Effects of a health management intervention program using WeChat platform in a hypertensive population aged under 45 / 中华健康管理学杂志

Objective This study aims to determine the effects of a health management program based on WeChat platform on a hypertensive population aged under 45. Methods 1 128 hypertensive patients aged between 18 and 44 received a health examination from January 2016 to December 2016 and they were divided into intervention (n=561) and control (n=567)groups. The two groups were followed up after 1 year, and initially both the intervention group (n=521) and the control group (n=510) completed a lifestyle questionnaire, and their systolic blood pressure, diastolic blood pressure, triglyceride (TG), total cholesterol (TC), high density lipoprotein‐cholesterol (HDL‐C), low density lipoprotein‐cholesterol (LDL‐C), body mass index (BMI), and pulse wave velocity (PWV) were recorded. For the control group, lifestyle health management programs were conducted. For the intervention group, a learning platform was arranged on WeChat, which uploaded questionnaires, and provided medical information to create electronic health records. The group gained hypertension‐related knowledge, dynamically monitored blood pressure and lifestyle, and participated in interactive question‐and‐answer sessions. Both groups were followed up after a year, and their systolic pressure, diastolic blood pressure, TG, TC, HDL‐C, LDL‐C, BMI, and PWV levels were measured. The changes in their daily exercise time, vegetable intake, sleep time, weekly blood pressure reading, smoking, and salt intake were recorded. Results The mean age of the WeChat intervention group was 33.1 (+10.6) years, which had 319 males (61.2%), and the mean age of the control group was 32.8 (+10.2) years, with 307 males (60.1%). No difference of clinical data was found between the two groups at baseline. The systolic and diastolic blood pressure of the intervention group, (142.4±10.4) mmHg (1 mmHg=0.133 kPa) (85.1±8.2) mmHg was significantly lower than that of the control group (149.6±10.1) mmHg, (92.3±9.1) mmHg (t=3.67, 2.33, P<0.05) at the end of the first year of follow‐up. The TG, TC, LDL‐C, BMI, and PWV levels of the intervention group [(1.6±0.6) mmol/L, (4.4±0.7) mmol/L, (2.8± 0.4 ) mmol/L, (23.9±4.2) kg/m2, (11.3±3.7) m/s respectively] were significantly lower than those of the control group [(1.8±0.7) mmol/L, (5.0±0.8) mmol/L, (3.3±0.5) mmol/L, (25.9±4.5) kg/m2, (15.8± 4.8) m/s, respectively] (t=6.63, 7.24, 4.96, 5.68, 9.25, all P<0.05). The HDL‐C level of the intervention group (1.8±0.7) mmol/L was significantly higher than that of the control group (1.4±0.4) mmol/L(t=8.14, P<0.05). After 1 year of intervention, daily exercise time [(40.5±12.2)min/d, (20.8±9.2) min/d)], vegetable intake [(423.6±145.8) g/d, (204.8±79.3) g/d)], sleeping time [(6.3±2.2) h/d, (5.9±1.7) h/d)], and weekly monitoring of blood pressure (23.4%, 8.1%) showed an increase with statistical significance (t =2.36, 1.95, 9.07, χ2=46.31, P<0.05), while smoking (14.4%, 21.9%) and high‐salt diet (20.2%, 30.5%) decreased showing statistical significance ( χ 2=‐9.83, -14.27, P<0.05). The daily exercise time [(22.9±11.3)min/d, (21.7±9.5)min/d], vegetable intake [(211.8±85.4) g/d, (198.5±81.4) g/d], sleeping time [(5.9±1.8) h/d,(5.8±1.9) h/d], weekly monitoring of blood pressure (9.2%, 8.6%), smoking(18.9%, 19.8%), and high‐salt diet (28.8%, 30.2%) were not significantly different in the control group at the one‐year follow‐up (t=0.14, 0.26, 0.31, χ2=0.11, 0.16, 0.23, all P>0.05). Conclusions The health management program based on WeChat platform can improve diet, exercise compliance, and lifestyle, and effectively reduce blood pressure and blood lipid levels for a hypertensive population under the age of 45.

Relationship between serum homocysteine level and first-ever cardiocerebral vascular events in elderly hypertension-free population / 中华老年心脑血管病杂志

Objective To study the relationship between serum homocysteine (Hey) level and firstever cardiocerebral vascular events in elderly hypertension-free population.Methods A total of 6124 hypertension-free patients aged 60-80 years admitted to our hospital for physical examination were randomly divided into control group (n=4122) with their Hcy≤13 μmol/L and experimental group (n=2002) with their Hcy＞13 μmol/L.Their serum Hcy levels were measured.The patients were followed up for 3 years,during which the incidence of first-ever cardiocerebral vascular events was recorded every 6 months and compared.Results No significant difference was found in sex,age,smoking,BMI,SBP,DBP,FBG and LDL-C between the two groups (P＞0.05).The serum Hcy level was significantly higher in experimental group than in control group (29.68±12.87 μmol/L vs 8.12 ± 4.36 μmol/L,P =0.001).The incidence of cardiocerebral vascular events,cerebral infarction and non-lethal myocardial infarction was significantly higher in experimental group than in control group at the end of 3-year follow-up period (18.8％ vs 10.2％,P=0.001;9.0％ vs 4.6％,P=0.025;5.8％ vs 3.0％,P=0.034).Multivariate Cox harzards regression analysis showed that serum Hcy level was an independent risk factor for first-ever cardiocerebral vascular events in elderly hypertension-free population (β=0.78,95 ％ CI:1.76-4.12,P =0.003).Conclusion Elevated serum Hcy level is a risk factor for first-ever cardiocerebral vascular events,especially for cerebral and myocardial infarction in elderly hypertension-free population.

The changes of new guidelines for hypertension in the United States in 2017 and the thoughts on the management of hypertension in China / 中华健康管理学杂志

The latest American hypertension guideline in 2017 proposed new diagnostic criteria for hypertension,control target values,and threshold for starting a drug treatment.This article reviews the related contents of hypertension guidelines in Europe,America and China in recent years,hoping to help clinicians and health managers better understand the new progress of hypertension,and manage patients with hypertension more scientifically and more regularly.

Health management reduces risk factors of cardiovascular diseases in community residents / 中华健康管理学杂志

Objective To investigate the effects of health management on risk factors of cardiovascular diseases in community residents.Methods A total of 208 adults from one single community who visited our health check-up center were randomly assigned to the control group(receiving routine consultation,n =104)and health management group(receiving health management intervention,n =104).At 1-year follow-up,fasting blood glucose(FBG),lipid profiles,and blood pressure(BP)were measured and risk factors of cardiovascular were surveyed.t or x2 test was used for data analysis.Results No difference of clinical data was found between the two groups at baseline.Follow-up results indicated that absolute risk of cardiovascular diseases,number of risk factors,health satisfaction,sick leave,daily vegetables intake and physical exercise,and BP were significantly improved in the health management group.Ten-year absolute risk of cardiovascular diseases(0.8 ± 0.4 vs 1.3 ± 0.5),number of risk factors(172 vs 283),and sick leave per year(118 d vs 264 d)were significantly decreased in the health management group when compared to the control group(all P ＜ 0.05).Furthermore,health satisfaction(83.7％(87/104)vs 52.9％(55/104)),and daily vegetables intake(520.5 g vs 348.3 g)and physical exercise(1.2 h vs 0.3h)were significantly improved in the health management group(all P ＜ 0.05).Conclusion Health management may be effective in decreasing risk factors of cardiovascular diseases in community residents.

Rescued influenza A virus with codon deoptimized NS1 gene is attenuated both in vitro and in vivo / 生物工程学报

Abstract: To develop novel live attenuated influenza vaccine, we explored the feasibility to attenuate influenza virus by codon deoptimization of NS1. According to the codon usage bias in influenza A virus, we designed and synthesized a condon-deoptimized NS gene by substituting codons of 110 amino acids in the NS1 gene of A/Puerto Rico/8/34(H1N1) with unpreferred synonymous codons. The influenza A virus with the codon deoptimized NS1 gene (deoNS virus) was rescued by reverse genetics. Plaque forming assay and virus growth curve showed that the growth of deoNS virus was reduced about 1000 times in MDCK cells compared to that of the wild-type virus. Intranasal inoculation with deoNS virus did not cause death or evident disease in infected BALB/c mice. Furthermore, the virus titer in the lungs of mice infected with deoNS virus was significantly lower (i.e. 100-1000 times) than that of wild-type virus. Our results indicated that influenza virus could be effectively attenuated by synonymous codon deoptimization of NS1 gene. This strategy will be useful to develop new attenuated candidates for the production of live attenuated influenza vaccines.

Identification and Molecular Analysis of H5N2 Subtype Highly Pathogenic Avian Influenza Virus Isolated From Goose / 生物化学与生物物理进展

A H5N2 subtype avian influenza virus isolated from goose belongs to highly pathogenic avian influenza virus, and the intravenous pathogenicity indexes (IVPI) =2.99. But ducks are not sensitive to this isolated influenza virus. The virus can infect mouse but only replicates in lung and has no pathogenicity. HA and NA gene of this isolated strain share 99.4% and 99.8% nucleotide sequence identity to the HA gene of A/chicken/Hubei/ 489/2004 (H5N1) and the NA gene of A/chicken/Jilin/53/01 (H9N2), and share 99.3% and 99.6% amino acid sequence identity to the HA protein of A/chicken/Hubei/489/2004 (H5N1), A/swan/Guangxi/307/2004 (H5N1), A/wild duck/ Guangdong/314/2004(H5N1), A/chicken/Henan/210/2004(H5N1) and the NA protein of A/chicken/ Jilin/53/01 (H9N2). There are several continuous basic amino acids (-RRRKKR-) at the cleavage site of HA protein. Phylogenetic trees analysis of HA and NA gene suggests that the isolated influenza virus probably originated from the reassortment of H5N1 and H9N2 subtype influenza virus.