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 summarize and analyze the efficacy and influencing factors of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia relapsing after the first allo-HSCT. Methods Clinical data of 17 patients with acute leukemia who underwent second allo-HSCT at Peking University First Hospital from January 2005 to December 2024 were retrospectively analyzed. Results Among the 17 patients, 7 achieved long-term disease-free survival after second transplantation. The median progression-free survival after successful second transplantation was 7 months (range 8 days to 69 months). The relapse fatality was 24%, and the transplant-related fatality was 35%. Conclusions Second transplantation is an effective treatment for relapsed and refractory acute leukemia, but the relapse fatality and transplant-related fatality remain high. Patient age, time of relapse after the first transplantation and disease status before second transplantation are all factors that affect the efficacy of second transplantation. Younger age, late relapse and complete remission of disease before second transplantation are all beneficial for long-term disease-free survival after second transplantation.

Thyroid-associated ophthalmopathy(TAO)is a common autoimmune complication in thyroid diseases. Its pathogenesis is complex and involves the abnormal activation of multiple signaling pathways. With the rapid development of molecular biology and genomics technologies, the signal transduction mechanisms and regulatory networks related to TAO have been deeply analyzed. At present, studies have found that the interaction between the TSH receptor(TSHR)and the insulin-like growth factor-1 receptor(IGF-1R)signaling pathway, as well as immune inflammation-related pathways, oxidative stress, and calcium signaling pathways, play important roles in the pathogenesis of TAO. In addition, the research on the regulatory mechanism of non-coding RNA and fibrosis-related signaling molecules has gradually become the focus. Despite much advancement, there are still many unsolved mysteries regarding the exact pathogenesis of TAO. This article aims to systematically review the latest research progress of the main signaling pathways of TAO. By combining the latest achievements in gene expression profiles, single-cell sequencing and drug design, it analyzes potential therapeutic targets and the development directions of innovative drugs, providing a theoretical basis for the pathological mechanism of TAO and a scientific basis for the optimization of clinical treatment strategies at the same time.

Medical humanities consistently run through the entire process of medical development and educational reform. However， with the increasingly prominent dominance of evidence-based medicine in clinical practice， the medical humanities have gradually been weakened in both medical education and clinical practice. Narrative medicine， through telling and listening to patients’ stories， enhances healthcare professionals’ empathy， fosters doctor–patient communication， and facilitates a return to the humanistic essence of medical education and clinical practice. By sorting out and reviewing related literature and developmental trends both at home and abroad， this paper pointed out the existing structural problem of an imbalance between technological priority and humanistic care in medical education， focusing on how to achieve an effective integration of medical humanities and narrative medicine in medical education. This paper also systematically analyzed the significance of both medical humanities and narrative medicine in the medical education system and proposed promoting the deep embedding of narrative medicine in medical education from three entry points， namely， curriculum integration， interdisciplinary collaboration， and the construction of teaching evaluation systems. The aim was to provide theoretical support and practical experience for medical education reform， foster the coordinated development of professional competence and humanistic spirit among medical talents， and truly achieve the goal of cultivating well-rounded medical talents.

Objective To systematically evaluate the rehabilitation effect of immersive virtual reality technology for patients with peripheral vestibular dysfunction,and to provide theoretical basis and practical guidance for the design of efficient rehabilitation training programs.Methods PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,Wanfang Database,VIP Database,and China Biomedical Literature Database were searched for randomized controlled trials on the intervention effect of immersive virtual reality technology in patients with peripheral vestibular dysfunction from inception to February 2025.RevMan5.4 software was used to perform meta-analysis of the literature that met the quality standards.Results A total of 10 papers with 491 patients with peripheral vestibular dysfunction were included.Meta-analysis showed that immersive virtual reality technology improved vertigo symptoms in patients with peripheral vestibular dysfunction compared with conventional vestibular rehabilitation care[SMD=-1.41,95％CI(-1.58,-0.70),P＜0.001],and subgroup analysis showed that the frequency of intervention was＜5 times/week[SMD=-1.31,95％CI=(-1.96,-0.66),P＜0.001],single intervention duration＜30 min[SMD=-1.45,95％CI=(-2.21,-0.70),P＜0.001],and intervention period≤7 weeks[SMD=-1.49,95％CI(-2.04,-0.94),P＜0.001]were more significant.Immersive virtual reality technology reduced the risk of falls[MD=4.66,95％CI(3.84,5.48),P＜0.001],and improved anxiety and depression[SMD=2.65,95％CI(1.98,3.33),P＜0.001].Conclusion Immer-sive virtual reality technology improves vertigo symptoms,reduces the risk of falls,and improves anxiety and depres-sion symptoms in patients with peripheral vestibular dysfunction,in which the intervention period of ≤7 weeks,＜5 training sessions per week,and each training session of＜30 min are better for improving vertigo symptoms in patients with peripheral vestibular dysfunction.

Objective:To sinicize the Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care (OCBS-MPPRBC) to test its reliability and validity, and to provide an evaluation tool for evaluating the degree of compulsive behaviors of postpartum mothers regarding baby care.Methods:Following the principles of Brislin translation, back translation and cross-cultural adaptation, the Chinese version of OCBS-MPPRBC was formed. A convenient sampling method was used to investigate 360 women in Mianyang Central Hospital from November 2023 to February 2024, and to test the reliability and validity of the Chinese version OCBS-MPPRBC. The critical ratio method and the total correlation analysis method were used for item analysis, the reliability test was based on Cronbach α coefficient and half-reliability method, and the content validity index, exploratory factor analysis, confirmatory factor analysis and aggregate validity were used for validity test. Results:A total of 352 women aged 21-41 (31.55 ± 3.17) years who met the exclusion criteria were included. The Chinese version of OCBS-MPPRBC contained 9 items, and 2 common factors were extracted by exploratory factor analysis, and the cumulative total variance contribution rate was 65.523%. The content validity index of the scale level was 0.89, the content validity index of each item level was 0.86-1.00, and the Cronbach α coefficient of the total scale was 0.844, and the half-folded reliability was 0.759. The results of confirmatory factor analysis showed that the fitting index of the Chinese version of the OCBS-MPPRBC model was better. Conclusions:The Chinese version of the OCBS-MPPRBC scale has good reliability and validity, and has good operability, which can be used to evaluate the degree of compulsive behavior of postpartum mothers about baby care in China.

Objective:To analyze the patterns of change of brain function among civil pilots in prospective memory tasks by using task-state functional magnetic resonance imaging (fMRI) and a cue-based repetitive search task.Methods:A total of 85 subjects were enrolled, including 47 civil pilots (pilot group) and 38 ordinary workers (control group). The task-state fMRI data during the execution of the prospective memory task was analyzed using a general linear model to find out about the activation patterns of brain functions in the 2 groups in the 3 phases of encoding, maintenance, and retrieval of the prospective memory task. The differences in activation patterns between the 2 groups and correlations between regions of interest and the rate of accuracy, reaction time and flying hours were analyzed.Results:The repeated measurement analysis of variance showed that there were no interactions of reaction time or of the rate of accuracy between the task and grouping ( P>0.05), and that the difference in the main effect of grouping was significant ( F=5.67, 15.46, P=0.020, <0.001). The difference in the main effect of grouping on the rate of accuracy was significant ( F=5.42, P=0.022), and the rate of accuracy in the pilot group was higher than in the control group ( P=0.048). In the phase of encoding, the activation in the bilateral cerebellum, bilateral superior frontal gyrus, bilateral fusiform gyrus, and temporal lobe regions decreased in the pilot group compared with the control group ( t=2.68-4.13, all P<0.05), while the activation in the fusiform gyrus and the right parietal superior gyrus increased, and the differences were statistically significant ( t=3.28, 3.35, 3.02, P=0.038, 0.024, 0.042). During the phase of maintenance, the pilot group showed significantly reduced activation in the bilateral cerebellum, bilateral medial superior frontal gyrus, bilateral middle occipital gyri, and the right middle temporal gyrus compared with the control group ( t=2.24-3.36, P<0.05 or 0.01). In the retrieval phase, activation in the right peri-calcarine cortex, bilateral caudate nuclei, and bilateral precentral and postcentral gyri was enhanced in the pilot group compared with the control group ( t=2.57-3.35, all P<0.05), especially in the right middle frontal gyrus ( t=3.12, P=0.007). In the encoding phase, activation was increased in the left fusiform gyrus and right parietal superior gyrus of the pilot group, which was positively correlated with flying hours in the last 3 months ( r=0.347, 0.418, P=0.020, 0.005). Conclusions:Due to long-term flights, the way in which such regions as the frontal lobe, cerebellum, and default mode network are activated in civil pilots is likely to undergo some changes during prospective memory activities, which is why they have higher processing efficiency when performing prospective memory tasks.

OBJECTIVES: This cross-sectional study aims to explore the association between oral health status and cognitive function in Chinese elderly individuals. METHODS: The survey participants were composed of elderly people aged≥60 who were admitted to West China Hospital of Stomatology, Sichuan University from August 2022 to March 2024. They were divided into a cognitive impairment (CI) group and a healthy control (HC) group according to the Montreal Cognitive Assessment (MoCA) score. General information and oral health indicators of all elderly people were collected. Independent sample t-test and chi-square test were used for inter-group comparison, and multiple linear regression model was applied for multivariate analysis of MoCA scores. RESULTS: A total of 402 elderly people were included in the study, and the number of remaining teeth in the CI group was significantly lower than that in the HC group. The decayed, missing, filled teeth index, debris index-simplified, gingival index, probing depth (PD), and clinical attachment loss in the CI group were all significantly higher than those in the HC group. There was no difference in denture wearing between the two groups. The results of multiple linear regression showed that there was a correlation between the number of remaining teeth and PD and MoCA scores after correcting for confounding factors. CONCLUSIONS Elderly individuals with CI have more prominent oral health issues compared to those with normal cognitive function. There may be a bidirectional relationship between the number of remaining teeth, PD, and cognitive function in elderly people.
Humans ; Oral Health ; Aged ; Cross-Sectional Studies ; Cognitive Dysfunction/epidemiology* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Linear Models ; Aged, 80 and over ; Periodontal Index ; Cognition

Objectives:To assess the situation of retained cardiac implantable electronic device(CIED)leads after cardiac transplantation,the associated factors,and their impact on long-term prognosis.Methods:A retrospective analysis was conducted on 1 096 patients who underwent cardiac transplantation at Fuwai Hospital of the Chinese Academy of Medical Sciences from January 1,2005 to January 1,2022.Among them,204 patients(18.6%)received CIED therapy before cardiac transplantation.Two physicians independently reviewed the pre-and post-transplant chest X-rays to determine the presence of retained CIED leads.Logistic multivariate regression analysis was used to assess factors associated with retained CIED leads,and Kaplan-Meier survival curves were plotted to analyze the impact of retained CIED leads on long-term prognosis.Results:Among the 204 patients who received CIED therapy before cardiac transplantation,the highest proportion were those treated with implantable cardioverter defibrillator(ICD)and cardiac resynchronization therapy-defibrillator(CRT-D),accounting for 47.5%(97/204)and 40.7%(83/204),respectively.The mean duration from CIED implantation to cardiac transplantation was(45.1±40.0)months,and 38 patients(18.6%)had retained CIED leads after cardiac transplantation.The results of the logistic multivariate regression analysis showed that the duration from CIED implantation to cardiac transplantation was the only factor associated with retained CIED leads after cardiac transplantation(OR=1.020,95%CI:1.011-1.030,P=0.000).Cumulative all-cause survival rates among patients without CIED implantation(n=892),those without retained CIED leads(n=166),and those with retained CIED leads(n=38)were 88.5%,93.3%and 84.2%,respectively.Kaplan-Meier survival curve analysis showed no significant difference in cumulative all-cause survival among the three groups(log-rank P=0.643).Conclusions:In patients who received CIED implantation before cardiac transplantation,18.6%had retained leads after surgery.The duration from CIED implantation to cardiac transplantation is the only factor associated with lead retained after cardiac transplantation,but retained leads does not affect the outcome post heart transplantation.

AIM:To investigate the mechanism by which muscle segment homeobox 2(Msx2)regulates the differentiation of outer enamel epithelial cells in the enamel organ.METHODS:Tissue paraffin sections were prepared and subjected to hematoxylin-eosin(HE)staining to analyze the effect of Msx2 deficiency on the differentiation status of epithelial cells in the enamel organ at the morphological level.At the ultrastructural level,alterations in cell structure were analyzed.The intermediate steps mediating cell differentiation were identified.Transcriptome sequencing analysis was performed to validate the molecular mechanisms underlying the observed phenomena.RESULTS:Msx2 deficiency was innovatively found to induce severe squamous epithelial hyperplasia in outer enamel epithelial cells of enamel organ,accompanied by dynamic restructuring of the cell cytoskeleton and alterations in cell adhesion at the ultrastructure level.As a transcriptional repressor,the loss of Msx2 expression results in significant increases(P＜0.05 or P＜0.01)in the mRNA expression levels of integrin β2(Itgβ2),ItgαM,Itgα4,Rac family small GTPase 2(Rac2),Rac/Cdc42 guanine nucleo-tide exchange factor 6(Arhgef6)and protein tyrosine phosphatase receptor type C(Ptprc).CONCLUSION:Msx2 regu-lates cytoskeleton structure and cell-cell interaction through the Rho GTPases signaling pathway,thereby influencing the differentiation state of outer enamel epithelial cells.This study reveals the mechanism through which Msx2 regulates the differentiation of outer enamel epithelial cells,providing a theoretical foundation for the prevention and treatment of enam-el-related clinical dental diseases.