持续性正加速度致意识丧失的机理及其监测

正在加速度引起的意识丧失（Ｇ－ＬＯＣ）是当胶威胁飞行安全的主要因素。综述了Ｇ＿ＬＯＣ的机理及其生理监测,慢增长率正加速度导致的意识丧失的机理主要大脑缺血／缺氧;快增长率正加速度导致物意识丧失可能与颅内高应力有关,但缺直接的实验证据。用于Ｇ－ＬＯＣ监测的生理指标中,眼水平动脉血压、脑氧饱和度等可能具有重要作用。     

The Effects of 10 Weeks Military Training on Heel Ultrasound and Bone Turnover

To measure the physiological changes in bone in response to strenuous exercise we performed a prospective study of male army recruits over 10 weeks of basic training. Measurements performed at the start and completion of training consisted of ultrasound (US) measurements of the heel: velocity of sound (VOS in m/seconds) and broadband ultrasound attenuation (BUA in dB/MHz) and bone turnover markers; osteocalcin (OC), bone-specific alkaline phosphatase (BALP), and tartrate-resistant acid phosphatase (TRAP). Forty subjects were recruited for the study and 26 completed training. Over the 10-week study period there was a significant 1.7% fall in mean VOS [mean paired difference (mpd) 27.2 m/second, SEM 9.5 (95% CI 7.5–46.8) P= 0.009] and a nonsignificant 3.4% increase in BUA (P= 0.159). There were significant falls in markers of bone formation OC [11.6%, mpd 0.11 μg/liter (95% CI 0.07–0.14) P < 0.001] and BALP [13.3%, mpd 3.49 U/liter (CI 0.80–6.18) P= 0.013] and a nonsignificant 9.5% fall in TRAP a marker of bone resorption. The 10 recruits subsequently injured had a significantly lower VOS on entry [mean difference 24.2 m/seconds (95% CI 4.6–43.7) P= 0.017] and nonsignificantly raised BUA and baseline levels of all bone markers. The ultrasound changes may be accounted for by increase in trabecular separation and a fall in trabecular connectivity due to microfracture. The decrease in bone markers implies a fall in bone turnover. Received: 26 June 1997 / Accepted: 26 August 1998     

40所军队医院病种病例分型质量评价结果分析

应用病例分型质量费用监控管理软件和ＳＡＳ６．１２统计软件包,对４０所军队医院５０万份病例样本资料进行深入分析,结果显示：病例分型组合数据稳定,分析结果合理。     

军医大学各类学生学习动机强度比较

目的:比较军医大学各类学生的学习动机,为教育管理部门提供依据。方法:应用学习动机简易评定量表,横向比较本科生、八年制、研究生等不同类别学生的学习动机强度,并进行前后5年的纵向追踪。结果:(1)2010年该军医大学各类学生学习动机有统计学差异(F=82.489,P0.001),SNK检验研究生学习动机(2.16)高于本科生(1.86)和八年制学生(1.94)。2015年第二次调查,军医大学各类学生学习动机未见统计学差异(F=4.150,P=0.06)。(2)2015年相比2010年,该军医大学学生总体学习动机没有统计学差异(F=0.458,P=0.499),但本科生的学习动机有所提高(F=31.080,P0.001),研究生的学习动机有所下降(F=11.090,P=0.001)。结论:军医大学各类学生学习动机差别不大,比较稳定;针对薄弱的学生群体,寻找提升学习动机的对策。     

高等军事医学院校教师工作绩效评价

[目的]通过对2所高等军事医学院校教师相关指标进行调查,探讨建立高等军事医学院校人才评价方法及评价指标体系.[方法]运用两因素等级相关分析、指标聚类分析,确定有代表性的指标；用矩阵法求个人综合得分划分层次.[结果]入选的8项评价指标为:军区或总部级研究所或中心、全军级研究所或中心、为首国内核心期刊发表论文数等.[结论]在高等军事医学院校进行教师人才评价及选拔优秀人才过程中,该评价方法及指标体系是可行的.     

Modelling the risk of noise-induced hearing loss among military pilots

Noise is a significant risk factor in aviation, especially in military aviation. Even though our earlier studies have shown that the risk of noise-induced hearing loss (NIHL) among military pilots is small and the monitoring of their hearing is effective, we still need to develop methods of assessing the risk of NIHL more effectively at both the general and individual levels. In addition, many other risk factors are considered to contribute to the development of hearing impairment. The novel NoiseScan data management system enables assessment of the risk of developing hearing impairment on the basis of known risk factors. This study investigates the risk of hearing impairment among Finnish Air Force pilots using reasonably accurate noise exposure data and other risk factors for hearing impairment. This risk is also compared with that of industrial workers, whose risk followed the ISO 1999 prediction. Hearing among Finnish military pilots turned out to be better than predicted by the ISO 1999 model. The industrial workers had a larger number of risk factors than the pilots. Owing to the small number of risk factors, the hearing of pilots corresponds to approximately the 80th percentile, being 9-13 dB better than the 50th percentile obtained with the industrial population.     

Diagnostic échographique d’un souffle cardiaque systolique au sein d’une population de 280 jeunes militaires français. Implications en médecine d’expertise militaire

Clinically discovering a systolic murmur is frequent among the young military population. When this murmur does not sound benign, a transthoracic echocardiography (TTE) is made to detect any cardiopathy, which could cause sudden cardiac death. The aim of this study was to evaluate the interest of systematic TTE in the assessment of any cardiac systolic murmur (CSM) among militaries.MethodsWe ran a retrospective monocentric study in the “Clermont-Tonnerre” military hospital in Brest. We included all patients sent for TEE, aged 15 to 30 years old, from the 1st January 2010 until the 31st July 2013.ResultsTwo hundred and eighty TTES assessing CSM were performed. We found 28/280 (10%) echocardiographic abnormalities: 13 were bicuspid aortic valves (4.6%), 6 were ventricular septal defects (2.15%), 3 were atrial septal defects (1.07%), 4 were mild mitral regurgitations (1.43%), one mild pulmonary stenosis (0.35%) and one aortic stenosis (0.35%). No hypertrophic cardiomyopathy was found. Concerning military expertise, 11 (3.92%) patients among these 28 with abnormal TEE were considered unfit for work or “fit for work with limitations”.ConclusionAssessing a cardiac systolic murmur with TEE lead to the diagnosis of a cardiomyopathy in 10% of the case. This study enhances the importance of systematic TEE when a CSM is detected in the young military, in order to determine if those soldiers can still fulfill their military duty.