Differences in expression profiles in malingant melanoma patients according to immunotherapy response

One of the most important branch of modern molecular genetics and biomedicine is the search for predictive markers that help choose the most effective way of treatment, drug and also determine its individual dosage. Among the markers, those that can provide the possibility of using a non­invasive, so­called “liquid biopsy” are considered particularly promising. This method allows the condition of the tumor to be assessed by analyzing the body’s natural fluids, such as blood, urine or saliva. Such studies are most convenient in those cases when it is necessary to monitor the effectiveness of therapy in order to record the time of the onset of resistance of tumor cells, the onset of relapse and to move on to the next line of therapy. In the treatment of aggressive and rapidly became metastatic malignant tumors, such as melanoma, the presence of reliable markers that allow quick and accurate determination of treatment tactics is especially important. Nowadays, there is an increasing number of studies devoted to the search for predictive markers of the effectiveness of immunotherapy. Melanoma is one of the most immunogenic tumors and, as a result, has become a model object for research into and introduction of new approaches to immunotherapy. In this study, we compared two groups of patients with metastatic skin melanoma, with different responses to immunotherapy with blockers of immune control points, to identify new predictive expression biomarkers among microRNAs and mRNAs, and to identify the genes responsible for the occurrence of an objective response to therapy. As a result, the study detected several microRNAs with a significant change in expression level within the tumor tissue of patients responding differently to immunotherapy. Differences in the level of expression of their target genes have also been found, that will allow a more detailed analysis of the molecular mechanisms that determine the sensitivity or resistance of malignant melanoma cells to the immunotherapy. Based on the obtained data, we have proposed expression markers (mRNAs and microRNAs) that can be used as predictors of malignant melanoma tumors to immunotherapy

Опыт использования системы вакуумной терапии ран при лечении высокого наружного тонкокишечного свища

The article presents the experience of successful patient treatment with a high external small bowel fistula using a combined approach: surgery and vacuum therapy.В статье приведен опыт успешного лечения пациента с высоким наружным тонкокишечным свищом с помощью комбинированного подхода, сочетающего хирургическое вмешательство и вакуумную терапию

НАСЛЕДСТВЕННЫЙ РАК МОЛОЧНОЙ ЖЕЛЕЗЫ И ЯИЧНИКОВ

The annual incidence of breast cancer (BC) in the world is 1,383,000 cases. Genetic predisposition is one of the major risk factors for breast cancer and ovarian cancer (OC). The proportion of hereditary breast cancer ranges from 5 to 10%, which amounts 69 150-138 000 cases. Family history of accumulation of breast cancer and tumors of the female reproductive system have 25% of patients. Thus, patients with hereditary forms and family breast cancer account 345,700 of all diagnosed cases of breast cancer. Hereditary ovarian cancer occurs in 10-17% cases. Hereditary breast and ovarian cancer are characterized by autosomal dominant inheritance with high (incomplete) penetrance, incidence in early age and pronounced phenotypic and genotypic heterogeneity. According to numerous studies, 20-50% of hereditary breast cancer cases and 90-95% of hereditary ovarian cancer cases in women, and from 4 to 40% of breast cancer cases in men are caused by germinal mutations in the BRCA1 and BRCA2 genes. Considering the syndromic pathology of hereditary BC and OC and can also be associated with mutations in genes TP53, CHEK2, MLH1, MSH2, PALB2, PTEN, NBS1, ATM, BRIP1, RAD50, BLM, FGFR2, and others.Ежегодная заболеваемость раком молочной железы (РМЖ) в мире составляет 1 383 000 случаев. Генетическая предрасположенность является одним из основных факторов риска развития РМЖ и рака яичников (РЯ). Доля наследственно-обусловленного РМЖ колеблется от 5 до 10 %, что составляет 69 150-138 000 случаев. Семейную историю накопления РМЖ и опухолей женской репродуктивной системы отмечают 25 % заболевших женщин. Таким образом, пациенты с наследственными и семейными формами РМЖ в целом составляют 345 700 от всех диагностированных случаев РМЖ [1]. Наследственный рак яичников встречается с частотой 10-17 % [2,3]. Наследственные РМЖ и РЯ характеризуются аутосомно-доминантным типом наследования с высокой (неполной) пенетрантностью, ранним возрастом возникновения и выраженной генотипической и фенотипической гетерогенностью [3-6]. По данным многочисленных исследований, 20-50 % наследственного рака молочной железы (НРМЖ) и 90-95 % — наследственного рака яичников (НРЯ) у женщин, а также от 4 до 40 % РМЖ у мужчин обусловлены герминальными мутациями в генах BRCA1 и BRCA2 [2,3,7,8]. С учетом синдромальной патологии НРМЖ и НРЯ могут быть ассоциированы также с мутациями в генах TP53, CHEK2, MLH1, MSH2, PALB2, PTEN, NBS1, ATM, BRIP1, RAD50, BLM, FGFR2 и др. (таблица 1)

ГЕРМИНАЛЬНЫЕ МУТАЦИИ В ГЕНАХ ГОМОЛОГИЧНОЙ РЕКОМБИНАЦИИ В ПОПУЛЯЦИИ ПАЦИЕНТОВ РАКОМ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ: ОПЫТ ОДНОГО ЦЕНТРА

Objective. To estimate the frequency of germline mutations in homologous recombination genes in a population of patients with pancreatic cancer and to assess the possibility to predict the risk of mutation carriage based on the clinical and anamnestic data.Materials and methods. The study included patients diagnosed with pancreatic cancer, blood samples of which were taken to detect clinically significant germline mutations in the BRCA1, BRCA2, CHEK2, BLM, NBS1, and PALB2 genes. Clinical data and family history data were collected for each patient.Results. The study included 99 patients. Mutations in BRCA1 gene were detected in 4 % of cases, in CHEK2 gene – in 2 %. No mutations were detected in the BRCA2, as in BLM, NBS1, and PALB2 genes. Localization of primary tumor, presence of distant metastases, stage of disease, family history of malignant neoplasms did not correlate with the risk of BRCA1 mutation (p>0.05). The patient’s eligibility for NCCN criteria for BRCA1 gene mutation diagnosis proved to be a significant marker of germline mutation presence (p=0.043).Conclusions. NCCN criteria for genetic testing are the best predictor of BRCA1 germline mutation in patients with pancreatic cancer.Цель исследования. Изучить частоту герминальных мутаций в генах гомологичной рекомбинации в популяции пациентов раком поджелудочной железы и оценить возможность предсказания риска носительства мутации в этих генах на основе сбора клинических и анамнестических данных.Материалы и методы. В исследование включались пациенты с диагнозом рака поджелудочной железы, у которых осуществлялся забор крови для выявления клинически значимых герминальных мутаций генов BRCA1, BRCA2, CHEK2, BLM, NBS1 и PALB2. У каждого пациента проводился сбор клинических данных и данных семейного анамнеза.Результаты исследования. В исследование включено 99 пациентов. Мутации в гене BRCA1 выявлены в 4 % случаев, в CHEK2 – в 2 %. В гене BRCA2 не выявлено ни одной мутации, как и в генах BLM, NBS1, PALB2. Локализация первичного очага, наличие отдаленных метастазов, стадия опухолевого процесса, отягощенный семейный анамнез по любому из злокачественных новообразований не коррелировали с риском носительства мутации BRCA1 (p>0,05). Соответствие пациента критериям отбора NCCN для диагностики мутаций в гене BRCA1 оказалось значимым маркером наличия герминальной мутации (р=0,043).Выводы. Критерии отбора NCCN для генетического тестирования являются наилучшим предиктором наличия герминальной мутации BRCA1 у пациентов раком поджелудочной железы.риска носительства мутации в этих генах на основе сбора клинических и анамнестических данных.Материалы и методы. В исследование включались пациенты с диагнозом рака поджелудочной железы, у которых осуществлялся забор крови для выявления клинически значимых герминальных мутаций генов BRCA1, BRCA2, CHEK2, BLM, NBS1 и PALB2. У каждого пациента проводился сбор клинических данных и данных семейного анамнеза.Результаты исследования. В исследование включено 99 пациентов. Мутации в гене BRCA1 выявлены в 4 % случаев, в CHEK2 – в 2 %. В гене BRCA2 не выявлено ни одной мутации, как и в генах BLM, NBS1, PALB2. Локализация первичного очага, наличие отдаленных метастазов, стадия опухолевого процесса, отягощенный семейный анамнез по любому из злокачественных новообразований не коррелировали с риском носительства мутации BRCA1 (p>0,05). Соответствие пациента критериям отбора NCCN для диагностики мутаций в гене BRCA1 оказалось значимым маркером наличия герминальной мутации (р=0,043).Выводы. Критерии отбора NCCN для генетического тестирования являются наилучшим предиктором наличия герминальной мутации BRCA1 у пациентов раком поджелудочной железы

E-Learning and Smart-Education in Transport University

The report examines some aspects of e-learning and smart-education in the training of transport engineers. If we consider classical e-learning and smart-education, we can distinguish three main approaches. Technological approach assumes that the main difference is in the technologies used. Organizational approach assumes that the very organization of the educational process determines what kind of education is being used now. And, finally, pedagogical approach is oriented to the form of presentation of material, formed skills and the results of training. Technological basis of e-learning in the Ural State University of Railroad Transport (USURT) is the platform Blackboard Learn, which is used in many countries around the world and is aimed at the implementation of various tasks. For example, it allows you to create an online course, available for viewing on various mobile devices. Development of electronic training courses allowed to solve the following tasks: 1 Ensuring around-the-clock access to the materials of the training program for all students. 2 Managing the trajectories of student learning. 3 Involving students in teamwork using built-in communication tools. 4 The possibility of organizing a centralized and independent evaluation of student work using a variety of testing and knowledge validation tools. 5 Preparation of reports on student learning and the dynamics of student performance in the academic discipline. 6 Preparation of reports on the degree of correspondence between sections and training activities created within the framework of the course and the requirements of the Russian federal educational standard. 7 Development of additional motivation for learning by providing additional modern services for obtaining knowledge. 8 Ensuring the accounting, control and planning of training at the level of the educational institution, groups of students and each individual student. From the technological point of view, e-learning is considered as a stage of transition to the means of smart-education. Unlike e-learning, the concept of smart-education assumes the presence of elements in the education system, ensuring rapid adaptation of the entire system to the changing demands of the external environment, not just the learning process. Smart technologies are a visualization of intellectual systems; we can say that they are born at the intersection of artificial intelligence and human-computer interaction. Here we come to another dimension of smart-education, namely, organizational one. The principal difference of smart-education, in our opinion, is that the humanitarian disciplines in it are not included as an additional, albeit necessary, appendage of professional education, but are organically combined together with technical and natural science disciplines within a single educational program. Such an association provides intensive development of cognitive engineering and creates prerequisites for the pedagogical measurement of smart-education. Here, the formation of cognitive competence among students is at the forefront, the general feature of which is proposed to outline cognitive-complex thinking. The report shows how the interactive system developed by us, being an intelligent simulator for accelerated training of dispatchers in the efficient management of transport objects, is consistent with the modern concept of smart-education

RBE of "Prometeus" Facility Protons for Irradiation of Tumor Cells in Vitro with One and Three Fields

The study was aimed to the biological effectiveness of the proton scanning beam of the first Russian medical facility. The clonogenic assay of B-16 tumor cells was used as a test system. Cell irradiation was carried out in a suspension condition in a water phantom. Single and three-field exposures were studied. The dose interval was 2-8 Gy. The energy range from 47.5 to 92.0 MeV was used for the Bragg peak formation. The relative biological effectiveness of protons comparing to gamma-rays was 1.2 for single-field and 1.5 for three-field irradiation. The results obtained agree with literature data related to the used cell culture (B-16) and linear energy transfer range (3÷8 keV/µm)