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The paper describes the process of designing the cutting tool feed drive of a special metalworking machine, which due to the circuit solution and automatic control system will increase the productivity of processing one cell of wafer background on sheet material up to 10–15 seconds. On the basis of the analysis of the technology of milling of a given regular pattern of wafer background and peculiarities of the equipment operation it proposed to replace the traditional ball bearing gear in the cutting tool feed drive with a flat combined crank-slide mechanism. Geometrical parameters of the lever transmission mechanism calculated in accordance with the known dimensions of the regular cell pattern and the recommended value of the angle of motion transmission. The analysis of kinematic and power characteristics of the lever mechanism allowed to justify the technical characteristics of the electric motor. In order to realize the required trapezoidal law of the output link speed change, the inverse problem of kinematics solved, numerical values of the instantaneous angular velocity of the input crank and pulse control signals to the servomotor obtained.

Purpose of the study. Analytical review and analysis of available literature on texture analysis of computed tomgraphy (CT) and magnetic resonance imaging (MRI) in noninvasive diagnosis of ICC and correlation with molecular genetic features and tumor immunophenotype.Materials and methods. The scientific publications and clinical guidelines in the information- analytical systems PubMed, Scopus for 2012–2022 were carried out using the keywords: "mri", "radiomics", "texture analysis", "radiogenomics", "intrahepatic cholangiocarcinoma", "molecular". 49 articles were selected for analysis after excluding studies dealing with technical aspects of radiomics and describing individual clinical observations.Results. The presented review demonstrated the broad possibilities and prospects of application of CT and MRI texture analysis in the study of cholangiocellular cancer, including the first results in the study of molecular features (signatures) of this tumor. Correlation of texture features with the expression of immunotherapy target genes KRAS/NRAS/BRAF as well as IDH1/2 mutation was shown. Texture scores were the predominant independent predictor of microvascular invasion, which was a major independent risk factor for postoperative recurrence.Conclusion. The use of texture analysis undoubtedly demonstrates promising possibilities both in noninvasive assessment of the HCC histological differentiation grade, as well as in differential diagnosis with hepatocellular carcinoma, metastases, and requires further study for systematization and standardization of the obtained data.

Breast cancer (BC) is the most common malignant disease. The use of neoadjuvant drug therapy increases the likelihood of achieving a complete pathomorphological response (pCR), leads to an increase in resectability and ablation; helps to determine the sensitivity of tumor cells to chemopreventive agents, thereby improving the patient’s prognosis. Since pathomorphological assessment occurs aſter surgery, it is necessary to develop methods for non-invasive response assessment for timely correction of the volume of treatment. One such method is magnetic resonance imaging (MRI). Assessment of the obtained images using texture analysis allows to increase the accuracy of the method both in the control of neoadjuvant treatment and in the assessment of the response to neoadjuvant therapy during preoperative planning.This article provides an analysis of the literature data on the potential to improve the prognostic value of breast MRI in assessing the complete pathomorphological response to neoadjuvant drug treatment of breast cancer using texture analysis of data.

The article considers the factors affecting the accuracy of Electrical Discharge Machining. The process of formation of conglomerates resulting from processing is mainly investigated. Based on the literature analysis, the theoretical and real scheme of Electrical Discharge Machining is compared. As a result of the experiments carried out, it is revealed that in the process of deep holes, the electrode deviates from its axis due to the destabilization of the tool due to the non–rigidity of the electrode and the sticking of debris formed in the processing zone. The deviation of the electrode from the axis of rotation leads to uneven pressure from the liquid washing out the debris, which leads to uneven wear on the side of the electrode. During the study, samples of electroerosive debris are collected and studied. A direct relationship between the processing depth and the deviation value is revealed: the greater the processing depth, the greater the deviation value, which leads to distortion of the shape of the hole section and the formation of a cone instead of a cylinder. To improve the accuracy of processing deep holes, it is necessary to minimize the deviation of the electrode from the axis of rotation and protect the side surface of the electrode from the effects of current.

АКТУАЛЬНОСТЬ: Септический шок считается наиболее серьезным осложнением в интенсивной медицине и сопровождается значительной летальностью. Экстракорпоральная гемокоррекция может улучшить результаты лечения пациентов с септическим шоком. ЦЕЛЬ ИССЛЕДОВАНИЯ: оценка влияния гемокоррекции с помощью мультимодального адсорбента «Эфферон ЛПС» на динамику органной дисфункции и маркеры воспаления у пациентов с септическим шоком. МАТЕРИАЛЫ И МЕТОДЫ: Мультицентровое рандомизированное контролируемое исследование проведено в четырех медицинских организациях города Москвы (НИИ СП им. Н.Ф. Склифосовского ДЗМ, ГКБ № 1 им. Н.И. Пирогова ДЗМ, ГКБ им. С.С. Юдина ДЗМ, ГКБ № 68 им. В.П. Демихова ДЗМ) с марта 2021 г. по май 2022 г. В исследование включены 58 пациентов (29 мужчин и 29 женщин) с септическим шоком. Рандомизацию проводили в соотношении 2:1 (гемоперфузия: контроль). Не позднее 24 ч после включения пациента в исследование выполняли процедуры селективной гемоперфузии или использовали стандартную терапию. Гемосорбцию с использованием «Эфферон ЛПС» проводили двукратно, с интервалом 24,5 (23,3–26,0) ч. РЕЗУЛЬТАТЫ: Применение селективного гемосорбента «Эфферон ЛПС» позволило уже через 72 ч снизить тяжесть органной дисфункции у пациентов с септическим шоком с 7 до 3 баллов по шкале SOFA (Sequential Organ Failure Assessment) за счет улучшения гемодинамики, респираторной и почечной функции. В отличие от контрольной группы, в группе «Эфферон ЛПС» уже через 72 ч значимо снижался уровень С-реактивного белка (СРБ) в 1,5 раза, прокальцитонина (ПКТ) — в 2,7 раза, интерлейкина-6 — в 2,3 раза. Тяжесть органной дисфункции значимо коррелировала с уровнем СРБ (r = 0,346) и ПКТ (r = 0,444). Длительность госпитализации выживших пациентов составила 16,1 и 30,1 дня в группе «Эфферон ЛПС» и контрольной группе соответственно (p = 0,032). Потребность в проведении заместительной почечной терапии у выживших к 3-м суткам значимо снижалась с 73,7 до 33,3 % только в группе «Эфферон ЛПС», но не в контрольной группе. ВЫВОДЫ: Применение селективного гемосорбента «Эфферон ЛПС» позволило уменьшить выраженность системного воспаления и значимо снизить тяжесть органной дисфункции у пациентов с септическим шоком за счет улучшения показателей гемодинамики, газообмена и почечной функции.

Treatment results in a group of patients with multiple myeloma (n=18) treated with melfalan (200 mg/m2) followed by autologous peripheral blood stem cell transplantation as a second-line therapy are presented. Thirteen patients received one course of high-dose chemotherapy (HDCT), 5 had 2 courses. Before HDCT all treated patients achieved a partial remission (15 patients after 3 courses VAD, 3 patients after 3 courses of VAD and 2 courses of velcade- doxorubicin- prednisolone). The median time to disease progression was 33.1 (range 26—40) months; that of overall survival was 55.4 (range 29— 40) months.

To obtain a sufficient number of hemopoietic progenitor cells (HPCs) for a rapid and stable recovery of hematopoiesis is one of the major conditions for safe high-dose chemotherapy. The paper analyses the current approaches to mobilizing and collecting HPCs, as well as the factors influencing their efficiency. By using their own large material (264 patients who had undergone mobilizing procedures), the authors have shown that none of predictors (age, a history of multiple courses of chemotherapy, peripheral blood levels of CD34+ cells at sampling, etc.) may identify patients in whom peripheral blood HPCs cannot be certainly ineffectively collected. At the same time, combined mobilization with myelostimulating factors (granulocyte, granulocytemacrophage colony-stimulating factors) and cytostatics (high-dose cyclophosphamide) yield the greatest quantities of HPCs from peripheral blood in patients with solid tumors and multiple myeloma.

Urothelial cancer occupies a significant place in the routine practice of cancer treatment. Systemic antitumor treatment of patients with metastatic urothelial cancer in the first line is currently well studied, has its own standards, implemented in clinical practice. However, the problem of choosing antitumor treatment for patients with metastatic urothelial cancer in the second line remains relevant. Vinflunine is one of the treatment options for such patients. This article presents the case of successful treatment of metastatic urothelial cancer in the second line with vinflunine. A 63-year-old patient with a diagnosis of C65 Urothelial cancer of the pelvis of the left kidney T3N0M1, stage IV, bone metastases. Condition after cytoreductive left-sided nephrectomy, para-aortic lymphadenectomy from 04/16/2021. Concomitant pathology: Anemia. Diabetes mellitus type 2 Hypertonic disease. As the 1st line of treatment, 6 courses of CT were performed according to the scheme: Cisplatin + Gemcitabine. The effect was evaluated according to MSCT data of 3 zones and bone scintigraphy in accordance with Recist 1.1. The best response was obtained after the 4th cycle in August 2021 in the form of stabilization. October 2021 follow-up examination revealed progression. Since October 2021, chemotherapy of the 2nd line with Vinflunin is carried out in mono mode. All AEs are well controlled and do not require discontinuation of the drug. According to the results of the control examination, stabilization was achieved. Thereby vinflunine has been shown to be effective as a second-line treatment for platinum-resistant recurrent urothelial cancer.

The efficiency of regenerative heat exchangers with heat storage nozzles made of rolled corrugated tapes depends on the type of their corrugation profile. The most effective form is a triangular one with sharp peaks and troughs. It is technically advisable to get corrugations of a given shape by rolling between two rollers. Determining the required contact load and forces is one of the main tasks when rolling corrugated belts. Insufficient load leads to incomplete formation of the profile, and excessive load leads to warping of the belt. The article presents the results of an experimental study aimed at determining the required load when rolling a corrugated heat exchanger belt for wind tunnels. Experiments and force measurements are carried out on a standard milling machine with a spring dynamometer. The results of the experiment are applied to stainless steel strips with a thickness of 0,3 to 0,4 mm and triangular fluting

Objective: to evaluate the role and place of MRI lung screening in the detection of pneumonia and patient routing.Material and methods. 500 MRI tests were performed in the period from November 1, 2020 to December 15, 2020 on the basis of more than 20 diagnostic centers of the federal MRI-Expert network. Two groups were identified. In Group 1 (control, n = 50) MRI studies were compared with CT studies in a single time interval of 0–2 days; 25 patients had a positive PCR test for SARS-CoV-2 and 25 patients were conditionally healthy. In Group 2 (effective, n = 450) mediastinal MRI was performed with lung screening on Philips 1.5 T and Siemens 1.5 T devices. The statistical analysis of the medical data base was performed.Results. During the study, mandatory and additional MRI scanning programs were identified: for Philips 1.5 T tomograph, the mandatory programs are sSSh_fb: tra and cor; THRIVE: tra (inhale/exhale); for Siemens 1.5 T – T2_BLADE: cor, tra, sag. When comparing the visual data of the control group (n = 25) with a positive PCR test in a single time interval of 0–2 days, the fact of detecting MR changes coincided with CT changes in 76% of cases (n = 19). The group of patients were examined by only one method – MRI-screening of the lungs (n = 475), pathological changes in the lungs were detected in 44% (n = 209). Localizations of the pathological changes were as follows: bilateral changes – 70.3% (n = 147), right-side changes – 19.6% (n = 41), left-side changes – 10% (n = 21); lower parts 26.8% (n = 26), average departments – 10% (n = 21), the upper divisions – 14.8% (n = 31), mid-lower 29.6% (n = 62), total – 18.6% (n = 39). The ranges of the area of lesion of the pulmonary parenchyma on MRI were graded according to MRI criteria into 4 groups (< 25%, 25 – 50%, 50 – 75%, > 75%). The collective radiation dose decrease was calculated for a group of patients (n = 450), which averaged 2.025 man-Sv for 1.5 months, of which 0.077 man-Sv were control studies.Conclusion. Based on the results obtained, the analyses of the possibilities of the MRI method in displaying pulmonary changes was performed. The method of MRI screening of the lungs is recognized as a possible alternative to computed tomography for dynamic monitoring in conditions of a shortage of CT records or the inability to perform it, and as a tool to reduce the collective effective dose of radiation to the population.

This article discusses the methods of processing gas exhaust grooves on molds for rubber goods planning on a curved surface. The purpose of this work is to improve the efficiency of processing gas-venting grooves of angular shape on molds for rubber technical products on curved surfaces by using the planning method on machines with computer numerical control.

This article discusses the methods of processing gas exhaust grooves on molds for rubber goods planning on a curved surface. The purpose of this work is to improve the efficiency of processing gas-venting grooves of angular shape on molds for rubber technical products on curved surfaces by using the planning method on machines with computer numerical control.

Aim. Creating a mathematically based scale of risk stratification of thromboembolic complications in patients with acute abdominal organs pathology requiring urgent surgical treatment.Material and Methods. This work is based on data from 185 case reports of patients with acute surgical diseases of the abdominal organs that had undergone emergency operations. Clinical and statistical analyses were carried out and the most significant risk factors for venous thromboembolic complications were identified. By digitally estimating the specific gravity of each of the factors, the method of sequential probability ratio criterion was applied to the obtained data.Results and Discussion. Based on a retrospective analysis of clinical records, 13 most informative prognostic criteria for thromboembolic complications formed in the prognostic table were identified. Each sign, depending on its value, had a specific gravity. For the convenient using of the prognostic scale in practice, the indicators of natural logarithms are translated into arbitrary units (points). The results are checked on available archival records. The overall forecast reliability was 97%.Conclusion. The proposed prognostic scale made it possible to optimize the likelihood of a feasibility study in patients with acute diseases of the abdominal organs.

To improve the quality of the pneumatic sowing apparatus, it is necessary to study its aerodynamics. (Research purpose) Determination of air flow distribution in the upper part of the seed chamber of the sowing apparatus, taking into account the protrusions of the sowing disk, on which the quality of seeds dosing depends. (Materials and methods) The author chose a sowing apparatus operating at overpressure as an object of research. The author showed that the seed chamber constant sealing in it is provided by the protrusions of the sowing disk, which are made with cut edges on the side of the sowing disk metering element in two planes. The author applied computer simulation of the sowing apparatus. To conduct a numerical experiment, the initial and boundary conditions were determined, and the rotation of the seed disk was taken into account. The calculation of the model was carried out by changing the volumetric air flow in the range of 15-35 liters per second. (Results and discussion) The author constructed isolines of the air velocity distribution at various air flow rates. He determined the values of the air flow in the directions X, Y and Z in the sowing apparatus seed chamber. It was revealed that the largest and the smallest values of this indicator are achieved at 35 and 25 liters per second respectively. It was shown that at an air flow rate in the range of 15-25 liters per second, the distribution of the air flow in the upper part of the seed chamber would be optimal for transporting the seeds with a metering element. The air flow velocity components in Z direction vary in the range from 5.4 to 16.5 meters per second, and in the X and Y directions do not exceed 8 meters per second. (Conclusions) Based on simulation modeling, the author constructed and analyzed graphs of air flow velocity components changes in the three directions of air flow propagation. He determined the nature of the distribution of air flow in the excess seeds discharge area in the design of protrusions with cut corners. He proposed a rational range of air volumetric flow rate of 15-25 liters per second.

Objective. Improvement of treatment outcomes in patients with the cholelithiasis complicated by mechanical jaundice when it is impossible to apply retrograde techniques for biliary tract decompression.Material and Methods. From 2014 to 2017 in our hospital 1158 patients with cholelithiasis complicated by mechanical jaundice have been treated. The group consisted of 59 (5.1%) patients with initially predicted difficulties for endoscopic lithoextraction. In 12 of that group antegrade decompression was the only surgical method for completing treatment. In 2 cases the ‘rendezvous’ technique was used, and in 23 patients the antegrade decompression it was complemented with laparotomy and choledocholithotomy. In 22 patients for verification the nature of the bile-excreting ducts and the cholelithic occlusion revealed at the same time the first stage included an antegrade decompression that allowed to finish surgical treatment by an endoscopic transpapillary lithoextraction.Results. In the main group of clinical observations for 59 patients the surgical treatment complemented with an antegrade decompression was without fatal outcomes. All patients were cured of cholelithic occlusion and recovered. In the study group with 1099 patients that were treated with only an endoscopic lithoextraction 8 patients died that showed 0.7 ± 0.2% of operational mortality. Complications, in the form of operational wounds in the main group of observations were found in 7 patients and it was 11.8 ± 4.2%. Other postoperative complications in the main group were not observed. In the control group similar wound complications were seen in 13 patients (1.2%). In the control group with 57 patients we observed intraabdominal complications which resulted in mortality (5.2 ± 0.7%). Of those postoperative reversible pancreatitis was found in 34 patients, 3 patients had fulminant pancreonecrosis, in 4 cases there was profuse bleeding from a papillosphincterotomy area, in 3 cases we observed insertion of Dormia basket at lithoextraction, septic cholangitis was in 11 and duodenum perforation with retroperitoneal phlegmon was in 3 cases.Conclusion. Mortality in the group with antegrade treatment application for choledocholithiasis was not found. On the contrary, rather higher rate of complications in the control group testifies in advantage of the antegrade techniques for choledocholithiasis treatment in the shown cases.

Background. Optimization of the process and improved efficiency of the prolonged compulsory enteroalimentation in the patients who require it for more than 4 weeks.Materials and Methods. We analyzed the first experience of percutaneous endoscopically assisted gastrostomy in 32 patients. Patients were treated in the neurosurgical and neurologic department of Research Scientific Institute – Ochapovsky Regional Clinical Hospital no. 1 in Krasnodar.Results. Application efficiency of percutaneous endoscopically assisted gastrostomy for prolonged enteral feeding in patients with combined trauma and neurological deficiency was shown. The greatest number of complications 3 (33.3%) was observed in the group of patients with cranio-cereberal traumas.

The article considers modern sectioning points on contact network and determining the location of the damage, imthe switches, which differs by the introduction of new functions for plemented in the IntTer smart terminal. These new functions are determining a stable (or passing) short circuit in the disconnected deciding whether to perform a quick automatic restart of the circuit breakers after an emergency shutdown or finding the fault zone without testing the insulation of the contact network. The principle of operation of the functions under consideration is analyzed in the article. The limits of the optimum time of the current-free pause of the circuit breaker for automatic re-activation (AR) for each inter-substation zone are established. The paper describes the existing algorithm for automating power supply of an AC traction network (the normal reclosing algorithm) and indicates the unfavorable consequences from its application, in particular, related to the long time of the absence of voltage in the contact network. It was noted that the decision to reduce the voltage recovery time performed by introducing the function of determining the passing (or stable) short-circuit in the switched-off contact network in traction substations is due to the cost of additional high-voltage equipment and requires a rethinking. Thus, a new algorithm for automating the power supply of the traction network (the BAR algorithm) is presented, which is quite easily implemented at the modern sectioning post, which has voltage transformers for each supply line of the contact network, in contrast to the supply lines of the substation contact network and is caused by the transfer of the function of determining the passing (or steady ) short circuit to the sectioning point. In the article, the issue of performing the automatic reclosure of the power line of the traction substation is considered dependent on the successful operation of the BAR algorithm of the sectioning point. It is established that the most rational option is the implementation of a dependent automatic reclosing of a traction substation using telemechanics. The authors analyze the possibility of manufacturing compact sections of the ac contact network on the basis of single-phase re-closers OR-27.5 kV. It is noted that it is advisable to use a new automation scheme in conjunction with the sectionalization points on reclosers.

In modern herniology tension free technic of hernia repair is a leading, thanks mainly to fewer recurrences. However, hernia repair breaks anatomy and functionality of the anterior abdominal wall, which leads to a deterioration in the quality of life of patients. Objective: To analyze the quality of life of patients after hernia repair ventral hernias. Materials and Methods: The analysis of the results of surgical treatment of 199 patients with ventral hernias after hernia repair in 6 months. For the study used questionnaires quality of life using the SF-36 form. Results: characteristics of each operation, positive and negative, are reflected in the indices of physical and mental health of the survey. Conclusions: onlay, inlay methods of hernia repair are characterized by the best indicators of physical health in the late postoperative period. Methods sublayplastics have a greater impact on the health of the patient in the postoperative period. However, mental health indicators surpass a simple hernia repair techniques.

The new data on a composition of the Osipa and the Chaidakh Formations (Upper Triassic) in the Pronchishev Range region has been obtained. Stratigraphic subdivision of the geological succession by complex bio- and lithostratigraphic methods was carried. By results of the carried-out (implemented, done) litofaciesanalysis the studied deposits have been found to represent the uniform regressive sedimentological cycle with the transgressive pack in the basis. Consecutive change of sea-shallow sedimentation conditions by coastal is noted. The comparative analysis of the studied geological succession with basic successions of adjacent areas showed that its structure has the Leno-Olenek type but with moredistinct far-coastal deposits characteristics.