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Objective: To explore the value of heparin-binding protein (HBP) in early diagnosis of severe infection in silicosis patients. Methods: From January 2017 to June 2018, fifty silicosis patients with severe infection and fity without infection were recruited in the Second Affiliated Hospital of Xuzhou Medical University. In the severe infection group, the time of patients diagnosed with severe infection was set as the reference point for time. Blood samples were selected from the hospital inspection system sample library at the time of 24, 48, and 72 hours prior to the reference point. In the non-infection group, blood samples were selected within 24 hours of admission. The blood samples were tested for the levels of HBP, C-reactive protein (CRP), procalcitonin (PCT), and white blood cell (WBC) count. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, sensitivity, specificity and Youden index (YI) were used to evaluate the diagnostic efficacy of each indicator. Results: The HBP levels at 72, 48, 24, and 0 hours before the diagnosis in the severe infection group were significantly higher than those in the non-infection group (all of the P values <0.001), and decreased with the prolonged time before diagnosis. The ROC curve showed that the AUC of HBP at 72, 48, 24, and 0 h before the diagnosis in the severe infection group [0.828 (0.750-0.907), 0.966 (0.920-0.998), 0.967 (0.961-0.998), 0.997 (0.994-0.999)] was higher than that of PCT [0.563 (0.450-0.677), 0.687 (0.581-0.794), 0.726 (0.622-0.829), 0.982 (0.973-0.986)] and CRP [0.564 (0.449-0.680), 0.648 (0.535-0.761), 0.705 (0.594-0.817), 0.963 (0.924-0.983)] and WBC [0.492 (0.377-0.607), 0.497 (0.383-0.612), 0.628 (0.519-0.738), 0.700 (0.598-0.802)] at the corresponding time. The sensitivity, specificity and YI of HBP were 88.9%-97.6%, 77.1%-98.4% and 0.66-0.96 at 72, 36, 24 and 0 h before diagnosis, respectively. Conclusion: Heparin-binding protein can be used for early diagnosis of severe infection in silicosis patients.

Objective: To explore the changes of blood viscosity and external thrombus in patients with silicosis and silicosis complicated with tuberculosis (TB)., Method: Blood viscosity and external thrombus were measured in 288 patients with silicosis, 178 patients with silicosis complicated by TB and 150 healthy subjects., Results: Blood viscosity and external thrombus value were significantly higher in the patients of silicosis and silicosis complicated with TB than in the healthy controls, except for patients of phase I of silicosis. Blood viscosity in the silicotics increased significantly with the advance of the disease, but no significant difference in external thrombus between patients in different phases. Apparent viscosity of whole blood significantly increased in the high-shear rate (200 s(-1)) and middle-shear rate (30 s(-1)) in patients of silicosis complicated with TB than in those without complication of TB at the same phases, but not seen in the low-shear rate (5 s(-1)) and in plasma viscosity, and the length and dried weight of external thrombus increased significantly too. There was no significant difference in blood viscosity and external thrombus between patients of silicosis at phase III and those of silicosis complicated with TB at the same phase., Conclusion: Blood in patients with silicosis appeared highly viscous and highly coagulant status. Blood viscosity and external thrombus value significantly increased with the advance of the disease, especially in the patients complicated with TB.

Objective: To study relationship between silicosis and hemorrheology and its clinical significance., Methods: Varied indices for hemorrheology were measured in 85 male patients with silicosis, 45 male patients with chronic bronchitis and 100 healthy male subjects., Results: Compared with the control group and the chronic bronchitis patient group, average hematocrit (Hct), whole blood apparent viscosity (eta(a)) at 4 s(-1) - 200 s(-1) shear rates, plasma viscosity (eta(p)), erythrocyte electrophoresis time (EET) and platelet electrophoresis time (PET) all significantly increased in patients with silicosis (P < 0.001). Hemorrheological indices in patients with silicosis increased with severity of disease, increased with decrease in their pulmonary function, and were all significantly higher than those in the control group (P < 0.01 approximately equal 0.001). Stepwise regression analysis showed that severity of disease correlated closely to Hct, eta(a) at 4 s(-1) - 200 s(-1), EET and PET, and that pulmonary function status in patients with silicosis and their courses correlated closely to Hct, eta(a) at 4 s(-1) - 200 s(-1), eta(p), EET and PET., Conclusions: Blood of patients with silicosis was in highly viscose status, which was easy to be complicated with multiple diseases.

Objective: To explore the relationship between nitric oxide, oxidation, lipoperoxidation and silicosis., Methods: Blood plasma levels of nitric oxide (P-NO), vitamin C (P-VC), vitamin E (P-VE), beta-carotene (P-beta-CAR), lipoperoxidase (P-LPO), and erythrocyte activities of superoxide dismutase (E-SOD), catalase (E-CAT), glutathione peroxidase (E-GSH-Px) and lipoperoxidase (E-LPO) were measured in 73 patients with silicosis and 60 healthy subjects., Results: The average levels of P-VC, P-VE, P-beta-CAR, E-SOD, E-CAT and E-GSH-Px were significantly lower and the average levels of P-NO, P-LPO and E-LPO significantly increased in the silicosis with varied severity of the disease and lung function status more than in the controls. There was linear relationship between all the above indices and length of the disease. Stepwise regression analysis showed that the severity of the disease and lung function status correlated most closely with the levels of P-NO, P-VE, E-SOD and E-LPO., Conclusion: Metabolism of nitric oxide was abnormal, balance between oxidation and antioxidation was disturbed seriously, and oxidation and lipoperoxidation reaction pathologically exacerbated in the bodies of the patient with silicosis.