糖尿病并发脑梗塞浅析

本文观察102例经CT证实确诊为脑梗塞的病人，并对其中12例糖尿病并发脑梗塞报告如下：本组12例，男7例，女5例，年龄39～72岁，平均58岁。均符合1998年世界卫生组织糖尿病“糖尿病专家委员会”的糖尿病诊断标准。随机血糖≥11．1mmol／L和（或）空腹血糖≥7．8mmol／L，或口服75克葡萄糖耐量试验2小时后血糖≥11．1mmol／L。其中无糖尿病症状者7例，平均均年龄52岁；入院后24小时内空腹血糖11．1～20．5mmol／L，，平均15mmol／L。有糖尿病病史者5例，平均63岁；病程1～12年，平均9年，4例空腹血糖＞7．8mmol／L，1例口服糖耐量试验2小…     

飞行人员冠心病危险因素聚集度与胰岛素抵抗的关系

目的研究飞行人员心血管病危险因素聚集情况及其与胰岛素抵抗（IR）的关系。方法对230名健康疗养飞行人员进行心血管病危险因素问卷调查，检查血糖、血脂和血胰岛素水平，计算胰岛素抵抗指数（HOMA—IR）及8细胞的分泌功能，比较心血管病危险因素聚集度与胰岛素抵抗的关系。结果230名飞行人员中完成全部设计项目的155名，体质指数（BMI）、收缩压（SBP）、舒张压（DBP）与HOMA—IR呈正性相关，分别为：r=0．236，P=0．003；r=0．221，P=0．012；r=0．200，P=0．023。年龄≥40岁者HOMA—IR高于年龄〈40岁者（P〈0．05）；BMI≥25kg／m^2者HOMA—IR大于BMI〈25kg／m^2者（P〈0.05）；具有1项、2项代谢危险因素者HOMA-IR大于无危险因素者（P〈0.05）；同时具有≥3项代谢危险因素和心血管病相关生活因子者HOMA—IR大于无危险因素者（P〈0.05）。结论飞行人员胰岛素抵抗与体质指数、收缩压、舒张压相关，与年龄、飞行时间、血脂等因素不相关；具多项危险因素者IR高于不具危险因素者；BMI≥25kg／m^2可作为初步筛查飞行人员IR的界值。     

飞行员高血压病胰岛素抵抗与代谢指标异常的关系

目的 探讨高血压病飞行员胰岛素敏感性与代谢指标(血脂、尿酸、体重指数)异常的关系。方法 42例高血压病飞行员为试验对象，测定空腹葡萄糖、胰岛素、血脂、血尿酸和体重指数，并进行葡萄糖耐量试验。根据检测结果飞行员分为2组：胰岛素正常组(Ⅰ组)，胰岛素抵抗组(Ⅱ组)。并追踪治疗结果1年。结果 42例高血压病飞行员22例有胰岛素抵抗(52．38％)。Ⅱ组代谢指标异常发生率高于Ⅰ组，差异有显著性意义。Ⅱ组治疗后停飞率(10／22)高于Ⅰ组(5／20)。结论 胰岛素抵抗是高血压病飞行员早期治疗的重要环节。建议高血压病飞行员应常规检测葡萄糖耐量，确定是否存在胰岛素抵抗，以制定适宜的治疗方案。     

飞行员患酒精性肝炎一例

一、临床资料 患者男性，飞行员，43岁，飞行总时间2000h。因体检发现转氨酶升高，于2006年3月27日入院。患者入院前两周连续饮酒均超过80g／d，无明显不适。入院后化验：谷草转氨酶105．4u／L，谷丙转氨酶135．3U／L，γ谷氨酰转肽酶90．6U／L，血糖7．49mmol／L，三酰甘油1．8mmol／L，总胆固醇5．2retool／L；心电图、胸部X线拍片检查结果正常；腹部B超示：轻度脂肪肝。诊断：①酒精性肝炎；②高脂血症。经禁酒、保肝及控制饮食等治疗3周后，复查肝功能：谷草转氨酶36．4U／L，谷丙转氨酶40．0U／L，血糖4．8mmol／L；血脂正常：三酰甘油1．6mmol／L，总胆固醇4．9mmol／L；体重减轻3kg。经我院健康鉴定委员会体检鉴定，结论：飞行合格。     

民航飞行员血脂现状调查分析

目的 调查中国民航飞行员的血脂现状,为做好血脂异常的防治提供依据. 方法 收集2009年度中国民航11 817名飞行员的血脂数据,分析和评价不同年龄、不同性别和不同国籍飞行员的血脂水平和血脂异常的患病率. 结果 中国民航飞行员的血脂平均水平及其异常率分别为:TC:(4.65±0.94) mmol/L和25.7％; TG:(1.35±0.91) mmol/L和23.0％; HDL-C:(1.31±0.38) mmol/L和21.2％;LDL-C:(2.73±0.90) mmol/L和21.4％.血脂异常的患病率为51.4％,男、女性飞行员分别为52.2％、29.5％,血脂水平和血脂异常的患病率随年龄增长而呈增加的趋势.此外,男性飞行员血脂TC、TG、HDL-C及LDL-C的异常率高于女性飞行员(x2=6.31、61.48、59.29、14.20,P＜0.05或0.01).与中国籍飞行员相比,外籍飞行员的TC和LDL-C的水平较高(Z=13.29、14.92,P＜0.01)、异常率较高(x2=154.14、240.24,P＜0.01). 结论 中国民航飞行员血脂水平和血脂异常的患病率较高,需要采取有效的预防措施和医学干预.     

17例胆囊结石患者血清总胆固醇分析

1资料与方法 1．1一般资料选取南方航空公司参加98年度大体检的飞行员胆囊结石患者17例(包括已治愈者)为研究对象，年龄25岁～57岁．分为3组，第1组：未手术(指胆囊切除手术）组，共5例，血清总胆固醇(以下均简写为血清TC)最高值6．78mmol/L，最低值4．50mmol/L,平均5．79mmol／L；第2组：     

飞行员超敏C反应蛋白与血脂水平相关分析

目的　调查飞行员超敏 C反应蛋白 (Hs- CRP)与血脂水平的关系 ,为控制飞行员心血管疾病的发生提供参考。　方法　在实验室建立 Hs- CRP的测定方法 ,测定了 2 0 0名飞行员血清胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (L DL)、高密度脂蛋白 (HDL)和 Hs- CRP浓度 ,探讨了飞行员血脂水平与 Hs- CRP的关系。　结果　血脂偏高 ,特别是血清 TG、L DL 升高的飞行员 Hs- CRP明显增高 ,而 HDL 偏低能够造成 Hs- CRP升高。经线性回归分析发现 ,血清 Hs- CRP升高与 TG呈明显正相关 (r=0 .998,P<0 .0 5 )。　结论　对高血脂飞行员的高 TG、L DL 状况要严格控制 ,从而减低Hs- CRP水平以达到预防心血管疾病的目的。     

民航非酒精性脂肪肝飞行员血清瘦素、血糖和血脂变化的研究

目的分析2009年4月至2010年7月在民航广州医院航空体检中心体检的民航60例现役非酒精性脂肪肝（nonalcoholic fatty liver disease, NAFLD）飞行员血清瘦素、血糖、血脂的变化,探讨飞行员患NAFLD的危险因素及其预防措施。方法60例NAFLD飞行员作为试验组,体检结论正常的60例飞行员作为对照组。询问病史,空腹测量身高、体重、腰围、臀围及血压;检测血脂、空腹血糖（fasting plasma glucose,FPG）和血清瘦素水平,并进行组间比较。结果NAFLD组体重指数（bodymass index,BMI）、腰臀比、收缩压、舒张压、甘油三酯（triglyceride,TG）和血清瘦素水平较对照组显著上升（t=4．62-12．20,P〈0．01）;FPG较对照组上升（t=2．63,P〈0．05）;高密度脂蛋白胆固醇（highdensitylipid—cholesterol,HDL-C）明显下降（t=3．65,P〈0．01）。瘦素水平与TG、FPG呈正相关（r=0．72、0．82,P〈0．05）,与HDL-C呈负相关（r=-0．62,P〈0．05）。结论飞行员患NAFLD与其饮食结构及活动减少造成肥胖有关,并与瘦素水平升高密切关联。应加强对患NAFLD飞行员的预防和治疗工作,为飞行员的健康和飞行安全提供保障。     

民航飞行员心脑血管病危险因子分析

目的 分析南方航空公司飞行员血糖、血脂、血压和身体质量指数等指标,了解其变化的严重程度,以加强预防。方法 对象为南方航空公司飞行部497名健康在飞的男性驾驶员或副驾驶员。全部空腹采血测定,血糖用葡萄糖氧化酶直接法;血清胆固醇用氧化酶法;三酰甘油用氧化酶法;高密度脂蛋白胆固醇用直接法。血压取坐姿测量左臂;选用SK-7A型超声波检查仪测定身高、体重。用SPSS统计软件以不同年龄组的各项指标进行方差分析和X~2检验分析。结果 飞行员的三酰甘油、身体质量指数和舒张压有随年龄的增长而上升的趋势,血清高密度脂蛋白胆固醇有随年龄增加而下降趋势,血糖和血清总胆固醇也有随年龄的增加而上升的趋势,生化指标超常者的百分比随年龄的增加也呈现上升。结论 民航飞行员血糖、血脂、身体质量指数及血压随年龄增加的异常变化是心脑血管发病的危险因子,应加强预防措施。     

飞行员血脂偏高20例分析

血脂偏高是飞行员的常见病症之一。早期发现并有计划地对血脂偏高飞行员实施膳食治疗,防止并发症的发生,对促进飞行员的健康,延长飞行年限有重要意义。现将我部飞行员自1991～2003年健康疗养体检发现的20例血脂偏高的情况报告如下。1 对象本组20例均属歼-7飞行员,年龄在30～42岁,其中30岁2名,35～42岁18名(占90.0%)。2 结果本组20例均是在疗养院进行大体检时查出血脂偏高,其中胆固醇偏高者16例(6.47～8.20 mmol/L,平均6.82     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）