COMPREHENSIVE ASSESSMENT THE QUALITY OF LIFE IN PATIENTS WITH ESOPHAGEAL ACHALASIA OF III-IV STAGES AFTER EZOPHAGOCARDIOFUNDOPLASTY IN THE DISTANT POSTOPERATIVE PERIOD

The choice of an optimum method of surgical treatment in case of esophageal achalasia of III-IV stage is still a pressing problem. Geller's operation, balloon dilatation and other minimally invasive methods do not allow to achieve the desired effect of smoothing dysphagia. On the other hand, a number of surgeons in case of III-IV stage consider esophageal resection to be more preferable. Due to the attempt to find an optimum method of conservation of the esophagus in case of esophageal achalasia a laparoscopic esophagocardiofundoplasty operation with partial Hill fundoplication was developed. The aim of the research is to assess the long term results of the operation in terms of the quality of life and effectiveness of treatment. The cases of 51 patients suffering from esophageal achalasia of III-IV stage during the period from 2002 to 2016 were included in the research and these cases received special methods developed by the author. The quality of life was assessed with the help of specific questionnaires GERD-HRQL, GIQLI, the dynamics of changes in the weight of the body and the Eckardt scale of indicating the effectiveness of treatment. The results of the research show decrease of indicators on the Eckardt scale from 9.2 ± 0.5 to 1.9 ± 0.2 points, the GERD questionnaire from 17.3 ± 0.8 to 5.9 ± 0.7 points and increase of indicators according to the GIQLI questionnaire from 92.3 ± 1.2 to 122.9 ± 1.5 points and increase in the weight of the body from 22.9 ± 0.6 to 24.7 ± 0.6 kg

Orbitally induced hierarchy of exchange interactions in zigzag antiferromagnetic state of honeycomb silver delafossite Ag3Co2SbO6

We report the revised crystal structure, static and dynamic magnetic properties of quasi-two dimensional honeycomb-lattice silver delafossite Ag3Co2SbO6. The magnetic susceptibility and specific heat data are consistent with the onset of antiferromagnetic long range order at low temperatures with N\'eel temperature TN ~ 21.2 K. In addition, the magnetization curves revealed a field-induced (spin-flop type) transition below TN in moderate magnetic fields. The GGA+U calculations show the importance of the orbital degrees of freedom, which maintain a hierarchy of exchange interaction in the system. The strongest antiferromagnetic exchange coupling was found in the shortest Co-Co pairs and is due to direct and superexchange interactions between the half-filled xz+yz orbitals pointing directly to each other. The other four out of six nearest neighbor exchanges within the cobalt hexagon are suppressed, since for these bonds active half-filled orbitals turned out to be parallel and do not overlap. The electron spin resonance (ESR) spectra reveal a Gaussian shape line attributed to Co2+ ion in octahedral coordination with average effective g-factor g=2.3+/-0.1 at room temperature and shows strong divergence of ESR parameters below 120 K, which imply an extended region of short-range correlations. Based on the results of magnetic and thermodynamic studies in applied fields, we propose the magnetic phase diagram for the new honeycomb-lattice delafossite

Preparation and characterization of metastable trigonal layered MSb2O6 phases (M = Co, Ni, Cu, Zn, and Mg) and considerations on FeSb2O6

MSb2O6 compounds (M = Mg, Co, Ni, Cu, Zn) are known in the tetragonal trirutile forms, slightly distorted monoclinically with M = Cu due to the Jahn-Teller effect. In this study, using a low-temperature exchange reaction between ilmenite-type NaSbO3 and molten MSO4-KCl (or MgCl2-KCl) mixtures, these five compositions were prepared for the first time as trigonal layered rosiaite (PbSb2O6)-type phases. Upon heating, they irreversibly transform to the known phases via amorphous intermediates, in contrast to previously studied isostructural MnSb2O6, where the stable phase is structurally related to the metastable phase. The same method was found to be applicable for preparing stable rosiaite-type CdSb2O6. The formula volumes of the new phases show an excellent correlation with the ionic radii (except for M = Cu, for which a Jahn-Teller distortion is suspected) and are 2-3% larger than those for the known forms although all coordination numbers are the same. The crystal structure of CoSb2O6 was refined via the Rietveld method: P31m, a = 5.1318(3) Å, and c = 4.5520(3) Å. Compounds with M = Co and Ni antiferromagnetically order at 11 and 15 K, respectively, whereas the copper compound does not show long-range magnetic order down to 1.5 K. A comparison between the magnetic behavior of the metastable and stable polymorphs was carried out. FeSb2O6 could not be prepared because of the 2Fe2+ + Sb5+ = 2Fe3+ + Sb3+ redox reaction. This electron transfer produces an additional 5s2 shell for Sb and results in a volume increase. A comparison of the formula volume for the stable mixture FeSbO4 + 0.5Sb2O4 with that extrapolated for FeSb2O6 predicted that the trirutile-type FeSb2O6 can be stabilized at high pressures. © 2017 The Royal Society of Chemistry.The work was supported by the Russian Foundation for Basic Research under the grant 14-03-01122. A. N. V. acknowledges the support in part from the Ministry of Education and Science of the Russian Federation in the framework of Increase Competitiveness Program of NUST (no. K2-2016-066) and by Act 211 of the Government of Russian Federation, contract no. 02.A03.21.0006

Modern issues of sugar beet (<i>Beta vulgaris</i> L.) hybrid breeding

High efficiency of the cultivation of unfertilized sugar beet ovules and preparation of haploid regenerants (microclones) of pollinators – maintainers of О-type sterility and MS forms of the RMS 120 hybrid components has been shown. A technological method that accelerates the creation of new uniform starting material is proposed. It speeds up the breeding process two to threefold. The identification of haploid regenerants with sterile cytoplasm in initial populations is of great theoretical and practical importance for breeding, as it facilitates the production of homozygous lines with cytoplasmic male sterility and high-performance hybrids on sterile basis. As shown by molecular analysis, a single-nucleotide polymorphism never reported hitherto is present in the mitochondrial genome of the haploid plant regenerants. It allows identification of microclones as fertile and sterile forms. It has been found that DNA markers of the sugar beet mitochondrial genome belonging to the TR minisatellite family (TR1 and TR3) enable reliable enough identification of haploid microclonal plants as MSor O-type forms. Fragments of 1000 bp in length have been detected in monogenic forms in the analysis of 11 sugar beet plants cultured in vitro by PCR with the OP-S4 random RAPD primer. Testing of the OP-S4 marker’s being in the same linkage group as the genes responsible for expression of the economically valuable trait monogermity demonstrates its relative reliability. By the proposed method, dihaploid lines (DH) of the male-sterile form and the О-type sterility maintainer of the RMS 120 sugar beet hybrid have been obtained in in vitro culture. These lines are highly uniform in biomorphological traits, as proven under field conditions

Synthesis and characterization of MnCrO4, a new mixed-valence antiferromagnet

A new orthorhombic phase, MnCrO4, isostructural with MCrO 4 (M = Mg, Co, Ni, Cu, Cd) was prepared by evaporation of an aqueous solution, (NH4)2Cr2O7 + 2 Mn(NO 3)2, followed by calcination at 400 C. It is characterized by redox titration, Rietveld analysis of the X-ray diffraction pattern, Cr K edge and Mn K edge XANES, ESR, magnetic susceptibility, specific heat and resistivity measurements. In contrast to the high-pressure MnCrO4 phase where both cations are octahedral, the new phase contains Cr in a tetrahedral environment suggesting the charge balance Mn2+Cr 6+O4. However, the positions of both X-ray absorption K edges, the bond lengths and the ESR data suggest the occurrence of some mixed-valence character in which the mean oxidation state of Mn is higher than 2 and that of Cr is lower than 6. Both the magnetic susceptibility and the specific heat data indicate an onset of a three-dimensional antiferromagnetic order at TN ≈ 42 K, which was confirmed also by calculating the spin exchange interactions on the basis of first principles density functional calculations. Dynamic magnetic studies (ESR) corroborate this scenario and indicate appreciable short-range correlations at temperatures far above T N. MnCrO4 is a semiconductor with activation energy of 0.27 eV; it loses oxygen on heating above 400 C to form first Cr 2O3 plus Mn3O4 and then Mn 1.5Cr1.5O4 spinel. © 2013 American Chemical Society

Static and dynamic magnetic response of fragmented haldane-like spin chains in layered Li3Cu2SbO6

The structure and the magnetic properties of layered Li3Cu2SbO6 are investigated by powder X-ray diffraction, static susceptibility, and electron spin resonance studies up to 330 GHz. The XRD data experimentally verify the space group C2=m with halved unit cell volume in contrast to previously reported C2=c. In addition, the data show significant Li=Cuintersite exchange. Static magnetic susceptibility and ESR measurements show two magnetic contributions, i.e., quasifree spins at low-temperature and a spin-gapped magnetic subsystem, with about half of the spins being associated to each subsystem. The data suggest ferromagnetic-antiferromagnetic alternating chains with JFM = -285 K and JAFM = 160 K with a significant amount of Li-defects in the chains. The results are discussed in the scenario of fragmented 1D S = 1 AFM chains with a rather high defect concentration of about 17% and associated S =1=2 edge states of the resulting finite Haldane chains. © 2016 The Physical Society of Japan

Ретроспективный анализ анестезиологического обеспечения пострадавшим при землетрясении в Непале

Objective. Retrospective analysis of anesthesia service while rescuing specialized surgical and traumatological operation for earthquakestricken in Nepal (2015).Materials and methods. Team of Russian doctors of GBUZ NII NDHiT DZ of Moscow rescued specialized medical operation for earthquake-stricken in Nepal from 30.04.2015 to 18.05.2015. The team sonsisted of 7 doctors: 2 surgeons, 2 traumatologists, 1 neurosurgeon and 2 anesthesiologists. The last ones performed 235 anesthesia at 59 patients (32 adults at the age of 36 ± 14 years and 27 children at the age of 7,5 ± 4 years with different surgical pathology).Results. From the whole number of anesthesia, there were 98 (41,7 %) inhalational anesthesia; 44(18,7 %) intravenous anesthesia; 39 (16,6 %) combined (intravenous and inhalational with regional anesthesia); 36 (15,3 %) regional anesthesia; 18 (7,7 %) endotracheal anesthesia. At the phase of wound process preparation to plastic closing at children, mostly intravenous and inhalational anesthesia were used, and regional anesthesia at adults. At the phase of plastic closing of soft-tissue defects endotracheal or combined anesthesia were used. In presence of orthopedic trauma and reposition with osteosynthesis combined anesthesia was used - intravenous or inhalational anesthesia with regional anesthesia, endotracheal anesthesia in combination of epidural one. Infusion therapy, antibacterial therapy, anticoagulation reversal and anaesthesis were provided to all patients. Complications at anesthesia: arterial hypotension – 12 (5,1 %), “agitation” after anesthesia with Sevoflurane – 32 (13,6 %), long postanesthesia respiratory depression – 2 (0,9 %). No lethal outcomes.Conclusions. It’s up to anesthesiologist to choose the type of anesthesia, it depends on timelines of surgical help, seriousness of the case, combination, extensiveness and trauma localization. Цель. Проведение ретроспективного анализа анестезиологического обеспечения при оказании специализированной хирургической и травматологической помощи пострадавшим от землетрясения в Непале (2015).Материалы и методы. С 30.04.2015 г. по 18.05.2015 г. бригада российских врачей ГБУЗ «НИИ НДХиТ» ДЗМ оказывала специализированную медицинскую помощь пострадавшим в результате землетрясения в Непале. В состав бригады вошли 7 врачей: 2 хирурга, 2 травматолога, 1 нейрохирург и 2 анестезиолога-реаниматолога. Всего было проведено 235 анестезий у 59 пациентов (32 взрослых в возрасте 36 ± 14 лет и 27 детей в возрасте 7,5 ± 4 лет) с различной хирургической патологией.Результаты. Специалисты бригады провели 98 (41,7 %) ингаляционных, 44 (18,7 %) внутривенных, 39 (16,6 %) сочетанных — внутривенная или ингаляционная с регионарной, 36 (15,3 %) регионарных и 18 (7,7%) эндотрахеальных анестезий. На этапе подготовки раневого процесса к пластическому закрытию у детей использовали преимущественно ингаляционный или внутривенный, а у взрослых пациентов – регионарный метод анестезии. При пластическом закрытии мягкотканных дефектов предпочтение отдали комбинированной эндотрахеальной или сочетанной анестезии. У пациентов со скелетной травмой и при репозициях с металлоостеосинтезом использовали сочетанный метод, совмещая внутривенную или ингаляционную анестезию с регионарной, а эндотрахеальную с эпидуральной. Всем больным также назначили инфузионную, антибактериальную, гемостатическую терапию и обезболивание. В ходе анестезии были зафиксированы следующие осложнения: артериальная гипотензия – 12 (5,1 %) пациентов, «ажитация» после анестезии «Севофлураном» – 32 (13,6 %), длительная постнаркозная депрессия дыхания – 2 (0,9 %). Случаи с летальным исходом отсутствовали.Выводы. Выбор метода анестезии при массовых катастрофах является прерогативой анестезиолога и зависит от сроков оказания хирургической помощи, тяжести состояния пациента, сочетанности, обширности и локализации травмы.

Возможности магнитно-резонансной томографии в диагностике острого асептического сакроилиита у детей

INTRODUCTION: Children and adolescents with juvenile spondyloarthritis (JSA) are at risk of developing sacroiliitis. MRI is the most preferred method of diagnosing sacroiliitis in adults over radiography and computed tomography. However, in the case of diagnosing childhood sacroiliitis, there is little information about the capabilities of MRI, and the reliability of the results in studies varies.OBJECTIVE: To show the possibilities of MRI in the diagnosis of infectious-allergic sacroiliitis.MATERIALS AND METHODS.: In this report, we present an analysis of data from 16 patients with aseptic (infectious-allergic) sacroiliitis only. Boys and girls aged 6 to 17 years (mean age 12.2±4.9) were equally divided. Magnetic resonance imaging, including contrast-enhanced imaging (used in 14 patients out of the total), was performed on a 3 T scanner (Achieva dStream Phillips) using a standard protocol that included multiplanar 3D T1-, T2WI, FLAIR and STIR with oblique coronal projection, diffusion-weighted images (DWI).RESULTS: MRI in all 16 patients revealed changes, even in those cases when X-ray and CT did not reveal pathological changes in bone or the changes were on the verge of normal (n=15). Of the 16 children, 10 (62.5%) had unilateral changes (50% on the right, 50% on the left) and six (37.5%) had bilateral changes. The bone marrow edema affected the sacrum in 10 patients, the ilium in three, and both bones of the joint in three patients. On DWI (10 children), increased diffusion was observed in five patients, on the right — in three, and on the left — in two patients.CONCLUSION: Currently, the best imaging modality for suspected acute sacroiliitis is MRI, which is more sensitive and specific, allowing early diagnosis of the disease and, accordingly, initiation of treatment, improving the prognosis. Disadvantages of MRI are long scan times, susceptibility to motion artifacts that require sedation or anesthesia in young children.ВВЕДЕНИЕ: Дети и подростки с ювенильным спондилоартритом (ЮСA) подвержены риску развития сакроилиита. МРТ является наиболее предпочтительным, чем рентгенография и компьютерная томография, методом диагностики сакроилиита у взрослых. Однако в случае диагностики детского сакроилиита недостаточно информации о возможностях МРТ, а надежность результатов в исследованиях варьируется.ЦЕЛЬ: Показать возможности МРТ в диагностике инфекционно-аллергического сакроилиита.МАТЕРИАЛЫ И МЕТОДЫ: В данном сообщении мы приводим анализ данных 16 пациентов только с асептическим (инфекционно-аллергический) сакроилиитом. Мальчиков и девочек в возрасте от 6 до 17 лет (средний возраст 12,2±4,9 года) было поровну. Магнитно-резонансная томография, в том числе с контрастным усилением (применена у 14 пациентов из общего числа), проведена на томографе 3 Тл (Achieva dStream Phillips) с использованием стандартного протокола, который включал мультипланарные 3D T1-, T2-ВИ, FLAIR и STIR с косой коронарной проекцией, диффузионно-взвешенные изображения (ДВИ).РЕЗУЛЬТАТЫ: МРТ у всех 16 больных выявила изменения, даже в тех наблюдениях, когда рентгенография и КТ костных патологических изменений не выявили или изменения были на грани нормы (n=15). Из 16 детей у 10 (62,5%) имелись односторонние изменения (50% справа, 50% слева) и шести (37,5%) двусторонние изменения. Отек костного мозга затронул крестец у 10 пациентов, подвздошную кость у трех и обе кости сустава у трех пациентов. На ДВИ (10 детей) повышенная диффузия наблюдалась у пяти пациентов, справа — у трех и слева — у двух пациентов.ЗАКЛЮЧЕНИЕ: В настоящее время лучшим методом визуализации при подозрении на острый сакроилиит является МРТ, которая более чувствительна и специфична, что позволяет диагностировать заболевание на ранней стадии и соответственно начать лечение, улучшить прогноз. Недостатками МРТ являются длительное время сканирования, подверженность артефактам движения, которые требует седации или анестезии у маленьких детей