Year 2020 Vol. 28 No 3




Ulyanovsk State University 1 , Ulyanovsk,
"Gammamed-Soft", Ltd 2, Moscow,
The Russian Federation

Objective. The present study is focused on risk factors of burn wound conversion in the local treatment with DDBM (dressing, dressing, Breitman-Menzul) dressing material in comparison with routine treatment based on gauze bandages with iodophors.
Methods. During the research work, we used retrospective data of 281 patients with second-degree burn injuries. The group was divided into two: those who were treated with DDBM dressing (n=130), and those who were treated with gauze bandages with iodophors (n=151). Patients were included in this study if: 1) their age was over 18; 2) they had II degree burns without scab; 3) admission was not later than 3 days after trauma; 4) predominance of II degree burns in case of its combination with full-thickness skin burns (III degree). A predictive model of burn wound conversion was designed with logistic regression.
Results. The analysis showed that usage of DDBM dressing led to wound epithelialization on 15th [13; 17] day and to the reduction of burn conversion frequency by 28% in comparison with the treatment with gauze bandages with iodophors. Body mass index was found to be a highly significant predictor: risk of wound conversion tended to increase strongly for patients with body mass index over 29.5 kg/m2. A set of such variables as the location of burns on the back of the body and buttocks, body mass index, and treatment method allowed development of a binary regression model with high sensitivity and specificity (97.2% and 99.5%, respectively).
Conclusions. The study identified the advantages of local treatment with DDBM in comparison with iodophors gauze bandages. The developed predictive model allowed calculating the probability of burn wound conversion with high accuracy.

Keywords: burn wound conversion, dermal burns, moist wound healing, film dressing, predictive model
p. 249-257 of the original issue
  1. Bogdanov SB, Afaunova ON, Babichev RG. Topical application of wound dressings in early surgical treatment of burns on border course children. Medical Herald of the South of Russia. 2016;(3):27-30. doi: 10.21886/2219-8075-2016-3-27-30 (In Russ.)
  2. Singh V, Devgan L, Bhat S, Milner SM. The pathogenesis of burn wound conversion. Ann Plast Surg. 2007 Jul;59(1):109-15. doi: 10.1097/
  3. Glutkin AV, Kovalchuk VI Termicheskii ozhog kozhi u detei rannego vozrasta (opyt eksperimenta i kliniki): monografiia. Grodno, RB: GrGMU, 2016. 180 p. (In Russ.)
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  6. Obshcherossiiskaia obshchestvennaia organizatsiia Obedinenie kombustiologov Mir bez ozhogov Ozhogi termicheskie i khimicheskie. Ozhogi solnechnye. Ozhogi dykhatelnykh putei. Klinicheskie rekomendatsii [Elektronnyi resurs]. Moscow, RF; 2017 [data obrashcheniia: 2019 Mart 18]. 118 p. Available from: (In Russ.)
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  8. Sokolov VA, Efimenko NA. Admakin AL, Petrachkov SA, Stepanchenko AA. Piecetime burns. Sources of danger. Klin. Med. 2015; 93 (6): 30-35. (In Russ.)
  9. Aksoy N, Arli S, Yigit O. A retrospective analysis of the burn injury patients records in the emergency department, an epidemiologic study. Emerg (Tehran). 2014 Summer;2(3):115-20.
  10. Zinoviev EV, Alov NV, Apchel AV, Vasilieva AG, Yakimov DK. Effectiveness of antiseptic solutions in treating dermal burns. Vestn Ros Voen-Med Akad. 2014;(4):173-81. (In Russ.)
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  12. Singer AJ, Towery H, McClain SA. Effect of tadalafil on reduction of necrosis in the ischemic zone in a rat comb burn model. Burns. 2018 Sep;44(6):1427-32. doi: 10.1016/j.burns.2018.05.013
  13. Widgerow AD, King K, Tocco-Tussardi I, Banyard DA, Chiang R, Awad A, Afzel H, Bhatnager S, Melkumyan S, Wirth G, Evans GR. The burn wound exudate-an under-utilized resource. Burns. 2015 Feb;41(1):11-17. doi: 10.1016/j.burns.2014.06.002
  14. Bagnenko SF, Krylov KM. The real means of burn depth diagnostics. Skoraia Med Pomoshch. 2000;1(4):28-33. (In Russ.)
Address for correspondence:
432071, Russian Federation,
Ulyanovsk, Ryleev str., 30/30,
Ulyanovsk State University,
Institute of Medicine, Ecology and Physical Culture, the Department of Hospital Surgery,
Anesthesiology, Resuscitation, Urology,
Traumatology and Orthopedics,
tel. mobile: +79603686624,
Kobelev Konstantin S.
Information about the authors:
Kobelev Konstantin S., Post-Graduate Student of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Traumatologist-Orthopedist of the Highest Category, Burn Department Employee, Central City Clinical Hospital, Ulyanovsk, Russian Federation.
Dolotova Daria D., PhD, Leading Researcher, Gammamed-Soft, Ltd, Moscow, Russian Federation.
Midlenko Oleg V., MD, Professor of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
Belonogov Nikolaj I., MD, Professor of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute Of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
Midlenko Vladimir I., MD, Professor, Head of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.



Medical Center Palitra 1, Vladimir,
N.I.Pirogov Russian National Research Medical University of the Ministry of Health 2, Moscow,
N.P. Bekhterev Institute of the Human Brain, RAS 3, St. Petersburg,
The Russian Federation

Objective. To conduct clinical experimental studies on the use of cyancrylate glue Sulfacrylate (produced in Russia) for obliteration the lower extremities varicose veins in humans.
Methods. Endovascular catheter obliteration of the tributaries and main trunks of the great saphenous vein on the tibia was performed in 15 patients with varicose disease (C2 to CEAR) in order to substantiate the possibility of using the adhesive compound Sulfacrylate. Pain severity was clinically evaluated as well as presence or absence of phlebitis and thrombophlebitis, hyper pigmentation, neurological disorders, allergic reaction. Ultrasound control was carried out at various terms, starting from the 3rd day up to 6 months. Histological study of morphological changes was carried out selectively.
Results. All patients after the introduction of the glue Sulfacrylate had a clinic of moderate phlebitis, without the formation of blood clots in the lumen of the vein. No local or general allergic reaction was observed. Starting from the 7th day occluded venous segments were palpated in the form of moderate density bands without any infiltration of the surrounding tissues. In the absence of blood flow ultrasound examination showed gradual biodegradation of the adhesive strip inside the vein with the development of complete obliteration of the lumen starting from the 4th month. Starting from the 7th day aseptic inflammation in the wall of the vein was observed on histological examination which gradually stopped. Monocytic infiltration of the venous wall with the formation of multinucleated cells of foreign bodies was present until the complete biodegradation of the glue. The process of diffuse growth of connective tissue with the presence of fibroblasts from the subendothelium and in the middle shell was most actively observed in histological material from 90 to 120 days after occlusion. Within 180 days, the lumen of the veins occluded by "Sulfacrylate" was completely obliterated by mature connective tissue, in the absence of glue particles, which indicated its complete biodegradation.
Conclusions. The experimental studies conducted with the assessment of clinical symptoms, ultrasound examination and histological study of morphogenesis in the lumen of blood vessels in different periods up to 6 months allow us to conclude the potential use of the adhesive compound Sulfacrylate for endovasal obliteration of varicose veins in humans.

Keywords: cyanoacrylate embolization, non-thermal obliteration, non-tumescent obliteration, endovenous cyanoacrylate obliteration, varicose veins, cyanoacrylate medical glue "Sulfacrylate"
p. 258-267 of the original issue
  1. Morrison N, Gibson K, McEnroe S, Goldman M, King T, Weiss R. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg. 2015 Apr;61(4):985-94. doi: 10.1016/j.jvs.2014.11.071
  2. Proebstle TM, Alm J, Dimitri S, Whiteley M, Lawson J, Cher D, Davies A. The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins. J Vasc Surg Venous Lymphat Disord. 2015 Jan;3(1):2-7. doi: 10.1016/j.jvsv.2014.09.001
  3. Bozkurt AK, Ylmaz MF. A prospective comparison of a new cyanoacrylate glue and laser ablation for the treatment of venous insufficiency. Phlebology. 2016 Mar;31(1 Suppl):106-13. doi: 10.1177/0268355516632652
  4. Yasim A, Eroglu E, Bozoglan O. A new non-tumescent endovenous ablation method for varicose vein treatment: Early results of N-butyl cyanoacrylate (VariClose). Phlebology. 2017 Apr;32(3):194-99. doi: 10.1177/0268355516638577
  5. Srinath SR, Sharma G. Review of non-thermal non-tumescent endovenous ablation using cyanoacrylate. Surgery. 2018;14(2):10. doi: 10.7438/1584-9341-14-2-10
  6. Shaidakov EV, Meltsova AZh, Porembskaia OIa, Kudinova EA. Opyt primeneniia tsianokrilatnogo kleia pri endovaskuliarnom lechenii varikoznoi bolezni. Angiologiia i Sosud Khirurgiia. 2017;23(4):62-66. (In Russ.)
  7. Marchenko VT, Prutovykh NN, Tolstikov GA, Tolstikov AG. Meditsinskii klei Sulfakrilat. Antibakterialnaia protivovospalitelnaia kleevaia kompozitsiia: ruk dlia primeneniia v khirurg otrasliakh [Elektronnyi resurs]. Novosibirsk, RF; 2013. 80 c. Rezhim dostupa: (In Russ.)
  8. Marchenko VT, Shkurupii VA. Morfologicheskie osobennosti reparativnoi regeneratsii organov i tkanei pri ispolzovanii Sulfakrilata novogo pokoleniia. Biul Eksperim Biologii i Meditsiny. 2004;137(2):231-36. (In Russ.)
  9. Almeida JI, Javier JJ, Mackay E, Bautista C, Proebstle TM. First human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. J Vasc Surg Venous Lymphat Disord. 2013 Apr;1(2):174-80. doi: 10.1016/j.jvsv.2012.09.010
  10. Min RJ, Almeida JI, McLean DJ, Madsen M, Raabe R. Novel vein closure procedure using a proprietary cyanoacrylate adhesive: 30-day swine model results. Phlebology. 2012 Dec;27(8):398-403. doi: 10.1258/phleb.2011.011084
  11. Almeida JI, Min RJ, Raabe R, McLean DJ, Madsen M. Cyanoacrylate adhesive for the closure of truncal veins: 60-day swine model results. Vasc Endovascular Surg. 2011 Oct;45(7):631-35. doi: 10.1177/1538574411413938
  12. Almeida JI, Javier JJ, Mackay EG, Bautista C, Cher DJ, Proebstle TM. Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology. 2014 Jul;30(6):397-404. doi: 10.1177/0268355514532455
  13. Eroglu E, Yasim A, Ari M, Ekerbicer H, Kocarslan A, Kabalci M, Acpayam M. Mid-term results in the treatment of varicose veins with N-butyl cyanoacrylate. Phlebology. 2017 Dec;32(10):665-69. doi: 10.1177/0268355517718761
  14. Zielinski A, Sweircz P. Are non-thermal, non-tumescent techniques more recommended? Endovenous treatment of saphenous veins reflux methods and results overview and discussion. Phlebological Review. 2018;26(1):4-9. doi: 10.5114/pr.2018.76383
Address for correspondence:
600031, Russian Federation.,
Vladimir, Dobroselskaya str., 36b,
Medical Center Palitra,
tel.: 8(999) 776-47-73,
Sannikov Alexander B.
Information about the authors:
Sannikov Alexander B., PhD, Head of the Surgical Department of the Medical Center Palitra, Vladimir, Associate Professor of the Department of Continuing Education of Health Professionals, N.I.Pirogov Russian National Research Medical University of the Ministry of Health, Moscow, Russian Federation.
Drozdova Irina V., Functional Diagnostics Physician of the Medical Center Palitra, Vladimir, Russian Federation.
Demidenko Yaroslav A., PhD, Head Physician of the Medical Center Palitra, Vladimir, Russian Federation.
Shajdakov Evgeny V., MD, Professor, N.P. Bekhterev Institute of the Human Brain, RAS, St. Petersburg, Russian Federation
Emelynenko Vladimir M., MD, Professor, Head of the Professor of the Department of Continuing Education of health Professionals, N.I. Pirogov Russian National Research Medical University of the Ministry of Health, Moscow, Russian Federation.




Moscow Regional Research Clinical Institute named after M.F. Vladimirskiy, Moscow,
The Russian Federation

Objective. To perform a multiple factor analysis of the impact of the epitope mismatche number on the renal transplant survival.
Methods. An observational retrospective cohort study including 824 adult kidney graft recipients was performed.
Results. All recipient donor pairs had human leukocyte antigen mismatches. Significant risk factors for graft loss in the preassigned multivariate model were as follows: HLA MM (1 HR 1; 2 HR 1.24 [95% confidence interval 95% CI 0.7; 2.15], p=0.344; 3 HR 1 , 48 [95% CI 0.86; 2.33], p=0.251; 4 HR 1.88 [95% CI 1.32; 2.52], p<0.001; 5 HR 2.41 [95 % CI 2; 2.93], p<0.001; 6 HR 2.98 [95% CI 2.59; 3.46], p<0.001) p<0.001; duration of HR conservation 1.08 per hour [95% CI 1.02; 1.16], p=0.01; panel-reactive antibodies value (PRA) HR 1.24 per every 10% [95% CI 1.06; 1.58], p=0.01; but not the type of donor, age and gender of the recipient.
When including the epitope mismatches (EpMM) in the model, significant risk factors were: EpMM (<10 HR 1; 10-19 HR 1.71 [95% CI 1.09; 2.49], p=0.021; 20-29 HR 2,11 [95% CI 1.59; 2.68], p<0.001; 30-39 HR 2.4 [95% CI 1.96; 2.86], p<0.001; 40-49 HR 2 , 59 [95% CI 2.17; 3.04], p<0.001; ≥50 HR 2.71 [95% CI 2.31; 3.15], p<0.001) p<0.001; PRA HR 1.18 for every 10% [95% CI 1.09; 1.5], p=0.007; but not the duration of conservation, donor type, age and gender of the recipient. However, HLA MM was no longer a significant risk factor for HR graft loss 1.19 [95% CI 0.88; 1.55], p=0.451
Conclusions. The number of epitope mismatches between donor phenotype and recipient phenotype remains an important factor in long-term graft survival, even in despite of some corrections of the number of HLA mismatches, the donor type and the level of pre-sensitization of the recipient.

Keywords: kidney transplantation, HLA, epitope, eplet, tissue compatibility, recipient selection
p. 268-275 of the original issue
  1. Williams RC, Opelz G, Weil EJ, McGarvey CJ, Chakkera HA. The Risk of Transplant Failure With HLA Mismatch in First Adult Kidney Allografts 2: Living Donors, Summary, Guide. Transplantation Direct. 2017 May;3(5):e152. doi: 10.1097/TXD.0000000000000664
  2. Posmertnoe donorstvo organov. Natsionalnye klinicheskie rekomendatsii [Elektronnyi resurs]. Ros transplantol o-vo; 2016 [data dostupa 2019 Avg 20]. 59 p. Rezhim dostupa: (In Russ.)
  3. Abramowicz D, Cochat P, Claas FH, Heemann U, Pascual J, Dudley C, Harden P, Hourmant M, Maggiore U, Salvadori M, Spasovski G, Squifflet JP, Steiger J, Torres A, Viklicky O, Zeier M, Vanholder R, Van Biesen W, Nagler E. European Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care. Nephrol Dial Transplant. 2015 Nov;30(11):1790-97. doi: 10.1093/ndt/gfu216
  4. Shi X, Lv J, Han W, Zhong X, Xie X, Su B, Ding J. What is the impact of human leukocyte antigen mismatching on graft survival and mortality in renal transplantation? A meta-analysis of 23 cohort studies involving 486,608 recipients. BMC Nephrol. 2018 May 18;19(1):116. doi: 10.1186/s12882-018-0908-3
  5. Massie AB, Leanza J, Fahmy LM, Chow EK, Desai NM, Luo X, King EA, Bowring MG, Segev DL. A risk index for living donor kidney transplantation. Am J Transplant. 2016 Jul;16(7):2077-84. doi: 10.1111/ajt.13709
  6. Campos A, Malheiro J, Tafulo S, Santos S, Dias L, Martins S, Almeida M, Pedroso S, Henriques AC, Cabrita A. Increase of allosensitization after a kidney graft failure: Predictors and effect on retransplantation outcomes. Nefrologia. 2017 Jul-Aug;37(4):397-405. doi: 10.1016/j.nefro.2016.11.020 [Article in English, Spanish]
  7. Lim WH, Chadban SJ, Clayton P, Budgeon CA, Murray K, Campbell SB, Cohney S, Russ GR, McDonald SP. Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients. Clin Transplant. 2012 Jul-Aug;26(4):E428-37. doi: 10.1111/j.1399-0012.2012.01654.x
  8. Süsal C, Opelz G. Current role of human leukocyte antigen matching in kidney transplantation. Curr Opin Organ Transplant. 2013 Aug;18(4):438-44. doi: 10.1097/MOT.0b013e3283636ddf
  9. Snell GD, Dausset J, Nathanson S. Histocompatibility. New York: Academic Press; 1976. 401 p.
  10. The National Marrow Donor Program Database [Internet] [cited 2018 May 12]. Available from:
  11. The Allele Frequency Net Database [Internet] [cited 2018 May 12]. Available from:
  12. HLA Epitope Registry Database [Internet] [cited 2018 May 12]. Available from:
  13. Stolyarevich ES, Zhilinskaya TR, Artyukhina LYu, Kim IG, Zaydenov VA, Tomilina NA. Morphological structure of late renal graft dysfunction and its effect for long-term results. Russian Journal of Transplantology and Artificial Organs. 2018;20(1):45-54. doi: 10.15825/1995-1191-2018-1-45-54 (In Russ.)
  14. Campos A, Malheiro J, Tafulo S, Santos S, Dias L, Martins S, Almeida M, Pedroso S, Henriques AC, Cabrita A. Increase of allosensitization after a kidney graft failure: Predictors and effect on retransplantation outcomes. Nefrologia. 2017 Jul-Aug;37(4):397-405. doi: 10.1016/j.nefro.2016.11.020 [Article in English, Spanish]
  15. Jerne NK. Immunological speculations. Annu Rev Microbiol. 1960;14:341-58. doi: 10.1146/annurev.mi.14.100160.002013
  16. Lobashevsky AL, Senkbeil RW, Shoaf JL, Stephenson AK, Skelton SB, Burke RM, Deierhoi MH, Thomas JM. The number of amino acid residues mismatches correlates with flow cytometry crossmatching results in high PRA renal patients. Hum Immunol. 2002 May;63(5):364-74. doi: 10.1016/s0198-8859(02)00371-3
  17. Dankers MK, Witvliet MD, Roelen DL, de Lange P, Korfage N, Persijn GG, Duquesnoy R, Doxiadis II, Claas FH. The number of amino acid triplet differences between patient and donor is predictive for the antibody reactivity against mismatched human leukocyte antigens. Transplantation. 2004 Apr 27;77(8):1236-39. doi: 10.1097/
  18. Duquesnoy RJ, Takemoto S, de Lange P, Doxiadis II, Schreuder GM, Persijn GG, Claas FH. HLAmatchmaker: a molecularly based algorithm for histocompatibility determination. III. Effect of matching at the HLA-A,B amino acid triplet level on kidney transplant survival. Transplantation. 2003 Mar 27;75(6):884-89. doi: 10.1097/01.TP.0000055101.20821.AC
Address for correspondence:
129110, Russian Federation,
Moscow, Schepkin str., 61/2, 6,
Moscow Regional Research Clinical Institute
Named after M.F. Vladimirskiy,
the Surgical Department of Kidney Transplantation,
tel. mobile +7-916-705-98-99,,
Zulkarnaev Alexey B.
Information about the authors:
Vatazin Andrey V., MD, Professor, Chief Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research Clinical Institute Named after M.F. Vladimirskiy, Moscow, the Russian Federation.
Zulkarnaev Alexey B., MD, Associate Professor, Leading Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research Clinical Institute Named after M.F. Vladimirskiy, Moscow, Russian Federation.
Stepanov Vadim A., PhD, Senior Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research Clinical Institute Named after M.F. Vladimirskiy, Moscow, Russian Federation.




National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of Russia, Kurgan,
The Russian Federation

Objective. To study the peculiarities of cell-mediated immunity in patients with periprosthetic hip joint infection depending on disease severity and according to the method of surgical intervention, subsequently used.
Methods. The values of cell-mediated immunity were studied at the preoperative stage in patients (n=66) with periprosthetic hip joint infection who were divided into three groups: group I (n=13) debridement of the infected joint with the replacement of the implant modular components; group II (n=36) articulating spacer installation; group III (n=17) resection arthroplasty. Lymphocyte subpopulations were studied by laser flow cytofluorimetry method.
Results. In comparison of the cell immunity values in groups I, II, III with those of the control group there was observed the absence of subpopulation alterations in group I, as well as the elevation of relative content of D3+D8+ for normal content of D3+D4+ in group II; the elevation of both relative and absolute values of D3+D8+ while reduction of the values of D3+D4+ in group III. The content of activated T-lymphocytes was elevated in all three groups. A Kruskal-Wallis test to analyze 3 groups revealed significant difference between the groups (I, II, III) regarding the immunoregulatory index (CD4/CD3); (H-6,67; =0,035). There was statistically significant difference between groups I-III (p=0,012) and between groups II-III (p=0,011). Intergroup difference was also identified regarding D3+D4+ (%); (H-22,57; =0,0003). Statistically significant difference was determined between groups I-III (p=0,0002) and between groups II-III (p=0,0003).
Conclusions. The alterations in lymphocyte population composition can be considered as an informative marker of severe infection. The study of T-lymphocyte subpopulations -helpers (D3+D4+) and cytotoxic T-lymphocytes (D3+D8+)) can be used to reveal immuno-compromised patients. These values can be regarded as additional diagnostic tests to select the optimal surgical treatment of periprosthetic infection.

Keywords: periprosthetic infection, hip joint, cell-mediated immunity, -helpers (D3+D4+), cytotoxic T-lymphocytes (D3+D8+)
p. 276-283 of the original issue
  1. Kurtz SM, Lau EC, Son MS, Chang ET, Zimmerli W, Parvizi J. Are We winning or losing the battle with periprosthetic joint infection: trends in periprosthetic joint infection and mortality risk for the medicare population. J Arthroplasty. 2018 Oct;33(10):3238-45. doi: 10.1016/j.arth.2018.05.042
  2. Gomes LSM. Early Diagnosis of periprosthetic joint infection of the hip-current status, advances, and perspectives. Rev Bras Ortop (Sao Paulo). 2019 Jul;54(4):368-76. Published online 2019 Aug 20. doi: 10.1055/s-0039-1693138
  3. Izakovicova P, Borens O, Trampuz A. Periprosthetic joint infection: current concepts and outlook. EFORT Open Rev. 2019 Jul;4(7):482-94. Published online 2019 Jul 29. doi: 10.1302/2058-5241.4.180092
  4. Abblitt WP, Chan EW, Shinar AA. Risk of Periprosthetic joint infection in patients with multiple arthroplasties. J Arthroplasty. 2018 Mar;33(3):840-43. doi: 10.1016/j.arth.2017.10.024
  5. Winkler T, Trampuz A, Renz N, Perka C, Bozhkova SA. Classification and algorithm for diagnosis and treatment of hip prosthetic joint infection. Traumatology and Orthopedics of Russia. 2016;(1):33-45. doi: 10.21823/2311-2905-2016-0-1-33-45 (In Russ.)
  6. Saleh A, George J, Sultan AA, Samuel LT, Mont MA, Higuera-Rueda CA. The quality of diagnostic studies in periprosthetic joint infections: can we do better? J Arthroplasty. 2019 Nov;34(11):2737-43. doi: 10.1016/j.arth.2019.06.044
  7. Carli AV, Abdelbary H, Ahmadzai N, Cheng W, Shea B, Hutton B, Sniderman J, Philip Sanders BS, Esmaeilisaraji L, Skidmore B, Gauthier-Kwan OY, Bunting AC, Gauthier P, Crnic A, Logishetty K, Moher D, Fergusson D, Beaulé PE. Diagnostic accuracy of serum, synovial, and tissue testing for chronic periprosthetic joint infection after hip and knee replacements: a systematic review. J Bone Joint Surg Am. 2019 Apr 3;101(7):635-49. doi: 10.2106/JBJS.18.00632
  8. Saleh A, George J, Faour M, Klika AK, Higuera CA. Serum biomarkers in periprosthetic joint infections. Bone Joint Res. 2018 Jan;7(1):85-93. doi: 10.1302/2046-3758.71.BJR-2017-0323
  9. Gómez-García F, Espinoza-Mendoza RL. Whats new for the diagnosis of periprosthetic infections after the Philadelphia consensus? Acta Ortop Mex. 2019 Mar-Apr;33(2):127-35. [Article in Spanish; Abstract available in Spanish from the publisher]
  10. Chepeleva MV, Klyushin NM, Ermakov AM, Ababkov YuV. Interleukin-6 in predicting the course of postoperative period in patients with periprosthetic infection of the hip. Sib Nauch Med Zhurn. 2015;35(4):45-48. (In Russ.)
  11. Heim CE, Vidlak D, Odvody J, Hartman CW, Garvin KL, Kielian T. Human prosthetic joint infections are associated with myeloid-derived suppressor cells (MDSCs): Implications for infection persistence. J Orthop Res. 2018 Jun;36(6):1605-13. doi: 10.1002/jor.23806
  12. Seebach E, Kubatzky KF. Chronic implant-related bone infections-can immune modulation be a therapeutic strategy? Front Immunol. 2019;10:1724. Published online 2019 Jul 23. doi: 10.3389/fimmu.2019.01724
  13. Preobrazhenskii PM, Kazemirskii AV, Goncharov MIu. Current views on diagnosing and treatment of patients with infection after the knee arthroplasty. Genii Ortopedii. 2016;(3):94-104. doi: 10.18019/1028-4427-2016-3-94-104 (In Russ)
  14. Lazarides AL, Vovos TJ, Reddy GB, Kildow BJ, Wellman SS, Jiranek WA, Seyler TM. Traditional laboratory markers hold low diagnostic utility for immunosuppressed patients with periprosthetic joint infections. J Arthroplasty. 2019 Jul;34(7):1441-45. doi: 10.1016/j.arth.2019.03.013
  15. Chuksina JuJu, Moscaletc OV, Jazdovskij VV, Eremin AV, Oshkukov SA. Clinical and immunological parallels in periprosthetic infection after total large joints arthroplasty. Kazan Med Zhurn. 2016;97(4):514-18. doi: 10.17750/KMJ2016-514 (In Russ.)
Address for correspondence:
640014, Russian Federation,
Kurgan, M. Ulyanova str., 6,
National Medical Research Center
of Traumatology and Orthopedics Named
after Academician G.A. Ilizarov of the Ministry
of Health of the Russian Federation,
tel. mobile: +7 912 838-42-49,
Kuznecova Elena I.
Information about the authors:
Chepeleva Marina V., PhD, Senior Researcher, Scientific Clinical Laboratory of Microbiology and Immunology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
Kliushin Nicolay M., MD, professor, Head of the Clinic of Purulent osteology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health the Russian Federation, Kurgan, Russian Federation. 9713
Ermakov Artem M., PhD, Traumatologist-Orthopedist, the Clinic of Purulent osteology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
Kuznecova Elena I., Junior Researcher, Scientific Clinical Laboratory of Microbiology and Immunology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.




South Ural State Medical University 1, Chelyabinsk,
Institute of Molecular and Cellular Biology of Siberian Branch of RAS 2, Novosibirsk,
JSC ''Vector-Best'' 3, Novosibirsk,
The Russian Federation

Objective. To assess the possibility of a molecular genetic classifier in the preoperative thyroid cancer diagnosis using colored cytological preparations obtained during fine needle aspiration biopsy of thyroid nodes.
Methods. The results of cytological, histological and molecular genetic studies of patients (n=138) were compared. To conduct a molecular genetic study, colored glasses with cytological material from the thyroid nodes of patients were selected, the preoperative cytological conclusions corresponding to the classification of Bethesda (2017) group IV, V, and VI. All patients were operated on at the Regional Center of the Endocrine Surgery or the Regional Oncology and Nuclear Medicine Clinical Center in Chelyabinsk, where a final histological diagnosis was made. To determine agreement of preoperative cytological and postoperative histological conclusions the specimens were divided into 4 groups: a benign node; a follicular tumor without malignancy markers; papillary cancer; and a follicular tumor with malignancy markers.
Results. In thyroid cancer, the coincidence of the results of the preoperative molecular genetic and postoperative histological studies was found in 53 (94.6%) cases (a true positive result), and a discrepancy in 10 (7.2%) (a false positive result). In 72 (52.2%) cases in benign tumors, no molecular genetic markers of malignancy were detected (a true negative result), in 3 (2.2%) cases the cancer was missed (a false negative result).
The prognostic value of a positive result of a molecular genetic study was 84.1%, and the prognostic value of a negative result 96%.
Conclusions. Molecular genetic testing using commonly prepared colored smears can determine accurately the malignant and benign thyroid nodules, thereby it lets improving the quality of pre-operative differential diagnosis of the thyroid nodules and reduce the number of unreasonable operations.

Keywords: thyroid cancer, fine needle aspiration biopsy, molecular genetic study, micro-RNA, Bethesda classification
p. 284-289 of the original issue
  1. Beltsevich DG, Vanushko VE, Rumiantsev PO, Melnichenko GA, Kuznetsov NS, Abrosimov AYu, Polyakov VG, Mudunov AM, Podvyaznikov SO, Romanov IS, Polyakov AP, Sleptsov IV, Chernikov RA, Vorobyov SL. Fadeyev VV. 2017. Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment. Endokrin Khirurgiia. 2017;11(1):6-27. (In Russ.)
  2. Ali S, Cibas E, eds. The Bethesda System for Reporting Thyroid Cytopathology: Definitions, Criteria, and Explanatory Notes. 2nd ed. New York: Springer; 2018.
  3. Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007 Oct 25;111(5):306-15. doi: 10.1002/cncr.22955
  4. Wormald R, Sheahan P, Rowley S, Rizkalla H, Toner M, Timon C. Hemithyroidectomy for benign thyroid disease: who needs follow-up for hypothyroidism? Clin Otolaryngol. 2008 Dec;33(6):587-91. doi: 10.1111/j.1749-4486.2008.01794.x
  5. Stoll SJ, Pitt SC, Liu J, Schaefer S, Sippel RS, Chen H. Thyroid hormone replacement after thyroid lobectomy. Surgery. 2009 Oct;146(4):554-8; discussion 558-60. doi: 10.1016/j.surg.2009.06.026
  6. Vargas-Salas S, Martínez JR, Urra S, Domínguez JM, Mena N, Uslar T, Lagos M, Henríquez M, González HE. Genetic testing for indeterminate thyroid cytology: review and meta-analysis. Endocr Relat Cancer. 2018 Mar;25(3):R163-R77. doi: 10.1530/ERC-17-0405
  7. Duick DS, Klopper JP, Diggans JC, Friedman L, Kennedy GC, Lanman RB, McIver B. The impact of benign gene expression classifier test results on the endocrinologist-patient decision to operate on patients with thyroid nodules with indeterminate fine-needle aspiration cytopathology. Thyroid. 2012 Oct;22(10):996-1001. doi: 10.1089/thy.2012.0180
  8. Titov SE, Ivanov MK, Karpinskaya EV, Tsivlikova EV, Shevchenko SP, Veryaskina YA, Akhmerova LG, Poloz TL, Klimova OA, Gulyaeva LF, Zhimulev IF, Kolesnikov NN. miRNA profiling, detection of BRAF V600E mutation and RET-PTC1 translocation in patients from Novosibirsk oblast (Russia) with different types of thyroid tumors. BMC Cancer. 2016 Mar 9;16:201. doi: 10.1186/s12885-016-2240-2
  9. Titov S, Demenkov PS, Lukyanov SA, Sergiyko SV, Katanyan GA, Veryaskina YA, Ivanov MK. Preoperative detection of malignancy in fine-needle aspiration cytology (FNAC) smears with indeterminate cytology (Bethesda III, IV) by a combined molecular classifier.J Clin Pathol. 2020 Mar 25:jclinpath-2020-206445. doi: 10.1136/jclinpath-2020-206445
  10. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009 Nov;19(11):1159-65. doi: 10.1089/thy.2009.0274
Address for correspondence:
454092, Russian Federation,
Chelyabinsk, Vorovskii str., 64,
South Ural State Medical University,
the Department of General
and Pediatric Surgery,
tel. +7 950 744-45-95,
Lukyanov Sergey A.
Information about the authors:
Lukyanov Sergey A., PhD, Assistant, the Department of General and Pediatric Surgery, South Ural State Medical University, Chelyabinsk, Russian Federation.
Sergiyko Sergey V., MD, Associate Professor, Head of the Department of General and Pediatric Surgery, South Ural State Medical University, Chelyabinsk, the Russian Federation.
Titov Sergei E., PhD, Senior Researcher of the Laboratory of the Molecular Genetics, Institute of Molecular and Cellular Biologyof Siberian Branch of RAS, JSC Vector-Best, Novosibirsk, Russian Federation.
Veryaskina Yuliya A., PhD, Researcher of the Laboratory of the Molecular Genetics, Institute of Molecular and Cellular Biology of Siberian Branch of RAS Novosibirsk, Russian Federation.




Mogilev City Emergency Hospital 1,
Mogilev Regional Hospital 2, Mogilev,
The Republic of Belarus

Objective. To analyze the serum cortisol level during the operation and in the early postoperative period in patients with traumatic brain injury to assess the effectiveness of anesthetic management methods for craniotomy.
Methods. The study included patients (n=111) with the traumatic brain injury. The patients of the 1st group (n=57) underwent to a combination of general anesthesia and cranial soft tissue nerve blockade with low-volumes of local anesthetics during craniotomy.
The patients of the 2nd group (n=58) underwent to general anesthesia. The serum cortisol was examined during the operation and within 10-12 hours after the intervention in 22 (38.6%) patients of the 1st group and 20 (37%) of patients in the 2nd group.
Results. During craniotomy in patients with cranial soft tissue nerve blockade the level of serum cortisol at the main stage of the operation and at the end of the intervention was lower than in patients of the 2nd group. In the 1st group cortisol level at the main stage of the operation was 136.4 (75; 325.4) ng/ml, and in the 2nd group 258.8 (161.7; 543.5) ng/ml, p=0.024. At the initial stage of the operation in the 1st group cortisol level was 119.6 (47.6; 327.2) ng/ml, and in the 2nd group it was 323.1 (156.9; 673.1) ng/ml, p=0.027. Difference of cortisol levels in patients of both groups 10-12 hours postoperatively have not been detected.
Conclusions. The concentration of blood cortisol was lower in patients with traumatic brain injury who received a combination of general anesthesia and cranial soft tissue nerve blockades than in patients who underwent only general anesthesia. Cranial soft tissue nerve blockades with small volumes of local anesthetics in patients with traumatic brain injury during surgery demonstrated high pain relief.

Keywords: traumatic brain injury, craniotomy, cotrisol, general anesthesia, nerve blockades
p. 290-298 of the original issue
  1. Shanko YG, Sidarovich RR, Tanin AL, Naledzka AN, Zurauleu UA. Epidemiology of traumatic brain injury in the Republic of Belarus. Mezhdunar Nevrol Zhurn. 2017;5(91):33-37. (in Russ.)
  2. Kusmenkov T, Braunstein M, Schneider HJ, Bidlingmaier M, Prall WC, Flatz W, Boecker W, Bogner V. Initial free cortisol dynamics following blunt multiple trauma and traumatic brain injury: a clinical study. J Int Med Res. 2019 Mar;47(3):1185-94. doi: 10.1177/0300060518819603
  3. Haldar R, Kaushal A, Gupta D, Srivastava S, Singh PK. Pain following craniotomy: reassessment of the available options. Biomed Res Int. 2015;2015:509164. doi: 10.1155/2015/509164
  4. Citerio G, Pesenti A, Latini R, Masson S, Barlera S, Gaspari F, Franzosi MG; NeuroMorfeo Study Group. A multicentre, randomised, open-label, controlled trial evaluating equivalence of inhalational and intravenous anaesthesia during elective craniotomy. Eur J Anaesthesiol. 2012 Aug;29(8):371-79. doi: 10.1097/EJA.0b013e32835422db
  5. Dzyadzko AM, Bolonkin LS, Minov AF, Piskun AB, Chugunova OA, Katin ML, Brukhatsky AA, Fedoruk AM, Shcherba AE. Evaluation of sympathetic blockade under thoracic epidural versus bilateral paravertebral anesthesias during high-traumaticity operations on the upper abdominal organs. Messenger of Anesthesiology and Resuscitation. 2015;12(1):34-40. doi: 10.21292/2078-5658-2015-12-1-34-40 (In Russ.)
  6. Papangelou A, Radzik BR, Smith T, Gottschalk A. A review of scalp blockade for cranial surgery. J Clin Anesth. 2013 Mar;25(2):150-59. doi: 10.1016/j.jclinane.2012.06.024
  7. Dimopoulou I, Tsagarakis S. Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury. Intensive Care Med. 2005 Aug;31(8):1020-28. doi: 10.1007/s00134-005-2689-y
  8. Klose M, Feldt-Rasmussen U. Hypopituitarism in Traumatic Brain Injury-A Critical Note. J Clin Med. 2015 Jul 14;4(7):1480-97. doi: 10.3390/jcm4071480
  9. Mirzaie B, Mohajeri-Tehrani MR, Annabestani Z, Shahrzad MK, Mohseni S, Heshmat R, Afshani HR, Meybodi HR, Larijani B. Traumatic brain injury and adrenal insufficiency: morning cortisol and cosyntropin stimulation tests. Arch Med Sci. 2013 Feb 21;9(1):68-73. doi: 10.5114/aoms.2012.30833
  10. Llompart-Pou JA, Raurich JM, Pérez-Bárcena J, Barceló A, Ibáñez J, Ayestarán JI. Acute Hypothalamic-pituitary-adrenal response in traumatic brain injury with and without extracerebral trauma. Neurocrit Care. 2008;9(2):230-36. doi: 10.1007/s12028-008-9115-6
  11. Kuvshinov MV, Obryadina AP. The actual issues of comparing the results of quantative immune-enzyme tests. Klin Lab Diagnostika. 2012;(4):32-35. (In Russ.)
  12. Canakci E, Unal D, Yildirim T, Yilmaz A. Our scalp block results in craniotomy cases. J Anest & Inten Care Med. 2017;2(4):555592. doi: 10.19080/JAICM.2017.02.555592
  13. Can BO, Bilgin H. Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial. J Int Med Res. 2017 Apr;45(2):439-50. doi: 10.1177/0300060516665752
  14. Ayoub C, Girard F, Boudreault D, Chouinard P, Ruel M, Moumdjian R. A comparison between scalp nerve block and morphine for transitional analgesia after remifentanil-based anesthesia in neurosurgery. Anesth Analg. 2006 Nov;103(5):1237-40. doi: 10.1213/01.ane.0000244319.51957.9f
  15. Geze S, Yilmaz AA, Tuzuner F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesthesiol. 2009 Apr;26(4):298-303. doi: 10.1097/EJA.0b013e32831aedb2
Address for correspondence:
212030, Republic of Belarus,
Mogilev, Botkin str., 2,
Mogilev City Emergency Hospital,
Anesthesiology and Intensive Care Unit,
tel./fax: +375(222) 22-16-26,
Markevich Denis P.
Information about the authors:
Markevich Denis P., Head of Anesthesiology and Intensive Care Unit, Mogilev Emergency City Hospital, Mogilev, Republic of Belarus.
Marochkov Alexey V., MD, Professor, Anesthesiologist-Resuscitator, Mogilev Regional Hospital, Mogilev, Republic of Belarus.




Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine 1
National Medical University Named after A.A. Bogomolets 2, iev,

Objective. Determination of the optimal type of facial nerve neurotization in patients with the consequences of its traumatic injury.
Methods. The treatment results of patient (n=172) with the facial nerve injury who underwent neurotization using different donor nerves was analized.
Women (n=97) made up 56.4%, men (n=75) 43.6%. The median age was 38 years; the interquartile range was 29 50 years. The most common cause of the facial nerve damage was the removal of posterior fossa tumor 123 patients (71.5%). Various types of reconstructive interventions were performed: facial nerve neurotization by the branches of the accessory nerve to the sternocleidomastoid muscle 87 patients, facial nerve neurotization by branch of the accessory nerve to the sternocleidomastoid muscle and the descending branch of the hypoglossal nerve 62 patients, by the accessory nerve 10 patients, by the descending branch of the hypoglossal nerve 10 patients, anterior motor branches C2-C3 3 patients.
The immediate and long-term results of treatment were studied. Patients underwent a follow-up examination and an ENMG study no earlier than 4 months after the surgery. Long-term results were studied no earlier than 12 months and up to 24 months after the surgery by means of repeated neurological examinations and additional electrophysiological techniques.
Results. In all cases, a positive result has been achieved. In 147 (85.4%) out of 172 patients, the recovery of facial nerve function according to the House Brackmann scale to II III level was observed. The best results were achieved in the cases of neurotization by the branches of the accessory nerve and the simultaneous use of several donor nerves (p<0.001).
Conclusion. The use of the accessory nerve branches as donors ensures restoration of the facial nerve function to level II-III on the House Brackmann scale in 89.7% of patients and in terms of effectiveness, it does not differ from the technically more complex and prognostically less favorable facial nerve neurotization by the descending branch of the hypoglossal nerve and the branch of accessory nerve.

Keywords: neurotization, facial nerve, donor nerve, electroneuromyography, surgical treatment
p. 299-308 of the original issue
  1. Spencer CR, Irving RM. Causes and management of facial nerve palsy. Br J Hosp Med (Lond). 2016 Dec 2;77(12):686-91. doi: 10.12968/hmed.2016.77.12.686
  2. Reich SG. Bells Palsy. Continuum (Minneap Minn). 2017 Apr;23(2, Selected Topics in Outpatient Neurology):447-66. doi: 10.1212/CON.0000000000000447
  3. Zhang W, Xu L, Luo T, Wu F, Zhao B, Li X. The etiology of Bells palsy: a review. J Neurol. 2019 Mar 28. doi: 10.1007/s00415-019-09282-4. Online ahead of print.
  4. Chang YS, Choi JE, Kim SW, Baek SY, Cho YS. Prevalence and associated factors of facial palsy and lifestyle characteristics: data from the Korean National Health and Nutrition Examination Survey 2010-2012. BMJ Open. 2016 Nov 9;6(11):e012628. doi: 10.1136/bmjopen-2016-012628
  5. Gordin E, Lee TS, Ducic Y, Arnaoutakis D. Facial nerve trauma: evaluation and considerations in management. Craniomaxillofac Trauma Reconstr. 2015 Mar;8(1):1-13. doi: 10.1055/s-0034-1372522
  6. Salles AG, da Costa EF, Ferreira MC, Remigio AF, Moraes LB, Gemperli R. Epidemiologic Overview of Synkinesis in 353 Patients with Longstanding Facial Paralysis under Treatment with Botulinum Toxin for 11 Years. Plast Reconstr Surg. 2015 Dec;136(6):1289-98. doi: 10.1097/PRS.0000000000001802
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  12. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985 Apr;93(2):146-47. doi: 10.1177/019459988509300202
  13. Sforza C, Ulaj E, Gibelli DM, Allevi F, Pucciarelli V, Tarabbia F, Ciprandi D, DellAversana Orabona G, Dolci C, Biglioli F. Three-dimensional superimposition for patients with facial palsy: an innovative method for assessing the success of facial reanimation procedures. Br J Oral Maxillofac Surg. 2018 Jan;56(1):3-7. doi: 10.1016/j.bjoms.2017.11.015
  14. Tretiakova A. Klnko-elektroneiromografchna dagnostika urazhen litsovogo nerva, kriter prognozuvannia efektivnost lkuvannia. Ukr Vsn Psikhonevrologii. 2002;10(2):79-81. (In Ukr.)
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  16. Kanda Y. Investigation of the freely available easy-to-use software EZR for medical statistics. Bone Marrow Transplant. 2013 Mar;48(3):452-58. doi: 10.1038/bmt.2012.244
  17. Nerobeev AI, Plotnikov NA. Vosstanovitelnaia khirurgiia miagkikh tkanei cheliustno-litsevoi oblasti: ruk dlia vrachei. Moskva, RF: Meditsina; 1997. 228 p. (In Russ.)
Address for correspondence:
04050, Ukraine,
iev, Platon Mayboroda str., 32,
Institute of Neurosurgery Named
after A.P. Romodanov NAMS of Ukraine,
Department of Restorative Neurosurgery,
tel.: +38 (044) 483-12-53,
Tsymbaliuk Iaroslav V.
Information about the authors:
Tsymbaliuk Iaroslav V., Postgraduate Student of the Department of Neurosurgery, National Medical University Named after. A.A. Bogomolets, Neurosurgeon of the Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, iev, Ukraine.
Tsymbaliuk Vitalii I., Academician of NAMS of Ukraine, Corresponding Member of NAS of Ukraine, MD, Professor, President of NAMS of Ukraine, Head of the Department of Neurosurgery, National Medical University Named after A.A. Bogomolets, Scientific Supervisor of Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, iev, Ukraine.
Tretyak Igor B., MD, Head of Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, iev, Ukraine.
Medvediev Vladimir V., MD, Associate Professor of the Department of Neurosurgery, National Medical University Named after. A.A. Bogomolets, iev, Ukraine.
Gurianov Vitaly G., PhD, Associate Professor of the Department of Public Health Service Management, National Medical University Named after A.A. Bogomolets, iev, Ukraine.
Gatskiy Alexander A., PhD, Neurosurgeon of the Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, iev, Ukraine.
Petriv Taras I., PhD, Neurosurgeon of the Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, iev, Ukraine.




West Kazakhstan Marat Ospanov State Medical University 1, Aktobe,
The Republic of Kazakhstan
Hepato-Pancreato-Biliary Association of Commonwealth of Independent States 2, Moscow,
The Russian Federation,
Military Institute of Air Defense Named after T.J. Begeldinov 3, Aktobe,
The Republic of Kazakhstan

Objective. The performance of a systematic review of the current literature and meta-analysis to provide the more precise estimations of the association between TNF-α gene polymorphism with the development and severity of acute pancreatitis (AP).
Methods. A systematic review, searching the Medline and Web of Science databases revealed the relevant researches. The analysis based on ten molecular genetic case-control studies of the TNF-α promoter in patients with acute pancreatitis (n=1660) and healthy volunteers (n=1618).
Results. A systematic review showed discrepant results. In three studies the association of functionally significant polymorphism -308G> A in the TNF gene promoter with a severe form of AP, development SIRS and MODS have been established. The association of -308 G / A polymorphism of the TNF gene with the risk of a developing of moderate form of acute non-biliary pancreatitis was identified in one study. In other studies the association of TNF gene polymorphism with the severity of AP was not confirmed.
Conclusions. The presented genetic studies of the TNF-α promoter at acute pancreatitis manifested the controversal results.

Keywords: acute pancreatitis, clinical course, molecular genetic studies, tumor necrosis factorα, genetic polymorphism
p. 309-317 of the original issue
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Address for correspondence:
030019, Republic of Kazakhstan,
Aktobe, Maresyev str., 68,
West Kazakhstan Marat Ospanov Medical University, Surgical Diseases In the absenc No 1,
tel. +7 7132 544297,
Timur A. Jarkenov
Information about the authors:
Jarkenov Timur A.,MD, Professor of the Surgical Diseases Department No 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Skipenko Oleg G., MD, Professor, Member of Board of Hepato-Pancreato-Biliary Association of Commonwealth of Independent States, Moscow, Russian Federation.
Zhumabaev Marat N., PhD, Associate Professor, Head of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Zairova SauleT., PhD, Military Institute of Air Defense Named after T.J. Begeldinov, Aktobe, Republic of Kazakhstan.
Akataev Nagashybai A., PhD, Professor of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Yessenbaev Daulet B., Assistant of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Mukushev Manas M., PhD, Associate Professor of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan
Nurmanov Kairat Zh., Assistant of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University), Aktobe, Republic of Kazakhstan.
Balshambayev Madi E., Assistant of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.



Russian Research Surgery Center named after Academician B.V.Petrovsky 1,
N.I. Pirogov Municipal Clinical Hospital 1 2, Moscow
The Russian Federation

Minimally invasive surgery is an area of general surgery that allows surgical interventions to be performed with less damage to normal tissues and organs. Recently, a growth of operations on the aorto-iliac segment with the use of mini-laparotomy incisions is increasingly observed. Minimally invasive technologies are implemented through classical techniques of the reconstructive surgery of the abdominal aorta. According to most authors, the technique of mini-laparotomy access to the aorta has already been sufficiently studied and introduced into the standard clinical practice of many hospitals in our country. However, up to the present, many issues relating to abdominal aorta surgery from mini-access remain not covered: postoperative complications, features of surgical technique, causes of failures and conversion to laparotomy to complete the procedure, are not sufficiently described. Most surgeons dont have yet clear information about the spatial structure for the reproduction of manual techniques in the delimited wound volume. In addition, at present, despite a large number of scientific information in the native and foreign literature, there are no reliable data on modeling access to the working section of the abdominal aorta during operations for Leriche syndrome and abdominal aortic aneurysms by applying mini-laparatomic access.

Keywords: Leriche syndrome, abdominal aortic aneurysm, mini-access, mini-laparotomy, aorta surgery
p. 318-328 of the original issue
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Address for correspondence:
119049, Russian Federation,
Moscow, Leninsky pr., 8,
N.I. Pirogov Municipal Clinical Hospital No1,
Center for Vascular, X-ray Endovascular
Surgery and Minimally Invasive Phlebology,
tel. mobile:+7 985 353 51 90,
Gubarev Igor A.
Information about the authors:
Belov Yurii V., MD, Professor, Academician of RAS, Head of the Cardio-Aortic Surgery, Russian Research Surgery Center Named after Academician B.V.Petrovsky, Moscow, Russian Federation.
Gubarev Igor A., Aspirant, Russian Research Surgery Center Named after Academician B.V.Petrovsky, Cardiovascular Surgeon, No1. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
Salekh Amro Z., Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
Frolov Konstantin B., PhD, Head of the Center of Vascular, Endovascular Surgery and Minimally Invasive Phlebology of N.I. Pirogov Municipal Clinical Hospital No1, Moscow, the Russian Federation.
Rybakov Kirill N., Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.



Belarusian State Medical University, Minsk,
The Republic of Belarus

The spread of the new SARS-CoV-2 infection, now classified as COVID-19, has become global. The physician who treats patients with COVID-19 face daily new serious problems. One of them is a high prevalence of venous thromboembolic complications, especially in the group of patients with a severe course of the infectious process. Current recommendations allow an empirical approach to prescribing anticoagulation in the case of a reasonable suspicion on the pulmonary embolism/deep vein thrombosis, if the assumed waiting period for visualization is >4/24 hours, respectively. The use of prophylactic doses of low-molecular-weight or unfractionated heparin or fondaparinux is mandatory for all COVID-19-positive inpatients throughout the entire period of hospitalization. If there are the absolute contraindications to anticoagulation, it is recommended to use compression therapy or to perform vena cava filter implantation . Most patients with the confirmed COVID-19-associated venous thromboembolism (VTE) or those with its reasonable suspicion should be prescribed a full treatment dose of anticoagulant. In ambulatory conditions for secondary long-term thromboprophylaxis the preference should be given to direct oral anticoagulants. Patients who had a ≥3-fold elevation of D-dimer level upon admission should continue the therapeutic anticoagulation after discharge. This literature review summarizes the latest recommendations on prevention, diagnosis, and treatment of COVID-19-associated VTE. Further research should focus on developing optimal management strategies for both inpatients and outpatients with COVID-19-associated venous thromboembolism (VTE ).

Keywords: venous thromboembolism, COVID-19, thromboprophylaxis, diagnosis, treatment
p. 329-338 of the original issue
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  21. Vitali C, Minniti A, Del Papa N. Occurrence of pulmonary embolism in a patient with mild clinical expression of COVID-19 infection. Thromb Res. 2020 May 5. doi: 10.1016/j.thromres.2020.05.002 [Epub ahead of print]
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Address for correspondence:
220116, Republic of Belarus,
Minsk, pr. Dzerzhinskii, 83,
Belarusian State Medical University,
tel. +375 17277-11-55,
Khryshchanovich Vladimir Ya.
Information about the authors:
Khryshchanovich Vladimir Ya., MD, Professor, Vice-Rector for Scientific Work, Professor of the 2nd Department of Surgical Diseases, Belarusian State Medical University, Minsk, Republic of Belarus.




National Research Ogarev Mordovia State University, Institute of Medicine, Saransk,
The Russian Federation

The paper presents a clinical case of a 14-year-old child with a dermoid cyst of the right testicle. The formation was first detected during a routine check-up in the polyclinic. Then the external genitalia ultrasound examination was repeatedly performed to the patient, which revealed an inhomogeneous echostructure with dimensions of 14 mm, 13.7 mm and 12 mm with a clear, even contour in the upper pole of the right testicle.
The enzyme-linked immunosorbent assay (ELISA) did not show an increase in the main tumour markers. The biochemical blood test revealed an insignificant rise in conjugated bilirubin and serum iron.
To clarify the diagnosis, magnetic resonance tomography of the pelvic organs with intravenous contrast was recommended. After examination, the cystic lesion of the right testicle was diagnosed.
After carrying out the necessary additional diagnostic measures (ultrasound examination of the peripheral lymphatic nodes, the abdominal cavity exploration with intravenous contrast enhancement), the child underwent an operation consisting in revising the right half of the scrotum and removing the formation of the right testicle. Intraoperatively, according to the express biopsy test, the dermoid cyst of the right testicle was diagnosed, which was confirmed by the subsequent histological examination. The postoperative period was uneventful. The patient was discharged in satisfactory state.
Thus, the presented clinical observation emphasizes the need to optimize the preventive work of primary care medical personnel for timely diagnosis of tumor processes in the external genital organs, especially in children of puberty.

Keywords: dermoid cyst, testicle, ultrasound, magnetic resonance tomography, child
p. 339-343 of the original issue
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  2. Nemtsova MV, Andreeva YuYu. Testicular germ cell tumors: Molecular genetic and clinicomorphological aspects Onkourologiia. 2015;11(1):12-19. doi: 10.17650/1726-9776-2015-1-12-19 (In Russ.)
  3. Singh AP, Tanger R, Mishra D, Ansari M, Gupta AK, Shukla AK. Testicular mixed germ cell tumor in a newborn child: a rare case. J Indian Assoc Pediatr Surg. 2019 Apr-Jun;24(2):144-46. doi: 10.4103/jiaps.JIAPS_87_18
  4. Vasiliyeva IG, Strelnikov AI, Bogdanov GP, Alekseyev PV, Semenova EV. Testicle dermoid cyst in a child with indifferntiated connective tissue dysplasia. Vest IvGMA. 2011;16(1):71-72. (In Russ.)
  5. Nosov AK, Mamizhev EM, Reva SA, Novikov RV, Vorobyev AV, Gafton GI, Petrov SB. Impact of delayed prehospital diagnosis on the results of treatment in patients with germinogenic testicular tumors in Saint-Petersburg. Onkourologiia. 2013;9(2):63-68. doi: 10.17650/1726-9776-2013-9-2-63-68 (In Russ.)
  6. Shen J, Bi Y, Wang X, Lu L, Tang L, Liu Y, Chen H, Zhang B. Epidemiologic study of 230 cases of testicular/paratesticular tumors or masses: 15-year experience of a single center. J Pediatr Surg. 2017 Dec;52(12):2056-60. doi: 10.1016/j.jpedsurg.2017.08.027
  7. Akiyama S, Ito K, Kim WJ, Tanaka Y, Yamazaki Y. Prepubertal testicular tumors: a single-center experience of 44 years. J Pediatr Surg. 2016 Aug;51(8):1351-54. doi: 10.1016/j.jpedsurg.2016.02.042
  8. Kuleva SA, Faseeva ND, Ivanova SV, Nomogram for the determination of primary-resistant forms of germ cell tumors in children. Russian Journal of Pediatric Hematology and Oncology. 2019;6(3):26-30. doi: 10.21682/2311-1267-2019-6-3-26-30 (In Russ.)
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  11. Maizlin II, Dellinger M, Gow KW, Goldin AB, Goldfarb M, Nuchtern JG, Langer M, Vasudevan SA, Doski JJ, Raval MV, Beierle EA. Testicular tumors in prepubescent patients. J Pediatr Surg. 2018 Sep;53(9):1748-52. doi: 10.1016/j.jpedsurg.2017.09.020
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Address for correspondence:
430032, Russian Federation,
Saransk, Ulyanov str., 26 a,
National Research Ogarev
Mordovia State University,
Institute of Medicine,
the Department of the Faculty Surgery
with Courses of Topographic Anatomy
and Operative Surgery, Urology
and Pediatric Surgery, +7 917 699 06 04,
Markosyan Sergey A.
Information about the authors:
Markosyan Sergey A., MD, Associate Professor, Professor, the Department of the Faculty Surgery with Courses of Topographic Anatomy and Operative Surgery, Urology and Pediatric Surgery, National Research Ogarev Mordovia State University, Institute of Medicine, Saransk, Russian Federation.



Irkutsk State Medical University, Irkutsk,
The Russian Federation

Emphysematous osteomyelitis is an extremely rare, potentially fatal bacterial disease characterized by the presence of gas within bone and adjacent soft tissues.
The disease is often complicated by anaerobic necrotizing fasciitis. The article presents a clinical observation of successfully treated emphysematous osteomyelitis of the right femur complicated by necrotizing fasciitis and myositis in the 55-year-old man. The disease manifested 20 years later after a closed fracture of the right femur and osteosynthesis. Emphysematous osteomyelitis was characterized by severe pain in the right thigh, serious intoxication syndrome and the presence of gas bubbles in the medullary cavity of the right femur which was observed in the computed tomography scans.
The feature of emphysematous osteomyelitis management was a three-step approach. The first step was the opening of the purulent-necrotic focus with a wide longitudinal incision of the skin and fascia, excision of necrotic soft tissues. The second step was guillotine amputation of the right lower limb on the level of the upper third of the thigh. The third step was the formation of the thigh stump in the early stages with flow-washing drainage of a wound. This tactic helped to reduce the risk of primary amputation, saved more soft tissue to form the thigh stump more suitable for prosthetics and to shorten the treatment terms.

Keywords: emphysematous osteomyelitis, intraosseous gas, necrotizing fasciitis, necrotizing myositis
p. 344-349 of the original issue
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  7. Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014 Sep 29;1:36. doi: 10.3389/fsurg.2014.00036
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  9. Kumar J, Bandhu S, Kumar A. Intraosseous and intraarticular pneumatosis in anaerobic osteomyelitis. Pediatr Radiol. 2006 Nov;36(11):1220. doi: 10.1007/s00247-006-0279-y
  10. Ram PC, Martinez S, Korobkin M, Breiman RS, Gallis HR, Harrelson JM. CT detection of intraosseous gas: a new sign of osteomyelitis. AJR Am J Roentgenol. 1981 Oct;137(4):721-23. doi: 10.2214/ajr.137.4.721
  11. Patton HM, Conlan JK, Long RF, Waller JT. Unusual presentation of anaerobic osteomyelitis. Am J Med. 1983 Oct;75(4):724-26. doi: 10.1016/0002-9343(83)90465-5
  12. Aiyappan SK, Ranga U, Veeraiyan S. Spontaneous emphysematous osteomyelitis of spine detected by computed tomography: Report of two cases. J Craniovertebr Junction Spine. 2014 Apr;5(2):90-92. doi: 10.4103/0974-8237.139207
  13. Khanduri S, Singh M, Goyal A, Singh S. Emphysematous osteomyelitis: Report of two cases and review of literature. Indian J Radiol Imaging. 2018 Jan-Mar;28(1):78-80. doi: 10.4103/ijri.IJRI_28_17
  14. Potocki J, Kaushik S, Mira JL. Anaerobic osteomyelitis of femoral head with intraosseous, intra-articular, bursal and muscle pneumatosis. Skeletal Radiol. 2003 Jan;32(1):46-48. doi: 10.1007/s00256-002-0567-z
Address for correspondence:
664003, Russian Federation
Irkutsk, Krasnoe Vosstaniye str., 1,
Irkutsk State Medical University,
the Department of General Surgery
and Anesthesiology,
tel. mobile: +7 914 884-50-96,
Frolov Aleksandr P.
Information about the authors:
Beloborodov Vladimir A., MD, Professor, Head of the Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation.
Frolov Aleksandr P., PhD, Associate Professor of the Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation.
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