In the process of accelerating the construction of a strong country in health and sports in China， the mode of promoting health has shifted from passive health to active health. Guided by the concept of “active health”， there is a new understanding of the relationship between sports， health， and medical care. The integration of sports and medicine is a concrete manifestation and implementation of the concept of “active health”， and an important measure to implement the Healthy China strategy， which is regarded as an important strategy to promote public health reform. This article reviews the historical path of the integration of sports and medicine from its concept to practical implementation， and finds that China proposed the integration of sports and medicine relatively late， but it has become an intense focus of academic research； The sports and medical departments have launched guidelines for chronic disease exercise and standards related to exercise prescriptions， and local governments in China have explored diversified models of integrating sports and medicine； Under the institutional requirements of top-level design， the exploration of the “integration of sports and medicine” model is flourishing. There are currently problems in promoting the integration of sports and medicine， such as the lack of a “sports and medicine integration” system and a shortage of “sports and medicine integration” talents. Drawing on the international experience of integrating sports and medical services in other countries，We propose a development strategy of “concept first， government leading， and sports and medical cooperation”； We recommend institutional optimization such as improving medical insurance related systems， establishing certification， employment， and management systems for integrated sports and medical talents， and improving the training system for integrated sports and medical talents in universities； We also advocate propose a “dual wheel” promotion path of upgrading hospital rehabilitation centers and expanding community health centers， in order to provide reference for policy formulation and promote the integration of sports and medicine to play a greater role in China’s public health.

OBJECTIVE To compare the emergency specialist clinical pharmacist training programs between China and the United States， providing valuable insight for the development of specialized clinical pharmacist training in emergency departments within China. METHODS By reviewing the official website of the American Society of Health-System Pharmacists （ASHP）， the websites of some training institutions offering PGY2 emergency medicine （EM） residency programs in the United States， the official website of China’s National Health Commission， and the website of the Pharmaceutical Affairs Committee of the Chinese Hospital Association， relevant materials and data on the training of emergency medicine clinical pharmacists were collected. Microsoft Excel and NVivo software were utilized to analyze the implementation status of these training programs. Literature searches were conducted via Chinese （CNKI） and English （PubMed） databases， followed by screening， categorization， and thematic analysis aligned with research objectives. RESULTS As of now， there are 115 accredited PGY2 EM residency programs in the United States， which provide 120 specialized pharmacist training positions. These programs are distributed across 35 states and are hosted by a variety of institutions， including hospitals， medical centers， and universities. The predominant training model follows a hospital+acute care framework. Eligibility requirements for PGY2 EM residency programs include possession of a doctor of pharmacy （Pharm.D.） degree， pharmacist licensure， and completion of a PGY1 residency. The training standards are structured into three tiers： competency areas， competency goals， and learning objectives. The curriculum typically includes core rotations， elective rotations， and longitudinal training components. Assessment is conducted through a combination of formative and summative evaluations， with results categorized into four proficiency levels. In China， there is only one training base currently for emergency clinical pharmacist specialty training with an annual enrollment of three trainees. Applicant eligibility primarily involves requirements regarding academic degree， professional background， years of experience， and professional title. The training content covers four domains： general competency， clinical theoretical knowledge and skills， pharmacological knowledge and application， and clinical medication practice skills. The training process centers on rotations within emergency departments. Assessment methods include theoretical examinations， daily performance evaluations， and final completion assessments. CONCLUSIONS PGY2 EM residency programs in the United States emphasize inclusivity and professionalism in their implementation. Program admission involves a rigorous selection process， and they offer attractive incentive structures for trainees. The training content focuses on competency-based approaches and pragmatic applicability， while assessment methods are closely aligned with defined competence objectives. In contrast， specialist clinical pharmacist training in emergency medicine in China is currently in the exploratory and nascent stages. Admission criteria tend to be less stringent， and incentives for trainees are often insufficient. The training content appears relatively stereotyped and superficial， with assessment methods still primarily reliant on quantifiable metrics. In expanding and popularizing China’s emergency specialist clinical pharmacist training programs， it is essential to draw on advanced experiences from developed countries like the United States， particularly in areas such as training base distribution， application requirements， training content， and assessment methods. Aligned with the realities of emergency clinical practice in China， efforts should focus on enhancing program accessibility and training efficacy.

Objective To investigate the value of serum tumor markers in the diagnosis of lung cancer.Methods A total of 138 patients with newly diagnosed lung cancer patient(lung cancer group)and 52 patients with benign lung diseases(control group)in Anhui NO.2 Provincial People's Hospital from June 2020 to March 2024 were selected as the research objects.The clinical data and serum tumor markers[neuron-specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA),Pro-gastrin-relea-sing peptide(ProGRP)and squamous cell carcinoma antigen(SCC)]of all groups were compared.Results There were significant differences in age and smoking history between the two groups(P＜0.05).The serum levels of NSE,CYFRA21-1,CEA,ProGRP and SCC in lung cancer group were significantly higher than those in control group,and the differences were statistically significant(P＜0.05).The results of binary Logistic regression analysis showed that smoking history,age,CYFRA21-1 and CEA levels were all influen-cing factors for the occurrence of lung cancer(P＜0.05).Receiver operating characteristic(ROC)curve analy-sis results showed that the area under the curve(AUC)of smoking history,age,CEA and CYFRA21-1 in the combined diagnosis of lung cancer was 0.906(95％CI:0.865-0.947),which was higher than the AUC for the individual diagnosis of each index.The levels of serum CYFR21-1 and CEA in the stage Ⅰ—Ⅱ group were significantly lower than those in the stage Ⅲ-Ⅳ group,and the difference was statistically significant(P＜0.05).The results of binary Logistic regression analysis showed that CYFRA21-1 and CEA levels were influ-ential factors in the occurrence of lung cancer stage Ⅲ-Ⅳ(P＜0.05).ROC curve analysis showed that the AUC of CEA and CYFRA21-1 for the diagnosis of lung cancer stage Ⅲ-Ⅳ were 0.750(95％CI:0.667-0.832)and 0.771(95％CI:0.691-0.852),respectively.The AUC of combined diagnosis was 0.834(95％CI:0.765-0.902),the sensitivity was 58.9％,and the specificity was 95.3％.Conclusion Smoking history,age,CEA,and CYFRA21-1 may be potential biomarkers for the diagnosis and prognosis of lung cancer,espe-cially CEA and CYFRA21-1,which are also of great significance for the staging of lung cancer from stage Ⅲ to stage Ⅳ.

Objective To analyze the effects of erector spinae plane block(ESPB)on postoperative analgesic consumption,visual analog scale(VAS)pain scores,and postoperative nausea and vomiting(PONV)in breast cancer patients,and to evaluate its advantages and disadvantages compared to general anesthesia(GA),thoracic paravertebral block(TPVB),and pectoral nerve block(PECS),providing a systematic review of its clinical application.Methods We searched English databases including PubMed,Embase,Scopus,Cochrane Library,and Web of Science,as well as Chinese databases such as CNKI,Wanfang,and Weipu,including randomized controlled trials.The Cochrane bias risk assessment tool was used for bias risk evaluation,and RevMan 3.5 software was utilized for meta-analysis.Results A total of 31 randomized controlled trials involving 2296 patients were included.The meta-analysis results indicated that the morphine consumption in the ESPB group was lower than that in the GA group at 24 hours postoperative(MD-17.57,95％CI-23.99 to-11.14,P＜0.05).VAS scores at 2,6,12,and 24 hours postoperative were also lower in the ESPB group compared to the GA group(P＜0.05),and the incidence of PONV in patients was reduced(RR 0.57,95％CI 0.47 to 0.69,P＜0.05),with all differences being statistically significant.No statistically significant differences were found in morphine consumption at 24 hours postoperative between the ESPB and TPVB groups,nor in VAS scores at 2,12,and 24 hours postoperative,and the number of PONV cases showed no statistically significant difference.The morphine consumption in the PECS group at 24 hours postoperative was lower than that in the ESPB group(MD 10.94,95％CI 4.40 to 17.48,P＜0.05),and the VAS score at 12 hours postoperative in the PECS group was lower than that in the ESPB group(MD 0.59,95％CI 0.19 to 0.99,P＜0.05),indicating statistical significance,while no significant differences were observed at other time points.Conclusions The analgesic effect of the ESPB group is superior to that of the GA group and similar to that of the TPVB group,but inferior to that of the PECS group.Compared to the GA group,ESPB significantly reduces the incidence of postoperative PONV,showing similarity with the TPVB and PECS groups.

Objective:To investigate the effect of irisin on inflammatory response in brain tissue of neonatal rats with hy-perbilirubinemia. Method:Sixty-six neonatal SD rats were randomly divided into the normal control group(group A)and the model group(group M).Hyperbilirubinemia models were established by intraperitoneal injection of bilirubin so-lution at the age of 7 days and 10 days.After the last injection,6 rats were randomly selected from group A and M to verify the success of the model establishment,and then group M was randomly divided into group B and group C.Rats in group C were injected with 80 μg/kg irisin solution in lateral ventricles,and the oth-er groups were injected with the same amount of PBS.After the injection into lateral ventricle,groups A,B and C were further divided into three subgroups according to different points of death.Neurobehavioral tests were performed at each time point.Morphology of cortical or hippocampal nerve cells was detected by HE staining,and the concentrations of TNF-α,IL-1β and IL-6 were detected by ELISA. Result:At 12h,there was no significant difference in the time of plane righting reflex among the three groups(P＞0.05);At 24h,the rats in group B and C were longer than those in group A(P＞0.05);At 48h,group B was longer than group A and C(P＜0.05),and there was no significant difference between group A and C(P＞0.05).There was no significant difference in tropism test among the three groups at each time point(P＞0.05).Under the HE staining,the cortex neuron structure in group A were clear and complete but the number of hippocampal neurons was reduce;in group B and C,the number of neurons in cortex and hip-pocampus was decreased,the structure was disordered,and different degrees of pathological damage were ob-served.Group C was better than group B.Under the ELISA,the concentrations of TNF-α,IL-1β and IL-6 in group B were higher than those in group A at each time point(P＞0.05);the concentrations of TNF-α,IL1βand IL-6 in group C were significantly lower than those in group B at each time point(P＞0.05);the concen-tration of TNF-α in the brain tissue of group C was higher than that of group A at 12h(P＞0.05),and at 24h and 48h were lower than those in group A(P＞0.05);the concentration of IL-6 in the brain tissue of group C was lower than that of group A at 12h and 24h(P＞0.05);at 48h,there was no significant difference in the concentration of IL-6 between group C and group A(P＞0.05);the concentration of IL-1β in the brain tissue of group C was not significantly different from that of group A at the three time points(P＞0.05). Conclusion:Irisin can effectively reduce the release of TNF-α,IL-1β and IL-6 in the brain tissue of neonatal rats with hyperbilirubinemia,and play an anti-inflammatory role.

Objective:To investigate the value of the ratio of heparin binding protein (HBP) to albumin (ALB) in diagnosis and predict the severity of Kawasaki disease shock syndrome (KDSS).Methods:This study was a retrospective study. Pediatric patients with Kawasaki disease (KD) admitted to the Children's Intensive Care Unit and department of Pediatric Emergency Center of Hunan Children's Hospital from January 2019 to May 2022 were enrolled. The HBP/ALB ratio was calculated according to HBP and serum ALB. The children were divided into three groups (low, medium, and high ratio groups) according to the median and upper and lower quartiles of the HBP/ALB ratio. The differences of each index among the three groups were compared. The receiver operating characteristic curves were drawn to evaluate the clinical value of the HBP/ALB ratio in diagnosis of KDSS and the severity of the disease.Results:A total of 111 cases were included in this study, including 28 cases in the low ratio group, 56 cases in the medium ratio group, and 27 cases in the high ratio group. There were 24 cases with coronary artery damage, 87 cases without coronary artery damage, 27 cases with abnormal ECG findings, and 17 children with KDSS (including 5 cases in the medium ratio group, and 12 cases in the high ratio group). The incidence of KDSS, coronary involvement, and abnormal electrocardiogram proportions in the high ratio group were significantly higher than those in the other two groups. Compared with low and medium ratio groups, the levels of cardiac troponin I, N-terminal pro-brain natriuretic peptide, lactate, stroke output variation, trends in thoracic fluid content, white blood cell count, C-reactive protein, procalcitonin, and D-dimer levels were higher in the high ratio group, while ALB and blood sodium levels were lower in the high ratio group (all P<0.05). There was no significant difference in above indicators between the low and medium ratio groups (all P>0.05). The HBP/ALB ratio had a higher area under the curve, sensitivity, and specificity (0.942, 0.882, and 0.883, respectively) in predicting KDSS compared to HBP alone (0.776, 0.842, and 0.670, respectively). Conclusion:The HBP/ALB ratio could reflect the severity of children with KD and has certain clinical value for prognostic evaluation.

Objective:To explore the clinical characteristics of children with septic shock and analyze the drug resistance of blood culture positive bacteria.Methods:The clinical data,positive blood culture strains and drug sensitivity results of 127 children with septic shock admitted to the Department of Intensive Care Medicine of Hunan Children's Hospital from September 2015 to August 2021 were retrospectively analyzed.Results:A total of 134 strains of bacteria or fungi were isolated from the blood culture samples of 127 children with septic shock,and gram-negative strains were the main ones,accounting for 67.16% (90/134).Haemophilus influenzae and Escherichia coli were the main gram-negative bacteria,accounting for 38.81% (52/134) and 20.15% (27/134)，respectively,while Streptococcus pneumoniae was the main gram-positive bacteria,accounting for 8.21% (11/134),and Candida albicans was the main fungus,accounting for 10.45% (14/134).The number of white blood cells,the levels of serum C-reactive protein,procalcitonin,venous blood sugar and arterial blood lactic acid in patients were all significantly higher than normal values,and the white blood cells count and neutrophil percentage in gram-positive bacterial infections were significantly higher than those with gram-negative bacterial infections and fungal infections( P<0.05).Procalcitonin increased most obviously when infected by gram-negative bacteria,and the difference was statistically significant ( P<0.05).Gram-positive strains were sensitive to vancomycin,teicoplanin,and linezolid,but only 50% of Streptococcus pneumoniae were sensitive to penicillin.Gram-negative strains had relatively high drug resistance,among which Klebsiella pneumoniae were only highly resistant to imipenem,cilastatin and levofloxacin,reaching 50%.Haemophilus influenzae was resistant to cephalosporins and β-amides enzyme antibiotic,and the drug sensitivity rate of lactamase antibiotics was high,with a resistance rate of 50% only to ampicillin,cefuroxime,amikacin,and compound sulfamethoxazole.There were not many fungal strains,and most antifungal drugs were effective against blood culture-positive fungi. Conclusion:The main pathogens of infection in children with septic shock are gram-negative bacteria,and have high resistance to general antibiotics.We should pay attention to their drug resistance when using antibiotics empirically.