[Features of surgical patients of COVID-19 patients]. / Osobennosti khirurgicheskogo lecheniya bol'nykh COVID-19.

The novel coronavirus pandemic has significantly increased the workload of surgical service worldwide. Restrictive measures led to postponement of elective surgical and diagnostic interventions and reduced the number of emergency manipulations around the world. Large-scale studies identified optimal period for postponing surgical procedures and advisability of this postponement. The authors present opinions of surgeons and their views on treatment strategy for various elective and emergency surgical interventions in abdominal surgery, traumatology-orthopedics and oncology. The main factors reducing perioperative mortality in patients with a new coronavirus infection are observance of anti-epidemic measures by patients and medical personnel, competent use of personal protective equipment, as well as adherence to protocols and algorithms for the treatment of these patients.

[Liver regeneration: resolved and problem issues]. / Regeneratsiya pecheni: reshennye i problemnye voprosy (Soobshchenie 2).

Liver is an exceptional organ due to unique anatomical and physiological features, as well as advanced regenerative ability. Discovery of molecular mechanisms governing liver regeneration allowed researchers to use them to enhance liver regeneration. However, significant progress in this area was achieved through the introduction of gene therapy. In this manuscript, the authors consider stem cells for cell therapy and tissue engineering, as well as an alternative to liver transplantation.

[Liver regeneration: solved and problem issues]. / Regeneratsiya pecheni: reshennye i problemnye voprosy (soobshchenie 1).

It is known that liver is able to restore own dimensions and functional properties in response to various injuries. Despite extensive injuries, liver can preserve functional activity. Analysis of liver regeneration mechanisms allowed us to obtain significant results in the treatment of hepatitis, cirrhosis and liver failure. Liver regeneration processes substantiate the development of hepatocellular cancer following cirrhosis. Modern experimental and clinical data on liver regeneration, as well as current methods of stimulating this process are summarized in the manuscript. Despite significant advances in this issue, there are still many questions in scientific understanding of liver regeneration.

[Acute appendicitis within the strangulated femoral hernia]. / Sluchai ostrogo appenditsita v ushchemlennoi bedrennoi gryzhe.

Femoral hernia strangulation is usually observed in middle-aged women. There are few case reports of appendix strangulation in the femoral hernia. Acute appendicitis in a strangulated femoral hernia is relatively rare (0.4% of cases). Clinical case of acute destructive appendicitis within a strangulated femoral hernia in an elderly woman is reported in the article. If there is doubt about the urgency of surgical intervention, surgeon needs to take a proactive stance and lean toward emergency surgery. Surgeon should be aware of possible strangulation-associated destructive appendicitis due to injury of the appendix.

[Various endoscopic transpapilary interventions for choledocholithiasis]. / Otsenka éffektivnosti razlichnykh éndoskopicheskikh transpapilliarnykh vmeshatel'stv po povodu krupnogo kholedokholitiaza.

AIM: To evaluate the efficacy of the most common endoscopic transpapillary interventions for choledocholithiasis in randomized controlled trial. MATERIAL AND METHODS: There were 90 patients with choledocholithiasis who were randomized into 3 groups: main, clinical comparison 1, clinical comparison 2. In the main group A (n=30), patients underwent endoscopic partial papillosphincterotomy combined with balloon dilatation, in the group of clinical comparison 1 (n=30) - endoscopic papillosphincterotomy, in the group of clinical comparison 2 (n=30) - endoscopic papillosphincterotomy with mechanical lithotripsy. RESULTS: The greatest number of complications (38%) was observed in the group of clinical comparison 2. Less morbidity was noted in the group of clinical comparison 1 (19%). Minimum number of complications was observed in the main group (6%). Acute pancreatitis was diagnosed in groups of clinical comparison 1 and 2 as a rule, whereas only 3% of patients had this complication in the main group. Cholangitis was predominantly observed in the group of clinical comparison 2, in other groups this complication occurred in 3% of patients. Bleeding was observed only in the groups of clinical comparison 1 and 2 (10 and 13%, respectively). Loss of the lithotripter rope (3%) was detected only in the group of clinical comparison 2. CONCLUSION: Endoscopic partial papillosphincterotomy with balloon dilatation is advisable for choledocholithiasis due to minimal risk of intra- and postoperative complications.

[THE PHARMACOTHERAPEUTIC EFFICIENCY OF CYTOFLAVIN IN PATIENTS WITH DIABETIC FOOT SYNDROME: IMMEDIATE AND LONG-TERM RESULTS].

Immediate and long-term results of parenteral and oral administration of cytoflavin to patients with diabetic foot complicated by grade I and II trophic ulcers (Wagner classification) are considered with special reference to the assessment of reparative processes, normalization of the serum pro oxidant-antioxidant system, and improvement of clinical and instrumental bloodflow characteristics.

[Syndrome of diabetic foot: modern diagnostic methods].

We summarize the literature data on diagnostics of diabetic foot syndrome including clinical examination and special invasive and non-invasive studies of the vascular system. The main methods are ultrasound dopplerography, X-ray contrast angiography, and ultrasound duplex scanning. Special attention is given to instrumental diagnostics of diabetic neuropathies. The golden standard for the evaluation of the function of the peripheral nervous system is electroneuromyography. Methods for the study of diabetic foot complications, such as osteoarthropathy and trophic ulcers, are discussed.

[Certain aspects of therapy of acute hepatic insufficiency].

The author analysed and summarized available information on acute hepatic insufficiency (AHI) with reference to its diagnostics and treatment. The principal cause of AHI is hepatitis and alcohol-induced lesions in the liver, the main pathogenetic mechanisms are hepatocyte necrosis, apoptosis, and necrapoptosis, clinical manifestations include jaundice, coagulopathy and hepatic encephalopathy. Special emphasis is laid on the role of cytokines. Liver transplantation is the sole radical method for the treatment of AHI despite a variety of other therapeutic modalities. Positive effect of efferent and gravitational treatment is confirmed Survival in AHI depends on the regenerative potential of the liver. Prognosis of AHI is individual even though many scales and criteria were proposed.

[Traumatic diaphragmatic hernia].

Historical and statistical data on traumatic diaphragmatic hernias are presented. It was shown that frequency of occurrence of the pathology in question was dependent on principal causes of its development, anatomic features of diaphragmatic hernias and mechanisms of damage of the diaphragm. In the article the author notes that the worsening of criminogenic situation, increased number of road and traffic accidents were principal causes of the development of diaphragmatic hernias. Special place in the review is given to strangulated diaphragmatic hernias. The basic diagnostic methods for this pathology are radiological investigation, computed tomography and ultrasonic scanning. In addition, the methods of treatment, prognosis of the development of diaphragmatic hernias, complications included, are presented.

[Acute pleural empyema: modern methods of treatment].

The prinicipal methods (conservative, surgical, parasurgical) for the treatment of acute pleural empyema are discussed with special reference to antibacterial and immunotherapy and surgical operations.

[Diabetic foot syndrome: modern approaches to its treatment].

Recent data on the results of treatment of diabetic foot syndrome are reported with special reference to its conservative therapy, surgical and endovascular methods. Modern dressing materials are described.

Experimental xenotransplantation hepatocytes in correction of hepatic insufficiency / Монголын Анагаах Ухаан

In article on a sufficient experimental material efficiency xenotransplantation hepatocytes in correction of hepatic insufficiency after a resection of a liver is proved. Xenotransplantation hepatocytes improves proteinsynthetic function of a liver, reduces activity cytolisis, normalizes parameters of a hemostasis, and also positively influences activity of regeneration of a liver. The estimation of regeneration was made on the basis of research of weight of a liver and a spleen. The most effective in correction postresection hepatic failure is xenotransplantation cryoconservated isolated hepatocytes in a spleen.

Clinical and experimental study of apoptosis, necrosis and regeneration of hepatocitis in patients with hepatopathy / Монголын Анагаах Ухаан

Apoptosis the programmed death of a cell represents the biological and physiological process proceeding on type morphogenesis, directed on restriction of the immune answer. Apoptosis is important pathophysiology the mechanism of damage of a cell. He is shown at some illnesses and pathological processes in a liver, for example, at virus defeats, tumors’, inflammatory diseases, toxic defeats, metabolic dysfunctions, hepatic insufficiency. The functional deficiency caused by reduction of quantity of a fabric of a liver or destruction of cells, causes proliferative processes which, finally, result in restoration of hepatic functions.The understanding of mechanisms apoptosis will promote perfection of studying of illnesses of a liver at the person.

[Hemodynamic and immunologic criteria of assessment of functional reserve of the liver].

Results of examination of 233 patients with hepatic tumors provided new criteria of the patients' selection for extended hepatic resections. Correlation between the degree of affection of porto-hepatic hemodynamics and the risk of hepatic failure was found. It is also demonstrated that an increase in the diameter of hepatic tumor leads to a decrease in the main hemodynamic parameters in the portal vein. The level of proinflammatory cytokines may be regarded not only as an indicator of tissue alteration but also as a significant prognostic criterion.

[Transplantation of isolated hepatocytes in hepatic failure]. / Sovremennoe sostoianie problemy transplantatsii izolirovannykh hepatotsitov pri pechenochnoi nedostatochnosti.

The authors review achievements in the field of prophylaxis and treatment of acute liver failure with donor's allo- and xenogenic isolated hepatocytes. Present-day clinical and experimental data on transplantation of hepatocytes evidence for their ability to produce a detoxicating action, to restore the lost functions of the affected part of the liver, to prevent death of hepatocytes caused by ischemia, to activate regeneration. This method is easy to conduct and obtained cells from one donor can by used for many recepients. Problems in transplantation of isolated hepatocytes are shown. Factors stimulating hepatocyte regeneration are mentioned with a special focus on hepatocyte growth factor having the most potent mitogenic effect.