歼击机飞行员腰背痛发病特征及康复治疗现状调查

背景 随着空军飞行员训练的深入及飞行装备的更新换代,腰背痛成为影响歼击机飞行员飞行安全和飞行效能的关键因素。目的 调查空军歼击机飞行员腰背痛发病的最新流行病学特征、康复治疗现状,分析其影响因素。方法 2020年7月-2021年3月,采用分层整群随机抽样的方法选取323名男性歼击机飞行员进行问卷调查,该问卷由人口统计学数据、飞行训练、腰背痛情况和生活方式等内容组成。对腰背痛情况和关联因素进行单因素分析和多因素回归分析。结果 调查对象的年龄分布为23～47(33.12±5.52)岁。调查回收有效调查问卷304份。歼击机飞行员腰背痛的年发病率为62.5%(190/304),3个月发病率为51.0%(155/304),疼痛程度以中度疼痛为主,占比52.1%。总飞行时长≥2 000 h(P=0.001)、高性能歼击机飞行员(P=0.035)、飞行座椅不合适(P=0.019)是歼击机飞行员腰背痛的重要危险因素,飞行后行腰背肌锻炼(P=0.005)是腰背痛的重要保护因素。核心力量训练和物理治疗是现有腰背痛飞行员最常采用的康复治疗方法。结论 歼击机飞行员腰背痛发病率高、疼痛程度较重、对飞行和生活影响大...     

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。     

空军歼击机飞行员高脂血症患病率及特点

目的:研究中国空军歼击机飞行员高脂血症患病率及特点,以便采取防治措施。方法:对入院体检的800名男性歼击机飞行员测定空腹血脂水平。参照我国“血脂异常防治建议”对结果进行分析。结果:本组飞行员高脂血症患病率为57.00%。其中高TG血症占23.75%;高TC血症占17.13%;低HDL-C血症占10.13%;混合型高脂血症占6.00%。结论:空军歼击机飞行员高脂血症的患病率高于一般人群,应加强对该病症的预防和治疗。     

一汽职工脂肪肝现状调查

目的调查一汽职工脂肪肝的现状,探讨发病因素,研究预防措施。方法对在体检中心作健康体检的职工进行身高、体重、肝脏B超、肝功能、血脂等检测。结果10541例体检者中脂肪肝平均患病率为16.30%,随年龄增高脂肪肝患病率增高,且不同劳动强度组比较,脂肪肝患病率有显著差异,高胆固醇、高甘油三酯、单纯肥胖、常饮酒、高血糖、HbsAg( )等为脂肪肝的危险因素。结论一汽职工脂肪肝患病率相对较高,且以高胆固醇、高甘油三酯为首要危险因素,因脂肪肝可导致肝纤维化、肝硬化,因此应加强对脂肪肝的防治工作。     

歼击机飞行员鼻窦冠状扫描CT影像分析

目的 了解歼击机飞行员鼻罕炎发生率及相关因素,方法 同期对歼击机飞行员５７人和地勤人员２８人行鼻空运ＣＴ冠状扫描检查,进行鼻罕炎发生率的比较以及飞行员组鼻空运炎与窦口鼻道复合体病变关系的比较。结果 歼击机飞行员鼻窦炎患病率４９．１％,显高于对照组２１．４％（Ｐ〈０．０５）。歼击机飞行人员组 着年龄增长,飞行时间增加,鼻罕炎患病率亦增加,鼻罕炎患罕口鼻道复合体病变明显增加。结论 飞行 员鼻罕炎发     

某市公务员脂肪肝患病状况及危险因素分析

目的:探讨某市公务员脂肪肝患病状况及危险因素.方法:采用logistic回归对10 097份公务员健康体检资料进行分析.结果:脂肪肝患病率为20.33%,男性脂肪肝的患病率明显高于女性,是女性的5.49倍;随年龄增加,保健级别的升高,脂肪肝患病率逐渐增高.性别、年龄、保健级别、饮酒、体重指数(Body mass index,BMI)、血糖、尿酸、甘油二酯、胆固醇、转氨酶(Aminotransferase,ALT)与脂肪肝的发生密切相关;其中BMI、甘油二酯、性别是最主要的相火因素,其OR值分别为3.780、2.802、2.650.结论:高体重指数者、高甘油三酯者及男性是公务员脂肪肝的高风险人群.     

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。     

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。     

超重和肥胖人群非酒精性脂肪肝的流行现状及相关危险因素分析

目的:探讨超重和肥胖人群非酒精性脂肪肝的患病率及分析非酒精性脂肪肝的相关危险因素。方法:按照随机分层整群抽样方法对2300例来自上海、无锡、苏州、常州地区来我院体检的18岁以上成年人进行调查,内容包括询问病史、体格检查、血生化检查、腹部彩色B超等,统计非酒精性脂肪肝的患病率并分析相关危险因素。结果:2300例成年人中共检出非酒精性脂肪肝患者453例,设为非酒精性脂肪肝组,非酒精性脂肪肝的患病率是19.7%;按体重指数分层后,肥胖人群非酒精性脂肪肝的患病率为68.1%,明显高于超重人群(27.6%)和正常体重人群(6.1%),与485例正常对照组相比较,非酒精性脂肪肝组的体重指数(BMI)、血压(SBP/DBP)、空腹血糖(FPG)、血甘油三酯(TG)、血总胆固醇(TC)、低密度脂蛋白(LDL)、血尿酸(UA)均值明显高于正常对照组,差异有统计学意义(P<0.01);非酒精性脂肪肝组超重或肥胖、高血压病、2型糖尿病、高脂血症及肝功能异常的患病率明显高于正常对照组(P<0.01)。结论:超重和肥胖人群非酒精性脂肪肝的患病率较高,非酒精性脂肪肝的发生与超重或肥胖、高血压、高血糖、高血脂等代谢紊乱危险因素的聚集密切相关。     

乌市水磨沟区维吾尔族和汉族脂肪肝患病率及其危险因素流行病学调查

目的：明确水磨沟区维吾尔族和汉族脂肪肝的患病情况及主要危险因素。方法：以在新疆乌鲁木齐市六道湾职工医院进行体检人员为研究对象,分析其体检结果和血液生化检测结果,包括血压、体重指数、空腹血糖、血脂、腹部B超等检查。结果：2567名体检居民脂肪肝检出率为27.35%。酒精性、可疑酒精性、非酒精性脂肪肝占脂肪肝的比例分别为39.12%、10.24%、50.64%。汉族和维吾尔族的脂肪肝患病率分别为22.75%和39.02%,存在统计学意义（P〈0.05）。多因素非条件Logistic回归分析显示年龄、高血脂症、2型糖尿病、高血压、肥胖、饮酒均为脂肪肝发病的危险因素（P〈0.01或P〈0.05）。结论：维吾尔族脂肪肝的患病率较高,年龄、饮酒、体重指数、糖脂代谢紊乱与脂肪肝的关系更为密切。     

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.