China Northwest Cohort(Study2017YFC0907200)

In recent decades, the disease spectrum of urban and rural residents in China and the etiology of major diseases have undergone significant changes. The criteria and methods for the etiology, prevention, diagnosis and treatment of various diseases based on western population studies are not fully applicable to Chinese People, especially those in the Northwest. Therefore, it is urgent to integrate existing research sites, establish a natural population cohort in the northwest region, and carry out high-quality precision medical research. The project strictly follows the requirements of the project guide, and refers to the international frontier, according to the standards of the demonstration queue, relying on the professional epidemiology and clinical phenotype research team to build 120,000 covering the five northwestern provinces (Shaanxi, Gansu, Ningxia, Qinghai, Xinjiang). A multi-ethnic natural population cohort that clarifies the causal relationship between environment, behavioral lifestyles, heredity and its interactions with common high-risk diseases and health status. Establish a health management system with efficient endpoint tracking function to conduct dynamic follow-up and follow-up to ensure that the 4-year loss of follow-up rate is less than 8%, revealing the common occurrence and outcome of high-risk diseases. Relying on the high-quality database and biological sample database generated by the research, build an open sharing platform for precision medical big data, and build a risk early warning system for common high-risk diseases such as cardiovascular and cerebrovascular diseases, tumors, diabetes, chronic obstructive pulmonary disease, and support accurate medical research and application. . The queue site was selected according to the principles of existing research, local government support, high population compliance, good representativeness, and easy follow-up. Considering the characteristics of special ecological environment (drought, high altitude, etc.) and population distribution in Northwest China, a multi-stage random cluster sampling design is adopted to obtain a well-represented multi-ethnic natural population queue. In the specific investigation work, computer-assisted questionnaires, physical examinations, and laboratory tests were used to obtain basic and accurate personal information. Build a health management system including existing health records, disease monitoring network, inpatient electronic medical record system, social security and service institutions (medical insurance, civil affairs, household registration, environmental protection, etc.) and mobile Internet medical application platform to achieve clinical phenotype and Efficient dynamic tracking of disease endpoints, dynamic measurement of internal and external environmental exposure indicators, and real-time health management of subjects. Relying on Baidu Medical Big Data Management and Analysis Platform, integrating individual exposure data, life-group information and health endpoint event outcomes, establish a high-quality cohort study shared database. Absorbed the experience of the establishment of the cohort biological sample bank of the Huada Gene Research Institute, and coordinated the construction of a biological sample bank management system that conforms to national standards, is convenient to query, and is highly shared. The project team has many years of experience in queue construction and maintenance, clinical medical research, sample library construction, bio-group analysis, big data management platform construction, mobile medical applications and statistical analysis of vertical and complex data. Professor Yan Hong's team established and maintained a queue of more than 100,000 natural populations in Shaanxi and a follow-up queue of more than ten years of continuous follow-up; Professor Zhang Yuhong's team established a natural population queue of more than 20,000 people in Pingluo-Qingtongxia, Ningxia, and has carried out 2 The follow-up work; Professor Dai Jianghong established a 10,000-dimensional-Han chronic disease management cohort, a special environmental occupational cohort and conducted a follow-up survey for the local arsenic-arsenic-contaminated ward for more than 30 years; Gansu and Qinghai CDC continued chronic disease for a long time. Monitor and conduct large-scale epidemiological investigations to fully grasp the prevalence and distribution of major chronic diseases and risk factors in the two provinces. The participating companies Baidu Company and Huada Gene Research Institute have rich work experience and research results in the fields of mobile Internet medical application development, big data analysis theory and technology, and biological sample library construction. The core members of the research team are experts from the fields of epidemiology, clinical medicine, genetics, environmental monitoring, big data analysis, etc. They have rich research and design experience, large-scale cohort research experience, and experience in clinical diagnosis and treatment of complex diseases. The ability to measure, manage, and analyze data in complex internal and external environments. The professional background, academic level, research experience and innovative ability of the team can ensure the scientific design, orderly implementation and high quality completion of the project. At the same time, the project receives strong support from local governments and undertakers in policy, on-site work and human resources.The project is expected to establish a cohort of more than 120,000 multi-ethnic natural populations covering five provinces in the northwest, and follow-up for 4 years to obtain a database of full exposure information, clinical phenotypes and disease outcomes, and a standardized, highly shared library of biological samples. A health management system with independent intellectual property rights. Based on this queue, the project team will declare more than 4 national research projects, publish a number of high-level research papers and declare relevant patents. This cohort will provide a high-quality database for the Northwestern Region for the millions of national precision medicine cohorts, and promote the rapid development of precision medicine in the field of disease prevention, clinical diagnosis and treatment.

Primary prevention and mechanisms of multiple micronutrient supplementation during periconception against congenital heart Disease

Congenital heart diseases (CHD) have become the most common of all birth defects in recent decades. It is a serious disease with a high burden of clinical treatments but the causes remain unclear. At present there are no effective primary prevention measures. Based on our previous studies of community-based micronutrient interventions to prevent preterm birth, low birth weight and neonatal mortality, the present study will be conducted in high risk areas of CHD in China and focus on an in-depth analysis of epidemiological characteristics of CHD, the identification of specific risk factors and the investigation of the impact of periconceptional deficiency of micronutrients on the occurrence of CHD by a range of approaches including cross-sectional and case-control studies,nutritional and molecular epidemiological studies assisted with meta analysis and a focus group study. Further, a large-scale community-based trial with three interventions, the first randomized controlled intervention study targeted on CHD primary prevention registered in the international clinic trial registry, will be conducted among periconceptional women. The three intervention arms will be iron/folic acid, multiple micronutrients containing iron/folic, and folic acid only (as control). Simultaneously a basic intervention will delivered in each of the treatment arms to control potential risk factor exposures. The study aims to verify the preventive effect of periconceptional iron and/or multiple micronutrient supplements on CHD occurrence using a randomized trial study design to control for potential risk factors. The relationship of CHD with polymorphism of susceptible genes, nutrients and active elements will be clarified. The mechanisms by which multiple micronutrients containing iron/folic acid play roles in preventing CHD will also be explored at the population and molecular levels. This project has the potential to establish the first model of primary prevention against CHD.