Cholangiocarcinoma (CCA) is a cancer with high mortality owing to its aggressiveness and resistance to therapy. The liver flukes of the Opisthorchiidae family have been recognized as risk factors of CCA. Opisthorchis felineus infection occurs in Western Siberia, the biggest endemic area in the Russian Federation, and is associated with chronic inflammation of the bile ducts, which may be linked to severe hepatobiliary morbidity. We report two cases of confirmed CCA who had a chronic O. felineus infection. Both cases presented unspecific symptoms at the onset of the disease, a stage when severe pathological changes already had occurred. Both patients were living in endemic areas but did not receive any antihelminthic treatment. This report underlines the need for assessment of O. felineus infection as a causative factor of CCA. The results will provide further arguments for control of O. felineus in the Russian Federation.

Alloys based on TiNi are widely used in various fields of technology and medicine. In the present work, we report on the preparation of TiNi-alloy-based wire with the shape-memory effect, which was used for compression clips for surgery. The composition and structure of the wire and its martensitic and physical–chemical properties were studied using SEM, TEM, optic microscopy, profilometry, mechanical tests, etc. The TiNi alloy was found to consist of B2 and B19′ and secondary-phase particles of Ti₂Ni, TiNi₃ and Ti₃Ni₄. Its matrix was slightly enriched in Ni (50.3 at.% of Ni). A homogeneous grain structure was revealed (an average grain size of 19 ± 0.3 μm) with equal quantities of grain boundaries of special and general types. The surface oxide layer provides improved biocompatibility and promotes the adhesion of protein molecules. Overall, the obtained TiNi wire was concluded to exhibit martensitic, physical and mechanical properties suitable for its use as an implant material. The wire was then used for manufacturing compression clips with the shape-memory effect and applied in surgery. The medical experiment that involved 46 children demonstrated that the use of such clips in children with double-barreled enterostomies permitted improvement in the results of surgical treatment.

BACKGROUND: Staged treatment of small bowel diseases involves the formation of an enterostomy. BishopKoop T-anastomosis and Mikulicz double-barreled enterostomy with compression clamp are widely applied. The disadvantages of Mikuliczs can be eliminated using a clip of titanium nickelide with shape memory instead of a clamp. AIM: This study aimed to evaluate the efficacy and safety of a titanium nickelide device in double-barreled enterostomy and compare the results of treatment with a T-anastomosis. MATERIALS AND METHODS: The study included newborns and infants. The clip was applied on 958 days postoperatively. Differences were accepted as significant at p 0.05. RESULTS: Since 2000, enterostomy was performed in 79 children: 12 (15.2%) had T-anastomoses, 44 (55.7%) had double-barreled stomas, and 18 (40.9%) had a titanium nickelide clip. In the study groups, stomas were applied for ileus, atresia, and aganglionosis. In the group of double-barreled enterostomies with a clip, the stoma was closed later (p = 0.027) and the operation time was short (p = 0.013). In the T-anastomosis group, parenteral nutrition was required for a longer period (p = 0.018). Self-removal of the clip and appearance of the stool occurred on days 5 and 13. Compression anastomosis was obtained in 83.3% and stoma closure outside in 73.3%. With a double-barreled enterostomy, hepatic failure (p = 0.018) and anastomosis dysfunction (p = 0.046) were less common. T-anastomosis revealed an increase in the incidence of CDC II (p = 0.013) and III (p = 0.015) complications. DISCUSSION: The results reflect the safety of the presented method in comparison with the T-anastomosis, since the operation time and duration of the parenteral nutrition are reduced, invasive treatment is less often required for complications, and anastomosis dysfunction rarely occurs. CONCLUSIONS: Double-barreled enterostomy with a compression clip is an effective and safe alternative to T-anastomosis in children aged 1 year. The formed compression anastomosis allows closure of the stoma by suturing its outer part. The conditions for the formation of the anastomosis are the patency of the distal sections and bowel diameter 1 cm.

Introduction. Emergency intestinal surgeries in neonates can lead to stoma formation. Indications for stoming, associated complications and ways to prevent them are being actively discussed. The aim of this study was to analyze results of surgical treatment of neonates with intestinal stomas in a perinatal center for the last 10 years.Material and methods. 81 children with intestinal obstruction (32), necrotizing enterocolitis (27), meconium ileus (14) and others abdominal pathologies (8) were included into the study. Statistical processing was carried out using the SPSS v.26 package; differences were significant at p-value ≤0.05. Complications were assessed with the Clavien-Dindo Сlassification (CDC).Results. There were 59 premature infants (72.8%); 32 had body weight below 1000 grams (54.2%). Initially performed: 15 (18.5%) colostomies, 49 (60.5%) enterostomies, 17 (21%) T-anastomoses. A compression clip was put in six children with double-barreled ileostomies. Complications were the following: prolapse (12.3%), skin excoriation (43.2%), bleeding (19.8%), large losses of intestinal chyme (17.3%), liver failure (19.8%), sepsis (17.3%), wound dehiscence (6.2%), adhesive obstruction (16%), necrosis (9.9%) and stenosis (7.4%). 16 (19.7%) patients had no complications. 28 (43%) patients had complications by CDC of grade III, and 37 (57%) - by CDC of grade ≥III. Stomas were closed in 32 children (39.5%) after 35 days, on average (6-126 days). Mortality was 28.4%, mainly in children weighing less than 1000 gramm (p = 0.03).Conclusion. If a neonate patient has contraindications to primary anastomosing, double-barreled enterostomy with a compression clip is a safe alternative to it. The enterostomy technique in premature newborns does not increase the rate of complications and mortality. Skin excoriation, increased bleeding from the stoma, and liver failure are most common in neonates with enterostomy.

Even though enterostomy in neonates is widely used in the treatment of congenital and acquired pathology, there is still no generally accepted tactics for stoma formation, prevention of associated complications, and the timing and method of stoma closure. Existing publications are few, prospective multicenter studies, systematic reviews, and meta-analyses are practically absent in Russia. The purpose of this review is to search for relevant publications on surgical treatment and complications in neonates with small-bowel stomas over the last 20 years. Study articles were identified through a search of the Scopus, Web of Science, MedLine, The Cochrane Library, Elibrary, and CyberLeninka electronic databases.

Эффективность экстрактов Saussurea controversa и Fillipendula ulmaria на фоне антибиотикотерапии остеомиелита в эксперименте