THE STRUCTURE OF THE SIBERIAN GEOGRAPHICAL FLORAL ELEMENT IN THE MIDDLE SIBERIAN FOREST STEPPES

Background. The ultimate goal of studies of any flora is the clarification of the history of vegetation cover and individual taxa formation in the studied region, determination of the degree of its individuality, of floristic links with other territories, and of regularities in flora formation.Materials and methods. The flora of vascular plants in the island forest steppes of Middle Siberia, i. e. of the Krasnoyarsk, Kansk and Achinsk forest steppes, identified by the specific floras method of A. I. Tolmachev, was chosen as the object of research. The purpose of the paper was to study the structure of the Siberian geographical element in the steppe flora, characteristics of the types of constituent distribution areas selected on the basis of the phytochorion concept. The basis for determining the types of habitats was the planetary regionalization scheme by A. L. Takhtajan, complemented by statistical convergent zonation for Siberia by L. I. Malyshev, and for the Russian Far East by R. V. Kamelin.Results. The territory of the Middle Siberian forest steppes is a part of the Altai-Yenisei Province. The Krasnoyarsk, Kansk and Achinsk forest steppes (Krasnoyarsk Territory) are the most northern parts of the region (55°28’–57°28’N, 89°– 96°40’E). Twenty-six local floras were examined. Ten distribution area types were identified within the Siberian geographical element of the boreal group according to the names of sub-regions and provinces (154 species, 11.12%), limiting their distribution from West to East or from East to West, including all intermediate Siberian provinces between them. All types of distribution areas were combined into four large subgroups, namely Siberian, West Siberian, Middle Siberian, and East Siberian. Names of geographical elements were composed from the names of several phytochoria, in which they had been registered, according to the rules by M. G. Popov.Conclusions. The Siberian geographical element rates third in all three forest steppes after the Euro-Siberian and Circumboreal geographical elements. In the flora of the Middle Siberian forest steppes Siberian elements amount to 11%, among which the Middle Siberian ones prevail (4.4%, 61 species) due to the geographical position of the flora. The fraction of species distributed throughout Siberia is 3.25% (45 species), followed by East Siberian species (2.24%, 31 species) and West Siberian ones (1.23%, 17 species)

TUTORING AS A FORM OF PEDAGOGICAL SUPPORT OF STUDENTS’ INDIVIDUAL EDUCATIONAL TRAJECTORIES

Purpose: The key provisions on which the tutor relies on the context of his work are the principles underlying open education: transparency; flexibility; continuity; variability; individual approach; individualization. Methodology: The relevance of the study is associated with the processes characteristic of the school system in modern Russia (modernization, optimization, change in the structural foundations), as well as the objective need of society in the search for fundamentally new approaches to the content and construction of the educational process in the educational institution. Result: Tutoring should be considered as a resource of individual evolution of personality, as a form of productive exploitation of open education opportunities for the development of individual educational programs, taking into account the specifics of a particular student. As pedagogical conditions for the implementation of the model of tutor support of the formation of basic school students’ research skills should be considered: innovative educational environment; scientific and methodological provision of tutor support of the process of building basic school students’ research skills; professional skills of the tutor. Applications: This research can be used for universities, teachers, and students. Novelty/Originality: In this research, the model of Tutoring as a Form of Pedagogical Support of Students’ Individual Educational Trajectories is presented in a comprehensive and complete manner

FUNCTIONAL FOOD COMPOSITIONS BASED ON WHEY PROTEIN ISOLATE, FISH OIL AND SOY PHOSPHOLIPIDS

The aim of the research was to study the impact of whey protein isolate on the solubility and oxidative stability of the lipid composition based on soy phosphatidylcholine and fish oil. The relationship between the molecular parameters (density; ζ-potential) of the formed complex particles and their functional properties was found using laser light scattering (static, dynamic, electrophoretic) and spectrophotometry. The studied compositions could be used as the basis for the development of multifunctional food additives with an objective of the enrichment of foods and beverages with omega-3 polyunsaturated fatty acids (PUFAs). The main advantages of such composition are a high level of protection of the lipids against oxidation and degradation, a high solubility in an aqueous medium and the clean label.The aim of the research was to study the impact of whey protein isolate on the solubility and oxidative stability of the lipid composition based on soy phosphatidylcholine and fish oil. The relationship between the molecular parameters (density; ζ-potential) of the formed complex particles and their functional properties was found using laser light scattering (static, dynamic, electrophoretic) and spectrophotometry. The studied compositions could be used as the basis for the development of multifunctional food additives with an objective of the enrichment of foods and beverages with omega-3 polyunsaturated fatty acids (PUFAs). The main advantages of such composition are a high level of protection of the lipids against oxidation and degradation, a high solubility in an aqueous medium and the clean label

THE INFLUENCE OF HEMERIN ON THE COURSE OF CHRONIC GLOMERULONEPHRITIS

Objective: determination of the infl uence of hemerin on the features of the course of chronic glomerulonephritis.Materials and method: the study included 80 patients with chronic glomerulonephritis. Th e criterion for including patients in the study was the presence of indications for nephrobiopsy and the patient’s consent to perform it. All patients underwent general clinical examination with establishment of anamnesis of the disease, creatinine level, urea, calculation of GFR, determination of the general blood test, general urine analysis, daily proteinuria. Venous blood sampling was used to determine the level of hemerin. Twelve months aft er the patients were admitted to the study and treated according to standard therapy, several indicators were re-recorded.Results: positive correlation associations of hemerin and sedimentation rate of erythrocytes, total cholesterol and negative - with the level of protein in the blood have been established. It was shown that significantly more significant improvement in the clinical manifestations of renal remodeling was observed in patients with a high level of hemerin (≥ 297 pg / ml) 12 months aft er treatment in comparison with the group of patients with lower values of Hemerin (<297 pg / ml) - the hyperhydration Syndrome, the proteinuria of a single and daily portion, total cholesterol, fibrinogen decreased to a greater extent.Conclusion: based on the presented results of statistical analysis, it is possible to judge the severity of clinical manifestations associated in patients with elevated values of hemerin. However, aft er the standard therapy of chronic glomerulonephritis, these patients have better dynamics in stabilizing clinical parameters. It is possible to assume some protective function of hemerin in patients with glomerulonephritis

Quality of colonoscopy in an emerging country: A prospective, multicentre study in Russia

Background: The quality of colonoscopy has been related to a higher risk of interval cancer, and this issue has been addressed extensively in developed countries. The aim of our study was to explore the main quality indicators of colonoscopy in a large emerging country. Methods: Consecutive patients referred for colonoscopy in 14 centres were prospectively included between July and October 2014. Before colonoscopy, several clinical and demographic variables were collected. Main quality indicators (i.e. caecal intubation rate, (advanced) adenoma detection rate, rate of adequate cleansing and sedation) were collected. Data were analysed at per patient and per centre level (only for those with at least 100 cases). Factors associated with caecal intubation rate and adenoma detection rate were explored at multivariate analysis. Results: A total of 8829 (males: 35%; mean age: 57 + 14 years) patients were included, with 11 centres enrolling at least 100 patients. Screening (including non-alarm symptoms) accounted for 59% (5188/8829) of the indications. Sedation and split preparation were used in 26% (2294/8829) and 25% (2187/8829) of the patients. Caecal intubation was achieved in 7616 patients (86%), and it was ≥85% in 8/11 (73%) centres. Adenoma detection rate was 18% (1550/8829), and it was higher than 20% in five (45%) centres, whilst it was lower than 10% in four (33%) centres. At multivariate analysis, age (OR: 1.020, 95% CI: 1.015–1.024), male sex (OR: 1.2, 95% CI: 1.1–1.3), alarm symptoms (OR: 1.8, 95% CI: 1.7–2), split preparation (OR: 1.4, 95% CI: 1.2–1.6), caecal intubation rate (OR: 1.6, 95% CI: 1.3–1.9) and withdrawal time measurement (OR: 1.2, 95% CI: 1.6–2.1) were predictors of a higher adenoma detection rate, while adequate preparation (OR: 3.4: 95% CI: 2.9–3.9) and sedation (OR: 1.3; 95% CI: 1.1–1.6) were the strongest predictors of caecal intubation rate. Conclusions: According to our study, there is a substantial intercentre variability in the main quality indicators. Overall, the caecal intubation rate appears to be acceptable in most centres, whilst the overall level of adenoma detection appears low, with less than half of the centres being higher than 20%. Educational and quality assurance programs, including higher rates of sedation and split regimen of preparation, may be necessary to increase the key quality indicators

Factors affecting the results of analgesic therapy. Results of the Russian multicentre study of NOTE (NSAID: Open-label Trial of Efficacy)

Non-steroidal anti-inflammatory drugs (NSAIDs) are most popular medications for the treatment of pain in common musculoskeletal diseases such as osteoarthritis (OA) and non-specific low back pain (LBP). However, the factors affecting the effectiveness of these drugs have not been determined fully. Aim: to identify factors affecting the effectiveness of NSAIDs in patients with OA and LBP. Materials and methods. An observational study was conducted to evaluate the effectiveness of a 2-week course of NSAIDs in OA and LBP in real clinical practice. The study group consisted of 3604 patients with OA and LBP (60.6% women and 39.4% men, mean age 55.0±13.4 years). According to the study design, aceclofenac (Airtal) and other NSAIDs used in the ratio 1:1. The main criterion of effectiveness was the frequency of complete pain relief after 2 weeks of therapy. In addition, the decrease of pain and general health were determined on a 10-point numerical rating scale (NRS). We compared the frequency of complete pain relief in patients who had and did not have the studied factors. The value of the studied factors was determined using OR (95% CI). Results and discussion. Most patients received aceclofenac (54.9%), as well as diclofenac (2.0%), ketoprofen (1.9%), lornoxicam (2.2%), meloxicam (13.7%), naproxen (2.1%), nimesulide (5.8%), celecoxib (5.9%), ethicoxib (7.1%) and other NSAIDs (4.4%); 56.2% of patients received muscle relaxants, mainly tolperisone (74.7%), vitamin B (10.4%), and proton pump inhibitors (42.8%). Complete pain relief was achieved in 54.8% of patients. The pain decrease and general health improvement were (for NRS) 63.9±13.4% and 61.7±14.8%, respectively. The efficacy of aceclofenac was slightly higher than in the whole group: complete pain relief was in 59.9% of patients. Adverse events in aceclofenac use were observed in 2.3% of patients, other NSAIDs-from 2.4 to 14.1%. The frequency of complete pain relief was higher in men: OR 1,239 (95% CI 1.08-1.418; p=0.002), who had the first episode of pain - OR 3.341 (95% CI 2.873-3.875; p=0.000), a good" response " to NSAIDs in history - OR 1.656 (95% CI 1.385-1.980; p=0.000) and received NSAIDs in combination with muscle relaxants - OR 1.218 (95% CI 1.067-1.390; p=0.004). The effect of therapy is lower in patients 65 years and older-OR 0,378 (95% CI 0.324-0.442; p=0,000), with body mass index >30 kg/m² - OR 0.619 (95% CI 0.529-0.723; p=0.000), with severe pain (≥7 points NRS) - OR 0.662 (95% CI 0.580-0.756; p=0.002), with pain at rest, - OR 0.515 (95% CI 0.450-0,589; p=0.000), pain at night - OR 0.581 (95% CI 0.501-0.672; p=0.000) and the presence of stiffness - OR 0.501 (95% CI 0.438-0,573; p=0.000). Treatment results are significantly worse in the cases of combination of LBP and joint pain, as well as pain in the trochanter major and pes anserinus area (

Влияние аллогеной трансплантации мезенхимальных стволовых клеток жировой ткани на ноцицептивную чувствительность и репаративные процессы при экспериментальной травме ахиллова сухожилия у крыс

On the model of Achilles tendon injury in rats, the antinociceptive and regenerative effect of allogeneic transplantation of various doses of adipose-derived mesenchymal stem cells (ADMSCs) into the lesion area was studied. It was found that netiher of tested regimens of allogeneic transplantation of ADMSCs contributed to a decrease in the edema of the injured limb. Among the studied regimens, only a twofold administration of 0.25 • 106 ADMSCs exhibited an antinociceptive effect. Administration of 0.50 • 106 ADMSCs promoted the accelerated onset of neovascularization of tendon tissue, while enhancing inflammation and the formation of granulation tissue. Double transplantation of 0.25 • 106 ADMSCs led to accelerated reorganization of collagen fibers, later neovascularization, however, there was an absence of inflammatory infiltrate, lipomatosis, and massive formation of granulation tissue in the lesion area.На модели травмы ахиллова сухожилия у крыс изучен антиноцицептивный и регенеративный эффект аллогенной трансплантации различных доз мезенхимальных стволовых клеток жировой ткани (МСК ЖТ) в область повреждения. Установлено, что аллогенная трансплантация МСК ЖТ ни в одном из тестируемых режимов не способствовала уменьшению величины отека травмированной конечности. Среди исследуемых режимов только двукратное введение 0,25 • 106 МСК ЖТ оказывало антиноцицептивное действие. Введение 0,50 • 106 МСК ЖТ способствовало ускоренному началу неоваскуляризации ткани сухожилия, одновременно усугубляя воспаление и образование грануляционной ткани. Двукратная трансплантация 0,25 • 106 МСК ЖТ приводила к ускорению реорганизации коллагеновых волокон, более поздней неоваскуляризации, однако наблюдалось отсутствие воспалительного инфильтрата, липоматоза и массивного образования грануляционной ткани в области травмы

Ревматоидный артрит в реальной клинической практике. Результаты проекта «Компьютерные терминалы самооценки для пациентов с ревматическими заболеваниями» («ТЕРМИНАЛ-I»)

Objective: to describe the portrait of a patient with rheumatoid arthritis (RA) in real clinical practice, to assess disease activity from the point of view of a physician and a patient, functional status, quality of life (QOL), and the efficiency of the therapy performed.Patients and methods. The investigation enrolled 976 RA patients from a cohort of patients in the TERMINAL-I multicenter study, who, when visiting a rheumatologist, independently assessed the disease activity and QOL using a computer system (the «Computer Terminals of SelfAssessment for Patients with Rheumatic Diseases» project). The mean age of the patients was 52.30±13.3 years; women accounted for 85%; the median disease duration 8.0 [4.0; 14.0] years. Baseline clinical parameters and pharmacotherapy were evaluated for 6 months. The disease activity was determined by the DAS28 and RAPID-3 indices; functional status and quality of life were evaluated by the HAQ and the EQ-5D, respectively.Results. 83% of the RA patients were positive for rheumatoid factor and 60% were for anti-cyclic citrullinated peptide antibodies. There was a preponderance of patients with high (40.5%) and moderate (46.8%) RA activity; 6.9% were observed to have a low activity; 5.8% had clinical remission. The mean values of DAS28 and RAPID-3 were 4.7±1.3 and 13.7±3.6, respectively. Only 14.3% of patients had a good functional status that was comparable with the population-based control (HAQ≤0.5). The remaining patients were found to have a substantial decrease in joint functional parameters (median HAQ 1.88 [1.0; 2.5]) and EQ-5D QOL (0.60 [0.60; 0.74). Prosthetic joints were present in 7.4% of patients. At visit 1 to a rheumatologist, the therapy was changed in 15% of patients. During 6-month follow-up, conventional disease-modifying anti-rheumatic drugs were taken by almost all (91.2%) patients. Of them, 70.9% of the patients were treated with methotrexate (MTX): 77.0% received the latter at a dose of 15 mg/week and 23.0% had it at a dose of >15 mg (17.5 to 40 mg/week). Glucocorticoids could be stopped in 20.5% of the patients within six months. Tumor necrosis factor-α inhibitors and anti-B-cell therapy were used in 6.6 and 16.2% of patients, respectively. At 6-month follow-up (Visit 2), 54% of patients achieved a 20% clinical improvement in the ACR criteria. At the same time, the DAS28 scores decreased substantially from 4.5±1.2 to 3.8±1.1 (p = 0.0001). There was a minimal functional improvement in the HAQ index in 64% of patients and a better EQ-D QOL scores in 16%.Conclusion. The majority of RA patients who came to the rheumatologists showed high to moderate disease activity. This was due to long disease duration, inadequate MTX dose, and insufficient patient monitoring in real clinical practice. Introduction of a computer system for selfassessment of their health status by RA patients in an outpatient setting could improve the interaction of physicians, nurses, and patients, better monitor disease activity, and enhance therapeutic efficiency. Цель исследования – описание «портрета» пациента с ревматоидным артритом (РА) в реальной клинической практике, оценка активности заболевания с точки зрения врача и пациента, функционального состояния, качества жизни (КЖ) и эффективности проводимой терапии.Пациенты и методы. В исследование включено 976 пациентов с РА из когорты больных, входящих в многоцентровое исследование «ТЕРМИНАЛ-I», которые при обращении к ревматологу самостоятельно оценивали активность заболевания и КЖ с помощью компьютерной системы (проект «Компьютерные терминалы самооценки для пациентов с ревматическими заболеваниями»). Средний возраст пациентов составил 52,30±13,3 года, 85% – женщины, медиана длительности заболевания – 8,0 [4,0; 14,0] лет. Проводилась оценка базовых клинических параметров и фармакотерапии в течение 6 мес. Активность заболевания определялась по индексам DAS28 и RAPID-3, функциональный статус – по индексу HAQ, качество жизни – по EQ-5D.Результаты. 83% больных РА были позитивными по ревматоидному фактору и 60% – по антителам к циклическому цитруллинированному пептиду. Преобладали пациенты с высокой (40,5%) и умеренной (46,8%) активностью РА, у 6,9% отмечалась низкая активность, у 5,8% –клиническая ремиссия. Среднее значение индекса DAS28 составило 4,7±1,3, RAPID-3 – 13,7±3,6. Только 14,3% пациентов имели хорошее функциональное состояние, сравнимое с популяционным контролем (HAQ ≤0,5). У остальных больных отмечалось значительное снижение показателей функции суставов (медиана HAQ 1,88 [1,0; 2,5]) и КЖ по индексу EQ-5D (0,60 [0,60; 0,74]). Протезированные суставы имели 7,4% больных. При 1-м визите к ревматологу терапия была изменена у 15% пациентов. В течение 6 мес наблюдения практически все пациенты (91,2%) получали стандартные базисные противовоспалительные препараты. Из них 70,9% пациентов находились на терапии метотрексатом (МТ): 77,0% получали его в дозе 15 мг/нед и 23,0% – >15 мг (от 17,5 до 40 мг/нед). 20,5% пациентам в течение полугода удалось отменить глюкокортикоиды. Ингибиторы фактора некроза опухоли α использовали 6,6% больных, анти-В-клеточную терапию – 16,2%. После 6 мес наблюдения (2-й визит к врачу) 20% клиническое улучшение по критериям ACR достигнуто у 54% больных. При этом отмечалось значительное снижение индекса DAS28 (с 4,5±1,2 до 3,8±1,1 балла; p=0,0001). Минимальное функциональное улучшение по индексу HAQ зафиксировано у 64% пациентов, улучшение КЖ по EQ-5D – у 16%.Выводы. Высокая и умеренная активность заболевания, снижение показателей КЖ были характерны для большинства пациентов с РА, обратившихся к ревматологу. Это было связано с большой длительностью заболевания, неадекватной дозой МТ и недостаточным мониторингом пациентов в реальной клинической практике. Введение компьютерной системы самооценки состояния здоровья пациентов с РА на поликлиническом уровне позволило улучшить взаимодействие врачей, медицинских сестер и пациентов, более качественно контролировать активность заболевания и повысить эффективность терапии.

ЭКСПРЕССИЯ РАКОВО-ТЕСТИКУЛЯРНЫХ ГЕНОВ PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 У БОЛЬНЫХ МНОЖЕСТВЕННОЙ МИЕЛОМОЙ, ИХ ВЛИЯНИЕ НА ПОКАЗАТЕЛИ ОБЩЕЙ ВЫЖИВАЕМОСТИ И СКОРОСТЬ ВОЗНИКНОВЕНИЯ РЕЦИДИВА

Objective: to study the prognostic significance of the expression of cancer-testis (CT) genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 in patients with multiple myeloma (MM) and their influence on overall survival and relapse rate. To determine their effect on suсh clinical parameters as levels of lactate dehydrogenase, leucocytes, hemoglobin, calcium, albumen, creatinine, beta-2-microglobulin.Materials and methods. Real-time polymerase chain reaction was performed on complementary DNA obtained from bone marrow of 77 patients with MM. The statistical analysis was performed using the Statistica 10.0 software package. To estimate prognostic values of the CT gene expression data were analyzed by the Kaplan – Meier method.Results. The study was conducted to determine the level of expression of CT genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 in a group of patients with MM. The group included primary and receiving cancer treatment in MM patients. According to the log-rank criterion expression of any of the CT genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 exerts a significant influence on overall survival and progression-free survival/relapse. It was also determined that providing expression of some CT genes, the levels of creatinine, calcium, beta-2-microglobulin were much higher to compare with patients without expression.Цель исследования – изучить прогностическое значение экспрессии раково-тестикулярных генов (РТГ) PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 у больных множественной миеломой (ММ) и их влияние на показатели общей выживаемости и скорость возникновения рецидивов, определить их влияние на такие клинические показатели, как уровни лактатдегидрогеназы, лейкоцитов, гемоглобина, кальция, альбумина, креатинина и бета-2-микроглобулина.Материалы и методы. Количественную полимеразную цепную реакцию в реальном времени проводили на комплементарной ДНК, полученной из образцов костного мозга 77 больных с установленным диагнозом ММ. Статистический анализ выполняли с помощью программного пакета Statistica 10.0. Для построения кривых общей выживаемости использовали метод Каплана–Майера.Результаты. Проведено исследование для определения уровня экспрессии РТГ PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 в группе больных ММ. В группу вошли как первичные пациенты, так и получающие лекарственную противоопухолевую терапию при ММ. Согласно log-rank-тесту существенное влияние на показатели общей выживаемости и выживаемости без прогрессирования/рецидива заболевания оказывает экспрессия любого из РТГ NY-ESO1, MAGE A6, MAGE A12, SSX11, PASD1. Также определено, что при экспрессии некоторых РТГ уровни креатинина, кальция и бета-2-микроглобулина были на порядок выше, чем у больных без экспрессии