A new hypothesis for the etiology of Kaschin-Beck disease

Kaschin-Beck disease (KBD) could be exogeneous free radical induced endemic osteoarthropathy under conditions of lacking necessary antioxidant defences.especially selenium-cored defence in Chinese eco-en-vironment. Experimental evidences have been provided for the internal relations among previously suggested pathologic factors, i.e., selenium deficiency, organic matters of drinking waterand mycotoxins from contaminated grains, based on the facts that the former is a preventory factor while the others are exogenous freeradical carriers. ESR spectrum shows that these exogenous free radical carriers have a property of semi-quinone compounds and are toxic in in-vitro cartilage cell culture and animal tests in inducing lipid peroxidation process.

Effect of applying selenium fertilizer to improve soil and increase selenium level in food for prevention and treatment of Kaschin-Beck disease

For prevention and treatment of Kaschin-Beck disease by applying Se fertilizer to soil to increase Se up to normal level for the wheat grains is introduced in this paper. After use this measure the intake of Se by the residents in the exemplary area increased from 10.4μg to 33.6 μg per day in average. After supplementing Se to human body one year, there is no new patient found among 300 healthy children in the exemplary area but 4 patients found among 264 healthy children in the control area. It is shown that by applying Se fertilizer to KBD area is a effective way for preventing and cure this disease.

Study on correlation between humic acid and selenium in Kaschin-Beck disease areas

The relationship between humic acid and selenium content was studied in this research. The results of calculation showed that there is more humic acid and less selenium in Kaschin-Beck disease areas in China. Fulvic acid in soil could increase selenium level in plants. The chemical bonding between humic acid and selenium was observed with an I.R. spectroscope. It was remarkable for the changes of absorption peak and frequency in 1100-1000 cm-1, 900-700 cm-1.

The epidemic characteristics of Kaschin-Beck disease (KBD) in different eco-environments

Epidemiological survey of 573 families, clinical examination of 2593 persons, and X-ray examination of 1136 persons (in 16 typical endemic villages) were conducted, based on the classification of endemiology for KBD disease areas, i.e, mountain type, loess plateau type, plateau type, and flatlands type. It was revealed that the KBD disease areas exhibited the regular pattern of corming-into-being, development and passing-away and the characteristics of growth and decline. Further, it was found clinically that the disease areas may be divided into 4 types, i.e., recent onset, developing, stable, and historical. This division is simple and easy, practical, scientific, and reliable and can be applied by medical personnel at different levels.

Role of interaction between selenium and organic matters on causes of Kaschin-Beck disease

Influences of organic matters of soil and water on speciation and biological utilization of selenium are discussed. Humic acid is found to be the main pool of selenium in soil and affects the bio-availability of the element in soil-plant system. Fulvic acid from drinking water inhibits the absorption of selenium taken from diet. The relationship between high content of organic matters of water and selenium deficiency on the causes of KBD could be reflected in the limited synthesis of glutathione peroxidase, which is generally stimulated by fulvic acid from drinking water.

A retrospective survey on the effect of Kaschin-Beck disease prophylaxis by a change of water sources

In order to provide further references for studing on the causes of Kaschin-Beck discase (KBD) and measuring for its prevention and treatment from a macroscopic view, we analyzed the natural growth and declineof KBD and the effects of selenium and humic acid on its occurrence from an epidemiologic angle. In this article through a retrospective survey on the spots of disease areas by comparison between a change in water sources and that without. It was proved that a change in water sources was an effective measure for the prevention of KBD occurrence, and the pathogenic factor of KBD was one (or several kinds) of organic compounds or active radicals related to water.

Humic acid and free radical in environment of Kaschin-Beck disease areas

The humic acid contents in drinking water and soil in Kaschin-Beck disease areas were found more than that of non-disease areas in this research. Changes of free radical concentration in drinking water were agreed with that of humic acid contents in drinking water of Kaschin-Beck disease areas. A positive correlation of free radical concentration and humic acid content in drinking water has been shown (r=0.913) . The structure of I. R. spectra of humic acid under ultraviolet light has been changed. Thus it indicated that free radical was resulted from benzoqiunonyl groups of humic acid in environment.

The roles of organic degradation products andselenium in the pathogenesis ofKaschin-Beck disease

An investigation on the organic degradation products and selenium in the pathogenesis of Kaschin-Beck disease was carried out. The results demonstrated that the organic degradation products existed in food and drinking water were the pathogens of the KBD; their leading pathological process of cells would be 'membrane injury' due to peroxide. As GSH-Px is a selenium contained enzyme, therefore insufficient selenium would be one of the most important conditions to cause KBD.

Redox potential E_H [Se(VI)/Se(IV)] of aqueous extractof soils from Yongshou Kaschin-Beck diseaseregion and the influence by humic acid

The relation between EH [Se(VI)/Se(IV)] and pH of soil aqueous extract in Kaschin-Beck disease region and the effects of natural redox agents, namely humic substances, MnO2 and Fe2+, on the redox property of the system were studied. The results indicated that both humic acid and Fe2+ could enhance the reducibility of Se(VI) and MnO2, a limited oxidizability for Se(IV). Fe2+ showed a weak reducibility only at low pH value. The reducibilities of three sulfur-containing compounds for Se(VI) were in following order:thioglycollic acid > L-cysteine > sulfide

Research on organic matters in the drinking water of Kaschin-Beck disease area

Organic matters in drinking water of Kaschin-Beck disease areas were extracted. Then analyses and characterization were performed by means of multiply chemical and physical methods. The results did not show the obvious difference in the frame structure of humic substances and the structure of rmcromolecular compounds in the drinking water of disease and non-disease areas, but the difference in the contents of some micromolecular compounds and radicals. The investigation also includes the preliminary research on the photoreaction of drinking water from disease and non-disease areas and the accumulation of natural organic matter in the bone of tested animals.

Study on the action and mechanism of humic acids in Kaschin-Beck disease

Humic acids, especially FA in fractions, contain more oxygen functional groups. In this experiment, on the basis of confirming the action of humic acids on KBD, what was studied is the biological effects of one of main oxygen functional groups, hydroxy group (-OH). The results indicate that inducing pathologic process of KBD, obviously decrease the GSH-Px activity and induce peroxidation membrane injury of tissue. The SOD activity increase in the tissues caused by oxygen functional groups showed that enhancing of free radical reaction should not be neglected.

Immunology of Kaschin-Beck Disease:Studies on lymphocyte subsets, humoral immunity and their relationship with selenium

Objective To study the humoral immunity status 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), And 25 in KBD non-affected area (KNAA) were randomly selected. Immunohistochemistry with monoclonal antibodies anti-CD4, anti-CD8, anti-CD20 was conducted to analyze the lymphocyte subsets. Serum IgM, IgA, IgG, Complement C3 and C4 were assayed using rate nephelometry (Array 360 System, USA). The contents of erythrocyte selenium was determined by 2,3-diaminonaphthalene fluorescence assay. Results CD4+ and CD8+ cells percentage in PBMCs and serum IgA were significantly lower in KAA than those in KNAA(P<0.05). CD20+ percentage in KAA displayed a decreasing trend compared to KNAA, although not statistically significantly. No statistical differences were found in CD4/CD8 ratio, serum IgG, IgM, C3 and C4 levels. Erythrocyte 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 IgA and CD4+ percentage (r=0.130, P>0.05).Conclusion Taken together, our results suggested that children in KAA had a comparably low cellular immunity level manifested by the marked depression of CD4 and CD8 cells percentage, and their humoral immunity status was also in a state of moderate immune suppression. Of this immune disorder in KBD patients, selenium deficiency probably played a critical role via affecting the distribution pattern of peripheral blood lymphocyte. Selenium-deficiency and immune impairment maybe both have something to do with the cause-effect chain of KBD.

双螺孔型重建板前路双关节融合术治疗黄土高原地区晚期踝大骨节病

目的探讨双螺孔型重建板前路双关节融合术治疗黄土高原地区晚期踝大骨节病的疗效。方法采用双螺孔型重建板前路双关节融合术治疗36例黄土高原地区晚期踝大骨节病患者。记录手术情况、疼痛VAS评分、AOFAS踝-后足评分以及并发症发生情况。结果患者均获得随访,时间6~20(9.4±2.2)个月。手术时间50~60(55.0±5.0)min。切口均一期愈合,术后未发生断钉、断板等并发症。疼痛VAS评分及AOFAS踝-后足评分:术后6个月、末次随访时均较术前改善(P<0.05)。末次随访时,X线片显示踝关节植骨均融合,患侧外观正常,患肢行走无明显不适感;采用AOFAS踝-后足评分评价疗效:优30例、良6例,优良率100%。结论采用双螺孔型重建板前路双关节融合术治疗黄土高原地区晚期踝大骨节病,术中能够充分处理关节面,实现坚强固定,术后能够较好地恢复和维持踝关节的矫形位置,并发症少,疗效满意。

Changes of selenium content in hair samples of people in Kaschin- Beck disease areas two months after stopping selenium salt in Shaanxi Province in 2012

Objective To compare selenium content in hair samples of people in Kaschin-Beck disease(KBD)areas and non KBD areas two months after stopping selenium salt in Shaanxi Province,to provide a scientific basis for KBD control and prevention.Methods In September2012,four historical KBD areas were selected,including Yongshou,Yuyang,Linyou and Nanzheng,four

提高食物链硒通量防治大骨节病和克山病示范研究

本研究在黄土高原的陕西省彬县大骨节病和克山病重病区，进行小麦、蔬菜的叶面喷Ｓｅ和主食加Ｓｅ防治地方病的示范研究。结果显示，喷Ｓｅ小麦含Ｓｅ量达０．０８１μｇ／ｇ，明显高于未喷Ｓｅ的小麦（０．００９μｇ／ｇ）；示范点膳食含Ｓｅ达０．０７６μｇ／ｇ，显著高于对照点（０．０１４μｇ／ｇ）；示范点人均日摄Ｓｅ量由１３．４０μｇ／ｇ提高到６０．３９μｇ／ｇ；大骨节病Ｘ线阳性检出率由４３．３３％下降到６．４５％，达到国家控制标准。

中国主要地方病区地质环境研究进展与展望

地方性砷中毒、氟中毒和大骨节病是中国目前流行的主要地方病病种,严重威胁着群众的身体健康。本文总结了中国北方主要盆地高砷水、高氟水分布规律及形成机理和中国大骨节病区地质环境的特点及其相互关系研究的进展,并就其研究方向进行了展望。

西藏大骨节病区的地理环境特征

西藏90％以上的大骨节病县分布在高山温带环境中，病区最暖月平均气温在10—18℃之间，≥0℃日数在180—350天之间；病区集中分布在喜马拉雅山与冈底斯山和念青唐古拉山之间以及横断山北段山间地带的山区或高山谷地地区，病县山地、丘陵占78．4％，非病县山地、丘陵面积占66．7％；就海拔高度而言，病区主要分布在3600～4000m之间；病区涉及多种类型的耕作土壤，其中酸性棕壤和暗棕壤、灰褐土和石灰性褐土、褐土性土等淋溶、半淋溶土壤类型是大骨节病集中分布区；在高山土壤类型中病区趋于分布在典型亚高山草甸土和山地灌丛草原土地带，而亚高山草原土带相对较少。西藏大骨节病区地理环境特征既与内地大骨节病区有很强的相似性，又因其独特的地域分异格局而具特殊性。

大骨节病和克山病老病区粮食中T-2毒素和黄绿青霉素污染状况调查

目的观察大骨节病与克山病老病区丰田村和林茂村地产粮食中T鄄2毒素和黄绿青霉素(CIT)的污染状况。方法选40岁以上自愿者作右手X线拍片检查,评估大骨节病历史患病情况;收集文献数据评估克山病历史病情;用ELISA法和高效液相色谱(HPLC)法检测病区地产粮食T鄄2毒素和CIT。结果丰田村和林茂村成人大骨节病患病率很高,是历史上的严重病区。地产面粉中T鄄2毒素阳性检出率为77.78%,T鄄2毒素平均水平为120.64 μg/kg;地产玉米面中CIT阳性检出率为42.31%,CIT毒素平均水平为12.33 μg/kg,均明显地高出本省市场同类粮食。结论丰田村和林茂村是大骨节病、克山病历史上的严重病区,地产粮食中T鄄2毒素、CIT 水平仍然相当高,如果不是当地粮食占居民主食中的比例已经很小(< 20%),这两种病的当前检出率也许达不到现在程度的低水平。

西藏大骨节病地区儿童发硒与病情分布的关系

目的分析西藏不同地区儿童发硒水平,探讨大骨节病的分布特征与儿童发硒的关系。方法采集典型病区与非病区内儿童的发样,用原子荧光法测定硒。结果西藏大骨节病区与非病区儿童发硒平均值分别为(0.13±0.04)μg/g、(0.18±0.07)μg/g,二者比较差异有统计学意义(P<0.01);补硒病区与非病区的儿童发硒平均值分别为(0.28±0.03)μg/g、(0.18±0.04)μg/g,二者比较差异有统计学意义(P<0.01)。结论西藏儿童发硒普遍偏低,病区儿童发硒更低,发硒与大骨节病病情关系密切,补硒可以显著提高人体发硒水平,补硒措施是大骨节病防治的重要措施之一。

陕西省大骨节病病情现状与相关因素调查

目的进一步掌握陕西省大骨节病病情消长态势和相关环境因素对大骨节病发生、发展的影响,为今后大骨节病的防治决策提供依据。方法在陕西省大骨节病病区范围内分别选择了6个项目调查点和20个省级自设监测点。临床检查7～12岁儿童2568例。右手X线拍片1788例。采集项目点粮样600份和发样300份。测定粮硒、发硒及食粮(180份)T-2毒素水平,调查相关因素与病情的关系。结果全省23个病区县(区)26个调查点中,大骨节病临床Ⅰ度以上患者无检出,X线总检出率为1.29%;儿童发硒为(0.37±0.07)mg/kg,粮食硒(0.049±0.016)mg/kg,粮食T-2毒素(3.82±4.38)μg/kg。结论陕西省儿童大骨节病病情处于基本控制后的平稳低发态势,病区内外环境硒水平的明显升高、饮食结构的明显改善、粮食卫生学质量的提高及经济收入的增加是病情得到控制的主要因素,应进一步深化防治措施落实和加强病区群众健康教育。