人工血栓抽吸联合置管溶栓在急性非肝硬化性门静脉血栓治疗中的应用

目的探讨人工血栓抽吸联合置管溶栓在急性非肝硬化性门静脉血栓治疗中的临床价值。方法回顾性分析2019年1月至2023年4月张家界市人民医院血管介入外科采用人工血栓抽吸联合置管溶栓的9例急性非肝硬化性门静脉血栓患者的临床资料与影像资料,分析溶栓治疗后血栓的清除程度。结果所有患者均在CT引导下成功穿刺门静脉,均行人工血栓抽吸及置管溶栓治疗。术后即刻造影评估门静脉血栓清除Ⅲ级6例,Ⅱ级3例。治疗后腹痛症状均明显好转。其中1例患者出现肠坏死,切除部分肠管后好转;1例患者在溶栓期间发生穿刺点出血,经输血、穿刺点弹簧圈栓塞止血后恢复;3例患者溶栓过程中出现发热,经抗感染治疗后好转。人工血栓抽吸及置管溶栓治疗后6个月,门静脉系统血栓清除Ⅲ级8例,Ⅱ级1例。腹痛症状均未复发。结论人工血栓抽吸联合置管溶栓治疗急性非肝硬化性门静脉血栓安全、有效。

术前支气管动脉CTA在大咯血支气管动脉栓塞治疗中的临床价值

目的探讨术前支气管动脉CTA在大咯血支气管动脉栓塞治疗中的临床应用价值和疗效分析。方法选取张家界市人民医院2016年11月至2018年9月因咯血行支气管动脉栓塞术的75例患者,术前行支气管动脉CTA检查后介入手术的38例患者作为联合组,未行CTA检查直接介入手术的37例患者作为对照组,术后随访1年,对比两组责任动脉、非支气管动脉源性体循环动脉的检出率,栓塞术后的疗效和复发情况。结果联合组术前CTA检出责任动脉93支,其中非支气管动脉22支,术中DSA检出责任动脉126支,其中非支气管动脉46支,行CTA敏感率为73.8%(93/126),止血有效率92.11%,复发率5.26%。对照组术中检出责任动脉97支,其中非支气管动脉24支,止血有效率83.79%,复发率13.51%。联合组责任血管检出数目、非支气管动脉源性体循环动脉检出数目均优于对照组;在治疗有效率上联合组更优,且复发率明显降低;CTA检出责任血管的能力低于DSA。结论CTA能敏感发现支气管动脉及非支气管动脉源性体循环供血动脉,术前行CTA检查后再行支气管动脉造影栓塞,能明显提高责任动脉的检出率;而且疗效优于未行CTA直接介入栓塞,术后复发率降低。支气管动脉CTA在介入术前能充分了解责任血管的开口、位置、血管走行及直径,为术中快速准确寻找责任血管、超选择插管、合理选择导管提供帮助,可以缩短操作和曝光时间、缩小辐射量、减少造影剂用量,明显提高介入治疗疗效,减少复发,具有重要的临床使用及推广价值。

急诊介入引流治疗急性重症胆道感染的临床疗效分析

目的探讨急诊行介入引流治疗急性重症胆道感染的临床疗效。方法回顾性分析本院2014年6月至2019年8月因急性重症胆道感染急诊行经皮肝穿刺胆道引流(PTCD)及经皮胆囊穿刺置管引流(PTGD)的29例患者的临床资料,通过手术前后症状体征、感染指标、细菌培养、胆红素的变化情况,总结介入临床疗效及治疗经验。结果介入引流手术成功率96.55%,并发胆道出血1例,围术期死亡2例。26例患者术后3~5 d症状体征明显减轻,胆汁引流正常,感染指标明显好转,胆红素下降。后续外科手术13例,其中3例因复发行两次手术治疗。未进行手术14例,4例胆囊造瘘患者4~6周后复查造影胆囊管通畅而拔除引流管,5例在随访中病情进展死亡,5例继续带管(其中2例为肿瘤患者拒绝手术,1例结石患者拒绝手术,2例结石患者拟择期行外科手术)。结论介入引流能迅速解除胆道梗阻,降低胆道压力,缓解临床症状,降低病死率,并为后续二期再处理创造条件和机会,并发症及围术期死亡率较低,安全有效。

Invariant subspaces and conditional Lie-Bcklund symmetries of inhomogeneous nonlinear difusion equations

The inhomogeneous nonlinear diffusion equation is studied by invariant subspace and condi- tional Lie=Bgcklund symmetry methods. It is shown that the equations admit a class of invariant subspaces governed by the nonlinear ordinary differential equations, which is equivalent to a kind of higher=order conditional Lie-B^icklund symmetries of the equations. As a consequence, a number of new solutions to the inhomogeneous nonlinear diffusion equations are constructed explicitly or reduced to solving finite-dimensional dynamical sys- tems.

Lie group classification of the N-th-order nonlinear evolution equations

In this paper, Lie group classification to the N-th-order nonlinear evolution equation Ut ： UNx ＋ F（x, t, u, ux, . . . , U（N-1）x）is performed. It is shown that there are three, nine, forty-four and sixty-one inequivalent equations admitting one-, two-, three- and four-dimensionM solvable Lie algebras, respectively. We also prove that there are no semisimple Lie group 50（3） as the symmetry group of the equation, and only two realizations oral（2, R） are admitted by the equation. The resulting invariant equations contain both the well-known equations and a variety of new ones.

Symmetry and regularity of solutions to a system with three-component integral equations

Consider the system with three-component integral equations{u（x） ：fRn│x - y│α-nw（y）^v（y）^qdy,v（x） =fRn│x-y│^α-nu（y）^pw（y）^rdy, w（x） =fRn│x - y│α-nv（y）qu（y）Pdy,where 0 〈 a 〈 n, n is a positive constant, p, q and r satisfy some suitable conditions. It is shown that every positive regular solution （u（x）, v（x）, w（x）） is radially symmetric and monotonic about some point by developing the moving plane method in an integral form. In addition, the regularity of the solutions is also proved by the contraction mapping principle. The conformal invariant property of the system is also investigated.

Symmetry and nonexistence of positive solutions to an integral system with weighted functions

Consider the system of integral equations with weighted functions in Rn,{u(x) =∫Rn|x-y|α-nQ(y)v(y)qdy1,v(x)=∫Rn|x-y|α-nK(y)u(y)pdy,where 0 < α < n,1/(p+1) + 1/(q+1)≥(n-α)/n1,α/(n-α) < p1q < ∞1,Q(x) and K(x) satisfy some suitable conditions.It is shown that every positive regular solution(u(x)1,v(x)) is symmetric about some plane by developing the moving plane method in an integral form.Moreover,regularity of the solution is studied.Finally,the nonexistence of positive solutions to the system in the case 0 < p1q <(n+α)/(n-α) is also discussed.

Symplectic invariants for curves and integrable systems in similarity symplectic geometry

In this paper, similarity symplectic geometry for curves is proposed and studied. Explicit expressions of the symplectic invariants, Frenet frame and Prenet formulae for curves in similarity symplectic geometry are obtained by using the equivariant moving frame method. The relationships between the Euclidean symplectic invariants, Frenet frame, Frenet formulae and the similarity symplectic invariants, Frenet frame, Frenet formulae for curves are established. Invariant curve flows in four-dimensional similarity symplectic geometry are also studied. It is shown that certain intrinsic invariant curve flows in four-dimensional similarity symplectic geometry are related to the integrable Burgers and matrix Burgers equations.

几何曲线流和可积系统

本文综述了不变几何曲线流和可积系统关系的相关研究.证明了包括KdV方程、修正KdV方程、非线性可积薛定谔方程和Burgers方程在内的一些古典可积系统自然来源于中心等仿射几何、欧氏几何和相似几何中的平面或空间曲线流,刻画了对应于可积系统一些特殊解的曲线流.并给出了可积系统的Miura变换、Bäcklund变换和哈密顿结构等典型性质的几何描述还建立了曲线流和Camassa-Holm类方程的一些对应关系.