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1.
OBJECTIVES: To determine the prevalence of overweight and obesity in students from a private school in Recife; compare the prevalence rates of overweight and obesity in boys and girls and in different age groups (children and adolescents) and verify the correlation between body mass index and triceps skinfold thickness in this population. METHODS: Cross-sectional study with 762 students (332 children and 430 adolescents) from a middle/upper class school in Recife, in 1999. Overweight was defined as body mass index equal or above the 85th percentile for age and gender. Obesity was defined as body mass index and triceps skinfold thickness equal or above the 85th percentile. RESULTS: The prevalence rates were 26.2% (95%CI = 23 to 29%) for overweight, and 8.5% (CI95% = 6.5 to 10.5%) for obesity. Overweight was more prevalent among children (34.3%) than among adolescents (20.0%) (P<0.001). Obesity was more frequent among children (14.2%) than among adolescents (4.2%) (P<0.001). The prevalence of overweight in boys (34.6%) was higher than in girls (20.6%) (P<0.001). The prevalence of obesity was also higher in boys (14.7%) than in girls (4.4%) (P<0.001). The correlation coefficient between body mass index and triceps skinfold thickness was equal to 0.64 (95%CI = 0.60 to 0.68). CONCLUSIONS: The prevalence of overweight in our study population was as high as that found in industrialized countries; obesity, however, was less frequent.  相似文献   

2.
To assess the prevalence of obesity and overweight in adolescent girls between 10-15 years of age, among the affluent families of Chennai--two studies are compared using body mass index (BMI) as a parameter. The first study done in the year 1981 (Group I) was compared with the second study in 1998 (Group II). Group I had 707 and group II had 610 girls. Overweight and obesity were denoted by BMI above 85th and 95th percentile respectively. Results showed a 9.6% prevalence of overweight and 6% prevalence of obesity in both studies. It was also observed that the BMI for the same age in the two study periods showed an increase from 1981 to 1998. BMI approximated the international reference values for BMI at age 13 years in the year 1998.  相似文献   

3.
This study was conducted to assess the prevalence of obesity and overweight in adolescent public school girls ( 10-15 years of age) of Chennai in 1981 and 1998. The first part of the study done in the year 1981 (Group I; n = 707) was compared with the second part in 1998 (Group II; I = 610).Overweight and obesity were denoted by body mass index (BMI) above 85th and 95th percentile respectively. The prevalence of overweight (9.6 per cent in 1981 and 9.7 per cent in 1998) and obesity (5. 9 per cent in 1981 and 6.2 per cent in 1998) was comparable in both studies. It was also observed that the BMI for the corresponding age showed an increase front 1981 to 1998.  相似文献   

4.
The objective was to study the prevalence of obesity among adolescents in public schools of Ludhiana, catering to the affluent segment of population. We selected 1000 students from these schools by random, purposive sampling. Their anthropometry was taken. Students also filled-up a prevalidated questionnaire regarding dietary habits and lifestyle. Overweight/Obesity was defined using age and sex specific Body mass index (BMI) cut off points. Incidence of obesity was 3.4% and overweight was 12.7%. A significantly greater number of boys (15%) were overweight as compared to girls (10%).  相似文献   

5.
Objective: To investigate the prevalence and the trends of overweight and obesity in Finnish 5- and 12-year-old children in 1986 and 2006.
Design: Retrospective cross-sectional study.
Subjects and methods: Anthropometric data were collected retrospectively from health examinations in Tampere and in three rural municipalities. The size of the 5- and 12-year-old cohorts were 2108 in 1986 and 4013 in 2006, respectively. The body mass index (BMI) was calculated. Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI).
Results: The prevalence of overweight (ISO BMI >25) and obesity (ISO BMI >30) in 5-year-old boys in 2006 was 9.8% and 2.5% and in girls 17.7% and 2.5%, respectively. At the age of 12 years, the corresponding figures in boys were 23.6% and 4.7% and in girls 19.1% and 3.2%. Between 1986 and 2006, the prevalence of overweight in 12-year-old children had increased 1.8 fold in boys (p < 0.001) and 1.5 fold in girls (p = 0.008). Overweight was significantly more common in rural than in urban areas.
Conclusion: During the last 20 years the prevalence of overweight has markedly increased in 12-year-old Finnish children, but remained nearly unchanged in 5-year-old children.  相似文献   

6.
AIM: The aim of this study was to establish physical fitness (PF) levels in a school population of 11-18-year-old students and analyse differences according to body mass index (BMI) status in overweight METHODS: This is a cross-sectional study. The sample comprises 636 children and adolescents (mean age of 14.5+/-1.5 years), 288 boys (45.3%) and girls 347 (54.7%). Six tests from Fitness-gram battery were used as an objective measure of physical fitness. Overweight/ Obesity status was determined using age and sex adjusted cut-off points. RESULTS: Both girls and boys with obesity performed a significantly reduced number of tests in healthy fitness zone suggesting a decrease of performances in strength and cardiovascular fitness, from normal weight status to overweight and from overweight to obesity. Boys and girls with obesity are likely to be Under HFZ than normal weight. CONCLUSION: The results suggest that obese and overweight children have low PF level compared to normal weight peers. A large number of children with normal weight were identified as well as unfit. These data also showed that a low BMI level would significantly improve some PF component.  相似文献   

7.
北京市儿童青少年青春期发育与肥胖相关关系的研究   总被引:7,自引:0,他引:7  
目的 分析北京市6~18岁儿童青少年青春期发育与超重肥胖的关系。方法 利用2004年北京市儿童青少年代谢综合征调查总样本中19 085名6~18岁儿童青少年的青春期发育、体重指数(BMI)和体脂含量百分比(FMP)等数据。采用女性乳房和男性睾丸容积Tanner分期指标衡量青春期发育,结合个体年龄将群体分为早、晚发育组;以BMI和生物电阻抗法所测FMP作为反映体脂含量的指标;7~18岁人群超重和肥胖的诊断采用中国肥胖问题工作组(WGOC)推荐的中国学龄儿童青少年超重、肥胖筛查BMI值分类标准进行,6岁组采用美国疾病预防与控制中心 2000年发布的儿童超重和肥胖BMI标准第P85和第P95分位值进行诊断;采用多元线形回归、Logistic回归分析早发育与体脂含量和超重、肥胖的相关联系。结果 早发育组的超重(合并肥胖)率和肥胖率均高于晚发育组,女性两组间差异大于男性;控制可能的混杂因素后,女性BMI和FMP与早发育呈正相关(BMI:β=2.25,P<0.001;FMP:β=4.55,P<0.001);而男性BMI和FMP与早发育的联系相反,早发育组的BMI高于晚发育组,而FMP却低于晚发育组;以晚发育为参照组,控制年龄、城郊居住地等因素的影响后,早发育预测超重、肥胖的OR值(95%CI):女性为3.39(2.94~3.92)和3.12(2.53~3.85),男性为1.12(0.96~1.31)和1.31(1.06~1.62)。结论 北京市儿童青少年青春期发育与肥胖密切相关,在评价超重、肥胖率及进行不同地区间肥胖流行状况的比较时,要注意青春期发育的效应修正作用。  相似文献   

8.
OBJECTIVE: (1) To assess the height, weight and body mass index (BMI) of school children from Delhi and generate percentile charts as appropriate for age, gender and socio-economic status. (2) To determine the prevalence of overweight and obesity in school children from low and upper socioeconomic status (LSES and USES respectively). DESIGN: Cross sectional evaluation of anthropometric parameters in Delhi school children (5-18 years) from different geographical zones. SETTING: Government schools (non-fee paying) and Private Schools (fee paying) in Delhi. SUBJECTS: 21485 children, 8840 (3566 boys, 5274 girls) from government schools and 12645 (6197 boys, 6448 girls) from private schools. Methods: Subjects underwent assessment of height and weight and calculation of BMI. Children were classified as normal, overweight and obese as per IOTF guidelines. Height, weight and BMI percentile charts specific for the socioeconomic status were generated using the LMS method. Prevalence of overweight and obesity was assessed and compared between the two socio-economic groups. RESULTS: A significant difference was noted in height, weight and BMI between LSES and USES. The prevalence of overweight and obesity in USES children was 16.75 % and 5.59 % in boys and 19.01 % and 5.03 % in girls respectively. CONCLUSIONS: There is a significant disparity in anthropometric parameters between children from USES and LSES, with a high prevalence of overweight and obesity in USES children.  相似文献   

9.
目的:分析上海市1985至2014年7~18岁学生的超重和肥胖的动态变化趋势。方法:选取1985(n=14 677)、1995(n=7 916)、2000(n=15 270)、2005(n=7 492)、2010(n=14 301)和2014(n=15 423)年6次中国学生体质与健康调研上海地区资料进行分析。采用中国学龄儿童超重、肥胖BMI分类标准。结果:基于上海市6个区总调查样本量,以10年(1985、1995、2005和2014年)为1个周期,随年代增长上海市7~18岁男、女学生BMI P50百分位数曲线逐年提高,总体男生较女生提高更为明显,不同年龄组的男女生BMI均值呈上升趋势且均为男生高于女生。2014年上海市BMI和全国比较,P50男女生均高于全国水平,P85和P95男女生11和12岁前与全国水平重合,之后高于全国水平。与1985年比较,2014年上海市7~18岁男生超重检出率增加了11倍(19.3% vs 1.7%),肥胖检出率增加了29倍(11.7% vs 0.4%),平均增长率为12.3%;上海市7~18岁女生超重检出率增加了7倍(11.6% vs 1.5%),肥胖检出率增加了31倍(6.4% vs 0.2%),平均增长率为12.7%。各年龄组男生超重检出率14.3%~26.9%、肥胖检出率7.3%~17.0%,男生11岁超重和肥胖检出率最高;各年龄组女生超重检出率8.6%~14.0%、肥胖检出率2.8%~11.2%,女生7岁超重和肥胖检出率最高。男生各年龄段超重和肥胖检出率均高于女生。结论:上海市1985至2014年7~18岁学生超重与肥胖检出率持续增长。低年龄段男生超重流行程度较为严重,已处于国际高位水平。  相似文献   

10.
Aim: To provide updated prevalence data of BMI and obesity in 4‐year‐old Swedish children, also exploring socioeconomic differences. Subjects: A total of 4407 children born 1998–1999 (2231 boys and 2176 girls) in the county of Västerbotten, Sweden. Methods: Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI). Information about socioeconomic level of the municipalities was collected from a health survey of the adult population. Results: Of the boys, 16.7% were classified as overweight and 3.1% of these as obese. Corresponding figures for girls were 22.1% and 4.5%. The P50 and P95 values for BMI were 16.2 and 18.8 for boys and 16.1 and 19.3 for girls, respectively. P50 was at the same level as in previous Swedish studies, while P95 was higher in this study. Obesity, in girls, was more prevalent in municipalities with a low socioeconomic level. Conclusion: Overweight and obesity in pre‐school children in Sweden is more prevalent in girls than in boys, and the prevalence is as high as in school age children. A low socioeconomic level of living area seems to be related to a higher prevalence of obesity. Increased preventive efforts, both on the individual and the societal level, must be undertaken to reduce future health risks in obese children.  相似文献   

11.
AIMS: To identify familial and school determinants of overweight in 13-year-old adolescents. METHODS: All 27 public and 19 (79%) private schools allowed to contact age eligible students, 77.5% accepting to participate (1116 girls, 1045 boys). Self-administered questionnaires were completed and physical examination performed, including weight and height measurements. Overweight (> 95th percentile) and at risk of overweight (85th-95th) were defined using CDC standards. Its determinants were identified using logistic regression models, entering parents' education and all variables significantly associated in crude analysis. RESULTS: Prevalence of overweight (10.2%) and at risk of overweight (16.5%) was not influenced by type of school, vending machines and number of school canteen meals. In girls, the prevalence of body mass index (BMI) > 85th percentile increased significantly with decreasing age at menarche (45.7% if menstruating before 11-year and 13.2% when pre-menarche), and increasing parental BMI or time spent on sedentary activities. In multivariate analysis, age at menarche and increasing parental BMI remained significant risks in girls. In boys, besides parental BMI, ever smoking, sleeping < 9 h and sedentary leisure activities were significant determinants. CONCLUSIONS: Food offered at school had no significant impact on adolescents overweight, which was mainly dependent on parental anthropometrics and leisure time activities.  相似文献   

12.
目的 描述2011年北京市7~18岁儿童青少年超重和肥胖的检出率,并比较基于不同BMI筛查标准的检出率的差异。方法 研究对象为2011年北京市中小学体检的7~18岁学龄儿童青少年。采用BMI作为评价超重和肥胖的指标。超重和肥胖筛查分别采用4种不同的国内(CN2010和WGOC)和国际(IOTF和WHO2007)标准。不同BMI筛查标准之间超重、肥胖检出率比较采用McNemar检验。结果 ①92 212名男女生BMI在P50、P85和P95上均显著高于全国水平(2009年“中国0~18岁儿童青少年体块指数的生长曲线”),男女生在对应百分位曲线上无交叉现象,男生BMI水平高于女生。②基于CN2010和WGOC标准,男生肥胖检出率分别为17.8%和18.2%,女生检出率分别为10.8%和10.9%;基于IOTF和WHO2007标准,男生肥胖检出率分别为12.9%和21.0%,女生检出率分别为6.0%和8.6%。③基于CN2010和WGOC标准,男生超重(含肥胖)检出率两标准间差异无统计学意义,均为36.0%,各年龄组差异亦不明显,但女生检出率CN2010标准高于WGOC标准(28.1% vs 24.1%),在7~15岁组差异较为明显,但在16~18岁组差异较小;与国际标准相比,基于国内标准的男生超重(含肥胖)检出率略高于IOTF标准,但却明显低于WHO2007标准,女生检出率超重(含肥胖)明显高于IOTF标准,但与WHO2007标准较为接近。④与基于WGOC标准的2004年北京市7~18岁儿童青少年超重和肥胖检出率相比,2011年超重和肥胖检出率显著增长,男女肥胖检出率分别增长5.8%和3.8%,超重(含肥胖)检出率分别增长9.3%和7.6%。结论 2011年北京市7~18岁学生中有1/3处于超重或肥胖状态。国内标准与国际标准存在明显差异,在反映中国儿童的超重肥胖流行状况时建议采用国内标准,而理想的国内标准应实现2~18岁的统一,并与成人接轨。  相似文献   

13.

Objective

Overweight among adolescents is not only an important public health problem but also a problem affecting economic growth in developing countries. The aim of this study was to investigate the parental determinants of overweight and obesity in Iranian adolescents at national level.

Methods

This cross sectional study was conducted within the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of IR Iran during 2001-2003. In adolescents, anthropometric indices were defined based on the CDC 2000 cut-off points for age and gender-specific body mass index (BMI). Parental characteristics were collected by questionnaire. Among the 7158 participating households, data on 7908 adolescents aged 11-19 years (3750 girls and 4158 boys) was analyzed.

Findings

The prevalence of overweight (85–94th percentile) in boys and girls was 6.2%, and 8.7%, respectively. The prevalence of obesity (≥95th percentile) among boys and girls was similar (3.3%). Parents’ weight status, father''s job and parents’ education showed significant association with weight status in adolescents. Logistic regression analysis showed that parental overweight and obesity, parental education and father''s job were the main parental determinants of overweight and obesity in Iranian adolescents.

Conclusion

Parental overweight and obesity, parental education and father''s job seem to be the major parental determinants of overweight in Iranian adolescents. Future prevention programs must take these risk factors into account.  相似文献   

14.
Aim:  To assess in a subset of a nationally representative sample of Portuguese adolescents, the validity of Body Mass Index (BMI) based on self-reported weight and height.
Methods:  This study included 462 students in grades 6, 8 and 10 (mean age 14.0 ± 1.9 years) from 12 public schools randomly selected from the list of schools which took part in the 2006 Health Behaviour in School Aged Children Portuguese survey, corresponding to approximately 10% of the sample. Self-reported weight and height were recorded and then measured.
Results:  Prevalence of normal weight, overweight and obesity based on self-report compared with that of measured values was not significantly different for boys and girls, and among age groups. BMI based on measured weight and height was underestimated compared with BMI based on self-reported data, both among girls and boys. Larger limits of agreement were found for boys, indicating a higher variability of self-reported BMI in estimating measured BMI, specifically below the age of 14 years.
Conclusion:  These data suggest that BMI based on self-reported weight and height is not accurate for BMI prediction at an individual level. However, self-reported BMI may be used as a simple and valid tool for BMI estimates of overweight and obesity in epidemiological studies.  相似文献   

15.
Aim: To study the prevalence of overweight and obesity, and weight-related concerns and behaviours among overweight, obese and non-overweight children and adolescents. Methods: We carried out a cross-sectional survey of all Chinese students in primary schools in the Central and Western District of Hong Kong in March 2002. Thirty-one of 32 schools participated, and 5402 boys and 5371 girls aged 8 to 15 y who completed a standardized questionnaire were included. We used the International Obesity Task Force definition (IOTF reference) to define overweight and obesity. Results: The prevalence (95% CI) of overweight was 16.4% (15.7-17.1%) (19.9% in boys, 12.9% in girls), and that of obesity was 7.7% (7.2-8.2%) (10.3% in boys and 5.1% in girls). The combined prevalence of overweight and obesity was similar to that based on the local reference. Overweight children had more concerns about their weight than obese children. They were more likely than obese children to feel fat, wish to be lighter, diet and exercise to lose weight. Although obese children were heavier, they did not make more effort to lose weight than overweight children.

Conclusions: The differences in weight-related concerns and behaviours among overweight, obese and non-overweight children suggested good validity of the IOTF reference and the self-reported data. The differences between overweight and obese children suggested that the two groups had different psychological states and that they needed different weight management programmes and other intervention strategies.  相似文献   

16.
《Academic pediatrics》2014,14(6):639-645
ObjectiveTo describe childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identify among gender- and race/ethnicity-specific groups any trends for increased risk.MethodsA retrospective cohort study was conducted among 2- to 12-year-old patients (2006–2013) visiting a safety-net provider. BMI z-score trajectories were calculated overall, for gender- and race/ethnicity-specific groups, and for peak BMI percentile subgroups to describe weight gain longitudinally.ResultsFrom 2006 to 2013, a total of 26,234 eligible children were followed for an average of 3.7 years. At baseline (mean age, 4.2 years), 74% of patients were at a normal weight compared to 65% at most recent observation (mean age, 7.8 years). All gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood. Children consistently under the 50th percentile and those of white race had the most stable BMI z-score trajectories. BMI z-score increased with increasing age in all subgroups. Hispanic boys and black girls had the most significant increase in BMI z-score during this observation period. Children observed in early childhood and whose BMI exceeded the 95th percentile at any time were often already overweight (20%) or obese (36%) by 3 years of age.ConclusionsThe entire population demonstrated an upward trend in BMI z-score trajectory. This trend was most notable among black girls and Hispanic boys. Many obese children were already overweight by age 3, and persistence of obesity after 3 years of age was high, suggesting that intervention before age 3 may be essential to curbing unhealthy weight trajectories.  相似文献   

17.
目的了解郑州地区儿童肥胖发生情况和探索干预措施。方法于2001年抽样调查5688例中小学生,男2848名,女2840名,年龄7~18岁。肥胖标准以Cole等的诊断儿童肥胖的参考BMI值判断,并对筛选出的单纯性肥胖儿童22例(7~15岁,男18例,女4例)以中医循经推拿和行为矫正及饮食、运动调整综合治疗1个月,且于治疗结束6个月后随访。结果所调查的5688名中小学生超重发生率15.4%,肥胖发生率3.2%,男生超重、肥胖发生率(19.2%,4.6%)明显高于女生(11.5%,1.7%P<0.001);各年龄阶段超重发生率有明显差异(χ2=42.88P<0.001),高发年龄为8~15岁;各年龄阶段肥胖发生率亦有差异(χ2=21.28P<0.05),高发年龄为7~10岁和14~15岁;治疗1个月后22例肥胖儿童体质量均有下降,由入院时(76.45±19.87)kg下降至(69.06±17.98)kg,下降幅度(7.43±2.58)kg,BMI值由治疗前(31.05±3.96)下降至(27.72±3.54),治疗前后体质量和BMI值比较均有显著差异(t=13.6,12.88P<0.01),且体质量、BMI值下降幅度与入院时体质量、BMI值均呈明显相关性(r=0.77P<0.01;r=0.49P<0.05)。结论近年来儿童肥胖发生率增高,以中医循经推拿和行为矫正及饮食、运动调整综合治疗的方法疗效好且舒适,儿童易于接受。  相似文献   

18.
BACKGROUND: To investigate the prevalence of overweight and obesity in an adolescent group representative of a rural Mediterranean area and to determine possible associations with energy and nutrient intakes and levels of physical exercise. METHODS: A representative sample of adolescents was drawn from the secondary school of Torre Pacheco (Murcia), a rural Mediterranean area located in the southeast of Spain. The population selected (331 adolescents aged 14-18 years), was divided into two groups: normal-weight subjects with a body mass index less than 23 kg/m2 and overweight or obese subjects with a body mass index of 23 kg/m2 or more. Weight, height, abdominal and hip perimeters, triceps skinfold, and upper arm circumference were measured. A prospective 7-consecutive-days food record and physical activity questionnaire were completed. RESULTS: Overweight boys and girls had an apparently lower energy intake (P = 0.001 and P = 0.042, respectively), and carbohydrate intake (P = 0.000, P = 0.032) than their normal-weight counterparts, but they tended to underreport more often. Overweight boys derived a greater percentage of their energy from fat (P = 0.049) and less from carbohydrate (P = 0.016) than their normal-weight counterparts. Among girls, the percentage of energy derived from fat increased with body mass index (r = 0.210, P = 0.008), whereas fiber intake decreased (r = -0.145; P = 0.041). Overweight and obesity were negatively related to physical activity level only among boys (P = 0.033). CONCLUSION: There is a high prevalence of overweight and obesity in the adolescent population studied (48.2% in boys and 30.7% in girls). The study shows an association between overweight and obesity and nutrient intake and activity level.  相似文献   

19.
OBJECTIVE: To assess the frequency of obesity, overweight and underweight (thinness) in Polish 7-9-year-old children using a population specific definition as compared to the French, US and IOTF references based on body mass index (BMI). DESIGN: Height and weight were measured and BMI was calculated in a randomly selected representative sample of 7-9-year-old Polish children (N = 2916; 1445 girls; 1471 boys) to define their nutritional status. Overweight (including obesity) was estimated according to four and underweight (thinness) according to three definitions Polish national references; French references; United States references and International Obesity Task Force references. RESULTS: According to Polish, French, U.S. and IOTF references overweight (including obesity) was found in 12.1, 14.3, 20.7 and 15.4% of children, respectively; 3.5, 9.4 and 3.6% of children were obese according to national, U.S. and IOTF references, respectively while underweight (thinness) was present in 6.9, 2.6 and 4.2% of children according to Polish, French and U.S. references, respectively. A trend of decreasing overweight and increasing underweight through age classes was observed. CONCLUSION: The rates of underweight (thinness), overweight and obesity in Polish 7-9-year-old children calculated according to the national, French, U.S. and IOTF references were significantly different. Therefore even if the IOTF reference is considered superior for international epidemiological studies, population specific standards should probably coexist for clinical practice.  相似文献   

20.
The aim of this study was to determine the prevalence of overweight and obesity in Saudi children from different provinces of the country and in different age groups. A total of 12,701 children (6,281 boys and 6,420 girls) with ages ranging from 1 to 18 years were enrolled during a household screening programme in different provinces of Saudi Arabia and height and weight were recorded. Body Mass Index (BMI) was calculated and applying age and sex specific cut-off points for BMI the children were grouped into overweight and obese. The overall prevalence of overweight was 10.68 and 12.7 per cent and that of obesity was 5.98 and 6.74 per cent in the boys and girls, respectively. In the different provinces the prevalence of overweight ranged from 8.8 to 27.4 per cent and from 9.3 to 27.6 per cent and obesity ranged from 4.7 to 10.4 per cent and from 4.3 to 13.8 per cent in the boys and girls, respectively. Prevalence of overweight and obesity was also calculated after grouping the children into 17 groups according to age. It is concluded that overweight and obesity occur in all provinces of Saudi Arabia although at a variable prevalence. In general, girls have a higher prevalence of both overweight and obesity compared with boys. Eastern province children have the highest prevalence and the Southern province children have the lowest prevalence of overweight and obesity. When grouped according to age, overweight and obesity tend to increase with age. Suggestions are made to prevent overweight and obesity development in Saudi children.  相似文献   

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