Abstract Nutritional literacy is an important component of health literacy and closely related to adolescents dietary habits and health conditions. Improving nutrition literacy not only helps adolescents to make healthier dietary choices but also aids in disease prevention. The article systematically reviews the individual and environmental factors influencing adolescent nutrition literacy, with a focus on exploring innovative intervention strategies based on traditional school interventions, new media platforms and virtual reality technology, so as to provide a theoretical foundation and practical guidance for improving the nutrition literacy and overall health of Chinese adolescents.

Objective: To analyze the influence of stress and psychological resilience on the dietary behavior of middle school students so as to privide a basis for the development of policies and interventions aimed at improving middle school students dietary behavior. Methods: A total of 8 874 middle school students in Shanghai were surveyed using stratified cluster random sampling method from November 2019 to January 2020. The questionnaire included general information, dietary behavior, Perceived Stress Scale (PSS-10) and Connor-Davidson Resilience Scale (CD-RISC-10). Factor analysis was used to analyze the dietary behavior model. Logistic regression model was used to explore the correlation between stress, psychological resilience and dietary behavior in adolescents. Besides, a structural equation model was established to analyze the mediating effect of psychological resilience on stress and dietary behavior. Results: The total score of psychological resilience among middle school students was (27.99±9.83), and the total score of stress was (25.56±7.06). Factor analysis categorized dietary behavior into two types: the high energy dietary behavior and balanced dietary behavior. High energy dietary behavior exhibited statistically significant differences across genders and schooling stage ( χ 2=41.37, 204.03), while balanced dietary behavior showed statistically significant differences across schooling stage and socioeconomic status ( χ 2=130.23, 96.53) (all P <0.01). Logistic regression analysis showed that adolescents with moderate and high stress levels had an increased risks of high energy dietary behavior ( OR=1.25, 95%CI =1.12-1.39; OR=1.58, 95% CI = 1.39-1.79) and a reduced likelihood of reduced balanced dietary behavior ( OR=0.73, 95%CI =0.65-0.81; OR=0.53, 95%CI =0.47-0.60); adolescents with high levels of psychological resilience had a decreased risk of highenergy dietary behavior ( OR= 0.73 , 95%CI =0.65-0.83), and those with moderate and high resilience levels showed improved balanced dietary behavior ( OR= 1.45 , 95%CI =1.29-1.62; OR=2.50, 95%CI =2.21-2.84) (all P <0.01). The mediating effect of psychological resilience between stress and high energy dietary behavior or balanced dietary behavior accounted for 15.61% and 56.10% of the total effects, respectively. Conclusions Stress and psychological resilience are the influencing factors of dietary behavior in middle school students. Psychological resilience have a partial mediating effect between stress and high energy dietary behavior or balanced dietary behavior.

Objective To investigate the role of delta/notch-like epidermal growth factor-related receptor(DNER)in gastric cancer and its regulatory mechanism.Methods The mRNA and protein levels of DNER in gastric cancer tissues and cells were detected with quantitative real time polymerase chain reaction(qRT-PCR)and Western blot.Gastric cancer cell line SGC7901 with silenced DNER expression was constructed,and cells were treated with mitochondrial dynamin-related protein 1(DRP1)inhibitor Mdivi-1.CCK-8 assay,Transwell assay,and flow cytometry were used to detect cell viability,invasion ability and apoptosis,respectively.Western blot was used to detect DNER protein levels,apoptosis-associated proteins[Cysteinyl aspartate-specific proteinase-3(Caspase-3),Bcl-2 Associated X(Bax)],autophagy associated proteins[microtubule-associated protein 1 light chain 3-Ⅱ/Ⅰ,LC3 Ⅱ/Ⅰ),p62,PTEN induced putative kinase 1(PINK1)and Parkin],and mitochondrial fission and fusion protein[DRP1,mitochondrial fission factor(MFF),mitochondrial fission protein 1(FIS1),Optic Atrophy 1(OPA1),mitofusin 1(MFN1)and MFN2]levels.Results The expression levels of DNER mRNA and protein in gastric cancer tissues were higher than those in adjacent normal tissues(t=-52.485,-46.955),while expression levels of DNER mRNA and protein in gastric cancer cells were higher than those in normal gastric epithelial cells(F=60.551,60.652),and the differences were significant(P＜0.001).Silencing DNER inhibited the proliferation and invasion of SGC7901 cells,induced apoptosis,and increased the expression of apoptosis-related proteins,with significant differences(t=8.026～25.903,all P＜0.05).Silenced DNER increased LC3 Ⅱ/Ⅰ ratio(t=18.086),decreased p62 protein level(t=6.747),promoted the aggregation of PINK1 and Parkin proteins in mitochondria(t=15.630,18.171),inhibited the expression of mitochondrial fusion proteins OPA1,MFN1 and MFN2(t=12.835,8.963,9.732),and promoted the expression of mitochondrial fission proteins DRP1,MFF and FIS1(t=16.034,16.939,15.971),with significant differences(all P＜0.05).Mdivi-1 treatment could counteract the effects of silencing DNER on mitochondrial autophagy,proliferation,invasion and apoptosis of gastric cancer cells.Conclusion DNER can reduce mitochondrial autophagy by inhibiting mitochondrial dynamic imbalance,promote cell proliferation and invasion,and inhibit cell apoptosis,thus promoting the progression of gastric cancer.

Objective: To assess the status of current e cigarette perception and its influencing factors among adolescents in Shanghai, so as to provide reference for the refinement of the prevention and control measures of teenagers e cigarette use. Methods: From May to June 2021, a stratified random cluster sampling was used to investigate 7 456 junior high and high school students in Shanghai. Harm and benefit perception of e cigarette as well as its social environment benefits were collected. Results: The rate of adolescents ever and current e cigarette use was 3.19% and 1.09%, respectively. The top four risk factors for low harm perception of e cigarette were adolescent e cigarette use( OR=2.74, 95%CI =2.10-3.59), high school students ( OR=1.47, 95%CI = 1.32 - 1.64 ), family members ( OR=1.45, 95%CI =1.24-1.70) and friends ( OR=1.36, 95%CI =1.20-1.54) using e cigarette. Adolescent ecigarette use ( OR=2.77, 95%CI =1.97-3.89), high school students( OR=2.11, 95%CI =1.89-2.36), friends ( OR= 1.63, 95%CI =1.42-1.87) and family members using e cigarette( OR=1.39, 95%CI =1.18-1.65) were the top four associated factors for high benefit perception of e cigarette. And, adolescent e cigarette use ( OR=1.95, 95%CI =1.47-2.59), high school students ( OR= 1.73, 95%CI =1.55-1.93), friends ( OR=1.60, 95%CI =1.40-1.82) and pocket money≥200 yuan using e cigarette( OR= 1.29 , 95%CI =1.17-1.43) were the top four risk factors for high social environmental benefit perception of e cigarette. Moreover, perception of e cigarette harm, benefit and social environmental benefit were associated with the risk of future use of e cigarette( OR = 0.78,1.44,1.21, P <0.01). Conclusion Being high school students and using e cigarette by oneself, friends, and family members are the important influencing factors for adolescents e cigarette perception. Both low harm and high benefit perception of e cigarette elevate the risk of future e cigarette use among adolescents, so effective measures should be taken to promote control education about e cigarette and smoke free environment construction.

ObjectiveTo explore the association between social support， parent-child relationships， and depression， anxiety， and loneliness among adolescents， in order to provide a reference for improving mental health in youth. MethodsA total of 11，596 middle school students from two districts of Shanghai were investigated with the stratified random cluster sampling method. The Chinese version of Patient Health Questionnaire （PHQ-2-C）， Generalized Anxiety Disorder （GAD-7）， UCLA Loneliness Scale （ULS-6）， Perceived Social Support Scale and Parent-child Cohesion Questionnaire were used in the survey. Statistical inferences were made using t-test， ANOVA， and logistic regression analysis. ResultsGirls， non-graduates， students ranking in the top 25%， adolescents living with parents and with higher socioeconomic status had higher scores of social support and parent-child cohesion than boys， graduates， students ranking in the middle or in the bottom 25%， adolescents not living with parents and with lower socioeconomic status （P<0.05）. Adolescents' parent-child cohesion and social support were negatively correlated with all kinds of emotions. Parent-child cohesion was an associated factor of depression （OR=0.93， 95%CI：0.91‒0.94）， loneliness （OR=0.94， 95%CI：0.94‒0.95） and anxiety （OR_mild=0.98， 95%CI： 0.98‒0.99； OR_{moderate or severe}=0.96， 95%CI： 0.95‒0.98）， but there were differences in the correlation between emotions and social support in different dimensions. ConclusionSocial support and parent-child relationship are significantly associated with depression， anxiety and loneliness in adolescent students. Paying more attention to youth with different characteristics， taking targeted measures to improve the level of social support and establishing a good family relationship are conducive to promoting the mental health of adolescents.

Abstract Social network of adolescents is one of the important factors affecting the initiation and development of their unhealthy eating behaviors, and different types of social networks shows varied influences on adolescents eating behaviors through divergent mechanisms. In the context of the new media era, social networks of adolescents establish via social media appear more complex and extensive. Based on relevant previous literature, the paper explores the impact and possible mechanisms of social network on eating behavior of adolescents, as well as its development and application in the new media era to provide references for better intervention strategies and healthier eating behaviors among adolescents from the perspective of social network.

ObjectiveTo investigate the cognition of e-cigarette compositions and hazards and its influencing factors among secondary school personnel （junior， senior and vocational high school） in Shanghai， so as to provide ideas for improving the cognition level of e-cigarettes among the school personnel and tobacco control efforts on campus in the future. MethodsA multi-stage stratified cluster random sampling method was used to conduct an anonymous online questionnaire survey among 1 767 secondary school personnel in Shanghai. ResultsThe proportion of school staff who had used e-cigarettes was 3.79%. The participants who were not sure whether the e-cigarette smoke was “mainly water vapor （incorrect）” and whether the e-cigarette smoke “contained nicotine （correct）” and “contained formaldehyde （correct）” accounted for 62.71%， 54.44% and 61.91%， respectively. Among them， 68.48%， 55.46% and 50.37%， respectively， agreed that e-cigarettes would be “addictive”， “harmful” and “that second-hand smoke was harmful”. Binary logistic regression analysis showed the following risk factors for the low level of school personnel’s awareness of e-cigarette compositions： age ≥40 years （OR=1.65， 95%CI： 1.32‒2.06）， working in junior high school （OR=1.37， 95%CI： 1.09‒1.73）， educational attainment level as junior college or below （OR=1.67， 95%CI： 1.02‒2.74）， and not having participated in tobacco control education activities （OR=1.37， 95%CI： 1.08‒1.73）. Meanwhile， working in junior （OR=1.43， 95%CI： 1.12‒1.83） or senior （OR=1.44， 95%CI： 1.08‒1.92） high school， educational attainment level as junior college or below（OR=2.10， 95%CI： 1.24‒3.56）， having used e-cigarettes （OR=2.98， 95%CI： 1.63‒5.42）， not having participated in tobacco control education activities （OR=1.49， 95%CI： 1.16‒1.92） and low level of awareness of e-cigarette compositions （OR=4.24， 95%CI： 3.44‒5.23） were risk factors for the low level of school personnel’s awareness of e-cigarette hazards. ConclusionsThe level of e-cigarette awareness among school personnel in Shanghai is low， especially those who are older， had low educational attainment level and had used e-cigarettes. In the future， tobacco control education for school personnel should be strengthened to improve their cognition and ability of tobacco control on campus.

Background At present, insufficient support for enterprise health environment and career development may lead to severe depressive emotion among occupational groups. Objective To investigate current state of depressive emotion and the relationship between health literacy and depressive emotion among occupational groups in Shanghai, and to provide evidence for formulating health management measures to alleviate depressive emotion among the occupational population. Methods This cross-sectional survey, using two-stage stratified sampling, was from December 2022 to February 2023, and selected 2548 active workers from 151 enterprises in Shanghai. A total of 2489 valid questionnaires were returned, with a recovery rate of 97.68%. Health literacy, internality health locus of control, and depressive emotion were evaluated by the Health Literacy Questionnaire, the Multidimensional Health Locus of Control Scale-Internality Health Locus of Control, and the Patient Health Questionnaire Depression Scale-9 item (PHQ-9), respectively. R 4.2.2 software was used for statistical analysis, binary logistic regression model was used to analyze the association between health literacy, internality health locus of control, and the risk of depressive emotion, and multiple linear model was used to analyze the correlation between health literacy, internality health locus of control, and PHQ-9 related indicators (total score, affective score, and somatic score). Results A total of 2489 workers aged 18 years and above in Shanghai were included in the analysis, 868 of them reported depressive emotion, and the positive rate of depressive emotion was 34.9%. The total score, affective score, and somatic score of PHQ-9 in M(P₂₅, P₇₅) were 3.00 (0.00, 6.00), 1.00 (0.00, 4.00), and 1.00 (0.00, 3.00), respectively. The results of binary multiple logistic regression analysis showed that after adjusting for selected confounders, no health literacy (OR=1.32, 95%CI: 1.10, 1.60; P=0.004) and low level of internality health locus of control (OR=1.66, 95%CI: 1.35, 2.05; P < 0.001) were associated with an increased risk of reporting depressive emotion. The results of multiple linear model showed that the lack of health literacy and low internality health locus of control were positively correlated with the total score, affective score, and somatic score of PHQ-9. Conclusion Depressive emotion among the working population in Shanghai is prominent, and more than 1/3 of them report depressive emotion. Lower health literacy and internality health locus of control are related to an increased risk of depressive emotion in the study population. Improving occupational health literacy and enhancing internality health locus of control are expected to prevent depressive emotion in occupational groups.

In recent years, with the vigorous marketing of e-cigarette manufacturers, e-cigarettes have become a popular tobacco product for adolescents. The problem of e-cigarette environmental exposure among adolescents is also getting worse and its associated adverse impacts cannot be ignored. However, domestic research on the environmental exposure to e-cigarettes among youth is insufficient, and experience on e-cigarette regulation is also limited. This review first briefly introduced the definition and sources of e-cigarette environment exposure, then focused on the differences of e-cigarette environmental exposure among adolescents with different characteristics to identify possible influencing factors, as well as the impacts of e-cigarette environmental exposure on adolescents, and finally summarized international countermeasures to prevent e-cigarette environmental exposure in adolescents, aiming to provide directional guidance for China to conduct e-cigarette control activities among adolescents.

Objective: To investigate the prevalence of adolescents dietary behavior in Shanghai, and to explore emotional influence on dietary behavior. Methods: A total of 7 456 students from 10 junior and 6 senior high schools in Shanghai were selected to participate in the questionnaire survey with the stratified random cluster sampling method. The survey included general information, eating behavior, PHQ-2 and GAD-7. Results: During the past week, the proportion of adolescents in Shanghai reported consumption of sugar sweetened beverages, sweet desserts, frequent fried food and fast food (≥4 times/week) were 13.26%, 16.90%, 6.99 % and 13.01%, respectively. The proportion of students reported consumption of fruits, vegetables, milk and breakfast every day were 56.96%, 73.00%, 65.03% and 76.11%, respectively. There were significant differences by sex and educational stages(both P <0.05). Adolescents with depression or anxiety have a higher incidence of unhealthy eating behaviors than those without depression or anxiety( P <0.01). After adjusting for gender, school, accommodation, grades, pocket money and social class, depression and anxiety increase the risk of various unhealthy eating behaviors in adolescents( P <0.05). Compared with those without anxiety, the risks of sugar sweetened beverages consumption (≥1 time/d) among adolescents with mild and moderate to severe anxiety were 1.42 times (95% CI =1.20-1.67) and 2.51 times (95% CI =2.09-3.01), the risks of insufficient fruits consumption (<1 time/d) were 1.30 times (95% CI =1.16-1.45) and 1.28 times (95% CI =1.11-1.47), the risks of insufficient vegetable consumption (<1 time/d) were 1.35 times (95% CI =1.20-1.52) and 1.41 times(95% CI =1.21-1.65), the risks of insufficient milk consumption (<1 time/d) were 1.29 times (95% CI =1.15-1.44) and 1.20 times(95% CI =1.04-1.39), and the risks of breakfast skipping were 1.75 times (95% CI =1.54-1.99) and 2.97 times (95% CI =2.55-3.46) among adolescents with mild and moderate to severe anxiety. Conclusion The proportion of unhealthy eating behaviors among adolescents in Shanghai is still high. Early education and intervention for students eating behaviors should be carried out, and attention should be paid to the occurrence of adolescents negative emotions, so as to reduce the risk of unhealthy eating behaviors among adolescents through the promotion of mental health.