CDU; in 23 patients, the contrast agent reached the portal vein at the presence of contrast in the hepatic artery or earlier (difference: 2.21±1.09 s). Splenic artery embolization was done in 17 of 23 patients with ASS. The hepatic artery flow velocity, hepatic artery resistance index, splenic artery velocity and time to the presence of contrast were significantly improved after embolization (P<0.05). Conclusion: CDU and CEU are the preferred, effective tools in the diagnosis of ASS. Reduced peak hepatic artery velocity, increased spleen artery velocity and reduced time difference in the contrast reaching the portal vein and hepatic artery are indicative of ASS.

Research progress on the application of photodynamic therapy in periodontal treatment / 口腔疾病防治

@#Periodontitis is a chronic inflammatory disease that is initiated by bacteria. Pathogens and their virulence factors alter normal cellular metabolic activity and deteriorate periodontal microconditions. Owing to the complexity of tooth structure and the limitation of conventional treatment, we may not live up to all patients’ expectations, especially those with grade C and stage Ⅲ or Ⅳ periodontitis. With the advantages of bactericidal effects, high safety, inhibition of bacterial drug resistance and promotion of tissue healing, photodynamic therapy （PDT） seems to be an ideal technology in periodontal treatment. However, it cannot remove subgingival stones and still cannot replace mechanical treatment to preliminarily control periodontal inflammation. Therefore, near-infrared low-energy light combined with traditional photosensitizers is mostly used in clinical periodontal adjuvant treatment. In periodontal maintenance treatment on a regular basis, a single application can also reduce the sensitivity of patients and effectively control plaque, but its effect will be affected by the degree of periodontal inflammation, the concentration and type of photosensitizer, the energy of the light source, etc. With the further development of material science, the performance of photosensitizers to accelerate oxides and target bacteria will be optimized. In the future, parameters of PDT need to be designed in large-scale studies in accord with different stages and grades of periodontitis.

Dysbiosis of saliva microbiome in patients with oral lichen planus.

BACKGROUND: Oral microbiota is not only important for maintaining oral health but also plays a role in various oral diseases. However, studies regarding microbiome changes in oral lichen planus (OLP) are very limited. To the best of our knowledge, there has been only two studies investigating salivary microbiome changes in OLP. Therefore, the purpose of this study was to identify the characteristic microbial profile in the saliva of OLP patients, with or without erosive lesions, and compare that with recurrent aphthous ulcer (RAU), a common oral immunological disorder that also shows multiple erosive/ulcerative lesions. Whole saliva samples were collected from 20 patients with OLP (erosive E, n = 10 and non-erosive NE, n = 10), 10 patients with RAU (U) and 10 healthy controls (C). DNA was extracted from the saliva samples, and the 16S rDNA gene V4 hypervariable region was analyzed using Illumina sequencing. RESULTS: We obtained 4949 operational taxonomic units (OTUs) from the V4 region in all saliva samples. Community composition analysis showed a clear decreased relative abundance of genera Streptococcus and Sphingomonas in saliva from RAU patients when compared to the other three groups. Relative abundance of Lautropia and Gemella were higher in E group, whereas relative abundance of Haemophilus and Neisseria were higher in NE group when compared to C group. Abiotrophia and Oribacterium were higher in OLP (combining E and NE groups), while Eikenella and Aggregatibacter were lower when compared to C group. There was statistically significance in α-diversity between E and RAU groups(p < 0.05). Significant differences in ß-diversity were detected in bacteria between E and C; NE and C; as well as E and NE groups. The LDA effect size algorithm identified the g_Haemophilus might be the potential biomarker in NE group. CONCLUSIONS: We found that salivary microbiome in erosive OLP was significantly different from that found in RAU; and these changes may be related to the underlying disease process rather than presence of ulcerative/erosive lesions clinically. In addition, our findings in bacterial relative abundance in OLP were significantly different from the previously reported findings, which points to the need for further research in salivary microbiome of OLP.

[Influence of periodontal non-surgical therapy on serum interleukin 6 expression and carotid artery wall in rats with periodontitis and type 2 diabetes mellitus].

OBJECTIVE: To study the effect of periodontal non-surgical treatment on serum interleukin-6 (IL-6) expression and carotid vascular wall in a rat model of chronic periodontitis (CP) with type 2 diabetes mellitus (T2DM). METHODS: Twenty-eight 6-week-old SD rats were randomly divided into group A (control group, 7 rats) and group B (T2DM+CP group, 21 rats). According to different intervention measures, group B was randomly subdivided into B1 (natural process), B2 (periodontal mechanical treatment), and B3 (periodontal mechanical treatment + 2% minocycline hydrochloride + systemic metronidazole plus amoxicillin). Serum IL-6 was measured by enzyme-linked immunosorbent assay, and carotid tissue was observed under light microscopy after hematoxylin-eosin (HE) staining. RESULTS: The carotid artery wall of group A was normal. In group B1, the endothelial cells disappeared, the elastic fibers of the middle membrane were disordered, the local necrosis of smooth muscle tissue was amorphous particles, a small amount of calcium salt was deposited, and the wall thickening was obvious. The endothelial cells in groups B2 and B3 disappeared, and the smooth muscle cells in the middle membrane underwent denaturation. No significant thickening of the vessel wall was noted. The serum IL-6 level in group B1 continually increased with time, and it was higher than that in group A (P<0.001). The IL-6 levels of groups B2 and B3 peaked a week after the first intervention. Subsequently, IL-6 levels gradually decreased. At the last point (five weeks after the second intervention ), the IL-6 levels of groups B2 and B3 were significantly lower than that of group B1 (P<0.001). CONCLUSIONS: For rats with periodontitis and diabetes, periodontal mechanical treatment may elevate serum IL-6 levels in the short term but might reduce the whole inflammatory state in the long term. Thus, this treatment might be valuable to the improvement of vascular disease. The adjunctive benefits of systemic metronidazole and amoxicillin in non-surgical periodontal therapy are decreased serum IL-6 expression and normal carotid artery.

Effects of Periodontal Intervention on Levels of Serum High-sensitivity C-reactive Protein and Interleukin 6, and on Carotid Artery in Rats with Chronic Periodontitis and Hyperlipidemia.

OBJECTIVE: To investigate the effects of nonsurgical periodontal therapy on the serum interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) and on the carotid artery in rats with chronic periodontitis (CP) and with or without hyperlipidemia (HL). METHODS: A total of 29 Sprague-Dawley rats were randomly divided into two groups: group A (CP, n = 14) and B (CP + HL, n = 15), and subjected to the corresponding treatment. Groups A and B were further divided into groups A1/B1 (without periodontal interventions) and A2/B2 (with periodontal interventions). The serum IL-6 and hsCRP levels were evaluated before periodontal intervention and at 1, 3, 5, and 7 weeks after periodontal intervention. The rats were euthanised 8 weeks after the periodontal intervention and the histopathologic changes in the carotid artery were observed. RESULTS: The serum hsCRP and serum IL-6 levels in groups A1 and B1 were elevated with time; they were significantly higher in group B1 than in group A1 (P < 0.001) at all time points. The hsCRP and IL-6 levels in groups A2 and B2 increased with time and reached the maximum level 1 week after the second intervention, and then gradually decreased. Atherosclerotic plaques, fibrous cap, and calcium salt deposits were apparent in the rats of group B1, whereas no obvious atherosclerotic changes were observed in the rats of groups A2 and B2. CONCLUSION: Periodontal interventions resulted in acute, short-term systemic inflammation. However, it was beneficial in long-term as it improved the carotid artery integrity.

[Nonlinear Regression Methods of Ethanol Raman Spectra Quantitative Analysis].

Ethanol concentration quantitative analysis of ethanol-water solution can be realized by measuring the ratio of Raman characteristic peak heights. The content of ethanol can be determined by linear relation between relative intensity ratio and ethanol concentration. However, this analytical method only applies to the ethanol solution at low concentration. Concerning this issue, relative intensity of characteristic peak of ethanol (asymmetric stretching vibration of CH2 2 924.0 cm-1) and peak background of water (3 350 cm-1) at different ethanol concentration is experimentally measured by using a self-developed laser Raman ethanol content detection system. According to the relationship between relative ratio of characteristic peak heights and ethanol concentration, the nonlinear regression analysis methods are proposed to apply in the measurement of ethanol concentration in a wide range. Adjacent region average method is utilized to remove mutational random noise in Raman spectra of ethanol solution. Combined with multi-point interpolation processing, the baseline of Raman spectra can be calibrated. The influences of mutational random noise and the strong fluorescence background can be effectively eliminated with baseline correction and normalization methods. Polynomial and exponential mathematical models are adopted for nonlinear regression analyses by the relation between ratio of characteristic peak heights and concentration of ethanol solution. The analysis results show that the correlation coefficient of linear fitting and nonlinear fitting is about 0.991 and higher than 0.997 respectively. The linear analytical method can be effectively applied when ethanol concentration range is 15%～60%. The nonlinear analytical method has higher measurement accuracy in a wider ethanol concentration range of 3%～97%. Nonlinear mathematical model will provide theoretical basis for analysis of ethanol concentration, which can be applied in laser Raman ethanol content detection system to calculate the relatively accurate ethanol concentration of ethanol-water solution. Rapid, real-time and accurate quantitative analysis of wide concentration range ethanol solution, which has mutational random noise and strong fluorescence background interference, can be achieved by these analytical methods.

[A preliminary study on the genetic mode of aggressive periodontitis in Chinese Han nationality].

OBJECTIVE: To investigate the potential genetic mode of aggressive periodontitis (AgP) in Chinese Han nationality. METHODS: A total of 233 subjects from 73 nuclear families were recruited. All probands were diagnosed according to the criteria of AgP in 1999 classification of periodontal diseases. Ninety parents, 35 siblings and three grandparents and two offspring were examined based on full-mouth periodontal chartings (including parameter of probing depths, attachment loss, bleeding on probing at six sites per tooth) and full-mouth periapical radiographs. The genetic ratio was calculated and analyzed by the methods of Edwards and simple segregation. RESULTS: The prevalence of AgP in probands' siblings was close to the square root of the prevalence of general population. The segregation ratio was 0.2419, which was close to the theoretical ratio for autosomal recessive inheritance. However, autosomal dominant inheritance could not be rejected in families whose parent(s) suffered from severe chronic periodontitis. CONCLUSIONS: The genetic heterogeneity of AgP existed in Chinese Han nationality. The genetic mode was autosomal recessive inheritance in general, and autosomal dominant inheritance could not be excluded in families whose parent(s) suffered from severe chronical periodontitis. The results imply the genetic heterogeneity of AgP, and further demonstrate that AgP was a multifactorial disease with major genetic component in the disease etiology.

[FBAT analysis of polymorphisms of vitamin D receptor (Taq I and Fok I) in aggressive periodontitis families].

OBJECTIVE: To analyze the correlation between polymorphisms of the vitamin D receptor gene (Taq I and Fok I) and the aggressive periodontitis by FBAT method. METHODS: 93 AgP nuclear families including 93 probands and their 155 relatives were recruited. The genotype frequency and polymorphism for VDR for the patients and their pedigree were detected by using polymerase chain reaction (PCR) combined with restriction fragment length polymorphism (RFLP). RESULTS: The frequency of allele T and t accounted for 94.6 % and 5.4 % in the total populations. No tt genotype were detected. The fathers of probands carried more allele t than the mothers(9.8% vs 1.6%, P=0.005). The frequency of allele F and f accounted for 57.1 % and 42.9 % in the total populations. The result of family based associated test (FBAT) including additive model, dominant model and recessive model showed that different alleles of Taq I and Fok I had no correlation with the onset of AgP(P>0.05). CONCLUSION: This was the first time to detect the VDR gene polymorphisms in Chinese families. The result of FBAT analysis can not show the correlation between vitamin D receptor gene polymorphisms (Taq I and Fok I) and the onset of AgP.

[Monitoring vascular complications following liver transplantation using color Doppler flow imaging].

OBJECTIVE: To assess the value of color Doppler flow imaging (CDFI) in monitoring vascular complications following orthotopic liver transplantation (OLT). METHODS: Seven hundred ninety-two patients who received OLT from April 2002 to December 2006 in the Organ Transplantation Center, General Hospital of Chinese People's Armed Police Forces, Beijing, and underwent CDFI examinations in different periods after OLT were enrolled in this study. Their vascular complications were monitored by CDFI and confirmed by angiography or spiral CT. RESULTS: Of the 792 patients, 54 were diagnosed with vascular complications that occurred 1-360 days after their OLT operations. These complications occurred within 1-30 days, 31-60 days, 61-90 days, 91-180 days, 181-360 days, with the proportions of 46.30%, 22.22%, 14.81%, 9.26% and 7.41% respectively. The proportion of hepatic artery and portal vein complications and outflow occlusions were 61.11%, 35.19% and 3.70% respectively. CONCLUSION: Most vascular complications occurred within six months after the OLT operation. The continuous and careful monitoring by CDFI is beneficial in an early diagnosis of vascular complications after OLT.

[Interleukin-1 family polymorphisms in aggressive periodontitis patients and their relatives].

OBJECTIVE: To study whether interleukin-1( IL-1 )genotype and/or alleles were associated with aggressive periodontitis (AgP) patients and their relatives. METHODS: Sixty-six AgP nuclear families including 66 probands and their 114 relatives were recruited. All probands were diagnosed as AgP according to 1999 classification of periodontal diseases and conditions, the diagnoses of their relatives were using a system of assessment (including the current and retrospective diagnosis and reported case history). Anti-coagulated peripheral blood samples were collected from all of the 180 subjects, and DNA was extracted from each blood sample. Single nucleotide polymorphisms (SNPs) at IL-1A +4845 and IL-1B j 511 were analyzed by PCR-RFLP assay. The polymorphism of a variable number of tandem repeat (VNTR) in intron 2 of IL-1RN was detected by PCR amplification and fragment size analysis. The distributions of genotypes and/or alleles in all groups were analyzed by logistic regression analysis. Data were also analyzed using the family-based association test. RESULTS: The frequency of all markers (at IL-1A +4845 and IL-1B -511 and VNTR) showed no association wih AgP in relatives (P>0.05). Tests of association by Family-Based Association Test showed no difference in the distribution of the allele 1 of IL-1B-511 under all three genetic models tested (Additive: Z=0.389, P=0.6969; Dominant: Z=0.089, P=0.9287; Recessive: Z=0.089, P=0.9287). The distribution of the allele 1 of IL- 1A+4845 also showed no significant difference under all three models (P>0.05). But when all AgP patients were stratified by the clinical subtype, the frequencies of A1A1 genotype and allele 1 at IL-1B-511 were significantly increased in the localized subtype AgP patients compared to unaffected (genotype: 43.8% vs 22.8%,OR=7.32,95% CI=1.84-29.11,P=0.005; allele 1: 71.9% vs 41.2%,OR=3.64,95% CI=1.55-8.58,P=0.002), while no significant difference was observed between the generalized subtype and the unaffected (genotype: P=0.88, allele: P=0.64). CONCLUSION: The polymorphism of IL-1B-511 may have an effect on the susceptibility of localized AgP in Chinese population. It should be tested in larger family samples.

[Monitoring portal vein complications following liver transplantation by color Doppler flow imaging].

OBJECTIVES: To explore the diagnostic value of color Doppler flow imaging (CDFI) in monitoring portal vein complications (PVC) following orthotopic liver transplantation (OLT). METHODS: Five hundred and four patients received OLT and had CDFI examinations before and after their transplantations. CDFI monitoring parameters before the operation included portal vein diameter, blood flow velocity and the presence of thrombi within the portal vein. Monitoring parameters after the operation included portal vein diameters of donor and receiver sides, and the diameter of the mouth of anastomosis, inner side of blood vessel echo, the direction of blood flow and its speed. RESULTS: Of the 504 patients examined, the median velocity of the portal blood flow was 46.27 cm/s (range: 15.8 to 110.8) on the day of the operation. The blood flow speed of 358 cases (71.03%) was higher than 40 cm/s. Of the 358 patients, 347 (68.85%) had a blood flow speed lower than 40 cm/s one month after the operation. Sixty-four patients (12.70%) showed hepatofugal blood flow once, and only one case had a total hepatofugal blood flow. Thirteen patients (2.58%) had portal vein complications, including 4 cases with portal vein thrombosis and 9 with portal vein stenosis. CONCLUSION: Not all abnormal portal vein blood flow signals will lead to complications. It is worthwhile to monitor the portal blood flows. CDFI plays an important role in the diagnosis of portal vein complications after orthotopic liver transplantation.

Optimal annular computer-generated holograms for the generation of optical vortices.

We analyze a method for efficiently generating optical vortices by use of annular computer-generated holograms and a spatial light modulator. We found that there exists an optimal annular width by which the reconstructed vortex ring in the focal plane has the steepest gradient and the worthless subbright rings can be largely suppressed. We fitted a general formula for determining the value of this optimal annular width and propose a method for designing a multiring structure of optical vortices and specialized interferometric vortex patterns. Finally, we discuss the situation of a Gaussian beam as illuminated light and find that there exists an optimal beam waist that results in the best energy efficiency.

[The effects of feeding methods on deciduous caries.].

PURPOSE: The goal of this study was to explore the relationship between feeding methods and deciduous caries. METHODS: An investigation on children's feeding methods, caries prevalence and dmft was made, using 260 cases which were provided with whole primary teeth. Chi-square test was used for statistical analysis on feeding methods and caries prevalence, and variance analysis was used on feeding methods and dmft. RESULTS: The results showed that the deciduous caries rate, mean dmft in breast feeding (BF) group were lower than those in mixed feeding (MF) group and artificial feeding (AF) group, there were significant differences between BF group and MF group,also between BF group and AF group. But there were no significant differences between MF group and AF group. CONCLUSION: It is concluded that proper breast feeding seems to be important for preventing deciduous caries.

Optical vortex phase-shifting digital holography.

We report a new optical vortex phase-shifting method for digital holography, in which an optical vortex mode is taken as the reference beam for holographic recording, and the required phase shifts are directly generated by rotating the vortex mode. In digital reconstruction, the complex amplitude of the object wave can be retrieved by use of the conventional phase shifting algorithm on condition that the digital illumination beam is replaced by an vortex beam with the same topological charge as the reference used. Both the theoretical analysis and experimental results demonstrate the feasibility of this approach.