[The role of polymorphic variants rs11546155 and rs6119534 of the GGT7 gene and risk factors in the development of acute pancreatitis].

Glutathione is an antioxidant with powerful restorative and detoxifying properties, a progressive decrease in its reserves in erythrocytes and pancreas observed in pancreatic necrosis indicates a lack of functioning of the system for maintaining the level of glutathione in cells and the use of its endogenous reserve. The study of the role of glutathione metabolism enzyme genes in the risk of acute pancreatitis in this regard is especially relevant. The aim of the study was to evaluate the joint contribution of the rs11546155 and rs6119534 polymorphic loci of the GGT7 gene and some risk factors to the development of acute pancreatitis (AP). Material and methods. Molecular genetic analysis of DNA samples of 506 unrelated patients with acute pancreatitis and 524 unrelated individuals of Russian nationality without gastrointestinal diseases, isolated by the standard method of phenol-chloroform extraction, was carried out. The average age of patients was 48.9±13.1 years, healthy persons - 47.8±12.1 years. The diagnosis was established using Clinical guidelines developed by the working group of the Russian Society of Surgeons. All patients signed informed consent to participate in the study. Genotyping was performed using iPLEX technology by time-of-flight mass spectrometry. Associations of gene alleles and genotypes with the risk of acute pancreatitis were assessed by the χ2 criterion and the odds ratio with 95% confidence intervals. Statistical analysis was performed using the SNPStats and Statistica 10.0 programs (Stat-Soft, USA). Results. We have identified an association of the C/T (rs6119534) GGT7 genotype with an increased risk of AP, both in men and women. When analyzing the effect of polymorphic loci on the development of the polymorphic locus rs6119534 of the GGT7 C>T gene with an increased risk of developing acute alcoholic (AAlcP) and biliary pancreatitis (ABP), it was found that the C/T rs6119534 genotype of the GGT7 gene was more common both among patients with AAlcP and ABP, and the G/G GGT7 genotype (rs11546155) was found only among ABP patients. An analysis of the combined influence of polymorphic loci and environmental factors showed that the frequency of drinking alcohol more than 2 times a week and eating fat more than 89 grams per day increased the risk AAlcP in carriers of C/T-T/T rs6119534 of the GGT7 gene. As for ABP, non-smoking carriers of the G/A-A/A GGT7 (rs11546155) genotypes had a reduced risk of the disease, while the consumption of fats over 89 g/day and fresh vegetables and fruits below 27 g/day increased the risk in carriers of genotypes C/T-T/T and C/T rs6119534 of the GGT7 gene, respectively. Conclusion. Polymorphic loci rs6119534 and rs11546155 of the GGT7 gene, when exposed to certain risk factors, increase the risk of acute pancreatitis.

[Coaxial system with permanent infiltration anesthesia for ct-assisted transthoracic trepanobiopsy of lung tumors]. / Transtorakal'naya trepanobiopsiya obrazovanii legkogo pod KT-navigatsiei s ispol'zovaniem koaksial'noi sistemy.

OBJECTIVE: To assess irradiation time, pain syndrome and safety of the proposed device and technique compared to conventional CT-assisted transthoracic biopsy. MATERIAL AND METHODS: CT-guided transthoracic trepanobiopsy of thoracic tumors was carried out in 296 patients between January 2017 and January 2020. There were 189 (63.8%) men and 107 (36.2%) women. Mean age of patients was 64.1±9.6 years (range 35-83). All patients were randomized into 2 groups by 148 people: group 1 - morphological verification via conventional CT-guided transthoracic trepanobiopsy, group 2 - morphological verification using a coaxial system and a specially developed CT-guided transthoracic trepanobiopsy. RESULTS: Coaxial system with permanent anesthesia in CT-guided transthoracic manipulations reduces post-manipulation complications by 4-5%, get more qualitative morphological material (by 4%), reduces the time of procedure by 2 times and irradiation of patients by 27%, excludes irradiation of physicians and significantly reduces pain syndrome.

rs11927381 Polymorphism and Type 2 Diabetes Mellitus: Contribution of Smoking to the Realization of Susceptibility to the Disease.

In the study that included 579 patients with type 2 diabetes mellitus and 542 healthy individuals from Slavonic population, an association was found between IGF2BP2 gene rs11927381 polymorphism and increased risk of developing the disease. However, this association was observed for smoking patients and was not detected for non-smokers. Bioinformatics analysis showed that the spectrum of transcription factors binding with high-risk C allele differ from the spectrum of transcription factors specifically binding with the reference T allele; these factors are involved in the regulation of the biosynthesis of ketone bodies and cellular response to glucocorticoid hormones. The results suggest that smoking plays a trigger role in the relationship of the polymorphic variant rs11927381 of the IGF2BP2 gene with the development of type 2 diabetes mellitus.

[Preventative repair of postoperative ventral hernia considering the markers of connective tissue dysplasia]. / Opredelenie pokazaniia k preventivnomu éndoprotezirovaniiu na osnovanii markerov displazii soedinitel'noi tkani u bol'nykh s posleoperatsionnymi ventral'nymi gryzhami.

OBJECTIVE: To define the indication for preventive mesh implantation in patients scheduled for laparotomy. MATERIAL AND METHODS: There were 108 patients divided into the control (52 patients without anterior abdominal wall hernia) and the main (56 patients with ventral hernia) groups. RESULTS: Predominance of collagen type III over type I was observed in patients older 60 years in the main group. The maximum ratio of collagen types I and III was 1.4 in the main group. The minimum number of inter-fiber spaces (n=5) was noted in patients aged 30-40 years. The maximum density of connective tissue was 250 pixels per inch. CONCLUSION: Analysis of connective tissue structures revealed some important age-related features and markers of connective tissue dysplasia in the main group. An indication for preventive mesh implantation in patients scheduled for laparotomy was determined.

Comment on "An unexpected formation of the novel 7-oxa-2-azabicyclo[2.2.1]hept-5-ene skeleton during the reaction of furfurylamine with maleimides and their bioprospection using a zebrafish embryo model" by C. E. Puerto Galvis and V. V. Kouznetsov, Org. Biomol. Chem., 2013, 11, 407.

It has been proved that the reaction between furfuryl amines and N-R-maleimides leads to the formation of aza-Michael addition products - 3-(furylmethylamino)-N-R-pyrrolidine-2,5-diones, instead of 7-oxa-2-azabicyclo[2.2.1]hept-5-enes, as this journal reported previously.

[Collagen types ratio in prediction of postoperative ventral hernias]. / Sootnoshenie tipov kollagena v prognozirovanii posleoperatsionnykh ventral'nykh gryzh.

AIM: To analyze collagen types ratio in skin and aponeurosis in order to predict postoperative ventral hernias. MATERIAL AND METHODS: The trial included 141 patients for the period 2012-2015. Group I (n=65) of patients without ventral hernias was divided into subgroup AI (primary operation, n=41) and BI (re-operation, n=24). Group II consisted of 76 patients with ventral hernias. We performed histological examination of skin and aponeurosis to define the collagen structure of connective tissue. RESULTS: There were significant differences between collagen type I/III ratio in skin (2.81±0.52 in group I vs. 1.13±0.48 in group II) and aponeurosis (2.69±0.41 vs. 1.09±0.21, respectively, p≤0.05). We revealed strong direct correlation (r=+0.92) between aponeurosis and skin specimens in one group. Collagen type I level was 73.81±2.74% in subgroup AI and 72.03±2.47% in subgroup BI. Collagen type I was predominant (p≤0.05). CONCLUSION: In patients with ventral hernias collagen type I/III ratio in skin is 2.54 times lower than in patients without hernias. Significant correlation of collagen types in skin and aponeurosis (r= +0.92) allows to predict the risk of postoperative ventral hernias on basis of skin fragment.

[The influence of 'potassium orotate' on neocollagenogenesis in implantation of polypropylene endoprosthesis and polypropylene combined with polylactic acid endoprosthesis]. / Vliyanie orotata kaliya na neokollagenogenez pri implantatsii polipropilenovogo endoproteza i endoproteza iz polipropilena s polimolochnoi kislotoi v eksperimente.

AIM: To study neocollagenogenesis after implantation of polypropylene endoprosthesis and polypropylene combined with polylactic acid endoprosthesis on background of «potassium orotate¼ administration. MATERIAL AND METHODS: We used two different types of endoprosthesis in the experiment. The first type was made of just polypropylene, the second type was made of polypropylene combined with polylactic acid. Histological examination was performed using polarizing microscopy. Collagen types I and III ratio in connective tissue around the prosthesis was analyzed according to the color that was individual for each type. RESULTS: The results were significantly better in case of collagenogenesis stimulation with Potassium orotate within 30 days and later for one type of endoprosthesis. Also we revealed that collagenogenesis and paraprosthesis capsule formation were more active in case of combined endoprosthesis. We revealed stimulating action of «Potassium Orotate¼ for collegenogenesis process, this fact was proved by increased collagen I/III ratio. CONCLUSION: Optimization of collagenogenesis was based on persistent 1,37-fold increase of collagen I/III ratio in case of combined endoprosthesis after 90 days. It was manifested by accelerated formation of connective tissue capsule and facilitated early isolation of the implant from surrounding tissues.

Structural study of the X-ray-induced enzymatic reaction of octahaem cytochrome C nitrite reductase.

Octahaem cytochrome c nitrite reductase from the bacterium Thioalkalivibrio nitratireducens catalyzes the reduction of nitrite to ammonium and of sulfite to sulfide. The reducing properties of X-ray radiation and the high quality of the enzyme crystals allow study of the catalytic reaction of cytochrome c nitrite reductase directly in a crystal of the enzyme, with the reaction being induced by X-rays. Series of diffraction data sets with increasing absorbed dose were collected from crystals of the free form of the enzyme and its complexes with nitrite and sulfite. The corresponding structures revealed gradual changes associated with the reduction of the catalytic haems by X-rays. In the case of the nitrite complex the conversion of the nitrite ions bound in the active sites to NO species was observed, which is the beginning of the catalytic reaction. For the free form, an increase in the distance between the oxygen ligand bound to the catalytic haem and the iron ion of the haem took place. In the case of the sulfite complex no enzymatic reaction was detected, but there were changes in the arrangement of the active-site water molecules that were presumably associated with a change in the protonation state of the sulfite ions.

Effect of a synthetic indolicidin analogue on lipid peroxidation in thermal burns.

Experimental simulation of burn was followed by accumulation of LPO products and suppression of antioxidant enzyme activity in the burn wound. Application of a synthetic analogue of indolicidin led to an increase in MDA and acylhydroperoxide concentrations in the burn wound on experimental day 1. Further application of the peptide in a dose of 100 mg/kg had no significant effect on the studied parameters, while the peptide in a dose of 500 mg/kg was followed by a decrease in the level of LPO products on days 10 and 14. Changes in antioxidant enzyme activities in rats treated with 500 mg/kg indolicidin analogue had a two-phase pattern: an increase on day 4 was followed by a decrease.

Synchrotron single-crystal XRD, IR-, Raman spectroscopy and high pressure study of synthetic krieselite.

Spontaneous crystals of krieselite (Ge analogue of topaz) with the chemical formula Al2[(Ge0.75Si0.25)O4](F1.63OH0.37) were synthesized using a thermo-gradient hydrothermal method at a temperature of 600/650 °C and pressure of 100 MPa. The unit cell parameters are: a = 8.9732(8) Å, b = 8.4823(7) Å, c = 4.7379(5) Å, V = 360.62(6) Å3, space group Pnma. The F-/OH- content of the samples was refined by FTIR spectroscopy method. Raman spectroscopy showed the main differences between the spectra of krieselite and topaz at the ambient conditions. The assignment of observed and calculated Ag bands (cm-1) for non-polarized Raman spectra was carried out. Using in situ Raman spectroscopy at high pressures, the dependence of the shift in the position of the main bands of the krieselite Raman spectrum on the pressure was established, and the corresponding paths of pressure induced distortion of crystal structure was assumed. According to the data of Raman spectroscopy, it was revealed that krieselite does not undergo the phase transitions up to 30 GPa. The probable way of crystal structure distortion within the space group Pnma was proposed based on simulation of high-pressure Raman spectra.

[Influence of exogenous embryonic fibroblasts on collagen type I and type III ratio in the tissues of paraprosthetic capsule (experimental work)].

Nowadays, the use of synthetic prosthesis is obligatory method in surgical treatment of large and giant ventral hernias. We have fulfilled comparative investigation of the dynamics of collagen Type I to Type III ratio in paraprosthetic region in mice when using implants, Esphyl - polyethylene, Ecophlon - polytetrafluorethylene, and Uniflex - polyvinylidenfluoride, with a one- and two-time introduction of cultured fibroblasts into paraprosthetic region at different times after implantations and without the introduction. Use of Sirius Red dye staining and polarization microscopy revealed that, in short period (10 days after endoprosthesis implantation), the implication of fibroblasts and the number of implications did not affect the collagen Types ratio. In later stages (30-60 days after endoprosthesis implantation) a significant increase in collagen Type I was observed when using all the materials. The ratio of collagen Type I to Type III was maximal at all stages of the experiment in the case of the implant Uniflex. Double implication of exogenous fibroblasts accelerated the increase in the collagen Type I to Type III ratio to a greater extent.

[The efficiency of antiadhesive means with "mezogel" having a barrier effect after dissection of the adhesions in patients with acute adhesive intestinal obstruction].

An antiadhesive absorbable means "Mezogel" produced by the firm "Lintex" (St. Petersburg) after intraperitoneal administration to animals in experiments was shown to reliably effectively reduce the degree of a recurrent adhesion process, and in 40% of the cases to completely prevent repeated formation of adhesions in the abdominal cavity. The use of "Mezogel" for intraperitoneal administration after dissection of adhesions in patients with acute adhesive intestinal obstruction results in relieving the course of the nearest and long term postoperative periods and reducing the number of recurrences, thus improving quality of life of the patients.

[Disturbance of body image in patients with meningiomas of parieto-occipital localization]. / Narushenie skhemy tela pri meningiomakh temenno-zatylochnoi oblasti.

AIM: To study body image disturbances in patients with typical meningioma of parietal-occipital localization before and after surgery. MATERIAL AND METHODS: Twenty-three patients with the diagnosis of «typical meningioma of parietal-occipital localization¼ were studied. A battery of neuropsychological tests, dissociation methodology of «Image-I¼ and the method «Silhouette¼ were used. RESULTS AND CONCLUSION: The body schema disorders were found in patients with meningioma of parietal-occipital area. There was the disturbance of the right-left orientation and position of body parts in space and in relation to each other as well as the disparity between the overall weight and height objective indicators and subjective perceptions of the body. After surgery, the body orientation was significantly improved. The distinct differentiation of the position of body parts relative to one another, adequate correlation between the position of two hands and unerring left-right orientation were seen. Perceptions of the body became more adequate for the number of body parts and their size, but the person's own ideas about the constitution as a whole remained inadequate.

[Pulmonary artery thromboembolism in patients with trauma].

The study accrued 257 patients with mechanical traumas of varying severity and sites, complicated by post-traumatic phiebothrombosis. In 87 (33.85%) patients, traumatic disease was aggravated by pulmonary artery thromboembolism (PTE). In the course of the study we evaluated risk factors of PTE related to the patient's condition and trauma. It has been established as a result that of 14 recognized risk factors of PTB determined by the patient's condition, only six influenced this disease outcome, namely: age over 40 years, a history of PTE or deep venous thrombosis (DVT), overweight, circulatory and respiratory insufficiency, bed regime. Among risk factors of PTE linked with trauma, the following factors had a significant impact on the emergence of PTE: treatment by means of skeletal traction, the site of trauma in the lower extremity (femoral or tibial bone), the site of previous thrombosis in the deep veins of the leg and thigh as well as floating thrombus.

[Actual aspects of phlebothromboses and thromboembolism of the pulmonary artery in trauma].

Risk factors of the development of phlebothrombosis and thromboembolism of the pulmonary artery (TEPA) were estimated in 257 patients as associated both with the patient and the trauma. The factors influencing the development of risk factors were: bed immobilization, age older than 40, heart failure and respiratory insufficiency, fractures of the lower extremities, skeleton traction, obesity, thrombosis of lower extremities, previous thrombosis or pulmonary embolism, floating clot. Risk factors of the development of vein thrombosis associated with trauma included the presence of lower extremity fractures, skeletal traction or immobilization in bandage, mechanism of injury and type of trauma.

[Possibilities of endoscopic surgery in treatment of chronic venous insufficiency of the lower extremities].

The authors present their experiences with endoscopic dissection of perforating veins in patients with severe forms of chronic venous insufficiency with special reference to the peculiarities of blood supply of the extremity superficial tissue. The generalized morphological description of the perforating arteriovenous structures of the leg is presented as a vascular formation including the arteries and veins put in the general connective-tissue vagina and beginning from the profound or/and muscular veins and arteries. Operations were made on 56 patients aged 25-76 years, 40 of them had postthrombotic disease, 16 - varicose disease. The endoscopic subfascial dissection of the perforating veins was conducted using the standard set of tools for laparoscopic surgery of K. Storz Company. During the surgical procedure the perforating vascular bunch in the subfascial space was isolated, the veins were intersected electrosurgically, the other parts of the vascular bunch were preserved. On the average, the patients were in the hospital for 7+/-2 days. Trophic ulcers healed up during 7-30 days. Long-term results were good in 30%, satisfactory in 64%, unsatisfactory - in 6%. So, the selective endoscopical dissection of perforating veins is thought to be a radical, minimally invasive, anatomically and functionally reasonable method of elimination of the horizontal venous blood regurgitation. This technique resulted in a considerably decreased number of postoperative complications and less time of hospital treatment.

[The treatment of critical lower limb ischemia using serotonin]. / Lechenie kriticheskoi ishemii nizhnikh konechnostei s ispol'zovaniem serotonina.

This paper describes the first experience with conservative treatment of 30 men suffering from critical lower limb ischemia using serotonin as an agent which may return endogenous vasomotility to normal and eliminate tissue hypoxia. Good and satisfactory results were obtained in 76% of patients (43 and 33% respectively). Deterioration followed by amputation was marked in 7% of patients. The removal or considerable abatement of rest pains was recorded in 86% (53 and 33% respectively) of cases. Amputation was performed in 10% of patients. It is recommended that serotonin adipinate should be included into multiraodality therapy of atherosclerotic critical lower limb ischemia. The use of the treatment method suggested will allow to improve the treatment results, to reduce the number and level of amputations, and to minimize the percentage of disability.

[Evaluation of changes in the deep veins of the lower limbs in varices]. / Otsenka izmenenii glubokikh ven nizhnykh konechnostei pri varikoznoi bolezni.

The authors analysed the results of studying disorders of the deep veins of the lower limbs in 106 patients with varicosity, who were examined by means of distal ascending and retrograde femoral and popliteal phlebography. Ectasia of the deep veins was revealed in 97 (91.5%) and valvular incompetence--in 89 (84%) patients. The authors elaborated a phlebographic evaluation of the degree of ectasia and a classification of valvular incompetence according to the manifestation of the retrograde blood flow in them, which is necessary for a differentiated approach to the surgical correction of these disorders.

[Effect of functional disorders of deep veins of the lower extremities on the clinical course of varicose veins]. / Vliianie narushenii funktsional'nogo sostoianiia glubokikh ven nizhnikh konechnostei na klinicheskoe techneie varikoznoi bolezni.

Results of the complex clinical and phlebographic examination of 106 patients with the varicose disease were studied. It was established that the degree of alterations of the venous outflow was dependent on the spread of ectasia of profound veins, while the clinical form of ectasia of the profound veins--on the state of the valve system.

[Segmentary venous hypervolemia as one of the main factors of the patho-hemodynamic development and progression of chronic venous insufficiency of lower extremities in patients with varicose disease ]. / Segmentarnaia venoznaia gipervolemiia kak odin iz osnovnykh patogemodinamicheskikh faktorov razvitiia i progressirovaniia khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei u patsientov s varikoznoi bolezn'iu.

Phlebographic examinations carried out in 91 patients with varicosity and 30 healthy subjects have determined structural peculiarities of the intramuscular shin veins in health and disease. A comparison of the anatomical findings with the degree of hemodynamic abnormalities allowed to make a conclusion that intramuscular segmental hypervolemia should be considered as one of the main pathogenic links in the pathophysiological chain of the development of chronic venous insufficiency. Further elevation of supravalvate venous segmental actazia forms a relative valve incompetence at the particular level which promotes the spreading of retrograde pathological blood flow in distal direction. Blood shunting into the intramuscular shin veins is one of the compensatory mechanisms of increasing pathological hypervolemia as a cause of valve incompetence and retrograde blood flow. The procedure of evacuation from the skin veins directly depends on the effective work of the shin muscular-venous pump. Further involvement of the intramuscular veins in the pathological process, the low effectiveness of the shin muscular-venous pump results in greater dysfunction and finally forms a hypodynamic vicious circle of chronic venous insufficiency with all its manifestations.