142 research outputs found
WaterβSulfuric Acid foam as a Possible Habitat for Hypothetical Microbial Community in the Cloud Layer of Venus
The data available at the moment suggest that ancient Venus was covered by extensive bodies of water which could harbor life. Later, however, the drastic overheating of the planet made the surface of Venus uninhabitable for Earth-type life forms. Nevertheless, hypothetical Venusian organisms could have gradually adapted to conditions within the cloud layer of Venusβthe only niche containing liquid water where the Earth-type extremophiles could survive. Here we hypothesize that the unified internal volume of a microbial community habitat is represented by the heterophase liquid-gas foam structure of Venusian clouds. Such unity of internal space within foam water volume facilitates microbial cells movements and trophic interactions between microorganisms that creates favorable conditions for the effective development of a true microbial community. The stabilization of a foam heterophase structure can be provided by various surfactants including those synthesized by living cells and products released during cell lysis. Such a foam system could harbor a microbial community of different species of (poly)extremophilic microorganisms that are capable of photo-and chemosynthesis and may be closely integrated into aero-geochemical processes including the processes of high-temperature polymer synthesis on the planetβs surface. Different complex nanostructures transferred to the cloud layers by convection flows could further contribute to the stabilization of heterophase liquid-gas foam structure and participate in chemical and photochemical reactions, thus supporting ecosystem stability. Β© 2021 by the authors. Licensee MDPI, Basel, Switzerland
Generalized Chaotic Synchronizationin Coupled Ginzburg-Landau Equations
Generalized synchronization is analyzed in unidirectionally coupled
oscillatory systems exhibiting spatiotemporal chaotic behavior described by
Ginzburg-Landau equations. Several types of coupling betweenthe systems are
analyzed. The largest spatial Lyapunov exponent is proposed as a new
characteristic of the state of a distributed system, and its calculation is
described for a distributed oscillatory system. Partial generalized
synchronization is introduced as a new type of chaotic synchronization in
spatially nonuniform distributed systems. The physical mechanisms responsible
for the onset of generalized chaotic synchronization in spatially distributed
oscillatory systems are elucidated. It is shown that the onset of generalized
chaotic synchronization is described by a modified Ginzburg-Landau equation
with additional dissipation irrespective of the type of coupling. The effect of
noise on the onset of a generalized synchronization regime in coupled
distributed systems is analyzed.Comment: 12 page
ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠ°ΡΠ³Π΅ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ Π²ΡΠ±ΠΎΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π² Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΠΎΠΉ ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
Renal cancer is one of the most rapidly spreading diseases in the world. As you know, a few years ago, overall survival of patients with metastatic renal cell carcinoma (mRCC) was disappointing: median overall survival rarely exceeded 13 months, while 5-year survival rate was less than 5 %. Immunotherapy with interferon-alpha and interleukins demonstrated low efficiency. Appearance of targeted therapies for the treatment of mRCC significantly increased the duration and quality of life of patients receiving drug treatment. Nowadays due to this methodology and guided by the results of randomized clinical trials we can choose an optimal sequence of therapy and control the disease in three consecutive lines for about 30 months. In this article we would like to share an experience of the use of targeted therapies in the Saint Petersburg City Clinical Oncology Dispensary in patients with clear-cell mRCC.Β Π Π°ΠΊ ΠΏΠΎΡΠΊΠΈ β ΠΎΠ΄Π½ΠΎ ΠΈΠ· Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π°ΠΊΡΠΈΠ²Π½ΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½ΡΡΡΠΈΡ
ΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π² ΠΌΠΈΡΠ΅. ΠΠ°ΠΊ ΠΈΠ·Π²Π΅ΡΡΠ½ΠΎ, Π΅ΡΠ΅ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ Π»Π΅Ρ Π½Π°Π·Π°Π΄ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ (ΠΌΠΠΠ ) ΡΠ°Π·ΠΎΡΠ°ΡΠΎΠ²ΡΠ²Π°Π»ΠΈ: ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΠ΅Π΄ΠΊΠΎ ΠΏΡΠ΅Π²ΡΡΠ°Π»Π° 13 ΠΌΠ΅Ρ, Π° 5-Π»Π΅ΡΠ½ΡΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΡΠΎΡΡΠ°Π²Π»ΡΠ»Π° Π½Π΅ Π±ΠΎΠ»Π΅Π΅ 5 %. ΠΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ Π³ΡΡΠΏΠΏΡ ΠΈΠ½ΡΠ΅ΡΡΠ΅ΡΠΎΠ½ Π°Π»ΡΡΠ° ΠΈ ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΠΉΠΊΠΈΠ½Π°ΠΌΠΈ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»Π° Π½Π΅Π²ΡΡΠΎΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ. ΠΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠ°ΡΠ³Π΅ΡΠ½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΌΠΠΠ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠ²Π΅Π»ΠΈΡΠΈΠ»ΠΎ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠΎΠ»ΡΡΠ°ΡΡΠΈΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅. ΠΠ° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ Π±Π»Π°Π³ΠΎΠ΄Π°ΡΡ Π΄Π°Π½Π½ΠΎΠΉ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ΅ ΠΈ ΡΡΠΊΠΎΠ²ΠΎΠ΄ΡΡΠ²ΡΡΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌΠΈ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΌΡ ΠΌΠΎΠΆΠ΅ΠΌ Π²ΡΠ±ΠΈΡΠ°ΡΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΡ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΠΎΠ²Π°ΡΡ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π² 3 ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΡ
Π»ΠΈΠ½ΠΈΡΡ
Π½Π° ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ ΠΎΠΊΠΎΠ»ΠΎ 30 ΠΌΠ΅Ρ. Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΉ ΡΡΠ°ΡΡΠ΅ ΠΌΡ Ρ
ΠΎΡΠ΅Π»ΠΈ Π±Ρ ΠΏΠΎΠ΄Π΅Π»ΠΈΡΡΡΡ ΠΎΠΏΡΡΠΎΠΌ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ°ΡΠ³Π΅ΡΠ½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² Π² Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³ΡΠΊΠΎΠΌ Π³ΠΎΡΠΎΠ΄ΡΠΊΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎ ΡΠ²Π΅ΡΠ»ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΠΌΠΠΠ .
ΠΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ ΠΏΠ°Π»Π»ΠΈΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ²Π΅ΡΠ»ΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ
Background. Experience with combination treatment, i.e. systemic therapy in combination with palliative surgery, in the treatment of metastaticΒ kidney cancer is very rarely described in world literature.Objective: to evaluate the efficiency of combination treatment in combination with palliative cytoreductive surgery and targeted therapy andΒ to define optimal indications for combination treatment.Subjects and methods. Data on 47 patients with metastatic renal cell carcinoma (mRCC) who received systemic (targeted) therapy in combinationΒ or after incomplete cytoreduction (iCR) were analyzed in this retrospective study. The proportion of men and women was 72.3 % andΒ 27.7 %, respectively; their ratio was 2.6:1. All the patients (100%) underwent surgical treatment as nephrectomy or kidney resection for primaryΒ tumor. In the patients who had received radical treatment in different periods, the median relapse-free survival was 25.3 (0-187) months;Β the mean follow-up duration in the study was 33.2 (27.4β39.0) months. Out of the histological characteristics of a primary tumor, its FuhrmanΒ grade was studied. Prior to initiation of mRCC therapy, Memorial Sloan Kettering Cancer Center (MSKCC) prognosis groups were assessed;Β the patients were divided into good (n = 9 (19.1 %)), interim (n = 28 (59.6 %)), and bad (n = 10 (21.3 %)) prognosis groups. Their totalΒ somatic status was separately rated using the ECOG scale: 0, (n = 10 (21.3%)), 1 (n = 24 (51.1 %)), and 2, (n = 13 (27.6 %)). The sitesΒ of metastases were as follows: the lung (n = 29), bones (n = 18), adrenals (n = 11), recurrence in the removed kidney bed (n = 10), andΒ liver (n = 10). Multiple organ involvements were detected in 22 (46.8 %) patients. There were more than 5 metastases in one organ in 18 (40.0Β %) patients and only 15 (33.3 %) were found to have a single focus in one organ.Β Whether iCR might be used as a separate line treatment was studied. A comparative analysis was made between 2 groups of patients withΒ mRCC: 1) 20 patients who underwent iCR and 2) 27 patients who received systemic therapy (immunotherapy (n = 12), sorafenib (n = 8), andΒ sunitinib (n = 7)). The control points were estimation of overall survival (OS), optimal indications for iCR in patients with mRCC, and timeΒ to progression (TTP) during first- and second-line systemic treatment.Resuts. The median OS duration in Group 1 was longer: 46 months versus 31 months (p = 0.09). TTP was comparable: 9 and 6 months, respectively.Β Comparison of first-line systemic treatment showed that the median TTP was twice longer (13 and 17 months in the targeted (sorafenib andΒ sunitinib) therapy group than that in the cytokine therapy group (6 months) (p = 0.0174). TTP during second-line therapy was 10 months.Β Median OS after immunotherapy, sorafenib and sunitinib therapy demonstrated no differences and was 34.2, 36.5, and 39.2 months (Ρ = 0.8).Β Conclusion. This investigation suggests that the comprehensive approach in effective in treating mRCC. iRC may be used as an individualΒ treatment in a certain patient group. However, survival rates in the examined group of patients can be increased only when targeted drugs areΒ necessarily used in both first- and second-line treatment regimens.Β In spite of the metastatic pattern of RCC, the treatment algorithm for these patients should estimate the possibilities of using palliative cytoreductiveΒ treatment since its use may provide a median TTP of as many as 9 months. Just the same, over 30-month survival rates may be obtainedΒ when the latter is used in combination with systemic treatment.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π ΠΌΠΈΡΠΎΠ²ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ ΠΊΡΠ°ΠΉΠ½Π΅ ΡΠ΅Π΄ΠΊΠΎ ΠΎΠΏΠΈΡΡΠ²Π°Π΅ΡΡΡ ΠΎΠΏΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, Ρ. Π΅. ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈΒ Ρ ΠΏΠ°Π»Π»ΠΈΠ°ΡΠΈΠ²Π½ΡΠΌ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²ΠΎΠΌ, Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΠΏΠΎΡΠΊΠΈ.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠ°Π»Π»ΠΈΠ°ΡΠΈΠ²Π½ΠΎΠΉ ΡΠΈΡΠΎΡΠ΅Π΄ΡΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Ρ ΡΠ°ΡΠ³Π΅ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ Π΄Π»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ 47 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°Ρ
Ρ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ (ΠΌΠΠΠ ), ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΡ (ΡΠ°ΡΠ³Π΅ΡΠ½ΡΡ) ΡΠ΅ΡΠ°ΠΏΠΈΡ Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ ΠΈΠ»ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π½Π΅ΠΏΠΎΠ»Π½ΠΎΠΉΒ ΡΠΈΡΠΎΡΠ΅Π΄ΡΠΊΡΠΈΠΈ (Π½Π¦Π ). ΠΠΎΠ»Ρ ΠΌΡΠΆΡΠΈΠ½ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 72,3 %, ΠΆΠ΅Π½ΡΠΈΠ½ β 27,7 %, ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ 2,6:1. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ (100 %) Π±ΡΠ»ΠΎΒ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Π² Π²ΠΈΠ΄Π΅ Π½Π΅ΡΡΡΠΊΡΠΎΠΌΠΈΠΈ ΠΈΠ»ΠΈ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΈ ΠΏΠΎΡΠΊΠΈ. ΠΠ΅Π΄ΠΈΠ°Π½Π° Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΠΎΠ³ΠΎΒ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° Π² Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠΎΠ΄Π²Π΅ΡΠ³ΡΠΈΡ
ΡΡ Π² ΡΠ°Π·Π»ΠΈΡΠ½ΡΠ΅ ΡΡΠΎΠΊΠΈ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΌΡ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 25,3 (0β187) ΠΌΠ΅Ρ;Β ΡΡΠ΅Π΄Π½ΠΈΠΉ ΡΡΠΎΠΊ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ β 33,2 (27,4β39,0) ΠΌΠ΅Ρ. ΠΠ· Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΈΠ·ΡΡΠ°Π»Π°ΡΡΒ ΡΡΠ΅ΠΏΠ΅Π½Ρ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΠΈ ΠΏΠΎ Π€ΡΡΠΌΠ°Π½Ρ. ΠΠ΅ΡΠ΅Π΄ Π½Π°ΡΠ°Π»ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΌΠΠΠ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΎΡΠ΅Π½ΠΊΡ Π³ΡΡΠΏΠΏ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΠΏΠΎ ΡΠΊΠ°Π»Π΅ MSKCC (MemorialΒ Sloan-Kettering Cancer Center), ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΠΎ Π³ΡΡΠΏΠΏΠ°ΠΌ Ρ
ΠΎΡΠΎΡΠ΅Π³ΠΎ, ΠΏΡΠΎΠΌΠ΅ΠΆΡΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΈ ΠΏΠ»ΠΎΡ
ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π°: 9 (19,1 %), 28 (59,6 %),Β 10 (21,3 %) Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΠ±ΡΠ΅ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΡΠ°ΡΡΡΠ° ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ ΠΎΡΠ΄Π΅Π»ΡΠ½ΠΎ: 0 ΠΏΠΎ ΡΠΊΠ°Π»Π΅ ECOG β 10 (21,3 %), 1β24Β (51,1 %) ΠΈ 2β13 (27,6 %) Π±ΠΎΠ»ΡΠ½ΡΡ
. ΠΠΎ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ²: Π»Π΅Π³ΠΊΠΈΠ΅ β 29 Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΊΠΎΡΡΠΈ β 18, Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΈ β 11, ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Β Π² Π»ΠΎΠΆΠ΅ ΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΉ ΠΏΠΎΡΠΊΠΈ β 10, ΠΏΠ΅ΡΠ΅Π½Ρ β 10 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΡΠ»ΡΡΠΈΠΎΡΠ³Π°Π½Π½ΠΎΠ΅ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ Ρ 22 (46,8 %) Π±ΠΎΠ»ΡΠ½ΡΡ
. Π£ 18 (40,0 %)Β ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² ΠΏΡΠ΅Π²ΡΡΠΈΠ»ΠΎ 5 Π² 1 ΠΎΡΠ³Π°Π½Π΅, Ρ 15 (33,3 %) Π²ΡΡΠ²Π»Π΅Π½ Π΅Π΄ΠΈΠ½ΠΈΡΠ½ΡΠΉ ΠΎΡΠ°Π³ Π² 1 ΠΎΡΠ³Π°Π½Π΅.Β ΠΠ·ΡΡΠ΅Π½Π° Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π½Π¦Π Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΎΡΠ΄Π΅Π»ΡΠ½ΠΎΠΉ Π»ΠΈΠ½ΠΈΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΌΠ΅ΠΆΠ΄Ρ 2 Π³ΡΡΠΏΠΏΠ°ΠΌΠΈΒ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΌΠΠΠ : 1-Ρ Π³ΡΡΠΏΠΏΠ° (n = 20), Π² ΠΊΠΎΡΠΎΡΠΎΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° Π½Π¦Π , ΠΈ 2-Ρ Π³ΡΡΠΏΠΏΠ° (n = 27), Π² ΠΊΠΎΡΠΎΡΠΎΠΉ Π±ΠΎΠ»ΡΠ½ΡΠ΅ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈΒ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ (12 β ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ, 8 β ΡΠΎΡΠ°ΡΠ΅Π½ΠΈΠ±, 7 β ΡΡΠ½ΠΈΡΠΈΠ½ΠΈΠ±). ΠΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΊΠ°ΠΌΠΈ Π±ΡΠ»ΠΈ ΠΎΡΠ΅Π½ΠΊΠ° ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ (ΠΠ), ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ Π΄Π»Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π½Π¦Π Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΌΠΠΠ , Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Π΄ΠΎ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ (ΠΠΠ) Π² 1-ΠΉ ΠΈ 2-ΠΉΒ Π»ΠΈΠ½ΠΈΡΡ
ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ΅Π΄ΠΈΠ°Π½Π° ΠΠ Π±ΡΠ»Π° Π²ΡΡΠ΅ Π² 1-ΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²: 46 ΠΌΠ΅Ρ ΠΏΡΠΎΡΠΈΠ² 31 ΠΌΠ΅Ρ (Ρ = 0,09). ΠΠΠ Π±ΡΠ»ΠΎ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡΠΌ: 9 ΠΈ 6 ΠΌΠ΅ΡΒ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ.Β ΠΡΠΈ ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π² 1-ΠΉ Π»ΠΈΠ½ΠΈΠΈ (Ρ = 0,0174) ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΠΠΠ Π² Π³ΡΡΠΏΠΏΠ΅ ΡΠ°ΡΠ³Π΅ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΡΠΎΡΠ°ΡΠ΅Π½ΠΈΠ± ΠΈ ΡΡΠ½ΠΈΡΠΈΠ½ΠΈΠ±)Β Π±ΡΠ»Π° Π²Π΄Π²ΠΎΠ΅ Π²ΡΡΠ΅ (13 ΠΈ 17 ΠΌΠ΅Ρ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ), ΡΠ΅ΠΌ ΠΏΡΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΈΡΠΎΠΊΠΈΠ½Π°ΠΌΠΈ (6 ΠΌΠ΅Ρ). ΠΠΠ Π²ΠΎ 2-ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 10 ΠΌΠ΅Ρ.Β ΠΠ΅Π΄ΠΈΠ°Π½Π° ΠΠ Π΄Π»Ρ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ, ΡΠΎΡΠ°ΡΠ΅Π½ΠΈΠ±Π° ΠΈ ΡΡΠ½ΠΈΡΠΈΠ½ΠΈΠ±Π° Π½Π΅ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»Π° ΡΠ°Π·Π»ΠΈΡΠΈΠΉ ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 34,2; 36,5 ΠΈ 39,2 ΠΌΠ΅ΡΒ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ (Ρ = 0,8).ΠΡΠ²ΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΠ΅Ρ ΠΎΠ± ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΌΠΠΠ . ΠΠ΅ΠΏΠΎΠ»Π½Π°Ρ ΡΠΈΡΠΎΡΠ΅Π΄ΡΠΊΡΠΈΡ ΠΌΠΎΠΆΠ΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡΡΡ ΠΊΠ°ΠΊ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΠΉ ΠΌΠ΅ΡΠΎΠ΄ Π»Π΅ΡΠ΅Π½ΠΈΡ Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ΄Π½Π°ΠΊΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅Β ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π² ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ ΡΠΎΠ»ΡΠΊΠΎ ΠΏΡΠΈ ΠΎΠ±ΡΠ·Π°ΡΠ΅Π»ΡΠ½ΠΎΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ Π² ΡΡ
Π΅ΠΌΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡΒ ΡΠ°ΡΠ³Π΅ΡΠ½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΊΠ°ΠΊ Π² 1-ΠΉ, ΡΠ°ΠΊ ΠΈ Π²ΠΎ 2-ΠΉ Π»ΠΈΠ½ΠΈΠΈ.Β ΠΠ΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΠΠ , Π² Π°Π»Π³ΠΎΡΠΈΡΠΌΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΡΠΈΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
Π΄ΠΎΠ»ΠΆΠ½Π° Π±ΡΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈΒ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°Π»Π»ΠΈΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠΈΡΠΎΡΠ΅Π΄ΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΡΠ°ΠΊ ΠΊΠ°ΠΊ Ρ Π΅Π³ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠΎΠΆΠ½ΠΎ ΠΏΠΎΠ»ΡΡΠΈΡΡ ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ ΠΠΠ Π΄ΠΎ 9 ΠΌΠ΅Ρ.Β Π’Π΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π΅ 30 ΠΌΠ΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ ΠΏΠΎΠ»ΡΡΠΈΡΡ ΡΠΎΠ»ΡΠΊΠΎ Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ Ρ ΡΠΈΡΡΠ΅ΠΌΠ½ΡΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ΠΌ
ΠΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Ρ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΄Π°Π»Π΅Π½ΠΈΡ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ Ρ ΡΠ°ΡΠ³Π΅ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ
Objective. To increase the effectiveness of drug treatment via systemic therapy (ST) in combination with incomplete cytoreductive interventions β incomplete metastasectomy (iME).Materials and methods. Three centers took part in the study. All 147 patients with mRCC received anticancer drug therapy. Part of them (n = 47) underwent surgery (iME) before or together with anticancer treatment, where iME meant complete metastasis excision within one organ with residual tissue in other organs (research group). Control group (n = 100) included patients who received only systemic antitumor treatment. Primary control point was overall survival (OS), secondary β time to progression.Results. Median OS in combined treatment group was 32 months, while in control group β 29 months (p = 0.21). When analyzing surgical stage in combined treatment, OS was statistically more significant in patients with iME before ST (n = 20) than in patients with two parallel treatment schemes: 46 and 31 months, respectively (p = 0.007). When analyzing metastases localization, it was found that iME is effective for metastases to distant lymph nodes and adrenal gland. Adrenalectomy (p = 0.03) and lymphadenectomy (p = 0.04) showed higher results than ST: 17 and 15 months versus 6 month, respectively. IME in patients with poor prognosis did not reveal any advantages: median OS reached 7 months, which was significantly inferior to the favorable prognosis group, where median OS was 25 months (p = 0.03).Conclusion. IME can be used as a part of combined treatment in mRCC patients. It should be considered as the first treatment stage with subsequent ST.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΠΏΠΎΡΠΊΠΈ Π·Π° ΡΡΠ΅Ρ ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π‘Π’) ΠΈ Π΅Π΅ ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ Ρ Π½Π΅ΠΏΠΎΠ»Π½ΡΠΌΠΈ ΡΠΈΡΠΎΡΠ΅Π΄ΡΠΊΡΠΈΠ²Π½ΡΠΌΠΈ (Π½Π¦Π ) Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°ΠΌΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠ½ΠΈΠΌΠ°Π»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 3 ΡΠ΅Π½ΡΡΠ°. ΠΡΠ΅ 147 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ. Π§Π°ΡΡΠΈ ΠΈΠ· Π½ΠΈΡ
(n = 47) Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎ Π±ΡΠ»ΠΎ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ Π½Π¦Π , Ρ. Π΅. ΠΏΠΎΠ»Π½ΠΎΠ³ΠΎ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·Π° Π² ΠΏΡΠ΅Π΄Π΅Π»Π°Ρ
1 ΠΎΡΠ³Π°Π½Π° ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΡΠ΅Π·ΠΈΠ΄ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ Π² Π΄ΡΡΠ³ΠΈΡ
ΠΎΡΠ³Π°Π½Π°Ρ
(Π³ΡΡΠΏΠΏΠ° ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ). ΠΠΎΠ½ΡΡΠΎΠ»ΡΠ½Π°Ρ Π³ΡΡΠΏΠΏΠ° (n = 100) ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ, ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΡΠΎΠ»ΡΠΊΠΎ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ Π‘Π’. ΠΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΎΠΉ Π±ΡΠ»Π° ΠΎΠ±ΡΠ°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ (ΠΠ), Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉΒ β Π²ΡΠ΅ΠΌΡ Π΄ΠΎ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ΅Π΄ΠΈΠ°Π½Π° ΠΠ Π² Π³ΡΡΠΏΠΏΠ΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 32 ΠΌΠ΅Ρ, Π² ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ β 29 ΠΌΠ΅Ρ (Ρ = 0,21). ΠΡΠΈ Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΠΏΠ° Π² ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΠ Π±ΡΠ»Π° ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΠΎΠΉ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π½Π¦Π , ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΠΎΠ²Π°Π²ΡΠ΅ΠΉ Π‘Π’ (n = 20), ΡΠ΅ΠΌ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠ°ΡΠ°Π»Π»Π΅Π»ΡΠ½ΡΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ 2 Π²ΠΈΠ΄ΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ: 46 ΠΈ 31 ΠΌΠ΅Ρ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ (Ρ = 0,007). ΠΡΠΈ Π°Π½Π°Π»ΠΈΠ·Π΅ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΉ ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π½Π¦Π ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½Π° ΠΏΡΠΈ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠΈ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
Π»ΠΈΠΌΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ·Π»ΠΎΠ² ΠΈ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠ°. Π’Π°ΠΊ, ΠΏΡΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ Π°Π΄ΡΠ΅Π½Π°Π»ΡΠΊΡΠΎΠΌΠΈΠΈ (Ρ = 0,03) ΠΈ Π»ΠΈΠΌΡΠ°Π΄Π΅Π½ΡΠΊΡΠΎΠΌΠΈΠΈ (Ρ = 0,04) ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π±ΡΠ»ΠΈ ΡΠ²Π½ΠΎ Π²ΡΡΠ΅, ΡΠ΅ΠΌ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ Π‘Π’: 17 ΠΈ 15 ΠΌΠ΅Ρ ΠΏΡΠΈ Π½Π¦Π ΠΏΡΠΎΡΠΈΠ² 6 ΠΌΠ΅Ρ ΠΏΡΠΈ Π‘Π’. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π½Π¦Π Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
Π³ΡΡΠΏΠΏΡ ΠΏΠ»ΠΎΡ
ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° Π½Π΅ Π²ΡΡΠ²ΠΈΠ»ΠΎ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²: ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΠΠ Π΄ΠΎΡΡΠΈΠ³Π»Π° 7 ΠΌΠ΅Ρ, Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΡΡΡΠΏΠ°Ρ Π³ΡΡΠΏΠΏΠ΅ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° Ρ ΠΌΠ΅Π΄ΠΈΠ°Π½ΠΎΠΉ ΠΠ 25 ΠΌΠ΅Ρ (Ρ = 0,03).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΠΏΠΎΠ»Π½Π°Ρ ΡΠΈΡΠΎΡΠ΅Π΄ΡΠΊΡΠΈΡ ΠΌΠΎΠΆΠ΅Ρ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ ΠΊΠ°ΠΊ ΠΎΠΏΡΠΈΡ Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ Ρ Π‘Π’ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ. ΠΡΠΈ Π²ΡΠ±ΠΎΡΠ΅ Π΄Π°Π½Π½ΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π½Π¦Π Π½ΡΠΆΠ½ΠΎ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡ ΠΊΠ°ΠΊ 1βΠΉ ΡΡΠ°ΠΏ Π»Π΅ΡΠ΅Π½ΠΈΡ Ρ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠΈΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π‘Π’
Phenotypic effects of the dwarfing gene Rht-17 in spring durum wheat under two climatic conditions
Alleles of the genes, conferring a dwarfing phenotype, play a crucial role in wheat breeding, as they not only reduce plant height, ensuring their resistance to lodging, but also have a number of positive and negative pleiotropic effects on plant productivity. Durum wheat carries only two subgenomes (A and B), which limits the use of the D-subgenome genes and requires the expansion of the arsenal of dwarfing alleles and the study of their effects on height and agronomically important traits. We studied the effect of the gibberellin-insensitive allele Rht-B1p in the B2F2:3 families, developed by crossing Chris Mutant /#517//LD222 in a field experiment in Moscow and Krasnodar. In our experiments, plants homozygous for Rht-B1p were shorter than those homozygous for the wild-type allele Rht-B1a by 36.3 cm (40 %) in Moscow and 49.5 cm (48 %) in Krasnodar. In the field experiment in Krasnodar, each plant with Rht-B1p had one less internode than any plant with Rht-B1a, which additionally contributed to the decrease in plant height. Grain weight per main spike was lower in plants with Rht-B1p than in plants with Rht-B1a by 12 % in Moscow and by 23 % in Krasnodar due to a decrease in 1000 grain weight in both regions of the field experiment. The number of grains per main spike in plants with Rht-B1p was higher in comparison to that with Rht-B1a by 6.5 % in Moscow due to an increase in spikelet number per main spike and by 11 % in Krasnodar due to an increase in grain number per spikelet. The onset of heading in plants with Rht-B1p in comparison with the plants with the wild-type allele Rht-B1a was 7 days later in Krasnodar. The possibility and prospects for the use of Rht-B1p in the breeding of durum wheat are discussed
Watch me grow integrated (WMG-I): protocol for a cluster randomised controlled trial of a web-based surveillance approach for developmental screening in primary care settings
Introduction The increasing prevalence of developmental disorders in early childhood poses a significant global health burden. Early detection of developmental problems is vital to ensure timely access to early intervention, and universal developmental surveillance is recommended best practice for identifying issues. Despite this, there is currently considerable variation in developmental surveillance and screening between Australian states and territories and low rates of developmental screening uptake by parents. This study aims to evaluate an innovative web-based developmental surveillance programme and a sustainable approach to referral and care pathways, linking primary care general practice (GP) services that fall under federal policy responsibility and state government-funded child health services. Methods and analysis The proposed study describes a longitudinal cluster randomised controlled trial (c-RCT) comparing a Γ’ β¬ Watch Me Grow Integrated' (WMG-I) approach for developmental screening, to Surveillance as Usual (SaU) in GPs. Forty practices will be recruited across New South Wales and Queensland, and randomly allocated into either the (1) WMG-I or (2) SaU group. A cohort of 2000 children will be recruited during their 18-month vaccination visit or opportunistic visit to GP. At the end of the c-RCT, a qualitative study using focus groups/interviews will evaluate parent and practitioner views of the WMG-I programme and inform national and state policy recommendations. Ethics and dissemination The South Western Sydney Local Health District (2020/ETH01625), UNSW Sydney (2020/ETH01625) and University of Queensland (2021/HE000667) Human Research Ethics Committees independently reviewed and approved this study. Findings will be reported to the funding bodies, study institutes and partners; families and peer-reviewed conferences/publications
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