42 research outputs found
ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΈΠ½ΡΠ΅Π»Π»Π΅ΠΊΡΡΠ°Π»ΡΠ½ΡΡ ΡΠΈΡΡΠ΅ΠΌ Π½Π° ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ΅
The article discusses the application of intelligent transport systems for railway transport. The purpose of developing intelligent transport systems on railway transport is to strictly comply with the requirements for ensuring transport safety, reducing the level of environmental impact, significantly improving the efficiency of production activities. The software makes automatic accounting, control and analysis of fuel and energy resources consumption on the basis of the obtained data. At the same time, the dynamics of changes in fuel consumption indicators, actual and estimated costs of diesel fuel are visually reflected in real time on the monitor screen. If necessary, the system will help to identify the reasons for non-matching of these parameters and quickly contact the locomotive team to provide qualified assistance in their elimination. It is important that the hardware structure and the structure of the system software expand functionality, providing continuous operation and repair work, increasing the number of measured parameters, creating a closed fuel consumption control system in a locomotive economy. The use of these systems makes it possible to obtain an integrated assessment of the heat engineering condition of a locomotive with further scientifically substantiated correction of overhaul runs, to control its location and solve many other problems, which contributes to an increase in overhaul runs and the operational life of the locomotive.Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΈΠ½ΡΠ΅Π»Π»Π΅ΠΊΡΡΠ°Π»ΡΠ½ΡΡ
ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΡΡ
ΡΠΈΡΡΠ΅ΠΌ Π½Π° ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ΅. Π¦Π΅Π»ΡΠΌΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΈΠ½ΡΠ΅Π»Π»Π΅ΠΊΡΡΠ°Π»ΡΠ½ΡΡ
ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΡΡ
ΡΠΈΡΡΠ΅ΠΌ Π½Π° ΠΆΠ΅Π»Π΅Π·Π½ΠΎΠ΄ΠΎΡΠΎΠΆΠ½ΠΎΠΌ ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ΅ ΡΠ²Π»ΡΡΡΡΡ Π½Π΅ΡΠΊΠΎΡΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΏΠ΅ΡΠ΅Π²ΠΎΠ·ΠΎΠΊ, ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Ρ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° ΠΎΠΊΡΡΠΆΠ°ΡΡΡΡ ΡΡΠ΅Π΄Ρ, ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ½ΠΎΠ΅ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡ Π°Π²ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΡΠ΅Ρ, ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΈ Π°Π½Π°Π»ΠΈΠ· ΡΠ°ΡΡ
ΠΎΠ΄Π° ΡΠΎΠΏΠ»ΠΈΠ²Π½ΠΎ-ΡΠ½Π΅ΡΠ³Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΡΡΡΡΠΎΠ². ΠΡΠΈ ΡΡΠΎΠΌ Π½Π° ΡΠΊΡΠ°Π½Π΅ ΠΌΠΎΠ½ΠΈΡΠΎΡΠ° Π½Π°Π³Π»ΡΠ΄Π½ΠΎ Π² ΡΠ΅ΠΆΠΈΠΌΠ΅ ΡΠ΅Π°Π»ΡΠ½ΠΎΠ³ΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΠΎΡΡΠ°ΠΆΠ°Π΅ΡΡΡ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠΎΠΏΠ»ΠΈΠ²ΠΎΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ, ΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ ΡΠ°ΡΡΠ΅ΡΠ½ΡΠ΅ Π·Π°ΡΡΠ°ΡΡ Π΄ΠΈΠ·ΡΠΎΠΏΠ»ΠΈΠ²Π°. Π ΡΠ»ΡΡΠ°Π΅ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ ΡΠΈΡΡΠ΅ΠΌΠ° ΠΏΠΎΠΌΠΎΠΆΠ΅Ρ Π²ΡΡΠ²ΠΈΡΡ ΠΏΡΠΈΡΠΈΠ½Ρ Π½Π΅ΡΠΎΡΡΡΠΊΠΎΠ²ΠΊΠΈ ΡΡΠΈΡ
ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎ ΡΠ²ΡΠ·Π°ΡΡΡΡ Ρ Π»ΠΎΠΊΠΎΠΌΠΎΡΠΈΠ²Π½ΠΎΠΉ Π±ΡΠΈΠ³Π°Π΄ΠΎΠΉ Π΄Π»Ρ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΊΠ²Π°Π»ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΠΎ ΠΈΡ
ΡΡΡΡΠ°Π½Π΅Π½ΠΈΡ. ΠΠ°ΠΆΠ½ΠΎ, ΡΡΠΎ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΡ Π°ΠΏΠΏΠ°ΡΠ°ΡΠ½ΠΎΠΉ ΡΠ°ΡΡΠΈ ΠΈ ΡΡΡΡΠΊΡΡΡΠ° ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ½ΠΎΠ³ΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠ΅Π΄ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅Ρ ΡΠ°ΡΡΠΈΡΠ΅Π½ΠΈΠ΅ Π΅Π΅ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π·Π° ΡΡΠ΅Ρ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ Π²ΠΈΠ΄Π΅ΠΎΠ½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π·Π° Π΄Π΅ΠΉΡΡΠ²ΠΈΡΠΌΠΈ Π»ΠΎΠΊΠΎΠΌΠΎΡΠΈΠ²Π½ΡΡ
ΠΈ ΡΠ΅ΠΌΠΎΠ½ΡΠ½ΡΡ
Π±ΡΠΈΠ³Π°Π΄, ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° ΠΈΠ·ΠΌΠ΅ΡΡΠ΅ΠΌΡΡ
ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ², ΡΠΎΠ·Π΄Π°Π½ΠΈΡ Π·Π°ΠΌΠΊΠ½ΡΡΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΡΠ°ΡΡ
ΠΎΠ΄Π° ΡΠΎΠΏΠ»ΠΈΠ²Π° Π² Π»ΠΎΠΊΠΎΠΌΠΎΡΠΈΠ²Π½ΠΎΠΌ Ρ
ΠΎΠ·ΡΠΉΡΡΠ²Π΅. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π΄Π°Π½Π½ΡΡ
ΡΠΈΡΡΠ΅ΠΌ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΠΎΠ»ΡΡΠΈΡΡ ΠΈΠ½ΡΠ΅Π³ΡΠ°Π»ΡΠ½ΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΡΠ΅ΠΏΠ»ΠΎΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π»ΠΎΠΊΠΎΠΌΠΎΡΠΈΠ²Π° Ρ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅ΠΉ Π½Π°ΡΡΠ½ΠΎ-ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠ΅ΠΉ ΠΌΠ΅ΠΆΡΠ΅ΠΌΠΎΠ½ΡΠ½ΡΡ
ΠΏΡΠΎΠ±Π΅Π³ΠΎΠ², ΠΏΡΠΎΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΠΎΠ²Π°ΡΡ Π΅Π³ΠΎ ΠΌΠ΅ΡΡΠΎΠ½Π°Ρ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ ΠΈ ΡΠ΅ΡΠΈΡΡ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²ΠΎ Π΄ΡΡΠ³ΠΈΡ
Π·Π°Π΄Π°Ρ, ΡΡΠΎ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΠ΅Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΠΆΡΠ΅ΠΌΠΎΠ½ΡΠ½ΡΡ
ΠΏΡΠΎΠ±Π΅Π³ΠΎΠ² ΠΈ ΡΡΠΎΠΊΠΎΠ² ΡΠΊΡΠΏΠ»ΡΠ°ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠ°Π±ΠΎΡΡ Π»ΠΎΠΊΠΎΠΌΠΎΡΠΈΠ²Π°
Πn experimental study of heat and mass transfer in a falling liquid film evaporation into a cross flow of a neutral gas
The work is devoted to the study of heat and mass transfer in a liquid film flowing down on a heated surface under conditions of evaporation into a crossflow of a gas neutral with respect to the liquid. The work aimed to experimentally determine the average heat transfer coefficients from a heated surface to the film, heat transfer and mass transfer from the film to the gas flow and to establish their dependence on the input parameters of the heat and mass transfer process. To achieve this goal, an experimental setup was created, and a research technique was developed based on the proposed mathematical model of the heat and mass transfer process. The results of the study showed that the dependences of the average heat and mass transfer coefficients on the initial liquid flow rate are extreme with the minimum values of these coefficients at the liquid flow rate, which corresponds to the critical value of the Reynolds criterion Re l cr β 500, which indicates a transition from the laminar falling films to turbulent mode under the considered conditions. The dependences of the heat and mass transfer coefficients on other process
parameters for both modes of film falling are established. A generalization of the experimental data made it possible to obtain empirical equations for calculating these coefficients
Les facteurs de la formation de la conduite destructive des infectΓ©s par le VIH
On sait que le VIH est une maladie infectieuse, qui provoque mΓ©diatement le dΓ©veloppement des maladies mentales, en consΓ©quence de la rΓ©action Γ la maladie, des nΓ©cessitΓ©s de se tenir au traitement de longue durΓ©e, du dΓ©veloppement des dΓ©faites organiques de l'encΓ©phale. Ces derniΓ¨res armΓ©es l'intΓ©rΓͺt pour le style particulier de la conduite des infectΓ©s de lβVIH, qui est le sΓ©rieux problΓ¨me mΓ©dico-social (il complique le traitement, contribue Γ la diffusion du VIH), a augmentΓ©
Raman scattering from confined phonons in GaAs/AlGaAs quantum wires
We report on photoluminescence and Raman scattering performed at low temperature (T = 10 K) on GaAs/Al 0.3Ga 0.7As quantum-well wires with effective wire widths of L = 100.0 and 10.9 nm prepared by molecular beam epitaxial growth followed by holographic patterning, reactive ion etching, and anodic thinning. We find evidence for the existence of longitudinal optical phonon modes confined to the GaAs quantum wire. The observed frequency at Ο L10 = 285.6 cm -1 for L = 11.0 nm is in good agreement with that calculated on the basis of the dispersive dielectric continuum theory of Enderleinβ as applied to the GaAs/Al 0.3Ga 0.7As system. Our results indicate the high crystalline quality of the quantum-well wires fabricated using these techniques. Β© 1998 Academic Press
Study of 0.3-0.8 THz flux generated by magnetized plasma column due to relaxation of high-current REB
World Health Organization: story of creation and development
Over its 70-year history, the World Health Organization (WHO) has become the leading global organization in the medical field. The publication analyses the history of the creation of the WHO. The authors also consider international health organizations, that have become the basis for the further creation of a global health organization
ΠΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΡΠΏΠ°Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ
Aim. To assess adhesions of the abdominal cavity in children with varying degrees of connective tissue dysplasia (CTD) severity.
Methods. A total of 91 children with average age of 10.6 1.4 years were observed from 2005 to 2019. Composed of 53 boys (58.2%) and 38 girls (41.8%). Patients were divided into two groups: group 1 (69 children without CTD) and group 2 (22 children with CTD). Clinical data and screening cards were used to diagnose DST. All patients underwent an assessment for the clinical course, a macroscopic visual assessment adhesive process severity in the abdominal cavity according to three different scales (Nair, F. Coccolini, N.I. Ayushinova). Immunohistochemistry was performed against collagen I, III, IV type, Laminin 1, angiogenesis factors, transforming growth factor beta (TGF-), and Fibroblast Growth Factor Receptor 1 (FGFR1). A semi-quantitative counting method was used to record the relative number of immunopositive structures. Statistical analysis was carried out by methods of variation statistics using the Chi-square test and MannWhitney U-tests, as well as the Spearman rank correlation method for the reliability of differences between groups.
Results. In the adhesive process visualization, the N.I. Ayushinov scale was revealed to be the most informative, showing the average score of 7 0.8 points in group 2 and 14 1.2 in group 1 (rs 0.35; p 0.05). In group 2, the adhesive material showed no (56%) or chaotic fragments (44%) of type I collagen, and the ratio of type I to type III collagen is 2.7: 5.1. In group 1, the ratio of type I to type III collagen is 5.9:1.8. The ratio of collagen IV to type I is 6.5: 2.9. Both groups have a moderate (++) amount of TGF-. TGF- is positive with macrophages. FGFR1 was found in the control group (++++). A positive response was seen in fibroblasts and macrophages (U = 79.00; p = 0.006). Statistically significant analyzes of vascular endothelial growth factor in compared groups (rs = 0.632, p 0.001) had a positive correlation..
Conclusion. Thus, the study showed features of clinical course and morphological changes during the development of adhesions in the abdominal cavity in children with varying degrees of severity of CTD. Data obtained dictate the need for an individual approach in predicting adhesive disease, as well as targeted preventive care.Π¦Π΅Π»Ρ. ΠΡΠ΅Π½ΠΊΠ° ΡΠΏΠ°Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ (ΠΠ‘Π’).
ΠΠ΅ΡΠΎΠ΄Ρ. Π ΠΏΠ΅ΡΠΈΠΎΠ΄ c 2005 ΠΏΠΎ 2019 Π³. Π½Π°Π±Π»ΡΠ΄Π°Π»ΡΡ 91 ΡΠ΅Π±Π΅Π½ΠΎΠΊ ΡΠΎ ΡΠΏΠ°Π΅ΡΠ½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 10,6 1,4 Π³ΠΎΠ΄Π°. ΠΠ°Π»ΡΡΠΈΠΊΠΎΠ² Π±ΡΠ»ΠΎ 53 (58,2 %), Π΄Π΅Π²ΠΎΡΠ΅ΠΊ 38 (41,8 %). ΠΠ°ΡΠΈΠ΅Π½ΡΡ Π±ΡΠ»ΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° 2 Π³ΡΡΠΏΠΏΡ: Π³ΡΡΠΏΠΏΠ° 1 (69 Π΄Π΅ΡΠ΅ΠΉ Π±Π΅Π· ΠΠ‘Π’) ΠΈ Π³ΡΡΠΏΠΏΠ° 2 (22 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΠΠ‘Π’). ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ ΠΠ‘Π’ ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΈ Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΈ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³ΠΎΠ²ΡΡ
ΠΊΠ°ΡΡ. Π£ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ, ΠΌΠ°ΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠ°Ρ Π²ΠΈΠ·ΡΠ°Π»ΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΡΠΏΠ°Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° Π² Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ ΠΏΠΎ ΡΡΠ΅ΠΌ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌ ΡΠΊΠ°Π»Π°ΠΌ (Nair, F. Coccolini, Π.Π. ΠΡΡΠΈΠ½ΠΎΠ²Π°). ΠΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΊ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Ρ I, III, IV ΡΠΈΠΏΠΎΠ², ΠΊ Laminin 1, ΡΠ°ΠΊΡΠΎΡΠ°ΠΌ Π°Π½Π³ΠΈΠΎΠ³Π΅Π½Π΅Π·Π°, TGF- ΠΈ FGFR1. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ Π²Π°ΡΠΈΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Ρ
ΠΈ-ΠΊΠ²Π°Π΄ΡΠ°Ρ-ΡΠ΅ΡΡΠ°, U-ΡΠ΅ΡΡΠΎΠ² ΠΠ°Π½Π½Π°Π£ΠΈΡΠ½ΠΈ, Π΄Π»Ρ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎΡΡΠΈ ΡΠ°Π·Π»ΠΈΡΠΈΠΉ ΠΌΠ΅ΠΆΠ΄Ρ Π³ΡΡΠΏΠΏΠ°ΠΌΠΈ, ΡΠ°ΠΊΠΆΠ΅ ΠΌΠ΅ΡΠΎΠ΄ ΡΠ°Π½Π³ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΈ Π‘ΠΏΠΈΡΠΌΠ΅Π½Π°.
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΏΠ°Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎΠΉ ΠΎΠΊΠ°Π·Π°Π»Π°ΡΡ ΡΠΊΠ°Π»Π° Π.Π. ΠΡΡΠΈΠ½ΠΎΠ²Π°. ΠΡΠΈ ΡΡΠΎΠΌ Π² Π³ΡΡΠΏΠΏΠ΅ 2 ΡΡΠ΅Π΄Π½ΠΈΠΉ Π±Π°Π»Π» ΡΠΎΡΡΠ°Π²ΠΈΠ» 7 0,8 Π±Π°Π»Π»Π°, Π² Π³ΡΡΠΏΠΏΠ΅ 1 14 1,2 Π±Π°Π»Π»Π° (rs 0,35; Ρ 0,05). Π Π³ΡΡΠΏΠΏΠ΅ 2 Π² ΠΈΠ½ΡΡΠ°Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΡΡ
ΡΠΏΠ°ΠΉΠΊΠ°Ρ
ΠΎΡΡΡΡΡΡΠ²ΠΎΠ²Π°Π»ΠΈ (56 %) ΠΈΠ»ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈΡΡ Ρ
Π°ΠΎΡΠΈΡΠ½ΡΠ΅ ΡΡΠ°Π³ΠΌΠ΅Π½ΡΡ (44 %) ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Π° I ΡΠΈΠΏΠ°. Π‘ΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Π° I ΡΠΈΠΏΠ° ΠΊ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Ρ III ΡΠΈΠΏΠ° ΡΠΎΡΡΠ°Π²Π»ΡΠ»ΠΎ 2,7:5,1. Π Π³ΡΡΠΏΠΏΠ΅ 1 ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Π° I ΡΠΈΠΏΠ° ΠΊ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Ρ III ΡΠΈΠΏΠ° 5,9:1,8. Π‘ΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Π° IV ΠΊ ΠΊΠΎΠ»Π»Π°Π³Π΅Π½Ρ I ΡΠΈΠΏΠ° 6,5:2,9. Π ΠΎΠ±ΠΎΠΈΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π±ΡΠ»ΠΎ ΡΠΌΠ΅ΡΠ΅Π½Π½ΠΎΠ΅ (++) ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ TGF-. FGFR1 ΠΈΠΌΠ΅Π» ΠΌΠ΅ΡΡΠΎ Π² Π³ΡΡΠΏΠΏΠ΅ 1 (++++). ΠΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅Π°ΠΊΡΠΈΡ Π±ΡΠ»Π° Π² ΡΠΈΠ±ΡΠΎΠ±Π»Π°ΡΡΠ°Ρ
ΠΈ ΠΌΠ°ΠΊΡΠΎΡΠ°Π³Π°Ρ
(U = 79,00; Ρ = 0,006). Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈΡΡ Π΄Π»Ρ VEGF Π² ΡΡΠ°Π²Π½ΠΈΠ²Π°Π΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
(rs = 0,632; Ρ 0,001) Ρ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠ²ΡΠ·ΡΡ.
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΏΡΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΡΠΏΠ°Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ Π΄ΠΈΡΠΏΠ»Π°Π·ΠΈΠΈ ΡΠΎΠ΅Π΄ΠΈΠ½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ Π΄ΠΈΠΊΡΡΡΡ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° Π² ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΡΠΏΠ°Π΅ΡΠ½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ΅Π»Π΅Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΉ Π»Π΅ΡΠ΅Π±Π½ΠΎ-ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ
ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠD-Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΡΠΌ ΡΡ ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΠΎΠ·ΠΎΠΌ
BACKGROUND: Laparoscopy in the treatment of abdominal echinococcosis is accompanied by complications. Therefore, studies on optimizing surgical approaches that reduce intra- and postoperative complications in liver echinococcosis are extremely relevant.
AIM: This study aimed to assess the possibility of using three-dimensional (3D) technologies in children with abdominal echinococcosis to determine whether it can increase the efficiency of laparoscopic treatment and reduce complications.
MATERIALS AND METHODS: A prospective analysis was conducted from 2013 to 2019 among 43 children with isolated liver echinococcosis who underwent multiport laparoscopic echinococcectomy. In the preoperative period, 25 patients from the main group used a complex of modern 3D technology: creating a 3D reconstruction of a liver with a parasitic cyst and then printing a 3D model of an organ with vessels and bile ducts.
RESULTS: The use of virtual computer visualization with the 3D reconstruction of the parasitic cyst and adjacent blood vessels with bile ducts made it possible to produce a 3D liver model. This approach provided the possibility of personalized laparoscopic access and precision in performing surgeries. Postoperatively, residual cavity (n = 1, 4.0%) was observed in the main group and biliary fistula and residual cavity (n = 2, 11.1%) in the comparison group
CONCLUSIONS: Thus, the use of 3D technologies in children with abdominal echinococcosis can increase the efficiency of laparoscopic treatment and reduce the number of early and late complications.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΠΎΠ·Π° ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. ΠΠΎΡΡΠΎΠΌΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π½Π° ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΎΠ², ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°ΡΡΠΈΡ
ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΈΠ½ΡΡΠ°- ΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΠΏΡΠΈ ΡΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΠΎΠ·Π΅ ΠΏΠ΅ΡΠ΅Π½ΠΈ, ΡΠ²Π»ΡΡΡΡΡ ΠΊΡΠ°ΠΉΠ½Π΅ Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌΠΈ.
Π¦Π΅Π»Ρ. ΠΡΠ΅Π½ΠΊΠ° Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ 3D-ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΡΠΌ ΡΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΠΎΠ·ΠΎΠΌ, ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ²ΡΠΈΡ
ΠΏΠΎΠ²ΡΡΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ.
ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Ρ 2013 ΠΏΠΎ 2019 Π³. Ρ 43 Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΈΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΡΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΠΎΠ·ΠΎΠΌ ΠΏΠ΅ΡΠ΅Π½ΠΈ, ΠΊΠΎΡΠΎΡΡΠΌ Π²ΡΠΏΠΎΠ»Π½ΡΠ»Π°ΡΡ ΠΌΠ½ΠΎΠ³ΠΎΠΏΠΎΡΡΠΎΠ²Π°Ρ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΡΠΊΡΠΎΠΌΠΈΡ. Π ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ 25 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΡΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
3D-ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ (ΡΠΎΠ·Π΄Π°Π½ΠΈΠ΅ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ 3D-ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΠΏΠ΅ΡΠ΅Π½ΠΈ Ρ ΠΏΠ°ΡΠ°Π·ΠΈΡΠ°ΡΠ½ΠΎΠΉ ΠΊΠΈΡΡΠΎΠΉ ΠΈ ΠΏΠ΅ΡΠ°ΡΡ 3D-ΠΌΠΎΠ΄Π΅Π»ΠΈ ΠΎΡΠ³Π°Π½Π° Ρ ΡΠΎΡΡΠ΄Π°ΠΌΠΈ ΠΈ ΠΆΠ΅Π»ΡΠ΅Π²ΡΠ²ΠΎΠ΄ΡΡΠΈΠΌΠΈ ΠΏΡΠΎΡΠΎΠΊΠ°ΠΌΠΈ).
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ Π²ΠΈΡΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Ρ ΡΡΠ΅Ρ
ΠΌΠ΅ΡΠ½ΠΎΠΉ ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ΅ΠΉ ΠΏΠ°ΡΠ°Π·ΠΈΡΠ°ΡΠ½ΠΎΠΉ ΠΊΠΈΡΡΡ ΠΈ ΠΏΡΠΈΠ»Π΅ΠΆΠ°ΡΠΈΡ
ΠΊ Π½Π΅ΠΉ ΠΊΡΠΎΠ²Π΅Π½ΠΎΡΠ½ΡΡ
ΡΠΎΡΡΠ΄ΠΎΠ² Ρ ΠΆΠ΅Π»ΡΠ½ΡΠΌΠΈ ΠΏΡΠΎΡΠΎΠΊΠ°ΠΌΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΠΈΠ·Π³ΠΎΡΠΎΠ²ΠΈΡΡ 3D-ΠΌΠΎΠ΄Π΅Π»Ρ ΠΏΠ΅ΡΠ΅Π½ΠΈ. ΠΠ°Π½Π½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ» Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°. ΠΡΠΈ ΡΡΠΎΠΌ Π² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΎΡΡ Π² ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΎΠ΄Π½ΠΎΠ³ΠΎ (4,0 %) ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ (ΠΎΡΡΠ°ΡΠΎΡΠ½Π°Ρ ΠΏΠΎΠ»ΠΎΡΡΡ). Π Π³ΡΡΠΏΠΏΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΠΈΠΌΠ΅Π»ΠΎ ΠΌΠ΅ΡΡΠΎ Π΄Π²Π° (11,1 %) ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ Π² Π²ΠΈΠ΄Π΅ ΠΆΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ²ΠΈΡΠ° ΠΈ ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ.
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ 3D-ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΡΠΌ ΡΡ
ΠΈΠ½ΠΎΠΊΠΎΠΊΠΊΠΎΠ·ΠΎΠΌ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΠΎΠ²ΡΡΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡ
ΠΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΌΠ΅ΠΆΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ Π²Π΅ΡΠ΅ΡΡΠ²Π° Π³ΠΈΠΏΠ΅ΡΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ ΡΡΠ±ΡΠΎΠ² Π½Π° ΡΠΎΠ½Π΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΡΠ±ΡΠΎΠ²ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ
AIM: This study aimed to assess the formation of scar tissue after burns under the influence of an anti-scar gel. Understanding of the processes involving scars and the morphofunctional features of the tissue at different stages of development allows targeted selection of therapy and prevention of scars.
MATERIALS AND METHODS: We conducted a comparative prospective analysis from 2005 to 2020. Of which two groups were identified. In group 1 (n = 47), burns were treated according to the standard scheme without the use of modern wound coverings. In group 2 (n = 41), early primary prevention of pathological scarring was performed, where the Contractubex gel was applied to the area of burn injury from the moment of epithelialization. Histological examination included the analysis of skin biopsies in the area of damage before and after conservative treatment.
RESULTS: Histological examination showed quantitative changes in the cellular composition of the scar tissue in all groups. The average quantitative index of the fibroblast activity was significantly reduced in group 2 using Contractubex gel. Thickness of collagen fibers, according to the morphometric analysis, is most reduced in all layers of the dermis in group 2 (p 0.05). In group 1, collagen fibers are represented as nodular clusters; in some areas of the reticular layer of the dermis, fibers have a more fragmented appearance. In group 2, the use of Contractubex leads to a significant decrease in the level of tumor growth factor- in the papillary and reticular layers of the dermis.
CONCLUSION: The use of Contractubex gel in the early prevention of pathological scarring significantly reduces the need for subsequent reconstructive surgical interventionsΠ¦Π΅Π»Ρ. Π Π΄Π°Π½Π½ΠΎΠΉ ΡΡΠ°ΡΡΠ΅ ΡΠ΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΠ»ΡΠΆΠΈΠ»Π° ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ±ΡΠΎΠ²ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΎΠΆΠΎΠ³ΠΎΠ² ΠΏΠΎΠ΄ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ΠΌ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΡΠ±ΡΠΎΠ²ΠΎΠ³ΠΎ Π³Π΅Π»Ρ. Π’Π°ΠΊ ΠΊΠ°ΠΊ ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ², ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΡΡΠΈΡ
Π² ΡΡΠ±ΡΠ°Ρ
, ΠΈ ΠΌΠΎΡΡΠΎΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΡΠΊΠ°Π½ΠΈ Π½Π° ΡΠ°Π·Π½ΡΡ
ΡΡΠ°ΠΏΠ°Ρ
ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΡΡ ΡΠ°ΡΠ³Π΅ΡΠ½ΡΠΉ ΠΏΠΎΠ΄Π±ΠΎΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΡΡΠ±ΡΠΎΠ².
ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Ρ 2005 ΠΏΠΎ 2020 Π³. ΠΡΠ»ΠΈ Π²ΡΠ΄Π΅Π»Π΅Π½Ρ 2 Π³ΡΡΠΏΠΏΡ. Π Π³ΡΡΠΏΠΏΠ΅ 1 (47 Π±ΠΎΠ»ΡΠ½ΡΡ
) Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΠΆΠΎΠ³Π°ΠΌΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΏΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΡΡ
Π΅ΠΌΠ΅ Π±Π΅Π· ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΡΠ°Π½Π΅Π²ΡΡ
ΠΏΠΎΠΊΡΡΡΠΈΠΉ. Π Π³ΡΡΠΏΠΏΠ΅ 2 (41 ΠΏΠ°ΡΠΈΠ΅Π½Ρ) ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΡΠ°Π½Π½ΡΡ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΡΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ±ΡΠ°, Π³Π΄Π΅ ΠΈΠΌ Ρ ΠΌΠΎΠΌΠ΅Π½ΡΠ° Π½Π°ΡΡΡΠΏΠ»Π΅Π½ΠΈΡ ΡΠΏΠΈΡΠ΅Π»ΠΈΠ·Π°ΡΠΈΠΈ Π½Π° ΠΎΠ±Π»Π°ΡΡΡ ΠΎΠΆΠΎΠ³ΠΎΠ²ΠΎΠΉ ΡΡΠ°Π²ΠΌΡ Π΅ΠΆΠ΅Π΄Π½Π΅Π²Π½ΠΎ Π½Π°Π½ΠΎΡΠΈΠ»ΠΈ Π³Π΅Π»Ρ ΠΠΎΠ½ΡΡΠ°ΠΊΡΡΠ±Π΅ΠΊΡ. ΠΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ°Π»ΠΎ Π°Π½Π°Π»ΠΈΠ· Π±ΠΈΠΎΠΏΡΠ°ΡΠΎΠ² ΠΊΠΎΠΆΠΈ Π² Π·ΠΎΠ½Π΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π΄ΠΎ ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ.
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Ρ Π²ΡΠ΅Ρ
ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π² Π³ΡΡΠΏΠΏΠ°Ρ
Π½Π°Π±Π»ΡΠ΄Π°ΡΡΡΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠΎΡΡΠ°Π²Π° ΡΡΠ±ΡΠΎΠ²ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ. Π£ΡΡΠ΅Π΄Π½Π΅Π½Π½ΡΠΉ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΈΠ±ΡΠΎΠ±Π»Π°ΡΡΠΎΠ² Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ Π² Π³ΡΡΠΏΠΏΠ΅ 2 ΠΏΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ Π³Π΅Π»Ρ ΠΠΎΠ½ΡΡΠ°ΠΊΡΡΠ±Π΅ΠΊΡ. Π’ΠΎΠ»ΡΠΈΠ½Π° ΠΊΠΎΠ»Π»Π°Π³Π΅Π½ΠΎΠ²ΡΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½, ΠΏΡΠΈ ΠΌΠΎΡΡΠΎΠΌΠ΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠΌ Π°Π½Π°Π»ΠΈΠ·Π΅, Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ½ΠΈΠΆΠ΅Π½Π° Π²ΠΎ Π²ΡΠ΅Ρ
ΡΠ»ΠΎΡΡ
Π΄Π΅ΡΠΌΡ ΠΊΠΎΠΆΠΈ Π² Π³ΡΡΠΏΠΏΠ΅ 2 (p 0,05). Π Π³ΡΡΠΏΠΏΠ΅ 1 ΠΊΠΎΠ»Π»Π°Π³Π΅Π½ΠΎΠ²ΡΠ΅ Π²ΠΎΠ»ΠΎΠΊΠ½Π° ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π² Π²ΠΈΠ΄Π΅ ΡΠ·Π΅Π»ΠΊΠΎΠ²ΡΡ
ΡΠΊΠΎΠΏΠ»Π΅Π½ΠΈΠΉ, Π² Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
ΡΡΠ°ΡΡΠΊΠ°Ρ
ΡΠ΅ΡΡΠ°ΡΠΎΠ³ΠΎ ΡΠ»ΠΎΡ Π΄Π΅ΡΠΌΡ Π²ΠΎΠ»ΠΎΠΊΠ½Π° ΠΈΠΌΠ΅ΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΡΠ°Π³ΠΌΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π²ΠΈΠ΄. Π Π³ΡΡΠΏΠΏΠ΅ 2, Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΠΎΠ½ΡΡΠ°ΠΊΡΡΠ±Π΅ΠΊΡΠ°, Π½Π°Π±Π»ΡΠ΄Π°Π΅ΡΡΡ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Ρ TGF- Π² ΡΠΎΡΠΎΡΠΊΠΎΠ²ΠΎΠΌ ΠΈ ΡΠ΅ΡΡΠ°ΡΠΎΠΌ ΡΠ»ΠΎΡΡ
Π΄Π΅ΡΠΌΡ.
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π³Π΅Π»Ρ ΠΠΎΠ½ΡΡΠ°ΠΊΡΡΠ±Π΅ΠΊΡ Π² ΡΡ
Π΅ΠΌΠ°Ρ
ΡΠ°Π½Π½Π΅ΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ±ΡΠ° Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠΌΠ΅Π½ΡΡΠ°Π΅Ρ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠΈΡ
ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ²Π½ΡΡ
Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²