[Evaluation of the effectiveness of various regimens of the immunomodulatory drug Superlimf in the prevention of relapses of chronic abacterial prostatitis].

INTRODUCTION: Immune defense mechanisms, including a decrease in the functional activity of monocytes/macrophages, neutrophils, as well as a violation of the balance of pro- and anti-inflammatory cytokines, are important in the development of chronic abacterial prostatitis (CAP). The discovery of the cytokine system and the determination of their biological role in the development and functioning of the immune system and in the pathogenesis of a wide range of human diseases led to the development of a new direction in immunotherapy - cytokine therapy. The aim of the study was to evaluate the effectiveness of various regimens of the use of the immunomodulatory drug Superlimf in the prevention of recurrence of CAP. MATERIALS AND METHODS: The study included 90 patients with category IIIa CAP (NIH, 1995). All patients underwent basic complex therapy was performed, which included behavioral therapy, taking an 1-adrenoblocker, an antibacterial drug from the fluoroquinolone group for 28 days, as well as the drug Superlimph 10 ME 1 suppository rectally 2 times a day for 20 days. Dynamic follow-up was recommended for patients of group (CG) in the next 12 months. In the main group 1 (MG1), patients underwent basic complex therapy, after which a preventive courses of Superlimph 10 ME 1 suppository 1 time per day for 10 days every three months for 12 months was prescribed. In the main group 2 (MG2), patients also underwent basic complex therapy, after which a preventive courses of Superlimph 10 ME of 1 suppository was prescribed 2 times a day for 10 days every three months for 12 months. The effectiveness of the treatment was evaluated after 4 weeks (visit 2). Long-term treatment results were assessed after 3 months (visit 3), 6 months (visit 4), and 12 months (visit 5). RESULTS: The study groups were homogeneous, and the results of examinations obtained before treatment did not differ statistically significantly (p>0.05). At visit 2, 4 weeks after the start of therapy, a statistically significant positive dynamics of the studied indicators in the main groups and CG was recorded. Thus, the average score on the IPSS scale decreased by 56.4% from the initial value, on the Qol scale - by 57.7%, on the NIH-CPSI scale - 70.2%. The number of leukocytes in the prostate secretion decreased to the normal level to 7.9 in the field of vision, which is 86.2% less than the initial value. The average Qmax value also increased to a normal value of 15.2ml/s, which is 51.3% higher than the initial value (p<0.001). In this study, for the first time, a comparative analysis of two different regimens of preventive administration of the drug Superlimf was carried out. In MG1, the drug was prescribed to patients at a dose of 10 ME 1 time a day, in MG2 - 10 ME 2 times a day. The data obtained indicate a comparable effectiveness of both dosage regimens after 3 months of therapy. However, after 6 months and 12 months, the results in MG2 were statistically significantly better than in MG1. In addition, during 12 months of therapy, the number of relapses in MG2 was 2.3 times less. According to ultrasound examination, the volume of the prostate gland in CG, after a significant (p<0.001) decrease against the background of basic complex therapy, increased by 24.6% from visit 2 to visit 5, whereas in MG2 the average value of this indicator did not significantly change. And according to the Doppler study, by the end of the observation period at visit 5, hemodynamic parameters in CG were statistically significantly worse than in MG1 and MG2. CONCLUSION: Thus, the use of Superlymph in patients with CAP as a preventive therapy every 3 months results to a longer preservation of the therapeutic effect and improved hemodynamics in the prostate. In addition, preventive courses of Superlymph 10 units 2 times a day for 10 days led to an increase in the duration of the relapse-free period and a decrease in the number of recurrences within 12 months by 7 times, while preventive courses of Superlymph 10 units 1 time per day for 10 days decreased risk of recurrence by 3 times. According to our results, the most effective preventive scheme in patients with CAP is the use of Superlymph 10 units, 1 suppository 2 times a day for 10 days every 3 months.

Application of a Fork Plate for Greater Trochanter Osteosynthesis in Total Hip Arthroplasty.

The aim of the study was to assess the effectiveness of using an original technique of greater trochanter fragment fixation during total hip replacement. MATERIALS AND METHODS: Since 2013, this construction has been implanted in 175 patients in the clinic of the Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden. By the present time, 50 patients have been examined in order to assess the effectiveness of this construction. They were divided into three groups depending on the cause of greater trochanter fixation by the original plate: osteotomy according to T. Paavilainen, periprosthetic Vancouver type AG fractures, false joints of the greater trochanter. The degree of consolidation of the greater trochanter fragment with the femoral bone metadiaphysis was assessed using the roentgenometric technique according to M. Hamadouche's recommendations. The functional result of the hip was evaluated according to the Oxford Hip Score scale. RESULTS: The nonunion rate in the presented groups was 8.3% in fragment fixation after osteotomy according to T. Paavilainen, 25% after fragment fixation in periprosthetic Vancouver type AG fracture, and 11.1% in fixation of the greater trochanter fragment when treating a false joint of the given localization. CONCLUSION: Preliminary results of the greater trochanter fixation using the original fork plate during total hip replacement showed sufficient effectiveness not only in osteotomies of the greater trochanter, periprosthetic iatrogenic and pathological Vancouver type AG fractures but also in case of false joints of this localization developed due to the failure of the previous fixation.

[Injected non-absorbable fillers in large volumes]. / In''ektsionnye nerassasyvaemye fillery miagkikh tkanei v bol'shikh ob''emakh.

AIM: To present treatment strategy for large volumes of injectable non-absorbable 'shell-less' soft tissue fillers (vaseline, synthol, silicone etc.). MATERIAL AND METHODS: The authors present an experience of surgical treatment of 8 patients who underwent injections of medical vaseline (breast augmentation, n=5) and synthol (muscles enlargement, n=3) and review of the current literature devoted to this problem. RESULTS: Injection of large amounts (over 50 ml) of non-absorbable fillers into soft tissues is unacceptable and leads to numerous complications. Oil-based 'shell-less' fillers cannot be removed by minimally invasive techniques (puncture, mini-incisions, etc.) due to multiple diffuse lesions in the form of oleogranulomas (cysts of different size) and surrounding widespread inflammation and fibrosis of tissues. Surgery is the only adequate method. However, this approach is followed by scars and often tissue contour deformation. Migration of these fillers to other anatomical areas (from the neck to the lower extremities) significantly complicates the situation, treatment and results. In case of categorical refusal of patients from surgical treatment and no complaints, they should be properly informed about possible consequences and complications and dynamic medical supervision is necessary. Intraoperative ultrasound examination is useful for the control of radical removal of pathological areas. Timely removal of non-absorbable fillers allows to avoid serious complications and to achieve good aesthetic results.

[CHANGES IN THE INDICATORS OF LIPID PEROXIDAL OXIDATION AND ANTIOXIDANT SYSTEM IN THE SERUM OF THE BLOOD IN ANIMALS WITH EXPERIMENTAL PERIODONTITIS WITH CHANGED REACTIVITY].

The purpose of the experimental study was to study the activity of lipid peroxidation and antioxidant systems in animals of different ages with experimental periodontitis with altered reactivity. Experiments were carried out on 30 non-linear white rats aged 2 months, which were divided into three groups: Group I - 10 animals with a hypoergic reaction, which was modeled by the administration of cyclophosphamide; Group II - 10 animals with hyper-hypergly reaction, which was modeled by administration of pyrogenal; Group III - 10 animals with normal reaction - a control group, which was intramuscularly injected with 1 ml of saline. Blood sampling and killing of animals were performed under thiopental anesthesia 7 days after the start of the experiment. In the blood serum, the content of diene conjugates, thiobarbituric oxidative active products, reduced glutathione, ceruloplasmin and catalase activity were determined by spectrophotometric method. In modeling hypoergic and hyperergic periodontitis, lipid peroxidation was activated with an increase in its initial products. The activity of the antioxidant system tended to decrease both in the hyperergic and hypoergic periodontitis in prepubertal animals, while at the same time there was a tendency to increase in adults. The data obtained indicate certain differences in the processes of lipid peroxidation and antioxidant protection in animals of different ages, which should be taken into account when extrapolating the data obtained in the clinic.

[The importance of cytokine profile characteristics for evaluating the therapeutic effectiveness of monoclonal antibodies against IL-6 receptors in patients with rheumatoid arthritis].

AIM: To evaluate dynamics of cytokine profile characteristics in patients with rheumatoid arthritis (RA) treated with tocilizumab and to identify parameters that can be used to predict the effectiveness of therapy. MATERIALS AND METHODS: 42 patients (32 women) aged 43-55 (mean 50.5) years with the duration of disease 23-81 (mean 56.5 months), DAS28 6.4 (5.8-7.05). Each patient was given 6 i/v infusions of 8 mg tocilizumab/day at 4 week intervals in addition to standard therapy. Serum levels of IL-1b, IL-1Pa, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-15, IL-17, Eotaxin, FGF-basic, G-CSF, GM-CSF, IFN-g, IP-10, MCP-1, MIP-1alpha, MIP-1b, PDGF bb, RANTES, TNF-alpha, VEGF were determined by xMAP multiplex technology. RESULTS: Good therapeutic effect in accordance with EULAR criteria was documented in 35 and satisfactory one in 7 patients; remission based on CDAI occurred in 33% of the cases. The levels of proinflammatory (IL-1b, -2, -6, -12, -15, -17, IFN-gamma, TNF-alpha) and anti-inflammatory (IL-4, -5, -9, -10, -13) cytokines, hemokines (IL-8, MCP-1, MIP-1a, MIP-1b, MIP-1b) and growth factors (IL-7, GM-CSF, VEGF, FGF basic, IP-10) dropped down by week 24 of the treatment (p < 0.05). Remission based on CDAI was associated with higher baseline levels of IL-1b, -2, GM-CSF and TNF-alpha and good outcome according to EULAR criteria with the rapid fall in IL-10 and -13 levels. CONCLUSION: Therapy with tocilizumab results in the rapid and well apparent decrease in the concentration of the practically entire spectrum of cytokines. Measurement of IL-1b, -2, -10, -13, GM-CSF and TNF-alpha may be useful for the prediction of the effectiveness of therapy of RA with tocilizumab.

[Regulated expression systems for gene therapy].

Gene therapy is a perspective and rapidly developing field of modern medicine, which is expected to improve state of or even cure patients that are not curable by classical methods of therapy. The logics of development of gene therapy in the near future will require the use of systems in which expression of therapeutic gene can be regulated. This review critically evaluates current regulated systems of gene therapy that can be divided into two major classes. The first class is formed by systems in which induction of therapeutic gene expression is effected by an external inducer introduced into an organism. The second class includes systems based on autoregulation principle that function without an external inducer. The review evaluates the most important systems of gene expression regulation belonging to the first class, namely systems based on tetracycline regulation, dimerization induced by rapamycin derivatives, regulation by steroid hormones, regulatory RNAs and physical principles. The most important systems of the second class that are regulated by oxygen or glucose levels are also discussed.

[Characteristics of the injuries inflicted by high-energy bullets from pneumatic air weapons].

The author compares the properties (caliber, power, speed) of the firearm projectiles and bullets with the high muzzle energy shot from pneumatic weapons. Results of experimental observations with the use of biological and non-biological objects are presented. The entry and exit wounds in the skin and bones as well as the resulting damage inflicted to the tissues and the character of bullet deformation are described.

[Gene frequencies and heterozygosity of the AB0 and RH blood group alleles in the populations of two cities of the Donetsk region, Ukraine]. / Chastoty genov i geterozigotnost' po alleliam sistem grupp krovi ABO i RH naseleniia dvukh gorodov Donetskoi oblasti Ukrainy.

The frequencies of the AB0 and RH blood group alleles and heterozygosity indices were determined for the populations of two large industrial cities of Gorlovka and Mariupol. In the population of Gorlovka the gene frequencies were as follows: AB0*0 = 0.576, AB0*A = 0.266, AB0*B = 0.158, and RH*D = 0.592, in Mariupol the frequencies were AB0*0 = 0.584, AB0*A = 0.265, AB0*B = 0.151, and RH*D = 0.604. In Gorlovka the heterozygosity indices in respect to the AB0 and RH alleles were 0.572 and 0.483, respectively; in Mariupol, 0.566 and 0.478, respectively. There were no statistically significant differences between the two populations in respect to the genetic markers analyzed. However, the heterozygosity values obtained were more similar to the corresponding estimates for some populations of Russia, than for the total population of the Ukraine.

[Characteristics of trauma in victims falling on a staircase]. / Kharakteristika travmy pri padenii na stupeni lestnichnogo marsha.

When a human falls on the staircase, dust traces can be found on his/her clothes and body, and he/she has injuries of certain type and location. The frequency of injuries in traumas on a flight of the stairs is analyzed from 72 files and studied in 262 experiments on biomannequins falling from steps on a flight of stairs. A relationship between the position of the body during falling and type and location of injuries was revealed. Mathematical analysis helped define the differential criteria of location of skeletal fractures for different conditions of falling on staircase.

[Biological traces after falling on the staircase]. / Osobennosti sledov nalozhenii biologicheskogo proiskhozhdeniia pri padenii cheloveka na lestnichnom marshe.

Presents the results of experimental studies of biological traces which adhered during simulation of a trauma on a staircase, making use of anthropometrically balanced mannequins and biomodels. Analyzes blood and dust traces on clothes and shows that their position on clothes depends on the presence of pre-acceleration.

[Establishing the cause of death in finding a corpse on a flight of stairs]. / Ustanovlenie prichiny smerti v sluchae obnaruzheniia trupa na lestnichnom marshe.

A total of 793 forensic medical conclusions concerning corpses found in vestibules are analyzed. The circumstances of death were unknown in the majority of cases. Causes other than injuries were responsible for the majority (72.4%) of deaths: coronary diseases, hanging, alcohol intoxication, or general hypothermia. Strikes with blunt objects and falling on the staircase or floor rank second among causes of death. Injuries caused by falling from staircase and cases with this cause suspected were responsible for 9.6% deaths. Murders with acute objects and guns were recorded in 6% cases. For facilitating differential diagnosis, a list of signs and injuries occurring as a result of falling from staircase and main causes of death in such injuries, made with consideration for the place where the corpses are found, is offered.

The reactions of a heterogeneous population to perturbation. An interpretative model of mortality trends in Russia.

PIP: "The rapid increase in mortality in Russia during the past ten years is perplexing.... In this paper, the authors offer a new interpretation of these dynamics.... They suggest that recent developments are the cumulative result of a compensation mechanism which followed the rapid decrease in mortality which occurred around 1985, and of the continuation of a deterioration movement which began in the early 1960s.... To prove this and to explain these rapid fluctuations, the authors have developed a model based on hypotheses which involve heterogeneous populations. In addition to analysing mortality in Russia, they provide new models which relate to the consequences of heterogeneity on the dynamics of mortality." (EXCERPT)^ieng

[Experience in organizing the work of forensic medical experts with mass human victims after an earthquake (Neftegorsk, May-June 1995)]. / Opyt organizatsii raboty sudebno-meditsinskikh ékspertov pri massovykh chelovecheskikh zhertvakh posle zemletriaseniia (Neftegorsk, mai--iiun' 1995 g.).

The authors analyze the activities of a group of forensic medical experts of the Khabarovsk Bureau of Forensic Medical Expert Evaluation working in the team for liquidation of the consequences of the catastrophe in the town of Neftegorsk. The principles of work organization in the field were demonstrated under conditions of the minimal financing and material supply. General recommendations on the preparation and equipment of forensic medics for work in far-away regions in a focus of disaster involving numerous victims are offered.

[Providing alternatives to induced abortion in the Soviet Union]. / Osnovni zadachi na profilaktikata na izkustveniya abort v SSSR.

PIP: The author examines levels and trends in induced abortion in the former Soviet Union. The focus is on the dissemination of contraceptive methods as a preventive measure. (SUMMARY IN ENG)^ieng

[The mechanism and nature of the injuries when a human body falls on a flight of stairs]. / Mekhanizm i kharakter povrezhdenii pri padenii tela cheloveka na lestnichnom marshe.

The results of experimental studies on modelling of mechanism of lesion formation in falling of human body at the flight of stairs both spontaneously and with given acceleration are presented. Mathematical processing of material with calculation of diagnostical factors revealed the possibility of differentiation between spontaneous fall and fall with given acceleration at different areas of the flight of stairs.

[Electron microscopic structure of stomach cancer]. / Elektronno-mikroskopicheskoe stroenie raka zheludka.

Parallel histological and electron microscopy studies of 18 gastric cancers have demonstrated that the Lauren classification may be reproduced at ultrastructural level, which allow the type of carcinoma to be identified even in microscopically obscure cases. Intestinal type of cancer is characterized by marked intercellular connections, a brushy margin from enteroid microvilli and the cell cytoplasm rich in polyribosomes. A diffuse type is characterized by detached cells and the presence of mucoid secretion granules in them. The cells per se are similar to mucoid epithelium of gastric glands. Detection of tumor cells showing the signs of both enterocytes and mucoid epithelium of the stomach as well as the elements differentiating toward basic cells speaks in favour of histogenetic affinity of separate types of gastric cancer.