Implementation science aims to close the gap between knowledge and practice by fostering the uptake and implementation of evidence-based practices. In Europe and America, implementation science is rapidly evolving and improving. In China, the field is still in its infancy. This paper focuses on the definition, origin, domestic and international development, research hotspots, challenges, and opportunities of implementation science. Although implementation science is still at an early stage in China, it has shown rapid development momentum. Chinese scholars, therefore, should leverage China's distinctive research environment to conduct high-quality and innovation implementation studies in order to excel in implementation science areas and lead globally.

Implementation science has evolved over more than 20 years and established a set of theories, models, and frameworks that can be used to guide the implementation process, identify implementation-influencing factors, and evaluate implementation effectiveness. Guided by theories, the implementation research paradigm has been developed to emphasize a problem-oriented approach that seeks to solve problems, identify barriers to implementing evidence-based practices, and selectively employ implementation strategies to facilitate their adoption, implementation, and maintenance. This paradigm also gives implementation research distinctive characteristics in terms of research design, including extensive use of theories, models, and frameworks, alignment with real-world and contextual settings, use of mixed research designs, use of rapid research methods, and optimization of interventions for the context in which they are to be implemented. As the second part of Past and Present of Implementation Science, this paper provides a brief introduction to the theories, paradigms, and characteristics of implementation science.

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.

ObjectiveTo analyze the epidemic characteristics and trend of mosquito vectors related to Japanese encephalitis （JE） in Mengla County， and to provide scientific evidence for JE prevention and control. MethodsThe JE related mosquito vector monitoring data in Mengla County from 2016 to 2020 were collected and subjected to further statistical analysis. ResultsA total of 1 689 mosquitoes were captured at the JE mosquito vector monitoring sites in Mengla County， 36.3% of which were captured in 2020 and 13.3% in 2017. The density of Culex tritaeniorhynchus was the highest （3.04 per lamp per day）， and that of Anopheles sinensis was the lowest （1.03 per lamp per day）. The distribution of mosquito species showed significant difference in the same year. The mosquito density in pig house was 12.93 per lamp∙day， and that in human house was 4.67 per lamp∙day. The mosquito density of different mosquito species in pig house was higher than that in human house. There was no significant difference in the site distribution of Anopheles sinensis， but there were significant differences in the site distribution of Culex tritaeniorhynchus， Culex pipiens quinquefasciatus and other mosquito species. The mosquito density peaked in May （12.78 per lamp per day） and July （10.28 per lamp per day）. The temporal distribution showed that the vector density decreased gradually from May to October， however， the species population structure also varied significantly， and the trends of each mosquito species also varied greatly. In Mengla， Culex tritaeniorhynchus peaked in May. ConclusionThe JE epidemic situation in Mengla County is still severe. It is recommended to strengthen prevention and control in the peak season of mosquito activities， such as actively carrying out patriotic health campaigns， and effective public education. At the same time， we should also strengthen the JE vaccination for school-age children and the training of medical personnel.

ObjectiveTo analyze the epidemic characteristics of dengue fever in Mengla County and provide basis for scientific prevention and control of dengue fever. MethodsWe collected the case information of dengue fever in Mengla County reported by the infectious disease reporting information system of China Center for Disease Control and prevention from January 1 to December 31， 2019 and the case field investigation records. The case data were analyzed by descriptive epidemiological method. ResultsIn 2019， Mengla County reported 369 cases of dengue fever， all of which were unclassified， including 354 clinically diagnosed cases， 15 confirmed cases， 6 severe cases， and there was no deaths. The annual incidence rate was 120.98/10⁵. Mengla Town had the most cases （145 cases， 39.30%） followed by 63 cases （17.07%） in Mengpeng Town. The reported cases were mainly local cases （65.85%）. The ratio of male to female was 1.25∶1. The age distribution was mainly in the group of 21‒60 years old （82.38%）. Farmers （112 cases， 30.35%） and business service providers （85 cases， 23.04%） were the majority. The annual cases were distributed from May to November， of which the most were reported in September， and the number of cases reported from July to October accounts for 93.22% of all cases. ConclusionMengla County is still a high incidence area of dengue fever in Yunnan Province， and the vector Aedes is widespread. It is suggested to strengthen mosquito prevention and control in the epidemic season， actively carry out patriotic health campaign， carry out special rectification of the environment in rural areas， and conduct effective public education.

Objective:To compare the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with expanded polytetrafluoroethylene (ePTFE)-covered stent and drug combined with gastroscopy as the secondary prevention of esophageal-gastric variceal bleeding in portal hypertension.Methods:Patients with esophageal-gastric variceal bleeding who received TIPS treatment (ePTFE covered stent) or gastroscopy for the first time as the secondary prevention for portal hypertension at Nanfang Hospital of Southern Medical University through March to July 2017 were selected. One year after the operation, liver function changes, ascites remission rates, incidence of hepatic encephalopathy, re-bleeding rate, average hospitalization frequency and expenses, survival time, as well as the TIPS patency conditions were analyzed in the two groups of patients. 2 test, Kaplan-Meier method and Mann-Whitney U test were used to analyze the data.Results:There were 74 and 66 cases in the TIPS and the drug combined gastroscopy group and the follow-up duration (14.57 ± 0.79) was 12-16 months. One year after surgery, the remission rate of ascites in the TIPS group was higher 57.1% (32/56) than that of the drug combined gastroscopy group (0), and the difference was statistically significant (χ 2 = 2 = 36.73, P < 0.01). The cumulative incidence of hepatic encephalopathy at 1, 3, 6, and 12 months after surgery in the TIPS group was 32.4% (24/74), 37.8% (28/74), 40.5% (30/74), and 40.5% (30/74), respectively. The cumulative incidence of hepatic encephalopathy in the drug combined gastroscopy group was 3.0% (2/66), 3.0% (2/66), 3.0% (2/66), and 6.1% (4/66), respectively. Kaplan-Meier analysis showed that the cumulative incidence of hepatic encephalopathy in the TIPS group was higher than that of the drug combined gastroscopy group (χ 2 = 11.29, P < 0.01). The incidence of severe hepatic encephalopathy ( grade III to IV) at 1, 3, 6, and 12 months after surgery in the TIPS group was 2.7% (2/74), 0, 0, and 0, respectively. The incidence of severe hepatic encephalopathy in drug combined gastroscopy group was 0, and there was no statistically significant difference in development of hepatic encephalopathy between the two groups ( P > 0.05). The re-bleeding rates of TIPS group and drug combined gastroscopy group were 0 and 27.3% (18/66), respectively, and the difference was statistically significant (χ 2 = 22.42, P < 0.01). There was no death reported during the follow-up period between both groups. The hospitalization frequency times (1.45 ± 0.80) in TIPS group was lower than that of the drug combined gastroscopy group times (3.24 ± 1.80), and the difference was statistically significant ( U = -4.52, P < 0.01). Conclusion:In the prevention of esophageal-gastric variceal bleeding, TIPS (ePTFE-covered stent) treatment has the advantages of reducing re-bleeding rate, high ascites remission rate and hospitalizations frequency. In addition, patients treated with TIPS have a higher incidence of hepatic encephalopathy than that of drugs combined with gastroscopy. However, TIPS did not exacerbate the incidence of hepatic encephalopathy, and there was no significant difference in the 1-year survival rate after TIPS and drugs combined with gastroscopy treatment.

In order to fully understand the status quo of the healthcare plus elderly care mode development in China, this paper comprehensively analyzed the progress of China in this respect, from four aspects as follows. These include the policy making, service mode development, number of elderly care beds and long-term care insurance. In view of the current shortage of resources in China, namely that of talents, poor teambuilding, imbalance between supply and demand of medical institutions, and the lack of coordination among healthcare and elderly care institutions, this paper suggests that China should focus on strengthening the construction of diversified elderly care system and professional elderly care personnel. In addition, it suggests to establish and improve the long-term care system with Chinese characteristics and promote the introduction of hospice care services for elderly care institutions, hence encouraging a high level healthcare plus elderly care career in China.

Objective: To learn the job experience and cognition of the staff working in elderly-healthcare institutions by means of the psychological contract theory and the questionnaire so developed, for probing into the factors affecting the work recognition. Methods: The psychological contract questionnaire was used to conduct on-site questionnaires on 232 staff of such institutions in Hubei province between July 2018 and February 2019. The study covered their job experience and organizational contract, responsibility cognition. The data collected were analyzed statistically by methods such as variance analysis, descriptive statistics and related analysis. Results: It was found that personal responsibility scoring(76.0±11.8) was generally higher than organizational responsibility scoring(60.9±10.0). 46.1%(107/232) of the employees had the intention of resignation. The respondents′ resignation intention was correlated with the performance of the organization, and there was a strong correlation between employees′ career development and their resignation intention(Gamma coefficient G≥0.5). Conclusions Organizational performance needs further enhancement, and institutions should better the income distribution and incentive mechanism, and raise the income level of the staff. At the same time, the managers should optimize the institutional environment, improve the social status of the staff, strengthen career planning, training, and provide them with a more promising career development path.

Objective: To understand the healthcare and elderly care needs of the elderlies. Methods: From July to December 2018, a questionnaire survey was conducted to investigate the healthcare and elderly care status and characteristics of the elderly under different modes of combination of medical care and elderly care, and to analyze their objective needs for both cares. Results: There was an outstanding need for daily life care for the elderlies in the healthcare plus elderly care mode. 71.8% of them were senior elderlies, and 61.1% had obvious disabilities. It was found that elderly-adaptive transformation was required for their living environment in the home care mode, as 41.7% of them live in elevator-free buildings, and 48.2% use squat-type toilets. The elderlies need in general cultural services, and widowhood and solitary living were common. The home care mode required disease prevention services, as 43.6% of them had weight problems, and smoking and drinking rates were very high(9.4%, 13.7%). The elderly care in medical mode required medical services, because the proportion of two or more chronic diseases was very high(27.2%). Conclusions The healthcare and elderly care modes vary in terms of needs, thus it is necessary to adapt to specific conditions.

Mitochondrial diseases are maternally inherited heterogeneous disorders that are primarily caused by mitochondrial DNA (mtDNA) mutations. Depending on the ratio of mutant to wild-type mtDNA, known as heteroplasmy, mitochondrial defects can result in a wide spectrum of clinical manifestations. Mitochondria-targeted endonucleases provide an alternative avenue for treating mitochondrial disorders via targeted destruction of the mutant mtDNA and induction of heteroplasmic shifting. Here, we generated mitochondrial disease patient-specific induced pluripotent stem cells (MiPSCs) that harbored a high proportion of m.3243A>G mtDNA mutations and caused mitochondrial encephalomyopathy and stroke-like episodes (MELAS). We engineered mitochondrial-targeted transcription activator-like effector nucleases (mitoTALENs) and successfully eliminated the m.3243A>G mutation in MiPSCs. Off-target mutagenesis was not detected in the targeted MiPSC clones. Utilizing a dual fluorescence iPSC reporter cell line expressing a 3243G mutant mtDNA sequence in the nuclear genome, mitoTALENs displayed a significantly limited ability to target the nuclear genome compared with nuclear-localized TALENs. Moreover, genetically rescued MiPSCs displayed normal mitochondrial respiration and energy production. Moreover, neuronal progenitor cells differentiated from the rescued MiPSCs also demonstrated normal metabolic profiles. Furthermore, we successfully achieved reduction in the human m.3243A>G mtDNA mutation in porcine oocytes via injection of mitoTALEN mRNA. Our study shows the great potential for using mitoTALENs for specific targeting of mutant mtDNA both in iPSCs and mammalian oocytes, which not only provides a new avenue for studying mitochondrial biology and disease but also suggests a potential therapeutic approach for the treatment of mitochondrial disease, as well as the prevention of germline transmission of mutant mtDNA.
Animals ; DNA, Mitochondrial ; genetics ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; MELAS Syndrome ; genetics ; Male ; Mice ; Microsatellite Repeats ; genetics ; Mitochondria ; genetics ; metabolism ; Mutation ; genetics