1.Factors affecting implementation of weight management services in primary medical and healthcare institutions based on the consolidated framework for implementation research
SUN Jie ; LI Yun ; WEI Jiayu ; SHAO Xiaofang ; YE Xiaojun ; FU Yeliu ; GU Wei ; YANG Min
Journal of Preventive Medicine 2025;37(11):1087-1092
Objective:
To explore the influencing factors for implementation of weight management services in primary medical and healthcare institutions, so as to provide references for implementing sustainable services of weight management.
Methods:
From May to June 2025, Pinghu City, Zhejiang Province was selected as the survey site. Personnel responsible for weight management in primary medical and healthcare institutions were selected as the survey subjects using a combined method of purposive sampling and snowball sampling. Based on the five core domains of the consolidated framework for implementation research (CFIR), a semi-structured interview outline for weight management services in primary medical and healthcare institutions was designed. Original data was collected through face-to-face semi-structured interviews. Interview data was organized and analyzed using framework analysis. Factors affecting weight management services were quantitatively analyzed by referencing CFIR's structural rating criteria.
Results:
A total of 21 participants completed interviews, covering positions in nutrition, endocrinology, traditional Chinese medicine, general practice, maternal health, and public health. There were 9 males and 12 females. Fifteen participants (71.43%) were aged 35 years and above, 18 (85.71%) held a bachelor's degree or higher, and 15 (71.43%) were frontline medical staff. Fifteen factors affecting weight management services were identified across five domains: innovation, outer setting, inner setting, individuals, and implementation process. Six barrier factors were identified: difficulties in policy implementation, time-consuming interventions, limited incentive measures, lack of professional skills, unclear weight-loss plans and goal setting, and imperfect follow-up and evaluation mechanisms. Three neutral factors were identified: the development and refinement of policies and regulations, the implementation of weight management training, and the optimization of the referral process within integrated healthcare systems (medical alliances / communities). Six facilitating factors were identified: the relatively significant advantages of lifestyle interventions, collaboration and coordination across multiple departments, cooperative communication among different units within the institution, the inherent convenience of primary care settings, a strong sense of professional responsibility, and the establishment of multidisciplinary teams.
Conclusions
The delivery of weight management services in primary medical and healthcare institutions is influenced by a wide array of factors across multiple domains. It requires policy support, multi-department coordination, a practice-oriented training system, optimized team resource allocation, incentives, and improved professional skills of medical staff to jointly promote long-term implementation.
2.Epidemiological characteristics and immunization history of pertussis cases in Yichang City 2018 - 2023
Weiwei WANG ; Xiaojun LIU ; Yi YAN ; Jing JIANG ; Qiujing YU ; Wei JIANG ; Li GUO ; Jialian YU ; Guiwen LI ; Qiwei WANG
Journal of Public Health and Preventive Medicine 2025;36(6):86-89
Objective To analyze the epidemiological characteristics and immunization history of pertussis cases in Yichang City, Hubei Province from 2018 to 2023. Methods Data on the incidence and immunization history of pertussis cases were collected in Yichang City from 2018 to 2023, and the epidemiological characteristics was analyzed and described. Results A total of 109 cases of pertussis were reported in Yichang from 2018 to 2023, and the annual average reported incidence rate was 0.45/100,000. The incidence rate reported in each year was between 0~1.58/100,000. The area with the highest annual reported incidence rate was Xiling District (1.19/100,000). There was a statistically significant difference in the incidence rate between different years (χ2=208.26, P < 0.001). The annual reported incidence rate showed a significant increasing trend (χ2 trend =125.71, P < 0.001). The ratio of male to female cases was 1.22. There was no significant difference in the annual reported incidence rates between males and females (χ2=0.85, P=0.36). Children aged 3-9 years accounted for 60.55%. Students and scattered children accounted for 45.87% and 36.70%, respectively. Before the onset of the disease, 72.48% had a history of immunization with pertussis-containing vaccine, and 27.52% had no history of immunization. The shortest interval between the last dose of pertussis-containing vaccine and the onset of the disease was 8 days, the longest was 4057 days, and the median was 1882 days. Conclusion From 2018 to 2023, the reported incidence of pertussis in Yichang City has been on the rise, with the majority of cases occurring in children and students under the age of 9. It is recommended to strengthen pertussis disease monitoring.
3.Development and validation of a prediction score for subtype diagnosis of primary aldosteronism.
Ping LIU ; Wei ZHANG ; Jiao WANG ; Hongfei JI ; Haibin WANG ; Lin ZHAO ; Jinbo HU ; Hang SHEN ; Yi LI ; Chunhua SONG ; Feng GUO ; Xiaojun MA ; Qingzhu WANG ; Zhankui JIA ; Xuepei ZHANG ; Mingwei SHAO ; Yi SONG ; Xunjie FAN ; Yuanyuan LUO ; Fangyi WEI ; Xiaotong WANG ; Yanyan ZHAO ; Guijun QIN
Chinese Medical Journal 2025;138(23):3206-3208
4.Timing and surgery option of keratinized mucosa augmentation around implant site
Hang YANG ; Jie NI ; Wei LU ; Xiaojun LI ; Fuming HE
Chinese Journal of Stomatology 2024;59(2):182-190
In recent years, clinicians have paid more attention to the biological and esthetic effects of the 2 mm keratinized mucosa width (KMW) around dental implant. How to increase the keratinized mucosa is the focus of clinicians. While the free gingival graft (FGG) is still the gold standard of keratinized mucosa augmentation, alveolar ridge preservation (ARP), connective tissue graft (CTG) and apically positioned flap (APF) can also be used to obtain more than 2 mm keratinized mucosa width when they are used before implantation, with implantation, within the implant-healing phase, with second stage of implantation or after rehabilitation according to different indications. This article comprehensively summarizes the influencing factors of timing and surgical procedures for keratinized mucosa augmentation, providing guidance for clinicians to treat peri-implant keratinized mucosa deficiencies.
5.Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions
Jiaojie ZHENG ; Mingzi ZHANG ; Loubin SI ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1233-1237
Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.
6.Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiuzuo HUANG ; Nanze YU ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1318-1324
To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control. National Quality Control Center of Plastic and Aesthetic Major established a working group in February 2023. Guided by the "structure-process-outcome" theory, the working group formulated medical quality control indicators for Plastic and Aesthetic major by learning from relevant indicators of other majors, reviewing literature, discussing in meetings, and combining opinions from quality control experts. The quality control indicators system was finally established by Delphi expert consultation. Delphi survey was 100% of 2 rounds. The authorities of 2 rounds of expert consultation were 0.854 and 0.857. The harmonious coefficients were 0.387 of primary indicators and 0.425 of secondary indicators( The quality control indicators system established in this study for Plastic and Aesthetic major in China has a certain degree of scientificity and rationality, which offers reference for medical quality control of Plastic and Aesthetic major in China. However, this system should be improved and ameliorated in practical application.
7.Data Development Trend of Public/Private Medical Institutions in Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1325-1333
To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years. The national quality control center of plastic and aesthetic major formulated quality control indicators, collected indicator data through the National Clinical Improvement System, conducted feedback verification on the data, organized and summarized the final data, and convened expert committees to analyze the data change trends. In the past three years, the number of both public and private medical institutions specializing in plastic and aesthetic major has shown an upward trend. The number of doctors increased significantly in 2022, with over 90% of doctors in public institutions (about 70% in private institutions) receiving higher education. In recent years, the proportion of doctors from other specialties engaging in plastic and aesthetic activities has increased. The proportion of inpatients seeking aesthetic treatments has also increased. Among outpatient patients, the proportion of injection procedures was relatively low. About one-third of private medical institutions have not yet adopted an electronic medical record system. Data feedback is the cornerstone of medical quality control in Chinese plastic and aesthetic major. Existing data indicates that the related industry is developing steadily, but there is still room for improvement in terms of some indicator data. However, due to the limited data from private medical institutions, it is still necessary to encourage them to improve their reporting enthusiasm in order to conduct a more comprehensive assessment in the future.
8.A genetic variant in the immune-related gene ERAP1 affects colorectal cancer prognosis
Danyi ZOU ; Yimin CAI ; Meng JIN ; Ming ZHANG ; Yizhuo LIU ; Shuoni CHEN ; Shuhui YANG ; Heng ZHANG ; Xu ZHU ; Chaoqun HUANG ; Ying ZHU ; Xiaoping MIAO ; Yongchang WEI ; Xiaojun YANG ; Jianbo TIAN
Chinese Medical Journal 2024;137(4):431-440
Background::Findings on the association of genetic factors and colorectal cancer (CRC) survival are limited and inconsistent, and revealing the mechanism underlying their prognostic roles is of great importance. This study aimed to explore the relationship between functional genetic variations and the prognosis of CRC and further reveal the possible mechanism.Methods::We first systematically performed expression quantitative trait locus (eQTL) analysis using The Cancer Genome Atlas (TCGA) dataset. Then, the Kaplan-Meier analysis was used to filter out the survival-related eQTL target genes of CRC patients in two public datasets (TCGA and GSE39582 dataset from the Gene Expression Omnibus database). The seven most potentially functional eQTL single nucleotide polymorphisms (SNPs) associated with six survival-related eQTL target genes were genotyped in 907 Chinese CRC patients with clinical prognosis data. The regulatory mechanism of the survival-related SNP was further confirmed by functional experiments.Results::The rs71630754 regulating the expression of endoplasmic reticulum aminopeptidase 1 ( ERAP1) was significantly associated with the prognosis of CRC (additive model, hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.08-1.88, P = 0.012). The results of dual-luciferase reporter assay and electrophoretic mobility shift assay showed that the A allele of the rs71630754 could increase the binding of transcription factor 3 (TCF3) and subsequently reduce the expression of ERAP1. The results of bioinformatic analysis showed that lower expression of ERAP1 could affect the tumor immune microenvironment and was significantly associated with severe survival outcomes. Conclusion::The rs71630754 could influence the prognosis of CRC patients by regulating the expression of the immune-related gene ERAP1. Trial Registration::No. NCT00454519 (https://clinicaltrials.gov/)
9.Investigation and analysis of the review and comment on inpatient medical orders in Beijing municipal hospitals
Wei SUO ; Yue WANG ; Liang CHEN ; Zhaoqi ZHANG ; Haocong GU ; Xiaojun LUO ; Wenfeng WANG
China Pharmacy 2024;35(10):1266-1270
OBJECTIVE To investigate the current situation of the review and comment on inpatient medical orders in Beijing municipal hospitals, and to put forward countermeasures and suggestions for further improving related work. METHODS A questionnaire survey was conducted to investigate the current situation of the review and comment on inpatient medical orders in 22 Beijing municipal hospitals. The statistical analysis was conducted for the survey results. RESULTS A total of 22 questionnaires were distributed, with recovery effective rate of 100%. The 22 hospitals carried out inpatient medical order comment, but their proportion varied among hospitals (0.88%-98.54%); medical order comment mainly focused on antibiotics, proton pump inhibitors, anesthetic drugs/class Ⅰ psychotropic drugs, auxiliary drugs and other categories; 205 pharmacists participated in the comment of inpatient medical orders, most of whom hold intermediate or higher professional titles (89.27%); 21 hospitals conducted inpatient medical order comment and feedback the results to relevant departments/responsible persons, but the intervention situation was not the same. Eighteen hospitals had carried out the review of inpatient medical orders; reviewed drug category was roughly the same as the category involved in the medical order comment; review content involved the suitability of administration routes, dosage, etc. The review was conducted mainly through the cooperation of audit software and pharmacists. CONCLUSIONS The comment and review of inpatient medical orders in Beijing municipal hospitals carried out in an orderly manner, and preliminary results have been achieved; at the same time, it is necessary to further increase the ability of participating pharmacists, improve audit standards, optimize pre-audit (No.ZYLX201805) software, and promote rational drug use among hospitalized patients through doctor-pharmacist collaboration.
10.Association between quantitative CT-measured body composition and metabolic syndrome components in obese patients before bariatric surgery
Wei HONG ; Xiaojun HAO ; Chao TAO ; Pengzhan YIN ; Yabin XIA ; Yan JIN ; Yunfeng ZHOU
Chinese Journal of Health Management 2024;18(2):127-134
Objective:To investigate the association between quantified CT (QCT)-measured body composition and metabolic syndrome (MS) components in obese populations before bariatric surgery.Methods:A cross-sectional study. A retrospective analysis was conducted on a cohort of 97 obese patients scheduled for weight-loss surgery at the First Affiliated Hospital of Wannan Medical College from January 2021 to March 2023. The patients′ body mass index (BMI), biochemical parameters and body composition measurements obtained by QCT were recorded. The patients were stratified into groups based on gender, obesity severity and the number of MS components. Differences in body composition among the groups were compared. Additionally, the correlations between each body composition parameter and metabolic indicators were analyzed. The diagnostic efficacy of each body composition parameter for identifying obese individuals with different MS components was assessed using receiver operating characteristic (ROC) curve analysis.Results:There were 75 females (77.3%). Male obese patients had higher total abdominal fat area [(693.23±148.90) vs (574.99±114.89) cm 2, t=-3.958, P<0.001], visceral fat area [(289.65±57.67) vs (195.60±57.37) cm 2, t=-6.753, P<0.001], fat content of pancreatic head [27.45%(21.65%, 45.48%) vs 21.60%(17.6%, 26.9%), Z=-2.675, P=0.007], and skeletal muscle index [73.36(68.74, 81.26) vs 61.52(55.74, 66.41) cm 2/m 2, Z=-5.246, P<0.001]. With the increase of obesity, abdominal fat mainly increases in subcutaneous fat. With the increase of MS components (MS2 group, MS3 group, MS4 group, MS5 group), the abdominal fat area, abdominal fat/subcutaneous fat, liver fat content, pancreatic head fat content, and skeletal muscle index of patients all increased accordingly. In diagnosing the presence of two components of MS, area under the curve of visceral fat area was the largest (AUC=0.706, 95% CI=0.577-0.834). For diagnosing the presence of three, four and five components of MS, area under curve of liver fat content were all the largest (MS3=0.712, 95% CI=0.605-0.818; MS4=0.652, 95% CI=0.537-0.766; MS5=0.706, 95% CI=0.576-0.836). Conclusion:There are differences in QCT body composition among obese patients with different MS components, and there is a correlation between each body composition and MS component. Among them, intra-abdominal fat area and liver fat content are of great value in evaluating obese patients with different MS components.


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