[Preventability of perinatal losses by the example of the large industrial cities Chelyabinsk and Novosibirsk]. / Predotvratimost' perinatal'nykh poter' v Cheliabinske i Novosibirske.

Perinatal mortality rate is an indicator that characterizes the quality of medical care, as well as the social and economic situation in the region. OBJECTIVE: to audit perinatal losses in large regional centers of the Russian Federation with a population of over 1 million inhabitants, such as Chelyabinsk and Novosibirsk. MATERIAL AND METHODS: A comprehensive postmortem examination of 309 cases of perinatal losses in 2016 was made, which was supplemented with an assessment of preventability according to the Scandinavian-Baltic classification. RESULTS: The rate of preventable deaths in Chelyabinsk and Novosibirsk amounted to 91 and 81.5% of cases, respectively; the deaths were due to stillbirths at more than 28 weeks' gestation and to dead newborns in almost half of cases. The proportion of intranatal deaths was shown to increase in Chelyabinsk; the number of neonatal deaths at more than 33 weeks' gestation rose in Novosibirsk. CONCLUSION: Supplementing the traditional clinical and postmortem analysis with an assessment of the preventability of perinatal loss makes it possible to ensure a unified approach to evaluating these conditions and the comparability of autopsy results in different subjects of the Russian Federation and to determine regional reserves for reducing perinatal mortality rates.

Molecular profiling reveals primary mesothelioma cell lines recapitulate human disease.

Malignant mesothelioma (MM) is an aggressive, fatal tumor strongly associated with asbestos exposure. There is an urgent need to improve MM patient outcomes and this requires functionally validated pre-clinical models. Mesothelioma-derived cell lines provide an essential and relatively robust tool and remain among the most widely used systems for candidate drug evaluation. Although a number of cell lines are commercially available, a detailed comparison of these commercial lines with freshly derived primary tumor cells to validate their suitability as pre-clinical models is lacking. To address this, patient-derived primary mesothelioma cell lines were established and characterized using complementary multidisciplinary approaches and bioinformatic analysis. Clinical markers of mesothelioma, transcriptional and metabolic profiles, as well as the status of p53 and the tumor suppressor genes CDKN2A and NF2, were examined in primary cell lines and in two widely used commercial lines. Expression of MM-associated markers, as well as the status of CDKN2A, NF2, the 'gatekeeper' in MM development, and their products demonstrated that primary cell lines are more representative of the tumor close to its native state and show a degree of molecular diversity, thus capturing the disease heterogeneity in a patient cohort. Molecular profiling revealed a significantly different transcriptome and marked metabolic shift towards a greater glycolytic phenotype in commercial compared with primary cell lines. Our results highlight that multiple, appropriately characterised, patient-derived tumor cell lines are required to enable concurrent evaluation of molecular profiles versus drug response. Furthermore, application of this approach to other difficult-to-treat tumors would generate improved cellular models for pre-clinical evaluation of novel targeted therapies.

[The dynamics of biochemical blood indicators in patients with hemophilia and posttransfusion hepatitis receiving hepatotropic therapy].

The sample of 128 patients with hemophilia aged from 1 to 71 years (Me 32) was examined. The study established that 109 patients (85.2%) had hemophilia A and 19 patients (14.8%) had hemophilia B. In 77 adult patients (60%) markers of viruses of hepatitis C and B were detected and the signs of disorders of liver functions were established in 64% out of them. These signs included reliable increasing of levels of AST and ALT, total and conjugated bilirubin, urea and creatinine and absence of any clinical manifestations. The detected alterations served as a background for implementation of hepatotropic therapy with pharmaceutical Heptral. The ademetionin is the reactant of preparation. After two weeks of intravenous application of Heptal the tendency to normalization of content of bilirubin was established. The significant decrease of activity of aminotransferases was detected, nevertheless their levels still overridden physiological standard. This situation required to prescribe pharmaceutical and to continue treatment in out-patient conditions. The continuous repair of functional activity of hepatic cells requires further search of more effective schemes of therapy.

[A combination of dipeptidyl peptidase-4 inhibitor and metformin in the treatment of patients with type 2 diabetes mellitus: effective control of glycemia, weight, and quantitative body composition].

AIM: To study the impact of intensified therapy with the dipeptidyl peptidase-4 (DPP-4) inhibitor vilagliptin or sulfonylurea (SU) on the control of glycemia, weight, and quantitative body composition in patients with type 2 diabetes mellitus (DM-2) who have failed to achieve compensation during metformin monotherapy. SUBJECTS AND METHODS: Forty patients (mean age 55.0 (range 53.0-60.7) years; disease duration 2.0 (range 1.1-5.0) years) with poor glycemic control (7%

[The IgG subclasses in patients with inhibitory form of hemophilia infected and noninfected with viruses].

The sample consisted of 102 patients with hemophilia infected and non-infected with hepatitis viruses. It is established that in case of inhibitory form of hemophilia concentration of IgG increases at the expense of subclass II and in case of non-inhibitory form of hemophilia valuable increase of concentration of IgG occurs at the expense of subclasses I, II and III under concomitant chronic hepatitis. No significant differences between these groups in levels of antibodies to factors VIII and IX is established.

[Assessment of the predisposing risk factors of the complicated postoperative course after combined operations].

Results of 335 combined operations were analyzed. Men were 89 (27%), women - 246 (73%), the majority of patients were of middle age. 285 (85%) operations included cholecystectomy. 195 (58%) patients had hernioplasty. The third place belonged to vascular operations - 76 (23%). Certain predisposing factors, correlating with the risk of the complicated postoperative course, were marked out. Indications and contraindications to the combined operation were assigned, based on the number of predisposing factors in a patient. Considering the increased risk of intraoperative complications during the combined operation (increased duration, blood loss), participation of highly experienced surgeons and use of modern high-tech equipment seem to be reasonable. The general results of the analysis prove that combined operations are effective, safe and economically beneficial.

[Senescence and apoptosis of protoplasts from flax fibers: an ultrastructural analysis].

Plant fibers represent specialized cells that perform a mechanical function. Their development includes the following phases, typical for the most plant cells: anlage, extension growth, specialization, senescence, and apoptosis. Ultrastructural analysis of these cells has been carried out at the late phases of their development (senescence and apoptosis) using flax phloem fibers, a classical object for the analysis of sclerenchyma fiber formation. The results of the performed analysis show that flax fiber protoplasts remain viable until the end ofa vegetation season. The ultrastructural analysis of flax phloem fibers has not revealed any typical apoptosis manifestations. Gradual degradation of the cytoplasm starts during the active thickening of a secondary cell wall and manifests via the intensification of autolytic processes, causing a partial loss of cell content. The final stage represents the breaking of tonoplast integrity. The obtained data allow us to suppose that the apoptosis of flax fibers occurs during their senescence, and its program is similar to the cell death program realized in the xylem fibers of woody plants.

[The nosological structure of mortality of low-weight fetuses in Novosibirsk].

The nosological structure of mortality was studied among low-weight fetuses, by analyzing 667 autopsy protocols over 2006-2008. There were 255 cases of spontaneous miscarriage and 412 cases of medically indicated abortion. Spontaneous and artificial abortions most frequently occur in repeated pregnant women at 26-27 weeks gestational age. In the nosological structure of fetal mortality, intrauterine fetal asphyxia was most commonly in spontaneous miscarriage; intrauterine pneumonias and generalized infection ranked second; in artificial abortion, the number of congenital malformations doubled and that of intrauterine fetal asphyxia reduced. In spontaneous and artificial abortions, the incidence of decompensated chronic placental insufficiency increased by twice.

[The nosological structure of congenital fetal malformations in Novosibirsk].

The authors comparatively studied the nosological structure of congenital malformations (CM) in 395 fetuses at 22-27 weeks post-conception age and the efficiency of prenatal diagnosis in Novosibirsk. They analyzed 227 and 168 autopsy protocols of fetuses with CM over the periods from 2000 to 2002 and from 2006 to 2008, respectively. In the nosological structure of mortality among low-weight fetuses, CM ranked third in 2000-2002 and second in 2006-2008. During all the observation periods, the structure of CM showed 4 major systemic CMs: multiple anomalies of development, the central nervous and urogenital systems, heart, and vessels; multiple CMs occupying a prominent place. There was a preponderance of hydrocephalus and spinal hernias among central nervous system CMs, that of hydronephrosis with megaureter among urogenital CMs, and that of ventricular septal defect among CMs of the heart and vessels. The efficiency of prenatal diagnosis in the above observation periods was 46-75%.

Evaluation of the efficiency and safety of anaferon (pediatric formulation) in the treatment of chickenpox in children.

Addition of anaferon (pediatric formulation) to the therapy of chickenpox patients led to more rapid disappearance of the main symptoms and alleviated the course of the disease. The safety of the preparation is confirmed by the absence of undesirable events and stability of laboratory indexes against the background of therapy.

Granulomatous inflammation in the lungs of mice with systemic candidiasis receiving a composition of amphotericin B and dialdehyde dextran.

A composition of amphotericin B and dialdehyde dextran was used for the therapy of male C57Bl/6 mice with systemic candidiasis. The composition was more effective than free amphotericin B. A decrease in the number and size of candidal granulomas in the lungs was more significant after therapy with the study composition (compared to free amphotericin B).

[Biogenesis of plant fibers].

The fiber (in terms of plant biology) is an individual cells characterized by spindle shape, length of up to several centimeters, well developed cell wall, and mechanical function. The review summarizes different, sometimes contradictory view points about duration, segregation and mechanisms of realization of individual stages of fiber biogenesis. Initiation and coordinated and intrusive growth are considered, as well as formation of secondary cell wall, including its gelatinous layers, and senescence. Biogenesis of fibers ontogenetically related to various tissues has been analyzed and the data about marker stage-specific characters of these cells. The data summarized in this review willow not only deeper understanding the development of cells with such unique characters, but also interpret the growth mechanisms for much more cell types, in which it is more difficult to identify individual stages of biogenesis than in the sclerenchyme fibers.

[On the restructuring of the blood service].

The issue of the restructuring of the blood service is discussed. The actuality and and the need of this process is substantiated. Four alternative organizational models of the blood service institutions (the centralized model, the regional model, the model based of the hospital ground and the mix model) acclaimed by the international community are proposed to be adapted to the Russia conditions. The model of the blood service of the Sverdlovsk oblast is discussed.

Immunomorphological characteristics of animals with different levels of orientation and exploratory behavior.

We revealed some relationships between the level of orientation and exploratory behavior, functional activity of the immune system, and structural and functional organization of the CNS in animals. Significant differences in brain morphology and expression of cytokine IL-1 beta, type I IL-1 receptor, and erythropoietin receptor genes in brain cells were detected in (CBA x C57Bl/6)F1 mice with different initial levels of orientation and exploratory behavior. Immunocompetent cells of mice with high and low levels of exploratory behavior differ by spontaneous and mitogen-induced proliferative activity. The formation of humoral and cellular immune response in these animals causes opposite changes in exploratory behavior and the type of these changes depends on the initial level of this behavioral reaction.

[A comprehensive evaluation of the management effectiveness in a multi-specialty hospital]. / Kompleksnaia otsenka éffektivnosti v upravlenii mnogoprofil'noi bol'nitsei.

The medical-and-economic efficiency, involving the traditional, newly designed and tested methodic approaches, was evaluated in respect to 19 inhospital department of a multidiscipline hospital in the city of Yekaterinburg. A necessity was proven to use the integral indices in assessing the medical efficiency. The economic and medical efficiencies were found to coincide in 62.5% of cases, which is indicative of that it is not always the case, when the amount of the spent means directly influence the activity output. The study results showed that the technology of integral assessments of the medical-and-economic activity efficiency enables the hospital's manager to define the best and worst functioning units and to make subsequently the appropriate correcting managerial decisions.

[Bronchopulmonary and laryngeal symptoms of gastroesophageal reflux disease: diagnosis and treatment]. / Bronkhopul'monal'nye i laringeal'nye simptomy gastroézofagealnoi refliuksnoi bolezni: diagnostika i lechenie.

The article discloses the results of the examination and treatment of patients with gastroesophageal reflux disease, the course of which was complicated with extraesophageal (bronchopulmonary and laryngeal) symptoms. The authors managed to establish the connection between gastric reflux and pulmonary and laryngeal symptoms with a high degree of reliability, based on the results of functional methods of research (24-hour pH-measurement in the esophagus). The obtained results of the treatment testify to the efficiency of active surgical tactics in this group of patients.

[Analysis of efficiency of the region's health facilities]. / Analiz éffektivnosti diiatel'nosti uchrezhdenii zdravookhraneniia raiona.

A comprehensive study of the efficiency of activities of 5 principle therapeutic-and-preventive institutions (TPI) was conducted in a typical Ural industrial region by using the traditional and newly developed approaches. Both the medical and economic efficiency of their activities was found to be not high in a majority of them. The analysis results were used to work out a scientifically substantiated program for reforming the health care system of the region.