Completely weathered phyllite (CWP) soil is a kind of special soil with high swell potential, while red clay is a special soil with high shrinkage. This means that these two kinds of special soils are usually not suitable for direct use as subgrade fill. To reduce the swell index of the CWP soil and the shrinkage of red clay at the same time, it was proposed to blend the CWP soil with red clay to improve their basic characteristics. A series of swell index tests and dry-wet cycle tests of the blended soils have been carried out at varying blending ratios, compaction coefficients and moisture contents. The test results show that the free swell index of the blended soil decreases with the increase of red clay, moisture content and compaction coefficient, respectively. The fissure density of the blended soil first decreases and then increases with the blending ratio, with the lowest being zero when the blending ratio is ranging from 20% to 40%. Through particle microscopic analysis and elemental composition analysis, it is found that the neutralization effect, the dilution effect of swell minerals, and the partition effect of coarse particles play an important role in restraining expansion and shrinkage deformation of the blended soil. Based on the liquid limit requirement of Chinese Railway Design Code (TB 10001-2016), the optimal blending ratio of red clay has been proposed to be 50%. Compared with the CWP soil, the free load swell index of the blended soil is reduced by 45.0% and the fissure density is reduced by 99.3% compared with that of red clay. Therefore, it is feasible to improve the CWP soil by blending it with red clay at an optimal ratio of 50% by using the neutralization effect of the expansion of CWP and shrinkage of red clay.
Objective: High ligation of great saphenous vein combined with laser in the treatment of varicose veins of lower limbs is a minimally invasive and efficient operation, which is widely used. However, there is less discussion on the risk control and management of this kind of operation. So the study was undertaken to identify the hidden dangers and risks and improve the safety of operation. Methods: 214 cases (201 patients) of lower extremity treated by high ligation of great saphenous vein combined with laser in varicose vein cavity were treated from January 2016 to December 2018. The complications, adverse events and treatment were analyzed. There were no great saphenous vein, root injury of great saphenous vein, guide wire entering deep vein, guide wire or cannula breaking or breaking, skin nerve burn, local skin and soft tissue thermal injury in the groin incision. The patients were followed up for 1 month to 3 years. Results: 30 cases (14.0%) had risk or adverse events. During the operation, there were 7 cases without great saphenous vein in the groin incision, 3 cases with root injury of great saphenous vein, 3 cases with guide wire entering deep vein, 1 case with guide wire breaking, and 1 case with cannula burning through and breaking. In the follow-up, 8 cases had local skin and soft tissue thermal injury, 3 cases had saphenous nerve burn, 2 cases had lower extremity deep vein thrombosis and 2 cases had recurrence operated again. Other patients had no adverse consequences. Conclusion: Open operation and intracavitary interventional treatment are better than single operation, but at the same time, they have double risks. During and after the operation, appropriate measures should be taken according to the causes to avoid serious consequences.
The ethics of Noddings' care is an ethical theory which discusses the responsibility, emotion, relationship and mutual care between people, which has strong applicability in the relationship between doctors and patients. Amputation has the function of disability and is also a great blow to the patients' psychology. Under the influence of traditional culture, Chinese people have a lower reception degree of this operation, and need to give more professional care. Besides the indication and necessity of amputation, the medical side should also consider the acceptance of patients and their families. This is related to the age and occupation, cultural customs, ideological cognition, economic situation of the patients, and not only the medical technology. In clinical work, we should fully recognize the necessity and limitation of this surgical treatment method, and pay attention to the advantages and disadvantages of amputation. This paper summarizes the effect of doctor-patient communication and clinical teaching of 22 amputated patients, discusses the use of Noddings' care ethics knowledge to realize the good communication between doctors and patients, and at the same time, the specific application methods of Noddings' care ethics are transferred to lower doctors, and finally achieve the equal and reciprocal interpersonal relationship among doctors, patients and students.
BackgroundThe aim of the study was to compare the clinical characteristics of diabetic carpal tunnel syndrome between patients with neuropathic pain (NeuP) and non-NeuP.MethodsWe enrolled 276 patients with diabetic carpal tunnel syndrome. Pain symptoms were evaluated using a visual analog scale. Douleur Neuropathique 4, the Neuropathic Pain Symptoms Inventory questionnaire, and the body map were used to assess neuropathic symptoms. Baseline information, clinical manifestations, electrophysiological test results, and psychological status were compared between the neuropathic pain (NeuP) and non-NeuP to identify the risk factor for NeuP occurrence.ResultsResults showed that the degree of pain was more severe in NeuP patients than in nociceptive pain patients (p = 0.025). The frequencies of light touch and pinprick were more pronounced in the NeuP group than in the non-NeuP group (light touch: p = 0.001; pinprick: p = 0.004). There were 48 and 27 NeuP patients with extramedian and proximal spread, respectively, whereas in the non-NeuP group, there were 11 and 9 patients, respectively (p = 0.03). Electrophysiological results showed that patients in the NeuP group exhibited greater sensory nerve conduction velocity impairment compared with the non-NeuP group (p = 0.033). Pain Catastrophizing Scale total scores of the NeuP group were significantly higher than those of the non-NeuP group (p = 0.006).ConclusionOf the 276 diabetic carpal tunnel syndrome patients studied, the majority had NeuP. Furthermore, light touch, electrophysiological test results, and psychological factors were found to be related to NeuP occurrence in patients with diabetic carpal tunnel syndrome.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.