Objective To evaluate the changes in levels of fatigue during 24-hour simulated flight tasks and the anti-fatigue effect of modafinil based on electroencephalogram（EEG）technology so as to provide data for research on the applicability of modafinil to the military. Methods Six male subjects who met the physical requirements of pilots were selected. Within-subjects-design was adopted. Each subject participated in two 24-hour continuous simulated flight tasks. During the task, modafenib and placebo were taken separately, with modafenib as the experimental group and placebo as the control group. The subjective evaluation score（including the subjective sleepiness score and fatigue score）, critical flash fusion frequency and EEG data were collected throughout the experiment. Subjective evaluation and critical flash fusion frequency evaluation were used as auxiliary means to define the level of fatigue. The changes of four EEG rhythm waves, proportional parameters and wavelet entropy with flight time and the differences between the two groups were analyzed. Results During the 24-hour continuous simulation flight task, the δ-wave activity and wavelet entropy in the prefrontal area of the subjects were significantly reduced（F=1.981, 0.643, P=0.030, 0.016）, the subjects became less vigilant, the degree of inhibition of brain activity was elevated, and fatigue was intensified. There was no significant difference between the two groups, that was, modafinil did not completely block the positive increase of fatigue, which was basically consistent with the results of subjective and critical flash fusion frequency evaluation. Conclusion The δ-wave of EEG in the prefrontal region and wavelet entropy can be used as a potential objective and effective indexes to assess the fatigue level of flight personnel and the anti-fatigue effect of modafinil.

Objective To find out about the role of occupational exposure such as electromagnetic radiation, acceleration load and mental stress in the pathogenesis of thyroid diseases in flight personnel so as to provide data for the research on aerospace medical care. Methods The physical examination and assessment data of 8 057 military pilots who rehabilitated between January 2022 and July 2024 was collected, the incidence rates of thyroid diseases were calculated, and the differences in incidence rates between groups of different ages, aircraft types, jobs and flight hours were analyzed. Results The total prevalence rate of thyroid diseases among these flight personnel was 46.54%, including thyroid nodules（41.16%）, Hashimoto's thyroiditis（4.22%）, thyroid cancer（1.96%）, and thyroid dysfunction（0.84%）. The incidence of the above thyroid diseases increased with age（Z=190.500, 6.433, 63.164, 15.979, 308.026, P<0.001, =0.011, <0.001, <0.001, <0.001）and flight hours（Z=109.791, 9.864, 60.778, 16.943, 209.829, P<0.001, =0.002, <0.001, <0.001, <0.001）. Thyroid diseases were more prevalent in flight personnel of airborne early warning aircraft than in those of other types of aircraft（all P<0.05）, and among service crews than among pilots（χ²=4.209, 12.489, 4.723, 6.009, 18.536, P=0.040, <0.001, 0.030, 0.014, <0.001）. Age（OR=1.028, 95%CI: 1.019~1.037）, accumulated hours of flight（OR=1.114, 95%CI: 1.088~1.142）, aircraft types（OR=2.195, 95%CI: 1.337~3.606）, and service jobs（OR=1.669, 95%CI: 1.109~2.239）were all contributors to thyroid diseases in pilots. Conclusion The incidence of thyroid diseases in flight personnel is high, and age, accumulated hours of flight, aircraft types, and service jobs can make a difference in the vulnerability to thyroid diseases in pilots. Occupational exposure during flight is an important cause of thyroid diseases.

Objective To explore the abnormal spectra detected during ophthalmic selections of students from teenager aviation schools in Northeast China. Methods A total 173 students in Northeast China who were eliminated during Air Force recruitment medical selections in 2015-2020 were selected to analyze the abnormal spectra of ophthalmic diseases. Results A comparison of the rates of elimination due to ophthalmic diseases over the six years suggested that the percentage was over 50%. The analysis of the proportion of various diseases eliminated in ophthalmology showed that the diseases eliminated in ophthalmology in each year were mainly concentrated in fundus lesions and refractive errors, accounting for 35.40%（40/113）and 46.02%（52/113）respectively, and there was no statistically significant difference between the years（χ²=4.372, 3.881, P=0.497, 0.567）. Peripheral retinal degeneration was the main cause of retinal diseases（P=0.137）while myopia that exceeded the permitted level was the chief contributor to refractive errors（P=0.623）. The changes of the spherical degree were the main manifestation in myopia that exceeded the permitted level（F=3.968, P=0.006）. Conclusion Peripheral retinal degeneration and refractive errors are the major reasons that candidate from teenager aviation schools are eliminated ophthalmologically, and refractive errors mostly manifest themselves as myopia that exceeds the permitted level.

Objective To unveil the patterns of change in heart rate during long-haul simulated flights, summarize how flight fatigue varies, and analyze the persistent physiological changes throughout the experiment. Methods Eight healthy males were selected and assigned to four groups to perform tasks as a captain and a co-pilot respectively. Flights were simulated using a 4-hour work and 4-hour rest mode, and the experiment lasted 48 hours. Electrocardiogram signals were recorded throughout the process and individual physiological changes were evaluated using heart rate variability（HRV）indicators. Results Both the captains and co-pilots were affected by the circadian rhythm and workload accumulation to varying degrees. The circadian rhythm resulted in regular changes during seven independent flights within 48 hours, and reached the peak by midnight. The impact of workload accumulation resulted in differences in HRV indicators between the beginning and the end of the 4-hour simulated flight. Conclusion In the shift-simulating flight, the levels of fatigue of pilots are affected by the circadian rhythm and workload accumulation. The analysis of heart rate variability can intuitively capture the changes, and effectively distinguish the fatigue status from the non-fatigue status of pilots at the beginning and the end of the simulated flight in combination with related machine learning models.

长新冠是一种与感染相关的慢性疾病，个体化、多学科协作的综合康复是长新冠的重要治疗方法。为促进长新冠的康复，由中国康复医学会居家康复专委会发起，空军特色医学中心具体承担制定任务，依据《世界卫生组织制订手册》、采用GRADE方法，组建了多学科指南工作组，遴选出长新冠诊断、康复评价与治疗的16个相关问题，并提出相应建议。

在全球范围内，炎症性肠病（inflammatory bowel disease，IBD）发病率和流行率均在迅速上升。IBD是一种慢性肠道炎症性疾病，主要表现为溃疡性结肠炎和克罗恩病。IBD患者中肠道微生物的多样性和物质代谢途径受到严重破坏，表现为肠道内致病微生物和初级胆汁酸增加。肠道微生物通过将初级胆汁酸转化为次级胆汁酸来调节肠道胆汁酸谱，而胆汁酸也能影响肠道微生物群的多样性。这些失衡均能促进肠道免疫反应，加剧炎症。因此，通过改善肠道微生物失调和胆汁酸代谢紊乱，促进肠道炎症的消除和肠道屏障修复，有利于IBD患者病情缓解。此外，IBD患者炎症性肠病相关的结直肠癌的发生风险随确诊时间的增加而增加。因此开发可识别的生物标志物，用于监测IBD患者的疾病活动和疾病进展，具有重要的临床意义。

Objective To investigate the prevalence of hyperuricemia（HUA）in military aircrews and analyze the contributing factors so as to provide a reference for the prevention and treatment of HUA. Methods The clinical data of 1 531 military aircrews admitted to the Aviation Medicine Department of Air Force Medical Center between December 2017 and December 2020 was retrospectively analyzed, including age, gender, aircraft types, flight time, height, weight, BMI, blood pressure, medical history, and related biochemical test results. These aircrews were divided into the HUA group（n=402）and non-HUA group（n=1 129）according to the national diagnostic criteria for HUA. The data was compared between the two groups and multivariate logistic regression analysis was used to analyze the related contributors to HUA. Results The incidence rate of HUA in military aircrews was 26.26%（402/1 531）. The HUA group had higher levels of BMI, SBP, DBP, serum creatinine（Scr）, fasting blood glucose（FBG）, TG, TC and LDL-C（Z=－6.920~－2.173, all P<0.05）, but lower HDL-C levels（Z=－3.300, P=0.001）than in the non-HUA group, with statistically significant differences. The HUA group also had a significantly higher incidence rate of combined glucose metabolism abnormalities, hypertension, and dyslipidemia（χ²=5.728, 12.562, 23.756, all P<0.05）. Multivariate logistic regression analysis revealed that higher BMI（OR=1.089, 95%CI: 1.022~1.161）, elevated DBP（OR=1.026, 95%CI: 1.009~1.044）, increased TG（OR=1.345, 95%CI: 1.064~1.700）, and elevated Scr（OR=1.029, 95%CI: 1.017~1.040）were risk factors for HUA while older age（OR=0.974, 95%CI: 0.959~0.990）served as a protective factor. Conclusion The prevalence of HUA in military aircrews reaches 26.26% in our aviation medicine department. Age, BMI, DBP, TG and Scr are closely related to the occurrence of the disease, which points to the need to develop personalized comprehensive prevention and treatment plans in order to reduce the occurrence and development of HUA in military aircrews.

Objective To investigate the incidence of asthenopia among operators of medium and large-sized unmanned aerial vehicles（UAVs）in the Air Force and analyze its influencing factors. Methods A cross-sectional study was carried out. The Asthenopia Survey Scale（ASS）were used to survey 78 operators of medium and large-sized UAVs from the Air Force Units stationed in plateau areas in 2024. Based on the ASS scores, the subjects were divided into 2 groups: the asthenopia group（total score ≥15 points）and the non-asthenopia group（total score <15 points）. The occurrence of asthenopia was analyzed, and univariate analysis and multivariate Logistic regression were used to identify the influencing factors of asthenopia. Results A total of 76 valid questionnaires were collected. Among the subjects, 22 operators had asthenopia（total score ≥15 points）, resulting in an asthenopia incidence rate of 28.95%. Among all items in the scale, 8 items had a detection rate of ≥80%, which were as follows: Item A: "Do you have symptoms of asthenopia"（90.90%）; Item B: "Does asthenopia affect your study, work, or life"（81.82%）; Item 1: "Do you feel discomfort around the eyes"（95.45%）; Item 2: "Do you have dry eyes"（95.45%）; Item 3: "Do you have eye pain such as stabbing pain or distending pain"（86.36%）; Item 5: "Do you have sore eyes"（86.36%）; Item 6: "Do you feel tightness in the eyes"（81.82%）; Item 8: "When using electronic devices such as mobile phones or computers, does the screen brightness cause eye discomfort"（81.82%）. The results of multivariate Logistic regression analysis indicated that two factors were identified as risk factors for asthenopia: "Dry eyes"（OR=6.101, 95%CI: 1.549-24.031）; "Reduced reading speed due to eye symptoms"（OR=12.741, 95%CI: 1.990-81.569）. Conclusion Asthenopia symptoms are relatively prevalent among medium and large-sized UAV operators in the Air Force, primarily manifested as dry eyes and reduced reading speed due to eye symptoms. Dry eyes are the lead contributing factor to asthenopia.

飞机事故应急救援和现场急救工作面临复杂的环境条件、时间压力和资源管理等各类挑战，军用飞机事故更有其特殊危险性。笔者从军用飞机通信、应急预案与响应机制、应急救援设备工具、应急救援环境和现场急救等方面，对美国军用飞机遭遇地面险情或空中险情迫降时的救援体系进行初步研究，以期为我军救援急救流程的规范与优化、装备的研究与开发提供思路。

炎症小体是一种在炎症反应中发挥重要作用的多蛋白复合体，其激活受到多种因素的调节和影响。小泛素相关修饰物（small ubiquitin-related modifier，SUMO）化是一种翻译后修饰（post-translational modifications，PTMs）的方法，在炎症小体激活的调节过程中也发挥着重要作用。笔者通过对核苷酸结合寡聚化结构域样受体蛋白3（NOD-like receptor family pyrin domain-con-taining protein 3，NLRP3）炎症小体的SUMO化修饰进行系统回顾，阐述多种SUMO修饰分子和SUMO化酶发挥激活NLRP3的生物学作用，总结SUMO化影响NLRP3炎症小体激活的规律，为调节炎症小体激活和治疗炎症小体相关疾病提供新思路。

Objective To explore the relationship between probiotic supplements and fatigue in servicemen/veterans and to provide data for the use of probiotics in overcoming fatigue in military personnel. Methods Servicemen/veteran who had participated in the National Health and Nutrition Examination Survey（NHANES）from 2009-2018 were selected. Levels of fatigue were assessed via item DPQ040 from the Patient Health Questionnaire-9（PHQ-9）based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition（DSM-IV）. The usage of probiotics from dietary supplements over a 30-day period was calculated. Latent class analysis（LCA）was used to determine the patterns of co-morbidity of common chronic diseases. Multifactor Logistic regression was used to analyze the correlations between probiotics and fatigue. Results A total of 1 536 servicemen/veterans were enrolled, 44.3% of whom manifested fatigue, and 7.6% habitually took probiotics. Consumption of probiotics was a protective factor against fatigue（OR=0.565, 95%CI: 0.561 to 0.569）. The LCA categorized the subjects into four distinct patterns by the incidence of common chronic diseases: the hypertension-dominated, diabetic hypertension, multimorbidity, and relative healthy. Multifactorial logistic regression analysis showed that probiotics were a protective factor against fatigue in the relative healthy group（OR=0.492, 95%CI: 0.488 to 0.497）and the diabetic hypertension group（OR=0.743, 95%CI: 0.736 to 0.751）. Conclusion Consumption of probiotics may be associated with a reduced risk of fatigue in servicemen/veterans, suggesting a potential anti-fatigue effect of probiotics, but differences in the effects of probiotics on different diseases need to be studied.

富血小板血浆（platelet-rich plasma，PRP）是一种通过离心处理自体全血获得的血液制品，具有生物相容性和非免疫原性等特点，在骨关节炎治疗中被广泛应用。然而，由于PRP中生长因子的生物半衰期较短和注射部位的流动性，通常需要重复注射，增加了感染的风险。近年来，负载PRP的水凝胶得到了广泛关注，与单纯的PRP相比，可以减少治疗频率、增强局部疗效并提高注射的安全性。笔者阐述了负载PRP水凝胶在骨关节炎治疗中的作用机制、实验应用、主要优势和局限性，说明其在改善关节功能和缓解疼痛方面的潜力，为未来的临床应用提供参考。

“航空航天医学高峰论坛-2024”于2025年1月17—18日在北京举办。论坛以“作战航卫，数智空军”为主题，邀请了800余位来自航空航天医学领域的专家学者，就航空临床医学现状与展望、作战航卫实践探索、医工交叉进展等内容进行报告交流。会议论文集共收录交流论文287篇，笔者对航空航天医学领域的论文进行综述，主要包括飞行人员选拔鉴定与医学恢复、飞行人员身心训练与能力保持、航空医疗救援与海上救生、人机工效与新质效能、医工交叉与智能化创新融合等方面。

互联网技术飞速发展，在医疗卫生领域的应用已呈现出不可逆转的趋势。本研究基于互联网技术的视角，对传统骨科延续护理模式进行创新性的审视，探索依托互联网的新型骨科延续护理模式，深入解析这一模式对整合社会资源以及提升服务效率的巨大潜力。研究表明，通过巧妙利用互联网技术，可以有效地将社会资源引入医疗卫生体系，以实现护理服务的质量、满意度和效率的提高。此外，应正视互联网技术在骨科延续护理应用中所面临的安全问题以及受众范围的限制。这些挑战为未来的研究提供了明确的方向。通过深入研究，以期为互联网技术在骨科延续护理领域的广泛应用提供理论支持和实践指导。

Objective To explore the feasibility and effectiveness with which a new scenario simulation exercise model based on virtual simulation technology is used for organizing high-altitude physiological training in order to improve the quality and efficiency of high-altitude physiological training and update the training model. Methods Immersive high-altitude physiological training mission scripts were designed based on high-altitude emergencies, and corresponding evaluation criteria were established. Forty-four students of aviation medicine were divided into 3 groups randomly, with 14 or 15 students per group, to engage in training laid out in a scenario simulation exercise mode using virtual simulation technology alone or using traditional methods. After training, such indicators as changes in students' physiological parameters, mastery of skills and levels of satisfaction were analyzed. Results During the pressure breathing training, the differences in the total scores of physiological parameters, increases of systolic blood pressure, scores of subjective feelings and those of index recovery times between the three groups of trainees were statistically significant（F=4.139, 7.160, 5.770, P=0.023, 0.002, 0.006）. The trainees in the scenario simulation training group scored higher than those in the traditional mode group（P=0.019, 0.001, 0.005）. The differences in scores of indicators of training effect between the three groups were also of statistical significance（F=4.139~27.452, all P<0.05）. The trainees in the scenario simulation training group compared favorably with the traditional mode group and the virtual simulation platform group in terms of the total score of training, enthusiasm for training, subjective feelings, and mastery of knowledge and skills（all P<0.05）. Conclusion Scenario simulation exercises based on virtual simulation technology can effectively improve the quality and efficiency of high-altitude physiological training. This study is expected to provide a new line of thought for improving the ability of aviation health care givers to offer medical support and for updating high-altitude physiological training modes.

脑小血管病（cerebral small vessel disease，CSVD）是一类以脑内小血管受损为主的临床影像综合征，是导致血管性认知障碍甚至痴呆的重要病因。近年来，多模态MRI技术的发展为全面无创评估脑小血管病所继发的脑认知功能损伤情况提供了新视角。其中，结构MRI通过量化白质病变体积和脑萎缩模式提示认知损害的严重程度；弥散张量成像通过评估白质纤维完整性提示早期微结构损伤与特定的认知障碍存在关联；动脉自旋标记提示皮层下认知障碍患者中部分脑区的脑血流量显著降低；而血氧水平依赖成像可通过局部脑功能改变、功能连接和功能网络3个方面评估脑小血管病诱发的认知功能障碍情况。鉴于此，笔者对多模态MRI在CSVD相关认知功能障碍评价中的研究进展进行综述。以期为临床早期干预与治疗提供指导意义。

Objective To analyze the changes in indicators of heart rate variability of pilots and cadets before, during, and after flights in order to provide data for analysis of psychological stress and for safety assurance during flight training. Methods Forty-two male pilots and cadets were selected for collection of physiological data during flights, with electrocardiogram（ECG）parameters recorded. Results The differences in heart rate, low frequency（LF）, high frequency（HF）, and the ratio of low to high frequency（LF/HF）of pilots during non-training periods and before, during, and after flight training were statistically significant（F=4.791~31.909, P<0.05）. During daily flight training, heart rate, LF, and LF/HF of pilots increased（P<0.001, =0.001, 0.004）while HF decreased（P=0.001）. The differences in the standard deviation of normal-to-normal intervals（SDNN）and the root mean square of successive differences of RR intervals（RMSSD）before, during and after flight training between cadets were also of statistical significance（F=6.479, 8.005; P=0.005, 0.002）. During daily flight training, the RMSSD decreased（P=0.008）. Conclusion The heart rate and frequency domain indicators of pilots change significantly during flight training, so do the time domain indicators of cadets, which can provide a reference for aviation health and safety assurance of pilots and flight cadets during flight training.

Objective To explore the effect of mindfulness-based stress reduction（MBSR）on nonpathological high blood pressure in students of teenager aviation schools of Air Force（TASAF）. Methods In November of 2022, TASAF students in grade 9 whose blood pressure increases were found to exceed the standard during the first-round test in the annual reexamination were randomly divided into the MBSR group（n=121）and self-relaxation group（n=120）before the effectiveness of the two approaches in reducing blood pressure was compared. A scale was designed to investigate the accumulation of physical fatigue-psychological tension among the subjects. Results There was statistically significant difference in the initial systolic blood pressure between students with different scores of physical fatigue-psychological tension（F=15.670, P=0.012）. After pairwise comparison, the results showed that the higher the score of physical fatigue-psychological tension, the higher the initial systolic blood pressure（all P<0.05）. There was no statistically significant difference（all P>0.05）in systolic blood pressure, diastolic blood pressure or heart rate between the two groups before relaxation. Students in both groups underwent relaxation adjustment using the prescribed method and had their blood pressure retested according to the prescribed procedure. There was more significant difference in systolic blood pressure, diastolic blood pressure, and heart rate before and after relaxation in MBSR group than in self-relaxation group（t=6.873, 5.144, 3.651, P=0.001, 0.002, 0.013）. Conclusion The MBSR method is more effective than the self-relaxation method in improving the excessive increase of blood pressure and heart rate among students in TASAF, which is why this method should be used more widely and MBSR training be incorporated into daily courses.

目的 调查分析放射治疗科护士对医用粘胶相关性皮肤损伤的知信行现状，探究相关认知水平的影响因素，为加强相关管理提供依据。方法 采用自制问卷进行一般情况调查，并参考《预防医用粘胶相关皮肤损伤的最佳实践国际共识》制定医用粘胶相关皮肤损伤（medical adhesive-related skin injury，MARSI）知信行水平问卷，对综合医院放射治疗科护士开展调查，并对调查数据进行统计分析。结果 共发放140份问卷，回收有效问卷120份。听闻过MARSI的护士MARSI知信行得分较高（t=3.544，P<0.001）；参加相关培训的护士对MARSI知信行得分较高（t=3.188，P=0.002）；不同职称MARSI知信行得分比较，差异有统计学意义（F=3.331，P=0.039）。不同性别、年龄、学历、护龄、医院等级、是否为护理管理者及病区存在MARSI护士间的MARSI知信行得分比较，差异均无统计学意义（P均>0.05）。结论 综合医院放射治疗科护士基本了解MARSI，并能在实际操作中注意预防。参与多种形式的MARSI处理培训能有效提高放射治疗科护士对MARSI的知信行水平。

运动病严重影响从事海陆空相关行业人员的正常工作，以及多数人的海陆空航行、虚拟现实观影和游戏等日常生活活动。目前，国内外主要通过运动病史问卷、运动病症状问卷、前庭功能相关指标和运动病症状相关生理指标等方法，综合评估和量化个体对运动病的易感性，但尚未建立一种具有高特异性和高灵敏度的易感性评价金标准。笔者综述主观和客观评价方法在运动病易感性评价中的研究进展，旨在为运动病的深入研究提供理论基础。

Objective To explore the changes and significance of exercise cardiopulmonary indexes of pilots with reduced left ventricular diastolic function. Methods Thirty pilots with reduced left ventricular diastolic function were selected as the study group while another 30 healthy pilots served as the control group. Both groups underwent exercise cardiopulmonary function tests. The indexes of echocardiography in the resting state as well as the maximum exercise power, respiratory reserve, stroke output, post-exercise recovery heart rate, maximum kilogram oxygen uptake, estimated maximum oxygen uptake, metabolic equivalent, peak heart rate and oxygen pulse in exercise cardiopulmonary function tests were recorded. Results There were statistically significant differences in maximum motion power, respiratory reserve, stroke volume, rates of heart rate recovery two minutes and three minutes after exercise between the two groups（t=2.019~3.740, all P<0.05）. The maximum kilogram oxygen uptake was positively correlated with the rate of heart rate recovery two minutes and three minutes after exercise（r=0.558, 0.457, P=0.001, 0.011）. The case was the same with the left ventricular end diastolic diameter, left atrial anterior posterior diameter, left ventricular ejection fraction, and Tei index（t=3.179~9.617, P=0.002 or <0.001）. Conclusion Pilots with reduced left ventricular diastolic function may be vulnerable to changes in exercise cardiopulmonary function and to abnormal regulation of the autonomic nervous system in the early stage. The rate of heart rate recovery two and three minutes after exercise can reflect the ability of autonomic nerves for regulation and aerobic exercise, which can be used to serve pilots' physical training and prescriptions for exercise.

目的 探讨心脏骤停患者抢救过程中急诊护理流程优化措施的应用价值。方法 选取2021年6月—2023年7月联勤保障部队第九〇八医院急诊医学科接收的71例心脏骤停患者，其中35例予以常规急救护理措施的患者为对照组，36例予以急诊护理流程优化措施的患者为观察组。对比2组心肺复苏效果及动脉血气、平均动脉压、心脑功能和并发症等指标。结果 观察组患者自主循环、心律和呼吸恢复时间短于对照组（t=10.015、6.838、6.790，P均<0.001）；观察组动脉血二氧化碳分压低于对照组，动脉血氧分压和平均动脉压高于对照组（t=8.803、6.959、8.673，P均<0.001）；观察组α-羟丁酸脱氢酶、氨基末端B型利钠肽前体、肌酸激酶同工酶、神经元特异性烯醇化酶、髓磷脂碱性蛋白和中枢神经特异蛋白低于对照组（t=2.576~18.605，P<0.001或=0.013）；观察组并发症总发生率较对照组低（χ²=4.396，P=0.036）。结论 心脏骤停患者抢救过程中优化急诊护理流程，能够提高心肺复苏效果，值得推广应用。

盆底功能障碍性疾病是严重影响女性身心健康和生活质量的非致命性疾病，盆底超声结合临床可以给予诊断。盆底功能障碍性疾病发病因素是多维度的，女飞行员由于其职业特殊性，高载荷、长航时和高强度等增加了患盆底功能障碍性疾病的风险。笔者通过综述国内外女军人、特殊职业盆底功能的相关研究，以及盆底功能障碍性疾病的诊疗进展。盆底康复理疗与盆底肌训练能有效促进盆底功能的恢复，对于尿失禁患者进行至少16周盆底肌功能锻炼是一线治疗方案。应充分重视女飞行员盆底功能障碍性疾病相关知识的宣教和防护，早期诊断和治疗是盆底功能障碍性疾病诊治的关键。笔者旨在加强女飞行员自身盆底功能的健康防护意识，提高女飞行员群体盆底功能水平，提升部队作战力。

日益复杂的作战环境和任务要求让飞行人员承受着更大的身心压力，心理应激已成为影响飞行安全和任务执行的重要因素。每个应激源都会引发不同的身心反应，飞行人员个体的特殊性决定了应激外在表现形式、持续时间和强度方面的不同，因此针对性的干预措施非常重要。笔者梳理总结了飞行人员心理应激的影响因素、心理干预的介入时机和干预措施，并对未来的研究方向提出建议。

目的 探讨鼻腔免填塞技术在鼻中隔偏曲矫正术中的应用效果及围手术期护理。方法 回顾分析空军特色医学中心耳鼻咽喉头颈外科2023年10月—2024年1月收治的60例军队官兵患者鼻中隔偏曲矫正术围手术期临床资料，将60例患者随机分为免填塞组和填塞组。比较2组术后各项观察指标情况，对手术效果及围手术期护理进行分析。结果 2组术后6 h鼻胀痛、头痛和睡眠障碍等方面视觉模拟评分比较，差异有统计学意义（Z=－4.929、－3.418、－2.806，P<0.001、=0.001、0.005）。2组术后24 h鼻胀痛、头痛、流泪和睡眠困难等方面VAS评分比较，差异均有统计学意义（Z=－6.022~－2.314，P均<0.05）。结论 鼻腔免填塞技术在军队患者鼻中隔偏曲术中应用效果明显，可减轻伤患者术后头面部各部位疼痛等不适症状，减少并发症的发生，患者体验良好，提高护理满意度。

Objective To explore the characteristics and patterns of medical evacuations out of high-altitude areas in order to provide a reference for military training at high altitudes. Methods Cases of medical evacuation in an Air Force unit during high-altitude training between May 2020 and May 2024 were retrospectively analyzed. Results From May 2020 to May 2024, a total of 61 cases of medical evacuation were recorded. The top three causes were injuries and poisoning（19 cases, 31.15%）, digestive system diseases（13 cases, 21.31%）, and diseases of the ear, nose, throat, and eyes as well as acute high-altitude reactions（8 cases each, 13.11%）. Medical evacuations accounted for 47.54% of the total（29/61）in 2020 and 26.23%（16/61）in 2021. Cases that occurred in December 2020, January 2021, and September 2020 accounted for 22.95%（14/61）, 11.48%（7/61）, and 9.84%（6/61）respectively. Conclusion The diseases that led to medical evacuations in high-altitude areas were mostly injuries and poisoning, digestive system diseases, diseases of the ear, nose, throat and eyes, and acute high-altitude reactions. They were more prevalent in December 2020, January 2021, and September 2022. There is an urgent need to plan for medical support in winter, enhance the high-altitude adaptability of soldiers in order to reduce the incidence of training injuries and improve the combat effectiveness of the troops.

Objective To summarize the clinical and imaging features of pulmonary bullae in aviators and to offer data for aeromedical assessments. Methods We retrospectively analyzed the clinical data of aviators who were diagnosed with pulmonary bullae during routine physical examinations at Dalian Rehabilitation and Convalescence Center of the Joint Logistic Support Force between September 2020 and December 2023. Grouped by aircraft type, participants were categorized as fighter pilots（n=15）, helicopter pilots（n=15）, and bomber/transport pilots（n=21）. Baseline data, total flight hours, sizes and locations of bullae, and multiplicity were compared. Results Age and cumulative flight hours differed significantly between the three groups（F=11.568 and 8.563, P<0.001）. Fighter pilots were younger than both helicopter and bomber/transport pilots（P=0.029 and <0.001, respectively）, and had shorter accumulated flight hours （P=0.010 and <0.001, respectively）. There was no significant difference in height, body mass, BMI, or sizes of bullae between these groups（P>0.05）. Bullae were chiefly subpleural, and differences in locations of bullae were insignificant（P>0.05）. Conclusion The annual detection rate of pulmonary bullae in aviators is rising. More rigorous screening and cautious aeromedical assessments are needed. Prompt surgery is recommended when necessary.

Objective To analyze the incidence of pulmonary bullae detected by chance in pilots who underwent annual physical examinations at our center over the past three years in order to offer recommendations about related aeromedical assessments. Methods The results of chest CT examination of 5069 military pilots who received treatment at our center between July 2020 and November 2022 were retrospectively analyzed. The rates of detection, locations and sizes of pulmonary bullae were summarized. The detection rates of pulmonary bullae were compared between aircrews of different armed forces, aircraft types, flight times and jobs. The current number of confirmed cases of pulmonary bullae and the incidence of this disease accidentally found during aircrew physical examinations were analyzed. Considerations for aeromedical assessments were determined. Results The medical examination of aircrew found that the incidence of pulmonary bullae was about 4.46%（226/5 069）. The annual large-scale medical examination concluded that 6 cases were temporarily disqualified for flight, accounting for approximately 2.65%（6/226）of the total number of patients. Pulmonary bullae that ranged from over 1 to 2 cm in diameter accounted for 67.26%（152/226）. The detection rate of pulmonary bullae varied depending on the types of armed forces, with the army aircrews having a rate of 6.79%（55/810）, which was higher than that of aircrews from Air Force or Navy. The detection rate also varied according to types of aircraft（P=0.006, =0.001）, with the transport aircraft crews having a rate of 7.22%（76/1 052）, which was higher than among other crews（P=0.005, <0.001, <0.001）. The detection rate of pulmonary bullae in the group with flight time that ranged from over 3 000 to less than 5 000 hours was 8.70%（105/1213）, which was higher than in the group with flight time of ≤1 000 h and over 1 000 to 3 000 h（both P<0.001）. All these differences were statistically significant. However, no statistically significant difference was found in the detection rate of pulmonary bullae between aircrews doing different jobs（P=0.615）. Conclusion Aeromedical assessments should take into account such factors as the location and size of pulmonary bullae as well as the aircraft types and jobs of aircrews.

Objective To study the curative effect of electric fire needle acupuncture combined with Shentong Zhuyu decoction against lumbar disc herniation（LDH）. Methods A total of 48 LDH patients treated at Dalian Rehabilitation and Convalescence Center between July 2023 and December 2023 were selected as the subjects and randomly divided into two groups. The observation group（n=24）was treated with electric fire needles combined with Shentong Zhuyu decoction while the control group（n=24）was given Shentong Zhuyu decoction alone. The time the symptoms disappeared, scores of quality of life（6 Item Short Form Survey Instrument, SF-36）, scores of the visual analogue scale（VAS）, and scores of lumbar spine function（Japanese Orthopaedic Association Scores, JOA）were compared between the two groups. Results After 5 weeks of treatment, the pain and discomfort in the waist and leg disappeared more quickly in the observation group than in the control group（t=7.530, 7.988, 11.735, 12.890, all P<0.001）. The scores of SF-36 were higher in the observation group than in the control group（t=12.493, 12.357, 12.531, 12.034, all P<0.001）. After 1 week, 3 weeks and 5 weeks of treatment, the scores of VAS were lower in the observation group than in the control group（P=0.001, <0.001, =0.001）while the JOA scores were higher（P=0.015, <0.001, <0.001）. Conclusion Electric fire needles combined with Shentong Zhuyu Decoction have obvious advantages over Shentong Zhuyu decoction alone in the treatment of lumbar disc herniation, which can significantly improve the quality of life of LDH patients, effectively restore the lumbar function, and reduce such symptoms as lumbar pain.

自噬是亚细胞膜结构发生动态变化，经溶酶体介导后对细胞内蛋白质和细胞器降解的过程，是一种调节细胞稳态的机制，其功能异常常与多种重大疾病的发生发展密切相关。本研究综述了基于动物模型开展自噬调控的研究，重点探讨其在肿瘤、神经退行性疾病、心脑血管疾病、代谢性疾病和骨骼疾病中的作用机制及干预进展，以期为后续临床研究和疾病防治提供新思路和潜在靶点。

Objective This study aims to investigate the therapeutic effects of Jingning Decoction（JND）in a rat model of Tourette Syndrome（TS）and to explore the potential mechanisms through which JND modulates gut microbiota, influences neuroinflammation, and alters neurotransmitter levels. Methods A total of 48 male Wistar rats were used to establish a TS model by administering intraperitoneal injections of 3,3-iminodipropionitrile（IDPN）at a dosage of 150 mg/kg/day for one week. A stereotyped behavior score greater than 1 indicated successful modeling. Using the random number table method, the patients were randomly divided into six groups: control group（Control group）, model group（TS group）, positive drug group（Hal group）, low-dose Jingning decoction group（JND-LD group）, medium dose Jingning decoction group（JND-MD group）, and high-dose Jingning decoction group（JND-HD group）. After 4 weeks of administration, the efficacy was evaluated through stereotype scoring, ELISA assay, and histopathological analysis; Extract fecal genome and perform 16S rRNA sequencing detection. Results After 4 weeks of administration, the stereotype scores of the JND-HD group, JND-MD group, and JND-LD group were lower than those of the TS group（P=0.032, <0.001, 0.160）; The ELISA analysis results showed that the IL-4 levels in the JND group were higher than those in the TS group（P=0.002, 0.015, <0.001）, while the IL-6 and DA levels in the Hal group, JND-MD group, and JND-LD group were lower than those in the TS group（P=0.016, 0.017, 0.006, <0.001, 0.016, 0.006）. The Glu levels in the Hal group and JND-MD group were lower than those in the TS group（P=0.040, 0.027）; The results of histopathological analysis showed that the protein levels of ZO-1, Occludin, and Claudin-1 in the TS group were lower than those in the Control group（P=0.014, 0.007, 0.009）, while the JND-MD group was higher than the TS group（P=0.004, 0.021, <0.001）. The protein levels of Occludin and Claudin-1 in the Hal group were higher than those in the TS group（P=0.040, 0.012）. The 16S rRNA sequencing analysis results showed that the Shannon index and thickness/pseudo ratio of the TS group were lower than those of the Control group（P=0.033, 0.006）, while the JND-MD group was higher than the TS group（P<0.001, =0.003）. Conclusion JND demonstrates significant therapeutic efficacy in the treatment of Tourette Syndrome model in rats, with its mechanism of action mediated through the regulation of gut microbiota, modulation of inflammatory cytokines, and expression of neurotransmitters.

Objective To investigate the effect of cannabidiol（CBD）on propofol（PPF）-induced sleep rhythm disturbances in rats. Methods Twenty-four SD rats were divided into the control（CON）group, model（MOD）group, melatonin（MLT）group, and CBD group, and each group was acclimatized to a 12 h/12 h light/dark rhythm environment for one week. The MLT and CBD groups were given 15 mg·kg^-1 melatonin and 10 mg·kg^-1 CBD, respectively, by gavage at CT12（circadian time, CT12 was set at 20:00）while the other groups were given an equal volume of solvent. On the same day, all these groups except the CON group were anaesthetized with propofol at CT16（CT16 was set at 22:00）. Blood was collected through the fundus sinus vein at 1 h and 24 h after anesthesia and circadian rhythm was monitored for one week. The endogenous melatonin level of rats was detected by ELISA before the CTX-TNA2 cell lines were divided into the negative control（NC）group, 6.25, 12.50, 50.00 and 100.00 μM PPF group, and 2.50, 5.00, 10.00, 20.00, 40.00, 60.00, 80.00 and 100.00 μM CBD group. The cell survival rate was detected using the CCK-8 method. The CTX-TNA2 cell lines were divided into the NC group, PPF group, PPF+2.5 μM CBD group, PPF+5.0 μM CBD group, and PPF+10.0 μM CBD group. The NC group was routinely cultured, the PPF group was cultured for 24 h in medium containing propofol, while the PPF+2.5 μM CBD group, PPF+5.0 μM CBD group and PPF+10.0 μM CBD group were pretreated with media containing different concentrations of CBD for 4 h before being treated with media containing propofol for 24 h. Cellular γ-aminobutyric acid levels were measured by ELISA. Results Compared with the CON group, the circadian rhythm of rats in the MOD group was phase-delayed by 1-3 hours（P<0.001 or <0.05）, and serum melatonin levels were significantly increased at 1 h after anesthesia（P<0.001）. Compared with the MOD group, serum melatonin levels in the CBD group rats remained at normal levels after anesthesia（P=0.997）. Compared with the NC group, the cell survival rate decreased in the 40.00, 60.00, 80.00 and 100.00 μM CBD group（P<0.001）, but there was no significant difference in cell survival rates between other doses in the PPF and CBD groups compared with the NC group（P>0.05）. Compared with the NC group, the GABA level in the PPF group increased（P=0.014）. Compared with the PPF group, the GABA levels in the PPF+2.5 μM CBD group and PPF+5.0 μM CBD group decreased（P=0.002, <0.001）. Conclusion Propofol anesthesia can significantly disrupt normal circadian rhythm and serum melatonin levels in rats. After CBD intervention, circadian rhythm disturbances can be improved and serum melatonin levels can return to normal. CBD can down-regulate GABA levels in PPF induced CTX-TNA2 cells.

Objective To explore the correlations between the risk of obstructive sleep apnea syndrome（OSAS）and heart rate variability（HRV）based on HRV, and to study the effect of sleep-disordered breathing on daytime autonomic nervous function in high-altitude military flying personnel. Methods A total of 47 military flying personnel stationed at high altitudes were selected as the subjects. A sleep questionnaire survey was conducted, data on short-term HRV was collected by a head-mounted HRV monitoring device and the risk of OSAS was assessed using the STOP-BANG scale and Epworth scale. Participants were divided into the risk group and normal group according to the results of evaluation of scales. The findings of the survey, the difference in HRV indexes and correlations between HRV and the scores of STOP-BANG scale and Epworth scale were analyzed across the 2 groups. Results Out of the 47 flying personnel, 20 were in the risk group and the rest were in the normal group. There were no significant differences in age, BMI, durations of flight, length of long-term stay on the plateau and total sleep time（all P>0.05） between the 2 groups. The incidence of attention/memory decline in the risk group was higher than that in the normal group（χ²=4.335, P=0.037）, so was the high frequency power（HF）（t=2.933, P=0.007）. There was no significant difference between other HRV indexes（all P>0.05）. The Epworth scale score had a moderate positive correlation with HF（r_s=0.402, P=0.005）, while the STOP-BANG scale had a low positive correlation with HF and PNN50（%）（r_s=0.394, 0.299, P=0.006, 0.041）. Conclusion Flying personnel at high risk of OSAS are more vulnerable to daytime symptoms related to sleep deficiency, especially decreased attention/memory. In addition, they are likely to develop autonomic nervous dysfunction, such as increased parasympathetic excitability. The more sleepy during the day, the higher the parasympathetic tension. It is recommended that autonomic nervous dysfunction be taken into consideration in case of sleep disorders among flying personnel at high altitudes.

Objective To explore the effects of sleep deprivation on functional brain connectivity in simulated extended-duration flights using a graph-theoretic approach in order to provide data for formulating precautions and ensuring flight safety. Methods Forty-four young and middle-aged subjects were enrolled in this study. Resting-state functional magnetic resonance（rs-fMRI）examinations were performed before and after 24 hours of sleep deprivation. Time series and functional connectivity matrices were extracted from rs-fMRI and visualized via graph theory metrics and computation of brain network metrics. The degrees, local efficiencies, clustering coefficients, and bridging connections in each brain region were computed while the global network characteristics of each subject were compared before and after sleep deprivation to assess its effects on functional brain connectivity. Results After sleep deprivation, the local efficiency in the right middle frontal gyrus and left inferior occipital gyrus increased（Z/t=2.026, 3.532, P_FDR=0.049, <0.001）, so did clustering coefficients（t=2.377, 3.146, P_FDR=0.022, 0.003）. The degree of the right middle occipital gyrus was also elevated（t=2.096, P_FDR=0.042）. In contrast, the degrees of the left superior temporal gyrus, right Heschl's gyrus, and left insula as well as the local efficiency of the right Heschl's gyrus decreased（Z/t=－2.026, 2.177, 2.959, 2.177, P_FDR=0.049, 0.035, 0.005, 0.033）. In addition, both average local efficiency and bridging connections increased（t=2.090, 2.310, P_FDR=0.042, 0.025）. Conclusion Sleep deprivation impacts the cognitive function of subjects in a simulated extended-duration flight, particularly in terms of attention and delayed memory. The brain may make adaptive responses to sleep deprivation at the local network level, but the global network efficiency may decline.

Objective To find out more about the differences in gut microbiota between aircrews with hyperlipidemia（HL）, hyperuricemia（HA）or both（HA+HL）and healthy aircrews（NC）. Methods A total of 40 aircrews who underwent physical examinations at our hospital between September 2022 and September 2023 were enrolled and divided into four groups: a normal control group（NC group, 10 participants）, a hyperlipidemia group（HL group, 10 participants）, a hyperuricemia group（HA group, 10 participants）, and a hyperlipidemia combined with hyperuricemia group（HA+HL group, 10 participants）. The basic demographic information, important data and metabolic indicators（including blood lipid parameters and serum uric acid levels）were collected. Fecal samples were obtained and subjected to 16S rDNA amplicon sequencing to analyze gut microbiota composition. Differential bacterial communities were identified before their functional characteristics were investigated. Results Based on the Bray-Curtis distance matrix, weighted differences between samples were calculated and analyzed using principal coordinate analysis（PCoA）. The results showed that the microbial structures of the HA group, HA+HL group, and HL group were significantly different from those of the NC group（F=1.625, 1.654, 1.400, all P<0.05）. At the phylum level, the top five bacterial phyla across all four groups were Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, and Desulfobacterota. The relative abundance of Firmicutes in the HA+HL group was significantly higher than in the NC group（P<0.001）, and that of Bacteroidetes and the Bacteroidetes-to-Firmicutes ratio in the HA, HL, and HA+HL groups were all significantly higher than in the NC group（all P<0.001）. At the genus level, the top eight gut bacterial genera across the four groups were Megamonas, Bacteroides, Faecalibacterium, Bifidobacteriaceae, Prevotella-9, Streptococcus, Agathobacter, and Escherichia-Shigella. Significant differences were observed in the abundance of Escherichia-Shigella between the four groups（H=9.000, P=0.029）, with the relative abundance of the HA+HL group significantly lower than in the NC group（P<0.05）. Conclusion Aircrews with HA, HL or both（HA+HL）are vulnerable to gut microbiota dysbiosis. Alterations in the abundance of fermentative carbohydrate-related bacterial genera may serve as significant biomarkers for metabolic abnormalities.

Objective To analyze pilots' behavior related to visual information acquisition and cognitive processing during turning and landing of simulated flights. Methods Forty-two male pilots performed the designated flight mission in the same simulator. Data on their eye movement was recorded using an SMI eye tracker, and the fixation durations in each area of interest（AOI）across different stages were statistically analyzed. Results During turning, there was a statistically significant difference in the median fixation duration of the subjects on graphic and digital AOIs（Z=－2.737, P=0.006）. Participants' fixation durations on lower AOIs were longer than on upper AOIs（P=0.043）and on right AOIs（P<0.001）, and fixation durations on central AOIs were longer than on right ones（P=0.015）. However, there was no significant difference in durations between the subjects' fixation on the external runway and on the first fixation point when shifting back to the instrument panel（both P>0.05）. Besides, there was statistically significant difference in the median fixation duration between the first fixation point when the subjects shifted back to the instrument panel and other AOIs of the instrument（Z=－3.036, P=0.002）. During landing, participants exhibited longer fixation durations on the runway centerline than on the instrument panel（P=0.008）. Conclusion Pilots pay more attention to graphic AOIs, lower AOIs, central AOIs, and the first fixation point when shifting back to the instrument panel during turning, but they focus their attention on aligning with the runway during landing, suggesting that the design of human-machine interaction interfaces can be optimized by taking actual flights into consideration.

Objective To explore the levels of serum albumin（ALB）, lactate dehydrogenase（LDH）, interleukin-17 （IL-17）, and tumor necrosis factor alpha（TNF-α）in patients with interstitial pneumonia（IP）who received targeted therapy and chemotherapy for recurrent drug-resistant ovarian cancer (RDROC), and to construct a nomogram prediction model for IP based on these levels. Methods A total of 80 patients with RDROC who had been treated for IP related to targeted therapy+chemotherapy in Zhangjiakou Xuangang Hospital between June 2020 and June 2022 were assigned to the study group while another 80 patients with RDROC who had not were selected as the control group. The clinical data and serum levels of ALB, LDH, IL-17, and TNF-α were compared between the two groups. A logistic regression model was used to analyze the contributors to IP. A nomogram prediction model was constructed according to these contributors, whose prediction efficiency and clinical applicability were evaluated. Results Age, percentages of patients in primary FIGO stage Ⅲ-Ⅳ, with preexisting lung diseases, or with a history of smoking, and serum levels of LDH, IL-17, and TNF-α in the study group were higher than those of the control group（t=4.006-21.973, all P<0.001）, while the ALB level was lower（t=7.118, P<0.001）. The serum level of ALB in patients with acute exacerbation was lower than that of patients in stable condition（t=5.311, P<0.001）, but levels of LDH, IL-17, and TNF-α were higher（t=3.712, 4.390, 14.132, all P<0.001）. Preexisting lung diseases（OR=6.152, 95%CI: 2.406-15.729）, smoking（OR=5.017, 95%CI: 1.965-12.810）, serum LDH（OR=3.642, 95%CI: 1.733-7.652）, IL-17（OR=4.889, 95%CI: 2.267-10.543）, and TNF-α（OR=8.064, 95%CI: 3.012-21.591）were all independent risk factors for the occurrence of IP in patients with RDROC undergoing targeted therapy+chemotherapy, while serum ALB（OR=0.426, 95%CI: 0.215-0.843）was an independent protective factor（all P< 0.001）. ROC analysis showed that the AUC of the nomogram prediction model was 0.887 for predicting the occurrence of IP, with a good predictive performance. Conclusion Preexisting lung diseases, smoking, serum LDH, IL-17, and TNF-α are all independent risk factors for IP in patients with RDROC undergoing targeted therapy+chemotherapy. Serum ALB is an independent protective factor. A nomogram prediction model has been constructed, which can help predict the occurrence of IP.

Plateau frostbite is one of the common injuries and illnesses among officers and soldiers in high-altitude areas of China. It not only affects the physical health of officers and soldiers, but also affects their combat and survival abilities, posing a serious threat to the combat effectiveness of the military. Hyperbaric oxygen, as an adjuvant therapy, can effectively treat and prevent high-altitude frostbite by reducing cell damage and promoting wound healing. The author reviews the research progress of hyperbaric oxygen therapy in the treatment of high-altitude frostbite, aiming to lay a more solid foundation for subsequent clinical applications.

Objective To investigate the effects of serum total bilirubin（STB）and alanine aminotransferase （ALT） on blood lipids and the incidence of fatty liver among aviators. Methods A total of 1,318 flight personnel who underwent medical evaluation at Guilin Rehabilitation and Recuperation Center between January 2021 and January 2024 were selected and divided into three groups based on types of aircraft: the fighter jet group（581 cases）, transport aircraft group（376 cases）, and helicopter group（361 cases）. The detection rates of related diseases and abnormal indicators were analyzed under different levels of STB and ALT across the three groups. Results Significant differences were observed in the detection rates of fatty liver between the three groups（χ²=7.820, P=0.021）, with a notable difference between the fighter jet group and the helicopter group （χ²=7.424, P=0.006）. The detection rates of elevated HDL-C also differed significantly（χ²=9.208, P=0.010）, particularly between the fighter jet group and the other two groups（χ²=6.050, 6.029, P=0.014, 0.014）. Total cholesterol（TC）levels were significantly different between the three groups（F=6.307, P=0.002）, with a marked difference between the fighter jet group and the helicopter group（P=0.002）. There were significant differences in HDL-C levels between these groups（F=3.987, P=0.019）, especially between the fighter jet group and the transport aircraft group（P=0.025）. A comparison of incidences of lipid metabolism disorders between elevated STB levels and normal ones suggested that the detection rates of high levels of TG were significantly different between the transporter aircraft group and the helicopter group（χ²=4.704, 11.446, P=0.030, 0.001）, and that the detection rates of fatty liver（χ²=4.762, P=0.031）and abnormalities of low-density lipoprotein cholesterol (LDL-C)（χ²=14.23, P=0.001）were significantly different in the fighter jet group. The comparison of incidences of lipid metabolism disorders between elevated and normal ALT levels showed that the levels of TG differed significantly between the three groups（Z=3.638, 2.509, 5.515, P=0.001, 0.012, 0.001）. The differences in TC levels of the fighter jet and helicopter groups, HDL-C levels of the transport aircraft group, LDL-C levels of the helicopter group were of statistical significance（t=2.850, 3.297, 2.107, 2.617, P=0.005, 0.001, 0.036, 0.009）. Conclusion Fighter crews have better lipid profiles than transport and helicopter crews. Moderate SSTB levels may reduce hypertriglyceridemia and fatty liver risks while elevated ALT levels are associated with increased risks.

目的 构建野战传染病医院护理人员生物安全核心能力培训体系。方法 在文献回顾和半结构式访谈的基础上形成“培训模块-子模块-培训条目”三级培训体系初稿，采用德尔菲法对16名专家进行2轮函询，对培训内容进行修订和完善。结果 2轮专家函询问卷有效回收率100%，专家权威系数均为0.878，专家的肯德尔协调系数分别为0.346、0.290（P均<0.001）；最终形成的野战传染病医院护理人员生物安全核心能力培训体系包括野战传染病医院概论及军事素养、生物安全知识与救护技能、生物安全防护能力、生物武器袭击下护理人员适应能力及护理人员生物安全防御作战能力等5个培训模块、11个子模块、47项具体培训条目。结论 本研究构建的野战传染病医院护理人员生物安全核心能力培训体系具有可靠性、科学性和实用性，可为我国野战传染病医院护理人员生物安全核心能力的培养提供依据。