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 evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Humans ; Non-alcoholic Fatty Liver Disease ; Prospective Studies ; Risk Factors ; Exercise ; Liver

Osimertinib, the third generation of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), has demonstrated notable clinical benefit in the targeted therapy for patients with non-small cell lung cancer (NSCLC). However, the development of drug resistance is an inevitable challenge. In order to tackle this issue, ongoing efforts are being made to develop new generations of targeted drugs and treatment strategies, some of which are already undergoing clinical trials. This article aims to review the current research on the mechanisms of osimertinib resistance and outline the advancements made in post-drug resistance treatment strategies.

Objective:To explore the application of nested PCR in the detection of occult hepatitis B virus infection (OBI) in blood donors, and improve the detection rate of OBI in blood screening before blood transfusion.Methods:From July 2021 to August 2022, 37 blood donors who donated blood in our center were found to have HBsAg- and nucleic acid testing (NAT)+ by serological tests and nucleic acid amplification tests. The CT value of nucleic acid amplification test was recorded, and the HBV DNA was quantitatively detected by fluorescent quantitative PCR; Conventional PCR primers and nested PCR primers were designed to amplify HBV S gene and pre-S gene using conventional PCR and nested PCR respectively, and gene sequencing was performed for the amplification result.Results:Among the 37 HBsAg- and NAT+ blood donors, 33 nucleic acid detection CT values were in the gray area, and the fluorescent quantitative PCR detection of HBV DNA value was negatively correlated with the nucleic acid detection CT value; 37 cases of HBsAg-, NAT+ blood donors could not be amplified by conventional PCR. After using nested PCR, 34 cases could detect the S gene of HBV virus, and 28 cases could detect the pre S gene of HBV virus; The amplified bands were all HBV genome bands by gene sequencing.Conclusions:The plasma HBV viral load of HBsAg- and NAT+ blood donors was very low; nested PCR has high sensitivity, which can improve the detection rate of HBV S gene and pre-S gene, and has certain application value for the pre transfusion screening and follow-up research of OBI.

Objective:To study clinical characteristics and pregnancy outcomes under anti-coagulation therapy of non-criteria obstetric antiphospholipid syndrome.Methods:Patients suspected of obstetric antiphospholipid syndrome(OAPS) were recruited through Chinese Rheumatism Data Center from 2015 to 2019 consecutively. Patients fulfilling 2006 Sydney revised antiphospholipid syndrome criteria were classified as OAPS. Patients fulfilling definition of non-criteria OAPS(NCOAPS) by expert consensus on diagnosis and management of obstetric antiphospholipid syndrome of China were classified as NCOAPS. Clinical characteristics and laboratory results of two groups were compared. Live birth rates and pregnancy outcomes under anti-coagulation therapy were studied.Results:A total of 88 patients were enrolled, including 56 patients (63.6%) as OAPS, 32(36.4%) as NCOAPS. Live births were only reached in 16.1% (9/56) in OAPS patients and 12.5%(4/32) in NCOAPS. Fetal losses after 10 weeks of gestation and pre-eclampsia before 34 weeks were more common in OAPS group compared to NCOAPS group [78.6%(44/56) vs. 18.8%(6/32), P<0.001; 25.0%(14/56) vs. 3.1%(1/32), P=0.020, respectively]. After enrollment, 15 pregnancies were recorded in OAPS, 10 in NCOAPS, all of whom were treated with low-dose aspirin (LDA) combined with low-molecular weight heparin (LMWH). Live birth rates saw dramatic improvements compared to baseline levels in OAPS [16.1% (9/56) vs. 11/15] along with NCOAPS [12.5% (4/32) vs. 7/10]. Conclusion:Though NCOAPS and OAPS patients differ in antiphospholipid antibody spectrum and pattern of pregnancy morbidities, both groups benefit from LDA combined with LWMH treatment, as live birth rates improve. Non-criteria OAPS patients are recommended to receive anti-coagulation therapy during pregnancy.

Objective:To analyze the value of shear wave velocity (SWV) combined with thyroid stimulating hormone (TSH) in the diagnosis of hyperthyroidism.Methods:Thirty-five patients with hyperthyroidism who were treated and confirmed in the Fuyang Affiliated Hospital of Anhui Medical University from December 2017 to September 2019 were selected as hyperthyroidism group, and 30 cases of normal health check-up patients in the outpatient department were selected as control group. All of the patients and medical persons were checked by conventional two-dimensional ultrasound and SWV, and the SWV and serum TSH, thyrotrophin receptor antibody(TRAb), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) expression levels of two groups were tested and compared. The correlation relationship in SWV value and serum TSH, TRAb, TGAb, TPOAb levels of hyperthyroidism patients was analyzed by Pearson methods. The receiver operating characteristic curve (ROC curve) method was used to analyze the value of SWV, serum TSH and SWV combined with serum in diagnosis of hyperthyroidism.Results:The SWV values of upper pole, middle pole and lower pole in the hyperthyroidism group had no significant differences ( P>0.05). The SWV values of upper hole, middle pole and lower pole of the left and right lobe of thyroid in the hyperthyroidism group were significantly higher than those in the control group [left lobe: (2.41 ± 0.34) m/s vs. (2.07 ± 0.28) m/s, (2.44 ± 0.39) m/s vs. (2.08 ± 0.25) m/s, (2.46 ± 0.43) m/s vs. (2.04 ± 0.30) m/s; right lobe: (2.47 ± 0.42) m/s vs.(2.01 ± 0.25) m/s, (2.41 ± 0.40) m/s vs. (1.95 ± 0.23) m/s, (2.43 ± 0.35) m/s vs. (2.06 ± 0.24) m/s] ( P<0.01). The serum TSH level in the hyperthyroidism group were significantly lower than that in the control group [(0.05 ± 0.03) kU/L vs. (2.74 ± 1.17) kU/L], while serum TRAb, TGAb and TPOAb levels were significantly higher than those in the control group [(15.82 ± 5.54) U/L vs. (0.55 ± 0.13) U/L, (290.63 ± 145.03) kU/L vs. (25.63 ± 7.12) kU/L, (627.17 ± 250.33) kU/L vs. (34.32 ± 5.95) kU/L], and the differences were statistically significant ( P<0.01). In the hyperthyroidism group, the SWV was negatively correlated with serum TSH ( r=- 0.862, P<0.05), but positively correlated with serum TRAb, TGAb and TPOAb ( r=0.763, 0.837, 0.804, P<0.05). The area under curve(AUC), sensitivity and specificity of combined diagnosis of hyperthyroidism with SWV value and serum TSH were 0.936, 94.29% and 91.43%, which was better than that of SWV (0.803, 80.00%, 74.29%) and serum TSH (0.842, 82.86%, 77.14%). Conclusions:SWV combined with TSH has a high clinical value in the diagnosis of hyperthyroidism.

Objective: To compare the indirect immunofluorescence staining effect of urinary podocytes by thinprep liquid-based cytologic test (TCT) with that by the conventional centrifugal smear method, and explore its clinical application value. Methods: The morning urine samples from 50 patients with type 2 diabetic nephropathy and 14 healthy controls were smeared with the TCT and conventional centrifugation method, respectively, and then the indirect immunofluorescence staining were performed to observe the morphology of podocytes. Results: For 64 urine samples, the satisfactory rate of TCT smears (85.94%) was significantly higher than that of conventional smears (50.00%), and the podocyte detection rate of TCT smears (73.47%) was also significantly higher than that of conventional smears (51.02%) (P＜0.05). When urinary podocytes of the same patient were positive by both methods, the reading effect of TCT smears was obviously superior to that of conventional smears. Conclusion The TCT combined with indirect immunofluorescence staining is obviously superior to the conventional centrifugal smear method in the podocyte diagnosis of urine samples.

Objective To evaluate the clinical characterisitics of polyarteritis nodosa (PAN) patients with acromelic gangrene,and to improve the understanding of this disease by clinicians.Methods The clinical and laboratory data of PAN patients with acromelic gangrene admitted to Peking Union Medical College Hospital (PUMCH) between November 1986 to October 2016 were collected and summarized.According to the ratio of 1∶2,PAN patients without acromelic gangrene during the same period were randomly selected and compared with patients with acromelic gangrene.The comparison of the demographic data,system involvement,laboratory and other auxiliary examination results,the treatment were included in this study.All data were analyzed by SPSS 19.0 statistical software.T test,Mann Whitney U test,x2 test were used for statistical analyses.Results Among 204 PAN patients admitted to PUMCH during this period,22 cases were complicated with gangrenes.In PAN patients with gangrenes,-male/female ratio was 4.5/1,the mean age was (43±19) years,and the disease duration (from onset of disease to gangrene) was 3.5 months (ranged from 1 week to 20 years).Simple finger gangrenes occurred in 7 cases(32％),simple toe gangrenes in 8 cases (36％),both gangrenes in 7 cases (32％).In the involvements of limb arteries,15 cases (68％) were posterior tibial artery involvement,12 cases (55％) were anterior tibial artery involvement,10 cases (45％) were radial artery involvement,7 cases (32％) were ulnar artery involvement,5 cases (23％) were peroneal artery involvement,5 cases (23％) were superficial femoral artery involvement,4 cases (18％) were dorsal foot artery involvement,3 cases (14％) were popliteal artery involvement,1 case (5％) was anterior interosseous artery involvement.There were significant difference in PAN patients with and without acromelic gangrene as patients with acromelic gangrene were more prone to arthritis/pain (45％ vs 2％;x2=16.71,P＜0.01),new-onset hypertension (41％ vs 7％;x2=9.28,P＜0.01),intestinal bleeding/perforation (41％ vs 14％;x2=6.21,P=0.01),increased eosinophils (55％ vs 7％;x2=19.02,P＜0.01),artery (91％ vs 27％;x2=23.78,P＜0.01) involvement in extremities,head and neck (41％ vs 18％;x2=3.96,P=0.05),arteriovenous thrombosis (27％ vs 2％;x2=7.21,P=0.007),glucocorticoid pulse therapy (73％ vs 14％;x2=23.05,P＜0.01).Conclusion PAN patients with acromelic gangrene have significant increase of eosinophils and widespread internal organ ischemia.Aggressive treatment should be taken in these patients.

Objective The aim of this study was to evaluate the long-term efficacy and safety of tocilizumab (TCZ) in Chinese patients with Takayasu's arteritis (TA).Methods We retrospectively studied the active TA patients treated with TCZ from January 2014 to April 2016 in our hospital.The demographic and clinical data,laboratory tests and vascular images were collected.Doppler ultrasonography was used to track vascular changes during TCZ treatment.The data were analyzed by t test and rank sum test.The data were analyzed by Fisher exact test or Chi square test.Results Eighteen patients with a median age of 25.5 (range 18,47) were analyzed.Seventeen patients had taken a median of 3 (range 1,5) immune suppressants before TCZ therapy.Three patients withdrew TCZ after receiving 1 infusion each due to unbearable neck pain.The other 15 patients were treated with TCZ for a median of 13 (range 6,26) months.After TCZ treatment,the median ESR level,hsCRP level,mural thickness of common carotid artery and subclavical artery decreased from 45.5 (range 7-101) mm/1 h (Z=6.731,P＜0.01),37.40 (range 7.6-163.12) mg/L,0.25 (range 0.06-0.59) cm,0.18 (range 0.07-0.47) cm to 7 (range 1-44) mm/l h (Z=6.731,P＜0.01),0.94 (range 0.08-93.21) mg/L (Z=3.212,P=0.016),0.18 (range 0.04-0.53) cm (Z=4.873,P=0.001),and 0.12 (range 0.07-0.18) cm (Z=5.568,P＜ 0.01) respectively,with median glucocorticoid dosage being successfully tapered.One patient discontinued TCZ for unsatisfactory response after 6 TCZ infusions.One episode of urinary infection was recorded and relieved after antibiotic therapy.Neither neutropenia nor abnormal liver enzyme was observed.Conclusion Our study suggests that tocilizumab is a safe and effective agent for long term use among Chinese TA patients,especially for those refractory cases.