飞行员人工晶体植入术后十年疗效观察

目的：结合1例飞行员外伤性白内障人工晶体（IOL）植入术后10年疗效的观察,探讨人工晶体植入术在民航飞行员白内障患者中的应用前景。方法：1名领航员因气枪子弹击伤右眼后引起外伤性白内障,伤后半年于1990年9月行白内障囊外摘除术并人工晶体植入术。其后进行了10年疗效跟踪观察。结果：术后1年远视力为1．0,视功能正常,1991年12月取得中国民航总局特许签发的体检合格证。1995年参加领航员改飞机驾驶专业训练,现为空中客车A－320型飞机副驾驶。截止2000年6月IOL植入术后已累计飞行4079h。结论：白内障囊外摘除联合IOL植入术用于飞行员各种原因引起的白内障的治疗,其疗效是肯定的。没有发现因手术后遗症或并发症而影响飞行安全的现象。建议对飞行员IOL植入术后视力恢复正常、视功能正常无并发症者,可由体检鉴定部门鉴定为飞行 合格,申请特许签发的体检合格证。     

民航飞行员屈光不正患病率分析

飞行员视功能直接影响飞行安全.屈光不正是民航飞行员常见的眼病.笔者回顾分析民航飞行员屈光不正的患病特点,探讨航空医学鉴定方法. 一、对象与方法 1.对象:民用航空体检合格证管理系统中2010年5月至2011年4月申请体检合格证的民航飞行员26 018名,年龄16～73岁,男性25 857名,女性161名.     

民航飞行员先天性二叶式主动脉瓣畸形医学鉴定的探讨——附二例病例报告

目的 分析民航飞行员先天性二叶式主动脉瓣畸形的航空医学意义,探讨民用航空医学体检鉴定的政策、标准、方法和措施,提高体检鉴定水平.方法 报告2例民航飞行员先天性二叶式主动脉瓣畸形的临床资料,分析其发病特点;检索并借鉴国外航空医学的处置政策及具体方法,对我国民用航空医学的体检鉴定提出意见和建议.结果 确诊2例飞行员先天性二叶式主动脉瓣畸形,无任何临床症状,无明显血流动力学改变的临床证据,亦不具备介入和(或)手术治疗的临床指征.根据我国现行民航飞行人员体检鉴定标准,仅可按特许鉴定方案进行体检鉴定;两例飞行员特许鉴定合格后,分别恢复飞行3个月和13个月,飞行耐力良好,未见因医学原因出现的飞行事故或飞行事故征候.结论 民航飞行员先天性主动脉瓣畸形的航空医学评定应遵循个别评定、风险评估和谨慎的原则,若无症状、无血流动力学改变的临床证据、不具备介入治疗或手术治疗的指征等,总体风险水平在可接受范围内.在飞行员自我认识、密切航医监控、定期专科会诊的前提条件下可给予特许合格,或考虑授权航空体检医生进行协助特许体检鉴定.     

民航飞行员先天性二叶式主动脉瓣畸形医学鉴定的探讨——附二例病例报告

目的 分析民航飞行员先天性二叶式主动脉瓣畸形的航空医学意义,探讨民用航空医学体检鉴定的政策、标准、方法和措施,提高体检鉴定水平.方法 报告2例民航飞行员先天性二叶式主动脉瓣畸形的临床资料,分析其发病特点;检索并借鉴国外航空医学的处置政策及具体方法,对我国民用航空医学的体检鉴定提出意见和建议.结果 确诊2例飞行员先天性二叶式主动脉瓣畸形,无任何临床症状,无明显血流动力学改变的临床证据,亦不具备介入和（或）手术治疗的临床指征.根据我国现行民航飞行人员体检鉴定标准,仅可按特许鉴定方案进行体检鉴定;两例飞行员特许鉴定合格后,分别恢复飞行3个月和13个月,飞行耐力良好,未见因医学原因出现的飞行事故或飞行事故征候.结论 民航飞行员先天性主动脉瓣畸形的航空医学评定应遵循个别评定、风险评估和谨慎的原则,若无症状、无血流动力学改变的临床证据、不具备介入治疗或手术治疗的指征等,总体风险水平在可接受范围内.在飞行员自我认识、密切航医监控、定期专科会诊的前提条件下可给予特许合格,或考虑授权航空体检医生进行协助特许体检鉴定.     

我军首例复飞运输机飞行员白内障围手术期护理

白内障首选的治疗方法是白内障超声乳化摘除+人工晶状体植入术,此项手术技术成熟,术后效果好[1].近年来,飞行员患白内障呈现年轻化,可能与高空飞行中强紫外线和宇宙电离辐射相关[2].但对于军事飞行员,由于工作特殊性以及极高视功能要求,因此对他们实施白内障手术不仅要提高术后视力,更要的是要在飞行中获得更优的视觉质量.曾有文献报道,军事飞行员行白内障超声乳化+人工晶体植入术复飞的病例[3],但目前我军尚未见飞行员白内障手术后特许复飞的案例.2019年3月,空军特色医学中心收治1例白内障军事飞行员,根据不同飞行机种对飞行员视力的要求,预判性讨论进行白内障手术术后效果,针对可能出现的各类并发症及对飞行的影响,制围手术期的治疗与护理的最佳方案,并对患者开展出院后地面观察期的延续性护理.本例飞行员3个月后返院检查,结论飞行合格,成功复飞.现将护理体会报道如下.     

我军首例复飞运输机飞行员白内障围手术期护理

白内障首选的治疗方法是白内障超声乳化摘除+人工晶状体植入术,此项手术技术成熟,术后效果好[1].近年来,飞行员患白内障呈现年轻化,可能与高空飞行中强紫外线和宇宙电离辐射相关[2].但对于军事飞行员,由于工作特殊性以及极高视功能要求,因此对他们实施白内障手术不仅要提高术后视力,更要的是要在飞行中获得更优的视觉质量.曾有文献报道,军事飞行员行白内障超声乳化+人工晶体植入术复飞的病例[3],但目前我军尚未见飞行员白内障手术后特许复飞的案例.2019年3月,空军特色医学中心收治1例白内障军事飞行员,根据不同飞行机种对飞行员视力的要求,预判性讨论进行白内障手术术后效果,针对可能出现的各类并发症及对飞行的影响,制围手术期的治疗与护理的最佳方案,并对患者开展出院后地面观察期的延续性护理.本例飞行员3个月后返院检查,结论飞行合格,成功复飞.现将护理体会报道如下.     

民航飞行员机械瓣膜置换术后的航空医学鉴定——附病例报告一例

目的 通过分析民航飞行员1例机械瓣膜置换术后病例及文献回顾,以期加强对该病的认识,提高鉴定水平.方法 介绍1例飞行员主动脉瓣机械瓣置换术后的临床资料,分析并探讨该病的医学鉴定方法.结果 该飞行员2年前体检时发现血压脉压差大,超声心动图示左室明显增大,左房增大,主动脉瓣重度返流,左室收缩功能测量值在正常低限的52%.1个月后行主动脉机械瓣置换术.术后1年申请特许鉴定,考虑其血凝控制稳定,心功能良好,在自我认识充分、密切随访和严格的航医监控的前提下特许合格,但不担任机组必需成员,每月飞行不超过50 h.特许合格后安全飞行200 h,未见因医学原因出现的飞行事故或飞行事故征候.结论 民航飞行员机械瓣膜置换术后的航空医学评定应遵循个别评定、风险评估和谨慎的原则,若心功能良好,血凝较为稳定,且控制在可接受范围内,无出血、栓塞的高危因素,预计发生出血、栓塞、卡瓣、瓣膜功能不良等总体风险水平在可接受范围内,在飞行员自我认识充分、密切航医监控、定期专科会诊的前提条件下可给予有限制的特许合格,但仍需密切随访.     

歼击机飞行员准分子激光角膜屈光手术后放飞一例并文献复习

目的 探讨飞行员角膜屈光手术治疗的飞行适应性及航空医学的鉴定原则.方法 分析1例歼轰-7飞行员双眼近视的临床诊断、治疗过程及医学鉴定情况,复习相关文献.结果 本例飞行员诊断为近视性屈光不正2年,保守治疗无效.本人要求手术治疗.眼科检查未见手术禁忌证,经过准分子激光上皮下角膜磨削术治疗,术后常规局部抗炎、促进角膜伤口愈合等药物治疗约1个半月,3个月后复查视功能（包括视力、立体视觉、对比敏感度）恢复正常;双眼角膜伤口愈合良好,电脑验光屈光度稳定;角膜地形图示切削区居中.经低压舱模拟航空低压缺氧环境检查,视功能稳定,给予特许飞行合格.术后正常参加双座机飞行40 h. 结论 军事飞行员近视角膜屈光手术治疗后,角膜伤口愈合良好,视功能恢复正常者可以考虑放飞.飞行适应性评价除常规定期视功能、屈光度、角膜等检查外,应进行对比敏感度、眩光等与飞行环境相关的特殊视功能检测.准分子激光角膜屈光手术是解决军事飞行员近视的有效方法.     

民航招飞体检中晶状体混浊的航空医学鉴定与初步探讨

晶状体混浊可引起飞行员视疲劳感,出现核性近视,视物不清、视物变形,产生眩光现象和对比敏感度下降,影响其在飞行过程中的视物和阅读仪表资料,影响对地面障碍情况的判断和跑道信号的识别以及飞行操作.因此,在招飞体检中,对晶状体混浊人员的航空医学鉴定相对严格,不同于临床诊治标准,主要侧重于行业安全和工作环境的影响.     

民航飞行员冠状动脉-肺动脉瘘2例航空医学鉴定及文献复习

目的:分析民航飞行员冠状动脉-肺动脉瘘（coronary-pulmonary artery fistulas,CPAF）的影像学特征及其航空医学鉴定,旨在提高其诊断及鉴定水平,保障民航飞行安全。方法:回顾2例民航飞行员CPAF的病历资料并复习相关文献资料,总结该病的影像学特征、诊断及其航空医学鉴定。结果:2例飞行员均因...     

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.     

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）     

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.