Objective: To investigate the therapeutic advantages of closed reduction and Kirschner wire fixation versus open reduction and plate fixation in patients with hand surgery fractures. Methods: The sample was collected ...Objective: To investigate the therapeutic advantages of closed reduction and Kirschner wire fixation versus open reduction and plate fixation in patients with hand surgery fractures. Methods: The sample was collected from May 2021 to May 2025, consisting of 80 patients with hand surgery fractures. These patients were randomly divided into two groups using the red and blue ball method: the plate fixation group (40 cases, treated with open reduction and plate fixation) and the Kirschner wire fixation group (40 cases, treated with closed reduction and Kirschner wire fixation). The therapeutic effects between the two groups were randomly compared. Results: The Kirschner wire fixation group outperformed the plate fixation group in all indicators except for hand function scores (p < 0.05). There was no statistically significant difference in hand function scores between the two groups (p > 0.05). Conclusion: Compared with open reduction and plate fixation, closed reduction and Kirschner wire fixation for patients with hand surgery fractures achieves a more pronounced therapeutic effect, with advantages such as less trauma, shorter operation time, less bleeding, and a lower incidence of complications. It is suitable for hand surgery fractures with good stability. Open reduction and plate internal fixation have greater advantages in complex fractures and cases requiring high stability, and are worthy of promotion and application.展开更多
Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge ev...Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.展开更多
Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduc- tion and intramedullary nail...Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduc- tion and intramedullary nail fixation to determine the therapeutic effect of this closed reduction tech- nique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a. gentle traction was attempted on the limb. Usu- ally, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the me- dullary cavity, and the ＂T＂ sharp handles were fixed on the Schanz pins. The fragments were then re- duced by reversing the deforming forces for segmental fractures by two assistants~ And then, the re- duction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all pa- tients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen （86.7%） patients had anatomic reduction and two of them （13.3%） had minor varus alignment of 3° and 5°. Knee stiffness was Observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures With four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.展开更多
Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
BACKGROUND Traumatic hip dislocation usually occurs following high-velocity trauma.It is imperative that the dislocation be reduced in a timely manner,especially in a closed manner,as an orthopedic emergency.However,c...BACKGROUND Traumatic hip dislocation usually occurs following high-velocity trauma.It is imperative that the dislocation be reduced in a timely manner,especially in a closed manner,as an orthopedic emergency.However,closed reduction can hardly be achieved in patients who also have ipsilateral lower extremity fractures.Herein,we focus on hip dislocation associated with ipsilateral lower extremity fractures,excluding intracapsular fractures(femoral head and neck fractures),present an early closed hip joint reduction method for this injury pattern,and review the literature to discuss the appropriate closed reduction technique for this rare injury pattern.CASE SUMMARY We report a case of a 37-year-old male who sustained a left acetabular posterior wall fracture,an ipsilateral comminuted subtrochanteric fracture and dislocation of the hip.The hip dislocation was reduced urgently in a closed manner using the joy-stick technique with a T-shaped Schanz screw.The fractures were reduced and fixed as a 2nd-stage surgery procedure.At the 17-month postoperative follow-up,the patient had full range of motion of the affected hip.CONCLUSION Closed reduction of a hip dislocation associated with ipsilateral lower extremity fractures is rarely achieved by regular maneuvers.Attempts at closed reduction,by means of indirectly controlling the proximal fracture fragment or reconstructing the femoral leverage rapidly with the aid of various external reduction apparatuses,were shown to be effective in some scenarios.Mandatory open reduction is indicated in cases of failed closed reduction,particularly in irreducible dislocations.展开更多
To determine the optimal pricing and carbon emission reduction decision, a closed-loop supply chain with a manufacturer and a retailer is investigated. In this system, the manufacturer manufactures new products and re...To determine the optimal pricing and carbon emission reduction decision, a closed-loop supply chain with a manufacturer and a retailer is investigated. In this system, the manufacturer manufactures new products and remanufactures used products while the retailer is responsible for selling new products and remanufactured products. The profit functions of the manufacturer and the retailer are developed, and the corresponding solution formulae for decision variables are given by the Stackelberg game model. Finally, a numerical example is given, and the optimal wholesale price, retail price, carbon emission reduction and others are obtained. Through the sensitivity of the unit carbon allowance price, some significant managerial insights are derived.展开更多
To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who s...To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who sustained displaced supracondylar fracture of distal humerus treated by closed reduction and percutaneous K wires fixation Results. All patients’ K wires were removed at 4 weeks post operation Their elbow function regained at 8 weeks The average period of followed up was 10 month (varies from 6 to 18 month), all fractures healed very well without any permanent complications Two transient nerves palsy,ulnar and radial nerve each, recovered completely at 12 weeks and 16 weeks post operation respectively Conclusion. Closed reduction and percutaneous K wires fixation is a safe and efficient treatment for displaced humerus surpracondylar fracture in children展开更多
Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The ...Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.展开更多
Hydraulic systems provide a clean and stable supply of hydraulic fluid for subsea valves and actuators installed on the subsea bed in subsea production systems.Subsea control systems are used for contemporary subsea f...Hydraulic systems provide a clean and stable supply of hydraulic fluid for subsea valves and actuators installed on the subsea bed in subsea production systems.Subsea control systems are used for contemporary subsea fields instead of installing the control system on topside.Although all-electric subsea systems are state-of-the-art with benefits such as health,safety,and environment improvement,as well as efficiency and lower cost,hydraulic systems are still used for the development of many subsea fields.One of the main questions in the selection of a subsea hydraulic field is whether to choose an open or closed loop hydraulic system.The main characteristic of an open loop hydraulic system is that the hydraulic fluid is discharged into the marine environment during the actuation of the subsea valves.Conversely,the hydraulic fluid is returned to the topside facilities through an umbilical system in a closed loop system.Given that closed loop systems are more eco-friendly,the main question in this research is to examine the effect of the actuator connection of the closed loop system on actuator design.Two cases of actuated valves connected to a closed loop system are analyzed in this paper.The first is a 71/16-in.subsea slab gate valve in the pressure class of 517 bar with a linear spring return fail-safe close(FSC)actuator located on a manifold branch.The data indicates that the piston rod and cylinder diameter of the FSC linear actuator should be increased by some millimeters due to the accumulation of hydraulic oil at the bottom of the actuator.The hydraulic oil in the closed loop system helps in closing the actuator and spring force,so the spring constant and torque should be reduced as a result.The second case involves a 16-in.subsea ball valve in the pressure class of 517 bar with a double-acting fail-as-is rack and pinion actuator.The conclusion in this case is to avoid making any change in the design of double-acting actuator in connection to the closed loop system.展开更多
Al-Si closed-cell aluminum foam bare boards of 1 240 mm×1 100 mm with different densities and thicknesses wereprepared by molten body transitional foaming process.The sound reduction index(R)of Al-Si closed-cell ...Al-Si closed-cell aluminum foam bare boards of 1 240 mm×1 100 mm with different densities and thicknesses wereprepared by molten body transitional foaming process.The sound reduction index(R)of Al-Si closed-cell aluminum foam bareboards was investigated experimentally under different frequencies(100-4 000 Hz).It is found that sound reduction index(R)issmall under low frequencies,large under high frequencies and is controlled by different mechanisms.The sound insulation propertybasically conforms with the monolayer board sound insulation theory.The sound reduction index(R)increases with the even growthof thickness and density,but its rising trend is tempered.The single number sound reduction indexes(RW)of specimen with thicknessof 20 cm and density of 0.51 g/cm3are 30.8 dB and 33 dB respectively,which demonstrates good sound insulation property forlightmass materials.展开更多
This study has been performed to investigate the different parameters affecting on the production of high carbon ferromanganese in closed submerged arc furnace. The analysis of industrial data revealed that using mang...This study has been performed to investigate the different parameters affecting on the production of high carbon ferromanganese in closed submerged arc furnace. The analysis of industrial data revealed that using manganese ores with low Mn/Fe ratio necessitates higher amount of Mn-sinter in the charge. Using Mn-blend with higher Mn/Fe ratio reduces the coke consumption and this leads to reducing the electrodes consumption. The recovery of Mn ranges between 70 and 80 %. Much higher basic slag has slight effect on Mn- recovery. However, as slag basicity increases, the MnO- content of slag decreases. The manganese content of produced HCFeMn depends mainly on Mn/Fe ratio of Mn-blend. For obtaining HCFeMn alloy containing minimum 75%Mn, it is necessary to use Mn-blend with Mn/Fe ratio of higher than 6. A model for determination of the amount and composition of off-gases has been derived based on the chemical composition and material balance of the input raw materials and the produced alloy and slag. By using this model, the amount of off-gases was found to increase by increasing both Mn-blend and coke consumption.展开更多
In order to optimize and transform closed mature apple orchards with standard rootstocks and improve the quality of fruit,taking a closed Red Fuji apple orchard as the test object,the effects of different density-redu...In order to optimize and transform closed mature apple orchards with standard rootstocks and improve the quality of fruit,taking a closed Red Fuji apple orchard as the test object,the effects of different density-reducing methods(deinterlacing,removing every other plant in each row,removing every other plant every other row)on the canopy microenvironment,tree structure,leaf photosynthesis and fruit quality were studied.The results showed that different density-reducing methods significantly reduced the orchard coverage and increased the crown transmittance.Among them,the deinterlacing treatment was the best in improving the population structure of the closed orchard,as it reduced the orchard coverage rate by 55.68 percentage points and the canopy transmittance by 82.38 percentage points,compared with the control(CK).Different density-reducing methods all could significantly reduce the branch amount in the closed orchard and optimized the branch composition.The three density-reducing methods decreased the number of branches per plant by 18.96%,12.41%and 19.58%,respectively,compared with the CK.And compared with the CK,the proportion of short branches and leafy branches to the total branches was increased by 17.13%,14.27%and 7.37%,respectively,and the proportion of long branches and developmental branches to the total branches was decreased by 24.47%,18.04%and 10.79%,respectively.The effects of the different density-reducing methods on the temperature,relative light intensity,SPAD and leaf photosynthetic rate in canopies all followed an order of deinterlacing>removing every other plant in each row>removing every other plant every other row>CK,while those on the relative humidity showed an order of deinterlacing>removing every other plant in each row>removing every other plant every other row>CK,while those on the relative humidity showed an order of deinterlacing<removing every other plant in each row<removing every other plant every other row<CK.The average single fruit weight(238.3 g),coloring index(89.2),smoothness index(83.2),soluble solid content(15.1%)and high quality fruit rate(82.4%)of the deinterlacing treatment were higher than those of other treatments,and the values were 18.2%,11.4%,5.85%,26.9%and 25.2%higher than the CK,respectively.The use of dein￣terlacing to reduce density is the best for improving the microenvironment of closed apple orchards and improving the photosynthetic efficiency and fruit quality.展开更多
This paper investigates impact of noise and signal averaging on patient control in anesthesia applications, especially in networked control system settings such as wireless connected systems, sensor networks, local ar...This paper investigates impact of noise and signal averaging on patient control in anesthesia applications, especially in networked control system settings such as wireless connected systems, sensor networks, local area networks, or tele-medicine over a wide area network. Such systems involve communication channels which introduce noises due to quantization, channel noises, and have limited communication bandwidth resources. Usually signal averaging can be used effectively in reducing noise effects when remote monitoring and diagnosis are involved. However, when feedback is intended, we show that signal averaging will lose its utility substantially. To explain this phenomenon, we analyze stability margins under signal averaging and derive some optimal strategies for selecting window sizes. A typical case of anesthe-sia depth control problems is used in this development.展开更多
In this manuscript, the authors have studied the Disc Displacement (DD) status of patients with acute Closed Lock (CL) to determine differences between DD with Reduction (DDwR) and DD without Reduction (DDwoR). Among ...In this manuscript, the authors have studied the Disc Displacement (DD) status of patients with acute Closed Lock (CL) to determine differences between DD with Reduction (DDwR) and DD without Reduction (DDwoR). Among the acute CL patients who visited our hospital within 2 weeks of the onset of CL, we studied 10 patients whose CL was released (DDwR) and 13 patients whose CL was not released (DDwoR). The DDwoR group was significantly older than the DDwR group. Although the mouth opening distance was significantly greater in the DDwoR group than in the DDwR group, the two groups were identical in the duration of CL. Sagittal MRI images showed no significant differences between the two groups in disc length and disc thickness (anterior band, intermediate zone, and posterior band). Multisection sagittal and coronal images identified lateral DD in 7 of the 10 patients in the DDwR group, although no specific direction of the DD was observed in the DDwoR group. Furthermore, deformation of the medial disc was common in the DDwoR group but uncommon in the DDwR group.展开更多
文摘Objective: To investigate the therapeutic advantages of closed reduction and Kirschner wire fixation versus open reduction and plate fixation in patients with hand surgery fractures. Methods: The sample was collected from May 2021 to May 2025, consisting of 80 patients with hand surgery fractures. These patients were randomly divided into two groups using the red and blue ball method: the plate fixation group (40 cases, treated with open reduction and plate fixation) and the Kirschner wire fixation group (40 cases, treated with closed reduction and Kirschner wire fixation). The therapeutic effects between the two groups were randomly compared. Results: The Kirschner wire fixation group outperformed the plate fixation group in all indicators except for hand function scores (p < 0.05). There was no statistically significant difference in hand function scores between the two groups (p > 0.05). Conclusion: Compared with open reduction and plate fixation, closed reduction and Kirschner wire fixation for patients with hand surgery fractures achieves a more pronounced therapeutic effect, with advantages such as less trauma, shorter operation time, less bleeding, and a lower incidence of complications. It is suitable for hand surgery fractures with good stability. Open reduction and plate internal fixation have greater advantages in complex fractures and cases requiring high stability, and are worthy of promotion and application.
基金supported by the National Key Research and Development Program of China(2022YFC2504303)Innovation Foundation of National Clinical Research Center for Orthopaedics,Sports Medicine&Rehabilitation(2021-NCRC-CXJJ-ZH-24)Medical Innovation and Transformation Incubation Project of Tongji Hospital(2022ZHFY10).
文摘Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.
基金supported by grants from the National Natural Science Foundation of China(No.81401789)the Key Medical Science Research Plan of Hebei Province(No.ZL2014208)
文摘Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduc- tion and intramedullary nail fixation to determine the therapeutic effect of this closed reduction tech- nique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a. gentle traction was attempted on the limb. Usu- ally, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the me- dullary cavity, and the ＂T＂ sharp handles were fixed on the Schanz pins. The fragments were then re- duced by reversing the deforming forces for segmental fractures by two assistants~ And then, the re- duction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. Closed reduction was achieved in all pa- tients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen （86.7%） patients had anatomic reduction and two of them （13.3%） had minor varus alignment of 3° and 5°. Knee stiffness was Observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures With four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘BACKGROUND Traumatic hip dislocation usually occurs following high-velocity trauma.It is imperative that the dislocation be reduced in a timely manner,especially in a closed manner,as an orthopedic emergency.However,closed reduction can hardly be achieved in patients who also have ipsilateral lower extremity fractures.Herein,we focus on hip dislocation associated with ipsilateral lower extremity fractures,excluding intracapsular fractures(femoral head and neck fractures),present an early closed hip joint reduction method for this injury pattern,and review the literature to discuss the appropriate closed reduction technique for this rare injury pattern.CASE SUMMARY We report a case of a 37-year-old male who sustained a left acetabular posterior wall fracture,an ipsilateral comminuted subtrochanteric fracture and dislocation of the hip.The hip dislocation was reduced urgently in a closed manner using the joy-stick technique with a T-shaped Schanz screw.The fractures were reduced and fixed as a 2nd-stage surgery procedure.At the 17-month postoperative follow-up,the patient had full range of motion of the affected hip.CONCLUSION Closed reduction of a hip dislocation associated with ipsilateral lower extremity fractures is rarely achieved by regular maneuvers.Attempts at closed reduction,by means of indirectly controlling the proximal fracture fragment or reconstructing the femoral leverage rapidly with the aid of various external reduction apparatuses,were shown to be effective in some scenarios.Mandatory open reduction is indicated in cases of failed closed reduction,particularly in irreducible dislocations.
基金supported by the National Natural Science Foundation of China (Grant No. 71661003)
文摘To determine the optimal pricing and carbon emission reduction decision, a closed-loop supply chain with a manufacturer and a retailer is investigated. In this system, the manufacturer manufactures new products and remanufactures used products while the retailer is responsible for selling new products and remanufactured products. The profit functions of the manufacturer and the retailer are developed, and the corresponding solution formulae for decision variables are given by the Stackelberg game model. Finally, a numerical example is given, and the optimal wholesale price, retail price, carbon emission reduction and others are obtained. Through the sensitivity of the unit carbon allowance price, some significant managerial insights are derived.
文摘To observe the effects of closed reduction and percutaneous K wires fixation of displacd supracondylar humerus fracture in children MethodsRetrospective review of fourteen patients who sustained displaced supracondylar fracture of distal humerus treated by closed reduction and percutaneous K wires fixation Results. All patients’ K wires were removed at 4 weeks post operation Their elbow function regained at 8 weeks The average period of followed up was 10 month (varies from 6 to 18 month), all fractures healed very well without any permanent complications Two transient nerves palsy,ulnar and radial nerve each, recovered completely at 12 weeks and 16 weeks post operation respectively Conclusion. Closed reduction and percutaneous K wires fixation is a safe and efficient treatment for displaced humerus surpracondylar fracture in children
基金2022 Key Specialty Construction Project of Traditional Chinese Medicine:Traditional Chinese Orthopedics and Traumatology Department (No.962042)2020 Regional Traditional Chinese Medicine (Orthopedics and Traumatology)Diagnosis and Treatment Center (Jin Wei Zhong[2020]No.5)。
文摘Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.
文摘Hydraulic systems provide a clean and stable supply of hydraulic fluid for subsea valves and actuators installed on the subsea bed in subsea production systems.Subsea control systems are used for contemporary subsea fields instead of installing the control system on topside.Although all-electric subsea systems are state-of-the-art with benefits such as health,safety,and environment improvement,as well as efficiency and lower cost,hydraulic systems are still used for the development of many subsea fields.One of the main questions in the selection of a subsea hydraulic field is whether to choose an open or closed loop hydraulic system.The main characteristic of an open loop hydraulic system is that the hydraulic fluid is discharged into the marine environment during the actuation of the subsea valves.Conversely,the hydraulic fluid is returned to the topside facilities through an umbilical system in a closed loop system.Given that closed loop systems are more eco-friendly,the main question in this research is to examine the effect of the actuator connection of the closed loop system on actuator design.Two cases of actuated valves connected to a closed loop system are analyzed in this paper.The first is a 71/16-in.subsea slab gate valve in the pressure class of 517 bar with a linear spring return fail-safe close(FSC)actuator located on a manifold branch.The data indicates that the piston rod and cylinder diameter of the FSC linear actuator should be increased by some millimeters due to the accumulation of hydraulic oil at the bottom of the actuator.The hydraulic oil in the closed loop system helps in closing the actuator and spring force,so the spring constant and torque should be reduced as a result.The second case involves a 16-in.subsea ball valve in the pressure class of 517 bar with a double-acting fail-as-is rack and pinion actuator.The conclusion in this case is to avoid making any change in the design of double-acting actuator in connection to the closed loop system.
基金Project(2002AA334060)supported by Hi-tech Research and Development Program of China
文摘Al-Si closed-cell aluminum foam bare boards of 1 240 mm×1 100 mm with different densities and thicknesses wereprepared by molten body transitional foaming process.The sound reduction index(R)of Al-Si closed-cell aluminum foam bareboards was investigated experimentally under different frequencies(100-4 000 Hz).It is found that sound reduction index(R)issmall under low frequencies,large under high frequencies and is controlled by different mechanisms.The sound insulation propertybasically conforms with the monolayer board sound insulation theory.The sound reduction index(R)increases with the even growthof thickness and density,but its rising trend is tempered.The single number sound reduction indexes(RW)of specimen with thicknessof 20 cm and density of 0.51 g/cm3are 30.8 dB and 33 dB respectively,which demonstrates good sound insulation property forlightmass materials.
文摘This study has been performed to investigate the different parameters affecting on the production of high carbon ferromanganese in closed submerged arc furnace. The analysis of industrial data revealed that using manganese ores with low Mn/Fe ratio necessitates higher amount of Mn-sinter in the charge. Using Mn-blend with higher Mn/Fe ratio reduces the coke consumption and this leads to reducing the electrodes consumption. The recovery of Mn ranges between 70 and 80 %. Much higher basic slag has slight effect on Mn- recovery. However, as slag basicity increases, the MnO- content of slag decreases. The manganese content of produced HCFeMn depends mainly on Mn/Fe ratio of Mn-blend. For obtaining HCFeMn alloy containing minimum 75%Mn, it is necessary to use Mn-blend with Mn/Fe ratio of higher than 6. A model for determination of the amount and composition of off-gases has been derived based on the chemical composition and material balance of the input raw materials and the produced alloy and slag. By using this model, the amount of off-gases was found to increase by increasing both Mn-blend and coke consumption.
基金Supported by Key Research and Development Program of Shandong Province(2017CXGC0210)Agricultural Science and Technology Innovation Project of Shandong Academy of Agricultural Sciences(CXGC2017D01)+3 种基金National Key R&D Program of China(2016YFD0201100)National Natural Science Foundation of China(31600021)Modern Agricultural Industry Technology System of China for Apple(CARS-27)Dongying Science and Technology Program(2015GG0104)
文摘In order to optimize and transform closed mature apple orchards with standard rootstocks and improve the quality of fruit,taking a closed Red Fuji apple orchard as the test object,the effects of different density-reducing methods(deinterlacing,removing every other plant in each row,removing every other plant every other row)on the canopy microenvironment,tree structure,leaf photosynthesis and fruit quality were studied.The results showed that different density-reducing methods significantly reduced the orchard coverage and increased the crown transmittance.Among them,the deinterlacing treatment was the best in improving the population structure of the closed orchard,as it reduced the orchard coverage rate by 55.68 percentage points and the canopy transmittance by 82.38 percentage points,compared with the control(CK).Different density-reducing methods all could significantly reduce the branch amount in the closed orchard and optimized the branch composition.The three density-reducing methods decreased the number of branches per plant by 18.96%,12.41%and 19.58%,respectively,compared with the CK.And compared with the CK,the proportion of short branches and leafy branches to the total branches was increased by 17.13%,14.27%and 7.37%,respectively,and the proportion of long branches and developmental branches to the total branches was decreased by 24.47%,18.04%and 10.79%,respectively.The effects of the different density-reducing methods on the temperature,relative light intensity,SPAD and leaf photosynthetic rate in canopies all followed an order of deinterlacing>removing every other plant in each row>removing every other plant every other row>CK,while those on the relative humidity showed an order of deinterlacing>removing every other plant in each row>removing every other plant every other row>CK,while those on the relative humidity showed an order of deinterlacing<removing every other plant in each row<removing every other plant every other row<CK.The average single fruit weight(238.3 g),coloring index(89.2),smoothness index(83.2),soluble solid content(15.1%)and high quality fruit rate(82.4%)of the deinterlacing treatment were higher than those of other treatments,and the values were 18.2%,11.4%,5.85%,26.9%and 25.2%higher than the CK,respectively.The use of dein￣terlacing to reduce density is the best for improving the microenvironment of closed apple orchards and improving the photosynthetic efficiency and fruit quality.
文摘This paper investigates impact of noise and signal averaging on patient control in anesthesia applications, especially in networked control system settings such as wireless connected systems, sensor networks, local area networks, or tele-medicine over a wide area network. Such systems involve communication channels which introduce noises due to quantization, channel noises, and have limited communication bandwidth resources. Usually signal averaging can be used effectively in reducing noise effects when remote monitoring and diagnosis are involved. However, when feedback is intended, we show that signal averaging will lose its utility substantially. To explain this phenomenon, we analyze stability margins under signal averaging and derive some optimal strategies for selecting window sizes. A typical case of anesthe-sia depth control problems is used in this development.
文摘In this manuscript, the authors have studied the Disc Displacement (DD) status of patients with acute Closed Lock (CL) to determine differences between DD with Reduction (DDwR) and DD without Reduction (DDwoR). Among the acute CL patients who visited our hospital within 2 weeks of the onset of CL, we studied 10 patients whose CL was released (DDwR) and 13 patients whose CL was not released (DDwoR). The DDwoR group was significantly older than the DDwR group. Although the mouth opening distance was significantly greater in the DDwoR group than in the DDwR group, the two groups were identical in the duration of CL. Sagittal MRI images showed no significant differences between the two groups in disc length and disc thickness (anterior band, intermediate zone, and posterior band). Multisection sagittal and coronal images identified lateral DD in 7 of the 10 patients in the DDwR group, although no specific direction of the DD was observed in the DDwoR group. Furthermore, deformation of the medial disc was common in the DDwoR group but uncommon in the DDwR group.
