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Leakage of intestinal anastomoses remains an issue in view of the increasing number of patients who need reconstructive interventions in different parts of the gastrointestinal tract. Researchers around the world are actively looking for methods of strengthening intestinal anastomoses. The literature presents various approaches to sealing intestinal anastomoses in experimental animals using allografts, biological sealants, polymer film materials, etc. This article classifies and analyzes innovative methods of strengthening intestinal anastomoses to prevent their leakage. We also describe a concept of developing polymer membranes for interventions on hollow organs and our experience in this field of work and making of medical devices at the premises of a university research laboratory.

Introduction: In modern clinical practice, there is no common and effective hemostatic agent for solid organs of the abdomen. Local agents such as hemostatic sponges, membranes, powders seem promising. The main advantages of hemostatic powders include relatively high efficacy, portability, versatility, as well as simplicity and low cost of manufacturing.Objective: To study the hemostatic efficacy of hemostatic powders’ samples based on the sodium salt of carboxymethylcellulose (Na-CMC) in an acute in vivo experiment.Materials and methods: The study was based at Kursk State Medical University. Fifty male Wistar rats (weighing 220-239 g) were selected as test animals. They were evenly divided into 5 groups: ARISTA AH, Cutanplast Powder, and Na-CMC hemostatic powders with 3 different dynamic viscosities: low (50-200 cP), medium (400-800 cP) and high (1500-3000 cP). Under general inhalation anesthesia, median laparotomy was performed in Wistar rats, the middle lobe of the liver was removed into the wound, and then marginal tangential resection was performed. We applied hemostatic powders of each group to the resulting wound, and then estimated the bleeding time and the volume of blood loss. We used the Mann-Whitney test (P ≤ .05) to assess the statistical significance of differences between the study groups.Results: We recorded the minimum bleeding time and the smallest volume of blood loss for the samples based on the Na-CMC and found no statistically significant differences between the viscosities groups.Conclusions: With Na-CMC hemostatic powder the bleeding time and the volume of blood loss were reduced by 3.6 and 2.2 times, respectively, comparing to the control group. These results were considered statistically significant (P ≤ .05).

Introduction: There is no adequate and easily reproducible model of complicated necrotizing enterocolitis (NEC) that allows to study its etiopathogenesis and test various surgical treatment options in an experiment.Objective: To devise a method for in vivo modeling of complicated NEC using laparoscopy.Materials and methods: Our study was conducted at the premises of the Laboratory of Experimental Surgery and Oncology (Scientific Research Institute of Experimental Medicine, Kursk State Medical University) in compliance with international ethical standards and guidelines for humane animal treatment. Fifteen immature male rabbits underwent laparoscopy under inhalation anesthesia and then subserosal injection of damaging solutions (33% H2O2, 10% CaCl2, 4% KCl, 70% C2H5OH, 10% CH2O) into the intestinal wall. In 24 hours, we performed laparotomy, assessed pathological changes visually, and resected the section of the intestinal tube at the injection site. Then we performed a single­layer end­to­end intestinal anastomosis. Histological samples were made from a biopsy specimen. Morphological assessment of the changes was performed.Results: The most pronounced macro­ and microscopic changes were found in the animals injected with hydrogen peroxide. We assessed changes in the abdominal cavity 24 hours since the start of modeling and observed a pattern of partial intestinal obstruction and serous peritonitis. The morphological pattern was characterized by acute circulatory disorder in the intestinal wall with ulcerative necrotic defects and perforations.Conclusions: Based on morphological manifestations we devised a method for modeling complicated NEC using laparoscopy. It is easily reproducible in an in vivo experiment, close to the clinical situation, and allows to simulate typical morphological changes during severe NEC.

Currently, purulent-inflammatory diseases of the abdominal organs are the prevalent causes of complications and mortality. Treatment of these diseases complicated by peritonitis is one of the urgent problems in modern clinical medicine. Experiment is important for testing new treatment methods. This article provides a systematic analysis of the current in vivo models of the purulent peritonitis, which are used to test the options for surgical treatment and combinations of antibacterial drugs. We describe the most common models as well as rare simulations of specific peritonitis. It should be noted that despite the wide use of minimally invasive techniques, the literature has few reports on simulation of peritonitis through the laparoscopic approach.

Purpose of the study. Assessment of the effect of hemostatic materials on concentration of calcium of blood.Materials and methods. The following groups of local hemostatic materials were studied: collagen plate (No. 2), hemostatic sponge from medical gelatin (No. 3), oxidized cellulose material (No. 4), experimental samples of hemostatic sponge developed by the team of authors, based on the sodium salt of carboxymethylcellulose with various modifications (groups No. 5-8). In the control group (No. 1), only blood of volunteer donors was used, without introducing the test materials. Evaluation of the effect of hemostatic materials on blood calcium concentration was carried out according to the described method: «Method for comparative investigation of the effectiveness of local hemostatic agents in an in vitro experiment» Russian patent No. 2709 517. According to the results of the study, median, 25 and 75 percentiles were calculated. The validity of differences between groups was determined using the non-parametric Mann-Whitney test (p

Background Today, one of the problems of modern society in the health are the high rates of mortality from cardiovascular disease.Aim of study Study of physico-mechanical properties of the vascular implants and aortic wall to support an adequate choice of the plastic material when performing reconstructive surgeries in patients of various age groups.Material and methods As an object of study, sections of the anterior wall of the thoracic and abdominal aorta were taken from 30 corpses. Study groups: Group 1 - from 33 to 60 years, Group 2 - from 60 to 92 years. We also evaluated the physical and mechanical properties (finite length, plastic strain ratio, tensileuniaxial load (longitudinal)) of the three vascular implants made of polyethylene terephthalate and polytetrafluoroethylene. Kruskal–Wallis H test was used to determine the significance of differences.Results The finite length of the aortic wall varies slightly in the study groups, while plastic strain rate of the abdominal aorta in Group 1 was 1.3 times higher than that in the chest. When assessing physical and mechanical properties of thoracic and abdominal aorta, values of “finite length” (1.4 times) and “plastic strain ratio” (1.5 times) were higher in Group 1, and the value of the tensile load indicator is higher in Group 2 compared to Group 1 (1.47 times). The tensile load of the thoracic aorta in Group 1 is 14 H and 27 H lower than the samples of Groups 1 and 3, respectively, but 1.6 times higher than the sample of Group 2. The tensile load of the abdominal aorta of Group 1 is 13 H higher compared to the sample of Group 1 and twice higher compared to the sample of Group 2. The study Group 2 values of tensile load for thoracic aorta are 1.3 times, 2.4 times and 1.16 times higher than respective implant values (sample 1, 2 and 3, respectively).Conclusion We used samples of Group 3 vascular implants for replacement of abdominal aorta and Group 1 implants for thoracic aorta. In study Group 2 vascular implants of Group 3 may be used for abdominal and thoracic aorta replacement due to the proximity of the values of the evaluated characteristics.

Purpose of the study. To evaluate the dynamics of deformation of spongy application hemostatic materials in an in vitro experiment. Materials and methods. As materials of the study the following samples of hemostatic materials were used: Tachocomb (No. 1), Gelita-Spon Standard (No. 2), Reggicel Fibrillar (No. 3), samples of hemostatic sponges developed jointly with Lintex (St.Petersburg, Russia) on the basis of sodium-Carboxymethyl Cellulose (No. 3): Samples were placed on a glass substrate which was mounted on the rising REM cross-arm 0.2–1 to estimate 50% compression residual strain. A glass substrate rigidly attached to the indenter was mounted so that its lower surface would touch the upper surface of the sample. The crossarm was then lifted at 30 mm/min, compressing the sample until the force reached 50 N, after which the sample was allowed to stand under pressure for 10 seconds. After the load was removed, the sample was removed from the substrate and the compression thickness measured (immediately after compression, after 5, 10 and 30 minutes). Results. The values of the compression residual deformation on the thickness 50% (immediately after the load removal) of the samples of group No. 1 differ statistically significantly from the values of groups No. 2 and No. 3 on 5.92 and 3.51, respectively. The difference between groups No. 1 and No. 4 is 5.61. The ODP values 50% 5 minutes after the load of Group No. 1 samples was removed differ from Groups No. 2 and No. 3 on 5.93 and 3.85, respectively. The difference between groups No. 1 and No. 4 is 6.57. After 30 minutes after compression, the values of the residual deformation of the samples of group No. 1 differ from those of groups No. 2 and No. 3 on 6.9 and 4.3. The difference between groups No. 1 and No. 4 is 6.9. Also, the values of the residual deformation of the samples of group No. 2 exceed the values of the samples of group No. 3 by 1.6 times, and in comparison with group No. 4 is less by 0.03. There are fewer statistical differences with other groups in pilot groups 5–7. Conclusion. The highest values of the indicator "residual deformation at compression by thickness 50%" are noted in group No. 7 (samples based on Na-CMC unpressurized) — 32.34, which causes high mechanical properties of jaws made from this material.

One of the biggest challenges facing Russian higher schools administrations is a necessity of management system modernization. That is why in the present study we aimed to measure the effectiveness of a new innovative ranking system implemented at Kursk State Medical University, and finding the part of personal teacher rating determined by his scientific activity. Methods: As criteria for this study, we used data, obtained during an external audit, performed by Interdepartmental monitoring commission in higher educational institutions of Russian Ministry of Education in 2013–2017. Higher school administration, as well as university teachers, could directly affect these rates by making of administrative decisions and act more like scientist or teacher. Results: In 2017, level of integral rate called «Scientific and research activities» showed 2.2 time increasing if compared to 2013. Meanwhile, next rates (per 100 university teaching staff workers) also increased: citation number in Web of Science and Scopus (in 31,6 times), citation number in Russian Science Citation Index (in 22,5 times), number of publications in Web of Science and Scopus (in 2,5 times) and number of research and development projects (in 2 times). According to these measures, we can conclude that levels of scientific activity carry on large part in university rating and appear to be easiest productivity indicators to manage. Practical implications: At the end of the article the authors present recommendations for increasing scientific ranking levels for high schools administrations.

The article presents the background of healthcare system computerization development starting from the time when preconditions for IT systems implementation appeared up to the present moment. It outlines the problems that emerged in the course of implementing the projects aimed at computerizing the RF Healthcare System and providing a high-technology support for it; it features also the indicators related to financial investments into the healthcare information systems. Based on the reports of the authorized agencies the project implementation efficiency is analyzed and solution options for the existing problems are shown. The article reveals development prospects for IT implementation in healthcare.Objective. Study of IT systems development and incorporation into the practical healthcare structure of the Russian Federation based on the freely available data. Laws and regulations, including reports in healthcare, publications of Russian and foreign lead researchers in economics and medical administration, analytical reviews of consulting companies such as RBC, Price Waterhouse Coopers (London, UK), C-News Analytics (Russia, Moscow), and Vademecum business magazine (Russia, Moscow).Results. The healthcare computerization process in Russia is slower than it is set out in the Governmental plans. The most common and significant problems include the following: lack of funding for the computerization process in general; irrational distribution of resources within the projects and selection of a costly computerization strategy from the beginning; corrupt practices; conflicts between customers with the contractors because of which many projects were not implemented; management problems; a clash between the current legislation to modern technologies and trends, lack of efforts aimed at implementation of healthcare information systems on the part of the regional authorities.Conclusion. To make the healthcare computerization more successful it is required to awaken a commercial interest in the private IT companies to attract additional investment. Personal responsibility of the officials in charge of the computerization should become more stringent in case of a delay in a project or a project failure, the government procurement system should be improved in order to attract the most qualified integrators, the interaction between healthcare managers at various levels with the integrators should be facilitated through reducing bureaucratic «paper» load. At the state level it is necessary to focus on the operational improvement of the RF legislation to ensure the progressive development and implementation of information technologies.

The distance education contributes to the solution of educational problems of disabled persons. The study of foreign experience is extremely important. North American universities saved up a wide experience in this sphere. Unlike self-made software products created by many Russian universities, Blackboard is the leading educational software package that professionally helps to solve educational problems of disabled persons. The international University of the Arctic has a growing interest in the use of information communication technologies and open educational resources and networks. In 2008 the subject network of University of the Arctic on distance education and e-learning began to function. The Internet and distance learning creates a new opportunity for disabled persons. Main goal: Whether distance education on Alaska and in Northern and Siberian regions of the Russian Federation promotes the solution of educational problems of the North for disabled persons. Main research problems: to reveal modern educational Arctic problems for disabled persons; to analyse specifics of remote education; to analyse a question of distance training of the circumpolar North; to carry out the comparative analysis of distance training on Alaska and in Russian northern and the Siberian regions; to analyse a contribution of distance training to wider problems of the Arctic policy and management. Relevance of work: The Arctic Human Development Report I specifi es that there are very few circumpolar researches in the fi eld of education, including for disabled persons. This article can begin initial discussion of a subject which can be in addition studied in future works. An emerging trend for Arctic education is its increasing accessibility. Accessibility is about students being able to take classes and fulfi ll their potential, that is, it concerns their possibilities for attending school, both physically and culturally. Even though this increased accessibility of education is occurring in some places, it is not unique to the North. Rather, it is a refl ection of changes that have occurred in urbanized areas around the world, where population growth, increased living standards, modernity, and technology have been transforming schools for the past fi fty years (AHDR I, Arctic Human Development Report I). The basis of researches consists of research works and conferences on distance training for disabled persons in the Arctic; the legal acts created by the international organizations, the American and Russian departments; the websites with information on the Russian and American universities. The international, Russian and American legislation, statistical sources, mass media concerning educational policy for disabled persons.