Objective To investigate the current incidence of neck pain among pilots, analyze the risk factors, and provide data for related prevention and intervention. Methods From July 2019 to November 2020, 284 pilots were selected. A cross-sectional study of pilots' neck pain involved questionnaires and assessment of neck function, and a logistic regression model was used to screen out risk factors for neck pain. Results Valid data was collected from a total of 217 people, including 118 fighter pilots, 52 helicopter pilots and 47 transport pilots. The overall incidence of neck pain among these pilots was 29.0%. Height（P<0.001）, weekly flight hours（P<0.001）, neck training（P=0.023）, alcohol consumption（P<0.001）, upper back pain（P<0.001）, the strength of neck flexors（P=0.012）, neck extension（P<0.001）, left lateral neck flexion（P=0.037）, right lateral neck flexion（P=0.011）, left upper neck rotation（P=0.002）, right upper neck rotation（P=0.005）, left lower neck rotation（P<0.001）, right lower neck rotation（P<0.001）and deep neck flexor activation（P=0.030）were significantly different between pilots of different aircraft. After adjusting for age and total flying hours, the risk factor for neck pain of pilots were upper back pain（OR=6.956, 95%CI: 2.167~22.232）and the protective factor was deep neck flexors（OR=0.146, 95%CI: 0.033~0.272）. The risk factors for fighter pilots was upper back pain（OR=17.718, 95%CI: 2.034~154.362）while the protective factors were strength of left lateral neck flexion（OR=0.015, 95%CI: 0.001~0.351）, left lower neck rotation（OR=0.950, 95%CI: 0.911~0.990）, and deep neck flexor activation（OR=0.125, 95%CI: 0.094~0.341）. The risk factors for helicopter pilots were weekly flying hours（OR=1.183, 95%CI: 1.106~1.624）and smoking status（OR=23.663, 95%CI: 1.597~350.779）while the protective factor was the strength of left upper neck rotation（OR=0.143, 95%CI: 0.082~0.884）. The protective factor for transport pilots was the strength of neck flexors（OR=0.894, 95%CI: 0.008~0.943）. Conclusion Pilots are vulnerable to neck pain, and risk factors vary among pilots of different aircraft. Better neck muscle strength and deep neck flexor function can be protective. The impact of personal habits and flight duration on neck pain should not be ignored, so targeted interventions are critical.

Objective To find out the nutritional status of aircrews and explore the correlations between blood metabolism indexes and body composition indexes in order to provide data for proper nutrition and training among aircrews. Methods During health checkups, the body composition of aircrews was measured who were recuperating between July and November in our center. The metabolism-related indexes and body composition indexes of these aircrews were collected, their nutritional status was evaluated and the correlations between those indexes were analyzed. Results The abnormal rates of those indexes were high. Total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholesterol（LDL-C）, fasting blood glucose（FBG）, blood uric acid（BUA）were positively correlated with the body mass index（BMI）, body fat mass, body fat percentage，visceral fat area, and waist to hip ratio respectively（P<0.01）while high density lipoprotein cholesterol（HDL-C）was negatively correlated with the BMI, body fat mass, body fat percentage and visceral fat area（P<0.01）. Conclusion The abnormal rates of metabolism-related indexes and body composition indexes are high. The two types of indexes are closely correlated. Body composition analysis could be included during physical examinations. Nutritionists should conduct precise nutrition assessment and dietary guidance by analyzing those indexes so as to improve the health of aircrews.

Objective To investigate the current competence and expectations of 2 047 flight cadets who were born after 2 000 and 86 instructors in aviation schools in China. Methods A total of 2 047 flight cadets and 86 instructors were investigated. The revised competence questionnaire was used to evaluate their competence. Paired analysis was used to reveal the differences between their current competence and expected levels. Results The current competence of the cadets exceeded the theoretical average. The cadets' evaluation of current factors of competence was lower than that of expected competence（Z=-37.918, -37.383, -36.925, -37.721, -37.008, all P<0.001）. The same was true of instructors（Z=-7.428, -7.062, -7.406, -7.278, -7.235, all P<0.001）, but the cadets' evaluation of current factors of competency was higher than that of instructors（Z=2.47, 3.34, 3.35, 3.39, 2.98, P=0.014, 0.001, 0.001, 0.001, 0.003）, so was their evaluation of the expected factors of competence（Z=8.71, 10.05, 8.92, 11.04, 9.30, all P<0.001）. In addition, ideological competence was considered the most important by cadets and instructors alike. Conclusion The cadets' competence remains to be improved. Ideological competence is considered the most important competence among cadets and instructors. There is a need to synchronize the expectations of competence as well as the importance of different competence factors among cadets and instructors.

Objective To accomplish simulated design of experiments for detection of impulse noise from explosive cutting during aircraft escape in order to protect against hearing damage. Methods The relationship between the proportional distance of the overpressure estimation of the impulse noise from explosion cutting during aircraft escape and the point of measurement of bombing in the cockpit of the aircraft was analyzed according to the overpressure evaluation standard stipulated in the safety threshold of auditory damage by impulse noise. Then, simulated design was initiated based on the spatial and temporal characteristics of the instantaneous ejection of the pilot and on the ejection design of the aircraft cockpit and seat. The instantaneous scenario of explosion cutting during aircraft escape was analyzed and simulated. An experimental platform was built with adjustable points of explosion and measurement that were accurately simulated in each posture of the seat. Finally, ground experiments for detection of explosion cutting were carried out and data was collected and analyzed. Results The simulated design was completed based on the cockpit scenario of explosive cutting during aircraft escape. The values of impulse noise overpressure calculated by the two experiments were 165.9 dB and 165.2 dB, respectively. The results of simulated experiments were consistent with the peak value of impulse noise of the measurement curve. In the experiment, the sound insulation value of the helmet was 21.8 dB and the actual value of sound insulation of the helmet was 22 dB. Conclusion The simulated design of experiments for detection of impulse noise from explosion cutting during aircraft escape can provide data for pilots' protection against hearing damage and other research.

目的 回顾性分析胡桃夹综合征的临床特点,增强招飞医学选拔检查人员对该疾病的认识,提高诊断准确率,进一步实现精准招飞的目标。方法 收集2022年参加青少年航空学校飞行学员医学选拔定选阶段的1 140名学员超声检查结果和临床表现、实验室检查结果,对结果进行分析。结果 超声诊断胡桃夹现象16例。临床表现血尿1例,直立性蛋白尿0例,左侧腰腹部疼痛2例,左侧精索静重度曲张1例。结论 彩色多普勒超声作为诊断招飞工作中胡桃夹综合征首选的无创性检查,检查人员应增强对该疾病的认识,提高招飞医学选拔过程中胡桃夹综合征诊断准确率,进一步实现精准招飞的目标。

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 explore the impact of pilots' visual attention features on combat performance during simulated air-to-air combat, and provide data for simulated air-to-air combat training. Methods A total of 25 pilots were selected as the subjects to complete simulated air to air combat tasks on a computer wearing an eye tracking device that recorded the pilots' eye movement while the computer recorded related combat performance indicators such as the time taken to complete a task and results of attacks. Eye movement indicators related to visual attention were selected before correlations with the time taken to complete a task were analyzed and a correlation regression model was constructed to study the differences in eye movement indicators between pilots with successful attacks and those whose attacks failed. Results There was a significant positive correlation between eleven eye tracking indicators and the time taken to lock in the enemy's aircraft（r=0.399-0.657, all P<0.05）.A linear regression equation was constructed that involved such eye movement indicators as the number of fixations on the radar image area, the entry time of the first complete fixation in the data area of the enemy's aircraft, the latency time of first complete fixation on the area of height data, and the average time taken by complete fixation on the task command area（R²=0.712, F=12.375, P<0.001）. There were four eye movement indicators that were significantly negatively correlated with attack duration（r=－0.459, －0.486, －0.480, －0.420, all P<0.05）. A linear regression equation between eye movement indicators and the time taken by an attack was constructed involving six eye movement indicators, including the total time of gaze at the radar image area, the number of gazes at the radar image area, the number of scans in the radar image area, the number of scans in the locked image area, the entry speed of peak scans in the airspeed data area, and the entry speed of peak scans in the data area of the enemy's aircraft（R²=0.736, F=3.540, P=0.017）. Compared with pilots who failed in an attack, the successful pilots had shorter latency times in the first fixation on the area of height data, the first complete fixation on the area of height data, the first complete fixation on the area of data on enemy's aircraft, and the first departure from the area of data on enemy's aircraft, and the differences were statistically significant（t=－2.206~－2.059, all P<0.05）. Conclusion In simulated air combat scenarios, pilots exhibit distinct visual attention patterns, and their eye tracking indicators can provide important data for simulated air-to-air combat training.

Objective To investigate the effect of osteostatin (OST) on the proliferation, osteogenic differentiation, and angiogenesis of bone marrow mesenchymal stem cells (BMSCs) under hypoxia, and to explore its applicability in bone defect repair. Methods BMSCs were isolated from bone marrow of rats before being treated with OST and cultured under normoxic (21% oxygen) or hypoxic (1% oxygen) conditions. CCK-8 assay was used to evaluate cell proliferation, while trypan blue staining was adopted to detect cell mortality. Osteogenic differentiation was evaluated via alkaline phosphatase (ALP) staining and alizarin red S (ARS) staining. Levels of ALP, RUNX2 (runt-related transcription factor 2) and OCN (osteocalcin) were measured by Western blot. Concentrations of Ang-1 (angiopoietin-1) and VEGF (vascular endothelial growth factor) in the medium were detected by ELISA. Angiogenesis was evaluated by tube formation assay. Results The proliferation of BMSCs in rats was enhanced in an OST dose-dependent manner (F=4.89, P=0.006). Under hypoxic inductions, the proliferation and tubule formation of BMSCs increased (F=28.98, 76.68, both P<0.001), so did the concentrations of Ang-1 and VEGF (F=183.7, 585.6, both P<0.001). The protein levels of ALP, RUNX2, and OCN decreased (F=646.8, 432.7, 257.5, all P<0.001). After OST treatment, the proliferation (normoxia+OST vs normoxia, both P<0.001; hypoxia+OST vs hypoxia, P=0.005) and tubule formation of BMSCs (normoxia+OST vs normoxia, P=0.002; hypoxia+OST vs hypoxia, P=0.005) continued to increase. The concentrations of Ang-1 (normoxia+OST vs normoxia, P<0.001; hypoxia+OST vs hypoxia, P<0.001) and VEGF (normoxia+OST vs normoxia, P<0.001; hypoxia+OST vs hypoxia, P<0.001) further increased. The protein levels of ALP, RUNX2, and OCN increased (normoxia+OST vs normoxia, both P<0.001; hypoxia+OST vs hypoxia, both P<0.001). Conclusion OST can enhance proliferation, osteogenic differentiation and angiogenesis of BMSCs under hypoxic conditions.

未来军事作业环境要求在复杂的、不确定的信息环境下展开联合作战行动,认知战也正在引起越来越多的重视,这对军事人员保持良好的心理和认知状态、决策能力和注意力,以及促进人机协同、提高联合作战的效能提出新的挑战。笔者总结欧洲研究与技术组织召开的“将神经科学应用于效能”研讨会论文交流情况,着重对可应用于军事人员的神经增强和神经反馈训练技术、认知状态评估技术和心理/精神状态评估技术进展情况进行综述,以期为开展相应的科学研究提供参考。

抗生素相关性腹泻（antibiotic-associated diarrhea，AAD）指各种原因应用抗生素后出现腹泻等症状，是抗生素应用后最常见的并发症之一。AAD与诸多危险因素相关，并呈现出临床异质性。随着医学技术的不断进步，医学领域对AAD的认识不断加深，相关研究取得较大进展。笔者拟就AAD的相关进展进行综述，为其诊治和预防提供一定参考。

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.

Objective To study the effects of environmental factors and workload on the health of aircrews by analyzing the health status of flight personnel in helicopter troops of Army Aviation so as to improve the ability to support aviation safety. Methods The diagnostic data on aircrews discharged from the sanatorium was collected and statistically analyzed. Results 91.3% of the 275 aircrews were in excellent health. 88.6% of the aircrews suffered from one or more diseases, and 34.9% of them were afflicted with three or more types of diseases. The average BMI was（24.26±0.84）kg/m². A total of 66 types of diseases were detected in 680 cases, among which thyroid nodules, hyperuricemia, hyperlipidemia, fatty liver and gallbladder polyps were more common, accounting for 11.62%, 6.91%, 5.88%, 4.56% and 4.41%, respectively. The top five diseases were metabolic diseases, thyroid diseases, bone and joint motor diseases, circulatory system diseases, and digestive system diseases. The proportion of diseased aircrews increased with age, reaching 100% in the group aged 43 to 46 and in the group aged 47 to 51. With the increase of age, the number of diseases per capita increased, reaching 4 diseases per capita in the 47 - 51 age group. The detection rate of metabolic diseases increased with age, so did the proportion of individuals suffering from more than two metabolic diseases. Conclusion The combined effect of environmental factors and workload of aviation may be the leading cause of the high incidence of metabolic diseases in army helicopter aircrews. Improvement of diets, nutrition and drinking water conditions and engagement in moderate exercise can be effective for prevention and control of metabolic diseases among helicopter aircrews.

Objective To investigate the sleep quality and perceived stress of military aircrews and the moderating effects of coping styles. Methods The Pittsburgh Sleep Quality Index（PSQI）scale, the Perceived Stress Scale（PSS）, and the Simplified Coping Style Questionnaire（SCSQ）were employed to conduct a questionnaire survey among 102 military aircrews. The results of the survey were subjected to descriptive statistical analysis, correlation analysis, and moderation effect analysis on 98 valid questionnaires. Results The total score of PSQI for military aircrews was（7.95±3.03）points, and 39.80% of these aircrews（39/98）had sleep disorders（PSQI≥8 points）. The total score of PSS was（25.85±8.15）points, with 34.69%（34/98）experiencing high levels of stress and 6.12%（6/98）experiencing extremely high levels of stress. The sleep quality index was positively correlated with perceived stress and negative coping（r/r_s=0.909, 0.901, all P<0.001）, while positive coping was negatively correlated with the sleep quality index, perceived stress, and negative coping（r/r_s=－0.865, －0.911, －0.898, all P<0.001）. Positive coping styles played a moderating role in the relationships between perceived stress and sleep quality（P<0.001）, while negative coping styles had no moderating effect（P=0.676）. Conclusion Military aircrews have suboptimal sleep quality. The greater the stress, the poorer the sleep quality. Positive coping styles can mitigate the negative impact of stress on sleep quality.

Objective To analyze the characteristics of the disease spectrum of permanently grounded military aircrews in order to improve aviation medicine and reduce the medically permanently grounded rate. Methods The clinical data on 204 grounded aircrews between January 2015 and March 2020 was collected. Then the data was divided into different groups according to the types of disease, age distribution, departments concerned, types of aircraft and specialties. Results The top twenty diseases included headache, hypertension, cervical spondylopathy, lumbar disc herniation and depression disorder. The top ten departments involved were those of neurology, orthopedics, cardiology, otolaryngology and psychiatry. Most of the aircrews were between 31 and 40 years old (64.70%) and the pilots accounted for the highest proportion (72.06%). As for the types of aircraft, the proportion of pilots of transport aircraft was the highest (29.90%). Conclusion Most of the diseases prevalent among pilots are related to departments of orthopedics, neurology, cardiogy and psychiatry. In order to reduce the rate of medically permanently grounded pilots, it is critical to pay close attention to the health of pilots aged 31 to 40 while improving the screening rate and diagnosis level.

借鉴国外重症空运医疗后送队伍训练经验,笔者结合南部战区空军医院空运医疗队近来年演训的实践经历,分析空运医疗队队员重症救护能力建设中存在的不足,并提出通过开展急危重症基础培训、组织综合素质评定、空运医疗后送专项训练等措施为提升医疗队重症救护能力,高效完成多样化卫勤保障任务提供有效支撑。

Objective To develop a night vision imaging system for pilots' night vision training. Methods Using technologies of far-red light emitting diode（LED）dimming, digital light processing and projection optical design, a night vision imaging system composed of 6 subsystems was designed: LED light source, optional module, video processing module, digital micromirro device, digital light processing control module, projection primary mirror. The radiance spectrum, brightness contrast and uniformity were tested to verify the system performance and imaging quality. The night vision goggle（NVG）effects of visual function improvement, special visual phenomena and imaging quality of different luminance were evaluated by 12 subjects with good visual function. Results The system peak wavelength was 743.1 nm, brightness contrast was 143:1, and brightness uniformity was 87.2%. The spectrum energy was concentrated in the NVG sensitive spectrum, which ensured good imaging quality. The scores of NVG effects of visual function improvement, special visual phenomena and imaging quality of different luminance were（8.08±1.16）,（7.58±0.90）and（8.25±1.42）, respectively. The results were regarded as very good or relatively good by 30 people. Conclusion The imaging quality and night vision effects for the developed night vision imaging system are good. It can be used in pilot night vision training.

针对辅助穿刺机器人存在严重依赖医师经验的问题，进行临床操作的人因优化分析和研究设计。基于数字孪生技术构建含扰动因素的数字仿生器官，通过临床实时参数驱动生成映射真实器官的数字孪生器官；利用增强现实技术将其与真实器官无缝重合，并支持医师进行透视观察、实时交互的临床操作，进而由器官映射实现视觉感知优化和穿刺操作感知增强。辅助穿刺机器人结合数字孪生器官、增强现实系统的人因优化设计，使辅助穿刺机器人临床操作就如同开放手术一样，改变传统影像引导穿刺手术方式和理念，能够提高临床穿刺治疗效果。

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 provide evidence for aeromedical support by analyzing the disease spectra of permanently-grounded helicopter aircrews between 2003 and 2020. Methods The data on helicopter aircrews permanently grounded between 2003 and 2020 was collected retrospectively. The ranking, constituent ratio, distribution and varieties of diseases that led to grounding in different types of aircraft, age groups and years were statistically analyzed. Results There were 144 helicopter aircrews grounded, mostly due to motor system diseases. The top ten diseases causing permanent grounding of helicopter aircrews were headache, vertigo, fundus lesions, lumber intervertebral disc diseases, knee diseases, hypertension, ametropia, neck intervertebral disc diseases, syncope and depressive disorders. Far more helicopter aircrews were grounded due to motor system diseases and ophthalmological diseases than fighter（attacker）aircrews（χ²=4.182, 4.381, P=0.041, 0.036）, but the proportion of helicopter aircrews grounded due to diseases of the cardiovascular system was significantly lower than that of fighter（attacker）aircrews（χ²=10.486, P=0.001）. However, no significant difference was observed in the proportion of diseases of other systems. More aircrews were grounded because of ophthalmological diseases between 2003 and 2011 than between 2012 and 2020（χ²=6.329, P=0.012）, but fewer aircrews were grounded due to nervous system diseases between 2003 and 2011 than between 2012（P>0.012）and 2020（χ²=5.777, P=0.016）. The average age of medically-grounded helicopter aircrews was 34.31±5.42 years old, and most of these helicopter aircrews were aged 30 to 39. Conclusion More military helicopter aircrews are grounded due to motor system diseases and ophthalmological diseases than fighter（attacker）aircrews so that aeromedical health care should focus on the prevention and treatment of cervical and lumbar spine disorders, knee diseases, fundus lesions and ametropia so as to extend the flight life and improve the combat effectiveness of military helicopter aircrews.

Objective Investigate the situation of neck and back pain in flight pilots and cadets, analyze the relevant risk factors, and provide reference for the early and targeted prevention and treatment of neck and back pain in flight pilots and cadets. Methods A questionnaire was used to investigate the incidence of neck and low back pain among pilots, the questionnaire included basic information, military training, physical training, and neck and back pain. 272 flight personnel divided into the instructor group and cadet group. Both groups were re-divided into a group with neck and low back pain and one without. Univariate analysis was conducted to identify risk factors for neck and low back pain. Results Among the 272 pilots, 75（27.6%）suffered from neck and low back pain, including 15 cadets（9.3%）and 60 instructors（54.5%）, so the difference was statistically significant（χ²=67.279, P<0.001）. Forty-one pilots were afflicted with chronic neck and low back pain（15.1%）, including 4 cadets（2.5%）and 37 instructors（33.6%）, and the difference was statistically significant（χ²=49.714, P<0.001）. The difference in the incidence of neck and back pain between pilots of different age groups, BMI, and flight time was statistically significant（χ²=64.022, 23.585, 73.262, all P<0.001）. The incidence among pilots ages 31 and older, with a BMI of above 24 kg/m²and a flight time over 1 000 h was higher than among those ages 30 and younger, whose BMI was below 24 kg/m² and flight time was 1 000 h or less（all P<0.05）. There were statistically significant differences in military training, physical training, and neck and back pain among flight trainees and instructors with or without neck and back pain in each group（all P<0.05）. The risk factors for neck and low back pain among pilots included a cumulative flight time of over 1 000~2 000 h（OR=14.191, 95%CI: 4.213~47.802, P<0.001）and 2 000 h（OR=18.412, 95%CI: 6.850~49.492, P<0.001）, invasive treatment（OR=13.835, 95%CI: 2.264~84.549, P=0.004）, poor posture（OR=3.937, 95%CI: 1.649~9.398, P=0.002）and improper methods of exercise（OR=2.735, 95%CI: 1.096~6.824, P=0.002）. The risk factors in the instructor group included a flight time of over 1 000~2 000 h（OR=115.580, 95%CI: 3.164~4 221.890, P=0.010）and 2 000 h（OR=197.790, 95%CI: 5.226~7 486.187, P=0.004）, lack of guidance for prevention and treatment of neck and low back pain（OR=20.010, 95%CI: 3.932~101.836, P<0.001）, poor posture at ordinary times（OR=4.586, 95%CI: 1.232~17.075, P=0.023）and too long a single flight（OR=5.346, 95%CI: 1.347~21.212, P=0.017）. Conclusion The prevention and treatment of neck and low back pain require attention to both flight related factors and non-flight factors so as to effectively reduce the prevalence of neck and low back pain among flight personnel.

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 difference in cervical spine function, core stability and strength between fighter pilots and transport pilots. Methods Thirty-eight fighter pilots and eighteen transport pilots in Air Force were enrolled. The cervical spine function, core stability and core strength were measured and compared. Results The difference in basic data of the two groups was not statistically significant（P>0.05）. In the fighter pilot group, there were 11 pilots with neck pain（28.9%）and 15 with low back pain（39.5%）, compared with 4（22.2%）and 7（38.9%）in the transport pilot group. In terms of superficial cervical muscles, the maximum isometric strength of the rotator muscle in the left upper neck and the left lower neck of fighter pilots was better than that of transport pilots（t=2.115, 2.289, P<0.05）, but that of other muscles in the two groups was not significantly different（P>0.05）. As for core stability and strength, the maximum isometric strength of the right hip flexors, extension muscle in both hips, adduction muscle and abduction muscle in both hips were better in fighter pilots than in transport pilots（t=2.561, 4.162, 4.118, 4.013, 4.000, 5.758, 5.226, P=0.013, <0.001, <0.001, <0.001, <0.001, <0.001, <0.001）. There was significant difference in the muscle strength ratio of flexors to extension muscles in both hips, external rotator muscles to inter rotator muscles in the left hip, abduction muscles to adduction muscles in the left hip（t=2.615, 2.309, 2.980, 4.607，P=0.012, 0.025, 0.005, <0.001）. In addition, there were 11（28.9%）and 8（44.4%）pilots respectively in the two groups who were unable to activate the deep cervical flexors, and 20（52.7%）and 7（38.9%）respectively with reduced endurance. However, there was no significant difference in the constituent ratio of endurance of deep cervical flexors between the two groups（Z=－1.046, P=0.296）, as in the constituent ratio of endurance of transversus abdominis muscles（Z=－0.924, P=0.355）. There were 22（57.9%）and 13（ 72.2%）pilots respectively unable to activate the transversus abdominis muscles, 5（13.1%）and 1（5.6%）with reduced endurance in the fighter pilot group and transport pilot group respectively. Conclusion The deep cervical flexors and core muscles of fighter pilots and transport pilots are evidently left unactivated and their endurance is reduced. There is the need to improve the balance and coordination between the deep and superficial neck muscles.

Objective To investigate the competency of millitary flight cadets by using the competency questionnaire for fighter pilots, and cross-validate it via evaluation by instructors. Methods 2 047 millitary cadets were investigated through cluster sampling. Half of the data was analyzed with exploratory factor analysis, while the rest was analyzed with confirmatory factor analysis. At the same time, 86 instructors were surveyed, whose results of evaluation of the competence of cadets were taken as the benchmark. Results Five factors including professional competence, psychological competence, ideological competence, general competence and developmental competence were obtained by exploratory factor analysis, which accounted for 58.92% of the total variance of the questionnaire. Confirmatory factor analysis showed that the five-factor model fitted well with the data（χ²=4.38, GFI=0.870, CFI=0.917, NNFI=0.910, IFI=0.917, TLI=0.910, RMSEA=0.057）. There were difference between instructors and cadets in the five factors（t=2.107、4.001、3.600、3.532、2.690，P=0.034、<0.001、<0.001、<0.001、0.007）. Conclusion The competency of flight cadets consists of professional competence, psychological competence, ideological competence, general competence and developmental competence.

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（r_s=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（r_s=－0.208, －0.325, P=0.027, <0.001）, positively correlated with other forms of exercise（r_s=0.343, P<0.001）, and negatively correlated with types of exercise（r_s=－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（r_s=－0.247, －0.264, P=0.009, 0.005）, but positively correlated with such influencing factors as dreaminess and early waking（r_s=0.209, 0.330, 0.312, P=0.027, <0.001, <0.001）. The difficulty in falling asleep was negatively correlated with sleep time（r_s=－0.430, P<0.001）, and negatively correlated with the rate of sleep deficiency（r_s=－0.352, P<0.001）. Dreaminess was negatively correlated with jogging（r_s=－0.221, P=0.019）, and positively correlated with light sleep（r_s=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.

现代高技术战争和多样化的非战争军事行动中，军事人员随时可能面临睡眠剥夺与保持良好工作状态的矛盾与挑战。睡眠不足会导致运动、警戒和决策等能力下降，对军事行动造成较大影响。笔者梳理总结了睡眠剥夺对机体的影响、各国军事人员对抗睡眠剥夺所采取的对策措施，并对未来的研究方向提出建议。

通过追踪和研究美国空军机动司令部组织的“机动卫士”演习动态与进展,深度分析其空运医疗后送的特点和发展趋势,为我军空运医疗后送训练和能力建设提供参考性的意见和建议。

Objective To investigate the common psychosomatic diseases and causes among hospitalized military aircrews and those under physical examination, and to provide reference for the prevention and treatment of these diseases. Methods One thousand military aircrews who were hospitalized and underwent physical examination in the 900th Hospital of Joint Logistic Support Force between 2009 and 2023 were randomly selected and divided into the psychosomatic diseases group and non-psychosomatic diseases group. The medical data of these patients was collected to analyze the incidence of common psychosomatic diseases and risk factors. Results Among these military aircrews, there were 311 cases of psychosomatic diseases, including chronic back pain, chronic gastritis, essential hypertension, tension headache, arrhythmia, sleep disorders, oral ulcer, allergic rhinitis, diabetes mellitus and peptic ulcer. The total score of the Symptom Check List-90, somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia, and psychogenic factor scores of military aircrews were lower than the norm of Chinese soldiers（t=2.961~11.220, all P<0.01）. The total score of the Symptom Check List-90 of military aircrews with psychosomatic diseases and the scores of anxiety, somatization, paranoia, interpersonal sensitivity, depression and hostility were significantly higher than those of aircrews without（t=1.964~4.042, all P<0.05）. Regular Exercise was a protective factor for the common psychosomatic diseases in military aircrews（OR=0.52, P<0.001）. Overweight/obesity, smoking, hyperlipidemia and hyperuricemia were independent risk factors（OR=3.81, 5.11, 1.65, 1.59, P<0.001, <0.001, =0.001, =0.027）. Conclusion The prevalence of psychosomatic diseases in military aircrews is high. While taking psychological interventions seriously, we should work harder to correct unhealthy lifestyles and reduce the incidence of psychosomatic diseases in military aircrews.

Objective To analyze the prevalence of hyperlipidemia and related influencing factors in military aircrews, and to provide reference for aviation and health support for pilots. Methods A retrospective survey was used to collect health care data on hospitalized military aircrews in the Air Force Characteristic Medical Center between 2020 and 2021. The prevalence of hyperlipidemia was compared between these patients grouped according to aircraft types, length of flight, jobs, BMI, history of alcohol consumption, history of smoking, blood pressure, age and uric acid levels, respectively. Results The prevalence of hyperlipidemia among the 926 military aircrews was as high as 17.7%. There was no significant difference in the prevalence of hyperlipidemia between aircrews for different aircraft types and jobs, But there was significant difference between aircrews with different lengths of flight（χ²=32.61, P=0.001）. The prevalence of hyperlipidemia was significantly higher among aircrews with hypertension, high uric acid levels and high body mass index than in the normal group（χ²=10.13, 18.82, 33.59, all P=0.001）. Hyperlipidemia was more common among aircrews who smoked cigarettes, and the difference was statistically significant（χ²=20.58, P=0.001）. Multifactorial logistic regression analysis showed that smoking status, body mass index, blood pressure, and uric acid levels were influencing factors of hyperlipidemia（OR=3.080, 1.489, 3.760, 1.629, P<0.001、=0.025、<0.001、=0.026）. Conclusion The prevalence of hyperlipidemia is high among aircrews. Smoking, body mass index, blood pressure and uric acid levels are the influencing factors of hyperlipidemia. Aviation health support should focus on the development of healthy lifestyles among aircrews.

Objective To conduct cluster analysis of 12 anthropometric indicators and to explore the relationships between fasting insulin（FINS）, annual flight time and obesity among civil aviation pilots. Methods A total of 1,250 male pilots in East China who underwent physical examinations and auxiliary examinations in Shanghai Hospital between September 2021 and February 2022 were selected to have their height, weight, waist circumference, hip circumference and body fat percentage（PBF）determined using an Inbody body composition analyzer. The data on their aircraft types and duration of flight in 2021 was obtained via a questionnaire survey. Twelve anthropometric indicators were used for cluster analysis using principal component analysis, and the relationships between fasting insulin（FINS）, annual flight time of civil aviation and anthropometric indicators were analyzed using multiple linear regression models to validate the cluster analysis of anthropometric indicators. Results After suitability testing of the 12 anthropometric variables, factor analysis was conducted, and three common factors were extracted using the principal component method, with a cumulative variance contribution rate of 95.29%. Linear regression was used to calculate standardized score coefficients. Multiple linear regression analysis revealed that fasting insulin was related to annual flight time and the three common factors（partial regression coefficients of three common factors were 12.37, 8.90 and 6.78, all P<0.001）, with central obesity making the greatest difference to elevated fasting insulin levels. Conclusion All the three common factors are found to be related to elevated fasting insulin levels, especially the central obesity factor, suggesting the clinical predictive value of anthropocentric indicators.

Objective To study the mobility of the head and neck under head-supported weight in order to provide data on the movement of the head and neck under sustained positive acceleration and on the use of head-borne equipments for pilots. Methods A large aperture visual field measurement system was used as a test platform. A helmet system that weighed 1.955 kg included pilot helmets, night vision goggles and oxygen masks. 12 volunteers were divided into 2 groups: group A[6 males with an average age of（18.8±1.2）years old] and group B[6 males with an average age of（40.8±5.9）years old]. The volunteers wore the helmet system. The counterweight was added to the helmets as double weight of the system. The angle and angle velocity of head and neck rotation were recorded under each weight. After each test, the complaints from the subjects were recorded. Results The end load was 16 kg in group A and 12 kg in group B, corresponding to 3.0 G and 2.4 G respectively. With the increase of the load, the level rotation angles and angle velocities in the 2 groups decreased, the uppitch angles decreased and the down angles increased, and the pitch angle velocities decreased. The difference in head and neck rotation angle velocities between group A（F=5.912, 3.681, P=0.001, 0.010）and group B（F=4.422, 5.571, P=0.015, 0.006）was statistically significant under different loads when the volunteers' heads and necks rotated from the left to the right or vice versa. Conclusion Methods of measurement of the mobility of heads and necks under head-supported weight have been established. The results are expected to provide data on the movement of heads and necks under sustained positive acceleration and with pilot head-borne equipments.

航空卫生保障的水平直接关系到航空兵部队的战斗力生成。笔者深入基层航空兵部队围绕航空卫生保障问题展开调研，发现了日常航空卫生保障过程中存在的问题，分析了影响航空卫生保障水平的原因，并从航医培训的角度出发，针对工作中出现的航空卫生保障问题，围绕院校教育、任职培训、专项培训等几个方面提出了相应的对策，以提高航医教育质量，最终提升航卫保障水平，增强航空兵部队的战斗力。

腰痛是一种常见的肌肉骨骼疾病，按持续时间可分为急性腰痛、亚急性腰痛和慢性腰痛。临床上绝大部分腰痛患者无明确的疼痛来源，诊断为非特异性腰痛。根据O'Sullivan多维分类系统，腰痛患者可分为病理因素、心理或社会因素和运动控制障碍3个亚组，运动控制训练作为新的治疗方法逐渐应用于腰痛患者中。笔者通过查阅相关文献，将近年来对腰痛患者运动控制改变、运动控制训练治疗腰痛的进展进行系统综述。

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.

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 explore the effects of simultaneous physical activities on subjective load perception, work performance and heart rate variability（HRV）in the process of accomplishing cognitive tasks. Methods Thirty-three eligible male subjects completed 2-back cognitive tasks under three isotonic physical load conditions（0, 3, 5 Kg）of the left upper limb（with one week interval between conditions）, and their ECG signals were collected during the whole process. After the task, the National Aeronautics and Space Administration-Task load index（NASA-TLX）scale was used to evaluate the subjective task load of the subjects, and their cognitive performance（mean reaction time, correct rate, etc.）was recorded. Results Compared with none physical activity, moderate physical and high physical activities significantly increased subjects' subjective load during cognitive tasks（t=2.235~14.841, all P<0.05）, average reaction time（t=－2.263, －3.284, P=0.031, 0.002）and the wrong responsing rate of cognitive tasks（Z=－2.978, P=0.003）. At the same time, the physical load also significantly increased the operator's heart rate（Z=－4.899, P<0.001）and the low-frequency power value of heart rate variability（Z=－2.253, P=0.024）, while high frequency components were significantly decreased（Z=－2.010, P=0.044）. However, there was no statistical difference in functional status between medium and high physical load（P>0.05）. Conclusion During cognitive tasks, the physical load of the operator will further intensify the perception of task load, reduce execution ability, and cause the increase of sympathetic nerve tension. The results of this research provide a theoretical basis for the real-time evaluation of pilots' mental load in flight.

Objective To establish an evaluation method for visual attention ability in flight spatial orientation. Methods 168 fighter pilots took part in the study. Thirty-two fighter pilots were selected as the subjects before tasks and indicators for evaluation were determined via experiments using static attention scales, desktop dynamic simulation flight experimental systems, and illusion simulation training systems. An evaluation system was developed and 35 pilots were enrolled in the experiment to test the reliability and validity of the system. Test data from 195 pilots was used to establish the score norm for evaluation. Results The dual task in which the primary task was simulating flight while the secondary task was responding to the warning information was used as the evaluation paradigm. The primary task involved five tasks of simulating flight combat or stages, while the secondary tasks included 2-level response tasks to information on warning and attention. Thirteen evaluation indicators were identified. The retest reliability and criterion-related validity of the evaluation system were 0.993 and 0.753, respectively, both of which were statistically significant（P<0.001）. Conclusion Tasks and indexes for evaluation of pilots' visual attention ability in spatial orientation have been established, which have proved the good reliability and validity of the system. At the same time, a set of evaluation methods has been established, which can be used for the selection, evaluation and training of pilots' visual attention ability in spatial orientation.

Objective To explore the influencing factors of effectiveness of aviation physiological training. Methods A total of 1 032 questionnaires were collected from pilots who came to our center for aviation physiological training between 2015 and 2021, involving such information as the basic data of the pilots, attitudes to and compliance with aviation training, and suggestions and opinions about training. According to the amount of knowledge of hypoxia experience training, the above pilots were divided into the effective training group（n=612）and ineffective training group（n=420）. The differences of the above indicators between the two groups were analyzed using t-test and chi-square test while the influencing factors of training effect were analyzed by logistic regression. Results The pilots attached more importance to aviation training year by year. The more fighter and trainer pilots cared about training, the more frequently they encountered dangers and applied results of aviation physiology training to actual flight, the more effective the training was, and the differences were statistically significant（all P<0.001）. The weight pilots gave to aviation physiology training, the number of times they encountered dangers in the air, the types of machine, and the number of times they actually used what they had learned were risk factors affecting the efficiency of aviation training, but there was no statistically significant difference between the length of flight and the efficiency of aviation training（P=0.431, 0.950）. Conclusion Effort should be made to remind pilots to attach more importance to training and improve their compliance in order to enhance the effectiveness of training.

Objective To investigate the effectiveness and safety of VR（virtual reality）simulated flight environment provocation tests in electroencephalogram（EEG）monitoring. Methods Based on the occupational environmental characteristics of flight personnel, this study designed VR-simulated flight glasses（Patent No. ZL202320554741.9）incorporating such scenarios as aircraft takeoff and landing, formation flight, maneuvering flight, and snow flight. From September 2020 to September 2023, 60 flight personnel, 60 healthy volunteers, and 100 patients with epilepsy underwent video-EEG monitoring and VR-simulated induction tests. The effectiveness of the VR simulated induction test was demonstrated by comparing the positive detection rates in different induction tests. Results Among the 100 patients with epilepsy, 2（2%）were positive for intermittent photic stimulation（IPS）, 2（2%）for hyperventilation（HV）, and 3（3%）for the VR simulated flight test. Both IPS and HV were negative in the 60 flight personnel and 60 healthy subjects. Additionally, 1 of the 60 flight personnel experienced dizziness during the VR-simulated flight test, while 7 of the 60 healthy subjects felt dizzy during the test, with 1 discontinuing the test due to dizziness, nausea, and vomiting. Conclusion The VR simulated provocation tests have demonstrated good safety and the ability to induce epileptiform discharges. However, more studies with larger sample sizes are needed to validate the feasibility of using this approach during EEG monitoring of aircrew members.

Traditional Chinese medicine has been used to prevent and treat diseases thanks to its ability to promote rehabilitation and health care under the guidance of theoriesof traditional Chinese medicine. This paper summarizes the applications of traditional Chinese medicine and TCM compound preparationsin improving operational performance of pilots, focusing on its therapeutic effect againsthypoxia, fatigue and its role in improving cognition.The future research hotspots and developments of traditional Chinese medicine in the field of aeromedicine are also outlined.