Background:Fracture is a common large-organ traumatic injury and usually leads to complications in other systems.Multiple fractures are often associated with gastrointestinal(GI)dysfunction.However,no study has evalua...Background:Fracture is a common large-organ traumatic injury and usually leads to complications in other systems.Multiple fractures are often associated with gastrointestinal(GI)dysfunction.However,no study has evaluated the treatment of GI dysfunction.The purpose of the study is to explore the efficacy and mechanism based on ICC pathway of Banxia-Houpu decoction on GI.Methods:Male Sprague-Dawley mice were randomly divided according to the fracture modeling method and intervention.We detected the“GI residual rate”and motility.Gastric antrum and jejunum tissues were dissected for hematoxylin and eosin staining to observe the structural integrity of the GI tract,and immunohistochemistry was used to detect the expression of c-kit protein.Results:Compared with the fracture group the GI residual rates in the Banxia Houpu decoction and mosapride groups were significantly low,while GI motility was significantly high.HE staining revealed significant GI tissue necrosis and inflammatory cell infiltrations in the fracture groups.The Banxia Houpu decoction and mosapride groups,exhibited less pathology.Immunohistochemical staining showed upregulated c-kit protein expression in the fracture groups.The c-kit protein level was decreased in the mosapride group.Additionally,c-kit protein expression in the Banxia Houpu decoction groups was significantly decreased in a concentration-dependent manner.Conclusion:Banxia Houpu decoction improves GI dysfunction after multiple fractures,reduces inflammation and necrosis of gastric epithelial cells,and inhibits c-kit protein expression in GI tissues of mice.Results showed revealed one of the mechanisms underlying the effects of this decoction on the GI dysfunction in mice after multiple fractures.展开更多
BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur separately.CASE SUMMARY We ...BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur separately.CASE SUMMARY We report the case of a 37-year-old woman with open(IIIA)fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a balcony.After providing advanced trauma life support,damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating room.Subsequently,one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb swelling.The patient achieved good outcome at the 7 mo follow-up.CONCLUSION One-or two-stage treatment must be performed according to the type of injury;we efficiently used the“damage control principle.”展开更多
Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with compl...Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with complications, and is most often based on a two-stage strategy: Damage Control Orthopaedics, followed by delayed internal osteosynthesis. The aim is to allow early functional rehabilitation and rapid recovery of patients. We report the case of a 39-year-old man, bike rider, after his RTA, presented with segmental homolateral fractures of the femur and two bones of the left leg. Short-term evolution was marked by the appearance of significant lymphedema and bone infarctions of the lower left limb necessitating a transfemoral amputation. Through this observation, the authors highlight the problems related to the complexity of the management of multiple segmental fractures of the lower limb by emphasizing two post-traumatic complications rarely described but to be feared: chronic lymphedema and bone infarction.展开更多
BACKGROUND Hemophilia A is a rare inherited bleeding disorder caused by mutations in the factor Ⅷ gene. This clotting factor plays an intrinsic role in the blood coagulation pathway. Patients with hemophilia may deve...BACKGROUND Hemophilia A is a rare inherited bleeding disorder caused by mutations in the factor Ⅷ gene. This clotting factor plays an intrinsic role in the blood coagulation pathway. Patients with hemophilia may develop orthopedic manifestations such as hemarthrosis, but multiple malunion of fractures over the knee is rare and difficult to treat.CASE SUMMARY We report a patient with hemophilia A who developed severe knee osteoarthritis along with fracture malunion and nonunion. Total knee replacement was performed using a custom-made modular hinged knee prosthesis(cemented) equipped with extended distal and proximal stems. At 3 years’ follow-up, the patient exhibited excellent clinical function and remained satisfied with the surgical outcome. Surgical intervention was accompanied by rigorous coagulation factor replacement.CONCLUSION This case highlights various unique scenarios specific to individuals with hemophilia and fracture deformity.展开更多
Drilling fluids with complicated compositions are becoming more common as the oil and gas industry develops. The production of hazardous cuttings is increasing, which not only stifles the oil and gas industry’s devel...Drilling fluids with complicated compositions are becoming more common as the oil and gas industry develops. The production of hazardous cuttings is increasing, which not only stifles the oil and gas industry’s development but also poses a severe environmental threat. Deep underground re-injection is a cost-effective and efficient method for dealing with hazardous cuttings. Numerous experiments and numerical studies on cuttings re-injection have been conducted in the past thirty years. However, there is still a divergence of views on the fracture development in the process of cuttings re-injection. A comprehensive review of existing studies is necessary to help researchers advance this technology. This paper provides a review of the fundamental studies on fracture behaviors during the deep underground re-injection of drilling cuttings. The limitations of the existing studies are also discussed to inspire new research endeavors.展开更多
Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness...Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness of reservoir stimulation. Temporary plugging and diverting fracturing(TPDF) is considered to be a potential uniform-stimulation method for creating multiple fractures simultaneously in the oilfield. However, the multi-fracture propagation morphology during TPDF is not clear now. The purpose of this study is to quantitatively investigate the multi-fracture propagation morphology during TPDF through true tri-axial fracturing experiments and CT scanning. Critical parameters such as fracture spacing, number of perforation clusters, the viscosity of fracturing fluid, and the in-situ stress have been investigated. The fracture geometry before and after diversion have been quantitively analyzed based on the two-dimensional CT slices and three-dimensional reconstruction method. The main conclusions are as follows:(1) When injecting the high viscosity fluid or perforating at the location with low in-situ stress, multiple hydraulic fractures would simultaneously propagate. Otherwise, only one hydraulic fracture was created during the initial fracturing stage(IFS) for most tests.(2) The perforation cluster effectiveness(PCE) has increased from 26.62% during the IFS to 88.86% after using diverters.(3) The diverted fracture volume has no apparent correlation with the pressure peak and peak frequency during the diversion fracturing stage(DFS) but is positively correlated with water-work.(4) Four types of plugging behavior in shale could be controlled by adjusting the diverter recipe and diverter injection time, and the plugging behavior includes plugging the natural fracture in the wellbore, plugging the previous hydraulic fractures, plugging the fracture tip and plugging the bedding.展开更多
BACKGROUND Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission.However,pericardial injuries not bad enou...BACKGROUND Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission.However,pericardial injuries not bad enough to dislocate the heart may only cause intermittent electrocardiogram(ECG)changes or be asymptomatic.CASE SUMMARY In this case,we report a blunt pericardial injury undetected on preoperative transthoracic echocardiography and chest computed tomography.We misjudged intermittent ECG changes and blood pressure fluctuations as minor symptoms resulting from cardiac contusion and did not provide intensive treatment.The pericardial injury was found incidentally during surgical stabilization of rib fractures and was successfully repaired.CONCLUSION Post-traumatic blunt pericardial ruptures should be considered in patients with blunt chest trauma showing abnormal vital signs and ECG changes.展开更多
Under the policy background and advocacy of carbon capture,utilization,and storage(CCUS),CO_(2)-EOR has become a promising direction in the shale oil reservoir industry.The multi-scale pore structure distribution and ...Under the policy background and advocacy of carbon capture,utilization,and storage(CCUS),CO_(2)-EOR has become a promising direction in the shale oil reservoir industry.The multi-scale pore structure distribution and fracture structure lead to complex multiphase flow,comprehensively considering multiple mechanisms is crucial for development and CO_(2) storage in fractured shale reservoirs.In this paper,a multi-mechanism coupled model is developed by MATLAB.Compared to the traditional Eclipse300 and MATLAB Reservoir Simulation Toolbox(MRST),this model considers the impact of pore structure on fluid phase behavior by the modified Peng—Robinson equation of state(PR-EOS),and the effect simultaneously radiate to Maxwell—Stefan(M—S)diffusion,stress sensitivity,the nano-confinement(NC)effect.Moreover,a modified embedded discrete fracture model(EDFM)is used to model the complex fractures,which optimizes connection types and half-transmissibility calculation approaches between non-neighboring connections(NNCs).The full implicit equation adopts the finite volume method(FVM)and Newton—Raphson iteration for discretization and solution.The model verification with the Eclipse300 and MRST is satisfactory.The results show that the interaction between the mechanisms significantly affects the production performance and storage characteristics.The effect of molecular diffusion may be overestimated in oil-dominated(liquid-dominated)shale reservoirs.The well spacing and injection gas rate are the most crucial factors affecting the production by sensitivity analysis.Moreover,the potential gas invasion risk is mentioned.This model provides a reliable theoretical basis for CO_(2)-EOR and sequestration in shale oil reservoirs.展开更多
Currently,most models for multiple fractured horizontal wells(MFHWs)in naturally fractured unconventional reservoirs(NFURs)are based on classical Euclidean models which implicitly assume a uniform distribution of natu...Currently,most models for multiple fractured horizontal wells(MFHWs)in naturally fractured unconventional reservoirs(NFURs)are based on classical Euclidean models which implicitly assume a uniform distribution of natural fractures and that all fractures are homogeneous.While fractal theory provides a powerful method to describe the disorder,heterogeneity,uncertainty and complexity of the NFURs.In this paper,a fractally fractional diffusion model(FFDM)for MFHWs in NFURs is established based on fractal theory and fractional calculus.Particularly,fractal theory is used to describe the heterogeneous,complex fracture network,with consideration of anomalous behavior of diffusion process in NFURs by employing fractional calculus.The Laplace transformation,line source function,dispersion method,and superposition principle are used to solve this new model.The pressure responses in the real time domain are obtained with Stehfest numerical inversion algorithms.The type curves of MFHW with three different outer boundaries are plotted.Sensitivity analysis of some related parameters are discussed as well.This new model provides the relatively more accurate and appropriate evaluation results for pressure transient analysis for MFHWs in NFURs,which could be applied to accurately interpret the real pressure data of an MFHW in field.展开更多
基金supported by Natural Science Foundation of Zhejiang Province(grant number LY20H270012)Zhejiang Traditional Chinese Medicine Administration(2020ZB090)+1 种基金Zhejiang Chinese Medical University Research Fund(2021JKGJYY011)Hua Jiang Famous Expert Inheritance Studio of Traditional Chinese Medicine(GZS2021020).
文摘Background:Fracture is a common large-organ traumatic injury and usually leads to complications in other systems.Multiple fractures are often associated with gastrointestinal(GI)dysfunction.However,no study has evaluated the treatment of GI dysfunction.The purpose of the study is to explore the efficacy and mechanism based on ICC pathway of Banxia-Houpu decoction on GI.Methods:Male Sprague-Dawley mice were randomly divided according to the fracture modeling method and intervention.We detected the“GI residual rate”and motility.Gastric antrum and jejunum tissues were dissected for hematoxylin and eosin staining to observe the structural integrity of the GI tract,and immunohistochemistry was used to detect the expression of c-kit protein.Results:Compared with the fracture group the GI residual rates in the Banxia Houpu decoction and mosapride groups were significantly low,while GI motility was significantly high.HE staining revealed significant GI tissue necrosis and inflammatory cell infiltrations in the fracture groups.The Banxia Houpu decoction and mosapride groups,exhibited less pathology.Immunohistochemical staining showed upregulated c-kit protein expression in the fracture groups.The c-kit protein level was decreased in the mosapride group.Additionally,c-kit protein expression in the Banxia Houpu decoction groups was significantly decreased in a concentration-dependent manner.Conclusion:Banxia Houpu decoction improves GI dysfunction after multiple fractures,reduces inflammation and necrosis of gastric epithelial cells,and inhibits c-kit protein expression in GI tissues of mice.Results showed revealed one of the mechanisms underlying the effects of this decoction on the GI dysfunction in mice after multiple fractures.
基金Supported by Discipline Construction Project of Characteristic Clinic of Pudong New Area Health Commission,China,No.PWYts2018-03Research Grant for Health Science and Technology of Pudong Health and Family Planning Commission of Shanghai,China,No.PW2020A-28Top-notch Talent Training Program of Pudong Gongli Hospital,China,No.GLRb2020-04.
文摘BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur separately.CASE SUMMARY We report the case of a 37-year-old woman with open(IIIA)fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a balcony.After providing advanced trauma life support,damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating room.Subsequently,one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb swelling.The patient achieved good outcome at the 7 mo follow-up.CONCLUSION One-or two-stage treatment must be performed according to the type of injury;we efficiently used the“damage control principle.”
文摘Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with complications, and is most often based on a two-stage strategy: Damage Control Orthopaedics, followed by delayed internal osteosynthesis. The aim is to allow early functional rehabilitation and rapid recovery of patients. We report the case of a 39-year-old man, bike rider, after his RTA, presented with segmental homolateral fractures of the femur and two bones of the left leg. Short-term evolution was marked by the appearance of significant lymphedema and bone infarctions of the lower left limb necessitating a transfemoral amputation. Through this observation, the authors highlight the problems related to the complexity of the management of multiple segmental fractures of the lower limb by emphasizing two post-traumatic complications rarely described but to be feared: chronic lymphedema and bone infarction.
文摘BACKGROUND Hemophilia A is a rare inherited bleeding disorder caused by mutations in the factor Ⅷ gene. This clotting factor plays an intrinsic role in the blood coagulation pathway. Patients with hemophilia may develop orthopedic manifestations such as hemarthrosis, but multiple malunion of fractures over the knee is rare and difficult to treat.CASE SUMMARY We report a patient with hemophilia A who developed severe knee osteoarthritis along with fracture malunion and nonunion. Total knee replacement was performed using a custom-made modular hinged knee prosthesis(cemented) equipped with extended distal and proximal stems. At 3 years’ follow-up, the patient exhibited excellent clinical function and remained satisfied with the surgical outcome. Surgical intervention was accompanied by rigorous coagulation factor replacement.CONCLUSION This case highlights various unique scenarios specific to individuals with hemophilia and fracture deformity.
基金financially supported by National Natural Science Foundation of China(Grant Nos.52074312 and 52004298)。
文摘Drilling fluids with complicated compositions are becoming more common as the oil and gas industry develops. The production of hazardous cuttings is increasing, which not only stifles the oil and gas industry’s development but also poses a severe environmental threat. Deep underground re-injection is a cost-effective and efficient method for dealing with hazardous cuttings. Numerous experiments and numerical studies on cuttings re-injection have been conducted in the past thirty years. However, there is still a divergence of views on the fracture development in the process of cuttings re-injection. A comprehensive review of existing studies is necessary to help researchers advance this technology. This paper provides a review of the fundamental studies on fracture behaviors during the deep underground re-injection of drilling cuttings. The limitations of the existing studies are also discussed to inspire new research endeavors.
基金the National Natural Science Foundation of China fund (Project number: 52174045 and No. 52104011)Research Foundation of China University of Petroleum-Beijing at Karamay (No. XQZX20210001)PetroChina Innovation Foundation (2020D50070207)。
文摘Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness of reservoir stimulation. Temporary plugging and diverting fracturing(TPDF) is considered to be a potential uniform-stimulation method for creating multiple fractures simultaneously in the oilfield. However, the multi-fracture propagation morphology during TPDF is not clear now. The purpose of this study is to quantitatively investigate the multi-fracture propagation morphology during TPDF through true tri-axial fracturing experiments and CT scanning. Critical parameters such as fracture spacing, number of perforation clusters, the viscosity of fracturing fluid, and the in-situ stress have been investigated. The fracture geometry before and after diversion have been quantitively analyzed based on the two-dimensional CT slices and three-dimensional reconstruction method. The main conclusions are as follows:(1) When injecting the high viscosity fluid or perforating at the location with low in-situ stress, multiple hydraulic fractures would simultaneously propagate. Otherwise, only one hydraulic fracture was created during the initial fracturing stage(IFS) for most tests.(2) The perforation cluster effectiveness(PCE) has increased from 26.62% during the IFS to 88.86% after using diverters.(3) The diverted fracture volume has no apparent correlation with the pressure peak and peak frequency during the diversion fracturing stage(DFS) but is positively correlated with water-work.(4) Four types of plugging behavior in shale could be controlled by adjusting the diverter recipe and diverter injection time, and the plugging behavior includes plugging the natural fracture in the wellbore, plugging the previous hydraulic fractures, plugging the fracture tip and plugging the bedding.
文摘BACKGROUND Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission.However,pericardial injuries not bad enough to dislocate the heart may only cause intermittent electrocardiogram(ECG)changes or be asymptomatic.CASE SUMMARY In this case,we report a blunt pericardial injury undetected on preoperative transthoracic echocardiography and chest computed tomography.We misjudged intermittent ECG changes and blood pressure fluctuations as minor symptoms resulting from cardiac contusion and did not provide intensive treatment.The pericardial injury was found incidentally during surgical stabilization of rib fractures and was successfully repaired.CONCLUSION Post-traumatic blunt pericardial ruptures should be considered in patients with blunt chest trauma showing abnormal vital signs and ECG changes.
基金supported by the National Natural Science Foundation of China(No.52174038 and No.52004307)China Petroleum Science and Technology Project-Major Project-Research on Tight Oil-Shale Oil Reservoir Engineering Methods and Key Technologies in Ordos Basin(No.ZLZX2020-02-04)Science Foundation of China University of Petroleum,Beijing(No.2462018YJRC015)。
文摘Under the policy background and advocacy of carbon capture,utilization,and storage(CCUS),CO_(2)-EOR has become a promising direction in the shale oil reservoir industry.The multi-scale pore structure distribution and fracture structure lead to complex multiphase flow,comprehensively considering multiple mechanisms is crucial for development and CO_(2) storage in fractured shale reservoirs.In this paper,a multi-mechanism coupled model is developed by MATLAB.Compared to the traditional Eclipse300 and MATLAB Reservoir Simulation Toolbox(MRST),this model considers the impact of pore structure on fluid phase behavior by the modified Peng—Robinson equation of state(PR-EOS),and the effect simultaneously radiate to Maxwell—Stefan(M—S)diffusion,stress sensitivity,the nano-confinement(NC)effect.Moreover,a modified embedded discrete fracture model(EDFM)is used to model the complex fractures,which optimizes connection types and half-transmissibility calculation approaches between non-neighboring connections(NNCs).The full implicit equation adopts the finite volume method(FVM)and Newton—Raphson iteration for discretization and solution.The model verification with the Eclipse300 and MRST is satisfactory.The results show that the interaction between the mechanisms significantly affects the production performance and storage characteristics.The effect of molecular diffusion may be overestimated in oil-dominated(liquid-dominated)shale reservoirs.The well spacing and injection gas rate are the most crucial factors affecting the production by sensitivity analysis.Moreover,the potential gas invasion risk is mentioned.This model provides a reliable theoretical basis for CO_(2)-EOR and sequestration in shale oil reservoirs.
基金The authors would like to acknowledge the financial support provided by the China Joint Foundation for Petrochemical Industry(A)(No.U1562102).
文摘Currently,most models for multiple fractured horizontal wells(MFHWs)in naturally fractured unconventional reservoirs(NFURs)are based on classical Euclidean models which implicitly assume a uniform distribution of natural fractures and that all fractures are homogeneous.While fractal theory provides a powerful method to describe the disorder,heterogeneity,uncertainty and complexity of the NFURs.In this paper,a fractally fractional diffusion model(FFDM)for MFHWs in NFURs is established based on fractal theory and fractional calculus.Particularly,fractal theory is used to describe the heterogeneous,complex fracture network,with consideration of anomalous behavior of diffusion process in NFURs by employing fractional calculus.The Laplace transformation,line source function,dispersion method,and superposition principle are used to solve this new model.The pressure responses in the real time domain are obtained with Stehfest numerical inversion algorithms.The type curves of MFHW with three different outer boundaries are plotted.Sensitivity analysis of some related parameters are discussed as well.This new model provides the relatively more accurate and appropriate evaluation results for pressure transient analysis for MFHWs in NFURs,which could be applied to accurately interpret the real pressure data of an MFHW in field.