In this article, the author has studied the content of the role of the principle of equality and its role in the international private labor relations, as well as studying the views of domestic and foreign scientists. As a result of analysis, the authors put forward proposals to improve national legal acts.
In this article, the principle of economy is one of the factors that characterize the development of the language, its essence in the language, ensuring the maximum transfer of information in a short period of time, in other words, contributing to the improvement of the communicative function of the language. He seeks to get rid of words, syllables and grammatical forms that do not carry information and do not help explain. The role of language in the evolution of language cannot be absolute: there are tendencies and phenomena in the language that oppose both strictness and counteraction, for example, an excess of language and its special cases at the level of the word are the prosthesis and pleonasm.
Закон Республики Узбекистан «О товарных знаках, знаках обслуживания и наименованиях мест происхождения товаров» от 30 августа 2001 г. 1 регулирует отношения в области правовой охраны и использования товарных знаков, знаков обслуживания.
Relevance of the problem.Despite the great successes of angiosurgery, the problem of surgical treatment of abdominal aortic aneurysms does not lose its relevance. World health statistics records a steady increase in the incidence of abdominal aortic aneurysm (ABA). According to L.J. Melton et al. (1984) and L.K. Bickerstaff et al. (1984) in the USA the number of patients with abdominal aortic aneurysm has increased 7 times in 30 years since 1951. In England and Wales, according to F.G. Fowkers et al. (1989) for the same period revealed a 20-fold increase in abdominal aortic aneurysms in men and 11-fold in women. According to the results of multicentre screening studies ABA was detected in 8% of the examined (E.S. Vourvouri, 2001), and in the age group of 64-69 years ABA was detected in 5.7% of the examined, and in the age group of 75-81 years - in 8.9% (R.A.P. Skott et al., 2001). A similar trend is observed in other countries. Accordingly, mortality from ABA is also increasing - aneurysm rupture in a number of countries is one of the ten most frequent causes of death among elderly and senile people (F.A. Lederle et al., 1990)
Currently, planned aneurysm resection has become a recognised standard of radical treatment of ABA patients and the number of these operations is steadily increasing. For example, about 40,000 ABA resections are performed annually in the USA (J.J. Grange et al., 1997). In Sweden during the period from 1987-89 to 1993-95 the number of ABA operations increased 5 times and currently 10 operations per 100,000 population are performed (A.Hallin et al., 2001), although this is 1.5 - 2 times less than the required number. However, postoperative lethality is still quite high and makes 5-7% (A.V.Pokrovskiy et al., 1992; Y.V.Belov et al., 1992; V.V.Vakhidov et al., 1992; A.W. Bradbury et al. Bradbury et al., 1997; A.Hallin et al., 2001).
E.W. Steyeberg et al. (1995) summarised the data of literature on 17238 ABA resection operations and gave an average mortality of 6.8%.
Multicentre studies in five major hospitals in the Netherlands found that only 74% of patients underwent ABA resection without complications; 26% had some complications, 9% of which were severe and 4.1% of which were fatal (G.J. Akkersdijk et al., 1998). Similar results were obtained in the Canadian Cooperative Study (K.W. Johnston et al., 1990). It was established that the peculiarity of complications in the majority of patients was their systemic character (L.L. Lau et al, 2001) The course of the postoperative period is most often complicated by cardiac, respiratory, renal, cerebrovascular, as well as complications associated with thrombosis and bleeding (W.E. Lloyd et al., 1996; R.D. Sayers et al., 1997; J.D. Blankenstein et al., 1998; R. Ayari et al., 1998). Ayari et al., 2001)
The undisputed leadership, without doubt, belongs to cardiac complications, the incidence of which varies from 10% to 20%. Moreover, cardiac complications account for 50-70% of total mortality. Cerebrovascular complications, although not uncommon, account for no more than 1-1.5%, but their mortality reaches 40%. Complications associated with thromboses and haemorrhages in the perioperative period reach 2-5% (M.M.Reigel et al., 1987; K.W.Johnson et al., 1990; N.Franklin et al., 1993; A.A.Milne et al., 1994).
Certainly, a large number of complications after resection of abdominal aortic aneurysms is caused by the initial severity of patients' condition, however, many unresolved tactical and technical issues of patients' preparation for the operation, stage of performance in case of combined lesions of several vascular basins play a practically significant role. Adequate management of the operation itself and the immediate postoperative period is no less important, taking into account the possibility of such dreadful complications as thrombosis and embolism, cerebral and cardiac death. Until now there is no unified complex analysis of the results of treatment of uncomplicated abdominal aortic aneurysms and, accordingly, recommendations for the prevention of possible complications.
All this determined our aim and objectives of the study.
The aim of the study is to improve the results of surgical treatment of ABA by developing an effective system for determining the main risk factors of surgical treatment and optimal surgical tactics to prevent possible complications.
Scientific novelty.For the first time a complex analysis of indications and contraindications to surgical treatment of abdominal aortic aneurysms was carried out
The most significant concomitant pathology capable to lead to formidable complications and lethality during the intervention and in the nearest postoperative period was revealed. Adequate measures of their prevention and treatment were proposed.
The algorithm of surgical treatment tactics for patients with combined pathology of coronary arteries and aortic arch branch lesions was developed
The state of haemostasis system at all stages of reconstructive surgery on abdominal aorta, starting from skin incision to wound closure, was studied for the first time.
Conclusions:
1. The proposed original classification of ABA, based on mutual dependence on the etiology of the disease, localisation, concomitant diseases, clinic and its course, allows to determine the strategy of early diagnosis, to estimate the most significant risk factors, the stage of intervention in combined lesions of adjacent and distant vascular basins and, ultimately, to determine the ways to reduce complications and mortality in patients with ABA.
2. The most informative methods of ABA diagnostics are duplex scanning and computed tomography. Non-invasive diagnostics capabilities are enough to determine the aneurysm size, its relation to the renal arteries, as well as to find out the state of visceral branches and aortic bifurcation. Abdominal aortography is indicated in patients with concomitant arterial hypertension to identify the state of the renal arteries.
3. Significant risk factors in these patients are ischaemic heart disease (44.1%), arterial hypertension (49%), haemostasis disorders (almost 100%).
4. The leading concomitant disease in the development of postoperative complications is ischaemic heart disease. Its share in abdominal aortic aneurysms is 40%. Postoperative cardiac complications reach 14.9%. Diagnostics of ischaemic heart disease should be based on the stage-by-stage detection of coronary lesions and its functional-compensatory abilities.
5. The main complications of the postoperative period after ABA resections are acute heart failure (14,9%), cerebral circulatory disorders (1,5%), acute renal failure (3,33%).
6. When significant coronary vascular channel lesions are detected in patients with ABA, it is fundamental to solve the issue of intervention staging. At 3-4 functional classes of circulatory insufficiency, appearance of new zones of hypo- or akinesia, decrease of ejection fraction below 40%, the first stage should be myocardial revascularisation surgery
7. In patients with combined lesions of brachiocephalic vessels in patients with ABA it is reasonable to assess the cerebral blood flow. In the presence of 70% or more stenosis of VCA, presence of embologenic plaque, bilateral haemodynamically significant stenosis it is necessary to perform carotid artery intervention as the first stage.
8. One of the most difficult problems of reconstructive operations in ABA is the contiguous lesion of renal and visceral branches of the abdominal aorta. The principle is their one-stage reconstruction. The types of reconstruction of these branches should be variable depending on the volume and extent of the pathological process.
9. Patients with aneurysmal lesion of abdominal aorta initially always have significant disorders of haemostasis system. In 30% of patients with occlusive diseases of aorta and its branches in the preoperative period the activity of thrombocytic-vascular link of hemostasis is increased, antithrombotic ability of vascular wall endothelium is decreased and blood rheological properties are disturbed. Activation of fibrinolysis was noted in patients with aneurysmal lesion of abdominal aorta.
10. During the operation for abdominal aortic aneurysmal lesion, after starting the blood flow the level of plasminogen increases additionally by 30%, which is a risk factor for haemorrhagic complications in the perioperative period. On the 1-3 day after the operation there is a significant decrease of blood anticoagulant potential - antithrombin-Sh by 25-27%, protein C by 23-25%. This period is the most dangerous in terms of thrombohemorrhagic complications development.
11. When using standard heparin during the operation there is a consumption of antithrombin-Sh by 30-45% and increase of platelet aggregation by 10%, which is a threatening condition for the occurrence of thrombosis of deep veins of the lower extremities with subsequent TELA. When using fraxiparin during reconstructive vascular surgeries the consumption of antithrombin-Sh and increase in platelet aggregation do not occur, prothrombin time, activated partial thromboplastin time, thrombin time are lengthened insignificantly that testifies to expediency of its use for prevention of thrombohemorrhagic complications.
12. Application of the diagnostic methods proposed by us to detect the main risk factors during the operation and in the nearest postoperative period, use of the algorithm of stage and volume of intervention allowed to reduce significantly the number of threatening complications, thus the lethality decreased 4 times, and the number of non-fatal complications - 4 times non-fatal complications - 1.5 times.
Бугунги пандемия шароитида шифокорлар маънавиятига қўйилаётган юксак талабларнинг ошаётгани, бўлажак давлат хизматчилари, ижтимоий соҳалар ходимларининг маънавий-ахлоқий тафаккур савясини ва ижтимоий фаоллигини оширишга қаратилган талаблар билан тавсифланади. Давлатимиз раҳбари Шавкат Мирзиёев. "Бугун замон ўзгармоқда, одамларнинг талаби ошиб бормоқда. Халқимизнинг тиббий маданияти юксалиб, энг сўнгги усул ва русумларда тиббий хизмат кўрсатилишини истайди. Бизга шу ҳам бўлаверади, деган тушунча энди ўз умрини ўтаб бўлди. Бу барча соҳалар қатори тиббиёт соҳасига ҳам бевосита даҳлдор. Олимларнинг таъкидлашича “донолик, комиллик ва жамиятнипг тараққиёти кўп холларда интеллектуал ва ахлоқий салоҳият билан белгиланади”. Ахлоқий маданияти қанчалик бой, теран ва чуқур бўлса - жамият ҳам шу қадар бой бўлади. Яна шуни алоҳида таъкидлаш жоиз, бугунги бошимизга тушган синов бераётган сабоқдан хулоса чиқариб, барчамизни жиддий ташвишга солиб турган коронавирус пандемияси ҳам мукаммал билимларга эга тажрибали ва ахлоқий маданиятли шифокорлар, бизга нақадар керак эканлигини яна бир бор яққол намоён этди- қўйди. Республикамизда мустақил Ҳамдўстлик давлатлари орасида биринчилардан бўлиб миллий-тиббий қадриятларимиз ва улуғ ўтмишдошларимиз амалий меросларини ўрганиб, халқ саломатлиги йўлида амалиётга киритиш учун “Халқ табобати“ Академиясининг ташкил қилиниши, Тиббиёт олийгоҳларида “Ҳалқ табобати” факультети очилиши, кафедраларда тиббий деонтология ва касб этикаси фанининг кенг ўқитилиши каби ҳолатлар киради
В статье рассматривается вопрос исследования относительных рельсовых цепей с комбинированным сопряжением, принцип работы и недостатки, которые решаются разработанным математическим моделированием.
The article considers urgent issues concerning the activity of the prosecutor on the pre-trial stage.
It is substantiated the importance of the optimization of the prosecutor’s supervision under preliminary investigation, which is consisted in obligatory agreement of the prosecu-
tor on the important procedural activities/
The article outlines the information about various visual technologies based on the principles of demonstration and their impact on the representational thought of pre-school learners. It also discusses the significance of the development of education of pre-school learners. Visual imaginative thinking emerges in the child when solving new demands and practical tasks. In this process, the child tries to know the truth and searches different options.
The history of language economy has a long tradition. It has been addressed by various thinkers, starting with Aristotle. Systematic study of the principle of economy in language should be associated with research in the field of phonetics and, above all, with the names of such linguists as H.Sweet, P.Passy, V.Whitney, who indicated the presence of two opposite trends in the language: the tendency to facilitate pronunciation and its opposite — the tendency to redundancy.
The article is devoted to the development of a mathematical model of the process of geometric nonlinear deformation of thin magnetoelastic plates of a complex structural shape based on the Hamilton-Ostrogradsky variational principle, and conducting computational experiments. In this case, the three-dimensional mathematical model was transferred to a two-dimensional view using the Kirchhoff-Liav hypothesis. Cauchy's relationship, Hooke's law, Lawrence's force and Maxwell's electromagnetic tensor were used to determine kinetic and potential energy and work done by external forces. The effects of the electromagnetic field on the deformation stress state of the magnetoelastic plate were observed, as a result, a mathematical model was created in the form of a system of differential differential equations with initial and boundary conditions for displacement. To solve the equation, a calculation algorithm was developed using the R-function, Bubnov-Galerkin, Newmark, Gaussian, Gaussian squares, and Iteration number methods. Calculation experiments were carried out in various mechanical states of the magneto-elastic plate, its borders were tightly fixed, one side was hinged and the other side was free, and numerical results were obtained. A comparative analysis of the results of the calculations was presented.
Питание является одной из важнейших составляющих здорового образа жизни человека, обеспечивает организм необходимой энергией. Рациональное питание студентов следует рассматривать как одну из главных составных частей профилактической медицины, как один из факторов здорового образа жизни молодежи. Возраст первокурсников относится к критическому периоду в жизни, что обусловлено наибольшей интенсивностью роста и развития, гормональной перестройкой организма, когда максимальны потребности в энергетических затратах. Организм человека подчиняется законам термодинамики. В соответствии, с чем различают один из принципов рационального питания: его энергетическая ценность должна соответствовать энергетическим затратам организма. К сожалению, на практике этот принцип часто нарушается. В связи с избыточным потреблением энергоемких продуктов (хлеб, картофель, животные жиры, сахар и др.) энергетическая ценность суточных рационов часто превышает энергетические затраты.
The article analyzed the theoretical and legal aspects of the principle of social justice in laws and other normative legal acts. Also mechanisms for organization lawmaking on the basis of constitutional principles were covered, proposals and recommendations aimed at improvement the quality and effectiveness of legislation have been developed.