Sechenov Medical Journal

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No 2 (2017)
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20-27 467
Study Objective . To evaluate the correlation between cytokine synthesis and organ involvement in patients with granulomatosis with polyangiitis (GPA). Methods. The study involved 60 patients with GPA diagnosed following the ACR criteria and the CHCC-2012 definition. Cytokines genes expression was studied in blood samples from 57 patients with reverse transcription polymerase chain reaction. We evaluated mRNA for the following cytokines: interferon (IFN)-α, IFN-γ, interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18, tumor necrosis factor (TNF)-α production. Also, we investigated the serum concentration of IFN-α, IL-1β, IL-8 IL-18 and TNF-α by ELISA in 40 patients with GPA. Results . Markers for granulomatous disease were detected in 45 (75,0%) GPA patients, markers for vasculitis - in 23 (38,3%) patients. GPA affected eyes in 33 patients (55,0%), ears in 29 (48,3%), nose and sinuses in 57 (95,0%), lungs in 35 (58,3%) and kidneys in 28 (46,7%). There was total positive correlation between eye disease and IL4 and IL12 genes expression ( r =1,00). Total negative correlations were between ear disease and IL-12 gene expression; glomerular filtration rate reduction more than 50% and serum IFN-α ( r =-1,00). Conclusion. Cytokines may upregulate the direct immune response in organ damage in GPA patients. Markers for granulomatous disease correlated with cytokines, that suppressed Th2 type immune response and promoted Th1 type immune response. Correlation between vasculitis markers and cytokines showed that IFN-α, TNF-α, IL-1β and IL-6 participated in vascular damage in GPA patients.
28-32 390
Trombotic microangiopathy is heterogeneous group of the diseases united by a community of a histological and clinical implications at difference of pathogenetic mechanisms, presents clinical-morphological syndrome characterizing a lesion of vessels of a microcirculatory channel. Currently thrombotic microangiopathy include thrombotic thrombocytopenic purpura (TTP), atypical hemolytic uremic syndrome (aHUS), heparin-induced thrombocytopenia, HELLP-syndrome. One of the most important triggers of emergence of a thrombotic microangiopathy is pregnancy. The article describes the clinical observation of atypical hemolytic uremic syndrome in obstetric practice.
33-37 241
We analyzed estimated the prevalence and predisposing factors of gastrointestinal tract functional diseases in children under 1 year in Belgorod Region. The survey involved 348 women with children aged 1 to 4 years. The main sections of the questionnaire dealt with the pregnancy, delivery and feeding details, antibiotics prescription in 1st year, the gastroenterological complaints and therapy. The functional disorders in children included regurgitation syndrome (18.3%), infant intestinal colic (74.4%) and constipation (33%). Predisposing factors were problematic pregnancy and delivery (31.3% and 25.3%, respectively), feeding (late breastfeeding and early termination of breastfeeding up to 3 months of life in 44% and 29.8%, respectively), antibiotic therapy in the first months of life - 23.6%.
38-41 280
We analyzed the dynamics of comorbid gastroesophageal reflux disease and type 2 diabetes mellitus. The sudy involved 216 patients with diagnosed type 2 diabetes mellitus combined with gastroesophageal reflux disease. We found that in 57.8% of the cases type 2 diabetes mellitus preceded gastroesophageal reflux disease, in 31.0% of the cases, type 2 diabetes mellitus debuted following gastroesophageal reflux disease and in11.2% of the cases both diseases were diagnosed concurrently within a year. We showed that the time of gastroesophageal reflux disease manifestation for any particular type 2 diabetes mellitus patient are determined by the severity of vegetative dystonia syndrome and the number of risk factors provoking gastroesophageal reflux disease.
42-46 257
The article compares the capabilities of modern external respiration function tests, such as peakflowmetry, spirometry and bodipletizmography, in diagnosing bronchial obstruction syndrome in children with bronchial asthma.


4-11 479
The article presents data on the state of health of modern youth and organizational forms of rendering medical and preventive assistance for medical university students in Russia. The article provides an overview of student health status and health care activities, the sources of information on healthy lifestyles. The article discusses subjective factors of health and healthy lifestyle: diet, student and sports leisure time activities, bad habits. The article summarizes the long work results on both general theoretical-methodological approaches and practical mechanisms of health care activities organization and management in university students; the basic shortcomings of medical care for this cohort. The article puts forward options for disease prevention and rehabilitation optimization in university students. The problem requires a new approach to guarantee the quality health care for university students, innovative forms of organization, establishment of uniform model of student health management.
12-19 221
The article analyzes medical personnel resources of system of penitentiary health care of Volga federal district in 2006-2016. The article dwells upon the strength and structure of the healthcare including regional variations and peculiarities. The study revealed the increase in the number of medical personnel from 78.6 to 109.3 per 10 thousand inmates. The in-situ health care priorities are therapy, phthisiology and psychiatry. Other health care interventions are as a rule provided in hospital setting. The study found negative tendencies in undestaffing (87.7%) and part-time employment, as well as regional problems with the personnel continuous training.


47-51 301
Selection of the optimal tactics of pregnancy and childbirth significantly depends on the expected volume of amniotic fluid. The amount of amniotic fluid reflects a condition of a fetus and changes at pathological conditions of both a fetus, and an uteroplacental complex. The aim of the study was a modification of ultrasound’s methods for determining the expected volume of amniotic fluid. The error in determining volume of amniotic fluid by the Chamberlain’s and Phelan’s methods exceeds 10%. On the basis of 3D-modeling of the volume of amniotic fluid and fetal weight determined pattern change, which is expressed by the formula: V AF=200× IAF +0,08× М -1 500, where IAF - index of amniotic fluid (mm), M - fetal weight (g). The index of amniotic fluid is defined as the sum of the following pockets: K 1 - the perpendicular from the calvarium of the fetus to the prevailing wall of the uterus; K 2 - the perpendicular from the pelvis of the fetus to the prevailing wall of the uterus; K 3, K 4, K 5, K 6 - perpendiculars from the anterior, posterior and lateral surfaces of the abdomen fetus at the level of the stomach to the prevailing walls of the uterus. In calculating volume of amniotic fluid according to the proposed ultrasonic formula error does not exceed 5,3%.
52-55 467
We performed chromatography analysis of alcoholic tincture of fruits and seeds of Chinese Magnolia-Vine ( Schisándra chinénsis Baill.). The fruits and seeds of Chinese Magnolia-Vine ( Fructus Schisandrae and Semina Schisandrae ) is used for herbal drug production. To date there is a pharmacopoeia monograph for the seeds of Chinese Magnolia-Vine. The chromatography analysis made with Agilent Technologies device revealed the major and minor components. The qualitative and quantitative comparison between the tinctures was done with ChemStationE 02.00 software and library for Mass Spectrometry NIST-05. The analysis revealed 14 and 24 substances in the tincture of the fruits and seeds, respectively. We found spirits, acids, sugars, ketons, anthracene derivatives, terpens, ethers etc. We calculated the percentage of each including the unidentified peaks. The study revealed chemical heterogeneity of fruits and seeds of Chinese Magnolia-Vine. The primary components of tinctures were schisandrin and schisandrol. The former is the marker compound which is associated with the pharmacological properties of the drug by many researchers.
56-60 291
The article discusses spectrofluorimetric detection of antibiotic drugs based on the intrinsic fluorescence of antibiotics, the formation of fluorescent products following the interaction of antibiotics with other compounds, and the application of the antibiotic-induced fluorescence quenching of specific dyes. Based on the literature data, the authors summarized and systematized information about parameters of antibiotic fluorescent analysis - the excitation and emission wavelengths, the reagent used and reaction conditions, the detection limit.
61-66 347
The article discusses the fundamental concept of life and health as a manifestation of solar energy transformation into other types of energies (thermal, mechanical, electric, etc.) providing life. The article states that the efficiency of intracellular energy as a manifestation of mitochondrial function (the final stage of solar energy transformation) indicates the organism’s resistance to external and internal negative influences. This provides the opportunity of quantitative health (and viability) estimation of an individual. Neither endogenous risk factors nor diseases are found above a certain level of energy production. This is a quantitative (“safe”) health level. The article demonstrates that if the majority of population goes beyond “safe” health level results in CNID epidemic. The article postulates the necessity supplement the “industry of illness” (establishment of Health Мinistries) with the “industry of health”, responsible for maintenance and increase of the biosystem energy potential.


67-72 206
The article presents an assessment of the clinical, economic and clinical-economic components of the basic anti-asthmatic therapy regimens in children in hospital setting. The analysis involved mathematical and statistical modeling methods, such as beta distribution, gamma distribution, Monte-Carlo simulation based on simulation of the distribution. The study material was the baseline therapy of bronchial asthma exacerbation in children in hospital setting. The study includes the pharmacotherapy data from 608 inpatient records in 2014-2015. The basic anti-asthmatic therapy in hospital setting in the analyzed period was: 1) inhalation glucocorticoid (as a monotherapy); 2) a combination of an inhalation glucocorticosteroid and a short-acting β2-agonist; 3) a combination of an inhalation glucocorticosteroid and a long-acting β2-agonist; 4) a combination of an inhalation glucocorticosteroid and a leukotriene receptor antagonist; 5) a combination of an inhalation glucocorticosteroid, a short acting β2-agonist and a leukotriene receptor antagonist; 6) a combination of a short acting β2-agonist and a leukotriene receptor antagonist. Βeta-distribution was used to calculate the clinical outcome probability, and gamma distribution was used to calculate the costs. The highest values of confidence-based clinical efficacy, calculated on the basis of beta distribution and demonstrating the probability of a positive clinical effect, are characteristic for the regimens that include a combination of an inhalation glucocorticosteroid and a leukotriene receptor antagonist, as well as an inhalation glucocorticosteroid regimen and a long-acting β2-agonist. Similarly, the average cost of treatment regimens were determined. It based on gamma distribution. The combination of the results of these two distributions for each treatment regimen on the graph allowed us to obtain a cloud of distributions that clearly illustrates the clinical and economic effectiveness of the therapy regimens analyzed when used in the population. The article presents the curves of beta distributions and a graphic representation of Monte-Carlo simulation results.

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ISSN 2218-7332 (Print)
ISSN 2658-3348 (Online)