THE THERAPEUTIC TACTICS OF INTRA-ARTICULAR FRACTURES OF THE ANKLE (LITERATURE REVIEW)

As a result of the analysis of literature it was revealed that in case of pronation-abduction ankle injury takes place injury of the articular surfaces. The hyaline cartilage significantly suffers. Typical localization of damage of the articular cartilage is the middle or front third of the inner edge of talus block. The damage can spread to articular surface of the outer block of the talus. In 50 % cases the articular cartilage is the front edge of the tibia is damaged. The combination of damages of the articular cartilage of the inner edge of the block of the talus and the outside the department anterior edge of the tibia is more often (from 43 % till 57 %). In 80 % cases the damage of the articular cartilage surface of the talus ankle as roughness, cracks, defects with exposure of subchondral bone was revealed. The results say that in case of damage bony and ligamentous structures of the ankle at the joint pronation-abduction mechanism the articular cartilage significantly suffers. The size and character of the damages of the articular cartilage differs. i4s a result we can say that initially severe damage of the articular cartilage at trauma will significantly worsen the immediate and long-term results and this fact should be taken into account while making plan of the treatment of patients with ankle injury

Comparative Determination of the Mechanical Strength of a Transplant from a Tendon of a Semitendinosus Muscle for Plastic Surgery of the Anterior Cruciate Ligament Prepared in Various Ways (Experimental Study)

According to modern literature, a sufficient number of studies have been carried out to determine the mechanical strength of transplants from the tendon of the semitendinous and gracilis muscles, the autologous ligament of the patella, the broad fascia, peroneus longus tendon, each of which has unique characteristics, but at present, transplants prepared by original (new) methods are understudied.In the period from November 5 to December 17,2018 we conducted an experimental study to determine the mechanical strength of a transplant from a tendon of a semitendinosus muscle taken from cadaveric material. The transplants were prepared by original and well-known (Graft-Link technique) methods.The experimental study was approved by the Ethics committee of Irkutsk Scientific Center of Surgery and Traumatology. The material for the study was prepared on the basis of the Irkutsk Regional Bureau of Forensic Medical Examination.After sampling the cadaveric material being studied, the main stages of the experimental study were carried out at the materials resistance department of the Irkutsk State Technical University. Studies of the mechanical properties of the transplant were carried out on a Shimadzu testing machine registered in the State Register of Measuring Instruments and approved for use in the Russian Federation.As a result of the study, we obtained the following data. The mechanical strength of the graft obtained from the tendon of the semitendinosus muscle in an original way is on average 607.8 ± 101.2 N/mm. The mechanical strength of the graft obtained from the tendon of the semitendinosus muscle in a traditional manner (Graft-Link technique) is on average 351.8 ± 133.0 N/ mm

Tobacco peroxidase as a new reagent for amperometric biosensors

The results of testing a new enzyme, anionic tobacco peroxidase (TOP), in various amperometric biosensors are summarized. The biochemical and electrochemical properties of the enzyme are briefly characterized. As compared to the commonly used cationic peroxidase from horseradish roots, TOP exhibits a wider optimum stability pH range, higher stability to inactivation with hydrogen peroxide, and higher efficiency in direct electron-transfer processes. The enzyme immobilized by adsorption on graphite is effective in determining aminophenols and aromatic diamines under flow conditions with a detection limit of 10 nM. Upon immobilization on graphite by incorporation into a get of a redox-active polymer (crosslinked polyvinylimidazole with osmium 4,4'-dimethylbipyridinium chloride), TOP exhibited sensitivity and stability comparable to those of horseradish peroxidase and a wider linearity range. Upon immobilization on a self-assembled thiol monolayer at a gold electrode, TOP was much superior to horseradish peroxidase in the sensitivity of determining hydrogen peroxide, regardless of the charge of the monolayer. Prospects for the further use of the native enzyme and its genetically engineered unglycosylated form are considered

Comparative analysis of the results of the anterior cruciate ligament reconstruction using an autograft preparation by known and new methods

Background. To date, the problem of choosing the optimal graft for anterior cruciate ligament (ACL) reconstruction and the methods for its formation is one of the main trends in the surgical treatment of patients with anterior knee joint instability.The aim. To compare the results of the anterior cruciate ligament reconstruction using the known method and the new proposed method for autograft formation.Materials and methods. The results of treatment of ACL injury in 44 patients were assessed. In the main group (19 patients), an original technique of ACL reconstruction from 1/2 of the width of m. peroneus longus tendon was used. In the control group (25 patients), ACL reconstruction was performed using a graft from the m. semitendinosus tendon prepared by the Lubowitz method.Results. The mean difference in the circumference of the distal third of the hip in the main group was 1.57 ± 1.162 cm and was statistically significantly better than in the control group, where the mean difference in the hip circumference was 4.74 ± 1.7207 cm.The range of motion of the knee joint in the main group 3 months after the surgery was 128.42 ± 9.287°, and in the control group mean flection was 109.6 ± 9.120°.The functional results in the main group were assessed by the Lisholm scale and were statistically significantly better than the results in the control group. The functional results by the AOFAS (American Orthopedic Foot & Ankle Society) scale in the main group were 100 points before the surgery and at all terms after the surgery: this indicates that the use of 1/2 of the width of m. peroneus longus tendon does not cause the its functional impairement.Conclusion. Anterior cruciate ligament plasty with use of 1/2 of the width of m. peroneus longus tendon prepared by the proposed method showed statistically significantly better results compared to the preparation of autograft from semitendinous muscle tendon using known method

Анализ производственного и финансового потенциала как основы для разработки стратегии модернизации экономики России

The article is devoted to an assessment of the potential for modernization of the Russian economy in the face of external challenges that make it difficult for domestic companies to access international financial markets and technologies. The relevance of the study is due to the need to search for own resources for the required large-scale modernization. The purpose of the study is to assess the production and financial potential in the modernization process. This goal predetermines the solution of such problems as analysis of the current state of the production base, assessment of financial resources for the production upgrade, identification of opportunities and risks in the implementation of modernization processes. In this connection, the authors focus on analyzing the factors constraining modernization processes, such as: a low level of capital accumulation, inadequate development of the financial services market, and uneven spatial accessibility of credit institutions.The methodological apparatus for analyzing the production and financial potential is based on the allocation of basic non-financial sectors of the economy and the financial market, using the methods of detailing, grouping, vertical and horizontal analysis, comparison and synthesis. In addition, graphical analysis is used. The empirical basis of the study was the statistical indicators of the Federal State Statistics Service for the branches of the economy and the data of the Central Bank of the Russian Federation on the state of the banking sector. The theoretical basis was the works of well-known scientists, dedicated to the issues of re-industrialization and the development of strategic priorities for innovative modernization of the Russian economy.The article compares the dynamics of investment in fixed assets with the rate of increase in depreciation of production assets, analyzes the sources of financing investment activities in the part of updating production systems, and assesses the methods of state regulation of the banking sector as one of the main external suppliers of investment resources in non-financial sectors of the economy. The quality of regulation of financial market institutions is assessed from the standpoint of its diversification and ensuring greater accessibility to the borrowed capital of not only business but also the population.Based on the results of the analysis, factors that limit the scope for large-scale structural modernization of the economy are identified. It is revealed that the pace of renewal of fixed capital is insufficient and does not contribute to reducing the wear and tear of production assets in the basic sectors of the Russian economy. The availability of borrowed capital for the modernization of production systems is differentiated in a spatial aspect. The functioning institutions of the financial market also do not ensure equal access to credit resources for small and medium-sized businesses.The scientific novelty of this study is that the authors identified the main problems of the process of modernization and implementation of innovative developments in the context of high levels of depreciation of production systems and inadequate investment resources. In addition, worthy of attention is the conclusion that the structure of the financial services market is inadequate for the scale of structural modernization and it needs to be diversified. The results of the research can find practical application in the development of modernization strategies in the leading sectors of the economy.Статья посвящена оценке потенциальных возможностей модернизации экономики России в условиях внешних вызовов, затрудняющих отечественным компаниям доступ к международным финансовым рынкам и технологиям. Актуальность исследования обусловлена необходимостью поиска собственных ресурсов для проведения требуемой масштабной модернизации. Целью исследования является оценка производственного и финансового потенциала в процессе модернизации. Поставленная цель предопределяет решение таких задач как: проведение анализа современного состояния производственной базы, оценка финансовых ресурсов для обновления производства, выявление возможностей и рисков при проведении модернизационных процессов. В этой связи основное внимание авторы уделяют анализу факторов, сдерживающих модернизационные процессы, таких как: низкий уровень накопления капитала, неадекватное потребностям экономики развитие рынка финансовых услуг, неравномерность пространственной доступности кредитных организаций.Методологический аппарат анализа производственного и финансового потенциала строится на выделении базовых нефинансовых секторов экономики и финансового рынка с применением методов детализации, группировки, вертикального и горизонтального анализа, сравнения и синтеза. Кроме того используется графический анализ. Эмпирическую базу исследования составили статистические показатели Росстата по отраслям экономики и данные Центрального Банка Российской Федерации по состоянию банковской сферы. Теоретической основой послужили труды известных ученых, посвященные вопросам реиндустриализации и выработки стратегических приоритетов инновационной модернизации экономики России. В статье проводится сравнение динамики инвестиций в основной капитал с темпами нарастания износа производственных фондов, анализируются источники финансирования инвестиционной деятельности в части обновления производственных систем, дается оценка методов государственного регулирования банковского сектора как одного из основных внешних поставщиков инвестиционных ресурсов в нефинансовые сектора экономики. Качество регулирования институтов финансового рынка оценивается с позиций его диверсификации и обеспечения большей доступности к заемному капиталу не только бизнеса, но и населения.По результатам анализа выделены факторы, ограничивающие возможности масштабной структурной модернизации экономики. Выявлено, что темпы обновления основного капитала недостаточны и не способствуют снижению износа производственных фондов в базовых отраслях экономики России. Доступность заемного капитала для модернизации производственных систем дифференцирована в пространственном аспекте. Действующие институты финансового рынка также не обеспечивают равный доступ к кредитным ресурсам субъектам малого и среднего предпринимательства.Научная новизна данного исследования заключается в том, что авторы обозначили основные проблемы процесса модернизации и внедрения инновационных разработок в условиях высокого уровня износа производственных систем и недостаточности инвестиционных ресурсов. Также заслуживает внимания вывод о неадекватности структуры рынка финансовых услуг масштабам структурной модернизации и необходимости его диверсификации. Результаты исследования могут найти практическое применение при разработке стратегий модернизации в ведущих отраслях экономики

Assessment of the effectiveness of surgical treatment of patients with massive tears of the rotator cuff tendons using arthroscopically assisted transposition of the latissimus dorsi tendon

Rotator cuff tears are one of the most common musculoskeletal injuries and account for about 20 %. Massive rotator cuff tears account for up to 40 % of all tears. There  is  no  single approach in the treatment of patients with massive rotator cuff tears. We have developed a new method of surgical treatment of these patients – arthroscopically assisted transposition of the latissimus dorsi tendon using 1/2 of the tendon of the long peroneal muscle. The aim of the study. To assess the effectiveness of surgical treatment of patients with massive rotator cuff tears who had arthroscopically assisted transposition of the latissimus dorsi tendon using an autograft of a 1/2 of the tendon of the long peroneal muscle. Materials and methods. The study included 15  patients with Patte stage  III and Thomazeau grade 2–3 massive rotator cuff tears, who had arthroscopically assisted transposition of the latissimus dorsi tendon using 1/2 of the tendon of the long peroneal muscle. Results. The article presents the long-term results of surgical treatment of patients using the developed method. The following criteria were evaluated: average age; time since injury; duration of surgery. Functional outcome was assessed using the ASES (American Shoulder and Elbow Surgeons) scale. Taking into account the indicators on the ASES functional scale 1 year after surgical treatment, the following results were obtained: excellent – in 14 (93.3 %) patients, satisfactory – in 1 (6.7 %) patient. Conclusion. The developed method allows us to restore the function of the shoulder joint as early as it possible, to reduce the severity of the pain syndrome and to improve the quality of life of patients

Bacterial formate dehydrogenase. Increasing the enzyme thermal stability by hydrophobization of alpha-helices

AbstractNAD+-dependent formate dehydrogenase (EC 1.2.1.2, FDH) from methylotrophic bacterium Pseudomonas sp.101 exhibits the highest stability among the similar type enzymes studied. To obtain further increase in the thermal stability of FDH we used one of general approaches based on hydrophobization of protein α-helices. Five serine residues in positions 131, 160, 168, 184 and 228 were selected for mutagenesis on the basis of (i) comparative studies of nine FDH amino acid sequences from different sources and (ii) with the analysis of the ternary structure of the enzyme from Pseudomonas sp.101. Residues Ser-131 and Ser-160 were replaced by Ala, Val and Leu. Residues Ser-168, Ser-184 and Ser-228 were changed into Ala. Only Ser/Ala mutations in positions 131, 160, 184 and 228 resulted in an increase of the FDH stability. Mutant S168A was 1.7 times less stable than the wild-type FDH. Double mutants S(131,160)A and S(184,228)A and the four-point mutant S(131,160,184,228)A were also prepared and studied. All FDH mutants with a positive stabilization effect had the same kinetic parameters as wild-type enzyme. Depending on the position of the replaced residue, the single point mutation Ser/Ala increased the FDH stability by 5–24%. Combination of mutations shows near additive effect of each mutation to the total FDH stabilization. Four-point mutant S(131,160,184,228)A FDH had 1.5 times higher thermal stability compared to the wild-type enzyme

Assessment of the effectiveness of surgical treatment of patients with massive ruptures of rotator cuff tendons using latissimus dorsi tendon transposition

Rotator cuff ruptures are the most common injuries of shoulder joint with an incidence of about 20 %. This pathology is more common in adults over 60 years of age because it is caused by degenerative changes in the tendon. Massive injuries account for 10–40 % of all rotator cuff injuries. Currently, there is no unified surgical tactics for the treatment of patients with massive ruptures of rotator cuff tendons.The aim. To assess the efficiency of transposition of the latissimus dorsi tendon in patients with massive ruptures of the rotator cuff tendon.Materials and methods. The study included 15 patients with Patte stage III massive ruptures of the rotator cuff who had transposition of the latissimus dorsi tendon.Results. The article presents clinical cases of surgical treatment of patients. The following criteria were assessed: mean age; time since injury; duration of the surgery; blood loss volume; functional results by the ASES (American Shoulder and Elbow Surgeons) Shoulder Score. Taking into account the ASES Shoulder Score indicators 1 year after the surgical treatment, the following results were obtained: excellent results – in 9 (53.3 %) cases; good results – in 1 (13.4 %) case; satisfactory results – in 5 (33.3 %) cases.Conclusion. When preserving the articular cartilage, the method of choice in the treatment of patients with massive ruptures of rotator cuff tendons is transposition of the latissimus dorsi tendon. At the same time, an incomplete restoration of the function of the injured limb was registered in 33.3 % of patients, which requires further study and modification of the known method of transposition of the latissimus dorsi tendon

MODERN METHODS OF ANTERIOR CRUCIATE LIGAMENT TENDOPLASTY (LITERATURE REVIEW)

The first description of surgical treatment of anterior cruciate ligament injuries has become known about a hundred years ago. At the beginning, complete ruptures of the anterior cruciate ligament was treated by open restoration with arthrotomy. At present, open ACL plasty is practically out of use, except for single cases. In recent decades, worldwide, surgical treatment of knee ligament injuries has been performed with arthroscopic techniques. It has long been proven that arthroscopic operations are able to restore the primary anatomy of the damaged joint, combining anatomical validity and minimal traumaticity, pathogenetic justification and high functional efficiency. For more than 50 years, surgeons have been offered many different materials and methods for ACL reconstruction, but nevertheless there is currently no consensus on the choice of rational treatment tactics and the percentage of unsatisfactory results remains significant. Based on the data of modern authors, it can be concluded that the issue of knee joint ligaments damage not only does not lose its relevance, but, on the contrary, due to the increased interest in active lifestyle, it becomes more and more popular and studied. The article presents various views on the basic methods of arthroscopic restoration of the anterior cruciate ligament of the knee joint at the present stage of the development of surgery

Influence of disturbed conditions of reparative regeneration of bone tissue on the dynamics of thyroid hormones

Managing bone tissue regeneration is a key problem in traumatology and orthopedics. The researches proved that thyroid hormones affect hemostasis and reparative regeneration of bone tissue favorably and promote osteogenesis and bone consolidation. The aim of this research is to study the influence of disturbed reparative regeneration on the concentration of thyroid hormones in blood in the dynamics. Experimental research on rabbits (n = 12) with modelling of disturbed reparative regeneration revealed disorder in thyroid hormones synthesis and different directions of T3 and unbound T3 production on the 35th day when the maximum decrease of T3 (2 times) and unbound T3 (1.5 times) compared to normal values was registered. The analysis of production of T4 and unbound T4 revealed suppression of the values from the 1st to 50th day and gradual increase in unbound T4 from the 50th day. The most significant manifestation of thyroid gland reaction on the disturbed reparative regeneration of shin bones was the decrease in T3 and peripheral conversion of thyroid hormones up to 50th day with formation of false joint in these terms