ARTERIAL CHEMOINFUSION IN PATIENTS WITH LOCALLY ADVANCED AND METASTATIC PANCREAS CANCER.

The chemoinfusions (310) were carried out in celiac trunk in 167 patients with non-removed pancreas cancer at the period from 2000 to 2015. Locally advanced timorous process (stage III, n=79) was revealed in 79 patients and liver metastases (stage IV, n=88) were noted in 88 cases. The celiac axis infusion by Gemcitabine (1000 mg/m²) was applied for patients and GEMOX (Gemcitabine+Oxaliplatin 75 mg/m²) has been using since 2012. Symptomatic improvement such as decrease of pain, growth of body weight was noted in majority of patients. An average lifetime, median and one-year survival consisted of 7,6 months, 5,8 months and 10%. The patients (133) were treated by 1­2 cycles and after that by course of total body chemotherapeutics. There weren't any serious complications. Toxic manifestations of chemotherapy weren't higher than I­II degree and they were arrested by corrective therapy in 92 patients (55%). The celiac axis infusion is safe in patients with locally advanced and inoperable pancreas cancer. Symptomatic improvement showed the most patients. The objective response to the treatment had 20% patients and performance of repeated cycles led to increase of their survival.

[The laboratory diagnostic of patients with tuberculosis with medicinal resistance of agent].

The article considers possibilities and means of transition to personalized treatment of patients with tuberculosis conditioned by fast development and spreading of medicinal resistance of tuberculosis agent. The technical possibilities are demonstrated for realization of this approach and also necessity of information possessing in the field of evaluation of treatment effectiveness. Also, attention was paid to relationship ofpharmacogenetics and pharmacokinetics of wide spectrum of anti-tuberculosis medications, medicinal resistance of agent and genetic conditioning of development of side-effect negative reactions to chemotherapy.

Study of skin anti-ageing and anti-inflammatory effects of dihydroquercetin, natural triterpenoids, and their synthetic derivatives.

Accessible triterpenoids of ursane and lupane series, the flavonoid dihydroquercetin and their synthetic derivatives with polar substituentss were tested in vitro for inhibition of collagenase 1 (MMP-1) in UVB irradiation assay. Ursolic acid and uvaol disuccinate were the most active inhibitors in the ursane series. In the lupane series, the best inhibition was manifested by carboxymethyl ester of betulonic acid and betulin succinates. Down- regulation of MMP-1 by dihydroquercetin and its synthetic derivatives surpassed the activity of a standard (retinoic acid).

[Roentgenoendovascular hemostasis of arterial bleeding after major surgery for pancreatic cancer].

The efficacy of angiographic hemostasis in cases of massive arterial bleeding after major pancreatic resection was evaluated. Late life-threatening arterial hemorrhage developed in 3 out of 65 patients (4.6%) within 12, 20 and 42 days after pancreatic carcinoma resection. In all cases emergency roentgenoendovascular procedures were fulfilled for hemostasis. Six therapeutic angiographic procedures (from one to three per a patient) were performed. All of them were clinically and technically successful. Depending on the bleeding localization and the character of vascular lesion, the embolization (n = 5) or stent-grafting (n = 1) were used. The further prognosis was dependent on the success of treatment of complications and the course of the malignant disease. The emergency angiography with endovascular hemostasis appears to be the method of choice in treatment of postoperative visceral bleedings especially in patients with high surgical risk.

Inhibitory effect of ursolic acid derivatives on recombinant human aldose reductase.

Aldose reductase (AR) is the first enzyme in the polyol pathway. AR has been reported to play an important role in the pathogenesis of diabetic complications. Ursolic acid and fourteen synthetic derivatives with ursane skeleton were tested for recombinant human aldose reductase (rhAR) inhibitory activity for development of diabetic complications. Among them, N-(3beta-hydroxyurs-12-en-28-oyl)-4-aminobutyric acid (XV) showed most potent rhAR inhibitory activity in vitro. Inhibition mode of N-(3beta-hydroxyurs-12-en-28-oyl)-4-aminobutyric acid (XV) was tested uncompetitively by kinetic analysis using the Lineweaver-Burk plots. Ursolic acid derivative N-(3beta-hydroxyurs-12-en-28-oyl)-4-aminobutyric acid is able to inhibit rhAR uncompetitively and could be offered as a lead compound for AR inhibition.

[Determination of critical kanamycin concentration for Mycobacterium tuberculosis in the MGIT Bactec 960 system].

The critical concentration of canamycin for the MGIT Bactec 960 system, which has been determined on a panel of the tho--roughly characterized genetically heterogeneous clinical Mycobacterium tuberculosis isolated in the Central Region of Russia, is equal to 1.25 microg/ml.

[Problems in the formation of tuberculosis epidemiological parameters].

UNLABELLED: The information obtained from 83 subjects of the Russian Federation on 107,306 new tuberculosis (TB) cases and TB relapses, recorded for treatment in the tuberculous facilities of the Ministry of Health and Social Development of the Russian Federation (RF), was analyzed. The completeness and validity of indicators and their compliance with Russian Statistics Committee's form 8 were studied. RESULTS: among the new TB cases, bacterial discharge was found in 33.3 +/- 5.2% by microscopy and in 44.9 +/- 8.9% by cultures tests. Decay cavity was observed in 42.6 +/- 4.9% of the patients. In the RF, the coverage of patients to be tested for Mycobacterium tuberculosis susceptibility was 76.3-83.1% of culture-positive TB patients. Among the new TB patients, drug resistance (DR) of M. tuberculosis to one drug or more was detected in 30.6 +/- 6.7% of those tested for drug susceptibility. Multidrug resistance (MDR) was recorded in 11.4 +/- 4.2% of the examinees. Among the patients with TB relapses, DR and MDR were found in 45.4% and 24.7% of the examinees, respectively. The detection rate of epidemically dangerous patients in the general health care facilities was as high as 12.5%, which is an extremely low value. CONCLUSION: Order No. 50 reporting documents needs to be improved for the evaluation of the efficiency of treatment and monitoring a tuberculosis epidemic process. It is necessary to follow the uniform rules for calculating the values for all RF reporting forms. In particular, this concerns the indicators of the prevalence of DR tuberculosis. The efficiency of a microbiology study of patients varies in federal districts; however it is generally inadequate.

[Role of 18F-FDG PET scan in the differential diagnosis of large pancreatic masses].

Results of standard 18FDG PET and double-phase scanning were compared in the course of differential diagnosis of pancreatic cancer and chronic pseudotumorous pancreatitis, particularly, during exacerbation. PET diagnosis of cancer was confirmed in 6.5% while that of double-phase scanning--100%.

[Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion in the combined treatment of pancreatic cancer].

Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion with gemicitabine was administered to 28 patients with operable exocrine pancreatic cancer. It was well tolerated and not followed by complications which allowed for gastropancreatoduodenal resection to be carried out in all cases. Complete course of combined treatment was given to 23 out of 28 patients (82.1%). As a result, 2-, 3- and 5-year actuarial survival rates were 23.9, 17.4 and 13%, respectively. Long-term survival was recorded among patients without metastases into regional lymph nodes: two of them have survived without relapse for more than 5 years and one died of tumor progression after 4 years of the follow-up.

[Electropulse therapy in the early postoperative rehabilitation period after reconstructive and plastic surgery on fallopian tubes].

The efficiency of sinusoidal modulated currents applied to the vaginosacral region in the early postoperative rehabilitation period after plastic and reconstructive surgery on the fallopian tubes was assessed in 30 women aged from 21 to 38 (mean 29.3+/-0.6) years. All of them had endoscopically diagnosed tubuloperitoneal infertility. Treatment with sinusoidally-modulated current in he early postoperative period had beneficial effect on the luteal phase of the menstrual cycle in 55.6%, on the hypothalamo-pituitary-ovarian axis in 23.3%, on hemodynamics in the small pelvis organs in 46.7%, on uterine tube activity in 36.7%, and on the reproductive function in 30% of the patients. These women suffered tubuloperitoneal infertility for less than 5 years and underwent grade I-II adhesive process in the absence of endoscopic signs of atrophic or hypetrophic changes in uterine tube walls.

[Cardinal problems of the regional bacteriological laboratories of tuberculosis facilities].

Restructuring the health care system and the epidemiological situation associated with tuberculosis result in an increased burden on the bacteriological laboratories (BLs) of tuberculosis facilities. At present, there are no statistical data that enable one to estimate the capacity of a laboratory service to assure the adequate quality and efficiency of bacteriological diagnosis. To assess the state of the headquarters BLs of tuberculosis facilities, the authors have worked out a questionnaire to glean necessary information on the activity of the laboratories to such an extent that suffices to reveal cardinal problems in the work of individual laboratories and the laboratory network as a whole. Out of the 48 questionnaires sent from the regional BLs, the data available from 22 laboratories that had fully answered all the questions were analyzed. The data obtained are referred to as of 2004, i.e. when the current antituberculous care projects were launched, which is of significance in organizing the monitoring of a laboratory service and in assessing the progress of the projects. The authors have identified the following cardinal problems: inadequate readiness of most laboratories to fully perform their incumbent functions; no coordination in providing data at the regional and federal levels; inefficient laboratory diagnosis that is associated with the disintegration of the curatorial institution, with neither reference relations no united external or internal quality control programs, with the lack of expertise and the undermanning of the laboratories, with the obsolete list of staff members and the obsolete standards for calculation of their loads, with the deterioration of a material and technical base, and with the unconformity of equipment to the state-of-the-art technologies. In order to solve the above problems, the authors offer a laboratory service monitoring system based on the proposed questionnaire, followed by the computerization of data collection and the compulsory supervision of regional laboratories by the officials of district and federal BLs.

[Antioxidative defense in patients with acute coronary syndrome and concomitant type 2 diabetes and its modification by lisinopril].

AIM: To study antioxidative defense in patients with acute coronary syndrome (ACS) and concomitant type 2 diabetes and its modification by lisinopril. MATERIAL AND METHODS: Activity of glutathione reductase and myeloperoxidase in neutrophils, catalase and superoxide dismutase in blood was measured in 94 patients with ACS (including 35 with diabetes) and the patients were followed up for 1 year. RESULTS: Number of coronary events during observation was significantly higher in patients with diabetes. At baseline these patients had significantly lower catalase activity which was associated with elevated blood glucose, circulating immune complexes, creatinine, and proteinuria. Baseline catalase activity was the lowest in diabetic patients with events (reinfarction or death) during follow-up. The latter patients had highest levels of blood creatinine and proteinuria, and most pronounced left ventricular systolic dysfunction. The use of lisinopril during initial hospitalization was associated with elevation of catalase activity, lowering of creatinine and elimination of proteinuria.

[Lisinopril-induced changes in antioxidant defense in patients with acute coronary syndrome and concomitant diabetes mellitus type 2].

AIM: To examine antioxidant defense (AOD) in patients with acute coronary syndrome (ACS) and concominant diabetes mellitus type 2 (DM2) as well as AOD changes related to lisinopril administration. MATERIAL AND METHODS: AOD was studied for a year (by activity of glutathion reductase and myeloperoxidase of neutrophils, catalase and superoxide dismutase of blood) in 94 patients with ACS (35 of them had DM2). RESULTS: The number of recurrent coronary events for a year was significantly more in patients with ACS and DM. Such patients had initially lower activity of catalase, higher blood glucose, circulating immune complexes, creatinine, urinary protein. The lowest catalase activity was in DM patients who had recurrent infarction or died. Low catalse activity was accompanied with the highest blood creatinine and protein, more severe systolic dysfunction of the left ventricle. Compared to captopril, administration of lisinopril in hospital increased catalase activity, lowered blood creatinine, eliminated protein in the urine. These changes were associated with a significantfall in the number of cases with progressive chronic cardiac failure and lethal outcomes.

[System monitoring health state of individuals suffering from occupational diseases in the Rostov region]. / Sistema monitoringa za sostoianiem zdorov'ia bol'nykh professional'nymi zabolevaniiami v Rostovskoi oblasti.

The authors describe experience associated with creation of automated system registering patients with occupational diseases, monitoring health state of patients with occupational diseases, specifying thorough analysis of occupational morbidity.

[Components of monitoring drug resistance of tuberculosis agent in the evaluation of effectiveness of the national tuberculosis control program]. / Komponenty monitoringa lekarstvennoi ustoichivosti vozbuditelia tuberkuleza dlia otsenki éffektivnosti natsional'noi programmy protivotuberkuleznoi pomoshchi naseleniiu.

The authors analyzed the changes and pattern of drug-resistance in tuberculosis pathogen by using the reports of over 700 microbiological laboratories of tuberculosis control service in Russia in the past 20 years (1979-1998), which yielded a monitoring system for drug resistance in the pathogen in this country. Seven underlying informational blocks were identified. These included more than 20 different quantitative and qualitative parameters covering the characteristics of a patient and the pathogen and regionally environmental and epidemiological indices. Analysis of the data on the united northern, west-northern, and Baltic regions is given as an example of successful use of the monitoring system.

[The monitoring of the drug resistance of the causative agent of tuberculosis in Russia in 1979-1998]. / Monitoring lekarstvennoi ustoichivosti vozbuditelia tuberkuleza v Rossii za 1979--1998 gg.

The Russian 1979-1998 annual reports of the centralized microbiology laboratories of the tuberculosis controlling service were used to examine the pattern and trends of formation of drug-resistance in the tuberculosis pathogen. The data on over 1.2 million cases of drug resistance to 7 antituberculous drugs were pooled. The analysis indicated that drug resistance had increased in two steps in the past 2 decades. The maximum levels of the drug resistance of Mycobacterium tuberculosis to some drugs were limited (7.8 and 37.2%), which are not greater those as indicated by the international statistics.

[Planning and implementation of protective measures in emergencies during railway transportation of radioactive cargo]. / Planirovanie i provedenie zashchitnykh meropriiatii v avariinykh situatsiiakh pri zheleznodorozhnykh perevozkakh radioaktivnykh gruzov.

Protective measures in emergencies during railway transportation of radioactive cargoes must be planned in advance, by obligatorily taking into account many factors that influence the scope, nature, specific features and consequences of radiation transport accidents. Of great importance are radiation monitoring, protective regimens, and requirements for decontamination of various objects in liquidating the consequences of a radiation transport accident.