Background The objectives of this study were to analyze the clinical features of coronavirus disease 2019 and evaluate the diagnosis and treatment. Methods A retrospective analysis of the clinical manifestation and auxiliary examination of 19 patients with COVID-19 from the Liyuan Hospital intensive care unit (ICU) between January 16, 2020 and February 20, 2020 was undertaken. Results There were 11 male and 8 female cases among the patients. The median (range) age was 73 (38-91) years. Of these patients, 8 (42.1%) had died and the median duration from ICU admission to death was 2 (interquartile range (IQR): 1-10.75) days. Seven of these 8 patients had underlying diseases. The auxiliary examination showed fever (68.4%), dry cough (15.8%), dyspnea (10.5%), and diarrhea (5.3%). All 19 cases showed ground-glass changes on chest computed tomography. Serum hypersensitive C-reactive protein (hs-CRP) and serum amylase A (SAA) were clearly increased in all of the cases. Among the 19 cases, there were 16 (84.2%) cases in which the total number of lymphocytes decreased, 12 cases (63%) had reduced liver function, and 11 cases (58%) had deviant results for fibrinogen (FIB) and D-dimer, in particular, the D-dimer level was significantly higher in the non-survivors compared with the survivors. Conclusion There were more men than women among critically ill patients. All of the cases showed ground-glass changes on chest computed tomography and the vast majority of patients displayed fever and dry cough. The clinical laboratory indices change significantly, especially the D-dimer level among non-survivors.
Ratcheting assessment by elastic-plastic stress analysis is presented in ASME VIII-2, paragraph 5.5.7. There are three criteria. The first one is strict in engineering design. It’s hard for most of structures to satisfy it. If the plastic strain in the structure is zero, it means that the material is not fully utilized and maybe the structure is unreasonable. Therefore, the second and third criteria are used much more. The first one and the third one can be observed directly and judged accurately by the finite element analysis results. The second one demands an elastic core in the primary-load-bearing boundary. It could be easily observed when the structure is axisymmetric, but hard to judge in the 3D structure. Okamoto in Committee on Three Dimensional Finite Element Stress Evaluation (C-TDF) has studied two thermal stress ratchet criteria: evaluating variations in the plastic strain increments and evaluating variations in the elastic core region, which can accurately assess ratcheting. Recent years, based on the criteria above, more researches have been performed by engineers not only from C-TDF but from all over the world. In this work, several two-dimensional structures and three-dimensional structures under particular load and displacement boundaries are performed by using finite element software ANSYS, aiming to compare the similarities and differences between the criteria in ASME VIII-2, 5.5.7.2 and those given by C-TDF. The assessment of these structures presented in this work will help engineers understand the realization of the criteria and methods in engineering design, especially how to utilize the results from ANSYS.
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