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.

Objective To propose a lung artery segmentation method that integrates shape and position prior knowledge, aiming to solve the issues of inaccurate segmentation caused by the high similarity and small size differences between the lung arteries and surrounding tissues in CT images. Methods Based on the three-dimensional U-Net network architecture and relying on the PARSE 2022 database image data, shape and position prior knowledge was introduced to design feature extraction and fusion strategies to enhance the ability of lung artery segmentation. The data of the patients were divided into three groups: a training set, a validation set, and a test set. The performance metrics for evaluating the model included Dice Similarity Coefficient (DSC), sensitivity, accuracy, and Hausdorff distance (HD95). Results The study included lung artery imaging data from 203 patients, including 100 patients in the training set, 30 patients in the validation set, and 73 patients in the test set. Through the backbone network, a rough segmentation of the lung arteries was performed to obtain a complete vascular structure; the branch network integrating shape and position information was used to extract features of small pulmonary arteries, reducing interference from the pulmonary artery trunk and left and right pulmonary arteries. Experimental results showed that the segmentation model based on shape and position prior knowledge had a higher DSC (82.81%±3.20% vs. 80.47%±3.17% vs. 80.36%±3.43%), sensitivity (85.30%±8.04% vs. 80.95%±6.89% vs. 82.82%±7.29%), and accuracy (81.63%±7.53% vs. 81.19%±8.35% vs. 79.36%±8.98%) compared to traditional three-dimensional U-Net and V-Net methods. HD95 could reach (9.52±4.29) mm, which was 6.05 mm shorter than traditional methods, showing excellent performance in segmentation boundaries. Conclusion The lung artery segmentation method based on shape and position prior knowledge can achieve precise segmentation of lung artery vessels and has potential application value in tasks such as bronchoscopy or percutaneous puncture surgery navigation.

Arginine methylation is a critical post-translational modification that plays multifaceted biological functions. However, the manipulation of protein arginine methylation largely depends on genetic or pharmaceutic inhibition of the regulatory enzymes, protein arginine methyltransferases (PRMTs), or non-methylation substitution of corresponding arginine residue to lysine or alanine of protein of interest (POI), which inevitably affects other substrates, or disrupts the structure of POI. Thus, it urges an approach to specifically modulate the arginine methylation of a POI under physiological conditions. To this end, we report the discovery of a methylation tagging system (MeTAG), that enables targeted modification of protein arginine methylation. Through bridging the methyltransferase PRMT5 proximity to a POI, MeTAG facilitates the arginine methylation of POIs, including known arginine methylated proteins, androgen receptor (AR) and protein kinase B (AKT), as well as a neo-substrate E1A binding protein (p300), in a reversible and PRMT5-dependent manner. Moreover, MeTAG can regulate downstream signaling in a methylation dependent manner, leading to downregulation of PSMA mRNA level and activation of AKT. Therefore, MeTAG represents a feasible approach to modulate protein methylation and thereby perturbs protein function in biological and therapeutic contexts.

Objective:To investigate the related factors affecting the survival of adult patients with newly diagnosed chronic myeloid leukemia in the chronic phase (CML-CP) treated with tyrosine kinase inhibitor (TKI) and the prognostic predictive effect of the nomogram constructed according to them.Methods:A retrospective cohort study was conducted. Clinical general information and laboratory index data of 243 newly diagnosed adult CML-CP patients treated with TKI in the First Hospital of Lanzhou University from December 2008 to June 2023 were collected, and they were divided into a training set (194 patients) and a validation set (49 patients) by complete randomization in the ratio of 8∶2. In the training set, variables affecting poor overall survival (OS) of patients were analyzed using univariate and multivariate Cox proportional hazards models by R4.3.2 software to obtain the independent influences of poor OS, on the basis of which the Cox regression model was constructed and the nomogram predicting the OS rate at 8 and 10 years was plotted. Kaplan-Meier method was applied to analyze the OS in all 243 patients and patients stratified by the screened independent influencing factors for poor OS, and log-rank test was used for comparison between the groups. In the training and validation sets, receiver operating characteristic (ROC) curve was used to analyze the effect of the nomogram on predicting 8- and 10-year OS rates of patients with actual survival as the gold standard; calibration curve was used to assess the accuracy of predictions of the nomogram; decision curve analysis (DCA) was used to assess the clinical utility of the nomogram.Results:The median age of 243 CML-CP patients [ M ( Q1, Q3)] was 46 (35, 58) years old, 150 cases (61.7%) were male and 9 cases (38.3%) were female, 119 cases (49.0%) had comorbidities, and the efficacy of 82 cases (33.7%) reached molecular response (MR) 5.0. Differences in patient compositions for age and gender, levels of major indicators for peripheral blood and bone marrow, spleen size, comorbidities, short-term efficacy, Sokal score, and long-term survival score of European Treatment and Outcomes Study between the training and validation sets were not statistically significant (all P > 0.05). Multivariate Cox regression analysis showed that patients with elevated age ( HR = 1.04, 95% CI: 1.01-1.08, P = 0.041), comorbidities (with vs. without, HR = 3.48, 95% CI: 1.23-9.86, P = 0.019), and those who did not achieve MR5.0 (achieved vs. unachieved, HR = 0.13, 95% CI: 0.02-0.97, P = 0.046) were independent risk factors for poor OS in TKI-treated newly diagnosed adult CML-CP patients. By the last follow-up (December 2023), the median follow-up was 72 months, with the range of 6-180 months. Kaplan-Meier method analysis showed that the 8- and 10-year OS rates of 243 patients were 83.7% and 81.6%, respectively; patients with age ≥46 years compared to <46 years, with comorbidities compared to without comorbidities, and who did not achieve MR5.0 in terms of efficacy compared to who achieved MR5.0, the OS was poorer, and the differences were statistically significant (all P < 0.01). The nomogram of 8- and 10-year OS rates in TKI-treated newly diagnosed adult CML-CP patients was constructed based on the screened independent influencing factors of poor OS. The area under the ROC curve was 0.910 and 0.851 in the training set and 0.778 and 0.764 in the validation set for the predicted 8- and 10-year OS rates based on the nomogram, respectively, and the calibration curve showed that the predicted 8- and 10-year OS rates based on the nomogram were in high agreement with the actual ones in the training and validation sets; the DCA showed that the nomogram within a certain prediction threshold could benefit the clinical decision-making in both the training and validation sets. Conclusions:Having comorbidities, not reaching MR5.0 in efficacy and old age are independent risk factors for poor survival of TKI-treated adult patients with newly diagnosed CML-CP, and the nomogram constructed based on these 3 factors has a good predictive ability for the survival of such patients.

Objective: To investigate the effects of decabromodiphenyl ether (BDE-209) on the size of subcutaneous transplanted tumors, related genes and signaling pathways of cervical cancer in mice. Methods: Forty female C57BL/6 mice were subcutaneously inoculated with mouse cervical carcinoma U14 cells in the lateral axilla to establish a mouse subcutaneous transplanted tumor model. These mice were randomly divided into a high-dose group (500 mg/kg), a medium-dose group (100 mg/kg), a low-dose group (20 mg/kg) and a control group (corn oil), and were exposed to BDE-209 or corn oil by gavage. Subcutaneous transplanted tumor tissue was taken after 21 days of BDE-209 poisoning, and the differentially expressed genes in the subcutaneous transplanted tumors of cervical cancer among the four groups were analyzed by high-throughput transcriptome sequencing and were subjected to Gene Ontology (GO) annotations and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Protein-protein interactions (PPI) were analyzed using the STRING database, and the mRNA expression of hub genes was determined by real-time fluorescence polymerase chain reaction. Results: Compared with the control group, low-dose group and medium-dose group, the mass of subcutaneous transplanted tumors in the high-dose group was decreased (all P<0.05). Transcriptome sequencing results showed that compared with the control group, 2 011 genes were up-regulated and 1 165 genes were down-regulated in the high-dose group; 960 genes were up-regulated and 357 genes were down-regulated in the medium-dose group; 537 genes were up-regulated and 262 genes were down-regulated in the low-dose group (all P<0.05). GO and KEGG analysis showed that the differentially expressed genes in the high-dose group were mainly involved in cell chemotaxis and NOD-like receptor signaling pathway; the differentially expressed genes in the medium-dose group were mainly involved in cell chemotaxis and cytokine-cytokine receptor interactions; and the differentially expressed genes in the medium-dose group were mainly involved in processing and presentation of antigens, and the signaling pathways of the complement and coagulation cascades. Compared with the control group, the mRNA expression of TLR2, MMP9, IL-6, Fos, and TNF was up-regulated in the high-dose group (all P<0.05). Conclusion High-dose BDE-209 may affect Toll-like receptors, NOD-like receptors, and other immune and inflammatory-related signaling pathways and cancer-related genes, leading to a decrease in the mass of subcutaneous transplanted cervical cancer tumors in mice.

Lipid Droplets/metabolism* ; Bacteria ; Lipid Metabolism

Objective     To assess the safety and clinical outcomes of segmentectomy in one- or two-staged video-assisted thoracoscopic surgery (VATS) for bilateral lung cancer. Methods    We retrospectively enrolled 100 patients who underwent VATS segmentectomy for bilateral lung cancer at the Department of Thoracic Surgery of Peking Union Medical College Hospital from December 2013 to May 2022. We divided the patients into two groups: a one-stage group (52 patients), including 17 males and 35 females with a mean age of 55.17±11.09 years, and a two-stage group (48 patients), including 16 males and 32 females with a mean age of 59.88±11.48 years. We analyzed multiple intraoperative variables and postoperative outcomes. Results     All 100 patients successfully completed bilateral VATS, and at least unilateral lung received anatomical segmentectomy. Patients in the one-stage group were younger (P=0.040), had lower rate of comorbidities (P=0.030), were less likely to have a family history of lung cancer (P=0.018), and had a shorter interval between diagnosis and surgery (P=0.000) compared with patients in the two-stage group. Wedge resection on the opposite side was more common in the one-stage group (P=0.000), while lobectomy was more common in the two-stage   group. The time to emerge from anesthesia in the one-stage group was longer than that in the first and second operations of the two-stage group (P=0.000, P=0.002). Duration of surgery and anesthesia were similar between two groups (P>0.05). Total number of lymph node stations for sampling and dissection (P=0.041) and lymph nodes involved (P=0.026) were less in the one-stage group. Intraoperative airway management was similar between two groups (P>0.05). The one-stage group was associated with lower activities of daily living (ADL) scores. Conclusion     Segmentectomy is safe in one- or two-staged VATS for bilateral lung cancer, including contralateral sublobectomy and lobectomy. Duration of surgery and perioperative complications are similar between two groups, but the one-stage group is associated with lower ADL scores. On the basis of comprehensive consideration in psychological factors, physical conditions and personal wishes of patients, one-staged sequential bilateral VATS can be the first choice.

Purpose To explore the value of insulinoma associated protein 1(INSM1)in the pathological diagnosis and differential diagnosis of medullary thyroid carcinoma(MTC).Methods Twenty-eight cases of MTC were collected as the ex-perimental group and 25 cases of thyroid tumors(6 cases of transparent trabecular tumors,16 cases of poorly differentiated cancer,2 cases of spindle cell papillary carcinoma,and 1 case of thyroid paraganglioma)that needed to be differentiated from MTC in the same period were collected as the control group.The expression of INSM1 was detected using immunohistochemical EnVision method,and the sensitivity and specificity of INSM1 in MTC were analyzed,and compared with traditional MTC markers(Syn,CgA,CT,and CEA).Results The positive rate of IN-SM1 in the MTC group was96.4%(27/28),significantly high-er than the control group of 4.0%(1/25)(P<0.05).INSM1 had a sensitivity of 96.4%in MTC,significantly higher than CgA(71.4%)(P<0.05),and was positively expressed in CT negative MTC cases.The specificity of INSM1 in MTC was 96.0%,significantly higher than that of CEA(72.0%)(P<0.05).Conclusion INSM1 has high sensitivity and specificity in MTC,with a nuclear positive staining pattern,clear back-ground,and easy identification.It is superior to the traditional biomarkers and has high diagnostic value in MTC.

Objective:To analyze the clinical characteristics of chronic Q fever.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, diagnosis, treatment and prognosis of 12 patients with chronic Q fever admitted in Peking Union Medical College Hospital from January 2008 to December 2022 were analyzed retrospectively.Results:Of the12 cases, there were 11 males and 1 female with a median age at diagnosis of 58 years (47-68). The median time interval between the onset of symptoms and diagnosis was 9.5 months (4.0-28.5). Ten patients had fever, and the common symptoms included weakness ( n=6), weight loss ( n=5) and shortness of breath ( n=3). Seven patients presented with hepatomegaly and splenomegaly. Among the 12 patients, 1 patient suffered from cardiac valve and artery involvement at the same time, 8 patients suffered from infective endocarditis, and 1 patient suffered from aneurysm. No definite infection site was found in 2 patients. Seven of the 12 patients (58.3%) had elevated serum creatinine. Rheumatoid factors were detected in 8 patients, all of which were elevated. Nine patients were treated with doxycycline/minocycline plus hydroxylchloroquine and 3 patients were treated with doxycycline/minocycline. Patients were followed up for 3 months to 14 years, 7 patients stopped antibiotics after 12 to 30 months and were in stable condition. One patient died of heart failure 6 months after diagnosis and 1 patient lost follow-up. Three patients diagnosed in 2022 were still under treatment and in stable condition. Conclusions:The clinical manifestations of chronic Q fever lack of specificity and may involve multiple systems. Endocarditis and mycotic aneurysm are common complications. For long-term fever with new heart valve function damage or mycotic aneurysm patients, chronic Q fever should therefore be considered.

Pulmonary inflammatory myofibroblastic tumor (PIMT) is a rare lung tumor that is poorly understood by clinicians. Based on the data of patients with PIMT in our center, a comprehensive search and a brief summary analysis of previous reports of the disease were carried out in this article. PIMTs were more likely to be present in male patients and in the right lung, and their clinical and radiographic findings were heterogeneous. Surgery is the most important treatment method, and complete resection is of great significance to the prognosis of patients. Targeted therapy represented by crizotinib may be helpful for patients with positive ALK mutations.