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Abstract Background The Basic Public Health Service (BPHS), a recently announced free healthcare program, aims to combat the most prevalent Noncommunicable Disease-“Hypertension” (HTN)-and its risk factors on a nationwide scale. In China, there is a rife that HTN less impacts women during their lifetime. We, therefore, aimed to evaluate the sex disparity in hypertension patients with comorbidities among south-west Chinese and the contribution of BPHS to address that concern. Methods We have opted for a multistage stratified random sampling method to enroll hypertensive patients of 35 years and older, divided them into BPHS and non-BPHS groups. We assessed the sex disparity in HTN patients with four major comorbidities- Dyslipidemia, Diabetes Mellitus (DM), Cardiovascular Disease (CVD), and Chronic Kidney Disease (CKD), and descriptive data were compiled. Odds ratios from logistic regression models estimated the effectiveness of BPHS in the management of HTN with comorbidities. Results Among 1521 hypertensive patients,1011(66.5%) were managed in the BPHS group. The proportion of patients who had at least one comorbidity was 70.7% (95% confidence interval [CI]: 66.3-76.8%), patients aged 65 years and older were more likely to have coexisting comorbidities. Participants who received the BPHS showed significant blood pressure (BP) control with two comorbidities (odds ratio [OR] = 2.414, 95% CI: 1.276–4.570), three or more (OR = 5.500, 95%CI: 1.174–25.756). Patients with dyslipidemia and DM also benefited from BPHS in controlling BP (OR = 2.169, 95% CI: 1.430–3.289) and (OR = 2.785, 95%CI: 1.242–6.246), respectively. In certain high-income urban survey centers, there was sex differences in the HTN management provided by BPHS, with men having better BP control rates than women. Conclusions Perhaps this is the first study in China to succinctly show the effectiveness and sex disparity regarding “management of hypertensive comorbidities”. This supports that the BPHS program plays a pivotal role in controlling BP, therefore should recommend the national healthcare system to give women a foremost priority in BPHS, especially to those from low-socioeconomic and low-scientific literacy regions.

ObjectiveTo investigate the effect of blood pressure control its influencing factors in hypertensive patients under disease management of basic public health services (BPHS) in Yunnan province for improving the patients′ blood pressure control and BPHS′ community disease management. Methods The participants of the study were 1 521 previously diagnosed hypertension patients aged ≥ 35 years identified via questionnaire interview, physical examination, and laboratory tests conducted among 9 600 permanent adult residents recruited with multistage stratified random sampling in 8 counties/districts of Yunnan province during 2021. Of the participants, 1 011 (66.5%) were assigned into a management group (under the BPHS′s disease management confirmed by matching the participants′ identification card [ID] number with the records in the BPHS′s disease management information system) and 510 (33.5%) into a non management group (with the ID numbers not matched with the records of the information system). Demographic characteristics, disease management/blood pressure control (maintaining a systolic/diastolic blood pressure below 140/90 mmHg) and their associates of the participants were analyzed and compared between the two groups.ResultsThe observed blood control rate was significantly higher among the participants of management group than that among those of non management group (33.2% vs. 22.0%, P < 0.05). Compared to those of the non management group, the participants of management group reported significant higher proportions of having received doctors′ lifestyle guidance on decreasing salt intake (89.5% vs. 81.7%), regular physical exercise (86.9% vs. 79.2%), body weight control (84.6% vs. 77.4%), smoking cessation (83.8% vs. 78.7%), restricting alcohol consumption (84.1% vs. 78.3%), and psychological counseling (81.3% vs. 72.9%) (all P < 0.05); for all the participants having accepted the six items of lifestyle guidance mentioned above, the observed blood pressure control rates of the management group′s participants were significantly higher than those of the non management group′s participants ( 33.6% vs. 22.8%, 33.5% vs. 22.0%, 34.3% vs. 22.3%, 33.7% vs. 22.4%, 34.0% vs. 22.5%, and 33.4% vs. 21.7%, all P < 0.05). The results of multivariate logistic regression analysis showed that the participants with higher education, being urban residents, having medication according to physician′s prescription, and receiving BPHS′s disease management were more likely to have their blood pressure under control. ConclusionIn Yunnan province, the community hypertension patients under BPHS′ disease management have a better blood pressure control compared to the patients without the management, suggesting a good efficiency of the BPHS′ disease management in the province.

Abstract Background Congenital heart disease (CHD) is the leading cause of mortality in childhood worldwide. However, a large number of children with CHD are not diagnosed promptly in low- and middle-income regions, due to limited healthcare resources and lack the ability of prenatal and postnatal ultrasound examinations. The research on asymptomatic CHD in the community is still blank, resulting in a large number of children with asymptomatic CHD can not be found and treated in time. Through the China-Cambodia collaborative health care initiative, the project team conducted research, screened children’s CHD through a sampling survey in China and Cambodia, collected relevant data, and retrospectively analyzed the data of all eligible patients. Objectives The project aimed to evaluate the prevalence of asymptomatic CHD in a sample population of 3-18years old and effects on their growth status and treatment outcomes. Methods We examined the prevalence of ‘asymptomatic CHD’ among 3-18years old children and adolescents at the township/county levels in the two participating. A total of eight provinces in China and five provinces in Cambodia were analyzed from 2017 to 2020. During 1 year follow-up after treatment, the differences in heights and weights of the treated and control groups were evaluated. Results Among the 3,068,075 participants screened from 2017 to 2020, 3967 patients with asymptomatic CHD requiring treatment were identified [0.130%, 95% confidence interval (CI) 0.126 -0.134%]. The prevalence rate of CHD ranged from 0.02 to 0.88%, and was negatively related to local per capita GDP (p = 0.028). The average height of 3310 treated CHD patients were 2.23% (95% CI: -2.51%~-1.9%) lower than that of the standard group and the average weight was − 6.41% (95% CI: -7.17%~-5.65%) lower, the developmental gap widening with advancing age. One year after treatment, the relative height difference remained comparable while that, in weight was reduced by 5.68% (95% CI: 4.27% ~7.09%). Conclusions Asymptomatic CHD now is often overlooked and is an emerging public health challenge. Early detection and treatment are essential to lower the potential burden of heart diseases in children and adolescents.

ObjectiveTo investigate the prevalence of metabolic syndrome (MS) and its associated factors among adult residents in Yunnan province, and to provide a reference for the adoption of targeted MS prevention and control measures. MethodsFace-to-face interview with a questionnaire developed by National Center for Cardiovascular Diseases, physical examination and laboratory tests were conducted among 9 600 adult permanent residents ( ≥ 18 years of age) recruited in 8 counties (districts) of Yunnan province with stratified multistage random sampling during 2021. ResultsOf the 7 396 participants surveyed effectively, 1 210 (16.4%) were assessed as suffering from MS. Multivariate logistic regression analysis showed that age ≥ 35 years old, family history of hypertension and with a body mass index (BMI) of ≥ 24.0 were risk factors for MS; while, female gender was a protective factor for MS. Among different aggregation patterns for abnormal components of MS, the most common combination of metabolic abnormalities detected among the participants was “abdominal obesity + elevated blood pressure + high triglycerides”. ConclusionMS is prevalent seriously among adult residents in Yunnan province. Middle-aged and elderly men, persons being overweight or obese, and people with family history of hypertension should be considered as high-risk groups in MS prevention and control.

Background: Progress in cardiovascular health is increasingly concentrated in high-income countries, while the burden of cardiovascular disease (CVD) is high in low - and middle-income countries, a clear health inequity that must be urgently addressed. Objective: This study aims to evaluate the prevalence and clustering of CVD risk factors in the three Lancang-Mekong regions. Methods: We conducted a population-based cross-sectional survey from January 2021 to March 2023 in China, Laos, and Cambodia. We compared the prevalence and clustering of CVD risk factors including hypertension, dyslipidemia, diabetes mellitus, overweight / obesity, current smoker, current drinker, inadequate vegetable and fruit intake, and insufficient physical activity across the three regions, and were further stratified by gender and age. Multivariate logistic regression models were performed to explore factors influencing the aggregation of CVD risk factors (≥2, ≥3, ≥4). Results: A total of 11005 adults were included. Hypertension emerged as the primary metabolic risk factors in Laos (36.8%) and Cambodia (23.5%), whereas overweight / obesity was 37.6% in China. In terms of behavioral risk factors, all three regions showed insufficient vegetable and fruit intake. The prevalence of individuals without CVD risk factors was 10% in China, 1.9% in Laos, and 5.2% in Cambodia. Meanwhile, the prevalence of two or more risk factors was 64.6% in China, 79.2% in Laos, and 76.0% in Cambodia. Multivariate logistic regression models revealed that the propensity for CVD risk factors clustering was higher in men and increased with age in all three countries. Conclusions: CVD risk factors and multiple clustering are pressing health threats among adults in low- and middle-income areas along the Lancang-Mekong River Basin. This study highlights the urgent need for proactive tailored strategies to control CVD risk factors.

Yunnan, the region hardest hit by HIV/AIDS in China, is also an area with the most abundant HIV-1 genetic diversity. A large number of novel HIV-1 circulating recombinant forms (CRFs) and unique recombinants were identified among injection drug users in Yunnan; however, few were found among sexual contacts. Here, we obtained 15 near full-length genome sequences (NFLGs) from HIV-1 seropositive heterosexual contacts in Yunnan who received antiretroviral therapy during the period from 2014 to 2016. Phylogenetic analysis showed that six NFLGs belonged to CRF01_AE (n = 3) and CRF106_cpx (n = 3), and the other nine sequences were novel inter-subtype recombinants. Of the recombinants, two novel CRFs (CRF111_01 C (n = 4) and CRF116_0108 (n = 4)) and one CRF106_cpx variant (n = 1) were identified. CRF111_01 C had a CRF01_AE backbone with seven subtype C fragments inserted into the gag, pol, vif, env, nef and 3ʹLTR regions. CRF116_0108 had a CRF08_BC backbone with a CRF01_AE fragment inserted into the pol, tat, rev, vif, vpr, vpu and env regions. Phylogeographic analyses estimated that CRF111_01 C and CRF116_0108 originated approximately 1995.7–1998.6 and 1991.7–1993.7, respectively. These identifications of two novel HIV-1 CRFs highlighted the importance of continuous surveillance in heterosexual contacts and other high-risk groups in this region and the surrounding regions.

The concentration of nitrogen fertilizer is matched with the nutrient requirements in different growth stages of plants, which coordinates their vegetative and reproductive growth. In this study, the influences of nitrogen concentration before and after initiation of flower bud differentiation (first and second stage, respectively) on pepper seedling quality were studied. The chlorophyll a content, sucrose synthase activity, and sucrose phosphate synthase activity of pepper seedlings grown under moderate nitrogen (15 mmol L−1) in the first stage combined with high nitrogen (25.61 mmol L−1) in the second stage were 15.7%, 39.3%, and 34.6% higher than those of the same nitrogen concentration (15 mmol L−1) in the first and second stages treatment, respectively. The regression model also showed that the values of flower bud diameter, shoot fresh weight, root fresh weight, and glutamine synthetase activity of pepper were high under the condition of moderate nitrogen in the first stage and higher nitrogen in the second stage. In addition, the results of comprehensive evaluation showed that moderate nitrogen (15 mmol L−1) in the first stage and high nitrogen (25.61 mmol L−1) in the second stage treatment ranked first, which improved carbon and nitrogen metabolism, increased biomass accumulation, and promoted the flower bud differentiation and flowering of pepper seedlings. [ABSTRACT FROM AUTHOR]

BackgroundTo alleviate the rising mortality burden due to hypertension and other non-communicable diseases, a new public health policy initiative in 2009 called the Basic Public Health Services (BPHS). Program was introduced by the Chinese government. The goal of the study is to assess the feasibility and impact of a nationwide health care service—the “BPHS”.MethodsFrom January to December 2021, a stratified multistage random sampling method in the survey was conducted to select 6,456 people from 8 cities/districts in Yunnan Province, China, who were above the age of 35 years. 1,521 hypertensive patients were previously aware of their high blood pressure status were matched to the BPHS program database based on ID number and then further divided into BPHS group and non-BPHS (control) group. The results of the current study are based on their responses to a short structured questionnaire, a physical examination, and laboratory tests. The association between BPHS management and its effect on the control of hypertension was estimated using multivariable logistic regression models. We evaluated the accessibility and efficacy of BPHS health care services by analyzing various variables such as blood pressure, BMI, lifestyle modification, anti-hypertensive drugs taken, and cardiovascular risk factors.ResultsAmong the 1,521 hypertensive patients included in this study, 1,011 (66.5%) were managed by BPHS programme. The multivariable logistic regression model demonstrated that the BPHS facilitated hypertension control (OR = 1.640, 95% CI: 1.237–2.175). A higher proportion of participants receiving lifestyle guidance from the BPHS management showed lowering of total cholesterol. In comparison to the non-BPHS group, those under BPHS management adhered better to antihypertensive medications either single drug (54.3%) or in combination (17.3%) of drugs. Additionally, we also noticed that urban areas with centralized and well-established digital information management system had better hypertension treatment and control.ConclusionsNearly two-thirds of the hypertensive patients in Yunnan Province were included in BPHS management. The impact of the national BPHS program was evident in lowering risk factors for cardiovascular diseases, promoting healthy lifestyles, lowering blood pressure, increasing medication adherence, and the better control rate of hypertension.

Two-dimensional (2D) coordination polymers have attracted great attention for catalysis because of their abundant exposed active sites. Here, we show that bending the local structure of 2D coordination polymers can inverse the electrocatalytic selectivity. A series of ultrathin nanosheets based on isoreticular/isostructural/isomeric 2D Cu(I) triazolate coordination polymers were successfully prepared. By introducing an amino group on the triazolate ligand, the shape of the 2D layer transforms from planar into wavy, which inverses the electrocatalytic selectivity from the HER (selectivity ∼ 80%) to the CO2RR (selectivity ∼ 76%, C2H4 up to 52%). Computational simulations showed that the wavy structure allows the amino groups to form attractive hydrogen-bonding interactions with the key reaction intermediates of the CO2RR for C2H4 and steric hindrance with the key reaction intermediates of the HER, giving lower and higher reaction energy barriers, respectively. [ABSTRACT FROM AUTHOR]

Injecting drug users (IDUs) are the major risk group for HIV-1 infection in the China-Myanmar border area. There are a large number of Burmese IDUs living in Yunnan (Yunnan-mIDUs) who might be associated with the cross-border transmission of HIV-1. From 2010 to 2013, 617 Yunnan-mIDUs were recruited from three counties of Yunnan, 19.0% of whom were detected to be HIV-1 positive by serological testing. Partial HIV-1 p17, pol, vif-env, and env genes were amplified from the positive samples and were sequenced. Phylogenetic and HIV-1 subtyping analyses revealed that HIV-1 recombinant forms (RFs), including RF_BC (36.4%), RF_01BC (26.1%), RF_01C (9.1%) and RF_01B (1.1%), were predominant among this cohort. Of the identified HIV-1 strains, 14.8%, 9.1% and 3.4% belonged to subtype C, CRF01_AE and subtype B, respectively. Transmission cluster analysis showed that sequences from the Yunnan-mIDUs formed transmission clusters not only with those from Burmese IDUs but also with those from Chinese IDUs, indicating that Yunnan-mIDUs might acquire HIV-1 infection from or spread HIV-1 to both Burmese and Chinese IDUs. Phylogeographic analyses revealed three cross-border transmission patterns associated with Yunnan-mIDUs, in which Yunnan-mIDUs served as the crucial nodes linking the Burmese and Chinese IDUs. These results suggest that Yunnan-mIDUs are a potential viral reservoir for the diffusion of HIV-1 in Yunnan and play a pivotal role in the bidirectional cross-border transmission of HIV-1 in the China-Myanmar border region. More intervention efforts that focus on Yunnan-mIDUs are recommended in Yunnan’s campaign against HIV/AIDS.

Background: The present study aimed to explore the correlation between calcium-activated potassium channels, left atrial flow field mechanics, valvular atrial fibrillation (VAF), and thrombosis. The process of transforming mechanical signals into biological signals has been revealed, which offers new insights into the study of VAF. Methods: Computational fluid dynamics simulations use numeric analysis and algorithms to compute flow parameters, including turbulent shear stress (TSS) and wall pressure in the left atrium (LA). Real-time PCR and western blotting were used to detect the mRNA and protein expression of IKCa2.3/3.1, ATK1, and P300 in the left atrial tissue of 90 patients. Results: In the valvular disease group, the TSS and wall ressure in the LA increased, the wall pressure increased in turn in all disease groups, mainly near the mitral valve and the posterior portion of the LA, the increase in TSS was the most significant in each group near the mitral valve, and the middle and lower part of the back of the LA and the mRNA expression and protein expression levels of IKCa2.3/3.1, AKT1, and P300 increased (p < 0.05) (n = 15). The present study was preliminarily conducted to elucidate whether there might be a certain correlation between IKCa2.3 and LA hemodynamic changes. Conclusions: The TSS and wall pressure changes in the LA are correlated with the upregulation of mRNA and protein expression of IKCa2.3/3.1, AKT1, and P300.