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.

Objective: To explore whether the long-term and frequent use of citrate anticoagulants negatively affects the bone metabolism balance of female frequent plateletpheresis donors, so as to better protect their health. Methods: A total of 65 female plateletpheresis donors and 55 female whole-blood donors from Guangzhou Blood Center (May to December 2024) were enrolled as experimental and control groups respectively, stratified into age subgroups (18-39 years and 40-60 years). Serum levels of 25-hydroxyvitamin D [25(OH)D], procollagen type I N-terminal propeptide (PINP), osteocalcin (OC), and type I collagen carboxy-terminal telopeptide (CTX) were measured. Differences in bone metabolism markers between experimental and control groups across age subgroups were compared. ANOVA was used to analyze dose-response relationships between donation age, annual apheresis donation frequency, and biochemical indicators. Results: In the 40-60 age subgroup, 25(OH)D levels were significantly lower in the experimental group (P<0.05), exhibiting a linear increase with age and a linear decrease with annual donation frequency. No significant differences in CTX or PINP levels were observed between experimental and control groups in either age subgroup. Conclusion: High-frequency plateletpheresis donation does not disrupt bone metabolic balance in female donors. However, it is associated with reduced vitamin D levels in female donors aged >40 years, potentially increasing the risk of osteoporosis. Vitamin D supplementation is recommended for high-frequency female plateletpheresis donors in this age group.

Glaucoma, the leading cause of irreversible blindness worldwide, remains a central focus of ophthalmic research, particularly with regard to surgical management. Conventional procedures, such as trabeculectomy with mitomycin and glaucoma drainage device implantation, continue to be considered the gold standard because of their strong intraocular pressure lowering efficacy. However, these operations are associated with relatively high rates of postoperative complications, and perioperative fluctuations in intraocular parameters can introduce refractive prediction errors that ultimately compromise visual quality. In recent years, minimally invasive glaucoma surgery(MIGS)has gained increasing attention for its advantages in reducing complications, shortening operative time, minimizing incision size, and accelerating visual recovery, while better preserving postoperative refractive stability. This review systematically summarizes the differences in refractive outcomes between conventional surgery and MIGS, examines the underlying mechanisms, and discusses practical clinical strategies to manage refractive shifts. The aim is to provide a theoretical foundation for precise refractive management in glaucoma surgery, thereby enhancing patients' visual quality and overall quality of life.

Vision is the primary perceptual mode through which humans and higher animals acquire external information. Visual perception encompasses various aspects of visual processing and has been widely applied in ophthalmic clinical practice. Based on the principle of neural plasticity, visual perception training relies on the visual signal processing mechanism. After receiving external visual signals, the retina transmits them via the optic nerve to the brain, where the cerebral cortex decodes, extracts, and processes the information. By stimulating specific visual information, visual perception training activates visual processing pathways, strengthens synaptic connections among neurons within these pathways, and ultimately enhances the cerebral cortex's ability to integrate and process information, thereby improving patients' visual function and experience. This article explores the application of visual perception training in conditions such as amblyopia, myopia, presbyopia, strabismus, glaucoma, macular degeneration, and optic pathway lesions, discussing its value in improving visual function. It provides theoretical references for the intervention and treatment of related diseases. Visual perception training has been widely applied in various ophthalmic diseases with confirmed clinical efficacy, and it may play a broader role in neurologically related systemic diseases, demonstrating certain clinical application value.

AIM:To investigate the predictive value of aqueous humor stromal cell-derived factor-1(SDF-1)and epithelial neutrophil-activating peptide-78(ENA78)for visual impairment following vitrectomy in patients with diabetic retinopathy(DR).METHODS: Patients with DR who underwent vitrectomy in the ophthalmology department of our hospital from March 2022 to March 2024 were enrolled as study group. According to the results of uncorrected visual acuity examination during the 1-year follow-up after surgery, they were further divided into visual impairment group and good visual acuity group. In addition, patients with cataracts who were treated in our hospital during the same period were recruited as control group. The levels of SDF-1 and ENA78 in aqueous humor were detected by enzyme-linked immunosorbent assay(ELISA). Pearson correlation analysis was used to evaluate the correlation of indicators. Multivariate Logistic regression analysis was performed to identify the influencing factors of postoperative visual impairment in DR patients. Relative risk analysis was conducted to assess the impact of different aqueous humor SDF-1 and ENA78 levels on postoperative visual impairment in DR patients. Receiver operating characteristic(ROC)curve analysis was applied to determine the predictive value of aqueous humor SDF-1 and ENA78 levels for postoperative visual impairment in DR patients.RESULTS: Totally 156 cases(156 eyes)were enrolled in the study group, including 87 males and 69 females, with a mean age of 60.65±8.91 years old; and 91 cases(91 eyes)were enrolled in the control group, including 53 males and 38 females, with a mean age of 58.72±8.43 years old. The levels of SDF-1 and ENA78 in aqueous humor of the study group were significantly higher than those of the control group(P<0.001). According to the results of uncorrected visual acuity during the 1-year follow-up after surgery, the study group was further divided into the visual impairment group(n=49)and the good visual acuity group(n=107), including 28 males and 21 females in the visual impairment group, with a mean age of 63.73±7.41 years, and 59 males and 48 females in the good visual acuity group, with a mean age of 59.24±8.47 years. The age and glycated hemoglobin(HbA1c)levels of the visual impairment group were higher than those of the good visual acuity group(all P<0.05). Compared with the good visual acuity group, the levels of SDF-1 and ENA78 in aqueous humor of the visual impairment group were significantly elevated(all P<0.05). A positive correlation was found in the study group between the levels of SDF-1, ENA78 in aqueous humor and HbA1c(r=0.314, 0.362, all P<0.05). Elevated levels of aqueous humor SDF-1(OR=2.936, 95% CI: 1.628-5.296)and ENA78(OR=3.092, 95% CI: 1.738-5.502)were identified as risk factors for postoperative visual impairment in DR patients(all P<0.05). High levels of SDF-1 and ENA78 increased the risk of postoperative visual impairment by 1.958-fold and 2.030-fold compared with the low-level groups, respectively; the area under the curve(AUC)of combined detection of aqueous humor SDF-1 and ENA78 for predicting postoperative visual impairment in DR patients was 0.936, which was superior to the predictive value of SDF-1 or ENA78 alone(Zcombination-SDF-1=2.850, Zcombination-ENA78=2.445, all P<0.05).CONCLUSION: Elevated levels of aqueous humor SDF-1 and ENA78 are risk factors for postoperative visual impairment in DR patients, and the combined detection of SDF-1 and ENA78 has high clinical application value for predicting postoperative visual impairment in DR patients.

Objective To quantitatively assess the exposure-response association between exposure to heatwave and sudden death, estimate the attributable excess deaths, and identify potential vulnerable subgroups. Methods A time-stratified case-crossover study was conducted among residents who died from sudden death in Jiangsu Province, China between 2015 and 2021. Heatwave events in Jiangsu Province, defined using varying relative temperature thresholds and durations, were identified using temperature data from the China Meteorological Administration Land Data Assimilation System (CLDAS V2.0). Individual heatwave exposure was assessed based on each subject's residential address. The exposure-response association between heatwave and sudden death was evaluated using conditional logistic regression model combined with a Distributed Lag Nonlinear Model(DLNM). Heatwave-attributable excess deaths were estimated. Stratified analyses by sex and age were performed to assess potential effect modifications. Results Under all definitions, exposure to heatwave was significantly associated with an increased risk of sudden death, and the risk increased with the intensity of heatwave. Using the P95_3d definition (temperature exceeding the 95th percentile for ≥3 consecutive days), heatwave was significantlyassociated with a 56% increased risk of sudden death (95% CI: 31%, 86%). The population-attributable fraction of sudden death due to heatwave exposure was 1.45% (95% CI: 0.97%, 1.90%). Stratified analyses indicated no statistically significant differences in the association between heatwave exposure and sudden death across age or sex subgroups. Conclusion Heatwave exposure was associated with an increased risk of sudden death. Reducing heatwave exposure during summer may help lower the occurrence of sudden death.

Objective To analyze the changes of levels of serum soluble growth stimulation expressed gene 2 (sST2) and albumin (ALB) in patients with chronic heart failure (CHF) and their correlation with prognosis. Methods The data of 216 patients with CHF (CHF group) and 98 healthy subjects with physical examination (healthy control group) were retrospectively analyzed. The changes in levels of serum sST2 and ALB between both groups and among different grades of New York Heart Association (NYHA), and their correlation with NYHA grading and cardiac function and their diagnostic value on the prognosis in patients with CHF were compared. Results The level of serum sST2 and LVEF value of CHF group were significantly higher than those of healthy control group (P<0.05) while the level of serum ALB was significantly lower than that of healthy control group (P<0.05). There were significant differences in the levels of serum sST2 and ALB and LVEF value among patients with different HYHA grades and pairwise comparison between the any two grades (P<0.05). Serum sST2 level in patients with CHF was positively correlated with NYHA grading (P<0.001) and was negatively correlated with LVEF (P<0.001), and serum ALB level was negatively correlated with NYHA grading (P<0.001), and was positively correlated with LVEF (P<0.001). Serum sST2 level of poor prognosis group was significantly higher than that of good prognosis group (P<0.05) while serum ALB level was significantly lower than that of good prognosis group (P<0.05). ROC curve analysis of serum sST2 combined with ALB in diagnosing poor prognosis in CHF patients showed that the AUC and sensitivity were 0.907 and 98.04%, which were higher than the single diagnosis, and the specificity was 81.82%, which was lower than the single diagnosis. Conclusion The levels of serum sST2 and ALB in patients with CHF are correlated with NYHA grading and cardiac function, and the combination of the two indicators has high diagnostic value on predicting the poor prognosis of patients.

Objective To evaluate the effects of inhaled conditioning with a mixture of lavender oil and citrus oil on sleep and depressive symptoms in puerperium women. Methods A randomized controlled trial design was used in this study. Convenience sampling method was used to select 144 pregnant women who gave birth in different hospitals in Shenzhen and were willing to spend the puerperium in the maternity center. According to the random number table method, the subjects were divided into the control group (n=68) and the intervention group (n=76). The intervention was mixed inhalation of lavender oil and citrus oil. Pittsburgh Sleep Quality Index (PSQI), Edinburgh Postnatal Depression Scale (EPDS) and numerical rating Scale (NRS) were used to evaluate the subjects before and after the intervention. Results After the intervention, the PSQI total score, EPDS total score and pain score of the intervention group were significantly lower than those before the intervention (P<0.05). In particular, the intervention group showed the most significant improvements in sleep quality, time to fall asleep, sleep disturbance, and hypnotic medication use (P<0.05), while the control group showed improvements only in time to fall asleep and sleep disturbance. In addition, pain scores decreased in both groups, but the decrease was greater in the intervention group. Conclusions Inhalation of lavender oil and citrus oil can effectively improve the sleep quality, depression and pain of puerperium women, and provide a safe and effective non-drug therapy for puerperium women.

Objective To investigate the effect of bone metabolic markers on sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 412 patients with T2DM in the department of endocrinology of Nanjing Central Hospital from May 2020 to June 2025 were selected as the research subjects. According to Asian Working Group for Sarcopenia (AWGS) in 2019, these patients were evaluated for skeletal muscle mass index (ASMI), muscle strength, and muscle function, and were divided into a sarcopenia group (84 cases) and a non-sarcopenia group (328 cases). The glucolipid metabolic indexes were detected in both groups of patients, and the bone metabolic markers were evaluated, including procollagen type 1 N-terminal peptide (P1NP), beta-C-terminal telopeptide of type 1 collagen (β-CTX), and 25-hydroxy vitamin D [25-(OH)D]. The factors influencing the occurrence of sarcopenia in T2DM patients were analyzed by logistic regression analysis, and the diagnostic values of bone metabolic markers on sarcopenia in patients with T2DM were assessed by ROC curve. Results The levels of P1NP and 25-(OH)D were lower, while β-CTX level was higher in the sarcopenia group compared to the non-sarcopenia group, with statistical differences (P<0.05). After logistic correlation analysis, it was found that P1NP, β-CTX and 25-(OH)D were all influencing factors for the occurrence of sarcopenia in T2DM patients. ROC curve analysis suggested that combined detection of PINP, β-CTX, and 25-(OH)D had higher diagnostic value, with an area under the curve up to 0.805. Conclusion The abnormal expression of bone metabolic markers is associated with the increased risk of sarcopenia in patients with T2DM. The detection of serum bone metabolic markers expression level is of certain significance for the assessment of diabetes-related sarcopenia.

Objective The aim of this study was to investigate the correlation between the interaction of uric acid and inflammatory factors and hyperuricemia in overweight/obese patients. Methods The personnel with hyperuricemia who underwent physical examination in our hospital from September 2021 to September 2022 were selected as the study subjects, and they were divided into 100 cases of overweight group and 90 cases of obese group according to the BMI index; 120 cases of healthy and non-hyperuricemic personnel were randomly selected as the control group; venous blood of the three groups was collected in 5 mL after 8 h of fasting, and were tested respectively for serum uric acid, lipid indexes and inflammatory factors: IL-6, IL-2, IFN-γ, TNF-α, IL-4, IL-10. Results Glucose, triglycerides, total cholesterol, and LDL were significantly higher in the obese group versus the overweight group (P<0.001), while HDL was significantly lower than the control group (P<0.001), and these changes were more pronounced in the obese group (P<0.001).The Pearson correlation coefficient pointed out that the levels of serum uric acid in patients with hyperuricosuric acid were significantly associated with the pro-inflammatory factors IL- 6, IL-2, IFN-γ, and TNF-α were significantly positively correlated (P<0.001), whereas they were significantly negatively correlated with the anti-inflammatory factors IL-4, IL-10 (P<0.001). Conclusion High uric acid levels in overweight/obese patients can cause enhanced inflammatory responses and reduced expression levels of anti-inflammatory factors, and the interaction between uric acid and pro-inflammatory factors aggravates the condition of patients with hyperuricemia.