Pulmonary Tuberculosis (PTB) is a significant global health issue due to its high incidence, drug resistance, contagious nature, and impact on people with compromised immune systems. As mentioned by the World Health Organization (WHO), TB is responsible for more global fatalities than any other infectious illness. On the other side, WHO also claims that noncommunicable diseases (NCDs) kill 41 million people yearly worldwide. In this regard, several studies suggest that PTB and NCDs are linked in various ways and that people with PTB are more likely to acquire NCDs. At the same time, NCDs can increase susceptibility to active TB infection. Furthermore, because of potential drug interactions and therapeutic challenges, treating individuals with both PTB and NCDs can be difficult. This study focuses on seven NCDs (lung cancer (LC), diabetes mellitus (DM), Parkinson's disease (PD), silicosis (SI), chronic kidney disease (CKD), cardiovascular disease (CVD), and rheumatoid arthritis (RA)) and rigorously presents the genetic relationship with PTB regarding shared genes and outlines possible treatment plans. BlueThis study aims to identify the drug components that can regulate abnormal gene expression in NCDs. The study will reveal hub genes, potential biomarkers, and drug components associated with hub genes through statistical measures. This will contribute to targeted therapeutic interventions. Numerous investigations, including protein-protein interaction (PPI), gene regulatory network (GRN), enrichment analysis, physical interaction, and protein-chemical interaction, have been carried out to demonstrate the genetic correlation between PTB and NCDs. During the study, nine shared genes such as TNF, IL10, NLRP3, IL18, IFNG, HMGB1, CXCL8, IL17A, and NFKB1 were discovered between TB and the above-mentioned NCDs, and five hub genes (NFKB1, TNF, CXCL8, NLRP3, and IL10) were selected based on degree values. In this study, we found that all of the hub genes are linked with the 10 drug components, and it was observed that aspirin CTD 00005447 was mostly associated with all the other hub genes. This bio-informatics study may help researchers better understand the cause of PTB and its relationship with NCDs, and eventually, this can lead to exploring effective treatment plans.

As a chronic occupational disease, silicosis could cause irreversible and incurable impair to the lung. The current diagnosis of silicosis relies on imaging of X-ray or CT, but these methods cannot detect lung lesions in the early stage of silicosis. To establish a regular screening and early diagnosis methods for silicosis, which could be helpful for the prevention and treatment of silicosis. A total of 161 subjects were enrolled in the study, including 69 patients with silicosis (SILs) and 92 healthy controls. The exhaled breath samples of the subjects were collected with breath sampler and Tedlar bag. The analysis of volatile organic compounds (VOCs) in exhaled breath was performed by solid-phase microextraction (SPME) combined with gas chromatography mass spectrometry (GC-MS). After excluding the pollutants from sampling bags and instruments, 86 VOCs have been identified in the exhaled breath. The orthogonal partial least squares-discriminant analysis (OPLS-DA) was employed for the screening of potential biomarkers of silicosis. Those components that related to smoking were also excluded from the biomarkers. Finally, nine possible biomarkers for silicosis were screened out, including 2,3-butanedione, ethyl acetate, chlorobenzene, o-cymene, 4-ethylhex-2-ynal, 3,5-dimethyl-3-heptanol, hydroquinone, phthalic anhydride and 5-(2-methylpropyl)nonane. Based on these biomarkers screened, a predicted model for silicosis was generated with the accuracy of 89.61%. The nine biomarkers in exhaled breath were preliminarily screened out for the early diagnosis of silicosis, which can be helpful to the establishment of a noninvasive screening method for silicosis. Follow-up studies should be conducted to further verify these markers.

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.

Silicosis is still one of the main occupational diseases in China.Early diagnosis or prediction may be very useful to control the disease, yet only relatively late stage patients with silicosis could be diagnosed based on radiological and lung function abnormalities.Seeking for biomarkers in blood serum that change their values with deposition of silica dust in the lung and onset of lung fibrosis has been one of the hot areas in the study of silicosis.This particular review focusses on the recent advances in the study of serum biomarkers for silicosis including inflammatory cytokines(tumor necrosis factor-α, interleukin-17, transforming growth factor-β1 and IL-12p40-containing cytokines, etc), miRNAs (miR-21, miR-200c, etc), serum enzymes (proline peptidase, heme oxygenase-1, superoxide dismutase, glutathione peroxidase and angiotensin-converting enzyme), immunoglobins and nephronectin, Clara cell protein 16, etc.There have been quite a lot of biomarkers being studied and some showed potential usefulness in the early detection and diagnosis of silicosis.Further improvement in the sensitivity and specificity of biomarkers and large scale multicenter validation are needed for the application in the future. Key words: Silicosis; MicroRNAs; Biomarker cytokines; Inflammatory cytokines; Enzyme

Exposure Assessment of Crystalline Silica in Diatomite Powder Handling Workplace with Acute Silicosis

Objective To investigate the perioperative anaesthesia treatment for a patient complicated with silicosis and its effect. Methods The perioperative anaesthesia of a patient with gallbladder stones and silicosis undergoing laparoscopic cholecystectomy was analyzed retrospectively; and the preoperative anaesthesia evaluation, intervention, and intraoperative anaesthesia treatment were discussed based on the patient’s physiological changes. The literatures were reviewed. Results Through a series of perioperative anesthesia, the patient successfully completed laparoscopic cholecystectomy under general anesthesia of tracheal intubation and epidural anesthesia. The main preoperative evaluation was to improve the status: oxygen inhalation atomization, lung function exercise, and infection control; enhancing lung function protection and maintaining airway stability during surgery; proper sedation and analgesia after operation as well as promoting postoperative recovery. The patient’s vital signs were relatively stable throughout the perioperative period. There were no related anesthesia complications after the postoperative follow-up and he was successfully discharged after 3 days. Conclusion The enhancement of perioperative lung exercise and protection is beneficial to the stability of perioperative period and clinical transition. Key words: Silicosis; Perioperative period; Anesthesia treatment

Silicosis refers to an occupational fibrotic pulmonary disease associated with the inhalation of silica dioxide dust or respirable silica. While the use of personal protective equipment (PPE) has been shown to decrease the risk of the disease, the condition still remains one of the most common occupational lung diseases globally. A review was conducted to provide an overview of the disease, its presentation, treatment, and prevention. The review examined special concerns of silica exposure with relation to World Trade Center Dust.

Objective To investigate the relationship between the insertion/deletion polymorphism (including three genotypes II, ID and DD) in the 16th intron of angiotensin Ⅰconverting enzyme (ACE) gene and the serum ACE activity in patients with silicosis. Methods 114 patients with silicosis in Meitan General Hospital and 109 healthy control subjects were collected from July 2011 to April 2016.The serum ACE activity was measured by enzyme linked immunosorbent assay.The genotyping of ACE gene polymorphism was performed by polymerase chain reaction-restriction fragment length polymorphism in silicosis group and healthy control group. Results There was no significant difference in the genotype distribution of ACE gene polymorphism between silicosis group and healthy control group.The serum ACE activity among the three genotypes was significant difference in silicosis group and healthy control group (all P<0.01). There was significant difference between ID and DD genotypes in silicosis group (P<0.01), whereas there was no difference between the same two genotypes in healthy control group.In silicosis group, the percentage of the II, ID, DD genotypes was 38.6% (44 cases), 43.0% (49 cases) and 18.4% (21 cases), respectively.The serum ACE activity in the patients with ID genotype was the highest [37.24 (22.96, 43.90) U], the second was DD genotype [24.76 (20.02, 29.80) U], the lowest was II genotype [20.46 (14.53, 30.51) U]. On the other hand, in healthy controls, the percentage of the II, ID, DD genotypes was 44.0% (48 cases), 44.0% (48 cases), and 11.9% (13 cases), respectively.The serum ACE activity was the highest in healthy controls with ID genotype [26.64 (18.15, 31.71) U], the second was DD genotype [19.92 (16.96, 24.16) U], the lowest was II genotype [13.48 (10.54, 16.69) U]. The serum ACE activity in the patients with ID and II genotypes was higher than that in the healthy controls with the same two genotypes (U=427.5, 651.0, all P<0.01). The serum ACE activity in silicosis group was significantly higher than that in healthy control group (P<0.01). There was no correlation between ACE gene polymorphism and the lung function (OR=0.98, 95% CI: 0.91-1.07, P=0.941). There was no correlation between ACE gene polymorphism and the stage of silicosis (OR=0.91, 95%CI: 0.05-18.18, P=0.736). Conclusions ACE gene polymorphisms influences the serum ACE activity in patients with silicosis.It is speculated that the morbidity incidence of silicosis may be related to high ACE activity. Key words: Silicosis; Angiotensin Ⅰ converting enzyme gene; Polymorphism; Angiotensin Ⅰ converting enzyme activity

Silicosis: biomarkers and pathogenesis

Objective To determine the clinical application value of percutaneous lung biopsy guided by ultrasound in the diagnosis of peripheral lung lesions of silicosis. Methods Experimental silicosis was produced in rabbits by the intratracheal administration of silica with non-exposure method. Imaging changes were observed in 36 rabbits on 60 days after intratracheal instillation of silica. To contrast with CT results, percutaneous lung biopsy of peripheral lesions was guided by ultrasound. The success rate of sufficient material, the diagnosis rate of coincidence between biopsy and pathology, and the incidence of complications were calculated. The biopsy with sufficient material, biopsy findings coincided with pathological results and no complications were defined as strictly success of the puncture. The baseline data and monitoring index were compared between successful biopsy group and unsuccessful biopsy group. Each rabbit was intravenously administrated by 10 000 U of heparin for the antiocoagulation and sacrificed by fast injection of 10% KCl through jugular vein catheterization. Specimens from lung tissue were collected and stained with hematoxylin-eosin. Pathological changes of lung tissue were observed through an optical microscope. Results Of 36 silicosis rabbits, peripheral lung lesions of silicosis were observed in 30 rabbits. Biopsy procedures were performed with ultrasound guidance in 30 rabbits. The total success rate of biopsy was 70% (21/30). The success rate of sufficient material was 93% (28/30), the diagnosis rate of coincidence between biopsy and pathology 86%(24/28), and the incidence of complications was 10% (3/30) respectively. Compared with failure group, peripheral lesions in successful biopsy group were bigger in size, closer to the chest wall, and lower respiratory rate, the difference was statistically significant (P 0.05). The pathological results showed typical silicosis nodules. Silica-exposed rabbit also showed signs of vascular remodeling with pulmonary artery muscularization, vascular occlusion, and medial thickening. Conclusions Ultrasound-guided percutaneous lung biopsy is an effective and safe method in peripheral lung lesions of silicosis. It can serve as an important technical means to monitor the evolution of silicosis lesions and provide reference for the diagnosis of silicosis. Observation of small vascular changes in silicosis nodules by lung biopsy is helpful for clinical intervention treatment. Key words: Ultrasonography; Silicosis; Vascular remodeling; Biopsy, needle

Silica-associated diseases, including tuberculosis and other related diseases, such as COPD, lung cancer, autoimmune diseases, renal diseases, etc. remain an important public health concern in the 21th century. Silica exposures and silicosis increase the risk of active tuberculosis development by approximately 30-40 times, compared to populations without silica exposure. Workers with periods of silica exposure longer than 10 years should be provided tuberculosis chemoprophylaxis. Although evidences of silicosis are not detected, the risk of active tuberculosis can increase. However, further studies are urgently needed to identify the best chemoprophylaxis regimen for tuberculosis.

Background: The staff of the Office of Disease Prevention and Control 4, Saraburi, Department of Disease Control, Ministry of Public Health, Thailand analyzed the data of 28 cases of diagnosed silicosis (J62.8) whose data were reported to the Health Data Center in Saraburi province, Thailand. Thus, its staff in collaboration with the staff of the Bureau of Occupational and Environmental Diseases, Department of Disease Control, Ministry of Public Health, Thailand formed the outbreak investigation team for this epidemiological outbreak of silicosis in Saraburi province, Thailand and operated from May 15, 2017 to May 17, 2017. Objective: 1. To confirm the diagnosis of Silicosis. 2. To find the causes of Silicosis. 3. To advice the health-care issues for Silicosis prevention to all patients diagnosed of Silicosis including high-risk populations of Silicosis Methodology 1. Meeting with stakeholders at Saraburi Hospital. This aimed to examine diagnostic Criteria from medical records in Saraburi Hospital and to define the definition of patients and suspected patients with Silicosis as well as organizing an investigation team. 2.Investigated suspected patients with Silicosis by using the clinical criteria which was provided by Saraburi Provincial Public Health Office, the Office of Disease Prevention and Control 4, Saraburi, Saraburi Hospital as well as the Health Promoting Hospitals.3.Meeting of a summarizing the investigation and root cause analysis regarding Silicosis with the Bureau of Occupational and Environmental Diseases, Saraburi Provincial Public Health Office and the Office of Disease Prevention and Control 4, Saraburi at Saraburi Hospital as well as planning for a surveillance system. Results: From analysis of 28 cases registered in Health Data Center, Saraburi province, Thailand by the outbreak investigation team, there were one case with no data availability, three cases with non-classification of suspected Silicosis, and 24 cases of suspicion criteria. Out of 24 Silicosis suspected cases, 8 cases were unable to follow up due to their homes being out of the Health Inspection Region 4, one case died of Nocardia species infection, one case of not being occupational cause, and one case of refuse to provide personal health data. Thus, only 13 cases were eligible for study. Of 13 cases, 12 cases were diagnosed of chronic Silicosis whereas one case was not compatible with the diagnostic criteria. Conclusion: As a result of the investigation of 13 cases, 12 cases were diagnosed as chronic silicosis. The main cause of silicosis in this study population was receiver, whereas the secondary causes were source and passage.

This study is descriptive research. The objective of the study was to monitor silicosis and follow upon subjects in neighboring communities of a stone crushing factory in Mueang District, Surin Province, Thailand for three years. The study applied chest x-ray examination and reports by ILO classification for pneumoconioses. Also, the environmental inspection was performed through air monitoring sampling on 24-hour basis by Air Metrics/Model: TAS 5.0 S/N 5547 between 2014-2016. Subjects of this study were 10-years old and older, residing within 5-kilometer radius around the factory, and along the road that was used by gravel trucks from the factory. The total subjects were voluntary 1,602 persons with consenting to the chest radiographing. The results of air monitoring sampling during 2014-Year 2016 are 0.049, 0.035 and 0.032 average of PM10, respectively. TSP results were 0.014, 0.074 and 0.078 respectively and did not exceed standards limit.The health surveillance findings of voluntary subjects were from 1,602 persons, at 61.15 % out of population at potential risk affected by stone dust on 2,620 persons. The results of chest radiograph by ILO classification pneumoconioses revealed that 13 cases (0.81%) were Categories 1 (profusion 1/0, 1/1, 1/2), 2 cases (0.12%) were Categories 2 (profusion 2/1, 2/2, 2/3) respectively. The results from 3-year surveillance of abnormal chest radiograph reports of profusion 1/0-2/2 group of 6 cases indicated 1 case with confirmation of profusion 1/1 silicosis (0.06%) of at-risk population, and non-occupational silicosis. In conclusion, silicosis surveillance from chest radiograph reports by ILO classification pneumoconioses, and by two NIOSH reports found 1 case was confirmed 1 non-occupational profusion PP 1/1 silicosis. However, reports found 5 profusion 1/0 - 2/2 cases (0.19%) and required continuous monitoring. The study needed further monitoring to include population in silicosis-risk zone.

The article is investigates occupational risk in workers with prolonged working experience who are exposed to industrial aerosols of varying degrees of fibrogenicity with excessive concentration. Immunological profile of patients with chronic dust bronchitis, silicosis and pneumoconiosis due to the effects of highly dispersed welding aerosols is studied. To solve the set goals and objectives of the study at the clinical stage, 161 people of the contact group, patients with chronic dust bronchitis, silicosis and pneumoconiosis caused by the exposure to highly dispersed welding aerosols were examined. The control group included 60 people. There was also a survey of 304 people with experience of more than 10 years under the influence of high concentrations of industrial fibrogenic aerosols, who underwent an in-depth periodic medical examination at the Regional Center of Occupational Pathology where occupational risk (RR), its etiological fraction (EF) and the ratio of chances (OR) of the development of occupational respiratory diseases were assessed. The features of the course of dust lung diseases, features of the immunological profile, increase in the level of growth factors were established. This allows us to establish the features of the occurrence, course and progression of dust lung diseases, as well as to improve the quality of early diagnosis, optimize prevention strategies for this pathology.

Objective: Occupational exposure to silica has been thought to be associated with renal diseases for some 40 years, but there are no data about the kidney function of silicosis patients in Turkey.

Objective To investigate the institution of extracorporeal membrane oxygenation(ECMO) for primary graft dysfunction(PGD) after lung transplantation and analysis its clinical outcome. Methods From September 2002 to December 2013, 286 patients with end-stage lung disease underwent lung transplantation(LTx) in Wuxi People’s Hospital. Among them, there were 22 patients occured grade 3 PGD in early stage after LTx. In which there were 2 cases with chronic obstructive pulmonary disease, 12 with idiopathic pulmonary fibrosis, 4 case with primary pulmonary hypertension, 1 case with lung tuberculosis, 1 case with silicosis, 2 cases with bronchiectasis. There were 7 patients with single LTx(3 cases with ECMO support) and 15 patients with bilateral LTx(2 cases with CPB support and 6 cases with ECMO support). According to the severity levels of PGD, different treatment measures were used, such as reinforce ventilatory support, negative fluid balance, extending the treatment time of the ventilator, the use of pulmonary vasodilators, such as prostaglandin E1 and ECMO. Results Six patients were treated by adjusting low volume, high frequency and high positive end expiratory pressure ventilation(PEEP) mode, and 2 cases reversed, 4 cases died of respiratory failure. 16 cases accepted ECMO support, among them 10 cases apply venous-venous mode, 6 cases venous-artery mode, the average flow time was 5.5 days. 10 cases dismantled from ECMO successly and 6 cases died of multiple organ failure, infection and cardiac arrest. 30-day, 1-year and 5-year survival of PGD recipients post-operatively were 55%, 40%, 25%, respectively. Conclusion The high incidence of PGD causes high mortality peri-operatively after LTx. Preventing PGD can improve the survival rate of the lung transplant patients. Once PGD happens, appropriate treatment should be given as soon as possible.ECMO can effectively promote the transplanted lung function recovery, reduce the perioperative mortality. If the indications of ECMO use was reached, the institution of ECMO should as soon as possible. Key words: Lung transplantation; Primary graft dysfunction; Extmcorporeal membrane oxygenation; Prevention; Therapy

BackgroundAdministration of bone marrow mononuclear cells (BMMCs) modulates lung inflammation and fibrosis in experimental silicosis. However, no studies have evaluated whether silicosis affects the efficacy of autologous BMMCs treatment. We hypothesized that BMMCs obtained from healthy or silicotic mice may improve lung function, but they might affect the inflammatory and fibrotic processes differently in experimental silicosis.MethodsC57BL/6 mice were randomly divided into control (C) and silicosis (SIL) groups. Mice in the SIL group were instilled with silica particles intratracheally; the C animals received saline using the same protocol. On day 15, the animals were treated with saline (Sal) or BMMCs (2 × 106 cells) from healthy (BMMC-healthy) and silicotic (BMMC-sil) donors. Lung mechanics were measured, and lungs were collected for histology and molecular biology analysis.ResultsBMMCs obtained from healthy and silicotic donors presented similar percentages of cell populations. 99mTc-BMMCs tracking revealed preferential migration of cells to the liver, and only a few GFP+ BMMCs were observed in lung tissue 24 h after treatment, regardless of donor type. Both the SIL-BMMC-healthy and SIL-BMMC-sil groups showed improvement in lung function, a reduction in the fractional area of granuloma, and a decrease in the number of mononuclear and apoptotic cells in lung parenchyma. In addition, the number of F4/80+ macrophages, the levels of interleukin-1 beta and transforming growth factor beta, and collagen fiber content in granuloma were reduced in SIL-BMMC-healthy mice, whereas mRNA expression of MMP-9 and procollagen I and III was reduced in the SIL-BMMC-sil group.ConclusionsAdministration of BMMCs from healthy and silicotic donors reduced lung inflammation and fibrosis, thus improving lung function. In addition, BMMC-healthy exhibited a greater improvement in lung morpho-functional changes in murine model of silicosis.

Objective To explore the curative effect and prognosis of traditional Chinese medicine combined with western medicine in the treatment of silicosis patients. Methods 74 patients with silicosis were selected as the research subjects.According to the admission time, the patients were divided into the observation group and the control group, 37 patients in each group.The control group was treated with conventional western medicine, the observation group was given the combined treatment of traditional Chinese medicine and western medicine.The clinical curative effect, pulmonary function index, symptoms improved time and the reduce of lung shadow were observed and compared. Results The reduction rate of lung shadow in the observation group was 75.67%, which in the control group was 62.16%, there was statistically significant difference between the two groups(u=2.419, P=0.015). The total effective rate of the observation group was 86.49%, which of the control group was 67.57%, there was statistically significant difference between the two groups(u=2.116, P=0.034). After treatment, the vital capacity(VC), forced vital capacity(FVC) and the first second forced expiratory volume(FEV1) in the observation group were (69.15±18.34)%, (71.08±16.93)%, (68.91±18.75)%, respectively, which in the control group were (63.37±20.53)%, (63.13±18.69)% and (55.47±17.58)%, respectively, which in the two groups were higher than those before treatment, which in the observation group increased significantly, there were statistically significant differences between the two groups(t=6.778, P=0.000, t=8.836, P=0.000, t=10.133, P=0.000). The wheezing, cough, pulmonary rales and other symptoms improved time in the observation group were shorter than those in the control group, the differences were statistically significant(t=8220, P=0.000, t=6.836, P=0.000, t=6.909, P=0.000). Conclusion Traditional Chinese medicine combined with western medicine in the treatment of silicosis has higher reduction rate of lung shadow, lung function improved significantly, shorter improved time of cough, wheezing and other symptoms, its curative effect is better than western medicine. Key words: Pneumoconiosis; Drugs, Chinese herbal; Drug therapy, combination; Treatment outcome

Objective To investigate the relationship between serum tumor markers and the severity of silicosis. Methods Retrospective study.Total of 160 patients with silicosis were included in the study, and 160 healthy volunteers were recruited as the control group. Tumor marker levels in both bronchoalveolar lavage fluid(BALF)and serum were detected by the immunochemiluminecence methods. The pulmonary function parameters, blood gas analysis and lactate dehydrogenase(LDH)were also analyzed. Lung tissue obtained by a patient with silicosis was stained by neuron specific enolase(NSE), carbohydrate antigen125(CA125) and carbohydrate antigen19-9(CA19-9). Results Serum NSE, CA125 and CA19-9 levels were significantly higher in cases than those in controls[(34.47±13.30)μg/L vs(10.24±7.20)μg/L, t=20.27, P<0.000 1; (33.96±17.80)kU/L vs(12.23±15.30)kU/L, t=11.71, P<0.000 1; (4.68±5.67)kU/L vs(2.78±3.45)kU/L, t=3.67, P<0.002]. Significant negative correlations were found between values of tumor markers(CA125 and CA19-9) and spirometric parameters, such as forced expiratory volume in one second %(FVE1%), forced expiratory volume in one second/forced vital capacity(FVE1/FVC), carbon monoxide diffusion capacity (Dlco) and total lung capacity(TLC) (r=-0.423, P=0.001; r=-0.323, P=0.011; r=-0.479, P=0.001; r=-0.285, P=0.043) and (r=-0.324, P=0.022; r=-0.256, P=0.023; r=-0.354, P=0.013; r=-0.356, P=0.012). Significant positive correlations were also observed between values of these tumor markers and LDH(r=0.378, P=0.001 and r=0.347, P=0.21). Significant negative correlations were found between NSE and Dlco and TLC(r=-0.374, P=0.004 and r=-0.368, P=0.002). Significant positive correlations were also observed between NSE and LDH(r=0.404, P=0.001). The NSE and CA19-9 levels in BALF were significantly higher than those in serum[(39.32±29.30)μg/L vs(25.7±12.12)μg/L, t=2.15, P=0.036; (21.36±12.11)kU/L vs(11.28±10.78)kU/L, t=2.64, P=0.012]. Patients experienced a decrease in NSE and CA19-9 concentrations following whole lung lavage[(39.20±10.24)μg/L vs(15.32±8.35)μg/L, t=8.02, P<0.05; (26.24±12.23)kU/L vs(18.84±5.64)kU/L, t=2.46, P<0.05]. Immunohistochemical studies showed positive NSE and CA19-9 staining in lung biopsy specimen. Conclusion Elevated serum tumor markers including NSE, CA125 and CA19-9 would provide valuable clinical information to assess disease severity in silicosis.(Chin J Lab Med, 2017, 40: 515-519) Key words: Silicosis; Tumor markers, biological; CA-125 antigen; CA-19-9 antigen

Objective To explore the expression of peripheral T cell subgroup (CD3+ , CD4+ , CD8+ , CD4+ CD25 high regulatory T cells) and the level and significance of serum cytokines in patients with silicosis. Methods One hundred and six cases patients with silicosis were collected in the Fifth People′s Hospital of Suzhou as study subjects and 56 healthy subjects as control group.Flow cytometry was used to detect the peripheral CD3+ , CD4+ , CD8+ and CD4+ CD25 high regulatory T cells (Treg) of the patients and the control group, while chemiluminescence immunoassay was utilized to measure the peripheral serum soluble interleukin-2 receptor (sIL-2R), interleukin 6 (IL-6), interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α). Results (1) The percentages of peripheral CD3+ , CD4+ and CD8+ in the silicosis group were all lower than those in the control group (t=3.755, 3.828, 2.347, P<0.05); the percentage of Treg cells was higher in the silicosis group than in the control group, the difference was statistically significant (t=-8.345, P<0.05). Compared with the control group, based on the one-way analysis of variance, the differences in CD3+ , CD4+ , CD8+ and CD4+ CD25 high cells were all statistically significant ( F=5.620, 8.007, 26.71, P<0.05); in the silicosis group, the percentage of CD4+ T cells was lower in stage III than in stage I (t=3.424, P<0.05); compared with the control group, the percentages of Treg cells in the silicosis group were lower in all stages (t=-7.934, -9.445, -5.096, P<0.05). (2) The levels of peripheral sIL-2R, IL-6, IL-8 and TNF-α in the silicosis group were higher than those in the control group, the difference were statistically significant(t=-6.952, -4.506, -2.551, -5.670, P<0.05); compared with the control group, based on the one-way analysis of variance, the differences in sIL-2R, IL-6 and TNF-α in all stages were statistically significant (F=11.03, 11.31, 13.22, P<0.0001); the sIL-2R was higher in patients with stage III silicosis than that of stage I (t=-2.882, P<0.05); IL-6 was significantly higher in stage II and III silicosis group than that of stage I group (t=-3.022, -2.632, P<0.05), and TNF-α was higher in patients with stage II silicosis than patients with stage I silicosis (t=-2.322, P<0.05). (3) The level of peripheral Treg cells was negatively correlated with the percentages of CD3+ and CD8+ cells in patients with silicosis (r=-0.357, -0.508, P<0.05); sIL-R2 was positively correlated with IL-6, IL-8 and TNF-α, respectively (r=0.483, 0.199, 0.392, P<0.05); TNF-α was positively correlated with IL-6 and IL-8, respectively (r=0.338, 0.338, P<0.05). Conclusion Patients with silicosis have abnormal expression in peripheral T cell subgroups, significantly increased Treg cell and dysfunctional cytokines, which may be associated with the pathogenesis of silicosis, the detection of these indicators may have significance of diagnosis, staging, disease monitoring and prognosis of the diseases. Key words: T cell subgroup; Cytokines; Silicosis