神经行为评价系统在飞行员脑功能评定中的应用研究

Objective To explore the application of neurobehavioral evaluation system-C3(NES-C3) for pilot's cerebral function (CF) evaluation. Methods The characters of CF under interference of simulated jet engine noise and neurobehavioral ability index (NAI) were investigated in 45 military pilots [(27.6±2.5) yr] (as pilot group) and in 45 college students [(27.5±2.6) yr] (as control group) by NES-C3. The variance of profile of mood statues (POMS) scales, (including tension-anxiety, angry-hostility, exhausted-inertia, gloom-depressed, powerful-restless and stumblepuzzle) and NAI (including memory scanning, digital scanning, visual simple reaction time, visual complex reaction time, pursuit aiming, and consecutive performance) were compared respectively.Results With or without interference of noise, the score of "powerful-restless" in pilot group was higher than that in control group (t=9.74, 12.52, P＜0.05), and the score of tension-anxiety in control group was higher than that in pilot group (t= 10. 46, 14.25, P＜0. 05). When noise was applied, the score of POMS in control group was significantly increased (t=2. 85-6. 33, P＜0. 05) but in pilot group only "tension-anxiety" and "powerful-restless" were significantly increased (t = 4. 12,5.92, P＜0.05). The score of "tension-anxiety" in control group was higher than that in pilot group.Four items of NAI in pilot group were significantly higher than those in control group (t= 2 91-10.55, P＜0. 05). There were no noised induced significant NAI changes in pilot group but in control group. They were not only lower than that in the state without noise interference (t-5.24-29.24,P＜0. 05) but also lower than that in pilot group (t=4. 07-28. 41, P＜0. 05). Conclusions NES-C3 is a useful tool for the identification of pilot's CF.     

神经行为评价系统在飞行员脑功能评定中的应用研究（摘要）

目的探讨神经行为评价系统（NES-C3）在飞行员脑功能（CF）评定中的应用价值。方法采用NES-C3评价系统分别测试45名飞行员（年龄25～31岁，平均27．6±2．5岁）和非飞行员（大学生，年龄25~30岁，平均27．5±2．6岁）在模拟喷气发动机噪声干扰环境下的CF状态（通过POMS量表评定紧张-焦虑、愤怒-敌意、疲惫-惰性、     

飞行员血液同型半胱氨酸与心血管疾病的相关性研究

目的 研究飞行员血液同型半胱氨酸(homocysteine,Hcy)水平变化,预测飞行员心血管事件的发生. 方法 将163例飞行员和60例男性健康地面工作人员(对照组)按年龄分别设21～30岁、31～40岁和41～50岁组;同时按飞行时间将飞行员分别设≤1000 h、1001～2000 h、2001～3000 h和3001～4000 h组;采用全自动生化分析仪测定Hcy浓度. 结果 飞行员组血液Hcy浓度为(9.86±4.45)μmol/L,对照组为(7.10±1.77)μmol/L.两组比较显示飞行员组血液Hcy明显高于对照组(t=4.67,P＜0.01);在不同年龄组血液Hcy测定中,对照组21～30岁组与41～50岁组差异显著(P＜0.05),飞行员不同年龄组之间差异均显著(P＜0.05或P＜0.01);在不同飞行时间血液Hcy测定中,1001～2000 h组、2001～3000 h组均与≤1000 h组差异显著(P＜0.01).同一年龄组中,飞行员血液Hcy浓度均高于对照组(t=3.893、6.221、3.193,P＜0.01). 结论 测定血液Hcy可预测飞行员心血管事件发生的危险性,应针对飞行员血液Hcy升高采取强有力的干预措施,从而有效预防飞行员冠心病的发生. Abstract： Objective To study the change of homocysteine (Hcy) concerntration in pilot's blood and to predict the occurrence of cardiovascular events of pilots. Methods One hundred and sixty-three pilots and 60 male health ground service personnel were selected as pilot and control groups and respectively divided by age as 21-30, 31-40 and 41-50 yrs sub-groups. Pilots were also grouped into ≤ 1000 h, 1001-2000 h, 2001-3000 h and 3001-4000 h sub-groups by flying hours. The concentration of Hcy were detected by using automatic biochemical analyzer. Results The Hcy concentration in pilot group was (9.86±4.45) μmol/L comparing to (7.10±1.77) μmol/L in control group and the difference between groups was significant (t=4.67, P＜0.01). For the Hcy change by age, significant differences were between sub-group 21-30 yrs and 41-50 yrs in control group (P＜0.05), and between each two sub-groups in pilot group (P＜0. 05 or P＜0. 01). For the Hcy detection by flying hours, sub-group 1001-2000 h and 2001-3000 h respectively showed significant difference to ≤ 1000 h sub-group (P ＜ 0.01). Between the same age sub-groups, the Hcy concentration in pilots is higher than that in control groups (t=3. 893, 6. 221, 3. 193, P＜0.01).Conclusions Detecting the Hcy concentration in blood can be used to predict the risk of cardiovascular events of pilot. Taking powerful intervention measure to restrict the elevation of Hcy level can effectively prevent coronary heart disease of pilot.     

长链非编码RNA punisher对血管平滑肌细胞

目的探究长链非编码RNA（long noncoding RNA,lncRNA）punisher与动脉粥样硬化的关系及其对血管平滑肌细胞增殖和凋亡的影响及机制。方法12只健康纯种雄性8周龄载脂蛋白E（apolipoprotein E,ApoE ）基因敲除小鼠（ApoE-/- 小鼠）,通过高脂饲喂制作动脉粥样硬化模型小鼠（模型组）;12只健康C57BL/6J小鼠饲以基础饲料为对照组;人体血管平滑肌细胞系根据转染情况分为小干扰-punisher组和阴性对照（negative control,NC）组。通过荧光定量聚合酶链反应测定模型组与对照组小鼠主动脉弓的punisher表达。通过合成punisher的小干扰RNA作为反向对照抑制punisher在人血管平滑肌细胞中的表达,应用实时荧光定量聚合酶链反应验证punisher表达情况;分别采用细胞计数试剂盒（cell counting kit-8,CCK-8）、划痕实验及流式细胞术检测抑制punisher表达对人血管平滑肌细胞增殖、迁移和凋亡的影响;蛋白印迹法检测B淋巴细胞瘤-2（B-cell leukemia-lymphoma-2,Bcl-2）、半胱氨酸的天冬氨酸蛋白水解酶3（cysteinyl aspartate specific proteinase 3,caspase3）、caspase8、p-p38、p53凋亡相关蛋白的表达。结果①血脂4项及血管苏木精-伊红染色证明造模成功。荧光定量聚合酶链反应显示,动脉粥样硬化模型组小鼠血管punisher表达高于对照组（P＜0.05）;②CCK-8检测显示小干扰-punisher组的光密度值在转染36h之后低于NC组（t36=2.683、P＜0.05,t48=2.554、P＜0.05）;划痕实验显示小干扰-punisher组细胞迁移低于NC组（t=3.136、P<0.05）;③流式细胞术显示,小干扰-punisher组中凋亡细胞数占比多于NC组（22.6%和11.7%,χ2=4.245、P＜0.05）;④蛋白印迹法显示小干扰-punisher组Bcl-2、caspase3-30×103、p53蛋白表达水平明显低于NC组（t分别为9.546、5.647、5.42,P＜0.05）,caspase3-17×103蛋白表达水平高于NC组（t=4.892、 P＜0.05）。结论沉默lncRNA punisher可以促进血管平滑肌细胞的凋亡并抑制其增殖。     

阻塞性睡眠呼吸暂停低通气综合征对飞行员操作能力的影响

目的 探讨中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对飞行员空中操作能力的影响.方法 OSAHS组13例患者临床有睡眠异常主诉,并经多导睡眠图(PSG)确诊为中重度OSAHS,对照组为住院进行年度大体检的13名健康飞行员.所有人选者进行Epworth嗜睡程度问卷(ESS)评分,两项单任务测试包括视觉Sternberg记忆任务和听觉Oddball任务,以及一项由视觉追踪和听觉Oddball组合的双重任务测试.比较OSAHS组与对照组各项任务完成情况,同时在OSAHS组进行ESS评分、睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度与各项任务成绩间的相关性分析.结果 ①OSAHS组存在白天嗜睡、精力减退等临床主诉,其中两例甚至在飞行中出现事故征候.②OSAHS组ESS评分明显高于对照组(t=7.64,P＜0.01).OSAHS组视觉Sternberg记忆任务反应时较对照组明显延长(t=2.28,P＜0.05),听觉Oddball任务两组间无显著差异,双重任务OSAHS组追踪误差明显大于对照组(t=2.45,P＜0.05).③OSAHS组ESS评分与视觉Sternberg记忆任务的反应时存在正相关(r=0.605,P＜0.05).结论 中重度OSAHS患者有不同程度的操作能力损害,存在飞行安全隐患.临床未进行有效治疗的患者应适当限制飞行.     

畸变产物耳声发射在飞行员早期听力损失诊断中的应用

目的 了解噪声对飞行员畸变产物耳声发射的影响,以便及早发现听力损失,为空军卫生勤务保障提供参考.方法 采用纯音听力计和耳声发射测试仪,对30名低年龄段飞行员、7名高年龄段飞行员及30名健康青年分别进行纯音听阈和畸变产物耳声发射检查.结果 飞行员听力损失主要在3 ～8 kHz,可以出现单耳高频听力损失.随着年龄增加,逐渐出现双耳高频听力损失.低年龄段飞行员和健康青年两组受试者0.5～8 kHz平均纯音听阈差异无统计学意义.低年龄段飞行员1 kHz和6 kHz畸变产物耳声发射幅值低于健康青年,两组差异具有统计学意义（t=2.11,P＜0.05;t =2.41,P＜0.05）.低年龄段飞行人员2、3、4、8 kHz畸变产物耳声发射幅值与健康青年类似,两组差异无统计学意义.低年龄段军事飞行员高频纯音听阈异常率（13.3％）和健康青年（6.7％）的差别无统计学意义.低年龄段飞行人员高频畸变产物耳声发射异常率（33.3％）高于健康青年（6.7％）,两组差异具有统计学意义（x2 =5.10,P＜0.05）.结论 畸变产物耳声发射受噪声的影响较纯音听阈敏感,畸变产物耳声发射可早期发现飞行员的噪声性听力损失.     

模拟高性能战斗机座舱噪声对健康志愿者认知能力的影响

目的 探讨模拟高性能战斗机座舱噪声对健康志愿者基本认知操作能力的影响. 方法 采用神经行为测试评价系统-中文第3版测评系统对10名健康志愿者在模拟高性能战斗机座舱噪声108 dB(A)(歼A组)、122 dB(A)(歼-B组)和隔声室的本底噪声35 dB(A)(本底噪声组)背景下进行暴露即刻、30 min、60 min的基本认知操作能力测试;采用美国航空航天任务负荷指数量表评价噪声对心理负荷的影响. 结果 ①在3种噪声背景下以及3个时间段之间,系列加减测试能力指数的比较均无统计学差异.连续识别记忆能力指数的比较:在测试30 min时,歼-B组低于本底噪声组(t=2.084,P＜0.05);在测试60 min时,歼-A组、歼-B组低于本底噪声组(t=2.222、2.783,P＜0.05或P＜0.01).注意力调转能力指数比较:在测试30 min时,歼A组、歼-B组低于本底噪声组(t=3.614、2.342,P＜0.05或P＜0.01);在测试60 min时,歼-B组低于本底噪声组(t=2.823,P＜0.01);在歼-A组,30 min时低于即刻(t=2.583,P＜0.05);在歼-B组,60 min时低于即刻(t=2.222,P＜0.05).视复杂反应时能力指数的比较:在歼-B组,60 min低于即刻(t=2.369,P＜0.05);在测试30 min、60 min时,歼-B组低于本底噪声组(t=2.232、2.961,P＜0.05或P＜0.01).②在3种噪声背景下以及3个时间段之间,脑力需求、业绩评估的比较均无统计学差异.体力需求结果比较:在测试30 min、60 min时,歼-B组高于本底噪声组(t=2.082、2.154,P＜0.05).时间需求结果比较:在测试即刻、30 min时,歼-B组高于本底噪声组(t=2.793、2.792,P＜0.01).努力程度结果比较:在测试30 min时,歼-B组高于本底噪声组(t=2.793,P＜0.01)和歼-A组(t=2.792,P＜0.01);在测试60 min时,歼-B组高于本底噪声组(f=3.572,P＜0.01)和歼-A组(t=2.901,P＜0.01);在歼-B组,60 min高于30 min(t=2.223,P＜0.05).挫折程度结果比较:在测试即刻、60 min时,歼-B组高于本底噪声组(t=2.681、2.139,P＜0.05). 结论 模拟高性能战斗机座舱噪声对人的认知能力有一定不良影响,且随着噪声暴露时间的延长和强度的增加影响更为严重;应从设备减噪、机身隔噪、个体防噪以及加强飞行员心理干预等多方面入手,尽量减小高性能战斗机飞机座舱噪声对飞行员认知工效的影响.     

46例民航飞行员血清尿酸水平与冠心病的相关分析

目的 研究血清尿酸（serum uric acid,SUA）水平与民航飞行员冠状动脉粥样硬化性心脏病（冠心病）的相关性.方法 对46例疑似冠心病的民航飞行员行冠状动脉造影,并采集空腹静脉血样测定血清尿酸、血糖及血脂水平,分析上述生化指标、病史、年龄与冠心病的相关性.结果 经冠状动脉造影,18例（39.1%）确诊冠心病,列为冠心病组;28例（60.9%）冠状动脉造影正常或病变轻微,列为非冠心病组.两组间年龄差异有统计学意义（t=2.187,P＜0.05）;合并高血压、低高密度脂蛋白胆固醇血症及高尿酸血症方面差异有统计学意义（P＜0.05）;但在合并糖尿病、吸烟、高胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇血症方面差异无统计学意义（P＞0.05）;冠心病组飞行员平均血清尿酸水平为（430.58±89.10） μmol/L,明显高于非冠心病组的（341.70±78.11） μmol/L,差异有统计学意义（t=3.565,P＜0.01）.精确Logistic检验结果显示SUA是冠心病的独立危险因素.结论 高尿酸血症可能是引起飞行员冠心病的独立危险因素.     

不同飞行时间飞行员模拟定向飞行任务的眼动研究

目的 探讨经验飞行员和新手飞行员在模拟定向飞行任务中眼动规律的差异. 方法 飞行时间≥1000 h(经验组)与≤300 h(新手组)两组共30名飞行员分别完成空间定向仪中坚信仪表飞行课目,并在此过程中佩戴眼动仪,同步收集各个眼动指标并记录各任务成绩.依据数据完整性和录制眼动视频的准确性,每组选取9名飞行员的数据进行分析.采用SPSS 16.0软件对两组飞行员的任务成绩、附加任务成绩进行独立样本t检验. 结果 飞行时间≥1000 h组任务成绩和附加任务成绩均优于≤300 h组,其差异具有统计学意义(t=2.387～4.731,P＜0.05或0.01);注视频率、平均注视时间、眼跳频率、眼跳速度及平均眼跳幅度5个眼动指标,两组间差异均有统计学意义(t=2.212～5.601,P＜0.05或0.01);在注意力分配上,两组间高度表、速度表注视时间百分比差异具有统计学意义(t=2.007～2.731,P＜0.05). 结论 经验组飞行员比新手组拥有更高效率的眼动模式和更好的飞行绩效.     

60岁民航航线飞行员双重任务能力及一年追踪研究

目的 研究60岁民航航线飞行员的认知能力状况,并进行1年的追踪观察,探讨老年航线飞行员认知能力的发展变化规律. 方法 52名60岁民航航线飞行员,在计算机上完成双重任务认知能力测试,包括单项心算4数连加任务、单项模拟飞行姿态控制任务和两者复合的双重任务.同时通过将60岁组航线飞行员各项指标的成绩与31～39岁组、40～49岁组、50～59岁组的航线飞行员进行均数差异比较,观察年龄因素的影响.以配对t检验的方法将26名航线飞行员1年前后双重任务测试成绩进行对比,检验其认知能力的变化. 结果 各项认知指标均存在明显的年龄效应(F=2.98～13.47,P＜0.05),但60岁组民航航线飞行员的认知能力仅与31～39岁组飞行员的差异有统计学意义(t—2.33～7.46,P＜0.01或P＜0.05),而与其他年龄组在绝大多数指标上的差异均没有统计学意义(P＞0.05).动态观察26名航线飞行员1年前后认知能力的变化,其双重任务的认知能力并没有出现衰减. 结论 横向比较和动态追踪的研究结果均支持60岁并非航线飞行员认知功能急剧衰减的转折点.本研究为特殊职业退休政策的制定提供一定的参考依据.     

歼(强)击机飞行员心脏瓣膜生理性返流调查分析

目的 观察歼(强)击机飞行员心脏瓣膜生理性返流的发生情况.方法 100例歼(强)击机飞行员为观察对象,按机型不同分为高性能机组56例和普通机组44例,进行超声心动图检查,观察瓣膜运动及血流情况,测量心脏结构指标并计算其心功能.结果 100例飞行员中,共检出各种瓣膜生理性返流55例(55.00%),其中高性能机组32例(...     

不同飞行条件飞行员训练前后凝血及纤溶指标的对比研究

目的检测不同飞行条件下飞行员飞行训练前后凝血及纤溶指标的变化,以了解飞行训练对其凝血和纤溶平衡的影响。方法应用生物活性法和免疫比浊法,检测40名飞行员飞行训练前后的静脉血凝血酶原时间（prothrombin time,PT）、凝血酶时间（thrombin time,TT）、活化部分凝血活酶时间（activated partial thromboplastin time, APTT）、纤维蛋白原（fibrinogen,Fg）和D-二聚体（D-dimer,D-D）。依不同飞行强度（1次飞行和两次飞行）、不同飞行场次（昼航和跨昼夜飞行）、不同飞行载荷（＋3Gz和＋5Gz）、不同飞行高度（3km和5km）分别各分为两组。另设30名场站地勤人员为对照组。比较自身飞行训练前后,及不同组间凝血善F溶指标的差异。结果飞行前飞行员组与对照组凝血一纤溶指标的差异无统计学意义。飞行训练后PT、TT、APTT缩短、Fg、D-D升高,分别与飞行前自身及对照组比较,差异有统计学意义（t=2．925-6．908,P〈0．01）。完成各飞行课目后分别与飞行前比较,PT、TT、APTT缩短,Fg、D-D升高,差异有统计学意义（t=2．348-8．717,P％0．01或P〈0．05）。第1次飞行后与第2次飞行后、昼航与跨昼夜飞行后、3km与5km飞行后比较,凝血-纤溶指标的差异无统计学意义。＋5Gz飞行后与＋3Gz飞行后比较,TT缩短、Fg升高,差异有统计学意义（t=2．605、5．772,P=0．013、0．000）;其他指标差异无统计学意义。结论飞行员飞行训练后凝血与纤溶指标可发生改变,属于机体应激状态下的适应性反应。     

模拟长航时飞行心理疲劳的对抗措施效果评价

目的评价模拟长航时飞行时心理疲劳的对抗措施的效果。方法16名男性飞行学员按抽签法随机分为对照组和试验组,在教-8飞行模拟器上进行8h的航线飞行。试验组施加心理疲劳对抗措施。通过模拟电码判译成绩、飞行成绩和焦虑自评量表（self-r ating anxiety scale,SAS）评分评价对比两组飞行学员的心理疲劳程度。结果随着飞行时间的增加,对照组的电码判译成绩、飞行成绩均显著下降（F=4．406、10．166,P=0．039、0．002）,试验组的两项成绩则均无显著下降（F=1．015、0．780,P=0．405、0．477）;对照组在飞行4h后,两项成绩与试验开始阶段相比差异有统计学意义（P〈0．05）,试验组的成绩则在飞行开始后的各时段间差异均无统计学意义（P〉0．05）。飞行前后,对照组的SAS得分无明显变化（t=1．032,P=0．329）;飞行后试验组的SAS得分则出现显著降低,与飞行前比较差异有统计学意义（t=3．222,P=0．010）。结论本研究采用的心理疲劳对抗措施对长航时飞行引起的心理疲劳现象有明显的对抗效果。     

血管回声跟踪技术对男性飞行员颈动脉血管弹性的定量检测

目的 通过血管回声跟踪(echo-tracking,ET)技术对颈动脉血管弹性的定量检测,探讨年龄及飞行时间对男性飞行员颈动脉血管弹性的影响. 方法 根据年龄将72例飞行员分为20～29岁(27人)、30～39岁(30人)和40～49岁(15人)3组.应用ET技术检测各组飞行员的颈动脉血管,并采用t检验分别对各个年龄组颈动脉血管弹性值[僵硬度(stiffness parameter,β)、弹性模量(pressure-strain elastic modulus,Ep)、顺应性(arterial compliance,AC)和脉搏波传导速度(pulse wave velocity calculated from β value,PWVβ)]与国人正常测量值(对照组)进行对比分析,采用方差分析对各组间血管弹性值和飞行时间进行比较,通过直线相关和偏相关分析对各组飞行员年龄与飞行时间对颈动脉血管弹性的影响进行分析. 结果 飞行员各组β、Ep及PWVβ均较国人正常测量值降低,AC增高.飞行员20～29岁及30～39岁组血管弹性值与其对照组比较,有统计学意义(t=2.061～6.712,P＜0.05或P＜0.01),40～49岁组与对照组比较,无统计学意义.通过直线相关分析,30～39岁组的年龄、飞行时间与β、Ep和PWVβ均存在显著正相关;在20～29岁和30～39岁组中,年龄与飞行时间存在显著性正相关(r=0.655、0.723,P=0.001、0.000).通过偏相关分析,在控制飞行时间因素时,30～39岁组中β和Ep值与年龄存在显著正相关(r=0.516、0.452,P=0.007、0.020),即随着年龄的增加,β和Ep值增加. 结论 年龄对男性飞行员颈动脉血管弹性影响较大,而飞行时间影响较小.ET技术对飞行员颈动脉血管弹性值的定量检测有助于进一步了解男性飞行员的血管功能状态. Abstract： Objective To investigate quantitative detection of the carotid elasticity of male pilots in different age groups by using echo-tracking (ET) technique. Methods The carotid arteries were detected by ET technique in 72 male pilots who were divided into 3 groups according to age. The elasticity values, including stiffness parameter (β), pressure-strain elastic modulus (Ep), arterial compliance (AC) and pulse wave velocity calculated from β value (PWVβ) were analyzed by t test.The elasticity values and flying hours were also processed by variance analysis among 3 groups. The influence of age and flying hours to elasticity values was resolved by linear correlation and partial correlation analysis. Results There was no difference on elasticity values of bilateral carotid. The arterial stiffness indices, such as β, Ep and PWVβ in each group, were lower than those by the normal measuring, but AC value was higher. By comparing with control group, the carotid elasticity values had statistical difference in 20-29 yrs and 30-30 yrs groups, but for 40-49 yrs group comparison there was no significant difference (t= 2. 061-6. 712, P＜0.05 or P＜0.01). Linear correlation analysis showed that age and flying hours appeared significant and positive correlation to β, Ep and PWVβ in 30-39 yrs group. In 20-29 and 30-39 yrs groups, age was significantly and positively correlated to flying hours (r=0. 655, 0. 723, P=0. 001, 0. 000). In 30-39 yrs group β and Ep were positively correlated with age based on partial correlation analysis (r= 0. 516, 0. 452, P= 0. 007, 0. 020), which meant that β and Ep significantly increased with age. Conclusions For male pilot age expresses greater influence than flying hours to carotid artery elasticity. Quantitatively detecting male pilot's carotid artery elasticity by ET technique will contribute to the delermination of pilot's artery functional status.     

The impact of resistance exercise on the cognitive function of the elderly

PURPOSE: The purpose of this study was to assess the impact of 24 wk of resistance training at two different intensities on cognitive functions in the elderly. METHODS: Sixty-two elderly individuals were randomly assigned to three groups: CONTROL (N = 23), experimental moderate (EMODERATE; N = 19), and experimental high (EHIGH; N = 20). The volunteers were assessed on physical, hemodynamic, cognitive, and mood parameters before and after the program. RESULTS: On the 1 RM test (P < 0.001), the two experimental groups performed better than the CONTROL group, but they did not show differences between themselves. The EHIGH group gained more lean mass (P = 0.05) than the CONTROL group and performed better on the following tests: digit span forward (P < 0.001), Corsi's block-tapping task backward (P = 0.001), similarities (P = 0.03), Rey-Osterrieth complex figure immediate recall (P = 0.02), Toulouse-Pieron concentration test errors (P = 0.01), SF-36 (general health) (P = 0.04), POMS (tension-anxiety, P = 0.04; depression-dejection, P = 0.03; and total mood disorder, P = 0.03). The EMODERATE group scored higher means than the CONTROL group on digit span forward (P < 0.001), Corsi's block-tapping task backward (P = 0.01), similarities (P = 0.02), Rey-Osterrieth complex figure immediate recall (P = 0.02), SF-36 (general health, P = 0.005; vitality, P = 0.006), POMS (tension-anxiety, P = 0.001; depression-dejection, P = 0.006; anger-hostility, P = 0.006; fatigue-inertia, P = 0.02; confusion-bewilderment, P = 0.02; and total mood disorder, P = 0.001). We also found that IGF-1 serum levels were higher in the experimental groups (EMODERATE, P = 0.02; EHIGH, P < 0.001). CONCLUSIONS: Moderate- and high-intensity resistance exercise programs had equally beneficial effects on cognitive functioning.     

兔VX2 肝癌放疗后的MR扩散加权成像特征与细胞凋亡情况

目的 研究VX2肝癌三维立体定向适形放疗后的DWI特征及肿瘤细胞凋亡情况.方法 成功制成60只兔肝癌模型后,待瘤体直径≥1 cm时,应用随机数字表法随机抽取40只瘤兔进行放疗,将放疗后40只兔用同样方法随机分成4组,每组10只,各组兔分别于放疗后1、5、10和15 d进行MR扫描,另20只作为对照组,不行放疗,随机分配到各组中,测量VX2肿瘤、肝脏ROI的ADC值,并计算两者比值.肿瘤标本行DNA缺口末端标记(TUNEL)法测定肿瘤细胞凋亡情况,计算凋亡指数(AI),采用方差分析比较组间差异有统计学意义后,再采用SNK检验分别比较不同放疗时间点各组ADC比值和AI,不同放疗时间点放疗组与对照组之间比较采用两样本t检验.结果 放疗后1、5、10和15 d,放疗组ADC比值分别为0.74±0.15(8只)、1.04±0.09(7只)、1.43±0.12(7只)、1.25±0.23(8只),差异有统计学意义(F=24.221,P＜0.01);相应对照组ADC比值分别为0.78±0.07(5只)、0.79±0.07(4只)、0.83±0.14(4只)、0.97±0.19(4只).2组放疗后5和10 d差异有统计学意义(t值分别为4.417和7.259,P值均＜0.01),放疗后1和15 d差异无统计学意义(t值分别为0.569和1.957,P值均＞0.05).1、5、10和15 d放疗组凋亡指数分别为0.39±0.13(8只)、0.29±0.08(7只)、0.28±0.07(7只)、0.58±0.19(8只),差异有统计学意义(F=8.128,P＜0.05);相应对照组凋亡指数分别为0.26±0.13(5只)、0.18±0.03(4只)、0.16±0.06(4只)、0.18±0.08(n=4),差异无统计学意义(F=1.006,P＞0.05);2组放疗后5、10和15 d差异有统计学意义(t值分别为2.348、2.386和3.756,P值均＜0.05),放疗后1 d差异无统计学意义(t值为1.716,P＞0.05).结论 DWI可以反映兔VX2肝放疗后不同时间点细胞凋亡的动态变化.     

脉搏波传导速度和踝臂指数在飞行人员动脉硬化早期检测中的应用

目的 探讨脉搏波传导速度(pulse wave velocity,PWV)和踝臂指数(ankle brachial pressure index,ABI)在飞行人员动脉硬化早期检测中的应用价值.方法 应用动脉硬化检测仪,检测107例飞行人员的PWV和ABI,并与107例地方体检人员进行对比分析.结果 飞行人员组发现PWV异常10例(9.3%),对照组发现36例(33.6%);对照组发现1例ABI异常,而飞行人员组未见ABI异常;两组人群PWV均值随着年龄的增长而增大(F=3.314～13.819,P＜0.05),但飞行人员PWV均值显著低于同年龄组一般人群(t=2.187～4.208,P＜0.05).线性回归分析结果表明,飞行人员PWV与年龄、血压、腰围和体重指数显著相关(β=0.439～0.634,P＜0.01).结论 年龄、血压、腰围或体重指数的增加是飞行人员大动脉弹性降低的主要危险因素,PWV可以作为飞行人员血管早期病变检测与评价的功能指标. Abstract： Objective To explore the value of using pulse wave velocity (PWV) and ankle brachial pressure index (ABI) to detect the early arteriosclerosis in flying personnel. Methods PWV and ABI were detected in 107 cases of flying personnel by arteriosclerosis detector and 107 civil personnel were examined as control group. Results 10 cases (9.3%) of abnormal PWV were found in flying personnel group while 36 cases (33.6%) found in control group. Only one abnormal ABI case was in control group but in flying personnel group. The mean PWV of both groups' showed significant increase with the age growing (F= 3. 314-13. 819, P＜0. 05). The mean PWV of flying personnel group was significantly lower than that of the control group in same age segment (t= 2. 187-4. 208,P＜0.05). Linear regression analysis showed that PWV was closely related to the age, blood pressure, waist circumference (WC) and body mass index (BMI) in flying personnel group (β=0. 439-0. 634, P＜0. 05). Conclusions The increases of age, blood pressure and WC or BMI are the major risk factors of causing aorta elasticity decreased in flying personnel. It is suggested that the PWV would be an applicable functional index in early diagnosis of vascular pathological changes and in medical evaluation.     

空军飞行员角膜内皮细胞的初步分析

目的 探讨我国空军飞行员角膜内皮细胞密度和形态特征,初步了解细胞密度和形态学的生理学参数.方法 应用角膜内皮细胞显微镜及仪器自带的角膜内皮细胞分析系统,对男性56例(112眼)现役飞行员角膜内皮细胞进行了观察,同时选取30例(60眼)与其年龄和裸眼视力具有可比性的健康男性作为对照组,两组进行分析和比较.结果 数据显示空军飞行员平均角膜内皮细胞密度为2797.0±330.3个/mm2,显著低于对照组的2917.57±318.04个/mm2(t=2.286,P=0.024).平均六角形细胞构成比,飞行员组(56.46±7.19)显著低于对照组(60.33±7.68),差异有显著性意义(t=3.253,P=0.001).飞行员组和对照组随着年龄的增加,六角形细胞构成比均逐渐减少(r=-0.395、-0.268,P=0.000、0.038).通过偏相关系数分析,在年龄因素控制条件下,飞行员飞行时间的延长伴随着细胞平均面积的增大(r=0.244,P=0.01).结论 对飞行员角膜内皮细胞形态学参数的测定和初步数据分析将有助于进一步了解高速飞行情况下眼角膜内皮的变化.     

64层螺旋CT胸部低剂量扫描方案优选的多中心研究

目的 比较自动曝光控制技术(AEC)与管电流恒定技术(CCC)2种不同低剂量MSCT扫描方案对胸部CT图像质量的影响,探讨更加合理的肺低剂量扫描参数方案.方法 采用前瞻性多中心研究方法,研究对象为7所医院就诊的280例行胸部低剂量MSCT检查的受检者,设定管电流(mA)为研究变量,方法一为AEC技术,下设噪声标准差值(SD)为25(A1)及30(A2)各1组,并设定管电流上限为80 mA,下限为10 mA;方法二为CCC技术,下设40 mA(C1)及50 mA(C2)各1组;共4组,采用同一机型64层MSCT行胸部低剂量扪描.2名放射科医师应用双肓法阅片,比较2种不同扫描技术的曝光剂量、SD值,横断面、MPR的图像质量以及体质量指数(BMI)对图像质量的影响.曝光剂量及SD比较行方差分析及t检验;图像质量比较行Mann-Whitney检验;医师对图像诊断一致性检验行Kappa分析.结果 剂量长度乘积(DLP)AEC组较CCC组明显降低[(82.62±40.31)和(110.81±18.21)mGy·cm,F=56.88,P＜0.01].AEC技术中A2组DLP较A1组低[(72.77±36.68)和(92.46±41.61)mGy·cm],差异无统计学意义(t=0.82,P＞0.05).前者SD值在肺窗[(41.50±9.58)和(40.86±7.03)HU]及纵隔窗[(41.19±7.83)和(40.92±9.89)HU]均略高于后者,差异无统计学意义(F肺窗=0.835、1.910,P值均＞0.05).横断面图像质量AEC组肺窗得分除右下肺静脉水平[(4.92±0.25)和(4.93±0.17)分]、[左膈顶上缘水平(4.91±0.27)和(4.93±0.22)分]较CCC组略低外,AEC组得分均较CCC组略高[头臂静脉上缘(4.49±0.56)和(4.38±0.64)分;主动脉弓上缘(4.86±0.23)和(4.81±0.32)分;右肺上叶支气管开口(4.87±0.27)和(4.84±0.22)分;右肺中叶支气管开口(4.90±0.25)和(4.88±0.21)分],差异无统计学意义(F=0.076～1.748,P值均＞0.05);纵隔窗得分除头臂静脉上缘水平AEC组较CCC组高[(2.57±0.77)和(2.46±0.59)分],且差异有统计学意义(F=8.459,P=0.047)外,余各层面AEC组得分均较CCC组略低[(主动脉弓上缘(3.36±0.63)和(3.45±0.60)分;右肺上叶支气管开口(3.94±0.56)和(3.95±0.51)分;右肺中叶支气管开口(3.80±0.58)和(3.87±0.50)分;右下肺静脉(3.72±0.56)和(3.78±0.53)分;左膈顶上方(3.58±0.63)和(3.68 ±0.56)分],但差异均无统计学意义(F=0.083～3.380,P值均＞0.05).MPR图像质量肺窗及纵隔窗观察均略好于CCC组(Z肺窗=-2.358,Z纵隔窗=-1.330,P值均＞0.05).偏瘦、正常或偏重人群组,A1组肺窗及纵隔窗图像质量均优于A2组,差异无统计学意义(偏瘦:Z肺窗=0.000、Z纵隔窗=0.000;正常:Z肺窗=-0.062、Z纵隔窗=-0.746;偏重:Z肺窗=-1.177、Z纵隔窗=-1.715;P值均＞0.05),但在偏重人群纵隔窗图像质量A1组更好于A2组(Z=-1.715,P=0.144).结论 AEC组总曝光剂量明显低于CCC组,而AEC组的图像质量及SD值无论在肺窗或纵隔窗均与CCC组无明显差异,故建议在胸部低剂量筛查方案选择中应用AEC技术,对偏胖者宜采用SD=25方案,对正常及偏瘦者宜采用SD=30方案.

Abstract：

Objective To compare the image quality of chest low dose CT (LDCT) using automatic exposure control (AEC) and constant current control (CCC) and explore a more reasonable scanning protocol. Methods Two hundred and eighty participants were examined with 64 CT scanner at 7 centers in China. All were divided into 4 groups. Two groups underwent LDCT using AEC with standard deviation set at 25 (A1) and 30 (A2) respectively and the tube current ranged from 10 mA to 80 mA. The other two groups underwent LDCT using CCC with tube current set at 40 mA (C1) and 50 mA (C2) respectively. The axial and MPR images were evaluated by two radiologists who were blinded to the scanning protocols.The radiation dose, noise and the image quality of the 4 groups were compared and analyzed statistically.Differences of radiation dose and noise among groups were determined with variance analysis and t test,image quality with Mann-Whitney test and the consistency of diagnosis with Kappa test. Results There was a significant lower DLP in AEC group than in CCC group [(82.62±40.31)vs ( 110.81±18.21) mGy·cm (F =56. 88 ,P ＜ 0. 01 )], whereas no significant difference was observed between group A2 and group A1 0. 05]. The noisy of AEC group was higher than that of CCC group both on lung window(41.50±9.58 vs 40.86±7.03) and mediastinum window (41.19±7.83 vs 40.92±9.89), but there was no significant difference( Flung =0.835, P=0.476, Fmediastinum =1.910, P=0.128).The quality score of axial image in AEC group was higher than that in CCC group (superior margin of the brachiocephalic vein level: 4.49±0.56 vs4.38±0.64,superior margin of the aortic arch: 4.86±0.23 vs 4.81±0.32,the right superior lobar bronchus Level:4.87±0.27 vs 4. 84 ± 0. 22, the right middle lobar bronchus Level: 4.90±0.25 vs 4.88±0.21) except on the right inferior pulmonary vein level(4. 92 ±0. 25 vs 4. 93 ±0. 17) and superior margin of the left diaphragmatic dome level (4. 91±0.27 vs 4.93±0.22) on lung window, but no significant differences (F=0.076-1.748, P＞0.05) were observed. A significant higher score in AEC group was observed on mediastinum window compared with CCC group on superior margin of brachiocephalic vein level (2.57±0.77 vs 2. 46 ± 0. 59, F = 8. 459, P ＜ 0. 05 ), however, the score of AEC group was lower than that of CCC group on other levels without significant differences (superior margin of the aortic arch:3.36 ±0. 63 vs 3.45 ±0. 60,the right superior lobar bronchus level: 3.94 ±0. 56 vs 3. 95 ±0. 51 ,the right middle lobar bronchus Level: 3.80 ±0. 58 vs 3. 87 ±0. 50,the right inferior pulmonary vein level: 3.72 ±0. 56 vs 3.78 ±0. 53, superior margin of the left diaphragmatic dome level: 3.58 ± 0.63 vs 3.68±0.56,F=0.083-3.380,P ＞ 0.05 ). The MPR image quality of AEC group was better than that of CCC group both on lung window and mediastinum window (Zlung =-2.258, Zmedlastinum=-1.330, P＞0.05). For all participants including the underweighted group, the normal group and the overweighted group, the image quality of A1 group was better than that of A2 group without significant differences (the underweighted group: Zlung=0.000, P=1.000, Zmedastinum= 0.000, P=1.000;the normal group: Zlung =-0.062, P=0.950, Zmediastinum =-0.746, P = 0.456; the overweighted group: Zlung = - 1.177, P = 0.239,Zmediastinum =-1.715, P=0.144) both on lung and mediastinum windows, and for the higher BMI participants, a better image quality was obtained in A1 group than in A2 group on the mediastinum window (Z = -1. 715, P = 0. 144). Conclusions The total radiation exposure dose of AEC group is significantly lower than that of CCC group, but no statistical significant differences are observed between both groups in image quality and noise level. The AEC technique is highly recommended in thoracic LDCT scan for screening program, and the SD25 ( SD value = 25) scan protocol is suggested for higher BMI population while the SD30 (SD value = 30) scan protocol for lower BMI population.