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Goal: Presentation of the first Russian computer program (www.carotidscore.ru) for risk stratification of postoperative complications of carotid endarterectomy (CEE)., Material and Methods: The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE., Results: In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%-myocardial infarction, 0.35%-stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in "%" and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework (https://www.qt.io), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient's personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person., Conclusion: CarotidSCORE (www.carotidscore.ru) is able to determine the likelihood of postoperative complications in patients undergoing CEE., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Analysis of the results of emergency carotid endarterectomy (CEE) against the background of internal carotid artery (ICA) thrombosis in the acute period of acute cerebrovascular accident (ACVA) in patients with COVID-19. During the COVID-19 pandemic (April 1, 2020-May 1, 2021), 43 patients with ICA thrombosis and a positive polymerase chain reaction (PCR) result for SARS-CoV-2 were included in this prospective study. In all cases, CEE was performed in the acutest period of ACVA. These patients were included in group 1. The comparison group was represented by 89 patients who underwent CEE in the acute period of stroke, in the period before the COVID-19 pandemic (April 1, 2019-March 1, 2020). According to laboratory parameters, patients with COVID-19 had severe coagulopathy (with an increase in D-dimer: 3832 ± 627.2 ng/mL, fibrinogen: 12.6 ± 3.1 g/L, prothrombin: 155.7 ± 10, 2%), inflammatory syndrome (increased ferritin: 646.2 ± 56.1 ng/mL, C-reactive protein: 161.3 ± 17.2 mg/L, interleukin-6: 183.3 ± 51.7 pg/mL, leukocytosis: 27.3 ± 1.7 10E9/L). In the hospital postoperative period, the groups were comparable in terms of the incidence of deaths (group 1: 2.3%, n = 1; group 2: 1.1%, n = 1; P= 0.81; OR=2.09; 95 % CI = 0.12-34.3) myocardial infarction (group 1: 2.3%, n = 1; group 2: 0%; P= 0.7; OR = 6.3; 95% CI = 0.25-158.5), CVA (group 1: 2.3%, n = 1; group 2: 2.2%, n = 2; P= 0.55; OR = 1.03; 95% CI = 0,.09-11.7). ICA thrombosis and hemorrhagic transformations were not recorded. However, due to severe coagulopathy with ongoing anticoagulant/antiplatelet therapy, patients with COVID-19 more often developed bleeding in the operation area (group 1: 11.6%, n = 5; group 2: 1.1%, n = 1; P= 0.02; OR = 11.5; 95% CI = 1.3-102.5). In all cases, the flow of hemorrhagic discharge came from the drainage localized in the subcutaneous fat. This made it possible to remove skin sutures in a dressing room, suturing the source of bleeding and applying secondary sutures under local anesthesia. Emergency CEE in the acute period of stroke is an effective and safe method of cerebral revascularization in case of ICA thrombosis in conditions of COVID-19., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The study consists in determining the effect of renal artery stenting in patients with arterial hypertension in combination with renal artery stenosis on the dynamics of clinical and geriatric status in terms of such indicators as the number of drugs taken, cognitive status, determined by the MMSE scale, prevalence of the frequency of falls, psycho-emotional status by the Beck scale, the quality of sleep on the VAS scale, the index of age discrimination according to the E.Palmore ageism questionnaire, the quality of life according to the SF 36 questionnaire. The study involved 72 elderly patients with arterial hypertension in combination with renal artery stenosis. According to the results of the study, as a result of stenting of the renal arteries, there is a decrease in the number of drugs taken, an improvement in the cognitive status on the MMSE scale, a decrease in the frequency of falls, an improvement in the psycho-emotional status on the Beck scale, an improvement in the quality of sleep on the VAS scale, a decrease in the level of age discrimination, an increase in the quality of life according to questionnaire SF-36 on all scales.

Complex I is the first enzyme in the respiratory chain, which is responsible for energy production in mitochondria and bacteria 1 . Complex I couples the transfer of two electrons from NADH to quinone and the translocation of four protons across the membrane 2 , but the coupling mechanism remains contentious. Here we present cryo-electron microscopy structures of Escherichia coli complex I (EcCI) in different redox states, including catalytic turnover. EcCI exists mostly in the open state, in which the quinone cavity is exposed to the cytosol, allowing access for water molecules, which enable quinone movements. Unlike the mammalian paralogues 3 , EcCI can convert to the closed state only during turnover, showing that closed and open states are genuine turnover intermediates. The open-to-closed transition results in the tightly engulfed quinone cavity being connected to the central axis of the membrane arm, a source of substrate protons. Consistently, the proportion of the closed state increases with increasing pH. We propose a detailed but straightforward and robust mechanism comprising a 'domino effect' series of proton transfers and electrostatic interactions: the forward wave ('dominoes stacking') primes the pump, and the reverse wave ('dominoes falling') results in the ejection of all pumped protons from the distal subunit NuoL. This mechanism explains why protons exit exclusively from the NuoL subunit and is supported by our mutagenesis data. We contend that this is a universal coupling mechanism of complex I and related enzymes., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Pulmonary embolism is a life-threatening condition, which can result in respiratory insufficiency and death. Blood clots occluding branches of the pulmonary artery (PA) are traditionally considered to originate from thrombi in deep veins (usually in legs). However, growing evidence suggests that occlusion of the vessels in the lungs can develop without preceding deep vein thrombosis (DVT). In this work, we used an inferior vena cava (IVC) complete ligation model of DVT in Wistar rats to explore the possibility and mechanisms of PA thrombosis under the conditions where all routes of thrombotic mass migration from peripheral veins are blocked. We demonstrate that rats both with normal and reduced neutrophil counts developed thrombi in the IVC, although, neutropenia caused a substantial decrease in thrombus size and a shift from fresh fibrin toward mature fibrin and connective tissue inside the thrombus. Massive fibrin deposition was found in the PA branches in the majority of DVT rats with normal neutrophil counts, but in none of the neutropenic animals. Neutrophil ablation also abolished macroscopic signs of lung damage. Altogether, the results demonstrate that thrombi in the lung vasculature can form in situ by mechanisms that require local neutrophil recruitment taking place in the DVT setting.

The main idea of this literature review is based on the uncertainty in the current recommendations regarding the treatment of patients with vertebrobasilar insufficiency (VBI) caused by the presence of hemodynamically significant stenosis of the vertebral artery (VA). The authors present comparative results of medical, endovascular, open surgical methods of treatment, demonstrating the advantages and disadvantages of each of them, describe new hybrid correction options with substantiation of their effectiveness and safety. The results of treatment of patients with VBI without VA stenosis, with atherosclerotic lesions of the internal carotid arteries are presented. The role of carotid endarterectomy in these conditions has been substantiated. Rare cases of VBI caused by abnormal origin of VA from atherosclerotically changed common carotid artery are demonstrated. The treatment options for patients with combined hemodynamically significant stenosis of the VA and carotid arteries are described. The emphasis is made on the need to stratify the risk of complications in this cohort of patients using modern programs to implement a personalized approach to treatment.

Dental plaques are biofilms that cause dental caries by demineralization with acidogenic bacteria. These bacteria reside inside a protective sheath which makes any curative treatment challenging. We propose an antibiotic-free strategy to disrupt the biofilm by engineered clustered carbon dot nanoparticles that function in the acidic environment of the biofilms. In vitro and ex vivo studies on the mature biofilms of Streptococcus mutans revealed >90% biofilm inhibition associated with the contact-mediated interaction of nanoparticles with the bacterial membrane, excessive reactive oxygen species generation, and DNA fragmentation. An in vivo examination showed that these nanoparticles could effectively suppress the growth of S. mutans. Importantly, 16S rRNA analysis of the dental microbiota showed that the diversity and richness of bacterial species did not substantially change with nanoparticle treatment. Overall, this study presents a safe and effective approach to decrease the dental biofilm formation without disrupting the ecological balance of the oral cavity., (© 2021. The Author(s).)

This review is devoted to the management of primary artery thrombosis (PAT). This disease was always considered only as a part of other venous thromboembolic events, in particular isolated pulmonary embolism (PE). Various studies show that PAT can develop as an independent event without concomitant damage to extra-vessels. PAT is characterized by own typical signs as primary and recurrent event that can determine special strategies of treatment. However, there are no studies devoted to this problem. We can only make some assumptions about PAT anticoagulation (AC) considering data on isolated PE comprising PAT. These data are available in PADIS-PE, ASPIRE, EINSTEIN-PE, Hokusai-VTE studies underlying modern guidelines of various societies. In the absence of studies on PAT AC these guidelines should regulate PAT AC approaches. AC is recommended in all cases of PE except isolated subsegmental PAT in ambulatory patients. Duration of AC depends on risk factors (major or minor). Anticoagulation for PAT following chronic inflammatory diseases is still disputable.

Objective: To analyze hospital and long-term results of stenting of the V1 segment of the vertebral artery (VA) in the first hours after acute cerebral hemopoiesis/transient ischemic attack (stroke/TIA) in the vertebrobasilar territory (VT)., Material and Methods: The current retrospective study from 2012 to 2019 included 169 patients with hemodynamically significant stenosis of the V1 segment of the VA, who underwent emergency stenting in the first hours after the onset of stroke. The mean time between the development of stroke and correction was 368.5±129.8 minutes. The average time between admission to the medical institution and submission to the X-ray operating room was 89.2±10.7 minutes. VA stenting was performed through the transfemoral approach. In 118 cases (69.8%) a drug eluting stent was implanted, in 51 (30.2%) a bare metal stent was implanted. 90% of VA segment V1 stenosis was diagnosed in 48 patients before the onset of stroke. Of these, 33 received conservative therapy for vertebrobasilar insufficiency (VBI) for 2.5±1.0 months in anticipation of regression of the disease. The remaining 15 did not have VBI symptoms and did not need active drug treatment. Ultimately, within this sample, the time interval between the visualization of stenosis and the onset of stroke was 3.0±1.0 months. In 17 patients, stroke/TIA in VT became recurrent. The period between two neurological events was 1.5±0.5 months. Nine patients did not wait for the planned intervention due to the development of an adverse neurological event before the appointed date of hospitalization. The other 8 did not appear for the interventional correction on time due to subjective reasons and were again admitted to the medical facility on an urgent basis., Results: During the hospital follow-up period, no adverse cardiovascular events were recorded. When assessing the dynamics in the neurological status, there was a significant regression of the deficit by the time of discharge from the hospital. In the long-term follow-up period (38.2±20.4 months), a fatal outcome was recorded in 2.4% of cases ( n =4). Non-fatal myocardial infaction was diagnosed in 5 patients (2.9%). Restenosis of the stent in the VA was visualized in 56 patients (33.1%). In 17 cases, it became symptomatic (10.0%). All patients underwent repeated stenting with a successful result of the procedure., Conclusion: Emergency stenting of hemodynamically significant stenosis of the V1 segment of the VA in the acute period of stroke in VT is a safe and effective method of revascularization characterized by the absence of adverse cardiovascular events at the hospital stage of observation.

Aim: The aim of our investigation was to analyse the results of autotransplantation, creation of a neobifurcation or prosthetic repair of the internal carotid artery during the in-hospital and long-term follow-up periods., Patients and Methods: The study included a total of 241 patients presenting with and treated for extended atherosclerotic lesions of the internal carotid artery from 2016 to 2019. The patients were divided into three groups depending on the surgical modality employed: group 1 - autotransplantation of the internal carotid artery (27.8%, n=67), group 2 - creation of a neobifurcation (55.2%, n=133), and group 3 - prosthetic repair of the internal carotid artery (17.0%, n=41). The duration of the postoperative follow-up period amounted to 24.8±11.9 months. The outcome measures selected were as follows: all-cause mortality, myocardial infarction, ischaemic stroke, haemodynamically significant restenosis, and a composite endpoint (death + myocardial infarction + ischaemic stroke + haemodynamically significant restenosis)., Results: During the in-hospital postoperative period we registered 1 (2.4%) ischaemic stroke in the group of prosthetic repair, with no significant inter-group difference revealed (p=0.08). In the remote period of follow-up, no statistical differences were revealed for the following outcome measures: all-cause mortality (group 1: 7.5%, n=5; group 2: 10.5%, n=14; group 3: 14.6%, n=6; p=0.49); cardiovascular-related death (group 1: 4.5%, n=3; group 2: 6.7%, n=9; group 3: 12.2%, n=5; p=0.31); myocardial infarction (group 1: 1.5%, n=1; group 2: 3%, n=4; group 3: 4.9%, n=2; p=0.59). However, the patients in the group of prosthetic repair of the internal carotid artery were found to have the highest incidence rates of ischaemic stroke (group 1: 3%, n=2; group 2: 3%, n=4; group 3: 14.6%, n=6; p1-2=0.1; p1-3=0.02; p2-3=0.008), haemodynamically significant restenosis (group 1: 0%, n=0; group 2: 0%, n=0; group 3: 14.6 %, n=6; p1-2>0.99; p1-3=0.000; p2-3=0.000), and higher values of the composite endpoint (group 1: 12 %, n=8; group 2: 16.5%, n=22, group 3: 48.8%, n=20; p1-2>0.99; p1-3=0.000; p2-3=0.000)., Conclusion: Prosthetic repair of the internal carotid artery for an extended atherosclerotic lesion is a less preferable method compared with autotransplantation and creation of a neobifurcation, as evidenced by the highest incidence rates of ischaemic stroke, haemodynamically significant restenosis, and higher values of the composite endpoint in the remote period of follow up.

Objective: To analyze the dynamics of systolic blood pressure (SBP) and the results of various types of carotid endarterectomy (CEE) in patients with resistant arterial hypertension (RAH)., Materials and Methods: The study included 1577 patients with hemodynamically significant stenosis of the internal carotid artery (ICA) and RAH for more than 3 years. Patients were enrolled from January 2014 to December 2020. Depending on the implemented revascularization strategy, 5 groups were formed: group 1 ( n =289 (18.3%)) with classical CEE with plasty of the reconstruction zone with a patch, group 2 ( n =472 (29.9%)) with eversional CEE with cut-off of carotid glomus (CG); group 3 ( n =109 (6.9%)) with the formation of a new bifurcation; group 4: ( n =117 (7.4%)) with autoarterial reconstruction; group 5: ( n =590 (37.4%)) with glomus-saving CEE., Results: In the postoperative period, no significant differences were obtained in the frequency of deaths (0.34% for group 1; 0.63% for group 2; 0% for groups 3, 4 and 5), myocardial infarction (0.34%, 0.84%, 1.83, 0.85%, 0.33%, respectively); ischemic stroke (0.34%, 1.27%, 0.91%, 0.85%, 0.17%, respectively), hemorrhagic transformation (0%, 0.84%, 0.91%, 0.85%, 0%, respectively). However, according to the frequency of the combined endpoint (death + myocardial infarction + ischemic stroke + hemorrhagic transformation), the lowest rates were observed in the group of classical carotid endarterectomy with plasty of the reconstruction zone with a patch and glomus-sparing CEE (1.03%, 3.6%, 3.67%, 2.56%, 0.5%, respectively). This is due to the absence of cases of labile AH and hypertensive crises among patients of groups 1 and 5, which was ensured by the preservation of carotid glomus (CG). As a result, the number of patients with 2 and 3 degrees of hypertension in these groups decreased statistically significantly. The vast majority of patients after these operations achieved a stable target SBP. In groups 2, 3, and 4, there was a statistically significant increase in the number of patients with 2 and 3 degrees of AH, which is associated with excision of the CG., Conclusion: Classical CEE and glomus-sparing CEE techniques make it possible to achieve a stable target SBP level in patients with RAH as a result of CG preservation. Removal or traumatization of the latter during eversional CEE, the formation of a new bifurcation, autoarterial reconstruction is accompanied by the development of labile hypertension, an increase in the degree of hypertension and a high risk of hemorrhagic transformation in the brain. Thus, the most effective and safe types of CEE in the presence of RAH are classical CEE with plasty of the reconstruction zone with a patch and glomus-sparing CEE.

Background: Venous thromboembolism (VTE) with the prevalence of pulmonary microcirculatory thrombosis is considered a common complication of novel coronavirus disease (COVID-19) that develops despite anticoagulation., Methods: The clinical course of the disease and the autopsy findings of seven deceased patients with verified COVID-19 were analyzed. The chest computed tomography (CT) scan was routinely performed while CT pulmonary angiography and a duplex ultrasound scan (DUS) of the lower limbs were used in cases of suspected VTE. The VTE prophylaxis was administered to all patients with intermediate or therapeutic doses of low-molecular-weight heparin. The histological examination of the lung tissue and other organs was performed with particular attention paid to the pulmonary vasculature., Results: Venous thromboembolism, including deep vein thrombosis in one patient and pulmonary artery thrombosis in two patients, was confirmed by imaging tests despite anticoagulation. Systemic thrombolysis was performed in two patients with putative and confirmed pulmonary embolism. An autopsy revealed the signs of acute respiratory distress syndrome in all seven patients. Abnormalities of lung vessels were found in all cases and were represented by dystrophy and necrosis in the endothelium and muscle fibers, and by infiltration by plasmatic cells, neutrophils, and lymphocytes. Multiple clots of variable maturity were observed. All those changes developed despite anticoagulation and were preserved after systemic thrombolysis., Conclusion: Inflammatory and prothrombotic changes in the arterial wall in parallel with the lack of lung perfusion may cause diffuse arterial thrombosis in the lungs. This background may be responsible for the low response to systemic anticoagulation and thrombolysis in severe forms of COVID-19., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Author(s).)

According to a widespread theory, thrombotic masses are not formed in the pulmonary artery (PA) but result from migration of blood clots from the venous system. This concept has prevailed in clinical practice for more than a century. However, a new technologic era has brought forth more diagnostic possibilities, and it has been shown that thrombotic masses in the PA could, in many cases, be found without any obvious source of emboli. Chronic obstructive pulmonary disease, asthma, sickle cell anemia, emergency and elective surgery, viral pneumonia, and other conditions could be complicated by PA thrombosis development without concomitant deep vein thrombosis (DVT). Different pathologies have different causes for local PA thrombotic process. As evidenced by experimental results and clinical observations, endothelial and platelet activation are the crucial mechanisms of this process. Endothelial dysfunction can impair antithrombotic function of the arterial wall through downregulation of endothelial nitric oxide synthase (eNOS) or via stimulation of adhesion receptor expression. Hypoxia, proinflammatory cytokines, or genetic mutations may underlie the procoagulant phenotype of the PA endothelium. Both endotheliocytes and platelets could be activated by protease mediated receptor (PAR)- and receptors for advanced glycation end (RAGE)-dependent mechanisms. Hypoxia, in particular induced by high altitudes, could play a role in thrombotic complications as a trigger of platelet activity. In this review, we discuss potential mechanisms of PA thrombosis in situ.

Retrovirus assembly is driven by the multidomain structural protein Gag. Interactions between the capsid domains (CA) of Gag result in Gag multimerization, leading to an immature virus particle that is formed by a protein lattice based on dimeric, trimeric, and hexameric protein contacts. Among retroviruses the inter- and intra-hexamer contacts differ, especially in the N-terminal sub-domain of CA (CANTD). For HIV-1 the cellular molecule inositol hexakisphosphate (IP6) interacts with and stabilizes the immature hexamer, and is required for production of infectious virus particles. We have used in vitro assembly, cryo-electron tomography and subtomogram averaging, atomistic molecular dynamics simulations and mutational analyses to study the HIV-related lentivirus equine infectious anemia virus (EIAV). In particular, we sought to understand the structural conservation of the immature lentivirus lattice and the role of IP6 in EIAV assembly. Similar to HIV-1, IP6 strongly promoted in vitro assembly of EIAV Gag proteins into virus-like particles (VLPs), which took three morphologically highly distinct forms: narrow tubes, wide tubes, and spheres. Structural characterization of these VLPs to sub-4Å resolution unexpectedly showed that all three morphologies are based on an immature lattice with preserved key structural components, highlighting the structural versatility of CA to form immature assemblies. A direct comparison between EIAV and HIV revealed that both lentiviruses maintain similar immature interfaces, which are established by both conserved and non-conserved residues. In both EIAV and HIV-1, IP6 regulates immature assembly via conserved lysine residues within the CACTD and SP. Lastly, we demonstrate that IP6 stimulates in vitro assembly of immature particles of several other retroviruses in the lentivirus genus, suggesting a conserved role for IP6 in lentiviral assembly., Competing Interests: The authors have declared that no competing interests exist.

The removal of tenacious dental plaque is of paramount importance; however, early diagnosis can be a challenging task in dental clinics due to the limitations of current approaches, specifically X-ray-based techniques. We have approached this problem by integrating antibacterial properties and X-ray contrast enhancement in a single probe specific to colonies of Streptococcus mutans as the most predominant and carious oral bacteria. We report the synthesis of an inherently therapeutic polymeric silane conjugated hafnium oxide nanoparticles (Hf PS NPs). Using a high-affinity pathogen-selective peptide, the concept of molecularly targeted X-ray imaging of cariogenic pathogen S. mutans was demonstrated. Ex vivo studies using extracted human tooth demonstrated striking X-ray attenuation of NPs vs. tooth. Additionally, Hf PS NPs exhibited significant bactericidal properties against cariogenic pathogen. Electron microscopy revealed that the antibacterial activity occurred via a 'latch and kill' mechanism. Mechanistic studies determined that these NPs fragmented bacterial DNA components to exert their antimicrobial effect. Importantly, Hf PS NPs effectively inhibited the growth of a mature biofilm on an ex vivo human tooth model. Finally, the NPs were applied to the rodent model of dental biofilm. Topical administration of the Hf PS NPs for 8 days (1X daily) could effectively attenuate the S. mutans biofilm challenge. This report is the first of its kind to demonstrate that HfO 2 -based NPs can be used for simultaneous diagnosis and antibacterial treatment without requiring an additional drug., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Planning and organisation of allo-grafting performed on the soldier's face. According to the experience of military conflicts facial trauma with the Ioss of person's social function occurs in 4,5-5% of patients with such injury. In most cases, these injuries can be fixed with the help of reconstructive plastic surgery using their own tissue. However, some of the wounded to various reasons the use of autologous tissue is not possible or does not allow adequately restoring the appearance and function of the person. In such cases the only way is a donor allograft. There are just over 3 dozens of such successful operations, which indicates of their uniqueness and complexity. In May 2015 at the S.M.Kirov Military Medical Academy for the first time in our country made a successful transplantation of a difficult graft to a conscript, who was injured during the duty. The article presents the basic directions of the planning and organization of this unique operation.

Hybrid revasculization of myocardium combined the advantages of mammary-coronary bypass surgery and coronary arteries stenting. It presented itself as a perspective direction in treatment of ischemic coronary disease. The article provides the results of comparison of usage of hybrid revasculization of myocardium and aortocoronary bypass in 71 patients with multivessel coronary artery disease. The data obtained indicated, that hybrid approach allowed complete revasculization of the myocardium (as in case of aortocoronary bypass), fast recovery of the patient, shortening a hospital stay due to decrease of intra- and postoperative complications.

Increasingly, there are patients with concomitant coronary artery disease and aortic valve, especially in elderly patients, who often have severe comorbidities and high surgical risk, which is undoubtedly a certain effect on the choice of method and tactics of treatment. Today, there are several approaches to the treatment of patients in this category, and all of them have certain advantages and disadvantages.

The article provides the results of minimally invasive direct revasculization of myocardium at the period from 2012 to 2014. Given method was used in 49 interventions. There weren't any lethal cases or myocardial infarctions. A mean hospital stay consisted of 8,6±2,7. Computer thomographic coronary bypass angiography was carried out after operation in terms of 6-48 months. The occlusion of mammary coronary shunt was revealed in 3 patients with minimally invasive revasculization of the myocardium in terms up to 48 months. There were noted a decrease' of hospital stay, bleeding during surgery and in early postoperative period, duration of artificial pulmonary ventilation, length of stay in intensive care unit for this group of patients.

Intervention in bifurcation coronary arteries disease is complicated kind of endovascular treatment of coronary heart disease, especially in patients of elderly and senile age. Recently, in the practice of the operating surgeon there is a large choice of bifurcation coronary artery stents. This report contains the views, features and shortcomings of the presented bifurcation structures. Despite the fact that in the Russian Federation bifurcation stents are rarely implanted, their use can greatly simplify and accelerate interventional procedures, along with the decrease of peri- and postoperative complications.

Stenting of coronary artery bifurcation lesions is one of the most difficult types of interventional procedures for coronary heart disease. The frequency of coronary artery bifurcation lesion occurs up to 20%. The article reflects a wide variety of types of classifications of coronary bifurcations compared with the basic classification for A. Medina. Having considered the arts of bifurcations stenting, from a provisional Tstenting to complex procedures culote and crush stenting, we advocate the use of bifurcation structures, especially in elderly and senile.

Modifying the curvature in magnetic nanostructures is a novel and elegant way toward tailoring physical phenomena at the nanoscale, allowing one to overcome limitations apparent in planar counterparts. Here, we address curvature-driven changes of static magnetic properties in cylindrically curved magnetic segments with different radii of curvature. The curved architectures are prepared by capping nonmagnetic micrometer- and nanometer-sized rolled-up membranes with a soft-magnetic 20 nm thick permalloy (Ni(80)Fe(20)) film. A quantitative comparison between the magnetization reversal processes in caps with different diameters is given. The phase diagrams of magnetic equilibrium domain patterns (diameter versus length) are generated. For this, joint experimental, including X-ray magnetic circular dichroism photoelectron emission microscopy (XMCD-PEEM), and theoretical studies are carried out. The anisotropic magnetostatic interaction in cylindrically curved architectures originating from the thickness gradient reduces substantially the magnetostatic interaction between closely packed curved nanowires. This feature is beneficial for racetrack memory devices, since a much higher areal density might be achieved than possible with planar counterparts.

An atomic clock based on x-ray fluorescence yields has been used to estimate the mean characteristic time for fusion followed by fission in reactions 238U + 64Ni at 6.6  MeV/A. Inner shell vacancies are created during the collisions in the electronic structure of the possibly formed Z=120 compound nuclei. The filling of these vacancies accompanied by a x-ray emission with energies characteristic of Z=120 can take place only if the atomic transitions occur before nuclear fission. Therefore, the x-ray yield characteristic of the united atom with 120 protons is strongly related to the fission time and to the vacancy lifetimes. K x rays from the element with Z=120 have been unambiguously identified from a coupled analysis of the involved nuclear reaction mechanisms and of the measured photon spectra. A minimum mean fission time τ(f)=2.5×10(-18)  s has been deduced for Z=120 from the measured x-ray multiplicity.

The investigation included 45 patients with coronary heart disease operated for aorto-(mammaro)-coronary artery bypass grafting. It was found that surgical treatment resulted in the improvement of subjective symptoms of angina and increased contractile reserve of the myocardium during the first days after surgery. Significantly increased subjective and objective exercise tolerance, improvement of local myocardial contractility, diastolic function and symptoms of myocardial remodeling were registered only within 6 months after surgery. Assessment of the dynamics of the myocardial contractile reserve can be used as an objective criterion of the earliest positive result of surgical treatment of coronary artery disease.

Determination of the necessary length of the bypass is one of the principal stages of operation of the aorta-coronary bypass. The greatest difficulty of the determination of the bypass length is the first-priority applying of proximal anastomoses. It requires the surgeon to have great experience, the operation to be longer. It also makes it necessary to prepare a conduit of deliberately excessive length. A device is proposed for the determination of the necessary bypass length during operation of aorta-coronary bypass consisting of a crocodile grip with a fixed to it polymer tube.

The article presents a technique of performing coronary bypass operations on the beating heart used by the authors in 847 patients which is based on high thoracic epidural anesthesia, primary formation of proximal anastomoses of the aorto-coronary bypasses and specified succession of the formation of distal, stabilization of the local part of the heart in the field of placing distal anastomosis and access to the lateral and posterior surface of the heart with vacuum stabilizers, using blower-humidifier and intracoronary shunts.

Left ventricular assist device "Incor" ("Berlinhear", Germany) implantation experience in patient with ischemic cardiomiopathy and severe congestive heart failure is presented. Left ventricular assist device implantation was followed by coronary artery bypass grafting simultaneously. Total assist time was 211 days. Complications developed during assisting time are shown. After Left ventricular assist device explantation three chamber pacemaker was implanted as cardiac resynchronization therapy. Left ventricular end diastolic size decreased (from 78 to 70 mm), ejection fraction increased (from 19 to 35%) during assist time.

Polysiloxane-based scintillators are promising for employment in harsh environments, owing to their outstanding radiation resistance and thermal properties over the traditional plastics (polyvinyltoluene and polystyrene). In this work, cross-linked polydimethyl-co-diphenylsiloxane (PMPS) scintillators with 22% molar percentage of diphenylsiloxane units have been synthesised. 2,5-Diphenyloxazole and Lumogen Violet (BASF) were employed as primary and secondary fluor, respectively. Thermal neutrons sensitivity was achieved through the addition of 3% wt of ortho-carborane. Scintillation yield measurements were made by exciting with (241)Am alpha source samples with different concentrations of dye molecules. PMPS-based scintillators with ∼50% light yield as compared with the commercial plastic scintillator EJ212 were produced. The scintillation yield of the B-loaded samples under thermal neutrons was tested with a moderated Am-Be source and compared with the commercially available EJ254 (5% wt B). 2.2 MeV neutrons were produced by irradiating with a 4.0 MeV proton beam an LiF target, thus exploiting the reaction (7)Li(p,n)(7)Be. Time-of-flight measurements were performed to distinguish pulses due to neutrons or gamma. A similar test was performed with an EJ254 commercial scintillator for comparison. Using the same set-up, polyethylene bricks were used as a moderator to produce low-energy neutrons for testing B-loaded samples.

The features of preoperative status, course of the perioperative period and immediate results of coronary shunting were compared and analyzed in 523 patients, 56 of them were women. In female patients there were more often factors negatively influencing the course of the postoperative period. No additional intraoperative risk factors were found. The direct results of coronary shunting proved to be similar in men and women. No significant difference in the frequency of the development of early postoperative complications and hospital lethality, considerable correlation between the gender and frequency of postoperative complications were established by the methods of correlative analysis.

Diffuse lesions of the anterior interventricular artery (AIVA) at different levels were diagnosed in 27 out of 417 patients operated for post-infarction aneurysm of the left ventricle (PIALV). During the preoperative period coronography, ventriculography, ultrasonic examination of the heart were made in all the patients, one-photon emission computed tomography with 123I-iodopent was used for radioisotope investigation of perfusion and metabolism of the myocardium. The presence of PIALV, diffuse atherosclerotic lesion of AIVA and viable myocardium in its basin was taken as an indication for autovenous plasty of the artery with the following shunt of the left intrathoracic artery and resection of PIALV.

The gamma decay of the giant dipole resonance (GDR) in the 132Ce compound nucleus with temperature up to approximately 4 MeV has been measured, using the reaction 64Ni + 68Zn at E(beam) = 300, 400, and 500 MeV. The gamma and charged particles measured in coincidence with recoils are consistent with a fully equilibrated compound nucleus emission. The GDR width, obtained with the statistical model analysis, is found to increase almost linearly with temperature. This increase is rather well reproduced within a model including thermal shape fluctuations and the lifetime of the compound nucleus.

The features of pilot organism adaptation to the conventional for this professional group hypoxic load were studied by mathematical analysis of heart rate. Significant alteration of structure and amount of correlation intercommunications between the indices of the heart rate in pilots of different age and state of health was established.

Interrelation features of professionally important psychophysiological qualities for candidates to flying training with a different suitability level were studied in research by means of the factorial analysis. It is revealed that the factorial structure of psychophysiological qualities for persons with a various suitability degree to flying work differs appreciably, that has allowed to allocate the characteristics determining a "suitability" and "unfit" degree to professional work. The two-stage and one-stage procedures of professional psychophysiological selection, and also those realizations of initial selection and monitoring of adjunct pilot's psychophysiological functions which are taking into account the purposes, technologies and opportunities of the selection organization in the given establishment are offered.

The emission time chronology of neutrons, protons, and deuterons from the E/A=61 MeV 36Ar+27Al reaction is deduced from two-particle correlation functions.

Radiative capture of protons is investigated as a probe of clustering in nuclei far from stability. The first such measurement on a halo nucleus is reported here for the reaction 6He(p,gamma) at 40 MeV. Capture into 7Li is observed as the strongest channel. In addition, events have been recorded that may be described by quasifree capture on a halo neutron, the alpha core, and 5He. The possibility of describing such events by capture into the continuum of 7Li is also discussed.

Some early symptoms of devascular femoral head necrosis are covered in the paper together with the results of surgical treatment of 48 cases. Both extra- and intraarticular operations were performed. The extraatricular interventions proved to be the best: intertrochanteric medializing osteotomies, drilling of the canal with introduction of cortical bone grafts into the femoral neck and head and tunnelization followed by the replacement of the femoral head defect with autospongy bone tissue.

The author reports the results of treatment in 58 patients with oblique aplastic pseudarthrosis of tubular bones diaphyses of the lower limbs. For treatment extrafocal with counter-lateral compression by means of pins with bearing surfaces. By the present time nearly in all patients (52 of 58) with the mentioned complications such kind of treatment resulted in rehabilitation of the main motion-bearing function of the extremity.

The experience of the treatment of 107 patients with nonunited open and gunshot fractures of the crus bone complicated by osteomyelitis is described. In 100 patients osteomyelitis was liquidated, in 97 patients consolidation of bone fragments was achieved, the supporting ability and joint movements were restored.

By using a complex of investigation methods variants of branchingout of the spinal cord and spinal ganglia blood supply sources and their anatomo-topographic interrelations were discerned in 140 preparations of lumbar spinal ganglia obtained from human cadavers of both sexes and different age. With the help of anastomoses these sources form a specific arterial circle around the ganglion. The radicular arteries are noted to be non-equivalent. The annular architectonics of the blood vessels is considered as a morphological manifestation of a functionally reliable blood supply to the border area between the central and peripheral divisions of the nervous system.