Dynamics of cell population structure in liver biopsy of the patients with chronic hepatitis viral infection

The cell population analysis of liver biopsies from the patients with both chronic hepatitis, chronic viral hepatitis C (HCV) and chronic viral hepatitis B (HBV) included the comparative evaluation of the specific part of non-parenchymal elements, analysis of the liver plates and sinusoids areas, the cell population of liver plates and sinusoids, the caryometric description of different types of cells. The essential difference of similar quantitative indexes in the biopsy specimens of patients with HCV and НВV was revealed and discussed. In total, the quantitative analysis of cell population structure in liver biopsies during the course of chronic hepatitis, especially in the case of defective biopsies, could be used for diagnostics and prognoses by expert evaluation

Диагностические и прогностические лабораторные критерии развития сепсиса при гнойно-воспалительных заболеваниях мягких тканей

Objective. Identification of laboratory parameters that are used in routine practice and can serve as diagnostic and prognostic criteria for the development of sepsis and its outcomes in patients with purulent-inflammatory diseases of soft tissues.Materials and methods. The study included 48 patients with purulent-inflammatory diseases of soft tissues. Recorded the occurrence of such clinical events as the development of sepsis or septic shock, intensive therapy, death or recovery and discharge from the hospital. For the diagnosis of sepsis, a SOFA (Sepsis-related organ failure assessment score) ³ 2 points was used. Patients were divided into subgroups according to the number of points according to the SOFA scale, intensive care and depending on the outcome of the disease: Subgroup 1 – 26 patients with sepsis (SOFA ³ 2 points) and 22 patients with systemic inflammatory response syndrome (SIRS) and SOFA <2 points; 2nd subgroup – 12 people who underwent intensive therapy and 36 people without it; 3rd subgroup – 7 patients with a fatal outcome and 41 patients with a favorable outcome.Results. In patients with sepsis, albumin concentration was 24,07 g / l in median versus 34,65 g / l in the control group of patients with SOFA <2 points (p <0,01); glucose -7,82 mmol / l and 5,15 mmol / l (p <0,01); sodium concentration of 133 mmol / li 139 mmol / l (p <0,01). The values of the international normalized ratio (INR) amounted to a median of 1,29 and 1,04 (p <0,01); activated partial thromboplastin time -36,20 seconds and 31,50 seconds (p <0,01). In the subgroup of patients for whom intensive therapy was required, the concentration of albumin was 22,34 g / l by median versus 30,10 g / l (p <0,01); urea – 15,50 mmol / l versus 6,00 mmol / l (p <0,05), glucose – 9,61 mmol / l against 5,80 mmol / l (p <0,05), lactate dehydrogenase-644,00 U / l and 426,00 U / l (p <0,05); INR – 1,35 against 1,05 (p <0,05). The aver-age total protein concentration is 47,80 g / l versus 57,90 g / l (p <0,01). The average albumin is 22,34 g / l versus 28,50 g / l (p <0,05). The glucose concentration among patients with a fatal outcome was 12,00 mmol / l in median versus 5,95 mmol / l (p <0,01); urea – 23,22 mmol / l versus 6,00 mmol / l (p <0,01). The incidence of lethal disease was statistically significantly higher in patients with a total protein level of less than 52 g / l 5,96 times (RR = 5,96, 95% CI 1,32 – 26,89), glucose more than 11 mmol / l – 7,00 times (OR = 7,00, 95% CI 1,25 – 39,15), urea more than 20 mmol / l – 7,05 times (RR = 7,05, 95% CI 2,00 – 24,85).Conclusion. Routine laboratory indicators as the level of total protein, albumin, glucose, sodium and urea, as well as indicators of the blood coagulation system (INR and APTT), can serve as diagnostic and prognostic criteria for the development of sepsis and its outcomes in patients with purulentinflammatory diseases. soft tissue.Цель: выявление лабораторных показателей, которые используются в рутинной практике и могут служить диагностическими и прогностическими критериями развития сепсиса и его исходов у пациентов с гнойно-воспалительными заболеваниями мягких тканей.Материалы и методы. В исследование включено 48 пациентов с гнойно-воспалительными заболеваниями мягких тканей. Проводили учет наступления таких клинических событий, как развитие сепсиса или септического шока, проведение интенсивной терапии, летальный исход или выздоровление и выписка из стационара. Для постановки диагноза «сепсис» применяли шкалу SOFA (Sepsis-related organ failure assessment score) ³ 2 баллов. Пациенты были распределены в подгруппы по количеству баллов по шкале SOFA, проведения интенсивной терапии и в зависимости от исхода заболевания: 1-я подгруппа – 26 больных сепсисом (SOFA ³ 2 баллов) и 22 пациента с синдромом системного воспалительного ответа (ССВР) и SOFA < 2 баллов; 2-я подгруппа – 12 человек, которым проводилась интенсивная терапия, и 36 человек без нее; 3-я подгруппа – 7 больных с летальным исходом и 41 пациент с благоприятным исходом.Результаты. У пациентов с сепсисом концентрация альбумина составила по медиане 24,07 г/л против 34,65 г/л в контрольной группе больных с SOFA < 2 баллов (p< 0,01); глюкозы – 7,82 ммоль/л и 5,15 ммоль/л (p< 0,01); концентрация натрия 133 ммоль/л и 139 ммоль/л (p< 0,01). Значения международного нормализованного отношения (МНО) составили по медиане 1,29 и1,04 (p< 0,01); активированного частичного тромбопластинового времени – 36,20 с и 31,50 с (p< 0,01). В подгруппе пациентов, которым потребовалось проведение интенсивной терапии, концентрации альбумина составили по медиане 22,34 г/л против 30,10 г/л (p< 0,01); мочевины – 15,50 ммоль/л против 6,00 ммоль/л (p< 0,05), глюкозы– 9,61 ммоль/лпротив 5,80 ммоль/л(p< 0,05), лактатдегидрогеназы – 644,00 Ед/л и 426,00 Ед/л (p< 0,05); МНО – 1,35 против 1,05 (p< 0,05). Средняя концентрация общего белка – 47,80 г/л против 57,90 г/л (p < 0,01). Средние показатели альбумина – 22,34 г/л против 28,50 г/л (p < 0,05). Концентрация глюкозы среди пациентов с летальным исходом составила по медиане 12,00 ммоль/л против 5,95 ммоль/л (p< 0,01); мочевины – 23,22 ммоль/л против 6,00 ммоль/л (p < 0,01). Частота наступления летального исхода болезни была статистически значимо выше у пациентов с уровнем общего белка менее 52 г/л в 5,96 раз (ОР = 5,96, 95 % ДИ 1,32 – 26,89), глюкозы более 11 ммоль/л – в 7,00 раз (ОР = 7,00, 95 % ДИ 1,25 – 39,15), мочевины более 20 ммоль/л – в 7,05 раз (ОР = 7,05, 95 % ДИ 2,00 – 24,85).Заключение. Такие рутинные лабораторные показатели, как уровень общего белка, альбумина, глюкозы, натрия и мочевины, а также показатели свертывающей системы крови (МНО и АЧТВ) могут служить диагностическими и прогностическими критериями развития сепсиса и его исходов у пациентов с гнойно-воспалительными заболеваниями мягких тканей

IMMUNOHISTOCHEMICAL ANALYSIS OF CASPASE-3 ACTIVITY IN LIVER BIOPSIES OF PATIENTS WITH MONO AND MIXED INFECTIONS

Objective: to study the activity of proapoptotic signal protein caspase-3 for determination of peculiarities of apoptosis regulation under liver chronic diseases.Subjects and methods. The immunohistochemical analysis of caspase-3 activity in 5 liver biopsies of the patients with mono infection of chronic hepatitis B and 5 liver biopsies of the patients with mixed infection of tuberculosis, chronic hepatitis C and human immunodeficiency virus was fulfilled. Morphological and morphometric analysis of serial microphotographs was performed using an image analysis system (microscope Leica DM 2500, digital camera Leica DFC320 R2 and a computer).Results. The activity of caspase-3 as dark brown granularity was revealed in all tis-sue components of liver (hepatocytes, epithelium of bile ducts, endotheliocytes, Kupffer cells of sinusoids, in compositions of lymphohistiocyte infiltrations). The maximal activity was discovered in hepatocytes nuclei. The expression of caspase-3 was significantly higher in liver biopsies of the patients with mixed infection. It is typical that the immunoreactive hepatocytes had not any morphological marks of apoptosis.Conclusion. The caspase-3 expression of proapoptotic signal protein caspase-3 may serve as an early marker of liver damage including the possibilities of apoptosis development.</p

Diagnostic and prognostic laboratory criteria for the development of sepsis in purulent-inflammatory diseases of soft tissues

Objective. Identification of laboratory parameters that are used in routine practice and can serve as diagnostic and prognostic criteria for the development of sepsis and its outcomes in patients with purulent-inflammatory diseases of soft tissues.Materials and methods. The study included 48 patients with purulent-inflammatory diseases of soft tissues. Recorded the occurrence of such clinical events as the development of sepsis or septic shock, intensive therapy, death or recovery and discharge from the hospital. For the diagnosis of sepsis, a SOFA (Sepsis-related organ failure assessment score) ³ 2 points was used. Patients were divided into subgroups according to the number of points according to the SOFA scale, intensive care and depending on the outcome of the disease: Subgroup 1 – 26 patients with sepsis (SOFA ³ 2 points) and 22 patients with systemic inflammatory response syndrome (SIRS) and SOFA &lt;2 points; 2nd subgroup – 12 people who underwent intensive therapy and 36 people without it; 3rd subgroup – 7 patients with a fatal outcome and 41 patients with a favorable outcome.Results. In patients with sepsis, albumin concentration was 24,07 g / l in median versus 34,65 g / l in the control group of patients with SOFA &lt;2 points (p &lt;0,01); glucose -7,82 mmol / l and 5,15 mmol / l (p &lt;0,01); sodium concentration of 133 mmol / li 139 mmol / l (p &lt;0,01). The values of the international normalized ratio (INR) amounted to a median of 1,29 and 1,04 (p &lt;0,01); activated partial thromboplastin time -36,20 seconds and 31,50 seconds (p &lt;0,01). In the subgroup of patients for whom intensive therapy was required, the concentration of albumin was 22,34 g / l by median versus 30,10 g / l (p &lt;0,01); urea – 15,50 mmol / l versus 6,00 mmol / l (p &lt;0,05), glucose – 9,61 mmol / l against 5,80 mmol / l (p &lt;0,05), lactate dehydrogenase-644,00 U / l and 426,00 U / l (p &lt;0,05); INR – 1,35 against 1,05 (p &lt;0,05). The aver-age total protein concentration is 47,80 g / l versus 57,90 g / l (p &lt;0,01). The average albumin is 22,34 g / l versus 28,50 g / l (p &lt;0,05). The glucose concentration among patients with a fatal outcome was 12,00 mmol / l in median versus 5,95 mmol / l (p &lt;0,01); urea – 23,22 mmol / l versus 6,00 mmol / l (p &lt;0,01). The incidence of lethal disease was statistically significantly higher in patients with a total protein level of less than 52 g / l 5,96 times (RR = 5,96, 95% CI 1,32 – 26,89), glucose more than 11 mmol / l – 7,00 times (OR = 7,00, 95% CI 1,25 – 39,15), urea more than 20 mmol / l – 7,05 times (RR = 7,05, 95% CI 2,00 – 24,85).Conclusion. Routine laboratory indicators as the level of total protein, albumin, glucose, sodium and urea, as well as indicators of the blood coagulation system (INR and APTT), can serve as diagnostic and prognostic criteria for the development of sepsis and its outcomes in patients with purulentinflammatory diseases. soft tissue

Devising A Procedure to Calculate and Analyze Parameters for Passing the Flood and Breakthrough Wave Taking Into Consideration the Topographical and Hydraulic Riverbed Irregularities

It has been established that the most likely period of breakthrough wave occurrence is the time of spring flooding or heavy rain when water-head facilities are subjected to significant loads that lead to the collapse of their individual elements or the entire structure. In addition, the possibility of man-made accidents that can occur at any time cannot be ruled out. It has been proven that breakthrough wave formation depends on the nature of the destruction or the overflow through a water-head facility. For the study reported in this paper, a model of the kinematics of riverbed and breakthrough flows was used, which is based on the equations of flow, washout, and transport of sediments that are averaged for the depths of the stream. The differential equations describing the nonstationary flow averaged for depth are solved using the numerical grid system FST2DH (2D Depth-averaged Flow and Sediment Transport Model), which implements a finite-element method on the plan of a riverbed's topographic region. These tools are publicly available, which allows their wide application to specific loads and boundary conditions of mathematical models. The construction of an estimation grid involving the setting of boundary conditions and the use of geoinformation system tools makes it possible to simulate the destruction of a culvert of the pressure circuit and obtain results for a specific case of an actual riverbed and a water-head facility. It has been established that there is a decrease in the speed of wave propagation along the profile, from 3 m/s to 1 m/s. The impact of bottom irregularities, the effect of floodplains, and the variety of bottom roughness have also been assessed, compared to the results of their calculation based on one-dimensional models given in the regulatory documents. Hydraulic calculations were carried out taking into consideration the related properties of the main layer of the floodplain, which consists of peat accumulations, and the heterogeneity of the depths and roughness of floodplain surfaces of soils. It has been established that there is almost no erosion of supports in the floodplain zone in this case. It was found that as the distance between the flow and breakthrough intersection increases, there is a decrease in the height of the head from 2.1 m to 1.25 m