[Surgical treatment of patients with chest malignancies in anti-tuberculosis hospital]. / Khirurgicheskoe lechenie bol'nykh zlokachestvennymi novoobrazovaniyami organov grudnoi kletki v protivotuberkuleznom statsionare.

OBJECTIVE: To evaluate the effectiveness of surgical treatment of patients with malignancies of lungs, pleura and chest wall in early and long-term follow-up period in anti-tuberculosis hospital. MATERIAL AND METHODS: There were 2139 patients between 2016 and 2020. Chest tumors were diagnosed in 290 (13.6%) patients and 210 (94.2%) ones underwent surgery. RESULTS: Surgical interventions are rare in patients with lung cancer and active tuberculosis (0.7%, n=15). Lobectomies prevailed (73.3%). All sublobar resections were performed in elderly patients with severe comorbidities and low functional reserves. Postoperative complications occurred in 9% of cases. Overall 3-year survival rate was 84.8%, overall 5-year survival rate - 70.8%. Overall survival of patients with lung cancer and tuberculosis does not depend on activity of specific process. CONCLUSION: The TRA test used in differential diagnostics of tuberculosis and lung cancer has a mediating value. Lung cancer surgery in patients with active tuberculosis has no negative effect on effectiveness of tuberculosis treatment. Surgical treatment of malignancies in anti-tuberculosis hospital can be performed in accordance with standards of specialized medical care in oncology.

[Nonimmunogenic staphylokinase in the treatment of acute ischemic stroke (FRIDA trial results)]. / Neimmunogennaya stafilokinaza ­ novyi tromboliticheskii preparat v lechenii ishemicheskogo insul'ta (rezul'taty issledovaniya FRIDA).

AIM OF THE STUDY: To investigate the efficacy and safety of non-immunogenic staphylokinase (NS) compared with alteplase (A) in patients with acute ischemic stroke (AIS) within 4.5 h after symptom onset. MATERIAL AND METHODS: 336 patients with IS within 4.5 h after symptom onset were included in a randomized, open-label, multicenter, parallel-group, non-inferiority comparative trial of NS vs A (168 patients in each group). NS was administered as an intravenous bolus in a dose of 10 mg, regardless of body weight, over 10 s, A was administered as a bolus infusion in a dose of 0.9 mg/kg, maximum 90 mg over 1 hour. The primary efficacy endpoint was a favorable outcome, defined as a modified Rankin scale (mRS) score of 0-1 on day 90. Safety endpoints included all-cause mortality on day 90, symptomatic intracranial haemorrhage, and other serious adverse events (SAEs). RESULTS: At day 90, 84 (50%) patients reached the primary endpoint (mRS 0-1) in the NS group, 68 (41%) patients - in the A group (p=0.10, OR=1.47, 95% CI=0.93-2.32). The difference between groups NS and A was 9.5% (95% CI= -1.7-20.7) and the lower limit of the 95% CI did not cross the margin of non-inferiority (pnon-inferiority<0.0001). There were no significant differences in the frequency of deaths between the groups: on day 90, 17 (10%) patients in the NS group and 24 (14%) in the A group had died (p=0.32). There was a trend towards significant differences in the frequency of symptomatic intracranial haemorrhage: NS group - 5 (3%) patients, A group - 13 (8%) patients (p=0.087, OR=0.37, 95% CI=0.1-1.13). There were significant differences in the number of patients with SAEs: in the NS group - 22 (13%) patients, in the A group - 37 (22%) patients (p=0.044, OR=0.53, 95% CI=0.28-0.98). CONCLUSION: The presented results of the FRIDA trial are the first in the world to use a drug based on NS in patients with IS. It has been shown that a single bolus (within 10 s) administration of NS at a standard dose of 10 mg, regardless of body weight, allows to conduct fast, effective and safe thrombolytic therapy in patients with IS within 4.5 h after symptom onset. In further clinical tials of NS, it is planned to expand the therapeutic window beyond 4.5 h after symptom onset in patients with IS.

["Forbidden" lymphocytes clones]. / K voprosu o "zapreshchennykh" clonakh limfotsitov.

The investigations of humoral autoimmune phenomena in healthy subjects have found autoantibodies to different structure self-antigens in the sera of all examinees. It is concluded that autoantibody-producing lymphocytes are a normal morphological component of the immune system which is frequently present in man and mammals.

[Gram-negative virulent bacterial lipopolysaccharide: role in infection and immunity]. / Lipopolisakharidy gramotritsatelnykh virulentnykh bakterii i ikh rolv infektsii i immunitete.

The paper discusses the data available in the literature on the studies on lipopolysaccharides (LPS) of bacteria which show their different virulence. A comparative study of the chemical composition and structure of LPS of the bacteria fails to detect any great difference, but they differ in their biological, especially immunobiological properties. It is suggested that the differences are associated with LPS conformation, chiefly its lipid moiety and ion-coordinating processes and free radical reactions are involved in the conformation. Examining just these phenomena may made advances in further studies of virulent bacterial LPS and possibilities of its use while designing new-generation vaccines.

[Analysis of ordinary microbial relationships in human colonic dysbacteriosis]. / Analiz prostykh mezhmikrobnykh vzaimootnoshenii v mikrobiotsenoze tolstoi kishki cheloveka.

A relationship between the qualitative and quantitative characteristics of representatives of the normal microflora in biocenosis of the colonic lumen (CL) was studied in 18 patients with subacute bacterial endocarditis, 18 patients with rheumatic heart disease, 13 with chronic renal failure and 50 healthy individuals without clinical signs of dysbacteriosis. The number of intermicrobial relationships was found to be rather small both in health and in disease. However, a disease shows a considerably greater number of different relations, synergic ones in particular. Analysis indicated that in the conditions under study 72 to 93% of relations that were realized in the healthy human CL biotope disappeared and the established intermicrobial relationships were found 86-97% quite new. Summing up, the authors have concluded that, first, the CL microflora exists under the conditions of excess nutrient substrate and is not a factor of self-regulation, second, changes in the body's metabolic systems are primary in the diseases examined, which the normal lumenal microflora is responsive to.