1.Rapid Qualitative Analysis Methods and Their Application in Implementation Science
Xuehan WEI ; Xiaoying CHEN ; Runze WANG ; Yingqian ZHANG ; Xuehan LIU ; Jin SUN ; Guoyan YANG ; Wei XIAO ; Chunli LU
Medical Journal of Peking Union Medical College Hospital 2026;17(2):546-556
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.
2.Antidepressant mechanism of Jieyu-Anshen formula combined with sele-nium in CUMS mice via NF-κB signaling pathway
Yuanyuan WANG ; Fandi TAN ; Guoyan WANG ; Shenghui HUANG
Chinese Journal of Pathophysiology 2025;41(11):2110-2119
AIM:This study investigates the antidepressant mechanism of Jieyu-Anshen formula combined with selenium in chronic unpredictable mild stress(CUMS)mice through network pharmacology and animal experiments.METHODS:Potential drug targets were identified using the TCMSP,Genecards,and STRING databases.A protein-pro-tein interaction network was then constructed,followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Ge-nomes(KEGG)enrichment analyses and molecular docking validation.Sixty male KM mice were divided into six groups:control,model,selenium,Jieyu Anshen formula,selenium+Jieyu Anshen formula,and fluoxetine.Depression-like behav-iors were assessed using the tail suspension test,forced swimming test,and elevated plus-maze test.Enzyme-linked immu-nosorbent assay(ELISA)was used to measure hippocampal levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,5-hydroxytryptamine(5-HT),and dopamine(DA).Histopathological changes in the hippocampus were ex-amined using hematoxylin and eosin(HE)staining.Additionally,protein expression levels of nuclear factor-κB p65(NF-κB p65),phospho-NF-κB-p65(p-NF-κB p65),prostaglandin-endoperoxide synthase 2(PTGS2),glutathione peroxidase 4(GPX4),and selenoprotein S(SelS)were detected through immunohistochemistry and Western blot.RESULTS:Jieyu-Anshen formula combined with selenium significantly improved depression-like behaviors in CUMS mice,reduced inflammatory cytokine(IL-6,TNF-α and IL-1β)levels,restored the levels of 5-HT and DA,and inhibited NF-κB signal-ing pathway activation.CONCLUSION:Jieyu Anshen formula combined with selenium significantly improved depres-sion-like behaviors in CUMS mice,potentially by improving hippocampal morphology,modulating the NF-κB signaling pathway,suppressing inflammatory factor expression,and enhancing hippocampal 5-TH and DA levels.
3.Antidepressant mechanism of Jieyu-Anshen formula combined with sele-nium in CUMS mice via NF-κB signaling pathway
Yuanyuan WANG ; Fandi TAN ; Guoyan WANG ; Shenghui HUANG
Chinese Journal of Pathophysiology 2025;41(11):2110-2119
AIM:This study investigates the antidepressant mechanism of Jieyu-Anshen formula combined with selenium in chronic unpredictable mild stress(CUMS)mice through network pharmacology and animal experiments.METHODS:Potential drug targets were identified using the TCMSP,Genecards,and STRING databases.A protein-pro-tein interaction network was then constructed,followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Ge-nomes(KEGG)enrichment analyses and molecular docking validation.Sixty male KM mice were divided into six groups:control,model,selenium,Jieyu Anshen formula,selenium+Jieyu Anshen formula,and fluoxetine.Depression-like behav-iors were assessed using the tail suspension test,forced swimming test,and elevated plus-maze test.Enzyme-linked immu-nosorbent assay(ELISA)was used to measure hippocampal levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,5-hydroxytryptamine(5-HT),and dopamine(DA).Histopathological changes in the hippocampus were ex-amined using hematoxylin and eosin(HE)staining.Additionally,protein expression levels of nuclear factor-κB p65(NF-κB p65),phospho-NF-κB-p65(p-NF-κB p65),prostaglandin-endoperoxide synthase 2(PTGS2),glutathione peroxidase 4(GPX4),and selenoprotein S(SelS)were detected through immunohistochemistry and Western blot.RESULTS:Jieyu-Anshen formula combined with selenium significantly improved depression-like behaviors in CUMS mice,reduced inflammatory cytokine(IL-6,TNF-α and IL-1β)levels,restored the levels of 5-HT and DA,and inhibited NF-κB signal-ing pathway activation.CONCLUSION:Jieyu Anshen formula combined with selenium significantly improved depres-sion-like behaviors in CUMS mice,potentially by improving hippocampal morphology,modulating the NF-κB signaling pathway,suppressing inflammatory factor expression,and enhancing hippocampal 5-TH and DA levels.
4.Diagnostic value of D-dimer combined with NT-proBNP and neutrophil percentage in differentiating acute aortic dissection from acute myocardial infarction and pulmonary embolism
Guoyan ZHU ; Ximing WANG ; Dongze YU ; Kai CUI ; Zhou ZHOU ; Jinxing YU
Chinese Journal of Laboratory Medicine 2025;48(8):985-991
Objective:To investigate the application value of D-dimer (D-D) as the primary indicator, combined with NT-proBNP and neutrophil percentage in the differential diagnosis of acute aortic dissection (AAD), pulmonary embolism (PE), and acute myocardial infarction (AMI).Methods:A retrospective case-control study was conducted, including 764 patients with acute chest pain who presented to the Emergency Department of Beijing Fuwai Hospital from March 1st, 2024, to February 28th, 2025. Patients were clinically diagnosed with AAD (299 cases) and other acute chest pain conditions (AMI 425 cases, PE 40 cases). The AAD group had the age of 56.00 (45.00, 64.00) years old with 226 males (75.59%); the AMI group had a median the age of 65.00 (55.00, 70.00) years with 339 males (79.76%); and the PE group had the age of 70.00 (59.75, 74.00) years with 15 males (37.50%). Baseline clinical data were collected and compared among the three groups, including general parameters such as heart rate, systolic blood pressure, and diastolic blood pressure. Laboratory parameters included N-terminal pro-brain natriuretic peptide (NT-proBNP), prothrombin time (PT), activated partial thromboplastin time (APTT), D-D, cardiac troponin I (cTnI), myoglobin, creatine kinase-MB (CK-MB), white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, and mean platelet volume (MPV). Comparisons between groups were performed using the Kruskal-Wallis rank-sum test and χ2 test. Independent discriminatory factors were identified through multivariate logistic regression analysis, and the diagnostic performance of individual indicators and combined models were analyzed using receiver operating characteristic (ROC) curves.Results:The D-D level in the AAD group [3.93 (1.48, 19.59) μg/ml] was significantly higher than that in the AMI group [0.26 (0.14, 0.56) μg/ml] and PE group [2.13 (0.84, 6.13) μg/ml] ( F=200.12, P<0.001). Multivariate analysis showed that D-D, NT-proBNP, neutrophil percentage, and lymphocyte percentage were all independent factors for differentiating AAD from AMI. NT-proBNP, total white blood cell count, neutrophil percentage, and lymphocyte percentage were independent predictors for differentiating AAD from PE. ROC analysis showed that D-D had an area under the curve (AUC) of 0.93 (95% CI 0.91-0.95) for differentiating AAD from AMI, with a sensitivity of 81.6% and specificity of 92.9%. In the differential diagnosis between AAD and PE, the model combining D-dimer, NT-proBNP, and neutrophil percentage had an AUC of 0.86 (95% CI 0.80-0.91), with a sensitivity of 85.0% and a specificity of 72.5%. Conclusion:D-D has significant value in the differential diagnosis of AAD from AMI and PE, with particularly good individual diagnostic performance for differentiating AAD from AMI. Combining NT-proBNP and neutrophil percentage can significantly improve differential diagnostic performance.
5.Application and efficacy of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery
Zihui SUN ; Wei MENG ; Guoyan SUN ; Wenjuan WANG ; Min YAN ; Hui XIAO ; Shuangba HE
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(5):520-526
Objective:To explore the the application and outcomes of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery.Methods:We conducted a retrospective analysis of 296 patients(including 3 cases of pseudohermaphroditism and 293 transgender women)who underwent this procedure at the Voice Center of Nanjing Tongren Hospital of Otolaryngology-Head and Neck Surgery between November 2014 and August 2023. The patients, aged 18-50 years (mean age of 28.3±14.5) underwent feminizing laryngoplasty via transoral microsurgery, involving resection of the superficial lamina propria of the anterior vocal cords and subglottic tissues of the anterior commissure, followed by vocal ligament plication to achieve vocal cords shortening and anterior commissure retrodisplacement. Patients adhered to a1-month voice rest postoperatively and subsequently underwent speech rehabilitation training. Subjective/objective voice analyses, aerodynamic evaluations, and stroboscopic examinations were performed at 3, 6, and 12 months postoperatively to assess the effectiveness of voice feminization.Results:All surgeries were performed successfully and 94.3% (279/296) of the patients reported satisfaction at the end of the one-year follow-up. For effective cases, fundamental frequency (F 0) increased by 57.42±16.72 Hz compared to baseline. Postoperative acoustic/aerodynamic parameters and stroboscopic findings of vocal cord mucosal wave motion remained within normal ranges. These results indicated that this voice feminization surgery combined with postoperative pronunciation training achieved natural and feminine vocal characteristics. Conclusion:The combination of vocal cord shortening and anterior commissure retrodisplacement, along with postoperative pronunciation training, represents an effective surgical strategy for achieving a natural feminine voice.
6.Diagnostic value of D-dimer combined with NT-proBNP and neutrophil percentage in differentiating acute aortic dissection from acute myocardial infarction and pulmonary embolism
Guoyan ZHU ; Ximing WANG ; Dongze YU ; Kai CUI ; Zhou ZHOU ; Jinxing YU
Chinese Journal of Laboratory Medicine 2025;48(8):985-991
Objective:To investigate the application value of D-dimer (D-D) as the primary indicator, combined with NT-proBNP and neutrophil percentage in the differential diagnosis of acute aortic dissection (AAD), pulmonary embolism (PE), and acute myocardial infarction (AMI).Methods:A retrospective case-control study was conducted, including 764 patients with acute chest pain who presented to the Emergency Department of Beijing Fuwai Hospital from March 1st, 2024, to February 28th, 2025. Patients were clinically diagnosed with AAD (299 cases) and other acute chest pain conditions (AMI 425 cases, PE 40 cases). The AAD group had the age of 56.00 (45.00, 64.00) years old with 226 males (75.59%); the AMI group had a median the age of 65.00 (55.00, 70.00) years with 339 males (79.76%); and the PE group had the age of 70.00 (59.75, 74.00) years with 15 males (37.50%). Baseline clinical data were collected and compared among the three groups, including general parameters such as heart rate, systolic blood pressure, and diastolic blood pressure. Laboratory parameters included N-terminal pro-brain natriuretic peptide (NT-proBNP), prothrombin time (PT), activated partial thromboplastin time (APTT), D-D, cardiac troponin I (cTnI), myoglobin, creatine kinase-MB (CK-MB), white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, and mean platelet volume (MPV). Comparisons between groups were performed using the Kruskal-Wallis rank-sum test and χ2 test. Independent discriminatory factors were identified through multivariate logistic regression analysis, and the diagnostic performance of individual indicators and combined models were analyzed using receiver operating characteristic (ROC) curves.Results:The D-D level in the AAD group [3.93 (1.48, 19.59) μg/ml] was significantly higher than that in the AMI group [0.26 (0.14, 0.56) μg/ml] and PE group [2.13 (0.84, 6.13) μg/ml] ( F=200.12, P<0.001). Multivariate analysis showed that D-D, NT-proBNP, neutrophil percentage, and lymphocyte percentage were all independent factors for differentiating AAD from AMI. NT-proBNP, total white blood cell count, neutrophil percentage, and lymphocyte percentage were independent predictors for differentiating AAD from PE. ROC analysis showed that D-D had an area under the curve (AUC) of 0.93 (95% CI 0.91-0.95) for differentiating AAD from AMI, with a sensitivity of 81.6% and specificity of 92.9%. In the differential diagnosis between AAD and PE, the model combining D-dimer, NT-proBNP, and neutrophil percentage had an AUC of 0.86 (95% CI 0.80-0.91), with a sensitivity of 85.0% and a specificity of 72.5%. Conclusion:D-D has significant value in the differential diagnosis of AAD from AMI and PE, with particularly good individual diagnostic performance for differentiating AAD from AMI. Combining NT-proBNP and neutrophil percentage can significantly improve differential diagnostic performance.
7.Application and efficacy of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery
Zihui SUN ; Wei MENG ; Guoyan SUN ; Wenjuan WANG ; Min YAN ; Hui XIAO ; Shuangba HE
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(5):520-526
Objective:To explore the the application and outcomes of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery.Methods:We conducted a retrospective analysis of 296 patients(including 3 cases of pseudohermaphroditism and 293 transgender women)who underwent this procedure at the Voice Center of Nanjing Tongren Hospital of Otolaryngology-Head and Neck Surgery between November 2014 and August 2023. The patients, aged 18-50 years (mean age of 28.3±14.5) underwent feminizing laryngoplasty via transoral microsurgery, involving resection of the superficial lamina propria of the anterior vocal cords and subglottic tissues of the anterior commissure, followed by vocal ligament plication to achieve vocal cords shortening and anterior commissure retrodisplacement. Patients adhered to a1-month voice rest postoperatively and subsequently underwent speech rehabilitation training. Subjective/objective voice analyses, aerodynamic evaluations, and stroboscopic examinations were performed at 3, 6, and 12 months postoperatively to assess the effectiveness of voice feminization.Results:All surgeries were performed successfully and 94.3% (279/296) of the patients reported satisfaction at the end of the one-year follow-up. For effective cases, fundamental frequency (F 0) increased by 57.42±16.72 Hz compared to baseline. Postoperative acoustic/aerodynamic parameters and stroboscopic findings of vocal cord mucosal wave motion remained within normal ranges. These results indicated that this voice feminization surgery combined with postoperative pronunciation training achieved natural and feminine vocal characteristics. Conclusion:The combination of vocal cord shortening and anterior commissure retrodisplacement, along with postoperative pronunciation training, represents an effective surgical strategy for achieving a natural feminine voice.
8.Effects of beta-blockers for congestive heart failure in pediatric patients:Meta-analysis
Yadan WANG ; Hui LI ; Jinping LIU ; Kunxian ZHANG ; Guoyan ZHAO
China Pharmacist 2024;27(2):345-356
Objective To systematically evaluate the efficacy of β-blocker in pediatric patients with congestive heart failure and congenital heart disease,and to provide evidence for clinician.Methods Before-and-after self-control study and randomized controlled trials were retrieved from PubMed,EMbase,the Cochrane Library,CNKI,WanFang,VIP databases,and the search time was from the establishment of the database to October 31,2023.All outcomes included left ventricular ejection fraction(LVEF),left ventricular fraction shortening,LVFS),left ventricular end-diastolic dimension(LVDD),Left ventricular end-systolic dimension(LVSD),N-terminal proB brain natriuretic peptide(NT-proBNP),heart rate,blood pressure and cardiac function improvement.Results A total of 20 trials involving 1 068 children with heart failure(dilated cardiomyopathy and endocardial fibroelastosis were included.Meta-analysis results showed that the addition of β-blockers(metoprolol succinate,bisoprolol and carvedilol)on the basis of conventional drug therapy for heart failure had significant effects on LVEF[MD=13.06,95%CI(11.67,14.45),P<0.001],LVFS[MD=6.96,95%CI(6.54,7.37),P<0.001],LVDD[MD=-6.43,95%CI(-7.58,-5.28),P<0.001]and LVSD[MD=-8.30,95%CI(-8.83,-7.76),P<0.001]were significantly improved.In addition,blood pressure,heart rate,NT-proBNP and cardiac function could also be improved.Conclusion The combination regimen of β-blockers on the basis of conventional drug therapy for heart failure can improve cardiac function and symptoms of heart failure in children with congestive heart failure.Therefore,it is recommended that β-blockers should be actively used in the conventional treatment regimen for children with congestive heart failure.
9.Chinese Translation of the Stanford Expectations of Treatment Scale and Its Application Evaluation on Traditional Chinese Medicine for Diarrhea-Predominant Irritable Bowel Syndrome with Liver-Constraint and Spleen-Deficiency Syndrome
Shibing LIANG ; Yingying ZHANG ; Zhijie WANG ; Zeyu YU ; Mei HAN ; Huijuan CAO ; Guoyan YANG ; Shihuan CAO ; Hongjie CHENG ; Qiaoyan ZHANG ; Youzhu SU ; Yufei LI ; Jianping LIU
Journal of Traditional Chinese Medicine 2024;65(19):1994-2001
ObjectiveTo adapt the Stanford Expectations of Treatment Scale(SETS) into Chinese(C-SETS) and test the feasibility, validity and reliability of its application in patients with diarrhea-predominant irritable bowel syndrome(IBS-D) with liver-constraint and spleen-deficiency syndrome treated with traditional Chinese medicine(TCM). MethodsWe obtained authorisation from the developer of the SETS, and followed the principle of "two-way translation" to translate the SETS by literal translation and back translation to form the C-SETS. Ninety-six IBS-D patients with liver-constraint and spleen-deficiency syndrome were enrolled as respondents and filled out C-SETS before receiving treatment; the feasibility was assessed by the recall rate, completion rate and the duration of filling out the scale; the reliability was assessed by Cronbach's α; the structural validity was assessed by exploratory and confirmatory factor analysis, and the content validity was assessed by correlation analysis. ResultsThe C-SETS consists of 10 items, with the 1st, 3rd, and 5th rating items constituting the Positive Expectations subscale, and the 2nd, 4th, and 6th rating items constituting the Negative Expectations subscale, each of which is rated on a 7-point Likert Scale. The recall of C-SETS was 100%(96/96), the completion rate was 89.58%(86/96); Cronbach's α for the Positive and Negative Treatment Expectations subscales were 0.845 and 0.854, respectively; exploratory factor analysis showed that the coefficient of commonality for all six entries was larger than 0.4, and that the six entries could be used by both factors to explain 77.092% of the total variance; validation factor analysis showed that the goodness-of-fit index, comparative fit index, root mean square of approximation error, canonical fit coefficient, and chi-square degrees of freedom ratio took the values of 0.943, 1.003, 0, 0.943, and 0.626, respectively; and the results of Spearman's analysis suggested that the C-SETS had good content validity. ConclusionThe C-SETS has well feasibility, reliability, and validity, which initially proves that it can be used as a tool to assess the treatment expectation of patients with IBS-D with liver-constraint and spleen-deficiency syndrome before receiving TCM treatment.
10.Clinical remission and transmural healing of ustekinumab in patients with Crohn's disease
Yun WU ; Yalan XU ; Guoyan ZHANG ; Yuanyuan ZHANG ; Junyao WANG ; Peng YOU ; Tao PENG ; Yulan LIU ; Ning CHEN
Journal of Peking University(Health Sciences) 2024;56(2):253-259
Objective:To treat the Crohn's disease(CD)patients with ustekinumab(UST),to eva-luate their clinical and endoscopic remission,and to evaluate their transmural response(TR)and trans-mural healing(TH)condition using intestinal ultrasonography(IUS).Methods:Retrospective analysis was made on patients diagnosed with CD in Peking University People's Hospital from January 2020 to Au-gust 2022,who were treated with UST for remission induction and maintenance therapy.All the patients were evaluated on both week 8 and week 16/20 after treatment,including clinical,biochemical indica-tors,colonoscopy and IUS examination.Results:A total of 13 patients were enrolled in this study,inclu-ding 11 males and 2 females.The minimum age was 23 years,the maximum age was 73 years and the mean age was 36.92 years.All the patients were in the active stage of disease before treatment,and the average Best Crohn's disease activity index(Best CDAI)score was 270.12±105.55.In week 8,the Best CDAI score of the patients decreased from 270.12±105.55 to 133.16±48.66(t=4.977,P<0.001).Eight patients achieved clinical remission while 5 patients remained in the active stage.Nine patients underwent colonoscopy evaluation.The average simple endoscopic score for Crohn's disease(SES-CD)score decreased from 10.71±7.14 before treatment to 6.00±7.81(t=2.483,P=0.048)in week 16/20.Four patients achieved endoscopic remission while 5 patients did not.In week 8,5 pa-tients achieved TR,2 patients achieved TH,the other 6 patients did not get TR or TH.In week 16/20,6 patients achieved TR,3 patients achieved TH while the other 4 patients did not get TR or TH.There was no significant statistical difference in the TR effect of UST between small intestine and colon lesions(Fisher test,P>0.999).The rate of UST transmural response in the patients who had had previous bio-logical agent therapy was lower than those with no previous biological agent therapy,but there was no sig-nificant statistical difference(Fisher test,P=0.491).Conclusion:After treatment of UST,the clinical and endoscopic conditions of the CD patients had been improved,and some patients could achieve clini-cal remission and endoscopic remission.UST had good TR and TH effects on CD.TR might appear in week 8,and the TR effect increased in week 16/20.There was no significant statistical difference in the TR effect between small intestine and colon lesions.TR effect of UST was better in the patients who had no previous biological agent therapy than those who had had other biological agents,but the result had no significant statistical difference.

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