2021, volume 17

The research follows the career of a trauma orthopedist, scientist, and inventor Ya. I. Shersher and his contribution to the development of joint replacement techniques in Russian traumatology and orthopedic science. Shersher's artificial hip joints were recommended for application in the clinical practice of Russian medical institutions. The scientist's inventions affected the further development of the hip replacement method in both in this country and around the world. Shersher's contribution as a science organizer involves active participation in the foundation of the Republican Arthrol-ogy Center of the Russian Soviet Federative Socialist Republic as well as the Joint Replacement Center. Many archive documents are introduced into scientific research for the first time.

The aim of the study was to determine the features of intercellular interaction of platelets and neutrophils expressing adhesion molecules in patients suffering from psoriasis. Material and Methods. The study involved 82 patients aged 20 to 60 years, suffering from vulgar and exudative psoriasis. As a control group, 50 practically healthy persons aged from 20 to 60 years were examined. The study of the adhesion molecules spectrum on neutrophils was carried out on a Beckman Coulter FC-500 flow cytometer (USA) using monoclonal antibodies. The determination of neutrophils-platelet aggregates was carried out according to the method proposed by Y. A. Vitkovsky et al. (2006). Results. In patients with psoriasis, compared with the control group, a low content of intercellular contacts of neutrophils with platelets was revealed. Low values of neutrophils-platelet aggregates with 3, 4, and 5 segments in the nucleus, which were statistically significantly correlated with the adhesion molecules LFA-1 and PECAM-1, were found. Conclusion. In the conditions of psoriasis, low rates of intercellular interaction of platelets with 3, 4, and 5 segmental neutrophils indicate an increased migration of them from the peripheral blood to the epidermis. The adhesion molecules LFA-1 and PECAM-1 play a key role in the migration of platelet-derived neutrophils.

The aim is to study of the dose-dependent effects of glucagon-like peptide-1 receptors agonist liraglutide on the microcirculation of white rats under the alloxan-induced insulin deficiency. Material and methods. The studies were carried out on 70 white rats, divided into 4 groups: 20 control intact animals, 20 animals of the comparison group with alloxan diabetes, 10 animals with insulin deficiency, which were injected with liraglutide at a dose of 0.2 mg/kg/day (experimental group No 1) and, 20 animals with insulin deficiency of which were treated with liraglutide at a dose of 0.4 mg/kg/day (experimental group No 2). Diabetic status, skin perfusion of the posterior paw and mechanisms of blood flow modulation were assessed in all groups of animals. Results. It was found that the administration of liraglutide at a dosage of 0.4 mg/kg/day allows achieving complete normalization of carbohydrate metabolism in rats with alloxan-induced insulin deficiency, and it is more effectively improves the state of microcirculation compared with the use of a dosage of 0.2 mg/kg/day. Conclusion. The effectiveness of the correction of microcirculatory disorders with liraglutide correlates to the correction of carbohydrate metabolism in rats with insulin deficiency and depends on the dose of the drug. The dose-dependent effect is determined by the endothelial mechanism of microcirculation modulation. At the same time, the restoration of the neurogenic component of the vasculartone is independent from the dose of liraglutide.

Purpose: to analyze the functional state of mast cells (MC) after bone marrow allografting in the early stages of the experiment. Material and Methods. The experiments were carried out on 40 outbred male mice, which were divided into 3 groups: 1st group — intact (n=10); 2nd — control animals, which were injected with 0.85% sodium chloride solution (n=10); 3rd group was experienced (n=30), who received a cell suspension from another mouse under ether anesthesia into the tail vein. The state of mast cells was assessed by the method of staining with polychrome toluidine blue according to Unna. Results. 40 minutes after the introduction of bone marrow analog in the medulla, metachromatic mast cells are found near the vessels, their percentage (60%) prevails over orthochromic (40%). Mast cells are predominantly located in groups, especially near the vessels, in contact with each other. The morphometric parameters of mast cells change (diameter, 8.00-17.00, in intact ones — 6.00-12.00 urn). Two hours after the experiment, according to the degree of sulfation of heparin, mainly metachromatic mast cells are detected, their percentage is 92% and actively degranulated mast cells (61 %), p<0.05, predominate. The size of mast cells changes (diameter — 3.00-9.00 urn; distance between cells — 29.00-53.00). One-way analysis of variance found that there is a significant effect of the experiment period on the change in the proportion of mast cells with metachromatic staining. Conclusion. The introduction of bone marrow transplant significantly changes the functional profile of mast cells.

The analysis is based on the materials of literature sources of native and foreign authors, including the Global Strategy forthe Protection of Women's, Children's and Adolescents' Health, the Federal Law "On the Basics of Public Health Protection in the Russian Federation", regulatory documents of the Ministry of Health and the Union of Pediatricians of Russia, Bulletins of the National Research Institute of Public Health and data of the Federal State Statistics Service. 50 sources of information have been used from 2005 to 2020.

The purpose of the study is to identify existing organizational problems and determine possible perspectives for the development of the palliative care system in the Russian Federation. 10 fundamental current regulatory legal acts the implementation of palliative care in the Russian Federation have been analyzed during the period from 2011 till 2020. The systematization of pathological conditions in which patients need the provision of palliative medical care was carried out, the procedure for the actions of medical workers during its provision was concretized. A regulatory framework has been formed for the systematic expansion of the volume of palliative care in outpatient settings, including at home. The problem of training specialists in palliative care was identified, as well as the problem of accessibility of primary care for the population due to the limited list of medical indications. The main development prospects are the expansion of indications for primary care, the preparation of residency programs for palliative care physicians, the synchronization of regulations, the priority development of regional infrastructure, and the expansion of interaction with non-medical organizations.

The article presents an overview of the data on the study of the effectiveness of modern endoscopic methods of surgical treatment of benign prostatic hyperplasia. The positive and negative aspects of each method are characterized. The review is based on the analysis of databases: PubMed, eLibrary, Cohrane Library, UpToDate, MEDLINE, Embase from 1991-2020 in the number of 40 sources.

Differential diagnosis of volume formations of the brain with a ring-shaped type of contrast enhancement is extremely difficult. This is due to the fact that this type of contrast is observed in: cysts, abscesses, metastases, demyelinating diseases, post-infectious, post-vaccination vasculitis, vasculopathies, hematomas, brain infarction. In this article, the features of the diagnosis and approach to the treatment of a patient with a volume formation of the brain with a ring-shaped type of contrast enhancement.

The aim of the study was to analyze in-hospital mortality and long-term survival of elderly patients who underwent open heart surgery and meet the criterion of "frailty". Material and Methods. The study included 266 "frail" patients over 75 years old (F-index <5). 155 operations of coronary artery bypass grafting (CABG), 47 operations of aortic valve replacement (AVR), 64 operations of CABG in combination with AVR were performed. They were divided in groups depending on type of surgery. Postoperative complications, early and long-term outcomes were compared. Results. In-hospital mortality in general group was 5.3%, in CABG+AVR group — 9.4%, in CABG group — 3.9%, in AVR group — 4,2%. There was no significant difference in in-hospital mortality between groups (p>0.05). Long-term survival in general group was: 1-year survival — 98.3%, 3-year survival — 94.6%, 5-year survival — 82.1 %. Type of surgery has no significant impact on outcome (p>0.05). Conclusion. Early and long-term results of CABG, AVR, and combination of CABG with AVR in the group of elderly patients who meet the criterion of "frailty" are characterized by low mortality and low incidence of non-fatal complications. The type of cardiac surgery and old age do not significantly affect the outcome of surgical treatment.

Treatment of victims with widespread deep burns is a serious problem in modern medicine. First of all, this is due to the high mortality rate in such patients from complications of burn disease, which develop due to the presence of extensive wound surfaces. This article demonstrates a case of successful treatment of a teenager with a flame burn on an area of 65% of the body surface of 2-3 degrees. On the example of clinical observation, the possibility of using active surgical tactics of treatment and cell cultures of autologous fibroblasts in the treatment of a patient with a critical area of burn lesions was demonstrated, which made it possible to successfully restore the lost skin in conditions of a shortage of donor resources, stop the complications of burn disease, and also activate the patient.