Objective This study aimed to investigate the temporal and spatial changes in the expression of perios-tin during periodontal inflammation in mice.Methods A periodontitis model was constructed using silk thread ligation.Mice were randomly divided into five groups in-cluding control group,4-day ligation group,7-day liga-tion group,14-day ligation group,and self-healing group(thread removal for 14 days after 14-day ligation).Mi-cro-CT and histological staining were performed to char-acterize the dynamic changes in the mouse periodontal tissue in each group.RNAscope and immunohistochemical staining were used to analyze the pattern of changes in peri-ostin at various stages of periodontitis.The cell experiment was divided into three groups:control group,lipopolysac-charide(LPS)stimulation group(treated with LPS for 12 h),and LPS stimulation removal group(treated with LPS for 3 h followed by incubation with medium for 9 h).Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of periostin,transforming growth factor-β1(TGF-β1),and matrix metalloproteinase 2(MMP2).Results Significant alveolar bone resorption was observed 7 days after ligation.With increasing duration of ligation,the damage to the mouse periodontal tissue was aggravated,which manifested as increased osteoclasts,widen-ing of the periodontal membrane space,and decreased alveolar bone height.Some degree of periodontal tissue repair was observed in the self-healing group.Periostin expression decreased at 4 and 7 days compared with the control group and increased at 14 days compared with 4 and 7 days.A significant recovery was found in the self-healing group.The qRT-PCR results showed that the expression of periostin and TGF-β1 in the LPS stimulation group decreased compared with that in the control group but significantly recovered in the LPS removal group.Conclusion Periostin expression in the PDL of mice showed a downward and upward trend with inflammation progression.The significant recovery of periostin expression after removing inflammatory stimuli may be related to TGF-β1,which is crucial to maintain the in-tegrity of the PDL.

Objective:To investigate the value of contrast-enhanced ultrasonography (CEUS) in detecting minute renal cell carcinoma (MRCC) smaller than 15 mm (by ultrasonic measurement) and the strategy to improve its detection rate.Methods:Fifty-three pathologically confirmed MRCCs by surgery from November 2007 to October 2019 at Zhongshan Hospital of Fudan University were enrolled in this retrospectively study. All of them underwent both conventional ultrasound and CEUS examinations. The clinical and imaging data were collected and analyzed. Common features, such as tumor size, location, echogenicity, morphology, border, and blood flow signals were observed on conventional ultrasound. On CEUS, the presence of enhancement, wash in and wash out pattern, perfusion uniformity within the lesions were observed.Results:Post-operative pathology confirmed 48 clear cell carcinomas, 4 papillary carcinomas, and 1 chromophobe cell carcinoma. On conventional ultrasound, 12/53 lesions showed no protrusion out of the kidney, and 41/53 cases slightly protruded out of the kidney. There was considerable difficulty in the detection of ten lesions, which was achieved with the guidance of CT/MRI, due to their dorsal location of the kidney. On conventional ultrasound, solid, hyper-echoic, color flow signal with varying degrees were the main features of MRCC.The boundary could be well- or ill-defined, and cystic changes existed in part of cases. On CEUS, most MRCCs showed simultaneous enhancement in cortical phase, iso- to hyper-enhancement at peak, and rapid washout in parenchymal phase. The comparisons of imaging features demonstrated that the characteristics were significantly different between conventional ultrasound and CEUS with regard to boundaries, blood supply, and perfusion uniformity (χ 2=12.425, 20.247, 7.185; all P<0.01). Conclusions:CEUS can significantly improve the detection rate of MRCC, which is superior to conventional ultrasound.

Objective:To explore the value of contrast-enhanced ultrasound(CEUS) in distinguishing of renal oncocytoma(RO) and chromophobe renal cell carcinoma(chRCC).Methods:The ultrasonic image features of 49 ROs and 72 chRCCs between October 2007 and January 2020 were retrospectively analyzed, all lesions underwent ultrasonic examination (including 19 ROs and 70 chRCCs with CEUS imaging) and were pathologically approved in our institution. The statistically significant parameters from univariate analyses were then entered for further multivariable Logistic regression. The value of each ultrasonic imaging feature in differentiating RO and chRCC was evaluated.Results:According to the univariate analyses, all imaging features on conventional ultrasound were not statistically different between RO and chRCC (all P>0.05), while the characteristics of tumor wash-in/out pattern, enhancement degree and homogeneity at peak time and pseudocapsule around tumor were significantly different (all P<0.05). After multivariable analyses, tumor wash-in and wash-out pattern were excluded for tumor differentiation ( P>0.05), and the parameters of enhancement degree or homogeneity at peak time and pseudocapsule around tumor were still significantly different between tumor types (all P<0.05, odd ratio was 8.683, 6.667 and 18.774 respectively). The overall sensitivity, specificity and accuracy of these three parameters in diagnosing RO was 68.4%, 91.4% and 86.5%, respectively. Conclusions:CEUS can provide some useful information for the differentiation of RO and chRCC.

Objective To compare the efficiencies of handheld ultrasound ,automated breast volume scanner ( ABVS) and breast specific gamma imaging (BSGI) in the diagnosis of breast cancer . Methods A retrospective review was performed in 200 women ( 210 breast lesions) underwent handheld ultrasound , ABVS and BSGI before surgery . The results were verified with histological examination . Results There was no obvious difference among the three methods in the sensitivity for the diagnosis of breast cancer( P >0 .05) . There was no difference of specificity between handheld ultrasound and ABVS ,BSGI( P = 0 .393 , 0 .139) . Compared with BSGI ,ABVS was an imaging modality with highest specificity for the diagnosis of breast cancer( P = 0 .021) ,and there was no difference between handheld ultrasound and ABVS ,BSGI ( P =0 .07 ,0 .29) . The areas under the ROC curve of handheld ultrasound ,ABVS and BSGI were 0 .855 ,0 .894 and 0 .818 ,respectively . The difference was obvious between ABVS and BSGI ( P = 0 .02) . Conclusions The diagnostic efficacy of ABVS in diagnosis of breast malignant lesions is similar to that of handheld ultrasound . BSGI has certain clinical value in the diagnosis of breast cancer ,and it is an effective supplement for breast cancer ultrasound examination .

Objective To compare the ultrasound differences between gouty arthritis with chronic kidney disease( GCKD) and simple gouty arthritis( GA) ,and evaluate the correlation between the number of tophi and the degree of renal impairment . Methods Twenty-two patients with GCKD and 22 patients only with GA were examined by high frequency and color Doppler ultrasound . The differences between the tophus , intra-tendinous aggregate , double contour sign , hyperechoic spots in synovium , synovium hyperplasia ,effusion and erosion of the knee ,ankle and first metatarsophalangeal joint ( M TP 1 ) were examined . The correlation between the degree of renal impairment and the number of tophi was analyzed . Results The prevalence of tophi in GCKD group were significant serious compared with simple GA group ( Z = - 3 .915 ,P < 0 .001) . The articulations involved tophi in GCKD group were more than those in simple GA group( χ2 = 20 .283 , P < 0 .001) . And the tophi in GCKD group were more likely to involve multiple articulations while simple GA group frequently manifested none or single articulation involved( χ2 = 13 .165 , P = 0 .001 ) . The tophus in GCKD group was more frequently involved tendon than that in simple GA group ( χ2 = 6 .783 , P = 0 .009) ,but the number of aggregates in tendon showed no significant difference between the two groups ( Z = - 1 .499 , P = 0 .134) . The double contour sign was more frequent in GCKD group than that in simple GA group( χ2 = 7 .511 , P = 0 .006) ,there was no difference of hyperechoic spots in synovium ,synovium hyperplasia ,effusion and erosion between the two groups . The number of tophi was correlated with estimated glomerular filtration rate ( eGFR) ,serum creatinine( SCr) and blood urea nitrogen ( BUN) ( rs = - 0 .595 ,0 .511 ,0 .583 ;all P < 0 .001) ,respectively .Conclusions GCKD is more likely to manifest multiple tophi ,multiple tophus-involved articulations ,intra-tendinous tophi and double contour sign .The number of tophi is correlated with the degree of renal impairment .

Objective To evaluate the effectiveness of automated breast volume scanner(ABVS) and magnetic resonance imaging(MRI) in the detection and diagnosis of breast cancer and to assess the value of these modalities as well as the joint use of the two.Methods In this study,a total of 50 breast lesions in 37 patients proved by surgery and pathology were included.Before operation,all patients were underwent both ABVS and dynamic contrast-enhanced (DCE-MRI) examinations,and classified into groups according to BI-RADS classification.Then the effectiveness of the two examinations were contrasted,the image features on the two techniques were analyzed,and their differential diagnosis in benign and malignant breast lesions were compared.Results The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value(NPV) of ABVS and MRI for the diagnosis of breast cancer were 91.67％ and 95.83％,88.46％ and 80.77％,90.00％ and 88.00％,88.00％ and 82.14％,92.00％ and 95.45％,respectively,and there was no statistical difference between ABVS and MRI(P ＞0.05);The sensitivity and specificity of the combination of the two were 99.65％ and 97.78％,respectively.The difference of the ABVS coronal features and MRI dynamic enhancement curve types between malignant breast lesions and the benign were statistically significant (P ＜ 0.05).Conclusions Both ABVS and MRI are effective to diagnose breast cancer well,while the combination of the two can improve the diagnosis more accurately.

Objective To explore the image performance of mucinous breast carcinoma( MBC) on automated breast volume scanner ( ABVS ) and its pathologic features ,for the purpose of improving the recognition of this disease on ABVS ,as well as diagnostic ability . Methods Retrospectively analyzed the sonogram and pathological data of 17 patients with 18 MBC lesions that included 9 PMBC ( pure mucinous breast carcinoma) and 9 MMBC( mixed mucinous breast carcinoma) ,all patients were examined by ABVS before operation and confirmed by pathology . Results Luminal A was the main molecular subtype of MBC ,as well as rarely lymph node metastases;The image of the MBC on ABVS mainly showed a round like or irregular mass ,isoechoic or slightly lower with posterior acoustic enhancement ,and clearly edge with microlobulated or angular ;While on the coronal plane ,it might presented unsmoothed contour ,retraction phenomenon and expansive growth pattern like a spherical nodular;The image characteristics of the PMBC and MMBC lesions on ABVS had no statistical difference( P > 0 .05) ,but the PMBC often performed isoechoic mass with clearly marge ,in contrast , the MMBC usually performed hypoechoic mass with indistinct and angular edge ,and the malignant image features on the coronal plane . Conclusions The three vertical sections of ABVS are beneficial to observe the morphological features of MBC completely ,which can help to identify it from the benign lesions ,reduce misdiagnosis ,and provide some guidance for MBC surgical treatment in the early stage .

Objective To explore the value of readout segmentation of long variable echo-trains (RESOLVE) in the differentiation of prostate cancer from benign prostatic hyperplasia (BPH).Methods Seventy two consecutive patients with suspected prostate cancer were evaluated by 3.0 T MR examination (RESOLVE sequence included,b values=0 and 800 s/mm2) were included in our retrospective study.All the patients had ultrasound guided systemic biopsy with histopathological diagnosis.The patients were divided into group A (23 prostate cancer cases with total 43 malignant lesions) and group B (49 BPH cases with total 64 benign lesions).Two radiologists who were blinded to the clinical data quantitatively analyzed the ADC values of suspicious lesions independently.Inter-reader agreement for ADC values was assessed with Bland and Altman test,and the intra-class correlation coefficient (ICC).Difference of ADC values in two groups was assessed by student's t test.Receiver operating characteristic curve (ROC) was used to determine the best predictor and cutoff value.Results A total of 107 lesions (43 malignant and 64 benign) were identified in 72 patients.ICC was 0.976,P＜0.01.The mean ADC value of prostate cancer is lower than BPH (t=19.223,P＜0.01),(0.74±0.12) × 10 3 and (1.21±0.12) × 10-3mm2/s respectively.Diagnostic cut-off point was 0.946× 10-3mm2/s,diagnostic sensitivity 95.3 ％ (41/43),specificity 98.4％ (63/64),accuracy 97.2％ (104/107).Conclusion RESOLVE ADC value is valuable in the differential diagnosis of prostate cancer and BPH.

Objective To assess the clinical value of batroxobin plus aspirin therapy in reducing the incidence of arterial re-stenosis or re-occlusion in diabetic patients with lower-limb ischemia after receiving angioplasty. Methods A total of 110 diabetic patients with symptomatic arterial obstructions were randomly divided into study group (n=50) and control group (n=60). Aspirin 100 mg/d plus batroxobin 5 IU every other day for six times was used in patients of the study group, while only aspirin 100 mg/d was used in patients of the control group. The follow-up finishing point was the end of 12 months. The arterial re-stenosis or re-occlusion was evaluated with magnetic resonance angiography (MRA) and/or vascular sonography. Amputation above the ankle, death, and the cumulative rate of amputation or death were determined, and the limb salvage and survival rates were assessed by using Kaplan-Meier analysis method. Results Twelve months after the treatment, the occurrence of restenosis in the study group and the control groups was 42.8%and 28.9% respectively (P = 0.002). MR angiography and color- duplex sonography revealed that the restenosis occurrence was much higher in infrapopliteal artery (P = 0.003) and in longer (length > 10 cm) diseased artery (P = 0.001). Twelve months after angioplasty Kaplan-Meier analysis showed that the limb salvage-survival rates of the study group and the control group were 78.2%and 93.5%respectively (log-rank test, P = 0.032 4). Conclusion Combination use of batroxobin and aspirin can effectively reduce the occurrence of restenosis after arterial angioplasty, and the clinical effect is particularly better for the artery distal to the knee and the artery with longer lesion (length > 10 cm), besides this treatment can also improve limb salvage rate.

Objective To evaluate the clinical results of Willis covered stent implantation and coil embolization in the treatment of cranial internal carotid artery (CICA) aneurysm. Methods Eighty-nine patients with CICA aneurysms were selected for treatment with Willis covered stents (n = 43, group A) or coil embolization (n =46, group B) according to the patients'will. Data on the technical success, initial procedure time and in-hospital interval, initial and final angiographic results, mortality, morbidity, and final clinical outcomes were collected and analyzed for the two groups at 6 months post-procedure. Results Endovascular covered stent placement and coil embolization were technically successful in all patients,except for one patient in group A. The initial angiographic results showed complete occlusion in 34 patients of group A (81%, 95% CI: 69%, 93% ) and 24 patients of group B (52%, 95% CI: 37%, 67% ) ( P ＜0. 05). The final angiographic results indicated complete occlusion in 39 patients of group A (39/41,95%,95% CI: 88%, 102% ) and 22 patients of group B (22/45,49%, 95% CI: 34%, 64% ,P ＜0. 01 ). The average procedure time was(103 ± 13)min in group A and (143 + 39) min in group B (P＜0. 01). No significant differences were seen between the two groups in technique success, mortality, morbidity, or final clinical outcomes. Conclusion In this nonrandomized, prospective trial, CICA aneurysm treatment with covered stents yielded midterm angiographic results that were superior to those of coil embolization.