№2, 2020, volume 16

The objective of the article is to estimate the impact of the histaminergic system in the effects of skin flap autotrans-plantation (SFA) on microcirculation in white rats with alloxan insulin deficiency. Material and Methods: The studies were carried out in 60 white rats, divided into 3 groups: 20 control intact animals, 20 animals with alloxan diabetes — the comparison group, 20 animals with alloxan diabetes and SFA— the experimental group. The mechanisms of blood circulation modulation and perfusion of posterior paw dorsal skin, the concentration of histamine in the blood serum, and morphological changes in the SFAarea were evaluated. Results: The significant increase of skin perfusion on 43%, redistribution of microcirculation modulation active mechanisms and the increase in histamine serum concentration in 2,5 times underthe influence of SFA were observed in rats of the experimental group. Conclusion: The distant stimulating effect of SFA on microcirculation in conditions of absolute insulin deficiency is realized with increasing histamine serum concentration. Moreover, the stimulation of the blood flow regulation active mechanisms by increasing the histamine concentration is not equivalent — the effects on endothelium-dependent and neurogenic regulation mechanisms prevail, and the activation of histamine smooth muscle cell receptors is much less pronounced.

The objective of the study is to analyze the activities within the framework of the regional program «Development of the palliative care system», which was developed and approved in the Krasnodar region in order to increase the availability and quality of palliative care for residents of the region. During the analysis, problems were identified that arose during the implementation of the program: lack of a single focal point for monitoring, analysis and forecasting of palliative care in the region, insufficient provision of internists, pediatricians, paramedical staff in hospitals for palliative care. By comparing emerging problems with available research in this area, measures are proposed that will improve the quality of palliative care, which in turn, will bring palliative care closer to international standards. In the region, by 2021, it is planned to put into operation 2 focal points; creation and maintenance of a unified database (registers) of patients suffering from chronic pain syndrome who receive primary medical care by the end of 2020, with the subsequent integration of electronic registries into a unified health information system of the region by 2024. An 80% staffing level is planned for medical organizations providing specialized palliative care, by 2024.

Objective: To analyze the tendency in morbidity and primary disability of adult population in the Saratov region due to endocrine system diseases, eating disorders and metabolic disorders. Material and Methods: Using analytical and statistical research methods, the official data on morbidity and disability levels of adult population in Saratov region for 2009-2018 was processed. Results: During the study period in the Saratov region there was an increase in primary and general endocrine system morbidity, eating disorders and metabolic disorders by 25.7 and 7.2%, a similar situation was recorded in the Russian Federation and Volga Federal District (by 41.8 and 25.7%); by 41.5 and 31.8%, respectively), the annual increase in the above class of diseases was 5±2.2%; the level of total endocrine system diseases, eating disorders and metabolic disorders among the adult population of the region is 14 and 20% higher than in the Volga Federal District and the Russian Federation, respectively. Conclusion: The data obtained during the study indicate a high level and steady growth of primary and general morbidity of endocrine system diseases, eating disorders and metabolic disorders in the Saratov region, which makes it urgent to conduct a study on the organization of medical care for patients with diseases of endocrine system.

Objective: development of a method for the prevention of postoperative ventral hernias based on an experimental assessment of the deformation-strength properties of aponeurosis in various types of median laparotomy. Material and Methods. 42 fascial-muscular-aponeurotic complexes of the anterior abdominal wall were evaluated. In accordance with a variant of the method for dissecting the aponeurosis and its suturing, the complexes are divided into two groups (21 samples each): group 1 —with a bypass of the umbilical ring on the left, group 2 — with the dissection of the umbilical ring. Results. Fascial aponeurotic complexes dissected and sutured through the umbilical ring, belonging to group 2, have higher mechanical characteristics. So, the average level of tensile stress (S), the average stress at maximum load (Load), Young's modulus (E), the average values of tensile strain, aponeurosis (D) and deformation at maximum load (Dmax) average level of maximum load (Smax) prevails in group 2 by 35.4; 39.8; 14.9; 34.6; 30.2 and 40.2%, respectively. Conclusion. The development, experimental application and evaluation of a new method for the prevention of postoperative ventral hernias after median laparotomy was performed based on the assessment of the deformation-strength properties of aponeurosis.

The article reviews 37 Russian and foreign literature sources available at PubMed, E-library, Cyberleninka databases on flexion-extension injuries of the cervical spine, simulation capacities, and measures of traffic accident trauma primary prevention. The authors analyzed contemporary data on the mechanics of flexion-extension injuries of the cervical spine, described the capacities of simulation for this common trauma that brings significant medical and social consequences, and drew conclusions on the prospects of traffic injury primary prevention.

Objective: To evaluate capabilities of magnetic resonance imaging including T2 relaxometry in combination with laboratory studies of biological markers for diagnostics of hyaline cartilage pathology in the initial stages of knee joint osteoarthritis (OA). Material and Methods: 37 patients of both sexes aged 35-50 years suffering from intermittent pain and discomfort in their knee joints (the main group). The control group was made up of 20 persons of the same age without clinical manifestations of joint pathology. Instrumental research included radiography, ultrasonography, and magnetic resonance imaging of knee joints, including T2 relaxometry measurement. The cartilage oligomeric matrix protein (COMP) content and daily urinary losses of C-terminal telopeptides of collagen type II Urine CartiLaps (CTX II) were determined. Inflammatory activity was evaluated by serum interleukin-1 (3 (11-1(3) with multiplex analysis and C-reactive protein concentration. Results: The increased content of cartilage extracellular matrix biopolymers in the biological fluids (serum COMP, urine excretion Urine CartiLaps (CTX II)) and inflammatory activity was found in patients of the main group compared to those in patients of the control group. Correlation between the COMP concentration and T2 relaxometry digital data (in CU) was characterized as positive strong (R = 0.83), and between COMP and articular cartilage thickness (in mm) on ultrasound data as negative medium (R = -0.63). Interconnections of the same kind were found between the level of daily excretion CTX II and articular cartilage morphometry findings with ultrasound (R = -0.59). Conclusion: Structural changes in the extracellular matrix in early stages of OA can be objectified using T2 cartilage relaxometry and determining COMP as well as CTX II in biological media.

The article presents a clinical case history of successful two-stage surgical reconstruction of a rare injury — a simple thoracolumbar fracture-dislocation (Type С AOSpine classification). The optimal arrangement of the stabilizing system at the stage of surgical intervention planning was designed using computer biomechanical simulation. The functional outcome was optimal ensuring complete reconstruction of the lost anatomy with no complication in post-operative period observed.

An actual case of total metacarpophalangeal joint replacement with prosthetic ceramic-on-ceramic implant for un-united articular fracture of the base of the second finger proximal phalanx is presented.

Objective: To evaluate thrombinogenesis in patients with periprosthetic infection and aseptic loosening of endoprosthesis after primary knee arthroplasty. Material and Methods: 28 of 52 examined patients who suffered from the loosening of knee endoprosthesis components and 24 from periprosthetic infection; 18 healthy individuals were also engaged into the study. Thrombinogenesis was analyzed with thrombin generation assay in an automated Ceveron alpha coagulometer (Technoclone, Austria) using RB and RC-low activators containing 2 and 5 pmol/ml of tissue factor respectively. Each of the main groups of patients was divided into two subgroups: in patients of the 1st subgroups RC-low activator aggravate thrombinogenesis while in the 2nd subgroups it inhibited the process as compared to the effects of RB activator. Results: In the 1st subgroup of patients with aseptic loosening RC-low activator caused chronometric hyperthrombinogenesis, and in the 2nd — both chronometric and structural ones. In patients with periprosthetic infection the effects of RB and RC-low activators were comparable. Conclusion: In patients with aseptic loosening of the implant and stopped periprosthetic infection that developed after primary knee replacement, the thrombin generation test reveals normal, paradoxical and inert types of thrombinogenesis.

A literature review is devoted to root resorption of a permanent tooth. Literature data, eLibrary Internet resources and PubMed National Library of Medicine databases databases for 2010-2020 (34 sources) were used to collect the research material. Timely diagnosis using cone beam computed tomography, which provides visualization in the three-dimensional space of root resorption, allows a conservative adequate endodontic intervention and improves the medical effectiveness of the treatment.