The problem of the risk of development of infection of surgical obstetric wound after cesarian section in women of the Kirov region.

Over the past decade, the frequency of abdominal delivery in Russia has increased to an average of 25 %. The widespread use of abdominal delivery has not been without an increase in the incidence of complications. Among them is an infectious complication of a surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after a caesarean section, which in some regions reaches 43 %. The development of complications is facilitated by various clinical and laboratory risk factors, the analysis of which in women of the Kirov region is the subject of this article. The analysis of clinical and laboratory risk factors was carried out on the basis of the data presented in the case histories of women hospitalized in the gynecological departments of the city of Kirov. Statistical data processing was carried out on a personal computer using the R-4.0.2 statistical program and Excel spreadsheets. When assessing the relevance of the problem for the Kirov region, it was found that the frequency of caesarean section over the past 10 years from 2011 to 2021 increased from 27,0 % to 34,0 %. The incidence of infectious complications in the Kirov region can be presented as follows: infection of the surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after caesarean section - 27,0 %; peritonitis after caesarean section - 0,94 %-1,01 %; diffuse sepsis - 0,93 %-0,97 %. An important role, according to reports, in the addition of an infection of a surgical obstetric wound after cesarean section is played by the general morbidity and obstetric history in women with abdominal delivery, a detailed statistical analysis of which is presented in the materials of the article. The results of the study substantiated the problem of the development of an infection of a surgical obstetric wound after a caesarean section for the healthcare of the Kirov region, comparable to that for the healthcare of the entire Russian Federation. The analysis of clinical and laboratory risk factors showed the feasibility of using a comprehensive analysis of infection of a surgical wound after cesarean section at an early stage of its development to quickly resolve complications, reduce the duration of hospitalization of women after cesarean section, and subsequently preserve the reproductive function of a woman.

Comparative assessment of the results of detection of СagА-positive strains of Helicobacter pylori by molecular-genetic and immunochromatographic methods in different biological materials.

A comparative analysis of the detection of CagA-positive strains of H. pylori by immunochromatographic and molecular genetic methods was carried out. We used H. pylori strains isolated from individuals with diseases of the gastrointestinal tract. The immunochromatographic method was implemented using a developed experimental model of an immunochromatographic test system for detecting the H. pylori CagA protein in various biological materials. Determination of the pathogenicity gene cagA of H. pylori was carried out using the «Helikopol SA¼ test system («Litekh¼, Russia). The assessment of the comparability of the results of detecting CagA-positive strains of H. pylori was carried out using statistical methods: Monte-Carlo, calculation of the chi-square test (χ2) and Kendall's τ-b and Somer's d coefficients. Statistical analysis was performed using the software packages «Microsoft Office Excel¼, «Statistica 10.0¼, «WinBUGS 1.4.0.¼ The study showed the absence of a statistically significant difference and the presence of a direct strong correlation between the results of detecting CagA-positive strains by molecular genetic and immunochromatographic methods, which indicates that these methods provide similar results in identifying highly pathogenic strains of H. pylori.

Production of subtilisin proteases in bacteria and yeast.

In this review, we discuss the progress in the study and modification of subtilisin proteases. Despite longstanding applications of microbial proteases and a large number of research papers, the search for new protease genes, the construction of producer strains, and the development of methods for their practical application are still relevant and important, judging by the number of citations of the research articles on proteases and their microbial producers. This enzyme class represents the largest share of the industrial production of proteins worldwide. This situation can explain the high level of interest in these enzymes and points to the high importance of designing domestic technologies for their manufacture. The review covers subtilisin classification, the history of their discovery, and subsequent research on the optimization of their properties. An overview of the classes of subtilisin proteases and related enzymes is provided too. There is a discussion about the problems with the search for (and selection of) subtilases from natural strains of various microorganisms, approaches to (and specifics of) their modification, as well as the relevant genetic engineering techniques. Details are provided on the methods for expression optimization of industrial subtilases of various strains: the details of the most important parameters of cultivation, i.e., composition of the media, culture duration, and the influence of temperature and pH. Also presented are the results of the latest studies on cultivation techniques: submerged and solid-state fermentation. From the literature data reviewed, we can conclude that native enzymes (i.e., those obtained from natural sources) currently hardly have any practical applications because of the decisive advantages of the enzymes modified by genetic engineering and having better properties: e.g., thermal stability, general resistance to detergents and specific resistance to various oxidants, high activity in various temperature ranges, independence from metal ions, and stability in the absence of calcium. The vast majority of subtilisin proteases are expressed in producer strains belonging to different species of the genus Bacillus. Meanwhile, there is an effort to adapt the expression of these enzymes to other microbes, in particular species of the yeast Pichia pastoris.

[ENDOMETRIOSIS AND PREGNANCY (REVIEW)].

The purpose of this review was to systematize the data on the effect of endometriosis on the fertility index, the course of pregnancy, and the modern diagnosis of changes the endometriotic implants during pregnancy. There are many factors that can potentially affect fertility in patients with endometriosis: anatomical changes in the pelvic floor, impaired transport function of the fallopian tubes due to the formation of adhesions, impaired steroid and folliculogenesis, anovulation and peritoneal changes that contribute to the formation of a harmful prooxidant microenvironment, which can affect the quality and quantity of oocytes and cause a violation of the susceptibility of the endometrium. If the patient with endometriosis still managed to get pregnant, then the problem of maintaining this pregnancy arises even more. The data indicate that pregnancy has a positive effect on the symptoms of endometriosis, and also has a beneficial effect on the growth rate and relapse rate of endometriosis, and may also cause a regression of the formed endometriotic implants. However, data on the effect of pregnancy on endometriosis are contradictory, and pregnancy in women with endometriosis does not always lead to the disappearance of symptoms and a decrease in the size of endometrioid lesions. Moreover, there is growing evidence that endometriosis can affect pregnancy outcomes. Currently, it is impossible to predict changes in the endometriotic implants due to insufficient knowledge about the pathogenesis of this disease. A deeper understanding of the pathogenesis should help prevent hasty obstetric decisions that can lead to iatrogenic diseases in newborns, and patients should be informed about possible complications during pregnancy when planning a birth.

Diversity and occurrence of methylotrophic yeasts used in genetic engineering.

Methylotrophic yeasts have been used as the platform for expression of heterologous proteins since the 1980's. They are highly productive and allow producing eukaryotic proteins with an acceptable glycosylation level. The first Pichia pastoris-based system for expression of recombinant protein was developed on the basis of the treeexudate- derived strain obtained in the US southwest. Being distributed free of charge for scientific purposes, this system has become popular around the world. As methylotrophic yeasts were classified in accordance with biomolecular markers, strains used for production of recombinant protein were reclassified as Komagataella phaffii. Although patent legislation suggests free access to these yeasts, they have been distributed on a contract basis. Whereas their status for commercial use is undetermined, the search for alternative stains for expression of recombinant protein continues. Strains of other species of methylotrophic yeasts have been adapted, among which the genus Ogataea representatives prevail. Despite the phylogenetic gap between the genus Ogataea and the genus Komagataella representatives, it turned out possible to use classic vectors and promoters for expression of recombinant protein in all cases. There exist expression systems based on other strains of the genus Komagataella as well as the genus Candida. The potential of these microorganisms for genetic engineering is far from exhausted. Both improvement of existing expression systems and development of new ones on the basis of strains obtained from nature are advantageous. Historically, strains obtained on the southwest of the USA were used as expression systems up to 2009. Currently, expression systems based on strains obtained in Thailand are gaining popularity. Since this group of microorganisms is widely represented around the world both in nature and in urban environments, it may reasonably be expected that new expression systems for recombinant proteins based on strains obtained in other regions of the globe will appear.

[The development of experimental sample of immune chromatographic test-system for detecting protein of pathogenicity of CagA Helicobacter pylori.]

The immunochromatographic test-system was developed for detecting protein of pathogenicity of CagA Helicobacter pylori in various biological samples (feces, content of dento-gingival recesses) and also in culture of H.pylori. The test-system represents multi-membrane composite on the basis of membranes manufactured by "MDI" (India). The main immunochemical components of test-system are conjugate of nanoparticles of colloid gold with size of 30 nm with monoclonal antibodies (clone HP-387), applied to membrane for conjugate; monoclonal antibodies (clone HP-1811) and anti-species antibodies of goat against Ig of mouse, applied to nitrocellulose membrane correspondingly in test and control zones. All antibodies are produced by the firm "Bialeksa" (Russia).

[The comparative evaluation of components used in development of immune chromatographic test-systems].

The article summarizes data of research studies concerning searching optimal conditions of development of highly specific and highly sensitive immune chromatography test-systems designed for detection of agents of infectious diseases. The analysis was implemented concerning choosing of optimal size of nano-particles of colloid gold and concentration of antibodies for production of conjugate. The alternatives are presented concerning the most frequently used combinations of buffer solutions applied for development and analysis of immune chromatography test-systems. The preferences are established in the field of characteristics of membranes used in composition of multi-membrane composite of immune chromatographic test-systems.

[Gold weight implants for lagophthalmos correction in chronic facial nerve paralysis (late results)].

UNLABELLED: Upper eyelid weigh gold implant is the widely accepted standard for the treatment of paralytic lagophthalmos (PL). AIM: To evaluate late outcomes of PL correction with chain gold implants. MATERIAL AND METHODS: Chain gold implants were inserted in the upper eyelids of 70 patients with lagophthalmos due to chronic facial paralysis. A comprehensive ophthalmic examination was performed prior to surgery and then at months 1, 3, 6, 12, 24, and 36. RESULTS: The results obtained prove the method highly effective. None of the patients developed any severe complications. Cases of implant removal were few. Some of the studied biometric parameters decreased significantly after surgery, while the upper eyelid excursion increased. The implant had no effect on the inner surface of the cornea and its peripheral thickness. CONCLUSION: Efficacy of the proposed eyelid implant has been convincingly demonstrated; late complications have been analyzed.

[Genetic determinants of resistance of hospital-associated strains of Klebsiella pneumoniae to ß-lactam antibiotics isolated in neonates].

According to the results of analysis of whole genome sequencing, the presence of genes having resistance to ß-lactam antibiotics in hospital-associated strains of Klebsiella pneumoniae was studied. The strains were isolated from neonatal intensive care units. The data obtained were compared with the results of antimicrobial susceptibility testing of isolated microorganisms. Among other strains resistant to cephalosporins, the dominance of genes of CTX-M-type extended-spectrum ß-lactamases was shown. It was revealed that one of eight strains phenotypically resistant and moderately resistant to carbapenems have the blaOXA-48 carbapenemase gene.

[The experimental evaluation with flow cytofluorimetry technique of the level of cellular immunologic memory in persons vaccinated against plague and anthrax].

The article deals with experimental evaluation with flow cytofluorimetry technique of the level of cellular immunologic memory in persons vaccinated with plague and anthrax live dry vaccines. It is established that the introduction of plague and anthrax live dry vaccines into organism of vaccinated persons ignites immunologic rearrangement manifested by reliable increase of level of blood concentration of Th1-lymphocytes (immunologic memory cells) against the background of vaccination. The higher correlation coefficient is detected between leucocytes lysis coefficient and stimulation coefficient according blood concentration level of T-lymphocytes predominantly at the expense of Th1-lymphocytes. The values of stimulation coefficient were calculated for corresponding blood cells of vaccinated persons. This data testifies the effectiveness of application of vaccination against plague and anthrax.

[The immune-enzyme testing of titers of serum anti-botulin antibodies type A during immunization of patients with botulin trianiatoxin].

The article discusses the effectiveness of the technique of immune-enzyme detection of anti-botulin antibodies type A in human blood serum. The presence of antibodies is registered in blood serum after second and subsequent immunization with botulin trianatoxin (titer from 1:400 to 1:3200). The establishment of relationship between the registered titers of anti-botulin antibodies and the activity of serum during protection of white mice from toxin revealed the correlation coefficient between these values as 0.58.

[Current laboratory methods to evaluate the efficiency of immunization against dangerous and extremely dangerous infections].

By taking into account the leading role of specific cellular immunity in the development of protection against the majority of dangerous and extremely dangerous infections of bacterial, viral, and rickettsial nature, the study of the above immunity should be considered as most important on estimating the body's immunological rearrangement when vaccines against respective infections are administered. The battery of the test used to date for the analysis of specific cellular immunity is mainly restricted to skin tests that have disadvantages. This paper reviews the currently available laboratory methods for in vitro studies of a specific cellular immune response as a criterion for evaluating the efficiency of immunization.

Electromuscular stimulation with VEINOPLUS® for the treatment of chronic venous edema.

AIM: Electromuscular stimulation (EMS) with VEINOPLUS® has recently emerged as a new technique to activate the calf muscle pump, improving the symptoms of venous disease. The aim of the study was to evaluate efficacy of EMS and its impact on evening edema, venous pain, venous outflow and patients quality of life. METHODS: Thirty patients (32 legs) aged 19-50 (mean 45.2±1.3) classified CEAP C3 with chronic evening venous edema took part in the study (22 limbs: C3, S, Ep, Asp, Pr and 10 limbs: C3, S, Es, Aspd, Pr). All patients were treated with CE-registered VEINOPLUS® neuromuscular stimulator for 30 days. 3 sessions per day (each session lasted for 20 minutes) for the first 10 days, the next 10 days 2 sessions per day and one session per day for the last 10 days. The main evaluated criteria for venous edema was the circumference of the supramaleoal shin segment, measured twice with a tape measure; in the evening the day before and then 5 days after the treatment. All measurements were taken during the interval between 6 and 8 o'clock P.M. All the patients were asked to evaluate venous pain using the Visual Analog Scale, and to fill in a CIVIQ questionnaire (validated for Russian patients) for the Quality Of Life (QOL) measurement. Also venous refilling time (RT) was measured by digital PPG. That was also made twice - before the treatment and in 35 days after the treatment. No other treatments were used. RESULTS: The EMS treatment was well tolerated by patients. There were no drop outs and patients had no need to change their lifestyles. After the treatment, total or partial reduction of evening edema was shown in 93.8% of limbs, the circumference of the lower leg diminished by 20.3mm (P<0.001), the number of painful legs reduced from 28 to 12 and the severity score of venous pain was cut from 8.3 ±1.1 to 3.8 points ±0.9 (P<0.001), QOL improved significantly as the score dropped from 34.5 ±7.8 to 17.2 points ±4.6 (P<0.001) and RT increased from 17.3 ±0.9 to 21.5 seconds ±1.1 (P<0.001). Three months after VEINOPLUS® treatment, total remission of symptoms was observed in 50% of legs, despite there being no other treatments. CONCLUSION: VEINOPLUS® stimulation is an effective and well-tolerated therapeutic method for the treatment of chronic venous disease. The introduced scheme of EMS application was shown to be useful for treatment of chronic edema, for reducing pain and improving quality of life. It can be used as an additional mean in treatment and to prevent symptoms of CVI. This study also reveals that stimulation of calf muscles with VEINOPLUS® can improve venous outflow and symptoms of CVI. This finding should be investigated and confirmed in further studies.

[The time course of changes in cell immunological parameters during administration of live dry plague vaccine].

The study of the time course of changes in cell immunological parameters by a magnetic separation technique in human beings during the administration of plague vaccine in relation to the immunological load revealed the higher blood levels of all T lymphocyte subpopulations on day 14 after vaccination. These changes are most typical of a primary vaccinated cohort. The increased frequency of plague vaccine administration and multiple immunizations with live plague, anthrax, and tularemia vaccines produce the time-course of changes in T lymphocyte populations (subpopulations) in response to the regular administration of plague vaccine. A high immunological load in man also promotes a significant reduction in the level of B lymphocytes.

[Clinico-laboratory variants of the course and results of therapy of hepatitis-associated aplastic anemias in children].

AIM: To study clinical and laboratory characteristics of hepatitides and evaluate efficacy of immunosuppressive therapy and transplantation of the bone marrow in hepatitis-associated aplastic anemia (HAAA). MATERIAL AND METHODS: A retrospective analysis of case histories of children with HAAA was made. For all the patients standard tests for detection of aquired aplastic anemia and hepatitis were conducted. Transplantation of hemopoietic stem cells (THSC) from HLA-identical donors was made in 4 patients, 25 patients were treated with combined immunosuppressive therapy (antithymocytic globulin--ATG plus cyclosporin A -CsA), one patients received monotherapy with CsA, two--prednisolone and a short course of CsA, one child was untreated. RESULTS: Of 260 children admitted to hospital from April 1989 to July 2005 for aquired aplastic anemia, 33 (12.7%) met diagnostic criteria of HAAA. Boys to girls ratio was 267. Hepatitides were severe: median of alaninaminotransferase concentration was 1215 IU/l, aspartataminotransferase--789 IU/l, bilirubin--152.5 mcmol/l. Median of the interval from hepatitis symptoms to documentation of pancytopenia was 66 days (0-204 days). All four patients after THSC are alive for 30-72 months. Probability of complete remission after the first course of ATG+CsA is 0.72 +/- 0.09, probability of survival 0.81 +/- 0.07, median of the interval to transfusion independence--50 days. CONCLUSION: HAAA prognosis is good only in administration of up-to-date therapy. After seronegative hepatitis it is necessary to control hemogram parameters and in the presence of minimal cytopenia patients should be directed to hematological hospital.

[A computer method for assessing the average rate of movement of Paramecium caudatum by a cross-sectional light beam]. / Komp'iuternyi metod otsenki srednei skorosti dvizheniia infuzorii-tufel'ki po peresecheniiu lucha sveta.

The possibility of using the motility of Paramecium caudatum for computer biotesting of toxic substances was studied. The method is based on measuring the number and duration of impulses that arise when protozoa chaotically moving in a layer 0.5 mm thick cross a red light beam (1 mm in diameter). It was found that, in the presence of Cu2+ ions and menadione bisulfite, a compound having prooxidant properties, the number of impulses decreased with a concurrent increase in the duration of impulses. The high correlation between the number of impulses and the reciprocal of impulse duration indicates that the motility of paramecium by the action of Cu2+ ions and menadione slow down, and even an immobilization of some of them occurs. The mean swimming velocity of protozoa was reduced by half within 20 min by the action of Cu2+ at a concentration of 90 microM (6 mg/l of Cu2+ ions) and within 80 min by the action of menadione bisulfite at a concentration of 50 microM. It was shown that the slowing down of motility, which indicates the presence of a toxicant in the medium, is a faster physiological reaction than cell death.

[Time course changes in the count of peripheral granulocytes in children with acquired aplastic anemias treated with antithymocyte globulin, cyclosporin A and granulocytic colony stimulating factor]. / Dinamika kolichestva granulotsitov v perifericheskoi krovi u detei s priobretennymi aplasticheskimi anemiiami, poluchivshikh lechenie antitimotsitarnym globulinom, tsiklosporinom A i granulotsitarnym koloniestimuliruiushchim faktorom.

AIM: To examine the pattern of changes in the count of peripheral granulocytes in children with aplastic anemias (AA), receiving a combined immunosuppressive therapy with antithymocytic globulin (ATG) and cyclosporin A in combination with granulocytic colony-stimulating factor (G-CSF). MATERIALS AND METHODS: 31 children (17 boys and 14 girls) aged 2-15 years (median 9 years) with newly diagnosed severe and very severe acquired AA took a combined immunosuppressive therapy with ATG and cyclosporin A in combination with G-CSF in an initial dose of 10 micrograms/kg a day. RESULTS: A three-linear and response was recorded in 19 (61%) children, an isolated granulocytic response was in 26 (84%). The interval median before the recovery of granulocytes to 1.5 x 10(9)/l and 5 x 10(9)/l was 19 and 38 days, respectively. CONCLUSION: Use of G-CSF may increase the count of granulocytes in the vast majority of patients with AA, without dramatic influence on the frequency of a three-linear response. Intermittent use of G-CSF may maintain the count of granulocytes long at the safe level and reduce the cost of treatment.

["Cyclosporin dependence" in the treatment of severe aplastic anemia in children]. / "Tsikloporinovaia zavisimost'" pri lechenii tiazhelykh aplasticheskikh anemii u detei.

Cyclosporin A (CA) was used in the treatment of 2 patients with acquired aplastic anemia. Upon reaching hematological remission these children had recurrence consequent to dose lowering or discontinuation of CA. The remission occurred again when full-dose CA treatment was resumed. Slow 2-year decrease in CA dose led to uneventful end of CA treatment without deterioration of blood picture.