输尿管软镜在单座歼击机飞行员肾脏小结石治疗中的应用

目的 观察输尿管软镜治疗单座歼击机飞行员肾脏小结石的疗效. 方法 回顾分析2009年12月至2012年4月我院采用输尿管软镜诊疗的3例单座歼击机飞行员肾脏小结石患者病历资料及随访情况. 结果 患者均为男性,年龄分别为23岁、25岁及27岁.左肾结石1例,右肾结石2例,术前CT提示结石长径0.2～0.4 cm.3例患者均为年度体检行超声检查时发现,无腰腹疼痛、尿路刺激症状及肉眼血尿.3例患者行输尿管软镜检查,其中2例明确为肾乳头钙化,未行特殊干预;1例为肾脏小结石合并肾乳头钙化,采用钬激光光纤将结石击碎,术后结石碎屑经尿路排出.3例患者术后均恢复良好,准予飞行.术后随访6～22个月,随访期间患者均安全飞行,复查CT肾乳头钙化斑无明显变化. 结论 对于单座歼击机飞行员肾脏小结石,输尿管软镜是安全有效的诊疗手段,可帮助飞行员重返飞行岗位,避免停飞或改飞其他机种（型）.     

飞行员肾脏小结石的治疗

我们一般把肾结石直径小于 5 m m的结石称为小结石 ,因为其较容易通过输尿管排出体外 ,对于普通人群未进入输尿管引起输尿管梗阻 ,不影响尿液引流 ,一般不需要特殊处理。但对于飞行员 ,特别是单座机飞行的飞行员 ,如飞行中排石导致肾绞痛发作 ,将会造成严重后果 ,为保证飞行安全 ,必须避免带石飞行。因此 ,飞行员的保健有特殊的要求 ,对有腹部绞痛 ,血尿 ,疑为结石的人员必须仔细检查明确诊断 ,积极地治疗。我院自 1991～ 1998年收治肾脏小结石 32例 ,报告如下。一、对象与方法本组 32例 ,均为男性 ,年龄 2 8～ 5 2岁。结石大小 :直径小于 5…     

飞行人员肾脏小结石的治疗

我们一般把肾结石直径小于5mm的结石称为小结石,因为其较容易通过输尿管排出体外,对于普通人群未进入输尿管引起输尿管梗阻,不影响尿液引流一般不需要行特殊的处理。但对于空勤人员,特别是单座机飞行的飞行员,如飞行中排石导致肾绞痛发作,将会造成严重后果,为保证飞行安全,必须避免带石飞行。因此对于空勤人员的保健有特殊的要求,对有腹部绞痛、血尿,疑为结石的人员必须仔细检查明确诊断,对首次诊断为小结石及肾结石行体外冲击波碎石术(ExtracorporealshockwavelithotripsyESWL)后残留下的小结石,都必须予以积极的治疗。我院自1991年～199…     

1991～2007年泌尿外科飞行员住院疾病谱分析（摘要）

目的探讨住院飞行员泌尿系统疾病的规律。方法对我科1991年1月～2007年10月收治战斗机飞行员154例的病例进行分析。结果泌尿系统结石最多（70．13％）,其次是泌尿系统感染（15．58％）,泌尿系统结石以肾脏小结石居多为其特点。结论肾脏小结石有可能引发肾绞痛,对飞行安全造成威胁,因此,加强飞行员肾脏小结石的防治有助于保障飞行安全。     

飞行员肾脏疾病九例的医学鉴定并文献复习

目的 探讨飞行员肾脏疾病的发病特点、诊疗经验以及医学鉴定原则,提出应对策略.方法回顾性分析2005年6月至2008年5月3年间我科收治的9例飞行员肾脏疾病患者的资料和在此期间收治的住院飞行员病历. 结果 ①9例飞行员均为青壮年男性,年龄25～40岁.飞行员肾脏疾病主要分3类:原发性肾小球疾病、先天性尿路畸形和肾结石.②3年问检出各类肾脏疾病占同期本科住院飞行人员总人次的14.9‰.其中,原发性肾小球疾病4例,先天性尿路畸形3例,肾结石4例,有2例飞行员同时患有2种肾脏疾病.③原发性肾小球疾病停飞率高;成人期诊断的先天性尿路畸形多不严重,不影响肾功能者飞行合格;肾结石排出后飞行合格,稳定的肾结石无症状者双座机飞行合格,活动性肾结石飞行不合格.9例飞行员肾脏疾病患者,飞行不合格2例,均为肾小球肾炎患者(其中1例合并肾结石);飞行暂时不合格2例,1例为肾病综合征患者,1例为单纯肾结石患者;其余5例飞行合格,其中2例肾结石患者限双座机飞行. 结论 原发性肾小球疾病、先天性尿路畸形及肾结石在飞行员中均多见,对飞行安全有一定影响,应引起重视并加强相关研究.     

民航飞行人员肾结石与肾钙化灶的鉴别诊断

目的结合民航航线运输驾驶员肾结石的医学鉴定，探讨民航飞行人员肾结石与肾钙化灶鉴别诊断，为航卫保障及医学鉴定提供依据。方法主要从三个方面综合考虑，一是病史，包括肾绞痛病史、血尿史，二是治疗效果，三是B超的形态改变。结果22例患者发现肾结石或钙化灶，至今2～16年不等，平均6．9年，经观察随访，无一有结石发作迹象，所特许放飞的患泌尿系统结石飞行人员至今最长安全飞行12100h，无因病影响飞行安全及出勤情况的发生。结论民航飞行人员肾结石的医学鉴定应慎重，对其最终能否鉴定为合格，具有重要意义的是相关的医学检查以及航空体检医师的正确评估。     

飞行员肾盏憩室内结石放飞一例

一、临床资料患者男性,31岁,歼-7飞行员,飞行时间2000 h.患者2005年健康体检肾脏超声检查发现右肾小结石或钙化,但无任何症状,尿常规正常,结论:飞行合格.2006年疗养时超声检查见右肾小结石,结论:飞行暂不合格.     

歼击机飞行员继发孔型房间隔缺损医学鉴定的探讨——附二例临床病例

目的 探讨歼击机飞行员继发孔型房间隔缺损的治疗、航空医学随访方案及医学鉴定原则. 方法 分析我院2例确诊为继发孔型房间隔缺损的歼击机飞行员临床诊治过程及最终医学鉴定结果,并进行相关文献复习. 结果 2例歼击机飞行员均无临床症状、体征,体检时心脏超声检查意外发现,缺损直径小于≤10 mm,无明显心脏扩大,治疗前头颅影像学检查未见栓塞引起的脑梗塞.2例均经导管介入成功封堵治疗.术后9～13个月地面观察随访,心脏功能正常,封堵完全,局部无残余分流,无新发心律失常.经离心机、加压呼吸等模拟航空环境下检查,封堵器稳定,心脏功能正常,给予特许飞行合格.其中1例经限制双座机实际飞行检验,空中适应性良好,监测心律正常,目前已取消限制,正常参加单座机飞行约120 h,定期检查未发现异常.另1例目前正限制双座机飞行. 结论 歼击机飞行员继发孔型房间隔缺损封堵治疗后,心脏结构恢复正常,血液动力学稳定者可考虑放飞.飞行适应性评价除常规定期进行心脏超声、动态心电图、心肌酶学等检查外,应进行次极量运动试验、离心机、加压呼吸等与飞行耐力相关的检查,并逐步放飞,适当进行空中生理参数监测.     

飞行员肾结石一例

一、临床资料 患者,男性,29岁,歼-7飞行员,飞行时间:700 h.2006年12月高性能战斗机改装体检时腹部B超检查双肾无异常,CT示右肾上极有1个约2 mm×3 mm大小结石,腹部X线平片及静脉肾盂造影检查均未见肾结石,倾斜试验阳性,无任何不适,查体无异常,结论:改装体检飞行不合格,原机种暂时飞行不合格;建议地面观察3个月后返院复查.     

飞行员肾盏憩室内结石放飞一例

一、临床资料 患者男性,31岁,歼-7飞行员,飞行时间2000 h.患者2005年健康体检肾脏超声检查发现右肾小结石或钙化,但无任何症状,尿常规正常,结论:飞行合格.2006年疗养时超声检查见右肾小结石,结论:飞行暂不合格.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）