[Structural and functional changes in the retinal layers in patients with primary glaucoma and possible means of retinoprotection]. / Strukturno-funktsional'nye izmeneniia sloev setchatki pri pervichnoi glaukome i vozmozhnye puti retinoprotektsii.

Glaucoma is one of the most severe forms of ophthalmic pathology which can lead to low vision and blindness. Therapy aimed only at reducing intraocular pressure (IOP) may be insufficient in patients with this disease. PURPOSE: To study the structural and functional changes occurring in the retina and the effect of peptide bioregulator on the state of various retinal layers in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 62 patients (123 eyes) with POAG. The control group consisted of 25 people (50 eyes) of the same age. After the initial examination, patients of the glaucomatous group were divided into two equal subgroups. Patients of the first subgroup received 10 intramuscular injections of the peptide bioregulator; in the second subgroup, patients did not receive any retinoprotective therapy. The state of the visual analyzer was assessed using spectral optical coherence tomography (SOKT), electrophysiological research methods (ERG, PERG, flicker ERG), photostress test. RESULTS: Patients with POAG were found to have current and developing changes in the thickness and the configuration of various layers of the retina in the macular area as the disease progresses - particularly, in the nerve fiber layer (p=0.02), ganglion cells (p=0.002), inner nuclear layer (p=0.003) and the layer of pigment epithelium (p=0.049). Electrophysiological research methods helped reveal statistically significant changes in the functional parameters reflecting the generation and conduction of nerve impulses in retinal layers in patients with glaucoma. The patients undergoing peptide bioregulator therapy showed statistically significant positive changes in the state of ganglion cells observed as a decrease in the latency of the PERG N-95 wave (p=0.002) and stabilization of the structural indicators of SOCT (RNFL peripapillary zone). CONCLUSION: Patients with POAG exhibit progressive decrease in the thickness of not only the inner, but also the outer layers of the retinal macular area. According to objective structural and functional criteria, retinoprotective therapy leads to stabilization of the glaucomatous process.

[Planning and organization of allo-grafting performed on the soldier's face].

Planning and organisation of allo-grafting performed on the soldier's face. According to the experience of military conflicts facial trauma with the Ioss of person's social function occurs in 4,5-5% of patients with such injury. In most cases, these injuries can be fixed with the help of reconstructive plastic surgery using their own tissue. However, some of the wounded to various reasons the use of autologous tissue is not possible or does not allow adequately restoring the appearance and function of the person. In such cases the only way is a donor allograft. There are just over 3 dozens of such successful operations, which indicates of their uniqueness and complexity. In May 2015 at the S.M.Kirov Military Medical Academy for the first time in our country made a successful transplantation of a difficult graft to a conscript, who was injured during the duty. The article presents the basic directions of the planning and organization of this unique operation.

[Modern aspects of surgical treatment of locally advanced pelvic cancer].

The aim of investigation is to improve surgical treatment of patients with locally advanced pelvic cancer. The basis of investigation is 186 patients with locally advanced pelvic cancer. The average age of patients is 65.2 ± 5.2 years (from 43.7 to 88.4 years). Among them are 112 women and 74 men. In the period from 2007 to 2015 they were carried out combined (101 patients) and expanded (85 patients) surgical intervention in the department of naval surgery of the Military medical academy after S.M.Kirov. Pelvic evisceration was performed in 63 cases. Both patients were performed isolated vascular hyperthermic chemical pelvic perfusion. Indications for plastic surgery of peritoneum pelvic were: total infralitoral pelvic evisceration (9 patients), dorsal infralitoral pelvic evisceration (11 cases) and expanded abdominoperineal rectum extirpation (34 patients). Plastic surgery with autogenouse tissues was performed to 43 patients, with reticulate explants--to 11 patients. The rate of postoperative complications was 40.2%. The rate of postoperative lethality was 8%. Expanded and combined operations of pelvic at patients with locally advanced cancer without absolute contra-indications can be performed irrespective of age. Plastic surgery of peritoneum pelvic after total and dorsal infralitoral pelvic evisceration and expanded abdominoperineal rectum extirpation indicated in all cases. The easiest method is plastic surgery with greater omentum or peritoneum pelvic. Plastic surgery with reticulate explants is performed when autoplastic is impossible.

[Prophylaxis of substance abuse in the Armed Forces: organization and performance of screening. Problem of substance dependence disorders is the actual for many countries in the world and affects on health of servicemen].

Due to this fact specialists underline the necessity of implementation of constant drug testing system of servicemen. The most effective researches individuals suffering from substance abuse are sample and control survey. Promising areas of prevention of addictive disease include the use of modem technologies for early detection of drug narcotic drugs and psychotropic substances, using the psychophysiological and laboratory techniques. The most common rapid laboratory procedure is the use of test strips (tablets) based immunoassay analysis. To facilitate the evaluation of the results is increasingly incorporated hardware and software systems based on photometric detection. The work done on the testing of such complexes allowed us to determine the algorithm of screening soldiers to assess the effectiveness of various hardware and software systems and identify promising technologies to identify individuals with addictive disorders.

[Nonspecific low-back pain: from symptomatic treatment to pathogenesis-based treatment].

OBJECTIVE: To study the efficacy and safety of artrosilene in the combination with piascledine in patients with low-back pain. METHODS: Sixty patients, 42 women and 18 men (mean age 53,6±10,4 years) with chronic nonspecific low-back pain were treated with artrosilene (ketoprofen lysine salt) in the combination with the chondro protector piascledine (a mix of avocado and soybean oil extracts). RESULTS: There the persistent decrease in the intensity of pain syndrome and severity of vertebral syndrome and improvement of quality of life. CONCLUSIONS: The drugs can be recommended for treatment of nonspecific low-back pain.

[Ontogenetic aspects of changing lysozyme activity under acute somatic pain].

OBJECTIVE: Ouraim was to study influence of acute somatic pain on lysozyme activity of rats of different age: newborn, rats after eye opening, rats at the age of a month, adult and old rats. METHODS: Lysozyme activity was checked before pain irritation and 2, 30, 60, 120, 180min afterwards using Dorofeychuk's method in our modification. Pain effect was modeling by electrical stimulation. RESULTS: activity of lysozyme was 0. 434±0. 01 units in intact newborn rats, It was higher than in adult rats - 0.260 ±0.01 units (p <0.001) and it was unchanged during the experiment. We found low lysozyme activity in rats after eye opening - 0.015±0.003 units and it was stable during the experiment. Rats at the age ofa month had diphasic reaction: lysozyme activity was 0.191±0.01 units in intact rats, it increased up to 0.378±0.01 units (p <0.001) in 2 min after painful irritation and it decreased up to 0.113±0.02 units (p <0.001) in 30 min. Lysozyme activity was 0.260±0.01 units. Single-phase reaction was determined after acute painful irritation: increase of lysozyme activity after acute somatic pain up to 0,450±0,014 units (p <0.001). Lysozyme activity was 0.246±0.02 units in blood plasma of old rats. It decreased up to 0.1701±0.01 units (p <0.01) after painful irritation and it was 0.387±0.01 (p <0.001) in the end of the experiment. CONCLUSION: Response on pain irritation has differences in different groups. The common vector of pain response was the increase of lysozyme activity in rats at the age of a month, adult rats, rats after eye opening and old rats. Reaction of increasing lysozyme activity was strongly detected in adult rats. The results demonstrate preventive lasozyme resistance to potential tissue damage or contamination.

[About the estimation of non specific protective effect of vaccination against infections actual for military personnel].

Flue and other respiratory diseases morbidity of servicemen of training students are researched. Epidemiological and economic effectiveness of flue vaccine "Bakcuspun" (Vaksigrip) is estimated. Its non-specific protective effect in case of acute respiratory diseases and pyodermia is shown.

[Comparative study of central and peripapillary retina in primary open-angle glaucoma using spectral-domain optical coherence tomography].

The aim of the study was to compare outer retinal layers in primary open-angle glaucoma (POAG) using spectral-domain optical coherence tomography (OCT). 15 patients (27 eyes) and 16 normal subjects (32 eyes) were examined. Patients were examined using OCT Spectralis ("Heidelberg Engineering", Germany) in order to analyze outer retinal layers and evaluate beta-zone extent. Significant difference such as thining of retinal pigment epithelium/Bruch's membrane (RPE/ BrM) complex was found in OCT images of outer retinal layers. Negative correlation of RPE/BrM complex thickness and peripapillary beta-zone extent was found. Changes of central and peripapillary retina detected using spectral-domain OCT may be considered for diagnosis and monitoring of POAG.

Pharmacokinetics of liposomal gentamicin.

We present data on pharmacokinetics of free and liposomal forms of gentamicin. Comparative study of two drug forms showed that immobilization of gentamicin in liposomes significantly increased most important pharmacokinetic parameters of the antibiotic (AUC, Cmax, MRTpo, T(1/2), Kel, Vzpo) and reduced Clpo and Kel.

[About non-specific prophylaxis of infections typical for organized groups].

Respiratory tract infections and pyodermia are typical for personnel doing military service under conscription. Risk of progression of these infections is connected with activation of carry-over of causative agents among military personnel during replacement and decrease in immunity of conscripts. Usage of medication "Karmolis Kapli" for the purpose of prophylaxis allows to reduce cases of respiratory tract infections among the military personnel. Among the military servicemen who had take "Karmolis Kapli" was noted reduction of community-acquired pneumonia, tonsillitis and pyodermia morbidity. Non-specific protective effect of medication "Karmolis Kapli" is conditioned by increase of the common resistance of the body. For the purpose of prophylaxis it is necessary to use this medication during the personnel formation before the beginning of seasonal morbidity.

[Epidemiologic situation of West Nile fever in Russia in 2010].

Problem of tropical arbovirus infection--West Nile fever (WNF)--spread in Russian Federation is discussed. Biology of WNF is discussed, WNF sources and reservoir are characterized. WNF outbreaks in Russia during the past 2 decades are presented in detail. Outbreaks of different years, possible causes and epidemiology are discussed. Features of WNF clinical course during various outbreaks and WNF diagnostic problems are presented.

[Comparative analysis of retinotomographic and histological examinations of retina in health and primary open-angle glaucoma].

Comparative analysis of retinal structure was performed in patients with POAG and control healthy group using spectral OCT and histology. An apparent similarity of tomographic and histological patterns of retinal changes was found in patients with POAG. These results make OCT potentially appropriate method for vital examination of retinal structure in glaucomatous eyes including early stages of the disease. Degeneration of all retinal layers is revealed. Blood flow deficiency due to sclerosis and hyalinosis of uveal vessels is considered to be an immediate cause of outer and intermediate retinal layers degeneration.

Activity of some enzymes in the liver of experimental animals after treatment with the liposomal formulation of tetracycline and streptomycin.

A new method for obtaining the liposomal formulation of streptomycin and tetracycline is described in the present work. The physicochemical properties of this formulation were evaluated. We compared the effects of free and liposomal formulations from streptomycin and tetracycline on activity of liver enzymes in albino mice. Immobilization of antibiotics in liposomes was followed by a decrease in the inhibitory effect on protease, alkaline phosphatase, and phosphorylase. The influence of this preparation on ATPase was reduced by 2 times.

[Faith to the traditions (military hospital of Smolensk--205 years)].

Military hospital of Smolenks was founded in 1805 and nowadays it is the basic hospital in Moscow military district, more than 5 thousand patients get treatment annually. 45 thousands military men, retirees and members of their families are at medical provision. Since 1997 hospital passed licensing of medical activities four times. Number of licensing types increased from 25 to 72. During the reorganization of Armed Forces since 1 December 2009 hospital went on to 300 beds, also it was reformed to the structural subdivision of district hospital.

[Pathogenicity of West Nile virus: molecular markers].

The review describes the phenotypic properties, structure, and expression pattern of West Nile virus genome (Flaviviridae, Flavivirus, Japanese encephalitis antigenic complex), as well as the clinical picture and pathogenesis of its etiologically related disease West Nile fever. It also analyzes the available data on the impact of genetic mutations in the genome on the biological properties of the virus.

[Species-specific sera against surface antigens of Bacillus anthracis strains].

The species-related specificity of sera against 94-KD proteins isolated from culture filtrates of B. anthracis strains with different levels of virulence plasmids was studied to determine whether they might be used to identify the pathogen of anthrax. Sera against fractions 1 of culture filtrates of B. anthracis strains CTI (pXO1+ pXO2-), 81/1TR (pXO1- pXO2-), Davies (pXO1- pXO) separated by gel chromatography on Sephacryl S-300 were examined. In the gel immunodiffusion test with growing cultures, the sera exhibited non-identical antigens and differed in the presence of antibodies to antigens of related bacilli. The sera against fractions 1 of culture filtrates of toxin-producing and plasmidless strains displayed antigens produced only by B. anthracis strains into nutrient agar. Electroimmunotransblotting revealed that they contained antibodies mainly to 94-kD proteins and failed to react with B. cereus proteins with a molecular weight of 94 kD and with B. thuringiensis proteins with a molecular weight of 97 kD, which were extracted from autonomous cells. In the immunofluorescence test, immunoglobulins of sera against fractions 1 of culture filtrates of three strains stained autonomous cells and spores of 23 B. anthracis strains with different levels of virulence plasmids. In working dilutions, they did not react with antigens of 18 strains of related bacilli, which presents a possibility of using them for species identification of B. anthracis.

[Minimal compression-load ophthalmoplethysmography in health and in primary open-angle glaucoma].

The investigation was undertaken to study intraocular blood flow in health and in primary open-angle glaucoma, by applying ophthalmoplethysmography with the minimum compression load on the eyeball. Sixty-nine patients (129 eyes) with primary open-angle glaucoma and 41 healthy individuals (82 eyes) were examined. In healthy individuals, the ophthalmoplethysmographic parameters of ocular volumetric blood flow averaged 7.3 mm3 for pulse volume and 493 mm3 for minute volume. There was a noticeable drop in volumetric ocular blood flow parameters in early primary open-angle glaucoma and their further decrease as a glaucomatous process progressed. The patients with primary open-glaucoma showed an inverse correlation of the volumetric hemodynamic parameters with the intraocular pressure. Worse temporary plethysmographic parameters were found in patients with normal intraocular pressure, which is an indirect indication of impaired choroidal blood microcirculation in glaucoma even within the normal range of intraocular pressure.

Effect of liposomal tetracycline hydrochloride on enzymatic function of the liver.

Preparation and physicochemical properties of liposome-incorporated tetracycline are described. Comparison of the effects of tetracycline hydrochloride in free and liposome-incorporated forms on enzymatic functions of the liver showed that immobilization of the antibiotic into liposomes protects liver cells from functional disturbances.