飞行学员椎动脉二维及彩色多普勒超声检测分析

目的 了解2010年度招收的飞行学员椎动脉发育情况,为椎动脉超声检查列入招飞体检提供依据.方法 利用二维及彩色多普勒超声回顾性分析722名飞行学员的椎动脉起始位置、内径、走行及血流动力学变化等,总结飞行学员中椎动脉先天发育异常的比例.结果 722名飞行学员左侧椎动脉起始段(Dl)与椎动脉椎间段(D2)内径(分别为3.624±0.017、3.623±0.018mm)宽于右侧(分别为3.489±0.018、3.438±0.019mm,P＜0.05),左侧椎动脉椎间段收缩期峰值流速(53.547±0.412cm/s)高于右侧(48.463±0.405cm/s,P＜0.05).椎动脉直径在2.5 ～3.0mm的比例较大,为17.5％,而小于2.5mm比例稍低,为6.9％;右侧椎动脉窄细者(16.0％,116/722)多于左侧(8.3％,60/722),差异有统计学意义(P＜0.05).双侧椎动脉走行异常者24例(占3.3％),其中双侧椎动脉起始位置正常,仅走行异常者19例,起始部伴走行异常者5例.19例仅走行异常者左右侧之间无明显差异(P＞0.05),5例起始部伴走行异常者中2例伴有同侧椎动脉窄细.结论 飞行学员中存在多种椎动脉先天发育异常,应早日将椎动脉的超声检查列入招飞体检项目中.     

招飞体检椎动脉超声检查标准的初步探讨

近年来,随着招飞体检项目的不断完善,是否应该将椎动脉超声检查列入《招收飞行学员体格检查标准》受到了广泛关注。由于适龄人员椎动脉可能存在多种先天性变异,因此,有必要制定适合招飞体检的椎动脉超声检查标准。本文旨在通过对某年度正式招收飞行学员722例的椎动脉超声检查结果进行汇总分析,以对制定招飞体检椎动脉超声检查标准进行初步探讨。     

飞行员颈性眩晕与椎动脉先天发育异常的关系

目的探讨飞行员颈性眩晕与椎动脉先天发育异常之间的关系。方法利用二维超声及彩色多普勒超声回顾性分析71例颈性眩晕飞行员患者的椎动脉走行、内径及血流动力学变化等,总结颈性眩晕飞行员患者中椎动脉先天发育异常的比例。结果根据椎动脉异常的超声诊断标准,本组71例患者142条椎动脉中,85条椎动脉起始段清晰显示,显示率为59.9%(85/142),椎间段均清楚显示,显示率为100%;椎动脉纤细者20例,占28.2%(20/71),共包括21条椎动脉(左侧8条,右侧13条),其中1例为双侧椎动脉纤细,均为均匀性纤细;椎动脉走形变异22例,占31.0%(22/71),共包括椎动脉37条;同时存在椎动脉纤细和椎动脉走行异常者12例,占16.9%(12/71)。血流动力学参数异常者13例,28例患者合并颈椎X线片改变;椎动脉纤细者左右侧椎动脉内径、收缩期峰值流速(Vmax)及血流量之间差异无统计学意义。结论椎动脉发育异常是飞行员颈性眩晕的主要原因之一,椎动脉超声检查可作为招飞检查项目。     

7430名招飞学生体质调查

根据飞行学员的体检标准。对7430名招飞学生进行了体质调查,高于或低于标准身长、体重者只占6.04％,凡体重为身长-110±10％者多为体质优良。被检者胸经差多在5～10厘米之间,应视为正常范围。若<5厘米或>10厘米则示胸部有发育异常。脊柱发育异常占26.53％,脊柱侧弯Cobb氏角>15度者及X线拍片证实脊柱有先天变异者不适合学习飞行。四肢形态异常者占18.71％,影响操纵飞机。易发生跳伞损伤。 1983年3月空军医院八个体检队在招飞体检中,对7430名参加招飞学生进行了体质调查,现将结果总结如下。     

招收飞行学员中的超声检查特点及评价

目的:探讨超声诊断在招收飞行学员体检中的诊断及鉴定价值。方法:对某部2005～2006年度"招飞"学员复检的超声检查阳性结果进行回顾性分析。结果:超声检查不合格共36例,占复检不合格总数的16.2%,主要包括肝内钙化灶、肾囊肿、脾大、肝血管瘤等。结论:招飞体检时的超声检查标准应更具科学性和可操作性。     

中美空军飞行学员医学选拔对照实证研究——心脏瓣膜病

目的 分析我军招飞体检时因心脏瓣膜病而不合格的学员参照美军招飞标准的判定结果 ,为我军招收飞行学员体检标准中心脏瓣膜病相关内容的修改提出合理建议.方法 对2012—2015年参加招飞医学选拔定选的学员进行心脏听诊,存在杂音者行超声心动图检查,对于不符合我军心脏瓣膜病相关标准而淘汰的学员,参照美军招飞体检标准判定其是否合格.结果 2012—2015年我军招飞体检定选的心脏瓣膜病不合格率具有显著性差异(P＜0.05);我军招飞体检中的心脏瓣膜病主要包括二尖瓣疾病、主动脉瓣疾病、三尖瓣和肺动脉瓣疾病,对比中美招飞标准后,我军因心脏瓣膜病不合格的学员参照美军标准有68%合格,20%可以特许飞行.结论 我军和美军招飞医学选拔标准中关于心脏瓣膜病的相关内容具有一定差异.     

彩色多普勒超声在诊断颈性眩晕飞行人员椎动脉异常中的临床应用价值

目的 探讨彩色多普勒超声在诊断颈性眩晕飞行人员椎动脉异常中的临床应用价值,分析飞行人员颈性眩晕与椎动脉异常的相关性.方法 对168例颈性眩晕飞行人员患者的椎动脉超声检查结果及相关影像学资料进行回顾性分析.结果 椎动脉发育异常78例,发育异常包括起源异常、行径异常和发育不良.其中起源异常9例,单侧或双侧行径异常11例,单侧或双侧发育不良32例,完全闭塞1例,行径异常伴发育不良25例;发育异常的椎动脉中血流动力学异常者48例.飞行不合格8例,暂时飞行不合格25例,临床诊治后飞行合格45例.结论 飞行人员颈性眩晕患者椎动脉先天异常所占比例较大,招飞工作是飞行工作的源头,提示我们应从源头把关,降低飞行人员的停飞率,建议将椎动脉超声检查纳人空军招收飞行学员体格检查标准. Abstract： Objective To study the correlation between cervical vertigo and vertebral artery abnormality by analyzing the clinical application of color Doppler ultrasonography on flying personnel.Methods The ultrasound imaging and related data of 168 flying personnel's with cervical vertigo were reviewed and analyzed.Results There were 78 cases of vertebral artery abnormalities,including 9 cases of anomalous origin, 11 cases of unilateral or bilateral behavior abnormalities, 33cases of dysplasia (32 cases of unilateral or bilateral dysplasia and 1 case of complete occlusion) and 25cases of behavior abnormality plus dysplasia.Vertebral artery hemodynamics abnormality was found in 48 cases.Among vertebral artery abnormalities, 8 and 25 cases were respectively assessed as permanently or temporally grounding while the rest 45 were qualified.Conclusions Congenital vertebral artery abnormalities take high proportion in the flying personnel with cervical vertigo.Vertebral artery ultrasound examination would be helpful for diagnosing vertebral artery abnormalities at recruiting stage and furthermore for reducing grounding rate.It is suggested that to include vertebral artery ultrasound examination in flying cadets physical examination.     

1974～1997年招飞学员入校耳鼻喉科体检结果分析

目的 总结招飞体检中耳鼻喉科检查中的问题,提高体检质量。方法 分析某飞行基础学院1974～1997年学员入校体检耳鼻喉淘汰及观察矫治的原因和规律。结果 人校体检耳鼻喉科淘汰中初检漏诊占70.3％,检查出入、标准掌握不当占28.6％,身体变化和新发病占1.1％。观察矫治中漏诊占1.2％,检查出入和标准掌握不当占38.3％,身体变化和新发病占59.0％,隐瞒病史占1.5％。结论 加强招飞体检人员的管理,提高耳鼻喉科医生业务水平,提高检测手段,预防新发病才能降低学员入校体检耳鼻喉科淘汰率和观察矫治率。     

飞行员多发血管畸形一例

一、临床资料 患者,男性,39岁,教练机-8飞行员,飞行时间3 570 h.患者因入睡困难2个月余,胸痛1个月就诊.入院查体：左侧上肢血压：104/70 mmHg（1 mmHg＝0.133 kPa）,右侧上肢血压：134/76 mmHg,双侧收缩压相差30 mmHg,左锁骨上窝可闻及收缩期血管杂音.行颈部血管超声检查：双侧椎动脉起始处走行变异,均于C5水平人横突孔（图1,见封四）;右侧椎动脉代偿性增宽,内径约0.41 cm,左侧椎动脉纤细,内径约0.08 cm.彩色及频谱多普勒检查显示：右侧椎动脉内血流通畅,峰值流速72.5 cm/s,左侧椎动脉血流呈反向血流信号（图2,见封四）,峰值流速39.1 cm/s;左侧锁骨下动脉狭窄处呈花色血流信号,收缩期峰值流速347 cm/s.     

招飞体检可疑肾积水情况分析

目的 分析招飞体检中超声对可疑肾积水的诊断情况,探讨可疑肾积水产生的原因,诊断依据及判定标准。方法 选取参加某地区2017—2018年度空军招飞体检的学生为研究对象,对其临床资料进行回顾性分析。结果 参加某地区空军招收飞行学员全面体检的高中毕业生1197人,检出36例可疑肾积水,其中17人确诊肾结石合并肾积水,招飞结论不合格,占可疑受检人数的47.2%。另19人经多体位检查排除明显结石或其他继发性病变,嘱咐学生排尿后复查,4人排尿后积水未见明显改变,招飞结论不合格,占可疑受检人数的11.1%。12人排尿后肾积水减轻,肾盂分离小于10 mm,招飞结论为待结,占可疑受检人数的33.3%。3人排尿后肾积水消失,招飞结论合格,占可疑受检人数的8.3%。结论 建议招飞体检中,对肾积水范围在10～15 mm的可疑肾积水需谨慎淘汰,应嘱学生排尿后反复检查,减少招飞误诊淘汰。     

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）