Objective: To analyze the trends in incidence and mortality of Alzheimer's disease (AD) in Zhejiang Province from 2003 to 2017, so as to provide the evidence for the development of AD prevention and control strategies. Methods: The data pertaining to the incidence and mortality of AD in China from 2003 to 2017 were collected from the Global Burden Disease Study, and standardized to the data of the Sixth National Population Census in China in 2010. The trends in incidence and mortality of AD were analyzed using annual percent change (APC) and average annual percent change ( AAPC ) in Zhejiang Province from 2003 to 2017. Results: The incidence of AD increased from 96.05/105 in 2003 to 140.96/105 in 2017 in Zhejiang Province, with AAPC of 2.776% ( P<0.05 ), and the greatest APC ( 3.419% ) was found during the period between 2003 and 2005 ( P<0.05 ). The standardized incidence of AD increased 102.06/105 in 2003 to 106.09/105 in 2017 in Zhejiang Province, with AAPC of 0.274% ( P<0.05 ), and the greatest APC ( 1.177% ) was measured during the period between 2003 and 2005 ( P<0.05). The mortality of AD increased from 24.60/105 in 2003 to 41.44/105 in 2017 in Zhejiang Province, with AAPC of 3.862% ( P<0.05 ), and the greatest APC (4.667%) was found during the period between 2005 and 2011 ( P<0.05 ). The standardized mortality of AD increased 26.83/105 in 2003 to 27.16/105 in 2017 in Zhejiang Province, with AAPC of 0.142% ( P>0.05 ), and the greatest APC ( 1.048% ) was measured during the period between 2005 and 2012 ( P<0.05 ). Conclusion Both the incidence and mortality of AD appeared a tendency towards a rise in Zhejiang Province from 2003 to 2017.

Objective: To investigation the correlation between sleep duration and hypertension among adults in Zhejiang Province, and to provide scientific evidence for the prevention and control of hypertension. Methods: Permanent residents at age of 18 years and older were enrolled from 10 surveillance sites for risk factors of chronic diseases included in the 2018 China Chronic Diseases and Risk Factors Surveillance Program. Subjects' demographic characteristics, smoking, alcohol consumption, sleep duration and development of hypertension were collected, and following complex weighting calculations, the association between sleep duration and hypertension were examined using a multivariable logistic regression model. Results: Totally 5 770 adults were included, including 2 952 men (50.72%) and 3 178 women (49.28%), and the prevalence of hypertension was 29.39% (2 702 cases). There were 712 (8.37%), 1 077 (18.77%), 1 582 (28.68%), 1 717 (34.60%) and 682 adults (9.57%) with sleep duration of <6 h/d, 6 to 7 h/d, 7 to 8 h/d, 8 to 9 h/d and 9 h/d and longer, respectively. Taking the sleep duration of 7 to 8 h/d as a reference, multivariable logistic regression analysis identified a significant association between sleep duration of <6 h/d and the risk of hypertension (OR=1.709, 95%CI: 1.184-2.466), a significant association between sleep duration of 9 h/d and longer and the risk of hypertension (OR=1.369, 95%CI: 1.006-1.862) in men, significant associations between sleep duration of <6 h/d (OR=2.174, 95%CI: 1.528-3.093) and 6 to 7 h/d (OR=1.412, 95%CI: 1.078-1.850) and the risk of hypertension in women, and significant associations between sleep duration of <6 h/d (OR=3.095, 95%CI: 1.025-9.347) and 6 to 7 h/d (OR=2.046, 95%CI: 1.156-3.622) and the risk of hypertension in residents at ages of 18 to 44 years. Conclusions Short sleep duration may increase the risk of hypertension among adults at ages of 18 to 44 years in Zhejiang Province. Short sleep duration may increase the risk of hypertension in women and long sleep duration may increase the risk of hypertension in men.

Objective: To analyze the disease burden and risk factors of colorectal cancer in Zhejiang Province from 1990 to 2019, so as to provide the basis for prevention and control of colorectal cancer. Methods: Based on data of 2019 Global Burden of Disease (GDB 2019), disease burden and risk factors of colorectal cancer in Zhejiang Province from 1990 to 2019 was assessed using years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALY). Results: In 2019, the YLL rate, YLD rate and DALY rate caused by colorectal cancer in Zhejiang Province were 496.15/105, 31.81/105 and 527.96/105, respectively. From 1990 to 2019, the YLL rate, YLD rate and DALY rate caused by colorectal cancer in Zhejiang Province increased by 114.90%, 482.60% and 123.38%, respectively, showing increasing trends (average annual percent change values were =2.663, 6.283 and 2.800, respectively,all P<0.05). From 1990 to 2019, the YLL rate, YLD rate and DALY rate in the age groups of 15 to 49 years, 50 to 69 years and 70 years and older showed increasing trends (all P<0.05). In 1990, the top ten risk factors for colorectal cancer in Zhejiang Province were diet low in calcium, diet low in milk, diet low in whole grains, smoking, alcohol use, low physical activity, high fasting plasma glucose, diet high in red meat, diet low in fiber and high body mass index. In 2019, the top ten risk factors for colorectal cancer in Zhejiang Province were diet low in milk, diet low in whole grains, diet low in calcium, alcohol use, diet high in red meat, high body mass index, high fasting plasma glucose, low physical activity, diet low in fiber and diet high in processed meat. Conclusions The disease burden of colorectal cancer in Zhejiang Province showed an upward trend from 1990 to 2019. The top ten risk factors for colorectal cancer remained between 1990 and 2019, while there was a slight change in ranking.

Objective:To explore the spatial autocorrelation and macro influencing factors of stroke mortality in Zhejiang Province in 2015-2020 and provide a scientific basis for stroke prevention and control strategy.Methods:The data on stroke death were obtained from Zhejiang Chronic Disease Surveillance System. The spatial distribution of stroke mortality was explored by mapping and spatial autocorrelation analysis. The spatial panel model analyzed the correlation between stroke mortality and socioeconomic and healthcare factors.Results:From 2015 to 2020, the average stroke mortality was 68.38/100 thousand. The standard mortality of stroke was high in the areas of east and low in the west, high in the south and low in the north. Moreover, positive spatial autocorrelation was observed (Moran's I=0.274-0.390, P<0.001). Standard mortality of stroke was negatively associated with per capita gross domestic product (GDP) ( β=-0.370, P<0.001), per capita health expenditure ( β=-0.116, P=0.021), number of beds per thousand population ( β=-0.161, P=0.030). Standard mortality of ischemic stroke was negatively associated with per capita GDP ( β=-0.310, P=0.002) and standard management rate of hypertension ( β=-0.462, P=0.011). Standard mortality of hemorrhagic stroke was negatively associated with per capita GDP ( β=-0.481, P<0.001), per capita health expenditure ( β=-0.184, P=0.001), number of beds per thousand population ( β=-0.288, P=0.001) and standard management rate of hypertension ( β=-0.336, P=0.029). Conclusions:A positive spatial correlation existed between stroke mortality in Zhejiang Province in 2015-2020. We must focus more on preventing and controlling strokes in relatively backward economic areas. Moreover, to reduce the mortality of stroke, increasing the investment of government medical and health funds, optimizing the allocation of medical resources, and improving the standard management rate of hypertension are important measures.

Objective:To analyze the epidemiological patterns of comorbidity of anxiety symptoms and depression symptoms among middle and high school students in Zhejiang Province and to provide evidence for making strategy and evaluation of intervention.Methods:Through a multi-stage sampling design, 28 043 students from 376 schools in 30 counties/districts were recruited and surveyed using anonymous self-administered questionnaires in classrooms under the supervision of trained staff between April and June 2022. Anxiety symptoms were assessed using generalized Anxiety Disorders 7-Item Scale, and depression symptoms were assessed using Patient Health Questionnaire 9-Item Depression Scale. A total of 27 004 students were included in the final analysis.Results:The overall prevalence of comorbidity of anxiety symptoms and depression symptoms was 11.54% (95% CI: 10.90%-12.19%), higher among girls (15.42%, 95% CI: 14.47%- 16.38%) than boys (8.05%, 95% CI: 7.43%-8.67%) ( P<0.001), higher among students living in rural areas (12.35%, 95% CI: 11.49%-13.22%) than those in urban areas (10.06%, 95% CI: 9.27%-10.86%) ( P<0.001). The prevalence of comorbidity of students attending middle school, academic high school, and vocational high school was 11.73% (95% CI: 10.82%-12.64%), 12.49% (95% CI: 11.20%- 13.79%), and 9.98% (95% CI: 8.68%-11.27%), respectively ( P=0.025). The prevalence of comorbidity was higher among students in divorced/widow/separated families (16.64%, 95% CI: 14.86%-18.43%) than those in intact families (10.82%, 95% CI: 10.14%-11.50%) ( P<0.001). The wealthier the families, the lower the prevalence of comorbidity ( P<0.001). The prevalence of comorbidity was higher among cigarettes smokers in the past 30 days (21.70%,95% CI: 18.24%- 25.16%) than non-smokers (11.13%, 95% CI: 10.51%-11.76%), higher among alcohol drinkers in the past 30 days (19.36%, 95% CI: 17.58%-21.14%) than non-drinkers (10.05%, 95% CI: 9.43%- 10.68%), higher among students engaging in physical fight in the past 12 months (18.42%, 95% CI: 16.75%-20.09%) than those without physical fight (10.45%, 95% CI: 9.81%-11.10%). The more frequently students engaged in physical exercise, the lower the prevalence of comorbidity ( P<0.001). The poorer the academic performance self-reported, the higher the prevalence of comorbidity ( P<0.001). Conclusion:More than one-tenth of middle and high school students in Zhejiang Province have comorbidity of anxiety symptoms and depression symptoms, and more attention should be paid to adolescent mental health.

Objective:To understand the epidemiological characteristics of metabolic syndrome(MetS) among adult residents in Zhejiang Province and compare three diagnostic criteria in adult residents.Methods:In this cross-sectisnal study participants were randomly chosen using multi-stage stratified cluster sampling method from 10 national chronic disease risk factor monitoring sites in Zhejiang Province of the 2018 China Chronic Disease and Risk Factors Surveillance Project. Demographics and information on chronic disease prevalence were obtained through questionnaire, physical measurements, and laboratory. After complex weighting of the data, an analysis and comparison of the prevalence of MetS under different diagnostic criteria among adult residents in Zhejiang Province was conducted.Results:A total of 5 369 adult residents were included, 2 411 males and 2 958 females. The prevalence of MetS using JIS, CDS and IDF diagnostic criteria was 33.62%, 25.32%, and 24.25%, respectively. The consistency rate between IDF and JIS was the highest(89.11%) and the Kappa value was 0.768( P<0.001). The consistency rate between IDF and CDS diagnostic criteria was 84.53%, and the Kappa value was 0.631( P<0.001). The consistency rate between JIS and CDS was the lowest(83.17%), and the Kappa value was 0.621( P<0.001). Under CDS diagnostic criteria, the prevalence of MetS was associated to gender, marital status, smoking and drinking. Conclusion:The prevalence of MetS is at a relatively high level among adult residents in Zhejiang province. The consistency between IDF and JIS diagnostic criteria is the highest. Screening for MetS should be strengthened to detect high-risk individuals early, reduce the risk of cardiovascular and cerebrovascular diseases and diabetes, and improve the quality of life of residents.