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Siberian Scientific Medical Journal

2020 year, number 2

Platelet microvesicles and their role in providing hemostatic capacity (literature review)

Andrey P. Momot1, Natalia O. Tsarigorodtseva2, Dmitry V. Fedorov2, Konstantin M. Bishevski2, Natalia V. Vostrikova2, Elena E. Klimova2
1Altai Branch of National Research Center for Hematology of Minzdrav of Russia, Barnaul, Russia
2Altai State Medical University of Minzdrav of Russia, Barnaul, Russia
Keywords: тромбоцитарные микровезикулы, система гемостаза, кровотечения, криопреципитат, platelet microvesicles, hemostatic system, bleeding, cryoprecipitate

Abstract >>
In recent years the role of microvesicles in endocrine system transmission, in providing cellular connectivity, in transportation of proteins and nucleic acids from one cell to another, in angiogenesis regulation, in inflammatory reactions and in dissemination of tumors is actively studied. This article reviews the mechanisms of microvesicle formation, the structure of microvesicles and their potential value as biomarkers. Among all essential reactions involving microvesicles one thing especially stands out: their direct participation in providing hemostatic reactions for bleeding control in case of a solution of continuity in blood vessels due to different reasons. Platelet microvesicles play an important role in this process, and it has been proved by several experimental and clinical studies. In this review we evaluate prospects for clinical use of one of modern blood components - cryoprecipitate - as the source of platelet microvesicles.

Interferons lambda - therapeutic application

Nikolai A. Kikhtenko, Larisa A. Oleynik, Vyacheslav K. Makarov, Elizaveta P. Nagorskaya, Pavel G. Madonov
Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
Keywords: интерфероны лямбда, клиническое применение, иммунобиологическая терапия, противовирусная терапия, пегилированный интерферон лямбда, interferons lambda, clinical use, immunobiologic therapy, antiviral therapy, pegylated interferon lambda

Abstract >>
Interferons are a group of protein molecules with a broad spectrum of effects on the human body. Interferon lambda (type III interferon) was discovered comparatively recently about 20 years ago and its action is still poorly understood. However, the study of its properties and mechanisms of action is of great interest, since it not only has similarity with type I interferons, but has a number of distinctive features that create prerequisites for expanding its clinical use. Particularly, interferon lambda is not produced by all cells of the body, and therefore has a more targeted effect and lower systemic side effects than type I interferons. This review considers the biological activity of exogenous interferon lambda: the mechanisms of its antiviral, antitumor, antifungal and immunomodulatory activity. The possibility of its use in clinical practice for the treatment of such diseases as Sjogren’s syndrome, atopic asthma, autoimmune arthritis, various tumors, as well as against a various of RNA- and DNA-containing viruses that attack the anatomical barrier surface of the respiratory tract, gastrointestinal tract, blood-brain barrier and liver is discussed. This review also considers pegylated recombinant interferon lambda. Recent clinical studies have demonstrated a higher safety profile of pegylated interferon lambda compared with pegylated interferon alpha.

The experimental model of laboratory animals’ intoxication by polyacrylonitrile pyrolysis products

Pavel G. Tolkach1, Vadim A. Basharin1, Sergey V. Chepur2, Tat`yana V. Gorbacheva1, Margarita A. Chaykina1
1Military Medical Academy n.a. S.M. Kirov of Ministry of Defense of Russia
2State Research Institute of Military Medicine of Ministry of Defense of Russia
Keywords: продукты горения, полиакрилонитрил, цианистый водород, экспериментальная модель, интоксикация, витальные функции, products of pyrolysis, polyacrylonitrile, hydrogen cyanide, the experimental model, intoxication, vital functions

Abstract >>
Purpose of research - To develop an experimental model of intoxication of laboratory animals by polyacrylonitrile pyrolysis products. Materials and methods. The study was performed on the rats. Pyrolysis of polyacrylonitrile fibers was carried out at temperature of 270-350 °C. The laboratory animals were exposed to static inhalation intoxication by pyrolysis products for 15 min. Vital signs were determined in animals before and 5 minutes after intoxication. Arterial blood oxygenation index and acid-base state parameters were evaluated at 10 min after exposure. Qualitative detection of cyanides in brain and myocardial samples obtained 15 minutes after intoxication was carried out by gas chromatography. Results and discussion. It was found that the weight of the material (containing 85 % polyacrylonitrile), which pyrolysis products lead to the death of 50 % of laboratory animals within 24 hours after exposure, was 0.81 ± 0.15 g. The animals showed signs of poisoning by substances interrupting the processes of cell bioenergy when exposed to pyrolysis products obtained under specified conditions. The evident bradycardia and bradypnea ( p < 0,05), and significant decrease in rectal temperature was marked. The exposed animals did not differ ( p > 0,05) from the rats of the control group by the parameters of oxygenation. The signs of decompensated metabolic acidosis were detected in blood. The cyanide peak was detected by gas chromatography with a retention time of 3.78 min in brain and heart muscle biopsies. The experimental model, in which inhalation exposure of pyrolysis products of polyacrylonitrile fibers led to severe intoxication of laboratory animals, was developed. The model can be used to search for means of etiotropic and pathogenetic therapy of poisoning by combustion products of nitrogen-containing polymeric materials.

Morphological disturbances of rat parietal cortex and hippocampus neurons in the dynamics steady subtotal ischemia of the brain

Elizaveta I. Bon, Natalia E. Maksimovich, Sergey M. Zimatkin, Nikita A. Valko, Victoria N. Kot
Grodno State Medical University, Republic of Belarus, Grodno
Keywords: ишемия, мозг, нейроны, ischemia, brain, neurons

Abstract >>
The purpose of the work is to analyze changes in the morphological characteristics of neurons of phylogenetical different parts of the cerebral cortex (parietal cortex and hippocampus) of rats at different periods in the dynamics of stepwise subtotal experimental cerebral ischemia. Methods. The experiments were performed on 42 males of outbred white rats. Step subtotal cerebral ischemia was performed as follows: first, one common carotid artery was ligated, simulating partial ischemia. Then, with an interval of 1 day (subgroup 1), 3 days (subgroup 2) or 7 days (subgroup 3), the second common carotid artery was ligated. Results. A microscopic study of the size, shape, degree of chromatophilia of the cytoplasm and the content of ribonucleoproteins in pyramidal neurons of phylogenetically different parts of the cerebral cortex have shown the dependence of the severity of brain damage on the interval between the cessation of blood flow in both carotid artery. Adaptation was better with a 7-day interval between dressings, while the ligation with an interval of 1 day, the degree of morphological changes was maximum indicating a lack of resources for the implementation of adaptation mechanisms.

Composition based on aluminum oxide and polydimethylsiloxane - matrix for enhancing drug targeting

Maksim A. Korolev, Lyubov N. Rachkovskaya, Vladimir I. Konenkov, Andrey Yu. Letyagin, Pavel G. Madonov
Research Institute of Clinical and Experimental Lymphology - Branch of the Institute of Cytology and Genetics, SB RAS, Novosibirsk, Russia
Keywords: оксид алюминия, полидиметилсилоксан, композиция лития, фармакологический апгрейд, aluminum oxide, polydimethylsiloxane, lithium compositions, pharmacological upgrade

Abstract >>
Methodological approaches developed at Research Institute of Clinical and Experimental Lymphology for a number of years allow formulating the importance of embedding active pharmaceutical ingredients (API) in the structure of porous carriers (sorbents). The composition of the carrier and API is an enteral system for prolonged dosing of pharmacological agents, which allows providing a specific pharmacological effect and safety of use. The pores of the media (sorbents) act as containers for API. This is especially important for rapidly absorbed drugs, which include, for example, lithium preparations that are used in narrow concentration limits due to their side effects. At the moment, an innovative technology for creating new medicines with an improved combination of efficiency and safety (pharmacological upgrade) has been developed and implemented. The essence of the technology is to create a composition of aluminum oxide and polydimethylsiloxane (matrix) and an active pharmacological ingredient (API). A study of two drugs based on matrix / lithium citrate and matrix / melatonin showed continued specific pharmacological activity of API, better pharmacokinetics, and better safety parameters. The matrix of aluminum oxide and polydimethylsiloxane provides an upgrade of the pharmacological properties of drugs for the dosed and safe delivery of API to the zone of their therapeutic effect.

The safety of the use of the conditioned medium obtained by directed osteogenic induction of rat bone marrow mesenchymal stem cells

Lyubov’ A. Pokrovskaya1, Evgeniy Yu. Sherstoboev1,2, Sergey V. Nadezhdin3, Marina G. Danilets4, Evgeniya S. Trofimova4, Anastasiya A. Ligacheva4, Aleksey A. Churin4, Tat’yana Yu. Dubskaya4
1National Research Tomsk State University, Tomsk, Russia
2Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center of RAS
3Belgorod National Research University, Belgorod, Russia
4Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center of RAS, Tomsk, Russia
Keywords: мезенхимальные стволовые клетки костного мозга крыс, кондиционная среда, цитотоксичность, подострая токсичность, крысы SD, rat bone marrow mesenchymal stem cells, conditioned medium, cytotoxicity, subacute toxicity, SD rats

Abstract >>
The purpose of the study was to evaluate in vitro cytotoxicity and in vivo sub-acute toxicity of conditioned medium obtained from rat bone marrow-derived mesenchymal stem cells directed to osteogenic differentiation. Material and methods. Conditioned medium was obtained by culturing rat bone marrow-derived MSCs induced under osteogenic condition. Results and discussion. Conditioned medium from rat bone marrow-derived MSCs was shown to have no significant cytotoxic effect on Ehrlich adenocarcinoma cell culture and in vitro expanded peripheral blood mononuclear cells from healthy donors. The use of MSC-CM did not have a significant effect on the state of experimental SD rats, the total body weight and growth rate of animals. A pathomorphologic study revealed no any abnormalities associated with MSC-CM injection. Conclusion. The use of conditioned medium from rat bone marrow-derived mesenchymal stem cells stimulated under osteogenic condition was found to be safe for both in vitro studies (with respect to Ehrlich adenocarcinoma cell line and peripheral blood mononuclear cells from healthy donors) and in vivo studies (injection of MSC-CM to animals).

Dual-port operations in surgery of bullous lung emphysema

Evgeniy A. Drobyazgin1,2, Yuriy V. Chikinev1,2, Konstantin I. Tshcherbina3, Vitaliy F. Khusainov1,2
1Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
2Novosibirsk State Regional Clinical Hospital
3Novosibirsk State Regional Clinical Hospital, Novosibirsk, Russia
Keywords: bullous emphysema of the lungs, spontaneous pneumothorax, video-assisted thoracoscopy, dual-port operations, буллезная эмфизема легких, спонтанный пневмоторакс, видеоторакоскопия, двухпорто-вые операции

Abstract >>
The purpose of the study is to assess the perioperative period and the immediate results of dual-port operations in patients with bullous emphysema. Material and methods. The analysis of the perioperative period and the immediate results of two-port operations in patients with bullous emphysema of the lungs were performed. This surgical intervention was performed in 36 cases with bullous emphysema of the lungs (men - 31, women - 5). The average age of patients was 28.91 years. In all cases, the diagnosis was made on multispiral computer tomography of the chest. The duration of the surgical intervention, the periods of lung spread, the duration of the pleural drainage standing, the assessment of the pain syndrome, intra- and postoperative complications were assessed. Results and discussion. The intervention duration ranged from 70 to 125 minutes at the stage of implementation of the dual-port operations procedure. Now the intervention duration does not exceed 80 minutes for most cases. There were not registered any intraoperative complications. The duration of air leakage through pleural drainage was up to 1 day in 27 (75 %) patients. The duration of postoperative pain in most cases (28) did not exceed 1 day. Early postoperative complications were in 2 cases (1 - intrapleural bleeding; 1 - postoperative wound seroma). These complications were cured in both cases. The proposed access method for the surgery of bullous emphysema of the lungs can be used in a wide clinical practice. To determine the location of this method, it is necessary to compare it with other minimally invasive interventions.

Comparing the impact of beta-blockers and prostaglandin analogues on ocular surface change in glaucoma patients

Mariya M. Pupysheva1,2, Olga G. Gusarevich1, Anna A. Gusarevich1,2, Tatyana L. Poloz3
1Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
2Railway Clinical Hospital on the Station Novosibirsk-Glavniy
3Railway Clinical Hospital on the Station Novosibirsk-Glavniy, Novosibirsk, Russia
Keywords: глаукома и изменения глазной поверхности, бета-блокаторы, аналоги простагландинов, ОКТ-менискометрия, цитология, эпителий конъюнктивы, атрофия, пролиферация, glaucoma and ocular surface changes, beta-blockers, prostaglandin analogues, tear meniscus by OCT, cytology, conjunctival epithelium, atrophy, proliferation

Abstract >>
The connection between glaucoma and ocular surface disease (OSD) is determined more distinct due to increasing research of these chronic and progressive diseases. The purpose of research - an assessment of an impact of beta-blockers and prostaglandin analogues on ocular surface in glaucoma patients. Data and methods. 25 patients (25 eyes) with primary open-angle glaucoma (POAG) were examined: group I - 10 patients (10 eyes) receiving antihypertensive therapy with beta-blocker timolol maleate (monotherapy); group II - 15 patients (15 eyes) receiving prostaglandin analogues (monotherapy); control group - 15 patients (15 eyes) without POAG not receiving eye drops). Results. Total tear production (Schirmer test), the stability of the tear film (Norn test), the degree of conjunctiva and cornea staining with the Bengal pink, ocular surface disease index were similar in patients of groups I and II, while differed from the control group. Measurement of the height of the tear meniscus using optical coherence tomography showed that in patients of group I it was higher than in patients of group II, but in both cases less than in individuals of the control group. Cytological results shows us atrophy, dyskeratosis in group I; proliferation in group II and no changes in normal conjunctival epithelium in group III. Conclusion. Atrophy and dyskeratosis are shown in conjunctival epithelium by using cytological method. These changes lead to abnormality of functioning of conjunctival epithelium. Proliferation may cause an increased blood supply and therefore a hyperemia of conjunctiva. Considering the changes of conjunctival epithelium PA therapy is preferable.

Endocopic diverticuloesophagotomy in dysphagia of combined genesis in aged patient (clinical case)

Irina E. Sudovykh1, Evgeniy A. Drobyazgin1,2, Yuriy V. Chikinev3
1State Novosibirsk Regional Clinical Hospital, Novosibirsk, Russia
2Novosibirsk State Medical University of Minzdrav of Russia
3Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
Keywords: дивертикул Ценкера, эндоскопическая дивертикулоэзофагостомия, эндоскопия, гибкая эндоскопия, дисфагия, Zenker’s diverticulum, endoscopic diverticuliesophagostomy, endoscopy, эндоскопия, flexible endoscopyб dysphagia

Abstract >>
Zenker’s pharyngeal-esophageal diverticulum is more common in elderly patients, manifests itself with dysphagia and is dangerous with aspiration complications. The clinical case describes a combination of the first detected large Zenker diverticulum, pneumonia, neurological symptoms in an 86-year-old patient with aphagia. Despite the combination of aggravating factors, oral endoscopic ventriculostomy was performed using a flexible endoscope. After surgery: there are no violations of the act of swallowing. The patient eats liquid and semi-liquid food. No complaints of dysphagia were presented. At x-ray control, there is some delay of the contrast agent in the diverticulum, which does not prevent its emptying. The case demonstrates the effectiveness of endoscopic intervention in large-sized Zenker diverticulum, the possibility of its implementation in age-related patients with combined pathology, including neurological deficiency, preserving the patient’s chance of recovery.

Cardiovascular system state changes in non-Hodgkin’s lymphoma patients during chemotherapy

Ay-Suu O-O. Bady, Sof’ya S. Fedorova, Davyd A. Yakhontov, Tat’yana I. Pospelova
Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
Keywords: кардиотоксичность, антрациклиновые антибиотики, неходжкинские лимфомы, химиотерапия, доксорубицин, NTproBNP, кардиомиопатия, cardiotoxicity, anthracyclines, non-Hodgkin’s lymphoma, chemotherapy, doxorubicin, NTproBNP, cardiomyopathy

Abstract >>
Chemotherapy is one of reliable and proven methods of malignant tumor and blood diseases treatment but however the drug side effects (particularly cardiotoxicity) occur. More often cardiovascular complications connect with anthracyclines and related drugs (doxorubicin, daunorubicyn, epirubicyn, idarubicyn, mitoxantron) which usually used at medical scheme because of wide spectrum of action and high effectiveness prescription. Risk of cardiotoxicity formation and existing  diseases  progression  increases  according  to  drug  dose,  patient’s  age,  cardiovascular  risk  factors  presence and cardiovascular diseases history. Material  and  methods. 88 patients with established non-Hodgkin’s lymphoma diagnosis were examined in order to assess cardiovascular system state and pathology nature - 33 patients before chemotherapy and 55 patients in the long-term follow-up period (one year after the start of chemotherapy). Results. It was found that antitumor drugs induced cardiotoxicity may manifest at the beginning of chemotherapy as well as following up period. The cardiac cameras dilation associated with the increase of NTproBNP serum content (N-terminal fragment of natriuretic peptide type B precursor) - the main biomarker of myocardial dysfunction has been revealed by instrumental research.

Substantiation of the choice of open surgical intervention in treatment of false axillary artery aneurysm

Norman Zayniddin, Oybek A. Toirov, Feruza S. Ilhamova
Republican Specialized Center for Surgery named after academician V. Vakhidov, Uzbekistan, Tashkent
Keywords: травматическая аневризма, артерии верхних конечностей, хирургическое лечение, traumatic aneurysm, arteries of the upper extremities, surgical treatment

Abstract >>
The article describes the methods and procedures of reconstructive operations of false aneurysms of the axillary artery. We observed false aneurysms forming as a result of a stab wound in the region of the right chest (lath). It should be noted that open surgical reconstructive surgery tactics to date remains the «gold standard» in the treatment of this pathology. Our experience shows that the optimal choice and method of surgical treatment of arterial aneurysms of the axillary artery by restoring the arterial defect. The elimination of the aneurysm was accompanied by a patch of the defect (1.5 cm) in the axillary artery autovein, on the right. The article presents the surgical treatment of a false aneurysm of the right axillary artery after an injury of the right chest and the rationale for the choice of open surgery.

The interrelation between the Ketle index and the body component composition (muscle, fat, bone) in students with different levels of physical fitness

Elena A. Chanchaeva1, Sergey S. Sidorov1, Aleksandr V. Kozlov1, Vera A. Vodoleeva1, Roman I. Aizman2,3
1Gorno-Altaisk State University
2Novosibirsk State Pedagogical University
3Novosibirsk Science Research Institute of Hygiene of Rospotrebnadzor
Keywords: избыток массы тела, ожирение, индекс Кетле, компонентный состав тела, excess body mass, obesity, Ketle index, body component composition

Abstract >>
The process of body mass increasing among the population becomes global, which updates the need for early diagnosis of obesity. An informative method of determining the body mass excess and obesity is the determination of muscle and fat components, as well as the analysis of correlations between weight, mass index and component composition of the body. Aim of the study was to identify the availability and character of relationship between body mass, index Ketle and body component composition in students with different level of physical fitness. Material and methods. Length, weight, body mass index, level of physical fitness, body component composition (muscle, fat, bone) have been investigated in 107 students (52 boys and 55 girls) of the main medical group studying at the Gorno-Altai State University. Results. Trained young man and girls with higher level of physical fitness were characterized by higher body mass, a positive correlation between weight, index Ketle, muscle and bone components and an inverse correlation between index Ketle and total fat. In young man and girls with low physical fitness, total mass and Ketle index positively correlated with the fat component. The nature of the correlation between body mass, Ketle index and composition of the body allows us to identify the trend of weight gain due to fat or muscle components.

Changes in glomerular filtration rate in young adults: population data

Natalya A. Kovalkova, Alyona D. Khudyakova, Liliya V. Shcherbakova, Elena A. Vaskina, Diana V. Denisova, Yuliya I. Ragino, Mihail I. Voevoda
Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics of SB RAS, Novosibirsk, Russia
Keywords: скорость клубочковой фильтрации, хроническая болезнь почек, распространенность, популяция, эпидемиология, glomerular filtration rate, terminal renal failure, prevalence, population, epidemiology

Abstract >>
Aim of the study was to investigate glomerular filtration rate in population of 25-45 years old young people of Novosibirsk city. Material and methods. A survey of Novosibirsk typical district’s population has been carried out by the Institute of Internal and Preventive Medicine since 2013 to 2016. 1074 people (467 males and 607 females of 25-45 years old) have been included into the survey. The levels of glomerular filtration rate (GFR) were chosen according to KDIGO (2012) recommendation, such as: GFR more than 90 ml/min/1.73 cm2 - high or optimal, 60-89 ml/min/1.73 cm2 - slightly reduced, 45-59 ml/min/1.73 cm2 - moderately reduced, 30-44 ml/min/1.73 cm2 - vastly reduced, 15-29 ml/min/1.73 cm2 - highly reduced, lower than 15 ml/min/1.73 cm2 - terminal renal failure. Results and discussion. Average GFR(CKD-EPI) level in all age groups was 99,9 ml/min/1.73 cm2. Average GFR(CKD-EPI) was 104.41 ml/min/1.73 cm2 in 25-34 age group. Male average GFR(CKD-EPI) levels in appropriate age groups were reliably higher comparing to female levels. Both male and female analyzed indicators turned out to be reliably lower in older group than in the younger one. 95.1 % of male participants at the age from 25 to 34 years old had GFR ≥ 90 ml/min/1.73 cm2, while female indicator was 76.9 %. The indicators in the age group from 35-45 years old were: for males - 86.4 %, for females - 58.3 %. Both male and female groups at the age from 35 to 45 contained people with GFR < cm2 (2 men - 0,8 %; 1 woman - 0.4 %). While GFR calculating according to MDRD and CKD-EPI formulas two dissimilar results were revealed. The advantages of CKD-EPI formulas calculating for higher GFR indicators have been evidenced.

Insufficiency of timeliness and efficiency of diagnosis of malignant tumors of visual localization in the female reproductive system

Nataliya V. Voroshina1, Andrey V. Vazhenin1,2, Yuriy A. Tyukov3
1Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine, Chelyabinsk, Russia
2South Ural State Medical University
3South Ural State Medical University, Chelyabinsk, Russia
Keywords: своевременность диагностики, рак молочной железы, рак шейки матки, рак вульвы, рак влагалища, маршрутизация пациентов, timely diagnosis, breast cancer, cervical cancer, vulva cancer, vaginal cancer, routing scheme of patients

Abstract >>
Reproductive system cancer is the most common female malignancy, accounting for 36.1 to 37.6 % of all gynecological cancers. The incidence rate of female reproductive system cancer continues to increase. Material and methods. The study was conducted in 2018 by interviewing 391 patients with breast cancer, 273 patients with cervical cancer, 30 patients with cancer of the vulva and 11 patients with vaginal cancer were interviewed. Results. The time period for making diagnosis lasted no longer than a week in 2.0 % of respondents with breast cancer, 5.9 % with vaginal tumor and 11.3 % with cervical cancer. A long period of cancer detection was the cause of advanced cancer (56.5 and 47.0 % of cases of breast and cervical cancer, 40.0 % of vulva and 11.6 % of vaginal cancer). Discussion. The majority of district oncologists and other allied healthcare professionals are not able to identify abnormalities caused by cancer. Physicians of municipal health care facilities are either completely unaware of the procedure for routing patients with suspected malignant neoplasm or simply cannot explain it to patients. Conclusions. Oncologists working in outpatient health care facilities and other allied healthcare professionals need a special methodical literature on cancer screening. It is necessary to optimize the routing scheme of patients with suspected malignant tumors with mandatory training of oncologists and other allied healthcare professionals on the routing of such patients.