Objective To find out about the molecular mechanisms of repair after aspirin related gastric mucosal injury based on network pharmacology and immunohistochemical staining assay.Methods The SwissTargetPrediction database and DrugBank database were used to predict the target genes of aspirin,and the GeneCards database was searched to obtain the genes involved in gastric mucosal repair.The intersection targets of the two databases were collected.A protein-protein interaction network was constructed by the STRING database.The hub genes were analyzed for KEEG signal pathways and GO enrichment by using the DAVID database.Immunohistochemical staining was applied to verify the expression of a core gene in aspirin related human gastric mucosal lesions.Results It was found that 56 hub genes were involved in the repair after aspirin related gastric mucosal injury,including the key gene PCNA.The PPI network showed that PCNA mainly interacted with CCNA2 and HDAC1.KEGG pathway analysis found that PCNA participated in the related signal pathways,including cell cycle and DNA replication.GO enrichment showed that the intersection target proteins were mainly located in the nucleus.The main molecular functions of PCNA included binding to damaged DNA and histone acetyltransferase.The biological processes involved included negative transcriptional regulation of RNA polymerase Ⅱ promoter,cell reaction to hydrogen peroxide and DNA replication.Immunohistochemical staining confirmed that the expression of PCNA was up-regulated in aspirin related human gastric mucosal Lesions(Z=3.974,P＜0.001).The expression of PCNA in aspirin related superficial active gastritis and ulcerative lesions was significantly higher than in acute erosive hemorrhagic gastritis(H=13.935,P=0.001).Conclusions The repair process after aspirin related gastric mucosal injury involves multiple targets and multiple signal pathways.The interaction of PCNA with CCNA2 and HDAC1 is involved in the repair after aspirin related gastric mucosal injury,and the repair mechanism is more evident in aspirin related superficial active gastritis and gastric ulcer lesions.
Objective To prepare dexamethasone polylactic-co-glycolic acid(PLGA)magnetic microspheres and evaluate their therapeutic efficacy against chronic pain in inflammatory rats.Methods Dexamethasone PLGA magnetic microspheres were prepared using the emulsion-solvent evaporation method.Chronic pain models in rats were established by injecting complete Freund's adjuvant into the plantar surface of the left hind paw.Therapeutic efficacy was assessed in 36 model rats,which were randomly divided into six groups according to treatments:the positive control,magnetotherapy,dexamethasone PLGA magnetic microspheres,dexamethasone sodium phosphate injection,dexamethasone PLGA magnetic microspheres plus magnetotherapy,and dexamethasone sodium phosphate injection plus magnetotherapy,with six rats per group.The appearance of the rat's left hind paw skin and the mechanical pain threshold were observed from day 2 to day 10 post-modeling.On the 10th day,the left hind paw skin was pathologically examined under anesthesia using hematoxylin and eosin staining.Results After treatment,all groups except the positive control and magnetotherapy groups showed significant improvement in the mechanical pain threshold of the left hind paw between days 4 and 6 post-treatment,particularly in the microspheres plus magnetotherapy group.Inter-group comparisons revealed no significant difference in the mechanical pain threshold between the microspheres plus magnetotherapy group and the injection plus magnetotherapy group during the first two days post-administration.However,from day 4 to day 10,the microspheres plus magnetotherapy group showed significantly higher thresholds compared to the other groups.Except for the magnetotherapy group,all the other groups showed a significant reduction in inflammatory cells compared to the positive control group on day 10 post-administration,espeically in the dexamethasone PLGA magnetic microspheres group and the microspheres plus magnetotherapy group.Conclusion Dexamethasone PLGA magnetic microspheres exhibit sustained-release properties and good biocompatibility,which can significantly alleviate chronic pain caused by chronic inflammation.
目的 探讨军事人员上肢骨骨折患者心理弹性与焦虑敏感和运动功能的关系,为军事人员创伤后恢复训练提供心理建设依据.方法 选取厦门大学附属东南医院2020年6月—2022年6月收治的83例军事人员上肢骨骨折患者作为研究对象,采用心理弹性量表(Connor-Davidson Resilience Scale,CD-RISD)、焦虑敏感性指数-3(Anxiety Sensitivity Index-3,ASI-3)、运动功能评估量表(Fugl-Meyer Assesment,FMA)评估患者心理状态,计算Pearson相关系数,利用AMOS 21.0软件构建心理弹性、焦虑敏感和运动功能模型,并分析心理弹性在焦虑敏感和运动功能中的中介效应.结果 83例军事人员上肢骨骨折患者CD-RISD评分(86.57±9.64)分、ASI-3评分(34.75±4.74)分、FMA评分(88.65±8.27)分;心理弹性与焦虑敏感及各维度之间均为负相关(r=-0.646、-0.597、-0.637、-0.558,P=0.003、=0.020、＜0.001、=0.031);心理弹性与运动功能及各维度之间均为正相关(r=0.846、0.747、0.696,P均＜0.001);焦虑敏感与运动功能及各维度之间均为负相关(r=-0.684、-0.651、-0.621,P＜0.001、＜0.001、=0.010);中介效应检验显示,心理弹性作为焦虑敏感和运动功能中介因素拟合度良好(χ2=53.647、df=29、χ2/df=1.85、拟合优度指数=0.964、修正拟合优度指数=0.947、规范拟合指数=0.951、比较拟合指数=0.977、近似误差均方根=0.027);路径分析显示,焦虑敏感可以直接作用于运动功能,也可以通过心理弹性作用于运动功能,中介效应为0.27,总效应为0.83.结论 军事人员上肢骨骨折后运动功能与心理弹性和焦虑敏感相关,心理弹性在焦虑敏感和运动功能中具有中介效应,可以通过心理弹性建设,改善军事人员军事训练伤后运动功能.
On the basis of literature review,previous research and the experience gained from the medical identification expert group,we made an in-depth analysis of the major problems with imaging techniques,criteria for imaging diagnosis and evaluation of safety risks of facet joint injuries.Advice and expert consensus were offered in order to make medical identification more accurate and ensure safety for military pilots with facet joint injuries.
Objective To investigate the comfortableness of an air urinary device via a questionnaire in order to provide data for related research and design.Methods A survey was conducted among 23 pilots of high performance fighter aircraft by means of a self-developed"feedback questionnaire on the use of a urinary device"before the data on the utility of and problems with this urinary device was statistically analyzed.Results Among the 23 pilots,19(82.6%)reported discomfort within 1 h of use of the urination device.They agreed that a urinary device had to be used in as short as 2 h.Pilots used to urinate into bottles(52.17%),hold urine(52.17%),and wear diapers(21.74%).The main reasons for failure to urinate with a urination device were personal urinary habits(56.52%)and discomfort or pressure of the device(56.52%).A total of 11 pilots(47.83%)were"strongly dissatisfied"or"mildly dissatisfied"with the currently-used urinary device,and 15 pilots(65.22%)said that the device was"merely acceptable"or"acceptable".The pilots recommended that the urinary device be improved in terms of materials,speed of urination and user-friendliness.Conclusion This questionnaire has shed light on how high-performance fighter pilots feel when using the air urination device.The comfortableness of this urinary device needs to be improved.
疲劳状态是诱发安全事故的重要人为因素之一,但作业人员早期的脑力疲劳不易检测,干预措施无法及时精准介入,影响疲劳恢复效果.人体姿势控制功能的调节涉及认知、肌肉运动等多系统整合机制,可能与疲劳时生理心理功能调节联系紧密.因此,笔者以包含认知-运动成分的姿势控制功能作为切入点,从感觉信息输入与中枢认知改变方面探索姿势控制上游通路中大脑感觉运动区功能激活状态,从预期姿势调节与补偿姿势调整方面探索下游通路中肌肉的激活改变,以阐明疲劳早期人体功能的调节机制,为作业者疲劳早期及时预警与精准干预提供理论基础,进而降低疲劳引起的人因失误和事故发生风险.
医疗救护飞机空运医疗后送是战时快速医疗救护的重要方式,机上医护人员是实现应急医学救援的主要载体.通过文献查阅、调查研究和专家咨询等方法构建一套模拟医疗救护飞机机上医护人员能力评价指标体系,并对医疗救护飞机机上医护人员评价工作进行深入探索.
Objective To explore the clinical efficacy of systematic rehabilitation training strategies in patients with dysarthria after stroke based on Internet platforms.Methods Fifty-five patients with post-stroke dysarthria admitted between June 2019 and June 2021 were selected.These patients were divided into the control group and research group using the random number table method.In the control group,27 patients received routine stroke care and telephone follow up after discharge while the 28 patients in the research group were treated with systematic rehabilitation training in in-hospital care before being given instructions about rehabilitation and followed up after discharge via the WeChat platform.The clinic data,Frenchay Activities Index(FAI)and scores of Stroke Specific Quality of Life Scale(SS-QOL),Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were compared between the two groups.Results After systematic rehabilitation training,the FAI scores of patients in the research group were decreased compared with the control group(t=3.10,P=0.003)while the SS-QOL scores of patients in the research group were significantly increased(t=4.38,P=0.001).Furthermore,the SAS and SDS scores of patients in the research group were also decreased(t=2.94,3.33,P=0.005,0.002).Conclusion The Internet-based systemic rehabilitation training can improve the prognosis of patients with dysarthria after stroke,help enhance the patients'ability to live on their own,and lead to better quality of life.Systemic rehabilitation training can also alleviate the anxiety and depression of patients.
Objective To investigate the way in which BMI,exercise habits and sleep quality of flight personnel of different ages tend to change so as to provide data for aeromedical support for flight personnel.Methods By means of a questionnaire,112 personnel were randomly selected and divided into four groups by age.BMI,exercise habits and sleep quality were investigated to analyze the correlations between age and the above factors.Results Among the 112 personnel,83.04%were normal weight and 16.96%were overweight or obese.There were statistical differences in BMI between different age groups(F=4.278,P=0.007).Within the normal range of weight,there were statistical differences in BMI between different age groups(F=3.586,P=0.017),the average BMI in groups ages 30 to 39 and 40 to 49 was higher than that of the group under 30(P＜0.05).There was a positive correlation between age and BMI(rs=0.318,P＜0.001).There were statistically significant differences in the types of physical activity these subjects were engaged in(χ2=190.903,P＜0.001).More people took to jogging and workout with equipment than ball games and other forms of exercise(P＜0.05),with jogging as the most popular exercise(P＜0.05).There were statistically significant differences between the four age groups in preference for jogging,workout with equipment,ball games and other forms of exercise(χ2=15.136,8.333,10.728,16.153,P=0.001,0.036,0.008,＜0.001).Jogging was less popular in the group aged 50 and older(P＜0.05),and the participation rate of other sports is higher than that of the other three age groups(all P＜0.05).There were significant differences in the types of exercise chosen by personnel of different ages(H=8.719,P=0.033).The group aged 50 and older were engaged in smaller varieties of exercise than those in the group under 30(P＜0.05).The age of personnel was negatively correlated with workout with equipment and ball games(rs=-0.208,-0.325,P=0.027,＜0.001),positively correlated with other forms of exercise(rs=0.343,P＜0.001),and negatively correlated with types of exercise(rs=-0.248,P=0.008).There were statistically significant differences in the proportion of sleep deficiency between the four age groups(χ2=8.148,P=0.041).There were significant differences in sleep time between the four age groups(H=9.113,P=0.028).There are differences in the factors that affect the sleep quality of flight personnel(χ2=20.341,P＜0.001).Light sleep was more common than dreaminess and early waking(P＜0.05).Early waking was more prevalent in the group ages 40 to 49 and in the group aged 50 and older than in the other two groups(P＜0.05).There is a statistically significant difference in the incidence of early awakening among flight personnel of different age groups(χ2=13.258,P=0.002).There were statistically significant differences in influencing factors of sleep quality(H=13.879,P=0.003).There are more types of influencing factors on sleep quality among flight personnel in the group ages 30 to 39 and in the group ages 40 to 49 than those in the group under 30(all P＜0.05).The age of personnel was negatively correlated with the rate of sleep deficiency and sleep time(rs=-0.247,-0.264,P=0.009,0.005),but positively correlated with such influencing factors as dreaminess and early waking(rs=0.209,0.330,0.312,P=0.027,＜0.001,＜0.001).The difficulty in falling asleep was negatively correlated with sleep time(rs=-0.430,P＜0.001),and negatively correlated with the rate of sleep deficiency(rs=-0.352,P＜0.001).Dreaminess was negatively correlated with jogging(rs=-0.221,P=0.019),and positively correlated with light sleep(rs=0.200,P=0.035).Conclusions With the increase of age and BMI,flight personnel tends to engage in simpler types of exercise,and is more vulnerable to sleep deficiency and early waking.They should be given guidance and quick interventions to ensure their sleep quality.Flight personnel of different ages should be scientifically guided based on their exercise habits and promptly intervened in factors that affect their sleep quality decline,in order to maintain their physical health and extend their flight lifespan.
传染病感染者空运医疗后送具有感染防控难度大、个人防护要求严、途中医疗操作少等特点.后送分队抽组规模与后送传染病病种、传染病病员数量、传染病病员病情及基础病情况、空运医疗后送航程等诸多因素有关.目前,国内外传染病感染者批量空运医疗后送相关实践较少,笔者根据任务实践经验,从人员备勤、物资备勤、技术备勤等方面探讨分队备勤模式,从抽组基本原则、抽组方式、岗位职责、分队人员要求等方面探讨分队抽组模式.以期对生物战、生物恐怖袭击、传染病大流行等状况下的传染病感染者批量空运医疗后送提供参考.
Objective To analyze the disease spectrum of temporarily grounded military aircrews and explore the risk factors.Methods The data of 344 military aircrews who were medically identified as disqualified for flight during recuperation in Dujiangyan Special Servicemen Recuperation Center of PLA Air Force was retrospectively analyzed.Results In the disease spectrum of temporarily grounded military aircrews,the most common diseases were liver dysfunction(17.15%),hypertension(9.88%)and cervical and lumbar spine related diseases(7.85%).In terms of aircraft types,hypertension was more prevalent among crews for transport aircraft,bombers and early warning aircraft(χ2=7.41,P=0.025),cervical and lumbar spine related diseases(χ2=15.53,P＜0.001)and renal calculus(χ2=6.15,P=0.036)were more common among fighter pilots,and leukopenia(χ2=7.15,P=0.010)was more prevalent in helicopter crews.Compared with aircrews under 45,the risk of flight suspension due to hypertension among pilots aged 45 and older was significantly higher(OR=7.958,95%CI:2.867～22.092,P＜0.001).Compared with pilots,air technicians were at higher risk of flight suspension due to hypertension(OR=2.328,95%CI:0.908～5.972,P=0.079).In addition,compared with crews for transport aircraft,bombers,early warning aircraft and helicopters(OR=4.965,95%CI:1.385～17.790,P=0.014)(OR=5.126,95%CI:1.342～19.580,P=0.017),the risk of flight suspension due to cervical and lumbar spine related diseases was significantly higher for fighter pilots.Conclusion There are significant differences in the disease spectrum of temporarily grounded military aircrews for different aircraft types.During health checkups,personalized examination and evaluation,treatments and physical training should be provided for aircrews of different aircraft types.Meanwhile,targeted guidance should be offered to prevent such diseases as cervical and lumbar spine related diseases.Faster recovery can help reduce the rates of grounding and improve the overall health of military aircrews.
通过阐述美军平战时航空卫生保障的主要做法,为我军的航卫保障建设和改革发展提供借鉴思路.笔者通过CNKI、超星、PubMed、Web of Science等数据库检索美军在航卫保障领域的相关文献,对美军平时航卫保障的体系结构、医学选拔、航空生理训练和特定疾病分析进行梳理,并分别介绍了美军以及战时联合搜救体系、专业搜救力量以及分级救助阶梯等内容分别介绍.美军立体机动、精准高效的航卫保障体系,能够为我军优化和创新航卫保障体制,构建精准化、专业化和智能化的航卫保障提供启示.
1 病例资料 患者,男,58岁,因全身反复出现红斑、鳞屑25年,加重5年,于2021年2月来空军特色医学中心皮肤科就诊.患者25年前无明显诱因出现双小腿散在约甲盖大小红斑、鳞屑,偶有瘙痒,皮损逐渐加重,头皮、躯干、四肢均出现类似红斑、鳞屑,到当地多家医院就诊,诊断为银屑病.
Objective To investigate the disease spectrum of hospitalized PLA aircrews,analyze the changes of the disease spectrum,and provide data for military aeromedical support.Methods The data of aircrews hospitalized in the Air Force Hospital between January 2007 and December 2021 was collected.The patients'age,gender,years of fight,and results of clinical diagnosis were recorded.Results A total of 2 489 aircrews were included in the study,The most common diseases involved the musculoskeletal system and connective tissues,digestive system,injuries,poisoning,and the circulatory system.The incidence of respiratory infections,fractures and trauma was negatively correlated with age(r=-0.46,-0.67,-0.41,P＜0.001,＜0.001,=0.021).Compared with the disease spectrum of inpatients in 2000-2005,the rate of respiratory infections,hypertension,fractures,cervical disc herniation trauma and gastritis increased(χ2=40.14,21.06,24.29,6.03,13.92,9.14,P＜0.001,＜0.001,＜0.001,=0.014,＜0.001,=0.003),while that of prolapse of lumbar inter vertebral discs and cervical spondylosis decreased(χ2=100.53,48.02,both P＜0.001).The incidence of diseases with the digestive system,respiratory system,and genitourinary system was higher than that of US military aircrews(χ2=30.28,51.09,429.64,all P＜0.001),while the incidence of diseases with the ear,mastoid process,eyes and adnexa was lower(χ2=317.02,619.99,both P＜0.001).Conclusion Precautions and interventions should be based on the disease spectrum of aircrews.Routine training and dietary support should be improved for aircrews so as to ensure their physiological and mental health.
笔者介绍了空军飞行人员常见的口腔科急症分类,筛选出5种已经出现并引起暂时停飞的口腔科急症,分析其症状以及对飞行的影响,并提出治疗建议以及医学鉴定建议.探讨应用最新口腔治疗技术快速有效地解决口腔科急症,尽可能减少对飞行的影响,保障空军战斗力.
近年来,各国对飞行员的体能标准研究取得大量成果,但在体能训练中,仍存在受训者伤病较多、与飞行员职业所需能力衔接不够紧密的情况.2021年美国空军发布最新的体能测试指南,与旧版不同的是删除原评估标准中的腰围指标;提供体能测试的替代项目,使飞行员有更多的选择权;年龄组划分由原来的10岁改为以5岁为1个测试年龄组.笔者重点梳理过去20年美军体能测评标准的研究成果,借鉴其经验,提出未来应在区分关键任务、实施更具个性化及性价比的替代项目和方案的基础上,努力构建更为科学合理、具体实用、贴近实战和全面有效的飞行员体能考核评估体系.同时在体能的标准设置、参加人员、评估频率和测试内容方面进行细化研究,并且规范实施,提高体能测评方案的可行性和有效性.
Objective To explore the feasibility of evaluating the personality traits of pilots.Methods Twenty-six pilots under aviation training were randomly selected to complete the Cattell's 16 personality factors questionnaire(16PF),cliff edge walking,cliff jumping,and desktop simulation cruise in a virtual reality(VR)environment.Before and after the VR task,the skin signals of the subjects were collected and the level of stress was self-rated.During the task,the electrical signals and jump reaction time were synchronously monitored and recorded.The correlations between the changes of skin electrical values,jump response and 16PF were analyzed.Results 1)In 16PF,the factors of automaticity,tension,daring and sophistication were significantly correlated with the change rate of the corresponding skin electrical values(r=-0.464～0.482,all P＜0.05).2)Subjects with a short jump time had significantly lower scores in the skeptical dimension of the Cattell's 16 personality factors questionnaire than those with a long jump time(t=3.25,P=0.007).3)The target search time of subjects was positively correlated with the change rate of skin electrical values in the cliff formation stage,the change rate of skin electrical values in the jump task stage,and the jump time(r=0.416,0.416,0.490,P=0.035,0.035,0.011).Conclusion The change rate of skin electrical values in virtual reality tasks may be a potential objective index for evaluation of personality traits of pilots.
Objective To explore the factors affecting qualification after non-operative treatment of low back pain in aircrews,and to provide reference for improving the rate of resumption of flight and reducing the rate of grounding.Methods The medical records of 90 aircrews who received treatment of low back pain in Air Force Medical Center of PLA between January 2016 and December 2018 were retrospectively analyzed.These pilots were divided into the qualified group and the unqualified group(including temporarily unqualified)according to the conclusions from the last aviation medical identification conducted in Air Force Medical Center of PLA before April 2022.The two groups were compared in terms of age,gender,years of flight,BMI,low back pain,duration of low back pain,lower limb pain,duration of lower extremity pain,numbers of lumbar MRI disc degenerative segments,sites of disc herniation,and degree of disc herniation in order to analyze the correlations with outcomes.Results Only age(χ2=11.75,P=0.003),years of flight(χ2=7.20,P=0.007)and BMI(χ2=5.383,P=0.020)were significantly different between the two groups.Logistic regression analysis showed that only durations of flight and BMI were associated with conclusions from medical identification.Conclusion Durations of flight of over 2 000 h and BMI of over 24 kg/m2 are risk factors for qualification after non-operative treatment of low back pain in aircrews.
1 病例资料 患者,男性,95岁,因吸入性肺炎于2021年6月3日在解放军总医院第二医学中心老年病房住院,既往因球麻痹、吞咽功能障碍、胃食管反流等原因反复误吸,多次住院治疗,且合并老年衰弱,咳痰无力,频繁出现痰堵窒息,遂于2021年8月4日给予气管切开、呼吸机辅助呼吸.
Objective To review the clinical data on acute ischemic stroke(AIS)in aircrews and to provide reference for diagnosis,treatment and aeromedical evaluation.Methods Related cases and reports were retrieved from the electronic medical record system of Air Force Medical Center and databases of CNKI and PubMed.The clinical characteristics and results of aeromedical evaluations of these aircrews were summarized.Results A total of nine cases with AIS were retrieved,all of whom were male and aged 36 to 50.There were six pilots,one correspondent,one mechanist and one aviator.The National Institute of Health Stroke Scale(NHISS)scores of all these aircrews were 3 at most.According to the Trial of Org 10172 in Acute Stroke Treatment(TOAST)classification,two cases were attributed to small-artery occlusion,two cases to cardiogenic embolism and one case to eosinophilia.Four cases were classified as stroke of undetermined etiology due to multiple possible causes or incomplete evaluation.A total of eight aircrews underwent aeromedical evaluation.Four of these aircrews had no recurrence or sequelae after follow-up and were identified as qualified for flying.Two cases were still under ground observation and another two were identified as disqualified for flying.Conclusion AIS among aircrews is mostly mild.The capability of aircrews after AIS should be assessed in combination with such factors as the severity of health conditions,etiology,recurrence risk,outcomes,jobs,aircraft types and intentions.
