Medical academic journal

The journal “Meditsinskiy Akademicheskiy Zhurnal” published since 2001 is an official journal of the Northwest Branch of the Russian Academy Sciences. Its initiator and Editor-in-Chief in 2001-2009 was Academician of the Russian Academy of Medical Sciences Boris Ivanovich Tkachenko whose contribution to the development of the journal is invaluable. The first Deputy Editor-in-Chief of the journal was Academician of RAMS V.A. Nagornev, and its Executive Secretary was Corresponding Member of RAMS N.S. Sapronov.

In September 2009, the position of Editor-in-Chief was taken by Corresponding Member of RAMS I.P. Dudanov, of Deputy Editor-in Chief, by Corresponding Member of RAMS N.S. Sapronov, and of Executive Secretary, by Prof. P.D. Shabanov.

The high publication level and wide appreciation by specialists in the course of formation and development of the journal were ensured by outstanding contributors, including Academicians E.K. Ailamazyan, N.A. Belyakov, Yu.D. Ignatov, Yu.V. Lobzin, V.I. Mazurov, N.A. Maystrenko, and A.A. Totolyan, and Corresponding Members of RAS I.A. Yeriukhin, S.A. Ketlinskiy, M.M. Odinak, Ye.A. Selivanov, and S.A. Simbirtsev.

Since 2010 up to the present time, Editor-in-Chief of the journal is Academician G.A. Sofronov. Since 2012, its Deputy Editor-in-Chief is Academician N.A. Belyakov, and its Executive Secretary is A.B. Dmitriyev PhD. The Editorial and Advisory Boards of the journal include prominent scientists representing the Northwest of Russia and distinguished scientific schools of Saint Petersburg.



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Vol 21, No 4 (2021)

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Original research

Sleep EEG-pattern alteration as a specific marker of neuroplasticity in intellectually gifted schoolchildren
Berdina O.N., Madaeva I.M., Polyakov V.M., Rychkova L.V.

BACKGROUND: At school, children constantly acquire new knowledge, which provokes changes in the brain structures, especially during intensive learning. Neuroplasticity enables a person to realize his potential, to show giftedness. However, data on electroencephalographic (EEG) features during the sleep in gifted schoolchildren are insufficient and contradictory.

AIM: To study the features of EEG sleep patterns according to neurophysiological research data in intellectually gifted schoolchildren and their correlation with verbal and non-verbal mental abilities.

MATERIALS AND METHODS: 48 lyceum students aged 14-15 years were examined. All participants were performed the Wechsler-Intelligence test (children’s version) to determine them intelligence quotient (IQ). Two groups of adolescents were identified: the main group (n = 20) — with a high IQ (137.0±12.7 points), the control group (n = 28) — with an average IQ (110.9±10.4 points). Neurophysiological examination during the sleep was performed using an ambulatory wireless system for registration of electroencephalograms and polysomnograms “Neuron-Spectrum-AM” (“Neurosoft”, Ivanovo, Russian Federation,). The identification and analysis of EEG sleep patterns: cyclic alternating patterns and sleep spindles were carried out according to standard methods. Differences between groups were considered statistically significant at p < 0.05.

RESULTS: In gifted schoolchildren, significant changes were revealed as an increase in the time and the rate of cyclic alternating patterns with a predominance of A1 subtype (p = 0.0001) and a decrease in the proportion of А2-A3 subtypes, as well as an increase of sleep spindles density (p = 0.01), which significantly correlated with the Wechsler-Intelligence Test’s scores. So, percentage of A1 subtype had correlation with the index of thinking flexibility, while percentage of A2 subtype correlated with general and non-verbal intelligence, non-verbal visual-spatial abilities, the index of working memory) and the index of verbal perception, as well as the sleep spindles index and sleep spindles frequency peak correlated with the index of verbal perception, the index of working memory, the index of information processing speed and general intelligence.

CONCLUSIONS: Thus, we have demonstrated significant changes in the sleep microstructure and different correlations depending on the IQ values in schoolchildren, which was not previously covered in the literature. Cyclic alternating patterns and sleep spindles are recommended to be considered as physiological indicators of intelligence and academic performance, as well as specific markers of neuroplasticity in the intensification of learning.

Medical academic journal. 2021;21(4):7-16
pages 7-16 views
Evaluation of indicators of red blood and some indicators of the aggregate state of blood in students in different periods of study, taking into account gender differences
Maslyakov V.V., Pavlova O.N., Fedotova N.N., Foht Y.V., Akmalov N.A.

BACKGROUND: An examination session in students can be considered as a manifestation of a stress factor. As a result, during this period there are changes in the basic physiological parameters of students, which are due to the release of a large amount of cortisol.

AIM: To evaluate the indicators of red blood and some indicators of the aggregate state of blood in students in different periods of study, taking into account gender differences.

MATERIALS AND METHODS: The study design included 100 examined. Of the total number of examined relatively healthy (did not make complaints, were not on the dispensary register and did not have established diagnoses) – 100 people (50 men and 50 women). The absence of diseases was confirmed by medical documentation, since all persons of this group underwent an annual preventive examination for admission to study. Included in the study were volunteers aged between 18 and 30 years who, based on medical records, had no acute or chronic illness and gave voluntary consent to participate in the study. The average age was 23 ± 3 years.

RESULTS: Based on the presented study, it was found that the stressful situation caused by the examination session leads to pronounced changes in the hemostasis system, which may be a manifestation of endothelial dysfunction, while there are differences between these changes in men and women, which are manifested by differences in indicators of red blood, rheological properties of blood, endothelin levels, von Willebrand factor, tPA-PAI-1 complexes, antithrombin III. In addition, when comparing these indicators by gender, the predominance of fibrinogen levels in female students over men was noted. However, despite the pronounced changes in the hemostasis system, they were not critical and did not lead to the development of pathological conditions, moreover, as further studies showed, these changes were quickly stopped when the stress factor was stopped. As our research shows, after the end of the session, in the period of 7-8 days, both men and women, all analyzed indicators returned to physiologically normal indicators.

CONCLUSIONS: Thus, the conducted studies show that during the examination session, which can be regarded as a stressful situation, there is a significant activation of the hemostasis system, while there are certain differences related to gender. Thus, the predominance of fibrinogen levels in female students over men was established.

Medical academic journal. 2021;21(4):17-30
pages 17-30 views
Multiparameter study of the physiological reactions of the human organism to complex postural loads
Sergeev T.V., Agapova E.A., Anisimov A.A., Belov A.V., Guseva N.L., Kuropatenko M.V., Novikova T.V., Sagirov A.F., Suvorov N.B., Tolkachev P.I., Shabrov A.V.

BACKGROUND: Reactions of human cardiovascular system to complex dynamic postural loads were under investigation by previous authors. Individual limiting mode of postural loads, i.e. alternating negative-positive periodic changes of body position angle on tilting table with regard to clinostatic position, was defined. It was demonstrated that application of oscillatory passive dynamic postural loads can cause certain hemodynamic reactions, which expression depend on postural loads dynamic characteristics and subject’s primary state.

AIM: Aim of the study is to develop comprehensive methodology (practice) that explores regulation mechanisms of cardiovascular, respiratory, central and autonomic nervous systems and their reactions to physiological strains with assigned properties (intensity, direction, periodicity and duration of postural loads).

MATERIALS AND METHODS: 30 young healthy participants took part in the study. Physiological indicators were registered in dynamic mode synchronously with trajectory of participant’s motion. This study implemented common statistical methods as much as original means of analysis by integrating theory of dynamic systems.

RESULTS: Evaluation of synchronously registered physiological indicators by means of instrumental and software application, in particular, postural loads protocols of various intensity and motion direction, showed that oscillatory passive dynamic postural mode allows considerable improvements in overall blood circulation and gas exchange in the lungs. These changes constitute in a rise of systemic and local blood flow without significant shift of arterial pressure, increased frequency of heartbeats and respiratory rate.

CONCLUSIONS: Continuous monitoring of participant’s condition during complex postural loads give an opportunity for studying a set of physiological reactions and has a future implication in scientifically approved recommendations that describe practical use of postural loads as a correction technology for human health state and training.

Medical academic journal. 2021;21(4):31-46
pages 31-46 views
Features of the intestinal microbiota composition in multiple sclerosis patients receiving oral disease-modifying therapy
Tarasova E.A., Lioudyno V.I., Matsulevich A.V., Negoreeva I.G., Ilves A.G., Ivashkova E.V., Shkilnyuk G.G., Abdurasulova I.N.

BACKGROUND: Heterogeneous dysbiosis of the intestinal microbiome is a common hallmark of multiple sclerosis. In this pilot study, we compared the level of some gut bacteria in multiple sclerosis patients receiving oral disease-modifying therapy versus untreated.

MATERIALS AND METHODS: Subjects were patients with relapsing-remitting or secondary and primary progressive multiple sclerosis. Multiple sclerosis patients were treated by Fingolimod (n = 31), Teriflunomide (n = 21) or were untreated (n = 31). The bacterial levels in stool samples were analyzed by cultivation method and real time PCR.

RESULTS: The levels of symbiotic and opportunistic bacterial species in the fecal samples of multiple sclerosis patients receiving disease-modifying therapy were different from those in untreated patients. Also, there was a difference in the spectrum of gastrointestinal tract disorders between these patients. Fingolimod-treated patients showed decreased levels of some bacterial species compared to untreated subjects, including Escherichia coli with regular enzymatic activity, Sutterella wadsworthensis (phylum Proteobacteria), butyrate-producing bacteria Roseburia spp., Faecalibacterium prausnitzii, and Ruminococcus spp. (phylum Firmicutes, class Clostridia). Teriflunomide-treated patients demonstrated decreased levels of Lactobacillus spp. and Enterococcus spp. (phylum Firmicutes, class Bacilli) and Ruminococcus spp. Increased levels of Bifidobacterium spp. were observed in treated and untreated multiple sclerosis patients with higher EDSS scores.

CONCLUSIONS: This study shows the negative effect of oral disease-modifying therapy on intestinal microbiota composition and gastrointestinal tract disorders. However, more extensive studies are needed to confirm these preliminary results and develop ways to normalize intestinal dysbiosis in multiple sclerosis patients.

Medical academic journal. 2021;21(4):47-56
pages 47-56 views
Polymorphism of TLR genes and the course of COVID-19 bilateral pneumonia
Evdokimov A.V., Suslova T.A., Belyaeva S.V., Burmistrova A.L., Stashkevich D.S.

BACKGROUND: COVID-19 is a disease which course depends on a number of factors, including genetic ones, among which the genes of the innate immune system receptors – TLR (toll-like receptors), which play a central role in the development of innate immunity reactions, are of particular interest. The SARS-CoV-2 virus structure includes, in addition to the nucleocapsid, a protein-lipid membrane envelope, which determines the recognition of virus components by different TLRs, including TLR2 subfamily receptors (TLR1, 6, 10), which genetic polymorphisms occur with different frequencies in different human populations and affect not only the functional activity of the innate immunity but also determine the quality of the adaptive immune response.

AIM: The study aimed to determine the association of polymorphisms of toll-like receptor genes TLR1, TLR6 and TLR10 with the severity of coronavirus infection (COVID-19) in the Russian population of the Chelyabinsk region.

MATERIALS AND METHODS: The study included 86 patients from COVID-departments of hospitals in Chelyabinsk with a diagnosis of bilateral pneumonia with a degree of severity: moderate (M-BLP, n = 36) or severe (S-BLP, n = 50). The control group consisted of 100 healthy individuals from the register of the Chelyabinsk regional hemotransfusion station (“Control”). All the individuals studied belonged to the Russian ethnic group. Polymorphisms 1805T>G of TLR1 gene, 745C>T of TLR6 gene and 721A>C of TLR10 gene were determined using polymerase chain reaction with restriction fragment length polymorphism. The analysis of the association between genotypes and the status of individuals was carried out using the correspondence analysis and the Monte Carlo method.

RESULTS: It was revealed that the differences between the studied groups are completely determined by TLR1 genotypes. The GG genotype with statistical significance is more often detected in the “Control” group compared to M-BLP and S-BLP (p < 0.001, OR = 12.94) and can be assessed as protective in relation to the development of bilateral pneumonia in COVID-19. The TT genotype can be considered as predisposing to the development of a severe form of bilateral pneumonia in COVID-19 (p = 0.022): the TT genotype is significantly less common (OR = 0.20) in the M-BLP group compared to S-BLP.

CONCLUSIONS: It can be assumed that the genetic variant 1805*G of the TLR1 gene, which provides a moderate pro-inflammatory response and predominates in European populations, gives an advantage to its owners, preventing the development of complicated conditions in COVID-19 infection.

Medical academic journal. 2021;21(4):57-66
pages 57-66 views
The effect of the composition of leuzea and cranberry meal extracts on testosterone level in mice
Khalikova D.A., Ankov S.V., Meshkova J.V., Tolstikova T.G.

BACKGROUND: Current research suggests the potential use of natural components as sources of anabolic compounds. One of these is a new composition of leuzea and cranberry meal extracts, which, as was found earlier, exhibits a dose-dependent anabolic effect.

AIM: To establish the supposed mechanism of the anabolic effect in the composition of leuzea and cranberry meal extracts.

MATERIALS AND METHODS: In the experiment, CD-1 mice of both sexes weighing 20–25 g were used. All animals were measured blood testosterone concentration in dynamics: 0 point (before the administration of the analyzed compositions), 30, 60, 120, 180 minutes after administration.

RESULTS: After a single administration of the composition of leuzea and cranberry meal extracts at a dose of 70+500 mg/kg, the level of testosterone in the blood mice of both sexes increases, and the increase in testosterone levels in females is less pronounced than in males.

CONCLUSIONS: One of the supposed mechanisms of the anabolic effect in the composition, characterized by an increase in blood testosterone levels, has been established.

Medical academic journal. 2021;21(4):67-72
pages 67-72 views

Analytical reviews

Platelets and other cells interactions in the atherosclerosis development
Parfenova N.S.

Atherosclerosis of the blood vessels is one of the main causes of severe chronic vascular pathologies, which quite often lead to the fatal end. It is well known that the development of atherosclerosis is an inflammatory process going through several stages until the formation of an atherosclerotic plaque. The latter, due to increased instability, would come off and cause thromboembolism. Low density lipoproteins, endothelium, platelets, neutrophils, monocytes / macrophages and smooth muscle cells of the vessel wall are all active participants in the development of atherosclerosis. Thus, they trigger and carry out the process by forming a platelet thrombus on the surface of the ulcerated calcified atherosclerotic plaque. In the recent time interest in the role of platelets in inflammatory processes has grown immensely, first of all due to their ability to interact with cells participating in different stages of atherosclerosis development through adhesion, formation of aggregations, the exchange of exovesicles and microparticles, as well as through the mutually increasing secretion of cytokines, chemokines, growth factors and other chemical mediators. This review is devoted to the role of platelets in the formation and regulation of the multicellular ensemble and also local cell modules specific for each stage of atherosclerosis development.

Medical academic journal. 2021;21(4):73-84
pages 73-84 views
Molecular mechanisms of drug resistance of glioblastoma part 1: ABC family proteins and inhibitors
Chernov A.N., Shamova O.V.

The most common high-grade brain tumor in the adult population is glioblastoma. The life expectancy of patients with this tumor does not exceed 12-15 months, while relapses are observed in 100% of cases. One of the main reasons for the low efficiency of glioblastoma therapy is its multidrug resistance. In the development of the latter, transporter proteins of the ABC family play a key role. In this part, the emphasis is on the search for new molecular targets among growth factors, their receptors, signal transduction kinases, microRNAs, transcription factors, protooncogenes, and tumor suppressor genes involved in the regulation of proteins and genes of the ABC family and associated with the development of multidrug resistance in glioblastoma cells. The review also discusses the mechanisms of the cytotoxic action of inhibitors: ABC family proteins, tyrosine kinase receptors, non-receptor tyrosine kinases, vascular endothelial growth factor, kinases of signaling cascades, transcription factors, histone deacetylases, methyltransferases, replication and synthesis of DNA, microtubules and proteasome used in glioblastoma therapy or undergoing clinical trials.

Medical academic journal. 2021;21(4):85-106
pages 85-106 views
Pathophysiological and genetic mechanisms of migraine
Chernov A.N., Galimova E.S.

Migraine is a heterogeneous neurological disease characterized by the development of periodic attacks of severe throbbing headache and related disorders, which occur in 11–15% of the adult population of the planet. The article discusses the main forms of migraine with aura, migraine without aura, hereditary hemiplegic migraine in the context of their main clinical symptoms, molecular genetic risk factors involved in vascular and neurological processes, including activation trigeminovascular system. Emphasis is placed on the role of polymorphisms, hormone genes, neurotransmitters, their receptors, ion imbalance, ion channels, cytokines and growth factors, adhesion molecules, metabolic enzymes, matrix metalloproteases, vascular tone enzymes, antioxidant defense, lipid metabolism, proteins with a not yet established function.

Medical academic journal. 2021;21(4):107-128
pages 107-128 views

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