Method for control of bleedings accompanying perforating wound of liver
SUBSTANCE: wound canal is packed with a preparation of recovered oxygenated cellulose. Thereafter in an entrance wound, the preparation is exposed to 2 cycles of cryotherapy with liquid nitrogen at a temperature of minus 196°C for 1-2 minutes until an ice crust is formed on the wound surface.
EFFECT: method provides excluding the possibility of bleeding and bile flowing from an inner surface of stab wounds, reducing a risk of recurrent bleedings, formation of liver haematomas postoperatively.
3 dwg, 2 tbl, 2 ex
The invention relates to medicine, namely to abdominal surgery, and can be used to stop bleeding when a through stab wounds of the liver.
At the present time to stop bleeding in injuries of the liver using suturing the tissue in various modifications.
One way of achieving hemostasis is the body wrapping compression mesh from strands of catgut [S. R. Sabirov Organ principles of hemostasis in injuries of parenchymal organs (liver, spleen and kidneys). // Author. Diss. doctor. honey. of Sciences, Moscow, 2006. - 34 p.]. The described method does not lead to hematoma formation, but in the tissues develops adhesions in the area of the implanted mesh, this method is not widely used in the clinic due to technical difficulties arising from the anatomical features of the human liver and its massiveness.
Many researchers noted a high hemostatic effect of ultrasonic (harmonic) scalpel [Biryukov Yu. V liver Injury / Y. V. Biryukov, O. V. Volkov, S. Roy // Surgery. - 1997. - No. 2. - Pp. 24-27; Sun, D. Development and application of ultrasonic surgical instruments / D. Sun, Z. Y. Zhou, Y. H. Liu // Trans. Biomed. Eng. - 1997. - Vol. 44. - Pt. 6. - P. 462-467]. The disadvantages of this device is not effective hemostasis the coagulation of vessels of over 1 mm in diameter and the high cost of this device�VA [K. V. Lapkin Feedback on the use of radiosurgical device "SURGITRON" in surgery of abdominal organs / K. V. Lapkin // Actual problems of surgical Hepatology. - M - 2000. - P. 54].
Famous drug tachocomb. It is made from the collagen of tendons of the horse, lyophilized human fibrinogen, porcine fibrin, animal Aprotinin. Components of this drug of animal origin and can cause allergic reactions to the introduction of a foreign protein. The physical properties of this drug does not allow you to apply it to the wound channels, it sticks to hands and tools, require special storage conditions (2-8°C), has no bactericidal effect and the high cost of the drug [Khorobrykh T. V. Treatment of traumatic injuries of the liver with the use of analogue fibrin glue: dis. ...candidate. honey. Sciences: 14.01.17 / T. V. Khorobrykh. - M., 1995. - 168 s.; Kram, N. B. Use of fibrin glue in hepatic trauma / H. B. Kram, Reuben B., A. W. Fleming, W. C. Shoemaker // J. Trauma. - 1988. - Vol. 28. - Pt. 8. - P. 1195-1201].
Known way to stop the bleeding with a sponge containing collagen and drug substance (Patent RF №2122867 from running from 10.12.1998). These components are evenly applied on the entire area of the wound surface. This method is chosen as a prototype. The proposed method is only applicable in capillary bleeding, and when applying the sponge to the surface of the wound occur �nutricentre hematoma, liver abscesses and ongoing bleeding, which causes the need for re-operations.
The present invention is to eliminate the possibility of bleeding and seletected from the inner surface of the stab wounds and reduce the risk of recurrent bleeding and the formation of a Central hematoma of the liver after surgery.
The technical result is simple and lies in the combined effect on the inner surface of the stab and incised wounds with liquid nitrogen at minus 196°C and stopped using the drug recovered from oxygenizing cellulose, and the effectiveness of the freezing of the drug is controlled by the appearance of ice on the wound site.
The technical result of the proposed method is achieved by tamponade of the wound surface of stab and incised wounds and cooling plugging of the drug with liquid nitrogen to minus 196°C. the Technical result is achieved in that according to the invention the wound channel tamponiruut drug recovered from oxygenizing pulp, then in the input hole of the wound channel on the drug spend 2 cycles of cryotherapy with liquid nitrogen at minus 196°C for 1-2 minutes until formation of an ice crust on the surface of the wound.
The proposed method is carried out� as follows: the wound channel tamponiruut drug recovered from oxygenizing pulp. The drug effect within 1-2 minutes with liquid nitrogen at minus 196°C. is Carried out 2 cycles of cryotherapy, and the effectiveness of the freezing of the drug is controlled by the formation of ice on the wound surface.
The described method is illustrated graphic material. Figure 1 depicts a bleeding stab wound of the liver (1). Figure 2 - plugging the wound channel from a recovered drug oxygennitrogen pulp (2). Figure 3 - the effects of liquid nitrogen on the surface with a DAB of the drug at the inlet exit wounds of the liver (3).
Examples of the practical use of
An experimental study on dogs. The day before surgery, the animal number 3 stopped feeding is not restricted to the consumption of water. For the purpose of relieving tension, aggression and to reduce salivation, 30 minutes before the start of anesthesia premedication was administered (intramuscularly introduced diphenhydramine 1%, droperidol 0.25% and rometer 2% and subcutaneous platifillina tartrate 0.2%) and dosing per 1 kg of body weight. After sedation was carried out by fractional anesthesia is the introduction of a 5% solution of thiopental sodium at a dose of 7 mg/kg intravenously at the rate of animal weight. The weight of the animal was 9 kg. In the period between the fractional anesthesia the animal shaved off the hair on the anterior abdominal wall. Dogs� in the supine position was fixed to the operating table. The operation field was treated with a solution of itaperuna and alcohol. Further laparotomy was performed. The operation field was overlaid with sterile towels. In the center of the left medial lobe of the liver with a sharp scalpel was applied through stab wound 2 cm and with diastasis of the wound edges of 0.3-0.4 cm From the wound surface was observed constant bleeding. In the wound channel was introduced captured with tweezers separate layers restored oxygennitrogen cellulose, the bleeding stopped after 45 seconds. After tamponade of the wound channel drug recovered from oxygenizing cellulose on the drug worked for 2 minutes in liquid nitrogen at minus 196°C. was Performed twice cryosurgery. The efficiency of a freezing of the drug is controlled by the formation of ice on the wound surface. After thawing bleeding from the wound was observed. Following the audit the abdominal cavity was sutured in layers. The animal was removed from the experiment for 14 days. At the time of observation of clinical signs of re-bleeding is not noted. At the autopsy of the animal revealed unexpressed adhesions at the wound of the liver, signs of hemorrhage were not observed.
An experimental study on dogs. The day before surgery animal No. 8 removed the food, but have limited� in the receiving water. 30 minutes before the start of anesthesia prescribed premedication (intramuscularly introduced diphenhydramine 1%, droperidol 0.25% and rometer 2% and subcutaneous platifillina tartrate 0.2%) and dosing per 1 kg of body weight. The dog's weight is 12 kg. Anesthesia was carried out by fractional introduction of a 5% solution of thiopental sodium at a dose of 10 mg/kg intravenously. After sedation and the period between the introduction of fractional anesthesia it's not your fault the animal. Lying on the back of the animal was fixed to the operating table. Treated surgical field with an antiseptic, performed a laparotomy. The area of application of the wound was covered with sterile Drapes. Further modeling was performed through stab-incised wounds of the liver. In the center of the left medial lobe of the liver with a sharp scalpel was applied through stab wound 2 cm and with diastasis of the wound edges of 0.3-0.4 cm From the wound surface was observed constant bleeding. The wound channel tamponirovanie individual layers restored oxygennitrogen cellulose, hemostasis observed in 55 seconds. After tamponade of the wound channel drug recovered from oxygenizing cellulose on the drug worked for 2 minutes in liquid nitrogen at minus 196°C. was Performed twice cryosurgery. The efficiency of a freezing of the drug is controlled by the formation of ice on the wound surface. �after thawing bleeding from the wound was absent. Following the audit the abdominal cavity of the latter was sutured in layers. Animal No. 8 was removed from the experiment on day 7. During observation of the dog were not observed signs of re-bleeding and peritonitis. At autopsy of a corpse of an animal in the wounds of the liver was visualized unexpressed adhesions, bleeding is not noted.
These examples illustrate the possibility of applying the proposed method to stop bleeding at through stab wounds of the liver.
Experimental study was conducted on 21 animal. As experimental animals, we have selected mongrel dogs of both sexes weighing from 6 to 25 kg. the Experiment was performed at the animal clinic at the Federal state institution "Russian scientific center "Restorative traumatology and orthopedics named after academician G. A. Ilizarov of Russia, the city of Barrow. Description of possible complications during experiments on laboratory animals are presented in table 1. Table 2 provides the timing stop bleeding after applying the proposed method and the prototype 5 examples of experimental studies.
The proposed method allows to reduce the number and frequency of occurrence of postoperative complications, save the budget by reducing the time of hospitalization and lack of cost �and repeated surgical intervention. The simplicity and effectiveness of the proposed method in the experimental model allows to test this method on people.
|Possible complications when using the proposed method|
|Complication||The complication rate in % (n=21)|
|Ruptures of the liver parenchyma during the plugging of the wound channel||0±4,3|
|The timing of bleeding when using the proposed method and the prototype (in seconds)|
|Time stop bleeding, sec (prototype)||Time stop bleeding, sec (proposed method)|
|M±M||A total of 115.4±21||53,6±9|
The way to stop bleeding through the wounds of the liver characterized in that the wound channel tamponiruut drug recovered from oxygenizing pulp, then in the input hole of the wound channel on the drug spend 2 cycles of cryotherapy with liquid nitrogen at minus 196°C for 1-2 minutes until formation of an ice crust on the wound surface.
SUBSTANCE: invention relates to medicine and veterinary and is intended for the acceleration of stopping bleeding in case of injury to blood vessels in traumas and wounds. A haemostatic agent contains 3-20 wt % of a polysaccharide, where the polysaccharide is represented by chitosan and/or starch, 0.1-2 wt % of calcium chloride and a 0.5-5% water solution of succinic or hydrochloric acid - the remaining part.
EFFECT: accelerating the initiation of the thrombus-forming process and enhancement of the regenerative ability of tissues in the area of wounds of different aetiology.
1 tbl, 14 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to pharmaceutically acceptable salts specified in a group consisting of sodium salt, lithium salt, potassium salt, calcium salt, magnesium salt, arginine salt, lysine salt, methanamine salt, dimethylamine salt, trimethylamine salt, ethylamine salt, diethylaminte salt, triethylamine salt, ethanolamine salt, piperazine salt, dibenzylethylene diamine salt, methyl glucamine salt, tromethamine salt, quaternary tetramethylammonium salt, quaternary tetraethylammonium salt and choline salt, bicyclosubstituted azopyrazole derivatives of general formula
The invention also refers to a method for preparing them, a pharmaceutical composition containing them, and using them as a therapeutic agent, particularly as thrombopoietin (TPO) mimetics, using them as TPO agonists. In general formula (I), Het is specified in a group consisting of phenyl, furanyl and thienyl; each R1, R2, R3 andR4 are independently specified in a group consisting of hydrogen and alkyl; n is equal to 0, 1 or 2.
EFFECT: improving the pharmokinetic properties of the compound of formula (I) ensured by better solubility.
19 cl, 1 tbl, 25 ex
SUBSTANCE: bispecific antibody is proposed, that binds to both the blood coagulation factor IX/activated blood coagulation factor IX and with the blood coagulation factor X, and functionally replaces the function of blood coagulation factor VIII. The nucleic acid is considered, encoding the antibody of the invention, a vector, a cell and a method of producing the antibody, and also a pharmaceutical composition and a kit for use in the method of preventing and/or treating bleeding or diseases associated with or caused by bleeding.
EFFECT: invention may find further application in the treatment of diseases associated with impaired blood clotting.
16 cl, 2 ex, 6 dwg
SUBSTANCE: claimed is bispecific antibody, which is bound with both blood coagulation factor IX/activated blood coagulation factor IX and with blood coagulation factor X and functionally replaced function of blood coagulation factor VIII. Described are nucleic acid, coding antibody by invention, vector, cell and method of obtaining antibody, as well as pharmaceutical composition and set for application in method of prevention and/or treatment of bleeding or diseases, associated with or induced by bleeding.
EFFECT: invention can be applied in therapy of diseases, associated with blood coagulation disorders.
16 cl, 2 ex, 6 dwg
SUBSTANCE: antiproteolytic preparation Ambene in a dose of 50-250 mg is introduced intravenously by the stream infusion for at least three days every 3-4 hours in a combination with heparin. Heparin is introduced subcutaneously is a dose of 250 units 4 times a day.
EFFECT: effective treatment of endogenous intoxication syndrome caused by proteolysis by blocking fibrinolysis and enhancing the detoxifying and anti-inflammatory action of Ambene.
2 tbl, 2 ex
SUBSTANCE: what is described is a biodegradable haemostatic therapeutic agent for control of bleeding, which provides co-immobilising ε-aminocapronic acid 50 mg, lysozyme 5 mg in distilled water 6.5 l for 3 hours at room temperature for dialdehyde cellulose 1 g at a degree of oxidation 12%. The material is pressed out and dried to residual moisture no more than 10% in the air in darkness. After having dried, the material is milled in a fine mill to particles having a size of 20 to 50 mcm. A rate of control of bleeding is 102 seconds. A time of total resorption is 10 days.
EFFECT: agent provides a high degree of hydrolytic destruction and a good haemostatic activity.
4 cl, 2 ex
SUBSTANCE: invention represents a biodegradable haemostatic therapeutic agent for bleeding. Using the prepared haemostatic agent according to the declared method provides a rate of control of bleeding making 45±2 seconds.
EFFECT: higher rate of control of bleeding.
4 cl, 2 tbl
SUBSTANCE: agent further contains aluminium and/or magnesium oxides and satisfies the formula: CaO·(SiO2)m·(M)n·(H2O)k, where M is Al2O3 and/or MgO; m=0.5-3.0; n=0.01-0.05; k=0.2-1.2.
EFFECT: shorter time for onset of hemostasis and low exothermic effect during interaction with blood.
2 tbl, 9 ex
SUBSTANCE: invention refers to medicine, namely to hematology and oncology, and concerns correction of amegakaryocytic thrombocytopenia. That is ensured by introducing a platelet concentrate and performing autologous peripheral haemopoietic stem cell transplantation with performing a single subcutaneous injection of romiplostim 200-300 mcg on the day of the transplantation.
EFFECT: method provides reducing a risk of the haemorrhagic complications following the high-dose chemotherapy, ensured by the fast and effective platelet growth.
2 ex, 1 tbl
SUBSTANCE: agent contains chitosan salt 75-95 wt % of polydisperse powders of chitosan hydrochloride, hydrobromide, formate, acetate, succinate, citrate, glycolate or lactate and polyhexamethylene guanidine hydrochloride 4-20 wt %. The chitosan salt and polyhexamethylene guanidine hydrochloride are covalently cross-linked by a polyfunctional compound 1-5 wt % of glycidyl ethers. The chitosan salt is specified with an average particle size of 0.2÷2.0 mm, degree of chitosan deacetylation 0.75÷0.95, and molecular weight 10÷500 kDa. The above polyfunctional compound of glycidyl ethers is presented by a diglycidyl ether of butandiol, di- or triethylene glycol or propylene glycol, oligoethylene oxide, as well as triglycidyl ethers of glycerol or trimethylol propane.
EFFECT: method possesses high blood sorption capacity, rapid hemostasis time and high antimicrobial activity.
3 cl, 2 tbl, 12 ex
SUBSTANCE: conducting No. 5 dietary therapy and doing therapeutic exercises are prescribed. That is combined with taking low-mineralised carbonated sodium calcium chloride hydrogen carbonate sulphate mineral water "Essentuki Novaya" at 3.5 ml per 1 kg of patient's body weight 30-40 minutes before meals; 2% pentoxiphyline full-length ampli-pulse-phoresis procedures are performed daily with an anode placed on a projection of liver, whereas a cathode is placed symmetrically on back in the III and II operation modes (6 minutes each), at modulation frequency 150 Hz, modulation depth 75%; the therapeutic course includes 10 procedures.
EFFECT: method enables reducing the length of treatment and increasing the clinical effectiveness.
5 tbl, 2 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: what is presented is a group of inventions concerning a new application of bicyclo[2,2,2]octane-2-carboxylic acid salt. What is presented is using it for treating dysphoria in a person suffering epilepsy for treating alcohol addiction, for reducing the level of hepatic function marker specified in AST (aspartate aminotransferase), ALT (alanine aminotransferase) or bilirubin in the person for reducing an erythrocyte sedimentation rate, as well as for reducing a number or an intensity of epileptic attacks in a daily dose of min 400 mg.
EFFECT: implementing the above applications with no negative effect on patient's behaviour and the functions of the main organs and systems.
19 cl, 6 tbl, 2 ex
FIELD: food industry.
SUBSTANCE: method for production of Siberian cedar seeds liqueur (with hepatoprotective, antioxidant, antihypoxic, hypolipidemic effect) by way of maceration with ethyl alcohol usage; whole Siberian cedar seeds are loaded into the reactor, poured with 70% ethyl alcohol water solution; extraction is performed under preset conditions. The medicinal preparation with hepatoprotective, antioxidant, antihypoxic, hypolipidemic effect contains Siberian cedar seeds liqueur. Usage of the medicinal preparation as a hepatoprotective remedy.
EFFECT: liqueur has pronounced hepatoprotective, antioxidant, antihypoxic and hypolipidemic effect.
6 cl, 3 dwg, 8 tbl
FIELD: medicine, pharmaceutics.
SUBSTANCE: present invention refers to chemotherapy of cancer and represents a composition for hepatic cancer in individuals and containing a complex of formula [M(RCS3)2(RCS2)], wherein M represents 188Re having an activity of more than 3.7 GBq and a lipophilic organic phase emulsified with a water phase; as well as a method for preparing the above composition.
EFFECT: invention provides higher stability and efficacy of the composition for treating hepatic cancer in the individuals.
17 cl, 1 dwg, 9 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to the pharmaceutical industry, particularly to a composition for treating or preventing the human immunodeficiency virus (HIV) or hepatitis C. The herbal composition used for treating or preventing the patients infected by the HIV or hepatitis C viruses and containing a herbal ingredient with tannin agents and catechin, and a pharmaceutically acceptable carrier; the herbal ingredient is Agrimonia Eupatoria (GAFT) and/or gambier (Uncaria gambir). A method for preparing the herbal composition for treating or preventing the patients infected by the HIV or hepatitis C viruses.
EFFECT: composition is effective for treating or preventing the patients infected by the HIV or hepatitis C viruses.
12 cl, 6 dwg, 2 tbl
SUBSTANCE: group of inventions refers to medicine, namely to hepatology and neurology, and can be used for using rifaximin for preparing a drug preparation for maintaining hepatic encephalopathy (HE) remission in a subject. That is ensured by daily administration of rifaximin into the subject for approximately 12 months or more, or approximately 1095 days or longer, thereby maintaining the HE remission.
EFFECT: group of inventions provides the stable HE remission, as well as a low antibiotic resistance of the patient's bacterial flora.
16 cl, 34 dwg, 28 tbl, 6 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to medicine and can be used as a hepatotrophic, lipotropic agent in gastroenterology, as well as for treating cardiac and cerebral atherosclerosis, in neurology in the lower extremity artery diseases (endarteritis). The agent contains tabletted powders of diisopropylammonium dichloroacetate, microcrystalline cellulose, lactose and excipients presented by Aerosil, Primogel and calcium stearyl fumarate.
EFFECT: agent possesses no toxicity, has the high adsorption properties, the apparent anti-inflammatory action, and provides metabolism and the liver regeneration.
3 tbl, 2 ex
SUBSTANCE: according to a known method of treating the liver disease accompanying type 2 diabetes mellitus involving the baseline therapy of diabetes mellitus and prescribed hepatoprotectors, the above hepatoprotector is presented by Mexicor in a daily therapeutically effective dose of not less than 16 weeks. The therapeutically effective dose of Mexicor makes 100 mg 4 times a day.
EFFECT: higher clinical effectiveness ensured by eliminating the liver disease more prominently, reducing the length of treatment, normalising the liver function test results over a short period of time, and avoiding any side effects.
2 cl, 2 tbl
SUBSTANCE: invention refers to medicine and aims at treating the non-alcoholic fatty liver disease. Increasing a transaminase level to three normal values inclusively requires applying essential phospholipids for 2-3 months twice a year that is followed by using statin 10-20 mg in a combination to ursodeoxycholic acid 15-20 mg/kg for 3-6 months. If the transaminase level exceeds three normal values, the treatment is isolated and includes ursodeoxycholic acid 15-20 mg/kg for 3-6 months.
EFFECT: method enables providing the higher clinical effectiveness of the non-alcoholic fatty liver disease.
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to medicine, namely to endocrinology, and can be used for treating non-alcoholic liver disease accompanying type 2 diabetes mellitus. The declared preparation Mexicor provides reducing manifestations of cytolysis and cholestasis, decreasing the steatosis index, enables improving metabolic lipid and glycaemic values and reducing insulin resistance. Mexicor is applied in a daily therapeutically effective dose of 100 mg 4 times a day for at least 16 weeks.
EFFECT: high pharmacological activity of Mexicor has been shown by achieving the pronounced and stable elimination of fatty liver disease that enables reducing the length of treatment with no side effects.
2 cl, 2 tbl
FIELD: veterinary medicine.
SUBSTANCE: preparation for treatment of infected wounds in the toe region of animals, containing dimethyl sulphoxide, methyl cellulose, additionally comprises tylosin tartrate, sulphadimine, trimethoprim in the following ratio of components, wt %: tylosin tartrate - 2-3, sulphadimine - 4-5, trimethoprim - 1-1.5, dimethyl sulphoxide - 10-15, methylcellulose - 3.0-3.5, water - the rest. The claimed method comprises applying the claimed preparation without preliminary wound cleaning. The preparation is applied to the wound with the layer thickness of 2-3 mm, without application of soft dressing. The treated animals are kept for 2-3 hours on the dry surface.
EFFECT: use of claimed group of inventions increases the efficiency of treatment.
4 cl, 7 tbl, 2 ex