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EVALUATION OF MARKERS OF TARGET ORGANS PRECLINICAL DAMAGE IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE COMBINED WITH METABOLIC SYNDROME DEPENDING ON THE OBESITY STAGE 非酒精性脂肪肝合并代谢综合征患者靶器官临床前损伤标志物与肥胖分期的关系
Pub Date : 2019-06-28 DOI: 10.21272/EUMJ.2019;7(2):142-147
O. Kocherzhat
Purpose. Тo assess the indicators of early predictors of NAFLD in patients with MS by assessing the functional state of the liver and systemic inflammation, depending on the degree of obesity. Material and methods. The study included 90 patients with NAFLD, divided in to 3 groups: group 1 – 30 patients with NADH without MS, group 2 – patients with NADH combined with MS: with BMI 25 – 29.9 kg/m 2 (n = 30) – group 2a, with BMI > 30 kg/m 2 (n = 30) – group 2b. The control group consisted of 20 apparently healthy individuals. All patients were evaluated for the activity of ALT, AST, LDH, SDH, CHE, total bilirubin level; levels of leptin, adiponectin, TNF-α. Results. Significant increase in the level of SDH in patients of both groups was found. In patients of group 2a LDH level exceeded the value in healthy persons by 2.5 times (p < 0.05) and was 1.3 times higher than in patients of group 1 (p < 0.05); in patients of group 2b was exceeded the control index in 3.7 times (p < 0.05), in 1,6 times as compared to the patients of group 1 (p < 0.05) and 1,3 times in comparison with patients of group 2a (p < 0.05). The activity of CHE in patients of group 1 significantly was not different from the index of control (p > 0.05), in patients of group 2b significant decrease of CHE activity was found (р < 0.05). The presence of hyperleptinemia, hypoadiponectinemia, and systemic inflammatory response according to the level of TNF -α was characteristic for patients with NAFLD and MS. Conclusions. Hyperleptinemia, hypoadiponectinemia, the presence of a systemic inflammatory response to the level of TNF-α, and a violation of the synthetic and detoxification functions of the liver, which are more pronounced in patients with NAFLD and MS with concomitant obesity of І–ІІІ degrees, can be considered not only as markers of preclinical lesions of target organs, but and as an indicators of the severity of the combined flow of NAFLD and MS.
目的。Тo根据肥胖程度,通过评估肝脏功能状态和全身性炎症,评估MS患者NAFLD早期预测指标。材料和方法。本研究纳入90例NAFLD患者,分为3组:1组- 30例NADH合并MS患者,2组- NADH合并MS患者,BMI 25 - 29.9 kg/ m2 (n = 30) - 2a组,BMI > 30 kg/ m2 (n = 30) - 2b组。对照组由20名表面健康的个体组成。检测患者ALT、AST、LDH、SDH、CHE活性、总胆红素水平;瘦素,脂联素,TNF-α的水平结果。两组患者SDH水平均显著升高。2a组患者LDH水平是正常人的2.5倍(p < 0.05),是1组患者的1.3倍(p < 0.05);2b组患者超过对照指标的次数为3.7次(p < 0.05),与1组患者相比为1.6次(p < 0.05),与2a组患者相比为1.3次(p < 0.05)。1组患者CHE活性与对照组指标无显著性差异(p > 0.05), 2b组患者CHE活性明显降低(p < 0.05)。存在高瘦素血症、低脂联素血症和根据TNF -α水平的全身炎症反应是NAFLD和ms患者的特征。高瘦素血症、低脂联素血症、对TNF-α水平的全身性炎症反应、肝脏合成和解毒功能的破坏,这些在伴有І -ІІІ程度肥胖的NAFLD和MS患者中更为明显,不仅可以被认为是靶器官临床前病变的标志,而且可以作为NAFLD和MS合并血流严重程度的指标。
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引用次数: 0
CONDITION OF THE UTERINE CERVIX DURING UNCOMPLICATED MULTIPLE PREGNANCY 无并发症多胎妊娠期间子宫颈的状况
Pub Date : 2019-06-28 DOI: 10.21272/EUMJ.2019;7(2):116-120
A. Sukharev
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引用次数: 0
MOLECULAR ASPECTS OF THE BONE METASTASTASES DEVELOPMENT IN PROSTATE CANCER 前列腺癌骨转移发展的分子机制
Pub Date : 2019-06-28 DOI: 10.21272/EUMJ.2019;7(2):96-108
A. Piddubnyi, R. Moskalenko
This review is devoted to the topical issue of modern medicine – the molecular mechanisms and factors for the development of bone metastases of malignant tumors, in particular prostate cancer. The recent publication on the formation and progression of prostate cancer bone metastases were analyzed in this study. The expression of some molecular markers in tumor and metastatic tissue and their role in tumor progression were also analyzed in this study. A common concept for the development of specific metastases is a seed and soil theory. According to this concept, circulating cancer cells recognize some organs as the optimal microenvironment for their development. However, the molecular mechanisms of this phenomenon remain unknown. Molecular and genetic features of the androgen receptors expression in the tumor and their role in metastatic tissue were summarized and compared in this study. We also demonstrated the effect of these receptors on the development of osteoblastic metastases and castration-resistant prostate cancer. Authors analyzed and summarized data about the role of p53 protein, Bax and activated caspase 3 in apoptosis, mechanisms of neoangiogenesis and remodeling of tumor connective tissue with matrix metalloproteinase 1, the presence of collagen type I and osteonectin in neoplastic tissues and the role of inflammation in metastasis development. Functions of heat shock proteins with molecular masses of 70 and 90 kDa and their role in tumor and metastatic tissue were also analyzed. Thus, the study complements and summarizes the data on the development of bone metastases of prostate cancer. The study analyzed the molecular characteristics of prostate cancer during its metastatic spread.
本文就恶性肿瘤尤其是前列腺癌骨转移发生的分子机制和因素进行综述。本研究对近年来发表的前列腺癌骨转移的形成和进展进行了分析。本研究还分析了一些分子标志物在肿瘤和转移组织中的表达及其在肿瘤进展中的作用。特定转移发展的一个共同概念是种子和土壤理论。根据这一概念,循环癌细胞将某些器官识别为其发展的最佳微环境。然而,这一现象的分子机制尚不清楚。本文就肿瘤中雄激素受体表达的分子遗传学特征及其在转移组织中的作用进行综述和比较。我们还证明了这些受体在成骨细胞转移和去势抵抗性前列腺癌发展中的作用。作者对p53蛋白、Bax和活化caspase 3在细胞凋亡中的作用、基质金属蛋白酶1在肿瘤结缔组织新生血管生成和重塑中的作用、肿瘤组织中I型胶原和骨连接素的存在以及炎症在转移发展中的作用等方面的资料进行了分析和总结。分析了分子质量为70和90 kDa的热休克蛋白的功能及其在肿瘤和转移组织中的作用。因此,本研究补充和总结了前列腺癌骨转移发生的相关资料。本研究分析了前列腺癌转移扩散过程中的分子特征。
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引用次数: 0
INFLUENCE OF CARDONAT ON INDICATORS OF BIOCHEMICAL AND HORMONAL HOMEOSTASIS IN SPORTSMANS WITH CARDIOMYOPATHY AFTER PHYSICAL OVERLOAD 卡多那特对体力负荷后心肌病运动员生化和激素稳态指标的影响
Pub Date : 2019-06-28 DOI: 10.21272/EUMJ.2019;7(2):148-158
V. Bezugla, L. Gunina, Yu. D. Vinnichuk, V. Klapchuk
Introduction. Modern sport of the highest achievements is inextricably linked with the constant physical activity of high intensity, which ultimately leads to the formation of overvoltage phenomena of various body systems. The purpose. To substantiate the expediency of appointment of athletes with clinical and instrumental signs of the cardiomyopathy, caused by chronic physical overload (CMPCPO) of the metabolic preparation Cardonat on the basis of evaluation of its influence on the indices of biochemical and hormonal homeostasis. Materials and methods. The study involved 48 athletes, representatives of cyclic sports, with a diagnosis CMPCPO who were randomized to 2 equivalent (n = 24) groups: the main group and the controls. The volume and intensity of training loads was reduced in athletes of both groups by 75%. The control group participants received only basic therapy (the combination of the drug panangin (potassium and magnesium aspartate) and the drug Trіovіt, at therapeutic doses of vitamin-mineral orientation and placebo (capsule with starch). Athletes of the main group in addition to basic therapy used Cardonat for one capsule three times a day for 4 weeks. A comprehensive laboratory study of athletes before and after the course of treatment included a study of the indicators of biochemical and hormonal homeostasis, as well as prooxidant-antioxidant balance. Results. The addition of Cardonat to the complex therapy of athletes from the CMPCPO during the month is accompanied by a positive effect on the structural characteristics of the erythrocyte membranes of the athletes, which is reflected in the improvement of the state of prooxidant-antioxidant equilibrium: in the representatives of the main group, the administration of the drug caused a statistically significant decrease, compared with the data in the control group, malodialdehyde (MDA), increase in the concentration of reduced glutathione (GSH) in erythrocyte membranes and decrease of prooxidant-antioxidant coefficient (Cpa), indicating the predominance of antioxidant processes over lipopereoxidation processes. It is also shown that taking a Cardonat with athletes with manifestations CMPCPO is not accompanied by negative changes in standard laboratory biochemical parameters that reflect the functional state of various organs and systems of the body's organs. The decrease in the activity of aspartate aminotransferase (AST) and the tendency towards a more pronounced decrease in alanine aminotransferase (ALT), α-amylase and urea content in comparison with the values of the corresponding indices in the control group, confirms the positive effect of the drug on the functional state of the liver and pancreas. Indicators of hormonal homeostasis are indicative of improving the ratio of anabolic and catabolic processes in the body of athletes and reducing the level of stress due to the use of the drug. Thus, after taking Cardonat in the main group, testosterone levels increased by 31.6 %
介绍。现代体育运动的最高成就与持续高强度的身体活动密不可分,最终导致身体各系统的过电压现象的形成。的目的。通过评价代谢制剂卡多那特对生化和激素稳态指标的影响,证实有慢性身体负荷(CMPCPO)引起的心肌病临床和仪器体征的运动员预约的便利性。材料和方法。本研究涉及48名诊断为CMPCPO的周期性运动代表运动员,他们被随机分为2个等效组(n = 24):主要组和对照组。两组运动员的训练负荷量和强度都减少了75%。对照组参与者仅接受基础治疗(药物panangin(钾和镁天冬氨酸)和药物tr ov的组合,以治疗剂量的维生素矿物质取向和安慰剂(淀粉胶囊)。主组运动员在基础治疗的基础上,每天三次,每次服用一粒卡多那,持续4周。对运动员治疗前后进行了全面的实验室研究,包括对生化和激素稳态指标以及促氧化-抗氧化平衡的研究。结果。在CMPCPO运动员的综合治疗中加入Cardonat,对运动员红细胞膜的结构特征有积极的影响,体现在促氧化-抗氧化平衡状态的改善:在主要组的代表中,与对照组的数据相比,给药导致丙二醛(MDA),红细胞膜还原性谷胱甘肽(GSH)浓度增加和促氧化-抗氧化系数(Cpa)降低,具有统计学意义上的显著降低,表明抗氧化过程优于脂质过氧化过程。研究还表明,与表现为CMPCPO的运动员一起服用Cardonat,并不伴有反映身体各器官和系统功能状态的标准实验室生化参数的负变化。与对照组相比,天冬氨酸转氨酶(AST)活性下降,丙氨酸转氨酶(ALT)、α-淀粉酶和尿素含量下降趋势更为明显,证实了该药对肝脏和胰腺功能状态的积极作用。激素稳态指标表明,运动员体内合成代谢和分解代谢过程的比例得到改善,并且由于使用该药物而降低了应激水平。因此,主组服用卡多那特后,睾酮水平较基线升高31.6% (p < 0.05),皮质醇下降63.8% (p < 0.05);治疗后主组的平均合成代谢指数提高了58.9% (p < 0.05),表明合成代谢过程的速率显著提高。结论。在治疗中额外使用 ardonat是安全的、方便的、病理合理的,特别是用于治疗具有CMPСPО临床和心电图表现的运动员体内的稳态变化。
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引用次数: 3
OPTIMIZATION OF EPIDEMIOLOGICAL SUPERVISION FOR ACUTE INTESTINAL INFECTIONS IN UKRAINE 优化乌克兰急性肠道感染流行病学监测
Pub Date : 2019-03-29 DOI: 10.21272/EUMJ.2019;7(1):28-38
N. Malysh, M. Chemych, O. Kuzmenko
standard" microbiological indicators of meat and meat products. Thus, identifying risk factors for epidemic situation and using a mathematical model to predict the development of the epidemic process of acute intestinal infections, taking into account demographic indicators and socio-hygienic monitoring data can be an important part of the system for improving epidemiological surveillance.
《肉类及肉制品微生物指标标准》。因此,在考虑人口指标和社会卫生监测数据的情况下,识别疫情危险因素,利用数学模型预测急性肠道感染流行过程的发展,可以成为改进流行病学监测系统的重要组成部分。
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引用次数: 0
EVALUATION OF EXOCRINE PANCREATIC FUNCTION IN PATIENTS WITH CHRONIC PANCREATITIS IN COMBINATION WITH HYPERTENSION 慢性胰腺炎合并高血压患者外分泌胰腺功能的评价
Pub Date : 2019-03-29 DOI: 10.21272/EUMJ.2019;7(1):39-47
Е. J. Arhij, L. Prylypko, B. Halay
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引用次数: 0
HYPERURICEMIA AS A RISK FACTOR OF ARTERIAL HYPERTENSION 高尿酸血症是动脉高血压的危险因素
Pub Date : 2019-03-29 DOI: 10.21272/EUMJ.2019;7(1):11-19
Y. L. Kovalenko
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引用次数: 0
EFFECTIVENESS OF 5-ALPHA-REDUCTASE INHIBITORS IN PATIENTS WITH PROSTATIC INTRAEPITHELIAL NEOPLASIA OF PERIPHERAL PROSTATE ZONE 5- α还原酶抑制剂治疗前列腺周围区上皮内瘤变的疗效
Pub Date : 2019-03-29 DOI: 10.21272/EUMJ.2019;7(1):66-71
M. Melnychuk
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引用次数: 0
THE STRUCTURE OF THE QUALITIES WHICH CAUSES TRUST TO THE DOCTOR 对医生产生信任的素质结构
Pub Date : 2019-03-29 DOI: 10.21272/EUMJ.2019;7(1):81-93
A. Kustov, A. M. Chikmariоva
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引用次数: 0
POST-STROKE FATIGUE AND AMBULATORY PHARMACOTHERAPY AFTER ACUTE CEREBROVASCULAR EVENTS 急性脑血管事件后脑卒中后疲劳和非卧床药物治疗
Pub Date : 2019-03-29 DOI: 10.21272/EUMJ.2019;7(1):72-80
I. Delva
Introduction. Post-stroke fatigue (PSF) is a common complication of acute cerebrovascular events (ACE) that occurs in about 50% of patients within the first post-stroke year. It is well-known that PSF has multiple negative influences on post-stroke rehabilitation, life quality, mortality rates and so on. Purpose: find possible associations between ambulatory pharmacotherapy since hospital discharge and regularities of PSF onset and PSF clinical course within the first year after ACE occurrence. Material and methods. The study included 318 patients with ACE (217 had ischemic strokes, 39 – hemorrhagic strokes and 62 – transient ischemic attacks). Exclusion criteria were major medical illness that could cause secondary fatigue (oncological, hematological diseases, cardiac, liver, kidney and respiratory insufficiency, progressive angina pectoris, acute myocardial infarction), alcohol abuse, consciousness impairments, insufficient cognitive ability (Mini-Mental State Examination scores less than 24), depressive and anxious disorders (Hospital Anxiety and Depression Scale scores more than 10 for both pathologies), impaired speech function to participate (severe dysphasia or dysarthria), impaired language or written ability to complete the study questionnaires, severe functional disabilities (modified Rankin scale scores ≥ 4). Patients' characteristics were evaluated at definite time points: in 1, 3, 6, 9 and 12 months after ACE occurrence. PSF and its components were measured by three self-report questionnaires: fatigue assessment scale (FAS), fatigue severity scale (FSS) and multidimensional fatigue inventory-20 (MFI-20). PSF characteristics included time of occurrence, time of disappearance, duration, intensity. Characteristics of hospital pharmacotherapy (groups of used drugs, number of drugs prescribed for patient) were analyzed using a special algorithm. Results and discussion. There were no associations between any drug group prescriptions as well as between number of used drugs and PSF characteristics (rates and intensities) according to all used scales within the whole one-year observation period. There were no association between the number of used drugs and number of new PSF cases that were diagnosed in 1 month and in 3 months after ACE occurrence. Also, we didn’t find any significant correlation between number of used drugs and risk of PSF prolongation during one year observation period. None of the drug groups (with the exception of beta-blockers) was associated with a significant change of PSF intensity during the first post-stroke year. Finally, beta-blockers usage during the first post-stroke year was associated with statistically significant increase of PSF intensity (according to FAS) in 1, 3 and 6 months after ACE. Moreover, there was statistically significant association between beta-blockers intake and increasing intensity of the most of PSF components (according to MFI‑20): global PSF in 1, 3 and 6 months, physical PSF in 3 mont
介绍。卒中后疲劳(PSF)是急性脑血管事件(ACE)的常见并发症,约50%的患者在卒中后第一年发生。众所周知,PSF对脑卒中后康复、生活质量、死亡率等有多重负面影响。目的:探讨ACE发生后一年内PSF发病及临床病程的规律与出院后门诊药物治疗的关系。材料和方法。该研究包括318例ACE患者(217例为缺血性卒中,39例为出血性卒中,62例为短暂性缺血性发作)。排除标准为可引起继发性疲劳的重大内科疾病(肿瘤、血液病、心、肝、肾和呼吸功能不全、进行性心绞痛、急性心肌梗死)、酗酒、意识障碍、认知能力不足(精神状态检查评分低于24分)、抑郁和焦虑障碍(两种病理的医院焦虑和抑郁量表评分均超过10分)、参与言语功能受损(严重的发音障碍或构音障碍),完成研究问卷的语言或写作能力受损,严重的功能障碍(改良Rankin量表得分≥4分)。在ACE发生后的1、3、6、9和12个月的特定时间点评估患者的特征。采用疲劳评定量表(FAS)、疲劳严重程度量表(FSS)和多维疲劳量表-20 (MFI-20) 3份自述问卷对PSF及其组成部分进行测量。PSF特征包括发生时间、消失时间、持续时间、强度。采用专用算法分析医院药物治疗特点(用药分组、患者用药数量)。结果和讨论。在整个1年的观察期内,所有用药量表的PSF特征(发生率和强度)与用药组处方、用药次数均无相关性。在ACE发生后1个月和3个月内诊断出的PSF新病例数与使用药物数量之间没有相关性。在1年的观察期内,我们没有发现使用药物的数量与PSF延长的风险有显著的相关性。没有任何药物组(β受体阻滞剂除外)与卒中后第一年内PSF强度的显著变化相关。最后,脑卒中后第一年内β受体阻滞剂的使用与ACE后1、3和6个月PSF强度的统计学显著增加相关(根据FAS)。此外,β受体阻滞剂摄入与大多数PSF成分(根据MFI - 20)强度增加之间存在统计学显著关联:1、3和6个月的整体PSF, 3个月的身体PSF, 6和12个月的精神PSF, 6个月的动机性PSF。从实际角度来看,对于已诊断为PSF的脑卒中后患者,为了降低PSF强度,可能需要取消-受体阻滞剂的摄入(或尽可能减少药物剂量)。结论:1。ACE患者出院后的门诊药物治疗的定量和定性特征与PSF发生率和卒中后第一年内PSF持续的风险没有任何可靠的关联。2. 在脑卒中后的第一年,β受体阻滞剂的门诊使用可能是导致PSF及其大部分成分强度增加的因素之一。
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引用次数: 0
期刊
Eastern Ukrainian Medical Journal
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