Sovremennye tekhnologii v meditsine最新文献

{"title":"A New Neuroanesthetic Protocol of Rendering Specialized Care in Treating Degenerative Lumbar Spine Diseases in High-Risk Patients: Prospective Analysis of the Results.","authors":"A A Kalinin, V Yu Goloborodko, Yu Ya Pestryakov, R A Kundubayev, M Yu Biryuchkov, A V Shchegolev, V A Byvaltsev","doi":"10.17691/stm2024.16.3.06","DOIUrl":"10.17691/stm2024.16.3.06","url":null,"abstract":"<p><p><b>The aim of the study</b> is to assess the effectiveness of a new neuroanesthetic protocol for treating degenerative lumbar spine diseases in high-risk patients.</p><p><strong>Materials and methods: </strong>Two groups of patients with a high risk of anesthesia and surgery determined by the authors' clinical decision support system (CDSS) have been prospectively studied. A new neuroanesthetic protocol was used in the experimental group (EG, n=25), while the control group (CG, n=25) underwent intravenous anesthesia based on propofol and fentanyl. Minimally invasive transforaminal lumbar interbody fusion was performed in all cases. Changes of the intraoperative mean arterial pressure and heart rate, intensity of the local pain syndrome, amount of the opiates used, presence of cognitive disorders, adverse effects of anesthesia, and surgical complications have been compared.</p><p><strong>Results: </strong>The groups were representative (p>0.05) in terms of the age-gender parameters, anthropological data, comorbid background, involvement in smoking, preoperative characteristics of the lumbar spine, as well as the level of cognitive functions. No statistically significant changes of the mean arterial pressure (p=0.17) were registered in EG patients relative to the CG (p=0.0008). Intraoperative reduction of the heart rate in patients of the CG was not noted (p=0.49) in comparison with the EG (p=0.03). In the postoperative period, the best indicators of cognitive functions on the FAB test (p=0.02) and MoCA test (p=0.03) were revealed in EG. A significantly less amount of perioperative opiates (p=0.005) at a low level of the local pain syndrome was also noted (p=0.01). The intergroup analysis has shown fewer adverse effects of anesthesia in EG compared to CG (p=0.01) with a comparable number of postoperative surgical complications (p=0.42).</p><p><strong>Conclusion: </strong>A new neuroanesthetic protocol of rendering a specialized care to patients with a high risk of anesthesia and surgery, assessed by the authors-developed CDSS, has resulted in effective elimination of the local postoperative pain syndrome, reduction of perioperative application of opioids, and stabilization of intraoperative indicators of cardiovascular activity. In addition, no postoperative cognitive disorders, anesthetic side-effects, adverse pharmacological consequences of the complex usage of non-steroidal anti-inflammatory drugs, prolonged local anesthetics, alpha-2-agonist, and non-narcotic analgesics have been registered.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 3","pages":"51-59"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualization of Gastric Adenocarcinoma Lymph Node Metastases by Microscopy with Ultraviolet Surface Excitation.","authors":"G M Denisenko, Y M Valieva, S E Solovyeva, N B Serejnikova, V A Petrov, G S Budylin, P S Timashev, A L Fayzullin","doi":"10.17691/stm2024.16.6.03","DOIUrl":"10.17691/stm2024.16.6.03","url":null,"abstract":"<p><p>The detection of lymph node metastases is crucial in oncopathology, as it makes it possible to determine the TNM stage, to design a treatment plan, and predict the survival for cancer patients. The current gold standard for this process is hematoxylin and eosin staining. However, new alternative methods leveraging the unique optical properties of tissue structures are being developed for rapid intraoperative or postoperative application. <b>The aim of the study</b> is to evaluate the effectiveness of identifying lymph node metastases using microscopy with ultraviolet surface excitation (MUSE).</p><p><strong>Materials and methods: </strong>17 lymph nodes from the Sechenov University archive (Russia) collected intraoperatively from 6 patients with gastric cancer have been investigated.In this study, we utilized a MUSE optical system consisting of three UV light-emitting diodes (265 nm) and the Axio Scope A1 microscope (Carl Zeiss, Germany) with various objectives. We introduced a novel combination of fluorescent dyes - Nile red and Hoechst - that had not been previously used with MUSE.</p><p><strong>Results: </strong>The combination of fluorescent dyes yielded high-contrast images with blue-stained nuclei and orange-to-red stained cytoplasm, effectively visualizing gastric adenocarcinoma cells characterized by abundant cytoplasmic components and large polymorphic nuclei. The presence of irregularly shaped cavities, formed by adenocarcinoma metastases, was also detectable by MUSE.</p><p><strong>Conclusion: </strong>Biophotonics provides alternative methods for tissue imaging. However, traditional methods are still unsurpassed in the accuracy of detecting cancer metastases and other pathologies. Further refinement of imaging protocols and expanded research into other cancer types are needed to make methods like MUSE applicable for intraoperative diagnosis.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 6","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Photodynamic Therapy of Recurrent Malignant Gliomas.","authors":"A A Rafaelian, B V Martynov, K A Chemodakova, A I Kholyavin, R S Martynov, E Yu Klimenkova, M Yu Prokudin, G V Papayan, I V Boykov, D V Svistov","doi":"10.17691/stm2024.16.2.06","DOIUrl":"10.17691/stm2024.16.2.06","url":null,"abstract":"<p><p><b>The aim of the study</b> is to assess the effectiveness and safety of stereotactic photodynamic therapy (sPDT) with 5-aminolevulinic acid (5-ALA) in patients with recurrent malignant supratentorial gliomas in functionally relevant brain areas.</p><p><strong>Materials and methods: </strong>In a retrospective single-center study the results of sPDT with 5-ALA in 10 patients (6 of 10 were male), aged 30 to 62 years (median: 51.5 years; 95% CI: 38-59 years) with recurrent malignant brain gliomas after standard therapy who underwent surgery during the period of 2020-2023 were analyzed. sPDT was conducted during 15 min using 5-ALA at a dosage of 20 mg/kg, a diode laser with a wavelength of 635 nm and power of 1 W, and the LFT-02-BIOSPEC unit (BIOSPEC, Russia). Three patients got repeated sPDT after 3, 7, and 15 months due to a relapse. The number of target points and the optimal position for intervention paths were determined according to the data of preoperative stereotactic MRI of the brain with contrast intensification using the CRW Precision stereotactic navigation system (Integra, USA) and intraoperative registration of the area with the highest intensity of protoporphyrin IX fluorescence along the path (according to fluorescence biospectroscopy).</p><p><strong>Results: </strong>Glioblastoma (grade IV, WHO) was diagnosed in 7 patients, anaplastic astrocytoma (grade III, WHO) - in 3 persons. Genetic studies were performed for 9 patients, 7 of them had tumors without the <i>IDH1</i> gene mutation. None of the patients had a combined 1p/19q deletion. The median volume of the contrast-enhancing part of the recurrent tumor was 7.95 cm³ (95% CI: 3.3-13.6 cm³). The median time to relapse after sPDT in patients with anaplastic astrocytomas and glioblastomas was 14.5 and 6.5 months, respectively. The median survival time after sPDT in patients with glioblastomas was 15.8 months (95% CI: 0.5-20.1 months), and in patients with anaplastic astrocytomas - 46.3 months (95%, CI not specified). In the early postoperative period, two patients had motor aphasia and hemiparesis, which further regressed.</p><p><strong>Conclusion: </strong>The results of a small group of patients allow to consider sPDT with 5-ALA as a promising technique to treat patients with recurrent high-grade gliomas in functionally relevant brain areas and require further prospective assessment.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 2","pages":"58-65"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics and Quantitative MDA Criteria in Breast Cancer with Bone Metastases by MRI: Examples of Calculation Algorithms and Their Practical Use.","authors":"V Steinhauer, G Hartung","doi":"10.17691/stm2024.16.3.01","DOIUrl":"10.17691/stm2024.16.3.01","url":null,"abstract":"<p><p>In the practical work of a radiologist or oncologist, especially in the context of individualized treatment, there is a need for fast and in-depth diagnostics. Radiomics and artificial intelligence can be of great help here. Quantitative and qualitative assessments obtained in this way act as decision support for the physician. <b>The aim of the study</b> is to enhance the ability of quantitative and qualitative assessment of metastatic spinal lesions in breast cancer, to better evaluate the nature of changes under the influence of therapy, in addition to MDA.</p><p><strong>Materials and methods: </strong>We used MRI data in sagittal projection for a patient diagnosed with T2N3M1 breast cancer when treated according to accepted clinical protocols. Metastases to the spine were assessed by a radiologist and by machine analysis using the described software: image internal structure extraction operators and recognition based on traditional neural networks. Fragments of the program codes used are also given.</p><p><strong>Results: </strong>The structure of metastatically changed vertebrae in sagittal projection was analysed using machine operators of image analysis. Subtle changes in structure such as several types of \"calderas\" and the pattern of change in image complexity as treatment with CDK 4/6 inhibitors were detected. Measurements were supported by metastasis recognition using neural networks, to increase the reliability of the estimates. In addition to the ability to record response to therapy, a fundamental ability to assess the degree of action compared to previous therapy was identified.</p><p><strong>Conclusion: </strong>The study showed high efficiency of using image structure analysis algorithms, good correlation of the results obtained with the radiologist's opinion and with clinical and laboratory data, and allowed to approach the analysis of subtle effects to obtain not only quantitative characteristics in addition to MDA, but also to obtain new qualitative results.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 3","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capabilities of Cephalometric Methods to Study X-rays in Three-Dimensional Space (Review).","authors":"I O Ayupova, A Yu Makhota, A V Kolsanov, N V Popov, M A Davidyuk, I A Nekrasov, P A Romanova, A M Khamadeeva","doi":"10.17691/stm2024.16.3.07","DOIUrl":"10.17691/stm2024.16.3.07","url":null,"abstract":"<p><p><b>The aim of the study</b> was a systematic review of modern methods of three-dimensional cephalometric analysis, and the assessment of their efficiency. The scientific papers describing modern diagnostic methods of MFA in dental practice were searched in databases PubMed, Web of Science, eLIBRARY.RU, as well as in a searching system Google Scholar by the following key words: three-dimensional cephalometry, three-dimensional cephalometric analysis, orthodontics, asymmetric deformities, maxillofacial anomalies, 3D cephalometry, CBCT. The literature analysis showed many methods of cephalometric analysis described as three-dimensional to use two-dimensional reformates for measurements. True three-dimensional methods are not applicable for practical purposes due to the fragmentary nature of the studies. There is the disunity in choosing landmarks and supporting planes that makes the diagnosis difficult and costly. The major issue is the lack of uniform standards for tree-dimensional measurements of anatomical structures of the skull, and the data revealed can be compared to them. In this regard, the use of artificial neuron networks and in-depth study technologies to process three-dimensional images and determining standard indicators appear to be promising.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 3","pages":"62-73"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Electrocardiographic Complex for Risk Stratification of Paroxysmal Atrial Fibrillation.","authors":"A V Frolov, O P Melnikova, A P Vorobiev, T G Vaikhanskaya","doi":"10.17691/stm2024.16.3.05","DOIUrl":"10.17691/stm2024.16.3.05","url":null,"abstract":"<p><p><b>The aim of the study</b> was to develop and clinically test a hardware and software system capable of identifying the predictors of the hidden forms of atrial fibrillation (AF) using 12-lead ECG data in sinus rhythm.</p><p><strong>Materials and methods: </strong>There was developed the hardware and software system \"Intecard 8.1\" to assess a set of markers for atrial electrical instability by 3-5-minute ECG recordings in sinus rhythm. The markers include P-wave amplitude in lead II <0.1 mV, P-wave duration >120 ms, advanced interatrial block, the area of the biphasic P-wave terminal part <-4 mV·ms, and MVP (morphology-voltage- P-wave duration) score >3 points.The clinical testing of \"Intecard 8.1\" system was carried out on 120 patients with ischemic heart disease or dilated cardiomyopathy. The patients' average age was 57.9±13.1 years.</p><p><strong>Results: </strong>P-wave detection is a challenging task due to a low signal amplitude, noise, high error probability in atrioventricular block or T-wave and P-wave superposition in case of marked tachycardia. To improve detection, a phase transformation method was used, according to which there was studied its phase component arctg[<i>x</i>(<i>n</i>)<i>/Rv</i>], where <i>x</i>(<i>n</i>) <i>-</i> ECG signal samples, <i>Rv -</i> a constant. We developed an identification algorithm implemented in \"Intecard 8.1\" software, its clinical trials being conducted.During the 12 [6; 22] month observation period, AF episodes were recorded in 22 from 120 patients (18.3%). The patients with AF episodes exhibited a significant decrease in P-wave amplitude (p=0.029), its duration increase (p<0.001), and a significantly high MVP score (p<0.01). The MVP score with a cut-off point >3 points is of the highest prognostic significance. The area under the ROC curve AUC was 0.988 with a 95% confidence interval: 0.975-0.999 (p<0.001). The prediction model of hidden AF paroxysms has sensitivity and specificity: 92 and 89%, respectively.</p><p><strong>Conclusion: </strong>The digital electrocardiographic complex \"Intecard 8.1\" when analyzing 3-5-minute ECG recordings with sinus rhythm enables to identify the patients with high risk or with hidden AF forms. The dynamic assessment of P-wave parameters offers an opportunity to personalize heart rhythm control in this patient cohort.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 3","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Model of Crohn's Disease on Large Laboratory Animals - Pigs.","authors":"E N Fedulova, S N Saralov, O V Shumilova, N Yu Shirokova, K N Ilyina, E A Farafontova, Yu P Rubtsova, M N Egorikhina","doi":"10.17691/stm2024.16.6.04","DOIUrl":"10.17691/stm2024.16.6.04","url":null,"abstract":"<p><p>Dissatisfactory results of treating inflammatory bowel disease require the development of new modern methods of therapy. <b>The aim of the study</b> is to create a model of Crohn's disease on large animals, in which ulcerative defects can be formed, for testing new treatment techniques and assessing their effectiveness by endoscopic and morphological methods.</p><p><strong>Materials and methods: </strong>The model was created and tested on 12 castrated male pigs (hybrids between the Wiesenau and the Vietnamese black potbellied pigs), aged 6 months. The animals were manipulated under general sedation in the operating room of the SPF-vivarium for large laboratory animals at Privolzhsky Research Medical University (Russia). Endoscopic techniques and a highfrequency electrosurgical apparatus were used to create the required defects. The results were assessed endoscopically and with histological and morphometrical techniques on days 7, 14, and 21.</p><p><strong>Results: </strong>The morphological examination of the pigs' intestinal mucous membrane has detected the signs typical of Crohn's disease, demonstrating the possibility of using pigs as a model of ulcerative defects in Crohn's disease.</p><p><strong>Conclusion: </strong>This model of Crohn's disease on large animals (pigs, in particular) significantly widens the borders of using new treatment techniques at the preclinical stage and will improve therapy effectiveness in patients with this disease reducing the risk of surgical intervention.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 6","pages":"34-42"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Pancreatectomy with Islet Autotransplantation (TPIAT) as a Technique to Treat Chronic Idiopathic Pancreatitis: Early Experience Analysis.","authors":"V E Zagainov, D M Kuchin, A V Kashina, L A Lugovaya, N V Zarechnova, T A Galanina, N U Naraliev, Y I Kolesnik, E A Vasilchikova, P S Ermakova, E M Zagaynov, Yu A Kucheryavy, A Yu Bogomolova, A L Potapov, I Yu Shirokova","doi":"10.17691/stm2024.16.6.05","DOIUrl":"10.17691/stm2024.16.6.05","url":null,"abstract":"<p><p>Chronic pancreatitis (CP) is a quite common disease with an annual incidence of up to 30 new cases per 100,000 persons in Russia, and 9.6 cases per 100,000 persons abroad. Idiopathic pancreatitis associated with genetic mutations ranks second in frequency. When conservative therapy is ineffective, surgical intervention is considered. Total pancreatectomy reduces pain, but leads to pancreatogenic diabetes mellitus. In case of hereditary pancreatitis caused by mutations in the <i>PRSS1</i>, <i>CFTR</i>, <i>SPINK1</i> genes, pancreatectomy becomes advisable, including for prevention of pancreatic cancer. Isolation of Langerhans islets from the excised pancreas and their autotransplantation (total pancreatectomy with islet autotransplantation, TPIAT) provides additional treatment options. Such surgical interventions are not performed in Russia as of yet. <b>The aim of the study</b> was to assess the effectiveness of total pancreatectomy followed by restoration of glucose tolerance in treatment of patients with chronic genetically determined pain pancreatitis.</p><p><strong>Materials and methods: </strong>Two patients with chronic pain pancreatitis with the <i>SPINK1</i> and <i>PRSS1</i> genetic mutations were examined and underwent surgical total pancreatectomy. Islets were isolated from the excised glands and implanted into the liver. Postoperative followup included an assessment of quality of life and pain intensity based on questionnaires, as well as determination of the glycemic level.</p><p><strong>Results: </strong>Following total pancreatoduodenectomy and autotransplantation, a significant decrease in pain and an improvement in quality of life were noted. Transplanted islets' function was reduced, due to their insufficient number, which required administration of exogenous insulin.</p><p><strong>Conclusion: </strong>The described experience demonstrates the TPIAT effectiveness in treatment of chronic pancreatitis, which can become a basis for further research and introduction of the technique into domestic clinical practice.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 6","pages":"44-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite Tissue-Engineered Small-Diameter Vascular Grafts Based on Polycaprolactone and Polyurethane with Growth Factors and Atrombogenic Drug Coatings: Surface Ultrastructure, Physical and Mechanical Properties.","authors":"E A Senokosova, E S Prokudina, E S Krivkina, T V Glushkova, E A Velikanova, M Yu Khanova, E A Torgunakova, V G Matveeva, L V Antonova","doi":"10.17691/stm2024.16.5.02","DOIUrl":"10.17691/stm2024.16.5.02","url":null,"abstract":"<p><p>There is a growing need for synthetic small-diameter vascular grafts (<6 mm) for bypass surgery since the majority of currently developed products have demonstrated unacceptable high frequency of thrombosis in preclinical studies. The proprietary composite vascular graft based on a nonwoven polymer with anti-thrombogenic and anti-aneurysm effect and functional activity is aimed at stimulating the formation of vascular neotissue at the implantation site. <b>The aim of the investigation</b> is to study the surface morphology, physical and mechanical properties of the polycaprolactone/ polyurethane (PCL/PU) small-diameter tissue-engineered vascular graft with growth factors and an anti-thrombogenic surface coating.</p><p><strong>Materials and methods: </strong>PCL/PU vascular grafts with growth factor mix (GFmix) were manufactured using the electrospinning method. The hydrogel coating containing iloprost (Ilo) and heparin (Hep) was formed by complexation with polyvinylpyrrolidone. The controls were multilayer vascular grafts of similar composition and nonwoven matrices based on 12% PCL and 12% PU. The surface structure was analyzed with the S-3400N scanning electron microscope (Hitachi, Japan). The physical properties of the surface were determined by the wetting angle method. The mechanical properties were evaluated on a Z series universal testing machine (Zwick/ Roell, Germany). Statistical processing of the data was performed using the GraphPad Prism 8 software.</p><p><strong>Results: </strong>Our new manufacturing technique for the composite PU/PCL/GFmix/^Ilo/Hep graft has eliminated the problem of graft delamination. The inner surface of the graft consisted of interwined microfibers (1.34 [1.15; 2.28] μm thick), nanofibers (790.0 [604.0; 853.5] nm thick), and interpenetrating pores of different diameters (5.4 [3.8; 8.4] μm). The process of coating formation did not affect the fibers and did not seal the pores, the surface retained its hydrophilic properties (θ=68.61±11.85°). The tensile strength (3.45 [3.17; 4.03] MPa) and Young's modulus (4.88 [3.95; 5.80] MPa) of PU/PCL/GFmix/^Ilo/Hep grafts were almost similar to the human internal thoracic artery compared to the multilayer analogs. The PU/PCL/GFmix/^Ilo/Hep grafts were superior to the multilayer PCL/PU/GFmix/^Ilo/Hep grafts in terms of reduced excessive elasticity (to 118.0 [111.0; 125.0]%; p=0.043).</p><p><strong>Conclusion: </strong>The composite functionalized vascular PU/PCL/GFmix/^Ilo/Hep grafts have enhanced characteristics and compliance, which, in turn, increases the probability of their high patency in future preclinical studies.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 5","pages":"18-25"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Assessment of Combatants' Psychological and Psychophysiological State in Exposure Therapy of Post-Traumatic Stress Disorder Using Virtual Reality.","authors":"L N Kasimova, A N Kuznetsov, I I Kropinova, D V Kuznetsov, M G Volovik, M V Svyatogor, E M Sychugov, G Y Borovskoy, M E Khalak","doi":"10.17691/stm2024.16.5.04","DOIUrl":"10.17691/stm2024.16.5.04","url":null,"abstract":"<p><p><b>The aim of the study</b> was to develop the rehabilitation technology that enables the monitoring of psychophysiological stress markers during exposure therapy of post-traumatic stress disorder in combatants using virtual reality (VR).</p><p><strong>Materials and methods: </strong>The study involved 69 men: 31 combatants (mean age - 35.61±9.13 years) and 38 healthy research subjects - a control group (mean age - 24.68±5.71 years) not engaged in active combat.Post-traumatic stress disorder was diagnosed using Structured Clinical Interview for DSM and Mississippi Scale.We suggested an original hardware and software system for exposure therapy in VR. Stimulus material included a number of virtual scenes: three combat scenes and a non-combat one.Heart rate variability was recorded to control a patient's state during the session. As markers of stressogenic situations we used CS-index (suggested by S.V. Bozhokin), as well as the indices of functional reserve and tension degree of the regulatory systems (according to R.M. Baevskiy).</p><p><strong>Results: </strong>There were revealed three main responses on VR scenes with an original content. The three variants were called as follows: \"anxious\", \"neutral\", and \"inverse\". The suggested methodology enables to continuously monitor psychophysiological parameters during a certain session, and analyze their dynamics within a therapy course.Using calculated indicators by Baevsky makes it possible to classify combatants by adaptive potential at the beginning and at the end of the exposure therapy course in VR; make use of online-control of a patient's functional state in virtual environment, and create conditions for controlled information influence (CS-index by Bozhokin).The preliminary results presented in the study are promising regarding the possibility to choose a personalized program of rehabilitation measures for each response type using a developed hardware and software system. Biological feedback on heart rate variability included in hardware and software system will contribute to train and harness a patient's habit of an operative independent correction of the patient's state.</p>","PeriodicalId":520289,"journal":{"name":"Sovremennye tekhnologii v meditsine","volume":"16 5","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}