Objective To analyze the results of training and respiratory rates of aircrews of different ages during anti-G breathing maneuvers under load conditions in order to provide data for anti-G breathing maneuvers training. Methods Three hundred and thirty-nine aircrews were collected from the Air Force Medical Center who participated in manned centrifuge training in 2019-2022. The differences in the respiratory rate, pass rate, visual field or changes in states of consciousness during high load training between the group ages 20 to 25（n=69）, group ages 26 to 30（n=110）, group ages 31 to 34（n=83）, and the group ages 35 and older（n=77）were analyzed. Results A total of 339 aircrews participated in the high load training in this study（212 passed the test, and 127 did not pass）. The results showed that there were statistically significant differences in the pass rate between the four age groups（χ2=13.294, P=0.004）. Pairwise comparisons indicated that the pass rate in the group ages 20 to 25（55.07%, 38/69） was lower than in the group ages 31 to 34（74.70%, 62/83）, and lower in the group ages 26 to 30（52.73%, 58/110） than in the group ages 31 to 34（74.70%, 62/83）and the group ages 35 and older（70.13%, 54/77）（all P<0.05）.The respiratory frequency results showed that there were statistically significant differences during the 8 G and 9 G plateaus across age groups（F=3.476, P=0.016）, and the respiratory frequency in the group ages 20-25 was significantly lower than in the other three groups（P=0.002, 0.028, 0.011）. The results of the visual field or states of consciousness showed statistically significant differences in the percentage of aircrews rated as "GOOD" and "A-LOC" or "G-LOC"（χ2=8.619, 8.491, P=0.035, 0.037）between the four groups. Pairwise comparisons showed that the incidence of A-LOC or G-LOC in the group ages 26 to 30 was significantly higher than that in the group ages 31 to 34（P<0.05）. Conclusion The pass rates for high-load training vary among aircrews in different age groups, which may be related to increased accumulated experience in countering high-G forces, pointing to the need to strengthen the load resistance of young aircrews. In addition, the anti-G breathing rate of aircrews under high load conditions is relatively fast, so the training on action of breathing should be improved to ensure flight safety.
Objective To investigate and assess the incidence of craniocerebral diseases in military flight personnel and their impact on flight safety, and to explore the implications of the results of cranial magnetic resonance examination for aeromedical assessment. Methods The data on head magnetic resonance examinations of 196 military flight personnel was collected, and the results of aeromedical assessment were analyzed. Results Among the 196 cases, there were 114 cases with no obvious abnormality（58.16%）and 82 cases with abnormal imaging, including 33 cases with leukodystrophy（40.24%）. Cerebral arteriosclerosis occurred in 8 cases（9.76%）, intracranial cysts in 8 cases（9.76%）, vacuolar sella in 8 cases（9.76%）, lacunar cerebral infarction in 7 cases（8.53%）, ischemic lesions in 7 cases（8.53%）, cavernous hemangioma occurred in 2 cases（2.44%）, vascular malformation in 2 cases（2.44%）, intracranial tumor（schwannoma）in 1 case（1.22%）, and cerebellar calcification in 1 case（1.22%）, all the above-mentioned cases were determined as qualified for flight. Aneurysms occurred in 4 cases（4.88%）, 3 of whom were considered qualified for flight, and 1 case（1.22%）reached the age limit of service during observation and was grounded. Conclusion Head magnetic resonance screening during physical examinations of flight personnel can help detect brain diseases quickly that may make a difference in flight safety. This study is expected to provide data for developing and improving standards for aeromedical assessment.
Objective To review the clinical characteristics and results of aeromedical assessment of aircrews with essential tremor（ET）in order to provide references for related assessments. Methods Cases of ET among aircrews and clinical reports were retrieved from the electronic case system in our center and from related databases. The conditions, clinical manifestations, treatment regimens, prognosis and aeromedical assessment of these aircrews were summarized. Results Seven male cases were enrolled in this study, who ranged from 27 to 43 in age. Among these patients, there were 3 helicopter pilots, 2 instructor pilots, 1 weapons controller, and 1 fighter pilot. In terms of clinical tremor grading, 2 patients were rated as level 2, 3 as level 1, 1 as level 3, and 1 case had an unknown grading（not recorded in the literature）. The three pilots graded as level 1（two helicopter pilots and one instructor pilot）were not treated and given special flight permit after aeromedical assessment. One military weapon controller and one helicopter pilot, both graded as level 2, were treated（with gabapentin and arotinolol respectively）before being given special flight permit. One pilot graded as level 3 was considered disqualified for flying, while the one case who could not be graded in literature was approved to be qualified for flying double-seat aircraft. The follow-up for the six hospitalized aircrews ranged from 5 to 31 months. There were no changes in clinical grading, no drug intolerance, and they were healthy enough for flying. Conclusion Limb tremor associated with ET in aircrews can impact flight safety and requires accurate assessment based on clinical grading. Aircrews with tremor grades 1 and 2 may be granted special flight permit. It is recommended that aircrews given special flight permit return to the hospital for annual re-assessment.
Objective To investigate the symptoms and incidence of dry eye among helicopter aircrews and analyze the contributors. Methods A total of 636 helicopter aircrews who underwent annual physical examinations at Beidaihe Rehabilitation and Recuperation Center between January and September 2024 were selected as the subjects. Dry eye symptoms were screened using the Ocular Surface Disease Index（OSDI）. Among these aircrews, 97 with dry eye symptoms were examined using the EyesisDEV-1000 comprehensive eye surface analyzer, involving non-invasive tear break-up time（NIBUT）, corneal and conjunctival sodium fluorescein staining, and meibomian gland atrophy status. Based on results of ophthalmic examinations, these participants were divided into a dry eye group（n=97）and a control group（n=539）. The consistency between OSDI scale results and findings by the comprehensive eye surface analyzer was tested. Basic information, routine blood tests, and biochemical indicators were obtained from medical records upon admission to the hospital, and multivariate logistic regression analysis was conducted to identify contributors to dry eye in helicopter aircrews. Results The OSDI scale results revealed that 15.25%（97/636）of these aircrews had dry eye symptoms, with 4.09%（26/636）classified as severe, 5.50%（35/636）as moderate, and 5.66%（36/636）as mild. Ophthalmic examination results suggested that all the 97 aircrews with dry eye symptoms had abnormal NIBUT and were diagnosed with dry eye. In the dry eye group（194 eyes）, 76.80%（149/194）presented with meibomian gland atrophy. The OSDI scale results pointed to good consistency with the findings by the comprehensive eye surface analyzer（Kappa coefficient=0.748, 95%CI: 0.620-0.857）. Logistic regression analysis indicated that indirect bilirubin（OR=1.046, 95%CI: 1.012-1.081）and serum alanine aminotransferase（ALT）（OR=1.014, 95%CI: 1.001-1.028）were risk factors for dry eye, while thyroxine（T4）（OR=0.969, 95%CI: 0.958-0.981）was a protective factor. Conclusion Dry eye is relatively prevalent among helicopter aircrews. The OSDI scale shows good consistency with the findings by the comprehensive eye surface analyzer, and is considered applicable to routine dry eye screening. ALT, T4, and IBIL are contributors to dry eye. It is recommended that aviation management authorities incorporate regular eye examinations into pilot health management for prevention and treatment of dry eye.
Objective To investigate the distribution of and contributors to training-induced knee joint injuries among paratroopers. Methods A stratified random sampling method was used to select 2 583 paratroopers as the subjects. A large-sample cross-sectional analysis was conducted using an epidemiological questionnaire designed to assess knee joint injuries due to parachuting training. Results Among the 2,407 military personnel, 358 sustained knee joint injuries. Among these cases, 293（81.84%）occurred exclusively during ground training, 15（4.19%）during high-altitude parachuting alone, and 50（13.97%）during both phases of training. The most common injuries from ground training were meniscal injury（30.61%, 105/343）, followed by synovitis（22.74%, 78/343）, musculotendinous injury（19.24%, 66/343）, ligament injury（16.91%, 58/343）, and osteoarticular injury（10.50%, 36/343）. The items of training most likely to cause injury included running（30.61%, 105/343）, platform training（16.33%, 56/343）, tactical training（16.03%, 55/343）, and ring training（12.24%, 42/343）. Multivariate analysis showed lengths of service ≤4 years（OR=1.091, 95%CI: 1.043-1.133）, daily durations of training >4 hours（OR=1.052, 95%CI: 1.020-1.091）, and previous synovitis of the knee joint（OR=3.691, 95%CI: 2.023-6.734）and meniscal injury（OR=3.543, 95%CI: 1.911-6.442）were independent risk factors for knee joint injuries, while previous ankle joint injury（OR=0.482, 95%CI: 0.384-0.613）and wearing knee pads（OR=0.751, 95%CI: 0.623-0.924）were independent protective factors. The most prevalent injuries during high-altitude parachuting were musculotendinous injury（27.69%, 18/65）, followed by meniscus injury（23.08%, 15/65）, ligament injury（20.00%, 13/65）, osteoarticular injury（16.92%, 11/65）, and synovitis（12.31%, 8/65）. These injuries usually occurred at the moment of landing（96.92%, 63/65）, caused by excessive surface wind speed（28.57%, 18/63）, crosswind landing（19.05%, 12/63）, uneven grounds（17.46%, 11/63）, wrong landing postures（12.70%, 8/63）, and ground obstacles（11.11%, 7/63）. Multivariate analysis showed that lengths of service ≤4 years（OR=1.111, 95%CI: 1.062-1.151）, daily training durations >4 hours（OR=1.063, 95%CI: 1.011-1.114）, and previous knee musculotendinous injury（OR=2.561, 95%CI: 1.323-4.972）were independent risk factors. Conclusion Parachuting training is likely to cause injuries, so a well-conceived training program involving good planning and effective protection can reduce the incidence of knee joint injuries during parachuting training.
Objective To analyze the changes in the spectrum of infectious diseases among military personnel in a department of infectious disease in order to find out about the incidence and epidemiological pattern. Methods A retrospective analysis was conducted of the medical records of 1 311 military personnel admitted to the department of infectious diseases in 2014-2023. The spectrum of infectious diseases was analyzed based on rates of detection. Results Among the 1 311 hospitalized military personnel, the top five prevalent infectious diseases were pulmonary tuberculosis（503 cases, 38.37%）, influenza（202 cases, 15.41%）, varicella（136 cases, 10.37%）, acute febrile respiratory disease（126 cases, 9.61%）, and dengue fever（98 cases, 7.48%）. Compared with the spectrum of infectious diseases for 2014-2019, the proportion of influenza（χ2=27.981, P<0.001）, acute febrile respiratory disease（χ2=26.331, P<0.001）, viral hepatitis（χ2=6.214, P=0.013）and novel coronavirus infection（P<0.001）increased between 2020 and 2023, while the proportion of pulmonary tuberculosis（χ2=69.280, P<0.001）, dengue fever（χ2=35.355, P<0.001）, and scrub typhus（χ2=7.211, P=0.007）decreased. There were 332 cases（93.26%）of respiratory infectious diseases in spring, compared with 266 cases（75.35%）of respiratory infectious diseases, 31 cases（8.78%）of natural focus and vector-borne infectious diseases, and 28 cases（7.93% each）of blood-borne and sexually transmitted diseases and intestinal infectious diseases in summer. There were 218 cases（64.31%）of respiratory infectious diseases and 93 cases（27.43%）of natural focus and vector-borne infectious diseases in autumn, and 216 cases（82.13%）of respiratory infectious diseases in winter. Conclusion Respiratory infectious diseases are the common infectious diseases that pose a threat to the health of military personnel. Military hospitals and medical support departments should enforce targeted epidemic prevention and control according to the pattern of high incidence in spring.
Objective To investigate the prevalence of and contributors to high altitude polycythemia（HAPC）in high altitude military personnel. Methods This study selected 324 high altitude military personnel admitted to the Military Special Service Recuperation Center of Xiamen between July 2019 and July 2024. Based on the presence of HAPC, the military personnel were divided into an HAPC-positive group（37 cases）and an HAPC-negative group（287 cases）. Data collected included results of medical examinations, Pittsburgh Sleep Quality Index（PSQI）scores, and Physical Activity Rating Scale-3（PARS-3）scores. The prevalence of HAPC was compared across variables including age, altitudes, sleep quality, durations of high-altitude exposure, obesity, physical activity intensity, and smoking status. Contributors to HAPC were analyzed. Results The prevalence of HAPC in high altitude military personnel was 11.42%（37/324）. A higher incidence rate was observed in personnel ages 35 and older, stationed at altitudes ≥4 000 m, with poor sleep（PSQI>5）, with an exposure duration of 12 months or longer, with a BMI ≥28 kg/m2, or engaged in high-intensity physical activity（PARS-3≥43）（χ2=4.209-44.502, all P<0.05）. Univariate analysis showed that HAPC-positive group was significantly higher in terms of altitudes（Z=-4.773, P<0.001）, exposure durations（Z=-4.180, P<0.001）, PARS-3（Z=-4.683, P<0.001）and PSQI scores（Z=-7.371, P<0.001） than the HAPC-negative group. Multivariate Logistic regression analysis identified stay at high altitudes（OR=2.868, 95%CI: 1.120-7.339）, exposure durations（OR=1.153, 95%CI: 1.012-1.315）, PARS-3 scores（OR=1.054, 95%CI: 1.003-1.108）, and PSQI scores（OR=2.288, 95%CI: 1.699-3.083）as independent risk factors for HAPC. Conclusion HAPC is quite prevalent in high altitude military personnel. Preventive strategies should be intended for those with poor sleep, prolonged exposure durations, higher altitude, and high intense physical activity to reduce the incidence of HAPC.
Objective To explore the occurrence of mild cognitive impairment after traumatic brain injury and establish a predictive model. Methods A total of 108 patients with traumatic brain injury admitted between December 2020 and December 2023 were selected. According to the occurrence of cognitive impairment one week after admission, they were divided into two groups: the cognitive impairment group（48 cases）and the non-cognitive impairment group（60 cases）. Multivariate logistic regression was used to analyze the risk factors for cognitive impairment in traumatic brain injury patients. A column chart of cognitive impairment in traumatic brain injury patients was constructed based on R language before the accuracy of the prediction model was verified using the Bootstrap method. Results Forty-eight out of 108 patients with traumatic brain injury experienced cognitive impairment, accounting for 44.44%. The cognitive impairment group was significantly higher than the non-cognitive impairment group in terms of age, levels of education, the incidence of frontal lobe contusion and multi-site injury, and levels of central nerve specific protein（s100-β）（t/χ2=2.585-7.914, all P<0.05）. Age（OR=3.762, 95%CI: 1.729-8.185）, education levels（OR=3.529, 95%CI: 1.622-7.677）, frontal lobe injury（OR=4.019, 95%CI: 1.847-8.743）, multiple site injury（OR=3.827, 95%CI: 1.752-8.360）, and s100-β（OR=4.133, 95%CI: 1.892-9.023）were risk factors for cognitive impairment in patients with traumatic brain injury. The sensitivity of the risk model for predicting cognitive impairment in patients with traumatic brain injury was 0.825（95%CI: 0.701-0.914）, the specificity 0.835（95%CI: 0.715-0.937）, and the area under the curve was 0.839（95%CI: 0.728-0.953）. Conclusion A predictive model for cognitive dysfunction after traumatic brain injury is of clinical significance.
Objective To explore the role of capecitabine combined with oxaliplatin in improving immune function and quality of survival in patients with gastrointestinal malignancies. Methods A total of 120 patients with gastrointestinal malignant tumors admitted to a department of medical oncology in 2020-2022 were enrolled as the subjects, and randomly divided into a control group（60 cases）and an observation group（60 cases）. The control group was treated with oxaliplatin plus 5-fluorouracil, while the observation group was administered with oxaliplatin plus capecitabine. After 2 courses of treatment, the short-term efficacy, changes in immune function, quality of life and adverse reactions were compared between the two groups. Results After treatment, the objective response rate of the observation group was significantly higher than that of the control group（χ2=4.821, P=0.028）. In both groups, the levels of CD4+, CD4+/CD8+ ratio and natural killer（NK）cells were significantly increased after treatment（t=3.506-15.872, all P<0.05）, whereas the CD8+ level was decreased（t=6.308, 2.389, P<0.001, =0.019）. The changes in CD4+, CD8+, CD4+/CD8+ ratios and NK cell levels were more remarkable in the observation group than in the control group after treatment（t=173.923, 99.880, 23.447, 38.159, all P<0.001）. The scores of the Quality of Life-100 scale became higher in both groups after treatment（t=32.612-74.278, all P<0.001）, especially in the observation group（t=25.605, 132.976, 541.084, 151.673, all P<0.001）. There was no statistically significant difference in the incidence of grade Ⅰ-Ⅳ adverse reactions between the two groups（χ2=0.386, P=0.751）. Conclusion Capecitabine combined with oxaliplatin in the treatment of gastrointestinal malignant tumors can enhance the efficacy while improving patients' immune function and quality of survival.
Objective To identify high-risk factors for thrombosis/embolism in patients with EML4-ALK-mutated non-small cell lung cancer（NSCLC）and to develop a nomogram for risk prediction. Methods Data from 58 patients diagnosed with EML4-ALK-mutated NSCLC in Air Force Medical Center between January 2018 and October 2024 was analyzed. Patients were categorized into the thrombosis group（32 cases）and non-thrombosis group（26 cases）. The OS of the two groups was analyzed using the Kalpan-Meier curve. The cutoff value was obtained through the ROC. Logistic multiple regression analysis was conducted to identify the risk factors for thrombosis in EML4-ALK-mutated NSCLC patients. A nomogram prediction model was established based on the identified risk factors before its predictability, accuracy, and clinical applicability were evaluated. Results Compared with the non-thrombosis group, patients in the thrombosis group were older and higher in the proportion of males, rate of ECOG-PS>2, prevalence of stage Ⅲ-Ⅳ disease, incidence of brain metastasis, levels of CEA and CA125, EML4-ALK V3 variant, and PLR×D-D（t/χ2=3.985-9.568, P<0.05）. Kaplan-Meier analysis found that the median overall survival（OS）was 49 months in the non-thrombosis group and 35 months in the thrombosis group（P<0.05）, suggesting a statistically significant difference. Within the thrombosis group, 13 patients died and 19 remained alive. Multivariate logistic regression analysis identified the ECOG-PS score（OR=1.291, 95%CI: 1.029-1.590）, stage Ⅲ-Ⅳ disease（OR=1.572, 95%CI: 1.147-1.604）, brain metastasis（OR=1.406, 95%CI: 1.018-1.639）, EML4-ALK V3 variant（OR=1.502, 95%CI: 1.183-1.792）, PLR×D-D≥79.68 mg/L（OR=1.603, 95%CI: 1.402-1.732）, and CEA≥11.74 ng/ml（OR=1.473，95%CI：1.136~1.554）as independent risk factors for thrombosis in patients with EML4-ALK-mutated NSCLC. The AUC of this risk prediction model was 0.738（95%CI: 0.628-0.837）, compared with 0.824 for the internally validated predictive model（95%CI: 0.703-0.912）, suggesting that the model had a good degree of differentiation. The Spiegelhalter Z-test indicated a good fit between the calibration curve and the actual prediction（P=0.943）, demonstrating favorable accuracy. The DCA results showed that the model was highly applicable clinically. Conclusion The nomogram prediction model based on PS, stage Ⅲ-Ⅳ, brain metastasis, EML4-ALK V3 variant, PLR×D-D, and CEA in this study can well predict thrombosis/embolism in the EML4-ALK-mutated NSCLC population.
Objective To investigate the correlations between corneal neuropathy and the severity of diabetic retinopathy（DR）in patients with diabetes mellitus, and to analyze the effect of clinical characteristics and metabolic indicators on corneal nerve parameters in order to clarify the influencing factors of DR. Methods A total of 90 patients with diabetes mellitus admitted to the 904th Hospital of the Joint Logistic Support Force between April 2021 and April 2024 were enrolled as the diabetes group. According to the severity of DR, the diabetes group was divided into a non-DR group（NDR, 34 cases）, a non-proliferative DR group（NPDR, 28 cases）, and a proliferative DR group（PDR, 28 cases）. In addition, 50 healthy individuals undergoing physical examinations during the same period were enrolled as the control group. Basic data（gender, age, history of smoking and drinking, and metabolic indicators）was compared between these groups. Corneal nerve parameters [corneal nerve fiber length（CNFL）, corneal nerve fiber density（CNFD）, and corneal nerve branch density（CNBD）] were quantitatively evaluated using confocal microscopy. Logistic regression was used to analyze risk factors for the development of DR in diabetic patients and to construct a nomogram. Pearson correlation analysis was conducted to find out about the association between variables. Results The diabetes group had significantly higher levels of total cholesterol（TC）, triglycerides（TG）, HDL-C, LDL-C, fasting blood glucose（FBG）, glycated hemoglobin（HbA1c）, and fasting insulin（FINS）than the control group（t=4.230-63.992, all P<0.001）while CNFL, CNFD, and CNBD were significantly lower（t=10.730, 27.398, 27.757, all P<0.001）. Significant differences were observed in disease duration, TC, FBG, HbA1c, and FINS between the NDR, NPDR, and PDR groups（F=3.537-48.416, P<0.001 or =0.033）, as with corneal nerve parameters（F=63.323, 65.927, 24.754, all P<0.001）. CNFL, CNFD, and CNBD were significantly lower in the PDR group than in the other groups（all P<0.001）, and values were lower in the NPDR group than in the NDR group（all P<0.001）. Multivariate logistic regression analysis identified disease duration（OR=4.446, 95%CI: 1.712-11.547）, FBG（OR=2.886, 95%CI: 1.069-7.791）, and HbA1c（OR=12.750, 95%CI: 4.094-39.709）as independent risk factors for DR in diabetic patients, while CNFL（OR=0.105, 95%CI: 0.031-0.351）, CNFD（OR=0.052, 95%CI: 0.014-0.194）, and CNBD（OR=0.414, 95%CI: 0.190-0.903）were protective factors. Pearson correlation analysis showed that disease duration, FBG, and HbA1c were negatively correlated with CNFL, CNFD, and CNBD（r=-0.571~-0.361, all P<0.001）. Conclusion The degree of corneal neuropathy is closely related to the severity of diabetic retinopathy, suggesting that corneal nerve parameters may provide a new line of thought for clinical prevention and treatment of DR.
Objective To evaluate the predictive value of serum iron concentrations in acute stroke complicated with pneumonia. Methods A retrospective analysis was conducted of 204 acute stroke patients admitted to the Emergency Department of Beijing Jingmei Group General Hospital between January 2019 and August 2023. These patients were divided into the pneumonia group（60 cases）and non-pneumonia group（144 cases）based on the incidence of pneumonia. The basic data, medical history, stroke-related indicators, and laboratory test results of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the contributors to pneumonia after acute stroke. The receiver operating characteristic（ROC）curve was used to analyze serum iron concentrations. Results Multivariate Logistic regression analysis showed that age >65 years（OR=2.343, 95%CI: 1.335-3.572）, subcortical lesions（OR=2.100, 95%CI: 1.019-4.323）, National Institute of Health Stroke Scale Median scores>8 on admission（OR=3.582, 95%CI: 1.794-14.873）, RBC<4.5×1012/L（OR=1.158, 95%CI: 1.050-1.278）, WBC>9×109/L（OR=1.665, 95%CI: 1.232-2.265）, and serum iron concentrations ≤10 μmol/L（OR=1.674, 95%CI: 1.455-1.826）were risk factors for pneumonia after stroke. The area under the ROC curve for serum iron concentrations in predicting pneumonia was 0.758（95%CI: 0.726-0.779）, with an optimal cutoff value of 10.35 μmol/L, sensitivity of 72.4%, and specificity of 61.2%. Conclusion Serum iron concentrations can well predict the occurrence of pneumonia in patients with acute stroke, which is expected to provide a new idea for clinical prevention and treatment of acute stroke complicated with pneumonia.
Objective To investigate the clinical efficacy of super-activated platelet lysate（sPL）injection as an adjunct to subgingival scaling and root planning（SRP）in the treatment of chronic periodontitis. Methods Thirty-six patients with chronic periodontitis treated at the Department of Stomatology between October 2021 and April 2022 were enrolled, who were randomly divided into the control group and experimental group, with 18 patients in each. Patients in the control group received only SRP, while those in the experimental group received both SRP and localized gingival injection of sPL. Periodontal indicators, including the plaque index（PLI）, bleeding index（BI）, periodontal probing depth（PD）, and gingival recession depth（GRD）, were measured before treatment（baseline）, three and six months after treatment. The related indicators were statistically analyzed. Results At 6 months, PLI scores were lower in the experimental group than in the control group（P<0.001）. Compared with baseline, PLI scores in both groups decreased at 3 and 6 months, especially at 6 months （all P<0.001）. BI was lower at 6 months than at 3 months and baseline（all P<0.001）in both groups. At 6 months, PD was lower in the experimental group than in the control group（P=0.018）. Compared with baseline, PD decreased in both groups at 3 and 6 months, and more significantly at 6 months（all P<0.001）. Compared with baseline, GRD decreased in both groups at 3 and 6 months, particularly at 6 months（all P<0.001）. Conclusion sPL as an adjunct to SRP may effectively control gingival inflammation and improve gingival conditions in patients with chronic periodontitis.
Objective To evaluate the efficacy and safety of the combination treatment with a tumor necrosis factor-α antagonist adalimumab. Methods A retrospective analysis was conducted of 16 patients with severe drug eruptions hospitalized in the Department of Dermatology at the Air Force Medical Center between January 2023 and February 2024. Based on medication, the patients were divided into two groups: a hormone group（10 cases）and an adalimumab combined with hormone therapy group（combined therapy group）,（6 cases）. The DASI score, curative effect, time itch in the skin was alleviated, glucocorticoids burden and length of hospital stay, time rash stopped progressing, time the dose of glucocorticoids was reduced, initial and maximum doses of glucocorticoids, cumulative dose of glucocorticoids when rash stopped growing and such laboratory test indicators as serum ferritin, D-dimer and $\beta$2 microglobulin were compared between the two groups. Results The DASI score after treatment was lower in the combined therapy group than in the hormone therapy group（F=6.618, P=0.023）. The serum ferritin level was lower after treatment in the combined therapy group（P=0.002）, but was higher in the hormone therapy group than in the combined therapy group（P=0.046）. The D-dimer level decreased after treatment in the hormone therapy group（P<0.001）. There was a statistically significant difference in $\beta$2-microglobulin levels between the two groups after treatment（Wald χ2=11.066, P=0.001）. The combined therapy group compared favorably with the hormone therapy group in terms of the time rash progression stopped, time skin and mucosal pruritus was relieved, time the dosage of hormone was lowered, cumulative hormone doses at the time of rash cessation, and total hormone dose during hospitalization（t=2.221-3.733, P=0.002-0.043）. There was no statistically significant difference in adverse reactions between the two groups（all P>0.05）. Conclusion Adalimumab combined with glucocorticoids therapy may be a good option for severe drug eruptions. For patients with severe disease, long courses of treatment and a lack of effective control over rash by high-dose glucocorticoids therapy, early combination can shorten the course of the disease and reduce the dosage of glucocorticoids.
Objective To analyze the ultrasound detection rates and characteristics of thyroid nodules during the medical selection of pilots in order to provide data for revising the thyroid ultrasound standards for recruitment. Methods A retrospective analysis was conducted of results of thyroid ultrasound examination obtained from 8,893 male applicants ages 16 to 20 during the final medical selection for pilot recruitment, and from 3,313 male patients ages 11-80 examined at the Air Force Medical Center between December 2023 and May 2024. The analysis involved the number and location of thyroid nodules, the maximum nodule diameter, the sum of maximum diameters, and nodule classification. Thyroid ultrasound findings from applicants were compared with those from outpatients in the same age group. Additionally, thyroid ultrasound results were compared between outpatients of different ages, and the correlation between the average maximum nodule diameter and age was analyzed. Results Among the applicants, thyroid nodules were detected in 180 cases. The cumulative detection rate for subjects with ≤2 thyroid nodules（inciuding no nodules）was 99.88%, 99.82% for nodules with a maximum diameter ≤1.50 cm（inciuding no nodules）, and 99.82% for the sum of maximum diameters ≤2.00 cm（inciuding no nodules）. No statistically significant difference was observed between the latter two rates（χ2=5.512, P=0.357）. A negative correlation was observed between the maximum nodule diameter and the independent detection rate（rs=-0.996, P<0.001）. The detection rate of TR3 category nodules was higher than that of TR2 and TR4 category nodules. No statistically significant differences were observed in detection rates of thyroid nodules or in the composition ratio of nodule numbers between applicants and outpatients of the same age group（all P>0.05）. Among outpatients with thyroid nodules, the proportion of multiple nodules was observed to gradually increase with age（linear trend χ2=149.091, P<0.001）, and a positive correlation was identified between the average maximum nodule diameter and age（rs=0.158, P<0.001）. Statistically significant differences were found in the distribution of Chinese Thyroid Imaging Reporting and Data System（C-TIRADS）categories among thyroid nodule patients across age groups（P<0.001）, with the proportion of TR3 category nodules being higher than that of TR4 and ≥TR5 category nodules in each age group. Conclusion It is recommended that the qualification standard for thyroid examination during medical selection of pilots require bilateral thyroid nodules ≤2 in number, maximum nodule diameter ≤1.5 cm, or the sum of maximum nodule diameters ≤2.0 cm, concurrently with a C-TIRADS classification of TR3 or lower.
Objective To analyze the reasons for surgical disqualification of candidates from five southern provinces during the secondary medical selection of Air Force flying cadets, and to explore the corresponding healthcare countermeasures. Methods A retrospective analysis was conducted of the surgical examination results of candidates from five southern provinces who participated in the secondary medical selection of Air Force flying cadets between 2020 and 2024. The causes of surgical disqualification were statistically analyzed. Results Over the past 5 years, the percentage of surgically disqualified candidates during the secondary medical selection was 7.53%. The top 10 reasons included insufficient upper limb length（18.49%）, surgical history（13.75%）, insufficient height（9.17%）, bone and joint injuries（8.67%）, abnormal limb morphology（6.06%）, skin scars（6.06%）, spinal deformities（4.26%）, pigmented nevi（3.44%）, pelvic tilt（2.95%）, and overweight（1.97%）. Among them, there were statistically significant differences in the rates of disqualification due to insufficient upper limb length, surgical history, insufficient height, bone and joint injuries, and skin scars in the past 5 years（χ2=73.949, 18.803, 9.544, 9.655, 14.789, P<0.001, <0.001, =0.049, 0.047, 0.005）, excluding abnormal limb morphology, spinal deformities, pigmented nevi, pelvic tilt, and overweight（all P>0.05）. Conclusion Insufficient upper limb length, surgical history, insufficient height, bone and joint injuries, and skin scars are the major reasons for surgical disqualification during the secondary medical selection of Air Force flying cadets. Early prevention and health care can increase the number of surgically qualified candidates and improve the quality and efficiency of medical selection.
Ophthalmology involves so many items during medical selection of Air Force flying cadets, with a high rate of elimination and challenging borderline cases. Based on a review of results of ophthalmic examinations conducted during medical selection of flying cadets, we analyzed the related items that led to elimination and future developments in hopes of providing guidance and reference for the examiners so as to improve the accuracy and rationality of medical selection of Air Force flying cadets. This study is expected to help ensure that selected cadets enjoy exceptional visual health and are able to meet future challenges.
