1.Introduction to Implementation Science Theories, Models, and Frameworks
Lixin SUN ; Enying GONG ; Yishu LIU ; Dan WU ; Chunyuan LI ; Shiyu LU ; Maoyi TIAN ; Qian LONG ; Dong XU ; Lijing YAN
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1332-1343
Implementation Science is an interdisciplinary field dedicated to systematically studying how to effectively translate evidence-based research findings into practical application and implementation. In the health-related context, it focuses on enhancing the efficiency and quality of healthcare services, thereby facilitating the transition from scientific evidence to real-world practice. This article elaborates on Theories, Models, and Frameworks (TMF) within health-related Implementation Science, clarifying their basic concepts and classifications, and discussing their roles in guiding implementation processes. Furthermore, it reviews and prospects current research from three aspects: the constituent elements of TMF, their practical applications, and future directions. Five representative frameworks are emphasized, including the Consolidated Framework for Implementation Research (CFIR), the Practical Robust Implementation and Sustainability Model (PRISM), the Exploration, Preparation, Implementation, Sustainment (EPIS)framework, the Behavior Change Wheel (BCW), and the Normalization Process Theory (NPT). Additionally, resources such as the Dissemination & Implementation Models Webtool and the T-CaST tool are introduced to assist researchers in selecting appropriate TMFs based on project-specific needs.
2.Prediction of Screw Loosening After Dynamic Pedicle Screw Fixation With Lumbar Polyetheretherketone Rods Using Magnetic Resonance Imaging-Based Vertebral Bone Quality Score
Guozheng JIANG ; Luchun XU ; Yukun MA ; Jianbin GUAN ; Yongdong YANG ; Wenqing ZHONG ; Wenhao LI ; Shibo ZHOU ; JiaWei SONG ; Ningning FENG ; Ziye QIU ; Zeyu LI ; YiShu ZHOU ; Letian MENG ; Yi QU ; Xing YU
Neurospine 2024;21(2):712-720
Objective:
To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value.
Methods:
A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL).
Results:
A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%).
Conclusion
The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.
3.Prediction of Screw Loosening After Dynamic Pedicle Screw Fixation With Lumbar Polyetheretherketone Rods Using Magnetic Resonance Imaging-Based Vertebral Bone Quality Score
Guozheng JIANG ; Luchun XU ; Yukun MA ; Jianbin GUAN ; Yongdong YANG ; Wenqing ZHONG ; Wenhao LI ; Shibo ZHOU ; JiaWei SONG ; Ningning FENG ; Ziye QIU ; Zeyu LI ; YiShu ZHOU ; Letian MENG ; Yi QU ; Xing YU
Neurospine 2024;21(2):712-720
Objective:
To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value.
Methods:
A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL).
Results:
A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%).
Conclusion
The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.
4.Prediction of Screw Loosening After Dynamic Pedicle Screw Fixation With Lumbar Polyetheretherketone Rods Using Magnetic Resonance Imaging-Based Vertebral Bone Quality Score
Guozheng JIANG ; Luchun XU ; Yukun MA ; Jianbin GUAN ; Yongdong YANG ; Wenqing ZHONG ; Wenhao LI ; Shibo ZHOU ; JiaWei SONG ; Ningning FENG ; Ziye QIU ; Zeyu LI ; YiShu ZHOU ; Letian MENG ; Yi QU ; Xing YU
Neurospine 2024;21(2):712-720
Objective:
To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value.
Methods:
A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL).
Results:
A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%).
Conclusion
The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.
5.Long non-coding RNA RMST inhibits cell proliferation,migration and invasion by targeting microRNA-24-3p in OSCCs
Journal of Practical Stomatology 2024;40(1):47-52
Objective:To explore the role of long non-coding RNA rhabdomyosarcoma 2 associated transcript(lncRNA RMST)and microRNA-24-3p(miR-24-3p)in proliferation,migration and invasion of oral squamous cell carcinoma cells(OSCCs).Methods:The RMST expression in head and neck squamous cell carcinoma(HNSC)was analyzed by UALCAN data base.qRT-PCR was used to detect the expression of RMST and miR-24-3p in 5 human OSCC cell lines.CAL27 cells were in vitro cultured and allocated into con-trol group,pcDNA3.1 group(vector),pcDNA3.1-RMST+mimics-NC group(overexpression of RMST+negative control of miR-24-3p)and pcDNA3.1-RMST+miR-24-3p mimics group(overexpression of RMST+miR-24-3p).Dual luciferase reporter assay was per-formed to analyze the interaction between RMST and miR-24-3p.MTT assay,wound-healing and transwell assay were applied to de-tect the proliferation,migration and invasion of the cells.Western blot and qRT-PCR were conducted to measure the expression of E-cadherin,N-cadherin and c-myc in the cells.Results:RMST level were down-regulated in HNSC tissues and OSCC cell lines(P<0.01).While miR-24-3p level was elevated in OSCC cell lines(P<0.01).miR-24-3p was identified and confirmed as a potential binding partner to RMST.miR-24-3p level was lower in pcDNA3.1-RMST group than in pcDNA3.1 group(P<0.01).The prolifera-tion,migration and invasion abilities of CAL27 cell in pcDNA3.1-RMST+mimics-NC group were lower than in pcDNA3.1 group(P<0.01).While those of CAL27 cells in pcDNA3.1-RMST+miR-24-3p mimics group were higher than in pcDNA3.1-RMST+mimics-NC group(P<0.01).Compared with pcDNA3.1 group,pcDNA3.1-RMST+miR-24-3p mimics showed higher expression of E-cad-herin,lower expression of N-cadherin and c-myc(P<0.01).Compared with pcDNA3.1-RMST+miR-24-3p mimics group,pcD-NA3.1-RMST+miR-24-3p mimics group showed lower expression of E-cadherin,higher expression of N-cadherin and c-myc(P<0.01).Conclusion:Down-expressed RMST may suppress the proliferation,migration and invasion progression of OSCC cells through targeting miR-24-3p.
6.Diagnostic value of procalcitonin in infections in patients with malignant hematologic diseases
Mei LIU ; Yishu TANG ; Yulian XIAO ; Lingyan YAN ; Linzhi XIE ; Xinyi LONG ; Yan YU ; Xin LI
Journal of Central South University(Medical Sciences) 2024;49(5):721-729
Objective:The incidence of infections in patients with malignant hematologic diseases is extremely high and significantly affects their prognosis.Identifying early and precise biomarkers for infection is crucial for guiding the treatment of infections in these patients.Previous studies have shown that procalcitonin(PCT)can serve as an early diagnostic marker for bloodstream infections in patients with malignant hematologic diseases.This study aims to compare serum PCT levels in these patients with different pathogens,disease types,infection sites,and severity levels. Methods:Clinical data and laboratory results of infected patients with malignant hematologic diseases treated at the Department of Hematology,the Third Xiangya Hospital of Central South University from January 2018 to August 2023 were collected.General patient information was retrospectively analyzed.Serum PCT levels were compared among patients with different pathogens,types of malignant hematologic diseases,infection sites,and infection severity;Receiver operator characteristic(ROC)curves were used to determine the cut-off values and diagnostic value of serum PCT levels in diagnosing bloodstream infections versus local infections and severe infections versus non-severe infections.Mortality rates after 4-7 days of anti-infective treatment were compared among groups with rising,falling,and unchanged PCT levels. Results:A total of 526 patients with malignant hematologic diseases were included.The main pathogens were Gram-negative bacteria(272 cases,51.7%),followed by Gram-positive bacteria(120 cases,22.8%),fungi(65 cases,12.4%),viruses(23 cases,4.4%),and mixed pathogens(46 cases,8.7%).The main types of malignant hematologic diseases were acute myeloid leukemia(216 cases,41.1%),acute lymphoblastic leukemia(107 cases,20.3%),and lymphoma(93 cases,17.7%).Granulocyte deficiency was present in 68.3%(359 cases)of the patients during infection,with severe infection in 24.1%(127 cases).Significant differences in serum PCT levels were found among patients with different types of pathogens(P<0.001),with the highest levels in Gram-negative bacterial infections.Significant differences in serum PCT levels were also found among patients with different types of malignant hematologic diseases(P<0.05),with the highest levels in lymphoma patients.Serum PCT levels were significantly higher in systemic infections and severe infections compared to local infections and non-severe infections(both P<0.001).ROC curve analysis showed that the cut-off values for diagnosing bloodstream infections and severe infections were 0.22 and 0.28 ng/mL,with areas under the curve of 0.670 and 0.673,respectively.After 4-7 days of anti-infective treatment,the mortality rates of the PCT declining,PCT unchanged,and PCT rising groups were 11.9%,21.2%,and 35.7%,respectively,and pairwise comparisons were statistically significant(all P<0.05). Conclusion:PCT can be used as an auxiliary indicator for early identification of different pathogens,infection sites,and severity levels in patients with malignant hematologic diseases combined with infections.Dynamic monitoring of PCT levels after empirical antibiotic treatment provides important guidance for assessing patient's prognosis.
7.Prediction of Screw Loosening After Dynamic Pedicle Screw Fixation With Lumbar Polyetheretherketone Rods Using Magnetic Resonance Imaging-Based Vertebral Bone Quality Score
Guozheng JIANG ; Luchun XU ; Yukun MA ; Jianbin GUAN ; Yongdong YANG ; Wenqing ZHONG ; Wenhao LI ; Shibo ZHOU ; JiaWei SONG ; Ningning FENG ; Ziye QIU ; Zeyu LI ; YiShu ZHOU ; Letian MENG ; Yi QU ; Xing YU
Neurospine 2024;21(2):712-720
Objective:
To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value.
Methods:
A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL).
Results:
A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%).
Conclusion
The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.
8.Prediction of Screw Loosening After Dynamic Pedicle Screw Fixation With Lumbar Polyetheretherketone Rods Using Magnetic Resonance Imaging-Based Vertebral Bone Quality Score
Guozheng JIANG ; Luchun XU ; Yukun MA ; Jianbin GUAN ; Yongdong YANG ; Wenqing ZHONG ; Wenhao LI ; Shibo ZHOU ; JiaWei SONG ; Ningning FENG ; Ziye QIU ; Zeyu LI ; YiShu ZHOU ; Letian MENG ; Yi QU ; Xing YU
Neurospine 2024;21(2):712-720
Objective:
To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value.
Methods:
A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL).
Results:
A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%).
Conclusion
The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.
9.Clinical Efficacy of Qimai Qinlou Prescription in Treating Elderly Community-acquired Pneumonia (Non-severe) with Qi and Yin Deficiency and Phlegm-heat Obstructing Lung Syndrome
Yishu LIU ; Qiuyue HUANG ; Huan ZHU ; Hanjiao LI ; Ruoheng WEI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(15):88-95
ObjectiveTo evaluate the clinical efficacy of Qimai Qinlou prescription in the treatment of elderly community-acquired pneumonia (CAP) (non-severe) with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome and its impact on immune-inflammatory factors. MethodA total of 120 eligible patients were randomly divided into an observation group (60 cases) and a control group (60 cases). Both groups received intravenous cefoxitin sodium. In addition, the observation group received oral Qimai Qinlou prescription, while the control group received an oral placebo simulating Qimai Qinlou prescription. The treatment course was 14 days. The disappearance time of major clinical symptoms and signs was recorded. Traditional Chinese medicine (TCM) syndrome scores and the Clinical Research Outcome (CAP-CRO) scale scores for pneumonia of the two groups were compared. Chest computed tomography (CT) scans were performed, and peripheral blood levels of procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), CD4+, CD8+, and CD4+/CD8+ were measured. The conversion rate to severe condition during hospitalization, readmission rate within 30 days after discharge, and safety evaluation were recorded. ResultAfter treatment, the observation group showed significantly shorter time of fever, cough, expectoration, and disappearance time of lung moist rales than the control group (P<0.01). The TCM syndrome scores, CAP-CRO scores in all dimensions, and total scores in both groups were significantly reduced as compared with those before treatment (P<0.01). After treatment, the observation group had a more significant reduction than the control group (P<0.01). The levels of PCT, IL-6, SAA, and hs-CRP in both groups were significantly reduced as compared with those before treatment (P<0.01). After treatment, the observation group showed a more significant reduction than the control group (P<0.01). There was no statistically significant difference in the changes of CD4+, CD8+, and CD4+/CD8+ in the control group before and after treatment. However, in the observation group, CD4+ and CD4+/CD8+ levels significantly increased (P<0.01), while CD8+ level significantly decreased (P<0.01) after treatment. After treatment, CD4+ and CD4+/CD8+ in the observation group significantly increased (P<0.01), and CD8+ significantly decreased as compared with those in the control group (P<0.01). At 7, 10, and 14 days after treatment, the curative rates in the observation group were 53.33% (32/60), 85.00% (51/60), and 91.67% (55/60), respectively, which were higher than 31.67% (19/60), 61.67% (37/60), and 68.33% (41/60) in the control group (χ2=5.763, 8.352, 10.208, P<0.05). After treatment, the total effective rate of CT scanning in the observation group was 93.33% (56/60), higher than 80.00% (48/60) in the control group (χ2=4.615, P<0.05). The conversion rate to severe condition during hospitalization in the observation group was 3.33% (2/60), lower than 15.00% (9/60) in the control group (χ2=4.904, P<0.05). The readmission rate within 30 days after discharge in the observation group was 8.33% (5/60), lower than 23.33% (14/60) in the control group (χ2=5.065, P<0.05). No serious adverse drug reactions were observed in either group during the treatment period. ConclusionQimai Qinlou prescription can enhance immune function, alleviate inflammatory reactions, significantly relieve clinical symptoms, shorten the duration of the disease, improve the curative rate and CT scanning efficacy, prevent disease progression, reduce the readmission rate in the short term, and is clinically safe for the treatment of elderly patients with non-severe CAP with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome. It is worthy of further research and application.
10.Research progress in decision-making aids for breast cancer patients.
Juan LI ; Bo YUAN ; Yishu WANG ; Jie ZHANG ; Silan YANG ; Yuchen WU ; Jingping ZHANG ; Yao XIAO
Journal of Central South University(Medical Sciences) 2021;46(2):176-182
Decision-making aid for cancer patients is of great significance in the diagnosis and treatment for diseases. Breast cancer is one of the most common malignant tumors in women all over the world, and breast cancer patients have become the main target population for decision-aided research. Application of decision-making assistance for patients in Western countries has developed to a certain extent, while relevant research in China is still at the early stage. There are kinds of intervention forms for patients' decision aids, including traditional brochures and videos, decision aids systems, decision coaching, multidisciplinary breast cancer teams, etc. The tools for decision-making quality evaluation include the patients' awareness for decision-making, participation, decision-making conflict, decision-making satisfaction, decision-making regret, which can provide important guidance for the application of decision-making aid treatment in breast cancer patients in the future.
Breast Neoplasms/therapy*
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China
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Decision Making
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Emotions
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Female
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Humans
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Personal Satisfaction

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