高性能战斗机飞行员脊柱损伤与退变及其临床意义

目的 概述关于高性能战斗机飞行员脊柱损伤与退变研究概况。资料来源与选择国内外近二三十年来相关文献报道。资料引用 相关文献19篇。资料综合 对脊柱生物力学及临床实验研究、脊柱X线平片研究、脊柱局部CT扫描的研究、临床症状学分析等诸方面问题都做了详细论述。结论 高性能战斗机飞行员工作环境具有加速脊柱(尤其是颈椎)退变的作用。但是，高性能战斗机飞行员脊柱提前退变的实际临床意义仍然不是十分清楚。     

高性能战斗机飞行员航卫保障面临的问题及对策

具备强大攻防能力的高性能战斗机,“四高二长”的特点更为突出,这给我们航卫保障工作提出了新问题和新要求。 1 高性能战斗机飞行员航卫保障面临的问题 1.1 高过载问题仍突出,被动承受载荷的情况增多 高性能战斗机的可用载荷是-2 G～+9 G,载荷增长率可达6 G/s。其高过载和高过载增长率可引起空中意识丧失,严重危及飞行安全。     

高性能歼击机飞行员体质指数与＋Gz耐力分析

随着空军发展步伐的加快,高性能战斗机逐步装备部队,对高性能战斗机飞行员的身体素质提出了更高的要求.如何更好地适应现代高性能战斗机的持续高载荷、高载荷增长率、高角加速度[1-2]等特点,充分发挥飞行员自身的潜能,更加熟练地驾驭战斗机,体质在其中起到了非常关键的作用.我院空勤科通过对310名不同年龄段经高性能战斗机改装体检合格后的飞行员身高、体重进行测量,计算出体质指数（kg/m2）,同时收集飞行员的飞行时间,在离心机上进行测试,从而得出＋Gz耐力与身高、体重、体质指数及飞行时间的关系,为高性能战斗机改装体检提供了客观依据;为飞行员的合理膳食及有效地进行专项体能训练起到了很好的指导作用,现报道如下.     

颈椎间盘置换术后假体相关并发症的研究现状

近年来,为避免颈椎融合术治疗颈椎退行性疾病所带来的假关节形成及邻近节段退变加速等问题,颈椎间盘置换术作为一种非融合技术广泛应用于临床,其疗效确切,已逐渐成为治疗颈椎退行性疾病的常规手术方式。但随着该技术应用的深入,随访年限的增加,颈椎间盘置换术后与假体相关的一系列特殊并发症逐渐被学者报道。本文就颈椎间盘置换术后假体相关并发症的研究现状作一综述。     

1260例飞行人员住院疾病谱分析

目的 分析近10年住院飞行人员疾病谱特点.为提高新时期特勤医疗保障水平提供依据. 方法采集2001 2010年1 260例住院飞行人员的资料信息,对其年龄分布、疾病种类、飞行机型、飞行时间等进行统计分析.对比高性能战斗机飞行员及普通歼击机飞行员的疾病谱特点.结果 飞行人员肌肉骨骼系统疾病、消化系统疾病、神经系统疾病成为位居前3的住院疾病种类;高性能战斗机飞行员常见疾病种类为肌肉骨骼系统疾病、神经系统疾病、泌尿生殖系统疾病,主要疾病是泌尿系结石、关节软组织损伤、神经衰弱、腰椎间盘突出症、偏头痛、航空性疾病及代谢异常;与普通歼击机飞行员相比,高性能战斗机飞行员泌尿系结石、神经衰弱的疾病比例显著增加(x2 =26.28、5.23,P＜0.05或0.01),腰椎间盘突出症、航空性疾病的住院年龄显著增大,偏头痛的住院年龄明显减小、飞行时间明显减少. 结论 现代军事飞行人员的疾病谱发生变化,高性能战斗机飞行员常见疾病与飞行特点、生活方式密切相关,应全方位给予干预指导.     

破坏载荷下椎间盘对胸腰段脊柱应力分布影响的研究

目的：对比正常与退变椎间盘在破坏载荷下对胸腰段脊柱应力分布的影响，探讨其生物力学背景及临床意义，为临床诊断及治疗提供理论依据。方法：用三维有限元法建立正常及退变椎间盘的胸腰段脊柱活动节段的力学模型，并对其在垂直压缩，屈曲压缩，屈曲分离三种外加载荷下的应力分布进行对比分析。结果：垂直压缩及屈曲压缩载荷下，正常的椎间盘的胸腰段脊柱活动节段显示椎体上，上终板的中央及松质骨邻近终板的中央部位应力值最高，椎间盘纤维环的后外侧应力集中；退变椎间盘的胸腰段脊柱显示椎体松质骨的应力分布相对平均，邻近终板的中央部分应力水平减低，周边部分水平相应上升，椎间盘纤维环的后侧应力集中；屈曲分离载荷下，退变椎间盘的胸腰段脊柱与正常相比，椎体皮质骨，松质骨，终板及纤维环应力水平有所降低，后部结构的应力水平相应上升。结论：正常与退变椎间盘对破坏载荷下胸腰段脊柱应力分布的影响明显不同，椎间盘退变后载荷的传递方式发生了改变。     

高性能战斗机飞行对飞行员脊柱影响的研究

随着各国空军不断发展和装备高性能战斗机,其高机动性和高加速度(+G_z)无疑对飞行员身体各个系统带来了明显影响,特别是飞行员的脊柱。可以说脊柱在飞行员的身体中是最容易受到高G影响的部分。美、俄、日和西欧各国空军等对此非常重视,并积极地进行了研究。由于我国空军开始装备高性能战斗机才是近几年的事,对此方面还没有更多的研究。重视对飞行员脊柱改变和损伤的研究,不仅对高性能战斗机飞行员的选拔有重要意义,同时对保护现有高性能战斗机飞行员的     

X线导引下针刺诱导兔椎间盘退行改变的研究北大核心CSCD

目的采用X线导引下针刺诱导建立兔椎间盘退行性变(退变)模型,并对椎间盘进行T2Mapping检测,为深入研究椎间盘退变的磁共振(MR)定量检测奠定基础。方法选择新西兰大白兔5只,在X线导引下采用穿刺髓核和穿刺软骨终板两种手术方式,分别在穿刺前、穿刺后30 min、4和8周进行常规T2WI、T2Mapping成像和CT三维重建等影像学检查,8周时对诸椎间盘进行病理学分析。结果造模后30 min,各椎间盘MR信号未见明显异常;4周穿刺髓核组T2WI信号明显降低,高信号区范围缩小;T2Mapping显示高值范围明显缩小;8周髓核变化与4周类似,未见明确退变进展;正常对照组和穿刺软骨终板组的椎间盘信号和量值改变不明显。病理学检查发现穿刺髓核组的髓核组织发生非常明显的退变,而穿刺软骨终板组发生轻度退变。结论采用X线导引下针刺椎间盘髓核的方式成功建立兔椎间盘退变模型,此模型具有操作简单、经济、并发症低、影响因素少等优势,并且证明了T2Mapping技术可用于兔椎间盘退变的检测,为深入研究MR定量技术对椎间盘退变的价值奠定了基础。     

飞行员年度体检结果分析及医学鉴定

目的 了解高性能战斗机飞行员的患病及医学鉴定情况,探讨常见疾病的发病规律.方法 对250名高性能战斗机飞行员年度体检检出的疾病进行统计分析.按年龄分为5组：≤30岁（Ⅰ组,n=104）,31～35岁（Ⅱ组,n=63）,36～40岁（Ⅲ组,n=55）,41～45岁（Ⅳ组,n=21）,＞45岁（Ⅴ组,n=7）,比较不同年龄组疾病检出情况及医学鉴定情况. 结果 ①检出疾病者占61.20％,检出2种以上疾病者占检出疾病人数的79.74％.医学鉴定结论：飞行合格243名,暂时飞行不合格7名.②不同年龄组疾病检出率差异有统计学意义（χ^2=50.777,P＜0.01）,Ⅰ组明显低于其他年龄组（P＜0.05）.③检出位列前10位的疾病为高脂血症、脂肪肝、高尿酸血症、胆囊息肉、椎间盘突出症、肝血管瘤、肾囊肿、腰椎峡部裂、肝囊肿和肝功能异常.④不同年龄组间,高脂血症、脂肪肝、高尿酸血症、椎间盘突出症、肾囊肿、肝囊肿及肝功能异常检出率差异有统计学意义（χ^2=9.797～56.140,P＜0.01或＜0.05）. 结论 高性能战斗机飞行员罹患病症以与生活方式相关的代谢性疾病为主,椎间盘突出症检出率也较高.应加强对飞行员健康生活方式的引导,加强颈腰背肌专项锻炼,促进飞行员健康.     

高性能战斗机飞行员的医学选拔与医学鉴定

随着高性能战斗机大量装备于部队,必须对现有歼击机飞行员进行医学选拔,确保飞行员能够高标准、高质量地完成高性能战斗机的飞行训练和实战训练。 1 高性能战斗机的飞行特点及其对飞行员的影响 高性能战斗机的飞行具有“三高两长”特点,即高加速度和高加速度增长率、高角加速度、高认知负荷和长航程、长续航时间。这些飞行特点对飞行员产生极大的影响,并且出现3个主要问题:加速度晕     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

Interventions in the chest in children

The scope for image-guided intervention in the chest is very wide and encompasses procedures in the heart, pulmonary and systemic vasculature, lungs and pleural cavities, airway, and esophagus. This review describes the most important procedures that are usually performed by radiologists. Percutaneous drainage is now the most common method of treating both empyemas and lung abscesses in children. Although most lung biopsies are carried out by other means, percutaneous biopsy and localization are important alternatives for the diagnosis of focal lung lesions. Esophageal strictures are common in children and are usually best treated by balloon dilatation. The use of retrievable or biodegradable stents has recently been introduced for refractory esophageal strictures. Similarly, balloon dilatation and stenting are now increasingly used in children with stenosis or extrinsic compression of the trachea or bronchi.