[Value of N-terminal pro brain natriuretic peptide in predicting acute kidney injury in patients with acute decompensated chronic heart failure]. / Znachenie N-kontsevogo predshestvennika mozgovogo natriiureticheskogo peptida v prognozirovanii ostrogo povrezhdeniya pochek u bol'nykh s ostroi dekompensatsiei khronicheskoi serdechnoi nedostatochnosti.

AIM: To investigate the prognostic value of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in the development of acute kidney injury (AKI) in patients with acute decompensated chronic heart failure (ADCHF). SUBJECTS AND METHODS: Eighty-three patients (55 (66%) men and 28 (34%) women; mean age, 65±11 years) with ADCHF were examined. AKI was diagnosed and classified according to the 2012 Kidney Disease Improving Global Outcomes Clinical Practice guidelines. To rule out contrast-induced AKI, the investigation enrolled only patients in whom radiopague agents had not been injected 7 days before and during hospitalization. Enzyme immunoassay was used to determine serum NT-proBNP concentrations in all the patients upon hospital admission. RESULTS: AKI was diagnosed in 18 (22%) patients, 13 (16%) had Stage I, 4 (5%) had Stage II, and 1 (1%) had Stage III. The serum concentration of NT-proBNP was significantly higher in patients with AKI than that in the other patients [1512.1 (981.0; 2246.2) and 861.8 (499.0; 1383.6) pg/ml (p=0.008). The rise in NT-proBNP concentrations of more than 942 pg/ml was established to be associated with a considerable increase in the risk of AKI (relative risk (RR) was 4.3; 95% confidence interval (CI), 1.27-14.90; p=0.02). RОС analysis indicated that a NT-proBNP level of >942 pg/ml allows prediction of AKI with a sensitivity of 78% (52; 94) and a specificity of 55% (44; 69) (AUC=0.70; p=0.006). Four (5%) patients died in hospital. NT-proBNP levels in all the dead were greater than 942 pg/ml. Two of the 4 deceased patients had AKI. CONCLUSION: A high level of NT-proBNP in a patient with ADCHF during hospitalization can serve as a biomarker for high risk of AKI and for high mortality rates.

[EFFECT OF EXTRACHROMOSOMAL ELEMENTS OF HEREDITY ON TOXIC PROPERTIES OF YERSINIA PESTIS].

AIM: Elucidation of the role of extrachromosomal elements of heredity in manifestations of toxic properties of Yersinia pestis. MATERIALS AND METHODS: The study was carried out in vac- cine strain Y pestis EV76 (pMT1, pCD1, pPCP1) and non-plasmid variants of vaccine EV76 (pMT1⁻, pCD1⁻, pPCP1⁻) and virulent 231 (pMT1⁻, pCD1⁻, pPCP1⁻) strains of Y pestis. Presence of functionally active form of lipopolysaccharide (LPS) in.the incubation medium of the bacteria was evaluated via toxicity of supernatant of Y pestis for intactanimals (infec- tion-toxic shock) and mice sensitized by D-GalN. RESULTS: 37°C cultures of Y pestis EV76 containing a full amount of plasmids were established to release LPS into the environment. Non-plasmid variants of both vaccine and virulent strains of Y.pestis pMT-, pCD1-, pPCP1- do not have this ability. Separation of LPS from cell wall was detected in live bacteria of plague infectious agent. This process is assumed to be coupled with translocation of proteins coded by pMT1, pCD 1, pPCP 1 plasmids from the cell into the environment. CONCLUSION: Functional inter-connection between extrachromosomal elements of heredity and toxic activity of Y pestis LPS is established for the first time.

[Endogenous erythropoietin, acute kidney injury, and prognosis in patients with acute coronary syndrome].

AIM: To investigate the prognostic value of serum endogenous erythropoietin (EPO) in patients with acute coronary syndrome (ACS), including that in the development of acute kidney injury (AKI). SUBJECTS AND METHODS: Eighty-four patients (46 men, 38 women; mean age 63 ± 11 years) with ACS were examined. Twenty-one (25%) patents were diagnosed with ECG ST-segment elevation acute myocardial infarction (STSEAMI), 12 (14%) had ECG non-STSEAMI, and 51 (61%) had unstable angina. Thrombolytic therapy was performed in 10 (48%) patients with STSEAMI. The patients whom had not undergone coronarography were included in the investigation to exclude the nephrotoxic effect of X-ray contrast agents. RESULTS: AKI was observed in 7 of the patients with acute myocardial infarction and in only 1 of those with unstable angina. Four (5%) patients died during hospitalization. The EPO level of > 10.5 IU/ml predicted the development of AKI in the ACS patients with a sensitivity of 71% and a specificity of 67%. That of > 13.7 IU/ml was associated with hospital death in the ACS patients with a sensitivity of 100% and a specificity of 75% (AUC = 0.93%). CONCLUSION: High serum EPO levels in an ACS patent during his hospital stay may serve as a biomarker for a high risk for AKI and high death rates.

Expression in E. coli and purification of the fibrillogenic fusion proteins TTR-sfGFP and ß2M-sfGFP.

The possibility of obtaining recombinant fibrillogenic fusion proteins such as transthyretin (TTR) and ß2-microglobulin (ß2M) with a superfolder green fluorescent protein (sfGFP) was studied. According to the literature data, sfGFP is resistant to denaturating influences, does not aggregate during renaturation, possesses improved kinetic characteristics of folding, and folds well when fused to different polypeptides. The corresponding DNA constructs for expression in Escherichia coli were created. It could be shown that during expression of these constructs in E. coli, soluble forms of the fusion proteins are synthesized. Efficient isolation of the fusion proteins was performed with the help of nickel-affinity chromatography. For this purpose a polyhistidine sequence (6-His-tag) was incorporated into the C-terminus of the sfGFP. We could show that the purified fusion proteins contained full-size sequences of the most amyloidogenic TTR variant, TTR(L55P) and ß2M, and also sfGFP possessing fluorescent properties. In the course of fibrillogenesis both fusion proteins demonstrated their ability to form fibrils that were clearly detectable by atomic force microscopy. Furthermore, with the help of confocal microscopy we were able to reveal structures (exhibiting fluorescence) that are formed during fibrillogenesis. Thus, the use of sfGFP has made it possible to avoid formation of inclusion bodies (IB) during the synthesis of recombinant fusion proteins and to obtain soluble forms of TTR(L55P) and ß2M that are suitable for further studies.

[Transthyretin gene V30M, H90N, and del9 mutations in cardiomyopathy patients from St. Petersburg].

A search of transthyretin (TTP) gene mutations was conducted in patients with cardiomyopathies from St. Petersburg. Mutations H90N, V30M, G47A, and deletion (del9) of nucleotides GACTTCTCC in position 6776 from the start codon of the TTP gene (in position 98782 according to reference sequence AC079096 (NCBI) was found. The H90N mutation in the third exon of TTP gene was detected in a son of a cardiomyopathy patient and in his mother, which lacked any clinical manifestations. Mutations V30M and G47A in exon 2 of TTP gene were found in heterozygous and homozygous state, respectively, in one of the probands. Deletion (del9) was revealed in a patient with cardiomyopathy and in his two daughters from different marriages, who had no clinical manifestations of the disease. All the mutations revealed in this study were previously identified in other populations.

[Biological activity of the components of F1-antigen of Yersinia pestis].

Components of the capsule antigen (Baker), described early as F17, F18, F43, Flp, which positively reacts with commercial poly- and monoclonal antifractions plague diagnosticums were studied. Differences and their impacts on vaccine bacteria survival within peritoneal macrophages, guinea pigs and protection of white mice after immunization and fast protection against plague were shown. Hemolytic, cytolytic and hemo- and cytoagglutinations activities of lipoprotein (Flp) and capacity of glycoproteins F17 and F43 for induction of hemo- and cytoagglutinations were detected. Similarity of properties of enumerated components and lectins and their role in infection development and immunogenesis are discussed.

[Resistance of experimental antibiotic resistant variants of Yersinia pestis EV76 (NIIEG line) to modern marker antibiotics].

Lower susceptibility of previously designed experimental polyresistant variants of Yersinia pestis EV76 (NIIEG line) with inserted R plasmid or transposons to some present antibiotics efficient in the treatment of plague, i. e. doxycycline, amikacin and ceftriaxone, was shown. Clones, more resistant to them vs. the initial variants, were selected. They accustomed in vivo in laboratory animals per se and after administration of antibiotics. The data on the protective activity of the new variants in the treatment of experimental plague after combined vaccination and antibiotic prophylaxis are presented.

[Construction of variants of Yersinia pestis EV76 (RIEG line) vaccine strain differing in antibiotic resistance spectra with stage-by-stage transduction of R-transposons].

Mono- and polyresistant variants of the plague vaccinal strain Yersinia pestis EV76 (RIEG line) were constructed with stage-by-stage transduction of transposons Tn5, T, Tn10 and Tn9 located in the phage vectors. Methods for stage-by-stage selection of the transductants that preserved intact determinants of surviving, antiphagocytic activity and immunogenic properties were designed for their further testing as model vaccinal strains in combined specific and emergent medicamentous prophylaxis of plague.

[Cholera in the Far East of Russia. Communication 2. Epidemiological characteristics of the outbreak of cholera El tor in Iuzhno-Sakhalinsk]. / Kholera na Dal'nem Vostoke Rossii. Soopshchenie 2. Epidemiologicheskaia kharakteristika vspyshki kholery él'tor v g. Iuzhno-Sakhalinske.

The outbreak of cholera eltor in Yuzhno-Sakhalinsk has been analyzed. The fact of the import of this infection from China and its transmission mainly by the water route due to the intensive contamination of environmental objects has been substantiated. The effective purification decontamination of sewage water plays decisive role on the system of anticholera measures. The conclusion on the necessity of increasing the effectiveness of measures for the sanitary protection of the territory has been made.

[A new method of formation of chorioretinal adhesions in retinal detachment]. / Novyi sposob formirovaniia khorioretinal'noi adgezii pri retinal'noi otsloike setchatki.

A method of intrascleral transplantation of foam gel providing the creation of stable chorioretinal adhesion at the site of the retinal defect has been experimentally developed and clinically tried. A special injector has been designed for the realization of the method, permitting stratification of the scleral capsule at a given depth. The suggested method is recommended for practical use in patients with rheumatogenic detachment of the retina in the initial and moderate degrees of vitreoretinal proliferation.

[The use of new scleroplastic materials in the surgery of traumatic retinal detachment]. / Primenenie novykh skleroplasticheskikh materialov v khirurgii travmaticheskoi otsloiki setchatki.

New textile-based material is suggested for scleroplastic surgery for detachment of the retina. Features of the design of the new material are described and the efficacy of the implants assessed. Textile-based implants are recommended for clinical practice.

[Inhibition of cholinesterase activity with fluorine-containing derivatives of alpha-aminophosphonic acid]. / Ingibirovanie aktivnosti kholinésteraz ftorsoderzhashchimi proizvodnymi alpha-aminofosphonovykh kislot.

A series of O,O-diethyl-1-(N-alpha-hydrohexafluoroisobutyryl)aminoalkylphos phonates (APh) has been synthesized and their interaction with human erythrocyte acetylcholinesterase (AChE) and with horse serum butyrylcholinesterase (BuChE) studied. Most of the APhs inactivated the cholinesterases irreversible through formation of the enzyme-inhibitor intermediate. The inactivation rate constants and the enzyme-inhibitor intermediate dissociation constants are calculated. The quantitative structure-activity relationships including both hydrophobic and calculated steric parameters of substituents are developed for APh--ChE interactions. Molecular mechanics (programme MM2) was used for determining steric parameters (Es). On the basis of QSAR models analysis it was concluded that hydrophobic interactions play an essential role in APh--AChE binding, whereas for APh--BuChE binding steric interactions are essential. Presence of at least two APh binding centres on the surface of AChE and BuChE is suggested.

[A clinical case. A case of bilateral retinal detachment after scleroplasty]. / Sluchai iz praktiki. Sluchai dvukhstoronnei otsloiki setchatki posle operatsii skleroplastiki.

After prophylactic scleroplasty for high complicated myopia the patient developed bilateral detachment of the retina. Therapeutic strategy with this patient is followed up. The described clinical case evidences the necessity of a strict validation of the choice of this or that surgical modality, particularly in cases when it concerns the only eye with vision.

[A combination of scleroplasty with intrascleral revascularization in myopia]. / O sochetanii skleroplastiki s intraskleral'noi revaskuliarizatsii pri miopicheskoi bolezni.

A combination of scleroplasty after Pivovarov-Pristavko with revascularization of the sclera in the author's modification was used for treatment of myopic disease with expressed dystrophic changes in the eye fundus (stages III-V). For revascularization, the Tenon's capsule is used. It is introduced and sutured in the intrascleral pocket in the superexternal quadrant of the eye ball. The operation was used in 31 patients (35 eyes). No complication was recorded. Remote observations, from 1 to 3 years, over 21 patients (23 eyes) have shown stabilization of dystrophic processes and preservation or rise of visual acuity in 21 eyes (91%). The effectiveness of the operation is explained by improved blood circulation in the eye coats on account of both scleroplasty and revascularization of the sclera by the Tenon's capsule.