Молодежный инновационный вестник

Учредитель: Федеральное государственное бюджетное образовательное учреждение высшего образования «Воронежский государственный медицинский университет имени Н.Н. Бурденко» Министерства здравоохранения Российской Федерации

Свидетельство о регистрации СМИ ПИ № ТУ 36-00228 от 22 декабря 2011 года
Адрес:
394036, г. Воронеж, ул. Студенческая, 10

Главный редактор: Андреев Александр Алексеевич - доктор медицинских наук, профессор кафедры общей хирургии

Издается с 2011 г. Периодичность выхода: 2 выпуска в год

ISSN: 2415-7805 (print)

Издатель: ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России

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Vol 10, No 1 (2021): Материалы XIV Международного хирургического форума «ИННОВАЦИОННЫЕ ТЕХНОЛОГИИ В ХИРУРГИИ»

ХИРУРГИЯ
Nikolai Aleksandrovich Velyaminov - Russian surgeon, organizer of military health care. To the 165th birthday anniversary.
Abasov A.R., Ostroushko A.P., Andreev A.A.
Abstract

Nikolai Aleksandrovich Velyaminov - the largest domestic surgeon, lieutenant general, privy councilor (1916), honorary life surgeon of the imperial court, doctor of medicine, professor, academician.
Purpose. The purpose of the presented article is to describe the role of N.A. Velyaminov in the development of military field surgery and domestic medical printing.
Methods. Using the literature used, the key stages of the development of the medical career of Nikolai Alexandrovich are described. Particular emphasis in the publication is placed on his court position as a physician and a person close to the imperial family. Results The analysis of the biography of Nikolai Aleksandrovich Velyaminov confirms his important role in the development of domestic medicine, in particular, military field surgery. "Velyaminov's surgical archive", which was later renamed into "Bulletin of surgery of I.I. Grekov ”is still being published, and its editorial board is made up of professors, academicians of the Russian Academy of Sciences.
Conclusions During his life N.A. Velyaminov managed to bring many innovations to surgery. The development of some principles of medical triage of wounded soldiers, participation in the work of the Red Cross society, the position of a doctor at the imperial court, participation in the main domestic military events, the development of a scientific medical journal and many other merits of Velyaminov allow us to conclude about his important role in domestic medicine in general.

Молодежный инновационный вестник. 2021;10(1):4-5
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A new method of treating soft tissue wounds
Arhipov D., Ostroushko A.P., Andreev A.A., Mikhhailov N.
Abstract

Surgical infection occupies one of the leading places in the structure of surgical morbidityand occurs with open soft tissue injuries in 60% of victims 

The aim of the study is to study the effectiveness of the combined use of oxygen and sorption effects in the treatment of soft tissue wounds 

Materials and methodsThe study of the effect of the new treatment method on the course of the wound process of "clean" (block I) and purulent wounds (block II) was performed on 240 Wistar ratsEach block included 4 groups of animalsin the 1st control groupno treatment was performedin the 2nd control groupthe wounds were treated with an oxygen jetin the 3rd control groupthe sorbent was appliedand in the main groupthe developed method was used. 

ResultsIn the treatment of purulent woundsthe use of the developed method accelerated the duration of the wound process by an average of 1.2-1.6 timesand reduced the wound area by 85.0% of the initial values by the 7th day. 

ConclusionThe study showed the safety and high efficiency of the combined use of oxygen and sorption effects in the treatment of woundswhich was confirmed by a reduction in the time of purificationgranulation and epithelization of defectsand consequentlythe time of the wound process. 

Keywordswoundssoft tissuestreatment. 

Молодежный инновационный вестник. 2021;10(1):5-6
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REGULATION OF REPARATIVE LIVER REGENERATION AFTER SUBTOTAL RESECTION
Vityutina a.А., Laptiyova A.Y., Glukhov A.A.
Abstract

Post-resection regeneration is one of the criteria for the effectiveness of surgical treatment for traumatic, toxic, infectious and metastatic organ lesions. The article is devoted to the study of modern ideas about the reparative regeneration of the liver after extensive resection - more than three segments. Much attention is paid to the mechanisms of organ restoration, the phases of the proliferative process. Inducers of hepatocyte regeneration and their effect on the phases of the cell cycle are described. The article emphasizes that the problem of post-resection reparative regeneration of the liver remains relevant, since the frequency of postoperative complications during resections continues to average 38%.

Молодежный инновационный вестник. 2021;10(1):7-8
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RESULTS OF PERCUTANEOUS CORONARY INTERVENTIONS IN PATIENTS WITH ACUTE CORONARY INSUFFICIENCY
Davydkin V.V., Volchkova A.A., Karapetyan S.R.
Abstract

Clinical and instrumental substantiation of angioplasty with stenting of coronary arteries in ACS is an urgent and debatable problem. The aim is to compare the early results of myocardial revascularization in ACS by angioplasty with stenting. Coronary angiography determined the localization, type of stenosis, the severity of atherosclerotic narrowing, as well as the anatomical features and vascular geometry of the coronary bed. After the study, PCI was performed according to the indications. For risk stratification, the GRACE scale was used with the identification of low-risk groups.

It was found that the systolic function of the left ventricle affects the level of risk of an unfavorable outcome of ACS. In the groups of patients of medium and high risk according to the GRACE scale, after the stenting of the coronary arteries, the systolic function of the left ventricle significantly improved. In the group of patients with ACS with ST segment elevation, angioplasty with stenting of the coronary arteries did not reduce the incidence of myocardial infarction, but significantly reduced the risk of an unfavorable outcome of ACS. In patients with ACS with ST segment elevation, prehospital thrombolysis significantly improved the parameters of myocardial systolic function, therefore, reduced the risk of an unfavorable outcome of ACS.

Молодежный инновационный вестник. 2021;10(1):8-10
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BENIGN BONE NEOPLASMS IN CHILDREN IN THE SVERDLOVSK REGION
Deryabina A.
Abstract

The study presents a retrospective analysis of children from 0 to 17 years old treated in the traumatological and orthopedic department of the Regional Children's Clinical Hospital of Yekaterinburg with benign bone neoplasms over the past five years, in particular: with osteochondromes, osteoid osteomas, chondromes and tumors with intraossal growth. The article presents the options of number of classifications of benign bone tumors, therapeutic and tactical decisions, various options for bone grafting from 446 patients treated in trauma and orthopaedic Department WITH GAUZ "CSTO", Yekaterinburg, and long-term results of treatment.

Молодежный инновационный вестник. 2021;10(1):10-12
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Morphometric E indicators and in relieving chronic osteomyelitis with ultrasound, rubidium chloride and amikacin
Zolotukhin v., Ostroushko A.P., Andreev A.A., Novomlinsky V.V.
Abstract

Abstract: Relevance: Osteomyelitis is one of the intractable inflammatory diseases of the musculoskeletal system . Difficulties in the early diagnosis and treatment of osteomyelitis lead to a large number of complications and to the disability of the working-age population aged 35 to 50 years.
            

Purpose: increasing the efficiency of relief of chronic osteomyelitis using ultrasonic cavitation and a complex consisting of rubidium chloride, amikacin and hydroxyapatite .

Methods: The experiment s prov edeny on 175 male rats Wistar weighing 280-300 g . All the animals were divided into 5 groups : 3 -x experienced e and 2 -x controlling e . In the 1st control group, no treatment was performed . In other g RUPP ah performed two-stage surgical remediation using micromotor and mud pulse systems with subsequent ultrasonic cavitation. In the 1st experimental group, powdered rubidium chloride was additionally introduced into the defect area. In the 2nd test group after surgeons h eskoy readjustment was introduced into the wound antibiotic amikacin a maximum concentration of 15 mg / kg / day. In the 3rd experimental group, the combined use of both techniques was used.

Results: The combined application of ultrasonic cavitation, rubidium chloride, and mikatsina and hydroxyapatite bone regeneration was observed much earlier , than at their isolated application .

Conclusion: The proposed method for the treatment of chronic osteomyelitis using a complex consisting of rubidium chloride, amikacin and hydroxyapatite has shown high efficiency .

Молодежный инновационный вестник. 2021;10(1):12-14
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Comparative analysis of the effectiveness of treatment of distal radius fractures in patients in the Voronezh region.
Zolotukhin v., Arzhanykh Y.
Abstract

Annotation:

Relevance: A distal radius fracture is one of the most common fractures of the musculoskeletal system, accounting for 34% of all fractures and up to 90% of forearm fractures.

Goal: - improving the effectiveness of treatment of the distal radius.

Materials and methods: A retrospective analysis of 78 case histories of patients with distal radius fractures treated at the BUZ WAS performed VOKB No. 1 in the Department of traumatology in the period from January 2020 to December 2020. The patients ranged in age from 18 to 65 years. Terms from fractures ranged from a week to 5 months. Conservative treatment was used in 31.5% of cases (23 patients). Hospitalization and surgical treatment were required in 68.5% (56 patients). Osteosynthesis was performed with a plate, which was used in the following procedure: T-shaped, angular stability plate and foot plate.

Discussions: The greatest number of complications occurs when using a conservative method of treatment.

Results: When using the foot plate , there are no complications, the restoration of the function of the damaged limb occurred 3-4 days faster than when using the foot plate. other methods of surgical treatment.

Conclusions: The use of a paw plate combines the positive aspects of extrafocal and submerged osteosynthesis and is the optimal method of surgical treatment of DOLC fractures.

Key words:: traumatology, surgery, and fractures of the distal radius.

Молодежный инновационный вестник. 2021;10(1):15-16
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Richard Volkmann, Director of the University Surgical Clinic in Halle, Chairman of the German Society of Surgeons
Kalinina K.M., Ostroushko A.P., Andreev A.A.
Abstract

Richard Folkman was born in 1830 in Leipzig in family of the privatdozent of the local university. Richard Folkman studied medicine at Gallet and Gissen's universities, in 1854 graduated from medical faculty of the Berlin university. In 1854 Folkman defended the dissertation then he works as the assistant, the privatdozent, extraordinary professor in surgical clinic of professor Blazius at Halle University. He participates in the German military campaigns 1865-1866 and 1870-1871 of. During the French-German war works as the chief physician in the 4th army body, is later in the Maas and Southern army. In 1866 receives the invitation to management of surgery of Halle University of department. From 1867 to 1885 Folkman ordinary professor of surgery and the director of university surgical clinic in Halle. From 70th years he begins to publish a series of monographs devoted to internal diseases, surgery and gynecology "A collection of clinical reports", since 1880 becomes the coeditor of the surgical edition "Zentralblatt fur Chirurgie". One of the main merits of Richard Folkman is broad promoting of a method of antiseptics. Folkman made extremely important contribution to increase in efficiency of treatment of the patients by use of an occlusive bandage in the conditions of wartime developed by it wire T-shaped immobilized tires, ways of treatment of bone changes by an extension method. It described several forms of bone tuberculosis. In 1872 Richard Folkman with colleagues created the German society of surgeons which chairman he was since 1885. In 1885 Folkman was awarded a noble rank. The name of Folkman is born by the contracture described by it, a number of surgeries, devices and tools. In 1889 Richard Folkman died.

Молодежный инновационный вестник. 2021;10(1):16-17
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Bobrov A.A. is a Russian surgeon, an ordinary professor of operative surgery at Moscow University.
Keda K., Ostroushko A.P., Andreev A.A.
Abstract

One of the outstanding figures of Russian medicine. A surgeon-clinician, a talented teacher, inventor, innovator, scientific and public figure. Alexander Alekseyevich Bobrov made a great contribution to the development of Russian surgery in his short life. He was considered the founder of oriented anatomy. Bobrov's methods and techniques have long been preserved in the treatment of echinococcal liver cysts and in the surgical techniques of inguinal hernias.

Молодежный инновационный вестник. 2021;10(1):17-18
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Intraoperative correction of risk factors for acute liver failure during liver resection
Andreev A.A., Ostroushko A.P., Glukhov A.A., Laptiyova A.Y., Antakova L.N.
Abstract

Relevance. The introduction of new methods of liver resection has contributed to a significant expansion of the indications for liver resections, but acute liver failure remains a difficult problem among postoperative complications. 

Aim of the study. Reducing the risk of acute liver failure during liver resection, by intraoperative administration of cyanocobalamin in an experiment. 

Materials and methods. The experiments were performed on 96 male Wistar rats. All animals underwent typical liver resection (TRP); in the 2nd control group-additional intrahepatic injections of 1 ml of 0.9% NaCl were performed; in the 1st experimental group – intrahepatic injections of 1 ml of cyanocobalamin; in the 2nd experimental group-1 ml of cyanocobalamin was administered intraperitoneally. On days 1, 5, 7, and 14, blood was collected for biochemical testing. Statistical processing was performed using the program Statistica 6.0. 

Results. On the 14th day of the study, normalization of the indicators of cytolysis, cholestasis and hepatic cell insufficiency syndromes was observed in the 1st experimental group in almost all animals, in the control groups and the 2nd experimental group, the results were significantly lower. 

Conclusion. The proposed method provides normalization of the metabolic processes of the liver in the early postoperative period, prevents the development of acute liver failure. 

Молодежный инновационный вестник. 2021;10(1):18-19
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EVALUATION OF TGF-β AND IL-1β EXPRESSION DURING LIVER RESECTION
Andreev A.A., Glukhov A.A., Ostroushko A.P., Laptiyova A.Y.
Abstract

Relevance. Surgical treatment of large liver formations is an urgent problem of operative hepatology, since the risk of post-resection remains at a high level. 

Goal. Increase in the reparative potential of hepatocytes by intraoperative intrahepatic administration of cyanocobalamin during liver resection in the experiment. 

Materials and methods. The experiments were performed on 96 male Wistar rats. All animals underwent typical liver resection (TRP); in the 1st control group, prevention of post-resection liver failure was not performed; in the 2nd control group, intrahepatic injections of 1 ml of 0.9% NaCl solution were performed; in the 1st experimental group, intrahepatic injections of 1 ml of cyanocobalamin were administered intraperitoneally; in the 2nd experimental group, 1 ml of cyanocobalamin was administered intraperitoneally. On days 1, 5, 7, and 14, blood was collected for biochemical testing. Statistical processing was performed using the program Statistica 6.0. 

Results. Intraoperative intrahepatic administration of cyanocobalamin increases the expression of growth factors TGF-β and IL-1β by 2.5-3 times, affecting the proliferative activity of hepatocytes, while not violating the physiological norms of mitotic activity. 

Conclusion. The proposed method promotes increased expression of growth factors, promotes the most rapid recovery of the initial liver mass, and, as a result, the normalization of its functional activity.

Молодежный инновационный вестник. 2021;10(1):19-20
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MECHANISMS OF THE EFFECT OF CYANOCOBALAMIN ON THE PROLIFERATIVE ACTIVITY OF HEPATOCYTES
Andreev A.A., Ostroushko A.P., Laptiyova A.Y., Markin D.
Abstract

Cyanocobalamin is a "classic" hepatoprotector that has hematopoietic, hemostatic and analgesic effects. Most of the mechanisms of its action are realized through participation in the processes of nucleic acid synthesis, homocysteine metabolism, and DNA replication. Methylcobalamin – one of the active coenzyme forms, has a stimulating effect on rapidly proliferating cells, including the liver. The use of cyanocobalamin preparations leads to the elimination of hypoxia, is accompanied by an increase in hepatocyte resistance, acceleration of regenerative processes in the liver parenchyma and improvement of its detoxification function. Thus, today the use of cyanocobalamin as a drug that promotes the recovery of the liver after surgery is relevant. 

Молодежный инновационный вестник. 2021;10(1):20-22
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THE USE OF RUBIDIUM CHLORIDE IN THE TREATMENT OF CHRONIC OSTEOMYELITIS
Ostroushko A.P., Sakovich N.V.
Abstract

In the structure of surgical infectionchronic osteomyelitis accounts for up to 10% of caseswhich is detected in a quarter of cases after open fractures with a recurrent course in a third of cases. 

The aim of the study was to improve the results of treatment and prevention of chronic post-traumatic osteomyelitis by topical application of rubidium chloride. 

Materials and methodsThe study was performed in 3 groups on 36 Vitar rats with hip osteomyelitis. 

The results were evaluated by analyzing the dynamics of objective clinical data and LPO indicators (malondialdehyde /MDA/ and thiol groupson the 7th and 14th daysThe maximum level of thiol groups on the 7th and 14th days was observed in the 3rd group – 81.54±3.74 and 75.48±4.03 mg% (p<0.05). MDA values were minimal on the 7th and 14th days in the 3rd group – 21.62±1.75 and 19.31±1.84 nmol / l (p<0.05). 

ConclusionThe lowest intensity of POL, as a result of the relief of the inflammatory processwas observed when using rubidium chloride. 

Молодежный инновационный вестник. 2021;10(1):22-23
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Advantages and disadvantages of different methods of endoscopic hemostasis syndrome Delfoi
Orevkov E.B., Alieva E.S., Spiridonova E.V., Strinkevich A.V., Pavlova V.N.
Abstract

Abstract: the paper presents the experience of treating patients with lesions Delfoi.
Diagnosis and treatment of the syndrome Delfoi remains one of the most important problems of emergency surgery. Today is the actual task of creating a unified and effective tactics of treatment of lesions Delfoi.
Goal. Improve the results of diagnosis and treatment of Dielafua lesion by identifying the nuances of its clinical course and analyzing the use of different types of endoscopic hemostasis in patients with this syndrome.
Methods and materials. The analysis of 21 case histories of patients with Dielafua lesion who were treated in the Department of Surgery of the Tverye State Clinical Hospital in Perm was performed. The features of the clinical course and laboratory data, the results of fibroesophagogastroduodenoscopy( FEGDS), endoscopic and surgical methods of treatment and their final results were studied.
Results. 66.6% of patients with Dielafua lesion were men, 61.9% of patients were in the age category of 40-59 years. Upon admission, all patients underwent fibroesophagogastroduodenoscopy in combination with subsequent endoscopic hemostasis using alcohol irrigation, clipping, and argonoplasmic coagulation. Relapse of bleeding occurred in 4 patients who were treated with alcohol irrigation and clipping. When combined irrigation alcohol with argon plasma coagulation recurrence was not observed. All patients with recurrent bleeding were operated on.
Conclusion. Among patients with lesions Delfoi dominated by men 40-59 years with severe blood loss. The most effective method of endoscopic hemostasis with the defeat of Dieulafoy showed a combination of irrigation alcohol with argon plasma coagulation.

Молодежный инновационный вестник. 2021;10(1):23-25
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Nikolai Ivanovich Pirogov: the past, present and future of Russian surgery.
Popova A., Ostroushko A.P., Andreev A.A.
Abstract

The works of N. I. Pirogov covered a wide range of the most important issues of practical medicine: infectious diseases and methods related to the fight against them, asepsis, antiseptics, sorting of the wounded during the war, surgical interventions. He paid great attention to the development of practical skills of doctors. N. I. Pirogov-the creator of topographic (surgical) anatomy, a clinical practitioner and theorist.

Молодежный инновационный вестник. 2021;10(1):25-26
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The use of electrostimulation for the treatment of purulent wounds in an experiment
Ostroushko A.P., Andreev A.A., Rodriguez M., Laptiyova A.Y.
Abstract

The article presents experimental data about the treatment of purulent wound process by electrostimulation in rats with simulated purulent wounds, and reveals the effects of electrostimulating impacts on body tissues, in particular in the wound.

Молодежный инновационный вестник. 2021;10(1):27-28
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Abdominal aortic aneurysms: assessment of surgical treatment and surgically induced complications, analysis of mortality
Runge A.E., Sharylava M.D.
Abstract

Actuality: Abdominal aortic aneurysm (the ABA) - the most frequent localization of aneurysms of the cardiovascular system - it accounts for around 80% [1].

Objective: to assess the surgical treatment of patients with AAA, consider the complications that have arisen, study the mortality. Materials and Methods: The study of the examination results and the outcomes of surgical treatment of AAA was carried out in 30 inpatients who were operated on in the department of vascular surgery of the Grodno University Clinic. 

Results of the study: all operations were performed exclusively with open access; in all cases, a total midline laparotomy was used. The most frequently performed operation was resection of the aortic aneurysm with aortobifemoral prosthetics - in 27 patients (90%), aortobilial prosthetics was also used - in 1 patient (3.33%), in 1 (3.33%) - aortic ligation in the area of ​​the aneurysm neck and axillobifemoral prosthetics and in 1 (3.33%) aortobifemoral prosthetics with aortic resection to turn off the aneurysm due to long-term organized extensive hematoma. The most frequent postoperative complication was hematoma of the retroperitoneal space - observed in 8 cases (26.67%), ureterohydronephrosis - in 5 patients (16.67%), hydrothorax - in 2 (6.67%), in 2 (6.67%) ) - lumbosacral plexopathy with gross flaccid paresis of the lower limb, in 2 (6.67%) - pneumonia. Postoperative mental disorders were observed in 4 patients (13.33%): in 3 (10%) - delirium not caused by alcohol or other psychoactive substances (F05) and in 1 (3.33%) - mild cognitive disorder (F06.71 ). 7 patients died, all of them were operated urgently for ruptured AAA.

Conclusion: According to the results of the study, it was revealed that the most frequently performed intervention is resection of the aortic aneurysm with aortobifemoral prosthetics. The course of the postoperative period in all patients with elective resection was satisfactory, and in cases of ruptured AAA, there were lethal outcomes. The most common complications were retroperitoneal hematomas, ureterohydronephrosis and postoperative mental disorders (delirium and mild cognitive impairment).

Молодежный инновационный вестник. 2021;10(1):28-30
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