We examined 43 patients with breast cancer, who, as in the previous group, underwent percutaneous transhepatic cholecystostomy, however, the bile separated through the external drainage was preliminarily purified from toxic and ballast substances using the Lignov sorbent. Subsequently, the patients took it orally.
In the first group of patients, the concentration of IL-6 in the blood serum prior to the application of percutaneous transhepatic cholecystostomy was higher than normal, averaging 152.65±16.3 pg/ml. Immediately after the application of percutaneous transhepatic cholecystostomy in bile, this indicator averaged 68.58±7.24 pg / ml. At the end of the observation, the decrease in the level of IL-6 in the blood compared to the initial one was 64.4%, and in bile-54.3 (P<0.001). In the second group of patients, after the application of percutaneous transhepatic cholecystostomy, the concentration of IL-6 in the blood serum averaged 151.52±14.2 pg / ml, and in bile - 67.43±9.14 pg/ml. The initially high concentration of IL-6 in the blood and bile after bile absorption decreased by 75.7% (36.81±4.4 pg /ml) and 73.9% (17.57±2.2 pg/ml), respectively, from the initial level. The inclusion of bile absorption in the therapeutic complex significantly changed the concentration of IL-6 in blood serum (P<0.01) and bile.
The dynamics of parameters in blood serum and bile in patients of this group indicates a significant efficiency of bile absorption. Initially high indicators of endotoxicosis, such as SMP, TNF-α, IL-6 and bilirubin, were removed from the body by bile absorption, which made it possible to remove toxic substances from the body. The study of SMPs in blood serum and bile in patients of the main group revealed a more accelerated elimination of them with bile than in the control group. An increase in the concentration of SMP in bile was accompanied by a decrease in it in the blood serum.
Objects of research: 1st group (control) - 8 dogs, which apply traditional intensive therapy at craniocereberal trauma without hypothermia. 2 st group - 8 dogs, which apply drug treatment with external craniocerebral hypothermia. 3 st group -8 dogs, which apply drug treatment with perfusion method of hypothermia. At 286 patients with heavy craniocerebral trauma, efficiency hyperventilation on a background of various methods CCH is investigated depending on type of infringement of a cerebral blood flow.
Purpose: to optimize results of protection and reanimation of a brain at a severe craniocereberal trauma by perfection of a method craniocerebral hypothermia and the differentiated choice of a mode of artificial ventilation easy.
Methods: the cerebral blood flow parameters estimated by transcranial Dop-plcrography datas. Also was definite saturation of arterial (SataO2) and venous (SaI. vjO2) blood oxygen, cerebral blood flow (arteriovenous difference O2), a level of lactate in peripheral blood and in liquor, parameters of intensity.
Results and novelty: by complex study was proved that perfusion method of the craniocerebral hypothermia is an effective and adequate method of protection of a brain caused by hypoxia and secondary damages at severe craniocerebral trauma. It is established, that at carrying out perfusion CCH the important factor of protection of a brain from hypoxia and secondary damages to which the death of animals at severe craniocerebral trauma, is preservation on a limit of physiological norm of functioning erythrocytes owing to adaptable decrease in processes the lipid peroxidation, preservation at high enough level of activity of enzymes antioxidant system, reactions peroxide hemolysis erythrocytes and which can serve as criteria of an estimation of the forecast of efficiency of spent treatment, an outcome of disease.
Practical value: it is developed and pathogenetic efficiency of a perfusion method of the CCH is proved at severe craniocerebral trauma. The algorithm of differential use hyperventilation at patients with severe craniocerebral trauma is developed depending on type of cerebral blood supply disturbance and a degree of development intracranial hypertension.
Inclusion of a method perfusion method of the CCH increase efficiency of protection of a brain from hypoxia and secondary damages reduces frequency of lethal outcomes at severe craniocerebral trauma.
Introduction and economic efficiency: results of research are introduced in practice of the Republican science centre of neurosurgery Health Ministry of the Republic of Uzbekistan and department of anesthesiology and resuscitation of 2-clinic of the Tashkent medical academy.
Field of application: resuscitation and neurosurgery.
At present, the cerebral circulation disorder is caused by various factors. According to the Ministry of Health of the Republic of Uzbekistan, 62876 cases of strokes were registered in Uzbekistan in 2019. 15% acquired lethal outcome, 10-15% returned to their previous state, 55 - 70% became disabled. Stroke is translated from the Latin language as a "stroke" which means an acute cerebral circulation disorder. Regardless of the cause of cerebral circulation disorder, the result is always the same - the death of brain neurons. The most common cause is atherosclerosis on the inner walls of blood vessels that supply the brain. They narrow the blood vessels and make them less flexible. In this case, the probability of clogging the blood vessels with blood clots increases, as a result, the blood vessels cannot supply blood to the brain.
The effect of sulfated polysaccharides on the hemostatic system in conditions in vitro. Platelet-rich plasma was obtained by centrifugation at 200 g for 10 minutes. The remaining citrate blood was further centrifuged at 1500 g for 10 min to obtain platelet-poor plasma. The antithrombin activity of the compounds was evaluated in vitro by their effect on the recalcification time, thrombin, and prothrombin time of human blood plasma stabilized with a 3.8% sodium citrate solution in the ratio of 9:1. In studies conducted on the blood plasma of rats, it was found that the studied compounds, to varying degrees, lengthen the APTT, APTT, prothrombin time. At the same time, anticoagulant activity was established to block one of the factors II, V, X. Polysaccharide exhibit a combined anticoagulant effect in the body, due to which they are classified as anticoagulant and antithrombin agents.
Purpose of the study: to study some biochemical parameters of mesenchymal-inflammatory and hypercoagulable syndromes in patients with liver damage who underwent SARS-COV2 infection.
Materials and research methods. 243 patients who had COVID-19 at the age of 18-60 were under observation. Inclusion criteria in the study were: transferred no earlier than 10 days prior to entry into the COVID-19 study; at the time of inclusion in the study PCR-negative COVID-19, negative PCR and markers of replication of hepatitis viruses. As a control group (CG), 20 healthy volunteers were examined. Enzymes were determined in the blood serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl aminotransferase (GGT), lactate dehydrogenase (LDH), alkaline phosphatase (AP), total and direct bilirubin, albumin, ferritin, C reactive protein and complete blood count.
Research results The activity of blood liver enzymes in patients who underwent COVID-19 was significantly increased compared to CG: ALT exceeded the average values in CG by almost 10 times, AST = almost 3 times, LDH - 3 times, GGT and ALP - almost 1 .5 times. The level of bilirubin in the CG was significantly higher (p<0.001). The concentration of albumin in the peripheral blood of patients was reduced (p<0.001 significance of the difference from CG). The level of hemoglobin and erythrocytes in peripheral blood was significantly lower than in the CG (p<0.001 and p<0.05). The platelet count was reduced (p<0.001 significant difference from CG). The ESR and CRP concentrations were significantly increased compared with the CG (p<0.001 significance for both indicators).
Conclusion
In patients who have undergone COVID-19, functional changes in the liver are noted, characterized by cytolytic, cholestatic syndrome, and a decrease in protein-synthesizing function. Also, these patients have signs of redistributive anemia and sideropenia, thrombocytopenia, and persistent activity of mesenchymal-inflammatory and coagulopathic syndromes. ALT activity significantly positively correlates with the activity of systemic inflammation and hypercoagulability indices.
The study involved 76 patients with children (46 boys and 30 girls) aged from 9 to 15 years, 34 of them - with allergic conjunctivitis and rhinosinusitis, 24 - with chronic recurrent obstructive bronchitis (preasthma), 18 - with asthma. Duration of illness ranged from a few months to 5 years examination. To clarify the rheological properties of blood there were determined electrical breakdown of the membrane, the electrophoretic mobility, the zeta potential of the membrane of erythrocytes and blood viscosity. The extent and intensity of the rheological properties of blood disorders in association with other clinical and laboratory data has prognostic significance in the development of respiratory allergies in children.
The goal was to assess the microbial landscape of peripheral blood and peritoneal fluid of laboratory animals in experimental intestinal obstruction. It was found that in the case of experimental obstruction of the small and large intestines, few microorganisms were sown in the peripheral blood, and there were no noticeable changes in the microbial landscape depending on the time of obturation. In both models, microorganisms were seeded in the peritoneal fluid by an order of magnitude greater than in the blood, and the microbial landscape was diverse.
Viral hepatitis (VH) belongs to the category of infectious diseases of the human body that develop under the influence of viruses, which are diverse in nature, in the ways of their spread and transmission from a patient to a healthy person and have one identical attribute - liver damage. VG is an atroponous infection, which means that their pathogens in natural conditions can only be present in the human body.
In hepatitis of viral origin, pathogens have a selective similarity (tropism) to liver cells. For this reason, the early location of viruses and their replication (reproduction) are manifested mainly in the liver tissue, primarily in liver cells (hepatocytes).
According to the nature and duration of development, hepatitis of viral origin is divided into acute and chronic. The threshold among these two types of disease is relatively taken into account 6 months from the onset of the disease or in certain patients from the onset of infection (if the disease does not develop) and up to 6 months - acute hepatitis B or acute virus carrier, after 6 months - chronic hepatitis or chronic virus carrier. [4; 8].
According to WHO, in different countries of the world more than 2 billion people are infected with viral hepatitis (VH), while about 350 million are carriers of hepatitis B and 500 million of hepatitis C [3; 5].
All known hepatitis viruses are present in the CIS countries. In relation to parenteral infections of viral hepatitis, the CIS countries belong to the region with a moderate incidence rate (35.2 cases per 100,000 people). In Tatarstan, the share of viral hepatitis "B" and "C" in the total number of viral hepatitis is 80%. According to some authors [1], the number of so-called "virus carriers" of infection is growing in our republic, more than 10,000-12,000 primary carriers of hepatitis B and C viruses are registered annually. However, the registered incidence is only a part of the true incidence and only the visible part of the "iceberg". This is due to the fact that most cases of hepatitis B occur outside the scope of medical diagnosis, without jaundice and with minor clinical symptoms. However, the anicteric form of parenteral hepatitis is less dangerous than the icteric form in terms of infection and consequences [10].
Viral hepatitis B and C belong to the group of viral hepatitis with a parenteral transmission mechanism. These pathogenic viruses are taxonomically distinct. Common features are the parenteral transmission mechanism and the obligatory circulation of the virus in the blood [7].
Viral hepatitis B is a strictly parenteral infection caused by the IIBV virus, including CMV; IIBV is highly resistant to cold, heat, chemical and physical attack. It persists for 3 months at room temperature and 25 years in dried plasma; a direct correlation has been demonstrated between IIBV duration and blood levels. [6].
The source of transmission of the virus (HBV) can be all forms of acute and chronic HBV, as well as virus carriers. More important as the main source of infection for the epidemic potential are chronic forms of HBV infection than acute ones. An important role is played by chronic carriers of HbsAg and patients with clinically icteric form of IIBV; the ability of IIBV to persist for a long time, often for life, in the human body is considered as an ecological form of its existence [3; 5].
The most fully studied artificial (artifacial) ways of HBV infection as a result of various parenteral therapeutic, diagnostic, therapeutic and non-medical manipulations, leading to a violation of the integrity of the mucous membranes and skin. The source of infection can be contaminated blood products, medical equipment and instruments, transplanted organs and tissues; transfusion of blood or blood products containing HBV can also cause infection (post-transfusion hepatitis) [8; 11].
In addition to medical procedures, non-medical parenteral injections are of paramount importance in the transmission of IIBV infections. This is especially true of intravenous administration of drugs, which has become widespread in recent years. According to a number of authors [2], it has been shown that in recent years there has been a rapid increase in the number of patients with acute viral hepatitis "B", which is associated with the use of intravenous drugs, and a quantitative increase in the incidence is observed among young men aged 15 to 30 years. . Below is a list of the most common causes of acute viral hepatitis B.
The purpose of this study is to substantiate the functional features of periodontal tissues in chronic hepatitis B, C and mixed infection B + C.
Subject of the inquiry: rabbits, visceral-ischemic shock, metabolism, mitochondria, suktsinasol, suktsivil.
Aim of the inquiry: to study effect of new hemocorrectors such as suktsinasol and suktsivil on the basic pathogenetic mechanisms of visceral-ischemic shock.
Methods of inquiry: physiological, biochemical, biophysical, statistical.
The results achieved and their novelty: A complete evaluation of indices in hemodynamics is given in VIS including AAB and toxemia, functional changes in liver, indices of carbohydrate-phosphoric metabolism. A number of research methods have been studied which gave the opportunity to have a distinct understanding about metabolic status of the organism. Efficiency of a new polyfunctional hemocorrection - suktsinasol on hemodynamic and metabolic indices of VIS have been studied for the first time. The effect of a new polyfunctional hemocorrector Suktsivil on the hemodynamical and metabolic indices of VIS have been studied. A comparative analysis of effective blood substitutes during infusion for VIS in experiment has been carried out.
Practical value: We have determined hypothesis about disorder of energetic metabolism in liver cells in VIS. We have proved efficiency of using new complex blood substitutes sulktsinasol and suktsivil as supply of rich energetic compounds (sulktsinasol) and corrector of electronic and transport function of mitochondria in liver in emergency complicated by hypoxia and toxemia.
Degree of embed and economical efficiency: Obtained results concerning effective new substitutes suktsinasol and sukrsivil for VIS can be recommended for combined treatment of VIS in medicine new blood substitutes can restore hemodynamics, acid-alkaline balance, metabolism, reduce toxemia.
Sphere of usage: medicine.
Currently, the most effective method of treating chronic purulent middle otitis is tympanoplasty surgery. In our clinic, the introduction of laser radiation into the vein is used to improve the effectiveness of tympanoplasty. With the help of the method of irradiation of blood in the vein to the reparative processes of blood in the postoperative area, the increase in microcirculation of the mucous membrane under the influence of laser irradiation of blood was studied.
To study the characteristic features of the cellular composition of blood in patients with acute purulent odontogenic ostitis of the jaw. Material and methods: The data obtained during the examination and treatment of 42 patients with acute purulent odontogenic ostitis at the age of 7 to 9 years, who applied to the TGSI clinic, were studied. Results: In the patients, the indices of the red part of the blood were significantly lower than in the comparison group. A low level of hemoglobin can cause hemic tissue hypoxia and affect the state of the acid-base state of the blood, expressed in the form of acidosis, which activates anaerobic glycolysis. An increase in the level of lactic acid in cells can be one of the reasons for the disruption of local microcirculationand the accumulation of endogenous toxins. Conclusions: This pathology is accompanied by a shift in the indicators of the white part of the blood, the observed hemic hypoxia leads to an increase in the level of lactic acid in the cells, which may be one of the reasons for the disruption of local microcirculation and the accumulation of endogenous toxins.