Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and life-threatening complication of pulmonary embolism. As existing animal models of CTEPH do not fully recapitulate complex disease pathophysiology, we report a new rat model for CTEPH evoked by repetitive embolization of the distal pulmonary artery branches with partially biodegradable alginate microspheres (MSs). MSs (180 ± 28 μm) were intravenously administered eight times at 4-day intervals; control animals received saline. The validity of the model was confirmed using transthoracic echocardiography, exercise testing, catheterization of the right ventricle, and histological examination of the lung and heart. The animals in the CTEPH group demonstrated a stable increase in right ventricular systolic pressure (RVSP) and decreased exercise tolerance. Histopathological examination revealed advanced medial hypertrophy in the small pulmonary arteries associated with fibrosis. The diameter of the main pulmonary artery was significantly larger in the CTEPH group than in the control group. Marinobufagenin and endothelin-1 serum levels were significantly elevated in rats with CTEPH. In conclusion, repetitive administration of alginate MSs in rats resulted in CTEPH development characterized by specific lung vasculature remodeling, reduced exercise tolerance, and a persistent rise in RVSP. The developed model can be used for pre-clinical testing of promising drug candidates.

Method for synthesis of double lithium-titanium phosphate is suggested. The method includes mechanical activation of the precursor and makes it possible to reduce the temperature and shorten the annealing duration when reaching a highly dispersed state of the substance. Application of this method provides a substantial advantage in the discharge potential, capacity, and stability for electrodes of a lithium battery.

Background. Number of injuries of the hand and wrist is constantly growing from year to year. Inpatient treatment of these patients increases both time and financial costs for healthcare organizations. Thus, analysing the structure of patients who applied to the emergency department would make it possible to take more objective decisions on the organization of healthcare delivery. The aim — to analyse outpatient visits and treatment methods of patients with hand and wrist injuries who applied to the emergency department of the Vreden National Medical Research Center of Traumatology and Orthopedics. Methods. A sample of 18.848 patients who applied to the emergency department with hand and wrist injury in the period from 2020 to 2023 was drawn in the database of the Medialog medical information system of the Center. Results. The most common types of hand and wrist injuries were: metacarpal and phalangeal fractures, damage to the skin and subcutaneous tissue, damage to the finger flexor tendons and nerves. Of the operations performed, K-wire osteosynthesis and primary suture of the extensor or flexor tendons of the fingers were most often used. Significantly less common were the following operations: primary surgical debridement, suture of nerves and blood vessels, replantation and revascularization. About 20% of patients with hand injuries can receive emergency medical care in emergency rooms of Saint Petersburg, thereby reducing the queue for surgical service in the Center’s emergency department. Conclusion. Treatment of patients with hand and wrist injuries requires comprehensive approach involving doctors of various specialties at each stage of the treatment. Proper organization of such patients’ treatment will significantly improve the quality of medical care and the treatment outcomes.

BACKGROUND: Congenital knee dislocation is a significant topic of interest in the possible application of new reduction techniques immediately after birth. This initiative aims to minimize the consequences of dislocation, ensuring the possibility of normal joint formation and functioning from the very first stages of life. This is not only a technical achievement but also an approach to providing optimal conditions for the health and development of children with congenital knee dislocation. AIM: This study aimed to evaluate the functional and long-term treatment outcomes of congenital knee dislocation using a new patented method. MATERIALS AND METHODS: A total of 120 patients (194 knees) with congenital knee dislocation were examined. The patients were divided into the main group (55 patients, 90 knee joints) and the control group (65 patients, 104 knee joints). The main group received the treatment developed by the authors using an Ergopower ER 7028 vibration massager. In the control group, the traditional method of orthopedic correction of congenital knee dislocation using a Von Rosen splint and circular plaster casts was employed. At the start of treatment, the age of the patients in the main group was Me 28 [Q1 28; Q3 30] hours and that of the control group was Me 30 [Q1 28; Q3 34.5] hours. RESULTS: A comparative analysis of the treatment outcomes of the main and control groups showed that the developed method for correcting congenital knee dislocation using a vibration massager and careful manipulations, in contrast to traditional technology, achieved the most accurate orthopedic correction in 95% of cases, ensured the restoration of the axial profile of the knee joint and its stability, and created conditions for the harmonious growth and development of the lower extremities in adulthood. In the main group, after conservative treatment of congenital knee dislocation using improved technology, indicators for assessing knee joint function (66.7%) and pain relief (98.2%) were excellent after 5 years of observation, which was confirmed by data from a clinical study and use of specialized questionnaires. CONCLUSIONS: The proposed innovative method of conservative orthopedic correction of congenital knee dislocation by vibrovascularization of the thigh muscles is a differentiated approach to conservative treatment, which improved the overall and long-term treatment outcomes.

Background. Surgical treatment of malleoli injuries is performed according to the principles of articular fractures management. It is particularly true for ankle injuries involving fractures of posterior edge of the tibia. The posteromedial approach enables to improve the results of surgical treatment of patients due to the direct reduction of tibia fragments. Aim of the study to evaluate the efficacy and advisability of the modified posteromedial approach in patients with unstable fractures of malleoli and posterior edge of the tibia. Methods. Twenty two patients with unstable fractures of malleoli and posterior edge of the tibia underwent surgical treatment via the posteromedial approach. The X-ray control was performed the next day after the surgery as well as 6, 12, 24 and 48 weeks from the osteosynthesis. The functional results were evaluated in 12, 24 and 48 weeks after the surgery with the use of AOFAS and Neer scales. Results. The average duration of postoperative period (9.33.8 days) was mainly determined by the state of the soft tissues. 91% of patients had anatomical reduction of posterior edge fragment of the tibia, 17 (77%) from 22 patients demonstrated fracture consolidation in X-rays 12 weeks after the surgery and all 22 patients (100%) 24 weeks after surgery. There were no cases of postoperative complications in patients 24 weeks after the surgery. While managing patients the range of motion in the ankle joint increased from 41.16.9 12 weeks after the surgery to 57.34.6 48 weeks after the surgery, that was statistically significant (p0.01). The functional results improved as well according to both AOFAS and Neer scales and this improvement was also statistically significant (p0.01). Conclusion. The is rather effective in Patients with unstable fractures of malleoli and posterior edge of the tibia had a statistically significant improvement in function after posteromedial approach.