儿童乳糖酶缺乏的临床评价

目的　探讨健康儿童乳糖吸收不良 (LM )和乳糖不耐受 (LI)的发生率与年龄的关系 ;研究感染性腹泻LM和LI的发生与临床特征。方法　随机选择健康儿童 138名 ,男 72名 ,女 6 6名 ,年龄为 4个月至 12岁 ,和感染性腹泻患儿 95名 ,男 5 9名 ,女 36名 ,年龄为 2个月至 4岁。采用乙醇乳糖耐量试验 (LTTE)尿半乳糖 (U gal)测定法与症状反应评分 (SRS)进行判断。结果　 138名儿童中LM和LI的发生率 :<4岁、4～ 5岁、6～ 7岁、8～ 9岁、10～ 12岁分别为 10 %、5 0 %、6 9.6 %、87%和 91.7%。 <4岁组LM和LI发生率明显低于其它各组 (P <0 .0 1)。 95名感染性腹泻患儿LM和LI的发生率和恢复率与腹泻病原有关。轮状病毒肠炎 ,大约 4周可痊愈。结论　健康儿童LM和LI发生率 4岁后明显增加 ;感染性腹泻儿童LM和LI的发生率与感染原有关 ,腹泻期免乳糖食品值得推荐     

Milk consumption and lactose intolerance in adults

Objective To investigate relations between milk consumption and lactose intolerance (LI) in adults and to explore the effect of milk consumption on lactase activity.Methods Total of 182 subjects aged 20‐70 years were recruited and interviewed by questionnaires,and their accumulative cow's milk intake (AMI) was calculated.LI was evaluated by hydrogen breath test (HBT).Results A negative correlation was found between AMI and severity of observed LI symptom (r=-0.2884;P<0.05).Binary logistic regression analysi...     

Lactase deficiency in Australian school children

The prevalence of lactase deficiency is high in Mediterranean, Middle Eastern and Asian countries, which suggests that many immigrants and immigrant children from these regions may be unable to produce lactase. Therefore, the aim of this study was to determine the prevalence of lactose malabsorption in primary school-aged children, in two communities with a high proportion of immigrants in metropolitan Sydney. A total of 109 children, aged five to 12 years, were studied by means of the breath hydrogen method. Forty per cent (44/109) showed lactose malabsorption, as defined by a rise in end-expiratory hydrogen levels of 20 ppm or more, two hours after loading with lactose. The prevalence was highest in the subjects of Asian origin (93%; 14/15), followed by Greek subjects (56%; 14/25) and subjects from other Mediterranean and Middle Eastern countries (41%; 15/37). Of the 77 children who were available for follow-up, 57% (44) reported symptoms of lactose intolerance, of whom nearly two-thirds were children who showed lactose malabsorption. The high prevalence of lactase deficiency in children at both schools underlines the need to consider the multiracial identity of Australians in planning educational programmes about nutrition.     

The Influence of Secular Trends in Body Height and Weight on the Prevalence of Overweight and Obesity among Chinese Children and Adolescents

Objective To explore the influence of secular trends in body height and weight on the prevalence of overweight and obesity among Chinese children and adolescents. Methods The data were obtained from five cross-sectional Chinese National Surveys on Students’ Constitution and Health. Overweight/obesity was defined as BMI-for-age Z-score of per the Wold Health Organization (WHO) reference values. Body height and weight for each sex and age were standardized to those reported in 1985 (standardized height: SHY; standardized weight: SWY) and for each sex and year at age 7 (standardized height: SHA; standardized weight: SWA) using the Z-score method. Results The prevalence of overweight/obesity in Chinese children was 20.2% among boys and 10.7%among girls in 2010 and increased continuously from 1985 to 2010. Among boys and girls of normal weight, SHY and SHA were significantly greater than SWY and SWA, respectively (P < 0.001). Among boys and girls with overweight/obesity, SHY was significantly lower than SWY (P < 0.001), and showed an obvious decreasing trend after age 12. SHA was lower than SWA among overweight boys aged 7-8 years and girls aged 7-9 years. SHY/SHW and SHA/SWA among normal-weight groups were greater than among overweight and obese groups (P < 0.001). Conclusion The continuous increase in the prevalence of overweight/obesity among Chinese children may be related to a rapid increase in body weight before age 9 and lack of secular increase in body height after age 12.     

Prevalence of overweight/obesity in Chinese children

BACKGROUND: The purpose of this paper was to report the prevalence of overweight/obesity by area, age, and gender in the year 2000 and to explore at what age adiposity rebound as measured by BMI occurs for Chinese children. METHODS: A cross-sectional study was carried out among 262,738 children aged 3.5-6.4 years in 26 counties/cities in China. Weight and height were measured from March 2000 through July 2000 by local trained health workers. International age- and gender-specific BMI cut-off points were used to obtain comparable prevalence rates of overweight/obesity. Multiple logistic regression was used to estimate odds ratios (OR) of being overweight/obesity for different comparisons. RESULTS: There were 19,390 overweight (16,738) or obese (2,652) children, resulting in an overall prevalence rate of 7.4% (95% CI: 7.3-7.5%). Girls were more likely to be overweight or obese than boys (OR = 1.14, 95% CI: 1.11-1.17). Compared with children living in the southern urban area, multivariate ORs for those living in northern rural and southern rural areas were 2.58 and 1.15, respectively. Compared with children aged 6.0-6.4 years old, multivariate ORs for children aged 3.5, 4.0, 4.5, 5.0 and 5.5 years were 1.96, 1.88, 1.56, 1.53, and 1.11, respectively (p<0.001). CONCLUSIONS: Childhood overweight/obesity in Chinese children in 2000 is similar to the conditions of Great Britain or the U.S. in the 1980s or earlier. Age at adiposity rebound as measured by BMI for Chinese children is >6.5 years old.     

伴与不伴学习困难的注意缺陷多动障碍儿童脑α波竞争图特点

目的:探讨伴与不伴学习困难(LD)的注意缺陷多动障碍(ADHD)儿童脑α波竞争图特点及其神经生理机制.方法:以符合美国《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)诊断标准,并按照性别、年龄及ADHD亚型配对的单纯ADHD患者、ADHD共患LD患者及正常儿童各68例为研究对象,应用脑电超慢涨落分析仪,采集并分析处理三组儿童的脑电信号α波特点.结果:(1)单纯ADHD组:8 Hz全脑平均优势几率(25.84%±14.81%)高于正常儿童(16.50%±11.42%,P=0.000),主频是10 Hz,但α波能量分布均分散、低平.(2)ADHD共患LD组:8、13 Hz全脑平均优势几率(分别为25.11%±11.88%,1.14%±1.14%)均高于正常儿童(分别为16.50%±11.42%,0.74%±0.97%,P值分别为0.000, 0.009);10 Hz全脑平均优势几率(27.80%±13.28%)低于正常儿童(36.06%±17.21%,P=0.011);主频是9 Hz,α波能量分布均分散、低平;患者右脑及左侧顶、颞、枕部的熵值高于正常儿童,右侧颞、枕部的熵值高于单纯ADHD组(P均＜0.05).结论:伴与不伴LD的两组ADHD儿童具有不同的神经病理机制:单纯ADHD儿童脑发育迟缓;共患LD儿童脑波发育偏离正常,认知参量10 Hz成分减少,脑有序度差,脑处于低功效状态.     

Trichuris Dysentery Syndrome: evidence that it may be underdiagnosed in Kelantan

The prevalence rate of trichuriasis in children in certain areas of Kelantan is high. However the Trichuris Dysentery Syndrome (TDS), a condition in children characterized by chronic diarrhoea, stunting and anaemia is said to be rare. A recent change in policy at our institution to lower the threshold for undertaking colonoscopy in children with chronic diarrhoea resulted in the detection of 6 cases of TDS in less than a year. The median age was 7 years (range 3-13) and the median duration of symptoms before diagnosis was 2 years (range 1-8). The insidious nature of TDS and the low level of awareness of this condition even among health care workers may result in considerable underdiagnosis.     

Report on Childhood Obesity in China （4） Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students' constitution and health (CNSSCH) between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China (WGOC) was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to socioeconomic status (SES) of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children's life styles.     

乳糖酶缺乏基础研究进展

乳糖酶是存在于哺乳动物小肠黏膜微绒毛膜表面上的一种双糖酶。乳糖酶缺乏(LD)是个世界性的问题,影响了全世界近2/3的人口,亚洲的患病率高达95%~100%。LD会造成乳糖吸收不良,甚至出现一系列乳糖不耐受的症状,对人类的健康造成很大的威胁。现就LD的分子生物学研究进展综述如下。     

Effect of lactase preparations in asymptomatic individuals with lactase deficiency--gastric digestion of lactose and breath hydrogen analysis

We compared two lactase preparations derived from Aspergillus orizae (AOL) and Penicillinase multicolor (PML) for stability in the stomach and overall enzymatic activity in 10 asymptomatic subjects with lactase deficiency. The subjects were given 10,000 FCC units of either AOL or PML 30 min prior to or simultaneously with 300 ml of milk. Gastric juice was withdrawn through a nasogastric tube immediately after and every 15 min for 60 min, and breath was sampled before and every 15 min for 6 h after the milk ingestion. When lactase was given simultaneously with the milk, gastric juice lactase activity and galactose concentration were significantly higher than the control levels. When lactase preparations were given 30 min prior to the milk, neither lactase activity nor galactose was detected in the gastric juice. The pH of the gastric juice was about 6.0 after the milk ingestion. Breath hydrogen did not increase when milk was ingested simultaneously with enzymes, but did increase if enzymes were given 30 min prior to milk ingestion. There were no significant differences in lactase activity, galactose concentration in gastric juice, or breath hydrogen when AOL and PML were compared. In conclusion, with exogenous lactase, digestion of lactose begins in the stomach when pH is raised to 6.0 by the buffering action of milk. Lactase preparations are effective assessed by breath hydrogen analysis in asymptomatic individuals with lactase deficiency if the enzymes are given simultaneously with milk.     

城市0～7岁儿童单纯肥胖症流行病学研究

目的了解我国０～７岁儿童单纯肥胖症流行情况及特征,并与１９８６年我国的调查资料作比较。方法身高别体重大于美国卫生统计中心／疾病控制中心参照人群的１０％～１９％为超重,２０％～２９％为轻度肥胖,３０％～４９％为中度肥胖,５０％为重度肥胖。共调查了１１个城市２０８５１３名儿童。结果总肥胖检出率为：男２．２％,女１．９％。总超重率男女均为４．２％;肥胖超重比男１．９,女２．１。从地区分布看,肥胖与超重的检出率为：北片、南片高,中片低。脂肪重聚年龄为５岁,脂肪重聚比前半年为：男２．９％,女３．５％,后半年为男１．７％,女２．４％。与１９８６年相比,１０年动态趋势为：肥胖检出率年增长值,男１０％,女８．７％;南片和中片高,北片低。结论（１）单纯肥胖症已成为学龄前儿童严重健康问题。（２）１９８６～１９９６年肥胖检出率年增长率处于失控的奇高速度。（３）脂肪重聚年龄超前和肥胖－超重比过大是肥胖检出率上升的重要危险因素。（４）脂肪重聚比提示学龄前控制肥胖的两个重要时期为生后１岁和５岁。     

乳糖酶缺乏的间接诊断法（乙醇乳糖耐量试验血,尿半乳糖测定法）

乳糖酶缺乏(LD)是儿童和成人的常见疾病,确定诊断最可靠的方法是小肠粘膜活检直接测定酶活性,然而其侵入性难以作为常规手段应用。本文旨在通过血和尿半乳糖测定建立一LD的间接诊断法。在受试者口服含乳糖和乙醇150mg/kg溶液时,于空腹和乳糖负荷后40分钟分别采静脉血、毛细血管血和尿液各一次测定半乳糖浓度。血半乳糖<0.3mmol/L、尿半乳糖<2mmol/L诊断为LD。试验表明本法简便可信,可做为LD的间接诊断法供临床选用。     

石家庄市7～13岁儿童肥胖及家庭聚集性调查研究

目的 调查石家庄市7～13岁儿童超质量率和肥胖率以及肥胖儿童家庭肥胖集聚性比例.方法 采用营养流行病学研究方法,对石家庄市95 292例7～13岁儿童进行体检,调查石家庄市学龄儿童超质量肥胖率.按照整群抽样的方法选取450例超质量肥胖儿童进行膳食行为、生活方式、肥胖儿童家庭聚集性调查.结果 ①石家庄市7～13岁儿童超质量率27.4%,肥胖率13.2%.儿童超质量肥胖率在性别、年龄方面,差异有统计学意义（P〈0.05）.②肥胖家庭聚集性比例20.3%,超质量家庭聚集性比例75.3%.Ⅰ代亲属超质量率54.6%,肥胖率14.1%.Ⅱ代亲属超质量率53.1%,肥胖率13.7%.不同年龄儿童肥胖家庭聚集性比例不同,差异有统计学意义（P〈0.05）.肥胖家庭聚集性在性别、出生体质量、家庭收入方面,差异无统计学意义.结论 石家庄市7～13岁儿童超质量和肥胖率较高.超质量肥胖儿童家庭存在集聚性而且肥胖家庭聚集性比例较高.所以需要探索对家庭成员实施整体干预的肥胖干预新模式,从而达到有效控制和改善儿童肥胖的目的.     

Prevalence of Intestinal Parasites among Pupils in Rural North Eastern, Nigeria

BACKGROUND: The study determined the prevalence of intestinal parasitism among pupils in rural schools (Almajiris) in Konduga local Government Area of Borno state. MATERIALS AND METHODS: A total of 257 stool specimens were collected at random among pupils (Almajiris) in rural quranic schools; the stools were processed and examined both macroscopically and microscopically by concentration techniques. RESULTS: The prevalence of intestinal parasitism among the Almajiris was 80.9%. The highest prevalence rate was 97.8% while the least prevalence was 67.4%. The 6-8 years age group had the highest prevalence of 85.7% while the least prevalence of 77.7% in the 13-16years age bracket. Ascaris lumbricoides had the highest prevalence of (19.1%) while Trichuris trichiura had the least prevalence of (3.5%). Thirteen pupils in the 5-8 years had multiple parasites; multiple parasitism also occurred in 22 pupils aged 9-12 years and in 11 pupils aged 13-16 years. CONCLUSION: There is a high prevalence rate of intestinal parasites with attendant risk of intestinal obstruction among the Almajiris in rural north eastern Nigeria.     

Current trends of the prevalence of childhood asthma in three Chinese cities: a multicenter epidemiological survey

Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthrna was conducted in children aged from 0 to 14 years in 3 major cities of China （Beijing, Chongqing, and Guangzhou） with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase III questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question＂ Has your child ever been diagnosed as asthma by a doctor＂ were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria （x^2=3.938, P=-0.047; 22=73.506, P≤0.001; x^2=11.956, P=0.001, in each city）. Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.     

Prevalence of asthma, rhinitis and eczema among children in 2 Canadian cities: the International Study of Asthma and Allergies in Childhood

BACKGROUND: Wide variations in the prevalence of asthma, rhinitis and eczema have been reported between regions within Canada and between different countries. The International Study of Asthma and Allergies in Childhood (ISAAC) was developed to provide a standardized tool and methodology to ascertain the prevalence of asthma and allergies in different regions. Comparisons of prevalence rates across geographic regions and at different times may help to identify factors that contribute to the development of these conditions in individuals. METHODS: Two Canadian centres, Hamilton and Saskatoon, participated in the ISAAC. A standard questionnaire was distributed through schools and completed by 13- and 14-year-old children and by the parents of 6- and 7-year-old children. Prevalence rates and 95% confidence intervals were calculated for asthma, wheezing, rhinitis and eczema. RESULTS: The overall response rates were 75.1% among the children 6 and 7 years old and 68.6% among those 13 and 14 years old. Among the younger children, the lifetime prevalence of asthma was 17.2% in Hamilton and 11.2% in Saskatoon; the corresponding rates among the older children were 19.2% and 12.2% respectively. The prevalence of wheezing in the 12 months before the survey in the younger group was 20.1% in Hamilton and 14.1% in Saskatoon; in the older group it was 30.6% and 24.0% respectively. The prevalence of rhinitis in the 12 months before the survey was 28.6% in Hamilton and 22.6% in Saskatoon in the younger group and 45.8% and 33.8% respectively in the older group. The prevalence of eczema was slightly higher in Saskatoon in both age groups. INTERPRETATION: High prevalence rates of asthma, rhinitis and eczema exist among school children in Hamilton and Saskatoon, similar to rates in other Western countries. Further studies are required to determine the factors associated with the high rates in the 2 regions and possible reasons for the higher rates in Hamilton.     

2005年至2014年中国7~18岁儿童青少年营养不良流行现状及趋势变化分析

目的：了解2005年至2014年中国7~18岁儿童青少年营养不良的流行现状及其变化趋势,为改善学生的营养状况提供依据。方法：利用2005年、 2010年和2014年3次“中国学生体质与健康调研”数据,按照2014年颁布的国家卫生标准《学龄儿童青少年营养不良筛查标准》（WS/T456-2014）, 对中国31个省市自治区（除港澳台）7~18岁儿童青少年的营养不良检出率分性别、分年龄、分地区和省市自治区以及年份进行分析,西藏自治区为藏族学生,其他30个省市自治区均为汉族学生。结果：2014年中国7~18岁汉族学生的营养不良检出率为10.0%,其中生长迟缓、中重度消瘦、轻度消瘦分别为0.8%、 3.7%、 5.5%,较2005和2010年营养不良检出率分别下降了5.0和2.6个百分点,其中生长迟缓、中重度消瘦、轻度消瘦分别下降1.0、 1.8、 2.2个百分点和0.4、 1.1、 1.2个百分点;2014年7~18岁男生营养不良检出率高于女生（11.1% vs. 8.9%）,乡村高于城市（11.0% vs. 9.1%）,7~9岁、10~12岁、13~15岁和16~18岁4个年龄段的检出率分别为10.5%、 9.0%、 9.1%、 11.5%,东、中、西部分别为9.0%、 9.2%和11.7%;我国学生营养不良主要以轻度消瘦为主,汉族和藏族学生的生长迟缓检出在营养不良中仅占到8.0%和7.5%; 2005年至2014年的3次调查中,中国7~18岁汉族和藏族学生的营养不良检出率均逐次下降,差异均有统计学意义（P<0.05）; 2005年至2014年全国31个省市自治区男女生的营养不良检出率较高,多集中在西南地区,东部省市自治区营养不良检出率较低;与2005年和2010年相比,2014年全国31个省市自治区营养不良检出率均出现下降,且营养不良检出率较高的地区逐渐减少,检出率较低的地区逐渐增多。结论：2005年至2014年全国31个省市自治区的7~18岁儿童青少年的营养不良检出率呈持续下降趋势,但总体检出率仍然较高,以消瘦型营养不良为主,生长迟缓检出率低,西南地区各省市自治区营养不良检出率较高。     

An epidemiological study of energy protein malnutrition in a rural community in Egypt.

A field study was carried out in Sendion Village in Qualyubeya Governorate, Egypt, to assess the nutritional status of infants and preschool children. 1527 children from 0-6 years were studied. Of the 840 males and 687 females studied, 404 children (26.45%) were suffering from various degrees of energy protein malnutrition (EPM). The total prevalence rate was lower among male than among female children but the difference was not statistically significant. 97 of the 404 EPM cases were considered severe while 307 were classified as underweight or mildly undernourished. Age was an important factor in the incidence of malnutrition. The prevalence rate of EPM was 13.6% in the 1st 6 months of life, 23.2% in the 2nd 6 months, and highest (32.6-35.2%) in the 12-47 month age group. The rate dropped off after 48 months. The prevalence rate was higher among those fed with all artificial milk or a combination of artificial and breast milk (29.8%) than among those infants who were totally breast fed (22.49%); the difference was statistically significant at the p.01 level. Birth order had no effect on the incidence of EPM. There was a greater but not significantly different incidence of EPM among children in larger families. Prevalence rates in this study were lower than have been found by other investigators.     

酵母菌药用乳糖酶制备新方法

目的:建立一种简易的从酵母菌制备克鲁维酵母乳糖酶的方法.方法:在30L发酵罐中进行发酵,用对羟基苯甲酸酯进行细胞破壁,用超微过滤方法浓缩破壁液.结果:乳糖酶的收率可达到每毫升发酵液含11.4 ONPG单位.从酵终细胞中释放乳糖酶可达70%,每毫升牛奶中加入1.2 ONPG单位制备的液态乳糖酶可使牛奶中的乳糖水解率达到70%.     

新疆伊宁市1306名7～9岁儿童六龄齿患龋率调查分析

目的了解新疆伊宁市7～9岁儿童第一恒磨牙(六龄齿)患龋率水平及其主要原因,为预防和治疗儿童龋病提供参考依据。方法选择1 306名7～9岁儿童作为调查对象,由接受过口腔健康调查培训的口腔专业医师使用常规口腔检查器械对龋病现况进行调查记录,按照不同年龄、性别、民族分为7、8、9岁组和民、汉男女童组,并对各组患龋率进行分析。结果 (1)伊宁市7～9岁儿童患龋率为29.94%,各年龄组患龋率分别为13.92%、28.30%、36.90%,差异均具有统计学意义(P<0.05)。(2)不同性别及不同民族儿童间患龋率差异均有统计学意义(P<0.05)。结论伊宁市7～9岁儿童六龄齿患龋率随着年龄增长而增加,女童患龋率高于男童,少数民族儿童患龋率高于汉族儿童。