Vol 27, No 3 (2019)

Original researches
Structural condition of synovial medium of joint in patients with III stage coxarthrosis
Menshchikova T.I., Matveeva E.L., Lyneva S.N., Menshchikov I.N., Spirkina E.S.
Abstract

Aim. To study peculiarities of synovial medium of a joint in patients with III stage coxarthrosis (CA) using methods of ultrasound and biochemical examination.

Materials and Methods. Ultrasound examination (US) of hip joints (n=18) and biochemical examination of synovial fluid (n=12) were conducted in patients with posttraumatic III stage CA. Echographic examination was carried out using diagnostic devices Voluson 730 PRO (Austria) and Hitachi (Japan) equipped with transductor with 7.5 MHz frequency. Total protein was measured in alkaline medium with copper sulfate. Protein fractions of synovial fluid were separated using a method of separation of a mixture of proteins to fractions or to individual proteins. The activity of catalase enzyme was determined by speed of degradation of hydrogen peroxide and of liberation of cell from its excess. Processes of peroxide oxidation of lipids (POL) were assessed by measurement of the content of the primary (diene conjugates, DC) and secondary (malondialdehyde, MDA) products of POL. Products of lipoperoxidation and of oxidative modification of proteins were presented as an estimated coefficient of sum and ratios. Lipid spectrum (cholesterol, triglycerides) was measu-red using a colorimetric method.

Results. There were revealed structural disorders in the synovial medium of the joint. US data showed thickening of synovial and fibrous membranes of the joint capsule by 60 and 40% of the age-related norm, separation of fibers of the fibrous membrane of the joint. Biochemical examination of synovial fluid revealed reduction in the activity of enzymes of antioxidant system and accumulation of peroxidation products which evidences development of a local oxidative stress in the joint medium. In development of destructive processes in the region of joints affected by arthrosis, the activity of free radical processes considerably increases which leads to decompensation of antioxidant mechanisms with development of imbalance in the anti-oxidant protection system.

Conclusion. In clinical practice, diagnosis of degenerative-dystrophic processes in the joint, along with X-ray data, should also include the results of biochemical and ultrasound methods of examination.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):305-314
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Expression of p63 protein in pulmonary adenocarcinomas as factor of poor prognosis
Byakhova M.M., Glazkov A.A., Vinogradov I.Y., Frank G.A.
Abstract

Aim. To study the spectrum of cellular molecular-biological markers and identify those of them that can be used as prognostic factors for the clinical course of pulmonary adenocarcinoma.

Material and Methods. In the given work archive material of 129 patients with confirmed diagnosis of pulmonary adenocarcinoma was used. In the work, histological, immunohistochemical, molecular-genetic and statistical methods were used.

Results. In 29 cases (47.5%) of pulmonary adenocarcinoma, focal cytoplasmic and/or nuclear expression of p63 protein was observed in different proportions of cells. With expression of p63 in tumor cells, relapse-free survival was on average 25.7±5.1 months, while in patients with no expression of р63 it was 26.1±2.8 months. This parameter did not influence the overall survival of patients which was on average 33.6±2.7 months.

Conclusion. A weak tendency to reduction of relapse-free survival of patients with p63-positive pulmonary carcinoma of lungs was revealed. Identification of p63 in pulmonary adenocarcinoma may be regarded as a factor of unfavorable prognosis and of risk of faster tumor progression, which requires further study to increase the statistical value of research.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):315-324
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A study of osteoprotective effect of l-arginine, l-norvaline and rosuvastatin on a model of hypoestrogen-induced osteoporosis in rats
Gudyrev O.S., Faitelson A.V., Sobolev M.S., Pokrovskiy M.V., Pokrovskaya T.G., Korokin M.V., Povetka E.E., Miller E.S., Soldatov V.O.
Abstract

Effect on the microcirculatory bed of the bony tissue is one of promising approaches to treatment of osteoporosis.

Aim. To study anti-osteoporotic properties of endothelioprotectors: L-arginine, L-norvaline and rosuvastatin.

Materials and Methods. Osteoprotective properties of L-arginine, L-norvaline and rosuvastatin, and also of a reference drug– strontium ranelate – were studied on 152 female rats of Wistar line using a model of hypoestrogen-induced osteoporosis. Anti-osteoporotic and endothelioprotective effect of the drugs were evaluated by laser dopplerflowmetry (LDF) of the proximal metaphysis of the femoral bone, morphometry of trabeculae of bone, and also by calculation of the coefficient of endothelial dysfunction.

Results. LDF showed that maximal increase in microcirculation of the proximal metaphysis of the femoral bone, in comparison with animals with untreated osteoporosis (61.52±3.74 perfusion units, PU) was achieved with L-norvaline (115.25±5.36 PU, p<0.001) and rosuvastatin (106.57±5.22 PU, p<0.001), less expressed effect was demonstrated by L-arginine (98.10±4.48 PU, p<0.001) and a reference drug – strontium ranelate (86.49±4.99 PU). A similar tendency was observed in morphometry of trabeculae of bone: in the group with untreated osteoporosis the diameter of trabeculae was 61.68±1.24 µm, in the group with use fL-norvaline – 91.86±1.8 µm (p<0.001), in the group with use of L-arginine – 86.64±1.39 µm (p<0.001) and in the group with use of strontium ranelate – 89.08±1.09 µm.

Conclusion. L-arginine and L-norvaline and also rosuvastatin possess the property of improving a morphofunctional condition of bone tissue and may be recommended for further preclinical study.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):325-332
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Physiological ‘cost’ of activity of individuals with different effectiveness in dynamics of endosurgical training
Klimenko A.V., Pertsov S.S., Yakovenko I.Y., Levkin E.I., Samratov T.U., Gubenko M.S.
Abstract

Aim. The work was designed to study the physiological ‘cost’ of purposeful behavior on the model of endosurgical training.

Materials and Methods. The research was implemented on 87 men of 18-24 years of age. The volunteers per formed a number of exercises 30 minutes each according to the Basic Endosurgical Simulation Training and Attestation System (BESTA system) on a T5 Large RM box-trainer within 10 consecutive days. The total time and the number of mistakes were recorded. During the training sessions an electromyogram was recorded on a BIOPAC MP 36 device. ECG was recorded and processed using a Varicard 2.51 device before and after the training sessions. ECG was analyzed by evaluation of the average differences of spectral analysis of heart rate variability before and after training.

Results. It was shown that high-performance individuals were characterized by less energy spent on motor work in purposeful activity. Irrespective of the effectiveness of training, the purposeful behavior in conditions of psychoemotional stress was characterized by depletion of functional reserves of an organism. Low-performance subjects demonstrated a more evident weakening of parasympathetic (start of observations) and of sympathetic influences (end of observations) on the functional activity of the heart.

Conclusion. Specific features of physiological ‘cost’ of purposeful behavior in individuals with different effectiveness of the activity were revealed on the model of endosurgical training. Better results in the dynamics of purposeful activity were achieved on this model at a higher physiological ‘cost’.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):333-341
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Morphological status of students with different level of motor activity
Mikhailova S.V., Deryugina A.V., Syomova S.G.
Abstract

A study of the effect of motor activity on the health condition of students that generalizes peculiarities of the morphological status and of physical development on the whole, permits to identify mechanisms controlling health factors.

Aim. Determination of the peculiarities of the dynamics of morphological status of students with different levels of motor activity in the period of study at aninstitution of higher education (IHE).

Materials and Methods. A prospective study of physical health of 630 students of 17-22 years of age in the period from 2010 to 2018. In students, the body length, body mass, chest circumference and other parameters were measured and the somatotype was determined every year in the period of study at anIHE (5 years).

Results. It was found that in the period of study at anIHE, growth processes continued only in 51.9% of examined boys and gradually terminated at 21-22 years of age, and in 36.9 % of girls with termination at 21-22 years. In most students increment of the body mass and chest circumference was recorded, there were also found boys and girls with these parameters remaining unchanged during period of study at anIHE, and in some cases their decline was found. The increment of the body mass and chest circumference was demonstrated to slow down with termination of growth processes, but did not stop altogether which resulted in increase in the amount of students with excessive weight. This was also facilitated by reduction of the level of motor activity in senior years when physical culture classes are no longer included into the curriculum. The dependence of growth processes in boys and girls at the age of 17-22 years on the level of motor activity was revealed that influenced the speed and direction of increment of the total dimensions of the body and the type of body-build. According to our data, the majority of boys support a high level of motor activity to buildup the body mass, and girls lead an active way of life to decrease the body mass and to keep it on the optimal level.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):342-352
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Comparative characteristics of emissions priority carcinogens by stationary sources into the air atmosphere of areas of the Ryazan region
Dementyev A.A., Lyapkalo A.A., Tsurgan A.M., Bulychova G.N., Korshunova E.P.
Abstract

Aim. Evaluation of dynamics of emission of priority carcinogens by stationary sources in the regions of the Ryazan region in 2009 and 2016.

Materials and Methods. For analysis, official statistical data about volumes of pollutants emitted by stationary sources into the atmospheric air, were used. The priority was determined by calculation of equivalent emission with taking into account the slope factor of carcinogenic potential in inhalation entry (SFi). The dynamics of emissions of carcinogens was evaluated by the growth rate.

Results. The study showed that priority chemical carcinogens released into the atmospheric air of municipal units by stationary sources included: chromium (Cr) (VI), carbon (soot), benzol, petrol and formaldehyde. From 2009 to 2016 a 39.4% decline in the total equivalent emission of carcinogens was reported, especially of benzol, soot and formaldehyde which considerably changed the structure of emission – a significant increase in the share of Cr (VI) (up to 55.7%, 1.5-fold) and almost twice reduction in the share of benzol (to 23.3%). In the reported years more than 90% of the total equivalent emission of carcinogens in the Ryazan district were formed by stationary sources of Ryazan and Skopin towns, of Ryazan and Skopin districts.

Conclusion. In most municipal units of the Ryazan district a reduction of the total equivalent emission was noted except in Aleksandro-Nevsky, Miloslavskoye, Pronsk, Zakharovo and Shilovo districts where emission increased. In Ryazan, against the background significant reduction of emission of soot and benzol by 81.7 and 69.4%, respectively, a 37.4% increase in the emission of formaldehyde into the atmosphere was recorded.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):353-359
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Fetuin-a and secondary osteoporosis in patients with rheumatoid arthritis
Papichev E.V., Zavodovsky B.V., Seewordova L.E., Akhverdyan Y.R., Polyakova Y.V.
Abstract

Aim. To study the level of fetuin-A (FA), bone mineral density (BMD) and certain markers of bone remodeling in patients with rheumatoid arthritis (RA).

Materials and Methods. 110 Patients with RA and 30 conventionally healthy patients were examined. In both groups the levels of FA and BMD were determined. In the group of patients with RA the levels of C-telopeptide of type I collagen, N-terminal propeptide of procollagen I, 25-hydroxy-cholecalciferol, total alkaline phosphatase, total calcium of blood were determined.

Results. The mean concentration of FA in blood serum of patients with RA was 765.67±120.66 µg/mL, which was below the respective parameter in donors – 812.95±76.21 µg/mL (p=0.0437). In the group of patients with RA with osteoporosis (n=52) the mean level of FA was 733.65±135.84 µg/mL, and in the group without osteoporosis – 794.37±97.7 µg/mL (p=0.0044). The level of FA was also reduced in patients with osteoporotic fractures (n=24) – 694.79±110.47 µg/mL against 785.45±116.43 µg/mL in patients without osteoporotic fractures (n=86; p=0.00091). A positive correlation relationship was found between the level of FA and BMD of L1-L4 (r=0.194; p=0.042), femoral neck (r=0.328; p<0.0001) and proximal femur (r=0.293; p=0.002), and the level of 25-hydroxy-cholecalciferol (r=0.259; p=0.006), and the negative correlation relationship – with C-telopeptide of type I collagen (r=-0.203; p=0.033).

Conclusions. Patients with RA with reduced FA level were characterized by a higher detection rate of osteoporosis and of osteoporotic fractures, and by a lower BMD of L2-L4, femoral bone and proximal femur. Besides, a lower level of FA was associated with a lower level of 25-hydroxy-cholecalciferol and with a higher level of C-telopeptide of type I collagen which permits to suggest existence of osteoprotective function in this glycoprotein.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):360-366
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Assessment of effectiveness of training of respiratory musculature in patients with chronic obstructive pulmonary disease and obesity
Ovsyannikov E.S., Budnevsky A.V., Shkatova Y.S.
Abstract

Aim. To assess the influence of training of respiratory musculature on the expressiveness of symptoms, tolerance to physical loads, spirometric parameters and quality of life of patients with chronic obstructive pulmonary disease (COPD) and obesity.

Materials and Methods. The study included 52 patients with COPD (clinical group D) and obesity, of them 42 men and 10 women with the mean age 65.4±6.8 years and body mass index 33.6±2.9 kg/m2. The patients were divided to 2 groups: the main group with training of respiratory musculature (TRM) within 12 months using a respiratory exerciser, and the control group with simulation of TRM using the same exerciser, but with minimal load.

Results. In 12 months the patients of the main group showed a reliable reduction of dyspnea on mMRC scale (Modified Medical Research Council), improvement of health related quality of life on St. George’s Respiratory Questionnaire (SGRQ), increase in forced expiration volume in 1 second and in forced vital capacity of lungs, increase in the covered distance in 6-minute walk test, reduction of the average duration of hospitalization for exacerbation of COPD.

Conclusion. Taking into account the obtained data, TRM can be considered as an effective component of the lung rehabilitation program in patients with COPD.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):367-374
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Operations on working heart in lesion of left main coronary artery in acute coronary syndrome
Staroverov I.N., Staroverov I.N., Churakov S.O., Lonchakova O.M.
Abstract

Aim. To study safety and effectiveness of operations on the working heart in patients with damage to the left main coronary artery (LMCA) and with acute coronary syndrome (ACS), to determine the optimal time for operation.

Materials and Methods. The work was based on the analysis of examination and treatment of 62 patients with damage to LMCA. Patients were divided to 2 groups depending on the kind of surgery: in the first group of patients (n=31) the operation was performed under cardiopulmonary bypass (CPB), in the second group (n=31) – on the working heart. The groups were comparable by the main clinico-demographic parameters. The risk for unfavorable outcome was determined on EuroSCORE II scale.

Results. Operation on the working heart in patients with damage to LMCA and ACS permitted to reduce the time of operation (253.44±36.84 against 188.13±45.37 min, p=0.0001), blood loss in postoperative period (607.00±432.34 ml against 413.21±167.08 ml, р=0.03), frequency of use of blood preparations (47.62% against 18.18%, р=0.04). However, the revascularization efficiency was higher in the group operated under CPB (2.93±0.8 against 2.29±0.82, р=0.005). Operations under CPB performed at later time (14-30 days) were associated with increased lethality. In operations on the working heart no lethal outcomes were reported.

Conclusion. Operations on the working heart are safe and effective in the early period after development of ACS. The optimal operation time under CPB is 7-14 days. Lethality and postoperative complications in operation on the working heart before 7 days, within 7-14 days, and after 14 days did not differ.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):375-384
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Reviews
The role of vascular reconstructions in surgery of tumors of the hepatopancreatobiliary zone
Katelnitskiy I.I., Katelnitskaya O.V.
Abstract

According to the point of view that has been dominating for many years, pancreatoduodenal resection was indicated only for localized tumors of the pancreas without involvement of the major vessels. In view of the prevalence of this pathology, many authors have recently pointed out the need to perform resection of a pancreatic tumor in a single bloc with the vessels involved, which gives a chance to increase the resectability in a larger number of patients.

Aim. Analysis of resectability of pancreatic tumors on the basis of the data of current clinical research. In recent decades many different surgical approaches have been improved which increases chances for successful and safe surgical intervention. The data of the analysis of literature on vascular reconstructions in surgery for tumors of the hepatopancreatobiliary zone showed that resections and reconstructions of the mesenteric portal venous segment permit to increase resectability of tumor and should correspond to the fundamental principles of surgical oncology. To date, in terms of the incidence of postoperative complications and mortality, no statistically significant differences were found between the group of patients in whom vascular resection was performed, and the group with a standard pancreatoduodenal resection. A thorough preoperative selection of patients along with the correct strategy of venous reconstruction is equally important for correct and successful resection of the blood vessels en bloc.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):385-392
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Analysis of regeneration mechanisms in auto ransplantation
Pronina E.A., Maslyakov V.V., Ivanov A.N., Stepanova T.V., Popyhova J.B.
Abstract

Search for effective and available methods of stimulation of regenerative processes is a priority task of restorative medicine. Of high interest is a kind of biostimulation that induces activation of metabolic and reparative processes in the whole organism.

Aim. Generalization of the relevant literature data concerning possible mechanisms of biostimulation in transplantation of self tissues of an organism. The results of literature survey showed that there still remain many debatable questions concerning cellular and molecular mechanisms that underlie intermolecular interactions in the stage of regeneration. Stimulating effects of an autotransplant both in the zone of the transplant or in an organism in whole may be caused by mediators and signal molecules released in destruction of the autotransplant tissues and of its perifocal region, and also by bioactive substances produced by immune-competent and stem cells.

Conclusion. Tissue transplants may be used as inductors of production of biologically active substances and activators of immune and/or stromal cells. The latter, in turn, are producers of a number of chemical mediators required for large-scale regeneration. Therefore, a promising method of stimulation of regenerative processes is transplantation of self tissue. This method is characterized by simplicity, effectiveness and availability which evokes special interest and requires further study.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):393-406
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Clinical cases
Clinical observation of paroxysmal atrioventricular reciprocal tachycardia in intermittent Wolff–Parkinson–White syndrome
Pavlova N.P., Artemova N.M., Maksimtseva E.A., Uryasiev O.M.
Abstract

Aim. To present potentials of electrocardiographic (ECG) research method in the diagnosis of paroxysmal tachycardia, as well as in the presence of additional conduction pathways (DPP). To demonstrate potentials of a trivial method for identification of the type of arrhythmia, the mechanism of occurrence, and topics of the additional conduction pathway in Wolf-Parkinson-White syndrome on a clinical example.

Conclusion. A widely available routine method of the ECG allows to determine the nature of arrhythmia, to choose the treatment tactics, to assess the prognosis of the disease, prior to performing complex invasive procedures.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):407-412
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Chronicles
Ryazan genius of Russia (to the 170th anniversary of the birth of academician I.P. Pavlov and the 115th anniversary of the Nobel prize)
Zagrina N.A., Lapkin M.M., Kozeevskaya N.A.
Abstract

The article is devoted to the 170th anniversary of academician I. P. Pavlov (1849) and the 115th anniversary of the Nobel prize (1904). The authors reflected the main directions in the scientific work of the great scientist and emphasized the relevance of the results of his research for modern medicine in the field of physiology of blood circulation, of digestion and of higher nervous activity.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):413-417
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Pyotr Kuzmich Anokhin – my teacher
Yumatov E.A.
Abstract

The article presents biographical and historical facts reflecting the scientific environment in which the author and his teacher P.K. Anokhin lived and worked. Discussions around the positions and ideas of the theory of functional systems are analyzed. The living language conveys the atmosphere of scientific creativity, which is usually not present in the texts of scientific articles. The little-known and unpublished facts and photos from the author's archive, which are of both historical and scientific interest, and have not lost their importance to date, are given.

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):418-425
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Anniversury
To professor V.V. Davydov`s 80th birthday
I.P. Pavlov Russian medical biological herald B.
Abstract

To professor V.V. Davydov`s 80th birthday

I.P. Pavlov Russian Medical Biological Herald. 2019;27(3):426-427
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