The effect of local immunity on gastric cancer prognosis

Aim. To study the state of local immunity in patients with gastric adenocarcinoma. Materials and methods. From 2017 to 2018, 45 previously untreated patients with gastric adenocarcinoma (25 with stage IIII, 20 with stage IV) received surgical/combined treatment or chemotherapy, respectively, at the Blokhin Scientific Research Center of Oncology. Tumor tissue was taken before treatment. By using flow cytometry there were evaluated the percentage of tumor tissue infiltration by lymphocytes (CD45+CD14-TIL); T cells (CD3+CD19-TIL); B cells (CD3-CD19+TIL); NK cell (CD3-CD16+CD56+TIL); effector cells CD16 (CD16+Perforin+TIL) and CD8 (CD8+Perforin+TIL) with their cytotoxic potential active CD16TIL and active CD8TIL; subpopulations of regulatory T cells NKT cells (CD3+CD16+CD56+TIL), regulatory cells CD4 (CD4+CD25+CD127-TIL) and CD8 (CD8+CD11b-CD28-TIL). The prognostic value of immune cells for overall survival (OS) and progression-free survival (PFS) was assessed. Results. A favorable prognosis factor for progression-free survival in patients with local and locally advanced forms of gastric cancer was an increase in the number of CD3-CD19+TIL (HR 0.862, 95% CI 0.7820.957, p=0.005), and an unfavorable prognosis was an increase in NK cells (CD3-CD16+CD56+TIL); HR 1.382, 95% CI 1.0871.758, p=0.008. The negative effect of the relative content of NK cells (CD3-CD16+CD56+TIL) and NKT cells (CD3+CD16+CD56+TIL) on OS of patients with metastatic gastric cancer noted (HR 1.249, 95% CI 0.9971.564, p=0.053; HR 1.127, 95% CI 1.0251.239, p=0.013). At the same time, an increase in the percentage of tumor tissue infiltration by lymphocytes (CD45+CD14-TIL) and an increase in the age of patients (HR 1.005, 95% CI 1.0021.008, p=0.003; HR 1.098, 95% CI 1.0311.170, p=0.004) reduce the incidence of PFS in patients with metastatic gastric carcinoma. Conclusion. Indices of local immunity can serve as additional prognostic factors for gastric carcinoma

The system of organ donation in the Orenburg region - prospects for further development

The article presents the results of the analysis and evaluation of the regional blood transfusion service. It is noted that in the Orenburg region carried out the restructuring of services, created and functioning system for ensuring quality and safety of all phases of the process of procurement, storage and transportation of blood components. The region has successfully implemented a comprehensive program of development of blood transfusion services, including the development of donor movement. Events of this program will stop the process of reducing the number of blood donors, noted in 2011-2012. In addition, the increase in the number of blood donations, which allowed to harvest up to 18 tons of blood components per year.В статье представлены результаты анализа и оценки деятельности региональной службы переливания крови. Отмечено, что в Оренбургской области осуществлена реструктуризация службы, создана и функционирует система обеспечения качества и безопасности всех этапов технологического процесса заготовки, хранения и транспортировки компонентов крови. В регионе успешно реализуется комплексная Программа развития службы переливания крови, включающая развитие донорского движения. Мероприятия данной Программы позволили остановить процесс снижения числа доноров крови, отмеченный в 2011 -2012 годах. Помимо этого увеличилось и число донаций крови, что позволило заготавливать до 18 тонн компонентов крови в год

The case of a large left atrial myxoma complicated by a cardioembolic cerebral infarction

With the advent of echocardiography significantly increased frequency of in vivo diagnosis of cardiac myxomas. Needs awareness of cardiologists and experts of related specialties regarding the polymorphism of clinical manifestations, morphology, complications and other features of cardiac myxomas is the key to early diagnosis and successful treatment, because it is one of the few potentially curable tumors of the heart. Although a myxoma of the heart belongs among the most studied tumors, ongoing research on etiology, morphology, histogenesis mix, and given us a clinical case indicate the need for improved knowledge about mixomas in order to improve the diagnosis and treatment of patients with cardiac tumors.С появлением эхокардиографии существенно увеличилась частота прижизненной диагностики миксом сердца. Должная осведомленность кардиологов и специалистов смежных специальностей касательно полиморфизма клинических проявлений, морфологии, осложнений и других характеристик миксомы сердца является залогом ранней диагностики и успешного лечения, поскольку это одна из немногих потенциально излечимых опухолей сердца. Хотя миксома сердца принадлежит к наиболее изученным опухолям, продолжающиеся исследования в области этиологии, морфологии, гистогенеза миксом, а также приведенный нами клинический случай указывают на необходимость совершенствования знаний о миксомах в целях улучшения диагностики и лечения пациентов с опухолями сердца

ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ НОВОГО РОССИЙСКОГО НЕНУКЛЕОЗИДНОГО ИНГИБИТОРА ОБРАТНОЙ ТРАНСКРИПТАЗЫ ЭЛСУЛЬФАВИРИНА В ПЕРВОЙ ЛИНИИ ЛЕЧЕНИЯ ВИЧ-ИНФЕКЦИИ В КОМБИНАЦИИ С ДВУМЯ НУКЛЕОЗИДНЫМИ/НУКЛЕОТИДНЫМИ ИНГИБИТОРАМИ ОБРАТНОЙ ТРАНСКРИПТАЗЫ – ИССЛЕДОВАНИЕ 96 НЕДЕЛЬ

A randomized multicenter 96-week study of an elsulfavirine (ESV),  non-nucleoside reverse transcriptase inhibitor (NNRTI) of novel  generation, in combination with 2 nucleoside/ nucleotide reverse  transcriptase inhibitors (NRTIs) was conducted in naive HIV adult  patients, divided by 2 parts: 1) partially blind comparative to  efavirenz (EFV) 48-week study, 2) open-label observational study  during additional 48 weeks. High virological and immunological  effectiveness maintained during the study: proportion of patients  with HIV RNA <50 copies/ml in 48 weeks achieved 81,6%, in 96  weeks – 83,9% (MITT-analysis) and 91% (if patients withdrawn from the study due to other reasons not related to treatment were excluded). No resistance mutations were found in patients with viral  replication blips (HIV RNA 50-1300 copies/ml). CD4+-lymphocytes  count was increased by 187,5 at week 48 and 251,0 cells/mcl at  week 96. Good tolerability and safety were confirmed during second year of treatment: no additional safety data which could influence  benefit/risk ratio were recorded as well as withdrawal from the  treatment due to adverse events. Serious adverse events, connected with treatment, allergic reactions were not registered during the whole 96-week study. Conclusion. Results of the 96-week study confirm earlier data from  48-week study on high efficacy and safety of ESV. Based on these  data ESV was included into “National recommendations on  dispensary follow-up and treatment of patients with HIV-infection” as the first-line ART regime in combination with 2 NRTIs.Проведено многоцентровое рандомизированное исследование элсульфавирина (ESV) –  ненуклеозидного ингибитора обратной транскриптазы (ННИОТ) нового поколения в  комбинации с 2 нуклеотидными/нуклеозидными ингибиторами обратной транскриптазы  (НИОТ) у взрослых пациентов с ВИЧ-инфекцией, ранее не получавших АРТ, длительностью  96 недель, состоявшее из 2 этапов: 1) частично слепое, сравнительное с эфавирензом (EFV) исследование – 48 недель, 2) открытое наблюдательное исследование – дополнительные 48 недель. Наблюдалась высокая вирусологическая и иммунологическая эффективность  лечения, устойчивая в течение 96 недель: доля пациентов с неопределяемым уровнем РНК  ВИЧ <50 копий/мл через 48 недель составила 81,6%, через 96 недель – 83,9% (MITT- анализ) и 91% (без учета пациентов, выбывших по не связанным с лечением причинам). Ни  в одном случае всплесков репликации вируса (РНК ВИЧ от 50 до 1300 копий/мл) не  выявлено мутаций резистентности ВИЧ к препаратам. Прирост медианы количества CD4+- лимфоцитов через 48 недель составил 187,5 клеток/мкл, через 96 недель – 251,0 клетку/ мкл. Подтверждена хорошая переносимость и безопасность лечения в течение второго года  исследования: не выявлено каких-либо новых значимых данных в отношении безопасности,  негативно влияющих на соотношение польза/риск, не зарегистрировано  случаев отмены лечения из-за нежелательных явлений. На протяжении 96 недель не  зарегистрированы серьезные нежелательные явления, связанные с приемом препарата,  аллергические реакции. Заключение. Результаты 96-недельного исследования подтверждают полученные ранее  (по итогам 48 недель применения) данные о высокой эффективности и безопасности  элсульфавирина. На основании полученных результатов элсульфавирин включен в «Национальные рекомендации по диспансерному наблюдению и лечению больных ВИЧ- инфекцией» в качестве режима первой линии АРТ в комбинации с 2 препаратами группы НИОТ

RAPE SWITCHGRASS BIOMASS (Brassica napus) AS RAW MATERIALS FOR BIOBUTANOL PRODUCTION

The aim of the work was to investigate the accumulation of butanol by Clostridium strain producers using meshed green rape biomass as substrate. The accumulation of butanol by producer strains was studied using rape as substrate in the doses of 5–30 g/l. The cells were precipitated in an ultracentrifuge, the supernatant was distilled, and fermentation products were determined. The presence of solvents in the culture fluid was determined by gas chromatography. The biggest accumulation of butanol was produced by the strain Clostridium sp. IMB B-7570 on 2.3 g/l mashed switchgrass biomass. The optimal inoculum concentration for maximum accumulation of butanol using switchgrass biomass was 10% of the volume of fermentation liquid. The greatest accumulation of butanol (2.9 g/l) was obtained in optimal culture conditions and at 10 g/l dry switchgrass biomass in the fermentation medium. Thus, the present study showed that mashed switchgrass biomass was assimilated by Clostridium sp. strains. The accumulation of butanol depended of Clostridium strain, the amount of inoculum, the concentration and degree of grinding of the substrate

Frequency of knee and hip joint pain in Saha (Yakut) republic rural inhabitants

Objective. To assess frequency of knee and/or hip joint pain in Saha (Yakut) republic niral inhabitants. Material and methods. Population eross-sectional epidemiological study was performed in 7 rural settlements. 3401 inhabitants filled the questionnaire (53,9% - female, 46,1% - male, mean age 44,4± 14,1 years). 52,5% of them were in middle age (30-49 years). Completeness of the study was 82,4%. Results. Frequency of pain in knee and hip joints was 44,8%. 38,9% of respondents experienced pain in current year. People with longstanding pain were older (mean age 50,2+13,7 years) than people without pain (mean age 40,9+13,5 years). Pain was more frequent in female (OR= 1,5) and positively correlated with age (p=0,86, p=0,007), particularly in women (p=0,93, p=0,0009). Maximal frequency of pain (56,6%) was found in respondents aged 70-79, minimal — 18-19 years. Conclusion. High frequency of knee and hip joint pain was revealed in Saha (Yakut) republic rural inhabitants in history and in current year. Pain was more frequent in female and increased with age

Vascular age concept: role in assessing risk and choosing therapy

The article discusses the vascular age concept and modern approaches to assessing vascular age. It describes modern methods for measuring arterial stiffness (applanation tonometry or ultrasonic Doppler examination) as the most frequently used index of vascular age. The authors discuss the role of antihypertensive therapy and statins in preventing early vascular aging, and the relationship between the role of achieving lower blood pressure levels and the choice of certain antihypertensive agents to reduce arterial stiffness and ensure optimal vascular age. Increased arterial stiffness has been reported to be a marker of risk for developing severe complications of cardiovascular diseases, in particular, a meta-analysis showed that after taking into account the known risk factors for developing cardiovascular complications, higher carotid stiffness was associated with an increased risk of stroke. It is stated that in addition to biological age, vascular age may increase due to the cumulative effect of such risk factors as high blood pressure, impaired glucose homeostasis, obesity and hypercholesterolemia. Modern approaches to the preservation and maintenance of vascular age are discussed. The key role of achieving lower blood pressure levels is considered. It is emphasized that the role of combination drugs in preventing complications of cardiovascular diseases is strengthened, and approaches to choosing the optimal components of such combination drugs are also considered. The relationship between increased arterial stiffness and the development of cognitive disorders is discussed. The article describes the role of statins and effectiveness of the concomitant use of statins and combination antihypertensive therapy in reducing the pulse wave velocity

Muller Muscle of the Upper Eyelid: Histopathological Features of Congenital and Acquired Ptosis

Purpose: to study the histological features of the Muller muscle of the upper eyelid in patients with congenital and acquired ptosis to understand the mechanism of ptosis. Material and methods. Retrospective analysis of 27 intraoperatively obtained biopsies of the Muller muscle of the upper eyelid. For the study, the biopsies were fixed in a formalin and prepared by paraffinization. After  staining with hematoxylin and eosin and Van Gieson, the preparations were studied in a light microscope. Results. In congenital ptosis of the upper eyelid histologically revealed atrophy of smooth muscle tissue, which manifested itself in a decrease in the number of muscle fibers on the background of fibrous transformation. In micro specimens of patients with acquired ptosis discovered fat cells located among the bundles of smooth muscle fibers, the dispersion of the myocytes. Fat infiltration of muscle ranged from 29 to 51.6 %.Conclusion The presence of dystrophic changes in Muller muscle in congenital and acquired ptosis was proved by histological method. The revealed features explain the pathogenetic mechanisms of the formation of congenital and acquired ptosis. In the case of acquired ptosis, fat dystrophy is an independent etiological factor, and therefore requires non-standard tactics of surgical treatment in order to neutralize the risk of recurrence in the early and late postoperative periods

CHARGE syndrome

The article provides literature data and description of the clinical case of CHARGE syndrome with an autosomal – dominant type of inheritance in a child of 3 years and 7 months. The name of the syndrome is formed by the first letters of the characteristic congenital malformations: “C” (coloboma) – optic disc coloboma, “H” (heart defects) – cardiovascular abnormalities, “A” (atresia of choanae) – atresia or stenosis of choan, “R” (retardation of growth and development) – growth deficit, developmental delay, “G” (genital anomalies) – genital anomalies, “E” (ear abnormalities and sensorineural hearing loss) – hearing organ abnormalities. A feature of the clinical case is the early diagnosis of CHARGE syndrome, manifested by bilateral optic disc coloboma; unilateral paresis of the facial nerve; congenital heart disease (open aortic duct); retardation of growth, psychomotor and psycho-speech development; cryptorchidism; bilateral anomaly of the outer ear (short, wide, absence of the lobe and external curl), sensorineural hearing loss; bilateral renal hypopalasia, chronic kidney disease

FEATURES OF INNATE AND ADAPTIVE IMMUNITY IN PRETERM INFANTS WITH HYPOXIC-ISCHEMIC LESIONS OF THE CENTRAL NERVOUS SYSTEM

For abstract to evaluate the clinical adaptation and immunological parameters in infants with severe hypoxic-ischemic lesions of the central nervous system, we examined small premature, extremely low birth weight (ELBW) infants with gestational age (GA) of 24 to 27,6 and infants with gestational age of 28 to 31 weeks (group 1, n=26 and group 2, n=16). The control group consisted of 15 full-term babies with uncomplicated early period of adaptation, born from apparently healthy women. The immune system of preterm infants at birth, regardless of their gestational age and birth weight, is characterized by decrease of the absolute number of white blood cells, increase of the percentage of lymphocytes and the number of NK-cells, as well as the prevalence of Th1-dependent immune response (increased level of γ-interferon against decrease in levels of interleukine – 1β and interleukine – 4). A specific feature of the immune response of extremely low birth weight infants is abnormal interaction between innate immunity cells and adaptive immunity cells, which is manifested in reduction of the percentage of regulatory CD4+ cells associated with inhibition of the functional activity of T-cells (CD4+CD25+) and monocytes (CD14+HLA-DR+). The decrease in the number of circulating ferritin levels indicates a predisposition of extremely premature infants to viral and bacterial infections