| Environmental problem is an international and regional issue. Only by correctly dealing with the relationship between environment and development can national sustainable development be achieved. Coal exploit has promoted China’s economic development, but inevitably brought about the pollution of the environment, especially the harm of dust was very common, which severely affected practitioners’health. Therefore, environmental problem is the main reason resulting in occupation disease. Pneumoconiosis is a chief occupational disease in coal mine workers owing to environmental dust pollution. It has high mortality rates since there is a lack of radically curative drugs for the treatment of pneumoconiosis. The dust concentration, free SiO2 content and environmental microorganism in mining areas were studied in the present study, to investigate the mechanism of coal worker’s pneumoconiosis, and explore the therapeutic effects of Chinese medicine on pneumoconiosis complications, in order to provide scientific basis for prevention and control of pneumoconiosis.Research on the environmental factors resulting in pneumoconiosis.The two mine coals in Huainan Mining Group were chosen as the research object. The coal dust was collected by the dust sample, to calculate the results of PC-STEL and PC-TWA. The free SiO2 content was determinated by using pyrophosphate quality method. The contents of main metal and metalloid elements were detected by atomic absorption spectrometry. In addition, FA-1 type impact type air microorganism sampler was used to detect bacterium and fungus. The results showed that (1) the PC-STEL of dust samples in two coal mines which were 42.59% and 50.00% exceeded the national standard, and the PC-TWA were 27.78% and 25.93%. (2) The concentration of free silica was 11.28 mg/m3; the worker place of rock opening was obviously higher than others (P<0.05). (3) The content of Fe, Cu, Zn, Mn, Pb, Ni, Cd and As were respectively 25.68±7.24 μg/g,37.21±8.16μg/g, 64.85±36.97 μg/g,611.80±70.34 μg/g,30.15±10.95 μg/g,106.84±38.68 μg/g, 2.31±1.65 μg/and 3.18±1.70 μg/g in dust samples. The contents were different in different coal mines, and in different sampling places even in the same coal mine. (4) The concentrations of bacteria and fungi in the workplace air accounted for 73.81% and 26.19% of the total microbial concentration, bacterial concentration was significantly higher than that of fungi (P<0.001). The bacteria were Gram-positive cocci and Gram-positive rod, the former were mainly Staphylococcus and Micrococcus, the latter was Bacillus. The preponderant fungi were mold (Aspergillus and Penicillium). The particle concentration distribution of air microorganism was peaked in the third level (3.3～4.7 μm) and level fifth (1.1～2.1 μm), the peak values were 1 025 cfu/m3 and 1134 cfu/m3. It suggested that mine workplace dusts is seriously over the standard in Huainan mining district, the content of SiO2 was positively related to the occurrence of pneumoconiosis in dust.In the coal dust with high dust concentration and type of metal and metalloid elements, coal worker’s pneumoconiosis is in higher incidence, but can’t be determined on the threshold dose of human body injury. The air bacterial concentration in the workplace was significantly higher than that of fungi. The particle concentration distributions of air microorganism were peaked in the third stage and level fifth, which were mainly less than or equal to 5 μm particles. It provided the experimental evidence for the direct toxic effect of dust particles on lung. Therefore, it is the key to improve the dust control technology, strengthen individual protective measures, implement standard occupational disease prevention and cure law.Research on pneumoconiosis in terms of epidemiology’s perspective.Epidemiology is the study of the prevalence of the status and clinical characteristics of pneumoconiosis by using the epidemiological method to provide scientific basis for prevention and control strategy of pneumoconiosis. A total of 6378 mining workers were diagnosed as having stage â… , â…¡ or â…¢ pneumoconiosis in the occupation disease prevention and treatment hospital of Huainan Mining Group from 1954 to 2012. The cumulative prevalence rate is about 6.38%. The patient is given priority to with tunneling engineering, mining engineering, accounting for 56.13% (3580/6378). Length of service of stage â… , â…¡ or â…¢ pneumoconiosis prolonged gradually as the era increased, the average of 22.35±8.26 years. In addition, the age of onset was extended to the average of 52.44±12.19 years. The prevalence of pneumoconiosis patients complicated with pulmonary tuberculosis rate was 11.30%, which was significantly higher than the general population (523/100000). The concurrent rate of stage I pneumoconiosis (7.33%) was the lowest, then stage III was the highest,36.81%. The concurrent rate of each stage of pulmonary tuberculosis increased with the increase of stage of pneumoconiosis, the difference was significant (P<0.01). The total mortality in pneumoconiosis patients was 45.17%, the mortality of pneumoconiosis combined with tuberculosis was obviously higher than that of simple pneumoconiosis (P<0.01). Among 2881 deceased workers, the direct causes of deaths included 46.13% pneumoconiosis,31.03% pulmonary tuberculosis,6.18% lung cancer,5.73% pneumocardial disease and 3.58% hypertension and heart disease. It suggested that the mining workers’ survival time was correlated with the stage of pneumoconiosis, early clinical intervention may be useful to decline fatality in later years. Tuberculosis was a common complication of pneumoconiosis and a significant cause of death.Research on the drug resistance of pneumoconiosis complicated with tuberculosis.Due to the lack of specific medicine for pneumoconiosis, anti-tuberculosis treatment is the key of pneumoconiosis complicated with tuberculosis. A total of 114 clinical isolated strains of Mycobacterium tuberculosis were collected, MDR-TB were identified by conventional antimicrobial susceptibility test (AST). The genomes DNA were extracted, the target genes were amplified by PCR technology, and the hot regions in the katG gene were analyzed by direct sequencing. The results showed that (1) The results of AST analysis demonstrated that there were 31 strains of MDR-TB in 114 clinical isolates. (2) In total, there were 29 mutational strains of the rpoB gene within the 31 RFP-resistant strains. The rate of mutation was observed to be 93.55% (29/31), mainly concentrated in codon 531 (51.61%,16/31) and 526 (32.26%,10/31) and occurring by base substitutions, including 27 unit point mutations and two two-site point mutations. The mutation of codon 516 was a novel observation. No rpoB mutation was identified in the 11 RFP-sensitive strains. Furthermore, two strains of two-site point mutations were identified, one at codon 526 (Ginâ†'-Leu) and 531 (Serâ†' Trp) and the other at codons 511 (Leuâ†'Pro) and 526 (Glnâ†'Leu). The mutation rate was 6.45%(2/31). (3) The mutation rate of katG was 61.3%(19/31) in isoniazid-resistant strains, mainly concentrated in codon 315 (Ser315Thr and Ser315Asn,48.4%) and 431 (Ala431Val,3.23%), happened base substitutions, no found multisite mutation. It suggested that the situation of isoniazid-resistance was more serious in MDR-TB among pneumoconiosis patients complicated with tuberculosis. The substitution of highly conserved amino acids encoded by rpoB and katG genes resulted in the molecular mechanism was responsible for the resistance in MDR-TB. It also proved that the drug resistance genes were in diversiform.Research on Chinese herbal medicines on the healing of pneumoconiosis.The present study aimed to investigate the effects of Radix Ranunculi Ternati, Radix Sophorae Flavescentis, Prunella Vulgaris L. and Stellera Chamaejasme L. extracts on cell-mediated immunity in a rat model induced by MDR-TB from pneumoconiosis patients complicated with tuberculosis, accordingly provide the theory base of healing of pneumoconiosis patients with them. In the present study, rats were infected with MDR-TB in order to establish the models. A total of 60 adult, male Kunming rats were randomly divided into six groups, each containing ten rats:The normal group (fed daily on a standard diet); the model group (drenched with 5 ml sodium chloride and then fed on a standard diet); and four groups that were each treated with one of the extracts of Chinese herbal medicines. PBMCs were isolated and cultivated, and the serum levels of IFN-y, IL-4, IL-10 and IL-12 were examined by ELISA method. The mRNA expression levels of certain cytokines in PBMCs were additionally detected using RT-PCR technology. The results that (1) The serum levels of IFN-y, IL-4, IL-10 and IL-12 were examined using ELISA analysis. The levels of IFN-y and IL-12 were significantly decreased in the model group compared with the normal group, and the levels of IL-4 and IL-10 were significantly increased (P<0.01). The levels of IFN-y, IL-12, IL-4 and IL-10 in the Radix Ranunculi Ternati group demonstrated a significant increase compared with the model group (P<0.05). In the Radix Sophorae Flavescentis group, the levels of IFN-y and IL-12 were significantly increased (P<0.05), and the levels of IL-4 and IL-10 were significantly decreased compared with the model group (P<0.05). In the Prunella Vulgaris L. group, the levels of IFN-y, IL-10 and IL-12 were significantly increased compared with the model group (P<0.05); however, no significant changes in IL-4 levels were detected. In the Stellera Chamaejasme L. group, the levels of IL-4, IL-10 and IL-12 were significantly increased (P<0.05) and the levels of IFN-y were significantly decreased (P<0.05) compared with the model group. (2) Furthermore, results of the RT-PCR analysis demonstrated that the mRNA expression levels of IFN-y, IL-12 and GLS in the PBMCs of MDR-TB infected rats were significantly increased, and the levels of IL-4 and IL-10 were significantly decreased compared with the normal group; these differences were significant (P<0.05 or P<0.01). The four extracts of Chinese herbal medicines were found to be capable of stimulating the expression of IFN-y, IL-12 and GLS mRNA and downregulating the expression of IL-4 and IL-10. The results demonstrated the regulation of cellular immunity of the extracts were accomplished at the level of gene transcription. It suggested that appropriate concentrations of the four extracts of Chinese herbal medicines were capable of enhancing cell-mediated immunity in rats infected by MDR-TB, providing an experimental basis for the clinical treatment of pneumoconiosis complications using these extracts.In summary, the incidence of pneumoconiosis in Huainan mine area may be the comprehensive effect of various environmental factors, Dust pollution, SiO2 content, less than or equal to 5 μm microbial granule and heavy metal played the key roles in direct toxicity on pulmonary. Radix Ranunculi Ternati, Radix Sophorae Flavescentis, Prunella Vulgaris L. and Stellera Chamaejasme L. extracts in the treatment of pneumoconiosis complication are obviously effective, and have broad application prospect. |
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