Comprehensive treatment of deep frostbite of multiple fingers after trauma:A case report

BACKGROUND Frostbite is becoming increasingly common in urban environments,and severe cases can lead to tissue loss.The treatment goal is to preserve tissue and function;the sooner appropriate treatment is administered,the more tissue can be saved.However,not every patient with deep frostbite seeks medical care promptly.CASE SUMMARY We report the case of a 73-year-old male patient who was lost in the wilderness for 2 d due to trauma and confusion.He experienced deep frostbite on multiple fingers.Treatment should not be discontinued for patients with deep frostbite who present after the optimum treatment timing.Bullae that no longer form(bloody)blisters within 24 h of aspiration should be removed.Mucopolysaccharide polysulfate cream has clinical value in frostbite treatment.The patient was transferred to Chinese Academy of Medical Sciences and Peking Union Medical College Hospital 12 h after being rescued.The patient had contraindications for thrombolysis,the most effective treatment,due to intracranial hemorrhage and presenting past the optimum treatment timing.We devised a comprehensive treatment plan,which involved delayed use vasodilators and high-pressure oxygen therapy at day 49 post-injury.We experimented with mucopolysaccharide polysulfate cream to treat the frostbite.The aim of the treatment was to safeguard as much tissue as possible.In the end,the fingers that suffered from frostbite were able to be partially preserved.CONCLUSION The case indicated that patients with severe frostbite who missed the optimal treatment time and had contraindications for thrombolysis could still partially preserve the affected limbs through comprehensive treatment.

Acoustic logging response law in shales based on petrophysical model

Shale acoustic logging response law is complex due to the multiple minerals and pores,which limits the application of acoustic logging in shale reservoir parameter evaluation,therefore clarifying the shale acoustic logging response law is of great importance.Different petrophysical models are adopted for the equivalence of organic matter,clay,matrix minerals,and fractures,in Wufeng-Longmaxi shale formation in the Jiaoshiba area.Finally,the self-consistent approximation model is used to combine different components,and a shale petrophysical model with a complex pore structure is constructed.The model verification results show it has good predictability for shale.Based on the model,the effect of different mineral compositions and different types of pores are studied.The results show that:1)The effect of clay and organic matter is very complex,and the variation laws of layered clay(organic matter)and dispersed clay(organic matter)on the acoustic wave are consistent.2)Layered clay or organic matter leads to the formation anisotropy increase,which makes the acoustic time difference greater than that of containing dispersed clay(organic matter).3)The fracture is the main control factor of anisotropy,and the anisotropy of gas-bearing fracture is higher than that of water/oil fracture.