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Assessment of Nutritive Status in Patients with Symptoms of Heart Failure 心力衰竭患者营养状况的评估
Pub Date : 2020-09-07 DOI: 10.29413/abs.2020-5.4.2
O. Yu. Bastrikov, U. V. Kharlamova, A. I. Zakharova, E. A. Pripadchev, S. A. Shakhov
Aim of the research. To study the parameters of nutritional status of patients with acute and chronic coronary syndromes and symptoms of heart failure in conjunction with clinical, anthropometric, laboratory parameters, structural and functional characteristics of the heart. Materials and methods. A cross-sectional study of 106 patients with acute and chronic coronary syndromes and symptoms of heart failure. All subjects underwent an integrated assessment of the nutritional status (anthropometric, caliperometric (caliper metric) indicators, CONUT scale (lymphocytes, total cholesterol, albumin), hormonal indicators (N-terminal brain natriuretic propeptide), structural changes in the myocardium using echocardiography, exercise tolerance by 6-minute walk test. Results. Nutritional deficiency, according to CONUT scale, was found in 81.1 % of cases (86 patients). In the group of patients with the presence of malnutrition, there were significantly high level of fibrinogen and N-terminal brain natriuretic propeptide. The interpretation of changes in body composition showed a significant upward trend in the prognostic index of hypotrophy and a decrease in lean body mass as heart failure progresses. The dependence of nutritive insufficiency on the CONUT scale with laboratory parameters (creatinine, fibrinogen, brain natriuretic propeptide), structural and functional characteristics of the heart (diastolic and systolic dimensions of the left ventricle, ejection fraction, left ventricular myocardial mass index), a functional indicator of tolerance to the physical load (6-minute walk test) was determined. Conclusion. An integrated analysis of nutritional status indicators of patients with heart failure revealed an increase of malnutrition signs with an increase of the severity of HF. Pathological effects of nutritional deficiency are associated with impaired left ventricular systolic function, reduced exercise tolerance.
研究的目的。结合临床、人体测量、实验室参数、心脏结构和功能特征,研究急慢性冠状动脉综合征和心衰症状患者的营养状况参数。材料和方法。106例急性和慢性冠状动脉综合征和心衰症状的横断面研究所有受试者均接受营养状况(人体测量、卡尺测量)指标、CONUT量表(淋巴细胞、总胆固醇、白蛋白)、激素指标(n端脑利钠前肽)、超声心动图心肌结构变化、6分钟步行试验运动耐受性的综合评估。结果。根据CONUT量表,81.1%的病例(86例)存在营养缺乏。在存在营养不良的患者中,纤维蛋白原和n端脑利钠前肽水平明显升高。对身体成分变化的解释显示,随着心力衰竭的进展,预后指标萎缩和瘦体质量下降呈显著上升趋势。测定营养不全对CONUT量表的依赖性,包括实验室参数(肌酐、纤维蛋白原、脑利钠前肽)、心脏结构和功能特征(左心室舒张和收缩尺寸、射血分数、左心室心肌质量指数)、对体力负荷耐受的功能指标(6分钟步行试验)。结论。对心力衰竭患者营养状况指标的综合分析显示,随着心衰严重程度的增加,营养不良体征也随之增加。营养缺乏的病理影响与左心室收缩功能受损、运动耐受性降低有关。
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引用次数: 1
Dynamics of the Level of Myeloperoxidase and Serum Calprotectin in Local Cold Injury 局部冷损伤中髓过氧化物酶和血清钙保护蛋白水平的动态变化
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.3
M. I. Mikhailichenko, K. Shapovalov, V. A. Mudrov, O. Gruzdeva
Relevance. Cold injury is defined as a complex of pathophysiological and pathomorphological changes arising as a result of local or general cooling of the human body. Endothelial dysfunction provokes a powerful cascade of cellular interactions with expressed excretory activity, which ultimately leads to a pronounced remodeling of microcirculation and a protracted process of inflammation in the focus of alterations. Aim of the study. To establish the dynamics of the level of myeloperoxidase and calprotectin in the serum of patients with local cold injury. Materials and methods. The study included 80 patients with III–IV degree lesions in the late reactive period and the period of granulation and epithelialization. The average age of patients was 38 ± 8 years. The myeloperoxidase level was measured on the 5th and 30th days from the moment of cryopreservation using multiplex analysis of blood serum. Results. The level of myeloperoxidase and serum calprotectin increases. In late reactive period (day 5), MPO level in patients with frostbite is 7.25 times higher in comparison with control values, in the period of granulation and epithelialization (day 30), it remains elevated, but only 3.63 times higher than in the control group. In the late reactive period, the level of calprotectin in the blood serum of patients with local cold injury was 4.6 times higher in comparison with control values, and on the 30th day of cryopreservation, the value of calprotectin was 4.5 times higher than in the control group. Changes in the level of myeloperoxidase and serum calprotectin reflect the flow of destructive and reparative mechanisms in tissues during local cold trauma and can be used in predicting an unfavorable prolonged course of the wound process.
的相关性。冷损伤被定义为由于人体局部或全身冷却而引起的病理生理和病理形态学变化的复合体。内皮功能障碍引发了细胞与表达的排泄活动的强大级联相互作用,最终导致微循环的明显重塑和改变焦点的长期炎症过程。研究的目的。目的探讨局部冷损伤患者血清中髓过氧化物酶和钙保护蛋白水平的变化规律。材料和方法。本研究纳入80例反应期晚期及肉芽和上皮化期的III-IV级病变患者。患者平均年龄38±8岁。在冷冻保存后第5天和第30天采用血清多重分析检测髓过氧化物酶水平。结果。髓过氧化物酶和血清钙保护蛋白水平升高。在反应后期(第5天),冻伤患者的MPO水平比对照组高7.25倍,在肉芽和上皮化期(第30天),MPO水平仍然升高,但仅比对照组高3.63倍。在反应后期,局部冷损伤患者血清钙保护蛋白水平比对照组高4.6倍,在低温保存第30天,钙保护蛋白水平比对照组高4.5倍。髓过氧化物酶和血清钙保护蛋白水平的变化反映了局部冷创伤时组织中破坏和修复机制的流动,并可用于预测创伤过程的不利延长过程。
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引用次数: 0
Development and Application of a Mathematical Model in the Prediction of Stroke in People Exposed to Toxic Dust Factors in the Workplace 工作场所接触有毒粉尘因素人群中风预测数学模型的建立与应用
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.4
M. V. Yashnikova, E. L. Poteryaeva, B. Doronin, V. Maksimov, E. Smirnova
Background. The problem of studying the development of stroke in men of working age working in conditions of high professional risk is relevant. Aim of the research. To develop a method for predicting the development of stroke in men working under conditions of exposure to toxic dust factors. Materials and methods. The study included 111 men aged 30 to 65 years who worked for 5 or more years in the following professions: electric gas welder, gas welder, smelter. The study participants were divided into two groups: the first group – 45 men who had a stroke; the second group – 66 men who did not have stroke history. The subjects of both groups were comparable in terms of occupational structure, age and length of service. Using the method of sequential inclusion of the studied risk factors for stroke development (Forward Stepwise), we determined those that made a significant contribution to the possible development of stroke. Results. Based on multivariate analysis, a logistic regression formula was derived that determines the likelihood of a stroke in patients working under the influence of the toxic dust factor, which included the following factors: the presence of dyslipidemia factor (β-coefficient = 3.7; p = 0.001), the patient’s diagnosis is “stage III arterial hypertension” (β-factor = 5.6; p = 0.002), blood pressure control (β-factor = –3.4; p = 0.005). The patient determines the value of these three parameters, substitutes the appropriate formula for calculating the value of p(X). A value of p(X) in excess of 0.5 indicates a high risk of stroke in men working under conditions of exposure to toxic dust factors. The sensitivity of the proposed method was 84.4 %, specificity – 92.4 %. Conclusion. The multivariate model is informative for the individual prediction of the development of stroke in men working under the influence of the toxic-dust factor, since it reflects the degree of influence of one or another factor on the development of the disease.
背景。研究在高职业风险条件下工作的工作年龄男性中风的发展问题是有意义的。研究的目的。目的:建立一种预测在有毒粉尘环境下工作的男性中风发病的方法。材料和方法。该研究包括111名年龄在30至65岁之间的男性,他们在以下行业工作了5年或更长时间:电焊工、气体焊工、冶炼厂。研究参与者被分为两组:第一组有45名中风患者;第二组是66名没有中风史的男性。两组被试在职业结构、年龄和服务年限方面具有可比性。采用顺序纳入研究卒中发展危险因素的方法(Forward Stepwise),我们确定了那些对卒中可能发展有重大贡献的因素。结果。在多因素分析的基础上,导出了确定在有毒粉尘因素影响下工作的患者发生卒中可能性的logistic回归公式,该公式包括以下因素:血脂异常因素的存在(β-系数= 3.7;p = 0.001),诊断为“III期动脉性高血压”(β-factor = 5.6;P = 0.002)、血压控制(β-因子= -3.4;P = 0.005)。患者确定这三个参数的值,代入相应的公式计算p(X)的值。p(X)值超过0.5表明在接触有毒粉尘因素的条件下工作的男性中风的风险很高。该方法的灵敏度为84.4%,特异度为92.4%。结论。多变量模型对于在有毒粉尘因素影响下工作的男性中风发展的个体预测提供了信息,因为它反映了一个或另一个因素对疾病发展的影响程度。
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引用次数: 0
Cyclooxygenase 2 as a Marker of Early Pregnancy Loss in Cytomegalovirus Infection 环合酶2作为巨细胞病毒感染早期妊娠丢失的标志
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.1
N. A. Ishutina, I. Andrievskaya, M. German
Background. Increased expression of cyclooxygenase 2 in the placenta plays a significant role in the formation of placental disorders in the pathological course of pregnancy. It was shown that a high level of expression of cyclooxygenase 2 leads to excessive synthesis of prostaglandins, which stimulate the contractile activity of the uterine myometrium and trigger the abortion mechanism. An analysis of modern literature has shown a lack of data proving the involvement of cyclooxygenase 2 in the pathogenesis of early miscarriages in cytomegalovirus infection. Objective. To establish the pathogenetic role of cyclooxygenase 2 in early pregnancy in the course of miscarriage during exacerbation of cytomegalovirus infection. Materials and methods. The study included 86 women with a gestational age of 8–12 weeks, of which 46 women with spontaneous abortion (O03) and exacerbation of cytomegalovirus infection (main group) and 40 women with medical abortion (O04) without cytomegalovirus infection (control group). The material for the study was peripheral blood serum, urine, homogenate of the villous chorion of the placental tissue. The content of cyclooxygenase 2, the level of IgM and IgG antibodies to cytomegalovirus, low-type IgG antibodies to cytomegalovirus (avidity index) were analyzed by enzyme-linked immunosorbent assay; the content of arachidonic acid – by capillary gas-liquid chromatography. Results. During the study, women of the main group found an increase in the concentration of arachidonic acid by 59 % (p < 0.001) and the activity of the lipolytic enzyme cyclooxygenase 2 – by 58 % (p < 0.001) in the placenta villous chorion homogenate. Conclusion. With an exacerbation of cytomegalovirus infection in the homogenate of the villous placenta chorion of pregnant women with spontaneous abortion, an increase in the content of arachidonic acid and the level of cyclooxygenase 2 is observed. An increased level of cyclooxygenase 2 indicates the development of pregnancy complications and can be used as a non-specific marker predictor of pregnancy termination during exacerbation of cytosis.
背景。环氧化酶2在胎盘中的表达增加在妊娠病理过程中胎盘紊乱的形成中起重要作用。结果表明,环氧化酶2的高水平表达导致前列腺素的过度合成,从而刺激子宫肌层的收缩活性,触发流产机制。对现代文献的分析表明,缺乏数据证明环氧化酶2参与巨细胞病毒感染早期流产的发病机制。目标。目的探讨环合酶2在巨细胞病毒感染加重期妊娠早期流产过程中的致病作用。材料和方法。本研究纳入86例胎龄8 ~ 12周的产妇,其中自然流产46例(O03)合并巨细胞病毒感染加重(主组),药物流产40例(O04)合并巨细胞病毒感染(对照组)。本研究的材料为外周血血清、尿液、胎盘组织绒毛绒毛膜匀浆。采用酶联免疫吸附法检测各组小鼠环氧合酶2含量、巨细胞病毒IgM抗体、IgG抗体及巨细胞病毒低型IgG抗体(亲和力指数)水平;毛细管气液色谱法测定花生四烯酸的含量。结果。在研究中,主组妇女发现胎盘绒毛绒毛膜浆液中花生四烯酸浓度增加了59% (p < 0.001),脂溶酶环加氧酶2 -活性增加了58% (p < 0.001)。结论。随着自然流产孕妇绒毛胎盘绒毛膜匀浆巨细胞病毒感染的加重,花生四烯酸含量和环加氧酶2水平升高。环加氧酶2水平升高表明妊娠并发症的发生,可作为细胞增多症加重期间终止妊娠的非特异性标志物预测因子。
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引用次数: 0
Comparative Assessment of Changes in the Blood Coagulation System in Rats When Exposed to Organic Boron Compounds of Various Chemical Structures 暴露于不同化学结构的有机硼化合物对大鼠血液凝固系统变化的比较评价
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.6
G. Yushkov, V. V. Igumenshcheva, A. Krasnova
Background. Despite the available information on the clinical manifestations of acute and chronic intoxication with boron compounds, no clear evidence was found among studies to research the effect of boron compounds with different chemical structures on key factors of the blood coagulation system. The data are presented in full for the first time. Aim of the study. Identification of possible signs of the effect of boron compounds on selected indicators of hemostasis in laboratory animals and their characteristics depending on the chemical structure of the compounds. Methods. Modern methods of studying hemostasis are used. Nonlinear rats were chosen as the experimental biological model. Once through the mouth, in the maximum tolerated dose, the following drugs were administered: isopropylmethacarborane, 1,2-di(oxymethyl)orthocarborane, 1,7-di(oxymethyl)methacarborane, polyethylammonium triethylammonium salt, boric acid. Research conducted against a background of dynamic control. Results. Materials were obtained that testify to the effect of boron compounds under the conditions of this experiment on factors of the blood coagulation system. The differences in this effect are established in connection with the chemical structure of the compounds, which are especially pronounced after the introduction of methacarboranes. The effect of orthocarborane and the polyethylammonium triethylammonium salt on factors was less significant. An important fact is that boric acid per se, by its effect on the blood coagulation system, turned out to be less effective than other compared compounds. Conclusion. The polytropy of the toxic effect of boron compounds of different chemical structures was confirmed, including with the involvement of the blood coagulation system, but with the essential features of each of them under conditions of a single exposure to laboratory animals in the maximum tolerated dose.
背景。虽然对急慢性硼化合物中毒的临床表现有一定的了解,但不同化学结构的硼化合物对凝血系统关键因子影响的研究尚无明确证据。数据首次完整呈现。研究的目的。鉴定硼化合物对实验动物选定的止血指标的影响的可能迹象及其取决于化合物化学结构的特征。方法。使用现代止血研究方法。选择非线性大鼠作为实验生物模型。一旦通过口腔,以最大耐受剂量给予以下药物:异丙基甲基碳硼烷,1,2-二(氧甲基)正碳硼烷,1,7-二(氧甲基)甲基碳硼烷,聚乙烯三乙基铵盐,硼酸。以动态控制为背景进行的研究。结果。在本实验条件下,获得了证明硼化合物对凝血系统因子影响的材料。这种效果的差异与化合物的化学结构有关,在引入甲基碳硼烷后,这种差异尤为明显。正硼烷和聚三乙胺盐对各因子的影响不显著。一个重要的事实是,硼酸本身,通过其对血液凝固系统的影响,被证明比其他比较的化合物效果更差。结论。证实了不同化学结构的硼化合物的毒性作用的多变性,包括涉及血液凝固系统,但在最大耐受剂量的单次暴露于实验动物的条件下,每种化合物都具有基本特征。
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引用次数: 0
Pharmacogenetic Aspects of Type 2 Diabetes Treatment 2型糖尿病治疗的药物遗传学方面
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.2
N. Pozdnyakov, I. N. Kagarmanyan, A. E. Miroshnikov, E. S. Emelyanov, A. Gruzdeva, A. Sirotkina, I. Dukhanina, A. A. Milkina, A. Khokhlov, S. Pozdnyakov
In this article, we analyze the role of different variants of the KCNJ11, TCF7L2, SLC22A1, SLC22A3, CYP2C9, CYP2C8, PPARγ genes polymorphisms in efficacy of diabetes mellitus pharmacotherapy. T allele of the KCNJ11 rs2285676 gene polymorphism and G allele of KCNJ11 rs5218 gene polymorphism are associated with the response to IDPP-4 therapy; the presence of KCNJ11 gene rs5210 polymorphism A allele is a predictor of poor response. The effect of rs7903146 polymorphism of TCF7L2 gene was evaluated on the response to treatment of patients taking linagliptin. Linagliptin significantly reduced HbA1c levels for all three rs7903146 genotypes (CC: –0.82 %; CT: –0.77 %; TT: –0.57 %). A significantly smaller effect of therapy was observed with the genotype with ТТ. The rs622342 polymorphism of SLC22A1 gene was studied in effectiveness of metformin. The researches demonstrated that carriers of variant AA had an average decrease of HbA1c of 0.53 %, heterozygous – decrease of 0.32 %, and carriers of a minor variant of SS had an increase of 0.2 % in the level of HbA1c. A significant effect of CYP2C9 polymorphisms on the pharmacokinetic parameters of PSM was noted. When studying the kinetics of glibenclamide, it was found that carriage of the allele *2 significantly reduces glibenclamide metabolism: homozygous carriers had clearance 90 % lower than homozygous carriers of the wild variant. The studies confirmed the association of the allelic variants of Thr394Thr and Gly482Ser of PPARγ gene with higher efficacy of the rosiglitazone. The data obtained from the analysis of the association of the Pro12Ala polymorphism of PPARγ gene and the response to therapy is contradictory. Thus the personalized approach, based on the knowledge of polymorphism options, will allow choosing the most effective drug with transparent kinetics for each individual patient.
本文分析KCNJ11、TCF7L2、SLC22A1、SLC22A3、CYP2C9、CYP2C8、PPARγ基因多态性在糖尿病药物治疗疗效中的作用。KCNJ11 rs2285676基因多态性的T等位基因和KCNJ11 rs5218基因多态性的G等位基因与IDPP-4治疗的应答相关;KCNJ11基因rs5210多态性A等位基因的存在是不良反应的预测因子。评价TCF7L2基因rs7903146多态性对利格列汀患者治疗效果的影响。利格列汀显著降低了所有三种rs7903146基因型的HbA1c水平(CC: - 0.82%;Ct: - 0.77%;Tt: - 0.57%)。对于基因型为ТТ的患者,治疗效果明显较小。研究SLC22A1基因rs622342多态性对二甲双胍疗效的影响。研究表明,变异AA携带者的HbA1c平均降低0.53%,杂合型降低0.32%,SS小变异携带者的HbA1c平均升高0.2%。CYP2C9多态性对PSM药代动力学参数有显著影响。在研究格列本脲的动力学时,发现携带*2等位基因显著降低了格列本脲的代谢:纯合携带者的清除率比野生变异的纯合携带者低90%。研究证实PPARγ基因Thr394Thr和Gly482Ser等位基因变异与罗格列酮的高疗效相关。从PPARγ基因Pro12Ala多态性与治疗反应的关联分析中获得的数据是矛盾的。因此,基于多态性选择知识的个性化方法将允许为每个患者选择具有透明动力学的最有效药物。
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引用次数: 0
Mobile Health Intervention for Outpatient Treatment of Tuberculosis and HIV Infection 结核病和艾滋病毒感染门诊治疗的流动卫生干预
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.7
S. Zhdanova, O. Ogarkov, S. Heysell
Aim of the study. To describe the results of using mobile health intervention for improving the compliance of patients with tuberculosis and HIV (TB/HIV). Materials and methods. Piloted clinic-affiliated mobile intervention was carried out in 54 patients with TB/HIV and with a history of psychoactive substances abuse in Irkutsk Regional Clinical Tuberculosis Hospital. The mobile intervention included a smartphone application that connected the participants to the staff of Irkutsk Regional TB Hospital and provided daily queries on stress, mood and medication adherence; appointment reminders; virtual support group and consultation resources; weekly quizzes. We assessed longitudinal impact on retention in medical care, visit constancy, viral loads and CD4 counts, TB outcomes. Results. In 6 months, we registered the increase (in comparison with baseline) in mean CD4 counts (F = 6.61; р = 0.04) and in the number of cases of suppressed viral loads – from 20.5 % (9/44) to 55.3 % (21/38) (p < 0.01) in TB/HIV users of e-health app. We found a lower level of TB treatment interruption in patients who used the application in comparison with the patients who refused to use it (4/44 vs 5/10; χ2 = 7.09; р = 0.008). App users completed the course of TB treatment in 63.6 % of cases (28/44), and 61.4 % of patients (27/44) were cured which was higher than the level in the control group (20 % (2/10)) (χ2 = 7.54; p = 0.03). Conclusion. This study has demonstrated that a mobile health intervention can have a positive impact on improving the medical and social care and clinical outcomes for TB/HIV patients with history of psychoactive substances abuse.
研究的目的。描述使用流动卫生干预措施改善结核病和艾滋病毒(TB/HIV)患者依从性的结果。材料和方法。在伊尔库茨克地区临床结核病医院,对54名结核病/艾滋病毒患者和有精神活性药物滥用史的患者进行了临床附属流动干预试点。移动干预包括一个智能手机应用程序,该应用程序将参与者与伊尔库茨克地区结核病医院的工作人员连接起来,并提供关于压力、情绪和药物依从性的每日查询;约会提示;虚拟支援小组和咨询资源;每周测验。我们评估了对医疗保健保留率、就诊稳定性、病毒载量和CD4计数、结核病结局的纵向影响。结果。在6个月内,我们记录了平均CD4计数(与基线相比)的增加(F = 6.61;在TB/HIV用户中,病毒载量被抑制的病例数从20.5%(9/44)降至55.3% (21/38)(p < 0.01)。我们发现,与拒绝使用该应用程序的患者相比,使用该应用程序的患者结核病治疗中断的水平较低(4/44 vs 5/10;χ2 = 7.09;r = 0.008)。应用程序用户完成TB疗程的患者占63.6%(28/44),治愈率为61.4%(27/44),高于对照组(20% (2/10))(χ2 = 7.54;P = 0.03)。结论。这项研究表明,流动卫生干预可以对改善有精神活性物质滥用史的结核病/艾滋病毒患者的医疗和社会护理以及临床结果产生积极影响。
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引用次数: 0
Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case) 粘连性蛛网膜炎伴硬膜外纤维化反复手术治疗的原因(临床一例)
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.8
A. Zhivotenko, V. Sorokovikov, Z. Koshkareva
The work presents a rare clinical case of adhesive arachnoiditis, which developed against the background of epidural fibrosis during repeated surgical interventions. The cicatricial adhesion in the epidural space is formed in 100% of cases after surgery and is a frequent cause of intraoperative complications during repeated surgical interventions (bleeding, damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc. The cicatricial adhesion in the epidural space is the main reason for the development of failed back surgery syndrome (FBSS), which today is an important and unresolved problem in spinal surgery. The epidural, as well as the subdural and subarachnoid space of the operated spinal motor segment of the spinal canal can be involved in the cicatricial adhesion, as it is shown in our clinical example. In this regard, it is important to prevent the development of the cicatricial adhesion in the epidural space during primary spinal surgeries, since with the increase in life expectancy of the population and increase in surgical activity during spinal surgeries, the patient can be operated repeatedly. Consequently, the question arises of preventing the formation of the cicatricial adhesion in 100% of cases with each surgical intervention, since the formed cicatricial adhesion in the epidural space does not have effective methods of conservative and surgical treatment and worsens favorable and satisfactory forecasts of surgical treatment for repeated surgical interventions.
该工作提出了一个罕见的临床病例粘连蛛网膜炎,其发展对背景硬膜外纤维化反复手术干预。硬膜外腔瘢痕性粘连在术后100%形成,是反复手术干预(出血、脊髓及硬脑膜损伤及脑脊液流出)术中并发症的常见原因,因此手术治疗效果不理想,形成不同程度的持续疼痛、假性脑膜膨出、联合蛛网膜炎等。硬膜外腔瘢痕性粘连是导致背部手术失败综合征(FBSS)发生的主要原因,是目前脊柱外科的一个重要且尚未解决的问题。经手术的椎管脊髓运动段的硬膜外、硬膜下和蛛网膜下腔均可参与瘢痕粘连,我们的临床病例显示。在这方面,预防硬膜外腔瘢痕粘连的发展是重要的,因为随着人口预期寿命的增加和脊柱手术期间手术活动的增加,患者可以反复手术。由于硬膜外腔形成的瘢痕粘连没有有效的保守和手术治疗方法,反复手术干预会使手术治疗的良好和令人满意的预测变得更差,因此每次手术干预都不能100%地防止瘢痕粘连的形成。
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引用次数: 0
Clinical Case of Goldenhar Syndrome in Psychiatric Practice 精神病学实践中的高氏综合征临床一例
Pub Date : 2020-07-13 DOI: 10.29413/abs.2020-5.3.5
A. Kovaleva
A clinical case of a rare genetic oculo-auriculo-vertebral syndrome (Goldenhar syndrome) is presented in a young man of 18 years old, who was first sent for examination and treatment to the psychiatric ward. A retrospective analysis of anamnestic information indicates the emergence of psychopathological disorders in childhood in the form of a delay in psychoverbal development, emotional immaturity, and delays in the development of social behavior. Subsequently, persistent encephalasthenic and neurosis-like disorders were complicated by the addition of affective disorders of the depressive-dysphoric type and psychotic disorders. The lack of a timely integrated therapeutic approach with the addition of psychopharmacotherapy, psychotherapy and social therapy led to the formation of specific personality changes in organic etiology with significant disorders in the emotional sphere (lability of emotions, irritability, outbursts of anger, constant resentment and dissatisfaction with others), a decrease in the level of cognitive activity and a tendency to chronic course of neurosis-like and affective disorders. A statement of persistent pronounced violations of mental functions during follow-up observation caused severe restrictions in the main areas of life (communication, behavior control, education, work) and social maladaptation of the patient, which was the basis for referral to medical and social examination with the establishment of a disability group.
一个罕见的遗传性眼-耳-椎综合征(Goldenhar综合征)的临床病例出现在一个18岁的年轻人身上,他首先被送到精神科病房进行检查和治疗。回顾性分析的失忆症信息表明,精神病理障碍的出现在儿童的形式,在心理发展的延迟,情绪不成熟,在社会行为的发展延迟。随后,持续性脑衰弱和神经症样障碍合并抑郁-烦躁型情感性障碍和精神病性障碍。缺乏及时的综合治疗方法,加上精神药物治疗、心理治疗和社会治疗,导致在情感领域(情绪不稳定、易怒、愤怒爆发、持续怨恨和对他人不满)形成特定的有机病因性人格改变,认知活动水平下降,并倾向于慢性神经症和情感障碍。在后续观察期间,关于精神功能持续受到明显侵犯的陈述,导致患者在主要生活领域(沟通、行为控制、教育、工作)受到严重限制,社会适应能力下降,这是在成立残疾小组后进行医疗和社会检查的基础。
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引用次数: 1
The Use of Drainage Structures in Abdominal Surgery in the Postoperative Period (Experimental Study) 引流结构在腹部手术术后的应用(实验研究)
Pub Date : 2020-05-09 DOI: 10.29413/abs.2020-5.2.11
I. Shurygina, N. Ayushinova, M. Shurygin, N. Dremina, E. A. Lozovskaya, A. V. Nevezhina, E. Chepurnykh
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引用次数: 0
期刊
Acta Biomedica Scientifica (East Siberian Biomedical Journal)
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