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.

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.

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