卷 7, 编号 1 (2010)

Nowadays the occurrence of diabetes mellitus is on the rise, mostly due to type II diabetes, which causes early incapacitation of working-age people. The mechanisms of lesion of the heart and vessels in patients with diabetes mellitus are still unclear. That is why the issue of cardiovascular diseases in diabetic patients is so urgent in clinical diabetology. A review of literature throws light on the main factors promoting the development of ischemic heart disease in diabetes mellitus type II as well as on the mechanisms of diabetic cardiomyopathy development.

The article presents analysis of personnel resources of Volgograd healthcare agencies for the year 2007—2008 is given. Issues of morbidity with temporal disability among medical staff in Volgograd are discussed.

One of the ways to optimize drug therapy in diabetes mellitus is rationalization of the expenses required to treat the patients when applying the standards of type II diabetes management used by endocrinologists. Pharmaeconomic analysis shows that treatment expenses and the extent of drug therapy for type II diabetic patients will significantly rise if strict compliance with pharmacotherapy standards is not achieved.

Data of pharmacoeconomic analysis of cardioselective beta-adrenoblockers (BAB) are presented, efficiency and safety of metoprolol succinate, nebivolol, bisoprolol for the long control of frequency of atrial contractions (FAC) in patients with constant form of atrial fibrillation (AF) are demonstrated. From pharmacoeconomic point of view bisoprolol can be regarded as a drug of choice among cardioselective beta-adrenoblockers of prolonged action for prolonged therapy of patients with AF.

We determined the specifics of the course of inflammatory parodontal diseases in patients with NAD-gastropathy. The study established that chronic gingivitis and chronic parodontitis are more persistent when accompanied by NAD-gatsropathy. Helicobater infection causing a disorder of cellular regeneration of epitheliocytes in oral and gastric mucosa is one of the factors of the onset and development of both parodontal inflammation and NAD-gastropathy. Elimination of Helicobacter pylori in patients with the above-mentioned mixed disease has a positive impact on remission of both chronic gingivitis and chronic parodontitis.

We analyzed bench tests of the strength of osteosynthesis with the use of clamps with thermomechanical memory 64 of the femur obtained from the corpses of people who died at the age of 30—56. The findings showed a multiple increase (in our case 15—20 times) in the resistance to stress in tension and torsion strapped to the pin bone fragments. Also it was found that if you install compress staple legs through both cortical layers of the femur, femoral fixation increases 1,5 times in comparison with involvement of only one cortical layer

This study focused on central hemodynamics and endothelial function in 49 adolescents with high normal blood pressure. 68 % of patients revealed an increased vascular tone. In this group of patients a marked endothelial dysfunction and prevalence of hypokinetic type of hemodynamics were revealed. 32 % of the adolescents studied revealed a hyperkinetic type of blood circulation accompanied by normal and decreased vascular tone. These findings indicated that adolescents with elevated vascular tone and endothelial dysfunction are at risk of developing primary arterial hypertension.

In ischemic heart disease the level of proinflammatory cytokines IL-1 p, IL-6 and FNO-а is increased. In acute myocardial infarction the highest possible levels of proinflammatory cytokines are noted. In patients with multivascular lesion of coronary arteries the level of cytokines was higher than in patients with a lesion 1—2 main arteries. Patients with high levels of IL-6 and TNF-а, even in hemodynamically insignificant stenoses of coronary arteries, should be ranked as a group of high risk of an adverse outcome of ischemic heart disease.

Implementation of the guidelines of postoperative pain management based on the concept of multimodal analgesia helped along an improvement of the quality of postoperative analgesia in hospitals of Volgograd. However, modern requirements for quality of life and health force one to seek new approaches to the guidelines. One of the proposed options is individualization of the guidelines of postoperative pain management based on a study of the pain threshold.

The influence of new GABA structural analog on LPO processes and antioxidant system activity in myocardial ischemia lesion has been studied. It is shown that in the group of animals with occlusion of left coronary artery descending branch, which had received RGPU-147 compound intravenously in dose 50 mg/kg, the content of DK, KA and MDA in cytoplasm of the affected cardiac hystiocytes was increased by 116,6; 40 and 40,8 % correspondingly in comparison with tissues of intact myocardial zones, whereas analogous indices in control group increased by 341.6; 118; 61,9%. SOD and GPO enzymes activity as well as the concentration of reduced glutathione in cytoplasm of ischemic myocardial area of animals, which had received RGPU -147 compound, were decreased by 18.1; 11.5 and 32.5% correspondingly, relative to recorded indices of unaffected areas, in control group of animals — by 35,2; 29,7; 52,3 % correspondingly.

With a view to finding a way to enhance pharmacotherapy for type II diabetic patients in indigenous people of the Republic of Kalmykia there was first carried out a pharmacokinetic typing for CYP2C9 activity with the help of high performance liquid chromatography. The study revealed a high incidence of the phenotypes that characterize reduced CYP2C9 activity in this ethnic group, which allows us to recommend evaluation of the CYP2C9 activity so as to enhance pharmacotherapy by using sulfonylurea derivatives and reduce the risks of developing undesirable drug reactions.

The paper presents the results of studying the rigidity indices of great arteries, namely the time of pulse transit time (PTT), dp/dt, which were obtained as a result of processing the 24-hour monitoring data using a portable register BPLab. A stable negative correlation between the PTT index and systolic, diastolic, and pulse BP and heart rate in the 24-h dynamics was revealed. The possibility of using the PWP index calculated on the basis of the data of monitoring BP using BPLab MnSDP-3 as an additional rigidity index of great arteries while making clinical and physiological studies was proved.

The dependence between intensity of processes peroxide oxidations of lipids and intoxication at patients with postnecrotic pancreatic cysts by means of registration ferrum-induced chemiluminescence and oligopeptids is revealed. These indicators can be a criteria of postnecrotic pancreatic cysts walls formation and development of complications on what the choice of a surgical treatment method of these patients is depended

In our research carried out on experimental animals we produced a model of ischemia-reperfusion. We dyed a section of brain tissues with hematoxiline-eosine, Nissl and used immunohistological exposure of expression of NOS1, NOS3, TRAIL. We estimated pathology in parts of brain and the nature of delayed death of neurons (apoptosis) without cerebroprotection and with popular neuroprotectors. Typical cytotoxic (coagulation, picnomorphic and colliquative necrosis of neurons) and vascular (haemostasis, erythropedesis) changes were revealed. A conclusion was made that neuroprotective activity of drugs decreases in the following way: AKF-90-7>Cytoflavin > Enoxifol> Actovegin> Mexidol.

An analysis of current concepts of the causes, diagnostics and treatment of nodular goiter is provided. The authors' data of treatment of patients with nodular formations of the thyroid gland are presented. An algorithm of the patients' management and indications for surgery on nodular euthyroid goiter is formulated.