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.Mechanism of calcium-sensing receptor regulating macrophage polariza-tion in hypertensive rats
Xiaofang YANG ; Lijuan HE ; Na TANG ; Lamei WANG ; Yuanyuan QU ; Hua ZHONG ; Qiang ZHANG ; Fengmei DENG ; Bin TANG ; Dongmei XI ; Fang HE
Chinese Journal of Pathophysiology 2025;41(4):625-636
AIM:To explore the role and mechanism of calcium-sensing receptor(CaSR)in regulating macro-phage polarization in hypertensive rats.METHODS:Male spontaneously hypertensive rats(SHR)and Wistar-Kyoto(WKY)rats were categorized into WKY group,SHR group,SHR+R568(CaSR agonist)group,and SHR+NPS2143(CaSR inhibitor)group.The thoracic aorta was isolated,and the expression of CaSR and macrophage polarization markers in the aorta was observed through immunofluorescence staining.The primary peritoneal macrophages of SHR and WKY rats were aseptically extracted following anesthesia.After intervention with R568 and NPS2143,the expression levels of M1 and M2 markers of peritoneal macrophages were observed by Western blot and immunofluorescence staining.The levels of interleukin(IL)-1β and IL-10 were measured by ELISA.The concentration of Ca2+in peritoneal macrophages was mea-sured by immunofluorescence.Western blot was employed to identify the expression of CaSR and nucleotide-binding oligo-merization domain-like receptor protein 3(NLRP3)inflammasome components.Following anesthesia,vascular smooth muscle cells(VSMCs)were isolated from SHR using an adherent method.Subsequently,a co-culture system was estab-lished with macrophage supernatant.The optimal action time for this co-culture system was determined through CCK-8 as-say.RESULTS:Compared with SHR group,activation of CaSR resulted in a significant decrease in the protein expres-sion of M1 polarization markers(P<0.05)and a concomitant increase in the protein expression of M2 polarization markers in the aorta(P<0.05).Compared with SHR group,administration of R568 led to a significant decrease in the protein ex-pression of M1 polarization markers(P<0.05)and a concomitant increase in the protein expression of M2 polarization markers(P<0.05)in peritoneal macrophages.Additionally,there was a notable reduction in the protein levels of NLRP3 inflammasome components(P<0.05).Furthermore,the fluorescence intensity of intracellular Ca2+was significantly en-hanced following R568 treatment(P<0.05).After administration of MCC950,an NLRP3 inflammasome inhibitor,the re-sults were consistent with those observed following R568 treatment,demonstrating statistical significance(P<0.05).This effect was reversed by the combined intervention of U73122,a phospholipase C(PLC)inhibitor(P<0.05).Compared with the control(0 h),the 24-h peritoneal macrophage supernatant exhibited the strongest capacity to enhance the viabili-ty of VSMCs after 24 h of culture(P<0.05).CONCLUSION:In hypertensive rats,the CaSR inhibits NLRP3 inflamma-some activation via the PLC-Ca2+signaling pathway,thereby mediating an increase in macrophage polarization towards the M2 phenotype and a decrease towards the M1 phenotype.
3.Mechanism of calcium-sensing receptor regulating macrophage polariza-tion in hypertensive rats
Xiaofang YANG ; Lijuan HE ; Na TANG ; Lamei WANG ; Yuanyuan QU ; Hua ZHONG ; Qiang ZHANG ; Fengmei DENG ; Bin TANG ; Dongmei XI ; Fang HE
Chinese Journal of Pathophysiology 2025;41(4):625-636
AIM:To explore the role and mechanism of calcium-sensing receptor(CaSR)in regulating macro-phage polarization in hypertensive rats.METHODS:Male spontaneously hypertensive rats(SHR)and Wistar-Kyoto(WKY)rats were categorized into WKY group,SHR group,SHR+R568(CaSR agonist)group,and SHR+NPS2143(CaSR inhibitor)group.The thoracic aorta was isolated,and the expression of CaSR and macrophage polarization markers in the aorta was observed through immunofluorescence staining.The primary peritoneal macrophages of SHR and WKY rats were aseptically extracted following anesthesia.After intervention with R568 and NPS2143,the expression levels of M1 and M2 markers of peritoneal macrophages were observed by Western blot and immunofluorescence staining.The levels of interleukin(IL)-1β and IL-10 were measured by ELISA.The concentration of Ca2+in peritoneal macrophages was mea-sured by immunofluorescence.Western blot was employed to identify the expression of CaSR and nucleotide-binding oligo-merization domain-like receptor protein 3(NLRP3)inflammasome components.Following anesthesia,vascular smooth muscle cells(VSMCs)were isolated from SHR using an adherent method.Subsequently,a co-culture system was estab-lished with macrophage supernatant.The optimal action time for this co-culture system was determined through CCK-8 as-say.RESULTS:Compared with SHR group,activation of CaSR resulted in a significant decrease in the protein expres-sion of M1 polarization markers(P<0.05)and a concomitant increase in the protein expression of M2 polarization markers in the aorta(P<0.05).Compared with SHR group,administration of R568 led to a significant decrease in the protein ex-pression of M1 polarization markers(P<0.05)and a concomitant increase in the protein expression of M2 polarization markers(P<0.05)in peritoneal macrophages.Additionally,there was a notable reduction in the protein levels of NLRP3 inflammasome components(P<0.05).Furthermore,the fluorescence intensity of intracellular Ca2+was significantly en-hanced following R568 treatment(P<0.05).After administration of MCC950,an NLRP3 inflammasome inhibitor,the re-sults were consistent with those observed following R568 treatment,demonstrating statistical significance(P<0.05).This effect was reversed by the combined intervention of U73122,a phospholipase C(PLC)inhibitor(P<0.05).Compared with the control(0 h),the 24-h peritoneal macrophage supernatant exhibited the strongest capacity to enhance the viabili-ty of VSMCs after 24 h of culture(P<0.05).CONCLUSION:In hypertensive rats,the CaSR inhibits NLRP3 inflamma-some activation via the PLC-Ca2+signaling pathway,thereby mediating an increase in macrophage polarization towards the M2 phenotype and a decrease towards the M1 phenotype.
4.Comparison of esketamine versus dexmedetomidine in improving adverse mood after cesarean section
Dongmei ZHU ; Fengzhi LIU ; Ximing LI ; Xiaoyan ZHANG ; Benjuan LIU ; Lina ZHONG ; Peng XIA
Chinese Journal of Anesthesiology 2024;44(3):277-281
Objective:To compare esketamine versus dexmedetomidine in improving the adverse mood after cesarean section.Methods:One hundred and fourteen pregnant women undergoing elective cesarean section, aged 20-45 yr, with body mass index≤33 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, were divided into 3 groups ( n=38 each) by the random number table method: esketamine group (group S), dexmedetomidine group (group D) and control group (group C). After delivery, esketamine was intravenously injected as a bolus of 0.3 mg/kg, followed by an infusion of 0.3 mg·kg -1·h -1 throughout the surgery in group S, dexmedetomidine was intravenously injected as a bolus of 0.6 μg/kg, followed by an infusion of 0.6 μg·kg -1·h -1 throughout the surgery in group D, while the equal volume of normal saline was given instead, followed by an infusion of 14 ml/h throughout the surgery in group C. Patient-controlled intravenous analgesia was performed after the end of surgery. Esketamine 50 mg, sufentanil 50 μg and ondansetron 8 mg were given in group S, dexmedetomidine 200 μg, sufentanil 50 μg and ondansetron 8 mg were given in group D, while sufentanil 50 μg and ondansetron 8 mg were given in group C. When the visual analog scale score ≥4 within 48 h after operation, flurbiprofen axidate was intravenously injected as a rescue analgesic. Self-rating Anxiety Scale (SAS) scores and Edinburgh Postnatal Depression Scale (EPDS) scores were assessed at 1 day before surgery and 2 and 7 days after surgery. Serum levels of brain-derived neurotrophic factor (BDNF) were measured by enzyme-linked immunosorbent assay at 1 day before surgery and 2 days after surgery. The effective pressing times of patient-controlled analgesia (PCA) and requirement for rescue analgesia after operation were recorded. The occurrence of adverse reactions during operation and within 48 h after operation was also recorded. Results:Compared with group C, SAS scores and EPDS scores were significantly decreased at 2 and 7 days after surgery, serum BDNF concentrations were increased at 2 days after surgery, the effective pressing times of PCA were reduced, the requirement for rescue analgesia was decreased, and the incidence of intraoperative nausea and vomiting was reduced in S and D groups ( P<0.05). Compared with group D, SAS scores and EPDS scores were significantly decreased at 7 days after surgery, the effective pressing times of PCA were reduced ( P<0.05), and no significant change was found in serum BDNF concentrations at 2 days after surgery and requirement for rescue analgesia in group S ( P>0.05). The incidence of dreaminess was significantly higher in group S than in group C and group D ( P<0.05). Conclusions:Esketamine is better than dexmedetomidine in improving the adverse mood after cesarean section.
5.Effect of loading angle and fabrication materials on stress distribution with periodontal splint in compromised periodontal tissues: a finite element study
Ming FANG ; Yuchen LIU ; Sheng ZHONG ; Dongmei LI ; Tong YANG ; Shizhu BAI
Chinese Journal of Stomatology 2024;59(11):1120-1125
Objective:To evaluate the effect of polyetheretherketone (PEEK) periodontal splints and splints made from other materials under static loading on stress distributions in periodontal tissues, cement layer, and splints themselves.Methods:A finite element model based on cone-beam CT imaging data of a 25-year-old male patient (treated at the Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University in October 2021 for a cracked maxillary molar) with a healthy and intact mandibular dentition and periodontal health was constructed. The finite element model included anterior mandible dentition, mandibular bone model without bone resorption (WBR group), a periodontally compromised mandible model (control group), and three types of periodontal splints: a PEEK periodontal splint (0.7 mm thick, Young′s modulus: 4.1 MPa), a fiber-reinforced resin (FRC) splint (1.0 mm thick, Young′s modulus: 37.0 MPa), and a titanium splint (1.2 mm thick, Young′s modulus: 110.0 MPa). The bone resorption models fixed with different periodontal splints constituted the experimental groups (PEEK group, FRC group and titanium group). Loading of 100 N was applied on the midpoint of the incisal edge of tooth 41. The direction was set at 0°, which was parallel to the long axis of the tooth and downward. The buccal to lingual and downward angles were 30°and 60°, respectively, perpendicular to the long axis of the tooth and 90° to the lingual side. The finite element analysis software was utilized to analyze the stress distribution characteristics of the periodontal tissues, adhesive layer, and the splint itself in the anterior mandibular teeth among the different group.Results:Under the different loading simulation, in the control group, the maximal von Mises stresses of periodontal ligament and bone were 15.7-50.2 MPa and 38.8-130.3 MPa, respectively, and in the WBR group, the maximal von Mises stresses of periodontal ligament and bone were 3.6-6.4 MPa and 16.5-42.7 MPa, respectively. Under the same loading conditions, the magnitude of maximal von Mises stresses in periodontal tissues in the PEEK group was 4.6-6.2 MPa, and the magnitude of stresses in the periodontal ligament of 41 teeth in the WBR group was similar to that in the PEEK group, but higher than that in the FRC and titanium groups. The maximal von Mises stresses of each group is primarily distributed in the periodontal ligament and alveolar bone at the cervical area of the tooth. The higher the elastic modulus of the splint, the higher its own maximal von Mises stresses, and the smaller the maximal principal stresses transmitted to the adhesive layer. In the PEEK group and titanium group, the stress distribution area in the adhesive layer and the splint was near the splint connection adjacent to tooth 41.Conclusions:Periodontal splints fabricated from three types of materials, are effective in distributing stress within the periodontal tissues of the abutment teeth. Compared to FRC and titanium group, the higher PEEK splint stress value was obtained, and the smaller the stress value was transmitted to its adhesive layer.
6.A Method for Developing Implementation Strategies to Address Implementation Barriers: the CFIR-ERIC Matching Tool
Wanqing HUANG ; Dongmei ZHONG ; Siyuan LIU ; Yunyun XIE ; Jiangyun CHEN ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1182-1191
Implementation strategies are targeted interventions aimed at promoting the adoption, implementation, and sustainment of research findings or evidence-based practices in routine healthcare. If implementation strategies can precisely match implementation barriers and facilitators, the likelihood of successful implementation will increase. The CFIR-ERIC matching tool, which can match corresponding ERIC implementation strategies based on CFIR barriers, is a convenient and direct tool for developing implementation strategies. This paper provides a detailed overview of the origins and development of the CFIR-ERIC matching tool, outlines its contents and usage, and illustrates how to apply the tool to develop implementation strategies by using a brief smoking cessation intervention project as an example. The paper also discusses the advantages and limitations of using this tool for developing implementation strategies, with the aim of providing methodological reference for other researchers.
7.High quality development of large public hospital procurement agency management practice
Huimei DENG ; Dongmei LI ; Junxue ZHONG ; Yun HE
Modern Hospital 2024;24(12):1872-1874
Government procurement in large public hospitals is one of the important links in hospital internal control management.Procurement agencies play an important role in hospital procurement,and are important participants and assistants in hospital government procurement.In order to strengthen the hospital integrity risk prevention and control system and strictly strengthen the internal control management,it is particularly important to select a procurement agency that conforms to the hospi-tal's own business characteristics and explore the establishment of a scientific and reasonable procurement agency management system and process.This paper takes the Cancer Prevention and Control Center of Sun Yat-sen University as an example to ex-plore the practical experience of procurement agency management,which is of great significance for the standardized and effi-cient,risk prevention and fine management of public hospitals'procurement activities and the improvement of the service level of procurement agencies.
8.High quality development of large public hospital procurement agency management practice
Huimei DENG ; Dongmei LI ; Junxue ZHONG ; Yun HE
Modern Hospital 2024;24(12):1872-1874
Government procurement in large public hospitals is one of the important links in hospital internal control management.Procurement agencies play an important role in hospital procurement,and are important participants and assistants in hospital government procurement.In order to strengthen the hospital integrity risk prevention and control system and strictly strengthen the internal control management,it is particularly important to select a procurement agency that conforms to the hospi-tal's own business characteristics and explore the establishment of a scientific and reasonable procurement agency management system and process.This paper takes the Cancer Prevention and Control Center of Sun Yat-sen University as an example to ex-plore the practical experience of procurement agency management,which is of great significance for the standardized and effi-cient,risk prevention and fine management of public hospitals'procurement activities and the improvement of the service level of procurement agencies.
9.Effect of kaempferol on the proliferation, migration and invasion of cervical cancer cells through circFBXW7
Min ZHONG ; Jiangyue TANG ; Dongmei JIANG ; Jie ZHOU
International Journal of Biomedical Engineering 2023;46(2):110-115
Objective:To investigate the effect of kaempferol on proliferation, migration, and invasion of cervical cancer SiHa cells by regulating circFBXW7.Methods:SiHa cells were treated with kaempferol at low, medium, and high doses (15, 30, and 60 μmol/L) for 24 h. Untreated SiHa cells were used as the control group. CCK-8 was used to detect the effect of kaempferol on the proliferation of SiHa cells. Transwell was used to detect the effect of kaempferol on the migration and invasion of SiHa cells. Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of circFBXW7 in SiHa cells. pcDNA and pcDNA-circFBXW7 were transfected into SiHa cells, respectively, and si-NC and si-circFBXW7 were transfected into SiHa cells after adding 60 μmol/L kaempferol treatment for 24 h. The effects of circFBXW7 and its knockdown, circFBXW7, on the proliferation, migration, and invasion of SiHa cells were investigated, and the effects of E-cadherin and N-cadherin protein expression levels were detected by Western Blot. Results:Compared with the control group, the cell value-added, migration, and invasion abilities of the low, medium, and high dose groups were decreased (all P < 0.05) and were dose-related, and the expression of circFBXW7 was increased ( P < 0.05). After transfection with pcDNA-circFBXW7, the expression of circFBXW7 increased ( P < 0.05), while promoting the proliferation, cell migration, and invasion of kaempferol on SiHa cells (all P < 0.05). After transfection with si-circFBXW7, the expression of circFBXW7 decreased ( P < 0.05), while inhibiting the proliferation, cell migration, and invasion of kaempferol on SiHa cells (all P < 0.05). That indicated that the transfection of si-circFBXW7 could attenuate the inhibitory effects of kaempferol on the above oncogenic phenotypes of SiHa cells. Compared with the control group, E-cadherin expression was upregulated, and N-cadherin expression was downregulated in the low, medium, and high dose groups (all P < 0.05) in a dose-related manner. After transfection of pcDNA-circFBXW7 with SiHa cells, the expression of E-cadherin was increased, and the expression of N-cadherin was decreased (all P < 0.05). After transfection of si-circFBXW7 with SiHa cells, the expression of E-cadherin decreased, and the expression of N-cadherin increased (all P < 0.05). Conclusions:Kaempferol can reduce the proliferation, migration, and invasion abilities of SiHa cells by promoting circFBXW7 expression.
10.Short-term clinical outcomes of different courses of antenatal corticosteroids for preterm twins
Dongmei SUN ; Zhiye QI ; Qinghua ZHONG ; Siyu LIU ; Baowen FAN ; Xiaoxiao TANG ; Yi HE ; Wanxin LI ; Zhuoyi GAO ; Yunbo XIE ; Li YANG ; Yue NING ; Kun LIANG ; Jiang DUAN
Chinese Journal of Neonatology 2023;38(9):539-544
Objective:To study the short-term clinical outcomes of different courses of antenatal corticosteroids (ACS) for preterm twins.Methods:From January 2017 to December 2021, preterm twins with gestational age (GA) 24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied. The infants were assigned into single-course group, partial-course group and multiple-course group according to ACS courses. The short-term clinical outcomes were compared among the groups. SPSS software version 25.0 was used for statistical analysis.Results:A total of 286 infants were enrolled in this study, including 128 in single-course group, 89 in partial-course group and 69 in multiple-course group. Compared with single-course group, the risks of neonatal respiratory distress syndrome (RDS) in both partial-course group ( OR=2.332, 95% CI 1.028-5.293, P=0.043) and multiple-course group ( OR=3.872, 95% CI 1.104-13.584, P=0.034) were higher. The birth length in multiple-course group ( β=-0.016, 95% CI -0.029 - -0.002, P=0.024) was lower than single-course group. Conclusions:The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS. A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.

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