Microcirculatory Status and Metabolic Activity of Tissues after Local Administration of Autologous Plasma on the Model of Explosive Soft Tissue Wound in Rats

Background. The possibility of local application of autologous blood plasma (ABP) in soft tissue injuries is currently of particular interest.Objectives. Evaluation of the effects of peri-wound (perifocal) administration of ABP on red blood parameters, microcirculation and oxygen supply of soft tissues of the limb in experimental explosive wound (EW) in rats.Methods. EW was simulated on male Wistar rats (n=146) using a firecracker with a pyrotechnic mixture (patent RU No. 2741238 dated 22.01.2021). Animals were divided into 4 groups: control (2), comparison (1), main (1). The volume of blood loss in explosive wounds was 8 and 15% of the estimated circulating blood volume (CBV) of the animal. Blood was drawn from the rat tail to obtain ABP. 3 hours after the injury, ABP or 0.9% sodium chloride solution was injected intramuscularly into the explosive wound area at a rate of 2.0 ml/kg of animal weight. After 3, 7, 14, 28 days, the number of red blood cells, haemoglobin content, haematocrit were determined in the blood, and microcirculation and oxidative metabolism parameters were determined in the skeletal muscles of the injured area. The data were processed using Microsoft Excel 2013 (Microsoft, USA) and Statistica 10.0 (StatSoft Inc., USA).Results. Blood loss of 8% of the CBV in injured animals did not lead to changes in the quantitative composition of peripheral red blood. After an explosive wound with a blood loss of 15% of the CBV, there was a moderate decrease in the number of red blood cells (from 8.3×1012/l to 6.5×1012/l, p < 0.02), haemoglobin level (from 149.5 g/l to 118 g/l, p < 0.01), haematocrit (from 43.8% to 33.6%, p < 0.01) with recovery by day 7 of observation. The explosive soft tissue wound was characterized by marked post-traumatic microcirculatory disorders irrespective of the amount of blood loss. Perifocal intramuscular administration of ABP in animals with an explosive wound and blood loss of 15% CBV reduced the severity of post-traumatic microcirculatory and oxidative metabolic disorders mainly in the early post-traumatic period, as evidenced by an increase in the perfusion variation coefficient Kv by 1.2–1.3 times (p < 0.05), tissue oxygen consumption U by 20–22% (p < 0.05) and fluorescent oxygen consumption by FPC by 48% (p < 0.05).Conclusion. With an experimental explosive wound of the soft tissues of the thigh in rats, a single early (3 hours after the injury) peri-wound intramuscular administration of ABP reduces the severity of local post-traumatic microcirculatory and metabolic disorders in skeletal muscle

The efficiency of replenishment of acute blood loss by an experimental blood substitute comprising human’s umbilical cord blood red blood cells

То assess the effectiveness of the experimental blood substitute containing erythrocytes of human umbilical cord blood, were analyzed the dynamics of indicators of cardiovascular and respiratory systems, quantitative indicators of red blood, the severity of hemolysis in dogs within 24 hours after equivalent replenishment of acute blood loss for about 50% of the volume of circulating blood. The comparative drug was the adult human packed RBCs, used in clinical practice. It was found that after replenishment of blood loss in dogs, hemolytic anemia developed less pronounced after transfusion of the blood substitute with erythrocytes of human umbilical cord blood. Indicators of cardiovascular and respiratory systems were restored to the baseline in 24 hours after replenishment of acute blood loss by an experimental blood substitute with human umbilical cord blood erythrocytes with persistent changes after transfusion of the adult human packed RBCs. The relatively higher efficiency of the experimental blood substitute is due to the structural and functional stability of erythrocytes in the umbilical cord blood. A conclusion was made about the prospects of development of blood substitutes-oxygen carriers containing human umbilical cord blood erythrocytes.С целью оценки эффективности экспериментального кровезаменителя, содержащего эритроциты пуповинной крови человека, проведен анализ динамики показателей сердечно-сосудистой и дыхательной систем, количественных показателей красной крови, выраженности гемолиза у собак в течение 24 часов после восполнения острой экспериментальной кровопотери около 50% от объема циркулирующей крови. Препаратом сравнения служила эритроцитарная масса человека, используемая в клинической практике. Установлено, что после восполнения кровопотери у собак развивалась гемолитическая анемия, менее выраженная после трансфузии кровезаменителя с эритроцитами пуповинной крови человека. Показатели деятельности сердечно-сосудистой и дыхательной систем восстанавливались до исходного уровня через 24 часа после восполнения кровопотери экспериментальным кровезаменителем с эритроцитами пуповинной крови человека при сохраняющихся изменениях после вливания эритроцитарной массы человека. Сравнительно более высокая эффективность экспериментального кровезаменителя объясняется структурно-функциональной стабильностью эритроцитов пуповинной крови. Сделано заключение о перспективности разработки кровезаменителей-переносчиков кислорода, содержащих эритроциты пуповинной крови человека

Vitamin D (steroid hormone) and the nervous system diseases (literature review)

The present review aims to summarize the activities of vitamin D effects on the nervous system and to clarify a vitamin D role in brain diseases, in the pathogenesis or as a serum biomarker for the disease development and severity. Objective: correlation between chronic nervous system diseases and vitamin D level. Methods: a literature research in PubMed and in Russian electronic resources by keywords: vitamin D, brain diseases, chronic nervous system diseases. Results. Vitamin D as a neurosteroid hormone stimulates cerebral activity in both adult and embryonic brain regulates the activity of neural circuits which are responsible for locomotor, reward-dependent and emotional behavior. Patients with autism spectrum disorders, schizophrenia, Alzheimer disease, multiple sclerosis, Parkinson disease and sleep disorders have been shown to have low level of vitamin D. Discussion. Data are controversial, a further study of vitamin D hypovitaminosis significance is essential for the nervous system chronic diseases manifestation and evaluation of the vitamin D dietary supplement efficiency in patients with the nervous system pathology

То the question about the requirements of translation of medical organizations on a strict anti-epidemic regime

The paper presents an overview of the legislative and regulatory framework, on the basis of which is the translation of multidisciplinary healthcare organizations on a strict anti-epidemic mode. Reviewed the list of guidance documents that are working in medical organizations in identifying patients (corpses) infectious diseases, which are categorized vysokochastotnykh, particularly hazardous and quarantine infections.В статье проведен обзор законодательной и нормативной базы, на основе которой проводится перевод многопрофильных медицинских организаций на строгий противоэпидемический режим работы. Рассмотрен перечень руководящих документов, отрабатываемых в медицинских организациях при выявлении больных (трупов) инфекционными заболеваниями, которые относятся к категории высококантагиозных, особо опасных и карантинных инфекций

Механизмы повреждения эритроцитов при токсическом действии метгемоглобинобразователей

Structural properties of lipid component of erythrocyte membrane of Wistar rats with methemoglobinemia were investigated after one injection of sodium nitrite and phenylhydrazin chloride in DL50 dose. It was shown that in methemoglobinemia cholesterol, lysophosphatidylcholine, sphingomyelin, phosphatidylserine levels are increased and phosphatidylcholine and phosphatidyletanolamine levels are decreased, and an increase of microviscousity of erythrocyte membrane lipid matrix was elevat-ed. The degree of the elucidated changes depends on a xenobiotic and a time of methemoglobinemia period.Исследованы структурные свойства липидного компонента эритроцитарной мембраны у крыс линии Wistar при метгемоглобинемиях, индуцированных однократным введением нитрита натрия и солянокислого фенилгидразина в дозах DL50. Показано, что при метгемоглобинемиях увеличивается содержание холестерина, лизофосфатидилхолина, сфингомиелина, фосфатидилсерина, снижается уровень фосфатидилхолина и фосфатидилэтаноламина, в мембране эритроцитов возрастает микровязкость липидного матрикса. Степень выявленных изменений зависит от вида ксенобиотика и продолжительности периода метгемоглобинемии

The list of potentially hazardous biopathogens affecting the functioning of the hospital phase medical evacuation

The article analyzes the biopathogenic, which can be used by medical evacuation hospital stage diversion for terrorist purposes.В статье проведен анализ биопатогенов, которые могут применяться по госпитальному этапу медицинской эвакуации диверсионным методом с террористической целью

Local treatment of chloasma in pregnant women

Goal. To assess the efficacy and safety of Azelic (15% gel of azelaic acid for topical administration) for the treatment of chloasma in pregnant women. Materials and methods. The study involved 28 pregnant women aged 18-36 (mean age: 24.7) with a normal course of pregnancy. The patients consulted a doctor in the spring, summer or fall complaining of focal skin hyperpigmentation on the face, chin and chest area. Ten patients (35.7%) developed hyperpigmentation prior to their pregnancy and 18 women (64.3%) - during the pregnancy. As of the consultation date, the pregnancy terms in all of the patients were 18-20 weeks. Chloasma was diagnosed by using dermatoscopy and skin examination with the Wood’s lamp. The patients were informed about the content and procedure of the study and gave their consent to take part in the study. Thin layers of Azelic (15% gel of azelaic acid for topical administration) were applied to the hyperpigmented skin of the patients and gently rubbed twice a day (in the morning and evening) as topical treatment for four months. The treatment results were assessed taking into consideration the patient’s subjective assessment, study group structure depending on the clinical efficacy, percentage of adverse events, and survey results based on the Dermatology Life Quality Index questionnaire. To reveal any potential general toxicological effects of the treatment, hepatic samples, total blood count and coagulogram results were analyzed as a part of obstetrical and gynecologic care for pregnant women. Key findings. Positive dynamics of the following characteristics was revealed: subjective assessment of treatment results by the patients, clinical efficacy of treatment and life quality index. Therapeutic results were observed as early as after one month but not later than three months after the treatment began. The therapeutic efficacy was recorded in 92.9-96.4% of all cases after four months of treatment: pigment spots disappeared or became paler, and their dimensions and their contrast as compared to the healthy skin reduced, the skin texture and life quality improved (the Dermatology Life Quality Index reduced from 15.5 ± 1.8 to 6.7 ± 0.5 points against the background of the treatment efficacy: from severe to moderate impact of the disease on the patient’s life, respectively). Five women (17.9%) developed erythema and burning sensations in the drug application site within the first two weeks immediately after the gel application (one of the patients had the same symptoms for six weeks of the treatment); the symptoms were weak and transient and did not require any additional treatment. Hepatic samples, total blood count and coagulogram results were within physiological standards during the treatment. Conclusion. Topical application of Azelic (15% gel of azelaic acid for topical administration) twice a day for four months is an efficient and safe method to treat chloasma in pregnant women