As one of the most serious global public health concerns, malaria is highly prevalent in Africa and has severely hindered local social and economic developments. Anti-malaria aid underpinned by artemisinin has emerged as an iconic practice of China’s engagement in global health governance in the context of evolving global health governance, which continuously exerts its distinctive impact. The Artemisinin Anti-Malaria Team at Guangzhou University of Chinese Medicine is dedicated to safeguarding global health, committed to transforming artemisinin, a precious gift of traditional Chinese medicine to the world, into tangible impetus for malaria elimination. At the convergence of the China-Africa Year of People-to-People Exchanges and World Malaria Day, a review of China-Africa health cooperation is of specific significance. Based on the practices of international anti-malaria projects led by the Artemisinin Anti-Malaria Team at Guangzhou University of Chinese Medicine, this paper systematically summarizes the theoretical innovations, practical values and humanistic core of China’s anti-malaria approaches, and analyzes the core challenges in global malaria elimination programmes in the new era.

Objective:To investigate the association between intraoperative hypotension and postoperative cerebral ischemia in patients undergoing malignant brain tumor resection.Methods:The study was a secondary analysis of a randomized, double-blind, placebo-controlled trial. Four hundred and eighty patients with malignant brain tumor from November 2018 to September 2022 in Beijing Tiantan Hospital, Capital Medical University were selected. All patients were treated with selective supratentorial tumor resection. The demographic characteristics, perioperative indexes, postoperative outcomes and intraoperative hypotension characteristics were recorded. The cerebral ischemia during postoperative hospitalization (within 10 d after operation) was documented, and the patients were categorized based on the occurrence of postoperative cerebral ischemia.Results:Among 480 patients, 28 cases (5.83%) developed postoperative cerebral ischemia (cerebral ischemia group), while 452 cases did not experience cerebral ischemia during hospitalization (non-cerebral ischemia group). The proportion of WHO grade Ⅲ to Ⅳ, secondary surgery rate and postoperative hospital stay in cerebral ischemia group were significantly higher than those in non-cerebral ischemia group: 96.43% (27/28) vs. 81.19% (367/452), 10.71% (3/28) vs. 1.99% (9/452) and 13 (10, 16) d vs. 10 (8, 14) d, and there were statistical differences ( P<0.05); there were no statistical differences in gender composition, age, body mass index, medical history, medication history, American Society of Anesthesiologists classification, Charlson comorbidity index, preoperative Karnofsky performance status score, tumor laterality, tumor volume, midline shift, operative time, operative time >5 h, fluid intake, red blood cell transfusion, plasma transfusion, blood loss, urine output, fluid balance, serum urea, serum creatinine, glomerular filtration rate, β 2-microglobulin, prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen, postoperative complications, ICU admission, ICU stay duration, mechanical ventilation and hospitalization costs between the two groups ( P>0.05). There were also no statistical difference in the duration, time-weighted average and cumulative area under the threshold curve for mean arterial pressure (MAP) at 65, 70 and 75 mmHg (1 mmHg = 0.133 kPa), nor in the duration, time-weighted average and cumulative area under the threshold curve for relative reductions of 20%, 30% and 40% in MAP between the two groups ( P>0.05). Conclusions:The patients undergoing malignant brain tumor resection have the higher risk of postoperative cerebral ischemia. The association between intraoperative hypotension and postoperative cerebral ischemia is not significant. Maintenance of intraoperative circulation should be guided by individualized monitoring and target values, which requires further interventional studies for validation.

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

AIM:To evaluate the effectiveness of EYESI binocular indirect ophthalmoscope simulation system as a training platform for fundus examination skills of general practitioner.METHODS:Prospective randomized study. A total of 40 general practitioners who received clinical ophthalmology training at Shenzhen Eye Hospital from January 2021 to December 2024 were selected and randomly divided into two groups by random number table method, with 20 cases in the study group and 20 cases in the control group. The study group was trained by EYESI binocular indirect ophthalmoscope simulation system and the control group was trained by conventional teaching. Training effects of the two groups were analyzed.RESULTS: The general information of the two groups was comparable. Through training with the EYESI binocular indirect ophthalmoscope simulator, the study group showed significant improvements in total examination and drawing scores compared to pre-training results(all P<0.001). Additionally, examination duration, retinal light exposure time, and drawing time were all significantly shorter than those before training(all P<0.001).The study group achieved significantly higher total examination and drawing scores than the control group during the EYESI binocular indirect ophthalmoscope simulator assessment(all P<0.001). Furthermore, examination duration, retinal light exposure time, and drawing time were all significantly shorter in the study group compared to the control group(all P<0.001). Moreover, ratings for the novelty of the training method and overall satisfaction with the training were significantly higher in the study group than in the control group(all P<0.001); while the perceived psychological stress during training was significantly lower in the study group(P<0.001).CONCLUSION:The EYESI binocular indirect ophthalmoscope simulaton system effectively enhances both the proficiency in fundus examination skills and overall training satisfaction among general practitioners.

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

Objective To observe the value of contrast-enhanced ultrasound(CEUS)for evaluating DeBakey Ⅰ aortic dissection involved renal artery.Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled,including 132 cases involved unilateral and 5 cases involved bilateral renal arteries.The opening of totally 274 renal arteries in bilateral kidneys were observed.Taken CT angiography(CTA)as reference standard,the renal artery opened in true lumen was considered as unaffected,while opened in false lumen or true-false lumen were both considered as affected.Relative CEUS manifestations were observed,and their value for evaluating involved renal artery or not were analyzed.Results CTA showed that 132 renal arteries opened in true lumens,90 opened in false lumens and 52 opened in true-false lumens.CEUS diagnosed 131 renal arteries opened in true lumens,111 opened in false lumens and 32 opened in true-false lumens,and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84％,81.08％and 90.63％,respectively.The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good(Kappa=0.786).Logistic regression analysis showed that the time to peak(TTP)and peak intensity(PI)of time intensity curve(TIC)were both impact factors for differentiating renal artery opened in true lumen or false lumen,as well as true lumen or true-false lumen(both P＜0.05),while the area under the curve(AUC)of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen(P＜0.05).The AUC of receiver operating characteristic curve of the combination of TTP,PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen,true lumen or true-false lumen and false lumen or true-false lumen was 0.703,0.686 and 0.493,respectively.Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery.

Objective To observe the value of contrast-enhanced ultrasound(CEUS)for evaluating DeBakey Ⅰ aortic dissection involved renal artery.Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled,including 132 cases involved unilateral and 5 cases involved bilateral renal arteries.The opening of totally 274 renal arteries in bilateral kidneys were observed.Taken CT angiography(CTA)as reference standard,the renal artery opened in true lumen was considered as unaffected,while opened in false lumen or true-false lumen were both considered as affected.Relative CEUS manifestations were observed,and their value for evaluating involved renal artery or not were analyzed.Results CTA showed that 132 renal arteries opened in true lumens,90 opened in false lumens and 52 opened in true-false lumens.CEUS diagnosed 131 renal arteries opened in true lumens,111 opened in false lumens and 32 opened in true-false lumens,and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84％,81.08％and 90.63％,respectively.The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good(Kappa=0.786).Logistic regression analysis showed that the time to peak(TTP)and peak intensity(PI)of time intensity curve(TIC)were both impact factors for differentiating renal artery opened in true lumen or false lumen,as well as true lumen or true-false lumen(both P＜0.05),while the area under the curve(AUC)of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen(P＜0.05).The AUC of receiver operating characteristic curve of the combination of TTP,PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen,true lumen or true-false lumen and false lumen or true-false lumen was 0.703,0.686 and 0.493,respectively.Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery.

Objective:To investigate the association between intraoperative hypotension and postoperative cerebral ischemia in patients undergoing malignant brain tumor resection.Methods:The study was a secondary analysis of a randomized, double-blind, placebo-controlled trial. Four hundred and eighty patients with malignant brain tumor from November 2018 to September 2022 in Beijing Tiantan Hospital, Capital Medical University were selected. All patients were treated with selective supratentorial tumor resection. The demographic characteristics, perioperative indexes, postoperative outcomes and intraoperative hypotension characteristics were recorded. The cerebral ischemia during postoperative hospitalization (within 10 d after operation) was documented, and the patients were categorized based on the occurrence of postoperative cerebral ischemia.Results:Among 480 patients, 28 cases (5.83%) developed postoperative cerebral ischemia (cerebral ischemia group), while 452 cases did not experience cerebral ischemia during hospitalization (non-cerebral ischemia group). The proportion of WHO grade Ⅲ to Ⅳ, secondary surgery rate and postoperative hospital stay in cerebral ischemia group were significantly higher than those in non-cerebral ischemia group: 96.43% (27/28) vs. 81.19% (367/452), 10.71% (3/28) vs. 1.99% (9/452) and 13 (10, 16) d vs. 10 (8, 14) d, and there were statistical differences ( P<0.05); there were no statistical differences in gender composition, age, body mass index, medical history, medication history, American Society of Anesthesiologists classification, Charlson comorbidity index, preoperative Karnofsky performance status score, tumor laterality, tumor volume, midline shift, operative time, operative time >5 h, fluid intake, red blood cell transfusion, plasma transfusion, blood loss, urine output, fluid balance, serum urea, serum creatinine, glomerular filtration rate, β 2-microglobulin, prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen, postoperative complications, ICU admission, ICU stay duration, mechanical ventilation and hospitalization costs between the two groups ( P>0.05). There were also no statistical difference in the duration, time-weighted average and cumulative area under the threshold curve for mean arterial pressure (MAP) at 65, 70 and 75 mmHg (1 mmHg = 0.133 kPa), nor in the duration, time-weighted average and cumulative area under the threshold curve for relative reductions of 20%, 30% and 40% in MAP between the two groups ( P>0.05). Conclusions:The patients undergoing malignant brain tumor resection have the higher risk of postoperative cerebral ischemia. The association between intraoperative hypotension and postoperative cerebral ischemia is not significant. Maintenance of intraoperative circulation should be guided by individualized monitoring and target values, which requires further interventional studies for validation.

OBJECTIVE To systematically evaluate the risk factors for ineffective eradication therapy of adult Helicobacter pylori(Hp)infection.METHODS Retrieved from PubMed,Web of Science,the Cochrane Library,Embase,CNKI,VIP and Wanfang Data,cohort studies and case-control studies on the eradication therapy for Hp infection in adult patients were searched from Jan.2000 to Jul.2024.After screening literature,extracting data,and evaluating the quality of literature,RevMan 5.3 software was used for meta-analysis,and sensitivity analysis and publication bias analysis were also performed.RESULTS A total of 19 articles were included,all of which were cohort studies,involving 9 931 patients in total.Among them,1 929 patients were ineffective in eradication therapy,with the ineffective rates ranging from 8.02%to 33.33%.Meta-analysis showed that age＜50 years[OR=1.33,95%CI(1.12,1.57),P＜0.001],body mass index(BMI)＞25 kg/m2[OR=1.87,95%CI(1.35,2.59),P=0.000 2],a history of smoking[OR=1.62,95%CI(1.35,1.95),P＜0.001],a history of drinking[OR=1.93,95%CI(1.47,2.54),P＜0.001],living in a rural area[OR=1.74,95%CI(1.41,2.15),P＜0.001],having non-peptic ulcer[OR=3.45,95%CI(1.75,6.67),P=0.000 3],a family members'infection history[OR=4.72,95%CI(3.32,6.74),P＜0.001],poor treatment compliance[OR=4.89,95%CI(3.07,7.79),P＜0.001],amoxicillin resistance[OR=3.42,95%CI(1.95,6.00),P＜0.001]and clarithromycin resistance[OR=8.14,95%CI(5.00,13.24),P＜0.001]had significant impacts on ineffective eradication therapy of Hp infection in adults.Sensitivity analysis and publication bias analysis showed that the result of this study was robust and reliable.CONCLUSIONS Age＜50 years,BMI＞25 kg/m2,a history of smoking,a history of drinking,living in a rural area,having non-peptic ulcer,a family members'infection history,poor treatment compliance,amoxicillin resistance and clarithromycin resistance are risk factors for failure of Hp infection eradication therapy in adults.

Objective:To compare the therapeutic efficacy between femoral neck system (FNS) and cannulated compression screws (CCS) in the fixation of femoral neck fractures in the elderly patients aged 65 to 75 years old.Methods:A retrospective study was conducted to analyze the data of 39 patients aged 65 to 75 years old who had been treated for femoral neck fractures at Department of Trauma Surgery, Hospital Affiliated to Qingdao University from January 2015 to September 2022. The patients were divided into 2 groups according to their internal fixation methods. In the FNS group of 18 cases subjected to FNS fixation, there were 8 male and 10 females with an age of (71.1±2.8) years. In the CCS group of 21 cases subjected to CCS fixation, there were 7 males and 14 females with an age of (70.1±2.9) years. The 2 groups were compared in terms of intraoperative fluoroscopy frequency, surgical time, intraoperative bleeding, hospitalization costs, fracture healing time, internal fixation failure, and Harris hip score, changes in neck shaft angle, and femoral neck shortening at 1 year after surgery.Results:The differences were not statistically significant in the preoperative general data or follow-up time between the 2 groups, indicating comparability ( P>0.05). In the FNS group, the intraoperative fluoroscopy frequency [(15.1±2.3) times] was significantly lower than that in the CCS group [(19.5±3.5) times], the surgical time [(49.2±5.2) minutes] was significantly shorter than that in CCS group [(62.4±11.2) minutes], and the intraoperative bleeding [(74.2±15.6) mL] and hospitalization costs [(39,928.7±1,438.3) yuan] were significantly higher than those in the CCS group [(53.1±17.3) mL and (23,527.9±2,126.3) yuan] (all P<0.05). The difference in fracture healing time was not statistically significant between the 2 groups ( P>0.05). In the FNS group, the decreased neck shaft angle (2.65°±1.66°) and femoral neck shortening (3.9±1.3 mm) were significantly smaller than those in the CCS group [4.18°±2.13° and (6.3±2.5) mm] at 1 year after surgery, and the Harris hip score [(82.2±7.2) points] was significantly higher than that in the CCS group [(76.4±5.9) points] (all P<0.05). Internal fixation failure occurred in 1 case in the FNS group and in 4 cases in the CCS group, respectively, showing no statistically significant difference ( P>0.05). Conclusions:Compared with CCS fixation, FNS fixation may lead to better therapeutic efficacy in patients with femoral neck fracture aged 65 to 75 years old. However, the risk of internal fixation failure should also be taken into consideration.