Implementation science (IS) aims to systematically analyze and address the real-world gaps from evidence to practice and the influencing factors of the context. It is necessary to carry out qualitative research to gather relevant implementation outcomes. Nevertheless, traditional qualitative analysis has issues such as consuming a great deal of time and energy, and it is unable to promptly provide the crucial data required for implementation science research. The Rapid Qualitative Analysis (RQA) method, through semi-structured interviews and the adoption of techniques such as immediate data condensation and matrix analysis, can effectively shorten the cycle of qualitative data collection and data processing. RQA can promptly identify social determinants of health such as structural barriers, facilitators, and the behavioral characteristics of target groups. It provides a real-time basis for public health decision-making, the interpretation of complex social phenomena, and the process and effectiveness evaluation of research projects. Although RQA is difficult to conduct in-depth theoretical analysis based on grounded theory, its efficiency and flexibility make it the preferred tool for large-scale and time-sensitive research. Thus, it has been widely applied in implementation science research. This paper sorts out the core concepts and commonly used technical methods of RQA, as well as the differences between RQA and traditional qualitative analysis. It also explores the applications of RQA in intervention optimization, process evaluation, and implementation outcome evaluation. By integrating specific cases, this paper clarifies its application value in the field of implementation science. In the future, it is advisable to explore the integration of RQA with technologies such as artificial intelligence and big data, in order to bridge the gap between the transformation of scientific research achievements into practice. Under circumstances of limited resources or tight time constraints, RQA can be used to efficiently conduct implementation science research, providing convenient and scientific methodological and technical support for accelerating evidence-based practice.

Objective:To explore the the application and outcomes of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery.Methods:We conducted a retrospective analysis of 296 patients(including 3 cases of pseudohermaphroditism and 293 transgender women)who underwent this procedure at the Voice Center of Nanjing Tongren Hospital of Otolaryngology-Head and Neck Surgery between November 2014 and August 2023. The patients, aged 18-50 years (mean age of 28.3±14.5) underwent feminizing laryngoplasty via transoral microsurgery, involving resection of the superficial lamina propria of the anterior vocal cords and subglottic tissues of the anterior commissure, followed by vocal ligament plication to achieve vocal cords shortening and anterior commissure retrodisplacement. Patients adhered to a1-month voice rest postoperatively and subsequently underwent speech rehabilitation training. Subjective/objective voice analyses, aerodynamic evaluations, and stroboscopic examinations were performed at 3, 6, and 12 months postoperatively to assess the effectiveness of voice feminization.Results:All surgeries were performed successfully and 94.3% (279/296) of the patients reported satisfaction at the end of the one-year follow-up. For effective cases, fundamental frequency (F 0) increased by 57.42±16.72 Hz compared to baseline. Postoperative acoustic/aerodynamic parameters and stroboscopic findings of vocal cord mucosal wave motion remained within normal ranges. These results indicated that this voice feminization surgery combined with postoperative pronunciation training achieved natural and feminine vocal characteristics. Conclusion:The combination of vocal cord shortening and anterior commissure retrodisplacement, along with postoperative pronunciation training, represents an effective surgical strategy for achieving a natural feminine voice.

Objective:To investigate the application value of D-dimer (D-D) as the primary indicator, combined with NT-proBNP and neutrophil percentage in the differential diagnosis of acute aortic dissection (AAD), pulmonary embolism (PE), and acute myocardial infarction (AMI).Methods:A retrospective case-control study was conducted, including 764 patients with acute chest pain who presented to the Emergency Department of Beijing Fuwai Hospital from March 1st, 2024, to February 28th, 2025. Patients were clinically diagnosed with AAD (299 cases) and other acute chest pain conditions (AMI 425 cases, PE 40 cases). The AAD group had the age of 56.00 (45.00, 64.00) years old with 226 males (75.59%); the AMI group had a median the age of 65.00 (55.00, 70.00) years with 339 males (79.76%); and the PE group had the age of 70.00 (59.75, 74.00) years with 15 males (37.50%). Baseline clinical data were collected and compared among the three groups, including general parameters such as heart rate, systolic blood pressure, and diastolic blood pressure. Laboratory parameters included N-terminal pro-brain natriuretic peptide (NT-proBNP), prothrombin time (PT), activated partial thromboplastin time (APTT), D-D, cardiac troponin I (cTnI), myoglobin, creatine kinase-MB (CK-MB), white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, and mean platelet volume (MPV). Comparisons between groups were performed using the Kruskal-Wallis rank-sum test and χ2 test. Independent discriminatory factors were identified through multivariate logistic regression analysis, and the diagnostic performance of individual indicators and combined models were analyzed using receiver operating characteristic (ROC) curves.Results:The D-D level in the AAD group [3.93 (1.48, 19.59) μg/ml] was significantly higher than that in the AMI group [0.26 (0.14, 0.56) μg/ml] and PE group [2.13 (0.84, 6.13) μg/ml] ( F=200.12, P<0.001). Multivariate analysis showed that D-D, NT-proBNP, neutrophil percentage, and lymphocyte percentage were all independent factors for differentiating AAD from AMI. NT-proBNP, total white blood cell count, neutrophil percentage, and lymphocyte percentage were independent predictors for differentiating AAD from PE. ROC analysis showed that D-D had an area under the curve (AUC) of 0.93 (95% CI 0.91-0.95) for differentiating AAD from AMI, with a sensitivity of 81.6% and specificity of 92.9%. In the differential diagnosis between AAD and PE, the model combining D-dimer, NT-proBNP, and neutrophil percentage had an AUC of 0.86 (95% CI 0.80-0.91), with a sensitivity of 85.0% and a specificity of 72.5%. Conclusion:D-D has significant value in the differential diagnosis of AAD from AMI and PE, with particularly good individual diagnostic performance for differentiating AAD from AMI. Combining NT-proBNP and neutrophil percentage can significantly improve differential diagnostic performance.

AIM:This study investigates the antidepressant mechanism of Jieyu-Anshen formula combined with selenium in chronic unpredictable mild stress(CUMS)mice through network pharmacology and animal experiments.METHODS:Potential drug targets were identified using the TCMSP,Genecards,and STRING databases.A protein-pro-tein interaction network was then constructed,followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Ge-nomes(KEGG)enrichment analyses and molecular docking validation.Sixty male KM mice were divided into six groups:control,model,selenium,Jieyu Anshen formula,selenium+Jieyu Anshen formula,and fluoxetine.Depression-like behav-iors were assessed using the tail suspension test,forced swimming test,and elevated plus-maze test.Enzyme-linked immu-nosorbent assay(ELISA)was used to measure hippocampal levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,5-hydroxytryptamine(5-HT),and dopamine(DA).Histopathological changes in the hippocampus were ex-amined using hematoxylin and eosin(HE)staining.Additionally,protein expression levels of nuclear factor-κB p65(NF-κB p65),phospho-NF-κB-p65(p-NF-κB p65),prostaglandin-endoperoxide synthase 2(PTGS2),glutathione peroxidase 4(GPX4),and selenoprotein S(SelS)were detected through immunohistochemistry and Western blot.RESULTS:Jieyu-Anshen formula combined with selenium significantly improved depression-like behaviors in CUMS mice,reduced inflammatory cytokine(IL-6,TNF-α and IL-1β)levels,restored the levels of 5-HT and DA,and inhibited NF-κB signal-ing pathway activation.CONCLUSION:Jieyu Anshen formula combined with selenium significantly improved depres-sion-like behaviors in CUMS mice,potentially by improving hippocampal morphology,modulating the NF-κB signaling pathway,suppressing inflammatory factor expression,and enhancing hippocampal 5-TH and DA levels.

AIM:This study investigates the antidepressant mechanism of Jieyu-Anshen formula combined with selenium in chronic unpredictable mild stress(CUMS)mice through network pharmacology and animal experiments.METHODS:Potential drug targets were identified using the TCMSP,Genecards,and STRING databases.A protein-pro-tein interaction network was then constructed,followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Ge-nomes(KEGG)enrichment analyses and molecular docking validation.Sixty male KM mice were divided into six groups:control,model,selenium,Jieyu Anshen formula,selenium+Jieyu Anshen formula,and fluoxetine.Depression-like behav-iors were assessed using the tail suspension test,forced swimming test,and elevated plus-maze test.Enzyme-linked immu-nosorbent assay(ELISA)was used to measure hippocampal levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,5-hydroxytryptamine(5-HT),and dopamine(DA).Histopathological changes in the hippocampus were ex-amined using hematoxylin and eosin(HE)staining.Additionally,protein expression levels of nuclear factor-κB p65(NF-κB p65),phospho-NF-κB-p65(p-NF-κB p65),prostaglandin-endoperoxide synthase 2(PTGS2),glutathione peroxidase 4(GPX4),and selenoprotein S(SelS)were detected through immunohistochemistry and Western blot.RESULTS:Jieyu-Anshen formula combined with selenium significantly improved depression-like behaviors in CUMS mice,reduced inflammatory cytokine(IL-6,TNF-α and IL-1β)levels,restored the levels of 5-HT and DA,and inhibited NF-κB signal-ing pathway activation.CONCLUSION:Jieyu Anshen formula combined with selenium significantly improved depres-sion-like behaviors in CUMS mice,potentially by improving hippocampal morphology,modulating the NF-κB signaling pathway,suppressing inflammatory factor expression,and enhancing hippocampal 5-TH and DA levels.

Objective:To investigate the application value of D-dimer (D-D) as the primary indicator, combined with NT-proBNP and neutrophil percentage in the differential diagnosis of acute aortic dissection (AAD), pulmonary embolism (PE), and acute myocardial infarction (AMI).Methods:A retrospective case-control study was conducted, including 764 patients with acute chest pain who presented to the Emergency Department of Beijing Fuwai Hospital from March 1st, 2024, to February 28th, 2025. Patients were clinically diagnosed with AAD (299 cases) and other acute chest pain conditions (AMI 425 cases, PE 40 cases). The AAD group had the age of 56.00 (45.00, 64.00) years old with 226 males (75.59%); the AMI group had a median the age of 65.00 (55.00, 70.00) years with 339 males (79.76%); and the PE group had the age of 70.00 (59.75, 74.00) years with 15 males (37.50%). Baseline clinical data were collected and compared among the three groups, including general parameters such as heart rate, systolic blood pressure, and diastolic blood pressure. Laboratory parameters included N-terminal pro-brain natriuretic peptide (NT-proBNP), prothrombin time (PT), activated partial thromboplastin time (APTT), D-D, cardiac troponin I (cTnI), myoglobin, creatine kinase-MB (CK-MB), white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, and mean platelet volume (MPV). Comparisons between groups were performed using the Kruskal-Wallis rank-sum test and χ2 test. Independent discriminatory factors were identified through multivariate logistic regression analysis, and the diagnostic performance of individual indicators and combined models were analyzed using receiver operating characteristic (ROC) curves.Results:The D-D level in the AAD group [3.93 (1.48, 19.59) μg/ml] was significantly higher than that in the AMI group [0.26 (0.14, 0.56) μg/ml] and PE group [2.13 (0.84, 6.13) μg/ml] ( F=200.12, P<0.001). Multivariate analysis showed that D-D, NT-proBNP, neutrophil percentage, and lymphocyte percentage were all independent factors for differentiating AAD from AMI. NT-proBNP, total white blood cell count, neutrophil percentage, and lymphocyte percentage were independent predictors for differentiating AAD from PE. ROC analysis showed that D-D had an area under the curve (AUC) of 0.93 (95% CI 0.91-0.95) for differentiating AAD from AMI, with a sensitivity of 81.6% and specificity of 92.9%. In the differential diagnosis between AAD and PE, the model combining D-dimer, NT-proBNP, and neutrophil percentage had an AUC of 0.86 (95% CI 0.80-0.91), with a sensitivity of 85.0% and a specificity of 72.5%. Conclusion:D-D has significant value in the differential diagnosis of AAD from AMI and PE, with particularly good individual diagnostic performance for differentiating AAD from AMI. Combining NT-proBNP and neutrophil percentage can significantly improve differential diagnostic performance.

Objective:To explore the the application and outcomes of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery.Methods:We conducted a retrospective analysis of 296 patients(including 3 cases of pseudohermaphroditism and 293 transgender women)who underwent this procedure at the Voice Center of Nanjing Tongren Hospital of Otolaryngology-Head and Neck Surgery between November 2014 and August 2023. The patients, aged 18-50 years (mean age of 28.3±14.5) underwent feminizing laryngoplasty via transoral microsurgery, involving resection of the superficial lamina propria of the anterior vocal cords and subglottic tissues of the anterior commissure, followed by vocal ligament plication to achieve vocal cords shortening and anterior commissure retrodisplacement. Patients adhered to a1-month voice rest postoperatively and subsequently underwent speech rehabilitation training. Subjective/objective voice analyses, aerodynamic evaluations, and stroboscopic examinations were performed at 3, 6, and 12 months postoperatively to assess the effectiveness of voice feminization.Results:All surgeries were performed successfully and 94.3% (279/296) of the patients reported satisfaction at the end of the one-year follow-up. For effective cases, fundamental frequency (F 0) increased by 57.42±16.72 Hz compared to baseline. Postoperative acoustic/aerodynamic parameters and stroboscopic findings of vocal cord mucosal wave motion remained within normal ranges. These results indicated that this voice feminization surgery combined with postoperative pronunciation training achieved natural and feminine vocal characteristics. Conclusion:The combination of vocal cord shortening and anterior commissure retrodisplacement, along with postoperative pronunciation training, represents an effective surgical strategy for achieving a natural feminine voice.

Objective:To understand the emotional experiences of Intensive Care Unit(ICU)nurses facing pa-tient deaths,particularly those exhibiting signs of vicarious trauma.Methods:Employing a descriptive phenomeno-logical research design,sixteen ICU nurses with signs of vicarious trauma(scores above the theoretical median on the Disaster Responders Vicarious Trauma Questionnaire)were selected for in-depth interviews.The interviews fo-cused on their reference frameworks,self-capacities,resources,psychological needs,cognitive schemas,and image-ry.Data were analyzed using Colaizzi's seven-step methodology.Results:The emotional experiences of ICU nurses in the face of patient deaths were categorized into two themes,namely self-defense mechanisms under stress and e-motional exhaustion following prolonged exposure.The first theme includes unconscious temporary closures and personalized emotional reactions.The latter encompasses mirroring emotions of patients and their families,the sense of finality triggered by handling deceased bodies,feelings of helplessness in comforting families,unavoidable re-sponsibility,diminished sense of professional belonging,and strained family relationships.Conclusion:This study highlights the two-fold emotional impact on ICU nurses dealing with patient deaths,namely self-defense under stress and emotional exhaustion following prolonged immersion.

Objective:To investigate the effect of inflammatory factors(IL-2,INF-γ,IL-10,TNF-α)and CD4+and CD8+T cells in vaginal lavage in high-grade cervical squamous intraepithelial lesions(HSIL)and early cervical cancer(CC).Methods:To collect clinical data of HSIL(n=120)and early CC patients(n=44)after high-risk human papilloma virus(HR-HPV)infection.And healthy middle-aged women not infected with HR-HPV were randomly selected as control.The clinical data of the subjects in three groups were compared,inflammatory factors distribution and ratio of CD4+and CD8+T cells in serum and vaginal lavage fluid were compared.Multivariate Logistic regression performed to analyze the influencing factors of HSIL progression to early CC,ROC and calibration plot were drawn to evaluate the model.Results:The difference was not statistically significant in serum IL-2,INF-γ,IL-10,TNF-α levels,CD4+T cell distribution,CD8+T cell distribution and CD4+/CD8+ratio in sub-jects of control group,HSIL group and early CC group(P>0.05).The difference was statistically significant in the vaginal lavage levels of IL-2,INF-γ,IL-10,TNF-α levels,CD4+T cell distribution,CD8+T cell distribution and CD4+/CD8+ratio(P<0.05),plus the level of HSIL patients was higher than that of control subjects(P<0.05).Logistic regression analysis showed that parity>2(OR=3.119,95%CI:4.353～6.737)and the percentage of CD4+T cells in vaginal lavage fluid(OR=0.327,95%CI:0.188-0.478)in model 2(P<0.001,AUC=0.908),CD4+/CD8+(OR=0.809,95%CI:0.356-1.868)(P<0.001,AUC=0.873)in model 3 has an independent influence on the development of HSIL to early CC;the difference is not significant(Z=1.550 4,P=0.121)in ROC curves of the two models.CD4+/CD8+ratio as only one indictor in Model 3 can be good predic-tion,and the calibration curve of this model is close to the standard curve.Conclusions:After HR-HPV infection,the systemic immune status does not participate in HSIL and HSIL progression to early CC,but the cervical local immune status is involved,in which CD4+/CD8+T cell ratio is an independent protective factor.

Objective:To understand the current status of financial toxicity in patients with heart failure and the factors affecting it, and to provide ideas for making personalized and informed decisions.Methods:Using a scoping review methodological framework, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP, Wanfang, and SinoMed Databases were searched and screened for relevant literature on financial toxicity in patients with heart failure, with a timeframe of January 1, 2014-October 31, 2023, respectively. Relevant literature was identified based on inclusion and exclusion criteria, and data were extracted, collected, summarized, and the findings were reported.Results:Ten literatures that met the inclusion and exclusion criteria were identified. The results showed 5 cross-sectional surveys, 2 qualitative studies, and 1 each of reviews, mixed studies and commentaries. Heart failure patients generally faced high levels of financial toxicity, the incidence and severity of patient financial toxicity varied somewhat between study outcomes. Factors influencing financial toxicity in heart failure patients included age, education level, family income level, discussion of medical costs with physicians, type of insurance the patient had, and occupational status.Conclusions:In the future, we can develop and apply a specialized assessment tool for financial toxicity in heart failure patients in China, further explore the factors affecting financial toxicity in heart failure patients, and formulate personalized treatment plans and financial support strategies for patients according to the influencing factors, so as to reduce the impact of financial toxicity on heart failure patients.