44 research outputs found
Finite-difference iterative solver with spectrally equivalent preconditioner for anisotropic electrical impedance tomography problems
ΡΠ΅ΠΊΡΠΈΡ: ΠΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΠΈ ΠΈΡ
ΠΏΡΠΈΠ»ΠΎΠΆΠ΅Π½ΠΈ
Investigation of the properties of magnetocaloric Mn1-xFexNiGe (0.05 β€ x β€ 0.30) films
MnNiGe-based solid solutions are currently positioned as βgreenβ magnetocaloric materials, promising for use in magnetic refrigerators [1-3]. The magnetic behavior of the MnNiGe system is strongly dependent on doping, special heat treatment, pressure imposition, etc. One of the most important factors determining the magnetic behavior of the system is the state of the sample - film or massive. Π’Π²Π΅ΡΠ΄ΡΠ΅ ΡΠ°ΡΡΠ²ΠΎΡΡ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ MnNiGe Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΠΎΠ·ΠΈΡΠΈΠΎΠ½ΠΈΡΡΡΡΡΡ ΠΊΠ°ΠΊ Β«Π·Π΅Π»Π΅Π½ΡΠ΅Β» ΠΌΠ°Π³Π½ΠΈΡΠΎΠΊΠ°Π»ΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ, ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠ΅ Π΄Π»Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π² ΠΌΠ°Π³Π½ΠΈΡΠ½ΡΡ
Ρ
ΠΎΠ»ΠΎΠ΄ΠΈΠ»ΡΠ½ΠΈΠΊΠ°Ρ
[1-3]. ΠΠ°Π³Π½ΠΈΡΠ½ΠΎΠ΅ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΡ MnNiGe ΡΠΈΠ»ΡΠ½ΠΎ Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ Π»Π΅Π³ΠΈΡΠΎΠ²Π°Π½ΠΈΡ, ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠΌΠΎΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠΈ, Π΄Π°Π²Π»Π΅Π½ΠΈΡ ΠΈ Ρ. Π. ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²Π°ΠΆΠ½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ², ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠΈΡ
ΠΌΠ°Π³Π½ΠΈΡΠ½ΠΎΠ΅ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΡ, ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΎΠ±ΡΠ°Π·ΡΠ° - ΠΏΠ»Π΅Π½ΠΊΠΈ ΠΈΠ»ΠΈ ΠΌΠ°ΡΡΠΈΠ²Π°
Π‘ΠΎΡΠ΅ΡΠ°Π½Π½Π°Ρ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΡ ΠΏΡΠΈ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΠΎΠΌ ΡΡΠ½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π±Π΅Π· ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π²ΠΈΡΡΠ΅ΡΠ°Π»ΡΠ½ΡΠΌ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ
The objective: to analyze results of the use of combined anesthesia for coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG) in patients with visceral obesity (VO). Subjects and methods. A randomized study of results of surgical treatment in patients with VO and coronary heart disease who underwent off-pump CABG was conducted. 197 patients were included in the study. The main group (n = 98) included patients who underwent combined anesthesia (with thoracic epidural analgesia (TEA)) and patients in the control group (n = 99) underwent total intravenous anesthesia (with narcotic analgesics). Results. In patients from the main group, a significant decrease in the incidence of acute kidney injury (p = 0.0180), respiratory complications (p = 0.0177), atrial and ventricular arrhythmias (p = 0.0029) was recorded. With the use of TEA, the duration of treatment of patients in the intensive care unit (p = 0.0229) and duration of hospital stay (p = 0.0419) significantly decreased. Conclusion: The use of combined anesthesia (with TEA) for off-pump CABG in patients with visceral obesity reduces the risk of early postoperative complications, the duration of hospital stay and treatment in the intensive care unit.Π¦Π΅Π»Ρ: ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π°Π½Π°Π»ΠΈΠ· ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ ΠΏΡΠΈ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΠΎΠΌ ΡΡΠ½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π±Π΅Π· ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ (off-pump ΠΠ¨) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π²ΠΈΡΡΠ΅ΡΠ°Π»ΡΠ½ΡΠΌ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ (ΠΠ). ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΡΠ΅ΡΠ΄ΡΠ° Ρ ΠΠ, ΠΊΠΎΡΠΎΡΡΠΌ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ off-pump ΠΠ¨. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 197 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΡΠ½ΠΎΠ²Π½ΡΡ Π³ΡΡΠΏΠΏΡ (n = 98) ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ, Ρ ΠΊΠΎΡΠΎΡΡΡ
Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΈ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΡΡ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΡ (Ρ Π³ΡΡΠ΄Π½ΠΎΠΉ ΡΠΏΠΈΠ΄ΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π°Π½Π°Π»ΡΠ³Π΅Π·ΠΈΠ΅ΠΉ β ΠΠΠ), Π±ΠΎΠ»ΡΠ½ΡΠΌ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ (n = 99) ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΡΠΎΡΠ°Π»ΡΠ½ΡΡ Π²Π½ΡΡΡΠΈΠ²Π΅Π½Π½ΡΡ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΡ (Ρ Π½Π°ΡΠΊΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π°Π½Π°Π»ΡΠ³Π΅ΡΠΈΠΊΠ°ΠΌΠΈ). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ΠΎ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΡΠΎΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ (p = 0,0180), ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ (p = 0,0177), ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄Π½ΡΡ
ΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΡΡ
Π°ΡΠΈΡΠΌΠΈΠΉ (p = 0,0029). ΠΠ° ΡΠΎΠ½Π΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΠΠ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ½ΠΈΠ·ΠΈΠ»Π°ΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Π² ΠΏΠ°Π»Π°ΡΠ΅ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (p = 0,0229) ΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ (p = 0,0419). ΠΡΠ²ΠΎΠ΄. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ (Ρ ΠΠΠ) ΠΏΡΠΈ off-pump ΠΠ¨ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°Π½Π½ΠΈΡ
ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΈ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π² ΠΏΠ°Π»Π°ΡΠ΅ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
The morphology and surface wettability alloy AMg2M modified precipitation of Mo under ion assistance
ΠΠ·ΡΡΠ΅Π½Ρ Π·Π°ΠΊΠΎΠ½ΠΎΠΌΠ΅ΡΠ½ΠΎΡΡΠΈ ΡΠΌΠ°ΡΠΈΠ²Π°Π½ΠΈΡ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈ Π°Π»ΡΠΌΠΈΠ½ΠΈΠ΅Π²ΠΎΠ³ΠΎ ΡΠΏΠ»Π°Π²Π° ΠΠΠ³2Π ΠΏΠΎΡΠ»Π΅ ΠΎΡΠ°ΠΆΠ΄Π΅Π½ΠΈΡ ΠΠΎ ΠΏΡΠΈ ΠΈΠΎΠ½Π½ΠΎΠΌ Π°ΡΡΠΈΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ, ΠΊΠΎΡΠΎΡΠΎΠ΅ ΡΠ½ΠΈΠΆΠ°Π΅Ρ ΡΠ΅ΡΠΎΡ
ΠΎΠ²Π°ΡΠΎΡΡΡ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΡ ΡΠΏΠ»Π°Π²Π° ΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΡ Π³ΠΈΠ΄ΡΠΎΡΠΎΠ±Π½ΠΎΠΉ ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ ΡΡΠΊΠΎΡΡΡΡΠ΅Π³ΠΎ Π½Π°ΠΏΡΡΠΆΠ΅Π½ΠΈΡ Π΄Π»Ρ Π°ΡΡΠΈΡΡΠΈΡΡΡΡΠΈΡ
ΠΈΠΎΠ½ΠΎΠ² ΠΠΎ+ Π΄ΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ 9, 12, 15 ΠΊΠ, Π° ΠΈΡΡ
ΠΎΠ΄Π½Π°Ρ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΡ Π΄ΠΎ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»Π° Π³ΠΈΠ΄ΡΠΎΡΠΈΠ»ΡΠ½ΠΎΠΉ.The paper discusses the wetting regularities of the aluminum alloy AMg2M surface after modification by deposition of Mo with ion assisting, which reduces the surface roughness. It is established that the alloy surface becomes hydrophobic for accelerating voltage above 9 kV, while the surface before modification was hydrophilic
Topography of the surface of precursors Cu-Zn-Sn layered electrochemically deposited on Mo / glass and Mo-foil
Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Π° Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΏΠΎΡΡΡΠΎΠ΅Π½ΠΈΡ ΡΠΎΠ½ΠΊΠΎΠΏΠ»Π΅Π½ΠΎΡΠ½ΡΡ
ΡΠΎΡΠΎΠΏΡΠ΅ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»Π΅ΠΉ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ Π½Π΅ΡΠΎΠΊΡΠΈΡΠ½ΡΡ
ΠΈ Π΄ΠΎΡΡΡΠΏΠ½ΡΡ
ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠΎΠ² Cu2ZnSnSe4 Π½Π° ΠΏΠΎΠ΄Π»ΠΎΠΆΠΊΠ°Ρ
ΠΈΠ· ΡΡΠ΅ΠΊΠ»Π° ΠΈ Π³ΠΈΠ±ΠΊΠΎΠΉ ΠΌΠ΅ΡΠ°Π»Π»ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΠ»ΡΠ³ΠΈ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΎΡΠΊΡΡΠ²Π°ΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π³ΠΈΠ±ΠΊΠΈΡ
ΡΠΎΠ½ΠΊΠΎΠΏΠ»Π΅Π½ΠΎΡΠ½ΡΡ
ΡΠΎΡΠΎΠΏΡΠ΅ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»Π΅ΠΉ. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΡΡΡΠΊΡΡΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈΠ°ΡΠΎΠΌΠ½ΠΎ-ΡΠΈΠ»ΠΎΠ²ΠΎΠΉ ΠΈ ΡΠΊΠ°Π½ΠΈΡΡΡΡΠ΅ΠΉ ΡΠ»Π΅ΠΊΡΡΠΎΠ½Π½ΠΎΠΉ ΠΌΠΈΠΊΡΠΎΡΠΊΠΎΠΏΠΈΠΈ.We discuss the abibility to construct thin-film solar cells based on non-toxic and available Cu2ZnSnSe4 components on glass substrates and flexible metal foil, which opens the possibility of application of flexible solar cells. The structures were studied by atomic force and scanning electron microscopy combined with energy dispersive spectrometry of secondary electrons
Influence of the substrate type on the surface morphology of Cu2ZnSnSe4 thin films
Investigations into the influence of the substrate type (a glass substrate with a molybdenum sublayer, tantalum and molybdenum foils) on the surface morphology of Cu2ZnSnSe4 thin films obtained by selenization of electrochemically deposited and preliminary annealed metallic precursors are presented. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π²Π»ΠΈΡΠ½ΠΈΡ ΡΠΈΠΏΠ° ΠΏΠΎΠ΄Π»ΠΎΠΆΠΊΠΈ (ΡΡΠ΅ΠΊΠ»ΡΠ½Π½Π°Ρ ΠΏΠΎΠ΄Π»ΠΎΠΆΠΊΠ° Ρ ΠΏΠΎΠ΄ΡΠ»ΠΎΠ΅ΠΌ ΠΌΠΎΠ»ΠΈΠ±Π΄Π΅Π½Π°, ΡΠΎΠ»ΡΠ³ΠΈ ΡΠ°Π½ΡΠ°Π»Π° ΠΈ ΠΌΠΎΠ»ΠΈΠ±Π΄Π΅Π½Π°) Π½Π° ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠΈ ΡΠΎΠ½ΠΊΠΈΡ
ΠΏΠ»Π΅Π½ΠΎΠΊ Cu2ZnSnSe4, ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΡΠ΅Π»Π΅Π½ΠΈΠ·Π°ΡΠΈΡ ΡΠ»Π΅ΠΊΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈ ΠΎΡΠ°ΠΆΠ΄Π΅Π½Π½ΡΡ
ΠΈ ΠΏΡΠ΅Π΄Π²Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΠΎΡΠΎΠΆΠΆΠ΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠ°Π»Π»ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΊΡΡΡΠΎΡΠΎΠ²
Equivalence of Conventionally-Derived and Parthenote-Derived Human Embryonic Stem Cells
As human embryonic stem cell (hESC) lines can be derived via multiple means, it is important to determine particular characteristics of individual lines that may dictate the applications to which they are best suited. The objective of this work was to determine points of equivalence and differences between conventionally-derived hESC and parthenote-derived hESC lines (phESC) in the undifferentiated state and during neural differentiation.hESC and phESC were exposed to the same expansion conditions and subsequent neural and retinal pigmented epithelium (RPE) differentiation protocols. Growth rates and gross morphology were recorded during expansion. RTPCR for developmentally relevant genes and global DNA methylation profiling were used to compare gene expression and epigenetic characteristics. Parthenote lines proliferated more slowly than conventional hESC lines and yielded lower quantities of less mature differentiated cells in a neural progenitor cell (NPC) differentiation protocol. However, the cell lines performed similarly in a RPE differentiation protocol. The DNA methylation analysis showed similar general profiles, but the two cell types differed in methylation of imprinted genes. There were no major differences in gene expression between the lines before differentiation, but when differentiated into NPCs, the two cell types differed in expression of extracellular matrix (ECM) genes.These data show that hESC and phESC are similar in the undifferentiated state, and both cell types are capable of differentiation along neural lineages. The differences between the cell types, in proliferation and extent of differentiation, may be linked, in part, to the observed differences in ECM synthesis and methylation of imprinted genes
ΠΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΏΠ°ΡΠΈΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π°Π»ΠΈΠΌΠ΅Π½ΡΠ°ΡΠ½ΡΠΌ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·ΠΎΠΌ
The objective: to develop a predictive model for assessing the risk of developing encephalopathy (EP) in patients with nutritional pancreatic necrosis.Subjects and Methods. A single-center prospective cohort study was conducted at Faculty Surgery Clinic of Volgograd State Medical University from 2010 to 2020. Logistic regression analysis was used to build a model for predicting the risk of developing EP.Results. A total of 429 patients were included in the study. It was determined that in the majority of patients EP manifested in the first three days after hospitalization. A statistically significant predictive model of correlation of the risk to develop EP with clinical and demographic variables showed that an increase in the severity of the patient's condition (according to the SOFA scale) by 1 point increased the risk by 1.9 times, and an increase in bilirubin levels by 1 ΞΌmol/l, and urea by 1 mmol/l increased the risk of AED by 8.0% and 28.0%, respectively. In non-alcoholic pancreatic necrosis, compared with the alcoholic genesis of the disease, and when using early (before day 3) enteral nutrition, there was a significant reduction in the risk of developing EP by 175.5% and 137% of cases. The specificity and sensitivity of the model were 78.7% and 82.8%, respectively.Conclusions. In nurtitional pancreatic necrosis, an increase in the severity of the patient's condition, alcoholic genesis of the disease, progression of signs of liver and kidney failure significantly increased the risk of developing EP. At the same time, early enteral nutrition contributed to a significant reduction in the risk of this complication. The presented predictive model is recommended to be used in routine clinical practice. Β Π¦Π΅Π»Ρ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°ΡΡ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΡΡ ΠΌΠΎΠ΄Π΅Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΏΠ°ΡΠΈΠΈ (ΠΠ) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π°Π»ΠΈΠΌΠ΅Π½ΡΠ°ΡΠ½ΡΠΌ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·ΠΎΠΌ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΎΠ΄Π½ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ΅ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΊΠΎΠ³ΠΎΡΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π½Π° Π±Π°Π·Π΅ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΈ ΡΠ°ΠΊΡΠ»ΡΡΠ΅ΡΡΠΊΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΠΈ ΠΠΎΠ»Π³ΠΠΠ£ Π·Π° ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 2010 ΠΏΠΎ 2020 Π³. ΠΠ»Ρ ΠΏΠΎΡΡΡΠΎΠ΅Π½ΠΈΡ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΠ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠ΅Π³ΠΎ Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 429 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΎ, ΡΡΠΎ Ρ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π»Π° Π² 1-Π΅, 2-Π΅ ΠΈΠ»ΠΈ 3-ΠΈ ΡΡΡ ΠΏΠΎΡΠ»Π΅ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠ°Ρ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ ΠΎΡ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°Π»Π°, ΡΡΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (ΠΏΠΎ ΡΠΊΠ°Π»Π΅ SOFA) Π½Π° 1 Π±Π°Π»Π» ΠΏΠΎΠ²ΡΡΠ°Π»ΠΎ ΡΠΈΡΠΊ Π² 1,9 ΡΠ°Π·Π°, Π° ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Π΅ΠΉ Π±ΠΈΠ»ΠΈΡΡΠ±ΠΈΠ½Π° Π½Π° 1 ΠΌΠΊΠΌΠΎΠ»Ρ/Π» ΠΈ ΠΌΠΎΡΠ΅Π²ΠΈΠ½Ρ Π½Π° 1 ΠΌΠΌΠΎΠ»Ρ/Π» ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π»ΠΎ ΡΠΈΡΠΊ ΠΠ Π½Π° 8 ΠΈ 28% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΡΠΈ Π½Π΅Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡΠ½ΠΎΠΌ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·Π΅, ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡΠ½ΡΠΌ Π³Π΅Π½Π΅Π·ΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΈ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ°Π½Π½Π΅Π³ΠΎ (Π΄ΠΎ 3 ΡΡΡ) ΡΠ½ΡΠ΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΈΡΠ°Π½ΠΈΡ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ Π½Π° 175,5 ΠΈ 137% ΡΠ»ΡΡΠ°Π΅Π². Π‘ΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 78,7 ΠΈ 82,8% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ.ΠΡΠ²ΠΎΠ΄Ρ. ΠΡΠΈ Π°Π»ΠΈΠΌΠ΅Π½ΡΠ°ΡΠ½ΠΎΠΌ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·Π΅ ΡΡΡΠ³ΡΠ±Π»Π΅Π½ΠΈΠ΅ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, Π°Π»ΠΊΠΎΠ³ΠΎΠ»ΡΠ½ΡΠΉ Π³Π΅Π½Π΅Π· Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠ½ΠΎΠΉ ΠΈ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π»ΠΈ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ. Π ΡΠΎ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ ΡΠ°Π½Π½Π΅Π΅ ΡΠ½ΡΠ΅ΡΠ°Π»ΡΠ½ΠΎΠ΅ ΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΠΎΠ²Π°Π»ΠΎ Π·Π½Π°ΡΠΈΠΌΠΎΠΌΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠΈΡΠΊΠ° ΡΡΠΎΠ³ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½Π°Ρ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΡΠ΅ΡΡΡ ΠΊ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π² ΡΡΡΠΈΠ½Π½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅.
ΠΠ½ΡΠ΅Π³ΡΠ°Π»ΡΠ½ΡΠΉ ΡΠΏΠΎΡΠΎΠ± ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΡΠΊΠ° ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ° ΠΏΠΎΡΠ»Π΅ ΡΠ½Π΄ΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΡΠΎΠ³ΡΠ°Π΄Π½ΠΎΠΉ Ρ ΠΎΠ»Π°Π½Π³ΠΈΠΎΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΎΠ³ΡΠ°ΡΠΈΠΈ
The objective: development of a method for determining the individual risk of post-ERCP pancreatitis (PEP) before endoscopic intervention.Subjects and Methods. A prospective observational study of the results of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was performed in 1,210 patients. The primary end point was the development of PEP. Multiple regression logistic analysis was used to determine the risk of developing PEP.Results. A model of independent variables was determined, which significantly (p = 0.0001) affected the risk of developing PEP. Based on the results of the logistic analysis, regression coefficients were calculated for all significant patient-dependent factors (gender, age, preoperative level of amylasemia and bilirubinemia, and nature of the underlying disease). The risk of PEP decreased in men (by 47.5%), with an increase in the age of patients (for 1 year by 2.3%) and bilirubin (with an increase of 1 ΞΌmol/l by 0.3%) but increased with an increase in amylase activity blood serum (by 0.7% for each 1 U/l). A formula has been developed to assess the individual risk of PEP at the stage of preparing a patient for therapeutic ERCP.Conclusion. Analysis of patient-dependent factors makes it possible to reliably determine the risk of developing PEP. It was determined that a female gender, young age (under 40 years old), sphincter of Oddi dysfunction increased the risk of PEP, while a male sex, stenting of the main pancreatic duct, and jaundice reduced this risk. The use of the proposed formula will help predict a significant (p = 0.0001) degree of risk of PEP before performing primary therapeutic ERCP in a particular patient.Π¦Π΅Π»Ρ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΡΠΏΠΎΡΠΎΠ±Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΠΎΡΡ-ΠΠ Π₯ΠΠ-ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ° (ΠΠΠ) Π΄ΠΎ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΡΠ½Π΄ΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π»Π΅ΡΠ΅Π±Π½ΠΎΠΉ ΡΠ½Π΄ΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΡΠΎΠ³ΡΠ°Π΄Π½ΠΎΠΉ Ρ
ΠΎΠ»Π°Π½- Π³ΠΈΠΎΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ Π₯ΠΠ) Ρ 1 210 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΎΠΉ ΡΡΠΈΡΠ°Π»ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΠΠ. ΠΠ»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΉ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΠΌΠΎΠ΄Π΅Π»Ρ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΡ
ΠΏΠ΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
, ΠΊΠΎΡΠΎΡΠ°Ρ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ (p = 0,0001) Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π²ΡΡΠΈΡΠ»Π΅Π½Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΊΠΎΡΡΡΠΈΡΠΈΠ΅Π½ΡΡ Π΄Π»Ρ Π²ΡΠ΅Ρ
Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½Ρ-Π·Π°Π²ΠΈΡΠΈΠΌΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² (ΠΏΠΎΠ», Π²ΠΎΠ·ΡΠ°ΡΡ, ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΡΡΠΎΠ²Π΅Π½Ρ Π°ΠΌΠΈΠ»Π°Π·Π΅ΠΌΠΈΠΈ ΠΈ Π±ΠΈΠ»ΠΈΡΡΠ±ΠΈΠ½Π΅ΠΌΠΈΠΈ, Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ). Π ΠΈΡΠΊ ΠΠΠ ΡΠ½ΠΈΠΆΠ°Π»ΡΡ Ρ ΠΌΡΠΆΡΠΈΠ½ (Π½Π° 47,5%), ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (Π·Π° 1 Π³ΠΎΠ΄ Π½Π° 2,3%) ΠΈ ΡΡΠΎΠ²Π½Ρ Π±ΠΈΠ»ΠΈΡΡΠ±ΠΈΠ½Π° (ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π½Π° 1 ΠΌΠΊΠΌΠΎΠ»Ρ/Π» Π½Π° 0,3%), Π½ΠΎ ΠΏΠΎΠ²ΡΡΠ°Π»ΡΡ ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π°ΠΌΠΈΠ»Π°Π·Ρ ΡΡΠ²ΠΎΡΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²ΠΈ (Π½Π° 0,7% Π½Π° ΠΊΠ°ΠΆΠ΄ΡΡ 1 ΠΠ΄/Π»). Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΡΠΎΡΠΌΡΠ»Π°, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡΠ°Ρ ΠΎΡΠ΅Π½ΠΈΡΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΠΉ ΡΠΈΡΠΊ ΠΠΠ Π½Π° ΡΡΠ°ΠΏΠ΅ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΠΊ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π»Π΅ΡΠ΅Π±Π½ΠΎΠΉ ΠΠ Π₯ΠΠ.ΠΡΠ²ΠΎΠ΄. ΠΠ½Π°Π»ΠΈΠ· ΠΏΠ°ΡΠΈΠ΅Π½Ρ-Π·Π°Π²ΠΈΡΠΈΠΌΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΎ, ΡΡΠΎ ΠΆΠ΅Π½ΡΠΊΠΈΠΉ ΠΏΠΎΠ», ΠΌΠΎΠ»ΠΎΠ΄ΠΎΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ (Π΄ΠΎ 40 Π»Π΅Ρ), Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΡ ΡΡΠΈΠ½ΠΊΡΠ΅ΡΠ° ΠΠ΄Π΄ΠΈ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π»ΠΈ, Π° ΠΌΡΠΆΡΠΊΠΎΠΉ ΠΏΠΎΠ», ΡΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π³Π»Π°Π²Π½ΠΎΠ³ΠΎ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΎΠΊΠ°, Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΆΠ΅Π»ΡΡΡ
ΠΈ ΡΠ½ΠΈΠΆΠ°Π»ΠΈ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½Π½ΠΎΠΉ ΡΠΎΡΠΌΡΠ»Ρ ΠΏΠΎΠΌΠΎΠΆΠ΅Ρ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°ΡΡ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΡ (p = 0,0001) ΡΡΠ΅ΠΏΠ΅Π½Ρ ΡΠΈΡΠΊΠ° ΠΠΠ Π΄ΠΎ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ Π»Π΅ΡΠ΅Π±Π½ΠΎΠΉ ΠΠ Π₯ΠΠ Ρ ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°
ΠΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·ΠΎΠΌ
Relevance. The incidence of acute pancreatitis is growing worldwide, being one of the leading causes of hospitalization in urgent surgery. The most common complication of pancreatic necrosis (PN) in the aseptic phase is acute kidney injury (AKI), which is an independent risk factor for an unfavorable outcome.The objective was to develop a personalized risk model for AKI in the aseptic phase of pancreatic necrosis.Materials and methods. A comparative cohort study of the results of treatment of 502 patients with pancreatic necrosis was conducted. The primary endpoint was considered to be the development of AKI, for the development of a personalized model of the probability of its development in sterile pancreatic necrosis, binary logistic regression analysis was used.Results. A model of independent variables was developed that reliably (p < 0.001) determined that with an increase in age by 1 year, the probability of developing AKI increased by 2.3%, and with a history of chronic kidney disease in a patient β by 3.2 times.The same model demonstrates that the risk of AKI in patients with pancreatic necrosis with an increase in glomerular filtration rate by 1 mlΒ·minβ1Β·1.73 m2 and with the use of balanced crystalloid solutions decreased by 5.0% and 3.0 times, respectively.The specificity of the model was 79.8%, sensitivity β 79.1%.Conclusion. The proposed model makes it possible to reliably predict the individual risk of AKI on the first day of hospitalization.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡ ΠΎΡΡΡΡΠΌ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡΠΎΠΌ ΡΠ°ΡΡΠ΅Ρ Π²ΠΎ Π²ΡΠ΅ΠΌ ΠΌΠΈΡΠ΅, ΡΠ²Π»ΡΡΡΡ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π²Π΅Π΄ΡΡΠΈΡ
ΠΏΡΠΈΡΠΈΠ½ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π² ΡΡΠ³Π΅Π½ΡΠ½ΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΠΈ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·Π° (ΠΠ) Π² Π°ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΡΡ ΡΠ°Π·Ρ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΡΡΠΎΠ΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ΅ΠΊ (ΠΠΠ), ΠΊΠΎΡΠΎΡΠΎΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°ΠΊΡΠΎΡΠΎΠΌ ΡΠΈΡΠΊΠ° Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π°.Π¦Π΅Π»Ρ β ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ Π² Π°ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ°Π·Π΅ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·Π°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΊΠΎΠ³ΠΎΡΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ 502 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΡΠΎΠ·ΠΎΠΌ. ΠΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΎΠΉ ΡΡΠΈΡΠ°Π»ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΠΠ, Π΄Π»Ρ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΠΎΡΠΎΡΠΎΠΉ ΠΏΡΠΈ ΡΡΠ΅ΡΠΈΠ»ΡΠ½ΠΎΠΌ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·Π΅ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈ Π±ΠΈΠ½Π°ΡΠ½ΡΠΉ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΠΌΠΎΠ΄Π΅Π»Ρ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΡ
ΠΏΠ΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
, Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ (p < 0,001) ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠ°Ρ, ΡΡΠΎ ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Π½Π° 1 Π³ΠΎΠ΄ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅ΡΡΡ Π½Π° 2,3%, Π° ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΠΎΡΠ΅ΠΊ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ β Π² 3,2 ΡΠ°Π·Π°. ΠΡΠ° ΠΆΠ΅ ΠΌΠΎΠ΄Π΅Π»Ρ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΡΠ΅Ρ, ΡΡΠΎ ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠ°Π½ΠΊΡΠ΅ΠΎΠ½Π΅ΠΊΡΠΎΠ·ΠΎΠΌ ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠΈ ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΊΠ»ΡΠ±ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ Π½Π° 1 ΠΌΠ»βΠΌΠΈΠ½β1/1,73ΠΌ2 ΠΈ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ±Π°Π»Π°Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΊΡΠΈΡΡΠ°Π»Π»ΠΎΠΈΠ΄Π½ΡΡ
ΡΠ°ΡΡΠ²ΠΎΡΠΎΠ² ΡΠ½ΠΈΠΆΠ°Π»ΡΡ Π½Π° 5,0% ΠΈ Π² 3,0 ΡΠ°Π·Π° ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. Π‘ΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 79,8%, ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ β 79,1%.ΠΡΠ²ΠΎΠ΄. ΠΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½Π½Π°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΠΉ ΡΠΈΡΠΊ ΠΠΠ Π² ΠΏΠ΅ΡΠ²ΡΠ΅ ΡΡΡΠΊΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ