Vol. 1 No. 1 (2021): VESTNIK of KSMA

The article presents a historical certificate of medical scientific research conducted by leading medical scientists of the USSR and the Kyrgyz SSR at the Tuya-Ashu pass (Tian-Shan, 3200 m). For research begun in adapted buildings by employees of the Kyrgyz State Medical Institute in the 1960s, highland research units of the National Center for Cardiology and Therapy (1989) and the Kyrgyz Scientific Center of Hematology (2004) were subsequently built. Studies of the therapeutic effect of the mountain climate in blood diseases and bronchial asthma are covered. In the conditions of the Tuya-Ashu scientific base, a number of doctoral and master's theses of scientists of Kyrgyzstan of high mountain physiology and medicine were completed.

The article presents modern data on cutaneous and systemic forms of mastocytosis. Mastocytosis is a rare disease. The most common variants are cutaneous and indolent systemic mastocytosis, less often obesity leukemia. The clinical picture of mastocytosis is heterogeneous – from skin lesions that can spontaneously progress to aggressive forms of the disease associated with organ failure and a short life span. According to the WHO classification (2016), 7 subtypes of mastocytosis have been identified. It is diagnosed on the basis of clinical manifestations and the detection of infiltrates of tumor mast cells using morphological, immunohistochemical, immunophenotypic, genetic and molecular methods. Treatment of mastocytosis requires a deep understanding of their molecular and cellular pathogenesis and accurate diagnostic assessment.

Abstract. Recent developments in the field of transcatheter aortic valve implantation (TAVI) have led to arised interest for the optimization of this procedure and related devices for patients with severe aortic valve stenosis. This is the first study to examine novel XPand device, jointly developed by German, French and Ukrainian scientists. This study aims to
contribute to this growing area of research by exploring efficacy and safety in patients with severe aortic stenosis.
Objective. To evaluate the procedure effectiveness and long-term outcomes for XPand device implantation in patients with severe aortic valve stenosis. Materials and methods. We initiated a single-center clinical trial to evaluate the XPand
device and already perform an initial analysis of the primary outcomes. After patients fitted the inclusion criteria full examination they underwent TAVI procedure using the XPand system. Postoperative result evaluation was performed according to the established protocol.
Outcomes. Primary good results for TAVI XPand were obtained in all patients (n = 7). The average length of stay in the hospital after the procedure was 20 ± 1.25 days. The postoperative period was unremarkable. In 71.5% of patients the minimal paravalvular insufficiency or insufficiency absence were obtained after the final aortography.
Comments. The first experience of using modern device XPand for transcatheter implantation of the aortic valve prosthesis confirms its effectiveness and safety in patients with severe aortic stenosis.

The author provides an overview of the literature on the problem of the mechanism of
damage ligamentous apparatus of the acromioclavicular joint (ACJ), accompanied by the
dislocations of the acromial end of the clavicle. The article deals with the mechanisms of
injury, the role of the elements of ligamentous apparatus in the event of dislocations of the
acromial end of the clavicle. Noting the need for further biomechanical research AKC to
assess the extent of damage ligamentous apparatus. Proper assessment of the extent of
damage ligamentous apparatus of game play an important role in choosing the optimal
treatment vyvihihov acromial end of the clavicle.

The article presents modern classifications of injuries of the acromioclavicular joint, as well as the mechanism of their occurrence. Modern classifications should take into account the degree of damage to the ligamentous apparatus, the type of displacement of the clavicle and
morphological changes occurring in the surrounding tissues of the ACS and the shoulder girdle. The values of the classification of injuries are shown when choosing a rational treatment for injuries of the acromioclavicular joint. Knowledge of the mechanism of damage allows the specialist to predict the nature and severity of damage to the structures of the joint. The importance of the nature of the traumatic force in case of damage to the acromioclavicular joint is noted.

Hernias of the anterior abdominal wall are often the cause of the development of adhesions in the abdominal cavity.
The aim of the study was to acquire scientific data on the features of the adhesion process in the abdominal cavity in patients with hernias of the anterior abdominal wall of different localization to optimize diagnostic methods and surgical treatment of hernias.
Clinical material comprised 350 patients of both sexes who suffered from hernias of the anterior abdominal wall of various shapes, operated on at the National Surgical Center from 2015 to 2019.
As a result of the studies, it was proved that postoperative ventral hernias are always accompanied by the presence of an adhesive process of the abdominal cavity in the area of hernias and in any other areas of the abdominal cavity.
Umbilical hernias, regardless of their size, in most cases are accompanied by the presence in the cavity of the hernias of parieto-parietal adhesions of a filmy and heavy nature. The presence of an intensive adhesive process in the area of hernial gates is also characteristic. Inguinal hernias are characterized by the presence of viscero-visceral adhesions. In the area of hernial gates, such adhesions were not observed.

Summary. The process of adhesion formation is a polyetiological phenomenon with a
complex pathogenesis. Adhesion and antiadhesive properties of the peritoneum are
interrelated, and the predominance of one over the other is likely to have a fundamental
effect on the severity of adhesions.
The basis of the pathogenesis of adhesions after operations on the abdominal organs is
considered to be the germination of connective tissue fibers and, subsequently, vessels and
nerves that have fallen out of the peritoneal effusion of fibrin, which "joins" the serous
cover of the organs.
The basis of the pathogenesis of the adhesive process is the organization of the tissues of the fibrin matrix formed after intraperitoneal exudation of free fibrin, the active phase of which
begins as early as 12 hours after injury of the peritoneum.
In the course of the study, we conducted a randomized controlled study to experimentally
evaluate the effect of antibacterial agents on the formation of adhesions in the abdominal
cavity. In parallel randomized study presents the results of the impact of antibiotiсs on the
adhesion formation of the abdominal cavity. An experimental surgery was conducted on 60
outbred rats. In three experimental groups were used: Vancomycin, Levofloxacin and
Metronidazole.

Since its inception at the beginning of the last century minimally invasive
thoracic surgery (MTX) underwent long way of becoming. A real revolution in thoracic
surgery the emergence of a new direction - videothoracoscopic surgery (VTS). The
introduction of new endoscopic technology into general practice has radically changed the
understanding of the diagnostic and therapeutic possibilities of surgical interventions on the
chest organs. The use of video endoscopic technology, the creation of new instruments and
advanced technologies allows a qualitatively new solution to the issue of treating patients
with injuries of the chest organs, including residual hemothorax, to improve the results of
surgical treatment, reducing postoperative complications and mortality to a minimum, and
to reduce the length of hospital stay. The possibilities of video thoracoscopy (VTS) have
increased so much in recent years that they have turned it from a method for diagnosing
pleural diseases into a therapeutic and diagnostic procedure with a wide range of
indications, including chest trauma.

The aim of the study is - by analyzing the relevant literature and describing clinical experience, to highlight the main schemes for managing a patient with recessive loss of periodontal tissue, recommendations for manipulations in diagnosis and treatment, options for conservative maintenance of therapy. At the end of the work, treatment algorithms were presented, recommended depending on which Miller class is observed in the clinical picture. Also, the key points of management of such patients were identified.

Inspection of 80 students of KSMA named after I.K. Akhunbaeva found that a wedge-shaped defect occurred in 9 cases (1.13%), in 6 cases (12.5%) among males (48 participants), while among females (32 participants), a wedge-shaped defect was detected only in 3 cases (9.37%). A "wedge-shaped defect" appears at the age of 21 and occurs in 9 cases out of 68 examined in this age category. When localized, this pathology was more pronounced on the teeth of the lower jaw – in 7 out of 9 cases.

The examination of 80 students of dental and medical faculties of KGMA named after I.K. Akhunbaev aged 18 to 29 years for the presence of "pathological erasability" of hard tissues of teeth found that 10% of the examined aged 21 to 29 years showed the presence of "pathological erasability." At the same time, in females it was found in 12.5%, in males - in 8.33% of the examined. Localization of them is detected on both upper and lower jaw teeth, in one case - on teeth of both jaws.

Goal: comparative evaluation of strength properties and composition of the osteoplastic materials after putting them to the compression test, with taking into account their anisotropic properties. We studied samples of a human femur and samples of a cow femur. And for the comparative analysis of indicators, there was some steel No. 3 taken in addition. The test was carried out on a tensile testing machine P-50. The measurements of the samples were taken by means of the use of calipers. During the test, the behavior of the samples under stress was monitored by means of a diagram. The strength properties were studied through compressing the bone tissue samples and simultaneous automatic recording a deformation diagram. The mechanical characteristics were calculated by means of a compression diagram, they are: proportionality point, breaking point, relative deformation up to failure and Young's modulus. The changes of the morphology of the surface of bone materials were studied. All received data were tabulated. Studying the physical and mechanical properties of femoral samples provides an idea of the influence of deforming factors on the structure and properties of bone tissue.

The article outlines the pathogenesis of COVID-19 development, which clearly states that the disease is based on thrombosis in small vessels of the lungs, heart and other vital organs, i.e. DIC syndrome with its various clinicalmanifestations. A pathological picture of the organs of those who died of COVID-19 is given.
A list of the main laboratory studies of the hemostasis system and inflammatory markers in COVID-19 is given. Treatment of DIC syndrome in COVID-19 is also described depending on the severity of the course of the disease. The important role of freshly frozen plasma (FFP) and sessions of therapeutic plasmapheresis (TP) is detailed in the treatment of the
medium - and especially severe course of FWD syndrome in COVID-19.

In memory of the doctor of medical sciences, professor Raushanbek Dobulbekovich Alymkulov