Vol 10, No 1 (2018)

One of the clinicians’ major concerns is the biological safety of MSC. The critical question for clinical application of human MSC is their ability to undergo spontaneous malignant transformation in a recipient organism. The goal of our research was to study umbilical cord hMSC proliferative and differentiation capacities, karyotype stability, telomerase activity and telomere length, oncomarkers expression and tumorigenicity during long-term (6 months) cultivation ex vivo. Here we report on the establishing the primary culture of human umbilical cord MSC, MSC_0714, that was capable to proliferate ex vivo for up to 59 passages (6 months). During this period, the cells preserved their normal karyotype, morphology and MSC immunophenotype. Telomeres started to shorten only after the passage 20, while hTERT was inactive in these cells for the whole period of expansion. At the beginning of cultivation the number of SA-β-gal positive cells did not exceeded 3-5%, after the 22th passage their number started to increase and reached 49% at the passage 57. Thus, it was shown that MSC during long-term culture retain their characteristics and undergo cell senescence.

In the work of the particularities of clinical course of perforation of hollow organs and peritonitis in conjunction with infectious diseases in patients on treatment in infectious and surgical department compared to patients receiving treatment of perforation of hollow organs in “normal” surgical hospital. Analyzed the differences in the level and nature of perforations, types of peritonitis, infectious diseases have reasons for late diagnosis of these complications.

The analysis of results of treatment of 113 patients with postoperative ventral hernias was carried out patients divided into two groups. 74 patients have received treatment (II (control) group) from 2013 to 2014 year. Patients of the control group were examined according to the accepted diagnostic algorithms, in addition to physical examination algorithm include chest and abdominal x-ray examination, ultrasound diagnosis of abdominal organs and fibro-esophagogastroduodenoscopy. Plastic by reticular endoprostheses was carried out in various methods. Methods have been chosen directly by surgeon during the operation. The draining of the postoperative wound was mandatory. Main (I) group included 39 patients who received treatment from 2015 to 2016. The diagnostic algorithm was supplemented with fibrocolonoscopy and spiral computed tomography, and the plastic method was predominantly sub-lay. Hypoderma treatment by high-temperature oscillating plasma flow energy according to the original technique for the prevention of lymphorrhea was provided to all patients. Maims were mostly sutured tightly. This approach allowed to reliably reduce frequency complications from 13.4% (14) to 1.8% (2) and, as a consequence, the length of stay of the patient in the hospital.

In connection with the ambiguity in the interpretation of the results of stimulation tests in congenital hypopituitarism, children need to search for molecular genetic markers of the disease. Molecular genetic analysis in patients with congenital hypopituitarism (genes GH1, GHRH, GHRHR,BTK, GHSR, PROP1, POU1F1, HESX1, LHX3, LHX4, SOX3, SOX2, OTX2, GLI2, ARNT2, ARPC5L, DLK1, DRD2, PAX6, RNPC3, SHH, SPCS2, SPCS3), was carried out by new-generation sequencing (NGS) with “Amplisek” technology. All patients with congenital hypopituitarism, who are in a special registry of Saint Petersburg, were included in this study. A difference in the incidence of mutations in patients with multiple deficiency of adenohypophysis hormones (27.7%) and in patients with isolated growth hormone insufficiency (9.6%) was revealed. The mutation frequency of diagnosis in genes responsible for congenital hypopituitarism in patients of Saint Petersburg were studied. Mutations in genes associated with congenital hypopituitarism were identified in 16.3% of patients with pituitary dwarfism (16 of 98). The most commonly diagnosed mutations are changes in gene PROP1. In carrying out the molecular genetic studies of patients with congenital hypopituitarism is necessary to consider the likelihood of the presence of these rare pathologies such as loss of genes GHSR, ARNT2, BTK. Currently conducting molecular genetic studies in patients with congenital hypopituitarism further predicts development of the disease and, if necessary, adjust the ongoing replacement therapy.

To determine the factors that affect the effectiveness of gastroesophageal reflux disease therapy, a correlation analysis was performed that included the international GERD questionnaire, the hospital anxiety and depression score (HADS), and data on the polymorphism of cytochrome P450 2C19 in 136 patients with different variants gastroesophageal reflux disease (GERD): reflux esophagitis (RE), non-erosive reflux disease (NERD) and reflux hypersensitivity (RH). The presence of a strong negative relationship between the favorable outcome of PPI therapy and the GERD score was demonstrated after 4 weeks of therapy in the RE, NERD and RH groups (p < 0.001). When analyzing the relationship between the HADS scale and the effectiveness of therapy, a strong negative correlation was found only in the RE group (p < 0.001), the fact that the metabolic rate of the PPI moderately correlated with the favorable outcome of therapy in the RH and NERD groups (p < 0.05).

The present article revealed the results on evaluation of medical care quality in 430 patients with parodontologic diseases provided in 14 municipal and city dental policlinics in 2014-2016 under the compulsory health insurance (CHI) in Saint Petersburg. The performed analysis allows to compare the possibilities of therapeutic and diagnostic assistance to treat periodontitis, provided under CHI and regulated by the clinical recommendations developed by Russia Dental Association. Due to the developed clinical recommendations the quality dental care under CHI could be provided only on the initial and supportive treatment stages and considered to be therapeutic, thus the surgical treatment could not be fully provided. The types of medical services provided under CHI restrict the use of clinical recommendation (Russia Dental Association) to treat patients with periodontal diseases in dental policlinics and do not ensure the provision of entirely quality dental care under CHI. Therefore, the development of new criteria to include the full range of treatment and diagnostic dental services into the basic CHI is of high importance.

Acute appendicitis in children — the most common acute surgical disease of the abdominal cavity is found at any age. For children of the first 3 years of life, acute appendicitis is considered a rare disease and, according to various authors, occurs in 0.5-2% of cases. It is in young children that the diagnosis of acute appendicitis is complex and difficult, especially at the prehospital stage and therefore diagnostic errors are allowed.