[Molecular Biological Aspects of Depressive Disorders: A Modern View].

Depression is a serious mental disorder that affects more than 300 million people worldwide. Due to the lack of effective treatment methods, the pathogenesis of depression is necessary to study in order to understand its development and find new therapies. The review describes the main mechanisms of depression, including the monoamine hypothesis, impairment of the hipotalamic-pituitary-adrenal axis, decreased production of neurotropic factors, and neuroinflammation. Genetic correlations, gene polymorphisms, and epigenetic mechanisms are also considered. Common and different features of the etiology are analyzed for depression and depressive conditions associated with other pathologies (schizophrenia, Parkinson disease, and Alzheimer's disease). Modern experimental methods used to investigate the molecular mechanisms of depressive conditions are described with a focus on gene knockouts in laboratory animals and the CRISPR/Cas technology. Consideration is given to optogenetic and chemogenetic methods and analyses of genetic polymorphisms and their combinations. The data may provide for a better integral understanding of the modern ideas about the pathogenesis of depression as an isolated or comorbid disorder and the prospects in studying the mechanisms of depressive conditions.

[Biobanks as the basis for developing biomedicine: Problems and prospects].

Biobanking is crucial for the development of life sciences in general and biomedical science in particular. A systematic study of stored biomaterials enables the discovery of new biomarkers for various physiological and pathophysiological states, identification of the drug targets, and validation of these findings in human population studies. During the last decades, the importance of biobanking has increased in parallel with the growth in their size from relatively small collections to very large national and international biorepositories. Here, we have systematically reviewed modern approaches to biobanking, a variety of biobank definitions and types, and the current states of biobanking art in Russia and in the world and have discussed the obstacles to the global development of biobanking, along with possible solutions.

[The comparative analysis of cardiac contractility associated with certain causes of death].

Results of the comparative analysis of structural changes in cardiomyocyte sarcomers revealed by polarization microscopy in certain fatal cases. The main causes of impaired cardiac contractility and cardiac arrest in the victims of craniocerebral injury and in the subjects with acute forms of ischemic heart disease (acute coronary artery insufficiency and acute myocardial infarction in the pre-necrotic phase), pneumonia, or mechanical strangulation asphyxia (resulting from hanging, with the loop placed around the anterior upper third of the neck and the knot in the posterolateral aspect).

[Social and economic burden of stroke in Russian Federation]. / Sotsial'no-ekonomicheskoe bremya insul'ta v Rossiiskoi Federatsii.

OBJECTIVE: The purpose of this study was to assess the annual socio-economic burden of stroke in the Russian Federation from the position of the state. MATERIAL AND METHODS: Based on official statistics on morbidity and mortality due to stroke (2019), the results of a survey of patients or caregivers (680 respondents) and cost indicators of 2022, the social and economic burden of stroke during the 1st year after the acute period is modeled. All cost estimates are made from the position of the state. RESULTS: In 2019 435.2 thousand cases of stroke have been registered in the Russian Federation, 30% of those patients died during the year after the acute episode, thus annually up to 1.7 million years of life are lost. According to our study, stroke accounted for 2% of all days of disability paid by Social Insurance Fund in 2019 and 9% of cases of primary receiving of disability. More than 139 thousand working people assisted their relatives who suffered a stroke, 59.2 thousand of them were forced to change jobs, 18 thousand people left work due to the need to care for a relative. The economic burden of stroke amounted to more than 490 billion rubles. or 0.3% of GDP. The average costs per 1 registered case of hemorrhagic stroke amounted to 0.93 million rubles, ischemic - 1.2 million rubles, of which about 10% are medical costs, 5% are non-medical costs and 85% are costs associated with loss of productivity. CONCLUSION: Stroke causes a significant socio-economic burden for the state in the Russian Federation, the economic losses within 1 year is equal to the 0.3% of the country's annual GDP. The main contribution to the stroke economic and social burden is not only mortality, but also disability, leading to incapacitation of patients who have suffered a stroke, as well as to a reduction in the contribution to the economy of their relatives who help and care for them.

[Dynamics of postmortem autolysis of cardiomyocytes].

Dynamics of postmortem autolysis of cardiocytes was evaluated using cells and tissues obtained from the patients who died from acute forms of ischemic heart disease, such as acute coronary insufficiency and acute myocardial infarction in the pre-necrotic phase. The studies were carried out at a temperature of 7, 20, and 37 degrees C. It was shown that autolysis of cardiac muscular fibers proceeds through three successive stages. A rise in temperature from 7 to 20 degrees C accelerated autolysis by one third while further elevation of the temperature up to 37 degrees C was associated with a 9-fold decrease in the duration of autolysis.

[Optimization of kidney transplantation from elderly donors].

Operations of transplantation of kidneys taken from donors with expanded criteria with satisfactory results were made on 27 recipients of the older age group (from 60 through 76 years). Standard transplantation of the kidney was made to 20 recipients, and dual renal transplantation to 7 recipients. Mean level of creatinine in elderly patients on the 21st day was (340.9 +/- 49.3) microM/l, on the 90th day (124.6 +/- 6.9) microMl/l.

A solid-state amorphous selenium avalanche technology for low photon flux imaging applications.

PURPOSE: The feasibility of a practical solid-state technology for low photon flux imaging applications was investigated. The technology is based on an amorphous selenium photoreceptor with a voltage-controlled avalanche multiplication gain. If this photoreceptor can provide sufficient internal gain, it will be useful for an extensive range of diagnostic imaging systems. METHODS: The avalanche photoreceptor under investigation is referred to as HARP-DRL. This is a novel concept in which a high-gain avalanche rushing photoconductor (HARP) is integrated with a distributed resistance layer (DRL) and sandwiched between two electrodes. The avalanche gain and leakage current characteristics of this photoreceptor were measured. RESULTS: HARP-DRL has been found to sustain very high electric field strengths without electrical breakdown. It has shown avalanche multiplication gains as high as 10(4) and a very low leakage current (< or = 20 pA/mm2). CONCLUSIONS: This is the first experimental demonstration of a solid-state amorphous photoreceptor which provides sufficient internal avalanche gain for photon counting and photon starved imaging applications.

[Morphology of acute myocardial infarction at prenecrotic stage].

We studied morphological changes of myocardium and content of glucose, potassium, calcium, sodium in pericardial fluid in persons who died suddenly of myocardial infarction at its prenecrotic stage at prehospital phase. It was established that acute myocardial infarction at prenecrotic stage can run in 2 morphological forms - either with transmural or with subendo- or epicardial localization of ischemic process in left ventricular wall. Transmural injury is characterized by large volume of ischemic damage of the left ventricle, generalized spasm of arterial system of the heart, changes of cardiomyocytes with derangement of their energy metabolism and contractile capacity. In subendo- or epicardial localization foci of ischemic injury alternated with areas of normal blood supply. Similar character of disturbances of rheological properties of blood with thrombosis of microcirculatory bed and of number of markers of ventricular fibrillation between these two forms create preconditions for increase of the zone of necrosis in myocardium and cause high risk of development of rhythm disorders.

[Normothermal perfusion rehabilitation of donor organs in situ after 90 minute-long primary thermal ischemia].

Results of the first using of abdominal prolonged normothermal perfusion with transmembrane oxigenation and removal of leukocytes from the perfusion contour in situ are presented. The investigation included 6 asystolic donors with primary thermal ischemia from 49 to 90 minutes and transplantation of their kidneys to recipients. In half of the patients there was immediate function of the transplant. This protocol is the method of choice in getting transplants from donors with a sudden irreversible arrest of blood circulation and prolonged 90 min primary thermal ischemia.

[Psychotic disorders in the veterans of local wars]. / Psikhoticheskie rasstroistva u veteranov lokal'nykh voin.

OBJECTIVE: To determine the frequency of the key psychopathological syndromes, the dynamics and comorbidity of schizophrenia and other psychoses in Russian veterans of local wars receiving hospital treatment. MATERIAL AND METHODS: The study included 685 patients of a psychiatric department of a military hospital, including 264 veterans of the local wars (the main group), 296 people (career military servicemen and retirees), who do not take part in combat actions (the first comparison group) and 125 people matched for the middle age and the age distribution curve with the main group (the second comparison group). RESULTS AND CONCLUSION: The frequency of psychoses appeared to be slightly less in veterans (7.2%) compared to patients of comparison groups (14.5% and 8.8%, respectively). In all groups, most patients were diagnosed with schizophrenia (ICD-10 F20): 3.8% in the main group, 4.4% in the first comparison group and 4.0% in the second comparison group. Other acute and chronic psychotic disorders (F22-F23) were diagnosed in 0.8, 5.4 and 3.2% patients, respectively. Organic delusion disorders were diagnosed in 1.5% patients of the main group, 3.7% patients of the first comparison group and were not detected in the second comparison group. Comorbidity of posttraumatic stress disorder (PTSD) and psychosis was about 2% in the main group in whole and 26.3% in those with schizophrenia and other delusional disorders. The degree of incidence of symptoms of PTSD in veterans diagnosed with psychosis was significantly less than their frequency among all veterans (20% and 46.9%, respectively). Military stress factors do not influence the development of hallucinations and delusions in the main group. In the majority of veterans, psychotic symptoms manifested for the first time after stopping combat stress, the subsequent development and recurrence of psychotic symptoms happened regardless of the influence of combat stress factors.

[Alimemazine in treatment of agitation in schizophrenia]. / Primenenie Alimemazina pri kupirovanii vozbuzhdeniya u bol'nykh shizofreniei.

OBJECTIVE: An analysis of the efficacy and safety of additional therapy of excitement with the injectable form of alimemazine during exacerbations of schizophrenia with psychomotor agitation, impulsivity, including dangerous behavior, irritability, conflict, hostility, aggressiveness, anxiety, sleep disturbances (insomnia). MATERIAL AND METHODS: Thirty patients, aged 18 to 65 years, with a diagnosis of «paranoid schizophrenia¼, established in accordance with the ICD-10 criteria, were studied. The patients received treatment with a second-generation antipsychotic and alimemazine (intramuscular injection solution) in daily dose from 25 mg to 150 mg during no more than 9 days. The patients were assessed with psychometric scales (PANSS, ABS, HARS and VAS) four times during the observation period. RESULTS AND CONCLUSION: During therapy with a combination of second-generation antipsychotics and alimemazine solution for intramuscular injection, a reliable (p<0.001) reduction in the severity of psychotic symptoms assessed with PANSS was achieved by 8-9 days (the average total score decreased by 30% relative to the initial level) that indicated the improvement in all manifestations of schizophrenia exacerbation. A decrease of 34.8% (p=0.007) in the risk of aggression (PANSS points S1-S3) was established. The level of excitation on the agitation scale (ABS) decreased by 3.6% (p<0.001). In 50% of patients, manifestations of anxiety disappeared, and the average HARS score decreased by 2.2 times compared with the initial level (p<0.001). Almost half of the patients noted the normalization of sleep, and the average value of sleep disturbance on a visual analogue scale decreased threefold compared with the initial level (p<0.001). The observed adverse events were moderate or mild. Alimemazine shows the highest efficacy in the treatment of anxiety arousal in patients with schizophrenia with affective-delusional attacks.

[Network analysis of cognitive, oculomotor and speech parameters in schizophrenia]. / Setevoi analiz kognitivnykh, glazodvigatel'nykh i rechevykh pokazatelei pri shizofrenii.

OBJECTIVE: To determine the network connections between clinical, cognitive, speech and oculographic parameters in patients with schizophrenia. MATERIAL AND METHODS: The study included 104 patients with schizophrenia and schizophrenia spectrum disorders and 70 healthy subjects. Clinical assessment of the patients was performed using a number of scales: PANSS, CDSS, YMRS, SAS and BAS. Basic cognitive functions were assessed by BACS. Eye movements were recorded using the SMI RED-500 non-invasive eye tracking system. Several experimental paradigms were used - free viewing of animal images with subsequent description of these images, performing progressive saccades in the experimental Go/NoGo scheme, and performing anti-saccades. RESULTS: The severity of clinical symptoms, cognitive impairments, oculomotor parameters and characteristics of speech structure of written speech are largely independent, although not completely isolated from each other. Cognitive and oculomotor parameters have the largest number of connections. In this case, the results of cognitive tests are the central element of the «network¼ that connects other groups. CONCLUSION: Further development of the approach should be aimed at studying the influence of node changes on the structure of the network that would potentially allows the identification of the most effective points of application of therapeutic and rehabilitation programs.

[Morphological prerequisites of heart ventricles fibrillation in sudden cardiac death].

We studied morphological changes in the myocardium and content of glucose, magnesium, calcium, sodium in pericardial fluid of victims of out of hospital sudden death due to acute coronary insufficiency and prenecrotic stage of myocardial infarction. We established that both in regions of ischemic injury appearing as III degree contracture lesions of cardiomyocytes, zones of intracellular myocytolysis and primary breakdown of myofibrils, as will as in zones of relaxation myocardium loses its contractile properties. This in turn leads to asynchronous contraction of left and right ventricles. As fibrillation develops in both ventricles simultaneously there are all grounds to believe that morphological prerequisite (source of origin) of fibrillation is the presence of areas of ischemic injury and relaxation in the myocardium.

[Approaches to the choice of control group for a pathomorphological study of the heart].

It is generally accepted that an optimal control group for pathomorphological studies of the heart should be constituted by individuals who died from a craniocerebral injury without near-death experience. Polarization microscopy is a principal tool for the assessment of pathomorphological characteristics of myocardium. The presence of ethanol in the blood of a dead individual is associated with enhanced permeability of vascular walls, venous plethora, sludge phenomenon, microcirculatory thrombosis, perivascular and intermuscular oedema but does not on the whole interfere with the objective evaluation of microscopic images of the cardiac muscle.

[Perspectives of the use of pharmacogenetic tests in neurology and psychiatry]. / Perspektivy primeneniia farmakogeneticheskikh testov v psikhiatrii i nevrologii.

The review is devoted to the analysis of the current state of pharmacogenetic research and their use in psychiatric practice. The main genes responsible for the pharmacodynamics and pharmacokinetics of drugs used in psychiatry are listed. Foreign pharmacogenetic clinical recommendations and progress on their implementation in medical practice in various countries of Europe and the USA are analyzed. The need to create Russian clinical guidelines on pharmacogenomics to improve the effectiveness of patient care and to implement a personalized approach to therapy is discussed.

[The informative value of pericardial fluid electrolytes and glucose in acute forms of coronary heart disease].

The informative value of the levels of calcium, potassium, sodium, magnesium, and glucose was estimated in individuals who had suddenly died from acute coronary insufficiency or acute myocardial infarction in the prenecrotic phase. The informational variations in the concentrations of electrolytes and glucose were found to reflect the differences available in the pathogenesis of an ischemic process in acute coronary insufficiency and acute myocardial infarction in the prenecrotic phase.

[Effect of nibentan on dispersion of repolarization of ventricular myocardium in the rabbit].

Among factors determining development of polymorphic ventricular tachycardia torsades de pointes under influence of class III antiarrhythmic drugs great value is attributed to enhanced heterogeneity of repolarization of ventricular myocardium which can cause functional conduction blocks and development of re-entry of excitation. In this work with the help of optical mapping of electrical activity of the heart we investigated effect of nibentan (0.3 and 1 mM) on chronotopography of repolarization of epicardial surface of ventricles of isolated after Langendorf rabbit heart (n=5). For assessment of heterogeneity of repolarization we measured the following parameters: standard deviation of mean action potential duration (APDm) along mapped region (SD-APD), dispersion index (DI=1000 SD-APDm), maximal dispersion (Dmax=APDmax-APDmin). Nibentan in concentrations 0.3 and 1 mM increased APD at the level of 90% repolarization (APD90%) from 231 +/- 12 to 277 +/- 7 ms (p < 0.05) 318 +/- 7 ms (p < 0.001), respectively, but in concentration 1 mM it practically did not affect parameters of heterogeneity of repolarization (SD-APD: from 4.4 +/- 0.9 to 5.7 +/- 1.1 ms, p=0.4; DI: from 19.1 +/- 4.2 to 18.0+3.5, p=0.8; Dmax: from 16.6 +/- 2.5 to 24.8 +/- 4.3 ms, < 0.05). These results show that nibentan in the range of clinically used doses does not effect heterogeneity of ventricular myocardium. This can explain low proarrhythmic effect of nibentan.

[Psychologic stress of participants in combat actions and their subjective feelings].

Using the method of nameless interrogation, there were investigated 119 service-men, served by contract on Northern Caucasus. 76,5% of investigated persons recognized different types of distress. The most often, features of psychic ill-being were signed by persons, obtained different wounds. Among typical symptoms of acute stress reactions the most often were the evidences of "invasion" (21%), tension (13,5%), lowed attune (14,3%). It's necessary attend, that involuntary revising and high irritation with an aptitude of evidence of anger often worried participants of warfare. Tension, backward, worried, in general, the persons, not yet participated in warfare. Persons, participated in warfare for the first time,signed the psychic tension rather rare. Lowed attune were signed very rare for the persons, served in the area of contraterrorist actions for the second time and having a big battle experience. During the evaluation of comorbidity of different symptoms of stress disease were signed, that the most often with another types of symptoms are conjoined: high irritation, sense of weariness, sense of fault and lowed attune. These symptoms can serve as markers of tendency to syndrome-making and, that's why, require special attention of psychologist and psychiatrist of military unit of medical service.

[Neuro-physiological and morphological manifestations of posttraumatic stress disorder (review of literature)].

The article presents the review of neurophysiological and neuro-morphological researches of combat posttraumatic stress disorder. Also in the article presented data about the existence by the veterans, suffered by combat posttraumatic stress disorder, a regular dysfunction of hypothalamus-pituitary-paranephric system, approving by excessive allowance ruffling ofcortisol, tending the activation neuro-trasmitteric systems. These changes conjoin with predominance of sympaticotony and of increased psycho and physiological inflammability in response to cues, associated with real or imaginable danger. Methods of neurovisulisation show the existence of changes in visceral brain, prefrontal and sense-motorical zone of cerebrum, corresponded to stress signals. The article presents the discuss of cause-and-effects conditions between the morphological changes in central nervous system, influence of stress-factors and advance of disease.

[Information value of electrolytes, glucose, and urea in pericardial liquid in different terminal conditions].

The informative worth of sodium, potassium, calcium, magnesium, glucose, and urea levels in the pericardial liquid is analysed. The values of these parameters in a terminal disease of cerebral origin may testify to the absence of disturbances of energy and protein metabolism or electrolyte disbalance in the myocardium. Disturbances of myocardial electrolyte balance, energy and protein metabolism develop in cardiac, pulmonary, and mixed type terminal conditions. Cardiac arrest is associated with impaired myocardial conduction.