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Уважаемые читатели!
стр.5-5
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Современные технологии в медицине
стр.6-7
A development of practical public health in all the times wasn't possible and full-blooded without a parallel development of medical science. The applied and scientific research constituents of medicine are mutually supplementing ones: the actual questions of clinical picture frequently initiate investigations in the corresponding direction; sometimes the scientific achievements permit to optimize the used methods or create the new ones of diagnosis, treatment and prophylaxis of the different diseases.
The main directions of a medical science development for the last decades are highlighted. One of the main aspects of modern medicine is an aggregate of many disciplines, which is reflected not only in the scientific research work development, dealing simultaneously with several medical fields, but in the scientific direction forming with the medicine, biology, physics, chemistry, informatics and other science branch achievement attraction.
A special attention is paid to introduction into public health of the information technologies, which are used both for organization and methodical question solution and creation of the new treatment-and-diagnostic methods directly. A great number of elaborations, as it was expected, are dedicated to optimization of the diagnosis and treatment methods of the most prevalent diseases: cardiovascular, oncologic ones.
An important aspect of the present medicine is a possibility of investigations at the molecular and submolecular levels, which permits to regard the disease development mechanisms and accomplish a medical process quite differently.
All the enumerated aspects define a variety of modern medical technologies, a creation and introduction of which is a priority direction of a state policy for the nearest years.
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Мультиэлектродные матрицы - новые возможности в исследовании пластичности нейрональной сети
стр.8-15
Мухина
И.В. Казанцев
В.Б. Хаспеков
Л.Г. Захаров
Ю.Н. Ведунова
М.В. Митрошина
Е.В. Коротченко
С.А. Корягина
Е.А.
Investigation is dedicated to important problem of the brain neuronal network plasticity mechanism revealing. One of the key moments for that problem solution is a possibility of the functional process noninvasive monitoring in brain at life from a molecular and cellular level to a systemic organization level. Such a possibility is realized in multielectrode systems, used in neurophysiology and characterized by many advantages: a cellular noninvasiveness; a possibility of a simultaneous registration of signals and the cell stimulation; a chronic experiment
(months); a possibility of pharmacologic manipulations, including a medicinal screening; a structural and functional neurovisualization at life. A combination of the cell culture with a multielectrode system of registration and a stimulation of the neuron activity permit to simulate in dynamics the different stages of the neuronal chain development. An alteration of that activity pattern, the mechanisms of which are still not clear, takes place depending on a culture age, the cultivation conditions and pharmacologic effects.
The aim of investigation is a study of the hippocamp neuron spontaneous bioelectrical activity appearance conditions in vitro depending on time of development and the cell density in culture.
Materials and methods. The experiments are made on dissociated cultures of the mouse embryo hippocamp embryonal cells (E18). A combination of the MED64 neuron activity extracellular registration multielectrode system (Alpha MED Sciences, Japan) with the methods of the intracellular calcium alteration visualization at life with a use of a fluorescent stain Oregon Green 488 WARTA-1 and a laser scanning confocal microscope Zeiss LSM510 NLO Duoscan has permitted to investigate in dynamics the different stages of the neuronal network development.
Results. It is established, that a functional activity of culture, registered both at extracellular electrodes MED64 and with a use of a confocal microscopy (the calcic oscillations) compared to the morphologic imaging investigation data, is actually an indicator of forming in a process of the active neuroglial network cultivation. An appearance of the neuron spontaneous activity in a network depends on age and density of the hippocamp cell culture.
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Влияние липидов хрусталика на его физические характеристики
стр.16-20
Кудрявцева
Ю.В. Чупров
А.Д. Треушников
В.М. Чупров
Д.К. Иванова
И.П. Цапок
П.И.
The aim of investigation is a study of the lens lipid influence on its physical characteristics.
Materials and methods. 114 patients at the age of 55 to 78 years with a cataract of a different degree of maturity are selected for investigation. The clinical investigations of the lens in vivo, investigations of the lens nucleus lipids and the lipid peroxidation in vitro were conducted.
Results. It is established, that the most important link in the lens function disturbance processes is the lens fiber biological membrane lipids. A reverse strong dependence between the accommodation volume and nucleus hardness, a strong direct dependence between a content of the polyunsaturated fatty acids and the lens hardness (r=0.7; p
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Влияние противоопухолевого лечения и озонотерапии на показатели перекисного окисления липидов концентрации некоторых микроэлементов в плазме крови больных раком молочной железы
стр.21-27
Алясова
А.В. Конторщикова
К.Н. Коркотошвилли
Л.В. Терентьев
И.Г.
The aim of investigation is a revealing of the complex treatment and ozonized physiologic salt solution infusion influence on alterations of the lipid peroxidation values and concentrations of zinc, cuprum, ferrum in blood plasma of patients with a mammary gland cancer.
Materials and methods. 300 patients with a mammary gland cancer (MGC) at the age of 35-65 years with a histologically confirmed diagnosis, predominantly with the III-IV stages (73.6%) were observed. A state of a protection antioxidant system and lipid peroxidation (by the induced biochemiluminescence method with a use of the BChL-06 device), the lipoperoxidation molecular product content (by the method of ultraviolet spectroscopy and with a use of a fluorimetric method) and concentrations of zinc, cuprum, ferrum in blood plasma (with a use of the atomic and absorption spectrophotometer S-115-M1) were investigated in patients. 48 patients with the III-IV stages (the 1st group) were additionally prescribed the ozonized physiologic salt solution infusions except the antitumoral treatment, 48 patients (the 2nd group) were receiving a standard antitumoral therapy, 15 females (the 3d group) were infused a nonozonized physiologic salt solution at the background of antitumoral treatment. A domestic serial medical ozonator ph. «Quazar» (N. Novgorod) was used for receipt of ozone. The received data was treated with a use of the STADIA 4.51 statistical program package.
Results. It is established, that a radial therapy favored a trustworthy increase of the cuprum and ferrum content in patients at a zinc level decrease; a polychemotherapy favored a significant decrease of a zinc level and a trustworthy increase of the ferrum content. A depression of the protection antioxidant system activity and accumulation of the lipoperoxidation molecular products were simultaneously observed. The ozonotherapy addition to a standard treatment was accompanied by a free-radical oxidation process normalization, a zinc serous content increase (p
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Биоцидный эффект некогерентного импульсного излучения искрового разряда в экспериментах in vitro и in vivo
стр.28-31
Иванова
И.П. Заславская, М.И.
The aim of work is investigation of the spark discharge plasma non-coherent impulse radiation (NCIR) use possibility as a factor capable of the microorganism growth and reproduction suppression in experiments in vitro and in vivo. The tasks of the bacteriostatic, bactericidal and fungicidal effect study, as well as the free-radical process level assessment in experiments in vitro and in vivo after the spark discharge plasma NCIR effect, were solving.
Materials and methods. A non-coherent impulse radiation in optical range of 180-800 nm was generated in a process of a highly energetic spark discharge initiation with a use of experimental device, created on a base of the ARSRIEPh (Sarov).
The microorganism cultures S. epidermidis, strain 51-1; E. coli, strain 18M and C. albicans, strain 601 from the NNSMA microbiology and immunology chair museum are used in work. The bacterial suspensions were irradiated in modes of 5 to 600s, there was inoculation of the corresponding selective media after treatment. The intact microorganism suspension was used as a control. An assessment of the free-radical reaction level after a NCIR treatment was made in the microorganism suspension with a method of induced chemiluminescence (Feand H2O2) at a biochemiluminometer BChL-6.
An assessment of fungicidal effect and free-radical homeostasis of animals after a non-coherent impulse radiation effect in experiments in vivo is made on 72 laboratory rat-males of the Wistar line with a mass of 200±10g by 12 samples in each series. All manipulations with animals were made with a use of ether anesthesia. The animals were divided into 6 series: the intact ones, effect of 100s, effect of 300s, contaminated C. albicans and effect of 100s, contaminated C. albicans and effect of 300s. The animals were infected perorally with a C. albicans suspension. The oral cavity irradiation with a NCIR has been made during 100 or 300s, in each 24 hours during 6 days after contamination. A concentration of C. albicans in the oral cavity was detected at the 7th day of contamination (in 24h after the last irradiation). An assessment of a free-radical homeostasis of animals after a NCIR treatment was made according to the blood plasma and erythrocyte free-radical reaction level, which was studied with a method of induced chemiluminescence.
Results. Both bacteriostatic and biocydic effects of the spark discharge gas discharge plasma NCIR, as well as an increase of the free-radical process level in experiments in vitro and in vivo are established. It is revealed, that a NCIR of the gas discharge plasma possesses of 100% of a bactericidal and fungicidal effect at the bacterial suspension treatment during 200s in experiments in vitro. A bacteriostatic effect of a NCIR is demonstrated in experiments in vivo. The free-radical process level after a NCIR effect was increased in the cell suspension in experiments in vitro, that radiation in a microorganism activates the free-radical processes at the erythrocyte membranes in the studied modes.
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Современные технологии в хирургии грыж передней брюшной стенки
стр.32-38
Паршиков
В.В. Петров
В.В. Ходак
В.А. Самсонов
А.А. Романов, Р.В. Градусов
В.П. Бабурин
А.Б.
The aim of work is a study of the non-intentional plasty possibility depending on material, a method of endoprosthesis fixation, the patient age, a clinical situation.
Materials and methods. 1081 operations on occasion of hernias have been made since 2002 to 2009 in the MTPI «City hospital N 35»; 665 operations - with a use of endoprostheses from polypropylene and reperene. The Liechtenstein's method, a herniosystem implantation, was used in patients with inguinal hernias. The inlay, sublay, onlay, sutureless plasty methods are used at postoperative hernias. A life quality of patients was assessed with a use of the MOS SF-36 questionnaire.
Results and discussion. It is established during analysis of the reperene (n=68) and polypropylene (n=240) use results at inguinal hernias, that the infiltrates are twice frequently observed (5,8%) at a polypropylene use, than in cases of a reperene use (2.9%; p=0.13). A reperene plasty at the ventral hernias (n=22) doesn't lead to suppurations and infiltrates; a suppuration was developed in 4 patients ((1.47%; p=0.02) at a polypropylene use (n=273), an infiltrate - in 10 patients (3.66%; p=0,0007). A non-intentional plasty use at the strangulated hernias decreases a number of systemic complications (from 17.65 to 5.95%; p=0,02) and lethality (from 11,76 to 3,57%; p=0,04). A number of purulent wound complications is not trustworthy increased. A postoperative wound suppuration is developed in 1,47% of cases at the local tissue use, in 1,53% - at alloplasty, p=0,49. There were no complications and lethality (p
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Инфракрасный спектральный анализ сыворотки крови как отражение уровня нарушения метаболических процессов при инфекционной патологии у детей
стр.39-43
Краснов
В.В. Гордецов
А.С.
The aim of work is a detection of the IR-spectroscopic analysis integrative value correlation with a toxicosis expression degree, stipulated by the metabolic disturbance level.
Materials and methods. 183 children with different clinical variants of diphtheria, angina, infectious mononucleosis and 30 healthy children at the age of 1 to 14 years were observed. The dried blood serum, prepared for the IR-spectral analysis, was investigated.
Results and discussion. The differences of the spectral analysis conventional mathematical symbol (parameter) numerical meanings at different diseases in children depending on a degree of intoxication expression, characteristic of each disease, as well as on their meanings in healthy children, are revealed. Besides, the substantional differences of numerical meanings are marked at different outcomes of the diphtheria critical forms (the survived and died children). A correlation between the blood serum IR-spectral analysis alterations and a metabolism disturbance level at infectious pathology, defined by the intoxication expression degree, is revealed. It is presumed, that the blood serum IR-spectra reflect a level of metabolic disturbances in the organism, appearing under the influence of infectious agent. These alterations are not specific for any separate disease and reflect the common regularities of the infectious process pathogenesis.
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Роль метода экстракапсулярной факоэмульсификации в оперативном лечении возрастной и осложненной патологии хрусталика
стр.44-47
The collaborators of the NNSMA ocular disease clinic have made more than 10000 operations of the extracapsular phacoemulsification with the artificial lens implantation at cataracts of the different degrees of opacity and a density of 1-5 since November 1995.
A flow of operation and postoperative period in more than 95% of cases was uncomplicated. In 80% of cases the operation was terminated with a soft artificial lens implantation. A high stable visual acuity - 0.4-1.0 (with correction or without it) is marked in 90% of patients. The indications and contraindications of the extracapsular phacoemulsification method use are regarded. An original universal model of artificial lens, used for correction of a visual acuity in complicated and uncomplicated cases, is elaborated.
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Нарушения ритма и проводимости у больных хроническим легочным сердцем и их коррекция препаратом небилет
стр.48-53
Конюхова
И.В. Суворов
А. В.
The cardiac rhythm disturbances frequently attend a chronic pulmonary heart (ChPH) development. An insufficient effectiveness of a traditional antiarrhythmic therapy in patients with the chronic obstructive diseases of lungs necessitates a search of the new methods of treatment.
The aim of investigation is a study of the cardiac rhythm and conduction disturbance character and rate in patients with a ChPH depending on a clinicofunctional class (CFC), detection of the nebilet (nebivolol) superselective beta-blocker use effectiveness in patients with extrasystole and ciliary arrhythmia.
Materials and methods. 125 humans with a ChPH (average age is 57,3±0,89 years) are examined. All the patients were divided into two basic groups: the 1st one - with a pulmonary heart without an attendant ischemic heart disease (IHD) and the 2nd one - with a combination of a pulmonary heart and IHD. According to a ChPH flow the patients were divided into four CFC. The patients were undergoing a physical examination, a general analysis of blood investigation, investigation of the external respiration function (ERF), electrocardiography (ECG), a daily monitoring of ECG according to Holter, echocardiography (echoCG) with a systolic pressure registration in a pulmonary artery, detection of acidic and basic state of blood.
An «acute» experiment (n=25) and a course treatment with a nebilet preparation in patients with a ChPH (n=17) were conducted.
Results and discussion. The alterations of the ERF values, echoCG and acidic and basic state of blood depending on a CFC were compared.
The rhythm and conduction disturbances in patients of the 1st group at the Holter's monitoring were 95%. The supraventricular rhythm disturbances were diagnosed in 92.5%, the ventricular ones - in 65% of patients; a combination of the several types of arrhythmias and blockades was frequently registered. A tendency to the ventricular rhythm disturbance increase, an increase of the high gradation ventricular extrasystole per cent was observed in patients with attendant IHD (2nd group). A more significant intercommunication between the pathogenetic factors and their influence on arrhythmia development with a use of a correlation analysis with the Spierman's coefficient detection are determined.
An 'acute' medicinal experiment and a course treatment with nebilet were conducted. An effectiveness of the nebilet beta-adrenoblocker use at the extrasystole treatment without aggravation of the peak expiration rate is marked. A transition of the auricle fibrillation tachysystolic form to a normosystolic one is registered in several patients.
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Особенности нарушений липидного обмена и их коррекция препаратом фосфоглив при хроническом гепатите С
стр.54-56
Ситников
И.Г. Рыжкина
А.В. Бохонов
М.С.
The aim of investigation is a study of the phosphogliv preparation hepatoprotective effect mechanisms at a model of experimental chronic hepatitis and assessment of the preparation therapeutic effectiveness at a monotherapy in patients during a chronic hepatitis C acute attack.
Materials and methods. A simulation of a chronic tetrachloromethane hepatitis was accomplished on rats according to the generally-accepted method. The biochemical investigations of blood and liver, a histomorphology of the liver tissue were made. A clinical part of work included examination of 68 patients with a chronic hepatitis C. A diagnosis was verified by standard methods. A clinical examination, USI of the liver and biliferous ducts were accomplished. An activity of transaminases, the values of precipitated albuminous tests, the concentrations of bilirubin, glucose, triglycerides, a general cholesterol, a cholesterol of lipoproteins of a high, low and very low density, the concentrations of the non-etherified (free) fatty acids were detected in a blood serum.
Results. A good hepatoprotective activity of the phosphogliv preparation, preventing the destruction and metabolic disturbance development in the liver, improving the synthetic and reparation processes, is revealed according to the experiment data. A clinical investigation has confirmed a necessity of the lipid metabolism disturbance correction in patients with a chronic hepatitis C for effective treatment and a disease prognosis improvement. A phosphogliv preparation as a means of etiopathogenetic effect is recommended with that purpose.
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Малоинвазивные методы лучевой диагностики механической желтухи опухолевого генеза
стр.57-62
Забавина
Н.И. Плотников
А.Ф. Колпащиков
И.Е. Загайнов
В.Е.
The authors have elaborated a complex method of the hepatopancreatobiliary zone tumoral disease diagnosis in patients with mechanical jaundice, including external drainage of the biliferous system elements (a transcutaneous punction cholecystostomy, cholangiostomy) under the US-control with a subsequent transcatheter roentgenocontrast investigation at the X-ray apparatus with a remote control.
The aim of article is the given method diagnostic possibility assessment.
Materials and methods. Peculiarities of the biliferous tract roentgenologic picture at a high and low biliary block in 31 patients are studied. An assessment of a patient irradiation average dose, received as a result of X-ray investigation, is made.
Results. It is established, that a method of the biliferous system transcatheter roentgenocontrast investigation is just as good as a generally-accepted one according to its diagnostic possibilities, besides a radial load to patients is significantly decreased (by 86.4%). A radial load to a medical staff is completely excluded. The standardized program and protocol, permitting to optimize the biliary duct X-ray investigation, are elaborated.
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Опыт применения операции TVT-O в лечении стрессового недержания мочи у женщин
стр.63-66
Атдуев
В.А. Березкина
Г.А. Семенычев
А.В. Данилов
А.А. Строганов
А.Б. Березин
К.В. Хазов
М.В.
The aim of investigation is a study of the stress urinary incontinence treatment results in females with a use of the TVT-O method. Just the given operation best corrugates the basic reasons of a stress urinary incontinence - a pathologic mobility of the urethrovesical angle, insufficiency of the external sphincter of urethra and weakness of a pelvic musculofascial fastening as well.
Materials and methods. Despite a sufficiently large number of the presently elaborated operations on a surgical correction of a stress urinary incontinence a retrograde method of the TVT-O operation is successfully used in our clinic. 37 patients had been operated from May
проопериро
2006 to November 2008 on occasion of a stress urinary incontinence with a use of the TVT-O retrograde method. The average age of patients was 48 years (from 33 to 72 years).
Results and discussion. The authors have managed to receive the positive results in 91.9% of observations with a use of the given technique of operation. It testifies to the fact, that the TVT-O method is a really low-invasive, safe and sufficiently effective method of a stress urinary incontinence surgical correction in females. Such operations favor a rapid rehabilitation of patients in the active able-bodied age, which permits them to preserve a social activity, occupational fitness and significantly improve a life quality as well.
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Долихосигма как причина рецидивирующего болевого синдрома в правой подвздошной области у детей
стр.67-69
A retrospective analysis of 140 case histories of children of a year to 17 years with a verified diagnosis «dolichosigmoid» is made. It was revealed, that more than a half of examined children (56,4%) had the recurring pains in the right iliac area. It is demonstrated, that a dolichosigmoid with a recurring painful syndrome in the right iliac area occupies the first place in a spectrum of other intestine diseases in children with analogous painful syndrome. Such peculiarities of a clinical picture, as the durative constipations (up to 7 days) and even a lack of independent stools - in 39,3% of examined children, a phenomenon of encopresis - 53,2%, as well as a red blood appearance in feces- 10,1%, which can be explained by the anal canal mucous membrane damage at the hard fecal mass passing, are described.
The X-ray investigation (irrigoscopy) was of a primary importance at a diagnosis among the instrumental methods; the endoscopic investigation (a rectoromanoscopy, colonoscopy) was used as a supplementary one, besides a lengthening and extension of the colon sigmoid department clearance was revealed.
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Современный взгляд на проблему локальных рецидивов рака молочной железы
стр.70-83
Поддубная
И.В. Комов
Д.В. Колядина
И.В. Керимов
Р.А. Рощин
Е.М. Макаренко
Н.П. Ожерельев
А.С.
The notions of local, regional and locoregional recurrences of the mammary gland cancer are singled out in modern literature. A confusion of the recurrence notions leads to difficulties not only in detection of their appearance rate and a clinicomorphological characteristic, but in assessment of the disease treatment and prognosis possibilities. The world data of the recurrence appearance clinicomorphological risk factors such as a primary tumor size, the regional lymph node lesion, the patient age, a presence of multiple centers and peritumoral tumor invasion, a use of postoperative radial therapy and etc. is systematized in the review. The data of the tumor receptor status and genetic factor role in development of the mammary gland local recurrences is presented. A clinicomorphological characteristic of the local recurrences considering a localization, number of tumoral nodes, a tumor shift, a presence of calcinates and such complications as a tumor ulceration or decomposition, a germination of neighboring structures and infection is given. The different types of the local recurrence treatment (surgical, medicinal, radial method and their combinations) and a site of local recurrence in prognosis of disease in patients with a mammary gland cancer are studied.
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Гепатопульмональный синдром: состояние проблемы
стр.84-88
Ильченко
Л.Ю. Федоров
И.Г. Карабиненко
А.А. Осканова
Р.С. Сторожаков
Г.И.
A portal hypertension is one of the leading syndromes characteristic of the liver cirrhosis. The serious disturbances of circulation, accompanying the liver cirrhosis, are in a basis of the circulation disorders in all the organs practically, including the lungs, with the critical pathologic change development in them. The variants of the lung lesions, the characteristics of the lung lesion basic syndromes at the liver cirrhosis (a hepatopulmonary syndrome, a portopulmonary hypertension syndrome), the methods of diagnosis and treatment of the patients (including a medicamental correction and surgical treatment) are regarded.
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Современная тактика ведения больных внебольничной пневмонией на амбулаторном и стационарном этапах
стр.89-94
Сторожаков
Г.И. Карабиненко
А.А. Борисов
В.И. Широхова
Н.М. Светлаков
В.И.
The modern tactics questions of the patient with extrahospital pneumonia treatment at the outpatient and hospital stages are regarded. It is demonstrated, that it's necessary to follow a combined diagnostic approach concept, considering etiology in a disease diagnosis, presuming a consideration of the clinical signs, roentgenologic, laboratory and microbiological defining signs, and to assess a clinical effectiveness of the conducted treatment as well; their defining criteria are regarded. The standards of the antibiotic modern use presume consideration of a pneumonia gravity degree, an age and attendant diseases. The peculiarities of antibacterial treatment at the different gravity degree pneumonias at a hospital are regarded.
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Случай успешного излечения больной с синдромом полиорганной недостаточности при акушерском сепсисе
стр.95-98
Зубеев
П.С. Романов
Э.И. Мокров
К.В. Меркулов
С.П.
A case of a successful healing of a 26 year patient with a syndrome of polyorganic insufficiency at obstetrical sepsis because of a criminal abortion is described. The methods of prolonged venovenous hemodiafiltration and prolonged venovenous hemodialysis, permitted to briefly eliminate the endotoxicosis, improve the water and electrolytic balance values and successfully treat a syndrome of polyorganic insufficiency, were used in complex treatment of a patient.
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Редкая клиническая маска болезни крона подвздошной кишки
стр.99-101
Кокобелян
А.Р. Абелевич
А.И.
A rare clinical observation of the ileum terminal department Crohn's disease, simulating the rectum tumor, is made. It was possible to make a final diagnosis intraoperationally only. A plan of operation was timely altered, which permitted to achieve the good treatment results.
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Случай успешного лечения эндокардита искусственного протеза трехстворчатого клапанасердца с применением антибактериальной терапии и гипербарической оксигенации
стр.102-104
Шаров
А.А. Пичугин
В.В. Шмыков
Э.Я.
A case of the heart tricuspid valve artificial prosthesis endocarditis effective treatment with a use of antibacterial therapy in combination with a hyperbaric oxygenation in patient, actively taking the drugs, as a result of which there was no need in surgical intervention, is described.
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Материалы VIII научной сессии «Современное решение актуальных научных проблем в медицине»
стр.105-119
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Требования к рукописям, направляемым в журнал «Современные технологии в медицине»
стр.120-124
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