Numerical Simulation of Wormhole Propagation with Foamed-Viscoelastic-Surfactant Acid in Carbonate Acidizing

Successful matrix acidizing for extremely thick carbonate reservoirs with long horizontal well sections and strong heterogeneity requires efficient temporary plugging and diverting of acid fluid, ensuring acid fluid distribution to each production layer. Foamed-viscoelastic-surfactant (Foamed-VES) acid combines the benefits of both foam acid and viscoelastic surfactant (VES) acid, integrating foam plugging and viscous plugging. It can achieve uniform acid distribution in highly heterogeneous reservoirs. However, little research has been conducted on the wormhole propagation law of foamed-VES acid. To address this gap, this study established a mathematical model of foamed-VES acid wormhole propagation based on the dual-scale model. The model was coupled with a random porosity distribution generated with geological statistical software. The effects of different factors on foamed-VES acid etching were simulated. Numerical results show that foamed-VES acid can stimulate low-permeability reservoirs with a permeability differential of 20. Its inherent mechanism lies in the synergy of foam plugging and VES viscous plugging. This study enhances our understanding of the acid diversion mechanism of foamed-VES acid, providing a theoretical foundation for on-site acidizing treatment

Case report: A case of complete clinical response in a patient experiencing high microsatellite instability unresectable colon cancer being treated with a PD-L1 inhibitor after interstitial pneumonia

Immune checkpoint inhibitors (ICI) have dramatically transformed the treatment landscape for metastatic colorectal cancer (mCRC) with deficient DNA mismatch repair (dMMR) or high microsatellite instability (MSI-H). Envafolimab, a novel programmed death-1 ligand 1 (PD-L1) inhibitor, has been reported to be efficient and safe for the management of advanced MSI-H/dMMR solid tumors. Here, we report the case of a 35-year-old female patient with MSI-H/dMMR mCRC who was treated with envafolimab following mFOLFOX6 (oxaliplatin, leucovorin, and fluorouracil) plus bevacizumab. While suffering from interstitial pneumonia after chemotherapy, the patient achieved a complete clinical response with the use of envafolimab without additional adverse events. Thus, PD-L1 inhibitors may be potential candidates for treating patients with MSI-H/dMMR mCRC

Prognostic significance of COX-2 immunohistochemical expression in colorectal cancer: a meta-analysis of the literature.

BACKGROUND: Cyclooxygenase-2 (COX-2) is believed to be an important enzyme in the pathogenesis of colorectal cancer (CRC). Correlations between the expression of COX-2 with tumor growth and distant metastasis have become an issue; thus, attention has been paid to COX-2 as a prognostic factor. Various studies examined the relationship between COX-2 immunohistochemistry (IHC) overexpression with the clinical outcome in patients with colorectal cancer, but yielded conflicting results. The prognostic significance of COX-2 overexpression in colorectal cancer remains controversial. METHODS: Electronic databases updated to October 2012 were searched to find relevant studies. A meta-analysis was conducted with eligible studies which quantitatively evaluated the relationship between COX-2 overexpression and survival of patients with colorectal cancer. Survival data were aggregated and quantitatively analyzed. RESULTS: We performed a meta-analysis of 23 studies (n  =  4567 patients) that evaluated the correlation between COX-2 overexpression detected by IHC and survival in patients with colorectal cancer. Combined hazard ratios suggested that COX-2 overexpression had an unfavorable impact on overall survival (OS) (HR [hazard ratio]  =  1.193, 95% CI [confidence interval]: 1.02 ∼ 1.37), but not disease free survival (DFS) (HR  =  1.25, 95% CI: 0.99 ∼ 1.50) in patients with colorectal cancer. CONCLUSIONS: Cox-2 overexpression in colorectal cancer detected by IHC appears to have slightly worse overall survival. However, the prognostic value of COX-2 on survival in colorectal cancer still needs further large-scale prospective trials to be clarified

Clinical characteristics, risk factors, and outcomes after adjuvant radiotherapy for patients with thymoma in the United States: analysis of the Surveillance, Epidemiology, and End Results (SEER) Registry (1988–2013)

<p><b>Purpose:</b> The surgery with adjuvant radiation for the treatment of thymoma is still debated. The aim of this study was to examine the efficacy of postoperative radiotherapy (PORT) in a population-based registry of patients with thymoma.</p> <p><b>Materials and methods:</b> We conducted a retrospective analysis of the Surveillance, Epidemiology, and End Results database to compare the outcomes of patients with thymoma who received surgery with or without PORT.</p> <p><b>Results:</b> Among the 2234 patients of this study, the surgery with PORT group had a longer mean overall survival (OS) and cancer-specific survival (CSS) than did the surgery without PORT group (OS: 172.3 vs. 155.3 months, <i>p</i> = .005; CSS: 247.3 vs. 241.8 months, <i>p</i> = .04). PORT significantly improved OS and CSS of patients with stage III/IV disease, but decreased CSS for those with stage I/IIA disease. Although the surgery with PORT group had a higher rate of secondary cancers, the between-group difference in the disease-free interval was not significant.</p> <p><b>Conclusions:</b> PORT provides a significant benefit for patients with thymoma, particularly those with advanced disease. However, it also increases the risk of a second malignancy. We suggest that treatment guidelines should adopt a more positive stance on the use of PORT.</p

Funnel plot for studies included in the meta-analysis.

<p>Plots are arranged as follows: (A) COX-2 overexpression with OS, (B) COX-2 overexpression with OS by multivariate analysis, (C) COX-2 overexpression with OS in Asian population, (D) COX-2 overexpression with OS in non-Asian population, (E) COX-2 overexpression with DFS, (F) COX-2 overexpression with DFS in Asian population, and (G) COX-2 overexpression with DFS in non-Asian population.</p

Meta-analysis (Forest plot) of the eligible studies evaluating the association between COX-2 overexpression and survival.

<p>Each study was shown by the name of the lead author and the HR with 95% CI. The summary HR and 95% CI were also shown (overall). (A) The 18 studies assessing COX-2 overexpression with OS in all population, (B) The 7 studies assessing COX-2 overexpression with OS with multivariate analysis, (C) The 9 studies assessing COX-2 overexpression with OS in Asian population, (D) The 9 studies assessing COX-2 overexpression with OS in non-Asian population, (E) The 9 studies assessing COX-2 overexpression with DFS in all population, (F) The 5 studies assessing COX-2 overexpression with DFS in Asian population. (G) The 4 studies assessing COX-2 overexpression with DFS in non-Asian population.</p

Main Characteristics and Results of the Eligible Studies (cont.d).

<p>Summary table of studies included in the meta-analysis. Results were either unfavorable (95% CI above 1.0) or indeterminate (95% CI crossing 1.0). Abbreviations: COX-2, Cyclooxygenase-2; N, number of patients; Surv curve: survival curve; IHC, immunohistochemistry; OS, overall survival; DFS, disease-free survival; CI, confidence interval; CS, complex score combining intensity and percentage; NS, not specified.</p