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。

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

“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。

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

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

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

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。

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

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

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

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

Objective To 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.

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

Objective To investigate the impact of varying ambient light intensity and display brightness on pilots' visual behavior using eye-tracking technology. Methods Nineteen military pilots were selected as the subjects between July 2024 and December 2024. Under three levels of ambient light intensity（dim light, medium-intensity light, and strong light）, the subjects adjusted the display brightness to the three levels（minimum, moderate, and maximum）. Data on their pupil diameter, saccade duration, blink duration, and gaze trajectory was collected by eye-tracking system. Results In the dim light environment, the pupil diameter was larger when the display brightness was at the minimum level compared to the moderate and maximum levels（P=0.010, <0.001）, and it was also larger at the moderate level than at the maximum level（P<0.001）. Under any of the display brightness levels, the pupil diameter in the dim light environment was significantly larger than in either the medium-intensity or strong light environment（all P<0.001）. Under the maximum display brightness, the pupil diameter in the medium-intensity light environment was larger than in the strong light environment（P=0.012）. The effects of ambient light intensity and display brightness on the saccade duration were insignificant（all P>0.05）. In the medium-intensity light environment, the blink duration was significantly shorter than in the strong light environment（P=0.019）. The gaze trajectories varied with ambient light intensity. Paths were more tortuous with more fixation points in the dim and the strong light environments, whereas they were more direct in the medium-intensity light environment. Conclusion The results suggest that both ambient light intensity and display brightness impact the pupil diameter rather than on the saccade duration. Ambient light intensity influences the blink duration, while display brightness has little effect. Gaze trajectories also vary widely under varying ambient light intensities. These findings can provide a reference for the optimized design of light environments and display brightness.

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

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

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

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

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

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

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

Objective To study the role of a stepwise electric rotary chair training protocol in enhancing the vestibular function stability of airsickness-prone individuals in order to provide evidence for screening and managing these individuals. Methods Forty-four volunteers underwent airsickness susceptibility screening using an electric rotary chair that rotated at 180°/s for 120 s. Failures of the screening received 1 to 4 days of training, with daily sessions lasting for a minimum of 25 minutes, plus psychological guidance and relaxation. Pre and post-training tolerance time and pass rates of screening in different genders were compared to analyze the contributing factors. Results Of these participants, 15 were identified as susceptible to airsickness. After training, their mean tolerance time significantly improved（t=24.100,P<0.001）. The detection rate of susceptibility was 66.67%（6/9）among females, compared with 25.71%（9/35）among males（P=0.044）. There was no statistically significant difference in susceptibility between different age groups（all P>0.05）. Moreover, 93.33%（14/15）of the susceptible individuals met the training standard within three days. Conclusion The stepwise rotary chair training protocol can rapidly and effectively improve vestibular stability and reduce adaptation time. A 120-second screening duration seems feasible.

Objective To explore the effects of quadriceps relaxation training combined with Zhoulin spectrum therapeutic apparatus on knee joint pain and functions as well as inflammatory factors in military personnel with post-exercise knee pain. Methods A total of 80 military personnel with knee pain caused by high-intensity training between February 2024 and January 2025 were selected as subjects and randomly divided into a control group（Zhoulin spectrum therapeutic apparatus alone, n=40）and an observation group（quadriceps relaxation training combined with Zhoulin spectrum therapeutic apparatus, n=40）. The course lasted 4 weeks, with both groups receiving guided therapy and relaxation training under medical supervision. Clinical efficacy, scores of the Lysholm Knee Scoring Scale（LKSS）, scores of the Visual Analog Scale（VAS）, and rates of recurrence were compared between the two groups before and after 4 weeks of treatment. Levels of interleukin（IL）-6 and IL-10 were compared at 1 day before treatment, 1 day after treatment, and 3 days after treatment. Results The clinical efficacy in the observation group was much better than that of the control group（Z=－1.993, P=0.046）. Both groups had their VAS scores reduced and Lysholm knee scores increased after 4 weeks of treatment（t=12.079, 9.038, 20.574, 13.148, all P<0.001）. The recurrence rate in the observation group was lower than that of the control group at 4 weeks post-treatment（χ²=6.667, P=0.010）. Simple effect analysis by group found that IL-6 levels were higher（P=0.005, <0.001）while IL-10 levels were lower（P=0.011, <0.001）in the control group than in the observation group at 1 and 3 days post-intervention. Time-based simple effect analysis showed that IL-6 levels peaked at 1 day post-treatment and declined after 3 days of treatment in both groups（both P<0.001）. IL-10 levels kept increasing in the observation group（all P<0.05）, and were elevated in the control group at 1 and 3 days post-treatment compared with baseline（both P<0.001）. Conclusion Combining quadriceps relaxation training with Zhoulin spectrum therapeutic apparatus can yield better outcomes in military personnel with post-exercise knee pain, improve their clinical symptoms, enhance knee function, mitigate pain intensity, lower recurrence rates, and regulate inflammatory cytokine levels.

腰痛指肋骨下缘至臀部下缘之间的疼痛或不适，伴或不伴一侧或双侧下肢疼痛。依据病因和病理，腰痛分为伤害感受性、神经性和伤害可塑性腰痛。腰痛是飞行人员最常见疾病之一，针对目前军事飞行人员腰痛缺乏系统康复治疗规范的现状，全军航空航天医学专业委员会依据军事飞行人员腰痛特征及全军重点课题研究成果，参照美国物理治疗协会骨科分会制定的基于国际健康、功能分类的腰痛康复指南，组织相关专家制定《军事飞行人员腰痛康复操作指南（2025）》，以规范军事飞行人员腰痛的康复评价、分类、分期及康复治疗方法。

各国空军通过航空生理训练锻炼飞行员驾驭装备、应对极端航空条件的能力，提高飞行耐力和心理应激能力水平，提升飞行效率和飞行安全。笔者前往新加坡空军基地航空医学中心参加了航空生理训练，充分了解了新加坡空军的航空生理训练组织机构、人员设备和训练方案等内容，对比分析我军情况，以期有所借鉴，提高航空生理训练水平，提升航卫保障能力。

目的 调查某部雷达站部队训练伤的损伤部位及损伤类型分布情况，为科学制定官兵训练伤的防控措施提供参考依据。方法 对2024年4—5月就诊的188例雷达站官兵进行现场调查，统计其训练伤的伤病部位及损伤类型的分布情况。结果 雷达站官兵训练伤伤病部位占比前3为膝关节及小腿23.40%（44/188）、腰背部15.96%（30/188）和踝关节及足部13.30%（25/188）；损伤类型占比前3为韧带损伤19.15%（36/188）、腰椎间盘突出12.76%（24/188）和肌肉损伤10.64%（20/188）。结论 雷达站官兵训练伤中膝关节及小腿、腰背部损伤发生率较高，损伤类型大多为韧带损伤和腰椎间盘突出，因此需加强其下肢稳定性和灵活性的训练和指导，以及腰背部核心训练。

目的 针对高原高海拔地区边防官兵眼部健康管理分散化的问题，构建基于循证医学的“环境适配-技术赋能-制度创新”三级防控体系，并验证其实际应用效果。方法 采用前瞻性队列研究设计，整合世界卫生组织健康促进理论与《高原战伤救治实用手册》《军队卫勤保障条例》为依据，通过环境适配、技术赋能和制度优化建立眼健康三级防控体系。选取2023年10月—2024年9月西南某海拔>4 500 m边防连队126名官兵为研究对象，采用随机数字表法将其分为观察组（n=63）和对照组（n=63）。观察组实施三级防控体系，对照组维持常规卫勤保障。对比观察组和对照组官兵的眼外伤发生率、干眼症发病率、后送时间、护目镜佩戴依从性、筛查覆盖率及满意度评分。结果 本研究实施三级防控体系，观察组官兵的眼外伤发生率和干眼症发病率均低于对照组，差异均有统计学意义（χ²=5.896、5.642，P=0.015、0.018）；观察组后送时间短于对照组，差异有统计学意义（t=24.260，P<0.001）。观察组官兵的护目镜佩戴依从性和筛查覆盖率均高于对照组（χ²=18.106、62.745，P均<0.001）。观察组官兵总体满意度评分高于对照组（t=11.310，P<0.001），各维度评分均高于对照组（t=9.371~12.795，P均<0.001），差异均有统计学意义。结论 高原高海拔边防连队官兵眼健康保障实施“环境改良、技术创新与制度保障”多维度干预有效降低高海拔官兵眼部风险，为我国高原边防官兵眼部健康卫勤管理提供了科学的保障方案。

Objective To explore the characteristics of balance and gait of patients after lateral ankle ligament reconstruction and compare them with healthy individuals in order to help develop precise and personalized postoperative rehabilitation programs. Methods Thirty male patients undergoing ankle ligament reconstruction surgery at the Fourth Medical Center of Chinese PLA General Hospital between October 1, 2023 and August 1, 2024 were selected as the study group, while another thirty healthy male peers served as the control group. The balance platform was used to collect data on the two groups of subjects regarding the area and perimeter of their motion trajectories, anterior-posterior and lateral standard deviations, average movement distance of the center of foot pressure on the X and Y axes, and their stability limit values under both eyes-open and eyes-closed conditions. A three-dimensional gait analysis system was employed to collect gait parameters and assess gait characteristics, including the double support phase, foot angle, step uniformity, support phase, swing phase, gait cycle, ankle dorsiflexion-plantarflexion, inversion-eversion, step frequency, step speed, and step width. Results In the eyes-open state, the motion trajectory area, motion trajectory perimeter, lateral standard deviation of the trajectory, and anterior-posterior standard deviation of the trajectory of patients in the ankle ligament reconstruction group were all greater than those of the control group（Z=－3.504 to －2.454, all P<0.05）. In the eyes-closed state, the motion trajectory area, motion trajectory perimeter, lateral standard deviation of the trajectory, anterior-posterior standard deviation of the trajectory, and the average movement distance of the center of pressure on the Y-axis in the ankle ligament reconstruction group exceeded those of the control group（Z=－3.755 to －2.247, all P<0.05）. The stability limit value of the ankle ligament reconstruction group was lower than that of the control group（Z=2.292, P=0.022）. During walking, compared with the control group, there was a decrease in step frequency and step speed in the reconstruction group（Z=－2.434, －3.756, P=0.015, <0.001）, but a significant increase in the double support phase（Z=－4.132, P<0.001）and swing phase（Z=－2.432, P=0.015）in the affected side of the reconstruction group, the support phase（Z=－2.225, P=0.024）, step length（Z=－2.561, P=0.010）, while the ankle dorsiflexion/plantar flexion range of motion（Z=－3.297, P=0.001） was significantly reduced. The healthy side also showed a significant increase in the double support phase（Z=－2.366, P=0.018）. Compared with the healthy side, patients in the reconstruction group had a significant increase in the double support phase（Z=－2.513, P=0.012）and swing phase（Z=－3.962, P<0.001）in the affected side, while the support phase（Z=－4.007, P<0.001）and ankle dorsiflexion/plantar flexion range of motion（Z=－2.188, P=0.029）were significantly reduced. Conclusion Eight weeks after lateral ankle ligament reconstruction, patients' balance stability remains impaired under both eyes-open and eyes-closed conditions, with more pronounced anterior-posterior instability when eyes are closed. Abnormal gait patterns persist during walking.

Objective To study the incidence of neck and waist diseases among military aircrews flying different types of aircraft and of different ages so as to provide a reference for the precise prevention and treatment of neck and waist diseases among aircrews. Methods By retrospectively analyzing the clinical data of 9 126 aircrews in Lintong Rehabilitation and Convalescent Center, according to different aircraft types, the aircraft（bombers and ptransport aircraft）group consisted of 2 593 aircrews, the aircraft（fighters）group consisted of 1 851 aircrews, and the aircraft（helicopters）group consisted of 4 682 aircrews, the prevalence of neck and waist diseases among these aircrews and the relationships with aircraft types and age of aircrews were studied. Results The incidence rates of neck, waist and concurrent neck and waist diseases in 9 126 aircrews were 6.99%（638/9 126）, 12.92%（1 179/9 126）and 2.55%（233/9 126）respectively. The top three neck diseases were neck muscle strain（276/9 126）, accounting for 3.02%, cervical spondylosis（203/9 126）, accounting for 2.22%, and cervical disc herniation（154/9 126）, accounting for 1.69%. The top three waist diseases were lumbar disc herniation（647/9 126）, accounting for 7.09%, lumbar muscle strain（441/9 126）, accounting for 4.83%, and lumbar spondylolysis（42/9 126）, accounting for 0.46%. In the aircraft（bombers and ptransport aircraft）groups, the prevalence of neck disease in the group of aircrews ages 30 and younger was lower than in the group ages 41 to 50（P<0.05）, and waist disease was not so prevalent in the group ages 30 and younge as in the other three age groups（all P<0.05）. In the aircraft（fighters）groups, the incidence of neck disease in the group aged 30 and younger was lower than in the other three age groups（all P<0.05）, and that of waist disease in the group ages 30 and younger was lower than in the group between the ages of 41 and 50（P<0.05）. The incidence of neck and waist disease in the group ages 30 and younger was lower than in the groups ages 31 to 40 and 41 to 50（both P<0.05）. In the aircraft（helicopters）group, the prevalence of neck, waist, and concurrent neck and waist diseases in aircrews aged 30 and younger was lower than in the other age groups（all P<0.05）. Neck disease was more common in the aircraft（fighters）group than in the aircraft（bombers and ptransport aircraft）groupand aircraft（helicopters）group（both P<0.05）. There was no significant difference in the incidence of waist disease between aircrews of different aircraft types（all P>0.05）. The incidence of neck and waist disease in the aircraft（fighters）group was higher than that in the aircraft（bombers and ptransport aircraft）group and the aircraft（helicopters）group（both P<0.05）. Conclusion The incidence of neck, waist and concurrent neck and waist diseases in aircrews of the same type of aircraft in the group ages 30 and younger is lower than in the other age groups. After the age of 30, these diseases become more common with the increase of flight time. Aviation security personnel should take precautions according to age and types of aircraft and get treated as early as possible to keep their necks and waists healthy.

Objective To explore the applicability of virtual endoscopic reconstruction technology in the treatment of pilot kidney stones using ureteral flexible ureteroscopy. Methods A total of 32 pilots who underwent ureteral flexible ureteroscopy for kidney stones at the Urology Department between January 2021 and February 2024 were selected for this study, who were randomly divided into two groups using a random number table method: the control group（16 cases）and the experimental group（16 cases）. The control group underwent traditional CT imaging for stone localization and subsequent ureteral flexible ureteroscopy while the experimental group used virtual endoscopy reconstruction technology for preoperative stone localization and intraluminal surgical path planning. During surgery, the planned path was followed for ureteral flexible ureteroscopy. The age, stone length, stone location, intraoperative stone localization time, surgical durations, and postoperative complications were compared between the two groups. Results There were no statistically significant differences between the two groups in terms of age, stone location, stone length or the incidence of surgical complications（all P>0.05）. The experimental group had a shorter stone localization time and a shorter surgical duration than the control group, with statistically significant differences（Z/t=－2.488, 2.643, P=0.013, 0.014）. Conclusion The application of virtual endoscopy reconstruction technology in preoperative stone localization, surgical path planning, and intraoperative navigation can shorten stone localization time and surgical durations in ureteral flexible ureteroscopy, thereby improving surgical efficiency.

Objective To compare the results of vestibular function tests conducted on pilots before and after the COVID-19 pandemic and analyze the possible causes of vestibular dysfunction in order to provide data for aeromedical assessment. Methods The medical records of 60 pilots who underwent vestibular function tests at the Air Force Medical Center between 2016 and 2023 were reviewed. The data of pilots diagnosed with unilateral vestibular dysfunction for the first time was selected. January 1, 2020 was taken as the day the COVID-19 pandemic broke out. Among the 60 cases, 51 were diagnosed after this date and assigned to the study group, and 9 were diagnosed before this date and served as the control group. Clinical features of these cases were statistically analyzed. Results The proportion of the study group in all pilots tested during the same period was significantly higher than that of the control group（χ²=4.284, P=0.038）. In the study group, 47 had no vestibular-related symptoms, but 4 did. In the control group, 3 had no vestibular-related symptoms, but6did. The proportion of cases without vestibular-related symptoms was significantly higherin the study group（χ²=15.059, P<0.001）. There was no statisticallysignificant difference between the two groups in the distribution of the abnormal tests. When diagnosed for the first time, 41（80%）were assessed as qualified for flight and 6（12%）were temporarily grounded in the study group, compared with 3（33%）and 5（56%）in the control group. The qualified rate of the study group was significantly higher than that of the control group（χ²=6.424, P=0.011）, while the proportion of temporarily grounded pilotsin the study group was significantly lower（χ²=7.092, P=0.008）. Conclusion The increase of asymptomatic cases of unilateral vestibular dysfunction in pilots may be related to infections with low-virulent strain of SARS-CoV-2 or vaccination. The damage to vestibular function is mild, and detailed classification and aeromedical assessment can be carried out according to vestibular receptor diseases（VRDs）.

Objective To explore the therapeutic effect of warm moxibustion and skin scraping (gua sha) against primary dysmenorrhea in high-altitude and extremely cold areas, and to recommend a better treatment for primary dysmenorrhea in young women in these areas. Methods Sixty cases of primary dysmenorrhea collected from high-altitude and extremely cold areas were divided into the observation group and control group by random number table method, with 30 cases in each. The observation group received the warm moxibustion and skin scraping therapy while the control group was treated with ibuprofen extended-release capsules. The patients in both groups were treated for three menstrual cycles and followed up for another 3 months. The clinical efficacy, the Cox Menstrual Symptom Scale（CMSS）scores, Numerical Rating Scale（NRS）scores, and pressure pain thresholds at different sites were compared between the two groups before treatment and at months 1, 2, 3 and 6 after treatment. Results At the 6th month, the total effective rate of the observation and control groups was 63.33% and 20.00%, respectively, and the differences were statistically significant（χ²=11.589, P=0.001）. The dynamics were compared between the 2 groups at different time points. The CMSS scores were statistically significant at months 3 and 6（P<0.001, =0.025）while the NRS scores were of statistical significance at months 1 and 6（P=0.008, <0.001）. The pressure pain threshold scores for the left lumbar vertebrae, right lumbar vertebrae, left rectus abdominis muscle and right rectus abdominis muscle were statistically significant at month 6 in the 2 groups（P<0.001, <0.001, <0.001, =0.001）. After treatment, the differences in CMSS scores, NRS scores, and pressure pain threshold scores of the left side of the lumbar spine, the right side of the lumbar spine, the left side of the rectus abdominis muscle, and the right side of the rectus abdominis muscle were statistically significant in the observation group at months 1, 2, 3 and 6（all P<0.05）, but at months 1, 2 and 3 in the control group（all P<0.05）. Conclusion The efficacy of the warm moxibustion and skin scraping therapy against primary dysmenorrhea in young women in high-altitude and extremely cold areas is definite. This therapy is environmentally-friendly, safe, user-friendly, and better than ibuprofen interventions in terms of the sustainability of the effect.

笔者通过回顾医院空中机动医疗队参加全军基地化训练的任务经历，分析训练质效和下一步医院医疗队建设重点，系统阐述基地化训练对于提升医院机动卫勤分队卫勤保障能力的关键性与必要性，并对下个阶段训练基地建设提出意见建议。基地化训练的逐步实施有助于促进机动卫勤分队实战化卫勤保障水平的提高，规范机动卫勤分队展开救治流程，推动机动卫勤分队训练向实战化的目标方向迈进，但因空中机动站卫勤保障理念起步较晚，仍有部分问题亟待解决。空中机动站是空运医疗后送的关键环节，进行空中机动医疗队基地化训练是空军今后实施基地化卫勤训练发展的趋势和方向，是提高空军医院遂行实战化卫勤保障任务，强化向战为战、为战练兵和标准化、体系化、集成化空军卫勤系统演习演训卫勤保障能力生成的重要途径。

Objective To investigate the effect of doses of radioactive iodine-131（¹³¹I）therapy on survival and quality of life of patients with differentiated thyroid cancer（DTC）. Methods The clinical data of 126 DTC patients who received ¹³¹I treatment after total thyroidectomy between 2017 and 2020 at Quanzhou First Hospital was retrospectively analyzed. The patients were divided into group A（53 patients, 1.1 GBq）, group B（45 patients, 3.7 GBq）, and group C（28 patients, 5.5 GBq）according to the dose of ¹³¹I treatment before the clearance rate of residual thyroid tissue, the incidence of tumor recurrence or metastasis, adverse reactions, overall survival（OS）, disease-free survival（DFS）and scores of quality of life were compared. Results There were no statistically significant differences in the clearance rate of thyroid residual tissue or the incidence of tumor recurrence or metastasis between the three groups（P>0.05）. The incidence of hematologic adverse reactions in Group C was higher than in Groups A and B（all P<0.05）. Multivariate analysis showed that the ¹³¹I dose（HR=1.989, 95%CI=1.029~3.845）and age（HR=1.080, 95%CI=1.008~1.157）were risk factors for the survival curve. Postoperative complications（HR=0.066, 95%CI=0.014~0.301）was protective factor for the survival curve. The SF-36 scores of group A were higher than those of groups B and C（P=0.046, P<0.001）, and higher in group B than in group C（P=0.020）. EQ-5D scores were higher in Group A than in Group C（P=0.002）. The levels of thyroglobulin（Tg）, thyroglobulin antibody（TgAb）, thyroid stimulating hormone（TSH）, and parathyroid hormone（PTH）in Group B were lower than in Groups A and C（P<0.001 or P<0.05）. Conclusion In patients with DTC, the dose of ¹³¹I therapy should be chosen based on the individual patient's condition. Too high a dose may increase the risk of adverse effects, lower the patient's quality of life, and impact the patient's physical, psychological, and social functioning.

Objective To study the differences in brain functions between pilots of different aircraft types when performing selective tasks, and to analyze the correlations between related indicators and cardiopulmonary exercise testing so as to provide data for daily training and selection of pilots. Methods Fourteen pilots（8 fighter pilots and 6 transport pilots）and 9 healthy subjects underwent functional magnetic resonance imaging（fMRI）scan and cardiopulmonary exercise testing（CPET）during selective tasks. The activated brain regions were located, while the relationships between the degree of activation of brain regions and the cardiopulmonary exercise testing were analyzed. Results The response of the left middle frontal gyrus, anaerobic threshold, relative anaerobic threshold and maximum oxygen pulse level of cardiopulmonary function of the pilot group were higher than those of healthy controls（t=4.215, 3.898, 4.231, 2.386, all P<0.05）. There was no difference in the extent to which the left middle frontal gyrus was activated between pilots of different aircraft（P>0.05）, and the anaerobic threshold of the transport pilots was higher than that of fighter pilots（t=－2.611, P=0.023）. The response of the left middle frontal gyrus was negatively correlated with the anaerobic threshold（r=－0.242, P=0.043）. Conclusion The left middle frontal gyrus may be a key brain area for selective attention among pilots, and anti-load training may help fighter pilots keep the left middle frontal gyrus highly activated.