Objective To analyze the risk of COVID-19 epidemic at various stages in Wenzhou City， Zhejiang Province and explore the establishment of rapid risk assessment method for changes in the COVID-19 epidemic situation in urban areas， so as to provide evidence for effective response strategies. Methods Data of COVID-19 cases were collected from official websites of the national and local health committees published from January 21， 2020 to February 16， 2020. The risk of COVID-19 in Wenzhou in different periods was assessed using the outbreak risk index （RI）. Results A total of 503 confirmed COVID-19 cases were reported in Wenzhou City， including 22 severe cases， and no deaths. The cases were aged from 2 to 93 years， with an average age of （47.69 ± 14.30） years. Males accounted for 49.30% and females accounted for 44.33%. Cases in four districts/counties/cities of Yueqing， Ruian， Lucheng， and Yongjia accounted for 72.37% of the total ones. During this period， the incidence rate of COVID-19 was 6.07/100 000 in Wenzhou， with statistically significant difference compared with Ningbo （2.59/100 000； 156/7 741 016）， Hangzhou （2.17/100 000； 168/7 741 016）， and Taizhou （2.41/100 000； 146/6 053 971） （P＜0.01）， and higher than that of the whole province （2.34/100 000， 1 171/49 998 360， P＜0.01）. The RI assessment showed that epidemic RIs were 19 points at the early stage， 19 at the mid stage， and 15 at the late stage. Both the early and mid stages were high-risk， and the risk was reduced to medium-high level at the late stage. Conclusion The rapid risk assessment method can be used to assess the epidemic risk in urban areas quickly and effectively， easy to be mastered by grass-roots prevention and control personnel， and suitable for governments at all levels to quickly assess the epidemic risk for decision-making.

Objective To understand the status of cognition and protective practice of COVID-19 among residents in Guangdong Province during the epidemic period. Methods From February 3, 2020 to February 6, 2020, residents in Guangdong Province were surveyed through an online questionnaire. The survey content included demographic characteristics, going out and mask protection, disinfection protection, and cognition of COVID-19. Univariate and multivariate logistic regressions were used to determine factors influencing cognition of COVID-19 knowledge. Results A total of 1 367 residents in Guangdong Province were surveyed. Of the participants, 50.0% were Shantou residents, 50.7% aged 18-30 years, 53.5% had bachelor degree, 73.7% linved in urban area, and 42.6% had medical background. After the outbreak of COVID-19, 75.3% of the residents had the experience of going out. The main destination was a market or supermarket （62.6%）. The main way of going out was by private car （56.2%）. During the epidemic period, most residents （77.9%） must wear masks when going out, increased hand washing frequency （91.7%） and hand washing time （84.5%）. The average score of COVID-19 knowledge was （12.4 ± 1.4） points, and 753 persons （55.1%） got ≥13 points. Multivariate logistic regression analysis showed that the residents aged 31-40 years （OR=1.433） and with higher education levels （OR=1.945 for high school/secondary school, OR=2.524 for college, OR=3.507 for undergraduate, OR=4.374 for master's degree and above） had higher cognition level of COVID-19 knowledge. Conclusions After the outbreak of COVID-19, residents in Guangdong were generally able to wear masks, and increase the frequency and duration of hand washing. However, the cognitions of daily health protection and disease, and ability of rumor identification need to be improved.

Objective To explore factors affecting the effectiveness of nutritional intervention for fetal growth restriction （FGR）. Methods Data of social demography, pregnancy and birth of singleton neonates and pregnant women who were diagnosed with FGA by ultrasound and delivered at the Maternal and Child Health Hospital of Nanshan District, Shenzhen from January 2014 to June 2017 were collected through the Shenzhen Maternal and Child Health Care System and Hospital Information System. After adjusting for maternal age, education, parity, and newborn sex, a multiclass logistic regression model was used to explore the factors affecting effectiveness of nutrition intervention on different types of FGR. Results In this study, 3 051 eligible mothers and their newborns were recruited. The maternal ages were 18 to 44 years, 86.7% （2 644） of them were 18 to 34 years, 95.3% （2 909） were Han nationality, 55.1% （1 680） had the university education or above, and 64.0% （1 954） had BMI from 18.5 to 23.9 before pregnancy. After adjusting for the maternal age and other confounding factors, multiclass logistic regression showed that the parturients with low pre-pregnancy weight （OR=1.44）, gestational hypertension （OR=2.86）, oligohydramnios （OR=2.39）, abnormal umbilical cord （OR=1.49）, and placental weight <500 g （OR=3.72） were more likely to give birth to symmetrical small for gestational age （SGA） newborns; the parturients with anemia （OR =0.70） and trace element deficiency （OR =0.62） were less likely to have symmetrical SGA newborns; the parturients with low pre-pregnancy weight （OR=2.59）, oligohydramnios （OR=3.30）, placental weight <500 g （OR=2.39）, preterm delivery （OR=2.81） were more likely to give birth to asymmetric SGA newborns; the parturients with anemia （OR=0.60） and reproductive system infection （OR=0.47） were less likely to have asymmetric SGA newborns. Conclusions There are many factors affecting the effectiveness of nutritional intervention on FGR and the influencing factors of different prognosis outcomes are different.

Objective To evaluate the dietary quality of adults in Guangdong Province, so as to provide a basis for nutritional intervention. Methods Based on data from a dietary survey conducted in Guangdong Province in 2015, dietary quality of adults was evaluated by Diet Balance Index （DBI_16） scoring method. Results A total of 3 424 residents aged 18-92 years in Guangdong Province were included for analysis. Of the participants, 1 254 （36.6%） were living in the Pearl River Delta region （Guangzhou, Shenzhen, Foshan, Huizhou, Jiangmen）, 1 570 （45.8%） were males, 1 854 （54.2%） females, 1 538 （44.9%） aged 41-60 years, and 1 636 （47.8%） had the educational level at primary school or lower. The overall diet of the residents in Guangdong Province was in the status of moderate inadequate intake （29 ＜DBI-LBS ＜43）, lightly excessive intake （7 ＜DBI-HBS ＜13）, and moderate dietary imbalance （39 ＜DBI-DQD ＜57）. The dietary inadequate and imbalance were evident in residents of the male, rural areas, western rigion of the province, aged over 70 years, and with the educational level at primary school or lower. Of the participants, 86.5% had insufficient intake of vegetables and fruits, 98.5% had insufficient intake of beans and milk, and 53.8% were short of food diversities. Conclusion The dietary imbalance problem exists among adult residents in Guangdong Province. The differences in dietary balance among different groups should be considered when formulating strategies for improving nutrition in Guangdong Province.

Objective To investigate the current situation of internet addiction and sleep deficiency and their relationship among students in Guangzhou, so as to provide theoretical basis for the establishment of prevention and control policies. Methods Using stratified cluster random sampling method and the “Student Health Status and Influencing Factors Questionnaire” , internet addiction and length of sleep were surveyed among students of primary, junior high, and senior high schools, and universities in 11 districts of Guangzhou City. Univariate and multivariate logistic regressions were applied to explore the relationship between sleep deficiency and internet addiction. Results A total of 19 716 students were selected from primary, junior high, and senior high schools, and universities in Guangzhou. Of the students, 9 811 were boys and 9 905 girls, 17 400 in urban areas and 2 316 in suburbs; 5 215 in primary schools, 5 476 in junior high schools, 5 188 in senior high schools, 2 068 in vocational high schools, and 1 769 in universities; 93.4% surfed the internet in the past week, and 16.2% surfed the internet for 4 hours or more every day in the past week. The report rate of internet addiction was 4.0%; the rate in girls （4.7%） was higher than boys （3.4%）, suburbs （4.5%） was higher than urban areas （2.3%）; the rates in primary school, junior high school, senior high school, vocational high school, and university students were 0.7%, 3.7 %, 3.4%, 6.0%, and 14.5%, respectively. The rate of internet addiction reported by suburban elementary, junior and senior high school students was higher than that of urban students, and junior high school girls （7.7%） were the highest in the suburbs （P <0.05 or P <0.01）. The incidence of sleep deficiency was 71.2%. After controlling for factors such as gender, school period, and region, the binary classification logistic regression analysis showed that the risk of lack of sleep in internet addictive behavior was 1.579 times that of non-internet addictive behavior. Conclusion The prevalence rates of internet addiction and insufficient sleep were high in students in Guangzhou, with a trend of younger age. The phenomenon of internet addiction was particularly serious among students in suburb, vocational high schools, and universities. The problem of sleep deficiency was more obvious in middle and primary school students. Internet addiction can increase the risk of insufficient sleep.

Objective To observe changes in cytokine secretion induced by Zika virus （ZIKV） infection in human neuroblastoma SH-SY5Y and explore the mechanism of ZIKV affecting nervous system dysfunction. Methods A model of SH-SY5Y cells infected with ZIKV was established and the cell viability was detected by MTT assay. Cell culture supernatants were harvested at 24, 48, and 72 hours. Concentrations of IL-1β, IL-2, IL-4, IL-5, IL-13, IL-18, IFN-γ, TNF-α, IL-12P70, and GM-CSF were measured simultaneously and quantitatively using the Bio-Plex^? 200 system. Results The cell survival rates at 24, 48, and 72 hours in the virus infection group were lower than those in the normal control group （all for P <0.01）. The levels of IL-1β, IL-5, IFN-γ, TNF-α, IL-12P70, and GM-CSF secreted by the virus infection group （24-72 h） were higher than those of the control group （all for P <0.01）. The levels of IL-1β, IL-12P70, and GM-CSF secreted by the virus infection group （48 h） were higher than those of the control group （48 h）, and the level of TNF-α secreted by the virus infection group （72 h） was higher than that of the control group （72 h） （P <0.05 or P <0.01）. Conclusion SH-SY5Y cells infected with ZIKV resulted in the decrease in cell viability and the secretion of relatively high concentration of pro-inflammatory cytokines in a time-dependent manner.

Objective To investigate the adherence to antiretroviral therapy （ART） and its influencing factors among HIV/AIDS patients. Methods A questionnaire survey was conducted among HIV/AIDS patients undergoing ART in Huangpu District, Guangzhou. The survey content included self-made questionnaire, multidimensional scale of perceived social support, and visual analogue scale. Univariate and multivariate logistic regressions were used to determine factors associated with ART adherence. Results A total of 205 valid questionnaires were collected. The average age of the respondents was （35.79 ± 10.66） years. Of all the respondents, 183 （89.3%） were males, 102 （49.8%） unmarried, 93 （45.4%） had occupations of workers or migrant workers, 81 （39.5 %） were college graduates or above, and 121 （59.0%） were infected through homosexual transmission. The adherence to ART was good at 75.6%, of which 21.5% had an on-time medication rate of 90% -94%. The HIV/AIDS patients aged 25-39 years （OR=0.28）, with occupations of worker/migrant worker, others （unemployed, student, etc.） （OR=0.13, 0.13）, the latest CD4 count ≥350 / μL and 500/ μL（OR=0.34, 0.13）, and intermediate social support status （OR=0.24） had poor adherence to ART. Those who persisted in taking medicines regime to prolong life （OR=5.15） and were satisfied with the service of follow-up doctors （OR=3.90） had better adherence to ART. Conclusion The adherence to ART was moderate for the HIV/AIDS patients in Huangpu District and influenced by many factors. Active intervention measures should be taken to improve the adherence to ART.

Objective To survey the status and influencing factors of sub-health in the medical staff, so as to provide scientific basis for the prevention and treatment of sub-health. Methods An equal proportion stratified random sampling method was adopted to investigate the sub-health status of the medical staff in Jinshan District, Shanghai from July to September 2017. Data were analyzed by univariate and multivariate logistic regressions. Results A total of 628 valid questionnaires were included, the average age of the subjects was （34.55 ± 9.14） years old, and the male-to-female sex ratio was 2.2∶1. Of the participants, the detection rate of sub-health was 47.9% （301/ 628）, the rates in tertiary hospitals, secondary hospitals, community health service centers and centers for disease prevention and control were 55.8%, 48.7%, 37.7%, and 50.0% respectively（P<0.05）. Multivariate logistic regression showed that medical personnel in Jinshan District aged 30-39,40-49 and ≥50 years （OR=0.470, 0.468, 0.163） were less likely to have sub-health, while those who were ethnic minorities（OR=10.670）, married seperalion or widowed （OR=13.070, 47.807）, had depressed mood and depression lasting for more than one week in recent three months （OR=2.578）, never ate regularly （OR=5.218）, had poor sleep quality （OR=2.873）, worked more than 40 hours a week （OR=2.717）, and had high working stress （OR=2.099, 3.760） were more likely to have sub-health. Conclusions The sub-health detection rate of medical staff in Jinshan District, Shanghai was relatively high and affected by many factors. Corresponding intervention measures should be taken according to the risk factors.