1.Reporting Guidelines in Implementation Science:Overview,Categorization and Future Directions
Xiaoshan CHEN ; Dadong WU ; Run WANG ; Qing ZHAO ; Siyuan LIU ; Wanqing HUANG ; Zizhen HUANG ; Yuting WAN ; Huanyu HU ; Junlin ZHU ; Jiangyun CHEN ; Zhiwei HUANG ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(4):1033-1046
Reporting guidelines are structured checklists for researchers to follow when reporting spe-cific types of studies.As researches conducted in real-world settings to address practical issues,implementa-tion research has stringent requirements for the replicability of result and the transparency of reporting,making its reporting guidelines particularly important.This paper systematically introduces the reporting guidelines in the field of implementation science,outlines their classification systems and scopes of applica-tion,and focuses on explaining the core characteristics and functions of five key reporting guidelines,inclu-ding the Standards for Reporting Implementation Studies(StaRI),Reporting guidelines for implementation and operational research,the Template for Intervention Description and Replication(TIDieR),the Frame-work for Reporting Adaptations and Modifications-Enhanced(FRAME),and recommendations for specifying and reporting implementation strategies.Furthermore,combined with the PEDALs research paradigm in im-plementation science,this paper further clarifies the specific application pathways for reporting guidelines and discusses directions for refinement,aiming to provide references for researchers to select appropriate reporting guidelines.
2.Innovative Practices of Precision Nutrition in Obesity Intervention:From Theory to Application
Hua NING ; Rennan FENG ; Huanyu WU ; Changhao SUN
Journal of Sichuan University (Medical Sciences) 2025;56(4):893-899
Obesity has emerged as a critical global public health challenge,with an urgent need for effective prevention and control strategies.Traditional nutritional intervention approaches often overlook individual variability and dietary complexity,which limits their effectiveness in achieving precision-based prevention and control.In this context,nutritional intervention strategies are gradually shifting from population-based models to individualized precision nutrition models,which integrate and analyze multidimensional data to open new pathways for obesity prevention and control.The theoretical framework of precision nutrition is based on the recognition that individual heterogeneity in biological mechanisms underlies individual variations in nutritional needs.The research approaches in precision nutrition include genomics,epigenetics,metagenomics,metabolomics,and integrated multi-omics analyses.In terms of application,precision nutrition combines advanced external dietary exposure assessment tools—such as Internet-based dietary assessment systems and AI-driven image recognition—with omics-derived internal biomarkers to enable accurate quantification of dietary intake.Principles such as holistic dietary integrity,full coverage of dietary restrictions,optimized cooking methods,and chrononutrition are emphasized in intervention strategies.Future efforts in precision nutrition should focus on overcoming technical challenges,including thorough integration of multi-omics data and the development of intelligent decision-making systems.The goal is to move beyond generalized,"one-size-fits-all"model toward tailored,precision-based intervention.Precision nutrition will provide essential scientific and technological support for the Healthy China 2030 initiative and help usher in a new era of scientific and individualized obesity prevention and control.
3.Seroprevalence and influencing factors of low-level neutralizing antibodies against SARS-CoV-2 in community residents
Shiying YUAN ; Jingyi ZHANG ; Huanyu WU ; Weibing WANG ; Genming ZHAO ; Xiao YU ; Xiaoying MA ; Min CHEN ; Xiaodong SUN ; Zhuoying HUANG ; Zhonghui MA ; Yaxu ZHENG ; Jian CHEN
Shanghai Journal of Preventive Medicine 2025;37(5):403-409
ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.
4.Etiological surveillance and antimicrobial resistance analysis of Legionella pneumophila in the aqueous environment of public places in Shanghai, 2011-2020
Jun FENG ; Wei GAO ; Yuan ZHUANG ; Lingyue YUAN ; Yanxin CHEN ; Zhen XU ; Jiayuan LUO ; Yong CHEN ; Huanyu WU ; Xin CHEN ; Jing ZHANG ; Min CHEN
Chinese Journal of Epidemiology 2025;46(9):1600-1609
Objective:To understand the etiological surveillance and drug resistance characteristics of Legionella pneumophila (LP) from the aqueous environment of public places in Shanghai, from 2011 to 2020, and provide evidence for surveillance of the disease. Methods:Environmental water samples were systematically collected from public venues in urban and suburban districts of Shanghai for LP surveillance. All the identified LP isolates underwent a series of testings including serotyping, pulsed field gel electrophoresis (PFGE), sequence-based typing, and antimicrobial susceptibility testing. χ2 test or Cochran-Armitage trend tests were used for statistical analysis and for temporal resistance patterns. Results:Among 6 263 water samples, the LP-positive rate was 20.93% (1 311/6 263). The positivity rate decreased from 24.98% (287/1 149) in 2011-2012 to 20.02% (1 024/5 114) in 2013-2020 ( χ2=13.92, P<0.001), with the highest monthly positivity observed from June to August (23.79%, 745/3 132). A total of 1 365 LP strains were isolated, of which 912 were further characterized, including 10 serotypes, 149 PFGE patterns, and 33 sequence types (ST). The predominant serotype was Lp1 (86.84%, 792/912), and the dominant ST was ST752 (29.50%, 269/912). ST clustering revealed two major clonal groups CG1 and CG2, accounting for 91.12% (831/912) of the isolates. The 190 LPs involved in the drug sensitivity test showed three resistance profiles: azithromycin resistance (31.05%, 59/190), ciprofloxacin resistance (0.53%, 1/190) and azithromycin+ciprofloxacin resistance (0.53%, 1/190). Azithromycin-resistant strains were predominantly ST1 (64.41%, 38/59). The antimicrobial resistance rate showed a significant decline, from 48.65% (18/37) in 2011-2012 to 28.10% (43/153) in 2013-2020 ( χ2=9.38, P=0.002). Conclusions:Compared to from 2011 to 2012, both the positivity rate and antimicrobial resistance prevalence of LP in public aqueous environments of Shanghai exhibited an overall decline from 2013 to 2020. The predominant types of LP were serotype Lp1 and sequence type ST752, with notable high-level resistance to azithromycin. Measures as enhancing the enforcement of water safety regulations and prioritizing surveillance of azithromycin resistance in LP were recommended to mitigate public health risks.
5.Research on Construction of Negative Defensive Medicine Priority Governance Strategies Based on the WSR Methodology
Weijian SONG ; Huanyu ZHANG ; Lihan ZHANG ; Qunhong WU ; Libo LIANG
Chinese Hospital Management 2025;45(7):6-9,29
Objective Based on the WSR methodology,a three-dimensional integrated perspective of Wuli,Shi-li,and Renli dimensions was used to sort out the logical relationships and architectures among negative defensive medical governance strategies,forming the priority governance strategies for improving negative defensive medical care.Methods Based on the literature research method and the expert consultation method,the governance strate-gy and the conceptual connotation of WSR are classified into items,and the role relationship in the complex sys-tem of passive defensive medical governance is clarified through the WSR methodology.Results A collection of 40 negative defensive medicine governance strategies has been developed,comprising 8 strategies in the Wuli dimen-sion,23 strategies in the Shili dimension,and 9 strategies in the Renli dimension.Conclusion The WSR methodology provides a three-dimensional systemic perspective for governance strategies against negative defen-sive medicine.Addressing this issue requires comprehensive and systematic governance strategies.
6.Research on the Synergistic Enhancement of the In Vitro Bactericidal Effect of Tigecycline-resistant CRKP by Traditional Chinese Medicine Radix Sophorae Flavescentis and Its Mechanism
Huanyu ZHOU ; Huiyan WU ; Yilin GUAN
Journal of Modern Laboratory Medicine 2025;40(6):176-180
Objective To investigate the in vitro antibacterial effect of Radix Sophorae Flavescentis on tigecycline-resistant carbapenem-resistant Klebsiella pneumonia(CRKP)and elucidate how Radix Sophorae Flavescentis restores the sensitivity of CRKP to tigecycline through the efflux pump pathway.Methods The CRKP standard strain BAA1705 was induced to be tigecycline-resistant using the microdilution broth method,and the expression of efflux pumps was verified by efflux pump inhibitors.The fractional inhibitory concentration index(FIC)was calculated using the microdilution checkerboard method to determine the minimum inhibitory concertration(MIC)of the two drugs in combination.Fluorescent real-time quantitative PCR(qRT-PCR)was used to analyze the expression of the AcrB gene before and after Radix Sophorae Flavescentis treatment,and the e?ux pump activity was validated by the Rhodamine 6G e?ux assay.Results The e?ux pump inhibition experiment on the artificially induced T-BAA1705 strain showed overexpression of e?ux pumps.The combined antibacterial test results indicated synergy between Radix Sophorae Flavescentis and tigecycline(FIC=0.375 2).The qRT-PCR results showed that the AcrB levels in the Radix Sophorae Flavescentis monotherapy group were lower than in the untreated group(0.018±0.002 vs 0.040±0.001),and the AcrB levels(0.009±0.001),RamA levels(0.184±0.003)and MarA(0.013±0.001)levels in the combination therapy group were all lower than in the untreated group(0.040±0.001,0.387±0.016,0.125±0.007),while the AcrR level was higher than in the untreated group(0.388±0.001 vs 0.288±0.001),and the differences were statistical significance(t=12.28~47.12,all P<0.05);the e?ux pump activity in the Radix Sophorae Flavescentis monotherapy group and the combination therapy group was lower than in the untreated T-BAA1705(60.667±0.448,60.267±0.376,65.133±0.296),and the differences were statistical significance(t=8.31,10.17,all P<0.05).Conclusion Radix Sophorae Flavescentis can restore the sensitivity of tigecycline-resistant CRKP to tigecycline and effectively inhibit bacterial growth when used in combination with tigecycline.The mechanism may involve Radix Sophorae Flavescentis inhibiting the expression of the AcrAB-TolC e?ux pump.
7.Reporting Guidelines in Implementation Science:Overview,Categorization and Future Directions
Xiaoshan CHEN ; Dadong WU ; Run WANG ; Qing ZHAO ; Siyuan LIU ; Wanqing HUANG ; Zizhen HUANG ; Yuting WAN ; Huanyu HU ; Junlin ZHU ; Jiangyun CHEN ; Zhiwei HUANG ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(4):1033-1046
Reporting guidelines are structured checklists for researchers to follow when reporting spe-cific types of studies.As researches conducted in real-world settings to address practical issues,implementa-tion research has stringent requirements for the replicability of result and the transparency of reporting,making its reporting guidelines particularly important.This paper systematically introduces the reporting guidelines in the field of implementation science,outlines their classification systems and scopes of applica-tion,and focuses on explaining the core characteristics and functions of five key reporting guidelines,inclu-ding the Standards for Reporting Implementation Studies(StaRI),Reporting guidelines for implementation and operational research,the Template for Intervention Description and Replication(TIDieR),the Frame-work for Reporting Adaptations and Modifications-Enhanced(FRAME),and recommendations for specifying and reporting implementation strategies.Furthermore,combined with the PEDALs research paradigm in im-plementation science,this paper further clarifies the specific application pathways for reporting guidelines and discusses directions for refinement,aiming to provide references for researchers to select appropriate reporting guidelines.
8.Molecular epidemiological characteristics and hypervirulence evolution of ST11 carbapenem-resistant Klebsiella pneumoniae in medical institutions in Shanghai
Jing BI ; Wenjie CHEN ; Liang TIAN ; Qian LIU ; Huanyu WU ; Min CHEN ; Taiyao CHEN ; Tingting SHI ; Wei MA ; Hongzhi ZHANG
Chinese Journal of Infection Control 2025;24(8):1075-1082
Objective To understand the molecular epidemiological characteristics and hypervirulence evolution trend of ST11 carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from medical institutions in Shanghai,and provide scientific basis for formulating the prevention and control measures of drug-resistant organisms.Methods A total of 201 strains of CRKP isolated from 12 medical institutions in Shanghai from 2021 to 2022 were collected.Antimicrobial susceptibility testing and whole genome sequencing were performed.The concatenated data was used for multilocus sequencing typing(MLST),serum typing(wzi typing),as well as analysis of resistance and viru-lence genes.Results All 201 CRKP strains were multidrug-resistant organisms(MDROs).These strains were al-most completely resistant to carbapenems,cephalosporins,and quinolones.Drug resistance gene analysis showed that 93.03%of CRKP strains carried KPC gene.201 CRKP strains were divided into 6 ST types and 10 capsule wzi types,with ST11-KL64(n=104)being the dominant type,followed by ST15-KL19(n=54).52.24%(n=105)of CRKP carried rpmA/rpmA2+iucA+iutA+iroN genes.Conclusion CRKP isolated from medical institutions in Shanghai is mainly ST11-KL64 type with severe multidrug resistance,and more than half of the strains are hyper-virulent carbapenem-resistant Klebsiella pneumoniae(hv-CRKP).It is necessary to continuously strengthen the monitoring of the molecular characteristics of CRKP,so as to prevent outbreaks of healthcare-associated infection.
9.Research on Construction of Negative Defensive Medicine Priority Governance Strategies Based on the WSR Methodology
Weijian SONG ; Huanyu ZHANG ; Lihan ZHANG ; Qunhong WU ; Libo LIANG
Chinese Hospital Management 2025;45(7):6-9,29
Objective Based on the WSR methodology,a three-dimensional integrated perspective of Wuli,Shi-li,and Renli dimensions was used to sort out the logical relationships and architectures among negative defensive medical governance strategies,forming the priority governance strategies for improving negative defensive medical care.Methods Based on the literature research method and the expert consultation method,the governance strate-gy and the conceptual connotation of WSR are classified into items,and the role relationship in the complex sys-tem of passive defensive medical governance is clarified through the WSR methodology.Results A collection of 40 negative defensive medicine governance strategies has been developed,comprising 8 strategies in the Wuli dimen-sion,23 strategies in the Shili dimension,and 9 strategies in the Renli dimension.Conclusion The WSR methodology provides a three-dimensional systemic perspective for governance strategies against negative defen-sive medicine.Addressing this issue requires comprehensive and systematic governance strategies.
10.Molecular epidemiological characteristics and hypervirulence evolution of ST11 carbapenem-resistant Klebsiella pneumoniae in medical institutions in Shanghai
Jing BI ; Wenjie CHEN ; Liang TIAN ; Qian LIU ; Huanyu WU ; Min CHEN ; Taiyao CHEN ; Tingting SHI ; Wei MA ; Hongzhi ZHANG
Chinese Journal of Infection Control 2025;24(8):1075-1082
Objective To understand the molecular epidemiological characteristics and hypervirulence evolution trend of ST11 carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from medical institutions in Shanghai,and provide scientific basis for formulating the prevention and control measures of drug-resistant organisms.Methods A total of 201 strains of CRKP isolated from 12 medical institutions in Shanghai from 2021 to 2022 were collected.Antimicrobial susceptibility testing and whole genome sequencing were performed.The concatenated data was used for multilocus sequencing typing(MLST),serum typing(wzi typing),as well as analysis of resistance and viru-lence genes.Results All 201 CRKP strains were multidrug-resistant organisms(MDROs).These strains were al-most completely resistant to carbapenems,cephalosporins,and quinolones.Drug resistance gene analysis showed that 93.03%of CRKP strains carried KPC gene.201 CRKP strains were divided into 6 ST types and 10 capsule wzi types,with ST11-KL64(n=104)being the dominant type,followed by ST15-KL19(n=54).52.24%(n=105)of CRKP carried rpmA/rpmA2+iucA+iutA+iroN genes.Conclusion CRKP isolated from medical institutions in Shanghai is mainly ST11-KL64 type with severe multidrug resistance,and more than half of the strains are hyper-virulent carbapenem-resistant Klebsiella pneumoniae(hv-CRKP).It is necessary to continuously strengthen the monitoring of the molecular characteristics of CRKP,so as to prevent outbreaks of healthcare-associated infection.

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