某学院飞行人员颈腰痛患病情况调查分析

目的：了解飞行员、飞行学员及机务人员颈腰痛的患病情况及发病因素。方法调查分析2001例资料,比较分析飞行员、飞行学员及机务人员颈腰痛的情况。结果飞行学员颈腰痛患病率为19．3％,飞行员颈腰痛患病率为43．0％,机务人员颈腰痛患病率为31．9％。歼击机飞行（学）员颈腰痛患病率为29％,运输机飞行（学）员颈腰痛患病率为44．1％,直升机飞行（学）员颈腰痛患病率为37．4％。飞行（学）员颈腰痛患病危险因素包括年龄、飞行时间、吸烟史、体质量指数和腰背肌锻炼。结论飞行员颈腰痛患病率高于飞行学员及机务人员,运输机飞行（学）员颈腰痛患病率较高,飞行时间是飞行（学）员颈腰痛患病的最危险因素,腰背肌锻炼是保护因素。应重视飞行（学）员及机务人员颈腰痛的预防,研发有针对性的防护措施。     

鼻内镜下窦口鼻道复合体微创手术治疗慢性鼻窦炎的探讨

目的探讨微创手术窭口鼻道复合体对治疗慢性鼻窦炎的疗效。方法在鼻内镜下对60例（90侧）慢性鼻窭炎患者进行窦口鼻道复合体微创手术，观察疗效，同时随机选择60例（90侧）以传统方法治疗作对照。结果观察组治愈率76．67％（69／90），好转率13．33％（12／90），显著优于传统术式（p〈0．01）结论鼻内镜下窦口鼻道复合体微创手术有利于改善引流，恢复鼻腔、鼻窦的生理功能，促进鼻窭的慢性炎症消除。     

鼻渊舒口服液对FESS术后早期恢复的影响

目的在功能性内镜鼻窦手术术后应用鼻渊舒口服液,探讨其对FESS术后窦口鼻道复合体早期恢复阶段的影响并分析其意义。方法 2003年9月至2004年5月收治成人慢性鼻窦炎患者100例,随机分为空白对照组(C)及3个试验组:阿莫西林组(S1)、鼻炎丸组(S2)和鼻渊舒组(S3),每组25例。术后3周比较恢复评分(RS)及窦口鼻道复合体需氧菌培养阳性率(ACRO),并比较术后6个月疗效。结果术后3周恢复评分鼻渊舒组与其他各组差异有统计学意义(P<0.01),术后3周ACRO及术后6个月疗效比较,鼻渊舒组与其他各组差异无统计学意义(P>0.05)。结论鼻渊舒口服液可能对窦口鼻道复合体的微生态系有一定调节作用,因此对FESS术后早期窦口鼻道复合体的恢复有明显促进作用,从而影响其早期良性转归。     

改装体检直升机和歼击机飞行员颈腰椎病症比较

摘要：目的比较改装体检直升机和歼击机飞行员的颈腰椎病症状况。方法1127名飞行员改装体检时（直升机飞行员149名,歼击机飞行员978名）,全部行颈腰椎x线和L4、L5螺旋cT检查;统计两组资料颈腰椎病症的总检出率,并分别统计颈椎病症、腰椎弓峡部裂和其他腰椎病症的检出率及对改装体检结论的影响。结果直升机飞行员颈腰椎病症的总检出率为41．6％（62／149）,高于歼击机飞行员的28．3％（277／978）（X2=5．65,P〈0．05）。直升机飞行员颈椎病症的检出率为9．4％（14／149）,高于歼击机飞行员的5．2％（51／978）（X2=4．16,P〈0．05）;直升机飞行员腰椎弓峡部裂的检出率为4．0％（6／149）,与歼击机飞行员的6．9％（67／978）的差异无统计学意义;直升机飞行员其他腰椎病症的检出率为28．2％（42／149）,高于歼击机飞行员的16．3％（159／978）（Y。12．56,P〈0．01）。直升机飞行员因颈腰椎病造成改装体检飞行不合格的比率为0,歼击机飞行员为2．4％（23／978）,差异有统计学意义（X2=10．23,P〈0．01）。结论颈腰椎病症在改装体检直升机飞行员中的检出率很高,应作为高性能武装直升机飞行员重点随访内容之一。     

直升机飞行员与歼击机飞行员听力比较

目的比较陆军直升机飞行员与空军歼击机飞行员的听力资料,观察不同机种飞行员的听力差别。方法收集处于飞行合格状态的陆航部队157例直升机飞行员听力资料和空军105例歼击机飞行员听力资料,分别比较纯音测听在0.25、0.5、1、2、3、4、8 k Hz时和言语频率、全频左右耳听阈差别,及两组噪声性聋的发生率。结果 0.25 k Hz,直升机飞行员平均听阈(左耳9.78±5.50,右耳9.27±4.49)小于歼击机飞行员(左耳11.52±3.41,右耳10.86±2.54),差异有统计学意义(t=2.903、t=3.648,P<0.01)。0.5 k Hz,直升机飞行员平均听阈(左耳9.59±4.12,右耳8.89±3.95)小于歼击机飞行员(左耳10.71±2.34,右耳10.43±1.98),差异有统计学意义(t=2.817、t=4.179,P<0.01)。言语频率,直升机飞行员右耳平均听阈(9.85±3.79)小于歼击机飞行员(10.75±2.39),差异有统计学意义(t=2.356,P<0.05)。全频,直升机飞行员右耳平均听阈(10.66±4.09)小于歼击机飞行员(11.60±2.98),差异有统计学意义(t=2.027,P<0.05)。其他频率,两组噪声性聋的发生率,差异无统计学意义。全部飞行员均达到飞行人员体格检查标准对纯音听阈的要求。结论直升机飞行员听力状况整体优于歼击机飞行员,与直升机飞行员的防护意识强有关。     

前组鼻窦炎与窦口鼻道复合体改变的CT分型

目的:研究鼻窦炎与窦口鼻道复合体之间的关系。方法:回顾临床证实的前组鼻窦炎53例,分析窦口鼻道复合体的改变。结果:根据其影像学表现将其分为5型,①窦口鼻道复合体无改变型;②筛漏斗型;③鼻额管型;④窦口鼻道复合体型;⑤鼻息肉型。结论:提高认识水平,为内镜检查和手术提供更多信息。     

空军战斗机飞行员脂肪肝患病率及危险因素研究

目的:了解空军歼击机飞行员脂肪肝患病率及危险因素,以便采取预防措施。方法:对入院体检的662名男性歼击机飞行员进行肝脏B超检查,测身高、体重和清晨空腹血脂,并进行有关因素的调查登记。危险因素的确定采用单因素和多因素Logistic回归分析方法。结果:本组飞行员脂肪肝患病率为9.7%。脂肪肝的危险因素为:饮酒、体重指数、高甘油三酯血症、飞行总时间、年龄,其优势化(OR)值以饮酒为最高(11.60)。结论:空军歼击机飞行员脂肪肝患病率高于一般人群和民航飞行人员,应加强对可控危险因素的干预。     

改装体检歼击机飞行员睡眠打鼾调查

摘要：目的调查歼击机飞行员睡眠中打鼾现状,为阻塞性睡眠呼吸暂停综合征的预防提供航卫保障建议。方法对2008年9月一2012年5月在我院进行高性能战斗机改装体检的健康歼击机飞行员开展自制睡眠问卷调查、Epworth嗜睡程度问卷,并收集颈围、身高及体重数据。计算健康歼击机飞行员睡眠打鼾率的发生,并比较打鼾飞行员与非打鼾飞行员晨起头痛发生情况、白天困倦感、记忆力下降、空中错忘漏动作发生等的差别。结果歼击机飞行员平均睡眠时间为7．71h。嗜睡量表（epwo~hsleepinessscale,ESS）平均分为6．79分。睡眠中打鼾发生率为22．94％,其中35岁以上飞行员睡眠打鼾发生率为37．5％。打鼾飞行员晨起头痛、记忆力下降及空中错忘漏动作的发生率明显高于睡眠中无打鼾症状者（P〈0．05）。打鼾飞行员颈围、体质量指数及ESS评分与无打鼾飞行员相比存在统计学差异（P〈0．05）。结论歼击机飞行员打鼾存在一定安全隐患,应注意追踪随访。     

东北地区某部歼击机各年龄段飞行员血脂异常分布调查

目的:调查东北地区某部歼击机各年龄段飞行员血脂异常分布,加强对飞行员血脂异常预防。方法:对138名健康,年龄为22～50岁的歼击机飞行员按年龄进行分组,采用全自动生化分析仪对其总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)进行分析。结果:A组TC、TG检测结果与B、C组比较差异有统计学意义(P<0.05),血脂异常的比例A组TC、TG分别为1.4%和8.5%;B组TC、TG分别为10.6%和17.0%;C组TC、TG分别为10.0%和10.0%。结论:本组资料显示B组歼击机飞行员TG较其他组歼击机飞行员增高显著本。血脂异常对歼击机飞行员飞行安全存在潜在威胁,应建立一套有效加强预防飞行员高脂血症的发生机制,控制疾病的发生,以延长飞行寿命,保障飞行安全。     

鼻内窥镜下窦口鼻道复合体手术治疗前组付鼻窦炎

目的：报告在鼻内窥镜下行窦口鼻道复合体手术治疗前组鼻窦炎、鼻息肉３０例。方法：对我科施行鼻内窥镜下窦口鼻道复合体手术病历完整，随访观察３个月以上的３０例病例进行回顾性分析总结，结果：治愈２５例（占８３３３％）；好转３例（占１０％）；无效２例（占６６７％），总有效率为９３３３％。结论：本术式手术并发症低，且解决了传统术式疗效不理想的问题     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.