Diabetic retinopathy and diabetic nephropathy are two chronic microvascular complications of diabetes. Some studies have shown that the both microvascular complications possess similar pathological mechanisms and some differences. The gold standard for clinical diagnosis of diabetic nephropathy is the pathology of renal biopsy. Of which, however, the acceptance of patients and the popularity of the technology have been limited for its invasiveness and technical difficulty. Therefore, the key to solve this problem is to seek a reliable noninvasive diagnosis method. The diabetic retinopathy diagnosed by color fundus photography opens the possibility of noninvasive diagnosis of diabetic nephropathy. A growing number of studies have shown that it has a high degree of credibility and feasibility to combine diabetic retinopathy and other clinical indicators to assist in diagnosing diabetic nephropathy. The effects and diagnostic value of diabetic retinopathy on diabetic nephropathy, therefore, have been reviewed in present article.

Objective To improve doctors' understanding of giant perivascular space (PVS) in the brain. Methods A case of giant intracranial polycystic PVS was analyzed retrospectively by searching the databases of PubMed and Medline, combining with literature reports, the anatomy, pathophysiology, clinical manifestations, imaging changes, and treatment principles of giant PVS were summarized. Results A 19-year-old male solder was admitted due to intermittent occipital distension pain for 2 weeks. The brain MRI showed multiple cystic lesions in the right cerebral hemisphere without enhancement. The head-carotid artery CT angiography found no abnormality. The diagnosis was polycystic giant PVS in the brain. His headache was relieved after 3 days of oral compound paracetamol tablets. During a regular follow-up period for 3.5 years, he complained no discomfort. Until October 13, 2020, there were only 41 English articles about brain polycystic giant PVS collected in PubMed, including total of 46 cases. The clinical manifestations were not specific, depending on whether the nerve tissue around PVS was compressed or not. Headache accounted for 32.6%, and hydrocephalus for 43.5%. The MRI of PVS was characterized by its round, oval or tubular structure with a clear, smooth and homogeneous edge, its signal intensity was equal to that of cerebrospinal fluid (CSF) without enhancement. It is called giant or huge PVS when its diameter is more than 15 mm. There was no special treatment unless the giant PVS causes surrounding tissue oppression or hydrocephalus, if so, neurosurgical operation could be help to improve patient's status. Conclusions Characteristics of giant PVS appeared on all sequences of MIR is a CSF-like intensity cystic lesion without enhancement. Clinical attention should be paid to differential diagnosis and follow-up and. If space-occupying effect or hydrocephalus development, it can be intervened by neurosurgery, otherwise no special treatment.

Objective To analyze the clinical features of primary appendiceal mucinous adenocarcinoma (AMAC), and investigate the diagnosis and treatment principles of the disease. Methods Thirty cases of primary AMAC from October 2011 to September 2019 in Daping Hospital of the Army Medical University were retrospectively analyzed, including demography, imaging, hematology, pathology and treatment method. Results The main clinical features of the 30 cases were right lower abdominal pain. Of whom 12 cases were diagnosed as acute or chronic appendicitis before operation, and 8 cases were as combined with ovarian space occupying. Preoperative routine abdominal B ultrasonography combined with other imaging examinations (including abdominal CT, MRI and PET/CT) obviously improved the diagnostic accuracy (68.2%) than that with B ultrasonography alone(25.0%, P=0.049). Carcinoembryonic antigen (CEA) and carbohydrate antigens (CA199, CA125 and CA242) were the most common tumor markers, which had the highest diagnostic value for AMAC. Intestinal obstruction occured in four patients undergoing stage Ⅱ extended surgery, while in only three patients without undergoing stage Ⅱ extended surgery (Fisher's exact test, P=0.181). The mean survival time of patients with R₀ resection was (57.5±9.5) months and the median survival time was 59.0 months. The mean survival time of patients without R₀ resection was (29.8±4.1) months and the median survival time was 33.0 months (χ²=1.255, P=0.263). Conclusions Appendiceal B ultrasound combined with abdominal enhanced MRI, CT or PET/CT can significantly improve the diagnostic rate of appendiceal mucinous adenocarcinoma. The monitoring of CEA, CA199, CA125, CA242 is helpful for the preoperative diagnosis of appendiceal mucinous adenocarcinoma.

Objective To analyze the clinical characteristics of 178 primary biliary cholangitis (PBC) patients with features of autoimmune hepatitis (AIH). Methods Four hundred and sixty-one PBC patients diagnosed in the Department of Gastroenterology, Xijing Hospital Affiliated to Air Force Medical University from December 2008 to December 2018 were included in this study. According to the diagnostic criteria of PBC-AIH, AIH-PBC and PBC, they were divided into PBC-AIH OS group(n=50), AIH-PBC group (n=178) and pure PBC group (n=233). Comparison of general clinical symptoms of three groups (jaundice, fatigue, pruritus, etc.); biochemical and immunological indices [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyltranspeptidase (GGT), immunoglobulin G/M (IgG, IgM), total/direct bilirubin (TBIL, DBIL), albumin/globulin (ALB, GLB)]; autoantibodies [antinuclear antibody (ANA), antimitochondrial antibody (AMA), anti-smooth muscle antibody (ASMA)]; stage and grade of the inflammation and fibrosis of the liver, noninvasive fibrosis score of fibrosis index based on the four factors (FIB-4) and aspartate aminotransferase/platelet ratio index (APRI); 5-year cumulative incidence of adverse events. Results The incidence of jaundice and inappetence in AIH-PBC group and PBC group was significantly lower than that in PBC-AIH OS group (P<0.05). The differences of ALT, AST, TBIL, IgG, IgM and GLB between the groups were statistically significant (P<0.05), and AIH-PBC group and PBC-AIH OS group were mostly higher than pure PBC group. Autoantibody detection showed that the positivity rates of SSA and Ro-52 antibodies in AIH-PBC group were significantly higher than those in pure PBC group, while the positivity rates of ASMA, soluble liver antigen/liver pancreatic antigen antibody (SLA/LP) and SSB were significantly lower than those in PBC-AIH OS group (P<0.05). The IgG and IgM of AIH-PBC group were significantly higher than those of pure PBC group (P<0.05). The liver histopathological stage, FIB-4 and APRI indexes of AIH-PBC group and PBC-AIH OS group were significantly higher than those of pure PBC group (P<0.05). The 5-year cumulative adverse event incidence of PCB-AIH OS group was significantly higher than that of AIH-PBC group, and that of AIH-PBC group was significantly higher than that of pure PBC group (P<0.05). Conclusions The clinical manifestations of AIH-PBC patients are significantly different from those of PBCAIH OS and pure PBC patients, and their long-term prognosis is worse than that of pure PBC patients.

Objective To investigate the effects of silencing axon guide protein 4D (Sema4D) on the growth, autophagy and epithelial-mesenchymal transformation of gastric cancer cell SGC-7901. Methods The cells were randomly divided into control group, shRNA-NC group, Sema4D-shRNA1 group, Sema4D-shRNA2 group and Sema4D-shRNA3 group, and transfected into SGC-7901 with shRNA Sema4D vector. The expression of Sema4D mRNA was detected by RT-PCR. The clone formation rate was determined by colony formation assay. Flow cytometry was used to detect apoptosis. Morphological changes of epithelial-mesenchymal transformation were observed microscopically. Western blotting was used to detect the expression levels of Ki67, proliferating cell nuclear antigen (PCNA), Bax, Bcl-2, caspase-3, cleaved caspase-3, Beclin1, p62, LC3Ⅰ, LC3Ⅱ, E-cadherin, N-cadherin, and vimentin proteins. Results The results of RT-PCR showed that compared with the control group, the mRNA levels of Sema4D-shRNA1 group, Sema4D-shRNA2 group and Sema4D-shRNA3 group were significantly lower, and the mRNA level of Sema4D-shRNA3 group was significantly lower than that of Sema4D-shRNA1 group and Sema4D-shRNA2 group (P<0.05).Sema4D-shRNA3 was selected for subsequent experiments. The results of colony forming assay showed that the colony forming efficiency of Sema4D-shRNA3 group was significantly lower than that of the control group (P<0.05). Flow cytometry results showed that compared with the control group, the apoptosis rate of Sema4D-shRNA3 group was significantly increased (P<0.05).Western blotting results showed that compared with the control group, the expression levels of Ki67, PCNA, p62, N-cadherin and vimentin proteins in the Sema4D-shRNA3 group were significantly lower, Beclin1 and E-cadherin proteins were significantly higher, and the ratios of Bax/Bcl-2, cleaved caspase-3/caspase-3 and LC3Ⅱ/LC3Ⅰ were significantly higher (P<0.05). Microscopically, the epithelial-mesenchymal transformation was inhibited in the Sema4D-shRNA3 group. Conclusion shRNA Sema4D can inhibit proliferation, autophagy and epithelial-mesenchymal transformation of SGC-7901 cells and promote apoptosis.

Haptoglobin (HP) is a kind of plasma glycoprotein with genetic polymorphism, secreted mainly in liver and has two alleles of HP1 and HP2, can form three potential genotypes: HP1-1, HP2-1 and HP2-2, which has the function of binding to free hemoglobin and antioxidation. At present, many studies have shown that HP may be a potential biomarker of diabetic kidney disease. Because of the special structure and function of HP, it has certain advantages in early diagnosis and prognosis prediction of diabetic nephropathy. The relationship has been mainly reviewed in present paper between the expression level of HP and its genotypes in the occurrence, development, diagnosis and prognosis prediction of diabetic nephropathy.

Traumatic arthritis (TA) is a kind of osteoarthritis secondary to joint trauma, and its pathogenesis is not clear at present. It is mainly related to the apoptosis of chondrocytes involved in a variety of cytokines and related signal pathways. Curcumin has anti-inflammatory, anti-oxidant and anti-apoptotic effects. Curcumin is used to treat TA mainly by inhibiting oxidase, scavenging free radicals' antioxidant effects, inhibiting the anti-inflammatory effects of cyclooxygenase, lipoxygenase and various inflammatory mediators, and acting on various signal transduction pathways to inhibit apoptosis of chondrocytes. This paper describes some of the biological functions of curcumin, and introduces its related mechanism of action in the treatment of TA.

Osteosarcoma is one of the most common primary malignant tumors in children and adolescents, and its development mechanism in human body has not been clearly explained by scholars. With the in-depth study of immunology, tumor immunity has gradually become a hot spot in the field of tumor research. A large number of studies have shown that programmed death protein-1 (PD-1)and its ligand 1 (PD-L1) can mediate immunosuppression, weaken the killing effect of immune cells on tumor cells, and lead to immune escape of tumor cells, thus promoting the development of tumor. This paper reviews the immune escape mechanism of PD-1/PD-L1 in osteosarcoma and the latest progress of PD-1/PD-L1 axis in the treatment of osteosarcoma, aiming to provide theoretical reference for understanding the role of PD-1/PD-L1 in osteosarcoma and developing new drugs for the treatment of osteosarcoma.

Type Ⅱ innate lymphoid cell (ILC2), a newly discovered important type of inherent immune cells closely related to T lymphocytes, has a significant regulatory impact on T lymphocytes. Many studies have demonstrated that ILC2 can effectively induce the differentiation of CD₄⁺ T cells to helper T cell (Th)2, thereby contributing to the modulation of host immune homeostasis. In the present paper, we would like to review the update of possible effects of ILC2 on Th2 differentiation and its role in immunity diseases.

As a treatment for end-stage joint disease, joint replacement is one of the most common surgeries in orthopedics. With the increasing number of joint replacement patients, the rehabilitation for most of the patients has become a key link affecting the prognosis. The effects of conventional rehabilitation treatment programs are not satisfactory. Telemedicine provides a new direction for the rehabilitation of patients after joint replacement. The coronavirus that emerged in early 2020 has made the importance of telemedicine more prominent. This article aims to summarize the current situation and development prospects of the clinical application of telemedicine in the rehabilitation of patients after joint replacement.