[Optical coherence tomography angiography in diagnosis of changes in macular capillary blood flow in chronic ischemic retinopathy]. / Opticheskaya kogerentnaya tomografiya-angiografiya v diagnostike izmenenii kapillyarnogo krovotoka makuly pri khronicheskoi ishemicheskoi retinopatii.

PURPOSE: Assessment of the indices of macular capillary blood flow and subfoveal choroidal thickness (SCT) using optical coherence tomography angiography in patients with retinal manifestations of ocular ischemic syndrome (RMOIS) associated with atherosclerotic internal carotid artery stenosis. MATERIAL AND METHODS: The study included 34 patients (68 eyes): 21 men, 13 women with RMOIS in one eye. All patients were divided into 2 groups depending on the severity of atherosclerotic internal carotid artery stenosis and ophthalmoscopic picture of the fundus. To obtain objective information we analyzed the degree of decrease in the main indices characterizing macular microcirculation and SCT depending on the severity of RMOIS. RESULTS AND DISCUSSION: Analysis of the results showed relationship between the severity of RMOIS and the deficit in macular microcirculation. The macula of the patients with mild RMOIS was characterized by a decrease in the density of superficial vascular plexus (SVP) and the density of deep capillary plexus (DCP) by 13.5% and 10.5% compared to the controls, respectively; in moderate RMOIS - by 19.7% and 14.6%; in severe RMOIS - by 35.9% and 28%, respectively. With an increase in the severity of RMOIS, the area of the foveal avascular zone increased too: in mild degree RMOIS - by 19%, in moderate - by 38.6%, in severe - by 51%. In proportion to the severity of RMOIS, SCT was reduced: in mild degree RMOIS - by only 8%, in moderate - by 22%, and in severe - by 29.8% of the control. CONCLUSION: The conducted research indicates that pathological changes in RMOIS extend to the entire capillary network of the macula and SCT. With increase in the degree of RMOIS, ischemic changes in all capillary layers of the central parts of the retina proportionally increase in comparison with the control group by 1.15 times in mild degree, by 1.24 times in moderate degree, and by 1.5 times in severe RMOIS.

[Pleiomorphism of the cytokine profile in nasal polyp tissue depending on the phenotype of chronic rhinosinusitis with nasal polyps]. / Pleiomorfizm tsitokinovogo profilya v tkani polipov v zavisimosti ot fenotipa polipoznogo rinosinusita.

Clinical phenotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) are characterized with different inflammation patterns of mRNA expression of cytokines and depend on presence of allergic rhinitis (AR), atopic bronchial asthma (aBA) or nonatopic bronchial asthma (nBA). OBJECTIVE: To compare inflammation response in patients with different phenotypes of CRSwNP according to level secretion of the key cytokines in nasal polyp tissue. MATERIAL AND METHODS: 292 patients with CRSwNP were divided into four phenotypes: group 1 - CRSwNP without respiratory allergy (RA) and without BA; group 2a - CRSwNP+ AR with aBA; group 2b - CRSwNP+AR without aBA; group 3 - CRSwNP+nBA. Control group (n=36) included patients with hypertrophic rhinitis without atopy or BA. Using multiplex assay we defined the level of IL-1ß, IL-4, IL-5, IL-6, IL-13, IFN-γ, TGF-ß1, TGF-ß2, TGF-ß3 in nasal polyp tissue. RESULTS: The evaluation of cytokines levels in nasal polyps in different CRSwNP phenotypes showed a pleiotropy of different cytokine secretion depending on different comorbid pathology. In control group we estimated the lowest levels of all detected cytokines in comparison with other CRS groups. High levels of local proteins IL-5 and IL-13 and low levels of all isoform of TGF-ß characterized CRSwNP without RA and BA. The combination of CRSwNP with AR showed high levels of proinflammatory cytokines IL-6 and IL-1ß, and high levels of TGF-ß1 and TGF-ß2. The combination of CRSwNP with aBA estimated low levels of proinflammatory cytokines IL-1ß, IFN-γ; in case of CRS+nBA we determined the highest levels of TGF-ß1, TGF-ß2 and TGF-ß3 in nasal polyp tissue. CONCLUSIONS: Each CRSwNP phenotype is characterized by different mechanism of local inflammation. This underlies the necessity to diagnose BA and respiratory allergy among these patients. The evaluation of local cytokine profile in different CRSwNP phenotypes can help to determine the target anticytokine therapy for patients who has low efficacy of basic corticosteroid therapy.

Inside and outside of virus-like particles HBc and HBc/4M2e: A comprehensive study of the structure.

Hepatitis B virus core antigen (HBc) with the insertion of four external domains of the influenza A M2 protein (HBc/4M2e) form virus-like particles whose structure was studied using a combination of molecular modeling and cryo-electron microscopy (cryo-EM). It was also shown that self-assembling of the particles occurs inside bacterial cells, but despite the big inner volume of the core shell particle, purified HBc/4M2e contain an insignificant amount of bacterial proteins. It was shown that a fragment of the M2e corresponding to 4M2e insertion is prone to formation of amyloid-like fibrils. However, as the part of the immunodominant loop, M2e insertion does not show a tendency to intermolecular interaction. A full-atomic HBc-4M2e model with the resolution of about 3 Å (3.13 Å for particles of Т = 4 symmetry, 3.7 Å for particles of Т = 3 symmetry) was obtained by molecular modeling methods based on cryo-EM data.

Erratum: First Search for Bosonic Superweakly Interacting Massive Particles with Masses up to 1 MeV/c

This corrects the article DOI: 10.1103/PhysRevLett.125.011801.

[Improvement of cochleovestibular function in chronic non-inflammatory perilymphatic fistulas of the labyrinth windows: cases from practice]. / Vozmozhnosti vosstanovleniya slukha pri khronicheskikh nevospalitel'nykh perilimfaticheskikh fistulakh okon labirinta: sluchai iz praktiki.

After a brief discussion of the problem of idiopathic sensorineural hearing loss and perilymphatic fistulas of the labyrinth windows, audiometric tests are identified that are informative for the preoperative diagnosis of the latter. Taking into account the own results of surgical treatment, attention is drawn to the feasibility of a wider use of exploratory tympanotomy in cases of suspected occurrence of perilymphatic fistulas of the labyrinth windows.

[Distal pancreatectomy with resection of the celiac trunk, right or left hepatic artery without arterial reconstruction (extended DP-CAR)]. / Distal'naya rezektsiya podzheludochnoi zhelezy s rezektsiei chrevnogo stvola vmeste s pravoi ili levoi pechenochnoi arteriei bez arterial'noi rekonstruktsii (rasshirennaya DP-CAR).

OBJECTIVE: To evaluate safety and postoperative outcomes of DP-CAR with resection of one of the lobar hepatic arteries without arterial reconstruction (extended DP-CAR). MATERIAL AND METHODS: Perioperative data and survival after 7 extended DP-CARs R0 were retrospectively analyzed. Arterial blood flow in the liver was assessed using intraoperative ultrasound and postoperative CT angiography. RESULTS: Among 40 DP-CARs, resection of left or right hepatic artery was performed in 7 cases of aberrant anatomy including 1 case of portal vein resection. Mortality and ischemic complications were not observed. The main source of blood supply to the «devascularized¼ liver lobe was interlobar communicating artery or the arcade of the lesser curvature of the stomach. Incidence of pancreatic fistula was 44%, mean blood loss - 230 (100-650) ml, surgery time - 259 (195-310) min, mean hospital-stay - 14 (9-26) days. Median survival of patients with pancreatic ductal adenocarcinoma was 25 months after combined treatment. Three patients died after 26, 28 and 77 months. Other patients are alive without progression for 109, 24, 23 and 12 months after therapy onset. CONCLUSION: Extended DP-CAR is advisable and safe procedure if reliable intraoperative control of liver and stomach blood supply is ensured.

[Peculiarities of differential diagnostics of perilymphatic fistulas of the labyrinth windows of non-inflammatory genesis]. / Osobennosti differentsial'noi diagnostiki perilimfaticheskikh fistul okon labirinta nevospalitel'nogo geneza.

THE PURPOSE OF THE STUDY: To determine the value of the results of various audiological and vestibulometric studies for the differential diagnosis of non-inflammatory perilymphatic fistulas of the labyrinth windows (PFOLW). MATERIAL AND METHODS: The retrospective and prospective analysis of the informative value of the results of audiological and vestibulometric studies was carried out in 124 people with different combinations of cochleovestibular complaints, who had different pathology of the inner and middle ear, with different terms of the disease - from several days to 30 years. To assess the informativeness of the applied testing, the following operational characteristics were determined: general sensitivity (Se), specificity (Sp) and the prognostic value of a positive result (PPV=positive predictive value). A pair-by-pair comparison of the prognostic value of a positive result of vestibulometric and audiometric tests was performed using the Pearson criterion χ2 and the exact Fisher criterion. RESULTS: It is shown that none of the tests used has 100% reliability, but the consistent application of some of them can successfully improve the diagnosis of idiopathic PFOL. When comparing the results of a number of tests, such as the Fukuda walking test and / or the Babinsky-Weil walking test, audiometric tests with head clone and hyperventilation, the test of fluid injection into the external auditory canal and the test of J. Frasser & L. Flood, it was found that the average prognostic value of a positive result was 87.3%, which is statistically significantly higher than the average result (47.9%) for other samples. CONCLUSIONS: Correlations of the results of simple vestibulometric and audiometric tests allow us to recommend them to improve the diagnosis of idiopathic perilymphatic fistulas of the labyrinth windows. The possibilities of modern electrophysiological audiological research methods are subject to further study.

[Foreign bodies of the esophagus in children]. / Inorodnye tela pishchevoda u detei.

OBJECTIVE: Of this study is to determine the optimal algorithm for active verification and treatment of children with foreign bodies of the esophagus, analysis of the causes and development of related complications. PATIENTS AND METHOD: The results of examination and treatment of 320 children with foreign bodies of the esophagus for the period from 2011 to 2017 were analyzed. The vast majority of patients (79.4%) were between 1 and 5 years old. The period from the moment of accidental ingestion of a foreign body to hospitalization ranged from 3 hours to 2 months. It was found that the x-ray method made it possible to confirm the presence of a foreign body in the esophagus in 89.1% of cases, to identify the nature of the radiopaque foreign body and associated complications in 100% of cases. RESULTS: In order to remove a foreign body, 314 emergency endoscopic interventions were performed. In 79.6% of cases, a foreign body was localized in the upper third of the esophagus. Coins were the most frequently found foreign bodies of the esophagus (80.1%), the second place was taken by disk-type batteries (8.7%), and the third - by bones of various origin (4.5%). Among all foreign bodies, the most dangerous were disk batteries, causing serious complications in 72% of cases, the treatment of which requires the joint efforts of doctors of various specialties. The occurrence and severity of complications was directly dependent on the nature, size, location of fixation and the length of stay of a foreign body in the esophagus. CONCLUSION: Main conclusion of this study is that children with suspected foreign body of the esophagus need emergency examination and treatment exclusively in a multidisciplinary medical institution.

[The rhinophyma through the prism of time]. / Rinofima cherez prizmu vremeni.

One of the frequent causes of a significant increase in the external nose, forming a persistent deformity of the face, as well as leading to a non-standard clinical picture is rhinophyma disease. The article considers some historical data, epidemiology, peculiarities of pathogenesis, as well as the basics of surgical treatment tactics along with possible preventive measures against rhinophyma. At present, the treatment of this pathology presents great difficulties. Despite the many surgical methods, rhinophyma is poorly treatable, often relapses and leaves no less noticeable disfigurement of the face in the postoperative period. In this regard, there is a constant search for new surgical methods, which has not only medical but also important social significance.

Old dog, new tricks: Influenza A virus NS1 and in vitro fibrillogenesis.

The influenza NS1 protein is involved in suppression of the host immune response. Recently, there is growing evidence that prion-like protein aggregation plays an important role in cellular signaling and immune responses. In this work, we obtained a recombinant, influenza A NS1 protein and showed that it is able to form amyloid-like fibrils in vitro. Using proteolysis and subsequent mass spectrometry, we showed that regions resistant to protease hydrolysis highly differ between the native NS1 form (NS1-N) and fibrillar form (NS1-F); this indicates that significant structural changes occur during fibril formation. We also found a protein fragment that is capable of inducing the process of fibrillogenesis at 37 °C. The discovery of the ability of NS1 to form amyloid-like fibrils may be relevant to uncovering relationships between influenza A infection and modulation of the immune response.

[Resectable periampullary tumor in patients with previous pancreatitis. What type of surgical procedure to choose?] / Rezektabel'naya periampulyarnaya opukhol' u patsienta, perenesshego ostryi pankreatit. Kakuyu operatsiyu vybrat'?

OBJECTIVE: To evaluate the early outcomes of radical surgical treatment of patients with resectable periampullary tumors and previous acute pancreatitis (AP). MATERIAL AND METHODS: A retrospective analysis included 9 patients. AP was diagnosed in all patients at different times of preoperative period (post-manipulative AP in 7 cases, alcoholic AP in 2 cases). Pancreaticoduodenectomy was performed in 5 patients, total pancreatectomy (TP) - in 4 patients. RESULTS: Severe postoperative complications occurred in 3 patients after pancreaticoduodenectomy. There were no complications after TP. All complications after pancreaticoduodenectomy were associated with a pancreatic stump that required urgent surgical interventions. Three patients died from surgical complications. All postoperative deaths were observed after pancreaticoduodenectomy. CONCLUSION: TP may be a safer surgical option compared to pancreaticoduodenectomy in patients with resectable periampiullary tumors and preoperative AP.

[Method of endonasal endoscopic dacryocystorhinostomy with plastic stoma formation]. / Metod plasticheskogo formirovaniya stomy pri endonazal'noi endoskopicheskoi dakriotsistorinostomii.

The article presents modern methods of surgical treatment of chronic dacryocystitis, a brief historical review of various options for endonasal endoscopic dacryocystorhinostomy is carried out. The method of plastic seamless formation of dacryocystostomy, which does not require intubation of the lacrimal passages and/or using of silicone stoma dilators, is described. Between 2010 and 2019 at The State Budgetary Healthcare Institution of Moscow Area Moscow regional research clinical institute n.a. M.F. Vladimirskiy, according to the developed technique, 32 patients (32 eyes) with chronic dacryocystitis were operated on. According to the results of observation 1 year after surgical treatment, all 100% of patients recorded a positive result (absence or significant decrease in lacrimation, good anatomical visualization of dacryocystostomy with a good tear passage, both passive and during washing the lacrimal passages).

Cold and distant: structural features of the nucleoprotein complex of a cold-adapted influenza A virus strain.

Two influenza A nucleoprotein variants (wild-type: G102R; and mutant: G102R and E292G) were studied with regard to macro-molecular interactions in oligomeric form (24-mers). The E292G mutation has been previously shown to provide cold adaptation. Molecular dynamics simulations of these complexes and trajectory analysis showed that the most significant difference between the obtained models was distance between nucleoprotein complex strands. The isolated complexes of two ribonucleoprotein variants were characterized by transmission electron microscopy and differential scanning fluorimetry (DSF). Presence of the E292G substitution was shown by DSF to affect nucleoprotein complex melting temperature. In the filament interface peptide model, it was shown that the peptide corresponding in primary structure to the wild-type NP (SGYDFEREGYS) is prone to temperature-dependent self-association, unlike the peptide corresponding to E292G substitution (SGYDFGREGYS). It was also shown that the SGYDFEREGYS peptide is capable of interacting with a monomeric nucleoprotein (wild type); this interaction's equilibrium dissociation constant is five orders of magnitude lower than for the SGYDFGREGYS peptide. Using small-angle neutron scattering (SANS), the supramolecular structures of isolated complexes of these proteins were studied at temperatures of 15, 32, and 37 °C. SANS data show that the structures of the studied complexes at elevated temperature differ from the rod-like particle model and react differently to temperature changes. The data suggest that the mechanism behind cold adaptation with E292G is associated with a weakening of the interaction between strands of the ribonucleoprotein complex and, as a result, the appearance of inter-chain interface flexibility necessary for complex function at low temperature.Communicated by Ramaswamy H. Sarma.

Analysis of the chromatic dispersion effect on the subcarrier wave QKD system.

In this paper we investigate the chromatic dispersion impact on the quantum key distribution system based on multi-mode weak coherent phase-coded states. We provide an asymptotic secure key rate estimation, taking into account error detection probability due to chromatic dispersion. We demonstrate numerically and experimentally that the effect of chromatic dispersion in an optical fiber without any compensation hinders the secret key distribution at a distance more than 53 km. Finally, we propose a modification to the considered quantum communication system in order to mitigate the influence of chromatic dispersion on its performance.

[Functional rehabilitation of patients after endovitreal surgery of rhegmatogenous retinal detachment with complete retinal attachment]. / Otsenka rezul'tatov primeneniya novogo farmakoterapevticheskogo podkhoda v funktsional'noi reabilitatsii patsientov posle endovitreal'noi khirurgii regmatogennoi otsloiki setchatki s polozhitel'nym anatomicheskim rezul'tatom.

Rhegmatogenous retinal detachment (RRD) is one of the most severe eye diseases typically occurring in people of working age. The annual rates of primary vision disability in patients with RRD is 2-9%. PURPOSE: To increase the functional effectiveness of endovitreal surgery in patients with RRD by including Cytoflavin in the system of postoperative rehabilitation. MATERIAL AND METHODS: The study involved 68 patients with RRD aged 37 to 65 years. Patients underwent vitrectomy using the 25 Gauge technology with endolaser coagulation of rupture zones and silicone oil tamponade in the vitreous cavity. Three months after the surgery, silicone oil was removed from the vitreous cavity. Patients were divided into 2 groups: the main - 34 people who received Cytoflavin in addition to standard therapy, and the control - 34 people receiving only standard postoperative treatment. The time course of the treatment's functional effectiveness was analyzed using best corrected visual acuity (BCVA) and macular photosensitivity. Laser Doppler flowmetry (LDF) was used to register the microcirculation and microcirculation efficiency indices. Morphological signs of macular ischemia were registered by optical coherence tomography angiography (OCT-A). RESULTS: Patients of the main group showed higher level of restoration of macular function compared with the control group. The increase in functional activity of the macular area correlated with postoperative dynamics of restoration of central retinal thickness. Analysis of LDF and OCT-A indices showed that improvement of visual functions in patients treated with Cytoflavin is directly related to restoration of chorioretinal blood flow. CONCLUSION: The use of Cytoflavin in patients after endovitreal surgery of RRD led to improvement of BCVA by an average of 2.6 times and photosensitivity of the macula by 2 times. The visual functions of patients improved after using Cytoflavin due to its positive effect on chorioretinal microcirculation and the density of macular capillary plexuses.

First Search for Bosonic Superweakly Interacting Massive Particles with Masses up to 1 MeV/c

We present the first search for bosonic superweakly interacting massive particles (super-WIMPs) as keV-scale dark matter candidates performed with the GERDA experiment. GERDA is a neutrinoless double-ß decay experiment which operates high-purity germanium detectors enriched in ^{76}Ge in an ultralow background environment at the Laboratori Nazionali del Gran Sasso (LNGS) of INFN in Italy. Searches were performed for pseudoscalar and vector particles in the mass region from 60 keV/c^{2} to 1 MeV/c^{2}. No evidence for a dark matter signal was observed, and the most stringent constraints on the couplings of super-WIMPs with masses above 120 keV/c^{2} have been set. As an example, at a mass of 150 keV/c^{2} the most stringent direct limits on the dimensionless couplings of axionlike particles and dark photons to electrons of g_{ae}<3×10^{-12} and α^{'}/α<6.5×10^{-24} at 90% credible interval, respectively, were obtained.

Subcarrier wave continuous variable quantum key distribution with discrete modulation: mathematical model and finite-key analysis.

In this paper we report a continuous-variable quantum key distribution protocol using multimode coherent states generated on subcarrier frequencies of the optical spectrum. We propose a coherent detection scheme where power from a carrier wave is used as a local oscillator. We compose a mathematical model of the proposed scheme and perform its security analysis in the finite-size regime using fully quantum asymptotic equipartition property technique. We calculate a lower bound on the secret key rate for the system under the assumption that the quantum channel noise is negligible compared to detector dark counts, and an eavesdropper is restricted to collective attacks. Our calculation shows that the current realistic system implementation would allow distributing secret keys over channels with losses up to 9 dB.

[A new approach to bilateral atresia joan newborns]. / Novyi podkhod k dvustoronnei atrezii khoan u novorozhdennykh.

This article presents a new method which allows to prevent cicatricial atresia of the lumen of joan in the late postoperative period during their formation. By this method there is a patent No. 2614936 from 30.03.2017. In the Department of otorhinolaryngology, the SBHI of MAMRRCI n.a. M.F. Vladimirsky since 2010 operated on 20 children with the use of a new stent (a new technique). In the treatment of children with congenital atresia joan used the algorithm of diagnosis, definition of indications to the volume of operations and surgical procedure - transseptal/transnasal access the formation of choan.

Characterization of 30 76 Ge enriched Broad Energy Ge detectors for GERDA Phase II.

The GERmanium Detector Array (Gerda) is a low background experiment located at the Laboratori Nazionali del Gran Sasso in Italy, which searches for neutrinoless double-beta decay of 76 Ge into 76 Se+2e - . Gerda has been conceived in two phases. Phase II, which started in December 2015, features several novelties including 30 new 76Ge enriched detectors. These were manufactured according to the Broad Energy Germanium (BEGe) detector design that has a better background discrimination capability and energy resolution compared to formerly widely-used types. Prior to their installation, the new BEGe detectors were mounted in vacuum cryostats and characterized in detail in the Hades underground laboratory in Belgium. This paper describes the properties and the overall performance of these detectors during operation in vacuum. The characterization campaign provided not only direct input for Gerda Phase II data collection and analyses, but also allowed to study detector phenomena, detector correlations as well as to test the accuracy of pulse shape simulation codes.

[The regional model of palliative medical care support of patients with malignant neoplasms].

The article considers issues of development of model of palliative care and analysis of its activities. The study was based on the results of medical care provided by palliative service of the Republic of Tatarstan. The palliative service is complex system that unites several different institutions. The palliative care is provided in hospital and out-patient settings. In the oncologic hospital beds are integrated to provide urgent and palliative care to patients with cancer to apply comprehensive complex of medical interventions. Out-patient care is provided by 7 field teams including oncologist (3 teams) and two paramedics (4 teams). Four field teams function day-and-night seven days a week. Since 2014, the "Children's Hospice" unit functions as element of palliative service. Since 2015, in Almetyevsk, functions field department of palliative care attached to polyclinic of oncologic dispensary/ It co0nsists of two field medical teams. The provision of palliative care is to include all stages needed: palliative care offices, outpatient services, inpatient departments and hospices. The integration of palliative care into common health care network makes it possible to apply tangible possibilities and research potential of large medical institutions and advanced technologies of modern medicine as well.