2023, volume 19

A clinical case of small intestine intussusception with partial intestinal obstruction as a rare complication of small intestine tumor in adults is presented. This case demonstrates a variant of clinical signs of intussusceptions, features of preoperative diagnosis and importance of appropriate investigation of small intestine.

Objective: to evaluate the hospital results of coronary artery bypass grafting using autoarterial and au-tovenous conduits. Material and methods. A randomized clinical trial was conducted. The internal thoracic artery on the left was used in both groups (for shunting the anterior interventricular branch), the remaining conduits, depending on the distribution into groups, were either only the radial artery or the radial artery and the large subcutaneous vein (the study group) or only the large subcutaneous vein (the control group). The outcomes studied were: hospital mortality, myocardial infarction (type 5), cerebrovascular events, respiratory failure, bleeding, cardiac arrhythmias, acute kidney injury, etc. Results. 27 patients were randomized: 12 of whom were included in the study group, and 15 were included in the control group. According to operational and early postoperative data, there were no statistically significant differences between the groups, except for the duration of stay on a ventilator in the ICU: in the study group, the duration of a ventilator was longer than in the control group: 14 (12; 18) hours versus 9.3 (5.8; 13) hours, p=0.034. The most frequent complications were cardiac arrhythmias, as well as AKI. There were no statistically significant differences between the groups according to the outcomes studied. The bed-day after surgery also did not differ statistically significantly between the groups. Conclusion. According to the data obtained, it can be concluded that the first days after surgery, the use of the radial artery does not provide significant advantages compared to the use of a large saphenous vein.

Objective: at the assessment of bacteriostatic properties of the thin-film coating prototypes meant for orthopedic titanium and titanium alloys implants. Material and methods. The morphology of the Ti-6AL-4V, ASTM F1472 samples with the 50-70 nm thin-film CuO coating deposited on their surfaces with microarc oxidation was examined by scanning electron microscopy. Then we evaluated the effects of the thin-film prototypes on the clinical strains ability to adhere, form biofilms and their growth properties. Results. The newly designed prototype causes the significant decrease in the mass of biofilms pre-formed by the clinical strains (Staphylococcus aureus by 11%, Staphylococcus epidermidis by 38%, and Pseudomonas aeruginosa by 7%) and inhibits their growth properties (S. aureus by 12.7%, S. epidermidis by 13.3%, and P. aeruginosa by 10%). Conclusion. This thin-film coating prototype on the surfaces of the titanium and titanium alloys implants decreases pathogenic factors in the microorganism clinical strains due to its pronounced bacteriostatic effect, slowdown in adhesive activity and inhibition of their ability to form biofilms.

Objective: to determine the effectiveness of hip endoprosthesis friction pair materials in addressing aseptic instability. Review writing methodology. Literature data analysis was performed in the national database e-Library RSCI and the international database PubMed, with the search keywords being "materials of endoprosthesis friction pairs", "reasons for revision hip arthroplasty", "osteolysis". A total of 443 sources were analyzed, further using the filters of a systematic review and the knowledge of the authors on the topic (50 were selected for review). The duration of the retrospective analysis is 15 years (2009-2023). Conclusion. The materials used in modern endoprosthesis replacement can't solve the problem of aseptic loosening of endoprosthesis components. The main way to combat the complications associated with aseptic loosening is to use new bioinert materials whose wear products do not cause osteolysis.

Objective: to define bone mineral density and bone turnover indicators in primary osteoarthrosis accompanied with osteodeficiency conditions of varying severity as a means of early osteoarthrosis detection in individuals. Review method. We analyzed 157 Russian and foreign studies of 2005-2022 retrieved from e-Library, Medline, PubMed, PubMed Central, Google Scholar, SpringerLink и Elsevier. The keyword search in Russian and English involved "primary osteoarthritis", "osteoporosis", "osteopenia", "bone mineral density", "markers of bone resorption", "bone formation markers", "bone metabolism regulators", "RANKL/RANK/OPG system". 35 studies were considered the most valuable and eventually reviewed. Conclusion. The analysis suggested that primary osteoarthrosis accompanied by osteodeficiency conditions can be assessed by determining bone mineral density, bone turnover indicators as well as bone turnover regulators.

Objective: to realize the effectiveness of surgical treatment of patients with retinal detachment and macular hole PVR C, depending on the method of closing the macular hole. Material and methods. The data of 20 patients (20 eyes) with a diagnosis of retinal detachment with macular hole PVR С were studied. Patients of the 1st group (10 patients, 10 eyes) underwent surgical treatment with closure of the macular hole with an inverted flap of the inner limiting membrane. Patients of the 2nd group (10 patients, 10 eyes) did not undergo closure of the macular hole during the first stage of surgical treatment. Results. In the 1st group, it was possible to achieve closure of the macular hole in 80% of cases. In the 2nd group, a day after the operation, there was a significant decrease in the diameter to 263±46 urn. When re-examined a month later, in 80% of cases, the macular hole was closed. When studying the results of micro-perimetry one day after the operation, positive dynamics was noted. While after a month of observation, the indicators of patients in the second group were significantly higher. Conclusion. The method of surgical treatment of retinal detachment with macular hole showed greater efficiency in refusing to perform membranopiling; in patients of this group, higher functional results were achieved. During the observation period, cases of a decrease in the diameter of an intact macular hole and its complete closure under the action of silicone tamponade were recorded. If necessary, membrane peeling can be delayed during a second silicone oil removal operation.

Objective: to conduct a comparative analysis of coagulogram and acid-base composition of blood in pregnant women with moderate and severe preeclampsia (PE) and to assess the impact of the detected disorders on pregnancy outcomes. Material and methods. Group 1 consisted of patients with moderate PE (n=33), group 2 — with severe PE (n=34), and group 3 —women with physiological gestation (n=39). Parameters of coagulogram, acid-base composition of capillary blood of pregnant women (pH, pC02, p02, HC03-act) were determined on the RAPIDLAB 1265 device. Results. An increase in the level of fibrinogen was revealed in group 1 — by 9.9% relative to the indicator of group 3 (p=0.10), in group 2 — by 28.2% (p=0.002) against the background of a shortening of the APTT, respectively by 6.8% (p=0.003) and 9.9% (p<0.001) and a decrease in the number of platelets — by 11.9% (p=0.03) and 27.3% (p<0.001). Changes in the acid-base composition of capillary blood in PE were established: a decrease in HC03-act and p02 with an increase in pC02, which reflect the tendency to develop metabolic acidosis and respiratory alkalosis, more pronounced in group 2. Conclusions. PE is associated with disorders of blood coagulation potential and changes in blood gas composition, more pronounced in severe PE, which contributes to an increase in the frequency of premature birth (with moderate PE — up to 75.8%, severe — up to 100%) and cesarean section (respectively, by 7.7 and 18 times). The measurement of pC02 and p02 levels should be classified as informative and promising tests in terms of differential diagnosis of the severity of PE.

The article is dedicated to the anniversary of the Department of Public Health and Health (with courses in law and the history of medicine). The presented historical review made it possible to identify the practical and theoretical contribution of the department staff to its organization and development, to reflect the main stages of the formation of work aimed at training doctors — health organizers and health education among residents of the region. New data have been put into circulation, which previously remained outside the framework of scientific research and literature. The source study base of the article was the works written in the first quarter of the last century by prominent figures of regional health G.A. Lapidus and K.A. Konovalov, as well as collections of articles published in honor of the 40th anniversary and 50th anniversary of the October events of 1917. All this, along with the use of modern literature and the latest publications, made it possible to systematize and summarize the data obtained, writing a historical review on their basis.

The article presents the milestones of the life and professional activity of Professor Alexey Nikolaevich Protopopov, Head of the Department of Radiation Diagnostics n. a. Professor N. E. Stern at the Saratov State Medical University n. a. V.I. Razumovsky from 1973 to 1987. The contribution of A. N. Protopopov to the development of the Department and practical radiology in Saratov was noted.

The article is devoted to the description of the life and creative path of the Doctor of Biological Sciences, Professor of the Department of General Biology, Pharmacognosy and Botany of the Saratov State Medical University n. a. V.I. Razumovsky Svetlana Ivanovna Belyanina. Professional activity of S. I. Belyanina is associated with cyto-genetics and entomology. The range of her scientific interests is fundamental cytogenetic problems, in particular, the organization of interphase giant chromosomes and their functional activity in eukaryotic organisms — on the example of dipteran insect larvae — chironomids.