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INTRODUCTION. The issue of a relapse-free treatment in herniology has not yet been resolved. Over the past few years due to the development and wider use of modern technologies, there has been an improvement in the quality of surgical care for patients with inguinal hernias. Approaches to preparation for surgical interventions, redistribution of surgical options and postoperative management of patients have also changed significantly.The OBJECTIVE of this work was to determine modern aspects of the treatment of patients with inguinal hernias and the effectiveness of various methods of surgical treatment in herniology, as well as to identify differences due to statistical heterogeneity in research results.METHODS AND MATERIALS. More than 2,000 domestic and foreign publications on the surgical treatment of inguinal hernias were subjected to preliminary analysis. Taking into account the inclusion and exclusion criteria, the review included 10 scientific studies published in domestic and foreign scientific journals from 2014 to 2022. We analyzed 2649 cases of surgical treatment of patients with inguinal hernias, assessing the results of treatment and the clinical effectiveness of various methods.RESULTS. When comparing methods of operations, the best results in terms of the frequency of relapses and the frequency of specific complications were obtained with transabdominal preperitoneal plastic surgery of inguinal hernias. The worst results in terms of the frequency of relapses were demonstrated by total extraperitoneal plastic surgery, in terms of the frequency of specific complications, the highest percentage belongs to Liechtenstein hernia repair. Taking into account the heterogeneity of patients in the studies, we can conclude that the use of transabdominal preperitoneal plastic surgery is a priority.CONCLUSION. The overall effectiveness of treatment of patients with inguinal hernias has significantly improved using modern principles of evidence-based medicine, standardized approaches to the management of surgical patients and the prevention of possible complications. Endovideosurgical operations widely introduced into practice all over the world have shown the best results in assessing the risk of relapses and specific postoperative complications. However, compared to other methods, the share of endovideosurgical operations is a smaller percentage.

BACKGROUND. Absolute numbers of platelets are of key importance for determining the severity of multiple organ failure in sepsis, while their fluctuations within normal values are not taken into account. At the same time, early detection of a downward trend in this parameter may have greater predictive value in predicting disease outcomes. AIM OF STUDY. To identify trends in changes in platelet levels in patients with widespread peritonitis and determine the possible relationship of these changes with the outcome of the disease. MATERIAL AND METHODS. The basis of the work was an analysis of the results of treatment of 220 patients with diffuse secondary peritonitis who were treated at the Elizavetinskaya Hospital in 2013–2019. A correlation analysis was conducted to identify relationships between disease outcomes, assessed according to the severity of postoperative complications, and the degree of platelet reduction, expressed in platelet ratio. The further ROC analysis allowed us to identify a threshold value of the platelet ratio, which excess indicated a high risk of an unfavorable outcome. RESULTS. Based on the data obtained, the threshold value of the platelet ratio in the first two days has no clinical significance. At the same time, starting from the third 3rd day of the postoperative period, the quality of the resulting classifier increased, which confirms the prognostic significance of the threshold value of the platelet ratio, which was 1.72 on the third 3rd day after surgery. In other words, a decrease in platelet levels more than 1.72-fold on the 3rd day indicates a high risk of an unfavorable outcome, which may be associated primarily with intra-abdominal complications. This provision also indirectly confirms the fact that among patients with platelet ratio (PR) values exceeding 1.72 on the 3rd day, 68.7 % ultimately underwent repeated surgical interventions (33 patients out of 48 with high PR values, and the overall mortality rate was 72.1 %.Similar indicators in the subgroup with low PR values were 27.6 % of reoperated patients (29 of 105) and 26.7 % of unfavorable outcomes. CONCLUSION. The results obtained indicate that the degree of platelet reduction, rather than their absolute levels, has greater predictive value in patients operated on for diffuse peritonitis.

This review is devoted to the consideration of prospects and directions for the development of methods and approaches to the analysis of high-purity industrial gases and volatile hydrides, chlorides, fluorides, and organoelement compounds with natural and isotopically enriched compositions. The currently known capabilities for the determination of impurities in them using mass spectrometry, IR spectroscopy, gas chromatography, and chromatography-mass spectrometry are analyzed., Author(s): A. Yu. Sozin [sup.1] , V. A. Krylov [sup.2] , O. Yu. Chernova [sup.1] , T. G. Sorochkina [sup.1] , A. D. Bulanov [sup.1] , A. P. Kotkov [sup.3] [...]

BACKGROUND The question of the duration and volume of conservative measures in patients with acute adhesive intestinal obstruction (AAIO) remains the subject of numerous discussions. Aim of study To evaluate the efficacy and safety of various periods of conservative therapy in patients with AAIO using a systematic review. MATERIAL AND METHODS Criteria for inclusion in the systematic review were cohort studies investigating various regimens and duration of conservative therapy in adult patients with AAIO. The search for primary sources was carried out in the CENTRAL, PubMed and eLibrary databases. The assessment of the safety of various terms of AAIO was carried out by comparing the immediate results of treatment. RESULTS The review included 19 papers with a total of 2,570 observations. At the first stage, the effectiveness of various conservative therapy regimens was evaluated by calculating the risk ratio for the success of non-surgical treatment. Taking into account the significant statistical heterogeneity of the participants, the calculation of the final risk ratio was carried out using a random effects model. The hazard ratio for nonoperative success was 1.91 (95% CI 1.2–3.1) in favor of gastrografin and 3.71 (95% CI 1.3–10.6) in favor of preoperative intestinal intubation. Taking into account the multidirectional pathogenetic action of the studied methods of conservative therapy, the obtained results suggested that the probability of success of non-surgical treatment correlates to a greater extent with the total duration of the AAIO episode than with the duration of conservative therapy, which was indirectly confirmed by constructing scattering graphs with approximation lines and calculating the coefficients determination, which amounted to 0.69 and 0.77 for the subgroups of standard therapy and undiluted gastrografin, respectively. Subsequently, the impact of different duration of an episode of AAIO on the immediate outcomes was assessed: mortality, frequency of resection interventions, complications, and total bed-day. There were no statistically significant differences in favor of early interventions (up to 48 hours) for all compared parameters; an increase in the total duration of AAIO up to 89 hours was not associated with worse results. CONCLUSION The total duration of the episode of acute adhesive intestinal obstruction, including both the pre-hospital duration and the duration of non-surgical treatment is prognostically significant. In other words, when calculating the allowable duration of conservative measures, one should proceed from the total duration of intestinal passage disturbance, which should not exceed 89 hours.

INTRODUCTION. The main component of the treatment of patients with secondary diffuse peritonitis is surgical intervention aimed at controlling the source of infection. In some cases, a single intervention is not enough for effective sanation of the abdominal cavity, which requires relaparotomy. There is currently no generally accepted approach to the timing and order for such interventions. The OBJECTIVE was to carry out a comparative analysis of the immediate results of patients with secondary diffuse peritonitis treatment using strategies of planned and «on-demand» relaparotomies.METHODS AND MATERIALS. The inclusion criteria for the review were randomized and cohort controlled trials comparing the efficacy of planned and «on-demand» relaparotomies in the treatment of secondary diffuse peritonitis. Primary sources comparing the results of these surgical strategies in adult patients were searched using the CENTRAL, MEDLINE, Scopus and eLibrary databases. The studies were independently assessed for inclusion by two review authors according to the stated eligibility criteria followed by data extraction. The methodological quality of randomized trials was assessed using the Cochrane tool for assessing the risk of bias, nonrandomized ones – using the Russian version of the Newcastle-Ottawa scale. Arising disagreements were resolved through discussions.RESULTS. The review included one randomized controlled trial according to the inclusion criteria and 16 nonrandomized cohort studies with a total of 3672 participants (1835 and 1837 patients undergoing planned and «on-demand» relaparotomies, respectively). Given the significant statistical heterogeneity of the included studies (χ2=119.2, df=16, p

Relevance. The most practiced method of treating patients with acute intestinal obstruction - urgent surgical intervention - does not guarantee remission, contributing to the progression of morphological changes in the abdominal cavity. From this perspective, a shift in emphasis towards the planned surgical treatment of patients with adhesive disease with the use of the existing anti-adhesive methods after conservative resolution of the intestinal passage disorders looks like a promising direction.Aim of the study. Improving the results of patients with acute adhesive intestinal obstruction treatment by developing a point-rating scale that allows to highlight groups of patients who are prone to conservative resolution of intestinal passage disorders episode, and, thereby, reduces the proportion of urgent interventions.Material and methods. The analysis of the 125 patients treatment results (retrospective group) admitted with symptoms of acute adhesive intestinal obstruction was carried out. On this basis, the point-rating scale was developed including a number of factors that have certain value in terms of predicting the probability of conservative therapy success. Subsequently the developed scale was applied in 170 patients (prospective group) as part of treatment tactics implementation aimed at maximally conservative resolution of adhesive intestinal obstruction without negative effect on the immediate results of patients operated in later periods.Results. The developed point-rating scale made it possible to reduce the frequency of urgent interventions among patients with signs of acute adhesive intestinal obstruction (from 79.2% to 57.6%) due to longer conservative measures — 18.1±17.2 and 11,2±8.7 hours in prospective and retrospective groups, respectively). There was no negative impact on the frequency of resection interventions (12.2 and 16.1% in the prospective and retrospective groups) as well as postoperative complications and overall mortality.Conclusions. The developed point-assessment scale made it possible to stratify patients in accordance with the probability of conservative therapy success and to justify its continuation for more than 12 hours in low-risk patients. The obtained results allow us to recommend the proposed scale for use in clinical practice.

INTRODUCTION. The problem of treating patients with peritonitis has always been and still remains relevant in surgery. Moreover, aspects of treating patients with tertiary peritonitis requiring repeated interventions are of particular importance. The OBJECTIVE of this work was to develop and evaluate the clinical effectiveness of a score-prognostic scale that allows to identify groups of patients with a high risk of persistent surgical infection in the abdominal cavity, in which a single intervention cannot be considered effective even despite the elimination of the primary surgical infection focus.METHODS AND MATERIALS. To achieve the goal, a correlation was evaluated between a number of factors and the likelihood of relaparotomy in a retrospective group consisting of 111 patients with secondary peritonitis. Based on the achieved data, score-prognostic scale for assessing the severity of peritonitis was developed, which allowed to formulate an algorithm of surgical tactics, which was used in the treatment of 109 patients. A group of 34 people with a high risk of tertiary peritonitis development was allocated from the number of patients – of which 20 patients had a total number of 39 planned surgical interventions.RESULTS. The use of the developed scale led to an increase in the total number of surgical interventions, however, reducing postoperative mortality by 1.7 times (p = 0.001) mainly due to improved survival rates in the group of patients with severe forms of peritonitis.CONCLUSION. The obtained results allowed to recommend the developed integral prognostic scale for assessing the severity of peritonitis for use in clinical practice.

BACKGROUND Much attention is currently given to the issues of surgical treatment of common forms of secondary peritonitis, which is associated with unsuccessful results of treatment of this group of patients and the lack of a unified approach to surgical tactics among patients requiring repeated surgical interventions for adequate sanitation of the abdominal cavity.AIM OF STUDY Improvement of the immediate results of treatment of patients with generalized secondary peritonitis by determining the approaches to choosing the optimal surgical tactics.MATERIAl AND METHODS We analyzed the results of treatment of 220 patients with common forms of secondary peritonitis who were treated at the Elizavetinskaya hospital of St. Petersburg in the period from 2013 to 2019. The indicated patients were divided into two groups, comparable in terms of the main features, including the depth pathomorphological changes in the abdominal cavity, assessed by calculating abdominal cavity index (ACI) and the Mannheim peritonitis Index (MPI). The main group consisted of 109 patients, where developed algorithm was used, which supposed planned sanitation relaparotomies within up to 2 days in patients with high values of ACI and MPI. The comparison group included 111 patients who underwent sanitation interventions “on demand”, that is, in the presence of signs of persistence of the infectious process in the abdominal cavity. The results of treatment were compared by assessing the level and structure of postoperative mortality, the frequency of complications, and the length of stay in intensive care units and hospital. Mathematical-statistical dataprocessing, calculations of intensive and extensive coefficients of features, assessment of the statistical significance of differences in features for the studied groups were carried out.RESUlTS The use of a differentiated approach to performing planned relaparotomy in patients with generalized peritonitis made it possible to reduce the overall mortality 1.7-fold (from 51.3 to 30.2%) (p=0.001) due to a decrease in the proportion of abdominal sepsis as a cause of unfavorable the outcome. No significant effect of the use of this algorithm on the frequency and structure of complications, as well as the duration of multiple organ failure, was found.FINDINGS The use of planned relaparotomy among the selected patients helps to reduce postoperative mortality without significantly negatively affecting other treatment results.

The review is devoted to the capabilities of gas chromatography-mass spectrometry in the analysis of high-purity volatile hydrides of naturally occurring and isotopically enriched compositions. Problems related to experimental techniques, chromatographic separation, identification, and quantitative determination of impurities are discussed. The application of this method has significantly expanded data coverage on the nature, number, and limiting possibilities of the determination of impurities in volatile inorganic hydrides. The identified impurities are compounds of various classes. Among them are atmospheric gases; saturated, unsaturated, and aromatic C.sub.1-C.sub.9 hydrocarbons; chlorine- and fluorine-containing C.sub.1-C.sub.4 hydrocarbons; homologues and alkyl derivatives of hydrides; Si.sub.2-Si.sub.4 siloxanes; fluorosiloxanes; oxygen-containing hydrocarbons; sulfur-containing substances; and hydrides of other elements. Gas chromatography-mass spectrometry analysis made it possible to detect the presence of impurities in isotopically enriched silicon and germanium hydrides, which are their molecular isobars. The use of gas chromatography-mass spectrometry in the analysis of high-purity inorganic hydrides makes it possible to reach the detection limits of impurities of 10.sup.-8-10.sup.-5 mol %., Author(s): A. Yu. Sozin [sup.1], V. A. Krylov [sup.2], O. Yu. Chernova [sup.1], T. G. Sorochkina [sup.1], A. P. Kotkov [sup.3], N. D. Grishnova [sup.3], A. I. Skosyrev [sup.3], G. [...]

The impurity composition of arsine is studied by gas chromatography-mass-spectrometry. Impu-rities of permanent gases; carbon dioxide; hydrides; saturated, unsaturated, and aromatic hydrocarbons C.sub.1-C.sub.6; halogenated hydrocarbons; sulfur compounds; and arsine and diarsine alkyl derivatives are determined. The impurity level of high-purity arsine is 10.sup.-6-10.sup.-5 vol %. Impurity concentrations in arsine after synthesis and in the fractions extracted in the course of its rectification are rather high and lie in the range 10.sup.-6-0.1 vol %. The limits of detection for impurities are 2 x 10.sup.-7-2 x 10.sup.-4 vol %., Author(s): A. Yu. Sozin [sup.1], T. G. Sorochkina [sup.1], O. Yu. Chernova [sup.1], A. P. Kotkov [sup.2], N. D. Grishnova [sup.2], D. M. Polezhaev [sup.2], G. V. Pushkarev [sup.2], S. [...]

Various modifiers are used for non-furnace processing of cast iron. Some of them are designed for inoculating modification, which improves mechanical properties and eliminates the appearance of whiteness in castings, while others are designed for spheroidizing processing, in particular for producing cast iron with spherical and vermicular graphite. Some have both spheroidizing and inoculating properties. The main part of inoculating and spheroidizing modifiers is made on iron-silicon, Nickel and copper bases.In addition to the chemical composition, the size of the modifier particles, as well as their shape, are of great importance for modification. The optimal size of the fraction depends significantly on the non-furnace processing technology. Thus, for the larger the bucket and the longer the casting the longer the modification effect is required. One of the methods to achieve this is to increase the particle size of the modifier to 50 mm. When intraform processing of cast iron with spherical and vermicular graphite, magnesium-containing modifiers have strict limits on the upper size (4...5 mm), and in addition, the content of small fractions (less than 0.6...1 mm) is not allowed.The use of «heavy» magnesium-containing ligatures for spheroidizing modification of cast iron in order to obtain higher physical and mechanical properties has scientific and practical interest. Numerous studies show that for maximum effect the formation of the structure of the spheroidal graphite, dispersed pearlite metallic base of SGI (spheroidal graphite iron) relevant question is not only selection of the chemical composition of magnesium alloys, but also of the fractional composition, as well as effective method of input into the liquid melt.The purpose of this work was to study the technological features of obtaining cast iron with spherical graphite by bucket modification of copper-magnesium ligature.The researchers used a Leo–1420 scanning microscope, a Polam l-213 optical microscope, and a VEGA II LMU electron microscope with an INCA ENERGY 350 microanalyzer. High-speed induction melting plant, a set of equipment for analyzing the technological and mechanical properties of high-strength cast iron were used.Earlier experimental studies have shown the real possibility of obtaining in the laboratory a «heavy» copper-magnesium alloys as the alloying of magnesium metal with copper, followed by rapid cooling with use of rolling and plastic deformation of powder alloys. Analysis of test results of samples of such alloys showed that it depends on the value of its additives into liquid iron in the structure of formed graphite phase in compacted and globular form. At the same time, the metal base of cast iron is additionally alloyed with copper, which has a favorable effect on the strength characteristics of SGI.However, an urgent problem is the possibility of the appearance of a cementite phase in the structure of high-strength cast iron as a result of its increased supercooling due to the process of spheroidization of the graphite phase. This phenomenon is compounded by the fact that the copper-magnesium ligature, in contrast to the «light» ligature, does not contain silicon active graphitizer. This feature must be taken into account when obtaining high-strength cast iron of high grades.

The impurity composition of natural and isotopically enriched silane obtained from magnesium silicide and silicon tetrafluoride is studied by gas chromatography-mass-spectrometry. The impurities characteristic of silane with natural and isotopically enriched composition are atmospheric gases; carbon dioxide; hydrides; saturated, unsaturated, and aromatic hydrocarbons; halogenated hydrocarbons; alkyl derivatives and silane homologues, siloxanes. The impurity content of high-purity silane does not exceed 10.sup.-7-10.sup.-5 mol % After synthesis, the concentrations of impurities in the silane and fractions isolated by its distillation purification lie in the range n x 10.sup.-6 - n x 10 mol % The limits of detection for impurities are 1 x 10.sup.-8-9 x 10.sup.-4 mol %, Author(s): A. Yu. Sozin [sup.1], V. A. Krylov [sup.2], O. Yu. Chernova [sup.1], T. G. Sorochkina [sup.1], A. D. Bulanov [sup.1], O. Yu. Troshin [sup.1], A. P. Kotkov [sup.3], N. [...]

A method of chromatography-mass spectrometry is used to study the impurity composition of arsine synthesized by the reaction of arsenic chloride with sodium borohydride. Capillary adsorption columns with adsorbents modified silica and polytrimethylsilylpropine is used for the separation of impurities. Impurities are identified by comparing their mass spectra with the NIST database, published data, as well as by reconstructing their structures from fragment ions. Impurities of permanent gases; saturated and unsaturated hydrocarbons C.sub.1-C.sub.6; chlorinated, oxygenated, and aromatic hydrocarbons; volatile inorganic hydrides; and alkyl derivatives of arsine, trimethyl fluorosilane, carbon sulfur dioxide, and dimethyl sulfide are identified in arsine. Mass spectra of C.sub.2H.sub.3AsH.sub.2, CH.sub.3AsHC.sub.2H.sub.5, and C.sub.2H.sub.5As.sub.2H.sub.3 impurities are obtained for the first time., Author(s): A. Yu. Sozin [sup.1], O. Yu. Chernova [sup.1], T. G. Sorochkina [sup.1], A. P. Kotkov [sup.1] [sup.2], N. D. Grishnova [sup.1] [sup.2], D. M. Polezhaev [sup.2], G. V. Pushkarev [...]