Home – Home – Jornals – Siberian Scientific Medical Journal 2020 number 4

Cytokines are unique biologically active substances that form the system of regulation of basic body functions that simultaneously with the nervous and endocrine systems maintain homeostasis under adverse conditions - the introduction of pathogens or violation of the integrity of tissues. Cytokines regulate the amplitude and duration of inflammatory and immune responses, so they are produced and secreted transiently and have a short half-life. These biologically active substances act in very low concentrations. At the same time, the main properties of cytokines are pleiotropy, lack of antigenic specificity, and the ability to form a cascade chain, that allows versatile correction of the spectrum of reparative processes. There are evidences of the possibility of using cytokines in the regeneration of damaged tissues in recent decades. In this connection, a new vector of search for pathogenetically directed ways to improve and restore lost functions using both individual representatives of cytokines and their natural complex is determined. The article reflects the basic information about the influence of cytokines on the development of various diseases of the cornea, as well as the methods of cytokine therapy in the treatment of these pathologies and prospects for their development.

Corneal diseases are the fourth leading cause of blindness in the world, accounting for approximately 5 % of cases. Existing methods of treatment in more than 30 % of cases do not have a full therapeutic effect and when the process is stopped, they end with a persistent violation of corneal transparency, a decrease or complete loss of visual functions. The lack of effective means that evidence-based restore corneal transparency determines the relevance of the search for modern drugs and ways to deliver them, the possibilities of enhancing the therapeutic effect. The possibilities of using hyaluronidase preparations in ophthalmology are considered based on the study of its biological and pharmacological properties. Enzyme catalyzes the breakdown of acid mucopolysaccharides including hyaluronic acid by cleavage of the glycosidic bond β(1→4), the biological effect is determined by the molecular weight of the resulting fragments: high-molecular fragments have antiangiogenic properties, increased ability to bind fibrinogen, anti-inflammatory and immunosuppressive effects, and low-molecular fragments have pro-inflammatory activity and promote angiogenesis. The barrier function of the cornea is provided by the features of its anatomical structure, while the features of its regeneration with the formation of turbidity are accompanied by overexpression and migration to the stroma of cytokines TGF-β and PDGF, activation of myofibroblasts and the formation of a fibroproliferative response. The high anti-inflammatory, immunomodulatory, regenerative and antifibrotic activity of hyaluronidase, the possibility of its effect on a complex pathophysiological cascade of destructive processes and minimization of the scarring process stimulate more extensive experimental and clinical studies on the development of new methods of treating ophthalmic diseases using hyaluronidase drugs.

An important step in preparation of cells for cell therapy and tissue engineering is the cultivation of cells in vitro. The aim of this work is to study the effect of human apolipoprotein A-I (apoA-I) on the functional activity of cultured bone marrow cells and to show the possibility of using this protein instead of animal fetal serum. Material and methods. Bone marrow cells were cultured in 24-well plates in RPMI-1640 medium in a CO₂ incubator at a temperature of 37 °C. The rate of incorporation of [¹⁴C]-leucine into the total cell protein and [³H]-thymidine into the DNA was used as an integral indicator of cell viability during cultivation. Results and discussion. It was found that the rate of DNA synthesis in bone marrow cells in the presence of apo A-I increased compared with the control group (without apo A-I) by 55 % after 8 hours, by 523 % after 24 hours and by 219 % after 48 hours. Under these conditions the rate of protein synthesis was also increased. The results indicate that the presence of apo A-I in serum-free culture medium preserves the functional activity of cultured bone marrow cells. Considering that the regulatory effect of apo A-I is achieved at a low protein concentration in the medium (15 μg/ml), isolation of apo A-I from the patient’s own blood serum will provide a practically safe nutrient medium for culturing autologous bone marrow cells with applications in personalized cell therapy and tissue engineering.

The aim of the study was to investigate morphofunctional disorders of neurons in the cerebral cortex and changes in the prooxidant-antioxidant state in rats after subtotal cerebral ischemia. Material and methods. The experiments were performed on 20 white outbred male rats. Surgical interventions were carried out under intravenous thiopental anesthesia (40-50 mg/kg). Subtotal cerebral ischemia was simulated by both common carotid arteries ligation. Animals were decapitated after 60 minutes of ischemia. Morphological and functional changes in the neurons of the parietal cortex and hippocampal CA1 field, and intensity of free radical oxidative processes (content of thiobarbituric acid reactive substances and thiol-disulfide system components) in brain homogenates were studied. Results and discussion. Brain ischemia has been followed by oxidative stress in brain tissue. The cellular metabolism has been disturbed under the oxidative stress that leads to a water-electrolyte imbalance, manifested by deformation of neuron bodies, wrinkling, and swelling. The changes in parietal cortex are to a greater extent expressed, as the neurons are more sensitive to oxygen deficiency.

Epidermal growth receptor HER2/neu is still of great interest, the overexpression of which is most often observed in patients with breast cancer and accounts for 15-20 % of cases. Present methods of HER2/neu determination have a number of significant drawbacks. In recent years, alternative framework proteins are used for the targeted radionuclide imaging. Molecules of DARPin (Design Ankyrin Repeat Protein) are one of representatives of scaffolds. Material and methods. The study included 4 breast cancer patients (T_1-2N_0-1M₀) who were not receiving systemic therapy at the time of the study: in 2 patients, HER2/neu overexpression was noted, in 2 patients - not detected. HER2/neu status was determined using an immunohistochemical method and a FISH assay. At the preclinical stage, radiopharmaceutical ^99mTc-DARPin9_29 was injected intravenously to all patients, «WholeBody» scintigraphy and single-photon emission computed tomography were performed 2 hours after injection. Results. The distribution of radiopharmaceuticals in organs 2 hours after injection revealed the greatest accumulation in the liver and kidneys. In studying of tumor/background indicator it was revealed that values of the studied parameter in patients with overexpression of HER2 receptors are more than 3 times higher than the values in the subgroup of patients with negative expression of this marker. Conclusion. According to the results of preliminary studies, the ^99mTc-DARPin9_29 demonstrated significant differences between tumors with and without HER2/neu overexpression.

The aim of the study was to investigate the indicators of the thyroid status in males with acute infectious pulmonary destruction (AIPD), depending on the disease form and the presence of complications. Material and methods. The serum levels of total triiodothyronine (T₃), total thyroxine (T₄) and thyroid-stimulating hormone (TSH) were measured by radioimmunoassay in 80 males with AIPD and 30 healthy males volunteers. Results. T₃ serum level is decreased in males with AIPD and is not depended on the disease form and complications. T₃ serum level reduction is occurred due to decrease of peripheral conversion of thyroid hormones. If AIPD is complicated by sepsis, then T₄ production is reduced. T₄ serum level correlates with the presence of sepsis in males with AIPD ( r_S = -0.49; p = 0.000003). The sepsis probability threshold in males with AIPD for value T₄ is ≤95.5 nmol/L with a sensitivity of 100 % and a specificity of 62.5 %. Thyroid function remains normal in 25 % (95 % CI: 16-34) of males with AIPD, in other cases it is represented by: primary hypothyroidism - in 11 % (95 % CI: 4-18), nonthyroidal illness syndrome (NTIS) type I - in 44 % (95 % CI: 33-55), NTIS type II - in 11 % (95 % CI: 4-18), NTIS type V - in 9 % (95 % CI: 3-15). NTIS type II is associated with the highest mortality rate ( p _Fisher = 0.0015). T₄ serum levels correlate with mortality in males with AIPD ( r_S = -0.37; p = 0.00082). The mortality probability threshold in males with AIPD for value T₄ is ≤70.1 nmol/L with a sensitivity of 68.7 % and a specificity of 78.1 %. The obtained data indicates the advisability of monitoring and analysis of the thyroid status indicators in males with AIPD for the diagnosis of sepsis and prognosis of the disease outcome.

Objective: To assess possible changes in the macular region of the retina and the thickness of the peripapillary retinal nerve fiber layer (RNFL) according to the results of a dynamic study of OCT parameters after Nd:YAG laser iridectomy in patients with relative papillary block. Material and methods. Optical coherence tomography (OCT) was performed in 28 patients (38 eyes) with a relative papillary block before and after 1 hour, 1 day, 3 days, 1 week, 1 and 6 months after Nd:YAG laser iridectomy. We analyzed changes in the thickness of the retina in 9 standard zones according to ETDRS, the thickness of the layer of ganglion cells and the peripapillary RNFL. Results. The thickness of the layer of ganglion cells, as well as the thickness of the peripapillary RNFL, did not change significantly after laser intervention (all p ˃ 0.05) during the entire observation period. According to OCT, the retinal thickness significantly increased an hour after Nd:YAG laser iridectomy in 5 zones out of 9 by ETDRS and continued to increase over the course of a day. After 1 week, the thickness of the retina returned to its original values and did not change throughout the observation period. Conclusion: In patients with the relative papillary block, Nd:YAG laser iridectomy has a negligible effect on the thickness of the retina, measured by OCT, does not fundamentally affect the thickness of the layer of ganglion cells and the thickness of the peripapillary RNFL, and is safe for the central zone of the retina.

More than 20 million inguinal hernia surgeries are performed annually. An international group of herniologists recommended performing transabdominal preperitoneal plastic surgery (TAPP), total extraperitoneal plastic surgery, and Liechtenstein hernioplasty in adults. At the moment, there are no criteria for choosing the method of plastic surgery in patients who may have TAPP, Liechtenstein hernioplasty. The study of two groups of 30 patients devided by the method of surgical treatment: transabdominal preperitoneal plastic (TAPP) and Liechtenstein hernioplasty has been carried out. The study included male patients with primary unilateral inguinal hernia older than 18 years. The groups were compared in the early and late postoperative period. The data obtained revealed that in the early postoperative period, patients after TAPP showed a higher level of pain by the visual-analog scale (VAS) in comparison with the patients after Liechtenstein plastic surgery in 3 hours after surgery, with longer operation time. The assessment of pain level by VAS in 1 day after surgery, at the time of discharge, the fever level, the analgesics need, and the hospitalization duration showed the TAPP advantage over Liechtenstein hernioplasty. Long-term results were obtained by Carolinas Comfort Scale (CSS) questionnaire within 3, 6 months after the operation. Patients after TAPP showed slightly better results in comparison with patients after Liechtenstein hernioplasty. Therefore, TAPP is the preferred method of inguinal canal surgery in patients with open and laparoscopic surgery.

The aim of the study was to establish the thickness of the ventricles and interventricular septum in individuals of the mesomorphic body type with a normal body mass index according to echocardiography and to assess the presence or absence of a relationship of these parameters with the gender and age of the subjects. Material and methods. The analysis of the protocols of ultrasound examination of the heart of 202 conditionally healthy persons of adolescence, the first and second periods of adulthood of the mesomorphic body type with a body mass index of 18.5-24.99 kg/m² was carried out. They have no pulmonary and cardiac pathology and risks of cardiovascular diseases. All subjects were divided into three age groups according to the age periodization of human ontogenesis (Moscow, 1965). Echocardiography was performed using a scanner Aloka ProSound Alpha 6. Results. The thicknesses of the anterior wall of the right ventricle, the posterior wall of the left ventricle, and the interventricular septum in women of the second period of adulthood is greater, than in young girl and women of the first period of adulthood ( p ˂ 0.05); the thickness of the interventricular septum in men of the second period of adulthood is greater, than in young men and men of the first period of adulthood ( p ˂ 0.05). It has been established that the thickness of the anterior wall of the right ventricle and interventricular septum depends on person gender: it is greater in men. In women, moderate correlation was found between the thickness of both the left ventricle ( r = 0.425; p < 0.001) and the right ( r = 0.411; p < 0.001) with age. A direct relationship (moderate strength) of the thickness of the interventricular septum with age ( r = 0.331; p = 0.014) was found in men. Conclusion. The results of this morphological study supplement the information available in the scientific literature on the thickness of the ventricles of the heart and interventricular septum in a conditionally healthy person of the mesomorphic body type with a normal body mass index.

The purpose of the study was to investigate the effect of overweight, obesity and fat distribution type on the severity of comorbid somatic pathology in men. Material and methods. 216 men, aged from 22 to 78 years, who were patients of therapeutic clinic from 2018 to 2019 years, were observed. Height, body weight, waist (WC) and hip (HC) circumference were measured using standard anthropometric procedures, and then WC/HC and body mass index (BMI) were calculated. Clinical signs of aging were estimated by using the AMS questionnaire. The CIRS was scored from the medical records after hospitalization. Results and discussion. It was shown that overweight and obesity increase the burden of cardiovascular, endocrine and general comorbidity in men. Nevertheless, the burden of cardiovascular pathology did not differ between overweight and obesity men. The contribution of fat distribution type in separate BMI-groups is different. The upper fat distribution type in normal body weight increases the burden of vascular pathology, in overweight - vascular pathology and endocrine system, in obesity - cardiovascular pathology, and general comorbidity in men. Conclusion. Thus, the BMI ≥ 25 kg/m² is associated with an increase burden of cardiovascular, endocrine and general comorbidity and upper fat distribution type increases the burden of vascular pathology in men.

The article is devoted to the study of the psychosomatic characteristics of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The study has been divided into 3 stages. The purpose of the first stage was to study the leading personality traits and prevailing types of attitude towards the disease in patients with RA and AS. The purpose of the second stage was to study the role of the social factor in RA patients based on the family pattern, to identify the relationship of intra-family problems with the duration and degree of the disease activity, the level of education. The third stage was aimed to demonstrate the effectiveness of biobehavioral therapy for the correction of pain in patients with RA. Material and methods. The contingent study consisted of patients with a reliable diagnosis of rheumatoid RA and AS, stage 1 - 26 patients (20 men, 6 women), stage 2 - 14 patients (11 women, 3 men), stage 3 - 46 women with RA. The patients underwent clinical, laboratory, X-ray examination. Psychological questionnaires and the Health Assessment Questionnaire (HAQ) were used. Results.: Hypochondria, increased anxiety, emotional immaturity, men’s behavioral characteristics in women have been revealed at the first stage of the study. In men with RA, the leading features are hypochondria, emotional immaturity. Types of attitude to the disease in women were: ergopathic 79 %, harmonious 37 %, neurasthenic 32 %; in men: ergopathic 57 %. The significant intercorrelation between the disease duration in women and the ergopathic and harmonious type of attitude toward the disease was found. The second stage of the study allowed the RA group to identify alienation, unwillingness and inability to independently solve family problems. According to the results of the third stage of the study, it was found that the patient’s acquired ability to control the alpha rhythm voluntarily allowed them to control the intensity of the pain syndrome and reduce the need for taking high doses of NSAIDs. A reduction of feelings of helplessness, hopelessness has been achieved. Conclusions. The study revealed psychological and social problems in patients with RA and AS, substantiating an interdisciplinary approach in the management of the patients with the rheumatologist and psychotherapist participation. Modern possibilities of psychotherapy can reduce the pharmacological burden in the treatment process.

Human immunodeficiency virus (HIV) infection remains a major medical problem due to its high prevalence and mortality. In order to study and identify clinical manifestations, frequency of their occurrence, as well as epidemiological features of this disease in the Penza region, we have analyzed 150 case histories. According to the results of the research, HIV infection is more common in men whose average age is 35.7 ± 9.1 years; in 69 % of cases-these are unemployed people; the average duration of the disease (by the date of registration at the dispensary) - 4.2 ± 4.1 years; unprotected sex is the leading factor of infection (35 %); there is a decrease in the share of infection by parenteral route with the use of drugs (32 %); in the structure of clinical manifestations, bronchopulmonary pathology (58 %) and chronic viral hepatitis C (60 %) prevails; diagnosed opportunistic infections were more often candidiasis of the oral cavity and esophagus (23 %), pneumocystic pneumonia (8 %) and Kaposi’s sarcoma (2 %). The etiological structure of purulent meningitis and meningoencephalitis is dominated by Staphylococcus aureus (25 %). The main etiological factor in the development of serous meningitis and meningoencephalitis are more often HSV DNA type 1, type 2 (12 %) and Enterovirus RNA (11 %).

Purpose. To evaluate changes in chorioretinal blood flow in the early postoperative period after non-penetrating deep sclerectomy (NPDS) in patients with primary open-angle glaucoma (POAG) and determine their relationship with the level of Goldman intraocular pressure (IOPg). Material and methods. The study included 36 patients with primary open-angle glaucoma of stage 1-2, with an IOP level above 21 mm Hg at the maximum hypotensive mode. All patients underwent glaucoma surgery (NPDS) by a single surgeon. IOP measurement was performed by dynamic bidirectional applanation using the Ocular Response Analyzer (Reichert Inc., USA). When evaluating the results, the Goldman IOP indicators (IOPg) were taken into account. The ophthalmic examination included optical coherence tomography of the optic disk and macular area, as well as assessment of the blood flow of these structures using optical coherence tomography in angio mode (OCTA) (RTVue XR Avanti, Optovue Inc., США). The thickness of the choroid was estimated using crossline protocols performed through the center of the fovea in the horizontal and vertical meridians. Results. Based on the assessment of changes in the indicators of ocular blood flow in the postoperative period, all patients were divided into 2 groups: group 1 - 28 patients (28 eyes) who showed improvement in OCTA after surgery, group 2 - 8 patients (8 eyes) who, according to OCTA data, showed no changes or decreased indicators of ocular blood flow after surgery. In patients of both groups, the level of IOPg before surgical treatment was comparable. On the 3rd day after NPDS IOPg in the group 1 decreased to 9.3 ± 1.2 mm Hg, while in group 2 hypotonia was detected (IOPg 3,6 ± 1,3 mm Hg, р = 0,001). All patients showed an increase in the thickness of the choroid in the central area and peripapillary after glaucoma surgery: in group 1 by 23 and 26 %, in group 2 by 48 and 62 %, respectively. In group 2 there was a significant increase in the large vessels caliber and the vascular membrane thickness as a whole to 115.4 % of the original. In group 1 patients, against the background of normalization of ophthalmotonus, there was a tendency to increase the capillary density of the superficial vascular plexus (from 40.9 ± 5.38 to 41.1 ± 3.56 %) and the deep vascular plexus (from 43.9 ± 6.1 to 44.7 ± 5.97 %). There was a positive trend of increasing capillary density in the radial peripapillary plexus (from 46.6 ± 8.9 to 47.2 ± 9.0 %). In patients of group 2, capillary density significantly decreased: from 39.9 ± 3.64 to 37.6 ± 2.48 % in the superficial vascular plexus and from 41.1 ± 4.72 to 38.7 ± 3.51 % in the deep vascular plexus. Conclusion. A decrease in the level of ophthalmotonus after NPDS was accompanied, in most cases, by a moderate increase in the thickness of the choroid and a tendency to improve blood flow in the retinal plexuses. Postoperative hypotension is characterized by dysregulation of choroidal blood flow, decompression violation of topographic relationships, which generally leads to the formation of choroidal effusion and vascular detachment.

Introduction Epidemiological studies indicate a high prevalence of overweight in all economically developed countries of the world, its growth was registered everywhere by the beginning of the century. According to the World Health Organization, over 30 % of the world’s inhabitants have overweight, and therefore, WHO has recognized it as a new non-infectious «21st century epidemic». The aim of the study was to determine the twenty-year dynamics of the prevalence of overweight among young and mature women in the open population of the mid-urban city of Western Siberia. Material and methods. Simultaneous epidemiological studies were conducted on representative samples in 1996 and 2016 among women of 25-64 years old with the allocation of categories of young and mature age. Overweight was determined based on body mass index (BMI), with BMI ≥ 30.0 obesity was recorded, with BMI ≥ 25.0 - overweight. Results. Over 20 years of monitoring the open population of the mid-urbanized city of Western Siberia, a positive trend has been established to reduce the prevalence of overweight in the category of young women. In the age range in relation to the prevalence of BMI according to the first and second screenings in the open urban population, a negative trend has been established for an increase in the prevalence of obesity and overweight among young women during the transition from the third to the fourth decade of life. According to the first screening in an open urban population, a negative trend was found to increase the prevalence of obesity and overweight among mature women during the transition from the fifth to the sixth decade of life, according to the second screening in the same groups, to an increase in the prevalence of overweight. Conclusion. Changes in population health at certain time intervals, depending on socio-economic, environmental, and behavioral factors, in each time period and in each individual population require specific, epidemiologically-related preventive measures.