ЦЕЛЬ ИССЛЕДОВАНИЯ Изучение частоты и структуры боевой огнестрельной минно-взрывной травмы (МВТ), полученной во 2-й Карабахской войне, и анализ результатов лечения раненых с МВТ. МАТЕРИАЛ И МЕТОДЫ В основу работы положен анализ результатов хирургическогого лечения 60 раненых с боевой огнестрельной хирургической травмой. У 25 (41,7%) пострадавших ранение произошло в результате МВТ. В зависимости от механогенеза МВТ раненые разделены на три группы. В 1-ю группу включены 7 (28%) из 25 раненых, которые получили МВТ вследствие непрямого (метательного) воздействия взрывной волны. Во 2-ю группу вошли 14 (56%) раненых, у которых МВТ была вызвана неконтактным (дистантным) воздействим осколков мин. Третью группу составили 4 (16%) раненых, у которых МВТ была вызвана непосредственным воздействием факторов взрыва на различные анатомические области. С учетом характера и тяжести МВТ раненые ранжированы на три группы: а) с изолированными повреждениями (16 (64%)); б) с сочетанными повреждениями (2 (8%)); в) с комбинированными и множественными повреждениями (7 (28%)). РЕЗУЛЬТАТЫ У большинства раненых выполняли органосохраняющие операции. Органоуносящие вмешательства произведены лишь у 4 раненых: спленэктомия у 3, нефрэктомия у 1. Послеоперационные осложнения развились у 23 (38,3%) раненых: нагноение послеоперационных ран у 13, посттравматический плеврит у 5, свернувшийся гемоторакс у 2, поддиафрагмальный абсцесс у 1, флегмона промежности и перианальной области у 2. Летальность составила 1,7%. ЗАКЛЮЧЕНИЕ Организация своевременной сортировки и эвакуации раненых и оказание ранней квалифицированной хирургической помощи, а также правильное ведение послеоперационного периода с мониторингом витальных функций позволяют улучшить результаты лечения раненых с МВТ. Аутодермопластика обширных раневых дефектов и ликвидация колостомы с восстановлением непрерывности толстой кишки являлись одними из основных составляющих комплексной системы реабилитации раненых данной категории.

This study represents the first report that evaluates the experience gathered from diagnosis, surgical treatment and outcome of insulinoma patients from Azerbaijan. We retrospectively review of insulinoma patients for a ten year period. Collected data included patient demographics, laboratory and imaging tests, detailed surgical reports, histopathological examination of resected specimens, and clinical follow-up. Twenty-one insulinoma patients were identified. Male patients comprised 52.4%; mean age was 44 years. Mean time to diagnosis was 14 months; 61% patients had ?3 medical referrals due to hypoglycemia-related symptoms. Diagnosis sensitivity of CT, MRI and US was 85%, 80%, and 55%, respectively. The mean glucose, insulin, C-peptide levels were 35.7±9.5 mg/dL, 33.5±21.9 µU/mL, and 3.74±1.88 ng/mL, respectively. Pancreatic head and tail were the most frequent tumor locations; mean tumor size was 1.5±0.7 cm. No statistical association was found between the tumor size and preoperative glucose, C-peptide and insulin levels. Distal pancreatectomy and enucleation were the most common surgical procedures. Local tumor recurrence rate was 14%. There was no mortality. To prevent delayed diagnoses, physicians should be familiar with the typical symptoms of these rare tumors.

The article proposes the principles for the development of a fuzzy rule-based physician decision support system n to determine the stages of the most common hepatocellular carcinoma (HCC) among malignant tumors of liver. The stages of HCC, i.e., critical situations, are expressed by different combinations of clinical signs of input data and emerging clinical conditions. These combinations shape the multiplicity of possible situations (critical situations) by forming linguistic rules that are in fuzzy relations with one another. The article presents the task of developing a fuzzy rules-based system for HCC staging by classifying the set of possible situations into given classes. In order to solve the problem, fuzzy rules of clinical situations and critical situations deviated from them are developed according to the possible clinical signs of input data. The rules in accordance with the decision-making process are developed in two phases. In the first phase, three input data are developed: nine rules are developed to determine possible clinical conditions based on the number, size, and vascular invasion of tumor. In the second phase, seven rules are developed based on possible combinations of input data on the presence of lymph nodes and metastases in these nine clinical conditions. At this stage, the rules representing the fuzzification of results obtained are also described. The latter provide an interpretation of results and a decision on related stage of HCC. It also proposes a functional scheme of fuzzy rules-based system for HCC staging, and presents the working principle of structural blocks. The fuzzy rule-based system for HCC staging can be used to support physicians to make diagnostic and treatment decisions

The principal aim of the current study was to investigate the relationship between miR-149 T>C (rs2292832) and miR-196a2 C>T (rs11614913) small non-coding RNA polymorphisms and the risk of developing CRC in the Azerbaijani population. The study included 120 patients diagnosed with CRC and 125 healthy individuals. Peripheral blood samples were collected from all the subjects in EDTA tubes and DNA extraction was performed by salting out. Polymorphisms were determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. While comparing without gender distinction no statistical correlation was found between the heterozygous TC (OR = 0.66; 95% CI = 0.37–1.15; p = 0.142), mutant CC (OR = 1.23; 95% CI = 0.62–2.45; p = 0.550), and mutant C (OR = 1.03; 95% CI = 0.72–1.49; p = 0.859) alleles of the miR-149 gene and the CT (OR = 1.23; 95% CI = 0.69–2.20; p = 0.485), mutant TT (OR = 1.29; 95% CI = 0.67–2.47; p = 0.452), and mutant T (OR = 1.17; 95% CI = 0.82–1.67; p = 0.388) alleles of the miR-196a2 gene and the risk of CRC. However, among women, miR-149 TC (OR = 0.43; 95% CI = 0.19–1.01; p = 0.048) correlated with a reduced risk of CRC, whereas miR-196a2 CT (OR = 2.77; 95% CI = 1.13–6.79; p = 0.025) correlated with an increased risk of CRC. Our findings indicated that miR-149 T>C (rs2292832) might play a protective role in the development of CRC in female patients, whereas the miR-196a2 (rs11614913) polymorphism is associated with an increased risk of CRC in women in the Azerbaijani population, highlighting the importance of gender dimorphism in cancer etiology.

Background: This study is the first to investigate the association between colorectal cancer (CRC) risk and the hMLH1 -93G>A and hMSH2 1032G>A polymorphisms of mismatch repair (MMR) genes in the Azerbaijani population. Methods: Peripheral blood samples containing EDTA were collected from the study subjects (134 patients and 137 controls), and genomic DNA was extracted using the non-enzymatic salting-out method. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and the results were visualized through agarose gel electrophoresis. Results: Overall, no statistically significant correlation was observed between CRC risk and the hMLH1 -93G>A polymorphism in the heterozygous GA (OR=0.76; 95% CI=0.37–1.54; P=0.446), mutant AA (OR=1.47; 95% CI=0.74–2.95; P=0.270), or the A allele (OR=1.062; 95% CI=0.735–1.534; P=0.748). However, in contrast to the dominant model, a statistically significant association was found between the recessive model and a reduced CRC risk, with an odds ratio of 0.56 (95% CI=0.35–0.91; P=0.018). The hMLH1 -93G>A polymorphism was identified at a significantly higher frequency across the TNM stages, with the distribution showing statistical significance (P0.05). Additionally, no statistically significant association was observed between the hMSH2 1032G>A polymorphism and CRC risk. Conclusions: Our results indicate that the hMLH1 -93G>A polymorphism, particularly under the recessive model, may play a protective role against CRC risk in the Azerbajani population. Further studies are required to validate these results and investigate the underlying biological mechanisms.