Important problems in the diagnosis and treatment of primary sclerosing cholangitis (based on the Russian consensus on diagnosis and treatment autoimmune hepatitis. Moscow, 2018).

The article is published based on the results of the Russian Consensus on the diagnosis and treatment of primary sclerosing cholangitis (PSC), discussed at the 44th annual Scientific Session of the CNIIG "Personalized Medicine in the Era of Standards" (March 1, 2018). The aim of the review is to highlight the current issues of classification of diagnosis and treatment of patients with PSC, which causes the greatest interest of specialists. The urgency of the problem is determined by the multivariate nature of the clinical manifestations, by often asymptomatic flow, severe prognosis, complexity of diagnosis and insufficient study of PSC, the natural course of which in some cases can be considered as a function with many variables in terms of the nature and speed of progression with numerous possible clinical outcomes. In addition to progression to portal hypertension, cirrhosis and its complications, PSC can be accompanied by clinical manifestations of obstructive jaundice, bacterial cholangitis, cholangiocarcinoma and colorectal cancer. Magnetic resonance cholangiography is the main method of radial diagnostics of PSC, which allows to obtain an image of bile ducts in an un-invasive way. The use of liver biopsy is best justified when there is a suspicion of small-diameter PSC, autoimmune cross-syndrome PSC-AIG, IgG4-sclerosing cholangitis. Currently, a drug registered to treat primary sclerosing cholangitis which can significantly change the course and prognosis of the disease does not exist. There is no unified view on the effectiveness and usefulness of ursodeoxycholic acid and its dosage in PSC. Early diagnosis and determination of the phenotype of PSC is of clinical importance. It allows to determine the tactics of treatment, detection and prevention of complications.

[Cholecystitis as a complication of typhoid fever].

The problems of chronic infection, pertaining to typhoid fever, with main complication as an acute and chronic cholecystitis, were addressed. The main method of chronic cholecystitis treatment, pertaining to typhoid fever, is cholecystectomy with consequent speciphic treatment using various routes of the drug introduction.

[Experimental and clinical grounds for using 30% solution of ethyl alcohol for chemical denervation of the gastric acid-producing zone].

Experiments were performed in 18 male rats followed by a histological investigation of the obtained material. The application of the 30% solution of ethyl alcohol was proved to cause irreversible dystrophic alterations of nerve fibers in the gastric wall when injected subserously and there were no irreversible destructive alterations in other organ tissues. Results of treatment of 82 patients with perforated pyloro-duodenal ulcers after suturing the perforated opening in combination with chemical denervation of the gastric acid-producing zone with 30% solution of ethyl alcohol injected subserously were analyzed. Reliably decreased acid-proteolytic activity of the gastric body was found to result in stable remission and low percentage of recurrent diseases. The method can be recommended for wide practical use due to its simplicity and low percentage of recurrences of ulcer disease of the duodenum against the background of preserved helicobacteriosis of the stomach.

[Synthesis of eicosanoids in the colonic mucosa in patients with ulcerative colitis]. / Sintez éikozanoidov v slizistoi tolstoi kishki u bol'nykh iazvennym kolitom.

The synthesis of cyclooxygenase (CO) and lipoxygenase (LO) metabolites of arachidonic acids, such as prostaglandins (PG) E2, F2 alpha, 6-keto-P1 alpha, thromboxane B2 (TB2), leukotriene B4 (LTB4) and hydroxyeicosatetraenic acids (HETEA) in the biopsy specimens of the colonic mucosa (CM) was studied in vitro in 30 patients aged 17-66 years who had ulcerative colitis (UC) of various severity and extent. The biopsy specimens of CM from 10 patients with the irritable bowel syndrome were used for comparison. A proportional severity of the disease and increased synthesis of CO and LO metabolites in CM was ascertained in a phase of UC. In the early phase of clinical remission (on the average, following 4 weeks of therapy), there was a comparative reduction in the level of eicosanoids with the preserved high production of TB2 and LO derivatives (LTB4 and HETEA). At the same time, in patients with severe UC, a higher synthesis of LTB4 and HETEA and PG was preserved. The predominance of CM production of eicosanoids having aggregative, vasoconstrictor, and proinflammatory effects (less coefficients of 6-keto-PGF1 alpha/TB2 and PG/LTB4 + ETEA), which had been detected in a phase of UC exacerbation, was preserved in a phase of remission development, by forming the metabolic basis for recurrence of the process.

[Microhemodynamics and energy metabolism in schizophrenia patients]. / Sostoianie mikrogemodinamiki i énergeticheskogo obmena u bol'nykh shizofreniei.

An apparent disturbance was revealed in microhaemodynamics of patients diagnosed as having schizophrenia (n = 210) which was more pronounced in continuously progredient form of the above medical condition. An increase in conjunctival indexes, polymorphic character of capillaries, decrease in numbers of capillary loops were revealed by biomicroscopy of the bulbar conjunctiva and capillaroscopy respectively. The patients showed lowering of ATP level and rise in the content of cathodic LDG4-LDG5 fractions, accumulation in blood of lactic and pyruvic acids.

[The effect of endovascular laser therapy and antioxidants on the immune status and energy metabolism of patients with treatment-resistant forms of schizophrenia]. / Vliianie éndovaskuliarnoi lazeroterapii i antioksidantov na immunnyi status i énergeticheskii obmen u bol'nykh s resistentnymi k lecheniiu formami shizofrenii.

The influence of endovascular laser therapy and of antioxidants on clinical immunological indices and energy metabolism was analysed in 148 schizophrenic patients including 86 patients with shift-like progredient (first group) and 62 patients with continuous-progredient (second group) forms of the disease. Positive trends in psychosis course were observed in 57% of cases in the first group and in 41.9% of patients of the second group. Pronounced improvement of the immunological indices was observed in patients with positive clinical dynamics: decreased peripheral blood immunocytes sensitization to the brain, hepatic, thymus tissue antigens as well as ATP elevation which was evidence of the improvement of energy metabolism.

[Antioxidants in the treatment of schizophrenia (the correction of lipid peroxidation processes)]. / Antioksidanty v lechenii shizofrenii (korrektsiia protsessov perekisnogo okisleniia lipidov).

It was established in the course of 185 schizophrenic patients' examination that intensification of lipid peroxidation (LP) took place in relapses of the disease. It was manifested either in increase of blood serum levels of both malonic dialdehyde and diene conjugates, or in decrease of erythrocytes' resistance to LP mediated hemolysis. Alterations in indices of either spontaneous or induced chemoluminescence were revealed too. LP indices were lower by the end of the treatment in hospital, but remained significantly higher than normal values. Application of antioxidants in combined treatment of schizophrenic patients promoted decrease of LP activity as well as improvement in mental state of patients. LP activity was high in the remission too. Determination of LP indices may have prognostic importance.

[Ploidy level in Streptomyces cerevisiae strain 15B-P4 strain]. / Issledovanie urovnia ploidnosti shtamma 15B-P4 Saccharomyces cerevisiae.

Hybridization analysis of seven clones of Saccaromyces cerevisiae 15B-P4 strain, which were obtained from different cultures, was carried out. Yeast strains taken from the Peterhoff breeding stocks were kept in the laboratory of genetics at Biological Institute of Irkutsk University from 1970. Increase in the number of prototrophic segregants was shown to by the result of aneuploidy (2n + 1) in the hybrids under study. Aneuploidy was revealed for the chromosomes I, III, IX, XII. Disomic clones of 15B-P4 strain were unstable.

[Use of intravascular laser irradiation of blood in the treatment of drug-resistant forms of schizophrenia]. / Primenenie vnutrisosudistogo lazernogo oblucheniia krovi pri lechenii terapevticheski rezistentnykh form shizofrenii.

Overall 62 schizophrenic patients resistant to all forms of treatment were examined for the clinical efficacy of the treatment method on the basis of intravascular laser blood irradiation. A detailed description of the method, equipment, optimal doses, and the degree of effect in different psychopathological syndromes are provided. The best results were obtained in cases where the depressive paranoid symptomatology was predominant. The authors give recommendations for practical use of laser therapy under the conditions of the psychiatric hospital, discuss its action mechanism.

[Possibility of selective binding of HIV-1 infected cells by immunosorbents]. / Izuchenie vozmozhnosti selektivnogo sviazyvaniia infitsirovannykh VICh-1 kletok s pomoshch'iu immunosorbentov.

A study was made of a possibility of specific sorption of HIV-1 infected cells with gamma-fraction of AIDS patients' serum containing high titer-specific antibodies, immobilized on the silica matrix (C-3). The laboratory tests were made with the use of the monocyte culture [symbol: see text] chronically infected with HIV-1. In addition to a decrease of the cell count after sorption, there was a decline of the activity of antigen material in the samples (to 43% of the initial). The selectivity rates were 0.92 for immunosorbents and 0.29 for sorbents of the control group, that confirms and increase of the delay of the cells expressing HIV-1 proteins on a column with the immobilized gamma-fraction of AIDS patients' serum. The use of the synthesized immunosorbents in vivo may appear debatable. However, this method can be employed for preparative purposes.

[Immunosorption of individual HIV proteins and virions]. / Immunosorbtsiia individual'nykh bel'kov i virionov VICh.

Immunosorbents specifically binding native (gp160, gp120, gp41) and recombinant env proteins and HIV-I virions were synthesized on the basis of Sepharose 4B and Silica with immobilized ligands such as gamma-fraction of rabbit antiserum to HIV-I proteins and purified antibodies to env proteins of HIV-I. The possibility was shown of selective extraction of HIV-I virions and individual HIV proteins both in vitro and in vivo. The titer of virus antigens (in ELISA) after perfusion via an immunosorbent of patterns with a high content of virions and HIV-I proteins was 8 times as low as the starting titer (after perfusion via the control sorbent it was 2-fold decreased). Extracorporeal immunosorption in animals after intravenous injection of recombinant env protein permitted the latter's titer to be 5 times lower. After perfusion via the control sorbent the titer dropped by at least 20% as compared with the starting titer. The possibility of using immunosorption in multimodality therapy of AIDS is under discussion.

[Toxicogenetic effects of azo- and arylmethane dyes]. / Toksikogeneticheskie éffekty azo-i arilmetanovykh krasitelei.

The haploid strain 15B-II4 of Saccharomyces cerevisiae was used to study in an acute experiment the toxic and mutagenic effects of arylmethane dyes Victory Blue (C.I. 44040), Methyl Violet (C.I. 42535), Brilliant Green (C.I. 42040) and cancerogenic aminoazo dye Chrysoidine (C.I. 11270). High biological activity of all the dyes tested was found, based on such toxic effects as cell killing and growth inhibition. Also, it was shown that the dyes could increase the frequency of appearance of nuclear point mutations and cytoplasmic mutations of respiratory deficiency.