Comparison of the Effectiveness of Surgical Versus Nonsurgical Treatment for Multiple Rib Fractures Accompanied with Pulmonary Contusion.

OBJECTIVE: To compare the effectiveness of surgical versus nonsurgical treatment for multiple rib fractures accompanied with pulmonary contusion. METHODS: The clinical records of consecutive 167 patients with multiple rib fractures accompanied with pulmonary contusion, who were treated from June 2014 to June 2017, were retrospectively analyzed. Of them, 75 and 92 underwent surgery (surgery group) and non-surgical treatment (non-surgery group), respectively. Patient pain score, complications, length of hospital stay, cost of hospitalization, and post-treatment 3-month follow-up results were compared. RESULTS: The mean number of days and moderate pain in the surgery group was significantly lower than that of the non-surgery group (p <0.01). The incidence of post-treatment complications was significantly lower in the surgery group than in the non-surgery group. The length of hospital stay of the surgery group was also significantly shorter than that of the non-surgery group (p <0.01). The cost of hospitalization was significantly higher in the surgery group than in the non-surgery group (p <0.01). The chest computed tomography (CT) scan which was performed 3 months after the treatment revealed that the surgery group had a better recovery than the non-surgery group. Physical recovery of the surgery group was also significantly better than that of the non-surgery group. CONCLUSION: Surgery to treat multiple rib fractures (≥ 4 fractures) accompanied with pulmonary contusion is safe and effective.

Mn-Modified CuO, CuFe2O4, and γ-Fe2O3 Three-Phase Strong Synergistic Coexistence Catalyst System for NO Reduction by CO with a Wider Active Window.

A series of samples with the precursor's molar ratio of {KMn8O16}/{CuFe2O4} = 0, 0.008, 0.010, 0.016, and 0.020 were successfully synthesized for selective catalytic reduction of NO by CO. The physicochemical properties of all samples were studied in detail by combining the means of X-ray photoelectron spectroscopy, H2-temperature-programmed reduction, scanning electron microscopy mapping, X-ray diffraction (XRD), N2 physisorption (Brunauer-Emmett-Teller), NO + CO model reaction, and in situ Fourier transform infrared spectroscopy techniques. The results show that three phases of γ-Fe2O3, CuFe2O4, and CuO, which have strong synergistic interaction, coexist in this catalyst system, and different phases play a leading role in different temperature ranges. Mn species are highly dispersed in the three-phase coexisting system in the form of Mn2+, Mn3+, and Mn4+. Because of the strong interaction between Mn2+ and Fe species, a small amount of Cu2+ precipitates from CuFe2O4 and grows along the CuO(110) plane, which has better catalytic performance. Mn3+ can inhibit the conversion of γ-Fe2O3 to α-Fe2O3 at high temperature and then increases the high-temperature activity. The synergistic effect between Mn4+ and the surfaces of three phases generates active oxygen species Cu2+-O-Mn4+ and Mn4+-O-Fe3+, which can be more easily reduced to some synergistic oxygen vacancies during the reaction. Furthermore, the formed synergistic oxygen vacancies can promote the dissociation of NO and are also propitious to the transfer of oxygen species. All of these factors make the appropriate manganese-modified three-phase coexisting system have better catalytic activity than the manganese-free catalyst, making NO conversion rate reach 100% at around 250 °C and maintain to 1000 °C. Combining comprehensive analysis of various characterization results and in situ infrared as well as XRD results in the equilibrium state, a new possible NO + CO model reaction mechanism was temporarily proposed to further understand the catalytic processes.