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Professor Zhengming Chen from the Nuffield Department of Population Health will deliver the 2019 Archie Cochrane Lecture at Green Templeton College.

Many important genetic and non-genetic causes of major diseases still await discovery.

Several big blood-based prospective studies have been undertaken this century, including the China Kadoorie Biobank (CKB) and UK Biobank, both based in Oxford. Each recruited 500,000 apparently healthy adults, recording lifestyle and physiological factors and storing blood. CKB covered ten diverse areas distributed across China, and after more than 10 years of follow-up through electronic linkage to hospital records and death registries, it has recorded more than one million disease episodes, including more than 50,000 well-characterised strokes or heart attacks.

Major findings are now emerging in CKB, some expected and some intriguingly unexpected but novel, including assessment of any causal protective effects of moderate alcohol drinking on stroke and heart disease using the East Asian specific “flushing” genes. The big maturing biobanks in the Eastern and Western populations with different lifestyles, environments and genetic architectures will greatly improve our understanding about aetiology of many diseases.

Zhengming Chen came to Green Templeton (then-Green College), Oxford, in late 1987, initially for one year, to analyse the Shanghai Factory Workers cohort. Subsequently he managed to pursue DPhil study in Oxford based on the Shanghai cohort data he brought with him.

The study showed that even at cholesterol levels well below those considered "normal" in Western populations, lower cholesterol still meant lower risk of IHD. This informed the design of large randomised trials in the UK (e.g. Heart Protection Study) that went on to show the benefits of lowering LDL cholesterol irrespective of presenting levels.

Zhengming previously studied medicine at Shanghai Medical University in China. His main research has focused on the determinants of chronic disease and development of evidence-based medicine.

Since mid-1990s, he has conducted several large randomised trials of treatment for MI, stroke and cancer in China, totalling more than 100,000 patients. These trials not only generated important findings that have changed the clinical practice worldwide (e.g. early aspirin in acute stroke, combined antiplatelet therapy in heart attack), but also helped establish the tradition of large randomised trials in China.

Building on the large collaborative epidemiological studies that the department established in China during 1980-90s, Zhengming initiated and established the CKB of 0.5 million adults, and has been the Lead Principal Investigator, together with Professor Liming Li in China, since its inception in 2003. CKB will continue indefinitely and the wealth range of exposure and disease outcome data collected or to be generated will lead to many novel findings over the next few decades.

Richard Doll seminars IN Public health and epidemiology

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