Improvement of long-term risks of cardiovascular events associated with community-based disease management in Chinese patients of the Xinjiang autonomous region of China.

BACKGROUND: A recent community-based disease management (CBDM) pilot study reported a 20.5% prevalence of hypertension and a 0.5 and 3.6% prevalence of stroke and coronary heart disease (CHD), respectively, in an elderly population (mean age 65 years) in the Xin Jiang autonomous region of China. The CBDM was initiated in 2013 as an essential public health service; however, the potential long-term impact of CBDM on cardiovascular (CV: CHD and stroke) events is unknown. The objective of the study was to understand the long-term impact of CBDM interventions on CV risk factors using disease-model simulation based on a single-arm experimental study. METHODS: A discrete event simulation was developed to evaluate the impact of CBDM on the long-term CV risk among patients with hypertension, in China's Xin Jiang autonomous region. The model generated pairs of identical patients; one receives CBDM and one does not (control group). Their clinical courses were simulated based on time to CV events (CHD and strokes), which are estimated using published risk equations. The impact of CBDM was incorporated as improvement in systolic blood pressure (SBP) based on observations from the CBDM study. The simulation estimated the number of CV events over patients' lifetimes. RESULTS: During a 2-year follow up, the CBDM led to an average reduction of 8.73 mmHg in SBP from baseline, and a 42% reduction in smoking. The discrete event simulation showed that, in the control group, the model estimated incidence rates of 276, 1789, and 616 per 100,000 individuals for lifetime CHD, stroke, and CV-related death, respectively. The impact of CBDM on SBP translated into reductions of 8, 28, and 23% in CHD, stroke, and CV-related deaths, respectively. Taking into account CBDM's reduction of both SBP and smoking, deaths from CHD, stroke, and CV-related deaths were reduced by 12, 30, and 26%, respectively. CONCLUSIONS: The implementation of CBDM in China's Xinjiang autonomous region is expected to significantly reduce incidences of CHD, strokes, and CV-related deaths.

Temporal and spatial dynamics of amphioxus population (Branchiostoma belcheri tsingtaneuse) and its influential factors in Luan River Estuary, China.

Population distribution of amphioxus (Branchiostoma belcheri tsingtauense) was investigated in the Luan River Estuary from 1999 to 2011, to describe its trends and discover the factors that influence its decline. Amphioxus are distributed on the seabed at 5-10 m depth, between the Xinkai Estuary and the Dapu River Estuary, where the primary sand components of the sediment are medium and fine, with particle size ranging from 0.001 to 1 mm. In recent years, the population density and biomass of amphioxus have sharply decreased. Changes in sediment granularity composition may significantly influence amphioxus distribution. Our data showed that the highest density region of amphioxus occurred where >90% of the sediment particles were between 0.063 and 0.5 mm in size. A reduction in sediment discharge from Luan River and the expansion of raft-breeding mariculture may be causing the decline in amphioxus through habitat destruction.