Репозиторий Университета

© 2018 Media Sfera. All rights reserved. The anterior capsular contraction syndrome (ACCS) in pseudophakic patients is known to be accompanied by postoperative opacity of anterior lens capsule (ALC) and partial or full closure of anterior capsulotomy opening. Purpose: to perform complex morphological assessment of ALC in patients with ACCS. Material and methods. The study involved complex analysis of ALC that was removed due to ACCS in the pseudophakic eye in the setting of diabetes mellitus and past vitreoretinal surgery. The following examination methods were used: light-optical microscopy of ALC samples in the form of polychrome-colored semifine sections using optical microscope Leica DM-2500 (Germany), scanning microscopy of ALC surface with EVO LS10 (Carl Zeiss, Germany) microscope, analysis of chemical element composition and its variation of the ALC sample with energy-dispersive spectrometer Oxford X-Max50 (Oxford, UK). Results. Light-optical microscopy showed altered state and plication of ALC induced by proliferation from inner surface of the fibrocellular tissue, which gradually thickens (up to 360 µm) towards center and causes reduction of anterior capsulotomy opening. Scanning electron microscopy revealed presence of tissue with uneven micro-relief and a porous three-dimensional structure uncharacteristic for capsule on the surface of ALC. Thickness of the fibrous deposition significantly exceeded the thickness of ALC. Evaluation of elemental composition of the fibrocellular tissue showed elevated concentration of sulfur and phosphorus, which indicates high activity of the regenerative process. In the observed case, the regenerative process was of substitute nature because an attempt to restore the lens was accompanied by formation of connective tissue structurally different from original. Conclusion. Complex assessment of an isolated ALC sample allowed revelation of the chain of pathological processes accompanying the development of ACCS.

© 2018 Media Sphera Publishing Group. All rights reserved. This article reflects the main stages of outpatient care formation in Moscow. It describes the most significant health care and health education reforms in different periods of Russian history. The article stresses the relevance of outpatient service modernization as a priority of Russian health care reform. The dominance of outpatient care and the introduction of a new three-level primary health care system into healthcare practice have demonstrated the optimal scheme of interaction of all Moscow medical institutions. The article shows the importance of consolidating the efforts of the Government of Moscow and Moscow medical universities, and the I.M. Sechenov First Moscow Medical University in particular, to solve the basic issues of prevention, early diagnosis, and treatment of diseases and to achieve the high quality of life in Muscovites.

© 2018 Nutritec. All rights reserved. The results of assessing the sufficiency offolic acid of the residents of the Moscow region have been presented depending on rs1801133 MTHFRgene polymorphism and rs9939609 FTO gene polymorphism. A total of 326 people were examined, including 74 men and 252 women aged 20 to 65 years. The results of determining the level of folic acid in blood serum showed insufficiency of this vitamin among the population of the Moscow region of the Russian Federation. The expressed vitamin deficit (level <3,0 ng/ml) was detected in 24.2% of the surveyed residents, in 22.8% folic acid level was at the lower bound of the norm (3.0-4.5 ng/ml). The results of genotyping showed a statistically significant association of low folic acid level with rs1801133 MTHFR gene polymorphism in carriers of A allele of rs9939609 FTO gene polymorphism both in the homozygous state (genotype AA) and in the heterozygous (genotype AT) state, OR=4.26; CI (1.40-12.9), p=0.008, as well as with rs9939609 FTO gene polymorphism in carriers of the T allele of rs1801133 MTHFR gene polymorphism both in the homozygous (genotype TT) and heterozygous (CTgenotype) state, OR-3.29; CI (1.07-10.1), p=0.03. In carriers of 3 alleles of risk offolic acid deficiency [rs9939609 FTO gene polymorphism and rs1801133 MTHFR gene polymorphism (genotypes CT/AA and TT/AT)] blood serum level of folic acid was below the norm, that indicated folate deficiency in this category of persons.

© 2018 SPIE. A reliable connection of dissected biological tissues is a popular problem in modern surgery. In the last decade, two methods of biological tissues connection using laser radiation have been actively developed: laser-assisted vascular repair (LAVR) and anastomosis (LAVA). These methods make it possible to obtain a weld impenetrable for blood and other biological fluids immediately after the welding. A solder is applied to a welding area. The main characteristic of the weld at LAVA is the tensile strength. A weld should be flexible enough to withstand repeated cycles of alternation of diastolic and systolic pressures. Single-walled and multi-walled carbon nanotubes (SWCNTs and MWCNTs respectively) are used to increase the weld tensile strength. They form a spatial bovine serum albumin (BSA)- nanocarbon scaffold under an action of laser radiation. It in real time varies the power of laser radiation (in the range 0.2- 5 W), which is necessary to stabilize the welding temperature (∼57C). In the present work new compositions of laser solder are proposed and the scheme of the installation for LAVR are offered. The proposed solder is based on an aqueous dispersion of BSA, MWCNTs and SWCNTs, ICG and collagen. The using of the chromophore ICG is due to its absorption maximum corresponding to the wavelength of the diode laser used (∼ 810 nm). The tensile strength was 0.8±0.3 MPa.

© 2018 SPIE. In this work, tissue-engineered structures based on a matrix of protein conjugates, chitosan and carbon nanotubes were prepared and studied. Bovine serum albumin (BSA), bovine collagen (BCrossed D sign¡) were used. Two types of single-walled carbon nanotubes (SWCNTs) were used to form a strong internal scaffold in a protein-chitosan matrix under the action of laser radiation. Tissue-engineered structures were created by means of layered deposition and laser evaporation of the initial aqueous dispersion from SWCNT, BSA, BC and chitosan succinate. As sources of laser radiation, a continuous diode laser with a wavelength of 810 nm and a pulsed fiber laser with a wavelength of 1064 nm and frequency of 80 kHz were used. Studies of tissue-engineered structures were carried out using vibrational spectroscopy methods (IR and Raman). The changes in the frequencies and intensities of the corresponding absorption bands and Raman lines of the amide group oscillations were analyzed. IR spectra of tissue-engineered structures demonstrated a high degree of binding of organic (protein, chitosan) and inorganic (SWCNT) components. The structure and defectiveness of the carbon nanotube scaffold were investigated in the Raman spectra.

© 2018 Media Sphera Publishing Group. All rights reserved. Ependymoma is a central nervous system tumor that grows from ependymal cells lining the cerebral ventricles, central canal of the spinal cord, and filum terminale. Regardless of the histological type of ependymomas, they rarely have exophytic growth. Because of an extremely low occurrence rate of this phenomenon, we present two clinical cases of patients with classical intramedullary ependymomas (Grade II) having an extramedullary component. Material and methods. The paper presents two clinical cases of patients with intramedullary-extramedullary ependymomas of the spinal cord. The surgical technique is described. After surgical treatment, the performance status of patients remained unchanged. Conclusion. Radical removal of complex ependymomas provides conditions for long-term disease-free survival and further neurological recovery.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. To assess the possibilities of functional multispiral computed tomography (fMSCT) in orbital tumors. Materials and methods. The patient M, 55 years old, was admitted to ENT doctor with complaints of difficulty in nasal breathing and nasal discharge. After clinical and in-strumental examination, orbital tumor in the posterior part near the oculomotor muscle and optic nerve was found. To clarify the state of the optic nerve and its involvement in the pro-cess, the patient was referred by an ophthalmologist to an additional orbit examination us-ing functional MSCT. Functional MSCT was performed on a multispiral computer tomograph Toshiba Aq-uilion One 640, with slice thickness 0.5 mm, in the soft-tissue mode. During the study, the patient made eye movements from the central position upwards, then down, to the right, to the left, with a return to the central position. The time of functional eye movement study was 7 seconds. Results. During the functional MSCT the optic nerves were symmetrical: the left and right optic nerves with distinct smooth contours have a smooth course and differentiated to the orbital apexes. The movements of the optic nerves were symmetrical, in full volume. Taking into account the results of FMSCT, the tactics of conducting and surgical treatment of the patient was changed due to the lack of connection between the orbit tumor and optic nerve. The patient underwent surgical treatment and removal of left orbit tumor. Histologi-cal examination revealed cavernous hemangioma. Conclusion. Functional MSCT is a new promising method in examining patients with neoplasm of orbit. There is an opportunity to obtain additional diagnostic information on the relationship between orbital bone and soft tissue structures with neoplasms within the preoperative planning and postoperative control.

© 2018 GEOTAR Media. All rights reserved. A monocenter randomized comparative study, based on 96 patients with inguinal hernia, was undertaken. All patients were divided into two groups according to the type of mesh prosthesis that was used in hernioplasty with the Lichtenstein technique: lightweight polyester monofilament mesh Parietex™ and standard monofilament polypropylene mesh Parietene™ (both Covidien, USA). We found out that during early postoperative period the intensity of pain syndrome and local tissue reactions do not fundamentally depend on the type of applied mesh prosthesis. It was concluded that in prosthetic hernioplasty the use of lightweight synthetic materials in stead of standard polypropylene mesh prosthesis leads to a significant reduction of pain intensity and duration, sense of discomfort, minimal limitation of patient activity during a long-term postoperative period.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Comparison of materials used in dental practice for the protection of patients with cancer of maxillofacial region from radiation was compared. Literature has been sought in the SCOPUS, Web of Science, Pubmed, Russian Science Citation Index database. The devices for the prevention of radiation reactions and damage of the oral mucosa, teeth, jaws, salivary glands are made of materials that have low absorption of radiation and have a toxic effect on the structure of oral cavity. It is not enough to protect patients with cancer of maxillofacial region during radiotherapy.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. An X-ray picture of tension pneumopericardium, as a transsternal transpericardial main bronchus stump occlusion complication, not previously seen after this sur-gery, is described. The clinical picture of a tension pneumopericardium and diag-nostic methods applied to determine this condition are reported. Successful elimination of complications in a somatically burdened patient was possible only due to rapid and accu-rate diagnostics of this condition.

© 2018 GEOTAR Media. All rights reserved. We created and tested an experimental model of spontaneous rupture of the esophagus (SRE). The 1st group consisted of live animals (n=5), the 2nd group consisted of dead animals (n=5). In all experiments rupture of the esophageal wall was performed, which with this method of modeling occurred in the lower third of the esophagus in mediamagnatom segment on the left side. The length of the gap ranged from 2.5 to 4.0 cm, the pressure difference of the gap between dead and live animals amounted to 0.2 bar - it means direct influence of the tone of the surrounding tissues and structures on spontaneous rupture of the esophagus. The level of intraluminal pressure wall rupture of the esophagus in live animals is much higher than physiological intraluminal pressure that occurs during vomiting (0.15 to 0.20 bar) and in vivo is not observed. Within experiment we created models of the intraorgan hypertension of the esophagus and stomach, defined intraluminal pressure wall rupture of the esophagus (1.3 bar) and stomach (0.5 bar), and the ratio of the received data with the level of hypertension in the lumen of the esophagus and stomach during vomiting. It is shown that intraluminal pressure that occurs while vomittting, can result in Mallory-Weiss syndrome, however, it is impossible to break the wall of the esophagus at this pressure. SRE is most likely a variant of mechanical damage to the esophagus caused by discoordination of muscle contractions that occur during vomiting.

© 2018 Russian Transplant Society. All rights reserved. Heart transplantation is the gold standard of treatment severe heart failure. Immunosuppressive therapy aimed at the prevention of acute allograft rejection is the cornerstone of post-transplant management. In addition to its direct effects, immunosuppressive therapy is also involved in the generation of a number of post-transplant morbidities that limit the long-term outcome of heart transplant recipients. Given these data it appears that the individual tailoring of immunosuppressive therapy is of paramount importance in determining the outcome of heart transplantation. The goal of immunosuppressive therapy is to prevent rejection of the transplanted heart, while minimizing drug-related effects, such as infection, malignancy, diabetes, hypertension, and renal insuffi ciency. This review aimed is to analyze the protocols for the appointment of immunosuppressive therapy in various groups of recipients after heart transplantation.

© 2018 GEOTAR Media. All rights reserved. The purpose of the study is to develop an accessible method of dynamic control of patients with mechanical jaundice for a practical doctor. Data from 258 medical histories of patients with mechanical jaundice were studied. To solve this problem we used a method for calculating the severity level using a universal statistical program StatSoft Statistica for OS Windows. A mathematical relationship between a degree of possibility of a fatal outcome and the nine significant parameters was developed. As a result of the calculations, such factors as disease duration (days), blood bilirubin, body temperature, blood leucocytosis, pulse rate, patient age, blood creatinine, blood lymphocytes, respiratory rate appeared to be significant parameters in calculating the severity of mechanical jaundice of a particular patient. At the second stage, a multivariate regression analysis was performed, used to assess the degree of influence of various factors on the resulting indicator. A statistical dependence was found on the basis of which a formula combining 9 significant parameters was developed to determine the severity level of a patient based on the degree of influence of each of these factors on the resulting parameter: G = 0,002 (d×b) + 1,2 (t - 36,6) + 0,001 (p×v) + 0,322 (L/1000 - 5) + + 0,22 (16 - Lim) + 0,0085 (K - 60) + 0,165 (Di - 20). The formula took into account the stochastic dependence of the resulting parameter on the factors influencing it. When calculating a correlation analysis was conducted aimed at establishing a stochastic relationship between the parameters and estimating the tightness of the connection between the factors and the resulting index. This method of calculating the severity level can be applied by any surgeon and can accurately monitor the minimum changes in the patient's condition, as well as the effect of individual elements of treatment on the state of the disease.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. The purpose of this clinical observation was to demonstrate an interesting and obvi-ous case of discrepancies in the clinical and radiological and morphological pat-terns of intrathoracic lymph nodes tuberculosis. Correct diagnosis is the key to a correct choice of further treatment of this patient, therefore, it is necessary to keep in mind possible variations and difficulties in establishing the stage of intrathoracic lymph nodes tuberculosis.

© 2018 All-Russian Public Organization Antihypertensive League. All rights reserved. The review discusses the role of blood pressure variability as a novel risk factor and its prognostic value in hypertension associated with the coronary artery disease. We discuss the modern approaches to calculation of blood pressure variability, its classification. The choice of antihypertensive drugs based on the blood pressure variability is discussed considering hypertension associated with coronary artery disease. We pay special attention to angiotensin enzyme converting inhibitors and calcium channel blockers, as well as their combinations. We present the evidence of the effects of perindopril and amlodipine and their fixed combination on the blood pressure variability and the decrease in cardiovascular risk in hypertension associated with coronary artery disease.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. The antidepressant-like effect of fluoxetine (20 mg/kg i.p.) has been assessed using the forced swimming test (FST) in IRC (CD-1) mice exposed or not to a pretest session of different duration (5 or 20 min). The influence of the mitochondrial translocator protein (TSPO) activity on the antidepressant-like effect of fluoxetine (20 mg/kg i.p.) in the FST was also studied. The antidepressant-like effect of fluoxetine was observed only in mice subjected to a 5-min pretest session 24 h before the FST. The TSPO antagonist PK11195 [1-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinolinecarboxamide; 1 or 3 mg/kg i.p.] inhibited the antidepressant activity of fluoxetine in the FST. In the present study, fluoxetine or PK11195 was administered for a short duration. We suppose that the functional activity of TSPO may depend on a pretest session and that using this procedure is necessary to detect antidepressant activity of fluoxetine-like drugs.

© 2018, SPb RAACI. The aim of the study was to determine efficiency of Glutoxim, aimed for correction of immune disorders. The drug was administered to the patients with chronic cerebral ischemia (CCI, Stage I and II) complicated by arterial hypertension. Increased contents of pro-And anti-inflammatory cytokines, IFNγ, IL- 2, G-CSF, and activation of the complement system have been revealed for these conditions, at both functional stages of the disease. The patients with stage II CCI showed elevated markers of oxygen-dependent activity in polymorphonuclear leukocytes (increased levels of spontaneous and stimulated nitroblue tetrazolium (NBT) reduction tests, phagocytic capacity and stimulation index of neutrophils). Stage I of chronic cerebral ischemia was characterized by normal values of NBT reduction tests and functional reserve of neutrophils, along with decreased stimulation index of neutrophils. Among 26 parameters of immune status, 73.1% and 80.8% of indices proved to be changed, respectively, in the patients with stage I and II CCI. 66.7% of immune indices appeared similar in magnitude and direction of changes, whereas the resting 33% are identical in orientation. Usage of Cereton and Actovegin in treatment of the stage I CCI caused normalization of 5.3% immune parameters, with partial normalization of 26.3% tests, and 68.4% of the indexes remaining unchanged or increased posttreatment. Inclusion of Glutoxim into the combined pharmacotherapy proved to be more effective since it totally normalized 52.6% of the indexes, along with partial normalization of 21.1%, while 26.3% of the indicators were not affected by the therapy. Administration of Cereton and Actovegin at the second stage of chronic brain ischemia was followed by partial normalization for 47,6% of the tests, while leaving unchanged or increased 52.4% of the indicators. Glutoxim Use fully normalize 19.0% and partially normalizes 57.1% of immune parameters.

© 2018, SPb RAACI. The aim of this work was to study features of gene expression TLR2, TLR4, and TLR9 in the course of acute respiratory infection, depending on the time elapsing since the contamination, and dose of infection. The studies of in vivo models of acute respiratory infections caused by Gram-negative Klebsiella pneumoniae showed that, at infection dose of 104 CFU/ml, the TLR4 gene expression levels in epithelium of upper respiratory tract at 1, 3, 10 days were increased 30 times and more, complete elimination of the pathogen was observed at 3 days. At the dose of infection of 107 CFU/ml, persistence of the pathogen in upper respiratory tract was observed within a few days, accompanied by a significant increase in the level of TLR9 expression in epithelium of upper respiratory tract, and TLR4 levels in the lungs 1 day after infection, in parallel to elimination of the pathogen from the lower respiratory tract. Thus, the characteristic features of TLR4 and TLR9 gene expression in the upper respiratory tract may be considered a potential diagnostic and prognostic factors in evaluation of the course of acute respiratory infections caused by Klebsiella pneumoniae.

© 2018 Izdatel'stvo Meditsina. All rights reserved. Organic nitrates are widely used in clinical treatment of cardiovascular diseases, but the problem of developing tolerance during long-term therapy remains urgent. The analysis of published works shows that the nitrate tolerance development is caused by various mechanisms, including disturbances in neurohormonal regulation of vessel tonus and biochemical pathways of realization of the nitrate effect. This review summarizes the current notions of the mechanisms of nitrate tolerance development and vascular changes during nitrate drug application and analyzes potential efficiency of using coenzyme Q10 for preventing the development of nitrate tolerance and nitrate-induced endothelial dysfunction.

© 2018 Izdatel'stvo Meditsina. All rights reserved. There were studied the impact of selective antagonist of the mitochondrial translocator protein (TSPO 18 kDa) PK11195 (N-butan-2-yl-l-(2-chlorophenyl)-N-methylisoquinoline-3-carboxamide; 1 or 3 mg/kg, i.p.) and 5α-reductase inhibitor finasteride (1.25; 2.5; 5 mg/kg, i.p.) on anticonvulsive effect of pyrazole[c]pyridine derivative GIZH-72 (4,6-dimethyl-2-(4-chlorophenyl)-2,3-dihydro-l//-pyrazolo[4,3-c]pyridin-3-one chloralhydrate, 20 mg/kg, i.p.) in marble burying test in C57BL/6 mice. It is established that PK11195 (1 or 3 mg/kg, i.p.) had no effects on both compulsive behavior of mice and anticompulsive effect of GIZH-72 (20 mg/kg, i.p.). Finasteride (2.5 or 5.0 mg/kg) decreased of compulsive behavior in the dose-dependent manner in C57BL/6 mice. Pretreatment with finasteride (2.5 or 5.0 mg/kg, i.p.) led to completely reduction of anticompulsive effect of GIZH-72 (20 mg/kg, i.p.). Thus, anticompulsive effect of GIZH-72 may depend on activity of 5α-reductase, but not TSPO 18 kDa.