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.Analysis of MET gene variation and clinicopathological characteristics of non-small cell lung cancer
Qiong ZHANG ; Yang SHEN ; Zhenhong JIANG ; Jianping HU ; Xinyu LONG ; Zhiqing CHEN ; Yuting RAO ; Yan ZHENG ; Yeqing ZOU
Chinese Journal of Clinical and Experimental Pathology 2025;41(6):713-718
Purpose The study aimed to analyze the relationship between MET gene variants and clinicopathologi-cal features in patients with non-small cell lung cancer(NSCLC).Methods Next-generation sequencing technology was used to detect MET gene variants in NSCLC specimens.The association between MET gene variant status and clini-copathological features was then analyzed.Results Among 1 633 cases of NSCLC,the overall MET mutation rate was 4.53%(74/1 633).Variants were mainly observed in male patients,never-smokers,those older than 60 years,ade-nocarcinoma histology,and patients with TNM stage Ⅲ+Ⅳ disease(P<0.05).MET gene variant status showed no significant assocication with patient age,sex,smoking history,or pathological subtype(P>0.05),but was statistical-ly correlated with clinical stage and presence of distant metastasis(P<0.05).The two major variant types were MET exon 14 skipping and MET amplification,which together accounted for 71.62%of all variants.In addition,MET am-plification was positively correlated with EGFR(P=0.003,rs=0.340)and TP53 mutations(P=0.002,rs=0.362),but showed no correlation with KRAS or ALK gene mutations.In contrast,MET exon 14 skipping was nega-tively correlated with EGFR gene mutations(P<0.001,rs=-0.409),and showed no significant correlation with KRAS,ALK,or TP53 mutations.Conclusion Different types of MET gene variants(amplification,exon 14 skip-ping,fusion,and others)are significantly associated with clinical advanced clinical stage and distant metastasis in NSCLC,but are independent of patient age,sex,smoking history,and pathological subtype.MET amplification fre-quently co-occur with EGFR and TP53 co-mutations.
3.An analysis of deaths in medical X-ray diagnostic workers in Jiangsu province during 1950-2021
Xindi WEI ; Wei CHEN ; Jin WANG ; Zihao ZHANG ; Yuji MIAO ; Yuanyuan ZHOU ; Xiangyong FAN ; Jinhan WANG ; Yeqing GU
Chinese Journal of Radiological Medicine and Protection 2025;45(7):655-662
Objective:To study the risk and pattern of deaths caused by various diseases in the population and in the case of long-term occupational X-ray exposure.Methods:Using a combination of retrospective and prospective cohort research methods, an exposure group of medical X-ray diagnostic workers who worked in the radiology department of Jiangsu Provincial Hospital between 1950 and 1980 and a control group of medical workers from other departments who did not work with radiolog during the same period in the same hospital were selected to form a study cohort. The cumulative number of person years of observation in the cohort during 1950-2011 was calculated, and the Cox regression model was used to calculate the risk of deaths of medical X-ray diagnostic workers for various diseases through adjusting sex, attained age, birth age, and starting working age.Results:A total of 6 953 follow-up visits was completed to the cohort, including 3 649 in the radiation group and 3 304 in the control group, with a total of 347 362 person years of observation. There were 2 099 deaths in the cohort as of December 31, 2021. Cox regression results showed that diseases with a significantly higher risk of death in the radiation group compared with the control group were: all-cancer ( RR=1.20, 95% CI: 1.04-1.39, Z=2.56, P<0.05, including lung cancer RR=1.52, 95% CI: 1.17-1.98, Z=3.10, P<0.01, and pancreatic cancer RR=1.96, 95% CI: 1.11-3.46, Z=2.31, P<0.05); diseases of the circulatory system ( RR=1.29, 95% CI: 1.06-1.57, Z=2.58, P<0.01); endocrine, nutritional and metabolic diseases ( RR=1.90, 95% CI: 1.06-3.42, Z=2.14, P<0.05). Stratified analyses showed that, of male workers, the radiation group had an increased risk of death caused by all-cancer and lung cancer ( Z=3.50, 2.92, P<0.01); of the age group at starting ages 26 to 30, the radiation group had an increased risk of death distributed to circulatory diseases ( Z=2.06, P<0.05); and in the age group at attained ages elder than 61 years, the radiation group had an increased risk of death distributed to all cancers, lung cancer, and circulatory diseases ( Z=2.90-4.31, P<0.01). Conclusions:As has been shown, threre is an increasing risk of death distributed to lung cancer, pancreatic cancer, and circulatory diseases in medical X-ray diagnostic workers in Jiangsu province. Further in-depth research in related areas may be conducted in the future.
4.RNA binding protein LIN28B promotes chemosensitivity of colon cancer by regulating the synthesis and activity of glutathione
Ning NING ; Yeqing SONG ; Yichao YAN ; Lin CHEN ; Yankai ZHANG
Chinese Journal of General Surgery 2025;40(8):643-649
Objective:To explore the influence of LIN28B on chemosensitivity of colon cancer by regulating GSH.Methods:Functional enrichment analysis of LIN28B target genes was performed using database. The primary tumor tissues of colon cancer patients who received neoadjuvant chemotherapy at Department of Gastroenterology, Peking University International Hospital from Nov 2017 to May 2020 were collected, and their LIN28B levels were detected by immunohistochemistry. According to the tumor regression grade, they were divided into chemotherapy sensitive group and chemotherapy resistant group, and the difference of LIN28B expression between the two groups was compared. LIN28B overexpression and knockdown colon cancer cell lines were constructed, and the effect of LIN28B on the chemosensitivity of colon cancer cells was detected by MTT assay. Double luciferase reporting experiment and Western blot were used to detect the direct binding and regulation of LIN28B to mRNA of four GSH related enzymes. At the same time, the regulation of LIN28B on total GSH and reduced GSH was tested. Finally, by detecting the level of reactive oxygen species (ROS) γ-H2AX and Comet assay to analyze the potential impact of LIN28B on genomic instability.Results:GSH-related enzymes were highly enriched in LIN28B target genes. The expression of LIN28B was heterogeneous in colon cancer patients. Compared with the low expression group, the average survival time of patients with high expression of LIN28B was significantly increased [(50.2±2.9 )months vs. (31.1±4.0 )months, P=0.001], and the proportion of tumor regression grade 0-1 was significantly different (48.0% vs. 16.0%, P=0.032). The expression level of LIN28B in chemotherapy sensitive group was significantly higher than that in drug resistant group ( P<0.01). LIN28B overexpression significantly increased the chemosensitivity of HCT116 cells to 5-fluorouracil (5-Fu) and oxaliplatin (L-OPH). The synthesis and activity of GSH were further inhibited (all P<0.01). At the same time, the ROS level of LIN28B overexpression cells was significantly increased after treatment with L-OPH. The level of γ-H2AX was significantly increased, and the content of comet tail DNA was also significantly increased ( P<0.01). Conclusion:LIN28B may increase the chemosensitivity of colon cancer cells by directly inhibiting the expression of GSH related enzymes, resulting in the decrease of GSH synthesis and activity, the increase of ROS level and genomic instability.
5.Effect of sodium-glucose cotransporter 2 inhibitor empagliflozin in alleviating uremic cardiomyopathy and related mechanism
Shi CHENG ; Yeqing XIE ; Wei LU ; Jiarui XU ; Yong YU ; Ruizhen CHEN ; Bo SHEN ; Xiaoqiang DING
Chinese Journal of Clinical Medicine 2025;32(2):248-258
Objective To investigate the effect of sodium-glucose cotransporter 2 inhibitor (empagliflozin, EMPA) on myocardial remodeling in a mouse uremic cardiomyopathy (UCM) model induced by 5/6 nephrectomy, through the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (PKB/AKT)/p65 signaling pathway. Methods The animals were divided into three groups: Sham group (n=6), UCM group (n=8), and UCM+EMPA group (n=8). A UCM model was established in C57BL/6N mice using the 5/6 nephrectomy. Starting from 5 weeks post-surgery, EMPA or a placebo was administered. After 16 weeks, blood pressure, serum creatinine, blood urea nitrogen, 24-hour urine glucose and urine sodium were measured. Cardiac structure and function were assessed by echocardiography. Hematoxylin-eosin (HE) staining and Masson trichrome staining were used to observe pathological changes in the heart and kidneys. Wheat germ agglutinin (WGA) staining was used to evaluate myocardial hypertrophy. The real-time quantitative PCR (RT-qPCR) was used to detect the expression levels of myocardial hypertrophy- and fibrosis-related mRNAs. Western blotting was used to detect the expression levels of PI3K, AKT and p65 in myocardial tissues. Results After 16 weeks, UCM group exhibited significantly higher blood pressure, serum creatinine, blood urea nitrogen than sham group (P<0.01); UCM+EMPA group exhibited lower blood pressure, serum creatinine, blood urea nitrogen, and higher 24 h urine sodium and glucose than UCM group (P<0.05). Echocardiographic results showed ventricular remodeling in the UCM group, evidenced by left ventricular wall thickening, left ventricular enlargement, increased left ventricular mass, and decreased systolic function (P<0.05); ventricular remodeling was alleviated (P<0.05), though there was no significant improvement in systolic function in UCM+EMPA group. HE and Masson stainings revealed myocardial degeneration, necrosis, and interstitial fibrosis in UCM group (P<0.01); the myocardial pathology improved with reduced collagen deposition in UCM+EMPA group (P<0.01). WGA staining confirmed myocardial hypertrophy in UCM group (P<0.01), while myocardial hypertrophy was alleviated in UCM+EMPA group (P<0.01). RT-qPCR results showed myocardial hypertrophy- and fibrosis-related genes (NPPA, NPPB, MYH7, COL1A1, COL3A1, TGF-β1) were upregulated in UCM group (P<0.05), but downregulated in UCM+EMPA group. Western blotting showed PI3K, p-AKT/AKT ratio, and p-p65/p65 ratio were increased in UCM group, but decreased in UCM+EMPA group (P<0.05). Conclusion EMPA can improve myocardial hypertrophy and fibrosis in the UCM mouse model, and it may play the role through inhibiting the PI3K/AKT/p65 signaling pathway.
6.Study on the Regularity of Essential Oils from Traditional Chinese Medicine with Hot Property in Enhancing Skin Permeabil-ity of Different Components
Zhichao SONG ; Senlan HUANG ; Xixi ZHU ; Shanshan LU ; Wenjun LIU ; Yeqing QU ; Jun CHEN
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(1):58-65
OBJECTIVE To study regularity of different components whose skin permeability is enhanced by essential oils(EOs)from traditional Chinese medicine(TCM)with hot property.METHODS Five EOs from TCM with hot property,namely Galangal oil,Dried Ginger oil,Cinnamon oil,Pepper oil,and Evodia oil were prepared and used in further studies.The in vitro skin cytotoxici-ty of these EOs and chemical penetration enhancer(PE)Azone were compared.HPLC method was established to determine 9 TCM components that are usually used in permeation studies.And the in vitro permeation experiments were carried out using the modified Franz diffusion cell method to evaluate the penetration enhancement effects of five EOs.RESULTS The cytotoxicity test revealed the IC50 value of EOs was 3.63-8.15 times of that of Azone,the classical chemical PE.HPLC method showed perfect specificity and 9 TCM components performed well in linear relationship,precision,repeatability,stability,and average recovery rate.The results of multiple linear regression showed a significant association between the penetration enhancement effects of EOs from TCM with hot prop-erty and log P values of the TCM components.EOs from TCM with hot property showed satisfactory penetration enhancement effects for hydrophobic components with log P values in the range of 2.6-3.5,e.g.resveratrol,tetrahydropalmatine and quercetin.CONCLU-SION EOs from TCM with hot property should be reasonably selected as PE according to the oil-water partition coefficient of the in-gredients.
7.An analysis of deaths in medical X-ray diagnostic workers in Jiangsu province during 1950-2021
Xindi WEI ; Wei CHEN ; Jin WANG ; Zihao ZHANG ; Yuji MIAO ; Yuanyuan ZHOU ; Xiangyong FAN ; Jinhan WANG ; Yeqing GU
Chinese Journal of Radiological Medicine and Protection 2025;45(7):655-662
Objective:To study the risk and pattern of deaths caused by various diseases in the population and in the case of long-term occupational X-ray exposure.Methods:Using a combination of retrospective and prospective cohort research methods, an exposure group of medical X-ray diagnostic workers who worked in the radiology department of Jiangsu Provincial Hospital between 1950 and 1980 and a control group of medical workers from other departments who did not work with radiolog during the same period in the same hospital were selected to form a study cohort. The cumulative number of person years of observation in the cohort during 1950-2011 was calculated, and the Cox regression model was used to calculate the risk of deaths of medical X-ray diagnostic workers for various diseases through adjusting sex, attained age, birth age, and starting working age.Results:A total of 6 953 follow-up visits was completed to the cohort, including 3 649 in the radiation group and 3 304 in the control group, with a total of 347 362 person years of observation. There were 2 099 deaths in the cohort as of December 31, 2021. Cox regression results showed that diseases with a significantly higher risk of death in the radiation group compared with the control group were: all-cancer ( RR=1.20, 95% CI: 1.04-1.39, Z=2.56, P<0.05, including lung cancer RR=1.52, 95% CI: 1.17-1.98, Z=3.10, P<0.01, and pancreatic cancer RR=1.96, 95% CI: 1.11-3.46, Z=2.31, P<0.05); diseases of the circulatory system ( RR=1.29, 95% CI: 1.06-1.57, Z=2.58, P<0.01); endocrine, nutritional and metabolic diseases ( RR=1.90, 95% CI: 1.06-3.42, Z=2.14, P<0.05). Stratified analyses showed that, of male workers, the radiation group had an increased risk of death caused by all-cancer and lung cancer ( Z=3.50, 2.92, P<0.01); of the age group at starting ages 26 to 30, the radiation group had an increased risk of death distributed to circulatory diseases ( Z=2.06, P<0.05); and in the age group at attained ages elder than 61 years, the radiation group had an increased risk of death distributed to all cancers, lung cancer, and circulatory diseases ( Z=2.90-4.31, P<0.01). Conclusions:As has been shown, threre is an increasing risk of death distributed to lung cancer, pancreatic cancer, and circulatory diseases in medical X-ray diagnostic workers in Jiangsu province. Further in-depth research in related areas may be conducted in the future.
8.Analysis of MET gene variation and clinicopathological characteristics of non-small cell lung cancer
Qiong ZHANG ; Yang SHEN ; Zhenhong JIANG ; Jianping HU ; Xinyu LONG ; Zhiqing CHEN ; Yuting RAO ; Yan ZHENG ; Yeqing ZOU
Chinese Journal of Clinical and Experimental Pathology 2025;41(6):713-718
Purpose The study aimed to analyze the relationship between MET gene variants and clinicopathologi-cal features in patients with non-small cell lung cancer(NSCLC).Methods Next-generation sequencing technology was used to detect MET gene variants in NSCLC specimens.The association between MET gene variant status and clini-copathological features was then analyzed.Results Among 1 633 cases of NSCLC,the overall MET mutation rate was 4.53%(74/1 633).Variants were mainly observed in male patients,never-smokers,those older than 60 years,ade-nocarcinoma histology,and patients with TNM stage Ⅲ+Ⅳ disease(P<0.05).MET gene variant status showed no significant assocication with patient age,sex,smoking history,or pathological subtype(P>0.05),but was statistical-ly correlated with clinical stage and presence of distant metastasis(P<0.05).The two major variant types were MET exon 14 skipping and MET amplification,which together accounted for 71.62%of all variants.In addition,MET am-plification was positively correlated with EGFR(P=0.003,rs=0.340)and TP53 mutations(P=0.002,rs=0.362),but showed no correlation with KRAS or ALK gene mutations.In contrast,MET exon 14 skipping was nega-tively correlated with EGFR gene mutations(P<0.001,rs=-0.409),and showed no significant correlation with KRAS,ALK,or TP53 mutations.Conclusion Different types of MET gene variants(amplification,exon 14 skip-ping,fusion,and others)are significantly associated with clinical advanced clinical stage and distant metastasis in NSCLC,but are independent of patient age,sex,smoking history,and pathological subtype.MET amplification fre-quently co-occur with EGFR and TP53 co-mutations.
9.Study on the Regularity of Essential Oils from Traditional Chinese Medicine with Hot Property in Enhancing Skin Permeabil-ity of Different Components
Zhichao SONG ; Senlan HUANG ; Xixi ZHU ; Shanshan LU ; Wenjun LIU ; Yeqing QU ; Jun CHEN
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(1):58-65
OBJECTIVE To study regularity of different components whose skin permeability is enhanced by essential oils(EOs)from traditional Chinese medicine(TCM)with hot property.METHODS Five EOs from TCM with hot property,namely Galangal oil,Dried Ginger oil,Cinnamon oil,Pepper oil,and Evodia oil were prepared and used in further studies.The in vitro skin cytotoxici-ty of these EOs and chemical penetration enhancer(PE)Azone were compared.HPLC method was established to determine 9 TCM components that are usually used in permeation studies.And the in vitro permeation experiments were carried out using the modified Franz diffusion cell method to evaluate the penetration enhancement effects of five EOs.RESULTS The cytotoxicity test revealed the IC50 value of EOs was 3.63-8.15 times of that of Azone,the classical chemical PE.HPLC method showed perfect specificity and 9 TCM components performed well in linear relationship,precision,repeatability,stability,and average recovery rate.The results of multiple linear regression showed a significant association between the penetration enhancement effects of EOs from TCM with hot prop-erty and log P values of the TCM components.EOs from TCM with hot property showed satisfactory penetration enhancement effects for hydrophobic components with log P values in the range of 2.6-3.5,e.g.resveratrol,tetrahydropalmatine and quercetin.CONCLU-SION EOs from TCM with hot property should be reasonably selected as PE according to the oil-water partition coefficient of the in-gredients.
10.RNA binding protein LIN28B promotes chemosensitivity of colon cancer by regulating the synthesis and activity of glutathione
Ning NING ; Yeqing SONG ; Yichao YAN ; Lin CHEN ; Yankai ZHANG
Chinese Journal of General Surgery 2025;40(8):643-649
Objective:To explore the influence of LIN28B on chemosensitivity of colon cancer by regulating GSH.Methods:Functional enrichment analysis of LIN28B target genes was performed using database. The primary tumor tissues of colon cancer patients who received neoadjuvant chemotherapy at Department of Gastroenterology, Peking University International Hospital from Nov 2017 to May 2020 were collected, and their LIN28B levels were detected by immunohistochemistry. According to the tumor regression grade, they were divided into chemotherapy sensitive group and chemotherapy resistant group, and the difference of LIN28B expression between the two groups was compared. LIN28B overexpression and knockdown colon cancer cell lines were constructed, and the effect of LIN28B on the chemosensitivity of colon cancer cells was detected by MTT assay. Double luciferase reporting experiment and Western blot were used to detect the direct binding and regulation of LIN28B to mRNA of four GSH related enzymes. At the same time, the regulation of LIN28B on total GSH and reduced GSH was tested. Finally, by detecting the level of reactive oxygen species (ROS) γ-H2AX and Comet assay to analyze the potential impact of LIN28B on genomic instability.Results:GSH-related enzymes were highly enriched in LIN28B target genes. The expression of LIN28B was heterogeneous in colon cancer patients. Compared with the low expression group, the average survival time of patients with high expression of LIN28B was significantly increased [(50.2±2.9 )months vs. (31.1±4.0 )months, P=0.001], and the proportion of tumor regression grade 0-1 was significantly different (48.0% vs. 16.0%, P=0.032). The expression level of LIN28B in chemotherapy sensitive group was significantly higher than that in drug resistant group ( P<0.01). LIN28B overexpression significantly increased the chemosensitivity of HCT116 cells to 5-fluorouracil (5-Fu) and oxaliplatin (L-OPH). The synthesis and activity of GSH were further inhibited (all P<0.01). At the same time, the ROS level of LIN28B overexpression cells was significantly increased after treatment with L-OPH. The level of γ-H2AX was significantly increased, and the content of comet tail DNA was also significantly increased ( P<0.01). Conclusion:LIN28B may increase the chemosensitivity of colon cancer cells by directly inhibiting the expression of GSH related enzymes, resulting in the decrease of GSH synthesis and activity, the increase of ROS level and genomic instability.

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