Environmental geohydrochemistry and health of the high altitude population in Ladakh

Background： Radiographic signs of Pneumoconiosis found in farming Ladakhi despite absences of mines and industries were believed to be due to exposure to frequent dust storms and domestic fire pollutions. Seasonal Koilonychia （spoon nail） occurring predominantly in farming women in absences of iron deficiency anaemia was thought to arise from exposure to water made alkaline by weathering of hornblende minerals. The relation of these health conditions to environmental geohydrochemistry is postulated as the source of irrigation water in the affected population originates from glaciers in trans-Himalaya range of sedimentary geology and steep landscape favouring flushing of silica/silicate containing silts. Methods and results： Survey in two central Ladakh villages revealed radiographic evidence of silicosis in all middle aged women and half in middle aged men. In a large-scale study of 3105 subjects aged over 30 years from three villages; 101 （22.5%） of the 449 radiographed showed signs of pneumoconiosis （ILO 1980 criteria） including eggshell calcification of hilar gland and progressive massive fibrosis. Indoor dust analyzed using Philips 400T electron microscope with energy dispersive analysis system attached showed SiO2 levels upto 53.27% with particle size of 0.5 to 5.0 microns and the concentration during cooking period in the worst affected area was 7.495 mg/m^3. Microscopy and histopathology from the subject was characteristic of pneumoconiosis. Analysis of the inorganic dust in the lung showed 40.2% muscovite, 37.3% quartz with the extracted dust wt 147.9 mg/gm of dry tissue. Prevalence of chronic cough with chronic phlegm and percentage of villagers with FEV1/FVC ratio of less than 65% rose with age. Of 70 subjects studied 19 women and 2 men had Koilonychia with incidence being highest in summer. Absence of seasonal Koilonychia in villages fed by water derived from northern mountain range glaciers with mainly igneous geology supports our hypothesis.     

痰热清治疗尘肺的Meta分析

目的：系统评价痰热清治疗尘肺疾病的临床有效性和安全性。方法：计算机检索Cochrane Library、Embase、PubMed、中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方数据(WANFANG DATA) 和中国生物医学文献服务系统(SinoMed) 中关于痰热清或痰热清联合西医常规疗法（治疗组)对比单用西医常规疗法(对照组) 治疗尘肺的临床随机对照试验(RCTs),检索时间为各数据库建库至2023年9月10日,使用Review Manger 5.4软件进行Meta分析,结果使用森林图、漏斗图展示。结果：纳入文献24篇,总样本量为2193 例。Meta分析结果显示,较于对照组,治疗组的总有效率显著提高［OR=3.62,95% CI（2.69,4.88）,P<0.00001］,1 秒用力呼吸容积（FEV1%）（MD=6.35,95%CI［4.73,7.98］,P<0.00001）、咳痰症状好转率（OR=3.09,95% CI［1.27,7.51］,P=0.01）、咳嗽症状明显好转率［OR=4.34,95% CI（2.16,8.72）,P<0.0001］、肺部啰音症状好转率（OR=4.07,95% CI［1.70,9.74］,P=0.002）的改善程度均优于对照组,且差异有统计学意义;不良反应发生率比较,差异无统计学意义（OR=0.55,95% CI［0.28,1.11］,P=0.10）。结论：痰热清或痰热清联合西医常规疗法治疗尘肺疾病能提高临床疗效,安全性好,但仍需要更多大样本、高质量的实验证据支持。     

Iron, calcite, and oxidative stress in coal dust-induced lung diseases

Backgrounds： Coal is and will remain a major energy resource worldwide with P.R. China and the U.S. the leading producers. It has long been known that coal mining causes health problems such as coal workers＇ pneumoconiosis （CWP） and chronic obstructive pulmonary disease （e.g., emphysema）. Yet, there are no accurate methods for predicting their occurrence. The goals of the present study are to determine whether bioavailable iron （BAI） is the active component in coal dust-induced lung diseases and to develop a model using BAI for the prediction of coal＇s pneumoconiotic potency. Methods： Thirty coal samples from Utah （UT）, West Virginia （WV） and Pennsylvania （PA） coalmine regions with a low, moderate, and high prevalence of CWP, respectively,