1.Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions
Wei YANG ; Yiyuan CAI ; Jiajia CHEN ; Run MAO ; Lang LINGHU ; Sensen LYU ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(2):479-491
The success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medical Appointment for Diabetes (SMART) in China: design of an optimization trial" and to enhance ORC and provide insights to support the effective implementation of the program. Qualitative interviews and quantitative surveys were conducted to evaluate the ORC level and its influencing factors in 12 institutions implementing the SMART program. The Scale for Assessing the Institution's Readiness to Implement Evidence-Based Practices was utilized to measure ORC levels. Qualitative interviews were conducted among change implementers to gather information regarding the status of influencing factors. Thematic analysis was applied to extract factors from the interview data, and an assessment questionnaire was developed to measure the perceived impact of these factors. A fuzzy-set qualitative comparative analysis (fsQCA) method was employed to identify the influencing factors of ORC and pathways leading to high-level ORC. Seventy implementers from 12 institutions, encompassing administrators, clinicians, and health managers, participated in the interviews and surveys. The median and interquartile of the ORC scores were 105.20 (101.23, 107.33). The fsQCA indicated that a clear understanding of specific tasks and responsibilities, the active engagement of key participants, sufficient preliminary preparation, and the use of audits and feedback mechanisms were critical pathways to a high-level ORC. Conversely, institutions lacking key participants, preliminary preparation, or marginal influence demonstrated a low-level ORC. Before implementing innovation, Coherence and Cognitive Participation were identified as critical factors in influencing ORC. Strong leadership from key participants played pivotal role in enhancing readiness for change and was essential for improving implementation fidelity and overall program success.
2.Growth retardation and hepatopathy associated with single heterozygous mutations in the IARS1 gene: A case report
Yang LI ; Di MAO ; Liya WEI ; Chunxiu GONG
Journal of Clinical Hepatology 2025;41(4):731-735
Mutations in the IARS1 gene are rare in clinical practice, and up to now, only ten cases with detailed clinical and genetic data have been recorded in the literature. This article reports a case of growth retardation, intellectual developmental disorder, hypotonia, and hepatopathy (GRIDHH) associated with single heterozygous mutations in the IARS1 gene and summarizes the clinical and genetic features of GRIDHH, thereby expanding the genetic spectrum of GRIDHH.
3.Localization and Content Validation of the Organizational Readiness of Implementing Evidence-based Practices Scale
Jiajia CHEN ; Yiyuan CAI ; Wei YANG ; Run MAO ; Lang LINGHU ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(3):765-776
This study aimed to localize the workplace readiness questionnaire (WRQ) and validate its applicability for assessing readiness for implementation of evidence-based practices (EBP) in primary care settings in China. The localization of the instrument will provide a practical instrument for assessing organizational readiness for change (ORC). The WRQ was translateed into Chinese version using the modified Brislin translation model, and its cross-cultural validity, content validity, and generalizability were evaluated by the Delphi method, and the expert feedback was evaluated using the item-level content validity index (I-CVI), scale-level content validity index (S-CVI), and corrected Kappa value. The index weights were evaluated by the analytic hierarchical process (AHP). The target users of the scale were invited to quantitatively evaluate its item importance score (IIS), and the surface validity was evaluated by combining the qualitative feedback from their cognitive interviews. To clarify the purpose of the scale, we revised its name to the Organizational Readiness of Implementing Evidence-Based Practices (ORIEBP) Scale. The ORIEBP scale contained five dimensions, which were Change Context, Change Valence, Information Evaluation, Change Commitment, Change Efficiency, and 32 items. After two rounds of the Delphi method to refine the construction of three dimensions and expressions of 11 items, the I-CVI were from 0.73 to 1.00, the Kappa value were from 0.70 to 1.00, and the S-CVI was over 0.92. All evaluation matrices of the hierarchical analysis method met the requirement of consistency ratio (CR < 0.1), and the weights of five dimensions were 0.2083, 0.2022, 0.1907, 0.2193, and 0.1795, in sequence. Nine out of eleven experts identified that items were applicable to other readiness assessment scenarios. The IIS scores for the five dimensions and 32 items were ranged from 2.93 to 3.54, and 2.71 to 3.42, presenting good face validity. The cognitive interview results showed that professional expressions were complex to understand. This study validated the ORIEBP scale and has good content validity and generalizability. The scale can be further improved by expanding its scope of use and validating its structure validity and reliability in different settings.
4.Mechanism of Ferroptosis in Regulating Chronic Heart Failure and Traditional Chinese Medicine Prevention and Treatment Based on Qi Deficiency and Stagnation: A Review
Ziyang YUAN ; Yan ZHANG ; Wei ZHANG ; Yaqin WANG ; Wenjun MAO ; Guo YANG ; Xuewei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):248-255
Chronic heart failure (CHF) is the final stage of cardiovascular diseases. It is a complex syndrome, with dyspnea and edema as the main clinical manifestations, and it is characterized by complex disease conditions, difficult cure, and high mortality. Ferroptosis, a new type of programmed cell death, is different from other types of programmed cell death. Ferroptosis is iron-dependent, accompanied by lipid peroxide accumulation and mitochondrial shrinkage, becoming a hot research topic. Studies have confirmed that ferroptosis plays a key role in the occurrence and development of CHF. The regulation of ferroptosis may become a potential target for the treatment of CHF in the future. The theory of Qi deficiency and stagnation refers to the pathological state of original Qi deficiency and abnormal transportation and distribution of Qi, blood, and body fluid, which has guiding significance for revealing the pathogenesis evolution of some chronic diseases. We believe that Qi deficiency and stagnation is a summary of the pathogenesis of ferroptosis in CHF. Deficiency of Qi (heart Qi) is the root cause of CHF, and stagnation (phlegm turbidity and blood stasis) is the branch of this disease. The two influence each other in a vicious circle to promote the development of this disease. Traditional Chinese medicine (TCM) plays an important role in the treatment of CHF, improving the prognosis and quality of life of CHF patients. This paper explores the correlation between the theory of Qi deficiency and stagnation and the mechanism of ferroptosis in CHF. Furthermore, this paper reviews the mechanism of Chinese medicines and compound prescriptions in preventing and treating CHF by regulating ferroptosis according to the principles of replenishing Qi and dredging to remove stagnation, aiming to provide new ideas and methods for the treatment of CHF with TCM.
5.Effect of interleukin-8 regulation on monocyte chemotactic protein-1 secretion and expression through the NF-kappaB/p65 signaling pathway on the migration of residual epithelial cells in the lens capsule
Wei SI ; Su XU ; Yuhang ZHANG ; Yi MAO ; Keyu GUO ; Yanzhong HU ; Fengyan ZHANG
International Eye Science 2025;25(4):537-543
AIM: To investigate the effect of interleukin-8(IL-8)on the regulation of monocyte chemotactic protein-1(MCP-1)secreted by lens epithelial cells(LEC)during cell migration in the development of posterior capsule opacification(PCO).METHODS: A rat lens capsule model was established and cultured in medium supplemented with 10% fetal bovine serum. Upon migration of LEC to 30%-50% of the posterior capsule, serum was removed. The capsule was subsequently divided into two groups: a control group and an IL-8(15 ng/mL)treatment group. LEC migration was captured at multiple time points. The secretion and mRNA expression of MCP-1 were quantified using ELISA and RT-qPCR, respectively. Immunofluorescence was used to assess MCP-1 expression in the different experimental groups. SRA01/04 cells were divided into three groups: control, IL-8(15 ng/mL), and IL-8(15 ng/mL)+200 μmol/L Bindarit(BND)groups, with migration measured by the Transwell assay. Additionally, SRA01/04 cells were divided into negative control(NC), NC+15 ng/mL IL-8, and 15 ng/mL IL-8+p65 siRNA groups, and MCP-1 secretion and mRNA expression were further analyzed by ELISA and RT-qPCR.RESULTS:LEC migration in the rat lens capsule cultured in vitro showed that the cells migration of the 15 ng/mL IL-8 group significantly increased at 48, 72 and 96 h(all P<0.05). ELISA results revealed that MCP-1 levels in SRA01/04 cells from the 15 ng/mL IL-8-treated group were markedly higher than those in the control group at both 12 and 24 h(all P<0.05). RT-qPCR analysis also demonstrated a significant increase in MCP-1 mRNA expression in the 15 ng/mL IL-8 group at both time points(all P<0.05). Immunofluorescence staining indicated greater MCP-1 expression in capsular epithelial cells of the 15 ng/mL IL-8 group at 24 h(P=0.007). Transwell assays further confirmed increased cell migration in the 15 ng/mL IL-8 group compared to the control group(P=0.001), while the migration reduced in the 15 ng/mL IL-8+200 μmol/L BND group compared to the 15 ng/mL IL-8 group(P=0.003). Moreover, ELISA and RT-qPCR results demonstrated a significant increase in MCP-1 secretion and mRNA expression in the NC+15 ng/mL IL-8 group at both 12 and 24 h compared to the NC group(all P<0.01). In contrast, MCP-1 secretion and mRNA expression were reduced in the 15 ng/mL IL-8+p65 siRNA group compared to the NC+15 ng/mL IL-8 group at both time points(all P<0.01).CONCLUSION: IL-8 promotes the migration of residual epithelial cells and regulates the secretion and expression of MCP-1 in LEC. The mechanism underlying IL-8's effects appears to be mediated through the activation of the NF-κB/p65 signaling pathway.
6.Neuroplasticity Mechanisms of Exercise-induced Brain Protection
Li-Juan HOU ; Lan-Qun MAO ; Wei CHEN ; Ke LI ; Xu-Dong ZHAO ; Yin-Hao WANG ; Zi-Zheng YANG ; Tian-He WEI
Progress in Biochemistry and Biophysics 2025;52(6):1435-1452
Neuroscience is a significant frontier discipline within the natural sciences and has become an important interdisciplinary frontier scientific field. Brain is one of the most complex organs in the human body, and its structural and functional analysis is considered the “ultimate frontier” of human self-awareness and exploration of nature. Driven by the strategic layout of “China Brain Project”, Chinese scientists have conducted systematic research focusing on “understanding the brain, simulating the brain, and protecting the brain”. They have made breakthrough progress in areas such as the principles of brain cognition, mechanisms and interventions for brain diseases, brain-like computation, and applications of brain-machine intelligence technology, aiming to enhance brain health through biomedical technology and improve the quality of human life. Due to limited understanding and comprehension of neuroscience, there are still many important unresolved issues in the field of neuroscience, resulting in a lack of effective measures to prevent and protect brain health. Therefore, in addition to actively developing new generation drugs, exploring non pharmacological treatment strategies with better health benefits and higher safety is particularly important. Epidemiological data shows that, exercise is not only an indispensable part of daily life but also an important non-pharmacological approach for protecting brain health and preventing neurodegenerative diseases, forming an emerging research field known as motor neuroscience. Basic research in motor neuroscience primarily focuses on analyzing the dynamic coding mechanisms of neural circuits involved in motor control, breakthroughs in motor neuroscience research depend on the construction of dynamic monitoring systems across temporal and spatial scales. Therefore, high spatiotemporal resolution detection of movement processes and movement-induced changes in brain structure and neural activity signals is an important technical foundation for conducting motor neuroscience research and has developed a set of tools based on traditional neuroscience methods combined with novel motor behavior decoding technologies, providing an innovative technical platform for motor neuroscience research. The protective effect of exercise in neurodegenerative diseases provides broad application prospects for its clinical translation. Applied research in motor neuroscience centers on deciphering the regulatory networks of neuroprotective molecules mediated by exercise. From the perspectives of exercise promoting neurogenesis and regeneration, enhancing synaptic plasticity, modulating neuronal functional activity, and remodeling the molecular homeostasis of the neuronal microenvironment, it aims to improve cognitive function and reduce the incidence of Parkinson’s disease and Alzheimer’s disease. This has also advanced research into the molecular regulatory networks mediating exercise-induced neuroprotection and facilitated the clinical application and promotion of exercise rehabilitation strategies. Multidimensional analysis of exercise-regulated neural plasticity is the theoretical basis for elucidating the brain-protective mechanisms mediated by exercise and developing intervention strategies for neurological diseases. Thus,real-time analysis of different neural signals during active exercise is needed to study the health effects of exercise throughout the entire life cycle and enhance lifelong sports awareness. Therefore, this article will systematically summarize the innovative technological developments in motor neuroscience research, review the mechanisms of neural plasticity that exercise utilizes to protect the brain, and explore the role of exercise in the prevention and treatment of major neurodegenerative diseases. This aims to provide new ideas for future theoretical innovations and clinical applications in the field of exercise-induced brain protection.
7.Discussion on key points for second type of medical sodium hyaluronate wound dressing
Yongxia CHEN ; Juntai ZHU ; Ruiqi MAO ; Wei SHI ; Deshuang GOU
International Journal of Biomedical Engineering 2024;47(4):411-414
With the development of the medical cosmetology industry, the market demand for medical sodium hyaluronate dressing is gradually increasing, but at present the product lacks the corresponding national standards. This problem makes this type of product face the problem of non-uniform standards in the quality control, registration declaration information content, technical review requirements, and other aspects. In this review paper, the classification of medical sodium hyaluronate wound dressing products was introduced, and the key points of the technical review were discussed, involving the division of the registration unit, raw material control, product performance indicators, and clinical evaluation. In addition, the key information review requirements in the process of registration and declaration of such products were analyzed, with a view to providing technical references for manufacturers and relevant regulatory agencies.
8.Correlation between femoral offset,rotation center and leg length discrepancy after total hip arthroplasty based on digital analysis
Mao-Yong LI ; Wei CAO ; Pei-Xin SHA ; Xu-Dong SUN ; Shi-Yuan HUANG ; Kuan-Xin LI ; Heng ZHANG
China Journal of Orthopaedics and Traumatology 2024;37(4):381-386
Objective CT scans combined with Mimics software were used to measure femoral offset(FO),rotation center height(RCH)and lower leg length discrepancy(LLD)following total hip arthroplasty(THA),and the relationship between FO,RCH and LLD after THA is discussed.Methods Retrospective analysis was performed on 40 patients with unilateral THA who met standard cases from October 2020 to June 2022.There were 21 males and 19 females,18 patients on the left side and 22 patients on the right side,aged range from 30 to 81 years old,with an average age of(58.90±14.13)years old,BMI ranged from 17.3 to 31.5 kg·m-2withan average of(25.3±3.4)kg·m-2.There were 30 cases of femoral head necrosis(Ficattype Ⅳ),2 cases of hip osteoarthritis(Tonnis type Ⅲ),2 cases of developmental hip dislocation combined with end-stage osteoarthritis(Crowe type Ⅲ),and 6 cases of femoral neck fracture(Garden type Ⅳ).Three-dimensional CT reconstruction of pelvis was taken preoperative and postoperative,and three-dimensional reconstruction model was established after processing by Mimics software.FO,RCH and LLD were measured on the model.The criteria for FO reconstruction were as follows:postoperative bi-lateral FO difference less than 5 mm;the standard for equal length of both lower limbs was as follows:postoperative LLD differ-ence less than 5 mm.Results Bilateral FO difference was positively correlated with LLD(r=0.744,P<0.00l).Chi-square test was performed between the FO reconstructed group and the non-reconstructed eccentricity group:The results showed that the i-sometric ratio of lower limbs in the FO reconstructed group was significantly higher than that in the FO reconstructed group(x2=6.320,P=0.012).The bilateral RCH difference was significantly negatively correlated with LLD(r=-0.877,P<0.001).There is a linear relationship between bilateral FO difference and bilateral RCH difference and postoperative LLD,and the lin-ear regression equation is satisfied:postoperative LLD=0.038x-0.099y+0.257(x:postoperative bilateral FO difference,y:post-operative bilateral RCH difference;Unit:cm),F=77.993,R2=0.808,P=0.009.Conclusion After THA,LLD increased with the increase of FO and decreased with the increase of RCH.The effect of lower limb isometric length can be obtained more easily by reconstruction of FO.There is a linear relationship between the bilateral FO difference and the bilateral RCH difference after THA and LLD,and the regression equation can provide a theoretical reference forjudging LLD.
9.Analysis of risk factors for postoperative delirium in elderly patients undergoing spinal surgery
Wei-Ping ZHANG ; Wen-Xi CHANG ; Wei-Yi LIU ; Zhen-Jun LI ; Jian-Wei MAO
China Journal of Orthopaedics and Traumatology 2024;37(7):700-705
Objective To investigate the risk factors of postoperative delirium in elderly patients undergoing spine surgery.Methods The basic case data of 566 patients who underwent spine surgery under general anesthesia from January 2021 to Jan-uary 2023 were retrospectively analyzed.There were 296 males and 270 females with an average age of(71.58±4.21)years old.There were 195 cases of cervical spine surgery,26 cases of thoracic spine surgery and 345 cases of lumbar spine surgery.According to the occurrence of postoperative delirium,the patients were divided into postoperative delirium group(41 patients)and non-delirium group(525 patients).Univariate analysis was used to analyze the possible influencing factors such as gen-der,age,weight,smoking history,drinking history,surgical site,preoperative anxiety,intraoperative hypotension times,blood loss and so on,and binary Logistic regression was used to analyze the univariate factors with P<0.05.Results A total of 41 pa-tients developed postoperative delirium.Univariate analysis showed that age(P=0.000),duration of surgery(P=0.039),preop-erative anxiety(P=0.001),blood loss(P=0.000),history of opioid use(P=0.003),history of stroke(P=0.005),C-reactive protein(P=0.000),sodium ion(P=0.000)were significantly different between delirium group and non-delirium group.These factors were included in the binary Logistic regression analysis,and the results showed that age[OR=0.729,95%CI(0.569,0.932),P=0.012],opioid use[OR=21.500,95%CI(1.334,346.508),P=0.031],blood loss[OR=0.932,95%CI(0.875,0.993),P=0.029],C-reactive protein[OR=0.657,95%CI(0.485,0.890),P=0.007],preoperative anxiety[OR=23.143,95%CI(1.859,288.090),P=0.015],and sodium[OR=1.228,95%CI(1.032,1.461),P=0.020]were independent risk factors for the development of delirium after spinal surgery in elderly patients.Conclusion Age,opioid use,blood loss,preoper-ative anxiety,elevated c-reactive protein,and hyponatremia are independent risk factors for the development of postoperative delirium in elderly patients undergoing spinal surgery.
10.Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex
Qi-Wei ZHANG ; Hong-Chao LI ; Lin NING ; Qing-Xiang MAO ; Hong YAN
Journal of Regional Anatomy and Operative Surgery 2024;33(9):815-819
Objective To observe the preventive effect of ultrasound-guided cervical vagus nerve block(CVB)in preventing oculocar-diac reflex.Methods A total of 86 patients who underwent posterior scleral reinforcement or ophthalmectomy were recruited and randomly divided into the general anesthesia group and the composite anesthesia group.After admission,patients in the two groups underwent conven-tional general anesthesia induction intubation,and the composite anesthesia group received another 1%lidocaine for right CVB under ultrasound guidance.The heart rate,blood pressure,saturation of peripheral oxygen,atropine usage and surgical procedures of the two groups were recorded.Postoperative comfort degree,hoarseness and complications related to nerve block were compared between the two groups.Results Compared with the general anesthesia group,the proportion of patients using atropine and the proportion of suspending operation in the composite anesthesia group were significantly reduced(P<0.05),and the incidence of oculocardiac reflex and the level of oculocardiac reflex were significantly decreased(P<0.05).The incidence of hoarseness in the composite anesthesia group was higher than that in the general anesthesia group,and the difference was statistically significant(P<0.05).There was no complication related to nerve block occurred in the composite anesthesia group.Conclusion In ophthalmic surgery,ultrasound-guided right CVB can safely and effec-tively inhibit the occurrence of oculocardiac reflex.

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