Kazan medical journal

BACKGROUND: In patients with colorectal cancer, the intestinal wall, which is not involved in the malignant process, despite histological signs of intactness, is characterized by impaired structure and metabolism. Modern optical bioimaging technologies make it possible to objectively assess these changes.

AIM: To study metabolism and morphological structure features of the mucous membrane of the relatively normal colon in patients with colorectal cancer.

MATERIAL AND METHODS: The object of study was the colon mucosa in patients with colorectal cancer stages I–IV. The study included 59 patients. There were 33 (56%) men, 26 (44%) women; median age — 67 [61; 74] years. In 10 cases, the tumor was localized in the right colon, in 9 — in the transverse colon, in 23 — in the sigmoid colon, in 17 — in the rectum. 7 samples were obtained from patients with stage I, 25 — with stage II, 21 — with stage III, 6 — with stage IV colorectal cancer. The metabolism of colon tissue from the mucosal side was studied using fluorescence-lifetime macroimaging, and the microstructure was studied using optical coherence tomography and histological examination. The results of calculating the weighted average fluorescence lifetime were presented as median values Me [Q1; Q3], comparison of this indicator between groups was carried out using the nonparametric Kruskal–Wallis test.

RESULTS: According to histological examination, progression signs of structural changes with increasing stage of colorectal cancer were revealed: from the conventional norm in samples with stage I to the appearance of signs of chronic colitis, atrophy and erosion of the mucous membrane in samples with stages II, III and IV. Visual analysis of optical coherence tomograms obtained from colon samples showed a high degree of agreement with histological data: the Spearman correlation coefficient was r=0.96. According to fluorescence-lifetime macroimaging, statistically significant differences (p=0.027) in the weighted average fluorescence lifetime were detected between stages IV and II of colorectal cancer: the values were 1.6 [1.4; 1.8] ns and 1.3 [1.1; 1.4] ns, respectively, which indicated an intensification of the glycolysis process in the tissues of the colon mucosa in stage IV colorectal cancer. Presumably, the identified changes will become the pathophysiological and anatomical basis of postoperative complications. In clinical oncology, it is advisable to use the obtained data to optimize the volume of intestinal resection and postoperative therapy algorithms.

CONCLUSION: Long-term tumor carriage and progression of colorectal cancer (invasion and metastasis) are associated with an increasing incidence of atrophy/erosion of the mucous membrane, the signs of which are determined both by optical coherence tomography and by histological examination.

BACKGROUND: The microbiome of the gastrointestinal tract ensures colonization resistance of the intestinal epithelium, produces enzymes, and participates in nutrient metabolism. Changes in its composition lead to pathological conditions of the intestines.AIM: To determine the structure of the incidence of acute intestinal infections in children living in the Southern Aral Sea region and to characterize the effect of bioimmune correction of changes in the intestinal microbiome in children with shigellosis.

MATERIAL AND METHODS: In the period from 06.07.2020 to 05.10.2020, 179 children with intestinal infections aged 2 to 7 years living in an environmentally unfavorable zone of Southern Uzbekistan were examined. The children were divided into two groups: the first (32 children) received basic therapy (pathogenetic therapy, antibiotic therapy, diet), the second (11 children) received basic therapy with bioimmune correction with bifidobacteria bifidum (bifidumbacterin PL) and thymus peptides of sheep embryos and newborn lambs (immunomodulin). To characterize the microbiome, the material was screened on differential diagnostic media, identifying obligate, facultative and opportunistic microflora. To assess the statistical significance of differences between data groups, the Student's t test was used, taking p ≤0.05 as a significant level.

RESULTS: Shigellosis was diagnosed in 43 sick children (24% of those examined), escherichiosis was diagnosed in 34 (19%), salmonellosis was diagnosed in 30 (16.3%), and diarrhea of other bacterial etiology was diagnosed in 23 (13%) patients. In all variants, changes in the intestinal microbiome were detected. Etiotropic therapy led to an improvement in the general condition of patients, but did not affect dysbiotic changes in the intestines and did not contribute to the restoration of the microbiome. Bioimmune correction of dysbiosis in shigellosis in 11 patients using preparations of bifidobacteria bifidum and fetal thymic peptides led to the restoration of intestinal microflora to normal values: the number of lactose-negative E. coli significantly decreased by more than 5 orders of magnitude (p=0.037), fungi of the genus Candida (p=0.030) and enterococci (p=0.019) by 3 orders of magnitude, and staphylococci by 2 orders of magnitude (p=0.048).

CONCLUSION: The use of preparations of bifidobacteria bifidum and fetal thymus peptides as bioimmunocorrectors is a promising therapeutic strategy for shigellosis in children.

BACKROUND: The development of capillaries in human embryogenesis is a multi-stage process influenced by genetic factors and signaling pathways, which is of interest in studying the mechanisms of vascular bed formation in the prenatal period of human development.

AIM: To study the development of capillaries in the embryonic and early fetal periods and determine the morphological prere­quisites leading to the formation of developmental defects.

MATERIAL AND METHODS: The biomaterial of 50 embryos and fetuses from 4 to 12 weeks was studied. A histological and electron microscopic examination of the specimens was performed in the axial plane at the level of both jaws and neck. The volume fraction of capillaries and muscle fibers in the structure of the sternocleidomastoid muscle was determined. Data on the volume fraction of each component were presented as median and interquartile range. Quantitative analysis was performed using the Kruskal–Wallis and Mann–Whitney methods with Bonferroni correction.

RESULTS: At the 4th week, a capillary network began to develop from the mesenchyme, which took on a complete form by the 8th–10th week. The proportion of capillaries increased from the 6th to the 10th week, and by the 12th week it decreased. A statistically significant pattern of changes in the ratio of the proportion of capillaries in muscles with the volume fraction of muscle fibers itself was revealed. As the mass of the muscle fibers themselves increased, the proportion of capillaries in it decreased significantly from 1.92 (1.77; 2)% at 4–6 weeks of embryogenesis to 0.25 (0.23; 0.26)% at 10–12 weeks.

CONCLUSION: The critical period for the development of capillaries is the intrauterine period from the 4th to the 12th week of development, when in the structure of muscles as an organ, the vascular component first prevails over the muscular component itself, and then sharply decreases.

BACKGROUND: Under the influence of external factors (learning), processes of microvasculature remodeling occur in the neurogenic niche to meet the metabolic needs of activated cells. However, it remains unclear how these mechanisms of brain plasticity are disrupted during neurodegeneration.

AIM: To study the expression features of markers of angiogenesis and microvascular remodeling in the subventricular zone of the brain during training of animals, including against the background of the development of Alzheimer’s-type neurodegeneration in them.

MATERIAL AND METHODS: The studies were carried out on C57BL/6 mice at the age of 8 months. Modeling of Alzheimer’s disease was carried out by intrahippocampal injection of 2 μl of a 1 mM solution of β-amyloid Aβ25-35. To assess cognitive deficits, a conditioned passive avoidance test using an aversive stimulus was used. The expression of LC3B, ZO1, VEGFR2, VEGFR3, CD146, ICAM2, Dll4, Tie2 in the subventricular zone per 100 DAPI-positive cells was assessed. The test results were processed using one-way ANOVA and Fisher's test, the Mann–Whitney U test, the results were considered significant at p <0.05.

RESULTS: On the 9th day after the administration of β-amyloid, before the application of the aversive stimulus, an increase in the expression level of LC3 (7.95±5.83%, p=0.045), CD146 (18.35±0.01%, p=0.045) was recorded, as well as VEGFR3 (17.13±5.05%, p=0.045), which continued to increase after the presentation of the stimulus (26.61±0.01%, p=0.045). By the beginning of registration of cognitive impairment (38th day of the experiment), the expression level of VEGFR2 (20.61±2.8%, p=0.045) and ICAM2 (126.61±41.28%, p=0.045) increased, the content of Dll4 (29.66±8.72%, p=0.045) and Tie2 (36.39±7.8%, p=0.045) decreased in animals with experimental Alzheimer’s disease.

CONCLUSION: An aversive stimulus stimulates microvascular remodeling mechanisms in the subventricular zone of the animal’s brain, but when exposed to β-amyloid, these processes are significantly disrupted.

BACKGROUND: Currently, the search and development of compounds, including herbal ones, with anti-influenza activity are relevant.

AIM: To study the effect of oral administration of the triterpene glycoside saponin tauroside Sx1 on survival and changes in the cytokine profile of the spleen of mice under conditions of lethal influenza infection.

MATERIAL AND METHODS: 78 male BALB/c mice aged 4–6 weeks, weighing 16–18 g, were used. They were divided into groups: first — control group; the second was a group of animals infected with influenza virus A/WSN/1/33(H1N1); the third was a group of infected animals that received saponin tauroside Sx1, isolated from the Crimean ivy Hedera taurica (Hibberd) Carrière at a dose of 11.8 mg/kg per day against the background of a viral infection for 3 days. The survival and expression of interleukins-1β and -10 in the spleen of mice on the 4th and 14th days of the experiment were studied. Spleen fragments were stained with hematoxylin and eosin. Microscopic analysis was performed using a video microscopy system. Immunohistochemical study was performed according to a standard protocol. Intergroup differences were assessed using the Kruskal–Wallis test and the Mann–Whitney U test using MS Office (Excel 2010) and Statistica 10.0.

RESULTS: Administration of saponin tauroside Sx1 significantly increased the average life expectancy of animals by 4.6 days compared to the group without correction; survival rate was 30.0% (p=0.0233). Against the background of influenza infection, an increase in the number of cells secreting interleukin-1β was detected in the spleen of mice. In the mantle zone of the second group, the level of cytokine expression exceeded the control values by 3.41 times (p=0.0001), and the values of the third group — by 3.38 times (p=0.0001). By the 14th day of the experiment in the mantle zone, expression in the group with saponin administration increased, exceeding the indicators of the group without correction by 34.78% (p=0.0482). By the 4th day of the experiment, in both experimental groups, the number of cells positive for interleukin-10 increased in the mantle zone and decreased compensatoryly in the marginal zone. By the 14th day, in the group without correction, a decrease in expression by 24.86% (p=0.0487) was recorded; after the administration of saponin, the number of immunopositive cells was practically no different from the control (p=0.0443).

CONCLUSION: Therapeutic administration of saponin tauroside Sx1 stabilizes the cytokine profile of the spleen of mice and promotes their better survival in conditions of lethal influenza infection.

Coping intelligence is associated with an individual’s ability to overcome stressful situations, maintaining health potential and increasing the potential for personal development. This study is a systematic review of biochemical and neuronal markers of different levels of coping intelligence, which determine different lines of human development in stressful situations. 45 publications selected from the Nature and RSCI electronic databases were analyzed, the results were summarized in three sections: (1) genetic and epigenetic correlates of individual differences in coping intelligence; (2) neurochemical systems of coping intelligence (glucocorticoids, interleukins, brain-derived neurotrophic factor, monoamines); (3) manifestations of stable and regressive lines of development of the subject in stressful situations. Molecular genetic determinants of coping intelligence were systematized according to the following systems: serotonergic, dopaminergic, noradrenergic, etc. The interaction of neurochemical systems (catecholamines, glucocorticoids, interleukins, brain-derived neurotrophic factor, monoamines) reflects the peculiarities of the stress reaction in humans and determines the development line of the subject in stressful situations. Genetic predisposition, unfavorable epigenetic factors and chronic stress increase the risk of developing stress-related diseases (regressive line of development). A stable stress-coping system is associated with a balance of mineralocorticoid and glucocorticoid receptors, pro-inflammatory and anti-inflammatory cytokines, an optimal ratio of cortisol and dehydroepiandrosterone sulfate, a sufficient level of brain-derived neurotrophic factor, and a healthy microbiota (stable line). A review of the literature indicated the need to analyze neurochemical systems (monoamines, opioid receptors, acetylcholine, microbiota) that determine a high level of coping intelligence (a progressive line of human development in stressful situations). The study of neurochemical markers of coping intelligence should be accompanied by personality analysis (mental representations of stress, coping strategies) to provide personalized medical care and preserve a person’s health potential.

Improved survival of children born with low, extremely low and very low body weight in modern conditions due to increased nursing capabilities, optimization of treatment and increased efficiency of resuscitation measures has led to the need for greater understanding of the importance of assessing the cardiovascular system’s state beyond the neonatal period. With approximately 10% of infants worldwide being born preterm, there is an increasing need for further research into optimal regimens, lifestyle and clinical interventions that can benefit and modify cardiovascular morphology and function in this growing population. Modern theoretical postulates on the physiology and pathophysiology of the child’s heart include ideas about the key process of cardiac biomechanics — diastole, during which the earliest disturbances, that precede the formation of systolic dysfunction, occur. Assessment of the pumping properties of the left ventricle in systole and diastole is a fundamental methodological technique for an in-depth understanding of the pathophysiological mechanisms of cardiovascular system’s emerging diseases, their early diagnosis and assessment of the complex therapy’s effectiveness. However, despite the widespread use of standard echocardiography to assess systolic and diastolic function, its traditional parameters have limitations in terms of diagnostic accuracy and effectiveness in practice. Expanding knowledge about new pathogenetic mechanisms of the cardiac dysfunction formation in conditions of prematurity at the current stage of cardiology development using the “trace spot” technology (two-dimensional speckle tracking echocardiography) will be very useful for scientists studying the mechanics formation of the child’s heart after premature birth, and for doctors of various specialties in early diagnosis of heart diseases.

BACKGROUND: Diseases of elderly and senile age are often accompanied by geriatric syndromes, leading to medical and social problems, of which hypomobility syndrome is one of the most common.

AIM: Analysis of factors that form the medical and social portrait of patients in older age groups, including disabled people with hypomobility syndrome, based on the biopsychosocial concept of the International Classification of Functioning, Disability and Health.

MATERIAL AND METHODS: The study was conducted at the Makhachkala Clinical Hospital of the Federal State Budgetary Institution “Southern District Medical Center of the Federal Medical and Biological Agency” in 2020–2022. A medical and social examination was carried out on 576 patients aged 56 to 65 years (average age 62.7±2.15 years) with hypomobility syndrome. Of these, 384 people were disabled, 192 did not have disabilities. To solve the problems of this study, an original questionnaire was specially developed. When conducting the study, the modern demographic structure in Russia was used, in which the elderly age (in years) for women was 55+; for men — 60+. In patients of the older age group, including disabled people, with hypomobility syndrome, the main elements of activity and participation in everyday and social life, as well as the dysfunctions of the body that affected them, were studied. The study was selective. Selection criteria: citizens of the older age group who sought medical help due to hypomobility syndrome. Research methods: documentary, expert-rehabilitation, survey, analytical, statistical.

RESULTS: Patients of the older age group, including disabled people, with hypomobility syndrome were characterized by manifestations of comorbidity and polymorbidity, accompanied by dysfunction of the cardiovascular and respiratory systems, global and specific mental/psychical functions, functions of the blood system, digestion and others, which led to the formation of difficulties in the implementation of everyday, social and professional activities related to the characteristics of national culture and way of life; formed patients' dependence on outside help. The following problems most significantly limited the lives of patients in the older age group with hypomobility: (1) difficulties in changing posture (χ2=107.4; p <0.001), which were identified to a moderate extent in 56 out of 100 disabled people in the main group and 14 out of 100 people without disability control group; in severe and significantly severe cases — in 6 out of 100 disabled people and 8 out of 100 without disabilities; (2) difficulties in rising from squats (χ2=64.54; p <0.001): moderate — in 44 out of 100 disabled people and 36 out of 100 representatives of the control group; pronounced and significantly expressed — in 27 out of 100 disabled people and 17 out of 100 non-disabled people; (3) difficulties with prolonged standing (χ2=67.39; p <0.001): moderate degree — in a third of disabled people (32 out of 100 people) and a quarter of people without disabilities (22 out of 100), severe and significantly expressed degree — in 13 out of 100 disabled people and 8 out of 100 non-disabled people.

CONCLUSION: For people of the older age group with hypomobility syndrome, the factors that shape their medical and social portrait are medical aspects and social problems in the form of restrictions on their activity, difficulties in everyday, professional, and social activities.

The use of computed tomography during diagnostic examinations makes it a source of additional radiation exposure to patients. In this regard, the development of test objects (phantoms) that simulate the X-ray properties of tissues, including for preliminary assessment of the ionizing radiation distribution, becomes relevant. These test objects play an important role in quality control and the development of new medical imaging methods in conditions where test scans of patients are not possible. Although a range of ready-made solutions is available on the market, there is a lack of prototypes with a certain set of properties to test scientific and practical hypotheses in solving specific clinical and technical problems. Finding materials for a fast and inexpensive production process and studying their properties could provide insight into the effectiveness of their use in making phantoms. The purpose of the work is to search and analyze materials for creating phantoms used in computed tomography. The article discusses materials for the production of non-anthropomorphic and anthropomorphic phantoms, including those printed on a 3D printer. The development of three-dimensional printing has facilitated the transition from simple test objects to high-precision anthropomorphic phantoms made from tissue-mimicking materials that have equivalent signals on computer tomograms. Plastics, silicones, polyvinyl chloride, resins, liquids are used for visualizations identical to soft tissues; plastics, gypsum, photopolymers, potassium hydrogen orthophosphate, calcium hydroxyapatite, plexiglass — for hard tissues. Commercial phantoms are made from materials with reproducible, stable properties, but these same materials must be retested to create test objects specific to a particular clinical task.

This study examines the functions of governors general, governors and heads of regions in coordinating measures and activities to develop medical care for the indigenous population of the northeastern districts of Eastern Siberia, who suffered from syphilis and leprosy that spread in the 19th century. A study of regulations, reports, telegrams, petitions, lectures, dispatches, orders, statements, instructions, correspondence of officials showed that the interaction between the administration of the Governor General, regional commanders, civil governors, district administration, medical boards and the Order of public charity was devoted to issues financing the organization of hospitals, drug supply, medical trips to the districts, wages and benefits for medical officials. The availability of medical care to the population of remote districts, associated with a shortage of personnel, difficulties in supplying medicines, pharmaceutical supplies, hospital supplies and food for patients, remained at a low level. Decisive and effective actions by the authorities were needed to preserve and increase the human resource in underdeveloped territories — one of the main wealth of the state. The article presents facts of the practical participation of governors general, governors of the Irkutsk province, chiefs (civil governors) of the Yakut region of Siberian (1803–1822), East Siberian (1822–1887), and then Irkutsk (1887–1917) governor generals in the decision issues of organizing medical care for the population of the northern districts. Historical facts indicate the implementation of state policy in matters of preserving the people of the outlying territories of Russia, the need to provide medical care to the population in hospital conditions. The study is based on archival sources of a record-keeping nature, available legislative acts and epistolary literature.