Prediction of early recurrencies of uterine body cancer based on monitoring of serum biological markers.

The aim of this work was to optimize the prognosis of early recurrences of uterine cancer by searching for informative laboratory biomarkers. The study included 343 patients with I-IV stages FIGO endometrial adenocarcinoma the ages of 53 and 76 years. In patients before surgery, as well as 3 and 6 months after the end of primary treatment, the concentration of oncological markers CA-125, HE4, DJ-1, DKK-1 was determined in blood serum by ELISA and electrochemiluminescence immunoassay. We analyzed the predictive informativeness of monitoring markers to assess the risk of early recurrences of cancer within two years after surgery. In patients with uterine cancer with the stage of the disease and the degree of tumor differentiation in the blood serum, the concentration of DJ-1 is changed. With myometrial invasion of more than 50%, increased serum levels of three markers - CA-125, HE4, and DJ-1. Depending on the risk of disease recurrence, the assessment of which was determined by intraoperative and histological characteristics, a difference was revealed in the content of HE4 and DJ-1 markers in the blood. It was found that the risk of early recurrence of uterine cancer increased (p<0,05) when the concentration of CA-125 exceeded the level of 29,3 U/ml, HE4 was above 79,3 pmol/l, DJ-1 was above 90,0 ng/ml and DKK-1 above 47,3 pg/ml 6 months after the end of primary treatment. The highest predictive information value was found for monitoring DJ-1 and HE4 in blood serum, which indicates that they are promising for use in continuous monitoring of the course of cancer.

[Strictureplasty or resection? Optimal approach for fibrostenotic Crohn's disease]. / Strikturoplastika ili rezektsiya? Optimal'naya taktika pri fibrostenoticheskoi forme bolezni Krona.

The indications for surgical intervention in patients with Crohn's disease (CD) are ineffective therapy and complications of this disease. In case of fibrostenotic CD, strictureplasty or bowel resection are indicated. The indications for organ-sparing surgeries are multiple small bowel lesions, previous surgery for CD and short bowel syndrome. Strictureplasty is not advisable in patients with fistulas, abscesses, bowel perforation and severe hypoalbuminemia due to extremely high risk of anastomotic leakage. Therefore, bowel resection is recommended if strict indications for various types of strictureplasty are absent. This approach is associated with effective maintenance of remission and longer recurrence-free period.

Laboratory control of the osteoresorptive effects of glucorcorticoids in patients with purpose colitis.

The aim of the work was to develop an informative method for laboratory monitoring of osteoresorbent action during systemic administration of glucocorticoids in patients with ulcerative colitis. The study included 54 patients with ulcerative colitis aged 18 to 44 years: 35 (64,8%) men and 19 (35,2%) women. In patients of the clinical group before and after the first, second, third courses of glucocorticosteroids, as well as during the formation of steroid dependence, the concentration of the osteoresorption marker cathepsin K was determined simultaneously in the blood serum and gingival fluid by enzyme immunoassay. The concentration of the osteomarker was compared with the parameters of the densitometric density of the lumbar vertebrae L1-L4 during X-ray examination. It was found that with the systemic use of glucocorticoids in patients with ulcerative colitis, the concentration of cathepsin K in the gingival fluid increased earlier than in the blood serum. It was found that with an increase in the concentration of cathepsin K in the gingival fluid of more than 2,6 pmol/l in conditions of systemic administration of glucocorticosteroids, the risk of osteoporosis increased with a diagnostic sensitivity of 81,8% and a specificity of 74,4% (p=0,0001).The diagnostic accuracy was 78,1%. With an increase in the concentration of cathepsin K in the gingival fluid above the differential separation level (2,6 pmol/l), the risk of developing osteoporosis increased 3,2 times (p= 0,0001). The study developed a methodological and informational algorithm has been developed for the non-invasive control of steroidal osteoporosis in patients with ulcerative colitis with systemic use of glucocorticoids by assessing the concentration of cathepsin K in the gingival fluid.

[Differential bioinformational model for diagnostics of inflammatory and tumor diseases of the parotid salivary gland]. / Differentsial'naya bioinformatsionnaya model' diagnostiki vospalitel'nykh i opukholevykh zabolevanii okoloushnoi slyunnoi zhelezy.

THE AIM: Of the work was to develop a diagnostic algorithm for the differentiation of chronic inflammatory, benign and malignant processes in the parotid salivary gland (PSG) by the ratio of pro- and anti-inflammatory cytokines in the oral fluid. MATERIALS AND METHODS: The epidemiological group of patients with cancer of the parotid salivary gland included 140 people from the oncological register of the Rostov region with the date of diagnosis, from 1969 to 2020. The clinical part of the work was performed on 70 patients of both sexes aged 50 to 80 years: 15 patients with chronic nonspecific parenchymal sialadenitis of the PSG (ICD K11.2) (group 1), 19 patients with pleomorphic adenoma of the PSG (ICD D11.0) (2 group), 20 patients with cancer of the PSG (ICD C07) (group 3) and 16 healthy individuals without pathology of the oral cavity (control group). The concentration of interleukin-6 (IL-6) and interleukin-10 (IL-10) was determined in the oral fluid by enzyme immunoassay. RESULTS: It was found that in 58.5% of cases at the initial examination of patients with PSG cancer referred to a tertiary care hospital an erroneous opinion was formed about the inflammatory origin of the process. In inflammatory and tumor lesions of the PSG multidirectional differences are noted in the ratio between the concentrations of pro- and anti-inflammatory mediators in the oral fluid. In chronic sialadenitis of PSG in the oral fluid a moderate increase in the levels of IL-6 and IL-10 occurs, in the presence of adenoma of PSG, the concentration of IL-6 does not change while IL-10 increases threefold, and there is a sharp and unidirectional increase in the concentration of cytokines of the opposite groups in case of a malignant lesion of PSG. CONCLUSION: Comparison of the concentration of IL-6 and IL-10 in saliva and their ratio defined by the developed discriminant models helps to make an individual diagnostic decision in a specific clinical situation.

[Osteoimmunological aspects of periodontal inflammatory destructive changes at periimplantitis, chronic periodontitis and oncological diseases of the oral cavity]. / Osobennosti osteoimmunologicheskikh aspektov osteorezorbtsii pri periimplantite, khronicheskom parodontite i rake al'veolyarnogo otrostka i al'veolyarnoi chasti chelyustei.

THE AIM OF THE STUDY: Was to analyze possible correlation between the concentration of the pro-inflammatory cytokine interleukin-6 and the activation marker of osteoclasts cathepsin K in the gingival fluid during osteoresorption of inflammatory (periimplantitis, chronic generalized periodontitis) and malignant oncological origin (malignant neoplasm of gums). MATERIALS AND METHODS: The study comprised 87 individuals of both sexes aged 30 to 60: 20 patients (group 1) with periimplantitis, 30 people with chronic generalized periodontitis (CGP) (group 2), 22 patients with squamous cell carcinoma of the upper and lower alveolar bone gingiva (group 3), 15 healthy individuals without periodontal disease. RESULTS: The concentration of interleukin-6 (IL-6) and cathepsin K was determined in the gingival fluid by enzyme-linked immunosorbent assay. The examination revealed that during CGP and peri-implantitis the accumulation of IL-6 in the contents of periodontal and peri-implantation pockets was a pathogenetic factor for the activation of osteoclasts and their secretion of proteolytic enzymes osteoresorption. In cancer the increase of cathepsin K expression was a lot higher than the accumulation of IL-6 in the gingival fluid reducing the dependence of the activation of osteoclasts on the local accumulation of pro-inflammatory cytokines. Conclusion. To formulate the prognosis of progressive bone loss in patients with peri-implantitis it is necessary to control the concentration of IL-6 and cathepsin K in the peri-implantation pocket, in case of CGP the concentration of IL-6 in the exudate of the periodontal pocket and in patients with cancer of the alveolar processes the content of cathepsin K of gingival fluid.

[Hypoxia-dependent transcriptional control of activity of destructive inflammatory and malignant periodontium changes]. / Gipoksiya-zavisimyi transkriptsionnyi kontrol' aktivnosti destruktivnykh izmenenii parodonta vospalitel'nogo i zlokachestvennogo geneza.

The aim of the study was to evaluate the diagnostic value of determining the level of hypoxia-inducible factor-1α (HIF-1α) in the gingival fluid in patients with chronic generalized periodontitis (CGP) and exacerbation of inflammatory periodontal diseases in patients with cancer of the oral mucosa (OM). A clinical study was carried out with the participation of 60 patients with CGP (group 1) and 22 patients with cancer of OM (group 2) of the T1-2N0M0 stage, as well as 15 healthy individuals with no revealed periodontal pathology. CGP patients, depending on the depth of periodontal pockets (PC), were divided into two subgroups - with a mild degree (PC depth up to 3.5 mm) and an average degree (PC depth from 4 to 6 mm). Group 2 patients were also divided into two subgroups - with exacerbation of CGP (n=12) and patients with no complications (n=10). The content of HIF-1α in the gingival fluid was determined by enzyme immunoassay. The results of the study made it possible to establish that in patients of group 1, the concentration of HIF-1α in inflammatory exudate increased by 2.4 times (p<0.001) compared with the control group. The concentration of HIF-1α in the contents of periodontal pockets in patients with CGP depended on the severity of the disease: with mild CGP, it did not differ from the control group, and with moderate CGP it was 3.15 times higher (p<0.001). In patients with cancer of OM, the concentration of HIF-1α in the gingival fluid did not depend on the presence of inflammatory periodontal lesions and was determined by a multiple increase in the biomarker level (7.5 times) due to the development of a malignant process in the oral cavity. Therefore, monitoring the concentration of HIF-1α in the gingival fluid is informative in patients with CGP in assessing the severity of periodontal conditions, as well as in differential diagnosis with malignant formations of the oral cavity.

Dynamics of the development of microvascular reactions in the projection zones of the somatosensory cortex of the brain in rats.

The aim of the present work was to study the nature of local vascular reactions in the whisker projection zones of the somatosensory cortex of the rat brain in conditions of changes in sensory stimulation parameters. Studies were performed on Wistar rats anesthetized with ketamine. Local blood flow, neuron activity, and PO2 were recorded simultaneously in the cortical projection zones during mechanical stimulation of the whiskers. Local development of functional hyperemia was demonstrated in neuronal modules in conditions of threshold stimulation of the corresponding whisker. Increases in the intensity and frequency of stimulation of the whiskers were accompanied by decreases in the latent period and increases in the amplitude of regulatory microvascular reactions and a transformation in the configuration of functional hyperemia from a one-component pattern to a two-component pattern. The first component in the mechanism of development appeared to be associated with the action of factors of extravasal (including neuroglial) origin, while the second component appeared to be endothelium-dependent, as it did not occur in conditions of chemical deendothelialization.

[Dynamics of the microvessel responses in the projection areas of the rat somatosensory cortex]. / Dinamika razvitiia mikrososudistykh reaktsii v proektsionnykh zonakh somatosensornoi kory mozga u krys.

A mosaic distribution of local cerebral blood flow was found in the rat border cells of the somatosensory brain cortes, as well as development of local functional hyperemia during whisker stimulation. The more intensive the stimulation the shorter were latency and amplitude of the hyperemia. The early phase of the hyperemia seems to be associated with neuronal factors, whereas the late component depended on the endothelium.