歼击机飞行员改装体检脊柱病症的医学鉴定和随访（摘要）

目的对近几年来我院改装体检歼击机飞行员脊柱病症健康鉴定结果进行归纳总结,为健康鉴定积累经验。方法采集分析了261例飞行员体检和随访资料,对脊柱病症体检不合格资料进行统计学分析,其中13例进行了随访。结果歼击机飞行员外科体检人数261人,20例脊柱病症改装体检不合格中,     

新型歼击机飞行员改装体检不合格的原因分析

目的 从不同层面总结新型歼击机飞行员改装体检的经验。方法 对93名新型歼击机飞行员改装体检不合格的资料进行综合分析。结果 改装体检不合格原因中内科病症12例，神经科病症3例，外科病症20例，眼科病症7例，耳鼻咽喉科病症4例，临床心理科异常1例，特殊功能检查不合格46例，分别占改装体检不合格的12．9％、3．2％、21．5％、7．5％、4．3％、1．1％和49．5％。结论 新型歼击机飞行员改装体检不合格的主要原因是离心机检查未达标和骨科病症，分别占改装体检不合格的46．2％和17．2％，应当引起高度重视。     

新型歼击机飞行员改装体检不合格的原因分析（2004--2008年）（摘要）

目的分析新型歼击机飞行员改装体检不合格原因的动态变化。方法对2004～2008年间102名新型歼击机飞行员改装体检不合格的资料进行综合分析,并与我们曾报道的1999-2003年间的相关资料比较。结果改装体检不合格的原因中,离心机检查未达标59例,外科病症26例,内科病症9例,神经科病症4例,耳鼻喉科病症3例,眼科病症1例,分别占改装体检不合格的58．4％、25．7％、7．9％、4．0％、3．0％、和0．9％。     

高性能战斗机改装体检原机种飞行合格者的随访观察

目的 从不同层面总结航卫保障和高性能战斗机改装体检经验. 方法 对高性能战斗机改装体检时结论为原机种飞行合格的127名飞行员进行随访,获取其健康状况和飞行结论资料,做出综合分析. 结果 ①改装体检原机种飞行合格原因中,特殊功能检查不达标及外、内科病症是主要原因,与同时段改装体检原机种暂时飞行不合格主因相似、程度不同.②其中32人再次入院改装体检,26例改装体检飞行合格,6例维持原机种合格.改装合格的26人中,17人原离心机检查不达标,后达标改装合格;余9例分别患各种病症,治疗及观察后明显好转改装合格,均飞行状况佳,完成和超额完成年度飞行任务.原机种合格的6例中,5人因离心机检查末达标,再次改装体检其中4人仍未达标.1人达标但因腰椎间盘突出症仍原机种合格;l例患白细胞减少症,2年半后白细胞仍低,再次结论为原机种飞行合格.③95例末进行第2次改装体检,其中9例停飞,余仍原机种飞行合格.停飞9人中,4例因新患疾病,3例因改装体检发现的病症,2例因技术或其他原因而停飞. 结论 高性能战斗机改装体检时所做的原机种飞行合格的结论是恰当的,《高性能歼击机飞行员体格检查要求》是符合实际的,但应重视社会-心理因素、特殊功能检查和脊柱问题对改装体检合格率的影响.应重视飞行人员年度大体检,及时发现健康隐患,保证飞行安全.     

飞行员腰椎椎弓根峡部裂的医学鉴定

目的总结飞行员腰椎椎弓根峡部裂的医学鉴定经验。方法对62名腰椎椎弓根峡部裂飞行员的资料进行分析，对其中14名高性能歼击机飞行员进行了1～4年的随访。结果62例中：27例改装合格，21例原机种合格，10例暂不合格，4例停飞。其中10例暂不合格中，有6例因腰椎峡部裂或伴滑脱，并有长期腰腿痛症状暂不合格，4例因其他疾病而暂不合格。停飞4例中：有2例因腰椎峡部滑脱合并长期腰腿痛症状或伴有腰椎间盘突出停飞，2例因其他疾病而停飞。结论在飞行员腰椎椎弓根峡部裂的医学鉴定时应考虑身体状况、飞行任务等各种因素的影响。     

高性能战斗机飞行员医学选拔若干问题探讨

目的 探讨高性能战斗机飞行员医学选拔中存在的问题，为选拔合格的高性能战斗机飞行员提供依据和指导。方法 采用询问病史、全面体检和综合评价的方法，对214例低机种歼击机飞行员体检发现的问题进行评价。结果 在参选低机种歼击机飞行员中，高性能战斗机改装合格192例，改装不合格并原机种合格，19例，原机种不合格3例。结论 飞行员基本身体状况、基础飞行耐力和加速度耐力是高性能战斗机飞行员的选拔评价重点。     

改装体检飞行员鼻科资料分析

目的 总结飞行员改装体检经验,提出飞行员鼻科体检的操作规范. 方法 分析改装体检和随访飞行员的×××份鼻科资料. 结果 鼻镜检查鼻中隔偏曲122例、下鼻甲肥大25例、中鼻甲肥大15例、均排除Ⅰ类疾病(地面有症状)和Ⅱ类疾病(地面无症状,飞行中有继发性气压伤表现),判断为生理性变异.诊断鼻窦囊肿9例、慢性肥厚性鼻炎2例、变应性鼻炎3例、慢性鼻窦炎鼻息肉21例(34例为Ⅰ类疾病,1例为Ⅱ类疾病).11例改装体检不合格,其余鼻科体检合格.新机飞行员中2例因鼻科疾病停飞,4例治疗后恢复飞行. 结论 飞行员患鼻科疾病可直接或因继发性气压伤而危及飞行安全.根据随访资料看,改装体检时所做的结论是恰当的,按操作规范进行鼻科体检,是保证体检和健康鉴定质量的重要措施之一.     

高性能战斗机飞行员选拔体检结果分析

目的 了解当前歼击机飞行员身体状况，进一步搞好高性能战斗机飞行员航空卫生保障工作。方法 对多个部队共计246名歼击机飞行员进行全面的临床体检和离心机 Gz耐力检查，确定飞行结论，并对结果进行统计分析比较。结果 评定飞行合格233人，占总人数的94．7％；飞行暂不合格13人，其中内科7人，外科2人，眼科3人，耳鼻喉科1人。少数飞行员患有活动性疾病仍在队飞行。心血管、消化系统疾病及脊柱疾患的检出率较高。有十分之一飞行员加速度耐力低下。结论 为适应高性能战斗机飞行员航空卫生保障工作的要求，要进一步加强飞行员各级体检工作，杜绝患有活动性疾病飞行员在队飞行，重点防治心血管、消化系统疾病。在招飞体检中，加强脊柱疾患的检查。迫切需要制定高G抗荷训练方案，以提高歼击机飞行员 Gz耐力。     

歼击机飞行员空晕病合并蛛网膜囊肿一例并文献复习

目的对歼击机飞行员空晕病及蛛网膜囊肿的临床诊治过程及医学鉴定进行探讨。方法分析1例以空晕病为临床表现的歼击机飞行员,同时影像学检查发现右侧颞叶蛛网膜囊肿,复习国内外相关文献。结果空晕病在飞行学员中较常见,飞行员中相对少见,同时合并颞叶蛛网膜囊肿更少见,本例患者症状明显,继续飞歼击机信心不足,加之颅内有囊肿,我们认为驾驶歼击机存在安全隐患,故结论为歼击机飞行不合格。结论空晕病可分为原发性和继发性,蛛网膜囊肿多为良性病变,但歼击机飞行员合并有颞叶蛛网膜囊肿可能诱发或加重空晕病的症状,提示对于飞行人员出现空晕病表现时应注意排除颅内病变的可能。     

歼击机飞行员飞行不合格的疾病谱分析

目的分析歼击机飞行员飞行不合格疾病谱,为新时期航卫保障提供参考依据.方法对空军总医院收集的飞行不合格的300名歼击机飞行员病例资料按疾病类别、涉及专科及不同年龄段进行分类计数.结果①歼击机飞行员飞行不合格的常见疾病为空中晕厥、加速度耐力不良、地面晕厥、航空性中耳炎、飞行错觉、眩晕、颈椎病、屈光不正、神经衰弱和血管性头痛等.②与歼击机飞行员飞行不合格最相关的专科有神经科、耳鼻咽喉科和骨科等.③飞行不合格的飞行员多集中在25～34岁间.结论与航空环境相关的一些疾病是空军总医院收集的歼击机飞行员飞行不合格的重要原因,今后应有针对性地加强歼击机飞行员的日常训练,同时重视社会-心理因素对飞行员的影响.     

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.     

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).     

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.     

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.     

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）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme