目的 研究大骨节病的始动病因。方法 对大骨节病既往的生物地球化学说（低硒说）、水中有机物中毒说、粮食真菌毒素中毒说3种病因说及我们发现的病毒病因说进行同步研究，探讨该病的始动病因。结果 生物地球化学说（低硒说）、水中有机物中毒说、粮食真菌毒素中毒说均不是大骨节病的始动病因。大骨节病的病因模式应该是与环境条件下的生物毒素中毒（低硒条件下的人类微小病毒B19感染）有较大关联性。结论 大骨节病的始动病因可能是低硒条件下的人类微小病毒B。。感染引起的。

目的 探讨大骨节病患者外周血淋巴细胞分布形式、血清可溶性白细胞介素-2受体（sIL-2R）及其与硒的相关性。方法 在大骨节病病区随机选取经X线和临床检查确诊的大骨节病儿童,同时在该病区和非病区分别选取健康儿童作为对照组。采用单克隆抗体（抗CD4，CD8）免疫细胞组化法检测淋巴细胞亚群。sIL-2R的测定采用双抗体夹心ELISA法。结果 大骨节病病区儿童外周血单核细胞（PBMC）中CD4+、CD8+率显著低于非病区水平（P<0.05），CD4/CD8各组间没有差异（P>0.05）。患儿组血清sIL-2R水平显著高于非病区水平（P=0.038）。病区健康儿童组较非病区有升高趋势，但差异无显著意义。另外,病区儿童红细胞硒水平仍显著低于非病区（P<0.001）。相关分析表明，红细胞硒水平与CD4+率呈典型正相关（r=0.625，P<0.05)，与血清sIL-2R水平则无明显相关关系。结论 大骨节病病区儿童外周血处于一种免疫抑制状态，以CD4+、CD8+比例的减少尤为明显。硒通过影响PBMC中T淋巴细胞亚群的分布形式从而在这种免疫紊乱中发挥了重要作用。建议把血清sIL-2R的测定作为检出大骨节病儿童的一种参考指标。

Objective To study the humoral immunity stares and distribution pattern of lymphocyte subgroups of peripheral blood mononuclear cell (PBMC) in patients with Kaschin-Beck Disease (KBD), and their relationship with erythrocyte selenium. Methods 23 X-ray diagnosed patients, 22 age-and sex-matched healthy children in KBD affected area (KAA), Aed 25 in KIID non-affected area (KNAA) were randondy selected. Inmonaohistochemistry with monocinnal antibodies anti-CD4, janti CD8. anti-CD20 was conducled to analyze the lymphocyte subsets. Serum IgM, lgA, IgG, Complement C3 and CA were assayed using rate nephalometry (Array 360 System, USA). The contents of erythrocyte selenium was determined by 2,3-diaminonaphthalene fluorescence assay. Results CD4+ and CD8+ eells percentage in PBMCs and serum lgA were significandy lower in KAA than those in KNAA(p<0.05). CD20+ percentage in KAA displayed a decreasittg trend compared to KNAA, although not statiatieally sigmiticanfly. No statistical differences were found in CD4/CD8 ratio, serum loG, lgM, C3 and CA levels. Ewthrncyte selenium level in KAA still showed a pronounced decrease compared to that in KNAA. Correlation analysis showed that erythrocyte selenium contents had a strong association with the CD4 cell percentage (r=0.625, P<0.05), and also a close relationship with serum IgA (r=0.462, P<0.05). In addition, we detected a moderate correlation between the serum lgA mad CIM+ percentage (r=0.130, P>0.05). Conclusion T tken tsgether, out restdts suggested that children in KAA had a comparably low eellulax immmtity level manifested by the marked depression of CD4 and CD8 cells percentage, and their humoral immunity status was also in a state of moderate inunune suppression. Of this immune diller in KBD patients, selenium dalicieney probably played a critical role via affecting the distribution pattern of peripheral blood lymphocyte. Selertlum-deficiency and immune impairment maybe both have something to do with the cause-effect chain of KBD.

目的 研究和掌握国家级监测点一陕西彬县大骨节病病情，为病因和防怡研究提供基础资料。方法 每年3，4月份对各监测点7一12岁全部在校小学生进行临床和右手X线拍片检测，并按国家大骨节病诊断标准进行诊断。结果 彬县大骨节病监测点的病情从1992年到1995年为上升趋势，其中1992年和1995年病悄均居全国之首，说明当时病情十分严重、活跃；从19% 年到2002年病情逐年下降，目前已降到中国西部地区中等水平。结论 从1992年到1995年彬县监测点大骨节病致病因子作用强烈，因为没有采取任何防治措施，故病情严重、活跃。从工996年到2002年通过在当地采取以补硒和发展生态经济为主的综合防治措施，使病情逐年下降。

通过成年雌性SD大鼠腹腔注射硝酸镓，观察了镓对在鼠骨代谢的影响；然后去除了大鼠双侧卵巢，复制骨质疏松模型。测定了血、尿、骨中镓及钙和磷的含量、骨密度、骨强度、骨重量，证实硝酸镓对去卵巢引起的大刀商用质疏松症有预防作用，并对其作用机制进行了探讨。

目的 探讨镓对去卵巢大鼠骨质疏松的治疗作用。方法 通过切除大鼠卵巢建立骨质疏松模型，经氯化镓治疗12周后，用单光子法测量骨密度；放免法检测相关血清学指标；测定骨病理形态学指标。结果 氯化镓治疗组血清抗酒石酸酸性磷酸酶、骨小梁间距低于骨质疏松对照组，而骨密度和骨小梁宽度高于骨质疏松对照组。结论 镓对去卵巢所致大鼠的骨质疏松有效。

We studied the status of selenium, iodine and fungal contamination in 353 school children (age 5-14 years) from four rural villages in the District of Yulin. In three villages Kashin-Beck disease (KBD) was endemic, whereas there were no cases of KBD in the fourth village. Clinical, biological and radiological examinations (right hand) were performed and KBD was established by X-ray diagnosis. The prevalence rate of KBD was 30.2%, 44.2% and 45.3% in the three endemic villages. Mean hair selenium and urine iodine concentrations were lower in affected than in unaffected children and fungal contamination in cereal grains stored in families with KBD was more elevated than in families without KBD. Low hair selenium concentration and presence of fungal cereal contamination were significantly associated with an increased risk of KBD, but low urine iodine was not.

Summary. The results of 247 osteotomies at the knee were analysed in 195 patients with Kashin-Beck disease. Since 1983, 37 varus and 210 valgus deformities have been operated on. Supracondylar osteotomy was carried out so that there is a cortical spike in the distal metaphysis which is impacted into the femoral condyle. A U-shaped tibial osteotomy is made 0.5 cm below the growth plate and around the insertion of the patellar ligament. The mechanical axis is corrected and stability obtained by impacting the fragments; internal fixation is not used. Correction of the initial angular deformities was achieved after the osteotomies, and function was improved. Re