[The use of underwater horizontal traction and mechanotherapy in the complex treatment of degenerative spondylolisthesis of the lumbosacral spine: a pilot clinical study]. / Primenenie podvodnogo gorizontal'nogo vytyazheniya i mekhanoterapii v kompleksnom lechenii degenerativnogo spondilolisteza poyasnichno-kresttsovogo otdela pozvonochnika: pilotnoe klinicheskoe issledovanie.

Underwater traction of the spine is a physiotherapeutic method that combines the effects of mechanical traction and fresh water of indifferent temperature and seems promising for the treatment of pain in the lower back, which is due to the physiological basis of the mechanism of action on the spinal motion segment by eliminating muscle spasm and restoring the biomechanics of the spine. OBJECTIVE: To study the effectiveness of underwater horizontal traction in combination with mechanotherapy in patients with non-stenosing unstable degenerative spondylolisthesis of the lumbosacral spine of the 1st degree, accompanied by pain. MATERIAL AND METHODS: The clinical study included 14 patients (mean age 50.21 years). Patients underwent underwater horizontal traction of the spine according to the modified Pushkareva-Vozdvizhenskaya method in a variable mode, the procedures were performed every other day, for a course of 6 procedures. After completion of the traction procedure, patients were recommended to put on a fixing lumbosacral corset, in which they rested for 30 minutes in the supine position. At the end of the rest period, the patients performed training of the back muscles with biofeedback on the mechanotherapeutic complex of simulators for 30 minutes daily, except for weekends, for a course of 10 procedures. RESULTS: All patients completed the course of treatment, during the procedures no side effects or deterioration were noted. During the treatment, motor and daily activity significantly improved according to the Oswestry scale (p=0.002), the severity of the pain syndrome and its effect on the patient's activity decreased, according to the Roland-Morris questionnaire (p=0.003). According to an objective assessment of the muscle strength of the lumbosacral spine at the initial level, no deviations from the normative parameters were revealed, however, during the treatment, a significant increase in strength was noted in all muscle groups. CONCLUSION: Underwater horizontal traction of the spine in variable mode according to Pushkareva-Vozdvizhenskaya is an effective and safe method of conservative treatment of unstable non-stenosing degenerative spondylolisthesis of the 1st degree, accompanied by back pain, which helps to reduce the intensity of the pain syndrome and improve the daily motor and social activity of patients. The traction method should be supplemented with therapeutic exercises using mechanotherapeutic simulators to achieve a clinical result.

Rituximab and Abatacept Are Effective in Differential Treatment of Interstitial Lymphocytic Lung Disease in Children With Primary Immunodeficiencies.

Background: Interstitial lymphocytic lung disease (ILLD), a recently recognized complication of primary immunodeficiencies (PID), is caused by immune dysregulation, abnormal bronchus-associated lymphoid tissue (BALT) hyperplasia, with subsequent progressive loss of pulmonary function. Various modes of standard immunosuppressive therapy for ILLD have been shown as only partially effective. Objectives: To retrospectively evaluate the safety and efficacy of abatacept or rituximab in treatment of ILLD in children with PID. Methods: 29 children (median age 11 years) with various forms of PID received one of the two therapy regimens predominantly based on the lesions' immunohistopathology: children with prevalent B-cell lung infiltration received rituximab (n = 16), and those with predominantly T-cell infiltration received abatacept (n = 17). Clinical and radiological symptoms were assessed using a severity scale developed for the study. Results: The targeted therapy with abatacept (A) or rituximab (R) enabled long-term control of clinical (A 3.4 ± 1.3 vs. 0.6 ± 0.1; R 2.8 ± 1 vs. 0.7 ± 0.05, p < 0.01) and radiological (A 18.4 ± 3.1 vs. 6.0 ± 2.0; R 30 ± 7.1 vs. 10 ± 1.7, p < 0.01) symptoms of ILLD in both groups and significantly improved patients' quality of life, as measured by the total scale (TS) score of 57 ± 2.1 in treatment recipients vs. 31.2 ± 1.9 before therapy (p < 0.01). Conclusions: ILLD histopathology should be considered when selecting treatment. Abatacept and rituximab are effective and safe in differential treatment of ILLD in children.

Morphofunctional State of the Large Intestine in Rats under Conditions of Restraint Stress and Administration of Peptide ACTH(4-7)-PGP (Semax).

We studied the effect of intraperitoneal administration ACTH(4-7)-PGP in doses of 5, 50, 150, and 450 µg/kg to Wistar male rats 12-15 min before modeling restraint stress on the morphofunctional state of the colon. In rats exposed to restraint stress, signs of atrophy and inflammatory reaction in the colon wall, changes in functional activity and number of mast cells, and increased serum level of corticosterone were observed. Administration of the peptide led to a decrease in corticosterone concentration, alleviated stress-induced pathomorphological changes, and promoted adaptation of the intestinal wall to stress. The positive effects of ACTH(4-7)-PGP can be determined by multifunctional nature of the physiological and pharmacological effects of the neuropeptide.

[Traditional nutrition and demography in the Arctic zone of Western Siberia].

High requirements for macro- and micronutrients of the organism of a pregnant woman living in the Far North are associated with the influence of extreme factors of high latitudes, and the needs of the mother and the growing fetus. Only the products of the unique food culture of the Arctic people - the Nenets, make it possible to meet the emerging needs. The aim of the work was to study the impact of traditional nutrition on the reproductive health of Nenets women living in the Arctic zone of Western Siberia. Material and methods. 619 indigenous inhabitants (Nenets) of the Yamal, Nadym and Taz districts of the Yamal-Nenets Autonomous Okrug at the age of 18-65 years were examined. The influence of the type of nutrition (traditional or imported products) on reproductive health indicators (the number of pregnancies, the number of children, the number of spontaneous abortions, frequency of gestosis, threats of termination of pregnancy, operative deliveries) for the period 2013-2018 was studied by analyzing official statistics and by questioning of the female population in own research. Results. The consumption of traditional products (venison, local fishery products, at least 3 times a week) by Nenets women was more often accompanied by a normal physiological course of pregnancy and childbirth (75.2 versus 64.2%, χ2=8.7; p=0.003). It led to a 1.5-fold decrease in the frequency of complications during pregnancy (gestosis, the threat of abortion) (χ2=5.8; p=0.01) and a 20% decrease in the frequency of delivery by cesarean section (χ2=16.6; p<0.001). As a result, a family whose diet was dominated by traditional products had a statistically significantly larger number of children (per child). Conclusion. The preservation of the consumption of reindeer and river fishery products by indigenous women will contribute to the sufficient intake of macro- and micronutrients, that will make it possible to gestate and give birth to a healthier generation of the Nenets society.

Composition of Colon Microbiota in Rats Treated with ACTH(4-7)-PGP Peptide (Semax) under Conditions of Restraint Stress.

We studied the effect of Semax on the state of intestinal microbiota in rats subjected to restraint stress. Semax was injected to Wistar male rats intraperitoneally in doses of 5, 50, 150, 450 µg/kg 12-15 min before modelling chronic restraint stress. It was found that stress exposure reduced the number of obligate bacteria in the colon microbiota, but increased the content of opportunistic microorganisms. Semax in doses of 50 and 150 µg/kg prevented the stress-induced changes in the composition of colon microbiota. The observed effects of Semax might be mediated by the central neurotropic effects as well as by binding to peripheral melanocortin receptors of the intestine.

Morphological Changes in the Large Intestine of Rats Subjected to Chronic Restraint Stress and Treated with Selank.

We studied the effects of Selank on the condition of the colon wall in Wistar male rats subjected to restraint stress. Selank was injected intraperitoneally in doses of 80, 250, and 750 µg/kg 15 min before stress exposure. In rats subjected to stress, signs of atrophy, inflammatory reaction, and changes in the number and functional activity of mast cells were observed against the background of increased corticosterone level. Selank administration led to a decrease in corticosterone levels, reduced pathomorphological manifestations of stress exposure, and accelerated adaptation. These effects were presumably realized due to multifunctional biological effects of Selank.

[General hydro galvanic baths in the treatment of patients with lumbosacral radiculopathy]. / Obshchie gidrogal'vanicheskie vanny v lechenii patsientov s poyasnichno-kresttsovoi radikulopatiei.

INTRODUCTION: Hydrogalvanic baths are a hydrotherapy method based on the combined effect of electric current and fresh water on the body. AIM OF STUDY: Scientific evidence and evaluation of the effectiveness of use of general hydrogalvanic baths in the treatment of patients with lumbosacral radiculopathy with the background of degenerative spinal disorder. MATERIALS AND METHODS: A randomized comparative clinical trial included 84 patients. The 1st (active) group included 43 patients, the 2nd (control) had 41 patients. Patients of the 1st group received general hydrogalvanic baths. Patients in the control group - drug treatment, including NSAIDs, muscle relaxants, anticonvulsants. The assessment was carried out before treatment, at the end of the course (on the 14th day) and 3 months after the end of treatment according to the results of neurological examination, VAS questionnaires, Pain DETECT, Beck scale, Oswestry scale, SF-36 scales, electroneuromyography (nerve conduction study). RESULTS: In patients receiving general hydrogalvanic baths, in comparison with the control group, there was an improvement in sensitivity (the incidence of hypesthesia decreased from 77 to 11%, p=0.008) and conductivity in peripheral sensory fibers. A decrease in pain was observed in both groups, however, a decrease in neuropathic pain was recorded only in patients receiving drug treatment. In the 1st group during therapy, an improvement in the emotional state in patients and a decrease in the level of depression were revealed. An analysis of long-term results showed that the delayed effect of non-drug treatment significantly increased in patients of the 1st group in comparison with the control group (p<0.05). CONCLUSIONS: Exposure to general hydrogalvanic baths is an effective way to treat lumbosacral radiculopathy, the main registered effects are: improvement of sensitivity, reduction of pain and stabilization of the emotional background. However, the studied method does not affect neuropathic pain.

State of Colon Microbiota in Rats during Chronic Restraint Stress and Selank Treatment.

We studied the effects of Selank on intestinal microbiota in Wistar male rats subjected to chronic restraint stress. Selank was injected intraperitoneally in doses of 80, 250 and 750 µg/kg 15 min before stress exposure. Chronic restraint stress led to a decrease in the content of obligate microflora, while the content of opportunistic microorganisms increased. Selank restored intestinal microbiota presumably via central (neurotropic) and peripheral (immunotropic) mechanisms.

[Hydrogalvanic baths as a method of medical rehabilitation: a literature review and the prospects for the clinical application].

The hydrogalvanic baths provide a tool for the combined application of warm fresh water and low frequency electric current. These procedures are suitable for both systemic and local treatments. The mechanism behind their therapeutic action is based on synergistic effect of two therapeutic agents. This article presents the literature and historical review of the method as well as the current concept of hydrohalvanic therapy. The history of its development is associated with the improvement of the technical equipment and accumulation of clinical experience. Numerous studies carried out up to the present time have demonstrated that hydrohalvanic therapy can be effectively applied for the treatment of diabetic angiopathy, rheumatoid and gouty arthritis, fibromyalgia, ankylosing spondylitis. At the same time, the high potential of this method remains underestimated. At present, one of the most promising approaches to its clinical applications is the treatment of lumbosacral radiculopathy caused by degenerative vertebral disk lesions. The hydrogalvanic baths have analgesic, anti-inflammatory, and decongestant effects, improve microcirculation, and reduce sensory impairment. It is necessary to continue clinical investigations to obtain further evidence of the effectiveness of the method under consideration for the treatment of lumbosacral radiculopathy and to evaluate its short- and long-term effects. Their results will hopefully provide an opportunity to include the hydrogalvanic baths in the programs of medical rehabilitation of the patients presenting with lumbosacral radiculopathy.

The role of L-type calcium channels in the accumulation of Ca2+ in soleus muscle fibers in the rat and changes in the ratio of myosin and serca isoforms in conditions of gravitational unloading.

Gravitational unloading is known to produce changes in the expression of a number of contractile and regulatory proteins in the soleus muscle. This applies particularly to isoforms of myosin heavy chains (MHC) and SERCA sarcoplasmic reticulum calcium pumps. Unloading increases the resting levels of extracellular calcium in soleus muscle fibers. The present study addresses verification of the hypothesis that changes in the expression of MHC and SERCA isoforms in gravitational unloading are linked with the accumulation of calcium ions in the myoplasm of muscle fibers. It is suggested that specific blockade of L-type calcium channels using nifedipine decreases the myoplasmic calcium ion concentration, thus preventing the development of changes in the expression of MHC and SERCA isoforms. A total of 36 male Wistar rats were divided into three groups: a control group, an unloading group using the Morley-Holton soleus muscle functional unloading model, and an unloading + nifedipine group, where animals received daily nifedipine (7 mg/kg/day) with their drinking water on the background of suspension. The results showed that blockade of L-type calcium channels on the background of gravitational unloading significantly decreased the extent of calcium ion accumulation in the myoplasm of soleus muscle fibers, which partly prevented the transformation of muscle fibers (in relation to the fast and slow isoforms of MHC and SERCA) to the rapid type. There was no nuclear translocation of the greater part of transcription factor NFATc1, as seen on unloading.

[Effects of creatine phosphokinase competitive inhibitor on system and tissue energy metabolism in rats in the norm and during unloading].

In an experiment with rats system and intracellular energy metabolism was assessed by cell reactions to chronic injection of beta-guanidine propionic acid (beta-GPA) stimulating AMP-dependent protein kinase (AMPK). Suspension was shown to inhibit the succinate dehydrogenase (SDH) activity, reduce glycogen in both types of muscle fibers, and stimulate the activity of alpha-glycerophosphate dehydrogenase (alpha-GPDH) in fast fibers. Supplementing the rat chow with beta-GPA did not modify these parameters during suspension; however, the blood urea level increased considerably in the suspended and control rats. In the controls, beta-GPA as well as suspension, stimulates growth of the aspartate aminotranspherase activity (AST) in blood. Yet, the suspension and beta-GPA injection had no additive effect. Moreover, their effects were opposite in rats subjected to suspension + beta-GPA. Glucose concentration was observed to become lowered in blood of resting rats treated with beta-GPA. This effect can be associated with a more intensive insulin-dependent glucose transport to muscles. The additional glucose, because of increased demand by fibers, underwent to oxidation and did not replenish the intracellular carbohydrate deposits These data suggest energy metabolism shifting toward activation of the processes of disintegration of substrates for energy production due to a sharp growth of energy demand.

[NFATc1 and slow-to-fast shift of myosin heavy chain isoforms under functional unloading of the rat m. soleus].

It was determined whether the content of NFATc1 (nuclear factor of activation of T cells) in the nuclear and cytoplasmic extracts is related to an increase in the content of fibers containing type IIa myosin heavy chains under gravitational unloading of m. soleus. It was found that three isoforms of NFATc1 with molecular masses of 140, 110, and 86 kDa are present in m. soleus. Under unloading, the translocation of 140 kDa NFATc1 into the nucleus, a decrease in the content of 110 kDa NFATc1 in the cytoplasmic extract of m. soleus, and an increase in the content of 86 kDa NFATc1 in the nuclear extract of m. soleus take place. The content of fibers containing type IIa myosin heavy chains under gravitational unloading increases. The increase in the level of 140 and 86 kDa NFATc1 in the nucleus is accompanied by a decrease in the percentage of fibers containing type I myosin heavy chains and an increase in the percentage of muscle fibers containing type IIa myosin heavy chains.

[Role of L-type Ca channels in Ca2+ accumulation and changes in distribution of myosin heavy chain and SERCA isoforms in rat M. soleus under gravitational unloading].

It is known that hindlimb unloading brings about the intracellular Ca2+ accumulation and MyHC slow-to-fast shift in m.soleus. SERCA (sarcoendoplasmatic reticulum Ca ATPase) function as a Ca pump to uptake to sarcoendoplasmatic reticulum after skeletal muscle contraction, and can modulate intracellular resting Ca level. The study was aimed at investigation of the role of intracellular Ca2+ level for MyHC and SERCA isoforms transformation in m.soleus under hindlimb unloading. To determine role of intracellular Ca we administrated nifedipin--specific blocker of L-type calcium channel in myofibers. We hypothesized that decrease of intracellular calcium level prevented-NFATc1 nuclear translocation and MyHC slow-to-fast transformation. 42 male Wistar rats (180-200 g) were divided in 3 groups: cage control (C, n = 14), 14 days HU (HU, n = 14), 14 days HU with 7 mg/kg/day of nifedipin administration with water (HUN, n = 14). The study has shown that increase of intracellular Ca2+ level under HU leads to MHC slow-to-fast shift via activation of calcineurin-NFATc1 signaling pathway. Percentage of muscle fibers with SERCA I increased under hindlimb unloading, being dependent of intracellular calcium level, percentage of muscle fibers with SERCA II decreased under hindlimb unloading but did not depend on calcium. We suppose that nifedipin administration decreases intracellular Ca level, prevents MHC slow-to-fast shift via prevention of NFATcl accumulation in nuclear extract of m.soleus, and prevent increase of SERCAI expression. The work was supported by grants RFBR N05-04-49255a, 04-04-49044, 05-04-08200-ofi-a, contract with Federal Agency for Science and Iinnovation N02.467.11.3005, and Presidium of RAS program "Basic sciences for medicine".

[Detection of sapoviruses in children with acute gastroenteritis in Moscow in 2002-2003].

Sapoviruses were found, for the first time, to be circulating in children with acute gastroenteritis in the city of Moscow. On the basis of a genetic analysis, they were classified as belonging to genotypes 1 and 2. Two groups of sapoviruses that are essentially different from the strains presented now at the GenBank NCBI were described within the case study.

Effects of deafferentation on the size and myosin phenotype of muscle fibers on stretching of the rat soleus muscle in conditions of gravitational unloading.

The aim of the present work was to assess the contributions of the reflex and local components to preventing decreases in the size and changes in the ratio of fibers containing the slow and fast isoforms of myosin heavy chains during chronic stretching of a postural muscle in rats in conditions of gravitational unloading. A unilateral surgical deafferentation method was used. The results demonstrated that deafferentation of the hindlimb had no effect on preventing reductions in muscle fiber size in conditions of chronic muscle stretching in conditions of gravitational unloading. The results obtained from these experiments did not support the hypothesis that the predominant contribution to preventing the development of atrophic changes comes from activation of muscle afferents in chronic stretching of the unloaded muscle. Deafferentation of both suspended animals and those with normal motor activity led to increases in the proportion of soleus muscle fibers containing the slow isoforms of myosin heavy chain.

[Human soleus fibers contractile characteristics and sarcomeric cytoskeletal proteins after gravitational unloading. Contribution of support stimulus]. / Sokratitel'nye kharakteristiki i belki sarkomernogo tsitoskeleta volokon m. soleus cheloveka v usloviiakh gravitatsionnoi razgruzki. Rol' opornogo stimula.

The effects of support withdrawal and support stimulation on the contractile characteristics of human soleus fibers and cellular factors which influence them were studied. The experimental model of the "dry" head-out water immersion was used in the study. In this model, the hydrostatic pressure on different sites of the body surface are equal so that the experimental conditions are close to the complete supportlessness. A 7-day exposure to dry immersion resulted in a decrease in the maximal isometric tension of the skinned fibers, a decline in the myofibrillar Ca2+-sensitivity, and the relative loss of the titin and nebulin content. A significant decrease in the percentage of fibers containing slow myosin heavy chains was also observed after dry immersion. The application of the mechanical stimulator influencing the plantar support zones with a pressure of 0.2 +/- 0.15 kg/cm2 6 times a day for 20 minutes of each hour brought about a complete prevention of the above listed effects of dry immersion. The data obtained allow one to conclude that the decline in maximal tension and Ca2+-sensitivity as well as myosin shift and loss of sarcomeric cytoskeletal proteins are associated with the support withdrawal during the exposure to dry immersion.

[Sarcomeric cytoskeletal proteins and myosin phenotype in stretched soleus of hindlimb-suspended rats]. / Belki sarkomernogo tsitoskeleta i miozinovyi fenotip volokon m. soleus pri ee khronicheskom rastiazhenii na vone vyveshivaniia zadnikh konechnostei krysy.

Changes in sarcomeric cytoskeletal proteins of rat m. soleus fibers upon the chronic stretching against the background of gravitational unloading were analyzed and compared with changes in fiber size and myosin phenotype. For rats exposed to gravitational unloading in the usual microgravity-simulating experimental model (hindlimb suspension (HS) according to Morey-Holten), a considerable reduction in the mass of m. soleus (by 54%) and the area of its fibers of both slow-twitch (by 47%) and fast-twitch (37%) types compared with control animals was revealed. Moreover, the percent of fibers containing only slow isoforms of myosin heavy chains (MHC) for suspended animals was slightly smaller and the portion of fibers interacting only with antibodies against fast myosin isoforms was significantly higher than for control animals. For hindlimb-suspended rats, the titin/MHC and nebulin/MHC ratios appeared to be reduced almost by two times as compared with those for the contriol group of animals. Chronic immobilization of m. soleus in stretched state against the background of suspension leads to a partial or complete prevention of the reduction in muscle fiber sizes, the transformation of the myosin phenotype into fast one, and a decrease in relative content of sarcomeric cytoskeletal proteins.

[Effect of deafferentation on the size and myosin phenotype of muscle fibers during stretching of rat m. soleus and gravitational unloading]. / Vliianie deafferentatsii na razmery i miozinovyi fenotip myshechnykh volokon pri rastiazhenii m.soleus krysy na fone gravitatsionnoi razgruzki.

The study was purposed to evaluate the contribution of the reflectory and local components during the chronic stretch of the postural muscle to the attenuation of the unloading-induced fiber size reduction and changes in the myosin heavy chain (MHC) profile. The surgical unilateral deafferentation (dorsal rhizotomy) was used. It was shown that unilateral deafferentation didn't influence on the amelioration of unloading-induced fiber size reduction in chronically stretched soleus muscle. Thus, the results obtained in the present study don't confirm the hypothesis, supposing the predominant contribution of the muscle afferent activation to the attenuation of unloading-induced fiber atrophy. Deafferentation of unloaded as well as control rats leads to the increase of the percentage of fibers expressing slow MYC isoforms.