I.P. Pavlov Russian Medical Biological Herald


A peer-reviewed scientific medical journal.

Editor-in-Chief

Roman E. Kalinin, MD, Dr. Sci. (Med.), Professor
ORCID iD: 0000-0002-0817-9573

Founders

Publisher

ISSN: 0204-3475 (Print) ISSN 2500-2546 (Online)

About

Is a periodical scientific journal of the Ryazan State Medical University.

Was founded in 1993 on the initiative of the famous biochemist academician E. A. Stroev.

The editorial board and editorial board of the journal are a team of eminent and actively working scientists from Russia, USA, Israel, Germany, Italy, India, Sweden, Ukraine, Tajikistan.

The mission of the journal is to introduce readers to the achievements of domestic and foreign biomedical science, to create a professional platform for the exchange of experience and scientific discussion, to publish the results of their own research in the field of fundamental and clinical medicine.

In the journal following article may be published: biology and genetics; morphology and pathological anatomy; biochemistry, physiology, biophysics and pathological physiology; microbiology, immunology, infectious diseases; pharmacology, clinical pharmacology; hygiene, ecology, epidemiology, healthcare organization, history of medicine; internal diseases; endocrinology; dermatovenerology; neurology, psychiatry, addiction medicine, clinical psychology; pediatrics; surgery; clinical and experimental oncology; ophthalmology; ENT-diseases; dentistry; rehabilitation medicine, physical education, exercise therapy and sports healthcare; obstetrics and gynecology; pharmacy.

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Peer-Review & APC

  • double blind
  • article submission charge 

Languages

  • English
  • Russian
  • Chineese

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  • original study
  • case reports
  • reviews
  • discussions
  • letters to the editor

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  • hybryd access (Open Access & subscription)
  • quarterly publishing of issues
  • continuously publishingof articles (Online First)

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Vol 31, No 4 (2023)

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Original study

Development of Methods to Obtain Grafts for the Anterior Abdominal Wall in Surgical Treatment of External Abdominal Hernias
Magomedrasulova A.A., Chernykh A.V., Shevtsov A.N., Aydiyev G.A., Leibovich B.E., Pul'ver A.Y., Pul'ver N.A., Cherednikov E.F.
Abstract

INTRODUCTION: Currently, tissue engineering is one of the most promising fields of medicine dealing with search for solutions to the problems of creation of biocompatible structures capable of partial or complete replacement of organs or tissues of an organism. An advanced method of tissue engineering implies using an extracellular matrix (ECM) cleared from the cellular material. The main problem of obtaining an ECM consists in the difficulty of selecting a suitable decellularization method and exposure time.

AIM: Development of a method for obtaining grafts for the anterior abdominal wall (AAW) and evaluation of the histological properties of the ECM to determine the optimal protocol for donor tissue decellularization providing a complete removal of cellular material without any significant damage to the scaffold.

MATERIALS AND METHODS: The experiments were conducted on 10 White Flemish Giant male rabbits. All the animals were withdrawn from the experiment, after which, on autopsy, AAW grafts were obtained for evaluation of the decellularization properties of three detergents (alkaline solutions): 2% SDS (sodium dodecyl sulfate) solution, 2% CHAPS (zwitterionic surfactant, 3-[(3-cholamidopropyl)-dimethylammonio]-2-hydroxy-1-propansulfonate) solution, and 1% Triton-X 100 solution. The decellularization quality was controlled in histological examination.

RESULTS: Morphological evaluation of tissue samples revealed that after decellularization of the material with 2% SDS solution and 2% CHAPS solution, the number of cells remaining in the preparations was comparable and significantly less (Me = 10 in a microscope field) than after treatment with 1% Triton-X 100 solution (Me = 45 in a microscope field). However, decellularization with 2% CHAPS solution led to fiber ruptures and tissue edema manifested by an increase in the distance between the fibers (Me = 163 µm).

CONCLUSIONS: Decellularization of the anterior abdominal wall tissues with 2% SDS solution provides a sufficient cell elimination while preserving the fiber integrity and ECM structure. 2% CHAPS solution was comparable to 2% SDS solution in terms of the quality of cell elements removal, but its more aggressive effect on collagen fibers was noted (their multiple ruptures and a more pronounced edema). 1% Triton-X 100 solution appeared to be of low efficiency in elimination of cellular material, although it had a minimal effect on the integrity of ECM network.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):513-524
pages 513-524 views
Culture Method and Regulation Mechanisms of Stages of C2C12 Cell Line Myogenesis
Isayeva M.O., Gadzhiyeva F.Т., Abalenikhina Y.V., Shchul’kin A.V., Yakusheva E.N.
Abstract

INTRODUCTION: C2C12 is an immortalized mouse myoblast cell line actively used as in vitro experimental models to study skeletal muscle metabolism in biomedical research. C2C12 cells can differentiate into myocytes under appropriate culture conditions. It is important to understand the specifics of each stage of myogenesis and its regulatory mechanisms for the targeted exposure and development of medical drugs, taking into account the mechanisms of pathogenesis of various diseases.

AIM: To describe the method of culturing С2С12 cell line and to study regulatory mechanisms of С2С12 cell line myogenesis.

MATERIALS AND METHODS: The study was conducted on C2C12 cell line. Differentiation of myoblasts was induced in the nutrient medium containing 2% horse serum. The differentiation stages were evaluated by studying the cells on the 1st, 4th and 7th days. Cells before differentiation were used as a comparison group. At each differentiation stage, the myoblast fusion index (IM) was evaluated with preliminary staining of the cells by Romanowsky–Giemsa method. The cell differentiation mechanism was evaluated by the level of myosin, a-actin, myogenic differentiation protein (MyoD), myogenin (MyoG) using Western blot method.

RESULTS: On the 1st day of C2C12 cells culturing, formation of myotubes was observed (IM = 0.15 ± 0.05), on the 4th day — fusion of myoblasts with the formation of binucleated cells accompanied by an increase in the amount of MyoD and α-actin protein (IM = 0.44 ± 0.14). By the 7th day of differentiation, the fusion of cells increased with the formation of myotubes containing more than two nuclei; the content of MyoD and α-actin did not differ from the control, and the amount of MyoG and myosin increased (IM = 0.77 ± 0.04).

CONCLUSION: The described method of culturing C2C12 cell line in Dulbecco’s Modified Eagle’s Medium with a high glucose content (4500 mg/l), containing 2% horse serum, L-glutamine (4 mМ), 100 Un/ml and 100 µg/ml of penicillin and streptomycin, is suitable for the formation of muscle cells, where MyoD and MyoG participate in the regulation of the increase in the amount of specific muscle proteins — α-actin and myosin. 

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):525-534
pages 525-534 views
Effectiveness of Different Treatment Tactics of Superficial Thrombophlebitis of Lower Limbs (with Development of Mathematical Model for Prediction of Therapeutic Effectiveness)
Kalinin R.E., Suchkov I.A., Uporov M.M., Taraskina A.N., Titov D.S., Klishchenko M.Y.
Abstract

INTRODUCTION: The main goals of treatment of superficial thrombophlebitis of lower limbs (ST LL) can be achieved using different treatment tactics: conservative treatment, surgical intervention, and their combination.

AIM: To perform a comparative analysis of the effectiveness of pharmacotherapy, crossectomy in combination with pharmacotherapy and of phlebectomy in combination with pharmacotherapy in patients with ST LL.

MATERIALS AND METHODS: A comparative analysis of the effectiveness of the therapeutic tactics of ST LL was conducted (86 patients; 36 men and 50 women). Group 1 patients received only conservative treatment, group 2 patients underwent crossectomy and conservative treatment in the postoperative period, group 3 — phlebectomy in combination with conservative treatment. The clinical effectiveness of treatment was evaluated by the recurrence rate and/or progression of the disease within 3 months after treatment and the level of life quality (Chronic Venous Insufficiency Questionnaire, CIVIQ 20, visual analog scale, VAS). Based on the data obtained in the study, a mathematical model was developed to determine the maximally effective treatment method. For mathematical modeling, a ‘random forest’ method was used.

RESULTS: All the studied treatment methods demonstrated a comparative clinical effectiveness. Analysis of the dynamics of the studied parameters (adjusted for gender and age of the patients) compared with their initial values within each group showed that statistically significant changes in the psychological factor were observed in the pharmacotherapy group already on the 7th control day (p = 0.024), while in the crossectomy and phlebectomy groups only on the 14th day. In the groups of pharmacotherapy (p = 0.001) and phlebectomy (p = 0.005), the improvement in terms of the social factor occurred faster than in the group of crossectomy, since statistically significant differences were found on the 7th day, and in the group of crossectomy only on the 14th day.

CONCLUSION: All the groups demonstrated comparable clinical effectiveness in normalization of the quality of life and the recurrence rate and/or progression of the disease within three months after completion of treatment. On the basis of the data obtained, predictive models have been constructed that allow, based on the initial characteristics of the patient, to determine the tactics of therapy that can ensure maximum effectiveness in terms of normalization of values, reflecting the quality of life and VAS parameter. 

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):535-550
pages 535-550 views
Laser Therapy in Comprehensive Treatment of Patients with Lymphedema of Lower Limbs
Yarovenko G.V., Katorkin S.E.
Abstract

INTRODUCTION: Methods of physiotherapy using intravenous laser irradiation of blood (ILIB) that affects various pathogenetic factors of lymphedema, permits to achieve the required therapeutic effect and shows its promising perspectives.

AIM: Evaluation of the effectiveness of ILIB to reduce the lymphedema volume in the lower limbs.

MATERIALS AND METHODS: In 2020–2022, a comprehensive conservative treatment including compression therapy, pharmacotherapy and ILIB, was conducted in 60 patients of the mean age 45.3 ± 1.6 years with I–III stage lymphedema. Group 1 included patients with primary (n = 8) and group 2 (n = 52) with secondary lymphedema of the lower limbs. Laser radiation at 632 nm wavelength was used with standardized parameters: power 3 to 15 mW, pulse rate 80 to 2,000 Hz, exposure time 5 to 15 min, with a course (up to 10 sessions), daily, or interval (every 2nd day) load. Lymph outflow, microcirculation, soft tissues of the affected limb were evaluated using electrocoagulography, ultrasound examination of inguinal lymph nodes and soft tissues, triplex scanning, thermal imaging and McClure-Aldrich test.

RESULTS: At the end of the treatment course, a reduction of the limb perimeter at the level of the middle third of the lower leg by 14.8 ± 0.7% was noted (from 48.7 ± 5.3 cm to 41.4 ± 0.9 cm). After 4 sessions and a treatment course, electrocoagulography revealed hypocoagulation with the formation of a loose clot with early retraction. Spearman test showed a direct relationship between changes in the fibrinolytic activity of blood and the perimeter of the lower leg in patients of group 2 with I–II stage of the disease (p < 0.005). Thermography of the lower limbs showed increased IR radiation with a statistically significant increase (p < 0.001) in the area of hyperthermia in the distal parts of the lower legs and the inner surface of the thighs. The results of McClure-Aldrich test showed a statistically significant slowdown of a skin papule resolution in the distal part of the lower legs from 27.13 ± 2.77 min to 35.72 ± 3.11 min (р < 0.05) after ILIB in I stage of the disease.

CONCLUSION: ILIB affects the internal factors of lymph outflow and contributes to its optimization in the comprehensive treatment of patients in the initial stage of secondary lymphedema of the lower limbs.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):563-572
pages 563-572 views
Atypical Forms of Lower Limb Varicose Vein Disease: Features of Diagnosis and Surgical Treatment
Shanayev I.N., Korbut V.S., Khashumov R.M.
Abstract

INTRODUCTION: Lower limb varicose vein disease (LLVVD) is the most common vascular disease with a predominant lesion of the main trunks of saphenous veins. At the same time, there exist atypical variants of lesion of the venous system in LLVVD, which cause difficulties in diagnosis and treatment.

AIM: To study the incidence rate, anatomical bases of the varicose transformation, the features of reflux formation and the results of surgical treatment in atypical forms of LLVVD.

MATERIALS AND METHODS: The study involved 600 patients with LLVVD, C2-C3 class of clinical manifestations in CEAP classification; 82 of them had atypical forms. The mean age of patients was 40.2 ± 9.2 years, duration of disease 15.0 ± 5.6 years. Duplex scanning of the lower limb venous system was conducted according to Russian recommendations for the diagnosis and treatment of chronic venous disorders of lower limbs of 2018. Patients with atypical forms of LLVVD additionally underwent computed tomography of the venous system with contrast. Surgical treatment of 50 patients with atypical forms of LLVVD included separation of the site of opening of a tributary in the area of saphenofemoral junction after preliminary marking and isolated elimination of varicose tributaries using Muller hooks; incompetent perforating veins were ligated at the epi- or subfascial levels depending on the location. The results were considered in the periods for up to two years.

RESULTS: According to our data, the incidence of atypical forms of LLVVD was 13.7%. Lesion of the large tributaries of the main saphenous veins accounted for the highest proportion of atypical forms of LLVVD — 68.3%. Of these, varicose transformation of the anterolateral tributary made 98.2%, and of the superficial iliac circumflex vein — 1.8%. Isolated varicose transformation of perforating veins occurred in 31.7% of cases, where transformation of perforating veins of the gluteal area made 7.7%, of perforating veins of the posterolateral surface of the thigh — 46.2%, and of perforating veins of the patella region — 46.2%. The technical success in the postoperative period in the form of elimination of varicose saphenous veins and of the source of their incompetence was achieved in 100% of cases.

CONCLUSIONS: The incidence of atypical forms of LLVVD is 13.7%, with the main trunks of saphenous veins remaining competent. The anatomical and hemodynamic basis for such forms of LLVVD is incompetence of the deep vein valves, from where the reflux is transmitted to tributaries of the saphenofemoral junction and/or perforating veins of the gluteal region, femoral region or popliteal fossa. Precise separation of varicose tributaries and perforating veins with preservation of the main trunks of subcutaneous veins is an organ-saving method of LLVVD treatment with a good effect in the follow-up period of up to two years.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):551-562
pages 551-562 views
Effect of Physical Activity on Portal Vein Resistance Index
Vinogradov A.A., Andreyeva I.V., Simakova E.S.
Abstract

INTRODUCTION: In norm, adaptation of an organism to physical exercise is determined by the liver functions that ensure high working capacity. To this end, of a special interest are parameters of portal hemodynamics, in particular, the resistance index (RI) as the main coordinator of the differences in the linear velocity of blood flow between the phases of cardiac cycle. Dosed physical exercise is a relevant way of health improvement for not only practically healthy people, but also for people who have suffered COronaVIrus Disease 2019 (COVID-19), and who were diagnosed with liver damage. Such patients are prescribed physical rehabilitation for their health recovery.

AIM: To study age-related changes in the portal vein (PV) RI and the effect of physical exercise in the form of forced dosed running on this parameter of the portal hemodynamics in an experiment on rats.

MATERIALS AND METHODS: In young rats of 14–16-month age, which corresponds to 35–40 years of human age, the age-related changes in the portal vein RI were studied using ultrasound Dopplerometry. In animals of the control group, PV RI was studied during 75-day observation, in the experimental group — in the course of daily forced, dosed running on the 1st day, after 15, 30, 45 and 60 days, and also in 15 days after cessation of physical exercise. The actual effect of physical exercise on the change in the PV RI was evaluated with the deduction of age-related changes of the parameter.

RESULTS: In the animals of the control group, after 60 days of the experiment, the PV RI increased by 5.44 ± 1.22%, and in the experimental group — by 24.10 ± 2.12%. After a 15-day recovery period, the parameter declined, but remained 9.11 ± 0.70% above the initial level. After deduction of the age-related changes of the parameter, the PV RI was 4.36 ± 1.93% above the initial one.

CONCLUSION: Changes in the PV RI in daily dosed physical exercise did not go beyond the physiological norm and were transient. After a 15-day recovery period, the PV RI practically approached the initial parameter.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):573-580
pages 573-580 views
Dynamic Changes in Brain Perfusion after Cognitive Rehabilitation in Patients with Type 1 and Type 2 Diabetes Mellitus
Tonkikh O.S., Samoylova I.G., Matveyeva M.V., Shuliko L.M.
Abstract

INTRODUCTION: The results of numerous studies indicate a high prevalence of cognitive impairment among patients with diabetes mellitus (DM).

AIM: To evaluate the effectiveness of computerized training in cognitive rehabilitation in individuals with type 1 and type 2 DM, taking into account the dynamics of brain perfusion.

MATERIALS AND METHODS: A randomized controlled study. The study group consisted of 25 patients with type 1 DM and 30 patients with type 2 DM aged 23 to 67 years. The comparison group included 20 patients with type 1 DM (mean age 28.4 years) and 20 patients with type 2 DM (mean age 56.0 years). Before and after the rehabilitation course, the patients of the study group underwent a general clinical examination, a blood test for carbohydrate metabolism, cognitive function testing using the Montreal Scale (MoCA test), contrast-free perfusion magnetic resonance imaging (MRI) of the brain. Active rehabilitation lasted 6 month; it was based on a computerized training, including exercises on verbal and nonverbal intelligence.

RESULTS: On the initial examination, all the subjects did not have the achieved target level of glycated hemoglobin. After completion of the training program, a decrease in the parameter in both groups was noted, as well as a decrease in the mean level of fasting glycemia in people with type 1 DM. The result of neuropsychological testing in all patients at the initial stage corresponded to the diagnosis of ‘cognitive dysfunction’. The control test revealed an improvement in cognitive status according to the overall score, the abstraction scale, speech, memory and visual-constructive skills. Correlation analysis in the group with type 1 DM showed that the result of exercises on visual attention and auditory perception was influenced by memory function. In individuals with type 2 DM, increased glycated hemoglobin was associated with a decrease in cognitive functions according to the overall score of the MoCA test, as well as in tasks for speech, memory, visual-constructive skills. Dynamic analysis of changes in the MRI picture revealed hypoperfusion in the area of the right and left thalamus in patients with type 1 and type 2 DM, respectively, as well as increased perfusion of the white matter of the right parietal lobe in the group with type 1 DM, and in the putamen area on the left in the group with type 2 DM.

CONCLUSION: In patients with type 1 and type 2 DM, as well as with cognitive deficit, who underwent a course of cognitive rehabilitation using computerized training, an improvement in cognitive status was noted, which was confirmed by the results of contrast-free perfusion MRI. to evaluate the effectiveness of computerized training in cognitive rehabilitation in people with type 1 and type 2 diabetes mellitus, taking into account the dynamics of brain perfusion.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):581-592
pages 581-592 views
Neurophysiological Factors Associated with Compression and Reflex Mechanisms of Lower Back Pain
Barinova I.A., Erkhova L.N., Zhadnov V.A., Zorin R.A., Kiryukhina N.N., Kosolapov A.A., Leonov G.A., Burshinov A.O.
Abstract

Introduction: Vertebrogenic pain syndromes (PSs) in the lower back (LB) are among the most common neurological disorders in the population. Currently, clinical, neurophysiological and neuroimaging characteristics are used as predictors of the course and effectiveness of the treatment for vertebrogenic PSs in the LB.

Aim: To identify the neurophysiological factors associated with compression and reflex mechanisms of PSs in the LB for their differentiation in complicated diagnostic cases.

Materials and methods: The study included 73 patients, 43 of them men and 30 women of the mean age 46.5 years. Based on the results of clinical neurological examination and the magnetic resonance imaging data, reflex vertebrogenic PSs (lumboischialgia) were verified in 40 cases, and radiculopathy of L5 and/or S1 (compression vertebrogenic PSs) in 33 cases. The patients underwent stimulation electroneuromyography with record of motor and sensory responses from the lower limbs, of F- and H-response, and examination of heart rate variability.

Results: Logit regression analysis was used to create models permitting to divide patients into groups with different mechanisms of PSs based on the neurophysiological parameters. The first model demonstrated high sensitivity in the identification of predominantly compression vertebrogenic disorders with the independent factors being the mean F-wave latency and the sensory response amplitude. The second model was more sensitive in identification of reflex PSs with the main predictors being the F-response amplitude and heart rate variability parameters.

Conclusion: The identified factors reflect the role of conduction disorders in compression PSs, as well as the involvement of segmental motor neuronal apparatus and autonomic regulatory mechanisms in the reaction in reflex PSs, which are additional sources of information in taking medical decisions in complicated diagnostic cases.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):593-600
pages 593-600 views
Evaluation of Cognitive and Biochemical Brain Status in Patients after Carotid Endarterectomy
Kalinin R.E., Suchkov I.A., Pshennikov A.S., Zorin R.A., Solyanik N.A., Nikiforov A.A., Klimentova E.A., Vezenova I. ., Leonov G.A., Burshinov A.O.
Abstract

INTRODUCTION: In the large studies such as NASCET, ESCT, VACS, ACAS and ACST-1, the role of alteration of the cognitive functions of a patient in the early and long-term postoperative periods have not been determined.

AIM: To evaluate the biochemical parameters of cerebral functions, the cognitive status of patients, and their interrelation after carotid endarterectomy.

MATERIALS AND METHODS: The study involved 60 patients divided into two groups. The mean age was 67.3 ± 7.9 years, there were 49 (81%) men and 19 (19%) women. Group A included ‘symptomatic’ patients (n = 30) who underwent carotid endarterectomy and had a history of an acute cerebrovascular event. Group B included ‘asymptomatic’ patients (n = 30) who underwent carotid endarterectomy but had no history of cerebrovascular events. As part of the study, the following data were evaluated within a 6-month period: cognitive status (on MMSE, FAB, MoCA-test, NIHSS scales), biochemical parameters (S100b protein, neuron specific enolase (NSE), brain derived neurotrophic growth factor (BDNF)) and the ultrasound data of the carotid arteries.

RESULTS: Patients of group A showed improvement of the cognitive status by the 6th month on MMSE scale (p = 0.001) and in MoCA-test (p = 0.09) relative to the initial parameters; on FAB scale relative to the data after 1 month (p = 0.01); a decline of the level of neurological deficit on NIHSS scale (p = 0.01). In group A, an inverse correlation was found between the results on MMSE scale and resistance index (r = -0.675; p = 0.005), and a direct correlation between the results on FAB scale and the end diastolic pressure in the internal carotid artery (r = +0.912; p = 0.005) according to the ultrasound data. The data obtained in group B, reflected improvement of the cognitive status by the 6th month only by 2 points on MoCA test (p = 0. 03) relative to the initial data. Besides, in 6 months after the surgery, there was a 2-fold increase in S100b marker (p = 0.01) and NSE protein (p = 0.02) and a 1.5-fold increase in BDNF protein as compared to the initial values (p = 0.005).

CONCLUSIONS: Carotid endarterectomy leads to improvement of the cognitive status evaluated on MMSE, FAB, MoCA, NIHSS scales in the long-term postoperative period in symptomatic patients. The extent of improvement of neuropsychological status depends on the level of the end diastolic pressure and resistance index in the internal carotid artery on the operated side.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):601-612
pages 601-612 views
Regulation of ABCB1 Protein Function in the Cerebral Cortex with the Underlying Global Cerebral Ischemia
Chernykh I.V., Shchul’kin A.V., Popova N.M., Gatsanoga M.V., Yakusheva E.N.
Abstract

INTRODUCTION: ABCB1 is a membrane transporter protein responsible for efflux of a wide range of drugs from cells. The study of the mechanisms of regulation of the functioning of ABCB1 protein in the brain in its ischemia will permit to propose new approaches to pharmacotherapy of cerebral ischemic pathology.

AIM: To study the regulation of ABCB1 protein function in the cerebral cortex of rats with global cerebral ischemia.

MATERIALS AND METHODS: The experiment was performed on 30 male rats with global cerebral ischemia modeled by bilateral occlusion of the common carotid arteries. The amount of ABCB1 protein and Nrf2 and HIF-1α transcription factors in the cerebral cortex was determined by enzyme immunoassay. The free radical status of the cerebral cortex was assessed by the concentration of malondialdehyde, SH groups, and by glutathione peroxidase (G-per) activity.

RESULTS: Bilateral occlusion of the common carotid arteries caused an increase in the level of ABCB1 protein in the cerebral cortex of rats by the 4th hour of ischemia; in 24 hours it remained elevated, and in 72 hours decreased to values that did not differ from those of falsely operated rats. The content of malondialdehyde in the cerebral cortex increased in 2 and 4 hours after occlusion and then gradually decreased to the initial values. In 30 minutes and 4 hours after ischemia modeling, G-per activity decreased compared to the control values. The content of Nrf2 in the cerebral cortex increased in 2 and 4 hours after occlusion, then slightly decreased on the next day, and reached the initial values on the 3rd day of the experiment. The amount of HIF-1α increased only in 24 and 72 hours after the surgery.

CONCLUSION: The amount of ABCB1 protein in the cerebral cortex of rats with global cerebral ischemia depends on the severity of oxidative stress, with Nrf2 and HIF-1α transcription factors playing a role in its regulation. Reduction of the amount of the transporter in the blood-brain barrier through the influence on the lipid peroxidation processes or synthesis of the studied transcription factors expands the possibilities of using ABCB1 protein substrates for improving the effectiveness of pharmacotherapy of diseases of the central nervous system.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):613-622
pages 613-622 views
Change in Frequency Modulation of Electroencephalographic Activity in Imaginary and Real Limb Movement
Тurovskiу Y.А., Davydova A.S., Alekseyev V.Y.
Abstract

INTRODUCTION: Investigation of electroencephalographic activity as a marker of cognitive processes in the brain traditionally focuses on the analysis in the frequency domain considering rhythms of encephalogram (EEG) as potential carriers of information needed for research. At the same time, analysis of the EEG frequency modulation effects requires improvement of approaches in the field of digital signal processing. Taking into account the fact that frequency modulation of EEG, as well as amplitude modulation, can be a marker of a number of states, it seems promising to develop a method for detecting this phenomenon and using it to evaluate a number of parameters of the brain dynamics associated with biological feedback systems. AIM: To evaluate the phenomena of frequency modulation when the user performs tasks associated with the control of external devices based on the brain–computer interface, implemented in the phenomena of electrical activity in the motor cortex area.

MATERIALS AND METHODS: To obtain the data, a group of thirty volunteers of both genders aged 17 to 23 years was formed. The participants of the experiment had to execute four commands and repeat them in an unknown order set by the program. The experiment was conducted in two ways: physically and mentally. That is, in the first method, each command corresponded to a certain movement of a person, in the second — the same commands were executed in imagination, the movement was imagined mentally. The command was considered successfully executed if the volunteer managed to repeat and hold the position set by the program for two seconds.

RESULTS: Based on the developed method for evaluating the frequency modulation of the EEG, the dynamics of the electrical activity of the brain was studied in the range of 9 Hz to 12 Hz when a user was performing real and imaginary movements. A comparative analysis showed that the differences were mostly recorded in the condition when the subject did not achieve the goal. At the same time, the differences to a greater extent were observed in the experiments where the subject had to make real, rather than imaginary movements. The significant differences between low- and high-frequency modulations were associated with the inability for the user to generate the requested command, which he could see by the biofeedback mechanism. It has been established that the greater the number of high-frequency restructures observed on the EEG, the smaller number of low-frequency restructures occur at the same epoch of analysis.

CONCLUSION: The results obtained considerably expand the understanding of the mechanisms of frequency modulation of the EEG. In general, the methods and algorithms underlying the analysis that permitted their identification can be used to solve a wide range of tasks related to processing of EEG signals, including improvement of methods for detecting user errors by EEG when controlling brain-computer interface devices.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):623-634
pages 623-634 views
Optimization of System of Early Detection of Oncological Diseases in Outpatient Medical Organizations
Esaulenko I.E., Petrova T.N., Tolbin A.A., Saurina O.S.
Abstract

INTRODUCTION: Increased attention to the early detection and prevention of malignant neoplasms (MNP) is conditioned by their high medical and social significance.

AIM: To develop a methodology of early defection and stratification of risk for development of MNP at the outpatient stage using modern information technologies.

MATERIALS AND METHODS: The data of the official statistics of Rosstat and Health Ministry of Russia for the Voronezh region (VR) were used. To collect the primary information about the level of oncological alertness (OA) of primary care workers, a survey was conducted using a specially designed questionnaire (Oncological Alertness on an Outpatient Visit) which contained 10 questions reflecting the frequency of MNP and precancer detection, doctors’ knowledge, methods of early diagnosis and patient routing in case this pathology is identified. In the survey, 112 medical workers participated. To identify MNP at early stages, methods of evaluation and stratification of the risk of MNP development were elaborated on the basis of a multi-stage analysis of significance of the identified risk factors (‘danger signals’) with the use of artificial intelligence. The method was tried on a test sample (100 patients, MNP in 55).

RESULTS: A ‘rough’ increase in the incidence rate for 2013–2022 was 11.4%. The mortality rate from MNPs in 2022 was 170.5 per 100 thousand cases, which is 0.2 higher than in the previous year. About 60% of the newly identified MNPs were diagnosed at III–IV stage. A comprehensive study of the causative factors of advanced cases permitted to identify the most significant ones: late seeking medical care, latent asymptomatic course of MNP and insufficient OA level of primary care physicians. When testing the developed technique, the probability for the development of the disease was estimated as high in 41 (82%) patients with MNP, medium in 7 (14%), and in 2 (4%) patients the prognosis was erroneous — a low probability was predicted. Of the 50 patients who did not have MNP at the time of examination, 23 (46%) were referred to the group of low, 21 (42%) — of medium, 6 (12%) — of high risk of having a MNP. After the introduction of the developed technique, the detectability of gastric cancer increased by 3%, of colon cancer — by 2%, of tracheal, bronchial and lung cancer — by 6%, of breast, cervix and prostate cancer — by 1%, 8%, and 2%, respectively.

CONCLUSION: The developed method permits to identify and exclude unreliable data, to select the optimal feature space characterized by the minimal dimension with sufficient informational value. This permits identification of precancerous conditions at the preclinical stage and facilitates timely detection of MNP at early stages. 

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):635-642
pages 635-642 views
The State of Colon Microbiocenosis and Antioxidant Properties of Rat Colonocytes in Environmental Dysbiosis and Use of Probiotic Bifidumbacterin® and Symbiotic Acipol®
Korolev V.A., Medvedeva O.A., Ryadnova V.A., Shevchenko A.V., Korolev I.V., Korolev E.V.
Abstract

INTRODUCTION: The microbial community of the colon is a single microecological system which quickly responds to the exposure to external and internal factors with quantitative and qualitative changes with the result of development of the condition termed dysbiosis. The changes in the composition of colon microbiocenosis can lead to a number of diseases and to the development of immunopathological and allergic conditions.

AIM: To evaluate the state of the colon microbiocenosis and antioxidant properties of rats’ colonocytes against a background environmental dysbiosis and the use of probiotic Bifidumbacterin® and symbiotic Acipol®.

MATERIALS AND METHODS: In the experiment, intoxication in rats was modeled with the fungicide Thiram® (dimethylcarbamothioylsulfanyl N,N-dimethylcarbamodithioate, 1.6 mg per animal of 200 g mass) for 28 days, which led to the development of environmental dysbiosis. The detected changes were subsequently corrected within 21 days with the probiotic Bifidumbacterin® (0.14 ml per animal of 200 g mass) and the symbiotic Acipol® (0.08 ml per animal of 200 g mass). The composition of the microflora of colon mucosa of rats was studied using a bacteriological method. The activity of antioxidant protection enzymes of colonocytes was studied by the content of superoxide dismutase and catalase. The condition of lipid peroxidation processes was assessed by the content of diene conjugates and malondialdehyde.

RESULTS: In introduction of Thiram®, reduction of the amount of obligate and opportunistic representatives of colon microbiocenosis was noted, as well as intensification of lipid peroxidation processes in the conditions of weakening of antioxidant protection in colonocytes. Application of Bifidumbacterin® and Acipol® resulted in increase in the amount of obligate bacteria and decrease in the content of opportunists of the colon microbiota with the strongest effect of Acipol® on the values of the determined parameters. When studying changes in biochemical parameters in animal colonocytes, both drugs were found to contribute to the normalization of the content of malondialdehyde in the colon tissue, besides, Acipol® led to a decrease in the concentration of diene conjugates in colonocytes.

CONCLUSION: Introduction of Thiram® in all the specified periods affected the qualitative and quantitative composition of the microbiota and biochemical parameters in the colonocytes of the animals. The use of Bifidumbacterin® and Acipol® preparations resulted in the restoration of the qualitative and quantitative composition of colonic microorganisms, and also had a positive effect on the content of lipid peroxidation products in colonocytes, but more efficient was found to be Acipol® symbiotic.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):643-654
pages 643-654 views

Clinical reports

Features of Angioarchitectonics of Uterus in Uterine Leiomyoma: a Series of Clinical Observations
Antropova E.Y., Sharafutdinov B.M., Ryzhkin S.A., Mazitova M.I., Nasrullayev M.N.
Abstract

INTRODUCTION: One of most important problems in the gynecological practice is the choice of the treatment method of uterine leiomyoma. Uterine artery embolization has been practiced in the Republic of Tatarstan (Kazan), since 2004. Individual peculiarities of blood supply to the uterus and ovaries become the cause of failure of the endovascular treatment of patients with uterine leiomyoma in 20%–25% of cases forcing the doctors to resort to traditional surgical methods. The article presents a series of clinical cases demonstrating variants of angioarchitectonics of uterus and the results of the analysis of uterine artery embolization (UAE, n = 1743) performed at the department of X-ray surgical methods of diagnostics and treatment in the Primary healthcare unit of Kazan (Privolzhsk) Federal University.

CONCLUSION: Endovascular occlusion of uterine arteries in patients with uterine myoma is a fairly effective method of treatment of this disease, and an adequate assessment of the peculiarities of the angioarchitectonics of uterus in uterine myoma permits to considerably increase the effectiveness of treatment and reduce the frequency of complications. The presented series of clinical observations from the clinical archive of the authors’ team demonstrates the variants of angioarchitectonics of uterus.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):655-662
pages 655-662 views
Robot-Assisted Thoracofemoral Bifurcation Bypass
Porkhanov V.А., Zakeryayev A.B., Vinogradov R.А., Bakhishev T.E., Khangereyev G.А., Butayev S.R., Erastova А.V., Baryshev A.G.
Abstract

INTRODUCTION: Thoracofemoral bypass surgery for occlusion of aortofemoral segment is a variant of choice for treatment of patients with impossibility of performing traditional aortofemoral bypass. The use of robot-assisted technologies in the formation of a proximal anastomosis permits to reduce the trauma of surgical access and to improve the results of surgical intervention. The article reports a case of a patient with occlusion of the aorto-iliac segment and total calcification of the infrarenal aorta, who underwent robot-assisted thoracofemoral bifurcation bypass surgery.

CONCLUSION: Use of modern technologies in the vascular surgery permits to reduce traumatization, minimize the effect of the human factor, improve visualization and freedom of movement and shorten the recovery period and the period of hospital stay.

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):663-670
pages 663-670 views
Rhinophyma in a Patient with Multibacterial Indeterminate Leprosy
Nabiyeva A.R., Lutsenko A.V., Shelepova T.N., Voronina L.P.
Abstract

INTRODUCTION: According to the clinical recommendations, the primacy in diagnosis of leprosy still remains with the laboratory methods, but the disease can also be suspected by the external pathological alterations in the face and limbs. This article presents a case report of one of leprosy masks commonly observed in lepromatous form of multibacterial leprosy (facies leonine), and also shows a combination of leprosy and acne rosacea in the form of rhinophyma.

CONCLUSION: Differential diagnosis did not permit the authors to rest only on the diagnosis of leprosy, because too many details indicated the simultaneous presence of vascular and fibrous alterations of the soft nose tissues uncharacteristic of leprosy, which were diagnosed as a concomitant rhinophyma. The case is indicative as an example of a possible combination of vivid clinical manifestations of two diseases of different nature, which can both hide and imitate each other. 

I.P. Pavlov Russian Medical Biological Herald. 2023;31(4):671-677
pages 671-677 views


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