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.Correlation of "Parts-components-properties" of Traditional Chinese Medicines from Latex-containing Plants
Jianglong HE ; Baoyu JI ; Panpan LI ; Xiuqing LI ; Wange WU ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):124-132
ObjectiveTo investigate the correlation among the botanical characteristics, biological characteristics, chemical composition, and medicinal properties and efficacy of traditional Chinese medicines (TCM) from latex-containing plants, so as to strengthen the theory of "identifying symptoms for qualities" and provide a reference for the development and utilization of the latex-containing plant resources. MethodStatistics on the meridians for properties and tastes, efficacy, medicinal parts, family and genus, and chemical components of TCM from latex-containing plants were carried out. A total of 53 TCM from latex-containing plants included in the 2020 edition of the Chinese Pharmacopoeia were screened by mining the Chinese Botanical Journal, Chinese Materia Medica, Dictionary of Traditional Chinese Medicines, and related literature. In addition, their meridians for properties and tastes, medicinal parts, chemical components, and TCM classifications were summarized and statistically analyzed by using Excel 2013 and ChiPlot 2023.3.31 software. ResultIt was found that latex-containing plants were mainly distributed in one kingdom, one phylum, two classes, and 20 families, and most of the TCM from latex-containing plants belonged to Dicotyledonaceae under Angiosperms. In terms of properties and tastes, plain>cold>warm>cool>hot and bitter>pungent>sweet>sour>salty. In terms of meridians, liver>lung>kidney>spleen=large intestine=stomach>heart>bladder=gallbladder=small intestines. In terms of medicinal parts, roots (root, rhizomes, tuberous root, and root bark)>resin>seed>whole herb (whole herb and above-ground part)>stem (stem and branch)>fruit>leaf>flower=skin. In terms of research on chemical components, they were mostly glycosides. In terms of TCM classification, they were mostly medicines for activating blood circulation and removing blood stasis. ConclusionThe TCM from latex-containing plants is mainly plain, with a uniform warm and cold distribution. The tastes are mainly bitter and pungent, and the major meridians are the liver and lung. The roots and resins are mainly used as medicines. The components mostly contain glycosides, alkaloids, and volatile oils, and most of them are medicines for activating blood circulation and removing blood stasis, as well as for removing heat and toxins. There is a certain degree of correlation among the growth habits, medicinal parts, chemical components, and the properties, tastes, and efficacy of the TCM from latex-containing plants. It may provide a reference for resource development and utilization of TCM from latex-containing plants.
3.Correlation Analysis of Traditional Chinese Medicines from Fungi Based on "Habit-Growth Environment-part-medicinal Properties"
Xiuqing LI ; Baoyu JI ; Jianglong HE ; Panpan LI ; Wange WU ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):133-139
ObjectiveThe relevant laws among the biological characteristics, medicinal parts, growth environment, and medicinal properties and efficacy of traditional Chinese medicines (TCM) from fungi were excavated, so as to strengthen the theory of distinguishing symptoms for quality and provide a reference for the development and utilization of TCM from fungi. MethodThe medicinal parts, meridians for properties and tastes, heterotrophic mode, and efficacy of commonly used TCM from fungi were summarized. By consulting the Compendium of Materia Medica, Shennong Materia Medica, Flora of China, and literature, the TCM from fungi indexed in the 2020 edition of the Chinese Pharmacopoeia and some local pharmacopeias were checked. ResultA total of 28 common TCM from fungi were selected. Different TCMs from fungi have different meridians for properties and tastes, medicinal parts, habits, and growth environments. The relevant information was counted. Among the four properties, plain>cold>warm. Among the five tastes, sweet>bitter>light>pungent=salty. In terms of medicinal parts, fruiting body>sclerotia>complex>spermia=outer skin=other. In terms of meridians, lung>liver=heart>spleen=kidney>stomach. In terms of habits, parasitism>saprophysis>symbiosis=facultative parasitism=facultative saprophysis. ConclusionTCM from fungi are mainly parasitic and saprophytic, and the plain property and sweet taste the most. The meridians are mostly lung, heart, and liver. Nourishment and diuresis are the main efficacy. There is a certain correlation between the color, habit, medicinal parts, and growth environment of TCM from fungi and their properties, tastes, and efficacy, providing comprehensive literature reference and theoretical basis for their in-depth research, clinical use, and resource development.
4.Correlation of "Medicinal Tissue-property, Taste, and Efficacy-clinical Application" of Traditional Chinese Medicine from Plant Skin
Panpan LI ; Baoyu JI ; Jianglong HE ; Xiuqing LI ; Wange WU ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):149-158
ObjectiveTo investigate the functions and characteristics of traditional Chinese medicine (TCM) from plant skin and their Chinese patent medicines and explore the related laws of the medicinal tissue, property, taste, efficacy, and clinical application, so as to strengthen the theory of identifying symptoms for qualities and provide references for the development and utilization of TCM from plant skin and their Chinese patent medicines. MethodBy reviewing the 2020 edition of the Chinese Pharmacopoeia and some local pharmacopeias, TCM from plant skin and their Chinese patent medicines were screened out, and the characteristics, functions, and precautions of TCM from plant skin and their Chinese patent medicines were summarized. Statistical analysis was carried out with Excel. ResultA total of 62 TCM from plant skin were found, mainly distributed in one kingdom, three phyla, and 31 families. In terms of the family genus, Rutaceae>Leguminosae>Cucurbitaceae. In terms of the medicinal tissue, bark>root bark>fruit bark>seed bark. In terms of property and taste, warm>cold>plain>cool>hot, and bitter>sweet=pungent>acidic. In terms of meridians, lung>liver>spleen>heart>colorectal>kidney>stomach=bladder. In terms of TCM classification, most of them belong to the category of heat-clearing medicines. There were 485 types of Chinese patent medicines from plant skin, with the most Chinese patent medicines containing Citri Reticulatae Pericarpium. Among the forms of administration, pills were the most predominant. In terms of the tastes of the medicines, bitter and sweet flavors predominated. In terms of functions, medicines for strengthening the body resistance were the most. For the precautions, contraindications during pregnancy were the most common. ConclusionThere is a correlation among medicinal tissue, property, taste, efficacy, and clinical application of TCM from plant skin. It is also necessary to pay attention to the contraindications of the medicines and rationally choose TCM from plant skin and their Chinese patent medicines under the guidance of TCM theory based on syndrome differentiation and treatment.
5.Reliability of photogrammetry for evaluating pelvic posture in healthy individuals
Miaomiao DONG ; Xiang LI ; Jiani XIE ; Lixin ZHANG ; Yuexi WANG
Chinese Journal of Tissue Engineering Research 2024;28(36):5846-5851
BACKGROUND:In clinical practice,the anterior superior iliac spine and posterior superior iliac spine are usually located by palpation,and the tilt of the pelvis is determined by visual observation method or photogrammetry.Among them,the visual observation method can only have qualitative conclusions,and its reliability is poor.The photogrammetry is not only more convenient and fast,but also can give more accurate quantitative data,which is one of the best clinical evaluation methods.However,there are no studies on the reliability of pelvic posture assessment using photogrammetry in China. OBJECTIVE:To evaluate the pelvic posture by visual observation method and photogrammetry,and to compare the reliability level of the two methods to guide clinical application. METHODS:Forty-five healthy subjects were selected and red marks were made at the bilateral anterior superior iliac spine and posterior superior iliac spine.Pelvic posture was photographed from the front,back(coronal plane),left,and right(sagittal plane).The left and right pelvic tilt angles(α,β angles)were selected from the front and back views,which represented the angle between the bilateral anterior superior iliac spine line or the bilateral posterior superior iliac spine line and the horizontal line.The anterior and posterior pelvic tilt angles(γ,θ angles)were selected from the side view,which represented the angle between the ipsilateral anterior superior iliac spine and posterior superior iliac spine line and the horizontal plane,indicating the sagittal plane pelvic tilt.Evaluation methods included visual observation method and photogrammetry.Two evaluators independently evaluated the pelvic α,β,γ,θ angles using the visual observation method first,and then recorded the pelvic α,β,γ,θ angles using the photogrammetry.After a one-month interval,the visual observation method and photogrammetry were performed again,and the pelvic α,β,γ,θ angles were recorded.The intraclass correlation coefficients were used to analyze the data obtained from the two evaluation methods and the before-and-after measurements:0.90-0.99 as an excellent correlation,0.80-0.89 as a good correlation,0.70-0.79 as a moderate correlation,and≤0.69 as a poor correlation.The standard error of measurement and the minimal detectable change with 95%confidence intervals were calculated to evaluate the inter-rater and intra-rater reliability. RESULTS AND CONCLUSION:(1)The interrater intraclass correlation coefficients of the visual observation method and photogrammetry were as follows:anterior view:0.682 and 0.718,posterior view:0.513 and 0.867,left view:0.739 and 0.960,and right view:0.756 and 0.971.The visual observation method showed poor correlation between the anterior and posterior views and moderate correlation between the left and right views,while the photogrammetry showed moderate correlation for the anterior view,good correlation for the posterior view,and excellent correlation for the left and right views.The standard error values of measurement were as follows:anterior view:3.266 and 1.625,posterior view:4.278 and 1.763,left view:5.935 and 1.787,and right view:5.723 and 1.698.The minimal detectable change values with 95%confidence intervals were as follows:anterior view:9.053 and 4.504,posterior view:11.858 and 4.887,left view:16.451 and 4.953,and right view:15.863 and 4.707.(2)The interrater intraclass correlation coefficients of the visual observation method and photogrammetry were as follows:anterior view:0.452 and 0.723,posterior view:0.483 and 0.904,left view:0.518 and 0.955,and right view:0.657 and 0.968.The visual observation method showed poor correlation in all four directions,while the photogrammetry showed moderate correlation for the anterior view and excellent correlation for the other three directions.The standard error values of measurement were as follows:anterior view:5.651 and 1.610,posterior view:4.237 and 1.523,left view:7.322 and 1.891,and right view:6.509 and 1.781.The minimal detectable change values with 95%confidence intervals were as follows:anterior view:15.664 and 4.463,posterior view:11.744 and 4.222,left view:20.296 and 5.242,and right view:18.042 and 4.937.(3)These results confirm that the sagittal and coronal plane photogrammetries have good intrarater and interrater reliability for evaluating pelvic posture,especially with the use of the photogrammetry,which has good data stability.This method is simple,fast,efficient,accurate,low-cost,and does not cause X-ray damage,and can qualitatively and quantitatively reflect the actual situation of the patient's pelvis,making it suitable for clinical use.
6.Study on the relationship between CHFR and MACC1 expressions and sensitivity of patients with rectal cancer for neoadjuvant concurrent chemoradiotherapy
Xinyuan ZHANG ; Yongfeng FU ; Lili BAI ; Sen YANG ; Lixin DONG
China Medical Equipment 2024;21(2):98-103
Objective:To investigate the relationship between the expressions of checkpoint with forkhead-associated and ring finger(CHFR)and metastasis-associated protein 1(MACC1)and the sensitivity of patients with rectal cancer for neoadjuvant concurrent chemoradiotherapy(nCRT).Methods:The medical documents of 166 patients with rectal cancer admitted to First Hospital of Qinhuangdao from March 2017 to February 2022 were collected.All patients only received nCRT before surgery,and the radiotherapy adopted three-dimensional conformal intensity modulated radiotherapy,and chemotherapy adopted Capeox scheme.All patients successfully completed total mesorectal excision after 4-6 weeks of nCRT treatment.Immunohistochemical SP staining method was used to detect the protein expressions of CHFR and MACC1 in rectal cancer and its adjacent tissues.According to the tumor regressive grading(TRG)standard of the Joint Committee on Cancer Staging in the United States,75 patients who were grade 0-2 as TRG after nCRT were included in the nCRT insensitive group,and 91 patients who were grade 3-4 as TRG were included in the nCRT sensitive group.The expression levels of CHFR and MACC1 proteins in cancer tissues before and after treatment between the two groups were compared.And then,the relationship between clinically pathological characteristics of patients and nCRT sensitivity was analyzed,and the influencing factors of nCRT sensitivity were analyzed.The receiver operating characteristic(ROC)curves of them were drawn,and area under curve(AUC)values were calculated,and the predictive values of CHFR and MACC1 for the sensitivity of patients with rectal cancer to nCRT were further analyzed.Results:The CHFR positive expression rate in rectal cancer tissue was significantly lower than that in adjacent tissues of rectal cancer,and the MACC1 positive expression rate in rectal cancer tissue was significantly higher than that in adjacent tissues of rectal cancer(x2=81.373,87.150,P<0.05),respectively.After 166 patients completed the nCRT treatment,there were 6 cases of TRG grade 0,8 cases of TRG grade 1,61 cases of TRG grade 2,59 cases of TRG grade 3 and 32 cases of TRG grade 4.The sensitivity rate of nCRT was 54.82%(91/166).The CHFR positive expression rate in the nCRT sensitive group was significantly higher than that in the nCRT insensitive group,and the MACC1 positive expression rate in the nCRT sensitive group was significantly lower than that in the nCRT insensitive group(x2=4.613,37.509,P<0.05).The proportions of T4 stage and N+stage in the nCRT sensitive group were higher than those in the nCRT insensitive group,and the differences were statistically significant(x2=54.432,28.912,P<0.05),respectively.The expressions of CHFR and MACC1 were respectively independent risk factor affected the sensitivity of patients with rectal cancer to nCRT[OR=2.456(95% CI:1.294-4.563),OR=3.281(95% CI:1.472-6.479),P<0.05].The sensitivity and specificity of the combined detection of CHFR and MACC1 were respectively 65.89% and 69.46% in predicting the nCRT sensitivity for rectal cancer.The predictive value of the combined detection was higher than that of single CHFR detection and single MACC1 detection(AUC values of them were respectively 0.713,0.564,0.589,P<0.05),respectively.Conclusion:CHFR and MACC1 are related to the sensitivity of patients with rectal cancer to nCRT,which means patients with high expression of CHFR and low expression of MACC1 are more sensitive to nCRT.Therefore,both of them may be indicators that predict the sensitivity of patients with rectal cancer to nCRT.
7."Medicinal Part-Habitat-Nature, Taste, and Effect" Correlations of Pteridophyte-derived Chinese Medicinal Materials
Wange WU ; Baoyu JI ; Jianglong HE ; Xiuqing LI ; Panpan LI ; Suiqing CHEN ; Chengming DONG ; Hongxin CUI ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):204-211
ObjectiveTo explore the correlations between botanical characteristics, biological characteristics, growth environment, and medicinal properties of common pteridophyte-derived Chinese medicinal materials, thus providing evidence for the theory of quality evaluation through morphological identification and giving insights into the extensive and reasonable application of pteridophytes in traditional Chinese medicine (TCM). MethodThe medicine parts, habitats, natures, tastes, and effects of the commonly used pteridophyte-derived Chinese medicinal materials were summarized. The commonly used pteridophyte-derived Chinese medicinal materials were retrieved from the Pharmacopoeia of China, Dictionary of Chinese Materia Medica, and related literature. Excel 2016, ChiPlot, Cytoscape 3.7.1, SPSS 21.0, and weiciyun software were used for statistical analysis. ResultThe frequency of the habitats followed the trend of streamside wetland>tree trunk and rock crevices>sunslope>water surface. The frequency of medicinal parts presented the trend of whole plant>rhizome>leaf>dried aboveground part>spore. The frequency of natures was in the order of cool>cold>plain>warm>hot, and that of tastes was in an order of bitter>pungent>sweet>bland>salty. The frequency of meridian tropism followed the trend of liver meridian>stomach meridian>lung meridian>kidney meridian>bladder meridian>heart meridian>large intestine meridian>spleen meridian>small intestine meridian. The effects of the pteridophyte-derived Chinese medicinal materials followed a frequency trend of clearing heat and detoxifying>promoting urination and relieving stranguria>cooling blood and stopping bleeding>activating blood and resolving stasis>dispelling wind and eliminating dampness. ConclusionThe pteridophyte-derived Chinese medicinal materials mainly have a cool nature, a bitter taste, and tropism to the liver meridian. Whole plants and roots are mainly used for medicinal purposes, and most of these plants grow in the wetlands near rivers, under trees, and in tree trunk and rock crevices. The main effects of these medicinal materials are clearing heat and detoxifying, dispelling wind and removing dampness, cooling blood and stopping bleeding, activating blood and resolving stasis, and soothing meridians and dredging collaterals. There are certain correlations between the structures, habitats, medicinal parts, and effects of pteridophyte-derived Chinese medicinal materials, which provide reference for the development and utilization of pteridophyte-derived Chinese medicinal material resources.
8."Medicinal Part-Habitat-Tissue-Component" Correlations of Aquatic Chinese Medicinal Plants
Lin CHEN ; Baoyu JI ; Lixin PEI ; Shuangquan XU ; Tangshuai LI ; Suiqing CHEN ; Chengming DONG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):212-221
ObjectiveTo explore the correlations between the medicinal parts, habitats, tissue, components, and medicinal properties (natures, tastes, and effects) of 100 aquatic Chinese medicinal plants, thus providing evidence for the relationship between image and analogy and laying a theoretical foundation for the clinical use and development of aquatic Chinese medicinal plant resources. MethodThe Aquatic Plants of China, Flora of China, and related literature were searched, and a total of 100 aquatic Chinese medicinal plants included in the Chinese Pharmacopoeia (2020 edition), Chinese Materia Medica, National Compilation of Chinese Herbal Medicines, Dictionary of Chinese Materia Medica, and local standards were screened out. The medicine-taxonomic status-life habit associations and nature-component-traditional Chinese medicine classification-pharmacological effect associations were analyzed respectively. ResultThe aquatic Chinese medicinal plants mostly had a cold nature, bitter, pungent, and sweet tastes, and tropism to the liver meridian. The whole plant or aerial part was mainly used for medicinal purposes, and these plants generally had well developed aerenchyma. These plants mainly contained flavonoids, alkaloids, and volatile oils and had the effects of clearing heat, detoxifying, and promoting urination. ConclusionThere are correlations between the medicinal parts, habitats, tissue, components, medicinal properties, and effects of aquatic Chinese medicinal plants, which provide reference for the development and utilization of aquatic Chinese medicinal plant resources.
9.Based on "Medicinal Part-Chemical Component-Pharmacological Activity-Nature, Taste, and Effect" Correlations of Thorny Medicinal Plants
Tangshuai LI ; Baoyu JI ; Lin CHEN ; Shuangquan XU ; Jianglong HE ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):222-230
ObjectiveTo make statistics on the biological characteristics, medicinal parts, chemical components, and other aspects of thorny medicinal plants and systematically analyze the correlations between their natures, tastes, and meridian tropism, so as to provide a theoretical basis for the clinical application and resource development of these plants. MethodThe Chinese Pharmacopoeia (2020 edition) and the processing standards of various provinces and cities and other related documents were reviewed, on the basis of which 46 species of thorny medicinal plants were selected. The natures, tastes, meridian tropism, medicinal parts, chemical components, pharmacological activities, and geographical distribution of these plants were summarized and analyzed in Excel 2013 and SPSS Statistics 26.0. ResultThe 46 species of thorny medicinal plants belonged to 25 families, 1 class, 1 phylum of 1 kingdom. In terms of the location of thorns, the frequency of these medicinal plants followed the trend of leaf thorns>peel thorns>branch thorns>fruit thorns. In terms of the nature, taste, and meridian tropism, the frequency of these plants was in the orders of warm>plain>cold>cool>hot, bitter>sweet>pungent>sour>salty, and liver>lung>spleen=large intestine>heart>kidney, respectively. In terms of the medicinal parts, the frequency followed the trend of roots and rhizomes>fruits>whole plants>flowers>leaves. The thorny medicinal plants were mainly distributed in north and southwest China. The thorny medicinal plants mainly contained flavonoids, alkaloids, and saponins and had the effects of clearing heat and detoxifying, resolving stasis and eliminating carbuncle, moving Qi and relieving pain, and alleviating edema and expelling pus. Moreover, 24 of them had anti-tumor activity. ConclusionMost of the thorny medicinal plants belong to Compositae, Leguminosae, and Rosaceae, have leaf thorns, a warm nature, a bitter taste, tropism to the liver meridian, and roots as the medicinal part. These plants are mainly distributed in north China, with the effects of clearing heat and detoxifying, resolving stasis and eliminating carbuncle. In summary, the thorn location, distribution, and medicinal parts of thorny medicinal plants are correlated with the natures, tastes, and meridian tropism. The findings provide clues for the development and utilization of these plants.
10.Influencing factors of occupational stress and health effect among grassroots medical and health personnel in Xiong’an New Area, Hebei Province based on Bayesian network
Huixia LI ; Junqin ZHAO ; Lixin YANG ; Qiuying DONG ; Jinmei SHI ; Jianguo LI ; Chunxiang ZHAO ; Yan GAO
Journal of Environmental and Occupational Medicine 2024;41(12):1400-1406
Background Grassroots medical and health personnel are an important component of China's public health system, and guaranteeing their physical and mental health will have a profound impact on the development of China's health service. Objective To identify potential influencing factors of occupational stress, anxiety, depression, and insomnia as well as their interactions. Methods In August 2021, a cross-sectional survey was conducted among all the staff (

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