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Objective:To analyze the prevention and treatment of Kaschin-Beck disease in Fu County, Shaanxi Province, so as to provide basis for consolidating the results of Kaschin-Beck disease prevention and control and the treatment of patients with Kaschin-Beck disease.Methods:The epidemiological investigation of data and clinical data Kaschin-Beck disease from 1954 to 2022 were collected from the Fu County Institute for Endemic Disease Prevention and Control and People's Hospital of Fu County in Shaanxi Province, respectively. The retrospective study was used to investigate the prevention and control of Kaschin-Beck disease in Fu County through the adoption of comprehensive measures such as relocation, grain exchange, water improvement, conversion of farmland to forest and so on.Results:In 1954, there were 6 endemic townships and 127 endemic villages of Kaschin-Beck disease in Fu County, with a total population of 78 781. A total of 16 327 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 20.72%, including 5 434 patients without clinical symptoms. There were 5 850 patients with clinical grade Ⅰ, 3 725 patients with clinical grade Ⅱ and 1 318 patients with clinical grade Ⅲ. In 1975, the first general survey of Kaschin-Beck disease was conducted in the whole county, with a total population of 101 341. A total of 9 575 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 9.45%, including 3 247 cases without clinical symptoms. Among the patients with symptoms, there were 3 704 cases of clinical grade Ⅰ, 2 006 cases of clinical grade Ⅱ and 618 cases of clinical grade Ⅲ. The patients with Kaschin-Beck disease were mainly local residents, accounting for 93.92% (8 993/9 575). In 1997, 27 320 students aged 7 to 16 years in 342 schools of 15 townships were examined and found that there were 169 cases without clinical symptoms with X-ray changes, only 2 cases with clinical grade Ⅰ, and the detection rate decreased to 0.63%. In 1997, Fu County began to encourage relocation and grain exchange to prevent Kaschin-Beck disease. The relocation targets were mainly the seriously ill villages with new cases among children and poor living conditions. By 1999, a total of 100 households and 469 people were relocated, and by 2020, 1 569 households and 5 334 people were relocated. In 1997 and 1998, measures were taken to improve water quality in 43 natural villages in 6 townships, with 1 591 households and 7 375 people benefiting. In 2010, a general survey of Kaschin-Beck disease was conducted in 15 townships of Fu County, with a total population of 135 858, and 3 424 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 2.52%. There were 2 885 cases with clinical symptoms, including 1 584 cases with clinical grade Ⅰ, 1 024 cases with clinical grade Ⅱ and 277 cases with clinical grade Ⅲ. Among them, 32 561 minors under 16 years old were examined, and 49 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 0.15%, and all of them were clinical gradeⅠ patients. In 2014, a total of 73 600 people were surveyed in 170 endemic villages of Fu county, and 2 885 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 3.92%. Compared with 2010, the number of patients with Kaschin-Beck disease increased zero, and there were no underage patients under the age of 16 for 4 consecutive years. By the end of 2016, 666.67 hm 2 of farmland had been converted to forest in Fu County, involving 9 townships (including communities), 33 administrative villages and 1 993 households. In 2018, another general survey of Kaschin-Beck disease was conducted in Fu County, with a total population of 157 362. A total of 2 308 patients were detected by X-ray examination, with a detection rate of 1.47%. Among them, there were 1 270 cases of clinical grade Ⅰ, 870 cases of clinical grade Ⅱ and 168 cases of clinical grade Ⅲ, and there were no patients with Kaschin-Beck disease under 16 years old in the county for 8 consecutive years (2011-2018). In the same year, 22 cases of Kaschin-Beck disease joint replacement were completed in Fu County, and by January 2022, about 60 cases had completed joint replacement. Conclusion:The prevention and control of Kaschin-Beck disease in Fu County has achieved remarkable results through comprehensive measures such as relocation, grain exchange, water improvement and conversion of farmland to forest.
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Objective:To compare the clinical effects of hip arthroplasty through direct anterior approach (DAA) in lateral decubitus in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia.Methods:The prospective study method was used to select the patients who needed hip arthroplasty in the Fourth Department of Orthopedics, the Second Affiliated Hospital of Harbin Medical University from January 2015 to December 2019. All of them were operated with lateral decubitus DAA. According to the inclusion criteria, they were divided into Kacshin-Beck disease hip osteoarthritis group (group A) and congenital acetabular dysplasia hip osteoarthritis group (group B). Hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, visual analogue scale (VAS) score were conducted, and hip abduction angle and flexion angle were measured before surgery, 3, 14 days and 1, 3, and 12 months after surgery.Results:Nineteen and twenty-two patients were included in group A and group B, respectively. All patients successfully completed the surgery. There was no significant difference in Harris score between the two groups before surgery, 3, 14 days, and 1, 12 months after surgery ( P > 0.05). There were no significant differences in WOMAC score, VAS score, hip abduction angle and hip flexion angle between the two groups before surgery and each time point after surgery ( P > 0.05). In the same group, there were significant differences in Harris score, WOMAC score, VAS score, hip abduction angle and hip flexion angle at different time points ( P < 0.001). All postoperative indicators were significantly improved compared with those before surgery. Conclusions:There is no significant difference in the clinical effects of hip arthroplasty through lateral decubitus DAA in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia. This surgical method has good therapeutic effect on both types of hip osteoarthritis.
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Objective:To investigate and analyze the living conditions of patients with Kaschin-Beck disease in Gansu Province, and to provide scientific basis for accurate treatment of the patients.Methods:From 2018 to 2019, case investigation, clinical examination and X-ray examination of patients with Kaschin-Beck disease were carried out in the Kaschin-Beck disease area of Gansu Province. The contents of the survey included basic information of the patients, clinical diagnosis classification, disease information, surgery and drug treatment, etc.Results:A total of 23 909 patients with Kaschin-Beck disease were diagnosed in 37 counties (districts) of 7 cities (states). The patients with grade Ⅰ, grade Ⅱ and grade Ⅲ accounted for 64.04% (15 312 cases), 26.12% (6 244 cases) and 9.84% (2 353 cases), respectively; 90.74% (21 694 cases) of the patients were over 50 years old, Han nationality was 97.15% (23 228 cases), and peasants were 99.25% (23 729 cases). The patients mainly had multiple joint thickening and deformation (89.30%, 21 350 cases) and pain (87.04%, 20 810 cases). Joint thickening and deformation and pain were more common in finger joint, knee joint and ankle joint. The thickening and deformation of the three joints accounted for 89.97% (21 512 cases), 78.18% (18 692 cases) and 63.81% (15 257 cases), respectively; pain accounted for 80.66% (19 285 cases), 78.75% (18 828 cases) and 64.50% (15 422 cases), respectively; 83.83% (20 044 cases) had joint rest pain, 82.63% (19 757 cases) had joint movement pain and 76.03% (18 177 cases) had joint morning stiffness. Surgical treatment was completed in 1.97% (470 cases). Long-term drug treatment (more than 6 months in the whole year) accounted for 47.78% (11 424 cases); the annual cost of drug treatment was mainly less than 500 yuan, accounting for 57.72% (13 800 cases).Conclusions:The quality of life of patients with Kaschin-Beck disease in Gansu Province is low. We should pay more attention to adult patients with Kaschin-beck disease and strengthen management and treatment.
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Objective:To analyze the results of serum erythropoietin (EPO) in adults patients with Kaschin-Beck disease (KBD) in Qinghai Province.Methods:According to the "Diagnosis of Kaschin-Beck Disease" (WS/T 207-2010), by using clinical examination and X-ray, adults over 20 years old in KBD areas of Xinghai County and Guide County, Hainan Tibetan Autonomous Prefecture, Qinghai Province, were divided into KBD case group ( n = 109) and internal control group ( n = 95) in July 2019. At the same time, healthy people were selected as external control group ( n = 90) in Xunhua County. Then 2 ml fasting cubital venous blood was collected from the target population to separate serum. The serum EPO level was determined by enzyme-linked immunosorbent assay (ELISA). Results:There was no significant difference in age and sex ratio among the 3 groups ( F = 0.73, P = 0.484; χ 2 = 1.03, P = 0.611). There was significant difference in serum EPO levels among the 3 groups [KBD case, internal and external control groups: (30.74 ± 26.23), (19.73 ± 11.53) and (10.83 ± 4.48) U/L, F = 26.51, P < 0.001]. Multiple comparisons showed that there were statistically significant differences in serum EPO levels between KBD case group and the internal and external control groups ( P < 0.05), but there was no significant difference between the internal and external control groups ( P > 0.05). Conclusions:The serum EPO level in adult KBD patients in Qinghai Province is increased significantly.
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Objective To investigate the effect of knee joint injection of sodium hyaluronate combined with oral administration of diacerein and/or glucosamine sulfate on knee joint of Kaschin-Beck disease.Methods The method of prospective study was used,80 patients with Kaschin-Beck disease admitted to the General Internal Medicine,Guang'an People's Hospital from January 2015 to December 2017 were selected as subjects.They were divided into 4 groups according to the difference of their medication methods,20 cases per group.Group A was treated with intra-articular injection of sodium hyaluronate,Group B was treated with intra-articular injection of sodium hyaluronate + oral diacerein,Group C was treated with intra-articular injection of sodium hyaluronate + oral glucosamine sulfate,Group D was treated with intra-articular injection of sodium hyaluronate + oral diacerein and glucosamine sulfate,and the overall therapeutic effects of the 4 groups were compared.Results The knee joint scores of Group D at 7,14,90,and 180 days after treatment were (6.25 ± 2.01),(4.22 ± 1.15),(2.21 ± 1.01),and (1.15 ± 0.15) scores,respectively,they were significantly lower than those of Group A [(12.11 ± 3.02),(11.91 ± 2.98),(11.85 ± 2.85),(11.05 ± 2.52) scores],Group B [(9.11 ± 2.85),(8.32 ± 2.45),(7.55 ± 2.32),(6.15 ± 2.01) scores] and Group C [(9.12 ± 2.84),(8.23 ± 2.32),(7.43 ± 2.29),(6.11 ± 2.00) scores],the differences were statistically significant (P ＜ 0.05).The total effective rates of the 4 groups were 60％ (12/20),65％ (13/20),70％ (14/20),and 90％ (18/20),respectively,Group D was significantly higher than those of other 3 groups (x2 =18.250,18.250,16.000,P ＜ 0.05).The scores of 20 m walking pain and joint tenderness in Group D after treatment and follow-up period were lower than those of other 3 groups (P ＜ 0.05).Conclusions In the clinical practice of Kaschin-Beck disease,intra-articular injection of sodium hyaluronate combined with oral diacerein and glucosamine sulfate can improve the knee joint function of patients,alleviate pain and enhance the overall therapeutic effect.The combined therapy has great clinical value.
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Objective To master the basic conditions of Kaschin-Beck disease areas and patients in Shaanxi Province,and provide a theoretical basis for prevention and control of Kaschin-Beck disease.Methods In 2018,the basic situation of the villages in Kaschin-Beck disease areas of Shaanxi Province and the implementation of prevention and control measures were investigated.The data of general population information,condition and treatment were collected from all the disease affected villages.Results The Kaschin-Beck disease areas of Shaanxi Province involves 4 194 disease affected villages in 62 counties.Among them,3 886 villages had completed the whole village water reform,215 villages changed some of the water,and 93 villages had not changed water;there were 3 835 disease affected villages met the hygienic standard of drinking water,accounting for 91.44％.A total of 60 157 patients with Kaschin-Beck disease were diagnosed.The male-female ratio was 1.0:0.9 (31 531:28 626).The age of the patients was mainly between 40 and 65 years old.There were no new cases of children.Among them,38 448 were degree Ⅰ patients,18 589 were degree Ⅱ patients and 3 120 were degree Ⅲ patients.The occupational distribution of patients was mainly peasant,with 59 703 cases,accounting for 99.25％.The distribution of education was mainly primary school,with 31 108 cases,accounting for 51.71％.There were 876 patients who had completed surgery and 23 284 patients who had been treated with long-term medication.Conclusions In recent years,there is no new case of Kaschin-Beck disease in children in Shaanxi Province.However,the condition of Kaschin-Beck disease in adults is serious,and great efforts should be made in rescue.
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Objective To find changes of urinary biomarkers of hydroxyproline (HYP) and C-terminal telopeptide of collagen type Ⅱ (CTX-Ⅱ) after celecoxib and anti-osteogenic tablets treatment among adult Kaschin-Beck disease (KBD) patients in Qinghai Province,and provide the scientific data for treatment effect of adult KBD.Methods According to the "Diagnosis of Kaschin-Beck Disease" (WS/T 207-2010),120 cases KBD patients and 89 cases healthy control were divided into three groups,including drug treatment group,non-drug therapy group and control group.The drug treatment group was taken celecoxib (200 mg/pill,1 pill/day,1 time/day) and anti-osteogenic tablets (0.4 g/pill,4 pills/time,2 times/day) for 6 month.The urine samples of these persons were detected with the method of enzyme linked immunosorbent assay (ELISA) for analyzing HYP and CTX-Ⅱ.The results were corrected by creatinine (Cr).Results There were 54 cases of KBD patients (24 males,30 females) in drug treatment group with average age of (47.51 ± 12.30) years old;there were 66 cases of KBD patients (31 males,35 females) in non-drug therapy group with average age of (46.85 ± 13.57) years old;and there were 89 healthy people (41 males,48 females) in control group with average age of (48.75 ± 13.92) years old.By comparing the three groups,there were no statistical significant differences in gender (x2 =0.820,P ＞ 0.05) and ages (F =0.379,P ＞ 0.05).Medians of urinary HYP contents among drug treatment group,non-drug therapy group and control group were 62.47,106.04,65.80 μg/μmol·Cr,respectively,and the difference was statistically significant (Z =12.114,P ＜ 0.01);medians of urinary CTX-Ⅱ contents among drug treatment group,non-drug therapy group and control group were 555.23,702.92,495.54 ng/μ mol· Cr,respectively,and the difference was statistically significant (Z =20.454,P ＜ 0.01).Conclusion Levels of HYP and CTX-Ⅱ among adult KBD patients have changed after treatment with celecoxib and anti-osteogenic tablets,and can be used to determine the effect of treatment.
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Objective To observe the expression level of insulin-like growth factor-1 receptor (IGF-1R) in the cartilage tissue of children with Kaschin-Beck disease (KBD) and T-2 toxin-poisoned rats under low selenium condition,and the effect of IGF-1R inhibitor on apoptosis of human normal chondrocytes (C28/I2 cells),and to investigate the role of IGF-1R in the pathogenesis of KBD.Methods The knuckles of dead children (5 cases) in the KBD areas,car accident death and congenital 6 finger deformity operation children (5 cases) in non-KBD areas in Shaanxi were collected,the expression of IGF-1R in the articular cartilage was detected by immunohistochemistry.Thirty-two male Sprague-Dawley rats with a body mass of 60-80 g were selected,according to the body mass,they were divided into the routine feed group (selenium content:101.5 μg/kg) and the low-selenium feed group (selenium content:1.1 μg/kg) by random number table method,16 rats in each group.After 30 days of feeding,the routine feed group was divided into control group and T-2 toxin group (100 ng·kg-1·d-1),the low-selenium feed group was divided into low selenium group and low selenium + T-2 toxin group,8 rats in each group,the expression of IGF-1R in the articular cartilage of the left knee joint was detected by immunohistochemistry after 30 days of feeding.C28/I2 cells were cultured in vitro and treated with T-2 toxin 0 (control),6,12,and 24 μg/L,and each concentration of T-2 toxin was accompanied with sodium selenite (+ 0.1 mg/L) for 72 h.Meanwhile,IGF-1R inhibitor with 0 (control),250,500,and 1 000 μg/L was treated on C28/I2 cells for 48 h.The expression levels of IGF-1R mRNA and protein in chondrocytes were detected by Real-time PCR and Western blotting,and the apoptosis of chondrocytes was detected by flow cytometry.Results Compared with the control group [(100.00 ± 0.00)％,(100.00 ± 0.00)％],the expression rates of IGF-1R positive cells in articular cartilage surface and middle layers [(72.71 ± 4.75)％,(36.33 ± 4.32)％] of children in KBD group were significantly reduced (t =12.852,32.650,P ＜ 0.01).Compared with control group [(100.00 ± 0.00)％,(100.00 ± 0.00)％,(100.00 ± 0.00)％],the expression rates of IGF-1R positive cells in articular cartilage middle layer [(20.83 ± 2.69)％,(26.45 ± 2.84)％,(20.34 ± 1.82)％],deep layer [(33.55 ± 5.66)％,(48.89 ± 8.39)％,(25.51 ± 7.50)％],and the expression rates of IGF-1R positive cells [(47.50 ± 1.47)％,(28.66 ± 3.58)％,(40.52 ± 6.78)％] in the hypertrophic layer of the metaphyseal plate of rats in low selenium,T-2 toxin,and low selenium + T-2 toxin groups were significantly reduced (P ＜ 0.01).C28/I2 cells were cultured in vitro,compared with the control group,IGF-1R mRNA and protein expression levels in each T-2 toxin groups were significantly reduced (P ＜ 0.05).The expression levels of IGF-1R mRNA (1.95 ± 0.35,2.44 ± 0.17,2.40 ± 0.15) in 6,12,24 μg/L T-2 toxin + 0.1 mg/L selenium groups were significantly higher than those in T-2 toxin groups (0.80 ± 0.08,0.63 ± 0.08,0.61 ± 0.11,t =-12.259,-11.279,-13.371,P＜ 0.05).The expression levels of IGF-1R protein (1.67 ± 0.70,1.07 ± 0.26) in 6,12 μg/L T-2 toxin + 0.1 mg/L selenium groups were significantly higher than those in T-2 toxin groups (0.52 ± 0.05,0.72 ± 0.05,t =-25.977,-10.776,P ＜ 0.05).Compared with the control group [(5.33 ± 0.85)％,(4.03 ± 1.15)％],C28/I2 cells early apoptosis rates [(8.26 ± 1.51)％,(13.00 ± 0.72)％,(13.19 ± 1.05)％] in each of IGF-1R inhibitor groups,and late apoptosis rates [(8.50 ± 0.71)％,(14.21 ± 1.10)％] in 500,1 000 μg/L IGF-1R inhibitor groups were increased significantly (P ＜ 0.05).Conclusions The expressions of IGF-1R in the cartilage tissue of KBD children and T-2 toxin-poisoned rats under low selenium condition are decreased.T-2 toxin decreases the expression of IGF-1R in chondrocytes,and selenium can partly inhibit the effect of T-2 toxin on IGF-1R.Down-regulation of IGF-1R causes chondrocyte apoptosis,and it may play an important role in KBD chondrocyte apoptosis.
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Objective To understand the current environmental selenium and T-2 toxin levels in the critically ill areas of Kaschin-Beck disease in Qinghai Province.Methods In three historical villages with serious diseases of Kaschin-Beck disease,Xia,Xiemalang and Yaoshidao were selected;at the same time,three villages from non-diseased areas were selected as control villages including Damitan,Gongba and Deang in 2018.Six villages were used as survey sites.Collected hair samples of children aged 6-12 years old,to measure the hair selenium content in Xinghai and Guide survey sites [children's selenium content reference value was (0.60 ± 0.03)mg/kg].Ten samples of self-produced grain were collected from each survey site,selenium content [wheat selenium content reference value was (0.053 ± 0.007) mg/kg] and T-2 toxin content in grain was detected in the six survey sites.Ten soil samples were collected from each survey sites.Soil selenium content was detected in the six survey sites [soil selenium content reference value was (0.24 ± 0.03) mg/kg].Results The selenium contents of children's hair in the diseased and non-diseased areas of Xinghai County,Guide County were (0.252 ± 0.071),(0.296 ± 0.087);(0.225 ± 0.032),(0.238 ± 0.040) mg/kg,respectively.The selenium contents of wheat in the diseased and nondiseased areas of the three counties were 0.000 19,0.003 66;0.000 15,0.004 16;0.016 78,0.016 94 mg/kg.The soil selenium contents in the diseased and non-diseased areas of the three counties were (0.095 ± 0.015),(0.114 ± 0.014);(0.082 ± 0.013),(0.083 ± 0.018);(0.080 ± 0.005),(0.060 ± 0.013) mg/kg.The T-2 toxin contents of wheat in the diseased and non-diseased areas of the three counties were (3.173 ± 0.762),(3.100 ± 0.473);(2.506 ± 0.430),(3.186 ± 0.451);(2.416 ± 0.619),(2.879 ± 0.456) μg/kg.Conclusions The content of hair selenium of children is close to the normal reference value in the area of Kaschin-Beck disease in Qinghai Province.The contents of soil selenium and the main grain selenium of the residents are low in the diseased village.A certain amount of T-2 toxin is detected in the main grain of residential households.
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Objective To understand the changes of serum tumor necrosis factor-α (TNF-α) among adults with Kaschin-Beck disease (KBD) in Qinghai,and to provide scientific data for KBD prevention and control.Methods A case-control study was used,according to "Diagnosis of Kaschin-Beck disease",104 cases of KBD patients [aged (47.61 ± 12.72) years old;50 males,54 females] and 95 cases of internal healthy controls [aged (48.28 ±14.87) years old;35 males,60 females],which were from KBD areas in Xinghai and Guide counties of Hainan Tibetan Autonomous Prefecture,Qinghai Province,and 73 cases of external healthy controls [aged (51.88 ± 13.93)years old;35 males,38 females] from non-KBD region of Xunhua County were included in July 2017.Serum TNF-α was determined via the enzyme linked immunosorbent assay (ELISA) method.Results Totally 272 persons were studied and divided into three groups,there was no statistical significant difference of ages among the three groups (F =2.236,P ＞ 0.05),meanwhile,there was no statistical significant difference of genders among the three groups (x2 =3.135,P ＞ 0.05).The serum TNF-α levels of KBD patients,internal and external healthy controls were (25.14 ± 10.29),(21.84 ± 9.37),and (24.98 ± 8.98) ng/L,respectively,which were statistically significantly different among the three groups (F =3.486,P ＜ 0.05).The serum TNF-α levels in the KBD group and the external healthy control were higher than that in internal healthy control (P ＜ 0.05).There was no significant difference between the KBD group and the external healthy control (P ＞ 0.05).Conclusion There may exist inflammatory changes among KBD patients in KBD areas of Qinghai Province.
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Objective To detect the metabolites of Fusarium poae strain isolated from self-produced grain in a new-onset patient with Kaschin-Beck disease,and to provide a scientific basis for studying the relationship between mycotoxins and Kaschin-Beck disease.Methods The strain of Fusarium poae was isolated from the self-produced spike wheat in a family of patient with new-onset Kaschin-Beck disease in Guide County,Qinghai Province in 2016.The isolated Fusarium poae strain was inoculated into potato dextrose agar (PDA) medium for enrichment culture.The metabolites of the fermentation were separated and purified,and the mycotoxins in the metabolite were detected by liquid chromatography-mass spectrometry (LC-MS).The full-spectrum identification was carried out by using the network database Metlin.Results The metabolites of this strain were identified by LC-MS and Metlin full spectrum,and mycotoxins such as trichothecenes,Fumonisin and Zearalenone (ZEA) were detected.A total of 1 601 material characteristic peaks were detected in positive ion mode,the most abundant mycotoxins were Fumonisin FP3,A2,FP1;and a total of 1 000 material characteristic peaks were detected in the negative ion mode,the most abundant were ZEA and monoacetoxyscirpenol.Conclusion The isolated metabolites of Fusarium poae strain mainly contain the three major classes of mycotoxins including trichothecenes,Fumonisins and ZEA.
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Objective To evaluate the reliability and validity of the Chinese version of European Five-dimensional Five-level Health Scale (EQ-5D-5L) for patients with Kaschin-Beck disease.Methods From May 2017 to September 2018,a total of 245 patients with Kaschin-Beck disease in Yongshou and Linyou counties,Shaanxi Province were interviewed face-to-face with the EQ-5D-5L.The health-related value score was used to calculate the overall health-related quality of life of patients with Kaschin-Beck disease.The higher the score,the better the overall health of the population,and vice versa (-0.391-1.000).The visual analogue system (VAS)score was used to calculate the individual health status,higher scores indicated that the health status of self-evaluation were better,and vice versa (0 to 100 points).Sixty-three patients were retested two weeks later.Evaluation was performed using internal consistency,test-retest reliability,structural validity and criterion validity.Results A total of 245 patients with Kaschin-Beck disease were investigated,including 127 males (51.8％) and 118 females (48.2％),aged (60.37 ± 7.10) years old.The medians and quartile ranges of EQ index and VAS of patients were 0.311 (0.504) and 42.5 (30.0) points,respectively.And the Cronbach coefficient of the five-dimensional score of the health description system was 0.828.The intra-class correlation coefficient (ICC) of each dimension of the health description system was 0.571-0.719.EQ index and VAS score showed that the two had a relatively stable correlation (rs =0.522,P ＜ 0.05),and the ICCs of EQ index and VAS score were 0.754 and 0.570,respectively;the EQ-5D-5L validity calculated by "Therapeutic Efficacy on Kaschin-Beck Disease" (WS/T 79-2011) was between 0.375-0.647 (P ＜ 0.05).Conclusions The overall health status of the Kaschin-Beck disease patient population and the health status of the individual self-evaluation measured by EQ-5D-5L are poor.The reliability test and validity test prove that the EQ-5D-5L is applied to the health status of patients with Kaschin-Beck disease.The EQ-5D-5L has good reliability and validity.
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Objective To study the level of serum interleukin-1β (IL-1β) among adult patients with Kaschin-Beck disease (KBD) in the KBD area of Xinghai County,Qinghai Province.Methods In 2017,cluster random sampling was used to carry out investigation in the KBD area of Xinghai County,Hainan Tibetan Autonomous Prefecture,Qinghai Province,and the residents aged over 20 years old were selected as the survey subjects.According to "the Diagnosis Criteria of Kaschin-Beck Disease" (WS/T 207-2010),the subjects were divided into KBD group and the control group.The serum IL-1β content of the subjects was detected by enzymelinked immunosorbent assay (ELISA).Statistical analysis of data was performed using SPSS 17.0 software.Results A total of 188 eligible residents were surveyed,including KBD group (97 cases) and control group (91 cases).The age [(45.89 ± 11.75),(47.95 ± 11.75) years] and gender (male:48,38,female:43,59) of two groups were no statistically significant (t =1.050,x2 =3.485,P ＞ 0.05).The serum IL-1β levels of KBD patients and healthy control were (94.54 ± 24.19) and (65.95 ± 20.08) ng/L,respectively,which were significantly different (t =8.839,P ＜ 0.05).Conclusion There is an inflammatory change in adults with KBD in Xinghai County,Qinghai Province.
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Deoxynivalenol (DON) is one of mycotoxins produced by fungal pathogen of fusarium,which has strong cytotoxicity.The study of articular cartilage injury is focused on the study of Kaschin-Beck disease (KBD)pathogenesis.DON can inhibit the proliferation of chondrocytes,induce apoptosis,affect the cell-related metabolic enzymes and other ways to break the balance of chondrocytes and extracellular matrix,eventually leading to irreversible damage of articular cartilage.This article reviews the role of DON toxin in the cartilage injury.
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Objective To investigate the expression of vascular cell adhesion molecule-1 (VC.AM-1) in oxidative stress induced hypertrophic chondrocytes,in Kaschin-Beck disease (KBD) patients and in rat fed with T-2 toxin under selenium deficient conditions in order to analyze the relationship between VCAM-1 biological function and the dysregulation of chondrocyte differentiation in KBD.Methods The ATDC5 was cultured in 1％ ITS solution (10 mg/L insulin,5.5 mg/L transferrin,and 6.7 μg/L sodium selenite) for 21 days,and stimulated with 3-morpholino-sydnonimine (SIN-1,a nitric oxide [NO] donor) to obtain the oxidative stress induced hypertrophic chondrocytes.Real-time PCR was used to detect VCAM-1 mRNA in hypertrophic chondrocytes induced by different concentrations of SIN-1.The expressions of VCAM-I in articular cartilage of child and adult KBD patients and KBD animal model were determined via the immunohistochemical method,and KBD cartilage samples were obtained in KBD areas from KBD child who had died or from adults who had had surgery.Results After treatment of hypertrophic chondrocytes (ATCD5 cells) with SIN-1 (0,1,3,5 mmol/L),VCAM-1 mRNA levels (1.00 + 0.00,1.22 ± 0.20,0.71 ± 0.22,0.37 ± 0.16) were decreased in a dose-dependent manner when compared with the control group (F =27.788,P ＜ 0.05).The densities of VCAM-1 positive cells in superficial and middle zones of the articular cartilage of children KBD patients [(16.08 ± 5.20)％,(19.20 ± 9.71)％] were higher than those of control group [(0.00 ± 0.00)％,(0.00 ± 0.00)％],while that in the deep zone [(7.00 ± 4.40)％] in children KBD patients was significantly lower than that of control [(51.60 ± 20.58)％,tS/M/D=-10.972,-6.249,6.564,P ＜ 0.05].The positive cell density of VCAM-1 in the adult patients was significantly increased in the superficial zone [(7.92 ± 4.29)％ vs (3.12 ± 1.12)％] but significantly decreased in the middle zone [(17.54 ± 8.27)％ vs (31.75 ± 13.30)％] of articular cartilage when compared with that of control group (tS/D =-3.824,3.037,P ＜ 0.05).In articular cartilage of the four groups of KBD rats,the density of VCAM-1 positive cells in the superficial zone was significantly higher in low selenium diet group,T-2 toxin diet group and selenium deficient plus T-2 toxin diet group [(4.11 ± 1.90)％,(5.00 ±2.02)％,(2.78 ± 1.48)％ vs (1.89 ± 1.76)％,P ＜ 0.05].But the density of VCAM-1 positive cells in the deep zone was significantly lower in rat feed with selenium diet and selenium deficient plus T-2 toxin diet [(13.67 ± 2.45)％,(20.56 ± 7.42)％] than that of control group [(33.00 ± 12.57)％,P ＜ 0.05] in the epiphyseal cartilage of KBD rats.Conclusions The level of VCAM-1 is decreased both in the SIN-1 induced hypertrophic chondrocytes and in the deep zone of articular cartilage in KBD patients and in rat fed with T-2 toxin and selenium-deficient diets.VCAM-1 may be associated with the death of deep zone chondrocytes and differentiation disorder in cartilage.
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Objective To search the different metabolites related with Kaschin-Beck disease (KBD) in urine of children with KBD by metabolomics technique,in order to provide clues in researching KBD biomarkers.Methods Among the children aged 7-15 years old in the KBD areas in Qinghai Province,the urine samples of 56 KBD children (case group),51 health children from the same area as the control group (internal control group) and 50 health children from non diseased areas (external control group) were examined by quadrupole-time of flight mass spectrometry (UPLC/QTOF-MS).Partial least squares discriminate analysis (PLS-DA) and multivariate statistical analysis were applied to explore and search the different endogenic metabolites associated with KBD.Results A obvious separation among three groups was observed,and the difference was significant among case group and internal,external control groups (P ＜ 0.05).Twenty-two different endogenic metabolites associated with KBD were found,compared with the external control group,21 metabolites were increased in the case group(P ＜ 0.05).Among them,14 kinds of metabolites (L-Cystine,isobutyryl carnitine,butyryl-L-carnitine,aspartyl-Asparagine,asparaginylAspartate and ubiquinone Q2,etc.) showed significant differences between the case group and internal control group (P ＜ 0.05).There were 4 kinds of metabolites showing significant differences between the two control groups(P ＜ 0.05).Condusion The metabolic profile in the urine of KBD children and healthy children is obviously different and the metabolites of L-Cystine,isobutyryl carnitine,butyryl-L-carnitine,aspartyl-Asparagine,asparaginyl-Aspartate and ubiquinone Q2 are more closely related with KBD,which can be considered as the clues in screening KBD biomarkers.
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Kaschin-Beck disease is an endemic and deformed chronic osteochondropathy. Though the etiology is not well clear, the etiologic hypotheses have been mainly focused on bio-geochemical hypotheses, the hypotheses of mycotoxin poisoning under low selenium condition and the hypotheses of toxic organic compounds in drinking water. Prevention and control measures based on these hypotheses have shown remarkable achievements. Depending on the related research at home and abroad, this paper reviews the new developments of pathogen, pathogenesis and prevention on Kaschin-Beck disease in recent years.In terms of scientific research,new progresses have been made in the aspects of environmental factors associated with the pathogenesis of Kaschin-Beck disease, molecular biology, genomics, proteomics and environmental response genes. As for prevention and treatment, new progress has been made in such fields as supplement of selenium and treatment of traditional Chinese medicine.
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Objective To search the different metabolites related with Kaschin-Beck disease (KBD) in serum of children with KBD. Methods Among the children aged 7 - 15 years old in the KBD areas in Qinghai Province,by the X ray and clinical examination,56 KBD patients(case group) and 51 non-KBD children (internal control group)were selected.Meantime,in non-KBD areas where the economic level and living habits was similar to that of the KBD areas, 50 healthy children were selected as external control group. Children's fasting blood samples were collected, and the metabolic profile in serum was determined by ultra performance liquid chromatography coupled with quadrupole-time of flight mass spectrometry (UPLC/QTOF-MS) technique. Combined with multivariate statistical analysis, database searching was applied to explore and search the different endogenic metabolites associated with KBD, to find biologically targeted makers. Results There were 1 384 serum metabolites with significant differences in case group, internal control group and external control group, 670 serum metabolites with significant differences in case group and external control group, including 25 KBD related endogenous differential metabolites. Among them, the relative contents of kynurenic acid and arachidonic acid in case group were higher than that of external control group, and the relative contents of N-α-acetylarginine, 6-hydroxymelatonin and sphinganine in case group were lower than that of external control group (P < 0.05). Conclusions The serum metabolic profile of children in KBD areas and children in non-KBD areas is significantly different. N-α-acetylarginine, kynurenic acid, 6-hydroxymelatonin, sphinganine and arachidonic acid are more closely related with KBD,and they can be considered as a clue in screening KBD biomarkers.
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The data used in this paper were mainly derived from historical literatures and monitoring reports of Kaschin-Beck disease (KBD) in China from 1990 to 2016. Based on these data, epidemic trend of the representative endemic areas was sorted out(every 10 years as an interval). In this paper, general situation of KBD in China was analyzed macroscopically,we expected that KBD will fade away gradually in China,and the prevention and control strategy of KBD in China was analyzed. One prospect was put forward, the sustainable elimination of KBD is becoming possible with the reform and progress of society.
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Objective To study the correlation of patellar stability with age ,knee Kellgren-Lawrence grading and patellar Wiberg typing of adults with Kaschin-Beck disease (KBD) .Methods Through cross-sectional study , we asked 143 adult patients with KBD from several villages in Gansu Province to receive digital radiographic x-ray (DR) which included lateral slice of knee joint and axis slice of patellar .Meanwhile ,each patient had to undergo patellar stability measurement on the DR film which included some indexes such as Insall index , lateral patellofemoral angle ,sulcus angle ,congruence angle ,lateral migrating ratio of patella ,and patellofemoral index . Then ,all the participants were divided into four groups based on the patella Wiberg typing and three groups based on KBD clinical grading .Last ,we analyzed the correlation of patellar stability with patellar Wiberg typing ,clinical KBD grading ,and Kellgren-Lawrence grading of the patients by Spearman test .Results ① By ANOVA test on the patella Wiberg typing ,lateral patellofemoral angle decreased with increased level of patella Wiberg typing ,but congruence angle ,lateral migrating ratio of patella ,and patellofemoral index were increased with increased level of patella Wiberg typing . P values of the six indexes were all <0 .05 ,which indicated that these differences between groups were significant .By ANOVA test on the KBD clinical grading ,lateral patellofemoral angle decreased with increased level of KBD clinical grading ,but congruence angle ,lateral migrating ratio of patella ,sulcus angle ,and patellofemoral index increased with increased level of KBD clinical grading .Besides that P value of Insall index was>0 .05 , P value of the other five indexes were all <0 .05 ,which indicated these differences between groups were significant .② Spearman test :a strong correlation lay between Wiberg patellar typing and other indexes including age ,lateral patellofemoral angle ,congruence angle ,lateral migrating ratio of patella ,and patellofemoral index ( R=0 .684 ,0 .752 ,0 .582 ,0 .533 ,0 .735 , P< 0 .05) .However ,there was no correlation between Wiberg patellar typing and K-L photographical grading (R=0 .030 ,P>0 .05) .K-L grading was strongly correlated with age (R=0 .782 , P< 0 .05 ) , weakly correlated with lateral migrating ratio of patella ( R = 0 .104 , P> 0 .05 ) , but not correlated with the others ( R < 0 .1 , P> 0 .05 ) . Age was strongly correlated with K-L grading and lateral patellofemoral angle (R=0 .782 ,0 .506 ,P<0 .05) ,moderately correlated with congruence angle ,lateral migrating ratio of patella ,and patellofemoral index (R=0 .403 ,0 .361 ,0 .475 , P< 0 .05) ,but not correlated with Wiberg typing ,sulcus angle ,or Insall index ( R=0 .024 ,0 .074 ,0 .053 , P>0 .05) .Conclusion Patellar Wiberg typing is the key factor which influences latellar stability ;age has a limited influence ,while K-L grading does not affect patellar stability .