2006年陆军航空兵直升机飞行员疾病谱分析

目的 研究陆军航空兵(陆航)直升机飞行员疾病谱,为航卫保障提供依据.方法 随机抽取2006年参加大体检的陆航直升机飞行员516人,查阅疾病诊断,分析疾病谱、年龄组疾病谱及主要疾病患病率,采用秩和比法比较各年龄组主要疾病类型构成.结果 ①2006年陆航直升机飞行员疾病谱的前10位疾病及其患病率分别是:脂肪肝(9.88%)、高脂血症(6.98%)、胆囊息肉(3.49%)、腰椎间盘突出症(2.33%)、窦性心动过缓(2.33%)、胆结石(2.13%)、慢性胃炎(1.74%)、肾囊肿(1.55%)、肝内钙化灶(1.36%)和高血压(1.16%).②3个年龄组陆航直升机飞行员脂肪肝患病率均较高,分别是1.98%、9.66%和45.59%.各年龄组患病率存在差异的主要疾病是脂肪肝、慢性胃炎、高脂血症、胆囊息肉、肝内钙化灶、高血压和糖尿病.③3个年龄组主要疾病类型构成的和谐系数是0.7486,各组主要疾病类型构成基本一致(χ~2=17.97,P<0.05).结论 ①陆航直升机飞行员主要疾病与我军空军飞行员基本相似,但疾病谱的前10位无歼击机飞行员常见的航空性疾病;疾病谱中多数顺位靠前的疾病患病率低于我军其他飞行员的患病率水平.②陆航直升机飞行员脂肪肝及高脂血症的患病率随年龄增长过快.各种致病因素对腰背部、颈肩部疾病的发生可能有累积作用.③在比较陆航直升机飞行员各组主要疾病类型构成的一致性时,秩和比法是一种有效的方法.     

Diffuse benign liver disease

Liver diseases are as varied as the numerous functions of this critical organ. Three of the most common are cirrhosis, fatty liver and vascular pathologies of the liver. This article examines the causes of these benign liver diseases, describes the laboratory tests and medical imaging examinations used to diagnose them and discusses treatments.     

CT检测脂肪肝技术与应用进展

脂肪性肝病由一组肝细胞内三酰甘油过度沉积为特征的疾病组成,与肝硬化、肝纤维化及很多代谢性、传染性疾病均有密切关系.CT为常用的脂肪肝影像学检查方法,能够有效地无创性检测肝脏的脂肪沉积.近年来CT设备和技术进展很快,双能量扫描(DECT)等新技术也被用于肝脏脂肪的检测.     

The spectrum of liver disease on CT.

Computed tomography (CT) is a useful imaging modality in a variety of liver diseases. The roles of radionuclide liver scanning, ultrasound and CT in liver disease are discussed and characteristic CT findings of cystic disease, trauma, abscess, primary and metastatic malignancy, fatty infiltration, hemochromatosis, and obstructive jaundice are illustrated.     

某部艇员超重、肥胖与非酒精性脂肪肝的变化趋势分析

目的分析某部1998～2005年艇员超重、肥胖及非酒精性脂肪肝比例的变化趋势，为部队制定训练计划、指导科学膳食、预防慢性疾病提供原始资料。方法收集某部1998～2005年艇员年度体检中统计的超重和肥胖及非酒精性脂肪肝的有关数据，进行动态分析。结果艇员超重人员由1998年的3．7％增加至2005的34．6％，肥胖者比例由1998年的1．2％增加至2005年的5．0％。非酒精性脂肪肝人数由1998年的0．36％增加至2005的5．34％。结论艇员超重、肥胖的比例呈现增加趋势，自2002年开始增长更为明显，与此同时，非酒精性脂肪肝的比例也有明显的增加。     

双能量CT在肝实质弥漫性疾病中的应用进展

双能量CT是一种采用2种不同能量进行数据采集的成像技术,可选择多种算法进行影像后处理。基于物质分离算法的双能量CT可以定量分析肝实质内的脂肪、铁、碘等物质,有助于早期评估肝实质弥漫性疾病及其严重程度,为肝实质弥漫性疾病的早期诊断及其发展的监测提供了一种新的影像学方法。综述近年来双能量CT在脂肪肝、肝铁沉积症、肝硬化等肝实质弥漫性疾病方面的应用进展。     

飞行员年度体检疾病谱比较分析

目的 比较2012年陆军航空兵直升机飞行员和空军歼击机飞行员疾病谱,分析其异同,为航卫保障提供依据. 方法 随机抽取参加2012年大体检的陆军航空兵直升机飞行员652人和空军歼击机飞行员830人,分别计算其疾病谱前10位疾病的患病率.分别按年龄分为20～29岁、30～39岁、40岁以上组,计算两个人群各年龄组疾病谱前10位疾病的患病率;计算并比较两个人群各系统疾病的患病人数及其构成比. 结果 ①陆军航空兵飞行员和空军飞行员前4位疾病均为高脂血症、脂肪肝、高尿酸血症、胆囊息肉,患病率分别是15.64％、14.57％、6.44％、5.37％和24.22％、19.85％、14.08％、9.17％.②高脂血症、脂肪肝在陆军航空兵飞行员和空军飞行员各年龄段中均排在前两位.③消化系统疾病与内分泌、营养和代谢疾病在2012年陆军航空兵飞行员和空军飞行员疾病谱中均居前两位,患病率分别是45.66％、26.91％和39.69％、28.37％. 结论 陆军航空兵飞行员主要疾病与空军飞行员基本相似;消化系统疾病及内分泌、营养和代谢疾病是本组飞行员疾病的主要类型;高脂血症、脂肪肝是其主要病种.内分泌、营养和代谢疾病成为影响陆军航空兵飞行员身体健康的重要疾病.     

The hyperechogenic liver in children: cause and sonographic appearance

The clinical records of 28 patients seen in one institution during a recent 2 year period who, on sonography, had been identified as having a hyperechogenic (bright) liver were reviewed. Seven children were diagnosed as having metabolic diseases, four were malnourished, four were receiving hyperalimentation, 10 were receiving chemotherapy, and three were undiagnosed. The sonograms of all the patients and the histologic sections on those who had biopsies, were reevaluated in order to assess the sonographic pattern in greater detail, and these findings were correlated with fatty infiltration and fibrosis of the liver. The bright liver corresponded to the pathologic finding of fatty change. This sonographic finding in children is important, as further evaluation (hepatic biopsy with fat stain, enzymatic analyses, amino acid screens) can be suggested to identify underlying metabolic disorders in those not on therapy. Often the complications of metabolic diseases can be prevented or delayed by early diagnosis and appropriate therapy.     

飞行员年度体检结果分析及医学鉴定

目的 了解高性能战斗机飞行员的患病及医学鉴定情况,探讨常见疾病的发病规律.方法 对250名高性能战斗机飞行员年度体检检出的疾病进行统计分析.按年龄分为5组：≤30岁（Ⅰ组,n=104）,31～35岁（Ⅱ组,n=63）,36～40岁（Ⅲ组,n=55）,41～45岁（Ⅳ组,n=21）,＞45岁（Ⅴ组,n=7）,比较不同年龄组疾病检出情况及医学鉴定情况. 结果 ①检出疾病者占61.20％,检出2种以上疾病者占检出疾病人数的79.74％.医学鉴定结论：飞行合格243名,暂时飞行不合格7名.②不同年龄组疾病检出率差异有统计学意义（χ^2=50.777,P＜0.01）,Ⅰ组明显低于其他年龄组（P＜0.05）.③检出位列前10位的疾病为高脂血症、脂肪肝、高尿酸血症、胆囊息肉、椎间盘突出症、肝血管瘤、肾囊肿、腰椎峡部裂、肝囊肿和肝功能异常.④不同年龄组间,高脂血症、脂肪肝、高尿酸血症、椎间盘突出症、肾囊肿、肝囊肿及肝功能异常检出率差异有统计学意义（χ^2=9.797～56.140,P＜0.01或＜0.05）. 结论 高性能战斗机飞行员罹患病症以与生活方式相关的代谢性疾病为主,椎间盘突出症检出率也较高.应加强对飞行员健康生活方式的引导,加强颈腰背肌专项锻炼,促进飞行员健康.     

4 190名干部体检结果分析

 目的 通过对4 190名干部体检检出病种进行分析,探讨各病种人数、顺位、比例、病因等,为进一步做好中高级干部群体的医疗、保健和康复工作提供参考.方法 主要检测体检对象的血压、血脂、血糖、血尿酸及肝肾功能,并行心电图、X线胸片、超声(肝、胆、肾、脾)及外科、五官科检查,对体检结果进行分析.结果 4 190例次中,检出患病人数3 832例(91.45%),其中,仅患1种疾病者占6.56%,同患2种疾病者占24.43%,3种疾病者占34.05%,4种疾病以上者占25.93%.未发现任何异常的健康人358例(8.55%);不同年龄段脂肪肝、高脂血症、高血压、前列腺增生、血糖异常等的患病率不同,随年龄增长而增加;不同年龄段现患病率差异有统计学意义(P＜0.05).结论 与生活方式、工作习惯相关的疾病如脂肪肝、高血脂、高血压、代谢综合征等已成为中、高级干部的主要病种,做好干部健康体检与宣教工作至关重要.     

Combined action of açai and aerobic exercise training on the development of NAFLD induced by a high-fat diet: a preliminary exploration

Sport Sciences for Health - Non-alcoholic fatty liver disease (NAFLD) is a metabolic condition that comprises a spectrum of liver diseases. Non-pharmacological treatments such as functional food...     

脂肪肝对超声诊断肝纤维化的影响

目的：探讨不同程度脂肪肝对超声诊断肝纤维化的影响。方法回顾性分析我院363例肝病患者,均经肝穿刺活检确诊为肝纤维化,病理分期为S1-S4四期,其中脂肪肝患者223例,无脂肪肝患者140例,按纤维化分期及脂肪肝分度,分别观察肝脏实质回声的改变,采用秩和检验的统计学方法,分析不同程度脂肪肝对肝纤维化超声诊断结果的影响。结果轻度脂肪肝对各程度肝纤维化超声诊断结果的影响差异无统计学意义（P〉0.05）,中、重度脂肪肝使诊断的准确率下降,中度脂肪肝与无脂肪肝组比较,在S1-S2期差异有统计学意义（P〈0.05）,重度脂肪肝与无脂肪肝组比较,在S1-S3期差异有统计学意义（P〈0.05）,S4期的诊断受肝细胞脂肪变性的影响较小,差异无统计学意义（P〉0.05）。结论不同程度脂肪肝对超声诊断肝纤维化存在影响,并可能使诊断结果偏轻于病理结果。     

Asialoglycoprotein receptor function in benign liver disease: evaluation with MR imaging

An arabinogalactan-coated ultrasmall superparamagnetic iron oxide (AG-USPIO) preparation specific for asialoglycoprotein (ASG) receptors on hepatocytes was used as a magnetic resonance (MR) imaging contrast agent in the evaluation of a spectrum of benign liver diseases in animal models. The activity of hepatocyte ASG receptors, which directly reflects liver function, was directly assessed by measuring liver relaxation times in vitro and MR signal intensity in vivo. The following measurements allowed three-dimensional assessment of liver function: (a) liver relaxation time, (b) native MR signal intensities of liver, (c) response of liver to the AG-USPIO probe (percentage decrease of liver signal intensity after intravenous administration of 10 mumol/kg of AG-USPIO: normal liver 55%, fatty liver 57%, acute hepatitis 36%, chronic hepatitis 29%, and cirrhosis 46%), and (d) redistribution of hepatocyte-specific AG-USPIO to the spleen (present in hepatitis and cirrhosis but not in normal liver and fatty liver). The results of this study indicate that cellular hepatic abnormalities can be detected and quantitated with MR receptor imaging.     

Radiorespirometric study of carbohydrate metabolism in childhood liver disease.

The need for a suitable parameter to evaluate patients with chronic liver disease has been felt for some time, especially in order to judge the response to surgical shunts and the influence of certain drugs and diets on the liver. Since the liver is a major organ for carbohydrate metabolism, it was decided to analyze the in vivo oxidation of such substrates as glucose and galactose labeled with 14C. Moderately advanced "Indian childhood cirrhosis" and idiopathic fatty hepatic infiltration were selected to represent diffuse chronic liver disease. Oral administration of 14C-U-glucose or 14C-1-galactose was followed by analyses of 14CO2 in breath by liquid scintillation counting. Conversion of 14C-glucose to 14CO2 was accelerated by both diseases. On the other hand, oxidation of 14C-galactose was slowed in fatty infiltration and was markedly subnormal in Indian childhood cirrhosis.     

Spectrum of CT findings in pediatric patients after partial liver transplantation.

Liver transplantation is an accepted therapy for patients with severe liver diseases. In pediatric liver transplantation, the application of reduced-size and split-liver transplantation has expanded the donor pool. The development of living related donor partial liver transplantation has further increased the availability of donors. Complications in patients after living related transplantation include hepatic arterial thrombosis, portal venous stenosis and thrombosis, hepatic venous stenosis, biliary stenosis or leak, biloma formation, fatty liver, extrahepatic fluid collection, posttransplantation lymphoproliferative disorder, and organ rejection. Ultrasonography is the primary imaging modality for evaluation of the vascular system of patients after liver transplantation, and computed tomography is useful to help diagnose hepatic parenchymal abnormalities including infarction, congestion, and fatty change; intrahepatic biliary damage; and extrahepatic disorders, including abnormal fluid collections, varicose veins, and lymphadenopathy.     

Chronic liver disease: value of volumetry of liver and spleen with computed tomography

Volumetric comparisons of portions of liver and spleen were performed in patients with chronic liver diseases to determine their diagnostic value. Volumetric ratios of liver and spleen were determined by CT examination in 34 normal subjects and 125 consecutive patients with histologically proved liver cirrhosis, chronic active hepatitis, chronic persistent hepatitis, acute hepatitis, or fatty liver. Ratios of caudate lobe, spleen, and lateral segment of the left lobe of the liver to the remainder of the liver, right lobe and medial segment of the left lobe (RL+LM), were calculated. The product of caudate lobe/RL+LM and spleen/RL+LM was of value in differentiating liver cirrhosis from other liver disease, with a sensitivity of 60%, specificity of 98%, and accuracy of 86%. The same ratios differentiated liver cirrhosis and chronic active hepatitis from other liver diseases with a sensitivity of 79%, specificity of 100%, and accuracy of 90%. Volumetric ratio measurements are useful in the diagnosis of cirrhosis and chronic active hepatitis.     

Role of exercise in the mechanisms ameliorating hepatic steatosis in non-alcoholic fatty liver disease

Hepatic steatosis is an abnormal lipid accumulation within hepatocytes, generally present in non-alcoholic fatty liver disease (NAFLD) patients, a starting-point pathology currently associated with other clinical manifestations such as metabolic syndrome, non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and eventually hepatocellular carcinoma. Hepatic steatosis in NAFLD may be induced by mechanisms such as insulin resistance, increased fatty acid uptake, a higher de novo lipogenesis from glucose or acetate, lower fatty acids oxidation and a decrease in fatty acid mobilization from liver. Among different therapeutic strategies appropriate for these patients, exercise has shown to be effective in reversing hepatic steatosis. However, the specific mechanisms involved in this response remain unclear. Therefore, the aim of this review is (1) to describe the mechanisms whereby exercise reverts hepatic steatosis, and (2) review the clinical outcomes of different exercise modalities in NAFLD parameters. Therefore, this knowledge may provide the basis suggesting potential clinical benefits of exercise as an adjunct therapy for patients with NAFLD and associated metabolic diseases.     

长链非编码RNA在非酒精性脂肪性肝病中作用机制的研究进展

随着肥胖和糖尿病的高发,非酒精性脂肪性肝病（non-alcoholic fatty liver disease,NAFLD）现已成为我国常见的慢性肝病之一,严重危害人民健康。在NAFLD的发生发展过程中,细胞中各种物质代谢失调是重要原因。长链非编码RNA（long non-coding RNA,lncRNA）可调控多种基因表达进而影响细胞内物质代谢,参与NAFLD的发生发展。作者综述了lncRNA在NAFLD中作用机制的研究进展。     

2009-2013年民航飞行人员年度体检疾病谱分析

目的 分析民航飞行人员年度体检高发疾病谱的特点及其演变规律,为民用航空卫生保障工作提供参考依据. 方法 收集2009-2013年某航空公司参加年度大体检的飞行人员的体检资料,统计主要疾病的构成情况,分析飞行人员高发疾病近5年的演变趋势,并比较高发疾病在不同职务、年龄、飞行时间飞行人员之间的差异. 结果 屈光不正居各年度体检疾病谱首位,其次为高脂血症、脂肪肝.2013年民航飞行人员年度体检疾病谱的前10位疾病是屈光不正、高脂血症、脂肪肝、高尿酸血症、听力损失、胆囊息肉、老视、腰椎间盘突出、心律失常及高血压病.高尿酸血症的检出率逐年上升,2013年明显高于2009年（χ^2=198.28,P＜0.01）;2013年屈光不正、脂肪肝、胆囊息肉的检出率明显高于2009年（χ^2 =56.27、13.98、8.12,P＜0.01）;听力损失、老视、腰椎间盘突出的检出率呈下降趋势,2013年明显低于2009年（χ^2=10.24、44.99、30.58,P＜0.01）.高脂血症、脂肪肝、高尿酸血症、胆囊息肉、听力损失、老视、心律失常和高血压病多见于驾驶员（χ^2=73.62～1 940.13,P＜0.01）,而屈光不正和腰椎间盘突出多见于乘务员（χ^2=1 869.64、43.48,P＜0.01）.高脂血症、脂肪肝、胆囊息肉、听力损失、老视及高血压病的患病率随年龄及飞行时间的增长而升高（P＜0.01）. 结论 掌握不同职务、年龄、飞行时间飞行人员的高发疾病谱,有利于针对性地开展飞行人员的健康维护,提高航卫保障水平.     

北京社区老年人群超重/肥胖与慢性疾病关系的调查

目的　调查北京社区老年人超重/肥胖的发生率与慢性疾病的关系。方法　随机抽取 134个社区共计 15 13位老年人进行了横断面调查 ,详细调查病史并全面查体 ,测量体重指数等。结果　北京社区老年人超重和肥胖率分别为 4 8 9%和 12 8% ,仅有 36 5 %的人体重正常。各种慢性病的发病率为 :高血压病 4 8 0 % ,冠心病 4 5 0 % ,糖尿病 4 4 9% ,脑血管病 10 2 % ,高脂血症 4 9 5 % ,慢性支气管炎18 9% ,慢性肾功能不全 3 4 % ,胆结石 4 8% ,脂肪肝 4 7 9% ,痔疮 4 2 % ,白内障 4 9 2 % ,前列腺肥大 5 2 8% ,高尿酸血症 17 1%。超重 /肥胖者高血压病、冠心病、糖尿病、高脂血症、高尿酸血症和脂肪肝的发病率明显高于正常体重者 (P <0 0 1)。多因素回归分析显示 ,体重指数与高尿酸血症和脂肪肝呈显著正相关 (P <0 0 1) ,与高血压病和冠心病亦非常接近正相关。结论　北京社区老年人超重 /肥胖情况较为严重 ,并且与多种慢性疾病的发病有密切关系。