The incidence of vascular diseases is extremely high and mechanical stress plays an important role in vascular remodeling.Reactive oxygen species(ROS)at physiological levels modulate cell signaling while excessive ROS trigger oxidative stress and induce injury.The types of mechanical stresses in the vascular system and the sources of ROS are summarized.Besides,the roles and mechanisms of mechanical stress-induced oxidative stress in vascular diseases are discussed.This review will facilitate a deeper understanding of vascular activity and disease development at the molecular level,provide potential targets for treating vascular diseases.In addition,there are still research gaps on the mechanism of oxidative stress induced by mechanical stress in vascular diseases.Therefore,the potential research direction of mechanical stress-induced oxidative stress in the vascular system is also predicted,with the aim to promote the development of mechanobiology to a certain extent.

Objective To analyze the effects of different traction sites and directions on the maxilla and upper dentition when using clear aligners combined with protraction for the treatment of maxillary deficiency.Methods A three-dimensional(3D)finite element model including the zygomaticomaxillary complex,maxillary dentition,and clear aligners was constructed.The models were divided into Group 1(traction hook at the distal of the lateral incisor)and Group 2(traction hook at the distal of the canine).Each group was analyzed under four loading conditions with protraction angles of 0°,10°,20°,and 30° relative to the occlusal plane.A unilateral protraction force of 500 g was applied.The differences in stress distribution and displacement of the maxillary bone and dentition under different loading conditions were analyzed.Results When the protraction angle was 30°,both groups showed forward and downward displacement of the maxilla,while other angles resulted in counterclockwise rotation.Under the same protraction direction,the total displacement of the maxilla and displacements in all directions in Group 2 were greater than those in Group 1.The upper central incisors in Group 1 showed lingual displacement,which increased with the protraction angle.The maxillary dentition in Group 2 showed forward displacement,with the minimum total and sagittal displacements at a protraction angle of 30°.Stress concentration was mainly observed in the zygomaticomaxillary suture and anterior alveolar bone regions in both groups,decreasing as the protraction angle increased.Conclusions Clear aligners combined with protraction can be applied to skeletal Class Ⅲ patients with mild maxillary deficiency.When the protraction site is located at the distal of the canine with a 30° downward and forward angle to the occlusal plane,the maxilla can achieve ideal forward and downward displacement with the minimum labial movement of the upper anterior teeth.

Video-assisted thoracoscopic surgery (VATS) is the standard procedure for the treatment of lung cancer in the early and middle stages in recent years. The diaphragm is the main respiratory muscle that maintains effective pulmonary ventilation. Diaphragmatic dysfunction is a short-term or permanent dysfunction of one or both diaphragms caused by various factors, mainly manifested as diaphragm distension, diaphragm weakness and diaphragm paralysis, which can lead to respiratory dysfunction, even respiratory failure. This article reviews the etiology, clinical symptoms and signs, diagnosis, treatment and prognosis of diaphragmatic dysfunction after VATS lobectomy, aiming to provide clinicians with assessment methods and management framework for timely diagnosis and treatment of diaphragmatic dysfunction after VATS lobectomy, so as to optimize postoperative respiratory rehabilitation and improve long-term prognosis and quality of life of patients.

Objective To analyze the effects of different traction sites and directions on the maxilla and upper dentition when using clear aligners combined with protraction for the treatment of maxillary deficiency.Methods A three-dimensional(3D)finite element model including the zygomaticomaxillary complex,maxillary dentition,and clear aligners was constructed.The models were divided into Group 1(traction hook at the distal of the lateral incisor)and Group 2(traction hook at the distal of the canine).Each group was analyzed under four loading conditions with protraction angles of 0°,10°,20°,and 30° relative to the occlusal plane.A unilateral protraction force of 500 g was applied.The differences in stress distribution and displacement of the maxillary bone and dentition under different loading conditions were analyzed.Results When the protraction angle was 30°,both groups showed forward and downward displacement of the maxilla,while other angles resulted in counterclockwise rotation.Under the same protraction direction,the total displacement of the maxilla and displacements in all directions in Group 2 were greater than those in Group 1.The upper central incisors in Group 1 showed lingual displacement,which increased with the protraction angle.The maxillary dentition in Group 2 showed forward displacement,with the minimum total and sagittal displacements at a protraction angle of 30°.Stress concentration was mainly observed in the zygomaticomaxillary suture and anterior alveolar bone regions in both groups,decreasing as the protraction angle increased.Conclusions Clear aligners combined with protraction can be applied to skeletal Class Ⅲ patients with mild maxillary deficiency.When the protraction site is located at the distal of the canine with a 30° downward and forward angle to the occlusal plane,the maxilla can achieve ideal forward and downward displacement with the minimum labial movement of the upper anterior teeth.

The incidence of vascular diseases is extremely high and mechanical stress plays an important role in vascular remodeling.Reactive oxygen species(ROS)at physiological levels modulate cell signaling while excessive ROS trigger oxidative stress and induce injury.The types of mechanical stresses in the vascular system and the sources of ROS are summarized.Besides,the roles and mechanisms of mechanical stress-induced oxidative stress in vascular diseases are discussed.This review will facilitate a deeper understanding of vascular activity and disease development at the molecular level,provide potential targets for treating vascular diseases.In addition,there are still research gaps on the mechanism of oxidative stress induced by mechanical stress in vascular diseases.Therefore,the potential research direction of mechanical stress-induced oxidative stress in the vascular system is also predicted,with the aim to promote the development of mechanobiology to a certain extent.

Objective To compare the incidence of perioperative complications and the degree of traumatic stress reaction between thoracoscopic radical esophagectomy and open radical esophagectomy for esophageal cancer.Methods 97 patients with esophageal cancer in our hospital were divided into group A (thoracoscopic esophagectomy,n =51) and group B (open esophagectomy,n =46) according to the operation method.The group A was given thoracoscopic radical resection of esophageal cancer,while the group B was given open radical resection of esophageal cancer.The operative indexes (intraoperative blood loss,intraoperative fluid volume,operative time,incision length),the incidence rate of perioperative complications,body traumatic stress response indexes [white blood cell count (WBC),serum C-reactive protein (CRP),free thyroxine (FT4)] and tumor markers [squamous cell carcinoma antigen (SCC),carbohydrate antigen 125 (CA125)] were compared between the two groups.Results The group A had less intraoperative blood loss,intraoperative fluid volume and shorter operative time and incision length compare with group B (P ≤ 0.05).The incidence rate of perioperative complications in group A was lower than that in group B (17.65％ vs 36.96％) (P ≤ 0.05).There was no significant difference in the levels of WBC,CRP and FT4 between the two groups at the same time (P ＞ 0.05),so as the levels of SCC and CA125 (P ＞ 0.05).Conclusions Compared with open radical esophagectomy,the thoracoscopic esophagectomy had lower incidence of perioperative complications,but there was no significant difference in the degree of traumatic stress reaction between the two methods.

Objective To investigate the clinical effect of thick drainage tube thoracic closed drainage assisted by thin drainage tube after esophagectomy. Methods A total of 112 patients who received esophagectomy in the Department of Thoracic Surgery of Shanxi Dayi Hospital from January 2014 to December 2017 were retrospectively analyzed. The patients were divided into the test group (60 patients) and the control group (52 patients). The test group used thick tube in thoracic close drainage assisted by thin drainage tube, and the control group took general thoracic closed drainage. The operation time, the bleeding of operation, the number of lymph node dissection, the number of post-operative complications, the hospitalization time after operation, postoperative fever time, the frequency of post-operative puncture in both groups were observed. The post-operative pain was evaluated by using visual analogue score (VAS). Results There were no statistical differences in the time of operation [(4.3±1.3) h vs. (4.5±0.9) h], bleeding of operation [(137±21) ml vs. (141±21) ml], the number of lymph node dissection [(18.5±5.2) vs. (17.2±2.4)] and the number of post-operative complications (11 cases vs. 7 cases) between the test group and the control group (all P>0.05). There were statistical differences in the hospitalization time after surgery [(14.9±2.4) d vs. (20.5 ±3.2) d], post-operative fever days [(5.8 ±1.4) d vs. (7.4 ±1.4) d] and the frequency of post-operative puncture (7 vs. 13) between the test group and the control group (all P< 0.05). And there were statistical differences in the VAS scores for post-operative resting and coughing from 48 h to 72 h (all P< 0.05). Conclusion The thin drainage tube is more effective in assisting thoracic closed drainage after esophagectomy. It can reduce post-operative pain and shorten the length of hospitalization, which is worthy of further promotion.

The main constituents of a typical medicinal herb,Polygonum muMflorum (Heshouwu in Chinese),that induces idiosyncratic liver injury remain unclear.Our previous work has shown that cotreatment with a nontoxic dose of lipopolysaccharide (LPS) and therapeutic dose of Heshouwu can induce liver injury in rats,whereas the solo treatment cannot induce observable injury.In the present work,using the constituent "knock-out" and "knock-in" strategy,we found that the ethyl acetate (EA) extract of Heshouwu displayed comparable idiosyncratic hepatotoxicity to the whole extract in LPS-treated rats.Results indicated a significant elevation of plasma alanine aminotransferase,aspartate aminotransferase,and liver histologic changes,whereas other separated fractions failed to induce liver injury.The mixture of EA extract with other separated fractions induced comparable idiosyncratic hepatotoxicity to the whole extract in LPS-treated rats.Chemical analysis further revealed that 2,3,5,4'-tetrahydroxy trans-stilbene-2-O-β-glucoside (trans-SG) and its cis-isomer were the two major compounds in EA extract.Furthermore,the isolated cis-,and not its trans-isomer,displayed comparable idiosyncratic hepatotoxicity to EA extract in LPS-treated rats.Higher contents of cis-SG were detected in Heshouwu liquor or preparations from actual liver intoxication patients associated with Heshouwu compared with general collected samples.In addition,plasma metabolomics analysis showed that cis-SG-disturbing enriched pathways remarkably differed from trans-SG ones in LPS-treated rats.All these results suggested that cis-SG was closely associated with the idiosyncratic hepatotoxicity of Heshouwu.Considering that the cis-trans isomerization of transSG was mediated by ultraviolet light or sunlight,our findings serve as reference for controlling photoisomerization in drug discovery and for the clinical use of Heshouwu and stilbene-related medications.

OBJECTIVETo identify the characteristics of chronic natural killer cell lymphocytosis (CNKL).

METHODSThe clinical data of eight cases defined by the World Health Organization classification was retrospectively analyzed and related literatures were reviewed.

RESULTSHalf of the 8 patients were asymptomatic. Among them, the most common abnormalities were leukocytosis with the median of 11.8(4.5-20.0)×10⁹/L and high proportion of lymphocytes [0.78(0.51-0.89)], while anemia and thrombocytopenia only in 1 patient respectively. The absolute CD3⁻CD16⁺ NK cell count with the median of 5.7(2.4-9.6)×10⁹/L increased in peripheral blood. By the end of follow-up, except one case was lost, the other seven patients were in stable condition,including four cases without any medications and three patients receiving chlorambucil or glucocorticoid.

CONCLUSIONAs an indolent chronic lymphoproliferative disease, CNKL was presented with mild clinical symptoms and increased number of CD3⁻CD16⁺ NK cells in peripheral blood. Patients with symptoms could be treated with immunosuppressive therapy while those asymptomatic could be followed up without intervention.

Adult ; Aged ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Killer Cells, Natural ; Lymphocytosis ; blood ; Male ; Middle Aged ; Prognosis