36 research outputs found
Everolimus in patients with metastatic renal cell carcinoma previously treated with bevacizumab: a prospective multicenter study CRAD001LRU02Tβ°
Everolimus is an orally administered inhibitor of the mammalian target of rapamycin (mTOR) recommended for patients with metastaticΒ renal cell carcinoma (mRCC) who progressed on previous vascular endothelial growth factor (VEGF) receptor-tyrosine kinase inhibitorΒ therapy. Efficacy of everolimus in patients who progressed on anti-VEGF monoclonal antibody bevacizumab is unknown. We did a multicenter prospective trial of everolimus in patients with mRCC whose disease had progressed on bevacizumab Β± interferon alpha (IFN). Patients with clear-cell mRCC which had progressed on bevacizumab Β± IFN received everolimus 10 mg once daily. The primary end point was the proportion of patients remaining progression-free for 56 days, and a two-stage Simon design was used, with 80 % power and an alpha risk of 5 %. This study is registered with ClinicalTrials.gov, number NCT02056587. From December 2011 to October 2013, a total of 37 patients (28 M, 9 F) were enrolled. Median age was 60.5 years (range 41-66), 11 % had Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, and Memorial Sloan-Kettering Cancer Center (MSKCC) favorable/intermediate risk was 38/62 %. Five (14 %) patients had a confirmed partial response and 26 (70 %) patients had a stable disease. Median progression-free survival was 11.5 months (95 % CI, 8.8β14.2). Median overall survival was not reached. No grade 3 or 4 treatment-related toxicities were observed. The most common grade 2 adverse events were fatigue (19 %) and pneumonitis (8 %). Everolimus demonstrated a favorable toxicity profile and promising anti-tumor activity as a second-line therapy in metastatic renal cell carcinoma (RCC) patients previously treated with bevacizumab Β± IFN
Polymorphism of CLE gene sequences in potato
CLE (CLV3/ESR) is one of the most important groups of peptide phytohormones: its members regulate the development of various plant organs and tissues, as well as interaction with some parasites and symbionts and response to environmental factors. In this regard, the identification and study of the CLE genes encoding the peptides of this group in cultivated plants are of great practical interest. Relatively little is known about the functions of CLE peptides in potato, since the CLE genes of the potato Solanum phureja Juz. et Buk. were characterized only in 2021. At the same time, potato includes plenty of tuberous species of the genus Solanum L., both wild and cultivated, and the diversity of its forms may depend on differences in the sequences of CLE genes. In this work, we performed a search for and analysis of the CLE gene sequences in three wild potato species (S. bukasovii Juz., S.Β verrucosum Schltdl., S. commersonii Dunal) and four cultivated species (S. chaucha Juz. et Buk., S. curtilobum Juz. et Buk., S. juzepczukii Juz. et Buk., S. ajanhuiri Juz. et Buk.). In total, we identified 332 CLE genes in the analyzed potato species: from 40 to 43 genes of this family for each potato species. All potato species taken for analysis had homologues of previously identified S. phureja CLE genes; at the same time, the CLE42 gene, which is absent from the S.Β phureja genome, is present in all other analyzed potato species. Polymorphism of CLE proteins of S. commersonii is significantly higher than that of other analyzed potato species, due to the fact that S. commersonii grows in places outside the growing areas of other potato species and this potato is probably not one of the ancestors of cultivated potato. We also found examples of polymorphism of domains of CLE proteins that carried different functions. Further study of potato CLE proteins will reveal their role in development, including regulation of productivity in this important agricultural crop
Effect of colchicine on physiological and biochemical properties of <i>Rhodococcus qingshengii</i>
The genus Rhodococcus includes polymorphic non-spore-forming gram-positive bacteria belonging to the class Actinobacteria. Together with Mycobacterium and Corynebacterium, Rhodococcus belongs to the Mycolata group. Due to their relatively high growth rate and ability to form biof ilms, Rhodococcus are a convenient model for studying the effect of biologically active compounds on pathogenic Mycolata. Colchicine was previously found to reduce biof ilm formation by P. carotovorum VKM B-1247 and R. qingshengii VKM Ac-2784D. To understand the mechanism of action of this alkaloid on the bacterial cell, we have studied the change in the fatty acid composition and microviscosity of the R. qingshengii VKM Ac-2784D membrane. Nystatin, which is known to reduce membrane microviscosity, is used as a positive control. It has been found that colchicine at concentrations of 0.01 and 0.03 g/l and nystatin (0.03 g/l) have no signif icant effect on the survival of R. qingshengii VKM Ac-2784D cultivated in a buffered saline solution with 0.5 % glucose (GBSS). However, colchicine (0.03 g/l) signif icantly inhibits biof ilm formation. Rhodococcus cells cultivated for 24 hours in GBSS with colchicine acquire a rounded shape. Colchicine at 0.01 g/l concentration increases C16:1(n-7), C17:0, C20:1(n-9) and C21:0 fatty acids. The microviscosity of the membrane of individual cells was distributed from the lowest to the highest values of the generalized laurdan f luorescence polarization index (GP), which indicates a variety of adaptive responses to this alkaloid. At a higher concentration of colchicine (0.03 g/l) in the membranes of R. qingshengii VKM Ac-2784D cells, the content of saturated fatty acids increases and the content of branched fatty acids decreases. This contributes to an increase in membrane microviscosity, which is conf irmed by the data on the GP fluorescence of laurdan. All of the above indicates that colchicine induces a rearrangement of the Rhodococcus cell membrane, probably in the direction of increasing its microviscosity. This may be one of the reasons for the negative effect of colchicine on the formation of R. qingshengii VKM Ac-2784D biof ilms
ΠΠ»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ°Ρ Π΅ΠΈ, Π±ΡΠΎΠ½Ρ ΠΎΠ², Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π² ΡΠ΅Π³ΠΈΠΎΠ½Π΅ Π‘ΠΈΠ±ΠΈΡΠΈ ΠΈ ΠΠ°Π»ΡΠ½Π΅Π³ΠΎ ΠΠΎΡΡΠΎΠΊΠ°: ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ
Epidemiology of lung cancer in Siberia and Russian Far East.ΠΠ»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΡΡΠ°Ρ
Π΅ΠΈ, Π±ΡΠΎΠ½Ρ
ΠΎΠ², Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π² ΡΠ΅Π³ΠΈΠΎΠ½Π΅ Π‘ΠΈΠ±ΠΈΡΠΈ ΠΈ ΠΠ°Π»ΡΠ½Π΅Π³ΠΎ ΠΠΎΡΡΠΎΠΊΠ°: ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ
ΠΠΠΠΠΠΠΠΠΠΠΠΠ― Π ΠΠΠ ΠΠΠ§ΠΠ Π ΠΠ ΠΠΠΠ Π‘ΠΠΠ ΠΠ ΠΠ
Results of epidemiological study on kidney cancer incidence among the population of the Primorsky Krai are presented. Methods of mathematical statistics recommended by the Ministry of Public Health were used. Within the first 5 years of the period 1994 to 2008, thekidney cancer incidence rate increased from 8,3 0/0000 to 12,5 0/0000 in men and from 4,4 0/0000 to 6,6 0/0000 in women, being the 8th most common cancer in men and the 11th most common cancer in women. The highest incidence rate was observed at the age of 55β59 years. The kidney cancer incidence rate in children for the period 1994β2008 was 1,8 0/0000, reaching peak incidence at age 0β4. Kidney cancer is the third most common cancer following hemoblastosis and brain tumors in children of this age group.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ Ρ ΡΡΠ΅ΡΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΈ ΠΏΠΎΠ»Π°. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈΡΡ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΌΠ°ΡΠ΅ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠΈ, ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΡΠ΅ΠΌΡΠ΅ ΠΠ. ΠΠ° ΠΏΠ΅ΡΠΈΠΎΠ΄ 1994β2008 Π³Π³. Π·Π°Π±ΠΎΠ»Π΅-Π²Π°Π΅ΠΌΠΎΡΡΡ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ Π²ΡΡΠΎΡΠ»Π° Ρ ΠΌΡΠΆΡΠΈΠ½ Ρ 8,3 0/0000 Π² ΠΏΠ΅ΡΠ²ΠΎΠΉ ΠΏΡΡΠΈΠ»Π΅ΡΠΊΠ΅Β ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΠΌΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° Π΄ΠΎ 12,5 0/0000, Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ 4,8 0/0000 Π΄ΠΎ 6,6 0/0000 ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΡΠΈ ΡΡΠΎΠΌ Π² ΡΡΡΡΠΊΡΡΡΠ΅ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΡΠ° Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΏΠ΅ΡΠ΅ΠΌΠ΅ΡΡΠΈΠ»Π°ΡΡ Ρ ΠΌΡΠΆΡΠΈΠ½ Ρ 10-Π³ΠΎ ΠΌΠ΅ΡΡΠ° Π½Π° 8-Π΅, Ρ ΠΆΠ΅Π½ΡΠΈΠ½ β Ρ 12-Π³ΠΎ Π½Π° 11-Π΅ ΠΌΠ΅ΡΡΠΎ. Π‘Π°ΠΌΡΠΉ Π²ΡΡΠΎΠΊΠΈΠΉ ΡΠΎΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΎΡΠΌΠ΅ΡΠ΅Π½ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 55β59 Π»Π΅Ρ. ΠΡΡΠ²Π»Π΅Π½ ΠΏΠΈΠΊ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 0β4 Π³ΠΎΠ΄Π°, ΠΊΠΎΡΠΎΡΡΠΉ ΠΊ 2004β2008 Π³Π³. ΡΠΎΡΡΠ°Π²ΠΈΠ» 1,8 0/0000 ΠΈ Π² ΡΡΡΡΠΊΡΡΡΠ΅ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΡΠΎΠΉ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ Π·Π°Π½ΡΠ» 3-Π΅ ΠΌΠ΅ΡΡΠΎ ΠΏΠΎΡΠ»Π΅ Π³Π΅ΠΌΠΎΠ±Π»Π°ΡΡΠΎΠ·ΠΎΠ² ΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°
ΠΡΡΠΈΠ»Π΅ΡΠ½ΡΡ ΠΎΠ±ΡΠ°Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ, ΠΏΠΎΠ»ΡΡΠ°Π²ΡΠΈΡ ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡ ΠΏΡΠΈ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π½Π° ΡΠΎΠ½Π΅ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±Π΅Π²Π°ΡΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ: ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ CRAD001LRU02T
Background. In a CRAD001LRU02T study of everolimus for metastatic renal cell carcinoma patients previously treated with bevacizumab Β±Β interferon, median overall survival (OS) was 17.4 months (95 % confidence interval 13.5β21.3 month).Objective of final analysis was to evaluate 5-year OS and long-term toxicity in this study.Materials and methods. Survival data were collected from 37 patients with bevacizumab-refractory metastatic renal cell carcinoma who received everolimus in a completed prospective multicenter study. Patients were predominantly male, 89 % had ECOG performance status of 0/1, 51 % received previous bevacizumab in combination with interferon, and 38/62% had MSKCC favorable/intermediate risk disease.Results. The 5-year survival rate was 16.2% (95 % confidence interval 14.1β18.3 %), with a median follow-up of 5 years. The 1-, and 3-year OS rates were 81.0 and 43.0 %, respectively. The median duration of second-line of everolimus was 315 (range 61β569) days. 11 (29.7 %) patients received third-line therapy with a median duration of 3.6 months. Confirmed objective tumor responses were seen in 5 (14.0 %) patients. 70.0 % (n = 26) patients had a stable disease. 1 (2.7 %) patient achieved complete response after 4 years of therapy. One (2.7 %) patientΒ discontinued everolimus therapy on their own accord due to relapse of systemic lupus erythematosus and one (2.7 %)Β patient had 14-days interruption of an everolimus therapy due to grade 3 hyperglycemia. No grade 4 treatment-related toxicity was found.Conclusions. Everolimus provided an estimated 5-year survival rate of 16.2 % for bevacizumab-resistant metastatic renal cell carcinoma. Prolonged everolimus was not associated with new types or increased severity of adverse events.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ CRAD001LRU02T ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡΠ° Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ, ΠΏΠΎΠ»ΡΡΠ°Π²ΡΠΈΡ
ΡΠ°Π½Π΅Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π±Π΅Π²Π°ΡΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ Ρ ΠΈΠ½ΡΠ΅ΡΡΠ΅ΡΠΎΠ½ΠΎΠΌ ΠΈΠ»ΠΈ Π±Π΅Π· Π½Π΅Π³ΠΎ, ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ (ΠΠ) ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 17,4 ΠΌΠ΅Ρ (95 % Π΄ΠΎΠ²Π΅ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π» 13,5β21,3 ΠΌΠ΅Ρ).Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ β ΠΎΡΠ΅Π½ΠΊΠ° 5-Π»Π΅ΡΠ½Π΅ΠΉ ΠΠ ΠΈ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΉ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ Π² ΡΡΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ°Π½Π½ΡΠ΅ ΠΏΠΎ ΠΠ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ Ρ 37 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠ΅ΡΡΠ°ΠΊΡΠ΅ΡΠ½ΡΡ
ΠΊ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±Π΅Π²Π°ΡΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ ΠΈ ΠΏΠΎΠ»ΡΡΠΈΠ²ΡΠΈΡ
ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² β ΠΌΡΠΆΡΠΈΠ½Ρ, 89 % Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΠΌΠ΅Π»ΠΈ ΡΡΠ°ΡΡΡ ΠΏΠΎ ΡΠΊΠ°Π»Π΅ ECOG 0 / 1, 51 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΠ»ΡΡΠΈΠ»ΠΈ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²ΡΡΡΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π±Π΅Π²Π°ΡΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ Ρ ΠΈΠ½ΡΠ΅ΡΡΠ΅ΡΠΎΠ½ΠΎΠΌ. ΠΠ»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΠΈΠΌΠ΅Π»ΠΈ 38 % Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΏΡΠΎΠΌΠ΅ΠΆΡΡΠΎΡΠ½ΡΠΉ β 62 %.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠΈ ΠΌΠ΅Π΄ΠΈΠ°Π½Π΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ 5 Π»Π΅Ρ 5-Π»Π΅ΡΠ½ΡΡ ΠΠ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 16,2 % (95 % Π΄ΠΎΠ²Π΅ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π» 14,1β18,3 %),Β 1- ΠΈ 3-Π»Π΅ΡΠ½ΡΡ ΠΠ β 81,0 ΠΈ 43,0 % ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΠ΅Π΄ΠΈΠ°Π½Π° ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ 2-ΠΉ Π»ΠΈΠ½ΠΈΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡΠΎΠΌ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 315 (61β569) ΡΡΡ. Π‘ ΠΌΠ΅Π΄ΠΈΠ°Π½ΠΎΠΉ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ 3,6 ΠΌΠ΅Ρ 3-Ρ Π»ΠΈΠ½ΠΈΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠΎΠ»ΡΡΠΈΠ»ΠΈ 11 (29,7 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π½ΡΠ΅ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠ΅ ΠΎΡΠ²Π΅ΡΡ ΠΎΡΠΌΠ΅ΡΠ΅Π½Ρ Ρ 5 (14,0 %) Π±ΠΎΠ»ΡΠ½ΡΡ
. Π‘ΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π½Π°Π±Π»ΡΠ΄Π°Π»Π°ΡΡ Ρ 70,0 % (n = 26) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΠ»Π½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΡΠΏΡΡΡΡ 4 Π³ΠΎΠ΄Π° ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π΄ΠΎΡΡΠΈΠ³ 1 (2,7 %) ΠΏΠ°ΡΠΈΠ΅Π½Ρ. ΠΠ·-Π·Π° ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΡ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΠΊΡΠ°ΡΠ½ΠΎΠΉ Π²ΠΎΠ»ΡΠ°Π½ΠΊΠΈ 1 (2,7 %) Π±ΠΎΠ»ΡΠ½ΠΎΠΉ ΠΏΠΎ ΡΠΎΠ±ΡΡΠ²Π΅Π½Π½ΠΎΠΌΡ ΠΆΠ΅Π»Π°Π½ΠΈΡ ΠΏΡΠ΅ΠΊΡΠ°ΡΠΈΠ» ΡΠ΅ΡΠ°ΠΏΠΈΡ ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡΠΎΠΌ ΠΈ 1 (2,7 %) ΠΏΠ°ΡΠΈΠ΅Π½Ρ ΠΈΠΌΠ΅Π» ΠΏΠ΅ΡΠ΅ΡΡΠ² Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 14 ΡΡΡ Π² ΡΠ²ΡΠ·ΠΈ Ρ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ Π³ΠΈΠΏΠ΅ΡΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ III ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ. ΠΠ΅ΠΆΠ΅Π»Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ²Π»Π΅Π½ΠΈΠΉ IV ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π’Π΅ΡΠ°ΠΏΠΈΡ ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡΠΎΠΌ ΠΏΡΠΈΠ²Π΅Π»Π° ΠΊ 5-Π»Π΅ΡΠ½Π΅ΠΉ ΠΠ 16,2 % Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠ°ΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΡΠ΅ΡΠ½ΠΎ-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ, ΡΠ°Π½Π΅Π΅ ΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΡΡ
ΠΊ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±Π΅Π²Π°ΡΠΈΠ·ΡΠΌΠ°Π±ΠΎΠΌ. ΠΠ»ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΡΠ²Π΅ΡΠΎΠ»ΠΈΠΌΡΡΠΎΠΌ Π½Π΅ Π±ΡΠ»Π° Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π° Ρ Π½ΠΎΠ²ΡΠΌΠΈ Π²ΠΈΠ΄Π°ΠΌΠΈ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠΉ ΡΠΎΠΊΡΠΈΡΠ½ΠΎΡΡΠΈ ΠΈΠ»ΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ°ΡΡΠΎΡΡ Π½Π΅ΠΆΠ΅Π»Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ²Π»Π΅Π½ΠΈΠΉ
ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΡ ΠΎΡΠ³Π°Π½ΠΎΡΠΎΡ ΡΠ°Π½ΡΡΡΠΈΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈΜ ΠΏΡΠΈ Π»ΠΎΠΊΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½ΠΎΠΌ ΡΠ°ΠΊΠ΅ ΠΏΠΎΡΠΊΠΈ
Objective: to evaluate the efficiency of surgical treatment in patients with locally advanced kidney cancer (KC), by comparing the immediate and late results of organ-sparing surgery (OSS) and nephrectomies. Subjects and methods. The results of surgical treatment were analyzed in 251 patients with KC who had undergone OSS (n = 124) or nephrectomy (n = 127). The groups were matched for gender, age, stage, and baseline glomerular filtration rate. Surgical complications were evaluated according to the Clavien-Dindo classification. Survival rates were calculated using the Kaplan-Meier method.Β Results. There were no significant differences between the two patient groups in the amount of blood loss (median 300 ml) and in the hospital length of stay. The median renal ischemia time was 15.0Β±3.4 min. Complications after OSS and nephrectomies occurred in 10.4 and 4.7% of cases. The OSS group was found to tend to have higher 5-year overall survival rates (89.1%) than the nephrectomy group (70.6%) (p = 0.248). Conclusion. OSS is an effective, safe treatment option for KC, at the same time it is still inadequately frequently used in wide clinical practice. The OSS group was found to tend to have higher 5-year overall and relapse-free survival rates than the nephrectomy group (p > 0.05).Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΎΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Π»ΠΎΠΊΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠΊΠΈ (Π Π) ΠΏΡΡΠ΅ΠΌ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΈ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΎΡΠ³Π°Π½ΠΎΡΠΎΡ
ΡΠ°Π½ΡΡΡΠΈΡ
ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈΜ (ΠΠ‘Π) ΠΈ Π½Π΅ΡΡΡΠΊΡΠΎΠΌΠΈΠΈΜ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ 251 Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ Π Π, ΠΏΠΎΠ΄Π²Π΅ΡΠ³Π½ΡΡΡΠΌ ΠΠ‘Π (n = 124) ΠΈΠ»ΠΈ Π½Π΅ΡΡΡΠΊΡΠΎΠΌΠΈΠΈ (n = 127). ΠΡΡΠΏΠΏΡ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡ ΠΏΠΎ ΠΏΠΎΠ»Ρ, Π²ΠΎΠ·ΡΠ°ΡΡΡ, ΡΡΠ°Π΄ΠΈΠΈ, ΠΈΡΡ
ΠΎΠ΄Π½ΠΎΠΈΜ ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΊΠ»ΡΠ±ΠΎΡΠΊΠΎΠ²ΠΎΠΈΜ ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ. Π₯ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ ΠΎΡΠ΅Π½Π΅Π½Ρ ΠΏΠΎ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ ClavienβDindo. ΠΡΠ΅Π½ΠΊΠ° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΠ°ΡΡΡΠΈΡΠ°Π½Π° ΠΏΠΎ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΠ°ΠΏΠ»Π°Π½Π°βΠΠ°ΠΈΜΠ΅ΡΠ°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΠΎΠ±Π΅ΠΈΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ Π·Π½Π°ΡΠΈΠΌΡΡ
ΡΠ°Π·Π»ΠΈΡΠΈΠΈΜ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (ΠΌΠ΅Π΄ΠΈΠ°Π½Π° β 300 ΠΌΠ») ΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ. ΠΠ΅Π΄ΠΈΠ°Π½Π° Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΠΈΡΠ΅ΠΌΠΈΠΈ ΠΏΠΎΡΠΊΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 15,0 Β± 3,4 ΠΌΠΈΠ½. ΠΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ ΠΏΡΠΈ ΠΠ‘Π Π²ΡΡΡΠ΅ΡΠ°Π»ΠΈΡΡ Π² 10,4 %, ΠΏΠΎΡΠ»Π΅ Π½Π΅ΡΡΡΠΊΡΠΎΠΌΠΈΠΈΜ β Π² 4,7 % ΡΠ»ΡΡΠ°Π΅Π². Π Π³ΡΡΠΏΠΏΠ΅ ΠΠ‘Π Π²ΡΡΠ²Π»Π΅Π½Π° ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ 5-Π»Π΅ΡΠ½Π΅ΠΈΜ ΠΎΠ±ΡΠ΅ΠΈΜ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ (89,1 %) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΠΌΠΈ Π½Π΅ΡΡΡΠΊΡΠΎΠΌΠΈΡ (70,6 %; Ρ = 0,248).Β ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ‘Π ΡΠ²Π»ΡΡΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ, Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ Π Π, ΠΏΡΠΈ ΡΡΠΎΠΌ Π²ΡΠ΅ Π΅ΡΠ΅ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ ΡΠ°ΡΡΠΎ ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΡΡ Π² ΡΠΈΡΠΎΠΊΠΎΠΈΜ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΈΜ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. Π Π³ΡΡΠΏΠΏΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΠΠ‘Π Π²ΡΡΠ²Π»Π΅Π½Π° ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ 5-Π»Π΅ΡΠ½Π΅ΠΈΜ ΠΎΠ±ΡΠ΅ΠΈΜ ΠΈ Π±Π΅Π·ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π½ΠΎΠΈΜ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΠΌΠΈ Π½Π΅ΡΡΡΠΊΡΠΎΠΌΠΈΡ (Ρ > 0,05).
ΠΠΠΠΠΠ¬ ΠΠ ΠΠΠΠΠΠΠ¦ΠΠ Π ΠΠΠΠΠ ΠΠΠΠΠΠΠ‘Π’ΠΠΠ Π ΠΠΠ ΠΠΠ§ΠΠ
Β Challenges of early kidney cancer detection and screening significantly increase morbidity and mortality rates, thus dictating the need to improve prevention, early diagnosis and organization of medical care for the population of primorsky Krai. The aim of the study was to create a model for improving early diagnosis of kidney cancer in the primorsky Krai using the program for assessing the risk of kidney cancer (ARKC). The model included a population questionnaire to identify risk factors and algorithm of patient routing (Β«roadmapΒ») with suspected kidney cancer for in-depth examination and treatment. Material and Methods. 2982 residents of the primorsky Krai (women β 1950, men β 1032) in the age range 29β75 took part in the questionnaire survey using the ARKC program. Results. No risk factors were identified in 1879 (63.0 %) individuals. All patients at high risk for kidney cancer (656 β 22.0 %) and patients of the uncertainty group (447 β 15.0 %) were referred for physical and ultrasound examination to exclude kidney tumors. Non-tumor pathology of the kidneys was revealed in 156 (14.0 %) patients. Renal mass suspicious for renal cell carcinoma was revealed in 21 (1.9 %) patients (later confirmed in 17 patients with stage IβII cancer, in 3 patients with stage III, in 1 patient with stage IV). According to the results of the factor analysis, two main groups of factors had a predominant effect on the rise in the overall kidney cancer incidencer. The first group of factors (65.0 %) is caused by smoking, excessive alcohol consumption, overweight, unbalanced nutrition, and the influence of carcinogens. The second group of factors (35.0 %) is caused by problems of a medical and social nature: the low material and technical base of primary care medical organizations, the insufficient professional training of medical workers on the issues of cancer prevention and treatment, including kidney cancer.Conclusion. To improve the early detection of kidney cancer, a prognostic model with computer program for assessing the individual risk of developing kidney cancer was developed. population survey using the ARKC computer program allowed us to narrow the diagnostic search, form risk groups and effectively route patients with suspected kidney cancer for in-depth examination in accordance with the Β«road mapΒ».Β Β ΠΡΠΎΠ±Π»Π΅ΠΌΠ° ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° ΡΠ°ΠΊΠ° ΠΏΠΎΡΠΊΠΈ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ Π²Π»ΠΈΡΠ΅Ρ Π½Π° Π·Π°ΠΏΡΡΠ΅Π½Π½ΠΎΡΡΡ ΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ ΠΎΡ Π΄Π°Π½Π½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΡΠΎ Π΄ΠΈΠΊΡΡΠ΅Ρ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ, ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ ΠΏΡΠΈ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΡ
(ΠΠΠ) ΠΏΠΎΡΠΊΠΈ. Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²ΠΈΠ»ΠΎΡΡ ΡΠΎΠ·Π΄Π°Π½ΠΈΠ΅ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΠΠ ΠΏΠΎΡΠΊΠΈ Π² ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠΌ ΠΊΡΠ°Π΅ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΈ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ Π² ΠΏΡΠ°ΠΊΡΠΈΠΊΡ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΈΡΠΊΠ° ΡΠ°ΠΊΠ° ΠΏΠΎΡΠΊΠΈ β Β«ΠΠ Π ΠΒ». ΠΡΠ° ΠΌΠΎΠ΄Π΅Π»Ρ Π²ΠΊΠ»ΡΡΠ°Π΅Ρ Π² ΡΠ΅Π±Ρ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ (ΠΎΠΏΡΠΎΡ) Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ Π½Π° Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΠΈ Π°Π»Π³ΠΎΡΠΈΡΠΌ ΠΌΠ°ΡΡΡΡΡΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (Β«Π΄ΠΎΡΠΎΠΆΠ½Π°Ρ ΠΊΠ°ΡΡΠ°Β») ΡΒ ΠΏΠΎΠ΄ΠΎΠ·ΡΠ΅Π½ΠΈΠ΅ΠΌ Π½Π° ΡΠ°ΠΊ ΠΏΠΎΡΠΊΠΈ Π΄Π»Ρ ΡΠ³Π»ΡΠ±Π»Π΅Π½Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ±ΡΠ΅ΠΊΡΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ΅ Β«ΠΠ Π ΠΒ», Π² ΠΊΠΎΡΠΎΡΠΎΠΌ ΠΏΡΠΈΠ½ΡΠ»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 2982 ΠΆΠΈΡΠ΅Π»Ρ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 29 Π΄ΠΎ 75 Π»Π΅Ρ (ΠΆΠ΅Π½ΡΠΈΠ½ β 1950, ΠΌΡΠΆΡΠΈΠ½ β 1032). Π‘ ΡΠ΅Π»ΡΡ ΠΏΠΎΠΈΡΠΊΠ° Π½Π°ΡΡΠ½ΡΡ
ΡΠ΅ΡΠ΅Π½ΠΈΠΉ ΠΏΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΠΎΠ²Π½ΡΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΎΡ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΠΏΡΠΈΡΠΈΠ½Β ΡΠΎΡΡΠ° ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌΒ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΊΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π²Π΅Π΄ΠΎΠΌΡΡΠ²Π΅Π½Π½ΡΡ
ΡΠΊΡΠΏΠ΅ΡΡΠΈΠ· ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ, ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠ°ΠΊΠΎΠ²ΡΡ
ΠΊΠΎΠΌΠΈΡΡΠΈΠΉ, ΠΊΠΎΠ»Π»Π΅Π³ΠΈΠΉ, Π°ΠΏΠΏΠ°ΡΠ°ΡΠ½ΡΡ
ΡΠΎΠ²Π΅ΡΠ°Π½ΠΈΠΉ, ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΠ½Π³Π° ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ Β«Π Π°Π·Π²ΠΈΡΠΈΠ΅ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°ΡΒ», Β«ΠΠ»Π°Π½Π° ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ ΠΏΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΎΡ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ, Π²ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Β». Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΠΎΠΏΡΠΎΡΠ° Ρ 1879 (63,0 %) Π»ΠΈΡ Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ°, ΠΈΠΌ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Π½ΠΎ ΠΏΡΠΎΠΉΡΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠ΅ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅ΡΠ΅Π· 3 Π³ΠΎΠ΄Π°. ΠΠ°ΡΠΈΠ΅Π½ΡΡ Π³ΡΡΠΏΠΏΡ Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° (656 β 22,0 %) Π±ΡΠ»ΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Ρ ΠΊ ΡΡΠΎΠ»ΠΎΠ³Ρ Π΄Π»Ρ ΡΠ³Π»ΡΠ±Π»Π΅Π½Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ Π³ΡΡΠΏΠΏΡ Π½Π΅ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΠΎΡΡΠΈ (447 β 15,0 %) Π±ΡΠ»ΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Ρ Π½Π° ΠΎΡΠΌΠΎΡΡ ΡΡΠ°ΡΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠ°. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π³ΡΡΠΏΠΏ Π½Π΅ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΠΎΡΡΠΈ ΠΈ Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° Π½Π°Π·Π½Π°ΡΠ°Π»ΠΎΡΡ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π»Ρ ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΈΡ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ. Π£ 156 (14,0 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½Π° Π½Π΅ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²Π°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΠΎΡΠ΅ΠΊ, Ρ 21 (1,9 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° β ΠΏΠΎΠ΄ΠΎΠ·ΡΠ΅Π½ΠΈΠ΅ Π½Π° ΠΠΠ ΠΏΠΎΡΠ΅ΠΊ, ΠΊΠΎΡΠΎΡΠΎΠ΅ ΠΏΠΎΠ·ΠΆΠ΅ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠ΄ΠΈΠ»ΠΎΡΡ (Ρ 17 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² IβII ΡΡΠ°Π΄ΠΈΠΈ, Ρ 3 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² β III ΡΡΠ°Π΄ΠΈΠΈ, Ρ 1 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° β IV ΡΡΠ°Π΄ΠΈΠΈ). ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ Π°Π½Π°Π»ΠΈΠ·Π° Π°Π½ΠΊΠ΅Ρ Π½Π° ΡΠΎΡΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΠ°ΠΊΠΎΠΌ ΠΏΠΎΡΠ΅ΠΊ ΠΎΠΊΠ°Π·Π°Π»ΠΈ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π΄Π²Π΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ Π³ΡΡΠΏΠΏΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ². ΠΠ΅ΡΠ²Π°Ρ Π³ΡΡΠΏΠΏΠ° ΡΠ°ΠΊΡΠΎΡΠΎΠ² (65,0 %) ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π° ΠΊΡΡΠ΅Π½ΠΈΠ΅ΠΌ,Β ΡΡΠ΅Π·ΠΌΠ΅ΡΠ½ΡΠΌ ΡΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΠ΅ΠΌ Π°Π»ΠΊΠΎΠ³ΠΎΠ»Ρ, ΠΈΠ·Π±ΡΡΠΎΡΠ½ΠΎΠΉ ΠΌΠ°ΡΡΠΎΠΉΒ ΡΠ΅Π»Π°, Π½Π΅ΡΠ±Π°Π»Π°Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΠΏΠΈΡΠ°Π½ΠΈΠ΅ΠΌ, Π²Π»ΠΈΡΠ½ΠΈΠ΅ΠΌΒ ΠΊΠ°Π½ΡΠ΅ΡΠΎΠ³Π΅Π½ΠΎΠ². ΠΡΠΎΡΠ°Ρ Π³ΡΡΠΏΠΏΠ° ΡΠ°ΠΊΡΠΎΡΠΎΠ² (35,0 %) ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π° ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌΠΈ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ°: Π½ΠΈΠ·ΠΊΠ°Ρ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±Π°Π·Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉΒ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ Π·Π²Π΅Π½Π°, Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½Π°Ρ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½Π°ΡΒ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠ° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΠ°Π±ΠΎΡΠ½ΠΈΠΊΠΎΠ² ΠΏΠΎ Π²ΠΎΠΏΡΠΎΡΠ°ΠΌΒ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ, ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΡΠ°ΠΊΠ° ΠΏΠΎΡΠΊΠΈ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ»Ρ ΠΎΡΡΡΠ΅ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ ΠΏΠΎ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΠΠ ΠΏΠΎΡΠ΅ΠΊ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ ΠΏΠΎΡΠ΅ΠΊ Ρ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡΒ ΠΡΠΈΠΌΠΎΡΡΠΊΠΎΠ³ΠΎ ΠΊΡΠ°Ρ. ΠΠ½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ Β«ΠΠ Π ΠΒ» ΠΊΠ°ΠΊ ΠΏΠ΅ΡΠ²ΠΎΠ³ΠΎ ΡΡΠ°ΠΏΠ° ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΡΡΠ·ΠΈΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΠΎΠΈΡΠΊ, ΡΡΠΎΡΠΌΠΈΡΠΎΠ²Π°ΡΡΠ³ΡΡΠΏΠΏΡ ΡΠΈΡΠΊΠ° ΠΈ ΠΎΡΡΡΠ΅ΡΡΠ²ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ ΠΌΠ°ΡΡΡΡΡΠΈΠ·Π°ΡΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ΄ΠΎΠ·ΡΠ΅Π½ΠΈΠ΅ΠΌ Π½Π° ΠΠΠ ΠΏΠΎΡΠΊΠΈ Π΄Π»Ρ ΡΠ³Π»ΡΠ±Π»Π΅Π½Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ.