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.Establishment of graded management standards for off-label use of Shenqi fuzheng injection
Min WU ; Mei YU ; Shengnan YIN ; Dongmei LIU
China Pharmacy 2026;37(5):650-654
OBJECTIVE To establish the graded management standards for off-label use of Shenqi fuzheng injection. METHODS Systematic searches were conducted in databases including CNKI, PubMed and the Cochrane Library to retrieve guidelines/consensuses, systematic reviews/meta-analyses, and randomized controlled trials (RCTs) of Shenqi fuzheng injection. The quality of evidence was evaluated using AGREE Ⅱ, AMSTAR Ⅱ, and the Risk of Bias 1.0 tool recommended by Cochrane Collaboration, and the graded management standard for off-label use of Shenqi fuzheng injection was developed by using the Thomson grading system. RESULTS A total of 534 articles were involved, including 11 guidelines, 22 systematic reviews/meta-analysis, and 501 RCTs. They covered 79 off-label indications for Shenqi fuzheng injection: cancer-related fatigue, colorectal cancer and breast cancer, all with high-quality evidence were classified under grade A management (grade Ⅰ commendation), allowing all physicians across the hospital to prescribe relevant treatments; five diseases, such as ovarian cancer, liver cancer, leukemia, heart failure and cerebral infarction, were classified under grade B management (grade Ⅱa commendation), with prescription restricted to physicians with intermediate or higher professional titles in specific departments; eleven diseases, including sepsis, cervical cancer, esophageal cancer, etc., were classified under grade C management (grade Ⅱb commendation), requiring strict evaluation by senior physicians before prescription; the use of Shenqi fuzheng injection for other conditions was explicitly prohibited due to a lack of sufficient evidence. CONCLUSIONS Off-label use of Shenqi fuzheng injection is prevalent. The graded management standard established by evidence-based medical approach provides a scientific basis for standardizing the clinical application of traditional Chinese medicine injections and offers an operable paradigm for implementing differentiated drug use supervision in medical institutions.
3.Placenta derived mesenchymal stem cells inhibit the activation of rat astrocytes via TGF-β/Smad pathway
Ningmei LIU ; Taojuan WU ; Dongmei CHEN ; Ting LIU ; Xiaona MA ; Haibin MA ; Xueyun LIANG
Chinese Journal of Neuroanatomy 2025;41(2):187-193
Objective:To investigate the effects and its related mechanism of placenta-derived mesenchymal stem cells(PMSCs)on the lipopolysaccharides(LPS)damaged astrocytes.Methods:Primary astrocytes were isolated from the cerebral cortex of neonatal rats.The expression of glial fibrillary acidic protein(GFAP)was identified using immu-nofluorescence staining to evaluate the purity of the primary astrocytes.PMSCs were cocultured with LPS-treated astro-cytes.The expression levels of factors related to inflammation including interleukin-1β(IL-1β),inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),arginase-1(Arg-1),S100 calcium-bind-ing protein A10(S100A10),and TGF-β/Smad signaling pathway-related proteins such as transforming growth factor beta 1(TGF-β1),transforming growth factor beta type I receptor(TβRⅠ),transforming growth factor beta type II re-ceptor(TβRⅡ),phospho-Smad2 and phospho-Smad3(p-Smad2,p-Smad3)in astrocytes from each group were detec-ted using real time RT-PCR or Western blot techniques.Results:Astrocytes at the third passage exhibited an 80%pos-itivity rate for GFAP.After treated with 10 μg/ml LPS,the astrocytes expression levels of pro-inflammatory factors IL-1β,iNOS,IL-6,and TNF-α were significantly increased(P<0.05),while their expression levels of the anti-inflam-matory factors of Arg-1 and S100A10 were significantly decreased(P<0.05).Meanwhile,their expression levels of TGF-β/Smad signaling pathway related proteins of TGF-β1,TβRⅠ,TβRⅡ,p-Smad2 and Smad3 were increased(P<0.05).After the LPS damaged astrocytes were cocultured with PMSCs,their expression levels of pro-inflammatory factors IL-1β,iNOS,IL-6,and TNF-α were significantly decreased(P<0.05),while their expression levels of the anti-inflammatory factors of Arg-1 and S100A10 were significantly increased(P<0.05).Also,their expression levels of TGF-β/Smad signaling pathway related proteins of TGF-β1,TβRⅠ,TβRⅡ,p-Smad2,and Smad3 were decreased(P<0.05).Conclusion:PMSCs may inhibit the activation of A1 astrocytes through the TGF-β/Smad signaling path-way,by which reducing the astrocytic activation.
4.Study on the morphology of the mandibular basal bone and dental arch of skeletal Class Ⅱ malocclusion
Yu BAI ; Meng GAO ; Dongmei LIU ; Tao WANG ; Xue FENG
STOMATOLOGY 2025;45(6):436-439
Objective To study the relationship between the mandibular bone arch and the dental arch in patients with skeletal Class Ⅱ malocclusion and compare it with the Class Imalocclusion by establishing a 3D digital model.Methods A total of 25 cases with skeletal Class Ⅱ malocclusion and 25 cases with skeletal Class Ⅰ normal occlusion were selected.The mandibular model was scanned and a three-dimensional digital model was set up.After the determination of the WALA ridge and the FA point,the reference plane and coordinate system was established.Four degree polynomial curve fitting was performed with WALA ridge and FA point coordinates to re-present the corresponding basal and dental arch curves.The width difference between the basal arch curve and the dental arch curve was measured and calculated at 3 mm,10 mm,and 18 mm away from the horizontal axis of the coordinate.The differences of basal bone and dental arch width between skeletal Class Ⅱ and skeletal Class Ⅰ malocclusion was compared.Results The width differences be-tween the arch and the dental arch in the anterior,middle and posterior mandibular segments of skeletal Class Ⅱ patients were-1.58 mm,1.80 mm and 3.80 mm,respectively.The width differences between the arch and the dental arch in the anterior,middle and pos-terior mandibular segments of skeletal Class Ⅰ patients were 2.08 mm,2.92 mm and 4.24 mm,respectively.There was a significant difference between skeletal Class Ⅱ and skeletal Class Ⅰ in the anterior and middle segments(P<0.05),but no significant difference in the posterior segment(P>0.05).Conclusion In skeletal Class Ⅰ patients,the width of the basal bone is larger than that of the dental arch,and the dental arch was located medial to the basal bone.In skeletal Class Ⅱ patients,the width of the anterior arch is larger than the width of the basal bone,that is,the dental arch is located outside the basal bone.The width difference of the basal arch in skeletal Class Ⅱ is smaller than that in skeletal Class Ⅰ.
5.Practice and exploration of establishing"six-good"model party branches for retired cadres
Qiuyan ZHU ; Hui LIU ; Dongmei WANG
Modern Hospital 2025;25(7):1006-1009
In 2024,the Beijing Municipal Committee Organization Department and the Municipal Bureau of Retired Ca-dres initiated the first city-wide campaign to establish"Six-Good"model Party branches for retired cadres.The campaign set cri-teria including"optimal organizational setup,effective leadership,exemplary Party members,enriching learning activities,im-pactful contributions,and robust institutional adherence,"recognizing 100"Six-Good"model Party branches.Among them,the Third Retired Party Branch of Beijing Anding Hospital was honored as one of the first"Six-Good"model Party branches.This ar-ticle,based on practical experience,explores how to enhance the operational standards of Party branches and strengthen Party-building efforts among retired cadres through the"Six-Good"model initiative.The discussion covers the campaign's background,implementation experiences,and reflective insights.
6.Effects of Lycium barbarum glycopeptide on testes of senescent rats induced by D-galactose
Wenxin MA ; Chang LIU ; Jing PU ; Hongmei LI ; Li YANG ; Xiangdong ZHU ; Dongmei CHEN ; Huiming MA
Chinese Journal of Veterinary Science 2025;45(6):1296-1304
To investigate the protective effect of Lycium barbarum glycopeptide(LbGp)on testicu-lar injury induced by D-galactose(D-gal)in aging rats,male SD rats were randomly divided into 6 groups:the blank control group(Control),aging model group(Model),positive control group(β-nicotinamide mononucleotide,NMN),low dose LbGp group(LLbGp),medium dose LbGp group(MLbGp)and high dose LbGp group(HLbGp).The testicular mass of rats was counted,the morphological changes of testicular tissue were observed by hematoxylin-eosin(HE)staining,the testicular senescence was detected by β-galactosidase(SA-β-gal)staining,and the levels of testos-terone(T),luteinizing hormone(LH)and follicle stimulating hormone(FSH)in serum were de-tected.The levels of oxidative factors such as glutathione peroxidase(GSH-Px),superoxide dis-mutase(SOD),malondialdehyde(MDA),catalase(CAT)and inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-6(IL-6)in rat tissues were measured.TUNEL staining was used to detect the apoptosis of testicular cells,epididymal sperm quality,and the expression of Keap1,Nrf2 and Nqo1 mRNA were analyzed.The results showed that compared with the Model group,the testicular coefficient of Lycium barbarum glycopeptide rats in MLbGp and HLbGp groups increased(P<0.01),the level of T in serum and sperm quality increased(P<0.05),the structural degeneration and aging of testicular tissue decreased(P<0.01),the level of antioxidant factors increased,and the levels of inflammatory factors and apopto-sis decreased(P<0.05).The expression of Keap1 decreased significantly(P<0.01),while the ex-pression of Nrf2 and Nqo1 mRNA increased(P<0.05).The above results indicate that Lycium barbarum glycopeptide can improve D-gal-induced testicular senescence,attenuate oxidative stress,reduce inflammatory response,decrease apoptosis,and exert a protective effect on testicular injury in rats due to senescence through the Keap1-Nrf2 signaling pathway.
7.Advances in uveitis-glaucoma-hyphema syndrome and related research
Jiawei SONG ; Xiujuan DU ; Dongmei LIU
Chinese Journal of Experimental Ophthalmology 2025;43(10):973-978
Uveitis-glaucoma-hyphema syndrome is a rare complication after intraocular lens (IOL) implantation.The cause of the disease is the mechanical friction of the intraocular lens on the anterior segment structures.There is no unified consensus on the pathogenesis of UGH syndrome, and it is generally accepted that disruption of the blood-aqueous humor barrier and reverse pupillary block are the two common mechanisms.The typical clinical manifestations of UGH syndrome include anterior chamber inflammation, increased intraocular pressure and hyphema, with or without vitreous hemorrhage.It is easily misdiagnosed as uveitis.If untreated, it can lead to serious consequences such as loss of vision.The diagnosis of UGH syndrome is based on IOL implantation history, slit-lamp microscopy examination (especially after pupil dilation) that observes an IOL deviation or absence of the capsule, and an ultrasound biomicroscopy that observes contact between IOL and the iris or ciliary body.Treatment for UGH syndrome includes drugs, lasers, and surgery.At present, surgery is the primary method, mainly including IOL alignment, IOL removal or replacement, capsular tension ring implantation, etc.Laser treatments include laser iridoplasty, laser iridotomy and ciliary body laser photocoagulation.UGH syndrome has been reported more frequently abroad and is only reported as case reports in China.The purpose of this review is to discuss the etiology, pathogenesis and diagnosis of UGH syndrome.In addition, we discuss the treatment and caveats of UGH syndrome.The aim of review is to provide a more comprehensive basis for clinicians to understand, diagnose and treat UGH syndrome.
8.Research progress on intestinal ultrasound in the diagnosis and treatment of Crohn's disease
Huixian HUANG ; Yuehua YAN ; Jiaqin YI ; Xiaoyu LIU ; Dongmei LUO ; Hao WANG
Chinese Journal of Inflammatory Bowel Diseases 2025;09(6):487-491
Crohn's disease (CD), a chronic and recurrent inflammatory bowel disease, requires repeated intestinal evaluations. As a non-radioactive, non-invasive, well-tolerated, inexpensive and easily reproducible detection tool, intestinal ultrasound (IUS) has been more and more widely used in the diagnosis and treatment of CD in recent years. Various parameters of IUS, such as bowel wall thickness, bowel wall stratification, color doppler signals, and inflammatory mesenteric fat, provide a lot of critical information in the diagnosis and treatment of CD. IUS can not only accurately diagnose CD and its complications, but also well evaluate CD disease activity and treatment response, and effectively predict CD transmural remission, disease duration, surgical risk, and postoperative recurrence. IUS has demonstrated good accuracy in the diagnosis, evaluation and prediction of CD.
9.Effect of degree of neuromuscular block on intraoperative surgical conditions and postoperative recovery quality in patients undergoing lumbar interbody fusion
Jie GUO ; Xiaoyi CHEN ; Junda CHEN ; Xinghe WANG ; Dong HUANG ; Dongmei YUE ; Linlin ZHAO ; Junli CAO ; Su LIU
Chinese Journal of Anesthesiology 2025;45(4):444-448
Objective:To evaluate the effect of the degree of neuromuscular blockade on the intraoperative surgical conditions and postoperative recovery quality in patients undergoing lumbar interbody fusion.Methods:In this randomized controlled trial, 100 patients of either sex, aged 18-79 yr, with a body mass index of 18.5-35.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification < Ⅳ, scheduled for elective lumbar interbody fusion at the Affiliated Hospital of Xuzhou Medical University from August to October 2024, were allocated into 2 groups ( n=50 each) using stratified randomization based on the number of lumbar segments: deep neuromuscular blockade group (group D) and moderate neuromuscular blockade group (group M). The intraoperative post-tetanic count was maintained at 1 or 2 in group D, and the intraoperative train-of-four was maintained at 1 or 2 in group M. The scores for surgical conditions, duration of operation, blood loss, length of incision, occurrence of severe hypoxemia after extubation, requirement for rescue analgesia in post-anesthesia care unit, 15-item Quality of Recovery scale score and length of stay were recorded. Results:Compared with group M, the scores for surgical conditions were significantly increased, the rate of rescue analgesia in post-anesthesia care unit was decreased, 15-item Quality of Recovery scale scores were increased at 3 days after surgery ( P<0.05), and no significant changes were found in the duration of operation, blood loss, length of incision, incidence of severe hypoxemia after extubation and length of hospital stay in group D ( P>0.05). Conclusions:Compared with moderate neuromuscular blockade, deep neuromuscular blockade can provide better surgical conditions and improve the quality of early postoperative recovery for patients undergoing lumbar interbody fusion.
10.Epidemiology analysis of carbapenemase-producing Escherichia coli in a hospital in Henan Province from 2021 to 2023
Yue HU ; Xinwei LIU ; Yanying REN ; Dongmei LIU ; Yuchun LIU ; Qing XIA ; Yongwei LI ; Chunxia WANG
Chinese Journal of Preventive Medicine 2025;59(1):53-61
Objective:To analyze the epidemiological characteristics of drug resistance genes of carbapenemase-producing Escherichia coli (CPECO) in Henan Province Hospital of Traditional Chinese Medicine from 2021 to 2023, providing data support and theoretical basis for controlling nosocomial infections of CPECO.Methods:Using a cross-sectional study, 30 carbapenem-resistant Escherichia coli (CRECO) strains confirmed by VITEK-2 Compact identification and drug sensitivity test in the Clinical Microbiology Laboratory of Henan Province Hospital of Traditional Chinese Medicine from 2021 to 2023 were tested, using carbapenemase inhibitor enhancement test to conduct preliminary screening of carbapenemases, and colloidal gold immunochromatography and polymerase chain reaction (PCR) were used to determine the phenotypes and genotypes of common carbapenemases ( blaKPC, blaNDM, blaVIM, blaIMP, blaOXA) respectively, and the genotypes ( blaSHV, blaTEM, blaCTX) of common extended Spectrum beta-lactamases (ESBL) were confirmed using PCR. The PCR amplification products of carbapenemase and ESBL positive strains were Sanger-sequenced, and the sequencing products were compared on the Blast website to determine the exact carbapenemase and ESBL genotypes. Sequence typing (ST) was performed on CPECO using the Achtman multi-locus sequence typing scheme to determine the cloning relationship between different strains. Results:A total of 21 CPECO strains were screened. Drug sensitivity test results showed that CPECO strains showed widespread drug resistance, with the resistance rate to monocyclic (aztreonam) and trimethoprim/sulfamethoxazole being over 60%(16/21, 14/21), and the resistance rate to other antibacterial drugs being 100%. Only the sensitivity to aminoglycosides and fosfomycin remained relatively high, and no strains resistant to tigecycline and colistin were found. Colloidal gold immunochromatography detected 18 blaNDM types, 2 blaKPC types, and 1 blaIMP type. Sequencing of drug resistance gene PCR products classified 17 blaNDM-5 strains, 1 blaNDM-4 strain, 2 blaKPC-2 strain, and 1 blaIMP-4 strain, which were completely consistent with the results of screening test and colloidal gold immunochromatography. ESBL resistance gene testing showed that the detection rate of blaTEM was 42.9%(9/21), blaCTX-M was 33.3%(7/21), and blaSHV was 4.8%(1/21). The rate of blaNDM producing CPECO carrying both ESBL resistance genes was 27.8%(5/18). The MLST typing results revealed 11 sequence types (STs), including one ST155 clonal complex and nine singleton STs. Among these, there were seven strains of ST167, five strains of ST410, and one strain each of ST58, ST68, ST69, ST93, ST131, ST155, ST648, ST1114, and ST3268. Conclusion:The main resistance mechanism identified in this study for CPECO was the production of blaNDM-5 carbapenemase, with a high proportion of strains also carrying blaTEM-1D and/or blaCTX-M-15 ESBLs. MLST typing found that the epidemic strain of CPECO showed certain polymorphism, but there were clonal transmission of multiple clonal complexes between ST167 and ST410.

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