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Background. The incidence of liver malignancies is increasing, radical surgery can be performed in a small number of patients, most of them receive drug treatment. Isolated liver chemoperfusion (ILP) is a method of regional chemotherapy that is effective for some metastases but has a high complexity and frequency of complications. An improved method of hybrid ILP may offer new opportunities for patients with unresectable liver tumors. Case report. A 64-year-old patient diagnosed with stage IV sigmoid colon cancer underwent hybrid ILP. The patient was discharged after 6 days in a satisfactory condition without complications. Systemic chemotherapy was performed 21 days after the first hybrid chemoperfusion. The second hybrid chemoperfusion procedure was performed without the laparotomy stage, mobilizing the right common femoral vein and artery. As a result of the chemotherapy, the patients received a positive result on the mRECIST scale – a complete tumor response. Conclusion. The developed method of hybrid ILP has several advantages over traditional ILP and chemosaturation with infusion into the hepatic artery. This method can also be performed repeatedly, which is not possible with traditional ILP.

For the treatment of patients with severe multysistem pelvic trauma accompanied by pelvic bleeding, many algorithms have been proposed that have different procedures for the use of various methods of surgical hemostasis, but none of them may guarantee the complete arrest of pelvic bleeding. The purpose of this study was to estimate clinical efficacy and developed algorithm, aimed at timely diagnosis of intrapelvic bleeding and its complete arrest with the help of different methods of surgical hemostasis in patients with severe concomitant injury of the pelvis. The article analyzes the results of treatment of 168 patients with unstable pelvic ring injuries and signs of intrapelvic bleeding, who were treated in two trauma centers of the first level in St. Petersburg: I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine and Military Surgery Clinic of S.M. Kirov Military Medical Academy in 2010-2018. The victims were divided into two statistically homogeneous groups. In the comparison group (75 people), the pelvic ring was mechanically stabilized with the Ganz C-clamp or the anterior part of the pelvis was fixed with an external fixation device (EFD), and the arrest of the ongoing pelvic bleeding was expected due to occur due to the effect of biological tamponade. In the main group (93 people), after mechanical stabilization of the pelvic ring, various methods of surgical hemostasis were used: balloon occlusion of the aorta, pelvic tamponade, angiography with embolization. The choice of method for surgical haemostasis after trauma depended on the severity of the affected condition of hemodynamic parameters, availability of life-threatening consequences of damage to other areas of the body and the efficacy of previously applied method for intrapelvic bleeding arrest. The introduction of modern diagnostic and treatment algorithm, aimed at complete hemostasis in patients with ongoing intrapelvic bleeding reduced the overall mortality rate by 1.7 times, mortality within 24 hours of admission by 2.3 times, as well as the duration and the volume of blood transfusion therapy by 3 and 1.8 times.Authors declare lack of the conflicts of interests.

The article describes the clinical case and analyzes the literature concerning endoprosthesis replacement in the case of traumatic thoracic aortic injury in polytrauma. Current strategy of diagnostics and treatment of patient in critical condition with rupture of isthmic aortic part is based on the principle of multistage surgical treatment (damage control orthopedic). The external fixation of multiple pelvis and extremities fractures and on-time implantation of stent-graft in thoracic aortic part were performed at first hours after the admission. A condition of the patient was stabilized. The delayed reconstructive operations on pelvis and extremities bones allowed obtaining the satisfactory functional result. The principles of staged surgical treatment and the use of on-time high-technology methods allowed saving life for the patient even in critical situation in I level traumatologic centre.

The authors consider one of possible variants of surgical treatment of shoulder girdle trauma, which is accompanied by an injury of the main artery. It is based on the application of the principle of staged surgical treatment (damage control orthopedic). The well-timed sufficient diagnostics and treatment of bone-arterial trauma, coordinated work of several surgical teams, the appropriate postoperative management of patients with the using of postponed high-technology intervention allowed obtaining an optimal functional result for extremely severe multitrauma of the chest and limb.

Вивчено динаміку локальних морфологічних змін при синдромі діабетичної стопи (СДС) у 215 хворих за умови адекватного місцевого лікування за розробленими стандартами. За даними гістологічних досліджень, відзначали зменшення набряку, клітинної інфільтрації, мікроциркуляторних розладів в крайовій зоні рани в динаміці лікування. Через 1 тиж від початку лікування у біоптатах виявляли молоду грануляційну тканину з великою кількістю петель судин, орієнтованих перпендикулярно рановій поверхні, і численних тяжів фібробластів. Через 2 тиж спостерігали активну епітелізацію ранового дефекту в декілька шарів. З боку збереженої шкіри наповзав пласт, що вкривав ранову поверхню.

Вивчені в динаміці локальні морфологічні зміни при синдромі діабетичної стопи (СДС) у 215 хворих. При адекватному місцевому лікуванні за розробленими стандартами за даними гістологічних досліджень відзначали зменшення набряку, клітинної інфільтрації, мікроциркуляторних розладів в крайовій зоні рани. Через 1 тиж лікування у біоптатах виявляли молоду грануляційну тканину, що складалася з великої кількості судинних петель, орієнтованих перпендикулярно рановій поверхні, численних тяжів фібробластів. Через 2 тиж спостерігали активну епітелізацію ранового дефекту в декілька шарів. З боку збереженої шкіри наповзав пласт, що вкривав ранову поверхню.

The relations for the polarizability of the metallic nanoparticles, coated with the shell of cyanine dyes, are obtained in the article. The frequency dependencies for light absorption and scattering efficiencies, the heating of the composite nanoparticle and the electric field amplification in its neighborhood are studied. It is established that all the dependencies have three maxima which correspond to the frequencies of hybrid plasmon-exciton resonance. It is shown that an increase in content of metal in the nanoparticle causes a blue shift of the maxima from the visible part of the spectrum and a red shift of the maximum from ultraviolet frequency range. The issue of application of metal-organic nanoparticles in nanomedicine, in particular for the photothermal therapy of malignant neoplasms is studied.