Objective:To analyze the intention to receive influenza vaccination and its associated factors among urban and rural residents aged≥50 in Zhejiang Province, China, in 2024.Methods:This cross-sectional study was conducted between March and May 2024 through a multi-stage intercept survey in 35 counties (cities, districts) selected from a total of 90 in Zhejiang Province, involving 175 communities/villages. The survey targeted residents visiting local hospitals and community health service centers/community health clinics. The questionnaire included basic demographic information, knowledge related to influenza prevention and treatment, chronic disease status, history of influenza vaccination, and intention to vaccinate. Urban and rural residents were classified based on their registered residence, according to the "Rules for Compilation of Statistical Regional Code and Urban-Rural Division Code" issued by the National Bureau of Statistics. Chi-square tests, ANOVA, and multivariate logistic regression models were used to analyze the factors influencing the intention to receive the influenza vaccine.Results:A total of 10 500 participants were surveyed, comprising 4 885 rural residents (46.52%) and 5 615 urban residents (53.48%). Of these, 3 430 rural residents (70.21%) and 3 718 urban residents (66.22%) expressed intention to receive the influenza vaccine. Multivariate logistic regression analysis revealed that for rural residents aged≥50, younger age groups (50-59 years: OR=1.747, 95% CI: 1.290-2.366; 60-69 years: OR=1.838, 95% CI: 1.401-2.411), history of influenza vaccination ( OR=6.721, 95% CI: 5.152-8.767), doctor′s recommendation for vaccination ( OR=3.788, 95% CI: 3.078-4.662), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.090, 95% CI: 1.054-1.128) were significant promoting factors for vaccination intent. For urban residents aged≥50, belonging to the 60-69 age group ( OR=1.264, 95% CI: 1.023-1.563), history of influenza vaccination ( OR=5.392, 95% CI: 4.309-6.748), doctor′s recommendation for vaccination ( OR=5.307, 95% CI: 4.420-6.371), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.051, 95% CI: 1.021-1.082) were significant promoting factors for vaccination intent. Conclusions:The intention to receive the influenza vaccination is notably high among residents aged≥50 in both urban and rural areas of Zhejiang Province, yet there remains potential for improvement. Age, history of influenza vaccination, doctor recommendation, and knowledge related to influenza prevention and treatment are significant factors influencing the intention to receive the influenza vaccination.

Objective:To analyze the attributable burden of active smoking on the deaths of cancer in inhabitants aged 30 years and above in Zhejiang Province.Methods:Comparative risk assessment approach in the Global Burden of Disease Study was used with the data from Zhejiang Adult Tobacco Surveillance System and Death Monitoring Surveillance System in 2020, and population attributable fraction (PAF), years of life lost (YLL), work of potential years of life lost (WPYLL) attributed to smoking on the deaths of cancer in inhabitants aged 30 years and above in Zhejiang Province were calculated with a linear regression model.Results:In 2020, there were 81 536 cancer deaths aged 30 years and above in the surveillance areas of Zhejiang Province, of which 24 518 were attributed to active smoking (PAF: 30.07%, attributable mortality rate: 55.04/100 000). The YLL was 553 078 person-years, with a standardized YLL rate of 12.40‰, and the WPYLL was 56 606 person-years. Among various cancer types, laryngeal cancer had the highest smoking-attributable PAF (44.75%), while lung cancer accounted for the most significant number of attributable deaths and life loss, with an age-standardized YLL rate of 4.65‰.Conclusions:Active smoking is a significant risk factor for cancer mortality in Zhejiang Province, with lung cancer posing the most significant disease burden. It is urgent to advance tobacco control legislation, strengthen targeted interventions, and promote early cancer screening to reduce the disease burden associated with smoking-related cancers effectively.

Objective:To analyze the attributable burden of active smoking on the deaths of cancer in inhabitants aged 30 years and above in Zhejiang Province.Methods:Comparative risk assessment approach in the Global Burden of Disease Study was used with the data from Zhejiang Adult Tobacco Surveillance System and Death Monitoring Surveillance System in 2020, and population attributable fraction (PAF), years of life lost (YLL), work of potential years of life lost (WPYLL) attributed to smoking on the deaths of cancer in inhabitants aged 30 years and above in Zhejiang Province were calculated with a linear regression model.Results:In 2020, there were 81 536 cancer deaths aged 30 years and above in the surveillance areas of Zhejiang Province, of which 24 518 were attributed to active smoking (PAF: 30.07%, attributable mortality rate: 55.04/100 000). The YLL was 553 078 person-years, with a standardized YLL rate of 12.40‰, and the WPYLL was 56 606 person-years. Among various cancer types, laryngeal cancer had the highest smoking-attributable PAF (44.75%), while lung cancer accounted for the most significant number of attributable deaths and life loss, with an age-standardized YLL rate of 4.65‰.Conclusions:Active smoking is a significant risk factor for cancer mortality in Zhejiang Province, with lung cancer posing the most significant disease burden. It is urgent to advance tobacco control legislation, strengthen targeted interventions, and promote early cancer screening to reduce the disease burden associated with smoking-related cancers effectively.

Objective:To analyze the intention to receive influenza vaccination and its associated factors among urban and rural residents aged≥50 in Zhejiang Province, China, in 2024.Methods:This cross-sectional study was conducted between March and May 2024 through a multi-stage intercept survey in 35 counties (cities, districts) selected from a total of 90 in Zhejiang Province, involving 175 communities/villages. The survey targeted residents visiting local hospitals and community health service centers/community health clinics. The questionnaire included basic demographic information, knowledge related to influenza prevention and treatment, chronic disease status, history of influenza vaccination, and intention to vaccinate. Urban and rural residents were classified based on their registered residence, according to the "Rules for Compilation of Statistical Regional Code and Urban-Rural Division Code" issued by the National Bureau of Statistics. Chi-square tests, ANOVA, and multivariate logistic regression models were used to analyze the factors influencing the intention to receive the influenza vaccine.Results:A total of 10 500 participants were surveyed, comprising 4 885 rural residents (46.52%) and 5 615 urban residents (53.48%). Of these, 3 430 rural residents (70.21%) and 3 718 urban residents (66.22%) expressed intention to receive the influenza vaccine. Multivariate logistic regression analysis revealed that for rural residents aged≥50, younger age groups (50-59 years: OR=1.747, 95% CI: 1.290-2.366; 60-69 years: OR=1.838, 95% CI: 1.401-2.411), history of influenza vaccination ( OR=6.721, 95% CI: 5.152-8.767), doctor′s recommendation for vaccination ( OR=3.788, 95% CI: 3.078-4.662), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.090, 95% CI: 1.054-1.128) were significant promoting factors for vaccination intent. For urban residents aged≥50, belonging to the 60-69 age group ( OR=1.264, 95% CI: 1.023-1.563), history of influenza vaccination ( OR=5.392, 95% CI: 4.309-6.748), doctor′s recommendation for vaccination ( OR=5.307, 95% CI: 4.420-6.371), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.051, 95% CI: 1.021-1.082) were significant promoting factors for vaccination intent. Conclusions:The intention to receive the influenza vaccination is notably high among residents aged≥50 in both urban and rural areas of Zhejiang Province, yet there remains potential for improvement. Age, history of influenza vaccination, doctor recommendation, and knowledge related to influenza prevention and treatment are significant factors influencing the intention to receive the influenza vaccination.

Objective:To investigate the level of health literacy and its influencing factors among residents aged 15-69 years with different chronic disease in Zhejiang Province.Methods:In this cross-sectional study, a stratified multistage whole cluster random sampling method was used to select 19 200 permanent residents aged 15-69 years from 30 monitoring sites in Zhejiang Province from June to November 2022, and a household questionnaire survey was carried out with the National Health Literacy Monitoring Questionnaire for the Population. The content of the survey included socio-demographic characteristics, health-related factors and health literacy level. A total of 19 200 questionnaires were distributed and 19 051 were collected, of which 18 857 (98.98%) were valid. The χ2 test was used to compare the health literacy levels of residents with different chronic diseases, and logistic regression was used to analyze the influencing factors of the health literacy levels. Results:The health literacy level of residents aged 15-69 in Zhejiang Province in 2022 was 38.36%. Among them, the health literacy level of patients with multiple chronic diseases was much lower than those with single chronic disease and those without chronic disease (14.70% vs 25.37%, 42.21%) ( χ2=483.05, P<0.001). It was positively associated between having multiple chronic diseases and insufficient health literacy ( OR=1.26, 95% CI: 1.01-1.58); compared with those without chronic disease ( OR=1.00), patients with multiple chronic diseases were significantly more likely to have inadequate health literacy in basic knowledge and concepts ( OR=1.29, 95% CI: 1.03-1.63), health behaviors ( OR=1.24, 95% CI: 1.01-1.53), basic skills ( OR=1.37, 95% CI: 1.11-1.69), and health information literacy ( OR=1.27, 95% CI: 1.08-1.50). Conclusions:The number of chronic diseases is a key factor that affects the residents′ health literacy level, and people with multiple chronic diseases are often associated with a higher risk of inadequate health literacy.

Objective To construct a model for predicting the benign and malignant risk of the patients with gastric diseases using con-ventional laboratory indicators such as tumor markers,blood routine,and coagulation indicators,and validate its predictive value.Methods The medical records of patients with gastric diseases who visited the First Affiliated Hospital of Guangzhou Medical Univer-sity from January 2018 to January 2023 were analyzed retrospectively.According to the pathological results,the patients were divided into the gastric cancer(GC)group(n=134)and chronic non-atrophic gastritis(CNAG)group(n=298).Their routine test data such as serum and whole blood tests were collected.The statistical analysis was conducted using the R 4.2.3 software,and a model for pre-dicting the risk of GC was constructed and validated.Results A model for predicting the risk of GC was constructed successfully using the Logistic regression analysis,which included D-dimer,carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4)and hemoglobin(Hb).A visual nomogram was plotted as the final prediction model.The areas under the receiver operating characteristic(ROC)curve(AUCROC)of the model in the training and testing sets were 0.809(95%CI:0.754-0.864)and 0.808(95%CI:0.724-0.892),respectively.The sensitivity and specificity of the model were 58.5%and 93.3%,respectively,indicating that it had good pre-dictive ability.Conclusion The model for predicting the malignant risk of patients with gastric diseases constructed using routine tes-ting indicators has good accuracy and can effectively predict the risk of gastric disease transforming into gastric cancer.It helps to find early gastric cancer patients in clinical practice and take targeted prevention and intervention measures.

Objective:To investigate the exposure to tobacco advertisement/promotion and smoking scenes from television/movie/video among middle school students in Zhejiang Province in 2021, and the influence on the knowledge and behavior about smoking of the students.Methods:Total 7 692 students were selected from 60 middle schools with the proportional probability sampling (PPS) method in Zhejiang Province. The investigation was performed with self-administered questionnaire survey which consisted of tobacco use, exposure to tobacco advertisement/promotion, et. The collected data was weighted and analyzed using the complex survey module of SPSS 21.0 software.Results:The prevalence of exposure to tobacco advertisement/promotion and smoking scenes from television/movie/video among the middle school students were 24.8% and 63.8% respectively. In recent 30 d, among those who had been exposed to the tobacco retail point, the proportion of those exposed to tobacco advertisement/promotion was 46.1%, and among those who surfed the internet, the proportion of those exposed to tobacco advertisement/video was 23.4%. Among the whole students, the proportion of those exposed to free tobacco product was 2.4%. The junior middle school students, regular high school students, and vocational school students who had been exposed to tobacco advertisement/promotion were more likely to feel smoking more comfortable in social occasions (5.6%, 6.7%, 8.8%), to feel smoking attractive for the young (9.1%, 8.4%, 8.8%), and also had higher rate of attempted smoking (12.5%, 16.9%, 20.5%) than non-exposed ones (junior middle school students: 2.3%, 5.5%, 4.8%; regular high school students: 2.9%, 2.9%, 9.8%; vocational school students: 4.0%, 4.0%, 15.3%) (all P<0.05). Among the students who had seen television/movie/video within 30 days, the junior middle school students, regular high school students, and vocational school students who had been exposed to smoking-related scenes had higher rate of attempted smoking (8.1%, 14.7%, 20.0%) than non-exposed ones (5.4%, 8.0%, 10.6%) (all P<0.05). Conclusion:The prevalence of exposure to tobacco advertisement/promotion and smoking scenes from television/movie/video are relatively high among the middle school students in Zhejiang province, which make exposed students more likely to report positive attitude to tobacco use, and more likely to smoke, to attempt to smoke.

Objective To investigate the correlation between sex hormone-binding globulin(SHBG)and lipid metabolism and visceral fat area(VFA)in male adults with different glucose tolerance.Methods A total of 473 male subjects were enrolled from the outpatient clinic and ward in PLA NO.903 Hospital from January 2018 to December 2020.All the subjects were divided into three groups according to OGTT results:normal glucose tolerance group(NGT,n=179),impaired glucose regulation group(IGR,n=90)and newly diagnosed type 2 diabetes mellitus group(T2DM,n=204).Serum SHBG level,abdominal visceral fat area(VFA)and biochemical indexes were compared among the three groups.Results Compared with NGT group,WC,WHR,BMI,HbA1c,FPG,2 hPG,2 hIns,TG and VFA were increased(P＜0.05),while SHBG was decreased(P＜0.05)in IGR group.WC,SBP,DBP,HbA1c,FPG,2 hPG,2 hIns,HOMA-IR,TG,FFA,VFA and VFA/SFA were increased,while HOMA-β,SHBG were decreased(P＜0.05)in T2DM group.Compared with IGR group,SBP,HbA1c,FPG,2 hPG,2 hIns and HOMA-IR were increased,HOMA-β was decreased in T2DM group(P＜0.05).Pearson correlation analysis showed that SHBG was positively correlated with HDL-C(P＜0.01),but was negatively correlated with WC,WHR,BMI,2 hIns,SUA,TG,VFA and SFA(P＜0.05 or P＜0.01).Multivariable linear regression analysis showed that HDL-C,TG and VFA were the influencing factors for SHBG.Conclusion Serum SHBG is closely related to abdominal obesity and lipid metabolism.Increasing the level of SHBG can reduce visceral fat accumulation and improve IR.

Objective:To describe the prevalence of tobacco use among college students in Zhejiang Province and analyze the influencing factors of second-hand smoke exposure on campus.Methods:In 2021, college students were selected from 9 colleges through stratified multi-stage cluster sampling from Zhejiang Province and surveyed using questionnaire. A total of 6 530 questionnaires were distributed and 6 035 were returned, with 6 030 valid questionnaires (96.48%). A descriptive analysis of the demography characteristics, cigarettes and electronic cigarettes (e-cigarettes) use, and second-hand smoke exposure of the subjects was carried out, and chi-square test was used for statistical analysis and multivariate logistic regression analysis was used to analyze influencing factors of second-hand smoke exposure on campus.Results:The current smoking rate and current use rate of e-cigarettes among college students were 3.70% and 1.56%, respectively, and the dual use rate of cigarettes and e-cigarettes was 1.16%. The exposure rate of second-hand smoke among college students on campus was 25.06%, while the exposure rate of second-hand smoke in off campus places was 32.35%. The awareness rates of smoking related diseases among college students were as follows: lung cancer (92.02%), heart disease (73.15%), stroke (72.87%), and impotence (64.08%). The awareness rate of second-hand smoke related diseases were as follows: lung cancer in adults (91.11%), heart disease in adults (78.91%), and lung disease in children (89.35%). The multivariate logistic regression analysis showed that seven factors (including gender, school type, major, grade, smoking ban regulations, smoking scenes, and knowledge about the health hazards of second-hand smoke) had a statistically significant impact on college students′ exposure to second-hand smoke at school [ OR=2.63, 0.67, 0.69, (0.39, 0.60, 0.68), 0.51, 1.74, 0.72] (all P<0.01). Conclusions:The use of cigarettes and e-cigarettes among college students in Zhejiang Province is not optimistic, especially the use rate of e-cigarettes is higher than adult. The status of second-hand smoke exposure among college students remains serious, with male students, non-medical students, students of special programs, and senior college students having more severe second-hand smoke exposure on campus, and students with high awareness of second-hand smoke exposure, less exposure to smoking scenes from media, from college with comprehensive smoke-free regulations are less exposed to second-hand smoke on campus.

Objective: To investigate the prevalence of cigarette and electronic cigarette ( e-cigarette ) use among adults in Zhejiang Province, so as to provide insights into tobacco control. Methods : Thirty study sites were randomly sampled from Zhejiang Province in 2020 using a multi-stage stratified random sampling method, and permanent residents at ages of 15 to 69 years were selected as study subjects. A questionnaire was designed based on the questionnaire for the China Adult Tobacco Survey to collect subjects' demographic characteristics, cigarette and e-cigarette use, smoking cessation and exposure to secondhand smoke ( SHS ). The weighted prevalence of smoking, current smoking, current e-cigarette smoking, smoking cessation and exposure to SHS was estimated based on the Seventh National Population Census in 2020. Results : A total of 19 200 questionnaires were recovered, and 19 180 were valid, with an effective recovery rate of 99.90%. The respondents had a mean age of ( 50.30±12.90 ) years, with a male to female ratio of 1∶1.06 and an urban/rural population ratio of 1∶1.31. Among all the respondents, there were 6 033 smokers ( 31.45% ), 4 163 current smokers ( 21.70% ), 201 current e-cigarette users ( 1.05% ), 146 cigarette and e-cigarette dual users ( 0.76% ), 1 870 respondents quitting smoking ( 31.00% of smokers ) and 7 189 respondents with exposure to SHS ( 47.87% of non-smokers ). The weighted prevalence of smoking, current e-cigarette use, cigarette and e-cigarette dual uses, smoking cessation and exposure to SHS was 20.49%, 1.34%, 0.94%, 29.56% and 49.53% in Zhejiang Province, respectively, and the prevalence of current smoking, current e-cigarette use, cigarette and e-cigarette dual uses and exposure to SHS was 40.39%, 2.39%, 1.86% and 55.31% among males and 0.35%, 0.28%, <0.01% and 46.02% among females, respectively. The highest prevalence of current smoking was seen among respondents at ages of 55 to 64 years ( 24.24% ), while the highest prevalence of current e-cigarette use and cigarette and e-cigarette dual uses was seen in adults at ages of 25 to 34 years ( 2.18% and 1.58% ). Conclusions The prevalence of current e-cigarette use was higher among adults in Zhejiang Province in 2020 than the nationwide level in China. The prevalence of cigarette use was lower among adults in Zhejiang Province in 2020 than the nationwide level in China; however, improving the management of tobacco control in public places and the capacity building of smoking cessation services is still required to reduce the use of cigarettes and e-cigarettes.