1.Introduction to Implementation Science Theories, Models, and Frameworks
Lixin SUN ; Enying GONG ; Yishu LIU ; Dan WU ; Chunyuan LI ; Shiyu LU ; Maoyi TIAN ; Qian LONG ; Dong XU ; Lijing YAN
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1332-1343
Implementation Science is an interdisciplinary field dedicated to systematically studying how to effectively translate evidence-based research findings into practical application and implementation. In the health-related context, it focuses on enhancing the efficiency and quality of healthcare services, thereby facilitating the transition from scientific evidence to real-world practice. This article elaborates on Theories, Models, and Frameworks (TMF) within health-related Implementation Science, clarifying their basic concepts and classifications, and discussing their roles in guiding implementation processes. Furthermore, it reviews and prospects current research from three aspects: the constituent elements of TMF, their practical applications, and future directions. Five representative frameworks are emphasized, including the Consolidated Framework for Implementation Research (CFIR), the Practical Robust Implementation and Sustainability Model (PRISM), the Exploration, Preparation, Implementation, Sustainment (EPIS)framework, the Behavior Change Wheel (BCW), and the Normalization Process Theory (NPT). Additionally, resources such as the Dissemination & Implementation Models Webtool and the T-CaST tool are introduced to assist researchers in selecting appropriate TMFs based on project-specific needs.
2.Adherence to blood glucose self-monitoring guidance and glycemic control in Chinese patients with type 2 diabetes mellitus initiating basal insulin: A mobile health-based prospective cohort study.
Lixin GUO ; Dalong ZHU ; Kaining CHEN ; Yaoming XUE ; Chao ZHOU ; Ping LIU ; Zhaohui HU ; Pei GU ; Wei ZHANG ; Huijie DONG ; Wanjun XIE ; Liqing GUAN
Chinese Medical Journal 2025;138(21):2832-2834
3.DiPTAC: A degradation platform via directly targeting proteasome.
Yutong TU ; Qian YU ; Mengna LI ; Lixin GAO ; Jialuo MAO ; Jingkun MA ; Xiaowu DONG ; Jinxin CHE ; Chong ZHANG ; Linghui ZENG ; Huajian ZHU ; Jiaan SHAO ; Jingli HOU ; Liming HU ; Bingbing WAN ; Jia LI ; Yubo ZHOU ; Jiankang ZHANG
Acta Pharmaceutica Sinica B 2025;15(1):661-664
4.Exploration of Milestone Evaluation System for Core Competencies in Knowledge and Skills of Neurology Residents
Liling DONG ; Dan XU ; Yuze CAO ; Siyuan FAN ; Hang LI ; Yicheng ZHU ; Lixin ZHOU ; Jun NI
Medical Journal of Peking Union Medical College Hospital 2025;16(6):1619-1628
To develop a milestone-based evaluation system for the core "knowledge and skills" competency of neurology residents that is tailored to China's medical context, so as to provide precise guidance for their training and assessment. Using the Delphi method, the study first constructed an initial framework through literature review, on-site investigation and expert-group discussion. Two rounds of expert consultation were then conducted among specialists in neurology education across China. Indicators were screened and optimized according to the mean score, agreement rate and coefficient of variation (CV), ultimately finalizing the system. The expert response rates in both rounds were 100%. The group authority coefficients were 0.97 and 0.98, with Cronbach's α of 0.90 and 0.88, respectively. The mean scores of all indicators ranged from 3.88 to 5.00, agreement rates from 62.50 % to 100 %, and CVs from 0 to 0.21. The finalized framework comprises one first-level indicator, three second-level indicators and 17 third-level indicators. The milestone evaluation system for core competencies in "knowledge and skills" of neurology residents developed in this study is scientific and reasonable, providing a standardized and scientific assessment tool for the standardized training of neurology residents.
5.Clinical features and disease outcomes of patients with fundus lesions associated with novel coronavirus infection
Shasha WANG ; Qiuming LI ; Yongwei ZHOU ; Jiahui WU ; Lixin MA ; Shuqian DONG
Chinese Journal of Experimental Ophthalmology 2024;42(11):1028-1035
Objective:To observe the clinical features and disease outcomes of patients with fundus lesions associated with novel coronavirus infection (COVID-19).Methods:A case series observational study was conducted.Eighteen eyes of 10 patients with COVID-19 related fundus lesions diagnosed in the First Affiliated Hospital of Zhengzhou University from December 2022 to February 2023 were included.The affected eyes were examined by best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscopy, scanning laser fundus photography (SLO), infrared fundus photography, optical coherence tomography (OCT), visual field and microperimetry.After the diagnosis was confirmed, according to the patients' willingness, 6 patients were treated with mecobalamin, vinblastine, and Aescuven forte orally.The other 4 patients were treated with glucocorticoid and methylprednisolone tablets orally with an initial dose of 32 mg/d, and the dose was reduced by 4 mg every 5 days, and potassium chloride tablets, calcium carbonate tablets, and omeprazole enteric-coated capsules were taken orally.According to the diagnosis and treatment of acute macular neuroretinopathy (AMN), the patients were divided into glucocorticoid treatment group (4 cases, 7 eyes) and non-glucocorticoid treatment group (4 cases, 8 eyes).The patients were followed up for 4 weeks.The BCVA, retinal morphology and structure, retinal sensitivity and fixation stability were compared before and after treatment.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (No.2022-KY-1482-002).Written informed consent was obtained from each subject.Results:Among the enrolled 10 cases (18 eyes), there were 9 cases (17 eyes) of AMN, including 1 eye with Purtscher-like retinopathy (PLR), 1 eye with acute para-central medial maculopathy (PAMM), and 1 eye with multiple transient white dot syndrome (MEWDS).The SLO images of AMN patients showed redbrown irregular lesions in the fovea or parafovea of the macular area.The OCT images showed patchy strong reflection between the OPL and ONL in the fovea or parafovea of the macular area, and the adjacent EZ/IZ had different degrees of local fracture, and the reflection signal was disordered.The BCVA of the eyes after 4 weeks of treatment was higher than that before treatment, and the difference was statistically significant ( Z=-2.823, P<0.05).After 4 weeks of treatment, the retinal sensitivity of the eyes was (26.57±2.24)dB, which was significantly higher than that before treatment (24.17±2.73)dB ( t=-11.329, P<0.001).There was no statistically significant difference in LogMAR BCVA and retinal sensitivity between the AMN glucocorticoid treatment group and the AMN non-glucocorticoid treatment group before and after 4 weeks of treatment ( Z=-0.986, P>0.05; t=-1.656, P>0.05). Conclusions:The main manifestations of COVID-19 related fundus lesions are AMN, PAMM, PLR, MEWDS, etc.OCT, microperimetry and other auxiliary examinations can help to diagnose the disease.The visual impairment and fundus structural changes caused by COVID-19 gradually improve after 4 weeks of treatment.
6.A chloride channel in mouse pancreatic acinar cells is activated by so-dium taurocholate and dependent on extracellular calcium but not reac-tive oxygen species pathway
Xiaoya YANG ; Jiawei LIN ; Dong YE ; Chan ZHAO ; Liwei WANG ; Lixin CHEN
Chinese Journal of Pathophysiology 2024;40(10):1806-1814
AIM:To investigate the activation of Cl-channels by sodium taurocholate(NaTC)in mouse pan-creatic acinar cells.METHODS:The single isolated pancreatic acinar cells from FVB/N mice were prepared using colla-genase digestion method.Whole-cell patch clamp technique was performed to record the currents.Intracellular adenosine triphosphate(ATP)dependence of the channels was examined via eliminating ATP from the pipette solution.Anion per-meability of the channels was investigated with ion-exchange method.The pharmacological characteristics of the channels was confirmed by two Cl-channel blockers.The volume sensitivity of the channels was detected using 47%hypertonic bathing solution.Extracellular Ca2+dependence of activating the channels was examined through eliminating Ca2+from the bathing solution.Intracellular reactive oxygen species(ROS)level was detected by an oxidation-sensitive fluorescent probe,2',7'-dichlorofluorescin diacetate.The experiment was repeated 6 times in each group.RESULTS:Extracellular application of 5 mmol/L sodium taurocholate induced a Cl-current,exhibiting the properties of outward-rectification,a se-lectivity sequence of I->Br-≥Cl->gluconate-and intracellularATP dependence(P<0.01).The currents were inhibited by chloride channel blocker 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid disodium salt hydrate(DIDS)and tamoxifen and by 47%hypertonicity stimulation(P<0.01).When ROS production was scavenged by N-acetyl-L-cysteine,the sodi-um taurocholate-induced Cl-currents were unaffected.The effect of sodium taurocholate on ROS production did not alter with the treatment with DIDS.Sodium taurocholate failed to induce Cl-currents when Ca2+was absent in extracellular bath-ing solution(P>0.05).CONCLUSION:Sodium taurocholate activates Cl-channels in mouse pancreatic acinar cells,which is dependent on extracellular Ca2+but not ROS pathway.
7.Correlation of "Parts-components-properties" of Traditional Chinese Medicines from Latex-containing Plants
Jianglong HE ; Baoyu JI ; Panpan LI ; Xiuqing LI ; Wange WU ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):124-132
ObjectiveTo investigate the correlation among the botanical characteristics, biological characteristics, chemical composition, and medicinal properties and efficacy of traditional Chinese medicines (TCM) from latex-containing plants, so as to strengthen the theory of "identifying symptoms for qualities" and provide a reference for the development and utilization of the latex-containing plant resources. MethodStatistics on the meridians for properties and tastes, efficacy, medicinal parts, family and genus, and chemical components of TCM from latex-containing plants were carried out. A total of 53 TCM from latex-containing plants included in the 2020 edition of the Chinese Pharmacopoeia were screened by mining the Chinese Botanical Journal, Chinese Materia Medica, Dictionary of Traditional Chinese Medicines, and related literature. In addition, their meridians for properties and tastes, medicinal parts, chemical components, and TCM classifications were summarized and statistically analyzed by using Excel 2013 and ChiPlot 2023.3.31 software. ResultIt was found that latex-containing plants were mainly distributed in one kingdom, one phylum, two classes, and 20 families, and most of the TCM from latex-containing plants belonged to Dicotyledonaceae under Angiosperms. In terms of properties and tastes, plain>cold>warm>cool>hot and bitter>pungent>sweet>sour>salty. In terms of meridians, liver>lung>kidney>spleen=large intestine=stomach>heart>bladder=gallbladder=small intestines. In terms of medicinal parts, roots (root, rhizomes, tuberous root, and root bark)>resin>seed>whole herb (whole herb and above-ground part)>stem (stem and branch)>fruit>leaf>flower=skin. In terms of research on chemical components, they were mostly glycosides. In terms of TCM classification, they were mostly medicines for activating blood circulation and removing blood stasis. ConclusionThe TCM from latex-containing plants is mainly plain, with a uniform warm and cold distribution. The tastes are mainly bitter and pungent, and the major meridians are the liver and lung. The roots and resins are mainly used as medicines. The components mostly contain glycosides, alkaloids, and volatile oils, and most of them are medicines for activating blood circulation and removing blood stasis, as well as for removing heat and toxins. There is a certain degree of correlation among the growth habits, medicinal parts, chemical components, and the properties, tastes, and efficacy of the TCM from latex-containing plants. It may provide a reference for resource development and utilization of TCM from latex-containing plants.
8.Correlation Analysis of Traditional Chinese Medicines from Fungi Based on "Habit-Growth Environment-part-medicinal Properties"
Xiuqing LI ; Baoyu JI ; Jianglong HE ; Panpan LI ; Wange WU ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):133-139
ObjectiveThe relevant laws among the biological characteristics, medicinal parts, growth environment, and medicinal properties and efficacy of traditional Chinese medicines (TCM) from fungi were excavated, so as to strengthen the theory of distinguishing symptoms for quality and provide a reference for the development and utilization of TCM from fungi. MethodThe medicinal parts, meridians for properties and tastes, heterotrophic mode, and efficacy of commonly used TCM from fungi were summarized. By consulting the Compendium of Materia Medica, Shennong Materia Medica, Flora of China, and literature, the TCM from fungi indexed in the 2020 edition of the Chinese Pharmacopoeia and some local pharmacopeias were checked. ResultA total of 28 common TCM from fungi were selected. Different TCMs from fungi have different meridians for properties and tastes, medicinal parts, habits, and growth environments. The relevant information was counted. Among the four properties, plain>cold>warm. Among the five tastes, sweet>bitter>light>pungent=salty. In terms of medicinal parts, fruiting body>sclerotia>complex>spermia=outer skin=other. In terms of meridians, lung>liver=heart>spleen=kidney>stomach. In terms of habits, parasitism>saprophysis>symbiosis=facultative parasitism=facultative saprophysis. ConclusionTCM from fungi are mainly parasitic and saprophytic, and the plain property and sweet taste the most. The meridians are mostly lung, heart, and liver. Nourishment and diuresis are the main efficacy. There is a certain correlation between the color, habit, medicinal parts, and growth environment of TCM from fungi and their properties, tastes, and efficacy, providing comprehensive literature reference and theoretical basis for their in-depth research, clinical use, and resource development.
9.Correlation of "Medicinal Tissue-property, Taste, and Efficacy-clinical Application" of Traditional Chinese Medicine from Plant Skin
Panpan LI ; Baoyu JI ; Jianglong HE ; Xiuqing LI ; Wange WU ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):149-158
ObjectiveTo investigate the functions and characteristics of traditional Chinese medicine (TCM) from plant skin and their Chinese patent medicines and explore the related laws of the medicinal tissue, property, taste, efficacy, and clinical application, so as to strengthen the theory of identifying symptoms for qualities and provide references for the development and utilization of TCM from plant skin and their Chinese patent medicines. MethodBy reviewing the 2020 edition of the Chinese Pharmacopoeia and some local pharmacopeias, TCM from plant skin and their Chinese patent medicines were screened out, and the characteristics, functions, and precautions of TCM from plant skin and their Chinese patent medicines were summarized. Statistical analysis was carried out with Excel. ResultA total of 62 TCM from plant skin were found, mainly distributed in one kingdom, three phyla, and 31 families. In terms of the family genus, Rutaceae>Leguminosae>Cucurbitaceae. In terms of the medicinal tissue, bark>root bark>fruit bark>seed bark. In terms of property and taste, warm>cold>plain>cool>hot, and bitter>sweet=pungent>acidic. In terms of meridians, lung>liver>spleen>heart>colorectal>kidney>stomach=bladder. In terms of TCM classification, most of them belong to the category of heat-clearing medicines. There were 485 types of Chinese patent medicines from plant skin, with the most Chinese patent medicines containing Citri Reticulatae Pericarpium. Among the forms of administration, pills were the most predominant. In terms of the tastes of the medicines, bitter and sweet flavors predominated. In terms of functions, medicines for strengthening the body resistance were the most. For the precautions, contraindications during pregnancy were the most common. ConclusionThere is a correlation among medicinal tissue, property, taste, efficacy, and clinical application of TCM from plant skin. It is also necessary to pay attention to the contraindications of the medicines and rationally choose TCM from plant skin and their Chinese patent medicines under the guidance of TCM theory based on syndrome differentiation and treatment.
10.Reliability of photogrammetry for evaluating pelvic posture in healthy individuals
Miaomiao DONG ; Xiang LI ; Jiani XIE ; Lixin ZHANG ; Yuexi WANG
Chinese Journal of Tissue Engineering Research 2024;28(36):5846-5851
BACKGROUND:In clinical practice,the anterior superior iliac spine and posterior superior iliac spine are usually located by palpation,and the tilt of the pelvis is determined by visual observation method or photogrammetry.Among them,the visual observation method can only have qualitative conclusions,and its reliability is poor.The photogrammetry is not only more convenient and fast,but also can give more accurate quantitative data,which is one of the best clinical evaluation methods.However,there are no studies on the reliability of pelvic posture assessment using photogrammetry in China. OBJECTIVE:To evaluate the pelvic posture by visual observation method and photogrammetry,and to compare the reliability level of the two methods to guide clinical application. METHODS:Forty-five healthy subjects were selected and red marks were made at the bilateral anterior superior iliac spine and posterior superior iliac spine.Pelvic posture was photographed from the front,back(coronal plane),left,and right(sagittal plane).The left and right pelvic tilt angles(α,β angles)were selected from the front and back views,which represented the angle between the bilateral anterior superior iliac spine line or the bilateral posterior superior iliac spine line and the horizontal line.The anterior and posterior pelvic tilt angles(γ,θ angles)were selected from the side view,which represented the angle between the ipsilateral anterior superior iliac spine and posterior superior iliac spine line and the horizontal plane,indicating the sagittal plane pelvic tilt.Evaluation methods included visual observation method and photogrammetry.Two evaluators independently evaluated the pelvic α,β,γ,θ angles using the visual observation method first,and then recorded the pelvic α,β,γ,θ angles using the photogrammetry.After a one-month interval,the visual observation method and photogrammetry were performed again,and the pelvic α,β,γ,θ angles were recorded.The intraclass correlation coefficients were used to analyze the data obtained from the two evaluation methods and the before-and-after measurements:0.90-0.99 as an excellent correlation,0.80-0.89 as a good correlation,0.70-0.79 as a moderate correlation,and≤0.69 as a poor correlation.The standard error of measurement and the minimal detectable change with 95%confidence intervals were calculated to evaluate the inter-rater and intra-rater reliability. RESULTS AND CONCLUSION:(1)The interrater intraclass correlation coefficients of the visual observation method and photogrammetry were as follows:anterior view:0.682 and 0.718,posterior view:0.513 and 0.867,left view:0.739 and 0.960,and right view:0.756 and 0.971.The visual observation method showed poor correlation between the anterior and posterior views and moderate correlation between the left and right views,while the photogrammetry showed moderate correlation for the anterior view,good correlation for the posterior view,and excellent correlation for the left and right views.The standard error values of measurement were as follows:anterior view:3.266 and 1.625,posterior view:4.278 and 1.763,left view:5.935 and 1.787,and right view:5.723 and 1.698.The minimal detectable change values with 95%confidence intervals were as follows:anterior view:9.053 and 4.504,posterior view:11.858 and 4.887,left view:16.451 and 4.953,and right view:15.863 and 4.707.(2)The interrater intraclass correlation coefficients of the visual observation method and photogrammetry were as follows:anterior view:0.452 and 0.723,posterior view:0.483 and 0.904,left view:0.518 and 0.955,and right view:0.657 and 0.968.The visual observation method showed poor correlation in all four directions,while the photogrammetry showed moderate correlation for the anterior view and excellent correlation for the other three directions.The standard error values of measurement were as follows:anterior view:5.651 and 1.610,posterior view:4.237 and 1.523,left view:7.322 and 1.891,and right view:6.509 and 1.781.The minimal detectable change values with 95%confidence intervals were as follows:anterior view:15.664 and 4.463,posterior view:11.744 and 4.222,left view:20.296 and 5.242,and right view:18.042 and 4.937.(3)These results confirm that the sagittal and coronal plane photogrammetries have good intrarater and interrater reliability for evaluating pelvic posture,especially with the use of the photogrammetry,which has good data stability.This method is simple,fast,efficient,accurate,low-cost,and does not cause X-ray damage,and can qualitatively and quantitatively reflect the actual situation of the patient's pelvis,making it suitable for clinical use.

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