ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить эффективность инъекционной аутотрансплантации продуктов на основе липоаспирата в лечении пациентов с патологическими рубцовыми изменениями. МАТЕРИАЛ И МЕТОДЫ В исследование включены 118 пациентов с рубцами наружной локализации. В зависимости от типа и размера рубца, его локализации и необходимости увеличения объема тканей в реципиентной зоне применялись три способа подготовки жирового трансплантата: седиментация в течение 15 мин, центрифугирование в режиме 1200 g в течение 3 мин и эмульсификация через переходник с диаметром канала 1,2 мм. Полученные результаты оценивались при помощи Манчестерской шкалы рубцов (Manchester Scar Scale — MSS) и цифрового фотографирования. РЕЗУЛЬТАТЫ При анализе данных по MSS получены следующие результаты: до лечения — 11,6 (9,3—13,3) балла, через 3 мес после окончания лечения — 6,5 (5,1—7,2) балла, через 6 мес после окончания лечения — 5,2 (4,5—6,1) балла. Статистически значимыми были различия между показателями до лечения и обеими контрольными точками (p=0,001). При наблюдении в отдаленные сроки (через 12—24 мес) подтверждены стабильные результаты. Серьезные нежелательные явления не зарегистрированы. Легкие осложнения отмечены у 10,1% пациентов. ЗАКЛЮЧЕНИЕ Инъекционная аутотрансплантация продуктов на основе жировой ткани — эффективный метод лечения пациентов с патологическими рубцовыми изменениями. Данный подход является промежуточным звеном между консервативными и хирургическими методами.

Cellular senescence is a key mechanism of aging. Senescent cells negatively affect the function of tissues and organs, significantly contributimg to the aging of the organism. Functional and structural characteristics of senescent cells, such as genomic changes and cell cycle arrest, lysosome and mitochondrial dysfunction, and production of SASP factors, are promising therapeutic targets in the context of healthy longevity. The present review was designed to characterize the features of senescent cells in order to discuss current methods and problems of geroprotective therapy and perspective factors for the development of new strategies of anti-aging treatment. Publications were searched based on the analysis of articles containing the keywords “senescent cells, aging, senolytic therapy, SASP, mitochondrial dysfunction” in the PubMed and Scopus databases up to March 2025.

АНГИОГЕНЕЗ (ЛИТЕРАТУРНЫЙ ОБЗОР)

Thirty-four Russian and foreign articles on the subject have been analyzed. Adipose-derived stromal cells isolation methods and comparative analysis of different lipoaspirate based products is described. Comparative characteristic of different stromal vascular fraction isolation devices is given in the article as well. Different methods of stromal vascular fraction isolation have advantages and disadvantages. Currently the most promising direction is development of an automatic medical device with standardized physical force impact that allows to obtaining high-quality product with predictable physical and biological properties.

Objective. To compare the effectiveness (healing of complex cryptoglandular fistula) and safety (complication rate) of mesenchymal stem cells (MSCs) in combination with filling of fistula with fibrin glue and isolated administration of fibrin glue in patients with complex cryptoglandular fistula. Material and methods. A systematic review and meta-analysis included studies devoted to isolated use of fibrin glue and topical use of MSCs combined with fistula filling with fibrin glue for the treatment of patients with complex cryptoglandular fistulas. Meta-analysis included 3 randomized clinical trials and 198 patients. Results. Cryptoglandular fistula healing rate in the MSCs + fibrin glue group in long-term period (12—24 months) was 50-52.4%, in another group — 26.3—37.3% (OR=2.15; 95% CI 1.08—4.29; p=0.03). This confirms the effectiveness of additional administration of MSCs. There were no significant differences in complication rate (abscesses) that indicates safety of technique. Certain factors can affect the results of surgical treatment (method of treatment and washing of fistulous canal, intensive mixing of cell suspension, method of MSC administration and small experience in fistulous canal closure with fibrin glue). Conclusion. Autologous adipose-derived stem cells are effective and safe for complex cryptoglandular fistula. However, significant limitations of meta-analysis make us cautious about the results and require further randomized trials.

Introduction. Treatment of post-radiation damage to the rectum is a complex medical problem. The search for new methods of treatment for this category of patients based on modern achievements in regenerative surgery is urgent.The aim of the study was to evaluate the immediate and long-term results of treatment of post-radiation lesions of the rectum using microfat grafting.Materials and methods. The study involved 66 patients — women aged 28 to 83 years inclusive with complications of radiation therapy (rectovaginal fistulas, radiation proctitis, radiation ulcers).Results and discussion. After the treatment, there is a tendency to improve the condition. So, if before the procedure the average sizes of fistulas and ulcers were 1.67 ± 0.54 cm in diameter, then after 3 months these indicators were 1.39 ± 0.54, and after 6 months — 1.1 ± 0.56 cm Complete epithelialization of the defect was observed in all patients. The period for which it was possible to achieve complete epithelialization varies from 6 months to 2 years. On average, to achieve complete epithelialization of post-radiation damage to the rectum, most patients required 3 injections of autologous adipose tissue. Also, all patients showed an improvement in elastometry indices over time. As a result of treatment, there is a tendency to improve the quality of life of patients.Conclutions. The study allows us to conclude about the effectiveness of the treatment, as well as that in the long term, the treatment will also be effective, the likelihood of relapse is minimal.