Home – Home – Jornals – Siberian Scientific Medical Journal 2018 number 2

The research objective was the study of antiulcer and anti-inflammatory activity of the 3-[3-(morpholine-4-yl)propyl]-2-[(2,2,3-trimethylcyclopent-3-en-1-yl)methyl]-1,3-thiazolydin-4-one. Material and methods. The study was performed on 24 male outbred mice and 102 female Wistar rats. The investigation of antiulcer activity of the substance as a preventive medication in comparison with omeprazole and famotidine was carried out on 24 rats using the 96 % ethanol-induced gastric ulcer test. The ethanol-induced lesion area was measured to evaluate the antiulcerogenic activity. The curative effect of the compound was studied on 78 female rats using the chronic acetic acid-induced model on the 5th, 10th, 15th, and 25th day of administration, omeprazole being used as a reference drug. A diameter of the ulcers was measured and a histological investigation of the gastric tissue samples including leukocyte counting was performed to estimate the influence on the regeneration process. Anti-inflammatory activity of the substance in comparison with diclofenac was studied on mice using histamine-induced edema model. Results and discussion. The substance of interest was shown to possess antiulcerogenic action comparable to the activity of omeprazole on ethanol-induced ulcer whereas famotidine did not exhibit gastroprotective properties. The administration of the agent did not lead to a significant decrease of acetic acid-induced ulcer size, whereas omeprazole promoted the marked reduction of the lesion area on the 15^th and 25^th day of the experiment. There were no significant morphological differences observed between the experimental groups. Notably, the administration of the substance under investigation resulted in significant decreasing of leukocyte quantity in the ulcer margins. The marked anti-inflammatory action of the substance similar to the effect of diclofenac was demonstrated on the histamine-induced edema model.

High-resolution melting analysis (HRMA) is promising for preliminary scanning of the nucleotide sequence of the cystic fibrosis transmembrane conductance regulator gene ( CFTR ), which mutations are responsible for the development of cystic fibrosis. In Russia this method has not yet found practical application. The aim of this work was the analysis of the efficiency of the HRMA method at the first stage of molecular diagnostics of cystic fibrosis in children. Materials and methods. In order to validate the new technique for extended molecular genetic analysis we examined 43 control DNA samples obtained from children with confirmed cystic fibrosis diagnosis and known CFTR mutations. Results. The specificity of cystic fibrosis molecular diagnostics with the implementation of the HRMA method was 100 %, the sensitivity was 97.3 %. In two samples with extended heterozygous deletion of the 2nd and 3rd exons melting patterns were identical to the wild type ones. Conclusions. The high efficiency of the HRMA method proves the possibility of its usefulness in clinical practice at the first stage of cystic fibrosis molecular diagnostics in children toward the reduction of the diagnostic search duration. In most cases this method allows to determine CFTR gene mutation type. Long deletions/insertions and complex heterozygous restructurings still cannot be detected using HRMA. Multiplex ligation-dependent probe amplification is required to determine this mutation type.

Aim of the study was to investigate the features of biochemical indices in patients with spinal diseases combined with diseases of the hepatobiliary system (HBS). Material and methods. The examination of 46 patients with dorsopathy combined with diseases of the hepatobiliary system has been carried out. Results and discussion. It has been shown that the transnosological polymorbidity value in patients with DP combined with diseases of HBS was statistically significant increased in comparison with groups of patients with isolated diseases (spinal diseases, HBS). It was determined that the severity of the inflammatory process, as well as disturbances of the liver functions, was higher in case of combined pathology than in the presence of isolated forms of diseases. The changes in carbohydrate, lipid and purine metabolism being the factors of severity growth of the pathology course and risk factors for the development of diabetes mellitus, atherosclerosis and associated conditions are more pronounced in case of this combined pathology. That requires a personified approach to treatment and prevention of this category of patients. The results of the study can form the basis for the development of a new medical technology for assessing the severity of condition of patients with dorsopathy combined with diseases of the hepatobiliary system.

Taking into account new technologies practical application, the evaluation of correlation between the expired costs and obtained utility for health is important today in the context of choice between open-cut and laparoscopic inguinal hernia treatment methods. Purpose of the study. The «cost-utility» analysis of the inguinal hernia treatment with the use of the Lichtenstein tension-free method and the laparoscopic transabdominal preperitoneal hernia repair method. Material and methods. The retrospective comparative analysis of 52 men underwent the laparoscopic transabdominal preperitoneal hernia repair (TAPP, n = 25) and the Lichtenstein tension-free method ( n = 27) has been carried out. The indicators of life quality were estimated by the scale «thermometer-health» before, after and in 6 months after surgery and than the indicators were used for QALY calculation. The intensity of pain after surgery was registered with visual-analog scale. The «cost-utility» analysis was carried out with direct expenses use. Results and discussion. The QALY increment was 0,10 in the patients underwent Lichtenstein tension-free method and 0,17 in the patients underwent TAPP. The postoperative pain syndrome intensity was less expressed after TAPP. The «cost-utility»coefficient was 644848,0 rub/QALY in case of Lichtenstein method, and 550796,5 rub/QALY for TAPP. Thus, the hernioplasty by TAPP method is dominant from the point of view of the carried-out clinical and economic analysis.

The aim of research was the analysis of nutritional and enteric inefficiency at complicated trauma of cervical region of vertebral column. Material and Methods. The retrospective observational investigation has been carried out. Medical records of 29 patients with complicated trauma of cervical region of vertebral column for 2017-2016 years have been analyzed. Results. Disorder of motor-evacuation function of digestive tract was revealed in 37 % of cases on the first day after accident. Maximal intensity of enteroparesis and minimal level of total protein were registered on 7-10 days. The albumin level has been progressively decreased till 15 days. The erosion of gastric and duodenum mucosa was revealed by esophagogastroduodenoscopy in 50 % of patients on the first day. The basal metabolism value detected by indirect calorimetry was 30-50 % higher than value calculated by formula.

According to the forecasts of the World Health Organization, cardiovascular diseases will remain the main cause of death of the world population for several decades. Based on this prediction, the diagnosis of heart disease at the preclinical stage remains a major problem for clinicians. For now the main non-invasive imaging methods for cardiovascular damage are still ultrasound and multispiral computed tomography, less often magnetic resonance imaging. In recent years, the application of poorly studied radionuclide methods such as positron emission and single-photon tomography to the diagnosis has been actively discussed. The use of these non-invasive techniques is capable to diagnose the cardiovascular system pathology at earlier terms, but it is necessary to know the possibilities and limitations of each method for the correct analysis and interpretation of the data obtained. In this review, the main aspects of modern radiation and radionuclide cardiologic diagnosis are described. The article is divided into two parts: the first section presents some aspects of individual ray imaging methods; the second included methods of radionuclide diagnostics of the most important diseases of the heart and blood vessels.

Objective: to assess the effect of propafenone and amiodarone on the diastolic function of the left ventricle and the quality of life in hypertension complicated by paroxysmal atrial fibrillation (AF) in patients with sinus rhythm remaining throughout the year. Material and methods. The study involved 185 patients with H, complicated by paroxysmal AF. No sinus rhythm disturbances were registered in 39 patients during the year. Patients without sinus rhythm disturbances belonged to different groups. In the first group ( n = 20), the sinus rhythm was restored against oral administration of 600 mg of propafenone and was subsequently maintained by taking this antiarrhythmic drug (AAP) at a daily dose of 450 mg. In the second group of patients ( n = 19), the sinus rhythm was restored with amiodarone (up to 600 mg intravenously) and maintained during the year by taking amiodarone at a daily dose of 200-600 mg. The patients of both groups underwent echocardiography with the definition of a set of generally accepted morphofunctional parameters at the beginning and at the end of the study (a year later). The SF-36 questionnaire was used to assess the quality of life. Results and conclusions The propafenone administration in a daily dose of 450 mg to the patients with hypertension complicated by paroxysmal atrial fibrillation significantly improves the diastolic function of the left ventricle during the year: the E/A index ( p = 0.016) increased significantly by 4.1 %; the IVRT index did not change significantly ( p > 0.05); the DT score significantly ( p = 0.009) decreased by 4.8 %; the PV S/D authentically ( p = 0.045) increased by 1.2 %; the indicator Em/Am significantly ( p = 0.03) increased by 4 %. The amiodarone administration in a daily dose of 200-600 mg to the patients with hypertension complicated by paroxysmal atrial fibrillation with restored and conserved sinus rhythm for 12 months does not influence on the left ventricle diastolic function. Both drugs significantly improves the indices of the physical and psychological components of health, however, therapy with propafenone improves the quality of life indicators significantly more efficiently than amiodarone therapy.

Comparative analysis of thoracoscopic methods of surgical treatment of spontaneous pneumothorax with bullous emphysema was performed. The material has been collected during the retrospective study of the medical documentation of the Department of Thoracic Surgery of the Novosibirsk State Regional Clinical Hospital of Ministry of Health of the RF. During the seven-year period from 2010 to 2017, 125 medical cases with different diagnoses were selected such as: spontaneous pneumothorax; bullous emphysema; recurrent spontaneous pneumothorax. The analysis of the entry criteria were specific pathological picture of chest organs multispiral computed tomography. The withdrawal criteria were conversion associated with technical complexity due to evident adhesive process (12 cases). The vast majority of complications were observed in patients underwent thoracoscopic lung resection. The manual intracorporal suture overlap on the lung tissue leads to a greater risk of prolonged air leakage in the postoperative period. Bullous diathermocoagulation has a small risk of prolonged air leakage in the postoperative period. The study findings require the development of an algorithm for spontaneous pneumothorax case management to reduce possible complications.

Aim of the study - to assess the impact of changes in women’s bodies with diabetes mellitus type 1 on the state of bone mineral density and its metabolic rate, to determine the tendency of changes in serum markers of bone remodeling and bone mineral density in peri- and postmenopausal periods in women with this disease. Material and methods: T-score of bone mineral density (by dual-energy X-ray absorbtiometry) and serum markers of bone remodeling (alkaline phosphatase activity, amino-terminal propeptide of type I collagen and C-terminal telopeptide), were measured in 57 peri- and postmenopausal women with type 1 diabetes and in the control group consisting of 43 women. Results. The obtained results indicate inconsistency of changes in bone remodeling processes in patients with type 1 diabetes with predominant bone formation changes (35.5 %) vs. bone resorbtion (16.6 %, p < 0.001). A positive correlation between the duration of type 1 diabetes and the level of b-C-terminal telopeptide ( r = 0.465, p = 0.001) was established in postmenopausal women. A negative correlation between the change in the T-score of the femoral neck and duration of diabetes ( r = -0.416, p = 0.04) was found in the subgroup of postmenopausal women. A statistically significant correlation between the T-score of the lumbar spine and the level of C-terminal telopeptide ( r = -0.489, p = 0.003) was revealed. Conclusions. Bone mineral density in postmenopausal women with type 1 diabetes demonstrates an earlier and accelerated bone mass loss, especially in the lumbar spine. The bone mass loss in the most of the examined patients is associated with the suppression of bone formation and, to a much lesser extent, with bone resorption, which is significantly accelerated during the late perimenopause and continues at a similar pace in the early years of postmenopause with decrease in the intensity of loss in the subsequent.

Capillaroscopy is simple, non-invasive, safe, and informative technique which provides vital real-time assessment of microvascular structure in various systemic disorders. Major capillaroscopy parameters are capillary density (the number of capillaries in a 1 mm length of the distal row of each finger or toe), capillary width and length, arterial and venous limb diameters, internal diameter, loop diameter, and intercapillary distance. Blood flow velocity in arterial and venous limbs is important as well. Avascular areas may be related to tissue hypoxia, therefore, they have a prognostic value. A homogeneous and ordered distribution of capillaries arranged in parallel and at regular narrow distances between ascending and descending branches is found in capillaroscopy examinations of healthy subjects. A regular capillary is shaped like a hair pin or like the English letter «U» upside-down, with a slimmer arterial arm, an upper part, and a venous arm. The venous arm is larger than the upper part. Capillaroscopy plays an important role in the diagnosis of diseases associated with microcirculation disorders, because it helps to choose the tactics of treatment, to monitor the effectiveness and to predict disease outcomes.