Abstract: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.

Abstract: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.

Abstract:Objective To investigate heart rate variability(HRV)of flying cadets during simulated flight missions in order to provide data for physiological assessment during psychological selections of flying cadets.Methods Sixty-three pilot candidates participating in the psychological selection in 2023 were selected,who were asked to wear ear clip-type HRV signal collectors from the"stability assessment system for the autonomic nervous system"and had their HRV monitored three times(five minutes each time)before,during,and after the simulated flight mission.And conducted data analysis.Results The time-domain indicators root mean square of successive differences and percentage of adjacent NN intervals differing by more than 50 milliseconds were higher before and after the mission than during the mission(all P＜0.05),while mean heart rate turbulence and standard deviation of heart rate turbulence were lower before and after the mission than during the mission(all P＜0.001).The frequency-domain indicators total power,low frequency,low frequency/high frequency ratio and 0.1 Hz frequency band power were lower before and after the mission than during the mission(all P＜0.05),while high frequency were higher before and after the mission than during the mission(both P＜0.001).Conclusion During high-difficulty simulated flight missions,the activity of the sympathetic nervous system in pilot candidates increases,while that of the parasympathetic nervous system decreases.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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(x2=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.

Abstract: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.

Abstract: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,PFDR=0.049,＜0.001),so did clustering coefficients(t=2.377,3.146,PFDR=0.022,0.003).The degree of the right middle occipital gyrus was also elevated(t=2.096,PFDR=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,PFDR=0.049,0.035,0.005,0.033).In addition,both average local efficiency and bridging connections increased(t=2.090,2.310,PFDR=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.

Abstract:Objective To compare the clinical effects of manual mechanical hysteroscopic tissue removal(mHTR)and that of hysteroscopic electricity resection(HEC)for the treatment of endometrialpolyps(EMPs).Methods Sixty patients with EMPs admitted to the Air Force Medical Center between August 2022 and February 2024 were enrolled in this study.According to surgical approaches,30 patients treated with the manual mHTR were assigned to the observation group while another 30 patients undergoing hysteroscopic resection served as the control group.The perioperative indicators of the two groups were compared,including the time taken to remove the largest polyp,numbers of times instrument entered the uterine cavity,amounts of bleeding,usage of distention solutions,menstrual recovery,endometrial thickness,maximum polyp volume,postoperative complications(patients with infection and intrauterine adhesions),recurrence(patients with endometrial polyps detected a second time via postoperative ultrasound examination),and pregnancy(patients with confirmed intrauterine pregnancy by postoperative ultrasound).Results The time taken to remove the largest polyp in the observation group was shorter than in the control group(Z=-3.691,P＜0.001).The number of times the hysteroscope entered the uterine cavity and the usage of distention solutions were both lower than those in the control group(Z=-7.125,-2.121,P＜0.001,=0.034).There was no statistically significant difference in the amount of intraoperative bleeding,postoperative menstrual recovery time,or endometrial thickness between the two groups(P＞0.05).All patients were followed up for at least 6 months.There was 1 case of recurrence but no occurrence of intrauterine adhesions in the observation group.Among the 17 married but childless subjects,7 became pregnant.In the control group,there was no recurrence but 1 case of intrauterine adhesion.Among the 14 married and childless individuals,6 became pregnant.Conclusion Both manual mHTR and HEC are effective in the treatment of endometrial polyps.Manual mHTR has some advantages over HEC in that it is portable,safe,effective and causes no electrical heating damage and fewer postoperative complications.Moreover,it does not affect pregnancy and is suitable for young women with both EMPs and fertility needs.

Abstract: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.

Abstract:Objective To explore the applicability of dynamic X-ray in early identification and prognosis prediction of vertebral osteoporotic fractures.Methods A total of 100 patients with vertebral osteoporotic fractures who were treated surgically at Langfang People's Hospital from June 2019 to June 2022 were selected and randomly divided into a control group and an observation group,each consisting of 50 cases.Both groups were diagnosed with vertebral osteoporotic fractures via anteroposterior and lateral X-ray imaging and underwent minimally invasive surgery,specifically percutaneous vertebroplasty or percutaneous kyphoplasty.The control group received only anteroposterior and lateral X-ray examinations before surgery while the observation group received dynamic imaging guidance during the procedure.The spinal angle,scores of Visual Analogue Scale(VAS),and vertebral function scores of the two groups were evaluated to assess the therapeutic effect.Results All patients had their fractures confirmed through X-ray examination.The imaging signs varied among patients,primarily characterized by calcification,gas accumulation,and vacuum fractures.Vacuum fractures amounted to severe fractures,while calcification features indicated mild fractures.In all fracture patients,the bone spongy level around the lesion was found to be elevated.After surgery,the comparison of sagittal parameters between the two groups showed no statistically significant differences in the T1 pelvic angle and lumbar lordosis angle(both P＞0.05).However,the observation group had significantly better results in the vertical axis,sacral angle,and thoracic kyphosis angle than the control group(t=2.061,2.310,2.242,P=0.042,0.023,0.027).The results of repeated measures analysis showed that the VAS scores and vertebral function scores in the observation group compared favorably with the control group at 4 and 8 weeks after surgery(P＜0.001,＜0.001,=0.012,＜0.001).The results of Logistic regressionanalyse indicated that three factors were indentified as influencing factors:the vertical axis(OR=0.200,95％CI=0.052-0.771),sacral angle(OR=0.097,95％CI=0.024-0.391)and thoratic kyphosis angle(OR=0.855,95％CI=0.754-0.970).Conclusion Dynamic X-ray can facilitate early identification and prognosis prediction of vertebral osteoporotic fractures.

Abstract:Objective To evaluate the causal association between psychobehavioral factors and essential hypertension or blood pressure using the Mendelian randomization(MR)method.Methods Single nucleotide polymorphism(SNP)strongly associated with eight psychobehavioral factors(depression,mood disorder,personality disorder,schizophrenia,dementia,substance abuse,sleep disorders,and alcohol dependence)were retrieved as instrumental variables from human genome-wide association studies.A two-sample Mendelian randomization analysis was conducted to assess the causal association between the eight psychobehavioral factors and essential hypertension,systolic blood pressure,and diastolic blood pressure using the random-effects inverse-variance weighted(IVW)method,MR-Egger method,and MR-PRESSO method.Cochran's Q test and MR-Egger intercept test were used to evaluate the heterogeneity and horizontal pleiotropy of the instrumental variable SNPs.Results The IVW model showed that sleep disorders were a risk factor for essential hypertension(OR=1.027,95％CI=1.015-1.039),and also a contributor to increased systolic blood pressure(β=0.543,95％CI=0.110-0.976)and diastolic blood pressure(β=0.796,95％CI=0.486-1.106).Dementia also contributed to increased systolic blood pressure(β=0.228,95％CI=0.093-0.363)and diastolic blood pressure(β=0.169,95％CI=0.001-0.337),but was not associated with an increased risk of essential hypertension(P＞0.05).No causal association was observed between other psychobehavioral factors and essential hypertension,systolic blood pressure,or diastolic blood pressure(all P＞0.05).The results of MR-Egger and MR-PRESSO aligned with those of IVW.Cochran's Q test indicated that there was heterogeneity among SNP in the causal association of sleep disorders with essential hypertension and diastolic blood pressure(Q=53.102,33.106,P=0.001,0.011),as well as in the causal association of dementia with diastolic blood pressure(Q=23.529,P=0.036).No heterogeneity was found among SNP in the causal association of sleep disorders and dementia with systolic blood pressure(both P＞0.05).MR-Egger intercept test showed no significant genetic-level pleiotropy(all P＞0.05).Conclusion Among the eight psychobehavioral factors,only sleep disorder are a risk factor for essential hypertension and elevated blood pressure at the genetic level.

Abstract:Objective To evaluate the applicability of kite flaps in the repair of upper lip defects.Methods A total of 30 patients with upper lip defects repaired with kite flaps were selected from July 2021 to August 2024 at the Dermatoplastic Center of Air Force Medical Center.Their clinical data was retrospectively analyzed.The therapeutic effect of kite flips against upper lip defects was studied.Results The age of these patients ranged from 10 to 69,the median age was 26.00(17.25,36.50),and the areas of skin defects ranged from 0.5 cm×0.5 cm to 3.3 cm×2.8 cm.The survival of the flaps at the site of surgery was satisfactory.Healing by first intention occurred in all the incisions and there was no local deformation.After follow-up of 3 months to 1 year,it was found that the surgical scars were not obvious,the lip hair grew normally,and the aesthetic effect was satisfactory.Conclusions Kite flaps have distinct advantages in repairing upper lip defects,such as smaller auxiliary incisions,less damage,quick recovery,well-concealed scars along the nasolabial sulcus,no obvious scars after healing,and no pronounced local deformation.

Abstract:Objective To study the disease spectrum of patients hospitalized at a medical facility between 2020 and 2024 so as to provide data on how to allocate healthcare resources properly and control critical diseases effectively.Methods Information on the first page of medical records between 2020 and 2024 was retrieved and classified using Pareto analysis.Results A total of 63 413 individuals were hospitalized(40 179 males and 23 234 females),so the ratio of males to females was approximately 1.73∶1.23 280 of these patients ranged from 60 to 79 in age and accounted for 36.71％of the total,more than one-third of hospitalized patients.The dominating types of diseases involved the circulatory and respiratory systems,digestive system,endocrine/nutrition/metabolism,genitourinary system,ears/mastoid processes,injury/poisoning and other factors that affected health,accounted for 79.95％of the total.Conclusion Diagnosis and treatment of these eight major categories of diseases should be prioritized in clinical practice.It is recommended that hospitals rationally allocate medical resources,establish better specialized departments,and put more effort into the prevention and treatment of these diseases.