目的 探索甲状旁腺激素相关肽（PTH rP）在大骨节病儿童及成人关节软骨中的表达及分布。方法 应用免疫组化方法比较正常儿童和成人与大骨节病儿童和成人关节软骨中PTH rP的表达。结果 ①大骨节病儿童关节软骨表层、中层、深层PTH rP阳性细胞表达率分别为30%、24% 和31%，中层、深层表达率比正常儿童明显增高（P<0.01）；②大骨节病成人关节软骨表、中、深层PTH rP阳性细胞表达率分别为54%、46% 和16%，各层细胞阳性表达率均明显高于正常组（P<0.01）。③大骨节病儿童与成人比较各层软骨细胞PTH rP的阳性表达差异均有显著意义（P<0.01），表现为表、中层成人高于儿童，深层儿童高于成人。结论 大骨节病患者关节软骨中PTH rP阳性表达率高于正常对照。

目的 探讨大骨节病患者关节软骨细胞凋亡及相关调控因子Bcl-2表达分布的特点。方法 采用脱氧核糖核酸末端转移酶介导的脱氧核糖核酸缺口标记法（TUN EL氏法）检测凋亡阳性细胞，利用单克隆抗体免疫组化检测Bcl-2在关节软骨中的表达。结果 ①TUN EL法染色的大骨节病儿童关节软骨凋亡阳性细胞数较正常关节软骨增多，且主要分布在中层。②大骨节病儿童关节软骨Bcl-2的表达显著高于正常关节软骨中的表达，以表层最多，其次为中层；成人晚期大骨节病患者剥蚀的关节软骨表层Bcl-2的表达聚集在软骨细胞团中。结论 大骨节病患者关节软骨细胞凋亡及相关调控因子Bcl-2表达较正常人显著增多。

The relation ship of cause-result between low selen ium (Se) and Kashin-Beck disease (KBD) was probed by the prospective study of epidemiolog icalmethod with regarding low-Se as an exposure factor in this paper. 597 healthy children l ived in KBD areas with low, middle and high prevalence were divided in to the low-Se exposed group and the non-low-Se exposed group according to their Secontent in hair. The low-Se exposed group was divided in to three subgroups, such as Secontent in hair ≤ 110ng/g, 110ng/g<Secontent in hair≤150ng/g and 150ng/g<Secontent in hair ≤ 200ng/g, respectively. Six new cases of the total with KBD (incidence was 01574% person-year) were found in the low-Se exposed group during three years period of the investigation. No new case was found in the non low-Se exposed group. KBD incidence was notsign if icantly different between those two groups. Two new cases were found in children with Secontent in hair keptbelow 110ng/g during three years (inc idence: 1121% person-year). SMR in each group indicated that the new cases observed in the low-Se exposed group was remarkable lower than the new cases expected. It was not observed that the dose-respon serelation ship between low-Se and KBD, and was not supported that the low-Se was a predominant factor to cause KBD.