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

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

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

Objective To study the relationships between postural control ability and cumulative fatigue under stress and to explore rapid methods for assessing fatigue. Methods Fifteen undergraduates from Shanghai University of Science and Technology who participated in the National Undergraduate Electronics Design Competition were enrolled to evaluate their postural control capabilities under fatigue and alertness. Participants were required to complete questionnaires assessing subjective fatigue and sleep duration and undergo dynamic balance tests and static balance tests on a balance testing device under both open-eye and closed-eye conditions. Statistical analysis was conducted using the Wilcoxon Signed-Rank Test. Results Data from subjective questionnaires and on sleep duration revealed a continuous increase in fatigue levels among subjects throughout the competition, indicating the cumulative nature of fatigue. The results of the balance ability assessments revealed statistically significant differences in such key metrics as the spiral trajectory accuracy（Z=2.329, P=0.020）, total length of open-eye trajectory（Z=2.272, P=0.023）, total length of closed-eye trajectory（Z=2.045, P=0.041）, and closed-eye envelope area（Z=2.329, P=0.020）. Conclusion There is a significant correlation between postural control ability and fatigue. The related metrics have demonstrated their utility as effective indicators for rapid assessment of fatigue status.

Objective To analyze the relationships between sleep quality, mental state and quality of life of civil aviation aircrews in order to provide a reference for preventing these conditions. Methods The convenient sampling method, a general questionnaire, Pittsburgh Sleep Quality Index（PSQI）, Self-Rating Depression Scale（SDS）, Self-Rating Anxiety Scale（SAS）, and a 12-Item Short-Form Health Survey Scale（SF-12）were used to survey 395 aircrews of an airline, assess their sleep quality, and analyze the causes of sleep disorders and the correlations between sleep quality and depression, anxiety and quality of life. Results The incidence of sleep disorders in these aircrews was 28.6%, and flying over more than 4 time zones for more than 3 times in one month was a risk factor for sleep disorders（OR=2.790, 95%CI: 1.266~6.147, P=0.011）. Among these aircrews, 28.9% suffered from depression（114/395）and 7.8% anxiety（31/395）. Depression and anxiety were more common among aircrews with sleep disorders than among those with normal sleep（t=7.102, 5.044, both P<0.001）. The scores of sleep quality of aircrews were positively correlated with the scores of depression and anxiety（r=0.304, 0.216, both P<0.001）. The scores of general health, role-physical scores, role-emotional scores and those of bodily pain, mental health, vitality and social function of the aircrew with normal sleep were higher than those of the sleep disorder group（t=4.111-8.323, all P<0.001）. Conclusion The body height is a factor leading to sleep disorders in aircrews, and flying over more than 4 time zones three times or more in a month is a risk factor for sleep disorders. Sleep quality, depression and anxiety of aircrews are mutually causal and complicated in their correlations. Airlines should attach importance to sleep and mental health management of aircrews who are different in heights, fly across time zones and remain physically inactive.

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

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

Objective To analyze the data on the video head impulse test（vHIT）in patients diagnosed with bilateral vestibular weakness（BVW）via the caloric test in order to explore the alternative role of vHIT in diagnosis of BVW. Methods Data on vestibular examination of 106 vertigo patients was retrospectively collected. The patients were divided into the BVW group and normal vestibular function group（control group）according to the caloric test results. Results of vHIT were compared between the two groups. Results Once either unilateral or bilateral anomalies in the horizontal semicircular canals were deemed positive in a vHIT, statistically significant differences could be observed between vHIT and the caloric test for detecting BVW（P=0.002）. Furthermore, when only bilateral anomalies in the horizontal semicircular canals were considered positive, but negative in normal canals, vHIT still remained significantly different from the caloric test in identifying BVW（P=0.019）. The area under the ROC curve for saccade frequency was 0.748, the sensitivity 60.3% and specificity 87.3%. As for the semicircular canal gain loss, the area under curve was 0.841, sensitivity 87.2% and specificity 76.1%, compared with 0.706, 87.2% and 43.3% for asymmetrical gain. Conclusion vHIT should be prioritized as an initial screening tool for diagnosing BVW. When vHIT results show no abnormalities, a caloric test should be conducted to confirm the diagnosis, thereby ensuring that no potential BVW cases are missed.

飞行人员在机动飞行中常常会受到各种加速度作用，从而引起飞行人员晕机反应和飞行错觉，对飞行安全构成严重威胁。前庭功能训练对提高飞行人员前庭功能稳定性和降低空晕病发生率具有重要作用。目前，亟待发展新型前庭功能训练技术，从而有效提高训练效果。笔者回顾三维滚轮前庭功能训练设备的研发过程，重点总结三维滚轮前庭功能评定和训练方法的研究进展，提出三维滚轮技术在飞行人员前庭功能评定和训练中的建议方案和应用前景。三维滚轮前庭功能评定和训练技术为未来提升飞行人员抗眩晕能力提供支撑。

Objective To find out about the incidence of thyroid nodules（TN）in naval pilots as well as factors related to lipid metabolism. Methods The results of thyroid ultrasound examination of naval pilots who had recuperated at our sanatorium between June 2019 and December 2021 were retrospectively analyzed to collect data and study the differences in blood lipid indicators between the TN group and the non-TN group. The distribution of TNs across naval pilots of different ages was analyzed while the correlations between blood lipid levels and the classification of TNs and the thyroid imaging reporting and data system（TI-RADS）were investigated. Results A total of 945 naval pilots were included in this study, with a thyroid nodule detection rate of 31.64%. The TN group was older than the non-TN group（t=3.332, P<0.05）, there was a statistically significant difference in detection rates among different age groups（χ²=21.196, P<0.01）. There was no statistically significant difference in blood lipid related indicators between the TN group and the non-TN group（P>0.05）. In groups with different blood lipid levels, the proportion of thyroid nodules classified was mostly TI-RADS 3. Conclusion Clinicians should attach importance to the screening of TNs in military pilots, keep track of malignant high-risk nodules with combined lipid abnormalities, clarify the nature of nodules early, and ensure early detection, diagnosis, and treatment of thyroid cancer.

黑洞错觉是一种常见的空间定向障碍。对于黑洞错觉的形成机制，相关研究尚不能给出明确解释。笔者基于生态心理学的视觉不变量假设，介绍了3种较有影响的关于黑洞错觉成因的理论，即恒定视角假设、动态空间策略假设和基于τ理论的假设。参考以上假设，笔者提出黑洞错觉的本质是一种在视觉信息贫乏状况下的视觉-动作控制策略，并指出可以结合τ理论与贝叶斯理想观察者模型构建一个整合模型框架。基于此框架，后续研究可以结合相关数据，定量预测黑洞错觉发生，并以之优化飞行员选拔过程。

为完善飞行员地面加压呼吸训练的方案，提高地面加压呼吸训练的效果，培养具有开展加压呼吸训练能力的专业人才，探索航空兵部队飞行员航空生理训练的组训方式，笔者依据现役装备的技术特点修改完善训练内容，根据训练技术的进步研制新型训练设备，完成新型多制式加压呼吸训练装置的研制，并通过训练检验其应用价值。同时，采用虚拟仿真技术，实现加压呼吸训练与空中特情模拟的结合。通过训练提升人员的能力，促进训练技术的改进与推广。建立一种具有推广潜力的地面加压呼吸训练模式，提升航空医学保障人员的能力与素质，为航空兵部队开展生理训练提供医学保障。

Objective To investigate the effect of miRNA hsa-let-7b-5p on factor-related apoptosis（Fas）expressions and apoptosis of human umbilical vein endothelial cells（HUVECs）in high glucose state. Methods HUVECs were cultured and divided into the control group（at the medium glucose concentration of 5.5 mmol/L）, high glucose group（at the medium glucose concentration of 33.0 mmol/L）, high glucose+miRNA hsa-let-7b-5p mimic group（at the medium glucose concentration of 33.0 mmol/L+miRNA hsa-let-7b-5p mimic transfected cells）, and high glucose+miRNA hsa-let-7b-5p inhibitor group（at the medium glucose concentration of 33.0 mmol/L+miRNA hsa-let-7b-5p inhibitor transfected cells）. The proliferation viability of the four groups was detected by CCK8 assay, the protein level of Fas in each group of cells by Western blotting, and the mRNA levels of miRNA hsa-let-7b-5p and Fas in HUVECs by RT-PCR. TUNEL staining was performed to detect the apoptosis of cells in each group. Results The miRNA hsa-let-7b-5p mimic transfection increased the proliferative activity（P<0.001）but decreased the apoptotic rate（P<0.001）of the cells. The expression levels of Fas mRNA（P<0.001）and Fas protein（P<0.001）were decreased while the expression level of hsa-let-7b-5p mRNA was increased（P<0.001）. The miRNA hsa-let-7b-5p inhibitor transfection decreased the proliferative activity（P<0.001）but increased the apoptotic rate（P<0.001）of the cells. The expression levels of Fas mRNA（P<0.001）and Fas protein（P<0.001）were increased while that of hsa-let-7b-5p mRNA was decreased（P=0.001）. Conclusion In high glucose state, miRNA hsa-let-7b-5p may inhibit apoptosis of HUVECs and protect vascular endothelial cells against atherosclerosis.

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

Objective To investigate the influencing factors of sarcopenia in patients with type 2 diabetes mellitus and the correlations with axial bone mineral density and blood lipids. Methods A total of 181 patients with type 2 diabetes admitted to the Second People's Hospital of Hefei between January 2020 to June 2022 were selected as the subjects and were divided into the sarcopenia group（n=63）and non-sarcopenia group（n=118）. Spearman correlation analysis was conducted to analyze the correlations of the axial bone mineral density (BMD) and blood lipids with sarcopenia in type 2 diabetes patients while Logistic regression analysis was used to screen the risk factors for type 2 diabetes patients with sarcopenia. Results The results of correlation analysis showed that L₁-L₄ BMD, BMD of the left femoral neck and of the right femoral neck, triglyceride and high density lipoprotein were negatively correlated with type 2 diabetes patients with sarcopenia（r=－0.368-－0.227, all P<0.05）, while total cholesterol, low density lipoprotein and type 2 diabetes patients with sarcopenia were positively correlated（r=0.250, 0.226; P=0.001, 0.002）. Logistic regression analysis showed the results of osteoporosis（OR=40.906, 95%CI=6.246-267.914）, glycated hemoglobin A1c, HbA1c（OR=2.583, 95%CI=1.619~4.121）, total cholesterol（OR=3.555, 95%CI=1.852~6.823）, low density lipoprotein（OR=3.371, 95%CI=1.561~7.276 ）were risk factors for type 2 diabetes patients with sarcopenia. L₁ BMD（OR=0.005, 95%CI=0.000~0.938）, BMD of the left femoral neck（OR=0.001, 95%CI=0.000~0.167）, and of the right femoral neck（OR=0.016, 95%CI=0.000~0.998）, parathyroid hormone, PTH）（OR=0.749, 95%CI=0.622~0.901）, triglyceride（OR=0.003, 95%CI=0.000~0.129）, high-density lipoprotein（OR=0.015, 95%CI=0.001~0.314）, skeletal muscle indexes（OR=0.199, 95%CI=0.081~0.489）were protective factors for type 2 diabetes patients with sarcopenia. Conclusion Axial bone mineral density and blood lipids are closely related to sarcopenia in patients with type 2 diabetes, suggesting that the axial bone mineral density and blood lipids in patients with type 2 diabetes should be monitored to prevent sarcopenia.

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

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

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

Objective To investigate the interventional effect of regular far-infrared irradiation on excessive proliferation of red blood cells at high altitudes via changes in red blood cell counts and regular far infrared irradiation. Methods After rigorous screening, the subjects were randomly divided into the far-infrared intervention group and control group. Patients with chronic high-altitude diseases were excluded. The intervention group received 50 days of far-infrared radiation at the intensity of 200 W once a day. Before and after interventions, peripheral blood was collected and biochemical analysis was conducted. Self-control and intra-group comparison methods were used for statistical analysis. Results Far infrared irradiation at a wavelength of 3.5~16.0 μm and an intensity above 200 W had no adverse effects on the subjects. The intervention group showed a significant decrease in systolic blood pressure, but an increase in blood oxygen saturation, diastolic blood pressure, and heart rate（Z=－3.184, －2.919, t=3.200, 3.983; P<0.001, =0.004, 0.007, 0.002）. After interventions, the red blood cell count in the control group was increased（P=0.001）. The results of intra-group comparison showed that there were statistically significant differences in hemoglobin, red blood cell counts, and HCT between the two groups before interventions（U=74.000, 49.000, 79.500, P=0.002, <0.001, =0.004）and after interventions（H_group=10.010, 13.370, 9.381, P=0.002, <0.001, 0.002）. Conclusion Whole-body far-infrared irradiation or local irradiation for more than 30 minutes per day for 50 days can effectively curb the increase in red blood cells caused by high-altitude exposure, suggesting that regular far-infrared radiation can effectively alleviate excessive proliferation of red blood cells caused by chronic diseases related to high altitudes.

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

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

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

登陆不良综合征（mal de débarquement syndrome，MdDS）是1种长时间在被动运动（如乘坐轮船、飞机和汽车等）状态下诱发的，以持续性振荡感为特征的前庭疾病。《MdDS诊断标准：巴拉尼学会分类委员会共识》对MdDS的认识历程、诊断标准、临床特征、实验室检查及鉴别诊断进行了详细阐述。笔者结合多年航空医学鉴定实践，对共识中的主要内容进行解读，旨在提升航空医学工作者对MdDS的认识。

Objective To investigate the expression and clinical significance of chemokine CXC subfamily receptor 4（CXCR4）in esophageal squamous cell carcinoma（ESCC）and its impact on biological characteristics of ESCC cell lines. Methods Bioinformatics methods were used to analyze the expression of CXCR4 in ESCC（82 cases）and normal tissues（1 456 cases）from the TCGA+GTEx dataset. Nine fresh ESCC tissues and their paired paracancerous tissues, 110 paraffin-embedded ESCC specimens, and 35 paired paracancerous tissues were collected. The mRNA levels of CXCR4 in 9 ESCC tissues and their paired paracancerous tissues were analyzed by qRT-PCR. The expression of CXCR4 in 110 ESCC and 35 paired paracancerous tissues was detected by immunohistochemistry. These tissues were divided into the CXCR4 low-expression group（46 cases）and the CXCR4 high-expression group（64 cases）. The differences in age, gender, TNM stage and lymph node metastasis between the two groups were studied. The proliferation, migration, and invasion abilities of cells with knocked down expressions of CXCR4 were detected using the cell counting kit-8（CCK-8 reagent）, scratch assay, and Transwell assay. The effect of knocking down CXCR4 expression on epithelial-mesenchymal transition（EMT）was examined by Western blot（WB）, immunofluorescence, and Transwell assay. Results The results of bioinformatics analysis showed that the expression of CXCR4 mRNA in ESCC tissues was higher than in normal esophageal tissues in the TCGA + GTEx dataset（t=9.524, P<0.001）. qRT-PCR analysis suggested that the mRNA level of CXCR4 in ESCC tissues was higher than in paracancerous tissues（t=9.967, P<0.001）. The CXCR4 protein expression level in ESCC tissues was higher than in paracancerous tissues（t=5.742, P=0.007）. There were statistically significant differences in TNM stage, N stage, and survival time between the CXCR4 low-expression group（46 cases）and the CXCR4 high-expression group（χ²=15.325, 13.628, both P<0.001; χ²=5.673, P=0.021）. The results of the CCK-8 assay indicated that the OD values of cells in the si-CXCR4 transfection group were lower than in the si-NC transfection group at 48 h and 72 h（P=0.019, 0.013）. Transwell assay showed that the numbers of migrating and invading cells in the si-CXCR4 transfection group were smaller than in the si-NC transfection group（t=5.790, 4.075, P=0.005, 0.008）. After knocking down CXCR4, the fluorescence intensity of E-cadherin expression increased, the fluorescence intensity of Vimentin decreased, and the EMT process induced by stromal cell-derived factor-1（SDF-1）was blocked. The numbers of migrating and invading cells in the si-CXCR4 transfection combined with SDF-1 treatment group were smaller than in the si-NC transfection combined with SDF-1 treatment group（F=14.290, 6.944, P=0.008, 0.044）. Conclusion Knocking down CXCR4 can inhibit the migration, invasion, and EMT process of ESCC cells. CXCR4 is highly expressed in ESCC tissues and is associated with poor prognosis, which can be used as a prognostic factor and a potential therapeutic target for ESCC.

目的 探讨Peutz-Jeghers综合征（Peutz-Jeghers syndrome, PJS）患者的临床特点和围手术期心理护理体会。方法 选取2020年3月1日—2023年3月1日在空军特色医学中心普通外科行手术治疗的24例PJS患者为病例组，同期在普通外科行小肠手术的32例患者为对照组，比较2组临床特点和心理状态等方面的差异，探讨PJS患者的临床和心理护理特点。结果 病例组中29.17%（7/24）为首次手术，而对照组中96.88%（31/32）首次手术，差异有统计学意义（χ²=28.826，P<0.001）。病例组接受手术年龄和BMI均小于对照组（t=－5.114、－5.098，P均<0.001），而平均手术时间、术后进食时间、首次术后排便时间和平均住院日均长于对照组，差异均有统计学意义（Z=－3.857、－3.128、－2.703、3.172，P<0.001、=0.002、=0.038、=0.002）。此外，病例组焦虑自评量表得分[（51.31±10.96）分 vs（41.55±5.40）分]和抑郁自评量表得分[（49.22±12.67）分 vs（43.81±6.42）分]均高于对照组，差异均有统计学意义（t=5.792、2.791，P<0.001、=0.007）。结论 PJS患者常有焦虑和抑郁情绪倾向，护理工作者应加强患者心理护理，增强患者治疗信心，提高护理质量。

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

目的 探讨同伴支持小组模式干预对肝门部胆管癌手术患者术后自我管理效能、社会支持及心理复原力的影响。方法 选取2022年6月—2023年10月解放军总医院第一医学中心肝胆胰外科收治的126例行肝门部胆管癌手术患者为研究对象，按照随机数字表法分为观察组和对照组，每组63例。对照组进行常规护理，观察组实施同伴支持小组协同护理模式护理。记录患者手术相关指标；比较2组患者干预前及干预3个月后的自我管理效能[自我管理效能量表（Chinese Version of Strategies Used by People to Promote Health，C-SUPPH）]、社会支持[领悟社会支持量表（Perceived Social Support Scale，PSSS）]评分、心理复原力[心理复原力量表（Connor Davidson Resilience Scale，CD-RISC-10）]、健康生活方式[健康促进生活方式（Health-Promoting Lifestyle Prolife-II，HPLP-Ⅱ）量表]和生活质量[癌症患者生活质量测定量表（European Organization for Research and Treatment of Cancer Quality of Life Questionnaire，EORTC QLQ-C30）]评分情况。结果 观察组肛门排气时间、卧床时间、住院时间均低于对照组（t=7.096、4.688、6.943，P均<0.001）；干预后，患者在C-SUPPH、PSSS、CD-RISC-10、HPLP-Ⅱ和EORTC QLQ-C30评分均较干预前提升（t=4.636~31.805，P均<0.001），且观察组提升幅度均高于对照组（t=12.130~25.911，P均<0.001）。结论 在肝门部胆管癌手术患者应用同伴支持小组模式进行干预，可缩短患者康复进程，让患者感知到更多社会支持，增强患者自我管理效能及心理复原力，促进生活方式的转变，提高其生活质量。

现代战争的高强度特点对军事人员的认知能力提出了更高的要求。膳食营养在维持认知功能方面发挥着重要作用，其中微量营养素和植物化学物在治疗认知功能障碍和维护认知功能健康方面有较好的效果。但是军人日常膳食普遍出现部分微量营养素和植物化学物摄入不足的情况。笔者对微量营养素和植物化学物改善认知功能障碍和维护认知功能发挥生物活性进行综述，系统概述维生素（维生素A、B族维生素、维生素C、维生素D和维生素E）、微量矿物元素（铁、碘、锰、锌和硒）及天然植物化的神经保护功能、改善认知能力的作用。旨在为维持军事人员认知功能的膳食营养补充方案提供理论依据，帮助军事人员更好地适应复杂多变的作战环境。

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

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

目的 探讨南部战区官兵门诊就诊皮肤病构成情况，与基层官兵皮肤病构成情况进行对比，为科学制定保障策略提供依据。方法 选取南部战区某医院皮肤科门诊自2019年1月—2023年12月就诊官兵为研究对象，回顾性分析其疾病谱特点，与南部战区基层官兵常见皮肤病构成比进行比较，并进行就诊患者满意度调查。结果 南部战区官兵门诊就诊皮肤病主要为变态反应性皮肤病、皮肤附属器皮肤病和真菌性皮肤病。与基层单位官兵抽样调查的结果差异存在统计学意义的病种有湿疹、痤疮、手足癣、疣、体股癣、疖肿、烂裆病（间擦性皮炎）、神经性皮炎、虫咬皮炎、甲沟炎、鸡眼、日光性皮炎、腋臭、痱子及其他（χ²=5.842~9 743.62，P≤0.016）。结论 南部战区官兵门诊皮肤病与基层官兵造成差异的可能因素有就诊流程和个人健康教育问题，所以要从预防策略和救治流程2方面进行保障策略的优化。

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

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

目的 探究前瞻性护理在预防机械通气患者发生ICU获得性衰弱（intensive care unit-acquired weakness，ICU-AW）中的作用。方法 选取2022年8月—2023年12月于南京医科大学附属南京医院呼吸与危重症医学科收治的67例机械通气患者。按照随机数字表法分为对照组（n=33）和研究组（n=34），对照组接受常规护理，研究组在常规护理的基础上接受前瞻性护理。采用医学研究委员会肌力评分（Medical Research Council Muscle Strength，MRC）比较2组肌力，采用日常生活活动量表（Activity of Daily Living，ADL）及巴氏指数（Barthel Index，BI）量表评估2组日常生活能力。采用焦虑自评量表（Self-Rating Anxiety Scale，SAS）及抑郁自评量表（Self-Rating Depression Scale，SDS）评估患者的焦虑、抑郁状态，统计2组患者的机械通气时间及住院时间。结果 护理前2组患者的MRC评分差异无统计学意义（P>0.05），研究组患者护理前后的MRC得分差值高于对照组，差异具有统计学意义（t=4.082，P<0.001）；护理前2组患者的ADL得分差异无统计学意义（P>0.05），研究组患者护理前后ADL评分差值高于对照组，差异具有统计学意义（t=8.906，P<0.001）；护理前2组患者的BI评分无统计学意义（P>0.05），研究组患者护理前后BI评分差值高于对照组，差异具有统计学意义（t=2.386，P=0.036）；护理前2组患者SAS评分及SDS评分差异均无统计学意义（P>0.05），研究组患者护理前后SAS评分及SDS评分差值均高于对照组，差异具有统计学意义（t=5.064、5.238，P均<0.001）；研究组患者机械通气时间低于对照组（t=11.063，P<0.001），研究组患者平均住院时间低于对照组（t=10.169，P<0.001 ）。结论 前瞻性护理可以有效预防ICU-AW，提高患者自理能力，同时缓解患者焦虑、抑郁心理状态，减少其机械通气时间及住院时间，值得在临床中进一步研究与推广。

目的 分析基层官兵年度体格检查异常项目情况，为制订有针对性的健康干预措施提供参考。方法 回顾性分析2023年8月—2024年2月936名基层官兵的体格检查资料，统计不同年龄段基层官兵异常项目的检出率和分布特点。结果 某部基层官兵体格检查中异常项目检出率前10位分别为：间接胆红素异常、BMI偏高、心动过缓、空腹血糖异常、心律不齐、尿酸偏高、总胆红素异常、脂肪肝、淋巴细胞绝对数偏高和屈光不正。不同年龄阶段的基层官兵中，BMI偏高、空腹血糖异常、心律不齐、尿酸偏高、脂肪肝和屈光不正的异常检出率差异具有统计学意义（χ²=9.140~40.975，P均<0.05）。结论 不同年龄段的基层官兵体格检查异常项目的检出率存在差异，需定期对基层官兵进行健康体检，并有针对性地指导预防各类疾病的发生发展，提高基层官兵对自身健康的管理意识，改变不良生活习惯，适当增加体训频率，提升基层官兵整体健康水平。

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

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