Objective:To analyze the results of low-dose lung CT screening for military flying personnel, and to explore its influence on aeromedical identification.Methods:The imaging and aeromedical identification data of military flying personnel who underwent annual physical examination in Air Force Healthcare Center for Special Services Hangzhou were analyzed retrospectively. According to the imaging manifestations, the enrolled low-dose lung CT results were divided into the following 6 categories: no obvious abnormality, old lesions, pulmonary nodules, pulmonary bullae, pulmonary inflammatory lesions and extrapulmonary diseases. The detection rates of various examination results were statistically analyzed. The military flying personnel were divided into 20-29 years group, 30-39 years group, 40-49 years group and 50-59 years group, and they were divided into fighter pilots, bomb-trans-helicopter pilots, and bomb-trans-helicopter crew members according to the post. The differences in various examination results of flying personnel were compared among different age groups and post groups. The influence of examination results on the aeromedical identification results was analyzed in accordance with the 3-level conclusions as not affecting the conclusion of aeromedical identification, leading to the decline of health grade and leading to temporary grounding. The overall significance level α=0.05, and the pairwise comparison with P< α/statistical times was statistically significant. Results:A total of 2 274 flying personnel was enrolled. The detection rates of various examination results from high to low was no obvious abnormality (45.82%), old lesions (37.55%), pulmonary nodules (14.86%), pulmonary bullae (6.73%), pulmonary inflammatory lesions (2.59%) and extrapulmonary diseases (1.85%). There was significant difference among examination results of different age groups ( χ2=183.43, P<0.001). The detection rate of no obvious abnormality was the highest in 20-29 years group and 30-39 years group; the detection rate of old lesions was the highest in 40-49 years group and 50-59 years group. The detection rate of no obvious abnormality decreased with age, and the detection rate of old lesions increased with age (both P< α/6=0.008). The detection rate of pulmonary nodules in 40-49 years group was higher than that in 30-39 years group; the detection rate of pulmonary bullae in 50-59 years group was higher than that in the other age groups; the detection rates of pulmonary inflammatory lesions in 40-49 years group and 50-59 years groups were higher than those in the other age groups; the detection rate of extrapulmonary diseases in 50-59 years group was higher than that in 20-29 years group, and the differences were statistically significant (all P<0.008). There was significant difference in the results of flying personnel among different post groups ( χ2=33.78, P=0.001). The detection rate of no obvious abnormality in bomb-trans-helicopter crew members group was lower than that in bomb-trans-helicopter pilots group and fighter-trainer pilots group, but the detection rates of old lesions and pulmonary nodules were higher than those in the other groups, the differences were statistically significant (all P< α/3=0.017). The detection rate of pulmonary bullae in fighter-trainer pilots group was lower than that in bomb-trans-helicopter crew members group, and the difference was statistically significant ( P<0.017). Although majority of the detected results had no effect on the results of aeromedical identification, there was a significant difference in the proportion of health grade decline and temporary grounding caused by different detected diseases (Fisher exact test value was 82.81, P<0.001). Conclusions:Low-dose lung CT screening plays an important role in the physical examination and aeromedical identification for military flying personnel. It can be routinely used during the annual physical examination for flying personnel, and the aeromedical identification standards and strategies for lung related diseases should be updated synchronously.

Objective:To improve the understanding of craniocerebral diseases and aeromedical assessment from the perspective of imaging by analyzing the results of craniocerebral MRI examination of military flying personnel.Methods:The results of craniocerebral MRI examination were retrospectively analyzed among the military flying personnel who underwent annual physical examination in Air Force Healthcare Center for Special Services Hangzhou from September of 2020 to December of 2021. They were divided into 20-29 years group, 30-39 years group, 40-49 years group, 50-59 years group according to the age, and they were divided into fighter pilots, bomb-transporter pilots, helicopter pilots, air combat/technical personnel according to the aircraft type and post. The detection of craniocerebral MRI examination results of the flying personnel in different age groups and aircraft type and post groups were compared. The influence of abnormal results on the conclusion of aeromedical assessment was analyzed. The α level of statistical analysis was set at 0.05, and the difference was statistically significant with P< α/statistical count for pairwise comparison among groups. Results:Among the craniocerebral MRI examination results of 975 military flying personnel, 473 cases were with no obvious abnormality, 194 were anatomical variation of Willis circle, 27 were congenital brain malformation, 54 were cerebrovascular disease, 279 were white matter hyperintensities (WMHs), 22 were tumor and tumor-like lesions, 26 were arachnoid cyst, 29 were empty sella, 7 were intracranial calcinosis and 2 were craniocerebral trauma. The proportion of no obvious abnormality in 20-29 years group and 30-39 years group were higher than those in other age groups; the detection rates of WMHs in 40-49 years group and 50-59 years group was higher than those in the other age groups; the detection rates of cerebrovascular diseases and empty sella in 50-59 years group were higher than those in the other age groups, and the differences were significant (all P< α/6=0.008). The proportion of no obvious abnormality in fighter pilots and helicopter pilots were higher than those in others; the detection rate of WMHs in air combat/technical personnel was higher than that in others; the detection rate of arachnoid cyst in bomb-transporter pilots was higher than that in fighter pilots, and the differences were significant (all P< α/6=0.008). Most of the abnormal results detected by craniocerebral MRI examination had no significant impact on the conclusion of aeromedical assessment, and those with greater impact were cerebrovascular disease, tumor and tumor-like lesions (both P< α/351=0.001). Conclusions:The MRI examination not only preliminarily explains the basic characteristics of the distribution of craniocerebral diseases among military flying personnel of different ages, aircraft types and posts from the perspective of imaging, but also provides the basis for dynamic follow-up and accurate aeromedical assessment.

Objective:To analyze the results of low-dose lung CT screening for military flying personnel, and to explore its influence on aeromedical identification.Methods:The imaging and aeromedical identification data of military flying personnel who underwent annual physical examination in Air Force Healthcare Center for Special Services Hangzhou were analyzed retrospectively. According to the imaging manifestations, the enrolled low-dose lung CT results were divided into the following 6 categories: no obvious abnormality, old lesions, pulmonary nodules, pulmonary bullae, pulmonary inflammatory lesions and extrapulmonary diseases. The detection rates of various examination results were statistically analyzed. The military flying personnel were divided into 20-29 years group, 30-39 years group, 40-49 years group and 50-59 years group, and they were divided into fighter pilots, bomb-trans-helicopter pilots, and bomb-trans-helicopter crew members according to the post. The differences in various examination results of flying personnel were compared among different age groups and post groups. The influence of examination results on the aeromedical identification results was analyzed in accordance with the 3-level conclusions as not affecting the conclusion of aeromedical identification, leading to the decline of health grade and leading to temporary grounding. The overall significance level α=0.05, and the pairwise comparison with P< α/statistical times was statistically significant. Results:A total of 2 274 flying personnel was enrolled. The detection rates of various examination results from high to low was no obvious abnormality (45.82%), old lesions (37.55%), pulmonary nodules (14.86%), pulmonary bullae (6.73%), pulmonary inflammatory lesions (2.59%) and extrapulmonary diseases (1.85%). There was significant difference among examination results of different age groups ( χ2=183.43, P<0.001). The detection rate of no obvious abnormality was the highest in 20-29 years group and 30-39 years group; the detection rate of old lesions was the highest in 40-49 years group and 50-59 years group. The detection rate of no obvious abnormality decreased with age, and the detection rate of old lesions increased with age (both P< α/6=0.008). The detection rate of pulmonary nodules in 40-49 years group was higher than that in 30-39 years group; the detection rate of pulmonary bullae in 50-59 years group was higher than that in the other age groups; the detection rates of pulmonary inflammatory lesions in 40-49 years group and 50-59 years groups were higher than those in the other age groups; the detection rate of extrapulmonary diseases in 50-59 years group was higher than that in 20-29 years group, and the differences were statistically significant (all P<0.008). There was significant difference in the results of flying personnel among different post groups ( χ2=33.78, P=0.001). The detection rate of no obvious abnormality in bomb-trans-helicopter crew members group was lower than that in bomb-trans-helicopter pilots group and fighter-trainer pilots group, but the detection rates of old lesions and pulmonary nodules were higher than those in the other groups, the differences were statistically significant (all P< α/3=0.017). The detection rate of pulmonary bullae in fighter-trainer pilots group was lower than that in bomb-trans-helicopter crew members group, and the difference was statistically significant ( P<0.017). Although majority of the detected results had no effect on the results of aeromedical identification, there was a significant difference in the proportion of health grade decline and temporary grounding caused by different detected diseases (Fisher exact test value was 82.81, P<0.001). Conclusions:Low-dose lung CT screening plays an important role in the physical examination and aeromedical identification for military flying personnel. It can be routinely used during the annual physical examination for flying personnel, and the aeromedical identification standards and strategies for lung related diseases should be updated synchronously.

Objective:To improve the understanding of craniocerebral diseases and aeromedical assessment from the perspective of imaging by analyzing the results of craniocerebral MRI examination of military flying personnel.Methods:The results of craniocerebral MRI examination were retrospectively analyzed among the military flying personnel who underwent annual physical examination in Air Force Healthcare Center for Special Services Hangzhou from September of 2020 to December of 2021. They were divided into 20-29 years group, 30-39 years group, 40-49 years group, 50-59 years group according to the age, and they were divided into fighter pilots, bomb-transporter pilots, helicopter pilots, air combat/technical personnel according to the aircraft type and post. The detection of craniocerebral MRI examination results of the flying personnel in different age groups and aircraft type and post groups were compared. The influence of abnormal results on the conclusion of aeromedical assessment was analyzed. The α level of statistical analysis was set at 0.05, and the difference was statistically significant with P< α/statistical count for pairwise comparison among groups. Results:Among the craniocerebral MRI examination results of 975 military flying personnel, 473 cases were with no obvious abnormality, 194 were anatomical variation of Willis circle, 27 were congenital brain malformation, 54 were cerebrovascular disease, 279 were white matter hyperintensities (WMHs), 22 were tumor and tumor-like lesions, 26 were arachnoid cyst, 29 were empty sella, 7 were intracranial calcinosis and 2 were craniocerebral trauma. The proportion of no obvious abnormality in 20-29 years group and 30-39 years group were higher than those in other age groups; the detection rates of WMHs in 40-49 years group and 50-59 years group was higher than those in the other age groups; the detection rates of cerebrovascular diseases and empty sella in 50-59 years group were higher than those in the other age groups, and the differences were significant (all P< α/6=0.008). The proportion of no obvious abnormality in fighter pilots and helicopter pilots were higher than those in others; the detection rate of WMHs in air combat/technical personnel was higher than that in others; the detection rate of arachnoid cyst in bomb-transporter pilots was higher than that in fighter pilots, and the differences were significant (all P< α/6=0.008). Most of the abnormal results detected by craniocerebral MRI examination had no significant impact on the conclusion of aeromedical assessment, and those with greater impact were cerebrovascular disease, tumor and tumor-like lesions (both P< α/351=0.001). Conclusions:The MRI examination not only preliminarily explains the basic characteristics of the distribution of craniocerebral diseases among military flying personnel of different ages, aircraft types and posts from the perspective of imaging, but also provides the basis for dynamic follow-up and accurate aeromedical assessment.

Objective:To investigate the alteration of right ventricular function after catheter ablation in patients with persistent atrial fibrillation(PAF) and concomitant heart failure with preserved ejection fraction (HFpEF).Methods:The prospective observational study was performed in patients with HFpEF-PAF and undergoing first-time radiofrequency ablation procedures in the First Affiliated Hospital of Nanjing University between May to December 2019. Right ventricular functional parameters were measured before and 5 days, 1, 3, 6 and 12 months after the ablation by transthoracic echocardiography, respectively, including the right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion(TAPSE), tricuspid annular diameter (TVAD), tricuspid annular peak systolic speed(TDI-S′) and longitudinal strain of right ventricular free wall (RVFLS). Meanwhile, routine ECG and Holter recordings were performed at each follow-up time point.Results:In this study, atrial fibrillation (AF) recurrence occurred in 4 patients at the 3rd month after ablation, and 7 patients failed to follow up due to the Covid-19. Finally, 19 patients were followed up for the evaluation of cardiac function after catheter ablation. Compared with pre-ablation, right ventricular structural and functional paramters(RVFAC, TAPSE, TVAD, TDI-S′, RVFLS) improved significantly at all stages of follow-up( all P<0.05). Patients with atrial fibrillation recurrence had lower RVFLS and TDI-S′ at the baseline( P=0.039, P=0.019). Conclusions:Right ventricular function could improve in HFpEF-PAF patients who maintain sinus rhythm after radiofrequency ablation.

Objective:To explore the influential factors of lumbar inter-vertebral disc degeneration and provide the references on flying personnel′s recruitment, physical checkup for transformation and medical identification.Methods:Lumbar MRI images and relevant data of 458 flying personnel who underwent medical identification in the Second Area of Air Force Healthcare Center for Special Services Hangzhou from March 2018 to May 2019 were retrospectively analyzed. Two thousand two hundred and ninety lumbar inter-vertebral discs of 458 flying personnel were semi quantitatively scored according to the Pfirrmann standard. The sum of five inter-vertebral disc scores of each flying personnel was taken as the lumbar inter-vertebral disc degenerative factor (LIVDDF). This factor was taken as the dependent variable ( y), and the age ( x1), height ( x2), weight ( x3), and flying hours ( x4) of flying personnel were taken as independent variables for linear regression analysis. The subgroup analysis was carried out based on the grouping of aircraft type and flight post. Results:The range of LIVDDF was 5-18, with an average of 10.87±2.83. Total analysis showed that age and weight were the influential factors of lumbar inter-vertebral disc degeneration in flying personnel. The regression equation was y=1.029+0.182 x1+0.038 x3 ( r=0.68, P<0.01). Subgroup analysis on the different aircraft types showed that the influential factor was age in the fighter subgroup. The regression equation was y=2.569+0.225 x1 ( r=0.59, P<0.01). Age and height were the influential factors in the trans-bomber aircraft subgroup. The regression equation was y=-8.848+0.186 x1+7.160 x2( r=0.69, P<0.01). Flying hours was the influential factor in the helicopter subgroup. The regression equation was y=7.823+0.001 x4 ( r=0.65, P<0.01). Subgroup analysis on different flight post showed that the influential factors were age in flying personnel. The regression equation was y=3.176+0.207 x1 ( r=0.65, P<0.01). Age and weight were the influential factors in crew members. The regression equation was y=-0.113+0.171 x1+0.056 x3( r=0.74, P<0.01). Conclusions:Age and weight are the main influential factors of lumbar inter-vertebral disc degeneration in flying personnel, but these factors show different influence on aircraft type and flight post. Due to the small sample size in this study, aviation related factors are not fully included. So other influential factors of lumbar inter-vertebral disc degeneration of flying personnel may exist.

Objective:To provide evidence for the physical examination of the subjects in pilot selection, aircraft transferring and normal health check by analyzing the applicability of low-dose chest CT in pulmonary nodule diagnose.Methods:The flying personnel who received the physical examination in Air Force Healthcare Center for Special Services, Hangzhou from December of 2018 to May of 2019 were enrolled in this prospective study. They were randomly divided into observation group and control group by a random number table. The subjects of observation group underwent low dose chest CT, while the subjects of control group underwent routine chest X-ray examination. The detection rate of pulmonary nodules and its influence rate on medical identification were respectively compared between 2 groups. Subgroup analysis based on the size, density, quantity and benign or malignant of pulmonary nodules were also analyzed between 2 groups.Results:A total of 238 flying personnel were enrolled down to each group of 119 subjects. There was no significant difference in age, height, weight, flying hours, flight post and aircraft type between observation group and control group. The detection rate of pulmonary nodules in observation group (41.18%) was significantly higher than that in control group (10.08%) ( P<0.05). The influence rate of pulmonary nodules detection on medical identification in observation group (24.45%) was higher than that in control group (16.67%), but it has no statistical significance ( P>0.05). Subgroup analysis showed that observation group had significantly higher detection rate of pulmonary nodule and ground-glass nodule which had the diameter smaller than 3 mm ( P<0.05). Compared with control group, there was no statistical difference on the detection rate of pulmonary multiple nodules and malignant nodules ( P>0.05). Conclusions:For screening pulmonary nodules in flying personnel, low-dose chest CT is obviously superior to routine chest X-ray examination and can provide better imaging basis for the medical evaluation of flying personnel.

Objective:To explore the influential factors of lumbar inter-vertebral disc degeneration and provide the references on flying personnel′s recruitment, physical checkup for transformation and medical identification.Methods:Lumbar MRI images and relevant data of 458 flying personnel who underwent medical identification in the Second Area of Air Force Healthcare Center for Special Services Hangzhou from March 2018 to May 2019 were retrospectively analyzed. Two thousand two hundred and ninety lumbar inter-vertebral discs of 458 flying personnel were semi quantitatively scored according to the Pfirrmann standard. The sum of five inter-vertebral disc scores of each flying personnel was taken as the lumbar inter-vertebral disc degenerative factor (LIVDDF). This factor was taken as the dependent variable ( y), and the age ( x1), height ( x2), weight ( x3), and flying hours ( x4) of flying personnel were taken as independent variables for linear regression analysis. The subgroup analysis was carried out based on the grouping of aircraft type and flight post. Results:The range of LIVDDF was 5-18, with an average of 10.87±2.83. Total analysis showed that age and weight were the influential factors of lumbar inter-vertebral disc degeneration in flying personnel. The regression equation was y=1.029+0.182 x1+0.038 x3 ( r=0.68, P<0.01). Subgroup analysis on the different aircraft types showed that the influential factor was age in the fighter subgroup. The regression equation was y=2.569+0.225 x1 ( r=0.59, P<0.01). Age and height were the influential factors in the trans-bomber aircraft subgroup. The regression equation was y=-8.848+0.186 x1+7.160 x2( r=0.69, P<0.01). Flying hours was the influential factor in the helicopter subgroup. The regression equation was y=7.823+0.001 x4 ( r=0.65, P<0.01). Subgroup analysis on different flight post showed that the influential factors were age in flying personnel. The regression equation was y=3.176+0.207 x1 ( r=0.65, P<0.01). Age and weight were the influential factors in crew members. The regression equation was y=-0.113+0.171 x1+0.056 x3( r=0.74, P<0.01). Conclusions:Age and weight are the main influential factors of lumbar inter-vertebral disc degeneration in flying personnel, but these factors show different influence on aircraft type and flight post. Due to the small sample size in this study, aviation related factors are not fully included. So other influential factors of lumbar inter-vertebral disc degeneration of flying personnel may exist.

Objective:To provide evidence for the physical examination of the subjects in pilot selection, aircraft transferring and normal health check by analyzing the applicability of low-dose chest CT in pulmonary nodule diagnose.Methods:The flying personnel who received the physical examination in Air Force Healthcare Center for Special Services, Hangzhou from December of 2018 to May of 2019 were enrolled in this prospective study. They were randomly divided into observation group and control group by a random number table. The subjects of observation group underwent low dose chest CT, while the subjects of control group underwent routine chest X-ray examination. The detection rate of pulmonary nodules and its influence rate on medical identification were respectively compared between 2 groups. Subgroup analysis based on the size, density, quantity and benign or malignant of pulmonary nodules were also analyzed between 2 groups.Results:A total of 238 flying personnel were enrolled down to each group of 119 subjects. There was no significant difference in age, height, weight, flying hours, flight post and aircraft type between observation group and control group. The detection rate of pulmonary nodules in observation group (41.18%) was significantly higher than that in control group (10.08%) ( P<0.05). The influence rate of pulmonary nodules detection on medical identification in observation group (24.45%) was higher than that in control group (16.67%), but it has no statistical significance ( P>0.05). Subgroup analysis showed that observation group had significantly higher detection rate of pulmonary nodule and ground-glass nodule which had the diameter smaller than 3 mm ( P<0.05). Compared with control group, there was no statistical difference on the detection rate of pulmonary multiple nodules and malignant nodules ( P>0.05). Conclusions:For screening pulmonary nodules in flying personnel, low-dose chest CT is obviously superior to routine chest X-ray examination and can provide better imaging basis for the medical evaluation of flying personnel.

Objective To evaluate the potential cerebral cortical volume alterations in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI) compared with T2DM patients and healthy controls,and to observe the correlations with the scores of neuropsychological scales.Methods Cortical volume based on high-resolution MR T1WI data from 30 healthy controls (HC),30 T2DM patients and 30 T2DM with MCI patients were evaluated with FreeSurfer software and compared with variance analysis.The correlations between cerebral cortical volume which had statistical difference and the scores of neuropsychological scales were analyzed.Results There were significant differences in auditory verbal learning test (AVLT) scores,complex figure test-delayed recall (20 min) scores,digit symbol-coding subtest scores,MoCA scores and higher trail-making test-A scores,as well as trail-making test-B scores between T2DM and T2DM with MCI patients (all P＜0.05).Compared with T2DM patients,cortical volume of left entorhinal cortex,left lateral orbitofrontal gyrus,left posterior cingulate gyrus and the right lateral orbitofrontal gyrus,right pars orbitalis,right insula reduced in T2DM with MCI patients (all P＜0.05).In T2DM with MCI patients,AVLT scores were positively correlated with volume of the left entorhinal cortex (r=0.452,P=0.018).Conclusion Several cortical volume reductions are exhibited in T2DM patients with MCI.The volume of the left entorhinal cortex may be a potential biomarker to diagnose and evaluate MCI in T2DM.