双壁钻杆反循环系统新型井下封阻导流器冲蚀与强度研究

井下封阻导流器的设计与优选是双壁钻杆反循环钻井的关键,针对高流速、大循环压差的工作环境,设计一种同一本体不同井眼的井下封阻器,并对不同入口质量流速与颗粒粒径条件下进行流体流动与封阻器磨损建模研究,依据冲蚀模拟结果对封阻器进行强度分析,设计并进行封阻器气密性验证与返砂实验。结果表明,封隔器壁面磨损程度随着入口流量的增大和颗粒粒径的减小而逐渐增大,且根据抗拉抗扭强度要求,封阻器最大安全扭矩为29 t/m,最大安全拉力约270 t。实验结果表明,新型井下封阻导流器符合双壁钻杆反循环要求。

Cardiac resynchronization therapy for heart failure induced by left bundle branch block after transcatheter closure of ventricular septal defect

A 54-year-old female patient with congenital heart disease had a persistent complete left bundle branch block three months after closure by an Amplatzer ventricular septal defect occluder. Nine months later, the patient suffered from chest distress, palpitation, and sweating at daily activities, and her 6-min walk distance decreased significantly （155 m）. Her echocardiography showed increased left ventricular end-diastolic diameter with left ventricular ejection fraction of 37%. Her symptoms reduced significantly one week after received cardiac resynchronization therapy. She had no symptoms at daily activities, and her echo showed left ventricular ejection fraction of 46%and 53%. Moreover, left ventricular end-diastolic diameter decreased 6 and 10 months after cardiac resynchronization therapy, and 6-min walk dis-tance remarkably increased. This case demonstrated that persistent complete left bundle branch block for nine months after transcatheter closure with ventricular septal defect Amplatzer occluder could lead to left ventricular enlargement and a significant decrease in left ventricular systolic function. Cardiac resynchronization therapy decreased left ventricular end-diastolic diameter and increased left ventricular ejection fraction, thereby improving the patient’s heart functions.