КЛИНИЧЕСКОЕ СОСТОЯНИЕ И ХЕМИЛЮМИНЕСЦЕНТНАЯ АКТИВНОСТЬ НЕЙТРОФИЛЬНЫХ ГРАНУЛОЦИТОВ БОЛЬНЫХ РАСПРОСТРАНЕННЫМ ГНОЙНЫМ ПЕРИТОНИТОМ В ДИНАМИКЕ ПОСЛЕОПЕРАЦИОННОГО ПЕРИОДА

The aim of this study was to evaluate the clinical condition and to study the chemiluminescent activity of granulocytes of patients with widespread purulent peritonitis in the dynamics of post-operative treatment. The severity of the patients was determined by the SAPS scale, the presence of systemic inflammatory response syndrome was assessed by the criteria of the ACCP/SCCM. Severity and prognosis of the disease was evaluated using the Mannheim peritonitis index and the index of abdominal cavity. The severity of multiple organ failure at admission to the hospital and in postoperative period dynamics were determined by the scale of the SOFA. The study of lucigenin- and luminal-dependent chemiluminescence of neutrophils in peritonitis were taken on admission to the hospital, and on the 7th, 14th and 24th day of the postoperative period. There were a variety of systemic complications (tertiary peritonitis, perforation of hollow organs, abscesses of the abdominal cavity and other) in patients with widespread purulent peritonitis 2nd severity in 96,2% of cases. The mortality rate among patients amounted to 22.2%. It was found in the study of neutrophils chemiluminescent activity that intensity of the “respiratory burst” in pre- and postoperative periods in patients with peritonitis is defined mainly by the synthesis level of secondary reactive oxygen species. The level of synthesis of superoxide radicals by neutrophils in a state of relative dormancy, increased by 14 days after the operation and is reduced to the reference level to the 21st day. In the preoperative period and before the end of the observation level of synthesis of secondary reactive oxygen species by neutrophils of patients with peritonitis was increased, but is on the background of the slow activation of enzymes, providing a “respiratory burst”. Trend towards normalization of neutrophils chemiluminescent activity in the blood of patients with peritonitis by the end of the observation period (24th day of the postoperative period).Целью исследования явилась оценка клинического состояния и изучение хемилюминесцентной активности нейтрофильных гранулоцитов больных распространенным гнойным перитонитом в динамике послеоперационного лечения. Степень тяжести состояния больных определяли по шкале SAPS, наличие синдрома системной воспалительной реакции – по критериям ACCP/SCCM. Тяжесть и прогноз заболевания оценивали с помощью Мангеймского индекса перитонита и индекса брюшной полости. Наличие и степень выраженности полиорганной недостаточности при поступлении и в динамике послеоперационного периода определяли по шкале SOFA. Исследование люцигенин- и люминол-зависимой хемилюминесценции нейтрофилов при перитоните производили при поступлении в стационар, а также на 7-е, 14-е и 24-е сут послеоперационного периода. У обследованных больных с диагнозом «Распространенный гнойный перитонит 2-й степени тяжести» в 96,2% случаев наблюдались различные системные осложнения (третичный перитонит, перфорации полых органов, абсцессы брюшной полости и др.). Летальность среди обследованных составила 22,2%. При исследовании хемилюминесцентной активности нейтрофильных гранулоцитов установлено, что у больных перитонитом в до- и послеоперационном периодах интенсивность «дыхательного взрыва» определяется преимущественно уровнем синтеза вторичных активных форм кислорода. Уровень синтеза супероксид-радикала нейтрофилами, находящимися в состоянии относительного покоя, повышается только на 14-сут после операции и снижается до контрольных значений к 21-м сут. При индукции «дыхательного взрыва» уровень синтеза супероксид-радикала повышается на 7-е сут послеоперационного периода и остается высоким до конца наблюдения. За весь период наблюдения уровень синтеза вторичных активных форм кислорода нейтрофилами больных перитонитом повышен на фоне замедленной активации ферментов, обеспечивающих «дыхательный взрыв». К концу периода наблюдения (24-е сут послеоперационного периода) выявляется тенденция к нормализации хемилюминесцентной активности нейтрофилов крови больных перитонитом

THE IMPLEMENTATION OF THE INNOVATIVE NUMERICAL SIMULATION SYSTEM (FEM) FOR THE INVESTIGATION IN THE VIBRO-ACOUSTIC (NVH) BEHAVIOR OF THE AUTOMOBILE PARTS

The numerical simulation system for structural intensity analysis and visualization to apply for FEM-models has presented. The mathematical formulation of the Structural Intensity has introduced, the numerical simulation system has implemented in ANSYS program software, the visualization technique of the vector fields of energy flow has realized in HyperView software. The intensity vectors, streamline map and energy distribution in shell-elements plate under excitation force are calculated and visualized to predict mechanical energy transmission. The cases with different excitations (point force and pressure) and different damping parameters have been studied. Using the system, the analysis was carried out to visualize structural intensity fields on the global shell-elements structure and to investigate dominant energy flow paths from harmonic excitation sources. The structural intensity analysis together with visualization techniques provides a powerful tool for vibration and noise control

RESULTS OF DYNAMIC ASSESSMENT OF MELATONIN RECEPTOR EXPRESSION IN LYMPHOCYTES IN PATIENTS WITH ACUTE MILD AND SEVERE PANCREATITIS

The authors present results of the investigation of melatonin receptors expression in lymphocytes in dynamics in 102 patients with acute pancreatitis of mild and severe form and in 50 volunteers. A correlated analysis was made between obtained results of laboratory and instrumental researches and clinical course of acute pancreatitis. The decrease of MT1 receptors expression was noted on 25% in patients with acute pancreatitis. The decline of MT2 receptors expression was observed on 40% of patients with acute severe pancreatitis and in a case of acute mild pancreatitis — on 15,5%, respectively. Values of MT1 and MT2 expression were equal between healthy volunteers. The decline of MT2 expression was a prognostic unfavourable sign. Obtained results of dynamic expression assessment of MT-receptors were presented as MT2/MT1 indices. Given index didn’t change during disease, because of this, the index could be used as a prognostic development marker of destructive form of acute pancreatitis at the moment of patient’s admission to hospital. Mean values of MT2/MT1 were determined for the purpose of universalization of used method (1,13±0,09 for mild form and 0,81±0,09 for severe form of acute pancreatitis, respectively)

THE PATTERNS OF FUNDUS ABNORMALITIES AND CARDIOVASCULAR DISEASES

Purpose: The patterns of findings in a fundus in cardiovascular (СVD) and chronic non-communicable diseases have been investigated in European and North American populations with heterogeneous results. The subject has not been practically studied in Russian population. We performed systematic literature search for 15 years (2001-2015) to summarize the data from published studies on the relationship between fundus abnormalities and CVD and its’ complications. Methods. We used the Internet resources: PubMed (http://www.ncbi.nlm.nih.gov/pubmed/), Scopus (http://www.scopus.com), e-library (http://elibrary.ru/defaultx.asp) and major domestic cardiological, therapeutic and ophthalmologic journals. Results. The analysis of the data accumulated in the literature showed the associations between specific patterns of fundus abnormalities and CVD, and also a prognostic impact of these changes on the development of complications of CVD. Namely are shown: the association between a narrowing of arteries and dilation of veins and the risk of ischemic heart disease and fatal CVD; the association between an increase of vein diameter and the risk of a cerebral stroke; the relationship between fundus changes and aging and risk factors of CVD; the contribution of ophthalmoscopic identification of fundus abnormalities to the stratification of cardiovascular risk