RELEVANCE. In conditions of increased sensitivity of damaged brain tissue to disruption of homeostasis, it is important to achieve stabilization of the vital functions of the body as soon as possible. Given the excess afferent impulse, adequate sedation and analgesia are an integral component of intensive care for patients with traumatic brain injury. The use of halogenated anesthetics is associated with a lower risk of complications associated with long-term sedation with intravenous drugs. In the example of two patients with severe traumatic brain injury, the effectiveness and safety of sevoflurane for prolonged inhalation sedation was noted. This study was approved at a meeting of the Local Ethics Committee of the Federal Scientific and Clinical Center for Resuscitation and Rehabilitation, an extract from protocol No. 5/21/1 dated December 23, 2021, as well as at a meeting of the LEC of the N. V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department, meeting No. 1-2022 dated January 11, 2022. AIM OF STUDY. To demonstrate the safety of inhalation sedation in patients with traumatic brain injury using clinical observations as an example. MATERIAL AND METHODS. An analysis of two clinical observations of patients with severe traumatic brain injury was carried out. The effectiveness and safety of prolonged inhalation sedation was assessed by indicators: intracranial pressure, dynamics of mean arterial pressure and blood saturation in the jugular vein bulb, as well as the total duration of artificial ventilation and stay in the intensive care unit. Clinical observation No. 1. Patient B., 41 years old, was admitted with cerebral insufficiency (GCS 8) with damage to the soft tissues of the head. As a result of the examination, the patient wasdiagnosed with “Closed craniocerebral injury.” Fracture of the bones of the vault and base of the skull. Severe brain contusion. Traumatic subarachnoid hemorrhage, acute subdural hematoma in the left frontotemporal region 3 cm3”. Considering the size of the trauma (65 cm3) and the life-threatening dislocation syndrome, the patient underwent surgical intervention: “Decompressive craniotomy, removal of contusion areas. Installation of a ventricular intracranial pressure sensor.” The early course of the postoperative period was complicated by the development of infectious complications, which led to the need for prolonged sedation in the intensive care unit. On the 3rd day, a lower tracheostomy was performed. The total time of sedation was 3 days, and the duration of artificial ventilation was 10 days. On the 21st day, the patient was decannulated and transferred to a specialized department. Clinical observation No. 2. Patient K, 42 years old, was admitted to the hospital with a depressed level of consciousness (GCS 6). Based on the results of the examination, a diagnosis was made: “Penetrating traumatic brain injury with severe brain contusion, a focus of crush contusion in the right temporal lobe, acute subdural hematoma of the right frontal-temporo-parietal region 100 cm3 and a fracture of the bones of the vault and base of the skull, facial skeleton, micropneumocephaly”. Considering the size and location of the hematoma, the patient underwent surgery including decompressive craniotomy, removal of an acute subdural hematoma, and a Spiegelberg intracranial pressure sensor was installed. In the early postoperative period, severe hemodynamic instability associated with vascular insufficiency of central origin was noted. The use of inhalational sedation sevoflurane did not lead to the development of intracranial hypertension and escalation of vasopressor therapy. The total time of use of sevoflurane was 36 hours. Spontaneous breathing was restored by the 18th day. The patient’s stay in the ICU was 31 bed days. CONCLUSION. Based on the data obtained, we may conclude that the use of inhalation sedation in this category of patients is safe, as well as the absence of a significant effect of sevoflurane on the level of intracranial pressure and central hemodynamic parameters. However, secondary complications that developed in patients do not allow us to draw an unambiguous conclusion about the effect of this method of sedation on the duration of artificial ventilation and stay in the intensive care unit. Only the accumulation of a sufficient volume of clinical material will reveal all the advantages and disadvantages of this method.

The use of an electrochemical approach for assessment of the oxidative stress severity is a promising direction for point-of-care testing development, which is especially important for critically ill patients. The aim of this study was to determine the influence of different types of blood collection tubes (with clot activator and separating gel, lithium heparin, sodium citrate and K2EDTA) and storage conditions (at 25, 4 and -23 degrees C up to 5 days) on the electrochemical analysis of the antioxidant status of blood plasma, assessed by measuring the open circuit potential of platinum electrode (OCP) and antioxidant capacity via cyclic voltammetry method (q). It was obtained that blood collection tubes with lithium heparin and clot activator are the most suitable for the electrochemical analysis of antioxidant status of blood plasma, since they do not affect the results of measurements. Furthermore, data obtained during storage blood plasma samples in different temperature conditions indicate that it is preferable to perform electrochemical analysis in fresh samples.

Experiments on 39 male Wistar rats were performed. A metal-organic coordination polymer modified with iron oxide and ascorbic acid (composite) was administered intravenously to healthy rats at doses of 25 and 50 mg/kg. The anti/prooxidant activity of the composite was assessed 3 and 24 hours after administration. The composite in both doses was shown to have no significant effect on the homeostasis of prooxidants/antioxidants in the blood serum in healthy animals. In high doses, the composite enhances apoptosis of lymphocytes, which indicates its possible use as a catalyst for free radical processes for further use in biomedicine.

Introduction. Harvesting of pooled platelet concentrates (PC) significantly expands the volume of transfusion support and could be used to create strategic platelet reserve.The aim of work. To compare the quality of pooled and apheresis platelet concentrates.Materials and methods. We studied platelet fractions (PF), isolated from the whole blood of cadre donors with Reveos system, platelet concentrates, obtained by pooling PF (Pooled PC), and platelet concentrates harvested by automatic apheresis. In all cases 2 days passed from the moment of blood donation to the platelet examination. In PC samples we studied cellular composition, morphofunctional parameters of platelets, pH and electrochemical parameters, hypotonic shock response.Results. The morphofunctional platelet rate in PF was significantly reduced, comparing to the normal levels. At the same time, the morphofunctional parameters of platelets did not significantly differ in PF and pooled PC. The pH values, the total content of platelets and leukocytes in the pooled PC corresponded to the requirements of The rules for procurement, storage, transportation and clinical use of donated blood and its components (2019). The total platelet count, the level of annexin-positive platelets, did not significantly differ in apheresis PC and pooled PC, hypotonic shock response was correct in apheresis PC and pooled PC. On the other hand, the level of platelets with granules in pooled PC was 1,8 times lower than in apheresis PC, other morphofunctional parameters of platelets in pooled PC were also reduced. Pooled PC were characterized by more positive level of open circuit potential and lower antioxidant capacity compared with apheresis PC on the same storage time.Conclusions. Platelet pooling with Reveos system is acceptable for obtaining PC doses that comply with Technical Regulations. Nevertheless, methods of pooled PC harvesting need further optimization.

A comprehensive study of hemocompatibility and gas permeability of 1,2-disubstituted polyacetylenes, namely poly(1-trimethylsilyl-1-propyne) and poly(4-methyl-2-pentyne), was carried out. The polymers were synthesized started from 1-trimethylsilyl-1-propyne and 4-methyl-2-pentynemonomers on the catalytic systems NbCl5 and NbCl5/n-Bu4Sn to form homopolymers containing 50 and 55

INTRODUCTION: Severe combined trauma remains the leading cause of mortality and disability of the workable population. Under damaging factor influence, a whole cascade of pathological processes is triggered, leading to development of multiple organ failure. OBJECTIVE: Exploration of the effects synthetic analogue of tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate (Dalargin) on the dynamics of oxidative stress markers in patients with severe polytrauma and the development of organ dysfunction. MATERIALS AND METHODS: 104 patients with severe combined trauma were included in study. There were 38 patients in the Dalargin group and 66 patients in the control group. Patients from main group received Dalargin in the form of a constant infusion through a syringe dispenser at the dose of 10 mcg/kg/hour at first 12 hours of hospitalization and 5 mcg/kg/hour up to 72 hours from the moment of admission. The control group received standard treatment. Indicators of oxidative stress were evaluated at the time of admission (0 days), 1, 3, 5, 7, 10 and 14 days from the therapy onset. RESULTS: In the main group, there was a significant decrease in oxidative stress markers such as malondialdehyde from the first day of treatment (p < 0.05), normalization of stable nitric oxide metabolites at day 10, and a decrease in total antioxidant activity below normal throughout the observation period. Mortality was comparable in both groups (p > 0.05), but the length of hospital stay was lower in surviving patients in the Dalargin group (p < 0.05). The development of organ dysfunction (acute respiratory distress syndrome, acute kidney injury) was less frequent in the Dalargine group (p < 0.05), but infectious complications (pneumonia, meningitis, wound suppuration) were comparable. CONCLUSIONS: Dalargin leads to a decrease of oxidative stress markers and normalization of endothelial function indicators, which contributes to a decrease of organ dysfunction frequency.

АКТУАЛЬНОСТЬ: Тяжелая сочетанная травма (ТСТ) остается ведущей причиной смертности и инвалидизации трудоспособного населения. При воздействии повреждающего фактора запускается целый каскад патологических процессов, приводящих к развитию полиорганной недостаточности. ЦЕЛЬ ИССЛЕДОВАНИЯ: Изучить влияние тирозил-D-аланил-глицил-фенилаланил-лейцил-аргинина диацетата (Даларгина) на динамику маркеров окислительного стресса у пациентов с ТСТ и развитие органной дисфункции. МАТЕРИАЛЫ И МЕТОДЫ: В исследование включено 104 пациента с ТСТ. В группе Даларгина 38 пациентов, в группе контроля 66 пациентов. Пациенты из основной группы получали Даларгин в виде постоянной инфузии через шприцевой дозатор в дозе 10 мкг/кг/ч в первые 12 ч от момента поступления в стационар и 5 мкг/кг/ч до 72 ч от момента поступления. Пациенты группы контроля получали стандартное лечение. Показатели окислительного стресса оценивались на момент поступления (0-е сутки), далее 1, 3, 5, 7, 10 и 14-е сутки от начала терапии. РЕЗУЛЬТАТЫ: В основной группе отмечалось значимое снижение маркеров окислительного стресса, таких как малоновый диальдегид, с 1-х суток лечения (р < 0,05), нормализация стабильных метаболитов оксида азота на 10-е сутки, а также снижение уровня ангиотензинпревращающего фермента на 1-е сутки. Значения общей антиоксидантной активности, измеренной спектрофотометрическим и электрохимическим методами, сохранялись ниже нормы на всем промежутке наблюдения. Летальность в обеих группах была сопоставима (p > 0,05), однако длительность госпитализации среди выживших пациентов была меньше в группе Даларгина (р < 0,05). Развитие органной дисфункции (острый респираторный дистресс-синдром, острое повреждение почек) встречались меньше в группе Даларгина (р < 0,05), но инфекционные осложнения (пневмония, менингит, нагноение ран) были сопоставимы. ВЫВОДЫ: Даларгин приводит к снижению маркеров окислительного стресса и нормализации показателей эндотелиальной функции, что способствует снижению частоты развития органной дисфункции.

ABSTRACTS Ischemic stroke occupies a leading position among the causes of mortality and disability. Long-lasting motor and cognitive impairments, a decrease in the level of consciousness over time aggravate the course of the disease, leading to immobilization syndrome and comorbidity load, which contributes to the development of life-threatening conditions in this category of patients. In this regard, the search for new neuroprotective strategies used at an early stage and capable of minimizing the severe consequences of stroke for the patient in particular and society as a whole seems extremely relevant. The paper presents the effect of inhaled xenon for sedation in patients with severe ischemic stroke on the level of consciousness and severity of neurological disorders, and also shows its effect on S100B protein, a marker for blood brain barrier damage. AIM OF STUDY To evaluate the effect of inhaled xenon for sedation in comparison with propofol intravenous sedation on the dynamics of the level of consciousness, the severity of neurological dysfunction and changes in the concentration of astroglial-derived S100B protein in severe ischemic stroke. MATERIAL AND METHODS The research was conducted on two groups of patients comparable in age, gender, comorbid background, as well as the severity of the underlying disease. In both groups, the condition of patients required the start of mechanical ventilation immediately after admission to the intensive care unit. Group I (control, n=12). After intubation and the start of ventilation, patients were sedated with propofol at a dose of 1-2 mg/ kg / hour for 24–72 hours. Group II (xenon, n=12). After intubation and the start of ventilation, patients underwent xenon inhalation at a concentration of 40 vol. % for the first 6 hours. If it was necessary to continue sedation after the end of xenon inhalation, propofol was used in doses similar to Group I. Neurological status was assessed on days 1, 3 and 8 using the Glasgow Coma Scale (GCS), the Full Outline of UnResponsivness (FOUR) score and the National Institutes of Health Stroke Scale (NIHSS). The critical analysis of the value of S100B as a marker of brain damage was carried out before the start of sedation, on the 3rd and 8th days. RESULTS Xenon inhalation (40 vol. %) in comparison with propofol intravenous sedation significantly increases the level of consciousness in patients with severe ischemic stroke (p=0,026), reduces neurological disorders assessed using NIHSS (p=0,007) on day 7, and also reduces serum S100B levels on day 3 (p<0,05) after ischemic stroke. CONCLUSION Our open randomized clinical trial of xenon inhalation versus propofol intravenous sedation revealed the neuroprotective properties of xenon anesthesia in patients with severe ischemic stroke. Based on the obtained clinical and laboratory data, it can be concluded about the effective implementation of the neuroprotective effects of xenon in the administration scheme used in the research.

Background: Sepsis is a serious clinical condition caused by a dysregulated immune response to infection resulting in multiple organ failure. In the pathogenesis of sepsis, especially that of septic shock, great importance is given to the endothelial marker of vascular regulation, nitric oxide (NO). In septic shock, dysregulation of the vascular tone plays a key role in the development of hypotension. Therefore, the control of the level of nitric oxide and its stable metabolites in critically ill patients is a very important task. Aim: the aim of this study was to evaluate the potential of the electrochemical nitrite detection in the patients blood serum. Methods: The levels of nitric oxide stable metabolites in the blood serum of healthy individuals (n=20) and septic patients (n=25) were studied by the electrochemical method using a composite electrode and by the spectrophotometric method using the Griess reagent. Results: The data in the groups of healthy people and patients with sepsis differ significantly (p 0.00001) both when measured using electrochemical and spectrophotometric methods. The median value of the current response in healthy people was 0.41 A (0.33; 0.55), and the total content of nitric oxide metabolites (NOx) was 26.8 mol/L (20.8; 31.0), while in patients with sepsis, these values were 0.79 A (0.61; 1.28) and 38.89 mol/L (29.64; 57.45), respectively. A negative correlation was found between the data obtained for practically healthy persons (r=-0.696, p=0.0007). Conclusion: The obtained results allow us to conclude that the nitrite measurement in the blood serum by amperometry using a composite electrode is promising as a diagnostic technique.

The leading role of neuroinflammation as the culprit of a long-term impairment of consciousness in patients after injuries to the central nervous system forces us to look for new effective strategies for resolving this pathological process. Xenon reducing the intensity of the inflammatory response due to the impact on several links is potentially able to have a beneficial effect on this category of patients. Using laboratory equipment, we evaluated the effect of half-hour daily inhalations of a 30% air mixture with 30% xenon for 7 days on the level of markers of neuronal damage and regeneration of nervous tissue. AIM To study the effect of inhalation of an air-xenon mixture on the dynamics of markers of neuroinflammation and restoration of nervous tissue in patients after traumatic brain injury (TBI). MATERIAL AND METHODS We conducted a prospective randomized clinical trial evaluating the effect of inhaled xenon for sedation on the level of consciousness and spasticity in patients with prolonged post-coma impairment of consciousness. Patients were randomized into 2 equal groups. In Group I (Comparison, n=15) in addition to the standard treatment for TBI, each patient included in the study underwent 7 sessions of inhalation of an air mixture with an oxygen content of at least 30 vol.% for 30 minutes. In Group II (Xenon, n=15) in addition to the standard treatment, each patient included in the study underwent a half-hour inhalation with an air-xenon gas mixture (with a xenon content of 30 vol.% and oxygen — 30 vol.%) for 7 days, 1 time per day. The levels of interleukin-6, α-1 acid glycoprotein (AGP), S100 b protein and brain-derived neurotrophic factor were assessed before the first treatment and then once a day for 6 days. RESULTS The final evaluation included 12 patients from the Comparison Group and 12 patients from the Xenon Group. The greatest difference in the concentration of interleukin-6 between the Comparison and Xenon Groups was noted on the 5th day - 12.31 (10.21; 15.43) pg/ml vs. 7.93 (3.61; 9.27) pg/ml, respectively; however, the findings only tended to be statistically significant (p=0.07). When assessing the AGP level, the maximum difference was noted on the 4th day. In the Comparison Group, the AGP level was 0.81 (0.74; 0.92) pg/ml versus 0.614 (0.4; 0.79) pg/ml in the Xenon Group. And again, the data showed only a trend towards statistical significance (p=0.09). The highest level of brain-derived neurotrophic factor in the Xenon Group was observed on the 3th day — 0.1271 (0.046; 0.2695) pg/ml, which was statistically significantly higher than the one in the Comparison Group — 0.062 (0.036; 0.121) pg/ml (p=0.04). The concentration of S100 b protein during the entire observation period in both groups did not exceed 0.005 pg/ml. CONCLUSION Xenon inhalation according to the method proposed by the authors had a beneficial effect on the processes of neural tissue regeneration, however, with regard to neuroinflammation, its effects were not so pronounced.

This article is devoted to an overview of approaches to improving the characteristics of electrosurgical instruments. Currently, in minimally invasive surgery, the main material of an electrosurgical instrument is usually stainless steel. However, during operation, tissue sticking and carbonization occur, as well as corrosion of the instrument, which leads to a decrease in efficiency and adverse events. In this regard, it is very promising to develop new physicochemical approaches to improve the characteristics of electrosurgical instruments in order to avoid disadvantages noted above. On the one hand, it is proposed to replace stainless steel with other electrically conductive materials (gold, tungsten, zirconium dioxide, etc.). On the other hand, options for developing functional coatings of stainless steel (metallic, polymeric and composite) are considered. Among the "classical" approaches, one can distinguish coatings with gold, as well as nitrides and oxides of refractory metals (Cr, Zr, Ti), which are characterized by higher thermal conductivity and a pronounced anti-sticking effect. Very promising is the use of coatings based on diamond-like carbon, which have a higher contact angle compared to stainless steel (97.25 +/- 1.87 degrees versus 75.47 +/- 2.55 degrees) with a higher microhardness of the coating (2250 Hv versus 500 Hv). Particular attention is drawn to superhydrophobic coatings, for example, a coating based on hexamethyldisilazane with Sid e nanoparticles, the contact angle of which is two times higher than stainless steel (153.4 +/- 2.6 degrees versus 73.1 +/- 0.6 degrees). An alternative to coatings is the formation of microchannels and nanoroughness on the surface of electrosurgical instruments in order to reduce tissue adhesion and the risk of carbonization. Implementation of the principles of biomimicry, i.e. imitation of the structures of wildlife, has led to research in the field of creating analogues of microstructures (pangolin scales, shark skin), as well as liquid-infused surfaces, imitating the properties of the leaves of the carnivorous Nepenthes pitcher plant, which, due to the lubricant layer on their surface, have lower adhesive properties compared to unmodified material. Thus, the problem of modifying the surface of electrosurgical instruments has already been approached from several angles, and it can be stated with a sufficient degree of confidence that the number of studies in this direction will only increase.

COVID-19 pandemic has posed a severe healthcare challenge calling for an integrated approach in determining the clues for early non-invasive diagnostics of the potentially severe cases and efficient patient stratification. Here we analyze the clinical, laboratory and CT scan characteristics associated with high risk of COVID-19-related death outcome in the cohort of severely-ill patients in Russia. The data obtained reveal that elevated dead lymphocyte counts, decreased early apoptotic lymphocytes, decreased CD14+/HLA-Dr+ monocytes, increased expression of JNK in PBMCs, elevated IL-17 and decreased PAI-1 serum levels are associated with a high risk of COVID-19-related mortality thus suggesting them to be new prognostic factors. This set of determinants could be used as early predictors of potentially severe course of COVID-19 for trials of prevention or timely treatment.

Using an electrochemical method based on the use of an optically transparent working electrode, it was shown that, under conditions of hypothermic (4°C) storage of erythrocytes, the degree of reversibility of changes in their shape decreases when exposed to direct electric current. With cathodic polarization of an optically transparent working electrode (–0.5 V), the proportion of erythrocytes converted to spheroechinocytes decreased from 99.6 ± 0.4 (day 1) to 42.8 ± 14.5% (day 42) (p < 0.05), and with anodic polarization (1.2 V), the proportion of erythrocytes converted to stomatocytes decreased from 80.6 ± 6.7 (day 1) to 35.4 ± 5.6% (day 42) (p < 0.05). At a later storage period, an increase in the number of cells that underwent destruction under the influence of direct electric current was observed in the samples, the presence of which in the transfused erythrocyte suspension can lead to an increase in free hemoglobin in the recipient’s blood after transfusion. The results obtained can form the basis for the development of new methods for assessing the quality of blood components.

INTRODUCTION: The pandemic of novel coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus has forced physicians to reconsider traditional approaches to the treatment of patients with viral pneumonia and acute respiratory distress syndrome, when normobaric oxygenation methods were ineffective. The way out of this situation was the inclusion of hyperbaric oxygenation in the complex therapy of patients with COVID-19, as a recognized means of eliminating any form of oxygen debt due to more efficient delivery of oxygen to organs and tissues. OBJECTIVE: To evaluate the effectiveness of hyperbaric oxygenation in the complex therapy of patients with a novel coronavirus infection with severe lung damage (more than 50%). MATERIALS AND METHODS: We examined 75 patients with the diagnosis «Coronavirus infection caused by the virus SARS-CoV-2» (64 patients with CT-3, 11 patients with CT-4), 50 of whom were prescribed a course of hyperbaric oxygen therapy (HBOT). The procedures were carried out in a Sechrist 2800 resuscitation pressure chamber (USA) at 1.4–1.6 ATA for no more than 60 minutes. Before and after each HBOT session, subjective indicators of the patients’ condition were assessed and blood oxygen saturation was measured. In addition, the dynamics of the level of leukocytes, platelets, ALT, AST and C-reactive protein were evaluated. In order to analyze oxygen support, the type (low-flow oxygen therapy, high-flow oxygen therapy) and daily oxygen consumption were recorded.RESULTS: The inclusion of hyperbaric oxygenation in the complex therapy of patients with a novel coronavirus infection led to a significant increase in the level of SpO2 by the 7th day in the study group to 92% (89; 94) vs. 88% (87; 92) in the control group (p=0.011), and by 14th day to 96% (95; 97) vs. 95% (90; 96) (p<0.001). This circumstance led to a significant decrease in the number of patients requiring additional oxygen support, which was 94% in the study group and 100% in the control group by the 7th day, and 16% in the study group and 44% in the control group by the 14th day. In particular, the number of patients requiring high-flow oxygen therapy in the study group decreased from 34% on the 5th day to 2% on the 14th day, while in the control group over the same period there was a decrease from 60% to 32%. When analyzing the volumetric oxygen consumption in the study group, even taking into account the oxygen consumption for hyperbaric oxygenation, a decrease in the average daily oxygen consumption was recorded from 13.9 L/min on the 5th day to 9.3 L/min on the 14th day, while in the control group for the same period from 17.2 L/min to 14.5 L/min. The length of stay of patients in the intensive care unit in the study group was 10 (8; 12) vs. 13 (11; 23) bed-days (p=0.002) in the control group, and the total length of hospitalization was 16 (13.3; 20) vs. 21 (19; 29) bed-days (p><0.001) in the study and control groups, respectively. DISCUSSION: The early inclusion of hyperbaric oxygen therapy in the complex therapy of patients with a new coronavirus infection led to a significant increase in the level of SpO2 starting from the 7th day. This circumstance led to a significant decrease in number of patients requiring additional oxygen support in the study group compared to the control. This, in turn, affected the reduction in volumetric oxygen consumption in the study group, even taking into account the oxygen consumption on hyperbaric oxygenation. In addition, in the study group, positive dynamics according to CT data, a more rapid decrease in the level of C-reactive protein, were more often recorded. All these observations indicate a more rapid normalization of the state of the body due to the elimination of hypoxia, a decrease in the inflammatory response and restoration of lung function in patients who underwent hyperbaric oxygen therapy. CONCLUSION: The inclusion of HBO in the complex therapy of patients with a new coronavirus infection with severe lung damage (more than 50%) allows to stabilize the condition in a short time due to a more intensive decrease in the degree of lung damage according to CT data, early refusal of additional oxygen support, improvement of the psycho-emotional state, which in generally leads to a reduction in the length of stay of patients both in the ICU and in the hospital department.>< 0.001). This circumstance led to a significant decrease in the number of patients requiring additional oxygen support, which was 94% in the study group and 100% in the control group by the 7th day, and 16% in the study group and 44% in the control group by the 14th day. In particular, the number of patients requiring high-flow oxygen therapy in the study group decreased from 34% on the 5th day to 2% on the 14th day, while in the control group over the same period there was a decrease from 60% to 32%. When analyzing the volumetric oxygen consumption in the study group, even taking into account the oxygen consumption for hyperbaric oxygenation, a decrease in the average daily oxygen consumption was recorded from 13.9 L/min on the 5th day to 9.3 L/min on the 14th day, while in the control group for the same period from 17.2 L/min to 14.5 L/min. The length of stay of patients in the intensive care unit in the study group was 10 (8; 12) vs. 13 (11; 23) bed-days (p=0.002) in the control group, and the total length of hospitalization was 16 (13.3; 20) vs. 21 (19; 29) bed-days (p< 0.001) in the study and control groups, respectively.DISCUSSION: The early inclusion of hyperbaric oxygen therapy in the complex therapy of patients with a new coronavirus infection led to a significant increase in the level of SpO2 starting from the 7th day. This circumstance led to a significant decrease in number of patients requiring additional oxygen support in the study group compared to the control. This, in turn, affected the reduction in volumetric oxygen consumption in the study group, even taking into account the oxygen consumption on hyperbaric oxygenation. In addition, in the study group, positive dynamics according to CT data, a more rapid decrease in the level of C-reactive protein, were more often recorded. All these observations indicate a more rapid normalization of the state of the body due to the elimination of hypoxia, a decrease in the inflammatory response and restoration of lung function in patients who underwent hyperbaric oxygen therapy.CONCLUSION: The inclusion of HBO in the complex therapy of patients with a new coronavirus infection with severe lung damage (more than 50%) allows to stabilize the condition in a short time due to a more intensive decrease in the degree of lung damage according to CT data, early refusal of additional oxygen support, improvement of the psycho-emotional state, which in generally leads to a reduction in the length of stay of patients both in the ICU and in the hospital department.

Introduction . Among the growing number of patients with chronic renal failure who need dialysis therapy or kidney transplantation, a significant proportion are people over 60 years old, making from 30 to 45% of all patients who need dialysis, according to various sources. The elderly age of the recipient contributes to the risk of developing graft dysfunction due to the presence of concomitant diseases that worsen the immediate and long-term results of transplantation. And the probability of receiving a kidney graft in elderly patients is significantly lower than in young recipients. One of the ways to solve this problem is to use kidneys from suboptimal donors. Material and methods . The analysis of clinical examinations, laboratory and instrumental test results obtained in 124 patients who underwent cadaveric kidney allotransplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine, including that from suboptimal donors, was carried out. Of these, 69 (55.6%) recipients aged 60 years and older were included in the main group (group 1), and 55 recipients younger than 60 years (44.4%) in the comparison group (group 2). Results . Kidney transplantation to elderly patients (aged 60 years and older), including from a suboptimal donor, provides a sufficiently high efficiency with a 1-year recipient survival rate of 98.6% and a functioning graft for 1 year in 75.4% of cases, which does not differ from the survival rate of younger recipients (98.2%), but is inferior by the case rate of keeping the graft functioning (91.9%). Meanwhile, the parameters characterizing the functional state of the transplanted organs that maintained their function for 1 year did not differ statistically significantly between elderly and younger recipients. Conclusions . The results of the study showed that kidney transplantation from suboptimal donors to patients of the older age group provides acceptable results with low mortality of recipients and a 1-year functioning of the graft in 75% of cases. This makes it possible to increase the availability of kidney transplantation for patients of the older age group and achieve better survival results, provided adequate selection of recipients and an objective assessment of the quality of transplanted organs.

The aim of the study was to assess the oxidant/antioxidant status in elderly patients in the early period of acute poisoning by psychotropic drugs or corrosive substances. Material and methods . An open prospective observational study with retrospective control was conducted in 80 patients (age ≥ 60 years) with acute poisoning, of which 49 patients aged 72.1±9.55 years had psychotropic drug poisoning (PDP) and 31 subjects aged 73.0±10.3 years had corrosive substance poisoning (CSP). Patients with mild poisoning were excluded from the study. The control group consisted of 39 volunteers aged 68.3±6.3 years. Total antioxidant status (TAS), blood levels of malondialdehyde (MDA), stable nitric oxide metabolites (nitrite/nitrate, NOx), and oxidative stress index (MDA/TAS) were measured on days 1, 3 and 5 after hospital admission. Results . When analyzing the changes in the parameters of the oxidant/antioxidant system, we observed lower values of the studied parameters in patients with both PDP and CSP compared to the control group. In patients with PDP, several parameters were reduced: MDA by 1.2 times on days 1 and 3 ( P =0.002; P =0.008, respectively), NOx by 1.7 times ( P <0.001) at all stages of the study, MDA/TAS by 2.4–2.9 times ( P <0.001). In patients with CSP, MDA level decreased by 1.1–1.2 times at all study timepoints ( P =0.003; P =0.010; P =0.046, respectively), NOx dropped 1.4–1.6-fold ( P =0.012; P =0.004; P =0.023, respectively), and MDA/TAS decreased by 2.3–2.4 times ( P <0.001). While comparing patients with favorable and fatal outcome, we found that in survived patients an increase of MDA/TAS along with growing NOx level was seen by day 5 with no significant changes of MDA and TAS, while in non-survivors MDA/TAS dropped continuously due to progressive fall of NOx level, reaching values 2.8–2.9 times (P<0.001) lower than those of the controls. Conclusion . In elderly patients with acute poisonings due to psychotropic drugs or corrosive substances, an inadequate response of the oxidant/antioxidant system occurs manifesting as a reduced blood level of peroxidation products with simultaneous normal or slightly decreased concentration of antioxidant protection system components. Thus, the oxidative stress develops, which contributes to the death of the patients.

Introduction. Chronic renal failure develops more often in elderly patients after previous repeated urological operations. Urological diseases are an important additional factor that multiply complicates kidney transplantation due to the need for preliminary correction of existing disorders. Not to mention the fact that the recipient's advanced age contributes to the risk of developing graft dysfunction due to the presence of concomitant diseases that worsen the immediate and long-term results of transplantation.Material and methods. We carried out the analysis of clinical observations and studies performed in 124 patients who underwent cadaveric renal allotransplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine, including from suboptimal donors. Of these, 69 (55.6%) recipients older than 60 years were included in the main group (group 1), and 55 recipients younger than 60 years (44.4%) – in the comparison group (group 2). From the patients of group 1, patients with urological diseases that led to the development of terminal chronic renal failure, or with previously undergone surgeries for urological diseases (subgroup 1A, 43 patients) were isolated. The remaining 26 patients who did not have urological diseases were put in subgroup 1B.Results. The analysis showed that in the early postoperative period in the recipients of group 1, complications developed in almost all the patients (80 complications in 64 of 69 patients, that is, 92.8% of patients in this group), whereas in group 2, complications developed only in 30.9% of patients (27 complications in 17 of 55 patients). At the same time, on average, 1.2 complications per 1 patient were noted in group 1, and 0.5 complications per 1 patient in group 2, a significant part of the complications occurred in the subgroup of patients with a burdened urological history (subgroup 1A). Late complications also developed statistically significantly more often (almost 2 times) in recipients with a burdened urological history.Conclusions. Complications of the early and late postoperative period develop statistically significantly more often in elderly recipients. The presence of a burdened urological history in elderly recipients significantly increases the risk of early and late postoperative complications.

The aim of the study is to evaluate the efficacy of hyperbaric oxygen therapy and its effect on oxidative stress and apoptosis in patients with new coronavirus infection COVID-19.Materials and methods. 90 patients diagnosed with new coronavirus infection caused by SARS-CoV-2 virus were examined. Hyperbaric oxygen therapy sessions were conducted in 57 patients (38 in severe condition (CT 3-4), 19 in moderate condition (CT 1-2)). The procedures were performed in 1.4-1.6 ATA mode for 40 minutes, 247 sessions in total were performed. The effect of hyperbaric oxygenation was assessed by measuring the level of oxygen saturation, the severity of oxidative stress and apoptosis of blood lymphocytes.Results. In all examined patients with new coronavirus infection caused by SARS-CoV-2, positive changes such as dyspnea reduction and improvement of general well-being were registered after hyperbaric oxygen therapy sessions. The level of oxygen saturation after the end of the hyperbaric oxygen therapy course was 95.0±1.6% (before the course — 91.3±5.9%), which allowed to return almost all patients to spontaneous respiration without the need for further oxygenation therapy. Hyperbaric oxygen therapy did not reduce the total antioxidant activity, however, it was associated with a decrease in the blood malone dialdehyde from 4.34±0.52 pmol/l to 3.98±0.48 pmol/l and a decrease in open circuit potential of platinum electrode from -22.78±24.58 mV to -37.69±17.4 mV. Besides, the positive effect of hyperbaric oxygen therapy was manifested in normalization of blood cell apoptosis.Conclusion. Hyperbaric oxygen therapy in patients with new coronavirus infection caused by the SARS-CoV-2 virus is an effective treatment method with multiple effects resulting in improvement of subjective indicators of the patients' condition, increase of hemoglobin oxygen saturation, decrease of lipid peroxidation intensity, activation of antioxidant system, restoration of pro- and antioxidant balance and apoptosis normalization.

The use of electrochemical methods to study living systems, including cells, has been of interest to researchers for a long time. Thus, controlling the polarization of the electrode contacting living cells, one can influence, for example, their proliferation or the synthesis of specific proteins. Moreover, the electrochemical approach formed the basis of the biocompatibility improvement of the materials contacting with body tissues that use in carbon hemosorbents and implants development. It became possible to reach a fundamentally new level in the study of cell activity with the introduction of optically transparent electrodes in this area. The advantage of the using of optically transparent electrodes is the possibility of simultaneous analysis of living cells by electrochemical and microscopic methods. The use of such materials allowed approaching to the study of the influence of the electrode potential on adhesion activity and morphology of the different cell types (HeLa cells, endothelial cell, etc.) more detailed. There are a negligible number of publications in this area despite the advantages of the usage of optically transparent electrodes to study living cells. This mini-review is devoted to some aspects of the interaction of living cells with conductive materials and current advances in the use of optically transparent electrodes for the study of living cells, as well as the prospects for their use in cellular technologies.