2025, volume 21

Objective: to evaluate the dynamics of intestinal wall perfusion in adhesive acute intestinal obstruction and to determine the critical period of reversibility of ischemic changes. Material and methods. The study was performed in 50 rats in an acute experimental setting. Chronic adhesive disease was induced 30 days prior to the main experiment. Animals were divided into a control group (laparotomy without adhesions) and four experimental groups with adhesive disease: sham group (without obstruction), group A (strangulation for 1 hour), group B (24 hours), and group C (48 hours). Microcirculation was measured using non-contact laser Doppler flowmetry with vibration noise suppression; the M1 parameter (first spectral moment reflecting blood flow intensity, TPU) was evaluated. Statistical analysis was performed using STATISTICA 10.0 with parametric and non-parametric tests. Results. Peritoneal adhesions were found to reduce basal perfusion by 10.5% (0.95±0.05 vs 0.85±0.06 TPU; p=0.0256). Initiation of strangulation resulted in a sharp decrease in M1 by approximately three-fold within the first 10 minutes (to 0.34±0.09 TPU). Perfusion recovery after obstruction resolution depended on ischemia duration: at 1 hour, 68% of baseline level was recovered; at 24 hours, 24%; at 48 hours, no recovery was observed (p=0.567), indicating development of the irreversible "no-reflow" phenomenon. Conclusion. After strangulation, perfusion levels progressively decreased until the development of "biological zero" of microcirculation. The critical period of ischemia reversibility in adhesive strangulation is in the range of 24–48 hours.

Objective: to present the results of intravitreal application of the new anti-Ang-2 and anti-VEGF-A drug faricimab in the treatment of neovascular age-related macular degeneration (AMD) using three clinical cases. Patients with newly diagnosed neovascular AMD received intravitreal faricimab (Vabismo) at a dose of 6 mg (0.05 ml of solution) every 4 weeks in the amount of 4 "loading" injections, further tactics depended on the dynamics and activity of the disease. The use of faricimab in the treatment of neovascular AMD is due to its effect on two mechanisms of pathogenesis: faricimab independently binds and neutralizes both angiopoietin-2 (stabilizes blood vessels, reduces vascular permeability and reduces inflammation) and VEGF-A (reduces vascular permeability and inhibits neovascularization). In the cases we considered the use of faricimab in clinical practice for the treatment of neovascular AMD has demonstrated high efficacy, long-term stabilization of the achieved results, and the absence of adverse events.

Objective: to evaluate the effectiveness of the original method of calcaneal osteotomy in treatment of pes planovalgus severe forms in children. Material and methods. The study included 90 patients with flat feet (mean age was 11,5±0,7 years). The 50 children of a similar age without static foot deformities were the comparison group. The patients of the experimental group were operated by using the modified method of treatment pes planovalgus, which includes interfacet osteotomy of the calcaneus with simultaneous correction of the soft-tissue component of the deformity. The postoperative follow-up period was 1,1±0,8 years. The effectiveness of the method was analyzed by use a clinical and instrumental score scale developed specifically for this pathology. Results. Complex clinical and instrumental assessment showed excellent results in 74,7% cases, good – 16,5%, fair – 8,2% and poor – in one child (0,6%). Conclusion. The use of the interfacet osteotomy of the calcaneus in the author's modification provides the best conditions for achieving good anatomical and functional results in treatment of the severe pes planovalgus in children.

A rare clinical case of recurrent laryngopharyngeal fibromyxoma detected 24 months after primary resection is presented. Histologically confirmed tumor recurrence was accompanied by symptoms of upper airway obstruction and phonation and swallowing disorders. Observation emphasizes the exceptional rarity of this localization and the tendency of fibromyx to relapse, which requires a radical surgical approach and long-term oncological monitoring. There is a need for increased alertness of otorhinolaryngologists and oncologists due to the risk of malignancy, even histologically benign mixes with their atypical localization.

The clinical picture and diagnostic features of bettolepsy are described. The development of this condition in middle-aged men with excess body weight and chronic obstructive pulmonary disease is typical. A special feature of the clinical case under consideration was the combination of cough syncope with cicatricial-granulation stenosis of the upper third of the trachea, which complicated the diagnostic search.

Objective: to determine the efectiveness of dynamic electrical stimulation on the functional state of the masticatory muscles in patients with temporomandibular joint pain dysfunction syndrome. Material and methods. The study involved 60 people aged 25 to 60 years with temporomandibular joint pain dysfunction syndrome, who were divided into two groups of 30 people. Patients of the frst group underwent dynamic electrical nerve stimulation in the area of pain complaints, and patients of the second group also in the projection of the trigeminal nerve exit on the face. Elec-tromyographic examination of the masticatory muscles and completion of the McGill pain questionnaire as modifed by V.V. Kuzmenko et al. before and after exposure to dynamic electrical nerve stimulation were performed by all patients. Results. All patients showed a signifcant improvement in the condition of the masticatory and temporal muscles according to electromyography p<0.001 in all measurements, the inclusion of additional zones did not afect the improvement in the condition. According to the pain questionnaire, the treatment results improved in both groups (p<0.001), M±m=10.7±0.89 points and M±m=5.87±0.81 points before and after treatment in the group1, M±m=10.83±0.86 and M±m=5.73±0.65 points before and after treatment in the group 2. When comparing results between groups, there were no signifcant diferences. Conclusion. Dynamic electrical neurostimulation has a positive clinical efect on the functional state of the masticatory and temporal muscles after just one session.

The scientific biography of the famous scientist, teacher, head of the Department of General Hygiene and Ecology of the V.I. Razumovsky Saratov State Medical University, Doctor of Medical Sciences, Professor, Honored Scientist of the Russian Federation Yuri Yu. Eliseev, celebrating his 70th birthday in 2025 is presented in this article.

Objective: to carry out a comparative analysis of the parameters of microcirculation of the gums and structural changes of the periodontium on the model of experimental periodontitis. Material and methods. The animals were divided into 2 groups: a control group of 15 intact animals and an experimental group of 30 rats with experimental periodontitis. Periodontitis was modeled using the ligature method. Microcirculation was studied using laser Doppler flowmetry in animals from the experimental group on days 14, 21, and 35 of the experiment. The rats of the experimental group were removed from the experiment on the days 21 and 35, 15 individuals each. The lower jaw was removed for histological examination. Results. Between days 14 and 21, perfusion continues to increase, increasing by 37% relative to the control. There is a change in the active and passive mechanisms of blood flow modulation. Microscopy shows edema and leukocyte infiltration in its own mucosal plate, mixed hyperemia, and signs of alveolar bone resorption. At week 5 of the experiment, gum perfusion decreased by no more than 5% relative to the control. There is a decrease in the amplitude of respiratory and cardiac oscillations. With the further development of periodontitis in animals, there is a reduction in blood flow, which leads to a decrease in perfusion. Conclusion. The changes in perfusion are comparable to the structural changes in the supporting apparatus of teeth during the development of experimental periodontitis.

Objective: to analyze the indices of immune cells in the blood and the level of proinflammatory cytokines in recovered and deceased patients with severe burns. Material and methods. The study included 45 burn victims with burns covering more than 30% of the body surface area (33 recovered, 12 deceased).The number of immune blood cells (neutrophils, lymphocytes, monocytes) and cytokine levels: tumor necrosis factor a (TNF-a), interleukin 12(IL-12), monocyte chemoattractant protein-1 (MCP-1) were determined. Samples were taken on days 1,3,7, 15, 30 and 45 af-terthe injury. Results. At all control points, an increase in the level of the studied cytokines was observed; on days 1-7, higher levels of TNFa - 0.6 (0.2; 101.0) pg/ml, 8.8 (0.25; 59.0) pg/ml and MCP-1 - 387.5 (147.9; 447.9) pg/ml, 306.8 (154.1; 1210.0) pg/ml were noted, and on days 30-45 - IL-12 - 102.2 (76.3; 148.7) pg/ml, 151.9 (83.5; 162.6) pg/ml. Higher levels of IL-12 and an increase in the number of lymphocytes on days 7-15 from the moment of injury (1.07±0.07; 1.19±0.05) were observed in patients with favorable outcome, and relatively low levels of IL-12 - 27.2 (9.6; 44.5) pg/ml, 32.1 (28.2; 50.7) pg/ml, and high levels of TNF-a-8.8 (0.25; 59) pg/ml, 15.2(0.5; 28.6) pg/ml) and neutrophils (7.67±0.49x109/l; 7.27±0.53><109/l) throughout all stages were more common in the deceased. Conclusion. In patients with severe burns, there is suppression of the parameters of the specific link of immunity (IL-12, the number of lymphocytes), with an increase in the non-specific link (neutrophils, TNF-a). The degree of disturbances depends on the severity and outcome of the injury.

Objective: to evaluate the proportion of leukocytes (CD45+ cells) and T-lymphocytes (CD3+ cells) in the liver during physical activity of varying degrees with and without meldonium. Material and methods. The experiments were conducted on male Wistar rats, which performed physical activity of varying intensity. Meldonium was added to the diet of experimental animals at a rate of 100-120 mg/kg of weight during water loading. After the end of the experiment, liver samples were taken, sections were prepared, stained with hematoxylin and eosin, and an immunohistochemical (IHC) reaction was performed for CD45+ and CD3+ cell markers. Results. During heavy physical exertion, the proportion of CD45+ and CD3+ liver parenchyma cells increased by 3.2 and 2.9 times and perivascularly by 3 and 6.3 times (p=0.001) compared to the intact group. After the use of meldonium during heavy physical exertion, the percentage of CD45+ cells decreased in the liver parenchyma and perivascularly by 1.8 times (p=0.008), the proportion of CD3 cells decreased by 1.7 times in the liver parenchyma (p=0.001) and around the vessels by 2.3 times (p=0.004) when comparing data with intact animals. Histologically, inflammation and alterative changes in the liver tissue decreased. Conclusion. The use of meldonium during heavy physical exertion led to a decrease in the percentage of CD45+ and CD3+ cells due to a decrease in the degree of inflammatory infiltration of the liver tissue and the severity of the destructive process.