ABSTRACT
Critically ill patients are prone to a series of complications during early enteral nutrition (EEN), including gastrointestinal complications, infectious complications, metabolic complications, and mechanical complications, with an incidence of 30.5-65.7%, which attributes to prolonged hospitalization and increased mortality. Therefore, this retrospective study aimed to construct a quality control system of enteral nutrition nursing for critically ill patients as well as apply this system in clinical practice to evaluate its effect. Delphi method was utilized for this purpose, and we compared the incidence of enteral nutrition complications between patients using quality control system and using routine enteral nutrition. The mastery of enteral nutrition related knowledge by nursing staff was also compared before and after the implementation of a quality control system. Our data showed that, after applying the system to patients with critical illness in the nursing clinic, the incidence of enteral nutrition gastrointestinal complications, infectious complications, metabolic complications, and mechanical complications was significantly decreased from 11.51%, 1.96%, 3.41% and 5.88% to 1.86%, 0.52%, 1.71% and 0.97% (P<0.005), respectively. Furthermore, the awareness of enteral nutrition theory by ICU nurses was also significantly improved, and the questionnaire score was increased from 70.22±8.78 to 95.25±4.18 (t=18.792, P<0.001). Hence, the enteral nutrition nursing quality control system we developed could effectively guide nursing staff to implement enteral nutrition, reduce the occurrence of enteral nutrition complications in patients with critical illness and ensure the safety of patients, suggesting the clinical application value of our system.
ABSTRACT
Herein, the hydrogen embrittlement of a heat-affected zone (HAZ) was examined using slow strain rate tension in situ hydrogen charging. The influence of hydrogen on the crack path of the HAZ sample surfaces was determined using electron back scatter diffraction analysis. The hydrogen embrittlement susceptibility of the base metal and the HAZ samples increased with increasing current density. The HAZ samples have lower resistance to hydrogen embrittlement than the base metal samples in the same current density. Brittle circumferential cracks located at the HAZ sample surfaces were perpendicular to the loading direction, and the crack propagation path indicated that five or more cracks may join together to form a longer crack. The fracture morphologies were found to be a mixture of intergranular and transgranular fractures. Hydrogen blisters were observed on the HAZ sample surfaces after conducting tensile tests at a current density of 40 mA/cm2, leading to a fracture in the elastic deformation stage.
ABSTRACT
The determination of an appropriate amount of turning for superalloy ingot surfaces, in a scientific and reasonable manner, is vital to the improvement of the metallurgical quality and comprehensive performance of superalloy ingots. In the present study, scanning electron microscopy with energy-dispersive spectroscopy, a high-temperature testing machine, a Brinell hardness tester and the Image-Pro Plus software were used to analyze and compare the types and amounts of inclusions, the average area of the (Al,Mg)O inclusions, and the mechanical properties of points at different distances from the edge of the GH4169 superalloy vacuum arc remelting (VAR) ingot edge. The effects of the amount of turning to which the superalloy is subjected, the metallurgical qualities, and the mechanical properties were systematically studied. The results showed that the five inclusion types did not change as the sampling locations moved away from the ingot edge, but the amount of inclusions and the average area of the (Al,Mg)O inclusions first decreased and then stabilized. Similarly, the tensile strength, elongation, section shrinkage, hardness, and fatigue life first increased and then stabilized. Finally, this experiment tentatively determined that an appropriate amount of turning for a GH4169 superalloy ingot is 36-48 mm.
ABSTRACT
Increasing the ingot size of GH4720Li superalloys makes it difficult to control their microstructure, and the withdrawal rate is an important factor in controlling and refining the microstructure of GH4720Li superalloys. In this study, GH4720Li superalloy samples were prepared via Bridgman-type directional solidification with different withdrawal rates. The morphology and average size of the dendrites in the stable growth zone during directional solidification in each sample, morphology and average size of the γ' phases, and microsegregation of each alloying element were analyzed using optical microscopy, Photoshop, Image Pro Plus, field emission scanning electron microscopy, and electron probe microanalysis. Increasing the withdrawal rate significantly helped in refining the superalloy microstructure; the average secondary dendrite arm spacing decreased from 133 to 79 µm, whereas the average sizes of the γ' phases in the dendrite arms and the interdendritic regions decreased from 1.02 and 2.15 µm to 0.69 and 1.26 µm, respectively. Moreover, the γ' phase distribution became more uniform. The microsegregation of Al, Ti, Cr, and Co decreased with the increase in the withdrawal rate; the segregation coefficients of Al, Cr, and Co approached 1 at higher withdrawal rates, whereas that of Ti remained above 2.2 at all the withdrawal rates.
ABSTRACT
The choice of melting technique is crucial for controlling the purity of a superalloy, which is especially important because purity has come to limit progress in the superalloy field. In this study, double- and triple-melting techniques were used to refine the GH4738 superalloy. Elemental analyses, inductively coupled plasma-atomic emission spectroscopy, X-ray diffraction analysis, scanning electron microscopy with energy-dispersive spectroscopy, high-temperature cupping machine, high-temperature fatigue testing machine, and Image-Pro Plus software were used to analyze and compare the contents of specific elements, the types and sizes of inclusions, the mechanical properties, and the probabilities of white spot formation using the two melting techniques. The effects of the different melting processes on the purity of the superalloy were systematically studied. In terms of controlling the presence of impurities, the triple-melting process resulted in lower levels of harmful N, S, and O impurities in the superalloy, the triple-melted superalloy also contained fewer types of inclusion of smaller sizes and in smaller amounts than the double-melted alloy. Triple melting also promotes tensile strength and fatigue life, and minimizes the probability of forming defects in the superalloy.
