股骨头坏死(osteonecrosis of the femoral head,ONFH)是临床常见的难治性疾病。虽然其确切的病理生理机制尚不完全清楚,但普遍认为与骨内循环中断和最终骨组织死亡紧密相关。股骨头坏死的预防和保头治疗一直是临床骨科医生面临的巨大...股骨头坏死(osteonecrosis of the femoral head,ONFH)是临床常见的难治性疾病。虽然其确切的病理生理机制尚不完全清楚,但普遍认为与骨内循环中断和最终骨组织死亡紧密相关。股骨头坏死的预防和保头治疗一直是临床骨科医生面临的巨大挑战。为进一步规范ONFH的诊断和治疗,2020版指南在"中国成人股骨头坏死诊疗指南(2016)"的基础上,对ONFH的流行病学、病因学、病理生理学、影像学、诊断和治疗的新进展等方面进行了修订和更新。国际骨循环研究学会(The Association Research Circulation Osseous,ARCO)制订的股骨头坏死分期在指导治疗、判断预后、评估疗效等方面广泛应用,最新的ARCO分期系统(2019版)也引入指南中。指南不仅建立了ONFH的基本诊断、治疗和评价体系,还提供了流行病学、病因学、诊断标准、病理分期、预防和治疗选择(包括中医药治疗)以及术后康复等方面的专家意见和标准。根据不同阶段骨坏死的骨内血供变化,推荐相应的非手术治疗和手术治疗;存在ONFH的可能危险因素时,建议采取一定的预防措施以避免股骨头坏死的发生。指南为骨坏死提供了简要的分类标准和治疗方案。明确病因、综合考虑不同阶段股骨头坏死的血运状态、髋关节功能、患者的年龄和职业是诊断和制定治疗策略的重要步骤。展开更多
The genome sequence of the Severe Acute Respiratory Syndrome (SARS)-associated virus provides essential information for the identification of pathogen(s), exploration of etiology and evolution, interpretation of trans...The genome sequence of the Severe Acute Respiratory Syndrome (SARS)-associated virus provides essential information for the identification of pathogen(s), exploration of etiology and evolution, interpretation of transmission and pathogenesis, development of diagnostics, prevention by future vaccination, and treatment by developing new drugs. We report the complete genome sequence and comparative analysis of an isolate (BJ01) of the coronavirus that has been recognized as a pathogen for SARS. The genome is 29725 nt in size and has 11 ORFs (Open Reading Frames). It is composed of a stable region encoding an RNA-dependent RNA polymerase (composed of 2 ORFs) and a variable region representing 4 CDSs (coding sequences) for viral structural genes (the S, E, M, N proteins) and 5 PUPs (putative uncharacterized proteins). Its gene order is identical to that of other known coronaviruses. The sequence alignment with all known RNA viruses places this virus as a member in the family of Coronaviridae. Thirty putative substitutions have been identified by comparative analysis of the 5 SARS- associated virus genome sequences in GenBank. Fifteen of them lead to possible amino acid changes (non-synonymous mutations) in the proteins. Three amino acid changes, with predicted alteration of physical and chemical features, have been detected in the S protein that is postulated to beinvolved in the immunoreactions between the virus and its host. Two amino acid changes have been detected in the Mprotein, which could be related to viral envelope formation. Phylogenetic analysis suggests the possibility of non-human origin of the SARS-associated viruses but provides noevidence that they are man-made. Further efforts should focus on identifying the etiology of the SARS-associated virus and ruling out conclusively the existence of otherpossible SARS-related pathogen(s).展开更多
文摘股骨头坏死(osteonecrosis of the femoral head,ONFH)是临床常见的难治性疾病。虽然其确切的病理生理机制尚不完全清楚,但普遍认为与骨内循环中断和最终骨组织死亡紧密相关。股骨头坏死的预防和保头治疗一直是临床骨科医生面临的巨大挑战。为进一步规范ONFH的诊断和治疗,2020版指南在"中国成人股骨头坏死诊疗指南(2016)"的基础上,对ONFH的流行病学、病因学、病理生理学、影像学、诊断和治疗的新进展等方面进行了修订和更新。国际骨循环研究学会(The Association Research Circulation Osseous,ARCO)制订的股骨头坏死分期在指导治疗、判断预后、评估疗效等方面广泛应用,最新的ARCO分期系统(2019版)也引入指南中。指南不仅建立了ONFH的基本诊断、治疗和评价体系,还提供了流行病学、病因学、诊断标准、病理分期、预防和治疗选择(包括中医药治疗)以及术后康复等方面的专家意见和标准。根据不同阶段骨坏死的骨内血供变化,推荐相应的非手术治疗和手术治疗;存在ONFH的可能危险因素时,建议采取一定的预防措施以避免股骨头坏死的发生。指南为骨坏死提供了简要的分类标准和治疗方案。明确病因、综合考虑不同阶段股骨头坏死的血运状态、髋关节功能、患者的年龄和职业是诊断和制定治疗策略的重要步骤。
文摘The genome sequence of the Severe Acute Respiratory Syndrome (SARS)-associated virus provides essential information for the identification of pathogen(s), exploration of etiology and evolution, interpretation of transmission and pathogenesis, development of diagnostics, prevention by future vaccination, and treatment by developing new drugs. We report the complete genome sequence and comparative analysis of an isolate (BJ01) of the coronavirus that has been recognized as a pathogen for SARS. The genome is 29725 nt in size and has 11 ORFs (Open Reading Frames). It is composed of a stable region encoding an RNA-dependent RNA polymerase (composed of 2 ORFs) and a variable region representing 4 CDSs (coding sequences) for viral structural genes (the S, E, M, N proteins) and 5 PUPs (putative uncharacterized proteins). Its gene order is identical to that of other known coronaviruses. The sequence alignment with all known RNA viruses places this virus as a member in the family of Coronaviridae. Thirty putative substitutions have been identified by comparative analysis of the 5 SARS- associated virus genome sequences in GenBank. Fifteen of them lead to possible amino acid changes (non-synonymous mutations) in the proteins. Three amino acid changes, with predicted alteration of physical and chemical features, have been detected in the S protein that is postulated to beinvolved in the immunoreactions between the virus and its host. Two amino acid changes have been detected in the Mprotein, which could be related to viral envelope formation. Phylogenetic analysis suggests the possibility of non-human origin of the SARS-associated viruses but provides noevidence that they are man-made. Further efforts should focus on identifying the etiology of the SARS-associated virus and ruling out conclusively the existence of otherpossible SARS-related pathogen(s).
