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Background Overweight and obesity rates have increased rapidly in Chinese school-age children, and previous studies have indicated that poor dietary literacy can lead to unhealthy eating behaviours. However, few studies have investigated the association between the dietary literacy of daily diet providers and the eating behaviours and nutritional status of school-age children raised by the providers. Thus, we aimed to explore this association. Methods We collected data on the eating behaviours and nutritional status of children in two primary schools in Anhui Province, as well as the dietary literacy of their daily diet providers. T-tests, one-way ANOVA, chi-square tests, and multiple linear regression were used to analyse the association. Results We found significant differences in the scores on the Questionnaire of Children's Daily Diet Providers' Dietary Literacy (QCDDPDL) by region, relationship with the child, age, and educational level of the daily diet provider (all p p p = .006). Conclusions Our study showed that the dietary literacy of diet providers may influence children's health and eating behaviours. Improving the dietary literacy of diet providers may promote the health status and eating behaviours of school-age children.

BackgroundSelf-harm (SH) increases significantly in early adolescence with great variability, and childhood maltreatment (CM) contributes to this increase. Understanding the developmental pathway from CM to SH could provide clues for SH prevention. This study used latent class analysis (LCA) to detect the phenotype of SH and explored the role of psychological resilience in the pathway from the CM to SH phenotype.MethodsA cross-sectional study was conducted with 5724 early adolescents from three middle schools in Anhui Province, China. We categorized SH into five subtypes based on their severity and further explored SH phenotypes by LCA to detect the heterogeneity of SH. Moreover, a path model was performed to test the mediation of resilience in the CM-SH association.ResultsThe prevalence rates of highly lethal SH, less lethal SH with visible tissue damage, SH without visible tissue damage, self-harmful behaviours with latency damage and psychological SH were 10.2%, 25.8%, 35.5%, 20.8% and 28.2%, respectively. Three interpretable phenotypes of SH were identified: low SH (57.8%), medium SH (29.0%), and high SH (13.2%). Furthermore, CM was positively associated with the SH phenotype, psychological resilience mediated the association between CM and the SH phenotype (all ps < 0.01), and a larger mediating effect was observed in the medium SH (22.41%).ConclusionsOur findings offer new perspectives that improving psychological resilience can be used as an efficient intervention to reduce the risk of SH among early adolescents who have experienced CM.

Increasing evidence suggests that immunological disturbances and abnormalities in axonal myelination are involved in the pathophysiology of autism spectrum disorder (ASD). The present study aimed to determine the role of cytokines in myelin damage in Chinese children with ASD and the role of cytokine dysregulation, myelin damage, and cytokine polymorphisms in ASD in Chinese children. The present case-control study included 98 ASD subjects and 252 typically developing (TD) controls; the levels of serum cytokines and myelin basic protein (MBP) were determined using enzyme-linked immunosorbent assay. Cytokine polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis. Autistic clinical manifestations were assessed by the Childhood Autism Rating Scale (CARS). The results showed that serum levels of interleukin (IL)-1β, IL-2R, IL-6, IL-8, and MBP were higher in children with ASD compared with those in TD children. In individuals with ASD, serum MBP level was significantly positively associated with the CARS total score, and serum levels of IL-1β, IL-2R, IL-6, and MBP demonstrated positive correlations. The data identified IL-6*MBP as a factor that influenced the risk of ASD, and IL-2R*MBP was identified as a factor that influenced symptom severity, which influenced auxiliary diagnosis of ASD. The presence of the interleukin-6-572CC genotype was associated with significantly higher serum levels of IL-6 and MBP but did not influence the risk and symptom severity of ASD. Therefore, the results suggested inflammatory responses and myelin damage in Chinese children with ASD. Cytokine dysregulation influenced myelin damage in ASD; moreover, the interactions of the cytokines and myelin damage influenced the risk and symptom severity of ASD. The IL-6-572C/G genotypes may be associated with myelin damage in ASD by influencing the circulating level of IL-6.

Child sexual abuse (CSA) has been recognized as a risk factor for sexual dysfunction and has attracted increasing attention. However, controversies remain regarding related research. The aim is to calculate the pooled effect size estimate for the correlation between CSA and sexual dysfunction in adults by meta-analysis. Five bibliographic databases (PubMed, Cochrane Library, Web of Science, Embase, and PsycINFO) were comprehensively searched to clarify the association between CSA and sexual dysfunction in adults. We used a fixed-effects model to determine the total pooled effect size estimate and reported odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Subgroup analysis, publication bias analysis, and sensitivity analysis were conducted. Adults who had a history of CSA experienced a higher proportion of sexual dysfunction than adults with no history of CSA (OR = 1.68, 95% CI [1.49, 1.87]). Subgroup analysis showed that women with a history of CSA reported a higher proportion of sexual dysfunction than men with a history of CSA (men: OR = 1.45, 95% CI [1.05, 1.84]; women: OR = 1.62, 95% CI [1.42, 1.83]). The estimates of the effect sizes differed substantially depending on the CSA and sexual dysfunction instruments that were used in each study and the region of each sample. This meta-analysis provides conclusive evidence of an association between CSA and sexual dysfunction in adults. Currently known interventions for the treatment of sexual dysfunction after CSA have only been evaluated in women, so specific interventions should be designed for men CSA survivors who experience sexual impairment.

Background A certain link between sexual abuse (SA) victimization and suicidal behaviors has been confirmed, but it remains unclear whether this association varies with regard to SA characteristics and gender. Methods Participants were 4034 college students drawn from a cross-sectional study conducted in Hefei, China. Gender-stratified latent class analysis (LCA) and logistic regression models were used to examine the relationships between timing, duration, types and patterns of SA victimization and suicidal behaviors. Results For the males, SA in the elementary school or earlier period was associated with suicidal ideation (OR: 3.29, 95%CI: 2.20-5.38), plans (OR: 3.44, 95% CI: 1.54-7.77) and preparations (OR:3.05, 95% CI: 1.19-7.74). All types of SA were significantly associated with the four types of suicidal behaviors. Dose-response relationship and cumulative effect were found between duration, types of SA victimization and suicidal behaviors. Three latent classes of SA victimization were identified for males and females, respectively. For males, the “moderate SA” class and “persistent SA” class were associated with the four types of suicidal behaviors. For the females, SA during the university period was associated with suicidal ideation (OR: 2.47, 95% CI: 1.24-4.93). Only suicidal ideation was associated with the “moderate SA” class. Limitations The cross-sectional survey design did not allow to conclude any causality. Conclusions The relationship between SA victimization and suicidal behaviors varies in terms of SA victimization characteristics and the relationships were stronger in males than in females.

Adolescent homicide rates have aroused global concern and better understanding of factors relating to homicidal ideation is critical. This study aimed to explore the correlates of homicidal ideation in a cross-sectional school-based sample of Chinese early adolescents.The data were obtained from the cross-sectional project 'Health and Risky Behaviors among Middle School Students in Anhui Province, China', which was conducted in November 2020. The entire sample of 5724 middle school students who completed the questionnaires was included in the present study. Network analysis was employed to examine the correlates of homicidal ideation at three levels: individual (sex, academic performance, childhood trauma, aggression, anxiety, severe physical illness), family (family economic status, family violence, parental crime, parental mental illness, relationship with father, relationship with mother), and school (school-bullying victimization and perpetration, relationship with classmates, teacher support). Additionally, sensitivity analyses were performed to evaluate sex differences.In the whole sample, 11.7 % of students reported homicidal ideation in the past six months. Network analyses revealed that individual-level (childhood maltreatment, aggression and anxiety) and school-level (teacher support, school-bullying victimization and perpetration) factors were associated with homicidal ideation. Sensitivity analyses showed that homicidal ideation was associated with academic performance and school-bullying victimization in boys but not in girls, although the sex differences were not significant.The cross-sectional design of this study limited the inference of causality.This study identified some correlates of homicidal ideation and provided some novel insights into homicide prevention and intervention in Chinese early adolescents.

To present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China.Totally, 5,726 adolescents aged 12-18 years were investigated about their ACEs in the family, peer, school, and personal domains and the occurrence of six types of risky health behaviors (i.e., smoking, drinking, sexual intercourse, self-harm, and suicidal ideation and attempts). Latent class analysis (LCA) was used to explore the ACE patterns.Six latent classes of ACEs were identified, including low adversity, school adversity, school adversity and peer victimization, peer victimization, maltreatment and peer victimization, and high adversity, and associated with risky health behaviors in adolescents. Being physically punished by a teacher, experiencing sexual abuse, and experiencing family trauma most strongly differentiated from the six ACE classes and were correlated with an increased risk for risky adolescent health behaviors.This study supports a positive association between ACEs and risky adolescent health behaviors. Peer victimization, school adversity and associated contexts need to be considered in future ACE studies.

Background Although childhood abuse is considered to be related to borderline personality disorder (BPD), few studies have elaborated on the mediating role of self-esteem and resilience in it. Thus, the present study aimed to explore the potential mediating role of resilience and self-esteem between childhood abuse and BPD. Methods This cross-sectional study was conducted with 4034 college students in Anhui Province, China. Participants were asked to complete Chinese versions of the following instruments: Childhood Trauma Questionnaire–Short Form (CTQ-SF), Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Connor-Davidson Resilience Scale (CD-RISC), and Rosenberg Self-Esteem Scale (RSES). Structural equation modeling (SEM) was used to test the mediation effects. Results Resilience and self-esteem were found to be mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately; however, when all three types of childhood abuse were entered into the model simultaneously, neither the indirect effects nor direct effects of physical abuse or sexual abuse were found to be significant, only the association between emotional abuse and BPD features was partially mediated by resilience and self-esteem. Conclusions Self-esteem and resilience mediate the links between childhood abuse and BPD features, and emotional abuse is uniquely associated with BPD features.

Little is known about the relationship between sensory processing problems and sleep disturbances, emotional and behavioral problems and mealtime behavioral problems in Chinese children with autism spectrum disorders (ASDs). This study examined those relationships in Chinese preschool children with ASD using a case-control design. Atypical sensory processing was associated with increased risks of sleep disturbances, emotional and behavioral problems, and abnormal mealtime behaviors in the children with ASD, whereas sensory processing problems were significantly correlated with abnormal mealtime behaviors only in the typically developing children. Based on our findings, clinicians must collect information about sensory problems when a child with ASD experiences sleep disturbances and emotional and behavioral problems or presents abnormal mealtime behaviors.

Little is known about the life course prevalence of bullying among university students. The current study examined the prevalence of bullying in different life periods among multi-university students. Our study included 4,034 university students from four types of universities. Participants self-reported four types of bullying (i.e., physical, verbal, relational, and cyber) with bullies and victims, and four periods (i.e., primary school or earlier, middle school, high school, and postsecondary education). Overall, the percentage of university students experiencing at least one type of bullying victimization (BV) and bullying perpetration (BP) during their lifetime was 59.7% and 31.6%, respectively; the percentage of the university students experiencing more than two types of BV and BP was 16.3% and 7.4%, respectively. The prevalence rates of each type of BV and BP were the highest in elementary school or earlier, and these rates decreased from elementary school or earlier to postsecondary education period. Four latent classes were identified for BV: low BV (73.8%), moderate BV (18.6%), secondary school BV (4.4%), and persistent BV (3.2%). Similarly, four classes for BP were identified: low BP (86.6%), primary school BP (8.1%), high school BP (1.5%), and persistent BP (3.8%). These findings may inform school health practice of bullying prevention by taking prevention programs, especially during elementary school or earlier period.

Objective To examine whether timing and chronicity of bullying victimization (BV) play a significant role in linking exposure to BV to suicidal behaviors in university students. Methods A multistage stratification sampling method was used to select a sample of 4034 university students (18–23 years, mean age 20.38±1.35 years, 41.9% female). We used latent class analysis and developmental-stage-based characterizations of BV timing and chronicity to explore the sensitive periods for the effect of BV on suicidal behaviors. Results The prevalence rates of suicidal ideation, plans and attempts among our study participants were 9.9%, 3.0% and 1.3%, respectively. BV during primary school (OR = 2.12, 95% CI: 1.55–2.90) and secondary school (OR = 2.65, 95% CI: 1.80–3.90) was associated with suicidal ideation among university students. We identified four classes of life-course BV experiences (low BV, 73.8%; moderate BV, 18.6%; secondary school BV, 4.4% and persistent BV, 3.2%). Persistent BV was associated with 2.50 times (95% CI: 1.56–3.98), 2.98 times (95% CI: 1.48–6.02), and 6.13 times (95% CI: 2.48–15.14) higher risk of suicide ideation, plans, and attempts, respectively. Both moderate BV (OR = 1.75, 95% CI: 1.35–2.26) and secondary school BV (OR=2.01, 95% CI: 1.29–3.12) were positively correlated with suicidal ideation. Furthermore, there was a dose-response relationship between the number of periods of BV and suicidal behaviors. Limitations This study was a cross-sectional study based on self-reported measures, especially BV experiences in each school stage. Conclusions This study identifies sensitive periods for the effect of BV on suicidal behaviors among university students in China.

Increasing evidence has revealed that genetic variants in Reelin (RELN) gene, especially single-nucleotide polymorphisms (SNPs), correlate with autistic spectrum disorders (ASD) risk; however, no consensus have been reached. This study aimed to provide additional evidence for the association between two SNPs of RELN (i.e., rs736707, rs2229864) and ASD risk, as well as the relationship between RELN gene and symptom-based and developmental deficits of ASD patients in Chinese Han children and adolescents. 157 ASD subjects and 256 typical development (TD) controls were genotyped by TaqMan® genotyping assay. ASD patients were assessed by Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), and Early Childhood Development Questionnaire (ECDQ). We found that SNP rs2229864 was associated with the genetic predisposition of ASD, whereas a negative association between SNP rs2229864 and symptom-based and developmental features was detected. In contrast, RELN rs736707 correlated with the sensory subscale of the ABC, the relating subscale of the ABC and the total score of ABC, although we did not detect a significant association between SNP rs736707 and ASD risk. Furthermore, a significant rs736707–rs2229864 haplotype was detected. Individuals with a CC haplotype were more likely to have ASD, but individuals with a CT haplotype had more chance be TD controls. Further studies using more samples and including more gene variants in RELN are warranted to confirm our results.

Background Self-harm (SH) is an emerging problem among Chinese adolescents. The present study aimed to measure the prevalence of SH behaviours and to explore the relationship between childhood adversity and different SH subtypes among Chinese adolescents. Methods A total of 5726 middle school students were randomly selected in three cities of Anhui province, China, using a stratified cluster sampling method. SH was categorized into five subtypes (highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm). Multivariate logistic regression was used to explore the relationships between childhood adversity and different subtypes of adolescent SH. Results The prevalence rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm were 6.1, 20.4, 32.0, 20.0 and 23.0%, respectively. Childhood sexual abuse and physical peer victimization were associated with each SH subtype with adjusted odds ratios (AORs) ranging from 1.23 to 1.76. Highly lethal self-harm was associated with childhood physical peer victimization, sexual abuse, emotional abuse, and emotional neglect. The less lethal SH subtypes (i.e., less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm) were associated with childhood peer victimization, family life stress event scores and childhood sexual abuse. Conclusions A high prevalence of SH exists among Chinese adolescents. The association of childhood adversity with SH merits serious attention in both future research and preventive interventions. Electronic supplementary material The online version of this article (10.1186/s12888-018-1607-0) contains supplementary material, which is available to authorized users.

Background Increasing evidence has suggested that childhood maltreatment might mediate the association between physical disability or chronic illness and depression among adolescents. We sought to identify whether childhood maltreatment mediated the relationship between physical disability or long-term health problems and depression in Chinese adolescents. Method A total of 5726 middle and high school students aged 12–18 years old were chosen to participant in this study. Participants completed the self-reported questionnaire on childhood physical or long-term health problems, childhood maltreatment and depression. Results The results showed that there were significant differences of childhood maltreatment, depression between adolescents with childhood physical disability or long-term health problems and those without. Physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect mediated the association between childhood physical disability or long-term health problems and depression accounting for 8.7%, 20.6%, 14.5%, 16.3% and 14.7% of the total effect of physical disability or long-term health problems on depression in each single mediator model respectively, whereas the indirect effect of emotional abuse and sexual abuse in the association between physical disability or long-term health problems and depression explained 15.6% and 8.0% of the total effect in a multiple mediation model respectively. Conclusion Childhood physical disability or long-term health problems was associated with the increased risk for depression, and the associations between childhood physical disability and long-term health problems and depression were partially mediated by childhood maltreatment experiences. Childhood maltreatment exposure should be considered to prevent depression among adolescents with childhood physical disability or long-term health problems.

Background School bullying is a destructive behaviour common among adolescents that can sometimes escalate to criminal activity. This study aimed to examine the association between four types of school bullying (i.e., physical, verbal, relational, and cyber) and murderous ideation and behaviours (i.e., ideation, plans, preparation, and attempts) among adolescent students. Methods Data were collected from 5726 middle and high school students using self-administered questionnaires in December 2013. The participants were selected using a 3-stage random cluster-sampling strategy. The participants were asked about the frequency of their bullying experiences in the past two months and the frequencies of their murderous ideation and behaviours in the past six months. Multivariate logistic regressions were performed to explore the association between school bullying and murderous ideation and behaviours. Results Each type of school bullying perpetration was associated with murderous ideation and behaviours, as was each type of bullying victimization. Students who experienced more types of school bullying perpetration and victimization were more likely to report murderous ideation and behaviours. Moreover, the number of types of bullying perpetration and victimization had a dose-response association with murderous ideation and behaviours (aOR min = 1.45, aOR max = 2.72), as did the frequency of involvement in bullying perpetration and victimization (aOR min = 1.33, aOR max = 2.00). Being a bully-victim was a risk factor for murderous ideation and behaviours (aOR min = 3.88, aOR max = 7.24). Conclusions Each type of school bullying was associated with an increased risk for murderous ideation and behaviours among adolescents. Dose-response relationships between the frequency of bullying and number of bullying types experienced and murderous ideation and behaviours were found in this study. Future studies are warranted to confirm our findings and explore the mechanisms underlying the relationship between school bullying and murderous ideation and behaviours. Electronic supplementary material The online version of this article (10.1186/s12888-019-2108-5) contains supplementary material, which is available to authorized users.

Little is known about the relationship between precollege school bullying and murder-related psychological behaviors. The present study aims to examine that relationship in Chinese college students using a cross-sectional study. Self-report data were collected from 4034 college students in Anhui Province using a proportional stratified cluster sampling method. Four types of school bullying (i.e., physical, verbal, relational, and cyber) with bullies and victims and two periods (i.e., primary and secondary) were measured. The prevalence rates of murderous ideation, plans, preparation, and attempts were 6.9%, 2.5%, 1.8%, 1.4%, respectively. Different stages of precollege cyber bullying were associated with murder-related psychological behaviors for both bullies (primary: AORs = 2.78 to 15.67; secondary: AORs = 2.43 to 9.99; both periods: AORs = 2.26 to 14.04) and victims (primary: AORs = 2.87 to 16.57; secondary: AORs = 1.89 to 4.49; both periods: AORs = 3.68 to 21.48). A dose-response relationship was found, such that college students with a bullying perpetration index of two types and more were more likely to have murder-related psychological behaviors than those who were not bullied. Notably, both primary and secondary school bullying, especially cyber forms, were more likely to be associated with murder-related psychological behaviors. Therefore, it is necessary to develop school bullying preventive measures beginning in primary school.

Previous research has revealed associations between childhood maltreatment (CM) and adverse health behaviors. However, little is known about the relationship between CM and adolescent murderous ideation and behaviors. A total of 5726 middle and high school students completed the Childhood Trauma Questionnaire-Short Form and the Murderous Ideation and Behaviors Questionnaire. The findings revealed that the prevalence rates for murderous ideation, plans, preparation, and attempts were 9.9%, 2.8%, 1.3%, and 0.6%, respectively. The results of multinomial logistic regression models indicated that adolescents who experienced CM were more likely to exhibit murderous ideation and behaviors, with adjusted odds ratios (AORs) ranging from 2.55 to 22.31. Additionally, a significant dose-response relationship was found between the number of CM types experienced and murderous ideation and behaviors (AORs ranging from 1.52 to 2.45). The odds of participants who had experienced three or five types of CM were significantly associated with murderous ideation and behaviors, with AORs ranging from 4.55 to 28.30 and from 5.26 to 85.45, respectively. The findings highlighted that adolescents who engaged in murderous ideation and behaviors were more likely to have a personal history of CM and revealed a dose-response relationship between the number of CM types and murderous ideation and behaviors.

Hepatocellular carcinoma (HCC) is diagnosed in more than half a million individuals worldwide every year. It is often invasive and metastatic, resulting in a poor prognosis. Our knowledge of the genomic alterations implicated in HCC initiation and progression is fragmentary, and few molecular alterations unique to HCC are known. We performed whole-exome sequencing for a pleomorphic cell-type HCC tissue and matched normal tissue, and uncovered seven non-synonymous somatic variants in SPATA21, PPCS, CDH12, OR1L3, PCK2, HUWE1 and PHF16. These variants were validated by PCR and sequencing, with the exception of that in PPCS. We further performed a bioinformatics analysis of the six validated variants. The results suggested that the function of the proteins of the three mutated genes, PCK2, HUWE1 and PHF16, may be changed significantly. Among these genes, PCK2, within the insulin signaling pathway, and HUWE1, within the ubiquitin-mediated proteolysis pathway, may be essential for cell proliferation. These pathways are known to be important for hepatocarcinogenesis. Hence, we suggest that PCK2 and HUWE1 are associated with carcinoma cell proliferation in HCC.

To explore the relationship between aggressive behaviors, parent-child separation and experience of childhood abuse among junior high school students.A total of 1417 students in ordinary junior high schools from 3 townships in Huoshan, Anhui were involved in this study. Self-made questionnaire was used to estimate aggressive behaviors, parent-child separation in childhood, child abuse and social demographic information of the students under this study.Related scores (2.52 ± 0.78) on physical aggression in boys was higher than in girls (2.29 ± 0.79) while the scores related to anger (2.60 ± 0.82) and hostility (2.58 ± 0.80) in girls, were higher than those in boys (2.41 ± 0.75, 2.47 ± 0.78), all with statistically significant differences (P0.05). Scores related to different types of aggressive behaviors and the scores in total, were higher in students from the senior class (P0.001). Scores on items as verbal aggression, hostility and in total, were higher in those adolescents which had undergone maternal-child separation during their childhood (P0.05). Scores on hostility and in total, were higher in those adolescents which had suffered from father-child separation during their childhood (P0.05). Scores related to anger, hostility and in total, were higher in those adolescents which had undergone both parent-child separation when they were much younger (P0.05). Students who had suffered from various types of repeated abuse showed higher scores in various types of aggressive behaviors and in total, than those who did not have the same experience. Most of the differences among groups were statistically significant (P0.05).Students that suffered parent-child separation in their earlier childhood and with repeated experiences of abuse in childhood appeared to be risk factors causing aggressive behaviors to develop during the age of adolescence.