Saratov JOURNAL of Medical and Scientific Research

2017, volume 13

Complex stimulation of peripheral nerve regeneration after deferred neurorrhaphy

Year: 2017, volume 13 Issue: №3 Pages: 732-737
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ivanov A.N., Korshunova G.A., Matveyeva O.V., Ninel V.G., Shutrov I.E., Shchanitsyn I.N., Andronova Т.А., Norkin I.A.
Organization: Saratov Regional Child Clinical Hospital, Saratov State Medical University
Summary:

The aim is to study the complex stimulation effect including skin autotransplantation and electrical stimulation of the sciatic nerve on microcircular, electrophysiological and morphological changes after deferred neurorrhaphy in rats. Material and methods. The experiment was performed in 50 albino rats divided into control, comparative and experimental groups. In the experimental group, on the background of deferred neurorrhaphy, skin autotransplantation and electrical stimulation of the sciatic nerve had been carried out. In the comparative group only deferred neurorrhaphy was performed. Research methods included laser doppler flowmetry, electroneuromyography and morphological analysis of the operated nerve. Results. Complex stimulation including skin autotransplantation and direct action of electrical pulses on the sciatic nerve after its deferred neurorrhaphy causes restoration of bloodstream in the operated limb, promotes intensification of restoration of nerve fibers. Conclusion. Intensification of sciatic nerve regeneration after deferred neurorrhaphy in rats under the influence of complex stimulation including full-thickness skin graft autotransplantation and direct action of electrical pulses substantiates experimentally appropriateness of clinical testing of the given method for treatment of patients with peripheral nerve injuries.

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Treatment of bone defects of tibia edge during external anchorage of fragments

Year: 2017, volume 13 Issue: №3 Pages: 727-731
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Grazhdanov К.А., Barabash А.Р., Barabash Yu.A., Rusanov A.G., Kauts O.A.
Organization:
Summary:

The aim: to identify the efficiency of the improved technology of treatment of tibia marginal defects with the use of granular composite osteoplastic materials during external fixation of fragments. Material and Methods. The observation group was made up of 12 patients with the consequences of lower extremity traumas who had undergone osteosyn-thesis of fractures by an external fixation device with defect alloplasty We used clinical and ray-tracing testing methods and also standardized system of assessment of outcomes of bone fractures and their consequences to control the processes of restoration of bone structure integrity. Results. According to the standardized system of assessment of outcomes in 12-18 months in the course of the rehabilitation measures degree of restoration of anatomic functional indices was 92±5%. Bone density made up 91,3±0,54 HU (p<0,05) before surgery according to the Hounsfield scale, increase in the given parameter was observed in a month and a half after surgery up to 153,1 ±0,97 HU and in 3 months up to 162,7±0,78 HU. Conclusion. Application of granular composite osteoplastic materials for plastic surgery of tibia marginal defects during external fixation of fragments allow us to carry out anatomic reconstruction of the bone reducing surgery injury rate based on the absence of necessity of taking autogenous tissues from the other zones.

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The peculiarities of bone and cartilage tissue remodeling in patients after hip joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 723-727
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Gladkova Е.М., Karyakina E.V., Tsareva Е.Е., Persova Е.А., Belova S.V.
Organization:
Summary:

The aim: to study the peculiarities of structural and metabolic state of bone and cartilage tissue in patients in the first 12 months after total hip replacement with respect to their immune state and lipid peroxidation activity. Material and Methods. Significant laboratory predictors of initial signs of aseptic instability were singled out allowing estimating the peculiarities of bone tissue remodeling as well as humoral and cellular immunity state. Results. The obtained results demonstrated that impairments in T-lymphocyte system in patients with initial signs of aseptic instability of en-doprosthesis were accompanied by reduction of its total number (CD3+), among that due to the population of cytotoxic (CD3+CD8+) cells with simultaneous increase of T-helpers (CD3+CD4+) number. Activation of serum proosteoclasto-genic factors (TNF-a and IL-1(3) was noticed on the background of anti-inflammatory humoral immunity failure (IL-10). Conclusion. The estimation of cellular immunity state, content of pro- and anti-inflammatory cytokines in blood serum combined with the bone tissue state markers and indexes of lipid peroxidation and antioxidant system as well as dual-energy absorptiometry allows identifying patients with high risk of further development of aseptic instability in hip joint implant in the period of up to 12 months postsurgically which can be useful while planning prevention management of implant or its components instability.

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Neurospecific proteins as markers of nervous tissue regeneration in focal cerebral contusions

Year: 2017, volume 13 Issue: №3 Pages: 720-722
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Galashina Е.А., Ulyanov V.Yu., Vygodchikova G.Yu., Chibrikova Yu.A., Klimov S.S.
Organization: Saratov State Medical University
Summary:

The aim: to study the dynamics of immunological markers of nervous tissue regeneration in patients with focal cerebral contusions in posttraumatic period. Material and Methods. Quantitative content of human NRG1-beta1, GFAP and anti-SGPG in patients with focal cerebral contusions was analyzed on the 1st-4th, 7th, 14th, 21st and 30th day post-injury, and one time only — in patients of control group. Results. In patients with focal cerebral contusions the content of NRG-1beta1 was characterized by two-phase increase on the 7th and 21st day, GFAP — on the 14th day, anti-SGPG — on the 21st and 30th day compared to the patients of control group. Conclusion. Functional restoration of the brain in cerebral focal contusions in the posttraumatic period is based on the significantly intensified axon and peripheral nervous fiber regeneration processes with intercellular structure regeneration being less intensified. The degree and direction of these processes is predicated upon the dynamics of immunocytochemical markers.

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Prognostic opportunities for infectious inflammatory complications in primary endoprosthesis of large joints

Year: 2017, volume 13 Issue: №3 Pages: 715-719
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Belova S.V., Mamonova I.A., Puchinyan D.M., Babushkina I.V., Gladkova E.M., Adilov R.G.
Organization: Saratov State Medical University
Summary:

The aim: to study prognostic and diagnostic opportunities for infectious inflammatory complications of primary endoprosthesis of hip and knee joints on the basis of cellular immunity indices. Material and Methods. 174 patients with large joint osteoarthrosis aged 61 ±13 yrs which had undergone total joint replacement were enrolled into the study. The experimental group consisted of 22 patients with infectious inflammatory complications emerging from 6 up to 12 months postsurgically. The comparison group included 152 patients with favorable postsurgical period. We carried out WBC differentiation by subpopulations (lymphocytes, monocytes, granulocytes) and their immunophenotyping. 40 conventionally healthy individuals comprised the control group. The outcomes were estimated using the worked-out score system. Results. In patients with favorable postsurgical period total value of indices equaled not more than 4-6 points. In all the other cases the risk of infectious inflammatory complications is significantly higher and reaches its maximal values in patients with 10-12 points. Conclusion. The assessment of laboratory indices reflecting immune response of the body allows estimating the risk of infectious inflammatory postsurgical complications and diagnosing them in III grade large joint osteoarthorisis patients after total replacement.

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Comparative retro- and prospective analysis of treatment outcomes in patients with SCI and cervical spine injuries in acute and early periods of traumatic disease

Year: 2017, volume 13 Issue: №3 Pages: 710-715
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bazhanov S.P., Ulyanov V.Yu., Chibrikova Yu.A., Biryukova A.V., Norkin I.A., Gulyaev D.A., Salihu H.
Organization: Almazov National Medical Research Centre, Saratov State Medical University
Summary:

The aim: to conduct comparative retro- and prospective study of treatment outcomes in patients with cervical spine and SC injuries on the basis of assessment scale analysis. Material and Methods. 217 patients with closed cervical spine and SC injuries commeasurable by age, degree of neurological deficit, acute physiological and chronic state disorders were enrolled into the study. 177 patients comprised the main group (prospective study) and 40 — comparison group (retrospective study). To compare treatment outcomes we used Karnofsky score (Karnofsky, 1949), a quantitative assessment score for general patient status scales, APACHE II, Acute Physiology and Chronic State Evaluations (Knaus — Draper, 1985) and SCIM II, Spinal Cord Independence Measure Scale. Results. Comparative analysis based on the quantitative values of assessment scales, indicates an improvement of short-term treatment outcomes in patients with SC and cervical spine injuries in the main group. Conclusion. Complex approach to differentiated surgical treatment management and unique neuroprotection methods significantly improves short-term treatment outcomes having positive effect on general patient status, severity of acute physiological and chronic state disorders and patients' independence in the post-surgical period.

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Comparative study of complex powdery preparations for soft tissue regeneration

Year: 2017, volume 13 Issue: №3 Pages: 705-710
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Gladkova Е.М., Mamonova I.A., Belova S.V.
Organization:
Summary:

The aim: comparative study of regenerative activity of powdery preparations for local treatment of soft tissue injuries developed from copper and silver nanoparticles in comparison with traditional powders containing antibiotics within the conditions of an experimental conditionally aseptic wound. Material and Methods. The investigation was carried out on 80 albino rats with an experimental conditionally aseptic wound. Copper and silver nanoparticles obtained by the plasma-chemical method, sterile starch, zinc oxide, Baneocin were used. Planimetric and bacteriological research methods were applied. Results. Treatment with the developed preparations in comparison with the traditional ones containing antibiotics supplied more effective course of reparative processes as evidenced by the data of the planimetric indices. Conclusion. Besides the developed preparations due to the evident antibacterial action supplied reliable prevention of the secondary infection which is a compulsory condition for the course of reparative regeneration processes. The use of metal nanoparticles for this purpose allowed to prevent the adverse reactions which are characteristic of similar preparations containing antibiotics.

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Professor A.G. Ge —the founder of Kazan school of dermatologists and venereologists (to the 175th anniversary)

Summary:

The article is devoted to medical, scientific, pedagogical and public activities of A. G. Ge -professor of Imperial Kazan University, the prominent scientist dermatologist and venereologist of the end of the 19th and the beginning of the 20th centuries, the founder of the Department of Skin and Venereal Diseases and Kazan school of dermatologists and venereologists.

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Purpose and methods of teaching dermatovenereology to students of the medical university

Year: 2017, volume 13 Issue: №3 Pages: 686-688
Heading: Dermatovenerology Article type: Short message
Authors: Utz S.R., Slesarenko N.A., Eremina M.G., Eremin A.V., Utz I.A.
Organization: Saratov State Medical University
Summary:

 Higher education is based on the assimilation of theoretical knowledge acquired in the process of teaching, practical skills and the development of intellectual abilities leading to self-development and creative thinking. The ultimate goal of education is the education of the student's need for cognitive activity, the result of which will be competence in the profession, the ability to think in the terms of the dermatovenereology subject materials and the khowledge of it.

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R. Willan founder of the world scientific dermatology

Year: 2017, volume 13 Issue: №3 Pages: 681-685
Heading: Dermatovenerology Article type: Short message
Authors: Betechtin M.S., Zavyalov A.I.
Organization: Moscow State Medical Stomatological University n.a. A. I. Evdokimov, Saratov State Medical University
Summary:

 The article presents the biography of R. Willan ar|d his scientific and practical contribution to the development of European clinical medicine in the second half of the 18 century and in the establishment of world scientific dermatology.

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