


卷 11, 编号 6 (2020)
Editorial
Modern medical and organizational features of coronavirus infection
摘要
So far in the history of mankind, the pandemic has been declared only twice. The first was the H1N1 influenza pandemic of 1918-1920, known as the “Spanish flu” or “Spanish”. The second is the 2009-2010 H1N1 flu pandemic, referred to in the media as “swine flu”. At the end of 2019, there was an outbreak of a new coronavirus infection COVID-19 with an epicenter in the people’s Republic of China (PRC) in the city of Wuhan (Hubei province), and since the beginning of 2020, cases of a new coronavirus infection have been recorded in other countries whose citizens visited the PRC. In some territories, such as South Korea, Iran and Italy, the epidemiological situation for COVID-19 has sharply worsened, which subsequently led to a significant increase in the number of cases in the world associated with travel to these countries. In connection with the current epidemiological situation, on March 11, 2020, the Director-General of the world health organization (who), Tedros Adhanom Ghebreyesus, said at a briefing in Geneva that the spread of the new coronavirus in the world has become a pandemic. According to experts, the new coronavirus infection has a number of features, both epidemiological and clinical. Currently, information about this is quite limited, which makes it difficult to prevent and treat this disease. In our article, we tried to present some aspects of the new coronavirus infection COVID-19, referring to data published in open scientific literature sources, and reporting data from two administrative districts of the city of St. Petersburg.



Original studies
Features of electrophysiological activity in a neonate with severe post-hypoxic brain damage (post-hypoxic cerebral depression)
摘要
The article briefly presents the literature data and a description of the clinical dynamic observation of a patient with severe hypoxic brain damage (from the neonatal period to 4 months of life), in the conditions of the neonatal intensive care unit. The article describes the clinical picture, features of paroxysmal states and antiepileptic therapy, dynamics of neuroimaging data, electroencephalographic phenomena recorded in a patient with cerebral depression and structural cerebral injuries. The significance of electroencephalographic examination in the intensive care unit as an informative method for assessing cerebral activity in young children with central nervous system depression syndrome is shown. Disorganization of background activity, indicating structural cerebral damage, long-term persistence of slow-wave activity, detection of epileptic changes in the form of generalized flashes of pointed waves in the theta range, alpha-coma pattern, subsequently replaced by suppression of the background pattern in the patient, are typical electrophysiological disorders recorded in severe hypoxic encephalopathy. In conditions of limited opportunities for visual diagnosis of a patient with impaired consciousness, EEG remains the only method of obtaining information about the functional state of the brain, the data obtained during the study are an important prognostic criterion.



An analysis of deviations from international standards of physique development in male youngsters from the former aral sea region
摘要
Introduction. According to the commonly accepted classification, geographical division of the Southern Near-Aral region (Karakalpakstan, Republic of Uzbekistan) is determined by the distance from the epicenter of the formal Aral Sea ecological disaster. The physique development was compared in male youngsters living in “Zone No. 1” (critical), “Zone No. 2” (stable) and “Zone No. 3” (normal). The aim was a comparison of body length and mass in male youngsters up to 17 years old living in all three zones.
Material and methods. Total body length and mass were studied in 320 male volunteers, age 17–19. Z-index of body length and body mass index (BMI) were estimated according to the standards of WHO Growth Reference, 2007. Batch-to-batch variations were studied with Kruskal–Wallis test, and Mann–Whitney criterion including Bonferroni correction for multiple comparison. Categorical features were compared using Fisher’s exact test for 3×3 contingency tables with calculating the proportion of children with one or another deviation in body weight. The results were considered statistically significant at p < 0.05.
Results. Subjects from Zone 1 possessed significantly lower valued of BMI and Z-index. The incidence of Z-index values lower than mean (less –1 SD) were significantly higher in Zone 1 (critical).
Conclusion. The results may be explained by via chemical pollution of the environment by the endocrine-disrupting chemicals in the critical zone of the Aral See region ecological disaster and can be implied for the health monitoring of the local population.



Features of sexual development, immune status and biochemical parameters in boys suffering from acne
摘要
Among skin diseases in children and adolescents, the most common pathology is acne. The main pathogenetic link of acne in adolescents is hormonal imbalance. The effect on the sebaceous glands of high concentrations of dihydrotestosterone causes a change not only in the quantitative but also in the qualitative composition of the sebaceous secretion. The study is devoted to assessing the characteristics of sexual development, immune status and biochemical parameters in boys suffering from acne. Materials and methods.
Materials and methods. A comparative analysis of the state of immunity, sexual development, biochemical parameters of 147 boys suffering from acne, and 142 healthy boys who do not suffer from acne.
It was found that the immune status of boys suffering from acne was characterized by a decrease in cytotoxic lymphocytes. In the peripheral blood of these boys, serum interferon γ, tumor necrosis factor α, interleukins 1, 2, 8 and 10, as well as small circulating immune complexes were significantly higher than in the boys of the control group. In boys suffering from acne, in the puberty period, the concentration of prolactin in 13–14 years is significantly lower, and testosterone levels are significantly higher than in boys of the control group of the same age. At 15–17 years of age, the concentration of luteinizing hormone in boys with acne is significantly lower, and testosterone is higher than in boys in the control group. Evaluation of the degree of formation of secondary sexual characteristics indicates that boys suffering from acne differed from their peers from the control group by a small advance in sexual development. Thus, boys suffering from acne, characterized by advanced and disharmonious puberty.



雌兔循环血容量反复增加时胎-胎盘复合体参数的变化
摘要
臨床前試驗是將新藥引入產科實踐的強制性階段之一,目的是研究藥物對胎兒和胎盤發育的影響。進行實驗研究時,將主要接受藥物治療的動物組與不接受藥物治療的對照組進行比較。這種情況下,受試藥物的量本身就可以顯著改變實驗動物,尤其是小動物的循環血(BCC)量,這種給藥在幾天內重複多次,可以累積這種效果。對胎兒的功能狀態有不利影響。使用在懷孕第18天通過將1/3胎盤血管結紮在一個子宮角中而在雌性兔子中產生的慢性胎盤功能不全模型,對正常發育和發育遲緩的多胎胎兒的大腦和胎盤發育產生影響每天(懷孕19-28天)向雌性體內註入生理鹽水,其量等於動物BCC的6%,與臨床實踐中用於治療胎盤功能不全的藥物的體積相當(雌性實驗組)。已經確定,在懷孕的後半段每天重複給雌性兔子每天施用生理溶液,大約是BCC的6%,會破壞其正常發育的胎兒的功能狀態,甚至破壞胎兒的功能狀態。更大程度上是胎兒發育遲緩。這表現為與對照組女性相比,完整子宮角中胎兒的存活率降低了1.4倍,完整和實驗角中胎兒的腦代謝受到了更明顯的干擾。



Сomparative analysis of acridineacetate-containing compounds’ radio-sensitizing effect during malignant tumor experimental radiotherapy in a metastatic colorectal cancer model in balb/c mice
摘要
Radio-sensitizing compounds are used to increase radiotherapy effectivity and reduce negative pathologic systemic effects of radiation. These radio-sensitizers selectively pile-up in tumor tissue and enhance necrobiotic processes caused by irradiation. Unfortunately, broad introduction of radio-sensitizers into clinical practice is hampered by their low effectivity and substantial negative side effects. This what determines radio-sensitizers effectivity studies high actuality in a colorectal cancer mice model. The study involved 156 male BALB/c mice who had been transplanted with colorectal cancer. After the transplantation they were injected with acridineacetate – containing compounds Cyclopherone and Procitol. A comparative assessment was undertaken of tumor growth dynamics and metastatic rate. A combination of gamma-irradiation with radio-sensitizing compounds produces a more substantial therapeutic effect according to all parameters of the experimental colorectal cancer growth and development than the isolated effect of radiotherapy or antitumor drugs. A considerable slowing down of tumor growth on the 14th and 28th day of the study was revealed as well as a reliable inhibition of lymphogenous and hematogenous metastatic spread of neoplasma during the entire study and a statistically valid increase of lifespan of the experimental animals. The radiosensitizing effect of Procitol in combination with radiotherapy turned out to be more substantial than that of Cyclopherone.



Reviews
Dermatological manifestations of psychic ailments
摘要
An increase in the number of patients with psychodermatological manifestations and the identification of a certain comorbidity during the course of diseases in patients with a dermatological profile makes us take a fresh look at this problem. Psychodermatology is one of the relevant and, at the same time, the least studied areas of modern medicine, which is at the junction of psychiatry and dermatovenereology. Psychiatry and psychotherapy studies the inner world of a person; Dermatovenerology deals with the diagnosis and treatment of diseases of the human skin and its appendages, and psychodermatology combines these two sections of medicine. In the modern world, as a result of increasing the amount of incoming sensory information, accelerating the rhythm of life, the action of harmful environmental factors, a person can be subjected to excessive psycho-emotional stress, leading to the development of mental disorders. Often it is skin rashes that are an objective manifestation of such disorders. Early diagnosis of psychodermatosis and signs of obsessive-compulsive pathology in sick people contributes to the timely identification of the category of people at risk of psychotic reactions and mental illness. This is especially true for young patients. Against the background of hormonal changes in the body, the crisis of adolescence, the increased educational load on them at school, the destroyed institute of family and marriage, an overabundance of sensory information and physical inactivity, the incidence of psychodermatosis throughout the world, including in our country, is increasing.



Morbid obesity in clinical practice: current treatment concepts
摘要
The article discusses modern methods of treatment of morbid obesity and associated diseases. It is known that obesity leads to disability in people, including young people, due to the frequent development of severe comorbid diseases. According to current clinical guidelines, the main goals of treating obese patients are: weight loss, achieving good metabolic control, and improving the course of diseases associated with obesity. A small selection of drugs for the treatment of obesity, the need for strict adherence to indications and contraindications to their appointment, significantly limits the possibilities of drug therapy for morbid obesity. With morbid obesity, the effectiveness of conservative treatment is only 5–10%. Up to 60% of patients cannot maintain the result of weight loss within 5 years of observation. Long-term use of bariatric surgeries, the purpose of which was initially to reduce body weight in patients with morbid obesity, showed certain possibilities of surgery in compensating for a number of diseases associated with obesity. Therefore, at present, the concept of bariatric surgery is not only to reduce the patient’s weight, but also to achieve beneficial metabolic effects (normalization of glycemia, lipid metabolism). In this regard, modern bariatric interventions are united by the term “metabolic surgery”. It has been proven that compensation of non-insulin-dependent diabetes mellitus after bariatric interventions is observed in 42–95% of patients, depending on the type of surgery, duration of non-insulin-dependent diabetes mellitus and basal C-peptide level. As a result of many years of research, bariatric surgery has allowed for the first time to formulate the term “remission of non-insulin dependent diabetes mellitus”.



Clinical observation
А clinical case of mumps incurred in orhiepididimita a teenager
摘要
Mumps currently is a vaccine-preventable infections. However, mumps still remains an urgent problem all over the world, due to periodic increases in the incidence in older children (including the vaccinated ones against this infection), in adults (the disease often does not go smoothly with involving various organs in the pathological process and systems). The literature describes the various adverse effects of male mumps, including infertility, testicular atrophy, testicular tumors, impotence, gynecomastia, etc. The article provides information on the incidence of mumps in the Russian Federation and St. Petersburg, the clinical manifestation of the infection. It was noted that in adolescent boys and men, the presence of orchitis (orchoepididymitis) is a frequent symptom of the disease. It is shown in the article, that testicular inflammation rate increases with age of patients. A brief description of modern methods of laboratory diagnostics and therapy is given in accordance with clinical recommendations and treatment standards. A clinical case of mumps, combined severe form (mumps + orchoepididymitis), in a 17-year-old boy is presented in this article. The features of the course of the disease, the results of laboratory and instrumental examination and treatment have been analyzed in this item. Conservative therapy (antiviral and antibacterial) of mumps, as well as timely surgical treatment of orchoepididymitis, led to a complete clinical and laboratory recovery of the patient.



小儿皮肤病学中的杜林氏疱疹样皮炎:诊断和治疗问题
摘要
本文介绍了一个5岁的杜林氏疱疹样皮炎儿童的临床观察病例。这种罕见的皮肤病的特征是慢性复发过程,发痒的多形性皮疹的存在,典型的组织学和免疫形态学体征。诊断是根据临床表现,皮肤活检的组织学和免疫组织化学研究数据以及PCR方法进行的HLA分型研究结果进行的。由于在儿童中杜林氏疱疹样皮疹少见,鉴别诊断的复杂性,这种情况的临床观察对执业的皮肤科医生来说是有意义的,这需要使用组织学,免疫组织化学和分子遗传学研究方法进一步总结经验。疱疹样皮炎是一种慢性剧烈瘙痒性丘疹性水泡疹,通常在四肢伸肌表面对称分布。根据组织学、免疫学和胃肠道标准,本病与其他皮疹有明显区别,皮疹形成于表皮下水疱。欧洲种族的不同人群中,皮肤病的患病率在每10万人口中有10到39例不等。杜林氏疱疹样皮炎可以在任何年龄发展(已报道了童年时期杜林氏疱疹样皮炎的病例),但该病最常发生于40-50岁。疱疹样皮炎可无限持续存在,但病情轻重不一。杜林氏皮炎患者通常伴有麸质敏感型肠病,在大多数情况下无症状。



Medical aspects of preschool and school education organization
现代国内为学龄前儿童组织学前教育组织工作的制度的弊端
摘要
这项工作的出现是由于俄罗斯联邦法律的现代要求,包括2012年12月29日第273号联邦法律«关于俄罗斯联邦的教育»,需要扩大俄罗斯联邦的网络。从2个月开始,设有针对幼儿的学前教育组织,并为婴儿期的孩子创建团体。本文分析了国内外学前组织留守儿童的现状。研究表明,为了保护儿童的健康,成功地适应和发展学前组织,并为一岁以下的儿童建立群体,不仅需要遵守现有的监管框架,还要对学前组织进行重大改组,为幼儿创造充分的条件。在不影响他们的健康和家庭的社会福利的情况下。强调有必要就健康保护和幼儿入园准备向家长提出建议,有针对性地向家长提供医疗、社会和物质援助,让家长有意识地选择在家里还是在幼儿园组织中抚养孩子。提请注意,学前组织必须提供认真的财政支助,安排建筑物和领土,使儿童安全地留在学前教育组织,对其给予充分的照顾,抚养和成功发展,并为其健康提供必不可少的条件。强调有必要修订学前组织的人员配置表,以便使儿科医生、护士、言语治疗师、教育心理学家重返工作人员队伍。本文比较了国外和俄罗斯学前教育组织的工作安排。本文简要介绍了婴幼儿的一些生理心理特点,并对家长提出了必要的建议。讨论了在不损害幼儿和婴儿健康的情况下,改善俄罗斯联邦学前教育机构适应期的可能性。


