Xingming Jin

Sleep and Obesity in Preschool Children

OBJECTIVE To examine the relationship between sleep and obesity in children 3 to 4 years old in Shanghai, China. STUDY DESIGN A total of 1311 Chinese children from 10 kindergarten classes in Shanghai, aged 3 to 4 years, who were participating in the kindergarten entrance health examination in 2000, were included in the study. Body weight and height were measured, and a questionnaire was given to the childrens parents about sleep and physical and social characteristics of the children and their family. The main outcome measure was obesity, defined as body mass index (kg/m2) > or = 95th percentile for the children. RESULTS Compared with children reporting > or = 11 hours of sleep per night, the odds ratio for childhood obesity was 4.76 (95% CI, 1.28-17.69) for children with <9 hours of sleep, and 3.42 (95% CI, 1.12-10.46) for children with 9.0 to 9.4 hours of sleep, after adjustment for age, sex, and other risk factors. Children with caregivers who slept less, who had mothers with higher education, or who co-slept with caregivers had less nighttime sleep than other children. CONCLUSION Short sleep duration is positively associated with obesity in preschool children, and short nighttime sleep duration is significantly related to bedtime and co-sleeping with caregivers.

Care for Development intervention in rural China: a prospective follow-up study.

Objective: The aim of this study was to test the efficacy and appropriateness of the World Health Organizations Care for Development (CFD) counseling materials, which form part of the Integrated Management of Childhood Illness (IMCI) strategy. The CFD materials are based on the Mothers Card, which contained age-specific messages on how caregivers can better play and communicate with a child. Method: We enrolled 100 families with a child of younger than 2 years of age from seven randomly selected villages in an impoverished rural county in Anhui Province, China. Two counseling sessions, using the CFD Mothers Card, were provided to 50 families randomly selected from among the study participants. All children were assessed with Gesell Developmental Schedules before counseling and after 6 months. A questionnaire on family situation and knowledge, attitudes, and practices regarding child development was also administered at the start and conclusion of the study. Results: At baseline assessment, both control and intervention groups were equal, with average developmental scores less than the national norms. Children in families who received counseling had significantly higher development quotient scores in cognitive, social, and linguistic domains. Questionnaire data on child rearing suggested that responsive and rich interactions and consistent caregivers correlated with higher scores. The CFD Mothers Card was found to be feasible and helpful in those families who received counseling. Conclusion: There is urgent need for further work on promotion of child development in rural China. The World Health Organizations CFD approach and Mothers Card is feasible and effective and should be expanded in use, especially within the national IMCI program.

Sleep, school performance, and a school-based intervention among school-aged children: a sleep series study in China.

Background Sufficient sleep during childhood is essential to ensure a transition into a healthy adulthood. However, chronic sleep loss continues to increase worldwide. In this context, it is imperative to make sleep a high-priority and take action to promote sleep health among children. The present series of studies aimed to shed light on sleep patterns, on the longitudinal association of sleep with school performance, and on practical intervention strategy for Chinese school-aged children. Methods and Findings A serial sleep researches, including a national cross-sectional survey, a prospective cohort study, and a school-based sleep intervention, were conducted in China from November 2005 through December 2009. The national cross-sectional survey was conducted in 8 cities and a random sample of 20,778 children aged 9.0±1.61 years participated in the survey. The five-year prospective cohort study included 612 children aged 6.8±0.31 years. The comparative cross-sectional study (baseline: n = 525, aged 10.80±0.41; post-intervention follow-up: n = 553, aged 10.81±0.33) was undertaken in 6 primary schools in Shanghai. A battery of parent and teacher reported questionnaires were used to collect information on children’s sleep behaviors, school performance, and sociodemographic characteristics. The mean sleep duration was 9.35±0.77 hours. The prevalence of daytime sleepiness was 64.4% (sometimes: 37.50%; frequently: 26.94%). Daytime sleepiness was significantly associated with impaired attention, learning motivation, and particularly, academic achievement. By contrast, short sleep duration only related to impaired academic achievement. After delaying school start time 30 minutes and 60 minutes, respectively, sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes, respectively. Moreover, intervention significantly improved the sleep duration and daytime sleepiness. Conclusions Insufficient sleep and daytime sleepiness commonly existed and positively associated with the impairment of school performance, especially academic achievement, among Chinese school-aged children. The effectiveness of delaying school staring time emphasized the benefits of optimal school schedule regulation to children’s sleep health.

Prevalence and risk factors of childhood allergic diseases in eight metropolitan cities in China: a multicenter study.

BackgroundSeveral studies conducted during the past two decades suggested increasing trend of childhood allergic diseases in China. However, few studies have provided detailed description of geographic variation and explored risk factors of these diseases. This study investigated the pattern and risk factors of asthma, allergic rhinitis and eczema in eight metropolitan cities in China.MethodsWe conducted a cross-sectional survey during November-December 2005 in eight metropolitan cities in China. A total of 23791 children aged 6-13 years participated in this survey. Questions from the standard questionnaire of the International Study of Asthma and Allergies in Children (ISAAC) were used to examine the pattern of current asthma, allergic rhinitis and eczema. Logistic regression analyses were performed to assess the risk factors for childhood allergies.ResultsThe average prevalence of childhood asthma, allergic rhinitis and eczema across the eight cities was 3∙3% (95% Confidence interval (CI): 3∙1%, 3∙6%), 9∙8% (95% CI: 9∙4%, 10∙2%) and 5∙5% (95% CI: 5∙2%, 5∙8%), respectively. Factors related to lifestyle, mental health and socio-economic status were found to be associated with the prevalence of childhood allergies. These risk factors were unevenly distributed across cities and disproportionately affected the local prevalence.ConclusionsThere was apparent geographic variation of childhood allergies in China. Socio-environmental factors had strong impacts on the prevalence of childhood allergies; but these impacts differed across regions. Thus public health policies should specifically target at the local risk factors for each individual area.

Case-only study of interactions between DNA repair genes (hMLH1, APEX1, MGMT, XRCC1 and XPD) and low-frequency electromagnetic fields in childhood acute leukemia

A case-only study was conducted in 123 patients with sporadic acute leukemia (AL). The locations of electric transformers and power lines were noted in each area, and their distances from the houses of the study patients were measured. The intensities of magnetic fields (B) were measured in 66 cases. Unconditional logistic regression analysis was performed adjusting for age, gender, parental education and occupation, indoor and outdoor pesticides use, presence of television sets, refrigerators and microwave ovens in childrens rooms and the presence of chemical factories or telecommunication transmitters within 500 m of the houses. The results of the gene–environment analyses revealed that an interaction existed between the XRCC1 Ex9 + 16 A allele and the presence of electric transformers and power lines within 100 m (Mean B = 0.14 μTeslas, μT) of the houses (interaction odds ratio, COR = 4.31, 95%CI: 1.54–12.08). The COR for the interaction of XRCC1 Ex9 + 16A and the presence of these installations within 50 m (Mean B = 0.18 μT) of the houses was 4.39 (95%CI: 1.42–13.54). Our results suggest a possible association between electric transformers and power lines and the XRCC1 Ex9 + 16A allele in patients with childhood AL.

Compensatory brain activation in children with attention deficit/hyperactivity disorder during a simplified Go/No-go task

Given that a number of recent studies have shown attenuated brain activation in prefrontal regions in children with ADHD, it has been recognized as a disorder in executive function. However, fewer studies have focused exclusively on the compensatory brain activation in ADHD. The present study objective was to investigate the compensatory brain activation patterns during response inhibition (RI) processing in ADHD children. In this study, 15 ADHD children and 15 sex-, age-, and IQ-matched control children were scanned with a 3-T MRI equipment while performing a simplified letter Go/No-go task. The results showed more brain activation in the ADHD group compared with the control group, whereas the accuracy and reaction time of behavioral performance were the same. Children with ADHD did not activate the normal RI brain circuits, which are thought to be predominantly located in the right middle/inferior frontal gyrus (BA46/44), right inferior parietal regions (BA40), and pre-SMA(BA6), but instead, activated brain regions, such as the left inferior frontal cortex, the right inferior temporal cortex, the right precentral gyrus, the left postcentral gyrus, the inferior occipital cortex, the middle occipital cortex, the right calcarine, the right hippocampus, the right midbrain, and the cerebellum. Our conclusion is that children with ADHD tend to compensatorily use more posterior and diffusive brain regions to sustain normal RI function.

Determinants of urinary 8-hydroxy-2'-deoxyguanosine in Chinese children with acute leukemia.

The 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG), an oxidized nucleoside of DNA, not only is a widely used biomarker for the measurement of endogenous oxidative DNA damage, but might also be a risk factor for many diseases including cancer. Elevated level of urinary 8‐OHdG has been detected in patients with various malignancies. In the present study, the level of urinary 8‐OHdG was examined in 116 Chinese children with acute leukemia (94 acute lymphoid leukemia, ALL, 22 acute myeloid leukemia, AML), and its correlation with urinary metal elements was investigated. Our result showed that the level of urinary 8‐OHdG in children with acute leukemia before treatment was significantly elevated compared with that in normal controls (11.92 ± 15.42 vs. 4.03 ± 4.70 ng/mg creatinine, P < 0.05). In particular, urinary 8‐OHdG was higher in children with acute leukemia aged under 3 years (20.86 ± 21.75 ng/mg creatinine) than in those aged 3–15 years (8.09 ± 9.65 ng/mg creatinine), whereas no differences were shown in terms of gender, parental smoking and education, household income, place of residence, and use of paracetamol. In addition, urinary 8‐OHdG levels were similar among different subtypes of acute lymphoid leukemia (ALL) patients. Furthermore, linear regression analysis revealed a significant correlation between urinary 8‐OHdG and urinary Cr, but not Fe or As, in group aged <3 years compared with group aged 3–15 years (P = 0.041), indicating that the metal elements may be involved in increasing urinary 8‐OHdG level in younger children with acute leukemia. Our results suggest that children with acute leukemia undergo an increased risk of oxidative DNA damage, which may be correlated with high level of Cr exposure in Chinese children with acute leukemia.

Epidemiological study of sleep characteristics in Chinese children 1 - 23 months of age

Background: Sleep plays a critical role in normal development and the effects of culture upon sleep are especially important in young children. The purpose of the present paper was to determine the sleep times and the prevalence of sleep problems and co‐sleeping in children from Shanghai.

Microstructural Abnormalities in the Combined and Inattentive Subtypes of Attention Deficit Hyperactivity Disorder: a Diffusion Tensor Imaging Study

Previous research has demonstrated that there are specific white matter abnormalities in patients with attention deficit/hyperactivity disorder (ADHD). However, the results of these studies are not consistent, and one of the most important factors that affects the inconsistency of previous studies maybe the ADHD subtype. Different ADHD subtypes may have some overlapping microstructural damage, but they may also have unique microstructural abnormalities. The objective of this study was to investigate the microstructural abnormalities associated with two subtypes of ADHD: combined (ADHD-C) and inattentive (ADHD-I). Twenty-eight children with ADHD-C, 28 children with ADHD-I and 28 healthy children participated in this study. Fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) were used to analyze diffusion tensor imaging (DTI) data to provide specific information regarding abnormal brain areas. Our results demonstrated that ADHD-I is related to abnormalities in the temporo-occipital areas, while the combined subtype (ADHD-C) is related to abnormalities in the frontal-subcortical circuit, the fronto-limbic pathway, and the temporo-occipital areas. Moreover, an abnormality in the motor circuit may represent the main difference between the ADHD-I and ADHD-C subtypes.

A case-only study of interactions between metabolic enzyme polymorphisms and industrial pollution in childhood acute leukemia

Cancer risk is modulated by gene-environment interactions between toxic exposure and genetic variation in carcinogen metabolism. Our objective was to assess interactions between exposure to industrial pollutants and polymorphisms affecting cytochrome P450s (CYP1A1 and CYP2E1) and glutathione S-transferases (GSTP1 and GSTT) in childhood acute leukemia (AL). A case-only design was conducted in 123 Chinese children with sporadic AL. Industrial plants in the vicinity were recorded and, if present, their size and proximity to the usual place of residence of AL children was evaluated. Unconditional logistic regression analysis was performed across the AL study group adjusting for age, gender, parental education, occupation and smoking, indoor and outdoor pesticide use, presence of television sets, refrigerators, microwave ovens and furniture material in childrens rooms, and electric transformers, power lines, and telecommunication transmitters within 500 m. This analysis revealed an interaction between the GSTT null allele and industrial plants within 500 m of the residences of childhood AL patients (interaction odds ratio, COR=2.96, 95% CI: 1.09-8.01). Furthermore, the COR for the interaction between GSTT null and industrial plants within 50 m was 5.99 (95% CI: 1.41-25.45). Our results suggest an association between proximity to industrial plants and the GSTT null allele in patients with childhood AL.