[Diagnostic possibilities of modern biochemical study of sputum from patients with cystic fibrosis (literature review).]

The review presents the pathobiochemical and molecular mechanisms of sputum formation in patients with cystic fibrosis associated with the pathophysiological features of the disease. Statistical data on the prevalence of this pathology in the world and in the Russian Federation are presented. The mechanisms of sputum formation and disorders of the mucociliary apparatus, leading to the accumulation of viscous bronchopulmonary secret in cystic fibrosis, are considered. The principles of the relationship between the rheological properties of sputum and the formation of inflammation in the lungs with the addition of a concomitant specific microflora in the bronchopulmonary system in patients with cystic fibrosis are presented. Describes the opportunities for biochemical studies of sputum of patients with this pathology: determining the activity of enzymes (myeloperoxidase), the content of proteinase inhibitors (α2-macroglobulin and α1-antitrypsin) and proinflammatory cytokines (IL-8 and TNFa), concentrations of iron and ferriferous proteins (lactoferrin and ferritin), which makes biochemical studies of sputum available, non-invasive, quick and cost-effective method of diagnosis, which can be widely used as an auxiliary laboratory method and makes it possible to use these metabolites as diagnostic markers to assess the severity of inflammation and infection of the lower respiratory tract and predict the development of respiratory complications in patients with cystic fibrosis.

[Metabolism processes and mechanisms of regulation of platelet activity (review of literature).]

Platelets play fundamental role in ensuring the hemostatic function in blood. In addition to this canonical function, the blood plates play angiotrophic, immunological, transport role, participate in the activation of plasma hemostasis, retraction of a blood clot, and can record circulating immune complexes. The review article presents current data on the structure and conjugation of molecular rearrangements of platelet ultrastructures associated with the functioning of an open canalicular platelet system, a dense tubular system, and a platelet cytoplasmic membrane. The main types of resting platelet metabolism, and the processes underlying the activation of platelets associated with the enhancement of carbohydrate and fatty acid catabolism are characterized, as well as some signaling pathways that regulate processes of induction of platelet aggregation. The data show the value of lipid components of activated platelet membranes, including phospholipids of various classes, glycolipids and cholesterol. The role of regulatory processes associated with the non-covalent modification of certain platelet proteins with fatty acids is reflected. Fundamental questions of platelet metabolism are relevant nowadays and require a combined approach of studying them, which can potentially solve many problems of clinical laboratory diagnostics, pathobiochemistry, and pharmacology. In preparing the review, we used sources from international and russian databases: Scopus, Web of Science, RSCI.

[Coagulation test features depending on the AB0-blood groups system antigenic composition.]

The maintenance of normal blood flow through the vessels is the result of the coordinated work of the coagulation and anticoagulation systems of our body. The balance of this system depends on many factors, including endothelial, humoral, platelet ones, however, we still lack knowledge about the effect of antigenic determinants on the state of the hemostatic system. This study is devoted to assessing the effect of the presence and absence of antigens on the AB0 system, presented on erythrocyte and platelet membranes, on hemostatic parameters. The study was conducted in the Clinics of Samara State Medical University and consisted of127 clinically healthy individuals who underwent a general analysis and biochemical blood analysis, 52 people with the most stable indicators of cell composition and metabolic profile were selected for a coagulation test, including determination of the activity of coagulation factors and routine tests. A significant decrease in the activity of the VIII and VII coagulation factors was revealed, as well as an increase in the prothrombin time in patients with 0 (I) blood group compared to the "antigenic" blood groups. The presence of biological variation for indicators of external and internal coagulation paths was noted, depending on the group of blood belonging to the AB0 system. The findings suggest that there is an increased susceptibility to bleeding in patients with 0 (I) blood groups due to the absence of antigenic determinants on the cell membrane, while for "antigenic" blood groups, on the contrary, there is a susceptibility to thrombosis due to increased activity of the components of the coagulation system.

[Polyresistent microflora in the structure of microorganisms divided from blood of patients of the general hospital.]

The aim of our research was to evaluate the structure and the determination of the phenotypes of antibiotic resistance of microflora isolated from patients' blood in a multidisciplinary hospital during the period from 2013 to 2017. The material was taken into BacT / ALERT bottles containing nutrient media, followed by incubation of blood. In case of a positive result, the material from the vials was dispersed into dense nutrient media. Species identification was carried out using commercial biochemical API test systems and MALDITOF mass spectrometry. The antibiotic resistance of the isolated microorganisms was evaluated by a classical disc-diffusion method. From 2013 to 2017, 3504 blood tests were performed, of which 16.8% were positive. Of the isolated strains, 69.6% were Gram-positive, 27% were Gram-negative, and 3.4% were fungi. The structure of Gram-positive bacteria included Staphylococcus spp - 71.46%, Enterococcus spp. - 21.22% and Streptococcus spp - 7.32%. Staphylococcus aureus (47,8%) prevailed among staphylococci (in 62.14% were methicillin-resistant) and coagulase-negative staphylococci. Among the genus Enterococcus spp, Enterococcus faecalis prevailed (27% resistant to macrolides, 14% to fluoroquinolones) and Enterococcus faecium (69% resistant to penicillins, fluoroquinolones, macrolides). Streptococcus pneumoniae, Streptococcus pyogenes and streptococci from the group of alpha-greening were isolated from streptococci. Clinically significant types of streptococci in 33.3% were resistant to macrolides and fluoroquinolones. In the structure of gram-negative bacteria, Enterobacteriaceae prevailed - 71.07% (Klebsiella pneumoniae, E. coli); the proportion of non-fermenting Gram-negative bacteria (NFGOB) was 28.93%. Most Gram-negative bacteria were producers of extended-spectrum beta-lactamases (BLBRs). In NFGOB structure allocated Acinetobacter baumanii - 56,5% (81% polyresistant), Pseudomonas aeruginosa - 30,4% (50% - Carbapenemase Producing Organisms), Stenotrophomonas maltophilia - 10,9%. Thus, microbiological research in septic blood conditions is an integral part of the diagnostic search, selection of etiotropic therapy and monitoring of its effectiveness.

[The effect of hyperglycemia on indices of biochemical blood analysis in vitro.]

The purpose of study was to detect possible deviations between the results of biochemical analysis of blood and true values in conditions of hyperglycemia in vitro and dependences of the given alterations from group belonging of analyzed blood. The biochemical analysis was applied to blood samples of patients with various blood groups according system AB0 in conditions of normo- and hyperglycemia in vitro. The criterion for choice was established the content of main biochemical indices of blood (total protein, total bilirubin, glucose, total cholesterol, urea, creatinine, activity of hylaninamitotransferase (ALT), aspartataminotransferase (AST), lactatedehydrogenase (LDG)) within the reference limits. The hyperglycemia was developed in vitro using 5% glucose solution and corresponded to 20,49±0,05 and 46,37±0,63 mmol/l. The content of total protein and total cholesterol turned out to be the most stable indices. The effect of increased level of glucose to following analytes was established: total bilirubin (+10,5%), ALT activity (±13,4%), AST activity (+11,1%) and creatinine (+51,4%). The alterations of indices up to level of ±10% and higher are clinically significant and have to be taking into account by physicians of clinical laboratory diagnostic and clinical physicians during interpretations of the results of biochemical analysis of blood for evaluation of true picture of condition of patient. The AB0-group specific characteristics of biochemical analysis of blood are established in conditions of hyperglycemia. The hyperglycemia is an interfering factor during implementation of laboratory analysis that is especially actual at interpretations of results of biochemical analysis of blood in patients of reanimation department and individuals suffering of persistent and severe diabetes mellitus with its complication with nephropathy. Besides, the established group-specific characteristics of hyperglycemia effecting the results of biochemical analysis of blood can be accounted in development of standards and guidelines of personified medicine.