Objective To understand the pattern of and influencing factors on leisure time physical exercises among adults in Zhejiang. Method Totally 17 437 residents aged 18 years and over selected by stratified cluster random sampling in Zhejiang in 2010 were investigated. Result Overall 21.82%(95%CI:17.12%-27.38%) of adults took part in leisure time physical exercises in 2010. The proportion was higher in urban (29.04%,95%CI:23.46%-35.33%) than in rural (18.81%,95%CI:12.89%-26.61%) (χ2=222.06, P<0.05) areas, and also higher in females (22.91%,95%CI:17.66%-29.15%) than in males (20.56%,95%CI:16.39%-25.48%) (χ2=13.94, P<0.05). Adults aged 18-24 and 55-74 years were more likely to take apart in physical exercises (χ2=266.73, P<0.05), and the lowest proportion was found among farmers (5.33%,95%CI:3.99%-7.11%) (χ2=2 078.40, P<0.05). These proportions both increased along with education level and family income increase (χ2=444.87, P<0.05;χ2=332.20, P<0.05). Overall 83.04%and 90.08%of physical exercisers took part in exercises at least 3 times per week and 30 minutes per time, only 30.67% of those reached moderate or vigorous intensity, and overall 5.38% (95%CI: 3.85%-7.48%) of adults took part in regular leisure time physical exercises in 2010. Multiple logistic regression showed that age, education level, occupation and chronic disease history have influence on regular physical exercises. Conclusion The leisure time physical exercises level was generally low among adults in Zhejiang. Young and middle-aged adults with less education and low income especially farmers should be put on emphasis.

Objective To evaluate the utility of waist-to-height ratio ( WHtR ) in predicting metabolic syndrome ( MS) among non-overweight Chinese adults, and to investigate the difference by age and sex. Methods Based on a population-based cross-sectional survey on MS in Zhejiang province in 2010, data of 10 792 non-overweight (body mass index<24. 0 kg/m2 ) adults aged 18 years and older were analyzed by using the receiver operating characteristic(ROC)curve analysis and multiple logistic regression. Results The area under ROC curve (AUC) values of WHtR in MS prediction were 0. 765(95%CI 0. 740-0. 789) and 0. 786(95%CI 0. 765-0. 807), and odds ratios(OR) of WHtR for MS were 1. 23(95%CI 1. 20-1. 27) and 1. 22(95%CI 1. 20-1. 26) in non-overweight men and women, respectively. These two values were with significant difference among non-overweight adults with different agedandsexes(P<0.01). No-overweightmenhadsmallerAUCandORamong18-34agegroupwhilelargerAUCand OR among 35-49, 50-64, and 65-plus age groups than women. The AUC and OR showed slight difference among age groups in non-overweight men, while these two values decreased with age in non-overweight women. The optimal cutoff value was higher in non-overweight women (0. 509 vs 0. 498) than that in men. Non-overweight men aged 50-64 years old had higher cutoff value than those aged 18-34, 35-49, and 65-plus years, while among non-overweight women the cutoff values increased with age. Conclusion WHtR had preferable discriminatory power and association with MS among non-overweight Chinese adults. Further studies should be conducted to explore the difference by age and sex.

Objective: To investigate the association between dietary selenium intake and hypertension among Zhejiang residents . Methods: By multistage stratified random sampling method,four urban sites and two rural sites out of Zhejiang Province,four communities or villages out of each site,then 20 households out of each community or village were selected,and all the family members of the selected households were recruited as participants. The questionnaire of Chinese Health and Nutrition Survey was used to collect information about socio-demographic characteristics and dietary selenium intake. The blood pressure,blood lipid and other data were collected via physical examination. A multivariate logistic regression model was used to analyze the relationship between dietary selenium intake and hypertension . Results: A total of 1 222 participants with complete dietary selenium intake data were included for analysis. The number（%）of participants with selenium intake higher than the level of estimated average requirement（EAR）,between the levels of EAR and recommanded nutrient intake （RNI）,between the levels of RNI and upper intake（UI）and higher than the level of UI were 729 （59.66%）,151（12.36%）,341（27.91%）and 1（0.01%）,respectively. There were 283 （30.53%）patients with hypertension out of 927 participants examined. The mean amount of selenium intake in patients with hypertention was（43.06±20.96）μg/d,which was significantly lower than（51.56±30.06） μg/d in non-hypertention participants（P<0.05）. After adjusting for age,body mass index,total cholesterol,triglyceride and diabetes mellitus in the multivariate logistic regression model,dietary selenium intake significantly reduced the risk of hypertension（OR=0.985,95%CI：0.978-0.993） . Conclusion About 60% of residents in Zhejiang Province had lower dietary selenium intake than estimated average requirement. Higher selenium intake was associated with lower risk of hypertension.

Objective:To construct a death education intervention program for advanced cancer caregivers to improve the reference for death education for advanced cancer caregivers.Methods:Content analysis, semi-structured interview, Delphi expert consultation method were used to develop a preliminary death education program based on the theory of knowledge, belief, and behavior. From April to May 2022, fifteen experts from palliative care, life and death education, oncology nursing, psychological nursing and other related fields were selected for two rounds of expert consultation, and the contents of the program were revised and improved through preliminary experiments.Results:After two rounds of expert consultation, the results showed that the expert opinions tend to be unanimous. The authoritative coefficient of experts was 0.87, and the Kendall coordination coefficients of feasibility, validity and scientificity of the two rounds of consultation were 0.181, 0.303, 0.363 and 0.249, 0.355, 0.366, respectively (both P<0.05). The preliminary experiments revised and improved the intervention frequency and content, and finally formed a death education intervention program for advanced cancer caregivers which included four-stage progressive death themes: made an appointment with death, made a discussion on death, made an embrace with death and made friends with death. Conclusions:The process of constructing a death education program for advanced cancer caregivers is scientific, and the content is feasible, valid, and scientific. In addition, it is of great significance to promote death education in palliative care.

Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus. Severe diabetic macular edema or proliferative retinopathy may lead to impaired vision or even blindness in diabetic patients. The glucagon-like peptide-1 receptor agonist (GLP-1RA) is now commonly used as novel glucose-lowering agents in the clinical management of type 2 diabetes, but the rapid glycaemic changes associated with the use of the GLP-1RA may aggravate the risk of an increase in the occurrence of short-term potential DR. Potential effects and mechanisms of DR include oxidative stress, vascular endothelial growth factor, inflammation, retinal neurodegeneration, and other cytokines.Whether GLP-1RA leads to the increased risk of DR remains controversial. More basic and clinical studies are needed with the aim of further clarifying the correlation between GLP-1RA and DR risk.

Objective: The study aimed to analyze the association between different types of obesity and dyslipidemia among rural primary and middle school students in Zhejiang Province, so as to inform strategies for prevention and control of childhood obesity and hyperlipidemia. Methods: As part of Nutrition Improvement Programme for Rural Compulsory Education Students, 1 244 participants were selected by stratified cluster random sampling in 5 counties of Zhejiang Province during September to December 2021. Physical examination, detection of blood lipid and questionnaire survey were conducted. The Chi -square test and Logistic regression analyses were used to assess the association between different types of obesity and dyslipidemia. Results: The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia were 15.11%, 12.46%, 17.60%, and 21.78%. Obesity and abdominal obesity were correlated to high risk of high triglycerides ( OR =3.97, 95% CI =2.54-6.20; OR =4.45, 95% CI =2.95- 6.72 )( P <0.05). Compared with the non overweight and obese group with normal waist circumference,the overweight and obesity group were correlated to high risk of high cholesterol ( OR=2.53, 95%CI =1.45-4.42, P <0.05). Abdominal overweight or obese group had the highest risk for dyslipidemia and triglycerides ( OR =1.82, 95% CI =1.33-2.48; OR =3.64, 95% CI =2.45-5.43) ( P < 0.05). Conclusions The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia are relatively high in rural primary and middle school students of Nutrition Improvement Programme for Rural Compulsory Education Students in Zhejiang Province. Abdominal obesity is a more important risk factor for hyperlipidemia. Waist circumference should be the focus of considerable attention.

ObjectiveTo study the epidemiological characteristics of diabetes mellitus and awareness rate in Zhejiang adults.MethodA total of 17 437 adults from 15 counties were randomly selected with stratified multi-stage cluster sampling method from July to November,2010.Each participant was required to complete a set of standardized questionnaire,physical examination,and blood specimen collection.ResultsThe overall standardized rate of diabetes mellitus was 5.94％ ( crude prevalence 8.80％ ).It was increased by 96.67％ during past 8 years,as compared with the prevalence 3.02％ in 2002.The standardized rate of diabetes mellitus of the urban and rural area were 7.52％ and 5.19％ ( crude prevalence 11.33％ and 7.09％ ),respectively.The standardized rate of diabetes mellitus in the urban was higher than rural ( u =6.58,P＜0.05 ).The standardized rate of diabetes mellitus of the male and the female were 5.74％ and 6.15％ ( crude prevalence 8.36％ and 9.13％ ),respectively,without significant difference ( u =1.39,P＞0.05 ).The awareness rate of diabetes mellitus was 59.19％ ( 56.66％ in male and 61.23 ％ in female,x2 =3.26,P＞0.05 ).The awareness rate of the urban was higher than the rural (63.47％ vs 54.69％,x2=12.20,P＜0.01 ).ConclusionThe prevalence of diabetes mellitus showed a rapidly rising trend in Zhejiang province.The effective intervention should be taken at its early stage.

Objective To access the prevalence of type 2 diabetes mellitus ( T2DM) and its associated risk factors among adults with obesity in Zhejiang province. Methods The enrolled subjects were selected among local residents aged≥18 years with body mass index≥28 kg/m2 from 15 counties by multi stage stratified cluster random sampling from July to November, 2010. Each participant was required to attend complete questionnaire, physical examination, and testing overnight fasting blood specimen. Results A total of 1 351 residents were enrolled, including 613 males and 738 females. The prevalence of T2DM in adult population with obesity was 15. 03%, being 14. 03% in male, and 15. 85% in female;and that in urban area was 16. 64%, and in rural area was 13. 93%. Data from multivariable logistic regression showed that factors such as ageing (OR=1. 473, 95% CI 1. 243-1. 747), a family history of T2DM(OR=8. 945, 95% CI 5. 481-14. 598), staple food intake (OR=1. 185, 95% CI 1. 017-1. 380), triglyceride(≥1. 7 mmol/L, OR=1. 542, 95%CI 1. 066-2. 232) were risk factors of T2DM;while annual income(OR=0. 695, 95%CI 0. 544-0. 888), and milk intake(OR=0. 750, 95%CI 0. 567-0. 993) were shown as protective factors. Conclusion The prevalence of T2DM in adults with obesity was raised, ageing, a family history of T2DM, staple food intake, and dyslipidemia appeared to be major risk factors for T2DM.