NEW IN THE PATELLA FRACTURES TREATMENT

In the literature there is a gap of publications about patella fractures management which is due to the absence of serious attention to the injuries of this largest sesamoid bone. In addition, in the world literature there is a lack of monographs and toolkits for the treatment of patients with these injuries, furthermore, in textbooks and traumatology manuals there are only a few template recommendations to the tactics of treating patients with this trauma. Meanwhile, patella fractures represent approximately 0.5-1.5% of all fractures, delayed union, formation of a false joint, and the emergence of patellofemoral arthrosis after these fractures is not uncommon. In the scientific literature on traumatology there is no unified, all-recognized classification of these fractures, which hinders the development of a single algorithm for the treatment of patients with patellar fractures. There are no contradictory views to the treatment of patella fractures without displacement; however, in relation to the treatment of patients with complex patella fractures, there are divergent views between the fracture fragments preservation to partial or even total patellectomy. In connection with the foregoing, We considered the issue of treating patients with patella fractures topical. Based on a thorough analysis of treatment results of 113 patients we provided a working classification based on the number of patellar fracture fragments (two-fragmentary, three-fragmentary, four-fragmentary, multi-fragmentary, upper and lower pole fractures). Based on this classification, traditional, modified and new methods of treating patients with patellar fractures were used. This is described in more detail in the forthcoming article

Features of laboratory parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2

Multisystem inflammatory syndrome (MIS-C) is a new childhood disease associated with coronavirus SARS-CoV-2 that manifests itself 3–4 weeks after infection. The development of MIS-C is possible, despite the asymptomatic course of coronavirus infection. The pathogenetic features of MIS-C remain unclear. The aim of the study was to investigate the state of peripheral blood parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2 upon admission to a hospital. Material and methods. We examined 52 children with MIS-C from 1 to 14 years old, hospitalized in Children`s Clinical Hospital No. 3 in Novosibirsk in October–December 2020. Testing for the isolation of SARS-CoV-2 RNA in scrapings from the nasopharynx and oropharynx was carried out using real time PCR (test systems of DNA-Technology, Russia). The presence of specific IgM and IgG antibodies to SARS-CoV-2 in blood serum was determined by ELISA using Vector-Best kits (Russia). Results and discussion. It was noted that SARS-CoV-2 virus RNA was found only in 12.8 % of cases, while specific IgG antibodies in blood serum were detected in 100 % of children. IgM to SARS-CoV-2 antigens were detected in the blood serum only in 53.85 % of children with MIS-C. It has been established that unexpressed leukocytosis was found both in children under the age of 7 and in children of 8–14 years old. However, the leukocytes content in children of the older age group was significantly lower than in children aged 1–7 years. At the same time, in both age groups, some children had extremely low values of the indicator. The causes of severe leukopenia against the background of excessive inflammation remain unclear. Age groups (1–7 and 8–14 years) do not differ statistically significantly in the relative content of lymphocytes and neutrophils. In the study of individual values of the relative content of lymphocytes within the age groups, it was noted that only some children had lymphopenia of varying severity. Conclusions. Against the background of minor leukocytosis in children with MIS-C, upon admission to the hospital, there is a tendency to develop both relative and absolute lymphopenia, regardless of age. The study noted an extremely pronounced variability of individual values of the evaluated peripheral blood parameters, regardless of age, which, with similar clinical symptoms, characterized as MIS-C, requires further study in dynamics, taking into account the initial values of the indicators.There is no pronounced relationship between the leukocytes content and specific IgM antibodies to SARS-CoV-2 antigens in the blood

Aplicarea sistemului de hidrochirurgie și a plasmajetului în debridarea toracoscopică a cavității pleurale la copii cu fibrinotorax

Toracoscopia a devenit o modalitate favorizată în tratamentul empiemului pleural la copii. Cu toate acestea, factorii care afectează rezultatul administrării toracoscopice rămân neclari. Scopul studiului este de a demonstra eficiența sistemului de hidrochirurgie "Versajet" și a unității de plasmă "Plasmajet" în tratamentul toracoscopic al copiilor cu complicații pleurale ale pneumoniei. MATERIALE SI METODE. În perioada 2015-2017, la Spitalul de Copii Speransky din Moscova, 377 copii cu pneumonie au fost tratați, la 62 pacienți (16,45%) din 377 am efectuat drenajul cavității pleurale, 14 pacienți cu vârste cuprinse între 1,6 și 15 ani (în medie, 3,2 ± 3,8 ani) cu empiem pleural au fost operați. S-a efectuat decorticarea pulmonară toracoscopică cu sistem de hidrochirurgie (Versajet-2). Sistemul hidrochirurgical este un instrument chirurgical bazat pe impactul jetului de apă de mare viteză asupra țesuturilor necrotice și inflamate, combinând avantajele debridării țesuturilor moi și evacuarea acestora prin pulsarea jetului de apă. Designul tubului de evacuare și apropierea acestuia de jetul lichid creează un vacuum local, care îndepărtează efectiv fibrina și conținutul lichid prin efectul Bernulli. Consimțământul informat a fost obținut de la toți părinții înainte de operare, iar procedura însăși a fost aprobată de comitetul de etică locală. REZULTATE. Recuperarea și reabilitarea fără particularități au fost în 13 cazuri. La un pacient cu empiem al cavității pleurale pe dreapta și leziune organică severă a sistemului nervos central a perioadei postoperatorii după o toracoscopie convențională complicată de recurența empiemului pleural.Retoracoscopia cu debridarea cavității pleurale de către sistemul de hidrochirurgie efectuată la șase zile după operația inițială, a avut rezultate satisfăcătoare. În cazul hemoragiei intraoperatorii, a fost efectuată coagularea plasmei de argon, obținându-se aerostasie completă la 2 pacienți și hemostază - la 1 pacient. Durata medie de funcționare a fost de 90 de minute (± 15 minute). Drenajul cavității pleurale este eliminat în ziua a 3-a sau a 4-a după operație. Copiii externați în ziua a 10-a (± 1,2 zile). Examinarea cu ultrasunete și cu raze X la patru luni după intervenția chirurgicală a confirmat absența inflamației în parenchimul pulmonar și reexpansarea plină pulmonară la toți pacienții. CONCLUZIE. Aplicarea sistemului hidrochirurgical în timpul toracoscopiei asigură o debridare sigură și eficientă a cavității pleurale, decorticările plămânului fiind fără deteriorarea severă a parenchimului pulmonar și crearea condițiilor pentru reabilitarea precoce a plămânilor compromiși.Thoracoscopy became a favored modality in pediatric pleural empyema treatment. However, factors affecting outcome of thoracos- copic management remain unclear. The purpose of the study is to demonstrate efficiency of hydrosurgery system "Versajet" and plasma unit "Plasmajet" in thoracoscopic treatment of children with pleural complications of pneumonia. MATERIALS AND METHODS. During the period of 2015-2017 at the Speransky Children’s Hospital in Moscow 377 children with pneumonia were treated, in 62 patients (16.45%) of 377 we perform drainage of pleural cavity, 14 patients from 1.6 to 15 years of age (on average, 3.2 ± 3.8 years old) with pleural empyema were operated. Thoracoscopic lung decortication with hydrosurgery system (Versajet-2) was performed. Hydrosurgery system is a surgical instrument based on impact of high-speed jet of water on necrotic and inflamed tissues, combining the advantages of soft tissues debridement and evacuation them by pulsating water jet. Design of the evacuation tube and its proximity to liquid jet creates a local vacuum, which effectively removes fibrin and liquid contents by Ber- nulli effect. Informed consent was obtained from all parents before operation, and procedure itself received approval from the local ethics committee. RESULTS. Recovery and rehabilitation was uneventful in 13 cases. In one patient with empyema of right pleural cavity and severe organic lesion of central nervous system postoperative period after conventional toracoscopy complicated by recurrence of pleural empyema. Rethoracoscopy with debridement of pleural cavity by hydrosurgery system performed six days after initial operation, with satisfactory results. In the event of intraoperative air leak or hemorrhage, application of argon plasma coagulation had been performed achieving complete aerostasis in 2 patients and hemostasis - in 1 patient. Average operation time was 90 minutes (± 15 minutes). Drainage of the pleural cavity removed on the 3rd or 4th day after surgery. Children discharged from the hospital on 10th PO day (± 1.2 days). Ultrasound and X-ray examination four months after surgery confirmed the absence of inflammation in the lung parenchyma and full lung reexpansion in all patients. CONCLUSION. Application of hydrosurgycal system during thoracoscopy provides safe and effective debridement of pleural cavity, decortications of the lung without severe damage to the lung parenchyma and create conditions for early rehabilitation of compro- mised lung

Fandom and Coercive Empowerment: The commissioned production of Chinese online literature

This article examines how the relationship between consumers and producers of cultural products is shaped by the proprietary nature of digital platforms. Drawing on 4 years of online observation and analysis, we examine the relationship between the producers of online Chinese fiction, amateur writers, and their consumers, that is, the fan communities of readers who respond to their work. Enabled by Chinese literary websites, readers act like sponsors who provide emotional and financial incentives for writers to produce online fictions by commenting, voting, and sending money. Readers become actively involved not just because of the content of the stories but because they form strong commitments to stories and their writers, and gain reciprocity and a sense of self-determination during the interactional process. We argue that although writers are freer from state control online, they are still beholden to the whims of their fans because of what we call the commissioned production of fictions. We contribute to fan community studies by analyzing how commercialized website settings structure the strategies available to participants, how these settings affect the content of the cultural products, and how the Chinese historical and cultural contexts impact the dynamics of the online community.postprin

Electronic properties and phase transitions in low-dimensional semiconductors

We present the first review of the current state of the literature on electronic properties and phase transitions in TlX and TlMX2 (M = Ga, In; X = Se, S, Te) compounds. These chalcogenides belong to a family of the low-dimensional semiconductors possessing chain or layered structure. They are of significant interest because of their highly anisotropic properties, semi- and photoconductivity, non-linear effects in their I-V characteristics (including a region of negative differential resistance), switching and memory effects, second harmonic optical generation, relaxor behavior and potential applications for optoelectronic devices. We review the crystal structure of TlX and TlMX2 compounds, their transport properties under ambient conditions, experimental and theoretical studies of the electronic structure, transport properties and semiconductor-metal phase transitions under high pressure, and sequences of temperature-induced structural phase transitions with intermediate incommensurate states. Electronic nature of the ferroelectric phase transitions in the above-mentioned compounds, as well as relaxor behavior, nanodomains and possible occurrence of quantum dots in doped and irradiated crystals is discussed.Comment: 70 pages, 38 figure

Динамика показателей систолической и диастолической функции левого желудочка на фоне химиотерапии рака молочной железы доксорубицином

Introduction. Detection of the cardiotoxic effect during chemotherapy (CT) for malignant neoplasms is one of the most important tasks of a practicing physician. Purpose: to study changes in left ventricular systolic and diastolic function using echocardiography (EchoCG) during chemotherapy with doxorubicin in patients with primary breast cancer (BC) and to identify potential markers of early cardiotoxicity (CT).Material and Methods. The study included 100 patients with a confirmed diagnosis of breast cancer who were treated at the health care institution “Grodno University Clinic” (Grodno, Belarus).Results. In the study sample, a number of EchoCG parameters were measured before and after chemotherapy in 100 patients with breast cancer. Depending on the choice of the threshold level of relative reduction in global longitudinal strain (GLS) in %, different median values were recorded in the subgroups with and without CT (before and after chemotherapy). Data are presented on the difference in the relative dynamics of EchoCG indicators in % between the subgroups with CT and without CT, which shows how large the differences between the subgroups are in % after the end of chemotherapy. Against the background of the absence of statistically significant differences, trends towards an increase or decrease in indicators were recorded, which can characterize them as potential CT markers.Conclusion. We hypothesize that indexed end-systolic volume, indexed end-diastolic volume, early diastolic peak velocity of lateral mitral annulus motion may be considered as potential CT markers in the subclinical stage along with GLS; if it is impossible to measure a relative decrease in GLS, these indicators collectively may indicate the development of a CT effect at the subclinical stage. When diagnosing a relative decrease in the GLS index by less than 15 %, but by more than 10 %, we propose to consider the indexed end-systolic volume index as a marker of the early CT effect if its increase after the end of chemotherapy is recorded by 10 % or more, respectively.Введение. Выявление кардиотоксического эффекта на фоне химиотерапии (ХТ) злокачественных новообразований является одной из важнейших задач практикующего врача.Цель исследования – изучить изменения показателей систолической и диастолической функции левого желудочка методом эхокардиографии (ЭхоКГ) на фоне ХТ доксорубицином у пациенток с первичным раком молочной железы (РМЖ) и выявить потенциальные маркеры ранней кардиотоксичности (КТ). Материал и методы. В исследование включено 100 пациенток с верифицированным раком молочной железы, проходивших лечение на базе учреждения здравоохранения «Гродненская университетская клиника» (Гродно, Беларусь).Результаты. В исследуемой выборке у 100 пациенток с РМЖ до и после ХТ измерили ряд показателей ЭхоКГ. В зависимости от выбора порогового уровня относительного снижения глобальной продольной деформации миокарда (global longitudinal strain, GLS) в % зафиксированы различные значения медиан в подгруппах с КТ и без КТ (до и после ХТ). Представлены данные о разности относительной динамики показателей ЭхоКГ в % между подгруппами с КТ и без КТ, что показывает, насколько велики различия между подгруппами в % после окончания ХТ. На фоне отсутствия статистически значимых отличий зафиксированы тенденции к росту или снижению показателей, что может характеризовать их как потенциальные маркеры КТ на раннем этапе.Заключение. Таким образом, индексированный конечный систолический объем, пиковая скорость раннедиастолического движения латеральной части митрального фиброзного кольца могут представлять интерес для диагностики КТ на ранних этапах; в случае невозможности измерения относительного снижения GLS данные показатели совокупно могут указывать на развитие КТ эффекта. Учитывая разнонаправленность изменений показателей ЭхоКГ, с целью подтверждения ранней КТ требуется построение многофакторных моделей, в том числе моделей классификаций

Перспективные интеллектуальные материалы для радиоэлектроники

The investigations of a multilayer material – a polymeric radio-transparent electrically conductive film of polyaniline with a concentration of 5, 10 and 50 % by weight on a radio-transparent fiberglass substrate were carried out. Such materials are multifunctional – the material itself has the required characteristics, but when it is exposed to external electromagnetic radiation, it provides shielding functions. Electrically conductive polymer samples (polyaniline film) deposited on a fiberglass substrate have low attenuation in the 8–12 GHz transparency band, low electromagnetic radiation reflection coefficient, high conductivity and performance characteristics, as well as manufacturability.Выполнены исследования многослойного материала – полимерной радиопрозрачной электропроводящей пленки полианилина концентрации 5, 10 и 50 % по массе на радиопрозрачной подложке из стеклопластика. Такие материалы являются многофункциональными – собственно материал с требуемыми характеристиками, но при воздействии внешнего электромагнитного излучения выполняет экранирующие функции. Образцы электропроводящего полимера (пленки полианилина), нанесенные на подложку из стеклопластика, обладают малым затуханием в полосе прозрачности 8–12 ГГц, низким коэффициентом отражения электромагнитного излучения, высокими проводимостью и эксплуатационными характеристиками, технологичностью