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ADVANCEMENTS IN UNDERSTANDING THE MOLECULAR MECHANISMS REGULATING URIC ACID METABOLISM IN THE INTESTINE 进一步了解调节肠道尿酸代谢的分子机制
V. Zhdan, M. Tkachenko, M. Babanina, H. Volchenko, Y. Kitura
This review provides contemporary insights into the direct and indirect pathogenetic connections between purine compound metabolism and biochemical processes within the cells of the gastrointestinal system. A thorough analysis of recent publications from 2000 to 2024, sourced from databases including Scopus, PubMed, eLIIBRARY, and Google Scholar, was conducted. Uric acid serves as the end product of purine-containing compound catabolism. Its concentration is intricately regulated through the collaboration of the kidneys and gastrointestinal organs, namely the small intestine and liver. Gout, a chronic condition, emerges from the interplay between molecular genetic factors and external influences. Elevated levels of urates in the blood serum (hyperuricemia) and the deposition of sodium urate crystals in organs and tissues set off a cascade of inflammatory and fibrotic processes within mucosal, smooth muscle, parenchymal, and endothelial cells, including those within the gastrointestinal tract. Normally, a person excretes about 1.5 g of uric acid per day. Under physiological conditions, two-thirds of uric acid is excreted from the body by the kidneys, one-third through the intestines, and a small part is excreted with bile. The hypothesis that links the pathogenesis of hyperuricemia with “renal overload” suggests that the disease may develop as a result of impaired renal excretion with insufficient elimination of uric acid through the intestines. Part of uric acid transport systems actively works in hepatocytes and enterocytes, which determines its formation and clearance. Uric acid transporter proteins are divided into two categories: urate reabsorption transporters and urate excretion transporters, their expression is regulated by transcription factors, hormones and metabolites of intestinal microflora. The influence of intestinal microbiota on uric acid metabolism is related to its participation in purine metabolism, decomposition and elimination of uric acid with metabolites of intestinal flora and inhibition of gouty inflammation and is evaluated as a new therapeutic potential in gout and hyperuricemia, which allows to avoid kidney damage and urolithiasis.
这篇综述深入探讨了嘌呤化合物代谢与胃肠道系统细胞内生化过程之间直接和间接的致病联系。我们对 2000 年至 2024 年期间的最新出版物进行了全面分析,这些出版物来自 Scopus、PubMed、eLIIBRARY 和 Google Scholar 等数据库。尿酸是含嘌呤化合物分解代谢的最终产物。尿酸的浓度由肾脏和胃肠道器官(即小肠和肝脏)共同调节。痛风是一种慢性疾病,是分子遗传因素和外部影响相互作用的结果。血清中尿酸盐含量的升高(高尿酸血症)以及尿酸钠结晶在器官和组织中的沉积引发了粘膜细胞、平滑肌细胞、实质细胞和内皮细胞(包括胃肠道内的细胞)的一连串炎症和纤维化过程。正常情况下,人每天排出约 1.5 克尿酸。在生理条件下,三分之二的尿酸通过肾脏排出体外,三分之一通过肠道排出,还有一小部分随胆汁排出体外。将高尿酸血症的发病机理与 "肾脏超负荷 "联系起来的假说认为,该病可能是由于肾脏排泄功能受损,而通过肠道排出的尿酸不足所致。尿酸转运系统的一部分在肝细胞和肠细胞中积极工作,这决定了尿酸的形成和清除。尿酸转运蛋白分为两类:尿酸重吸收转运蛋白和尿酸排泄转运蛋白,它们的表达受转录因子、激素和肠道微生物群代谢产物的调节。肠道微生物群对尿酸代谢的影响与其参与嘌呤代谢、利用肠道菌群的代谢产物分解和消除尿酸以及抑制痛风性炎症有关,被认为是痛风和高尿酸血症的一种新的潜在治疗方法,可避免肾脏损伤和尿路结石。
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引用次数: 0
THE EFFICIENCY OF CYTOKINE THERAPY IN TREATING DEGENERATIVE DISEASES OF THE OPTIC NERVE 细胞因子疗法在治疗视神经退行性疾病方面的效率
I. Olefir
Degenerative diseases of the optic nerve can result from a variety of causes, including increased intraocular pressure, impaired blood supply, and physical trauma (e.g. due to retroorbital hemorrhage and traumatic brain injury). As the optic nerve is composed of retinal ganglion cell axons, primary retinal lesions (especially those affecting the ganglion cells and nerve fiber layers) often result in concomitant optic nerve pathology, including degeneration. The aim of this study is to assess the effectiveness of treating degenerative diseases of the optic nerve with the drug cytocholine based on functional changes data. Матеріали та методи. Під спостереженням знаходилось 32 пацієнти з нейродегенеративними захворюваннями зорового нерву, які знаходились на лікуванні в офтальмологічному відділенні в 2019-2024 рр. Всі пацієнти були розділені на дві групи в залежності від вибору лікування. До першої групи пацієнтів увійшло 16 хворих, яким проводилась класична схема лікування дегенеративних захворювань зорового нерва (антиішемічна, нейропротекторна, метаболічна, гіпотензивна, ноотропна терапія та нейротропні вітаміни). Другу групу склала решта - 16 пацієнтів, які до вищевказаної терапії додатково приймали комбінований препарат з цитоколіном та вітамінним комплексом. Materials and methods. 32 patients with neurodegenerative diseases of the optic nerve who underwent therapy at the ophthalmology department from 2019 to 2024 were observed. All patients were divided into two groups based on their treatment choice. The first group included 16 patients who received standard treatment for degenerative optic nerve diseases (anti-ischemic, neuroprotective, metabolic, hypotensive, nootropic therapy, and neurotropic vitamins). The second group comprised the remaining 16 patients who, in addition to the standard therapy, were administered a combination drug containing cytocholine and a vitamin complex. Results. One of the most revealing and significant findings is the dynamic change in visual field among patients in group 2 (with the addition of cytocholine to the treatment regimen). A statistically significant positive trend (p < 0.001) in the increase of average deviation of retinal photosensitivity from the norm (MD) was observed that was confirmed not only by perimetry data but also by subjective reports from patients. These changes were noted in all 16 patients of the second group. Conclusions. Adding a complex of cytocholine with vitamins to the classic treatment regimens for degenerative diseases of the optic nerve lead to better functional results 6 months after the treatment.
视神经退行性疾病可由多种原因引起,包括眼压升高、供血障碍和物理创伤(如眶后出血和脑外伤)。由于视神经由视网膜神经节细胞轴突组成,原发性视网膜病变(尤其是影响神经节细胞和神经纤维层的病变)通常会导致视神经病变,包括视神经变性。本研究的目的是根据功能变化数据评估细胞胆碱药物治疗视神经退行性疾病的效果。Матеріали та методи.Під спостереженням знаходилось 32 пацієнти з нейродегенеративними захворюваннями зорового нерву, які знаходились на лікуванні в офтальмологічному віділенні в 2019-2024 р.Всі пацієнти були розділені на дві групи в залежності від вибору лікування.До першої групи пацієнтів увійшло 16 хворих, яким проводилась класична схема лікування дегенеративних захворювань зорового нерва (антиішемічна.)、нейропротекторна, метаболічна, гіпотензивна, ноотропна терапія та нейротропні вітаміни).Другу групу склала решта - 16 пацієнтів, які до вищевказаної терапі ї додатково приймали комбінований препарат з цитоколіном та вітаміним комплексом.材料与方法对2019年至2024年期间在眼科接受治疗的32名视神经神经退行性疾病患者进行观察。根据治疗选择将所有患者分为两组。第一组包括16名患者,他们接受了视神经退行性疾病的标准治疗(抗缺血、神经保护、代谢、降血压、神经营养疗法和神经营养维生素)。第二组包括剩余的 16 名患者,他们除了接受标准治疗外,还服用了含有细胞胆碱和维生素复合物的联合药物。研究结果最有启发性和意义的发现之一是第二组(在治疗方案中添加细胞胆碱)患者视野的动态变化。从统计学角度看,视网膜光敏感度平均偏离标准值(MD)呈明显的正增长趋势(p < 0.001),这不仅得到了视力测定数据的证实,也得到了患者主观报告的证实。第二组的所有 16 名患者都出现了这些变化。结论在视神经退行性疾病的传统治疗方案中加入细胞胆碱与维生素复合物,可在治疗 6 个月后获得更好的功能效果。
{"title":"THE EFFICIENCY OF CYTOKINE THERAPY IN TREATING DEGENERATIVE DISEASES OF THE OPTIC NERVE","authors":"I. Olefir","doi":"10.31718/2077-1096.24.2.40","DOIUrl":"https://doi.org/10.31718/2077-1096.24.2.40","url":null,"abstract":"Degenerative diseases of the optic nerve can result from a variety of causes, including increased intraocular pressure, impaired blood supply, and physical trauma (e.g. due to retroorbital hemorrhage and traumatic brain injury). As the optic nerve is composed of retinal ganglion cell axons, primary retinal lesions (especially those affecting the ganglion cells and nerve fiber layers) often result in concomitant optic nerve pathology, including degeneration. \u0000The aim of this study is to assess the effectiveness of treating degenerative diseases of the optic nerve with the drug cytocholine based on functional changes data. \u0000Матеріали та методи. Під спостереженням знаходилось 32 пацієнти з нейродегенеративними захворюваннями зорового нерву, які знаходились на лікуванні в офтальмологічному відділенні в 2019-2024 рр. Всі пацієнти були розділені на дві групи в залежності від вибору лікування. До першої групи пацієнтів увійшло 16 хворих, яким проводилась класична схема лікування дегенеративних захворювань зорового нерва (антиішемічна, нейропротекторна, метаболічна, гіпотензивна, ноотропна терапія та нейротропні вітаміни). Другу групу склала решта - 16 пацієнтів, які до вищевказаної терапії додатково приймали комбінований препарат з цитоколіном та вітамінним комплексом. \u0000Materials and methods. 32 patients with neurodegenerative diseases of the optic nerve who underwent therapy at the ophthalmology department from 2019 to 2024 were observed. All patients were divided into two groups based on their treatment choice. The first group included 16 patients who received standard treatment for degenerative optic nerve diseases (anti-ischemic, neuroprotective, metabolic, hypotensive, nootropic therapy, and neurotropic vitamins). The second group comprised the remaining 16 patients who, in addition to the standard therapy, were administered a combination drug containing cytocholine and a vitamin complex. \u0000Results. One of the most revealing and significant findings is the dynamic change in visual field among patients in group 2 (with the addition of cytocholine to the treatment regimen). A statistically significant positive trend (p < 0.001) in the increase of average deviation of retinal photosensitivity from the norm (MD) was observed that was confirmed not only by perimetry data but also by subjective reports from patients. These changes were noted in all 16 patients of the second group. \u0000Conclusions. Adding a complex of cytocholine with vitamins to the classic treatment regimens for degenerative diseases of the optic nerve lead to better functional results 6 months after the treatment.","PeriodicalId":24028,"journal":{"name":"Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PHARMACOLOGICAL EFFECTS OF MELATONIN AND ITS POTENTIAL APPLICATION IN THERAPY OF GOUT AND ASSOCIATED DISEASES 褪黑素的药理作用及其在痛风及相关疾病治疗中的潜在应用
O. Berzin, V.E. Kondratiuk
Introduction. The disturbance in biosynthetic activity of pinealocytes of the pineal gland and subsequent melatonin deficiency in the body are linked to the progression of certain chronic diseases. This has prompted research into correcting chrono-biological dysfunctions, particularly in conditions such as gout and its comorbidities. This study aims to analyze the potential use of melatonin in correcting metabolic disorders in gout and to justify its use as a pharmacotherapeutic agent for treating metabolic and cardiovascular diseases. Materials and methods. We conducted a comprehensive analysis of modern scientific literature from specialized domestic and foreign sources. Emphasis was placed on studies exploring the pharmacological and pharmacotherapeutic aspects of melatonin use in both experimental and clinical settings, particularly those conducted in the last 5-6 years. Results. The research data revealed three main aspects of the problem that must be addressed to understand the experimental, biological, pharmacological, and pharmacotherapeutic foundations for the long-term use of melatonin in clinical practice. The first part of the review highlighted the significant impact of melatonin homeostasis disruption on the pathogenesis of gout and its progression in comorbidity with other conditions such as hypertension, obesity, insulin resistance, metabolic syndrome, and type 2 diabetes. The role of chronobiological disorders and desynchronosis in the progression of these diseases was also established. Pharmacological studies demonstrated the pivotal role of melatonin, as an important factor in neuroendocrine regulation, in organizing the circadian rhythm of the body's vital functions under normal and pathological conditions. Melatonin was found to normalize the pathological processes underlying gout development and comorbid diseases, providing a scientific basis for its use in the treatment of gout, cardiovascular diseases, disturbed metabolic processes, and normalization of circadian rhythms in patients with these conditions. Conclusions. This paper presents data on the causes of gout development and progression, as well as some comorbid diseases, from the perspective of chronobiological disruptions in the body's functions. The review sections delve into the pharmacological and pharmacotherapeutic aspects of melatonin's therapeutic action. The findings confirm the importance of melatonin in effectively treating gout and other comorbid diseases and metabolic disorders.
导言。松果体松果体细胞生物合成活动的紊乱以及随后体内褪黑激素的缺乏与某些慢性疾病的进展有关。这促使人们研究如何纠正慢性生物功能障碍,尤其是痛风及其并发症。本研究旨在分析褪黑激素在纠正痛风代谢紊乱方面的潜在用途,并证明其作为治疗代谢和心血管疾病的药物治疗剂的合理性。材料和方法。我们对国内外专业现代科学文献进行了全面分析。重点关注在实验和临床环境中使用褪黑素的药理和药物治疗方面的研究,尤其是最近 5-6 年进行的研究。研究结果研究数据揭示了问题的三个主要方面,要了解在临床实践中长期使用褪黑素的实验、生物学、药理学和药物治疗学基础,就必须解决这些问题。综述的第一部分强调了褪黑激素平衡紊乱对痛风发病机制的重大影响,以及痛风与其他疾病(如高血压、肥胖、胰岛素抵抗、代谢综合征和 2 型糖尿病)的合并进展。此外,还确定了时间生物学紊乱和不同步在这些疾病的进展中所起的作用。药理学研究表明,褪黑激素作为神经内分泌调节的重要因素,在正常和病理情况下组织人体重要功能的昼夜节律方面发挥着关键作用。研究发现,褪黑素能使痛风发生和合并疾病的病理过程正常化,这为褪黑素用于治疗痛风、心血管疾病、紊乱的新陈代谢过程以及使这些疾病患者的昼夜节律正常化提供了科学依据。结论本文从昼夜节律扰乱人体功能的角度,介绍了痛风发生和发展的原因,以及一些并发症。综述部分深入探讨了褪黑激素治疗作用的药理学和药物治疗学方面。研究结果证实了褪黑激素在有效治疗痛风及其他合并疾病和代谢紊乱方面的重要性。
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引用次数: 0
ANTEGRADE METHODS OF BILIARY DECOMPRESSION IN TUMOR OBSTRUCTION OF THE BILIARY TRACT 胆道肿瘤梗阻的前向胆道减压法
M. Shevchuk, M. Dudchenko, M. Kravtsiv, D. Ivashchenko, G. Ivanova
Percutaneous transhepatic endoscopic ultrasound-guided intervention is a crucial method for addressing mechanical jaundice. This technique for restoring bile outflow enables the resolution of several medical and diagnostic issues with minimal invasiveness and fewer complications compared to traditional open surgical treatments. Most often, antegrade cholangiostomy is used in oncological practice, where the variety of clinical situations determines the indications for performing this intervention in different variants and with different goals. According to the world literature, at the moment, sufficient experience of transdermal technologies has been accumulated, their application in clinical practice has been worked out, which allows to recognize them, to a certain extent, as routine. The purpose of this work is to optimize biliary decompression in patients with tumor obstruction of the biliary tract, to improve the prevention of complications, to enhance the immediate results of treatment and the quality of life for this group of population. The study analyzed the examination and surgical treatment outcomes of 64 patients with tumor-related mechanical jaundice treated in surgical hospitals from 2017 to 2023. All patients underwent antegrade biliary drainage procedures, specifically percutaneous transhepatic cholangiostomy and bile duct stenting under ultrasound guidance, to achieve biliary decompression. Percutaneous transhepatic endoscopic interventions have become the primary method for biliary decompression in cases of bile duct obstruction due to tumors. These procedures, particularly for malignant tumors, are associated with relatively few complications and low mortality rates.
经皮经肝内镜超声引导介入治疗是解决机械性黄疸的重要方法。与传统的开腹手术治疗相比,这种恢复胆汁流出的技术能以最小的创伤和较少的并发症解决一些医疗和诊断问题。前路胆管造口术最常用于肿瘤治疗,临床情况的多样性决定了实施这种干预的不同变体和不同目标的适应症。根据世界文献,目前已经积累了足够的经皮技术经验,并已将其应用于临床实践,在一定程度上可以将其视为常规技术。这项工作的目的是优化胆道肿瘤梗阻患者的胆道减压术,改善并发症的预防,提高治疗的直接效果和这部分人群的生活质量。该研究分析了2017年至2023年外科医院收治的64例肿瘤相关机械性黄疸患者的检查和手术治疗结果。所有患者均接受了前路胆道引流术,特别是在超声引导下进行经皮经肝胆管造口术和胆管支架植入术,以实现胆道减压。经皮经肝内镜介入治疗已成为肿瘤导致胆管梗阻时进行胆道减压的主要方法。这些手术,尤其是针对恶性肿瘤的手术,并发症相对较少,死亡率较低。
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引用次数: 0
OSTEOGENESIS AND BONE RESORPTION IN PATIENTS WITH POSTOPERATIVE MANDIBULAR BONE DEFECTS DURING INFLAMMATORY PROCESSES 下颌骨术后骨缺损患者在炎症过程中的成骨和骨吸收情况
V.V. Khattu
Tooth extraction has long been the most common surgical procedure. Preserving the height of the alveolar ridge after extraction is crucial for further replacement of the missing tooth, including through dental implantation. This study aimed to assess the effect of cryopreserved placenta and quercetin on bone formation and osteoresorption markers in oral fluid. Ninety patients who underwent lower tooth extraction due to inflammation participated in the research. They were divided into three clinical groups of 30 each: the first group received cryopreserved placenta after extraction, the second group received combined therapy of cryopreserved placenta and quercetin, and the third (control) group underwent standard tooth extraction. Osteocalcin and matrix metalloproteinase-8 levels in the oral fluid were measured on days 1, 10, 20, 30, 90, and 180 after extraction for all groups. Antagonism between "osteocalcin" and "matrix metalloproteinase-8" was observed in the oral fluid during reparative osteogenesis. However, statistically significant changes in this marker were noted earlier in the observation period and were more pronounced, possibly due to local changes predominating. This suggests activation of bone tissue resorption processes in the early stages of the study and osteogenesis in the later stages of observation. The least dynamic changes in the studied indicators were observed when cryopreserved placenta was used in combination with quercetin treatment.
长期以来,拔牙一直是最常见的外科手术。拔牙后保持牙槽嵴的高度对于进一步替换缺失牙(包括通过种植牙)至关重要。本研究旨在评估低温保存胎盘和槲皮素对口腔液中骨形成和骨吸收标志物的影响。90名因炎症而进行下牙拔除的患者参与了研究。他们被分为三个临床组,每组30人:第一组在拔牙后接受低温保存胎盘,第二组接受低温保存胎盘和槲皮素联合治疗,第三组(对照组)接受标准拔牙。在拔牙后的第 1、10、20、30、90 和 180 天,对各组口腔液中的骨钙素和基质金属蛋白酶-8 水平进行了测定。在修复性骨生成过程中,观察到口腔液中 "骨钙素 "和 "基质金属蛋白酶-8 "之间存在拮抗作用。然而,在观察期的早期,该标记物发生了统计学意义上的显著变化,而且更加明显,这可能是由于局部变化占主导地位。这表明,在研究的早期阶段,骨组织的吸收过程被激活,而在观察的后期阶段,骨生成过程被激活。当低温保存的胎盘与槲皮素结合使用时,所研究指标的动态变化最小。
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引用次数: 0
HEALTHY LIFESTYLE INDICATORS AMING MEDICAL STUDENTS AT POLTAVA STATE MEDICAL UNIVERSITY 波尔塔瓦国立医科大学医学生的健康生活方式指标
V.M. Tymoshenko, A.M. Syngaivskyi, H.Y. Morokhovets, O. O. Pushko
The aim of the research is to study the indicators of a healthy lifestyle among Master students at Poltava State Medical University, and factors influencing this choice. The article analyzes the results of a survey among 228 students of the 1st-3rd years of study at Poltava State Medical University. We used the Google Forms service (https://docs.google.com/forms) to conduct the survey. The questionnaire was distributed through student groups in Viber and Telegram social networks. Results. In this study, 94.7% of students agreed to participate. Male students made up 29.6% of participants, female participants constituted 70.4%. The average value of BMI was 22.34 (CI [20.16-24.35]) in men and 21.07 (CI [19.23-22.29]) (p=0.019) in women. A statistically significant difference was observed between the BMI values of students who lived in a dormitory, the average BMI was 20.82 (CI [19.26-21.76]), compared to those who lived with their families in their own housing, where BMI was 21.54 (CI [19.46-22.82]), and those in rented housing, where BMI was 21.87 (CI [19.22-23.74]) (p<0.0001). The mean score for tendency to crash diet for weight loss in the male group was 0.15 (CI [0-1.0]), compared to the female group, where it was 0.41 (CI [0-1.0]) (p=0.0104). The mean score for the frequency of walking in the group aged 16-18 was 2.25 (CI [1.0-3.0]), 19-21 - 2.33 (CI [1.0-3.0]), 22-24 - 1.33 (CI [1.0-2.0]), >24 - 2.0 (CI [1.0-2.0]) (p=0.00805). The mean score for the frequency of walking in the group of students living in rented housing was 2.18 (CI [1.0-3.0]), in the group living in a dormitory - 2.47 (CI [1.0-3.0]), in the group living with family - 2.07 (CI [1.0-2.0]) (p=0.0014). Conclusion. A healthy diet, sleep, and exercise must be balanced to improve mental and physical health, and thus to improve the performance of medical students. In general, students should be instructed to maintain proper sleep hygiene, recommended reducing the time spent using the devices, especially in the evening, avoiding alcoholic beverages, as well as setting various reminders and alarms.
本研究旨在研究波尔塔瓦国立医科大学硕士生健康生活方式的指标以及影响这一选择的因素。文章分析了对 228 名波尔塔瓦国立医科大学一至三年级学生的调查结果。我们使用谷歌表单服务 (https://docs.google.com/forms) 进行了调查。问卷通过 Viber 和 Telegram 社交网络上的学生群组发放。调查结果在这项研究中,94.7% 的学生同意参与。男生占 29.6%,女生占 70.4%。男生的体重指数平均值为 22.34(CI [20.16-24.35]),女生为 21.07(CI [19.23-22.29])(P=0.019)。住在宿舍的学生的 BMI 值平均为 20.82(CI [19.26-21.76]),与住在自家住房的学生的 BMI 值 21.54(CI [19.46-22.82])和住在租房的学生的 BMI 值 21.87(CI [19.22-23.74])(p24 - 2.0(CI [1.0-2.0])(p=0.00805)相比,差异有统计学意义。租房住的学生组步行频率平均分为 2.18(CI [1.0-3.0]),住宿舍的学生组步行频率平均分为 2.47(CI [1.0-3.0]),与家人同住的学生组步行频率平均分为 2.07(CI [1.0-2.0])(p=0.0014)。结论健康的饮食、睡眠和运动必须兼顾,才能改善身心健康,从而提高医学生的成绩。一般来说,应指导学生保持适当的睡眠卫生,建议减少使用设备的时间,尤其是晚上,避免饮用含酒精的饮料,以及设置各种提醒和闹钟。
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引用次数: 0
THE ADVANTAGES OF SYDNONIMINES COMPARED TO NITRATES IN THE TREATMENT OF PATIENTS WITH ISCHEMIC HEART DISEASE AND CORONARY INSUFFICIENCY 在治疗缺血性心脏病和冠状动脉供血不足的病人时,与硝酸盐相比,西地那非类药物的优势
N.O. Vlasenko
One of the primary challenges in treating patients with coronary artery disease and coronary insufficiency using nitrates is the development of tolerance. Nitrate tolerance is a condition in which the duration and intensity of anti-anginal and anti-ischemic effects decrease, despite maintaining a high concentration of the drug in the blood. In cases of developing tolerance, a continual increase in the nitrate dose is necessary to achieve the previous effect. To eliminate developed nitrate tolerance, discontinuing nitrates for 3-5 days is typically sufficient. Currently, molsidomine is employed as an alternative to nitrates, with sydnonimines emerging as a noteworthy substitute. Among sydnonimines, molsidomine (marketed as Sydnopharm, Dilasidom, Corvaton) stands out as the most effective. Despite its chemical distinction from nitrates, molsidomine operates through a similar mechanism. Functioning as a nitric oxide donor, this antianginal drug avoids the development of tolerance even with prolonged use. Molsidomine, akin to nitrates, acts as a vasodilator, exhibiting efficacy as an anti-ischemic and anti-anginal medication when administered in appropriate doses. Upon entering the human body, molsidomine undergoes hepatic metabolism, transforming into an active derivative compound known as SIN-1. This metabolite, upon entering the bloodstream, further converts into an active form (SIN-1A). From this active metabolite, the nitric oxide (NO) group is released, influencing the activation of guanylate cyclase. This activation prompts guanosine triphosphate to convert into cyclic guanosine triphosphate, ultimately contributing to the synthesis of proteins that bind calcium. This cascade of events results in the vasodilatory effect of molsidomine. Indications for molsidomine include stable angina pectoris, acute coronary syndrome, early post-infarction angina, congestive heart failure, portal hypertension, pulmonary hypertension, and Aerz's disease. Possible side effects following the therapy with molsidomine (dizziness, headache, and diplopia) occur much less frequently compared to nitrates. After using nitrates, such a side effect as methemoglobinемia may occur. Therapy with molsidomine does not lead to the development of this side effect.
使用硝酸盐治疗冠心病和冠状动脉功能不全患者的主要挑战之一是耐受性的产生。硝酸盐耐受是指尽管血液中的药物浓度很高,但抗心绞痛和抗缺血作用的持续时间和强度却有所下降。在出现耐药性的情况下,必须不断增加硝酸盐剂量才能达到之前的效果。要消除已形成的硝酸盐耐受性,通常停用硝酸盐 3-5 天就足够了。目前,molsidomine 被用作硝酸盐的替代品,而 sydnonimines 则成为值得注意的替代品。在西地那非类药物中,莫西多明(市场名为 Sydnopharm、Dilasidom、Corvaton)最为有效。尽管其化学成分与硝酸盐不同,但莫西多明的作用机制相似。这种抗心绞痛药物作为一氧化氮供体,即使长期使用也不会产生耐受性。莫利多明与硝酸盐类似,都是血管扩张剂,在适当剂量下具有抗缺血和抗心绞痛的功效。进入人体后,莫西多明会经过肝脏代谢,转化为一种名为 SIN-1 的活性衍生物化合物。这种代谢物进入血液后,会进一步转化为活性形式(SIN-1A)。这种活性代谢物释放出一氧化氮(NO)基团,影响鸟苷酸环化酶的活化。这种活化促使三磷酸鸟苷转化为环状三磷酸鸟苷,最终促进与钙结合的蛋白质的合成。这一系列事件导致了莫西多明的血管扩张作用。莫西多明的适应症包括稳定型心绞痛、急性冠状动脉综合征、心梗后早期心绞痛、充血性心力衰竭、门静脉高压症、肺动脉高压症和阿尔茨海默病。与硝酸盐类药物相比,使用莫西多明治疗后可能出现的副作用(头晕、头痛和复视)要少得多。使用硝酸盐类药物后,可能会出现高铁血红蛋白емia等副作用。使用莫西多明治疗不会导致出现这种副作用。
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引用次数: 0
ENHANCING QUALITY OF MEDICAL EDUCATION THROUGH INNOVATIVE TECHNOLOGIES 通过创新技术提高医学教育质量
В.В. Іліка, O. Harvasiuk, O.I. Dogolych, V. Kulachek, M.O. Andrushchak
Objectives. The advancement of education is propelled by the integration of new ideas, tools, pedagogical methods, and management technologies, contibuting to a transformation of the education system. This scientific paper aims to explore the significance of innovations and their pivotal role in enhancing the quality of education, particularly through the implementation of innovative approaches in delivering the course "Pathomorphology" for future medical professionals. Results. The study findings unequivocally demonstrate that adopting an innovative approach in teaching "Pathomorphology" significantly contributes to the development of students' professional knowledge and fosters the cultivation of critical thinking and analytical skills. Leveraging advanced methodologies such as integrated learning and group learning technologies creates a dynamic learning environment wherein students collaborate, exchange ideas, and collectively address practical challenges. An important component is the utilization of the MOODLE system and online platforms like Google Meet, enabling students to access knowledge electronically while actively engaging with lecturers in a virtual setting. This facilitates communication between students and educators, fostering discussions, nurturing creative thinking, and tackling educational tasks collaboratively. Conclusion. Integrating innovative approaches in education enhances the quality of student learning, encouraging theri active research, fostering independent learning skills, and cultivating self-reliant individuals capable of continuous self-improvement. The consistent implementation of innovations not only enhances students' professional competence but also imposes high standards on educators, motivating them to pursue continuous professional development and strive for excellence. These factors render the teaching-learning process not only engaging but also exceptionally effective.
目标。新思想、新工具、新教学方法和新管理技术的融合推动了教育的进步,促进了教育系统的变革。本科学论文旨在探讨创新的意义及其在提高教育质量方面的关键作用,特别是通过采用创新方法为未来的医学专业人员开设 "病理形态学 "课程。研究结果研究结果明确表明,在 "病理形态学 "教学中采用创新方法大大有助于发展学生的专业知识,培养批判性思维和分析能力。利用综合学习和小组学习技术等先进方法创造了一个充满活力的学习环境,让学生在其中开展合作、交流思想并共同应对实际挑战。一个重要的组成部分是利用 MOODLE 系统和在线平台(如 Google Meet),使学生能够以电子方式获取知识,同时在虚拟环境中与讲师积极互动。这有利于学生和教育者之间的交流,促进讨论,培养创造性思维,共同完成教育任务。结论在教育中融入创新方法可以提高学生的学习质量,鼓励他们积极研究,培养独立学习能力,培养能够不断自我完善的自立型人才。坚持不懈地实施创新,不仅能提高学生的专业能力,还能对教育工作者提出高标准,激励他们不断追求专业发展,精益求精。这些因素使教学过程不仅引人入胜,而且异常有效。
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引用次数: 0
INDICATORS OF THE QUALITATIVE AND QUANTITATIVE COMPOSITION OF THE GUT COMMENSAL MICROBIOTA AS BIOMARKERS OF HOMEOSTASIS (Part 1) 作为同种异病生物标志物的肠道标本微生物的定性和定量组成指标(第一部分)
M. Ananieva, G. Loban', M. Faustova, Y. Chumak, S.M. Losev
In recent years, practical medicine has faced a surge of information highlighting the emergence of new microbes in the human body's microbiota, leading to challenges in interpreting laboratory test results. This study aims to equip medical professionals, including doctors of various specialties, medical students, and interns, with a comprehensive understanding of the current knowledge on the human gastrointestinal microbial profile. Our analysis included 53 articles from international literature sources indexed in PubMed, Scopus, and Google Scholar databases. These articles were identified through an electronic search. The composition of the human microbiome is shaped by alterations in environmental conditions, living environments, diet, climate, genetics, and various other factors. Following birth, the pivotal role in microbiome formation involves the vertical, horizontal, and mixed transfer of microorganisms. Navigating the diversity of resident microbiota can be challenging, leading scientists to suggest biomarkers such as diversity indices, enterotypes, and established ratios at typical taxonomic levels (genus, species) for convenience. In clinical practice, these indicators serve as indirect markers of microflora properties that model health or disease. To understand the distribution of species within types, ecologists introduced concepts like α-, β-, and γ-diversity, grounded in different mathematical models. These indicators are also employed to assess the human body microbiota. The division into enterotypes was proposed by scientists on the basis that the phylogenetic (species) composition of each category determines its own functional feature, which is likely to be related to long-term eating habits. Conclusion. Scientists endeavor to assess the intricate microbiome system and its substantial impact on the human body, as well as the adverse effects of dysbiosis, employing mathematical models applied in microbiology.
近年来,实用医学面临着各种信息的激增,这些信息突显了人体内微生物群中新微生物的出现,从而给解读实验室检测结果带来了挑战。本研究旨在让医学专业人员(包括各科医生、医科学生和实习生)全面了解当前有关人体胃肠道微生物特征的知识。我们的分析包括 53 篇文章,这些文章来自 PubMed、Scopus 和 Google Scholar 数据库收录的国际文献。这些文章是通过电子检索确定的。人类微生物组的组成受环境条件、生活环境、饮食、气候、遗传和其他各种因素的影响。出生后,微生物组形成的关键作用涉及微生物的垂直、水平和混合转移。探索常住微生物群的多样性是一项挑战,因此科学家们提出了一些生物标志物,如多样性指数、肠型和典型分类级别(属、种)的既定比率,以方便研究。在临床实践中,这些指标可作为模拟健康或疾病的微生物菌群特性的间接标记。为了解物种在不同类型中的分布情况,生态学家引入了α-、β-和γ-多样性等概念,并以不同的数学模型为基础。这些指标也被用来评估人体微生物群。科学家提出划分肠型的依据是,每个类别的系统发育(物种)组成决定了其自身的功能特征,而这很可能与长期饮食习惯有关。结论科学家利用微生物学中应用的数学模型,努力评估错综复杂的微生物组系统及其对人体的重大影响,以及菌群失调的不利影响。
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引用次数: 0
EXPLORATORY ACTIVITY OF RATS IN THE ACUTE PERIOD OF MILD BLAST-INDUCED TRAUMATIC BRAIN INJURY 轻度爆炸所致脑外伤急性期大鼠的探索活动
Yu.V. Kozlova
The relevance of this work is related to the widespread use of explosive devices in military conflicts. More common and "invisible" is mild blast-induced brain injury. This can manifest through anxiety, emotional dysregulation, and spatial memory impairments. However, significant variability exists in modeling blast-induced traumatic brain injury and spatial memory assessment methods. This study aimed to investigate the exploratory activity of rats during the acute phase of mild blast-induced traumatic brain injury modelled by using a newly developed device. The study carried out on 18 sexually mature male Wistar rats weighing 220-270 g. The selected rats were divided into three groups: an experimental group (n=6), animals were modeled with blast-induced trauma by generating an air shock wave with an overpressure of 26.4±3.6 kPa, sham group (n=6), animals were subjected only to inhalation anesthesia with halothane and fixed in a horizontal position, and an intact group (n=6). The exploratory activity was recorded by the iPhoneXR camera; the route of movement through the maze of rats from three groups was graphically depicted and visually analyzed, as well as the number of entries into the "false shelters" was counted and the performance of experimental, sham and intact rats was compared. On the 1st day of the post-traumatic period, the experimental rats explored a greater number of "false shelters", by 72% (p<0.01) compared to intact animals and by 65% (p<0.05) compared to control animals. On the 3rd day, this activity was higher by 53% (p<0.05) compared to intact and by 67% (p<0.05) compared to control rats. On day 7, experimental rats explored more, by 86% (p<0.01) compared to intact rats and also by 86% (p<0.01) compared to control animals. The obtained results indicate an increase in the exploratory activity of rats in the acute period of mild blast-induced brain injury.
这项工作与军事冲突中广泛使用爆炸装置有关。更常见、更 "隐形 "的是轻微爆炸引起的脑损伤。这可能表现为焦虑、情绪失调和空间记忆障碍。然而,爆炸诱发的创伤性脑损伤建模和空间记忆评估方法存在很大差异。本研究旨在使用一种新开发的装置,对大鼠在轻度爆炸诱发的脑外伤急性期的探索活动进行模拟研究。研究以18只体重220-270克的性成熟雄性Wistar大鼠为对象,将所选大鼠分为三组:实验组(n=6),通过产生超压为26.4±3.6千帕的空气冲击波模拟爆炸诱发的创伤;假组(n=6),仅对动物进行氟烷吸入麻醉,并将其固定在水平位置;完好组(n=6)。用 iPhoneXR 摄像头记录大鼠的探索活动;用图形描述和直观分析三组大鼠通过迷宫的路线,并统计进入 "假庇护所 "的次数,比较实验组、假组和完整组大鼠的表现。在创伤后的第一天,实验鼠探索 "假庇护所 "的次数比完整动物多 72% (p<0.01),比对照组多 65% (p<0.05)。第 3 天,实验鼠的 "假庇护所 "数量比完整大鼠高出 53% (p<0.05),比对照组高出 67% (p<0.05)。第 7 天,实验鼠的探索活动比完整大鼠多 86%(p<0.01),比对照组也多 86%(p<0.01)。这些结果表明,在轻度爆炸引起的脑损伤急性期,大鼠的探索活动有所增加。
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引用次数: 0
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Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії
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