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.

Objective To explore the effects of mid-term (4 weeks) and long-term (8 weeks) simulated microgravity on calcification of the common carotid artery in the rats. Methods Hindlimb-unweighted (HU) rat model was used to simulate the effects of weightlessness on the cardiovascular system. Seventy-five male SD rats were randomized into the control group, 4-week HU group (HU4w), and 8-week HU group (HU8w). After the common carotid arteries were separated, the quantification of calcium content and the alizarin red staining were used to detect the calcium salt deposition in the common carotid arteries. The alkaline phosphatase (ALP) activity of common carotid arteries was measured. Western blotting and the real-time polymerase chain reaction(RT-PCR) were performed to measure the protein and mRNA levels of Runx2, Msx2, BMP2, osteocalcin, and SM22α. Results Compared with the control group, the calcium content and the calcium salt deposition were increased, meanwhile, the ALP activity was enhanced in the common carotid arteries of 4-week and 8-week HU rats. Besides, the protein and mRNA levels of Runx2, Msx2, BMP2, osteocalcin were increased, while those of SM22α were decreased in the common carotid arteries of 4-week and 8-week HU rats (P<0.05 or P<0.01). Interestingly, there was no statistically significant difference of above tests between the HU4w and HU8w groups. Conclusion Mid- and long-term simulated microgravity induced the osteogenic transdifferentiation of smooth muscle cells and calcification in the common carotid artery of rats, while the degree of calcification did not change significantly with the prolonged period of simulated microgravity.

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.

Objective To investigate the effect of miR-1285 on migration and invasion of ovarian cancer OVCAR3 cells and its mechanism. Methods Human ovarian cancer OVCAR3 cells in logarithmic growth phase were collected and randomly divided into control group (liposomes added only), miR-1285-NC group (transfected randomly, nonsense sequence), miR-1285-mimics group (transfected with miR-1285-mimics), miR-1285-mimics+yes-associated protein 1 (YAP1) group (transfected with miR-1285 mimics and YAP1 overexpressed sequence). Stable transfected cells of each group were tested for relative expression level of miR-1285 by qRT-PCR, for cells migration ability by scratch test, for cells invasion ability by Transwell test, and for the expression levels of YAP1, E-cadherin and vimentin protein by Western blotting. Results The relative expression levels of miR-1285 were obviously higher in miR-1285-mimics group and miR-1285-mimics+YAP1 group than those in control group and miR-1285-NC group (P<0.05), while no significant difference when compared between control group and miR-1285-NC group and between miR-1285-mimics group and miR-1285-mimics+YAP1 group (P>0.05). The wound healing rate and the number of transmembrane cells were decreased in miR-1285-mimics group and miR-1285-mimics+YAP1 group than those in control group and miR-1285-NC group (P<0.05); among which the wound healing rate was obviously higher and much more transmembrane cells in miR-1285-mimics+YAP1 group than those in miR-1285-mimics group (P<0.05). The relative expression levels of YAP1 and Vimentin protein decreased and of E-cadherin protein increased in miR-1285-mimics group and miR-1285-mimics+YAP1 group than those in control group and miR-1285-NC group (P<0.05); while the relative expression levels of YAP1 and Vimentin protein were obviously higher and of E-cadherin protein markedly lower in miR-1285-mimics+YAP1 group than those in miR-1285-mimics group (P<0.05). No significant difference existed between miR-1285-NC group and control group on the wound healing rate, number of transmembrane cells and the relative expression levels of YAP1, Vimentin protein and E-cadherin protein (P>0.05). Conclusion Overexpression of miR-1285 may inhibit the migration and invasion of ovarian cancer cells by down-regulating the expression level of YAP1.

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.

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.

Objective To investigate the effects of simulated 2-week microgravity on the ocular fundus hemodynamics of central retinal artery and the retinal and choroidal thickness in autogenous rats. Methods Eight healthy SD rats were designed in self-control, designed for the control before tail suspension, the tail suspension for 1, 4, 7 and 14 d. A rat model of simulated microgravity method was established by tail suspension. The peak maximum systolic velocity (PSV) of central retinal artery(CRA) in rats was detected and analyzed by color Doppler ultrasonography. The retinal and choroidal thicknesses were measured by the enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT). Results The PSV value in each different period after tail suspension was decreased compared with that in the control before tail suspension (P<0.05). There was no significant difference in PSV value between the tail suspension for 1 d and both the tail suspension for 4 d and 7 d (P>0.05), but there was a significant difference between the tail suspension for 1 d and the tail suspension for 14 d (P<0.05). There was no significant difference in retinal thickness between the control and the each different periods after tail suspension (P>0.05). The choroidal thickness was lower in the control before tail suspension than that in each different period after tail suspension (P<0.05). Compared with the tail suspension for 1 d, the choroidal thickness of the rats was significantly increased in the tail suspension for 4, 7 and 14 d respectively (P<0.05). Conclusions Two-week simulated microgravity environment has significant effects on the fundus blood flow and choroid thickness in rats, but has no obvious effect on the retinal thickness in rats. The fundus flow velocity would decrease and choroid thickness would increase with the prolongation of the tail suspension time.

Objective To investigate the potential mechanisms of sulfate sodium (DS) on suppressing human gastric cancer cells (HGC-27) invasion and migration through regulating M2 tumor-associated macrophages (M2-TAMs). Methods (1) In vitro experiment: Differentiation of human monocytes (THP-1) into M0 macrophages was induced by phorbol 12-myristate 13-acetate(PMA). Interleukin 4 (IL-4) and interleukin 13 (IL-13) were used to activate M0 macrophages into M2 macrophages. Immunofluorescence and Western blotting were used to detect the expression of CD163, a specific marker of M2-TAMs. HGC-27 cells were divided into 4 groups, including the control group, DS group, M2 group (co-culture of M2 and HGC-27 cells) and M2+DS group (co-culture of M2 and HGC-27 cells treated with DS). Transwell and scratch tests were performed to detect the invasion and migration ability of HGC-27 cells. (2) Animal experiment: 24 nude mice were randomized into control group (n=12) and DS group(n=12). After 24 h intraperitoneally injecting HGC-27 cells, mice were treated with DS (DS group) or saline (control group) through intraperitoneal injections. Later, mice were sacrificed after 14 days. The number of nodules induced by peritoneal implantation of gastric cancer cells was counted and the omentum tumor tissue was collected to examine CD163 expression levels using immunohistochemistry. (3) Human gastric cancer tissue: Clinical gastric cancer samples were collected; the expression of CD163 and programmed death-ligand 1 (PD-L1) were detected by immunohistochemistry and immunofluorescence. Results (1) In vitro experiment: The expression of CD163 in successfully induced-M2 macrophages was increased; DS could inhibit the polarization of M0 to M2 macrophages; Compared with M2 group, M2+DS group could significantly reduce the invasion and migration ability of HGC-27 cells which was already enhanced by M2-TAMs (P<0.001). (2) Animal experiment: Compared with Control group, the number and volume of metastatic nodules implanted in the abdominal cavity in DS group were significantly decreased, and the expression of CD163 in omentum tumor tissue in DS group was significantly lower (P<0.001). (3) In human gastric cancer tissues: The expression of CD163 in poorly differentiated adenocarcinomas was significantly higher than those in well-differentiated adenocarcinomas and adjacent tissues (P<0.05), but there was no significant difference in CD163 expression between well-differentiated adenocarcinomas and adjacent tissues (P>0.05); The expression of CD163 in PD-L1 positive group was significantly higher than that in PD-L1 negative group (P<0.05). There was a positive correlation between CD163 and PD-L1 expression in human gastric cancer cells (P<0.05, r=0.40). Conclusion Dextran sulfate sodium can inhibit the invasion and migration of human gastric cancer cells by affecting M2 tumor-associated macrophages.

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.