Emotional symptoms have emerged as a major public health concern, affecting the mental and physical well-being of college students worldwide. Negative life events and mental health literacy are commonly recognized as significant predictors of emotional symptoms. However, research on their combined effects remains limited, particularly in longitudinal studies. This study aimed to investigate the interaction between negative life events and mental health literacy in relation to emotional symptoms among college students. A longitudinal study was conducted from November 2021 to June 2022 to assess negative life events, mental health literacy, and emotional symptoms among college students. A total of 3,210 students (mean age: 19.49 ± 0.87 years) were selected using a cluster sampling method in Anhui Province, China. Multivariate logistic regression models were employed to evaluate the combined effects of negative life events and mental health literacy on emotional symptoms. The prevalence of depressive symptoms, anxiety symptoms, and stress symptoms was 15.3

Background: Problematic smartphone usage (PSU) and mental health literacy (MHL) are potential factors to psychological problems, but interactive and mediate effects in this association remains unclear. This study aimed to examine whether MHL mediate associations of PSU with depression, anxiety, and their comorbidity, and the extent of interaction of PSU and MHL with psychological problems in Chinese college students. Methods: Pooled longitudinal data of 6879 participants was collected between November 2019 and June 2020 to assess the MHL, PSU, depression, and anxiety of college students in Anhui province, China. Mediation analyses and multiple logistic regression models were conducted to explore potential associations. Results: PSU was significantly was positively correlated with depression, anxiety, and their comorbidity, and this association mediated by MHL with the mediation ratio of 4.29 %, 5.86 % and 5.00 %, respectively. Furthermore, students with PSU and inadequate MHL had the highest risk of depression (RR = 4.041, 95 % CI: 3.132–5.214), anxiety (RR = 2.759, 95 % CI: 1.954–3.894), and their comorbidity (RR = 3.805, 95 % CI: 2.592–5.584). Limitations: Retrospective design may introduce recall bias. Conclusions: These findings underscore the vulnerability of individuals with PSU and inadequate MHL to longitudinal risks of experiencing depression, anxiety, and their comorbidity. And MHL mediating the association between PSU and psychological problems. In light of these results, interventions aimed at reducing the incidence and progression of mental health issues among college students should prioritize strategies for decreasing smartphone usage and enhancing MHL.

Metabolic-associated fatty liver disease (MAFLD) encompasses various chronic liver conditions, yet lacks approved drugs. Hypoxia-inducible factor-1α (HIF-1α) is pivotal in MAFLD development. Our prior research highlighted the efficacy of the nano-designed carbon monoxide (CO) donor, targeting HIF-1α in a mouse hepatic steatosis model. Given heme oxygenase-1 (HO-1, a major downstream molecule of HIF-1α) as the primary source of intrinsic CO, we hypothesized that upregulation of HO-1/CO, responsive to HIF-1α, forms a negative feedback loop regulating MAFLD progression. In this study, we explored the potential negative feedback mechanism of CO on HIF-1α and its downstream effects on MAFLD advancement. HIF-1α emerges early in hepatic steatosis induced by a high-fat (HF) diet, triggering increased HO-1 and inflammation. SMA/CORM2 effectively suppresses HIF-1α and steatosis progression when administered within the initial week of HF diet initiation but loses impact later. In adipose tissues, concurrent metabolic dysfunction and inflammation with HIF-1α activation suggest adipose tissue expansion initiates HF-induced steatosis, triggering hypoxia and liver inflammation. Notably, in an in vitro study using mouse hepatocytes treated with fatty acids, downregulating HO-1 intensified HIF-1α induction at moderate fatty acid concentrations. However, this effect diminished at high concentrations. These results suggest the HIF-1α-HO-1-CO axis as a feedback loop under physiological and mild pathological conditions. Excessive HIF-1α upregulation in pathological conditions overwhelms the CO feedback loop. Additional CO application effectively suppresses HIF-1α and disease progression, indicating potential application for MAFLD control.

Social anxiety symptoms are common and harmful psychological illness in college students. Although some studies have illustrated that physical activity could reduce social anxiety symptoms, the specific mechanism is still unclear. Based on theoretical studies on resilience and sleep, this study constructed a serial mediation model to explore whether they mediate between physical activity and social anxiety symptoms among college students. This study surveyed 9,530 college students from three colleges in China to explore the mediating effect of physical activity and sleep problems between physical activity and social anxiety symptoms. Participants were investigated with the International Physical Activity Questionnaire, Connor-Davidson Resilience Scale, Sleep-related problems, and the Social Interaction Anxiety Scale and the Social Phobia Scale. Correlations between variables were analysed using Pearson correlation analysis and mediation analyses were performed using SPSS PROCESS macro 3.3 software. The study found that physical activity was negatively associated with social anxiety symptoms and sleep problems, but positively with psychological resilience. After controlling for sociodemographic variables, physical activity can not only indirectly alleviate social anxiety symptoms through the separate mediation of psychological resilience and sleep problems, but also through the serial mediation of psychological resilience and sleep problems. These results suggest that improving physical activity levels could reduce social anxiety scores by increasing psychological resilience and sleep quality. This is of great reference significance for the prevention and intervention of college students’ mental health.

Metabolic-associated fatty liver disease (MAFLD) is one of the major classes of chronic liver diseases including steatohepatitis, cirrhosis, and liver cancer. However, currently no drugs are approved for MAFLD. Hypoxia-inducible factor-1α (HIF-1α) has been recognized as an early critical element in the development of MAFLD. Our previous studies indicated that the nano-designed carbon monoxide (CO) donor styrene maleic acid copolymer (SMA) micelle-encapsulating CO-releasing molecule (SMA/CORM2) achieved a potent protective effect in many inflammatory diseases in which suppression of HIF-1α plays an essential role. In this context, here we challenged the application of SMA/CORM2 for MAFLD in a high-fat methionine- and choline-deficient (HF-MCD) diet in the mouse hepatic steatosis model. We found marked lipid accumulation in the liver after feeding the HF-MCD diet for 4 weeks, accompanied by dysfunction of lipid metabolism, macrophage polarization toward the pro-inflammatory M1 phenotype, activation of the NLRP3 inflammasome, and activation of the TFGβ fibrosis signaling pathway. Up-regulation of HIF-1α is the early and upstream event of these pathological changes. Administration of SMA/CORM2 (10 mg/kg, three times per week) induced the significant increase of CO levels in the circulation and the liver, resulting in remarkable suppression of the HIF-1α expression from soon after the HF-MCD diet was eaten when the pathological changes were not apparently seen. Consequently, a significantly protective and therapeutic effect was achieved by SMA/CORM2 treatment. An invitro study with hepatocytes treated with a high concentration of fatty acids showed similar results, and knockdown of HIF-1α by using short hairpin RNA (shRNA) produced similar effects as SMA/CORM2. These findings suggest that the CO-HIF-1 axis may become a new therapeutic target for MAFLD, and we anticipate applications of SMA/CORM2 in the future.

BACKGROUND:Bullying victimization (BV) is a potential factor to sleep quality, but the role of BV characteristics in this association remains unclear. This study aimed to investigate correlation between the timing, duration, and patterns of BV and sleep quality among Chinese medical students. METHODS:4035 participants (mean age of 19.2 ± 1.0) were recruited. BV patterns from pre-school to college were estimated using latent class analysis. Multinomial logistic regression was conducted to evaluate the odds ratio (OR) and 95 % confidence interval (CI) between sleep quality and BV. E values were used to assess unmeasured confounding. RESULTS:Three patterns of BV were identified as follows: persistent BV (6.2 %), moderate BV (10.5 %), and low BV (83.3 %). BV during pre-school, elementary school, junior high school, senior high school, and college were all positively associated with poor sleep quality. The ORs were 2.30 (1.43-3.70), 3.00 (2.28-3.95), 2.71 (2.14-3.43), 3.34 (2.57-4.33) and 4.13 (3.19-5.36), respectively. The E value were 4.03 (2.21-NA), 5.45 (3.99-NA), 4.86 (3.70-NA), 6.14 (4.58-NA), 7.73 (5.83-NA), respectively. Those who experienced more periods of BV were more strongly associated with poor sleep quality, presenting a dose-response relationship [OR = 1.78, 95 % CI: 1.63-1.95, E value: 2.96 (2.64-NA)]. Those who experienced moderate BV [OR = 2.58, 95 % CI: 1.99-3.35; E value: 4.60 (3.39-NA)] and persistent BV [OR = 4.01, 95 % CI: 2.95-5.46; E value: 7.48(5.35-NA)] had higher odds of poor sleep quality. LIMITATIONS:Retrospective design may introduce recall bias. CONCLUSION:BV was positively related to poor sleep quality and chronic exposure to BV had a cumulative effect on poor sleep quality.

Acetaminophen (APAP) overdose-induced hepatotoxicity is the most common cause of acute liver failure. Excessive generation of reactive oxygen species (ROS) and inflammatory responses are the major causes of necrosis and/or necroptosis of the liver cells. Currently, the treatment options for APAP-induced liver injury are very limited, N-acetylcysteine (NAC) is the only approved drug to treat APAP overdose patients. It is of great necessity to develop new therapeutic strategies. In a previous study, we focused on the anti-oxidative, anti-inflammatory signal molecule carbon monoxide (CO), and developed a nano-micelle encapsulating CO donor, i.e., SMA/CORM2. Administration of SMA/CORM2 to the mice exposed to APAP significantly ameliorated the liver injury and inflammatory process, in which modulating macrophage reprogramming plays a critical role. Along this line, in this study, we investigated the potential effect of SMA/CORM2 on toll-like receptor 4 (TLR4) and high mobility group protein B1 (HMGB1) signaling pathways that are known to be closely involved in many inflammatory responses and necroptosis. In a mouse APAP-induced liver injury model, similar to the previous study, SMA/CORM2 at 10 mg/kg remarkably improved the condition of the liver after injury as evidenced by histological examination and liver function. During the process of liver injury triggered by APAP, TLR4 expression gradually increased over time, and it was significantly upregulated as early as 4 h after APAP exposure, whereas, an increase of HMGB1 was a late-stage event. Notably, SMA/CORM2 treatment suppressed significantly both TLR4 and HMGB1, consequently inhibiting the progression of inflammation and liver injury. Compared to CORM2 without SMA modification (native CORM2) of 1 mg/kg that is equivalent to 10 mg/kg of SMA/CORM2 (the amount of CORM2 in SMA/CORM2 is 10% [w/w]), SMA/CORM2 exhibited a much better therapeutic effect, indicating its superior therapeutic efficacy to native CORM2. These findings revealed that SMA/CORM2 protects against APAP-induced liver injury via mechanisms involving the suppression of TLR4 and HMGB1 signaling pathways. Taking together the results in this study and previous studies, SMA/CORM2 exhibits great therapeutic potential for APAP overdose-induced liver injury, we thus anticipate the clinical application of SMA/CORM2 for the treatment of APAP overdose, as well as other inflammatory diseases.

Abstract Background Suicide is a major public health problem as the second leading cause of death for adolescent. Inadequate mental health literacy (MHL) and psychological symptoms are risk factors of suicidal behaviors. But so far, no study has examined the interactive role of MHL and psychological symptoms in suicidal behaviors. In this context, the purpose of this study was to examine the independent and interactive association of MHL and self-reported psychological symptoms with suicidal behaviors in Chinese middle school students. Methods A total of 16 853 middle school students were recruited from October 2020 to June 2021. Psychological symptoms, MHL and suicidal behaviors were measured by self-reported validated instruments. Logistic regression models were conducted to examine relations between them. Results The prevalence of suicidal ideation, suicidal plan and suicidal attempt were 31.3%, 16.3% and 7.5%, respectively, Inadequate MHL was significantly associated with suicidal ideation, suicidal plan and suicidal attempt [ OR (95% CI) was 1.100 (1.018–1.189), 1.246 (1.125–1.380), 1.739 (1.488–2.033)]. Psychological symptoms were significantly related with suicidal ideation, suicidal plan and suicidal attempt [ OR (95%CI) was 4.749 (4.268–5.284), 5.463 (5.069–6.283), 5.970 (5.236–6.806)]. Furthermore, psychological symptoms and inadequate MHL were interactively associated with increased risks of suicidal behaviors. Conclusions These finding indicated that Chinese middle school students having psychological symptoms and inadequate MHL are at risk of exhibiting suicidal behaviors. Enhancing MHL and attenuating the severity of psychological symptoms should be considered and involved in the development of early intervention programs for suicide.

Background The impact of childhood maltreatment on multiple inflammatory cytokines among middle school students remains to be elucidated. This study aimed to examine the associations of different types of childhood maltreatment with peripheral serum inflammatory cytokines (interleukin-10, interleukin-1β, interleukin-6, interleukin-8, and tumor necrosis factor-α) in middle school students, and to explore the differences in these associations between boys and girls and between late (≥15 and<20 years) and early (≥11 and <15 years) adolescence. Methods A total of 1122 students were recruited from a boarding middle school. Each participant was asked to respond to a detailed questionnaire on childhood maltreatment, from whom one blood sample was drawn via venous blood. Results In the overall sample there was no association between childhood maltreatment and peripheral serum inflammatory cytokines; (2) emotional abuse was significantly correlated with IL-1β only in girls (B = -0.16; 95% CI, -0.28~-0.03; p = 0.06); (3) in late adolescence, emotional abuse, emotional neglect, and childhood maltreatment had marked link with IL-8 (B = 0.39; 95%CI, 0.16~0.63; p = 0.01; B =0.20; 95% CI, 0.04~0.37; p = 0.08; B = 0.50; 95% CI, 0.18~0.82; p = 0.01, respectively). Conclusion These findings also strengthened an inference regarding the effects of childhood maltreatment on inflammation of students in late adolescence.

Metabolic-associated fatty liver disease (MAFLD) encompasses a spectrum of chronic liver diseases, in-cluding steatohepatitis, cirrhosis, and liver cancer. Despite the increasing prevalence and severity of MAFLD, no approved pharmacological interventions are currently available. Hypoxia-inducible factor-1 alpha (HIF-1 alpha) has emerged as a crucial early mediator in the pathogenesis of MAFLD. Previously, we demon-strated the potent anti-inflammatory properties of the nano-designed carbon monoxide (CO) donor, styrene maleic acid copolymer (SMA) encapsulating CO-releasing molecule (SMA/CORM2), which effec-tively suppressed HIF-1 alpha in various inflammatory disorders. Here, we investigated the therapeutic poten-tial of SMA/CORM2 in a mouse model of MAFLD induced by a high-fat methionine-and choline-deficient (HF-MCD) diet. Following 4 weeks of HF-MCD diet consumption, we observed pronounced hepatic lipid accumulation accompanied by disrupted lipid metabolism, polarization of macrophages towards the pro-inflammatory M1 phenotype, activation of the NLRP3 inflammasome, and upregulation of the TGF-beta fi-brosis signaling pathway. Notably, the early and upstream event driving these pathological changes was the upregulation of HIF-1 alpha. Treatment with SMA/CORM2 (10 mg/kg, three times per week) led to a signif-icant increase in CO levels in both the circulation and liver, resulting in remarkable suppression of HIF-1 alpha expression even before the onset of apparent pathological changes induced by the HF-MCD diet. Conse-quently, SMA/CORM2 administration exerted a significantly protective and therapeutic effect on MAFLD. In vitro studies using hepatocytes treated with high concentrations of fatty acids further supported these findings, as knockdown of HIF-1 alpha using short hairpin RNA (shRNA) elicited similar effects to SMA/CORM2 treatment. Collectively, our results highlight the therapeutic potential of SMA/CORM2 in the management of MAFLD through suppression of HIF-1 alpha. We anticipate that SMA/CORM2, with its ability to modulate HIF-1 alpha expression, may hold promise for future applications in the treatment of MAFLD.Statement of significance Carbon monoxide (CO) is a crucial gaseous signaling molecule that plays a vital role in maintaining homeostasis and is a potential target for treating many inflammatory diseases. Developing drug delivery systems that can deliver CO stably and target specific tissues is of great interest. Our team previously de-veloped a nano micellar CO donor, SMA/CORM2, which exhibits superior bioavailability to native CORM2 and shows therapeutic potential in many inflammatory disease models. In this study, we showed that SMA/CORM2, through controlled CO release, significantly ameliorated steatohepatitis and liver fibrosis induced by an HF-MCD diet by suppressing an HIF-1 alpha mediated inflammatory cascade. These findings provide new insight into the anti-inflammatory function of CO and a promising approach for controlling metabolic-associated fatty liver disease.(c) 2023 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

BACKGROUND:Non-suicidal self-injury is a heavy burden on affected college students with rippling effects throughout their lives. Childhood maltreatment is strongly associated with non-suicidal self-injury among college students. However, it remains unclear whether perceived family economic status and social phobia exert significant moderating effects on the relationship between childhood maltreatment and non-suicidal self-injury. OBJECTIVE:This study aimed to identify the perceived family economic status and social phobia moderating the association between childhood maltreatment and non-suicidal self-injury. PARTICIPANTS AND SETTING:This study used data (N = 5297) from two local medical colleges in Anhui province, China. METHODS:Respondents completed questionnaires on childhood maltreatment, non-suicidal self-injury, social phobia and perceived family economic status online. Data were analyzed using Spearman's correlation followed by multiple moderation models. RESULTS:The association between childhood maltreatment and non-suicidal self-injury was moderated by social phobia (β = 0.03, p < 0.05) and perceived family economic status (β = -0.30, p < 0.05). When considered together, both factors were found to play synergistic roles in the association between childhood maltreatment and non-suicidal self-injury in college students (β = 0.08, p < 0.001). CONCLUSION:Our findings highlight that experience of childhood maltreatment, elevated social phobia, and low perceived family economic status increase the risk of non-suicidal self-injury. Future researches are recommended to conduct interventions from a more holistic perspective and integrate perceived family economic status as a relevant factor along with social phobia in coping with non-suicidal self-injury in college students.

Abstract Background Problematic mobile phone use (PMPU) is becoming increasingly popular and has serious harmful effects on physical and mental health among adolescents. Inadequate health literacy (HL) is related to some risky behaviors and mental health problems in adolescents. Nevertheless, few studies have explored the relationship between HL and PMPU and the gender difference in the relationship among Chinese adolescents. The aim of this study was to examine the associations between HL and PMPU and explore gender difference in the associations. Methods A total of 22,628 junior and senior high school students (10,990 males and 11,638 females) in 6 regions of China participated in this study. HL and PMPU were measured by self-report validated questionnaires. Chi-square tests and logistic regression analysis were conducted in the study. Results Logistic regression analysis showed that students with inadequate HL are likely to have PMPU (OR = 2.013, 95% CI: 1.840–2.202), and different degrees of association can be seen in six dimensions. Besides, in both males and females, students with inadequate HL had a higher risk of PMPU (OR male = 1.607, 95% CI: 1.428–1.807; OR female = 2.602, 95% CI: 2.261–2.994). Regarding the gender difference, the results showed that males had more PMPU than females, and the difference was more significant for students with adequate HL than those with inadequate HL (OR inadequate = 1.085, 95% CI: 1.016–1.159; OR adequate = 1.770, 95% CI: 1.490–2.101). Similarly, there were associations in the six dimensions. Conclusions HL decreases PMPU, and males have a higher risk of PMPU than females. These findings suggest a reasonable strategy to reduce PMPU by improving the HL level of adolescents.

BackgroundExposure to persistent bullying victimization across multiple periods results in a high risk of worse consequences. Although amples studies support the association between bullying victimization and symptoms of anxiety and depression, whether mental health literacy can serve as a moderator on this relationship remains unknown. Therefore, the aim of this study was to examine the patterns of bullying victimization across the life course, and disentangle the moderating effect of mental health literacy between bullying victimization patterns and symptoms of anxiety and depression in Chinese college students.MethodsA total of 4036 college students were enrolled by cluster sampling from November 2020 to January 2021. Bullying victimization, mental health literacy, and symptoms of anxiety and depression were measured by self-report validated questionnaires. A latent class analysis was applied to identify bullying patterns. The PROCESS program was conducted to analyze whether mental health literacy moderates the link between bullying victimization patterns and symptoms of anxiety and depression.ResultsThree latent patterns of bullying victimization were identified as follows: persistent bullying pattern (6.2%), moderate bullying pattern (10.5%), and low bullying pattern (83.3%). Logisitic regression analysis of anxiety and depressive symptoms indicated that compared with low bullying pattern, persistent bullying pattern had the highest risk. Specifically, mental health literacy moderated the association between bullying victimization pattern and anxiety symptoms (B = -0.039, P < 0.05).ConclusionsIt is important for practitioners to examine bullying victimization across the life course concurrently rather than a single period in isolation. Interventions and research should enhance mental health literacy to improve the mental health in college students with a history of bullying victimization.

Objective: To analyze the association between exposure patterns of adverse childhood experiences (ACEs) and anxiety symptom trajectories in medical college students. Methods: A survey was conducted on first-year students from Anhui Medical College and Anqing Medical College, using the Childhood Abuse Questionnaire, Family Disability Questionnaire, Childhood Adverse Social Experience Item, and Anxiety Self Rating Scale. The baseline survey was conducted from November to December 2019, and two follow-up visits were conducted once every six months until November to December 2020. The latent class analysis (LCA) was used to analyze the exposure patterns of ACEs. The latent class growth analysis (LCGA) was used to analyze the development trajectory of anxiety symptoms. The multiple logistic regression model was used to analyze the correlation between different exposure patterns of ACEs and the trajectory of anxiety symptom trajectories. Results: A total of 3 662 college students aged (19.2±1.0) were surveyed. The LCA showed that the exposure patterns of ACEs could be divided into the "high ACEs" group (13.4%), "high neglect/emotional abuse" group (25.7%), "high family dysfunction" group (6.9%), "high neglect" group (27.1%), and "low ACEs" group (26.3%). The LCGA divided anxiety trajectories into four groups: "high anxiety decline" (7.1%),"anxiety increase "(4.1%), "moderate anxiety"(52.9%), and "low anxiety"(35.9%). Using the low ACEs group as a reference group, compared with the low anxiety trajectory, the high ACEs group, high neglect/emotional abuse group, high family dysfunction group, high neglect group, and medium to high-level anxiety trajectory were all associated with an increased risk (P<0.05). Conclusion: There is heterogeneity in ACEs exposure patterns among medical college students, and ACEs exposure patterns are important influencing factors for anxiety symptom trajectories.

Background: Health literacy is associated with mental disorders in adolescents. This study aimed to examine the associations between health literacy, depressive symptoms, and suicide-related outcomes. Methods: In terms of participants, 937 middle school students in Shenyang City, China were enrolled between December 2018 and December 2019 to assess health literacy, depressive symptoms and suicide-related out-comes. Multiple logistic regression models were used to examine possible associations. Results: Adequate health literacy was negatively associated with 12-month follow-up depressive symptoms (RR = 0.115, 95 % CI: 0.032-0.411) and suicide-related outcomes (RR = 0.230, 95 % CI: 0.085-0.618) in females. Meanwhile, in females, interpersonal relationship, stress management, and self-actualization were negatively related to depressive symptoms, while physical activities, self-actualization, and health awareness are protective factors for suicide-related outcomes (P < 0.05 for each). Limitations: Recall and reporting bias might be inevitable for self-reported data, and due to the small sample size, the predictive effect may not be very significant. Conclusions: These findings suggest that adequate health literacy may serve as a critical and independent pro-tective factor for poor long-term mental health outcomes and that the predictive effect is more pronounced in female students. Public health efforts to enhance health literacy levels are required to maintain and improve adolescents' mental health outcomes.

This study aimed to examine the association between childhood maltreatment, parent-child relationship quality with psychological symptoms and to explore the moderating role of parent-child relationship quality in the association between childhood maltreatment and psychological symptoms among adolescents. It also probed to the role of gender differences in this effect. A representative sample of 14,500 middle school students in China were asked to complete a standard questionnaire on the details of childhood maltreatment, parent-child relationship quality, and psychological symptoms. All data were analyzed using SPSS 23.0. The PROCESS program was used to analyze whether parent-child relationship quality moderated the link between childhood maltreatment and psychological symptoms. The analyses revealed significant correlations between childhood maltreatment, parent-child relationship quality, and psychological symptoms (p < .001). Specifically, paternal relationship quality moderated the association between childhood maltreatment and psychological symptoms in the total sample (B = -0.01, p < .05) and the subgroup of girls (B = -0.01, p < .05), while maternal relationship quality moderated only the association between childhood maltreatment and psychological symptoms in the subgroup of boys (B = -0.01, p < .05). As the findings indicate, priority should be given to the quality of parent-child relationship and gender-specific methods employed to effectively reduce the psychological symptoms of adolescents with a history of childhood maltreatment.

OBJECTIVE:The aim of this paper is to understand the relationship between patterns of adverse childhood experiences(ACEs), screen time and non-suicidal self-injury behaviors(NSSI) among middle school students.METHODS:Stratified cluster sampling method was used to select 14 500 middle school students(7347 boys and 7153 girls; 7247 junior high school students and 7253 senior high school students; 7619 urban students and 6881 rural students) from Shenzhen, Guiyang, Nanchang and Zhengzhou Cities. Questionnaire surveys were conducted using the child abuse questionnaire, household dysfunction questionnaire, non-suicidal self-injury behavior questionnaire and screen time items. The latent class analysis was used to evaluate the ACEs exposure patterns, and multivariable logistic regressions was used to analyze the association between patterns of ACEs, screen time levels and their combined effects with NSSI.RESULTS:Latent class analysis indicated four distinct patterns of ACE exposure: highly ACEs group(6.3%), highly abuse and neglect group(21.4%), lowly ACEs group(26.8%), highly neglect group(45.5%). Those in highly ACEs(OR=4.65, 95%CI 3.73-5.80), highly abuse and neglect(OR=3.43, 95%CI 2.91-4.06) and highly neglect(OR=1.31, 95%CI 1.11-1.55) group had significantly higher risk of NSSI compared with those in lowly ACEs group(P&lt;0.001). In study days(OR=1.72, 95%CI 1.42-2.08) and weekends(OR=1.42, 95%CI 1.27-1.60), high screen time were associated with increased rate of NSSI(P&lt;0.01). There showed a trend toward increased risk of NSSI with increasing ACEs exposure and screen time level(P&lt;0.05).CONCLUSION:High ACEs exposure patterns and high screen time are associated with increased rate of NSSI. Reducing ACEs exposure and controlling screen time is beneficial to the prevention and control of NSSI in middle school students.

Di (2-ethyl-hexyl) phthalate (DEHP) is a wildly used plasticizer. Maternal exposure to DEHP during pregnancy blocks the placental cell cycle at the G2/M phase by reducing the efficiency of the DNA repair pathways and affects the health of offsprings. However, the mechanism by which DEHP inhibits the repair of DNA damage remains unclear. In this study, we demonstrated that DEHP inhibits DNA damage repair by reducing the activity of the DNA repair factor recruitment molecule PARP1. NAD(+) and ATP are two substrates necessary for PARP1 activity. DEHP abated NAD+ in the nucleus by reducing the level of NAD(+ )synthase NMNAT1 and elevated NAD+ in the mitochondrial by promoting synthesis. Furthermore, DEHP destroyed the mitochondrial respiratory chain, affected the structure and quantity of mitochondria, and decreased ATP production. Therefore, DEHP inhibits PARP1 activity by reducing the amount of NAD(+ )and ATP, which hinders the DNA damage repair pathways. The supplement of NAD(+) precursor NAM can partially rescue the DNA and mitochondria damage. It provides a new idea for the prevention of health problems of offsprings caused by DEHP injury to the placenta.

心理健康素养是改善心理问题的重要途径,其作为重要的心理健康资源,近年来备受关注.提高对心理健康素养的认识,制定适宜的干预措施,开发能更好预测人群心理健康状况的标准化评定量表,可推动我国心理健康素养研究、监测和干预的发展.本文通过对国内外心理健康素养对心理问题的影响研究进行综合阐述,以便为促进我国居民的心理健康发展提供参考.