The spine is the most common site of skeletal metastasis in lung cancer, which frequently leads to severe complications such as pathological fracture and neurological compromise and is associated with poor prognosis. The development and progression of spinal metastasis from lung cancer are linked to the unique local microenvironment and tumor microenvironment (TME) of the vertebral column. During metastatic evolution, the dense vascular network of the spine and a plethora of signaling molecules, together with the complex cellular constituents and their intricate interactions within the TME, all cooperate to facilitate the tumor invasion and colonization of the vertebral compartment. Mechanistic studies delineating the role of the TME in spinal metastasis from lung cancer have markedly expanded, fostering the emergence of innovative therapeutic strategies—including nanomedicines, sono-photodynamic therapy, gene therapy, and combination regimens. These strategies demonstrate remarkably potential for clinical translation and offer new directions for the precision management of spinal metastasis from lung cancer.

BACKGROUND:Lumbar disc degeneration is a common disease that causes lower back pain and lower limb neurological symptoms.The balance of collagen metabolism plays an important role in maintaining the stability of the intervertebral discs.OBJECTIVE:To review the research progress in the imbalance of collagen metabolism in intervertebral disc degeneration.METHODS:The first author searched for relevant literature published before May 2024 in CNKI,PubMed and Web of Science databases.Search terms were"degenerative disc disease,""collagen metabolism,""collagenase family,""collagen synthesis related factors,"and"collagen breakdown related factors"in Chinese and English.Seventy-six articles were finally included for review.RESULTS AND CONCLUSION:In the process of intervertebral disc degeneration,the balance of collagen metabolism plays a crucial role in maintaining the stability of the normal intervertebral disc.When intervertebral disc degeneration occurs,a large amount of pro-inflammatory factors,collagenase,and oxidative stress reactions occur in the intervertebral disc,which increases the breakdown of collagen in the intervertebral disc.At the same time,it inhibits the generation of growth factors,collagen synthase,and collagen synthesis-related factors,resulting in a decrease in collagen synthesis in the intervertebral disc.The combined effect of the above two conditions disrupts the balance of collagen metabolism in the intervertebral disc,further exacerbating the process of intervertebral disc degeneration.

BACKGROUND:Lumbar disc degeneration is a common disease that causes lower back pain and lower limb neurological symptoms.The balance of collagen metabolism plays an important role in maintaining the stability of the intervertebral discs.OBJECTIVE:To review the research progress in the imbalance of collagen metabolism in intervertebral disc degeneration.METHODS:The first author searched for relevant literature published before May 2024 in CNKI,PubMed and Web of Science databases.Search terms were"degenerative disc disease,""collagen metabolism,""collagenase family,""collagen synthesis related factors,"and"collagen breakdown related factors"in Chinese and English.Seventy-six articles were finally included for review.RESULTS AND CONCLUSION:In the process of intervertebral disc degeneration,the balance of collagen metabolism plays a crucial role in maintaining the stability of the normal intervertebral disc.When intervertebral disc degeneration occurs,a large amount of pro-inflammatory factors,collagenase,and oxidative stress reactions occur in the intervertebral disc,which increases the breakdown of collagen in the intervertebral disc.At the same time,it inhibits the generation of growth factors,collagen synthase,and collagen synthesis-related factors,resulting in a decrease in collagen synthesis in the intervertebral disc.The combined effect of the above two conditions disrupts the balance of collagen metabolism in the intervertebral disc,further exacerbating the process of intervertebral disc degeneration.

Objective:To investigate the occurrence of work-related musculoskeletal disorders (WMSDs) among underground coal mine workers, identify the risk factors for WMSDs, and provide a scientific evidence for the prevention and treatment of WMSDs.Methods:In March 2024, through cluster sampling, the on-the-job workers who underwent questionnaire surveys and health examinations at a certain coal mine from July to August 2018 were selected as the research subjects. Basic information of employees, ergonomics-related characteristics, and the occurrence status of WMSDs in each part were collected, and multivariate logistic regression was used for analysis.Results:The incidence rate of WMSDs in at least one site among underground coal mine workers within the past year was 62.22% (219/352). The top three sites in sequence were the lower back (44.32%, 156/352), neck (26.14%, 92/352), and knee (26.14%, 92/352). Multivariate logistic regression analysis showed that frequently exerting great force with arms or hands during work ( OR=2.223, 95% CI: 1.022-4.836), prolonged static forward bending ( OR=1.544, 95% CI: 1.305-1.972), and frequently exerting great effort to operate tools or machines ( OR=2.206, 95% CI: 1.011-4.813), absence of external support systems ( OR=1.589, 95% CI: 1.349-1.996), and repetitive full-body twisting ( OR=1.523, 95% CI: 1.298-1.916) were all risk factors for the occurrence of WMSDs in the lower back ( P<0.05). Both night shift work ( OR=1.564, 95% CI: 1.339-1.939) and frequent forward neck flexion ( OR=1.532, 95% CI: 1.312-1.907) were all risk factors for the occurrence of WMSDs in the neck ( P<0.05). Lifting heavy objects above the shoulder ( OR=1.333, 95% CI: 1.142-1.782), uncomfortable posture and inability to exert force ( OR=1.873, 95% CI: 1.104-2.712), the use of vibration tools ( OR=2.958, 95% CI: 1.255-6.972), and length of service >10 years ( OR=1.525, 95% CI: 1.105-1.967) were all risk factors for the occurrence of WMSDs in the knee ( P<0.05) . Conclusion:The incidence of WMSDs among underground coal miners is relatively high, mainly concentrated in the lower back, neck and knee, and is related to factors such as poor working postures, and work organization. Coal mining enterprises should strengthen work organization, provide appropriate working equipment, and ensure reasonable distribution of workloads.

Objective:To identify risk factors influencing the incidence of hypertension among steelworkers (Homo sapiens) and establish an effective and easily implementable hypertension prediction model.Methods:In September 2023, 2214 steelworkers (Homo sapiens) were selected as study subjects. Basic demographic information, lifestyle, and occupational exposure data were collected, along with physiological measurements such as height, weight, and blood pressure. Multivariate unconditional logistic regression analysis was employed based on relevant literature to determine influencing factors for hypertension among steelworkers (Homo sapiens). Python 3.9 software was used to construct and compare logistic regression, support vector machine (SVM), random forest, extreme gradient boosting tree (XGBoost), and LGBM models. Model performance was evaluated using metrics such as receiver operating characteristic (ROC) curves, accuracy, calibration curves, and F1 scores. The Shapley Additive Explanations (SHAP) model was introduced for feature importance analysis to enhance the interpretability of the prediction model.Results:A total of 432 cases of hypertension were detected among 2214 study subjects, with a detection rate of 19.51%. Age, smoking status, salt intake, use of cooling equipment, carbon monoxide exposure, family history of hypertension, fasting blood glucose, triglycerides, and hemoglobin were identified as independent risk factors for hypertension ( P<0.05). A comparison of the five models revealed the following performance metrics: logistic regression achieved an accuracy of 0.853, F1 score of 0.680, Brier score of 0.108, and AUC of 0.907; SVM demonstrated an accuracy of 0.863, F1 score of 0.687, Brier score of 0.081, and AUC of 0.910; random forest showed an accuracy of 0.857, F1 score of 0.603, Brier score of 0.105, and AUC of 0.861; XGBoost yielded an accuracy of 0.850, F1 score of 0.684, Brier score of 0.117, and AUC of 0.899; and the LGBM model exhibited an accuracy of 0.838, F1 score of 0.625, Brier score of 0.112, and AUC of 0.870. Conclusion:The SVM model demonstrated strong predictive performance, effectively assessing the risk of hypertension among steelworkers (Homo sapiens) and facilitating targeted health management interventions.

Objective To compare the safety and efficacy of vancomycin in obese patients guided by trough concentration and AUC24h/MIC,and to provide data for individualized administration of vancomycin in obese patients.Methods We retrospectively collected the data of obese adult patients(BMI 30 kg/m2)who had severe infection caused by gram-positive cocci and treated with vancomycin intravenously in two Grade A tertiary hospitals in Shanghai from 2012 to 2024.The patients were assigned to trough concentration monitoring group or AUC24h/MIC monitoring group according to the therapeutic drug monitoring(TDM)method at the time of admission.Nephrotoxicity and efficacy were compared between the two groups of patients.Results A total of 22 obese patients were included in this study,including 12 in the trough concentration monitoring group and 10 in the AUC24h/MIC monitoring group.No significant difference was found between the two groups in gender,age,BMI,creatinine clearance before treatment,underlying disease,site of infection,pathogen type,or concomitant medications.The proportion of ICU admission was higher in AUC24h/MIC monitoring group.The length of ICU stay,vancomycin treatment duration,bacterial clearance rate and comprehensive efficacy rate did not show significant difference between the two groups.The average daily dose of vancomycin in trough concentration monitoring group was significantly lower than that in A UC24h/MIC monitoring group[(1.63±0.59)g vs(2.29±0.72)g,P=0.026].The average treatment duration was not significantly different between the two groups[(15.33±10.28)d vs(14.90±6.92)d,P=0.911].Compared with the trough concentration monitoring group,the initial peak concentration[(30.99±16.22)mg/L vs(19.41±5.42)mg/L,P=0.025]and overall peak concentration[(33.67±16.53)mg/L vs(22.08±3.96)mg/L,P=0.045]of vancomycin were lower in theAUC24h/MIC monitoring group,but the initial trough concentration[(11.03±8.66)mg/L vs(6.33±4.45)mg/L,P=0.139]and overall trough concentration[(13.75±9.74)mg/L vs(9.74±4.24)mg/L,P=0.218]were similar in the two groups.Vancomycin-associated nephrotoxicity did not occur in any group,but 41.7％of the patients in the trough concentration monitoring group reached the threshold of renal toxicity,i.e.trough concentration ≥15 mg/L.Conclusions Vancomycin treatment with conventional dosing regimen still have good clinical efficacy in obese adult patients.Vancomycin therapy guided by A UC24h/MIC can achieve the target value at lower concentration or exposure,which is promising for reducing vancomycin-associated nephrotoxicity.

Objective To explore the serial mediating roles of physical functional impairment and cognitive function between chronic comorbidity and depression in older adults.Methods Based on 5773 older adults with at least one chronic disease from the 2020 China Health and Retirement Longitudinal Survey as study subjects,Spearman correlation analysis was used to explore the correlation between chronic comorbidities,physical functional impairment,cognitive function,and depression in older adults,and serial mediating effects were analyzed using the model 6 in Process 3.3 of SPSS.Results 4465 older adults(77.34%)had chronic comorbidities,and the direct effect of chronic comorbidities on depression in older adults was significant,with an effect size of 1.737(95%CI:1.373-2.101),the separate mediating effect of physical functional impairment was significant,with an effect size of 0.535(95%CI:0.432-0.642);the separate mediating effect of cognitive function was not significant,with an effect size of-0.037(95%CI:-0.086 to 0.011);the serial mediating effect of physical functional impairment and cognitive function was significant,with an effect size of 0.027(95%CI:0.018 to 0.037).Conclusion Chronic comorbidity promotes the development of depression in older adults and indirectly influences the development of depression through physical functional impairment and poorer cognitive function.Therefore,in order to avoid the onset or exacerbation of depression in older adults with chronic diseases,it is important to enhance the ability of this group to care for themselves in daily life as well as to promote the recovery of cognitive function,especially in older adults with chronic comorbidities.

Objective To explore the serial mediating roles of social participation and cognitive function in the relationship between internet use and depression in older adults.Methods Based on 6356 older adults from the 2020 China Health and Retirement Longitudinal Survey(CHARLS),the Process 3.3 of SPSS was employed to analyze the serial mediation effects.Results 1650 older adults(25.96％)had used the internet in the past month.The direct effect of internet use on depression was not significant,with an effect value of 0.088(95％CI:-0.282 to 0.458).The separate mediating effect of social participation was significant,with an effect value of-0.228(95％CI:-0.299 to-0.163).The separate mediating effect of cognitive function was also significant,with an effect value of-0.207(95％CI:-0.271 to-0.147).The serial mediation effect of social participation and cognitive function was significant,with an effect value of-0.027(95％CI:-0.038 to-0.017).Conclusion Internet use indirectly reduces or mitigates depression in older adults by promoting social participation and enhancing cognitive function.Therefore,efforts should be made to address the digital divide among older adults,encourage the internet use for recreational activities,facilitate social participation,and enhance cognitive function to prevent the onset or worsening of depression and to build a society conducive to active aging.

Objective To explore the serial mediating roles of physical functional impairment and cognitive function between chronic comorbidity and depression in older adults.Methods Based on 5773 older adults with at least one chronic disease from the 2020 China Health and Retirement Longitudinal Survey as study subjects,Spearman correlation analysis was used to explore the correlation between chronic comorbidities,physical functional impairment,cognitive function,and depression in older adults,and serial mediating effects were analyzed using the model 6 in Process 3.3 of SPSS.Results 4465 older adults(77.34%)had chronic comorbidities,and the direct effect of chronic comorbidities on depression in older adults was significant,with an effect size of 1.737(95%CI:1.373-2.101),the separate mediating effect of physical functional impairment was significant,with an effect size of 0.535(95%CI:0.432-0.642);the separate mediating effect of cognitive function was not significant,with an effect size of-0.037(95%CI:-0.086 to 0.011);the serial mediating effect of physical functional impairment and cognitive function was significant,with an effect size of 0.027(95%CI:0.018 to 0.037).Conclusion Chronic comorbidity promotes the development of depression in older adults and indirectly influences the development of depression through physical functional impairment and poorer cognitive function.Therefore,in order to avoid the onset or exacerbation of depression in older adults with chronic diseases,it is important to enhance the ability of this group to care for themselves in daily life as well as to promote the recovery of cognitive function,especially in older adults with chronic comorbidities.

Objective To explore the serial mediating roles of social participation and cognitive function in the relationship between internet use and depression in older adults.Methods Based on 6356 older adults from the 2020 China Health and Retirement Longitudinal Survey(CHARLS),the Process 3.3 of SPSS was employed to analyze the serial mediation effects.Results 1650 older adults(25.96％)had used the internet in the past month.The direct effect of internet use on depression was not significant,with an effect value of 0.088(95％CI:-0.282 to 0.458).The separate mediating effect of social participation was significant,with an effect value of-0.228(95％CI:-0.299 to-0.163).The separate mediating effect of cognitive function was also significant,with an effect value of-0.207(95％CI:-0.271 to-0.147).The serial mediation effect of social participation and cognitive function was significant,with an effect value of-0.027(95％CI:-0.038 to-0.017).Conclusion Internet use indirectly reduces or mitigates depression in older adults by promoting social participation and enhancing cognitive function.Therefore,efforts should be made to address the digital divide among older adults,encourage the internet use for recreational activities,facilitate social participation,and enhance cognitive function to prevent the onset or worsening of depression and to build a society conducive to active aging.