Analysis two types of K complexes on the human EEG based on classical continuous wavelet transform.

In our work, we compare EEG time-frequency features for two types of K-complexes detected in volunteers performing the monotonous psychomotor test with their eyes closed. Type I K-complexes preceded spontaneous awakenings, while after type II K-complexes, subjects continued to sleep at least for 10 s after. The total number of K-complexes in the group of 18 volunteers was 646, of which of which type I K-complexes was 150 and type II K-complexes was 496. Time-frequency analysis was performed using continuous wavelet transform. EEG wavelet spectral power was averaged upon several brain zones for each of the classical frequency ranges (slow wave, δ, θ, α, ß1, ß2, γ bands). The low-frequency oscillatory activity ( δ-band) preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere. Statistically significant differences were obtained by averaging over the left and right hemispheres, as well as projections of the motor area of the brain, p<0.05. The maximal differences between the types I and II of K-complexes were demonstrated in δ-, θ-bands in the occipital and posterior temporal regions. The high amplitude of the motor cortex projection response in ß2-band, [20;30] Hz, related to the sensory-motor modality of task in monotonous psychomotor test. The δ-oscillatory activity preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere may be due to the important role of the left hemisphere in spontaneous awakening from sleep during monotonous work, which is an interesting issue for future research.

[Assembly and Disassembly of the Nuclear Pore Complex: A View from the Structural Side].

Nucleocytoplasmic exchange in the cell occurs through the nuclear pore complexes (NPCs). NPCs are large multiprotein complexes with octagonal symmetry about their axis and imperfect mirror symmetry about a plane parallel with the nuclear envelop (NE). NPC fuses the inner and outer nuclear membranes and opens up a channel between nucleus and cytoplasm. NPC is built of nucleoporins. Each nucleoporin occurs in at least eight copies per NPC. Inside the NPC a permeability barrier forms by which NPCs can provide fast and selectable transport of molecules from one side of the nuclear membrane to the other. NPC architecture is based on hierarchical principle of organization. Nucleoporins are integrated into complexes that oligomerizes into bigger octomeric high-order structures. These structures are the main components of NPCs. In the first part of this work, the main attention is paid to NPC structure and nucleoporin properties. The second part is dedicated to mechanisms of NPC assembly and disassembly at different stages of the cell cycle.

[Measurement of benzodiazepine receptor agonists metabolites and their concentration in urine]. / Opredelenie metabolitov agonistov benzodiazepinovykh retseptorov i ustanovlenie ikh protsentnogo soderzhaniya v moche.

The study objective was to detect and measure the ratio of metabolites of benzodiazepine receptor agonists in urine during forensic chemical and chemical and toxicological studies, as well as to characterize the main metabolites to use them to confirm the oral intake of the test substances. Data on the presence of metabolites in the urine will allow us to reliably confirm the intake of zaleplon, zopiclone, clobazam, and phenazepam and determine the routes of administration (intake) into the body of the victim. Benzodiazepine derivatives (clobazam and phenazepam) and non-benzodiazepines (zaleplon and zopiclone) have different chemical structures and similar mechanisms of action resulting in a similar clinical presentation of side effects and the need for forensic chemical study according to poisoning symptoms. Metabolites of benzodiazepine receptor agonists and their ratio in urine after oral administration were measured: zaleplon (parent compound), deethylzaleplon, 5-oxozaleplon, 5-oxodeethylzaleplon, oxozaleplon glucuronide; zopiclone (parent compound), zopiclone-N-oxide, N-desmethylzopiclone; clobazam (parent compound), N-desmethylclobazam, 4-hydroxyclobazam, hydroxydesmethylclobazam; phenazepam (parent compound) and 3-hydroxyphenazepam. It is advisable to determine zaleplon in urine by the presence of 5-oxaleplon (97% of the total amount of metabolites), zopiclone by zopiclone-N-oxide (86% in urine), clobazam by the parent compound (61% in urine), phenazepam by the parent compound (90-100% in urine).

[Forensic chemical and chemicotoxicological examination of ricin poisoning by the HPLC-MS/MS method]. / Sudebno-khimicheskoe i khimiko-toksikologicheskoe issledovanie metodom VEZhKh-MS/MS pri otravlenii ritsinom.

THE AIM OF THE STUDY: Is to suggest the method of ricin determination in biological liquids during forensic medical and chemicotoxicological examination. This research describes the optimal conditions of sample processing of biological liquids, allowing to extract the components (ricinine and ricinoleic acid) of castor seeds. The recommended analysis conditions allow to perform research for 15 minutes by high resolution mass spectrometry method combined with high-value liquid chromatography on a chromato-mass spectrometer to detect ricinine and ricinoleic acid. The chromatographic (retention time) and mass-spectrometric parameters (mass spectra) were established for the exact high-quality determination of ricinine and ricinoleic acid.

[Venous thromboembolic complications in patients with chronic kidney disease: prevalence and features of drug treatment].

The article is an opinion on the problem of venous thromboembolic (VTE) complications in patients with chronic kidney disease (CKD), which is significant and urgent for Russia. Signs of CKD are noted in more than 1/3 of patients with chronic heart failure; a decrease in kidney function is observed in 36% of people over the age of 60, in people of working age, a decrease in function is noted in 16% of cases, and in the presence of cardiovascular diseases increases to 26%. Clinical research data convincingly show that CKD is an independent risk factor for the development of VTE complications. The last decade has given us the opportunity to observe a kind of "revolution" in VTE therapy, which is associated with the appearance on the market of direct oral anticoagulants, including inhibitors of factor IIa (thrombin) and factor Xa. These drugs are approved by the Food and Drug Administration for the treatment of acute thromboembolism. Nevertheless, patients with severe CKD (estimated glomerular filtration rate 30 ml/min) are still limited to the use of unfractionated heparin and vitamin K antagonists, as there is insufficient data to support the use of direct oral anticoagulants in this population.

[Higher efficacy of botulinum toxin therapy for hemifacial spasm recurrence after vascular decompression. Case report and literature review]. / Uvelichenie effektivnosti botulinoterapii pri vozvrate simptomov gemifatsial'nogo spazma posle vaskulyarnoi dekompressii. Klinicheskii sluchai i obzor literatury.

Hemifacial spasm (HFS) is an involuntary synchronous tonic and/or clonic contraction of mimic muscles following ipsilateral facial nerve dysfunction. The last one is a result of neurovascular conflict between the facial nerve and vessel. Currently, vascular decompression is a pathogenetic treatment modality for primary HFS. Various authors describe postoperative recurrence of HFS, and botulinum toxin therapy remains the only option for these patients. We aimed to describe the efficacy of botulinum toxin therapy in patients with HFS recurrence after surgical vascular decompression. The article presents a female patient with a long-term history of HFS and botulinum toxin therapy (with different formulations). Efficacy of therapy gradually decreased (progressive reduction of intervals between injections). MRI revealed a close relationship between posterior inferior cerebellar artery and roots of acoustic-facial nerves near the brainstem. The patient underwent vascular decompression of the left facial nerve root under intraoperative monitoring with positive postoperative outcome. However, HFS symptoms recurred in 3 days after surgery. Botulinum toxin type A (BTA) injections were resumed with significant positive effect that can be explained by reduction of one of the factors involved into HFS. Thus, patients with HFS recurrence after vascular decompression may benefit from BTA therapy.

[Potential for the use of cards for sampling and transportation of biological material during forensic chemical and toxicological examinations]. / Vozmozhnost' ispol'zovaniya kart dlya zabora i transportirovki biologicheskogo materiala pri sudebno-khimicheskom i khimiko-toksikologicheskom issledovaniyakh.

The objective of the study is to evaluate the potential for the use of cards for sampling and transportation of biological material during forensic chemical and toxicological examinations by the example of a biological sample, urine containing zopiclone. Two methods of sample preparation were compared. The use of cards for the collection and transportation of biological material, such as urine, followed by high-resolution high-performance liquid chromatography-mass spectrometry (HPLC-MS) for the identification of zopiclone metabolites was shown to be beneficial in forensic chemical and toxicological examination. The validation evaluation of the proposed sample preparation and identification method met the acceptance criteria.

[Analysis of the feasibility of a forensic chemical investigation in clobazam poisoning]. / Analiz vozmozhnosti provedeniya sudebno-khimicheskogo issledovaniya pri otravlenii klobazamom.

The study objective was to determine the relevance of methods to detect clobazam poisoning during the forensic and chemical toxicological examination. The lack of a systematic approach to clobazam identification and assay as a part of forensic chemical and chemical toxicological analyses was demonstrated. The published data on the study of clobazam in biological objects are inconsistent and incomplete, precluding the conduction of focused forensic chemical and toxicological investigations on biological objects with required validity. Various methods of forensic chemical and toxicological investigation of clobazam in biological objects were studied and presented. Data are presented on various physicochemical test methods (TLC, HPLC, UV spectrometry, GC, and GC-MS) for clobazam detection.

[The second stage of rehabilitation of post-infectious myelopathy after a new coronavirus infection]. / Vtoroi etap reabilitatsii postinfektsionnoi mielopatii posle perenesennoi novoi koronavirusnoi infektsii.

After suffering a new coronavirus infection (COVID-19), patients develop damage to various organs and systems, including the central nervous system. One of the rare and little-described complications is spinal cord injury. PURPOSE OF THE STUDY: Description of a clinical case of post-infectious myelopathy in a young patient after a new coronavirus infection. MATERIAL AND METHODS: Patient L., 28 years old, was admitted for rehabilitation treatment at the Regional Medical and Rehabilitation Center with a diagnosis of post-infectious myelopathy, acute period, lower central paraplegia. The patient underwent a comprehensive clinical and instrumental monitoring, including an assessment of the anamnesis, complaints, physical condition, and neurological status. The dynamics of the patient's condition was assessed using the rehabilitation routing scale, as well as the Rivermead mobility index, functional categories of walking, the Hauser walking index, the Berg balance scale, and the Frenchay hand test. RESULTS: After completion of the rehabilitation course, the patient showed positive dynamics in the form of an increase in exercise tolerance up to 40 minutes; increase in strength and volume of active movements in the lower extremities. Positive dynamics was revealed on all scales assessed. CONCLUSION: Due to the fact that the number of complications of COVID-19 is growing, it is necessary to inform doctors about the possibility of such a complication as myelopathy in order to timely diagnosis and effective treatment, which will reduce the incidence associated with spinal cord dysfunction.

[Determination of zaleplon and clobazam by high performance liquid chromatography - high resolution tandem mass spectrometry using Orbitrap technology]. / Opredelenie zaleplona i klobazama metodom vysokoeffektivnoi zhidkostnoi khromatografii ­ tandemnoi mass-spektrometrii s vysokim razresheniem s ispol'zovaniem tekhnologii Orbitrap.

THE AIM OF THE STUDY: Was to develop a method for the qualitative and quantitative determination of benzodiazepine receptor agonists (zaleplon and clobazam), taking into account different chemical structures, by high-performance liquid chromatography-high-resolution tandem mass spectrometry using Orbitrap technology for the purposes and tasks of forensic medical examination. A method has been developed for the identification and quantitative determination of zaleplon and clobazam by high-performance liquid chromatography-high-resolution tandem mass spectrometry using Orbitrap technology. The proposed identification method can be used in the future to form a database of domestic mass spectra for potent and narcotic substances.

[Efficacy of treatment of lower-limb critical ischaemia by methods of indirect revascularization]. / Éffektivnost' lecheniia kriticheskoi ishemii nizhnikh konechnostei metodami nepriamoi revaskuliarizatsii.

AIM: The study was aimed at comparing the efficacy of implantation of autologous bone marrow cells with that of revascularizing osteotrephination in treatment of lower limb chronic critical ischaemia in patients with a poor distal vascular bed. PATIENTS AND METHOD: We analysed the results of comprehensive examination and treatment of a total of 60 patients presenting with lower limb chronic critical ischaemia due to atherosclerotic lesions of the femoropopliteal-tibial segment. According to the technology of treatment, the patients were divided into two statistically homogenous groups of 30 people each. Group One patients underwent standard revascularizing osteotrephination and Group Two patients in accordance with the original technique received intramuscular implantation of 40 ml of autologous bone marrow cells, with this volume distributed in 2-ml injections to 20 points of the muscles of the crus and femur along the internal and external surface. RESULTS: The use of the original technique of treatment made it possible to achieve the clinical status in the form of moderate or minimal improvement 6 months after bone marrow cells implantation in 29 (96.7%) patients and after 12 months in 28 (93.3%) patients, whereas after revascularizing osteotrephination in 25 (83.3%) and 20 (66.7%) patients, respectively. In the remote period after 12 months, the limb was saved in 28 (93.3%) and 26 (86.7%) patients in Group Two and Group One, respectively. The patients of the second group as compared with those of the first group after 12 months demonstrated a statistically significant increase in the physical health component by 19.8% and the mental health component by 9.8%. CONCLUSION: Implantation of autologous bone-marrow cells in chronic critical limb ischaemia is pathogenetically substantiated and makes it possible to optimize the results of treatment of patients.

[The study of the pharmacokinetic parameters of ethanol 40% with carbonation for the purposes and objectives of forensic chemistry and forensic science]. / Izuchenie farmakokineticheskikh parametrov etanola 40% s gazatsiei dlya tselei i zadach sudebnoi khimii i sudebno-meditsinskoi ekspertizy.

The purpose of work is to study the characteristics of pharmacokinetic parameters of the influence of ethanol with carbonation («carbonated vodka¼) to the human body for the purposes and tasks of forensic chemical, chemical and toxicological and forensic research. The authors determined the concentration of ethanol in the blood and urine from oral intake of ethanol with and without carbonation. It was found that the suction stage of carbonated vodka is faster than that of vodka without carbonation by 17.1%, and the stage of elimination of ethanol with carbonation is faster on average by 16.6%.

[On the issue of the detection of pregabalin and lorazepam in the cases of their joint presence for the purpose of chemical toxicological studies]. / Izuchenie pregabalina i lorazepama pri sovmestnom prisutstvii dlia tselei khimiko-toksikologicheskogo issledovaniia.

Data on the detection of joint presence of pregabalin and lorazepam in the biological objects and material evidence. Aim of this study is to develop a method of the detection of pregabalin and lorazepam in urine. The proposed approach to sample preparation of a biological object and the detection of lorazepam and pregabalin allows the detection of toxicants in cases of their joint presence. It can be used in the analysis of urine in cases of acute poisoning for detoxification therapy or chemical toxicological analysis as a preliminary and confirmatory study for the presence of abuse of these drugs.

[The efficiency of functioning of regional vascular center in case of acute disorder of cerebral blood circulation].

The acute stroke is one of leading causes of mortality and disability both in Russia Federation and worldwide. The specialized vascular centers and units proved to be effective in improving diagnostics, treatment and functional outcome inpatients in various countries. The purpose of article is to evaluate efficacy of regional vascular center (RVC) in Tyumen. The functioning of RVC in 2011-2017 was assessed using purposefully developed and implemented score card of medical care quality assessment in vascular centers. The epidemiological data for 2007-2017 was obtained from statistical materials of the Department of Health of Tyumen oblast. The epidemiological parameters were calculated both in absolute units by simple summing up of cases of illness and in relative units per number of population. It was established that all diagnostic and treatment procedures in RVC were implemented according actual medical standards. The significant increase of the percentage of patients hospitalized during first three hours after the onset of stroke symptoms was established. The patients receiving thrombolytic therapy was observed, with an improvement of functional status of patients upon discharge. The significant improvement of early diagnosis of cerebrovascular diseases (CVD) in the service area of RVC was demonstrated. The development and implementation of the plan of a regional vascular center placement and stroke patient routing enabled optimization of medical care accessibility to this group of patients and increased identification of CVD.

[The study of fenspiride: goals and objectives for chemical and toxicological studies]. / Izuchenie fenspirida dlia tselei i zadach khimiko-toksikologicheskogo issledovaniia.

The purpose of this work is to study fenspiride for the purposes and tasks of chemical and toxicological research. The technique of chemical-toxicological study of fenspiride in urine by preliminary and confirming methods is proposed. The authors proposed a method of thin - layer chromatography in the solvent system of acetone - 25% ammonia solution (9:1) in a preliminary study of fenspiride. The Rf value of fenspiride is 0.80±0.02. The degree of extraction when used as an extractant mixture of chloroform-propanol (9:1) is 28.1±1.4% The conditions for identification of fenspiride by gas chromatography-mass spectrometry (fenspiride retention time 11.1±0.1 minutes), followed by quantitative determination of the analyte, are proposed as a confirming method. The conditions for qualitative (retention time of fenspiride 8.1±0.1 minutes) and quantitative determination of fenspiride by high-performance liquid chromatography are proposed.

Detection of a Disorder-Induced Bose-Einstein Condensate in a Quantum Spin Material at High Magnetic Fields.

The coupled spin-1 chains material NiCl_{2}-4SC(NH_{2})_{2} (DTN) doped with Br impurities is expected to be a perfect candidate for observing many-body localization at high magnetic field: the so-called "Bose glass," a zero-temperature bosonic fluid, compressible, gapless, incoherent, and short-range correlated. Using nuclear magnetic resonance, we critically address the stability of the Bose glass in doped DTN, and find that it hosts a novel disorder-induced ordered state of matter, where many-body physics leads to an unexpected resurgence of quantum coherence emerging from localized impurity states. An experimental phase diagram of this new "order-from-disorder" phase, established from nuclear magnetic resonance T_{1}^{-1} relaxation rate data in the 13±1% Br-doped DTN, is found to be in excellent agreement with the theoretical prediction from large-scale quantum Monte Carlo simulations.

[Role of TGFß1 and VEGF-А gene polymorphisms in development of chronic obliterating diseases of lower-limb arteries]. / Rol' polimorfizmov genov TGFß1 i VEGF-A v razvitii khronicheskikh obliteriruiushchikh zabolevanii arterii nizhnikh konechnostei.

The study was aimed at investigating the interrelationship of gene polymorphisms of transforming growth factor (TGFß1) and endothelial vascular growth factor (VEGF-A) with the risk for the development of chronic obliterating diseases of lower-limb arteries (CODLLA) in the Russian population of Central Russia. We studied polymorphism C-509T of the TGFß1 gene and polymorphism +936C>T of the VEGF-A gene in 202 patients with CODLLA and in 148 apparently healthy individuals. Genomic DNA was isolated by the standard method of phenol-chloroform extraction. These polymorphisms were genotyped by means of polymerase chain reaction followed by analysing restriction fragments length polymorphism. Patients with CODLLA were found to have a decrease of frequency of homozygous genotypes of transforming growth factor ß1 for the wild-type alleles: -509CC (p=0.02) and an increase of frequency of homozygotes for the variant allele: -509TT (p=0.00004), which was indicative of an abrupt increase in secretion of transforming growth factor. We revealed no deviation of associations of the examined polymorphisms by the significant homozygous carrier state for the normal allele +936CC of endothelial growth factor gene as compared with the healthy cohort. A conclusion was made that a proatherogenic risk factor for CODLLA is an increase of TGFß1 secretion, with no genetically-determined prerequisites of the effect of VEGF-A gene polymorphism on the development of the disease revealed.

[Public healthcare responsibilities of ophthalmologists according to professional regulations]. / Funktsii vracha po organizatsii oftal'mologicheskoi pomoshchi v sootvetstvii s polozheniiami professional'nogo standarta.

Modern public healthcare practices are constantly being improved by the medical community, which involves approval and implementation of professional standards such as including public health activities in the responsibilities of medical specialists. To understand how well such skills can be mastered by the specialists, we have conducted a comparative analysis of ophthalmologist qualifications found in the most often used guidelines and textbooks. With logical, analytical and hypothetical analysis, books and guides published before 2018 were found to have insufficient coverage of the public health responsibilities. Improvement of the public healthcare in terms of professional standards is an important course of development for the medical field. The continued work on Russian Federal State Educational Standard (Higher Education) for Ophthalmology - index number 31.08.59 - should include actualization of educational materials with modern public health notions, development of a universal learning evaluation database for specialist accreditation, as well as evaluation tools for the obtainment and confirmation of their qualification. The professional standards for ophthalmologists should fully account for the job responsibilities they acquire. Training of ophthalmologists in the public healthcare should utilize the following textbooks published in 2018: 'Organization of medical aid in the Russian Federation' under the editorship of V.A. Reshetnikova, 'Healthcare and public health' under the editorship of G.N. Tsarik, and 'Public health and healthcare' by V.A. Medic.

[Facial nerve injury in neurosurgery: a rehabilitation potential of botulinum therapy]. / Porazhenie litsevogo nerva pri neirokhirurgicheskikh operatsiiakh: reabilitatsionnyi potentsial botulinoterapii.

Surgical treatment of posterior cranial fossa and cerebellopontine angle tumors is associated with a risk of facial nerve dysfunction. The causes for facial muscle paresis include nerve compression by the tumor, destruction of the nerve structure by the tumor growing from nerve fibers, nerve injury during surgical removal of the tumor, etc. The first 3 months after facial nerve injury are a potential therapeutic window for the use of botulinum toxin type A (BTA). During this period, the drug is introduced both in the healthy side to improve the facial symmetry at rest and during mimetic movements and in the affected side to induce drug-induced ptosis. Post-paralytic syndrome develops 4-6 months after facial nerve injury. At this stage, administration of BTA is also an effective procedure; in this case, drug injections are performed on the affected side at small doses and symmetrically on the healthy side at doses doubling those for the affected side. BTA injections are mandatory in complex treatment of facial muscle paralysis.

[The efficacy of botulinum therapy in treatment of delayed facial palsy after resection of vestibular schwannoma]. / Éffektivnost' botulinoterapii v lechenii otsrochennoi neiropatii litsevogo nerva posle udaleniia nevrinomy slukhovogo nerva.

Delayed facial palsy is a complication developing 3 or more days after surgery. The etiology and pathogenesis of this condition has not been fully explored, and there are no treatment standards for it. As in the case of Bell's paralysis, glucocorticosteroids (GCSs) are currently used to treat delayed facial palsy. However, patients with contraindications to GCSs need new therapy modalities. AIM: We aimed to evaluate the efficacy and safety of botulinum therapy in patients with delayed facial palsy after neurosurgical interventions. MATERIAL AND METHODS: We examined 33 patients with delayed facial palsy developed 3 or more days after resection of vestibular schwannoma. The main group included 18 patients with contraindications to GCSs who received injections of botulinum toxin A (BTA) into the facial muscles of the healthy side for muscle relaxation. The comparison group consisted of 15 patients who received a course of prednisolone (1 mg/kg/day) for 5-7 days. The efficacy of treatment was assessed using the House-Brackmann scale and Clinical Global Impression Scale. The follow-up period after therapy was 3 months. RESULTS: Delayed facial palsy was more common in the following cases: the facial nerve was located near the antero-inferior tumor pole; the tumor was adherent to the facial nerve; the tumor extended in the oral direction; the tumor had with unclear borders and was 11 to 30 mm in size. In most patients of both groups, facial muscle palsy developed more than 11 days after surgery. Treatment both in the main and control groups resulted in a significant improvement: complete regression of the facial asymmetry in patients of the main group and comparison groups 3 months after treatment onset was 83.3 and 93.3% (House-Brackmann scale), respectively. CONCLUSION: Botulinum therapy may be recommended for patients with delayed facial palsy developed after vestibular schwannoma resection, who have contraindications to GCSs.