Objective:To investigate the association between sleep quality and the risk of acute exacerbation in mild and moderate chronic obstructive pulmonary disease （COPD） patients in Pudong New Area of Shanghai. Methods:This was a prospective study involving eligible mild and moderate COPD patients from 10 communities randomly selected in Pudong New District of Shanghai. A structured questionnaire was used to collect demographic characteristics， clinical information and information on acute exacerbation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index （PSQI） in Chinese. Multiple negative binomial regression was used to estimate the association between sleep quality and risk of exacerbation. Results:Altogether 212 mild/moderate COPD patients participated and completed the entire survey， of whom the majority （95.8%） were mild COPD patients， 110 persons female and over half （54.2%） over 65 years old. 32.9% of the patients had poorer sleep quality at baseline. 18.9% of the patients reported exacerbation over the past year during follow-ups. Multiple negative binomial regression suggested that increased PSQI was related to higher risk of exacerbation （RR_ad=1.12， 95%CI：1.02-1.24）， and patients with poorer sleep efficiency had a higher risk of exacerbation （RR_ad=1.66， 95%CI：1.17-5.43）. Conclusion:Poorer sleep quality is associated with a higher risk of exacerbation in community mild/moderate COPD patients， especially in those with problem of sleep efficiency. More attention to sleep disorders is warranted in community management or self-management of patients with COPD.

Objective:To determine the prevalence and risk factors of asthma among adults. Methods:A total of 37 670 adults aged 18 years and above was enrolled in Songjiang District， Shanghai using a multi-stage stratified sampling method between April 2016 and October 2017. Statistical analysis， such as t-test and Chi-square test， was performed to check the difference between the participants with asthma and non-asthma participants. Risk factors for asthma were examined by logistic regression analysis in all participants. Results:Overall， 36 698 subjects were enrolled in the study， in which 752 had asthma. The overall prevalence of asthma was determined to be 2.05%. The prevalence in females was 2.16%， and that in males was 1.88%， which didn’t achieve significance（P>0.05）. Compared to non-asthma participants， those with asthma were more likely to be older （［60.3±9.48］ years vs. ［56.29±11.31］ years）， widowed （6.91%>4.45%，P<0.05）， with educational level of primary school and below （58.64%>46.55%， P<0.01）， higher level of total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） （P<0.05）， had more co-morbidities， such as hypertension （42.00%>15.00%，P<0.001）， chronic obstructive pulmonary disease （COPD） （6.25%>0.41%，P<0.001）， chronic bronchitis （51.33%>6.32%，P<0.001） and tuberculosis （2.66%>0.96%，P<0.05）， depression（2.13%>0.41%，P<0.05）， and Parkinson's disease （0.93%>0.39%，P<0.05）. Multivariable analysis showed that family history of asthma， history of hypertension， chronic bronchitis， COPD， depression and educational level of primary school and below were the risks factors associated with adult asthma （P<0.05）. Conclusion:Prevalence of adult asthma in Shanghai has increased in recent years. Targeted health education may be strengthened for improving adult awareness towards asthma and reducing the disease burden.

Objective:To analyze the epidemiological characteristics and trend of stroke death among registered residents in Hexi District of Tianjin from 2007 to 2019，and to provide scientific basis for evaluation of comprehensive prevention and control strategies and measures of stroke. Methods:All death monitoring data of the residents was collected and the crude mortality， standardized mortality and annual percent change （APC） of stroke were obtained by statistical treatment. Results:A total of 15 235 stroke deaths were reported in Hexi District of Tianjin from 2007 to 2019，with an average annual mortality rate of 144.59/10⁵. The rate was higher in males than in females （169.02/10⁵ in males and 121.04/10⁵ in females， P<0.001）. The crude mortality rate showed an upward trend with the year （APC=1.51%， P<0.05）. The standardized mortality rate showed a downward trend （APC=-1.39%， P<0.05）. The crude mortality of ischemic stroke showed an upward trend with the year （APC=3.15%， P<0.01）， and the trend change in standardized mortality rate had no statistical significance. The crude mortality and standardized mortality of hemorrhagic stroke showed a downward trend，with the mortality rate decreased at 2.43% per year and the standardized mortality rate decreased at the 4.50% per year （all P<0.05）. Conclusion:Stroke is the main disease affecting the health of residents in Hexi District of Tianjin. Targeted measures should be taken to reduce the mortality of stroke. Stroke prevention and control should focus on winter and spring seasons， males， elderly people and patients with ischemic stroke.

Objective:To understand the status quo of relapse behavior among drug addicts and its related factors. Methods:A total of 1 225 community residents were randomly selected by stratified proportional sampling method. Data were collected by face-to-face questionnaire survey. Descriptive analysis， one-factor chi-square test and binary logistic regression were used to analyze the drug relapse behavior and possible related factors. Results:A total of 1 219 valid questionnaires were collected， with a recovery rate of 99.5%. The majority of the respondents were male （86.2%）， rural household registration （78.3%）， education level in junior high school or above （55.0%）， and unmarried （54.1%）， with an average age of （37.18±10.71） years old. 36.8% of the respondents had relapse behavior. The possible risk factors of relapse were age （OR=4.225， P<0.001）， education level （OR=1.530， P=0.003），urban and rural residence （OR=1.778， P=0.001）， employment status （OR=1.559， P=0.007）， marriage status （OR=1.581， P=0.001）and family support （OR=1.756， P=0.006） . Conclusion:We should focus on the influence of demographic factors such as age， education level， employment status， marital status， family relationship and social support under the background of urban-rural differences on relapse behavior of drug addicts. The whole society should work together to create a good environment for rehabilitation， effectively prevent the relapse behavior of drug addicts， and actively help them return to society smoothly， so as to reduce the social burden.

Objective:To analyze the cancer incidence and mortality in Yixing City， Jiangsu Province in 2019. Methods:The cancer incidence and mortality in Yixing residents in 2019 were collected. Based on the data， the incidence and mortality rate， standardized incidence and mortality rate and age-specific incidence and mortality rate of cancer were calculated， and the incidence and death of major malignant tumors were also analyzed. Life table method was used to calculate life expectancy and life expectancy without cause of death. Results:The crude incidence of cancer in Yixing in 2019 was 308.61/10⁵， the ASR China was 175.24/10⁵， and the ASR World was 134.56/10⁵. The crude mortality of cancer was 258.78/10⁵， the ASR China was 125.19/10⁵， and the ASR World was 93.01/10⁵. The cancer incidence rate and mortality rate in males were higher than those in females. The top 5 cancers in incidence were lung， gastric， colorectal， thyroid， and esophageal cancers. The top 5 cancer deaths were lung， gastric， liver， esophageal， and colorectal cancers. In 2019， the life expectancy of Yixing residents was 82.53 years old， and the life expectancy without cause of cancer death was 86.15 years old. The biggest loss of life expectancy in the population was caused by lung cancer， followed by gastric cancer and liver cancer. Conclusion:The mortality rate of malignant tumors in Yixing is at a high level. Cancer prevention and treatment should be focused on lung cancer， thyroid cancer and malignant tumors of the digestive tract.

Objective:To determine the association between recreational drug usage， high risk sexual behavior， and HIV infection among men who have sex with men（MSM） in Jinhua. Methods:A cross-sectional survey was conducted to recruit MSM for anonymous questionnaire survey and serological examination. We used EpiData3.1 for data entry and SPSS 19.0 for statistical analysis. Results:A total of 368 MSM were surveyed， in which the proportion of recreational drug usage was 13.3% （ 49 / 368 ）， with the HIV infection of 10.3% （38/ 368 ） and syphilis infection of 8.9% （25/368）. Risk factors associated with recreational drug usage were determined to be part-time job or being unemployed （OR=5.26； 95%CI： 2.10-13.18； P<0.001）， average monthly income ≥CNY 5 000 （OR=6.45； 95%CI： 2.87-14.61； P<0.001）， education level of high school or above （OR=1.56； 95%CI： 1.37-3.57； P=0.037）， sexual orientation being homosexual（OR=3.52； 95%CI： 1.60-7.33； P=0.002）， number of sexual partners >1 （OR=4.37； 95%CI： 1.76-10.82； P=0.001）， engaged in group sex （OR=7.90； 95%CI： 2.11-29.55； P=0.002） and previously diagnosed sexually transmitted diseases （OR=4.76； 95%CI： 1.29-17.65；P=0.019）. Conclusion:Prevalence of recreational drug usage among MSM in Jinhua is relatively low. MSM with part-time or unemployed status， monthly income ≥CNY 5 000， higher education level， homosexual orientation， multiple sexual partners， sexually transmitted diseases and group sex behavior are the risk factors associated with recreational drug usage in Jinhua city. Targeted countermeasures should be considered for intervention.

Objective:To analyze the epidemiological characteristics of hepatitis B （HB） in Huzhou from 2004 to 2017 in order to provide theoretical basis for the prevention of HB. Methods:Descriptive epidemiologic methods were used to analyze the data of HB cases in Huzhou city， 2004-2017. Results:A total of 16 685 HB cases were reported in Huzhou from 2004 to 2017. The average annual incidence of HB was 41.58/10⁵. Incidence tended to decrease （χ²=5 094.667， P<0.01）. The incidence of HB among males was higher than that among females （χ²=2 619.143，P<0.01）， and the incidence rate among males and females both tended to decrease （male： χ²= 3 408.813， P<0.01；female： χ²=1 716.388， P<0.01）. Of the reported case of HB， 83.0% involved individuals between 20 and 60 years of age. Most of the patients were farmers， accounting for 52.41% of the total cases. The top three districts reporting high case numbers were Changxing （4 584 cases （27.47%））， Wuxing （4 356 cases （26.11%））， Anji （3 192 cases（19.13%））， while the top county/district of the annual incidence was Changxing （50.10/10⁵）. Conclusion:Incidence of HB kept decreasing between 2004 and 2017 in Huzhou. Adults are the key population vulnerable to HB virus. To further reduce the incidence of HB， it is necessary to strengthen the prevention of HB and HB vaccination rate among high-risk groups.

Objective:To analyze the epidemiological characteristics of 8 clusters of coronavirus disease 2019 （COVID-19） in Chenzhou City， and provide scientific basis for epidemic prevention and control. Methods:Descriptive epidemiological analysis was conducted for 8 COVID-19 clusters， comparing and analyzing the differences of infection rates among close contacts within and outside the family， and emphatically describing two typical cases. Results:8 COVID-19 clusters were reported in Chenzhou with a total of 31 cases from January to February， 2020. The main source of infection of the family index cases was Hubei Province. Cough symptoms were observed in 67.74% of the cases， followed by fever （54.84%）. The infection rate of close contacts within the family （55.00%） was higher than that outside the family （2.56%）， and the difference was statistically significant （χ²=28.177， P<0.001）. The infection rate of spouse of the family index cases was 85.71%， higher than that of parents （77.78%）， other family members （44.44%） and children （40.00%）， and the difference was not statistically significant （χ²=6.004， P=0.120）. Two typical cases suggested that both COVID-19 pre-symptomatic and asymptomatic patients have the potential to excrete the virus from the body and become sources of infection. Conclusion:Effective family prevention and control measures and early sampling and screening of people in key epidemic areas are conducive to early detection， early isolation and early treatment of infected people， so as to avoid the occurrence and spread of family clusters.

Objectives:To analyze the outcome of treatment of patients with multidrug-resistant tuberculosis （MDR-TB） in Shandong Province from 2013 to 2017， and to discuss the impact of the global fund's multi-drug prevention and control program （hereinafter referred to as “ the Program”） on the outcome of treatment of MDR-TB patients， so as to provide a basis for the formulation of MDR-TB prevention and control strategy in Shandong Province. Methods:Information of MDR-TB patients in Shandong Province from 2013 to 2017 was collected from the TB Management Information System， and Excel was used for statistical analysis. Descriptive analysis was conducted on the number of MDR-TB patients found， treatment rate， and successful treatment rate in the province， 5 project cities， and other non-project cities. SPSS16.0 statistical software was used for data analysis. Chi-square test was performed for comparison between rates （P<0.05）. Result:The successful treatment rate in the province was the highest in 2014 （53.85%） and the lowest in 2017（22.93%）， with a statistically significant difference （χ²=40.96，P<0.001）. The treatment rate in the whole province increased year by year， from 66.97% to 85.06%， and the difference was statistically significant （χ²=30.53，P<0.001）. The successful treatment rate was above 46% every year between 2013 and 2016， and decreased to 22.93% in 2017， with a statistically significant difference （χ²=40.96，P<0.001）. The proportion of lost patients increased year by year since 2014， reaching 70.95% in 2017， with a statistically significant difference （χ²=2.32，P<0.001）. In 2017， the number of patients found in the five project cities was the lowest in five years. Conclusion:The result of the project has an impact on the discovery， treatment and management of MDR-TB patients in Shandong Province. There is an urgent need to pay more attention to and actively explore prevention and treatment strategies for MDR-TB at the provincial level.

Objective:To analyze the incidence and epidemic characteristics of local cases infected with SARS-CoV-2 in Yangpu District of Shanghai， China， and provide scientific evidence for the prevention and control of coronavirus disease-19 （COVID-19）. Methods:Descriptive epidemiological methods were applied to analyze the epidemic data of all the patients tested positive for SARS-CoV-2 RNA in Yangpu District of Shanghai， China. Results:A total of 9 local cases （7 males and 2 females） were documented in Yangpu District from January 30， 2020 to February 29， 2020. The average age was （48.56±13.85） years old. According to the body mass index， the patients with overweight and obesity accounted for 44.44% of the total cases. All the patients had fever at the onset and radiological findings of pneumonia by CT examination. They were diagnosed during January 24 and February 8， 2020. The median incubation period of the COVID-19 was 9 days and the median course was 22 days. Six cases had travel history in the epidemic areas and the other 3 cases had history of contact with confirmed cases. There were two familial clusters， both of which were husband-wife relationships. One cluster had a clear temporal sequence of onset， while the other one might be co-exposed or mutually infected. No new local case infected with SARS-CoV-2 was evident since February 8， 2020. Conclusion:All the local COVID-19 cases in Yangpu District have clear epidemiological exposure history. It warrants further attention to the family clustering SARS-CoV-2 transmission. Currently， containment of imported cases is crucial for the prevention and control of COVID-19 epidemic.