噪声对大鼠T淋巴细胞亚群及其功能的影响

（目的）观察噪声暴露不同时间对大鼠T淋巴细胞群及其功能的影响。（方法）将大鼠暴露于100dB(A)噪声中,在不同的噪声暴露时间（1天,7天及21天）对大鼠T淋巴细胞亚群和淋巴细胞的增殖功能进行了检测。（结果）与对照组相比,接噪7天组CD8^ 细胞显著升高,接噪1天7天组CD4^ /CD8^ 比值显著低于对照组,在接噪的不同时间淋巴细胞增殖功能均降低。（结论）噪声暴露不同时间可引起淋巴细胞数量和功能的改变。     

学龄前儿童血铅水平对T淋巴细胞亚群的影响

目的　探讨低水平铅暴露对学龄前儿童CD+ 4CD+ 8双阳性T淋巴细胞的影响。方法　用石墨炉原子吸收光谱法对 2 17名学龄前儿童进行血铅浓度检查 ,并在此基础上用流式细胞仪检测不同血铅水平对学龄前儿童淋巴细胞免疫表型CD+ 4CD+ 8、CD+ 4、CD+ 8的影响。结果　高铅组 (血铅≥ 0 483μmol/L)学龄前儿童CD+ 4CD+ 8、CD+ 4、CD+ 4/CD+ 8与低铅组 (血铅 <0 483μmol/L)比较显著下降 (P <0 0 5 ) ;而CD+ 8细胞显著升高 (P <0 0 5 )。结论　低水平铅暴露对学龄前儿童CD+ 4CD+ 8、CD+ 4、CD+ 8具有不利影响     

儿童呼吸道合胞病毒感染T细胞亚群变化

目的 分析儿童呼吸道合胞病毒感染后T细胞亚群变化情况. 方法 选择儿童呼吸道合胞病毒感染患者34例为观察组,并选取同期健康体检小儿35例为对照组,在明确诊断后检测两组患者外周血淋巴细胞亚群及T淋巴细胞亚群. 结果 观察组Th1和Th2比率均高于对照组（P＜0.05）,Th1/Th2则低于对照组（P＜0.05）,观察组外周血T淋巴细胞亚群中CD3＋和CD8＋低于对照组（P＜0.05）,CD4＋高于对照组（P＜0.05）,且CD4＋/CD8＋高于对照组（P＜0.05）. 结论 小儿呼吸道合胞病毒性毛细支气管炎与小儿哮喘的T细胞亚群及Th1/Th2功能变化存在相似性,两者发病机制之间存在一定的关联性.     

不同临床表型支气管哮喘儿童T淋巴细胞亚群改变

目的探讨不同临床表型支气管哮喘儿童T淋巴细胞亚群改变情况,以期为儿童支气管哮喘的治疗提供理论依据。方法对23例婴儿短暂的喘息患儿、23例非特应性喘息患儿、41例特应性喘息／哮喘患儿外周血的T淋巴细胞亚群进行检测分析。结果特应性喘息／哮喘患儿CD4＋、CD4＋／CD8＋值高于婴儿短暂的喘息和非特应性喘息患儿,差异均有统计学意义（t值分别为2．843、2．873,均P〈0．05）;与FEV1／FVC和FEV1％呈明显的负相关（r值分别为-0．654、-0．676;-0．067、-0．675,均P〈0．01）,且与嗜酸性细胞计数和IgE呈正相关（r值分别为0．656、0．632;0．453、0．676,均P〈0．01）。结论T淋巴细胞亚群的改变可能是导致儿童发生特应性喘息／哮喘发病的因素,并且与特应性喘息／哮喘发病的严重程度密切相关。     

儿童血小板减少性紫癜T细胞亚群观察

正常机体中各T细胞亚群相互作用，维持着机体正常的免疫功能，当不同的淋巴细胞亚群的数量和功能发生异常时，机体就可导致免疫紊乱并发生一系列的病理变化，我们就30例血小板减少性紫癜（ITP）患儿外周血T细胞亚群进行检测，探讨ITP与T细胞亚群变化关系。     

T淋巴细胞亚群与调节性B细胞在儿童手足口病中的表达及临床意义

目的探讨调节性B细胞(Breg)在儿童手足口病中的作用,为临床治疗提供参考依据。方法选取2015年4月-2015年7月就诊的手足口病患儿71例为观察组,另选取50例健康儿童为对照组,治疗康复后的62例为康复组;用流式细胞术检测手足口病患儿外周血T淋巴细胞亚群细胞表达情况。同时用ELISA方法分析血清白细胞介素(IL-10)、转化生长因子-β(TGF-β)分泌水平。结果手足口病患儿T淋巴细胞亚群CD_3~+CD_8~+CD_(28)~+细胞毒T细胞的表达,重症患儿和普通型患儿组较对照组增高(P<0.01),重症患儿又显著高于普通型患儿组(P<0.01);相关性分析显示,手足口病患儿Breg细胞表达水平与血清IL-10呈显著正相关(r=0.75,P<0.01),与血清TGF-β无相关性,与CD_3~+CD_8~+CD_(28)~+细胞毒T细胞表达水平呈显著性负相关(r=-0.74,P<0.01)。结论手足口病患儿存在显著免疫失衡,即CD_3~+CD_8~+CD_(28)~+细胞毒T细胞显著增多,可能与Breg细胞表达减低导致的免疫抑制功能不足有关;Breg细胞表达水平分析有助于手足口病的诊断、进展和预后评估。     

T细胞亚群在儿童喘息性疾病中表达的研究

目的 探讨喘息性疾病患儿外周血T淋巴细胞亚群的表达及意义。 方法 应用流式细胞仪检测哮喘急性发作组、喘息性肺炎组及正常对照组儿童外周血T细胞亚群表达水平。结果 哮喘急性发作组和喘息性肺炎组CD3⁺淋巴细胞百分比均较正常对照组明显降低(P<0.01),且二者降低水平一致(P>0.05)。哮喘急性发作组CD4⁺淋巴细胞百分比较正常对照组和喘息性肺炎组均明显增高(P<0.05),且喘息性肺炎组CD4⁺淋巴细胞百分比与对照组比较差异也有统计学意义(P<0.05)。哮喘急性发作组及喘息性肺炎组CD8⁺淋巴细胞百分比与正常对照组比较明显降低(P<0.05),而哮喘急性发作组及喘息性肺炎组之间差异无统计学意义(P>0.05)。哮喘急性发作组和普通喘息组CD3^-CD19⁺和CD19⁺CD23⁺较正常对照组明显升高,差异有统计学意义(P<0.05),但这些指标在哮喘急性发作组和普通喘息组之间差异均无统计学意义(P>0.05)。 结论细胞免疫功能紊乱参与儿童喘息性疾病的发病。     

46例小儿哮喘T细胞亚群检测

支气管哮喘是一种慢性气道变态反应性炎症性疾病,近年来免疫功能与哮喘之间的关系愈来愈受到人们的关注。我们通过检测哮喘患儿T细胞亚群和IgE水平,以探讨T细胞免疫功能失衡在本病中的临床意义。临床资料1．检测对象:46例支气管哮喘患儿来自我院儿科门诊或住院部,其诊断均符合1993年第三届全国小儿呼吸道疾病学术会议制定的儿童哮喘诊断标准。男性28例,女性18例,年龄1.5~12岁,平均5.3岁;其中6岁以下32例,＞6岁14例;首发年龄≤3岁30例;病程最长9年。2．方法:全部患儿均采取同份清晨空腹静脉血血清作检测。(1)T细胞亚群T1、T4、T8和T1/T2检测:应用荧光免疫法(试剂盒由武汉生物制     

儿童幽门螺杆菌感染T淋巴细胞亚群分析

[目的]探讨幽门螺杆菌(HP)感染后的细胞免疫状况，作为提出免疫调节治疗儿童慢性胃病的理论根据。[方法]30例HP-IgG( )的患儿及20例HP—IgG(-)的正常健康儿童用流式细胞仪做T淋巴亚群分析。[结果]30例胃病儿童CD3、CD4均明显低于对照组儿童，CD4／CD比值显著下降。[结论]慢性胃病儿童存在细胞免疫功能紊乱，临床上除了常规治疗外，可给予免疫调节剂治疗。     

食管鳞癌患者外周血T淋巴细胞亚群的变化

目的研究食管鳞癌患者外周血T淋巴细胞亚群的变化特点。方法采用流式细胞技术，对108例食管鳞癌患者（食管鳞癌组）术前检测其外周血T淋巴细胞亚群水平，并与50例健康献血者（对照组）对比，分析食管鳞癌患者T淋巴细胞亚群的变化特点。结果（1）与对照组比较，食管鳞癌组患者外周血CD3^＋ 、NK细胞水平差异无统计学意义（P=0．890；P=0．320）；CD4^＋和CD8^＋水平显著增高（P=0．001；P〈0．001），由于CD8^＋增高的程度大于CDZ增高的程度，使得CDgCDs~较对照组降低（P〈0．001）。（2）早期食管鳞癌患者外周血CD4^＋/CD8^＋低于对照组，但差异无统计学意义（P=0．112）；中晚期食管鳞癌患者CDgCDs~进一步降低，与对照组比较差异有统计学意义（P〈0．001），但与早期食管鳞癌患者相比，差异无统计学意义（P=0．218）。（3）有淋巴结转移食管鳞癌患者CD4^＋和CD4^＋/CD8^＋均低于无淋巴结转移患者（P均〈0．001），CD8^＋和NK细胞均高于无淋巴结转移患者，差异均有统计学意义（P=0．002；P=0．005）。结论食管鳞癌患者存在免疫功能低下，随着肿瘤的进展免疫功能进一步受到削弱；监测CD4^＋/CD8^＋的变化可作为食管鳞癌病情进展的标志之一。     

学龄儿童单纯肥胖症的群体干预研究

目的：探索儿童单纯肥胖症的群体干预方法，降低学龄儿童肥胖发病率。方法 从北京市城区选择5所小学作为研究现场，该小学所有学生均为研究，其中2所学校为干预组（1597人），3所学校为对照组（2118人），采用WHO身高标准体重值为肥胖判断标准。对干预组进行为期3年的群体干预，干预措施包括健康教育，增加运动和饮食调整，重点为调整晚餐进食顺序，增加蔬菜水果的摄入量，减少静坐时间，增加运动等。干预对象为超重儿童及其家长，肥胖儿童及其家长，非肥胖儿童家长。对照组除与干预组同期体检外不接受任何干预措施。结果：经过3年干预，干预组肥胖发病率从16．9％降至12．1％（P＜0．01），对照组肥胖发病率从17．4％上升为23．2％（P＜0．01）。干预后两组肥胖发病率差别极显著。对干预组757名1－3年级儿童进行追踪观察，3年后原非肥胖儿童中3．6％成为肥胖儿童，原肥胖儿童中59．1％仍维持肥胖状态。对照组1031名1－3年级儿童中，有11．9％的原非肥胖儿童三年后为肥胖儿童，原肥胖儿童中92．2％仍维持肥胖状态。干预组非肥胖儿童成为肥胖的危险性明显小于对照组，对照组肥胖儿童维持肥胖的可能性明显大于干预组。结论 在学校进行以健康教育为主的肥胖群体干预方案切实可行，能有效地降低学龄儿童的肥胖发病率。     

Amino Acid-Related Metabolic Signature in Obese Children and Adolescents

The growing interest in metabolomics has spread to the search for suitable predictive biomarkers for complications related to the emerging issue of pediatric obesity and its related cardiovascular risk and metabolic alteration. Indeed, several studies have investigated the association between metabolic disorders and amino acids, in particular branched-chain amino acids (BCAAs). We have performed a revision of the literature to assess the role of BCAAs in children and adolescents’ metabolism, focusing on the molecular pathways involved. We searched on Pubmed/Medline, including articles published until February 2022. The results have shown that plasmatic levels of BCAAs are impaired already in obese children and adolescents. The relationship between BCAAs, obesity and the related metabolic disorders is explained on one side by the activation of the mTORC1 complex—that may promote insulin resistance—and on the other, by the accumulation of toxic metabolites, which may lead to mitochondrial dysfunction, stress kinase activation and damage of pancreatic cells. These compounds may help in the precocious identification of many complications of pediatric obesity. However, further studies are still needed to better assess if BCAAs may be used to screen these conditions and if any other metabolomic compound may be useful to achieve this goal.     

合理营养干预对儿童青少年肥胖病伴高血压的治疗效果

目的 探讨肥胖儿童高血压的发病率及经合理饮食干预、运动等综合治疗后的转归.方法 以470例7～18岁的单纯性肥胖儿童为研究对象,采用高蛋白质、适量脂肪和碳水化合物的营养干预模式,三者占总热能的百分比分别为20%～25%、25%～30%和45%～50%.总热能根据年龄、性别、身高及肥胖程度制定,一般为4 180～7 524kJ/d.轻、中度肥胖取上述治疗方案的上限值,重度肥胖取下限值,早、中、晚3餐占总热能的百分比分别为25%、40%和35%.除营养干预外,每天至少运动30分钟并常规补充多种维生素及微量元素制剂,主要为B族维生素和抗氧化营养素硒.结果 470例超重及肥胖儿中有185例诊断为高血压.185例中行正规随访者共有140例,随访率75.6%（140/185）.经以合理营养干预为主的综合治疗后高血压的痊愈率为81.4%（114/140）,好转率为15.7%（22/140）,未愈率为2.9%（4/140）.肥胖儿童青少年的体重指数、腰围与血压呈明显正相关.结论 儿童青少年肥胖病常伴有高血压,以合理营养干预为主的综合治疗可提高高血压患儿的预后。     

7～18岁肥胖儿童BMI、REE与瘦素之间关系的探讨

肥胖是由于能量平衡的调节障碍 ,即能量摄入与能量消耗不符所致 ,但这种调节紊乱的机制还不清楚。并且肥胖的发生和发展究竟是由于能量摄入过高 ,还是由于能量消耗过低 ,或两者都有 ,至今尚未明了 [1 ] 。为了解国内肥胖儿童的能量消耗特征 ,找出与肥胖程度的关系 ,为制定合理的干预措施提出理论依据 ,对门诊 35例肥胖儿童进行了 REE(restenergy expenditure,静息能量消耗 )和血清瘦素(leptin )的测定。1　材　料　与　方　法1 .1　资料来源　　 2 0 0 0年 3月至 9月 ,共选择 35名门诊单纯性肥胖儿童的初诊病人 ,以 1 993年上海地区调查的…     

Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link

Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health.     

Obesity,Sodium Homeostasis,and Arterial Hypertension in Children and Adolescents

Background: The relationship between obesity, arterial hypertension, and excessive salt intake has been known for a long time; however, the mechanism of this relationship remains not clear. Methods: The paper presents a current literature review on the relationship between salt consumption and the development of arterial hypertension in children and adolescents with obesity. Results: In addition to the traditional theory of hypertension development due to the increase in intravascular volume and disturbances of sodium excretion, recent studies indicate the existence of a complex mechanism related to excessive, pathological secretory activity of adipocytes, insulin resistance, and impaired function of the renin–angiotensin–aldosterone axis. That makes obese children and adolescents particularly vulnerable to the development of salt-sensitive arterial hypertension. Studies performed in many countries have shown that children and adolescents consume more sodium than recommended. It is worth noting, however, that the basis for these recommendations was the extrapolation of data from studies conducted on adults. Moreover, more important than sodium intake is the Na/K ratio and water consumption. Conclusion: Regardless of the population-wide recommendations on reducing salt intake in children, specific recommendations for overweight and obese patients should be developed.     

Dietary Intakes and Eating Behavior between Metabolically Healthy and Unhealthy Obesity Phenotypes in Asian Children and Adolescents

Diet plays a critical role in the development of obesity and obesity-related morbidities. Our study aimed to evaluate the dietary food groups, nutrient intakes and eating behaviors of metabolically healthy and unhealthy obesity phenotypes in an Asian cohort of children and adolescents. Participants (n = 52) were asked to record their diet using a 3-day food diary and intakes were analyzed using a nutrient software. Eating behavior was assessed using a validated questionnaire. Metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) were defined based on criteria of metabolic syndrome. Children/adolescents with MUO consumed fewer whole grains (median: 0.00 (interquartile range: 0.00–0.00 g) vs. 18.5 g (0.00–69.8 g)) and less polyunsaturated fat (6.26% kcal (5.17–7.45% kcal) vs. 6.92% kcal (5.85–9.02% kcal)), and had lower cognitive dietary restraint (15.0 (13.0–17.0) vs. 16.0 (14.0–19.0)) compared to children/adolescents with MHO. Deep fried food, fast food and processed convenience food were positively associated with both systolic (β: 2.84, 95%CI: 0.95–6.62) and diastolic blood pressure (β: 4.83, 95%CI: 0.61–9.04). Higher polyunsaturated fat intake (OR: 0.529, 95%CI: 0.284–0.986) and cognitive dietary restraint (OR: 0.681, 95%CI: 0.472–0.984) were associated with a lower risk of the MUO phenotype. A healthier diet composition and positive eating behavior may contribute to favorable metabolic outcomes in children and adolescents with obesity.     

Research on Environmental Influencing Factors of Overweight and Obesity in Children and Adolescents in China

This study aimed to explore the impact of environmental factors such as latitude, altitude, family socioeconomic status (SES), and level of urbanization on overweight and obesity (ow/ob) in children and adolescents. The participants comprised 26,120 children and adolescents aged 10–18 from 16 provinces in China. Differences in the prevalence of ow/ob under different environmental conditions were evaluated by the chi-square test. The influence of various environmental factors on ow/ob was obtained by logistic regression analysis. We found that (1) the prevalence of ow/ob fell between from 19.2% to 11.9% at 10 years old and from 13.8% to 6% at 18 years old; (2) latitude, family SES, income, and urbanization level are positively correlated with the prevalence of ow/ob; and (3) altitude has a negative correlation with the prevalence of ow/ob. The prevalence of ow/ob decreased with age in children and adolescents aged 10–18, and the risk of ow/ob showed significant differences in latitude, altitude, family SES level, gross domestic product (GDP), and level of urbanization.     

Musculoskeletal Problems in Overweight and Obese Children

PURPOSE The obesity epidemic in children is spreading at alarming rates. Because musculoskeletal problems can influence physical activity, we compared the frequency of musculoskeletal problems in overweight and obese children with that in normal-weight children.METHODS We performed a cross-sectional database and face-to-face interview study that included 2,459 children aged 2 to 17 years from Dutch family practices. We collected data on self-reported height and weight (body mass index), self-reported musculoskeletal problems in the 2 weeks before the interview, number of family physician consultations for musculoskeletal problems in 1 year, and age (2 age-groups were analyzed: 2 to 11 years and 12 to 17 years, because of the proxy interview in the youngest age-group). We calculated the odds ratio (OR) and 95% confidence interval (CI) for musculoskeletal problems in overweight and obese children, compared with normal-weight children.RESULTS Overweight and obese children in both age-groups (2 to 11 years and 12 to 17 years) reported significantly more musculoskeletal problems (OR = 1.86; 95% CI, 1.18–2.93; and OR = 1.69; 95% CI, 1.08–2.65, respectively) than normal-weight children. The total group of children who were overweight or obese reported more lower extremity problems than did the normal-weight children (OR = 1.62; 95% CI, 1.09–2.41); furthermore, they reported more ankle and foot problems than children who were of normal weight (OR = 1.92; 95% CI, 1.15–3.20). Overweight and obese children aged 12 to 17 years consulted their family physicians more often with lower extremity problems than did the normal-weight children (OR = 1.92; 95% CI, 1.05–3.51).CONCLUSION This study shows that overweight and obese children more frequently experience musculoskeletal problems than do normal-weight children.     

Estimation of Resting Energy Expenditure: Validation of Previous and New Predictive Equations in Obese Children and Adolescents

Objective: Accurate estimation of resting energy expenditure (REE) in childrenand adolescents is important to establish estimated energy requirements. The aim of the present study was to measure REE in obese children and adolescents by indirect calorimetry method, compare these values with REE values estimated by equations, and develop the most appropriate equation for this group.

Methods: One hundred and three obese children and adolescents (57 males, 46 females) between 7 and 17 years (10.6 ± 2.19 years) were recruited for the study. REE measurements of subjects were made with indirect calorimetry (COSMED, FitMatePro, Rome, Italy) and body compositions were analyzed.

Results: In females, the percentage of accurate prediction varied from 32.6 (World Health Organization [WHO]) to 43.5 (Molnar and Lazzer). The bias for equations was ?0.2% (Kim), 3.7% (Molnar), and 22.6% (Derumeaux-Burel). Kim's (266 kcal/d), Schmelzle's (267 kcal/d), and Henry's equations (268 kcal/d) had the lowest root mean square error (RMSE; respectively 266, 267, 268 kcal/d). The equation that has the highest RMSE values among female subjects was the Derumeaux-Burel equation (394 kcal/d). In males, when the Institute of Medicine (IOM) had the lowest accurate prediction value (12.3%), the highest values were found using Schmelzle's (42.1%), Henry's (43.9%), and Müller's equations (fat-free mass, FFM; 45.6%). When Kim and Müller had the smallest bias (?0.6%, 9.9%), Schmelzle's equation had the smallest RMSE (331 kcal/d). The new specific equation based on FFM was generated as follows: REE = 451.722 + (23.202 * FFM). According to Bland-Altman plots, it has been found out that the new equations are distributed randomly in both males and females.

Conclusion: Previously developed predictive equations mostly provided unaccurate and biased estimates of REE. However, the new predictive equations allow clinicians to estimate REE in an obese children and adolescents with sufficient and acceptable accuracy.