Objective To verify the reliability of home blood pressure measurement in clinic and research works by comparison three methods[home(H),office(O) and ambulatory(A)]of blood pressure(BP) measurements. Methods The"study-effects of salt substitution on blood pressure among the hypertensive patients and their families"was a randomized,double blinded control trial.In this study,BP was measured in 220 hypertensive patients using office,home and ambulatory BP measurements concurrently at the baseline and the end of the intervention. Two hundred seventeen patients had baseline eligible data,while at the end of the intervention,only 189 patients had eligible data.Bland-Altman method and Person's correlation analysis were used to compare the agreement of BP levels by 3 methods,and McNemar chi-square test compared rates of the agreement,assuming the ambulatory as the reference.Results The mean BP levels using office,ambulatory and home BP measurements were 149.5?16.4/87.2?9.5 mm Hg,137.8?17.1/83.2?10.3 mm Hg,and 138.0?14.2/82.4?9.3 mm Hg,respectively. H BP was more strongly related with ambulatory BP(SBP/DBP)(H:r=0.55/0.62 vs O:r= 0.36/0.46).The difference of BP between H and A was smaller[H:A—0.2 mm Hg/—0.7 mm Hg vs O:A(ll.7 mm Hg/4.0 mm Hg)].Intra-individual agreement between H and A SBP was significantly higher than that between O and A(28.3%vs 16.5%for≤|5| mm Hg and 49.7%vs 33.5%for≤|10| mm Hg,all P0.05).Conclusion Home and ambulatory BP was more strongly related and better agreement than office-ambulatory BP measurement.

Objective Through summarizing quality management practices of international cooperative academic clinical studies funded by Peking University Health Science Center,analyzing its present major challenges of implementation in China,this paper proposed related measurements and suggestions to improve the quality of clinical research.Methods To sort the project management archive data,as well as descriptive analysis of the common monitoring/auditing findings.Results From the year 2011 to 2016,there were 14 such studies funded by Peking University health science center,common findings during monitoring and or auditing were classified as following categories,study files problem (100.0％),ethics problem (71.4％),protocol noncompliance (64.3％),data quality issues (71.4％),communication problem in study teams (14.3％),export problems of bio-specimens (14.3 ％),recruiting delay (14.3 ％) and cooperation termination in advance (7.1 ％).Conclusions In order to obtain credible and reliable data,peer recognized research conclusion and accurate answered scientific questions,it is essential for investigators to comply with laws and regulations and being strongly supported.Furthermore,researchers also need to establish and strictly follow study protocols,standard operating procedures (SOPs),research quality management system and relevant national laws and regulations that are comply with actual requirements in China.

Objective To evaluate effectiveness of guideline-oriented training for community healthcare workers (HCWs) with The Applied Standards for Hypertension Prevention and Control at the Grassroots to provide guidance to hypertension management in communities. Methods In 2003, four community health-care service centers in Beijing were selected and assigned as intervention (one at urban and one at rural) and control (one at urban and one at rural ) groups, respectively. HCWs in the intervention group received guideline-oriented training based on The Applied Standards for Hypertension Prevention and Control at the Grassroots, while HCW in the control group did not. All HCWs participated in tests of the knowledge of hypertension management using the same questionnaire before and after the training to analyze their changes in awareness scores with a full of 32. Results There were 39 and 33 HCWs in the intervention group and 15 and 16 HCWs in the control group, respectively at urban, and 30 and 33 HCWs in the intervention group and 21 and 22 HCWs in the control group, respectively at rural before and after the training were involved in the tests, respectively. After training, overall knowledge scores of hypertension prevention and control in HCWs in the intervention group at urban increased obviously, with an average score of 26 of 32 ( 81.0% ) after training from 15 of 32 (45. 6% ) before it ( P ＜ 0. 01 ) , with a net increase of 28.5% (9/32), as compared to HCWs in the control group. Those at rural increased to 6. 6% (20/32) after training from 40. 7% (13/32) before it ( P ＜ 0.01 ), with a net increase of 22. 2 percent (7/32), as compared to HCWs in the control group. Their awareness of knowledge of hypertension prevention and control significantly improved, with the most obviously in the target of blood pressure control (51.7% vs. 31.5% ) and principles of pharmaceutical therapy (42. 2% vs. 27. 6% ). Conclusions Guideline-oriented training based on The Applied Standards for Hypertension Prevention and Control at the Grassroots can effectively improve community HCWs' awareness of knowledge of hypertension management and should be widely promoted in communities.

Objective To evaluate the effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy.Methods The blood-lipid report was reformatted by adding three tables from the Chinese Guideline on the Prevention and Treatment of Adult Dyslipidemia on its back.The same questionnaire was used twice to evaluate the patients' behavior and knowledge of dyslipidemia therapy before and after reformat.Results Before and after reformat,the rates of correct deterination of their own risk stratification were 26.0％ ( 112/430 ) and 26.3％ ( 115/438 ) respectively.The awareness rates of Different LDL-C goals among different persons wcre 37.0％ (159/430) and 35.8％ (157/438).Only 0.7％ (2/306) and 1.0％ (3/299) of patients knew their blood lipid goals (P =0.557).When the report showed normal blood lipid levels,the percentages of taking lipid-lowering drug were 47.6％ ( 230/483 ) and 46.6％ ( 216/464 ),20.5％ ( 99/483 ) and 19.0％ ( 88/464 ) of patients questioned the prescription.Non-medication rates were 31.9％ ( 154/483 ) and 34.5％ ( 160/464 ) respectively before and after reformat ( P ＞ 0.05 ).For patients requiting lipid-lowering drug therapy by the guideline,treatment rate improved significantly in the low-risk group (13.3％ vs.75.0％,P =0.002).Treatment rate slightly increased in the high-risk and very high-risk groups after reformat (54.0％ vs.56.8％,62.4％ vs.69.0％,P ＞ 0.05 ).Rates of achieving lipid goal showed no change [ 41.5％ ( 102/ 245 ) vs.44.5％ ( 114/256 ),P ＞ 0.05 ] after reformat,especially among the very high-risk patients [17.9％(12/68) vs.21.6％(11/52),P＞0.05].Conclusions The blood-lipid report reformat did not improve the patient behaviors and knowledge of the prevention and treatment of dyslipidemia because of poor treatment rate and medication compliance.The combination of patient education and thorough blood-lipid report reformat may help to increase the attainment rate of dyslipidemia therapy.

Objective: To explore the relationship between body weight changes from early adulthood to middle age and the prevalence of hypertriglyceridemia by large-scale cardiovascular risk factor investigation.
Methods: A total of 15 population groups from China multi-center collaborative study of cardiovascular epidemiology in 1998 were enrolled. There were approximately 1000 participants in each group including 50% of each male and female at the age of (35-59) years which was deifned as middle age. The participants were surveyed for cardiovascular risk factors including the body weight and body mass index (BMI) at the age of 25 years which was deifned as early adulthood. The participants were divided into 4 groups based on BMI at early adulthood: Low body weight group, BMI < 18.5 kg/m2, Normal body weight group, BMI (18.5-23.9) kg/m2, Overweight group, BMI (24-27.9) kg/m2 and Obese group, BMI ≥ 28 kg/m2. The changes of body weight from early adulthood to middle age were calculated by body weight at present minus body weight at 25 years; according to the differences, participants were divided into another set of 6 groups: differences < -7.5 kg, (-7.5 to -2.6) kg, (-2.5 to 2.5) kg, (2.6 to7.5) kg, (7.6 to 12.5) kg and > 12.5 kg. The relationship between body weight status at 25 years of age with subsequent changes and the prevalence of hypertriglyceridemia were investigated.
Results: A total of 13883 participants finished the investigation.①The prevalence of hypertriglyceridemia by 4 BMI groups were at 22.8%, 26.0%, 27.4% and 30.8% respectively (the trend ofP<0.01).②The prevalence of hypertriglyceridemia by 6 age differences groups were at 12.5 %, 14.0 %, 17.8 %, 24.2 %, 31.5 % and 40.9 % respectively (the trend ofP<0.01). Multivariate Logistic regression analysis indicated that overweight and obesity at the age of 25 years with subsequent weight gain were positively related to the risk of hypertriglyceridemia at the middle age (the trend ofP<0.01).
Conclusion: Overweight and obesity in early adulthood with subsequent weight gain were independently related to the risk of hypertriglyceridemia at the middle age in our survey.

Objective To explore the effects of low-sodium salt on blood pressure and to find out an economical,effective and easy-to-implement method to reduce the blood pressure.Methods This study was a randomized controlled study based on family unit.The participation families were recommended by local newspaper reporters and each family included at least 2 family members over 50 years old,who composed the objects of the study.The intervention group received two-month salt substitution intervention (with low sodium and high potassium) for free,while the control group received no intervention.Results The decrement of systolic blood pressure in intervention group was (4.7±10.9)mmHg,while the systolic blood pressure in control group was decreased by (2.6± 10.3)mmHg.The decline range of blood pressure was higher in the intervention group than in the control group,and there was a statistical significance in the difference (t=2.19,P＜0.05).Conclusions Salt substitution (with low sodium and high potassium) is an economical,effective and easy-to-implement method to reduce the blood pressure.Therefore,it is recommended to promote salt substitution (with low sodium and high potassium) in the crowd.

Objective: To analysis the relationship between glucocorticosteroids (GCS) usage and side effects in the treatment of severe acute respiratory syndrome (SARS). Methods: All clinical records of probable SARS patients in Beijing were collected and input into an Epi6 database, in which 1 291 patients had entire information and met the clinical criteria of SARS. The usage of GCS and GCS associated side effects were analyzed retrospectively. Results: Patients accepted GCS therapy were 83.96% (n= 1 084), whereas 16.04%(n=207) did not take GCS. The average dosage of GCS was 160 mg/d in the first week, and then reduced to 80 mg/d and 40 mg/d in the second and the third weeks, respectively. Initial blood glucose, systolic pressure (SBP), and diastolic pressure (DBP) were no significant difference between GCS group and non-GCS group. The highest blood glucose during the treatment in GCS group was markedly higher than that in non-GCS group [(8.68? 4.80 ) mmol/L vs (6.39?3.71) mmol/L, P05). After GCS administration, SBP and DBP were increased gradually, and reached their peaks in the fourth week [SBP (117.2?14.0) mm Hg and DBP (72.5?9.1) mm Hg vs SBP (120.0?12.5) mm Hg and DBP (74.5?8.7) mm Hg, P

Objective: To investigate the relationship between exercise and serum lipid level in middle-aged population. Methods: Based on “multicenter collaborative study of cardiovascular epidemiology” research, a total of 3482 subjects at the age of (35-59) years from urban and rural areas of Beijing and Guangzhou were enrolled in this study. According to daily energy expenditure of exercise (EEexer), the participants were divided into 3 groups: No exercise group, (daily) EEexer below median group and (daily) EEexer above median group. The type and duration of exercise were collected by the questionnaire, daily EEexer was calculated and the relationship between exercise and serum lipid level was estimated by covariance analysis. Results: There were 47.1% (807/1712) male and 41.1% (727/1770) female participants having exercise. With controlled age, area, education level, smoking, drinking, BMI and energy expenditure of physical activity outside of exercise (EEPA), serum levels of TC, LDL-C, non-HDL-C and TG were decreased in women by elevated EEexer groups accordingly, and among them, there were significant differences in LDL-C and non-HDL-C levels between groups, P<0.05; compared with No exercise group, in female daily EEexer above median group, LDL-C and non-HDL-C levels decreased about 0.14 mmol/L,P=0.0063 and 0.14 mmol/L, P=0.0155 respectively; while in men, TC, LDL-C, non-HDL-C and TG levels showed a decreasing trends by elevated EEexer groups but with no statistical significance. No association was found for HDL-C in men and women. Conclusion: Serum levels of LDL-C and non-HDL-C were lower in female daily EEexer above median group than No excise group, the effects were independent from working and other physical activities.

Objective: To explore the progression rate of cortid maximal plaque area and the risk of new ischemic cardiovascular disease (ICVD) in a rural cohort in Beijing.
Methods: The PRC-USA collaborative study had been regularly conducted in Shijingshan area in Beijing. The carotid ultrasound examination, ICVD risk factor and acute cardiovascular events follow-up were conducted in those participants. A total of 1479 subjects who received at least 2 carotid ultrasound examinations and had no cardiovascular disease before the second ultrasound were studied. They were divided into 5 groups:①Control group, the participants had no plaque detected by 2 ultrasounds; ② New plaque group, new plaque was found at the second ultrasound examination; ③ Plaque regression group; ④ Plaque stabilized group and ⑤ Plaque progression group. The hazard ratio (HR) between the progression rate of corotid maximal plaque area and new ICVD events was estimated by Cox proportional hazard regression analysis .
Results: Compared with Control group, the HR for new ICVD events were higher in groups②,③,④and⑤at 3.5, 5.7, 6.2 and 7.3 respectively, all P<0.05. The increasing trend of HRs remained signiifcant with the adjusted age and gender, P<0.001.
Conclusion: The progression rate of maximal corot id plaque area rate could predict the risk of new ICVD events in clinical practice.

Objective The management of medical projects of the National Key Research and Development Program of China is difficult.Thus this article aims to analyze the common problems and summarize the preparatory work before the project initiation.Methods Comprehensively adopted the methodologies of literature analysis,survey investigation to analyze the common problems before the project initiation,and then particularly summarize the preparatory works for biomedical research,especially for clinical research,from the perspective of investigators.Results Proposed several aspects that should take into consideration before the initiation of the projects..clarify the organizational management framework,play the role of kick-off meeting,organize tailored training on financial management,prepare research protocol and related documents,seek Institutional Review Board approval and conduct clinical research registration,normalize document managment,formulate project management plan,and prepare research facilities timely.Conclusions Investigators should develop a detailed project management plan before initiation of the project,preparation work should focus on personnel,financial resources,facilities,research progress,quality,data,etc.