Analyzing the current status of newly diagnosed occupational pneumoconiosis patients in Zhangdian District of Zibo City / 中国职业医学

Objective To analyze the distribution, survival conditions, and medical support of newly diagnosed occupational pneumoconiosis (hereinafter referred to as pneumoconiosis) patients in Zhangdian District, Zibo City. Methods A total of 1 189 newly diagnosed pneumoconiosis patients in Zhangdian District from 1956 to 2019 were selected as the study subjects using retrospective method. Data of their age of onset, years of occupational exposure, category of working industry, type of pneumoconiosis, and status of medical support was collected and analyzed. Results The median and the 25th-75th percentiles ［M (P25, P75)］ of the age of onset were 51.8 (45.5, 56.1) years, and the mortality was 37.0%. The majority of pneumoconiosis cases were silicosis (45.2%) and coal workers' pneumoconiosis (39.8%). The highest prevalence of pneumoconiosis was in the coal mining and washing industry (42.4%), followed by manufacturing (33.4%). Pneumoconiosis patients in stage Ⅰ,Ⅱ, and Ⅲ accounted for 89.1%, 8.7%, and 2.2%, respectively. The M (P25, P75) of the length of work exposed to dust were 24.1 (16.5, 29.9) years.The higher stage of pneumoconiosis the shorter of the length of work exposed to dust among these pneumoconiosis patients(all P<0.05). The overall survival rate, the 5-year survival rate and the 10-year survival rate of these pneumoconiosis patients were 63.0%, 92.3% and 85.9%, respectively. Among the 749 surviving cases, 60.8% were aged 60.0 to <80.0 years. In terms of social security, 100.0% surviving cases enjoyed basic medical insurance, meanwhile, 96.1% and 81.8% patients were covered by major medical insurances and occupational injury insurances, respectively. The M (P25, P75) of age at death were 73.1 (64.0, 77.1) years. The main causes of death were respiratory diseases (59.3%) and malignant tumors (20.4%). Conclusion The prevalent types of pneumoconiosis in Zhangdian District, Zibo City, are coal workers' pneumoconiosis and silicosis. Medical support and assistance are relatively limited. The pneumoconiosis prevention and control focus should be on silicosis and coal workers' pneumoconiosis, particularly in the manufacturing industry.

Application of a light-weighted convolutional neural network for automatic recognition of coal workers' pneumoconiosis in the early stage / 中华劳动卫生职业病杂志

Objective: To construct and verify a light-weighted convolutional neural network (CNN), and explore its application value for screening the early stage (subcategory 0/1 and stage Ⅰ of pneumoconiosis) of coal workers' pneumoconiosis (CWP) from digital chest radiography (DR) . Methods: A total of 1225 DR images of coal workers who were examined at an Occupational Disease Prevention and Control Institute in Anhui Province from October 2018 to March 2021 were retrospectively collected. All DR images were collectively diagnosed by 3 radiologists with diagnostic qualifications and gave diagnostic results. There were 692 DR images with small opacity profusion 0/- or 0/0 and 533 DR images with small opacity profusion 0/1 to stage Ⅲ of pneumoconiosis. The original chest radiographs were preprocessed differently to generate four datasets, namely 16-bit grayscale original image set (Origin16), 8-bit grayscale original image set (Origin 8), 16-bit grayscale histogram equalized image set (HE16) and 8-bit grayscale histogram equalized image set (HE8). The light-weighted CNN, ShuffleNet, was applied to train the generated prediction model on the four datasets separately. The performance of the four models for pneumoconiosis prediction was evaluated on a test set containing 130 DR images using measures such as the receiver operating characteristic (ROC) curve, accuracy, sensitivity, specificity, and Youden index. The Kappa consistency test was used to compare the agreement between the model predictions and the physician diagnosed pneumoconiosis results. Results: Origin16 model achieved the highest ROC area under the curve (AUC=0.958), accuracy (92.3%), specificity (92.9%), and Youden index (0.8452) for predicting pneumoconiosis, with a sensitivity of 91.7%. And the highest consistency between identification and physician diagnosis was observed for Origin16 model (Kappa value was 0.845, 95%CI: 0.753-0.937, P<0.001). HE16 model had the highest sensitivity (98.3%) . Conclusion: The light-weighted CNN ShuffleNet model can efficiently identify the early stages of CWP, and its application in the early screening of CWP can effectively improve physicians' work efficiency.

Analyzing the distribution characteristics of occupational pneumoconiosis in Sichuan Province, 2012-2021 / 中国职业医学

Objective: To analyze the distribution feature of occupational pneumoconiosis in Sichuan Province. Methods: The cases of newly diagnosed occupational pneumoconiosis from 2012 to 2021 in Sichuan Province were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. Results: From 2012 to 2021, there were 30 136 newly diagnosed occupational pneumoconiosis cases in Sichuan Province. The average age of patients was 55.2 years and the median work age was 12.1 years. There were 6 471 cases (accounting for 21.5%) exposed to dust for less than 5.0 years. The number of the cases declined in newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure. The numbers of coal workers' pneumoconiosis and silicosis were 16 210 and 13 577, respectively (accounting for 98.9% of the total cases). The majority of pneumoconiosis cases were classified as stage Ⅰ(accounting for 67.1%). The cases from Leshan City, Bazhong City, Dazhou City, Yibin City, Guangyuan City and Luzhou City accounted for 68.8% of the total cases. The main types of work were coal miner and excavation worker, which accounted for 31.7% and 18.8%, respectively. The scale of enterprises was mostly small and micro, accounting for 35.1% of the cases, and the industry distribution was mostly coal mining and washing, accounting for 53.4% of the cases. Conclusion: In Sichuan Province, the number of cases shows an overall decline in both newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure, with a relatively short duration of occupational exposure. The key cities for pneumoconiosis prevention and control are Leshan City, Bazhong City, and Dazhou City, while the key industry is coal mining and washing.

Expression and functional SNP loci screen of ATM from coal worker's pneumoconiosis / 中华劳动卫生职业病杂志

Objective: To detect of gene expression and genotype of the ataxia telangiectasia mutated (ATM) from coal workers' pneumoconiosis (CWP) , It is explored whether CWP is related to ATM gene. Methods: In October 2020, the relevant information of 264 subjects who received physical examination or medical treatment in the Department of occupational diseases of Guiyang public health treatment center from January 2019 to September 2020 was collected. Through the occupational health examination, 67 healthy people with no history of exposure to occupational hazards were selected as the healthy control group; The coal miners with more than 10 years of coal dust exposure history and small shadow in the lung but not up to the diagnostic criteria were the dust exposure control group, a total of 66 people; The patients with the same history of coal dust exposure and confirmed stage I were coal worker's pneumoconiosis stage I group, a total of 131 people. The expression of ATM was detected by QRT PCR. ATM rs189037 and rs1801516 were genotyped by massarray. Results: There was significant difference in the expression of ATM among the groups (P<0.05) ; Compared with the healthy control group, the expression of ATM in the dust exposed control group was significantly increased (P<0.05) . With the occurrence and development of CWP, the GG of rs189037 wild type decreased, the GA of mutant heterozygote and AA of homozygote increased, but the difference was not statistically significant (P>0.05) ; Rs1801516 wild type GG and mutant heterozygote GA had no significant changes (P>0.05) . There were significant differences in age, neutrophils and basophils among rs189037 groups (all P<0.05) . There were no significant differences in blood pressure, eosinophils, lymphocytes, monocytes, smoking and drinking history among rs189037 groups (all P>0.05) . Compared with wild-type GG, the or of mutant heterozygotes and homozygotes increased, but the differences were not statistically significant (P>0.05) . Conclusion: ATM gene may be one of the early activation genes of CWP and rs189037 may be the functional loci which affects gene expression. ATM gene is related to inflammatory response, Neutrophils and basophils have an impact on the development of CWP.

Construction of a multi-level model for evaluating the association between the number of dust exposed workers and raw coal production / 中国职业医学

@#Abstract: Objective （ Based on the data from the ″Occupational Diseases Hazardous Items Reporting System″ hereinafter ）， referred to as the ″Reporting System″ a method was constructed to estimate the number of occupational dust exposed workers （ ） in coal mining and washing enterprises hereinafter referred to as "coal workers" at the provincial administrative level. Methods ， A typical sampling method was used to study 1 808 coal enterprises in Shanxi Province Inner Mongolia Autonomous ， ， Region Shaanxi Province and Xinjiang Uygur Autonomous Region in 2020 in the Reporting System. Based on the data of 1 217 ， ， - coal enterprises that were coal mining or integrated coal mining and washing enterprises a multi level model was established to analyze the association between the number of coal workers and raw coal production. Two scenarios were set up based on the ， enterprise scale composition ratio to estimate the number of underreported coal workers and the number of coal workers in each Results provincial administrative region was corrected. The data of the Reporting System in 2020 showed that the ranking of ， raw coal production and the number of coal workers from most to least were Shanxi Province Inner Mongolia Autonomous ， ， Region Shaanxi Province and Xinjiang Uygur Autonomous Region with a total of 1 002 842 coal workers. The random intercept ， model using raw coal production enterprise scale and their interaction terms was fitted optimally with a −2 log likelihood value of 2 005.96 and Akaike information criterion value of 2 017.95. The factors affecting the number of coal workers included raw ， coal production and its interaction with the scale of enterprises. For every 1.00% change in raw coal production the number of ， coal workers in small and micro enterprises changed by 0.62% and the number of coal workers in large and medium enterprises changed by 0.13% more than that in small and micro enterprises. The corrected total number of coal workers for the four ， Conclusion provincial administrative regions was 1 125 515 and 1 089 321 for the two hypothetical scenarios respectively.The multi level model constructed with the data of raw coal production enterprise scale and their interaction terms of four ， provincial administrative regions could estimate the number of coal workers accurately and could better correct the number of coal workers in each provincial administrative region.

Analysis on disease burden of occupational coal workers′ pneumoconiosis in Anhui Province / 中国职业医学

@# Objective To analyze the disease burden caused by occupational coal workers' pneumoconiosis (CWP) in Anhui Methods Province. A total of 1 649 patients with occupational CWP diagnosed in Anhui Province from 1950 to 2019 were selected as the study subjects using a retrospective study method. Age, gender, survival time, location, working age of disease onset, age of death, stage and date of diagnosis of CWP, comorbidities at the time of investigation, hospitalization and outpatient expenses in the past year, cost of absence from work, cost of absence from work of caregivers, and cost of nutrition and transportation were investigated. The years of life lost, years lived with disability (YLDs), disability adjusted life years (DALYs) Results and economic losses were calculated. Among these patients, 1 405 cases survived and 244 cases died. In the age range - - - of 20.0 70.0 years, the YLDs of surviving patients were 2.12 22.20 (8.19±3.59) person years. The YLDs of patients with disease vs - P complications was higher than that of patients without complications [(8.55±3.95) (7.87±3.21) person years, <0.01]. The total - - DALYs of the patients was 14 031.59 person years, and the average per capita DALYs was 8.51 person years. Its YLDs accounted for 82.0 % of the total DALYs. The total economic loss caused by CWP in the 1 405 surviving patients was 354.903 0 Conclusion million yuan, and the average per capita economic loss was 252 600 yuan. The disease burden caused by CWP is relatively high in Anhui Province. In addition to early detection, diagnosis and treatment, it is necessary to focus on prevention and treatment of CWP complications to reduce the disease burden.

Analysis of the epidemiological characteristics of new occupational pneumoconiosis in Jiangxi Province, 2010-2019 / 中国职业医学

OBJECTIVE: To analyze the epidemiological characteristics of new occupational pneumoconiosis(hereinafter referred to as pneumoconiosis) in Jiangxi Province from 2010 to 2019. METHODS: The data of new pneumoconiosis cases in Jiangxi Province from 2010 to 2019 were collected through the Occupational Disease and Occupational Disease Health Information Monitoring Subsystem in the China Disease Prevention and Control Information System, and a retrospective analysis was conducted. RESULTS: From 2010 to 2019, there were 4 450 new cases of pneumoconiosis in Jiangxi Province. Among these cases, the main disease types were coal workers′ pneumoconiosis and silicosis, accounting for 98.5%. The number of new cases of pneumoconiosis showed a decreasing trend with the increase of years for the last ten years(P<0.05). The median age and the 0 th-100 th percentile [M(P_0-P_(100))] of new-onset pneumoconiosis diagnosis was 56.6(34.0-97.0) years old. The service length M(P_0-P_(100)) with dust-exposure was 12.0(1.0-48.0) years. The main industry of the new pneumoconiosis cases was concentrated in the coal mining and washing industry(63.4%). The distribution of economic types of enterprises with new pneumoconiosis cases was mainly state-owned enterprises(70.0%). The enterprise scale was medium-sized and small enterprises(65.9% in total). The types of work were mainly coal blenders, rock drillers, and coal miners, accounting for 56.5%. CONCLUSION: The incidence of occupational pneumoconiosis in Jiangxi Province is not optimistic. It is necessary to strengthen the prevention and control of occupational diseases on workers exposed to dust in key industries, enterprises and types of work.

Role of ferroptosis in coal dust induced mouse models of coal workers' pneumoconiosis / 环境与职业医学

Background Coal workers' pneumoconiosis (CWP) is a serious occupational disease. Whether ferroptosis, a form of necrotic regulated cell death, is involved in coal dust induced mouse models of CWP needs further survey. Objective This experiment is designed to elucidate the role of ferroptosis in the formation of CWP induced by coal dust in mice. Methods C57BL/6J mice were randomly assigned to a saline group or a CWP group, with eight mice in each group. The mice were treated with 0.1 mL normal saline or 0.1 mL coal dust suspensions (50g·L-1) via intra-tracheal instillation. HE staining and Masson staining were used to show lung injury and lung fibrosis. Iron concentration in mouse lung tissues was measured using iron assay kit. Lipid peroxidation was estimated in lung tissues by malondialdehyde (MDA) concentration and immunofluorescence intensity, and the ratio of glutathione (GSH) to L-glutathione oxidized (GSSG). Western blotting and real-time fluorescence-based quantitative PCR were used to test protein and mRNA expression levels of glutathione peroxidase 4 (GPX4) and ferritin in mice. Results Coal dust injured pulmonary structure, thickened alveolar wall, and caused collagen deposition and infiltration of inflammatory cells in the CWP group. The iron concentration in the CWP group [(10.75 ± 5.42) mg·L−1] was higher than that in the saline group [(1.14 ± 0.37) mg·L−1] (P < 0.01). The MDA concentration in the CWP group [(37.32 ± 12.18) μmol·L−1] was higher than that in the saline group [(18.70 ± 8.22) μmol·L−1] (P <0.01). The immunofluorescence intensity of MDA in the CWP group was stronger than that in the saline group. The GSH/GSSG ratio decreased in CWP treated mice (1.50 ± 1.70) compared with the normal saline treated ones (4.95 ± 2.86) (P < 0.01). Compared with the saline group (38.84 ± 15.61 for GPX4, 225.90 ± 54.34 for ferritin), the relative expression levels of GPX4 and ferritin mRNA in the CWP group were downregulated (14.29 ± 7.21 for GPX4, 106.70 ± 36.70 for ferritin) (P < 0.01). Compared with the saline group (1.47 ± 0.54 for GPX4, 1.73 ± 0.34 for ferritin), the relative expression levels of GPX4 and ferritin protein in the CWP group were also downregulated (0.92 ± 0.22 for GPX4, 0.97 ± 0.09 for ferritin) (P < 0.05). Conclusion Ferroptosis may be involved in the formation of coal workers' pneumoconiosis induced by coal dust in mice.

Prediction of occupational coal workers′ pneumoconiosis incidence by a multi-layer perceptron neural network model / 中国职业医学

OBJECTIVE: To construct and verify the incidence prediction model of occupational coal workers′ pneumoconiosis(CWP) in coal mine workers exposed to dust(hereinafter referred to as ″dust exposure″) based on a multi-layer perceptron(MLP) neural network, and explore its application value in predicting CWP incidence. METHODS: A total of 17 023 dust exposed workers in a coal mining group in Hebei Province from 1970 to 2017 were selected as the research subjects by a typical sampling method. Among them, 839 patients were confirmed as CWP and 16 185 workers did not suffered from CWP. The MLP neural network model was established with the incidence of CWP as the target output variable, and the type of work, age, beginning year of dust exposure, observation year(i.e. incubation period) and cumulative dust exposure as the input variable. The receiver operating characteristic(ROC) curve was used to evaluate the predictive ability of the built model. The established model was used to predict the high-risk group and key monitoring group population of CWP in dust-exposed workers in the following 10 years. RESULTS: There were 44 synapses in the hidden layer of the established MLP neural network model. The area under ROC curve was 0.91. The accuracy, sensitivity and specificity of the model were 92.7%, 74.8% and 93.6%, respectively. In the validation samples, the accuracy, sensitivity and specificity were 92.1%, 70.5% and 93.2%, respectively. The MLP neural network model was used to predict 1 534 workers with high risk of CWP in the following 10 years, and the individuals were located. The number of workers in need of actively monitored was 7 599. Among them, it is predicted that the incidence of CWP in different types of dust exposed workers in the following 10 years from high to low is tunneling worker, coal miner, mixing worker and auxiliary worker(P<0.01). The earlier the dust exposure began, the higher the risk of CWP(P<0.01). CONCLUSION: The MLP neural network model based on the type of work, age, beginning year of dust exposure, incubation period and cumulative dust exposure has a good performance in predicting the incidence of CWP in coal mine dust exposure workers, and can provide a reference for early preventive management measures to prevent and cure CWP.

Comprehensive rehabilitation of individualized exercise program for coal workers pneumoconiosis in Huaibei Coal Mine Group / 中华劳动卫生职业病杂志

Objective@#To explore the effect of comprehensive rehabilitation treatment of individualized exercise program on lung function, exercise ability, quality of life and biochemical indexes of coal workers’ pneumoconiosis patients, and to provide scientific and effective methods for rehabilitation treatment of coal workers' pneumoconiosis.@*Methods@#In Huaibei Coal Mine Occupational Disease Prevention and Control Hospital, the data of pneumoconiosis patients treated by pneumoconiosis department in the hospital were collected and sorted out. 80 patients were selected according to the inclusion and exclusion criteria. Using a random number table, they were randomly divided into two groups with 40 cases in each group. The data investigated in this study include the results before and after treatment. Pulmonary function index, BMI index, six-minute walking distance (6MWD) , quality of life questionnaire (SF-36) , hospital anxiety and depression scale (HADS) , st George's breathing questionnaire (sgrq) , c-reactive protein (CRP) and blood oxygen saturation (SpO2) were used to evaluate and compare the efficacy of the two groups.@*Results@#The lung function indexes of the test group were significantly higher than those of the control group after treatment (P<0.05) , including forced vital capacity, forced vital capacity in the first second, maximum expiratory flow, expiratory flow when vital capacity was 75% and expiratory flow when vital capacity was 25%. The forced vital capacity, the first-second forced vital capacity and the maximum expiratory flow of the patients in the test group were higher after treatment than before (P<0.05) . The six-minute walking distance of the test group was greater than that of the control group after treatment (P<0.05) . After treatment, the scores of st George’s breathing questionnaire in the test group were lower than those in the control group (P<0.05) . The scores of quality of life questionnaire in the test group were higher than those in the control group after treatment (P<0.05) .@*Conclusion@#The comprehensive rehabilitation treatment of individualized exercise program improved the endurance and exercise ability of pneumoconiosis patients, improved the respiratory status and quality of life of pneumoconiosis patients in Huaibei Coal Mine, improved the lung function of pneumoconiosis patients, and improved the forced vital capacity of patients, but the small airway function has not been significantly improved.

Effect of exercise-based short-term rehabilitation therapy on pulmonary function of coal workers' pneumoconiosis / 中国职业医学

OBJECTIVE: To investigate the effect of short-term rehabilitation therapy based on exercise on lung function in coal workers' with pneumoconiosis(CWP). METHODS: A total of 74 CWP patients were divided into control group(32) and treatment group(42) by random number table method. The control group received routine treatment only. The treatment group underwent 6 months of exercise-based rehabilitation treatment on the basis of routine treatment. The lung function was assessed in two groups to evaluate the treatment efficacy. RESULTS: Before rehabilitation treatment, the vital capacity(VC) and forced vital capacity(FVC) of patients in the treatment group were lower than that in the control group(P<0.05). But there was no significant difference in forced expiratory volume in first second(FEV_(1.0)) and FEV_(1.0)% between the two groups(P>0.05). After treatment, VC and FVC in the treatment group were higher than that before treatment in the same group(P<0.05). However, there was no significant difference in the four lung function indexes before and after treatment in the control group(P>0.05). The difference of VC and FVC before and after treatment in the treatment group was higher than those in the control group(P<0.01). However, there was no significant difference in FEV_(1.0 )and FEV_(1.0)% between the two groups before and after treatment(P>0.05). CONCLUSION: Exercise-based short-term rehabilitation therapy can improve lung ventilation of CWP patients.

Biomarkers for early diagnosis of pneumoconiosis in coal workers / 中国职业医学

OBJECTIVE: To explore biomarkers for early auxiliary diagnosis of pneumoconiosis in coal workers(CWP) and its clinical significance. METHODS: Sixty-nine male coal miners exposed to dust were selected as control group, and sixty-seven CWP male patients were chosen as CWP group by purposive sampling method. Serum samples were collected from subjects of the two groups. The levels of malonaldehyde(MDA) and superoxide dismutase(SOD) were determined by colorimetric method. The enzyme-linked immunosorbent assay was used to measure the level of interleukin-6(IL-6) and tumor necrosis factor alpha(TNF-α). The acetylcholinesterase(AChE) activity was determined by modified Ellman method. The logistic regression model was used to analyze the risk factors of CWP. The receiver operating characteristic(ROC) curve was established to analyze the sensitive indicators in the pathogenesis of CWP. RESULTS: The serum SOD activity decreased(median: 65.1 vs 59.2 kU/L, P<0.05), and the MDA, IL-6 and TNF-α levels increased in the CWP group(median: 4.92 vs 6.68 μmol/L, 129.82 vs 163.18 ng/L, 63.90 vs 70.93 ng/L, P<0.05) compared with the control group. The logistic regression analysis results showed that AChE was the protective factor of CWP, while age, chronic respiratory symptoms, IL-6 and MDA were the risk factors of CWP(P<0.05). The ROC curve showed that IL-6 and MDA can be used as early indicators for the diagnosis of CWP in dust-exposed workers. CONCLUSION: The serum IL-6 and MDA levels can be used as biomarkers for early auxiliary diagnosis of CWP.

The influencing factors of cognitive function in coal workers / 中华行为医学与脑科学杂志

Objective To explore the influencing factors of coal workers''''cognitive function. Meth-ods There was a physical examination on 3205 workers in the coal mine enterprise.The physical examina-tion included height,weight,blood pressure,blood routine examination and routine urine test,and Mini Men-tal State Examination (MMSE) was used to evaluate the cognitive function.The coal workers were divided in-to cognitive dysfunction group (84 cases) and cognitive function normal group (3121 cases) according to MMSE scores.Logistic regression analysis was used to explore the influencing factors of cognitive function. Results The prevalence of cognitive dysfunction was 2. 62％ in coal workers. The age of the cognitive dys-function group(47.27±8.24) was significantly higher than that in the cognitive function normal group (41.39 ±8.65)(P<0.05),and the degree of culture in cognitive dysfunction group was significantly lower than those in the cognitive function normal group (χ2= 46. 610, P<0. 01 ) . The low density lipoprotein cholesterol ((2.72±0.65)mmol/L),urine pH(5.54±1.51) in the cognitive dysfunction group were significantly lower than those in the cognitive function normal group((2.89±0.73)mmol/L,(5.92±1.28))(P<0.05). The lo-gistic regression analysis showed that age, culture level, BMI, low density lipoprotein cholesterol, urine pH were the impacting factors of cognitive dysfunction. Conclusion Cognitive dysfunction is influenced by age, culture level,BMI and low density lipoprotein cholesterol. The higher of the age and the lower of the culture level,BMI,low density lipoprotein cholesterol,urine pH,the more vulnerable to cognitive dysfunction.

Serum levels of SP-A and SP-D in stage Ⅰ coal workers' pneumoconiosis and their significance / 中国职业医学

OBJECTIVE: To explore the changes of serum levels and significance of surfactant protein( SP) A and SP-D in patients with stage Ⅰ coal workers' pneumoconiosis( CWP). METHODS: A random sampling method was used to select 88 cases of stage Ⅰ CWP patients as the CWP group,50 cases of healthy underground miners with similar dust exposure history as the dust exposure group and 38 cases of ground workers without dust exposure history as the control group. The serum levels of SP-A and SP-D in 3 groups were detected by enzyme-linked immunosorbent assays. RESULTS: The levels of serum SP-A and SP-D in the CWP group and the dust exposure group were higher than that of the control group( P <0. 05). The serum level of SP-D in the CWP group was higher than that of the dust exposure group( P < 0. 01). The serum level of SP-D in the smoking CWP subgroup was lower than that of the non-smoking CWP subgroup( P < 0. 05).CONCLUSION: The abnormal serum levels of SP-A and SP-D were related to the development of stage Ⅰ CWP. Smoking might affect the serum level of SP-D in stage Ⅰ CWP patients.

Detection of autoantibodies in serum of patients with coal workers' pneumoconiosis / 中国职业医学

OBJECTIVE: To explore the detection of autoantibodies in serum of patients with coal workers' pneumoconiosis( CWP).METHODS: Eight hundred and three cases of stage Ⅰ CWP patients were selected as study subjects by random sampling method.Anti-nuclear antibody and anti-neutrophil cytoplasmic antibody( ANCA) in serum were detected by indirect immunofluorescence assay; myeloperoxidased efficiency( MPO) antibody,anti-mitochondrial M2 antibody( AMA-M2) and anti-cyclic citrullinated peptide( CCP) antibody were detected by enzyme-linked immunosorbent assay;rheumatoid factor( RF) was detected by enhanced immunoturbidimetry of latexa.Group analysis was conducted according to age,lung function,length of dust exposure and the nature of dust exposure collection.RESULTS: In the serum of 803 CWP patients,the positive rate of anti-nuclear antibody,AMA-M2,RF,anti-CCP antibody,ANCA and MPO antibody were 9.7%,7.5%,7.3%,4.0%,2.6% and 0.8% respectively; the karyotype distribution of 78 cases of anti-nuclear antibody positive specimens was spotted( 43.6%), cytoplasmic( 20.5%), homogenous( 7.7%) and nucleolus( 5.1%),with a titer of 1:100.The positive rate of anti-nuclear antibody in the > 70.0 years group was higher than that of ≤60.0 and ≤70.0 years group( P < 0.017); the positive rate of anti-nuclear antibody in the abnormal lung function group was lower than that of the normal group( P < 0.01); the positive rate of anti-CCP antibody in the dust exposure length > 30.0 years group was higher than that of ≤30.0 years group( P < 0.017); the positive rate of anti-CCP antibody in silica-exposed group was lower than that in the coal-exposed group( P < 0.01).CONCLUSION: The positive rate of antinuclear antibody,AMA-M2,RF and anti-CCP antibody in CWP patients were high.The positive rate of anti-nuclear antibody is associated with age and lung function.The positive rate of anti-CCP antibody is related to the duration and nature of dust exposure.

Magnetic resonance imaging in the diagnosis of large shadow of coal workers' pneumoconiosis and its clinical application / 中国职业医学

OBJECTIVE: To evaluate the clinical application of magnetic resonance imaging( MRI) in diagnosis of lung large shadow in coal workers' pneumoconiosis( CWP). METHODS: Twenty-five CWP patients with lung large shadow( 39 lesions) were selected as CWP group by using the judgment sampling method,and 34 cases( 34 lesions),including 21 cases of lung cancer( lung cancer subgroup) and 13 cases of lung mass( lung mass subgroup),were selected as control group. Routine MRI examinations was performed on these three groups of patients. T1 weighted imaging( T1 WI),T2 weighted imaging( T2 WI) and frequency pre-saturation inversion recovery( SPIR) imagings were performed to analyze the differences of MRI images. RESULTS: Large shadow lesions in patients with CWP showed slightly lower signal,equal signal and equal lower signal in T2 WI and SPIR,accounting for 97. 4%(38/39) and 94. 9%(37/39) respectively. Those show slightly higher signal accounted for 2. 6%(1/39) and 5. 1%(2/39),respectively. The proportions of lung large shadows showed slightly higher signal of CWP group at T2 WI and SPIR were lower than those in the control group( 2. 6% vs88. 2%,5. 1% vs 91. 2%,P < 0. 01),the lung cancer subgroup(2. 6% vs 95. 2%,5. 1% vs 95. 2%,P < 0. 01) and lung mass subgroup( 2. 6% vs 76. 9%,5. 1% vs 84. 6%,P < 0. 01). CONCLUSION: MRI has good specificity in identifying characteristics of lesion of CWP large lung shadow. The main manifestations are slightly lower signal,equal signal and equal lower signal on T2 WI and SPIR

Risk of Active Pulmonary Tuberculosis among Patients with Coal Workers'Pneumoconiosis: A Case-control Study in China / 生物医学与环境科学（英文）

The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis (PTB) among coal workers' pneumoconiosis (CWP) patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.

The TNF-α/TNFR/NF-κB pathway in regulating alveolar macrophage apoptosis in coal workers' pneumoconiosis / 中国职业医学

OBJECTIVE: To study the mechanism of tumor necrosis factor( TNF)-α and its receptor( TNFR) signal transduction pathways in regulating cell apoptosis of alveolar macrophage( AM) in coal workers' pneumoconiosis( CWP).METHODS: Twenty-four coal workers with pneumoconiosis at stage Ⅰ were selected as CWP group and four observation subjects exposed to coal were chosen as observation group by using simple random sampling method. The bronchoalveolar lavage fluids of whole-lung lavage of two groups were collected. AMs were separated and purified. Then they were divided into 6 groups: a control group,a superoxide dismutase( SOD) group,a TNF/TNFR group,an anti-TNF-α antibody group,a Caspase-8 suppression group and a nuclear factor-κB( NF-κB) suppression group. The AMs of 6 groups with corresponding treatment were cultivated. After 24 hours,the cells were harvested and proteins extracted. The relative expression of TNF-α,TNFR1,TNFR2,Caspase-8,Caspase-3,NF-κB P50 and NF-κB P65 protein was detected by Western blotting. RESULTS: The protein relative expression of TNF-α,TNFR2,Caspase-8,Caspase-3,NF-κB P50 and NF-κB P65 in CWP group was significantly higher than those in the observation group( P < 0. 05). The protein relative expression of TNF-α,TNFR1,Caspase-8,Caspase-3 and NF-κB P50 in the TNF/TNFR group and the anti-TNF-αantibody group was lower than that of the control group( P < 0. 05). The above indexes in the anti-TNF-α antibody group were lower than that of the NF-κB suppression group( P < 0. 05). The protein relative expression of TNFR1,Caspase-8and Caspase-3 in the TNF/TNFR group was higher than that of the SOD group and the Caspase-8 suppression group( P <0. 05). The protein relative expression of TNFR1,Caspase-8 and NF-κB P50 in the TNF/TNFR group was lower than that of the NF-κB suppression group( P < 0. 05). Among the CWP patients,the relative expression of TNFR2 and NF-κB P65 in the TNF/TNFR group was lower than that of the control group( P < 0. 05),and higher than that of the SOD group( P <0. 05). CONCLUSION: AM apoptosis mediated by TNF-α/TNFR/NF-κB signal transduction pathway plays an important role in the occurrence and development of CWP. The TNF-α/TNFR/NF-κB signal transduction pathways inhibited or blocked at different stages can affect the expression of proteins related to AM apoptosis.

Clinical analysis on 36 cases of coal workers' pneumoconiosis complicated with pulmonary tuberculosis and nosocomial infection of stenotrophomonas maltophilia / 中国职业医学

OBJECTIVE: To investigate the clinical characteristics of the coal workers' pneumoconiosis( CWP) complicated with both tuberculosis and nosocomial infection of stenotrophomonas maltophilia. METHODS: The clinical data of 36 CWP patients complicated with tuberculosis and nosocomial infection of stenotrophomonas maltophilia were collected and retrospectively analyzed. RESULTS: The results of sputum cultured for more than 3 times showed positive stenotrophomonas maltophilia. The main clinical manifestations were cough,sputum,fever and wet rale of lung. Most of the chest X-rays showed light and patchy infiltrated shadows. Drug susceptibility testing indicated that this kind of bacteria was extensively drug-resistant. The drug resistance rates to imipenem,cefepime,aztreonam and cefoperazone were 100. 0%,96. 1%,94. 5% and 89. 8%,respectively. The sensitivity of patients to sulfanilamide methyl isopropyl pbo, ciprofloxacin,levofloxacin and gentamicin were > 60. 0%. After antituberculosis therapy combined with 2 or more sensitive antibiotics treatment based on the sputum cultured results,there were 21 cases( 58. 3%) cured,2 cases( 5. 6%) improved,3 cases( 8. 3%) ineffective and 10 cases( 27. 8%) dead. CONCLUSION: The clinical features of tuberculopneumoconiosis combined with the nosocomial infection of stenotrophomonas maltophilia are un-typical. This disease is severely antibiotic-resistant.Timely pathogenic bacteria culture and drug sensitivity test have important significance in diagnosis and treatment.

Correlation analysis between serum and bronchoalveolar lavage fluid TNF-α and the lung function of coal workers' pneumoconiosis / 中国职业医学

OBJECTIVE: To explore the effect and significance of tumor necrosis factor-α( TNF-α) in serum and bronchoalveolar lavage fluid( BALF) of coal workers' pneumoconiosis( CWP). METHODS: Twenty-eight cases of CWP were selected by purposive sampling method and divided into 3 groups based on different stages of pneumoconiosis. There were 7 cases in stage Ⅰ,10 cases in stage Ⅱ,and 11 cases in stage Ⅲ. The venous blood and BALF were collected.TNF-α in the serum and BALF were detected by chemiluminescence assay. The lung function was determined. RESULTS: In the serum,the TNF-α level of CWP patients was positively correlated with the CWP stage [Spearman correlation coefficient( rS) = 0. 843,P < 0. 01],and negatively correlated with the forced expiratory volume in one second/forced vital capacity( FEV1/ FVC)( rS=- 0. 503,P < 0. 01). In BALF,the TNF-α level of CWP patients was negatively correlated with the CWP stage( rS=- 0. 654,P < 0. 01),and positively correlated with the FEV1/ FVC( rS= 0. 432,P <0. 05). The TNF-α level in the serum was negatively correlated with the TNF-α level in BALF( rS=- 0. 561,P < 0. 01).CONCLUSION: With the development of pneumoconiosis,the levels of TNF-α in the serum and BALF showed different variation,and were correlated with the changes of FEV1/ FVC. The level of TNF-α could be used as a reference index for evaluating the severity of CWP.