The revised Atlanta criteria more accurately reflect severity of post-ERCP pancreatitis compared to the consensus criteria.

Background and objective: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most prevalent complication after ERCP with an incidence of 3.5%. PEP severity is classified according to either the consensus criteria or the revised Atlanta criteria. In this international cohort study we investigated which classification is the strongest predictor of PEP-related mortality. Methods: We reviewed 13,384 consecutive ERCPs performed between 2012 and 2017 in eight hospitals. We gathered data on all pancreatitis-related adverse events and compared the predictive capabilities of both classifications. Furthermore, we investigated the correlation between the two classifications and identified reasons underlying length of stay. Results: The total sample consisted of 387 patients. The revised Atlanta criteria have a higher sensitivity (100 vs. 55%), specificity (98 vs. 72%) and positive predictive value (58 vs. 5%). There is a significant difference (p < 0.001) between the two classifications. In 124 patients (32%), the length of stay was influenced by concomitant diseases. Conclusion: The revised Atlanta classification is superior in predicting mortality and better reflects PEP severity. This has important implications for researchers, clinicians and patients. For the diagnosis of PEP pancreatitis, the consensus criteria remain the golden standard. However, the revised Atlanta criteria are preferable for defining PEP severity.

[Population genetic structure of wild-growing ginseng (Planax ginseng C. A. Meyer) assessed using AFLP markers].

Genetic variability in ten populations of wild-growing ginseng was assessed using AFLP markers with the application of fragment analysis on a genetic analyzer. The variation indices were high in the populations (P = 55.68%; H(S) = 0.1891) and for the species (P = 99.65%; H(S) = 0.2857). Considerable and statistically significant population differentiation was demonstrated (theta = 0.363; Bayesian approach, "full model"; F(ST) = 0.36, AMOVA). The results of AMOVA and Bayesian analysis indicate that 64.46% of variability is found within the populations. Mantel test showed no correlation between the genetic and geographic distances among the populations (r = -0.174; P = 0.817). Hierarchical AMOVA and analysis of genetic relationships based on Euclidean distances (NJ, PCoA, and MST) identified two divergent population groups of ginseng. Low gene flow between these groups (N(m) = 0.4) suggests their demographic independence. In accordance to the concept of evolutionary significant units (ESU), these population groups, in terms of the strategy and tactics for conservation and management of natural resources, should be treated as management units (MUs). The MS tree topology suggests recolonization of southern Sikhote-Alin by ginseng along two directions, from south and west.

[Polymorphism of RAPD, ISSR and AFLP markers of the Panax ginseng C. A. Meyer (Araliaceae) genome].

The genus Panax (Araliaceae) is world-famous because many its members have important medicinal properties. Panax ginseng C. A. Meyer is more popular than other species of the genus because remedies prepared from this plant stimulate immunity, help to prevent diseases, and have antistress effects. In addition, the ginseng root extract is traditionally used as a means against aging. At present, this species is found in the wild only in Primorsky krai, Russia, but its populations are extremely exhausted and need to be restored. In this study, effectiveness of molecular DNA markers in detecting genetic variation and differentiation of the ginseng populations was tested. Genetic variation of ginseng, identified using RAPD (P = 4%; H(pop) = 0.0130) and ISSR (P = 9.3%; H(pop) = 0.0139) markers was low. The AFLP* approach, according to which amplicons are separated in polyacrylamide gel and visualized by means of silver staining, showed somewhat higher variability (P = 21.8%; H(pop) = 0.0509), while its effectiveness in population differentiation was as low as that of RAPD and ISSR. The AFLP** technique, which included analysis of the fragments using genetic analyzer, revealed high genetic differentiation of ginseng (P = 94.4%; H(pop) = 0.3246). All populations examined using the AFLP** markers were statistically significantly differentiated based on the AMOVA results. Our result suggest effectiveness of AFLP** markers for characterization of the genetic structure and genetic relationships of the ginseng populations. These markers are recommended for use in large-scale population genetic studies of this species to develop measures of its conservation.

[The specific features of central nervous system lesions in children with type 1 diabetes mellitus].

The specific features of central nervous system lesions were studied in 100 children with type 1 diabetes mellitus (DM), by using the data of a survey, rheoencephalography (REG) and psychological tests (cognitive and emotional processes). The cerebroasthenic syndrome that manifested itself as headache (42%), dizziness (33%), overfatigability and weakness (49%) was diagnosed by the analysis of complaints. REG established that 42% of the children with DM have cerebral circulatory disorders. Psychological tests revealed cognitive disturbances in 74 children with DM, of them 54, 59, 21, and 30 children diminished thinking, mechanical and logical memory, and attention, respectively. Fifty children were found to have emotional disorders as anxiety in 50 children, depression in 32, and aggression in 25. The psychoneurological syndrome in the presence of DM was diagnosed in 33%; it appeared mainly as behavioral deviations (hypersexuality, autism, theft, and falseness). The level of cerebral circulation and cognitive and emotional processes in the examinees correlated with the values of HbA1с. Impairments of cerebral hemodynamics, cognitive and emotional' sphere were encountered in decompensated carbohydrate metabolism more frequently than in compensated and subcompensated DM (p < 0.01 and p < 0.05).

Characterization of the promoter of the human Gi2 alpha-subunit gene.

The promoter of the human gene for the alpha-subunit of Gi2, a GTP-binding signal transduction protein, was analyzed by cloning the 5' flanking region of the gene upstream of the bacterial chloramphenicol acetyltransferase (CAT) gene and measuring the level of CAT expression after transfection in CV-1 green monkey kidney cells. Analysis of multiple 5' deletion mutants reveals that a minimum of 85 bases upstream of the major transcriptional initiation site are required for full basal promoter activity. Deleting 11 bases to position -74 causes a 4-fold decrease in promoter activity. Another major decrement in activity is seen when a GC box between -46 and -33 is deleted, consistent with this region being a functionally active Sp1 factor-binding site. Primer extension of a CAT-specific primer hybridized to RNA from cells transfected with a Gi2 alpha promoter-CAT construct confirms approximately the same transcriptional start site as the endogenous Gi2 alpha gene. The 3' deletion mutants that either approach or delete the transcriptional start site have markedly diminished activity.

[Hemosorption in the combined treatment of patients with ischemic heart disease and diabetes mellitus]. / Gemosorbtsiia v kompleksnom lechenii bol'nykh ishemicheskoi bolezn'iu serdtsa i sakharnym diabetom.

Extracorporal hemosorption was carried out in 42 patients with diabetes mellitus and ischemic heart disease and a positive effort was observed. This was manifested in a reduction of the clinical manifestations of ischemic heart disease: decrease of the frequency, duration and intensity of stenocardia attacks, 2.5 times reduction on necessity in coronarolytic agents. Hemosorption was effective in the control of arrhythmia and disorders of cardiac conduction. The postsorption period was characterized by stabilization of diabetes mellitus reduction of diurnal fluctuations of glycemia and glucosuria, decrease of peroral sugar-reducing agents.

[Early clinical x-ray diagnosis of venous stasis in the lungs and pulmonary edema in acute myocardial infarct]. / Ranniaia kliniko-rentgenologicheskaia diagnostika venoznogo zastoia v legkikh i oteka legkikh pri ostrom infarkte miokarda.

The authors have analysed 527 case histories of patients with acute myocardial infarction, examined clinico-roentgenologically in intensive care wards in order to detect early venous congestions and oedema in the lungs. X-ray symptoms of these states are given as obtained from the patient in horizontal position. Either degree of the left ventricular insufficiency with venous congestion of the lungs were detected in 71% of cases, including 32% of interstitial or alveolar pulmonary oedema. Diagnostic information value of a number of clinical symptoms for early detection of lung oedema according to X-ray verification is discussed. Mortality of patients with acute myocardial infarction is in direct, clear-cut correlation with the degree of venous congestion in the lungs and lung oedema. Out of 306 patients with acute myocardial infarction without lung oedema at the moment of hospitalization, getting on admission small doses of strophantin (0.25 mg circadian) and diuretics lung oedema developed only in 11 (3.6%) as a result of relapse or early mobilization.

[Evaluation of myocardial contractile function in chronic postinfarct cardiac aneurysm]. / K otsenke sokratitel'noi funktsii miokarda u bol'nykh s khronicheskoi postinfarktnoi anevrizmoi serdtsa.

The ventriculograms of patients with chronic postinfarction aneurysm of the heart were studied with the use of separate analysis of the contraction indices of the functioning and non-functioning parts of the left ventricular myocardium. Relatively high indices of the ejection fraction of the functioning part of the myocardium with low indices of the total ejection fraction were noted. A correlative dependence was found between the total ejection fraction and the ratio of the volumes of the nonfunctioning part of the myocardium during systole and diastole to the total volume of the left ventricle during the same phases, which is evidence that these indices are important in appraising myocardial contractile function in aneurysm of the heart.

[Myocardial contraction in ischemic heart disease]. / Sokratitel'naia funktsiia miokarda u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The indices of contractility of the left ventricular myocardium were studied by means of ventriculography and catheterization in 84 patients with ischemic heart disease according to the extent of damage to the coronary arteries and the course of the disease. Changes in the coronary arteries were encountered twice as frequently among patients with postinfarction cardiosclerosis as among patients with angina pectoris and no history of infarction. The main cause of disorders of myocardial contractility in patients with ischemic heart disease is post-infarction cardiosclerosis (56% of cases). Signs of impaired functional capacity of the left ventricle appeared in segmental asynergy involving 20 to 25% of its circumference. Changes in the indices of contractility were revealed in 13% of patients with angina pectoris.