A FEM-DFN model for the interaction and propagation of multi-cluster fractures during variable fluid-viscosity injection in layered shale oil reservoir

To investigate the height growth of multi-cluster fractures during variable fluid-viscosity fracturing in a layered shale oil reservoir,a two-dimensional finite element method(FEM)-discrete fracture network(DFN)model coupled with flow,stress and damage is proposed.A traction-separation law is used to describe the mixed-mode response of the damaged adhesive fractures,and the cubic law is used to describe the fluid flow within the fractures.The rock deformation is controlled by the in-situ stress,fracture cohesion and fluid pressure on the hydraulic fracture surface.The coupled finite element equations are solved by the explicit time difference method.The effects of the fracturing treatment parameters including fluid viscosity,pumping rate and cluster spacing on the geometries of multifractures are investigated.The results show that variable fluid-viscosity injection can improve the complexity of the fracture network and height of the main fractures simultaneously.The pumping rate of15 m^(3)/min,variable fluid-viscosity of 3-9-21-36-45 mPa s with a cluster spacing of 7.5 m is the ideal treatment strategy.The field application shows that the peak daily production of the application well with the optimized injection procedu re of variable fluid-viscosity fracturing is 171 tons(about 2.85 times that of the adjacent well),which is the highest daily production record of a single shale oil well in China,marking a strategic breakthrough of commercial shale oil production in the Jiyang Depression,Shengli Oilfield.The variable fluid-viscosity fracturing technique is proved to be very effective for improving shale oil production.

Giant struma ovarii with pseudo-Meigs’syndrome and raised cancer antigen-125 levels:A case report

BACKGROUND Struma ovarii is a type of monodermal mature teratoma composed entirely or mainly of thyroid tissue,accounting for 1%to 3%of all ovarian teratomas and 0.3%to 1.0%of all ovarian tumors.Of which,struma ovarii with ascites and pleural effusion,called pseudo-Meigs’syndrome and raised cancer antigen-125levels(CA 125)is even rarer.CASE SUMMARY This paper reports the diagnosis and treatment of a patient of struma ovarii with pseudo-Meigs’syndrome,presenting with the clinical features of ovarian carcinoma:Complex pelvic mass,gross ascites,right pleural effusion and markedly elevated serum CA 125 levels.During the operation,a cystic-solid mass about 20cm×10 cm×5 cm in the right adnexa and a solid mass with the size of 3 cm×2cm×0.1 cm in the left ovary were observed.She underwent right adnexectomy and resection of the left ovarian mass and histopathology revealed a mature leftsided ovarian teratoma and struma ovarii of right adnexal mass.During 1-year follow-up,the patient recovered well,tumor markers and other indicators returned to normal.CONCLUSION The diagnosis and treatment process of this case suggests that the clinical symptoms of struma ovarii with pseudo-Meigs’syndrome are lack specificity,which is easily misdiagnosed.Clinicians should improve the understanding of this disease,enhance the awareness of early screening,and improve the level of diagnosis and treatment.

Various configuration types of the foveal avascular zone with related factors in normal Chinese adults with or without myopia assessed by swept-source OCT angiography

·AIM:To describe the morphological characteristics of foveal avascular zone(FAZ)in normal Chinese adults with or without myopia by swept-source optical coherence tomography angiography(SS-OCTA)and analyze the possible associated factors.·METHODS:Normal Chinese adults with or without myopia aged between 18 and 60 y were recruited into the study.One eye in each individual was randomly selected for scanning using SS-OCTA.FAZ parameters,central retinal thickness(CRT)and central choroidal thickness(CCT)were then analyzed.Correlations between systemic and ocular variables and FAZ parameters were subsequently evaluated.The subgroup analysis based on refractive error was also carried out.·RESULTS:In total,127 eyes out of 127 normal subjects were finally included in the study(mean age29.5±8.22 y,61 males and 66 females).The pattern of FAZ was variable:round configuration in 28 eyes(22%),quadrilateral configuration in 23 eyes(18%),pentagonal configuration in 20 eyes(16%),oval configuration in 15 eyes(12%),triangular configuration in 6 eyes(5%)and irregular configuration in 35 eyes(28%).The mean area of FAZ was0.37±0.12 mm^(2).Females had a larger FAZ(0.41±0.11 mm^(2)vs0.32±0.11 mm^(2))compared with that of males(P<0.01).All myopic individuals showed smaller FAZ area and perimeter compared with that of normal individuals(P<0.01).There was no obvious correlation between age and FAZ.In the univariate regression analysis,both axial length(AL)and refractive error were significantly related to FAZ parameters.However,only CRT showed negative correlation with FAZ in the multivariate regression analysis.·CONCLUSION:The pattern of FAZ configuration in normal Chinese adults with or without myopia is highly variable.Establishing quantitative parameters of FAZ would not only provide details of macular pathophysiology but could possibly contribute as a biomarker in disease staging.

Near-wellbore fracture initiation and propagation induced by drilling fluid invasion during solid fluidization mining of submarine nature gas hydrate sediments

Drilling in a natural gas hydrate formation is challenging due to the poor consolidation of the formation and the potential evaporation of the hydrate.The unreasonable down-hole pressure of the drilling fluid can not only lead to the wellbore instability,but also change the predrilling condition of the natural gas hydrate formation,thus leading to an instable wellbore.In this paper,the integrated discrete element method(DEM)-computational fluid dynamics(CFD)work flow is developed to study the wellbore instability due to the penetration of the drilling fluid into the hydrate formation during crack propagations.The results show that the difference between in-situ stresses and overpressure directly affect the drilling fluid invasion behavior.The lower hydrate saturation leads to an easier generation of drilling fluid flow channels and the lower formation breakdown pressure.The breakdown pressure increases with the increase of hydrate saturation,this also indicates that hydrates can enhance the mechanical properties of the formation.The induced cracks are initially accompanied with higher pressure of the drilling fluid.According to the rose diagram of the fracture orientation,a wider orientation of the fracture distribution is observed at higher pressure of the invasion fluid.

Correlation of serum nutrient levels with immune cell differentiation and inflammatory response activation in children with pneumonia

Objective:To investigate the correlation of serum nutrient levels with immune cell differentiation and inflammatory response activation in children with pneumonia.Methods:200 children with pneumonia who were treated in our hospital between April 2015 and August 2017 were selected as the pneumonia group, and 100 healthy children who were vaccinated in this hospital during the same period were selected as the normal control group. The differences in serum levels of nutrients, Th1/Th2 cytokines, Th17/Treg cytokines and inflammatory mediators were compared between the two groups. Pearson test was used to assess the relationship between serum nutrient levels and disease severity.Results: Serum Vit A, Fe and Zn levels of pneumonia group were lower than those of control group. The differences in serum Vit D, Ca and Mg levels were not statistically significant between the two groups of children. Serum Th1 cytokines IL-2 and TNF-β contents of pneumonia group were lower than those of control group whereas Th2 cytokines IL-4 and IL-5 contents were higher than those of control group;Th17 cytokines IL-17, IL-21 and IL-22 contents were higher than those of control group whereas Treg cytokines IL-10 and TGF-β contents were lower than those of control group;inflammatory mediators CRP, PCT and MCP-1 contents were significantly higher than those of control group. Pearson test showed that serum nutrients Vit A, Fe and Zn levels in children with pneumonia were directly correlated with the degree of immune cell differentiation and inflammatory response.Conclusion: Serum Vit A, Fe, Zn and other nutrient levels abnormally decrease in children with pneumonia, and the specific level are directly correlated with the severity of the disease.

Exploration of potential biomarkers and therapeutic targets for trauma-related acute kidney injury

Purpose:Acute kidney injury(AKI)is one of the most common functional injuries observed in trauma patients.However,certain trauma medications may exacerbate renal injury.Therefore,the early detection of trauma-related AKI holds paramount importance in improving trauma prognosis.Methods:Qualified datasets were selected from public databases,and common differentially expressed genes related to trauma-induced AKI and hub genes were identified through enrichment analysis and the establishment of protein-protein interaction(PPI)networks.Additionally,the specificity of these hub genes was investigated using the sepsis dataset and conducted a comprehensive literature review to assess their plausibility.The raw data from both datasets were downloaded using R software(version 4.2.1)and processed with the"affy"package19 for correction and normalization.Results:Our analysis revealed 585 upregulated and 629 downregulated differentially expressed genes in the AKI dataset,along with 586 upregulated and 948 downregulated differentially expressed genes in the trauma dataset.Concurrently,the establishment of the PPI network and subsequent topological analysis highlighted key hub genes,including CD44,CD163,TIMP metallopeptidase inhibitor 1,cytochrome b-245 beta chain,versican,membrane spanning 4-domains A4A,mitogen-activated protein kinase 14,and early growth response 1.Notably,their receiver operating characteristic curves displayed areas exceeding 75%,indicating good diagnostic performance.Moreover,our findings postulated a unique molecular mechanism underlying trauma-related AKI.Conclusion:This study presents an alternative strategy for the early diagnosis and treatment of trauma-related AKI,based on the identification of potential biomarkers and therapeutic targets.Additionally,this study provides theoretical references for elucidating the mechanisms of trauma-related AKI.

Advanced Role of Hippo Signaling in Endometrial Fibrosis： Implications for Intrauterine Adhesion

Objective： Intrauterine adhesion （IUA） is a major health problem that causes infertility, menstrual irregularities, and recurrent pregnancy losses in women. Unfortunately, treatments for IUA are limited, and there are currently no effective strategies for preventing IUA recurrence. In this review, we introduced the role of Hippo signaling in the normal endometrium and IUA and described the mechanisms by which the Hippo pathway integrates with the Wnt and transforming growth factor-β （TGF-β） signaling pathways to form an intricate network governing the development of fibrosis. Data Sources： Original research articles in English that were published until July 2017 were collected from the PubMed database. Study Selection： Literature search was conducted using the search terms ＂endometrial fibrosis OR fibrosis AND or OR intrauterine adhesion OR Asherman syndrome OR IUA,＂ ＂Hippo AND or OR Hippo/TAZ,＂ ＂TGF-β,＂ and ＂Wnt.＂ Related original research articles were included in the comprehensive analysis. Results： Endometrial fibrosis is recognized as a key pathological event in the development of IUA, which is characterized by epithelial/fibroblast-myofibroblast transition. Myofibroblasts play crucial roles in the pathogenesis of fibrous scarring, and myofibroblast differentiation can be triggered by multiple signaling pathways. H ippo signaling is a critical regulator of the epithelial/fibroblast-myofibroblast transition and α-smooth muscle actin, which exhibits a specific spatiotemporal expression in the endometrium. Conclusions： Hippo signaling plays a critical role in fibrous diseases and participates in cross talks with Wnt and TGF-β signaling. Our findings not only contributed to knowledge on the pathogenesis of endometrial fibrosis, but can also serve as a useful resource for developing specific molecular inhibitors for IUA treatment and prevention.

Increased risk of cardio-cerebrovascular disease after hematopoietic cell transplantation in patients with previous history

Background:The impacts of previous cardio-cerebrovascular disease(pre-CCVD)on the outcomes of hematopoietic cell transplantation(HCT)are not well described.Patients with pre-CCVD may often be poor candidates for HCT.This study aimed to investigate the impact of pre-CCVD on transplant outcomes.Methods:A retrospective study was conducted between patients with and without pre-CCVD who consecutively received allogeneic or autologous HCT between November 2013 and January 2020 with a matching of age and disease status.The cardiovascular complications and HCT outcomes of the two groups were evaluated and compared.The primary endpoints were post-transplant cardio-cerebrovascular disease(post-CCVD)and non-relapse mortality(NRM).We used a multivariable Cox proportional hazard model and the Fine-Gray competing risk regressions for analyses to estimate the hazard ratios(HRs).Results:The outcomes of 23 HCT recipients with pre-CCVD were compared with those of 107 patients in the control group.No significant differences were noted in terms of engraftment,overall survival(OS)(67.00%vs.67.90%,P=0.983),or relapse(29.78%vs.28.26%,P=0.561)between the pre-CCVD group and the control group.The cumulative incidences of 2-year NRM were similar between patients with pre-CCVD and the controls(14.68%vs.17.08%,P=0.670).However,pre-CCVD was associated with an increased incidence of post-CCVD(HR:12.50,95%confidence interval[CI]:3.88–40.30,P<0.001),which was an independent risk factor for increased NRM(HR:10.29,95%CI:3.84–27.62,P<0.001)and inferior OS(HR:10.29,95%CI:3.84–27.62,P<0.001).Conclusions:These findings suggest that the existence of pre-CCVD before transplantation might not result in increased mortality directly but superpose the toxicity of the transplantation procedure,leading to a risk of post-CCVD.Post-CCVD was a powerful predictor for high NRM and inferior OS.Further risk stratification of pre-CCVD is needed to reduce NRM in various transplantation settings.

Ectopic Thyroid Masquerading as Pituitary Adenoma

To the Editor： We reported 2 cases ofectopic thyroid gland （ETG） masquerading as pituitary adenoma （PA）. The first case was a 15-year-old boy with growth, and mental retardation whose height was 121 cm and weight was 44 kg on admission. Bone age development index was 40, while bone age showed 6-10 years old.