It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. Thelack of level 1...It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. Thelack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging(MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures(FHSP) and femoral head replacement procedures(FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated.展开更多
A careful study on the integral properties of the primitive hydrostatic balance equations for baroclinic atmosphere is carried out, and a new scheme todesign the global adiabatic model of atmospheric dynamics ispresen...A careful study on the integral properties of the primitive hydrostatic balance equations for baroclinic atmosphere is carried out, and a new scheme todesign the global adiabatic model of atmospheric dynamics ispresented. This scheme includes a method of weighted equal-areamesh and a fully discrete finite difference method with quadraticand linear conservations for solving the primitive equationsystem. Using this scheme, we established a new dynamical corewith adjustable high resolution acceptable to the availablecomputer capability, which can be very stable without anyfiltering and smoothing. Especially, some important integralproperties are kept unchanged, such as the anti-symmetries of thehorizontal advection operators and the vertical convectionoperator, the mass conservation, the effective energy conservationunder the standard stratification approximation, and so on. Somenumerical tests on the new dynamical core, respectively regardingits global conservations and its integrated performances inclimatic modeling, incorporated with the physical packagesfrom the Community Atmospheric Model Version 2 (CAM2) of NationalCenter for Atmospheric Research (NCAR), are included.展开更多
The climatic and environmental variations since the Last Interglaciation are reconstructed based on the study of the upper 268 m of the 309-m-long Guliya ice core. Five stages can be distinguished since the Last Inter...The climatic and environmental variations since the Last Interglaciation are reconstructed based on the study of the upper 268 m of the 309-m-long Guliya ice core. Five stages can be distinguished since the Last Interglaciation from the δ18O record in the Guliya ice core: Stage 1 (Deglaciation), Stage 2 (the Last Glacial Maximum), Stage 3 (interstadial), Stage 4 (interstadial in the early glacial maximum) and Stage 5 (the Last Interglaciation). Stage 5 can be divided further into 5 substages; a, b, c, d, e. The δ18O record in the Guliya ice core indicates clearly the close correlation between the temperature variation on the Tibetan Plateau and the solar activities. The study indicates that the solar activity is a main forcing to the climatic variation on the Tibetan Plateau. Through a comparison of the ice core record in Guliya with that in the Greenland and the Antarctic, it can be found that the variation of large temperature variation events in different parts of the world is generally the same, but the variation amplitude of temperature is different.展开更多
Osteonecrosis is a phenomenon involving disruption to the vascular supply to the femoral head, resulting in articular surface collapse and eventual osteoarthritis. Although alcoholism, steroid use, and hip trauma rema...Osteonecrosis is a phenomenon involving disruption to the vascular supply to the femoral head, resulting in articular surface collapse and eventual osteoarthritis. Although alcoholism, steroid use, and hip trauma remain the most common causes, several other etiologies for osteonecrosis have been identified. Basic science research utilizing animal models and stem cell applications continue to further elucidate the pathophysiology of osteonecrosis and promise novel treatment options in the future. Clinical studies evaluating modern joint-sparing procedures have demonstrated significant improvements in outcomes, but hip arthroplasty is still the most common procedure performed in these affected younger adults. Further advances in joint-preserving procedures are required and will be widely studied in the coming decade.展开更多
文摘It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. Thelack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging(MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures(FHSP) and femoral head replacement procedures(FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated.
基金This paper is supported by the 973 Project(Grant No.G1999032801)the Fund for Innovative Research Groups(Grant No.41221503)the National Natural Science Foundation of China(Grant No.40233031).
文摘A careful study on the integral properties of the primitive hydrostatic balance equations for baroclinic atmosphere is carried out, and a new scheme todesign the global adiabatic model of atmospheric dynamics ispresented. This scheme includes a method of weighted equal-areamesh and a fully discrete finite difference method with quadraticand linear conservations for solving the primitive equationsystem. Using this scheme, we established a new dynamical corewith adjustable high resolution acceptable to the availablecomputer capability, which can be very stable without anyfiltering and smoothing. Especially, some important integralproperties are kept unchanged, such as the anti-symmetries of thehorizontal advection operators and the vertical convectionoperator, the mass conservation, the effective energy conservationunder the standard stratification approximation, and so on. Somenumerical tests on the new dynamical core, respectively regardingits global conservations and its integrated performances inclimatic modeling, incorporated with the physical packagesfrom the Community Atmospheric Model Version 2 (CAM2) of NationalCenter for Atmospheric Research (NCAR), are included.
基金Project supported by the Climbing Program of the State Eighth Five-Year Plan and the National Natural Science Foundation of China
文摘The climatic and environmental variations since the Last Interglaciation are reconstructed based on the study of the upper 268 m of the 309-m-long Guliya ice core. Five stages can be distinguished since the Last Interglaciation from the δ18O record in the Guliya ice core: Stage 1 (Deglaciation), Stage 2 (the Last Glacial Maximum), Stage 3 (interstadial), Stage 4 (interstadial in the early glacial maximum) and Stage 5 (the Last Interglaciation). Stage 5 can be divided further into 5 substages; a, b, c, d, e. The δ18O record in the Guliya ice core indicates clearly the close correlation between the temperature variation on the Tibetan Plateau and the solar activities. The study indicates that the solar activity is a main forcing to the climatic variation on the Tibetan Plateau. Through a comparison of the ice core record in Guliya with that in the Greenland and the Antarctic, it can be found that the variation of large temperature variation events in different parts of the world is generally the same, but the variation amplitude of temperature is different.
文摘Osteonecrosis is a phenomenon involving disruption to the vascular supply to the femoral head, resulting in articular surface collapse and eventual osteoarthritis. Although alcoholism, steroid use, and hip trauma remain the most common causes, several other etiologies for osteonecrosis have been identified. Basic science research utilizing animal models and stem cell applications continue to further elucidate the pathophysiology of osteonecrosis and promise novel treatment options in the future. Clinical studies evaluating modern joint-sparing procedures have demonstrated significant improvements in outcomes, but hip arthroplasty is still the most common procedure performed in these affected younger adults. Further advances in joint-preserving procedures are required and will be widely studied in the coming decade.
