Osteoporosis (OP) is a prevalent metabolic bone disease with a complex pathogenesis that has not yet been fully elucidated. Recent studies have revealed that the Toll-like receptor 4 (TLR4) signaling pathway plays a significant role in the development and progression of OP. TLR4, a crucial immune receptor primarily expressed in immune cells, is involved in inflammatory responses and immune regulation. The TLR4 signaling pathway influences bone metabolism and remodeling through multiple mechanisms. Therefore, investigating the role of the TLR4 signaling pathway in OP is of great significance for its prevention and treatment. Research targeting the TLR4 signaling pathway provides novel insights and approaches for OP therapy. Future studies should further explore the mechanisms of the TLR4 signaling pathway, develop therapeutic agents that modulate this pathway, and validate their efficacy in OP through clinical trials, thereby offering more options for the clinical management of OP.

Objective:To investigate the physical and mental experience, treatment compliance and use barriers of patients with insomnia in using digital cognitive behavioral therapy for insomnia (dCBT-I) in order to provide qualitative evidence for the development and application optimization of the dCBT-I technology paradigm.Methods:From July to November 2021, a semi-structured interview outline was used to conduct in-depth interviews with the dCBT-I users ( n=10) to record their original feelings about the use of dCBT-I. Interpretative phenomenology's text analysis was used to explore the participants' experience and cognition of dCBT-I. Results:Text analysis and key information calibration were carried out on the verbatim transcripts of semi-structured interview recordings, and three core themes were extracted, namely stickiness factor, use barrier and optimization direction, as well as eight sub-themes, namely professionalism, accessibility, benefit experience, difficulty in task execution, instruction generalization, difficulty in software operation, enrich treatment content and personalized guidance.Conclusion:The present study showed that participants were receptive to the dCBT-I intervention and would be benefited from it.However, dCBT-I still needs to be optimized and improved to reduce the operating difficulty and explore more appropriate timing of manual intervention.

OBJECTIVES: To investigate the relationship between the fatty acid-binding protein 4 (FABP4) and colorectal cancer (CRC). METHODS: Using an enzyme-linked immunosorbent assay (ELISA), we measured the expression of FABP4 in plasma of 50 patients who underwent surgery for CRC from October 2017 to May 2018 and 50 healthy controls. The content of the visceral fat area (VFA) as seen with abdominal computed tomography (CT) scanning was measured by ImageJ software. The expression levels of FABP4, E-cadherin, and Snail proteins in CRC and adjacent tissues were determined by immunohistochemistry. RESULTS: The mean concentration of plasma FABP4 of CRC patients was higher than that of the control group (22.46 vs. 9.82 ng/mL; CONCLUSIONS High LPA and VFA were risk factors for increased plasma FABP4 in CRC patients. FABP4 protein was highly expressed in CRC tissues and associated with TNM stage, differentiation, and lymph node metastasis of CRC. The level of FABP4 in CRC tissue was correlated with E-cadherin and Snail expression, suggesting that FABP4 may promote CRC progression related to epithelial-mesenchymal transition (EMT).

Objective:To explore the feasibility of ultrasound screening and diagnosis of fetal cleft palate in early pregnancy, analyze and summarize the imaging technology and image characteristics of two-dimensional and three-dimensional ultrasound in normal fetus and cleft palate fetus.Methods:A total of 10 519 pregnant women participated in the early pregnancy were included from January 2016 to June 2020 in Shenzhen Hospital, University of Chinese Academy of Sciences. The palatal line on the standard section of fetal nuchal translucency (NT) measurement was used as a screening marker for routine observation. For fetuses with abnormal palatine line, posterior nasal triangle of coronal plane and axial plane of maxillary alveolar arch of two-dimensional ultrasound were added as the diagnostic sections, and three-dimensional volume data of fetal face were collected, and three dimensional multimodal imaging technology was used to analyze the volume data off-line to determine or exclude fetal severe cleft palate. All fetuses were followed up during the second trimester for deformity scanning and post natal (or induced labor) assessment.Results:Of the 10 519 fetuses, the standard NT plane was obtained and the palatal line was observed in 10 204 cases(97.01%), with normal palatal line in 10 169 cases.In 35 suspected cases, 13 cases were confirmed cleft lip and palate by two and three dimensions ultrasound, and were confirmed by induced labor. There were 7 cases in unilateral side, 3 cases in bilateral, 2 cases in median cleft lip and palate, 1 cases in irregular cleft lip and palate, and no false positive results were reported. Twenty-two suspicious cases were excluded by increasing the two-dimensional sectional and three-dimensional volumetric off-line analysis, and screening after the second trimester and after birth. There was 1 case of missed diagnosis of simple cleft palate.Conclusions:Palatal line is a good screening marker for fetal cleft palate in early pregnancy. For fetuses with abnormal palatine line, the adding of posterior nasal triangle and the axial plane of maxillary alveolar arch, and combining three-dimensional volume data for off-line analysis can determine or exclude severe cleft palate. This study is of great significance for early screening and diagnosis of severe fetal cleft palate, prenatal genetic counseling and prevention birth defect.

Objective:Hepatocellular carcinoma (HCC) is the fourth most dominant cancer in the world and the second leading cause of cancer-related deaths in the China. With the increase in the incidence of metabolic syndrome (MS) in the population, the correlation between MS and HCC has gradually been recognized. MS manifests as non-alcoholic fatty liver disease (shortly known as NAFLD) in the liver. A large number of research results has shown that the development of fatty liver is closely related to the occurrence of HCC, in which lipid metabolism plays a key regulatory role, and lipid metabolism is regulated by fatty acid binding protein (FABP). This study signifies the lipid metabolism analysis and the key FABP expression conditions in HCC.Methods:Data of patients who were first diagnosed with primary HCC between January 2016 to July 2019 were collected, and were divided into two groups according to the etiology, namely the viral and non-viral hepatitis-related HCC group. The relationship between MS-related factors and HCC was analyzed by t-test and chi square test. The expressions of FABP1, FABP4 and FABP5 were detected in cancer and adjacent tissues by immunohistochemistry, and the expressions of FABP1, FABP4 and FABP5 in HCC with fatty liver were detected by immunofluorescence. Finally, the expressional characteristics of the above-mentioned FABPs in HCC patients were analyzed with different clinicopathological features.Results:There were statistically significant differences in the rate of abnormal lipid metabolism and the number of abnormalities in MS-related factors between the viral and non-viral hepatitis-related HCC group. FABP1, FABP4, and FABP5 expression in HCC tissues were lower than the corresponding adjacent tumor tissues. Compared with simple HCC, FABP1, FABP4, FABP5 expression were increased in HCC tissues with steatosis, and the expression of FABP was closely related to the clinical characteristics of patients.Conclusion:Abnormal lipid metabolism is closely related to non-viral hepatitis-related HCC. The expression of lipid metabolism regulatory proteins FABP1, FABP4, and FABP5 are down-regulated in HCC tissues, but up-regulated in HCC with fatty liver, suggesting that the relationship between MS, especially dyslipidemia, and HCC should be paid attention to in clinical practice for early intervention. FABP1, FABP4, FABP5 may regulate HCC occurrence and development.

Objective To investigate the effect of exercise diary on arm exercise compliance ofpatients with peripherally inserted centralcatheter (PICC). Methods Thirty patients with PICC hospitalized in our hospital from June to August in 2017 were selected as the control group, where the patients received guidance on functional exercises through arm exercise videos and routine methods. Another thirty-two patients hospitalized in our hospital from September to November of 2017 were selected as the observation group, where in addition to the same treatment as in the control group and these patients received interventions using their self-designed exercise diary for a total of 31 days. Their compliance with functional exercises before and after intervention and the incidences of venous thrombosis after intervention were compared between the two groups. Results After interventions, the compliance rate of arm exercises in the observation group was significantly higher than that of the control group (90.6% vs. 26.7%, P＜0.05). The incidence of venous thrombosis in the observation group was significantly lower than that of the control group (3.1% vs. 30.0% , P＜0.05). Conclusions Exercise diary can improve the arm exercise compliance of PICC patients and prevent the occurrence of venous thrombosis. It is worthy of clinical application and promotion.

Objective To investigate the establishment of focal cerebral ischemia model in rabbits with the improved suture method.Methods A total of 45 healthy and clean adult New Zealand rabbits were divided into either a sham operation group (n =5) or a model group (n =40) using random number table method before modeling,and the sex was not limited.The self-made head ends of 2-0 fishing lines dipped in paraffin were used as the sutures.The external carotid artery was cut and inserted into a intracranial artery through the internal carotid artery and blocked the origin of middle cerebral artery.The neurological function score was performed after 6 h.The neurological deficit scores ≥2 was successful modeling.The rabbits were killed by anesthesia.The brain slices were stained with 2％ 2,3,5-triphenyl tetrazolium chloride solution.The infarct foci were observed.The diameters of suture head and the depth of suture insertion were compared in the model rabbits with successful modeling,failure,and death in the model group.Results There were 40 rabbits in the model group,six of them died,including 4 died of subarachnoid hemorrhage within 4 h after operation,and 2 died from anesthetic accident.The mortality rate was 15.0％.Seven rabbits failed,mainly because of cerebral vasospasm and the insertion depth of suture was insufficient.Twenty-seven had successful modeling,and the success rate was 67.5％.All the rabbits in the sham operation group survived.The diameter of the suture head and insertion depth in the successful modeling rabbits were compared with the death and failure outcome in rabbits.The difference was statistically significant (diameter:0.52 ± 0.14 mm vs.0.45 ±0.40 mm and 0.58 ±0.17 mm;depth:5.49 ±0.17 cm vs.6.04 ± 0.11 cm and 4.26 ±0.30 cm;all P ＜ 0.05).Conclusions The improved suture method can successfully prepare the focal cerebral ischemia model of middle cerebral artery in rabbits.The method is simple.Its repeatability and practicability are better.

Objective To explore the effectiveness of mindfulness-based four-step approach to obsessive compulsive disorder. Methods A total of 82 patients with obsessive compulsive disorder were divided into control group and study group with 41 cases each by admission order. The patients in control group were given routine drug treatment and nursing, and the patients in study group were given mindfulness-based four-step approach based on control group. The indexes were evaluated by Yale-Brown Obsessive Compulsive Scale, Hamilton Depressive Scale, Hamilton Anxiety Scale, Short Form 36 questionnaire before and after intervention. Results After 12 weeks treatment, the score of Yale-Brown Obsessive Compulsive Scale, compulsive thinking, compulsive behavior were (6.16 ±4.38), (3.23 ±1.93), (2.98 ± 2.01) points in study group and (10.81 ± 3.26), (6.05 ± 2.02), (4.09 ± 2.15) points in control group, and there were significant differences(t=5.386, 6.384, 2.385, all P < 0.05). The score of anxiety and depress were (1.98 ± 1.91), (2.16 ± 1.38) points in study group, and (4.05 ± 2.01), (5.11 ± 2.26) points in control group, and there were significant differences(t=4.722, 7.045, all P<0.05). The score of total life quality, physiological function, physiological function, body pain, general health, vitality, social function, emotional function, mental health were (77.32 ± 6.26), (89.11 ± 14.27), (78.19 ± 26.36), (82.33 ± 25.22), (60.18 ± 20.39), (55.31 ± 19.68), (80.13 ± 25.76), (72.13 ± 20.16), (60.12 ± 20.88) points respectively in study group, and (71.43 ± 5.62), (82.19 ± 13.36), (55.11 ± 23.27), (70.18 ± 25.71), (49.01 ± 20.13), (45.22 ± 18.11), (62.19±25.63), (45.23±23.02), (44.16±21.08) points in control group, and there were significant differences (t=2.134-6.621, all P<0.05). Conclusions The mindfulness-based four-step approach intervention can obviously relieve anxiety and depressive negativity mood in obsessive compulsive disorder patients. It can improve patient′s obsessive compulsive symptom, enhance the patient′s quality of life. It has important significance for obsessive compulsive disorder patients during their recovering period.

Objective To investigate the clinical value of multi-slice spiral CT in the evaluation of esophageal variceal bleeding .Methods 50 cirrhosis patients with esophageal varices received multi-slice spiral CT and gastroscopy detection .The application value of multi-slice CT in the assessment of esophageal bleeding was evaluated according to the results of gastroscopy detection .Results CT angiography score had significantly positive correlation with the severity of endoscopic varices and endoscopic red color sign (r=0.762,0.687,all P<0.01).The sensitivity and specificity of CT angiography score in diagnosis of endoscopic red signs RC 3 were 76.92% and 92.50%. Conclusion The results of multi-slice CT and gastroscopy are positively correlated with the severity of esophageal varices,which can be used to predict the risk of esophageal bleeding .

Objective To explore the applied value of static and dynamic of virtual defecography technology in the etiological diagnosis of constipation.Methods 50 patients with constipation were included.Conventional cleaning enema was performed firstly.Then they were injected the virtual defecography agentwith lateral position,filling the rectum,sigmoid and descending colon.Thirdly,siting on the qualities commode,adjusting height coincides with the left and right femur,displaying the pubic symphysis and coccyx dynamic acquisition image acquisition with the speed of 4/s,the dynamic changes of the rectum and anal canal were analyzed and measured.Results Among 50 patients,32 cases with rectocele,1 case with rectal bend,2 cases with anal canal stenosis,7 cases with rectal prolapse,4 cases pelvic floor spasm syndrome,and 4 cases with no cause.Conclusion Static and dynamic virtualdefecography was an important method in the etiological diagnosis of patients with constipation.