Vol 336, No 9 (2015)

One of the main priorities of the medical service of the armed forces of the Russian federation is a realization of rights for military retirees and members of their families to free medical care. For this purpose was founded a system of organization of medical care delivery at military-medical subdivisions, units and organizations of the ministry of defence of the Russian federation, based on territorial principle of medical support. In order to improve availability and quality of medical care was determined the order of free medical care delivery to military servicemen and military retirees in medical organizations of state and municipal systems of the health care.

The aim of investigation is to improve surgical treatment of patients with locally advanced pelvic cancer. The basis of investigation is 186 patients with locally advanced pelvic cancer. The average age of patients is 65,2±5,2 years (from 43,7 to 88,4 years). Among them are 112 women and 74 men. In the period from 2007 to 2015 they were carried out combined (101 patients) and expanded (85 patients) surgical intervention in the department of naval surgery of the Military medical academy after S.M.Kirov. Pelvic evisceration was performed in 63 cases. Both patients were performed isolated vascular hyperthermic chemical pelvic perfusion. Indications for plastic surgery of peritoneum pelvic were: total infralitoral pelvic evisceration (9 patients), dorsal infralitoral pelvic evisceration (11 cases) and expanded abdominoperineal rectum extirpation (34 patients). Plastic surgery with autogenouse tissues was performed to 43 patients, with reticulate explants - to 11 patients. The rate of postoperative complications was 40,2%. The rate of postoperative lethality was 8%. Expanded and combined operations of pelvic at patients with locally advanced cancer without absolute contra-indications can be performed irrespective of age. Plastic surgery of peritoneum pelvic after total and dorsal infralitoral pelvic evisceration and expanded abdominoperineal rectum extirpation indicated in all cases. The easiest method is plastic surgery with greater omentum or peritoneum pelvic. Plastic surgery with reticulate explants is performed when autoplastic is impossible.

The authors summarized literature sources, concerning modern ideas about the role of nutritional therapy in the system of health-resort treatment. The authors also made a research on the basis of literature, concerning health-resort nutrition divided into two systems - buffet system and special-order system. On the basis of sanatorium establishments of the Ministry of Defense authors summarized an experience of clinical nutrition in different age groups and categories of patients. On the basis of current regulatory acts were defined forms and methods of meal catering in the Russian Federation. The results of the study are a scientific supposition for substantiation of management decision-making process, which allows to increase an efficiency of health-resort treatment via nutrition therapy.

The analysis of the causes of lack of effective functioning of the medical and psychological rehabilitation of crew of the Navy in the Pacific Fleet is performed. Possible ways of solving existing problematic issues are suggested. For determination of fatigue and overwork it was suggested to undertake mandatory initial medical and psychological screening examination of crews immediately before the return to the naval base, using a simple and affordable methods of testing. Medical and psychological rehabilitation of soldiers after the long sea voyages proposed to take immediate military sanatorium of the Ministry of Defense of the Russian Federation (on the territorial principle).

This article is dedicated to the current state and prospectives of cell engineering in nephrology from the point of view of military medicine. The review is based on publications from January 1, 2014, to June 1, 2015, and consists of two parts. In the first part the main directions of the cell engineering development are mentioned. The only two clinical trials existed in the field are discussed in more detail. The second part deals with prospectives of cell engineering in nephrology. It is shown that currently this field is in the stage of preclinical experimentation. Of the two known clinical trials the first has failed to demonstrate any effectiveness of cell engineering, the second - will be completed only at the end of 2016. Also, the review notes an extraordinary cost of cell engineering experiments in nephrology. The analysis of publications allows to come to a conclusion that the future progress in prevention and treatment of acute kidney injury could go not in the direction of cell engineering but rather non-cell technologies. One of the practical consequence of such a conclusion is a necessity to continue the improvement of already existing methods of machine renal replacement therapy.

The authors gave modern ideas about methods of successful strategies of radiation injuries treatment. Pathogenetic mechanisms of radiation pathology and influence of accompanying factors are considered. The authors expounded the main principles of complex treatment of acute radiation sickness and provided information about results of medicaments usage and physiotherapeutic methods of treatment of patients with radiation injuries.

Authors described a successful case of antiviral treatment of gigantic lymphoadenopathy in patient with chronicle hepatitis C.

The authors analysed the history of the Saint-Petersburg naval hospital, founded in October, 1715 by Peter the Great, defined its role in the key historical events during organisation of medical aid delivery to wounded and patients, discussed current tasks, concerning development of hospital art when forming modern image of the navy of the Russian Federation.