ОПЫТ ЛАПАРОСКОПИЧЕСКОЙ ХИРУРГИИ ПРИ ЛЕЧЕНИИ ПОЧЕЧНО-КЛЕТОЧНОГО РАКА НА БАЗЕ РЕСПУБЛИКАНСКОГО КЛИНИЧЕСКОГО ОНКОЛОГИЧЕСКОГО ДИСПАНСЕРА

Purpose of the study. Study of the nearest results of laparoscopic operations in patients with localized renal cell carcinoma.Materials and methods. The results of treatment of 92 patients who underwent operative treatment in the period from 2015 to 2017 with the help of laparoscopic technique for kidney carcinoma were analyzed and evaluated. Of these, 57 men (62%) and 35 women (38%), the average age is 50.5 ± 2.25 years (min. 26 and not more than 75 years). Results. The duration of the operation was influenced by various factors, such as the features of the vascular anatomy of the kidneys, the presence of the adhesive process of the abdominal cavity, the state of paranephalic fat. When improving the technique of performing laparoscopic interventions, the operation time was reduced. In the period of mastering the technique of laparoscopic interventions on the kidney, the operation time averaged 210.0 ± 20.2 min (min 120 and max 300 min); subsequently it decreased on average to 130.00 ± 10.5 min (min 70 and max 190 min). After accumulation of experience, the technique of laparoscopic resection of the kidney without total ischemia with selective clamping of segmental arteries, or without compression of the renal artery was mastered.The conclusion. An analysis of the immediate results of laparoscopic interventions in patients with renal cell carcinoma showed their high efficacy and safety. The results of laparoscopic nephrectomies and kidney resections significantly improve with the improvement of technology and the accumulation of surgical experience. Введение. Цель исследования - изучение ближайших результатов лапароскопических операций у пациентов с локализованным почечно-клеточным раком.Материалы и методы. Проанализированы и оценены результаты лечения 92 пациентов, прооперированных с 2015 по 2017 гг. с помощью лапароскопической техники по поводу почечно-клеточного рака. Из них 57 мужчин (62%) и 35 женщин (38%), средний возраст 50,5±2,25 года (min 26 и max 75 лет).Результаты. На продолжительность операции влияли различные факторы, такие как особенности сосудистой анатомии почек, наличие спаечного процесса брюшной полости, состояние паранефральной жировой клетчатки. При совершенствовании техники выполнения лапароскопических вмешательств время операции значительно сократилось. В период освоения методики лапароскопических вмешательств на почке время операции в среднем составляло 210,0±20,2 мин (min 120 и max 300 мин), в последующем оно уменьшалось в среднем до 130,00±10,5 мин (min 70 и max 190 мин). После накопления опыта была освоена методика лапароскопической резекции почки без тотальной ишемии с селективным пережатием сегментарных артерий или без компрессии почечной артерии.Заключение. Анализ ближайших результатов лапароскопических вмешательств у пациентов с почечно-клеточным раком показал их высокую эффективность и безопасность. Результаты лапароскопических нефрэктомий и резекций почки существенно улучшаются с совершенствованием технологий и накоплением хирургического опыта.

A fluorescent microspheres-based microfluidic test system for the detection of immunoglobulin G to SARS-CoV-2

Background: The pandemic of the new coronavirus infection, COVID-19, is currently ongoing in the world. Over the years, the pathogen, SARS-CoV-2, has undergone a series of mutational genome changes, which has led to the spread of various genetic variants of the virus. Meanwhile, the methods used to diagnose SARS-CoV-2, to establish the disease stage and to assess the immunity, are nonspecific to SARS-CoV-2 variants and time-consumable. Thus, the development of new methods for diagnosing COVID-19, as well as their implementation in practice, is currently an important direction. In particular, application of systems based on chemically modified fluorescent microspheres (with a multiplex assay for target protein molecules) opens great opportunities. Aim: development of a microfluidic diagnostic test system based on fluorescent microspheres for the specific detection of immunoglobulins G (IgG) to SARS-CoV-2. Methods: A collection of human serum samples was characterized using enzyme-linked immunosorbent assay (ELISA) and commercially available reagent kits. IgG to SARS-CoV-2 in the human serum were detected by the developed immunofluorescent method using microspheres containing the chemically immobilized RBD fragment of the SARS-CoV-2 (Kappa variant) viral S-protein. Results: The level of IgG in the blood serum of recovered volunteers was 9-300 times higher than that in apparently healthy volunteers, according to ELISA (p0.001). Conjugates of fluorescent microspheres with the RBD-fragment of the S-protein, capable of specifically binding IgG from the blood serum, have been obtained. The immune complexes formation was confirmed by the fluorescence microscopy data; the fluorescence intensity of secondary antibodies in the immune complexes formed on the surface of microspheres was proportional to the content of IgG (r 0.963). The test system had a good predictive value (AUC 70.3%). Conclusion: A test system has been developed, based on fluorescent microspheres containing the immobilized RBD fragment of the SARS-CoV-2 S-protein, for the immunofluorescent detection of IgG in the human blood serum. When testing the system on samples with different levels of IgG to SARS-CoV-2, its prognostic value was shown. The obtained results allow us to present the test system as a method to assess the level of immunoglobulins to SARS-CoV-2 in the human blood serum for the implementation in clinical practice. The test system can also be integrated into various microfluidic systems to create chips and devices for the point-of-care diagnostics

EXPERIENCE OF LAPAROSCOPIC SURGERY IN THE TREATMENT OF RENAL CELL CANCER ON THE BASIS OF THE REPUBLICAN CLINICAL ONCOLOGICAL DISPENSARY

Purpose of the study. Study of the nearest results of laparoscopic operations in patients with localized renal cell carcinoma.Materials and methods. The results of treatment of 92 patients who underwent operative treatment in the period from 2015 to 2017 with the help of laparoscopic technique for kidney carcinoma were analyzed and evaluated. Of these, 57 men (62%) and 35 women (38%), the average age is 50.5 ± 2.25 years (min. 26 and not more than 75 years). Results. The duration of the operation was influenced by various factors, such as the features of the vascular anatomy of the kidneys, the presence of the adhesive process of the abdominal cavity, the state of paranephalic fat. When improving the technique of performing laparoscopic interventions, the operation time was reduced. In the period of mastering the technique of laparoscopic interventions on the kidney, the operation time averaged 210.0 ± 20.2 min (min 120 and max 300 min); subsequently it decreased on average to 130.00 ± 10.5 min (min 70 and max 190 min). After accumulation of experience, the technique of laparoscopic resection of the kidney without total ischemia with selective clamping of segmental arteries, or without compression of the renal artery was mastered.The conclusion. An analysis of the immediate results of laparoscopic interventions in patients with renal cell carcinoma showed their high efficacy and safety. The results of laparoscopic nephrectomies and kidney resections significantly improve with the improvement of technology and the accumulation of surgical experience