招飞青年运动试验后血尿和蛋白尿动态观察

目的：探讨运动试验后血尿和蛋白尿变化规律以及在飞行员医学选择中的价值。方法：应招青年435人,分别在运动试验瓣和运动试验后0．5、2．5、4．5、6．5、8．5及18h（次日晨）留取尿样作沉渣镜检,同时用尿液分析仪检测尿红细胞和尿蛋白。结果：运动试验前血尿阳性发生率为8．97％,并持续至运动试验后次日晨;运动试验前血尿和蛋白尿阴性者运动试验后阳性发生率均在0．5h达到高峰,在2．5h时即显著下降,少数受检者可持续至运动试验后次日晨;运动试验前蛋白尿阳性者在运动试验后不同时间段阳性率依次下降,部分受检者也可持续至次日晨。结论：运动试验后血尿和蛋白尿在不同时间段的变化有一定的规律,运动试验后次日晨检测对进一步明显成因、防止漏检、误淘以及减少医学停飞可能有一定的指导意义。     

航校飞行员飞行前后及运动前后血尿蛋白尿发生率分析

目的探讨航校飞行员飞行前后及运动前后血尿、蛋白尿发生率及在航空医学鉴定中的价值。方法212例航校飞行教员和学员为受试对象，用干化学法筛查飞行前后及运动前后血尿、蛋白尿。以镜检法红细胞≥3个／HP；加热醋酸法尿蛋白≥( )者为阳性判定值，统计其阳性发生率。结果血尿、蛋白尿阳性发生率特点是：运动后血尿、蛋白尿的发生率高于飞行后；运动后蛋白尿的发生率明显高于血尿的发生率；飞行学员运动后血尿、蛋白尿的发生率明显高于飞行教员。飞行后血尿、蛋白尿的发生率较低；飞行后发生血尿、蛋白尿者运动后同样产生血尿、蛋白尿。飞行前或运动前有轻度血尿者，在飞行后或运动后血尿仍为阳性，个别血尿程度加重。结论建议建立和完善尿液检测标准化方法和制度。飞行员无症状血尿、蛋白尿的防治以个体化防治为宜。运动试验可用做评价肾功能状态的客观方法。     

干化学分析与沉渣镜检相结合在招飞体检尿常规检测中的运用

目的通过尿液分析仪检测与尿沉渣镜检法的比较分析，探讨两法间的差异。方法招飞体检青年573人，按要求留取尿样，2h内完成两种方法检测。结果两法综合分析：红细胞总符合率为97．4％；白细胞总符合率为98．4％。结论为避免招飞体检中的漏淘和误淘，在尿常规检测中必须做到仪器和镜检相结合。     

招飞体检504人尿液分析

目的对招飞体检尿常规检测异常结果进行分析,进一步提高尿检合格率.方法招飞体检学生504人,按要求留取尿样,2 h内完成尿液干化学分析及沉渣镜检.结果尿液常规检测阳性率为22.6%;其中尿蛋白占9.6%,尿糖占5.3%,红细胞占27.2%,白细胞占51.8%,红、白细胞结果均阳性者占6.1%.结论为提高尿检合格率,在参检前1～2 d学生应洗澡,适当多饮水、不要喝含糖较高的饮料,不做强度大的体育活动.     

彩色多普勒超声对运动性蛋白尿/血尿的肾脏血流动力学观察

目的:探讨寒冷条件下、战士运动后出现蛋白尿与血尿的肾脏血流动力学变化情况。方法:以我军某部700名战士作为实验对象,室外温度-10℃~0℃时组织进行5km越野训练(30min),训练后留取尿样并检测,出现蛋白尿/血尿者为实验组,其余随机选取一组为对照组;应用彩色多普勒超声仪检查2组受检者的肾脏血流灌注情况及肾脏各级动脉血流动力学参数。结果:蛋白尿49例,血尿11例,蛋白尿/血尿发病率为8.57%;收缩期峰值血流速度、舒张期最低血流速度、阻力指数和搏动指数在各级肾动脉表现出不同的特点。结论:超声检查可以反映运动条件下人三级肾动脉的血流动力学改变,可为研究运动性肾损害提供信息。     

招飞体检尿液沉渣镜检方法对比分析

目的 探讨现行招飞体检尿液沉渣镜检方法的灵敏性与准确性,以确定其价值。方法 凡在应招青年尿液高倍镜下每视野查出红细胞多于1个者,均同时用《全国临床检验操作规程》和全军《医疗护理技术操作常规》中的尿液沉渣镜检方法对照检测,并分别计数每微升尿液沉渣中有形成分的数量。结果 共查出101例。对照结果发现招飞体检与《全国临床检验操作规程》尿液沉渣镜检方法检测的红细胞、白细胞、上皮细胞数有显著性差异;与全军《医疗护理技术操作常规》方法检测结果比较差异性不显著。结论 不同的尿液沉渣镜检方法检测结果有明显差异。《全国临床检验操作规程》尿液沉渣镜检法敏感性强,检出率高,计数每微升结果准确,重复性好,建议招飞体检选用。     

招飞体检中电脑验光的结果分析（摘要）

目的通过电脑验光对招飞体检人员的视力与屈光检测,为招飞体检提供可靠的实验数据。方法选取1010例参加招飞体检男性高中毕业生的2020眼,用复方托品酰胺散瞳后先后进行电脑验光及检影验光,比较验光符合率。结果合格组两种验光的符合率为100％,不合格组检影验光与电脑验光结果存在差异。结论电脑验光是快速和有价值的屈光筛选方法;     

心型脂肪酸结合蛋白和糖原磷酸化酶BB检测在招飞体检中的应用研究

目的 探讨心脏缺血损伤标志物心型脂肪酸结合蛋白(heart type-fatty acid-binding protein,H-FABP)和糖原磷酸化酶BB(glycogen phosphorylase BB,GPBB)检测在招飞体检中的应用价值. 方法 80名参加招飞体检的学生,按心电图正常与否分为两组.心电图异常组:静息和平板运动后心电图异常者50人;对照组:心电图正常者30人.采用酶联免疫吸附法检测招飞学生平板运动试验前和运动后即刻、8h、24 h血液H-FABP和GPBB浓度.采用重复测量方差分析比较两组结果,组内两两比较采用SNK检验. 结果 两组招飞学生血清H-FABP和GPBB浓度平板运动试验前后差异有统计学意义(F=29.000～67.494,P＜0.01),运动后较运动前均显著升高,以运动后8h水平最高,24 h后有所回落.无论运动前还是运动后各时间点,两组间血清H-FABP和GPBB浓度差异均有统计学意义,心电图异常组显著高于对照组(F=4.100～23.051,P＜0.01或0.05).结论 H-FABP、GPBB血液浓度检测反映了平板运动时心肌利用供能物质和细胞膜通透性的变化,可为招飞体检心脏功能评定提供参考.     

尿10项分析仪应用于招飞体检的价值

采用常规尿液检测方法及美国AMES公司生产的CLINITEK100型尿10项分析仪（以下简称分析仪），分别对401例临床病人、300树参加招飞体检的应招青年、201倒在校飞行学员进行了尿液检测，并比较了两种方法的敏感性、可靠性和实用性，以探讨尿10项分析仪在招飞体检中的应用价值。尿10项分析仪检测使用有效期内的专用试剂带，各项操作方法及结果判定按说明书要求。常规检测方法按《全国临床检验操作规程》的要求进行操作及结果判定。两种检测方法用同一份尿液，以避免标本误差。结果显示，三组人群的尿PH、比重二项，两种检测方法结果均一致…     

招飞体检中轻度上颌窦炎声导抗检测结果临床分析

目的：调查招飞体检中轻度上颌窦炎声导抗检测咽鼓管功能是否符合招飞标准。方法对42名招飞体检中轻度上颌窦炎的学生和42名招飞体检中正常学生行鼓室声导抗测试，对比结果。结果轻度上颌窦炎的患者中咽鼓管功能异常率为53．6％，鼓室导抗图异常率为52．4％，与正常学生组相比，差异有统计学意义（ P＜0．01）。结论轻度上颌窦炎易引起咽鼓管功能的改变，咽鼓管功能异常的发生率较正常学生显著增高。     

Hematuria and microalbuminuria after a 100 kilometer race

An investigation into hematuria and microalbuminuria induced by prolonged physical exercise was carried out by studying 26 runners who took part in a 100 km race by collecting urine samples before, after the race, and 24 hours later. Microscopic hematuria was present in two runners before the race. After this strenuous exercise there was macroscopic hematuria in five runners (19.2%) and microscopic hematuria in nine (34.6%). On examination by phase contrast microscopy there were neither dysmorphic erythrocytes nor red cell casts. Albuminuria was measured by radial immunodiffusion and was expressed as Ualb/Ucreat and Ualb/Uosm ratios. Clinical albuminuria was found in five runners with macroscopic hematuria, and microalbuminuria in 13 of the 21 remainders; in 6 of them it was associated with microscopic hematuria. Twenty-four hours later all of the results were normal with the exception of the five runners who have had macroscopic hematuria and another one with microalbuminuria without hematuria. We conclude that determination of albumin excretion in runners after exercise should be made as well as hematuria, and particular attention should be paid to cases of severe and/or prolonged microalbuminuria, since such individuals may be at risk of renal disease.     

中美空军飞行学员医学选拔对照实证研究——髂胫束发育不良与挛缩

目的 探讨中美空军飞行学员髂胫束发育不良与挛缩医学选拔标准的异同,并对我军标准的修订提供依据.方法 调查我军2012—2015年招飞定选体检中髂胫束发育不良与挛缩淘汰率与综合评定率,对比我军与美军飞行学员选拔髂胫束发育不良与挛缩医学标准,并进行实证研究.结果 髂胫束发育不良与挛缩淘汰人数每年均较少,4年共28例,占骨科疾病淘汰人数的14.2%;2014年髂胫束发育不良与挛缩患者获得综评合格的有5例,2015年获得综评合格的髂胫束发育不良与挛缩应征者7例,占骨科疾病获得综评合格总人数的5.1%.美军标准中没有直接的髂胫束发育不良与挛缩标准条目,而是从功能出发,对髂胫束发育不良与挛缩可能造成的症状和体征进行了全面的规定.2012—2015年因髂胫束发育不良与挛缩而淘汰的28例应征者以及2014—2015年综评合格的12例应征者,按照美军标准应全部合格.结论 我军关于髂胫束发育不良与挛缩标准需进一步研究评估,使其更加科学、客观.     

民航体检标准研究和二维双因素理论框架

通过对国内外空军与民航招飞体检淘汰结构分析，简述了民航体检标准研究的理论框架，即医学与心理学、筛选与控制的二维双因素理论框架的提出和发展。并从民航体检标准的原则性和灵活性出发，提出对民航体检医师的资格考核和分级授权的建议。     

招飞体检中常见周边部视网膜变性及其评定原则（摘要）

本文着重介绍了招飞体检中常见周边部视网膜变性的临床特点、病理特点、具体评定原则和方法。建议：重视三面镜检查,掌握常见视网膜变性的特征非常重要。     

招收飞行学员听力检查标准的研究

目的 通过分析招收飞行学员的纯音听阈及文献复习,提出新的招收飞行学员听力检查标准.方法 对2666名青年学生按空军统一听力检查方法进行纯音测听检查,测听频率为250～8000 Hz,分析其80%、90%、95%、99%百分位值.查阅外军飞行员选拔听力检查标准,与我军听力检查标准进行对比.结果 在第1次检查的2584耳中,80%的学生高频听力在正常范围.6000 Hz听力损失的程度和比率较高,90%分位值为30 dB,95%分位值为35 dB,99%分位值为55 dB;其次是4000 Hz和8000 Hz,95%分位值为25 dB,99%分位值为40 dB.在第2次检查的2748耳中,也有80%的学生高频听力在正常范围.6000 Hz和8000 Hz处听力损失的程度和比率较高,95%分位值为30 dB,99%分位值是45 dB;其次是4000 Hz,99%分位值是40 dB.结论 建议我军招收飞行学员听力检查标准,500～2000 Hz小于25 dB,3000 Hz、4000 Hz和6000 Hz平均听阈不超过40 dB;将低频250 Hz和高频8000 Hz两个频率去除. Abstract： Objective To raise new hearing examination standard for the selection of flying cadets by analyzing the pure tone threshold of audibility and reviewing related literatures.Methods Two thousand six hundred and sixty-six flying cadet candidates were tested by Audiomer.Testing frequencies were from 250 to 8000 Hz.Percentiles of 80%, 90%, 95% and 99% were analyzed.In literature review foreign military hearing examination standards were compared with China's.Results Hearing threshold of 80% candidates was normal in the first test of 2584 ears.Obvious audibility loss and high ratio were found at 6000 Hz and were respectively 30 dB, 35 dB and 55 dB corresponding to the percentiles of 90%, 95% and 99%.2748 ears were examined in second test and 80% of them showed normal value in high frequency range.6000 Hz and 8000 Hz were the frequencies where obvious audibility loss and high ratio of amblyacusia appeared, that was 30 dB loss for 95%percentile and 35 dB for 99 % respectively.Then 40 dB loss for 99 % percentile was got at 4000 Hz.Conclusions It is suggested that hearing standard for the selection of flying cadet should be revised and the tests at 250 Hz and 8000 Hz could be cancelled.New hearing exam standard could be suggested as less than 25 dB loss for 500-2000 Hz tests and the average hearing threshold couldn't exceed 40 dB corresponding to the tests at 3000 Hz, 4000 Hz and 6000 Hz.     

Exercise-induced urinary abnormalities in long-distance runners

The post-exercise urine samples from 122 long-distance runners showed evident abnormalities upon microscopic examination in 95% of all subjects. Proteinuria, alone or with microscopic hematuria, was frequently found. Macroscopic hematuria was a rare occurrence. The urine samples collected in 30 runners before, immediately after the race, and 6, 12, 24, 36, and 48 h later showed a significant post-race decrease in the osmolarity and a significant increase in gamma-glutamyl transferase and N-acetyl-beta-glucosaminidase enzyme activity. Plasma renin activity and plasma aldosterone, determined before and after the race in nine runners, showed a significant increase in the post-race samples. The abnormal urinary findings disappeared in all cases within 24-36 h. It can be concluded that urinary abnormalities are very common after exercise. These abnormalities are most often of a "renal" origin, probably due to a temporary hemodynamic impairment, partially of glomerular but principally of tubular function.     

Urinary excretion of free noradrenaline and adrenaline in trained and untrained men.

Measurements of free noradrenaline and adrenaline were made in the urine of 28 men sampled after rest and exercise prior to, and following six and twelve weeks of an excercise programme. The training consisted of thirty minutes of running and walking four times per week at an intensity estimated at 75% of the age-predicted maximum heart rate. A fifteen minute standardized cycle ergometer work test was conducted on all subjects prior to the training and following six and twelve weeks of training. Noradrenaline and adrenaline excretions in the urine were measured before and after the work test.