Characterization of the complete genome sequence of the recombinant norovirus GII.P16/GII.4_Sydney_2012 revealed in Russia.

Noroviruses (the Caliciviridae family) are a common cause of acute gastroenteritis in all age groups. These small non-envelope viruses with a single-stranded (+)RNA genome are characterized by high genetic variability. Continuous changes in the genetic diversity of co-circulating noroviruses and the emergence of new recombinant variants are observed worldwide. Recently, new recombinant noroviruses with a novel GII.P16 polymerase associated with different capsid proteins VP1 were reported. As a part of the surveillance study of sporadic cases of acute gastroenteritis in Novosibirsk, a total of 46 clinical samples from children with diarrhea were screened in 2016. Norovirus was detected in six samples from hospitalized children by RT-PCR. The identified noroviruses were classified as recombinant variants GII.P21/GII.3, GII. Pe/GII.4_Sydney_2012, and GII.P16/GII.4_Sydney_2012 by sequencing of the ORF1/ORF2 junction. In Novosibirsk, the first appearance of the new recombinant genotype GII.P16/ GII.4_Sydney_2012 was recorded in spring 2016. Before this study, only four complete genome sequences of the Russian GII.P16/GII.3 norovirus strains were available in the GenBank database. In this work, the complete genome sequence of the Russian strain Hu/GII.P16-GII.4/RUS/Novosibirsk/NS16-C38/2016 (GenBank KY210980) was determined. A comparison of the nucleotide and the deduced amino acid sequences showed a high homology of the Russian strain with GII.P16/GII.4_Sydney_2012 strains from other parts of the world. A comparative analysis showed that several unique substitutions occurred in the GII.P16 polymerase, N-terminal p48 protein, and minor capsid protein VP2 genes, while no unique changes in the capsid VP1 gene were observed. A functional significance of these changes suggests that a wide distribution of the strains with the novel GII.P16 polymerase may be associated both with several amino acid substitutions in the polymerase active center and with the insertion of glutamic acid or glycine in an N-terminal p48 protein that blocks the secretory immunity of intestinal epithelial cells. Further monitoring of genotypes will allow determining the distribution of norovirus recombinants with the polymerase GII.P16 in Russia.

CLINICAL AND LABORATORY FEATURES OF ACUTE VIRAL GASTROENTERITIS IN ADULTS, RESIDENTS OF NOVOSIBIRSK.

The aim of this study was to determine the frequency and the clinical and laboratory features of acute viral gastroenteritis in adult patients the residents of Novosibirsk. MATERIALS AND METHODS: A total of 363 patients aged 16 to 82 years hospitalized with a diagnosis of"acure gastroenteriris" in the winter-spring season 2016 and with no evidence of immunosuppression were examined. In addition to generally accepted diagnostic techniques faeces were investigated using polymerase chain reaction for the detection and differentiation group A and C rotaviruses (HRVA and HRVC), I norovirus genogroup II (HNoV Gil) and astroviruses (HAstV) with applying the original set of specific primers. RESULTS: Viral etiology has been set at 19,6% of patients with acute gastroenteritis. Noroviruses were predominant (10,2%), the proportion of rotavirus was 7,7%, astroviruses - 1,7%. The proportion of viral gastroenteritis was higher in the winter months and decreased in spring months. The moderate form of the disease dominated (99.4%). No significant differences in clinical symptoms, blood count and coprogram parameters were revealed in patients with different etiology of viral gastroenteritis, except the higher frequency of lymphocytosis in norovirus infection (p < 0,05). CONCLUSION: Set frequency of viral gastroenteritis in adults, no significant differences in the clinical picture of viral gastroenteritis of various etiologies determine the necessity of elaboration and introduction into clinical practice of universal test systems for the detection of common viral pathogens.

[Genetic diversity of group A rotavirus isolates found in Western Siberia in 2007-2011].

Genetic analysis of group A rotavirus recovered from fecal samples of children admitted to hospitals in Novosibirsk and Omsk during four epidemic seasons 2007, 2007/2008, 2009/2010, 2010/2011 was performed. A total of 1416 rotavirus isolates were genotyped using multiplex PCR. The isolates of the most common rotavirus genotypes G1P[8], G4P[8], G2P[4], G3P[8] co-circulated in Western Siberia during 2007-2011. In isolated cases G9P[8], G2P[8], G3P[9], and G4P[6] genotypes were detected. Change of dominant genotype from G1P[8] to G4P[8] occurred in 2008 in Omsk and in Novosibirsk in 2009 as well. Incidence and distribution of rotavirus genotypes differed and changed every epidemic season in both cities. The phylogenetic analysis based on VP4 (VP8*), VP7, and VP6 gene sequences showed that the majority of isolates from Novosibirsk and Omsk were clustered together and demonstrated high level homology with rotavirus isolates found in other regions of Eurasia. In addition, a rare P[8]b (OP354-like) subtype of the VP4 gene was identified in fourteen isolates (G9, G1, and G4) in Novosibirsk and in a single isolate Omsk08-381/G9P[8]b in Omsk. The results obtained in this study demonstrate the necessity of long-term monitoring of rotavirus isolates in Western Siberia. This is important for selection of rotavirus vaccine for immunization of infants, improvement of diagnostic kits and understanding of the epidemiology and the evolution of group A rotaviruses.

[Use of continuous epidural infusion of ropivacaine as a component of an anesthesiological appliance and postoperative analgesia in elderly patients in cancer surgery].

The study was undertaken to evaluate the effectiveness and safety of ropivacaine used via long-term epidural infusion and to define the optimum doses of the agent in the intra- and postoperative period. The parameters of hemodynamics, the adequacy of anesthesia, and the consumption of the agent were explored in 53 patients (ASA III-IV) aged 68 +/- 1.4 years operated on for abdominal cancer. Following 15 and 25 min of the injection of a bolus dose of ropivacaine, the occurrence of sensory block II was observed in 60 and 95% of the patients, respectively. After injection of ropivacaine in a bolus dose (56 +/- 3.4 mg), there was a 20% lowering of mean blood pressure and a 17% reduction in heart rate as compared with the baseline values. Maintenance infusion was made at a rate of 15-25 (20 +/- 1.9) mg/h. The total consumption was 126 +/- 13 mg. Bradycardia was noted in 4 (7.5%) cases; 7 (13%) patients required additional administration of phentanyl. The latter was used in a dose of 100 microg in 87% of the patients only prior to tracheal intubation. For postoperative analgesia, 0.2% ropivacaine was infused at a rate of 6-10 ml/h. Increasing its dose up to 12-14 ml/h resulted in hypotension and the occurrence of the signs of motor block. Postoperative analgesia was effective in 89% of cases when the agent was infused at rate of 8.8 +/- 0.9 ml/h and the hemodynamic parameters were stable. Postoperative intestinal paresis was abolished in 85.8% of patients after an average of 52 +/- 2.7 hours. Long-term epidural infusion of ropivacaine may be regarded as an effective component of anesthesia at abdominal surgery in elderly patients with severe comorbidity. The method allows one to completely refuse the use of narcotic analgesics in most cases both during a surgical intervention and in the postoperative period, which creates good conditions for an early activation of patients and for a reduction of postoperative complications.

[Policy and surgical treatment in malignant tumor of pancreatoduodenal zone].

Experience in the treatment of 65 patients with tumors of pancreatoduodenal zone is analyzed, 36 of them underwent standard and radical pancreatoduadenal resections. Diagnostic value of preoperative examinations is analyzed, type of surgery is substantiated depending of localization and spread of tumor, degree of hepatodepression. Features of pancreatoduodenal resection are described in detail. Lethal outcome was in 1 case. It is concluded that radical surgeries can be more widely used in cancer of periampullar zone and chronic pseudotumoric pancreatitis.

Integrated estimation of the effect of physical factors on human functional state during mental work.

The purpose of this study was to develop a model for an integrated estimation of the functional state of the human organism (FSHO) and an integral estimation of physical factors (PF) for hygienic rating. Tests were performed twice with 3 men in 0.7-clo clothing during 4-hr mental work with 9 combinations of 4 PF: wideband noise (55- 83 dB(A)), whole-body vibration (6 Hz, a(z) = 0.2-1.8 ms(-2)), air temperature (18-30 degrees C), and illumination (1, 3, 5 lx). Thermoregulatory, cardiovascular, and psychophysiological reactions and temporary threshold of hearing (TTS2) shifts were studied. For the integral estimation of PF influence on FSHO the model F(y1,y2..........ym) = f(x1,x2,.......xn) was used, relating both FSHO and PF sets. The most important physiological parameters in creating FSHO are defined and the contribution of individual parameters of FSHO and PF is found.

[Prognosis of the thermal status of man in view of the impact of a variety of factors]. / Prognozirovanie teplovogo sostoianiia cheloveka pri vozdeistvii kompleksa faktorov.

Mathematic and statistic analysis helped to determine classes of human functional state characterized by variable degree of thermoregulatory and cardiovascular strain. The authors represented technology forecasting a class of human functional state under influence of combined factors that change heat status and overcharge cardiovascular system and technology forecasting reliable time tolerance interval for the complex of factors influencing human.

[Evaluation of the effects of a complex of physical factors on the functional state of men doing mental work]. / Otsenka vliianiia kompleksa fizicheskikh faktorov na funktsional'noe sostoianie cheloveka, vypolniaiushchego umstvennuiu rabotu.

The article evaluates influence of environmental, physical factors (noise, vibration, ambient temperature, illumination) on human functional state. The study involved 3 males performing mental tasks (following the object movements on monitor and correcting the track after variable interferences appearing in uneven time intervals) in specific microclimate chamber. The study revealed physiologic parameters more substantial for human functional state if influenced by environmental physical factors. For each parameter of human functional state and environmental physical factor a significance share was determined. If significant (r = 0.82, p < 0.001), correlations between parameters of human functional state and environmental physical factors became a material for integral equations. Method of cluster analyses defined 3 classes of human functional state and environmental status. Evaluation and regulation of those integral parameters became possible through a probability nomogram obtained.