Fecal microbiota transplantation alleviates intestinal inflammatory diarrhea caused by oxidative stress and pyroptosis via reducing gut microbiota-derived lipopolysaccharides.

Infancy is a critical period in the maturation of the gut microbiota and a phase of susceptibility to gut microbiota dysbiosis. Early disturbances in the gut microbiota can have long-lasting effects on host physiology, including intestinal injury and diarrhea. Fecal microbiota transplantation (FMT) can remodel gut microbiota and may be an effective way to treat infant diarrhea. However, limited research has been conducted on the mechanisms of infant diarrhea and the regulation of gut microbiota balance through FMT, primarily due to ethical challenges in testing on human infants. Our study demonstrated that elevated Lipopolysaccharides (LPS) levels in piglets with diarrhea were associated with colon microbiota dysbiosis induced by early weaning. Additionally, LPS upregulated NLRP3 levels by activating TLR4 and inducing ROS production, resulting in pyroptosis, disruption of the intestinal barrier, bacterial translocation, and subsequent inflammation, ultimately leading to diarrhea in piglets. Through microbiota regulation, FMT modulated ß-PBD-2 secretion in the colon by increasing butyric acid levels. This modulation alleviated gut microbiota dysbiosis, reduced LPS levels, attenuated oxidative stress and pyroptosis, inhibited the inflammatory response, maintained the integrity of the intestinal barrier, and ultimately reduced diarrhea in piglets caused by colitis. These findings present a novel perspective on the pathogenesis, pathophysiology, prevention, and treatment of diarrhea diseases, underscoring the significance of the interaction between FMT and the gut microbiota as a critical strategy for treating diarrhea and intestinal diseases in infants and farm animals.

Bayesian linear mixed model with multiple random effects for prediction analysis on high-dimensional multi-omics data.

MOTIVATION: Accurate disease risk prediction is an essential step in the modern quest for precision medicine. While high-dimensional multi-omics data have provided unprecedented data resources for prediction studies, their high-dimensionality and complex inter/intra-relationships have posed significant analytical challenges. RESULTS: We proposed a two-step Bayesian linear mixed model framework (TBLMM) for risk prediction analysis on multi-omics data. TBLMM models the predictive effects from multi-omics data using a hybrid of the sparsity regression and linear mixed model with multiple random effects. It can resemble the shape of the true effect size distributions and accounts for non-linear, including interaction effects, among multi-omics data via kernel fusion. It infers its parameters via a computationally efficient variational Bayes algorithm. Through extensive simulation studies and the prediction analyses on the positron emission tomography imaging outcomes using data obtained from the Alzheimer's Disease Neuroimaging Initiative, we have demonstrated that TBLMM can consistently outperform the existing method in predicting the risk of complex traits. AVAILABILITY AND IMPLEMENTATION: The corresponding R package is available on GitHub (https://github.com/YaluWen/TBLMM).

Alfalfa leaf meal as a new protein feedstuff improves meat quality by modulating lipid metabolism and antioxidant capacity of finishing pigs.

The effects of alfalfa leaf meal (ALM) on the meat quality of finishing pigs are largely unknown. Here, we investigated the effects of ALM diet on meat quality by replacing 0%, 25%, 50%, and 75% of soybean meal in the diet of finishing pigs, respectively. The findings showed that 25% ALM diet increased the IMF, cooked meat rate, a* and antioxidant capacity of longissimus dorsi (LD), improved amino acid composition, increased MUFA content, and increased LD lipid synthesis and mRNA expression of antioxidation-related genes. At the same time, ALM diet altered serum lipid metabolism (TG, FFA). Correlation analysis showed that antioxidant capacity was positively correlated with meat quality. In addition, metabolomic analysis of LD showed that the main metabolites of 25% ALM diet altered stachydrine and l-carnitine were associated with meat quality and antioxidant capacity. In conclusion, ALM replacing 25% soybean meal diet can improve the meat quality of pigs.

Effects of Diets Combining Peanut Vine and Whole-Plant Corn Silage on Growth Performance, Meat Quality and Rumen Microbiota of Simmental Crossbred Cattle.

Peanut vine is a typical peanut by-product and can be used as a quality roughage resource. Whole-plant corn silage is a commonly used roughage. However, few studies have investigated the effects of diets combining peanut vine and whole-plant corn silage on growth performance, antioxidant capacity, meat quality, rumen fermentation and microbiota of beef cattle. To investigate these effects, eighty Simmental crossbred cattle (body weight, 451.27 ± 10.38 kg) approximately 14 months old were randomly divided into four treatments for a 90-day feeding experiment. A one-way design method was used in this experiment. According to the roughage composition, the cattle were divided into a control treatment of 45% wheat straw and 55% whole-plant corn silage (WG), and three treatments of 25% peanut vine and 75% whole-plant corn silage (LPG), 45% peanut vine and 55% whole-plant corn silage (MPG), and 65% peanut vine and 35% whole-plant corn silage (HPG), and the concentrate was the same for all four treatment diets. The results showed that compared to the WG group, the MPG group experienced an increase in their average daily feed intake of 14%, an average daily gain of 32%, and an increase in SOD activity in the spleen of 33%; in the meat, dry matter content increased by 11%, crude protein by 9%, and ether extract content by 40%; in the rumen, the NH3-N content was reduced by 36%, the relative abundance of Firmicutes increased, and the relative abundance of Bacteroidetes decreased (p < 0.05). These results showed the composition of 45% peanut vine and 55% whole-plant corn silage in the roughage improved growth performance, antioxidant capacity, meat quality, rumen fermentation, and microbiota of beef cattle.

Alfalfa Silage Diet Improves Meat Quality by Remodeling the Intestinal Microbes of Fattening Pigs.

Because the demand for pork is increasing, it is crucial to devise efficient and green methods to improve the quality and quantity of meat. This study investigated the improvement in pork quality after the inclusion of alfalfa meal or alfalfa silage in pig diet. Our results indicated that alfalfa silage improved meat quality more effectively in terms of water-holding capacity, drip loss, and marbling score. Besides, an alfalfa silage diet can affect the level of fatty acids and amino acids in pork. Further, alfalfa silage was found to improve meat quality by remodeling intestinal microbiota and altering the level of SCFAs, providing a viable option for improving meat quality through forage.

Effect of home cook interventions for salt reduction in China: cluster randomised controlled trial.

OBJECTIVE: To determine the effects of salt reduction interventions designed for home cooks and family members. DESIGN: Cluster randomised controlled trial. SETTING: Six provinces in northern, central, and southern China from 15 October 2018 to 30 December 2019. PARTICIPANTS: 60 communities from six provinces (10 communities from each province) were randomised; each community comprised 26 people (two people from each of 13 families). INTERVENTIONS: Participants in the intervention group received 12 month interventions, including supportive environment building for salt reduction, six education sessions on salt reduction, and salt intake monitoring by seven day weighed record of salt and salty condiments. The control group did not receive any of the interventions. MAIN OUTCOME MEASURE: Difference between the two groups in change in salt intake measured by 24 hour urinary sodium during the 12 month follow-up. RESULTS: 1576 participants (775 (49.2%) men; mean age 55.8 (standard deviation 10.8) years) from 788 families (one home cook and one other adult in each family) completed the baseline assessment. After baseline assessment, 30 communities with 786 participants were allocated to the intervention group and 30 communities with 790 participants to the control group. During the trial, 157 (10%) participants were lost to follow-up, and the remaining 706 participants in the intervention group and 713 participants in the control group completed the follow-up assessment. During the 12 month follow-up, the urinary sodium excretion decreased from 4368.7 (standard deviation 1880.3) mg per 24 hours to 3977.0 (1688.8) mg per 24 hours in the intervention group and from 4418.7 (1973.7) mg per 24 hours to 4330.9 (1859.8) mg per 24 hours in the control group. Compared with the control group, adjusted mixed linear model analysis showed that the 24 hour urinary sodium excretion in the intervention group was reduced by 336.8 (95% confidence interval 127.9 to 545.7) mg per 24 hours (P=0.002); the systolic and diastolic blood pressures were reduced by 2.0 (0.4 to 3.5) (P=0.01) and 1.1 (0.1 to 2.0) mm Hg (P=0.03), respectively; and the knowledge, attitude, and behaviours in the intervention group improved significantly. CONCLUSIONS: The community based salt reduction package targeting home cooks and family members was effective in lowering salt intake and blood pressure. This intervention has the potential to be widely applied in China and other countries where home cooking remains a major source of salt intake. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800016804.

Cancer survival analysis and spatial distribution during 2014-2016 in Shandong Province, China.

We aimed to analyse cancer survival and its spatial distribution in Shandong Province. A total of 609,861 cancer cases from 2014 to 2016 were included in the analysis. Survival analysis was performed using strs in Stata. Spatial analysis was performed with GeoDa to determine measures of global and local spatial autocorrelation. Hotspot analysis was used to identify spatial clusters of high values (hotspots) and low values (cold spots) through ArcGIS. The 5-year relative survival rates were 37.85% for all cancers combined, 29.29% for males and 48.88% for females. After age standardisation, the survival rates were 34.47% for all cancers, 28.43% for males and 41.56% for females. Cancers with higher survival rates included thyroid (78.80%), breast (69.52%), uterus (64.51%) and bladder (62.54%) cancers. However, cancers with lower survival rates included pancreatic (11.34%), liver (13.19%), lung (18.39%), bone (19.71%), gallbladder (19.78%), oesophagus (24.52%), and stomach (28.85%) cancers and leukaemia (26.30%). Cancer survival rates in urban areas (37.53%) were higher than those in rural areas (32.83%). From the geographic distribution of cancer survival, we observed that the survival rate displayed a downward trend from east to west and from north to south. The hotspot analysis revealed that some counties of Qingdao, Jinan, Zibo, Dongying and Yantai cities were hotspots, whereas almost all counties of Linyi city and some counties of Weifang, Heze, Rizhao, and Dezhou cities were cold spots. In conclusion, the cancer survival rate in Shandong is still lower than that in China overall. The early diagnosis and treatment of lung and digestive tract cancers need to be further strengthened. Nevertheless, our results reflect a critical first step in obtaining and reporting accurate and reliable estimates of survival in Shandong.

Estimating future PM2.5-attributed acute myocardial infarction incident cases under climate mitigation and population change scenarios in Shandong Province, China.

BACKGROUND: The effects of fine particulate matter (PM2.5) on acute myocardial infarction (AMI) have been widely recognized. However, no studies have comprehensively evaluated future PM2.5-attributed AMI burdens under different climate mitigation and population change scenarios. We aimed to quantify the PM2.5-AMI association and estimate the future change in PM2.5-attributed AMI incident cases under six integrated scenarios in 2030 and 2060 in Shandong Province, China. METHODS: Daily AMI incident cases and air pollutant data were collected from 136 districts/counties in Shandong Province from 2017 - 2019. A two-stage analysis with a distributed lag nonlinear model was conducted to quantify the baseline PM2.5-AMI association. The future change in PM2.5-attributed AMI incident cases was estimated by combining the fitted PM2.5-AMI association with the projected daily PM2.5 concentrations under six integrated scenarios. We further analyzed the factors driving changes in PM2.5-related AMI incidence using a decomposition method. RESULTS: Each 10 µg/m3 increase in PM2.5 exposure at lag05 was related to an excess risk of 1.3 % (95 % confidence intervals: 0.9 %, 1.7 %) for AMI incidence from 2017 - 2019 in Shandong Province. The estimated total PM2.5-attributed AMI incident cases would increase by 10.9-125.9 % and 6.4-244.6 % under Scenarios 1 - 3 in 2030 and 2060, whereas they would decrease by 0.9-5.2 % and 33.0-46.2 % under Scenarios 5 - 6 in 2030 and 2060, respectively. Furthermore, the percentage increases in PM2.5-attributed female cases (2030: -0.3 % to 135.1 %; 2060: -33.2 % to 321.5 %) and aging cases (2030: 15.2-171.8 %; 2060: -21.5 % to 394.2 %) would wholly exceed those in male cases (2030: -1.8 % to 133.2 %; 2060: -41.1 % to 264.3 %) and non-aging cases (2030: -41.0 % to 45.7 %; 2060: -89.5 % to -17.0 %) under six scenarios in 2030 and 2060. Population aging is the main driver of increased PM2.5-related AMI incidence under Scenarios 1 - 3 in 2030 and 2060, while improved air quality can offset these negative effects of population aging under the implementation of the carbon neutrality and 1.5 °C targets. CONCLUSION: The combination of ambitious climate policies (i.e., 1.5 °C warming limits and carbon neutrality targets) with stringent clean air policies is necessary to reduce the health impacts of air pollution in Shandong Province, China, regardless of population aging.

"King of the forage"-Alfalfa supplementation improves growth, reproductive performance, health condition and meat quality of pigs.

As one kind of high-quality feed with rich nutrients, including high quality protein and amino acids, dietary fiber, enriched vitamins and mineral elements and bioactive molecules, alfalfa has been widely used in the production of ruminant livestock. As the understanding of alfalfa becomes more and more comprehensive, it is found that the high-quality nutrients in alfalfa could have positive effects on pigs. An increasing number of researches have shown that supplementing dietary alfalfa to the diet of gestating sows reduced constipation, alleviated abnormal behavior, improved satiety and reproductive performance; supplementing dietary alfalfa to the diet of piglets improved growth performance and intestinal barrier function, reduced intestinal inflammatory response and diarrhea; supplementing dietary alfalfa to the diet of growing-fattening pigs improved production performance and pork quality. Moreover, the mechanisms by which various nutrients of alfalfa exert their beneficial effects on pigs mainly including dietary fiber stimulating intestinal peristalsis, enhancing the activity of digestive enzymes, and promoting the colonization of beneficial bacteria in the intestinal tract through fermentation in the intestine, producing short-chain fatty acids and thus improving intestinal health; high quality protein and amino acids are beneficial to improve animal health condition; rich vitamins and mineral elements play an important role in various physiological functions and growth and development of the body; and bioactive molecules can improve the antioxidant and anti-inflammatory level. Therefore, alfalfa could be used as pig feed ingredient to alleviate various problems in the pig industry and to improve pig production performance. In this review, we detail the current application of alfalfa in pigs and discuss the potential mechanisms involved in how alfalfa improves growth and reproductive performance, pork quality, and intestinal health of the animals, thus laying the foundation for the increased application of high-quality forage in pig production.

Visual Analysis of Colorectal Cancer Immunotherapy: A Bibliometric Analysis From 2012 to 2021.

An increasing number of studies have shown that immunotherapy serves a significant role in treating colorectal cancer (CRC) and has become a hotspot. However, few studies used the bibliometric method to analyze this field comprehensively. This study collected 1,899 records of CRC immunotherapy from 2012 to October 31, 2021, and used CiteSpace to analyze regions, institutions, journals, authors, and keywords to predict the latest trends in CRC immunotherapy research. The United States and China, contributing more than 60% of publications, were the main drivers in this field. Sun Yat-sen University was the most active institution, while the National Cancer Institute had the highest frequency of citations. Most publications were published in the Journal for Immunotherapy of Cancer. Adam E Snook was the most prolific writer, while Dung T. Le was the most commonly co-cited author. "T cell", "MMI" and "PD-1blocked" were the most widely studied aspects of CRC immunotherapy. "Immune checkpoint inhibitor", "combination therapy", "drug therapy" and "liver metastases" were current research hotspots. "Tumor microenvironment", "neutrophils", "tumor-associated macrophages", and "suppressor cell" have emerged as research hotspots in recent years. "Gut microbiota", "nanoparticle" and "tumor mutational burden" as recently emerged frontiers of research that should be closely monitored.

Weekly green space visit duration is positively associated with favorable health outcomes in people with hypertension: Evidence from Shenzhen, China.

BACKGROUND: Studies from high income 'western' countries indicate that green space visit duration is associated with better health. However, scant comparable research has been done in developing countries with rapid urbanization and on the potential health impacts of specific green infrastructure. OBJECTIVE: Associations between green space visit duration, green infrastructure and various health outcomes were assessed in hypertensive patients. METHODS: A stratified multi-stage cluster random sampling method was applied to select 1116 patients with hypertension aged 35 years or older in Shenzhen, China. Face-to-face survey, physical examination and laboratory biochemical tests were applied to obtain information. Binary logistic regressions with restricted cubic splines were used to explore the degree of linearity in associations between green space visit duration and the following health outcomes: central obesity; diabetes; blood pressure; dyslipidemia; poor physical health; poor mental health. Models were adjusted for age, sex, education, marital status, occupation, and socioeconomic status. Further analysis was made for presence of the following health promoting green infrastructure: health knowledge promotion areas; walking trails; fitness areas; group exercise venues. RESULTS: Each additional 30 min green space visitation was linearly associated with lower odds of self-reported poor mental health [OR (95%CI): 0.937 (0.891-0.985)], self-reported poor physical health [OR (95%CI): 0.918 (0.872-0.966)], and central obesity [OR (95%CI): 0.951 (0.907-0.997)]. Odds of poor mental health [OR (95%CI): 0.886 (0.788-0.997)], poor physical health [OR (95%CI): 0.882 (0.782-0.996)] and central obesity [OR (95%CI): 0.855 (0.765-0.955)] were founded to decrease with a greater number of health promoting green infrastructure. CONCLUSION: More time spent in green space and with more types of green infrastructure were favourably associated with central obesity, and physical and mental health in people with hypertension.

Combined consideration of body mass index and waist circumference identifies obesity patterns associated with risk of stroke in a Chinese prospective cohort study.

BACKGROUND: In China, few studies have examined the relationship between the combination of body mass index and waist circumference and the risk of stroke. Moreover, the relationship may also be different in different genders. Thus, we investigated the association between the combination of body mass index and waist circumference and the risk of stroke in Chinese. METHODS: This prospective cohort study included 36 632 participants aged 18 to 90 years. Participants were recruited from 60 surveillance sites (25 urban sites and 35 rural sites) across China in 2010 China Chronic Disease Risk Factor Surveillance, and followed up in 2016-2017. Incident cases of stroke were identified through questionnaires (including the basis of clinical diagnosis, imaging tests, time of diagnosis, diagnosis unit) and Cardiovascular Event Report System. Risk factors for stroke were collected at baseline using questionnaire, physical measurements and laboratory tests. Cox proportional hazards regression models were used to generate adjusted hazard ratios and 95%CI. All analyses were duplicated by gender stratification. RESULTS: During 6.42 ± 0.50 years of follow-up, 1 333 (597 males, 736 females) stroke events were observed among the 27 112 participants who did not have cardiovascular diseases at baseline. Compared with the general population who have normal weight or underweight with normal WC, those who have normal weight or underweight with abdominal obesity (adjusted hazard ratios 1.45, 95%CI 1.07-1.97 in males; 0.98, 95%CI 0.78-1.24 in females), overweight with abdominal obesity (1.41, 95%CI 1.14-1.75 in males; 1.33, 95%CI 1.10-1.61 in females), obesity with abdominal obesity (1.46, 95%CI 1.11-1.91 in males; 1.46, 95%CI 1.17-1.81 in females). Overweight with normal WC was found to be not statistically significant for both males and females (all P>0.05). Subgroup analysis found a multiplicative interaction between age and anthropometric group in females (P for interaction <0.05). Sensitivity analysis results did not change. In the subjects with CVD risk factors, we found a similar relationship as in the general population . CONCLUSIONS: Combined assessment of body mass index and waist circumference identifies obesity patterns associated with stroke risk.

The standard for healthy Chinese older adults (2022).

Healthy older adults refer to the elderly aged 60 and above who can take care of themselves or basically take care of themselves.

The Implementation of a Primary Care-Based Integrated Mobile Health Intervention for Stroke Management in Rural China: Mixed-Methods Process Evaluation.

Background: There is a lack of evidence concerning the effective implementation of strategies for stroke prevention and management, particularly in resource-limited settings. A primary-care-based integrated mobile health intervention (SINEMA intervention) has been implemented and evaluated via a 1-year-long cluster-randomized controlled trial. This study reports the findings from the trial implementation and process evaluation that investigate the implementation of the intervention and inform factors that may influence the wider implementation of the intervention in the future. Methods: We developed an evaluation framework by employing both the RE-AIM framework and the MRC process evaluation framework to describe the implementation indicators, related enablers and barriers, and illustrate some potential impact pathways that may influence the effectiveness of the intervention in the trial. Quantitative data were collected from surveys and extracted from digital health monitoring systems. In addition, we conducted quarterly in-depth interviews with stakeholders in order to understand barriers and enablers of program implementation and effectiveness. Quantitative data analysis and thematic qualitative data analysis were applied, and the findings were synthesized based on the evaluation framework. Results: The SINEMA intervention was successfully implemented in 25 rural villages, reached 637 patients with stroke in rural Northern China during the 12 months of the trial. Almost 90% of the participants received all follow-up visits per protocol, and about half of the participants received daily voice messages. The majority of the intervention components were adopted by village doctors with some adaptation made. The interaction between human-delivered and technology-enabled components reinforced the program implementation and effectiveness. However, characteristics of the participants, doctor-patient relationships, and the healthcare system context attributed to the variation of program implementation and effectiveness. Conclusion: A comprehensive evaluation of program implementation demonstrates that the SINEMA program was well implemented in rural China. Findings from this research provide additional information for program adaptation, which shed light on the future program scale-up. The study also demonstrates the feasibility of combining RE-AIM and MRC process evaluation frameworks in process and implementation evaluation in trials. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03185858.

Prevalence and Correlates of Healthy Aging Among Elderly Aged 65 Years and Over - 6 PLADs, China, 2019.

SUMMARY: What is already known on this topic? Healthy aging among Chinese older people has low prevalence. Some sociodemographic and lifestyle factors were shown to be associated with healthy aging. What is added by this report? The age-adjusted prevalence of healthy aging in the 6 provincial-level administrative divisions (PLADs) of China is 15.8 % in 2019. County-level factors, such as the prevalence of healthy communities in a county, as well as some sociodemographic variables and physical exercise, are potential factors of healthy aging. What are the implications for public health practice? These findings showed that more targeted actions, including generalizing healthy communities and individual-level interventions, may be of great importance for healthy aging.

Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020.

In order to identify the status of salt-related knowledge and behavior of the residents who were active in WeChat software between 2019 and 2020, 10-day salt-related surveys were conducted in 2019 and 2020 based on the WeChat public platform of China Healthy Lifestyle for All Campaign. Distribution and scores of salt-related knowledge, salt reduction behavior and high-salt intake behavior between 2019 and 2020 were compared. Data of 2109 participants in 2019 and 12,732 participants in 2020 were left for analysis. Overall, 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 (p-value < 0.05). In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contains salt. Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults, and about 98% of participants knew that excessive salt intake would increase the risk of hypertension in both years. The percentage of participants who used salt measuring spoons asked restaurants to use less salt, read the sodium content on the nutrition facts table, chose foods with low sodium content and regularly used low-sodium salt, were 36.1%, 45.0%, 44.1%, 40.3% and 35.8% in 2019, and the percentage increased significantly to 46.4%, 49.2%, 50.8%, 47.1% and 43.4% in 2020 (all p-value < 0.05). The percentage of people regularly eating pickled mustard tubers, salted vegetables and sauce foods or using high-salt condiments also increased from 2019 to 2020. The median of salt-related knowledge scores, salt reduction behavior scores and high-salt intake behavior scores were 11, 2, 5 points in 2019, and 10, 3, 5 points in 2020, respectively. Compared to 2019, the salt-related knowledge score was relatively lower, while the salt reduction behavior score and high-salt intake behavior score were relatively higher in 2020. Besides, the score of salt-related knowledge and behaviors differed in different gender, age and hypertension groups. The COVID-19 epidemic may have influenced the salt-related knowledge and behaviors status of WeChat users in China. Promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future.

Use of Salt-Restriction Spoons and Its Associations with Urinary Sodium and Potassium in the Zhejiang Province of China: Results of a Population-Based Survey.

In China, a major source of sodium is salt added during cooking. In this context, use of a salt-restriction spoon (SRS) has been promoted in public health campaigns and by health care providers. To describe use of and factors associated with SRS use, knowledge of correct use, and actual correct use. This study is a population-based, representative survey of 7512 residents, aged 18 to 69 years, of China's Zhejiang Province. The survey, which was conducted in 2017 using a multistage random sampling strategy, collected demographic information, SRS use, and physical measurements; a 24-h urine collection was obtained from 1,496 of the participants. The mean age of the participants was 44.8 years, 50.1% were females, and over 1/3 (35.3%) were classified as hypertensive. Mean 24-h urinary sodium and potassium excretions were 167.3(72.2) mmol/24 h and 38.2(18.2) mmol/24 h, respectively. Only 12.0% (899/7512) of participants once used or were currently using SRS; of the 899 users, 73.4% knew how to use the SRS correctly, and just 46.5% actually used it correctly. SRS use was more commonly associated with behavioral factors rather than socio-demographic factors. Initiation of SRS use by health care providers was associated with correct technical knowledge of SRS. Lower sodium-to-potassium ratio was associated with SRS use, while SRS use was not associated with urinary sodium and potassium excretion. Use of SRS was uncommon in Zhejiang Province of China. Given that a common source of sodium in China is salt added during cooking, use of SRS is an appealing strategy, ideally as part of a multi-component campaign.

Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension.

BACKGROUND: Home blood pressure monitoring (HBPM) is recommended for diagnosis, treatment adjustment and management of most hypertension cases in hypertension guidelines from multiple countries. This study aimed to evaluate HBPM behaviour and explore the routine-practice gap in HBPM among Chinese adults with hypertension. METHODS: Data were collected from 20 communities across three cities and six townships in three provinces (Beijing, Shandong and Jiangsu) in China between October 2014 and November 2014. In total, 2272 patients with hypertension aged ≥35 years that were registered with a primary health station in their local communities were selected by simple random sampling. RESULTS: Among the 2272 participants, 45.3% owned a home blood pressure (BP) monitor. In addition, 27.5% (625/2272) engaged in HBPM weekly or more frequently. Healthcare providers' advice was the strongest factor contributing to home BP monitor ownership and weekly HBPM behaviour, with odds ratios of 13.50 and 8.97, respectively. Approximately 4.4% of participants had achieved optimal HBPM regimens (duplicate measurements in the morning and evening for 7 days). Patients with uncontrolled office-measured BP were more likely to conduct HBPM regularly in the morning and evening, measure their BP two or three times in each session and maintain 7 consecutive days of HBPM than patients with controlled office BP (8.8% vs. 5.8%, P = 0.042; 14.3% vs. 8.1%, P = 0.002; and 19.9% vs. 12.4%, P = 0.005, respectively). Only 16.0% (165/1030) of participants actively reported their HBPM readings to doctors. CONCLUSION: The HBPM strategies specified in hypertension guidelines are seldom achieved in actual practice in China. Only a small proportion of patients actively participate in using HBPM to enhance their hypertension care. HBPM may be improved by healthcare providers offering specific advice and training.

[Evaluation of effects of salt reducing intervention among catering units in Shandong Province].

OBJECTIVE: To evaluate the effects of comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods among catering units. METHODS: The total of 36 catering units were selected randomly and divided into intervention group A, B and control group in August of 2015. Health education was initiated in the intervention group A, including the training of knowledge on salt reduction for managers, cooks and service personnel of catering units every month; distribution of special salt control spoon for cooks; the arrangement of environment of salt reduction in catering units. And health education and labeling less salt foods was provided to the intervention group B, The control group C did not actively provide any intervention. The cook records the quantity of low-salt dishes sold, salt collection and the number of persons per meal in according to the requirements. Questionnaire survey and physical examination were performed to evaluate the effects of comprehensive intervention measures among catering units in the three groups of staffs in the catering units in a baseline study and an evaluation survey six months after the intervention. RESULTS: Compared with group C, the knowledge, attitude and behavior of salt reduction was significantly improved in intervention group A and B(P<0. 05). The behavior towards salt reduction improved much better in group B than in group A(P<0. 05), and using salt spoon when cooking and recommending less salt food to customer improved 32. 1%(χ~2=51. 72, P<0. 05)and 24. 2%(χ~2=30. 01, P<0. 05)separately. The proportion of sales of low salt dishes in the unit canteen has increased steadily, reaching 16. 8% while the proportion of sales has dropped to 9. 2% in the hotel by the end of the intervention period(χ~2=44. 66, P<0. 05). CONCLUSION: The level of knowledge of reducing salt was improved by health education, and labeling less salt foods can promote reducing salt related behavior. The effect of comprehensive intervention measures for salt reduction in unit canteen is better than in the hotel. It was suggested that comprehensive intervention measures mainly consisting of salt reduction health education and labeling less salt foods should be used together in the catering units.

Twenty-Four-Hour Urinary Sodium and Potassium Excretion and Their Associations With Blood Pressure Among Adults in China: Baseline Survey of Action on Salt China.

This study aimed to assess current level of sodium and potassium intake and their associations with blood pressure (BP) using the 24-hour urinary data in a large sample of China. Data from participants aged 18 to 75 years were collected as the baseline survey of Action on Salt China in 2018. Of 5454 adults, 5353 completed 24-hour urine collection. The average sodium, potassium excretion, and sodium-to-potassium molar ratio were 4318.1±1814.1 mg/d (equivalent to 11.0±4.6 g/d of salt), 1573.7±627.1 mg/d, and 5.0±2.1, respectively. After adjusting for potential confounding factors and correcting for regression dilution, each 1000-mg increase in sodium excretion was associated with increased systolic BP (1.32 mm Hg [95% CI, 0.92-1.81]) and diastolic BP (0.34 mm Hg [95% CI, 0.09-0.60]). Each 1000-mg increase in potassium excretion was inversely associated with systolic BP (-3.19 mm Hg [95% CI, -4.38 to -2.20]) and diastolic BP (-1.56 mm Hg [95% CI, -2.29 to -0.90]). Each unit increase in sodium-to-potassium molar ratio was associated with an increase of systolic BP by 1.21 mm Hg (95% CI, 0.91-1.60) and diastolic BP by 0.44 mm Hg (95% CI, 0.24-0.64). The relationships between sodium and BP mostly increase with the rise of BP quantiles. Potassium shows the opposite trend. The current sodium intake in Chinese adults remains high and potassium intake is low. Sodium and sodium-to-potassium ratio were positively associated with BP, whereas potassium was inversely associated with BP. Registration- URL: https://tinyurl.com/vdr8rpr; Unique identifier: ChiCTR1800017553. URL: https://tinyurl.com/w8c7x3w; Unique identifier: ChiCTR1800016804. URL: https://tinyurl.com/s3ajldw; Unique identifier: ChiCTR1800018119.