Assessment of the Level of Matrix Metalloproteinases, VEGF and MicroRNA-34a in Patients With Non-obstructive and Obstructive Lesions of the Coronary Arteries.

AIM: To assess the levels of matrix metalloproteinases (MMP), vascular endothelial growth factor (VEGF), and miRNA-34a expression in patients with ischemic heart disease (IHD) and obstructive and nonobstructive coronary artery (CA) disease. MATERIAL AND METHODS: This cross-sectional observational study included 64 patients with IHD (diagnosis verified by coronary angiography or multislice computed tomography coronary angiography), of which 33 (51.6%) were men aged 64.9±8.1 years. 20 patients had nonobstructive CA disease (stenosis <50%), and 44 had hemodynamically significant stenoses. The control group consisted of 30 healthy volunteers. MMP-1, -9, -13, and -14, miRNA-34a, and VEGF were measured in all patients. RESULTS: The concentration of MMP-1 was significantly higher in patients with ischemia and nonobstructive CA disease (INOCAD) (p=0.016), and the concentration of MMP-9 was the highest in the group with obstructive CA disease (p<0.001). The concentrations of MMP-13 and MMP-14 did not differ significantly between the groups. The highest VEGF concentrations were observed in the INOCAD group (p<0.001). The expression of miRNA-34a significantly differed between the IHD groups with different types of CA disease and controls (p <0.001). Patients with hemodynamically significant stenosis showed moderate relationships between the concentrations of MMP-14 and VEGF (ρ=0.418; p=0.024), as well as between VEGF and miRNA-34a (ρ=0.425; p=0.022). Patients with INOCAD had a significant negative correlation between the concentrations of MMP-13 and VEGF (ρ= -0.659; p=0.003). Correlation analysis showed in all IHD patients a moderate relationship of the concentrations of MMP-1 and MMP-14 with VEGF (ρ=0.449; p=0.002 and p=0.341; p=0.019, respectively). According to ROC analysis, a MMP-9 concentration above 4.83 ng/ml can be a predictor for the presence of hemodynamically significant CA obstruction in IHD patients; a VEGF concentration higher than 27.23 pg/ml suggests the absence of hemodynamically significant CA stenosis. CONCLUSION: IHD patients with INOCAD had the greatest increase in MMP-1, whereas patients with obstructive CA disease had the highest level of MMP-9. According to our data, concentrations of MMP-9 and VEGF can be used to predict the degree of CA obstruction. The expression of miRNA-34a was significantly higher in IHD patients with INOCAD and CA obstruction than in the control group, which suggested a miRNA-34a contribution to the development and progression of coronary atherosclerosis. In the future, it may be possible to use this miRNA as a diagnostic marker for IHD.

[A rapid radionuclide method for clinical assessment of gastric juice proteolytic activity and acidity]. / Radionuklidnyi ékspress-metod klinicheskoi otsenki proteolitcheskoi aktivnosti i kislotnosti zheludochnogo soka.

A new method for radionuclide measurement of gastric juice proteolytic activity (GJPA) is described. GJPA is determined according to the time of dissolution of the protein capsule filled with 99mTc-pertechnetate solution. In vitro experiments made with 342 samples of gastric juice revealed a correlation (p1 less than 0.01) between the time of dissolution of the 99mTc-pertechnetate capsule and proteolytic activity measured according to Metta's method. No correlation was established between GJPA (measured by Metta's method and by radionuclide method) and gastric juice acidity (p greater than 0.05). In 63 patients examined, the time of capsule dissolution was 15 to 18 minutes with GJPA being normal, 8 to 14 minutes (p less than 0.01) with elevated parameters of GJPA, and 19 to 37 minutes (p less than 0.01) with GJPA being reduced. The given method is a physiological one, sufficiently precise and can be recommended for a screening analysis of GJPA.

[Experience with the work of the inpatient department of a polyclinic]. / Opyt raboty statsionarnogo otdeleniia polikliniki.

Analysis is done of the work of the inpatient department of a polyclinic belonging to the VPO "Orenburggazprom". In that department, the treatment is mainly given to the persons of a capable age with different visceral diseases. The authors have worded indications for referral of the patients to the indicated department, evaluated the social and economic advantages of that form of rendering medical services.