DYNAMICS OF PERIPHERAL BLOOD CIRCULATION IN TREATMENT OF RADIAL BONE FRACTURES WITH THE METHOD OF PEROSSEOUS OSTEOSYNTHESIS

To study the parameters of peripheral blood circulation of upper extremity in patients with fractures of radial bone at perosseous osteosynthesis we studied the group of patients with fractures externally fixed by apparatus with pin arrangement and the group of patients treated by apparatus of rod arrangement. Rheovasographic examination of upper extremities was performed before the surgery, the day after it, on the 7th, 14th and 21st day after the surgery. In all patients during preoperational period we revealed disturbances of blood circulation in distal parts of upper extremities of angiospastic type giving evidence of sympathicotonia. Having analized the results of clinical and rheovasographic researches in established terms of observation we were able to mark gradual improvement of arterial and venous blood flow in forearm in examined groups. In the group with rod fixation positive dynamics occurred 5-7 days earlier than in the group with pin fixation. Original method was applied, consisting in rod fixation of apparatus of external fixation. Evaluation of clinical parameters marks good results in 97 % of cases. In early postoperative period improvement of rheovasographic parameters has been marked, which says about increased blood perfusion in tissues and about normalized vessel tone

ADVANTAGES OF ROD EXTERNAL FIXATION AT DIAPHYSEAL FRACTURES OF FOREARM BONES ACCORDING TO THE DATA OF RHEOVASOGRAPHY

The authors present the result of the research of peripheral blood flow of upper extremity in patients with diaphyseal fractures of forearm bones at transosseous osteosynthesis by external fixation devices of different set. Significant difference between rheographic indices and the set of external fixation device: greater effectiveness of transosseous osteosynthesis by rod external fixation devices with saving of moves in joints interfacing with injured segments was determined

Functional state of the brain bioelectric activity in treatment of diaphyseal lesions of the radius using the transosseous osteosynthesis of the wire and rod arrangement

Radial fracture is the most common trauma to the musculoskeletal system and accounts for 50 % of traumatic injuries to the bones of the upper limb. Disability in patients with fractures of the forearm bones ranges from 6 to 8 months, so the choice of the most effective method of treatment is very relevant. Currently, an important point is the tendency of optimizing the transosseous method by eliminating the disadvantages and looking for new advantages of external fixation. Bone fracture and associated surgical intervention are always accompanied by varying degrees of changes in the links of the central nervous system, hemodynamics and metabolism. In order to study the bioelectrical activity of the brain in 47 patients with a fracture of the radial diaphysis treated in the Traumatology Department of the Irkutsk Scientific Centre of Surgery and Traumatology, in the pre- and postoperative period we compared EEG indicators of two variants of the layout of the external fixation apparatus (EF): wire and rod. Analysis of the rhythms of bioelectrical activity of the brain in both groups in the preoperative period revealed a normal zonal distribution with the dominance of the alpha rhythm on the EEG, which generally reflects a rather high degree of organization of neuroactivity and indicates the stability of cerebral homeostasis. At the same time, in the group of patients with a wire-mounted EF device in the postoperative period, EEG indices significantly differed from the values of the norm and ndicators in the group with a rod-shaped arrangement. A decrease in the amplitude of alpha and beta rhythms was noted, as well as a shift in the frequency of bioelectric activity towards slow waves, which is a sign characteristic of discirculatory encephalopathy. An EEG study using the method of transosseous osteosynthesis with EF devise of a rod assembly showed its greater efficiency compared to the use of an EF device of a wire assembly during treatment and rehabilitation. Thus, the study of the bioelectric activity of the brain is a reliable method for assessing its functional state after an injury, as well as the effectiveness of the treatment

THE PECULIARITIES OF DISTRACTION REGENERATE BONE IN EXPERIMENT WHILE CHRONIC STIMULATION OF BIOLOGICALLY ACTIVE POINTS

In experiment the forming and remodeling of distraction regenerate in rabbits Shinshila while conducting transosseous elements through the acupuncture points were studied. One of the rabbit's forearm was stretched by Hizarov's method for 10 mm. Multidetector CT gave the results of mineral density of the bone distraction regenerate. To the 10th day of fixation of bone fragments by the external fixation device the distraction regenerate with a clear zonal structure formed. To the 20th day of fixation in the middle zone there were clear signs of the formation of the medullary canal, that proves the decrease of mineral density to negative values. The prolonged stimulation of acupuncture points by introduced transosseous elements leads to formation of the structure and properties of bone regenerate, which are close by the characteristics to the parameters of the intact bone

Дифференциальная экспресс-диагностика и экстренная специфическая профилактика трансмиссивных клещевых инфекций в городе Иркутске

The results of differential express diagnostic of tick-borne encephalitis and Lyme borreliosis agents in ticks, removed from pa- tients are present in this article (1995—2004). The entire complex of serolological and genetical methods were used. The specific prophylaxis based on the results of diagnostic had shown to be very effective for both infections. The first data about human ehrli- chiosis and anaplasmosis in Irkutsk region had been obtained. The improvement of diagnostic and prophylactic procedures are pro- posed.В статье представлены результаты дифференциальной экспресс-диагностики возбудителей клещевого энцефалита и иксодовых клещевых боррелиозов в снятых с пострадавших лиц клещах или крови пациентов за период с 1995—2004 гг. Для дифференциальной диагностики применяли комплекс методов, включая стандартные серологические и современные молекулярно-генетические тесты. В зависимости от результатов исследования проводили экстренную специфическую профилактику, которая показала хорошие результаты предупреждения обеих инфекций. Получены первые сведения о воз- можной циркуляции возбудителей моноцитарного эрлихиоза человека и гранулоцитарного анаплазмоза человека на терри- тории Иркутской области. Предложены способы усовершенствования диагностики и профилактики

RESULTS OF GENOTYPING OF STRAINS AND RNA ISOLATES OF TICK-BORNE ENCEPHALITIS VIRUS ISOLATED FROM SICK PEOPLE IN IRKUTSK REGION AND BURYAT REPUBLIC

Genotyping of nine strains and nine isolates of tick-borne encephalitis virus RNA (TBE) isolated from patients in the Irkutsk Region and. the Buryat Republic in 1963-2009 years conducted. The investigations revealed that three TBE virus genotypes are involved in the etiology of the TBE: Ural-Siberian (genotype 3), Far Eastern (genotype 1) and. European (genotype 2). It is found that the TBE virus of Far East and. Ural-Siberian genotypes can cause disease with a wide spectrum of clinical manifestations: acute TBE (focal and. nonlocal forms), chronic TBE (encephalitic form, progressive course.) Prospects of application of molecular genetic techniques for the rapid indication and. identification of the TBE virus in the blood of sick people are shown

Characteristics of genetic and phenotypic properties of tick-borne encephalitis virus strains isolated from various source on the territory of Eastern Siberia

Since ixodid ticks and their feeders (vertebrates) form the basis of the tick-borne encephalitis virus (TBEV) population, it was interesting to obtain a genetic characteristic of strains isolated from various sources in the territory of Eastern Siberia. In our study, it was found that the circulation of TBEV of genotypes 1, 2, 3, 5 and "polytypic" strains in the territory of Eastern Siberia is maintained both by the main vectors (I. persulcatus ticks) and by their feeders (small and large mammals, birds). The distribution of genotypes in strains groups from ixodid ticks and vertebrates varied. TBEV strains of genotypes 1 and 2 were significantly more often isolated from rodents, and genotype 3 from ixodid ticks (p < 0.05). Isolates of genotype 3 (85.5 %) prevailed in the group of strains isolated from ixodid ticks, of which 29.6 % belonged to "Vasilchenko", and 25.6 % to "Zausaev"subgenotypes. Genotypes 1 and 2 were represented by single isolates (3.3 % and 1.3 %, respectively). Among strains isolated from warm-blooded hosts, the proportion of genotype 1 was 35.3 %, genotype 2 -11.8 %, genotype 3 - 35.3 %. More than half of genotype 3 strains (58.3 %) were related to "Vasilchenko" subgenotype, and the strains of "Zausaev" subgenotype were not detected. The obtained data suggest that ixodid ticks and warm-blooded animals are amplifiers of TBEV of genotypes 3 and 1, respectively. The certain differences in the phenotypic characteristics of strains isolated from ticks and warm-blooded animals have been revealed. It has been found that strains isolated from ticks are more homogeneous in their antigenic characteristics, less heterogeneous in S-feature than strains isolated from warm-blooded sources. The strains isolated from warm-blooded animals demonstrate somewhat greater resistance to warming but reducing the reproduction of the virus at 42 °C, and have greater virulence compared to strains isolated from ticks

The distribution of tick-borne encephalitis virus genotypes in different types of landscapes of Eastern Siberia

To find out what is the role of some environmental factors in the formation of a heterogeneous viral population, the analysis of the distribution of tick-borne encephalitis virus (TBEV) genotypes in different types of landscapes of Eastern Siberia has been carried out. In our study, it was shown that TBEV area in all investigated landscapes of Eastern Siberia is represented not only by TBEV of genotype 3, absolute dominance of which is noted in the studied regions, regardless the landscapes where the foci are located, but also by strains of other genotypes. The relationship between genotypes 1,3 and "polytypic" strains with a certain type of landscape and the degree of their development by man has not been established. The prevailing number of strains of TBEV genotype 5 is isolated from the material collected in the Transbaikalia, in the landscapes of the mountain taiga. They, as well as the strain of genotype 4, are found in the foci, where joint circulation of several TBEV genotypes is noted. The strains of TBEV genotype 2 were revealed in the landscapes of plains and plateaus taiga and insular steppes and forest steppes of the southern part of the Baikal region. Moreover, the detection of RNA of TBEV genotype 2 in the "polytipic" 763-87 and 765-87 strains isolated in the floodplain and forest-steppe landscapes of the Barguzin hollow does not exclude the possibility of circulation of TBEV genotype 2 in the Transbaikalian foci. The greatest genetic heterogeneity of TBEV is observed in natural foci located along Lake Baikal and in the southeastern part of Transbaikalia

BRIEF CHARACTERISTIC OF EUROPEAN GENOTYPE TICK-BORNE ENCEPHALITIS VIRUS STRAINS IDENTIFIED IN SIBERIAN REGION

The molecular-genetic analysis of 13 strains of Western genotype TBEV isolated in Western and Eastern Siberia demonstrated two groups of strains differed geneticallyfrom each other and had a high level of E gene sequences homology within each group. Nevertheless, the heterogeneity of biological propertiesfor some strains within a group was observed

CHARACTERISTICS OF THE BAIKAL SUBTYPE OF TICK-BORNE ENCEPHALITIS VIRUS CIRCULATING IN EASTERN SIBERIA

Background. During the study of the genetic variability of the tick-borne encephalitis virus (TBEV) in Eastern Siberia, a group of 22  strains with a unique genetic structure significantly different from all  known TBEV subtypes was identified. This TBEV variant was  tentatively called “group 886”. Therefore, for this original TBEV  variant it was necessary to study the genetic, biological properties of the “group 886” strains, clarify its TBEV taxonomic status, its range, evolutionary history, etc.Aim. The generalization of the currently available data on genetic and biological properties of TBEV “886” group.Materials and methods. The genetic structure of “group 886” strains was studied by the complex of molecular-genetic methods (MHNA, sequencing of fragments or the complete genome).Results. It was shown that “group 886” strains form a separate cluster on phylogenetic tree, and the level of genetic differences  from other genotypes is more than 12 %. It was defined that this  TBEV variant has its own area (Irkutsk region, Republic of Buryatia,  Trans-Baikal region, Northern Mongolia). Its ecological connection  with all links of the transmissive chain (ixodid ticks, small mammals,  human), participation in human pathology, stability and duration of  circulation in the Baikal region, individual evolutionary history  were proved. Some phenotypic characteristics of the “group 886” strains were considered.Conclusion. The presented data testify to the validity of the “886 group” isolation as an independent genetic type. Taking into account  the geographical distribution of this TBEV genotype, we propose to assign it the name “Baikal genotype/subtype”