No 4 (2016)

Dynamics of the content of biogenic amines in the structures of the acupuncture points of the skin at different times of the day is shown in article. Skin educations as epithelium, elastichesky fibers, the granular luminescing and corpulent cells of skin in the field of TR-20 acupuncture point at different times were for this purpose studied of days. Further, the statistical and correlation analysis of morphological and quantitative changes of catecholamines, serotonin, histamine and heparin in the skin structures is carried out.

The article is based on our clinical experience and modern tendencies of development of minimally invasive surgery. It contains analysis of percutaneus osteosynthesis of pelvic fractures with various metal fixation devices. We analyzed 74 cases of pelvic fractures in which minimally invasive osteosynthesis was used. The patients underwent operative treatment with cannulated screws and new metal fixation devices - CITO screws. The innovative technology showed its high clinical efficiency, its advantages and weak points were analyzed. The majority of pelvic ring injuries are life-threatening and are often accompanied by fractures of other parts of the skeleton and injuries of internal organs. High quality operative treatment of pelvic fractures is often limited by severe general condition of patients and the necessity of simultaneous operative treatment of internal organs and injured parts of musculoskeletal system. Thus, on the one hand, it is necessary to provide high quality fixation of pelvic bone fragments, on the other hand, it is important to reduce surgical aggression during osteosynthesis. The most serious conditions are pelvic ring fractures associated with acetabular fractures, when there is need for intracapsular acetabular fracture stabilization for successful pelvic functional recovery. Acetabular fractures still remain one of the most crucial issues of modern traumathology. Disability, low life quality, hip arthroplasty are the main sequences of inadequate treatment of such fractures. Conservative treatment results in disability in 22-66.7% cases, that is 3 times more frequent compared to the level of disability after operative treatment (1, 2, 3). Only operative treatment makes it possible to achieve successful longtime functional recovery (4). Open reduction with internal fixation is associated with large surgical incision, massive intraoperative blood loss and high risk of infectious complications. The main recognized condition for bone fracture consolidation is intact blood supply of fragments, that is provided only by minimal surgical invasion (5, 6, 7, 8). Thus, development and implementation of implants and minimally invasive methods of bone fragments stabilization are main innovative tendencies of internal osteosynthesis development. The aim of our research was to develop minimally invasive osteosynthesis technologies and to invent a new metal fixation device.

Polymyalgia rheumatica - a rare disease diagnosis is difficult in the absence of specific laboratory indicators, as well as from the similarity of the clinical picture of such diseases as bilateral humeroscapular nodosa, polymyositis, periarteritis nodosa, cancer, multiple myeloma. In some cases, with high fever, rheumatic polymyalgia necessary to differentiate from sepsis or tuberculosis; when the articular syndrome, brucellosis, toxoplasmosis, arthritis of the jaw joint, the jaw and facial neuralgia. In laboratory indicators - signs of inflammation. Quick response to treatment with prednisolone (within 2-3 days) confirms the diagnosis.

Among the main methods of examination of prostate cancer: finger rectal examination, PSA test, ultrasonography of prostate, none possesses enough specificity and sensitivity. In our research, we used special statistic and mathematic processing (multifactor analysis and binary logic regression) of main prostate cancer symptoms, which allows to suspect Prostate Cancer with 97% accuracy and also reduce the incidence of prostate biopsy. The article presents a clinical example of early diagnosis of prostate cancer.

This paper studied the biochemical and functional indices of myocardial fibrosis in patients with ischemic cardiomyopathy and atrial fibrillation. In the group of patients with ischemic cardiomyopathy with sinus rhythm, the level of transforming growth factor-β1, the ratios of matrix metalloproteinase-1 and its inhibitor and volume fraction of interstitial collagen were significantly higher than in patients with permanent form of atrial fibrillation in this group (P = 0.041, P = 0.045, P = 0,038, respectively), which suggests the presence of processes of fibrosis and collapse in the extracellular matrix, while in patients with atrial fibrillation there is a slight predominance towards the latter.This leads to electrical heterogeneity of the myocardium, the increase in the speed of wave propagation of excitation and activation of ectopy, creates favorable conditions for the occurrence of atrial fibrillation in these patients.

For optimal airway protection in early postoperative period after fossa posterior surgery (PFS) necessary prognosis of neurological dynamic through neurological exam before operation. We performed Neurological Evaluation Scale (NES). The aim of our study was research possibility NES to predict brain stem deterioration in early postoperative period after PFS It was a prospective study during. It included 182 patients operated for fossa posterior tumors (FPT). Including criteria were age elder 18 years, operation in fossa posterior non infiltrative paraxial tumors. We examined all pts. before and after operation immediately after extubation in ICU. NES provide complex neurological estimation with emphasis of brain stem function. NES points after operation were subtracted from points before operation - AB-criterion (ABc). Positive ABc correspond augmentation neurological impairment. Negative or zero ABc correspond neurological improvement. All neurological symptoms were grouped in 7 NES blocks in conformity their relation with CNS. We divided all pts. in two group by ABc and revealed, that pts with positive ABc has reliability less NES points before operation, than pts. with negative or zero ABc. We found frequency of occurrence of each of the NES blocks in full neurologic status. We reveal more frequency of involvement the caudal stem in pts. with more NES points. We evaluate probability impairment or regression neurological symptoms by ABc with sensitivity 90,7% and specificity 95%. We created prognostic model, which could predict outcome in discharge from clinic in terms on NES blocks in early postoperative period.

A comparative analysis of the quality of life of patients in the late postoperative period after hernia repair methods TAPP and TEP. To study the quality of life questionnaire SF-used 36.Na based study found that the quality of life of patients after hernia repair method TEP is higher than after TAPP.

On 16 Chinchilla rabbits males of breed with type 2 alloxan diabetes P-glycoprotein functional activity and expression was studied. The diabetes mellitus was modelled by intravenous administration of alloxan monohydrate in the citrate buffer. P-glycoprotein functional activity was assessed by pharmacokinetics of its probe substrate - fexofenadine after its single oral administration. P-glycoprotein expression was investigated by immunohistochemistry method. The inhibition of P-glycoprotein functional activity and expression was followed by decrease of postprandial insulin level and an insulinogenic index and increase of postprandial glucose level in a blood.

In article the questions connected with introduction in activity of State Healthcare Institution of the ISO-9001-2015 standard of quality management (SQM) are considered, examples of administrative processes, control methods and indicators of an assessment of efficiency are offered. The work results in the field of the standard of quality management, achievement of target indicators are summed also up and problems and risks which the medical organization when using faces in the two work of SMK are reflected.

Improver effectiveness of health care system is pretty much determined by professional competence of staff, it also depends upon staff policy. The aim of the study is to conduct a statistical analysis of medical and nursing staff, changes in its number.On the basis of official statistics (form of State Medical Statistics № 30) the authors conducted a specific characteristic of medical and nursing staff in the health care system of Russian Railways. Analysis of quantitative composition of staffrevealed to staffing in a medical organizations.

The fact that each management solution is made with the lack of information defines the risk of making a wrong decision. Such decisions made by competent specialists in individual agencies as well as networks of health authorities can produce a strong effect on lives and health of patients. It explains the increasing topicality for defining methods and means of making reasonable decisions. In the article based on the analysis of normative documents, scientific and methodical literatures, with the interaction of experts in health services, such methods and means are described, analyzed and systemized. The research showed that using of each alternative (analysis of regulatory documents, expert survey, clinical and economic analysis) has its own advantages and disadvantages. And it depends on the case which method will be the most reasonable to use.