ПАТОФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ ПРОЦЕССА ЗАЖИВЛЕНИЯ РАН В НОРМЕ И ПРИ СИНДРОМЕ ДИАБЕТИЧЕСКОЙ СТОПЫ

The main cause of long-term healing of ulcers in patients with diabetic foot is considered to be direct mechanical damage when walking due to reduced sensitivity to due to neuropathy, hyperglycemia, infection and peripheral artery disease. These factors determine the standard approaches to the treatment of diabetic foot, which include: offloading, glycemic control, debridement of ulcers, antibiotic therapy and revascularization. Recently, however, disturbances in the healing process of the skin in diabetes recognized an additional factor affecting the timing of healing patients with diabetic foot. Improved understanding and correction of cellular, molecular and biochemical abnormalities in chronic wound in combination with standard of care for diabetic foot gives new hope to solve the problem of ulcer healing in diabetes. Традиционно причинами длительного заживления язв при синдроме диабетической стопы (СДС) считаются прямое механическое повреждение при ходьбе в связи со снижением болевой чувствительности на фоне нейропатии, гипергликемия, инфицирование и нарушение кровоснабжения. Данные факторы определяют стандартные подходы к лечению СДС, включающие в себя: разгрузку пораженной конечности, гликемический контроль, хирургическую обработку язв, антибактериальную терапию и реваскуляризацию. Однако в последнее время нарушения непосредственно в процессе заживления кожных покровов при сахарном диабете (СД) признаются отдельным фактором определяющим вероятность и сроки излечения пациента с СДС. Улучшение понимания и коррекция клеточных, молекулярных и биохимических нарушений в хронической ране в сочетании с соблюдением стандартов лечения СДС дает новую надежду в решении проблемы заживления язв при СД.

Quantum mechanisms of tribosystems thermodynamic evolution

It is noted that while analyzing the tribosystems evolution it is potentially productive to use the methods of modern thermodynamics, nonlinear mechanics and quantum theory. Using the understandings of nonlinear dynamics and quantum-exchange interaction of solids surfaces an analytical expression is obtained for calculating the magnitude change of the tribosystems entropy. The expression for estimating the change in the tribosystems entropy is explicitly contained the tribotechnical parameter that is reciprocal to the wear. The case of relation between the tribosystems entropy change (decrease) and its wear resistance is analytically confirmed. The analytical expression for estimating the entropy change contains only those mechanical and physical parameters that can be measured by using modern physical methods. This allows to do not only an experimental verification of the obtained analytical dependence but also numerically evaluate the influence of the parameters of the tribosystems basic elements and its operating modes on the entropy values. In addition, it is possible to evaluate the tribosystems evolution itself and its constituent elements in the direction of their development or degradation. The obtained in this case data will allow proposing corrective structural and technological measures aimed to extend operational life of degrading elements and the tribosystem as a whole