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.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.
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.Application of multiple empirical kernel mapping ensemble classifier based on self-paced learning in ultrasound-based computer-aided diagnosis for breast cancer.
Linlin WANG ; Lu SHEN ; Jun SHI ; Xiaoyan FEI ; Weijun ZHOU ; Haoyu XU ; Lizhuang LIU
Journal of Biomedical Engineering 2021;38(1):30-38
Both feature representation and classifier performance are important factors that determine the performance of computer-aided diagnosis (CAD) systems. In order to improve the performance of ultrasound-based CAD for breast cancers, a novel multiple empirical kernel mapping (MEKM) exclusivity regularized machine (ERM) ensemble classifier algorithm based on self-paced learning (SPL) is proposed, which simultaneously promotes the performance of both feature representation and the classifier. The proposed algorithm first generates multiple groups of features by MEKM to enhance the ability of feature representation, which also work as the kernel transform in multiple support vector machines embedded in ERM. The SPL strategy is then adopted to adaptively select samples from easy to hard so as to gradually train the ERM classifier model with improved performance. This algorithm is verified on a B-mode ultrasound dataset and an elastography ultrasound dataset, respectively. The results show that the classification accuracy, sensitivity and specificity on B-mode ultrasound are (86.36±6.45)%, (88.15±7.12)%, and (84.52±9.38)%, respectively, and the classification accuracy, sensitivity and specificity on elastography ultrasound are (85.97±3.75)%, (85.93±6.09)%, and (86.03±5.88)%, respectively. It indicates that the proposed algorithm can effectively improve the performance of ultrasound-based CAD for breast cancers with the potential for application.
Algorithms
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Breast Neoplasms/diagnostic imaging*
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Computers
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Diagnosis, Computer-Assisted
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Humans
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Support Vector Machine
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Ultrasonography
5.Follow-up and retrospective investigation of patients with pneumoconiosis in Jiangsu Province, China
Lizhuang XIE ; Lang ZHOU ; Yuan ZHAO ; Jing LIU ; Wei WANG ; Wei ZHANG ; Minxia LU ; Yuexin YANG ; Zhiwen ZHOU ; Jiayi ZHUANG ; Dongdong HE ; Hongqun ZHANG ; Xiaoqin LI ; Yanping LI ; Ping ZHANG ; Renwei HE ; Baoli ZHU ; Hengdong ZHANG ; Lei HAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2020;38(4):251-255
Objective:To investigate the features, changing trend, and rules of pneumoconiosis in Jiangsu Province, China, as well as the health status of patients with pneumoconiosis.Methods:From July to October 2019, the patients with pneumoconiosis, reported up to the end of 2018 in Jiangsu Province, were enrolled as respondents, and follow-up and retrospective investigation were performed. A total of 24405 patients with pneumoconiosis were investigated, and related data were collected from the monitoring system of cause of death for residents, pneumoconiosis network reporting system, occupational disease diagnosis institution, management institutions for the reporting of occupational diseases, and related residents' committee or village committee. The patients with pneumoconiosis, who had been reported, were followed up by telephone or on-site visit to obtain the information on their conditions. A descriptive analysis was performed for age of onset, working years, sex, category of industry, type of pneumoconiosis, annual disease onset, geographic distribution, and medical security.Results:Among the 24405 patients, a male/female ratio was 16.81∶1. Of all 24405 patients, 15948 (65.35%) had stage 1 pneumoconiosis, 5289 (21.67%) had stage 2 pneumoconiosis, and 1637 (6.71%) had stage 3 pneumoconiosis. The mean working years for dust exposure was 16.25±9.95 years for all patients, and the mean working years for dust exposure was 15.80±9.95 years for patients with stage 1 pneumoconiosis, 17.82±9.80 years for patients with stage 2 pneumoconiosis, and 16.31±9.90 years for patients with stage 3 pneumoconiosis. The highest number of cases of pneumoconiosis was reported in Wuxi (5744 cases, accounting for 23.54%) , followed by Zhenjiang (4160 cases, accounting for 17.05%) , Xuzhou (3851 cases, accounting for 15.78%) , Yancheng (3340 cases, accounting for 13.69%) , and Suzhou (2948 cases, accounting for 12.08%) . Major types of pneumoconiosis included silicosis (15392 cases, accounting for 63.07%) and coal workers' pneumoconiosis (5253 cases, accounting for 21.52%) . In this survey, 21115 completed follow-up, among whom 15924 survived and 5191 died, 15924 patients with pneumoconiosis survived, among whom 7461 (46.85%) had an age of ≥70 years and 2515 (15.79%) were exposed to dust for 5-9 years. The industries involved were mainly coal mining and washing industry (5687 cases, accounting for 35.71%) and public management, social security, and social organization (3349 cases, accounting for 21.03%) ; in terms of security, 7999 patients (50.23%) were covered by occupational injury insurance, 946 (5.94%) were compensated by employers, 4537 (28.49%) were covered by basic medical insurance for urban and rural residents, 1590 (9.98%) were covered by critical illness insurance, and 5458 (34.28%) were covered by other types of social security, such as medical assistance and poverty relief.Conclusion:Silicosis and coal worker's pneumoconiosis are the key points for the prevention and treatment of pneumoconiosis in Jiangsu Province, and supervision should be strengthened for industries and regions with serious dust hazards.
6.Follow-up and retrospective investigation of patients with pneumoconiosis in Jiangsu Province, China
Lizhuang XIE ; Lang ZHOU ; Yuan ZHAO ; Jing LIU ; Wei WANG ; Wei ZHANG ; Minxia LU ; Yuexin YANG ; Zhiwen ZHOU ; Jiayi ZHUANG ; Dongdong HE ; Hongqun ZHANG ; Xiaoqin LI ; Yanping LI ; Ping ZHANG ; Renwei HE ; Baoli ZHU ; Hengdong ZHANG ; Lei HAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2020;38(4):251-255
Objective:To investigate the features, changing trend, and rules of pneumoconiosis in Jiangsu Province, China, as well as the health status of patients with pneumoconiosis.Methods:From July to October 2019, the patients with pneumoconiosis, reported up to the end of 2018 in Jiangsu Province, were enrolled as respondents, and follow-up and retrospective investigation were performed. A total of 24405 patients with pneumoconiosis were investigated, and related data were collected from the monitoring system of cause of death for residents, pneumoconiosis network reporting system, occupational disease diagnosis institution, management institutions for the reporting of occupational diseases, and related residents' committee or village committee. The patients with pneumoconiosis, who had been reported, were followed up by telephone or on-site visit to obtain the information on their conditions. A descriptive analysis was performed for age of onset, working years, sex, category of industry, type of pneumoconiosis, annual disease onset, geographic distribution, and medical security.Results:Among the 24405 patients, a male/female ratio was 16.81∶1. Of all 24405 patients, 15948 (65.35%) had stage 1 pneumoconiosis, 5289 (21.67%) had stage 2 pneumoconiosis, and 1637 (6.71%) had stage 3 pneumoconiosis. The mean working years for dust exposure was 16.25±9.95 years for all patients, and the mean working years for dust exposure was 15.80±9.95 years for patients with stage 1 pneumoconiosis, 17.82±9.80 years for patients with stage 2 pneumoconiosis, and 16.31±9.90 years for patients with stage 3 pneumoconiosis. The highest number of cases of pneumoconiosis was reported in Wuxi (5744 cases, accounting for 23.54%) , followed by Zhenjiang (4160 cases, accounting for 17.05%) , Xuzhou (3851 cases, accounting for 15.78%) , Yancheng (3340 cases, accounting for 13.69%) , and Suzhou (2948 cases, accounting for 12.08%) . Major types of pneumoconiosis included silicosis (15392 cases, accounting for 63.07%) and coal workers' pneumoconiosis (5253 cases, accounting for 21.52%) . In this survey, 21115 completed follow-up, among whom 15924 survived and 5191 died, 15924 patients with pneumoconiosis survived, among whom 7461 (46.85%) had an age of ≥70 years and 2515 (15.79%) were exposed to dust for 5-9 years. The industries involved were mainly coal mining and washing industry (5687 cases, accounting for 35.71%) and public management, social security, and social organization (3349 cases, accounting for 21.03%) ; in terms of security, 7999 patients (50.23%) were covered by occupational injury insurance, 946 (5.94%) were compensated by employers, 4537 (28.49%) were covered by basic medical insurance for urban and rural residents, 1590 (9.98%) were covered by critical illness insurance, and 5458 (34.28%) were covered by other types of social security, such as medical assistance and poverty relief.Conclusion:Silicosis and coal worker's pneumoconiosis are the key points for the prevention and treatment of pneumoconiosis in Jiangsu Province, and supervision should be strengthened for industries and regions with serious dust hazards.

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