Possibilities of prophylaxis of purulent complications in patients with acute intestinal obstruction

Academia Medicală de Studii Postuniversitare, Harkov, Ucraina, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Mortalitatea postoperatorie prin complicaţii septice acute ce survin la 50-85% dintre pacienţii cu ocluzii intestinale acute (OIA) ajunge pînă la 17-21%. Injectarea intraluminală a antibioticelor, terapia parenterală empirică cu antibiotice, cît şi intubarea intestinului urmată de lavaj nu îmbunătăţesc parametrii indicaţi mai sus. Scopul studiului: Definirea rolului antibioticilor, care reprezintă cel mai răspîndit grup, în profilaxia complicaţiilor purulente septice în OIA. Material şi metode: Au fost analizate rezultatele tratamentului a 176 pacienţi, inclusiv a 62 cazuri diagnosticate cu OIA; obturaţie – în 82 cazuri, iar în 32 cazuri cauza a fost hernia strangulată. Primul grup a inclus 81 pacienţi, 41 dintre care au beneficiat de tratament parenteral cu preparate din grupul aminoglicozidelor şi 40 – preparate din seria penicilinelor. Al doilea grup a inclus 95 pacienţi, la 48 dintre care li s-au administrat preparate din grupul fluorochinolonelor şi 47 – preparate din seria cefalosporinelor. Alegerea preparatelor antibacteriene s-a bazat pe rezultatele studiului experimental de acumulare a antibioticelor în peretele intestinal inflamat. Rezultate: Eficacitatea terapiei antibacteriene a fost estimată prin frecvenţa ritmului cardiac, temperatura corpului, timpul de restabilire a peristalticii, normalizarea indicilor clinici ai sîngelui şi urinei, caracterul şi calitatea complicaţiilor purulente. În ambele grupuri nu au fost stabilite diferenţe semnificative referitoare la temperatura corpului şi timpul de restabilire a peristalticii. Au fost atestate deosebiri semnificative între grupuri în ceea ce priveşte timpul de normalizare a frecvenţei ritmului cardiac, formula sîngelui şi rata complicaţiilor purulente. În grupul al doilea de pacienţi numărul complicaţiilor inflamatorii purulente a fost de 21%, iar în primul grup, în care pacienţilor li s-au administrat preparate aminoglicozide – 33,3%. Concluzii: Utilizarea parenterală a fluorochinolonelor şi cefalosporinelor a influenţat rezultatele experimentului, diminuînd esenţial complicaţiile purulente septice asociate cu OIA.Introduction: Post-operative mortality with acute-septic complications in patients with acute intestinal obstruction (AIO) as its reason in 50-85% cases comprises 17-21%. Intraluminal introduction of antibiotics, empirical parenteral antibiotic therapy as well as intestinal intubation with further lavage did not improve the parameters mentioned above. The aim of study: Definition of antibiotics role, the most widespread groups, in septic complications prophylaxis in AIO. Material and methods: There were analyzed the results of treatment of 176 patients, including 62 cases with diagnosed AIO of adhesive genesis, obstructive – in 82 cases and 32 cases with strangulated hernia. The first group included 81 patients, 41 – have incurred preparations with parenteral aminoglycosides and 40 – preparations with penicillin series. The second group included 95 patients, 48 of them followed preparations with fluoroquinolones and 47 – with cephalosporin. The choice of antibacterial preparations was based on the data of experimental trial on antibiotics cumulation in the wall of inflamed intestine. Results: Efficacy of antibacterial therapy was estimated considering heart rate frequency, body temperature, and terms of peristaltic restoration, normalization of blood and urine tests, character and quality of purulent complications. In the second group of patients (fluoroquinolones and cephalosporins preparations) the number of purulent inflammatory complications was 21%, but in the first group (aminoglycosides) – 33.3%. Conclusion: Parenteral indication of fluoroquinolones and cephalosporines in patients with acute intestinal obstruction influence on the results essentially decreases the number of purulent complications correlated with AIO

ASSOCIATION OF HLA AND CYTOKINES OF BLOOD WITH ANTIINFLAMMATORY EFFECTS IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS

Cytokines and HLA take important part in immunogenesis of many diseases, therefore the analysis of these indices and this associations in dependence of glomerulonephritis (GN) can define their value as the additional prognostic markers. Aim of the work is to determine the of associations the high serum levels of cytokines (IL-4, IL-17) and peculiarities of some HLA in phenotype to substantiate of chronic glomerulonephritis with nephrotic syndrome (CGN, NS) immunogen- esis and to ascertain the additional prognostic markers. Materials and methods. There was studied the HLA-antigens distribution in the 264 adult patients CGN, NS (the diagnosis was confirmed morphologically using the thin needle nephrobiopsy) and 350 healthy donors by typing the lymphocytes with the aid of standard microlymphocytotoxic test (Terasaki’s test). HLA antigens were defined using a standard microlymphocytotoxic test on the Terasaki's planchette with special panels ofanti-HLA serums (20 antigens of locus A, 31 - B and 9 - DR). The etiologic fraction (attributive risks ) was counted using the formula: ct = x - y/I - y, where x - frequency of antigen in patients and y - frequency in healthy. The ct reading was considered significant when it exceeded 0,1. Using ELISA, the level of the cytokines was studied in the blood serum - IL-4 in 76 and IL-17 – 79 patients. Results. HLA-A23, -24, -28, -B8, -38, -41, -44, DR1, -4, -w52 in adults patients have associations (RR>2) CGN, NS; the attributive risk (AR) (0,1) to develop GN detected in patients have A24, A28, B8, DR 1, 4, w52. The CGN, NS patients has statistically higher serum level of the IL-4 and IL-17, with more high indices of this cytokines in patients with attributive risk antigens HLA-A24 and A-28. The highest levels of IL-17 detected also in adults case have B14 and B38, which associated with steroid sensitive NS. HLA-B8, which associated with steroid resistant NS, have more patients with CGN, NS with lower serum level of antiinflammatory IL-4. Conclusion. The patients with CGN, NS have associations of HLA and serum levels of pro- and antiinflammatory cytokines IL-4 and IL-17, which play role of additional prognostic predictors

Особливості показників імунітету у хворих на непроліферативні форми хронічного гломерулонефриту

Мета роботи: визначити особливості HLA-фенотипів та показників цитокінової ланки імунітету з факторами ендотеліальної дисфункції у хворих на непроліферативні (НП) форми хронічного гломерулонефриту (ХГН) з нефротичним синдромом (НС). Матеріал та методи. Вивчали розподіл HLA-антигенів за допомогою мікролімфоцитотоксичного тесту Терасакі у 264 хворих на ХГН, НС (серед яких аналізували дані 96 з НП ГН) та 350 здорових донорів. Морфологічний діагноз був підтверджений методом тонкоігольної нефробіопсії. Для вивчення рівнів цитокінів та факторів ендотеліальної дисфункції в крові 110 пацієнтів використовували імуноферментний аналіз. Результати. Для ХГН, НС відносний ризик високий (RR> 2)за наявності HLA-А23, 24, 28, В8, 38, 41, 44 (у хворих на НП ГН +А30),причинна роль (σ> 0.1)показана для А24, 28, В8 (НП +A19+31+32); протекторами захворювання є В12 та В16 (НП +А9). Виявлені антигени-провокатори різних морфологічних форм ХГН. У пацієнтів з НП ГН виявлено в крові високі рівні як про- (трансформуючий фактор росту альфа (TNF-α), інтерлейкіну 17 (IL-17), моноцитарний хемоатрактантний протеїн 1 (МСР-1)), так і протизапальних (IL-4, трансформуючий фактор росту бета (TGF-β)) цитокінів, факторів ендотеліальної дисфункції (фактор росту ендотелію судин (VEGF), розчинна молекула адгезії судинних клітин (sVCAM-1)) та зниження Е-селектину. РівеньMCP-1 у хворих на проліферативні ГН був вищим, ніж у разі непроліферативних форм. Не виявлено достовірних змін цих показників імунітету в групі хворих на НП ГН після проведеного лікування, за винятком зниження TNF-α (р = 0,001), але позитивний ефект лікування асоціював з достовірним зниженням концентрацій МСР-1 (р = 0,005) і VEGF (р = 0,028). Висновки. Виявлені достовірні асоціаціїHLA з ХГН, НС та його непроліферативними морфологічними формами дозволяють вважати такі антигени в фенотипі пацієнтів та інші показники імунітету ((TNF-α,MCP-1 і VEGF) додатковими прогностичними маркерами

HLA-PHENOTYPE IN PATIENTS WITH GLOMERULONEPHRITIS WITH VARIOUS MORPHOLOGIC FORMS AND NEPHROTIC SYNDROM

In the work was determined the HLA-phenotype specificities in patients with different morphologic forms of chronic glomerulonephritis and nephrotic syndrome (CGN, NS) to define the additional predictors of a disease course. Materials and methods. There was studied the HLA-antigens distribution in the 264 CGN, NS patients and 350 healthy donors by typing the lymphocytes with the aid ofstandard microlymphocytotoxic test (Terasaki’s test). The diagnosis was confirmed morphologically using the thin needle nephrobiopsy. Results. It is advisable to associate CGN, NS (RR > 2) with antigens HLA- A23, 24, 28; B8, 38, 41, 44 in patients; the causal role (a > 0.1) was determined for A24, 28; B8. In proliferative GN was additionally revealed the etiologic role of B27 known as antigen associated with risk ofautoimmune diseases. In patients with various morphologic forms is advisable the association of some antigens with development of chronic renal failure (CRF) – A30, B41 in FSGS, A10 – MGN; and also hormone resistance (HR) – A19+31+32 in FSGS, B8 – MGN and MC. Conclusion. The revealed reliable associations ofHLA types both with CGN, NS and its separate morphologic forms with the risk of CRF and/or HR allow take into consideration the availability ofsuch antigens in phenotype ofpatients with confirmed by biopsy diagnosis as the additional diagnostic and prognostic markers

VASCULAR ENDOTHELIAL GROWTH FACTOR AND HLA-PHENOTYPE IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS

It was to determine associations the serum levels ofVEGF and with HLA inpatients with chronic glomerulonephritis and nephrotic syndrome (CGN, NS). Materials and methods. There was studied the serum levels of VEGF (80 patients) by ELIZA and HLA-antigens distribution in the CGN, NS patients (534) by typing the lymphocytes with the aid of standard microlymphocytotoxic test (Terasaki’s test). The diagnosis was confirmed morphologically using by nephrobiopsy. Results. The distribution of HLA-A, В antigens of the 2 group patients having the CGN, NS with various serum levels of VEGF is shown. Associations of some HLA-antigens and high levels of vascular endothelial growth factor in blood were noted. Conclusion. High serum level VEGF and HLA-A9, A10 (25+26) and B8 in CGN, NS patients associated with steroidoresistence

МОДЕЛІ АНАЛІЗУ ДИНАМІКИ ІНДИКАТОРІВ ФІНАНСОВОЇ БЕЗПЕКИ ДЕРЖАВИ

The paper presents a methodical approach to building complex models for analysis of the state’s financial security (SFS) indicators dynamics, based on such methods of multivariate data analysis as the principal component analysis, canonical correlation, level of development, vector autoregression technology, error correction model. Vector autoregressive models of the SFS indicators dynamics of Ukraine and the countries of the European Union have been developed. The interrelationships of the SFS components, short–term effects, the rate of return to the equilibrium trajectory after the impact of external "shocks" (threats) have been studied. Were selected the most sensitive to external "shocks" SFS subsystems, sources of threat occurrence. The proposed complex of models can be considered as an element of the model basis of the forecasting and analytical mechanism of the financial security provision system, which is aimed at earlier informing, detecting threats and preventing their negative impact.В работе предложен методический подход к формированию комплекса моделей анализа динамики индикаторов финансовой безопасности государства (ФБГ), основанный на таких методах многомерного анализа данных, как метод главных компонент, канонических корреляций, уровня развития, векторные авторегрессионные технологии, модели коррекции ошибки. Разработаны векторные авторегрессионные модели динамики показателей ФБГ Украины и стран Евросоюза. Исследованы взаимосвязи компонент ФБГ, краткосрочные эффекты, скорость возврата к равновесной траектории после воздействия внешних «шоков» (угроз). Выделены наиболее чувствительные к внешним «шокам» подсистемы ФБГ, источники возникновения угроз. Предложенный комплекс моделей может рассматриваться как элемент модельного базиса прогнозно–аналитического механизма системы обеспечения финансовой безопасности, направленной на ранее информирование, обнаружение угроз и предупреждение их негативного влияния.У роботі запропонований методичний підхід до формування комплексу моделей аналізу динаміки індикаторів фінансової безпеки держави (ФБД), заснований на таких методах багатомірного аналізу даних, як метод головних компонент, канонічні кореляції, рівня розвитку, векторні авторегресійні технології, моделі корекції помилки. Розроблені векторні авторегресійні моделі динаміки показників ФБД України й країн Євросоюзу. Досліджені взаємозв'язки компонент ФБД, короткострокові ефекти, швидкість повернення до рівноважної траєкторії після впливу зовнішніх «шоків» (погроз). Виділені найбільш чутливі до зовнішніх «шоків» підсистеми ФБД, джерела виникнення погроз. Запропонований комплекс моделей може розглядатися як елемент модельного базису прогнозно–аналітичного механізму системи забезпечення фінансової безпеки, яка спрямована на раннє інформування, виявлення погроз і попередження їх негативного впливу

Green synthesis of silver nanoparticles using transgenic <i>Nicotiana tabacum</i> callus culture expressing silicatein gene from marine sponge <i>Latrunculia oparinae</i>

<p>In the present investigation, transgenic tobacco callus cultures and plants overexpressing the silicatein gene <i>LoSilA1</i> from marine sponge <i>Latrunculia oparinae</i> were obtained and their bioreduction behaviour for the synthesis of silver nanoparticles (AgNPs) was studied. Synthesized nanoparticles were characterized using UV–visible spectroscopy, Fourier transformed infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), atomic flame electron microscopy (AFM) and nanoparticle tracking analysis (NTA). Our measurements showed that the reduction of silver nitrate produced spherical AgNPs with diameters in the range of 12–80 nm. The results of XRD analysis proved the crystal nature of the obtained AgNPs. FTIR analysis indicated that particles are reduced and stabilized in solution by the capping agent, which is likely to be proteins present in the callus extract. Interestingly, the reduction potential of <i>LoSiLA1</i>-transgenic callus line was increased three-fold compared with the empty vector-transformed calli. The synthesized AgNPs were found to exhibit strong antibacterial activity against <i>Escherichia coli</i> and <i>Agrobacterium rhizogenes</i>. The present study reports the first evidence for using genetic engineering for activation of the reduction potential of plant cells for synthesis of biocidal AgNPs.</p