Intraductal photodynamic therapy and its combination with intra-arterial chemoinfusion in the treatment of inoperable patients with Klatskin tumor

Background: A palliative or symptomatic treatment is indicated for 7080% of patients with Klatskins tumor because of the advanced lesion volume and the patients grave condition. Hepatic arterial infusion chemotherapy, chemoembolization, radioembolization are successfully used in the treatment of hepatocellular carcinoma and liver metastases. Aim: to estimate the immediate and long-term results of photodynamic therapy (PDT) and its combination with hepatic arterial infusion in inoperable patients with Klatskin tumors. Methods: Between 2010 and 2021, 83 palliative PDT sessions (from 1 to 8, average 2.4) were performed in 82 patients as a single treatment or in combination with hepatic arterial infusion. In all cases, percutaneous transhepatic biliary drainage was previously performed; no chemotherapy was applied. Two groups of 48 patients were stratified according to the ECOG status (23) and the numbers of PDT sessions (no more than two). The treatment group of the combination therapy consisted of 24 patients (13 male, 11 female) aged 38 to 85 (mean 63) years with the ECOG status of 24 (mean 2.4). This group received PDT with hepatic arterial infusion using a GemCis regimen. On average, 1.4 PDT sessions were performed, the treatment started on the 89th (27225) day after the biliary drainage. The hepatic arterial infusion was performed on the 2d3th day after the PDT. The control group received only PDT and consisted of 24 patients (13 male, 11 female) aged 51 to 83 (66 on average) years, with the ECOG status of 23 (mean 2.6). On average, 1.4 PDT sessions were performed, starting on the 106th (32405) day after the biliary drainage. Results: There were no serious adverse events associated with PDT in both groups. Toxic complications of hepatic arterial infusion were observed in 13 of 24 patients (54%): III grade hematological (54%) and gastrointestinal (69%); all were eliminated with medical therapy. Complications of the percutaneous transhepatic biliary drainage in three patients (hemobilia, n=2, and sepsis, n=1) were estimated as grade III by the CIRSE classification (2017) and successfully treated without surgery. In the combination treatment group, the overall mean survival and median survival were higher than those in the control group: 327.939.8 days (10.9 mo) versus 246.931.2 days (8.2 mo) and 275 days versus 244 days. However, these differences did not reach the statistical significance (p=0.12). Conclusions: PDT is a safe method of a palliative treatment of critically ill patients with Klatskin tumor (ECOG 23). PDT alone has limited clinical efficacy. A combination of PDT and hepatic arterial infusion does not cause serious complications and may increase the survival rates

Challenges in QCD matter physics - The Compressed Baryonic Matter experiment at FAIR

Substantial experimental and theoretical efforts worldwide are devoted to explore the phase diagram of strongly interacting matter. At LHC and top RHIC energies, QCD matter is studied at very high temperatures and nearly vanishing net-baryon densities. There is evidence that a Quark-Gluon-Plasma (QGP) was created at experiments at RHIC and LHC. The transition from the QGP back to the hadron gas is found to be a smooth cross over. For larger net-baryon densities and lower temperatures, it is expected that the QCD phase diagram exhibits a rich structure, such as a first-order phase transition between hadronic and partonic matter which terminates in a critical point, or exotic phases like quarkyonic matter. The discovery of these landmarks would be a breakthrough in our understanding of the strong interaction and is therefore in the focus of various high-energy heavy-ion research programs. The Compressed Baryonic Matter (CBM) experiment at FAIR will play a unique role in the exploration of the QCD phase diagram in the region of high net-baryon densities, because it is designed to run at unprecedented interaction rates. High-rate operation is the key prerequisite for high-precision measurements of multi-differential observables and of rare diagnostic probes which are sensitive to the dense phase of the nuclear fireball. The goal of the CBM experiment at SIS100 (sqrt(s_NN) = 2.7 - 4.9 GeV) is to discover fundamental properties of QCD matter: the phase structure at large baryon-chemical potentials (mu_B > 500 MeV), effects of chiral symmetry, and the equation-of-state at high density as it is expected to occur in the core of neutron stars. In this article, we review the motivation for and the physics programme of CBM, including activities before the start of data taking in 2022, in the context of the worldwide efforts to explore high-density QCD matter.Comment: 15 pages, 11 figures. Published in European Physical Journal

Innovative principles of pedagogical training of medical universities lectures

The organizational and methodological conditions are touched upon in the article as well as the problems in pedagogical training of entry-level lectures at medical universities. Also this article offers a new interpretation of andragogical principles of education, presents some advantages and disadvantages of concentrated organization of educational process and views the peculiarities in a usage of innovative didactics

SPORTS BOARD GAMES AS A MEANS OF PHYSICAL EDUCATION FOR STUDENTS OF SPECIAL MEDICAL GROUPS IN THE CONTEXT OF THE INCLUSIVE EDUCATION DEVELOPMENT

The article deals with the nuances of organizing work on physical education with students of SMG (special medical groups) by means of sports board games. The relevance of the study is substantiated by the need to search for new forms of physical activity of students with disabilities (limited health). The aim of the study is to analyze physical culture and health-improving activity in higher educational institutions using the example of a competitive event in sports board games among students of a special medical group and the main health group (MHG). The emphasis of the work is made on the need to introduce board sports games into the educational activities of higher professional institutions. It is concluded that sports board games contribute to the development of an inclusive educational environment, are a good means of health preservation and are suitable for students with any type of pathology. Methodology. In accordance with the intended scientific goal and the results of the scientific experiment, points were calculated and converted into a percentage. Results. As a result of the study, the effectiveness of the use of table sports for the development of an inclusive educational environment in higher educational institutions has been scientifically substantiated and experimentally proven. Practical implications. The practical application and introduction of board sports games into the educational process will help teachers and teachers of universities and colleges to adapt extracurricular and competitive activities for students of a special medical group

Mathematical modeling of non-steady heat exchange process in cryogenic coil-wound heat exchangers

The paper discusses a dynamic model of coil-wound heat exchanger and its implementation in the MathWorks SimulinkTM computer simulation system. As a simulation object was chosen a coil-wound heat exchanger with wire-finned tubes of a commercial low-capacity air separation unit. The methods for obtaining experimental data has been described, the non-steady heat exchange process has been simulated, and the obtained results have been analyzed

Mathematical modeling of non-steady heat exchange process in cryogenic coil-wound heat exchangers

The paper discusses a dynamic model of coil-wound heat exchanger and its implementation in the MathWorks SimulinkTM computer simulation system. As a simulation object was chosen a coil-wound heat exchanger with wire-finned tubes of a commercial low-capacity air separation unit. The methods for obtaining experimental data has been described, the non-steady heat exchange process has been simulated, and the obtained results have been analyzed

Experimental Evidence Questions the Relationship between Stress and Fluctuating Asymmetry in Plants

The eco-evolutionary theory of developmental instability predicts that small, non-directional deviations from perfect symmetry in morphological traits (termed fluctuating asymmetry, FA) emerge when an individual is unable to buffer environmental or genetic stress during its development. Consequently, FA is widely used as an index of stress. The goal of the present study was to experimentally test a seemingly trivial prediction derived from the theory of developmental instability—and from previous observational studies—that significant growth retardation (which indicates stress) in plants is accompanied by an increase in FA of their leaves. We induced stress, evidenced by a significant decrease in biomass relative to control, in cucumber (Cucumis sativus), sweet pepper (Capsicum annuum), and common bean (Phaseolus vulgaris) by applying water solutions of copper and nickel to the soil in which plants were grown. Repeated blind measurements of plant leaves revealed that leaf FA did not differ between stressed and control plants. This finding, once again, demonstrated that FA cannot be seen as a universal indicator of environmental stress. We recommend that the use of FA as a stress index is discontinued until the scope of the developmental instability theory is clarified and its applicability limits are identified

Differences of IL-1β Receptors Expression by Immunocompetent Cells Subsets in Rheumatoid Arthritis

IL-1β is involved in the induction and maintenance of chronic inflammation in rheumatoid arthritis (RA). Its activity is regulated and induced by soluble and membrane-bound receptors, respectively. The effectiveness of the cytokine depends not only on the percentage of receptor-positive cells in an immunocompetent subset but also on the density of receptor expression. The objective of this study was to investigate the expression of IL-1β membrane-bound receptors (IL-1R1 and IL-1R2) in terms of the percentage of receptor-positive cells and the number of receptors per cell in different subsets of immune cells in RA patients before and after a course of basic (excluding anticytokine) therapy and in healthy individuals. The resulting data indicate differences in the expression of IL-1β receptors among T cells, B cells, and monocytes in healthy volunteers and in rheumatoid arthritis patients. The importance of determining both the relative percentage of cells expressing receptors to immunomodulatory cytokines and the number of membrane-bound receptors per cell is highlighted by evidence of unidirectional or multidirectional changing of these parameters according to cell subset and health status