Bone metastasis is one of the common complications of lung cancer, which seriously affects the quality of life and survival of patients. At present, the clinical diagnosis of bone metastasis of lung cancer mainly depends on imaging methods, but due to its lack of sensitivity and potential radiation risk, about half of patients have already had bone-related events when they are diagnosed clearly. The treatment of bone metastasis of lung cancer mainly depends on surgery, radiotherapy and chemotherapy, targeted therapy, immunotherapy, etc. Although the treatment of bone metastasis of lung cancer has made some progress in recent years, there are still some problems such as high risk of other distant metastasis. This article mainly reviews the pathogenesis, diagnostic biomarkers and treatment progress of bone metastasis of lung cancer, in order to provide reference for the diagnosis and treatment of bone metastasis of lung cancer.

ObjectiveTo investigate the imaging features of calcium salt deposition and serological markers in patients with alveolar echinococcosis through a retrospective analysis， as well as independent risk factors for the degree of calcium salt deposition in lesions， and to provide a basis for assessing disease process. MethodsA retrospective analysis was performed for the imaging and clinical data of 107 patients with alveolar echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from December 2023 to June 2025， and according to the volume of calcium salt deposition， they were divided into non-deposition group with 16 patients， mild deposition group with 52 patients， moderate deposition group with 16 patients， and severe deposition group with 23 patients. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups， and the χ² test or Fisher’s exact test was used for comparison of categorical data between groups. The four groups were further combined into the low deposition group （no/mild deposition） and the high deposition group （moderate/severe deposition）. A binary logistic regression analysis was used to investigate the independent influencing factors for calcium salt deposition， and a predictive model was established. The receiver operating characteristic （ROC） curve was used to assess the predictive performance of the model， and the Bootstrap method was used for internal validation. ResultsThere were significant differences between the four groups in sex distribution， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.05）. The univariate analysis showed that there were significant differences between the four groups in sex， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， alanine aminotransferase， albumin， creatinine， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.1）. The multi-collinearity diagnosis showed that the VIF values for all continuous variables ranged from 1.104 to 1.760， suggesting that collinearity did not affect modeling. An ordinal logistic regression model was established based on sex， involvement of other sites， calcium ion， lymphocyte percentage， and uric acid. The multivariate analysis showed that lymphocyte percentage （odds ratio ［OR］=1.106， 95% confidence interval ［CI］： 1.041 — 1.174， P=0.001） and blood calcium level （OR=0.005， 95%CI： 0.000 —0.230， P=0.007） were independent influencing factors for the degree of calcium salt deposition. The regression equation was established as Logit（P）=8.231 + 0.100 × lymphocyte percentage -5.344 × calcium ion. The ROC curve analysis showed that the model had an area under the ROC curve of 0.716， with a Youden index of 0.353， a sensitivity of 1.000， and a specificity of 0.353. The Hosmer-Lemeshow test showed that the model had poor calibration （χ²=20.688， P=0.008）. The Bootstrap method with 1000 repeated samples showed that the estimated values of lymphocyte percentage （OR=1.106， 95%CI： 1.049 — 1.186， P=0.002） and calcium ion （OR=0.005， 95%CI： 0.000 — 0.214， P=0.010） were consistent with the original model， and the confidence intervals did not include 1， which further supported the reliability of the model. ConclusionBoth lymphocyte percentage and blood calcium level are independent influencing factors for calcium salt deposition in alveolar echinococcosis， and the degree of calcium salt deposition in alveolar echinococcosis lesions increases with the reduction in blood calcium level and the increase in lymphocyte percentage.

Background The quality of occupational health technical services is directly linked to the protection of workers' health rights and the efficacy of occupational disease prevention and control. However, the industry still faces critical challenges: sporadic instances of institutional non-compliance and persistent irregularities in professional practice continue to undermine overall service performance. Objective To assess the current quality status of occupational health technical services in Zhejiang Province and propose countermeasures for quality improvement, providing a scientific basis for policy optimization and service delivery quality enhancement. Methods A total of 69 occupational health technical service institutions in Zhejiang Province that obtained formal accreditation as of April 30, 2024, were sampled, including 3 public institutions and 66 private institutions (comprising 3 formerly Class-A, 28 formerly Class-B, 11 formerly Class-C, and 24 newly certified institutions). Following the Technical Protocol for Quality Monitoring of Occupational Health Technical Service in Zhejiang Province and the Technical Protocol for Proficiency Testing of Occupational Health Detection in Zhejiang Province, a quality assessment task force comprising national and provincial experts was established. Evaluation was conducted across four dimensions: qualification maintenance and compliance, standardization of technical services, authenticity of technical services, and proficiency testing, utilizing a combination of document review, on-site inspections, and technical skill assessments. Results The occupational health technical service institutions in Zhejiang Province were predominantly private entities (82.5%), with significant disparities in overall service quality. The pass rates for qualification maintenance and compliance, technical service standardization, technical service authenticity, and the excellence rate for laboratory proficiency testing were 81.5%, 80.7%, 97.3%, and 90.4%, respectively. Regarding qualification maintenance, the pass rates for "environmental conditions" (49.8%, 56.7%) and "instrumentation and equipment" (58.2%、65.6%) were significantly lower for formerly Class-C and newly certified institutions compared to other categories. In terms of technical standardization, "standardized on-site inspections" recorded the lowest pass rate (67.4%), with newly certified institutions at only 48.0%. Regarding technical service authenticity, formerly Class-C institutions exhibited issues such as missing raw chromatograms for blank samples (85.7% pass rate). In laboratory proficiency testing, public and formerly Class-A institutions achieved 100% excellence rates, but the performance of formerly Class-C and newly certified institutions was comparatively weak; specifically, the failure rate for organic analysis in formerly Class-C institutions reached 20%; the failure rate for dust testing items in newly certified institutions was 10.3%. Conclusion The overall quality of occupational health technical services in Zhejiang Province still requires significant improvement, particularly in basic institutional conditions, the standardization of on-site inspections, and laboratory proficiency in organic and dust analysis. Formerly Class-C and newly certified institutions should be the primary focus of quality management efforts. Differentiated regulatory strategies are recommended, alongside strengthening interim and ex-post supervision to gradually enhance the quality of occupational health technical services across all institutions.

Objective:To investigate the value of dual-energy CT parameters in the evaluation of pathological grade of pancreatic ductal adenocarcinoma.Methods:80 cases of pancreatic ductal adenocarcinoma confirmed by pathology were retrospectively analyzed and divided into high grade group (36 cases) and low grade group (44 cases) according to their differentiation degree. All 80 patients underwent SOMATOM Force DECT for arterial phase (AP) and pancreatic phase (PP) scanning, and measured dual-energy parameters including dual-phase iodine concentration (IC AP, IC PP) in tumors and normal pancreatic parenchyma, pancreatic phase and arterial phase iodine concentration difference (ICD PP-AP) in tumors, dual-phase iodine uptake ratio (IUR AP, IUR PP) , dual-phase tumor/normal pancreatic parenchyma fat fraction ratio, and dual-phase slope of energy spectrum curve. Differences between two groups were compared by two independent sample t-test or Mann-Whitney U test or chi-square test. The multivariate logistic regression model was used to analyze the influencing factors of pathological grading of PDAC. Results:There were statistically significant differences in gender, age, aspect ratio, positive lymph node, fat fraction ratio in pancreatic phase between the two groups ( P< 0.05) . The multivariate logistic regression analysis showed that fat fraction ratio in pancreatic phase ( OR=1.781, 95% CI 1.127-2.814, P=0.013) , positive lymph node ( OR=4.870, 95% CI 1.488-15.938, P=0.009) , aspect ratio ( OR=0.019, 95% CI 0.001-0.437, P=0.013) were independent factors influencing the pathologic grade of PDAC. Conclusion:Parameters of dual-energy CT are valuable in the evaluation of pathological grading of PDAC.

Objective To explore the application effect of the"Hospital-wide Centralized Bed Management"model in VIP wards,aiming to enhance medical service efficiency and patient experience through systematic resource integration and process optimization.Methods A VIP ward in a tertiary hospital in Southwest China was selected as the pilot site.From August 2024 to January 2025,a management model reform was implemented.Measures included the unified allocation of inpatient beds,construction of an information platform,establishment of interdisciplinary collaboration mechanisms,and optimization of medical staff responsibilities.Data on bed usage,service process indicators,and patient satisfaction were collected for three months before and after implementation.Statistical analysis was conducted using SPSS 26.0.Results After implementation,the bed utilization rate increased significantly from 20.0% to 55.0% (t=10.07,P＜0.001).The waiting time for admission was reduced from(48.0±12.5)hours to(23.5±6.8)hours(a 51.0% reduction,t=9.84,P＜0.001),and the bed transfer time decreased from(3.0±1.2)hours to(1.0±0.5)hours(a 66.7% reduction,t=7.62,P＜0.001).Patient satisfaction scores regarding bed arrangement,medical staff collaboration,and overall service significantly improved(all P＜0.001).After controlling for disease complexity,a strong positive correlation was found between bed utilization rate and overall satisfaction(r=0.68,P＜0.01).Conclusion By overcoming inter-departmental resource barriers,this model achieves efficient resource allocation and precise service process optimization in VIP wards,offering a replicable innovative approach for managing high-end medical serv-ices.

Objective To study the plasma metabolomics of mice poisoned by different dosage of the combination of diazepam and ethanol,and to reveal the toxicological mechanisms of combined poisoning of diazepam and ethanol.Methods Female Kunming mice were randomly divided into blank group,single and combined poisoning group(n=6),Based on the LD50 of diazepam co-administered with graded ethanol doses,mice in the single-drug and combined groups received oral gavage at 1/2,1,and 2 × LD50.Retro-orbital blood samples(～500 μL)were collected within 24 hours post-administration and analyzed by UPLC-QE-MS technology.Principal component analysis and orthogonal partial least squares discriminant analysis were used to identify differential metabolites and associated metabolic pathways.Results A total of 387 differential metabolites were identified in the combined poisoning group of diazepam and ethanol implicating the key pathways including tryptophan metabolism,phenylalanine metabolism,arginine and proline metabolism,Glycerophospholipid metabolism,phenylalanine,tyrosine and tryptophan biosynthesis.Conclusion Combined diazepam and ethanol poisoning exerts significant systemic effects by disrupting neurotransmitters conduction,exacerbating oxidative stress response and dysregulating energy metabolism.

Objective:To investigate the value of dual-energy CT parameters in the evaluation of pathological grade of pancreatic ductal adenocarcinoma.Methods:80 cases of pancreatic ductal adenocarcinoma confirmed by pathology were retrospectively analyzed and divided into high grade group (36 cases) and low grade group (44 cases) according to their differentiation degree. All 80 patients underwent SOMATOM Force DECT for arterial phase (AP) and pancreatic phase (PP) scanning, and measured dual-energy parameters including dual-phase iodine concentration (IC AP, IC PP) in tumors and normal pancreatic parenchyma, pancreatic phase and arterial phase iodine concentration difference (ICD PP-AP) in tumors, dual-phase iodine uptake ratio (IUR AP, IUR PP) , dual-phase tumor/normal pancreatic parenchyma fat fraction ratio, and dual-phase slope of energy spectrum curve. Differences between two groups were compared by two independent sample t-test or Mann-Whitney U test or chi-square test. The multivariate logistic regression model was used to analyze the influencing factors of pathological grading of PDAC. Results:There were statistically significant differences in gender, age, aspect ratio, positive lymph node, fat fraction ratio in pancreatic phase between the two groups ( P< 0.05) . The multivariate logistic regression analysis showed that fat fraction ratio in pancreatic phase ( OR=1.781, 95% CI 1.127-2.814, P=0.013) , positive lymph node ( OR=4.870, 95% CI 1.488-15.938, P=0.009) , aspect ratio ( OR=0.019, 95% CI 0.001-0.437, P=0.013) were independent factors influencing the pathologic grade of PDAC. Conclusion:Parameters of dual-energy CT are valuable in the evaluation of pathological grading of PDAC.

Objective:To explore the value of ultrasound elastography (USE) in evaluating the stability and prognosis of carotid plaque (CP) in patients with cerebral infarction(CI).Methods:A total of 94 patients with CI admitted to Dongying District People′s Hospital of Dongying City from January 2022 to December 2023 were retrospectively selected as the study objects, all of whom were treated with carotid artery dissection. The presence of CP was confirmed by pathological examination. The head and neck of patients were examined by conventional ultrasound and USE before surgery, respectively, and the diagnostic value of the two methods on CP stability was compared. The difference of strain value and strain rate among different plaque types was compared, and the correlation between different plaque types and the score of ESSEN Stroke Risk Scale (ESRS) was analyzed.Results:The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of conventional ultrasonic detection of CP were 75.00%, 71.43%, 74.00%, 87.10% and 52.63%; and of USE were 90.28%, 89.29%, 90.00%, 95.59%, 78.13%. The strain values and strain rates of stable plaques were lower than those of vulnerable plaques : (0.73 ± 0.11) × 10 3 vs. (2.42 ± 0.57) × 10 3, (6.57 ± 0.84) s -1 vs. (9.36 ± 2.55) s -1, there were statistical differences ( P<0.01). The ESRS scores of patients with vulnerable plaques were mostly ≥3 scores, and those with stable plaques were mostly<3 scores, there was statistical differences ( P<0.01). The scores of National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) 3 months after the onset of stable plaque were lower than those of vulnerable plaque patients: (26.80 ± 8.47) scores vs. (34.67 ± 8.98) scores, (3.97 ± 0.84) scores vs. (4.55 ± 1.61) scores, there were statistical differences ( P<0.01 or <0.05). Conclusions:USE has significant advantages in detecting CP stability in CI patients, which can efficiently and accurately assess the risk of plaque and provide important information for clinical use.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective To study the plasma metabolomics of mice poisoned by different dosage of the combination of diazepam and ethanol,and to reveal the toxicological mechanisms of combined poisoning of diazepam and ethanol.Methods Female Kunming mice were randomly divided into blank group,single and combined poisoning group(n=6),Based on the LD50 of diazepam co-administered with graded ethanol doses,mice in the single-drug and combined groups received oral gavage at 1/2,1,and 2 × LD50.Retro-orbital blood samples(～500 μL)were collected within 24 hours post-administration and analyzed by UPLC-QE-MS technology.Principal component analysis and orthogonal partial least squares discriminant analysis were used to identify differential metabolites and associated metabolic pathways.Results A total of 387 differential metabolites were identified in the combined poisoning group of diazepam and ethanol implicating the key pathways including tryptophan metabolism,phenylalanine metabolism,arginine and proline metabolism,Glycerophospholipid metabolism,phenylalanine,tyrosine and tryptophan biosynthesis.Conclusion Combined diazepam and ethanol poisoning exerts significant systemic effects by disrupting neurotransmitters conduction,exacerbating oxidative stress response and dysregulating energy metabolism.