1.Research Progress of Fuzheng Jiedu Huayu Method in Reducing Toxicity and Enhancing Efficacy of Immunotherapy
Yufan CHEN ; Sicong LI ; Yiyuan CUI ; Li FENG
Cancer Research on Prevention and Treatment 2025;52(1):11-18
Immunotherapy, including immune checkpoint inhibitors, tumor vaccine therapy, oncolytic virotherapy, and adoptive cell therapy, has made remarkably breakthroughs in the field of oncology. Immune checkpoint inhibitors, which block programmed death receptor 1 or programmed death ligand 1, have been included in the first-line clinical treatment for advanced solid tumors, such as non-small cell lung cancer and malignant melanoma. However, primary or secondary drug resistance in tumors severely limits the survival benefits for patients. Immune-related adverse reactions, such as pneumonia, hypothyroidism, hypophysitis, and myocarditis, also greatly affect the quality of life of patients. Fuzheng Jiedu Huayu is an important concept guiding the prevention and treatment of tumors with traditional Chinese medicine (TCM). It is also a curative principle and therapeutic TCM method to reduce the toxicity and enhance the efficacy of immunotherapy. This article summarizes the research progress of immunotherapy and discusses how TCM reduces the toxicity and enhances the efficacy of immunotherapy, hoping to provide a reference for the integrated treatment of tumors with TCM and immunotherapy.
2.Organizational Readiness for Change and Factors Influencing the Implementation of Shared Medical Appointment for Diabetes in Primary Healthcare Institutions
Wei YANG ; Yiyuan CAI ; Jiajia CHEN ; Run MAO ; Lang LINGHU ; Sensen LYU ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(2):479-491
The success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medical Appointment for Diabetes (SMART) in China: design of an optimization trial" and to enhance ORC and provide insights to support the effective implementation of the program. Qualitative interviews and quantitative surveys were conducted to evaluate the ORC level and its influencing factors in 12 institutions implementing the SMART program. The Scale for Assessing the Institution's Readiness to Implement Evidence-Based Practices was utilized to measure ORC levels. Qualitative interviews were conducted among change implementers to gather information regarding the status of influencing factors. Thematic analysis was applied to extract factors from the interview data, and an assessment questionnaire was developed to measure the perceived impact of these factors. A fuzzy-set qualitative comparative analysis (fsQCA) method was employed to identify the influencing factors of ORC and pathways leading to high-level ORC. Seventy implementers from 12 institutions, encompassing administrators, clinicians, and health managers, participated in the interviews and surveys. The median and interquartile of the ORC scores were 105.20 (101.23, 107.33). The fsQCA indicated that a clear understanding of specific tasks and responsibilities, the active engagement of key participants, sufficient preliminary preparation, and the use of audits and feedback mechanisms were critical pathways to a high-level ORC. Conversely, institutions lacking key participants, preliminary preparation, or marginal influence demonstrated a low-level ORC. Before implementing innovation, Coherence and Cognitive Participation were identified as critical factors in influencing ORC. Strong leadership from key participants played pivotal role in enhancing readiness for change and was essential for improving implementation fidelity and overall program success.
3.Localization and Content Validation of the Organizational Readiness of Implementing Evidence-based Practices Scale
Jiajia CHEN ; Yiyuan CAI ; Wei YANG ; Run MAO ; Lang LINGHU ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(3):765-776
This study aimed to localize the workplace readiness questionnaire (WRQ) and validate its applicability for assessing readiness for implementation of evidence-based practices (EBP) in primary care settings in China. The localization of the instrument will provide a practical instrument for assessing organizational readiness for change (ORC). The WRQ was translateed into Chinese version using the modified Brislin translation model, and its cross-cultural validity, content validity, and generalizability were evaluated by the Delphi method, and the expert feedback was evaluated using the item-level content validity index (I-CVI), scale-level content validity index (S-CVI), and corrected Kappa value. The index weights were evaluated by the analytic hierarchical process (AHP). The target users of the scale were invited to quantitatively evaluate its item importance score (IIS), and the surface validity was evaluated by combining the qualitative feedback from their cognitive interviews. To clarify the purpose of the scale, we revised its name to the Organizational Readiness of Implementing Evidence-Based Practices (ORIEBP) Scale. The ORIEBP scale contained five dimensions, which were Change Context, Change Valence, Information Evaluation, Change Commitment, Change Efficiency, and 32 items. After two rounds of the Delphi method to refine the construction of three dimensions and expressions of 11 items, the I-CVI were from 0.73 to 1.00, the Kappa value were from 0.70 to 1.00, and the S-CVI was over 0.92. All evaluation matrices of the hierarchical analysis method met the requirement of consistency ratio (CR < 0.1), and the weights of five dimensions were 0.2083, 0.2022, 0.1907, 0.2193, and 0.1795, in sequence. Nine out of eleven experts identified that items were applicable to other readiness assessment scenarios. The IIS scores for the five dimensions and 32 items were ranged from 2.93 to 3.54, and 2.71 to 3.42, presenting good face validity. The cognitive interview results showed that professional expressions were complex to understand. This study validated the ORIEBP scale and has good content validity and generalizability. The scale can be further improved by expanding its scope of use and validating its structure validity and reliability in different settings.
4.Function and advantages of magnetically responsive hydrogel in bone tissue engineering
Pinrui CHEN ; Xibo PEI ; Yiyuan XUE
Chinese Journal of Tissue Engineering Research 2024;28(3):452-457
BACKGROUND:Magnetically responsive hydrogels have great advantages in bone tissue engineering,which is more conducive to the minimally invasive and efficient promotion of osteogenesis. OBJECTIVE:To review the application advances of magnetically responsive hydrogels in bone tissue engineering. METHODS:PubMed,Web of Science,WanFang and CNKI databases were used to search relevant literature.The English search terms were"Magnetic Hydrogels,Magnetic Nanoparticles,Superparamagnetic Nanoparticles,Fe3O4,SPIONs,Magnetic Fields,Bone Regeneration,Bone Repair,Bone Tissue Engineering".The Chinese search terms were"Magnetic Hydrogel,Magnetic Nanoparticles,Superparamagnetic Iron Oxide Nanoparticles,Magnetic Field,Iron Oxide Nanoparticles,Bone Regeneration,Bone Reconstruction,Bone Repair,Bone Tissue Engineering".After preliminary screening of all articles according to the inclusion and exclusion criteria,60 articles were finally retained for review. RESULTS AND CONCLUSION:(1)In recent years,due to the emergence of magnetic nanoparticles,more and more magnetic responsive scaffold materials have been developed.Among them,magnetic responsive hydrogels containing iron oxide nanoparticles and superparamagnetic iron oxide nanoparticles have outstanding mechanical properties and good biocompatibility.It can quickly respond to the external magnetic field and provide the magnetic-mechanical signals needed for seed cells to form bone.(2)Magnetic-responsive hydrogel can be used as a carrier to accurately regulate the release time of growth factors.(3)Under the three-dimensional microenvironment culture platform based on magnetically responsive hydrogel,the magnetic force at the interface between the magnetic response hydrogel and cells can activate cell surface sensitive receptors,enhance cell activity,and promote the integration of new bone and host bone.(4)The injectable magnetically responsive hydrogel can be used in the field of magnetic hyperthermia and biological imaging of bone tumors.(5)At present,magnetically responsive hydrogels are expected to mimic the anisotropic layered structure observed in natural bone tissue.However,most of the studies on magnetically responsive hydrogels focus on in vitro studies,and the mechanism of interaction between magnetically responsive hydrogels and the local microenvironment in vivo is still insufficient.(6)Therefore,based on the successful application of magnetic nanoparticles in magnetic resonance imaging,it is expected to optimize the properties of magnetic nanoparticles in the future to construct magnetic responsive hydrogels with suitable degradation properties,mechanical properties,and vascular functionalization,which can monitor changes in vivo in real time.
5.Research progress on chemical constituents,pharmacological action and clinical application of Rubi fructus
Ping PAN ; Mengting CHEN ; Aoxiang LI ; Hongjang CHEN ; Yiyuan LUO
China Pharmacist 2024;27(1):155-170
Rubi fructus mainly contains contents of flavonoids,coumarins,phenolic acids,polysaccharides,alkaloids and trace elements.Meanwhile,it has activity effects of anti-tumor,anti-oxidation,anti-aging and anti-inflammation,and is widely used in medicine,food,health food and other fields.Research progress on chemical constituents,pharmacological action and clinical application of Rubi fructus were summarized in this paper,in order to provide the theoretical guidance for the rational use of Rubi fructus and the sustainable development of the resources.
6.Study on Mechanism of Sanhuang Decoction in Alleviating Ulcerative Colitis in Mice under Candida albicans Colonization Based on Dectin-1-Syk-CARD9 Signaling Pathway
Jing PENG ; Yiyuan PAN ; Xin BAO ; Feng CHEN ; Wenqian LI ; Kelong MA
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(4):86-93
Objective To study the mechanism of Sanhuang Decotion in the treatment of ulcerative colitis(UC)under Candida albicans colonization in mice based on Dectin-1-Syk-CARD9 signaling pathway.Methods Mice model of UC with fungal colonization were established with dextran sodium sulfate free drinking and C.albicans intragastric administration.Mice were divided into normal control group,model group,sulfasalazine group,fluconazole group,and Sanhuang Decotion low-and high-dosage groups,and receive corresponding drug interventions.General state of mice were observed,and the disease activity index(DAI)score of mice were calculated.The load of C.albicans in intestine was detected,the length of the colon was measured,and pathological scoring of the colon tissue was performed.The ultrastructural changes of colon epithelium were observed under transmission electron microscopy.The contents of TNF-α,IL-6 and IL-12 in serum and colon tissues were detected by ELISA.The mRNA and protein expression of Dectin-1,Syk,CARD9,NF-κBp65 and inflammation factors in intestinal epithelial cells and colon tissues were detected by qPCR,Western blot and immunohistochemistry.Results Compared with the normal control group,the model group mice showed reduced activity,decreased food intake,accompanied by loose stools,significantly increased DAI score,increased load of C.albicans in the intestine,shortened colon length,and increased histopathological score,with widening of gap between colon epithelial cells,cytoplasmic dissolution,mitochondrial swelling;TNF-α,IL-6 and IL-12 in serum and colon tissue increased,the expressions of Dectin-1 and CARD9 mRNA and protein in colon epithelial cells increased,p-Syk,p-NF-κBp65,CARD9,TNF-α,IL-1β,IL-6 protein expression in colon tissue increased(P<0.01,P<0.05).Compared with the model group,the Sanhuang Decotion high-dosage group mice showed a significant decrease in DAI score,decreased intestinal C.albicans load,increased colon length,decreased histopathological score,more complete and orderly arrangement of microvilli in colon epithelial cells,mild mitochondrial swelling,TNF-α,IL-6 and IL-12 in serum and colon tissue decreased,and the mRNA and protein expression of Dectin-1 and CARD9 in colon tissue increased,the expression of p-Syk,p-NF-κBp65,CARD9,TNF-α,IL-1β,IL-6 protein in colon tissue decreased(P<0.01,P<0.05).Conclusion Sanhuang Decotion may exert an anti C.albicans colonization UC effect by inhibiting the Dectin-1-Syk-CARD9 signaling pathway and reducing the release of inflammatory factors.
7.Stakeholder Preference Assessment in Implementation Research: Application of Best-worst Scaling
Run MAO ; Yiyuan CAI ; Wei YANG ; Zhiguo LIU ; Lang LINGHU ; Jiajia CHEN ; Mengjiao LIANG ; Lieyu HUANG ; Siyuan LIU ; Dong XU
Medical Journal of Peking Union Medical College Hospital 2024;16(1):224-234
In the field of healthcare service, it is crucial to optimize medical innovation services by combining the preferences of health service providers and demanders (i.e., stakeholders). The best-worst scaling (BWS) method is a recently developed stated preference method for assessing preferences with distinctive advantages. Nevertheless, there is a lack of a comprehensive introduction to stakeholder preference assessment using BWS, thus constraining its applications and promotion. This paper introduces the process of using BWS to assess service providers' preferences for the Shared Medical Appointment for diabetes (SMART), an integrated healthcare service of medicine and health management, in the hope of providing reference for researchers for promoting the use of BWS in implementation research.
8.Past and Present of Implementation Science (PartⅠ)—Origin and Development
Dong XU ; Jiangyun CHEN ; Yiyuan CAI
Medical Journal of Peking Union Medical College Hospital 2024;15(2):442-449
Implementation science aims to close the gap between knowledge and practice by fostering the uptake and implementation of evidence-based practices. In Europe and America, implementation science is rapidly evolving and improving. In China, the field is still in its infancy. This paper focuses on the definition, origin, domestic and international development, research hotspots, challenges, and opportunities of implementation science. Although implementation science is still at an early stage in China, it has shown rapid development momentum. Chinese scholars, therefore, should leverage China's distinctive research environment to conduct high-quality and innovation implementation studies in order to excel in implementation science areas and lead globally.
9.Past and Present of Implementation Science (Part Ⅱ)——Theories, Paradigm, and Characteristics
Dong XU ; Yiyuan CAI ; Jiangyun CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(3):686-693
Implementation science has evolved over more than 20 years and established a set of theories, models, and frameworks that can be used to guide the implementation process, identify implementation-influencing factors, and evaluate implementation effectiveness. Guided by theories, the implementation research paradigm has been developed to emphasize a problem-oriented approach that seeks to solve problems, identify barriers to implementing evidence-based practices, and selectively employ implementation strategies to facilitate their adoption, implementation, and maintenance. This paradigm also gives implementation research distinctive characteristics in terms of research design, including extensive use of theories, models, and frameworks, alignment with real-world and contextual settings, use of mixed research designs, use of rapid research methods, and optimization of interventions for the context in which they are to be implemented. As the second part of
10.Association between prenatal exposure to PM 2.5 and fetal growth: a prospective cohort study
Lei HUANG ; Hong LYU ; Xin XU ; Tianyu SUN ; Yiyuan CHEN ; Yanjie ZHANG ; Bo YANG ; Qun LU ; Yangqian JIANG ; Tao JIANG ; Jiangbo DU ; Xiaoyan WANG ; Hongxia MA ; Zhibin HU ; Yuan LIN
Chinese Journal of Epidemiology 2024;45(6):794-801
Objective:To investigate the association of exposure to PM 2.5 and its constituents during pregnancy and fetal growth and to further identify critical windows of exposure for fetal growth. Methods:We included 4 089 mother-child pairs from the Jiangsu Birth Cohort Study between January 2016 and October 2019. Data of general characteristics, clinical information, daily average PM 2.5 exposure, and its constituents during pregnancy were collected. Fetal growth parameters, including head circumference (HC), abdominal circumference (AC), and femur length (FL), were measured by ultrasound after 20 weeks of gestation, and then estimated fetal weight (EFW) was calculated. Generalized linear mixed models were adopted to examine the associations of prenatal exposure to PM 2.5 and its constituents with fetal growth. Distributed lag nonlinear models were used to identify critical exposure windows for each outcome. Results:A 10 μg/m 3 increase in PM 2.5 exposure during pregnancy was associated with a decrease of 0.025 ( β=-0.025, 95% CI: -0.048- -0.001) in HC Z-score, 0.026 ( β=-0.026, 95% CI: -0.049- -0.003) in AC Z-score, and 0.028 ( β=-0.028, 95% CI:-0.052--0.004) in EFW Z-score, along with an increased risk of 8.5% ( RR=1.085, 95% CI: 1.010-1.165) and 13.5% ( RR=1.135, 95% CI: 1.016-1.268) for undergrowth of HC and EFW, respectively. Regarding PM 2.5 constituents, prenatal exposure to black carbon, organic matter, nitrate, sulfate (SO 42-) and ammonium consistently correlated with decreased HC Z-score. SO 42- exposure was also associated with decreased FL Z-scores. In addition, we found that gestational weeks 2-5 were critical windows for HC, weeks 4-13 and 19-40 for AC, weeks 4-13 and 23-37 for FL, and weeks 4-12 and 20-40 for EFW. Conclusions:Our findings demonstrated that exposure to PM 2.5 and its constituents during pregnancy could adversely affect fetal growth and the critical windows for different fetal growth parameters are not completely consistent.

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