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NEOADJUVANT CHEMOTHERAPY FOR HER2-POSITIVE BREAST CANCER USING TRASTUZUMAB AND PERTUZUMAB 使用曲妥珠单抗和帕妥珠单抗治疗her2阳性乳腺癌的新辅助化疗
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2022-6-1-64-70
A.A. Chapanov, A.E. Kоzyakov, V.E. Voytsytskiy, O. A. Tkachuk
Breast cancer is the most common malignant tumor in women. HER2-positive (HER2+) breast cancer is a molecular subtype characterized by an aggressive course, a tendency for tumor cells to spread rapidly, and resistance to standard cytostatic regimens. A number of large randomized trials have shown that the use of neoadjuvant chemotherapy provides the same overall survival rates as adjuvant regimens. In addition, the use of neoadjuvant chemotherapy makes it possible to achieve therapeutic pathomorphosis. The discovery of new chemotherapeutic drugs has made it possible to use a dual blockade of HER2 receptors due to interaction with different subdomains of this protein. In particular, chemotherapy using Trastuzumab, Pertuzumab, and Docetaxel has proven to be an effective regimen to achieve high rates of therapeutic pathomorphosis and survival. The paper analyzes the mechanism of action and effectiveness of the combined use of Trastuzumab and Pertuzumab, presents two clinical cases of practical treatment using dual targeted blockade.
乳腺癌是女性中最常见的恶性肿瘤。HER2阳性(HER2+)乳腺癌是一种分子亚型,其特点是病程具有侵袭性,肿瘤细胞有快速扩散的倾向,并且对标准的细胞抑制疗法有耐药性。许多大型随机试验表明,使用新辅助化疗提供了与辅助方案相同的总生存率。此外,新辅助化疗的使用使得治疗性病理形态的形成成为可能。由于与HER2蛋白的不同亚结构域相互作用,新的化疗药物的发现使得使用HER2受体的双重阻断成为可能。特别是,使用曲妥珠单抗、帕妥珠单抗和多西他赛的化疗已被证明是一种有效的方案,可以实现高的治疗性病理形态学和生存率。本文分析了曲妥珠单抗与帕妥珠单抗联合应用的作用机制及疗效,并介绍了两例应用双靶向阻断治疗的临床实例。
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引用次数: 0
PECULIARITIES OF MORTALITY IN 2020 OF THE ALTAI TERRITORY RESIDENTS WHO SUFFERED FROM RADIATION EXPOSURE 阿尔泰地区受辐射照射居民2020年死亡率的特点
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2021-2-48-52
I. Kolyado, Environmental Problems, S. Plugin
In the Altai Territory, the Altai Medical Dosimetric Register is functioning, containing information on the health status of the inhabitants of the Territory exposed to radiation. The most numerous contingents are persons exposed to radiation as a result of nuclear tests at the Semipalatinsk testing area. The aim of the study is to obtain up-to-actual data on the health status of persons listed in the register. This research analyzed mortality rates for 2019 and 2020. Preliminary data for 2020 showed significant reductions in overall mortality and mortality from specific causes for the majority of the largest populations in the register.
在阿尔泰领土,阿尔泰医疗剂量测定登记册正在运作,其中载有关于该领土受辐射居民健康状况的信息。人数最多的特遣队是由于在塞米巴拉金斯克试验区进行核试验而受到辐射的人员。这项研究的目的是获得关于登记在册人员健康状况的最新数据。这项研究分析了2019年和2020年的死亡率。2020年的初步数据显示,登记人口最多的大多数人口的总死亡率和特定原因造成的死亡率显著下降。
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引用次数: 0
THE STUDY OF THE PSYCHO-EMOTIONAL STATUS LEVEL IN PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENT 急性脑血管意外患者心理情绪状态水平的研究
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2021-3-67-72
M.A. Zhivotova, A. Sultanova, D. Ioanidi, A. Stankevich
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引用次数: 0
DEVELOPMENT OF A RISK ASSESSMENT SYSTEM FOR GYNECOLOGICAL DISEASES 妇科疾病风险评估体系的建立
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2021-4-72-77
D.S. Denisov, N. Kondakova, A. V. Usova, Т.М. Sokolova
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引用次数: 0
DIASTOLIC DYSFUNCTION OF THE LEFT VENTRICLE AS A «TIME BOMB» IN THE PERIOPERATIVE PERIOD 围手术期左心室舒张功能障碍的“定时炸弹”
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2021-1-3-10
E. Vereshchagin, I. V. Peshkova, G. Vereshchagina, T. N. Rеider, V. Valeeva, M. Kozina
Despite of the growing number of patients, the understanding of diastolic dysfunction (DD) and heart failure with preserved ejection fraction (HFpEF) is still not sufficient. The pathophysiological mechanisms of HFpEF are not fully investigated. The mortality rate among patients suffering from heart failure with preserved ejection fraction is the same as among patients with heart failure and reduced ejection fraction. At the moment, the diagnosis and treatment of patients with HFpEF has not been optimized despite these alarming trends. Echocardiography is the main diagnostic tool. The identification of clinically significant echocardiographic changes, even without an evident clinical picture, can contribute to a change in the patient's treatment plan or a revision of surgical tactics and anesthetic management.
尽管患者数量不断增加,但对舒张功能障碍(DD)和保留射血分数(HFpEF)的心力衰竭的了解仍然不够充分。HFpEF的病理生理机制尚未得到充分研究。射血分数保留的心力衰竭患者的死亡率与射血分数降低的心力衰竭患者的死亡率相同。目前,尽管有这些令人担忧的趋势,但HFpEF患者的诊断和治疗尚未得到优化。超声心动图是主要的诊断工具。临床显著超声心动图变化的识别,即使没有明显的临床表现,也可以有助于改变患者的治疗计划或修改手术策略和麻醉管理。
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引用次数: 0
PECULIARITIES OF REMISSION IN BIPOLAR DISORDER ASSOCIATED WITH PLANT CANNABINOID ADDICTION SYNDROME (AMONG PATIENTS WHO STARTED THE USE OF CANNABINOIDS DUE TO BIPOLAR DISORDER, AND MORE THAN FIVE-YEAR DISEASE DURATION) 与植物大麻素成瘾综合征相关的双相情感障碍缓解的特点(在因双相情感障碍开始使用大麻素且病程超过5年的患者中)
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2022-6-3-43-49
I. Klimova, A. Ovchinnikov, Yu.S. Volnaya
Bipolar disorder (BD) is a severe mental illness characterized by recurrent episodes of mania, depression, or mixed states. The lifetime prevalence of bipolar disorder across the spectrum is estimated at 2–4% in the general population and is the sixth leading cause of disability worldwide. Cannabis is the most commonly used substance after alcohol and tobacco. Its use increased from 4 to 9.5% between 2020 and 2022, and the prevalence of cannabis use disorders rose from 1.5 to 2.9% over the same period. Among patients with mental disorders, the most common reason for using cannabinoids is to try to alleviate their underlying illness, which is probably achieved in the initial stages of using this type of psychoactive substsance. However, its influence on the course and prognosis of the disease in the long term remains insufficiently studied, which requires a detailed investigation of this problem. For our study, in the period from 2020 to 2022, we selected 104 patients with a diagnosis of bipolar disorder (F31) with a plant cannabinoid addiction syndrome (F12) with a disease duration of more than five years, and the onset of cannabinoid use was noted already amid an established diagnosis of bipolar disorder. The average age in the group was 39 ± 3 years, the distribution by sex was 47% (p < 0.005) — men, 53% (p < 0.005) — women. The study showed that the beginning of the use of plant cannabinoids in a context of BD generally worsens the mental state of patients and, in terms of prognosis, is unfavorable for the course of the disease. This conclusion is confirmed by the complete absence of remission in 2% of patients with an interval of 6 months from the beginning of the study of these patients, the severity of the condition in general, rapid change in the phases of bipolar disorder, and the need to prescribe higher doses of a pharmacological drug. A change in the labor activity of patients was noted — in the primary study we did not register non-working patients; in the study spaced 6 months apart, there were 5% of them; the level of qualification of the work performed in the group as a whole also decreased (employed in highly skilled labor in the primary study — 31%, in the study of this group of patients, this figure decreased to 25%. The motive for using plant cannabinoids was an attempt to alleviate their mental state (73%), 20% of patients noted the motive as “an attempt to experience pleasure”, 7% of patients could not explain the reason for starting cannabinoid use.
双相情感障碍(BD)是一种以反复发作的躁狂、抑郁或混合状态为特征的严重精神疾病。据估计,双相情感障碍在一般人群中的终生患病率为2-4%,是全球第六大致残原因。大麻是仅次于酒精和烟草的最常用的物质。在2020年至2022年期间,其使用率从4%上升到9.5%,同期大麻使用障碍的患病率从1.5%上升到2.9%。在精神障碍患者中,使用大麻素最常见的原因是试图减轻他们的潜在疾病,这可能在使用这种精神活性物质的初始阶段实现。然而,其对疾病病程和预后的长期影响研究尚不充分,需要对此问题进行详细的研究。在我们的研究中,在2020年至2022年期间,我们选择了104名诊断为双相情感障碍(F31)并伴有植物大麻素成瘾综合征(F12)的患者,病程超过五年,并且在确定的双相情感障碍诊断中已经注意到大麻素使用的开始。本组患者平均年龄39±3岁,按性别分布男性占47% (p < 0.005),女性占53% (p < 0.005)。研究表明,在BD患者中开始使用植物大麻素通常会使患者的精神状态恶化,并且就预后而言,对疾病的病程不利。这一结论得到了以下事实的证实:2%的患者在研究开始后的6个月内完全没有缓解,总体病情的严重程度,双相情感障碍阶段的快速变化,以及需要开出更高剂量的药物。注意到患者劳动活动的变化——在初步研究中,我们没有登记不工作的患者;在间隔6个月的研究中,有5%的人;在整个组中进行的工作的资格水平也下降了(在最初的研究中雇用高技能劳动力- 31%,在这组患者的研究中,这一数字下降到25%。使用植物大麻素的动机是试图缓解他们的精神状态(73%),20%的患者认为动机是“试图体验快乐”,7%的患者无法解释开始使用大麻素的原因。
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引用次数: 0
SCREENING PATHOANATOMICAL EXAMINATION OF THE PLACENTA AS A RESERVE FOR REDUCING PERINATAL MORTALITY 筛选病理解剖检查的胎盘作为储备,以减少围产期死亡率
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2022-6-3-9-15
A. P. Nadeev, M. A. Karpov, K.A. Nizovtsev
Introduction. The continuity of the morphofunctional system "mother-placenta-fetus" allows for the histological examination of the placenta to reveal risk groups for the newborn, pregnant women, puerperas, and to take out preventive measures. Aim of the research. To study the structure and localization of pathological changes in the placenta and the significance of mass pathomorphological studies as a reserve for reducing infant and perinatal mortality. Materials and methods. The afterbirths were examined according to the algorithm proposed by A.P. Milovanov (1999). Histological examination assessed the maturity of the placenta, the severity of compensatory-adaptive reactions and involutive-dystrophic changes, noted the presence and severity of inflammatory changes both in the placenta (placentitis, intervillusitis, villusitis) and extraplacental membranes (choriodeciduiitis, chorioamnionitis). Results. In a large-scale pathoanatomical examination of placentas, the proportion of normal mature placentas without pathological findings was up to 20%. The main pathological process in the placenta is an acute and chronic inflammation, often combined with chronic placental insufficiency (up to 77%). Among the forms of chronic placental insufficiency, the variant of pathological immaturity predominates – immature intermediate villi. For severe inflammation, the most common localization was noted in the fetal membranes, which reflects the ascending route of intrauterine infection. For chronic inflammation, the most common localization was basal deciduitis and parietal choriodeciduitis, which is associated with a high incidence of latent infectious foci in women. Conclusion. A large-scale pathoanatomical examination of placentas , with the identification of risk groups for newborns, along with other factors, can serve as a reserve for reducing perinatal and early neonatal mortality.
介绍。“母体-胎盘-胎儿”形态功能系统的连续性允许对胎盘进行组织学检查,以揭示新生儿、孕妇、产妇的危险群体,并采取预防措施。研究的目的。探讨胎盘病理变化的结构和定位,以及大量病理形态学研究作为降低婴儿和围产期死亡率的储备的意义。材料和方法。根据A.P. Milovanov(1999)提出的算法检测后代。组织学检查评估胎盘的成熟度、代偿适应性反应的严重程度和累及性营养不良变化,注意胎盘(胎盘炎、绒毛间炎、绒毛炎)和胎盘外膜(绒毛膜蜕膜炎、绒毛膜羊膜炎)炎症变化的存在和严重程度。结果。在大规模的胎盘病理解剖检查中,无病理发现的正常成熟胎盘比例高达20%。胎盘的主要病理过程是急性和慢性炎症,常合并慢性胎盘功能不全(高达77%)。在慢性胎盘功能不全的形式中,病理性不成熟的变体占主导地位-未成熟的中间绒毛。对于严重的炎症,最常见的定位是在胎膜上,这反映了宫内感染的上升途径。对于慢性炎症,最常见的定位是基底滤膜炎和壁绒毛膜滤膜炎,这与女性潜伏性感染灶的高发有关。结论。对胎盘进行大规模病理解剖检查,识别新生儿的危险群体,以及其他因素,可以作为降低围产期和早期新生儿死亡率的储备。
{"title":"SCREENING PATHOANATOMICAL EXAMINATION OF THE PLACENTA AS A RESERVE FOR REDUCING PERINATAL MORTALITY","authors":"A. P. Nadeev, M. A. Karpov, K.A. Nizovtsev","doi":"10.31549/2541-8289-2022-6-3-9-15","DOIUrl":"https://doi.org/10.31549/2541-8289-2022-6-3-9-15","url":null,"abstract":"Introduction. The continuity of the morphofunctional system \"mother-placenta-fetus\" allows for the histological examination of the placenta to reveal risk groups for the newborn, pregnant women, puerperas, and to take out preventive measures. Aim of the research. To study the structure and localization of pathological changes in the placenta and the significance of mass pathomorphological studies as a reserve for reducing infant and perinatal mortality. Materials and methods. The afterbirths were examined according to the algorithm proposed by A.P. Milovanov (1999). Histological examination assessed the maturity of the placenta, the severity of compensatory-adaptive reactions and involutive-dystrophic changes, noted the presence and severity of inflammatory changes both in the placenta (placentitis, intervillusitis, villusitis) and extraplacental membranes (choriodeciduiitis, chorioamnionitis). Results. In a large-scale pathoanatomical examination of placentas, the proportion of normal mature placentas without pathological findings was up to 20%. The main pathological process in the placenta is an acute and chronic inflammation, often combined with chronic placental insufficiency (up to 77%). Among the forms of chronic placental insufficiency, the variant of pathological immaturity predominates – immature intermediate villi. For severe inflammation, the most common localization was noted in the fetal membranes, which reflects the ascending route of intrauterine infection. For chronic inflammation, the most common localization was basal deciduitis and parietal choriodeciduitis, which is associated with a high incidence of latent infectious foci in women. Conclusion. A large-scale pathoanatomical examination of placentas , with the identification of risk groups for newborns, along with other factors, can serve as a reserve for reducing perinatal and early neonatal mortality.","PeriodicalId":342613,"journal":{"name":"Sibirskij medicinskij vestnik","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123983336","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
THE USE OF THE MEDICAL INFORMATION SYSTEM OF THE NOVOSIBIRSK REGION IN THE DOCUMENT FLOW OPTIMIZATION AND FORMATION OF PATIENT'S INTEGRATED ELECTRONIC MEDICAL CARD DURING LIFETIME PATHOANATOMICAL DIAGNOSTICS OF BIOLOGICAL MATERIAL 利用新西伯利亚地区医疗信息系统在生物材料终身病理解剖诊断过程中优化文件流程和形成患者综合电子医疗卡
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2022-6-2-4-10
Y. Bravve, N. N. Velichkina, I. V. Odarchenko, A. P. Nadeev, S.V. Sokolov, E.A. Kvashnina, O.E. Isupova
Early diagnosis of malignant neoplasms is ensured by the quality, accessibility and continuity between medical institutions in the organization of the lifetime pathoanatomical diagnostics of biological material. Improving medical information systems with the involvement of the lifetime pathoanatomical diagnostics in the process of informatization of regional health care, developing mechanisms for documenting, storing and electronic exchange of personal medical information between medical institutions in the Novosibirsk region, is the main task of the system for organizing this type of diagnostics. The urgency of solving this problem is due to the shortage of personnel in the pathoanatomical services, the distance barriers between medical specialists and pathologist; need to ensure the formation of a created system for the exchange of medical documentation. The article presents the experience of using the functionality of the components of the Medical Information System of the Novosibirsk Region (MIS NR) in a regional state budgetary healthcare institution to form a unified information environment, integrate approved accounting forms and ensure efficient workflow in the course of lifetime pathoanatomical diagnostics. The aim of this research is to study the possibilities of additional functionality of the components of the MIS NR, implemented by the employees of the Center for Informatization of Medical Information Analytical Center, to identify the advantages of using the developed functions in optimizing the workflow during the lifetime pathoanatomical diagnostics of biopsy (operative) material, in the formation of a regional Integrated electronic medical record.
恶性肿瘤的早期诊断是由医疗机构之间组织生物材料终身病理解剖诊断的质量、可及性和连续性来保证的。改进医疗信息系统,将终身病理解剖诊断纳入区域卫生保健信息化进程,开发新西伯利亚地区医疗机构之间个人医疗信息的记录、存储和电子交换机制,是组织此类诊断的主要任务。解决这一问题的紧迫性在于病理解剖服务人员的短缺,医学专家与病理学家之间的距离障碍;需要确保形成一个创建的医疗文件交换系统。本文介绍了在地区国家预算医疗机构中使用新西伯利亚地区医疗信息系统(MIS NR)组件功能的经验,以形成统一的信息环境,整合批准的会计表格,并确保终身病理解剖诊断过程中的高效工作流程。本研究的目的是研究由医疗信息分析中心信息化中心的员工实施的MIS NR组件的附加功能的可能性,以确定使用开发的功能在优化活组织(手术)材料的终身病理解剖诊断工作流程中的优势,形成区域综合电子病历。
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引用次数: 0
POSTCOITAL CYSTITIS: RESULTS OF SURGICAL TREATMENT 性交后膀胱炎:手术治疗的结果
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2021-3-19-23
I. V. Feofilov, М.М. Boboev, S. S. Shkuratov, А.К. Pochivalov, P. S. Plugin
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引用次数: 0
MODERN CHANGES IN THE VAGINAL MICROBIOCENOSIS THROUGH THE EXAMPLE OF WOMEN OF THE REPRODUCTIVE AGE IN NOVOSIBIRSK 以新西伯利亚育龄妇女为例,介绍阴道微生物病的现代变化
Pub Date : 1900-01-01 DOI: 10.31549/2541-8289-2023-7-2-48-53
U. Piletskaya, K. Makarov, T. M. Sokolova
Introduction. Bacterial vaginosis is associated with a large number of pregnancy complications as well as pelvic inflammatory diseases. However, it is necessary to take into account the species composition of pathogens before starting empirical therapy. Aim of the research. Study of the species composition of vaginal discharge in women of reproductive age in the city of Novosibirsk. Materials and methods. To assess the species composition of the vaginal microflora in women with complaints of pathological discharge from the genital tract, 485 women of the reproductive period of the Central District of Novosibirsk were selected who applied to the antenatal clinic and were diagnosed with bacterial vaginosis. All women underwent a bacteriological examination of the discharge from the genital tract, and 240 women with complaints of pathological discharge from the genital tract were assessed for microbiocenosis using the real-time PCR method. Results. According to the bacteriological examination, the majority of patients did not reveal opportunistic pathogens (75.05%). Representatives of the genus Candida sp. predominated among the identified microorganisms (11.55%), Enterococcus sp. – 9.07%. Representatives of the genus Proteus were detected least often during bacteriological examination – 0.21%. According to the RT-PCR study, representatives of Gardnerella vaginalis + Prevotella bivia + Porphyromonas (89.17%), Eubacterium spp. (68.33%), Megasphaera spp. + Veillonella spp. + Dialister spp. (37.5%) and Atopobium vaginae (30.83%) predominated. Staphylococcus spp., Mycoplasma ho-minis – 2.83% and Enterobacterium spp. were detected less frequently – 4.17%. Conclusion. Since in more than 50% of cases it is not possible to isolate an infectious agent in the presence of pathological discharge from the genital tract of women by the bacteriological method of research, while the real-time PCR method is not always available, an understanding of the microbial landscape of the vagina in women with pathological discharge from the genital tract will allow to prescribe an effective empiric therapy.
介绍。细菌性阴道病与大量妊娠并发症以及盆腔炎有关。然而,在开始经验性治疗之前,有必要考虑到病原体的种类组成。研究的目的。新西伯利亚市育龄妇女阴道分泌物种类组成的研究。材料和方法。为了解病理性阴道分泌物患者阴道菌群的种类组成,选取了新西伯利亚中央区产前门诊确诊为细菌性阴道病的育龄妇女485例。所有妇女都对生殖道分泌物进行细菌学检查,并使用实时PCR方法对240名有生殖道病理性分泌物的妇女进行微生物病评估。结果。细菌学检查未检出条件致病菌的占多数(75.05%)。检出的微生物以念珠菌属(11.55%)和肠球菌(9.07%)为主。在细菌学检查中,Proteus属的代表菌检出率最低,为0.21%。RT-PCR结果显示,以阴道加德纳菌+毕氏普氏菌+卟啉单胞菌(89.17%)、真杆菌(68.33%)、巨孢子菌+细孔菌+ Dialister菌(37.5%)和阴道托必菌(30.83%)为代表。葡萄球菌、小支原体和肠杆菌检出率较低,分别为2.83%和4.17%。结论。由于在超过50%的病例中,不可能通过细菌学研究方法在女性生殖道病理性分泌物中分离出感染因子,而实时PCR方法并不总是可用,因此了解生殖道病理性分泌物女性阴道的微生物情况将允许开出有效的经验性治疗处方。
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引用次数: 0
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Sibirskij medicinskij vestnik
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