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.Research hotspots and trends of tigecycline drug resistance: A study based on CiteSpace
Xinjing JIA ; Yanding WANG ; Chunyuan DUAN ; Lisha LIU ; Di WU ; Xinran GONG ; Zhiqiang LI ; Meitao YANG ; Dayang ZOU ; Yong WANG
Journal of Public Health and Preventive Medicine 2024;35(1):16-19
Objective To explore the research progress, research hotspot and development trend of tigecycline resistance based on the quantitative analysis and visualization function of CiteSpace. Methods The data were collected from 4,263 Chinese and English articles on tigecycline resistance in CNKI, Wanfang, VIP and Web of Science (WOS) databases from 2012 to 2022. CiteSpace 5.8.R3 software was used to analyze the cooperative network of authors, the cooperative network of countries and institutions, the total citation times of journals, and keywords included in the literature, to reveal the hotspots and trends of tigecycline resistance research. Results The number of articles published in English literature was higher than that in Chinese literature. China had the largest number of published documents, showing a significant international academic influence in this research field. Countries all over the world were concerned about the resistance of tigecycline, but Chinese literatures focused more on the clinical infection and prevention of tigecycline resistance, while English literatures placed special emphasis on the research about the drug resistance mechanism of tigecycline. Conclusion The research direction at home and abroad is basically the same, but the research focus has gradually shifted from the clinical treatment and monitoring of tigecycline to the molecular level of drug resistance mechanism.
3.Relationship among psychological resilience, parental control, and behavioral problems in junior high school students in Guizhou Province
Chinese Journal of School Health 2024;45(5):689-692
Objective:
To investigate the relationships among psychological resilience, parental control, and behavioral problems in middle school students, aiming to provide evidencebased recommendations for the prevention and intervention of behavioral issues in middle school students, as well as for the development of related policies.
Methods:
A stratified cluster sampling method was used to select 2 745 participants from three cities in Guizhou Province with different levels of economic development from August to December 2021. The Child Behavior Checklist (CBCL), Parental Control Questionnaire, and Psychological Resilience Questionnaire were administered to junior high school students and their parents. A network analysis method was employed to construct a network analysis model of factors influencing behavioral problems.
Results:
The detection rate of behavioral problems among junior high school students in Guizhou Province was 22.62%. The scores for psychological resilience (goal focus, emotional control, positive cognition, family support, and interpersonal assistance) and proactive inquiry in behavior control were higher in the group without behavioral problems than in the group with behavioral problems. Scores for psychological control (inducing guilt, with drawing affection, and asserting authority) were higher in the group with behavioral problems than in the group without behavioral problems, with statistically significant differences (t=9.80, 17.76, 6.21, 12.20, 13.18, 6.28, 11.58, 11.10, 10.74, P<0.05). The network model showed that among the same variable factors, the strongest connection weight was between inducing guilt and withdrawing affection, with a weight of 0.79. Between different variables, there were negative correlation between behavioral problems and psychological resilience (goal focus, emotional control, positive cognition, family support, interpersonal assistance) and behavior control (proactive inquiry, behavioral restraint) with correlation coefficients (r=-0.25, -0.42, -0.16, -0.31, -0.33, -0.17, -0.03, P<0.05), respectively. There were positive correlation between psychological control factors (inducing guilt, withdrawing affection, and asserting authority) and behavioral problems (r=0.29, 0.27, 0.27), and a negative correlation between these psychological control factors and psychological resilience factors (goal focus, emotional control, positive cognition, family support, interpersonal assistance)(r=-0.53--0.13)(P<0.05). The strongest connection weight was between withdrawing affection and family support, with a connection weight of -0.53. Family support was an important bridge symptom connecting the entire behavioral problem network model, with a high centrality.
Conclusions
The detection rate of behavioral problems among junior high school students in Guizhou Province is relatively high. Assisting adolescents in establishing a supportive family environment facilitates the cultivation of their psychological resilience, thereby mitigating the occurrence of behavioral problems.
4.A multicenter retrospective study discussion on maintenance treatment strategies for mantle cell lymphoma
Ping YANG ; Lan LUO ; Shuozi LIU ; Chunyuan LI ; Yingtong CHEN ; Wei ZHANG ; Hui LIU ; Xiubin XIAO ; Hongmei JING
Chinese Journal of Hematology 2024;45(7):660-665
Objective:This study aims to explore the survival advantages of different maintenance strategies for MCL.Methods:Clinical data of 693 newly diagnosed MCL patients in multi-centers admitted from April 1999 to December 2019 were collected. 309 cases received maintenance treatment. The characteristics of patients in different maintenance treatment groups were summarized and Kaplan-Meier survival and prognosis analysis were conducted.Results:The overall 3-year and 5-year progression-free survival (PFS) rates were (73.5±2.9) % and (53.6±4.3) %, respectively. The 3-year and 5-year overall survival (OS) rates were (94.2±1.5) % and (82.7±3.2) %, respectively. The clinical features of different maintenance treatment groups were generally consistent. The 3-year PFS rates of rituximab maintenance, lenalidomide maintenance, BTK inhibitor maintenance and dual-drug maintenance were (70.4±4.1) %, (69.1±7.6) %, (86.9±5.0) %, and (80.4±5.1) %, respectively. Corresponding 3-year OS rates were (92.9±2.4) %, (97.3±2.7) %, (97.9±2.1) %, and (95.3±2.7) %, respectively. There were no significant difference in different groups ( P=0.632, 0.313). Survival analysis identified the MCL International Prognostic Index (MIPI) high-risk group and achieving complete remission before maintenance treatment as independent risk factors for PFS. The MIPI high-risk group, high-dose cytarabine application, treatment lines, and early disease progression (POD24) emerged as independent risk factors for OS. Conclusion:Comparing the different maintenance strategies of MCL, the result showed that BTK inhibitors (BTKi) maintenance demonstrated preliminary advantages in survival. Meanwhile, high-risk group according to MIPI and incomplete remission before maintenance treatment were significant factors related to disease progression.
5.Risk factors and prediction model construction for preoperative frailty in elderly patients with spinal degenerative diseases
Mengxian OU ; Jun WANG ; Hongchao DUAN ; Haiyang ZHANG ; Huan LIU ; Chunyuan LI
Chinese Journal of Modern Nursing 2024;30(27):3727-3732
Objective:To screen for preoperative frailty risk factors in elderly patients with spinal degenerative diseases and construct a risk prediction model.Methods:From September 2021 to August 2022, convenience sampling was used to select 324 elderly patients who underwent spinal surgery in the Department of Neurosurgery at Xuanwu Hospital, Capital Medical University as research subjects. The patients were surveyed using the General Information Questionnaire, Barthel Index, Nutritional Risk Screening 2002, Mini-mental State Examination, Geriatric Depression Scale-15, Generalized Anxiety Disorde-7, Athens Insomnia Scale, Charlson Comorbidity Index (CCI), and Modified Frailty Index. Binary Logistic regression analysis was used to explore the influencing factors of preoperative frailty in elderly patients with spinal degenerative diseases and establish a risk prediction model. Receiver Operating Characteristic (ROC) curve was used to assess the discriminative power of the model, and Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model.Results:A total of 324 questionnaires were distributed, and 308 valid questionnaires were collected, with a valid response rate of 95.06% (308/324). Among 308 elderly patients with degenerative spinal diseases, 56 patients experienced preoperative frailty. Binary Logistic regression analysis showed that falls within one year, CCI, serum albumin, activities of daily living, and self-rated health status were the influencing factors for preoperative frailty in elderly patients with spinal degenerative diseases ( P<0.05). The area under the ROC curve of the prediction model was 0.851, with a sensitivity of 0.786 and a specificity of 0.778. Hosmer Lemeshow test indicated that the predictive model had a good fit (χ 2=3.764, P=0.709) . Conclusions:Falls within one year, CCI, serum albumin, activities of daily living, and self-rated health status are influencing factors for preoperative frailty in elderly patients with spinal degenerative diseases. The risk prediction model constructed can identify preoperative frailty early and has good predictive performance, which is worthy of clinical promotion.
6.Non-uremic calciphylaxis: a rare complication of primary hyperparathyroidism and literature review
Chunyuan MA ; Tian XU ; Hong LIU ; Li SUN ; Liyuan ZHANG ; Xiaoliang ZHANG
Chinese Journal of Nephrology 2024;40(11):901-904
Calciphylaxis is a rare ischemic necrotic skin disease characterized by skin ischemia, necrosis, and severe pain. Histopathological features include systemic arteriolar media calcification, intimal fibrosis, and thrombosis. While calciphylaxis is predominantly found in uremic patients, there have been a few case reports in non-uremic patients. This article presented a case of a non-uremic patient with primary hyperparathyroidism who underwent parathyroidectomy and subsequently developed severe calciphylaxis. The patient presented with symptoms of lower limb dermatalgia and ulceration, consistent with the classic clinical features of calciphylaxis. Following a systematic therapeutic approach in accordance with the "Zhongda Scheme", a complete remission of the condition was achieved. At the same time, the authors reviewed the relevant literature on the risk factors and possible mechanisms of non-uremic calciphylaxis based on this case.
7.Development and application of a rapid IgG antibody ELISA kit for Chikungunya virus
XU Xiaoli ; HU Xiaoyu ; LI Chunyuan ; CAO Mengtao ; LIU Jiru ; LIU Jiong ; REN Ruiwen
China Tropical Medicine 2024;24(4):438-
Abstract: Objective To develop an ELISA kit to detect IgG antibodies of Chikungunya virus (CHIKV), providing a new method for epidemiological investigation and detection in the field for CHIKV infection. Methods Using the CHIKV-specific recombinant protein pMal-chik23 as diagnostic antigen, HRP-labeled anti-IgG antibody as color-developing antibody, and the working concentration of diagnostic antigen, serum to be tested and second antibody were optimized using orthogonal. The reaction conditions of ELISA reaction, such as coating, blocking, incubation, and color-developing were systematically optimized. The cut-off value for ELISA detection was established based on the assessment of a large clinical sample set. On this basis, the specificity, sensitivity, and stability of the ELISA response were evaluated to develop and assemble a rapid ELISA kit for the detection of Chikungunya fever IgG antibodies. Results On the basis of systematic conditions optimization, an indirect ELISA kit for the detection of IgG antibodies against CHIKV was developed and assembled. The optimal reaction conditions were identified as 1.0 μg/mL antigen was coated using carbonate buffer at 4 ℃ for 24 hours. Then the microplate was blocked using HBV blocking solution at 37 ℃ for 4 hours. 100 μL/well samples to be tested were diluted at 1∶101, reacted at 37 ℃ for 40 minutes, and washed 4 times with PBST. Thus, HRP-labeled rabbit anti-human IgG was diluted at 1∶20 000, HRP-labeled sheep anti-mouse IgG was diluted at 1∶10 000, reaction at 37 ℃ for 30 minutes, and washed 5 times with PBST. Finally, 100 μL/well TMB solution was added and incubated at 37 ℃ for 10 minutes. Then terminate the reaction with 50 μL of 20% H2SO4 and measure the A450 value at dual wavelengths of 450/630 nm (A450) . The evaluation results showed that ELISA A450 of Chikungunya fever-positive samples were more than 0.43, while the ELISA A450 of negative samples was less than 0.04, and the S/N ratio > 10. Specificity test showed that the developed kit had no cross-reaction with 9 other similar arbovirus species such as Sindbis, Geta, Ross River, and Dengue virus. The stability evaluation of the reagent kit indicated that it had high stability, with a coefficient of variation (CV) within the microplate ranging from 0.76% to 2.12%, the coefficient of variation between the microplate ranged from 0.64% to 1.85%, and the coefficient of variation between batches ranged from 0.83% to 2.31%, all of which were less than 3%. The sensitivity of the kit did not decrease significantly after being stored at 4°C for 1 year. Conclusions A rapid indirect ELISA kit for the detection of Chikungunya fever IgG antibodies was successfully developed, exhibiting good sensitivity, specificity, and stability.
8.Early clinical prediction of coronary microcirculation disturbance after emergency percutaneous coronary intervention in patients with acute myocardial infarction
Li WANG ; Chunyuan WU ; Long KUANG ; Jiaxian SONG ; Cheng REN ; Fang XU
Journal of Clinical Medicine in Practice 2024;28(3):39-44
Objective To investigate the clinical value of left ventricular global longitudinal strain (LVGLS) combined with the global register of acute coronary events (GRACE) score in predicting coronary microcirculation disorder (CMD) in patients with acute myocardial infarction (AMI) after emergency percutaneous coronary intervention (PCI). Methods A total of 90 patients with AMI were selected as the study objects (10 cases were lost in follow-up, 4 cases were screened for poor image quality), and 76 cases were finally included. Left ventricular myocardial contrast echocardiography (MCE) was performed in patients at 48 h after surgery. Patients were divided into non-CMD group (
9.Design of SF 6 measurement system based on Visual TFT
Yi ZHANG ; Xiaofeng SHENG ; Yongzhen LI ; Xia ZHANG ; Wei WANG ; Chunyuan ZHANG ; Zhenglong CHEN
International Journal of Biomedical Engineering 2023;46(6):529-535
Objective:To design a Visual TFT-based SF 6 gas measurement system. Methods:Based on Visual TFT, an SF 6 gas measurement system is designed, including system hardware design and system software design. The system hardware mainly includes gas sensors, a Visual TFT display, a signal processing circuit, and a power supply circuit. The system software mainly includes data acquisition, data display, SF 6 monitoring system, and alarm program. The Visual TFT display is controlled by Keil code to display other parameters such as gas flow rate, concentration, and waveform, and calculate the error (? E). The measurement system extracts the gas flow rate and concentration data through the waveform graph and gets the change curve of functional residual gas volume (FRC) data. Results:The proposed Visual TFT-based SF 6 gas measurement system can detect SF 6 with an arithmetic mean value of concentration ? E of 8.906%, which is less than 10% of full scale and meets the design requirements. Conclusions:The Visual TFT-based SF 6 gas measurement system can monitor the concentration of SF 6 gas in real-time, which helps to control the release of SF 6 gas and reduce the impact of inert gas emission on the human body under test. At the same time, the system has an intuitive display interface and alarm function, which helps healthcare workers diagnose and treat lung and respiratory diseases more conveniently and quickly, and improves the efficiency and safety of healthcare workers.
10.Iodine nutrition status of adults and pregnant women in Jianshui and Zhenxiong counties, Yunnan Province
Jiaguo LI ; Hesong WU ; Feng YE ; Zhihua ZHAO ; Liangjing SHI ; Li CHEN ; Wanxian DONG ; Wei YANG ; Chunyuan DENG
Chinese Journal of Endemiology 2023;42(10):803-807
Objective:To investigate the iodine nutritional status of adults and pregnant women in Jianshui County and Zhenxiong County, Yunnan Province.Methods:From May to August 2021, one urban area and one rural area in Jianshui County and Zhenxiong County, Yunnan Province were selected as investigation sites. At least 100 adults (half male and half female) and 100 pregnant women were selected as survey subjects in each investigation site. Random urine samples were collected from all survey subjects once to detect urine iodine, creatinine and sodium contents. Venous blood samples of all pregnant women were collected to detect the serum iodine content, and the 95% medical reference range of serum iodine was established using the percentile method.Results:The medians urinary iodine, creatinine and sodium of adults in Jianshui County and Zhenxiong County were 184.7 μg/L ( n = 432), 12 355.0 μmol/L ( n = 431) and 156.5 mmol/L ( n = 420), respectively. The median urinary iodine of adults in Jianshui County was higher than that in Zhenxiong County (197.3 vs 170.2 μg/L), the difference was statistically significant ( Z = - 2.90, P = 0.003). The median serum iodine of pregnant women in Jianshui County and Zhenxiong County was 92.1 μg/L ( n = 412), with a 95% medical reference value ranged from 45.3 to 183.5 μg/L; the medians urinary iodine, creatinine and sodium of pregnant women were 138.6 μg/L ( n = 413), 12 173.0 μmol/L ( n = 408) and 152.2 mmol/L ( n = 409), respectively. The urinary iodine (154.1 vs 115.8 μg/L), urinary creatinine (13 216.0 vs 11 376.0 μmol/L) and urinary sodium (161.8 vs 141.8 mmol/L) of pregnant women in Jianshui County were higher than those in Zhenxiong County, with statistical differences ( Z = - 5.12, - 2.29, - 4.30, P < 0.05). Conclusion:Adults in Jianshui County and Zhenxiong County are at an appropriate level of iodine, but pregnant women in Zhenxiong County are at an iodine deficiency level.


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