为分析眼眶爆裂性骨折患者的视功能鉴定方法，着重探讨循证医学方法识别伪视力的应用价值，本文选择眼眶爆裂性骨折患者36例作为研究对象，探讨眼眶爆裂性骨折患者视功能的鉴定方法，并得出结论：对鉴定眼眶爆裂性骨折伤者，如无可见眼球组织结构损害，则为好视力可能性较大；如视功能与体征不符，应排除伪视力、伪复视、伪视野、伪视觉诱发电位(VEP)，应用循证医学方法有助于鉴定。

In order to discuss visual function identification methods for patients with orbital blowout fracture and emphasize the application value of the identification of pseudo vision with evidence-based medicine, in this paper, 36 patients with orbital blowout fracture were chosen.In the identification of patients with orbital blowout fracture, if there is no visible eyeball structure damage, it is more likely to be good-eyesighted; If visual function is inconsistent with physical signs, pseudo vision,pseudo diplopia, pseudo vision field, and the false visual evoked potential (VEP) should be eliminated, and evidence-based medicine should be helpful in the identification.

目的 探讨飞行员运动性横纹肌溶解症的诊断、治疗及医学鉴定,以提高对本病的认识,指导临床航空医疗工作和飞行员体能训练. 方法 分析1例飞行员运动性横纹肌溶解症的诊断、治疗、医学鉴定情况,结合相关文献,总结飞行员运动性横纹肌溶解症的病因、发病机制、临床特点、防治及医学鉴定. 结果 突然大量运动训练可导致机体能量耗损,自由基产生增加,组织渗透性加强,从而引起炎性因子释放,造成横纹肌溶解.本例飞行员经针对病因治疗,减少横纹肌损伤,恢复血流,防治急性肾功能衰竭等治疗,临床治愈.经康复疗养、地面观察,逐渐恢复体能训练,复查各项指标均正常,结论为飞行合格. 结论 运动性横纹肌溶解症是由于过度运动后所致的横纹肌损伤,对该病要做到预防为主,早发现、早诊断、早治疗,对飞行员改善预后和医学鉴定有着重要的临床意义.

Objective To improve the understanding of exercise-induced rhabdomyolysis by reviewing the diagnosis,treatment and medical evaluation of the disease and to guide aeromedical work and training technology.Methods One case of pilot with exercise-induced rhabdomyolysis was reviewed on clinical data,treatment,and medical evaluation.Combining with the relevant literatures,the etiology,pathogenesis,clinical features,prevention and medical evaluation were discussed.Results Sudden applied high strength exercise resulted in the energy depletion of body,increased the product of free radicals and pressurized the tissue permeability,then caused the release of inflammatory cytokines,and finally,the rhabdomyolysis.Aiming at the cause of the disease,such treatments as reducing skeletal muscle damage,restoring blood flow,preventing and treating acute renal failure,etc.were done and the pilot was eventually cured.He was qualified with normal state on the base of convalesce therapy,follow-up,and graduall

目的：研究法医鉴定结论准确性的影响因素及应对措施。方法：选择2012年7月至2013年7月需要进行法医鉴定的事件218例作为研究对象。根据鉴定需要分成普通鉴定组（143例）与专家鉴定组（75例）。比较两组法医鉴定结论的准确性，Logistic回归分析其独立危险因素。结果：Logistic回归分析结果显示，鉴定时机、医学资料收集、自述伤情真实度以及伤前状况均为法医鉴定结论准确性的独立危险因素。结论：法医鉴定结论准确性影响因素较多，鉴定过程中应予针对性处理，确保结论的准确性和公正性。

Objective:To study the influence factors and countermeasures of the accuracy of foren-sic conclusions .Methods: 218 cases needed forensic identification from July of 2012 to July of 2013 were selected and divided into ordinary-identified group (143 cases) and experts group (75 cases) according to identification requirements .The accuracy of forensic conclusions was com-pared .The independent risk factors were analyzed by Logistic regression .Results:Logistic regres-sion analysis showed that the timing of identification , collection of medical data , validity of re-adme injury and pre-injury status were independent risk factors for the accuracy of the conclusions of forensic identification .Conclusion:There were many factors influencing the accuracy of forensic conclusions .The countermeasures must be executed to ensure the accuracy and fairness of the con-clusions .

目的 通过对患有腰椎间盘突出症的飞行员实施精准微创外科手术及临床随访评估,制定术后飞行适应性评价原则,根据最终的医学鉴定结果对腰椎间盘突出术后飞行适应性进行初步探讨. 方法 确定入选病例的纳入排除标准,选择入组病例,根据病变节段及类型制定个性化手术并予以实施.利用腰椎疼痛视觉模拟量表(visual analogue scale,VAS)评分、下腰痛日本骨科学会(Japan Orthopedic Association,JOA)评分,Oswestry功能障碍指数(Oswestry disability index,ODD评分进行术前评估,及术后6个月、12个月的随访评估.采用SPSS 12.0软件对随访数据资料进行统计学分析. 结果 共有7例飞行员入组,平均年龄33.8岁,平均飞行时间1714 h.其中ODI、JOA、VAS评分术后6个月、术后12个月之间差异无统计学意义(P＞0.05),但二者与术前评分比较差异有统计学意义(P＜0.01).7例患者中,6例术后康复6个月,医学鉴定飞行合格;1例医学鉴定飞行不合格. 结论 对于单节段腰椎间盘突出的飞行员,经过保守治疗无效,利用精准微创外科手术治疗,术后效果满意,康复训练6个月左右可予以飞行合格.医学鉴定应在原有鉴定原则基础上进行补充,同时需要个体化评定.

Objective To find evaluation principles of post-surgery flight adaptability based on precise minimally invasive surgery for the pilots with lumber disk herniation (LDH),and to explore medical appraisement based evaluation method for adaptability after the surgery of LDH upon the follow-up clinical assessments.Methods The surgery was determined and carried out according to the lesions segment and pathological type of LDH.Referring to visual analogue scale (VAS),Japan Orthopedic Association (JOA) score and Oswestry disability index (ODI) assessments,the preoperative score and postoperative follow-up score (including 6 months and 1 year postoperative follow-up) were calculated and analyzed.SPSS 12.0 was used in the analysis of the data from the follow-up clinical assessments.Results Totally 7 male pilots with LDH were brought into.Their average age was 33.8 yrs and average flying hours were 1714 h.JOA,ODI and VAS assessments showed insignificant difference between the postoperative scores

通过对病残儿医学鉴定结果的分析,了解导致病残儿的疾病种类、病因,以预防和减少病残儿的发生。方法:对2008~2012年经黄山市专家委员会鉴定符合病残儿医学鉴定标准的311例病残儿资料进行整理分析。结果:311例病残儿中,遗传性疾病99例,以多基因遗传病、常染色体隐性遗传病、常染色体显性遗传病发病率较高。非遗传性疾病212例,位列前5位的非遗传性疾病为:精神发育迟滞、脑组织损伤(脑性瘫痪、大脑发育不全、不良、脑萎缩、脑积水)、癫痫、先天性心脏病、恶性肿瘤(含颅内肿瘤)。结论:为提高人口素质,预防和减少病残儿的发生,必须普及优生优育知识,建立健全出生缺陷干预机制。

Objective:Understand the types and causes of diseases of handicapped children by analyzing medical evaluation result. Methods:Organize and analyze the materials of 311 cases handicapped children identified by the expert committee of Huangshan City in the year 2008~2012. Results: 311 cases of handicapped children were identified to meet the handicapped children, of which 99 cases were hereditary diseases. Polygenic disease, autosomal recessive genetic disease and autosomal dominant genetic disease have higher incidence rate. And 212 cases were non-hereditary diseases, among them the top five diseases were:mental retardation, brain damage (cerebral palsy, cerebral hypoplasia, poor, cerebral atrophy, hydrocephalus), epilepsy, congenital heart disease, malignancy (Including intracranial tumors). Conclusion: In order to improve the population quality, prevent and reduce the incidence of handicapped children, we must popularize knowledge of prenatal and postnatal care, establish and improve