Theoretical foundations of increasing quality of production

The quality of the products is one of the main factors for increasing the competitiveness of the enterprise in the market. To this end, it is necessary to develop and implement a whole range of measures for lean manufacturing, to form a quality management systemКачество выпускаемой продукции является одним из основных факторов повышения конкурентоспособности предприятия на рынке. С этой целью необходимо разрабатывать и внедрять целый комплекс мероприятий по бережливому производству, формировать систему менеджмента качеств

Probing a Complex of Cytochromecand Cardiolipin by Magnetic Circular Dichroism Spectroscopy: Implications for the Initial Events in Apoptosis

Oxidation of cardiolipin (CL) by its complex with cytochrome c (cyt c) plays a crucial role in triggering apoptosis. Through a combination of magnetic circular dichroism spectroscopy and potentiometric titrations, we show that both the ferric and ferrous forms of the heme group of a CL:cyt c complex exist as multiple conformers at a physiologically relevant pH of 7.4. For the ferric state, these conformers are His/Lys- and His/OH–-ligated. The ferrous state is predominantly high-spin and, most likely, His/–. Interconversion of the ferric and ferrous conformers is described by a single midpoint potential of -80 ± 9 mV vs SHE. These results suggest that CL oxidation in mitochondria could occur by the reaction of molecular oxygen with the ferrous CL:cyt c complex in addition to the well-described reaction of peroxides with the ferric form

Метрологическое обеспечение в области измерений постоянного напряжения и ЭДС: от нормальных элементов к квантовому эталону

   The article deals with the issues of metrological support on the example of the highest level of the State Verification Scheme for measuring instruments of direct current voltage and electromotive force. The origin and development of reference measurements of DC voltage and electromotive force in the Russian Empire, the USSR, and modern Russia is briefly reviewed. The results of work on improving the State Primary Standard GET 13 completed in 2022 are presented.   В статье рассматриваются вопросы метрологического обеспечения на примере высшего звена Государственной поверочной схемы для средств измерений постоянного электрического напряжения и электродвижущей силы. Кратко рассмотрена история возникновения и развития эталонных измерений постоянного напряжения и электродвижущей силы в Российской империи, СССР и Российской Федерации. Приведены результаты работ по совершенствованию Государственного первичного эталона ГЭТ 13, завершенные в 2022 г

Phosphatidylserine Targets Single-Walled Carbon Nanotubes to Professional Phagocytes In Vitro and In Vivo

Broad applications of single-walled carbon nanotubes (SWCNT) dictate the necessity to better understand their health effects. Poor recognition of non-functionalized SWCNT by phagocytes is prohibitive towards controlling their biological action. We report that SWCNT coating with a phospholipid “eat-me” signal, phosphatidylserine (PS), makes them recognizable in vitro by different phagocytic cells - murine RAW264.7 macrophages, primary monocyte-derived human macrophages, dendritic cells, and rat brain microglia. Macrophage uptake of PS-coated nanotubes was suppressed by the PS-binding protein, Annexin V, and endocytosis inhibitors, and changed the pattern of pro- and anti-inflammatory cytokine secretion. Loading of PS-coated SWCNT with pro-apoptotic cargo (cytochrome c) allowed for the targeted killing of RAW264.7 macrophages. In vivo aspiration of PS-coated SWCNT stimulated their uptake by lung alveolar macrophages in mice. Thus, PS-coating can be utilized for targeted delivery of SWCNT with specified cargoes into professional phagocytes, hence for therapeutic regulation of specific populations of immune-competent cells

Трансплантация легких при первичной легочной артериальной гипертензии: особенности периоперационного периода

Lung transplantation (LT) for idiopathic pulmonary arterial hypertension (IPAH) now is the only radical treatment of this disease.Aim: to analyze own experience of performing LT in patients with IPAH.Materials and methods. 8 adult IPAH patients, who underwent LT between 2014 and october 2018, were included. In 7 of 8 patients undergoing bilateral lung transplantation on intraoperative venoarterial extracorporeal membrane oxygenation (VA ECMO) with prolongation into the postoperative period.Results. VA ECMO support was prolonged into postoperative period 6 and 7 days respectively in 2 (25,0%) patients and 3 days in 6 (75,0%) patients. Hospital mortality in IPAH patients was 1.Conclusions. Own experience demonstrates that LT is an effective method of treatment in patients with IPAH. Hospital, 1- and 3-year survival rates for the patient collective were 87.5, 75.0 and 75.0% respectively.Первичная легочная артериальная гипертензия (ПЛАГ) – необратимое заболевание, единственным методом радикального лечения которого является трансплантация легких (ТЛ).Цель исследования: анализ собственного опыта выполнения ТЛ у пациентов с ПЛАГ.Материалы и методы. В исследование включили 8 взрослых реципиентов, которым была выполнена ТЛ в период с 2014-го по октябрь 2018 г. Всем реципиентам была выполнена двусторонняя последовательная трансплантация легких. У 7 из 8 реципиентов ТЛ осуществляли в условиях периферической ВА ЭКМО.Результаты. В послеоперационном периоде первичная дисфункция 3-й степени по классификации ISHLT развилась у 2 (25,0%) из 8 реципиентов, которая проявилась невозможностью прекращения ВА ЭКМО. Общая продолжительность применения ЭКМО у этих пациентов (n = 2) составила 6 и 7 суток. У других 6 (75,0%) реципиентов проявления ранней дисфункции пересаженных легких не носили столь напряженного характера (2-я степень по классификации ISHLT), и продолжительность послеоперационной ВА ЭКМО составила 3 суток. Госпитальная летальность у реципиентов легких, оперированных по поводу ЛАГ, составила 1 наблюдение.Заключение. Собственный опыт демонстрирует, что ТЛ является эффективной лечебной мерой у пациентов с ПЛАГ с показателями госпитальной, 1- и 3-летней выживаемости соответственно 87,5; 75,0 и 75,0%

EFFICACY OF THE INDICATORS IN THE SYSTEM OF INTERNAL CONTROL AND MANAGEMENT OF THE QUALITY AND SAFETY OF MEDICAL ACTIVITY IN S. FYODOROV EYE MICROSURGERY FEDERAL STATE INSTITUTION

The purpose of the study was to evaluate the efficacy of quality indicators in the system of internal control and management of ophthalmic activities at S. Fyodorov Eye Microsurgery Federal State Institution (Institution).Material and methods. The values of quality indicators were determined and compared in dynamics over the last 5 years of the Institution (indicators of structure, indicators of technological processes, and indicators of results). The actual values of the indicators are calculated using statistical data of accounting principles on the structure, medical processes and results achieved. Target values were established on clinical recommendations results of best practices, based on the introduction of modern technologies in medicine.Results. Analysis of changes in the indicators of structure reflects a positive dynamics of realization of the potential of the Institution medical-industrial activity (over a 5 years period reduced staff turnover, increased the number of doctors and medical sisters having certification category). Indicators of medical technological processes demonstrate the stable increase of the technological level of the Institution (the proportion of implantation of toric multifocal intraocular lenses, microinvasive endovitreal interventions 25–27 G, femtosecond stages of corneal and cataract surgery were introduced). After the comparative analysis of target and actual indicators of the result, the dynamics of indicators over 5 years was evaluated and showed their growth.Conclusion. The effectiveness of quality control and safety of medical assistance in the Institution with the use of dynamic assessment system and analysis of indicators has been proven by the increase in the quantitative-qualitative indicators of health activity for the last 5 years

SYSTEM OF MANAGEMENT IN EFFICIENCY AND QUALITY OF MEDICAL CARE AT THE S. FYODOROV EYE MICROSURGERY FEDERAL STATE INSTITUTION

The system of management in efficiency and quality of medical care, developed at the S. Fyodorov Eye Microsurgery Federal State Institution, provides a constant growth of quantitative and qualitative indicators of the medical activities of the Institution that ensures for patients receive high-quality ophthalmic care services. The developed organizational and methodological principles of management in efficacy and a quality of medical care, methods of audit, a reasoned approach to the organization and remuneration of medical staff may be useful in the practice of health care facilities of ophthalmic profile and other specialized areas of medicine