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 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 investigate the efficacy of Vitapex paste and calcium hydroxide paste against apical periodontitis with sinus tract in flight personnel. Methods Sixty pilots with periapical periodontitis admitted to our hospital between 2019 and 2022 were selected as the subjects and randomly divided into two groups with 30 cases in each. The 30 patients treated with calcium hydroxide paste served as the control group while those treated with Vitapex paste combined with minocycline and ornidazole were assigned to the observation group. The therapeutic effect, levels of factors of inflammation and adverse reactions of the two groups were observed. Results The total effective rate was 100.00% in the observation group, compared with 76.67% in the control group, so the difference was statistically significant（χ²=5.822, P=0.016）. There was no significant difference in VAS scores between the two groups before treatment（t=0.079, 0.112, 0.261, P=0.938, 0.911, 0.795）, but the VAS score of the observation group was significantly lower than that of the control group 14 days after treatment（t=2.925, 2.516, 9.068, P=0.005, 0.015, <0.001）. Adverse reactions included stomach discomfort, infections and headache. The incidence of adverse reactions was 10.00% in the observation group and 3.33% in the control group, so there was no significant difference between the two groups（χ²=0.268, P=0.605）. Conclusion Vitapex paste combined with minocycline and ornidazole is effective in treating periapical periodontitis, which can help control bacterial infections of teeth of the flight personnel and quicken dental diagnosis and treatment during recuperation so that they can return to work sooner.

Objective To measure the daily energy expenditure of aircrews so as to provide data for studies on energy metabolism and to explore a new method to monitor energy expenditure for aircrews. Methods The total daily energy expenditure of 59 aircrews from 4 aviation units was calculated via life observation and actigraphy. The differences and correlations between the two methods were observed. Results The total daily energy expenditure measured by means of life observation and actigraphy was（3 102.1±372.4）kcal and（2 957.8±422.2）kcal, respectively. There was statistically significant difference between the two methods（t=3.170, P=0.002）, but strong correlations were also found between the two methods（r=0.619, P<0.001）. Conclusion The results of measurement by life observation and actigraphy are closely correlated. Actigraphy can replace life observation in measurement of the total energy expenditure of aircrews.

Objective To analyze the disease spectrum of grounded fighter pilots in terms of types of disease, patterns of change over time, and influencing factors so as to provide data for disease prevention, treatment, and health maintenance of fighter pilots in China. Methods The literature on disease spectrums of grounded fighter pilots was retrieved from the Chinese and English databases as of June 2022. After screening, the included literature was selected. The combination rate and publication bias of different components of disease were calculated using STATA 17 software before an appropriate effect model was chosen based on the heterogeneity test results. Subgroup analysis was made according to the time investigation was conducted to study the change of the disease spectrum, and Chi-squared test was performed using SPSS 26 software to find out whether the difference was statistically significant. Results Thirteen articles were included, involving 2 519 grounded pilots. Meta analysis results showed that the top ten diseases were occupational aviation diseases（18%）, nervous system diseases（14%）, motor system diseases（12%）, cardiovascular diseases（12%）, digestive system diseases（11%）, psychosocial diseases（8%）, respiratory system diseases（6%）, ophthalmic diseases（5%）, urinary system diseases（3%）and metabolic diseases（3%）. After 2010, the prevalence of occupational aviation diseases（χ²=88.40, P<0.001）, nervous system diseases（χ²=5.98, P=0.014）and digestive system diseases（χ²=23.87, P<0.001）among grounded fighter pilots decreased while the incidence of motor system diseases（χ²=12.32, P<0.001）, cardiovascular diseases（χ²=18.46, P<0.001） and respiratory diseases（χ²=34.77, P<0.001）increased. The difference was of statistical significance. Conclusion In the spectrum of diseases among grounded fighter pilots, the top two are occupational aviation diseases and nervous system diseases. The prevalence of motor system diseases, cardiovascular diseases and respiratory diseases has been on the rise in recent years. Related institutions need to take precautions to keep fighter pilots healthy in China and reduce the medical grounding rate.

Objective To find out about the mental health status and related changes among military personnel in scattered and remote troops in the past ten years, and to provide data for mental health assessment and interventions. Methods The literature that met the criteria for assessment was retrieved from CNKI, VIP and Wanfang databases using SCL-90 before meta-analysis was conducted using meta-package in R software. Results Sixteen studies were included after data screening, involving 5 375 subjects, whose scores of depression, interpersonal sensitivity, somatization, and anxiety factors were significantly higher than the military norm（2016 version）（WMD = 0.29, 0.26, 0.26, and 0.24, respectively while P values were<0.001）. The subgroup test showed that scores of interpersonal sensitivity and obsessive-compulsive factors were different between geographical groups（Q=12.8, 5.83, P<0.01, =0.05）. Meta-regression analysis showed that score of interpersonal sensitivity was influenced by the year the study was conducted and by the sample size of the experimental group, the score of depression factors was affected by the sample size of the experimental group while the score of hostility factors varied according to the age of the subjects. Conclusion The psychological health status of military personnel in scattered and remote troops is significantly lower than the military norm（the 2016 version）. The problems involve depression, interpersonal sensitivity, somatization and anxiety.

Objective To explore and discover the current research status, hotspots, and future trends in the field of mental health of recruits in China. Methods Retrieve 681 published documents in CNKI in the field of mental health of recruits and visualize and analyze the number of articles issued, authors and institutions, and the co-occurrence and mutability of keywords in this field with the help of the scientific metrology software. Results In terms of the number of publications, the research in this field is divided into three stages: slow start（1992-2002）, rapid development（2003-2015）, and gradual retreat（2016-2023）; In terms of authors and institutions, there was a great lack of communication and cooperation between authors and institutions; In terms of the research hotspots, it mainly includes four aspects, namely, the subject group, the mental health-related manifestations, the factors affecting the mental health, and the psychological interventions. In terms of research frontiers, subject to the development of the discipline and the influence of policies, different research frontiers are presented at different time stages, and the recent keywords of psychological resilience, perceptual stress, and sleep quality are still the research hotspots. Conclusion Future research is interdisciplinary to introduce emerging research methods and techniques and to enhance author-institutional collaboration to better serve the mental health of recruits.

Objective To study intestinal flora changes in patients with ischemic stroke, and to explore their correlations with prognosis and T helper cell type 1/T helper cell type 2（Th1/Th2）immune cell balance. Methods One hundred and six patients with ischemic stroke admitted to our hospital between January 2020 and March 2022 were enrolled and received intravenous thrombolytic therapy. After discharge, the prognosis of patients was evaluated using the Modified Rankin Scale（mRS）after 90-day follow-up. These patients were divided into the good group（mRS score ≤2, n=71）and poor group（3 <mRS score <6, n=35）according to the mRS score. The intestinal flora composition and levels of Th1/Th2 and related cytokines were compared between the two groups. Pearson correlation analysis was conducted to reveal the correlations between the relative abundance of intestinal flora and the levels of Th1/Th2 and related cytokines in these patients. Results Chaol index and Shannon index were lower in the poor group than in the good group（t=7.025, 5.033, all P<0.001）. The abundance of Firmicutes and Prevotella was decreased in the poor group（t=11.475, 6.514, all P<0.001）, while the abundance of Bacteroides and Escherichia was increased compared with the good group（t=19.289, 7.826, all P<0.001）. The poor group had elevated serum levels of interleukin-2（IL-2）and interferon-γ（IFN-γ）（t=12.685, 25.814, all P<0.001）but decreased levels of Th1/Th2, IL-4 and IL-5 compared with the good group（t=5.066, 12.793, 11.476, all P<0.001）. The results of Pearson correlation analysis suggested that Bacteroidetes and Escherichia were negatively correlated with Th1/Th2, IL-4, and IL-5（r=-0.604~-0.376, P<0.05）, but positively with IL-2 and IFN-γ（r=0.439~0.623, all P<0.05）. Firmicutes, Prevotella, Chao1 index, and Shannon index were positively correlated with Th1/Th2, IL-4, and IL-5（r=0.428~0.623, P<0.05）, but negatively with IL-2 and IFN-γ（r=-0.584~-0.397, P<0.05）. Conclusion Changes in intestinal flora in patients with ischemic stroke are associated with poor prognosis and levels of Th1/Th2 and related cytokines.

Objective To explore the levels and clinical significance of peripheral blood glucose-regulated protein 78（GRP78）and activating transcription factor 4（ATF4）in patients with postmenopausal osteoporosis（PMO）. Methods A total of 96 PMO patients admitted to the Third Hospital of Shijiazhuang between December 2018 and May 2021 were selected as the PMO group while another 96 menopausal women confirmed to be healthy by physical examinations served as the normal group. The basic data of the two groups was compared. Enzyme linked immunosorbent assaywas used to measure the serum levels of GRP78 and ATF4 while electrochemiluminescence immunoassay was adopted to measure the serum levels of β-Crosslaps and procollagen Ⅰ type N-terminal propeptide（PINP）. The dual-energy X-ray bone densitometer was used to detect lumbar bone mineral density（BMD）while the Pearson method was employed to analyze the correlations between serum levels of GRP78 and ATF4 in PMO patients and β-Crosslaps, PINP and BMD as well as those between serum levels of GRP78 and ATF4 in PMO patients. Logistic regression was used to analyze the influencing factors of PMO. Results The waist-to-hip ratio and BMD of the PMO group were lower than those in the normal group（t=9.76, 15.47, both P<0.001）, but the serum levels of GRP78, ATF4, β-Crosslaps and PINP were higher（t=18.32, 16.81, 8.15, 14.84, all P<0.001）. The serum levels of GRP78 and ATF4 in PMO patients were positively correlated with β-Crosslaps and PINP（r=0.56, 0.48, 0.48, 0.52, P<0.001, <0.001, <0.001, =0.006）, but negatively with BMD（r=-0.54, -0.44, both P<0.001）. The serum level of GRP78 of PMO patients was positively correlated with ATF4（r=0.595, P<0.001）. PINP, GRP78, β-Crosslaps and ATF4 were risk factors for PMO（OR=2.518, 2.672, 2.271, 2.336, all P<0.001）, while BMD was a protective factor（OR=0.583, P<0.001）. Conclusion The serum levels of GRP78 and ATF4 in patients with PMO are relatively high, which are related to β-Crosslaps, PINP, and BMD. GRP78 and ATF4 may be potential targets for the diagnosis and treatment of PMO. Determination of serum GRP78 and ATF4 levels is helpful for clinical prevention and treatment of PMO.

Objective To investigate the efficacy and safety of a self-heating Tengfu TCM package. Methods SD rats were divided into the normal control group, model control group, self-heating Tengfu TCM（3.06 g/kg）low, medium, and high dose groups（0.5 h, 3 h, 6 h），traditional Tengfu TCM package group（12.42 g/kg, 0.5 h）, and diclofenac diethylamine emulsion group（0.125 g）according to body weight. An acetic acid-induced pain model and a cotton ball granuloma hyperplasia model in rats were used respectively, and the number of twists, latency and cotton ball granuloma hyperplasia in rats were determined to reveal the differences between the self-heating Tengfu TCM low-, medium-, and high-groups on one hand and the traditional Tengfu TCM group and the diclofenac diethylamine emulsifier group on the other hand. The skin irritation and skin sensitization of self-heating Tengfu TCM packages were investigated via skin irritation tests in experimental rabbits and patch tests in guinea pigs. Results The medium-and high-dose self-heating Tengfu TCM packages Compared with the model control group, The difference was statistically significant（P=0.016, P=0.007）; traditional Tengfu TCM group Compared with low-dose self-heating Tengfu TCM packages The difference was statistically significant（P=0.029）. Comparison of latency in diclofenac diethylamide group with model control group, The difference was statistically significant（P=0.008）, high-dose self-heating Tengfu TCM packages Granuloma weight Compared with the model control group The difference was statistically significant（P=0.016）. The self-heating Tengfu TCM package caused no irritation or sensitization to the skin. Conclusion The self-heating Tengfu TCM package has properties of analgesia and anti-inflammation, and it is safe for transdermal administration.

Objective To investigate the clinical efficacy of filiform needles combined with wet cupping therapy at the meridian sinew nodal point of the quadriceps muscle against chondromalacia patellae among aircraft maintenance staffs. Methods Sixty aircraft maintenance staffs with chondromalacia patellae were randomly assigned to two groups: the observation group and the control group, with 30 cases in each. The observation group was treated with filiform needles combined with wet cupping therapy at the meridian sinew nodal point（treated with filiform needs once a day and with wet cupping therapy once every three days）. The control group received acupuncture therapy using filiform needles once a day. One course of treatment lasted 9 days in both groups. The Visual Analogue Scale（VAS）and Lysholm Scale were used to calculate the scores of the two groups before and after treatment. Results The difference was statistically significant in the treatment of patellar chondromalacia in the two group（Z=2.003, P=0.045）. After 9 days of treatment, the VAS score was substantially decreased in both groups（t=15.597, 17.000, all P<0.001）, the difference was statistically significant in the two group,and the pain level in the observation group was better than that in the control group（t=3.459, P=0.001）. The score of the Lysholm Scale was markedly increased in both groups（t=11.462, 8.104, all P<0.001）, and the observation group had better knee joint function than the control group（t=4.285, P<0.001）. Conclusion Filiform needles combined with wet cupping therapy at the meridian sinew nodal point of the quadriceps muscle can be effectively treat chondromalacia patellae than filiform needles alone.

Objective To explore the therapeutic effect of acupuncture and moxibustion combined with rehabilitation training on patients with peripheral facial paralysis in the acute stage. Methods A study was conducted on 80 patients with acute facial paralysis who were treated in the Physical Rehabilitation Department of Xiamen Special Service Sanatorium of the Army between January 2023 and September 2023. These patients were randomly divided into the control group and the observation group, with 40 patients in each. The control group was treated with acupuncture and moxibustion while the observation group received rehabilitation training plus acupuncture and moxibustion. The clinical efficacy of the two approaches was observed. Results The total effective rate and Portmann score of the observation group after treatment were significantly different from those of the control group（χ²=13.867, t=2.81, 3.98, 3.38, P<0.001, =0.007, <0.001, =0.001）. Conclusion Acupuncture and moxibustion combined with rehabilitation training can facilitate rehabilitation of patients with peripheral facial paralysis in the acute stage, improve the quality of life of patients and proves to be of clinical value.