Method of gas chromatography - mass spectrometry was used for the study of patients with microbial landscape pancreatonecrosis. In patients with necrotizing pancreatitis concentration of organisms was determined in serum at the admission to the hospital, in the middle of the treatment and at discharge. Increased concentrations of Helicobacter pylori, Herpes, anaerobic bacteria were detected in the blood serum of patients with limited sterile pancreatic necrosis who had medical diagnostic laparoscopy. This fact, in our opinion, extends the etiology of this disease. We found that patients with pancreatic necrosis has limited sterile dysbiosis, which can be adjusted over time by gas chromatography - mass spectrometry.

3 Republican Clinical Hospital named after N.A. Semashko, Ulan-Ude, Russia Method of gas chromatography - mass spectrometry was used for the study of microbial landscape of patients with pancreatonecrosis. It was found that the provision of sterile necrotic destruction dysbiosis occurs that requires correction during the treatment. Unlike conventional methods of diagnosis of infection pancreatogenic gas chromatography - mass spectrometry allows to express mode (3 hours) monitored landscape microbial degradation pancreatogenic patients. In patients with necrotizing pancreatitis concentration of organisms was determined in serum on admission, on day 5, day 10, day 15, day 20 of treatment. Data on the composition of microorganisms, participants of widespread sterile necrotic destruction when assessing the overall microecological status, obtained for each patient allow to get a quali- tatively new comprehensive information to make adequate antibiotic therapy and complex treatment that significantly broadens the etiology of this disease.

A clinical analysis of 51 patient treated, in surgical ward of Republican. Clinical Hospital named, after N.A. Semashko during the period, of 1993—2011. All patients had. pancreatoduodenal resection for chronic pancreatitis (7) and pancreatic cancer (44). In the nearest postoperative period, mortality was 7,8 %. In the remote postoperative period, terms of survivability in 8 patients with cancer were 18—34 months. One patient lived 10 years.

The authors analyzed microbial picture of patients with pancreatic diabetes. It was revealed that microflora evolved from necrotic suppurative nidus in patients with pancreatic diabetes was different from one in people without pancreatic diabetes.

Целью исследования была проверка гипотезы о том, что развертывание в регионе специализированной помощи пострадавшим с сочетанной травмой существенно улучшает результаты лечения по сравнению с таковыми при оказании квалифицированной помощи. В рамках разработанного ранее авторами протокола мониторинга сочетанной травмы (МОСТ) обследованы региональные центры Сибирского федерального округа - Барнаул (специализированная помощь пострадавшим), Иркутск и Улан-Удэ (оба - квалифицированная помощь). Проведен сравнительный анализ распределения пострадавших по полу, возрасту, механизму травмы, ведущему повреждению, тяжести повреждений, летальности. Исследованы эпидемиологические характеристики сочетанной травмы. Наибольшая заболеваемость отмечена в Иркутске - 165 на 100 000 населения, наибольшая смертность - также в Иркутске (58,6 на 100 000). Выявлено, что общая летальность при сочетанной травме, госпитальная летальность, а также летальность при крайне тяжелых повреждениях в Барнауле была статистически значимо ниже, чем в Иркутске и Улан-Уде. Таким образом, развертывание специализированной помощи пострадавшим позволило существенно снизить летальность, что является основным критерием эффективности оказываемой помощи.

The analysis was made of outcomes of 86 patients with diabetes mellitus complicated by diabetic foot syndrome aged from 46 to 78 treated over the period 2005-2008 in surgical department of Republican Clinical Hospital N2 named after N.A. Semashko, Ulan-Ude. It has been established that in accordance with the lesion degree of diabetic foot syndrome the definite and optimum complex treatment technique should be used. The treatment should include correction of local and general disturbances in the organism, and providing not only removal of damaged tissues but also preservation of support function of lower extremities.

The results of the examination and treatment of patients operated on account of focal masses in thyroid gland

Morphological, histological, biochemical and bacteriologic examination of 20 patients was carried out. In the complex of treatment of the main group (10 patients) URGOTUL RS.Ag was included. Local treatment of wound defect in the control group (10 patients) was performed with the use of atraumatic gel bands Appolo. During research its been established that argentiferous band URGOTUL RS.Ag can be effectively used in complex therapy of patients with neuropathic form of diabetic foot syndrome as a means having protective effect on regenerating tissues and stimulating reparative processes in the wound.

Results of treatment оf 115 patients with the generalized, peritonitis are analyzed, depending on time of its development, weight of a surgical infection. Variants of clinical current of the widespread, peritonitis which are compared, to the basic methods of surgical tactics half-closed, and considered. Studying conditions of patients is lead, on the basis of scale APACHE II, Mannheimer Peritoneal Index, degree organ dysfunctions. On the basis of these parameters the expediency of the elected variants of surgical tactics is investigated. At studying efficiency of various methods decompression a thin gut in a combination with peritoneal-enteral lavage value of these methods is confirmed at the widespread purulent peritonitis and in quality of the most expedient is determined (sub) total naso-intestinal intubation.

Method of intestinal suture protection proposed, by the authors not only reinforces physical hermiticity and mechanical strength of enteroanastomosis, but also accelerates reparative processes owing to angiogenesis stimulation.