Experience in the use of docosahexaenoic acid (BrudiPlus) in patients with increased sperm DNA fragmentation index in Acad. V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology

Male factor is the reason of infertility in almost half of marriages. Infertile men have the percentage of sperm with violations of DNA integrity of over 30 %; with that, healthy fertile men have that indicator of less than 15 %. Understanding of importance of damages of sperm DNA is growing with distribution ofauxiliary reproductive technologies. As of today, these consequences have not been studies yet, and the therapeutic effect of intake of antioxidants has not direct correlation with the sperm DNA fragmentation level. Docosahexaenoic acid is one of the most valuable omega-3 polyunsaturated fatty acids for human health. Docosahexaenoic acid is the main component of the brain gray matter, retina, testes, and sperm cell membranes. In connection with that, a study was held the purpose of which was to assess the effect of the nutraceutical enzymatic docosahexaenoic acid triglyceride (BrudiPlus) in high concentrations on damaged sperm DNA of patients with idiopathic pathozoospermia. 40 patients with idiopathic pathozoospermia and the level of DNA fragmentation over the statutory value took part in this study. The following positive results were received: intake of BrudiPlus allowed decreasing sperm DNA damages and improving of antioxidant system of sperm

The algorithm for generation of structured grids in deformed volumes of revolution

For the volume of revolution deformed by another volume of revolution, a grid generation algorithm is suggested. The algorithm is designed for multimaterial hydrodynamic simulation and for solving other physical and engineering problems. The algorithm represents the non-stationary procedure generating three-dimensional structured grids in domains with moving boundaries. The algorithm is developed within the variational approach for constructing optimal curvilinear grids. The volume of revolution is obtained by the rotation about the axis through 180° of a plane generatrix curve consisting of straight line segments and arcs of circles. The non-stationary algorithm is the iterative process at each stage of which the deformation of a grid and then its optimization are carried out. The deformation of a grid is implemented within the geometrical approach, and the optimization of a grid within the variational approach. Iterations are continued until the necessary deformation is reached. The algorithm is realized in the computer code written in C++. © Published under licence by IOP Publishing Ltd

Retrobulbar blockade during eyeball enucleation surgery in children with retinoblastoma

Retinoblastoma (RB) is a malignant tumor of the embryonic nerve retina.Purpose. To determine the effectiveness of retrobulbar blockade (RbB) with ropivacaine 0.5% for intra- and postoperative analgesia, as well as for the prevention of oculocardial reflex (OCR), postoperative nausea and vomiting (PONV) during enucleation.Material and methods. A prospective randomized controlled clinical trial was performed. Eighty patients aged 0 to 10 years were included, who were randomly assigned to the RbB group (retrobulbar blockade with ropivacaine 0.5% with general anesthesia) (n=40) and the GA control group (general anesthesia) (n=40).Results. There were no complications in the RbB group caused by the methodology. In the intraoperative period, the average dose of fentanyl in the RbB group was 4.7±0.7 μg/kg, which is significantly lower than in the OA group of 10.1±1.9 μg/kg (p<0.05). OCR in the RbB group was observed in 5% of cases versus 100% in the GA group (p=0.002). The average VAS score was 1.8 vs. 3.7 60 minutes after surgery (p<0.001). For the first time 12 hours after surgery, PONV was not observed in the RBB group, and in the control group it was observed in 45% of patients.Conclusion. The study revealed that intraoperative retrobulbar blockade with 0.5% ropivacaine solution in children with RB is effective and safe. Provides stable intraoperative hemodynamics and reduces the need for opioids. Promotes the prevention of OCD and PONV, as well as the improvement of postoperative analgesia during the operation of enucleation of the eyeball i n pediatric

Экстракорпоральная детоксикация при абдоминальном сепсисе у онкологических больных

The purpose is to evaluate the detoxification effects of the polymyxin sorption columns and filtration detoxification using polymethyl methacrylate membranes in abdominal sepsis in cancer patients.Materials and Methods. We examined 226 patients with oncological diseases of abdominal organs complicated by abdominal sepsis postsurgery. In 50 cases, septic shock was reported. In 173 patients an acute renal injury (ARI) was diagnosed in the structure of organ failures, of which a combination with acute respiratory distress syndrome (ARDS) was diagnosed in 61 patients. The severity was 26.3±3.3 points (APACHE-II scale), 10.2±2.5 points (SOFA scale), and 4.3±1.8 points (qSOFA scale). Microbiological identification was obtained in 155 (68.6%) cases. The polymyxin column sorption was used in 86 patients 2–6 hours after sepsis was diagnosed with the EAA greater than 0.5. The blood flow rate was 80–150 mL/min; the duration was 120–240 min; the sorption frequency was 2–3 sessions at a 24-hour interval. If ARI and ARDS were developed, detoxification by filtration using a dialyzer with a BK-1.6F polymethylmethacrylate membrane was included in the complex treatment of 144 patients. The detoxification was carried out for 8–12 hours changing the dialyzer every 4 hours.Results. A statistically significant decreases of hyperthermia, leukocytosis, neutrophilia, procalcitonin, and the EAA test values were revealed after the completion of the sorption treatment. Normalization of hemodynamic parameters, increase of the oxygenation index, and SOFA scoring decrease by 5.6±2.1 points (P<0.05) were found. PCT and IL-6 blood levels decreased from 6.7±2.7 ng/mL to 2.3±0.6 ng/mL and from 7300±7700 pg/mL to 860±180 pg/mL, respectively, as determined 60 minutes after completion of filtration detoxification procedure (P<0.05). The SOFA index decreased by 4.1±1.1 points (P<0.05).Conclusion. The use of polymyxin column sorption and filtration detoxification using a polymethyl metacrylate membrane improves the results of treatment of abdominal sepsis in cancer patients.Цель исследования – оценить детоксикационные эффекты использования колонок с полимиксиновым сорбентом и фильтрационной детоксикации с использованием мембраны из полиметилметакрилата при абдоминальном сепсисе у онкологических больных.Материал и методы. Обследовали 226 больных онкологическими заболеваниями органов брюшной полости, послеоперационный период у которых осложнился абдоминальным сепсисом. В 50-и случаях регистрировали развитие септического шока. У 173-х больных в структуре органных нарушений диагностировали острое почечное повреждение (ОПП), у 61-го – в сочетании с острым респираторным дистресс синдромом (ОРДС). Тяжесть состояния по шкале APACHE-II была 26,3±3,3 балла, SOFA – 10,2±2,5 баллов, qSOFA – 4,3±1,8 балла. Микробиологическую идентификацию получили в 155-и (68,6%) случаях. Полимиксиновую сорбцию применили у 86-и больных через 2–6 часов после диагностики сепсиса при ЕАА выше 0,5. Скорость кровотока — 80–150 мл/мин, длительность – 120–240 мин, кратность — 2–3 сеанса с интервалом 24 часа. При развитии ОПП и ОРДС 144-м больным в комплекс лечения включали фильтрационную детоксикацию с использованием диализатора с мембраной из полиметилметакрилата. Детоксикацию проводили в течение 8 – 12 часов со сменой диализатора каждые 4 часа.Результаты. После завершения сорбционного лечения отметили статистически значимое снижение гипертермии, лейкоцитоза, нейтрофилеза, прокальцитонина, показателей ЕАА-теста. Регистрировали нормализацию гемодинамики, увеличение индекса оксигенации, снижение SOFA на 5,6±2,1 баллов (p<0,05). Через 60 минут после завершения фильтрационной детоксикации РСT и IL-6 в крови снизились от 6,7±2,7 нг/мл до 2,3±0,6 нг/мл и от 7300±7700 пг/мл до 860±180 пг/мл соответственно (p<0,05). Индекс SOFA уменьшился на 4,1±1,1 балла (p<0,05).Заключение. Применение полимиксиновой сорбциии и фильтрационной детоксикации с использованием мембраны из полиметилметакрилата способствует улучшению результатов лечения абдоминального сепсиса у онкологических больных.

Efficiency of “Neo inulin” in the complex treatment of patients with type 2 diabetes

Diabetes mellitus is one of the most serious medical, social, and economic health problems in all countries of the world. The incidence of diabetes mellitus in the world doubles every 10–15 years, acquiring the character of a non-infectious epidemic. Therefore, it is extremely important to search for new drugs that help normalize glycemia, prevent complications of diabetes mellitus, and improve the quality of life of patients. These drugs include “Neo inulin”, which has a hypoglycemic, antioxidant, hepatoprotective and angioprotective effect.The aim: to evaluate the effectiveness of “Neo inulin” in the complex treatment of patients with type 2 diabetes mellitus.Materials and methods. The study involved 18 women (average age – 64.5 ± 8.7 years, average weight – 77.8 ± 11.4 kg) and 3 men (average age – 54.6 ± 12.4 years, average weight – 114 ± 40.2 kg). The average duration of type 2 diabetes was 11.0 (7.0–12.0) years. “Neo inulin” was prescribed as 2 capsules per day for 12 weeks in the complex of basic diabetes therapy To assess the effectiveness of therapy, a study of the quality of life related to health, a biochemical blood test (glycated hemoglobin), a clinical minimum (CBC, OAM, ECG, blood glucose) was carried out, the functional characteristics of tissue blood flow were investigated, and the ankle-brachial index (ABI) was determined. Statistical processing of the results was carried out using the Statistica 6.0 software package (StatSoft Inc., USA). Differences were considered statistically significant at p < 0.05.Results. Statistically significant differences were revealed in the values of all scales of health-related quality of life in patients in the groups before and after treatment with “Neo Inulin”, including the total physical and mental components. An improvement in the functioning of microcirculatory regulation mechanisms was noted, which is confirmed by a statistically significant increase in ABI (1.0 and 0.8 on the right; 0.9 and 0.8 on the left, respectively; p < 0.05) and the coefficient of microcirculation variation (9.2 and 8.3, respectively; p < 0.05). In 57,1 % of cases (12 people), the level of glycated hemoglobin was normalized.Conclusion. The use of a treatment regimen that includes “Neo Inulin” improves the effectiveness of treatment and improves the quality of life of patients with type 2 diabetes mellitus

Risk factors of adverse outcome of COVID-19 and experience of Tocilizumab administration in patients on maintenance hemodialysis due to diabetic kidney disease

BACKGROUND: Patients with Type 2 Diabetes (T2DM) and patients on maintenance hemodialysis (MHD) are at a high risk of adverse clinical course of COVID-19. To date, the causes of high mortality in these groups are not fully understood. Data about peculiarity of clinical course and Tocilizumab (TCZ) administration in patients with T2DM receiving MHD due to outcome of diabetic kidney disease (DKD) are not yet highlighted in current publications.AIMS: Identification of risk factors (RF) of adverse COVID-19 outcome and evaluation of TCZ administration in patients with T2DM receiving MHD due to DKD.MATERIALS AND METHODS: The patients treated in Moscow City Hospital No52 were included in retrospective observational study. The observation period was from 04.15 to 07.30 2020. The study endpoints were the outcomes of hospitalization — discharge or lethal outcome. Data were collected from electronic medical database. The following independent variables were analysed: gender, age, body mass index, time from the onset of symptoms to hospital admission, cardiovascular and general comorbidity (Charlson Index, CCI), cardiovascular event (CVE) during hospitalization, treatment in ICU, mechanical ventilation (MV), degree of lung damage according to CT data, level of prandial glycemia at admission, MHDassociated parameters (vintage, type of vascular access, frequency of complications). The autopsy reports were evaluated for the purpose of lethal structure investigation. In a subgroup treated TCZ the time from symptoms onset to TCZ administration and number of laboratory indicators were evaluated.RESULTS: 53 patients were included, mean age 68 ±9 y, males — 49%. General mortality in observation cohort was 45%, mortality in ICU — 81%, mortality on MV — 95%. High cardiovascular and general comorbidity was revealed (mean CCI — 8,3 ±1,5 points). The causes of outcomes according to autopsy reports data: CVE 37,5% (among them — acute myocardial infarction during hospitalization), severe respiratory failure — 62,5%. The independent predictors of lethal outcome were: MV (OR 106; 95% CI 11,5–984; р <0,001), 3-4 degree of lung damage according to CT data (ОR 6,2; 95% CI 1,803–21,449; р = 0,005), CVE during hospitalization (ОR 18,9; 95% CI 3,631–98,383; р <0,001); CCI ≥10 points (ОR 4,33; 95% CI 1,001–18,767; р = 0,043), level of prandial glycemia at admission ≥10 mmol/l (ОR 10,4; 95% CI 2,726–39,802; р <0,001). For risk identification of upcoming lethal outcome a predictive model was created with the use of discovered RF as variables. The predictive value of this model is 92,45% (positive prognostic value — 96,5%, negative prognostic value — 87,5%).In TCZ treated subgroup the laboratory markers of adverse outcome were detected with application of correlation analysis. Among them: increasing level of CPR 24-48 hours before lethal outcome (r = 0,82), the reduction of lymphocytes count after TCZ administration (r = -0,49), increasing of leukocytes and further reduction of lymphocytes count 24-48 hours before lethal outcome (r = 0,55 и r = -0,52, resp.)).CONCLUSIONS: The number of RF of adverse COVID-19 outcome in patients with T2DM receiving MHD due to DKD are identified. CVE is one of the leading causes of mortality in study cohort. According to our experience the preventive (instead of rescue) strategy of TCZ administration should be used

Синтез глицерофосфолипидов с полимериизуемыми группами для формирования стабильных наночастиц.

Synthesis of 1,2-di-(11,13-tetradecadienoyl)-sn-glycero-3-phosphocholine and 1,2-di- (2,4-hexadienoyl)-sn-glycero-3-phosphocholine, containing terminal polymerizable diene groups has been carried out. It is supposed that using of synthesized phosphorlipids mixtures followed by their polymerization will lead to formation of stable nanoparticles – bicelles, which will be capable to exist in a wide range of concentration of mixed components and resistant to organic solvents action.Осуществлен синтез 1,2-ди-(11,13-тетрадекадиеноил)-sn-глицеро-3-фосфохолина и 1,2- ди-(2,4-гексадиеноил)-sn-глицеро-3-фосфохолина, содержащих полимеризуемые диеновые группировки на концах жирнокислотных цепей. Предполагается, что использование смесей синтезированных фосфолипидов с последующей их полимеризацией приведёт к форми-рованию стабильных наночастиц – бицелл, способных существовать в широком диапазоне концентраций смешиваемых компонентов и устойчивых к действию органических растворителей

Синтез и свойства амфифильных мезо-арилзамещенных порфиринов

Synthesis of amphiphilic meso-arylsubstituted porphyrins with hydrophobic long chain groups and with terminal carboxylic and hydroxylic groups via dipyrrolylmethanes and with the use of monopyrrolic condensation is described. The synthesized porphyrins will allow studying the influence of fragments of amphiphilic structures of porphyrins on self-aggregation of porphyrins in micellar and bilayer model membrane systemsОсуществлен синтез амфифильных мезо-арилзамещенных порфиринов, содержащих длинноцепные гидрофобные заместители с терминальными карбоксильными и гидроксильными группами, через дипирролилметаны и с использованием монопиррольной конденсации. Синтезированные соединения позволят изучить влияние фрагментов амфифильной структуры порфиринов на самоагрегацию порфиринов в мицеллярных и бислойных модельных мембранных системах

Электрохимическое легирование кислороддефицитных оксидов YBa2Cu3O7-x и PrBaCuFeO5+x серой

Sulfur as a heteroadditive has been incorporated into oxygen-deficient YBa2Cu307-x and PrBaCuFeO5+x perovskites (ODP) using sulfur-ion-conducting solid electrolytes (CaPr2S4 and BaSm2S4). Composition of ODPs doped by sulfur was monitored by measuring electrical conductivity in combination with EMF method. The mechanism of sulfur incorporation into crystal lattice of nonstoichiometric layered YBa2Cu307-x and PrBaCuFeO5+x ODP has been proposed. Partial molar dissolution values of sulfur trace amounts in PrBaCuFeO5+x have been calculated.Проведено электрохимическое введение гетеропримеси - серы - в кислороддефицитные перовскиты (КДП) YBa2Cu3O7-x и PrBaCuFeO5+x с помощью сульфидионпроводящих твердых электролитов (CaPr2S4 и BaSm2S4). Контроль за составом легированных серой КДП осуществляли методом электропроводности в сочетании с методом ЭДС. Предложен механизм встраивания серы в кристаллическую решетку нестехиометрических слоистых КДП YBa2Cu3O7-x и PrBaCuFeO5+x. Рассчитаны парциальные молярные величины растворения микроколичеств серы в PrBaCuFeO5+

НОВЫЕ ГОРИЗОНТЫ ФИЛОСОФИИ ОБРАЗОВАНИЯ В АНАЛИЗЕ ПРОБЛЕМ УПРАВЛЕНИЯ ОБРАЗОВАНИЕМ В УСЛОВИЯХ ГЛОБАЛИЗИРУЮЩЕГОСЯ МИРА

The article explores theory and methodology of certain achievements and possible prospects of national education philosophy de-velopment on the issues of education policy and education management at the national and global levels of public organiza-tion in the context of accelerating the processes of globalization in the 21st century. The basis of conceptual approach to problem solving is the ideas of the noosphere developed by V. I. Vernadsky, which allow defining the strategies of modern educational policy, as well as the specifics of social management of noospheric education at the state and international levels at the be-ginning of the XXI century.В статье осуществлен теоретико-методологический анализ определенных достижений и возможных перспектив развития отечественной философии образования по вопросам образовательной политики и управления образованием на государственном и глобальном уровнях общественной организации в условиях ускорения процессов глобализации в XXI в. Основу концептуального подхода к решению проблем составляют идеи ноосферы В. И. Вернадского, позволяющие определить стратегии современной образовательной политики, а также специфику социального управления ноосферным образованием на государственном и международном уровнях в начале XXI в