Journal of Volgograd State Medical University

Peer-review scientific and practical medical journal


  • Vladimir I. Petrov, MD, Professor


  • Volgograd State Medical University


  • Volgograd State Medical University


Quarterly scientific journal "Journal of Volgograd State Medical University" ("Journal of VolgSMU") is included in the list of leading peer-reviewed scientific journals and publications, which should be published by a major scientific results thesis for the degree of doctor of medical and biological sciences.

As part of the Editorial Board: 4 academicians of RAS, 2 corresponding members of RAS, representatives of scientific and medical community in Moscow, the Volga regions and South of Russia.

Index in Russia's national catalog "Rospechat" – 20158.

Mailing list of the journal, in addition to mandatory organizations, includes more than 50 universities and research institutes in Russia, as well as a number of leading clinical institutions in the region.


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Current Issue

Vol 20, No 1 (2023)


Pedagogical process in the surgical clinic
Golbrah V.A., Maskin S.S., Matyukhin V.V., Klimovich I.N.

The article is devoted to the training of a surgeon – one of the most complex, painstaking and costly types of education. From the point of view of deontology and the legal framework, students do not have the opportunity to perform various manipulations on patients or participate in operations. In this regard, there is a problem of hyposkillia (lack of practical skills). Clinical skills include not just performing manipulations, but mastering clinical thinking as a special form of human knowledge to comprehend the nature of the disease, mental activity to combine clinical observations, paraclinical studies and personal practical experience. Some ways of solving this problem are proposed, which will improve the training of a competent surgical specialist.

Journal of Volgograd State Medical University. 2023;20(1):4-8
pages 4-8 views

Review Articles

Analytical review of graphic methods for the study of dental arches in clinical orthodontics
Shkarin V.V., Dmitrienko D.S., Yagupova V.T., Mansur Y.P., Sherbakov L.N., Verstakov D.V.

The analysis of textbook and modern literature sources devoted to the graphic construction of human dental arches was carried out in order to select the optimal research methods, taking into account the individual characteristics of the craniofacial morphology. The features of the construction of dental arches according to the Hawley method are presented and the possibilities of using this technique only for some types of dental arches are shown. Information is given on the amendments to the calculations of the radius of the Hawley circle, taking into account the geometric laws of the circle. Attention is paid to the shape of the dental arch of the milky period of the bite and the possibility of using the Schwartz method in children only with optimal occlusive ratios without signs of anomalies of the dentition-jaw system is noted. Amendments to the A. Schwartz method are presented, taking into account the size of the teeth and the size of the diastem component. The method for determining the size of the dental arches by the parameters of diagnostic triangles and the dental pentagon is shown. Methods of graphic construction of predicted forms of arcs with their anomalies, as well as with defects of long length, including complete adentia, are presented. This analysis can be useful to orthopedic dentists and orthodontists when choosing methods of prosthetic and orthodontic treatment.

Journal of Volgograd State Medical University. 2023;20(1):9-16
pages 9-16 views
Problems of adaptation of primary prosthetic patients with complete absence of teeth to removable plate prostheses
Chepuryaeva O.S.

The prevalence of total tooth loss has not decreased over the past decade. This is one of the most common pathologies, especially among the elderly. The restoration of the functions of chewing, aesthetics and speech in the complete absence of teeth is one of the most important tasks of modern dentistry. For the treatment of complete absence of teeth, removable plate prostheses are mainly used. The problem of adaptation of patients to them remains unresolved in the treatment of removable plate prostheses. There are many different approaches to improving the adaptation of patients with complete absence of teeth to removable plate prostheses: the installation of dental implants, the use of adhesive drugs, the use of local ozone therapy of the oral mucosa, the use of new structural materials. However, all these methods do not allow us to solve the fully existing problem of adaptation. In addition, the use of adhesive drugs can cause allergies in patients. It is not always possible to install implants and perform local ozone therapy, and expensive equipment is also necessary. An analysis of the scientific literature conducted in the article on the problems of adapting patients to orthopedic dental treatment with removable plate prostheses showed that among the methods of non-drug effects on these processes, the use of biological feedback methods may be preferable, which helps to reduce the adaptation period by stimulating the human body’s own reserves.

Journal of Volgograd State Medical University. 2023;20(1):17-23
pages 17-23 views

Original Researches

Electrical activity of the brain during the imagination of purposeful hand movements in persons playing stringed and keyboard musical instruments
Tkachenko P.V., Kononenko N.S., Nasmachnaya A.A.

The imagination of purposeful movements and their implementation activates the same areas of the cerebral cortex, which is actively used in the creation of the brain computer – interface and its implementation in the field of healthcare in the form of neuro-controlled exoskeletal limbs and robots that perform complex medical manipulations using the human brain. Playing musical instruments contributes to the development of upper limb motor skills and the development of interneuronal connections of the cerebral cortex. The aim of the work was to study brain activity when imagining purposeful movement in persons playing musical instruments. Brain activity was measured using electroencephalography. Interhemispheric asymmetry was determined using a complex method to determine the leading hemisphere. Because of the conducted research, it was found that the skills of playing musical instruments, even in the absence of sensory afferentation from the periphery during the imaginary initiation of movement, contribute to a stronger combined activation of the sensory and motor areas of the cortex.

Journal of Volgograd State Medical University. 2023;20(1):24-28
pages 24-28 views
Psychophysiological correlates of operators’ predisposition to the development of critical fatigue level
Naumenko A.E., Kluchek A.E., Kostyuchenko M.S.

Factors such as emotional stress, extreme work conditions, neuropsychiatric stress, the need to maintain an increased level of attention for a long time can lead to violations, maladaptation and the development of operator fatigue. In the course of the study, we revealed statistically significant differences in attentional-mnestic performance indicators in groups of operators with the absence or presence of a critical level of fatigue. It is established that the use of a complex of psychophysiological tests "Jaguar" in parallel with the study of sensorimotor tracking operations by the program "Smile" is informative for differentiating groups of operators with the absence or presence of a critical level of fatigue.

Journal of Volgograd State Medical University. 2023;20(1):29-32
pages 29-32 views
Application of interval normobaric hypoxia-hyperoxia in the treatment of high myopia
Bizhoeva L.K., Borukaeva I.K., Ivanov A.B.

The emergence of a new hypoxic therapy regimen in which hypoxic intervals alternate with hyperoxic intervals (30 % O2) led to the need to study the effectiveness of hypoxic-hyperoxic therapy for the treatment of progressive myopia. An ophthalmologic study was performed on 116 male patients from 8 to 21 years of age with severe myopia. Doppler study of cerebral vessels, determination of indices of functional respiratory system were carried out. Interval hypoxia-hyperoxia therapy proved to be an effective alternative method for improving visual function of the eye and preventing further progression of myopia as a result of improved blood supply to the central and peripheral parts of the visual analyzer.

Journal of Volgograd State Medical University. 2023;20(1):33-37
pages 33-37 views
The influence of different factors on corneal biomechanical properties in norm and in progressive keratoconus
Solodkova E.G., Balalin S.V., Fokin V.P.

A prospective study of corneal stiffness parameter of 174 eyes of 174 healthy subjects with different refractions as well as 56 eyes with keratoconus was carried out. The study groups were comparable in age and gender composition. Correlation was performed between corneal stiffness parameter (Stiffness Parameter (SP-A1), minimum corneal thickness (MCT) and biomechanically compensated intraocular pressure (bIOP) determined using Pentacam HR and Corvis ST (OCULUS, Germany), as well as the anteroposterior chamber (APC) value and patient age. Based on multivariate regression analysis, the correlation between corneal stiffness index SPA1, minimum corneal thickness (MCT) and biomechanically compensated IOP (bIOP) in healthy subjects (p = 0.00001, p = 0.005, respectively) as well as in patients with keratoconus (p = 0.00000, p = 0.0032, respectively) was established. Using the obtained data, the tables for determination of corneal stiffness in healthy subjects and patients with different stages of keratoconus, depending on the minimal thickness and level of biomechanically compensated intraocular pressure, were compiled. Application of the tables will allow in practical work to quickly analyze corneal stiffness index which can be used as an important diagnostic criterion in patients with keratectasia.

Journal of Volgograd State Medical University. 2023;20(1):38-45
pages 38-45 views
Analysis of the quality of osseointegration of dental implants by using the Periotest M device
Komlev S.S., Kapishnikov A.V., Pugachev S.A.

The main criterion for assessing the engraftment of dental implants is their high-quality osseointegration [1]. Unreasonable loads exerted on a dental implant integrated into the bone tissue lead to its premature rejection. Adequate osseointegration of dental implants is also influenced by their shape, size, quality of their installation, adherence to the operating protocol, as well as the start date of subsequent prosthetics [2]. A qualitative method for determining the stability of an installed dental implant is the method of periotestmetry. In the absence of general somatic pathologies and disorders in the structure of the dental system, stable osseointegration of dental implants, periotestometry data (averaged values for 16 strokes) are in the range from -8 to 0 units. The aim of the study was to analyze the osseointegration of installed dental intraosseous-on bone implants by performing periotestmetry. Materials and methods: The study group consisted of 116 patients who received 167 dental implants. At 1, 2, 4 months, half a year, a periotestmetric study was conducted using the Periotest M apparatus. Results and discussion: The analysis of the parameters obtained in the course of the study revealed the dependence of the periotestmetric data and the quality of osteontegration of intraosseous-extraosseous dental implants. Conclusion: The study of the indicators of periotestmetric data for intraosseous-bone dental implants made it possible to qualitatively predict the results of orthopedic treatment, and also made it possible to assess the degree of osseointegration of the installed dental implants.

Journal of Volgograd State Medical University. 2023;20(1):46-49
pages 46-49 views
Comparative analysis of clinical and functional parameters of the gingival margin of patients with low crown height against the background of various methods of preparation for prosthetics
Veremeenko S.A., Makedonova Y.A., Verstakov D.V., Bolovina Y.P., Glukhova E.S.

Currently, one of the most common types of prosthetics are restorative crowns or bridges, which cannot provide high-quality retention and long-term fixation with a low crown of supporting teeth. For an orthopedic dentist, the question arises of choosing a method of preparation before prosthetics. In this work, a comprehensive examination and treatment of 95 patients with a low crown of supporting teeth was carried out, who were randomized into 3 groups according to the methods of preparation for orthopedic treatment – gingivoretraction, gingivectomy and gingiviplasty. The change in the state of the dentoalveolar complex was carried out clinically and functionally. The hygienic index API, papillary bleeding index PBI, the index of need for periodontal treatment – CPITN, gum recession and depth of probing were determined. Laser Doppler flowmetry was used to assess the state of local blood flow and vasomotor activity of vessels. The studied parameters were evaluated before the start of preparation for orthopedic treatment and after 14 days. During the study, complications and side effects were not revealed, however, clinical and functional indicators indicate that preference should be given to gingivoplasty as one of the qualitative methods of preparing the dentoalveolar complex in patients with a low crown of supporting teeth.

Journal of Volgograd State Medical University. 2023;20(1):50-56
pages 50-56 views
Cerenerlal remodeling after cranio-brain injury in high mountains
Shidakov Y.H., Zhanuzakov D.Z., Shuvalova M.S.

The article discusses the presentation of the features of cerebellar remodeling after traumatic brain injury (TBI) in the highlands. The experiment was carried out on 106 outbred male rats weighing 210–290 g in compliance with the rules of laboratory practice. In high-altitude conditions, in contrast to low-altitude conditions, significant changes occur in the cerebellum, namely, changes in the membrane potential of cells, ectopia of Purkinje cells, pronounced changes in molecular and granular layers.

Journal of Volgograd State Medical University. 2023;20(1):57-63
pages 57-63 views
The importance of ventricular extrasystole risk factors in young athletes
Cherkasov N.S., Doronina T.N., Ledyaev M.Y.

Introduction: Sports loads predispose to the development of changes in autonomic regulation associated with metabolic disorders in the myocardium and, with prolonged exposure, can contribute to the formation of various extrasystolic arrhythmias. Materials and methods: 58 girls of 7–8 years old were selected, who underwent a routine preventive examination before gymnastics, which included: a clinical examination, as well as: ECG, Echo-CG, Holter-ECG, heart rate variability. Results: The analysis of the influence of factors suggests that heart rhythm disturbances in young athletes are primarily associated with physical activity, in combination with comorbid pathology. Conclusions: Stressful physical activity in children with polymorbidity leads to the development of ventricular extrasystole (VE) much earlier. It has been established that in these athletes, a decrease in energy supply often precedes the development of cardiac arrhythmias, in particular VE.

Journal of Volgograd State Medical University. 2023;20(1):64-68
pages 64-68 views
Ways to prevent acute postmanipulatory pancreatitis in endoscopic transpapillary interventions in patients with mechanical jaundice
Vedenin Y.I., Mandrikov V.V., Turovets M.I., Nogina A.A., Mikhaylichenko G.V.

To evaluate the effectiveness of preventive measures in relation to the development of acute postmanipulatory pancreatitis in patients after endoscopic transpapillary interventions. Materials and methods: In the period from September 2021 to June 2022, 73 endoscopic transpapillary interventions for benign pathology and malignant pathology were performed in patients. The analysis of the frequency of the development of acute postmanipulatory pancreatitis in different time intervals in patients who underwent prophylaxis in various ways, depending on the combination of risk factors. Results and discussion: Acute postmanipulatory pancreatitis developed in 2 (3.7 %) patients who underwent transpapillary interventions in various volumes for complicated cholelithiasis. Drug prophylaxis of acute postmanipulatory pancreatitis was carried out in the preoperative period for all patients. Preventive stenting of the main pancreatic duct was performed in the presence of a combination of risk factors. Conclusion: The analysis of the results of endoscopic transpapillary interventions made it possible to identify the most significant measures that allowed to reduce the number of developed to 3 acute postmanipulatory pancreatitis to 3.7 % and thereby increase the safety of transpapillary interventions.

Journal of Volgograd State Medical University. 2023;20(1):69-72
pages 69-72 views
Morphological assessment of reparative regeneration of experimental bleeding liver wounds in the treatment of hemostatic agent Surgitamp and granular sorbent Molselect G-50
Parkhisenko Y.A., Vorontsov A.K., Cherednikov E.F., Barannikov S.V., Korsakov A.V., Troshin V.P.

The problem of treating intra-abdominal bleeding in abdominal trauma is one of the most serious in urgent surgery. The most common cause of these hemorrhages is liver damage. For surgical hemostasis, local hemostatics and granular sorbents are becoming increasingly common. The aim of the study was to study in vivo the hemostatic properties and morphological features of the reparative regeneration of simulated bleeding liver wounds during treatment with the hemostatic agent Surgitamp and the sorbent Molselect G-50. The experiments were performed on 30 laboratory animals – Chinchilla rabbits. After reproducing the model of a bleeding liver wound, bleeding was stopped in the experimental group (n = 15) by applying Molselect G-50 (4.0 g) powdered sorbent into the wound, followed by tamponing with Surgitamp hemostatic gauze (4.0 x 2.0 cm). Hemostasis in the control liver wound was carried out by applying a U-shaped suture with a PGA-3.0 thread until the edges of the wound converged. Morphological studies were performed on the 7th, 14th and 28th days of the experiment. Experimental studies have shown that the time to stop bleeding in the experimental group was 280.0 (264.0–308.0) sec, in the control, the time of hemostasis was later – 461.0 (420.0–501.0) sec. Morphological studies have allowed us to establish differences in both the rate and quality of reparative regeneration of experimental simulated liver wounds compared with the control. Experimental studies using Molselect G-50 in combination with Surgistamp for local hemostasis of bleeding liver wounds in rabbits allowed us to conclude that such a combination makes it possible not only to reliably stop bleeding, but also promotes the stimulation of reparative regeneration.

Journal of Volgograd State Medical University. 2023;20(1):73-80
pages 73-80 views
Efficiency of new technologies in endovideosurgical treatment of liver echinococcosis
Krasnov A.O., Anishchenko V.V., Pachgin I.V., Krasnov K.A., Pelts V.A., Krasnov O.A., Pavlenko V.V., Shatalin V.A.

Introduction: Surgical operations remain the main and most effective option for the treatment of liver echinococcosis. With the development and mastering of the method, laparoscopic operations are being used more and more widely. New technologies aimed at improving treatment outcomes are being developed and implemented in laparoscopic surgical methods. The purpose of the study is to present and evaluate the results of treatment of operated patients with liver echinococcosis using new technologies. Materials and methods: The results of treatment of 19 patients (9/47.4 % men, 10/52.6 % women) with liver echinococcosis, who were treated with organ-sparing laparoscopic resection techniques using new technologies in the surgical department No. M.A. Podgorbunsky. Results: There was no statistically significant advantage in dissection rate among the methods used (p = 0.74). In the group of patients with the applied hemostatic matrix Floseal, the time of hemostasis was significantly less than in the group without using the method (p = 0.001). In the group of patients with the improved laparoscopic Pringle maneuver, the blood loss was significantly less than in the group without using the technique (p = 0.00008). Findings: A new patented improved method of temporary hemostasis in laparoscopic resection interventions on the liver in the study proved its effectiveness. The use of the Floseal hemostatic matrix made it possible to reduce the time of hemostasis, and, accordingly, reduce the duration of the operation and reduce intraoperative blood loss in general. The laparoscopic method of surgical intervention using the above technologies is effective and safe in the treatment of medium-sized echinococcal liver cysts.

Journal of Volgograd State Medical University. 2023;20(1):81-87
pages 81-87 views
Functional condition of microcirculation in the zone of intestinal anastomosis during postoperative period upon stimulation of its regeneration (experimental study)
Poroyskiy S.V., Morozov E.A.

Objectives: to conduct a comparative assessment of the functional condition of microcirculation of the digestive anastomosis zone in the early and delayed postoperative period upon local usage of autogenic growth factors (PRP). The experiment was performed on 30 mature laboratory rabbits. All animals underwent the imposition of two digestive "end-to-end" intestinal anastomosis: the control one – at a distance of 15 cm from the ileocecal angle and the experimental one – retreating 30 cm from the imposed anastomosis. The experimental anastomosis differed from the control one by using a method of local stimulation of its regeneration via injecting of platelet-riched-plasm (PRP). A comparative assessment of the functional state of the microcirculation of the intestinal anastomosis zone was carried out on the 3rd, 7th, 14th days in the postoperative period using the method of laser doppler flowmetry (LDF). The obtained data determined the ability of the PRP method to improve the conditions of the regenerative process in the intestinal anastomosis zone by increasing the rate of basal blood flow and tissue perfusion, the rates of which have maximum values in the early postoperative period (3 day).

Journal of Volgograd State Medical University. 2023;20(1):88-91
pages 88-91 views
The influence of concomitant extragenital pathology on the success of assisted reproductive technology procedures in women (according to clinics of the Volgograd region)
Rogova L.N., Lipov D.S., Tikhaeva K.Y., Mukhina A.V., Kornev A.V., Churzin D.A.

At the moment, the problem of infertility does not lose its relevance. In the structure of this disease, the violation of reproductive function in women is dominant. The present study is devoted to the study of the influence of concomitant extragenital pathology on the success of assisted reproductive technology procedures. The data of 184 women who underwent infertility treatment by ART methods in clinics of the Volgograd region in the period from 2015 to 2020 were analyzed. The following parameters of the patients were studied: age, gynecological history, the main cause of infertility, transferred diseases of non-productive organs, the protocol of ovarian stimulation with gonadotropins, the number of mature follicles by the end of stimulation, the number of received, fertilized eggs, the number of embryos by day 3, 5. It has been established that concomitant extragenital pathology affects the processes of folliculogenesis and qualitatively affects oogenesis.

Journal of Volgograd State Medical University. 2023;20(1):92-96
pages 92-96 views
Morphology of sustentocytes (Sertoli cells) with premature aging caused by light desynchronosis
Kondakova L.I., Bagmetova V.V., Maltsev M.V.

The effect of 30-day dark deprivation (light-dark cycle 24/0 h, artificial illumination 300 Lux) on the morphofunctional state of the testes was studied using morphological and morphometric analysis of histological preparations of white mongrel male rats 4 months of age. The level of follicle-stimulating hormone in blood serum was assessed by enzyme immunoassay. It was found that 30-day dark deprivation increases the level of follicle-stimulating hormone in the blood serum. Morphological changes in the testes were characterized by a decrease in the area of Sertoli cells and their nuclei, the thickness of the spermatogenic epithelium. The hormonal background and morphofunctional state of the testes were corrected by the administration of exogenous melatonin for 14 days.

Journal of Volgograd State Medical University. 2023;20(1):97-101
pages 97-101 views
Prevalence of diseases leading to upper flaccid para-monoparesis syndrome
Vorobyov A.A., Andryushenko F.A., Volynets I.V., Zozulya E.Y., Hubutia B.N., Gorelik I.M.

In this study, we analyzed and summarized statistical literature data on the prevalence of diseases corresponding to the symptom complex of upper flaccid paramonoparesis in general and data provided from official reports of healthcare institutions in the Republic of Tatarstan and the Volgograd region in particular, in which the EXAR-34 exoskeleton can be used for orthotics. The results obtained can be taken as the basis for the possibility of introducing the EXAR-34 exoskeleton into production, as the only passive exoskeleton model produced in the Russian Federation by the INNOMED LLC enterprise for medical purposes.

Journal of Volgograd State Medical University. 2023;20(1):102-108
pages 102-108 views
Comparative evaluation of the effectiveness of autological bone marrow aspirate concentrate and platelete-rich plasma injected intraosseously in the treatment of the knee osteoarthritis
Kondrashenko V.V., Malanin D.A., Sikilinda V.D., Gorbatenko A.I., Demeshchenko M.V., Perfilova V.N., Kostyanaya N.O.

The aim of the study was a comparative evaluation of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), administered intraosseously to patients with stage II–III knee osteoarthritis (OA) according to the Kellgren – Lawrence (K-L) classification. Materials and methods: 40 patients were recruited and divided into 2 groups for the multicenter randomized study. Patients in the main group (n = 19) underwent a single intraosseous BMAC injection, and those in the comparison group (n = 21) had a similar procedure, but with the use of PRP. Treatment results were assessed at follow-up after 1, 3, 6, and 12 months using the verbal patient satisfaction scale (VSS), visual analog scale (VAS), WOMAC index (Western Ontario and MCMaster Universities osteoarthritis index), and Leken. Results: Estimated effectiveness of the application according to VSS from 1 to 6 months of observation, the opinions of patients were intercepted in the direction of BMAC (up to 65% of positive reviews) in the detection of PRP (up to 55 % of positive reviews). However, during the period of 6 to 12 months of observation we did not get significant results. Interpretation of the application of the VAS scale indicated a pronounced decrease of pain in both groups of patients. However, in the PRP group pain scores were higher. Analysis of the treatment results according to the WOMAC scale allows us to identify significant differences at all periods of observation with the prevalence of results in the BMAC group. Evaluation of the efficacy of therapy according to the Leken index indicated a more than twofold decrease in the index in the first month of observation. Subsequently, we noticed insignificant negative dynamic up to the 12th month of observation. When checking data between groups, the statistical data was significantly better in BMAC group. Conclusion. A single intraosseous injection of BMAC has an advantage at all control periods of observation in comparison with a similar injection of PRP. Both treatments do not cause serious complications.

Journal of Volgograd State Medical University. 2023;20(1):109-116
pages 109-116 views
Long-term results of revascularization of the lower extremities in patients with critical ischemia and diabetes mellitus with localization of the occlusive-stenotic process in the femoral artery
Frolov D.V., Mozgovoy P.V., Linchenko D.V., Frolov M.V., Chernovolenko A.A., Dyachkova Y.A., Obukhov A.D.

Aim: to determine the most preferable tactics of surgical treatment of patients with critical ischemia of the lower extremities of atherosclerotic genesis and diabetes mellitus based on a comparison of the results of revascularizing interventions. Methods: The study involved 82 patients who were treated in the department of vascular surgery due to critical ischemia of the lower extremities as a result of atherosclerotic occlusive-stenotic lesion of the femoral arterial segment against the background of diabetes mellitus. After the diagnostic stage and preoperative preparation, the patients were divided into two groups depending on the nature of the intervention performed: endovasal revascularization or femoropopliteal autovenous bypass grafting above the knee joint gap. In the postoperative period, dynamic observation of patients was continued with a predominant assessment of the clinical status. Results: Clinically, circulatory decompensation requiring repeated intervention or amputation was observed in 9 (30 %) patients from the first group and in 13 (25 %) patients from the second. High amputation was performed in 2 (6.6 %) study participants from the endovasal revascularization group and 3 (5.7 %) from the open surgery group. Over the entire observation period, 2 (6.7 %) and 4 (7.8 %) patients died in the groups under consideration, respectively. No statistically significant differences were obtained for any of the studied parameters, however, repeated interventions were significantly more frequently performed in patients undergoing endovascular revascularization. Conclusion: When analyzing the advantages and disadvantages of endovascular and open surgery in patients with diabetes mellitus and critical ischemia, the first should be preferred due to the possibility of repeated repetition throughout the patient’s life. Particular attention should be paid to conservative therapy and assessment of clinical status in the late postoperative period.

Journal of Volgograd State Medical University. 2023;20(1):117-124
pages 117-124 views
Morphofunctional assessment of the regeneration of purulent wounds of the lower extremities in patients with diabetes mellitus with various treatment regimens
Nuzova О.В., Studenikin A.V., Stadnikov A.A.

The purpose of the study was to substantiate the effectiveness of local combined use of miliacil and EHF-therapy in the complex treatment of purulent wounds of the lower extremities in patients with diabetes mellitus and its effect on morphological and functional changes in tissue defects. Our studies included 96 patients with purulent wounds of the lower extremities, localized on the thigh or lower leg against the background of diabetes mellitus. In 48 patients of the main group, miliacil and EHF-therapy were used in the local treatment of wounds, 48 patients in the control group used only miliacil. Of the 96 patients, 56 patients received complex treatment of purulent wounds, 40 received conservative treatment and plastic surgery. In all patients receiving complex conservative treatment, morphological studies of wound tissues were performed at admission, on the 7th day of conservative treatment, with the consent of the patients. When miliacil and EHF-therapy were used, the wounds healed by 13 days in most patients. Most patients in the control group showed complete wound healing by the 18th day of treatment. The positive effect of miliacil and EHF-therapy on the course of purulent wounds in patients with diabetes mellitus was also confirmed by histological research methods. An increase in leukocyte and macrophage reactions, a more active formation of poorly differentiated granulation connective tissue due to the intensification of vasculogenesis. The new method of therapeutic correction contributed to better and adequate epithelialization of the wound defect, traced after 7 days of clinical observation. Thus, with the complex use of miliacil and EHF-therapy, its high efficiency was established in the treatment of purulent wounds against the background of diabetes mellitus.

Journal of Volgograd State Medical University. 2023;20(1):125-128
pages 125-128 views
Prevention of bladder damage during repeated caesarean sections
Omarov N.S., Dabuzov A.S.

Repeated cesarean section operations are becoming a daily practice in obstetric institutions of the 2nd and 3rd groups. With each subsequent operation, due to adhesions or infectious complications (obstetric peritonitis), the risks of injuries to organs adjacent to the uterus increase. Objective: development of a method for preventing to the bladder injury during repeated cesarean section operations. Materials and methods: Prospective cohort studies were performed in 320 patients with the scar after Caesarean Section who underwent a repeated cesarean section: 186 patients were operated in plan and 134 – in urgent situation. All patients had given the hydropreparation of paravesical tissue by 0.5 % solution of novocaine 20 ml, which was injected under the vesicouterine fold from the side of the round ligaments for the prevention injury of bladder. Statistical processing was carried out using the Statistica 13 package. Results and discussion: With partial mobilization of the posterior wall, bladder injury in group 1 was in 2 patients, in group 2 – in 4 patients (χ2 = 1.544, p = 0.215). The injury of the bladder walls in group 2 occurred in patients operated on for obstetric peritonitis and was caused by pronounced infiltration of paravisical tissue and inflammatory changes in the lower segment of the uterus. Conclusions: The developed method by hydropreparation the paravesical tissue allows minimizing the number of bladder injuries with a pronounced adhesive process in the lower segment of the uterus or tissue infiltration with purulent-inflammatory complications.

Journal of Volgograd State Medical University. 2023;20(1):129-131
pages 129-131 views
Effect of aminalon and picamilon on NLRP3 inflammasome activation in pancreatic cells during alloxan-induced diabetes mellitus
Tyurenkov I.N., Velikorodnaya Y.I., Bakulin D.A., Smirnov A.V.

It has been suggested that NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) activation is a critical trigger for functional impairment and damage to pancreatic β-cells in type 2 diabetes mellitus (DM). In this work, using the immunohistochemical method, we studied the effect of aminalon and picamilon on the early modulation of NLRP3 inflammasome activity during experimental alloxan-induced DM in laboratory rats. Per os administration of aminalon (500 mg/kg) and picamilon (250 mg/kg) for 5 days before the administration of alloxan and for 2 days after the injection, suppression of NLRP3 activity was noted, as indicated by a significant decrease in the area of immunopositive pancreatocytes to (21,30 ± 5,44) and (39,31 ± 5,24) %, respectively, relative to the value in the group of animals that were not treated (75,19±7,69%). The results of the study showed that the studied preparations with GABAergic action promoted correction of functional disorders of the pancreas during alloxan-induced DM by inhibiting activation of NLRP3 inflammasome in pancreatocytes.

Journal of Volgograd State Medical University. 2023;20(1):132-136
pages 132-136 views
Pharmacokinetic properties of the compound RU-891 with repeated administration
Smirnova L.A., Spasov A.A., Gaidukova K.A., Sirotenko V.S., Kucheryavenko A.F., Velikopolskaya M.V.

In experiments on rats, the pharmacokinetics of compound RU-891 was studied with single and multiple intravenous administration. Data on the linear dependence of pharmacokinetic parameters are obtained. The approximation coefficient is set equal to 0.9779. Changes in pharmacokinetic parameters with a three-time administration were not detected.

Journal of Volgograd State Medical University. 2023;20(1):137-139
pages 137-139 views
Prevention of gastrointestinal bleeding in patients after endovascular surgery on the arteries of the lower extremities for critical ischemia in diabetes mellitus
Polyantsev A.A., Frolov D.V., Linchenko A.M., Karpenko S.N., Kosivtsov O.A., Chernovolenko A.A., Kaplunova E.V.

Relevance: Patients with critical lower limb ischemia and diabetes mellitus are the most difficult group of patients in terms of a favorable outcome of the disease. The number of such patients increases annually. When treating these patients, it is necessary to take into account many different pathological conditions that can lead to fatal complications in the perioperative period. The purpose of the work: The aim of the work was to study methods of prevention of gastrointestinal bleeding in patients after endovascular surgery on the arteries of the lower extremities for critical ischemia in diabetes mellitus. Material and methods: The prospective study included 220 patients who were treated in the vascular surgery department of the A. A. Polyantsev General Surgery Clinic of the Volgograd State Medical University for obliterating atherosclerosis of the arteries of the lower extremities and diabetes mellitus in the period from 2017 to 2021 inclusive. All patients were diagnosed with critical ischemia of the lower extremities – stage III–IV ischemia according to the Fontaine-Pokrovsky classification. Results and discussion. The relationship between the number of painkillers taken per day to reduce pain syndrome and erosive and ulcerative lesions of the gastric mucosa and duodenum in both groups was noted. Conclusion: All patients with peripheral artery diseases accompanied by critical ischemia had endoscopic changes from gastritis to ulcerative lesions, including those complicated by bleeding, by the time they sought specialized medical care. The group at increased risk of gastrointestinal bleeding is patients with repeated reconstructions, surgical corrections of complications or amputations at various levels (from finger to hip), as well as taking anticoagulants in therapeutic dosage. Routine prevention of gastrointestinal bleeding with proton pump inhibitors is not acceptable for this group of patients.

Journal of Volgograd State Medical University. 2023;20(1):140-151
pages 140-151 views
Features of trophic processes occurring in the bone tissue after the operation of dental implantation
Losev F.F., Komlev S.S., Pugachev S.A., Bazhutova I.V., Volov N.V.

Relevance: A key aspect of success after dental implant surgery is obtaining reliable osseointegration of the installed dental implant. In modern literary sources, the problem of consistency of osseointegration after the installation of dental implants is quite often touched upon. A number of authors argue that the quality of osseointegration of a dental implant depends primarily on its primary stability. Long-term studies show that bone tissue permanently undergoes various resorption and recovery processes [1, 2]. Purpose – to determine the effectiveness of alkaline phosphatase and collagen protein osteocalcin in oral fluid after dental implantation. Materials and methods: Clinical studies were carried out on the basis of the Clinics of the Samara State Medical University of the Ministry of Health of Russia. A total of 240 patients with a diagnosis of partial absence of teeth were operated on. All patients received dental implants. The median age was 44.2 years (24 to 62 years; 182 women and 58 men). Results and discussion: At the stage of orthopedic rehabilitation, most patients had a low index of oral hygiene, OHI-S averaged (2.63 ± 0.27) c.u. All patients suffering from poor oral hygiene were recommended professional hygiene with the removal of soft and hard dental deposits. At the stage of dental implantation, the OHI-S and Mulleman index was (0.66 ± 0.03) and (0.49 ± 0.03) c.u. respectively. Conclusions: The results of the study showed that the increase in the titer of alkaline phosphatase and the collagen protein osteocalcin was statistically insignificant. The level of acid phosphatase titer in the oral fluid reaches its critical value two weeks after the dental implantation operation. Studies have shown that this indicator remains active up to six months after surgery. This indicator can be used to interpret various emerging trophic processes occurring in bone tissue after dental implantation.

Journal of Volgograd State Medical University. 2023;20(1):152-155
pages 152-155 views
The effectiveness of graphic prediction of the shape of the dental arches of the milk bite in the treatment of congenital anomalies
Shkarin V.V., Dmitrienko D.S., Yagupova V.T., Dmitrienko T.D., Mansur J.P.

Currently, experts have noted the need to search for new research methods based on the selection of the most stable anatomical landmarks for the graphic construction of dental arches of the milk bite and the assessment of their effectiveness in clinical practice. A retrospective biometric study of 27 pairs of plaster models of mammary bite jaws with their optimal functional occlusive relationships was carried out to develop diagnostic methods. Orthodontic treatment of 15 children with congenital pathology of the maxillofacial region was carried out by fixed arc equipment. Based on the analysis of biometrics, methods for the graphic construction of dental arches were developed. The first method was based on the laws of circle geometry (the prototype of the A.M. Schwarz method) and the calculation of the radius of the circle along its length (L = 2πR). To the sum of the crowns of 10 milk teeth, the value of the diastem component (in our case, 9 mm) was added and the length of the semicircle was obtained, which was enough to divide by the number π and get the magnitude of the radius of the circle. The effectiveness of treatment of children with unilateral cleft lip and alveolar process is shown. Analysis of dental arch biometric data showed that on the side of the cleft, the distance from the conditional sagittal to the milk canine was (11.52 ± 0.93) mm before treatment, and after treatment, the studied parameter was (16.39 ± 0.64) mm (p ˂ 0.05). On the cotrlateral side, the difference in the change in the position of the canine was not significant and in the dynamics of treatment changed from (14.93 ± 0.79) mm to (16.27 ± 0.84) mm (p ˃ 0.05). The diagonals of the dental arches (central-molar) on both sides after treatment were (35.52 ± 1.13) mm. Thus, taking into account the data obtained, it was concluded that the graphic reproduction of the dental arch of the milk bite in the treatment of children with anomalies of the dental arches was made.

Journal of Volgograd State Medical University. 2023;20(1):156-160
pages 156-160 views
The use of various sizes of burs by orthopedists of Volgograd state dental clinics
Parkhomenko A.N., Shemonaev V.I., Timacheva T.B., Gatsenko S.M.

The correct execution of teeth preparation for metal-ceramic crowns requires a certain range of dental bores, different in shape and cutting properties. However, according to a 2014 study, orthopedic dentists tend to use a reduced set of burs in their daily practice. The research material is the results of a survey of 59 orthopedic dentists of urban dental clinics, obtained by the questionnaire method. Data on the frequency of use of hogs of various shapes and grain size were obtained. There is an expansion of the range of tools used according to the criteria of grain size and shape. Despite this, there is a tendency to use a reduced set of dental burs and the prevalence of coarse-grained burs in its composition.

Journal of Volgograd State Medical University. 2023;20(1):161-165
pages 161-165 views

Guide for General Practitioners

Clinical case of two-stage surgical treatment large liver hemangioma
Pelts V.A., Tropin V.E., Pachgin I.V.

Postresection hepatic insufficiency is a formidable complication after liver resections, leading to an unfavorable course of the postoperative period and, often, to a fatal outcome. The article presents a clinical case of successful surgical treatment of tumor of the liver and prophylactics of hard remnant liver insufficiency. The article presents the results of treatment of a patient with a large liver tumor by a staged method, a review of the immediate data is given retrospectively by describing the course of diagnosis and treatment of the disease. We have illustrated a case of successful two-stage surgical treatment of a patient with a large hemangioma of the liver using laparoscopic ligation of the right branch of the portal vein, which makes it possible to prevent the development of severe post-resection liver failure.

Journal of Volgograd State Medical University. 2023;20(1):166-170
pages 166-170 views
Myoma of the rudimentary uterus in Mayer –Rokitansky – Kuster – Hauser syndrome. Clinical case
Selikhova M.S., Sviridova N.I., Yakhontova M.A., Maksimov S.N.

The article presents a clinical case of large fibroids with complete aplasia of the uterus and vagina (Mayer – Rokitansky – Kuster – Hauser syndrome), a retrospective analysis of the patient’s anamnestic data, the result of surgical treatment.

Journal of Volgograd State Medical University. 2023;20(1):171-175
pages 171-175 views
A clinical case of postinfaction aneurysm development, in a patient after COVID-19
Petrova O.V., Tverdokhlebova D.K., Shabanova G.R., Nikulina D.M., Shashin S.A.

There is no data in the literature on the course of myocardial infarction in patients after COVID-19. Purpose – to use a clinical example to present a case of postinfarction left ventricular aneurysm in a patient after undergoing COVID-19. Materials and methods: Patient T., 49 years old, was admitted to the federal state budgetary institution “Federal Center of Cardiovascular Surgery” of the Ministry of Health of the Russian Federation (Astrakhan) with complaints of pain in the heart with irradiation in the left shoulder and lower jaw. Considers himself ill for 7 days. It is known from anamnesis of life that the patient suffered COVID-19 two weeks ago. He has been suffering from arterial hypertension for a year. Results: A clinical example demonstrates that COVID-19 affects course of myocardial infarction: it is a risk factor for the development of post infarction aneurysm of the left ventricle in the early stages after a myocardial infarction. Myocardial infarction was accompanied by the formation of pathological Q waves, impaired conduction of the right leg of the Gis bundle a decrease in the ejection fraction of the left ventricle, acute occlusion of the right coronary artery. Postinfarction aneurysm of the left ventricle had an anterior-septal – apical localization. In addition, the study of highly sensitive troponin T and N-terminal fragment of the pro-brain natriuretic peptide type B in patients with myocardial infarction complicated by postinfarction aneurysm of the left ventricle after COVID-19 is also important for determining the stages of development of pathological processes in this pathology, evaluating the effectiveness of therapy and the outcome of this pathology.

Journal of Volgograd State Medical University. 2023;20(1):176-184
pages 176-184 views

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