[Clinical characteristics and follow-up analysis of 63 cases of silicosis complicated with cavity-pulmonary tuberculosis].

Objective: To investigate the clinical characteristics and prognosis of silicosis complicated with cavity-pulmonary tuberculosis. Methods: The clinical data of 63 patients with silicosis complicated with cavity-pulmonary tuberculosis (group A) and silicosis patients (group B) admitted to Yantaishan Hospital from July 2018 to July 2022 were collected and analyzed. Results: Patients in group A were all male, and the common symptoms were cough, expectoration, chest tightness, shortness of breath, and hemoptysis. CT cavity lesions involving the lung, often occurs in the lung after the tip section, after the back section and basal segment, thick-walled cavity, may be accompanied by satellite lesions, endobronchial spread focal, pneumothorax, pleural effusion, etc. 1225 cases of group B patients haemoptysis of 59 patients, cavity in 3 patients, haemoptysis and/or cavity rate was lower than that in group A, the difference was statistically significant (P<0.05) . In group A, CT reexamination 6-24 months after anti-tuberculosis treatment showed that 52 cases (82.5%) had cavity reduction/healing, 8 cases (12.7%) had recurrence, and 3 cases (4.8%) had damaged lung (2 died) . Conclusion: Silicosis patients with hemoptysis and/or CT in cavity should be more vigilant about combined tuberculosis, anti-tuberculosis treatment and/or dynamic CT follow-up helps laboratory diagnosis negative patients.

[A case of acute copper sulphate poisoning and literature review].

Objective: To analyze the clinical data of acute copper sulphate poisoning, and discuss the timing and prognosis of the treatment. Methods: The clinical data of a case of acute copper sulphate poisoning treated in Yantaishan Hospital in May 2020 were analyzed, and CNKI, Weipu database and Wanfang database were retrieved with "copper sulfate""poisoning" and "blood purification" as search terms respectively. Such as "copper sulphate/cupric sulfate""poisoning" and "blood purification " were respectively tested in the PubMed database and reviewed the literatures. Results: The patient was admitted to hospital due to "oral copper pentahydrate for 14 h". Plasma exchange and continuous venous hemofiltration were performed on the 2nd day of poisoning, and the liver enzymes and creatinine indexes were normal. The patient recovered and left the hospital after 10 days. After literature retrieval, 13 literatures were screened out, a total of 14 cases were reported. All recovered after blood purification, copper displacement and liver protection. Conclusion: When acute copper sulphate poisoning occurs with multiple organ function damage mainly caused by hemolysis and kidney injury, the treatment with blood purification has a good prognosis while removing copper and organ support.

[Evaluation of the right ventricular function in patients with pneumoconiosis by three-dimensional speckle-tracking imaging].

Objective: To evaluate the changes of right ventricular function in patients with pneumoconiosis in different stages using three-dimensional speckle-tracking imaging (3D-STI) . Methods: In June 2020, 114 pneumoconiosis patients were selected as subjects, including 45 patients in stage Ⅰ pneumoconiosis group, 36 patients in stage Ⅱ pneumoconiosis group and 33 patients in stage Ⅲ pneumoconiosis group. Fifty healthy subjects were enrolled and served as control group. The longitudinal strain (LS) , radial strain (RS) and circumferential strain (CS) of free wall middle and basal segment of right ventricular were collected and compared. The right ventricular global longitudinal strain (GLS) , right ventricular global circumferential strain (GCS) , right ventricular ejection fraction (RVEF) , right ventricular global radial strain (GRS) , the rate of fractional area change (FAC) , the tricuspid valve systolic peak velocity (TVSPV) and the pulmonary artery systolic pressure (PASP) of each subject in the groups were collected and compared by 3D-STI. Results: The LS and RS of the right ventricular basal segment of patients in stage Ⅱ pneumoconiosis group were significantly lower than those of control group (P<0.0125) . The LS, CS, RS of the right ventricular basal segment and RS of right ventricular middle segment of patients in stage Ⅲ pneumoconiosis group were significantly lower than those of control group (P<0.0125) . The LS, CS and RS of the right ventricular basal segment of patients in stage Ⅰ pneumoconiosis group were significantly higher than those of stage Ⅲ pneumoconiosis group (P<0.0125) , and the RS of the right ventricular basal segment of patients in stage Ⅱ pneumoconiosis group was significantly higher than that of stage Ⅲ pneumoconiosis group (P<0.0125) . The levels of RVEF and GLS of patients in stage Ⅱ and stage Ⅲ pneumoconiosis group were significantly lower than those of control group (P<0.0125) , while the levels of PASP were significantly higher than that of control group (P<0.0125) . The levels of FAC and TVSPV of patients in stage Ⅲ pneumoconiosis group were significantly lower than those of control group (P<0.0125) . The levels of RVEF, GLS and FAC of patients in stage Ⅰ pneumoconiosis group were significantly higher those that of stage Ⅲ pneumoconiosis group (P<0.0125) , and the PASP level was significantly lower than that of stage Ⅲ pneumoconiosis group (P<0.0125) . The FAC level of patients in stage Ⅱ pneumoconiosis group was significantly higher than that of stage Ⅲ pneumoconiosis group (P<0.0125) . Conclusion: Patients with pneumoconiosis could experience a decline in right ventricular function at an early stage. The 3D-STI can accurately detect the GLS, GRS, GCS and hemodynamic changes of the right ventricular and evaluate the right ventricular function comprehensively and objectively. 3D-STI is of great significance for the early detection of right ventricular dysfunction in patients with pneumoconiosis.

[Analysis of incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria].

Objective: To analyze the incidence characteristics of occupational chronic benzene poisoning under two diagnostic criteria. Methods: In March 2020, 126 patients who were divided into the old criteria group (74 cases) and the new criteria group (52 cases) were retrospectively analyzed. These patients were diagnosed with occupational chronic benzene poisoning, and were diagnosed in our hospital during the period of January 2009 to December 2019. The gender composition, age of onset, years of benzene exposure, industry distribution, work type, benzene concentration in working environment and diagnostic grade of the two groups of patients were analyzed and compared. The follow-up of 22 benzene poisoning observation subjects under the old criteria were retrospectively analyzed. Results: There were no statistically significant differences in gender composition, age of onset, years of benzene exposure, industry distribution and work type between the old criteria group and the new criteria group (P>0.05) . In the old criteria group and the new criteria group, 41.9% (31/74) and 17.3% (9/52) of the patients' workplace benzene concentration exceeded the maximum allowable concentration, respectively. The composition of different benzene concentration in the workplace between the two groups showed statistically significant (P<0.05) . In the old criteria group, the proportion of mild poisoning (79.7%, 59/74) was the majority, while in the new criteria group, the proportion of moderate and severe poisoning (51.9%, 27/52) were the majority, and there was statistically significance in the composition ratio of diagnostic grade between the two groups (P<0.05) . Under the old criteria, after folow-up of 22 cases of benzene poisoning observation subjects, we observed that 8 cases (36.4%) progressed to the level of chronic benzene poisoning. Conclusion: The revision of diagnostic criteria for benzene poisoning may affect the composition of diagnosis classification. Based on the rights and interests of workers, formulating more complete diagnostic criteria and system policies will be more conducive to the development of occupational benzene poisoning prevention and control.

[Changes of neuron specific enolase in serum of patients with silicosis].

Objective: To explore the changes of neuron specific enolase (NSE) concentration in serum samples of patients with silicosis. Methods: In January 2020, 455 cases of silicosis diagnosed in Yantaishan Hospital from January 2018 to December 2019 were collected, and 60 healthy cases and 120 cases of lung cancer were selected as the healthy group and the lung cancer group. The serum levels of NSE were detected by chemical immunofluorescence assay and compared. Results: The serum NSE level of silicosis patients was [(22.88±7.86) ng/ml], higher than that of healthy group [(17.96±4.42) ng/ml] (P<0.05) . Serum NSE levels in the first, second and third stage silicosis groups were higher than those in the healthy group (P<0.05) , but there was no statistically significant difference between the silicosis groups at different periods (P>0.05) . The serum NSE level of silicosis patients was lower than that of the small cell lung cancer group (P<0.05) , but there was no statistically significant difference between silicosis group and non-small cell lung cancer group (P>0.05) . The area under curve of silicosis NSE was 0.718 (P<0.01) when the cut-off was 17.49 ng/ml, the sensitivity and specificity of NSE was 78% and 57% respectively. Conclusion: The serum NSE level of patients with silicosis is significantly increased, which can be used as an important reference index for the diagnosis and the differential diagnosis of silicosis.

Characterization of a hospital-based gastroenteritis outbreak caused by GII.6 norovirus in Jinshan, China.

An acute gastroenteritis (AGE) outbreak caused by a norovirus occurred at a hospital in Shanghai, China, was studied for molecular epidemiology, host susceptibility and serological roles. Rectal and environmental swabs, paired serum samples and saliva specimens were collected. Pathogens were detected by real-time polymerase chain reaction and DNA sequencing. Histo-blood group antigens (HBGA) phenotypes of saliva samples and their binding to norovirus protruding proteins were determined by enzyme-linked immunosorbent assay. The HBGA-binding interfaces and the surrounding region were analysed by the MegAlign program of DNAstar 7.1. Twenty-seven individuals in two care units were attacked with AGE at attack rates of 9.02 and 11.68%. Eighteen (78.2%) symptomatic and five (38.4%) asymptomatic individuals were GII.6/b norovirus positive. Saliva-based HBGA phenotyping showed that all symptomatic and asymptomatic cases belonged to A, B, AB or O secretors. Only four (16.7%) out of the 24 tested serum samples showed low blockade activity against HBGA-norovirus binding at the acute phase, whereas 11 (45.8%) samples at the convalescence stage showed seroconversion of such blockade. Specific blockade antibody in the population played an essential role in this norovirus epidemic. A wide HBGA-binding spectrum of GII.6 supports a need for continuous health attention and surveillance in different settings.

[Clinical features analysis of 10 cases of acute arsenic trioxide poisoning].

Arsenic trioxide poisoning can cause damage to the nervous system, heart, liver, kidney and other organs, with a lethal dose of 0.8-2.0 mg/kg. Acute poisoning is now rare. This article analyzes the clinical characteristics of 10 patients with acute poisoning caused by the absorption of arsenic trioxide through the respiratory tract, digestive tract, and skin, in order to improve clinicians' understanding of acute arsenic trioxide poisoning.

[Clinical study of sequential glucocorticoids in the treatment of acute mercury poisoning complicated with interstitial pneumonia].

Objective: To study the clinical efficacy of sequential glucocorticoids in the treatment of acute mercury poisoning complicated with interstitial pneumonia. Methods: Retrospective analysis of 37 patients with acute mercury poisoning complicated with interstitial pneumonia admitted from January 2009 to April 2019, including the sequential treatment group (15 cases) and the conventional treatment group (22 cases) , all patients were treated with sodium dimercaptopropane sulfonate, and given anti-inflammatory, liver-protecting and other drugs for symptomatic treatment. The conventional treatment group was given methylprednisolone 1mg/kg once a day for 5-7 days. The sequential treatment group was given 1 mg/kg of methylprednisolone once a day for 5-7 days, then gradually reduced to 20 mg, and the total course of treatment was 14-21 days. To observe the changes of clinical symptoms, signs, lung function including forced vital capacity (FVC) , forced expiratory volume in the first second (FEV(1)) and ratio of forced expiratory volume in the first second to forced vital capacity (FEV(1)/FVC) , and chest CT indexes before and after treatment in the two groups. Results: The clinical symptoms and signs of the two groups were significantly improved compared with those before treatment, and there was no significant difference between the apparent efficiency and the total effective rate of the two groups (P>0.05) . The FVC, FEV(1), and FEV(1)/FVC of the two groups were significantly higher than those before treatment. After treatment, the indexes of the sequential treatment group were significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05) . The apparent efficiency (93.3%, 14/15) of CT lesions in the sequential treatment group was significantly higher than those of the conventional treatment group (59.1%, 13/22) , and the difference was statistically significant (P< 0.05) . Conclusion: Sequential glucocorticoid treatment of acute mercury poisoning complicated with interstitial pneumonia could improve the effect of clinical signs and symptoms which is equal to conventional treatment, but it could better promote the recovery of lung function and the absorption of lung lesions.

[Analysis of new pneumoconiosis in Yantai from 2010 to 2019].

Objective: To analyze the characteristics of new cases of pneumoconiosis in Yantai from 2010 to 2019, and to provide scientific basis for the prevention and control of pneumoconiosis. Methods: In March 2020, 2575 new pneumoconiosis cases in Yantai City from January 1, 2010 to December 31, 2019 were obtained through the "Health Hazard Information Monitoring System" platform under "China Disease Prevention and Control Information System" and patient hospital files. Excel 2007 was used to sort out the database of pneumoconiosis and analyze the epidemiological characteristics of new pneumoconiosis, including gender, age, length of service, type of work, etc. Results: From 2010 to 2019, the majority of new pneumoconiosis cases were male (2542 cases, 98.72%) , and the age of onset was 40-<60 years old (2074 cases, 80.54%) . The main age of onset was 15-<30 years (1534 cases, 59.57%) . Silicosis was the most common type of new pneumoconiosis (2313 cases, 89.83%) . There were 2262 cases (87.84%) with one stage of pneumoconiosis. The main types of work were rock driller (799 cases, 31.03%) , hauler (797 cases, 30.95%) , other mine workers (391 cases, 15.18%) . The economic type of enterprises was mainly state-owned enterprises (1156 cases, 44.89%) . The scale of enterprises mainly concentrated in large enterprises (1897 cases, 73.67%) . Conclusion: The new pneumoconiosis in Yantai City shows obvious concentration of disease and work types.It is necessary to strengthen the prevention and treatment of silicosis and the training of protection knowledge for rock drillers and transport workers.

Bioinformatic analysis of the nucleotide binding site-encoding disease-resistance genes in foxtail millet (Setaria italica (L.) Beauv.).

The nucleotide-binding site (NBS) disease-resistance genes are the largest category of plant disease-resistance gene analogs. The complete set of disease-resistant candidate genes, which encode the NBS sequence, was filtered in the genomes of two varieties of foxtail millet (Yugu1 and 'Zhang gu'). This study investigated a number of characteristics of the putative NBS genes, such as structural diversity and phylogenetic relationships. A total of 269 and 281 NBS-coding sequences were identified in Yugu1 and 'Zhang gu', respectively. When the two databases were compared, 72 genes were found to be identical and 164 genes showed more than 90% similarity. Physical positioning and gene family analysis of the NBS disease-resistance genes in the genome revealed that the number of genes on each chromosome was similar in both varieties. The eighth chromosome contained the largest number of genes and the ninth chromosome contained the lowest number of genes. Exactly 34 gene clusters containing the 161 genes were found in the Yugu1 genome, with each cluster containing 4.7 genes on average. In comparison, the 'Zhang gu' genome possessed 28 gene clusters, which had 151 genes, with an average of 5.4 genes in each cluster. The largest gene cluster, located on the eighth chromosome, contained 12 genes in the Yugu1 database, whereas it contained 16 genes in the 'Zhang gu' database. The classification results showed that the CC-NBS-LRR gene made up the largest part of each chromosome in the two databases. Two TIR-NBS genes were also found in the Yugu1 genome.

First Report of Foxtail Millet Seedling Damping-Off Caused by Binucleate Rhizoctonia AG-A in China.

Foxtail millet (Setaria italica) is an important food and fodder grain crop in China. In June 2013, foxtail millet seedlings of cultivar Jigu19 showing symptoms of damping-off were observed with about 30% incidence in Handan, Hebei Province. Infected plants showed pale brown lesions on the stems and brown discoloration of the roots, which later turned into root rot. As a consequence, infected seedlings wilted and died prematurely. Segments of the diseased root tissue (5 mm long) were washed with sterile water, disinfected with 0.5% NaOCl for 2 min, rinsed with sterile water, placed on potato dextrose agar (PDA), and incubated at 25°C in the dark. Three isolates were obtained and designated HD-1, HD-3, and HD-5. Morphological characteristics of the three isolates were similar with white colonies bearing large amounts of floccose aerial hyphae and no production of sclerotia after 14 days. Hyphal cells were stained with DAPI and all the three isolates were binucleate. Total genomic DNA was extracted from the mycelial mat using CTAB (4). The rDNA internal transcribed spacer (ITS) region was amplified using the universal primer pair ITS1 and ITS4 (1). PCR amplicons were purified and sequenced. A BLASTn search revealed that the resulting sequences (GenBank Accession Nos. KM017960, KM017961, and KM017962 for HD-1, HD-3, and HD-5, respectively) shared 99% identity with other Ceratobasidium sp. AG-A isolates (JX913824, FJ440197). In addition, sequence identity of HD-1, HD-3, and HD-5 with each other was 99.8%, 99.7%, and 99.8%, respectively. Thus, the isolates were identified as Ceratobasidium sp. AG-A, i.e., binucleate Rhizoctonia (BNR) AG-A. Pathogenicity tests were conducted by placing autoclaved wheat seeds, each colonized with Rhizoctonia isolates at inoculum density of 25 propagules per gram (ppg), on the surface of a sterilized mix of soil, sand, and nutrient soil (1:1:1, v/v/v) in pots (3). Each pot contained five healthy seedlings of the foxtail millet cultivar Yugu 1, and every seedling was inoculated by placing three colonized wheat seeds under the sheath of foxtail millet at the 2- or 3-leaf stage; non-inoculated sterilized wheat seeds were used as a control. Plants were incubated at 25°C with 14 h light and 10 h dark in a growth room for 10 days, and then assessed for disease. Damping-off symptoms similar to those in the field appeared on inoculated plants; control plants were asymptomatic. BNR Rhizoctonia were re-isolated from diseased plants and confirmed to be AG-A based on morphological characteristics and rDNA-ITS sequence. BNR AG-A has been reported in China as a pathogen of Chinese mustard, Chinese cabbage, potato, and sugar beet, but there are no previous reports of its presence on foxtail millet. R. solani AG-1 and AG-4 are usually regarded as pathogenic to foxtail millet (2). To our knowledge, this is the first report of BNR AG-A causing foxtail millet damping-off in China. We found binucleate Rhizoctonia AG-A, the anamorph of Ceratobasidium sp., can infect foxtail millet at seeding stage, which may cause serious losses of the crop. Therefore, we should pay particular attention to it when considering seeding disease control and breeding disease resistance varieties of foxtail millet in the future. References: (1) K. de la Cerda et al. Plant Dis. 91:791, 2007. (2) W. D. Gao. Acta Phytopathologica Sinica. 17:247, 1987. (3) M. J. Lehtonen et al. Plant Pathol. 57:141, 2008. (4) M. G. Murray and W. F Thompson. Nucleic Acids Res. 8:4321, 1980.

First Report of Sheath Blight Caused by Waitea circinata Affecting Foxtail Millet (Setaria italica) in China.

Foxtail millet (Setaria italica) is planted widely in northern China, especially in Hebei, Shanxi, Shandong, and Henan provinces. Although several diseases reduce production of this important crop species, sheath blight is considered one of the important diseases of foxtail millet in China. Sheath blight is caused by a soil-borne pathogen and is difficult to control. Epidemics are most common at the late growth stage of foxtail millet. In August 2013, an outbreak was recorded in Shijiazhuang city, Hebei, with an incidence of about 60%. Typical disease symptoms consisted of large, irregular lesions with reddish-brown margin and as the disease progressed, the plants lodge. Three representative sheath fragments (each 1 cm long) were collected from diseased plants during that outbreak. The samples were disinfected with 0.5% (v/v) sodium hypochlorite, rinsed with sterile water, placed on a water agar plate, and then incubated at 26°C in the dark for two days. After the hyphae appeared, ~3-mm-long hyphal tips from typical colonies were excised and transferred to potato dextrose agar (PDA) plates. Three isolates were obtained and all showed typical features of Rhizoctonia-like fungus. Each isolate occupied its whole plate within 5 days of incubation at 26°C in the dark, and abundant aerial mycelia were produced. The color of all colonies was first orange, turning a salmon color when the mycelia matured. Orange sclerotia appeared after 2 weeks of incubation. The nuclei were stained with DAPI (2-(4-amidinophenyl)-1H-indole-6-carboxamidine) and observed under a fluorescent microscope. The hyphal cells were multinucleate and the mycelia branched at a right angle. For molecular identification of the pathogen, mycelia of each isolate were cultured in potato dextrose broth at 26°C for a week, and genomic DNA was extracted from mycelia and used as a template for PCR amplification. The primers set of ITS1 and ITS4 was used for amplification of rDNA-ITS from these isolates and the amplified rDNA-ITS regions of all isolates (GenBank Accession Nos. KJ765700, KJ765701, and KJ765702, respectively) were 99% identical to other Waitea circinata deposited in GenBank (1,2). To further confirm the pathogenicity of the isolates, freshly collected PDA plugs were inoculated on the lower leaf blades of 8-week-old seedlings of the foxtail millet variety Yugu 1. PDA plugs without the isolate were used as a negative control. Five plants were used for each isolate and negative control. After inoculation, pots were placed together in a moist chamber at 26°C. No symptoms developed on the control plants, while obvious lesions appeared on the sheaths of tested plants at 5 days post inoculation and later the plants were lodging. The fungus was re-isolated from diseased plants and confirmed to be W. circinata based on morphological characteristics and sequence analysis as previously described, completing Koch's postulates. Further, on the basis of morphological tests, pathogenicity assays, and molecular analyses, the pathogen of foxtail millet sheath blight was identified as W. circinata (4). Although Rhizoctonia solani AG-1, AG-4 has been reported in earlier studies as the pathogen causing foxtail millet sheath blight, there has been no previous report of the disease caused by W. circinata (3). To our knowledge, this is the first report of foxtail millet sheath blight caused by W. circinata in China. With the spread of high millet plant density and fertilizer application, this disease may become a major threat to foxtail millet; therefore, W. circinata should be taken into account when designing measures for disease control in foxtail millet. References: (2) K. A. de la Cerda et al. Plant Dis. 91:791, 2007. (1) M. Fiers et al. Eur. J. Plant. Pathol. 128:353, 2010. (4) W. D. Gao. Acta Phytopathol. Sinica 17:247, 1987. (3) T. Toda et al. Plant Dis. 89:536, 2005.

First Report of Elm Yellows Subgroup 16SrV-B Phytoplasma Infecting Chinese Tulip Tree in China.

Chinese tulip tree (Liriodendron chinensis) is native to China and is planted all around the country as an ornamental tree. In July of 2011, some Chinese tulip trees with typical phytoplasma symptoms were found in Baoding City, Hebei Province, China. Symptoms included yellowing of leaves, slow decline, little leaves, and death of entire plants. To confirm phytoplasma infection of these plants, total DNA was extracted from 100 mg of fresh leaf midribs collected from leaves of nine symptomatic and eight asymptomatic plants with a plant DNA extract kit (Tiangen, Beijing, China) according to the manufacturer's protocols. Using 16S rRNA phytoplasma universal primer pairs P1/P7 followed by R16F2n/R16R2, a nest PCR was carried out (1,2). The results showed that the phytoplasma was only detected in symptomatic samples by nested PCR, while the asymptomatic were negative. An approximate 1.2-kb specific fragment was obtained from the DNA of nine symptomatic plants, but no product was amplified from the leaves of eight healthy ones. The amplified products were cloned and sequenced. The sequence was deposited in GenBank Data Libraries under Accession No. JQ585925 and shared the highest homology of 99% with Puna chicory flat stem phytoplasma (GenBank Accession No. JN582266), Apricot leaf roll phytoplasma (GenBank Accession No. FJ572660), Jujube witches'-broom phytoplasma (GenBank Accession No. AY197661), and other elm yellows group phytoplasmas by BLAST analysis with that of other phytoplasmas from GenBank. Meanwhile, the sequence data was analyzed by iPhyClassifier software and the result showed that the 16S rDNA F2nR2 fragment was identical (similarity coefficient 1.00) to the reference patterns of 16Sr group V, subgroup B (GenBank Accession No.AB052876) (3). Combining the BLAST analysis in GenBank and the analysis of iPhyClassifier, we classified the phytoplasma causing Chinese tulip tree yellow leaves disease into subgroup 16SrV-B. To our knowledge, this is the first report of the 16SrVB group phytoplasmas infecting Chinese tulip tree in China. References: (1) I. M. Lee et al. Int. J. Syst. Bacteriol. 48:1153, 1998. (2) I. M. Lee et al. Int. J. Syst. Evol. Microbiol. 54:337, 2004. (3) Y. Zhao et al. Int. J. Syst. Evol. Microbiol. 59:2582, 2009.