Interventions for Treating 3- or 4-part proximal humeral fractures in elderly patient: A network meta-analysis of randomized controlled trials.

BACKGROUND: The fractures of proximal humerus have a high incidence in elderly patients, especially 3- or 4-part fracture. There are 4 main treatments including nonoperation, open reduction and internal fixation(ORIF), hemiarthroplasty(HA) and reverse shoulder arthroplasty(RSA). However, which one is the optimal choice remains a controversial topic. METHODS: Through the search of three electronic databases (PubMed, Embase, and Cochrane), the randomized controlled trials of 3- or 4-part proximal humeral fracture, until the end of July 2017, which is concerned with the elderly patients, were identified. The quality evaluation of each study was evaluated, Constant score and reoperation rates were extracted and analyzed. We used R(R i386 3.3.2) and the package of gemtc to perform our network meta-analysis. RESULTS: Seven randomized controlled experiments with a total number of 347 patients were brought into our network meta-analysis. The rank probability plot of Constant score showed that the RSA had significantly the highest Constant score and lower reoperation than other treatments. The other way around, the efficacy of ORIF was the poorest. The rank for the Constant score was: RSA, HA, nonoperation and ORIF. The rank for the reduction in total reoperation rates was: RSA, nonoperation, HA and ORIF. CONCLUSIONS: The statistical result suggested that RSA has become a beneficial choice to treat displaced 3-or 4-part fracture in elderly patients, that might result in more favorable clinical outcomes and reduction of reoperation rates than other methods performed for the same indication. But the ORIF is the worst.

Investigation of the Defect Structure of Congruent and Fe-Doped LiNbO3 Powders Synthesized by the Combustion Method.

Fe-doped LiNbO3 synthesized by the combustion method to seek new multiferroic materials exhibits room-temperature ferromagnetism, as reported in our previous work [1]. In this work, the defect structure of congruent and Fe-doped LiNbO3 (0.57-3.3 mol %) powders was investigated in detail by several methods. The molar ratio of [Li]/([Li]+[Nb]) was determined by the Curie temperature (Tc) via DSC. Two peaks of Tc were observed due to phase splitting [2], and the phase at lower Tc disappears as the Fe doping concentration increases. The coexistence of two different oxidation states of Fe ions in LiNbO3 was probed by XPS and UV-Vis spectroscopy. The Raman spectra exhibit displacements along the c axis of Li and Nb ions, and a deformation of the NbO6 framework owing to Fe doping. Several doping models were applied in the Rietveld refinement of powder X-ray diffraction collected by synchrotron radiation. The fitting by the Nb vacancy model leads to an improbably distorted structure of congruent LiNbO3. In Fe-doped LiNbO3, we conjecture that Li and Nb vacancies coexist in the lattice structure; Fe+2/Fe+3 ions are substituted for Li ions at the regular Li site and may push the anti-site NbLi ion back to the regular Nb site.

Inclusions properties at 1673 K and room temperature with Ce addition in SS400 steel.

Inclusion species formed in SS400 steel with Ce-addition was predicted by thermodynamic calculation. The analysis of the inclusion morphology and size distribution was carried out by applying Scanning Electron Microscopy (SEM) and Transmission Electron Microscope (TEM). Nano-Fe3O4 particles were also found in cerium-deoxidized and -desulfurized steel and their shapes were nearly spherical. The complex Ce2O3 inclusions covering a layer of 218 nm composed by several MnS particles with similar diffraction pattern. Most importantly, the complex Ce2O3 characterized by using TEM diffraction is amorphous in the steel, indicating that Ce2O3 formed in the liquid iron and then MnS segregated cling to it.

Thermodynamic Calculation among Cerium, Oxygen, and Sulfur in Liquid Iron.

Thermodynamic calculation has been applied to predict the inclusion formation in molten SS400 steel. When the Cerium addition in liquid iron is 70 ppm and the initial Oxygen and Sulphur are both 110 ppm, the formation of oxides containing Cerium would experience the transformation from Ce2O3 to CeO2 and also the formation of sulfides containing Cerium would experience the transformation from CeS to Ce2S3 and then to Ce3S4. Below 2000 K the most thermodynamic stable matter is CeO2 and the less thermodynamic stable inclusion is CeS. Only when the amount of [O] is extremely low and the amount of [S] and [Ce] is relatively high, Ce2S3 has the possibility to form.

Effects of Rare Earth Metals on Steel Microstructures.

Rare earth metals are used in semiconductors, solar cells and catalysts. This review focuses on the background of oxide metallurgy technologies, the chemical and physical properties of rare earth (RE) metals, the background of oxide metallurgy, the functions of RE metals in steelmaking, and the influences of RE metals on steel microstructures. Future prospects for RE metal applications in steelmaking are also presented.