Objective:To investigate the diagnosis, treatment and aeromedical assessment of military flying personnel with cerebral cavernous malformations (CCM).Methods:The clinical data and aeromedical assessment conclusions of military flying personnel with CCM in Air Force Medical Center from 2015 to 2021 were collected and analyzed based on reviewing the relevant aeromedical assessment cases and literatures at home and abroad.Results:A total of 10 flying personnel, all male, 20-41 years old, with an average age of 28.3 years, including 8 pilots, 2 air combat/technical personnel, with the flying hours of 110-4 000 h and the average flying hours of 1 102.0 h. The sizes of lesions were 3-12 mm, including 2 cases were smaller than 5 mm, 6 cases were 5-10 mm and 2 cases were bigger than 10 mm. All lesions were located under the cortex, including a case of occipital lobe, 4 cases of frontal lobe, 2 cases of temporal lobe and 3 cases of cerebellar hemisphere. Among the 10 flying personnel, only a case presented intracranial haemorrhage (right cerebellar hemisphere) as first symptom and was treated surgically. Three cases were temporarily grounded due to they were under the grounding observation. Other 7 flying personnel had been followed up for more than 6 months. Their reexaminations of MRI showed no change in lesions and EEG examination showed no abnormalities. Two air combat/technical personnel were qualified for flight and 1 helicopter pilot was limited to be a co-pilot, and 2 dual-seat fighter pilots were qualified (limited to dual-seat fighter) and flight-qualified respectively. Two fighter pilots were qualified for lower performance aircraft (limited to bomber, transporter or helicopter).Conclusions:For CCM military flying personnel, the aeromedical assessment conclusion should be made according to the symptoms, lesion location and size, inflight incapacitation possibility assessment, treatment effect, ground observation and follow-up results, as well as the aircraft type and occupation.

Objective:To investigate the diagnosis, treatment and aeromedical assessment of military flying personnel with cerebral cavernous malformations (CCM).Methods:The clinical data and aeromedical assessment conclusions of military flying personnel with CCM in Air Force Medical Center from 2015 to 2021 were collected and analyzed based on reviewing the relevant aeromedical assessment cases and literatures at home and abroad.Results:A total of 10 flying personnel, all male, 20-41 years old, with an average age of 28.3 years, including 8 pilots, 2 air combat/technical personnel, with the flying hours of 110-4 000 h and the average flying hours of 1 102.0 h. The sizes of lesions were 3-12 mm, including 2 cases were smaller than 5 mm, 6 cases were 5-10 mm and 2 cases were bigger than 10 mm. All lesions were located under the cortex, including a case of occipital lobe, 4 cases of frontal lobe, 2 cases of temporal lobe and 3 cases of cerebellar hemisphere. Among the 10 flying personnel, only a case presented intracranial haemorrhage (right cerebellar hemisphere) as first symptom and was treated surgically. Three cases were temporarily grounded due to they were under the grounding observation. Other 7 flying personnel had been followed up for more than 6 months. Their reexaminations of MRI showed no change in lesions and EEG examination showed no abnormalities. Two air combat/technical personnel were qualified for flight and 1 helicopter pilot was limited to be a co-pilot, and 2 dual-seat fighter pilots were qualified (limited to dual-seat fighter) and flight-qualified respectively. Two fighter pilots were qualified for lower performance aircraft (limited to bomber, transporter or helicopter).Conclusions:For CCM military flying personnel, the aeromedical assessment conclusion should be made according to the symptoms, lesion location and size, inflight incapacitation possibility assessment, treatment effect, ground observation and follow-up results, as well as the aircraft type and occupation.

Objective To investigate the mechanisms of astrocytes modulating neurons in rat supraoptic nucleus induced by hypotonic stimulation and the effect of 6-aminomethyl-3-methyl-4H-1,2,4-benzothiadiazine-1,1dioxide HCl(TAG,a antagonist for taurine) or carbenoxolone(CBX,a gap junction blocker)on the responses of astrocytes and neurons in SON.Methods Adult male Sprague-Dawley rats were divided into four groups: the control group was injected with 5.5ml/kg 0.9% NaCl solution into the caudal vein;the hypotonic group was injected with 5.5 ml/kg hypo-saline(0.83% glucose plus 0.3% NaCl);TAG + hypotonic and CBX + hypotonic groups were injected with TAG(100?mol/L) or CBX(10g/L) into the lateral ventricle respectively,and were injected 2 hours later with hypotonic saline into the caudal vein.With anti-Fos,anti-vasopressin(VP),anti-glycine receptor(GlyR),anti-glial fibrillary acidic protein(GFAP) and anti-connexin43(Cx43) immunofluorescent staining methods,the responses of neurons and astrocytes in SON were studied.Results In control rats,Fos-,VP-,and GlyR-expression in the neurons and GFAP-or Cx43-expression in the astrocytes were lower.In hypotonic rats,GFAP-,Cx43-and GlyR signals were more than those in control rats,while Fos-and VP-signals were less.Compared with those in hypotonic rats in TAG + hypotonic or CBX + hypotonic rats,GFAP-and Cx43-signals in the astrocytes were the same,GlyR-signals in the neurons decreased,and Fos-and VP-signals increased.Conclusion Hypotonic stimulation activates SON astrocytes,which then release taurine through gap junction signaling to the neurons and inhibit the release of VP from the neurons.