Introduction: Surgical operations remain the main and most effective option for the treatment of liver echinococcosis. With the development and mastering of the method, laparoscopic operations are being used more and more widely. New technologies aimed at improving treatment outcomes are being developed and implemented in laparoscopic surgical methods. The purpose of the study is to present and evaluate the results of treatment of operated patients with liver echinococcosis using new technologies. Materials and methods: The results of treatment of 19 patients (9/47.4 % men, 10/52.6 % women) with liver echinococcosis, who were treated with organ-sparing laparoscopic resection techniques using new technologies in the surgical department No. M.A. Podgorbunsky. Results: There was no statistically significant advantage in dissection rate among the methods used (p = 0.74). In the group of patients with the applied hemostatic matrix Floseal, the time of hemostasis was significantly less than in the group without using the method (p = 0.001). In the group of patients with the improved laparoscopic Pringle maneuver, the blood loss was significantly less than in the group without using the technique (p = 0.00008). Findings: A new patented improved method of temporary hemostasis in laparoscopic resection interventions on the liver in the study proved its effectiveness. The use of the Floseal hemostatic matrix made it possible to reduce the time of hemostasis, and, accordingly, reduce the duration of the operation and reduce intraoperative blood loss in general. The laparoscopic method of surgical intervention using the above technologies is effective and safe in the treatment of medium-sized echinococcal liver cysts.

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most informative and often in-demand methods for the detection and treatment of pathology of the biliary tract, its diagnostic value is 79-98%. A significant disadvantage of the method are side effects and various complications (acute pancreatitis, bleeding, retroduodenal perforation, cholangitis, acute cholecystitis, etc.). Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is a common and severe complication of intraluminal endoscopic operations on the large duodenal papilla, its etiology is multifactorial, and the pathophysiology has not yet been fully studied. According to many randomized, controlled studies, the incidence of PEP ranges from 2.7 to 37%. Despite all the possibilities of modern medicine and the introduction of new methods, mortality with the development of PEP remains at a very high level: it reaches 7-15%, and with the development of destructive forms - 40-70%. The problems of prevention of PEP are still the subject of discussions and numerous studies by leading clinics around the world. In this paper, we conducted a review of the literature over the past decade using the sources of major medical libraries Medline, eLibrary, PubMed. The article discusses current modern pathogenetic mechanisms and the main risk factors for the development of PEP, related to both the characteristics of the patient and the procedure being performed, technical options for performing ERCP. The article also presents currently used and recommended by most authors methods of drug prevention of PEP and various technical solutions related to this complication. Thus, the not entirely satisfactory results of the proposed methods of prevention of PEP force the authors to search for safer and more effective solutions to this urgent problem at the present time.

A clinical case of successful radical multi-stage surgical treatment of a patient with bilobar parasitic lesion of the liver with echinococcosis complicated by infection of one of the cysts is presented. The patient was admitted to the clinic with volumetric lesions in both lobes of the liver. At the stage of differential diagnosis, on the basis of process verification by puncture biopsy under ultrasound control, the ethiology of mass lesions was reliably established. At the primary stationary stage, infection of one of the echinococcal cysts was diagnosed, for which the cyst was drained under ultrasound control. After that, the patient was discharged to the outpatient care for compensation, correction of the general level of health and nutritional status. At the next stage of the inpatient examination, the patient was determined to have an insufficient level of functional reserves of the liver to perform a radical operation. For this reason, laparoscopic ligation of the right branch of the portal vein was performed in order to develop vicarious hypertrophy of the contralateral lobe. After 30 days, the increased level of functional reserves of the liver made it possible to plan radical surgical treatment with an acceptable risk for the patient. The operation was performed in the amount of right-sided extended hemihepatectomy with marginal resection of the 3rd segment of the liver. The symptoms of liver failure in the postoperative period according to the ISGLS scale were regarded as Grade A. The patient was discharged from the hospital in a satisfactory condition on day 10 after the operation. In the postoperative period, courses of therapy with albendazole were prescribed according to the standard scheme. The patient is under observation for more than a year after treatment. The condition is satisfactory. No recurrence of the disease was noted.

Цель исследования. Изучение видового состава и инфицированности клещей-переносчиков возбудителей клещевых инфекций на территории Кемеровской области. Материалы и методы. Изучены морфологические признаки 1295 экземпляров клещей рода Ixodes, собранных с растительности области. Для определения роли клещей рода Dermacentor исследовано 1867 клещей разного вида. Определение видовой принадлежности 186 клещей в суспензиях проводили с использованием разработанной методики на основе метода мультипрайм-ПЦР в реальном времени для генотипирования клещей разных видов. Инфицированность 409 клещей, собранных с растительности, и 186 экземпляров, снятых с пострадавшего населения, возбудителями клещевого энцефалита (КЭ) иксодовых клещевых боррелиозов (ИКБ), гранулоцитарным анаплазмозом (ГАЧ), моноцитарным эрлихи

The article presents the pathogenetic mechanisms of eye damage by gas self-defense weapons in detail. We discuss the mechanisms of eye damage and structural changes of the tissues after gas-trauma. The causes of these changes and the main clinical manifestations accompanying them are analyzed. We analyzed the factors, influencing the development of dystrophic changes of the ocular surface in detail. The information on various techniques for self-assistance, mutual aid and earlier specific treatment of this injury was summarized. An aqueous solution of pediphene substance promising for use is considered, which has a number of pharmacological properties that fundamentally affect the pathogenetic mechanisms of gas-weapon trauma. Its effectiveness was shown in the experiment in comparison with the control group without treatment and the group using the combined drug-dexamethasone in combination with an antibiotic.