INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety. METHODS: A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR). RESULTS: We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR. CONCLUSION Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.
Humans ; Cross-Sectional Studies ; Pandemics ; COVID-19/epidemiology* ; Burnout, Psychological ; Health Personnel

Objective: To investigate the clinicopathological characteristics of occupational lung diseases, to reduce the missed diagnoses and misdiagnoses of the diseases and to help standardize the diagnosis and treatment of these patients. Methods: A total of 4 813 lung biopsy specimens (including 1 935 consultation cases) collected at the Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, China from January 1st, 2017 to December 31th, 2019 were retrospectively analyzed. Among them, 126 cases of occupational lung diseases were confirmed with clinical-radiological-pathological diagnosis. Special staining, PCR and scanning electron microscopy were also used to rule out the major differential diagnoses. Results: The 126 patients with occupational lung diseases included 102 males and 24 females. All of them had a history of exposure to occupational risk factor(s). Morphologically, 68.3% (86/126) of the cases mainly showed pulmonary fibrotic nodules, dust plaque formation or carbon end deposition in pulmonary parenchyma. 16.7% (21/126) of the cases mainly showed welding smoke particle deposition in the alveolar cavity and lung interstitium while 15.1% (19/126) of the cases showed granulomas with fibrous tissue hyperplasia, alveolar protein deposition or giant cell interstitial pneumonia. The qualitative and semi-quantitative analyses of residual dust components in the lung under scanning electron microscope were helpful for the diagnosis of welder's pneumoconiosis and hard metal lung disease. Conclusions: The morphological characteristics of lung biopsy tissue are important reference basis for the clinicopathological diagnosis and differential diagnosis of occupational lung diseases. Recognizing the characteristic morphology and proper use of auxiliary examination are the key to an accurate diagnosis of occupational lung diseases on biopsy specimens.
Male ; Female ; Humans ; Retrospective Studies ; Pneumoconiosis/pathology* ; Lung/pathology* ; Dust ; Pneumonia, Viral/pathology* ; Biopsy

OBJ ECTIVE To predict the quality marker （Q-Marker）of Forsythia suspensa . METHODS The fingerprints of 10 batches of F. suspensa were established by high performance liquid chromatography. The common peaks were confirmed. The candidate components of Q-Marker in F. suspensa were screened. The volatile oil of F. suspensa were analyzed by gas chromatography-mass spectrometry （GC-MS），and the candidate components of Q-Marker in volatile oil were screened. The network pharmacology analysis was performed for the candidate components of Q-Marker. The network diagram of the “candidate components of F. suspensa Q-Marker-target-pathway”was constructed to predict the Q-marker of F. suspensa . RESULTS & CONCLUSIONS Twenty-one common peaks were obtained for 10 batches of F. suspensa ，and four components were identified as phillyrin，forsythoside A ，pinoresinol-4-O-β-D-glucoside and rutin. Seven candidate components were obtained by GC-MS analysis，such as β-pinene，α-pinene，terpinen-4-ol，limonene，γ-terpinene，α-phellandrene，β-myrcene. By network pharmacology analysis， 16 key targets and 17 pathways were obtained. It was preliminarily predicted that phillyrin ， forsythoside A ， pinoresinol-4-O-β-D-glucoside，rutin，terpinen-4-ol，α-phellandrene，α-pinene and β-pinene were Q-marker of F. suspensa .

OBJEC TIVE To investigate the status and clinical characteristics of adverse drug reactions （ADRs）induced by sintilimab in order to provide references for clinical rational drug use. METHODS The cases of ADR induced by sintilimab were retrieved from the databases of PubMed ，Embase，CNKI，VIP and Wanfang. RESULTS A total of 32 literature were included ， involving 33 patients among which there were 25 males（75.76％）and 8 females（24.24％）. The incidence of ADRs was higher in patients aged over 40 years（81.82％）. The dose of sintilimab was the drug instructions recommended dose （200 mg）for 30 patients and 100 mg for a patient. The earliest ADR occurred 1 h after the first medication ，the latest ADR occurred after 14 cycles of sintilimab. The 27 cases suffered from ADR cases （81.82％）within 4 months after medication ，and no reports of ADR occurred after 12 months of medication. The major manifestations of ADR were myocarditis ，diabetes mellitus ，checkpoint inhibitor pneumonitis（CIP），cytokine release syndrome （CRS）and hypothyroid myopathy （HM），etc. CRS and HM belonged to ADRs not recorded in the drug instructions. The 29 cases of recovery and 4 deaths occurred after symptomatic treatment. CONCLUSIONS ADR caused by sintilimab often occurs within 4 months after treatment ，and it is high in males and patients over 40 years old. In clinical application of sintilimab ，attention should be paid to the occurrence of myocarditis ，diabetes mellitus ，CIP，as well as CRS and HM not recorded in the drug instructions.

Aiming at the medical practice problems of the surgical steel medical instruments, such as the crevice corrosion, the poor mechanical compatibility and the Ni, Cr plasma exudation, the laser deposition of Ti-6Al-4V alloy cladding layer at the local functional area as alternative coating was proposed and realized as a new process method. The accurate element content and good formability Ti-6Al-4V cladding powder was chosen, the low power and high duty cycle optimized laser process was adopt, the alternative coating of good fusion and low dilution was prepared. Through the elemental line scanning, the interface microstructure analysis and the experiments of basic mechanical properties, the basic properties of the cladding were characterized and verified. The experiments results showed that, the Ti, Al and V contents of the top coating were respectively about 88%, 4.9% and 3.9%, no sensitizing ions such as Cr and Ni were detected. Initial equiaxed α phase, flake β phase dist were distributed in the coating and interface, the α' martensite was precipitated at the boundary of the flake β phase, some refined granular β phase dispersion pinned to the grain boundary of basket structure. The microhardness of cladding layer was 352.08~312.76 HV_0.1. The friction coefficient of the cladding layer was about 0.22~0.65. A new technology and method reference for improving and upgrading the performance of surgical medical devices is provided by this research.
Alloys ; Corrosion ; Materials Testing ; Steel ; Titanium

COPD refers to a group of chronic respiratory diseases which seriously influence the people's health and life quality. The national COPD surveillance in China has been implemented since 2014 with the goal of monitoring the prevalence and trend of COPD and related risk factors in China. The paper summarizes the item and method of national COPD surveillance in China.
Aged ; China/epidemiology* ; Chronic Disease/psychology* ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance/methods* ; Prevalence ; Pulmonary Disease, Chronic Obstructive/psychology* ; Quality of Life ; Risk Factors

Objective: Smoking is the most important risk factor for COPD. Understanding the smoking rate, current smoking rate, average age to start smoking and average daily consumption of cigarettes among people aged ≥40 years in China can provide scientific evidence for the effective control and prevention of COPD. Methods: Data were from COPD surveillance in China (2014 to 2015) which covered 31 provinces, autonomous regions and municipalities. A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance sites (county/district) were surveyed by electronic questionnaire during face to face interviews. The smoking rate and other smoking index were estimated by using weighting complex sampling design. Results: The smoking rate and current smoking rate were 40.0% (95%CI: 38.5%-42.0%) and 31.0% (95%CI: 29.7%-32.0%), respectively, among the Chinese aged ≥40 years in 2014. The smoking rate and current smoking rate in males (74.1% and 57.6%) were much higher than those in females (5.4% and 4.0%). And the two rates were significantly higher in rural area (41.2% and 32.4%) than in urban area (38.8% and 29.5%). The mean age of smokers to start smoking was 20.1 (95%CI: 19.7-20.5) years. The younger the smokers were, the earlier their average age to start smoking was (The ages to start smoking for smokers aged 40-, 50-, 60-, ≥70 years were 18.3, 19.2, 20.9 and 23.1 years, respectively). Average daily cigarette consumption of current daily smokers was 18.9 (95%CI: 18.1-19.7) cigarettes, and the daily cigarette consumption was higher in males (19.3 cigarettes) than in females (12.5 cigarettes). Conclusion: The smoking rate in males aged ≥40 years is high in China. Compared with urban area, the smoking rate in rural area is higher, posing a big challenge for COPD control and prevention.
Adult ; Aged ; Asian People/statistics & numerical data* ; China/epidemiology* ; Female ; Humans ; Male ; Prevalence ; Risk Factors ; Smoking/psychology* ; Smoking Cessation ; Surveys and Questionnaires ; Young Adult

Objective: To describe and analyze the passive smoking exposure level in adults aged ≥40 years in China. Methods: A total of 75 107 adults from 125 sites of COPD surveillance points in China were surveyed by electronic questionnaire during face to face interviews. After comprehensive weighting of the samples, the passive smoking exposure level was analyzed. Results: The passive smoking exposure rate of the adults aged ≥40 years was 44.9% (95%CI: 42.3%-47.5%). The exposure rate was highest in those aged from 40 to 49 years (51.0%, 95%CI: 47.9%-54.1%) in term of age groups, in those with senior high school education level and above (48.6%, 95%CI: 44.9%-52.2%) in term of education level, and in office workers (57.7%, 95%CI: 51.8%-63.7%) in term of occupation. The adults reporting passive smoking exposure every days in a week accounted for 27.7% (95%CI: 25.5%-29.8%), and those reporting household passive smoking exposure accounted for 28.3% (95%CI: 26.2%-30.5%). Logistic regression analysis showed that the passive smoking exposure level was different in different age groups and occupation groups. Conclusion: The passive smoking exposure level is still high in adults in China. Age and occupation are the influencing factors of passive smoking exposure level.
Adult ; Aged ; Asian People/statistics & numerical data* ; China/epidemiology* ; Environmental Exposure ; Family Characteristics ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance/methods* ; Smoking/epidemiology* ; Surveys and Questionnaires ; Tobacco Smoke Pollution/statistics & numerical data*

Objective: To understand the current status of dust and/or harmful gas exposure in adults aged ≥40 years and corresponding protection in China, and provide evidence for strengthening the occupational protection against dust and harmful gas exposure. Methods: The data were obtained from 2014-2015 COPD surveillance in China. A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) were surveyed in face to face interviews. Occupational exposure was defined as occupational exposure to dust and/or harmful gas for more than 1 year. The weighted percentages of exposure were estimated by using complex sampling design. Results: Among eligible 71 061 participants, the exposure rate of dust and/or harmful gas was 46.3%. The exposure rate in rural area (51.7%) was significantly higher than that in urban area (40.3%), and the exposure rate in the western area was higher than those in the eastern and central areas (P<0.001). Among the groups with different education level, the exposure rate in those with education level of primary school and below was highest (49.7%, P<0.001). The exposure protection rate was 26.7%, and the exposure protection rate was highest in the eastern area (29.9%), followed by that in the central area (27.0%) and that in the western area (22.9%) The exposure protection rate in urban area was significantly higher than that in rural area, and the exposure protection rate was lowest in those with education level of primary school and below. The regular exposure protection was taken by only 50.7% of the adults surveyed. Conclusion: The exposure rate of dust and/or harmful gas is high in China, while the exposure protection rate is very low. Health education, occupational protection and supervision should be strengthened among those with low education level, and those living in rural area and in the western area.
Adult ; China/epidemiology* ; Dust ; Female ; Gases/toxicity* ; Humans ; Male ; Middle Aged ; Occupational Diseases/epidemiology* ; Occupational Exposure/statistics & numerical data* ; Residence Characteristics ; Rural Population ; Surveys and Questionnaires ; Urban Population