目的 通过德尔菲法确定军人应力性骨折预警指标体系及各级指标权重,为防治应力性骨折提供依据.方法 在既往研究基础上结合文献分析方法,初步编制军人应力性骨折预警指标体系框架和专家咨询表,选择20名骨科学、运动医学、体能训练和预防医学专家进行2轮德尔菲专家论证.使用肯德尔和谐系数评价结果的一致性,并采用百分权重法确定各指标权重进而建立应力性骨折预警指标体系.结果 2轮专家咨询积极系数分别为100.00％与88.24％;专家权威系数为0.90;Ⅰ级与Ⅱ级指标的协调系数检验结果均显著(P<0.05).构建的军人应力性骨折预警指标体系包括5个Ⅰ级指标和25个Ⅱ级指标.权重最高的Ⅰ级指标是"组训因素与条件(21.87％)";权重前3的Ⅱ级指标是"组训施训(6.16％)""训练环境(5.44％)"和"足弓异常(5.35％)".结论 军人应力性骨折预警指标体系具有一定的科学性和适用性,对减少军事训练伤发生与指导军事训练工作开展具有重要意义.

应力性骨折是军事训练伤中的常见损伤,严重影响参训人员的训练和健康.应力性骨折发生后,若没有得到及时的治疗,可能会导致严重后果,如长期疼痛或残疾,甚至可能会导致骨折不愈合,使参训者难以重返训练.应力性骨折的发生受多种因素影响,本文简述了应力性骨折的发生现状和分布特征,并从人口学特征、生活习惯、身体形态、体能和动作能力、组训因素与条件、遗传易感性6个方面来分析其影响因素,为开展相关研究提供参考.

目的 掌握某部现役人员慢性病住院病例的病种构成,住院时间及费用.方法 对2010年1月～2014年5月某部队现役人员慢性病住院病例进行现况研究.结果 共检索到某部军队现役人员慢性病住院病例23 138例,前5位病种依次为腰椎间盘疾患1998例(8.64％)、精索静脉曲张1 525例(6.59％)、慢性胃炎1 291例(5.58％)、痔1 244例(5.38％)、高血压899例(3.89％).腰椎间盘疾患、精索静脉曲张、慢性胃炎、痔、高血压、良性肿瘤、尿石病在2010-2013年的构成比差异有统计学意义(x2=16.91、33.73、13.76、19.63、43.09、64.18和14.34,P＜0.05).总医疗费用由高到低依次为腰椎间盘疾患、高血压、脑血管病、心律失常、痔、精索静脉曲张、关节病、慢性胃炎、良陛肿瘤、尿石病.结论 应对部队现役人员加强腰椎间盘疾患、精索静脉曲张、慢性胃炎、痔和高血压等慢性病的防控工作.

目的:通过入伍训练前、后新兵体质指标的对比,探讨新兵体质现状及体能训练对体质的影响.方法:采用整群抽样方法,选取某部新兵,测试其入伍体能训练前后的身体形态、身体成分和体能素质指标,对比分析变化情况.结果:新兵入伍时,体重、体质指数(BMI)、体脂率、100米跑和3000米跑等指标高于同龄入伍新兵,但是与体能标准存在一定差距.入伍体能训练结束时,新兵身体形态、身体成分和体能素质指标明显改善.

Objective To observe the effect of corrective movement training on recruits'movement patterns by carrying out corrective movement training for those who got lower scores in FMS.Methods Sixty recruits who had got low FMS scores were cho-sen as the intervention group that received additional corrective movement training during physical training for a month.Another eighty recruits who had normal movement patterns served as the control group. The intervention effect of corrective movement training was observed according to FMS scores before and after training.Results The total FMS scores of the intervention group were increased by (1.08±2.30)(P<0.01)after corrective movement training while those of the control group were decreased by (0.563±2.00)(P<0.05)after normal training. The difference between the two groups was statistically significant(P<0.01).All the six scores of FMS test in the intervention group were improved,especially in deep squat,hurdle step and in-line lunge (P<0.05).The scores of deep squat and of in-line lunge of the control group were increased after training,but the other five sin-gle scores of FMS were decreased,and scores of active straight leg raise as well as trunk stability push-up were significantly dif-ferent after training(P<0.01).Except deep squat,the scores of other six single items of the intervention group were significantly increased compared the control group.Conclusion The recruits'functional movement patterns can be improved obviously after cor-rective movement training,which will reduce the risk of exercise-induced injuries and contribute to normal training in the future.

目的 通过对后方医院现役军人慢性病住院病例数据进行统计分析,掌握部队现役军人慢性病发病情况,为制定针对性防控措施提供科学依据.方法 采用现况研究的方法分析某部2010年1月～2014年5月间的现役军人住院慢性病病例流行病学特征.结果 某部军队现役人员慢性病住院病例共23 138例,分布于390个慢性病类别.其中男性20 674例,占病例总数的89.35％,女性2464例,占10.65％;战士15 513例,占67.05％,团以下干部6 559例,占28.35％,师以上干部1 066例,占4.61％.21～25岁组最多,共6 672例,占病例总数的28.84％.战士前5位疾病依次为:腰椎间盘疾患、精索静脉曲张、痔、慢性胃炎、良性肿瘤;团以下干部分别为:高血压、腰椎间盘疾患、脑血管病、慢性胃炎、痔;师以上干部分别为:高血压病、脑血管病、缺血性心脏病、颈椎病、糖尿病.结论 军人慢性病疾病谱构成与地方人员有较大差异,不同类别人员的疾病谱构成差异也显著不同,应分别采取差异化的防控措施.

目的:了解特战训练运动损伤的发生状况和特点规律,为实施针对性防控措施提供依据.方法:通过问卷调查方式,调查某部特战队员运动损伤的发生情况、疾病谱构成、伤病部位、致伤科目和致伤原因.结果:在所调查的特战队员中,轻度损伤75.85％,中度损伤18.03％,重度损伤6.12％.以往一年内运动系统损伤反复发生人次较多,损伤发生率为151.81％;其中腰部34.31％、踝关节32.66％、膝关节27.71％,小腿5.32％;损伤发生季节以冬季为最高(56.82％),其次是夏季(21.46％)和春季(13.92％),秋季最低(7.80％).主要致伤科目依次为障碍训练、长跑训练和格斗训练,可能致伤原因主要为“训练疲劳累积”“放松恢复不足”和“场地条件差”.

Objective To investigate the status of recruits' functional action ability and to screen the high risk populations of military training-related injuries in order to improve the level of physical training and prevent military training-related injuries.Methods Movement patterns of 525 recruits were tested and assessed using the Functional Movement Screen (FMS).Results The total FMS scores of these 525 recruits ranged from 8 to 20 and the average FMS score of these recruits was (15.35 ± 1.98).In additon,the total FMS score of 154 recruits was less than 14.Among the scores of seven single items,the highest (2.60± 0.55) was from active straight-leg raise and the lowest (1.93±0.32) was from rotary stability.48 recruits felt pain while performing FMS movement,and 14 during trunk stability push-up.246 single movement pattern limitations were found on seven FMS tests,the most prevalent of which was functional movement pattern limitation,followed by flexibility limitation and motion control limitation.Conclusion Recruits' functional movement ability is at a normal level.Limitations and pain have been found on each movement pattern test,suggesting that recruits are at higher risk of injury in subsequent military training.Corrective exercises as well as treatment of pain are needed to improve recruits' movement patterns.

The military personnel is faced with various health hazards:such as common infectious diseases,drinking and drinking water safety problems,military training injuries,adverse psychological problems,vector-borne diseases and environmental hazards of military operations.Systematic surveillance of these hazards requires the establishment of monitoring network,s development of various automatic information analysis systems in the army by assessing the harm and studying the early warning levels,active intervention in the main health hazards and evaluation of the effect of intervention.It is imperative to establish systems for effective monitoring of population health risks,early warning,and intervention so as to improve the health of the military population effectively to ensure the combat effectiveness of the troops.

目的:评估炮兵部队新兵功能动作能力和运动损伤风险,指导体能训练和军事训练伤防治工作开展.方法:采用功能性动作筛查对某炮兵部队357名2016年度入伍新兵进行功能动作能力测试.结果:1)新兵FMS总分范围为8～20分,平均14.01±1.73,≤14分的占58.82％;2)得分最高的单项为肩部灵活性(2.63±0.52),最低的为躯干稳定性(1.43±0.78);3)受限比例最高的动作模式是躯干稳定性(54.62％),最低为肩部灵活性受限(1.68％);4)有5项测试出现人员疼痛,以躯干稳定性测试中的疼痛发生比例最高(7.00％);5)整体动力链受限情况,主要表现为髋、膝、踝灵活性和稳定性较差、骨盆控制能力和反射性躯干核心稳定性较弱、下肢肌肉柔韧性较差和肩胛稳定性不足等.结论:该部新兵FMS低分人员较多,整体动作能力较差,训练损伤风险较高,应开展针对性动作模式纠正训练,以提高功能动作水平,降低训练伤风险.

Objective To investigate the change of mental health status after systematic mental health maintenance among the contract medical personnel in a military hospital.Meetotis The symptom self-assessment scale (SCL-90) was used to survey 312 contract healthcare personnel in a military hospital.Results The total average score and scores of somatization,obsessivecompulsive behavior,interpersonal sensitivity,depression,anxiety,hostility,phobe and psychosis before intervention were significantly higher than the current national norms(P＜0.05),but there was no significant difference between the score of paranoid ideationand the national norms (P＞0.05).The total average score and scores of somatization,obsessive-compulsive behavior,interpersonal sensitivity,depression,anxiety,hostility,phobe and psychosis became significantly lower after intervention (P＜0.05).Conclusion The mental health of medical staff in a military hospital can be effectively improved by applying mental health maintenance.

Objective To construct the nursing positive occupational environment,and to analyze its appli-cation effect.Methods From March 2014,the nursing positive occupational environment was constructed, including amendment of the management policy of physiological needs guarantee,development of relevant plans of safety needs guarantee,creation of reserve forces management mode for the fulfillment of social in-teraction needs,and building the humanistic environment for the fulfillment of spiritual and cultural con-sumption demands,improvement of career planning.The symptom checklist-90 (SCL-90)was used to sur-vey 203 contract nurses before and after the construction of positive occupational environment.Results After the construction of positive occupational environment,except stubborn and psychosis,the scores of other dimensions were lower than those when before the construction of positive occupational environment (P <0.05 ).Conclusions The construction of positive occupational environment is beneficial to the improvement of mental health status.

Objective To study the various characteristics of a recovery heart rate that changes with time under different exercise intensities , and investigate the relationship between the exercise heart rate and the recovery one in order to find a method of speculating the exercise heart rate in the process of recovery .Methods Sixty young male soldiers were selected as subjects who were subjected to exercise of different intensities on the cycle ergometer (20,40,60,80,100,120, 140 ,160 and 180 W) .Each intensity lasted for 6 minutes while subjects were wearing heart rate bands to monitor the rate during exercise and recovery.Results (1)At 10, 20, 30, 40, 50, and 60 s, there was significant difference between the heart rate during exercise and that during recovery (P <0.05).(2) At 20,40 and 60 W , there was no significant difference in the decrease in recovery heart rates .Likewise , at the 80, 100 and 120 W intensity, 140, 160 and 180 W intensity , a significant difference was found in these three sections ( P <0 .05 ) .( 3 ) There was significant difference between the heart rate of 0-10 s and that of 10-20 s, and 20-30 s(P<0.05),but there was no significant difference between the 10-20 s and 20-30 s.(4)For the exercise heart rate of 20-60 W, 80-120 W,and 140-180 W and that of the 10-20 s recovery period , we set the regression equation of the exercise heart rate , the recovery rate , and the recovery time.Conclusion The recovery heart rates of different exercise intensities vary with the time .The heavt rate during exercise can be speculated by the recovery rate and time .The best measurement time is 10-30 s after exercise .

Objective To investigate the structure and features of the military training-related injuries in recruits during basic training period, and to provide scientific measures for prevention and intervention. Methods The incidence rate of military training-related injuries in recruits during basic training period in 2012 was investigated using question-naires, and the incidence rate, categories, positions, times, vulnerate training subjects and injury-causing factors were also analyzed. Results A total of 196 recruits among 2565 male recruits suffered military training-related injures during basic training period, and the total incidence rate of injures was 7. 64% . The top 5 categories of injures were stress frac-tures , joint sprain, tendonitis and tenosynovitis, contusion, lumbar muscle strain and acute lumbar muscle sprain, and the main injury positions were legs, feet, waist and upper extremity in turn. The numbers of recruits with military train-ing-related injuries began to increase from the 3rd week of training, and the peak number was recorded in the 11th week of training. The top 5 subjects of vulnerate training were 3000-metre-run, shuttle run, 100-metre-run, physical training and formation drill training. The main injury-causing factors were poor physical fitness or over-training, inadequate warming-up or relaxation exercise, over-hard or irregular ground, too much mental stress, lack of knowledge of protection and so on. Conclusion Running training and stress fractures are the key points of protecting military training-related injuries in recruits during basic training period, and scientific training and systematical prevention methods should be implemented.

采用功能性动作筛查(FMS)对特战队员的功能动作和损伤部位进行筛查和统计分析,以尽早发现技术训练过程中存在的功能性动作障碍,提出身体功能训练改进的方法和手段,为降低运动损伤发生率、保障日常体能训练和良好的健康水平提供参考.

The military training injury is an important factor which affects the normal training in army and endangers the soldiers' health.Because of the recruits' self factors,training factors and the environment factors,the incidence of training injuries in recruits during basic training is higher,and it is one of the research focus of military training injury.In order to provide the scientific basis for preventing the injury in military training,this paper has analyzed the reasons of the military training injury of recruits.

目的提高军队疾控机构实验室检测能力和管理水平,保证检测结果准确可靠。方法结合实际,建立并运行满足《检测和校准实验室能力认可准则》和《实验室资质认定评审准则》要求的实验室管理体系。结果通过了实验室认可和国家级资质认定评审。总结出6点做法:(1)精心组织、周密计划,真正做好顶层设计;(2)广泛调研,借鉴经验,结合实际建立体系;(3)充分授权,加强管理,按岗按责运行体系;(4)强调资质,加强培训,切实保证人员能力;(5)完善设施,溯源设备,全面做好质量保证;(6)纠正整改,持续改进,不断完善管理体系。结论开展实验室认可和计量认证应选择适合自身的方法途径,建立有效适用的文件化管理体系和确定适宜可行的能力范围。

[Objective]To analyze the features and regular pattern of military training injuries,put forward prevention and improvement measures,and reduce the incidence of military training injuries.[Methods]The hospitalization cases of military training injuries from 2006 to 2010 in a troop were collected as the research object.The data of first discharge diagnosis were collected and analyzed according to ICD-9 diagnostic criteria and the Diagnostic criteria and treatment principle for military training injuries.[Results]A total of 2 014 cases suffered from military training injuries,which accounted for 8.71‰ of the total army hospitalization cases of the military area,and the ratio in 2010 was the highest(11.4‰).1 709 cases were soldiers,which accounted for 84.85% of total hospitalization cases of training injuries.There were 853 fracture cases,accounting for 42.35% of total hospitalization cases of training injuries,which ranked the first place of military training injuries.The constituent ratio of articular wrick and dislocation,soft tissue injuries and organ injuries was 26.07%,17.97% and 12.26%,respectively.Three peaks of training injuries appeared both in 2009 and 2010.[Conclusion]The annual incidence rate of military training injuries has increased markedly in 2009 and 2010.It is important to strictly carry out the Rule for Health Protection in Military Training during training,and strengthen the prevention and protection of the military training injuries.The osteoarticular injury is the emphasis of prevention.

目的建立科学的部队疾控机构人员考核评价指标体系,对干部工作表现、绩效和贡献进行综合考核评价,提升个体能力和全员素质。方法采用专家访谈法确定综合考评项目、指标及其权重,经过筛选后建立干部综合考评指标体系;通过指标数据计权统计,获得量化的考评成绩;通过考评结果公示、内部沟通和奖励措施,实施和改进考评效果。结果通过6年的实践,单位劳动纪律和出勤率明显改善,参加任务的积极性明显提高,技术干部队伍流动正向有序,全员能力素质得到提升。结论部队疾控机构技术人员综合考评的实施,有利于个体自我约束机制和群体激励机制的形成,为科学评价专业技术干部提供了量化手段。

<正>为规范实验室管理,确保检测质量,向部队和社会提供准确、公正、可靠的数据,为客户提供优质服务,依据中国合格评定国家认可委员会(CNAS)发布的实验室认可准则的要求,结合本中心实际情况,组织实施实验室认可工作。现将主要做法和体会报告如下。