Meta-analysis of the efficacy of volar plate internal fixation versus closed reduction and external fixation in the treatment of adult distal radius fractures

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.

基于静定梁和田玉、岫玉、蓝田玉的力学解析

大部分玉雕作品中长、细特性都以悬臂梁和外伸梁的形式体现出来,长细比例的确定是雕刻工艺中的难点。采用抗拉以及抗压测试对和田玉、岫玉、蓝田玉试样进行力学强度试验,根据静定梁的种类及截面类型,运用最大弯曲正应力公式σmax=|M zmax|/Wz≤[σ],对试验数据进行力学解析,得出以下结论:三种玉石和田玉的抗拉抗压强度最大;和田玉雕刻为矩形截面外伸梁且满足a=0.71 l时,长细比值范围最大为l/2 h≤2924.38;且合理运用不等强梁特性,可扩大雕刻玉石的长细比值范围。

煤炭检测的质量管控研究

煤炭检测的目的在于获得准确可靠的检测结果,科学、客观地评价煤炭质量,做好进厂质量把关和指导配煤工作。煤炭检测的质量控制不仅要保证检测结果的准确还要保障企业原料煤的价值。因此,保证检验结果的准确性并使检验结果始终处于受控范围内,已成为质量管理的重要课题。

焦化企业危废资源化利用实践

焦化企业生产过程中不可避免地要产生危险废物,危险废物的处理必须严格按照法律法规的要求进行,危废对外处置费用高、手续复杂,转移后的不可控风险大,如何按照法律法规的要求尽可能内部资源化利用是解决危废的有效途径,也是国家提倡的最佳方式。主要总结了资源化利用的实际方法,便于行业做好自身工作,有利于行业自身发展,也有利于环保有序处理和效益最大化,有助于实体企业的可持续发展。

超大型火炬系统试压实践

大型化工装置的试车过程中,火炬系统气量大,火炬放空气种类多,试压难度大,试压过程危险性高。如何按照规范要求安全稳妥完成试压和气密工作,尤其是试车初期尚不具备提供大量的试压介质,选择方案的安全可靠性及有操作性尤为关键,也是试压和气密工作完成的前提。

中水回用系统优化研究

分析了中水回用超滤、纳滤、反渗透三种膜在处理焦化生化后废水运行过程,发现了污堵、后絮凝等问题,创造性提出针对性的操作优化措施和技术性改造,减少了在线加强洗和离线清洗频次,延长膜使用寿命经过长期运行实践,对中水回用稳定运行、提升产水量具有较好的借鉴和指导。

焦炉煤气全负压脱硫工艺改造分析

山东铁雄新沙能源有限公司化产一期采用的是两级脱硫工艺,前置负压氨法脱硫,后置正压钠法脱硫工艺,负压脱硫以煤气中的氨为碱源,使用络合铁脱硫催化剂,正压钠法加入纯碱为碱源,使用PDS脱硫催化剂。为降低运行费用,利用一期系统停车的机会把后置正压钠法脱硫全部改为前置负压氨法脱硫工艺,无需再添加纯碱,脱硫改为氨法后,消除了原来钠法需要定期排放脱硫液,硫泡沫处理系统统一使用,流程更加顺畅,物料消耗降低,整个脱硫系统的阻力下降,节约了运行费用。

降低初冷器阻力的改造方案及改造效果

初冷器是焦化企业的关键设备,初冷器是净化荒煤气中焦油和萘的重要设备,初冷器运行的好坏直接关系到后系统电捕和净化的运行质量,尤其是已经正常运行的初冷器。若设计之初能够充分考虑初冷器的重要作用,加大冲洗液的分类,不同类别的冲洗液按照其特性做好循环喷洒,一定能够实现初冷器的作用,达到长周期运行的目标。