卷 12, 编号 2 (2020)

In present medical practice adaptogens and antihypoxants are a promising, but still insufficiently studied group of medicines. The largest evidence base among plant adaptogens was developed for ginseng, aralia, eleutherococcus, lemongrass, rhodiola, leuzea, sterculia. Antihypoxants, like trimetazidine, meldonium, succinic and γ-aminobutyric acid medications are included in the clinical guidelines. They have the most pronounced antihypoxic effects in a variety of diseases and pathological conditions, accompanied by impaired energy metabolism in the tissues. But their effect is not always high due to the variety of etiological factors causing hypoxia.

Tetrahydropyrido[2,1-b][1,3,5]thiadiazine derivatives characterized by various pharmacodynamic effects with low toxicity which opens up prospects for a detailed further study. In animal experiments, the most pronounced adaptogenic and antidepressant effects is exerted by compounds TD-0348 and TD-0479, superior in strength to the antihypoxants used in modern clinical practice, the classic plant adaptogen ginseng.

Relevance. The article analyze the results of changes in the diuretic and natriuretic response to standard hypervolemic load and the injection of a diuretic in patients with chronic heart failure with preserved and reduced left ventricular ejection fraction.

Purpose. Evaluation of changes in the natriuretic response to hypervolemia and diuretic injection in patients with chronic heart failure.

Materials and methods. 25 men with chronic heart failure were examined; the average age was 68 y. o. (67; 73). Of these, 13 patients with chronic heart failure and a left ventricular ejection fraction (LVEF) of less than 50 % entered the first studied group and 12 patients with chronic heart failure with preserved LVEF (more than 50%), who entered the second studied group. In all the patients, hypervolemia was induced by Ringer’s solution, followed by the injection of furosemide and the registration of diuresis and natriuresis.

Results. When analyzing natriuresis in the studied patients, it was found that at the same concentration of serum sodium, there is a multidirectional reaction to the excretion of sodium in the urine in both groups. At the same time, the rates of diuresis in both groups did not differ significantly.

Conclusion. Thus, with chronic heart failure and reduced LVF less than 50% patients had a lower natriuresis compared to those studied with preserved LVF. In the patients with chronic heart failure fluid overload on the mixed response it is noted that if the urine sodium level is at the lower limit of normal in patients with reduced LVF less than 50%, then, against the background of stimulation of diuresis, sodium begins to be excreted more intensively. In the patients with chronic heart failure with preserved LVF, the urine sodium level is at the upper limit of the norm and when furosemide is stimulated, there is a decrease in its excretion.

The purpose of the investigation was to study the nootropic effects of rhythmic transcranial magnetic stimulation (rTMS) using low-intensity magnetic field with the induction rate of 45 mT, base frequency of 50 Hz, modulation frequency of 10 Hz in combination with standard medical and psychological therapy in the rehabilitation of patients with post-stroke cognitive impairment (PSCI).

Materials and methods. The rehabilitation outcomes in 98 patients with PSCI syndrome were studied. The patients were subdivided into 2 groups: 53 patients of the control group were treated with the standard nootropic medications and neuropsychological procedures; 45 patients of the main group were additionally treated with rTMS by the low-intensive running pulsed magnetic field of 10 Hz modulation frequency. The dynamics of the score increase according to Rivermid, Karnovsky, Roshina, MMSE, mRS, HDRS, SF-36 scales were analyzed.

Conclusion. Application of rTMS with low-intensive running pulsed magnetic field of 10 Hz modulation frequency in combination with a standard program of cognitive rehabilitation contributes to a significant improvement in the recovery of mental calculation function in ischemic stroke patients, as well as normalization in mood swings in the patients who had suffered a hemorrhagic stroke and post-stroke depression. This variant of rTMS can be safely used in patients with PSCI syndrome in the early recovery period, 3 weeks after the onset of stroke.

The article studies the correlation of the content of peripheral blood and red bone marrow eosinophils with the level of secretion of fibroblast growth factor (FGF-21), insulin-like factor (IGF-1) and vasculoendothelial growth factor (VEGF-C) in blood serum during the formation of dermal collagen after local cold damage. Animals of the experimental group after the onset of narcotic sleep on the depilated skin of the back were simulated contact frostbite of the 3^rd degree. On the 3^rd, 7^th, 14^th and 21^st day of the experiment, the concentrations of growth factors, % dermal collagen content, and also the content of eosinophils in peripheral blood and red bone marrow were determined in the blood serum. The research results showed that the development of eosinopenia after a local cold injury occurs due to the sequestration of eosinophils in the affected area. The presence of reactive changes after a local cold injury not only in peripheral blood, but also in the red bone marrow may indicate the participation of eosinophils in tissue repair processes after a local cold injury.

阑尾黏液囊肿是指由于阑尾膨胀，积聚大量粘液。黏液囊肿的机制和原因尚不完全清楚。
根据一些作者的观点，阑尾的这种变化可能是由于阑尾腔的瘢痕，压迫或堵塞。其他作者认为阑尾黏液囊肿是由原始间叶细胞残余发展而来的良性肿瘤，有时容易发生恶性肿瘤。阑尾黏液囊肿的临床表现是非特异性的。在一些患者中，这种疾病导致间歇性的腹部右侧疼痛，通常为牵拉性疼痛。然而，这种疾病通常是无症状的。在这方面，诊断只能在手术中确定，最常用于急性阑
尾炎。然而，这些仪器诊断方法，如超声和计算机断层扫描腹部和盆腔器官，可以让怀疑黏液囊肿。
尽管阑尾黏液囊肿常无症状，但可引起危及生命的并发症。最危险的并发症是阑尾黏液囊肿
破裂，并黏液进入游离腹腔，然后由于黏液形成细胞着床而发展为腹膜假粘液瘤。根治阑尾黏液囊肿的唯一方法是手术。本研究提出了一个阑尾黏液囊肿的临床病例，报告诊断的困难，以及手术治疗的特点。