Objective: To understand the parenting styles of junior high school students in Beijing, to explore the relationship between parenting styles with students academic performance and the role of mental health in this association. Methods: From October 2019 to January 2020, a stratified random cluster sampling method was used to select 5 196 students in the first and second grades of 11 public junior high schools in urban and rural areas in Beijing, and Slort Egna Minnenar Barndoms Uppfostran-China,Middle School Students Mental Health Scale-60 and self designed questions were used in the questionnaire survey. Results: The average score of parenting style rejection dimension was (9.44±3.88), and the average score of emotional warmth dimension was (19.85±5.66). The average score of comprehensive score of students mental health was ( 1.92 ±0.73). Mental health score of girls was higher than boys (1.97±0.74)(1.87±0.71), and the differences were of statistical significance( t=5.06, P <0.01). Parental rejection and emotionally warm parenting styles were significantly correlated with students academic performance （ β =-0.54，1.15， P <0.01). Mental health played a negative moderating role between parenting style and students academic performance. The better students mental health were, the greater the influence of parenting style on academic performance. Conclusion Parenting style is related to children s academic performance. Parents should give their children more affirmation, encouragement and praise, in order to improve their academic performance.

Objective: To understand the current situation regarding sex education in home and school settings in China, and to provide a scientific basis for more effective family and school sex education. Methods: Using a convenient sampling method, a crosssectional survey of students from grade 7 to grade 9 in Beijing, Liaoning, Sichuan, Chongqing, Yunnan and Henan was carried out from September to December 2021. The questionnaire covered general demographic information, sex education at home and school, and the status of comprehensive sexuality education. Finally, 4 109 valid questionnaires were collected. Results: A total of 760(18.50%) middle school students had not received any form of sex education, 923(22.46%) had only received sex education at school, 299(7.28%) had only received sex education at home, and 2 127 (51.76%) had received sex education at home and at school. The scores related to junior middle school students knowledge of comprehensive sexuality education was (12.43±2.89) points, the attitude score was (47.86±5.31) points, the behavior score was (40.44±5.18) points, and the comprehensive level score was (82.02±9.01) points. Junior middle school students who received sex education at home and in school had the highest comprehensive level of sex education( P <0.01). Junior middle school students who only received sex education at school had a higher comprehensive sexuality education knowledge level than those who only received sex education at home( P < 0.01 ). The level of comprehensive sexuality education behavior among junior middle school students who only received family sex education was significantly higher than among those who only received sex education at school( P <0.01). Conclusion Receiving sex education in both home and school settings can effectively improve the comprehensive sexuality education competency among junior middle school students. School based sex education should be further implemented in the future and family sex education should be encouraged.

Objective: To understand knowledge of comprehensive sexuality education and its associated factors among junior high school teachers in six provinces in China, in order to provide a scientific basis for teacher training. Methods: From June to December 2021, a convenience sampling method was used to select 1 016 junior high school teachers from Beijing, Chongqing, Liaoning, Sichuan, Yunnan and Guangdong provinces. A structured questionnaire was used to investigate teachers knowledge of comprehenswe sexuality education. Binary Logistic regression was used to analyze the related influencing factors of the knowledge of comprehensive sexuality education among junior high school teachers. Results: The study showed that the knowledge rate of comprehensive sexuality education among middle school teachers was 58.1%, and the knowledge rate was higher in teachers who had conducted sexuality education to students( χ 2=9.42, P <0.01). The percentage of the correct answer on the prevention and control of sexually transmitted diseases(26.0%), the impact of inequality on love relationships( 33.6 %), and the impact of mass media on sexual cognition(68.8%) was the lowest. Regardless of whether they had implemented sexuality education for students, the knowledge and awareness rate of sexual knowledge among biology teachers, school doctors/health teachers and mental health teachers was higher( OR=2.32, 4.17, P <0.05). Conclusion Knowledge of comprehensive sexuality education among middle school teachers still needs to be improved. It is advisable to strengthen the training of comprehensive sexuality education for middle school teachers and focus on teachers of subjects related to comprehensive sexuality education.

Abstract Improving health literacy can effectively reduce the risk of health risk behaviors and adverse health outcomes in children and adolescents. Global research on health literacy of children and adolescents has been increasing in recent years. The paper reviews the existing research and proposes that there is no universal definition and connotation of health literacy for children and adolescents, most of the studies use or make some revisions on the definition of adult health literacy in child and adolescent health literacy, failing to consider developmental characteristics and unique health needs of children and adolescents. Moreover, the assessment index system and instruments are diversified, making the research findings from different studies difficult to compare, and to obtain consistent and reliable conclusions. Future endeavors are encoouraged to expand health literacy researches and to update more comprehensive and practical definition, and to develop a standardized assessment instrument that can be validated in Chinese culture.

Objective: To explore the relationship between depressive symptoms, negative life events and resilience among primary and secondary school teachers, so as to provide a reference for mental health promotion in school teachers. Methods: During November to December 2022, a questionnaire survey was conducted using convenient cluster sampling method to select 11 332 in service teachers from 38 schools in 8 provinces (cities) including Beijing, Guangdong, Anhui, Hubei, Sichuan, Xinjiang, Liaoning, and Heilongjiang. The Patient Health Questionnaire-9 items, a self developed 21-item Adverse Life Events questionnaire, and a 10-item Conner-Davidson Resilience Scale were used to assess depressive symptoms, experiences of negative life events, and resilience levels of the teachers, respectively. The relationship between depressive symptoms, negative life events and psychological resilience were analyzed by multiple linear regression and stratified regression. Results: The detection rate of depressive symptoms among primary and secondary school teachers was 14.0%. Negative life events of primary and secondary school teachers were positively correlated with depressive symptoms ( r =0.35), while psychological resilience was negatively correlated with depressive symptoms ( r =-0.45) ( P <0.05). After adjusting for possible covariates including gender and marital status, negative life events were positively correlated with depressive symptoms ( β=0.22, P <0.01). Resilience played a moderating role in the association of negative life events with depressive symptoms among primary and secondary school teachers ( B=-0.15, P <0.01). Conclusions Negative life events experiences are associated with higher level of depressive symptoms among school teachers. However, resilience might mitigate the negative effects of negative life events on depressive symptoms, playing a protective role in teachers mental health.

Objective: To understand the association of healthrelated quality of life of middle school students with parental companionship, so as to provide a reference for school and family health education. Methods: From September to November 2023, 4 594 middle school students were selected through convenient sampling from four economic zones in China (Liaoning Province, Beijing City, Sichuan Province, Shanxi Province). Structured questionnaires were used to evaluate healthrelated quality of life among middle school students. The ttest, variance analysis and linear regression were used to analyze the relationship between healthrelated quality of life with parental companionship among middle school students. Results: The average score of healthrelated quality of life among middle school students was (140.99±21.38). There were statistically significant differences in the scores of healthrelated quality life among middle school students in different regions, genders, educational stages, grades, whether they live on campus and parental companionship(F/t=20.73, 8.62,16.71,105.70, -9.51, 52.29, P<0.01). Linear regression analysis showed that students who were living in eastern region, boys, with higher selfevaluation of academic performance, with higher subjective family socioeconomic status, with parental companionship (β=3.19, 4.96, 2.19, 6.11, 3.19), and older students had lower healthrelated quality of life levels (β=-2.34)(P<0.01). Conclusions There are significant regional differences in the healthrelated quality of life levels among middle school students. It is necessary to strengthen the popularization of school health education and focus on students who do not live with their parents on a daily basis to provide more psychological support for them.

Objective: To understand the current status of the team structure of health personnel in primary and secondary schools, and to provide suggestions and references for strengthening and optimizing school health workforce. Methods: A nationwide stratified random cluster sampling method was adopted to select provinces for investigation in stratification from 2015-2016, a total of 16 provinces, autonomous regions, and municipalities directly under the Central Government, 26 survey sites, 10 027 primary and secondary schools, 9 536 questionnaires of health personnel were collected. Results: Among the 9 536 school health staffs, there were various types of positions, and different types of schools had different position types construction. Elementary schools had the most part time health care teachers, accounting for 77.6%, while full time school doctors only accounting 10.0%; high schools had the most full time school doctors, accounting for 65.7%, and part time health care teachers only accounting for 15.1 %. There were various employment channels, with the most transfer jobs in schools, accounting for 70.7%. The series of professional titles were diverse, with the teaching profession accounting for 67.4%. Most of school health teachers had junior and intermediate professional titles, accounting for 42.6%, respectively. Proportion of medium, medium low, and low level of salary accounted for 39.3%, 27.9% and 21.1% respectively. Conclusion The educational background and age distribution of school health personnel is reasonable, but the proportions of medical background and full time school doctors are relatively low. School health personnel have various job types, professional titles, salary level, and limited space of career development. Top level design from the policy level, and clearly defined improve the structure of school health personnel to meet the needs of high quality development of school health work in the new era.

Objective:To investigate the application of serum creatinine to prealbumin ratio (Scr/PA) in the diagnosis of patients with heart failure complicated with renal failure.Methods:This was a case-control study. Patients with chronic heart failure and heart failure complicated with renal failure admitted to Dalian Central Hospital from January 5, 2020 to April 23, 2023 were retrospectively analyzed, and Scr/PA was calculated. The general data and laboratory examination indexes of the two groups were compared. According to the data type, t test, Wilcoxon rank sum test and χ 2 test were used for comparison between the two groups. The risk factors of heart failure complicated with renal failure were analyzed by univariate and multivariate logistic regression analysis, and Spearman correlation analysis was used to analyze the correlation between Scr/PA and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and hemoglobin (HGB). ROC curve was used to determine the predictive value of Scr/PA and NT-proBNP for heart failure complicated with renal failure. Results:Compared with the heart failure group, Triglyceride [1.25 (0.94, 1.81) mmol/L vs. 1.07 (0.76, 1.46) mmol/L, Z=-2.159, P=0.031], D-dimer [2.30 (1.53, 4.67) mg/L vs. 1.63 (0.64, 2.96) mg/L, Z=-2.339, P=0.02],NT-proBNP [18 500 (9 575, 30 000) pg/ml vs. 4 865 (1 600, 9 800) pg/ml, Z=-5.637, P<0.001], Scr/PA [0.233 (0.188, 0.351) mg/mg vs 0.064 (0.044, 0.103) mg/mg, Z=-8.197, P<0.001] were higher in heart failure complicated with renal failure group. While albumin [(33.9±5.2) g/L vs. (36.3±4.3) g/L, t=-2.173, P=0.008], estimated glomerular filtration rate[12.86 (7.88, 17.40) ml/(1 min×1.73 m 2) vs. 65.82 (48.66, 86.32) ml/(1 min×1.73 m 2), Z=-9.794, P<0.001], and HGB [(91±24) g/L vs. (123±23) g/L, t=-7.489, P<0.001] were lower. Univariate logistic regression analysis showed that albumin ( OR=0.900, 95% CI 0.830-0.975, P=0.010), HGB ( OR=0.948, 95% CI 0.930-0.966, P<0.001), Scr/PA ( OR=1.639, 95% CI 1.346-1.957, P<0.001) were associated with heart failure complicated with renal failure. Multivariate logistic regression analysis showed that only Scr/PA was an independent risk factor for heart failure complicated with renal failure. The correlation coefficients of Scr/PA with NT-proBNP and HGB were r=0.578 and r=-0.559, respectively (all P<0.001). The area under the AUC curve of Scr/PA and NT-proBNP for predicting heart failure complicated with renal failure was 0.927 (95% CI: 0.881-0.973, P<0.001) and 0.797 (95% CI: 0.717-0.877, P<0.001), respectively. Conclusions:Scr/PA is an independent risk factor for heart failure complicated with renal failure, and it has a good correlation with NT-proBNP and HGB. Scr/PA is superior to NT-proBNP in predicting heart failure complicated with renal failure.

Objective: To preliminarily develop Health Literacy Scale for pupils, providing a tool for dynamic monitoring and related health literacy research among pupils. Methods: Through policy and literature review, the health literacy evaluation index system of pupils was established. Through two rounds of expert consultation, the evaluation index system and scale item pool of three levels in primary school were formed, and "Evaluation Scale 1.0" was developed. Through two panel discussions, health education experts, teachers and students were invited to provide advices on the content, expression and structure of scale 1.0, turning it into "Evaluation Scale 2.0", and completing the preliminary development of the scale. Results: The health literacy assessment index system of primary school students includes three levels，including level-1 was Grade 1-2, level-2 was Grade 3-4,level-3 was Grade 5-6, covering two level indexes. The scale for primary school students contained five horizontal dimensions and four vertical dimensions. In the Delphi consultation, the response rate was 100%, and the authority coefficient was 0.85. After item selection and modification, the final version of level-1, level-2 and level-3 scales contained 36, 44 and 50 items respectively. Conclusion The development of Health Literacy Evaluation Scale for pupils has high applicability and practical value.