Yakut and Dolgan Epics about Heroes with a Horse Origin: Commonality and Differences

The results of a comparative analysis of the texts of the Yakut and Dolgan epics about lone heroes with a horse origin are presented. The relevance of the study is due to the inadequacy of the study of two related epics in a comparative aspect in order to identify commonality and originality in them. Particular attention is paid to comparing the themes, the imagery system and the plot-compositional structure of epics. A detailed analysis of plot components and epic motifs is given. As a result of the study, similarities were found in the development of the main storyline, the similarity of the main motifs, the similarity of the images of the heroes in their purpose, physical abilities and character is also noted. The discrepancy in the plot-compositional structure of epics - the presence of an additional link in the development of the plot in the Yakut olonkho is considered. The motifs of nominating a hero, consigning a horse, going on a military campaign and a wonderful marriage are highlighted. It is suggested that the epic about a hero with a horse origin, having its origins in the ancient Yakut myth of the ancestor horse, originally existed in the central region of Yakutia, and then became widespread among the northern population, including the Dolgan people

Evaluation of treatment outcomes in children with maxillofacial vascular tumors: Cohort study

Background. The variety of the clinical features of vascular tumors in the maxillofacial area limits the choice of method and is able to make difficulties in the treatment. The combined method of treatment proposed by the authors (vascular sclerotherapy with concurrent propranolol intake) demonstrates high efficacy, lack of invasiveness, shortening the rehabilitation period and less side effects. Objective. The aim of the study was to increase the effectiveness of conservative treatment of vascular tumors of the maxillofacial area in young children by combining the method of sclerotherapy and taking proprono-lol. Methods. In a cohort study, the results of treatment of 80 children aged 2 months to 2 years with vascular tumors of the maxillofacial region (ICD-10: D18.0) were evaluated. A comparison was made of the results in 2 groups of children who were treated with different methods: combined (n =40; main group; sclerotherapy and taking propranolol) and propranolol monotherapy (n =40; comparison group). Analysis of the data obtained in the main group and the comparison group led to the development of the criteria for evaluating the treatment results: good (regression of vascular tumors and the absence of a cosmetic defect), satisfactory (reduction of vascular tumors by 2/3 or more with maintaining cosmetic defect) and unsatisfactory (gross cosmetic defect) in terms of changes in the volume of tumor, the diameter of the supply vessels and the values of the linear velocity of blood flow according to ultrasound data. Results. Subjects treated by the combined treatment had a significant regression of vascular tumors in the maxillofacial area compared with the comparison group: reduction of the tumor volume, diameter of the supply vessels and linear blood flow velocity according ultrasound data reached zero after 6 months from the start of combined treatment — 6 months earlier than in the comparison group (p <0.001). Conclusion. According to the results of the study, the advantage of the author’s method over the traditional method was demonstrated, which resulted in a reduction in the duration of treatment, a decrease in the risk as well as in a degree of complications. © 2019 Paediatrician Publishers, LLC. All rights reserved

Epidemiology and etiology of strokes in babies

The paper summarizes an update on the morbidity, mortality, and a risk for recurrence of stroke occurring in babies. It shows a variety of conditions and syndromes which may be responsible for stroke in infancy. Babies with the signs of intrauterine infection and congenital heart disease, the carriers of major thrombophilia gene mutations, may be regarded as a risk group

Influence of VEGF deprivation upon vascular formation by endothelium in the presence of macrophages

Development of angiogenesis depends on the functional state of endothelial cells, as well as on the balanced secretion of cytokines, growth factors and chemokines by endothelial cells and cells of microenvironment. Macrophages represent an essential component of the microenvironment and take part in the formation of blood vessels both due to the production of cytokines and due to contact interactions with endothelial cells. VEGF is among the most important cytokines that control angiogenesis at all its stages. Currently, the role of VEGF in the intercellular interactions of endothelial cells and macrophages is not well described. The aim of our study was to investigate the effect of VEGF deprivation using monoclonal antibodies on angiogenesis under conditions of co-cultivation of endothelium and macrophages. Materials and methods: monoclonal antibodies to VEGF-A were used for VEGF deprivation in monoculture of endothelial cells and in co-culture of endothelial cells with macrophages. The IL-1β, IL-6 and TNFα cytokines were used as inducers. When VEGF-A was removed from the medium, endothelial cells show plasticity and form longer vessels, they modify the expression of VEGF receptors. Macrophages regulate endothelial cell activity through the secretion of cytokines, including VEGF, and through contact interactions with endothelial cells. THP-1 cells increase the sensitivity of endothelial cells to VEGF by stimulating the VEGFR1 and VEGFR3 expression, this effect is VEGF-A-independent. The IL-1β, IL-6, TNFa cytokines independently stimulate non-branching angiogenesis, increasing the length of the vessels. At the same time, IL-ip increases the VEGFR1 expression on the surface of endothelial cells. In contrast, IL-6 and TNFα decrease it, thereby regulating the sensitivity of endothelial cells to VEGF. The effects of these cytokines are not dependent on VEGF-A. The IL-1β, IL-6, TNFα cytokines promote acquisition of anti-angiogenic properties by THP-1 cells that is independent on VEGF-A, as well as on expression of its receptors by endothelial cells. Thus, VEGF is an important, but not the sole factor controlling angiogenesis. Under conditions of VEGF-A deficiency, either endothelial cells or microenvironment cells are able to compensate for its functional load due to the production of other growth factors

Догоспитальная внезапная смерть от острого инфаркта миокарда в Томске (1984 и 2018 гг.): что изменилось за 34 года

Aim. To compare the circumstances of the prehospital deaths among patients with acute myocardial infarction (AMI) in Tomsk in 1984 and 2018.Methods. Population-level data were collected from the WHO project “Acute Myocardial Infarction Registry”. In 1984, 739 cases of AMI were recorded, in 2018 - 924 ones. 262 (35.5%) and 359 (38.9%) deaths occurred in the acute phase, respectively. Of them, 158 (60.3%) and 148 (41.2%) patients died in the prehospital setting. 66 (41.8%) and 46 (31.1%) cases of deaths were selected for further analysis.Results. In 2018, the number of patients who did not receive timely medical care decreased from 74.2% to 52.2%, compared to 1984 (p &lt;0.05). The number of cases when patients failed to call the ambulance due to a rapid loss of consciousness (cardiac arrest) or managed to call, but died before the ambulance arrived, was similar. The number of death among patients who received emergency medical services (EMS) increased from 25.8% to 47.9% (p &lt;0.05).Conclusion. Prehospital mortality from AMI in Tomsk has improved over thirty years, but not drastically. Despite the number of patients who died before the first medical contact has decreased, they still make up about half of all cases. Every 4th-5th patient fails to contact EMS. In terms of reducing prehospital mortality, measures focused on the regular clinical examination of patients with cardiovascular diseases seem to be more promising for effective secondary prevention of coronary artery disease and AMI.Цель. Сравнить обстоятельства смерти больных острым инфарктом миокарда (ОИМ) на догоспитальном этапе в Томске в 1984 и 2018 гг.Материалы и методы. Исследование проведено на основе анализа базы данных многолетнего наблюдения острой коронарной патологии программы ВОЗ «Регистр острого инфаркта миокарда». В 1984 г. в Томске отмечено 739 случаев ОИМ, в 2018 г. - 924. В остром периоде заболевания в указанные годы погибли 262 (35,5%) и 359 (38,9%) больных соответственно, из которых 158 (60,3%) и 148 (41,2%) умерли на догоспитальном этапе. Для дальнейшего анализа отобраны 66 (41,8%) случаев смерти от ОИМ на догоспитальном этапе в 1984 г. и 46 (31,1%) случаев в 2018 г.Результаты. В сравнении с 1984 г. в 2018 г. количество больных, у которых смерть наступила в отсутствие медицинской помощи, сократилось (с 74,2% до 52,1; p&lt;0,05). Мало изменилось число эпизодов, при которых больные не успевали вызвать скорую медицинскую помощь в связи с быстрой потерей сознания (остановкой сердца) или успели обратиться за помощью, но погибли до ее приезда. Выросло число случаев смерти больных в присутствии врачей скорой медицинской помощи (с 25,8 до 47,9%; p&lt;0,05).Заключение. Ситуация с летальными исходами от ОИМ на догоспитальном этапе в Томске за более чем тридцатилетний период улучшилась, но радикальных изменений не произошло. Снизилось число больных, погибших в отсутствие медицинской помощи, хотя таких случаев по-прежнему более половины: каждый 4-5-й пациент не успевает вызвать скорую медицинскую помощь. Более перспективными в снижении догоспитальной летальности являются мероприятия, связанные с диспансеризацией пациентов с сердечнососудистыми заболеваниями для вторичной профилактики ишемической болезни сердца и острого инфаркта миокарда

ОБОСНОВАНИЕ ПРОГРАММЫ ЛЕЧЕБНО-ПРОФИЛАКТИЧЕСКИХ МЕРОПРИЯТИЙ У ЧАСТО БОЛЕЮЩИХ ДЕТЕЙ РАННЕГО ВОЗРАСТА

The results of complex clinical and laboratory examination of 146 children aged 2—3 years attending kindergarten were presented. The leading predictors of frequent respiratory disease: disturbance of microbiocenosis oropharyngeal mucosa, immunoglobulins decrease, respiratory allergic pathology were established and scientifically substantiated. The results obtained prove the main directions of therapeutic and preventive measures.Представлены результаты комплексного клинико-лабораторного обследования 146 детей в возрасте 2—3 лет, посещающих ДДОУ. Установлены и научно обоснованы ведущие предикторы частой респираторной заболеваемости: нарушение микробиоценоза слизистой ротоглотки, гипоиммуноглобулинемия, респираторная аллергическая патология. Полученные результаты позволяют обосновать основные направления лечебно-профилактических мероприятий

ОПТИМИЗАЦИЯ ДИАГНОСТИКИ ЦИТОМЕГАЛОВИРУСНОЙ ИНФЕКЦИИ У ДЕТЕЙ МЛАДШЕГО ВОЗРАСТА

The results of a laboratory examination of 520 children aged 1—3 years are presented. The examination was conducted to determine the DNA of cytomegalovirus in children with acute cytomegalovirus infection in various biological media by polymerase chain reaction. The differences in the virus shedding  into the blood, saliva, and urine are established: the median of the viral load for saliva is 4.9 lg copies of DNA/ml, the blood 3.4 lg copies of DNA/ml, urine — 3.85 lg copies of DNA/ml. The cut of extreme values of the viral load are determined with the help of mathematical modeling which determine the clinical probability of developing acute CMV infection which allows for more accurate and timely assignment of etiotropic therapy.Представлены результаты лабораторного обследования 520 детей в возрасте 1—3 лет. Обследование проводилось с целью определения  ДНК цитомегаловируса в различных биологических средах, методом полимеразной цепной реакции у детей, с острой цитомегаловирусной инфекцией в форме инфекционного мононуклеоза.Установлены различия вирусовыделения в кровь, слюну, и мочу: медиана вирусной нагрузки для слюны составляет 4,9 lg копий ДНК/мл, крови — 3,4 lg копий ДНК/мл, мочи  — 3,85 lg копий ДНК/мл. С помощью математического моделирования установлены «пороговые» значения вирусной нагрузки, определяющие  клиническую вероятность развития острой ЦМВИ, что дает возможность более точного и своевременного назначения этиотропной терапии

THE STUDY OF INFLUENCE OF SINGLE NUCLEOTIDE POLYMORPHISMS PROCOAGULANT GENES ON OUTCOME OF PEADIATRIC ARTERIAL ISCHEMIC STROKE USING LOGISTIC REGRESSION

In this article the results of study of influence of single nucleotide polymor-phisms procoagulant genes on outcome of pediatric arterial ischemic stroke are presented. The sample has included series of clinical cases of 142 children with proved ischemic stroke. All the children have been tested of 21 single by using polymerase chain reaction. The prediction rule has been designed using mathematic apparatus. This rule allows one to predict such outcome of ischemic stroke as disability (sensibility and specificity are 88,24% and 72,97% respectively).Работа выполнена при поддержке гранта РФФИ № 17-04-00703