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Medical Bulletin of the Main Military Clinical Hospital named after N.N. Burdenko最新文献

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Neoadjuvant immunotherapy in the treatment of squamous cell carcinoma of the head and neck 新辅助免疫疗法治疗头颈部鳞状细胞癌
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2023-4-1-63-71
A.V. Tsapir, Maria Yu. Pitkevich, Aleksej V. Smolin, Vladislav Ju. Kosyrev, A. A. Vologdin
Head and neck tumors are among the ten most common neoplasms both in the world and in Russia [1]. In 64% of cases, squamous cell carcinoma of the head and neck is first diagnosed at the stage of a locally spread process. The emergence of new equipment for radiation therapy, new irradiation techniques such as VMAT, IMRT, better visualization, positioning of the patient and the emergence of new methods of drug treatment have allowed to increase the duration and quality of life of patients. However, even with such treatment approaches, the 5-year overall survival rate is only 50% [11]. The effectiveness of immunotherapy in patients with advanced squamous cell carcinoma of the head and neck and unsatisfactory results of surgical treatment of operable stages have set the ground for active study of neoadjuvant therapy [11]. In the available literature, we found that neoadjuvant immunotherapy for squamous cell carcinoma of the head and neck has already demonstrated its effectiveness in preliminary clinical studies, which makes it a promising direction for further study and implementation in the daily practice of an oncologist
头颈部肿瘤是世界和俄罗斯最常见的十大肿瘤之一[1]。在64%的病例中,头颈部鳞状细胞癌在局部扩散过程阶段首次被诊断出来。新的放射治疗设备的出现,新的放射技术,如VMAT, IMRT,更好的可视化,患者的定位以及新的药物治疗方法的出现,使得患者的持续时间和生活质量得以增加。然而,即使采用这样的治疗方法,5年总生存率也只有50%[11]。免疫治疗在晚期头颈部鳞状细胞癌患者中的有效性和可手术期手术治疗的不理想结果为新辅助治疗的积极研究奠定了基础[11]。在现有文献中,我们发现头颈部鳞状细胞癌的新辅助免疫治疗已经在初步临床研究中证明了其有效性,这是肿瘤学家在日常实践中进一步研究和实施的一个有希望的方向
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引用次数: 0
A new method for shortsegment multi-rod posterior instrumental fixation of lumbar vertebral body fractures: development of the technology and a clinical case 腰椎骨折短节段多棒后路固定术新方法:技术进展及1例临床
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2023-4-2-47-54
Ramis A. Aslanov, A. K. Dulaev, D. Kutyanov, Z. Y. Alikov
A new method of short segmental multi-rod posterior instrumental fixation of lumbar vertebral body fractures (groups A3 and A4 according to the AO classification) characterized by the combined use of two short transpedicular screws with maximum lateralization of their heads fixing the injured and adjacent vertebrae and two short laminar implants in the form of distractors and contractors installed according to a standard technique with their positioning symmetrically to the spinous processes was developed. If transpedicular fixation of the fractured vertebra is impossible, both laminar systems are installed in the form of staples with circular coverage of the corresponding half-arc of the adjacent vertebrae due to supra- and infralaminar arrangement of standard hooks. The method involves the use of standard vertebrological instruments as well as widely available licensed implants and the classic technique of their installation. A clinical case of surgical treatment of a 27-year-old victim with a comminuted compression fracture (group A3 according to the AO classification) of the 3rd lumbar vertebra is reported. An excellent clinical and radiological result was obtained.
本文提出了一种短节段多棒后路器械固定腰椎骨折(AO分类为A3组和A4组)的新方法,其特点是联合使用两枚短经椎弓根螺钉,最大限度地侧移头部固定受伤的椎体和邻近的椎体,并根据标准技术安装两枚短椎板内固定物,其位置与棘突对称发展。如果骨折椎体不可能经椎弓根固定,两个椎板系统都以订书钉的形式安装,由于在椎板上和椎板下安排了标准挂钩,因此订书钉的圆形覆盖了相邻椎体的相应半弧。该方法包括使用标准的椎体仪器,以及广泛使用的许可植入物和经典的安装技术。报告一例27岁患者第3腰椎粉碎性压缩性骨折(AO分类为A3组)的手术治疗临床病例。取得了良好的临床和放射学结果。
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引用次数: 0
Dermatoscopic characterization of various vascular signs in skin tumors 皮肤肿瘤中各种血管征象的皮镜特征
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2023-4-1-12-21
I. Lamotkin, D. Korabelnikov, Elena G. Perevalova, A. Lamotkin
The authors considered the dermatoscopic vascular signs most frequently encountered in the practice of dermatologists, cosmetologists and oncologists in melanocytic and non-melanocytic skin tumors. The paper presents modern views on dermatoscopic diagnosis of skin tumors. Based on clinical experience and data from the literature, dermatoscopic features that occur in various melanocytic and non-melanocytic skin tumors are identified.
作者考虑了皮肤科医生、美容师和肿瘤学家在黑素细胞和非黑素细胞皮肤肿瘤中最常遇到的皮肤镜血管征象。本文介绍皮肤肿瘤的现代诊断观点。根据临床经验和文献资料,确定了各种黑素细胞性和非黑素细胞性皮肤肿瘤的皮肤镜特征。
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引用次数: 0
Biportal endoscopic surgery for degenerative diseases of the lumbar spine 双门静脉内窥镜手术治疗腰椎退行性疾病
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2022-3-1-63-70
V. Pereverzev, V. V. Shvets, Nadezhda A Chernova
Biportal endoscopic surgery is a minimally invasive innovative method of treatment, where two ports are used, one for visualization, the other for surgical instruments. In this article we describe the biportal endoscopic technique for laminectomy and discectomy, as well as discuss the features of these interventions in degenerative diseases of the spine.
双门静脉内窥镜手术是一种微创的创新治疗方法,其中使用两个端口,一个用于可视化,另一个用于手术器械。在这篇文章中,我们描述了双门静脉内窥镜技术用于椎板切除术和椎间盘切除术,并讨论了这些干预措施在脊柱退行性疾病中的特点。
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引用次数: 0
Extracorporeal detoxification in intensive care of metabolic acidosis in cancer patients 体外解毒在癌症代谢性酸中毒患者重症监护中的应用
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2022-3-2-44-47
E. Gromova
Metabolic acidosis is a satellite and a consequence of a number of damaging factors; it belongs to the category of critical pathological conditions, associated with high mortality, and requires appropriate intensive therapy. In cancer patients, the risk of decompensated homeostasis disorders is significantly higher compared to the general population of patients, which reduces the possibility of antitumor treatment and worsens the prognosis. Timely application of extracorporeal detoxification allows to avoid fatal complications and continue antitumor treatment.
代谢性酸中毒是一种伴随性疾病,是许多有害因素的结果;它属于严重病理状况,与高死亡率相关,需要适当的强化治疗。在癌症患者中,失代偿性体内平衡紊乱的风险明显高于普通人群,这降低了抗肿瘤治疗的可能性,恶化了预后。及时应用体外解毒可以避免致命的并发症,并继续抗肿瘤治疗。
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引用次数: 0
Integration of virtual reality into the program of non-drugtreatment of pain and early rehabilitation 将虚拟现实整合到疼痛的非药物治疗和早期康复方案中
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2022-3-1-5-14
Nadezhda A Veremeenko, Arina V Saukina, Svetlana A Perepelica
The article deals with the issues of non-drug treatment of pain from the standpoint of a biopsychosocial approach using virtual reality (VR) as well as the possibility ofintegrating this methodinto an early rehabilitation program for neurological patients. The historical aspects of discovery and integration of VRinto medicine and the results of using the method to reduce the intensity of pain in patients with burn disease the possibility of using VR technology in anesthesiology and resuscitation as an alternative to narcotic analgesics for certain types of intervention are presented The use of VR is promising in the motorand cognitive rehabilitation ofpatients with various pathologies ofthe central nervous system and can be used at any stage of rehabilitation at low financial costs with minimal involvement ofmedical personnel in the hospital and outpatient settings.
本文从使用虚拟现实(VR)的生物心理社会方法的角度讨论了疼痛的非药物治疗问题,以及将该方法整合到神经系统患者早期康复计划中的可能性。本文介绍了虚拟现实技术在医学中发现和整合的历史方面,以及使用该方法减轻烧伤患者疼痛强度的结果,以及在麻醉和复苏中使用虚拟现实技术作为麻醉性镇痛药的替代方法的可能性,并介绍了虚拟现实技术在各种中枢神经系统病变患者的运动和认知康复方面的应用前景,并且可以在任何阶段使用康复费用低,医院和门诊部医务人员的参与最少。
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引用次数: 1
Results of autologous peripheral hematopoietic stem cell transplantation in multiple myeloma in Kyrgyzstan 自体外周血干细胞移植治疗吉尔吉斯斯坦多发性骨髓瘤的结果
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2022-3-1-26-32
Abduhalim R Raimzhanov, Bahtiyar S Atabaev, Sherbet K Zhusupova
The article is devoted to performing a series of autologous transplantations of peripheral hematopoietic stem cells in multiple myeloma (MM). For the first time in Central Asia, in the Kyrgyz Scientific Center of Hematology of the Ministry of Health of the Kyrgyz Republic, autologous hematopoietic stem cells were used in the treatment of 26 patients with MM. Comprehensive laboratory and functional analyses were carried out to diagnose MM. Autologous stem cells were collected using the blood cell separator. Conditioning mode and an algorithm of therapeutic approaches of patients before autotransplantation and post-transplantation monitoring were used.
本文旨在探讨外周血造血干细胞在多发性骨髓瘤(MM)患者体内的一系列自体移植。在中亚首次,在吉尔吉斯共和国卫生部的吉尔吉斯血液学科学中心,自体造血干细胞用于治疗26例MM患者。进行了全面的实验室和功能分析以诊断MM。使用血细胞分离器收集了自体干细胞。采用自体移植前和移植后监测的调理模式和治疗方法算法。
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引用次数: 0
A case of successful treatment of a patient with splenic artery aneurysm, splenic vein malformation and splenomegaly 成功治疗脾动脉动脉瘤、脾静脉畸形及脾肿大1例
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2023-4-1-48-54
A. P. Chuprina, S. Y. Polushin, K. Zamsky, E. Vinogradov
The clinical picture, diagnosis and selected option of surgical treatment of splenic artery aneurysm with splenic vein malformation and splenomegaly in a 30-year-old patient are discussed.
本文讨论一例30岁脾动脉动脉瘤合并脾静脉畸形及脾肿大的临床表现、诊断及手术治疗的选择。
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引用次数: 0
Forensic medical examination of military personnel with postcommotion syndrome as a result of combat trauma 对因战斗创伤而患有骚乱后综合症的军事人员进行法医检查
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2023-4-2-77-82
V. A. Putintsev, Jurij E. Loginov, Shamil' Ch. Gizatullin, Dmitrij V. Bogomolov, P. Dzhuvalyakov, O. Romanova
The article represents the basic principles of forensic and forensic-psychiatric examination of servicemen in order to determine the severity of damage to human health in case of craniocerebral trauma as a consequence of combat trauma resulting in mental disorder – post-commotion syndrome.
这条规定了对军人进行法医和法医-精神检查的基本原则,以便在战斗创伤导致精神紊乱-骚乱后综合症的颅脑创伤的情况下确定对人体健康损害的严重程度。
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引用次数: 0
A variant of anesthesia for total arthroplasty of the lower extremity joints 下肢全关节成形术麻醉的一种变体
Pub Date : 1900-01-01 DOI: 10.53652/2782-1730-2021-2-4(6)-05-11
L.V. Ermokhina, N. V. Ermokhina, A. Zavarzin, V. Stets
In this study we sought to optimize analgesia in total joint arthroplasty of the lower extremity and reduce the risk of arterial hypotension in patients with various degrees of obesity. The optimization contributed to the development of a new technique of spinal anesthesia. The technique leads to the epidural volume extension, as well as the decrease of local anesthetic doses administered into the subarachnoid space and saving the level of sensory block. The aim of the study was to study the effect of the spinal anesthesia with the epidural volume extension technique on the level of sensory block and hemodynamics in patients with various degrees of obesity during total arthroplasty of the lower extremity joints for III stage osteoarthritis. The prospective single-center study included 103 patients (79 men (76.7%), mean age 59±11 years, range from 33 to 74 years) who were treated in the Department of Traumatology and Orthopedics from September 2019 to May 2020. Anthropometric parameters, levels of sensory and motor blocks, level of pain syndrome, sympathetic block, duration of surgery and anesthesia were analyzed. To assess the impact of all factors on the outcome, methods of one-dimensional analysis with the calculation of relative risk (RR) were used. All patients were divided into two groups: the control group (combined spinal-epidural anesthesia was used) and the main group (spinal anesthesia with epidural volume extension was used). The average upper level of the sensor block (Th-segment) at 15 minutes after spinal anesthesia did not significantly differ in the groups (p=0.95). Differences in the frequency of hypotension in the groups were not statistically significant (p˃0.05). RR: 1.17 [95% CI: 0.794; 1.726]. Reducing the dose of a local anesthetic by 25% to provide adequate spinal anesthesia with the epidural volume extension in patients with a high body mass index achieves the same result when assessing sensory, motor and sympathetic blockages when compared with the traditional method of anesthesia.
在这项研究中,我们试图优化下肢全关节置换术中的镇痛,降低不同程度肥胖患者动脉低血压的风险。这一优化促进了脊髓麻醉新技术的发展。该技术可扩大硬膜外容量,减少蛛网膜下腔局部麻醉剂量,降低感觉阻滞程度。本研究的目的是研究脊髓麻醉硬膜外扩容技术对不同肥胖程度的III期骨关节炎患者下肢关节全关节置换术中感觉阻滞水平和血流动力学的影响。该前瞻性单中心研究纳入了2019年9月至2020年5月在创伤与骨科接受治疗的103例患者(男性79例(76.7%),平均年龄59±11岁,年龄范围33 ~ 74岁)。分析人体测量参数、感觉和运动阻滞水平、疼痛综合征水平、交感阻滞、手术时间和麻醉时间。为了评估所有因素对结果的影响,采用一维分析方法计算相对风险(RR)。所有患者分为两组:对照组(采用脊髓-硬膜外联合麻醉)和主组(采用脊髓麻醉加硬膜外扩容量)。脊髓麻醉后15分钟传感器阻滞(th段)的平均上水平各组间无显著差异(p=0.95)。两组患者低血压发生率比较,差异无统计学意义(p < 0.05)。Rr: 1.17 [95% ci: 0.794;1.726]。与传统麻醉方法相比,在评估感觉、运动和交感神经阻塞时,将局麻药剂量减少25%以提供足够的脊髓麻醉,同时对高体重指数患者进行硬膜外容量扩大,可获得相同的结果。
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Medical Bulletin of the Main Military Clinical Hospital named after N.N. Burdenko
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