[AUTOVENOUS REVASCULARIZATION OF THE LOWER EXTREMITY ARTERIES IN PATIENTS WITH VARIANT ANATOMY OF THE PERIPHERAL BLOOD FLOW AND THE PROGRESSIVE ATHEROSCLEROTIC PROCESS].

Obliterating diseases of the lower extremity arteries occupy a high proportion in the structure of cardiovascular morbidity in the population among the developed countries. The steadily progressing course of obliterating atherosclerosis leads to the critical lower limb ischemia and causes an unfavorable prognosis for preserving the extremity, as well as the patient's life. Nowadays, there are two ways of surgical management of this pathology: endovascular and open reconstructive interventions. The choice of the method is based on a comprehensive keeping of the patient-specific records, including the anatomical characterization of the arterial bed lesions. In case of extended occlusion of the superficial femoral artery, the open reconstructive surgery using a large saphenous vein as a transplant is recommended. This circumstance is confirmed by the autovein patency in the long term compared with a synthetic prosthesis according to the results of randomized clinical trials. Therefore, with the formation of a distal anastomosis below the gap of the knee joint, the patency of the autovein and synthetic prosthesis after 5 years is 71% and 44% respectively. In this article, we represent a clinical case of successful treatment of a patient with progression of atherosclerotic lesions of the infrainguinal segment arteries. A staged revascularization of the femoral-popliteal segment arteries using technique of a reversed vein on both lower extremities after attempts of the conservative treatment and x-ray endovascular intervention was performed. A feature of this case is the creation of a new bifurcation of the popliteal artery during the formation of a distal anastomosis below the fissure of the knee joint under the contitions of a high discharge of the anterior tibial artery.The given clinical case demonstrates the advantages of invasive surgical tactics with the aim of preserving the limb and improving the patient's quality of life.

[Endotheliotropic effects of venotonic drugs in treatment of patients with varicose veins]. / Éndoteliotropnye éffekty venotoniziruiushchikh preparatov pri lechenii bol'nykh s varikoznoi bolezn'iu.

The authors analysed the effect of Venarus on the endothelial function in patients suffering from lower limb varicose veins. Our open-label prospective study included a total of 100 patients diagnosed as having CEAP class C1-C2 varicose veins and divided into two equal groups. Dynamic assessment of the clinical course of the disease in Group One patients was carried out on the background of taking Venarus and compression therapy, with Group Two patients evaluated without taking Venarus. At defined stages we determined the level of biochemical markers of endothelial function. The obtained findings demonstrated that the use of phlebotonic Venarus resulted in decreased activity of lipid peroxidation processes and reduced activity of antioxidant system enzymes. Using Venarus was followed by a statistically significant decrease in the concentration of malonic dialdehyde (from 1.220±0.190 µmol/l at baseline to 0.858±0.231 µmol/l after 2 months of treatment), whereas in Group Two patients the changes were insignificant (1.191±0.204 µmol/l before treatment and 1.138±0.175 µmol/l at 2 months thereafter). Patients taking Venarus were also found to have a higher level of nitric oxide metabolites compared with the patients treated by compression therapy alone (51.646±11.757 and 36.310±6.921 µmol/l in Groups One and Two, respectively). Hence, an evidence-based conclusion was drawn that Venarus proved efficient and may therefore be prescribed as pharmacotherapy for correction of endothelial dysfunction.

[Gene-mediated induction of angiogenesis in inoperable patients with atherosclerosis and diabetes mellitus]. / Gennaia induktsiia angiogeneza u neoperabel'nykh patsientov s aterosklerozom i sakharnym diabetom.

Analysed in the article are the results of a comprehensive approach to treatment of patients presenting with lower limb critical ischaemia and diabetes mellitus by means of gene-induced angiogenesis. The study comprised a total of 65 patients found to have an ill-suited for surgical reconstruction peripheral arterial bed and undergoing conservative therapy. The patients were divided into two groups. The Study Group patients additionally to the conventional conservative therapy received 2 intramuscular injections of therapeutic agent Neovasculgen at a course dose of 2.4 mg. The active period of follow up amounted to 6 months followed by evaluating limb salvage and lethal outcomes at a further 6 months thereafter. Efficacy of treatment was determined both by primary criteria (lethality rate, amputations, dynamics of necrosis healing, clinical relief of critical ischaemia) and secondary criteria (pain-free walking distance, ankle-brachial index, transcutaneous oxygen tension, linear velocity of blood flow, the Michigan Neuropathy Screening Instrument (MNSI) and Neurological Symptom Score (NSS) scale). After 6 months of follow up, the statistical significance in the intragroup and intergroup comparisons was reached for the pain-free walking distance (increment up to 72.9±9.2 m, p=0.032), transcutaneous oxygen tension (increment by 34.4%, p=0.028), linear velocity of blood flow (increment by 65.3%, p=0.047). Induction of angiogenesis also made it possible to statistically significantly decrease the manifestations of diabetic neuropathy, as was evidenced by the data of the MSNI (p=0.009) and the NSS scale (p=0.044). The findings of the study also demonstrated the best value of the limb salvage rate (p=0.049) and a lower number of lethal complications at 1 year of follow up.

Hybrid mode-locked erbium-doped all-fiber soliton laser with a distributed polarizer.

A soliton-type erbium-doped all-fiber ring laser hybrid mode-locked with a co-action of arc-discharge single-walled carbon nanotubes (SWCNTs) and nonlinear polarization evolution (NPE) is demonstrated. For the first time, to the best of our knowledge, boron nitride-doped SWCNTs were used as a saturable absorber for passive mode-locking initiation. Moreover, the NPE was introduced through the implementation of the short-segment polarizing fiber. Owing to the NPE action in the laser cavity, significant pulse length shortening as well as pulse stability improvement were observed as compared with a SWCNTs-only mode-locked laser. The shortest achieved pulse width of near transform-limited solitons was 222 fs at the output average power of 9.1 mW and 45.5 MHz repetition frequency, corresponding to the 0.17 nJ pulse energy.

Thulium-doped mode-locked all-fiber laser based on NALM and carbon nanotube saturable absorber.

We present a thulium-doped fiber laser mode-locked by a carboxymetylcellulose high-optical quality film with dispersed single-walled carbon nanotubes. Laser system based on the nonlinear amplifying loop mirror generates the shortest pulses earlier obtained in SWCNT mode-locked thulium-doped fiber lasers with a duration of 450 fs and 18 mW maximum average power at 1870 nm.

Transform-limited pulse generation in normal cavity dispersion erbium doped single-walled carbon nanotubes mode-locked fiber ring laser.

We demonstrate an erbium doped fiber ring laser mode-locked with a carboxymetylcellulose high-optical quality film with dispersed single-walled carbon nanotubes (SWCNT). The laser with large normal net cavity dispersion generates near bandwidth-limited picosecond inverse modified soliton pulses at 1.56 µm.

[Construction of the new Escherichia coli K-12 wild-type strain with improved growth characteristics for application in metabolic engineering].

MG1655 of Escherichia coli K-12 is frequently used in metabolic engineering as the wild-type strain. However, its two mutations, ilvG and rph-1 provide a negative effect on culture growth. The "polar effect" of rph-1 decreases the level of pyrE expression, causing partial auxotrophy for pyrimidines. Mutation ilvG leading to the appearance of Val(S) phenotype causes retardation of cell growth rate on media containing amino acids. In this work, the substitution of two loci in the genome of MG1655 with the recovery of the wild-type phenotype was accomplished. Gene rph(wt) from the chromosome of E. coli TG1 was marked via Red-dependent integration of DNA fragment carrying lambda attL-Cm(R)-lambda attR and transduced with phage P1 into MG1655; later, the Cm(R) marker was removed with the use of lambda Xis/Int recombinase. Parallel to this procedure, a spontaneous Val(R) mutant of E. coli MG1655 yielding colonies of maximal size on M9 medium with glucose in the presence of Val (50 microg/ml) was isolated. It was shown that a nucleotide deletion in the isolated Val(R) strain had been generated in the region of the identified E. coli K-12 ilvG mutation, which led to the recovery of the reading frame and active protein synthesis. This mutation named ilvG-15, which is the only reason for the Val(R) phenotype in the obtained strain, was transferred to MG1655-rph(wt) using cotransduction, by analogy to the transfer of rph(wt). Evaluation of rates of aerobically growing cells (microm, hour(-1)) on M9 medium with glucose produced the following values: 0.56, 0.69, and 0.73 for strains MG1655, MG1655-rph(wt), and MG1655-(rph(wt), ilvG-15), respectively.

[New method of construction of artificial translational-coupled operons in bacterial chromosome].

The new method of translational-coupled operons construction in bacterial chromosome has been developed on the basis of recombineering approach. It includes construction in vitro of the artificial operon with efficiently translated proximal cistron followed by its insertion E. coli chromosome, modification of the operon due to Red-driven insertion of the special "Junction" with excisable selective marker in the intercistronic region of the initial operon and excising the marker. The structure of this Junction has been designed and tested in the present investigation. It consists of: 1) E. coli rplC-rplD intercistronic region for placing the TAA-codon of the proximal operon's gene in the SD-sequence (TAAGGAG) of rplD; 2) Cm(R)-gene flanked by lambdaattL/R-sites in such a fashion that after lambdaInt/Xis-driven excision of the marker the residual lambdaattB-site would not contain the termination codons in frame with ATG of rplD; 3) E. coli trpE-trpD intercistronic region for location of ATG of trpD at the position of initiation codon of the distal gene of original operon. The general design of desired construction provides the conversion of the original two-cistronic operon into three-cistronic operon with translational-coupled genes, where the coupling of the artificial ORF (rplD'-lambdaattB-'trpE) with the proximal gene is occurred due to rplC-rplD intercistronic region and the coupling of this ORF with the distal gene--due to trpE-trpD. The experimental implementation of the described strategy was showed by construction of artificial operon P(tac-aroG4-serA5, where expression optimization of the distal serA5 gene was achieved via construction of three-cistronic operon with translational-coupled genes.

[Psychological and psychosomatic problems of oncology]. / Psikhologicheskie i psikhosomaticheskie problemy onkologii.

The paper concerns the issues of medical ethics and deontology in communication of a physician with cancer patients and their relatives. Ethic and deontological norms dictate the necessity to approach each patient individually, especially in terms of giving information about the disease. While informing the patient truly about his/her disease, it is important to keep the patient hoping and focus his/her efforts on radical treatment if the disease is not too advanced. If it is so, the patients need individual and group psychotherapy which is able to improve quality of life and to prolong the survival in cancer patients.