[The telemedicine and digital technologies in education programs of training medical personnel of higher qualification].

The article considers application of telemedicine and digital technologies in educational programs of training medical personnel in residency and graduate school for the Russian health care system. The possibilities of telemedicine and digital technologies that currently are in use for remote medical care, consultations of medical workers by qualified medical specialists and for training and re-training of medical personnel are investigated. The key topics of modern health care are improvement of system of training medical manpower, personalization of medical care in health care, individualization of professional orientation in the process of continuing medical education and current methods of information environment management in health care sector. The conclusion is made that owing to new technologies,such innovations as telemedicine, artificial intelligence, medical decision-making systems, remote platforms of patient health monitoring and other modern inventions are implemented into health care. The purpose of the study is to examine impact of transformational processes in higher medical education in epoch of digitization.

Single nucleotide polymorphisms of Beijing lineage Mycobacterium tuberculosis toxin-antitoxin system genes: Their role in the changes of protein activity and evolution.

The article investigates SNP in genes of toxin-antitoxin systems type II in Mycobacterium tuberculosis Beijing lineage strains and their possible role in the development and formation of new sublineages. We established the catalog of SNPs in 142 TA systems genes in 1349 sequenced genomes of the M. tuberculosis Beijing lineage. Based on the catalog, 15 new sublineages were identified as part of Beijing lineages by non-synonymous SNP in 21 genes of TA systems. We discovered three toxin genes with mutations specific for epidemiologically dangerous sublineages Beijing-modern (vapC37 A46G, vapC38 T143C) and Beijing-B0/W148 (vapC12 A95G). We proved the functional significance of these polymorphisms by cloning these genes wild-type and with marker mutations for the Beijing lineage vapC12 (A95G), vapC37 (A46G), vapC38 (T143C). In vitro study of their activities revealed effect of mutations on the RNase activity of toxin proteins. Mutations in vapC37 and vapC38 decreased toxin activity, and mutation in the vapC12 increased it. We cloned the toxin vapC37 gene of Mycobacterium smegmatis mc2 155 in both allelic variants: without mutation and with A46G mutation, specific for the Beijing-modern lineage. It was shown that this mutation leads to a loss of toxicity.

Noninvasive Assessment of Fractional Flow Reserve Using Mathematical Modeling of Coronary Flow.

Nowadays an invasive evaluation of fractional flow reserve (FFR) is one of the main methods used for detecting lesions that cause ischemia. Invasively obtained FFR <0.75 has the specificity of 100 %, and FFR >0.80 has the sensitivity >90 %. Recent achievements in computational fluid dynamics and computer simulations allow noninvasive assessment of FFR using data obtained by CT angiography performed according to standard protocol at rest without additional radiation, modification of image acquisition protocols, or added medications for vasodilatation. The present review covers the results of the DISCOVER, the NXT, the DEFACTO and the PLATFORM randomized multicenter studies as well as the prospects of using a noninvasive method for measuring FFR developed by specialists of the Institute of Numerical Mathematics in collaboration with specialists of the I. M. Sechenov First Moscow State Medical University.

[Effect of conditioned medium from mesenchymal stem cells on regeneration of endothelium at HCl-induced damage trachea in rats].

The purpose. Respiratory epithelium regeneration is studied in rats with tracheal damage induced by inhaling hydrochloric acid vapor. Method. Regeneration process after the chemical burn was activated by intratracheal administration of preparations obtained from the same-species mesenchymal stem cells (MSC). Results. Tracheal epithelium is shown to recover almost completely on day 3-7 after applying MSC compositions (MSCs). Closed structures containing ciliated cells similar to ciliated cells of the respiratory epithelium lining the trachea are formed in the submucosal epithelium during regeneration. These structures migrate towards epithelium and get incorporated into the damaged epithelium. This phenomenon is apparently indicative of the special mechanism of respiratory epithelium regeneration after HCl-induced injury. Conclusion. It is demonstrated in this study that cell-free MSCs instilled intratracheally promote the recovery of normal submucosal epithelium by either preventing or reducing necrosis and inflammation. Such topical MSCs administration significantly accelerates migration of ciliated cell towards the surface and de novo formation of the ciliary epithelium.