Development of fetal growth charts in twins stratified by chorionicity and mode of conception: a retrospective cohort study in China / 中华医学杂志(英文版)

BACKGROUND@#Twin pregnancies continue to increase worldwide; however, the current clinical prenatal evaluation for the intrauterine growth of twins still relies on the growth standards of singletons. We attempted to establish a set of fetal biometric references for Chinese twin pregnancies, stratified by chorionicity and conception mode as spontaneously conceived monochorionic diamniotic (SC-MCDA), spontaneously conceived dichorionic diamniotic (SC-DCDA), and assisted reproductive technology dichorionic diamniotic (ART-DCDA) twins.@*METHODS@#From 2016 to 2019, the ultrasonographic fetal biometric measurements were longitudinally collected in pregnant women, including fetal weight, biparietal diameter, head circumference, abdominal circumference, femur length, and humerus length. The linear mixed models were used to test the difference of growth patterns between groups, and the growth curve of each biometric parameter was modeled by a generalized additive model for location scale and shape.@*RESULTS@#A total of 929 twin pregnant women and 2019 singleton pregnant women, met the inclusion criteria. Among twin pregnancies, 148 were SC-MCDA, 215 were SC-DCDA, and 566 were ART-DCDA twins. Overall, SC-DCDA twins grew faster than SC-MCDA twins, while slower than ART-DCDA twins (all P < 0.05), and all of the three groups showed significant differences comparing with singletons, especially during the third trimester. Hence, the customized fetal growth charts of each fetal biometric parameter were, respectively, constructed for SC-MCDA, SC-DCDA, and ART-DCDA twins.@*CONCLUSIONS@#The fetal biometric trajectories demonstrated characteristic patterns according to chorionicity and conception mode. To fill the gap, we modeled fetal biometric parameters for Chinese SC-MCDA, SC-DCDA, and ART-DCDA twin pregnancies, hoping to provide a reference for the further establishment of fetal growth reference values for Chinese twin fetuses.

Association between maternal dietary patterns during pregnancy and risk of ventricular septal defect in offspring / 上海交通大学学报（医学版）

Objective·To examine the association of maternal dietary patterns during pregnancy with the risk of ventricular septal defect (VSD) in offspring.Methods · Seventy-three children with VSD were selected as cases from June 1,2016 to December 1,2016;another 73 children without congenital heart or other defects were selected as controls during the corresponding period.VSD was diagnosed by clinical examination and echocardiography figure.Both cases and controls were recruited from Shanghai Children's Medical Center.All the children's mothers were interviewed using a structured questionnaire,which includes information on demographic characteristics and food frequency during pregnancy.Dietary patterns were defined by the factor analysis module of SPSS 23.0.The association between dietary patterns during pregnancy and VSD risk was analyzed by Logistic regression model.Results · Four dietary patterns were obtained by the factor analysis,i.e.vegetable-fruit-high-quality protein pattern,animal food pattern,high sodium and high fat pattern and aquatic product pattern.After adjusting for possible confounding factors,it was demonstrated that the vegetablefruit-high-quality protein pattern and aquatic product pattern were negatively associated with VSD risk in offspring (P＜0.05).Conclusion · Maternal dietary patterns during pregnancy that are rich in high-quality protein,vegetables,fruit and aquatic products may be helpful for decreasing VSD risk in offspring.

The association of sleep hygiene and sleep quality among school-age children / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the association between sleep hygiene and sleep duration and quality among school-age children, and to explore the risk factors related to poor sleep hygiene.</p><p><b>METHODS</b>Totally 2019 grade-five children were sampled by stratified cluster random sampling from 10 primary schools in Shanghai, during November and December 2009. Questionnaires were used to investigate children and their parents. Adolescent Sleep Hygiene Scale (ASHS) was used to inquiry sleep hygiene of children; Children Sleep Habits Questionnaire (CSHQ) was used to assess their sleep duration and quality; Family and Social Environment Questionnaire was used to collect demographic and socio-economic information. T-test, one-way ANOVA and multiple linear regression model were established to identify the risk factors for sleep hygiene.</p><p><b>RESULTS</b>The age of subjects was (10.81 ± 0.38) years old, 49.0% (989/2019) were boys. The ASHS total score was 125.43 ± 15.17, girls with better sleep hygiene than boys (127.05 ± 14.41 vs 123.74 ± 15.75, P < 0.05). The sleep duration was (9.47 ± 0.58)h/d, children slept less than 9 h/d had lower ASHS total score than those slept 9 - 10 h/d or over 10 h/d (121.69 ± 16.09 vs 126.17 ± 14.62 vs 126.50 ± 15.36, P < 0.05). Children with poor sleep quality had worse sleep hygiene than those with good sleep quality (121.00 ± 15.84 vs 128.36 ± 13.92, P < 0.05). Children with television set in bedroom had lower ASHS total score than the others (122.40 ± 15.76 vs 126.74 ± 14.66, P < 0.05). Children from single parent family had lower ASHS total score (117.90 ± 16.80 vs 125.94 ± 14.89, P < 0.05). Children whose father had irregular sleep or wake pattern had lower ASHS total score (122.65 ± 15.30 vs 125.89 ± 14.90 vs 127.79 ± 14.71, P < 0.05). The regression model confirmed that existence of television set in children's bedroom, single-parent family and father's irregular sleep pattern were the risk factors of poor sleep hygiene.</p><p><b>CONCLUSION</b>Sleep hygiene was closely associated with sleep duration and quality among school-age children. Children with television set in bedroom, male, from single parent family and whose father had irregular sleep or wake pattern had worse sleep quality.</p>

Comparative study of children's sleep evaluation methods / 中华儿科杂志

<p><b>OBJECTIVE</b>To compare the compliance of using Actiwatch, parent report of sleep diary and sleep questionnaire in school age children, and to further evaluate agreement rates between actigraphy, diary, and questionnaire for children's sleep patterns.</p><p><b>METHOD</b>Two primary schools in Luwan District were selected and first grade students without obvious physical and mental illnesses or sleep disorders were enrolled in the study. Each student was home-monitored with an Actiwatch for 7 days, meanwhile parents were asked to complete a detailed sleep diary during the Actiwatch monitoring days. Sleep questionnaires were distributed to their parents who were asked to fill in these on the last monitoring day.</p><p><b>RESULT</b>Forty-five children participated in the study, 36 children completed sleep assessments by all the three methods, and among them 20 were boys and 16 were girls. The mean age of those children was (7.26±0.42) years. The completion rate of questionnaire was 100%, of diary was 86.7% (39/45) and of Actiwatch was 93.3% (42/45). The completion rate between sleep diary and sleep questionnaire was significantly different (P<0.05). The satisfactory agreement between Actiwatch and sleep diary was reached with sleep diary overestimating weekday and weekend sleep duration by 26 minutes and 25 minutes respectively. The agreement rates between Actiwatch and questionnaire was insufficient for all variables with sleep questionnaire overestimating weekday and weekend sleep duration by 37 minutes and 38 minutes respectively.</p><p><b>CONCLUSION</b>Sleep questionnaire is an easy and high compliance method for evaluating children's sleep pattern while sleep diary showed high agreement with Actiwatch. Using either of these methods for evaluating children's sleep pattern should be judged by research aim and sample size, and limitation of those methods should be considered when they are used in practice.</p>

Velocity vector imaging for left ventricular diastolic function assessment and the reference values / 南方医科大学学报

<p><b>OBJECTIVE</b>To study value of velocity vector imaging (VVI) in assessment of normal left ventricular diastolic function and the corresponding reference values.</p><p><b>METHODS</b>Ninety-seven healthy subjects were selected by combined clinical, ultrasound, and NT-proBNP examinations. Using a Siemens Acuson Sequoia C512 echocardiograph, VVI was adopted to examine the myocardial early diastolic velocity (E) of the septal, lateral, anterior, inferior, anterior septum, and posterior wall of the left ventricle at the level of mitral annulus. The images were analyzed for VVI and the mean diastolic velocity (E(m)) and hence the E/E(m) ratio was calculated based on the offline workstation interface.</p><p><b>RESULTS</b>The reference range of E/E(m) ratio derived from the data of the 97 healthy subjects was (unilateral boundaries with 95% limit) and (1, 22.935), was (1, 22.300) in male subjects and (1, 24.766) in female subjects. The reference E/E(m) range was (0, 22.413) in male subjects under 50 years of age, (1, 24.766) in female subjects under 50 years, (1, 22.300) in male subjects over 50 years, and (1, 24.766) in female subjects over 50 years.</p><p><b>CONCLUSION</b>VVI is a good method for non-invasive evaluation of the left ventricular diastolic function and provides an accurate and reliable means for clinical assessment of the left ventricular diastolic function.</p>

Follow-up study of school-age children's sleep quality in Shanghai / 中华儿科杂志

<p><b>OBJECTIVE</b>China has undergone massive socioeconomic change during the past several years, and its impact on children's sleep is still unrecognized. Shanghai, as one of typical economically fast-developing cities, was chosen as observational city in this study, which was designed to explore trends in sleep quality in Shanghai school-aged children and related high risk factors on sleep quality.</p><p><b>METHOD</b>Totally 884 fifth grade school-aged students were sampled by stratified cluster random sampling method from 10 primary schools of Shanghai in 2005, then four years later in 2009, 2161 same grade students were sampled from the same schools. Chinese version of Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate 8 sleep quality parameters among those children, and high risk factors on school-aged children's sleep quality were investigated as well.</p><p><b>RESULT</b>The prevalence of poor sleep quality decreased from 29.2% in 2005 to 27.9% in 2009, and among 8 sleep quality parameters, bedtime resistance decreased from 33.1% to 28.7%, sleep anxiety from 50.6% to 39.8%, night waking from 25.2% to 21.5%, and parasomnia from 51.2% to 45.8%. The factors, such as heavier homework burden, longer daily computer use, bright light during sleep, cosleeping, existence of chronic disease and irregular sleep habits of parents, were associated with poor sleep quality of school-aged children after adjusting for children's age, gender, and family social-economic status.</p><p><b>CONCLUSION</b>Part of sleep quality parameters improved during the past 4 years, but current situation is still tough with more than 1/4 poor sleep quality children. Helping children to develop good sleep hygiene as well as educating parents how to shape children's regular sleep habits might be effective methods to improve children's sleep quality.</p>

Effects of polyethylene oxide at different concentrations on abdominal aortic blood flow and vascular resistance in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of polyethylene oxide (PEO) solution at different concentrations on abdominal aortic blood flow and vascular resistance in rats and evaluate the safety and drag-reducing effect of PEO solution.</p><p><b>METHODS</b>Thirty-two rats were anesthetized and randomly divided into 4 groups. An ultrasonic flow probe was deployed on the abdominal aorta (5 mm above the common iliac artery) to measure the blood flow. The carotid artery pressure, iliac artery pressure, iliac vein pressure, central venous pressure (CVP) and ECG were also monitored. Saline or different concentrations of PEO [(1x10(-6)(low), 1x10(-5)(middle) and 5x10(-5)(high) g/ml)] were injected in the 4 groups of rats through the caudal vein at a constant rate of 5 ml/h for 20 min, and the changes of the vascular resistance was observed. RESULTS After injections of 1x10(-6) and 1x10(-5) g/ml PEO, the abdominal aortic flow increased significantly (P<0.05) while the vascular resistance was reduced (P(low)=0.052, P(middle)<0.001) as compared to those in the saline control group. Following the injection with 5x10(-5) g/ml PEO, the abdominal aortic flow increased to a threshold in the initial 4 min, after which it rapidly decreased to approach the baseline levels despite continuous infusion. Blood pressure remained stable after the injections except for 5x10(-5) g/mlPEO injection, which resulted in a reduction of the blood pressure by about 10 mmHg (P=0.014). The heart rate and CVP both underwent no significant changes following the injections.</p><p><b>CONCLUSION</b>The drag-reducing effect of PEO is closely related to its concentration, and compared with 1x10(-6) g/ml, 1x10(-5) g/ml PEO more effectively increases the blood flow and decreases the resistance. The effectiveness and safety of EPO are attenuated at a concentration higher than 5x10(-5) g/ml.</p>

Effects of chronic partial sleep deprivation on growth and learning/memory in young rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The effects of sleep deprivation on the immature brain remain unknown. Based on a computer controlled chronic sleep deprivation animal model, the effects of chronic partial sleep deprivation on growth, learning and memory in young rats were explored.</p><p><b>METHODS</b>Twelve weaned male Spraque-Dawley rats (3-week-old) were randomly divided into sleep deprivation, test control and blank control groups. Sleep deprivation was performed using computer-controlled "disc-over-water" technique at 8-11 am daily, for 14 days. The temperature and weights were measured every 7 days. Morris water maze was used to test spatial learning and memory abilities before and 7 and 14 days after sleep deprivation. After 14 days of sleep deprivation, the rats were sacrificed for weighting their major organs.</p><p><b>RESULTS</b>After 14 days of sleep deprivation, the rats' temperature increased significantly. During the sleep deprivation, the rate of weight gain in the sleep deprivation group was much slower than that in the test control and blank control groups. The thymus of the rats subjected to sleep deprivation was much lighter than that of the blank control group. After 7 days of sleep deprivation, the rats showed slower acquisition of reference memory, but were capable of successfully performing the task by repeated exposure to the test. Such impairment of reference memory was not seen 14 days after sleep deprivation.</p><p><b>CONCLUSIONS</b>Chronic sleep deprivation can affect growth of immature rats, as well as their abilities to acquire spatial reference memory.</p>

Evaluation of left ventricular diastolic function in canine acute myocardial ischemia using velocity vector imaging and quantitative tissue velocity imaging / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of velocity vector imaging (VVI) and quantitative tissue velocity imaging (QTVI) in assessing left ventricular diastolic function of the dogs with acute myocardial ischemia.</p><p><b>METHODS</b>Six healthy mongrel dogs were subjected to ligation of the left circumflex artery or left anterior descending artery to induce coronary artery stenosis of varying degrees. The mean peak diastolic velocity (Em) of the ventricular walls around the mitral annulus was recorded with VVI or QTVI in the coronary blood flow. The left ventricular end diastolic pressure (LVEDP) was measured with pigtail catheter in the left ventricle.</p><p><b>RESULTS</b>As the coronary blood flow decreased, LVEDP was gradually increased, and Em measured by VVI or QTVI were also gradually decreased. A good linear correlation was shown between Em measured by VVI or QTVI and LVEDP (r=-0.834, P<0.001, and r=-0.68, P<0.001, respectively). A significant difference was observed in the correlation coefficient between VVI and QTVI (Z=2.625, P=0.0087).</p><p><b>CONCLUSION</b>VVI and QTVI both provide good noninvasive means for measuring left ventricular diastolic function. VVI, a new echocardiographic modality without angular dependence, is better than QTVI in evaluating left ventricular diastolic function.</p>

Impact of television-watching and computer-using on sleep patterns and sleep problems of school-aged children in Shanghai / 上海第二医科大学学报

Objective To investigate the effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems of school-aged children in Shanghai. Methods A total of 4 108 school-aged children from 10 primary schools of Shanghai were enrolled by multi-stage cluster sampling and surveyed by questionnaires. The information of television-watching and computer-using, family and personal condition was investigated by self-prepared questionnaire, and the Chinese version of Children's Sleep Habits Questionnaire was employed to survey the sleep behaviors of children. The effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems were analyzed by multiple linear regression analysis and Logistic regression analysis. Results The percentage of children who watched television≥2 h per day was 4.1% during weekdays, and that came to 49.2% during weekends. In terms of frequency of computer-using, most children reported "rarely" (88.2%, 0-1 time/week), followed by "often" (11.0%, 2-4 times/ week) and "usually" (0.8%, 5-7 times/week). With the age increase, the percentages of children who watched television≥2 h per day and those who "often" used computer gradually increased. It was revealed by multiple linear regression analysis and Logistic regression analysis that television-watching and computer-using were not only positively correlated with later bedtime, later wake time and shorter sleep duration but also significantly associated with sleep problems such as bedtime resistance, sleep onset delay, sleep duration disorder, sleep anxiety and parasomnia. Conclusion Television-watching and computer-using exert influences on sleep behaviors of sleep/wake patterns, sleep duration and sleep problems. Concerns about the potential negative effects of television-watching and computer-using on sleep behaviors may help to promote healthy sleep patterns and improve sleep quality.

Sleep habits and sleep disturbance in school-age children of China / 中华儿科杂志

<p><b>OBJECTIVE</b>To survey the sleep habits (bedtime, wake time), sleep duration, and sleep problems in school-age children of China.</p><p><b>METHOD</b>From November to December, 2005, a total of 19,299 school-age children from 55 elementary schools of 9 cities entered the study by a cross-sectional survey. A parent-administered questionnaire and the Chinese version of the Children's Sleep Habits Questionnaire were applied to investigate children's sociodemographic characteristics and sleep behaviors, respectively.</p><p><b>RESULTS</b>The mean sleep duration was 9 hours and 10 minutes (9:10, SD:48 min) during the weekdays and 9:48 (SD: 63 min) during the weekends. In about 71.4% and 41.8% school-aged children the sleep duration per day did not reach the lowest criterion of 10 hours recommended by the Ministry of Education of China during weekdays and weekends, respectively. Sleep problems were common with prevalence ranging from 14.5% for sleep-disordered breathing to 75.3% for daytime sleepiness. Parasomnia (chi(2) = 13.76, P < 0.01) and sleep-disordered breathing (chi(2) = 119.83, P < 0.01) were more prevalent in boys than in girls; however, sleep anxiety was more prevalent in girls than in boys (chi(2) = 19.42, P < 0.01). Except for night waking, other types of sleep problems were significantly associated with age.</p><p><b>CONCLUSIONS</b>Inadequate sleep duration and sleep problems prevail among school-age children, which indicates that children's sleep health may be a major public health concern in China.</p>

Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire / 中华儿科杂志

<p><b>OBJECTIVE</b>To develop the Chinese version of Children's Sleep Habits Questionnaire (CSHQ) by translating and retranslating the English version of CSHQ and to examine the reliability, content validity, construct validity of the Chinese version in a general population of school-age children.</p><p><b>METHODS</b>During November and December 2005, a total of 20 457 school-age children from 55 primary schools of 9 cities were recruited through cluster-stratified selection, using geographic location, economic standard, and population density as criteria. A parent-administered questionnaire and the Chinese version of CSHQ were completed to quantify sociodemographic characteristics and to characterize sleep patterns and sleep disturbances, respectively.</p><p><b>RESULTS</b>The internal consistency of overall questionnaire and the eight subscales of the Chinese version of CSHQ was good (Cronbach's alpha coefficient was 0.73 and ranged from 0.42 to 0.69, respectively). The consistency between mother and father was ICCs = 0.89 for overall questionnaire and ranged from ICCs = 0.83 to ICCs = 0.92 for subscales. The test-retest reliability was ICCs = 0.85 for overall questionnaire and range from ICCs = 0.60 to ICCs = 0.88 for subscales. Factor analysis revealed a three-factor structure, which could represent bedtime behavior problems, sleep disturbance, sleep duration and daytime sleepiness, respectively, and the three factors could be used to explain 58.63% of the total variance. The factor loading was above 0.5 for the corresponding subscale.</p><p><b>CONCLUSIONS</b>Reliability, content validity and construct validity of the Chinese version of CSHQ in a general population of school-age children are good. It appears to be a suitable instrument for measuring sleep patterns and screening for sleep problems in school-aged children.</p>