Saratov State Medical University
Recent publications
Spinal muscular atrophy 5q (5q SMA) is one of the most prevalent autosomal recessive disorders globally. The underlying cause of 5q SMA is attributed to variants in SMN1. Exon 7 of SMN1 is not detectable in major of probands with 5q SMA, and minor of probands have a combination of the deletion and an intragenic subtle variant in the second allele. From 1991 to 2023, DNA samples from 2796 probands representing unrelated families were analyzed at the Research Centre for Medical Genetics for the diagnosis of 5q SMA. The copy number of Exon 7 of SMN1 and SMN2 was determined for all probands by MLPA. Subsequently, direct automated Sanger sequencing was employed to perform intragenic subtle variant screenings in all 116 probands with one copy of Exon 7 of SMN1. The diagnosis of 5q SMA was confirmed in 1495 probands. Among the 41 probands with one copy of Exon 7 of SMN1 from the initial 116 tested, 24 intragenic subtle variants in SMN1/SMN2 were documented. The aim of this study was to identify and characterize intragenic subtle variants in SMN1 and analyze their relationship with clinical manifestations in probands with 5q SMA in the Russian cohort.
Introduction. According to numerous studies, it is known that representatives of the genus Astragalus L. contain a variety of biologically active compounds: alkaloids, flavonoids, triterpene saponins, nitrogen-containing compounds, including amino acids, phenolic acids and their esters, coumarins, higher fatty acids, polysaccharides, vitamins B, C, E, PP, salts of glycyrrhizic acid, trace elements, tannins, essential oils, gums, etc. It is relevant to conduct a phytochemical analysis of herbs of new species of the genus Astragalus L., as well as screening the antioxidant activity of their extracts. The types of astragalus belonging to the Dissitiflori DC section can be a promising source of biologically active substances with an antioxidant effect. Aim. To conduct a comparative phytochemical analysis and scoring of the antioxidant activity of aqueous extracts from the herb of four species of astragalus section Dissitiflori growing in the Saratov region. Materials and methods. The objects of the study were dried herbs of Astragalus macropus Bunge, Astragalus zingeri Korsh., Astragalus varius S.G. Gmel. and Astragalus ucrainicus Klok. et M. Pop., collected in the Saratov region in 2023 and dried to a residual moisture content of no more than 14 %. The quantitative assessment of the content of tannins was carried out by the permanganometric method (titrant – 0.02 M potassium permanganate solution). The quantitative content of ascorbic acid was established by direct titration using a 0.0001 M solution of sodium 2,6-dichlorophenolindophenolate as a titrant. Antioxidant activity was determined by permanganometric titration in an acidic medium according to a patented technique. The antioxidant activity index was calculated in terms of flavonoid compounds known for their antioxidant activity: rutin, quercetin (mg/ml). Antiradical activity was assessed using the DPPH test. All analyses were performed in triplicate, the data were processed using standard statistical methods, using MS Excel packages, 2021. Results and discussion. During the experiment, the herb of the genus Astragalus L. section Dissitiflori was analyzed for the content of tannins and ascorbic acid, and the antioxidant activity of extracts from the herb was determined by two methods. It was found that the highest content of tannins is observed in the herb A. macropus Bunge (2.27 ± 0.06 %) and A. zingeri Korsh. (2.23 ± 0.05 %); the highest content of ascorbic acid is in the herb A. varius S.G. Gmel. and A . zingeri Korsh. (0.04 ± 0.001 %). The highest antioxidant activity was observed in the extraction of A. ucrainicus Popov et Klok. from grass, which contains 23.03 ± 0.57 mg/g and 15.71 ± 0.39 mg/g of oxidizing substances in terms of rutin and quercetin, respectively, and antiradical activity in A. zingeri Korsh. (IC 50 465.20 ± 12.2 mcg/ml). Conclusion. Analysis of the grass of four species of the genus Astragalus L. section Dissitiflori revealed a high content of tannins and ascorbic acid, as well as the presence of pronounced antioxidant activity in extracts from the grass of the analyzed species.
Relevance. Participation in military operations involves a large number of human resources, usually young men. In most cases, this leads to post-traumatic stress disorder (PTSD). In the pathogenesis of this condition, great importance is given to changes in the hormonal background, which in turn contribute to changes in the production of sex hormones. However, despite the active discussion on this topic, many unresolved issues. Objective. To study the effect of PTSD in participants of military operations on the level of free testosterone in the blood serum and the relationship with sexual activity Materials and methods. The study involved 100 participants who agreed to participate in the survey. All subjects were divided into five groups, depending on the time since participation. The average duration of combat was 6–8 months. The studies were conducted on an outpatient basis. A study of the level of free testosterone level and the assessment of sexual activity were evaluated. Results. The study revealed a certain discordance between the free testosterone levels in the blood serum of participants in military operations at different times compared with the stress factor received and sexual activity. This phenomenon was manifested by a decrease in sexual activity against the background of an increase in free testosterone in the blood serum. Perhaps this is due to several factors that should be considered in combination. Therefore, the first and main factor may be stress, which affects and activates the sympathoadrenal system, as confirmed in the literature. Conclusions. In participants of military operations, against the background of an increase in the amount of free testosterone in the blood serum, there is a decrease in sexual activity, which gradually recovers with increasing time elapsed from the moment of stress.
The OBJECTIVE was to study the effect of obesity on the severity of acute pancreatitis (AP), its outcome and complications. METHODS AND MATERIALS. The study included 212 patients with AP. Among the patients, 58 % (n=123) were men, and 42 % (n=89) were women. The severity of AP was mild in 63.2 %, moderate in 21.7 % and severe (SAP) in 15.1 % of cases. The average age of the patients was 52 years. Organ failure (both transient and persistent) was present in 20.3 % of all cases of AP, in 52.3 % of patients with moderate AP and in 59.4 % with SAP. The total mortality rate was 6.6 %, with mild and moderate AP, no deaths were noted, whereas with severe AP, the mortality rate was 43.8 %. The method of calculating body mass index (BMI) was used to diagnose obesity. The presence of obesity was noted at BMI of≥30 kg/m2. The number of obese patients was 39.6 % of all patients with AP. The Mann – Whitney U-test was used to compare patient groups. The criterion χ2 was used to compare the proportions of patients in different groups. RESULTS. When studying the average BMI and the proportion of obese patients, there were no significant differences in their values depending on the severity of AP. There were also no significant differences in the value of the average BMI and the proportion of obese patients in survivors and deceased patients with AP, as well as in survivors and deceased patients with SAP. Whereas, the surviving patients showed significant differences in the value of the average BMI and in the proportion of obese patients. There were no significant differences in the values of the average BMI and the proportion of obese patients in the groups of patients with OP without and with complications. CONCLUSION. Obesity does not significantly influence on the severity and frequency of complications in patients with AP.
Objective. To review the literature data on the comorbidity of cardiovascular disease with Parkinson’s disease (PD) and to evaluate the role of cardiovascular autonomic failure as a differential diagnostic criterion for synucleinopathy. Material and methods. The search of scientific literature was performed in PubMed, ProQuest Dissertations & Theses Global databases, electronic library system of the Media Sphere publishing house from 2014 to the present and includes 42 relevant sources. The methodological premise of the study is the notion of the differentiating role of autonomic dysfunction symptoms in the diagnosis of PD at the premotor stage. Conclusion. Autonomic cardiac denervation occurs at the premotor stage of PD and may be its primary manifestations. Patients with PD also develop other comorbid cardiovascular pathology: ischaemic heart disease, arrhythmias, cardiomyopathies and sudden cardiac death. Nosological substantiation of cardiovascular autonomic failure is crucial for providing specialised cardiological care to PD patients.
The article discusses various chemical and physico-chemical methods of teeth whitening, focusing on their effectiveness, safety, and potential side effects. The primary substances used for chemical whitening are hydrogen peroxide and carbamide peroxide, which cause oxidation of pigments in enamel and dentin, leading to tooth whitening. Despite the high effectiveness of such methods, prolonged use of chemical agents can lead to microstructural changes in the enamel, reducing its microhardness and increasing porosity. Physico-chemical methods, such as lasers and LEDs, activate low concentrations of whitening agents and require lower concentrations of active substances, which reduces the risk of enamel damage and tooth sensitivity. The speed and degree of whitening may vary depending on the concentration of active components and exposure time. Studies show that higher concentrations of hydrogen peroxide provide faster whitening but are also associated with an increased frequency of side effects (such as increased tooth sensitivity, irritation of gums, and oral soft tissues). Analysis of studies involving patients with tooth sensitivity confirms that these combined methods significantly reduce discomfort. The long-term stability of whitening results is a subject of active research, as repeated use of chemical whitening agents may exacerbate structural changes in the enamel.
Aim: to assess efficacy and safety of using colloidal silicon dioxide as an adjunct therapy in managing high-risk pregnant women with moderate COVID-19. Materials and Methods. A prospective comparative study was conducted by enrolling 62 pregnant women hospitalized with moderate COVID-19. Metabolic charts and delivery records were subsequently reviewed. Participants were divided into two groups: Group 1 (n = 32) received standard treatment, while Group 2 (n = 30) received standard treatment plus colloidal silicon dioxide. Clinical and laboratory markers of endotoxemia, pregnancy progression, and outcomes were assessed. Results. It was found that in Group 2 vs. Group 1 mean length of the following symptoms was significantly shorter: hyperthermia – by 2.4 days (p = 0.011), tachycardia – by 2.2 days (p = 0.037), weakness – by 2.1 days (p = 0.137), and headache – by 1.7 days (p = 0.042). In addition, women from Group 2 also showed significantly lower C-reactive protein and interleukin-6 levels (p = 0.006 and p = 0.019, respectively) as well as lacked blood flow disturbances at significantly more frequent level primarily Grade 1B uteroplacental insufficiency. Grade III blood flow disturbances were observed in one patient in Group 1 but none in Group 2. Regarding delivery outcomes, 97 % of Group 1 pregnancies resulted in live births (mean body length – 49.25 ± 1.75 cm, mean birth weight – 3126 ± 245.6 g), with vacuum extraction observed in 9 % of cases and cesarean section – in 31 %. One case of antepartum fetal demise occurred. In Group 2, all pregnancies resulted in live births (mean body length – 51.5 ± 2.5 cm, mean birth weight – 3360 ± 260 g), with vacuum extraction in 3 % of cases and cesarean section – in 30 %. While some patients exhibited combinations of these parameters, no significant inter-group differences were found. Assessing neonatal condition at one minute postpartum revealed significantly more cases of mild asphyxia in Group 1; the number of newborns without asphyxia was twice as high in Group 2 (p = 0.021). Conclusion. Comparing course of pregnancy, delivery, neonatal condition, and management of high-risk pregnant women with moderate COVID-19 using the proposed methodology suggests its high efficacy and safety.
Introduction. Percutaneous nephrolithotripsy is an important minimally invasive method for treating kidney stones. It is appreciated for its low injury rate and quick recovery. However, one of the most serious complications that can occur after this procedure is calculous pyelonephritis. The timing and safe removal of nephrostomy drainage in the postoperative period remain a significant concern for urologists. Objective. To determine the possibility of using joulemetry and monitoring urinary IL-8 levels to diagnose stone-related pyelonephritis activity following percutaneous nephrolithotripsy. Materials & methods. The study involved 220 patients with kidney stones who had percutaneous nephrolithotripsy at the SSMU Urology Clinic in 2022 – 2023. The patients were aged between 25 and 65 years, including 135 women (61.3 %) and 85 men (38.7 %). The control group consisted of 30 healthy people aged 24 to 67 years: 18 women (60 %) and 12 men (40 %). After surgery, electrochemical urine examination using the joulemetric method according to a patented technique was performed for patients with stone-related pyelonephritis and for those in the control group. Results. When analysing the urine IL-8 level, leukocyturia in the urine test, and the current operation based on joulemetry data, we observe a significant increase in all studied parameters on day 1 compared to the control group (p > 0.05). The values of the studied indicators reach their peak range by day 3 and return to those of the control group by day 5. At the same time, even if there is no leukocyturia on day three, the values of the current parameter and the urine IL-8 level remain elevated in most patients. Conclusion. Joulemetry helps to diagnose the activity of stone-related pyelonephritis in the postoperative period. This is confirmed by general clinical examinations and the determination of urine IL-8 as a marker of inflammation. Using this method allows optimising the timing of drainage removal after surgery.
Correction of behavioral risk factors (BRFs) as the basic basis of systems for the prevention of chronic non-communicable diseases for various population groups is one of the urgent tasks in the field of public health. Aim of the study was to investigate the prevalence of BRFs for cardiovascular diseases (CVD) among bearing production workers for the subsequent development of preventive measures. Material and methods . A sociological study of behavioral lifestyle factors contributing to the development of CVD (smoking, alcohol consumption, unhealthy diet, low physical activity, irresponsible medical behavior) was carried out in a group of bearing production workers ( n = 382), taking into account gender and age differences. Results and discussion . The prevalence of smoking was 39.7 %, with a higher proportion of men smoking than women (42.8 and 22.9 %, respectively, p < 0.001). Alcohol (in moderate quantities) is consumed by 71.5 % of respondents, statistically significantly more often ( p < 0.001) by men (75.8 %) than women (58.7 %). The prevalence of physical inactivity was 10.64 % and was more pronounced ( p = 0.011) among women compared to men (15.0 and 7.4 %, respectively) and among young people (18–39 years old) compared to middle-aged people (40–65 years old) ( p = 0.005). The majority of study participants (82.2 %) do not adhere to healthy eating rules (52.4 % men, 35.8 % women). Insufficient consumption of vegetables and fruits was found (in 30.0 and 34.0 %, respectively), fish (in 80 %), olive oil (in 100 % of those surveyed). 90 % consume excess salt. Low preventive medical activity of workers was revealed, manifested in an unreasonably high assessment of their own health, refusal to see a doctor for therapeutic purposes, self-medication, and neglect of preventive medical examinations. Conclusions . The results of the study indicate the priority of the population direction of preventive measures aimed at correcting the behavioral risk factors of CSD in the working population and increasing motivation for a healthy lifestyle and health-saving behavior.
Introduction . Diagnostics of blood circulation in skin microvessels and oxidative metabolism of biological tissue allows predicting the presence of microcirculatory disorders in the body, assessing their severity and monitoring therapy. The use of a functional test related to the change in the position of the entire human body in space is a well-known method for studying the functions of the autonomic nervous system and diagnosing cardiovascular diseases. Purpose . To study a set of parameters characterizing oxidative metabolism and dynamics of blood microcirculation in the finger during a sequence of tests with the change in the position of the upper limb using fluorescence spectroscopy and laser Doppler flowmetry. Materials and Methods . The study was conducted on a group of volunteers consisting of 10 people aged 21–40 years. The LAZMA PF device (Russia), implementing the methods of laser Doppler flowmetry and fluorescence spectroscopy, was placed on the pad of the middle finger. Each volunteer’s microcirculation parameters were measured in two arm positions: «at heart level» and with the limb vertically raised in the «up» position. Blood flow oscillations were continuously measured during all stages: three times in two positions. Results . A change in the limb position from the «at heart level» to «up» state leads to a decrease in the average values of microcirculation indices by 12 perfusion units (p. u.) and oxidative metabolism by 7 relative units (r. u.) with a simultaneous increase in the NADH coenzyme by 3 r. u., i.e. there is a unidirectional change in the microcirculation and oxidative metabolism parameters and an oppositely directed change of the NADH coenzyme values. According to the results of NADH coenzyme measurements, based on the analysis of statistical data, a statistically significant difference was found between the «at heart level» and «up» arm positions. This difference was not revealed only in the first cycle of the study, the reliability of p was greater than 0.05, between the arm positions 1–2, when the arm was «at heart level» and then raised «up». It was also found that with each new measurement cycle, the probability value of p for NADH indicators steadily decreased with a change in the arm position, at a significance level of p<0.05. The probability value of p became statistically significant starting from the second cycle of the study. Based on the results of oxidative metabolism indicator measurements, it was found that the probability value of p had a statistical significance of p<0.05 at each change of arm position in each cycle. Conclusion . The studies have shown that in order to obtain reliable information about the results of the limb position test, it is not enough to perform one-time measurements of the microcirculation indicator or the oxidative metabolism of biological tissue using laser Doppler flowmetry. The position of the limb and its change leads to significant changes in microcirculation and oxidative metabolism indicators, which should be taken into account when conducting medical and physiological studies
Background — Currently, there is a challenge in the dynamic prognostic assessment of haemorrhagic risks, particularly in recognising the development of bleeding in patients who have undergone cardiac surgery (CS). Bleeding frequently occurs in post-CS patients as they are receiving antithrombotic therapy (ATT), prescribed for continuous a period of 3, 6, or 12 months after surgery. This not only worsens prognosis and quality of life but also, if therapy is discontinued, increases the risk of thrombotic events. Objective — To investigate the diagnostic value of scales for assessing bleeding and predicting bleeding outcomes in individuals who have undergone myocardial revascularisation, and to assess the applicability of the ISTH scale for evaluating bleeding in this patient group. Methods — A total of 98 patients undergone myocardial revascularisation participated in the prospective study. An assessment of hemorrhagic risks according to the PRECISE-DAPT scale and hemorrhagic manifestations according to the ISTH scale was performed at visit 1 and 2 (0-1 month after revascularization). Results — It was found that the assessment of bleeding risk during antithrombotic therapy (ATT) in the first month after myocardial revascularisation, when performed using the PRECISE-DAPT scale, is not comparable to the assessment using the ISTH scale. However, the ISTH scale proved to be a useful tool for evaluating haemorrhagic complications of ATT in patients following cardiac surgery (CS). Conclusion — The use of the ISTH scale allows the assessment of early signs of bleeding during dual antiplatelet therapy (DAPT) following revascularisation, helping to foster a proactive attitude in patients towards monitoring complications of antithrombotic therapy. This approach can reduce risks of fatal haemorrhages and the development and progression of anaemia. However, the ISTH scale is not comparable to the PRECISE-DAPT scale for assessing hemorrhagic risks and cannot be recommended for dynamic prediction of hemorrhagic risks in post-CS patients.
BACKGROUND: A widespread visual impairment among medical students is known, but there are no data on the ophthalmic status of clinical residents. AIM: To carry out an assessment of the visual analyzer status in Russian medical universities graduates who begin the clinical residency according to the specialty 31.08.59 Ophthalmology. MATERIALS AND METHODS: An anonymous residents’ online survey was conducted in 15 universities from 14 cities using an original interactive questionnaire. Responses were received from 249 respondents (mostly females: n = 188, 75.5%; mean age 24.80 ± 0.06 years). To compare, we used previously published data on a survey of senior students from 5 Russian medical universities, including 549 respondents (425 females, 77.4%; mean age 22.4 ± 0.06 years). RESULTS: In comparison to students, residents were significantly more likely to rate their vision as excellent (20.8% and 28.9%, respectively, p = 0.01), to report emmetropia (16.2% versus 26.9%, p 0.001), to deny continuing vision deterioration (33.0% and 43.5%, p 0.005), to rate higher the importance of good vision (9.25 ± 0.06 and 9.73 ± 0.05 conditional points, respectively, p 0.01). Students significantly more often did not know the meaning of the “clinical refraction” term (2.6% and 0.4%, respectively, p = 0.04), more often reported vision problems interfering with their studies (26.2% and 15.7%, p = 0.01), and reported ongoing vision deterioration (57.9% versus 45.0%, p 0.001). Otherwise, survey results were comparable. CONCLUSIONS: Visual impairments are widespread among clinical residents-ophthalmologists of Russian medical universities, 58.2% of the responders had ametropia (including 56.1% of myopia), 28.5% had astigmatism, 3.6% had other ocular conditions. The majority of survey participants (59.8%) used or felt a need in optical correction, 19.7% rated their vision as “poor” or “very poor”, about a half (45.0%) believed their vision to worsen during recent years, and about as much (46.6%) reported that they experience limitations in everyday life related to decreased vision. Insufficient awareness of a part of the responders about their vision, and in some responders, a lack in basic ophthalmological knowledge were revealed.
Introduction. Obesity is one of the socially significant chronic non-communicable diseases and, according to numerous forecasts, the incidence of obesity may increase several times by 2030. Purpose of study. To analyze the primary and general morbidity of obesity and assess its relationship with the coefficient of availability of medical staff and the incidence of coronary heart disease among the working-age population over ten years on the example of the Saratov region. Materials and methods. Based on the data from the State Health Institution “Medical Information and Analytical Center” of Saratov, the trend indices of general and primary morbidity of obesity among the working-age population in the Saratov region over 10 years (2013–2022) were analyzed. Results. The overall obesity incidence in Saratov increased by 6.8%, in the Saratov region — by 22.2%; the primary morbidity increased by 53.3% and 81.4%, respectively. A correlation was established between the primary and general morbidity of obesity in Saratov: r = 0.63, p = 0.04; between the general morbidity in Saratov and the Saratov region: r = 0.68, p = 0.03. In all districts of the region, no correlation was found between the indices of general and primary morbidity of obesity and coronary heart disease: r = –0.13; p = 0.45 and r = 0.3; p = 0.07, respectively. The relationship between the coefficient of availability of medical staff and the incidence of obesity has not been established. Research limitations. The study has regional (Saratov region) and age (adult population) restrictions. Conclusion. To find out additional reasons for the insufficient detectability of obesity, it is advisable to conduct additional studies aimed at studying the level of awareness of primary care physicians, as well as the working-age population living in the Saratov region, about the role of obesity in the development and course of other diseases. An important area of research may be the search for external objective factors that cause different levels of obesity prevalence within the same group of districts formed taking into account the coefficients of availability of medical staff.
Legg – Calve – Perthes disease (LCPD) is the most common femoral head osteonecrosis in children. Until now, the knowledge of etiology, pathogenesis and clinical signs is partial and does not provide a coherent view of the disease. Despite modern advances in understanding and diagnosing of the disease, surgical interventions and stress release remain the standard treatment methods. Now there is a need to develop both new strategies for studying the pathogenesis of the disease and choosing methods of its treatment. The aim . Reproduction and development of morphological criteria for the early stage of Legg – Calve – Perthes disease (stages 1–2 by the modified Waldenström classification system). Materials and methods . The research involved 6 young gray giant rabbits (Flandres) aged 3–4 months. The early stages of LCPD were simulated by the pathophysiological model of Kuzhelivsky I.I. et al. (2016) with paraarticular adrenaline injections along with physical activity. We modified the physical activity regime for the subjects by daily free range for 1.5–3 hours. Results . The experiment confirmed the validity of the modified simulation and designed its morphological criteria. The osteochondropathy process was verified histologically, we also revealed the classic signs of damage to subchondral bone and hyaline cartilage as well as abnormal vascularization of cartilage sites and pathological neoangiogenesis. Conclusion . The technique of non-traumatic osteonecrosis simulation in young rabbits featured initial results in reproducing the pathological links of osteonecrosis process. The cartilage tissue featured the loss of isogeneity in chondrocytes structure and their column-like arrangement; its delamination and replacement with fibrous tissue, including fibroblast-like cells and collagen fibers; cartilage neovascularization and persistent mixed hyperemia. In the bone marrow, only the activation of the red blood cell line was noted. The bone tissue featured the abnormality of osteon structure with a mosaic arrangement of trabeculae as well as lacunar resorption, and osteoblast degeneration.
Introduction. Lung cancer remains one of the main causes of death for a long period of time. The existing screening methods are ambiguous. The presence of patients with metastatic stage of lung cancer justifies the creation of an optimal program for more accurate formation of risk groups. It is of interest to determine the intensity of the impact on the incidence rate from the point of view of both clarifying the parameters of urban pollution, but also a detailed analysis of other factors at the regional level. Aim. To identify the main potential risk factors in Saratov patients diagnosed with lung cancer, taking into account the ecological and geographical features of their place of residence in order to further create a model of active disease search by risk groups. Materials and methods. The complex of factors influencing the development of lung cancer among the population of Saratov has been studied. A group of 1049 patients was analyzed. The distribution of patients across urban landscape areas of the city has been determined depending on the impact of certain adverse environmental factors. To detail the remaining factors, the main group included 200 patients with the specified diagnosis who underwent outpatient and inpatient treatment in oncological institutions. All data was collected using official statistical documents and a medical information system. Results. When conducting a subgroup analysis by parameters (gender, age, localization and clinical form of the cancer process, stage of the disease, the patient’s attitude to smoking, body mass index, occupational hazards, the presence of oncopathology in the history of the patient and his relatives, the presence of chronic lung disease), the main patterns and features were identified depending on the histological variant. Given the complexity of the interaction of risk factors in the development of lung cancer, it becomes necessary to conduct further research to form a model questionnaire for lung cancer risk based on multifactorial analysis. Conclusion. The formation of a more precise risk group will increase the percentage of detection of early stages of lung cancer.
The aim of this study was to develop a combined technology of plasmon photothermal therapy and photodynamic therapy of transplanted cholangiocarcinoma PC-1 in rats. For photodynamic therapy, rats were intratumorally administered with indocyanine green diluted in polyethylene glycol at a ratio of 1 : 100 at a dose of 2 mg/kg. For plasmon photothermal therapy, gold nanorods diluted in polyethylene glycol (400 μg/mL) were intratumorally injected in a volume of 30% of the tumor volume. At 1 h after injection, the tumor was percutaneously irradiated with a diode infrared laser with a wavelength of 808 nm at a power density of 2.3 W/cm2 for 15 min. The animals were removed from the experiment 72 h and 21 days after therapy. Morphological studies of the tumor were performed on sections stained with standard and immunohistochemical methods. A significant increase in tumor temperature was noted, up to 60.0 ± 4.1°C with combined plasmon photothermal and photodynamic therapy. After 72 h, pronounced necrotic changes were observed in the tumor tissue and intact tumor cells were observed only on the periphery of the tumor. At 21 days after therapy, a significant inhibition of tumor growth was noted; the inhibition index by tumor mass was 77.4%.
Сhromatin remodeling tumor suppressor protein ARID1A (AT-rich interaction domain 1A) is coded by the ARID1A gene that is one of the most frequently mutated genes of human oncological diseases. Inactivating mutations in the ARID1A gene have a pronounced effect on cell survival, chemoresistance, transcription and regulation of the cell cycle. To date, a large number of studies have focused on assessing the effect of mutations leading to loss of ARID1A function on the occurrence, progression and resistance of tumors to therapy. The high frequency of ARID1A mutations in malignant tumors of the female reproductive system opens up unique opportunities for targeted preventive and therapeutic intervention. Clear cell carcinoma of the ovaries and uterine body cancer with ARID1A mutations do not respond well to standard chemotherapy and, to date, do not have effective targeted therapy, which underlines the need for further research in this area. ARID1A can be used as a biomarker of precancerous diseases, as well as as a tool for predicting the response to radiation therapy, immunotherapy and targeted therapies. Currently, clinical trials of several low molecular weight and epigenetic inhibitors are being conducted in tumors of the female reproductive system with ARID1A deficiency.
According to the lack of sufficient scientific data on the ratio, severity, and clinical pathomorphism of positive and negative symptoms in schizophrenia, a more detailed research of this issue is required. The ratio of positive and negative disorders in the structure of schizophrenia spectrum disorders is different in each specific case.It is known that problems associated with the formation of stable remission in schizophrenia significantly affect the functional well-being, quality and life expectancy of patients. To ensure comprehensive, effective and safe treatment of patients with schizophrenia antipsychotic drugs with a broad spectrum of action are needed. Cariprazine is one of the more effective antipsychotics, both in relation to positive symptoms and in relation to negative and cognitive symptoms.This paper presents a number of clinical observations that demonstrate the efficacy of the third-generation neuroleptic cariprazine as a potent antipsychotic drug with a favorable safety profile, providing high adherence to therapy and successfully used both in patients with the first psychotic episode and in patients with a disorder duration of more than five years. Also, the complex therapy schemes with psychosocial rehabilitation measures in the inpatient and outpatient departments of the Psychosocial Rehabilitation Center, located on the basis of the Regional Clinical Psychiatric Hospital, are described in detail.
The proposed article discusses the features of the presentation of “geography” and “chorography” by Marcianus Capella. Of the nine books of Marriages, seven are devoted to elementary secondary disciplines: grammar, dialectic, rhetoric, degree, arithmetic, astronomy and harmony. From the content of the story in the sixth book, it becomes clear that geometry is a complex and multifaceted discipline, which additionally includes geography and chorography. n a narrow sense, geometry deals with the study of figures, in a broad sense – the shape and position of the earth, thermal zones and indicating locations on a geographical map. These two disciplines complemented each other and allowed students to gain a broader understanding of the earth's surface. The educational cycle outlined by the author, to the 5th century. did not yet represent a firmly established intellectual concept and underwent significant changes over the course of two centuries. Hence, it is permissible to assume that each author, until the final design of the range of free disciplines, had the right to make changes to the list and content of subjects, including “geography” and “chorography”. Despite the obvious similarity of their content with the story of Claudius Ptolemy, the “Marriage” also indicates a strict terminological framework for each key discipline. For the first, the use of the terms terra and orbis is acceptable, for the second - orbis terrarum, provincia and finis. This circumstance allows us to see the approximate path of “geography” (in the ancient sense) from the ideas of Claudius Ptolemy, who lived during the period of the highest flowering of the Roman Empire, to late Antiquity. The ideas laid down by Marcian Capella formed the basis for the definition of “Geometry” in the developed Middle Ages.
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Anton Kiselev
  • Research Institute of Cardiology
Alla Bucharskaya
  • Centre of Collective Use
P.F. Zabrodskii
  • Saratov Military Medical Institute (Toxicology)
Anatoly Mikerov
  • Microbiology, Virology & Immunology; Environmental & Occupational Medicine
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