如何早期有效筛查冠心病一直是航空医学面临的主要问题之一.笔者就目前外军常用冠心病早期筛查手段及策略进行分析,并与我军筛查体系进行比较,发现基于CT的冠状动脉钙化积分对未来心血管事件的风险预测优于功能学检查,指出利用风险分层算法对飞行人员进行差异性筛选可以显著提升筛查体系的效能,并强调了基于CT的血流储备分数和心肌核磁共振新筛查技术在飞行人员冠心病早期筛查中的应用前景.

We evaluated the effect of acute hypobaric hypoxia (AHH) on the hippocampal region of the brain in early-stage spontaneously hypertensive male rats. The rats were classified into a control (ground level; ~ 400 m altitude) group and an AHH experimental group placed in an animal hypobaric chamber at a simulated altitude of 5500 m for 24 h. RNA-Seq analysis of the brains and hippocampi showed that differentially expressed genes (DEGs) were primarily associated with ossification, fibrillar collagen trimer, and platelet-derived growth factor binding. The DEGs were classified into functional categories including general function prediction, translation, ribosomal structure and biogenesis, replication, recombination, and repair. Pathway enrichment analysis revealed that the DEGs were primarily associated with relaxin signaling, PI3K-Akt signaling, and amoebiasis pathways. Protein–protein interaction network analysis indicated that 48 DEGs were involved in both inflammation and energy metabolism. Further, we performed validation experiments to show that nine DEGs were closely associated with inflammation and energy metabolism, of which two ( Vegfa and Angpt2 ) and seven ( Acta2, Nfkbia, Col1a1, Edn1, Itga1, Ngfr , and Sgk1 ) genes showed up and downregulated expression, respectively. Collectively, these results indicated that inflammation and energy metabolism-associated gene expression in the hippocampus was altered in early-stage hypertension upon AHH exposure.

目的 介绍行动为导向的项目教学法在航空航天临床医学课程中的应用,评价微课形式应用于航空卫生宣教任务的可行性和接受度.方法 选取空军军医大学30名2017级五年制航空航天医学专业本科学员、10名部队航空军医和78名部队飞行员作为研究对象.6名学员和1名带教教师组成一个项目小组,按确定项目任务、制定项目计划、实施项目计划、项目检查评估、项目结果应用等步骤完成航空卫生宣教微课制作项目,通过问卷调查微课制作项目对学员胜任能力的作用、部队飞行员和航空军医对微课形式的航空航卫宣教的接受度.结果 航空卫生宣教微课制作提升学员的学习兴趣和主动性,提高学习效率,提高学员多媒体应用能力,增进团队协作能力.飞行员对微课形式的航卫宣教形式接受度高,宣教效果较好,部队航空军医愿意尝试微课制作,但存在一定实际困难.结论 项目制作过程提高学员的岗位胜任能力,微课形式的航空卫生宣教接受度高.行动为导向的项目教学法在航空航天临床医学课程教学改革中值得推广.

Background As human transportation, recreation, and production methods change, the impact of motion sickness (MS) on humans is becoming more prominent. The susceptibility of people to MS can be accurately assessed, which will allow ordinary people to choose comfortable transportation and entertainment and prevent people susceptible to MS from entering provocative environments. This is valuable for maintaining public health and the safety of tasks. Objective To develop an objective multi-dimensional MS susceptibility assessment model based on physiological indicators that objectively reflect the severity of MS and provide a reference for improving the existing MS susceptibility assessment methods. Methods MS was induced in 51 participants using the Coriolis acceleration stimulation. Some portable equipment were used to digitize the typical clinical manifestations of MS and explore the correlations between them and Graybiel's diagnostic criteria. Based on significant objective parameters and selected machine learning (ML) algorithms, several MS susceptibility assessment models were developed, and their performances were compared. Results Gastric electrical activity, facial skin color, skin temperature, and nystagmus are related to the severity of MS. Among the ML assessment models based on these variables, the support vector machine classifier had the best performance with an accuracy of 88.24%, sensitivity of 91.43%, and specificity of 81.25%. Conclusion The severity of symptoms and signs of MS can be objectively quantified using some indicators. Multi-dimensional and objective assessment models for MS susceptibility based on ML can be successfully established.

神经精神科教学是航空航天临床医学教学的重要组成部分.目前神经精神科的教学内容和教学模式已经不能很好的匹配新的疾病谱和部队战斗力生成的紧迫需求.笔者重点讨论了航空神经精神科教学工作的现状和存在的一些问题,讨论了增加脑血管病、头痛、头晕与焦虑、抑郁状态,大龄飞行员的认知问题等讨论课,旨在增强航空军医解决部队实际问题的能力,面向新的时代、新的疾病谱,部队战斗力生成的新的需求,改进军医大学航空临床医学神经精神科教学工作,调整教学内容,改进教学方法 ,紧贴部队需求,培养实用型、新型航空军医.

目的 评价对分课堂教学模式在心血管病航空医学鉴定案例实习课中的应用效果.方法 空军军医大学2016级五年制航空航天临床医学专业32名本科学员,随机分为传统教学组和对分教学组,每组16名.传统教学组采用教员讲解的传统教学方式进行授课,对分教学组采用教员讲解和学员病例讨论相结合的对分课堂教学方式进行.采用理论测试、病例分析和调查问卷对授课效果进行评价.结果 与传统教学组比较,对分教学组的病例分析成绩显著提高(P＜0.05).调查问卷显示对分教学组学员学习的主动性有明显提高(P＜0.05),在航空医学思维培养方面,对分教学组学员的满意率也明显高于传统教学组(P＜0.05).结论 对分课堂案例教学法可显著改善心血管病航空医学鉴定教学效果,可在飞行人员常见疾病航空医学鉴定教学中进一步推广应用.