Cumulative Balance Research Articles

Rainfall Variability, Flood Hazards and Adaptation Strategies in Douala IV and V Municipalities, Littoral Region of Cameroon

Excessive rainfall resulting to floods remain a thorny problem in developing countries including Cameroon. This follows the negative impacts of floods on the population, infrastructure and public services. This study examines rainfall variability, population vulnerability to floods and measures put in place by the population and other stakeholders to adapt to the situation in the Douala IV and V municipalities in Littoral Cameroon. The study exploits both primary and secondary sources data for its realization. Heads of households, quarter’s heads, municipal authorities and its personnel, and public administrative officials were contacted for data collection. The data focused on floods manifestation, their effects on the city, and adaptation strategies put in place to mitigate the negative outcomes. Data from semi structured interview conducted were analyzed using content analysis methods. Sociological and spatial data also collected were analyzed using remotely sensed techniques and statistical tools such as SPSS and Microsoft excel. Climatic data were collected from the urban council, the meteorological units in the town and the National Observatory on Climate Change of Cameroon. Sequential analyses (linear trend curves, standard deviations, and cumulative balances) were used to evaluate the evolution of rainfall and correlation to floods events. The result revealed that floods in Douala IV and V result from rainfall variability, characterized by deficit and excessive rains in the months of June, July, August and September. These heavy rains accompanied by human induced factors such as uncontrolled urbanization, anarchy in construction and occupation of wetlands, poor waste management, pollution of water ways and lack of drains for stagnant water evacuation leads to floods. Also, natural drivers such as the low relief of the area, a dense hydrographic network and contact with the Atlantic Ocean via the Wouri estuary result to floods. These floods are a problem to the health of the population, public services and infrastructure and sustainability of the city. Faced with the numerous damages caused by floods, remediation strategies such as: the construction of traditional dikes, solid house foundations, water embankments, and periodic weather forecasting by the National Observatory on Climate Change of Cameroon to reduce the negative outcomes of flooding has been ineffective in reduction of floods outcomes. Consequently, floods still remains a concern in Douala town. Good environmental practices such as civil education on hygiene and sanitation, periodic cleaning of drains, combats on deforestation of mangroves and afforestation campaigns, government investment on decentralization of waste collection and management will be productive in reducing the effects of floods in Douala. The implementation of all these remedial measures will not only ensure the safety of vulnerable civilian populations but the protection of their activities.

Lightning Network Economics: Topology

By design, the Bitcoin protocol has a low throughput. The Lightning Network (LN) is a layer-two solution built to increase throughput by cryptographically securing commitments to transactions and only occasionally converting cumulative balances into on-chain transactions. LN channels enable payments between nodes connected by a path of channels. The payment flow through a channel determines its cost. Different channel topologies can support the same underlying flows but impose different costs. This paper obtains necessary conditions for cost-minimizing topologies by identifying local cost-reducing strategies. The first local strategy entails repositioning of channels. The second entails adding hubs to handle the flows of groups of nodes. The paper also evaluates the efficiency of a global configuration, obtaining bounds on the minimum cost topology and showing the unusual circumstances in which the cost minimal structure is a hub that connects to all other nodes. This paper was accepted by Joshua Gans, business strategy. Funding: This work was partially supported by Science Foundation Ireland [Grants 16/IA/4443, 16/SPP/3347], Columbia-International Business Machines Center for Blockchain and Data Transparency, Chaire Fintech at University Paris Dauphine-Paris Sciences et Lettres, Algorand Foundation, and Simons Institute.

Maintaining the Balance: Regulation of NK Cell Activity.

Natural Killer (NK) cells, integral components of the innate immune system, play a crucial role in the protection against intracellular threats. Their cytotoxic power requires that activation is tightly controlled, and in this, they take a unique position within the immune system. Rather than depending on the engagement of a single activating receptor, their activation involves a delicate balance between inhibitory and activating signals mediated through an array of surface molecules. Only when this cumulative balance surpasses a specific threshold do NK cells initiate their activity. Remarkably, the activation threshold of NK cells remains robust even when cells express vastly different repertoires of inhibitory and activating receptors. These threshold values seem to be influenced by NK cell interactions with their environment during development and after release from the bone marrow. Understanding how NK cells integrate this intricate pattern of stimuli is an ongoing area of research, particularly relevant for cellular therapies seeking to harness the anti-cancer potential of these cells by modifying surface receptor expression. In this review, we will explore some of the current dogmas regarding NK cell activation and discuss recent literature addressing advances in our understanding of this field.

Влияние бизнес-модели коммерческого банка на организацию работы с корпоративными клиентами

The study focuses on a business model that fully defines the approaches and methods of work of a commercial bank with corporate customers. The customer base of particular credit institutions changed considerably in 2022–2023, while the structure of the cumulative balance did not experience profound changes. Thus, PJSC JSCB Avangard’s focus on corporate services led to substantial changes in the liability structure, causing an outflow of funds from individuals. The authors analyzed the business model of Avangard in comparison with the activities of banks operating under the Tochka brand. The financial strategy of Avangard is to increase risk-free (transaction) income and liquid assets on the balance sheet while reducing the accepted credit risk. A special feature of the business model of Avangard is the fact that the majority shareholder takes an active part in resolving not only strategic but also major operational issues. Avangard is a member of a large financial group, which includes organizations in the agricultural, industrial, economic, and investment sectors and services their functioning, without placing much emphasis on attracting clients external to the group. According to the study, the business model of working with corporate customers of the classical bank PJSC JSCB Avangard has the main advantage of maintaining its traditionalism, while also being flexible in digital development, immediately adapting to the turbulence of the financial market, and developing its technological effectiveness. This model of a classic bank, focused on the quality of cash services, will be in demand among corporate customers in the coming years, and, perhaps, even more viable than the Tochka ecosystem models. The shortcomings of the business model of Avangard are the low level of involvement in the competition for servicing small and medium-sized businesses corporate segment, which is reflected in unfavorable tariffs, underdeveloped affiliate programs and digital areas of banking business, in comparison with the activities of Tinkoff Bank JSC, VTB Bank (PJSC), Alfa-Bank JSC and Sberbank PJSC.

Delayed Retirement and Evaluation of the Payment Ability of Jiangxi Province’s Basic Pension Fund in China

The current payment pressure on the basic pension fund of Jiangxi Province in China is continuously increasing, and what impact will the upcoming delayed retirement policy have on the payment capacity of this province’s pension fund? This study evaluates the impact of two representative delayed retirement policies on the payment capacity of the basic pension fund in Jiangxi Province using actuarial methods. We found that delayed retirement is beneficial for improving the current and cumulative balances of the pension fund, significantly improving the future payment capacity of the pension fund. Moreover, the favorable effect of delayed scheme 2 is stronger than that of scheme 1. Given the favorable effects of the delayed retirement, the Chinese government should seize the time to formulate feasible delayed retirement policies to enhance the sustainable operation ability of the basic pension fund and ensure the timely and full payment of pension benefits for retirees.

Albumin as Early Fluid Bolus Therapy after Cardiac Surgery in the Critical Care Units

Abstract Introduction After cardiac surgery, the use of intravenous fluids to reach specific goals is associated with improved clinical outcomes and shortened intensive care units (ICU) stay. Although type of fluid doesn’t seem to be of a great importance. Clinicians will have been involved in many local debates about the best fluid. Absence of evidence about what is the ideal fluid in this situation push researchers to conduct clinical trials in this context. Aim of the Work The aim of this study is to investigate the cardiovascular effect of using 20% albumin in patients after cardiac surgery. Methods This was a double blinded RCT that was conducted at Department of Critical Care Medicine, Ain Shams University Hospital over 6 months on post-cardiac surgery mechanically ventilated patients with a clinical decision to administer fluid bolus therapy, that was assessed for enrollment. Results There was no statistically significant difference between two groups regarding delta serum chloride at 24 h post-op (mmol/L) and renal replacement therapy post-operatively in ICU, and there was statistically significant difference found between two groups regarding ICU, and Hospital stay, duration of mechanical ventilation, total dose nor epinephrine/kg in the first 24 h post-op (microg/kg), time to cessation of nor epinephrine infusion (h) and Delta serum creatinine at 24 h post-op (mg/dl). Conclusion In patients admitted to ICU following cardiac surgery, FBT with 20% albumin, when compared to crystalloid FBT, achieved equivalent cardiovascular optimization with smaller volumes of resuscitation fluid, less positive cumulative balance, and without evidence of any negative sequelae. Moreover, the use of 20% albumin for FBT was associated with lower amounts of vasopressor being delivered and shorter duration.

Largely preserved functionality after the combined loss of NKG2D, NCR1 and CD16 demonstrates the remarkable plasticity of NK cell responsiveness.

Natural killer (NK) cells play an important role in the early defense against tumors and virally infected cells. Their function is thought to be controlled by the balance between activating and inhibitory receptors, which often compete for the same ligands. Several activating receptors expressed on virtually all NK cells lack an inhibitory partner, most notably CD16, NCR1 and NKG2D. We therefore hypothesized that a signal through at least one of these receptors is always required for full NK cell activation. We generated animals lacking all three receptors (TKO) and analyzed their NK cells. In vitro, TKO NK cells did not show reduced ability to kill tumor targets but displayed hyperresponsiveness to NK1.1 stimulation. In vivo, TKO animals had a minor reduction in their ability to control non-hematopoietic tumors and cytomegalovirus infection, which was the result of reduced NK cell activity. Together, our findings show that activating NK cell receptors without an inhibitory partner do not provide a 'master' signal but are integrated in the cumulative balance of activating and inhibitory signals. Their activity is controlled through regulation of the responsiveness and expression of other activating receptors. Our findings may be important for future development of NK cell-based cancer immunotherapy.

A study on the sustainability assessment of China's basic medical insurance fund under the background of population aging-evidence from Shanghai.

As China's population aging process accelerates, the expenditure of China's basic medical insurance fund for employees may increase significantly, which may threaten the sustainability of China's basic medical insurance fund for employees. This paper aims to forecast the future development of China's basic medical insurance fund for employees in the context of the increasingly severe aging of the population. This paper taking an empirical study from Shanghai as an example, constructs an actuarial model to analyze the impact of changes in the growth rate of per capita medical expenses due to non-demographic factors and in the population structure on the sustainability of the basic medical insurance fund for employees. Shanghai basic medical insurance fund for employees can achieve the goal of sustainable operation in 2021-2035, with a cumulative balance of 402.150-817.751 billion yuan in 2035. The lower the growth rate of per capita medical expenses brought about by non-demographic factors, the better the sustainable operation of the fund. Shanghai basic medical insurance fund for employees can operate sustainably in the next 15 years, which can further reduce the contribution burden of enterprises, which lays the foundation for improving the basic medical insurance treatment for employees.

Comparison of methods of analgesia in patients after pancreatic surgery: a cohort retrospective study

AIM: To compare the effectiveness of postoperative analgesia by methods of epidural blockade (EB) and rectus sheath block (RSB) in the early postoperative period in patients who underwent pancreatic surgery.
 MATERIALS AND METHODS: A retrospective analysis of inpatient case histories of patients after pancreatic surgery at JSC Ilyinsky Hospital for the period from 2019 to 2021 (n=92) was conducted. For the study, 78 cases were selected, which were divided into two groups: the first group (n=46) received EB with a local anesthetic in the postoperative period, and the second group (n=32) underwent RSB followed by the introduction of a local anesthetic solution.
 RESULTS:The level of pain on the visual analog scale was statistically significantly higher in the first group on day 1(1.07 [0.501.80] and 0.48 [0.081.13], respectively, p=0.013) and day 2 (0.82 [0.251.33] and 0.33 [0.060.75], respectively, p=0.021), and no differences were found on day 3 (p=0.060). The frequency of additional use of opioid analgesia did not differ between the study groups (day 1, p=0.233; day 2, p=0.570; and day 3, p=0.092 The use of norepinephrine infusion in the early postoperative period (p=0.842), daily and cumulative water balance (day 0, p=0.851; day 1, p=0.883; and day 2, p=0.319; day 3, p=0.718; and cumulative balance, p=0.707), and verticalization time (p=0.800) also showed no significant difference.). Orthostatic reactions during early mobilization were noted significantly more often in the EB group than in the RSB group (n=10, 21.7%; n=1, 3.2%, respectively; OR 8.333, 95% CI 1.00866.667, p=0.042). The appearance of the first stool was more common in the EB group (3 [24] days vs. 4 [35] days in the RSB group, p=0.027). No statistically significant difference was found between the groups in the development of infectious complications (p=1.000), gastrostasis (p=0.144), in-hospital mortality rate (p=0.460), ICU days (p=0.305), and lengths of stay (p=0.776).
 CONCLUSION: The data obtained in the study show the comparability of the use of analgesia methods, such as EB and RSB in patients who underwent pancreatic surgery.

Renal Preservation Increases Survival Rate in Critically Ill COVID-19 Patients

BACKGROUND: COVID-19 infection tends to cause organ dysfunction and disrupts immunity due to cytokine storm. In addition to pulmonary distress and myocarditis due to the aforementioned cytokine storm, another prominent clinical feature of this disease is kidney failure. Maintaining good kidney function, normal creatinine levels, removing cytokine, avoiding fluid overload, and implementing higher level additional measures such as early (renal replacement therapy) are expected to increase survival in critically ill COVID-19 patients. AIM: We aimed to analyze whether renal preservation increases survival rate in critically ill COVID-19 patients METHODS: An observational analytic study was conducted in 53 critically ill COVID-19 patients treated in the ICU (Intensive Care Unit). All patients were treated with either standard therapy with additional renal-focused fluid evacuation and cytokine removal method such as CRRT (continuous RRT) or cytokine removal only with plasmapheresis. RESULTS: investigation through Cox regression analysis revealed that only cumulative balance an creatinine have a significant relationship with mortality (p < 0.05). CONCLUSION: Maintenance of cumulative balance and serum creatinine will increase survival rates.

716 Safety and benefits of intraoperative enteral nutrition in critically ill pediatric burn patients

IntroductionBurn injuries significantly increase a patient’s metabolic demand. Adequate nutrition is essential to aid in recovery and reduce morbidity and mortality. This is important for pediatric patients, who have limited reserves and are in a period of growth, in contrast to adults. Burn patients often need multiple surgeries, with standard perioperative fasting periods leading to multiple nutritional interruptions. Continuous intraoperative feeding has been a proposed solution, but there is no current consensus on its role and safety, particularly in the pediatric population. The goal of our study was therefore to examine the safety and benefits of intraoperative nutrition in critically ill pediatric burn injury patients.MethodsA systematic review of MEDLINE, PubMed, Scopus, and Google Scholar was conducted using the following terms: Feeding or enteral or nutrition or fasting and adolescent or youth or pediatric or child or teen and burn or thermal injury or fire. The primary outcome was incidence of aspiration. Secondary outcomes included patient nutritional status (caloric deficit, weight), wound healing, days spent in the intensive care unit, ventilator days, pneumonia, number of surgeries, length of hospital stay, and mortality. Pooled analyses of binary outcomes were computed.ResultsFour studies consisting of 496 patients, met inclusion criteria. All studies were level IV evidence, but had high methodological quality. The median burn total body surface area (TBSA) was 43.8% (IQR 33.4-58.8%), with a median of one-third of patients having an inhalational injury. Patients underwent a median of 4.2 surgeries (IQR 1.8-7.4). Intraoperative feeding was conducted through nasoduodenal tubes. There were no aspiration events. Pooled analysis demonstrated that there were no differences in rates of aspiration, pneumonia, or wound infection (p >0.05) between patients who were intraoperatively fed and those who were not. Those fed intraoperatively had significantly more surgeries, ventilator days, longer hospital stays, but lower mortality (p< 0.05). There was large heterogeneity in nutritional assessment methods. Intraoperatively fed patients had an average gain of 144.4 kcal/kg and 1.7 days of exclusive enteral nutrition (vs. loss of -119.1 kcal/kg and -1.4 days) and cumulative positive caloric balance of +2673kcal ±2147 (vs. loss of -7899kcal ±3123), compared to those with interrupted feeding.ConclusionsContinuous intraoperative duodenal feeding during burn surgery appears to be safe in the Pediatric burn population, with no reported episodes of aspiration. Uninterrupted feeding was also associated with weight maintenance and reduced caloric deficit. It may also have survival benefit, as continuously fed patients needed more surgeries and intensive/hospital care, but had decreased mortality.

Odontogenic mediastinitis: intensive therapy experience (clinical observation)

Mediastinitis as complications of traumas and esophagus perforations are ill-controlled and characterized with high mortality. Yet clinical characteristics and therapeutic controllability of contact odontogenic mediastinitis are not covered enough in medical literature. Aim of the study was to investigate clinical characteristics and to analyze treatment results of odontogenic purulent mediastinitis according to data of pilot monocenter observational study. Material and methods. The results of treatment of the patients with odontogenic mediastinitis were analyzed in groups: panmediastinitis (8 participants) and posterior upper mediastinitis (12 participants). The following indexes were compared: body temperature, content of C-reactive protein, leucocytes, thrombocytes, creatinine, 24-hour and cumulative fluid electrolyte balance reproduced in hospitals of any equipment levels with using of criteria of nonparametric statistics for excluding of false positive results. Results. Causative agents of the infectious process were found in 65 % of patients in bacteriological study. The mortality was 5 %; the process controllability in conditions of described techniques of anesthesiology and intensive therapy has been shown, the danger of infusive overload of the interstitium of the lungs has been demonstrated.

Prevalence of twin deficits in selected European Union countries and in Poland in the years 2009-2018

The aim of the article is to determine the degree, direction and strength of impact of the studied variables, i.e. the state budget balance and the current account balance as part of Poland's balance of payments in the years 2009-2018 against the background of selected European Union (EU) countries. The main research questions focus on determining the type of relationships connecting the studied deficits in the light of previous studies dedicated to the twin deficits hypothesis. The methodology used is based on integrated correlation analysis, linear regression and an analysis of the coefficient of variation. As a result of the study, a strong correlation was found between the cumulative values of the studied deficits, which confirms the existence of the twin deficits hypothesis in Poland in the examined period and means that the budget deficit affects the current account balance. A change in the cumulative balance of the budget by 1% leads to a change in the cumulative balance of the current account of the balance of payments by 0.89%. It can be presumed that the problem of budget deficits and the related debt crisis as well as balance of payments balances under the dichotomy of "surplus north" and "deficit south" in the next decade will be one of the most conflicting and disintegrative for the EU. Thus, the search for a path to budget (internal) balance and balance of payments (external) is one of the key challenges for maintaining cohesion and maintaining sustainable development both in Poland and the entire EU.

The Sustainable Development and Expenditure: Revenues Nexus of the WII Fund in China

Work-related injury insurance (WII) has undergone a long period of rapid growth in China. Therefore, its sustainability, funding, and system of payments deserve serious attention. By analyzing the changes of the numbers of insured, the number of compensated, and the cumulative balance of WII Fund, this article systematically reviews and summarizes the various stages of the development of WII in China. The relationship between the WII Fund’s revenue and expenditure between 1997 and 2018 is analyzed using statistical methods, including the augmented Dickey–Fuller (ADF) unit root test, the cointegration test, the Granger causality test and an error correction model. Since 1996, China’s WII has been repeatedly adjusted and constantly growing. Our empirical evidence shows that there is a long-term equilibrium and cointegration relationship between the WII Fund’s revenue and expenditure. Revenue is the Granger cause of expenditure, but it does not conform to the fund-raising principle. WII Fund has a large accumulated balance over the years, which violates the principles of fund management and has caused considerable controversy. China’s WII has undergone several regulatory upgrades and management mode adjustments to better ensure its sustainable development. The fund has maintained a basic balance of revenue and expenditure. Nevertheless, at present, China’s WII Fund is facing the pressure of declining fund balance and, as such, medium- and long-term development risks deserve careful attention. As there is no sufficient literature on WII Fund management, this study is a valuable contribution to the existing body of knowledge.

Utilidad de la terapia de acuaféresis. Artículo de revisión

The therapy of Aquapheresis has been studied as a therapeutic tool for patients with volume overload refractory to treatment with ASA diuretics, whose main objective is to mitigate the clinical impact of the same in patients with decompensated heart failure and cardiorenal syndrome, recognizing positive cumulative balances in critically ill patients as a factor regardless of mortality. A search was made in the main scientific databases for review articles, and studies that included the Acuapheresis strategy. Bibliographic references were found in databases from 2005 to 2017. Aquapheresis therapy is a patented ultrafiltration therapy aimed at improving refractory overload in patients with congestive heart failure. There are gaps in knowledge regarding cost-effectiveness therapy, real adverse adverse event relationships attributable to it and candidates will benefit, and we believe that more quality studies are required to reach solid conclusions. So far there is no compelling evidence to support Aquapheresis therapy to implement its routine and routine use of the ICU.

The Anti-Social System Properties: Bitcoin Network Data Analysis

Bitcoin is a cryptocurrency and a decentralized semi-anonymous peer-to-peer payment system in which the transactions are verified by network nodes and recorded in a public massively replicated ledger called the blockchain. Bitcoin is currently considered as one of the most disruptive technologies. Bitcoin represents a paradox of opposing forces. On one hand, it is fundamentally social, allowing people to transact in a peer-to-peer manner to create and exchange value. On the other hand, Bitcoin’s core design philosophy and user base contain strong anti-social elements and constraints, emphasizing anonymity, privacy, and subversion of traditional centralized financial systems. We believe that the success of Bitcoin, and the financial ecosystem built around it, will likely rely on achieving an optimal balance between these social and anti-social forces. To elucidate the role of these forces, we analyze the evolution of the entire Bitcoin transaction graph from its inception, and quantify the evolution of its key structural properties. We observe that despite its different nature, the Bitcoin transaction graph exhibits many universal dynamics typical of social networks. However, we also find that Bitcoin deviates in important ways due to anonymity-seeking behavioral patterns of its users. As a result, the network exhibits a two-orders-of-magnitude larger diameter, sparse tree-like communities, and an overwhelming majority of transitional or intermediate accounts with incoming and outgoing edges but zero cumulative balances. These results illuminate the evolutionary dynamics of the most popular cryptocurrency, and provide us with initial understanding of social networks rooted in and driven by anti-social constraints.

Married with Children? The Role of Student Loan Debt

Data from the 2008:2012 Baccalaureate and Beyond panel dataset, collected by the US Department of Education, were used to analyze the role of student loan debt in separate predictive models for marriage and fertility decisions in a representative sample of four-year college graduates from institutions across the country. Subjective analysis of marriage and fertility decisions indicated that students identified debt as a significant factor in delaying progression to these major life events. In the empirical analyses of marriage and child birth, instrumenting student loans using in-state tuition rates, student loans were a significant predictor of actual marriage decisions but not a significant predictor for the birth of a first child in the first four years after graduation. Further, for four-year college graduates, a $1,000 increase in cumulative undergraduate student loan balance was associated with a 1.3% decreased likelihood of marriage in the first four years after college.

Decreasing the Premium Rate of Pension Insurance and the Sustainability of Pension Insurance Fund: Can You Have Your Cake and Eat It?

At present, the social insurance contribution rate of urban employees in China is as high as 40%. The excessive payment rate will bring heavy burden to enterprises and employees. Report of the Nineteenth National Congress of the Communist Party of China emphasizes the need to continue to reduce the premium rate of social insurance. However, as the degree of population aging deepens, the sustainability of social insurance funds is gradually being impacted. In this background, can we simultaneously achieve the two goals of reducing the social insurance contribution rate and fund sustainability? Taken the basic pension insurance for urban employees as an example, in the context of lowering the premium rate of social insurance, this paper uses the actuarial model to analyze whether social insurance funds can operate sustainably in the short-term （2019−2025） and medium-term （2019−2050）. Therefore, it provides an empirical reference for the government to promote the implementation of the tax reduction and fee reduction policy. The study finds that: （1） If there is no policy intervention, the fund will start to have a cumulative deficit around 2027. Since then, the cumulative deficit has expanded year by year. （2） In the short term, regardless of whether or not to introduce a policy to improve the financial operation of the fund, a further 1% reduction in the premium rate will not affect the sustainability of the fund. （3） After the implementation of the universal two-child policy, the fund is still running a cumulative deficit in 2027. （4） In the medium term, even if the universal two-child policy is implemented and the payment compliance is improved, the fund will start to have a cumulative deficit between 2029 and 2045; however, with the increase of payment compliance, the cumulative deficit scale shows a downward trend, and improving the payment compliance and implementing the universal two-child policy will not guarantee the realization of the two goals of reducing the payment rate and sustainable fund development in the medium term （2019−2050）. （5） After further delaying the retirement age, the fund will not run a cumulative deficit until 2050, and the cumulative balance will be 10.63−150.06 trillion yuan by 2050. Under this assumption, the fund will have a balance in 2050, thus creating a reduction room for 0.5−4.75 percentage point in the contribution rate; at the same time, it does not affect the sustainability of the fund. In summary, in the short term, the goals of reducing the premium rate of social insurance and fund sustainability can be achieved. But in the medium term, the introduction of policy adjustments can achieve the above two goals. Therefore, in order to reduce the burden of corporate contributions and ensure the sustainability of the fund, the government should encourage fertility, improve payment compliance, and implement a delayed retirement age policy as soon as possible.

IMPACT OF RESTRICTIVE REGIMEN OF INFUSION THERAPY ON THE PERIOPERATIVE PERIOD IN PATIENTS WITH URGENT ABDOMINAL PATHOLOGY

One of the leading pathogenetic processes that is specific for emergency abdominal pathology is hypovolemia. The primary method of its treatment is infusion therapy. The purpose of the study is to evaluate the effectiveness of the restrictive regimen of infusion therapy in patients with emergency abdominal pathology.&#x0D; Materials and methods. We examined 50 patients who were performed on emergency laparotomy. Perioperative infusion therapy in all patients was carried out in a restrictive regimen with balanced crystalloid solutions. We studied the indicators of water metabolism: daily and cumulative water balances, the percentage of fluid excess. We determined water sectors of the body by the method of non-invasive bioelectric rheography. Results. The study has found out the presence of the initial depletion of the extracellular fluid volume due to a decrease in both interstitial and intravascular volumes in patients with urgent abdominal pathology. Intravascular deficiency was due to a decrease in plasma volume. Replenishment of extracellular deficiency by restrictive regimen of infusion therapy restored the plasma volume to normal values since one day after surgery; interstitial volume started restoring on the 7th days of observation, compared to the normal intracellular volume on the 3 days of the postoperative period. Conclusions: restrictive infusion therapy regimen enables to completely and safely restore extracellular volume depletion on the 7 days of the preoperative period by correcting plasma deficiency since the 1 day of the post-operative period; to replenish interstitial volume on the 7 days and to prevent the development of oedema during “zero” daily water balance, as well as to slightly increase the cumulative water balance and the percentage of excess fluid.

Perioperative water balance in patients with acute abdominal pathology in a liberal regime of infusion therapy.

In order to evaluate the effectiveness of the liberal regime of infusion therapy, we examined 50 patients with acute abdominal pathology considering the state of the water sectors of the body. We established that liberal regime of infusion causes hypervolemia and hyperhydration of peripheral tissues during the first 6 hours of the perioperative period, it retains a moderate deficit of hypovolemia and dehydratation from 1 to 14 day of observation and forms an increase in interstanial volume, causing its maximum edema from the 3d to 7th day of observation. These changes are combined with positive daily and cumulative water balances, which is reflected in a critical increase in the percentage of excess fluid from the 5th day of postoperative period.