Хирургические методы стабилизации грудной клетки при множественных переломах ребер

Closed chest injury occupies one of the leading places among all injuries. Rib fractures can lead to the formation of floating fragments of the chest wall, the “costal valve”. With multiple rib fractures, surgical methods of chest stabilization have been used since the beginning of the 20th century, which have become more popular in recent decades.  Surgical treatment can significantly reduce pain, accelerate the recovery of respiratory function. In turn, a decrease in pain reduces the incidence of pneumonia, the need for mechanical ventilation and tracheostomy, and the period of hospitalization. There are four main surgical methods of treatment: 1) chest traction methods; 2) external fixation devices; 3) methods of permanent internal fixation; 4) plate osteosynthesis. We also separated the group of techniques performed via thoracoscopic access and the technique using biodegradable materials. Surgical options in the treatment of patients with multiple rib fractures have not been exhausted and are likely to improve with advances in technology. Закрытая травма груди занимает одно из лидирующих мест среди всех повреждений. Переломы ребер могут приводить к формированию флотирующих фрагментов грудной стенки — «реберному клапану». При множественных переломах ребер с начала ХХ века использовались хирургические методы стабилизации грудной клетки, которые в последние десятилетия стали более популярными.  Хирургическое лечение позволяет значительно уменьшить болевой синдром, ускорить восстановление респираторной функции и тем самым снизить частоту развития пневмонии, потребность в искусственной вентиляции легких и трахео­стомии и сократить период нахождения в стационаре. Различают четыре основные хирургические методики лечения, использующие: 1) тракцию грудной клетки; 2) аппараты внешней фиксации; 3) постоянную внутреннюю фиксацию; 4) накостный остеосинтез пластинами. В данном исследовании были дополнительно выделены методика, осуществляемая через торакоскопический доступ, и методика, использующая биоразлагаемые материалы. Хирургические возможности в лечении пациентов со множественными переломами ребер не исчерпаны и, вероятно, будут совершенствоваться по мере достижений в технологической сфере.

Perkov reaction in series of mixed bis(1,1,3-trihydroperfluoropropyl) alkyl phosphites

Mixed bis(1,1,3-trihydroperfluoropropyl) alkyl phosphites react under mild conditions with chloral to simultaneously give stable phosphoranes with a P-C bond and vinyl phosphates. © 1983 Plenum Publishing Corporation

Pentaalkoxyphosphoranes in the reactions of alkylene(1,1,3-trihydroperfluoropropyl) phosphites with chloral and bromal

For the first time, stable pentaalkoxyspirophosphoranes were isolated in addition to phosphoranes with P-C bond in the reactions of alkylene-(1,1,3-trihydroperfluoropropyl)phosphites with chloral or bromal. © 1987 Plenum Publishing Corporation

Reactions of triphenyl phosphite with di- and tribromoacetaldehydes

The reaction of triphenyl phosphite and di- and tribromoacetaldehydes proceeds through initial halophilic attack with subsequent formation of triphenyl phosphate and tetraphenylphosphonium bromide. © 1989 Plenum Publishing Corporation

Tris(fluoroalkoxy)methylphosphonium salts in the synthesis of methylphosphoranes

The reactions of phosphites containing electron-withdrawing fluoroalkyl groups with methyl triflate gave tris(fluoroalkoxy)methylphosphonium triflates, which react with alcohols to give either tetrakis(fluoroalkoxy)methylphosphoranes (in the case of fluoroalcohols) or alkylation products - ethers and bis(fluoroalkoxy)methylphosphonates (in the case of unsubstituted alcohols). The structures of the phosphonium salts and phosphoranes were supported by1H and31P NMR spectroscopy. © 1991 Plenum Publishing Corporation

Reaction of 2-tert-butoxy-4,5-benzo-1,3,2-dioxaphospholane with tribromoacetaldehyde

The reaction of 2-tert-butoxy-4,5-benzo-1,3,2-dioxaphospholane with tribromo-acetaldehyde proceeds by initial halophilic attack on the bromine atom, leading to a product with retention of the P-Br bond (pyrocatechol bromophosphate) and an anion exchange product (pyrocatechol dibromovinylphosphate), and by initial attack at the carbon atom of the C=O group, which is accompanied by the elimination of isobutylene to form an α-hydroxyphosphonate. © 1990 Plenum Publishing Corporation

Synthesis of 1,4,2-dioxaphosphepanes by the reaction of 2-fluoroalkoxy-4-oxo-5,6-benzo-1,3,2-dioxaphosphorinanes with chloral

The reaction of 2-fluoroalkoxy-5,6-benzo-1,3,2-dioxaphosphorinanes with chloral leads to the formation of ring expansion products with a P-C bond, namely, 2-fluoroalkoxy-2,5-dioxo-3-trichloromethyl-6,7-benzo-1,4,2-dioxaphosphepanes with high stereoselectivity. © 1992 Plenum Publishing Corporation

Успешное лечение пациента с тяжелым сепсисом и синдромом полиорганной недостаточности, осложнившими течение гнойных ран различной локализации

The article describes the complex surgical treatment of a patient with a bilateral hip phlegmon complicated by severe sepsis, multiple organ failure syndrome (cardiac, respiratory), as well as deep pressure ulcers of various depths and localization under the primarily diagnosed diabetes mellitus.В статье представлен опыт комплексного хирургического лечения пациента с флегмоной обоих бедер, осложнившейся развитием тяжелого сепсиса с синдромом полиорганной недостаточности (сердечной, дыхательной) и глубокими пролежнями различной локализации на фоне впервые выявленного сахарного диабета

The ReactorAFM: Non-contact atomic force microscope operating under high-pressure and high-temperature catalytic conditions.

Quantum Matter and Optic

Experience of Application of the ELISA Method for Detection of Antibodies to Ebola Virus during the SAET Team Work in the Republic of Guinea

The aim of the work was to develop a kit for detection of IgM and IgG antibodies to Ebola virus in ELISA.Materials and methods. Ebola virus strain Zaire H.sapiens-wt/GIN/2015/Kalidie-Kindia-1022 grown on cell culture was used as antigen.Results and conclusions. The kit was used by the Rospotrebnadzor SAET team in its work in Guinea while investigating cases during Ebola fever epidemics. It was established that specific IgG antibodies persisted in Ebola fever survivors for 2 years. Application of this kit in the laboratory diagnostics permits ELISA to become the main and confirmatory laboratory method of Ebola fever detection