Objective To evaluate the usage of renoportal anastomosis in the liver transplanta- tion.Method The successful experience about renoportal anastomosis for portal vein reconstruction in liver transplantation was reported,and related literature reviewed.Results Including our case,there have been 13 cases of liver transplantation using renoportal anastomosis for portal vein reconstruction. Among these patients,8 cases were complicated with diffuse portal vein thrombosis,and 10 cases had a splenorenal shunt(spontaneous shunt in 3 and surgical shunt in 7).Complications related to portal vein hypertension occurred in 3 cases(transient ascites in 2 cases and severe digestive bleeding in 1 case)after liver transplantation.There were 3 deaths which were not related to renoportal anastomo- sis.Conclusion Renoportal anastomosis is a safe and feasible technique in liver transplantation for the patients with diffuse portal vein thrombosis or with splenorenal shunt(spontaneous or surgical shunt).

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.

Animals ; Bone Density ; Bone and Bones ; metabolism ; Calcium ; metabolism ; Genetic Predisposition to Disease ; Humans ; Osteoporosis ; genetics ; Polymorphism, Genetic ; Receptors, Calcitriol ; genetics ; Rickets ; etiology ; genetics

OBJECTIVETo survey the sleep habits (bedtime, wake time), sleep duration, and sleep problems in school-age children of China.

METHODFrom 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.

RESULTSThe 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.

CONCLUSIONSInadequate 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.

Child ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Habits ; Humans ; Male ; Sleep ; Sleep Stages ; Sleep Wake Disorders ; epidemiology ; Students ; Surveys and Questionnaires ; Urban Population

OBJECTIVEChina 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.

METHODTotally 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.

RESULTThe 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.

CONCLUSIONPart 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.

Child ; China ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Sampling Studies ; Sleep ; physiology ; Sleep Wake Disorders ; epidemiology ; Surveys and Questionnaires

OBJECTIVETo understand prevalence of sleep problems and presence of improper sleep habit of children aged one to 23 months in Shanghai, and to identify their related factors.

METHODSTotally, 1 252 normal children, without severe illness and abnormal delivery history, aged one to 23 months were randomly selected from five districts of Shanghai. Under strict quality control system, their parents were interviewed with questionnaire to look into their familial and social environment, as well as sleep-related factors.

RESULTSFully-completed information was obtained in 1 129 of 1 252 children, with a response rate of 90.18%. Prevalence of sleep problems in children was 65.90% in Shanghai, remarkably higher than in the other areas. Prevalence of nightmare, level of fright at night, snore and sleep apnea in boys were significantly higher than those in girls. Prevalence of improper sleep habit in children was also higher, including sleeping with their parents, parental presence at sleep onset and irregular sleep time. Main risk factors related to children's sleep problems were maternal anxiety, children's irregular sleep time, parental presence at sleep onset, difficulty-type temperament and maternal poor sleep during pregnancy.

CONCLUSIONSIn Shanghai, prevalence of sleep problems in children aged one to 23 months was relatively higher and main risk factors for them were social, cultural and familial environment, especially negligence of cultivating proper sleep habit and parental improper response to children's poor sleep behavior.

Adaptation, Psychological ; China ; epidemiology ; Humans ; Infant ; Maternal Behavior ; psychology ; Mother-Child Relations ; Prevalence ; Risk Factors ; Sex Factors ; Sleep Wake Disorders ; epidemiology ; Surveys and Questionnaires ; Time Factors

OBJECTIVETo 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.

METHODSTotally 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.

RESULTSThe 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.

CONCLUSIONSleep 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.

Child ; Female ; Habits ; Humans ; Male ; Quality of Life ; Sleep ; Sleep Wake Disorders ; Students ; Surveys and Questionnaires

OBJECTIVETo evaluate the effectiveness of parental education on reducing lead exposure of children by examining the changes in blood lead levels of children whose parents receiving or not receiving educational intervention.

METHODSTwo hundred children with confirmed blood lead levels beyond 100 microg/L were selected. They were randomized into two groups, 107 children in study group and 93 in control. At the beginning of the study, parents of both study and control groups were called for interview to complete KABP questionnaire and lead study questionnaire. The study group was provided with interventional measures while control group was not contacted until the end of study. Intervention of parental education was undertaken by means of a TV program, a set of slides and a brochure, and focused on the questions regarding harmful effects of lead poisoning, the sources of environmental lead and prevention of this preventable disease. Tests for blood lead level were repeated for both study and control groups 3 months after the determination of the initial blood lead level.

RESULTSAll the relevant knowledge of health effect, lead sources and prevention of childhood lead poisoning of participating parents of study group were improved significantly (chi(2) = 14.06, 13.07, 10.08, 28.26, P < 0.01) after educational intervention while parents control group also were significantly improved in the sub-catalogs of concept and prevention (chi(2) = 7.69, 8.64, P < 0.01), but not the health effect and sources of childhood lead poisoning. Children and parents' behavior in study group was improved accordingly and significantly. Less children ate popcorn (chi(2) = 4.08, P < 0.05), less children drank tap-water in the morning (chi(2) = 23.04, P < 0.01), more kids washed their hands before eating (chi(2) = 5.82, P < 0.05), less kids played on road side (chi(2) = 9.60, P < 0.01), and more parents changed their coat or took shower or washed hands before going home after work (chi(2) = 4.00, P < 0.05). But in the control group only the number of kids playing on road side was decreased significantly (chi(2) = 9.60, P < 0.01). A general decline in blood lead levels was detected in both groups with statistical significance at P < 0.01. However, the decrease in blood lead levels was more remarkable in the study group. There was average reduction of 55 microg/L (35%) in blood lead levels for study group (t = 4.979, P < 0.01) and an almost 33 microg/L (20%) for control (t = 3.398, P < 0.01). The reduction in blood lead level was 22 microg/L greater in study group (t = 3.531, P < 0.01). The study also showed that the effectiveness of the educational interventions depended upon various aspects. Fourteen variables were included in the stepwise multiple regression equation of blood lead level changes. Such as parents' occupational exposure to lead, the improvement of knowledge about prevention of childhood lead poisoning, the chang of habit of snacks intake, parents' education levels, the change of attitude of parents for the childhood lead poisoning, etc.

CONCLUSIONEducating parents is proved to be an effective approach for children with mild and moderate lead poisoning.

Child ; Environmental Exposure ; Health Behavior ; Health Education ; Humans ; Lead ; blood ; Lead Poisoning ; blood ; therapy ; Parents ; education

OBJECTIVETo investigate the relation between the alleles of HLA-DRB1*04 and outcome of HBV infection.

METHODSThe alleles of HLA-DRB1*04 were detected by polymerase chain reaction-sequence specific primer (PCR-SSP). The frequency of allele of HLA-DRB1*04 in four groups[106 asymptomatic HBsAg carriers (group ASC), 93 chronic hepatitis B patients (group CHB), 77 patients with hepatitis B cirrhosis and 102 cases of spontaneous recovery after HBV infection (control group)] were studied, and the frequency of that in different replication of HBV was also studied.

RESULTSThe frequency of allele of HLA-RB1*04 in groups ASC, CHB and hepatitis B cirrhosis was markedly higher than that of control group (25.94%, 26.34%, 27.92% respectively versus 14.22%, P< 0.01); the frequency of HLA-DRB1*0401 in groups ASC, CHB and hepatitis B cirrhosis was also higher than that of control group (20.91%, 24.49%, 22.09% respectively versus 8.62%, P< 0.05, P< 0.01,P< 0.05 respectively); the frequency of HLA-DRB1*0405 in groups ASC, CHB and hepatitis B cirrhosis was lower than that of control group (3.64%, 2.04%, 3.49% respectively versus 15.52%, P< 0.01, P< 0.01, P< 0.05 respectively ). There was no statistical significance in the allele frequency of HLA-DRB1*04 among groups ASC, CHB and hepatitis B cirrhosis (P> 0.05), and the same result was observed in different replication of HBV (P> 0.05).

CONCLUSIONHLA-DRB1*04 gene is one of the factors which determine the outcomes of HBV infection, while it has no influence on HBV replication.

Adolescent ; Adult ; Alleles ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Hepatitis B ; genetics ; pathology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Prognosis ; Young Adult

OBJECTIVETo perform the functional analysis of a novel H436Y mutation of GATA-4 gene identified in Han Chinese patients with congenital cardiac septal defects.

METHODSUsing bioinformatics to predict if the H436Y mutation in the GATA-4 gene affects its protein function. H436Y mutation in the GATA-4 gene was generated by Quick Change Lightning site-directed mutagenesis kit and verified by DNA sequencing. GATA-4-wt or GATA-4-mut DNA was cotransfected into Hela cells with DNA for the luciferase reporter gene atrial natriuretic factor (ANF), and luciferase activity was measured by an LKB luminometer 48 h after transient transfection.

RESULTSAlignment of the GATA-4 amino acid sequence indicated that the histidine residue at position 436 was conserved, and H436Y mutation in the GATA-4 gene is expected to affect its protein function. The H436Y mutation significantly reduced the transcriptional activation of downstream reporter ANF when compared to wild-type GATA-4 (P<0.01).

CONCLUSIONThe mutation c.1306C-->T of the GATA-4 gene impaired the activation of the downstream target, suggesting that the H436Y mutation in the C-terminal region of the GATA-4 gene might prevent its biological function.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; GATA4 Transcription Factor ; genetics ; Heart Septal Defects ; genetics ; Humans ; Infant ; Male ; Molecular Sequence Data ; Mutagenesis, Site-Directed ; Sequence Alignment ; Sequence Analysis, DNA ; Young Adult