[Influence of chronic obstructive pulmonary disease on hospital outcomes of percutaneous coronary interventions in patients with acute coronary syndrome].

AIM: To evaluate the impact of chronic obstructive pulmonary disease (COPD) on hospital outcomes of percutaneous coronary interventions (PCI) in patients with acute coronary syndrome (ACS). MATERIALS AND METHODS: A cohort prospective study of the COPD effect on mortality and coronary microvascular obstruction (CMVO, no-reflow) development after PCI in ACS was carried out. 626 patients admitted in 2019-2020 were included, 418 (67%) - men, 208 (33%) - women. Median age - 63 [56; 70] years. Myocardial infarction with ST elevation identified in 308 patients (49%), CMVO - in 59 (9%) patients (criteria: blood flow <3 grade according to TIMI flow grade; perfusion <2 points according to Myocardial blush grade; ST segment resolution <70%). 13 (2.1%) patients died. Based on the questionnaire "Chronic Airways Diseases, A Guide for Primary Care Physicians, 2005", 2 groups of patients were identified: 197 (31%) with COPD (≥17 points) and 429 (69%) without COPD (<17 points). Groups were compared on unbalanced data (÷2 Pearson, Fisher exact test). The propensity score was calculated, and a two-way logistic regression analysis was performed. The data were balanced by the Kernel "weighting" method, logistic regression analysis was carried out using "weighting" coefficients. Results as odds ratio (OR) and 95% confidence interval. RESULTS: The conducted research allowed us to obtain the following results, depending on the type of analysis: 1) analysis of unbalanced data in patients with COPD: OR death 3.60 (1.16-11.12); p=0.03; OR CMVO 0.65 (0.35-1.22); p=0,18; 2) two-way analysis with propensity score: OR death 3.86 (1.09-13.74); p=0.04; OR CMVO 0.61 (0.31-1.19); p=0.15; 3) regression analysis with "weight" coefficients: OR death 12.49 (2.27-68.84); p=0.004; OR CMVO 0.63 (0.30-1.33); p=0.22. CONCLUSION: The presence of COPD in patients with ACS undergoing PCI increases mortality and does not affect the incidence of CMVO.

[Facet joint distraction as a risk factor for poor clinical outcomes in older patients after anterior cervical discectomy and fusion.]

The search for literature sources in domestic and foreign databases showed the absence of works devoted to the study of the influence of the degree of distraction of the facet joints in elderly and senile patients who underwent anterior cervical discectomy and fusion (ACDF). The purpose of the study was to study the effect of the degree of facet joint distraction on clinical outcomes in patients of the older age group who underwent ACDF. A single-center retrospective study included 47 elderly and senile patients who underwent ACDF for radiculopathy due to degenerative diseases of the cervical spine. A statistically significant correlation was found between the differences in the value of the interfacet distance and the severity of pain in the cervical spine according to VAS (p<0,01). Patients with X-ray semiotics of facet distraction more than 0,55 mm 12 months after the operation were significantly more likely to experience increased pain in the cervical spine according to VAS (p=0,028) and significantly limited daily activities due to pain in the neck NDI (p=0,043). The choice of indications for ACDF in patients of the older age group should be based on a rigorous analysis of facet distraction, cervical sagittal parameters in combination with the functional status of patients.

[Analysis of the effectiveness of various methods of rehabilitation of patients with subacromial impingement syndrome]. / Analiz effektivnosti primeneniya razlichnykh metodov reabilitatsii patsientov s subakromial'nym impindzhment-sindromom.

INTRODUCTION: Subacromial impingement syndrome is a common pathology that leads to a persistent decrease in the functioning of the affected limb and, as a consequence, a decrease in the quality of life and work ability of patients. According to various authors, the study of the effectiveness of treatment and rehabilitation of this pathology is quite widely presented in the literature: surgical, including arthroscopic operations, rehabilitation using various factors of physical therapy, manual and other practices. However, the issue of assessing the effectiveness of movement therapy, both alone and in combination with other therapeutic methods, remains relevant. AIM: To evaluate the effectiveness of therapeutic gymnastics procedures, both monotherapy and in combination with manual massage according to the therapeutic method and extracorporeal shock wave therapy (ESWT), in patients with subacromial impingement syndrome of the shoulder, in order to reduce pain and improve the function of the shoulder joint. MATERIAL AND METHODS: The study included 70 patients whose age was 42.18±10.42 years. Patients were divided into two main groups: group 1 (n=34) and group 2 (n=36). All patients received a course of treatment, including 10 procedures of therapeutic exercises, with recommendations at the end of the course for continuation in the form of independent studies using the proven methodology. The duration of the course of therapeutic exercises (in the form of procedures with a physical therapy instructor and subsequent independent studies) was 30 days. Patients in group 2 were divided into three subgroups: subgroup 2A, in which PH procedures were combined with massage of the cervical-collar area and the upper limb area of the affected side; subgroup 2B, where PH gymnastics was carried out in combination with extracorporeal shock wave therapy (ESWT) procedures; subgroup 2C - a comprehensive program including LH procedures, manual massage and shock wave therapy. RESULTS: 3 months after the end of the course of rehabilitation measures, patients of all groups showed a significant improvement in scores on the ASES and VAS scales, but there were no reliably significant differences between the results of different groups. CONCLUSION: The study indicates that movement therapy is an effective method of rehabilitation for patients with subacromial impingement syndrome, and conducting complex programs in which PH is combined with other rehabilitation methods (massage, shock wave therapy) doesn't have statistically significant advantages over PH alone within a 3-month observation period.

[Ultrastructure of neointima of native and artificial elements of the blood circulatory system]. / Ul'trastruktura neointimy nativnykh i iskusstvennykh elementov sistemy krovoobrashcheniya.

OBJECTIVE: To compare the neointima structure in conduits for coronary bypass grafting, bioprosthetic heart valves, tissue-engineered vascular grafts, and metal stents. MATERIAL AND METHODS: The objects of the study were the fragments of the human internal thoracic artery, experimental biodegradable vascular prostheses, leaflets of xenopericardial bioprostheses of heart valves, and fragments of stented vessels. Tissue samples were fixed in formalin and post-fixed in osmium tetroxide. After dehydration and epoxy resin embedding, the samples were ground and polished. Samples were counterstained with uranyl acetate and lead citrate and visualized by means of backscattered scanning electron microscopy. RESULTS: Neointimal pattern in all samples was similar. Neointima was comprised of endothelial cells, smooth muscle cells, fibroblasts, and the extracellular matrix. Endothelial cells showed significant diversity both between different elements of the circulatory system and within the same tissue, having either elongated or polygonal shape. Adhesion of leukocytes testified to the endothelial cell activation. In the absence of inflammation in the superficial layer of the neointima, the arrangement of smooth muscle cells and extracellular matrix fibers was parallel to the endothelium. Clusters of foam cells were frequently detected around the neointimal layers with solid inclusions (metal stents or calcium deposits). Thickening of the neointima was accompanied by the presence of capillaries and capillary-like structures. CONCLUSION: Neointima formation is a typical response to the damage inflicted to the elements of the circulatory system. Neointima underwent a constant remodeling characterized by an altered cellular composition, macrophage invasion, neovascularization, and calcification.

BLEPHARITIS AND HELICOBACTER-ASSOCIATED GASTRODUODENAL DISEASES (REVIEW).

The aim of the study was to find the relationship between the inflammatory process on the eyelids (blepharitis) and Helicobascter pylori infection. The data of numerous studies are analyzed, which give grounds to suggest a possible pathogenetic or mediated role of H. pylori infection in the development and course of inflammatory eye diseases. Fundamental in these studies are the release of harmful compounds in the exhaled air of patients with H. pylori, such as ammonia, hydrogen nitrate and hydrogen cyanide, the restoration of impression cytology after H. Pylori eradication, the presence of H. pylori in the lacrimal fluid. In this regard, the authors conclude that there are three main possible pathogenetic mechanisms for the association between H. Pylori infection and blepharitis: chronic inflammation, endothelial dysfunction, and oxidative stress.

Ultrafast Magneto-Optics in Nickel Magnetoplasmonic Crystals.

Here, we report on ultrafast all-optical modulation of the surface-plasmon (SP)-assisted transverse magneto-optical Kerr effect (TMOKE) and the reflectance in a one-dimensional nickel magnetoplasmonic crystal (MPC). A 50 fs nonresonant laser pump pulse with 7 mJ/cm2 fluence reduces the magnetization by 65%, which results in the suppression of TMOKE in the SP-resonant probe from 1.15% to 0.4%. The differential reflectance of SP-resonant probe achieves 5.5%. Besides this, it is shown that electron thermalization and relaxation in MPC are several times slower than those in the plane nickel.

[Comparative study of vasa vasorum and neointima in conduits for coronary artery bypass grafting]. / Sravnitel'noe izuchenie vasa vasorum i neointimy v konduitakh dlia koronarnogo shuntirovaniia.

AIM: This study was undertaken to investigate the preoperative incidence and severity of intimal hypertrophy, as well as the level of blood supply of arterial and venous conduits for coronary artery bypass grafting. MATERIAL AND METHODS: Segments of the internal thoracic artery and great saphenous vein (n=13) were harvested pairwise during coronary artery bypass grafting and were then visualized by scanning electron microscopy in back-scattered electrons. The analysis of the incidence and thickness of intimal hypertrophy, as well as the calculation of the number and the area of the vasa vasorum were performed using the programme ImageJ. RESULTS: Intimal hypertrophy was more characteristic for the great saphenous vein as compared with the internal thoracic artery (9/13 (69.2%) and 7/13 (55.8%), respectively), although this difference did not reach statistical significance. The maximal-to-minimal neointimal thickness ratio correlated with the percentage of stenosis (r=0.875, p<0.0001), the area (r=0.45, p=0.023) and the number (r=0.47, p=0.015) of the vasa vasorum in the conduits, thus confirming the hypothesis on possible participation of these vessels in the development of intimal hypertrophy, with the area of the vasa vasorum being greater in the vessels with >10% stenosis (p=0.051). The number of the vasa vasorum in the great saphenous vein exceeded that in the internal thoracic artery (p=0.0005), with this difference remaining significant after adjustment for the area of the adventitia (p=0.027). The number of the vasa vasorum per the percentage of stenosis in the great saphenous vein also exceeded that in the internal thoracic artery (p=0.039) and more strongly correlated with intimal hypertrophy in the great saphenous vein as compared with that in the internal thoracic artery (r=0.53 and r=0.27, respectively). CONCLUSION: Intimal hypertrophy correlates with the area and number of the vasa vasorum in conduits. The great saphenous vein is characterised by a larger number and higher density of the vasa vasorum as compared with the internal thoracic artery. The number of the vasa vasorum is correlated with stenosis of the great saphenous vein more closely than with stenosis of the internal thoracic artery. This may be suggestive of significant predisposition of the great saphenous vein to the onset of adventitial inflammation followed by the development of intimal hypertrophy.

Interhemispheric Asymmetry and Personality Traits of Brain-Computer Interface Users in Hand Movement Imagination.

Personality traits of users can affect the success in controlling brain-computer interfaces (BCIs), and the activity of right and left brain structures may differ depending on personality traits. Earlier, it was not known, how the success of BCI control with different personality traits is associated with interhemispheric asymmetry. In this work, the dependence of the success of imagination of movements, estimated by the success of recognition of EEG signals during imagination of hand movements compared to rest state, on the user's personal characteristics was studied. It is shown that in single control of BCI by naive subjects, recognition success in imagining right-hand (RH) movements was higher in expressive sensitive extroverts, and in imagining left-hand movements (LH) it was higher in practical, reserved, skeptical, and not very sociable persons. It is suggested that this phenomenon may be based on interhemispheric differences in dopamine level and in the way of encoding movement information.

[Results of surgical treatment of glaucoma using sinustrabeculectomy modified for drainage of anterior chamber and suprachoroidal space by autosclera]. / Rezul'taty khirurgicheskogo lecheniya glaukomy metodom sinustrabekulektomii s drenirovaniem perednei kamery i suprakhorioidal'nogo prostranstva autoskleroi.

In order to achieve a persistent hypotensive effect in primary open-angle glaucoma, a modification of the sinustrabeculectomy operation - modified sinustrabeculectomy with basal iridectomy combined with deep sclerectomy involving drainage of the anterior chamber and suprachoroidal space have been developed at the Department of Eye Diseases of the People's Friendship University of Russia. PURPOSE: Development of a new method of surgical treatment of primary open-angle glaucoma based on sinustrabeculectomy with basal iridectomy in combination with deep sclerectomy involving drainage of the anterior chamber and suprachoroidal space by autosclera, and evaluation of the surgical outcomes. MATERIAL AND METHODS: The study analyses the results of surgical treatment of 19 patients (19 eyes) with glaucoma, who underwent sinustrabeculectomy with basal iridectomy in combination with deep sclerectomy and drainage of the anterior chamber and suprachoroidal space. RESULTS: The level of intraocular pressure (IOP) on the first day after surgery decreased from 14 mm Hg to 17.5 mm Hg in the late postoperative period (after 12 months), IOP of 18 patients had normalized and stabilized (IOP averaged 17.0±1.8 mm Hg); in 1 case there was an increase in IOP level, for which hypotensive therapy was prescribed (ß-blockers). CONCLUSION: Modified sinustrabeculectomy with basal iridectomy in combination with deep sclerectomy and drainage of the anterior chamber and suprachoroidal space by autosclera helps achieve a persistent hypotensive effect and does not require the use of donor material.

[Biomechanical Analysis of Posture and Movement Coordination in Standing Human During Trunk Bending in the Sagittal Plane].

In most motor acts to achieve a behavioral goal requires coordination of posture and movement. In this paper, such coordination is studied by the example of human trunk bending in. the sagittal plane. Such movements are difficult to study because both components of this motor act (main - bending per se, and "accessory" - posture aimed on equilibrium. maintenance) involve massive movements of body segments, which complicates separation of these components. Their separation is based on the modem ideas about the special features of the posture component as compared with the main component. It is shown that the main and posture components correspond to the move- ments along eigenvectors of the dynamic equation. These movements are unique because they demonstrate at the same time "kinematic" as well as "dynamic" synergies. They were called there- fore "natural synergies". The coordination of natural synergies is investigated in human during standing on the wide and narrow supports. It is shown that the experimentally observed coordination is close to optimal, providing minimum movement of the center of pressure. This ensures the center of pressure Position keeping inside the support area that is necessary for equilibrium maintenance.

[Combination treatment for cataract and glaucoma]. / Kombinirovannye metody lecheniia pri sochetanii katarakty i glaukomy.

AIM: To develop a new combination treatment for cataract and glaucoma that would involve drainage of the suprachoroidal space with an autoscleral flap and to assess the outcomes of patients who underwent combined phacoemulsification and non-penetrating deep sclerectomy with suprachoroidal drainage with an autoscleral flap. MATERIAL AND METHODS: We have studied the results of combination surgical treatment of cataract and glaucoma performed in 34 patients (34 eyes), notably phacoemulsification and non-penetrating deep sclerectomy with suprachoroidal drainage. RESULTS: In the early postoperative period, visual acuity ranged from 0.5 to 0.7 and was consistent with retinal changes. Particularly, in 7 cases (21%) visual acuity was 0.5, in 16 cases (47%) - 0.6, and in 11 cases (32%) - 0.7. The intraocular pressure (IOP) decreased to an average of 17.2±2.4 mmHg. At 6 months, the IOP remained within statistically normal limits (16.0±1.8 mmHg) in all cases. Visual acuity ranged from 0.5 to 0.7. In the late postoperative period (after 1 year), 32 patients were normotonic (their IOP averaged 16.0±2.3 mmHg) and 2 patients developed elevated IOP and, thus, were prescribed antihypertensive therapy (ß-blockers). CONCLUSION: Non-penetrating deep sclerectomy with suprachoroidal drainage ensures the IOP reduction's stability and does not require the use of donor material.

[Analysis of Heteroplasmy in the Major Noncoding Region of Mitochondrial DNA in the Blood and Atherosclerotic Plaques of Carotid Arteries].

For identification of somatic mitochondrial DNA (mtDNA) mutations, the mtDNA major noncoding region (D-loop) sequence in blood samples and carotid atherosclerosis plaques from patients with atherosclerosis was analyzed. Five point heteroplasmic positions were observed in 4 of 23 individuals (17%). Only in two cases could heteroplasmy have resulted from somatic mutation, whereas three heteroplasmic positions were found in both vascular tissue and blood. In addition, length heteroplasmy in a polycytosine stretches was registered at nucleotide positions 303-315 in 16 individuals, and also in the 16184-16193 region--in four patients. The results suggest that somatic mtDNA mutations can occur during atherosclerosis, but some heteroplasmic mutations may appear in all tissues, possibly being inherited.

[TRANSFORMATIONS OF LIFE CYCLES IN THE EVOLUTIONARY HISTORY OF TRYPANOSOMATIDS. ENDOTRANSFORMATIONS AND ABERRATIONS].

Endotransformations and aberrations of the life cycle in the evolutionary history of trypanosomatids (Kinetoplastea: Trypanosomatidae) are analyzed. We treat the term "endotransformations" as evolutionarily fixed changes of phases and/or developmental stages of parasites. By contrast, we treat aberrations as evolutionary unstable, periodically arising deformations of developmental phases of trypanosomatids, never leading to life cycle changes. Various examples of life cycle endotransformations and aberrations in representatives of the family Trypanosomatidae are discussed.

[The Changes in the Hemodynamic Activity of the Brain during Moroe Imagery Training with the Use of Brain-Computer Interface].

With the use of functional MRI (fMRI), we studied the changes in brain hemodynamic activity of healthy subjects during motor imagery training with the use brain-computer interface (BCI), which is based on the recognition of EEG patterns of imagined movements. ANOVA dispersion analysis showed there are 14 areas of the brain where statistically sgnificant changes were registered. Detailed analysis of the activity in these areas before and after training (Student's and Mann-Whitney tests) reduced the amount of areas with significantly changed activity to five; these are Brodmann areas 44 and 45, insula, middle frontal gyrus, and anterior cingulate gyrus. We suggest that these changes are caused by the formation of memory traces of those brain activity patterns which are most accurately recognized by BCI classifiers as correspondent with limb movements. We also observed a tendency of increase in the activity of motor imagery after training. The hemodynamic activity in all these 14 areas during real movements was either approximatly the same or significantly higher than during motor imagery; activity during imagined leg movements was higher that that during imagined arm movements, except for the areas of representation of arms.

[Brain-Computer Interface: the First Clinical Experience in Russia].

Motor imagery is suggested to stimulate the same plastic mechanisms in the brain as a real movement. The brain-computer interface (BCI) controls motor imagery by converting EEG during this process into the commands for an external device. This article presents the results of two-stage study of the clinical use of non-invasive BCI in the rehabilitation of patients with severe hemiparesis caused by focal brain damage. It was found that the ability to control BCI did not depend on the duration of a disease, brain lesion localization and the degree of neurological deficit. The first step of the study involved 36 patients; it showed that the efficacy of rehabilitation was higher in the group with the use of BCI (the score on the Action Research Arm Test (ARAT) improved from 1 [0; 2] to 5 [0; 16] points, p = 0.012; no significant improvement was observed in control group). The second step of the study involved 19 patients; the complex BCI-exoskeleton (i.e. with the kinesthetic feedback) was used for motor imagery trainings. The improvement of the motor function of hands was proved by ARAT (the score improved from 2 [0; 37] to 4 [1; 45:5] points, p = 0.005) and Fugl-Meyer scale (from 72 [63; 110 ] to 79 [68; 115] points, p = 0.005).

[Sources of electrophysiological and foci of hemodynamic brain activity most relevant for controlling a hybrid brain­Computer interface based on classification of EEG patterns and near-infrared spectrography signals during motor imagery].

The method is described for joint use of electroencephalography and near-infrared spectrography for location of sources of electrophysiological and focuses of hemodynamic brain activity during motor execution and imagination. The sources of electrophysiological and focuses of hemodynamic activity the most relevant for controlling the hybrid brain-computer interface based on motor imagery are revealed and discussed.

[Arm Motor Function Recovery during Rehabilitation with the Use of Hand Exoskeleton Controlled by Brain-Computer Interface: a Patient with Severe Brain Damage].

We studied the dynamics of motor function recovery in a patient with severe brain damage in the course of neurorehabilitation using hand exoskeleton controlled by brain-computer interface. For estimating the motor function of paretic arm, we used the biomechanical analysis of movements registered during the course of rehabilitation. After 15 weekly sessions of hand exoskeleton control, the following results were obtained: a) the velocity profile of goal-directed movements of paretic hand became bell-shaped, b) the patient began to extend and abduct the hand which was flexed and adducted in the beginning of rehabilitation, and c) the patient began to supinate the forearm which was pronated in the beginning of rehabilitation. The first result is an evidence of the general improvement of the quality of motor control, while the second and third results prove that the spasticity of paretic arm has decreased.

[Light- and electron-microscopic study of pelobiont Pelomyxa secunda (Gruber, 1884) comb. nov. (Archamoebae, Pelobiontida)].

Morphology of a pelobiont Pelomyxa secunda (Gruber, 1884) comb. nov. was investigated at light- and electron-microscopical levels. Locomotive forms are elongated or cigar-shaped. The size of active forms varies from 200 to 300 µm. Larger individuals (up to 400 µm) are not able to directed movement. Organism can produce short, usually finger-shaped hyaline pseudopodia at the frontal side or laterally. The cell coat is represented by amorphous glycocalix, up to 300 nm in thickness. A thin periphery cytoplasmic zone is deprived of any organelles, vacuoles, endocytobionts and other inclusions and separated from main cytoplasm by a layer of arranged microfilaments. P. secunda is multinucleate organism; nuclei are of granular type. The nucleolar material is represented by two forms of discrete structures differing in size and electron density. Two or three layers of short microtubules organized in the parallel arrangement are associated with outer side of the nuclear envelop. P. secunda possess two types of obligate prokaryotic endocytobionts lying in individual symbiontophoric vacuoles. Undulipodia, kinetosomes and root microtubular derivatives are not observed in P. secunda cells as well as any developed cytoplasmic microtubular cytoskeleton.

[Septal Activation and Control of Limbic Structures].

Coherent activation of limbic system structures as the main function of theta-rhythm is widely discussed in the literature. However until now does not exist the common view on its generation in these brain structures. The model of septal theta-rhythmic activation and control of limbic structures is suggested basing on the literature and own experimental data.

[TRANSFORMATIONS OF LIFE CYCLES IN THE EVOLUTIONARY HISTORY OF TRYPANOSOMATIDS. MACROTRANSFORMATIONS].

The review concerns analysis of life cycle macrotransformations in the evolutionary history of trypanosomatids. The term "macrotransformations" stands for evolutionary processes leading to the establishment of heteroxenous and secondary homoxenous life cycles within Trypanosomatidae. There were three direct macrotransformations in the evolution of the group resulting in the rise of heteroxenous genera Leishmania, Trypanosoma and Phytomonas, and one case of reverse macrotransformation in trypanosomes of T. (b.) brucei group. The issues of the origin, diversity and phylogeny of taxa whose emergence resulted from macrotransformations of life cycles of homoxenous trypanosomatids.