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.Cleansing skin wound by irrigation with tap water replacing normal saline
Gaoxing LUO ; Rixing ZHAN ; Zhiqiang YUAN ; Huapei SONG ; Fei XIANG ; Siyuan MA ; Haisheng LI ; Wei QIAN ; Jianglin TAN ; Yizhi PENG
Chinese Journal of Burns 2025;41(3):201-205
Wound cleansing is an essential step in skin wound management. It can prevent local infection and optimize healing micro-environment by removing necrotic tissue and foreign matter, reducing microbial load, breaking bacterial biofilm formation and so on. Many randomized controlled trials and meta-analysis abroad have concluded that there is no significant difference in the incidence of wound infection and healing rate between the wounds irrigated with tap water and with sterile normal saline for skin wound cleansing. Considering the current requirements of medical fee policies in China, we recommend the use of tap water instead of saline or other wound cleansing solutions for cleansing skin wounds.
3.Application of high-frequency ultrasound-guided"cross-shaped"positioning method in open reduction of rib fractures
Tao JI ; Youtao WU ; Biao XIE ; Shuibo ZHU ; Siyuan ZHAN ; Gang YANG ; Yu ZHANG ; Erping XI
Journal of Clinical Surgery 2025;33(7):741-745
Objective To explore the advantages of high-frequency ultrasound-guided"cross-shaped"positioning method in accurate positioning and surgical effect in open reduction and internal fixation of rib fractures.Methods Retrospective analysis of 97 cases of multiple rib fractures treated surgically in our department from october 2019 to october 2024.Patients were divided into three groups based on different localization methods.The control group designed the surgical incision according to the results of chest three-dimensional reconstruction,the ultrasound group determined the incision based on the control group combined with high-frequency ultrasound,and Based on the method used in the ultrasound group,the"cross-localization"technique was combined to determine the incision in the cross-shaped group.The comparison of surgical-related data included fracture positioning accuracy,incision length of per singer rib,postoperative drainage volume,duration of drainage tube retention,postoperative pain score,operative time,intraoperative blood loss,length of hospital stay and incision infection rate.Additionally,commonly used inflammatory markers(white blood cell count,neutrophil percentage,CRP,IL-6,NF-κB)and pain-related biomarkers(PGE2,5-HT)were also included in the comparative analysis.Results In the control group,ultrasound group,and crossover group,aside from wound infections,the respective accuracies of fracture localization were 68.97%vs 87.50%vs 97.22%,the length of single rib incision was(3.50±1.23)cm vs(2.70±0.62)cm vs(2.45±0.58)cm,the volume of drainage on the day of surgery was(170.55±27.85)ml vs(150.69±24.67)ml vs(120.34±18.45)ml,the duration of drainage tube retention was(4.17±1.12)days vs(3.67±0.95)days vs(3.12±0.65)days,the postoperative pain scores were(6.86±2.15)vs(5.54±1.15)vs(4.89±1.53),the operation times were(75.84±15.62)minutes vs(67.74±11.85)minutes vs(57.35±9.36)minutes,the intraoperative blood loss was(85.78±11.78)ml vs(72.65±8.92)ml vs(62.23±9.63)ml,and the length of hospital stay was(8.42±1.47)days vs(7.12±1.14)days vs(6.56±1.32)days.The crossover group showed superior results in all metrics compared to the other two groups,with statistically significant differences(P<0.05).The inflammatory and pain stress indicators for the control,ultrasound,and crossover groups were as follows:white blood cell counts[(16.39±4.15)× 109/Lvs(13.25±2.45)× 109/L vs(12.02±2.77)× 109/L],neutrophil percentages[(80.14±12.21)vs(72.36±10.34)vs(65.73±8.83)],CRP[(31.86±6.87)mg/L vs(27.72±5.65)mg/L vs(24.69±4.11)mg/L],IL-6[(46.35±11.42)pg/L vs(41.42±8.75)pg/L vs(35.53±9.51)pg/L],NF-B[(22.55±4.98)pg/L vs(17.34±3.62)pg/L vs(15.91±3.84)pg/L],PGE2[(240.37±21.65)ng/L vs(209.45±23.24)ng/L vs(180.21±18.72)ng/L],and 5-HT[(290.62±34.37)ng/L vs(270.85±26.98)ng/L vs(210.62±19.64)ng/L].The crossover group demonstrated statistically significant differences compared to both the control and ultrasound groups(P<0.05).There was no statistically significant difference in incision infection among the three groups(P>0.05).Conclusion The ultrasound-guided"cross"positioning method for rib fracture open reduction and internal fixation can more accurately locate the incision,shorten the incision length and hospitalization time,reduce postoperative inflammatory response and patient pain,and facilitate rapid recovery after surgery.
4.Application of high-frequency ultrasound-guided"cross-shaped"positioning method in open reduction of rib fractures
Tao JI ; Youtao WU ; Biao XIE ; Shuibo ZHU ; Siyuan ZHAN ; Gang YANG ; Yu ZHANG ; Erping XI
Journal of Clinical Surgery 2025;33(7):741-745
Objective To explore the advantages of high-frequency ultrasound-guided"cross-shaped"positioning method in accurate positioning and surgical effect in open reduction and internal fixation of rib fractures.Methods Retrospective analysis of 97 cases of multiple rib fractures treated surgically in our department from october 2019 to october 2024.Patients were divided into three groups based on different localization methods.The control group designed the surgical incision according to the results of chest three-dimensional reconstruction,the ultrasound group determined the incision based on the control group combined with high-frequency ultrasound,and Based on the method used in the ultrasound group,the"cross-localization"technique was combined to determine the incision in the cross-shaped group.The comparison of surgical-related data included fracture positioning accuracy,incision length of per singer rib,postoperative drainage volume,duration of drainage tube retention,postoperative pain score,operative time,intraoperative blood loss,length of hospital stay and incision infection rate.Additionally,commonly used inflammatory markers(white blood cell count,neutrophil percentage,CRP,IL-6,NF-κB)and pain-related biomarkers(PGE2,5-HT)were also included in the comparative analysis.Results In the control group,ultrasound group,and crossover group,aside from wound infections,the respective accuracies of fracture localization were 68.97%vs 87.50%vs 97.22%,the length of single rib incision was(3.50±1.23)cm vs(2.70±0.62)cm vs(2.45±0.58)cm,the volume of drainage on the day of surgery was(170.55±27.85)ml vs(150.69±24.67)ml vs(120.34±18.45)ml,the duration of drainage tube retention was(4.17±1.12)days vs(3.67±0.95)days vs(3.12±0.65)days,the postoperative pain scores were(6.86±2.15)vs(5.54±1.15)vs(4.89±1.53),the operation times were(75.84±15.62)minutes vs(67.74±11.85)minutes vs(57.35±9.36)minutes,the intraoperative blood loss was(85.78±11.78)ml vs(72.65±8.92)ml vs(62.23±9.63)ml,and the length of hospital stay was(8.42±1.47)days vs(7.12±1.14)days vs(6.56±1.32)days.The crossover group showed superior results in all metrics compared to the other two groups,with statistically significant differences(P<0.05).The inflammatory and pain stress indicators for the control,ultrasound,and crossover groups were as follows:white blood cell counts[(16.39±4.15)× 109/Lvs(13.25±2.45)× 109/L vs(12.02±2.77)× 109/L],neutrophil percentages[(80.14±12.21)vs(72.36±10.34)vs(65.73±8.83)],CRP[(31.86±6.87)mg/L vs(27.72±5.65)mg/L vs(24.69±4.11)mg/L],IL-6[(46.35±11.42)pg/L vs(41.42±8.75)pg/L vs(35.53±9.51)pg/L],NF-B[(22.55±4.98)pg/L vs(17.34±3.62)pg/L vs(15.91±3.84)pg/L],PGE2[(240.37±21.65)ng/L vs(209.45±23.24)ng/L vs(180.21±18.72)ng/L],and 5-HT[(290.62±34.37)ng/L vs(270.85±26.98)ng/L vs(210.62±19.64)ng/L].The crossover group demonstrated statistically significant differences compared to both the control and ultrasound groups(P<0.05).There was no statistically significant difference in incision infection among the three groups(P>0.05).Conclusion The ultrasound-guided"cross"positioning method for rib fracture open reduction and internal fixation can more accurately locate the incision,shorten the incision length and hospitalization time,reduce postoperative inflammatory response and patient pain,and facilitate rapid recovery after surgery.
5.Cleansing skin wound by irrigation with tap water replacing normal saline
Gaoxing LUO ; Rixing ZHAN ; Zhiqiang YUAN ; Huapei SONG ; Fei XIANG ; Siyuan MA ; Haisheng LI ; Wei QIAN ; Jianglin TAN ; Yizhi PENG
Chinese Journal of Burns 2025;41(3):201-205
Wound cleansing is an essential step in skin wound management. It can prevent local infection and optimize healing micro-environment by removing necrotic tissue and foreign matter, reducing microbial load, breaking bacterial biofilm formation and so on. Many randomized controlled trials and meta-analysis abroad have concluded that there is no significant difference in the incidence of wound infection and healing rate between the wounds irrigated with tap water and with sterile normal saline for skin wound cleansing. Considering the current requirements of medical fee policies in China, we recommend the use of tap water instead of saline or other wound cleansing solutions for cleansing skin wounds.
6.Exploraion of the Pathogenesis Evolution and Treatment Rules of Obese Type 2 Diabetes Mellitus Based on the Theory of"Deficient Qi Leads to Stagnation"
Qige WANG ; Siyuan DING ; Libin ZHAN
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(8):2089-2094
Based on the theory of"deficient Qi leads to stagnation",this paper discusses the pathogenesis evolution and treatment of obese type 2 diabetes.The occurrence and development of obese type 2 diabetes mellitus has obvious stages,which often begins with spleen deficiency obesity,changes in qi full spleen dan,becomes dry retention diabetes,and appears toxic stagnation syndrome.According to the stage development characteristics of the pathogenesis,it can be summarized as"deficiency","Qi","retention"and"stagnation",which is in line with the overall theoretical connotation of"deficient Qi leads to stagnation".On this basis,according to the different periods of the disease,the treatment methods of"warm medicine treatment","orchid grass treatment","Yiyin treatment"and"Gongbu treatment"were summarized,which provided reference for guiding the accurate syndrome differentiation and treatment of obese type 2 diabetes in clinical practice.
7.Significance of fungus-bacterium homeostasis in inflammatory bowel disease
Siyuan CHEN ; Qunyan ZHOU ; Jing SUN ; Xinwen XU ; Zhongxia CHEN ; Fangmei AN ; Qiang ZHAN
Chinese Journal of Inflammatory Bowel Diseases 2024;08(4):314-318
Inflammatory bowel disease (IBD) is a group of digestive tract diseases characterized by chronic intestinal inflammation, including ulcerative colitis and Crohn′s disease. The over-sustained immune response driven by imbalance of intestinal microbiota plays a key role in the initiation and progression of IBD. Studies have identified that intestinal microbiome possesses more than a hundred trillion types, including bacteria and fungi, which collectively participates in energy metabolism, intestinal barrier function and immune balance. There exists a stable relationship between fungi and bacteria in the intestine, involving cooperation, antagonism, and mutualism. Fungus-bacterium homeostasis plays an important role in maintaining intestinal homeostasis. Based on intestinal fungus changes in IBD patients, this article reviews the research progress in intestinal immunomodulation and therapeutic strategies derived from fungus-bacterial homeostasis.
8.Significance of fungus-bacterium homeostasis in inflammatory bowel disease
Siyuan CHEN ; Qunyan ZHOU ; Jing SUN ; Xinwen XU ; Zhongxia CHEN ; Fangmei AN ; Qiang ZHAN
Chinese Journal of Inflammatory Bowel Diseases 2024;08(4):314-318
Inflammatory bowel disease (IBD) is a group of digestive tract diseases characterized by chronic intestinal inflammation, including ulcerative colitis and Crohn′s disease. The over-sustained immune response driven by imbalance of intestinal microbiota plays a key role in the initiation and progression of IBD. Studies have identified that intestinal microbiome possesses more than a hundred trillion types, including bacteria and fungi, which collectively participates in energy metabolism, intestinal barrier function and immune balance. There exists a stable relationship between fungi and bacteria in the intestine, involving cooperation, antagonism, and mutualism. Fungus-bacterium homeostasis plays an important role in maintaining intestinal homeostasis. Based on intestinal fungus changes in IBD patients, this article reviews the research progress in intestinal immunomodulation and therapeutic strategies derived from fungus-bacterial homeostasis.
9.Influence of Intestinal Immunity and Microecology on Concomitant Psychological Disorders in Patients With Inflammatory Bowel Disease
Ziru ZHOU ; Siyuan CHEN ; Qunyan ZHOU ; Jing SUN ; Qiang ZHAN
Chinese Journal of Gastroenterology 2024;29(8):499-504
Inflammatory bowel disease(IBD)is a group of non-specific chronic gastrointestinal inflammatory diseases whose etiology is not completely clear.In recent years,the problem of IBD complicated with psychological disorders has been widely concerned,which affects the quality of life of patients,and increases the recurrence of IBD and poor prognosis.The gut-brain axis is involved in the occurrence of IBD complicated with neuropsychiatric disorders.The gut regulates brain function through the nervous system,hypothalamic-pituitary-adrenal(HPA)axis and immune system.This article reviews the relationship between intestinal immunity,intestinal microecology and psychological disorders in IBD patients,as well as the treatment of psychological disorders based on intestinal immunity and microecology,so as to provide new ideas for the diagnosis and treatment of psychological disorders in IBD.
10.Influence of Intestinal Immunity and Microecology on Concomitant Psychological Disorders in Patients With Inflammatory Bowel Disease
Ziru ZHOU ; Siyuan CHEN ; Qunyan ZHOU ; Jing SUN ; Qiang ZHAN
Chinese Journal of Gastroenterology 2024;29(8):499-504
Inflammatory bowel disease(IBD)is a group of non-specific chronic gastrointestinal inflammatory diseases whose etiology is not completely clear.In recent years,the problem of IBD complicated with psychological disorders has been widely concerned,which affects the quality of life of patients,and increases the recurrence of IBD and poor prognosis.The gut-brain axis is involved in the occurrence of IBD complicated with neuropsychiatric disorders.The gut regulates brain function through the nervous system,hypothalamic-pituitary-adrenal(HPA)axis and immune system.This article reviews the relationship between intestinal immunity,intestinal microecology and psychological disorders in IBD patients,as well as the treatment of psychological disorders based on intestinal immunity and microecology,so as to provide new ideas for the diagnosis and treatment of psychological disorders in IBD.

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