Репозиторий Университета

Цель. Улучшение результатов лечения пациентов, страдающих циррозом печени, путем внутрипеченочного введения криопреципитата, стимулирующего регенерацию органа. Материал и методы. В исследование включено 72 пациента, страдающих циррозом печени вирусной (НСV и НВV) и токсической этиологии. Цирроз печени класса А и В по Child-Pugh до введения криопреципитата был у 32 (44%) пациентов, класса С у 40 (56%). Криопреципитат вводили чрескожно в печень пункционным методом под ультразвуковым контролем. Оценивали динамику клинико-лабораторных показателей, параметры портального кровотока у всех пациентов, изменения в морфологической картине биопсийного материала печени у 42 (58%) и показатели иммунного статуса у 38 (53%) пациентов до и после введения криопреципитата. Результаты. После стимуляции регенерации печени криопреципитатом у большинства пациентов отмечено уменьшение выраженности клинических и лабораторных проявлений цирроза печени как через 3, так и через 6 и 12 месяцев после введения криопреципитата. Цирроз печени класса С через год регистрировался у 7 пациентов (до стимуляции у 40). Через 12 месяцев у 65 (90%) достоверно уменьшился диаметр воротной и селезеночной вен. У 11 (15%) пациентов снизился индекс застоя, у 18 (25%) сплено-портальный индекс. У 40 (95%) из 42 больных при морфологическом исследовании биоптата печени спустя год после проведенного лечения была выявлена положительная динамика (снижение воспалительно-клеточной инфильтрации, дистрофических изменений, у 29 (69%) уменьшение выраженности ступенчатого некроза гепатоцитов. Заключение. Введение криопреципитата в печень под ультразвуковым контролем является безопасным, так как позволяет избежать травмирования крупных внутрипеченочных сосудов. Криопреципитат оказывает стимулирующее действие на регенерацию печени, что улучшает ее функциональную активность и позволяет продлить время до трансплантации печени.

Aim: To develop minimally invasive and safe endoscopic access to thyroid gland. Material and methods: Transoral pre-mandibular video-assisted gas-free access to thyroid gland was developed in experimental study that included 19 human cadavers. Stereometric modeling defined the evaluation criteria including the form of basal arch of lower jaw and its height. There was no conflict of instruments in working chamber under platysma. Additional trocar was deployed to resolve the conflict between working parts of instruments during thyroid gland mobilization. The angle of operative action between the instruments is close to 90°. Trocar hole is used for drainage. Results: The access provides good visualization of recurrent laryngeal nerve, upper and lower thyroid arteries and parathyroid gland. It is less traumatic compared with other extra-cervical accesses to thyroid glands.

There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, which may partially explain conflicting data. It is known that human milk composition is very complex and contains variable levels of immune active molecules, oligosaccharides, metabolites, vitamins and other nutrients and microbial content. Existing evidence suggests that modulation of human breast milk composition has potential for preventing allergic diseases in early life. In this review, we discuss associations between breastfeeding/human milk composition and allergy development.

(PDF) Human Milk and Allergic Diseases: An Unsolved Puzzle. Available from: https://www.researchgate.net/publication/319178514_Human_Milk_and_Allergic_Diseases_An_Unsolved_Puzzle [accessed Dec 25 2018].

With increased international travel over the world the need for safe and effective chemoprophylaxis for malaria is as great as ever. The choice of regimen is difficult, as effectiveness should be weighted against potential adverse effects. Although, some studies have reported high prophylactic efficacy of primaquine, there is no comprehensive evidence comparing its prophylactic effectiveness as well as toxicity. To fill the gap, this systematic review and meta-analysis study was carried out.

Despite recent advances, our knowledge of potential and rare human pathogens is far from exhaustive. Current molecular diagnostic tools mainly rely on the specific amplification of marker sequences and may overlook infections caused by unknown and rare pathogens. Using high-throughput sequencing (HTS) can solve this problem; but, due to the extremely low fraction of pathogen genetic material in clinical samples, its application is only cost-effective in special, rather than routine, cases. In this study, we present a method for the semi-specific enrichment of viral conservative sequences in a HTS library by hybridization in solution with genus-specific degenerate biotinylated oligonucleotides. Nucleic acids of the test viruses (yellow fever virus and Japanese encephalitis virus) were enriched by solution hybrid selection using pan-flavivirus oligonucleotides. Moreover, enterovirus (family: Picornaviridae, genus: Enterovirus) sequences were successfully enriched using foot-and-mouth disease virus (family: Picornaviridae, genus: Aphthovirus) oligonucleotide. The enrichment factor relative to the background nucleic acid was about 1,000-fold. As hybridization has less stringent oligonucleotide match requirements than PCR, few oligonucleotides are sufficient to cover the potential sequence variation in the whole genus and may even enrich nucleic acids of viruses of other related genera. Efficient enrichment of viral sequences makes its use in diagnostics cost-efficient.

(PDF) Enrichment of Viral Nucleic Acids by Solution Hybrid Selection with Genus Specific Oligonucleotides. Available from: https://www.researchgate.net/publication/319337364_Enrichment_of_Viral_Nucleic_Acids_by_Solution_Hybrid_Selection_with_Genus_Specific_Oligonucleotides [accessed Dec 25 2018].

The cell-to-cell transport of many plant viruses through plasmodesmata requires viral movement proteins (MPs) encoded by a ‘triple gene block’ (TGB) and termed TGB1, TGB2 and TGB3. TGB3 is a small integral membrane protein that contains subcellular targeting signals and directs both TGB2 and the helicase domain-containing TGB1 protein to plasmodesmata-associated structures. Recently, we described a ‘binary movement block’ (BMB) coding for two MPs, BMB1 and BMB2. The BMB2 protein associates with endoplasmic reticulum (ER) membranes, accumulates at plasmodesmata-associated membrane bodies and directs the BMB1 helicase to these structures. TGB3 transport to cell peripheral bodies was previously shown to bypass the secretory pathway and involve a non-conventional mechanism. Here, we provide evidence that the intracellular transport of both poa semilatent virus TGB3 and hibiscus green spot virus BMB2 to plasmodesmata-associated sites can occur via lateral translocation along the ER membranes. Agrobacterium-mediated transient co-expression in Nicotiana benthamiana leaves revealed that green fluorescent protein (GFP)-fused actin-binding domains of Arabidopsis fimbrin (ABD2–GFP) and mouse talin (TAL–GFP) inhibited the subcellular targeting of TGB3 and BMB2 to plasmodesmata-associated bodies, which resulted in TGB3 and BMB2 accumulation in the cytoplasm in association with aberrant ER structures. Inhibition of COPII budding complex formation by the expression of a dominant-negative mutant of the small GTPase Sar1 had no detectable effect on BMB2 subcellular targeting, which therefore could occur without exit from the ER in COPII transport vesicles. Collectively, the presented data support the current view that plant viral MPs exploit the ER:actin network for their intracellular transport.

Western Siberia is the region with little information on the prevalence of hepatitis C virus (HCV) infection, genotypic diversity of HCV isolates and risk factors. A molecular epidemiological survey was conducted to clarify these issues. Four groups of volunteers were included in a cross-sectional study (n = 500 in each group): health care workers; daycare patients from a hospital for drug users, daycare patients from an AIDS prevention and control center; and persons admitted to a local general practice clinic for any reason (outpatients). The anti-HCV IgG prevalence was 4.6% in health care workers, 48.0% in a narcological center, 35.8% in AIDS center, and 5.6% in outpatients. HCV RNA was found in 79.3%-86.3% of seropositives. A total of 388 HCV isolates were genotyped by direct sequencing and phylogenetic analysis of the 5'-UTR and NS5B regions of HCV genome. The genotypes distribution was: 1b--50.3%, 2a--4.4%, 2c--0.3%, 3a--44.8%. One isolate (0.3%) could not be typed unambiguously. This genotypic diversity is intermediate between that of European Russia and China. Genotype 1 prevailed in an older age group (75% among 51-60 years old), and genotype 3 was most prevalent in young people (51.4% in 16-20 years old). A statistically significant (P < 0.05) increase in risk was found in intravenous drug users (odds ratio (OR) = 77.5), unemployed persons (OR = 16.3), persons having >4 sexual partners during lifetime (OR = 4.3), and male homosexuals (OR = 6.6).

The TRPV1 receptor plays a significant role in many biological processes, such as perception of external temperature (above 43°C), inflammation development, and thermoregulation. Activation of TRPV1 leads to the pain occurrence and decrease in the body temperature, while inhibition of this receptor can lead to an increase in the temperature. The TRPV1 peptide modulators from sea anemone Heteractis crispa extract (APHC1 and APHC3) have been previously characterized as molecules, which generated a pronounced analgesic effect and a decrease in the body temperature in experimental animals. Using the combined APHC1 and APHC3 amino acid sequences, we have prepared a hybrid peptide molecule named A13 that contains all residues potentially important for the activity of the peptide precursors. Biological tests on animals have shown that the hybrid molecule not only combines the analgesic properties of both peptides but, unlike the peptide precursors, also raises the body temperature of experimental animals.

Acid-sensing ion channels (ASICs) ASIC3 expressed mainly in peripheral sensory neurons play an important role in pain perception and inflammation development. In response to acidic stimuli, they can generate a unique biphasic current. At physiological pH 7.4, human ASIC3 isoform (hASIC3) is desensitized and able to generate only a sustained current. We found endogenous isoquinoline alkaloids (EIAs), which restore hASIC3 from desensitization and recover the transient component of the current. Similarly, rat ASIC3 isoform (rASIC3) can also be restored from desensitization (at pH < 7.0) by EIAs with the same potency. At physiological pH and above, EIAs at high concentrations were able to effectively activate hASIC3 and rASIC3. Thus, we found first endogenous agonists of ASIC3 channels that could both activate and prevent or reverse desensitization of the channel. The decrease of EIA levels could be suggested as a novel therapeutic strategy for treatment of pain and inflammation.

Marital status is an independent prognostic factor for various cancer types. The present study used the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute (NCI) to analyze the impact of marital status on renal cancer patient survival outcomes. We identified a total of 62,405 eligible patients (23,800 women and 38,605 men). Overall 5-year renal cancer cause-specific survival (CSS) was 80.3% in the married group, 69.2% in the widowed group, 78.9% in the single group, and 76.5% in the divorced/separated group. The widowed patient group had the highest female/male ratio, more distant metastases, and fewer high-grade (III/IV) tumors. Most widowed patients (90.4%) were elderly (>60 years old). In our study, male renal cancer patients benefited more from marriage than females. We also found that white married patients had better survival outcomes than other white patient groups, but black unmarried and married patients exhibited similar survival outcomes. Our results show that, in general, unmarried patients have higher rates of cancer-specific mortality and highlight the importance of psychological intervention for cancer patients during treatment.

Perioperative corneal abrasion is a common ophthalmic complication detectable in patients undergoing general anesthesia. In this study, using experimental perioperative corneal abrasion in animals (rabbits) correlations have been found between development of corneal abrasion and proteomic changes in the tear film. The process of accumulation of pathological changes in the cornea begins after 1 h of general anesthesia while after 3–6 h of general anesthesia clinically manifested abrasions have been recognized. The development of corneal abrasions was associated with different changes in the content of the major proteins of the tear film. Analysis of the tear proteome points to suppressed lachrymal gland functioning, and suggests that serotransferrin, serum albumin and annexin A1 may be applicable as potential tear markers of the ophthalmic complication. The biochemical changes in the tear film included the rapid decrease in total antioxidant activity and activity of superoxide dismutase, as well as the decrease in interleukin-4 and the increase in interleukin-6 content thus indicating development of oxidative and pro-inflammatory responses. These findings suggest that antioxidant and anti-inflammatory therapy is a prospective approach for prevention/treatment of perioperative corneal abrasions. The observed anesthesia-induced effects should be taken into consideration in any study of ocular surface diseases employing anesthetized animals.

Anti-neutrophil cytoplasmic antibodies (ANCAs) are valuable laboratory markers used for the diagnosis of well-defined types of small-vessel vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). According to the 1999 international consensus on ANCA testing, indirect immunofluorescence (IIF) should be used to screen for ANCAs, and samples containing ANCAs should then be tested by immunoassays for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs. The distinction between PR3-ANCAs and MPO-ANCAs has important clinical and pathogenic implications. As dependable immunoassays for PR3-ANCAs and MPO-ANCAs have become broadly available, there is increasing international agreement that high-quality immunoassays are the preferred screening method for the diagnosis of ANCA-associated vasculitis. The present Consensus Statement proposes that high-quality immunoassays can be used as the primary screening method for patients suspected of having the ANCA-associated vaculitides GPA and MPA without the categorical need for IIF, and presents and discusses evidence to support this recommendation.

Cryofibrinogen is an abnormal protein that forms precipitate only in plasma. Cryofibrinogenaemia (CF) can be detected both in healthy persons and patients with autoimmune diseases, cancer and infections. Essential CF is frequently asymptomatic, although in a proportion of patients it is associated with skin lesions and systemic manifestations and can lead to refractory skin ulcers and gangrene or thrombotic events. Identification of CF in plasma is simple, but establishing a definite diagnosis may be a challenge due to a lack of accepted diagnostic criteria. Several treatment options have been suggested for patients with symptomatic CF, although their efficacy has been shown only in uncontrolled series or case reports. A variety of possible approaches to drug treatment poses additional problems for the physician. Treatment for secondary CF usually relies on effective management of the underlying disease. The clinical significance of CF and its true prevalence are apparently underestimated and should be further studied.

To the editor, In the excellent study recently published in the Annals of the Rheumatic Disease, Damoiseaux et al showed a high diagnostic performance of antigen-specific immunoassay for the detection of myeloperoxidase (MPO) and proteinase 3 (PR3) antineutrophil cytoplasmic antibodies (ANCAs). These data challenge the role of indirect immunofluorescence in the ANCA testing algorithm. In our centre, we have discarded ANCA indirect immunofluorescence more than a decade ago. Therefore, new data showing the feasibility of screening by antigen-specific immunoassay have a particular value for us. In the recent series of 284 patients with ANCA-associated vasculitides, we have detected ANCAs by this approach in 96.9% of patients with microscopic polyangiitis (MPA) but only in 72.7% of patients with granulomatosis with polyangiitis (GPA) (table 1). The latter result can be explained by a relatively high occurrence of localised GPA in our series, since a rate of ANCA positivity reached 92.2% in patients with renal GPA. ANCA testing should be performed only in the clinical context since PR3-ANCA and MPO-ANCA can be found in the other conditions than vasculitis, for example, infective endocarditis, tuberculosis, primary sclerosing cholangitis and interstitial lung diseases. The results of several studies suggest that in such patients, ANCAs have not been merely a chance finding and may be clinically relevant, for example, a high prevalence of ANCAs was identified in unselected patients with infective endocarditis (24%). Seropositive patients presented more commonly with a subacute form of infective endocarditis leading to multiple valve involvement and a more frequent renal impairment.

Over the last decades, numerous randomised clinical trials and long-term observational studies were conducted in dozens or hundreds patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) and provided a basis for an evidence-based treatment. With immunosuppressive therapy, up to 85%–90% of patients will achieve remission, though the disease can follow a relapsing course in a significant proportion of patients, and prolonged exposure to glucocorticoids and immunosuppressive agents may have devastating consequences. However, the attempts to shorten maintenance therapy can lead to recurrent exacerbations of AAV and an accumulation of irreversible organ damage.

In the recent randomised, prospective REMAIN (prolonged REmission-MAINtenance therapy in systemic vasculitis) study, conducted in 117 patients with AAV in stable remission after cyclophosphamide/prednisolone-based induction, Karras et al showed that prolonged maintenance therapy with azathioprine/prednisolone (up to 48 months from diagnosis) was relatively safe and more effective than withdrawal of azathioprine/prednisolone by 24 months1. Extension of immunosuppression was associated with a significantly lower risk both of any and major relapses (22% vs 63%, p<0.0001, and 14% vs 35%, p<0.007, respectively) and resulted in a better renal survival. Notably, almost all patients completed the prolonged follow-up. The results of the REMAIN study were satisfying to us since prolonged immunosuppression with low dose cyclophosphamide and currently azathioprine or metothrexate in combination with corticosteroids for many years remains a preferred treatment option for patients with AAV in our clinic.

However, there is the other side of the coin. A paradigm for treating patients with AAV has changed significantly over recent years. Currently, it is apparent that …

Tick-borne encephalitis virus (TBEV) is the causative agent of tick-borne encephalitis (TBE), a vector-borne zoonotic neuroinfection. For successful circulation in natural foci the virus has to survive in the vector for a long period of time. Information about the effect of long-term infection of ticks on properties of the viral population is of great importance. In recent years, changes in the eco-epidemiology of TBEV due to changes in distribution of ixodid ticks have been observed. These changes in TBEV-endemic areas could result in a shift of the main tick vector species, which in turn may lead to changes in properties of the virus. In the present study we evaluated the selective pressure on the TBEV population during persistent infection of various species of ticks and tick cell lines. TBEV effectively replicated and formed persistent infection in ticks and tick cell lines of the vector species (Ixodes spp.), potential vectors (Dermacentor spp.) and non-vector ticks (Hyalomma spp.). During TBEV persistence in Ixodes and Dermacentor ticks, properties of the viral population remained virtually unchanged. In contrast, persistent TBEV infection of tick cell lines from both vector and non-vector ticks favoured selection of viral variants with low neuroinvasiveness for laboratory mice and substitutions in the E protein that increased local positive charge of the virion. Thus, selective pressure on viral population may differ in ticks and tick cell lines during persistent infection. Nevertheless, virus variants with properties of the original strain adapted to mouse CNS were not eliminated from the viral population during long-term persistence of TBEV in ticks and tick cell lines.

This article presents the results of a comprehensive survey of the burden of tick-borne infectious diseases (TBIDs) in the Altai region of Russia. Official data for TBID incidence were analyzed and 201 samples from patients with suspected TBID were studied. Furthermore, questing ticks and ticks recovered from humans were examined to estimate prevalence of TBID-causative agents. The Altai region was determined to have a heightened risk for TBIDs in Russia. The most epidemiologically significant… CONTINUE READING

Transfusion of packed red blood cells (PRBC) to patients in critical states is often accompanied by post-transfusion complications. This may be related with disturbance of properties of PRBC and their membranes during long-term storage in the hemopreservative solution. The purpose of our work is the study of transformation of morphology, membranes stiffness and nanostructure for assessment of PRBC quality, in vitro. By atomic force microscopy we studied the transformation of cell morphology, the appearance of topological nanodefects of membranes and by atomic force spectroscopy studied the change of membrane stiffness during 40 days of storage of PRBC. It was shown that there is a transition period (20–26 days), in which we observed an increase in the Young’s modulus of the membranes 1.6–2 times and transition of cells into irreversible forms. This process was preceded by the appearance of topological nanodefects of membranes. These parameters can be used for quality assessment of PRBC and for improvement of transfusion rules.

Patients with coronary artery aneurysms (CAA) resulting from Kawasaki Disease (KD) are at risk for thrombosis and myocardial infarction. Current guidelines recommend CAA diameter ≥8mm as the criterion for initiating systemic anticoagulation. Transluminal Attenuation Gradient (TAG) analysis has been proposed as a non-invasive method for evaluating functional significance of coronary stenoses using Computerized Tomography Angiography (CTA), but has not previously been used in CAA. We hypothesized that abnormal hemodynamics in CAA caused by KD could be quantified using TAG analysis. We studied 23 patients with a history of KD who had undergone clinically indicated CTA. We quantified TAG in the major coronary arteries and aneurysm geometry was characterized using maximum diameter, aneurysm shape index (ASI) and sphericity index. A total of 55 coronary arteries were analyzed, 25 of which had at least one aneurysmal region. TAG in aneurysmal arteries was significantly lower than in normal arteries (-23.5±10.7 vs. -10.5±9.0, p=0.00002). Aneurysm diameter, ASI, and sphericity index were weakly correlated with TAG (r²=0.01, p=0.6: r²=0.15, p=0.06; r²=0.16, p=0.04). This is the first application of TAG analysis to CAA caused by KD, and demonstrates significantly different TAG values in aneurysmal versus normal arteries. Lack of correlation between TAG and CAA geometry suggests that TAG may provide hemodynamic information not available from anatomy alone. TAG represents a possible extension to standard CTA for KD patients that may improve thrombotic risk-stratification and aid in clinical decision-making.