[Unformed conglomerate debilitating jejunal fistulas and their two-stage surgical treatment via posterolateral laparotomy]. / Nesformirovannye konglomeratnye istoshchayushchie toshchekishechnye svishchi i ikh dvukhetapnoe khirurgicheskoe lechenie iz zadnebokovogo laparotomnogo dostupa.

OBJECTIVE: To create a method of two-stage repair of high unformed conglomerate delimited debilitating jejunal fistulas via posterolateral laparotomy with low risk of surgical complications. MATERIAL AND METHODS: Methodology and treatment outcomes were analyzed in 37 patients with unformed conglomerate high debilitating delimited jejunal fistulas. Of these, 22 patients underwent one-stage treatment through 2 converging incisions and/or two-stage treatment through anterolateral access. They made up a control group. Fifteen patients in the main group underwent two-stage treatment via posterolateral left-sided laparotomy with unilateral disconnection of jejunum with fistula. In most patients of both groups, fistulas complicated surgery for acute adhesive intestinal obstruction. Topography of adhesions that caused acute intestinal obstruction in both groups was studied in 172 other patients. Identical jejunal fistulas and two different surgical approaches made it possible to consider our groups representative. RESULTS: Two-stage treatment via posterolateral left-sided laparotomy reduced mortality from 63.6±10.2% to 20.0±10.3% (t=11.8; p<0.001). This approach simplified intraoperative diagnostics that became more informative. Posterolateral access increased the quality of anastomosis and safety of viscerolysis. CONCLUSION: A new two-stage approach with posterolateral left-sided laparotomy allowed atraumatic imposing of inter-intestinal anastomosis with proximal disconnection of jejunal fistula. This exclusion turns the fistula into analogue of the definitive Meidl's jejunostomy, unloads the intestinal anastomosis and increases the quality of suture. New strategy reduced the risk of complications and mortality.

[Biomarkers of neuroinflammation in patients with chronic cerebral ischemia during the therapy with vinpocetine (study INFLAMARK)]. / Dinamika kontsentratsii biomarkerov neirovospaleniya v krovi u patsientov s khronicheskoi ishemiei golovnogo mozga na fone terapii vinpotsetinom: rezul'taty issledovaniya INFLAMARK.

OBJECTIVE: To evaluate the effect of vinpocetine therapy on clinical manifestations of chronic cerebral ischemia (CCI) and the blood concentrations of neuroinflammation markers (S100B, IL-1ß). MATERIAL AND METHODS: The study included 30 patients (mean age 61.6 [56.9; 67.9] years) with CCI that received vinpocetine (30 mg/day) for 3 months. Brain changes according to magnetic resonance imaging data were assessed using the STRIVE protocol. We analyzed the dynamics of changes in the clinical questionnaires: Montreal Cognitive Assessment Scale (MoCA), Hospital Anxiety and Depression Scale (HADS), Asthenic State Scale (ASS), Epworth Sleepiness Scale (ESS), general impressions of treatment (Global Rating of Change Scale, GRC). RESULTS: In 3 months after vinpocetine therapy there was a significant improvement in cognitive status (MoCA: 25.1±2.1 vs 26.6±1.4 p<0.05), emotional state (HADS: 8.4±1.4 vs 7.1±1.8 (p<0.05)), daytime sleep parameters (ESS 8.4±2.1 vs 6.2±2.3 p<0.05) and reduction in asthenia (ASS: 72.2±18.1 vs 52.3±9.3, p<0.05). A significantly larger proportion of patients assessed the improvement from therapy as «moderate¼ and «pronounced¼ (GRC, n=22, 73.3%). Concentrations of S100B and IL-1ß decreased significantly by the time therapy was completed. The overall severity of cerebrovascular changes according to MRI was significantly associated with blood levels of S100ß, but not IL-1ß: ß=0.504, p=0.026, 95% CI 0.149-0.901, mainly due to periventricular changes in white matter (ß=0.562, p=0.035, 95% CI (-0.024-0.820). Blood levels of S100ß correlated with MoCA test results (r=0.6795), and IL-1ß correlated with ESS scores (r=0. 6657). CONCLUSIONS: The use of vinpocetine can significantly reduce the severity of cognitive and affective disorders, asthenia, normalize the circadian rhythm of sleep, suppress the expression S100ß and IL-1ß in patients with CCI. One of the vinpocetine's mechanisms of action may be the inhibition of neuroinflammation.

[Cognitive disorders in burnout syndrome]. / Kognitivnye narusheniya pri sindrome emotsional'nogo vygoraniya.

OBJECTIVE: To study the impairment of cognitive functions in patients with different stages of the burnout syndrome (BS). MATERIAL AND METHODS: 78 patients aged 25-45 years (average age 36.9±9.5 years) were examined, which at the BS stage were divided into two subgroups: Residence (51.3%, n=40) and Exhaustion (48.7%, n=38). The control group consisted of 106 practically healthy (average age 36.3±7.2 years) The following methods were used: Russian-language version of the MBI questionnaire, questionnaire to diagnose the level of emotional burnout by V.V. Boyko, questionnaire CFQ, method «Learning 10 words¼ by A.R. Luria, registration of cognitive evoked potentials (EP) in the psychophysiological visual test VCPT. RESULTS: Subjective symptoms of memory loss were in 47 patients (60.3% of the total number of patients with EBS): 17 patients (42.5%) from the subgroup Resistance and 30 patients (78.9%) from the subgroup Exhaustion. The quantitative evaluation of the subjective symptoms in the CFQ test showed a reliable increase in all patient groups (p<0.05) and especially in the subgroup Exhaustion. There was statistically reliable decrease of the P200 component in subgroup Resistence and control group in the alloys Cz (p<0.001) and Fz (p<0.001), as well as statistically reliable reduction of the P300 component in the indicated leads (Cz (p<0.001) and Pz (p<0.001)) in patients in the subgroup Resistance. Most BS patients had cognitive complaints that were more common at the Exhaustion stage. At the same time, objective cognitive impairments were detected only in patients at the stage of Exhaustion. Only the long-term memory is affected. Psychophysiological research has shown a decrease in the level of attention in both subgroups, which demonstrated an increased impairment of mental processes. CONCLUSION: Cognitive impairment in patients with BS manifests in various forms of attention, memory impairment, and performance degradation in the resistance and exhaustion phases, and can result from high asthenization.

[Analysis of the correlation between neuroimaging markers of the brain damage and the severity of postural instability in patients with chronic cerebrovascular insufficiency (NEMAN open observational study)]. / Svyaz' neirovizualizatsionnykh markerov porazheniya golovnogo mozga i vyrazhennosti postural'noi neustoichivosti u patsientov s khronicheskoi ishemiei golovnogo mozga (rezul'taty otkrytogo nablyudatel'nogo issledovaniya NEMAN).

OBJECTIVE: To analyze the relationship between the severity of postural instability in patients with CCI (chronic cerebral ischemia) and brain changes according to MRI, as well as to evaluate the efficacy and safety of vinpocetine. MATERIAL AND METHODS: The study included 60 patients with CCI: 40 people with postural instability made up the main group and 20 people without balance disorders - the control group. The severity of manifestations of cerebrovascular pathology was assessed according to the protocol STRIVE. Severity of postural instability was assessed with the VAS, anxiety syndrome - Hamilton Anxiety Rating Scale, asthenia - Asthenic Condition Scale, daytime sleepiness - Epworth Sleepiness Scale, cognitive impairment - Montreal scale assessment of cognitive functions, the overall impression of treatment - Global Rating of Change Scale. RESULTS: The main group was associated with older age, more significant decrease in cognitive functions, urination disorders, anxiety syndrome and asthenia, changes according to MRI of the brain. CCI burden scale was significantly associated with VAS: ß=0.479, P=0.035, 95% CI 0.023-0.928. The presence of lacunae was the most significant marker for the development of severe imbalance: ß=0.482, p=0.041, 95% CI 0.022-0.925. A significant relationship was found between the total number of lacunae and VAS (r=0.509, p=0.021), as well as between the number of lacunae in the basal ganglia (r=0.793, p=0.019), especially the lenticular nuclei (r=0.498, p=0.036), and VAS. After 3 months of vinpocetine treatment, a significant improvement in statodynamic function was noted in the main group, moreover - absence of anxiety, normalization of daytime sleep, «weak¼ asthenia, increasement in the value of the MoCA scale. Most of the patients regarded the improvement from the therapy as «moderate¼ and «pronounced¼. CONCLUSIONS: The presence of lacunes in the basal ganglia is a most prominent neuroimaging marker of brain damage in patients with CCI and postural instability. The use of vinpocetine can significantly reduce the severity of imbalance, anxiety and asthenia, and normalize the circadian rhythm of sleep.

[Quantative evaluation and analysis of the central mechanisms involved in analgesic effect of Alflutop in patients with chronic lower back pain]. / Kolichestvennaya otsenka i analiz tsentral'nykh mekhanizmov anal'geticheskogo effekta Alflutopa u patsientov s khronicheskoi bol'yu v nizhnei chasti spiny.

OBJECTIVE: Evaluation of Alfultop impact on nociceptive afferentation central mechanisms in patients with chronic lower back pain. MATERIALS AND METHODS: The study involved 40 patients with CLBP. The therapy included Alflutop, 2 ml once a day for 10 days. Mean VAS-pain, LANSS, Roland-Morris questionnaire, Global Rating of Change Scale (GRC), pressure pain thresholds data were analyzed. Follow-up duration was 3 months. RESULTS: Most of the patients were females (f:m=1.3:1); average age - 60.5 [54.2; 67.3] years with a mean disease duration of 14.3±4.2 mo. At visit 1, the VAS score was 63.2±9.4, LANSS 14.2±2.1 points, and the Roland-Morris questionnaire 9.9±3.5 points. There was a significant decrease in the pain threshold both in the zone of maximum pain, located in the lower back (3.97±0.9 kg/sm2), and in suprasegmental area (5.22±1.7 kg/sm2), and a pathological change in the temporal summation of pain (789.2±45.6 mm). After Alflutop therapy, significant changes in the parameters of the VAS, LANSS and Roland-Morris scores were recorded after 30 days of observation and maximum changes in 3 months. The pain threshold has significantly increased after 3 months of observation. The majority of patients rated the improvement from the therapy as «moderate¼ and «pronounced¼ (33/82.5%) according to the GRC scale. A significant relationship was established between the level of pain threshold and the intensity of pain on the VAS scale (R=0.714), its duration (R=0.799) and disability of the patients (R=0.706). CONCLUSIONS: Central sensitization develops in patients with CLBP, which correlates with VAS score of pain intensity, its duration and the degree of disability. Alflutop significantly reduces the intensity of the pain syndrome, its neuropathic component, significantly increases the level of pain threshold and improves the disability of patients in 3 months after the start of treatment.

Structure and antibacterial properties of Ag-doped micropattern surfaces produced by photolithography method.

Photolithography methods offer ample opportunities for creating biological surface patterns over large areas. Herein, samples with patterned surface having the same Ag total coverage area and content, but different surface topography made of periodically spaced Ag/Si pillars with a diameter of 10 and 50 µm and a height of 3, 1, and 0.2 µm were produced by photolithography technique and studied to uncover the dependences of bactericide ion release on surface topography and antibacterial effect on Ag+ ion concentration. Reactive ion etching of Si wafers in areas unprotected by Ag capping layer was accompanied by a number of competing processes: (i) formation of Ag particles on the tops of pillars due to temperature-activated diffusion and coalescence, (ii) sputtering of Ag from the pillar to surface and redeposition into the etching cavities, resulting in the formation of small Ag nanoparticles located in areas between pillars, (iii) precipitation of AgSix phase as a result of chemical interaction of sputtered Si ions with Ag ions and atoms in surrounding plasma. Samples with the largest pillar heights which had also Ag particles formed between pillars demonstrated the fastest Ag+ ion release and, correspondingly, a noticeable antibacterial effect toward antibiotic-resistant hospital Escherichia coli K-261 strains already after 3 h. All samples showed 100% antibacterial effect after 24 h. Thus our results open up new possibilities for the production of scalable micropattern surfaces with controlled bactericide ion release and pronounced antibacterial characteristics for future applications in the orthopedic field.

Antibacterial Performance of TiCaPCON Films Incorporated with Ag, Pt, and Zn: Bactericidal Ions Versus Surface Microgalvanic Interactions.

It is very important to prevent bacterial colonization at the early postoperative stages. There are four major strategies and their corresponding types of antibacterial surfaces specifically designed to fight infection: bactericide release, anti-adhesion, pH-sensitive, and contact-killing. Herein, we aimed at determining the antibacterial efficiency of different types of bactericidal ions and revealing the possible contribution of surface microgalvanic effects arising from a potential difference on heterogeneous surfaces. We considered five types of TiCaPCON films, with Ag, Zn, Pt, Ag + Zn, and Pt + Zn nanoparticles (NPs) on their surface. The Ag-modified film demonstrated a pronounced antibacterial effect at a very low Ag ion concentration of 0.11 ppb in physiological solution that was achieved already after 3 h of immersion in Escherichia coli ( E. coli) bacterial culture. The Zn-containing sample also showed a noticeable antibacterial effect against E. coli and Staphylococcus aureus ( S. aureus) strains, wherein the concentration of Zn ions was 2 orders of magnitude higher (15 ppb) compared with the Ag ions. The presence of Ag NPs accelerated the leaching of Zn ion out of the TiCaPCON-Ag-Zn film, but no synergistic effect of the simultaneous presence of the two bactericidal components was observed. After the incubation of the samples with Ag, Zn, and Ag + Zn NPs in E. coli and S. aureus suspensions for 24 and 8 h, respectively, all bacterial cells were completely inactivated. The Pt-containing film showed a very low Pt ion release, and therefore the contribution of this type of ions to the total bactericidal effect could be neglected. The results of the electrochemical studies and Kelvin probe force microscopy indicated that microgalvanic couples were formed between the Pt NPs and the TiCaPCON film, but no noticeable antibacterial effect against either E. coli or S. aureus strains was observed. All ion-modified samples provided good osteoblastic cell attachment, spreading, and proliferation and therefore were concluded to be nontoxic for cells. In addition, the TiCaPCON films with Ag, Pt, and Zn NPs on their surface demonstrated good osteoconductive characteristics.

Test of the Brink-Axel Hypothesis for the Pygmy Dipole Resonance.

The gamma strength function and level density of 1^{-} states in ^{96}Mo have been extracted from a high-resolution study of the (p[over →], p[over →]^{'}) reaction at 295 MeV and extreme forward angles. By comparison with compound nucleus γ decay experiments, this allows a test of the generalized Brink-Axel hypothesis in the energy region of the pygmy dipole resonance. The Brink-Axel hypothesis is commonly assumed in astrophysical reaction network calculations and states that the gamma strength function in nuclei is independent of the structure of the initial and final state. The present results validate the Brink-Axel hypothesis for ^{96}Mo and provide independent confirmation of the methods used to separate gamma strength function and level density in γ decay experiments.

Electric Dipole Polarizability of

The electric dipole strength distribution in ^{48}Ca between 5 and 25 MeV has been determined at RCNP, Osaka from proton inelastic scattering experiments at forward angles. Combined with photoabsorption data at higher excitation energy, this enables the first extraction of the electric dipole polarizability α_{D}(^{48}Ca)=2.07(22) fm^{3}. Remarkably, the dipole response of ^{48}Ca is found to be very similar to that of ^{40}Ca, consistent with a small neutron skin in ^{48}Ca. The experimental results are in good agreement with ab initio calculations based on chiral effective field theory interactions and with state-of-the-art density-functional calculations, implying a neutron skin in ^{48}Ca of 0.14-0.20 fm.

E2 decay strength of the M1 scissors mode of

The E2/M1 multipole mixing ratio δ_{1→2} of the 1_{sc}^{+}→2_{1}^{+} γ-ray decay in ^{156}Gd and hence the isovector E2 transition rate of the scissors mode of a well-deformed rotational nucleus has been measured for the first time. It has been obtained from the angular distribution of an artificial quasimonochromatic linearly polarized γ-ray beam of energy 3.07(6) MeV scattered inelastically off an isotopically highly enriched ^{156}Gd target. The data yield first direct support for the deformation dependence of effective proton and neutron quadrupole boson charges in the framework of algebraic nuclear models. First evidence for a low-lying J^{π}=2^{+} member of the rotational band of states on top of the 1^{+} band head is obtained, too, indicating a significant signature splitting in the K=1 scissors mode rotational band.

[Main directions of differential diagnosis optimization and rational treatment of an acute vertigo attack]. / Osnovnye napravleniia optimizatsii differentsial'noi diagnostiki i ratsional'noi terapii ostrogo pristupa golovokruzheniia.

AIM: To develop and assess the validity of the clinical algorithm VERTIGO for the differential diagnosis of central and peripheral vertigo and optimization of treatment of patients with vertigo. MATERIAL AND METHODS: Sixty-five patients with an acute attack of vertigo, aged from 18 to 75 years (53±6.7 years), were studied. All patients underwent standard neurological examination. In case of signs of central vertigo, patients underwent neuroimaging. Diagnostic accuracy, sensitivity and specificity of the VERTIGO algorithm as well as its positive and negative prognostic values were calculated. RESULTS: The sensitivity of VERTIGO for the diagnosis of central vertigo was 100% (95% CI: 78.2-100%), specificity 94.0% (95% CI: 83.5-98.8%), positive prognostic value 83.3% (95% CI: 58.6-96.4%); negative prognostic value 100% (95% CI: 92.5-100%). Cohen's kappa estimated by the results of final diagnosis was 0.88. CONCLUSION: Differential treatment of patients with acute vertigo should be performed according to the current recommendations and include multimodal pharmacological medications, e.g. cavinton forte, to restore the vestibular control by the stimulation of neuroplasticity. The VERTIGO algorithm allows the increase of the efficacy of clinical differential diagnosis of central and peripheral vertigo.

First Measurement of Collectivity of Coexisting Shapes Based on Type II Shell Evolution: The Case of

BACKGROUND: Type II shell evolution has recently been identified as a microscopic cause for nuclear shape coexistence. PURPOSE: Establish a low-lying rotational band in ^{96}Zr. METHODS: High-resolution inelastic electron scattering and a relative analysis of transition strengths are used. RESULTS: The B(E2;0_{1}^{+}→2_{2}^{+}) value is measured and electromagnetic decay strengths of the 2_{2}^{+} state are deduced. CONCLUSIONS: Shape coexistence is established for ^{96}Zr. Type II shell evolution provides a systematic and quantitative mechanism to understand deformation at low excitation energies.

Investigating the Pygmy Dipole Resonance Using ß Decay.

In this contribution it is explored whether γ-ray spectroscopy following ß decay with high Q values from mother nuclei with low ground-state spin can be exploited as a probe for the pygmy dipole resonance. The suitability of this approach is demonstrated by a comparison between data from photon scattering, ^{136}Xe(γ,γ^{'}), and ^{136}I [J_{0}^{π}=(1^{-})]→^{136}Xe^{*} ß-decay data. It is demonstrated that ß decay populates 1^{-} levels associated with the pygmy dipole resonance, but only a fraction of those. The complementary insight into the wave functions probed by ß decay is elucidated by calculations within the quasiparticle phonon model. It is demonstrated that ß decay dominantly populates complex configurations, which are only weakly excited in inelastic scattering experiments.

[Event-Related Potentials in Schizotypal Personality Disorder and Schizophrenia.]

The article presents an analysis of event-related potentials in Go/NoGo test from patients with schizophrenia and schizotypal personality disorder relative to healthy subjects. Identified differences in the group of patients with schizophrenia are consistent with previous studies and indicate a violation of the processes associated with different stages of visual information processing and executive functions. Special features of the brain activity from patients with schizotypal personality disorder were significantly less pronounced, and, presumably, pointed on the changes in the processes of attention redistribution and action monitoring. The results agree well with the clinical symptoms of schizophrenia and schizotypal personality disorder that allows us to consider this technique as a possible additional diagnostic criterion of these disorders.

Observation of the competitive double-gamma nuclear decay.

The double-gamma (γγ)-decay of a quantum system in an excited state is a fundamental second-order process of quantum electrodynamics. In contrast to the well-known single-gamma (γ)-decay, the γγ-decay is characterized by the simultaneous emission of two γ quanta, each with a continuous energy spectrum. In nuclear physics, this exotic decay mode has only been observed for transitions between states with spin-parity quantum numbers J(π) = 0(+) (refs 1-3). Single-gamma decays-the main experimental obstacle to observing the γγ-decay-are strictly forbidden for these 0(+) → 0(+) transitions. Here we report the observation of the γγ-decay of an excited nuclear state (J(π) = 11/2(-)) that is directly competing with an allowed γ-decay (to ground state J(π) = 3/2(+)). The branching ratio of the competitive γγ-decay of the 11/2(-) isomer of (137)Ba to the ground state relative to its single γ-decay was determined to be (2.05 ± 0.37) × 10(-6). From the measured angular correlation and the shape of the energy spectra of the individual γ-rays, the contributing combinations of multipolarities of the γ radiation were determined. Transition matrix elements calculated using the quasiparticle-phonon model reproduce our measurements well. The γγ-decay rate gives access to so far unexplored important nuclear structure information, such as the generalized (off-diagonal) nuclear electric polarizabilities and magnetic susceptibilities.

[Gypsy moth Lymantria dispar L. in the South Urals: Patterns in population dynamics and modelling].

The analysis is conducted on population dynamics of gypsy moth from different habitats of the South Urals. The pattern of cyclic changes in population density is examined, the assessment of temporal conjugation in time series of gypsy moth population dynamics from separate habitats of the South Urals is carried out, the relationships between population density and weather conditions are studied. Based on the results obtained, a statistical model of gypsy moth population dynamics in the South Urals is designed, and estimations are given of regulatory and modifying factors effects on the population dynamics.

[Neurogenic copulative dysfunction in men: theoretical aspects, differential diagnosis, and rational therapy].

UNLABELLED: Neurogenic copulative dysfunction (CD) is observed in different diseases and injuries of both the central and peripheral nervous system. CD concurrent with actual nervous system diseases has been established to be an important psychotraumatic factor that significantly reduces quality of life in these patients. AIM: To investigate the effect of aminophenylbutyric acid (Noophen) on male copulative function. SUBJECTS AND METHODS: Forty patients with chronic lumbosacral radiculopathy on an exacerbation and mild and moderate closed head injury were examined. RESULTS: The findings suggest that Noophen is effective in the combination therapy of neurogenic CD. CONCLUSION: The drug can normalize an autonomic control over nerve centers involved in the regulation of copulative function, and improve the psychoemotional status of patients.

[Hypertrophic basal pachymeningitis presenting as Tolosa-Hunt syndrome].

We examined 6 patients with hypertrophic basal pachymeningitis using clinical, laboratory and instrumental methods. The clinical presentations were similar to Tolosa-Hunt syndrome although the differences were noted. One case is described in-depth. Based on literature and own observations, we considered the etiology, pathogenesis, diagnostic features and treatment of hypertrophic basal pachymeningitis.

[Analysis of independent components for event-related potentials from patients with an established diagnosis of schizophrenia, obsessive-compulsive and depressive disorders].

We investigated the possibility to classify data from patients with different psychiatric disorders on the base of physiological measures of the brain activity. Event-related potentials during the execution of GO/NOGO task were recorded from age matched groups of patients with schizophrenia, major depression and obsessive-compulsive disorder. Separation of independent components for event-related potentials was performed by applying Independent Component Analysis method. Picked out components were used in the method of discriminant analysis to classify the data according to clinical diagnosis. Discriminant analysis of components for event-related potentials allows classifying the data of patients with a suitable amount of matches with an established diagnosis.

[Combinative methods of treatment of patients with complicated urolithiasis].

The authors showed that urolithiasis is the second disease after inflammatory nonspecific kidney and urinary tract diseases and has a tendency to increase. 3-5% of patients suffer this disease, and 30-40% of all patients of urology in-patients department suffer nephrolithiasis. Introduction into clinical practice of modern minimally invasive treatment methods changed the paradigm of treatment of urolithiasis, especially coral type nephrolithiasis - cause of 15-50% of all renal calculi. The authors presented results of combinative treatment of 183 patients with different complicated forms of urolithiasis. The technique of percutaneous nephrolithotripsy (in supine position) was modified. It helped to reduce complications, time of surgery and radiation exposure. The effectiveness of simultaneous contact ureterolithotripsy and percutaneous nephrolithotripsy in patients with renal or ureters calculi, and simultaneous litholysis and distance lithotripsy in patients with metabolic disorders is shown. Combinative methods of treatment of complicated forms of urolithiasis are based on modern minimally invasive technologies and are very effective.