Modern Development Problems of Russian Healthcare: Part 2.

The second part of the article (see the beginning in No. 6-2021) analyzes the negative consequences of the so-called health care optimization. It is shown that as a result of its implementation, the availability of medical care has decreased. A possible way to improve the territorial organization of medical services is considered. The effectiveness of the Russian health care system in the fight against the coronavirus pandemic was assessed.

Modern Development Problems of Russian Healthcare (Part 1).

The paper (part 1) analyzes the dynamics of indicators characterizing the state of health of the Russian population. A comparative analysis of the development of healthcare in Russia and other countries is carried out. The conclusion is confirmed that the main problem in the development of Russian healthcare is the insufficient volume of public funding. The drawbacks and limited potential of the adopted funding model are assessed. A possible way to increase public funding is proposed. It is shown that the availability of medical care is reduced as a result of the so-called optimization of healthcare. A possible way to improve the territorial organization of medical services is considered. The effectiveness of the Russian healthcare system in the fight against the coronavirus pandemic is assessed.

[Erectile dysfunction: choice of the treatment method].

The 15-year clinical experience with falloendoprosthetic operations (FEPO) in patients with erectile dysfunction is reviewed including algorithm of diagnostic examination, prostheses of different generations, indications and contraindications for falloendoprosthetic surgery. The results of 117 FEPO are outlined with special emphasis on 19 cases of postoperative complications. The conclusion is made that FEPO is most effective in erectile dysfunction by the presented criteria of the erectile dysfunction treatment efficacy.

[System of rehabilitation in the Armed Forces: history, current situation, and perspectives of development].

There are two main directions of development of medical rehabilitation in the Armed Forces of RF for now-days: medical-psychological rehabilitation of military service men among special contingents, realizing special military duty (air- and NAVY-staff, staff duty shift of Missile Force of Special Purpose) and medical rehabilitation of military service men, participants of battle action in accordance with sub-program "Social support and rehabilitation of invalids in consequence of battle action or battle trauma" of Federal Purpose Program in the sphere of social support of invalids. The authors mark necessity of reorientation of medical strategy from evaluation of determination of symptoms of already existent disease to evaluation of determination of adaptation reserves of organism of military service men, determination of changes in organism on the stage of pre-disease.

[Penile endoprosthesis in complex rehabilitation of wounded and ill persons with erectile dysfunction].

Morbidity of erectile dysfunction among men of every age is 10%. It's supposed that now-days in the world about 100 mln of men have organic erectile dysfunction. Specialist of the 6th MMCH of Ministry of Defense have elaborated a rehabilitation program for military service men with erectile dysfunction. This program includes a complex clinical-psychological checkup, methods of reconstruction of copulative capacity, evaluation of effectiveness of realized treatment. Evaluation of quality of result of phalloendoprosthesis has shown that 92,3% of patients estimate the result as excellent and good, 5,2%--as satisfactory, 2,5% have not sex life.

[The effect of various iron hydroxide concentrations on the anaerobic fermentation of sulfate-containing model sewage].

The addition of iron hydroxide and iron-reducing bacteria into a fermenter for anaerobic processing of sulfate-containing sewage was shown to decrease sulfate reduction and sulfide concentration, while increasing the total organic carbon (TOC) and methane production. The effect of iron (III) in sulfate-containing sewage depended on its dose, which can be expressed as molar ratio Fe(III)/SO4(2-). Sulfide concentration increased monotonically, reaching 91 mg/l and 45 mg/l after 15 days of processing at Fe(III)/SO4(2-) ratios of 0.06 and 0.5, respectively. However, soluble sulfide production was not observed at ratios equaling 1 and 2. At ratios of 0.06, 0.5, 1, and 2, the maximum rates of TOC removal were 0.75, 1.15, 1.39, and 1.55 g TOC/g of organic matter (OM) per 1 h. Methane production rates were 0.039, 0.047, 0.064, and 0.069 mg/g OM per 1 h, with the mean relative amounts of methane in the biogas being equal to 25, 41, 55, and 62%, respectively. These data can be applied to the development of new methods of anaerobic purification of sulfate-containing sewage.

[Effect of iron hydroxide on the phosphate elimination during anaerobic digestion of active sludge]. / Vliianie gidrookisi zheleza na udalenie fosfata pri anaérobnom sbrazhivanii aktivnogo ila.

Addition of iron (III) hydroxide during methanogenic digestion of active sludge by anaerobic sludge displaying an iron-reducing activity resulted in a microbial reduction of iron (III) with formation of iron (II), capable of precipitating phosphates. Feasibility of eliminating 66.6 to 99.6% of dissolved phosphate at initial concentrations of 1000 to 3500 mg PO4(3-)/l by adding 6420 mg/l iron (III) hydroxide into a reactor for anaerobic fermentation of active sludge. The optimal ratio of iron (III) added to dissolved phosphate eliminated (mg) providing a 95% elimination amounted to 2:1. These results may be used in a new technology for anaerobic wastewater treatment with phosphate elimination.

STRA13 interacts with STAT3 and modulates transcription of STAT3-dependent targets.

STRA13 is a pVHL-dependent bHLH transcription factor up-regulated on the mRNA level in multiple cancer cell lines and implicated recently in the regulation of immune cell homeostasis and autoimmunity. In searching for STRA13-interacting proteins with oncogenic potential by the yeast two-hybrid screening, we identified STAT3 beta as a STRA13-binding partner. We showed that STRA13 binds predominantly to phosphorylated (active) STAT3 alpha and beta isoforms via its HLH and C-terminal regions. We also found that STRA13 was able to activate transcription from STAT-dependent cis-elements. Expression of endogenous STRA13 was shown to be cytokine-inducible, consistent with STRA13 involvement in STAT-dependent transcription regulation. We demonstrated that the STAT3-regulated promoter of the pro-apoptotic Fas gene was activated upon STRA13 over-expression and that co-expression of STRA13 with STAT3 beta or STAT3 alpha modulated the transcriptional outcome. Forced expression of STRA13 induced apoptosis, in agreement with the STRA13 activation effect on the Fas promoter. Simultaneous expression of STRA13 and STAT3 beta resulted in alleviation of the STRA13 pro-apoptotic effect. Thus, for the first time, we identify STRA13 as a STAT3 partner and provide a consistent line of evidence for STRA13 involvement into regulation of apoptosis via the STAT pathways.

Microbiological monitoring in the biodegradation of sewage sludge and food waste.

AIM: To study the microbiology of intensive, in-vessel biodegradation of a mixture of sewage sludge and vegetable food waste. METHODS AND RESULTS: The biodegradation was performed in a closed reactor with the addition of a starter culture of Bacillus thermoamylovorans SW25 under conditions of controlled aeration, stirring, pH and temperature (60 degrees C). The content of viable bacterial cells, determined by flow cytometry, increased from 5 x 108 g-1 of dry matter to 61 x 108 g-1 for 6 days of the process and then dropped to the initial value at the end of the process. The reductions of organic matter, 16S rRNA of methanogens and coenzyme F420 fluorescence during 10 days of the treatment were 67, 54 and 87% of the initial values, respectively. The biodegradability of the organic matter decreased during the 10 days of the treatment from 3.8 to 1.3 mg CO2 g-1 of organic matter per day. The treatment of sewage sludge and food waste at 60 degrees C did not remove enterobacteria, which are the agents of intestinal infections, from the material. The percentage of viable enterobacterial cells, determined by fluorescent in situ hybridization (FISH) with Enterobacteriaceae-specific oligonucleotide probe and flow cytometry, varied from 1 to 14% of the viable bacterial cells. CONCLUSIONS: The mixture of sewage sludge and food waste can be degraded by the aerobic thermophilic bacteria; the starter culture of Bacillus thermoamylovorans SW25 can be used to perform this process; and enterobacteria can survive under treatment of sewage sludge and food waste at 60 degrees C for 13 days. SIGNIFICANCE AND IMPACT OF THE STUDY: The results show that FISH with an oligonucleotide probe can be used to study not only the growth but also the degradation of biomass. Obtained results could be used to design the bioconversion of sewage sludge and food waste into organic fertilizer.

[Effect of iron compounds on the treatment of fat-containing wastewaters]. / Vliianie preparatov zheleza na obrabotku zhirosoderzhashchikh stochnykh vod.

Effects of iron compounds on methanogenic fermentation the water polluted with fatty acids were studied. A natural readily available source of iron applicable to biological treatment of liquid wastes was searched for. A positive effect of iron on the methanogenic fermentation of fats and their degradation products--long-chain fatty acids--in aqueous media was demonstrated. It is recommended to add iron-containing clay, as an inexpensive and easily available iron source, in amounts providing the binding of the long-chain fatty acids present in wastewaters.

[Geometric method for determining the skull-portrait aspect in craniofacial identification of the body]. / Geometricheskii sposob opredeleniia rakursnogo polozheniia cherep-portret pri kraniofatsial'noi identifikatsii lichnosti.

Correspondence of the reference graphic images by the aspect is an important condition of craniofacial personality identification. The authors propose methods of determining the skull-portrait aspect by X and Y axes simultaneously. This allows 2 potentialities of comparing the photograph and the skull picture: 1) positioning the skull in a strictly determined aspect estimated by analysis of coordinates of reference points on the photoportrait and 2) positioning the skull and re-estimation of the photoportrait coordinates into the "zero" aspect (zero turning, inclination, and lateral deviation). Hence, all coordinates of the reference points of examined graphic images in the database can be estimated for the zero position and the same scale, which helps automate the search for analogs.

Cooperation between STAT3 and c-jun suppresses Fas transcription.

Decreased Fas expression during tumor progression often results in a loss of Fas-ligand (FasL)-mediated apoptosis. Human and mouse melanoma exhibit an inverse correlation between the degree of Fas cell surface expression, tumorigenicity, and metastatic capacity. The expression of dominant negative Stat3 or c-Jun in melanoma cells efficiently increased Fas expression and sensitized cells to FasL-induced apoptosis. Stat3+/- as well as c-Jun-/- cells exhibited increased Fas cell surface expression and higher sensitivity to FasL-mediated apoptosis. Suppression of Fas expression by Stat3 and c-Jun is uncoupled from Stat3-mediated transcriptional activation. Our findings indicate that Stat3 oncogenic activities could also be mediated through its cooperation with c-Jun, resulting in downregulation of Fas surface expression, which is implicated in the tumor's ability to resist therapy and metastasize.

Expression of ring finger-deleted TRAF2 sensitizes metastatic melanoma cells to apoptosis via up-regulation of p38, TNFalpha and suppression of NF-kappaB activities.

Mechanisms underlying radiation and chemotherapy resistance, the hallmark of human melanoma, are not well understood. Here we demonstrate that expression levels of signal adaptor protein TRAF2 coincide with melanoma resistance to UV-irradiation. Altered TRAF2 signaling by a form of TRAF2, which lacks the ring finger domain (TRAF2DeltaN), increases activities of p38 MAPK, ATF2, and the level of TNFalpha expression. Forced expression of TRAF2DeltaN in HHMSX highly metastatic melanoma cells that lack Fas expression and thus utilize the TNFalpha-TNFR1 as the major apoptotic pathway sensitized cells to UV-induced apoptosis. An over twofold increase in degree of apoptosis was observed in TRAF2DeltaN expressing cells that were treated with actinomycin D, anisomycin or with the radiomimetic drug neocarzinostatin. Sensitization by TRAF2DeltaN is selective since it was not observed in response to either Taxol or cis-platinum treatment. TRAF2DeltaN effects are primarily mediated via p38 since inhibition of p38 reduces, whereas activation of p38 promotes the level of UV-induced apoptosis. Conversely, activation of IKK attenuates the sensitization of melanoma by TRAF2DeltaN, indicating that p38-mediated suppression of NF-kappaB activity is among TRAF2DeltaN effects. Our finding identifies p38, TNFalpha and NF-kappaB among key players that efficiently sensitizes melanoma cells to UV-, ribotoxic (anisomycin) and radiomimetic chemicals-induced programmed cell death in response to aberrant TRAF2 signaling.

Jun NH2-terminal kinase phosphorylation of p53 on Thr-81 is important for p53 stabilization and transcriptional activities in response to stress.

The p53 tumor suppressor protein plays a key role in the regulation of stress-mediated growth arrest and apoptosis. Stress-induced phosphorylation of p53 tightly regulates its stability and transcriptional activities. Mass spectrometry analysis of p53 phosphorylated in 293T cells by active Jun NH2-terminal kinase (JNK) identified T81 as the JNK phosphorylation site. JNK phosphorylated p53 at T81 in response to DNA damage and stress-inducing agents, as determined by phospho-specific antibodies to T81. Unlike wild-type p53, in response to JNK stimuli p53 mutated on T81 (T81A) did not exhibit increased expression or concomitant activation of transcriptional activity, growth inhibition, and apoptosis. Forced expression of MKP5, a JNK phosphatase, in JNK kinase-expressing cells decreased T81 phosphorylation while reducing p53 transcriptional activity and p53-mediated apoptosis. Similarly transfection of antisense JNK 1 and -2 decreased T81 phosphorylation in response to UV irradiation. More than 180 human tumors have been reported to contain p53 with mutations within the region that encompasses T81 and the JNK binding site (amino acids 81 to 116). Our studies identify an additional mechanism for the regulation of p53 stability and functional activities in response to stress.

Phase synchronization in coupled Nd:YAG lasers.

We investigate experimentally the transition to phase synchronization in coupled Nd:YAG lasers. As the coupling strength increases, the phase difference of two chaotic laser outputs develops from nonsynchronous to a phase-synchronous state via +/-2pi phase jumps. We analyze this transition.

Transcription factors NF-kappaB and AP-1/c-fos in cell response to nocodazole.

The effects of nocodazole (an agent causing degradation of microtubules in vitro) on the content of transcription factors NF-kappaB and AP-1/c-fos in the nuclei of cultured cells CHO-K1 and HeLa, as well as on the activity of these factors in the nuclei of T-cell hybridoma 2B4 were studied. Immunoblotting, immunofluorescence, and gel retardation techniques revealed that in all cell lines studied nocodazole induced rapid and considerable activation (an increased content in the nuclei) of transcription factor AP-1/c-fos. In 2B4 cells, nocodazole had no effect on the activity of NF-kappaB, but in CHO-K1 and HeLa cells it caused a transient decrease, sometimes followed by an increase in the content of subunit p50. Besides, nocodazole inhibited proteolytic degradation of NF-kappaB in CHO-K1 and HeLa cells and caused a short-term decrease in the content of subunit p65 in CHO-K1 cells. The results suggest that nocodazole may interfere with the genome expression, and these alterations should be taken into consideration, whatever experimental studies this substance is used in.

Sex steroids induce apoptosis of CD8+CD4+ double-positive thymocytes via TNF-alpha.

T cell production by the thymus, thymic size, cellularity and output all decrease drastically after puberty. Among the candidates that may mediate this decrease are the sex steroids: hypersecretion or pharmacological administration of these hormones has long been known to induce thymic hypocellularity, and their depletion yields thymic hypercellularity. Here we show that a typical sex steroid, testosterone, specifically targets CD8+CD4+ double-positive (DP) thymocytes for apoptosis via TNF-alpha. Anti-TNF-alpha monoclonal antibodies abrogated testosterone-induced DP apoptosis, and TNF-alpha-/- DP thymocytes were largely resistant to testosterone-mediated apoptosis in vivo. Testosterone accomplished this effect by upregulating TNF-alpha production and by simultaneously sensitizing DP thymocytes to TNF-alpha. Thus, TNF-alpha is the critical mediator of sex steroid-induced apoptosis in thymocytes, and its manipulation should provide a point of intervention to modulate T cell production in sex hormone disorders.

Number of triplets in 16S rRNA gene related with pathogenicity of Bacillus spp. and Clostridium spp.

The relation between the number of some trinucleotides in the sequence of 16S rRNA gene and pathogenicity of bacterial species from the genera of Bacillus and Clostridium was revealed. The species of genus Bacillus, which are pathogenic for humans, mammals and insects, have an increased number of AAA and TAT triplets in 16S rRNA gene. Theoretically, these species, B. anthracis and B. cereus for example, may be detected in the specimen by the higher ratio of AAA plus TAT triplets to the number of GGG triplet. Species of genus Clostridium, which are pathogenic for humans and mammals, have a maximum ratio of AAA and TAT triplet numbers. This ratio was higher than 2.6 for pathogenic species and lower than 2.2 for saprophytic ones. These theoretical data may open a new way for detecting pathogenic bacteria through the determination of triplet numbers in the sequences of 16S rRNA or rRNA. However, the mechanism of evolutionary relation between the number of AAA and TAT triplets in the sequence of 16S rRNA gene and the pathogenicity of bacterial species is not known.

Glutathione S-transferase p elicits protection against H2O2-induced cell death via coordinated regulation of stress kinases.

To elucidate mechanisms underlying glutathione S-transferase p (GSTp)-mediated cellular protection against oxidative stress-induced cell death, the effect of GSTp on stress signaling pathways was investigated before and after H2O2 treatment. Under nonstressed conditions, increased expression of GSTp via a tet-off-inducible GSTp in NIH 3T3 cells increased the phosphorylation of mitogen-activated protein (MAP) kinase kinase 4, p38, extracellular receptor kinase (ERK), and inhibitor of kappa-kinase (IKK), and reduced phosphorylation of MAP kinase kinase 7 and Jun NH2-terminal kinase (JNK). Whereas H2O2 treatment of cells induced JNK, p38, and IKK activities, in the presence of H2O2 and elevated GSTp expression there was an additional increase in ERK, p38, and IKK activities and a decrease in JNK activity. GSTp-mediated protection from H2O2-induced death was attenuated upon inhibition of p38, nuclear factor KB, or MAP kinase by dominant negative or pharmacological inhibitors. Conversely, expression of a dominant negative JNK protected cells from H2O2-mediated death. These data suggest that the coordinated regulation of stress kinases by GSTp, as reflected by increased p38, ERK, and nuclear factor kappaB activities together with suppression of JNK signaling, contributes to protection of cells against reactive oxygen species-mediated death.

[Possible mechanisms of development of biliary diseases under the conditions of the Transbaikal region]. / Vozozhnye mekhanizmy razvitiia zabolevanii zhelchevyvodiashchikh putei v usloviiakh Zabaikal'ia.

Eighty one patients with various biliary diseases and 36 apparently healthy individuals were examined. There were relatively elevated lipid peroxidation (LPO) products (E 232/220 and E 278/220) in biliary diskynesia and higher concentrations of LPO intermediate products in cholecystitis. In cholelithiasis, the levels of LPO products were lower than those in cholecystitis. E 232/220 and 278/220 may be used for early diagnosis of biliary dysfunctions. Selenium deficiency observed in the Transbaikal region decreases antiradical protection and increases the incidence of biliary diseases.