Analysis of Health Service Utilization and its Influencing Factors among Patients with Pneumoconiosis in China.

Pneumoconiosis, an interstitial lung disease that occurs from breathing in certain kinds of damaging dust particles, is a major occupational disease in China. Patients diagnosed with occupational pneumoconiosis can avail of free medical treatment, whereas patients without a diagnosis of occupational diseases cannot not claim free medical treatment in most provinces from the government before 2019. This study aimed to analyze the priority of medical facility selection and its influencing factors among patients with pneumoconiosis. A total of 1,037 patients with pneumoconiosis from nine provinces in China were investigated. The health service institutions most frequently selected by the patients were county-level hospitals (37.5%). The main reason for the choice was these hospitals' close distance to the patients' homes (47.3%). The factors for the choice of health care institutions were living in the eastern region ( OR = 2.91), living in rural areas ( OR = 2.10), silicosis diagnosis ( OR = 2.44), employment in private enterprises ( OR = 2.91), smoking ( OR = 2.69), and quit smoking ( OR = 3.98). The diagnosis, treatment, and rehabilitation therapy of pneumoconiosis should be enhanced in primary medical institutions.

[The role of caveolin-1 for carbon black nanoparticles uptake in vitro].

OBJECTIVE: To investigate the protein expression of caveolin-1 in type II alveolar epithelial cells (A549) exposed to carbon black nanoparticles (CB NPs) and the role of caveolin in the endocytosis of CB NPs. METHODS: A549 cells were exposed to 0, 25, 50, 100, 200, and 400 µg/ml CB NPs for 24 h; then, trypan blue assay was applied to determine the cell viability. A549 cells were also exposed to 0, 25, 50, and 100 µg/ml CB NPs for 24 h, then, transmission electron microscopy (TEM) and flow cytometry were applied to observe the morphological change of cells and cellular side scatter (SSC), and Western blot was used to analyze the effect of CB NPs on the protein expression of caveolin-1. A549 cells were co-exposed to1 µg/ml filipin and 100 µg/ml CB NPs for 24 h, then, the cellular SSC was observed. RESULTS: Compared with controls, the A549 cells exposed to 200 and 400 µg/ml CB NPs had the cell viability decreased by 38.2% and 46.6%, respectively (P < 0.05), while those exposed to 25, 50, and 100 µg/ml CB NPs showed no significant decrease in cell vitality (P > 0.05). The protein expression of caveolin-1 was significantly higher in the cells exposed to 50 and 100 µg/ml CB NPs than in controls (P < 0.05). The TEM showed that plasmalemmal vesicles containing black particles were found in the cytoplasm of the cells exposed to 50 and 100 µg/ml CB NPs. The flow cytometry showed that the cellular SSC ratio increased from 1.007 to 1.331 as the dose of CB NPs rose within 0 ∼ 100 µg/ml and fell to 1.25 after the cells were co-exposed to1 µg/ml filipin and 100 µg/ml CB NPs. CONCLUSION: Carbon black nanoparticles can be transferred into A549 cells by endocytosis, but caveolin-mediated endocytic pathway plays a minor role in this process.

[Screening of differentially expressed serum proteins in patients with asbestosis].

OBJECTIVE: To screen differently expressed proteins for serum biomarkers by studying serum proteome of population with asbestosis, population exposed to asbestos without asbestosis and population never exposed to asbestos, to further understand the mechanisms of asbestosis. METHODS: The subjects of present study included 37 patients with asbestosis, 254 workers exposed to asbestos and 439 healthy controls. The 2-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization time of flight tandem mass spectrometry (MALDI-TOF-MS/MS) were used to screen and identify the differentially expressed serum proteins among all subjects. ImageMaster6.0 software was utilized to analyze the differentially expressed proteins. RESULTS: Well-qualified gel images of serum proteome were obtained, 21, 34 and 32 differentially expressed spots were found between asbestosis and normal controls, between asbestosis and negative controls or between negative controls and normal controls, respectively. Differentially displayed proteins were identified as cytokines, α1-AT, L-ficolin, etc. CONCLUSION: Exposure to asbestos for a long period could interfere with the immune system of workers exposed to asbestos, and some proteins may serve as the biomarkers for early diagnosis and intervention of asbestosis.

[The analysis of consistency between digital radiography and high-kV chest radiographs in diagnosis pneumoconiosis].

OBJECTIVE: To study the consistency between DR and high-kV chest radiographs in diagnosis of pneumoconiosis and to explore the feasibility of DR chest radiograph in the diagnosis of pneumoconiosis. METHODS: Twenty five coal miners were examined with DR and high-kV chest radiographs at the same time. Image post-processing parameters (density, contrast, etc.) were set to ensure the quality of DR chest radiograph in Philips Essenta DR machine. In order to avoid the repetitive numbers, 50 chest radiographs were numbered at random. Pneumoconiosis diagnosis was conducted by six independent certified occupational physicians of pneumoconiosis by blind method. The consistency between 2 kinds of chest films was assessed. RESULTS: All chest radiographs (25 cases, 50 chest films) were excellent. The diagnosis results of six readers on the 15 pairs of DR and high-kV chest radiographies were summarized. For high-kV chest radiographs, the consistency of pneumoconiosis classification for 12 pairs of readers was more than 68%, the consistency of total density for 11 pairs of readers was more than 68%. For DR chest radiographs, the consistency of pneumoconiosis classification for 13 pairs of readers was more than 60%, the consistency of total density for 14 pairs of readers was more than 60%. The consistency of pneumoconiosis classification between two chest radiographs was 72% (value: 0.69, 95% CI: 0.46-0.92), the consistency of total density between two chest radiographs was 80% (value: 0.78, 95% CI: 0.61-0.95). CONCLUSION: When the chest radiograph quality was good and the difference of reading films was low, there was a good consistency of pneumoconiosis diagnosis between DR chest radiographs and high-kV chest radiographs.

[Effects of image post-processing parameters on digital radiography chest radiograph for the diagnosis of pneumoconiosis].

OBJECTIVE: To explore the effects of image post-processing parameters on DR chest radiograph for the diagnosis of pneumoconiosis. METHODS: Eighty three coal miners were examined with high-kV and DR chest radiographs at the same time. Image post-processing parameters (density, contrast and so on) were designed in a Philips Essenta DR machine were designed, then differences of image quality between high-kV and DR chest radiographs were compared. RESULTS: After regulating image and proceeding the parameters, the OD (optical density) values of high density areas in the upper-middle lung fields, subphrenic and direct exposure areas were 1.58 +/- 0.10, 0.23 +/- 0.02 and 2.80 +/- 0.21, respectively. The quality of chest films met the requirements of diagnostic criteria of pneumoconiosis. The rate of excellent chest films for DR chest radiograph was 95.18%, which was significantly higher than that (80.72%) for high-kV chest radiograph (P < 0.01). CONCLUSION: Appropriate parameters of image post-processing can make DR chest radiograph to meet the requirements of chest radiograph quality for the diagnosis of pneumoconiosis.

[Pirfenidone diminishes SiO2 induced lung fibrosis in rats].

OBJECTIVE: to investigate whether pirfenidone (PFD) presents the antifibrotic effect in silicosis of rats. METHODS: SD rats were randomly divided into five groups: the non-treat group, the normal saline group, the normal saline + PFD group, the SiO2 group, the SiO2 + PFD group. Rats except in the non-treat group were intratracheally instilled with SiO2 (25 mg/ml) or normal saline. The rats in normal saline + PFD group and the SiO2 + PFD group were given PFD (50 mg/kg) orally the next day after instillation and throughout the study. Rats were respectively sacrificed 7, 21, 42 days after instillation. The pathology changes were evaluated by Haematoxylin-eosin (HE), Van Gieson and Foot staining, and the hydroxyproline (HYP) content of pulmonary tissue was determined. RESULTS: compared with the SiO2 group, PFD could relieve the fibrotic changes in the lungs of rats. The fibrotic degree in silicotic lesions of lungs was lower in the SiO2 + PFD group than that of SiO2 group. The HYP content in the lungs of the SiO2 + PFD group [(0.75 ± 0.12) mg/g] was significantly lower than that of the SiO2 group [(1.19 ± 0.17) mg/g] at 42 days after instillation (P < 0.05). CONCLUSION: these data support that PFD has an antifibrotic effect against SiO2 induced lung fibrosis in rats, Which appears to be changing collagen accumulation and inhibiting pulmonary fibrosis.