1.Case analysis on sequential latent occupational acute organotin poisoning
Lizhuang LU ; Linlin FAN ; Yinghua SONG ; Jia LIU ; Yongjian YAN
China Occupational Medicine 2025;52(3):308-312
A retrospective investigation was conducted to analyze the occupational exposure history, clinical manifestations, laboratory tests, imaging findings, and diagnosis and treatment of two cases of sequential latent occupational acute organotin poisoning. Both patients were successively employed in the same enterprise, engaged in crushing of waste polyvinyl chloride plastics, and thus potentially exposed to organotin hazards. Within several days of employment, both patients developed discomfort symptoms, and central nervous system impairment was observed, including short-term memory loss, slow response, and cognitive dysfunction. Hypokalemia was detected in both cases. Cranial magnetic resonance imaging showed abnormalities (multiple ischemic lesions in the bilateral frontal and parietal lobes), and urinary tin was positive. Symptoms relieved in both patients after treatments with tin-exclusion, potassium supplementation, and neurotrophic treatment. Based on the GBZ 26-2007 Diagnostic Criteria of Occupational Acute Trialkyltin Poisoning, and combined with worksite survey of occupational health and exclusion of cerebrovascular disease, viral encephalitis, and autoimmune encephalitis and other neurological disorders, both patients were diagnosed with mild occupational acute trialkyltin poisoning. Sequential latent occupational acute organotin poisoning is prone to misdiagnosis, with great difficulty in etiological identification. Comprehensive assessment of occupational exposure history and biomarker testing are essential for differential diagnosis. Early recognition and intervention improve prognosis, highlighting the need for strengthened occupational health supervision and protection in high-risk work posts.
2.Revision and Application of the General Rule for Particle Size Analysis by Light Scattering in the 2025 Edition of the Pharmacopoeia of the People's Republic of China
Hui WU ; Baoxi ZHANG ; Ping ZHENG ; Yongjian YANG ; Qiaoru XUE ; Yihong LU ; Xuefan CHEN ; Langui XIE ; Xia ZHAO
Herald of Medicine 2025;44(11):1773-1778
This article focused on the revision and application of General Rule 0982 Determination of Particle Size and Size Distribution by Light Scattering Method in the Chinese Pharmacopoeia(2025 edition).By referencing domestic and international technical requirements and considering practical applications,the structure and content of this general rule were analyzed,and specific revisions were proposed.Key recommendations included adding sections on method validation and results reporting to the current general rule,incorporating the appendix content into the main text,and revising/supplementing the method name,introduction,instrument requirements,and determination procedures.The revised light scattering method would strengthen China's capacity for pharmaceutical quality control.
3.Clinical feature analysis of 258 COPD patients with a history of occupational hazard exposure
Lizhuang LU ; Rui YUAN ; Yongjian YAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(10):761-766
Objective:Analyze the correlation between exposure to occupational hazard factors and clinical characteristics of chronic obstructive pulmonary disease (COPD) to provide a basis for early identification and prevention of occupational-related COPD.Methods:In May 2020, a study was conducted involving 258 chronic obstructive pulmonary disease (COPD) patients with occupational exposure history from three general hospitals in Jinan City. Such as symptoms, signs and the percentage of forced expiratory volnmein one second to predicted valve (FEV 1%pred) collectted exposure to occupational hazard factors such as length of strvice and types of exposure. Clinical characteristics were analyzed through questionnaire surveys and COPD-related data collection. Group comparisons employed t-tests or F-tests, while non-parametric tests were applied to non-normal distribution data. Differences in categorical variables between groups were examined using χ2-tests or Fisher's exact test. Multivariate analysis was performed using generalized linear models, with normal distribution correlation analyses conducted through linear regression. Results:Among 258 patients, 145 were male (56.2%) and 113 were female (43.8%), with 210 being smokers (81.4%). The exposure dust primarily consisted of plant-based organic dust (157 cases, 75.5%) and carbon-containing inorganic dust (24 cases, 11.5%). The majority (94 cases, 36.4%) were diagnosed in the 60+ age group. Regarding pulmonary function severity, 55 patients (21.3%) had mild airflow limitation, 99 (38.4%) moderate, 64 (24.8%) severe, and 40 (15.5%) very severe. For acute exacerbation hospitalizations within the past year, 195 (75.6%) had fewer than 2 hospitalizations, while 63 (24.4%) had more than 2. Comprehensive severity assessment showed most patients (91 cases, 35.3%) were in Group B and 62 (24.0%) in Group D. mMRC scores ranged from 0-1 (58.9%) and 2-4 (106 cases, 41.1%). The average CAT questionnaire score was 17.45±1.68. Respiratory symptoms significantly increased with higher occupational hazard exposure levels ( P<0.05). Moderate-to-high risk exposure showed a correlation with disease severity, with OR values (95% CI) of 1.30 (1.10-1.53) and 1.38 (1.20-1.59). There was a certain correlation between high risk exposure and the number of acute exacerbations in COPD patients in the past year, OR value (95% CI) was 1.410 (1.33-1.50) . Conclusion:Contact level is a major hazard factor affecting COPD respiratory symptoms, disease severity, and number of acute exacerbations. Older age at diagnosis, lower literacy, more smoking and higher exposure level, patients had worse lung function and more severe clinical symptoms.
4.Clinical feature analysis of 258 COPD patients with a history of occupational hazard exposure
Lizhuang LU ; Rui YUAN ; Yongjian YAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(10):761-766
Objective:Analyze the correlation between exposure to occupational hazard factors and clinical characteristics of chronic obstructive pulmonary disease (COPD) to provide a basis for early identification and prevention of occupational-related COPD.Methods:In May 2020, a study was conducted involving 258 chronic obstructive pulmonary disease (COPD) patients with occupational exposure history from three general hospitals in Jinan City. Such as symptoms, signs and the percentage of forced expiratory volnmein one second to predicted valve (FEV 1%pred) collectted exposure to occupational hazard factors such as length of strvice and types of exposure. Clinical characteristics were analyzed through questionnaire surveys and COPD-related data collection. Group comparisons employed t-tests or F-tests, while non-parametric tests were applied to non-normal distribution data. Differences in categorical variables between groups were examined using χ2-tests or Fisher's exact test. Multivariate analysis was performed using generalized linear models, with normal distribution correlation analyses conducted through linear regression. Results:Among 258 patients, 145 were male (56.2%) and 113 were female (43.8%), with 210 being smokers (81.4%). The exposure dust primarily consisted of plant-based organic dust (157 cases, 75.5%) and carbon-containing inorganic dust (24 cases, 11.5%). The majority (94 cases, 36.4%) were diagnosed in the 60+ age group. Regarding pulmonary function severity, 55 patients (21.3%) had mild airflow limitation, 99 (38.4%) moderate, 64 (24.8%) severe, and 40 (15.5%) very severe. For acute exacerbation hospitalizations within the past year, 195 (75.6%) had fewer than 2 hospitalizations, while 63 (24.4%) had more than 2. Comprehensive severity assessment showed most patients (91 cases, 35.3%) were in Group B and 62 (24.0%) in Group D. mMRC scores ranged from 0-1 (58.9%) and 2-4 (106 cases, 41.1%). The average CAT questionnaire score was 17.45±1.68. Respiratory symptoms significantly increased with higher occupational hazard exposure levels ( P<0.05). Moderate-to-high risk exposure showed a correlation with disease severity, with OR values (95% CI) of 1.30 (1.10-1.53) and 1.38 (1.20-1.59). There was a certain correlation between high risk exposure and the number of acute exacerbations in COPD patients in the past year, OR value (95% CI) was 1.410 (1.33-1.50) . Conclusion:Contact level is a major hazard factor affecting COPD respiratory symptoms, disease severity, and number of acute exacerbations. Older age at diagnosis, lower literacy, more smoking and higher exposure level, patients had worse lung function and more severe clinical symptoms.
5.The efficacy and safety of nebulized inhalation of recombinant human interferon α1b in the treatment of pediatric respiratory syncytial viral associated lower respiratory tract infections: a multicenter, randomized, double-blind, placebo-controlled phase Ⅲ clinical study
Xiaohui LIU ; Baoping XU ; Yunxiao SHANG ; Han ZHANG ; Zhenkun ZHANG ; Guangyu LIN ; Ju YIN ; Aihua CUI ; Guocheng ZHANG ; Zhaoling SHI ; Liwei GAO ; Chunming JIANG ; Junmei BIAN ; Yongjian HUANG ; Rongfang ZHANG ; Xiaomei LIU ; Xiaoqing YANG ; Yu TANG ; Lili ZHONG ; Hongmei QIAO ; Chuangli HAO ; Yuqing WANG ; Qubei LI ; Ling CAO ; Yungang YANG ; Ling LU ; Rongjun LIN ; Xingzhen SUN ; Wei ZHOU ; Qiang CHEN ; Jikui DENG ; Yuejie ZHENG ; Lin ZHAO ; Tao AI ; Xiaohong LIU ; Xiaoxia LU ; Ning JIANG ; Ming LI
Chinese Journal of Applied Clinical Pediatrics 2025;40(3):180-186
Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.
6.Revision and Application of the General Rule for Particle Size Analysis by Light Scattering in the 2025 Edition of the Pharmacopoeia of the People's Republic of China
Hui WU ; Baoxi ZHANG ; Ping ZHENG ; Yongjian YANG ; Qiaoru XUE ; Yihong LU ; Xuefan CHEN ; Langui XIE ; Xia ZHAO
Herald of Medicine 2025;44(11):1773-1778
This article focused on the revision and application of General Rule 0982 Determination of Particle Size and Size Distribution by Light Scattering Method in the Chinese Pharmacopoeia(2025 edition).By referencing domestic and international technical requirements and considering practical applications,the structure and content of this general rule were analyzed,and specific revisions were proposed.Key recommendations included adding sections on method validation and results reporting to the current general rule,incorporating the appendix content into the main text,and revising/supplementing the method name,introduction,instrument requirements,and determination procedures.The revised light scattering method would strengthen China's capacity for pharmaceutical quality control.
7.The efficacy and safety of nebulized inhalation of recombinant human interferon α1b in the treatment of pediatric respiratory syncytial viral associated lower respiratory tract infections: a multicenter, randomized, double-blind, placebo-controlled phase Ⅲ clinical study
Xiaohui LIU ; Baoping XU ; Yunxiao SHANG ; Han ZHANG ; Zhenkun ZHANG ; Guangyu LIN ; Ju YIN ; Aihua CUI ; Guocheng ZHANG ; Zhaoling SHI ; Liwei GAO ; Chunming JIANG ; Junmei BIAN ; Yongjian HUANG ; Rongfang ZHANG ; Xiaomei LIU ; Xiaoqing YANG ; Yu TANG ; Lili ZHONG ; Hongmei QIAO ; Chuangli HAO ; Yuqing WANG ; Qubei LI ; Ling CAO ; Yungang YANG ; Ling LU ; Rongjun LIN ; Xingzhen SUN ; Wei ZHOU ; Qiang CHEN ; Jikui DENG ; Yuejie ZHENG ; Lin ZHAO ; Tao AI ; Xiaohong LIU ; Xiaoxia LU ; Ning JIANG ; Ming LI
Chinese Journal of Applied Clinical Pediatrics 2025;40(3):180-186
Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.
8.Vaccination against coronavirus disease 2019 in patients with pulmonary hypertension: A national prospective cohort study
Xiaohan WU ; Jingyi LI ; Jieling MA ; Qianqian LIU ; Lan WANG ; Yongjian ZHU ; Yue CUI ; Anyi WANG ; Cenjin WEN ; Luhong QIU ; Yinjian YANG ; Dan LU ; Xiqi XU ; Xijie ZHU ; Chunyan CHENG ; Duolao WANG ; Zhicheng JING
Chinese Medical Journal 2024;137(6):669-675
Background::Coronavirus disease 2019 (COVID-19) has potential risks for both clinically worsening pulmonary hypertension (PH) and increasing mortality. However, the data regarding the protective role of vaccination in this population are still lacking. This study aimed to assess the safety of approved vaccination for patients with PH.Methods::In this national prospective cohort study, patients diagnosed with PH (World Health Organization [WHO] groups 1 and 4) were enrolled from October 2021 to April 2022. The primary outcome was the composite of PH-related major adverse events. We used an inverse probability weighting (IPW) approach to control for possible confounding factors in the baseline characteristics of patients.Results::In total, 706 patients with PH participated in this study (mean age, 40.3 years; mean duration after diagnosis of PH, 8.2 years). All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in China. Among them, 278 patients did not receive vaccination, whereas 428 patients completed the vaccination series. None of the participants were infected with COVID-19 during our study period. Overall, 398 patients received inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, whereas 30 received recombinant protein subunit vaccine. After adjusting for baseline covariates using the IPW approach, the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase (27/428 [6.3%] vs. 24/278 [8.6%], odds ratio = 0.72, P = 0.302). Approximately half of the vaccinated patients reported at least one post-vaccination side effects, most of which were mild, including pain at the injection site (159/428, 37.1%), fever (11/428, 2.6%), and fatigue (26/428, 6.1%). Conclusions::COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH, although there were some tolerable side effects. A large-scale randomized controlled trial is warranted to confirm this finding. The final approval of the COVID-19 vaccination for patients with PH as a public health strategy is promising.
9.Development of a national health standard:Guideline for pediatric transfusion
Rong HUANG ; Qingnan HE ; Mingyan HEI ; Minghua YANG ; Xiaofan ZHU ; Jun LU ; Xiaojun XU ; Tian-Ming YUAN ; Rong ZHANG ; Xu WANG ; Jinping LIU ; Jing WANG ; Zhili SHAO ; Mingyi ZHAO ; Jia GUO ; Xiny-In WU ; Jiarui CHEN ; Qirong CHEN ; Rong GUI ; Yongjian GUO
Chinese Journal of Blood Transfusion 2024;37(7):839-844
Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.
10.Ultrasmall, elementary and highly translational nanoparticle X-ray contrast media from amphiphilic iodinated statistical copolymers.
Lu SU ; Kellie S DALBY ; Hannah LUEHMANN ; Sussana A ELKASSIH ; Sangho CHO ; Xun HE ; Lisa DETERING ; Yen-Nan LIN ; Nari KANG ; Dennis A MOORE ; Richard LAFOREST ; Guorong SUN ; Yongjian LIU ; Karen L WOOLEY
Acta Pharmaceutica Sinica B 2023;13(4):1660-1670
To expand the single-dose duration over which noninvasive clinical and preclinical cancer imaging can be conducted with high sensitivity, and well-defined spatial and temporal resolutions, a facile strategy to prepare ultrasmall nanoparticulate X-ray contrast media (nano-XRCM) as dual-modality imaging agents for positron emission tomography (PET) and computed tomography (CT) has been established. Synthesized from controlled copolymerization of triiodobenzoyl ethyl acrylate and oligo(ethylene oxide) acrylate monomers, the amphiphilic statistical iodocopolymers (ICPs) could directly dissolve in water to afford thermodynamically stable solutions with high aqueous iodine concentrations (>140 mg iodine/mL water) and comparable viscosities to conventional small molecule XRCM. The formation of ultrasmall iodinated nanoparticles with hydrodynamic diameters of ca. 10 nm in water was confirmed by dynamic and static light scattering techniques. In a breast cancer mouse model, in vivo biodistribution studies revealed that the 64Cu-chelator-functionalized iodinated nano-XRCM exhibited extended blood residency and higher tumor accumulation compared to typical small molecule imaging agents. PET/CT imaging of tumor over 3 days showed good correlation between PET and CT signals, while CT imaging allowed continuous observation of tumor retention even after 10 days post-injection, enabling longitudinal monitoring of tumor retention for imaging or potentially therapeutic effect after a single administration of nano-XRCM.

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