Survival and disease burden analyses of occupational pneumoconiosis during 1958-2021 in Huangshi city, China: a retrospective cohort study.

BACKGROUND: Pneumoconiosis, a chronic disease stemming from prolonged inhalation of dust particles, stands as a significant global burden of occupational diseases. This study aims to investigate the survival outcomes of pneumoconiosis patients in Huangshi city, China, while also evaluating the disease burden on afflicted patients. METHODS: Data for this study were sourced from the Huangshi Center for Disease Control and Prevention. Survival analyses of pneumoconiosis patients were conducted employing life tables and the Kaplan-Meier method. The Cox proportional hazards models were deployed to identify factors influencing pneumoconiosis patients' survival duration. Competing risks models were employed to confirm the validity of the model outcomes. Additionally, in the disease burden assessment, disability-adjusted life years (DALYs) were computed for various demographic groups and time frames. RESULTS: A total of 5,641 pneumoconiosis cases, diagnosed in Huangshi City, Hubei Province between 1958 and 2021, were incorporated into the cohort analysis. The probability of mortality and the risk ratio increased with advancing age. Notably, the median survival time of stage III pneumoconiosis patients was significantly shorter compared with those in stages I and II. The Cox proportional hazards model and competing risks analyses underscored several significant factors influencing survival time, including dust exposure duration (HR = 1.197, 95% CI: 1.104-1.298), age at first diagnosis (HR = 3.149, 95% CI: 2.961-3.349), presence of silicosis (HR = 1.378, 95% CI: 1.254-1.515), and stage II-III pneumoconiosis (HR = 1.456, 95% CI: 1.148-1.848). Cumulatively, DALYs amounted to 7,974.35 person-years, with an average of 1.41 person-years. The period between 2000 and 2019 witnessed the highest disease burden. CONCLUSION: Our findings highlight the urgent need for improved prevention, earlier detection, and more effective management strategies for the occupational pneumoconiosis population. This study not only underscores the persistent issue of pneumoconiosis in industrial environments but also serves as a crucial call to action for policymakers and healthcare providers.

Integrated mRNA and microRNA profiling in lung tissue and blood from human silicosis.

BACKGROUND: The overwhelming majority of subjects in the current silicosis mRNA and microRNA (miRNA) expression profile are of human blood, lung cells or a rat model, which puts limits on the understanding of silicosis pathogenesis and therapy. To address the limitations, our investigation was focused on differentially expressed mRNA and miRNA profiles in lung tissue from silicosis patients to explore potential biomarker for early detection of silicosis. METHODS: A transcriptome study was conducted based on lung tissue from 15 silicosis patients and eight normal people, and blood samples from 404 silicosis patients and 177 normal people. Three early stage silicosis, five advanced silicosis and four normal lung tissues were randomly selected for microarray processing and analyze. The differentially expressed mRNAs were further used to conduct Gene Ontology and pathway analyses. Series test of cluster was performed to explore possible changes in differentially expressed mRNA and miRNA expression patterns during the process of silicosis. The blood samples and remaining lung tissues were used in a quantitative real-time PCR (RT-qPCR) (RT-qPCR). RESULTS: In total, 1417 and 241 differentially expressed mRNAs and miRNAs were identified between lung tissue from silicosis patients and normal people (p < 0.05). However, there was no significant difference in most mRNA or miRNA expression between early stage and advanced stage silicosis lung tissues. RT-qPCR validation results in lung tissues showed expression of four mRNAs (HIF1A, SOCS3, GNAI3 and PTEN) and seven miRNAs was significantly down-regulated compared to those of control group. Nevertheless, PTEN and GNAI3 expression was significantly up-regulated (p < 0.001) in blood samples. The bisulfite sequencing PCR demonstrated that PTEN had significantly decreased the methylation rate in blood samples of silicosis patients. CONCLUSIONS: PTEN might be a potential biomarker for silicosis as a result of low methylation in the blood.

[Quality of life and hostile mentality trend among 299 patients living with HIV/AIDS].

OBJECTIVE: To assess the quality of life (QOL) and hostile mentality trend (HMT) of 299 patients living with HIV/AIDS (Human immunodeficiency virus/Acquired immune deficiency syndrome) in three provinces in China, and to understand the major concerns of the these patients. METHODS: The SF-36 (short form -36) was used for assessing the QOL among 299 HIV-infected patients in Sichuan, Hubei and Guizhou provinces. Reliability and validity of SF-36 were evaluated. Consulting with experts and professionals, seven additional items were developed to evaluate the HMT. Mean scores of the 8 scales were compared between the patients and general rural residents in Sichuan province. RESULTS: For SF-36, internal consistent coefficients (Cronbach's alpha) of the 8 scales were between 0.75 to 0.90, test-retest reliability coefficient ranged from 0.54 to 0.80. The item-subscale correlation coefficients ranged from 0.46 to 0.97. Mean scores of the 8 scales of the patients ranged from 28.50 to 77.87, and 70.27 to 91.87 for the general rural residents. The variations of the scales were tested by means of Mann-Whitney test with u value ranged from -17.43 to -23.87. The QOL of the patients living with HIV/AIDS were significantly inferior to those of general population (all P < 0.01). The mean scores of the seven items to evaluate HMT ranged from 46.21 to 82.89. The major concerns of the patients living with HIV/AIDS included financial insecurity and family responsibilities, followed by death threat and no cure of HIV/AIDS. CONCLUSION: The SF-36 is a reliable instrument for assessing QOL of patients living with HIV/AIDS. The QOL of the patients living with HIV/AIDS in China is poor.

Quality of life and hostile mentality trend of patients with HIV/AIDS in China.

OBJECTIVE: To assess the quality of life (QOL) and hostile mentality trend (HMT) of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in China, and to identify their major concerns. STUDY DESIGN AND METHODS: Short Form-36 (SF-36) was used to assess QOL, and seven items were developed to assess the HMT. In-depth interviews were conducted with patients and health workers. RESULTS: SF-36 had moderate reliability, with Cronbach's alpha coefficients ranging from 0.75 to 0.90 and test-retest correlation coefficients ranging from 0.54 to 0.80 for the eight domains. The item-subscale correlation coefficients ranged from 0.46 to 0.97. The QOL of patients with HIV/AIDS was significantly lower than the average QOL of the general population (P<0.01). Hostile mentality of patients was significant (mean scores of the seven items ranged from 2.87 to 4.32, and the mean sum of scores was 3.45 from a range of 1-5). Cronbach's alpha coefficient of HMT items was 0.75 and the test-retest correlation coefficient was 0.80. The major concerns of patients with HIV/AIDS were financial insecurity and family responsibilities, followed by the fear of death and no cure for HIV/AIDS. CONCLUSION: SF-36 is a reliable instrument for the assessment of QOL of patients with HIV/AIDS. The QOL of patients with HIV/AIDS in China is poor. The HMT is a valuable indicator to monitor the outcomes of care for patients with HIV/AIDS.

[The development and assessment on an instrument regarding quality of life for patients living with HIV/AIDS in China].

OBJECTIVE: To develop a specific quality of life (QOL) instrument for Chinese patients living with HIV/AIDS and to assess its reliability and validity. METHODS: A primary questionnaire was developed with reference to existing instrument and information through discussion with experts, front-line professionals and patients living with HIV/AIDS. This questionnaire was applied in 443 patients living with HIV/AIDS. Some items were removed through the results of responsive rate, factor analysis, correlation matrix,internal consistency and so on. Reliability and validity were assessed after items reduction. RESULTS: The developed instrument contained 44 items, including 10 scales and other 3 items used for the evaluation of curative effect and side effect of anti-virus drug. No substantial ceiling/floor effects existed. All scales' internal consistency coefficients were > or = 0.70 and the whole instrument was 0.90. The two week retest reliability coefficient of the whole instrument was 0.80, and there were 6 scales below 0.70 of this coefficient. Multitrait/multiitem assessment indicated scaling success rates were all 100% for all items. Spearman correlation coefficient of total score of this instrument with SF-36 was 0.69. CONCLUSION: It was the first time that the developed QOL-CPLWHA instrument introducing the scale of hostility regarding mentality trend as well as expressed its acceptable reliability and validity so could be used for the evaluation of Chinese patients living with HIV/AIDS.