Objective:To quickly identify the causes of morphological abnormalities of microcytic hypochromic erythrocytes that are detected during health checkups for recruitment of flying cadets, and to explore its role in medical selection.Methods:Students with hemoglobin (Hb)≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes detected during the 2023 medical selection of flying cadets by Guangzhou Selection Center were selected. Their medical history was collected, and iron metabolism, Hb electrophoresis and hemoglobin H (HbH) inclusion bodies were examined to screen for thalassemia and iron deficiency. The diagnosis of thalassemia was confirmed by thalassemia gene testing. Those with iron deficiency received iron supplementation therapy and the recovery of Hb was observed.Results:Ninety-one students were diagnosed with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, accounting for 4.35% of the total. Among these cases, 85 with abnormal Hb electrophoresis and/or positive HbH inclusion body detection were confirmed as thalassemia minor via thalassemia genetic testing, and 3 cases with normal iron metabolism, Hb electrophoresis, and negative HbH inclusion body detection. A total of 88 cases of thalassemia minor were diagnosed, accounting for 96.70% of the total. Among them, 2 cases were complicated with iron deficiency while 3 were diagnosed with iron deficiency erythropoiesis. Out of the 91 students with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, 9 were recruited, including 7 cases with thalassemia minor (Hb≥130 g/L), 1 case with thalassemia minor combined with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation), and 1 case with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation). Among the 9 recruits, 8 were followed up for over one year and the results of their military physical fitness tests all reached or exceeded the standards, but the remaining one dropped out and lost contact.Conclusions:Among physical examinees during medical selection of flying cadets in South China, thalassemia is the leading cause of morphological abnormalities of microcytic hypochromic erythrocytes. Results of iron metabolism, Hb electrophoresis, and HbH inclusion body detection can help identify thalassemia and iron deficiency quickly. Cases of morphological abnormalities of microcytic hypochromic erythrocytes caused by iron deficiency can be considered eligible for selection after Hb levels return to normal following iron supplementation therapy. Students who are diagnosed with thalassemia with Hb<130 g/L can be determined as ineligible. Such rapid identification can facilitate the medical selection of the above 2 types of students.

Objective:To explore the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with portal vein system resection and reconstruction.Methods:The clinical data of 26 patients with pancreatic head cancer or distal bile duct malignant tumors who underwent reconstructive LPD combined with portal vein resection in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2016 to December 2023 were retrospectively analyzed, including 13 males and 13 females, aged 63.0 (57.2, 66.0) years. The clinical data of the patients, including the operation time, intraoperative blood loss and blood transfusion, blood flow interruption time, postoperative complications, intensive care unit (ICU) admission time, and hospital stay were recorded.Results:All 26 patients had completed the operation successfully. The operation time was (483.65±118.00) min, the intraoperative blood loss was 1 100 (625, 2 750) ml, the intraoperative blood transfusion was 600 (438, 1 050) ml, and the portal vein system blockade time was (35.00±6.00) min. There were 5 cases (19.2%, 5/26) with laparotomy, 5 cases (19.2%%, 5/26) with repair after partial resection of the portal vein system, 12 cases (46.1%, 12/26) with end-to-end anastomosis of the portal venous system, and 9 cases (34.6%, 9/26) with artificial vascular replacement. There was 1 case of grade B pancreatic fistula (3.8%, 1/26), 3 cases of bile leakage (11.5%, 3/26), 1 case of gastric paralysis (3.8%, 1/26), 3 cases of intestinal obstruction (11.5%, 3/26), 2 cases of abdominal infection (7.7%, 2/26), 2 cases of postoperative bleeding (7.7%, 2/26), 1 case of secondary surgery (3.8%, 1/26), and 1 case of perioperative death (3.8%, 1/26). The postoperative hospital stay was 14.00 (12.00, 20.75) d, the ICU length of stay was 3.0 (1.0, 6.5) d, the tumor length diameter was 4.00 (3.00, 5.38) cm, and the number of positive lymph nodes was 1.0(0.5, 3.5).Conclusion:LPD reconstructed with portal system resection is a safe and effective treatment of patients with pancreatic head cancer or distal bile duct malignancy.

Objective:To quickly identify the causes of morphological abnormalities of microcytic hypochromic erythrocytes that are detected during health checkups for recruitment of flying cadets, and to explore its role in medical selection.Methods:Students with hemoglobin (Hb)≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes detected during the 2023 medical selection of flying cadets by Guangzhou Selection Center were selected. Their medical history was collected, and iron metabolism, Hb electrophoresis and hemoglobin H (HbH) inclusion bodies were examined to screen for thalassemia and iron deficiency. The diagnosis of thalassemia was confirmed by thalassemia gene testing. Those with iron deficiency received iron supplementation therapy and the recovery of Hb was observed.Results:Ninety-one students were diagnosed with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, accounting for 4.35% of the total. Among these cases, 85 with abnormal Hb electrophoresis and/or positive HbH inclusion body detection were confirmed as thalassemia minor via thalassemia genetic testing, and 3 cases with normal iron metabolism, Hb electrophoresis, and negative HbH inclusion body detection. A total of 88 cases of thalassemia minor were diagnosed, accounting for 96.70% of the total. Among them, 2 cases were complicated with iron deficiency while 3 were diagnosed with iron deficiency erythropoiesis. Out of the 91 students with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, 9 were recruited, including 7 cases with thalassemia minor (Hb≥130 g/L), 1 case with thalassemia minor combined with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation), and 1 case with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation). Among the 9 recruits, 8 were followed up for over one year and the results of their military physical fitness tests all reached or exceeded the standards, but the remaining one dropped out and lost contact.Conclusions:Among physical examinees during medical selection of flying cadets in South China, thalassemia is the leading cause of morphological abnormalities of microcytic hypochromic erythrocytes. Results of iron metabolism, Hb electrophoresis, and HbH inclusion body detection can help identify thalassemia and iron deficiency quickly. Cases of morphological abnormalities of microcytic hypochromic erythrocytes caused by iron deficiency can be considered eligible for selection after Hb levels return to normal following iron supplementation therapy. Students who are diagnosed with thalassemia with Hb<130 g/L can be determined as ineligible. Such rapid identification can facilitate the medical selection of the above 2 types of students.

Objective:To explore the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with portal vein system resection and reconstruction.Methods:The clinical data of 26 patients with pancreatic head cancer or distal bile duct malignant tumors who underwent reconstructive LPD combined with portal vein resection in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2016 to December 2023 were retrospectively analyzed, including 13 males and 13 females, aged 63.0 (57.2, 66.0) years. The clinical data of the patients, including the operation time, intraoperative blood loss and blood transfusion, blood flow interruption time, postoperative complications, intensive care unit (ICU) admission time, and hospital stay were recorded.Results:All 26 patients had completed the operation successfully. The operation time was (483.65±118.00) min, the intraoperative blood loss was 1 100 (625, 2 750) ml, the intraoperative blood transfusion was 600 (438, 1 050) ml, and the portal vein system blockade time was (35.00±6.00) min. There were 5 cases (19.2%, 5/26) with laparotomy, 5 cases (19.2%%, 5/26) with repair after partial resection of the portal vein system, 12 cases (46.1%, 12/26) with end-to-end anastomosis of the portal venous system, and 9 cases (34.6%, 9/26) with artificial vascular replacement. There was 1 case of grade B pancreatic fistula (3.8%, 1/26), 3 cases of bile leakage (11.5%, 3/26), 1 case of gastric paralysis (3.8%, 1/26), 3 cases of intestinal obstruction (11.5%, 3/26), 2 cases of abdominal infection (7.7%, 2/26), 2 cases of postoperative bleeding (7.7%, 2/26), 1 case of secondary surgery (3.8%, 1/26), and 1 case of perioperative death (3.8%, 1/26). The postoperative hospital stay was 14.00 (12.00, 20.75) d, the ICU length of stay was 3.0 (1.0, 6.5) d, the tumor length diameter was 4.00 (3.00, 5.38) cm, and the number of positive lymph nodes was 1.0(0.5, 3.5).Conclusion:LPD reconstructed with portal system resection is a safe and effective treatment of patients with pancreatic head cancer or distal bile duct malignancy.

Platelet elevation is a rare manifestation in the peripheral blood of patients with chronic myeloid leukemia (CML). In this paper, we report for the first time a case of CML combined with cerebral hemorrhage manifested by abnormally elevated platelets. The patient had elevated platelets in the peripheral blood, showed normal coagulation function, and underwent intracranial hematoma removal due to cerebral hemorrhage. After the operation, bleeding from the operated area and other systems occurred, and the patient was diagnosed as having accelerated CML after combining bone marrow biopsy and genetic testing. His condition was controlled after administration of flumatinib through a jejunal tube. Based on this patient's experience, the feasibility ofadministering flumatinib via a jejunostomy tube was determined, which is the first report of its kind in China and abroad.This article summarizes the diagnosis and treatment process of this patient, with the aim of providing a warning and reference for clinicians.

Objective To retrospectively investigate and analyze the specially permitted aeromedical evaluation results of overage military flying personnel,in order to provide references for health management and related evaluation methods improvement.Methods The clinical data and evaluation results of overage flying personnel were collected from 2012 to 2023.Disease spectrum was analyzed,and qualified rates among different airplane types and aviation duties were compared.Results 79.57%of the 509 flying personnel were detected with diseases,and the top ten were hyperlipidemia,fatty liver,thyroid nodule,renal cyst,hepatic cyst,gallbladder polyps,hyperuricemia,carotid artery arteriosclerosis,hypertension and hepatic hemangioma.96.08%of the personnel were qualified to continue flying,1.96%were disqualified and 1.96%were temporarily disqualified.The qualified rates among different airplane types and aviation duties were not significantly different(P?>?0.05).Conclusion Overage military flying personnel could apply for specially permitted aeromedical evaluation to extend their flying lifespan.Attention should be paid to metabolic and cardiovascular diseases in aeromedical support and evaluation for these experienced flying personnel.

Objective:To provide data support to the anthropometry for medical selection of the Air Force flying cadets by investigating the accuracy of the measurement based on three-dimensional scanning technology.Methods:Using cluster sampling, 987 participants were selected for Air Force medical selection physical examination in 2022. The Air Force recruitment medical selection defined data (body height, sitting height, chest circumference, upper extremity length and lower extremity length) were measured manually and automatically by 3D CaMega which was based on three-dimensional scanning technology. The results of both measurements were compared. The accuracy of auto measurement was calculated against the manual measure result. The body height, sitting height, upper and lower limb lengths were respectively verified by 2 measurements upon selection criteria, and the concordance rate was calculated. The time spent on manual and auto measurements was compared in 107 students who were measured in the first examination day.Results:The body height, sitting height and chest circumference that measured by 3D CaMega were higher than those measured manually ( t=13.07, 14.45, 42.49, all P<0.001), but the lengths of upper and lower limbs were shorter ( t=39.66, 5.23, both P<0.001). In terms of the degree of difference, the variance of chest circumference between the 2 measurement methods was the greatest and followed by sitting height, lower limb length and upper limb length. Body heights showed the smallest difference. Compared with the manual measurement, the accuracy rates of auto measurement of body height, sitting height and upper and lower limb lengths were above 97%. The concordance rate of both measurements was above 98%. The automatic measurement by 3D CaMega took longer time ( t=29.39, P<0.001), compared with the manual measurement. Conclusions:Three-dimensional scanning technology can meet the demands of anthropometry for medical selection of the Air Force flying cadets and shows good application prospect in future.

Objective:To explore the feasibility and conformity of cone contrast test (CCT) and pseudoisochromatic plate test applied in medical selection of pilot.Methods:One hundred and sixteen male students were selected from pilot candidates by stratified sampling method. All students were tested the pseudoisochromatic plate test and the red, green, and blue cone contrast sensitivity and were divided into normal group, color weakness group and color blindness group according to the results of the pseudoisochromatic plate test. The students with a CCT score below 75 were judged as color vision anomalopia. The coincidence rates of the 2 detection results were compared and analyzed.Results:There were 76 students in normal group, 9 students in color weakness group and 31 students in color blindness group. Students with color vision abnormalities were mainly characterized by red-green color blindness and green color weakness, manifested by a significant decrease in CCT scores of red and green ( P=0.012 or <0.001), but there was no significant difference in the blue CCT scores among 3 groups (both P>0.05). The CCT scores of normal students were not less than 75 points, which meant that the compliance rate was 100%. The proportion of students in the color blindness group below 75 points was 29/31 (with a conformity rate of 93.5%), while the proportion in the color weakness group was 2/9. Conclusions:The conclusions of CCT and pseudoisochromatic plate test for identifying color blindness and normal students are basically consistent, but the conformity rate for identifying color weakness assessment by pseudoisochromatic plate test is relatively low. It is suggested that CCT would be the complement for identifying color weakness and marginal color vision abnormalities in the medical selection for pilot.

Objective:To provide data support to the anthropometry for medical selection of the Air Force flying cadets by investigating the accuracy of the measurement based on three-dimensional scanning technology.Methods:Using cluster sampling, 987 participants were selected for Air Force medical selection physical examination in 2022. The Air Force recruitment medical selection defined data (body height, sitting height, chest circumference, upper extremity length and lower extremity length) were measured manually and automatically by 3D CaMega which was based on three-dimensional scanning technology. The results of both measurements were compared. The accuracy of auto measurement was calculated against the manual measure result. The body height, sitting height, upper and lower limb lengths were respectively verified by 2 measurements upon selection criteria, and the concordance rate was calculated. The time spent on manual and auto measurements was compared in 107 students who were measured in the first examination day.Results:The body height, sitting height and chest circumference that measured by 3D CaMega were higher than those measured manually ( t=13.07, 14.45, 42.49, all P<0.001), but the lengths of upper and lower limbs were shorter ( t=39.66, 5.23, both P<0.001). In terms of the degree of difference, the variance of chest circumference between the 2 measurement methods was the greatest and followed by sitting height, lower limb length and upper limb length. Body heights showed the smallest difference. Compared with the manual measurement, the accuracy rates of auto measurement of body height, sitting height and upper and lower limb lengths were above 97%. The concordance rate of both measurements was above 98%. The automatic measurement by 3D CaMega took longer time ( t=29.39, P<0.001), compared with the manual measurement. Conclusions:Three-dimensional scanning technology can meet the demands of anthropometry for medical selection of the Air Force flying cadets and shows good application prospect in future.

Objective:To explore the feasibility and conformity of cone contrast test (CCT) and pseudoisochromatic plate test applied in medical selection of pilot.Methods:One hundred and sixteen male students were selected from pilot candidates by stratified sampling method. All students were tested the pseudoisochromatic plate test and the red, green, and blue cone contrast sensitivity and were divided into normal group, color weakness group and color blindness group according to the results of the pseudoisochromatic plate test. The students with a CCT score below 75 were judged as color vision anomalopia. The coincidence rates of the 2 detection results were compared and analyzed.Results:There were 76 students in normal group, 9 students in color weakness group and 31 students in color blindness group. Students with color vision abnormalities were mainly characterized by red-green color blindness and green color weakness, manifested by a significant decrease in CCT scores of red and green ( P=0.012 or <0.001), but there was no significant difference in the blue CCT scores among 3 groups (both P>0.05). The CCT scores of normal students were not less than 75 points, which meant that the compliance rate was 100%. The proportion of students in the color blindness group below 75 points was 29/31 (with a conformity rate of 93.5%), while the proportion in the color weakness group was 2/9. Conclusions:The conclusions of CCT and pseudoisochromatic plate test for identifying color blindness and normal students are basically consistent, but the conformity rate for identifying color weakness assessment by pseudoisochromatic plate test is relatively low. It is suggested that CCT would be the complement for identifying color weakness and marginal color vision abnormalities in the medical selection for pilot.