Search

INTRODUCTION: Anesthesia planning for cesarean section requires knowledge of physiological and functional features a pregnant patient has in her gestational age. Proper planning reduced the perioperative critical incidents risk. OBJECTIVE: Search for data on the methods and results of assessing the cardiorespiratory status of pregnant women using methods that involve such key mechanisms of arterial baroreflex (ABR) and peripheral chemoreflex (PCR) mechanisms. MATERIAL AND METHODS: We performed a systematic review of the literature in accordance with the PRISMA guidelines. The bibliographic search was performed in December 2022 in the Medline (Pubmed), RSCI (eLibrary.ru) and Cochrane Library databases. The search keywords were: “pregnancy breath holding test”, “pregnancy chemoreflex”, “pregnancy baroreflex”, “Valsalva test pregnancy”. RESULTS: 110 documents were found, after deleting 68 papers for various reasons 42 full-text sources were analyzed, including a detailed comparative analysis of 8 sources that met totally the inclusion criteria. The design, objectives, methods, data availability, and outcomes of the studies were heterogeneous, so a meta-analysis was not performed. Were extracted and summarized data on functional changes in the work of cardiorespiratory system during pregnancy and changes in the sensitivity of the baroreflex and chemoreflex. CONCLUSIONS: The sensitivity of PCR in pregnant women can be assessed by inhalation of hyperoxic, hypercapnic and isooxic-hypercapnic gas mixtures (rebreathing test). The sensitivity of ABR in pregnant can be assessed by phenylephrine test, Valsalva test, orthostatic test, and spectral analysis of the sequences of blood pressure values and the R-R interval. The sensitivity of PCR in full-term pregnancy increases. The sensitivity of ABR in pregnant progressively decreases from the beginning of pregnancy to the end of the second trimester and increases in the postpartum period to initial level; in the third trimester of pregnancy, changes in ABR sensitivity are individual and do not have a single trend.

INTRODUCTION: Approaches to sedation in the departments of anesthesiology, intensive care and intensive care have changed over the past 20 years. In 2020, the guidelines “Sedation of patients in the departments of anesthesiology, intensive care and intensive care” were placed in the rubric of clinical recommendations. OBJECTIVE: To contribute to improving the quality of planned updating of recommendations with the help of a modified Delphi analysis of the provisions and quality criteria of the current version of the document published in the rubricator of clinical recommendations of the Ministry of Health of the Russian Federation. MATERIALS AND METHODS: We used a modified Delphi method with two rounds of questionnaires to develop a consensus. The agreement of specialists was reached in three stages: preparatory, discussions and the development of a consensus conclusion. To conduct the assessment, a questionnaire was created consisting of 3 blocks: assessment of the provisions of the clinical recommendation; assessment of the quality criteria of the clinical recommendation and an overall assessment of the clinical recommendation. The assessment was made on the basis of the Likert scale. Median, fashion and weighted average score were calculated. If, when evaluating the provisions and quality criteria of a clinical recommendation, the median value or mode of any provision was less than 7, the weighted average score was less than 70 %; the median value or mode of quality criteria is less than 7.5, the weighted average score is less than 75 %, then this provision (quality criterion) should be recommended for processing. RESULTS: The assessment of the provisions and criteria was carried out in the first round of discussion. At the second round of discussion, comments and recommendations were finally developed for the developers of the methodological recommendation. Consensus was reached during two rounds of modified Delphi analysis. As a result of the analysis, 16 out of 21 provisions and 5 out of 6 quality criteria were agreed, the rest required processing. CONCLUSIONS: As a result of an independent assessment by experts, 5 provisions and 1 quality criterion were recommended for processing. Comments and recommendations on all these provisions and quality criteria of the methodological recommendation “Sedation of patients in the departments of anesthesiology, intensive care and intensive care” were also agreed.

Intrahospital transportation of critical patients is a frequent procedure in the practice of most medical organizations, which in some cases is accompanied by a number of adverse events up to the occurrence of critical incidents. In order to improve patient safety, the Federation of Anesthesiologists and Reanimatologists of Russia (FAR) initiated in 2022 the development of national guidelines for the intrahospital transportation of critically ill adult patients. The literature search was focused on meta-analyses and randomized controlled trials, but also included registries, non-randomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. Before publication, the guidelines were approved by the Presidium of the Board of the FAR. The guidelines are focused on the peculiarities of the organization of the process of intrahospital transportation, critical indicators of vital functions and their monitoring using methods for an objective assessment of the condition of patients. Special attention is paid to the need to form a specialized team and its training. For each recommendation, the level of evidence is presented. The guidelines were developed by experts in the field of anesthesiology and intensive care for anesthesiologists-reanimatologists and must be used as an evidence-based basis for making a decision to transport a particular critical patient by responsible health professional.

INTRODUCTION: Donor blood components are able to initiate a systemic inflammatory response syndrome (SIRS) and potentiate neuroinflammation with subsequent cerebral damage. OBJECTIVE: To study the effect of transfusion on the development of cerebral damage during the surgical correction of congenital heart defects in children. MATERIALS AND METHODS: 78 patients aged from 1 to 78 months, weighing from 3.3 to 21.5 kg, were studied. All patients underwent correction of a septal defect under cardiopulmonary bypass. All patients were divided to group 1 — without the use of transfusion and group 2 — with the use of red blood cell transfusion. Cerebral damage markers (S-100-β protein, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP)) and SIRS (interleukins 1 (ILb-1), 6 (IL-6), 10 (IL-10) and tumor necrosis factor alpha (TNF-α) were studied. Markers ware studied at three control points: 1 — before the start of surgery, 2 — immediately after end of cardiopulmonary bypass, 3 — 16 hours after the end of the operation. RESULTS: The peak concentration of most markers in the blood in both groups of patients was noted at the 2nd control point. The concentration of all markers of cerebral damage was significantly higher in the transfusion group at the 2nd control point: S-100-β protein (ng/ml) — 509.90 [379.30–871.70] and 717.10 [517.90–1195.33] (р = 0.024); NSE (ng/ml) — 17.55 [11.19–26.41] and 34.05 [17.06–44.90] (р = 0,023); GFAP (ng/ml) — 0.1190 [0.1135–0.1245] and 0.1231 [0.1138–0.1493]. Correlations were found between markers of cerebral damage and SIRS, the strongest of which was the relationship between NSE and TNF-α at the 3rd control point — Rho = 0.43 (p = 0.0001). A correlation of S-100-β protein with transfusion volume was observed at the 2nd (Rho = 0.48, p = 0.00065) and 3rd control points (Rho = 0.36, p = 0.01330). CONCLUSIONS: The influence of the fact of transfusion and the dose of red blood cell on the development of cerebral damage during cardiac surgery in children has been proven.

Pneumonia is one of the most common infectious diseases and the leading infectious cause of death worldwide. High rates of morbidity, frequency of complications, mortality, the emergence of new highly virulent strains of pneumonia pathogens, antibiotic resistance determine the global medical and social problem of community-acquired pneumonia. The economic consequences of pneumonia are represented not only by direct medical costs (the cost of maintaining a patient in a medical institution, the cost of medical services, the cost of medicines, laboratory and instrumental studies, other medical procedures, etc.), but also include non-material costs from pneumonia, which include pain, psycho-emotional experiences of the patient due to a decrease in the quality of life during the illness. One of the directions of increasing the effectiveness of pneumonia therapy is the widespread introduction of physical therapy (PT) and electrophysical modalities (EM) into complex treatment, which are an important part of the medical rehabilitation for pneumonia, aimed at the speedy restoration of the health and working capacity of patients. The effectiveness of EM in the treatment of pneumonia is due to the versatile therapeutic effect of physical factors that have anti-inflammatory, desensitizing, bacteriostatic, broncholytic, mucolytic, immunostimulant effects, improve blood supply to the lungs. PT contributes to the normalization of pulmonary ventilation, has an expectorant effect, strengthens the respiratory muscles, accelerates the resorption of the inflammatory focus, prevents the formation of pleural adhesions, activates blood and lymph circulation. PT and EM are relevant in the comprehensive treatment of community-acquired pneumonia since they accelerate the regression of clinical symptoms, decrease the drug load, reduce the duration of inpatient treatment, that is confirmed by the results of clinical studies. We assume that the inclusion of PT and EM in the comprehensive treatment of pneumonia can lead to minimizing the total cost of the disease while reducing the duration and volume of drug treatment.

In recent decades, the level of electrification and automation of ships has grown significantly. This is due to the increased requirements for technical, operational and technical and economic characteristics on the part of shipowners. The implementation of the requirements has become possible due to the development of related branches of science, engineering and technology: materials science, power converter technology, microprocessor electronics, and information technology. The main directions of development of ship electrical engineering and automation, namely, improvement of power generation and distribution systems, improvement of electric propulsion systems and propulsion systems, improvement of automation systems are considered in the paper. The expediency of using valve generator sets and the transition to electric power distribution on direct current is shown. Static power sources of new generation are actively developing and spreading both in industry and in maritime transport. Good control characteristics, no restrictions on the number of reverses and minimum speed, high efficiency when operating at fractional loads, high torque overload capacity on the propeller significantly expand the scope of modern AC electric propulsion systems. The desire to combine the advantages of different types of propulsion systems has stimulated the creation of combined (hybrid) propulsion systems. Combined installations incorporate a traditional thermal main engine and a propulsion electric motor. The activation of one or another engine is carried out depending on the mode of operation and the speed of the vessel. The introduction of information technologies makes it possible to automate the management and control of maintenance and repair of ship equipment. The modern development of software and hardware and algorithmic support makes it possible to create unmanned ships that can be controlled remotely and move independently (autonomously) according to predetermined algorithms, including algorithms for divergence from other ships at sea. It is concluded that the main tasks within the framework of the directions for development of ship electrical engineering and automation are increasing the energy efficiency of the process for generating electricity by introducing valve generator sets, introduction of innovative sources of electricity with high rates of efficiency and environmental friendliness, including static sources of electricity, the use of rowing electric motors with permanent magnets and inductor type, the use of combined propulsion systems with reversible electric propulsion systems, and increasing the level of automation through the introduction of information technology and artificial intelligence.

Cardiac surgery associated acute kidney injury (CSA-AKI) is a common complication of cardiac surgery resulting from the patient's exposure to a complex combination of factors in the perioperative period. Current diagnostic criteria for AKI may underestimate the incidence of this complication due to certain specific features of cardiac surgery patients. The introduction of new diagnostic biomarkers of kidney injury into clinical practice has shown the prospective of identifying patients in the early stages of CSA-AKI development. Accurate and timely identification of patients at high risk of developing CSA-AKI can also allow performing comprehensive interventions to prevent it. When diagnosed, CSA-AKI management limited to symptomatic treatment.

INTRODUCTION: Advances in modern anesthesiology have significantly reduced the risk of anesthesia compared to the last century, however, the level of perioperative in-hospital mortality after elective major abdominal surgery is still high at the moment. Poor outcome prediction is the cornerstone of individualized perioperative management of high-risk patients aimed at preventing complications. Despite the fact that a large number of risk assessment tools have been developed over the past decades, the accuracy of the forecast is still far from required. According to the literature data, models based on the study of risk factors in the national population of patients, of which comorbidities make the greatest contribution, have the greatest accuracy. MATERIALS AND METHODS: Design: prospective observational study. Setting: National multicenter study of patients in surgical hospitals. Patients: Patients undergoing abdominal surgery. Interventions: Not provided. RESULTS: The developed design was registered in the ClinicalTrials.gov database, a study organized by the Federation of Anesthesiologists and Resuscitators of Russia in cooperation with the Kuban State Medical University has now begun, 38 centers are participating in it, two papers have been published based on the results of an interim analysis. CONCLUSIONS: The study is of great scientific and medical and social importance, as a result of the analysis of the data obtained, the role of concomitant diseases in the development of an adverse outcome will be studied and a national risk assessment model will be developed.

In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was November 1, 2021. To develop the recommendations for the Guidelines, documents were used that directly describe the features of the management of patients with a new coronavirus infection COVID-19 (recommendations and guidelines — 35; randomized clinical trials and Cochrane Reviews — 23; observational and comparative studies — 134; other documents, notes and comments — 72). Compared to the previous, 5th, version of the recommendations, 35 provisions have been corrected in 10 sections. The provisions of the current version of the recommendations highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of the management of pregnant women, children, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered. For management of COVID-19 patients, the following were specified and supplemented: 1) indications and contraindications for the administration of drugs (acetaminophen, glucocorticosteroids, remdesevir, tocilizumab, baricitinab, statins, convalescent plasma), depending on the severity of the disease; 2) features of intensive care for concomitant diseases (cardiovascular system, inflammatory bowel disease, cancer, arrhythmia); 3) the timing of elective surgery in patients who survive COVID-19, and post vaccination; 4) thromboprophylaxis and management of coagulation disorders; 5) regulatory and legal documents concerning the activities of healthcare workers facing COVID-19.

Perioperative management of elderly patients remains one of the most difficult tasks of modern anesthesiology. Compared with younger patients, people over 60 years of age have a higher risk of developing adverse postoperative outcomes, as a result of age-related decline in physiological functions, the presence of several concomitant diseases, polypragmasia, cognitive dysfunction and specific geriatric syndromes, such as frailty. More than 25 % of this category of people have several chronic diseases of the cardiovascular, nervous, endocrine, hematopoietic, musculoskeletal systems, respiratory, digestive and other systems. In the process of aging, there is also a decrease and some perversion of metabolic processes, a decrease in the reactivity of the body. All of the above, along with the surgical intervention, increases the risk of postoperative complications and perioperative mortality. The recommendations present the definition of the category of elderly and senile patients, provide information about age-related changes in their body that affect anesthesia and intensive care. The main clinical syndromes and symptoms useful in predicting the unfavorable course of the perioperative period are indicated, including frailty, nutritional insufficiency, sarcopenia and cognitive dysfunction. Methods for assessing functional activity and the risk of falls are given separately. Attention is paid to the causes, diagnosis, prevention and treatment of delirium, cardiovascular, respiratory complications. The principles of choosing the method of anesthesia and management of the perioperative period in elderly and senile patients, depending on the features of interventions and concomitant pathology, are described.

INTRODUCTION. The need for accurate risk stratification is obvious. Modern methods are quite cumbersome, which can cause difficulties when applied in routine practice, and therefore relatively simple but accurate forecasting methods have become very popular, which, however, have not been validated in Russia: SORT (Surgical Outcome Risk Tool), SRS (Surgical Risk Scale), POSPOM (Preoperative Score to Predict Postoperative Mortality), NZRISK (New Zealand RISK), SMPM (Surgical Mortality Probability Model). OBJECTIVES. The aim of this work is to determine the prognostic value of risk assessment scales in predicting an unfavorable postoperative outcome based on the analysis of data obtained in the STOPRISK study in patients undergoing open abdominal surgery. MATERIALS AND METHODS. The analysis of data on perioperative parameters of 1,179 patients who underwent open abdominal surgery is presented. RESULTS. The fatal outcome was recorded in 14 patients (1.18 %). A total of 135 complications were registered in 92 patients (7.8 %). All scales demonstrated satisfactory prognostic value in assessing the risk of complications (the area under the operating characteristic curve (AUROC) for the Physical Status Scale of the American Society of Anesthesiologists (ASA) was 0.714 (0.687–0.739), for the Surgical Risk Scale (SRS) — 0.727 (0.701–0.753), for the Surgical Outcome Risk Scale (SORT) — 0.738 (0.712–0.763), for the New Zealand Risk Scale (NZRISK) — 0.763 (0.738–0.787), for the Surgical Mortality Probability Scale (SMPM) — 0.732 (0.706–0.757), for the Preoperative Postoperative mortality Prediction Scale (POSPOM) — 0.764 (0.738–0.788)) and good in assessing the risk of death (AUROC for the ASA scale was 0.82 (0.804–0.843), for the SRS scale — 0.860 (0.838–0.879), for the SORT scale — 0.860 (0.838–0.879), for the NZRISK scale — 0.807 (0.783–0.829), for the SMPM scale — 0.852 (0.831–0.872), for the POSPOM scale — 0.811 (0.788–0.833)). CONCLUSIONS. All the studied scales have good prognostic value in assessing the risk of 30-day mortality after major abdominal surgery. The NZRISK and POSPOM scales demonstrate good prognostic value for cardiovascular complications, POSPOM and SRS scales — for acute renal injury. POSPOM and NZRISK scales showed an excellent prognostic value in relation to the risk of postoperative delirium.

A method for calculating shock short-circuit currents in marine electric power systems with direct current distribution of electricity is presented in the paper. These systems are widely used in shipbuilding. The calculation of short-circuit currents in such systems has a number of features related to the operating modes of these networks. In the systems with direct current electricity distribution, the generation and consumption of electricity is carried out on alternating current, while the distribution is carried out on direct current. The current standards for calculating short-circuit currents in DC and AC systems in this case cannot be used for a number of reasons. These standards do not consider specific supply sources of short-circuit points (short circuit) and variable rotational speed of valve generators in the various operating modes. AC electric motors (ED), when they are mains powered with DC power distribution via autonomous inverters, supply the short-circuit point on the DC side. Capacitor banks and accumulator batteries connected to a system with direct current electricity distribution are additional sources for the short circuit site supply. The elements of a methodology for calculating short-circuit currents in marine power plants with direct current electricity distribution, taking into account all operating modes and additional sources of short-circuit location recharge, are proposed in the paper. A method for determining the maximum value of the shock current at the short circuit design point of the ship’s electric power system is proposed.

Introduction. Currently, the achievements of oncological hip replacement play an important role in the treatment and rehabilitation of patients with a tumor lesion of the proximal femur. The study objective – to evaluate the effectiveness of the use of the acetabulum component with double mobility in oncological hip replacement. Materials and methods. Our prospective study included 108 patients operated in the Department of Bone Oncology of the R.R. Vreden National Medical Research Center of Traumatology and Orthopedics, Ministry of Health of Russia for a tumor lesion of the proximal femur in the period from 2014 to 2019. There were 65 (60.2 %) women, 43 (39.8 %) men. The median age was 52.1 years. Primary malignant bone tumors were identified in 19 (17.6 %) cases; benign aggressive and tumor-like diseases in 18 (16.6 %) cases; metastatic lesion in 71 (65.8 %) cases. Patients operated with bipolar heads were included in Group 1B – 53 (49 %). The 2D Group included 55 (51 %) patients operated with the use of the acetabulum component with dual mobility. Classification and analysis of complications was carried out according to the international system International Society of Limb Salvage 2014 (ISOLS 2014). The functional result was evaluated using the international Musculoskeletal Tumor Society (MSTS) system and the Harris Orthopedic scale (Harris Hip Score) in terms of 3, 6 and 12 months. Results. The total number of complications detected during the follow-up period from 2014 to 2020 was 13 (12 %) cases. Type I complications (ISOLS 2014) were represented by dislocation of the endoprosthesis – subtype IA, which was detected in 7 (6.4 %) patients operated with bipolar heads. There were no cases of dislocation of the endoprosthesis in the group operated with the use of double mobility (p = 0.006). We were able to identify a statistically significantly better functional result in patients operated with using of double mobility at all follow-up periods, both on the MSTS scale and on the Harris scale (p = 0.004). The five-year survival rate for aggressive benign tumors and tumor-like diseases was 92 %; for malignant primary tumors – 82 %; in patients with secondary bone lesions – 60 %. Conclusion. Today, oncological hip replacement, is still lags behind in functional results from primary standard hip arthroplasty, and the number of complications is still several times higher. We consider that one of the solutions of this problem, is a wider use of acetabulum components with dual mobility in oncoortopedic practice.

Ti2Nb2O9 with a tunnel-type structure is considered as a perspective negative electrode material for Li-ion batteries (LIBs) with theoretical capacity of 252 mAh g-1 corresponding to one-electron reduction/oxidation of Ti and Nb, but only ≈160 mAh g-1 has been observed practically. In this work, highly reversible capacity of 200 mAh g-1 with the average (de)lithiation potential of 1.5 V vs Li/Li+ is achieved for Ti2Nb2O9 with pseudo-2D layered morphology obtained via thermal decomposition of the NH4TiNbO5 intermediate prepared by K+→ H+→ NH4+ cation exchange from KTiNbO5. Using operando synchrotron powder X-ray diffraction (SXPD), single-phase (de)lithiation mechanism with 4.8% unit cell volume change is observed. Operando X-ray absorption near-edge structure (XANES) experiment revealed simultaneous Ti4+/Ti3+ and Nb5+/Nb4+ reduction/oxidation within the whole voltage range. Li+ migration barriers for Ti2Nb2O9 along [010] direction derived from density functional theory (DFT) calculations are within the 0.15-0.4 eV range depending on the Li content that is reflected in excellent C-rate capacity retention. Ti2Nb2O9 synthesized via the ion-exchange route appears as a strong contender to widely commercialized Ti-based negative electrode material Li4Ti5O12 in the next generation of high-performance LIBs.

Aim: To assess the level of microRNA expression in the serum of patients who had undergone cardiac surgery depending on the postoperative complications (presence or absence of multiorgan failure, MOF). Materials and methods: The study group included 87 patients who had undergone heart surgery with cardiopulmonary bypass. The patients without postoperative complications comprised group 1 (n = 51), whereas those with postoperative MOF were in group 2 (n = 36). In all patients, blood samples were collected at two time points: before surgery and at 36 to 48 hours after surgery. The following miRNAs were chosen for the study: hsa-miR-486-5p (478128_miR), hsa-miR-191-5p (477952_miR), hsa-miR-192-5p (478262_miR), hsa-miR-146a-5p (478399_miR), hsa-miR-26a-5p (477995_miR), hsa-miR-30d-5p (478606_miR), hsa-miR-23a-3p (478532_miR), and hsa-miR-320a-5p (481049_miR). Polymerase chain reaction results were normalized to hsa-miR-16-5p (4427975). Results: Up-regulating miRNAs. Compared to baseline, there was a significant postoperative increase in miR-486-5p microRNA expression (group 1, 41.83 [19.86; 74.6] vs 940 [434.7; 1212.0]; group 2, 72.55 [21.37; 100.2] vs 492.4 [201.2; 998.0]; both p 0.001). An increase in the of microRNA miR-192-5p expression in the postoperative period was found both in the no-MOF group (from 0.39 [0.16; 1.07] at baseline to 5.96 [3.74; 10.35] after surgery, p = 0.002), and in the MOF group (from 1.74 [0.45; 3.35] at baseline to 17.16 [4.70; 24.96] after surgery, p = 0.003), with a statistically higher level of expression in group 2 (p = 0.028). Similar changes over time were observed for miR-30d-5p expression: group 1, 1.61 [0.47; 4.36] at baseline vs 5.03 [2.93; 6.56] after surgery (p = 0.002), group 2, 0.89 [0.32; 4.27] at baseline and 6.63 [3.92; 12.82] after surgery, respectively (p = 0.0045). Down-regulating miRNAs. The miR-191-5 and miR-146a-5p families demonstrated a significant increase in group 1 after surgery (3.85 [1.64; 5.6] vs 7.7 [5.48; 9.68], p = 0.021; and 18.1 [6.52; 19.9] vs 37.27 [29.13; 47.07], p = 0.016, respectively) and a significant postoperative decrease in group 2 (3.67 [2.60; 7.61] vs 1.66 [0.52; 2.36], p = 0.023; and 14.75 [12.79; 21.77] vs 5.96 [2.8; 8.2], p = 0.034, respectively), with between-group difference in the postoperative expression levels being also significant. As regards to miR-26a-5p и miR-23a-3p families, there was a similar trend: the group with uncomplicated postoperative course was had virtually no changes over time in their expression (the increase was non-significant), whereas the MOF group had lower postoperative values for this microRNA family. The between-group differences after surgery were significant for miR-26a-5p (group 1, 6.79 [3.38; 8.46], group 2, 0.26 [0.18; 1.9], p = 0.037) and for miR-23a-3p (14.14 [11.92; 26.63] and 2.0 [1.02; 4.18], respectively, p 0.001). Conclusion: When comparing microRNA expression before surgery, we did not find any significant differences between the patients groups without and with MOF. Assessment of microRNA expression in the no-MOF group after surgery showed an increase in the expression of microRNAs responsible both for up regulation (miR-486-5p, miR-192-5p, miR-30d-5p) and for down regulation (miR-191-5p, miR-146a-5p). In the group with a complicated postoperative course and with MOF, changes over time in the up-regulating microRNAs were characterized by increased expression (miR-486-5p, miR-192-5p, miR-30d-5p), whereas the down-regulating microRNAs (miR-191-5p, miR-146a-5p) demonstrated significantly decreased expression, which was different both that in the no-MOF group and from the baseline values.

Background. Violation of the regeneration of the tracheal wall after undergoing reconstructive surgeries remains an urgent problem of modern surgery. One of the reasons for the violation of the regeneration processes is insufficient blood supply to the organ. Finding new ways to improve blood flow is a promising area of research. Aim. To evaluate the effectiveness of VEGF effect on the regeneration of the anterior tracheal surface in the early postoperative period. Materials and methods. The study included 60 male Wistar rats at the age of 10 months. All animals underwent tracheal reconstructive surgery; the animals were divided into three groups: group 1 – without medicinal film, group 2 – with prolonged-release medicinal film, group 3 – with prolonged-release medicinal film containing VEGF. The sampling of histological material was carried out on days 3, 7 and 21 of the study, using morphometry to determine the thickness of the tracheal wall, the thickness of the postoperative scar, the area of the surgical intervention zone, the area of the vessels, the ratio of the thickness of the postoperative scar to the wall thickness trachea and the ratio of the area of the vessels to the area of the surgical intervention zone. Results . It was revealed that when exposed to a long-acting medicinal film containing VEGF, significant histological changes occurred on day 7 of the study. In groups 1 and 2, healing occurred by day 21 and was accompanied by defects of the mucous membrane and cartilage. On day 7 in group 3, there was a complete epithelialization of the tracheal wall, an increase in the number of newly formed vessels and glands in the area of surgical intervention. Healing was carried out with a thin postoperative scar without defects in all layers of the tracheal wall. Conclusion . The results obtained indicate the stimulating effect of VEGF on the regeneration of the tracheal wall in the early postoperative period after undergoing reconstructive surgery. The use of VEGF reduces the time of postoperative wound healing and preserves the anatomical structure of the tracheal wall.

Military-industrial complexes of many countries have invested billions of dollars in the industry over 120 years of development and have achieved significant progresses in the creation of surface, water and underwater equipment. Groups of military unmanned vehicles include unmanned aerial vehicles (UAVs), deck-based UAVs, water, underwater and hybrid unmanned vehicles (UAVs). Their purpose is intelligence, surveillance, strategic research projects, and military transport purposes. As for the civilian use of unmanned vehicles, this is a young industry, it is 15 years old. The beginning of the era of non-military unmanned aerial vehicles (UAVs) and then unmanned floating vehicles (UAVs) is considered to be 2006, when the US Federal Aviation Administration allowed the flights of small custom drones. At the same time, they were given a definition: a device that is remotely controlled by an operator; a device that moves along a pre-planned route. Unmanned vehicles the use of which for the purposes of the forest complex of our country is carried out or is planned to begin in the near future must meet some special requirements that are discussed in this article.

A variety of plant and animal resources (waste) can be used as biofuel. The use of biofuel is less profitable than fossil fuels, so many countries introduce special subsidies to encourage their consumption. However, to obtain these subsidies, it is necessary to prove that companies, in case of purchasing imported materials, buy them in countries that support the principles of the current climate agreement. Unlike the United States, which left the Paris climate agreement, Russia has ratified it. This means that European companies have a strong economic interest in purchasing biofuel from Russia, and not from the United States. And Russian timber companies are increased in their motivation for the efficient processing of waste of their main production into a popular export product — fuel pellets and briquettes. However, many timber producers are faced with the problem of choosing a particular type of fuel that is optimally produced in specific production conditions. Keywords: wood waste, biofuel, fuel pellet, fuel briquette.

Ti

A numerical nonstationary two-dimensional MHD model of a protoplanetary disk near T Tauri star with a jet is developed. The model assumes consideration of pure gas ionization, optically thin cooling, anisotropic thermal conductivity and viscosity. The relaxation of gas-dynamic flows is analyzed. Based on the evolution of plasma flows, profiles of hydrogen spectral lines have been obtained.

The results of studies of the structural, optical, photoluminescence, and photoelectric properties of the ZnO–LiNbO3 thin-film structure are reported. The results of X-ray structural analysis of a zinc-oxide film synthesized on a single-crystal lithium-niobate substrate and on a quartz glassy substrate are presented. The transmittance, reflectance, absorption, photoluminescence, and photocurrent spectra of the ZnO–LiNbO3 thin-film and ZnO–SiO2 structures in the ultraviolet and visible spectral regions are given.

Background. The social activity of young people is the driving force behind socio-economic and socio-political processes in society. It is due to their social activity that positive changes are taking place in different spheres of life. Objective. We set out to analyze the preferences and predictors of the directions of young people’s social activity. Design. Our study involved 251 people from the Saratov region, Russia, of median age (M) 20.11, SD = 1.2 (41% male). To measure their basic assumptions, we used the Janoff-Bulmann World Assumptions Scale (WAS); their identity characteristics were measured with the Kuhn and McPartland Twenty Statements Test (TST) “Who am I?”. To evaluate their social behavior preferences, we used 11 unique proprietary scales which we developed on the basis of a pilot study with relevant theoretical validity. Results. Our study found that youth preferences for various forms of social activity can be divided into two main clusters: organizational-social and individual-personal. Our results revealed that individual-personal activity had a more complex structure, with well-expressed intensity, than the organizational-social form of social activity Young people’s assumptions most strongly condition variations in their preferences for educational-developmental, socio-political, recreational-cognitive, and self-developmentrelated spheres of activity. The most influential predictors of social activity in young people are their assumptions regarding their own significance, their ability to manage events, and their luckiness. We established that an individual’s basic beliefs do not influence variations in their preferences for mass cultural, religious, creative, and informal activities in a group. Young people’s sense of identity influences variations in their preferred types of social activity. The most influential predictors of social activity preferences were negative personal, personal, and family-related identities. Preferences for social activity are less influenced by gender, religious, and ethnic identity, as well as by identity based on activity and appearance. Conclusion. We present some conclusions regarding the strong determination of the first cluster (political, religious and voluntary types of activity) by identity, and the second cluster (ranging from educational to recreational cognitive activity) by assumptions about the world.

Background. Oils of hemp and cotton presently have reduced retail trade offer in Russia, but are widely produced and used. Industrial hemp is still cultivated and processed domestically. In the 1950s, industrial cotton was cultivated on a hundred thousand hectares in the country, and now there are signs of its restored growing. Both crops have the ability to restore the raw material base to produce textile fibers, seed and oil as well as the potential to improve functional food production, because they contain functional food ingredients in their oil capable of reducing human nutrition disorder risks, preventing or restoring nutrient deficiencies, preserving and improving health.Materials and methods. Unsaturated and polyunsaturated fatty acids’ profiles of hempseed (Cannabis sativa L.) and cottonseed (Gossypium hirsutum L., G. herbaceum L., G. barbadense L.) oils were evaluated. Seeds were grown respectively under the conditions of the Russian North-West (hemp) and Adler District, Krasnodar Territory (cotton). The PUFA profile was measured using gas chromatography with mass spectrometry equipment (Agilent 6850, USA). All data were calculated using the UniChrom software.Results and conclusions. The content of the omega-6 linoleic acid in hemp accessions reached 64.2%; omega-3 alpha-linolenic acid, 27.1%; monounsaturated oleic acid, 14.0%. The sum of unsaturated acids was 94.2%; and that of polyunsaturated ones, 87.2%. Compared with hemp oil, cotton oil had a lesser sum of polyunsaturated (maximum 58.0%) acids, while its unsaturated acids were up to 79.0%. Oleic acid was found to reach 22.7% in cottonseed oil. Industrial cultivation of hemp and cotton in Russia need not be limited to textile fiber production, but may serve as a potential base of vegetable oils and food; just because of their PUFA contents, it is promising for the production of functional food ingredients, which have health benefits in reducing the risk of cancer and cardiovascular diseases, lowering the HDL cholesterol levels, and relaxing the smooth muscle cells in arteries, thus increasing the blood flow. Seed cake may be valuable addition to animal feed rations as well. As a result of the evaluations, valuable accessions (cultivars and lines) of hemp and cotton were identified. Although the selected accessions are not the products of previous breeding efforts aimed at the PUFA content improvement, they are promising source materials for the development of new cultivars with seeds enriched with compounds or sets of compounds that provide a beneficial effect on human health when included in the composition of food products (functional food ingredients).

Objective: to evaluate the data of cardiac screening to identify cardiac pathology and determine sports participation among in athletes of Youth Sports Schools in five districts of St. Petersburg. Materials and methods: 9847 young athletes (average age 13.8 ± 4.9 years, 6127 men) were included in the study during 8 months. Clinical protocol uncluded the collection of complaints, anamnesis, family anamnesis, physical examination, ECG in 12 leads. If necessary, Holter monitoring, echocardiography, and an exercise test were performed. Results: typical ECG changes were registered in 60.4% of athletes, borderline in 0.05% and pathological in 3.69%. All athletes with pathological changes were excluded from the training and competitive process for the period of in-depth medical examination. In the end, two athletes were not allowed to continue participation in sport (2 with stressful ventricular arrhythmias). There was not any lethal outcomes for the entire period of the study. Conclusions: cardiological screening using the routine ECG method remains the main tool for identifying a possible pathological substrate and assessing the risk of sudden cardiac death. Early detection of cardiac arrhythmias and conduction disturbances allow to take measures to prevent sudden cardiac death.

Introduction Rotator cuff tears is still a complex and unresolved problem, which solution requires a comprehensive approach and choosing the optimal way of treatment. Frequently, the results of surgical treatment do not satisfy both patient and surgeon. Objective Improve the results of treatment of patients with rotator cuff ruptures of the shoulder. Material and methods Results of arthroscopic treatment of rotator cuff tears in 15 patients (mean age, 54 ± 4 years) with combined technique are presented. None of the cases had severe muscle atrophy of the rotator cuff (supra- and infraspinatus muscles), according to Goutallier classification less than 3 grade. All patients underwent shoulder arthroscopy with rotator cuff repair by single or double row stitching and subacromial balloon InSpace implantation. Results The mean score according UCLA scale before the operation was 16 ± 2 (13–18), the mean score 12 months after the operation was 30 ± 3 (26–35); in most cases good and excellent results were obtained. Conclusion Preliminary results characterize the proposed method as a relatively easy, law-traumatic and effective procedure for pain relief and shoulder function recovery in this group of patients.

The immune system in critical illnesses initiates local inflammation in the damaged area. In the absence of a balance between local and systemic inflammations, an infectious or non-infectious systemic inflammatory response follows, which has a stage of "hyper inflammation - compensatory anti-inflammatory response", that may result in multi-organ failure. The final stage of critical ill-nesses, therefore, will be characterized by induced immunosuppression with the impaired function of neutrophils, monocytes, macrophages and dendritic cells and release of myeloid-derived suppres-sor cells. The aim of the review is to evaluate the contribution of various components of the im-mune response to the formation of induced immune suppression from the perspective of candidate diagnostic markers.

The study of students’ representations of a socially active individual is one of the major tasks of psychology of education. The purpose of the study is to carry out analysis of characteristics of an image of a socially active individual in the representations of student youth and to correlate them with self-assessment of social activity and assessment of real social activity. Students aged 17-23 years (n=251) took part in the study ?=20.11, SD=1.2 (41% men). We used the polling method with the scales developed by the authors of the present study in order to identify self-assessment of social activity, to evaluate real activity; and the associative experiment method. In the study we analysed qualitative and quantitative characteristics of the image of a socially-active individual in the representations of university students. We have established major meaningful characteristics of representations (personal qualities, self-improvement and personal transformation, states, representation in the group, process and activity-related characteristics). Conclusion has been made about the connection between the intensity of students’ social activity and cognitive complexity of the image of a socially active individual and the content of subjective (initiative, confidence) and psychodynamic (vigour) categories in it.

Comprehensive study of the structure and bonding of disodium, dipotassium and diammonium di-o-phthalatocuprates(II) dihydrates has been undertaken. The crystal structure of ammonium o-phthalatocuprate has been determined. The identity of structures of phthalatocuprate chains in potassium and ammonium salts has been revealed. Vibrational spectra of all three compounds have been recorded, and the assignment of vibrational bands has been made. Force field calculations have shown a minor effect of outer-sphere cations (Na+, K+, NH4+) on both intraligand (C-O) and metal–ligand bond strengths. Synthesized compounds have been tested as electrochemical sensors on D-glucose, dopamine and paracetamol. Their sensitivity to analytes varied in the order of Na+ &gt, K+ &gt, NH4+. This effect has been explained by the more pronounced steric hindrance of copper ions in potassium and ammonium salts.