Since the founding of the People’s Republic of China, remarkable achievements have been gained in infectious disease prevention and control, and rich practical experiences have been accumulated. If these experiences are shared with developing countries, it will greatly contribute to global infectious disease control and global health security. Under the framework of Forum on China-Africa Cooperation, a series of China-Africa public health capacity training programs have been recently held in China, in order to help improve the capability of infectious disease control in African countries. This article summarized and refined good design concepts and practices from these programs, so as to provide insights into sustainable optimization of China-Africa public health capacity training and improvements of the training effectiveness.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Objective This study aims to investigate the association between remnant cholesterol(RC)and the risk of metabolic-associated fatty liver disease(MAFLD)under the optimal triglyceride(TG)levels recom-mended by different guidelines.Methods The data were derived from the annual physical examinations of elderly people aged 65 and above in a community in 2023.Regression analysis was used to evaluate the association between RC and MAFLD risk.According to the TG normal level(<1.7 mmol/L)recommended by the Chinese Lipid Management Consensus and the TG ideal target(<1.2 mmol/L)proposed by the European Atherosclerosis Society,the individuals were divided into subgroups with different TG levels to explore the association between RC and MAFLD risk in each subgroup.Results A total of 2,800 elderly individuals aged 65 and above were included in this study.The proportion of the individuals meeting the diagnostic criteria for MAFLD was 20.85%,and RC was identified as an independent risk factor for MAFLD(P<0.001).In the elderly individuals with TG<1.7 mmol/L,RC level was not significantly associated with MAFLD risk(P=0.888).In contrast,in the elderly individuals with TG≥1.7 mmol/L,RC level was significantly and positively correlated with MAFLD risk(P<0.001).Interaction tests revealed no significant interaction between the stratification factor and the effect size of RC(P=0.115).In the elderly individuals with TG<1.2 mmol/L,RC level was not associated with MAFLD risk(P=0.505),while in the elderly individuals with TG≥1.2 mmol/L,RC level was significantly associated with MAFLD risk(P<0.001).Interaction tests showed a significant interaction between the stratification factor and the effect size of RC(P=0.011).Conclusion RC is an independent risk factor for MAFLD in older individuals.To reduce the risk of MAFLD related to RC in the elderly,a triglyceride level of<1.2 mmol/L can serve as a reference for identifying early-stage risk.

Objective:To investigate the impact of the number of cesarean deliveries on adverse maternal and neonatal outcomes.Methods:A retrospective analysis was conducted on 11 904 singleton pregnant women who underwent cesarean delivery at the Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2019 to December 31st, 2023. The women were grouped according to the number of cesarean deliveries: those undergoing their first cesarean delivery (1CD group, 7 231 cases), those undergoing their second cesarean delivery (2CD group, 3 749 cases), those undergoing their third cesarean delivery (3CD group, 841 cases), and those undergoing their fourth or more cesarean deliveries (4CD group, 83 cases). Differences in clinical characteristics, related surgical procedures, and adverse maternal and neonatal outcomes among the groups were compared. Binary logistic regression analysis was used to assess the impact of the number of cesarean deliveries on related surgical procedures and adverse maternal and neonatal outcomes.Results:(1) During the 5-year period, the total number of women undergoing cesarean delivery in our hospital showed a slight downward trend, while the proportion of women undergoing three or more cesarean deliveries increased. (2) Compared with women undergoing their first cesarean delivery, women in each repeat cesarean delivery group were older, had higher proportions of advanced maternal age and pre-pregnancy body mass index, and had more pregnancies, deliveries, and induced abortions; the incidence of placenta previa, placental implantation, antepartum hemorrhage, gestational hyperglycemia, and failed trial of labor requiring conversion to surgery was higher, while the incidence of premature rupture of membranes was lower; the proportions of ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and postoperative intestinal obstruction were higher, and the amount of postpartum hemorrhage was greater; the gestational age at delivery of neonates was earlier, but the rates of preterm birth at 28-31 +6 and 32-33 +6 weeks of gestation were lower; the differences were statistically significant ( P<0.05) for all comparisons. (3) The number of cesarean deliveries was not an independent risk factor for the dose-dependent occurrence of placenta previa (a OR=0.99, 95% CI: 0.98-1.01; P=0.261). In women without placenta previa, the number of cesarean deliveries was not a risk factor for placental implantation (a OR=1.12, 95% CI: 0.90-1.39; P=0.320). However, in women with placenta previa, the number of cesarean deliveries was a risk factor for placental implantation (a OR=4.01, 95% CI: 3.08-5.22; P<0.001). In the overall population, the number of cesarean deliveries was a risk factor for ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, bladder rupture repair, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and preterm birth (all P<0.05). However, the number of cesarean deliveries was not a risk factor for postoperative intestinal obstruction, admission to the intensive care unit, neonatal asphyxia, admission to the neonatal intensive care unit, or neonatal death (all P<0.05). Conclusions:The number of cesarean deliveries could lead to adverse maternal and neonatal outcomes, but the relationship is not simply dose-dependent. It is speculated that the occurrence of severe adverse maternal and neonatal outcomes is more closely related to maternal complications and comorbidities, as well as whether multidisciplinary comprehensive management was received.

Objective To investigate the incidence and economic burden of healthcare-associated infection(HAI)in patients after liver transplant.Methods Basic clinical information,infection status,and related medical expenses of liver transplant patients in the department of hepatobiliary surgery in a tertiary first-class hospital from November 2012 to December 2023 were investigated retrospectively.A case-control study design was employed,with post-li-ver transplant patients who developed HAI as the infection group and those without HAI during the same period as the control group.The 1∶1 propensity score matching(PSM)method was adopted(caliper value was set at 0.05,employing sampling without replacement).Length of hospital stay and hospitalization expenses between patients in the infection group and the control group were compared using Wilcoxon rank-sum test,and the economic burden due to HAI was calculated.Results A total of 336 liver transplant patients were included in study,out of which 48 had HAI,with an incidence of 14.29％.44 pairs were successfully matched by PSM.After matching,the median hospitalization expense for patients in the infection group was 334 473.73 Yuan,while that of the control group was 285 824.82 Yuan,with a statistically significant difference(Z=-3.430,P＜0.05).The direct economic burden of HAI in liver transplant patients was 48 648.91 Yuan.After matching,the median length of hospital stay in the in-fection group(37.0 days)was 12.5 days longer than that in the control group(24.5 days),with statistically sig-nificnat difference(Z=-3.630,P＜0.001).Conclusion HAI after liver transplant increases patients' hospitaliza-tion expense and prolongs their hospital stay,thus brings huge economic burdens to the patients.

Objective To investigate the clinical features,imaging features,diagnosis and treatment of empyema caused by Streptococcus constellatus for improving early diagnosis and treatment and reduce mortality rate.Methods The clinical data of 11 patients with empyema caused by S.constellatus who were treated in Fuding Hospital of Fujian Province from February 2021 to August 2024 were retrospectively analyzed.Results All the 11 patients were male,51 to 78 years old.Underlying disease was reported in 9 patients.The main clinical manifestations were chest tightness and dyspnea.Fever may not be present.The white blood cell count,neutrophil ratio,C-reactive protein,procalcitonin,fibrinogen and D-dimer were significantly increased in 11 patients.Chest imaging showed unilateral encapsulated effusion,more common on the right side(9/11),and sometimes accompanied by pneumothorax(2/10).The lung lobes of the same side of empyema were mostly accompanied by exudation and consolidation,and cavities were common(6/10)in the consolidation lesions.White blood cells,multinucleated cells,lactate dehydrogenase(LDH)and adenosine deaminase(ADA)were significantly increased in pleural effusion of 11 patients.The positive rate of pleural effusion culture in aerobic bottle(10/11)and anaerobic bottle(6/7)was higher than that in blood plate culture(1/7).All the 11 patients were treated with antibiotics combined with thoracentesis and drainage.Ten patients improved after treatment.One patient died of septic shock in a short time.Conclusions Drainage of pleural effusion and pleural fluid culture should be performed as soon as possible for middle-aged and elderly male patients with underlying diseases,acute or subacute onset of chest distress,dyspnea,associated with significantly increased blood inflammatory markers,and chest imaging suggesting pleural effusion.Pleural fluid can be injected into the blood culture bottle to improve the detection of S.constellatus.At the same time,antimicrobial therapy should be prescribed reasonably according to the results of antimicrobial susceptibility test.

Objective To analyze the potential biological relationship between Alzheimer disease(AD)and chronic periodontitis(CP)by bioinformatics.Methods We analyzed two datasets of AD and CP from the Gene Expression Omnibus database,and differentially expressed genes(DEGs)were identified from these datasets.Weighted gene co-expression network analysis(WGCNA)was used to identify the most relevant modules.Functional enrichment analysis of shared genes was performed,and a protein-protein interaction(PPI)network was constructed.MCODE was used to identify key modules,and machine learning was used to discover key genes.In addition,Gene Set Enrichment Analysis(GSEA)and CIBERSORT were used to investigate KLRB1-related molecular pathways and immune cell distribu-tion.Results The study identified 18 genes common to both AD and CP.MCODE analysis revealed five pivotal genes,machine learning identified 13 genes for AD,eight for CP,and KLRB1 was determined as a common gene for AD and CP.GSEA demonstrated the intricate involvement of these genes in disease-related pathways.Immunocellular analysis underscored a significant association between KLRB1 and γδT cells.Conclusion This research highlighted KLRB1 as a key gene for AD and CP,providing new insights into their molecular linkages.

Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn's disease(CD)through radiomics-assisted neurophenotyping,utilizing multiparametric brain MRI.Methods This prospective study enrolled patients with CD who underwent brain MRI,MR enterography,and ileocolonoscopy within one week.The Lémann Index was used to quantitatively assess cumulative structural bowel damage.CD patients were stratified into two groups based on a cutoff value of 4.8:those with bowel damage(LI>4.8)and those without bowel damage(LI≤4.8).A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD.Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort.Results The final study population comprised 109 patients,including 51 individuals with bowel damage and 58 without bowel damage.The neurophenotype model scores were 0.785(95%CI:0.506～0.945)in the bowel damage group and 0.155(95%CI:0.093～0.394)in the non-bowel damage group,showing a statistically significant difference between the two groups(P<0.001).The developed model exhibited strong discriminative performance,with area under the receiver operating characteristic curve(AUC)values ranging from 0.824 to 0.918 across the training,vali-dation,and test cohorts(all P<0.05).Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage,which may indicate extraintestinal manifestations associated with cumulative intestinal injury.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To explore the current status and trends in emergency nursing teaching methods based on CiteSpace software in China from 2012 to 2023, and to provide reference for subsequent research.Methods:Literature on teaching methods in emergency nursing was electronically searched in the China National Knowledge Infrastructure, WanFang Data, and VIP from January 2012 to December 2023. CiteSpace and Excel software were used to perform bibliometric analysis on the publication year, journal source, first author affiliation, keywords and clustering content.Results:An initial search yielded 1 550 articles and 936 relevant articles were screened and published in 194 journals. From 2012 to 2023, the number of publications on teaching methods in emergency nursing in China was relatively flat, the first author affiliations were mainly general hospitals, and the research methods were mainly quantitative. Keyword clustering showed that six themes were extracted, including exploration of professional skills, reform and application of teaching methods, nursing teaching and evaluation, teaching modes, teaching tools, and training modes.Conclusions:The trend of publications in emergency nursing teaching methods in China in the past 10 years has been relatively flat, and the quality of the literature needs to be improved. Emergency nursing teaching needs to focus on reforming teaching modes and methods, and further exploring the use of tools such as mind maps and teaching manuals to improve the quality of teaching.