1.Proctor's Reporting Guideline for Implementation Strategies: Interpretation, Application, and Challenges
Jiangyun CHEN ; Jinghan LIU ; Youping ZHUANG ; Xueying CHEN ; Siyuan LIU ; Xiaoshan CHEN ; Yeqing ZHAN ; Dongmei ZHONG ; Huadan HUANG ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):263-273
The Proctor's reporting guideline for implementation strategies represents a landmark framework in the field of implementation science, aiming to address the issue of inconsistent reporting in implementation research by standardizing the naming, definition, and operationalization of implementation strategies, thereby enhancing the credibility and utility of research findings. This paper provides an in-depth interpretation of the core connotations of this reporting guideline and illustrates its application in developing interview outlines and specifying implementation strategies, using a brief smoking cessation intervention project as a case study. Through this reporting guideline, abstract recommendations for implementation are systematically transformed into clear, multidimensional operational guides, significantly improving the transparency of strategy connotations and the replicability of actual execution. Meanwhile, the case study highlights the flexibility of the guideline, which allows researchers to adapt the content and format of strategies based on local resources and cultural contexts, thus enhancing practical adaptability while maintaining scientific rigor. However, the application of Proctor's reporting guideline still faces challenges, primarily manifested in the potential confusion surrounding the constructs of temporality and dose in practice, as well as the challenges that the inherent flexibility of the guideline may pose to the assessment of fidelity and effectiveness. Despite these limitations, the reporting guideline remains a vital tool for implementation research; future efforts should focus on optimizing its application—through refining operational guidelines, standardizing flexible adaptations, and involving stakeholders—to better guide implementation studies and continuously promote high-quality development in the field.
2.Key influencing factors and improvement strategies of prognosis in lung transplant recipients
Mengting ZHANG ; Xiaoshan LI ; Ting QIAN ; Lin MAN ; Min XIONG ; Shiqiang XUE ; Yetian QIAO ; Lin ZHU ; Jingyu CHEN ; Bo WU
Organ Transplantation 2026;17(5):875-882
In recent years, remarkable advances have been made in lung transplantation regarding donor evaluation, perioperative support, and immune regulation, laying a foundation for improving the long-term survival of recipients. The rational application of extended criteria donor lungs and the popularization of ex vivo lung perfusion technology have enhanced the utilization efficiency and safety of marginal donor lungs. Refined assessment of risk factors such as donors’ smoking history and infectious status has reduced the incidence of primary graft dysfunction and postoperative infection. In terms of recipient management, individualized assessment systems have been gradually optimized. The standardized application of intraoperative extracorporeal membrane oxygenation and the development of minimally invasive surgical techniques have effectively alleviated perioperative injuries. The optimization of postoperative immunosuppressive regimens and advances in rejection monitoring technologies have further improved the long-term survival of grafts. Nevertheless, chronic graft dysfunction and recurrent or refractory infections remain the major bottlenecks restricting long-term prognosis. Future research should focus on expanding donor sources, improving the repair quality of marginal donor lungs, promoting precise immunosuppression and anti-infection strategies, and comprehensively enhancing the long-term survival rate and quality of life of lung transplant recipients.
3.Knowledge, attitudes and practice regarding three major infectious diseases among freshmen in Jiangsu Province from 2019 to 2022
ZHANG Xiaolin, DU Guoping, CHEN Xiaoyan, LI Xiaoshan, WEI Yixuan, LI Yanhui, TAN Bingxin, YE Yuxiu
Chinese Journal of School Health 2025;46(2):205-209
Objective:
To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools.
Methods:
From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP.
Results:
From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01).
Conclusions
Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.
4.Influencing factors for medication adherence among inpatients with chronic diseases based on latent profile analysis
WANG Xiaoshan ; YE Lixiang ; CHEN Li ; LI Minxiang ; WANG Xinyu ; CAI Xiaoxia
Journal of Preventive Medicine 2025;37(3):217-222
Objective:
To explore the types of medication adherence and their influencing factors among inpatients with chronic diseases based on latent profile analysis, so as to provide the basis for improving medication adherence among patients with chronic diseases.
Methods:
The inpatients with chronic diseases admitted to the Second Affiliated Hospital of Hainan Medical University were selected as the study subjects. Demographic information, chronic disease status, and health education were collected through questionnaire surveys. Medication adherence was assessed using the Medication Adherence Scale and categorized based on the scores of its eight items through latent profile analysis. Factors affecting medication adherence among inpatients with chronic diseases were analyzed using a multinomial logistic regression model.
Results:
Totally 290 valid questionnaires were recovered, with an effective recovery rate of 97.64%. There were 157 males (54.14%) and 133 females (45.86%), with a median age of 61 (interquartile range, 21) years. The median score of medication adherence was 4.75 (interquartile range, 4.50). Based on latent profile analysis, medication adherence was categorized into three types: subjective neglect with poor adherence (38.97%), subjective confidence with fluctuating adherence (28.28%), and self-reflective with good adherence (32.76%). Multinomial logistic regression analysis showed that compared to the subjective confidence with fluctuating adherence, family monthly income (5 000-10 000 yuan, OR=2.981, 95%CI: 1.055-8.429), comorbidity of chronic diseases (OR=3.478, 95%CI: 1.579-7.661), number of health education sessions received in the past year (≤1 session, OR=0.329, 95%CI: 0.120-0.907; 2 sessions, OR=0.363, 95%CI: 0.138-0.950), and health information literacy scores (<60 points, OR=2.596, 95%CI: 1.209-5.573) were statistically associated with subjective neglect with poor adherence (all P<0.05).
Conclusion
Subjective neglect with poor medication adherence among inpatients with chronic diseases is associated with family monthly income, comorbidity of chronic diseases, the number of health education sessions received, and health information literacy.
5.Analysis of peripheral blood genetic material damage in children with vascular malformations after interventional procedures
Yuelong SHI ; Ying PANG ; Zhanchun GUO ; Ya MA ; Yingmin CHEN ; Xiaoshan WANG ; Rui CHEN
Chinese Journal of Radiological Health 2025;34(2):149-154
Objective To observe changes in genetic material in the peripheral blood of pediatric patients with vascular malformations after interventional procedures. Methods A total of 108 children with vascular malformations who underwent interventional procedures at Shandong University Affiliated Children’s Hospital between February 2021 and January 2024 were selected as the research subjects. Clinical data and peripheral venous blood samples before and after the interventional procedures were collected from the children. Two biological indicators, γ-H2AX and peripheral blood lymphocyte chromosomal aberration (CA), were used to determine the levels of genetic material damage in children with vascular malformations before and after interventional procedures. Results The median age of the children was 7 years and the median body weight was 27 kg. The median dose-area product (DAP) was 24.20 Gy·cm2 and the median DAP/kg was 1.04 Gy·cm2/kg. The incidence rates of both γ-H2AX foci and CA in children with vascular malformations significantly increased after the interventional procedures (Z = 5.924, P < 0.001; Z = 8.515, P < 0.001). The incidence of postoperative CA in 7 children were significantly higher than that in others, approaching or exceeding 4%. The incidence rates of postoperative γ-H2AX foci and CA in children with DAP/kg ≥ 1 Gy·cm2/kg were significantly higher than those in children with DAP/kg < 1 Gy·cm2/kg (U = 7.586, P = 0.031; U = 6.835, P = 0.009). No significant differences were observed in the incidence rates of postoperative γ-H2AX foci and CA among subgroups based on age, body weight, or surgical site. A positive correlation was observed between the difference in the incidence rates of γ-H2AX foci before and after the procedure and DAP/kg (R = 0.493, P = 0.027). Conclusion Ionizing radiation exposure during interventional procedures can increase peripheral blood genetic material damage levels in children with vascular malformations, and the damage levels show a correlation with the radiation dose, with some children being abnormally sensitive. Further research is needed to explore the influencing factors for genetic material damage in children with vascular malformations after interventional procedures, which is of great significance for reducing long-term cancer risks and achieving personalized treatment strategies.
6.Exploring the Principles of Syndrome Differentiation and Treatment for STC Based on the Theories of"Excess Syndrome is Corresponding to Zhanyu,Deficiency Syndrome is Corresponding to Zhengsheng"and the"Brain-Gut Axis"
Haipeng LU ; Xing CHEN ; Zhijin TAN ; Renbin GONG ; Ziqin WANG ; Shuhua CAO ; Xiaoshan GUO ; Ning TIAN
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(10):2950-2958
STC is a kind of clinically common functional gastrointestinal disease.Its pathogenesis hasn't been completely clarified,and current diagnosis and treatment norms are certainly limited.In recent years,"Brain-Gut Axis"theory has unveiled the complex bidirectional regulation mechanism between brain and intestinal tract,rendering new perspective for the research and treatment of STC.TCM theory demonstrates that there is close connection between brain and gut,has formed abundant experience in discrimination and treatment of STC and formed unique diagnosis and treatment ideas.Based on the theory of"Brain-Gut Axis"and"excess syndrome is corresponding to Zhanyu,deficiency syndrome is corresponding to Zhengsheng"in the chapter on Yangming diseases in"Treatise on Febrile Diseases",this paper elaborates on the relationship between the"Brain-Gut Axis"and STC.Meanwhile,by combining the theory of"excess syndrome is corresponding to Zhanyu,deficiency syndrome is corresponding to Zhengsheng"with the"Brain-Gut Axis"theory,it analyzes the influence of the excess and deficiency of the Yangming meridian on the mental state as well as the regulatory mechanism of the"Brain-Gut Axis",and puts forward corresponding treatment methods according to different syndromes.By integrating the relevant provisions in"Treatise on Febrile Diseases"with the"Brain-Gut Axis"theory of modern medicine,this paper makes a preliminary exploration of the laws of differentiating and treating STC,aiming to provide a theoretical basis for promoting a more comprehensive understanding of the pathogenesis of STC and developing more effective treatment strategies.
7.Correlation between coronary heart disease and hemoglobin levels in high-altitude regions, China
Chinese Journal of Primary Medicine and Pharmacy 2025;32(5):676-680
Objective:To investigate the correlation between coronary heart disease and hemoglobin levels in high-altitude regions, China.Methods:This study is a single-center retrospective study involving 298 patients who were hospitalized and underwent coronary angiography at the People's Hospital of Xizang Autonomous Region from January to December 2022. The patients were divided into a lesion group and a control group based on the presence of coronary artery lesions. Among them, 152 patients were diagnosed with coronary heart disease and were assigned to the lesion group, while 146 patients had normal coronary angiography results and were included in the control group. Hemoglobin levels, age, systolic blood pressure, diastolic blood pressure, and other relevant data were compared between the two groups. Furthermore, based on the status of the coronary artery lesions, the patients were categorized into single-vessel lesion, double-vessel lesion, and triple-vessel lesion groups to analyze the correlation between the Gensini score for coronary artery disease and hemoglobin levels in each group.Results:In the control group, hemoglobin, age, D-dimer, fibrinogen degradation products, glycated hemoglobin, C-reactive protein, and fibrinogen were (182.52 ± 28.45) g/L, (59.84 ± 13.14) years, (0.62 ± 1.70) mg/L, (2.92 ± 7.41) mg/L, (6.20 ± 1.22)%, (8.46 ± 21.90) mg/L, and (3.59 ± 1.87) g/L, respectively. In the lesion group, these values were (156.53 ± 23.35) g/L, (56.72 ± 12.70) years, (1.42 ± 2.69) mg/L, (5.32 ± 9.93) mg/L, (6.85 ± 1.88)%, (44.56 ± 64.29) mg/L, and (4.48 ± 2.18) g/L, respectively. The lesion group had lower hemoglobin levels and younger age, while levels of D-dimer, fibrinogen degradation products, glycated hemoglobin, C-reactive protein, and fibrinogen were significantly higher ( t = -5.58, -8.75, -2.59, -2.00, -2.82, -5.29, -3.21, all P < 0.05). A binary logistic regression analysis of these factors revealed that hemoglobin ( OR = 0.35, 95% CI: 0.08-0.78) is a protective factor for coronary heart disease ( P < 0.05). Both D-dimer ( OR = 1.42, 95% CI: 1.00-2.15) and glycated hemoglobin ( OR = 1.30, 95% CI: 1.00-1.60) were identified as independent risk factors for coronary heart disease (both P < 0.05). In the lesion group, hemoglobin levels were highest in the single-vessel lesion group [(161.22 ± 19.28) g/L], followed by the double-vessel lesion group [(154.84 ± 23.66) g/L], and lowest in the triple-vessel lesion group [(144.34 ± 26.57) g/L, all P < 0.05]. The Gensini scores were highest in the triple-vessel lesion group (89.96 ± 33.14), followed by the double-vessel lesion group (59.25 ± 17.28), and lowest in the single-vessel lesion subgroup (8.35 ± 4.56) (all P < 0.05). Conclusions:Hemoglobin is a protective factor for coronary heart disease, with lower hemoglobin levels associated with more severe coronary artery lesions in coronary heart disease.
8.Short-term efficacy of rituximab in children with calcineurin inhibitor resistant steroid resistant nephrotic syndrome
Sicheng YU ; Jialu LIU ; Jiaojiao LIU ; Xiaoyan FANG ; Jing CHEN ; Qianfan MIAO ; Xiaoshan TANG ; Zhiqing ZHANG ; Chunyan WANG ; Rufeng DAI ; Xinli HAN ; Yihui ZHAI ; Hong XU ; Qian SHEN
Chinese Journal of Pediatrics 2025;63(2):185-189
Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.
9.Treatment of pelvic fractures: the day before yesterday, yesterday, today and tomorrow
Zhiguang CHEN ; Jiaqi LI ; Wenhao CAO ; Jie HE ; Hongzhe QI ; Zhengguo ZHU ; Changda LI ; Hua CHEN ; Xiaoshan GUO ; Peifu TANG
Chinese Journal of Orthopaedic Trauma 2025;27(6):541-547
Pelvic fractures, the most severe bone trauma, account for approximately 3% of all fractures. As they are caused by high-energy injuries, their rates of mortality and disability are high. Over the past two centuries, the treatment strategies for these fractures have evolved from conservative therapy to open reduction and plate fixation, then to closed reduction and percutaneous screw fixation, and recently to screw fixation assisted by artificial intelligence. In the past 40 years, constant progress has been made in the treatment of pelvic fractures. It is generally acknowledged that a personalized treatment plan should be formulated based on each patient's age, fracture type, comorbidities, functional requirements and other factors when an appropriate treatment mode is chosen. The primary aim of treatment is to accelerate functional recovery, decrease the rate of disability after injury, and improve the quality of daily life of the patient. This paper reviews the treatment history of pelvic fractures, discusses the advantages and disadvantages of current treatment options, and looks ahead to future prospects, aiming to offer valuable references for related clinical practice.
10.Reporting Guidelines in Implementation Science:Overview,Categorization and Future Directions
Xiaoshan CHEN ; Dadong WU ; Run WANG ; Qing ZHAO ; Siyuan LIU ; Wanqing HUANG ; Zizhen HUANG ; Yuting WAN ; Huanyu HU ; Junlin ZHU ; Jiangyun CHEN ; Zhiwei HUANG ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(4):1033-1046
Reporting guidelines are structured checklists for researchers to follow when reporting spe-cific types of studies.As researches conducted in real-world settings to address practical issues,implementa-tion research has stringent requirements for the replicability of result and the transparency of reporting,making its reporting guidelines particularly important.This paper systematically introduces the reporting guidelines in the field of implementation science,outlines their classification systems and scopes of applica-tion,and focuses on explaining the core characteristics and functions of five key reporting guidelines,inclu-ding the Standards for Reporting Implementation Studies(StaRI),Reporting guidelines for implementation and operational research,the Template for Intervention Description and Replication(TIDieR),the Frame-work for Reporting Adaptations and Modifications-Enhanced(FRAME),and recommendations for specifying and reporting implementation strategies.Furthermore,combined with the PEDALs research paradigm in im-plementation science,this paper further clarifies the specific application pathways for reporting guidelines and discusses directions for refinement,aiming to provide references for researchers to select appropriate reporting guidelines.


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